scholarly journals An MRI-Based Patient-Specific Computational Framework for the Calculation of Range of Motion of Total Hip Replacements

2021 ◽  
Vol 11 (6) ◽  
pp. 2852
Author(s):  
Maeruan Kebbach ◽  
Christian Schulze ◽  
Christian Meyenburg ◽  
Daniel Kluess ◽  
Mevluet Sungu ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Computer Aided Design ◽  
External Rotation ◽  
Patient Specific ◽  
Computational Framework ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Significant Difference ◽  
Hip Replacements

The calculation of range of motion (ROM) is a key factor during preoperative planning of total hip replacements (THR), to reduce the risk of impingement and dislocation of the artificial hip joint. To support the preoperative assessment of THR, a magnetic resonance imaging (MRI)-based computational framework was generated; this enabled the estimation of patient-specific ROM and type of impingement (bone-to-bone, implant-to-bone, and implant-to-implant) postoperatively, using a three-dimensional computer-aided design (CAD) to visualize typical clinical joint movements. Hence, patient-specific CAD models from 19 patients were generated from MRI scans and a conventional total hip system (Bicontact® hip stem and Plasmacup® SC acetabular cup with a ceramic-on-ceramic bearing) was implanted virtually. As a verification of the framework, the ROM was compared between preoperatively planned and the postoperatively reconstructed situations; this was derived based on postoperative radiographs (n = 6 patients) during different clinically relevant movements. The data analysis revealed there was no significant difference between preoperatively planned and postoperatively reconstructed ROM (∆ROM) of maximum flexion (∆ROM = 0°, p = 0.854) and internal rotation (∆ROM = 1.8°, p = 0.917). Contrarily, minor differences were observed for the ROM during maximum external rotation (∆ROM = 9°, p = 0.046). Impingement, of all three types, was in good agreement with the preoperatively planned and postoperatively reconstructed scenarios during all movements. The calculated ROM reached physiological levels during flexion and internal rotation movement; however, it exceeded physiological levels during external rotation. Patients, where implant-to-implant impingement was detected, reached higher ROMs than patients with bone-to-bone impingement. The proposed framework provides the capability to predict postoperative ROM of THRs.

Comparision of Cup Anteversion and Tilt Effects on Dislocation Propensity for Small-Head-Size Total Hip Replacements

2000 ◽  
Author(s):  
Mark E. Nadzadi ◽  
Douglas R. Pedersen ◽  
John J. Callaghan ◽  
Thomas D. Brown
Keyword(s):  
Range Of Motion ◽  
Three Dimensional ◽  
Element Model ◽  
Head Size ◽  
Modular System ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Apparent Stiffness ◽  
Hip Replacements ◽  
Laboratory Examinations

Abstract While dislocation is a leading cause of total hip replacement failure, empirical observations far outnumber systematic laboratory examinations of this phenomenon. A previously validated three-dimensional, non-linear, contact finite element model was used to study how surgical placement affects dislocation propensity. The computational model employed a widely used 22mm modular system, and examined range of motion prior to impingement as well as peak moment developed to resist dislocation under a typical leg-crossing maneuver. Results were compared to a previous study of an otherwise similar 26mm modular head system, using the same formulation. Similar trends occurred. Increasing tilt and/or anteversion increased both the range of motion and the peak resisting moment, while apparent stiffness seemed to be unaffected. Further, impingement range of motion was independent of head size, but peak resisting moment was nearly 25% less for the 22mm head sizes.

scholarly journals The Effect of Straight-Line Long-Toss Versus Ultra-Long-Toss Throwing on Passive Glenohumeral Range of Motion Recovery After Pitching

2021 ◽  
pp. 194173812098001
Author(s):  
T. David Luo ◽  
Aaron D. Sciascia ◽  
Austin V. Stone ◽  
Chukwuweike U. Gwam ◽  
Christopher A. Grimes ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
National Collegiate Athletic Association ◽  
External Rotation ◽  
Level Of Evidence ◽  
Left Hand ◽  
Right Hand ◽  
Straight Line ◽  
Significant Difference ◽  
Baseball Pitchers

Background: Repetitive throwing in baseball pitchers can lead to pathologic changes in shoulder anatomy, range of motion (notably glenohumeral internal rotation deficit), and subsequent injury; however, the ideal strengthening, recovery, and maintenance protocol of the throwing shoulder in baseball remains unclear. Two strategies for throwing shoulder recovery from pitching are straight-line long-toss (SLT) throwing and ultra-long-toss (ULT) throwing, although neither is preferentially supported by empirical data. Hypothesis: ULT will be more effective in returning baseline internal rotation as compared with SLT in collegiate pitchers after a pitching session. Study Design: Cohort study. Level of Evidence: Level 3. Methods: A total of 24 National Collegiate Athletic Association Division I baseball pitchers with mean age 20.0 ± 1.1 years were randomized to either the ULT group (n = 13; 9 right-hand dominant, 4 left-hand dominant) or SLT group (n = 11; 10 right-hand dominant, 1 left-hand dominant). Measurements (dominant and nondominant, 90° abducted external rotation [ER], internal rotation [IR], and total range of motion [TROM]) were taken at 5 time points across 3 days: before and immediately after a standardized bullpen session on day 1; before and immediately after a randomized standardized ULT or SLT session on day 2; and before practice on Day 3. Results: ULT demonstrated significantly greater final ER compared with baseline (+10°; P = 0.05), but did not demonstrate significant IR changes. Similarly, SLT demonstrated significantly greater post-SLT ER (+12°; P = 0.02) and TROM (+12°; P = 0.01) compared with baseline, but no significant IR changes. Final ER measurements were similar between ULT (135° ± 14°) and SLT (138° ± 10°) ( P = 0.59). There was also no statistically significant difference in final IR between ULT (51° ± 14°) and SLT (56° ± 8°) ( P = 0.27). Conclusion: The routine use of postperformance, ULT throwing to recover from range of motion alterations, specifically IR loss, after a pitching session is not superior to standard, SLT throwing. Based on these findings, the choice of postpitching recovery throwing could be player specific based on experience and comfort. Clinical Relevance: The most effective throwing regimens for enhancing performance and reducing residual impairment are unclear, and ideal recovery and maintenance protocols are frequently debated with little supporting data. Two strategies for throwing shoulder recovery from pitching are SLT and ULT throwing. These are employed to help maintain range of motion and limit IR loss in pitchers. The routine use of ULT throwing for recovery and to limit range of motion alterations after a pitching session is not superior to SLT throwing.

scholarly journals Imageless navigation total hip arthroplasty – an evaluation of operative time

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 18 ◽  
Author(s):  
Epaminondas Markos Valsamis ◽  
David Ricketts ◽  
Adnan Hussain ◽  
Amir-Reza Jenabzadeh
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Operative Time ◽  
Statistical Tools ◽  
New Techniques ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Imageless Navigation ◽  
Significant Difference ◽  
Hip Replacements

Introduction: Imageless navigation has been successfully integrated in knee arthroplasty but its effectiveness in total hip arthroplasty (THA) has been debated. It has consistently been shown that navigation adds significant time and cost to the operation. Further, the relative success of traditional hip replacements has impeded the adoption of new techniques. Methods: We compared the operative time between fifty total hip replacements with and without the use of imageless navigation by a single senior surgeon in a retrospective study. We employed standard statistical tools to compare the two methods. A correlation-based analysis was used to delimit the “learned” phase of imageless navigation to make comparisons meaningful. Results: Contrary to what has previously been reported, there was no significant difference between operative time in navigated, when compared to traditional operations (p = 0.498). Only fourteen operations were required to delimit the learning phase of this operation. Discussion: This is the first study that demonstrates no added operative time when using imageless navigation in THA, achieved with an improved workflow. The results also demonstrate a very reasonable learning curve.

Range of Motion Studies for Total Hip Replacements

1975 ◽  
Vol 111 ◽  
pp. 124-130 ◽  
Author(s):  
Harlan C. Amstutz ◽  
R M Lodwig ◽  
D J Schurman ◽  
A G Hodgson
Keyword(s):  
Range Of Motion ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Motion Studies

scholarly journals Thirty patients with one-stage hip arthroplasty and multiple drilling decompression for bilateral osteonecrosis of the femoral head:outcomes at two-year follow up

2019 ◽  
Author(s):  
Lu Ding ◽  
Yu-Hang Gao ◽  
Shi Zhang ◽  
Yi-Fan Huang ◽  
Jian-Guo Liu ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Internal Rotation ◽  
Hip Arthroplasty ◽  
External Rotation ◽  
Radiographic Evaluation ◽  
Two Stage ◽  
Total Hip ◽  
One Stage ◽  
Significant Difference

Abstract Background: To investigate the postoperative outcome of decompresed hip following contralateral replacement in patients with bilateral osteonecrosis of the femoral head (ONFH). M ethods: This study retrospectively reviewed 30 patients with bilateral ONFH who underwent one-stage total hip arthroplasty (THA) and multiple drilling decompression from February 2014 to February 2016. For all patients, alendronate was prescribed. Postoperative Harris Hip Scores (HHSs), Oxford Hip Scores (OHSs), Self-Administered Patient Satisfaction (SAPS), hip internal and external rotation angles, and the time of one-leg standing were evaluated. All patients were followed up for an average of 30.33 months (ranged from 8 months to 48 months). Results: Twenty-four patients had no progression or collapse on radiographic evaluation within 2 years postoperatively. The following scores of the decompressed sides were significantly lower than those of the replaced sides: HHSs (mean: 96.5 versus 98.25, P <0.05), SAPS (mean: 96.35 versus 99.48, P <0.001), internal rotation (mean: 27.58° versus 30.50°, P <0.05), and the time of single-leg standing (mean: 24.17 s versus 31.83 s, P <0.05). There was no significant difference in OHSs and external rotation between the sides. The remaining 6 patients underwent two-stage THA on the decompressed sides within 2 years. Four of them underwent THA for severe pain and femoral head collapse. The other 2 patients showed no progression on radiographic evaluation but complained of an uncomfortable feeling in the joint. Conclusions: One-stage THA and multiple drilling decompression are effective surgical procedures for bilateral ONFH at different stages. However, a few patients with no progression on radiographic evaluation may require two-stage THA on the decompressed sides because of more pain, poorer internal rotation, and weaker gluteal muscle strength when compared with the replaced sides. Keywords: osteonecrosis of the femoral head, postoperative satisfaction, total hip arthroplasty, multiple drilling decompression

Range of Motion to Impingement Curves Create a New Patient-Specific Impingement-Free Zone for Acetabular Cup Placement

2021 ◽  
Author(s):  
Thomas McCarthy ◽  
Matthew Thompson ◽  
Jim Nevelos ◽  
Hytham Salem ◽  
Brandon Naylor ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Pelvic Tilt ◽  
External Rotation ◽  
Objective Assessment ◽  
Safe Zone ◽  
Patient Specific ◽  
Acetabular Cup ◽  
High Flexion ◽  
Free Zone

Introduction: The acetabular “safe zone” has recently been questioned as a reliable reference for predicting total hip arthroplasty impingement and instability as many dislocations occur within the described parameters. Recently, an improved understanding of spino-pelvic mechanics has provided surgeons useful information to both identify those at a higher risk of dislocation and, in some cases, allows altering component positioning to accommodate the patient’s individual “functional” range of motion. The purpose of this study was to create a new patient-specific impingement-free zone by considering range of motion (ROM) to prosthetic impingement for both high flexion and extension poses, thus demarcating a zone that avoids both anterior and posterior impingement, thereby creating an objective approach to identifying a patient’s ideal functional safe zone. Materials and Methods: A validated hip ROM three-dimensional simulator was utilized to create ROM-to-impingement curves for both high flexion as well as pivot and turn poses. The user imported a computerized tomography (CT) with a supine pelvic tilt (PT) value of zero and implant models (tapered wedge stem, 132° neck angle, 15° stem version, 36mm femoral head). Femur-to-pelvis relative motions were determined for three upright seated poses (femur flexed at 90° and 40° internal rotation, with 0°, 10°, and 20° posterior PT), one chair rise pose (femur flexed at 90° and 0° internal rotation, with the pelvis flexed anteriorly until the pelvis made contact with the femur), and three standing pivot and turn poses (femur set at 5° extension, and 35° external rotation, with 5° posterior PT, 0°, and 5° anterior PT). ROM-to-impingement curves for cup inclination versus anteversion were graphed and compared against the Lewinnek safe zone. Results: The ROM-to-impingement curves provide an objective assessment of potential impingement sites as they relate to femoral rotation and pelvic tilt. The area between the stand and sit curves is the impingement-free area. A sitting erect pose with a simulated stiff spine (0° PT) yielded less impingement-free combinations of cup inclination and version than poses with greater than 0° posterior pelvic tilt. Conclusion: The results demonstrate that the acetabular target zone has a relatively small margin for error between the sitting and standing ROM curves to impingement. Importantly, anterior and posterior pelvic tilt can markedly increase the risk of impingement, potentially leading to posterior or anterior dislocations, respectively. This study highlights the importance of correctly identifying the patient-specific functional range of motion to execute optimal component positioning.

Hip Profile in World Elite Junior Badminton Players: Impingement and Range of Motion Data from the World Junior Badminton Championship 2018

2021 ◽  
Author(s):  
Niels Christian Kaldau ◽  
Stewart Kerr ◽  
Steve McCaig ◽  
Per Hölmich
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Football Players ◽  
Motion Data ◽  
Femoroacetabular Impingement Syndrome ◽  
High Prevalence ◽  
The World ◽  
Hip Replacements ◽  
Hip Flexion

AbstractBadminton is played with repetitive high loading to the hip with lunging and jumps. In sports like soccer there is a high prevalence of femoroacetabular impingement syndrome in youth populations which may predispose them to osteoarthritis (OA). Internal rotation deficit in the hip of football players is a predictor of hip and groin pain and differences in the range of motion (ROM) of the hip between sex and different ethnicities exist. Early hip replacements in former elite badminton players due to OA seem to be a problem. There are no published values for ROM and impingement of the hip in badminton. The purpose is to report ROM and impingement of the hip in elite junior badminton players and to report any differences between sex and ethnicities. Players at the World Junior Championship 2018 were examined for hip flexion, rotation, and impingement test. Injury history was obtained from a questionnaire. Two hundred and eighty-four players of 433 aged 16 to 18 years were examined. One hundred and forty-three players answered the questionnaire. Females demonstrated greater hip ROM than males. In the dominant side hip flexion was (137.7 degrees [ ± 9.1] vs. 132.2 degrees [ ± 11.1], p < 0.001), internal rotation range of motion or IROM (60.0 degrees [ ± 10.9] vs. 49 degrees [ ± 11.1], p < 0.001) and external rotation range of motion or EROM (57.9 degrees [ ± 9.9] vs. 54.7 degrees [ ± 8.9], 0.004). Hip flexion was higher in Asian players compared with non-Asian players (139.1 degrees [ ± 8.4] vs. 130.3 degrees [ ± 10.7], p < 0.001). One hundred (35%) players had at least one positive impingement test. A possible relationship between a positive FADIR and a decrease in hip flexion was found in the dominant hip, OR 1.06 (1.02–1.11) p = 0.005. A total of 104 previous injuries lasting over 30 days were reported with five hip-related injuries. No correlation between injury and examinations was found. Females and Asians demonstrated higher ROM in the hip than males and non-Asians. Impingement of the hip is frequent and may be related to low hip flexion.

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