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KMID : 0438219770140030447
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Korea University Medical Journal
1977 Volume.14 No. 3 p.447 ~ p.476
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Kinematic Study for Stability of Tatal Hip Prosthesis
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Abstract
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Each artificial hip joint has differences in type of the prosthesis and in angle of insertion of the acetabular cup and femoral prosthesis.
These prostheses are devised suitably for Westerners who do not require the extreme range of motion of flexion, abduction or external rotation of the hip joint.
And they are not as suitable for Koreans who require a lot of flexion, abduction or external rotation of the hip joint in their daily activity such as cross-legged sitting or squatting position.
Therefore it may bs ideal to design one suitable to the activity of daily living of Koreans or we have to change the angle of insertion of the acetabular cup and, or femoral prosthesis. But when the angle of insertion in each prosthesis is changed, it is questionable whether it will maintain stabiliy.
The purpose of this paper is to study the normal range of motion of the hip joint for cross-l.-gged sitting and squatting positions in Korean life and to evaluate the angle of insertion of various prosthesis to adjust to the above mentioned cross-legged sitting and squatting postures so as to prevent the dislocation of the prosthesis.
As the first step, to observe normal range of motion of the hip joint during cross-legged sitting and squatting position in Korean life, the author examined the average range of motion of flexion, abduction and external rotation in the hip joint of 50 normal Korean soldiers in a cross-legged sitting or a squatting position, and then performed total hip replacement in 10 Korean skeletons in various angles of the acetabular cup and, or femoral prosthesis with McKee-Farrar, Charnley and Muller type respectively.
The results obtained are as follows.
I. The mean values of the range of motion of the hip joint during cross-legged sitting position of
50 normal Korean soldiers are 105.90.942 in flexion, 37. 14 0.423 in abductiion, and 41.46 0.584 in external rotation. The mean values of the range of motion of the hip joint during squatting position are 130.81+0.844 in flexion, 13.320.725 in abduction, and 10.360.240 in external rotation.
2. Among 3 types of prostheses of Mckee-Farrar, Charnley and Muller, the suitable prosthesis for the cross-legged sitting or squatting position of Korean is McKee-Farrar, Muller and Charnley in their order.
3. In order to maintain the stability and simultaneously to provide adequate range of motion in cross-legged sitting position, the acetabular cup has to be inserted with 45 or 60 inclination and 20 or 45 anteversion, and the femoral prosthesis has to be inserted with 20 or 30 anteversion.
In squatting position, the acetabular cup has to be inserted with 60 inclination and 20 or 45 anteversion, and the femoral prosthesis has to be inserted with 30 anteversion.
4. Among 3 types of prostheses, the maximum mean degree of flexion is 1462.2 in McKee-Farrar prosthesis with femoral neutral version, 45 of acetabular inclination, and 20 of acetabular anteversion. Among 3 types of prostheses, the minimum mean degree of flexion is 691. V in Charnley prosthesis with acetabular neutral version, 45 of acetabular inclination, and 25 of femoral retroversion.
5. Among 3 types of prostheses, the maximum mean degree of extension is 126.51.6 in McKee-Farrar prosthesis with femoral neutral version, 45 of acetabular inclination, and 20 of acetabular retroversion. Among 3 types of prostheses, the minimum mean degree of extension is - 10.3 0.6 in Charnley prosthesis with 10 of femoral anteversion, 45 of acetabular inclination, 45 of acetabular anteversion,
6. Among 3 types of prostheses, the maximum mean degree of abduction is 77.3 1.8 in Muller l prosthesis with femoral neutral version, acetabular neutral version, and 60 of acetabular inclination. Among 3 types of prostheses, the minimum mean degree of abduction is 291.9 in Charnley prosthesis with femoral neutral version, acetabular neutral version, and 20 of acetabular inclination.
7. Among 3 types of prostheses, the maximum mean degree of adduction is 56.51.1 in Muller prosthesis with femoral neutral version, acetabular neutral version, and 20 of acetabular inclination. Among 3 types of prostheses, the minimum mean degree of adduction is 220.8 in McKee-Farrar prosthesis with 10 of femoral anteversion, 45 of acetabular inclination, and 45 of acetabular anteversion.
8. Among 3 types of prostheses, the maximum mean degree of external rotation is 117.52. V in Muller prosthesis with femoral neutral version, acetabular neutral version, and 60 of acetabular inclination. Among 3 types of prostheses, the minimum mean degree of external rotation is 10.51. 1 in Charnley prosthesis with 10 of femoral anteversion, 45 of acetabular inclination, and 45 of acetabular anteversion.
9. Among 3 types of prostheses, the maximum mean degree of internal rotation is 1441.5 in Muller prosthesis with 10 of femoral anteversion, 45 of acetabular inclination, and 45 of acetabular anteversion.
Among 3 types of prostheses, the minimum mean degree of internal rotation is 521.3 in Charnley prosthesis with femoral neutral version, 45 of acetabular inclination, and 20 of acetabular retroversion.
10. As femoral or acetabular anteversion increases, flexion or internal rotation is increased,
but extension, external rotation, abduction or adduction -is reduced. As acetabular inclinatidn increases, flexion or extensior. or abduction or external rotation is increased but internal rotation or adduction is reduced.
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