title: [Virtual simulation for optimizing the range of motion in hip alloarthroplasty using an adapted thrust-plate prosthesis model].
abstract: The purpose of the present study was to increase the free range of motion in conventional trust-plate prosthesis design and to optimize the trust-plate contact as well as the osteointegration area below the trust-plate. For the first part of the study, the two-dimensional geometry of the osteotomy plane was demonstrated in 25 CT-reconstructed femora after performing a virtual cut at a CCD angle of 135 degrees. In the second part, we constructed a prototype of an anatomic adapted trust-plate prosthesis (A-TPP) with an optimized trust-plate and corpus geometry based on the three-dimensional data of three human cadaveric femurs (age 67-75 years). In the final step, we documented the range of motion with computer-aided movement-mapping and compared the conventional TPP with the A-TPP. The results showed a wide variance in osteotomy geometry in the 12 femurs. With the A-TPP, we were able to obtain a much better fit in the trust plate surface. The movement-mapping showed a much higher range of motion in the A-TPP implant. With the A-TPP, the implant surface area for osteointegration could also be significantly increased.
authors.affiliation: Klinik für Orthopädie und Orthopädische Chirurgie, Neuss.
authors.forename: J
authors.initials: J
authors.lastname: Jerosch
authors.forename: R
authors.initials: R
authors.lastname: Wetzel
authors.forename: G
authors.initials: G
authors.lastname: Aldinger
authors.forename: A
authors.initials: A
authors.lastname: Weipert
authors.forename: S
authors.initials: S
authors.lastname: Hanusek
authors.forename: T J
authors.initials: TJ
authors.lastname: Filler
authors.forename: E T
authors.initials: ET
authors.lastname: Peuker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D002102:Cadaver; D003198:Computer Simulation; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D015207:Osteoarthritis, Hip / Q000601:surgery; D010027:Osteotomy; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D016059:Range of Motion, Articular; D012984:Software; D014057:Tomography, X-Ray Computed