• 제목/요약/키워드: Total Hip Replacement(THR)

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Mid-term Results of Total Hip Arthroplasty for Posttraumatic Osteoarthritis after Acetabular Fracture

  • Sharath K. Ramanath;Tejas Tribhuvan;Uday Chandran;Rahul Hemant Shah;Ajay Kaushik;Sandesh Patil
    • Hip & pelvis
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    • 제36권1호
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    • pp.37-46
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    • 2024
  • Purpose: The prognosis of total hip replacement (THR) after open reduction and internal fixation (ORIF) versus THR following non-operative treatment of acetabular fractures is unclear. Few studies have been conducted in this regard. Therefore, the purpose of the current study was to perform an assessment and compare the functional outcomes for study subjects in the ORIF and non-ORIF groups during the follow-up period compared to baseline. Materials and Methods: This longitudinal comparative study, which included 40 patients who underwent THR for either posttraumatic arthritis after fixation of an acetabular fracture or arthritis following conservative management of a fracture, was conducted for 60 months. Twenty-four patients had undergone ORIF, and 16 patients had undergone nonoperative/conservative management for acetabular fractures. Following THR, the patients were followed up for monitoring of functional outcomes for the Harris hip score (HHS) and comparison between the ORIF and non-ORIF groups was performed. Results: The HHS showed significant improvement in both ORIF and non-ORIF groups. At the end of the mean follow-up period, no significant variation in scores was observed between the groups, i.e., ORIF group (91.61±6.64) compared to non-ORIF group (85.74±11.56). A significantly higher number of re-interventions were required for medial wall fractures and combined fractures compared to posterior fractures (P <0.05). Conclusion: THR resulted in improved functional outcome during follow-up in both the groups; however, the ORIF group was observed to have better functional outcome. Re-intervention was not required for any of the posterior fractures at the end of the mean follow-up period.

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.

인공고관절 골흡수로 인한 응력분포 변화의 2차원 유한요소 해석 (Two-Dimensional Finite Element Analysis of Bone Resorption from the Artificial Hip Replacement)

  • 최형연;채수원;김성곤
    • 대한의용생체공학회:의공학회지
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    • 제16권1호
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    • pp.25-32
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    • 1995
  • Clinically, proximal bone resorption in the femur is frequently seen postoperatively on the follow up XI-rays after total hip replacement (THR). We developed the finite element model of cementless THR. The model is two dimensional side plate model, whereby the three dimensional structural integrity of the bone can be accounted for by a separate two dimensional mesh, a side plate. The subject of this article is the development and application of this two dimensional side plate FEM to study the reverse effect of the various degree of bone resorption of femur after THR. The results of this study indicates that 1) two dimensional side plate model is good and simple alternative to complex three dimensional model and 2) the severity of the proximal bone resorption has the effect of more increasing stress on the cortex at the level of femoral stem tip.

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Effects of Squat Exercise according to Weight Support on Balance and Gait in Patients after Total Hip Replacement: a Pilot Study

  • Kim, So Yeong;Cho, Woon Su;Kim, Byeong Geun
    • The Journal of Korean Physical Therapy
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    • 제34권3호
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    • pp.104-109
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    • 2022
  • Purpose: The purpose of this pilot study is to identify the problems and stability of a study to investigate "Effects of Squat Exercise according to Weight Support on Balance and Gait in Patients after Total Hip Replacement." before proceeding with the study. Methods: Twenty-two rehabilitation patients after THR surgery who met the selection criteria participated. The study subjects were randomly assigned to a squat group using a slider or a squat group using a reformer. The interventions were applied for two weeks. The patients were assessed using Berg balance scale (BBS), Timed up and go test (TUG), and 10-meter walking test (10MW). Results: Although twenty-two study subjects participated in this study, eight study subjects participated dropouts occurred during the study period. There was a significant difference within the group in BBS and TUG in two groups (p<0.05). The difference between the two groups was not significant in all outcome measures (p>0.05). The largest effect size was 1.21 and the smallest effect size was 0.39, all from the BBS. Conclusion: This pilot study suggest that it is feasible with minor adjustment to conduct a larger scale, powered RCT to examine the efficacy of squat exercise according to weight support with patients after THR.

2차원 Side Plate FEM을 이용한 인공고관절 골흡수 연구 (A Study on the Bone Resorption of Artificial Hip Replacement by Two-Dimensional FEM)

  • 최형연;채수원;김성곤
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1994년도 추계학술대회
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    • pp.75-78
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    • 1994
  • Clinically, proximal bone resorption in the femur is frequently seen postoperatively on the follow up X-rays after total hip replacement(THR). We developed the finite element model of cementless THR. The model is two dimensional side plate model, whereby the three dimensional structural integrity of the bone can be accounted for by a separate two dimensional mesh, a side plate. The subject of this article is the development and application of this two dimensional side plate FEM to study the reverse effect of the various degree of bone resorption of femur after THR. The results of this study indicates that two dimensional side plate model is good and simple alternative to complex three dimensional model and the severity of the proximal bone resorption has the effect of more increasing stress on the cortex at the level of femoral stem tip.

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등쪽 관골절구 결손을 가진 진도견의 인공 대퇴 관절 전치환술 (Total Hip Replacement in a Jindo Dog with Dorsal Acetabular Rim Deficiency: a Case Report)

  • 허수영;이해범
    • 한국임상수의학회지
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    • 제31권2호
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    • pp.121-124
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    • 2014
  • 7년령의 암컷 진도견이 뒷다리 파행을 주증으로 내원하였다. 신체검사상에서 대퇴관절의 신전시 염발음과 통증을 보였고 방사선 검사상에서 양측 대퇴 관절 이형성증에 의한 퇴행성 관절염과 오른쪽 부위의 전측 대퇴 탈구를 보여 주었다. 오른쪽 관절의 탈구의 치료를 위해 인공 대퇴 관절 전치환 술을 실시하였다. 수술 중 오른쪽 등쪽 관절절구의 결손으로 인한 인공 관절절구 컵의 탈구의 위험성을 확인하고 등쪽 관절절구의 결손을 잠김 금속판과 골시멘트를 이용하여 보강하였다. 수술 후 환자는 성공적인 결과를 보여주었다. 또한 오른쪽 대퇴관절의 관절 운동 범위과 근육량이 개선 되었다. 등쪽 관골절구 결손을 가진 대퇴 관절 탈구에서 잠김 금속판과 골시멘트 이용하여 인공 대퇴관절 전치환술을 성공적으로 실시하였다. 본 증례와 같은 수술 기법이 등쪽 관골절구 결손이 있을 시 사용될 수 있다고 생각된다.

대퇴골 근위부 골흡수가 인공 고관절 대퇴 stem에 미치는 응력에 관한 연구-FEM을 이용한 분석 (A Finite Element Analysis of Stress on the Femoral Stem with Resorption of Proximal Medial Femur after Total Hip Replacement)

  • 김성곤
    • 대한의용생체공학회:의공학회지
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    • 제15권2호
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    • pp.183-188
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    • 1994
  • In clinical orthopaedics, bone resoption in the cortex is often seen post operatively on X-rays or bone densitometry after total hip replacement (THR) in the form of cortical osteoporosis or atropy. Stress shielding of bone occurs, when a load, normally carried by the bone alone, is shared with an implant as a result, the bone stresses are abnormal and with remodelling analysis this may cause extensive proximal bone resoption, possibly weakening the bone bed to the point of failure. The author made finite element models of the cemented and non-cemented type implanted femoral stem with bone resorption of the proximal medial femur and studied the feed back effect of the various degree of bone resoption to THR system by parametric analysis on the stress of the femoral stem and interface. The results of the present finite element analysis implied that the extent of proximal bone resorption has the effect of more increasing stress on the distal stem tip, cement mantle and interface in both type of femoral stem and this high distal stress possibly can cause the mechanical failure of loosening or failure after THR.

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고관절 인공관절 치환술 환자의 보행능력 증진을 위한 문제해결 접근: ICF Tool을 적용한 단일사례연구 (The Problem-Solving Approach for Improving Walking Ability in Patient with Total Hip Replacement: Applied ICF Tool for Case Study)

  • 송현승;김선엽
    • 대한정형도수물리치료학회지
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    • 제21권2호
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    • pp.63-71
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    • 2015
  • Background: The purpose of the study, using the ICF Tool in the process of rehabilitation of artificial joint replacement surgery of the hip joint, goal setting and understanding of the problem, through the process of creating intervention strategies, useful clinical practical course for rehabilitation I try to present the data. Methods: Fracture was the left total hip replacement (THR) surgery due to women of 76 years old. I proceed in order screening, evaluation, diagnosis, prognosis, treatment planning and intervention, re-screening. Needs of the patient was walking short distances for using the toilet. In order to improve was carried out arbitration, after you have created a list of issues that limit the ability to walk short distances. Results: It was revealed improved results in self-paced walk test (SPWT) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to examine whether the goals. In addition, MMT VAS, DGI, and TUG is a detailed goal was improved. Conclusions: It can be shown objectively the results of interventions performed for the purpose of solving the problem which is grasped through clinical Practical course for short-range walking ability enhance patient THR. I considered practical clinical course using the ICF Tool would be useful.

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