THE STUDY OF THE WORK OF THE MUSCLES RESPONSIBLE FOR THE FUNCTIONALITY OF THE HIP JOINT AFTER TOTAL HIP ARTHROPLASTY USING DIFFERENT SURGICAL APPROACHES

Stanislav Bondarenko, Dmytro Sereda, O. Karpinska
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Abstract

Muscles that can be damaged during endoprosthesis are indicated. Objective. To study the features of muscle work to ensure walking function after hip arthroplasty depending on the surgical approach. Methods. The basis of the simulation is the basic OpenSim Gate2392 model. Six models were created that predicted the condition of the muscles of the lower limb in normal conditions, during coxarthrosis and after 6 and 12 months. after surgery with lateral and anterior approaches. The results. For lateral access in 6 months. after the operation, the adductor muscles responsible for stabilizing the pelvis in the single-support phase of the step and during the transfer of the foot do not work enough, while the hip flexor muscles (in the model, the rectus femoris muscle) take over the responsibility for the step, but with overvoltage. On the contrary, with the front approach, we observe a weakening of the flexor muscles, which leads to overstrain of the gluteal muscles and hip stabilizer muscles. After 12 months, the muscle strength normalizes for most of them to 90–95 % of the norm, a 2–3 times increase in the torque of the hip flexor muscles and hip stabilizer muscles is observed. Taking a normal step causes muscle strain. During the anterior approach, the foot is transferred during the phase, that is, when most of the muscles are involved. The rectus femoris muscle, which is the strongest of the muscles discussed in the paper, does the main work of moving the foot. In the case of possible damage to the rectus muscle during anterior access, even after a year there is a violation of its work — excessive overexertion and involvement of the reserves of other muscles. Conclusions. Mathematical modeling of the work of muscles that may be damaged during hip arthroplasty surgery, conditional muscle strength for 6 months. after the operation, they are not able to develop the necessary torque to take a normal step. For muscle strength, which in the model corresponded to 12 months,the muscles are able to perform a normal function regardless of surgical access, but their overstrain is observed.
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使用不同的手术方法研究全髋关节置换术后负责髋关节功能的肌肉的工作情况
适用于内固定术中可能受损的肌肉。目的研究髋关节置换术后确保行走功能的肌肉工作特点,具体取决于手术方法。方法。模拟的基础是基本的 OpenSim Gate2392 模型。创建了六个模型,分别预测正常情况下、髋关节病变期间以及侧方和前方入路手术后 6 个月和 12 个月的下肢肌肉状况。结果如下对于手术后 6 个月的侧方入路,负责在迈步的单支撑阶段和转移足部时稳定骨盆的内收肌没有充分发挥作用,而髋屈肌(在模型中为股直肌肌群)则接管了迈步的责任,但却出现了过电压。相反,我们观察到,采用前置方法时,屈肌的力量减弱,导致臀肌和臀部稳定肌过度紧张。12 个月后,大多数人的肌肉力量恢复正常,达到正常值的 90-95%,髋关节屈肌和髋关节稳定肌的扭矩增加 2-3 倍。正常迈步会造成肌肉拉伤。在前方入路时,脚在阶段性转移,也就是大部分肌肉参与的时候。股直肌是本文所讨论的肌肉中最强壮的肌肉,承担着移动脚的主要工作。如果股直肌在前方入路过程中可能受到损伤,那么即使在一年后,它的工作也会受到影响--过度用力和其他肌肉储备的参与。结论对髋关节置换手术中可能受损的肌肉工作进行数学建模,有条件的肌肉力量在手术后 6 个月内都无法达到正常迈步所需的扭矩。至于肌肉力量,在模型中相当于 12 个月,无论是否进行手术,肌肉都能发挥正常功能,但会出现过度应变。
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