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THE EFFECT OF HIP JOINT PATHOLOGY (DYSPLASIA OF THE HIP AND FEMOROACETABULAR IMPINGEMENT) ON THE SPHERICITY OF THE JOINT

Diaz Lopez, Reynol Alejandro

[Thesis]. Manchester, UK: The University of Manchester; 2018.

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Abstract

The shape of the hip joint components has a crucial role in the loading distribution and functionality of the hip joint. Hip joint pathologies commonly diagnosed on adults, such as femoroacetabular impingement (FAI) and developmental dysplasia of the hip (DDH) are characterized by abnormalities in the morphology of the pelvic or/and femoral bone. Surgical procedures focus on restoring the mobility or slowing the degenerative process of cartilage damage by reorienting the acetabulum or removing abnormalities from the acetabulum and/or the femur. However, in a number of cases damage appears in a different location or symptoms do not disappear. This suggests that the shape of the articular surfaces of the hip joint is affected by the hip joint pathologies. To investigate this, anatomical angles of the hip joint were measured, finite element models were constructed, and a sphericity analysis of the femoral head and acetabulum surface was performed on thirty hip joints, 10 with cam-type impingement, 10 with DDH and 10 normal hips. Radiographic parameters were taken from CT scan data, finite element models were used to obtain hip joint contact areas and contact pressures from a one-leg-standing loading condition, and, regarding sphericity, acetabulum and femoral head surface sphericity was assessed using quantitative and visualization methods. It was found that the femoral head was more spherical than the acetabulum in all subjects. However, the sphericity percentage of the acetabulum and femoral head from the DDH and FAI group was lower than the normal hip joint group. Furthermore, DDH and FAI group had similar values on the sphericity of the acetabulum and femoral head. We believe that the abnormal morphology of the pelvic bone and femur found in DDH and FAI subjects affects the shape of the hips, and this leads to damage on the articular surface or acetabular rim.