Calculation of Total Joint Replacement Contact Forces During Level Walking

水平行走期间总关节置换接触力的计算

• 批准号: 7939750
• 负责人: Hannah Jean Lundberg
• 金额: $ 1.74万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7939750
• 关键词: Accounting; Affect; Data; Failure; Gait; Hip Joint; Hip region structure; Implant; Individual; Joints; Kinetics; Knee; Knee joint; Laboratories; Longevity; Lower Extremity; Methodology; Methods; Modeling; Muscle; Operative Surgical Procedures; Pain; Patients; Pattern; Physiological; Polyethylenes; Preclinical Testing; Process; Public Health; Recording of previous events; Replacement Arthroplasty; Research; Role; Solutions; Testing; Total Hip Replacement; Variant; Walking; arthropathies; clinical application; cohort; design; gait examination; improved; in vivo; insight; instrument; kinematics; knee replacement arthroplasty; mathematical model; novel; pre-clinical; quadriceps muscle

DESCRIPTION (provided by applicant): Total joint replacement (TJR) surgery decreases pain and increases functional mobility for patients with joint disease. As primary TJRs are implanted in patients who are younger, heavier, and more active, increases in TJR revision rates are expected. Polyethylene wear has been identified as a leading cause of TJR failure; therefore preclinical wear analysis has an essential role in the design process. Preclinical analysis of TJRs requires accurate joint contact force data which are difficult to obtain. A confounding issue is that variation in patient gait and activities results in different contact forces and corresponding polyethylene wear. It is likely that TJR wear simulators do not represent all TJR patients, but it is unrealistic to suggest that more than one set of input data be used for wear simulators to account for such variation. A validated mathematical model which calculates contact forces and allows variation of input data could add valuable insight for preclinical testing. We propose to extend our previous modeling methods to accurately calculate contact forces for TJR patients. Our methodology allows for variation in muscle activation levels to account for the full range of physiologic muscle activity and results in a solution space of contact forces rather than one profile. The proposed research will result in a model that can provide accurate contact forces and be sensitive enough to discern differences in TJR contact forces under a variety of loading conditions. The long-term objective is to provide additional information to aid the design of joint replacements which will help improve implant longevity. Our overall hypothesis is that a novel parametric model of the combined lower limb will constrain the solution space more effectively than isolated hip and knee models when compared to in vivo forces from instrumented joint replacements. We propose three aims to investigate our overall hypothesis. In the first aim we will validate our mathematical model. With the second aim we will compare the solution space of contact forces calculated with both models. In aim three we will investigate a relevant clinical application by comparing contact forces calculated with the new model for two total knee replacement patient cohorts. Relevance to Public Health: We propose to develop a new mathematical model of the lower limb to calculate joint contact forces for joint replacement patients. The model will be able to provide joint contact forces for variable patient gait and activities which are not otherwise available. Because of the increasing rate of total joint failures requiring revision surgery, our long-term aim is to help improve implant longevity by providing contact forces to supplement information provided by total joint simulators.

描述（由申请人提供）：总关节置换（TJR）手术可减轻疼痛并增加关节疾病患者的功能迁移率。由于原发性TJR被植入年轻，更重且更活跃的患者，因此TJR修订率会增加。聚乙烯磨损已被确定为TJR衰竭的主要原因。因此，临床前磨损分析在设计过程中起着至关重要的作用。 TJRS的临床前分析需要难以获得的准确的关节接触力数据。一个令人困惑的问题是，患者步态和活动的变化会导致不同的接触力和相应的聚乙烯磨损。 TJR磨损模拟器可能并不代表所有TJR患者，但是建议将多组输入数据用于磨损模拟器来解释这种变化是不现实的。经过验证的数学模型计算接触力并允许输入数据的变化可能会为临床前测试增加有价值的见解。我们建议将以前的建模方法扩展到准确计算TJR患者的接触力。我们的方法可以使肌肉激活水平的变化来解释各种生理肌肉活性，并导致接触力的解决方案空间，而不是一个特征。拟议的研究将导致一个模型，该模型可以提供准确的接触力并非常敏感，以辨别在各种加载条件下TJR接触力的差异。长期目标是提供其他信息，以帮助设计关节置换，以帮助改善植入物的寿命。我们的总体假设是，与仪器置换仪的体内力相比，合并后下肢的新型参数模型将比孤立的髋关节和膝盖模型更有效地限制溶液空间。我们提出了三个目的，以研究我们的整体假设。在第一个目标中，我们将验证我们的数学模型。在第二个目标中，我们将比较使用两个模型计算的接触力的解决方案空间。在AIM三中，我们将通过比较与新模型计算的两个膝关节置换患者队列的接触力来研究相关的临床应用。与公共卫生的相关性：我们建议开发下肢的新数学模型，以计算关节替代患者的关节接触力。该模型将能够为可变的患者步态和活动提供联合接触力。由于需要修订手术的总关节失败率的增加，我们的长期目标是通过提供接触力来补充总体模拟器提供的信息，以帮助改善植入物的寿命。