人工 股關節의 安定性에 對한 運動學的 硏究 = Kinematic Study for Stability of Total Hip Prosthesis

다국어 초록 (Multilingual Abstract)

Each artificial hip joint has differences in type of the prosthesis and in angle of insertion of the acetabular cup and femoral prosthesis.
These prostheses are devised suitably for Westerners who do not require the extreme range of motion of flexion, abduction or external rotation of the hip joint.
And they are not as suitable for Koreans who require a lot of flexion, abduction or external rotation of the hip joint in their daily activity such as cross-legged sitting of squatting position.
Therefore it may be ideal to design one suitable to the activity of daily living of Koreans or we have to change the angle of insertion of the acetabular cup and, or femoral prosthesis. But when the angle of insertion in each prosthesis is changed, it is questionable whether it will maintain stabiliy.
The purpose of this paper is to study the normal range of motion of the hip joint for cross-legged sitting and squatting positions in Korean life and to evaluate the angle of insertion of various prosthesis to adjust to the above mentioned cross-legged sitting and squatting postures so as to prevent the dislocation of the prosthesis.
As the first step, to observe normal range of motion of the hip joint during cross-legged sitting and squatting position in Korean life, the author examined the average range of motion of flexion, abduction and external rotation in the hip joint of 50 normal Korean soldiers in a cross-legged sitting or a squatting position, and then performed total hip replacement in 10 Korean skeletons in various angles of the acetabular cup and, or femoral prosthesis with McKee-Farrar, Charnley and Muller type respectively.
The results obtained are as follows.
1. The mean values of the range of motion of the hip joint during cross-legged sitting position of 50 normal Korean soldiers are 105.9°±0.942° in flexion, 37.14°±0.423° in abduction, and 41.46°±0.584° in external rotation. The mean values of the range of motion of the hip joint during squatting position are 130.84°±0.844° in flexion, 13.32°±0.725° in abduction, and 10.36°±0.240° in external rotation.
2. Among 3 types of prostheses of Mckee-Farrar, Charnley and Muller, the suitable prosthesis for the cross-legged sitting or squatting position of Korean is McKee-Farrar, Muller and Charnley in their order.
3. In order to maintain the stability and simultaneously to provide adequate range of motion in cross-legged sitting position, the acetabular cup has to be inserted with 45° or 60° inclination and 20° or 45° anteversion, and the femoral prosthesis has to be inserted with 20° or 30° anteversion. In squatting position, the acetabular cup has to be inserted with 60° Inclination and 20° or 45° anteversion, and the femoral prosthesis has to be inserted with 30° anteversion.
4. Among 3 types of prostheses, the maximum mean degree of flexion is 146°±2.2° in McKee-Farrar prosthesis with femoral neutral version, 45° of acetabular inclination, and 20° of acetabular anteversion. Among 3 types of prostheses, the minimum mean degree of flexion is 69°±1.4° in Charnley prosthesis with acetabular neutral version, 45° of acetabular inclination, and 25° of femoral retroversion.
5. Among 3 types of prostheses, the maximum mean degree of extension is 126.5°±1.6° in McKee-Farrar prosthesis with femoral neutral version, 45° of acetabular inclination, and 20° of acetabular retroversion. Among 3 types of prostheses, the minimum mean degree of extension is 10.3°±0.6°in Charnley prosthesis with 10° of femoral anteversion, 45° of acetabular inclination, 45° of acetabular anteversion.
6. Among 3 types of prostheses, the maximum mean degree of abduction is 77.3°±1.8° in Muller prosthesis with femoral neutral version, acetabular neutral version, and 60° of acetabular inclination. Among 3 types of prostheses, the maximum mean degree of abduction is 29°±1.9° in Charnley prosthesis with femoral neutral version, acetabular neutral version, and 20° of acetabular inclination.
7. Among 3 types of prosthese, the maximum mean degree of adduction is 56.5°±1.1° in Muller prosthesis with femoral neutral version, acetabular neutral version, and 20° of acetabular inclination. Among 3 types of prostheses, the minimum mean degree of adduction is 22°±0.8° in McKee-Farrar prosthesis with 10° of femoral anteversion, 45° of acetabular inclination, and 45° of acetabular anteversion.
8. Among 3 types of prostheses, the maximum mean degree of external rotation is 117.5°±2.1° in Muller prosthesis with femoral neutral version, acetabular neutral version, and 60° of acetabular inclination. Among 3 types of prostheses, the minimum mean degree of external rotation is 10.5°±1.1° in Charnley prosthesis with 10° of femoral anteversion, 45° of acetabular inclination, and 45° of acetabular anteversion.
9. Among 3 types of prsotheses, the maximum mean degree of internal rotation is 144°±1.5° in Muller prosthesis with 10° of femoral anteversion, 45˚ of acetabulat inclination, and 45° of acetabular anteversion. Among 3 types of prostheses, the minimum mean degree of internal rotation is 52°±1.3° in Charnley prosthesis with femoral neutral version, 45° of acetabular inclination, and 20° of acetabular retroversion.
10. As femoral of acetabular anteversion increases, flexion of internal rotation is increased, but extension, external rotation, abduction or adduction is reduced. As acetabular inclination increases, flexion of extension of abduction or external rotation is increased but internal rotation or adduction is reduced.

목차 (Table of Contents)

• Ⅰ. 緖論
• Ⅱ. 硏究對象 및 方法
• 1. 硏究對象
• 2. 硏究方法
• Ⅲ. 硏究成績
• 1. 韓國正常成人의 坐位 및 排便位時 股關節의 平勻角度
• 2. 3型 prosthesis의 揷入角度 및 股關節 運動範圍와의 關係
• (1) 屈曲運動과의 關係
• (2) 伸展運動과의 關係
• (3) 外轉運動과의 關係
• (4) 內轉運動과의 關係
• (5) 外回轉運動과의 關係
• (6) 內回轉運動과의 關係
• (7) 韓國人의 坐位에 適合한 prosthesis의 揷入角度의 測定과 安定性에 對한 成績
• (8) 韓國人의 排便位에 適合한 prosthesis의 揷入角度의 測定과 安定性에 對한 成績
• Ⅳ. 總括 및 考察
• Ⅴ. 結論
• 參考文獻