Altered Joint Forces Found in Symptomatic Dysplastic Hips in Women During Sport-Specific Activities.

IF 2.4 3区 医学 Q2 ORTHOPEDICS
Orthopaedic Journal of Sports Medicine Pub Date : 2025-03-14 eCollection Date: 2025-03-01 DOI:10.1177/23259671251318736
Molly C Shepherd, Rannon Huo, John C Clohisy, Jeffrey J Nepple, Michael D Harris
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引用次数: 0

Abstract

Background: Many patients with developmental dysplasia of the hip (DDH) are young and highly active but often become limited by activity-induced pain. Characterizing how the abnormal bony geometry of DDH affects hip joint loading and multiplanar kinematics during sport-specific motions relevant to active patients may provide insight into injury mechanisms and inform optimal treatment options.

Purpose/hypothesis: The purpose of this study was to determine how hip joint loading and kinematics are altered in DDH during 2 common sport activities: running and multidirectional hop-cutting. It was hypothesized that superior and medial joint-reaction forces (JRFs) would be elevated during running and that medial JRFs would be elevated during hop-cutting when compared with controls.

Study design: Controlled laboratory study.

Methods: Using patient-specific musculoskeletal modeling, both running and hop-cutting motions were analyzed for female patients with symptomatic DDH (DDH group) and female controls without hip disorders who were enrolled from October 2017 to August 2022. Hip joint angles, JRFs, and muscle forces were compared between the groups using 1-dimensional statistical parametric mapping.

Results: Overall, 19 women in the DDH group and 19 female controls were included in the running analysis, and 13 women in the DDH group and 10 female controls were included in the hop-cutting analysis. During the running motion, medial hip JRFs and gluteal muscle forces were significantly elevated in the DDH group, while rectus femoris muscle forces were reduced. During the hop-cutting motion, medial hip JRFs, gluteus minimus, and gluteus medius muscle forces were elevated, while gluteus maximus forces were reduced in the DDH group. There were no significant group differences in hip joint angles for either activity.

Conclusion: The lack of kinematic differences between women with symptomatic DDH and controls suggests that the JRF differences between groups stemmed from the abnormal joint geometry in the DDH group. These activities may have greater damaging potential than previously studied lower impact activities such as walking.

Clinical relevance: Better understanding of how loading varies from activity to activity can help patients with DDH, and clinicians understand the mechanistic causes of DDH-related hip pain and damage and plan appropriate intervention strategies.

在进行体育运动时,发现有症状的髋关节发育不良女性的关节力发生变化。
背景:许多患有发育性髋关节发育不良(DDH)的患者年轻且活跃,但经常因活动引起的疼痛而受到限制。描述DDH的异常骨几何形状如何影响与活跃患者相关的运动特定运动中的髋关节负荷和多平面运动学,可能有助于了解损伤机制并提供最佳治疗方案。目的/假设:本研究的目的是确定两种常见的运动活动(跑步和多向跳切)如何改变DDH的髋关节负荷和运动学。假设与对照组相比,在跑步过程中,上关节反作用力和内侧关节反作用力(jrf)会升高,而在跳切过程中,内侧关节反作用力(jrf)会升高。研究设计:实验室对照研究。方法:采用患者特异性肌肉骨骼模型,分析2017年10月至2022年8月入组的症状性DDH女性患者(DDH组)和无髋关节疾病的女性对照组的跑步和割草运动。使用一维统计参数映射比较各组之间的髋关节角度、jrf和肌肉力。结果:总体而言,DDH组19名女性和19名女性对照组被纳入跑步分析,DDH组13名女性和10名女性对照组被纳入跳切分析。在跑步运动中,DDH组髋内侧jrf和臀肌力显著升高,股直肌力降低。在跳切运动中,DDH组髋内侧jrf、臀小肌和臀中肌力量升高,而臀大肌力量降低。两组患者髋关节角度均无显著差异。结论:症状性DDH女性与对照组之间缺乏运动学差异,提示组间JRF差异源于DDH组关节几何形状异常。这些活动可能比先前研究的步行等低影响活动具有更大的破坏性。临床意义:更好地了解负荷如何随活动而变化可以帮助DDH患者,临床医生了解DDH相关髋关节疼痛和损伤的机制原因,并制定适当的干预策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Orthopaedic Journal of Sports Medicine
Orthopaedic Journal of Sports Medicine Medicine-Orthopedics and Sports Medicine
CiteScore
4.30
自引率
7.70%
发文量
876
审稿时长
12 weeks
期刊介绍: The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty. Topics include original research in the areas of: -Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries -Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot) -Relevant translational research -Sports traumatology/epidemiology -Knee and shoulder arthroplasty The OJSM also publishes relevant systematic reviews and meta-analyses. This journal is a member of the Committee on Publication Ethics (COPE).
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