Altered biomechanical stimulation of the developing hip joint in presence of hip dysplasia risk factors
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Published version
Author(s)
Type
Journal Article
Abstract
Fetal kicking and movements generate biomechanical stimulation in the fetal skeleton, which is important for prenatal musculoskeletal development, particularly joint shape. Developmental dysplasia of the hip (DDH) is the most common joint shape abnormality at birth, with many risk factors for the condition being associated with restricted fetal movement. In this study, we investigate the biomechanics of fetal movements in such situations, namely fetal breech position, oligohydramnios and primiparity (firstborn pregnancy). We also investigate twin pregnancies, which are not at greater risk of DDH incidence, despite the more restricted intra-uterine environment. We track fetal movements for each of these situations using cine-MRI technology, quantify the kick and muscle forces, and characterise the resulting stress and strain in the hip joint, testing the hypothesis that altered biomechanical stimuli may explain the link between certain intra-uterine conditions and risk of DDH. Kick force, stress and strain were found to be significantly lower in cases of breech position and oligohydramnios. Similarly, firstborn fetuses were found to generate significantly lower kick forces than non-firstborns. Interestingly, no significant difference was observed in twins compared to singletons. This research represents the first evidence of a link between the biomechanics of fetal movements and the risk of DDH, potentially informing the development of future preventative measures and enhanced diagnosis. Our results emphasise the importance of ultrasound screening for breech position and oligohydramnios, particularly later in pregnancy, and suggest that earlier intervention to correct breech position through external cephalic version could reduce the risk of hip dysplasia.
Date Issued
2018-09-10
Date Acceptance
2018-07-04
Citation
Journal of Biomechanics, 2018, 78 (1), pp.1-9
ISSN
0021-9290
Publisher
Elsevier
Start Page
1
End Page
9
Journal / Book Title
Journal of Biomechanics
Volume
78
Issue
1
Copyright Statement
© 2018 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license https://creativecommons.org/licenses/by/4.0/.
Sponsor
Arthritis Research UK
Identifier
https://www.sciencedirect.com/science/article/pii/S0021929018305220
Grant Number
20683
Subjects
Science & Technology
Life Sciences & Biomedicine
Technology
Biophysics
Engineering, Biomedical
Engineering
Musculoskeletal development
Joint biomechanics
Cine MRI
Developmental dysplasia of the hip
Computational model
External cephalic version
ECV
DEVELOPMENTAL DYSPLASIA
MORPHOGENESIS
SIMULATIONS
ETIOLOGY
SYSTEM
BONES
Cine MRI
Computational model
Developmental dysplasia of the hip
ECV
External cephalic version
Joint biomechanics
Musculoskeletal development
Female
Hip Dislocation
Hip Joint
Humans
Mechanical Phenomena
Movement
Pregnancy
Risk Factors
Stress, Mechanical
Hip Joint
Humans
Hip Dislocation
Risk Factors
Pregnancy
Movement
Stress, Mechanical
Female
Mechanical Phenomena
Biomedical Engineering
0903 Biomedical Engineering
0913 Mechanical Engineering
1106 Human Movement and Sports Sciences
Publication Status
Published
Date Publish Online
2018-07-20