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Three-dimensional assessment of impingement risk in geometrically parameterised hips compared with clinical measures.

ABSTRACT: Abnormal bony morphology is a factor implicated in hip joint soft tissue damage and an increased lifetime risk of osteoarthritis. Standard 2-dimensional radiographic measurements for diagnosis of hip deformities, such as cam deformities on the femoral neck, do not capture the full joint geometry and are not indicative of symptomatic damage. In this study, a 3-dimensional geometric parameterisation system was developed to capture key variations in the femur and acetabulum of subjects with clinically diagnosed cam deformity. The parameterisation was performed for computed tomography scans of 20 patients (10 female and 10 male). Novel quantitative measures of cam deformity were taken and used to assess differences in morphological deformities between males and females. The parametric surfaces matched the more detailed, segmented hip bone geometry with low fitting error. The quantitative severity measures captured both the size and the position of cams and distinguished between cam and control femurs. The precision of the measures was sufficient to identify differences between subjects that could not be seen with the sole use of 2-dimensional imaging. In particular, cams were found to be more superiorly located in males than in females. As well as providing a means to distinguish between subjects more clearly, the new geometric hip parameterisation facilitates the flexible and rapid generation of a range of realistic hip geometries including cams. When combined with material property models, these stratified cam shapes can be used for further assessment of the effect of the geometric variation under impingement conditions.

SUBMITTER: Cooper RJ

PROVIDER: S-EPMC5724697 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Three-dimensional assessment of impingement risk in geometrically parameterised hips compared with clinical measures.

Cooper Robert J RJ Mengoni Marlène M Groves Dawn D Williams Sophie S Bankes Marcus J K MJK Robinson Philip P Jones Alison C AC

International journal for numerical methods in biomedical engineering 20170405 11

Abnormal bony morphology is a factor implicated in hip joint soft tissue damage and an increased lifetime risk of osteoarthritis. Standard 2-dimensional radiographic measurements for diagnosis of hip deformities, such as cam deformities on the femoral neck, do not capture the full joint geometry and are not indicative of symptomatic damage. In this study, a 3-dimensional geometric parameterisation system was developed to capture key variations in the femur and acetabulum of subjects with clinica ...[more]

PMID: 28112875

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Project description:BackgroundFemoroacetabular impingement (FAI) may constrain hip articulation and cause chondrolabral damage, but to our knowledge, in vivo articulation and femur-labrum contact patterns have not been quantified.PurposeIn this exploratory study, we describe the use of high-speed dual-fluoroscopy and model-based tracking to dynamically measure in vivo hip articulation and estimate the location of femur-labrum contact in six asymptomatic hips and three hips with FAI during the impingement examination. We asked: (1) Does femur-labrum contact occur at the terminal position of impingement? (2) Could range of motion (ROM) during the impingement examination appear decreased in hips with FAI? (3) Does the location of femur-labrum contact coincide with that of minimum bone-to-bone distance? (4) In the patients with FAI, does the location of femur-labrum contact qualitatively correspond to the location of damage observed intraoperatively?MethodsHigh-speed dual-fluoroscopy images were acquired continuously as the impingement examination was performed. CT arthrogram images of all subjects were segmented to generate three-dimensional (3-D) surfaces for the pelvis, femur, and labrum. Model-based tracking of the fluoroscopy images enabled dynamic kinematic observation of the 3-D surfaces. At the terminal position of the examination, the region of minimal bone-to-bone distance was compared with the estimated location of femur-labrum contact. Each patient with FAI underwent hip arthroscopy; the location of femur-labrum contact was compared qualitatively with damage found during surgery. As an exploratory study, statistics were not performed.ResultsFemur-labrum contact was observed in both groups, but patterns of contact were subject-specific. At the terminal position of the impingement examination, internal rotation and adduction angles for each of the patients with FAI were less than the 95% confidence intervals (CIs) for the asymptomatic control subjects. The location of minimum bone-to-bone distance agreed with the region of femur-labrum contact in two of nine hips. The locations of chondrolabral damage identified during surgery qualitatively coincided with the region of femur-labrum contact.ConclusionsDual-fluoroscopy and model-based tracking provided the ability to assess hip kinematics in vivo during the entire impingement examination. The high variability in observed labrum-femur contact patterns at the terminal position of the examination provides evidence that subtle anatomic features could dictate underlying hip biomechanics. Although femur-labrum contact occurs in asymptomatic and symptomatic hips at the terminal position of the impingement examination, contact may occur at reduced adduction and internal rotation in patients with FAI. Use of minimum bone-to-bone distance may not appropriately identify the region of femur-labrum contact. Additional research, using a larger cohort and appropriate statistical tests, is required to confirm the findings of this exploratory study.

Project description:Astronauts may be at an increased risk for developing colorectal cancer after a prolonged interplanetary mission given the potential for greater carcinogenic effects of radiation to the colon. In addition, with an increase in age, there is a greater incidence of premalignant colon adenomas with age. In the present study, we have compared the effects of radiation on human colon epithelial cells in two-dimensional (2D) monolayer culture, in three-dimensional (3D) culture, and in intact human colon tissue biopsies. Immortalized colon epithelial cells were irradiated at the NASA Space Radiation Laboratory (NSRL) with either 1 Gy 1 GeV/nucleon (56)Fe particles or 1 Gy 1 GeV/nucleon protons and were stained at various times to assess DNA damage and repair responses. The results show more persisting damage at 24 h with iron-particle radiation compared to protons. Similar results were seen in 3D colon epithelial cell cultures in which (56)Fe-particle-irradiated specimens show more persisting damage at 24 h than those irradiated with low-LET gamma rays. We compared these results to those obtained from human colon tissue biopsies irradiated with 1 Gy gamma rays or 1 Gy 1 GeV (56)Fe particles. Observations of radiation-induced DNA damage and repair in gamma-irradiated specimens revealed more pronounced early DNA damage responses in the epithelial cell compartment compared to the stromal cell compartment. After low-LET irradiation, the damage foci mostly disappeared at 24 h. Antibodies to more than one type of DNA repair factor display this pattern of DNA damage, and staining of nonirradiated cells with nonphosphorylated DNA-PKcs shows a predominance of epithelial staining over stromal cells. Biopsy specimens irradiated with high-LET radiations also show a pattern of predominance of the DNA damage response in the highly proliferative epithelial cell compartment. Persistent unrepaired DNA damage in colon epithelial cells and the differing repair responses between the epithelial and mesenchymal compartments in tissues may enhance tumorigenesis by both stem cell transformation and alterations in the radiation-induced permissive tissue microenvironment that may potentiate cancer progression.

Project description:Implementation outcome measures are essential for monitoring and evaluating the success of implementation efforts. Yet, currently available measures lack conceptual clarity and have largely unknown reliability and validity. This study developed and psychometrically assessed three new measures: the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM).Thirty-six implementation scientists and 27 mental health professionals assigned 31 items to the constructs and rated their confidence in their assignments. The Wilcoxon one-sample signed rank test was used to assess substantive and discriminant content validity. Exploratory and confirmatory factor analysis (EFA and CFA) and Cronbach alphas were used to assess the validity of the conceptual model. Three hundred twenty-six mental health counselors read one of six randomly assigned vignettes depicting a therapist contemplating adopting an evidence-based practice (EBP). Participants used 15 items to rate the therapist's perceptions of the acceptability, appropriateness, and feasibility of adopting the EBP. CFA and Cronbach alphas were used to refine the scales, assess structural validity, and assess reliability. Analysis of variance (ANOVA) was used to assess known-groups validity. Finally, half of the counselors were randomly assigned to receive the same vignette and the other half the opposite vignette; and all were asked to re-rate acceptability, appropriateness, and feasibility. Pearson correlation coefficients were used to assess test-retest reliability and linear regression to assess sensitivity to change.All but five items exhibited substantive and discriminant content validity. A trimmed CFA with five items per construct exhibited acceptable model fit (CFI = 0.98, RMSEA = 0.08) and high factor loadings (0.79 to 0.94). The alphas for 5-item scales were between 0.87 and 0.89. Scale refinement based on measure-specific CFAs and Cronbach alphas using vignette data produced 4-item scales (?'s from 0.85 to 0.91). A three-factor CFA exhibited acceptable fit (CFI = 0.96, RMSEA = 0.08) and high factor loadings (0.75 to 0.89), indicating structural validity. ANOVA showed significant main effects, indicating known-groups validity. Test-retest reliability coefficients ranged from 0.73 to 0.88. Regression analysis indicated each measure was sensitive to change in both directions.The AIM, IAM, and FIM demonstrate promising psychometric properties. Predictive validity assessment is planned.

Project description:BackgroundThe accurate assessment of total body and regional body circumferences, volumes, and compositions are critical to monitor physical activity and dietary interventions, as well as accurate disease classifications including obesity, metabolic syndrome, sarcopenia, and lymphedema. We assessed body composition and anthropometry estimates provided by a commercial 3-dimensional optical (3DO) imaging system compared to criterion measures.MethodsParticipants of the Shape Up! Adults study were recruited for similar sized stratifications by sex, age (18-40, 40-60, >60 years), BMI (under, normal, overweight, obese), and across five ethnicities (non-Hispanic [NH] Black, NH White, Hispanic, Asian, Native Hawaiian/Pacific Islander). All participants received manual anthropometry assessments, duplicate whole-body 3DO (Styku S100), and dual-energy X-ray absorptiometry (DXA) scans. 3DO estimates provided by the manufacturer for anthropometry and body composition were compared to the criterion measures using concordance correlation coefficient (CCC) and Bland-Altman analysis. Test-retest precision was assessed by root mean square error (RMSE) and coefficient of variation.ResultsA total of 188 (102 female) participants were included. The overall fat free mass (FFM) as measured by DXA (54.1 ± 15.2 kg) and 3DO (55.3 ± 15.0 kg) showed a small mean difference of 1.2 ± 3.4 kg (95% limits of agreement -7.0 to +5.6) and the CCC was 0.97 (95% CI: 0.96-0.98). The CCC for FM was 0.95 (95% CI: 0.94-0.97) and the mean difference of 1.3 ± 3.4 kg (95% CI: -5.5 to +8.1) reflected the difference in FFM measures. 3DO anthropometry and body composition measurements showed high test-retest precision for whole body volume (1.1 L), fat mass (0.41 kg), percent fat (0.60%), arm and leg volumes, (0.11 and 0.21 L, respectively), and waist and hip circumferences (all <0.60 cm). No group differences were observed when stratified by body mass index, sex, or race/ethnicity.ConclusionsThe anthropometric and body composition estimates provided by the 3DO scanner are precise and accurate to criterion methods if offsets are considered. This method offers a rapid, broadly available, and automated method of body composition assessment regardless of body size. Further studies are recommended to examine the relationship between measurements obtained by 3DO scans and metabolic health in healthy and clinical populations.

Dataset Information

Three-dimensional assessment of impingement risk in geometrically parameterised hips compared with clinical measures.

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Three-dimensional assessment of impingement risk in geometrically parameterised hips compared with clinical measures.

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