We have developed a novel, computer-assisted operation method for minimal-invasive total hip replacement (THR) following the concept of “femur first/combined anteversion,” which incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position (CAS FF). The purpose of this study is to assess whether the hip joint reaction forces and patient's gait parameters are being improved by CAS FF in relation to conventional THR (CON). We enrolled 60 patients (28 CAS FF/32 CON) and invited them for gait analysis at three time points (preoperatively, postop six months, and postop 12 months). Data retrieved from gait analysis was processed using patient-specific musculoskeletal models. The target parameters were hip reaction force magnitude (hrf), symmetries, and orientation with respect to the cup. Hrf in the CAS FF group were closer to a young healthy normal. Phase-shift symmetry showed an increase in the CAS FF group. Hrf orientation in the CAS FF group was closer to optimum, though no edge or rim-loading occurred in the CON group as well. The CAS FF group showed an improved hrf orientation in an early stage and a trend to an improved long-term outcome.
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机译:我们遵循“股骨先行/联合前倾”的概念,开发了一种新型的计算机辅助手术方法,用于微创全髋关节置换(THR),该方法结合了对假体茎和杯位置进行功能优化的各个方面( CAS FF)。这项研究的目的是评估CAS FF相对于传统THR(CON)是否能改善髋关节反作用力和患者的步态参数。我们招募了60名患者(28 CAS FF / 32 CON),并邀请他们在三个时间点(术前,术后6个月和术后12个月)进行步态分析。使用特定于患者的肌肉骨骼模型处理从步态分析中检索到的数据。目标参数是髋部反作用力大小(hrf),对称性和相对于杯子的方向。 CAS FF组的Hrf接近年轻健康的正常人。相移对称性显示CAS FF组增加。尽管在CON组中也没有边缘或边缘负荷,但CAS FF组的Hrf方向更接近最佳状态。 CAS FF组在早期显示出改善的hrf方向,并具有改善长期预后的趋势。
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