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Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_8 | Pages 25 - 25
1 May 2016
Hamai S Nakashima Y Hara D Higaki H Ikebe S Shimoto T Iwamoto Y
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INTRODUCTION

Golf is considered low-impact sport, but concerns exist about whether golf swing can be performed in safe manner after THA. The purpose of this study was to clarify dynamic hip kinematics during golf swing after THA using image-matching techniques.

METHODS

This study group consisted of eight right-handed recreational golfers with 10 primary THAs. Each operation was performed using a posterolateral approach with combined anteversion technique. Nine of ten polyethylene liners used had elevated portion of 15°. Continuous radiographic images of five trail and five lead hips during golf swing were recorded using a flat panel X-ray detector (Fig. 1) and analyzed using image-matching techniques (Fig. 2). The relative distance between the center of cup and femoral head and the minimum liner-to-stem distance were measured using a CAD software program. The cup inclination, cup anteversion, and stem anteversion were measured in postoperative CT data. Hip kinematics, orientation of components, and cup-head distance were compared between patients with and without liner-to-stem contact by Mann-Whitney U test.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_2 | Pages 29 - 29
1 Jan 2016
Hara D Nakashima Y Hamai S Higaki H Shimoto T Ikebe S Hirata M Kanazawa M Kohno Y Iwamoto Y
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Introduction

3D-to-2D model registration technique has been used for evaluating 3D kinematics from 3D surface models of the prostheses or bones and radiographic image sequences. However, no studies have employed these techniques to evaluate in vivo hip kinematics under dynamic weight-bearing conditions. The purposes of this study were to evaluate kinematics of healthy hips and also hips with osteoarthritis (OA) prior to total hip arthroplasty (THA) during four different weight-bearing activities using 3D-to-2D model-to-image registration technique.

Measurement

Dynamic hip kinematics during gait, squatting, chair-rising, and twisting were analyzed for six healthy subjects and eleven patients with osteoarthritis (OA). Continuous anteroposterior radiographic images were recorded using a flat panel X-ray detector (Fig. 1), and each hip joint was scanned by computed tomography (CT). The 3D positions and orientations of the pelvis and femur in movement cycle were determined using a 3D-to-2D model-to-image registration technique. A matching algorithm maximizing correlations between density-based digitally reconstructed radiographs from CT data and the radiographic images was applied (Fig. 2). The relative positions and orientations of the pelvis with respect to the world coordinate systems were defined as pelvic movements (anterior-posterior tilt, contralateral-ipsilateral rotation, Fig. 3b and c), and those of the femur with respect to the world coordinate systems were defined as femoral movements (flexion-extension, internal-external rotation, Fig. 3d). We also defined the relative positions and orientations of the femur for the pelvis as hip movements (flexion-extension, internal-external rotation, Fig. 3e and f).