Developmental dysplasia of the hip (DDH) in infants under 6 months of age is typically treated by the Pavlik harness (PH). During successful PH treatment, a subluxed/dislocated hip is spontaneously reduced into the acetabulum, and DDH undergoes self-correction. PH treatment may fail due to avascular necrosis (AVN) of the femoral head. An improved understanding of mechanical factors accounting for the success/failure of PH treatment may arise from investigating articular cartilage contact pressure (CCP) within a hip during treatment. In this study, CCP in a cartilaginous infant hip was investigated through patient-specific finite element (FE) modeling. We simulated CCP of the hip equilibrated at 90 deg flexion at abduction angles of 40 deg, 60 deg, and 80 deg. We found that CCP was predominantly distributed on the anterior and posterior acetabulum, leaving the superior acetabulum (mainly superolateral) unloaded. From a mechanobiological perspective, hypothesizing that excessive pressure inhibits growth, our results qualitatively predicted increased obliquity and deepening of the acetabulum under such CCP distribution. This is the desired and observed therapeutic effect in successful PH treatment. The results also demonstrated increase in CCP as abduction increased. In particular, the simulation predicted large magnitude and concentrated CCP on the posterior wall of the acetabulum and the adjacent lateral femoral head at extreme abduction (80 deg). This CCP on lateral femoral head may reduce blood flow in femoral head vessels and contribute to AVN. Hence, this study provides insight into biomechanical factors potentially responsible for PH treatment success and complications.
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July 2018
Research-Article
Hip Joint Contact Pressure Distribution During Pavlik Harness Treatment of an Infant Hip: A Patient-Specific Finite Element Model
Behzad Vafaeian,
Behzad Vafaeian
Department of Civil and
Environmental Engineering,
University of Alberta,
7-203 Donadeo Innovation
Centre for Engineering,
9211–116 Street,
Edmonton, AB T6G 1H9, Canada
e-mail: vafaeian@ualberta.ca
Environmental Engineering,
University of Alberta,
7-203 Donadeo Innovation
Centre for Engineering,
9211–116 Street,
Edmonton, AB T6G 1H9, Canada
e-mail: vafaeian@ualberta.ca
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Samer Adeeb,
Samer Adeeb
Associate Professor
Department of Civil and
Environmental Engineering,
University of Alberta,
7-203 Donadeo Innovation
Centre for Engineering,
Edmonton, AB T6G 1H9, Canada
e-mail: adeeb@ualberta.ca
Department of Civil and
Environmental Engineering,
University of Alberta,
7-203 Donadeo Innovation
Centre for Engineering,
9211–116 Street
,Edmonton, AB T6G 1H9, Canada
e-mail: adeeb@ualberta.ca
Search for other works by this author on:
Marwan El-Rich,
Marwan El-Rich
Associate Professor
Department of Mechanical Engineering,
Khalifa University,
Abu Dhabi, UAE
e-mail: elrich@ualberta.ca
Department of Mechanical Engineering,
Khalifa University,
Abu Dhabi, UAE
e-mail: elrich@ualberta.ca
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Dornoosh Zonoobi,
Dornoosh Zonoobi
Department of Radiology and
Diagnostic Imaging,
University of Alberta,
2A2.41 WMC, 8440-112 Street,
Edmonton, AB T6G 2B7, Canada
e-mail: zonoobi@ualberta.ca
Diagnostic Imaging,
University of Alberta,
2A2.41 WMC, 8440-112 Street,
Edmonton, AB T6G 2B7, Canada
e-mail: zonoobi@ualberta.ca
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Abhilash R. Hareendranathan,
Abhilash R. Hareendranathan
Department of Radiology and
Diagnostic Imaging,
University of Alberta,
2A2.41 WMC, 8440-112 Street,
Edmonton, AB T6G 2B7, Canada
e-mail: hareendr@ualberta.ca
Diagnostic Imaging,
University of Alberta,
2A2.41 WMC, 8440-112 Street,
Edmonton, AB T6G 2B7, Canada
e-mail: hareendr@ualberta.ca
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Jacob L. Jaremko
Jacob L. Jaremko
Assistant Professor
Department of Radiology and
Diagnostic Imaging,
University of Alberta,
2A2.41 WMC, 8440-112 Street,
Edmonton, AB T6G 2B7, Canada
e-mail: jjaremko@ualberta.ca
Department of Radiology and
Diagnostic Imaging,
University of Alberta,
2A2.41 WMC, 8440-112 Street,
Edmonton, AB T6G 2B7, Canada
e-mail: jjaremko@ualberta.ca
Search for other works by this author on:
Behzad Vafaeian
Department of Civil and
Environmental Engineering,
University of Alberta,
7-203 Donadeo Innovation
Centre for Engineering,
9211–116 Street,
Edmonton, AB T6G 1H9, Canada
e-mail: vafaeian@ualberta.ca
Environmental Engineering,
University of Alberta,
7-203 Donadeo Innovation
Centre for Engineering,
9211–116 Street,
Edmonton, AB T6G 1H9, Canada
e-mail: vafaeian@ualberta.ca
Samer Adeeb
Associate Professor
Department of Civil and
Environmental Engineering,
University of Alberta,
7-203 Donadeo Innovation
Centre for Engineering,
Edmonton, AB T6G 1H9, Canada
e-mail: adeeb@ualberta.ca
Department of Civil and
Environmental Engineering,
University of Alberta,
7-203 Donadeo Innovation
Centre for Engineering,
9211–116 Street
,Edmonton, AB T6G 1H9, Canada
e-mail: adeeb@ualberta.ca
Marwan El-Rich
Associate Professor
Department of Mechanical Engineering,
Khalifa University,
Abu Dhabi, UAE
e-mail: elrich@ualberta.ca
Department of Mechanical Engineering,
Khalifa University,
Abu Dhabi, UAE
e-mail: elrich@ualberta.ca
Dornoosh Zonoobi
Department of Radiology and
Diagnostic Imaging,
University of Alberta,
2A2.41 WMC, 8440-112 Street,
Edmonton, AB T6G 2B7, Canada
e-mail: zonoobi@ualberta.ca
Diagnostic Imaging,
University of Alberta,
2A2.41 WMC, 8440-112 Street,
Edmonton, AB T6G 2B7, Canada
e-mail: zonoobi@ualberta.ca
Abhilash R. Hareendranathan
Department of Radiology and
Diagnostic Imaging,
University of Alberta,
2A2.41 WMC, 8440-112 Street,
Edmonton, AB T6G 2B7, Canada
e-mail: hareendr@ualberta.ca
Diagnostic Imaging,
University of Alberta,
2A2.41 WMC, 8440-112 Street,
Edmonton, AB T6G 2B7, Canada
e-mail: hareendr@ualberta.ca
Jacob L. Jaremko
Assistant Professor
Department of Radiology and
Diagnostic Imaging,
University of Alberta,
2A2.41 WMC, 8440-112 Street,
Edmonton, AB T6G 2B7, Canada
e-mail: jjaremko@ualberta.ca
Department of Radiology and
Diagnostic Imaging,
University of Alberta,
2A2.41 WMC, 8440-112 Street,
Edmonton, AB T6G 2B7, Canada
e-mail: jjaremko@ualberta.ca
1Corresponding author.
Manuscript received November 3, 2017; final manuscript received March 26, 2018; published online April 30, 2018. Assoc. Editor: Tammy L. Haut Donahue.
J Biomech Eng. Jul 2018, 140(7): 071009 (10 pages)
Published Online: April 30, 2018
Article history
Received:
November 3, 2017
Revised:
March 26, 2018
Citation
Vafaeian, B., Adeeb, S., El-Rich, M., Zonoobi, D., Hareendranathan, A. R., and Jaremko, J. L. (April 30, 2018). "Hip Joint Contact Pressure Distribution During Pavlik Harness Treatment of an Infant Hip: A Patient-Specific Finite Element Model." ASME. J Biomech Eng. July 2018; 140(7): 071009. https://doi.org/10.1115/1.4039827
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