The influence of the oscillation angle and the neck anteversion of the prosthesis on the cup safe-zone that fulfills the criteria for range of motion in total hip replacements. The required oscillation angle for an acceptable cup safe-zone

The calculation of range of motion (ROM) is a key factor during preoperative planning of total hip replacements (THR), to reduce the risk of impingement and dislocation of the artificial hip joint. To support the preoperative assessment of THR, a magnetic resonance imaging (MRI)-based computational framework was generated; this enabled the estimation of patient-specific ROM and type of impingement (bone-to-bone, implant-to-bone, and implant-to-implant) postoperatively, using a three-dimensional computer-aided design (CAD) to visualize typical clinical joint movements. Hence, patient-specific CAD models from 19 patients were generated from MRI scans and a conventional total hip system (Bicontact® hip stem and Plasmacup® SC acetabular cup with a ceramic-on-ceramic bearing) was implanted virtually. As a verification of the framework, the ROM was compared between preoperatively planned and the postoperatively reconstructed situations; this was derived based on postoperative radiographs (n = 6 patients) during different clinically relevant movements. The data analysis revealed there was no significant difference between preoperatively planned and postoperatively reconstructed ROM (∆ROM) of maximum flexion (∆ROM = 0°, p = 0.854) and internal rotation (∆ROM = 1.8°, p = 0.917). Contrarily, minor differences were observed for the ROM during maximum external rotation (∆ROM = 9°, p = 0.046). Impingement, of all three types, was in good agreement with the preoperatively planned and postoperatively reconstructed scenarios during all movements. The calculated ROM reached physiological levels during flexion and internal rotation movement; however, it exceeded physiological levels during external rotation. Patients, where implant-to-implant impingement was detected, reached higher ROMs than patients with bone-to-bone impingement. The proposed framework provides the capability to predict postoperative ROM of THRs.

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Comparision of Cup Anteversion and Tilt Effects on Dislocation Propensity for Small-Head-Size Total Hip Replacements

10.1115/imece2000-2490 ◽

2000 ◽

Author(s):

Mark E. Nadzadi ◽

Douglas R. Pedersen ◽

John J. Callaghan ◽

Thomas D. Brown

Keyword(s):

Range Of Motion ◽

Three Dimensional ◽

Element Model ◽

Head Size ◽

Modular System ◽

Total Hip ◽

Total Hip Replacements ◽

Apparent Stiffness ◽

Hip Replacements ◽

Laboratory Examinations

Abstract While dislocation is a leading cause of total hip replacement failure, empirical observations far outnumber systematic laboratory examinations of this phenomenon. A previously validated three-dimensional, non-linear, contact finite element model was used to study how surgical placement affects dislocation propensity. The computational model employed a widely used 22mm modular system, and examined range of motion prior to impingement as well as peak moment developed to resist dislocation under a typical leg-crossing maneuver. Results were compared to a previous study of an otherwise similar 26mm modular head system, using the same formulation. Similar trends occurred. Increasing tilt and/or anteversion increased both the range of motion and the peak resisting moment, while apparent stiffness seemed to be unaffected. Further, impingement range of motion was independent of head size, but peak resisting moment was nearly 25% less for the 22mm head sizes.

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