title: Effects of normal and abnormal loading conditions on morphogenesis of the prenatal hip joint: application to hip dysplasia.
abstract: Joint morphogenesis is an important phase of prenatal joint development during which the opposing cartilaginous rudiments acquire their reciprocal and interlocking shapes. At an early stage of development, the prenatal hip joint is formed of a deep acetabular cavity that almost totally encloses the head. By the time of birth, the acetabulum has become shallower and the femoral head has lost substantial sphericity, reducing joint coverage and stability. In this study, we use a dynamic mechanobiological simulation to explore the effects of normal (symmetric), reduced and abnormal (asymmetric) prenatal movements on hip joint shape, to understand their importance for postnatal skeletal malformations such as developmental dysplasia of the hip (DDH). We successfully predict the physiological trends of decreasing sphericity and acetabular coverage of the femoral head during fetal development. We show that a full range of symmetric movements helps to maintain some of the acetabular depth and femoral head sphericity, while reduced or absent movements can lead to decreased sphericity and acetabular coverage of the femoral head. When an abnormal movement pattern was applied, a deformed joint shape was predicted, with an opened asymmetric acetabulum and the onset of a malformed femoral head. This study provides evidence for the importance of fetal movements in the prevention and manifestation of congenital musculoskeletal disorders such as DDH.
authors.affiliation: Department of Bioengineering, Imperial College London, UK.
authors.forename: Mario
authors.initials: M
authors.lastname: Giorgi
authors.affiliation: Department of Bioengineering, Imperial College London, UK; Department of Biomedical Engineering, Florida Institute of Technology, USA.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Carriero
authors.affiliation: Department of Bioengineering, Imperial College London, UK; Department of Mechanical and Industrial Engineering, Northeastern University, USA.
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Shefelbine
authors.affiliation: Department of Bioengineering, Imperial College London, UK. Electronic address: n.nowlan@imperial.ac.uk.
authors.forename: Niamh C
authors.initials: NC
authors.lastname: Nowlan
mesh_terms: D000077:Acetabulum / Q000196:embryology / Q000473:pathology; D001696:Biomechanical Phenomena; D003198:Computer Simulation; D005260:Female; D005270:Femur Head / Q000196:embryology / Q000473:pathology; D006618:Hip Dislocation, Congenital / Q000196:embryology / Q000503:physiopathology*; D006621:Hip Joint / Q000196:embryology / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008954:Models, Biological; D009024:Morphogenesis; D009068:Movement; D011247:Pregnancy; D016059:Range of Motion, Articular
keywords: Computational model; DDH; Developmental dysplasia of the hip; Joint biomechanics; Joint development; Joint shape