AUTOMATED RANGE-OF-MOTION DEVICE FOR TOTAL HIP ARTHROPLASTY PROSTHESIS

2006 ◽  
Vol 10 (03) ◽  
pp. 151-155 ◽  
Author(s):  
Prashanth P. Prabhakar ◽  
Qingshan Chen ◽  
Fredrick Schultz ◽  
Jean Yves Lazennec ◽  
Kai-Nan An
Keyword(s):  
Total Hip Arthroplasty ◽  
Range Of Motion ◽  
Hip Arthroplasty ◽  
External Rotation ◽  
Three Dimensional ◽  
Coordinate Measuring Machine ◽  
Acetabular Cup ◽  
Total Hip ◽  
Rocking Motion ◽  
Measuring Machine

Hip simulators are regularly used by researchers to assess total hip arthroplasty (THA) implants, range of motion, stability, and alignment of acetabular cup and stem. Previous papers have described three types of simulators: three-dimensional protractors, biaxial rocking motion (BRM) protractors, and single-axis prosthetic range-of-motion (PROM) devices. We have developed a new hip simulator in which the ROM device is completely automated in three independent axes (elevation, internal/external rotation, and plane of elevation). Coupled with the simulator, we used a FaroArm Gold Series coordinate measuring machine (CMM) to accurately align the implant components. The results show that the methodology and alignment setup are accurate and repeatable. With this simulator and digitizer, we are able to study the characteristics of numerous THA implants at various orientations of the pelvis, acetabular cup, stem, and femur.

Activity and Quality of Life after Total Hip Arthroplasty

2017 ◽  
Vol 19 (5) ◽  
pp. 0-0 ◽  
Author(s):  
Anna Świtoń ◽  
Ewa Wodka-Natkaniec ◽  
Łukasz Niedźwiedzki ◽  
Tadeusz Gaździk ◽  
Tadeusz Niedźwiedzki
Keyword(s):  
Quality Of Life ◽  
Total Hip Arthroplasty ◽  
Range Of Motion ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
External Rotation ◽  
Harris Hip Score ◽  
Joint Analysis ◽  
Total Hip

Background. Coxarthrosis is a chronic musculoskeletal condition that causes severe pain and considerable limi­tation of the patient’s motor performance. Total hip arthroplasty is one of the most common and effective methods used in the treatment of advanced degenerative changes. The aim of the present study was to evaluate the activity and quality of life of patients after unilateral total hip arthroplasty. Material and methods. The study was conducted in a group of 189 patients who had undergone unilateral total hip arthroplasty. Goniometry was used to determine the range of motion of both hip joints. Patients’ physical ability and pain severity were assessed based on the Harris Hip Score (HHS) questionnaire. Results. The examination of the range of motion in the lower extremities revealed statistically significant diffe­rences in flexion (p<0.01), abduction (p=<0.01), adduction (p<0.01) and external rotation (p<0.01) between the operated and the healthy extremity. The greatest limitation of motion was demonstrated for external rotation (<14°). Approximately 14% of the patients were not able to perform this motion in their healthy hip joint, while 17.5% of them could not do so in the affected hip joint. Analysis of HHS results (mean = 79 pts) revealed that more than 50% of the patients described their functional ability and quality of life as good and excellent. It was demonstrated that 54% of patients did not suffer from pain, whereas minor or mild pain was noted in 35%. Conclusions: 1. A subjective clinical assessment of patients after total hip arthroplasty showed that their quality of life had improved. 2. It is necessary to perform physiotherapy after total hip arthroplasty, on both the operated and healthy side. 3. Exacerbation of pain and impaired activity in patients after total hip arthroplasty were associated with the female sex to a considerable extent.

scholarly journals Optimal combined anteversion pattern for obtaining a wider range of motion without prosthetic impingement after total hip arthroplasty: a three-dimensional analysis study

2021 ◽  
Author(s):  
Ryo Hidaka ◽  
Kenta Matsuda ◽  
Masaki Nakamura ◽  
Shigeru Nakamura ◽  
Hirotaka Kawano
Keyword(s):  
Total Hip Arthroplasty ◽  
Range Of Motion ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Target Range ◽  
Total Hip ◽  
Combined Anteversion ◽  
Significant Difference ◽  
The Absolute ◽  
Prosthetic Impingement

Abstract Background Obtaining a larger theoretical range of motion (ROM) is crucial to avoid prosthetic impingement after total hip arthroplasty (THA); however, no reports have examined the permissible range values of combined anteversion (CA) satisfying targeted ROM without prosthetic impingement. This retrospective study aimed to evaluate the possible postoperative CA extent that would allow meeting target ROM criteria according to Yoshimine’s theory using computed tomography (CT)-based three-dimensional motion analysis after THA. Methods This study included 114 patients (133 hips) who underwent cementless primary THA using a CT-based navigation system and implants (oscillation angle ≥ 135°). Implant positions were determined using Yoshimine's CA formula. Postoperative evaluation was conducted using a three-dimensional templating software for CT data. The postoperative Yoshimine’s and Widmer’s CA was calculated, and the difference between the target and postoperative values was defined as the error of Yoshimine’s CA and Widmer’s CA. Prosthetic ROM was assessed by Yoshimine’s stringent criteria for activities of daily living. Based on fulfilling these criteria, all patients were divided into the ROM (+) and ROM (-) groups. Evaluation items were compared between the two groups. Results There were 111 and 22 hips in the ROM (+) and ROM (-) groups, respectively. A significant difference was noted in the absolute error of Yoshimine’s and Widmer’s CA between the two groups. Using receiver operating characteristic analysis, threshold values of 6.0 (higher values indicate greater disability; sensitivity 90.9%, specificity 72.1%) for the absolute Yoshimine’s CA difference (area under the curve [AUC] 0.87, P < 0.01) and 6.9 (higher values indicate greater disability; sensitivity 68.2%, specificity 88.3%) for the absolute Widmer’s CA difference (AUC 0.83, P < 0.01) were predictors in the ROM (-) group. Conclusions The target range of Yoshimine’s CA (90.8°±6.0°) and Widmer’s CA values (37.3°±6.9°) was crucial in implant orientation for obtaining theoretical ROM without prosthetic impingement after THA.

Dynamic Hip Kinematics During the Golf Swing After Total Hip Arthroplasty

2016 ◽  
Vol 44 (7) ◽  
pp. 1801-1809 ◽  
Author(s):  
Daisuke Hara ◽  
Yasuharu Nakashima ◽  
Satoshi Hamai ◽  
Hidehiko Higaki ◽  
Satoru Ikebe ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
External Rotation ◽  
Axial Rotation ◽  
Golf Swing ◽  
Long Term Results ◽  
Acetabular Cup ◽  
Total Hip ◽  
Hip Kinematics ◽  
Head Translation

Background: Although most surgeons allow their patients to play golf after total hip arthroplasty (THA), the effect on the implant during the golf swing is still unclear. Purpose: To evaluate hip kinematics during the golf swing after THA. Study Design: Descriptive laboratory study. Methods: Eleven hips in 9 patients who underwent primary THA were analyzed. All patients were right-handed recreational golfers, and these 11 hips included 6 right hips and 5 left hips. Periodic radiographic images of the golf swing were taken using a flat-panel x-ray detector. Movements of the hip joint and components were assessed using 3-dimensional–to–2-dimensional model-to-image registration techniques. Liner-to-neck contact and translation of the femoral head with respect to the acetabular cup (cup-head translation) were examined. Hip kinematics, orientation of components, and maximum cup-head translation were compared between patients with and without liner-to-neck contact. Results: On average, the golf swing produced approximately 50° of axial rotation in both lead and trail hips. Liner-to-neck contact was observed in 4 hips with elevated rim liners (2 lead hips and 2 trail hips) at maximum external rotation. Neither bone-to-bone nor bone-to-implant contact was observed at any phases of the golf swing in any of the hips. Four hips with liner-to-neck contact had significantly larger maximum external rotation (37.9° ± 7.0° vs 20.6° ± 9.9°, respectively; P = .01) and more cup anteversion (26.5° ± 6.1° vs 10.8° ± 8.9°, respectively; P = .01) than hips without liner-to-neck contact. No significant differences between hips with and without contact were found for cup inclination (42.0° ± 2.5° vs 38.1° ± 5.5°, respectively; P = .22), combined anteversion (45.3° ± 8.9° vs 51.4° ± 7.9°, respectively; P = .26), or maximum cup-head translation (1.3 ± 0.3 mm vs 1.5 ± 0.4 mm, respectively; P = .61). Conclusion: In this analysis, the golf swing did not produce excessive hip rotation or cup-head translation in any hips. However, liner-to-neck contact during the golf swing was observed in 36% of the hips, with unknown effects on the long-term results. Clinical Relevance: Golf is an admissible sport after THA because dynamic hip stability was observed. However, the implant position, especially cup anteversion and the use of elevated rim liners, promoted liner-to-neck contact.

scholarly journals Optimal Combined Anteversion Range for Obtaining a Wider Range of Motion without Prosthetic Impingement after Total Hip Arthroplasty: A Three-dimensional Analysis Study

2021 ◽  
Author(s):  
Ryo hidaka ◽  
Kenta Matsuda ◽  
Masaki Nakamura ◽  
Shigeru Nakamura ◽  
Hirotaka Kawano
Keyword(s):  
Total Hip Arthroplasty ◽  
Range Of Motion ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Target Range ◽  
Total Hip ◽  
Combined Anteversion ◽  
Significant Difference ◽  
The Absolute ◽  
Prosthetic Impingement

Abstract Background: Obtaining a larger theoretical range of motion (ROM) is crucial to avoid prosthetic impingement after total hip arthroplasty (THA); however, no reports have examined the permissible range values of combined anteversion (CA) satisfying targeted ROM without prosthetic impingement. This retrospective study aimed to evaluate the possible postoperative CA extent that would allow meeting target ROM criteria according to Yoshimine’s theory using computed tomography (CT)-based three-dimensional motion analysis after THA.Methods: This study included 114 patients (133 hips) who underwent cementless primary THA using a CT-based navigation system and implants (oscillation angle ≥135°). Implant positions were determined using Yoshimine's CA formula. Postoperative evaluation was conducted using a three-dimensional templating software for CT data. The postoperative Yoshimine’s and Widmer’s CA was calculated, and the difference between the target and postoperative values was defined as the error of Yoshimine’s CA and Widmer’s CA. Prosthetic ROM was assessed by Yoshimine’s stringent criteria for activities of daily living. Based on fulfilling these criteria, all patients were divided into the ROM (+) and ROM (-) groups. Evaluation items were compared between the two groups.Results: There were 111 and 22 hips in the ROM (+) and ROM (-) groups, respectively. A significant difference was noted in the absolute error of Yoshimine’s and Widmer’s CA between the two groups. Using receiver operating characteristic analysis, threshold values of 6.0 (higher values indicate greater disability; sensitivity 90.9%, specificity 72.1%) for the absolute Yoshimine’s CA difference (area under the curve [AUC] 0.87, P<0.01) and 6.9 (higher values indicate greater disability; sensitivity 68.2%, specificity 88.3%) for the absolute Widmer’s CA difference (AUC 0.83, P<0.01) were predictors in the ROM (-) group.Conclusions: The target range of Yoshimine’s CA (90.8°±6.0°) and Widmer’s CA values (37.3°±6.9°) was crucial in implant orientation for obtaining theoretical ROM without prosthetic impingement after THA.

scholarly journals Cup-To-Neck Contact and Range of Motion after Total Hip Arthroplasty with Large Head Diameters: An Original Three-Dimensional Combined Gait and Videofluoroscopy Analysis

2020 ◽  
Vol 10 (8) ◽  
pp. 2695
Author(s):  
Claudio Belvedere ◽  
Giada Lullini ◽  
Maurizio Ortolani ◽  
Andrea Ensini ◽  
Stefano Durante ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Gait Analysis ◽  
Range Of Motion ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Motor Tasks ◽  
Large Femoral Head ◽  
Total Hip ◽  
Limited Range Of Motion

After a total hip arthroplasty, a limited range of motion and lower-limb disability continue to be observed, with these being mainly associated with the implant design and the head-to-neck ratio. Larger diameters of the head bearings were assumed to provide better stability, a larger range of motion, and smaller risks of dislocation and stem-to-liner impingement. However, these claims have never been demonstrated in real patients. The specific aim of this study was to assess, via multi-instrumental analysis, whether the range of motion of a replaced hip is limited by the stem-to-liner contact in patients with large femoral head diameters. Twenty-three patients with a total hip arthroplasty were evaluated at their one-year follow-ups using clinical and instrumental examinations. A combined three-dimensional gait analysis of the full body and videofluoroscopy analysis of the replaced hip were performed during the execution of standard, i.e., daily living, and more demanding motor tasks. The latter were meant to reach the extreme range of motion at the replaced hip site, thus revealing possible stem-to-liner contact. An original technique based on imaging and computer-aided design (CAD) models of the prosthesis components was developed to calculate the stem-to-liner distance. Excellent clinical scores were observed in the study. The gait analysis showed that the range of motion of the replaced hip in the sagittal plane, averaged over all patients, ranged from 28° to 78° in standard activities. In more demanding tasks, single peaks were as high as 110°, 39°, and 60° in the sagittal, frontal, and transverse anatomical planes, respectively. In all motor tasks, the stem-to-liner distances ranged from 8.7 to 13.0 mm on average, with one outlier minimum distance being 2.2 mm. This study shows that, even in demanding motor tasks and with an extreme range of motion, the hip joint replaced with large femoral head diameters did not experience impingement between the prosthesis components.

Effects of additional neck cut of the femur on the range of motion in total hip arthroplasty for hip dislocation: a computer simulation study

2020 ◽  
pp. 112070002093865
Author(s):  
Kazuya Makida ◽  
Taisuke Seki ◽  
Yusuke Osawa ◽  
Yasuhiko Takegami ◽  
Yoshitoshi Higuchi ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Range Of Motion ◽  
Hip Arthroplasty ◽  
External Rotation ◽  
Hip Dislocation ◽  
Operator Coefficient ◽  
Depth Limit ◽  
Total Hip ◽  
Shortening Osteotomy ◽  
Femoral Shortening

Background: Subtrochanteric shortening osteotomy (SSO) is commonly performed in total hip arthroplasty (THA) for high hip dislocation. However, this procedure is technically difficult and includes complications. Additional neck cut (ANC) of the femur is a procedure that involves femoral shortening by possibly eliminating the need for SSO in THA for high hip dislocation. Herein, we evaluated the effect and the depth limit of ANC of the femur on the range of motion (ROM) in THA for high hip dislocation. Methods: ROM was measured in 26 patients with high hip dislocation using computer software. The stem was deeply positioned at 5-mm intervals from 0 mm to 30 mm (7 groups). The ROM before impingement was measured during flexion, internal rotation (IR) at 90° flexion, external rotation (ER) and abduction. Receiver operator coefficient (ROC) curves for abduction were generated. The cut-off value of ANC where the required ROM was achieved was also determined. Results: Deeper ANCs increased the ROM values during flexion and IR, but they decreased the ROM values during ER and abduction. The ROM values during ER were also limited in 0-mm ANCs. According to the result of the ROC curve for abduction, 15 mm was considered as the permissible range of ANC. Conclusions: In THA for high hip dislocation additional neck cut should be taken into consideration for hips requiring less than 15-mm shortening. For more extended corrections a subtrochanteric shortening osteotomy should be performed.

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