Re: Influence of head constraint and muscle forces on the strain distribution within the intact femur.

The aim of this study was to analyse the influence of muscle action and a horizontally constrained femoral head on the strain distribution within the intact femur. The strain distribution was measured for three loading configurations: joint reaction force only, joint reaction force plus abductors, and joint reaction force plus the abductors, vastus lateralis and iliopsoas. In each case the strains were recorded from 20 uniaxial strain gauges placed on the medial, lateral, anterior and posterior aspects of the proximal femur. Application of the abductor muscle force produced a marginal decrease in the strain levels on all aspects of the femur as compared with the joint reaction force alone. This is in contrast with previous studies which have simulated an unconstrained femoral head. The inclusion of vastus lateralis and iliopsoas further reduced the strain levels. A horizontally constrained femoral head produces smaller variation in the strain levels when muscle forces are applied. In vivo data, demonstrating negligible movement of the femoral head in one-legged stance, support the results of this study and suggest that in the absence of comprehensive muscle force data, a constrained femoral head may provide a more physiologically relevant loading condition.