By Docteur Paul G. J. Maquet (auth.)
Dr. MAQUET, the most important disciple of Professor PAUWELS' and the orthopae dic inheritor to the PAUWELS' recommendations of osteotomy of the hip for arthritis, has assembled during this one publication the most powerful and so much lucid modern assertion of the foundations and perform of this extremely important university of hip surgical procedure. Professor PAUWELS' contributions to the knowledge of the biomechanics of the hip and to the thoughts and execution of osteotomy of the hip for arthritis are remarkable and undying. With readability, Dr. MAQUET articulates this place and refines it extra within the mild of his personal investiga tion. whereas different investigators, in fact, vary on person options or princi ples during this booklet or disagree with particular positions, assumptions, or conclu sions, it's transparent to all that this e-book is a benchmark paintings. Dr. MAQUET, as Professor PAUWELS constantly did, illustrates his textual content lavishly with appealing examples of person instances illuminating the foundations advert vanced. but additionally, he has long past additional and provides long term follow-up information, quantifying the result of those surgical precepts as skilled in his personal perform. it's a paintings that has been lengthy sought and is richly got. Boston, Massachusetts, 1984 WILLIAM H. HARRIS, M.D.
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Extra info for Biomechanics of the Hip: As Applied to Osteoarthritis and Related Conditions
After PAUWELS 1976) joint can increase considerably due to the remodelling, but the weight-bearing area progressively decreases and the articular compressive stresses thus increase (Fig. 43). This paradox results from the fact that the resultant force R continues to act at the initial centre of the femoral head, which is pushed further and further laterally. The medial osteophyte which develops on the medial aspect of the femoral head is at first made of cartilage and develops where there is moderate compression (GRASSET 1960).
31 h). If the epiphysial cartilage is unable to react normally, as in congenital coxa vara, the mechanical conditions become worse and worse and the typical picture of the condition develops (PAUWELS 1973a). f g h 29 c. Femoral Neck In a normal hip, the line of action of the resultant force R points away from the axis of the femoral neck from above downwards. The force R thus tends to bend the femoral neck more and more in this direction (Fig. 14). Oblique to the axis of the femoral neck, R evokes shearing stresses in the neck.
Both static forces C and K are vertical with opposite signs. Their resultant F is also vertical and F = K - C. The line of action of force F is at a distance s from the hip such that: a Fs=Kh'-Cj Kh'-Cj s K-C The force K, which normally tends to tilt the pelvis clockwise with the moment K h', is now replaced by force F. The moment F s is smaller because force F is less and it acts with a lever arm which is shorter than h'. The stick allows the trunk to straighten without increasing the force acting on the hip.