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Schumacher N, Geiger F, Spors S, Bader R, Haubelt C, Kluess D. Detection of Total Hip Replacement Loosening Based on Structure-Borne Sound: Influence of the Position of the Sensor on the Hip Stem. SENSORS (BASEL, SWITZERLAND) 2024; 24:4594. [PMID: 39065992 PMCID: PMC11280482 DOI: 10.3390/s24144594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
Accurate detection of implant loosening is crucial for early intervention in total hip replacements, but current imaging methods lack sensitivity and specificity. Vibration methods, already successful in dentistry, represent a promising approach. In order to detect loosening of the total hip replacement, excitation and measurement should be performed intracorporeally to minimize the influence of soft tissue on damping of the signals. However, only implants with a single sensor intracorporeally integrated into the implant for detecting vibrations have been presented in the literature. Considering different mode shapes, the sensor's position on the implant is assumed to influence the signals. In the work at hand, the influence of the position of the sensor on the recording of the vibrations on the implant was investigated. For this purpose, a simplified test setup was created with a titanium rod implanted in a cylinder of artificial cancellous bone. Mechanical stimulation via an exciter attached to the rod was recorded by three accelerometers at varying positions along the titanium rod. Three states of peri-implant loosening within the bone stock were simulated by extracting the bone material around the titanium rod, and different markers were analyzed to distinguish between these states of loosening. In addition, a modal analysis was performed using the finite element method to analyze the mode shapes. Distinct differences in the signals recorded by the acceleration sensors within defects highlight the influence of sensor position on mode detection and natural frequencies. Thus, using multiple sensors could be advantageous in accurately detecting all modes and determining the implant loosening state more precisely.
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Affiliation(s)
- Nico Schumacher
- Applied Microelectronics and Computer Engineering, University of Rostock, 18059 Rostock, Germany;
| | - Franziska Geiger
- Department of Orthopaedics, Rostock University Medical Center, 18057 Rostock, Germany; (R.B.); (D.K.)
| | - Sascha Spors
- Institute of Communications Engineering, University of Rostock, 18059 Rostock, Germany;
| | - Rainer Bader
- Department of Orthopaedics, Rostock University Medical Center, 18057 Rostock, Germany; (R.B.); (D.K.)
| | - Christian Haubelt
- Applied Microelectronics and Computer Engineering, University of Rostock, 18059 Rostock, Germany;
| | - Daniel Kluess
- Department of Orthopaedics, Rostock University Medical Center, 18057 Rostock, Germany; (R.B.); (D.K.)
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Soares Dos Santos MP, Bernardo RMC. Bioelectronic multifunctional bone implants: recent trends. Bioelectron Med 2022; 8:15. [PMID: 36127721 PMCID: PMC9490885 DOI: 10.1186/s42234-022-00097-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/23/2022] [Indexed: 12/04/2022] Open
Abstract
The concept of Instrumented Smart Implant emerged as a leading research topic that aims to revolutionize the field of orthopaedic implantology. These implants have been designed incorporating biophysical therapeutic actuation, bone-implant interface sensing, implant-clinician communication and self-powering ability. The ultimate goal is to implement revist interface, controlled by clinicians/surgeons without troubling the quotidian activities of patients. Developing such high-performance technologies is of utmost importance, as bone replacements are among the most performed surgeries worldwide and implant failure rates can still exceed 10%. In this review paper, an overview to the major breakthroughs carried out in the scope of multifunctional smart bone implants is provided. One can conclude that many challenges must be overcome to successfully develop them as revision-free implants, but their many strengths highlight a huge potential to effectively establish a new generation of high-sophisticated biodevices.
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Affiliation(s)
- Marco P Soares Dos Santos
- Department of Mechanical Engineering, Centre for Mechanical Technology & Automation (TEMA), Intelligent Systems Associate Laboratory (LASI), University of Aveiro, Aveiro, Portugal.
| | - Rodrigo M C Bernardo
- Department of Mechanical Engineering, Centre for Mechanical Technology & Automation (TEMA), Intelligent Systems Associate Laboratory (LASI), University of Aveiro, Aveiro, Portugal
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3
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Multiscale Sensing of Bone-Implant Loosening for Multifunctional Smart Bone Implants: Using Capacitive Technologies for Precision Controllability. SENSORS 2022; 22:s22072531. [PMID: 35408143 PMCID: PMC9003018 DOI: 10.3390/s22072531] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/16/2022] [Accepted: 03/23/2022] [Indexed: 02/06/2023]
Abstract
The world population growth and average life expectancy rise have increased the number of people suffering from non-communicable diseases, namely osteoarthritis, a disorder that causes a significant increase in the years lived with disability. Many people who suffer from osteoarthritis undergo replacement surgery. Despite the relatively high success rate, around 10% of patients require revision surgeries, mostly because existing implant technologies lack sensing devices capable of monitoring the bone–implant interface. Among the several monitoring methodologies already proposed as substitutes for traditional imaging methods, cosurface capacitive sensing systems hold the potential to monitor the bone–implant fixation states, a mandatory capability for long-term implant survival. A multifaceted study is offered here, which covers research on the following points: (1) the ability of a cosurface capacitor network to effectively monitor bone loosening in extended peri-implant regions and according to different stimulation frequencies; (2) the ability of these capacitive architectures to provide effective sensing in interfaces with hydroxyapatite-based layers; (3) the ability to control the operation of cosurface capacitive networks using extracorporeal informatic systems. In vitro tests were performed using a web-based network sensor composed of striped and interdigitated capacitive sensors. Hydroxyapatite-based layers have a minor effect on determining the fixation states; the effective operation of a sensor network-based solution communicating through a web server hosted on Raspberry Pi was shown. Previous studies highlight the inability of current bone–implant fixation monitoring methods to significantly reduce the number of revision surgeries, as well as promising results of capacitive sensing systems to monitor micro-scale and macro-scale bone–interface states. In this study, we found that extracorporeal informatic systems enable continuous patient monitoring using cosurface capacitive networks with or without hydroxyapatite-based layers. Findings presented here represent significant advancements toward the design of future multifunctional smart implants.
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Towards an effective sensing technology to monitor micro-scale interface loosening of bioelectronic implants. Sci Rep 2021; 11:3449. [PMID: 33568680 PMCID: PMC7876021 DOI: 10.1038/s41598-021-82589-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 01/13/2021] [Indexed: 12/25/2022] Open
Abstract
Instrumented implants are being developed with a radically innovative design to significantly reduce revision surgeries. Although bone replacements are among the most prevalent surgeries performed worldwide, implant failure rate usually surpasses 10%. High sophisticated multifunctional bioelectronic implants are being researched to incorporate cosurface capacitive architectures with ability to deliver personalized electric stimuli to peri-implant target tissues. However, the ability of these architectures to detect bone-implant interface states has never been explored. Moreover, although more than forty technologies were already proposed to detect implant loosening, none is able to ensure effective monitoring of the bone-implant debonding, mainly during the early stages of loosening. This work shows, for the first time, that cosurface capacitive sensors are a promising technology to provide an effective monitoring of bone-implant interfaces during the daily living of patients. Indeed, in vitro experimental tests and simulation with computational models highlight that both striped and circular capacitive architectures are able to detect micro-scale and macro-scale interface bonding, debonding or loosening, mainly when bonding is weakening or loosening is occurring. The proposed cosurface technologies hold potential to implement highly effective and personalized sensing systems such that the performance of multifunctional bioelectronic implants can be strongly improved. Findings were reported open a new research line on sensing technologies for bioelectronic implants, which may conduct to great impacts in the coming years.
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Remya AR, Vishwash B, Lee C, Pai PS, Espinoza Oras AA, Ozevin D, Mathew MT. Hip implant performance prediction by acoustic emission techniques: a review. Med Biol Eng Comput 2020; 58:1637-1650. [PMID: 32533510 DOI: 10.1007/s11517-020-02202-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/22/2020] [Indexed: 11/26/2022]
Abstract
Nowadays, acoustic emission (AE) has its applications in various areas, including mechanical, civil, underwater acoustics, and biomedical engineering. It is a non-destructive evaluation (NDE) and a non-intrusive method to detect active damage mechanisms such as crack growth, delamination, and processes such as friction, continuous wear, etc. The application of AE in orthopedics, especially in hip implant monitoring, is an emerging research field. This article presents a thorough literature review associated with the implementation of acoustic emission as a diagnostic tool for total hip replacement (THR) implants. Structural health monitoring of an implant via acoustic emission and vibration analysis is an evolving research area in the field of biomedical engineering. A review of the literature reveals a lack of reliable, non-invasive, and non-traumatic early warning methods to evaluate implant loosening that can help to identify patients at risk for osteolysis prior to implant failure. Developing an intelligent acoustic emission technique with excellent condition monitoring capabilities will be an achievement of great importance that fills the gaps or drawbacks associated with osteolysis/implant failure. Graphical abstract.
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Affiliation(s)
- Ampadi R Remya
- Department of Biomedical Science, UIC School of Medicine, Rockford, IL, USA
- Department of Material Science and Civil Engineering, University of Illinois, Chicago, IL, USA
| | - B Vishwash
- Department of Material Science and Civil Engineering, University of Illinois, Chicago, IL, USA
- Department of Mechanical Engineering, NMAM Institute of Technology, Nitte, Karnataka, 574110, India
| | - Christine Lee
- Department of Material Science and Civil Engineering, University of Illinois, Chicago, IL, USA
- Department of Bioengineering, University of Illinois, Chicago, IL, USA
| | - P Srinivasa Pai
- Department of Material Science and Civil Engineering, University of Illinois, Chicago, IL, USA
- Department of Mechanical Engineering, NMAM Institute of Technology, Nitte, Karnataka, 574110, India
| | - Alejandro A Espinoza Oras
- Department of Material Science and Civil Engineering, University of Illinois, Chicago, IL, USA
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Didem Ozevin
- Department of Material Science and Civil Engineering, University of Illinois, Chicago, IL, USA
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Mathew T Mathew
- Department of Biomedical Science, UIC School of Medicine, Rockford, IL, USA.
- Department of Material Science and Civil Engineering, University of Illinois, Chicago, IL, USA.
- Department of Bioengineering, University of Illinois, Chicago, IL, USA.
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
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Vogl F, Greger S, Favre P, Taylor WR, Thistlethwaite P. Differentiation between mechanically loose and fixed press-fit implants using quantitative acoustics and load self-referencing: A phantom study on shoulder prostheses in polyurethane foam. PLoS One 2020; 15:e0233548. [PMID: 32469919 PMCID: PMC7259646 DOI: 10.1371/journal.pone.0233548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 05/07/2020] [Indexed: 11/19/2022] Open
Abstract
This study proposes to use cross-interface quantitative acoustics (ci-qA) and load self-referencing (LSR) to assess implant stability in a radiation-free, inexpensive, rapid, and quantitative manner. Eight bone analog specimens, made from polyurethane foam, were implanted with a cementless stemless shoulder implant—first in a fixed and later in a loose configuration—and measured using ci-qA under two load conditions. The loose implants exhibited higher micromotion and lower pull-out strength than their stable counterparts, with all values falling within the range of reported reference values. All acoustic characteristics differentiated between loose and fixed implants (maximum area-under-curve AUC = 1.0 for mean total signal energy, AUC = 1.0 for mean total signal energy ratio, AUC = 0.8 for harmonic ratio, and AUC = 0.92 for load self-referencing coefficient). While these results on bone substitute material will need to be confirmed on real bone specimen, ci-qA could ultimately facilitate the assessment of primary stability during implantation surgery and avoid unnecessary revision through quantitative evaluation of secondary stability during follow-up.
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Affiliation(s)
- Florian Vogl
- Institute for Biomechanics, ETH Zürich, Zürich, Switzerland
- * E-mail:
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Yousefsani SA, Dejnabadi H, Guyen O, Aminian K. A Vibrational Technique for In Vitro Intraoperative Prosthesis Fixation Monitoring. IEEE Trans Biomed Eng 2020; 67:2953-2964. [PMID: 32091985 DOI: 10.1109/tbme.2020.2974380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE In this paper, a new vibrational modal analysis technique was developed for intraoperative cementless prosthesis fixation evaluation upon hammering. METHODS An artificial bone (Sawbones)-prosthesis system was excited by sweeping of a sine signal over a wide frequency range. The exponential sine sweep technique was implemented to the response signal in order to determine the linear impulse response. Recursive Fourier transform enhancement (RFTE) technique was applied to the linear impulse response signal in order to enhance the frequency spectrum with sharp and distinguishable peak values indicating distinct high natural frequencies of the system (ranging from 15 kHz to 90 kHz). The experiment was repeated with 5 Sawbones-prosthesis samples. Upon successive hammering during the prosthesis insertion, variation of each natural frequency was traced. RESULTS Compared to classical Fast Fourier Transform, RFTE provided a better tracing and enhancement of frequency components during insertion. Three different types of frequency evolving trends (monotonically increasing, insensitive, and plateau-like) were observed for all samples, as confirmed by a new finite element simulation of the prosthesis dynamic insertion. Two main mechanical phenomena (i.e., geometrical compaction and compressive stress) were shown to govern these trends in opposite ways. Follow-up of the plateau-like trend upon hammering showed that the frequency shift is a good indicator of fixation. CONCLUSION Alongside the individual follow-up of frequency shifts, combinatorial frequency analysis provides new objective information on the mechanical stability of Sawbone-prosthesis fixation. SIGNIFICANCE The proposed vibrational technique based on RTFE can provide the surgeon with a new assistive diagnostic technique during the surgery by indicating when the bone-prosthesis fixation is acceptable, and beyond of which further hammering should be done cautiously to avoid bone fracture.
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Cachão JH, Soares dos Santos MP, Bernardo R, Ramos A, Bader R, Ferreira JAF, Torres Marques A, Simões JAO. Altering the Course of Technologies to Monitor Loosening States of Endoprosthetic Implants. SENSORS 2019; 20:s20010104. [PMID: 31878028 PMCID: PMC6982938 DOI: 10.3390/s20010104] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/07/2019] [Accepted: 11/10/2019] [Indexed: 02/02/2023]
Abstract
Musculoskeletal disorders are becoming an ever-growing societal burden and, as a result, millions of bone replacements surgeries are performed per year worldwide. Despite total joint replacements being recognized among the most successful surgeries of the last century, implant failure rates exceeding 10% are still reported. These numbers highlight the necessity of technologies to provide an accurate monitoring of the bone–implant interface state. This study provides a detailed review of the most relevant methodologies and technologies already proposed to monitor the loosening states of endoprosthetic implants, as well as their performance and experimental validation. A total of forty-two papers describing both intracorporeal and extracorporeal technologies for cemented or cementless fixation were thoroughly analyzed. Thirty-eight technologies were identified, which are categorized into five methodologies: vibrometric, acoustic, bioelectric impedance, magnetic induction, and strain. Research efforts were mainly focused on vibrometric and acoustic technologies. Differently, approaches based on bioelectric impedance, magnetic induction and strain have been less explored. Although most technologies are noninvasive and are able to monitor different loosening stages of endoprosthetic implants, they are not able to provide effective monitoring during daily living of patients.
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Affiliation(s)
- João Henrique Cachão
- Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Marco P. Soares dos Santos
- Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal
- Center for Mechanical Technology & Automation (TEMA), University of Aveiro, 3810-193 Aveiro, Portugal
- Associated Laboratory for Energy, Transports and Aeronautics (LAETA), 4150-179 Porto, Portugal
- Correspondence:
| | - Rodrigo Bernardo
- Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal
| | - António Ramos
- Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal
- Center for Mechanical Technology & Automation (TEMA), University of Aveiro, 3810-193 Aveiro, Portugal
| | - Rainer Bader
- Department of Orthopedics, University Medicine Rostock, 18057 Rostock, Germany
| | - Jorge A. F. Ferreira
- Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal
- Center for Mechanical Technology & Automation (TEMA), University of Aveiro, 3810-193 Aveiro, Portugal
| | - António Torres Marques
- Associated Laboratory for Energy, Transports and Aeronautics (LAETA), 4150-179 Porto, Portugal
- Mechanical Engineering Department, University of Porto, 4200-465 Porto, Portugal
| | - José A. O. Simões
- Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal
- Center for Mechanical Technology & Automation (TEMA), University of Aveiro, 3810-193 Aveiro, Portugal
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Leuridan S, Goossens Q, Vander Sloten T, De Landsheer K, Delport H, Pastrav L, Denis K, Desmet W, Vander Sloten J. Vibration-based fixation assessment of tibial knee implants: A combined in vitro and in silico feasibility study. Med Eng Phys 2017; 49:109-120. [DOI: 10.1016/j.medengphy.2017.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 07/07/2017] [Accepted: 08/13/2017] [Indexed: 10/18/2022]
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Goossens Q, Leuridan S, Henyš P, Roosen J, Pastrav L, Mulier M, Desmet W, Denis K, Vander Sloten J. Development of an acoustic measurement protocol to monitor acetabular implant fixation in cementless total hip Arthroplasty: A preliminary study. Med Eng Phys 2017; 49:28-38. [PMID: 28760407 DOI: 10.1016/j.medengphy.2017.07.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 04/24/2017] [Accepted: 07/12/2017] [Indexed: 11/27/2022]
Abstract
In cementless total hip arthroplasty (THA), the initial stability is obtained by press-fitting the implant in the bone to allow osseointegration for a long term secondary stability. However, finding the insertion endpoint that corresponds to a proper initial stability is currently based on the tactile and auditory experiences of the orthopedic surgeon, which can be challenging. This study presents a novel real-time method based on acoustic signals to monitor the acetabular implant fixation in cementless total hip arthroplasty. Twelve acoustic in vitro experiments were performed on three types of bone models; a simple bone block model, an artificial pelvic model and a cadaveric model. A custom made beam was screwed onto the implant which functioned as a sound enhancer and insertor. At each insertion step an acoustic measurement was performed. A significant acoustic resonance frequency shift was observed during the insertion process for the different bone models; 250 Hz (35%, second bending mode) to 180 Hz (13%, fourth bending mode) for the artificial bone block models and 120 Hz (11%, eighth bending mode) for the artificial pelvis model. No significant frequency shift was observed during the cadaveric experiment due to a lack of implant fixation in this model. This novel diagnostic method shows the potential of using acoustic signals to monitor the implant seating during insertion.
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Affiliation(s)
- Quentin Goossens
- KU Leuven, Department of Mechanical Engineering, Smart Instrumentation, Andreas Vesaliusstraat 13, 3000 Leuven, Belgium.
| | - Steven Leuridan
- KU Leuven, Department of Mechanical Engineering, Biomechanics Section, Celestijnenlaan 300C, 3001 Leuven, Belgium
| | - Petr Henyš
- Technical University of Liberec, Studentská 1402/2,461 17 Liberec, Czech Republic
| | - Jorg Roosen
- KU Leuven, UZ Pellenberg, Department of Orthopaedics, Weligerveld 1, 3212 Pellenberg, Belgium
| | - Leonard Pastrav
- KU Leuven, Department of Mechanical Engineering, Smart Instrumentation, Andreas Vesaliusstraat 13, 3000 Leuven, Belgium
| | - Michiel Mulier
- KU Leuven, UZ Pellenberg, Department of Orthopaedics, Weligerveld 1, 3212 Pellenberg, Belgium
| | - Wim Desmet
- KU Leuven, Department of Mechanical Engineering, Production Engineering, Machine Design and Automation Division, Celestijnenlaan 300C, 3001 Leuven, Belgium
| | - Kathleen Denis
- KU Leuven, Department of Mechanical Engineering, Smart Instrumentation, Andreas Vesaliusstraat 13, 3000 Leuven, Belgium
| | - Jos Vander Sloten
- KU Leuven, Department of Mechanical Engineering, Biomechanics Section, Celestijnenlaan 300C, 3001 Leuven, Belgium
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Alshuhri AA, Holsgrove TP, Miles AW, Cunningham JL. Development of a non-invasive diagnostic technique for acetabular component loosening in total hip replacements. Med Eng Phys 2015; 37:739-45. [PMID: 26054805 DOI: 10.1016/j.medengphy.2015.05.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 03/10/2015] [Accepted: 05/03/2015] [Indexed: 10/23/2022]
Abstract
Current techniques for diagnosing early loosening of a total hip replacement (THR) are ineffective, especially for the acetabular component. Accordingly, new, accurate, and quantifiable methods are required. The aim of this study was to investigate the viability of vibrational analysis for accurately detecting acetabular component loosening. A simplified acetabular model was constructed using a Sawbones(®) foam block. By placing a thin silicone layer between the acetabular component and the Sawbones block, 2- and 4-mm soft tissue membranes were simulated representing different loosening scenarios. A constant amplitude sinusoidal excitation with a sweep range of 100-1500 Hz was used. Output vibration from the model was measured using an accelerometer and an ultrasound probe. Loosening was determined from output signal features such as the number and relative strength of observed harmonic frequencies. Both measurement methods were sufficient to measure the output vibration. Vibrational analysis reliably detected loosening corresponding to both 2 and 4 mm tissue membranes at driving frequencies between 100 and 1000 Hz (p < 0.01) using the accelerometer. In contrast, ultrasound detected 2-mm loosening at a frequency range of 850-1050 Hz (p < 0.01) and 4-mm loosening at 500-950 Hz (p < 0.01).
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Affiliation(s)
- Abdullah A Alshuhri
- The Centre for Orthopaedic Biomechanics, Department of Mechanical Engineering, University of Bath, Bath, BA2 7AY, United Kingdom.
| | - Timothy P Holsgrove
- The Centre for Orthopaedic Biomechanics, Department of Mechanical Engineering, University of Bath, Bath, BA2 7AY, United Kingdom.
| | - Anthony W Miles
- The Centre for Orthopaedic Biomechanics, Department of Mechanical Engineering, University of Bath, Bath, BA2 7AY, United Kingdom.
| | - James L Cunningham
- The Centre for Orthopaedic Biomechanics, Department of Mechanical Engineering, University of Bath, Bath, BA2 7AY, United Kingdom.
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Rieger JS, Jaeger S, Kretzer JP, Rupp R, Bitsch RG. Loosening detection of the femoral component of hip prostheses with extracorporeal shockwaves: a pilot study. Med Eng Phys 2015; 37:157-64. [PMID: 25553960 DOI: 10.1016/j.medengphy.2014.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 10/16/2014] [Accepted: 11/16/2014] [Indexed: 11/25/2022]
Abstract
The diagnosis of aseptic loosening of hip implants is often challenging. A vibrational analysis of the bone-implant interface could be an alternative method to analyze the fixation of endoprostheses. We assessed an innovative and new approach for excitation by using extracorporeal shockwaves in this study. In three cadaver specimens total hip arthroplasty was performed bilaterally. Four different states of implant loosening were simulated. Three accelerometers were fixed at the medial condyle, the greater trochanter, and the crest of the ilium. The bone-implant compound was excited with highly standardized extracorporeal shock waves. Resonance spectra between 100 Hz and 5000 Hz were recorded. This technique permitted a good adaptation to varying soft tissue conditions. The main resonance frequency of the hip joints occurred at about 2000 Hz. The analysis of the measured spectra showed an interrelation between the state of loosening and the frequency values of the resonances. In case of a stem loosening, there were significant shifts of the resonance into the lower frequency area between 386 Hz and 847 Hz. With this novel technique the degree of stem loosening could be assessed in a soft tissue considering configuration. This study forms a first step for future establishment of a non-invasive, non-radiological and fast applicable diagnostic procedure for early detection of endoprostheses loosening before manifest presence of clinical signs.
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Affiliation(s)
- Johannes S Rieger
- Heidelberg University Hospital, Department of Orthopedics, Trauma Surgery and Paraplegiology, Laboratory of Biomechanics and Implant Research, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany
| | - Sebastian Jaeger
- Heidelberg University Hospital, Department of Orthopedics, Trauma Surgery and Paraplegiology, Laboratory of Biomechanics and Implant Research, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany
| | - Jan Philippe Kretzer
- Heidelberg University Hospital, Department of Orthopedics, Trauma Surgery and Paraplegiology, Laboratory of Biomechanics and Implant Research, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany
| | - Rüdiger Rupp
- Heidelberg University Hospital, Spinal Cord Injury Center, Experimental Neurorehabilitation, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany
| | - Rudi G Bitsch
- Heidelberg University Hospital, Department of Orthopedics, Trauma Surgery and Paraplegiology, Laboratory of Biomechanics and Implant Research, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany.
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13
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Ruther C, Gabler C, Ewald H, Ellenrieder M, Haenle M, Lindner T, Mittelmeier W, Bader R, Kluess D. In vivo monitoring of implant osseointegration in a rabbit model using acoustic sound analysis. J Orthop Res 2014; 32:606-12. [PMID: 24391086 DOI: 10.1002/jor.22574] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 12/06/2013] [Indexed: 02/04/2023]
Abstract
Implant osseointegration can currently only be assessed reliably post mortem. A novel method that relies on the principle of acoustic sound analysis was developed to enable examination of the longitudinal progress of osseointegration. The method is based on a magnetic sphere inside a hollow cylinder of the implant. By excitation using an external magnetic field, collision of the sphere inside the implant produces a sound signal. Custom-made titanium implants equipped thusly were inserted in each lateral femoral epicondyle of 20 New Zealand White Rabbits. Two groups were investigated: Uncoated, machined surface versus antiadhesive surface; and calcium phosphate-coated surface versus antiadhesive surface. The sound analysis was performed postoperatively and weekly. After 4 weeks, the animals were euthanized, and the axial pull-out strengths of the implants were determined. A significant increase in the central frequency was observed for the loose implants (mean pull-out strength 21.1 ± 16.9 N), up to 6.4 kHz over 4 weeks. In comparison, the central frequency of the osseointegrated implants (105.2 ± 25.3 N) dropped to its initial value. The presented method shows potential for monitoring the osseointegration of different implant surfaces and could considerably reduce the number of animals needed for experiments.
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Affiliation(s)
- Cathérine Ruther
- Department of Orthopedics, University Medicine Rostock, Doberaner Strasse 142, D-18057, Rostock, Germany
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14
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Best estimation of spectrum profiles for diagnosing femoral prostheses loosening. Med Eng Phys 2014; 36:233-8. [DOI: 10.1016/j.medengphy.2013.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 10/16/2013] [Accepted: 11/06/2013] [Indexed: 11/23/2022]
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