@inproceedings{WeberDendorferGrifkaetal., author = {Weber, Tim and Dendorfer, Sebastian and Grifka, Joachim and Weber, Markus and W{\"o}rner, Michael and Dullien, Silvia and Verkerke, Gijsbertus Jacob and Renkawitz, Tobias}, title = {Verbessert die computerassistierte Femur First Operationstechnik f{\"u}r die H{\"u}ftendoprothetik den muskuloskelettalen Lastfall auf das H{\"u}ftgelenk?}, series = {DKOU 2015, Deutscher Kongress f{\"u}r Orthop{\"a}die und Unfallchirurgie 2015}, booktitle = {DKOU 2015, Deutscher Kongress f{\"u}r Orthop{\"a}die und Unfallchirurgie 2015}, language = {de} } @article{WeberDullienGrifkaetal., author = {Weber, Tim and Dullien, Silvia and Grifka, Joachim and Renkawitz, Tobias and Dendorfer, Sebastian}, title = {Validation of a Motion Capture Laboratory and a new marker-placement protcol for clinical applications}, series = {Gait \& Posture}, volume = {38}, journal = {Gait \& Posture}, number = {Suppl. 1}, doi = {10.1016/j.gaitpost.2013.07.229}, pages = {113 -- 114}, language = {en} } @inproceedings{WeberRenkawitzGrifkaetal., author = {Weber, Tim and Renkawitz, Tobias and Grifka, Joachim and Bulstra, Sjoerd K. and Verkerke, Gijsbertus Jacob and Dendorfer, Sebastian}, title = {The musculoskeletal load scenario of computer-assisted Femur-First THR up to one year after surgery}, series = {VI International Conference on Computational Bioengineering, Barcelona, Sept. 2015}, booktitle = {VI International Conference on Computational Bioengineering, Barcelona, Sept. 2015}, language = {en} } @article{BenditzAuerSpoerreretal., author = {Benditz, Achim and Auer, Simon and Sp{\"o}rrer, J.F. and Wolkerstorfer, S. and Grifka, Joachim and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Regarding loads after spinal fusion, every level should be seen separately: a musculoskeletal analysis}, series = {European Spine Journal}, volume = {27}, journal = {European Spine Journal}, number = {8}, publisher = {Springer-Verlag}, doi = {10.1007/s00586-018-5476-5}, pages = {1905 -- 1910}, abstract = {The number of spinal fusion surgeries is steadily increasing and biomechanical consequences are still in debate. The aim of this study is to provide biomechanical insights into the sagittal balance of the spine and to compare spinal load before and after spinal fusion. METHOD: The joint reaction forces of 52 patients were analyzed in proximo-distal and antero-posterior direction from the levels T12-L1 to L5-S1 using musculoskeletal simulations. RESULTS: In 104 simulations, pre-surgical forces were equal to post-surgical. The levels L4-L5 and T12-L1, however, showed increased spinal forces compression forces with higher sagittal displacement. Improved restauration of sagittal balance was accompanied by lower spinal load. AP shear stress, interestingly decreased with sagittal imbalance. CONCLUSION: Imbalanced spines have a risk of increased compression forces at Th12-L1. L4-L5 always has increased spinal loads. These slides can be retrieved under Electronic Supplementary Material.}, subject = {Biomechanische Analyse}, language = {en} } @inproceedings{WeberDendorferBulstraetal., author = {Weber, Tim and Dendorfer, Sebastian and Bulstra, Sjoerd K. and Grifka, Joachim and Verkerke, Gijsbertus Jacob and Renkawitz, Tim}, title = {Navigated Femur First Total Hip Arthroplasty leads to improved Biomechanical Outcome after surgery}, series = {ORS annual meeting, Las Vegas, USA, 2015}, booktitle = {ORS annual meeting, Las Vegas, USA, 2015}, language = {en} } @inproceedings{WeberDendorferDullienetal., author = {Weber, Tim A. and Dendorfer, Sebastian and Dullien, Silvia and Grifka, Joachim and Verkerke, Gijsbertus Jacob and Renkawitz, Tobias}, title = {Measuring functional outcome after total hip replacement with subject-specific hip joint loading}, series = {Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine}, volume = {226}, booktitle = {Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine}, number = {12}, doi = {10.1177/0954411912447728}, pages = {939 -- 946}, abstract = {Total hip replacement is an often-performed orthopedic surgical procedure; the amount of procedures undertaken will increase since our life expectancy is growing. In order to optimize function, hip biomechanics should be restored to as near normal as possible. The goal of this pilot study was to determine whether or not it is feasible to compute the vectorial hip reaction force pathways on the head of the prosthesis and the force angles relative to the cup of the prosthesis that occur during gait in total hip replacement patients, serving as an objective measurement of the functional outcome following hip replacement. A three-dimensional gait analysis, measuring ground reaction forces and kinematics, was performed. The data retrieved from the gait analysis was used as the input for the musculoskeletal model to compute vectorial joint reaction forces for data processing. To evaluate the position and orientation of the joint reaction forces, the force path, as well as the force angles for the operated and non-operated joint, has been calculated during the stance phase of the specific leg. The force path for subject 2 on the non-operated side is only located in the posterior-lateral quarter, as is the force path for subject 1. In contrast to this subject, the force path for subject 2 at the operated hip joint can be found only within the anterior quarter of the head of the implant, where it is nearly equally distributed in the medio-lateral half of the prosthesis head. The force-inclination angles on the cup of subject 1, with respect to the plane of the socket face, indicates that the force vector is mainly positioned in the same quadrant when compared with subject 2 (in a cup-fixed coordinate system). The force-anteversion angle behaves similarly to the force-inclination angle, even when the effects are not as pronounced. The proposed methods in this article are aiming to define two functional outcomes of total hip replacement that are related to wear and rim loading. It is accepted that wear is not only a function of time, but a function of use. Owing to the methods listed in this article, we are able to determine a) the applied force and b) the sliding distance (force pathway) in a subject-specific manner. The computed hip-reaction force angles and the distance to the rim cup are a measurement for cup or rim loading, and occurs in the so-called safe-zones. This method may well give us insight into the biomechanical situation during gait, after receiving total hip replacement, that we need to fully understand the mechanisms acting on a hip joint and to prove a possible increase of functional outcome after receiving total hip replacement.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{RenkawitzWeberDullienetal., author = {Renkawitz, Tobias and Weber, Tim A. and Dullien, Silvia and Woerner, Michael and Dendorfer, Sebastian and Grifka, Joachim and Weber, Markus}, title = {Leg length and offset differences above 5 mm after total hip arthroplasty are associated with altered gait kinematics}, series = {Gait \& Posture}, volume = {vol. 49}, journal = {Gait \& Posture}, doi = {10.1016/j.gaitpost.2016.07.011}, pages = {196 -- 201}, abstract = {We aimed to investigate the relationship between postoperative leg length/offset (LL/OS) reconstruction and gait performance after total hip arthroplasty (THA). In the course of a prospective randomized controlled trial, 60 patients with unilateral hip arthrosis received cementless THA through a minimally-invasive anterolateral surgical approach. One year post-operatively, LL and global OS restoration were analyzed and compared to the contralateral hip on AP pelvic radiographs. The combined postoperative limb length/OS reconstruction of the operated hip was categorized as restored (within 5 mm) or non-restored (more than 5 mm reduction or more than 5 mm increment). The acetabular component inclination, anteversion and femoral component anteversion were evaluated using CT scans of the pelvis and the femur. 3D gait analysis of the lower extremity and patient related outcome measures (HHS, HOOS, EQ-5D) were obtained pre-operatively, six months and twelve months post-operatively by an observer blinded to radiographic results. Component position of cup and stem was comparable between the restored and non-restored group. Combined LL and OS restoration within 5 mm resulted in higher Froude number (p < 0.001), normalized walking speed (p < 0.001) and hip range-of-motion (ROM) (p = 0.004) during gait twelve months postoperatively, whereas gait symmetry was comparable regardless of LL and OS reconstruction at both examinations. Clinical scores did not show any relevant association between the accuracy of LL or OS reconstruction and gait six/twelve months after THA. In summary, postoperative LL/OS discrepancies larger than 5 mm relate to unphysiological gait kinematics within the first year after THA. DRKS00000739, German Clinical Trials Register.}, language = {en} } @article{WeberSuessJerabeketal., author = {Weber, Markus and Suess, Franz and Jerabek, Seth and Meyer, Matthias and Grifka, Joachim and Renkawitz, Tobias and Dendorfer, Sebastian}, title = {Kinematic pelvic tilt during gait alters functional cup position in total hip arthroplasty}, series = {Journal of Orthopaedic Research}, volume = {40}, journal = {Journal of Orthopaedic Research}, number = {4}, publisher = {Wiley}, issn = {1554-527X}, doi = {10.1002/jor.25106}, pages = {846 -- 853}, abstract = {Static pelvic tilt impacts functional cup position in total hip arthroplasty (THA). In the current study we investigated the effect of kinematic pelvic changes on cup position. In the course of a prospective controlled trial postoperative 3D-computed tomography (CT) and gait analysis before and 6 and 12 months after THA were obtained in 60 patients. Kinematic pelvic motion during gait was measured using Anybody Modeling System. By fusion with 3D-CT, the impact of kinematic pelvic tilt alterations on cup anteversion and inclination was calculated. Furthermore, risk factors correlating with high pelvic mobility were evaluated. During gait a high pelvic range of motion up to 15.6° exceeding 5° in 61.7\% (37/60) of patients before THA was found. After surgery, the pelvis tilted posteriorly by a mean of 4.0 ± 6.6° (p < .001). The pelvic anteflexion led to a mean decrease of -1.9 ± 2.2° (p < .001) for cup inclination and -15.1 ± 6.1° (p < .001) for anteversion in relation to the anterior pelvic plane (APP). Kinematic pelvic changes resulted in a further change up to 2.3° for inclination and up to 12.3° for anteversion. In relation to the preoperative situation differences in postoperative cup position ranged from -4.4 to 4.6° for inclination and from -7.8 to 17.9° for anteversion, respectively. Female sex (p < .001) and normal body weight (p < .001) correlated with high alterations in pelvic tilt. Kinematic pelvic changes highly impact cup anteversion in THA. Surgeons using the APP as reference should aim for a higher anteversion of about 15° due to the functional anteflexion of the pelvis during gait.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{WeberMerleNawabietal., author = {Weber, Markus and Merle, Christian and Nawabi, Danyal H. and Dendorfer, Sebastian and Grifka, Joachim and Renkawitz, Tobias}, title = {Inaccurate offset restoration in total hip arthroplasty results in reduced range of motion}, series = {Scientific Reports}, volume = {10}, journal = {Scientific Reports}, number = {13208}, publisher = {Nature}, doi = {10.1038/s41598-020-70059-1}, pages = {9}, abstract = {Offset restoration in total hip arthroplasty (THA) is associated with postoperative range of motion (ROM) and gait kinematics. We aimed to research into the impact of high offset (HO) and standard stems on postoperative ROM. 121 patients received cementless THA through a minimally-invasive anterolateral approach. A 360° hip ROM analysis software calculated impingement-free hip movement based on postoperative 3D-CTs compared to ROM values necessary for activities of daily living (ADL). The same model was then run a second time after changing the stem geometry between standard and HO configuration with the implants in the same position. HO stems showed higher ROM for all directions between 4.6 and 8.9° (p < 0.001) compared with standard stems but with high interindividual variability. In the subgroup with HO stems for intraoperative offset restoration, the increase in ROM was even higher for all ROM directions with values between 6.1 and 14.4° (p < 0.001) compared to offset underrestoration with standard stems. Avoiding offset underrestoration resulted in a higher amount of patients of over 20\% for each ROM direction that fulfilled the criteria for ADL (p < 0.001). In contrast, in patients with standard stems for offset restoration ROM did increase but not clinically relevant by offset overcorrection for all directions between 3.1 and 6.1° (p < 0.001). Offset overcorrection by replacing standard with HO stems improved ROM for ADL in a low number of patients below 10\% (p > 0.03). Patient-individual restoration of offset is crucial for free ROM in THA. Both over and underrestoration of offset should be avoided.}, language = {en} } @article{WeberDendorferBulstraetal., author = {Weber, Tim A. and Dendorfer, Sebastian and Bulstra, Sjoerd K. and Grifka, Joachim and Verkerke, Gijsbertus Jacob and Renkawitz, Tobias}, title = {Gait six month and one-year after computer assisted Femur First THR vs. conventional THR. Results of a patient- and observer- blinded randomized controlled trial}, series = {Gait \& Posture}, volume = {vol. 49}, journal = {Gait \& Posture}, doi = {10.1016/j.gaitpost.2016.06.035}, pages = {418 -- 425}, abstract = {A prospective randomized controlled trial is presented that is used to compare gait performance between the computer assisted Femur First (CAS FF) operation method and conventional THR (CON). 60 patients underwent a 3D gait analysis of the lower extremity at pre-operative, 6 months post-operative and twelve months post-operative. Detailed verification experiments were facilitated to ensure the quality of data as well as to avoid over-interpreting of the data. The results confirm a similar data-quality as reported in the literature. Walking speed, range of motion and symmetry thereof improved over the follow-up period, without significant differences between the groups. While all parameters do significantly increase over the follow-up period for both groups, there were no significant differences between them at any given time-point. Patients undergoing CAS FF showed a trend to improved hip flexion angle indicating a possible long-term benefit.}, language = {en} }