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Emonde CK, Hurschler C, Breuer A, Eggers ME, Wichmann M, Ettinger M, Denkena B. Early monitoring of inlay wear after total knee arthroplasty on plain radiographs using model-based wear measurement. Sci Rep 2024; 14:18248. [PMID: 39107444 PMCID: PMC11303532 DOI: 10.1038/s41598-024-68383-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 07/23/2024] [Indexed: 08/10/2024] Open
Abstract
Wear of the ultra-high molecular-weight polyethylene (UHMWPE) component in total knee arthroplasty contributes to implant failure. It is often detected late, when patients experience pain or instability. Early monitoring could enable timely intervention, preventing implant failure and joint degeneration. This study investigates the accuracy and precision (repeatability) of model-based wear measurement (MBWM), a novel technique that can estimate inlay thickness and wear radiographically. Six inlays were milled from non-crosslinked UHMWPE and imaged via X-ray in anteroposterior view at flexion angles 0°, 30°, and 60° on a phantom knee model. MBWM measurements were compared with reference values from a coordinate measurement machine. Three inlays were subjected to accelerated wear generation and similarly evaluated. MBWM estimated inlay thickness with medial and lateral accuracies of 0.13 ± 0.09 and 0.14 ± 0.09 mm, respectively, and linear wear with an accuracy of 0.07 ± 0.06 mm. Thickness measurements revealed significant lateral differences at 0° and 30° (0.22 ± 0.08 mm vs. 0.06 ± 0.06 mm, respectively; t-test, p = 0.0002). Precision was high, with average medial and lateral differences of - 0.01 ± 0.04 mm between double experiments. MBWM using plain radiographs presents a practical and promising approach for the clinical detection of implant wear.
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Affiliation(s)
- Crystal Kayaro Emonde
- Laboratory for Biomechanics and Biomaterials, Hannover Medical School, Department of Orthopaedic Surgery, DIAKOVERE Annastift, Anna Von Borries Str. 1-7, 30625, Hannover, Germany.
| | - Christof Hurschler
- Laboratory for Biomechanics and Biomaterials, Hannover Medical School, Department of Orthopaedic Surgery, DIAKOVERE Annastift, Anna Von Borries Str. 1-7, 30625, Hannover, Germany
| | - André Breuer
- Laboratory for Biomechanics and Biomaterials, Hannover Medical School, Department of Orthopaedic Surgery, DIAKOVERE Annastift, Anna Von Borries Str. 1-7, 30625, Hannover, Germany
| | - Max-Enno Eggers
- Institute of Production Engineering and Machine Tools, Leibniz University Hannover, An Der Universität 2, Garbsen, 30823, Hannover, Germany
| | - Marcel Wichmann
- Institute of Production Engineering and Machine Tools, Leibniz University Hannover, An Der Universität 2, Garbsen, 30823, Hannover, Germany
| | - Max Ettinger
- Department of Orthopaedic Surgery, Pius-Hospital Oldenburg, University Clinic for Orthopaedics and Trauma Surgery, Georgstraße 12, 26121, Oldenburg, Germany
| | - Berend Denkena
- Institute of Production Engineering and Machine Tools, Leibniz University Hannover, An Der Universität 2, Garbsen, 30823, Hannover, Germany
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Shu J, Zheng N, Dai H, Wang Q, Tsai TY, Liu Z. Altered dynamic joint space in the lateral condyle compartment following medial unicompartmental knee arthroplasty. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 255:108330. [PMID: 39121602 DOI: 10.1016/j.cmpb.2024.108330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 07/02/2024] [Accepted: 07/15/2024] [Indexed: 08/12/2024]
Abstract
PURPOSE The progression of osteoarthritis in lateral compartment has been identified as a primary complication in medial unicompartmental knee arthroplasty (UKA) revisions, irrespective of whether employing fixed bearing (FB) or mobile bearing (MB) designs. Compared to the previous contact point analyses, the tibiofemoral contacts during knee movements are comprehended by a more comprehensive understanding of joint spaces. This study aims to dynamically map the joint spaces in the lateral compartment during the single-leg lunge following FB and MB UKA procedures, and compare them with the respective contralateral native knees. It is hypothesized that the significant change in joint space for post-UKA compared to their native knees. METHODS Twelve patients with unilateral medial FB UKA and eleven patients with unilateral medial MB UKA were included and underwent computed tomography scans. The exclusion criteria included anterior cruciate ligament deficiency, postoperative knee pain, any postoperative complications, and musculoskeletal illnesses. A dual fluoroscopic imaging system was utilized to capture the single-leg lunge, and 2D-to-3D registration facilitated the visualization of knee motion. According to the knee motions, joint spaces on tibial and femoral surfaces in the lateral compartments of native, FB, and MB UKA knees were calculated and mapped. RESULTS In comparison to the native knees, FB UKA knees exhibited significant increases in medial, lateral, central, and posterior joint spaces in the lateral compartment (p < 0.05), while MB UKA knees showed significant increases only in central and posterior joint spaces (p < 0.05). Moreover, FB UKA demonstrated greater increases in medial, central, and posterior joint spaces compared to MB UKA. Tibial varus and valgus during lunges, as well as the Oxford Knee Score (OKS) and Hip-Knee-Ankle angle (HKA), correlated with joint spaces. CONCLUSIONS Dynamic joint space analysis provided a more comprehensive insight into contact dynamics. FB UKA led to an enlargement of joint spaces, whereas MB UKA resulted in joint spaces closer to native knees. These findings contribute to understanding potential postoperative complication in UKAs.
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Affiliation(s)
- Jingheng Shu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin, China
| | - Nan Zheng
- School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China; Engineering Research Center for Digital Medicine of the Ministry of Education, Shanghai, China
| | - Huiyong Dai
- Department of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Wang
- Department of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tsung-Yuan Tsai
- School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China; Engineering Research Center for Digital Medicine of the Ministry of Education, Shanghai, China
| | - Zhan Liu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin, China.
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Kaptein BL, Pijls B, Koster L, Kärrholm J, Hull M, Niesen A, Heesterbeek P, Callary S, Teeter M, Gascoyne T, Röhrl SM, Flivik G, Bragonzoni L, Laende E, Sandberg O, Solomon LB, Nelissen R, Stilling M. Guideline for RSA and CT-RSA implant migration measurements: an update of standardizations and recommendations. Acta Orthop 2024; 95:256-267. [PMID: 38819193 PMCID: PMC11141406 DOI: 10.2340/17453674.2024.40709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/08/2024] [Indexed: 06/01/2024] Open
Abstract
Opening remarks: These guidelines are the result of discussions within a diverse group of RSA researchers. They were approved in December 2023 by the board and selected members of the International Radiostereometry Society to update the guidelines by Valstar et al. [1]. By adhering to these guidelines, RSA studies will become more transparent and consistent in execution, presentation, reporting, and interpretation. Both authors and reviewers of scientific papers using RSA may use these guidelines, summarized in the Checklist, as a reference. Deviations from these guidelines should have the underlying rationale stated.
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Affiliation(s)
- Bart L Kaptein
- Department of Orthopedics, Leiden University Medical Center, Leiden, The Netherlands.
| | - Bart Pijls
- Department of Orthopedics, Leiden University Medical Center, Leiden, The Netherlands
| | - Lennard Koster
- Department of Orthopedics, Leiden University Medical Center, Leiden, The Netherlands
| | - Johan Kärrholm
- Department of Orthopedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maury Hull
- Orthopedic Surgery Department, University of California, Davis, United States
| | - Abby Niesen
- Orthopedic Surgery Department, University of California, Davis, United States
| | - Petra Heesterbeek
- Orthopedic Research Department, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Stuart Callary
- Department of Orthopedics and Trauma, Royal Adelaide Hospital, Adelaide, Australia
| | - Matthew Teeter
- Department of Medical Biophysics, Western University, London, Canada
| | | | - Stephan M Röhrl
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Gunnar Flivik
- Department of Orthopedics, Skane University Hospital, Lund, Sweden
| | | | - Elise Laende
- Department of Surgery, Dalhousie University, Halifax, Canada
| | | | - L Bogdan Solomon
- Department of Orthopedics and Trauma, Royal Adelaide Hospital, Adelaide, Australia
| | - Rob Nelissen
- Department of Orthopedics, Leiden University Medical Center, Leiden, The Netherlands
| | - Maiken Stilling
- Department of Orthopedics, Aarhus University Hospital, Aarhus, Denmark
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Jürgens-Lahnstein JH, Petersen ET, Rytter S, Madsen F, Søballe K, Stilling M. Stable polyethylene inlay fixation and low polyethylene wear rate in fixed-bearing total knee arthroplasty at five to six years' follow-up. Bone Joint Res 2024; 13:226-236. [PMID: 38719208 PMCID: PMC11090217 DOI: 10.1302/2046-3758.135.bjr-2023-0126.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
Aims Micromotion of the polyethylene (PE) inlay may contribute to backside PE wear in addition to articulate wear of total knee arthroplasty (TKA). Using radiostereometric analysis (RSA) with tantalum beads in the PE inlay, we evaluated PE micromotion and its relationship to PE wear. Methods A total of 23 patients with a mean age of 83 years (77 to 91), were available from a RSA study on cemented TKA with Maxim tibial components (Zimmer Biomet). PE inlay migration, PE wear, tibial component migration, and the anatomical knee axis were evaluated on weightbearing stereoradiographs. PE inlay wear was measured as the deepest penetration of the femoral component into the PE inlay. Results At mean six years' follow-up, the PE wear rate was 0.08 mm/year (95% confidence interval 0.06 to 0.09 mm/year). PE inlay external rotation was below the precision limit and did not influence PE wear. Varus knee alignment did not influence PE wear (p = 0.874), but increased tibial component total translation (p = 0.041). Conclusion The PE inlay was well fixed and there was no relationship between PE stability and PE wear. The PE wear rate was low and similar in the medial and lateral compartments. Varus knee alignment did not influence PE wear.
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Affiliation(s)
- Jonathan H. Jürgens-Lahnstein
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark
- Department of Orthopedics, Aarhus University Hospital, Aarhus, Denmark
| | - Emil T. Petersen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark
- University Clinic for Hand, Hip and Knee Surgery, Holstebro Regional Hospital, Aarhus, Denmark
| | - Søren Rytter
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Orthopedics, Aarhus University Hospital, Aarhus, Denmark
| | - Frank Madsen
- Department of Orthopedics, Aarhus University Hospital, Aarhus, Denmark
| | - Kjeld Søballe
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Orthopedics, Aarhus University Hospital, Aarhus, Denmark
| | - Maiken Stilling
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark
- Department of Orthopedics, Aarhus University Hospital, Aarhus, Denmark
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Clinical usefulness and safety in the early phase after a newly designed rotating-platform total knee arthroplasty: A prospective multicentre cohort study with a 2-year follow up. Knee 2022; 39:269-278. [PMID: 36288655 DOI: 10.1016/j.knee.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/13/2022] [Accepted: 10/04/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND This study aimed to assess the clinical results and safety of a newly designed rotating-platform posterior-stabilised total knee arthroplasty (TKA) in the early postoperative phase, within 2 years of follow up. METHODS This prospective, multicentre cohort study included 100 consecutive patients who underwent rotating-platform posterior-stabilised (PS) TKA (Vanguard PSRP). After excluding dropouts, 93 patients were analysed. The objective Knee Society Score (KSS)-2011, subjective KSS-2011, knee range of motion, EuroQol 5 Dimension index, complications, and survival rates were assessed before TKA and at 6 months, 1 year, and 2 years postoperatively. The scores at each time-point were compared, and the survival rate was assessed with revision as the endpoint. To demonstrate non-inferiority, the clinical outcomes of patients who underwent rotating-platform PS TKA were compared with those collected retrospectively from 50 patients who underwent fixed-PS TKA (Vanguard PS), defined as the control group. RESULTS All clinical outcomes at the final follow up significantly improved compared with their preoperative values (P < 0.001). The objective KSS-2011 was 90.0 ± 8.2 points, subjective KSS-2011 satisfaction was 30.7 ± 8.6 points, expectation was 10.4 ± 2.1 points, and functional activity was 74.0 ± 18.5 points at 2 years postoperatively. Complications included knee dislocation in one patient and surgical site infection in one patient. The survival rate was 99% at 2 years postoperatively. Clinical outcomes, complications, and survival rates of newly designed TKA were not statistically different compared with the control group. CONCLUSION The newly designed rotating-platform PS TKA showed good clinical results and suitable safety during the early postoperative phase in this prospective multicentre cohort study.
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Bourdon CE, Broberg JS, McCalden RW, Naudie DD, MacDonald SJ, Lanting BA, Teeter MG. Comparison of long-term kinematics and wear of total knee arthroplasty implant designs. J Mech Behav Biomed Mater 2021; 124:104845. [PMID: 34555623 DOI: 10.1016/j.jmbbm.2021.104845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/23/2021] [Accepted: 09/17/2021] [Indexed: 11/16/2022]
Abstract
We sought to evaluate wear and kinematics in well-established implants of posterior stabilized (PS) and cruciate retaining (CR) designs. Ninety-one knees implanted for at least five years were examined. The implants were Genesis II PS (Smith & Nephew, Memphis, TN), Sigma PS (DePuy Synthes, Warsaw, IN), or Sigma CR. Radiostereometric analysis (RSA) images were acquired at multiple flexion angles and the 3D positions of the implant components were determined using model-based RSA software. The location of the center of the contact area between the femoral and polyethylene components was used to obtain contact kinematics, and the magnitude of the virtual intersection between the components indicated linear wear. All three groups had paradoxical anterior motion on both condyles, experienced similar net external rotation, and exhibited instances of internal rotation during flexion. The maximum observed wear rate was significantly greater for the Sigma PS than the Genesis II PS on the medial condyle (mean difference = 0.032 mm/year, p = 0.044), but not the lateral condyle, while there was no difference between the Sigma PS and Sigma CR for either condyle. Knees with lateral condylar separation had greater maximum wear rates on the medial condyle (mean difference = 0.033 mm/year, p = 0.001), while those with medial condylar separation had greater maximum wear rates on the lateral condyle (mean difference = 0.044 mm/year, p = 0.014). At long term follow-up in patients with well-functioning implants, there were differences in kinematics and wear resistance between implants. These results suggest that implant design affects long-term kinematics and wear in well-functioning implants and that condylar separation should be avoided to minimize wear.
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Affiliation(s)
- Caleigh E Bourdon
- Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, Canada; Robarts Research Institute, Schulich School of Medicine & Dentistry, Western University, Canada
| | - Jordan S Broberg
- Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, Canada; Robarts Research Institute, Schulich School of Medicine & Dentistry, Western University, Canada
| | - Richard W McCalden
- Department of Surgery, Schulich School of Medicine & Dentistry, Western University, Canada
| | - Douglas D Naudie
- Department of Surgery, Schulich School of Medicine & Dentistry, Western University, Canada
| | - Steven J MacDonald
- Department of Surgery, Schulich School of Medicine & Dentistry, Western University, Canada
| | - Brent A Lanting
- Department of Surgery, Schulich School of Medicine & Dentistry, Western University, Canada
| | - Matthew G Teeter
- Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, Canada; Orthopaedics Program, Lawson Health Research Institute, Canada.
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Williams HA, Broberg JS, Howard JL, Lanting BA, Teeter MG. Effect of gap balancing and measured resection techniques on implant migration and contact kinematics of a cementless total knee arthroplasty. Knee 2021; 31:86-96. [PMID: 34119998 DOI: 10.1016/j.knee.2021.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/05/2021] [Accepted: 05/21/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The purpose of this study was to compare implant migration and tibiofemoral contact kinematics of a cementless primary total knee arthroplasty (TKA) implanted using either a gap balancing (GB) or measured resection (MR) surgical technique. METHODS Thirty-nine patients underwent TKA via a GB (n = 19) or a MR (n = 20) surgical technique. Patients received an identical fixed-bearing, cruciate-retaining cementless implant. Patients underwent a baseline radiostereometric analysis (RSA) exam at two weeks post-operation, with follow-up visits at six weeks, three months, six months, and one year post-operation. Migration including maximum total point motion (MTPM) of the femoral and tibial components was calculated over time. At the one year visit patients also underwent a kinematic exam via RSA. RESULTS Mean MTPM of the tibial component at one year post-operation was not different (mean difference = 0.09 mm, p = 0.980) between the GB group (0.85 ± 0.37 mm) and the MR group (0.94 ± 0.41 mm). Femoral component MTPM at one year post-operation was also not different (mean difference = 0.27 mm, p = 0.463) between the GB group (0.62 ± 0.34 mm) and the MR group (0.89 ± 0.44 mm). Both groups displayed similar kinematic patterns. CONCLUSIONS There was no difference in implant migration and kinematics of a single-radius, cruciate retaining cementless TKA performed using a GB or MR surgical technique. The magnitude of migration suggests there is low risk of early loosening. The results provide support for using the cementless implant with either a GB or MR technique.
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Affiliation(s)
- Harley A Williams
- Robarts Research Institute, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Jordan S Broberg
- Robarts Research Institute, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - James L Howard
- Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Brent A Lanting
- Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Matthew G Teeter
- Robarts Research Institute, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
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Dai H, Zheng N, Zou D, Zhu Z, Liow MHL, Tsai TY, Wang Q. More Anterior in vivo Contact Position in Patients With Fixed-Bearing Unicompartmental Knee Arthroplasty During Daily Activities Than in vitro Wear Simulator. Front Bioeng Biotechnol 2021; 9:666435. [PMID: 34095100 PMCID: PMC8173134 DOI: 10.3389/fbioe.2021.666435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND While in vitro wear simulation of unicompartmental knee arthroplasty (UKA) showed outstanding long-term wear performance, studies reported that polyethylene (PE) wear was responsible for 12% fixed-bearing (FB) UKA failure. This paper aimed to quantify the in vivo 6-degrees-of-freedom (6-DOF) knee kinematics and contact positions of FB UKA during daily activities and compare with the previous results of in vitro wear simulator. METHODS Fourteen patients following unilateral medial FB UKA received a CT scan and dual fluoroscopic imaging during level walking, single-leg deep lunge, and sit-to-stand motion for evaluating in vivo 6-DOF FB UKA kinematics. The closest point between surface models of the femoral condyle and PE insert was determined to locate the medial compartmental articular contact positions, which were normalized relative to the PE insert length. The in vivo contact area was compared with the in vitro wear region in previous simulator studies. RESULTS The in vivo contact positions during daily activities were more anterior than those in the previous in vitro wear simulator studies (p < 0.001). Significant differences in the femoral anteroposterior translation and tibial internal rotation during the stance phase were observed and compared with those in lunge and sit-to-stand motions (p < 0.05). The in vivo contact position located anteriorly and medially by 5.2 ± 2.7 and 1.8 ± 1.6 mm on average for the stance phase, 1.0 ± 2.4 and 0.9 ± 1.5 mm for the lunge, and 2.1 ± 3.3 and 1.4 ± 1.4 mm for sit-to-stand motion. The in vivo contact position was in the more anterior part during the stance phase (p < 0.05). CONCLUSION The current study revealed that the contact position of FB UKA was located anteriorly and medially on the PE insert during in vivo weight-bearing activities and different from previous findings of the in vitro wear simulator. We should take in vivo 6-DOF knee kinematics and contact patterns of FB UKA into account to reproduce realistic wear performance for in vitro wear simulator and to improve implant design.
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Affiliation(s)
- Huiyong Dai
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Nan Zheng
- School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
- Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai, China
- Shanghai Key Laboratory of Orthopaedic Implants and Clinical Translation R&D Center of 3D Printing Technology, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Diyang Zou
- School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
- Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai, China
- Shanghai Key Laboratory of Orthopaedic Implants and Clinical Translation R&D Center of 3D Printing Technology, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhemin Zhu
- School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
- Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai, China
- Shanghai Key Laboratory of Orthopaedic Implants and Clinical Translation R&D Center of 3D Printing Technology, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Tsung-Yuan Tsai
- School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
- Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai, China
- Shanghai Key Laboratory of Orthopaedic Implants and Clinical Translation R&D Center of 3D Printing Technology, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Wang
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
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Raman spectroscopy reveals creep and wear rate of e-beam-sterilized conventional UHMWPE tibial inserts. J Mech Behav Biomed Mater 2020; 110:103902. [DOI: 10.1016/j.jmbbm.2020.103902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/01/2020] [Accepted: 05/30/2020] [Indexed: 11/19/2022]
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10
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Gascoyne T, Parashin S, Teeter M, Bohm E, Laende E, Dunbar M, Turgeon T. In vivo wear measurement in a modern total knee arthroplasty with model-based radiostereometric analysis. Bone Joint J 2019; 101-B:1348-1355. [DOI: 10.1302/0301-620x.101b11.bjj-2018-1447.r2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims A retrospective study was conducted to measure short-term in vivo linear and volumetric wear of polyethylene (PE) inserts in 101 total knee arthroplasty (TKA) patients using model-based radiostereometric analysis (MBRSA). Patients and Methods Nonweightbearing supine RSA exams were performed postoperatively and at six, 12, and 24 months. Weightbearing standing RSA exams were performed on select patients at 12 and 24 months. Wear was measured both linearly (joint space) and volumetrically (digital model overlap) at each available follow-up. Precision of both methods was assessed by comparing double RSA exams. Patient age, sex, body mass index, and Oxford Knee Scores were analyzed for any association with PE wear. Results Linear wear occurred at 0.015 mm/year (supine) and 0.220 mm/year (standing). Volumetric wear occurred at 10.3 mm3/year (supine) and 39.3 mm3/year (standing). Wear occurred primarily on the medial side of the joint. Weightbearing imaging greatly improved the reliability of measurement. Clinical precision of volumetric wear was 34 mm3. No significant associations were found between patient demographics or function scores and measured wear. Conclusion In vivo volumetric wear of TKAs can be assessed at short-term follow-up using MBRSA. Cite this article: Bone Joint J 2019;101-B:1348–1355.
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Affiliation(s)
- Trevor Gascoyne
- Orthopaedic Innovation Centre, Winnipeg, Canada
- Concordia Joint Replacement Group, Winnipeg, Canada
| | | | - Matthew Teeter
- London Health Sciences Centre, Western University, London, Canada
| | - Eric Bohm
- Orthopaedic Innovation Centre, Winnipeg, Canada
- Concordia Joint Replacement Group, Winnipeg, Canada
- University of Manitoba, Winnipeg, Canada
| | - Elise Laende
- QEII Health Sciences Centre, Dalhousie University and Nova Scotia Health Authority, Halifax, Canada
| | - Michael Dunbar
- QEII Health Sciences Centre, Dalhousie University and Nova Scotia Health Authority, Halifax, Canada
| | - Thomas Turgeon
- Concordia Joint Replacement Group, Winnipeg, Canada
- University of Manitoba, Winnipeg, Canada
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