The biomechanical outcome after total hip replacement
| PhD ceremony: | Mr T.A. (Tim) Weber |
| When: | June 17, 2015 |
| Start: | 11:00 |
| Supervisors: | prof. dr. ir. G.J. (Bart) Verkerke, prof. dr. S.K. Bulstra, prof. dr. S. Dendorfer |
| Co-supervisor: | dr. T. Renkawitz |
| Where: | Academy building RUG / Student Information & Administration |
| Faculty: | Medical Sciences / UMCG |
Sub-optimal implant positioning is one of the leading causes for implant failure in Total Hip Replacement (THR). Computer-assisted surgery in combination with ‘femur first’ (CAS FF) is believed to improve implant positioning and post-operative hip biomechanics. Combining patient-specific anatomy with patient-specific motion allows the computation of patient-specific biomechanics by means of musculoskeletal models (MM). This work applies MM to investigate operation-dependent differences between conventional THR and CAS FF in terms of biomechanics also focusing on MIS-approaches.
A computational study showed that MIS approaches are superior to conventional approaches in terms of biomechanics. A prospective randomized controlled trial showed that CAS FF leads to a significantly improved hip reaction force (hrf) orientation compared to conventional THR. A trend for improved gait post-operatively for the CAS FF group did not reach statistical significance. The Improved hrf symmetry of the CAS FF group indicates a possible long-term benefit.
Biomechanical load-cases as quantified by MM are an integral measure of patient-specific motion and anatomy and therefore able to provide a more complete picture of patients or populations in terms of biomechanics. The improved hrf orientation shows that the concept of combined anteversion leads to a favourable load-case scenario at an early stage.