• 제목/요약/키워드: Hip replacement

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고관절 전치환술을 시행 후 내원한 만성 강직성 척추염 환자 치험 1례 (A Case of Chronic Ankylosing Spondylitis with Total Hip Replacement - A Case Report -)

  • 조윤철;나경원;임세영;유상민;김상덕
    • 대한추나의학회지
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    • 제5권1호
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    • pp.141-150
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    • 2004
  • 본 증례는 약 30년전 임신 후부터 강직성 척추염의 증상이 나타나기 시작하였고, 15년 전부터 경추 부까지 강직이 진행되었으며, 10년전부터 고관절의 침습이 나타났고 이후 계속 강직이 진행되어 좌측 고관절에 전치환술을 시행하고 2주후 본원에 내원한 만성 강직성 척추염 환자로서, 그동안 적절한 치료를 꾸준히 받아오지 못하여 척추부 및 고관절의 강직과 흉협통 뿐 아니라 견관절, 슬관절 및 거의 전신관절에 강직과 통증이 나타났고 식욕부진, 소화 장애와 전신피로감까지 호소하여 증상의 별다른 호진을 기대하기 힘들 것으로 예상하였으나 64일간 본원에 입원하여 한의학적인 치료와 운동요법 및 물리요법으로 이학적 검사상의 호전과 전신증상의 호전을 보였다. 식욕부진, 소화불량, 피로감, 체중감소, 빈혈, 발열(發熱), 도한(盜汗) 등 만성 강직성 척추염 환자에게서 나타날 수 있는 전신증상은 한의학에서 허증(虛證)의 범주에 가깝고, 변증시치를 통한 한의학적인 치료로 전신증상의 개선을 도모하면서 꾸준한 운동치료, 호흡치료 등의 재활치료를 병행한다면 보다 나은 임상적 치료효능을 거둘 수 있을 것으로 생각된다.

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인공고관절 전치환술에서 세라믹 볼 헤드의 기계적 안정성 평가를 위한 유한요소 해석 (Mechanical safety evaluation of ceramic ball head for total hip replacement using finite element method)

  • 한성민;추준욱;전흥재;김정성;최귀원;윤인찬
    • 대한의용생체공학회:의공학회지
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    • 제31권6호
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    • pp.449-455
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    • 2010
  • A ceramic articulating system in total hip replacement thought to be superior to metal-on-polyethylene due to its extremely low coefficient of friction and potential for high resistance to wear. But ceramic is brittle, which makes it mechanically and theoretically susceptible to fracture under certain mechanical conditions. In the current study, nine different models of ceramic ball heads were mechanically evaluated using 3D finite element(FE) analyses. It was found that the maximum stress in all ceramic models was lower than ceramic flexural strength, and it satisfied the requirements of the FDA Gaudience for artificial hip implant. Thus, ceramic ball head models introduced in the current study could be mechanically safe for clinical applications.

인공 고관절 대치술에서 무시멘트형 스템의 원위부 압박이 고관철 성능에 미치는 영향 (The Distal Filling Effects on Hip Jont Function in Cementless Total Hip Replacement)

  • 채수원;박상석;박재원
    • 대한기계학회논문집A
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    • 제24권11호
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    • pp.2777-2785
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    • 2000
  • In cementless total hip replacement(THR), an initial stability of the femoral component is important to long term fixation of femoral stem. The intial stability has close relationship with the relative displacement of prosthessis and sponge bone at the proximal of femur. After implantation of the proshesis, the surrounding bone is partially shielded from load carrying and starts to resorb. Stress shielding is the cause of the loss of proximal bone. Assessing stress distribution of femur is important to predict stress shielding. The initial stability and the stress shielding were investigated for two loading conditions approximating a single leg stance and a stair climbing. Three types of stems were studied by the finite element method to analyze the biomechanical effects of distal filling of cementless femoral stems. Three types of stems empolyed are a distal filling stem, a distal flexible stem, and a distal tapered stem.

대퇴관절 전치환술을 이용하여 개의 재발되는 대퇴관절 탈구증의 치료 (Treatment of Recurrent Coxofemoral Joint Luxation by Total Hip Replacement in a Dog)

  • 김주호;허수영;김민수;이기창;김남수;이해범
    • 한국임상수의학회지
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    • 제31권2호
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    • pp.125-128
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    • 2014
  • 38 kg, 7년령의 골든리트리버가 대퇴관절 탈구증으로 의뢰되었다. 신체검사에서는 왼쪽 뒷다리를 신전시킬 때 통증과 염발음이 확인되었다. 방사선 검사를 통해 왼쪽 대퇴관절 탈구증 및 경도의 퇴행성 골변화가 관찰되었다. 치료로서 TightRope$^{(R)}$를 이용한 최소침습 관절경적 정복을 하였으나, 수술 후 한달이 지나 재탈구가 발생하였다. 이에 대해 무시멘트형 대퇴관절 전치환술을 실시하였다. 수술 후 10개월 경과된 결과, 환자는 정상적으로 앉기, 서기, 보행을 보였으며, 특이한 파행없이 편안하게 뛸 수 있었다. 수술한 뒷다리의 허벅지둘레는 반대쪽 다리의 그것에 비해 108.6%였다. 이 증례를 통해 대퇴관절 전치환술은 대퇴관절 정복이 실패하여 재탈구된 개의 대퇴관절 탈구 치료에 효과적인 수술법이 될 수 있다.

FEM을 이용한 cement type hip implant의 Stem 단면형상에 따른 응력분석 (The Stress analysis for a sectional stem shape of cement type hip implant using the finite element method)

  • 박흥석;이문규;전흥재;최귀원
    • 한국정밀공학회:학술대회논문집
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    • 한국정밀공학회 2006년도 춘계학술대회 논문집
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    • pp.651-652
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    • 2006
  • The choice of suitable hip implant is one of important factors in total hip replacement (THR). In clinical view points, improper adaptation of hip implant might cause abnormal stress distribution to the bone, which can shorten the lifespan of replaced hip implant. Currently, interest in custom-designed hip implants has increased as studies reveals the importance of geometric shape of patient's femur in modeling and designing custom hip implants. In this study, we have developed the custom-designed hip implant models with various sizes in hip implant, and the stress distribution in the bone was analyzed using Finite Elements methods. It was found that minimizing the gap between implant stem and femoral cavity is crucial to minimize stress concentration in the bone.

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Stress Analysis of Femoral Stems on Non-Cemented Total Hip Replacement - A Three-Dimensional Finite Element Analysis -

  • Kim, Sung-Kon;Chae, Soo-Won;Jeong, Jung-Hwan
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1997년도 추계학술대회
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    • pp.263-266
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    • 1997
  • Three dimensional numerical model based on the finite element method(FEM) were developed to predict the mechanical behavior of hip implants. The purpose of this study is to investigate the stress distribution of two types of cementless total hip replacement femoral component -a straight stem and a curved stem, and to compare their effect on the stress shielding between two types by three dimensional finite element method. The authors analyzed von Mises stress in the cortex & stem and compared the stress between the straight and the curved stem. In comparison of stresses between two different design of femoral stem, there was 25% more decrease of stress in straight stem than curved stem in the medial cortex at proximal region. The straight stem had consistently much lower stresses than the curved stem throughout the whole medial cortex with maximum 70% reduction of stress. However, there was little change in stress between nature and 2 implanted femur throughout the lateral cortex. Stress of femoral stem was much higher in the straight stem than the curved stem up to 60%. The straight stem had more chance of stress shielding and a risk of fatigue fracture of the stem compared with the curved stem in noncement hip arthroplasty. In design of femoral stem still we have to consider to develop design to distribute more even stress on the proximal medial cortex.

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기능적 마사지가 엉덩관절 전치환술 환자의 통증, 관절가동범위, 균형능력, 보행속도에 미치는 즉각적인 영향 (The Immediate Effect of Functional Massage on Pain, Range of Motion, Balance Ability and Gait Speed in Patients with Total Hip Replacement)

  • 박시현;정의용
    • 대한정형도수물리치료학회지
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    • 제28권1호
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    • pp.9-17
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    • 2022
  • Background: Functional massage is a therapeutic massage that incorporates joint motion in non-end-range to reduce pain and improve range of motion (ROM) in patients. This study was aimed at investigating the immediate effect of functional massage on pain, range of motion, balance ability and, gait speed of patients having undergone total hip replacement. Methods: Twenty patients were treated by one participating orthopedic manual physical therapist and randomly assigned to the control group (n=10) or the experimental group (n=10). To treat patients of each group, functional massage and range of motion exercises were used. The experimental group received a functional massage and the control group received range of motion exercise for minutes for one session. The visual analog scale was used for pain assessment. Balance ability was measured using a timed up and go test and a one-leg standing test for patients. The 10-meter walk test was used for the measurement of gait speed assessment of patients. Results: Significant improvements were observed in terms of balance ability (p<.05), gait speed (p<.05), and ROM (p<.05) after functional massage. There was no significant inter-group difference (p>.05). Conclusion: Application of the functional massage showed that statistically significant improvements in ROM, gait speed, and balance ability after a single treatment session. This technique may be a useful treatment in patients having undergone total hip replacement.