Individual motion patterns during gait and sit-to-stand contribute to edge-loading risk in metal-on-metal hip resurfacing

Mellon, Stephen; Grammatopoulos, George; Andersen, Michael Skipper; Pegg, Elise; Pandit, Hemant; Murray, David; Gill, H. S.

doi:10.1177/0954411913483639

Cited by 49 publications

(58 citation statements)

References 52 publications

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“…Martelli et al included a subject that was body‐matched to the cadaver from which a subject‐specific model was created. Alternatively, CT images have been used to further personalize the model . Comparing these studies to the results in the current work show that musculoskeletal modelling involves many steps starting from kinematic and kinetic measurements, the choice of a musculoskeletal model, adapting that model to the subject‐specific anatomy and the choice of an optimization criterion.…”

Section: Discussionmentioning

confidence: 69%

Muscle optimization techniques impact the magnitude of calculated hip joint contact forces

Wesseling

Derikx

Groote

et al. 2014

Journal Orthopaedic Research

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In musculoskeletal modelling, several optimization techniques are used to calculate muscle forces, which strongly influence resultant hip contact forces (HCF). The goal of this study was to calculate muscle forces using four different optimization techniques, i.e., two different static optimization techniques, computed muscle control (CMC) and the physiological inverse approach (PIA). We investigated their subsequent effects on HCFs during gait and sit to stand and found that at the first peak in gait at 15–20% of the gait cycle, CMC calculated the highest HCFs (median 3.9 times peak GRF (pGRF)). When comparing calculated HCFs to experimental HCFs reported in literature, the former were up to 238% larger. Both static optimization techniques produced lower HCFs (median 3.0 and 3.1 pGRF), while PIA included muscle dynamics without an excessive increase in HCF (median 3.2 pGRF). The increased HCFs in CMC were potentially caused by higher muscle forces resulting from co‐contraction of agonists and antagonists around the hip. Alternatively, these higher HCFs may be caused by the slightly poorer tracking of the net joint moment by the muscle moments calculated by CMC. We conclude that the use of different optimization techniques affects calculated HCFs, and static optimization approached experimental values best. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:???–???, 2015.

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Section: Discussionmentioning

confidence: 69%

Muscle optimization techniques impact the magnitude of calculated hip joint contact forces

Wesseling

Derikx

Groote

et al. 2014

Journal Orthopaedic Research

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“…Therefore, symmetry of the hrf estimates how much the specific surgical approach influences the opposite (untreated) side. The hip reaction angles (hra—orientation of hrf) estimate if critical edge (or rim) loading occurs during a certain motion . A knee bend can also be compared to the “sitting down” motion that is known to be the third most common motion that THR patients perform during their daily life …”

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confidence: 99%

Influence of minimally invasive total hip replacement on hip reaction forces and their orientations

et al. 2014

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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.

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“…Greater range of motion is associated with higher wear due to the impact of pressure on the edge of the artificial hip socket (Mellon et al. ; Matthies et al. ).…”

Section: Gender and Medical Implant Failuresmentioning

confidence: 99%

Gender Bias in Medical Implant Design and Use: A Type of Moral Aggregation Problem?

Hutchison¹

2019

Hypatia

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In this article, I describe how gender bias can affect the design, testing, clinical trials, regulatory approval, and clinical use of implantable devices. I argue that bad outcomes experienced by women patients are a cumulative consequence of small biases and inattention at various points of the design, testing, and regulatory process. However, specific instances of inattention and bias can be difficult to identify, and risks are difficult to predict. This means that even if systematic gender bias in implant design is an ethical issue, it is one with no clearly blameworthy player. From a practical perspective, there is no single obvious point at which to intervene. Philosophers working in other areas have explored structurally similar moral problems—sometimes referred to as “moral aggregation problems”—such as the type of environmental harm caused by small actions of many players. I describe key features of these type of problems and strategies to address them. I then draw on these to suggest an approach to gender bias in medical implant design and use.

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Individual motion patterns during gait and sit-to-stand contribute to edge-loading risk in metal-on-metal hip resurfacing

Cited by 49 publications

References 52 publications

Muscle optimization techniques impact the magnitude of calculated hip joint contact forces

Muscle optimization techniques impact the magnitude of calculated hip joint contact forces

Influence of minimally invasive total hip replacement on hip reaction forces and their orientations

Gender Bias in Medical Implant Design and Use: A Type of Moral Aggregation Problem?

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