TY - JOUR A1 - Renkawitz, Tobias A1 - Dendorfer, Sebastian T1 - Orthopedic navigation technology and biomechanical evaluation for total hip replacement JF - Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine KW - Hüftgelenkprothese KW - Orthopädische Chirurgie KW - Computerunterstütztes Verfahren KW - Biomechanische Analyse Y1 - 2012 U6 - https://doi.org/10.1177/0954411912458746 VL - 226 IS - 12 SP - 897 EP - 898 ER - TY - JOUR A1 - Dendorfer, Sebastian A1 - Weber, Tim A1 - Kennedy, O. T1 - Musculoskeletal modeling for hip replacement outcome analyses and other applications JF - The Journal of the American Academy of Orthopaedic Surgeons KW - Hüftgelenkprothese KW - Bewegungsapparat KW - Simulation Y1 - 2014 U6 - https://doi.org/10.5435/JAAOS-22-04-268 VL - 22 IS - 4 SP - 268 EP - 269 ER - TY - CHAP A1 - Weber, Tim A. A1 - Dendorfer, Sebastian A1 - Dullien, Silvia A1 - Grifka, Joachim A1 - Verkerke, Gijsbertus Jacob A1 - Renkawitz, Tobias T1 - Measuring functional outcome after total hip replacement with subject-specific hip joint loading T2 - Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine N2 - 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. KW - total hip replacement KW - subject-specific musculoskeletal modeling KW - functional outcome KW - force pathways KW - force angles KW - critical hip joint loading KW - rim loading KW - cup loading KW - Hüftgelenkprothese KW - Biomechanik KW - Lastverteilung KW - Ganganalyse KW - Simulation Y1 - 2012 U6 - https://doi.org/10.1177/0954411912447728 VL - 226 IS - 12 SP - 939 EP - 946 ER - TY - JOUR A1 - Weber, Markus A1 - Suess, Franz A1 - Jerabek, Seth A1 - Meyer, Matthias A1 - Grifka, Joachim A1 - Renkawitz, Tobias A1 - Dendorfer, Sebastian T1 - Kinematic pelvic tilt during gait alters functional cup position in total hip arthroplasty JF - Journal of Orthopaedic Research N2 - 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. KW - component position KW - gait analysis KW - kinematics KW - pelvic tilt KW - total hip arthroplasty KW - Hüftgelenkprothese KW - Haltungsfehler KW - Hüftgelenkpfanne Y1 - 2021 U6 - https://doi.org/10.1002/jor.25106 SN - 1554-527X VL - 40 IS - 4 SP - 846 EP - 853 PB - Wiley ER - TY - JOUR A1 - Weber, Tim A1 - Al-Munajjed, Amir Andreas A1 - Verkerke, Gijsbertus Jacob A1 - Dendorfer, Sebastian A1 - Renkawitz, Tobias T1 - Influence of minimally invasive total hip replacement on hip reaction forces and their orientations JF - Journal of Orthopaedic Research N2 - Minimally invasive surgery (MIS) is becoming increasingly popular. Supporters claim that the main advantages of MIS total hip replacement (THR) are less pain and a faster rehabilitation and recovery. Critics claim that safety and efficacy of MIS are yet to be determined. We focused on a biomechanical comparison between surgical standard and MIS approaches for THR during the early recovery of patients. A validated, parameterized musculoskeletal model was set to perform a squat of a 50th percentile healthy European male. A bilateral motion was chosen to investigate effects on the contralateral side. Surgical approaches were simulated by excluding the incised muscles from the computations. Resulting hip reaction forces and their symmetry and orientation were analyzed. MIS THR seemed less influential on the symmetry index of hip reaction forces between the operated and nonoperated leg when compared to the standard lateral approach. Hip reaction forces at peak loads of the standard transgluteal approach were 24% higher on the contralateral side when compared to MIS approaches. Our results suggest that MIS THR contributes to a greater symmetry of hip reaction forces in absolute value as well as force-orientation following THR. KW - THA KW - THR KW - Biomechanics KW - Conventional surgery KW - Early recovery KW - Hüftgelenkprothese KW - Minimal-invasive Chirurgie KW - Biomechanik Y1 - 2014 U6 - https://doi.org/10.1002/jor.22710 VL - 32 IS - 12 SP - 1680 EP - 1687 ER - TY - JOUR A1 - Weber, Tim A. A1 - Dendorfer, Sebastian A1 - Grifka, Joachim A1 - Verkerke, Gijsbertus Jacob A1 - Renkawitz, Tobias ED - Takagi, Michiaki T1 - Does Computer-Assisted Femur First THR Improve Musculoskeletal Loading Conditions? JF - BioMed Research International N2 - 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. KW - Hüftgelenkprothese KW - Operationstechnik KW - Computerunterstütztes Verfahren KW - Bewegungsapparat KW - Mechanische Belastung Y1 - 2015 U6 - https://doi.org/10.1155/2015/625317 VL - 2015 SP - ID 625317 ER - TY - JOUR A1 - De Pieri, Enrico A1 - Atzori, Federica A1 - Ferguson, Stephen J. A1 - Dendorfer, Sebastian A1 - Leunig, Michael A1 - Aepli, Martin T1 - Contact force path in total hip arthroplasty: effect of cup medialisation in a whole-body simulation JF - HIP International N2 - Background: Cup medialisation down to the true acetabular floor in total hip arthroplasty with a compensatory femoral offset increase seems to be mechanically advantageous for the abductor muscles due to the relocation of the lever arms (body weight lever arm decreased, abductor lever arm increased). However, limited information is currently available about the effects of this reconstruction type at the head cup interface, compared to an anatomical reconstruction that maintains the natural lever arms. Through a whole-body simulation analysis, we compared medialised versus anatomical reconstruction in THA to analyse the effects on: (1) contact force magnitude at the head cup interface; (2) contact force path in the cup; and (3) abductor activity. Methods: Musculoskeletal simulations were performed to calculate the above-mentioned parameters using inverse dynamics analysis. The differences between the virtually implanted THAs were calculated to compare the medialised versus anatomical reconstruction. Results: Cup medialisation with compensatory femoral offset increase led to: (1) a reduction in contact force magnitude at the head cup interface up to 6.6%; (2) a similar contact force path in the cup in terms of sliding distance and aspect ratio; and (3) a reduction in abductor activity up to 17.2% (gluteus medius). Conclusions: In our opinion, these potential biomechanical gains do not generally justify a fully medialised reconstruction, especially in younger patients that are more likely to undergo revision surgery in their lifetime. Cup medialisation should be performed until sufficient press fit and bony coverage of a properly sized and oriented cup can be achieved. KW - Cup medialisation KW - femoral offset KW - hip contact force KW - total hip anthroplasty KW - total hip replacement KW - Hüftgelenkprothese KW - Kontaktkraft KW - Biomechanische Analyse KW - Simulation Y1 - 2020 U6 - https://doi.org/10.1177/1120700020917321 VL - 31 IS - 5 SP - 624 EP - 631 PB - Sage ER -