Range of motion (ROM) simulation of the hip is useful to understand the maximum impingement free ROM in total hip arthroplasty (THA). In spite of a complex multi-directional movement of the hip in daily life, most of the previous reports have evaluated the ROM only in specific directions such as flexion-extension, abduction-adduction, and internal - external rotation at 0° or 90° of hip flexion. Therefore, we developed ROM simulation software (THA analyzer) to measure impingement free ROM in any positions of the hip. Recent designs of the hip implants give a wider ROM by increasing the head diameter and then, bone to bone impingement can be a ROM limit factor particularly in a combination of deep flexion, adduction and internal rotation of the hip. Therefore, the purpose of this study were to observe an individual variation in the pattern of the bone impingement ROM in normal hip bone models using this software, to classify the bone impingement ROM mapping types and to clarify the factors affecting the bone impingement type. The subjects were 15 normal hips of 15 patients. Three dimensional surface models of the pelvis and femur were reconstructed from Computer tomography (CT) images. We performed virtual hip implantation with the same center of rotation, femoral offset, and leg length as the original hips. Subsequently, we created the ROM mapping until bone impingement using THA analyzer. We measured the following factors influenced on the bone impingement map patterns; the neck shaft angle, the femoral offset, femoral anteversion, pelvic tilt, acetabular anteversion, sharp angle, and CE angle. These factors were compared between the two groups. Statistical analysis was performed with Mann-Whitney U test, and statistical significance was set at P<0.05.Introduction
Methods
Cervical orthoses are commonly used to regulate the motion of cervical spines for conservative treatment of injuries and for post-operative immobilization. Previous studies have reported the efficacy of orthoses for 2D flex-extension or 3D motions of the entire cervical spine. However, the ability of cervical orthoses to reduce motion might be different at each intervertebral level and for different types of motion (flexion-extension, rotation, lateral bending). The effectiveness of immobilizing orthoses at each cervical intervertebral level for 3D motions has not been reported. The purpose of this study is to evaluate the effectiveness of the Philadelphia collar to each level of cervical spines with 3D motion analysis under loading condition.
Introduction
Patients & Methods
