• 제목/요약/키워드: total hip replacement

검색결과 124건 처리시간 0.026초

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.

Correlation between anterior thigh pain and morphometric mismatch of femoral stem

  • Chung, Haksun;Chung, So Hak
    • Journal of Yeungnam Medical Science
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    • 제37권1호
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    • pp.40-46
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    • 2020
  • Background: Postoperative pain occurring after hip arthroplasty has become common since the expanded use of cementless femoral stems. The characteristic pain develop in the anterolateral thigh area. This study aimed to predict anterior thigh pain based on the measurements of postoperative anteroposterior (AP) and lateral (Lat) radiographs of the hip joint. Methods: The present study included 26 patients (29 hips) who underwent total hip replacement or bipolar hemiarthroplasty between March 2010 and May 2016, whose complete clinical information was available. AP and Lat radiographs of the affected hip were taken on the day of surgery and 1 and 6 months postoperatively. Patients with improper radiographs were excluded. The distance from the femoral stem to the nearest cortical bone in the distal region of the stem was measured. The patient group with a visual analog scale (VAS) score of ≥6 points was designated as patients with anterior thigh pain. Results: Sex, age, weight, height, body mass index, and bone mineral density in the lumbar spine and femur did not have a significant effect on postoperative VAS scores (p>0.05). Presence of contact between the femoral stem and cortical bone was associated with postoperative anterior thigh pain. Conclusion: Hip AP and Lat radiographs are usually taken to confirm fixation and alignment of the femoral stem after hip arthroplasty. The measurement method introduced in this study can be utilized for predicting anterior thigh pain after hip arthroplasty.

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.

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.

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.

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.

인공 고관절 수술 환자에서 지지간호중재가 고관절 기능, 불안 및 불확실성에 미치는 효과 (Effects of Supportive Nursing Care Program on Hip Function, Anxiety and Uncertainty for Patients with Total Hip Arthroplasty)

  • 김선화;이혜진
    • 임상간호연구
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    • 제19권3호
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    • pp.419-431
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    • 2013
  • Purpose: This study was to evaluate the effect of supportive nursing care program for patients with total hip arthroplasty. Methods: Forty-two patients with total hip arthroplasty were enrolled in this study from September, 20, 2011 to January, 3, 2012. The participants were assigned to one of two groups: Twenty-six subjects in the experimental group were provided with supportive nursing care program which comprised of 6 nurse visits pre and post operation and 4 follow-up phone calls after discharge. Another 26 subjects received conventional nursing care program as a control group. Hip function, anxiety, and uncertainty were evaluated before the intervention, and 5 weeks after completion of the intervention. The analysis included descriptive statistics, Chi-square test, and t-test by SPSS 18.0. Results: Hip function was significantly increased in the experimental group (t=-3.31, p<.002). Anxiety and uncertainty group was significantly lower in the experimental group (t=7.12, p<.001 and t=4.66, p<.001). Conclusion: The results of this study indicate that the supportive care intervention for patients receiving total hip arthroplasty could be utilized as a nursing intervention to improve hip function and to reduce anxiety and uncertainty of patients receiving total hip arthroplasty.