Bergmann G., Bender A., Dymke J., Duda G., Damm P.

Standardized Loads Acting in hip implants

PLoS ONE 11(5): e0155612. doi:10.1371/journal.pone.0155612

All activities, measurement conditions, numbers of analysed trials and postoperative times of
measurement are listed in Tables 2 and 3. Most data were captured 10 to 13 months after surgery.

Fig 3. Peak forces Fres from nine activities

Coloured lines = individual loads from 10 subjects with normalized BW = 75 kg .

Black solid line = average loads AVER75 for BW = 75 kg. Black dashed line = high loads HIGH100 for
BW = 100 kg. Factors f1 and f2 are shown for the data from standing up; for other activities, they are
different. See also Fig 2.
75kg= 165lb 5.547360oz

100kg= 220lb 7.396480oz

125kg= 275 lb.

1N =0.2248 lb.

The BW used to calculate the HIGH100 loads was not unrealistically high. The 95% percentile of BW for
the average European population from 65–74 years was reported to be 100.5 kg (Nordic Council of
Ministers, 2011). Moreover, the 85% percentile of BW for the average male population (70–79 years)
in the United States was reported to be 100 kg [26]. If the 95% percentile of BW for the male US
population (60–69 years) shall be respected, then even a BW of approximately 125 kg would be
realistic, i.e., all HIGH100 should be increased by 25%.

Schwachmeyer V, Damm P, Bender A, Dymke J, Graichen F, Bergmann G

In Vivo Hip Joint Loading during Post-Operative Physiotherapeutic Exercises.
PLoS ONE. 2013;8(10): e77807. doi:10.1371/journal.pone.0077807

The finally selected and evaluated measurements were taken between the 5th and 12th post-operative
month, except from exercise #11 with data taken from the 4th postoperative week.

To ensure optimal initial bone ingrowth around the implant, load-dependent micromotions at the
bone-stem-interface must be minimized as they may otherwise prevent implant stabilization and
cause loosening. Similarly, high loads acting at fracture implants may cause non-union or
pseudarthrosis.

One study found large diversity in rehabilitation protocols [12]: out of 53 surveyed surgeons, 38
allowed full weight bearing for uncemented implants, yet 10 prescribed partial weight bearing with
half body weight and 3 allowed only toe-touch weight bearing. Only 9 surgeons reported that their
protocols were evidenced-based, but no detailed information was provided.

Damm P, Schwachmeyer V, Dymke J, Bender A, Bergmann G

In vivo hip joint loads during three methods of walking with forearm crutches.
Clin Biomech (Bristol, Avon). 2013 Jun;28(5):530-5