title: Patient-specific analysis of cartilage and labrum mechanics in human hips with acetabular dysplasia.
abstract: BACKGROUND
  Acetabular dysplasia is a major predisposing factor for development of hip osteoarthritis (OA), and may result from alterations to chondrolabral loading. Subject-specific finite element (FE) modeling can be used to evaluate chondrolabral mechanics in the dysplastic hip, thereby providing insight into mechanics that precede OA.
  
  
  OBJECTIVE
  To evaluate chondrolabral contact mechanics and congruency in dysplastic hips and normal hips using a validated approach to subject-specific FE modeling.
  
  
  METHODS
  FE models of ten subjects with normal acetabula and ten subjects with dysplasia were constructed using a previously validated protocol. Labrum load support, and labrum and acetabular cartilage contact stress and contact area were compared between groups. Local congruency was determined at the articular surface for two simulated activities.
  
  
  RESULTS
  The labrum in dysplastic hips supported 2.8-4.0 times more of the load transferred across the joint than in normal hips. Dysplastic hips did not have significantly different congruency in the primary load-bearing regions than normal hips, but were less congruent in some unloaded regions. Normal hips had larger cartilage contact stress than dysplastic hips in the few regions that had significant differences.
  
  
  CONCLUSIONS
  The labrum in dysplastic hips has a far more significant role in hip mechanics than it does in normal hips. The dysplastic hip is neither less congruent than the normal hip, nor subjected to elevated cartilage contact stresses. This study supports the concept of an outside-in pathogenesis of OA in dysplastic hips and that the labrum in dysplastic hips should be preserved during surgery.
authors.affiliation: Department of Bioengineering and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, USA. Electronic address: corinne.henak@gmail.com.
authors.forename: C R
authors.initials: CR
authors.lastname: Henak
authors.affiliation: Department of Bioengineering and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, USA; Department of Orthopedics, University of Utah, Salt Lake City, UT 84108, USA. Electronic address: c.abraham@utah.edu.
authors.forename: C L
authors.initials: CL
authors.lastname: Abraham
authors.affiliation: Department of Bioengineering and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, USA; Department of Orthopedics, University of Utah, Salt Lake City, UT 84108, USA; Department of Physical Therapy, University of Utah, Salt Lake City, UT 84108, USA. Electronic address: Andrew.Anderson@hsc.utah.edu.
authors.forename: A E
authors.initials: AE
authors.lastname: Anderson
authors.affiliation: Department of Bioengineering and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, USA. Electronic address: steve.maas@utah.edu.
authors.forename: S A
authors.initials: SA
authors.lastname: Maas
authors.affiliation: Department of Bioengineering and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, USA. Electronic address: ben@sci.utah.edu.
authors.forename: B J
authors.initials: BJ
authors.lastname: Ellis
authors.affiliation: Department of Orthopedics, University of Utah, Salt Lake City, UT 84108, USA. Electronic address: Chris.Peters@hsc.utah.edu.
authors.forename: C L
authors.initials: CL
authors.lastname: Peters
authors.affiliation: Department of Bioengineering and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, USA; Department of Orthopedics, University of Utah, Salt Lake City, UT 84108, USA. Electronic address: jeff.weiss@utah.edu.
authors.forename: J A
authors.initials: JA
authors.lastname: Weiss
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D000328:Adult; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D020342:Finite Element Analysis; D006617:Hip Dislocation / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008954:Models, Biological; D013314:Stress, Mechanical; D014057:Tomography, X-Ray Computed; D016474:Weight-Bearing / Q000502:physiology; D055815:Young Adult
keywords: Acetabular dysplasia; Cartilage mechanics; Finite element; Hip; Labrum; Osteoarthritis