견관절과 고관절의 장력 패턴 상관성 연구

신동재 ( Dong Jae Shin ),이종수 ( Jong Soo Lee ),김성수 ( Sung Soo Kim ),정석희 ( Seok Hee Chung ) 한방재활의학과학회 2006 한방재활의학과학회지 Vol.16 No.2

Objectives : Muscle tone is proportional to passive tension, so passive tension of antagonist can be measured by measuring passive ROM of a joint. Considering close correlation between movement and muscle tension, we hypothesized that tension patterns of upper and lower limbs would exit, and we tried to prove the existence of tension patterns of shoulder and hip joints by measuring of passive ROM of those joints. Methods : We collected 110 volunteers(75 men and 35 women), whose age was from 20 to 30, BMI was less than 23kg/m2 and who had no musculoskeletal disorder. we had passively horizontally adducted and abducted shoulder joint and passively adducted and abducted hip joint, then measured passive ROM of those joints. We decided which side was relatively dominant by comparing between left and right ROM. We analyzed the differences of tensions of shoulder and hip joints by the handedness, and the relationships between the tensions of left and right shoulder joints, between the tensions of left and right hip joints and between the tensions of shoulder joints and hip joints. Results : The right hip adduction and the left hip abduction were relatively significantly limited at right-handed persons. There was statistically significant relationship between the tensions of left and right shoulder joints, and between the tensions of left and right hip joints. There was no significant relationship between the tensions of shoulder and hip joint. Conclusions : Right-handed has the tension patterns especially at hip joints. There is also tension patterns between the homologous joints.

자연과학편 : 달리기 동작 시 힙 관절 정의 방법이 힙 관절의 역학적 변인들에 미치는 영향

이효근(HyoKeunLee),신성휴(SeongHyooShin),고석곤(SukGonGo),권문석(MoonSeokKwon) 한국체육학회 2010 한국체육학회지 Vol.49 No.2

본 연구의 목적은 힙 관절 정의 방법이 힙 관절에 미치는 영향을 분석하는데 있었다. 본 연구에 참여한 근골격계 질환이 없는 8명의 20대 정상인들의 힙 관절 위치는 X-ray 촬영과 5가지 힙 관절 정의 방법(Functional, Bell's, Davis', Andriacchi, Tylkowski's Method)을 이용하여 정의하였다. 실험 시 모든 피험자들은 3.8±0.21 m/s 속도로 달리기 동작을 수행하였으며, 달리기 동작 중 RHS(Right Heel Strike)와 RTO(Right Toe Off)에서 가지 힙 관절 정의 방법에 따른 힙 관절의 역학적 변인들을 one-way repeated ANOVA(p < .05)을 이용하여 분석하였다. X-ray 방법을 통해 산출한 힙 관절의 위치와 가장 근접한 수치를 나타낸 힙 관절 정의 방법은 Functional Method였다. 달리기 동작 시 힙 관절의 운동학적 변인들인 내/외전, 내/외회전 운동은 5가지 힙 관절 정의 방법에 따라 유의한 차이를 나타내었다. 더불어 RHS에서 힙 관절의 내/외번 모멘트, RTO에서 힙 관절의 신전/굴곡 모멘트와 내/외회전 모멘트의 운동역학적 변인에서도 5가지 힙 관절 정의 방법에 따라 유의한 차이를 나타내었다. 그러므로 달리기 동작 시 힙 관절 정의 방법은 힙 관절의 회전 운동과 모멘트에 영향을 미쳤다. The purpose of this study was to analyze the effect of the method to define hip joint on the lower extremity biomechanics during running. 8 healthy university student, who had no serious musculoskeletal, coordination, balance or joint/ligament problems within one year prior to the study were participated. After finding the exact position of hip joint through X-ray, this exact position was compared with other positions estimated by 5 methods. During running, We analyzed various hip joint biomechanics generated by 5 methods using one-way repeated ANOVA(p < .05). The joint positions estimated by each method showed differences, and the position by Functional method was the most similar to the real position through X-ray. Adductive/abducent and internal/external rotated the angular hip joint position significantly changed in response to the change in 5 methods. Futhermore, adductive/abducent hip joint moment in the RHS and internal/external hip joint moment in the RTO were found to be significantly different among 5 methods. Therefore, The the method to define hip joint mainly affected the angular motion and moment of hip joint.

고관절의 해부학 및 생체역학

김용식 ( Yong Sik Kim ),권순용 ( Soon Yong Kwon ),한석구 ( Suk Ku Han ) 대한고관절학회 2009 Hip and Pelvis Vol.21 No.2

The ball and socket structure of the hip joint allows a wide range of motion that is exceeded in no other joint of the body except the shoulder. At the same time, a remarkable degree of stability is provided by the close fit of the femoral head into the acetabulum and its deepening lip, the glenoid labrum, and by the support of the strongest capsular ligaments and the thickest musculature of the body. Of all the joints, the hip is most deeply situated. This relative inaccessibility increases the difficulty of diagnosing hip lesions, rendering thorough operative exposure of the joint arduous. Precise knowledge about the anatomy of the hip joint and its surrounding structures help orthopaedic surgeons diagnose and treat various diseases and trauma around the hip joint. An understanding of the biomechanics of the hip is vital to advancing the diagnosis and treatment of many pathologic conditions. Benefits from advances in hip biomechanics include the evaluation of joint function, the development of therapeutic programs for treatment of joint problems, procedures for planning reconstructive surgeries, and the design and development of total hip prostheses. Biomechanical principles also provide a valuable perspective to our understanding of the mechanism of injury to the hip, to femoroacetabular impingement, and to the etiology of degenerative hip disease.

Bilateral Asymmetric Traumatic Dislocation of the Hip Joint

( Hee Gon Park ),( Hyung Suk Yi ),( Kyoo Hong Han ) 대한외상학회 2018 大韓外傷學會誌 Vol.31 No.1

Traumatic hip joint dislocations account for 2-5% of total joint dislocations. Bilateral asymmetric hip joint dislocation with anteriorly and posteriorly dislocation is an even more rare case because it was according to G. Loupasis reported in 11 cases only since 1879. We want to report 2 cases of bilateral asymmetric hip joint dislocation with unilateral acatabulum fracture which happened in our hospital. Bilateral asymmetric dislocation of hip joint accompanied by unilateral fracture of acetabulum is a very rare case so statistical verification cannot be done. However, close examinations are required at early treatment and follow-up because the patterns of dislocation and fracture of hip joint are variable and an orthopedic emergent condition and several complications may occur at both hip joints.

Non-destructive Biomechanical Analysis to Evaluate Surgical Planning for Hip Joint Diseases

Park, Won-Man,Kim, Yoon-Hyuk,Kim, Kyung-Soo,Oh, Taek-Yul 한국정밀공학회 2009 International Journal of Precision Engineering and Vol.10 No.3

The hip joint diseases have various kinds of origination, and they have multifarious forms according to the originations. One of the major concerns to plan the surgical operation for the hip diseases is the alternation of biomechanical environment, such as joint force and contact pressure. In this study, we analyzed the biomechanical effects of surgical techniques of the hip joint diseases by finite element analysis. We developed the finite element models of the pre-operative and post-operative hip joints for four children patients who have hip joint disease with abnormal joint anatomy. The models consist of two bones (pelvis and femur) reconstructed from CT images, and the articular cartilages on acetabulum and femoral head. Bones and cartilages were assumed having linear elastic material properties. The resultant joint force and the abductor force were calculated from 3-D static equilibrium in one-leg standing position. The calculated joint force was applied on the pelvis, the inferior plate of femur was fixed in all directions, and the medial edge of pelvis was constrained in vertical direction. Mechanical values such as contact force, pressure, and contact area on the hip joint were measured. The results of the finite element analysis were similar with those clinically estimated. The present non-destructive biomechanical evaluation method could be clinically useful for the optimal planning and selecting of surgical method by the rearrangement of contact pressure in the hip joint.

Severe hip joint motion restriction in a patient with diffuse idiopathic skeletal hyperostosis : A case report

Lee, Wonho,Kim, Wook Ro,Chang, Min Cheol Wolters Kluwer Health 2018 Medicine Vol.97 No.18

<P><B>Abstract</B></P><P><B>Rationale:</B></P><P>Severe limitation of motion (LOM) in the spine occasionally occurs in patients with diffuse idiopathic skeletal hyperostosis (DISH). However, in extraspinal areas, significant LOM has rarely been reported. In this study, we report a patient with DISH who had severe motion restriction within both hip joints.</P><P><B>Patient concerns:</B></P><P>A 57-year-old man presented with a 10-year history of LOM of bilateral hip joints. He had gait difficulty due to shortened stride length induced by LOM. Also, he had mild bilateral hip pain [numeric rating scale (NRS): 2].</P><P><B>Diagnoses:</B></P><P>Hip joint range of motion was 60.3% of normal. The patient had bridging ossification along the anterolateral borders of 7 contiguous vertebrae (T10 to L4) without the findings of ankylosing spondylitis or degenerative disc disease. In addition, severe hyperostosis was diffusely formed around bilateral hip joints. He was diagnosed with DISH.</P><P><B>Interventions:</B></P><P>No specific treatment was performed for controlling LOM of bilateral hip joints. Meloxicam 15 mg was administered to the patient for the management of mild bilateral hip pain.</P><P><B>Outcomes:</B></P><P>At 2-month follow-up visit, the degree of LOM in the bilateral hip joints was not changed. However, the patient's pain severity was reduced from NRS 2 to 1.</P><P><B>Lessons:</B></P><P>We showed that DISH can cause significant motion restriction due to severe hyperostosis in the bilateral hip joints.</P>

Non-destructive Biomechanical Analysis to Evaluate Surgical Planning for Hip Joint Diseases

박원만,김경수,오택열,김윤혁 한국정밀공학회 2009 International Journal of Precision Engineering and Vol. No.

The hip joint diseases have various kinds of origination, and they have multifarious forms according to the originations. One of the major concerns to plan the surgical operation for the hip diseases is the alternation of biomechanical environment, such as joint force and contact pressure. In this study, we analyzed the biomechanical effects of surgical techniques of the hip joint diseases by finite element analysis. We developed the finite element models of the pre-operative and post-operative hip joints for four children patients who have hip joint disease with abnormal joint anatomy. The models consist of two bones (pelvis and femur) reconstructed from CT images, and the articular cartilages on acetabulum and femoral head. Bones and cartilages were assumed having linear elastic material properties. The resultant joint force and the abductor force were calculated from 3-D static equilibrium in one-leg standing position. The calculated joint force was applied on the pelvis, the inferior plate of femur was fixed in all directions, and the medial edge of pelvis was constrained in vertical direction. Mechanical values such as contact force, pressure, and contact area on the hip joint were measured. The results of the finite element analysis were similar with those clinically estimated. The present non-destructive biomechanical evaluation method could be clinically useful for the optimal planning and selecting of surgical method by the rearrangement of contact pressure in the hip joint.

Study of Optimized Hip Implant Development for Hip Implant in Total Hip Replacement

김형진,추준욱,한성민,최귀원,유정훈,윤인찬 한국정밀공학회 2011 International Journal of Precision Engineering and Vol. No.

A hip implant re-operation is usually related to the service life of the component, as determined by its material properties, or a loosening of the hip implant resulting from a poor alignment with adjacent bone tissues. These issues invariably arise from the use of standardized products even though each patient differs in terms of anatomical parameters of their hips. To deal with such challenges, customized hip implants are needed that are designed to optimize the alignment with the hip according to the anatomical differences of individual patients. Therefore, this study presents an optimal joint restoration system optimized to the needs of the individual user as regards developing treatment technology to restore the function of an aged joint. A hip implant usually consists of a body and neck, thus, among 15 anatomical basic parameters of the human femur, 8are selected as hip implant design input parameters to focus on the most critical elements for a hip implant in the case of a total hip replacement. In addition, specific design input parameters are proposed including a wiring hole and distal slotted part, and analyzed using a finite element analysis method. The anatomical parameters in relation to a variation of the neck length are also analyzed in the same manner. To confirm the design parameters enabling normal hip implantation, a maximum neck shaft angle and length threshold model is implemented on the basis of the statistical average femoral configuration of Koreans and verified by a FEM (Finite Element Method) fatigue analysis. An analysis protocol aligned with international specifications as applied and a threshold for each of the aforementioned parameters set up to derive optimal design parameters. Finally, as a pre-operation planning tool, the parameters of choice are extracted from an X-ray femur image and reconstructed into a 2D/3D CAD model using a customized hip implant design software program, and the model stability is verified using a static FEM.

Study of Optimized Hip Implant Development for Hip Implant in Total Hip Replacement

Kim, Hyung-Jin,Chu, Jun-Uk,Han, Sung-Min,Choi, Kui-Won,Yoo, Jeong-Hoon,Youn, In-Chan 한국정밀공학회 2011 International Journal of Precision Engineering and Vol.12 No.4

A hip implant re-operation is usually related to the service life of the component, as determined by its material properties, or a loosening of the hip implant resulting from a poor alignment with adjacent bone tissues. These issues invariably arise from the use of standardized products even though each patient differs in terms of anatomical parameters of their hips. To deal with such challenges, customized hip implants are needed that are designed to optimize the alignment with the hip according to the anatomical differences of individual patients. Therefore, this study presents an optimal joint restoration system optimized to the needs of the individual user as regards developing treatment technology to restore the function of an aged joint. A hip implant usually consists of a body and neck, thus, among 15 anatomical basic parameters of the human femur, 8 are selected as hip implant design input parameters to focus on the most critical elements for a hip implant in the case of a total hip replacement. In addition, specific design input parameters are proposed including a wiring hole and distal slotted part, and analyzed using a finite element analysis method. The anatomical parameters in relation to a variation of the neck length are also analyzed in the same manner. To confirm the design parameters enabling normal hip implantation, a maximum neck shaft angle and length threshold model is implemented on the basis of the statistical average femoral configuration of Koreans and verified by a FEM (Finite Element Method) fatigue analysis. An analysis protocol aligned with international specifications as applied and a threshold for each 4 the aforementioned parameters set up to derive optimal design parameters. Finally, as a pre-operation planning tool, the parameters of choice are extracted from an X-ray femur image and reconstructed into a 2D/3D CAD model using a customized hip implant design software program, and the model stability is verified using a static FEM.

착지 동작 시 힙 관절 굴신 운동 차이가 하지 관절의 각 운동과 모멘트에 미치는 영향

권문석(MoonSeokKwon),김상규(SangKyuKim) 한국체육학회 2011 한국체육학회지 Vol.50 No.1

본 연구는 착지 동작 시 힙 관절 굴신 운동의 차이가 하지 관절의 각 운동과 모멘트에 미치는 영향을 분석하는데 목적이 있었다. 14명의 20대 체육학과 남자 대학생을 대상으로 착지 시 힙 굴곡 운동이 큰 그룹(G1)과 힙 굴곡 운동이 작은 그룹(G2)으로 나누어 착지동작을 실시하여 얻어진 결론은 다음과 같다. 착지 동작 시 G1과 G2 그룹간에 무릎과 발목 관절의 최대 굴곡 각도와 각속도에서 통계적 차이를 나타내었다. 그리고 힙 관절의 굴곡 운동이 클수록 무릎 관절 신전 모멘트는 유의한 증가를 나타낸 반면, 발목 관절 신전 모멘트는 유의한 감소를 나타내었다. 더욱이 각 관절 일률의 비에서 G1 그룹은 무릎 50%, 발목 27%, 힙 23%, G2 그룹은 발목 55%, 무릎 30%, 힙 15%순을 나타났다. 그러므로 힙 관절 굴곡 운동은 하지 관절의 각 운동과 신전모멘트에 영향을 미치는 것을 알 수 있었다. The purpose of this study was to analyze the effect of flexion/extention of hip joint difference in lower extremity angular motion and joint moment during landing. 14 healthy male university student, who had no serious musculoskeletal, coordination, balance or joint/ligament problems within one year prior to the study were participated. To classify the subjects according to flexed vs. extended hip joint motion, we had calculated maximum hip joint angle during landing. Results indicated statistical difference on maximum knee, ankle flexion angle and angular velocity between G1 and G2 group. The knee extension moment showed significantly higher values for G1 group as compared to G2 group. The other side, the ankle extension moment showed significantly lower values for G2 group as compared to G1 group. Futhermore, the contributions of muscle work rate of lower extremity joints for G1 group showed the knee - ankle - hip extensor to contribute 50%, 27%, 23%, whereas the G2 group used 30%, 55%, 15%. Therefor, the flexion-extension of hip joint mainly affected angular motion and extensor joint moment of the lower extremity during landing.