Sex differences in in vivo soft tissue compressive properties of the human hip in young adults: a comparison between...

Hip injuries are a frequent outcome of falls. Studying the biomechanics of hip injuries requires a comprehensive understanding of soft tissue properties and their responses to external loads. Particularly, muscle activity is crucial in arresting a fall and is likely to affect soft tissue properties. Failing to consider muscle activation might result in incorrect conclusions regarding the processes underlying injuries and the efficacy of preventive strategies. Soft tissue response is also affected by loading rate, sex, and mechanical testing protocols, highlighting the need for precise experimental design and interpretation. Forty individuals (age = 25.53 ± 3.41 years) were recruited (20 males and 20 females) to investigate the hip soft tissue response during a high-speed cyclic indentation testing. Muscle activity was recorded using electromyography (EMG) and soft tissue thickness was measured using ultrasound imaging. Peak force, energy, and tissue stiffness were measured using tissue indentation. The hip soft tissue exhibited hysteresis and was nonlinear during loading. Sex differences in trochanteric soft tissue stiffness resulted in males having 38% higher peak force than females and absorbed energy was 32% higher in the active state than the passive state (in combined participants). Characterizing the range of tissue responses for in vivo hip soft tissues emphasizes the natural variability in healthy human tissues and the need to consider the range of tissue behaviors in models, not just the average response. Both sex and muscle activation increased tissue mechanical variability and need to be considered in future physical and computational models of hip impact.