Author's School

School of Medicine

ORCID

https://orcid.org/0000-0002-8797-0848

Author's Department/Program

Movement Science

Language

English (en)

Date of Award

Summer 8-15-2024

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Chair and Committee

Michael D. Harris

Committee Members

John C Clohisy, Marcie Harris-Hayes, Gretchen A Meyer, Linda R van Dillen

Abstract

Developmental dysplasia of the hip (DDH) is a bony condition characterized by a shallow hip socket that reduces coverage of the femoral head and leads to instability, resulting in altered joint loading and an increased risk for early onset osteoarthritis (OA). Understanding the factors that influence loading in the dysplastic hip is necessary for developing effective treatment strategies and improving patient outcomes. The purpose of this dissertation was to examine multiple factors that could impact joint loading in DDH: 1) sport specific activities, 2) femoral version (FV) deformities, and 3) derotational femoral osteotomy (DFO) correction for FV deformities. Analyzing how these factors affect joint loading can provide valuable insights into the management and treatment of individuals with DDH, ultimately aiming to reduce pain, improve function, and delay or prevent the development of OA.

In Chapter 2, we looked at the influence of two sport specific activities, running and hop-cutting, on hip kinematics and joint reaction forces (JRFs). We found that medial JRFs were elevated during both activities when compared to controls, along with gluteus medius and minimus muscle forces. However, there were no differences in hip joint angles between individuals with DDH and controls. In Chapter 3, we examined the effect of FV deformities on hip joint loads during gait in individuals with DDH. We found that increased femoral anteversion increased anterior, superior, and resultant JRFs while decreasing medial JRFs. However, relative retroversion had the opposite effect, except for increasing superior and resultant JRFs in the early stance phase of the gait cycle. In Chapter 4, we compared the effects of two common DFO locations on joint forces in DDH. Additionally, we wanted to see if correcting for FV deformities would cause JRFs to be comparable to controls. We found that overall differences between correction locations were minimal, with subtrochanteric correction increasing forces more than intertrochanteric correction. While correcting for abnormal FV did alter JRFs, the medial and superior components were still elevated post-DFO when compared to controls.

The results of this dissertation add important novel factors, including sport-specific activities and femoral deformities, that contribute to abnormal joint loading in individuals with DDH. This work provides a more comprehensive understanding of damage risk which can not only improve our ability to treat pain and functional limitations but also contribute to the prevention of degenerative changes, such as OA. Future research should continue to explore these factors in greater detail to optimize clinical treatment.

DOI

https://doi.org/10.48765/2f1s-6991

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