Morphological and Biomechanical Insights into the Pathophysiology of Femoroacetabular Impingement Syndrome

股髋臼撞击综合征病理生理学的形态学和生物力学见解

基本信息

批准号：
10437851
负责人：
Andrew Edward Anderson
金额：
$ 48.13万
依托单位：
UNIVERSITY OF UTAH
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-01 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10437851
关键词：
Anatomy Animal Model Arthrography Articular Range of Motion Articulation Biomechanics Cartilage Clinical Computational Technique Conflict (Psychology)Control Groups Data Deformity Degenerative polyarthritis Development Diagnosis Disease Elements Etiology Evaluation Exhibits Film Finite Element Analysis Fluoroscopy Functional disorder Growth Head High Prevalence Hip Joint Hip Osteoarthritis Hip region structure Image Individual Injury Intuition Joints Lead Left Location Magnetic Resonance Measurement Measures Mechanics Methods Modeling Morphology Motion Neck Operative Surgical Procedures Outcome Pain Pathogenesis Pathologic Patients Population Positioning Attribute Procedures Replacement Arthroplasty Reporting Research Resource Sharing Scanning Shapes Stress Symptoms Syndrome Techniques Technology Traction Translations Walking aged bone cohort design experience gait rehabilitation improved in silico in vivo innovation insight kinematics novel strategies osteochondral tissue pain relief pathomechanics radiological imaging shear stress success theories treatment strategy young adult

项目摘要

PROJECT SUMMARY By some estimates, femoroacetabular impingement syndrome (FAIS) accounts for 82% of hip osteoarthritis (OA) cases. FAIS patients present with a loss of sphericity of the femoral head, reduction in femoral-neck offset, and/or an excessively prominent acetabular wall. Patients report pain that is position- or motion-related. Often, cartilage is delaminated from bone and the labrum is torn. The theory of FAIS pathophysiology is that pathoanatomy causes pathomechanics. However, we lack a quantitative understanding of the disease. Studies that have examined hip anatomy and biomechanics in FAIS patients have yielded conflicting data, likely due to the application of inaccurate measurement techniques. There is also a high prevalence of FAI morphology among the asymptomatic population (i.e., positive controls), which has hindered progress to understand why FAI morphology causes damage. Herein, we apply experimental and computational techniques to advance understanding of FAIS pathophysiology. We will examine three cohorts: FAIS patients, negative controls, and positive controls. Aim 1 will measure in-vivo hip articulation during inclined walking, pivoting, and squatting in the three cohorts using dual fluoroscopy. We hypothesize that patients with FAIS will exhibit altered kinematics; however, given our preliminary data, we posit that range of motion will not be reduced in patients. Further, we hypothesize that positive controls will have altered kinematics when compared to negative controls. In Sub-Aim 1, we will visualize the interaction between the shape of the hip joint and its kinematic position during dynamic loading using statistical shape modeling of the dual fluoroscopy data. Completion of Aim 1 improve clinical understanding of FAIS by enabling us to visualize the effects of pathologic shape during dynamic loading. Aim 2 will analyze chondrolabral mechanics in-silico to improve understanding of FAIS pathophysiology. Specifically, we will generate finite element models of bone, cartilage, and labrum using a validated pipeline. We will compare load transfer to the labrum and shear stresses and strains at the osteochondral and chondrolabral junction during inclined walking, pivoting, and squatting. We hypothesize that load transfer to the labrum is increased, and cartilage shear stresses and strains at the osteochondral and chondrolabral junctions are elevated in FAIS patients. Compensatory motion experienced by the positive control group may keep chondrolabral stresses and strains within normal. Thus, we hypothesize that there will be no significant differences in FE results between the two control groups. Sub-Aim 2 will quantify relationships between local measures of hip shape and chondrolabral mechanics. Completion of Aim 2 will enhance understanding of OA pathogenesis in patients with FAIS. Identifying how positive controls cope with their deformities could inform new treatment strategies.

项目摘要据某些估计，股骨替代障碍综合征（FAI）占髋关节骨关节炎的82％（OA）案件。 FAIS患者出现股骨头球体的丧失，股骨颈偏移的减少，和/或过度突出的髋臼壁。患者报告疼痛与位置或运动有关。经常，软骨从骨头分层，唇骨被撕裂。 FAIS病理生理学的理论是病原体引起病理学。但是，我们对疾病缺乏定量的理解。研究研究了FAIS患者的髋关节解剖结构和生物力学的数据，这可能是由于不准确的测量技术的应用。 FAI形态的流行率也很高在无症状人群（即阳性对照）中，这阻碍了进步以了解为什么FAI 形态会造成损害。本文中，我们应用实验和计算技术来推进了解毒性病理生理学。我们将检查三个队列：FAIS患者，阴性对照和阳性对照。 AIM 1将在倾斜的步行，枢转和蹲下期间测量体内髋关节表达使用双透视镜检查三个队列。我们假设FAI患者将表现出改变的运动学。但是，鉴于我们的初步数据，我们认为患者不会减少运动范围。此外，我们假设与阴性对照相比，阳性对照将改变运动学。在sub-aim 1，我们将可视化髋关节形状与动态过程中的运动学位置之间的相互作用使用双重透视镜数据的统计形状建模加载。 AIM 1的完成1改进临床通过使我们能够在动态载荷过程中可视化病理形状的影响，从而了解vais。目的 2将分析软骨力学，以提高对FAIS病理生理学的理解。具体来说，我们将使用经过验证的管道生成骨，软骨和唇部的有限元模型。我们将比较载荷转移到唇部和剪切应力和骨软骨和软骨上连接处的剪切应力和菌株倾斜的步行，枢转和蹲。我们假设向唇部的负载转移增加了，并且骨软骨和软骨连接处的软骨剪切应力和菌株在FAI中升高患者。阳性对照组经历的补偿运动可能会保持软骨应力和正常菌株。因此，我们假设Fe结果之间没有显着差异两个对照组。 Sub-aim 2将量化臀部形状的局部度量和软骨力学。 AIM 2的完成将增强对患者OA发病机理的理解 fais。确定积极控制如何应对其畸形可以为新的治疗策略提供信息。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Acetabular labrum and cartilage contact mechanics during pivoting and walking tasks in individuals with cam femoroacetabular impingement syndrome.

患有凸轮股骨髋臼撞击综合征的个体在旋转和行走任务期间髋臼盂唇和软骨接触力学。

DOI：
10.1016/j.jbiomech.2022.111424
发表时间：
2023
期刊：
Journal of biomechanics
影响因子：
2.4
作者：
Schuring,LindsayL;Mozingo,JosephD;Lenz,AmyL;Uemura,Keisuke;Atkins,PennyR;Fiorentino,NiccoloM;Aoki,StephenK;Peters,ChristopherL;Anderson,AndrewE
通讯作者：
Anderson,AndrewE

In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy.