Hip-joint and abductor-muscle forces adequately represent in vivo loading of a cemented total hip reconstruction

The major complications following total hip replacement (THA) are implant loosening, dislocation, instability, fracture and infection. It is hypothesized that vibration, in the range of the resonance frequencies, may cause pain, bone degeneration and fracture. A further understanding of the physical response resulting from impact during femoral head sliding may lead to valuable insight pertaining to THA failure. Therefore, the first objective of this present study was to determine if frequencies propagating through the hip joint near resonant frequencies may lead to wear or loosening of the components. Recently, studies found that femoral head sliding, often referred to as hip separation, between the acetabulum cup and the femoral head does occur, which may also play a role in complications observed with THA today, but a the effects of hip separation and the causes of its occurrence has not been studied as jet. Therefore, the second objective of this study was to determine if a sound sensor, externally attached, could be used to correlate impact loading sounds from femoral head sliding in the acetabular cup. Additional objective of this study was to develop a mathematical model that better simulates the in vivo loading conditions of total hip replacement patients using in vivo fluoroscopic and ground reaction data as input.

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IN VIVO MEASUREMENTS OF THE FRICTION MOMENT IN TOTAL HIP JOINT PROSTHESES DURING WALKING

Journal of Biomechanics ◽

10.1016/s0021-9290(12)70269-5 ◽

2012 ◽

Vol 45 ◽

pp. S268 ◽

Cited By ~ 4

Author(s):

Philipp Damm ◽

Robert Ackermann ◽

Alwina Bender ◽

Friedmar Graichen ◽

Georg Bergmann

Keyword(s):

Hip Joint ◽

Total Hip ◽

In Vivo Measurements ◽

Friction Moment ◽

Joint Prostheses

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The influence of shape and sliding distance of femoral head movement loci on the wear of acetabular cups in total hip arthroplasty

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1243/095441102321032184 ◽

2002 ◽

Vol 216 (6) ◽

pp. 393-402 ◽

Cited By ~ 14

Author(s):

D Bennett ◽

J F Orr ◽

D E Beverland ◽

R Baker

Keyword(s):

Femoral Head ◽

Aspect Ratio ◽

Hip Joint ◽

Wear Rates ◽

Total Hip ◽

Aspect Ratios ◽

Average Aspect Ratio ◽

Sliding Distance

Wear of the polyethylene acetabular component is the most serious threat to the long-term success of total hip replacements (THRs). Greatly reduced wear rates have been reported for unidirectional, compared to multidirectional, articulation in vitro. This study considers the multidirectional motions experienced at the hip joint as described by movement loci of points on the femoral head for individual THR patients. A three-dimensional computer program determined the movement loci of selected points on the femoral head for THR patients and normal subjects using kinematic data obtained from gait analysis. The sizes and shapes of these loci were quantified by their sliding distances and aspect ratios with substantial differences exhibited between individual THR patients. The average sliding distances ranged from 10.0 to 18.1 mm and the average aspect ratios of the loci ranged from 2.5 to 9.2 for the THR patients. Positive correlations were found between wear rate and average sliding distance, the inverse of the average aspect ratio of the loci and the product of the average sliding distance and the inverse of the average aspect ratio of the loci. Patients with a normal hip joint range of motion produce multidirectional motion loci and tend to experience more wear than patients with more unidirectional motion loci. Differing patterns of multidirectional motion at the hip joint for individual THR patients may explain widely differing wear rates in vivo.

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Numerical predictions of hip joint and muscle forces during daily activities: A comparison of musculoskeletal models

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1177/0954411919840524 ◽

2019 ◽

Vol 233 (6) ◽

pp. 636-647 ◽

Cited By ~ 3

Author(s):

Basil Mathai ◽

Sanjay Gupta

Keyword(s):

Hip Joint ◽

Reaction Force ◽

Daily Activities ◽

Hip Implants ◽

Muscle Forces ◽

Joint Reaction Force ◽

Musculoskeletal Models ◽

Standing Up ◽

Joint Reaction

Musculoskeletal loading plays an important role in pre-clinical evaluations of hip implants, in particular, bone ingrowth and bone remodelling. Joint force estimation using musculoskeletal models evolved as a viable alternative to in vivo measurement owing to the development of computational resources. This study investigated the efficiencies of four eminent open-source musculoskeletal models in order to determine the model that predicts the most accurate values of hip joint reaction and muscle forces during daily activities. Seven daily living activities of slow walking, normal walking, fast walking, sitting down, standing up, stair down and stair up were simulated in OpenSim using inverse dynamics method. Model predictions of joint kinematics, kinetics and muscle activation patterns were compared with published results. The estimated values of hip joint reaction force were found to corroborate well with in vivo measurements for each activity. Although the estimated values of hip joint reaction force were within a satisfactory range, overestimation of hip joint reaction force (75% BW of measured value) was observed during the late stance phase of walking cycles for all the models. In case of stair up, stair down, standing up and sitting down activities, the error in estimated values of hip joint reaction force were within ~20% BW of the measured value. Based on the results of our study, the London Lower Extremity Model predicted the most accurate value of hip joint reaction force and therefore can be used for applied musculoskeletal loading conditions for numerical investigations on hip implants.

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Total hip joint prosthesis for in vivo measurement of forces and moments

Medical Engineering & Physics ◽

10.1016/j.medengphy.2009.10.003 ◽

2010 ◽

Vol 32 (1) ◽

pp. 95-100 ◽

Cited By ~ 47

Author(s):

Philipp Damm ◽

Friedmar Graichen ◽

Antonius Rohlmann ◽

Alwina Bender ◽

Georg Bergmann

Keyword(s):

Hip Joint ◽

Joint Prosthesis ◽

Total Hip ◽

In Vivo Measurement

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In vivo loading on the hip joint in patients with total hip replacement performing gymnastics and aerobics exercises

Scientific Reports ◽

10.1038/s41598-021-92788-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Henryk Haffer ◽

Srdan Popovic ◽

Franziska Martin ◽

Sebastian Hardt ◽

Tobias Winkler ◽

...

Keyword(s):

Hip Joint ◽

Hip Prosthesis ◽

Rehabilitation Program ◽

Early Postoperative Period ◽

Evidence Based ◽

Basic Step ◽

Total Hip ◽

Resistance Bands ◽

Over The Top

AbstractA further increase in the number of total hip arthroplasty (THA) is predicted, in particular the number of young THA patients has raised and with it their demands. There is no standardized evidence-based rehabilitation program and no reliable guidelines for sports activities after THA. Stretching and strengthening gymnastics are routinely performed in rehabilitation and aerobics as a sport after THA. The aim of the investigation was to determine the in vivo force and moments acting on the hip prosthesis during gymnastics and aerobic exercises to provide a source for evidence-based recommendations. Hip joint loads were measured in six patients with instrumented hip implants. The resulting force FRes, bending moment MBend at the neck and torsional moment MTors at the stem were examined during seven strengthening (with two different resistance bands) and four stretching gymnastic exercises and seven aerobic exercises with and without an aerobic step board compared to the loads during the reference activity walking. The stretching and strengthening gymnastics exercises and the aerobic exercises with and without a board demonstrated in their median peak force and moments mostly lower or similar values compared to walking. Significantly increased loads were recorded for the flexor stretching exercise in monopod stand (Fres and MBend), the strengthening abduction exercise on the chair (MTors) and the strengthening flexion exercise with the stronger resistance band (MTors). We also found a significant increase in median peak values in aerobic exercises with a board for the "Basic Step" (ipsilateral started Fres and MTors; contralateral started MTors), "Kickstep ipsilateral started" (Fres and MTors) and "Over the Top contralateral started" (Fres). The in vivo loads in THA patients during frequently performed stretching, strengthening and aerobic exercises were demonstrated for the first time. It was proved that stretching gymnastic exercises are safe in terms of resulting force, bending and torque moments for THA patients, although an external assistance for stabilization may be considered. Strengthening gymnastics exercises are reliable in terms of Fres, MBend and MTors, but, based on our data, we recommend to adhere to the communicated specific postoperative restrictions and select the resistance bands with lower tension. Aerobic exercises without an aerobic board can be considered as reliable activity in terms of force and moments for THA patients. Aerobic exercises with a board are not recommended for the early postoperative period and in our opinion need to be adapted to the individual muscular and coordinative resources.

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