• 제목/요약/키워드: Stem Cup

검색결과 15건 처리시간 0.034초

Dual Mobility Cup for Revision of Dislocation of a Hip Prosthesis in a Dog with Chronic Hip Dislocation

  • Jaemin Jeong;Haebeom Lee
    • 한국임상수의학회지
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    • 제39권6호
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    • pp.390-394
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    • 2022
  • A 6-year-old, 36.5 kg castrated male Golden Retriever presented for revision surgery for left total hip replacement. The patient underwent removal of the cup and head implants due to unmanageable prosthetic hip dislocation, despite revision surgery. On physical examination, the dog showed persistent weight-bearing lameness after exercise of the left hindlimb with mild muscle atrophy. Radiographic examination revealed dorsolateral displacement of the femur with a remnant stem and bony proliferation around the cranial and caudal acetabulum rims. The surgical plan was to apply the dual mobility cup to increase the range of motion and jump distance to correct soft tissue elongation and laxity caused by a prolonged period of craniodorsal dislocation of the femur. The preparation of the acetabulum for cup fixation was performed with a 29-mm reamer, and the 29.5-mm outer shell was fixed with five 2.4-mm cortical screws. The head and medium neck of the dual-mobility system were placed on the cup, and the hip joint was reduced between the neck and stem. The dog exhibited slight weight bearing on a controlled leash walk the day after surgery. The patient was discharged 2 weeks postoperatively without any complications. Six months postoperatively, osseointegration and a well-positioned cup implant were observed, and the dog showed excellent limb function without hip dislocation until 18 months of phone call follow-up.

Surgeon's Experience and Accuracy of Preoperative Digital Templating in Primary Total Hip Arthroplasty

  • Maria Surroca;Silvia Miguela;Agusti Bartra-Ylla;Jorge H. Nunez;Francesc Angles-Crespo
    • Hip & pelvis
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    • 제36권2호
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    • pp.129-134
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    • 2024
  • Purpose: Preoperative planning has become essential in performance of total hip arthroplasty (THA). However, data regarding the effect of the planner's experience on the accuracy of digital preoperative planning is limited. The objective of this study was to assess the accuracy of digital templating in THA based on the surgeon's experience. Materials and Methods: A retrospective study was conducted. An analysis of 98 anteroposterior pelvic radiographs, which were individually templated by four surgeons (two hip surgeons and two orthopaedic residents) using TraumaCad® digital planning, was performed. A comparison of preoperatively planned sizes with implanted sizes was performed to evaluate the accuracy of predicting component size. The results of preoperative planning performed by hip surgeons and orthopaedic residents were compared for testing of the planner's experience. Results: Femoral stem was precisely predicted in 32.4% of cases, acetabular component in 40.3%, and femoral offset in 76.7%. Prediction of cup size showed greater accuracy than femoral size among all observers. No differences in any variable were observed among the four groups (acetabular cup P=0.07, femoral stem P=0.82, femoral offset P=0.06). All measurements showed good reliability (intraclass correlation coefficient [ICC] acetabular cup: 0.76, ICC femoral stem: 0.79). Conclusion: The results of this study might suggest that even though a surgeon's experience supports improved precision during the planning stage, it should not be restricted only to surgeons with a high level of experience. We consider preoperative planning an essential part of the surgery, which should be included in training for orthopaedics residents.

Avoidance of Internal Resonances in Hemispherical Resonator Assemblies from Fused Quartz Connected by Indium Solder

  • 세르게이 사라플로프;이희남;박상진
    • 한국소음진동공학회:학술대회논문집
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    • 한국소음진동공학회 2013년도 춘계학술대회 논문집
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    • pp.835-841
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    • 2013
  • Modern solid-state gyroscopes (HRG) with hemispherical resonators from high-purity quartz glass and special surface superfinishing and ultrathin gold coating become the best instruments for precise-grade inertial reference units (IRU) targeting long-term space missions. Designing of these sensors could be a notable contribution into development of Korea as a space nation. In participial, 40mm diameter thin-shell resonator from high-purity fused quartz, fabricated as a single-piece with its supporting stem has been designed, machined, etched, tuned, tested, and delivered by STM Co. (ATS of Ukraine) several years ago; an extremely-high Q-factor (upto 10~20 millions) has been shown. Understanding of the best way how to match such a unique sensor with inner glass assembly of the gyro means how to use the high potential in a maximal extent; and this has become the urgent task. Inner quartz glass assembly has a very thin indium (In) layer soldered the resonator and its silica base (case), but effects of internal resonances between operational modal pair of the shell-cup and its side (parasitic) modes can notable degrade the potential of the sensor as a whole, instead of so low level of resonator's intrinsic losses. Unfortunately, there are special combinations of dimensions of the parts (so-called, "resonant sizes"), when intensive losses of energy occurs. The authors proposed to use the length of stem's fixture as an additional design parameter to avoid such cases. So-called, a cyclic scheme of finite element method (FEM) and ANSYS software were employed to estimate different combinations of gyro assembly parameters. This variant has no mismatches of numerical origin due to FEM's discrete mesh. The optimum length and dangerous "resonant lengths" have been found. The special attention has been paid to analyses of 3D effects in a cup-stem transient zone, including determination of a difference between the positions of geometrical Pole of the resonant hemisphere and of its "dynamical Pole", i.e., its real zone of oscillation node. Boundary effects between the shell (cup) and 3D short "beams" (inner and outer stems) have been ranged. The results of the numerical experiments have been compared with the classic model of a quasi-hemispherical shell band with inextensional midsurface, and the solution using Rayleigh's functions of the $1^{st}$ and $2^{nd}$ kinds. To guarantee the truth of the recommended sizes to a designer of the real device, the analytical and FEM results have been compared with experimental data for a party of real resonators. The consistency of the results obtained by different means has been shown with errors less than 5%. The results notably differ from the data published earlier by different researchers.

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The Wear Rate and Survivorship in Total Hip Arthroplasty Using a Third-generation Ceramic Head on a Conventional Polyethylene Liner: A Minimum of 15-year Follow-up

  • Bum-Jin Shim;Sung-Jin Park;Chan Ho Park
    • Hip & pelvis
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    • 제34권2호
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    • pp.115-121
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    • 2022
  • Purpose: The purpose of this study was to evaluate the wear and survival rates of third-generation ceramic heads on a conventional ultra-high molecular weight polyethylene liner. Materials and Methods: A total of 160 hips (147 patients with a mean age of 55.9 years) who underwent total hip arthroplasty using the third-generation ceramic head on a conventional polyethylene liner from March 1998 to August 2003 were reviewed retrospectively. Evaluation of the wear rate for 56 hips (49 patients) followed-up for at least 15 years was performed using the PolyWare program version 8 (Draftware Developers, USA). The Kaplan-Meier survivorship was also evaluated. Results: Linear wear and volumetric wear rates were 0.11±0.47 mm/year and 32.75±24.50 mm3/year, respectively. Nine revisions were performed during the follow-up period because of cup or stem loosening. The Kaplan-Meier survival rate, using cup revision or total revision total hip arthroplasty (THA) as the endpoint of analysis, was 93.7% at 15 years and 73.6% at 20 years. Conclusion: Because all revisions were performed between 15 and 20 years in our study, surgeons should pay greater attention to patients who underwent THA with ceramic-on-polyethylene bearing from 15 years postoperatively. Contemporary alumina ceramic on highly cross-linked polyethylene could certainly be a good alternative bearing couple providing better longevity.

조숙 단경 내도복 다수성 풋땅콩 "조평" (A New Short Stem, Lodging Resistance and High Yielding Vegetable Peanut cultivar, "Jopyeong")

  • 배석복;박장환;정영근;정찬식;이명희;이유영;황정동;오세관;김정태;박금룡;김욱환;최규환;이재철;정병준;김호영
    • 한국육종학회지
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    • 제40권1호
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    • pp.63-67
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    • 2008
  • 간식용 대립 땅콩의 선호도가 높음에 따라 대립 양질 다수성 신품종 육성을 위하여 단경 다수성인 'CUP brittle'과 조숙인 '대광'를 인공교배하여 육성한 조평의 주요 특성을 요약하면 다음과 같다. 조평은 버지니아 초형으로 개화기가 빠르고 지상부 생장습성은 직립 단경 다분지성이다. 조평은 대광땅콩에 비해 성숙협수, 성숙협비율등 양호한 등숙특성을 보이며 100립중이 87g인 대립품종이다. 도복은 매우 강한 특성을 나타내며 갈반병, 그물무늬병, 흑반병에 비교적 강하고 낙엽율도 낮아 생육 후기까지 녹엽 유지에 유리하였다. 조평은 단백질이 30.9%, 기름함량이 43.1%이고 양질지방산중 올레산과 리놀산의 비율이 2.1로 산화안정성이 양호한 특성을 가진다. 조평은 3년간 지역적응시험 결과 대광땅콩에 비하여 전국평균 8.37ton/ha로서 11% 증수되었다. 조평은 개화가 빠르고 병해에도 강한 편이나 충분한 성숙을 위하여 강원도와 산간 고냉지를 제외한 지역에서 적응성이 높은 품종이다

일반 수술 침대와 짧은 대퇴 주대를 이용한 인공 고관절 전 치환술의 직접 전방 도달법과 변형된 전 측방 도달법에 따른 결과 비교 (Comparison of the Outcomes after Primary Total Hip Arthroplasty Using a Short Stem between the Modified Anterolateral Approach and Direct Anterior Approach with a Standard Operation Table)

  • 박명식;윤선중;최승민;조홍만;정우철;강경록
    • 대한정형외과학회지
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    • 제54권3호
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    • pp.244-253
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    • 2019
  • 목적: 일반 수술용 침대와 길이가 짧은 대퇴 주대(short stem)를 이용하여 인공 고관절 전 치환술을 직접 전방 도달법(direct anterior approach, DAA)을 이용하여 시행하고, 임상적 영상의학적 결과를 변형된 전 측방 도달법(modified Hardinge; anterolateral approach, ALA)을 시행한 경우와 비교하여 알아보고자 하였다. 대상 및 방법: 2013년 1월부터 2015년 11월까지 단일 술자가 DAA로 인공 고관절 전 치환술을 시행한(DAA group) 102명(102예)과 동 수의 ALA를 사용한 환자(ALA group)를 후향적으로 비교 분석하였다. 수술시간과 출혈량을 비교하였고, 수술 후 통증의 개선 정도와 보행 능력 및 고관절의 기능 회복을 알아보았다. 영상의학적으로 비구 컵과 대퇴 주대의 삽입 위치를 평가하였고, 두 군 간에 발생한 합병증을 알아보았다. 결과: 출혈량은 DAA group에서 유의하게 적었다(p=0.018). 수술 후 3주까지는 하지 근력의 회복이 DAA group에서 유의하게 높았다(굴곡/신전력 p=0.023, 외전력 p=0.031). Harris hip score를 이용한 기능 평가는 3개월까지(p≤0.001), Koval score를 이용한 보행 능력 평가는 6주까지(p≤0.001) DAA group에서 유의하게 나은 결과를 보였고, visual analogue scale score를 이용한 통증의 개선은 7일까지는 DAA group에서 유의하게 높았다(p=0.035). 비구 컵의 경사각(p≤0.001)과 전염각(p≤0.001)은 DAA group에서 ALA group보다 더 안정 범위에 위치하였고, 대퇴 주대의 위치와 하지 길이는 통계적 유의한 차이를 보이지 않았다. DAA group에서 수술 중 2예의 대전자 골절이 발생하였다(p=0.155). 결론: 길이가 짧은 대퇴 주대를 이용하여 일반 수술 침대에서 시행하는 DAA는 수술 후 조기 기능 회복을 보이며, 술자에게 친숙한 해부학적 자세로 수술 중 영상 증폭기 사용이 간편하여 원하는 위치에 인공 관절물을 삽입하는 것과 하지 부동 방지에 유용한 도달법으로 생각된다.

세라믹 대퇴 골두 및 교차결합 초고분자량 폴리에틸렌 라이너를 이용한 65세 이상 무시멘트형 인공 고관절 전치환술: 최소 5년 중기 추시 결과 (Cementless Total Hip Arthroplasty Using Ceramic Femoral Head on Cross-Linked Ultra-High-Molecular Weight Polyethylene Liner in Patients Older than 65 Years: Minimum Five-Year Follow-Up Results)

  • 윤호현;정지영;심현보;박재홍
    • 대한정형외과학회지
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    • 제53권6호
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    • pp.490-497
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    • 2018
  • 목적: 65세 이상 노인 환자들을 대상으로 세라믹 대퇴 골두 및 교차결합 폴리에틸렌 라이너를 인공 관절면으로 사용한 무시멘트형 인공 고관절 전치환술의 최소 5년 이상 임상 및 방사선 추시 결과들을 분석하여 세라믹-폴리에틸렌 관절면의 유용성 여부를 알아보고자 하였다. 대상 및 방법: 2010년 3월부터 2012년 9월까지 65세 이상 노인 환자 51명(56 고관절)을 대상으로 후향적 연구를 진행하였다. 평균 연령은 $70.9{\pm}5.1$세였다. 임상 평가는 Harris hip score를 이용하였고, 방사선 평가는 비구 컵 경사각 및 전염각, 대퇴 스템 정렬 상태, 마모를 측정하였다. 수술 후 합병증 발생 유무도 조사하였다. 결과: 임상 평가상 Harris hip score는 수술 전 평균 48점에서 최종 추시 시 평균 87점으로 향상되었다(p<0.05). 방사선 평가상 평균 비구 컵 경사각은 $40.9^{\circ}{\pm}6.4^{\circ}$, 평균 비구 컵 전염각은 $20.3^{\circ}{\pm}8.1^{\circ}$였다. 거상 라이너를 사용한 16예에서 평균 비구 컵 전염각은 $14.3^{\circ}{\pm}7.9^{\circ}$, 중립 라이너를 사용한 40예에서 평균 비구 컵 전염각은 $22.4^{\circ}{\pm}9.1^{\circ}$였다(p<0.05). 평균 대퇴 스템 정렬각은 $0^{\circ}$도(범위, 내반 $4^{\circ}$-외반 $4^{\circ}$)였다. 평균 선상 마모량은 $0.458{\pm}0.041mm$였으며 평균 연간 선상 마모율은 $0.079{\pm}0.032mm/yr$였다. 수술 후 합병증으로 대퇴 스템 주위 골절 6예(10.7%)가 발생하였다. 결론: 본 연구 결과 분석상 탈구나 세라믹-폴리에틸렌 관절면에서 기인한 합병증이 없으므로 65세 이상 노인 환자에서 무시멘트형 인공 고관절 전치환술 시행 시 세라믹-폴리에틸렌 관절면을 유용하게 사용할 수 있으나 수술 중 대퇴 스템 주위 골절 발생을 방지하기 위한 좀 더 세심한 노력이 필요하다.

줄기가 강하고 밝은 화색의 절화용 안개꽃 '더블샤인' 육성 (A New Cultivar of Gypsophila paniculata 'Double Shine' with Bright Colored Flower and Strong Stem)

  • 정동춘;최창학;송영주;임회춘;김정만;이진재;이정수
    • 원예과학기술지
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    • 제30권1호
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    • pp.93-96
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    • 2012
  • 1999년 'Bristol Fairy' 유래의 결실되는 아조변이체인 'Gyp99' 계통을 선발하였고, 계통의 실생 중 선발을 거듭한 결과, 특성이 우수한 'Gyp08-63' 계통을 선발하여 2년간 특성검정을 통해 'Double Shine' 품종을 육성하였다. 'Double Shine' 품종의 초형은 개장형이고, 잎 모양은 둥근 피침형, 소화는 꽃잎수가 많고 암술이 2개인 밝은 백색 겹꽃으로 꽃잎은 주걱형, 꽃받침 모양은 컵형인 식물체 고유 특성을 가졌다. 또한 화경이 단단하고, 흰가루병과 충해에도 강한 편이다. 여름절화 작형에서 'Double Shine' 개화는 대조품종인 'Bristol Fairy'보다 16일 늦고 절간장과 화경장이 길었으며, 측지 분화가 많고 줄기가 굵고 분지각은 작았고, 기형화 발생이 없었다.

맞춤형 인공관절 설계를 위한 인체 고관절의 3차원 형상 정보 추출 (Extracting 3D Geometry Parameters of Hip Joint for Designing a Custom-Made Hip Implant)

  • 서정우;전용태
    • 한국CDE학회논문집
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    • 제13권3호
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    • pp.200-208
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    • 2008
  • Total Hip Replacement(THR) is a surgical procedure that replaces a diseased hip joint with a prosthesis. A plastic or metal cup forms the socket, and the head of the femur is replaced by a metal ball on a stem placed inside the femur. Due to the various types and shapes of human hip joint of every individual, a selected commercial implant sometimes may not be the best-fit to a patient, or it cannot be applied because of its discrepancy. Hence extracting geometry parameters of hip joint is one of the most crucial processes in designing custom-made implants. This paper describes the framework of a methodology to extract the geometric parameters of the hip joint. The parameters include anatomical axis, femoral head, head offset length, femoral neck, neck shaft angle, anteversion, acetabulum, and canal flare index. The proposed system automatically recommends the size and shape of a custom-made hip implant with respect to the patient's individual anatomy from 3D models of hip structures. The proposed procedure creating these custom-made implants with some typical examples is precisely presented and discussed in this paper.

내마모성이 향상된 기능성 표면구조를 갖는 인공관절에 관한 기초적인 연구 (A Basic Study on Functional Friction Surface of Artificial Joints)

  • 김동욱
    • 대한의용생체공학회:의공학회지
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    • 제22권6호
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    • pp.519-526
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    • 2001
  • At present. about 0.3 million and more THRs (Total Hip Replacement) in a rear are being done worldwide. The increase in mechanical failure with the increase in THR, required more revisions. Revisions compensate mainly the wear of the artificial joint frictional surface and the loosening of the cup and stem. According to recent researches, loosening is mainly due to wear debris UHMWPE (Ultra High Molecular Weight Polyethylene) from frictional surfaces . To overcome the wear problems associated with artificial joint materials , new surface structures with regular Patterns were designed and fabricated The lubrication Properties were examined to evaluate the wear of the frictional surfaces. The surface structure manifested a Pattern of "dents" with a 0.2-1.0 mm of diameter and 0.6-2.0 mm of Pitch. From the friction test of the SUS316L vs UHMWPE using the frictional tester, we found that the lubrication Performance was improved due to of drastically reduced amount of abrasion. There were optimum sizes for the diameter and the pitch of the Pattern. The results demonstrated that the lubrication properties could be improved by Patterning of the frictional surfaces. The surface Patterning was effective in preventing wear of the frictional surfaces, and the life of an artificial joint could be extended with such Patterning.

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