TY - JOUR A1 - Renkawitz, Tobias A1 - Weber, Tim A. A1 - Dullien, Silvia A1 - Woerner, Michael A1 - Dendorfer, Sebastian A1 - Grifka, Joachim A1 - Weber, Markus T1 - Leg length and offset differences above 5 mm after total hip arthroplasty are associated with altered gait kinematics JF - Gait & Posture N2 - 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. KW - THA KW - Leg length KW - Offset KW - Gait analysis KW - Biomechanics Y1 - 2016 U6 - https://doi.org/10.1016/j.gaitpost.2016.07.011 VL - vol. 49 SP - 196 EP - 201 ER - TY - JOUR A1 - Völlner, Florian A1 - Weber, Tim A. A1 - Weber, Markus A1 - Renkawitz, Tobias A1 - Dendorfer, Sebastian A1 - Grifka, Joachim A1 - Craiovan, Benjamin T1 - A simple method for determining ligament stiffness during total knee arthroplasty in vivo JF - Scientific Reports N2 - A key requirement in both native knee joints and total knee arthroplasty is a stable capsular ligament complex. However, knee stability is highly individual and ranges from clinically loose to tight. So far, hardly any in vivo data on the intrinsic mechanical of the knee are available. This study investigated if stiffness of the native ligament complex may be determined in vivo using a standard knee balancer. Measurements were obtained with a commercially available knee balancer, which was initially calibrated in vitro. 5 patients underwent reconstruction of the force-displacement curves of the ligament complex. Stiffness of the medial and lateral compartments were calculated to measure the stability of the capsular ligament complex. All force-displacement curves consisted of a non-linear section at the beginning and of a linear section from about 80 N onwards. The medial compartment showed values of 28.4 ± 1.2 N/mm for minimum stiffness and of 39.9 ± 1.1 N/mm for maximum stiffness; the respective values for the lateral compartment were 19.9 ± 0.9 N/mm and 46.6 ± 0.8 N/mm. A commercially available knee balancer may be calibrated for measuring stiffness of knee ligament complex in vivo, which may contribute to a better understanding of the intrinsic mechanical behaviour of knee joints. KW - Biomechanische Analyse KW - Kniegelenkband KW - Steifigkeit Y1 - 2019 U6 - https://doi.org/10.1038/s41598-019-41732-x VL - 9 SP - 1 EP - 8 PB - Nature ER - TY - JOUR A1 - Weber, Tim A. A1 - Dendorfer, Sebastian A1 - Bulstra, Sjoerd K. A1 - Grifka, Joachim A1 - Verkerke, Gijsbertus Jacob A1 - Renkawitz, Tobias T1 - 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 JF - Gait & Posture N2 - 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. KW - Biomechanics KW - Combined anteversion KW - Computer-assisted surgery KW - Femur first KW - Gait analysis Y1 - 2016 U6 - https://doi.org/10.1016/j.gaitpost.2016.06.035 VL - vol. 49 SP - 418 EP - 425 ER - TY - JOUR A1 - Weber, Markus A1 - Merle, Christian A1 - Nawabi, Danyal H. A1 - Dendorfer, Sebastian A1 - Grifka, Joachim A1 - Renkawitz, Tobias T1 - Inaccurate offset restoration in total hip arthroplasty results in reduced range of motion JF - Scientific Reports N2 - 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. KW - Adaptive clinical trial KW - Bone imaging Y1 - 2020 U6 - https://doi.org/10.1038/s41598-020-70059-1 VL - 10 IS - 13208 SP - 9 PB - Nature ER - TY - JOUR A1 - Weber, Tim A1 - Dullien, Silvia A1 - Grifka, Joachim A1 - Renkawitz, Tobias A1 - Dendorfer, Sebastian T1 - Validation of a Motion Capture Laboratory and a new marker-placement protcol for clinical applications JF - Gait & Posture Y1 - 2013 U6 - https://doi.org/10.1016/j.gaitpost.2013.07.229 VL - 38 IS - Suppl. 1 SP - 113 EP - 114 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 - 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 - CHAP A1 - Weber, Joachim A1 - Doenitz, Christian A1 - Brawanski, Alexander A1 - Palm, Christoph T1 - Data-Parallel MRI Brain Segmentation in Clinicial Use BT - Porting FSL-Fastv4 to GPGPUs T2 - Bildverarbeitung für die Medizin 2015; Algorithmen - Systeme - Anwendungen; Proceedings des Workshops vom 15. bis 17. März 2015 in Lübeck N2 - Structural MRI brain analysis and segmentation is a crucial part in the daily routine in neurosurgery for intervention planning. Exemplarily, the free software FSL-FAST (FMRIB’s Segmentation Library – FMRIB’s Automated Segmentation Tool) in version 4 is used for segmentation of brain tissue types. To speed up the segmentation procedure by parallel execution, we transferred FSL-FAST to a General Purpose Graphics Processing Unit (GPGPU) using Open Computing Language (OpenCL) [1]. The necessary steps for parallelization resulted in substantially different and less useful results. Therefore, the underlying methods were revised and adapted yielding computational overhead. Nevertheless, we achieved a speed-up factor of 3.59 from CPU to GPGPU execution, as well providing similar useful or even better results. KW - Brain Segmentation KW - Magnetic Resonance Imaging KW - Parallel Execution KW - Voxel Spacing KW - General Purpose Graphic Processing Unit KW - Kernspintomografie KW - Gehirn KW - Bildsegmentierung KW - Parallelverarbeitung Y1 - 2015 U6 - https://doi.org/10.1007/978-3-662-46224-9_67 SP - 389 EP - 394 PB - Springer CY - Berlin ER -