Pre- and postoperative in silico biomechanics in individuals with cam morphology during stair tasks

Danilo S Catelli; Bruno L S Bedo; Paul E Beaulé; Mario Lamontagne

doi:10.1016/j.clinbiomech.2021.105387

Pre- and postoperative in silico biomechanics in individuals with cam morphology during stair tasks

Clin Biomech (Bristol, Avon). 2021 Jun:86:105387. doi: 10.1016/j.clinbiomech.2021.105387. Epub 2021 May 20.

Authors

Danilo S Catelli¹, Bruno L S Bedo², Paul E Beaulé³, Mario Lamontagne⁴

Affiliations

¹ School of Human Kinetics, University of Ottawa, Ottawa, Canada.
² School of Human Kinetics, University of Ottawa, Ottawa, Canada; Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
³ Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Canada.
⁴ School of Human Kinetics, University of Ottawa, Ottawa, Canada; Department of Mechanical Engineering, University of Ottawa, Ottawa, Canada. Electronic address: mlamon@uottawa.ca.

PMID: 34044296
DOI: 10.1016/j.clinbiomech.2021.105387

Abstract

Background: Osteochondroplasty for cam femoroacetabular impingement is a common treatment to improve hip function and prevent joint degeneration. The purpose was to compare in-silico hip biomechanics during stair tasks in pre- and postoperative patients matched with healthy controls.

Methods: Ten symptomatic cam femoroacetabular impingement patients performed stair ascent and descent pre- and 2 years postoperatively. Patients were age, and body-mass-index matched to controls. Full-body kinematics and kinetics were computed and, muscle and hip contact forces were estimated using musculoskeletal modeling and static optimization. Stance-phases were time-normalized and compared using statistical non-parametric mapping.

Findings: Preoperatives showed lower hip abduction than controls during stairs ascent (76-100%, P = .007). Pre- and postoperative showed lower hip external rotation compared to controls on stair ascent (Pre-op vs controls: 71-100%, P = .005; Post-op vs controls: 72-100%, P = .01) and stair descent (Pre-op vs controls: 0-62%, P = .001; Post-op vs controls: 0-60%, P = .001). Postoperatives showed lower iliacus force compared to preoperative (1-3%, P = .012) and control (3-6%, P = .008), and higher gluteus maximus and piriformis forces compared to controls during stair descent. Lower postoperative anterior hip contact force (0-7%, P = .004) during descent, and superior (33-35%, P = .018) during ascent compared to controls were observed. Postoperative contact forces were medialized compared to preoperative (0-2%, P = .011) and controls (1-2%, P = .016).

Interpretation: Forcing participants to adhere to standardized step length/rise minimized sagittal kinematic differences between conditions and groups. Persistent reduced hip external rotation postoperatively and minor muscle force adaptations led to reduced superior hip contact force during stair ascent and reduced anterior and more medialized contact forces during stair descent.

Keywords: Femoroacetabular impingement; Hip contact forces; Kinematics; Kinetics; Muscle forces; Stairs.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biomechanical Phenomena
Computer Simulation
Femoracetabular Impingement* / surgery
Hip
Hip Joint / surgery
Humans

Grants and funding

97778A/CIHR/Canada