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Does Computer-Assisted Femur First THR Improve Musculoskeletal Loading Conditions?

Weber TA, Dendorfer S, Grifka J, Verkerke GJ, Renkawitz T - Biomed Res Int (2015)

Bottom Line: Phase-shift symmetry showed an increase in the CAS FF group.Hrf orientation in the CAS FF group was closer to optimum, though no edge or rim-loading occurred in the CON group as well.The CAS FF group showed an improved hrf orientation in an early stage and a trend to an improved long-term outcome.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Mechanical Engineering, Laboratory for Biomechanics, Ostbayerische Technische Hochschule Regensburg, 93053 Regensburg, Germany ; Department of Orthopaedic Surgery, Regensburg University Medical Center (UKR), 93077 Bad Abbach, Germany.

ABSTRACT
We have developed a novel, computer-assisted operation method for minimal-invasive total hip replacement (THR) following the concept of "femur first/combined anteversion," which incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position (CAS FF). The purpose of this study is to assess whether the hip joint reaction forces and patient's gait parameters are being improved by CAS FF in relation to conventional THR (CON). We enrolled 60 patients (28 CAS FF/32 CON) and invited them for gait analysis at three time points (preoperatively, postop six months, and postop 12 months). Data retrieved from gait analysis was processed using patient-specific musculoskeletal models. The target parameters were hip reaction force magnitude (hrf), symmetries, and orientation with respect to the cup. Hrf in the CAS FF group were closer to a young healthy normal. Phase-shift symmetry showed an increase in the CAS FF group. Hrf orientation in the CAS FF group was closer to optimum, though no edge or rim-loading occurred in the CON group as well. The CAS FF group showed an improved hrf orientation in an early stage and a trend to an improved long-term outcome.

No MeSH data available.


Flow chart of patient acquisition with inclusion criteria according to Renkawitz et al. [11].
© Copyright Policy - open-access
Related In: Results  -  Collection


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fig1: Flow chart of patient acquisition with inclusion criteria according to Renkawitz et al. [11].

Mentions: Patients were randomly allocated to receive either Femur First CAS THR or conventional THR; see Figure 1. Patient characteristics according to allocation are presented in Table 1. The random allocation sequence was computer-generated in a permuted block randomization designed by the associate statistician using certificated randomization software (Rancode 3.6 Professional, IDV, Gauting, Germany).


Does Computer-Assisted Femur First THR Improve Musculoskeletal Loading Conditions?

Weber TA, Dendorfer S, Grifka J, Verkerke GJ, Renkawitz T - Biomed Res Int (2015)

Flow chart of patient acquisition with inclusion criteria according to Renkawitz et al. [11].
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4637031&req=5

fig1: Flow chart of patient acquisition with inclusion criteria according to Renkawitz et al. [11].
Mentions: Patients were randomly allocated to receive either Femur First CAS THR or conventional THR; see Figure 1. Patient characteristics according to allocation are presented in Table 1. The random allocation sequence was computer-generated in a permuted block randomization designed by the associate statistician using certificated randomization software (Rancode 3.6 Professional, IDV, Gauting, Germany).

Bottom Line: Phase-shift symmetry showed an increase in the CAS FF group.Hrf orientation in the CAS FF group was closer to optimum, though no edge or rim-loading occurred in the CON group as well.The CAS FF group showed an improved hrf orientation in an early stage and a trend to an improved long-term outcome.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Mechanical Engineering, Laboratory for Biomechanics, Ostbayerische Technische Hochschule Regensburg, 93053 Regensburg, Germany ; Department of Orthopaedic Surgery, Regensburg University Medical Center (UKR), 93077 Bad Abbach, Germany.

ABSTRACT
We have developed a novel, computer-assisted operation method for minimal-invasive total hip replacement (THR) following the concept of "femur first/combined anteversion," which incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position (CAS FF). The purpose of this study is to assess whether the hip joint reaction forces and patient's gait parameters are being improved by CAS FF in relation to conventional THR (CON). We enrolled 60 patients (28 CAS FF/32 CON) and invited them for gait analysis at three time points (preoperatively, postop six months, and postop 12 months). Data retrieved from gait analysis was processed using patient-specific musculoskeletal models. The target parameters were hip reaction force magnitude (hrf), symmetries, and orientation with respect to the cup. Hrf in the CAS FF group were closer to a young healthy normal. Phase-shift symmetry showed an increase in the CAS FF group. Hrf orientation in the CAS FF group was closer to optimum, though no edge or rim-loading occurred in the CON group as well. The CAS FF group showed an improved hrf orientation in an early stage and a trend to an improved long-term outcome.

No MeSH data available.