Biomechanics of the Dysplastic Hip

髋关节发育不良的生物力学

基本信息

批准号：
7460793
负责人：
JEFFREY A. WEISS
金额：
$ 25.25万
依托单位：
UNIVERSITY OF UTAH
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-07-01 至 2012-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7460793
关键词：
Address Affect Anatomy Anterior Area Arthroplasty Biomechanics Biomedical Engineering Cartilage Clinical Computer Simulation Condition Cross-Sectional Studies Data Degenerative polyarthritis Development Diagnosis Dysplasia Early identification Early treatment Elements Etiology Film Future Hip Joint Hip Osteoarthritis Hip region structure Human Joints Location Measurement Measures Mechanics Methods Modeling Natural History Numbers Operative Surgical Procedures Orthopedics Osteotomy Outcome Pain Pathologic Pathology Patients Pelvis Population Postoperative Period Preparation Principal Investigator Property Prospective Studies Public Health Rate Relative (related person)Research Research Project Grants Risk Secondary to Simulate Spatial Distribution Specimen Stress Surgeon Symptoms Techniques Testing Thick Walking acetabulum articular cartilage base experience programs research study shear stress simulation success

项目摘要

DESCRIPTION (provided by applicant): Acetabular dysplasia may be the leading cause of premature osteoarthritis (OA) of the hip. However, the relationship between the altered geometry associated with dysplasia and the resulting stresses in and around the joint is poorly understood. The overall hypothesis of this study is that acetabular dysplasia causes alterations in hip joint biomechanics, which predispose the joint to cartilage degeneration. Subject-specific, three-dimensional finite element modeling techniques will be developed and validated to study hip joint biomechanics. Then, using three patient populations (normal, traditional dysplastic and retroverted dysplastic), patient-specific finite element models will be used to determine stresses in and around the hip joint during simulated walking, stair-climbing and descending stairs. Patient-specific hip joint computational models also have a number of potential longer-term uses and benefits, including patient-specific approaches to treatment, and prediction of the long-term success rate of corrective surgeries based on pre- and post-operative mechanics. The methods to be developed and validated in this research can be directly applied to quantify changes in mechanical loading due to surgical intervention, allowing us to assess the efficacy of different approaches to osteotomy on a patient-specific basis. We also envision using these techniques for longer-term prospective studies, to correlate surgical correction with changes in mechanical loading and long-term outcome. Currently, the status quo is that long-term success is measured by avoidance of a total hip arthroplasty and is not correlated with any preoperative variable other than the relatively crude measurements made on an anteroposterior radiograph. Relevance to Public Health: Many orthopaedic surgeons are unaware of multiple facets of the hip dysplasia diagnosis and their potential implications for joint degeneration. Recognizing the mechanical consequences of different and often subtle forms of dysplasia allows earlier identification of "at risk' hips so that earlier treatment can be initiated, hopefully delaying the need for total hip athroplasty. This research will immediately help to delineate the true spectrum of this three-dimensional pathology by quantifying stress transfer in the hip joint using patient specific computational models.

描述（由申请人提供）：髋臼发育不良可能是髋部过早骨关节炎（OA）的主要原因。然而，与发育不良相关的几何形状改变与关节内及其周围产生的应力之间的关系知之甚少。这项研究的总体假设是髋臼发育不良会导致髋关节生物力学的改变，从而使关节容易发生软骨退化。将开发和验证特定主题的三维有限元建模技术来研究髋关节生物力学。然后，使用三种患者群体（正常、传统发育不良和后向发育不良），将使用患者特定的有限元模型来确定模拟步行、爬楼梯和下楼梯期间髋关节内部和周围的应力。患者特定的髋关节计算模型还具有许多潜在的长期用途和益处，包括患者特定的治疗方法，以及根据术前和术后力学预测矫正手术的长期成功率。本研究中开发和验证的方法可以直接应用于量化手术干预引起的机械负荷变化，使我们能够根据患者具体情况评估不同截骨方法的疗效。我们还设想使用这些技术进行长期前瞻性研究，将手术矫正与机械负荷和长期结果的变化联系起来。目前，现状是长期成功是通过避免全髋关节置换术来衡量的，除了前后位X光片上相对粗略的测量之外，与任何术前变量都不相关。与公共卫生的相关性：许多骨科医生不了解髋关节发育不良诊断的多个方面及其对关节退化的潜在影响。认识到不同且通常微妙的发育不良形式的机械后果，可以更早地识别“处于危险中”的髋关节，从而可以开始更早的治疗，有望推迟全髋关节置换术的需要。这项研究将立即帮助描绘这种情况的真实范围通过使用患者特定的计算模型量化髋关节中的应力传递来进行三维病理学分析。