Introduction:

Most cases of hip osteoarthritis (OA) are believed to be caused by alterations in joint contact mechanics resulting from pathomorphologies such as acetabular dysplasia and acetabular retroversion. Over the past 13 years, our research group has focused on developing approaches for patient-specific modeling of cartilage and labrum in the human hip, and applying these approaches to study hip pathomorphology. The long term objective is to improve the understanding of the etiology of OA related to hip pathomorphology, and to improve diagnosis and treatment. The objectives of this presentation are to provide a summary of our subject-specific modeling approach, and to describe the results of our analysis of hips from three populations of subjects: normal, traditional dysplastic, and retroverted.

This presentation will provide an overview of the interdisciplinary research program on hip pathomorphology at the University of Utah, including studies of dysplasia and femoracetabular impingement. The discussion will emphasize the implications of the research findings for hip preserving surgery

Introduction: It is generally agreed that the function of the knee after total knee arthroplasty needs to be improved to meet the expectations of younger and more active patients. However, little objective information consists to quantify the frequency and importance of activities that place increased biomechanical demand on the knee. This study was performed to asses which specific “high-demand” activities are actually performed by patients after knee replacement, and which activities are of greatest personal importance to the patient.

Methods: An initial group of 243 patients (47% male; 53% female, average age: 70 years; range: (45–91 yrs)) were enrolled in this study with Institutional approval. All were at least 1 year post knee replacement and resided in the Houston area. All participants completed a validated, self-administered knee function questionnaire consisting of 55 scaled multiple choice questions regarding each respondent’s physical activities, limitations, and level of importance for those activities. Participants were also asked to assess the personal importance of each activity and the severity of any symptoms experienced when each activity was performed. An expanded version of the Knee Function Questionnaire was completed by a second group of 101 patients from 5 centres in the United States and Canada. This instrument addressed 120 physical, vocational and recreational activities involving the knee. Fifty-four of these activities were considered “highly demanding” and were drawn from a wide variety of water and team sports, martial arts, running/biking, exercise, weight-lifting and fitness training.

Results: The initial study demonstrated that TKR patients participate in a wide range of “high demand” activities. Most commonly, activities requiring increased knee flexion were gardening (58% participation), kneeling (64%), and squatting (39%). Moderate to severe difficulty was reported by 39% (squatting) to 64% (kneeling) of respondents performing these activities. The most common activity which placed increased loads on the affected joint was carrying loaded shopping bags (47% participation), which provoked Significant symptoms in 23% of patients. The expanded nation-wide study showed that after TKR, few patients actually perform high impact competitive sports although many patients perform individual exercise routines which potentially place Significant demands on the knee. The most common of these “high demand” activities were still squatting and kneeling, but also included participation in gym and exercise activities, typically leg extensions (59%), leg curls (35%) and leg press exercises (33%).

Conclusions:

Kneeling and squatting are the most common “high-demand” activities actually performed on a routine basis by patients after TKR