Longitudinal Analysis of Hip Joint Contact Pressure in Growing Children using Subject-Specific Multi-Scale In-Silico Simulations
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Mechanical loading plays a central role in skeletal development during childhood. While bone adaptation has been widely studied, considerably less is known about how articular cartilage responds to loading during growth. Finite element studies in pediatric hip dysplasia have demonstrated abnormally high peak contact pressures, yet investigations in typically developing children are scarce and predominantly cross-sectional. Measuring longitudinal changes in physiological hip joint loading is essential for establishing normative reference data, improving our understanding of growth-related joint mechanics, and identifying early deviations that may precede orthopedic disorders. We hypothesized that growth-related increases in body weight are compensated by an increased joint contact area due to bone growth, thereby maintaining relatively stable cartilage contact pressures over time. Nine typically developing children underwent MRI-based anatomical imaging and gait analysis at two time points approximately two years apart. Subject-specific three-dimensional finite element models of the pelvis, femur, and hip cartilage were reconstructed from MRI data using manual bone segmentation and parametric cartilage extrusion. MRI-informed musculoskeletal simulations were used to compute joint kinematics and contact forces during walking, which served as subject-specific boundary and loading conditions for finite element simulations. Peak cartilage contact pressures, defined as the 95th percentile, were evaluated throughout the stance phase of gait at both time points. Preliminary analyses of three participants revealed a trend toward increased cartilage contact pressures over time, contrary to the initial hypothesis. Although qualitative and quantitative differences were observed, statistical significance was not reached due to limited sample size and pronounced inter-subject variability. The proposed longitudinal computational pipeline demonstrates the feasibility of integrating medical imaging, motion analysis, musculoskeletal modeling, and finite element simulation in pediatric cohorts. The emerging normative data will support future comparisons with orthopedic pathologies and may help identify early indicators of abnormal joint loading during growth.
