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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 4/2017

01-04-2017 | Symposium: 2016 Bernese Hip Symposium

Increased Hip Stresses Resulting From a Cam Deformity and Decreased Femoral Neck-Shaft Angle During Level Walking

Authors: K. C. Geoffrey Ng, MASc, Giulia Mantovani, PhD, Mario Lamontagne, PhD, Michel R. Labrosse, PhD, Paul E. Beaulé, MD, FRCSC

Published in: Clinical Orthopaedics and Related Research® | Issue 4/2017

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Abstract

Background

It is still unclear why many individuals with a cam morphology of the hip do not experience pain. It was recently reported that a decreased femoral neck-shaft angle may also be associated with hip symptoms. However, the effects that different femoral neck-shaft angles have on hip stresses in symptomatic and asymptomatic individuals with cam morphology remain unclear.

Questions/purposes

We examined the effects of the cam morphology and femoral neck-shaft angle on hip stresses during walking by asking: (1) Are there differences in hip stress characteristics among symptomatic patients with cam morphology, asymptomatic individuals with cam morphology, and individuals without cam morphology? (2) What are the effects of high and low femoral neck-shaft angles on hip stresses?

Methods

Six participants were selected, from a larger cohort, and their cam morphology and femoral neck-shaft angle parameters were measured from CT data. Two participants were included in one of three groups: (1) symptomatic with cam morphology; (2) asymptomatic with a cam morphology; and (3) asymptomatic control with no cam morphology with one participant having the highest femoral neck-shaft angle and the other participant having the lowest in each subgroup. Subject-specific finite element models were reconstructed and simulated during the stance phase, near pushoff, to examine maximum shear stresses on the acetabular cartilage and labrum.

Results

The symptomatic group with cam morphology indicated high peak stresses (6.3–9.5 MPa) compared with the asymptomatic (5.9–7.0 MPa) and control groups (3.8–4.0 MPa). Differences in femoral neck-shaft angle influenced both symptomatic and asymptomatic groups; participants with the lowest femoral neck-shaft angles had higher peak stresses in their respective subgroups. There were no differences among control models.

Conclusions

Our study suggests that the hips of individuals with a cam morphology and varus femoral neck angle may be subjected to higher mechanical stresses than those with a normal femoral neck angle.

Clinical Relevance

Individuals with a cam morphology and decreased femoral neck-shaft angle are likely to experience severe hip stresses. Although asymptomatic participants with cam morphology had elevated stresses, a higher femoral neck-shaft angle was associated with lower stresses. Future research should examine larger amplitudes of motion to assess adverse subchondral bone stresses.
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Metadata
Title
Increased Hip Stresses Resulting From a Cam Deformity and Decreased Femoral Neck-Shaft Angle During Level Walking
Authors
K. C. Geoffrey Ng, MASc
Giulia Mantovani, PhD
Mario Lamontagne, PhD
Michel R. Labrosse, PhD
Paul E. Beaulé, MD, FRCSC
Publication date
01-04-2017
Publisher
Springer US
Published in
Clinical Orthopaedics and Related Research® / Issue 4/2017
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-016-5038-2

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