Verbruggen, SW;
Kainz, B;
Shelmerdine, SC;
Arthurs, OJ;
Hajnal, JV;
Rutherford, MA;
Phillips, ATM;
(2018)
Altered biomechanical stimulation of the developing hip joint in presence of hip dysplasia risk factors.
Journal of Biomechanics
, 78
pp. 1-9.
10.1016/j.jbiomech.2018.07.016.
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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.
| Type: | Article |
|---|---|
| Title: | Altered biomechanical stimulation of the developing hip joint in presence of hip dysplasia risk factors |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jbiomech.2018.07.016 |
| Publisher version: | http://dx.doi.org/10.1016/j.jbiomech.2018.07.016 |
| Language: | English |
| Additional information: | © 2018 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | Musculoskeletal development, Joint biomechanics, Cine MRI, Developmental dysplasia of the hip, Computational model, External cephalic version, ECV |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10058661 |
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