Johnson Camille C, Ruh Ethan R, Frankston Naomi E, Charles Shaquille, Mauro Craig, McClincy Michael, Anderst William J
Department of Orthopaedic Surgery, University of Pittsburgh, 3820 South Water Street, Pittsburgh, Pennsylvania, 15203, USA.
Ann Biomed Eng. 2025 Aug 21. doi: 10.1007/s10439-025-03826-8.
PURPOSE: Understanding how hip coverage and congruency change during dynamic loading may provide insight into the etiology of long-term degenerative pathology and susceptibility to hip instability. The goal of this study was to determine how hip congruency and femoral head coverage change during activities of daily living and their relationship with bone morphology in an asymptomatic cohort. METHODS: Twenty-four healthy young adults (13 women, 21.9 ± 2.2 years) stood, walked, squatted, and ascended a step while synchronized biplane radiographs of the hip were collected. In-vivo bone motion was determined with sub-millimeter accuracy using a validated tracking technique that matched subject-specific bone models to the biplane radiographs. Dynamic congruency index (CI) and femoral head coverage were calculated across each activity. Mixed effects analyses determined effects of activity, region, and their interaction on CI or coverage, separately, and multiple linear regression determined the associations between alpha angle, lateral center edge angle (LCEA), and CI or coverage in each region and activity. RESULTS: During lower-flexion activities, Anterior-Inferior, Anterior-Superior, and Posterior-Inferior congruency decreased up to 30% (all p < 0.02), Superior and Posterior-Superior congruency increased up to 40% (all p < 0.01), and Anterior and Inferior coverage decreased (up to 40.1% and 9.4%, all p < 0.01) compared to higher-flexion activities. LCEA was a better morphologic predictor of coverage and congruency than alpha angle. CONCLUSION: These observed regional variations in hip coverage and congruency in asymptomatic individuals provide a potential mechanistic explanation for common patterns of cartilage degeneration in the anterior acetabular region and a reference for evaluating pathologic hips.
目的:了解髋关节覆盖度和匹配度在动态负荷过程中的变化,可能有助于深入了解长期退行性病变的病因以及髋关节不稳定的易感性。本研究的目的是确定在无症状队列中,髋关节匹配度和股骨头覆盖度在日常生活活动中的变化情况,以及它们与骨形态的关系。 方法:24名健康的年轻成年人(13名女性,年龄21.9±2.2岁)在站立、行走、下蹲和上台阶时,同步采集髋关节的双平面X线片。使用经过验证的跟踪技术,以亚毫米精度确定体内骨运动,该技术将个体特异性骨模型与双平面X线片进行匹配。计算每种活动的动态匹配指数(CI)和股骨头覆盖度。混合效应分析分别确定活动、区域及其相互作用对CI或覆盖度的影响,多元线性回归确定每个区域和活动中α角、外侧中心边缘角(LCEA)与CI或覆盖度之间的关联。 结果:在低屈曲活动期间,与高屈曲活动相比,前下、前上和后下匹配度下降高达30%(所有p<0.02),上和后上匹配度增加高达40%(所有p<0.01),前和下覆盖度下降(分别高达40.1%和9.4%,所有p<0.01)。LCEA比α角更能预测覆盖度和匹配度。 结论:在无症状个体中观察到的髋关节覆盖度和匹配度的这些区域差异,为髋臼前部区域软骨退变的常见模式提供了潜在的机制解释,并为评估病理性髋关节提供了参考。
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