Kotzar G M, Davy D T, Goldberg V M, Heiple K G, Berilla J, Heiple K G, Brown R H, Burstein A H
Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, Ohio 44106.
J Orthop Res. 1991 Sep;9(5):621-33. doi: 10.1002/jor.1100090502.
Two telemeterized femoral components were implanted in two patients as part of normal total hip replacement procedures. The two components were instrumented to measure the three force components directed along: (a) the neck axis, (b) transverse to the neck axis and in the plane of the prosthesis, and (c) transverse to the neck axis and perpendicular to the plane of the prosthesis. Data were collected at multiple sessions during the early postoperative period for a number of standard activities, including gait, stair climbing, rising from a chair, single leg stance, double leg stance, ipsilateral and contralateral straight leg lifts while supine, ipsilateral flexion and extension while standing, and ipsilateral abduction while standing and lying on the contralateral side. These data are summarized and compared with the published results from analytic studies and with the results from previous studies using instrumented femoral components. Peak loads for gait during the period of study were roughly 2.7 body weights (BW) when the patients walked at their normal pace. Contact forces at the hip during stationary single leg stance approximated the peak loads during gait with values ranging from 2.1 to 2.8 BW. The highest forces recorded reached values approaching 5.5 BW and occurred during periods of instability while the patient engaged in stationary single leg stance. Our in vivo data indicate that forces generated during the above activities increase in magnitude quite rapidly during the early postoperative period and that during this period the patients have the ability to perform the activities of daily living without generating the high amplitude joint contact forces suggested by the results of dynamic studies. Joint contact forces during gait were found to depend on speed, but the high absolute magnitudes predicted by model studies were not supported by the in vivo data.
作为正常全髋关节置换手术的一部分，在两名患者体内植入了两个遥测股骨组件。这两个组件被用于测量沿以下方向的三个力分量：(a) 颈轴方向；(b) 垂直于颈轴且在假体平面内；(c) 垂直于颈轴且垂直于假体平面。在术后早期的多个时间段收集了一系列标准活动的数据，包括步态、爬楼梯、从椅子上起身、单腿站立、双腿站立、仰卧时同侧和对侧直腿抬高、站立时同侧屈伸以及站立和对侧卧位时同侧外展。对这些数据进行了总结，并与分析研究发表的结果以及之前使用带仪器的股骨组件的研究结果进行了比较。在研究期间，患者以正常步速行走时，步态的峰值负荷约为2.7倍体重（BW）。静止单腿站立时髋关节的接触力接近步态时的峰值负荷，数值范围为2.1至2.8倍体重。记录到的最高力值接近5.5倍体重，发生在患者进行静止单腿站立时的不稳定阶段。我们的体内数据表明，上述活动中产生的力在术后早期会迅速增大，并且在此期间患者有能力进行日常生活活动，而不会产生动态研究结果所提示的高幅度关节接触力。研究发现，步态期间的关节接触力取决于速度，但模型研究预测的高绝对值并未得到体内数据的支持。
