Meyer Alex M, Thomas-Aitken Holly D, Brouillette Marc J, Westermann Robert W, Goetz Jessica E
Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Department of Orthopedics & Rehabilitation, University of Iowa, Iowa City, IA, USA; Department of Biomedical Engineering, University of Iowa, IA, USA.
J Biomech. 2020 Aug 26;109:109891. doi: 10.1016/j.jbiomech.2020.109891. Epub 2020 Jun 22.
Abnormal femoral version is a deformity in the angle between the femoral neck and the transcondylar axis of the knee. Both femoral anteversion and retroversion alter passive and active rotation of the hip and are associated with intra-articular or extra-articular impingement. However, little is known about the effect of abnormal femoral version on intra-articular hip contact stresses. To quantify the effect of femoral version on hip contact stress, five cadaveric pelvis specimens were mechanically tested with a hip-specific Tekscan sensor inserted in the joint space. Specimens were oriented in a heel-strike position and loaded with 1000 N of compressive force. Pressure measurements were recorded by the Tekscan sensor with the femur oriented in 0°, 15°, and 30° of version. At the completion of testing, specimens were locked into place at 0° and post-test CT scans were obtained to register the pressure sensor measurements to the joint anatomy. There were minor changes in contact area (<7%) and translation of the peak contact stress location (8.8 ± 7.6 mm). There was no significant change in peak contact stress (p = 0.901) in either the retroverted (0°) or anteverted (30°) conditions relative to normal version (15°) under identical gait-related loading conditions. While abnormalities in patient gait and resultant joint loading caused by femoral version abnormalities may contribute to hip pain, the present findings would suggest that future joint degeneration in hips with version abnormalities are not simply the result of abnormal contact stress induced by joint incongruity due to femoral version abnormalities.
股骨扭转异常是指股骨颈与膝关节髁间轴之间角度的畸形。股骨前倾和后倾都会改变髋关节的被动和主动旋转，并与关节内或关节外撞击有关。然而，关于股骨扭转异常对髋关节内接触应力的影响却知之甚少。为了量化股骨扭转对髋关节接触应力的影响，使用插入关节间隙的髋关节专用Tekscan传感器对五个尸体骨盆标本进行了力学测试。标本处于足跟触地位置，并施加1000 N的压缩力。通过Tekscan传感器记录股骨处于0°、15°和30°扭转时的压力测量值。测试完成后，将标本锁定在0°位置，并进行测试后CT扫描，以便将压力传感器测量值与关节解剖结构进行配准。接触面积有微小变化（<7%），峰值接触应力位置有平移（8.8±7.6 mm）。在相同的步态相关负荷条件下，相对于正常扭转（15°），后倾（0°）或前倾（30°）条件下的峰值接触应力均无显著变化（p = 0.901）。虽然股骨扭转异常导致的患者步态异常和由此产生的关节负荷可能会导致髋关节疼痛，但目前的研究结果表明，扭转异常的髋关节未来的关节退变并非仅仅是由于股骨扭转异常导致的关节不协调所引起的异常接触应力的结果。
