MECHANOBIOLOGY OF HIP DYSPLASIA
Wendy S. Foels, *Rory J. Todhunter, Marjolein C. H. van der Meulen
Sibley School of Mechanical and Aerospace Engineering
*Department of Clinical Sciences, Veterinary Medicine
Cornell University
Ithaca, New York
INTRODUCTION
Developmental dysplasia of the hip (DDH) is a common
orthopaedic disease. DDH is characterized by partial or total joint
dislocation in neonates and by a flattened femoral head and a
shallow acetabulum in adults. Left untreated, DDH invariably
results in osteoarthritis. At birth, the hip is composed entirely of
cartilage and has a remarkable potential to adapt to its mechanical
environment. Basic mechanical interventions (e.g. Pavlik harness)
are highly successful (95%) demonstrating that proper mechanical
contact is critical for normal joint development.
The etiologies of human and canine DDH are parallel making
canine DDH a unique model for the study of human hip dysplasia.
DDH offers a valuable opportunity to study the specific timing of
developmental events in relation to mechanical environmental
variables. An early feature of canine DDH is a delay in the onset of
the secondary center of ossification in the femoral head. The
average onset of ossification occurs at 16 days for dysplastic dogs
and 13 days for normal dogs (Todhunter et al., 1997).
The objective of this study was to model the effects of altered
joint loading on the initiation of ossification in the canine femoral
head. We hypothesized that dislocation of the femoral head will
substantially alter mechanical stresses resulting in altered
ossification, specifically a delay in onset.
MATERIALS AND METHODS
Finite element modeling techniques were used to calculate
stresses and predict the initiation of ossification in the early
postnatal canine femoral head. A 2-dimensional plane strain, linear
elastic finite element model (2,616 elements, 2,722 nodes) was
constructed from central, frontal magnetic resonance (MR) and
computed tomography (CT) images of a 2 week old Labrador
Retriever. Cartilage geometry was extracted from the MR image;
bone geometry was extracted from the CT image. Bone tissue
moduli were assigned based on apparent density values obtained
using a density phantom in the CT scan field of view. A
relationship between apparent density and modulus determined by
Kuhn et al. (1989) was used to calculate bone modulus values. The
cartilage modulus was assigned based on literature values.
Representative load cases were generated based on recorded
activities of neonatal pups (Figure 1). The range of activities for the
normal and dysplastic pups was represented by a combination of the
three respective load cases. The number of cycles for each load case
was selected to approximate the daily activity of a neonatal pup.
The total number of cycles applied was 1000 cycles/day. The
activity level and resultant load magnitudes were assumed to be
equivalent for normal and dysplastic pups.
Ossification of the femoral head was simulated by calculating
an ossification index based on hydrostatic (D) and octahedral shear
(S) stresses in the cartilage elements (Carter and Wong, 1988)
(Figure 2). The daily ossification index ( Idaily ) was calculated by
summing the contributions from each cycle of the applied load cases
where
Ncase Ncycle
∑ ∑ (S )
Idaily = ij + kDij .
i=1 j =1
Figure 1: Three load cases used to represent the range of activities
for normal and dysplastic pups.

To determine the temporal progression of ossification, the
ossification index was extended to account for time. Cumulative
ossification index values were calculated for the normal femoral
head at 13 days of age. The maximum index value for normal
ossification was used to normalize the index. The normalized index
was then used to determine the time of initiation of ossification in
the dislocated femoral head. Cartilage elements in which the
cumulative ossification index exceeded the 13 day value were
converted to low density trabecular bone. The time of ossification
onset for the dislocated hip was then compared to that of the normal
hip.
Results
Our simulation results demonstrate that alterations in femoral
head loading due to dislocation result in delayed ossification of the
femoral head. Based on the normal onset at 13 days, the time of
onset calculated for the dislocated femoral head was 14.5 days. The
cumulative index values and the onset of ossification can be seen for
a normal head at 13 days and for a dislocated femoral head at 13,
14, and 15 days of age (Figure 2).
Figure 2: Cumulative ossification index values for normal femoral
ossification events during skeletal development. In past literature,
canine hip dysplasia has been categorized as a purely congenital
disease. Our results demonstrate the importance of the mechanical
environment in the progression of hip dysplasia.
Acknowledgments: Support for this study was provided by a
National Science Foundation Graduate Fellowship (WSF), a
College of Veterinary Medicine Consolidated Research Grant, CU
Veterinary Medicine Radiology, and SUNY Health Sciences Center
NMR Research Laboratory.
REFERENCES
Carter, D. R., and Wong, M., 1988, “The Role of Mechanical
Loading Histories in the Development of Diarthroidal Joints,”
Journal of Orthopaedic Research, Vol. 6, pp. 804-816.
Kuhn, J. L., Goldstein, S. A., Ciarelli, M. J., Matthews, L. S.,
1989, “The Limitations of Canine Trabecular Bone as a Model for
Human: A Biomechanical Study,” Journal of Biomechanics, Vol.
22, pp. 95-107.
Todhunter, R. J., Zachos, T. A., Gilbert, R. O., Erb, H. N.,
Williams, A. J., Burton-Wurster, N., Lust, G., 1997, “Onset of
Epiphyseal Mineralization and Growth Plate Closure in
Radiographically Normal and Dysplastic Labrador Retrievers,”
Journal of the American Veterinary Medical Association, Vol. 210,
pp. 1458-1462.

head at 13 days and dislocated femoral head at 13, 14 and 15 days.

Octahedral and hydrostatic stresses are shown for a normal
femoral head at 13 days.

Discussion
Use of the ossification index has enabled us to predict the time
of onset of ossification for dislocated femoral heads. The delayed
ossification predicted for the dislocated femoral head supports our
hypothesis that an early abnormal mechanical environment will
substantially delay the onset of ossification in dislocated hips. The
predicted delay in onset of ossification was 1.5 days as compared to
3 days measured in our Labrador Retriever colony. The model
accounted for differences in load distribution, but did not include
potential differences in femoral head geometry or load magnitude.
Future analytical and experimental studies will investigate the
effects of altered joint geometry and loading magnitude on the
initiation of ossification in the femoral head.

The predicted delay in ossification supports the theory that

mechanical stimuli play a significant role in the timing of