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Hip Joint Stresses Due to Cam-Type Femoroacetabular Impingement: A Systematic Review of Finite Element Simulations
Open accessAbstract
BACKGROUND: The cam deformity causes the anterosuperior femoral head to obstruct with the acetabulum, resulting in femoroacetabular impingement (FAI) and elevated risks of early osteoarthritis. Several finite element models have simulated adverse loading conditions due to cam FAI, to better understand the relationship between mechanical stresses and cartilage degeneration. Our purpose was to conduct a systematic review and examine the previous finite element models and simulations that examined hip joint stresses due to cam FAI. METHODS: The systematic review was conducted to identify those finite element studies of cam-type FAI. The review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and studies that reported hip joint contact pressures or stresses were included in the quantitative synthesis. RESULTS: Nine articles studied FAI morphologies using finite element methods and were included in the qualitative synthesis. Four articles specifically examined contact pressures and stresses due to cam FAI and were included in the quantitative synthesis. The studies demonstrated that cam FAI resulted in substantially elevated contact pressures (median = 10.4 MPa, range = 8.5-12.2 MPa) and von Mises stresses (median 15.5 MPa, range = 15.0-16.0 MPa) at the acetabular cartilage; and elevated maximum-shear stress on the bone (median = 15.2 MPa, range = 14.3-16.0 MPa), in comparison with control hips, during large amplitudes of hip motions. Many studies implemented or adapted idealized, ball-and-cup, parametric models to predict stresses, along with homogeneous bone material properties and in vivo instrumented prostheses loading data. CONCLUSION: The formulation of a robust subject-specific FE model, to delineate the pathomechanisms of FAI, remains an ongoing challenge. The available literature provides clear insight into the estimated stresses due to the cam deformity and provides an assessment of its risks leading to early joint degeneration.
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“Persons with FAI exhibit impaired mobility at the hip (specifically hip flexion) and deficits in gluteal muscle activation.51,53”
From A Biomechanical Review of the Squat Exercise: Implications for Clinical Practice. (2024) · cites this paper as [51]
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“FAI, or abutment or impingement of the femoral neck against the acetabular labrum, can result in chondrolabral damage, thereby contributing to early onset of hip osteoarthritis.51,52”
From A Biomechanical Review of the Squat Exercise: Implications for Clinical Practice. (2024) · cites this paper as [51]
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Metadata
- Authors
- Ng, K. C. G., Lamontagne, M., Labrosse, M. R., & Beaulé, P. E.
- Affiliations
- University of Ottawa (CA)
- Corresponding author
- Lamontagne, Mario
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2016-01-26
- Volume
- 11
- Issue
- 1
- Pages
- e0147813
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4727804
- OpenAlex
- W2266069582
- Cited by
- 54
- References
- 81
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 7 · 2020: 4 · 2019: 5 · 2018: 11 · 2017: 4 · 2016: 4
- FWCI
- 1.58
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- uO Research (University of Ottawa) (submittedVersion, public-domain)
- Spiral (Imperial College London) (submittedVersion, other-oa)
- Funders
- Canadian Institutes of Health Research (97778A)
- Natural Sciences and Engineering Research Council of Canada (106769, 106769-2013)
- Topics
- Health Sciences › Medicine › Surgery › Hip disorders and treatments
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Health Sciences › Medicine › Surgery › Orthopaedic implants and arthroplasty
- Keywords
- cam-type femoroacetabular impingement, von Mises stress, maximum shear stress, hip osteoarthritis, hip biomechanics, finite element model
- MeSH terms
- Hip Joint, Humans, Models, Biological, Stress, Mechanical, Databases, Factual, Finite Element Analysis, Femoracetabular Impingement
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