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The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
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Ankle Joint01:10

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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Eccentric Axial Loading in a Plane of Symmetry01:16

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Eccentric axial loading occurs when an axial load is applied away from the centroidal axis of a structural member. This scenario is common in engineering, where structural elements may not be directly aligned due to various design or functional requirements.
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Normal Strain under Axial Loading01:20

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Normal strain under axial loading is an important concept in the field of mechanics of materials. Axial loading implies the application of a force along the axis of a material, like a column or bar. This force can either compress or stretch the material. In the context of axial loading, normal strain is the deformation experienced by the material in the direction of the loading force. It's calculated as the change in length divided by the original length of the material. This unitless ratio...
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Bones of the Lower Limb: Femur and Patella01:16

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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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Unsymmetrical bending occurs when the bending moment applied to a structural member does not align with its principal axis. This misalignment leads to complex stress distributions and deflection patterns that differ from symmetrical bending, which are essential for designing structures to withstand different loading conditions.
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Does surgical approach or prosthesis type affect hip joint loading one year after surgery?

Mariska Wesseling1, Christophe Meyer2, Kristoff Corten3

  • 1KU Leuven, Department of Kinesiology, Human Movement Biomechanics, Heverlee, Belgium.

Gait & Posture
|March 24, 2016
PubMed
Summary

Hip replacement surgery, including total hip arthroplasty (THA) and resurfacing hip arthroplasty (RHA), reduces hip loading compared to healthy controls. Different surgical approaches (direct anterior, direct lateral, posterolateral) show similar hip loading outcomes one year post-operation.

Keywords:
GaitHip arthroplastyHip loadingStair ascentStair descent

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Area of Science:

  • Orthopedic Surgery
  • Biomechanics
  • Musculoskeletal Modeling

Background:

  • Hip replacement surgery, including total hip arthroplasty (THA) and resurfacing hip arthroplasty (RHA), aims to restore function but can alter joint loading.
  • Different surgical approaches (direct anterior, direct lateral, posterolateral) are used, potentially influencing biomechanical outcomes.

Purpose of the Study:

  • To compare in vivo hip joint loading during gait and stair climbing in patients who underwent different hip replacement procedures (THA-DAA, RHA-DLA, RHA-PLA) versus healthy controls.
  • To determine if stair climbing is more sensitive than gait in differentiating hip loading between operated patients and controls.

Main Methods:

  • Utilized musculoskeletal modeling (OpenSim) to calculate in vivo hip joint loading in three patient groups (THA-DAA, RHA-DLA, RHA-PLA) and a control group.
  • Assessed hip loading during gait, stair ascent, and stair descent one year or more after surgery.

Main Results:

  • All surgical groups exhibited decreased hip loading compared to controls, with no significant differences observed between the different hip replacement approaches.
  • Stair climbing revealed more distinct differences in the orientation of hip loading compared to gait, but not in magnitude.
  • Patients adjusted their movement patterns to reduce the magnitude of hip joint loading post-surgery.

Conclusions:

  • Total hip arthroplasty via the direct anterior approach results in comparable hip loading to resurfacing hip arthroplasty via direct lateral or posterolateral approaches.
  • Post-hip replacement surgery, patients exhibit altered hip loading mechanics, characterized by reduced overall loading, irrespective of the surgical technique employed.