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THE POSITION OF THE EXTERNAL HIP JOINT IN THE ABOVE-THE-KNEE PROSTHESIS WITH PELVIC SUSPENSION An Experimental Approach to the Problem
A. R. BUCHANAN; BENJAMIN E. ROBINSON
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Department of Anatomy, University of Colorado School of Medicine, Denver
1946 by The American Orthopaedic Association, Inc.
The Journal of Bone & Joint Surgery.  1946; 28:71-80 
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Abstract

Three human cadavera were utilized for the study of the effects of varying axes of rotation upon flexion of the thigh. The investigation was carried out in an attempt to determine the optimum functional position of the external hip joint in the above-the-knee prosthesis with pelvic suspension. Variations in the angles formed between the axes of rotation and the frontal and transverse planes of the anterior superior iliac spines were facilitated by an adjustable ball-and-socket joint; this was placed opposite the hip joint of the cadaver, and a rod was passed through it into the center of the head of the femur.

Flexion to 54 degrees was carried out from starting positions—characterized by various combinations of flexion, abduction, and external rotation of the thigh—which simulated the postural deviations observed clinically in amputation stumps.

The results indicate that, for straight-forward flexion to occur, the external joint should be placed from one and one-quarter to one and three-quarters inches anterior to the middle of the greater trochanter.

An axis which passed through the greater trochanter was conducive to considerable abduction, as the thigh was moved forward in flexion. Conversely, when the external joint was placed too far anteriorly, adduction was associated with flexion.

Considerable adjustment in the position of the external joint, within rather narrow limits, is necessary to compensate for varying degrees of flexion, abduction, and external rotation of the thigh.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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