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Forschungsbericht 2013
(2014)
Influence of minimally invasive total hip replacement on hip reaction forces and their orientations
(2014)
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.
High loads can appear in the individual joints of the human foot while the driver uses the pedals, in particular, during breaking. Measuring these internal forces is very difficult or almost impossible; therefore, advanced models are necessary to perform musculoskeletal simulations. The objective of this investigation was to see what loads are acting in the individual foot joints from the phalanges to calcaneus and talus during different brake scenarios. The Glasgow-Maastricht AnyBody Foot Model with 26 separate segments, connected by joints, ligaments and muscles was used inside the AnyBody Modeling System to compute individual mid foot joint loads. The amount, the direction of the force and additionally also the load insertion point was varied for several simulations. Figure 1: Seated musculoskeletal body model with applied brake force and forces for the lateral, intermediate and medial cuneiform-navicular joint for two different brake forces. The simulation showed that for the different brake scenarios, different muscles will be activated in the human and therefore different loads are apply in the fore-and mid-foot, respectively. The torso of the subject was assumed to be fixed in the seat. Further studies are ongoing to simulate the seat as an elastic element that allows different H-point locations according to the different loadings in the foot from the brake pedal using a new inverse dynamics analysis method called force-dependent kinematics.