Quantitative Assessment of Walking Activity after Total Hip or Knee Replacement*

Schmalzried, Thomas P.; Szuszczewicz, Edward S.; Northfield, Mark R.; Akizuki, Kenneth H.; Frankel, Ryan E.; BELCHER, GREG; Amstutz, Harlan C.

doi:10.2106/00004623-199801000-00010

Cited by 339 publications

(195 citation statements)

References 21 publications

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“…Future versions of the IDEEA 1 system will be able to address this topic. The average number of steps taken per day by the patients in our study (6078 ± 3806) represents a 22% increase over averages reported previously (4988 steps per day in 111 patients) [36,52,53,63]. Although this increase is substantial, it does fall within the wide range of activity (395-17,718 steps per day) that has been described in the same studies.…”

Section: Discussionsupporting

confidence: 62%

2009 Marshall Urist Young Investigator Award: How Often Do Patients with High-Flex Total Knee Arthroplasty Use High Flexion?

Huddleston¹,

Scarborough

Goldvasser

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Although high-flexion TKA designs aim to safely accommodate deep flexion, it is unknown how often patients use deep flexion outside the laboratory. We used a validated smart-activity monitor to document the prevalence of knee flexion greater than 90°in 20 consecutive patients (21 knees) who had high-flexion TKAs, at a minimum of 2 years' followup. Patients wore the device continuously for a mean of 35.7 ± 0.5 hours. The 21 knees flexed more than 90°for an average of 10 ± 3.8 minutes (0.5%). Activities performed with flexion greater than 90°w ere, on average, 70% in single-limb stance, 12% moving from sitting to standing, 8% walking, 7% moving from standing to reclining, 2% stepping, 0.9% moving from lying to standing, and 0.1% running. Eight knees flexed greater than 120°for an average of 2.2 minutes (range, 0.2-15 minutes), or 0.1% of the testing time. Activities performed with flexion greater than 120°were, on average, 90% in single-limb stance, 6% moving from sitting to standing, 3% walking, 0.6% moving from standing to reclining, 0.3% stepping, and 0.1% moving from lying to standing. Peak flexion used at any time during testing was, on average, 84%

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Section: Discussionsupporting

confidence: 62%

2009 Marshall Urist Young Investigator Award: How Often Do Patients with High-Flex Total Knee Arthroplasty Use High Flexion?

Huddleston¹,

Scarborough

Goldvasser

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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show abstract

“…The slight difference in computational prediction with the CMM measurements specifically at 3 rd and 4 th million load cycles is likley due to the individual variation in loading conditions and activity levels related to the explants. For example, a 45-fold difference between the least and most active patients fitted with hip or knee implants has been reported previously (Schmalzried et al, 1998).…”

Section: Cmm Wear Measurement Of Retrieved Femoral Tapersmentioning

confidence: 79%

“…An average of 1 million walking cycles per year has been assumed in this study; as such, the volumetric wear rates demonstrated are over 1 million walking steps (Schmalzried et al, 1998). The volumetric wear rates and total volume loss have been determined based on the reduction of element volume ("EVOL" field output from ABAQUS) for all the elements at the taper junction contact zone using a separate custom Python script linked as a user plug-in within ABAQUS.…”

Section: Finite Element Wear Analysismentioning

confidence: 99%

A large taper mismatch is one of the key factors behind high wear rates and failure at the taper junction of total hip replacements: A finite element wear analysis

Ashkanfar

Langton

Joyce

2017

Journal of the Mechanical Behavior of Biomedical Materials

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A large taper mismatch is one of the key factors behind high wear rates and failure at the taper junction of total hip replacements: A finite element wear analysis.http://researchonline.ljmu.ac.uk/5442/ Article LJMU has developed LJMU Research Online for users to access the research output of the University more effectively. Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Users may download and/or print one copy of any article(s) in LJMU Research Online to facilitate their private study or for non-commercial research. You may not engage in further distribution of the material or use it for any profit-making activities or any commercial gain.The version presented here may differ from the published version or from the version of the record. Please see the repository URL above for details on accessing the published version and note that access may require a subscription. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Chromium femoral heads, which had been in service for 5.1 years in average, to validate the FE analyses. It was found that a large taper mismatch (e.g. 9.12´ ) results in a high wear rate (2.960mm 3 per million load cycles). Such wear rates can have a major negative effect on the clinical outcomes of these implants. It was also found that even a slight reduction in mismatch significantly reduced the magnitude of the wear rates (0.069mm 3 per million load cycles on average for 6´ taper mismatch). It is recommended that the cone angles of femoral head and femoral trunnion should be manufactured to produce a taper mismatch of less than 6´ at the taper junction.

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“…Implant wear and secondary osteolysis are major causes of THA failure and are of particular concern in young patients undergoing THA because of long lifespans [7,20,26,33,38]. Therefore, alternative bearing surfaces have been introduced to minimize wear particle-induced implant failure.…”

Section: Introductionmentioning

confidence: 99%

THA with Highly Cross-linked Polyethylene in Patients 50 Years or Younger

Shia¹,

Clohisy²,

Schinsky³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Highly cross-linked polyethylene has been associated with low in vitro wear, but also has decreased in vitro ultimate yield strength. We therefore asked whether highly cross-linked polyethylene would result in lower outcome scores, wear, or early failure in a young patient population. Seventy THAs in 64 patients were performed using a highly cross-linked (electron beam-irradiated to 9 Mrads) acetabular liner and a cobalt-chrome femoral head. The average age of the patients at surgery was 41 years (range, 19-50 years). The minimum followup was 2.4 years (average, 4 years; range, 2.4-6.5 years). We recorded demographic and clinical data, including Harris hip score. Polyethylene wear measurements were analyzed with a validated, computer-assisted, edge detection method. The average Harris hip score improved from 53 to 92 at last followup. There was no evidence of acetabular or femoral loss of fixation, subsidence, or loosening. Linear wear was undetectable at this followup interval. No patient experienced catastrophic failure or underwent revision surgery. These data show low polyethylene wear rates and no catastrophic failures at early followup in a young patient cohort.

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Quantitative Assessment of Walking Activity after Total Hip or Knee Replacement*

Cited by 339 publications

References 21 publications

2009 Marshall Urist Young Investigator Award: How Often Do Patients with High-Flex Total Knee Arthroplasty Use High Flexion?

2009 Marshall Urist Young Investigator Award: How Often Do Patients with High-Flex Total Knee Arthroplasty Use High Flexion?

A large taper mismatch is one of the key factors behind high wear rates and failure at the taper junction of total hip replacements: A finite element wear analysis

THA with Highly Cross-linked Polyethylene in Patients 50 Years or Younger

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