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Motion Analysis, Cartilage Mechanics, and Biology in Femoroacetabular Impingement: Current Understanding and Areas of Future Research

The effect and interplay of pathomorphology and joint kinematics is increasingly recognized as important in the study of femoroacetabular impingement (FAI). Hip joint kinematics consists of motion analysis at the macroscopic hip joint level. Although overall joint morphology and subject-specific kinematics are important, the cellular mechanobiology of cartilage and the biologic response to cartilage injury are poorly understood and require further study if surgeons are to understand how tissue damage actually occurs. A clearer understanding of these factors may provide the foundation for new treatments that could alter the joint injury associated with FAI. The purpose of this study group was to discuss the current evidence regarding the interaction of hip joint motion, cartilage mechanics, and cartilage biology with FAI and determine future priorities for research in these areas to expand the surgeon's ability to understand and manage this increasingly recognized clinical entity. Specific research needs were identified in four areas: motion analysis (how do muscle contributions to joint loading influence the disease process?), arthrokinematics (what happens at the joint level in vivo?), cartilage mechanics (how do cartilage cells respond to different mechanical stimuli?), and cartilage biology (need to identify biomarkers for cartilage degradation).