Biomechanical Analysis of the Impact of Lower Limb Length Discrepancy on Hip and Lumbar Spine Joints in Children
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 100
- 试验地点
- 1
- 主要终点
- Asymmetry of Hip Joint Contact Forces (%) in Static Standing
研究概览
简要总结
Lower limb length discrepancy (LLD) is a frequent condition in pediatric orthopedics. Even moderate discrepancies can induce pelvic obliquity and compensatory scoliosis, modifying the distribution of joint loads at the hips and lumbar spine. These biomechanical imbalances are suspected to contribute to early degenerative conditions such as osteoarthritis or chronic low back pain.
The aim of this study is to quantify the biomechanical impact of LLD in children aged 10 to 15 years, using a combination of low dose biplanar EOS imaging (EOS Imaging System) and synchronized ground reaction force (GRF) measurements from integrated force platforms. These data will be used in musculoskeletal models developed in collaboration with the Biomechanics and Impact Mechanics Laboratory (LBMC, Laboratoire de Biomécanique et Mécanique des Chocs), enabling the estimation of hip joint and lumbar intervertebral disc loads.
This is the first pediatric study integrating EOS imaging, force platforms, and personalized musculoskeletal modeling to explore the mechanical consequences of LLD. The findings are expected to improve clinical reasoning and guide early therapeutic strategies.
详细描述
Lower limb length discrepancy (LLD) is a frequent condition in pediatric orthopedics. Even moderate discrepancies can induce pelvic obliquity and compensatory scoliosis, modifying the distribution of joint loads at the hips and lumbar spine. These biomechanical imbalances are suspected to contribute to early degenerative conditions such as osteoarthritis or chronic low back pain.
The aim of this study is to quantify the biomechanical impact of LLD in children aged 10 to 15 years, using a combination of low dose biplanar EOS imaging (EOS Imaging System) and synchronized ground reaction force (GRF) measurements from integrated force platforms. These data will be used in musculoskeletal models developed in collaboration with the Biomechanics and Impact Mechanics Laboratory (LBMC, Laboratoire de Biomécanique et Mécanique des Chocs), enabling the estimation of hip joint and lumbar intervertebral disc loads.
A temporary orthopedic compensation (shoe lift) will also be tested to assess its immediate biomechanical effect. Participants will be evaluated at baseline (two EOS acquisitions: with and without compensation) and at 2 years (without compensation).
This is the first pediatric study integrating EOS imaging, force platforms, and personalized musculoskeletal modeling to explore the mechanical consequences of LLD. The findings are expected to improve clinical reasoning and guide early therapeutic strategies.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 10 Years 至 15 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Children aged 10-15 years
- •Anatomical LLD > 5 mm, clinically measured
- •EOS imaging indicated by the pediatric orthopedic surgeon in routine care
- •Ability to stand still for 30 seconds without assistance
- •Covered by social security
- •Parental consent and non-opposition obtained
排除标准
- •- Functional or postural LLD without true anatomical discrepancy
- •History of major pelvic or spinal surgery
- •Severe neurological or orthopedic condition preventing standing (e.g. cerebral palsy, progressive myopathy)
- •Fixed equinus deformity preventing plantar support
- •Major lower limb deformity (severe genu varum/valgum)
- •Contraindication or inability to undergo EOS imaging
研究组 & 干预措施
Children with lower limb length discrepancy (LLD)
Pediatric patients aged 10-15 years with an anatomical LLD > 5 mm, evaluated in the routine pediatric orthopedic care pathway.
干预措施: EOS Imaging System (Radiation)
Children with lower limb length discrepancy (LLD)
Pediatric patients aged 10-15 years with an anatomical LLD > 5 mm, evaluated in the routine pediatric orthopedic care pathway.
干预措施: Force Platform (Bertec®, integrated into EOS cabin) (Device)
结局指标
主要结局
Asymmetry of Hip Joint Contact Forces (%) in Static Standing
时间窗: At baseline (Day 0, without compensation)
Hip joint contact force asymmetry index (%): calculated as AI (%) = 100 × (F\_long - F\_short) / \[(F\_long + F\_short)/2\], where F\_long and F\_short are side-specific resultant hip joint contact forces (estimated by musculoskeletal modeling from EOS imaging and ground reaction force data). Units: percent (%).Higher values indicate greater asymmetry.
次要结局
未报告次要终点