Bergmann G, Graichen F, Rohlmann A
Oskar-Helene-Heim, Biomechanics-Laboratory, Orthopaedic Hospital, Free University Berlin, F.R.G.
J Biomech. 1993 Aug;26(8):969-90. doi: 10.1016/0021-9290(93)90058-m.
The resultant hip joint force, its orientation and the moments were measured in two patients during walking and running using telemetering total hip prostheses. One patient underwent bilateral joint replacement and a second patient, additionally suffering from a neuropathic disease and atactic gait patterns, received one instrumented hip implant. The joint loading was observed over the first 30 and 18 months, respectively, following implantation. In the first patient the median peak forces increased with the walking speed from about 280% of the patient's body weight (BW) at 1 km h-1 to approximately 480% BW at 5 km h-1. Jogging and very fast walking both raised the forces to about 550% BW; stumbling on one occasion caused magnitudes of 720% BW. In the second patient median forces at 3 km h-1 were about 410% BW and a force of 870% BW was observed during stumbling. During all types of activities, the direction of the peak force in the frontal plane changed only slightly when the force magnitude was high. Perpendicular to the long femoral axis, the peak force acted predominantly from medial to lateral. The component from ventral to dorsal increased at higher force magnitudes. In one hip in the first patient and in the second patient the direction of large forces approximated the average anteversion of the natural femur. The torsional moments around the stem of the implant were 40.3 N m in the first patient and 24 N m in the second.
使用遥测全髋关节假体,在两名患者行走和跑步过程中测量了合成髋关节力、其方向和力矩。一名患者接受了双侧关节置换,另一名患者除患有神经病变和共济失调步态外,接受了一个带仪器的髋关节植入物。分别在植入后的前30个月和18个月观察关节负荷情况。在第一名患者中,中位峰值力随着步行速度的增加而增加,从1 km/h时约为患者体重(BW)的280%增加到5 km/h时约为480%BW。慢跑和极快步行都将力提高到约550%BW;一次绊倒导致力达到720%BW。在第二名患者中,3 km/h时的中位力约为410%BW,绊倒时观察到的力为870%BW。在所有类型的活动中,当力的大小较高时,额面内峰值力的方向仅略有变化。垂直于股骨干长轴,峰值力主要从内侧向外侧作用。在较高的力大小下,从腹侧到背侧的分量增加。在第一名患者的一个髋关节和第二名患者中,大力的方向接近天然股骨的平均前倾角。第一名患者植入物柄周围的扭转力矩为40.3 N·m,第二名患者为24 N·m。