Transactions of the Korean Society of Mechanical Engineers B (대한기계학회논문집B)

The Korean Society of Mechanical Engineers (대한기계학회)
권호 표지
DOI QR코드

DOI QR Code

Development of Hip Joint Mechanical Stem for Minimally Invasive Surgery

최소침습술을 위한 고관절 메커니컬 스템의 개발

  • Lee, Sunghyun (School of Mechanical Engineering, Chonnam Nat'l Univ.) ;
  • Bae, Ji-Yong (School of Mechanical Engineering, Chonnam Nat'l Univ.) ;
  • Jeon, Insu (School of Mechanical Engineering, Chonnam Nat'l Univ.)
  • Received : 2013.03.25
  • Accepted : 2013.04.18
  • Published : 2013.07.01
Download PDF
⟨ Previous Next ⟩

Abstract

Conventional total hip joint replacement(THR) surgery requires a long incision and long rehabilitation time. The stem used in THR is inserted into the cancellous bone of the femur where it plays the role of the artificial joint. Minimally invasive surgery(MIS) has been devised to reduce muscle damage to patients. In this study, a mechanical stem was developed on the basis of MISto reduce the incision length through the principle of the gear. The mechanical stem consists of six components. A prototypical model for a mechanical stem was fabricated using an acryl-based polymer, and its workability was confirmed. To actualize the mechanical stem, a three-dimensional Bio-CAD modeling technique was applied. The hip joint area based on computed tomography(CT) was reconstructed. The safety of the mechanical stem by applying more load than the weight of a man under virtual surgery environment conditions was confirmed by finite element analysis.

고관절 전치환술은 대퇴골두와 비구 부분이 손상되어 제 기능을 하지 못하였을 때, 인공 고관절로 대체하는 수술로서 인체에는 많은 양의 절개를 필요로 하며 장기간의 회복시간과 재활시간을 필요로 한다. 최소침습술은 환자에게 흉터와 근육절개를 최소화하고, 회복시간을 단축하여 미관상 흉터가 적어 가장 선호되는 수술 방법이다. 이 논문에서는 최소침습술이 가능한 메커니컬 스템(Mechanical stem)을 기어의 원리를 이용하여 개발하였다. 재치환술을 할 경우에는 스템 전체를 교체할 필요 없이 일부 부품만을 교체하여 수술 시간을 단축할 수 있도록 설계하였으며, 아크릴 소재로 모형을 제작하여 작동에 문제가 없는 것을 확인하였다. 3D Bio-CAD 모델링 기법을 통하여 메커니컬 스템의 기하학적 모델링을 하였다. 실험 대상자의 고관절 부위는 컴퓨터 단층촬영 영상데이터를 기반으로 3차원 재구축을 하였고, 가상 시술 환경 조건에서 몸무게보다 더 과중한 하중을 적용하여 메커니컬 스템의 안전성을 유한요소해석으로 확인하였다.

Keywords

References

  1. Goldstein, W. M., Branson, J. J., Berland, K. A. and Gordon, A. C., 2003, "Minimal-Incision Total Hip Arthroplasty," J Bone Joint Surg Am, Vol. 85-A Suppl. 33-38.
  2. Bertin, K. C. and Rottinger, H., 2004, "Anterolateral Mini-Incision Hip Replacement Surgery: A Modified Watson-Jones Approach," Clin Orthop Relat Res, Vol. 429, pp. 248-255. https://doi.org/10.1097/01.blo.0000150294.81825.8c
  3. Wenz, J. F., Gurkan, I. and Jibodh, S. R., 2002, "Mini-Incision Total Hip Arthroplasty: A Comparative Assessment of Perioperative Outcomes," Orthopedics, Vol. 25, No. 10, pp. 1031-1043.
  4. Waldman, B. J., 2002, "Minimally Invasive Total Hip Replacement and Perioperative Management: Early Experience," J South Orthop Assoc, Vol. 11, No. 4, pp. 213-217.
  5. Yoon, T. R., Bae, B. H., Rowe, S. M., Chung, J. Y. and Lee, K. B., 2003, "Primary Total Hip Arthroplasty with Mini-Incision Technique: Preliminary Report," J Korean Orthop Assoc, Vol. 38, pp. 342-348. https://doi.org/10.4055/jkoa.2003.38.4.342
  6. Berger, R. A., 2003, "Total Hip Arthroplasty Using the Minimally Invasive Two-Incision Approach," Clin Orthop Relat Res, Vol. 417, pp. 232-241.
  7. Yoon, T. R., Bae, B. H. and Choi, M. S., 2006, "A Modified Two-Incision Minimally Invasive Total Hip Arthroplasty: Technique and Short-Term Results," Hip Int, Vol. 16, Suppl. 4, pp. 28-34. https://doi.org/10.5301/HIP.2008.2463
  8. Terry, L. D. and John, S. W., U.S. Patent US8048167, Aug. 30, 2005.
  9. Buly, R., 2005, "The S-ROM Stem: Versatility of Stem/Sleeve Combinations and Head Options," Orthopaedics, Vol. 28, pp. s1025-1032.
  10. Weisse, B., Zahner, M., Weber, W. and Rieger, W., 2003, "Improvement of the Reliability of Ceramic Hip Joint Implants," J. Biomech, Vol. 36, No. 11, pp. 1633-1639. https://doi.org/10.1016/S0021-9290(03)00186-6
  11. Mak, M. M., Besong, A. A., Jin, Z. M. and Fisher, J., 2002, "Effect of Microseparation on Contact Mechanics in Ceramic-on-Ceramic Hip Joint Replacements," Proc Inst Mech Eng Part H: J Eng Med, Vol. 216, No. 6, pp. 403-408. https://doi.org/10.1243/095441102321032193
  12. Phillips, A. T. M., Pankaj, P., Howie, C. R., Usmani, A. S. and Simpson, A. H. R. W., 2007, "Finite Element Modelling of the Pelvis: Inclusion of Muscular and Ligamentous Boundary Conditions," Medical Engineering & Physics, Vol. 29, pp. 739-748. https://doi.org/10.1016/j.medengphy.2006.08.010
  13. Phillips, A. T., Pankaj, P., Howie, C. R., Usmani, A. S. and Simpson, A. H., 2007, "Finite Element Modelling of the Pelvis: Inclusion of Muscular and Ligamentous Boundary Conditions," Med Eng Phys, Vol. 29, pp. 739-748. https://doi.org/10.1016/j.medengphy.2006.08.010
  14. Bae, J. Y., Farooque, U., Lee, K. W., Kim, G. H., Jeon, I. S. and Yoon, T. R., 2011, "Development of Hip Joint Prostheses with Modular Stems," Computer-Aided Design, Vol. 43, No. 1, pp. 1173-1180. https://doi.org/10.1016/j.cad.2011.05.004