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J Biomech. 2019 Feb 14;84:138-146. doi: 10.1016/j.jbiomech.2018.12.026. Epub 2018 Dec 23.

Hip joint muscle forces during gait in patients with femoroacetabular impingement syndrome are associated with patient reported outcomes and cartilage composition.

Author information

1
Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA; Department of Kinesiology & Health Promotion, University of Kentucky, Lexington, KY, USA. Electronic address: michael.samaan@uky.edu.
2
Department of Orthopaedic Surgery, University of California - San Francisco School of Medicine, San Francisco, CA, USA.
3
Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA.
4
Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA; Department of Physical Therapy and Rehabilitation Science, University of California - San Francisco, San Francisco, CA, USA.

Abstract

Femoroacetabular impingement syndrome (FAIS) consists of abnormal hip joint morphology and pain during activities of daily living. Abnormal gait mechanics and potentially abnormal muscle forces within FAI patients leads to articular cartilage damage. Therefore, there is a necessity to understand the effects of FAI on hip joint muscle forces during gait and the link between muscle forces, patient reported outcomes (PRO) and articular cartilage health. The purposes of this study were to assess: (1) hip muscle forces between FAI patients and healthy controls and (2) the associations between hip muscle forces with PRO and cartilage composition (T/T2 mapping) within FAI patients. Musculoskeletal simulations were used to estimate peak muscle forces during the stance phase of gait in 24 FAI patients and 24 healthy controls. Compared to controls, FAI patients ambulated with lower vasti (30% body-weight, p = 0.01) and higher sartorius (4.0% body-weight, p < 0.01) forces. Within FAI patients, lower peak gluteus medius, gluteus minimus, sartorius and iliopsoas forces were associated with worse hip joint pain and function (R = 0.43-0.70, p = 0-0.04), while lower muscle forces were associated with increased T and T2 values (i.e. altered cartilage composition) within the hip joint cartilage (R = -0.44 to -0.58, p = 0.006-0.05). Although FAI patients demonstrate abnormal muscle forces, it is unknown whether or not these altered muscle force patterns are associated with pain avoidance or weak musculature. Further investigation is required in order to better understand the effects of FAI on hip joint muscle forces and the associations with hip joint cartilage degeneration.

KEYWORDS:

Femoroacetabular impingement; Gait; Hip joint; Muscle force; Musculoskeletal simulation; OpenSim; T(1ρ)/T(2) mapping

PMID:
30600097
PMCID:
PMC6428078
[Available on 2020-02-14]
DOI:
10.1016/j.jbiomech.2018.12.026

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