The Geometry and Biomechanics of Normal and Pathomorphologic Human Hips

Geometric abnormalities of the human hip joint, as found in femoroacetabular impingement (FAI) and acetabular dysplasia, alter hip biomechanics and may be the primary causes of osteoarthritis in young adults. However, empirical evidence of direct correlations between abnormal geometry, altered biomechanics, and osteoarthritis is scarce. Also, clinical measures used to diagnose FAI and dysplasia still have substantial limitations, including questions about their reliability, assumptions about hip joint geometry and their ability to definitively distinguish pathologic from normal hips. The goals of this dissertation are twofold. First, a set of tools are presented and applied to quantify three-dimensional (3D) anatomical differences between hips with FAI and control subjects. The 3D tools were developed, validated and applied to patients with a subtype of FAI, called cam FAI, to improve basic understanding of the spectrum of FAI deformities, and to provide meaningful new metrics of morphology that are relatable to current diagnostic methods and translate easily for clinical use. The second goal of this dissertation is to improve our understanding of intra-articular hip contact mechanics as well as hip joint kinematics and muscle forces. To do so, a finite element study of intra-articular cartilage contact mechanics was completed with a cohort of live human subjects, using a validated modeling protocol. Finally, musculoskeletal modeling was used with gait data from healthy subjects and acetabular dysplasia patients to provide preliminary estimates of hip joint kinematics, kinetics, and muscle forces and compare differences between the groups. The translational methods of this dissertation utilized techniques from orthopaedics, computer science, physical therapy, mechanics, and medical imaging. Results from this dissertation offer new insight into the complex pathomechanics and pathomorphology of FAI and acetabular dysplasia. Application and extension of the work of this dissertation has the potential to help establish links between FAI and dysplasia with osteoarthritis and to improve patient care.

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Year

Entry

2001

Anderson FC, Pandy MG. Static and dynamic optimization solutions for gait are practically equivalent. J Biomech. February 2001;34(2):153-161.

1981

Rushfeldt PD, Mann RW, Harris WH. Improved techniques for measuringin vitro the geometry and pressure distribution in the human acetabulum, II: instrumented endoprosthesis measurement of articular surface pressure distribution. J Biomech. 1981;14(5):315-323.

1977

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. March 1977;33(1):159-174.

1994

Ateshian GA, Lai WM, Zhu WB, Mow VC. An asymptotic solution for the contact of two biphasic cartilage layers. J Biomech. November 1994;27(11):1347-1360.

2001

Bergmann G, Deuretzbacher G, Heller M, Graichen F, Rohlmann A, Strauss J, Duda GN. Hip contact forces and gait patterns from routine activities. J Biomech. July 2001;34(7):859-871.