• 제목/요약/키워드: Total Hip Replacement

검색결과 123건 처리시간 0.025초

인공 고관절 전치환술에서 주대-시멘트 경계층의 접착 및 비접착 고정술의 비교를 위한 실험적 연구 (The Comparison of Bonded/Unbonded Stem-Cement Interface in Total Hip Replacement -Experimental Study)

  • 한준호;윤용산;이정주
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2001년도 춘계학술대회논문집A
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    • pp.951-955
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    • 2001
  • The experimental comparison between bonded and unbonded types stem-cement interface was carried out on axisymmetric stem-cement-aluminum model of the femoral component of a total hip replacement. Human femur was modeled in non-tapered and tapered($7.5^{\circ}$) aluminum hollow cylinders to emulate the diaphyseal and metaphyseal segments of the femur. For unbonded type, we tested stems with three different taper angles($5^{\circ},\;7.5^{\circ},\;10^{\circ}$). In every case, the cement-aluminum interface was designed to endure 8MPa shear strength. (a measured value at cement-bone interface) We tested aluminum models under axial loading for both cases. As an experimental result, it was found that unbonded stem sustained more axial load as bonded stem in both cases, diaphyseal and metaphyseal models. The unbonded types failed in cement mantle under axial compressive load, while the bonded ones failed in shear at cement-aluminum interface. These results suggest that a polished stem will sustain much higher axial load than a roughened stem. And a polished stem will make more stable cement-bone interface that may promote better osteosythesis around the stem.

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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.

The Effect of Squat Exercise Using a Reformer on Muscle Strength, Range of Motion, and Gait in Patients who Underwent Total Hip Replacement Surgery : A Pilot Study

  • Se-Ju Park
    • 한국컴퓨터정보학회논문지
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    • 제28권12호
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    • pp.183-189
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    • 2023
  • 본 연구의 목적은 리포머를 이용한 스쿼트 운동이 엉덩관절전치환술 환자의 근력, 관절가동범위 그리고 보행 능력에 미치는 영향을 알아보고자 하였다. 본 연구는 G시 소재의 재활병원에 입원 중인 환자 20명을 대상으로 실험을 실시하였다. 중재 방법으로 주 7회 2주간 실험군은 리포머를 이용한 스쿼트 운동을, 대조군은 스쿼트 운동을 시행하였다. 리포머군의 그룹 내 비교에서는 엉덩관절 굽힘, 폄, 벌림 근력에서 유의한 차이가 있었다(p<0.05). 리포머군의 엉덩관절 폄과 벌림의 관절가동범위와 보행에서도 그룹 내 유의한 차이가 있었다(p<0.05). 그룹 간 비교에서는 엉덩관절 폄 근력, 엉덩관절 폄, 벌림 관절가동범위 그리고 보행에서 유의한 차이가 발생하였다(p<0.05).

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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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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Comparative study by the finite element method of three activities of a wearer of total hip prosthesis during the postoperative period

  • Abdelmadjid Moulgada;Mohammed El Sallah Zagane;Murat Yaylaci;Ait Kaci Djafar;Sahli Abderahmane;Sevval Ozturk;Ecren Uzun Yaylaci
    • Structural Engineering and Mechanics
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    • 제87권6호
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    • pp.575-583
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    • 2023
  • The postoperative period for a carrier of total hip prosthesis (THP), especially in the first months, remains the most difficult period for a patient after each operation, even if traumatologist surgeons want the relief and success of their operations. In this investigation, selected three of the daily activities for a wearer of total hip replacement (THR), such as sitting in a chair, lifting a chair, and going downstairs, and was performed a numerical simulation by finite elements based on experimental data by Bergmann (Bergmann 2001) in terms of effort for each activity. Different stresses have been extracted, and a detailed comparison between two activities with different induced stresses such as normal, tensile, and compressive shear stresses.

CT기반 3차원 모델을 이용한 고관절 운동범위 예측 (Hip Range of Motion Estimation using CT-derived 3D Models)

  • 이연수
    • 한국방사선학회논문지
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    • 제12권1호
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    • pp.115-122
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    • 2018
  • 본 연구에서는 CT영상기반 3차원 고관절모델을 이용한 컴퓨터시뮬레이션을 통해서 고관절의 운동범위(Range of Motion)를 측정하는 방법을 제시하였다. 본 연구에서는 그 측정방법에 대한 기술적인 사항을 제시하고, 그 기술이 재현성 있게 실현할 수 있도록 대퇴골두 중심점의 결절, 대퇴골 외전(Abduction)/내전(adduction)회전축, 굽힙(flexion)/신전(extension) 회전축을 정의하고 측정하는 명확한 방법을 제시하였다. 외전각은 해부학적인 시상면(Sagittal plane)상의 Anterior-Posterior축에 대해 아래쪽(Inferior)면으로부터 Lateral 쪽으로의 회전각으로 정의된다. 최대외전각은 대퇴골두가 엉덩이뼈(Pelvis)의 절구(Acetabulum)의 테두리와 겹치지 않고 Anterior-Posterior축을 중심으로 회전할 수 있는 최대 외전각으로 결정된다. 굴곡각은 해부학적인 관상면(Coronal plane)상의 Medial-Lateral축에 대해 아래쪽(Inferior)면으로부터 회전각으로 정의된다. 최대굴곡각은 대퇴골이 Medial-Lateral축을 중심으로 엉덩이뼈(Pelvis)의 절구(Acetabulum)의 테두리와 겹치지 않고 회전할 수 있는 최대 굴곡각으로 결정된다. 정상고관절에 비해 인공고관절술을 받은 해당 환자의 경우, 외전에서는 60도 정도, 굽힘에서는 4도 정도 운동범위가 줄어들 수 있다는 예측이 나왔다. 본 연구에서 행한 시뮬레이션을 해보고 외전의 경우 운동범위의 감소가 예측되므로, 대퇴골두를 조금 큰 것을 고르거나 대퇴골목부의 길이 (femoral neck offset)를 길게 시술해야 할 필요가 있음을 의미한다.

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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