Abstract Introduction Methods Preliminary Results
Graduate Category: Engineering and Technology Degree Level: PhD Abstract ID# 699
Altered Physeal Development in Young Athletes: Etiology of Femoroacetabular Impingement Rachel E. Horenstein,
1 MS ,
Matthew
1Northeastern
1 Lapointe ,
Sandra J. Shefelbine,
1 PhD
University College of Engineering
Abstract
Methods
Adolescent participation in elite sports activity can cause changes to the shape of the hip joint, a condition termed femoroacetabular impingement (FAI). Development of FAI during adolescence is recognized as a cause of hip pain and osteoarthritis later in life, however little is known about its etiology. To determine the etiology of FAI, we will evaluate the effects of ice hockey and dancing on skeletal development by characterizing hip motion during sports practice, analyzing changes in proximal femoral head morphology using medical imaging, and measuring balance of hip musculature in elite adolescent male ice hockey players, dancers, and nonathletic controls.
We will recruit elite male athletes and non-active adolescents between the ages of 11-12 years old. Athletes will fall into two motion categories: ice hockey players (single-plane) and dancers (multi-plane) (Fig. 3).
Introduction Adolescent participation in elite sports activity can cause changes to the shape of the hip joint after skeletal maturity, a condition termed femoroacetabular impingement (FAI). • •
The deformity is characterized by either a cam or pincer morphology of the proximal femoral head (Fig. 1), causing impingement of the joint in flexion and internal rotation. Development of FAI during adolescence is recognized as a cause of hip pain and osteoarthritis later in life1.
Fig. 3: Expected results. “Intensity” encompasses frequency and magnitude of movements. “Variability” captures the number of different movements seen.
Fig. 4: Sensor set-up for motion capture
1. Characterizing planes of motion: We will record hip motion during training practices using small wireless wearable sensors (APDM, Portland Oregon) (Fig. 4). These sensors capture acceleration and angular velocity which we will use to derive planes of motion. 2. Analyzing Hip Morphology: We will acquire an MRI image of each athlete’s hip at baseline and at two-year follow up to capture changes in morphology. 3. Measuring muscle balance: We will use standard physical therapy techniques to measure muscle strength and range of motion for the hip joint.
Fig. 1: Cam deformity on the anterior superior head-neck junction of the femur.
Preliminary Results
In phylogeny, we see that animals that swim or climb (multi-plane motion) have a well-defined spherical femoral head, while animals that run or jump have an ill-defined femoral head (Fig. 2).
Fig. 2: The proximal femur of animals with large ranges of motion at the hip (such as the chimpanzee) have a well-defined femoral head. Animals with limited out-of plane motion (such as a horse and jumpers) have a ‘cam’-like hip. Adapted from [2].
Coronal Plane Acceleration (m/s2)
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Vertical Acceleration (m/s2)
Little is known about what causes FAI; however it is clear that it develops as the growth plate in the proximal femur closes.
Sagittal Plane Acceleration (m/s2)
Accelerometers were used to find acceleration in three orthogonal directions (Fig. 5). Relative Acceleration of the Right Leg
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Fig. 5: Relative acceleration of the right hip in three orthogonal directions.
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Similarly, FAI is seen most commonly in sports with limited range of motion, such as basketball, soccer, and hockey.
We hypothesize that excessive repetitive motion with a limited range in elite adolescent athletes leads to the development of FAI. References [1] Philippon, M. J., Weiss, D. R., Kuppersmith, D. A., Briggs, K. K., & Hay, C. J. (2010). Arthroscopic Labral Repair and Treatment of Femoroacetabular Impingement in Professional Hockey Players. The American Journal of Sports Medicine, 38(1), 99–104. doi:10.1177/0363546509346393 [2] Bouma, H. W., De Boer, S. F., De Vos, J., Van Kampen, P. M., & Hogervorst, T. (2013). Mammal hip morphology and function: coxa recta and coxa rotunda. Anatomical Record (Hoboken, N.J.: 2007), 296(2), 250–256. doi:10.1002/ar.22634
Eigenvector analysis (Table 1) reveals that: 1. Sagittal plane acceleration is the greatest component in the maximum principle direction. 2. Coronal plane acceleration is the greatest component in the middle principle direction. 3. Vertical acceleration is the greatest component in the minimum principle direction. Principle Component Eigenvector Maximum [0.983, 0.079, 0.163] Middle [-0.103, 0.984, 0.144] Minimum [-0.149, -0.158, 0.976]
Eigenvalue 2.84 x 106 0.868 x 106 0.493 x 106
Table 1: Eigenvector analysis for right leg acceleration relative to the hip. The vectors indicate sagittal, coronal, and vertical components from left to right.
Altered Physeal Development in Young Athletes: Etiology of Femoroacetabular Impingement Rachel E. Horenstein,
1 MS ,
Matthew
1Northeastern
1 Lapointe ,
Sandra J. Shefelbine,
1 PhD
University College of Engineering
Abstract
Methods
Adolescent participation in elite sports activity can cause changes to the shape of the hip joint, a condition termed femoroacetabular impingement (FAI). Development of FAI during adolescence is recognized as a cause of hip pain and osteoarthritis later in life, however little is known about its etiology. To determine the etiology of FAI, we will evaluate the effects of ice hockey and dancing on skeletal development by characterizing hip motion during sports practice, analyzing changes in proximal femoral head morphology using medical imaging, and measuring balance of hip musculature in elite adolescent male ice hockey players, dancers, and nonathletic controls.
We will recruit elite male athletes and non-active adolescents between the ages of 11-12 years old. Athletes will fall into two motion categories: ice hockey players (single-plane) and dancers (multi-plane) (Fig. 3).
Introduction Adolescent participation in elite sports activity can cause changes to the shape of the hip joint after skeletal maturity, a condition termed femoroacetabular impingement (FAI). • •
The deformity is characterized by either a cam or pincer morphology of the proximal femoral head (Fig. 1), causing impingement of the joint in flexion and internal rotation. Development of FAI during adolescence is recognized as a cause of hip pain and osteoarthritis later in life1.
Fig. 3: Expected results. “Intensity” encompasses frequency and magnitude of movements. “Variability” captures the number of different movements seen.
Fig. 4: Sensor set-up for motion capture
1. Characterizing planes of motion: We will record hip motion during training practices using small wireless wearable sensors (APDM, Portland Oregon) (Fig. 4). These sensors capture acceleration and angular velocity which we will use to derive planes of motion. 2. Analyzing Hip Morphology: We will acquire an MRI image of each athlete’s hip at baseline and at two-year follow up to capture changes in morphology. 3. Measuring muscle balance: We will use standard physical therapy techniques to measure muscle strength and range of motion for the hip joint.
Fig. 1: Cam deformity on the anterior superior head-neck junction of the femur.
Preliminary Results
In phylogeny, we see that animals that swim or climb (multi-plane motion) have a well-defined spherical femoral head, while animals that run or jump have an ill-defined femoral head (Fig. 2).
Fig. 2: The proximal femur of animals with large ranges of motion at the hip (such as the chimpanzee) have a well-defined femoral head. Animals with limited out-of plane motion (such as a horse and jumpers) have a ‘cam’-like hip. Adapted from [2].
Coronal Plane Acceleration (m/s2)
•
Vertical Acceleration (m/s2)
Little is known about what causes FAI; however it is clear that it develops as the growth plate in the proximal femur closes.
Sagittal Plane Acceleration (m/s2)
Accelerometers were used to find acceleration in three orthogonal directions (Fig. 5). Relative Acceleration of the Right Leg
50
0
-50 30
31
32
33
34
35
36
37
38
39
40
36
37
38
39
40
36
37
38
39
40
Time (sec) 50
0
-50 30
31
32
33
34
35
Time (sec) 50
0
-50 30
31
32
33
34
35
Time (sec)
Fig. 5: Relative acceleration of the right hip in three orthogonal directions.
•
Similarly, FAI is seen most commonly in sports with limited range of motion, such as basketball, soccer, and hockey.
We hypothesize that excessive repetitive motion with a limited range in elite adolescent athletes leads to the development of FAI. References [1] Philippon, M. J., Weiss, D. R., Kuppersmith, D. A., Briggs, K. K., & Hay, C. J. (2010). Arthroscopic Labral Repair and Treatment of Femoroacetabular Impingement in Professional Hockey Players. The American Journal of Sports Medicine, 38(1), 99–104. doi:10.1177/0363546509346393 [2] Bouma, H. W., De Boer, S. F., De Vos, J., Van Kampen, P. M., & Hogervorst, T. (2013). Mammal hip morphology and function: coxa recta and coxa rotunda. Anatomical Record (Hoboken, N.J.: 2007), 296(2), 250–256. doi:10.1002/ar.22634
Eigenvector analysis (Table 1) reveals that: 1. Sagittal plane acceleration is the greatest component in the maximum principle direction. 2. Coronal plane acceleration is the greatest component in the middle principle direction. 3. Vertical acceleration is the greatest component in the minimum principle direction. Principle Component Eigenvector Maximum [0.983, 0.079, 0.163] Middle [-0.103, 0.984, 0.144] Minimum [-0.149, -0.158, 0.976]
Eigenvalue 2.84 x 106 0.868 x 106 0.493 x 106
Table 1: Eigenvector analysis for right leg acceleration relative to the hip. The vectors indicate sagittal, coronal, and vertical components from left to right.
