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1
Apatsidis, Dimitrios P. "The hip joint capsule : mechanical properties and contribution to joint stability in total hip replacement." Thesis, University of Strathclyde, 2002. http://oleg.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=21186.
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The hip joint capsule is a complex soft tissue structure that comprises a number of ligaments with different thickness and strength respectively, as well as a thinner membrane-like part that provides the structural integrity for the capsule. The role of the capsule is twofold, forming a closed environment around the joint surfaces, in which the synovial fluids are retained, but also providing a passive joint resistance that acts in addition to the surrounding muscles and mainly in extreme limb positions and in unexpected limb loading. Despite its important role, the capsule is commonly removed in Total Hip Replacement (THR), either fully or partially, to clear the view to the joint. The little existing knowledge on the mechanical properties of the capsule and its performance in situ during various walking activities makes it difficult to argue for its preservation and repair following THR, especially due to the additional efforts that this brings along for the surgical team. This project is an attempt to provide this required information and to highlight any changes in joint resistance that occur as a result of a complete or partial removal of the hip joint capsule. A cadaveric approach was used at first, in which complete human hip joints with intact capsules were tested. A sequential removal of the capsular ligaments was carried out, in order to reveal the total contribution to joint resistive moments of the individual ligaments. Anterior ligaments were distinguished from posterior ones and the tests were carried out in those limb positions in which the joint would be least stable under absence of the respective ligaments. Partial damage of the posterior aspects of the capsule showed increased risk for posterior joint dislocation when the limb was in flexion and internal rotation compared to the effects of an anteriorly damaged capsule. A 3-D computer model of the hip joint with its capsular ligaments was created, in order to confirm the findings from the cadaveric study, but also for the purpose of simulating effects in post-operative anatomies. Different methods of creating the geometric model were attempted and it was achieved to create a model that would be used to simulate the resistive moments produced by the individual ligaments. For simplicity, the ligament action was simulated by linear spring elements. The findings of the cadaveric experiments could not be reproduced, because of the way the ligament forces were modelled, which does not consider the viscoelastic properties of soft biological tissues. However, it was still possible to draw valuable conclusions on the effect that various prosthetic component attributes have on the total joint moments. Recommendations were made for the optimal approach to the capsule in THR.
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Aslan, Nuri. "A polymeric composite hip joint prosthesis." Thesis, University of Ulster, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.385672.
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Stroud, Nicholas James. "Advancements of a servohydraulic human hip joint motion simulator for experimental investigation of hip joint impingement/dislocation." Thesis, University of Iowa, 2010. https://ir.uiowa.edu/etd/746.
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A servohydraulic hip simulator was upgraded to experimentally investigate cadaveric impingement/dislocation of the hip with clinically releveant joint motions. The resulting biomechanical analysis provided insight into risk factors for dislocation/impingement and clearly demonstrated the potential of the hip simulator as a research tool.
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Chen, Shuenn-muh. "Kinematic and passive resistive properties of human shoulder hip and elbow complexes /." The Ohio State University, 1986. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487266691095932.
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Walter, William Lindsay School of Biomechanics UNSW. "Severe biomechanical conditions in total hip replacement." Awarded by:University of New South Wales. School of Biomechanics, 2006. http://handle.unsw.edu.au/1959.4/25968.
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Hip simulators are designed to reproduce the forces and motion patterns of normal walking. In vivo demands on total hip replacements, however, are varied and often more severe than normal walking conditions. It is these severe conditions that often lead to implant failure. This is clinically based research aimed at understanding some of the more severe conditions in hips and the effect that these have on the performance of the total hip replacement. The polyethylene liner can act as a pump in an acetabular component, forcing fluid and wear particles through the holes to the retroacetabular bone causing osteolysis. Ten patients were studied at revision surgery. Pressures were measured in retroacetabular osteolytic lesions while performing pumping manouvers with the hip. Two laboratory experiments were then designed to study pumping mechanisms in vitro. In patients with contained osteolytic lesions, fluid pressure fluctuations could be measured in the lesion in association with the pumping action. Patients with uncontained osteolytic lesions showed no such pressure fluctuations. In the laboratory we identified 3 distinct mechanisms whereby fluid can be pumped from the hip joint to the retroacetabular bone. These pumping effects could be mitigated by improved implant design. Loading of the femoral head against the edge of the acetabular component produces dramatically increased contact pressures particularly in hard-on-hard bearings. In an analysis of 16 retrieved ceramic-on-ceramic bearings we were able to characterise the mechanism of edge loading based on the pattern of edge loading wear on the bearing surface. Finally in a radiographic study of patients with squeaking ceramic-on-ceramic hips. Squeaking was found to be associated with acetabular component malposition. It seems that edge loading or impingement may be an associated factor in these cases.
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Watters, Eamon Patrick John. "Wear properties of artificial hip joint materials." Thesis, Queen's University Belfast, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.321968.
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Schumacher, Brian. "An analysis of the femoral head/stem taper lock for orthopaedic prostheses." Thesis, Georgia Institute of Technology, 1992. http://hdl.handle.net/1853/18927.
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Good, Victoria Diane. "The tribological significance of the joint fluid analog in a hip joint simulator." Thesis, University of Strathclyde, 2001. http://oleg.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=21422.
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Wear is the number one concern with regards to the longevity of THR (total hip replacement). Therefore, reliable in-vitro prediction of wear is necessary. Thus, the laboratory should first validate their hip simulators with known clinical materials. The limiting factor in hip wear simulation has been the joint fluid analog. Using 100% bovine serum as the joint fluid analog, UHMWPE (ultra-high molecular weight polyethylene) wear-rates have been continually underestimated and PTFE (polytetrafluoroethylene) wear has been overestimated. Therefore, this work investigated the effect of protein concentration in bovine serum on the wear of PTFE and UHMWPE in a biaxial hip joint simulator. Validation criteria were developed based on the clinical findings of: ball size effect of increased wear with increased head size, 6% increase in wear for each millimeter of increased head diameter, clinical wear magnitudes, PTFE/UHWMPE wear-rate ratio and debris morphology. Both materials duplicated the clinical criteria using bovine serum with 10mg/ml of protein concentration. As protein concentration went from 0 to 10mg/ml, wear of both materials increased, however with greater than 10mg/ml protein; a) the rate of increase for PTFE was reduced by 80% and b) the wear of UHMWPE reversed, thus, showing that proteins cause wear. Additionally as the volume of fluid was increased, wear increased. This change in wear with protein concentration and volume was due to a protection of protein precipitate. As protein concentration increased protein precipitation increased and wear was decreased due to a protective layer of precipitates. Furthermore, wear protection was dependent on the amount of protein precipitation which was in turn, dependent on the initial concentration, volume of fluid and time. Therefore, wear in-vitro was dependent on the joint fluid analog. This work proved that the laboratory could duplicate clinical findings using bovine serum with 10mg/ml of protein concentration as the joint fluid analog and thus increase confidence in wear evaluation; taking the first steps to showing reliability of in-vitro THR wear studies.
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Runser, Alicia M. "Global Joint Registry: Analysis of Revision Hip Arthroplasty Data." Wright State University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=wright1610382916575377.
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Weinrauch, Patrick Connor Lachlan. "Techniques for the Surgical Management of Adult Hip Joint Disorders." Thesis, Griffith University, 2017. http://hdl.handle.net/10072/366442.
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This thesis is a compilation of published manuscripts arising from research activities that I have undertaken over the last ten years in relation to the surgical management of adult hip joint disorders. The objectives of these research activities have been to improve the outcomes of the surgical procedures performed within my own clinical practice and to share my conclusions more broadly with the orthopaedic community by publication. Typically my publications are of a practical nature, often relating to the technical aspects of the conduct of surgery. They represent my attempts to answer questions that have arisen during my day-to-day clinical practice as an orthopaedic surgeon. The themes that constitute the majority of the material included within this thesis relate to the development of innovative surgical techniques, testing the validity of traditional methods of orthopaedic practice and the management of difficult clinical presentations. As my clinical practice and associated research activities span a number of topics within the broader discipline of adult hip joint surgery, I have divided this thesis into four chapters. Each chapter contains manuscripts that relate to a distinct area of my clinical practice - Perioperative Management, Trauma Management, Hip Arthroscopy and Elective Hip Arthroplasty. At the start of each chapter, a content introduction and concise background of the contained material is provided. A chronologic listing of each of the manuscripts contained within this thesis is provided in Appendix 1.Thesis (PhD Doctorate)
Doctor of Philosophy by Publication (PhD)
School of Medical Science
Griffith Health
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Stansfield, Benedict William. "Hip joint forces : hip joint forces of 40 to 60 year old normal and total hip replacement subjects during walking and stair, ramp and camber negotiation." Thesis, University of Strathclyde, 2000. http://oleg.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=21141.
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To design and test hip joint prosthesis it is essential to know the magnitude and character of forces that may be applied to them in-vivo. For this thesis the hip joint forces of 40 to 60 year old subjects (five male and six female normal subjects and five male hip replacement) were studied. To allow the calculation of hip joint forces data from three-dimensional motion analysis and force plates were applied to a model of the lower limb. The model included the hip, knee and talocrural joints with 3 hip, 8 knee and 8 ankle joint forces, 4 knee ligaments and 47 muscle elements. A double linear optimisation technique (first minimising the maximum muscle stress then minimising the sum of the forces in the force bearing structures) was applied to solve the redundancy problem of force distribution in the muscles. Walking and stair, ramp and camber negotiation were characterised. Ground reaction forces, joint angles, intersegmental forces and moments, joint and ligament forces and muscle forces are presented. Muscle forces predictions were in general agreement with those in the literature, although the model was not capable of correctly distributing forces in the vasti or in the ankle only muscles as patella and talocalcaneonavicular joint equilibria were not included. In general, hip replacement subjects demonstrated lower hip joint forces than normal subjects. The range of maximum resultant hip joint forces for all activities was 3.04 to 11.85 for male normal subjects, 4.18 to 11.50 for female normal subjects, 3.73 to 6.81 and 2.21 to 8.77 for male hip replacement subjects for their natural and replaced sides respectively. The results presented define in three dimensions the hip joint forces in both pelvic and femoral axes systems and thus characterise the probable in-vivo requirements of hip joint prostheses during performance of the activities studied.
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Smith, Simon Lawrence. "Design, development and applications of hip joint simulators." Thesis, Durham University, 1999. http://etheses.dur.ac.uk/1132/.
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Miles, Brad. "Reducing the risk of peri-prosthetic femoral fracture : prothesis, patient or procedure?" Phd thesis, Faculty of Engineering and Information Technologies, 2012. http://hdl.handle.net/2123/9987.
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IWATA, HISASHI, SEIKI IWASADA, KOUICHI KAWAMOTO, TOSHIKI IWASE, and YUKIHARU HASEGAWA. "MACROMOTION OF THE FEMORAL COMPONENT IN ARTIFICIAL HIP JOINT." Nagoya University School of Medicine, 1996. http://hdl.handle.net/2237/16103.
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Sadeghi-Mehr, Mohsen. "Investigation of rolling element bearings for hip joint prostheses." Thesis, Imperial College London, 1998. http://hdl.handle.net/10044/1/8491.
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Ramjee, Shatish. "Numerical analysis of lubrication in an artificial hip joint." Pretoria : [s.n.], 2007. http://upetd.up.ac.za/thesis/available/etd-09152008-133304/.
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Fitzsimmons, Anna. "Hip joint forces in hip replacement patients and normal subjects during activities of daily living." Thesis, University of Strathclyde, 1995. http://oleg.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=21386.
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A high number of revision hip replacement operations are currently performed due to loosening of the primary implant. The loading imposed on the prosthetic joint and its fixation mechanisms may be one of the many factors contributing to the loosening process. Previous work to determine hip joint loading has concentrated on gait, stair negotiation and rising from a chair. However, since patients often comment on the difficulty of getting into and out of a car and bath, these activities are also included in the current project. The 3 orthogonal components of hip joint force have been calculated for 16 postoperative hip replacement patients between one and two years after surgery and also for 10 age-matched normals. A biomechanical model of the lower limb was developed including 37 muscle elements. Algorithms were incorporated to correct for curved muscle paths, providing realistic muscle moment arms with changing joint angle configuration. An optimization routine which minimizes the o verall maximum muscle stress was incorporated to determine muscle forces which were then used in the calculation of joint force. The model utilizes anatomical muscle and bone data, kinematics measured using a 6 camera Vicon motion analysis system and ground reaction forces measured using force platforms. In validity tests, the predicted muscle activity patterns for normal subjects were found to be consistent with published EMG data for most muscles. The mean peak resultant hip joint force of 3.8 times body weight calculated for the patients during gait at 1.01 m/s was consistent with the results published for patients with instrumented hip prostheses at a measurement time of more than 12 months after surgery. The maximum mean peak resultant hip joint force determined for patients was 5 times body weight, calculated at the left hip when getting out of the passenger side of a right hand drive car. A simple calculation of torsional moment about the stem of the femoral component during this and other activities showed it to be close to or to exceed the experimentally determined limits of torsional strength of implant fixations, reported in the literature. The maximum mean peak resultant hip joint force calculated for normals was 6.3 times body weight, determined at the left hip on getting into the passenger side of a right hand drive car. It is suggested that car entry and exit and other activities should be performed in safer styles rid that the results of this thesis should be incorporated into the design and testing of hip prostheses.
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Hoang, Hoa. "Calibrated EMG-Informed Neuromusculoskeletal Modelling to Estimate Physiologically Plausible Hip Joint Contact Forces in People with Hip Osteoarthritis." Thesis, Griffith University, 2017. http://hdl.handle.net/10072/371909.
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Osteoarthritis (OA) is a common and progressive joint disease with a prevalence of 3.6-4.1% of the global population in 2010 and one of the leading causes of worldwide disability. Hip OA is less common than knee OA; although the prevalence of hip OA is 8% in people aged 85 years and over. There is no cure for hip OA, and pain and disability can be only managed through conservative therapies, or finally total hip replacement. Inappropriate hip joint loading, measured as hip joint contact forces (HJCF), during daily activities is believed to be a factor in hip OA initiation and progression.
Neuromusculoskeletal (NMS) models, which are anatomical and physiological mathematical representations of an individual, can be used to estimate muscle-tendon and internal joint contact forces (JCF) during human movement. However, the musculoskeletal system is inherently indeterminant and there are infinite combinations of muscle-tendon forces that can produce the same external joint loads. Two main neural control solutions that have been employed to solve this muscle-tendon force distribution problem: optimisation and electromyography (EMG)-informed solutions.
Although static optimisation is commonly used, an EMG-informed NMS approach may offer more physiologically plausible HJCF estimates, since it accounts for an individual’s unique muscle activation patterns. Indeed, individuals with hip OA have abnormal muscle activation, which may influence the HJCF. Calibration, or tuning, of the neuromuscular parameters in EMG-informed NMS modelling is required to create subject-specific models. There are various cost functions used for calibration and their selection is crucial for obtaining physiological plausible estimates of JCF.
EMG-informed NMS modelling is driven by EMG signals experimentally measured with surface electrodes. However, surface electrodes cannot record deep muscles important for hip function, which limits this application of EMG-informed modelling. Recently, EMG-hybrid and EMG-assisted modes have been developed to address this limitation, although, to date, there have been only two limited studies using these EMG-informed approaches for the hip, and only in healthy individuals. Furthermore, no studies have assessed how different calibrations cost functions and EMG-informed neural control solutions affect HJCF estimates. Subsequently, this thesis aimed to assess the use of calibrated EMG-informed NMS modelling, available in the Calibrated EMG-informed Neuromusculoskeletal Modelling toolbox (CEINMS), to explore the HJCF from healthy individuals and patients with mild-to-moderate hip OA during walking.
The first study compared how different calibration cost functions and EMG-informed neural solution modes affected the estimated HJCF from a healthy population. Calibrating with a cost function to minimise joint moments prediction errors and peak HJCF, used together with the EMG-assisted neural solution mode well tracked the external joint moments and measured EMGs, and was the recommended approach to calculate physiologically plausible HJCF. The study has been submitted to the Journal of Biomechanics with following author order and title: Hoang, H.X., Pizzolato, C., Diamond, L.E., Lloyd, D.G., 2017. “Subject-specific calibration of neuromuscular parameters enables neuromusculoskeletal models to estimate physiologically plausible hip joint contact forces in healthy adults.”
The second study compared estimated HJCF in people with mild-to-moderate hip OA obtained with the calibrated EMG-assisted pipeline in CEINMS (recommendation from the first study) and the static optimisation pipeline in OpenSim. The results showed that EMG-assisted mode and static optimisation both well tracked lower limb joint moments. However, the EMG-assisted mode was able to track hip muscle co-contraction patterns, whereas static optimisation did not. The associated manuscript is in preparation for submission to the Journal of Biomechanics as: Hoang, H.X., Diamond, L.E., Lloyd, D.G., Pizzolato, C., 2017. “A calibrated EMG-informed neuromusculoskeletal modelling method can appropriately account for muscle co-contraction to estimate hip joint contact forces in people with hip osteoarthritis.”
The third study assessed the hip muscle co-contraction and HJCF in people with mild-to-moderate hip OA and healthy individuals using the calibrated EMG-informed NMS modelling approach as recommended in the previous two studies. Higher hip muscle co-contraction and lower HJCF were observed in individuals with hip OA compared to controls. These findings challenge previous beliefs of over-loading due to muscle co-contraction in people with hip OA. The associated manuscript is in preparation for submission to Osteoarthritis and Cartilage as: Hoang H.X., Loureiro, A., Constantinou, M.,Barrett, R., Pizzolato C., Lloyd D.G., Diamond L.E., 2017. “People with symptomatic mild-to-moderate hip osteoarthritis exhibit higher muscle co-contraction and walk with lower hip joint contact forces compared to healthy people.”
The findings of this thesis showed that (i) the neural solution control is essential when estimating muscle-tendon forces and HJCF with NMS models and, therefore, subject-specific muscle activation patterns should be included in any modelling framework, (ii) calibration through tracking of joint moments and peak HJCF in conjunction with the EMG-assisted neural solution mode resulted in more physiologically plausible HJCF compared to other methods, and (iii) people with mild-to-moderate hip OA walk with more hip muscle co-contraction and lower HJCF compared to healthy people.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School Allied Health Sciences
Griffith Health
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Opperman, Tertius. "Tribological evaluation of joint fluid and the development of a synthetic lubricant for use in hip joint simulators." Pretoria : [s.n.], 2004. http://upetd.up.ac.za/thesis/available/etd-07282005-083909.
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Willson, John D. "Hip strength and lower extremity mechanics in females with and without patellofemoral pain." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file, 191 p, 2007. http://proquest.umi.com/pqdweb?did=1397905251&sid=14&Fmt=2&clientId=8331&RQT=309&VName=PQD.
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Wan, Ka-ming Bettina, and 尹家明. "Validation of the Nottingham hip fracture score in a Hong Kong population." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206951.
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Background
Musculoskeletal problems and falls are major contributors to disabilities, both globally and in East Asia and the Pacific. Osteoporosis and falls are common in the elderly. Their impact lies in the fragility fractures that result. Of these, hip fracture is the most costly, in terms of mortality, morbidity, and the medical and social care costs incurred. With an ageing population, the number of hip fractures is set to rise. Having a prediction model for outcomes will help risk stratification of patients, and aid planning of clinical care, rehabilitation and discharge. The objective of this study is to validate the Nottingham Hip Fracture Score for mortality prediction in Hong Kong.
Methods
This is a retrospective study of 2209 consecutive adult patients admitted to Caritas Medical Centre from 1st January 2007 to 31st December 2012. Data was collected from the Clinical Management System, a local rehabilitation unit database, and the Hong Kong Death Registry. Variables included to predict mortality were age, sex, place of residence, presence of ≤2 comorbidities, presence of cancer, and haemoglobin level on admission. Binary logistic regression was performed. A cognitive function test score is needed for full validation of the Nottingham Hip Fracture Score. This score was only available for patients admitted to the rehabilitation unit. A sensitivity analysis was therefore done.
Results
Presence of cancer [odds ratio 3.67 (2.26, 5.95)], male sex [odds ratio 2.32 (1.83, 2.93)], presence ≥2 comorbidities [odds ratio 1.38 (1.09, 1.74)] and age [odds ratio 1.05 (1.03, 1.06)] were associated with 1-year mortality. Low haemoglobin level on admission was found to be a poor prognostic factor in other studies, but appeared to be protective in ours [odds ratio 0.74 (0.70, 0.79)]. Admission from old age home was not statistically significant. Sensitivity analysis assuming both best and worst case scenarios for cognitive function test scores found the Nottingham Hip Fracture Score to be a poor prediction model in Hong Kong.
Conclusions
The Nottingham Hip Fracture Score was a poor prediction model in Hong Kong, because of the low hip fracture mortality rates in Hong Kong. To be locally useful, the score need to be re-calibrated. To reduce the burden of disability from hip fracture, prevention is important, as is helping patients to recover from their injury. Better understanding of variations in length of stay and discharge destinations between hospitals in Hong Kong may provide some insights into areas for improvement.published_or_final_version
Public Health
Master
Master of Public Health
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Philipp, Henry Peter. "Größere Köpfe kompensieren erhöhte HTEP-Luxationsgefahr bei Hochrisikopatienten: Eine Fallserie mit Literaturüberblick." Doctoral thesis, Universitätsbibliothek Leipzig, 2016. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-211040.
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Die Zielsetzung dieser Arbeit besteht darin zu prüfen, ob die Luxationsrate bei Hochrisikopatienten durch den Einsatz von 40-mm- und 44-mm-Köpfen im Vergleich zu Patienten mit maximal 36-mm-Köpfen reduziert werden kann.
Hierzu wurden die im Zeitraum von September 2009 bis Mai 2014 hüftendoprothetisch versorgten Patienten mit einem erhöhten Luxationsrisiko erfasst und die Verläufe auf Luxationen überprüft. Zur Risikobewertung diente eine eigens entwickelte Klassifikation. Des Weiteren erfolgte die Analyse der postoperativen Verläufe, der Röntgenbilder und eines Telefoninterviews in den Fällen, in denen Köpfe ≥ 40 mm zum Einsatz kamen.
Im Untersuchungszeitraum wurden 288 Hüftendoprotheseneingriffe mit erhöhtem Luxationsrisiko durchgeführt. Bei 278 HTEP-Implantationen erfolgte der Einsatz von Gelenkköpfen ≤ 36 mm. In dieser Gruppe betrug die Luxationsrate 15,1% (n=42). Bei 10 Patienten wurden 40-mm- oder 44-mm-Gelenkköpfe eingesetzt. In diesen Fällen wurde das Luxationsrisiko entsprechend der vorgeschlagenen Klassifikation mit 3A (hoch) bis 4B (sehr hoch) bewertet. Bei einem mittleren Follow up von 22,8 Monaten wurde bei diesen Patienten keine Luxation festgestellt.
Die mit 40-mm- sowie 44-mm-Köpfen erzielten Ergebnisse und die aktuelle Literatur sprechen für eine wesentlich höhere Gelenkstabilität und eine deutlich verminderte Luxationsneigung größerer Köpfe. Deren Einsatz ist daher gegenwärtig bei Risiko-patienten gerechtfertigt, sofern dieser in Abhängigkeit vom Pfannenaußendurch-messer konstruktiv möglich ist. In der weiteren Entwicklung der Hüftendoprothetik sollte die Verwendung größerer Köpfe angestrebt werden.
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Timoney, Patrick Eugene Mark. "The role of vibration arthrometry in the diagnosis of human joint pathology." Thesis, Queen's University Belfast, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.263489.
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Dwyer, Maureen Kelly. "THE ROLE OF THE HIP ABDUCTOR MUSCLE COMPLEX IN THE FUNCTION OF THE PATHOLOGICAL HIP JOINT." UKnowledge, 2009. http://uknowledge.uky.edu/gradschool_diss/700.
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The number of patients electing to undergo total hip arthroplasty (THA) in the United States has been projected to double by the year 2030, with a growing number of these patients below the age of 65 years. This cohort of patients not only desires to return to pain free daily activity, but wishes to participate in recreation and sporting activities. However, many of these patients report pain, impairments, and functional limitations following THA. The number one deficit observed for patients who fail conventional post-operative rehabilitation is persistent weakness of the hip abductor muscles. In order to safely progress these patients back to their desired activity level, appropriate postoperative rehabilitation programs need to be developed.
The primary objective of this dissertation was to examine the effectiveness of a hip abductor strengthening program on subjective and objective outcomes following THA. The secondary aims of this study were to document hip muscle activation and lower extremity movement patterns during functional exercises; and to compare shortterm subjective and objective clinical outcomes for subjects following THA compared to controls.
Several observations were made from our results. First, the lunge, single leg squat, and step-up and over exercises may be appropriate to include in post-operative rehabilitation programs to transition THA subjects from static strengthening exercises to dynamic activities. Second, subjects at 6- and 12-weeks following THA continue to exhibit strength and functional deficits, which contributes to decreases in activity level. Third, the addition of an exercise program targeting the hip abductor muscles following THA may help to improve subjective and objective outcomes compared to conventional post-operative rehabilitation. Finally, findings from our results are summarized and we propose a model to develop patient-specific rehabilitation programs.
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Langlotz, Ulrich. "Computer assisted reconstruction and replacement of the human hip joint /." Bern, 2002. http://www.stub.unibe.ch/html/haupt/datenbanken/diss/bestell.html.
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Given, Laura Elizabeth. "Effect of cam-type femoroacetabular impingement on hip joint kinematics." Thesis, University of British Columbia, 2010. http://hdl.handle.net/2429/27309.
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Cam-type femoroacetabular impingement is a painful disorder common in young adults, caused by decreased concavity of the femoral head-neck. It is associated with hip osteoarthritis, though the exact mechanism of joint damage is not fully understood. Gait analysis has shown that cam deformities cause changes to coupled motions in vivo, though it is unclear whether these changes are compensatory or due to direct bony contact. The objective of this study was to determine how cam deformities and surgical resection affect patterns of hip rotation, translation of the center of rotation, and force required to flex and abduct the hip.
We assessed the relationship between deformity and coupled motions, translations of center of femoral rotation, and force required to create active unconstrained flexion and abduction ex vivo. Three deformities were simulated on each of six hemi-pelvis/proximal femur specimens. Four muscles were simulated by cables drawn from the distal tendon to the location of proximal attachment. Motion was created by actively shortening one of these cables while statically loading the others. Markers on the femur and pelvis were tracked, allowing for calculation of joint rotations and translations. A load cell on the active cable allowed for measurement of the applied force.
We found that deformity resulted in increased external rotation, adduction and translation during flexion and increased internal rotation, extension and decreased translation during abduction. We also found that when a more severe deformity was present, more force was required to create both flexion and abduction to the same angle. Further, we found that resection resulted in increased internal rotation and translation during flexion and decreased internal rotation during abduction. Less force was required to create flexion and abduction following resection. Changes to motion patterns occur as a result of changed contact loads between the femoral head and acetabulum, resulting in loading of regions of articular cartilage which may not be optimized for these loads and may, therefore, begin a degenerative cascade leading to osteoarthritis. As coupled motions were observed within ranges of flexion and abduction required for daily living, it is recommended that resection be performed in an attempt to slow the progression of osteoarthritis by limiting contact between the femoral head-neck and acetabulum.
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Harun, Muhamad Noor. "Computational wear simulation for metal-on-metal hip joint replacement." Thesis, University of Leeds, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.444062.
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Lyons, Percie Jewell. "Effects of Hip Osteoarthritis on Lower Extremity Joint Contact Forces." Thesis, Virginia Tech, 2021. http://hdl.handle.net/10919/104968.
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People with osteoarthritis (OA) suffer from joint degeneration and pain as well as difficulty performing daily activities. Joint contact forces (JCF) are important for understanding individual joint loading, however, these contact force cannot be directly measured without instrumented implants. Musculoskeletal modeling is a tool for estimating JCF without the need for surgery. The results from these models can be very different due to different approaches used in the development of a model that was used for simulation. Therefore, the first purpose of this study was to develop and validate a musculoskeletal model in which lower extremity JCF were calculated at the hip, knee, and ankle in 10 participants with hip OA (H-OA) and 10 healthy control participants using OpenSim 4.0 [simtk.org, 23]. The generic gait2392 model was scaled to participant demographics, then the inverse kinematics (IK) solution and kinetic data were input into the Residual Reduction Algorithm (RRA) to reduce modeling errors. Kinematic solutions from RRA were used in the Computed Muscle Control (CMC) tool to compute muscle forces, then JCF were estimated using the Joint Reaction Analysis tool. Validation included JCF comparisons to published data of similar participant samples during level walking, and movement simulation quality was assessed with residual forces and moments applied at the pelvis, joint reserve actuators, and kinematic tracking errors. The computed JCFs were similar to the overall trends of published JCF results from similar participant samples, however the values of the computed JCFs were anywhere from 0.5 times body weight (BW) to 3BW larger than those in published studies. Simulation quality assessment resulted in low residual forces and moments, and low tracking errors. Most of the reserve actuators were small as well, besides pelvis rotation and hip rotation. The computed JCF were then used in the second portion of this study to determine the effect of group and side on JCF during both the weight acceptance and push-off phases of level walking. It was determined that there was a significant difference in the knee and ankle JCF during the weight acceptance portion of stance phase and at all joints during the push-off phase when comparing the H-OA and control groups on the affected limb. A significant interaction between group and limb was found for the peak hip JCF timing (% stance) during the push-off portion of the stance phase (p=0.009). These results demonstrate that H-OA participants experience an earlier peak hip JCF during propulsion on their affected limb. Based on previous research in OA that has examined spatiotemporal measures, this finding suggests that H-OA participants may use step or stride length changes as a strategy to decrease or limit pain and loading on the affected limb. Knowledge of potential JCF differences in H-OA participants, such as timing of the peaks in either portion of the stance phase, could provide useful insight to clinicians and therapists to make decisions on how to proceed with treatment or rehabilitation programs.Master of Science
People with osteoarthritis suffer from joint degeneration and pain as well as difficulty performing daily activities, like walking. It is important to understand the forces and loading within individual joints. Musculoskeletal modeling is one way that researchers can estimate these joint contact forces (JCF) without needing a joint replacement implant that can measure these forces. When it comes to modeling simulations, there is a wide variety of results. Therefore, the first purpose of this study was to develop and validate a musculoskeletal model in which JCFs were calculated at the hip, knee, and ankle in 10 participants with hip osteoarthritis and 10 healthy adults. Validation of the model was completed through a comparison between computed results and published data of similar participant samples during level walking. The computed results were similar to the overall trends of published JCF results, however the numerical values themselves were larger than those in published studies. The computed JCFs were then used in the second portion of this study to determine how the two groups and limbs differ during level walking. There was a significant difference in the knee and ankle JCF during the first half of the stance phase and in all joints during the second half of stance when comparing the two groups. The hip osteoarthritis participants also experience an earlier peak hip JCF during the second half of stance phase on their affected limb. This finding suggests that hip osteoarthritis participants may change the way they take a step as a strategy to decrease or limit pain and loading on the affected limb. Knowledge of potential JCF differences, such as timing of the peaks in either portion of the stance phase, could provide useful insight to clinicians and therapists to make decisions on how to proceed with treatment or rehabilitation programs.
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Modenese, Luca. "Biomechanics, musculoskeletal modelling, hip joint loads prediction, muscle force estimation." Thesis, Imperial College London, 2012. http://hdl.handle.net/10044/1/39476.
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A musculoskeletal model of the lower limb has been implemented and assessed in order to be used as a predictive tool to quantify the hip contact force (HCF) vector acting between the femoral head and the pelvic acetabulum. The model is based on a published anatomical dataset, which has been critically revised and extended. The HCFs obtained through the model have been assessed at multiple levels of detail against measurements from instrumented prostheses from a publicly available dataset. In the first instance, a direct comparison has been undertaken in order to verify predicted HCF magnitudes close to the measured and muscle recruitment consistent with electromyographic activation profiles reported in the literature. Secondly, a trend validation was performed to ensure the correct behaviour of the model when the same daily living task (level walking) was performed with different modalities. Finally, a falsification of the model was performed by challenging it to predict the exact components of the measured hip contact forces for both level walking and stair climbing. The closest achievable predictions were also calculated, together with the accuracy of a conventional use of the model not exploiting a priori knowledge of the joint contact forces. Once the assessment of the model was completed, a dataset of anthropometric, kinematic and kinetic data was collected on eight young healthy subjects performing daily living activities. As a demonstration of the potential use of the dataset, a subject specific model was generated and used to estimate HCF direction and magnitude for level walking and stair climbing, the same activities investigated during model validation. The model was further extended in order to include the upper part of the body and potentially analyze full body kinematics and kinetics. A further modified version of the model was finally developed in order to be used in finite elements analyses or more generally in applications requiring equilibrated sets of muscle and joint forces acting on a bone structure, as the highly discretized representation of the muscles makes the model particularly suitable for this kind of use. The developed model has been implemented in the open source software OpenSim and is freely available for download and use in research.
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Sun, Dan. "Abrasion-corrosion of cast CoCrMo in simulated hip joint environments." Thesis, University of Southampton, 2009. https://eprints.soton.ac.uk/67337/.
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Metal-on-metal (MoM) hip joint replacements have been increasingly used for younger and more active patients in recent years due to their improved wear performance compared to conventional metal-on-polymer bearings. MoM bearings operate at body temperature within a corrosive joint environment and therefore are inevitably being subjected to wear and corrosion as well as the combined action of tribo-corrosion. Issues such as metal sensitivity/metallosis associated with high levels of metal ion release triggered by the wear and corrosion products remain critical concerns. During the past few decades, significant research has been conducted into understanding the wear/lubrication mechanisms within the MoM hip joints in order to improve their performance and thereby prolonging their life. However, not much attention has been given to the combined effect of wear and corrosion of such devices in the hip joint environment, in addition, the role of third body particles and the effects of proteins have not been well understood. In this work, a systemic approach is presented for the first time for the mapping of abrasion and tribo-corrosion performance of a cast CoCrMo (F75) in simulated hip joint environments. The effects of third body particles have been studied in the MoM context using 4 μm SiC, 1 μm and 300 nm Al2O3, as well as sub-micron BaSO4. Modified tribo-testers (micro-abrasion, nanoindenter/scratching) incorporating a novel electrochemical cell have been used to monitor the abrasion-corrosion behaviour of the alloy in situ. The effects of solution chemistry, abrasives size / concentration and presence of proteins on the wear / corrosion level, wear-corrosion mechanisms, and the depassivation/repassivation kinetics of the CoCrMo have been explored. A variety of surface and sub-surface characterization techniques have been employed to identify the microstructual wear mechanism interactions. Results show that the change of protein concentration (0, 25% and 50% bovine serum) and pH (pH 7.4 and pH 4.0) of the test solutions can significantly influence the protein adsorption behaviour, which subsequently influence the wear rates (synergy), wear mechanisms as well as the wear-induced corrosion currents of the CoCrMo. For abrasion-corrosion tests, reducing abrasive size from 4 μm to 300 nm and/or abrasive volume concentration from 0.238 vol% to 0.006 vol% results in different abrasion-corrosion wear mechanisms (rolling or grooving abrasion) and the average wear-induced corrosion currents show a linear correlation with wear rates for 4 μm and 1 μm abrasives. For low volume concentration (< 0.03 vol%) slurries containing bovine serum, organo-metallic conglomerates have been found within the wear scars. These conglomerates help separate the surfaces, impose less damage to the surface passive film and polish the wear scars through a chemical mechanical polishing mechanism. In addition, tribo-corrosion tests at micro-/nano- scales reveal the effects of single abrasive particle on the surface/sub-surface microstructual change. This investigation has revealed the nanoscale wear mechanisms that generate nanoscale wear debris, the mechanical mixing of the surface nanostructure with adsorbed denatured protein and also the slip/dislocation systems that are present near and on abraded surfaces that are likely to disrupt the surface passive films. The findings give a better understanding of the evolution of the sub-surface nanocrystalline structures and tribo-layers formation seen for the retrieved implants. This near surface nanostructure layer and phase transformation might offer better wear resistance through these inherent self-protecting mechanisms (i.e. increased hardness); conversely, it may become the precursors to debris ejection and enhanced ion-release into the CoCrMo joints. This work established an experimental technique that gives greater understanding of the tribocorrosion behaviour of cast CoCrMo in simulated hip joint environments. In particular, the roles of third body abrasive particles and proteins have been addressed, which are relevant to clinical applications. The material multi-scale wear mechanisms as well as the evolution of the surface / subsurface microstructures and tribo-layers have been elucidated, which provide new insights into the in vivo wear mechanisms of CoCrMo. The findings of this study may provide some important indications for improved MoM joint materials, design, manufacture and evaluation.
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Ahzi, Zhor. "Durability improvement of total hip joint prosthesis by diamond coating." Strasbourg, 2011. http://www.theses.fr/2011STRA6197.
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Chaque année, environ 500000 personnes en Europe. Dont un cinquième en France, sub issent une opération de pose ou de remplacement de Prothèse Totale de Hanche (PTH). Les prothèses de hanche réalisées jusqu'à présenl ne peuvent pas sClVir plus de 15 années. L'objectif principal de cette étude est donc l'augmentation de la longévité des prothèses (» 15 années) par la minimisation voi r, si possible, l'élimination de la formation de débris sur les surfaces de contact d'articulation. Dans notre cas. Le substrat est une tête sphérique en alliage de titane Ti6AI4 V fro ttant contre une cupule en polyéthylène à po ids moléculaire ultra élevé ( UHMWPE). Or, le titane et ses alliages présentent d'assez médiocres performances caractérisées en frottement. Pour remédier à cet effet. On propose un rcvetemcnt de Ti6Al4V par le diamant s)'mhetique en utilisant une nouvelle technique de dépôt chimique à haute température avec modulation du temps (Time modulated CVO - TMCVD). Cependant. Ce revetemcnt présente quelques difficultés dues à la génération des contraintes résiduelles élevées. La spectroscopie de Raman et la diffraction des rayons X (XRD) onl été utilisées pour mesurer ces contraintes résiduelles. Pour réduire les intensités des contraintes résidue lles ct améliorer J'ad hé sion, nous avons utilisé une couche intennédiai re de DLC (diamond like carbon) entre [e substrat Ti6A I4 V ct le diarnond. En fin, pour évaluer les cOJltraintes rés id uel le d'origine thermique. La méthode des éléments finis a été employée pour simuler le procédé de refroidissement des couches minces de diamant déposées sur ['alliage Ti6AI4 V à des températures s'étendant de 600°C à 900 ocOrthopaedic implants have improved the quality of life for millions of people over the last quarter of a cenlllly. The chnical objective is 10 rclieve pain and increase case ofmovement in the joint. In this work. We focus on hipjoint replacements. The biomaterial used is Titanium alloys (Ti6AI4 V). Coating Ti6AI4 V with diamond makes it one of the promising strategies 10 improve the alloy wear behavior, The main goal of this study is to obtain such coating with high qualily. Unstressed, conti nuous and well-adhered diamond film on Ti6Al4 V using a new process named time modulated CVD (Tr. . 1CVD). This technique is able to produce ultra-hard, smoolh. And good quality diamond films. Nonetheless, satisfactory adherence of diamond coating tilms to Ti6AI4V will be attainable by the use of an interlayer. In order 10 compensale the large interfacial thermal expansion mismatch between the cOining and substrate material. For thi s, we have used OLC (diamond like carbon) as an inlcrlayer material between diamond coatings and Ti6AI4 V substrate. The residual stresses in the diamond lilm were characterized for the cases with and withou! the OLC intcrlayer using scanning cleClron microscopy (SEM), Raman speclroscopy and X-ray diffraction. Lower values of the rcsidual stresses \Vere obtained for the case \Vith DLC interlayer. Finally, a numcri cal simulation \Vas conduclcd to estimate the thermal residual stresses that dcvelop in the diamond film and in the substratc. Ln this. We simulatcd the cooling process from the deposition temperalurc of diamond (600 10 900 oC) 10 room tcmpcralurc The obtaincd results show that the predicted rcsidunl Stresses are of the sarne order as those measurcd experimcntally
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Ranuša, Matúš. "VOLUMETRIC WEAR ANALYSIS OF HIP JOINT IMPLANTS BY OPTICAL METHODS." Doctoral thesis, Vysoké učení technické v Brně. Fakulta strojního inženýrství, 2019. http://www.nusl.cz/ntk/nusl-391868.
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Predložená dizertačná práca sa zaoberá analýzou opotrebenia totálnych bedrových endoprotéz za použitia optických metód. V práci bol predstavený nový prístup hodnotenia objemového úbytku materiálu pomocou 3D optického skeneru. Tento nový prístup je časovo efektívny, poskytuje veľké množstvo snímaných bodov na povrchu implantátu. Množstvo bodov umožňuje presnejšiu rekonštrukciu pôvodnej geometrie a prípadné rekonštrukcie nežiaducich poškodení polyetylénovej vložky pri extrakcii. Predstavené metóda bola validovaná za pomoci štandardizovanej gravimetrickej metódy v súlade s ISO 14242. Následne bol optická skenovacia metóda použitá v troch štúdiách zameraných na analýzu opotrebenia, mechanické zmeny artikulujúceho povrchu a mikroštruktúrne zmeny v dôsledku zlyhania implantátu. Analýza 23 extrahovaných polyetylénových vložiek typ Bicon - plus s rozšíreným použitím v Českej republike poukázala na niektoré problémy spojené so zlyhaním implantátu. Adhezívno - abrazívne opotrebenie bolo identifikované v oblasti penetrácie femurálnej hlavice a následné poškodenia ako delaminácia materiálu , plastické deformácie a pitting boli pozorované v okolí tejto oblasti. Analýza materiálových vlastností poukázala na degradáciu mechanických a chemických vlastností, čo bolo prevažne závislé od rozsahu opotrebenia implantátu. U implantátov boli pozorované výrazné plastické deformácie , nárast oxidačného indexu a nižší pomer tvrdosti voči modulu elasticity, v porovnaní s novými vzorkami. Tečenie materiálu a plastické deformácie, ktoré vykazovali všetky extrahované vzorky boli analyzované v závere predloženej dizertačnej práce, na základe testov na nových implantátoch v zábehovom cykle. Cieľom práce je uviesť nový prístup analýzy opotrebenia polyetylénových vložiek za pomoci optických skenovacích metód a preukázať jeho použiteľnosť na analýze súboru extrahovaných implantátov. Výsledky získané pomocou tejto metódy sa ukázali ako vhodné a môžu viesť k lepšiemu pochopeniu procesov opotrebenia a zlyhávania implantátov.
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Selvey, David M. "Traumatic posterior fracture-dislocation of the hip joint in adults." Master's thesis, University of Cape Town, 2000. http://hdl.handle.net/11427/26636.
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During the period July 1994 to September 1998 surgery was carried out on seventy-six hips in seventy-five patients that sustained posterior fracture-dislocation of their hip joints. During my training I was personally involved in thirteen of these cases and was the primary surgeon in seven cases. Because of my personal interest in these patients Dr Siboto provided me the records of all seventy-five patients for my scrutiny. While he has carried out the surgery on all but the seven cases which I operated on, the literature review, the correlating of the data and all of the interpretation is my own personal work. At surgery prospective records were kept of the degree of comminution of the fracture, the presence of marginal impacting and the presence of fragments in the joint. Fractures were then classified according to Thompson and Epstein (1951). The surgical time was recorded as well as the nature of the associated acetabular floor fracture when it occurred. Anatomical reconstruction was always attempted including elevation of marginal impaction and bone grafting where appropriate. Fragments were only discarded when too small and unattached to permit their inclusion in the reconstruction. All patients had neurological assessment preoperatively and their Sciatic nerves were explored and the state of the nerve recorded at surgery. The process of formulating this dissertation took place over a two-year period from September of 1997 until June of 1999. As a result, the number of patients examined in relationship to a specific subject is not constant but alters according to the group under scrutiny at that particular point in time. An initial review of sixty cases in September 1997 was carried out and then an additional fifteen patients up until September 1998 were included where relevant. The aim of carrying out this study was to gain a better understanding of this injury so that we could formulate a management protocol for our patients in Groote Schuur Hospital. First of all, I reviewed the literature to discover exactly what has been written about this pathology. In the process I hoped to gain a better understanding of the problem and attempt to define a more concise approach to the injury by consolidating the broad array of articles written on this subject. Then by reviewing our findings in our large series of patients I aimed to discover whether we were encountering similar problems to the surgeons who had preceded us and whether we had made any new discoveries that might positively contribute to the future management of these patients.
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Wang, Allan W. "Femoral bone remodelling following cemented hip arthroplasty in a sheep model /." Title page, contents and abstract only, 1998. http://web4.library.adelaide.edu.au/theses/09PH/09phw2462.pdf.
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Al-Haifi, Nawaf. "Design and manufacture of a universal mechanical human joint simulator." Thesis, Brunel University, 2011. http://bura.brunel.ac.uk/handle/2438/9603.
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The work performed in this thesis involves the study of human hip joint kinematics and load analysis. Such analyses are very useful for investigating mobility and natural functionality as well as the variation in motion due to replacement implants. The objective of this study is to design, build and testing of a universal human joint simulator that is configurable to hold several human joints and easily programmable to create the required motion. This was performed by creating a Stewart Platform, which is capable of moving in all six degrees of freedom; the maximum number needed by any human joint. Many specific human joint simulators are available on the market for simulating all major human limbs. These are used for wear testing replacement joints by using high load repetitive motion. These systems have a predetermined limit degree of movement and are very expensive; if one wanted to emulate another joint, one would have to purchase a whole new system. This novel system compromises of a three-phase power supply, Control Area Network with six actuators and drivers, a force reading clamp with strain gauges and data logger. A user friendly computer program was developed that is able to derive joint movement data from two inputs and replicating the movement by driving the platform, as well as recording force and displacement data from the joint. The product would be marketed towards biomechanical researchers and implant designers. Verification of this system was performed by simulating the human hip joint. A known combination of kinematic and force data were inputted into the system for nine different types of activities. The resultant force and joint centre displacement was then compared to see how well the system perform in comparison to the inputted data from a previous study. The outcome of this project is a fully functional machine and configurable program that can create movement data at varying speeds and body weights; which is also able to drive the human joint simulator. The design also costs a fraction of any industrial joint simulator. It is hoped that the simulator will allow easier study of both the kinematics and load analysis within the human joints, with the intent on aiding investigation into mobility and functionality; as well as variation in motion caused by a replacement implant.
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Woodley, Stephanie Jane, and n/a. "Lateral hip pain : an anatomical and clinical study." University of Otago. Department of Anatomy & Structural Biology, 2006. http://adt.otago.ac.nz./public/adt-NZDU20061206.162321.
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Lateral hip pain (LHP), characterised by non-specific symptoms in the region of the greater trochanter, is a condition frequently encountered by physiotherapists and other health professionals. However, the pathogenesis of LHP is not well understood. Although pathology of the gluteal tendons and their associated bursae have long been implicated in the cause of this problem, trochanteric bursitis has emerged as the primary clinical diagnosis. In order to determine a differential diagnosis, clinicians are reliant on information collated from the patient history and physical examination, yet the validity of many of the tests used to diagnose LHP has not been established. Abnormalities of the gluteal bursae may give rise to LHP and therefore to ensure precision of clinical assessment and treatment techniques, knowledge of bursal morphology is essential. However, a review of the literature revealed that there are no complete morphological accounts of all the bursae in this area. Therefore, the main purposes of this study were (a) to determine the morphology of the bursae associated with the greater trochanter and (b) to examine the physiotherapy and radiological diagnoses of LHP, and the validity of selected tests used in the diagnosis of LHP.
In the anatomical study, the bursae deep to each of the layered gluteal tendons were examined in 21 embalmed human hips (9 male, 12 female; mean age 79 years, SD 9.4 years) using macro-dissection and histological techniques. Morphological associations, size, positions and histological characteristics of the bursae were recorded. A total of 121 bursae were identified in ten different locations, with an average of six bursae per hip. Variation was evident, but it was typical that at least two bursae were found deep to gluteus maximus (GMax) and the fascia lata, and gluteus medius (GMed). In approximately two-thirds of specimens a single bursa was situated deep to the tendon of gluteus minimus (GMin). All of these bursae demonstrated a synovial lining, which was predominantly areolar in type. This study revealed that numerous bursae are intimately associated with the greater trochanter, and provides new morphological detail which is of significance when considering clinical and biomechanical models of LHP.
A clinical study was undertaken whereby 40 consecutive patients (37 female, 3 male; mean age 54.4 years, SD 9.5 years) with unilateral LHP were recruited prospectively. Each eligible participant underwent a standardised physiotherapy assessment followed by a magnetic resonance (MR) imaging study of the pelvis and both hips. The MR images were analysed in random order by three radiologists blinded to clinical findings and symptomatic side, and the intra-and inter-observer reliability for image analysis was examined using the kappa statistic. To determine the validity of selected clinical tests as evaluated against MR imaging, sensitivity, specificity, and positive and negative likelihood ratios (LRs) were calculated, and the chi-squared test was used to determine association. As demonstrated by MR imaging, GMed tendon pathology, bursitis, osteoarthritis (OA) and gluteal muscle atrophy are all associated with the report of LHP. Interestingly, these various pathologies were identified in asymptomatic as well as symptomatic limbs. However, while bursitis was equally prevalent in symptomatic and asymptomatic hips, GMed tendon pathology and OA were observed more frequently on the symptomatic side. Furthermore, muscle atrophy which predominantly affected GMin, was specific to symptomatic hips.
Large variation was evident in the strength of agreement between radiologists and there was little agreement between physiotherapy and radiological diagnoses of pathology. Physiotherapists frequently diagnosed trochanteric bursitis as a cause of LHP and while palpation was identified as the most provocative test for reproducing patients complaint of LHP, it was not shown to be a valid technique. Instead, the outcomes pertaining to the validity of the clinical tests indicate that attention should be focused towards the assessment and treatment of gluteal tendon pathology. The two tests that appeared to be most useful for diagnosing gluteal tendon pathology were pain reproduction with passive hip abduction and resisted testing of GMed and GMin. While these findings demonstrate that various pathologies are associated with the report of LHP, they also highlight some problems associated with the use of MR imaging as a reference standard. Before further clinical validation studies of LHP are undertaken in larger populations, it is recommended that verification of MR imaging outcomes are performed against surgical and histological findings.
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Bicknell, Louise Susan, and n/a. "Genetic contributors to congenital joint dislocation." University of Otago. Dunedin School of Medicine, 2007. http://adt.otago.ac.nz./public/adt-NZDU20080211.151359.
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Understanding the molecular basis of Mendelian disorders featuring joint dislocation can enhance the knowledge of genetic or cellular pathways required in joint development, and provide candidate genes for studying related complex disorders, such as developmental dysplasia of the hip. Two strategies were employed in this project to investigate Mendelian contributors to congenital joint dislocation.
The first strategy was to investigate in-depth a gene known to be associated with joint dislocation. Missense mutations or small in-frame deletions in FLNB, encoding filamin B, have previously been associated with a spectrum of osteochondrodysplasias. Screening a larger cohort established FLNB as the sole underlying disease gene for atelosteogenesis type I and III and also boomerang dysplasia, which was previously thought clinically to be allelic to AOI. Mutations in FLNB cause a large proportion of Larsen syndrome cases with phenotypes reminiscent of the early case series reported. Atypical or "recessive" Larsen syndrome may therefore be due to a different underlying genetic aberration. The disease-associated amino acid substitutions or in-frame deletion/insertions cluster to two main regions of the filamin B protein: the calponin homology 2 domain of the actin-binding domain, and repeats 13-17 of the rod domain. To analyse the functions of these regions, yeast two-hybrid analyses were performed. No interactors were identified with the calponin homology 2 domain, which suggests the amino acid substitutions may disrupt actin binding or the regulation thereof. A candidate interactor, centromere protein J, was identified that binds to repeats 13-15, and could suggest a model for aberrant cell division seen in growth plates of bones of individuals with atelosteogenesis types I and III and boomerang dysplasia.
The second strategy used in this project was to investigate the genetic cause of a novel syndrome featuring joint dislocation. A neurocutaneous phenotype segregated in a consanguineous New Zealand family, and through a genetic mapping strategy, a significantly linked locus was identified at 10q23 (Z = 3.63), in which segregation of a common ancestral haplotype fits the linkage hypothesis of homozygosity by descent. Candidate gene analysis and subsequent screening identified a missense mutation 2350C>T in ALDH18A1, which predicts the substitution H784Y in the encoded protein [Delta]�-pyrroline-5-carboxylate synthase (P5CS). The known function of P5CS in proline and ornithine biosynthesis was not affected by the presence of H784Y in an indirect assay, and therefore the hypothesis proposed was that a novel, unknown moonlighting function of P5CS is perturbed causing the phenotype segregating in the family. As an initial exploration of functions of P5CS in the cell, yeast two-hybrid analysis was undertaken.
This project examined the contribution of two genes, FLNB and ALDH18A1, to Mendelian congenital joint dislocations. How the cellular functions of the encoded proteins in the cytoskeleton, metabolism, or signal transduction, are critical for joint development is ill understood. Future investigations aimed at identifying candidate genes that confer susceptibility to developmental dysplasia of the hip should consider candidate genes that encode proteins related in function to the products of the FLNB and ALDH18A1 genes.
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Parry, Jenna Marie. "Canine Hip Dysplasia: a Comprehensive Analysis." Kent State University Honors College / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ksuhonors1544365851905296.
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Dierks, Tracy Allan. "Kinematics and joint coupling in runners with patellofemoral pain during a prolonged run." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file 8.83 Mb., 176 p, 2006. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:3200532.
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Ng, Kwan-Ching Geoffrey. "The Effects of Cam Femoroacetabular Impingement on Mechanical Hip Joint Loading." Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/35918.
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A major contributing factor to the onset of early hip osteoarthritis is attributed to an enlarged, aspherical femoral head deformity, characterized as cam-type femoroacetabular impingement (FAI). The presence of the cam deformity alone does not explain differences in pathomechanisms and it has been theorized that adverse loading to the subchondral bone may play a predominant mechanical role in early joint degeneration. This doctoral thesis examined the adverse hip joint loading due to cam FAI and characterize mechanical stimuli associated with symptoms. Specifically, this research: 1) examined anatomical and functional characteristics associated with the cam morphology; 2) developed subject-specific finite element hip joint models to examine hip joint stresses, incorporating subject-specific geometries, materials properties, and joint loading; and 3) implemented loading parameters during level walking and squatting to examine hip joint stresses.
First, a classification study was conducted to recruit three participant groups: 1) symptomatic (where participants had the cam deformity and pain); 2) asymptomatic (where participants had the cam deformity, but no pain); and 3) control (where participants did not have the cam deformity or clinical signs). Each participant's CT data were evaluated for multiple anatomical hip joint parameters and then re-classified into their respective subgroups, using a discriminant function analysis, based on the most significant parameters. In addition to the cam deformity, symptomatic individuals had a lower femoral neck-shaft angle and reduced pelvic range of motion.
Second, using the classified participants, hip joint loading was determined for the various severities of cam FAI, with respect to alterations in hip contact forces and anatomical considerations. Hip joint assemblies were segmented and reconstructed from subject-specific CT and MRI data, where bone densities were quantified from CT data. A parametric study was conducted to understand how varying material properties and loading conditions affected the sensitivity of the predictive models, examining the most appropriate modelling parameters to capture relative measurements.
Third, in conjunction with the first two studies, hip contact forces for level walking and squatting tasks were applied to corresponding subject-specific models and simulated. As a cross-sectional analysis, the stress magnitudes and regions described the joint loading in vivo for each subject group and ascertained the risk of remodeling. For each subgroup (symptomatic, asymptomatic, control), the participants with the largest and smallest femoral neck-shaft angles were selected and compared. The symptomatic model with the lowest femoral neck-shaft angle demonstrated the highest stress on the cartilage, during walking and squatting, and on the subchondral bone, during squatting. The asymptomatic models showed cartilage stresses similar to the control group, but experienced high-risk subchondral bone stresses, similar to the symptomatic group. For both symptomatic and asymptomatic groups, the acetabular subchondral bone stresses coincided with known areas of bone adaptation and proteoglycan depletion.
The outcome of this research program supported that cartilage degradation might not be due to direct contact shear stresses, but perhaps rather attributed to the indirect effects of a stiffer subchondral bone plate. Individuals with a large cam deformity and decreased femoral neck-shaft angles are likely to experience severe subchondral bone stresses during higher amplitudes of hip motion. This provides clinicians with indications of how the pathology exacerbates and where initial cartilage delamination will likely occur, allowing them to perform the correct assessments and proceed with the correct form of care. From a patient's perspective, an early and accurate diagnosis could inhibit cartilage degradation and the progression of osteoarthritis.
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Upadhyaya, Swati. "Decreasing Error in Functional Hip Joint Center Calculation using Ultrasound Imaging." Thèse, Université d'Ottawa / University of Ottawa, 2013. http://hdl.handle.net/10393/26125.
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The hip joint center (HJC) is needed for calculation of hip kinematics in various applications. In the functional method, the center is determined by moving femur with respect to acetabulum. A popular way for measuring this movement is through an optical motion capture system. This method is fast and economical for most applications where we require an instant HJC even though the reconstruction error in bone position calculation exists due to skin artifact. This error is caused by movement of markers placed on skin rather than on actual bone. Here we introduce ultrasound imaging as an additional modality to measure the change in soft tissue thickness above bone while hip is flexed. We use this information on the tissue thickness change to recalculate position of markers placed on skin to match the movement of bone. A good advantage of using ultrasound machine is its non-invasiveness. We calculated HJC using a symmetric center of rotation estimation (SCoRE) algorithm, which uses the concept of coordinate transformation on 3D marker position data. The algorithm gives the 3D position of two centers, one for each hip bone. The distance between these two centers (SCoRE residual) gives us a hint on the accuracy of the HJC calculation and has been proved to be proportional to the error with respect to actual center in previous studies. These two centers should ideally coincide as they collectively form a spherical joint. Our new algorithm for HJC calculation with tissue thickness compensation, measured using ultrasound imaging shows the error has been reduced from 9.13 mm to 4.87 mm
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Rufaqua, Risha. "THE BIOCHEMICAL PROCESS OF LUBRICANT FILM FORMATION INSIDE HIP JOINT REPLACEMENT." Doctoral thesis, Vysoké učení technické v Brně. Fakulta strojního inženýrství, 2021. http://www.nusl.cz/ntk/nusl-446792.
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The dissertation thesis deals with the lubricant film formation chemistry on hip implant material surfaces with synovial fluid components. Biochemical and tribological properties of synovial fluid after joint replacement are focused, precisely on the chemical composition of the formed lubricating film and chemical structural changes of the associated constituents under mechanical loading. Nevertheless, the synovial fluid components‘ chemical structural changes after the joint replacement are rarely addressed and require further attention. Including metal and ceramics, various combination implant materials were applied within the lubricants of synovial fluid constituents separately and different model synovial fluids to reveal the biochemical reactions and frictional coefficients for understanding the possible lubrication mechanism. Raman Spectroscopic technique is manifested as the most appropriate method to explain the biochemical behaviour of synovial fluid and chemisorption on the surface of the implant material. The method is depicted presenting two different studies focusing on the chemical structure of the synovial fluid film on the implant surface and frictional coefficient measurement of the contact pair within the artificial hip joint. This latest methodological precedent also facilitates to evaluate the chemical structural change of the synovial fluid due to the tribological activity in the hip prosthesis. The thesis expounds original results concerning biotribology to increase the depth of knowledge on joint replacement procedure and to enhance the longevity of the orthopaedic implantations.
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Townsend, Kevin Charles. "Validation and applications of discrete element analysis in the hip joint." Thesis, University of Iowa, 2015. https://ir.uiowa.edu/etd/1777.
Full textAbstract:
Osteoarthritis is a progressive degenerative joint disease which causes pain, inflammation, and eventual loss of joint function. This debilitating disease affects approximately 3% of U.S. adults over 30 years old, with direct medical costs of over $100 billion each year. Post-traumatic osteoarthritis is a sub-set of osteoarthritis initiated by injuries such as a fracture of the joint surface. When a surgeon reconstructs a fractured joint, there are often residual incongruities on the surface, which can lead to elevated contact stresses. Increased cartilage contact stress has been shown to be a major risk factor for developing post-traumatic osteoarthritis. Computational modeling offers a method of detecting elevated contact stresses and thereby assessing the associated risk of a patient developing post-traumatic osteoarthritis. Discrete element analysis (DEA) is a computational method capable of fast and reliable contact stress predictions that has been used successfully to predict knee and ankle osteoarthritis. The purpose of this study was to validate the accuracy of DEA models of both intact and fractured hips by directly comparing experimentally measured intra-articular contact stresses in human cadaveric hips to corresponding DEA predictions. Overall correlation was greater than 90% for both intact and fractured hips. The validated DEA algorithm was then applied to a series of 3 patients with a hip fracture and another series of 19 patients with surgical hip re-alignment. As anticipated, changes in contact stress correlated well with pain and function (p < 0.05). This validated DEA model appears to be a clinically useful tool for identifying patients who are at higher risk for developing osteoarthritis as a result of elevated joint contact stresses.
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Klippel, Nathan John. "The effects of hip angle manipulation on submaximal oxygen consumption in collegiate cyclists." Thesis, Montana State University, 2004. http://etd.lib.montana.edu/etd/2004/klippel/KlippelN1204.pdf.
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McGee, Margaret Ann. "Health care outcomes evaluation of total hip arthroplasty patients : comparison of patient and doctor derived data /." Title page, contents and abstract only, 1999. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmm145.pdf.
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Goto, Shiho. "The effect of Patellofemoral pain syndrome on the hip and knee neuromuscular control on dynamic postural control task /." Connect to full text in OhioLINK ETD Center, 2009. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=toledo1254078175.
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Thesis (M.S.E.S.)--University of Toledo, 2009.Typescript. "Submitted as partial fulfillment of the requirements for The Master of Science degree in Exercise Science." "A thesis entitled"--at head of title. Bibliography: leaves 57-61.
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Thompson, Mark S. "The design of a novel hip resurfacing prosthesis." Thesis, Queen Mary, University of London, 2001. http://qmro.qmul.ac.uk/xmlui/handle/123456789/28944.
Full textAbstract:
Total hip replacement (THR) is one of the most successful and most frequently performed operations. For most implants the published rate of revision at 10 years is less than 10%. However the revision rates are higher for younger and more active patients who are likely to outlive their implants. The most frequent cause of THR failure is aseptic loosening, commonly accompanied by bone loss at the implant site. THR revisions give worse functional results and fail sooner than primary THR and are complicated by this loss of bone stock. A resurfacing hip prosthesis replaces the diseased surface layer of bone and cartilage and retains the majority of the femoral head. The stress distribution in the proximal femur is closer to that in an intact hip. A conservative resurfacing prosthesis will present the surgeon with no greater problems at revision than encountered at primary conventional 11-JR. Early designs of resurfacing prosthesis conserved femoral bone stock at the expense of acetabular bone. Revision rates were high and while some failures were caused by avascular necrosis and femoral neck fracture the predominant cause was acetabular loosening. The design of a bone conserving prosthesis requires knowledge of the shape of the bony surfaces of the hip joint. A survey of the morphology of the acetabulum showed a wide variation in shape. While early resurfacing designs had hemispherical acetabular cups the bony surface is less than hemispherical. The morphology and desired range of hip motion constrain prosthesis thickness and shape. A novel resurfacing design using a polyacetal femoral component and an UHMWPE acetabular component is proposed. This bearing combination has a lower volumetric wear rate than an equivalent Co-Cr on UHWMPE bearing. Computer modelling of the resurfacing concept showed that lower moduli materials reduced stress shielding and distributed implant-bone interface stresses more evenly. Mechanical testing of polyacetal following immersion in Ringer's solution showed substantial decreases in Young's modulus while strength was unaffected.
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Davidson, James A. "Evaluation of in-vivo frictional heating from articulation in the reconstructed hip joint." Thesis, University of Strathclyde, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.258356.
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Wu, Jun Jie. "The integrity of moulded ultra-high molecular weight polyethylene for joint replacement prostheses." Thesis, University of Oxford, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.325574.
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Rubin, Pascal. "Hip joint replacement biomechanics and morphometric aspects of the bone-implant system /." Lausanne : EPFL, 1992. http://library.epfl.ch/theses/?nr=1066.
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