Acoustic monitoring (RFM) of total hip arthroplasty results of a cadaver study

IntroductionAt present there are no reliable non-traumatic and non-invasive methods to analyse the healing process and loosening status after total hip replacement. Therefore early as well as late loosening of prosthesis and interface component problems are difficult to be found or diagnosed at any time.MethodsIn a cadaver study the potential application of Resonance Frequency Monitoring (RFM) will be evaluated as a non-invasive and non-traumatic method to monitor loosening and interface problems in hip replacement. In a 65 year old female cadaver different stability scenarios for a total hip replacement (shaft, head/modular head and cup, ESKA, Luebeck, Germany) are simulated in cemented and cement less prosthesis and then analysed with RFM. The types of stability vary from secure/press-fit to interface-shaft disruption.ResultsThe RFM shows in cemented as well as cement less prosthesis significant intra-individual differences in the spectral measurements with a high dynamic (20 dB difference corresponding to the factor 100 (10000%)), regarding the simulated status of stability in the prosthesis system.ConclusionThe results of the study demonstrate RFM as a highly sensitive non-invasive and non-traumatic method to support the application of RFM as a hip prosthesis monitoring procedure. The data obtained shows the possibility to use RFM for osteointegration surveillance and early detection of interface problems, but will require further evaluation in clinical and experimental studies.

[1]  G. Köster,et al.  Clinical value of combined contrast and radionuclide arthrography in suspected loosening of hip prostheses , 2004, Archives of Orthopaedic and Trauma Surgery.

[2]  J. Berkhof,et al.  Accuracy of diagnostic imaging techniques in the diagnosis of aseptic loosening of the femoral component of a hip prosthesis: a meta-analysis. , 2005, The Journal of bone and joint surgery. British volume.

[3]  D. Howie,et al.  Plain film and arthrographic findings in painful total hip arthroplasties with surgical correlation. , 1990, Australasian radiology.

[4]  P. Lachiewicz,et al.  The role of aspiration and contrast-enhanced arthrography in evaluating the uncemented hip arthroplasty. , 1997, AJR. American journal of roentgenology.

[5]  A. McCaskie,et al.  Radiological evaluation of the interfaces after cemented total hip replacement. Interobserver and intraobserver agreement. , 1996, The Journal of bone and joint surgery. British volume.

[6]  R. Barrack,et al.  Contemporary algorithms for evaluation of the painful total hip replacement. , 1993, Orthopaedic review.

[7]  G. Muhr,et al.  Endoprothesenlockerungen: Diagnostik mit Beschleunigungssensoren am Hüftschaft , 2007 .

[8]  J. Berkhof,et al.  A comparison of radiographic and scintigraphic techniques to assess aseptic loosening of the acetabular component in a total hip replacement. , 2004, Journal of Bone and Joint Surgery. American volume.

[9]  M A Freeman,et al.  Acetabular cup migration. Prediction of aseptic loosening. , 1995, The Journal of bone and joint surgery. British volume.

[10]  W. Dihlmann,et al.  [Alloarthroplasty of the hip joint. Radiologic diagnosis of loosening and infection in cemented total endoprostheses]. , 1991, Der Radiologe.

[11]  W H Harris,et al.  Monitoring the integrity of the cement-metal interface of total joint components in vitro using acoustic emission and ultrasound. , 1996, The Journal of arthroplasty.

[12]  H. Genant,et al.  99mTc-methylene diphosphonate bone imaging in the evaluation of total hip prostheses. , 1979, Radiology.

[13]  J. Berkhof,et al.  Diagnostic accuracy and interobserver variability of plain radiography, subtraction arthrography, nuclear arthrography, and bone scintigraphy in the assessment of aseptic femoral component loosening , 2006, Archives of Orthopaedic and Trauma Surgery.

[14]  E. Salvati,et al.  Evaluation of painful hip arthroplasties. Are technetium bone scans necessary? , 1993, The Journal of bone and joint surgery. British volume.

[15]  P. Herberts,et al.  The Swedish Total Hip Replacement Register , 2002, The Journal of bone and joint surgery. American volume.

[16]  C. Gentz,et al.  Radiographic versus clinical loosening of the acetabular component in noninfected total hip arthroplasty. , 1984, Clinical orthopaedics and related research.

[17]  I. Heyligers,et al.  The value of contrast and subtraction arthrography in the assessment of aseptic loosening of total hip prostheses: a meta-analysis. , 2005, European journal of radiology.

[18]  R. Barrack,et al.  The value of contrast arthrography in assessing loosening of symptomatic uncemented total hip components , 2004, Skeletal Radiology.

[19]  J. Barentsz,et al.  The use of subtraction arthrography in total hip arthroplasties. , 1986, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[20]  A. Georgiou,et al.  Accurate diagnosis of hip prosthesis loosening using a vibrational technique. , 2001, Clinical biomechanics.

[21]  F. Jensen,et al.  Inter- and intraobserver study of radiographic assessment of cemented total hip arthroplasties. , 1996, The Journal of arthroplasty.

[22]  R Bauer,et al.  Early migration predicts late aseptic failure of hip sockets. , 1996, The Journal of bone and joint surgery. British volume.

[23]  Gang Qi,et al.  How much can a vibrational diagnostic tool reveal in total hip arthroplasty loosening? , 2003, Clinical biomechanics.

[24]  N B Jones,et al.  Loosening of total hip arthroplasty. Diagnosis by vibration analysis. , 1995, The Journal of bone and joint surgery. British volume.

[25]  W. Hop,et al.  Digital subtraction arthrography in preoperative evaluation of painful total hip arthroplasty , 1996, Skeletal Radiology.

[26]  R. Barrack,et al.  Developments in diagnosis of the painful total hip replacement. , 1993, Orthopaedic review.

[27]  A. Krückhans,et al.  Indications, methods, and results of cemented, hybrid, and cement-free implantation of THR. , 2004, Surgical technology international.

[28]  J R van Horn,et al.  Nuclear arthrography: combined scintigraphic and radiographic procedure for diagnosis of total hip prosthesis loosening. , 1996, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[29]  H. Refior,et al.  Evaluation of imaging in loosening of hip arthroplasty in 326 consecutive cases , 1998, Archives of Orthopaedic and Trauma Surgery.

[30]  A. Davis,et al.  Classifying Failed Hip Arthroplasty: Generalizability of Reliability and Validity , 2003, Clinical orthopaedics and related research.

[31]  R. Brand,et al.  Interobserver variability in interpreting radiographic lucencies about total hip reconstructions. , 1985, Clinical orthopaedics and related research.

[32]  G F McCoy,et al.  The Differentiation of Loose and Secure Femoral Implants in Total Hip Replacement Using a Vibrational Technique: An Anatomical and Pilot Clinical Study , 1989, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[33]  B. Mjöberg.  Fixation and loosening of hip prostheses. A review. , 1991, Acta orthopaedica Scandinavica.

[34]  H Brenner,et al.  Indications for total hip replacement: comparison of assessments of orthopaedic surgeons and referring physicians , 2006, Annals of the rheumatic diseases.

[35]  M A Freeman,et al.  Early migration and late aseptic failure of proximal femoral prostheses. , 1994, The Journal of bone and joint surgery. British volume.

[36]  K. Miles,et al.  Bone Scintigraphy of Hip Prostheses: Can Analysis of Patterns of Abnormality Improve Accuracy? , 1994, Clinical nuclear medicine.

[37]  R. Bourne,et al.  Analysis of radionuclide arthrograms, radiographic arthrograms, and sequential plain radiographs in the assessment of painful hip arthroplasty. , 1990, The Journal of arthroplasty.

[38]  P L Li,et al.  Vibration analysis in the detection of total hip prosthetic loosening. , 1996, Medical engineering & physics.

[39]  R. Wixson,et al.  Arthrography after total hip arthroplasty: a modified technique used in the diagnosis of pain. , 1983, Radiology.