• Title/Summary/Keyword: Total Hip Replacement (THR)

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The Stress analysis for a sectional stem shape of cement type hip implant using the finite element method (FEM을 이용한 cement type hip implant의 Stem 단면형상에 따른 응력분석)

  • Park H.S.;Lee M.K.;Chun H.J.;Choi K.W.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2006.05a
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    • pp.651-652
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    • 2006
  • The choice of suitable hip implant is one of important factors in total hip replacement (THR). In clinical view points, improper adaptation of hip implant might cause abnormal stress distribution to the bone, which can shorten the lifespan of replaced hip implant. Currently, interest in custom-designed hip implants has increased as studies reveals the importance of geometric shape of patient's femur in modeling and designing custom hip implants. In this study, we have developed the custom-designed hip implant models with various sizes in hip implant, and the stress distribution in the bone was analyzed using Finite Elements methods. It was found that minimizing the gap between implant stem and femoral cavity is crucial to minimize stress concentration in the bone.

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Development of Hip Joint Mechanical Stem for Minimally Invasive Surgery (최소침습술을 위한 고관절 메커니컬 스템의 개발)

  • Lee, Sunghyun;Bae, Ji-Yong;Jeon, Insu
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.37 no.7
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    • pp.703-708
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    • 2013
  • 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.

Fracture behavior modeling of a 3D crack emanated from bony inclusion in the cement PMMA of total hip replacement

  • Mohamed, Cherfi;Abderahmane, Sahli;Benbarek, Smail
    • Structural Engineering and Mechanics
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    • v.66 no.1
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    • pp.37-43
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    • 2018
  • In orthopedic surgery and in particular in total hip arthroplasty, the implant fixation is carried out using a surgical cement called polymethylmethacrylat (PMMA). This cement has to insure a good adhesion between implant and bone and a good load distribution to the bone. By its fragile nature, the cement can easily break when it is subjected to a high stress gradient by presenting a craze zone in the vicinity of inclusion. The focus of this study is to analyze the effect of inclusion in some zone of cement in which the loading condition can lead to the crack opening leading to their propagation and consequently the aseptic loosening of the THR. In this study, the fracture behavior of the bone cement including a strange body (bone remain) from which the onset of a crack is supposed. The effect of loading condition, the geometry, the presence of both crack and inclusion on the stress distribution and the fracture behavior of the cement. Results show that the highest stresses are located around the sharp tip of bony inclusion. Most critical cracks are located in the middle of the cement mantle when they are subjected to one leg standing state loading during walking.

Effects of Critical Pathway(CP) on the patients with Primary Total hip replacement(THR) (고관절 전치환술 환자의 Critical pathway적용효과)

  • Lee, Mi-Kyoung;Doh, Bok-Num
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.2
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    • pp.295-308
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    • 2002
  • Purpose: The purpose of this quasi-experimental research is to develop the CP for primary THR patients and verify its effectiveness. Method: The CP is designed for both patients and medical employees to meet the 14-day-long hospitalization with an expert and clinical validity test, and the standardized orders are also created. 21 eligible subjects for the control group(with common care plan) and 27 subjects for the experimental group(with CP service) were assigned. Data were collected from questionnaires to evaluate patients' satisfaction level of nursing care and CP, investigation of physical complications, inspection of LOS(length of hospital stay) and hospital charges from April 2000 to February 2001 at K-hospital in Daegu. The collected data were analyzed by using the SAS program. Results: After implementation of CP, there was a statistically significant reduction in mean length of stay. The hospital charges have no considerable difference between two groups. Frequency of physical complications is reduced considerably. The experimental group scored much higher than the control group on the satisfaction level toward nursing care. And in the analysis of CP satisfaction questionnaires, many subjects have high satisfaction in items of 'I see the treatment process and hospital life', 'I feel that I am participating in my treatment process with health care staff'. The analysis of variances which cause a prolonged LOS supports that it's necessary to strengthen an evaluation of pre-operative outpatients' condition and link the home nursing care system in discharge for more shortening of LOS. Conclusion: The above results show that CP can have a positive impact on satisfaction level of inpatients with primary THR and the hospital.

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Biomechanical characteristics of the distal filling effects in cementless femoral stem (무시멘트형 대퇴스템에서 원위부 압박 정도에 따른 생체역학적 특성)

  • Park, Sang-eok;Park, Jae-Won;Chae, Soo-Won
    • Proceedings of the KSME Conference
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    • 2000.04a
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    • pp.387-392
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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 initial stability has close relationship with the relative displacement of prosthesis and spongy bone at the proximal of femur. After implantation of the prosthesis. the surrounding bone is partially shielded from load carrying and starts to resort. 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 employed are a distal filling stem, a distal flexible stem, and a distal tapered stem.

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Initiation and propagation of a crack in the orthopedic cement of a THR using XFEM

  • Gasmi, Bachir;Abderrahmene, Sahli;Smail, Benbarek;Benaoumeur, Aour
    • Advances in Computational Design
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    • v.4 no.3
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    • pp.295-305
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    • 2019
  • The sealing cement of total hip arthroplasty is the most widely used binder in orthopedic surgery for anchoring implants to their recipient bones. Nevertheless, this latter remains a fragile material with weak mechanical properties. Inside this material cracks initiate from cavities. These cracks propagate under the effect of fatigue and lead to the failure of this binder and consequently the loosening of the prosthesis. In this context, this work consists to predict the position of cracks initiation and their propagations path using the Extended Finite Element Method (XFEM). The results show that cracks can only be initiated from a sharp edges of an ellipsoidal cavity which the ratio of the minor axis over the major axis is equal to 0.1. A maximum crack length of 19 ?m found for a cavity situated in the proximal zone position under a static loading. All cracks propagate in same(almost) way regardless of the cavity(site of initiation) position and its inclination in the proximal zone.

Surface Tribology of Total Ankle Joint Replacement (인공발목관절의 표면 마모 특성)

  • Jeong, Yong-Hoon;Jung, Tae-Gon;Yang, Jae-Woong;Park, Kwang-Min;Lee, Su-Won
    • Proceedings of the Korean Institute of Surface Engineering Conference
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    • 2016.11a
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    • pp.117-117
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    • 2016
  • Total ankle replacement (TAR) is a visible option in the surgical treatment of degenerative or inflammatory diseases of ankle joint. it is attributed to the current TAR which has improvements in surgical technique, uncemented implant fixation and minimally constrained articulation. In the clinical result, they can show promised surgical result when compared to earlier attempts in TAR. However, TAR is still not as successful as total knee replacement (TKR) or total hip replacement (THR), it needs to be note that there are limitations in concerning of long term performance of TAR, the high failure rate still associated with wear of the PE (polyethylene) component that has related with their material property and surface roughness. The aim of this study was to introduce the tribology characteristics of total ankle joint prosthesis with one of TDR model which was fabricated to try multi-axis wear test as a region of motion in ankle joint. The wear specimen of TDR was prepared with Ti-6Al-4V alloy and UHMWPE (ultra-high molecular weight polyethylene) for tibia-talus and bearing component, respectively. A wear test was carried out using a Force 5 (AMTI, Massachusetts, US) wear simulator which can be allowed to move in three axis to flexion-extension ($+3^{\circ}{\sim}-6^{\circ}$), internal-external axial rotation (${\pm}5^{\circ}$), as well as sinusoidal compressive load (1.6 kN, R=10). All tests were performed following standard ISO 14243, wear rate was calculated with weight loss of UHMWPE bearing while the specimen has tested at certain cycles. As based on the preliminary results, wear rate of UHMWPE bearing was $7.9{\times}10^{-6}mg/cycles$ ($R^2=0.86$), calculated loss weight until $10^7cycles$ was 79 mg, respectively.

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Comparison of radiographic and computed tomographic acetabular index in small-breed dogs: a preliminary study using Maltese and Shih Tzu

  • Kanthavichit, Kanokporn;Klaengkaew, Auraiwan;Thanaboonnipat, Chutimon;Darawiroj, Damri;Soontornvipart, Kumpanart;Choisunirachon, Nan
    • Journal of Veterinary Science
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    • v.22 no.4
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    • pp.58.1-58.13
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    • 2021
  • Background: The morphometry of the acetabulum is one source of information that assists in the clinical diagnosis of the hip and influences the proper selection of a prosthesis, reducing post-operative complications such as those seen in total hip replacement (THR). However, acetabular parameters in small-breed dogs are rarely reported. Objectives: To investigate acetabular parameters using radiography and computed tomography (CT) in small-breed dogs with Maltese and Shih Tzu dogs used as model breeds. Methods: Standard calibrated, extended hip radiographs and CT images were obtained. Subsequently, acetabular width (AW) in various directions was measured using radiography and CT, whereas acetabular depth (AD) was obtained by CT. Acetabular index (AI) is a ratio calculated from AD and AW. Results: The values of AW and AD were much higher in Shih Tzu than in Maltese dogs. Male Shih Tzus showed higher values of these parameters than females, while sex-based differences in most of the parameters could not be detected in Maltese. Body weight, but not age, influenced AWs and ADs. While AWs and ADs were influenced by several factors, AI was comparable among the assessed factors and between Maltese and Shih Tzu dogs (p = 0.172; 31.42 ± 1.35 and 32.60 ± 1.80, respectively). Also, AI did not vary with breed, sex, or body size. Conclusions: The obtained radiographic and CT acetabular parameters could be useful as guidelines for evaluating the acetabulum of small-breed dogs in clinical practice.