• 제목/요약/키워드: Total Hip Replacement (THR)

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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.

인공고관절 치환술 후 세라믹 대퇴골두에서 발생하는 응력분포 예측 (Prediction of Stress Distribution in the Ceramic Femoral Head after Total Hip Replacement)

  • 한성민;추준욱;송강일;박성희;최재봉;김정성;서준교;최귀원;윤인찬
    • 한국정밀공학회지
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    • 제29권6호
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    • pp.680-685
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    • 2012
  • Ceramic femoral heads are now widely used in Total Hip Replacement (THR). Due to their high biocompatibility and low ductility, ceramic femoral heads are considered to be suitable for young and active patients. However, as in testing the mechanical stability of the femoral head, the conventional proof test (standard ISO 7206-10) has its limit of showing axisymmetric stress distribution on the contact surface, while non-uniformed stress distribution is expected after THR. Since non-uniformed stress distribution can result in the increased probability of ceramic femoral head fracture, it is considerable to evaluate the stress distribution in vivo-like conditions. Therefore, this study simulated the ceramic femoral heads under in vivo-like conditions using finite element method. The maximum stress decreased when increasing the size of the femoral head and stress distribution was concentrated on superior contact surface of the taper region.

골시멘트 특성 및 스템 형상에 따른 시멘트 타입 인공관절의 생체역학적 평가 (Biomechanical Evaluation of Cement type hip Implants as Conditions of bone Cement and Variations of Stem Design)

  • 박흥석;전흥재;윤인찬;이문규;최귀원
    • 대한의용생체공학회:의공학회지
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    • 제29권3호
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    • pp.212-221
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    • 2008
  • The total hip replacement (THR) has been used as the most effective way to restore the function of damaged hip joint. However, various factors have caused some side effects after the THR. Unfortunately, the success of the THR have been decided only by the proficiency of surgeons so far. Hence, It is necessary to find the way to minimize the side effect caused by those factors. The purpose of this study was to suggest the definite data, which can be used to design and choose the optimal hip implant. Using finite element analysis (FEA), the biomechanical condition of bone cement was evaluated. Stress patterns were analyzed in three conditions: cement mantle, procimal femur and stem-cement contact surface. Additionally, micro-motion was analyzed in the stem-cement contact surface. The 3-D femur model was reconstructed from 2-D computerized tomography (CT) images. Raw CT images were preprocessed by image processing technique (i.e. edge detection). In this study, automated edge detection system was created by MATLAB coding for effective and rapid image processing. The 3-D femur model was reconstructed based on anatomical parameters. The stem shape was designed using that parameters. The analysis of the finite element models was performed with the variation of parameters. The biomechanical influence of each parameter was analyzed and derived optimal parameters. Moreover, the results of FE A using commercial stem model (Zimmer's V erSys) were similar to the results of stem model that was used in this study. Through the study, the improved designs and optimal factors for clinical application were suggested. We expect that the results can suggest solutions to minimize various side effects.

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.

A 3D-printing Bone Model for Surgical Planning of Total Hip Replacement after Failed Triple Pelvic Osteotomy

  • Han, Kyungjin;Park, Jiyoung;Yoon, Jangwon;Lee, Young-Won;Choi, Ho-Jung;Jeong, SeongMok;Lee, Haebeom
    • 한국임상수의학회지
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    • 제34권6호
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    • pp.463-466
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    • 2017
  • A 3-year-old, 26 kg, castrated male Chow Chow was presented for assessment of weight-bearing lameness of the left hind limb. The patient had a history of triple pelvic osteotomy on the left side to correct hip dysplasia 2 years prior to his presentation of clinical signs and underwent total hip replacement on the right coxofemoral joint 1 year later. Upon physical examination, pain and crepitus were noted on the left hip joint during extension. Radiological examination revealed coxofemoral joint subluxation and moderate degenerative bone changes on the left hip joint and pelvic axis, which relates to acetabular angles that were changed after triple pelvic osteotomy (TPO). Preoperative computed tomography was used for 3-dimensional printing to establish an accurate surgical plan. The changed angles of the acetabulum after TPO were evaluated, and rehearsal surgery was performed using a 3-demensional printing bone model. Three months after the THR surgery, the function of the affected limb had improved, with no lameness. Complications, such as luxation and implant failure, were not observed until 6 months after the operation. Accurate evaluation of acetabulum angles and rehearsal surgery using a 3D-printed bone model is effective for total hip replacement after unsuccessful TPO.

Micro Total Hip Replacement in Two Dogs with Legg-Calvé-Perthes Disease

  • Roh, Yoon-seok;Heo, Su-Young;Yoon, Jang-won;Park, Jiyoung;Jeong, Seong-Mok;Lee, Hae-beom
    • 한국임상수의학회지
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    • 제34권6호
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    • pp.454-458
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    • 2017
  • A Maltese (case 1) and a Pomeranian (case 2) presented with acute right and left hind limb weight-bearing lameness. On physical examination, they exhibited severe pain and crepitus on the coxofemoral joint of affected hind limb. In addition, decreased thigh girth measurements were noted compared with the opposite leg. Radiological exam revealed necrotic areas in the femoral head of affected hind limb. These dogs were diagnosed with Legg-$Calv{\acute{e}}$-Perthes disease (LCPD). The dogs underwent micro total hip replacement (THR). After surgery, at 3 years (case 1) and 7 months (case 2), both dogs recovered normal activity. The thigh girth and lameness scores were apparently improved in the affected limbs of both dogs. No complications of prosthesis implants, such as loosening, were noted. The clinical outcomes of these cases indicate that dogs with LCPD can be successfully treated with micro THR and have a good prognosis immediately after surgery.

Comparative study by the finite element method of three activities of a wearer of total hip prosthesis during the postoperative period

  • Abdelmadjid Moulgada;Mohammed El Sallah Zagane;Murat Yaylaci;Ait Kaci Djafar;Sahli Abderahmane;Sevval Ozturk;Ecren Uzun Yaylaci
    • Structural Engineering and Mechanics
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    • 제87권6호
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    • pp.575-583
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    • 2023
  • The postoperative period for a carrier of total hip prosthesis (THP), especially in the first months, remains the most difficult period for a patient after each operation, even if traumatologist surgeons want the relief and success of their operations. In this investigation, selected three of the daily activities for a wearer of total hip replacement (THR), such as sitting in a chair, lifting a chair, and going downstairs, and was performed a numerical simulation by finite elements based on experimental data by Bergmann (Bergmann 2001) in terms of effort for each activity. Different stresses have been extracted, and a detailed comparison between two activities with different induced stresses such as normal, tensile, and compressive shear stresses.

내마모성이 향상된 기능성 표면구조를 갖는 인공관절에 관한 기초적인 연구 (A Basic Study on Functional Friction Surface of Artificial Joints)

  • 김동욱
    • 대한의용생체공학회:의공학회지
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    • 제22권6호
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    • pp.519-526
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    • 2001
  • At present. about 0.3 million and more THRs (Total Hip Replacement) in a rear are being done worldwide. The increase in mechanical failure with the increase in THR, required more revisions. Revisions compensate mainly the wear of the artificial joint frictional surface and the loosening of the cup and stem. According to recent researches, loosening is mainly due to wear debris UHMWPE (Ultra High Molecular Weight Polyethylene) from frictional surfaces . To overcome the wear problems associated with artificial joint materials , new surface structures with regular Patterns were designed and fabricated The lubrication Properties were examined to evaluate the wear of the frictional surfaces. The surface structure manifested a Pattern of "dents" with a 0.2-1.0 mm of diameter and 0.6-2.0 mm of Pitch. From the friction test of the SUS316L vs UHMWPE using the frictional tester, we found that the lubrication Performance was improved due to of drastically reduced amount of abrasion. There were optimum sizes for the diameter and the pitch of the Pattern. The results demonstrated that the lubrication properties could be improved by Patterning of the frictional surfaces. The surface Patterning was effective in preventing wear of the frictional surfaces, and the life of an artificial joint could be extended with such Patterning.

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