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

Abstract

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.

Loads in the hip joint during physically demanding occupational tasks: A motion analysis study

“…Considering the inter-subject variability and an imperfectly adjusted seat, this agrees well with our findings of HJCF between 1580 N and 2873 N for the seating motion. Another study considering a similar motion (squat, maximum of 80°knee flexion) calculated (146-243)%-BW for different muscle models that were developed with respect to different hip replacement surgery strategies (Weber et al, 2014). This also agrees with the magnitude of our data ((2417 60)%-BW) which were calculated for slightly higher flexion angles.…”

“…Some activities, like sitting down or squatting (Kunze et al, 2012;Weber et al, 2014) and of course level gait, have been simulated by multibody dynamics (Correa et al, 2010;Hornová and Daniel, 2013;Lenaerts et al, 2009;Manders et al, 2008). Different lifting techniques and their muscle activation were investigated but without exploring the hip joint contact forces (Mirakhorlo et al, 2014).…”

The History of Biomechanics in Total Hip Arthroplasty

“…The system can solve the associated equilibrium equations with an inverse dynamic approach: the external forces and motions are known and the internal forces have to be computed 77. Validated musculoskeletal hip models7980 have been developed and allow for evaluation of activities of daily life, sports, or occupational activities as well as surgical strategies81 without the need for expensive and invasive in vivo experiments.…”

Simulation Strategy to Enhance Oxygen Uptake and Reaction Forces at Leg Joints and Vertebral Bodies During Ergometer Exercise Under Altered Gravity

“…The musculoskeletal model in the AMS replicates a 50th percentile European male with a mass of 75 kg and a height of 1.76 m, respectively [6]. We modified the muscle activity function and muscle strength of "BikeModel" [7] in the AnyBody Managed Model Repository (AMMR ver.1.6.3) to construct a conventional ergometer (CER) exercise model with the HTS and reduced muscle strength.…”