Patient-Specific Safe Zone Based on Daily Positions and Range of Motion

Marchadour, Wistan; Dardenne, Guillaume; Guezou-Philippe, Aziliz; Lefèvre, Christian; Stindel, Éric

doi:10.29007/nw28

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…Since the PT in supine position is not as variable as the PT in standing position 16 and to limit the complexity of the study, the supine PT was not considered. In addition, the intended ROM for other PTs, such as supine or sitting, should be adapted since demands on the required ROM might be smaller 33 . Furthermore, consistent standards for intended ROM based on cultural and individual needs still have to be established 34 .…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the intended ROM for other PTs, such as supine or sitting, should be adapted since demands on the required ROM might be smaller. 33 Furthermore, consistent standards for intended ROM based on cultural and individual needs still have to be established. 34 Other studies propose a larger intended ROM than the one used in this study.…”

Section: Impact Of Prediction Uncertainties On the Target Zonesmentioning

confidence: 99%

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Implications of the uncertainty of postoperative functional parameters for the preoperative planning of total hip arthroplasty

Fischer

Tokunaga

Okamoto

et al. 2022

Journal Orthopaedic Research

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The functional parameters pelvic tilt (PT) and hip joint force (HJF) are required to calculate patient‐specific target zones based on the range of motion (ROM) and implant loading for preoperative planning of total hip arthroplasty (THA). Both functional parameters may change after THA. The preoperative prediction of the postoperative PT and HJF is associated with a specific amount of uncertainty. The prediction uncertainty has to be considered in the preoperative planning process to avoid a suboptimal implantation. So far, very little attention has been paid to the necessary reduction of patient‐specific target zones by the prediction uncertainties of postoperative functional parameters. Prediction models for the postoperative PT in standing position and for the HJF during one‐leg stance as a surrogate for the peak force phase during level walking were used to quantify the reduction of the ROM‐ and load‐based target zones of 196 Japanese THA patients. The prediction uncertainty was about 14° for the postoperative standing PT and ranged from 17% body weight to 37% body weight for the components of the HJF. On average, the prosthetic ROM‐based target zone had to be significantly reduced by 43% and the load‐based target zone by 39%. This led to a median reduction of the combined prosthetic ROM‐ and load‐based target zone of 96%. The study sharpens the awareness for the substantial reduction of ROM‐ and load‐based target zones by prediction uncertainties of the postoperative PT and HJF and highlights the importance of further research to improve prediction models for both functional parameters.

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Section: Discussionmentioning

confidence: 99%

Section: Impact Of Prediction Uncertainties On the Target Zonesmentioning

confidence: 99%

Implications of the uncertainty of postoperative functional parameters for the preoperative planning of total hip arthroplasty

Fischer

Tokunaga

Okamoto

et al. 2022

Journal Orthopaedic Research

View full text Add to dashboard Cite

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“…This target zone is defined regarding a target ROM, the patient-specific pelvic tilt and several prosthetic parameters (cup opening angle, femoral head and neck diameters, and femoral neck orientation). As proposed by Marchadour et al [7], our FSZ corresponds to the merging of three target zones computed for the supine, sitting and standing positions.…”

Section: Methodsmentioning

confidence: 99%

Functional Safe Zone for Cup Orientation in THA

Guezou-Philippe¹,

Marchadour²,

Pluchon³

et al.

EPiC Series in Health Sciences

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The usual safe zone for cup orientation in THA is not suitable for all patients, as the pelvic tilt varies with the movements of daily activities. A new Functional Safe Zone (FSZ) is proposed that considers the pelvic tilt in different positions. The aims of this study were to validate the proposed FSZ and to evaluate how the pelvic mobility impact it.We measured the pelvic tilts of 30 patients when standing, sitting and supine, using our ultrasound-based device and computed their FSZs. The FSZs accuracy was assessed using a Computer-Aided-Design (CAD) software. The pelvic mobility influence onto the FSZ was assessed by jointly analysing the patients’ FSZs and their pelvic tilt difference between positions.The true FSZ provided by the CAD software and the estimated FSZ were similar by 92% and differed by less than 0.5◦ at borders and at the mean orientation. Patients with stiff pelvic mobility obtained small FSZs, and conversely, patients with large pelvic tilt variations between positions obtained large FSZs.The proposed method allows the computation of a patient-specific FSZ without requir- ing additional X-ray or CT images. Patients having a low pelvic mobility with a higher risk of postoperative instability could be better managed using this FSZ.

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