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In vitro analysis of peri-articular soft tissues passive constraining effect on hip kinematics and joint stability

  • Hip
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Aim of the study is to assess the contribution of peri-articular soft tissues to hip joint kinematics and their influence on hip stability.

Methods

Four hemi-corpse specimens (3 males, average age 72 years) were studied using a custom navigation system. Hip kinematics (femoral head motion relative to the acetabulum and joint range of motion) were evaluated with the hip manually positioned in 36 different positions with (I) soft tissues intact, (II) after removal of the skin and muscles and (III) after partial capsulectomy. Each position was repeated 3 times in each state.

Results

Excellent interclass correlation for each test was determined (ICC range, 0.84–0.96). Femoral head anatomical centre displacement relative to the acetabulum occurred in all 3 planes, even with all the soft tissue intact (average, 3.3 ± 2.8 mm lateral translation; 1.4 ± 1.8 mm posterior translation and 0.3 ± 1.5 mm distally). These translations increased as more soft tissue was removed, except medial–lateral displacement, with an average 4.6 ± 2.9 mm lateral translation, 0.7 ± 1.3 mm posterior translation and 1.5 ± 1.9 mm distal translation when partial capsulectomy was performed. Range of motion increased in all 3 planes with increasing removal of the soft tissues.

Conclusions

This study showed that femoral head anatomical centre displacement within the acetabulum occurs and increases with increasing removal of peri-articular soft tissues, confirming their influence on hip stability. Hip kinematics was also influenced by peri-articular soft tissues; specifically range of motion increases with increasing removal of those tissues. From clinicians’ point of view, they have therefore to consider the influence of their surgeries on peri-articular soft tissues, since excessive translations may promote hip arthritis.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA

    Marc R. Safran, Zackary D. Vaughn & Garry Gold

  2. Laboratorio di Biomeccanica e Innovazione Tecnologica, Istituto Ortopedico Rizzoli, via Di Barbiano, 1/10, Bologna, Italy

    Nicola Lopomo, Stefano Zaffagnini, Cecilia Signorelli & Maurilio Marcacci

  3. Laboratorio di Nano Biotecnologie, NaBi, Istituto Ortopedico Rizzoli, Bologna, Italy

    Nicola Lopomo

  4. Dipartimento di Bioingegneria, Politecnico di Milano, Milan, Italy

    Cecilia Signorelli

  5. Bone and Joint Center, VA Palo Alto Health Care System, Stanford University, Stanford, CA, USA

    Derek P. Lindsey

  6. Ospedale “Morgagni-Pierantoni”, U.O. Ortopedia e Traumatologia, Forlì, Italy

    Giovanni Giordano

Authors
  1. Marc R. Safran
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  2. Nicola Lopomo
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  3. Stefano Zaffagnini
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  4. Cecilia Signorelli
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  5. Zackary D. Vaughn
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  6. Derek P. Lindsey
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  7. Garry Gold
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  8. Giovanni Giordano
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  9. Maurilio Marcacci
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Correspondence to Nicola Lopomo.

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Safran, M.R., Lopomo, N., Zaffagnini, S. et al. In vitro analysis of peri-articular soft tissues passive constraining effect on hip kinematics and joint stability. Knee Surg Sports Traumatol Arthrosc 21, 1655–1663 (2013). https://doi.org/10.1007/s00167-012-2091-6

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  • DOI: https://doi.org/10.1007/s00167-012-2091-6

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