Evaluation of predicted knee function for component malrotation in total knee arthroplasty.

Autor: Vanheule V; Biomechanics Section, Katholieke Universiteit Leuven, Celestijnenlaan 300C, 3001 Leuven, Belgium; Materialise N.V., Technologielaan 15, 3001 Leuven, Belgium. Electronic address: valentine.vanheule@kuleuven.be., Delport HP; Department of Orthopaedics, University Hospital Pellenberg, Katholieke Universiteit Leuven, Weligerveld 1, 3212 Pellenberg, Belgium., Andersen MS; Department of Mechanical and Manufacturing Engineering, Aalborg University, Fredrik Bajers Vej 5, 9100 Aalborg, Denmark., Scheys L; Department of Orthopaedics, University Hospital Pellenberg, Katholieke Universiteit Leuven, Weligerveld 1, 3212 Pellenberg, Belgium., Wirix-Speetjens R; Materialise N.V., Technologielaan 15, 3001 Leuven, Belgium., Jonkers I; Department of Kinesiology, Katholieke Universiteit Leuven, Tervuursevest 101, 3001 Leuven, Belgium., Victor J; Department of Physical Medicine and Orthopedic Surgery, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium., Vander Sloten J; Biomechanics Section, Katholieke Universiteit Leuven, Celestijnenlaan 300C, 3001 Leuven, Belgium.
Jazyk: angličtina
Zdroj: Medical engineering & physics [Med Eng Phys] 2017 Feb; Vol. 40, pp. 56-64. Date of Electronic Publication: 2016 Dec 15.
DOI: 10.1016/j.medengphy.2016.12.001
Abstrakt: Soft-tissue balancing for total knee arthroplasty (TKA) remains subjective and highly dependent on surgical expertise. Pre-operative planning may support the clinician in taking decisions by integrating subject-specific computer models that predict functional outcome. However, validation of these models is essential before they can be applied in clinical practice. The aim of this study was to evaluate a knee modelling workflow by comparing experimental cadaveric measures to model-based kinematics and ligament length changes. Subject-specific models for three cadaveric knees were constructed from medical images. The implanted knees were mounted onto a mechanical rig to perform squatting, measuring kinematics and ligament length changes with optical markers and extensometers. Coronal malrotation was introduced using tibial inserts with a built-in slope. The model output agreed well with the experiment in all alignment conditions. Kinematic behaviour showed an average RMSE of less than 2.7mm and 2.3° for translations and rotations. The average RMSE was below 2.5% for all ligaments. These results show that the presented model can quantitatively predict subject-specific knee behaviour following TKA, allowing evaluation of implant alignment in terms of kinematics and ligament length changes. In future work, the model will be used to evaluate subject-specific implant position based on ligament behaviour.
(Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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