미시적 수준에서 인공 고관절 삽입 후 근위 대퇴골의 구조적 거동 분석

류승헌,김정진 한국정밀공학회 2023 한국정밀공학회지 Vol.40 No.11

Total hip replacement is a representative treatment for avascular necrosis of the femoral head. However, the stress shielding caused by the replacement induces dissociation of the artificial hip joint and various complications. Many studies have tried to explore the stress shielding but, most studies have been conducted at macro level and not at micro level. Thus, this study aimed to quantitatively analyze the structural behavior of the proximal femur according to total hip replacement at the micro level to explore the stress shielding. For this purpose, this study selected the artificial hip joint of the single wedge type and implanted the joint into a proximal femur that has a high resolution of 50 μm. Then the structural behavior of the implanted femur was analyzed by comparing that of the intact femur under three daily activity loads. As a result, the high possibility was confirmed that the stress shielding will occur in both cortical and cancellous bones under the one-legged stance movements. Additionally, it was discovered that the cancellous bone had a considerably lesser chance of adducting at an angle similar to the neck shaft angle of an artificial hip joint.

SPECT/CT에서 인공고관절에 대한 감쇠보정지도(Attenuation Map)의 매개변수 변화에 따른 금속 인공물(Metal Artifact)의 영향 평가

김상규,김정열,박민수,조승현,임한상,김재삼,Kim, Sang Gyu,Kim, Jung Yul,Park, Min Soo,Jo, Seung Hyun,Lim, Han Sang,Kim, Jae Sam 대한핵의학기술학회 2014 핵의학 기술 Vol.18 No.2

CT를 기반으로 감쇠보정이 시행되는 SPECT/CT 검사에서는 금속 삽입물에 의한 선속경화현상으로 인접한 부위의 과대평가를 유발하며, 영상의 질을 저하시킨다. 이에 대해, 본 연구에서는 인공고관절이 삽입된 팬텀을 이용하여 감쇠보정지도의 매개변수 변화에 따른 금속 인공물이 SPECT/CT 영상에 미치는 영향을 알아보고자 한다. SPECT/CT 장비는 Siemens사의 Symbia T16을 사용하였다. SPECT/PET 팬텀에 인공고관절을 삽입하고, CT영상에서 Bright Streak 영역에 직경 17 mm의 구를 배후방사능 대비 8배가 되도록 Tc-99m을 채웠다. 이후 감쇠보정지도에서 Wide Beam Coefficient[수동모드(0.1~0.9), 자동모드]변화에 따른 열소와 배후방사능의 계수를 측정하였고, 고관절의 유무에 따라 Metal과 Non-Metal의 병소 대 배후방사능 비(Region to Background Ratio, RBR)를 산출 및 비교 분석하였다. 수동모드의 값이 증가할수록 Metal과 Non-Metal의 열소 계수는 증가하는 경향을 나타냈으며, 수동모드 0.4와 0.5에서 두 군과의 열소 계수비가 가장 일치하게 나타났다(수동모드 0.4=1.001, 0.5=0.999). 또한 $RBR^{Metal}$과 $RBR^{Non-Metal}$의 비는 자동모드에서 1.135이였고, 수동모드 0.4와 0.5에서 통계적으로 유의한 차이를 보이지 않았다(0.4=0.999, 0.5=1.028, p=0.78). 감쇠보정지도에서 Wide Beam Coefficient의 자동모드는 13.52% 과 보정 되는 것을 알 수 있었으며, 수동모드 중 0.4와 0.5에서 인공물에 의한 과 보정을 최소화 할 수 있었다. 이를 활용하여 환자에게 적용하기 위해서는 추가적인 연구가 이루어져야 할 것이며, 고관절전치환술 환자의 인공고관절 주변에서 금속 인공물에 의한 과 보정을 감소시켜 진단능을 향상시킬 수 있을 것으로 사료된다. Purpose SPECT/CT scan to be performed attenuation correction on the basis of CT induce an overestimation of the site due to the beam hardening artifact by metal cover and reduce the images quality. Therefore, this study using a phantom that has been inserted artificial hip joint investigated that effect on the SPECT/CT image causing by metal artifact for varying the parameters of the Attenuation Map. Materials and Methods Siemens Symbia T16 SPECT/CT equipment was used. Artificial hip joint was inserted to SPECT/PET phantom, 17 mm sphere of Bright Streak area in CT image was filled with Tc-99m so that the radiation activity was 8 times compared to background. And then Hot and Background was measured in varying Wide Beam Coefficient on Attenuation Map and RBR (Region to Background Ratio) of Metal and Non-Metal was calculated and analyzed depending on the presence or absence of the hip joint. Results It tended to hot count of Non-Metal and Metal to increase as the value of the manual mode is increased, hot count ratio with the group of both manual mode 0.5 and 0.4 is the best match. Also, in automatic mode, the ratio of RBRNon-Metal and RBRMetal was 1.135, statistically significant difference was not observed in the manual mode 0.5 and 0.4. Conclusion In the automatic mode of Wide Beam Coefficient in attenuation correction map, it was found that it is over-correction by 13.52%, it was possible to minimize the over-correction by the artifact in 0.5 and 0.4 of manual mode. Further studies should be performed in order to apply to a patient with the help of this and it is considered possible to reduce the over-correction by the metal artifact of an artificial hip joint for Hip-Resurfacing Arthroplasty patients, and to improve the diagnostic performance.

인공 고관절의 발전사

조명래 ( Myung Rae Cho ),장호진 ( Ho Jin Chang ) 대한고관절학회 2013 Hip and Pelvis Vol.25 No.1

Department of Orthopaedic Surgery, Daegu Catholic University Medical Center, Daegu, Korea For several centuries, orthopaedic surgeons have been given the task of managing the pain, limp, and gait disturbance that develop in association with various trauma and diseases of the hip joint. Progress has been made in development of surgical methods for the hip joint, and a recent concept was determined by introduction of the ``Clean Air Operating Enclosure`` system and ``low frictional arthroplasty`` in total hip arthroplasty (THA) by John Charnley, in 1960. THA has been performed as an exclusive method for hip joint reconstruction. We report on understanding of the current status from the past, present, and future trends with an introduction of the prior method of THA and a discussion of the history.

고관절 재치환술시 재료의 응력과 변형률의 비교 분석

심동혁(D. H. Shim),김정훈(J. H. Kim),고석훈(S. H. Ko),김경훈(K. H. Kim),김대열(D. Y. Kim),최명진(M. J. Choi) 한국정밀공학회 2006 한국정밀공학회 학술발표대회 논문집 Vol.2006 No.5월

According to development of medical science and engineering, people has made efforts to solve the discomfort of body accident as well as the life span. Many cases that reduce pain of a hip joint or limitation of motion using Revision Total Hip Replacement are getting increased. However it has not proved which material is the most appropriate. Scientists are still studying about materials of the artificial joint. In accordance with advance of science, the materials are getting better. Recently, when Revision Total Hip Replacement is performed, typical materials sre Ti-alloys Ceramics. We have studied materials of artificial joints and analyzed which one is better for human"s body.

Artificial Hip Joint의 표면정밀도를 개선하기 위한 MAF 기술 개발

행리다,김휘중,임홍철,김정수,씨압 잔점난,문상돈 한국기계기술학회 2022 한국기계기술학회 학술대회논문집 Vol.2022 No.11

내마모성이 향상된 기능성 표면구조를 갖는 인공관절에 관한 기초적인 연구

김동욱,T. Yuhta 대한의용생체공학회 2001 의공학회지 Vol.22 No.6

At present. about 0.3 million and more THRs (Total Hip Replacement) in a rear are being done worldwide. The increase in mechanical failure with the increase in THR, required more revisions. Revisions compensate mainly the wear of the artificial joint frictional surface and the loosening of the cup and stem. According to recent researches, loosening is mainly due to wear debris UHMWPE (Ultra High Molecular Weight Polyethylene) from frictional surfaces . To overcome the wear problems associated with artificial joint materials , new surface structures with regular Patterns were designed and fabricated The lubrication Properties were examined to evaluate the wear of the frictional surfaces. The surface structure manifested a Pattern of "dents" with a 0.2-1.0 mm of diameter and 0.6-2.0 mm of Pitch. From the friction test of the SUS316L vs UHMWPE using the frictional tester, we found that the lubrication Performance was improved due to of drastically reduced amount of abrasion. There were optimum sizes for the diameter and the pitch of the Pattern. The results demonstrated that the lubrication properties could be improved by Patterning of the frictional surfaces. The surface Patterning was effective in preventing wear of the frictional surfaces, and the life of an artificial joint could be extended with such Patterning.

진자식 관절 시뮬레이터를 이용한 기능성 표면구조를 갖는 인공관절의 내마모성 향상에 관한 연구

김동욱,황규윤 순천향대학교 부설 산업기술연구소 2001 순천향 산업기술연구소논문집 Vol.7 No.2

For the purpose of reduction of polyethylene wear generated in artificial hip joints, concave dimples were formed on the surface of the metal femoral head by electrical discharge etching with the constant diameter of 0.5mm, pitch of 1.2 mm, and depth of 0.1mm. Using a hip joint simulator, the total amount of polyethylene wear was 15.4 mg in the concave-patterned condition and 34.2 mg in the nonpatterned condition. The reasons for the reduction of polyethylene wear by the concave pattern may be ⅰ) a reduction of abrasive wear by providing escape dimples for wear particles and ⅱ) an improvement in the lubricity on the frictional surface by the supply of lubricant that is store in dimples.

THE EFFECTS OF MESH STYLE ON THE FINITE ELEMENT ANALYSIS FOR ARTIFICIAL HIP JOINTS

JAEMIN SHIN,DONGSUN LEE,SUNGKI KIM,DARAE JEONG,HYUN GEUN LEE,JUNSEOK KIM 한국산업응용수학회 2011 Journal of the Korean Society for Industrial and A Vol.15 No.1

In this paper, a good quality mesh generation for the finite element method is investigated for artificial hip joint simulations. In general, bad meshes with a large aspect ratio or mixed elements can give rise to excessively long computational running times and extremely high errors. Typically, hexahedral elements outperform tetrahedral elements during three-dimensional contact analysis using the finite element method. Therefore, it is essential to mesh biologic structures with hexahedral elements. Four meshing schemes for the finite element analysis of an artificial hip joint are presented and compared: (1) tetrahedral elements, (2) wedge and hexahedral elements, (3) open cubic box hexahedral elements, and (4) proposed hexahedral elements. The proposed meshing scheme is to partition a part before seeding so that we have a high quality three-dimensional mesh which consists of only hexahedral elements. The von Mises stress distributions were obtained and analyzed. We also performed mesh refinement convergence tests for all four cases.

인공관절 마찰소음 해석 및 시험 검증

최호일(Hoil Choi),강재영(Jaeyoung Kang) (사)한국CDE학회 2015 한국 CAD/CAM 학회 학술발표회 논문집 Vol.2015 No.동계

인공 고관절 비구컵의 끼워맞춤에 따른 변형량의 예측

안영명,박영배 한국기계기술학회 2008 한국기계기술학회지 Vol.10 No.3

In a total hip arthroplasty, the artificial hip joint is composed of an acetabular cup and a femoral head. To minimize the wear of the joint, the bearing surface should be precisely spherical. There were concerns that the press-fitting of the acetabular cup to the pelvis may cause the deformation of the cup and accelerate the wear of the joint, but its in-vivo measurement was challenging. In this paper, 3 dimensional finite element(FE) models of a pelvis and acetabular cups of Metasul 50mm and Pinnacle 50-60mm cups were used to simulate the deformation of the acetabular cups. For Metasul cups, the change of inner radius with respect to the location and the maximum shrinkage of the inner radius were found. For the Pinnacle cups, maximum change of the outer diameter were found and compared with the literature. FE model showed that the maximum shrinkage of the inner radius of the Metasul cup was 23μm (1.0mm press-fit, Bone stiffness 17GPa case). The shrinkage occurred mainly on the anterior and posterior side of rim of the cup, and the amount was proportional to the press-fit amount. The diametric change of the Pinnacle cup was 0.16mm on average, which was in same range of the clinically reported value. In conclusion, under the normal condition the reduction of the inner radius of the Metasul cup was too small to cause the jamming or the excessive wear.