Mathematical modeling as a tool for studying pelvic girdle muscle function in dysplastic coxarthrosis

Authors

  • А.А. Тyazhelov State Institution “Sytenko Institute of Spine and Joint Pathology of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine
  • М.Yu. Karpinsky State Institution “Sytenko Institute of Spine and Joint Pathology of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine
  • D.A. Yurchenko Donetsk National Medical University, Lyman, Donetsk Region, Ukraine
  • O.D. Karpinska State Institution “Sytenko Institute of Spine and Joint Pathology of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine
  • L.E. Goncharova Donetsk National Medical University, Lyman, Donetsk Region, Ukraine

DOI:

https://doi.org/10.22141/1608-1706.1.23.2022.876

Keywords:

dysplastic coxarthrosis, pelvic girdle muscles, hip joint

Abstract

Background. Dysplastic coxarthrosis in adult patients is characterized by changes in geometric parameters, proximal femur, acetabulum and their ratios. When changing the geometric parameters of the hip joint, the angles of muscles attachment and their moment arms change too, which determines the peculiarities of the pelvic girdle muscle functioning. The purpose of the work: substantiation and construction of a mathematical model of pelvic girdle muscles in dysplastic coxarthrosis. Materials and methods. The basic physical model of the pelvis and lower extremity was created to simulate the work of pelvic girdle muscles in dysplastic coxarthrosis. A change in the hip joint parameters was performed according to the data of previous radiography of 49 hip joints of adult patients with dysplastic coxarthrosis. For each of the muscles, the parameters of its work and its contribution into maintaining the horizontal balance of the pelvis were determined, the equation of a balance of moment arms of pelvic girdle muscles was compiled and the work of all pelvic girdle muscles specified in the model was analyzed. Results. Each of the muscles that ensure the horizontal ba-
lance of the pelvis, normally (at a patient’s weight of 80 kg) develops
an effort that is about half of its maximum possible strength, i.e. all muscles work with at least twice the margin of safety. Increasing the patient’s weight by 20–25 % (up to 100 kg or more) significantly impairs muscle performance. They are forced to use more than 70–80 % of their absolute strength, which dramatically reduces their endurance and efficiency. In mild dysplasia (Crowe type 1), each of the analyzed muscles develops effort that is only a third less than its absolute values. Increasing the patient’s weight by 20 % requires almost maximum efforts from all muscles. And further weight gain requires efforts that exceed the capabilities of the muscle. In severe hip dysplasia (Crowe type 3), the muscles are unable to cope with maintaining the horizontal balance of the pelvis. Patients will be forced to use additional support or adaptive mechanisms to facilitate movement. Conclusions. The mathematical model of pelvic girdle muscle in hip dysplasia developed by us reflects the clinical manifestations of dysplastic coxarthrosis and allows studying the peculiarities of pelvic girdle muscle function before and after arthroplasty of a dysplastic hip. Changing the geometric parameters of the hip joint leads to dysfunction of the pelvic girdle muscles and reduces the efficiency of the abduction mechanism. Geometric changes in the hip joint have the most significant negative impact on the work of the pelvic girdle muscles that increase the moment arm of gravity and reduce the moment arm of the abductor muscles. Correction of these parameters in hip arthroplasty improves the biomechanical conditions of the pelvic girdle muscles and increases the efficiency of the abduction mechanism. The results showed how dysplastic changes in the hip joint negatively affect the work of the pelvic girdle muscles, proved that the most important factors in the effective operation of the abduction mechanism are muscle strength and weight of the patient. And it is these factors that have a critical impact on the work of the pelvic girdle muscles in terms of maintaining the horizontal balance of the pelvis.

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Published

2022-05-16

How to Cite

Тyazhelov А., Karpinsky М., Yurchenko, D., Karpinska, O., & Goncharova, L. (2022). Mathematical modeling as a tool for studying pelvic girdle muscle function in dysplastic coxarthrosis. TRAUMA, 23(1), 4–11. https://doi.org/10.22141/1608-1706.1.23.2022.876

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Section

Original Researches

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