Regaining Gait Using an Early Postoperative Hip Prosthesis: A Case Report of an Elderly Woman

Iwasa, Saya; Uchiyama, Yuki; Kodama, Norihiko; Koyama, Tetsuo; Domen, Kazuhisa

doi:10.2490/prm.20210011

Cited by 2 publications

(6 citation statements)

References 7 publications

(11 reference statements)

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“…The movement of the hip joint in the frontal plane is the basis for maintaining a stable of the lower limb, and the movement of the hip joint in the frontal plane is between −5° and 5° in normal people during walking 25 . The conventional HDP solves the problem by adjusting the inclination angle of the prosthesis in the frontal plane, and the method has achieved good results in practice 26 . The new HDP we proposed used the same installation method, and the test results are shown in Figure 9.…”

Section: Resultsmentioning

confidence: 99%

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Design and optimization of a new integrated hip and knee prosthesis structure

Luo,

Shu,

Zhu

et al. 2023

Artificial Organs

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BackgroundConventional hip disarticulation prostheses (HDPs) are passive devices with separate joint structures, limiting amputees' ability to control and resulting in abnormal gait patterns. This study introduces a new HDP integrating the hip and knee joints for amputees' natural gait.MethodsThe new HDP restores the physiological rotation center of the hip with a remote center of motion (RCM) structure, and simulates the knee motion with a four‐bar structure. Nonlinear programming was employed to optimize the hip‐knee joint structure. A hybrid multi‐objective drive structure with a series–parallel connection was also designed to ensure motion synergy between the hip and knee joints. Finally, a prototype of the prosthesis was tested using the HDP test system.ResultsThe optimization results demonstrate that the new HDP accurately restores the rotation center of the femur in amputees, with the knee's instantaneous center of rotation (ICR) trajectory closely resembling that of the human knee (Pearson correlation coefficient is 0.999). The study shows that the new HDP achieves a motion reproduction accuracy of over 95% for the human hip joint at walking speeds above 1.5 km/h, 38% higher than conventional prosthesis. Similarly, at the same walking speed, the new HDP replicates the motion of the human knee at 82.89%, surpassing conventional prosthesis by 57.85%.ConclusionsThe new HDP restores symmetry and replicates synergistic movement in amputees' lower limbs, exhibiting superior movement characteristics compared to conventional prostheses. This innovative HDP has the potential to enhance the quality of life for amputees.

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Section: Resultsmentioning

confidence: 99%

“…The biological torque in the hip joint for an adult male weighing 100 kg is approximately 108 N•m. 22 Considering the optimized overall dimensions, the diameter of the flat (26) i knee : i hip = 1: 2…”

Section: Parametric Design Of the Flat Springmentioning

confidence: 99%

Design and optimization of a new integrated hip and knee prosthesis structure

Luo,

Shu,

Zhu

et al. 2023

Artificial Organs

View full text Add to dashboard Cite

show abstract

“…In addition, gait with a prosthetic limb leads to a higher energy consumption compared with gait with crutches [25][26][27][28], and energy expenditure for such a gait increases by 82%, which may potentially lead to patients being confined to a wheelchair or bedridden [29,30]. In previous case reports there are some significant successes with regaining gait with a fixed walker using a hip prosthesis during the early postoperative period [8,9]. Moreover, it might be considered that there are only small group of HD amputees with few comorbidities or high physical fitness/ activity who can walk with a hip prosthesis [31,32].…”

Section: Freely Chosen Pr and Krom In Downstroke And Upstroke Phasesmentioning

confidence: 99%

“…Limb exercise therapies such as walking using a crutch and/or upper arm/shoulder physical training including an arm cranking ergometer are well accepted for HD amputees [8,9]. Additionally, single leg ergometer activity may also provide an optimal exercise model for repeat leg cranking with working of the major thigh muscle mass, trunk, and buttocks for reduced muscle mass activity [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Multiple Sessions of One-Legged Recumbent Cycle Ergometer Exercise Improved Pedaling Rate and Knee Range of Motion in a Middle-Aged Man after Hip Disarticulation: A Clinical Case

Osada¹,

Ueno²

2022

J PhyMed Rehab Stud Rep

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Background: This case evaluates the short-term training effects with alterations in pedaling rate (PR) and its relationship to knee range of motion (KROM) after multiple sessions of one-legged recumbent cycle ergometer exercise (1LREx) in a patient after hip disarticulation (HD). Case: A 44-year-old male patient had left HD due to osteosarcoma. He performed unilateral right 1LREx at 10 W with a self-controlled freely chosen PR until exhaustion. Multiple 1LREx sessions (maximum 4-5 sessions/day) were performed over 6 consecutive days from day 15 post-HD. PR and right KROM in the downstroke (pushing) and upstroke (pulling) pedal phases were determined continuously using a goniometer placed between the thigh and lower leg. The PR time-course during 1LREx indicated differences among multiple daily sessions but tended to be higher and more stable at steady-state over the study period (average ± SD PR and its coefficients of variability, 33.2 ± 5.3 revolution per minute (rpm) and 28.0% on Day 1 versus 43.0 ± 3.0 rpm and 12.5% on Day 6). The time-course of KROM was similar among multiple sessions during each day; however, the average KROM over all sessions in a day tended to increase over the study period (51.0 ± 1.2° on Day 1 vs. 78.0 ± 2.3° on Day 6). Mean KROM in the downstroke or upstroke pedal phases during each session showed a significant positive linear correlation (total of 27 sessions, p < 0.05) with mean PR. Conclusion: After HD, short-term one-legged trainability with multiple 1LREx resulted in increased KROM and PR with uniformly faster PR with whole leg exercising in the sagittal plane

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Regaining Gait Using an Early Postoperative Hip Prosthesis: A Case Report of an Elderly Woman

Cited by 2 publications

References 7 publications

Design and optimization of a new integrated hip and knee prosthesis structure

Design and optimization of a new integrated hip and knee prosthesis structure

Multiple Sessions of One-Legged Recumbent Cycle Ergometer Exercise Improved Pedaling Rate and Knee Range of Motion in a Middle-Aged Man after Hip Disarticulation: A Clinical Case

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