Contact pressure distribution of the hip joint during closed reduction of developmental dysplasia of the hip: a patient-
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(2020) 21:600
RESEARCH ARTICLE
Open Access
Contact pressure distribution of the hip joint during closed reduction of developmental dysplasia of the hip: a patient-specific finite element analysis Zhiqiang Zhang1, Dashan Sui2, Haiyi Qin2, Hai Li3* and Ziming Zhang3*
Abstract Background: Developmental dysplasia of the hip (DDH) is the most common deformity of the lower extremity in children. The biomechanical change during closed reduction (CR) focused on cartilage contact pressure (CCP) has not been studied. Thereby, we try to provide insight into biomechanical factors potentially responsible for the success of CR treatment sand complications by using finite element analysis (FEA) for the first time. Methods: Finite element models of one patient with DDH were established based on the data of MRI scan on which cartilage contact pressure was measured. During CR, CCP between the femoral head and acetabulum in different abduction and flexion angles were tested to estimate the efficacy and potential risk factors of avascular necrosis (AVN) following CR. Results: A 3D reconstruction by the FEA method was performed on a 16 months of age girl with DDH on the right side. The acetabulum of the involved side showed a long, narrow, and “flat-shaped” deformity, whereas the femoral head was smaller and irregular compared with the contralateral side. With increased abduction angle, the stress of the posterior acetabulum increased significantly, and the stress on the lateral part of the femoral head increased as well. The changes of CCP in the superior acetabulum were not apparent during CR. There were no detectable differences in terms of pressure on the femoral head. Conclusions: Severe dislocation (IHDI grade III and IV) in children showed a high mismatch between the femoral head and acetabulum. Increased abduction angle corresponded with high contact pressure, which might relate to AVN, whereas increased flexion angle was not. Enhanced pressure on the lateral part of the femoral head might increase the risk of AVN. Keywords: Developmental dysplasia of the hip, Closed reduction, Finite element analysis, Cartilage contact pressure, Avascular necrosis
* Correspondence: [email protected]; [email protected] 3 Department of Pediatric Orthopedics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai 200092, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included i
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