Grenier Victor, Ruel Catherine, Ruel Jean, Sercia Quentin, Rioux Myriam, Corbeil Philippe, Belzile Etienne L
Mechanical Engineering Department, Université Laval, Québec, Canada.
Medicine Faculty, Université Laval, Québec, Canada.
Adv Orthop. 2025 Aug 22;2025:1479343. doi: 10.1155/aort/1479343. eCollection 2025.
Multiple biomechanical models have been suggested to quantify lower limb joint contact stress distributions, with varying results. Among others, the choice of cartilage morphology and gait loading patterns can significantly affect simulation results. Moreover, there is currently no consensus on simulating the input and output data needed to obtain reliable results and enable a comprehensive analysis. The aim of this study was to compare the reliability and clinical relevance of joint contact metrics by calculating pre- and postoperative hip joint contact stress distributions of a dysplastic cohort under various simulation scenarios. A cohort of 22 dysplastic patients has been treated using periacetabular osteotomy (6-month follow-up). Five radiographic measurements of the acetabular cup were taken from imagery pre- and postoperatively. Eight osteoarthritis-predictive joint stress metrics were computed using discrete element analysis in 6 unique simulation scenarios (2 cartilage models; 3 hip gait loading profiles) pre- and postoperatively. A multivariate analysis of variance confirmed the significant effects of treatment, cartilage model, and loading profile on the computed stress metrics ( < 0.01). Also, average- and threshold-based metrics, such as average contact area, average stress, and Maxian overdose, were shown as more reliable indicators of successful surgical treatment than the maximum-based metrics. Finally, correlations between radiographic measurements and stress metrics revealed greater influence of the acetabular index and anterior center-edge angle than the lateral center-edge angle. Average and threshold-based metrics, as well as the acetabular index and anterior center-edge angle, should be of greater interest in future studies regarding hip dysplasia. Level 2 (Prospective Study: Therapeutic).
已经提出了多种生物力学模型来量化下肢关节接触应力分布，但结果各异。其中，软骨形态和步态加载模式的选择会显著影响模拟结果。此外，目前对于模拟获得可靠结果并进行全面分析所需的输入和输出数据尚无共识。本研究的目的是通过计算发育异常队列在各种模拟场景下术前和术后的髋关节接触应力分布，比较关节接触指标的可靠性和临床相关性。一组22名发育异常患者接受了髋臼周围截骨术治疗（随访6个月）。术前和术后从影像学中获取髋臼杯的五项放射学测量值。在术前和术后的6种独特模拟场景（2种软骨模型；3种髋关节步态加载曲线）中，使用离散元分析计算8种骨关节炎预测性关节应力指标。多变量方差分析证实了治疗、软骨模型和加载曲线对计算出的应力指标有显著影响（<0.01）。此外，基于平均值和阈值的指标，如平均接触面积、平均应力和马克斯剂量，比基于最大值的指标更能可靠地指示手术治疗是否成功。最后，放射学测量值与应力指标之间的相关性表明，髋臼指数和前中心边缘角比外侧中心边缘角的影响更大。在未来关于髋关节发育异常的研究中，基于平均值和阈值的指标以及髋臼指数和前中心边缘角应更受关注。2级（前瞻性研究：治疗性）
