An implantable electronic system for in-vivo stability evaluation of prosthesis in Total Hip and Knee Arthroplasty

This paper describes an implantable system for the in vivo measurement of both micromotion and migration in applications such as total hip arthroplasty (THA) and total knee arthroplasty (TKA). The system is based on a modified form of linear variable differential transformer (LVDT) whose null-point is set automatically by means of a self-calibration algorithm. The self-calibration process not only allows the measuring bridge to work at maximum accuracy (i.e. for micromotion measurements) but also automatically records gross changes in position (migration). Simulations and preliminary measurements show that the calibration algorithm works correctly in spite of component tolerances and initial set up errors and that the device can measure micromotion with an amplitude as low as 1 μm with a gross displacement (migration) in the range 0~±4 mm.

[1]  S. Fuchs-Winkelmann,et al.  Primary stability of tibial components in TKA: in vitro comparison of two cementing techniques , 2009, Knee Surgery, Sports Traumatology, Arthroscopy.

[2]  R. Field,et al.  COST OF TOTAL HIP AND KNEE ARTHROPLASTY IN THE UK. A COMPARISON WITH THE CURRENT REIMBURSEMENT SYSTEM IN THE NHS. , 2009 .

[3]  Shiying Hao,et al.  An implantable system for the in vivo measurement of Hip and Knee migration and micromotion , 2008, 2008 International Conference on Signals and Electronic Systems.

[4]  K. Bozic,et al.  Computer-navigated joint-replacement surgery , 2008 .

[5]  E. Salvati,et al.  Thompson hip hemiarthroplasty: Asymptomatic after 44 years a case report , 2008 .

[6]  W. Harper,et al.  Does bone quality predict loosening of cemented total hip replacements? , 2007, The Journal of bone and joint surgery. British volume.

[7]  G C Bannister,et al.  Ten-year life expectancy after primary total hip replacement. , 2007, The Journal of bone and joint surgery. British volume.

[8]  M. Carter,et al.  Global cost-effectiveness of cataract surgery. , 2007, Ophthalmology.

[9]  I. Brenkel,et al.  Quality of life and functional outcome after primary total hip replacement. A five-year follow-up. , 2007, The Journal of bone and joint surgery. British volume.

[10]  C. Case,et al.  Metallic debris from orthopaedic implants , 2007, The Lancet.

[11]  A W Miles,et al.  A review of pre-clinical testing of femoral stem subsidence and comparison with clinical data , 2007, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[12]  H. Gill,et al.  RSA-measured Inducible Micromotion and Interface Modeling with Finite Element Methods , 2006, Clinical orthopaedics and related research.

[13]  D. Pedersen,et al.  Results of Charnley total hip arthroplasty with use of improved femoral cementing techniques. a concise follow-up, at a minimum of twenty-five years, of a previous report. , 2006, The Journal of bone and joint surgery. American volume.

[14]  I. Learmonth Total hip replacement and the law of diminishing returns. , 2006, The Journal of bone and joint surgery. American volume.

[15]  P. Herberts,et al.  Three hundred and twenty-one periprosthetic femoral fractures. , 2006, The Journal of bone and joint surgery. American volume.

[16]  J. Seon,et al.  Comparison of range of motion of high-flexion prosthesis and mobile-bearing prosthesis in total knee arthroplasty. , 2005, Orthopedics.

[17]  E. Castano,et al.  High sensitivity linear position sensor developed using granular Ag–Co giant magnetoresistances , 2005 .

[18]  Jurgen Kosel,et al.  Non-contact detection of magnetoelastic bilayer position sensors , 2005 .

[19]  Steven Kurtz,et al.  Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. , 2005, The Journal of bone and joint surgery. American volume.

[20]  J. Best,et al.  Revision Total Hip and Total Knee Arthroplasty , 2005, Orthopedic nursing.

[21]  W. Song,et al.  Alumina-on-alumina total hip arthroplasty. A five-year minimum follow-up study. , 2005, The Journal of bone and joint surgery. American volume.

[22]  Chua-Chin Wang,et al.  An implantable bi-directional wireless transmission system for transcutaneous biological signal recording , 2005, Physiological measurement.

[23]  E. Valstar,et al.  Comparison of micromotion in mobile bearing and posterior stabilized total knee prostheses , 2005, Acta orthopaedica.

[24]  L. Weidenhielm,et al.  All-polyethylene vs. metal-backed tibial component in total knee arthroplasty—a randomized RSA study comparing early fixation of horizontally and completely cemented tibial components: Part 2. Completely cemented components: MB not superior to AP components , 2005, Acta orthopaedica.

[25]  Patrick J. Prendergast,et al.  Measurement of the Relative Motion Between an Implant and Bone under Cyclic Loading , 2004 .

[26]  M. Peterson,et al.  Clinical and radiographic results associated with a modern, cementless modular cup design in total hip arthroplasty. , 2004, The Journal of bone and joint surgery. American volume.

[27]  J. Katz,et al.  Early failures of total hip replacement: effect of surgeon volume. , 2004, Arthritis and rheumatism.

[28]  D. Pedersen,et al.  Results of Charnley total hip arthroplasty at a minimum of thirty years. A concise follow-up of a previous report. , 2004, The Journal of bone and joint surgery. American volume.

[29]  Tomoyuki Saito,et al.  Mechanisms of failure of total hip replacements: lessons learned from retrieval studies. , 2004, Clinical orthopaedics and related research.

[30]  L. Toledo-Pereyra John Charnley—Father of Modern Total Hip Replacement , 2004, Journal of investigative surgery : the official journal of the Academy of Surgical Research.

[31]  J. Corda,et al.  Enhanced performance variable-reluctance transducer for linear-position sensing , 2003 .

[32]  P. Fleming,et al.  Strain on the human sciatic nerve in vivo during movement of the hip and knee. , 2003, The Journal of bone and joint surgery. British volume.

[33]  K. Koo,et al.  Contemporary Total Hip Arthroplasty with and without Cement in Patients with Osteonecrosis of the Femoral Head , 2003, The Journal of bone and joint surgery. American volume.

[34]  Richard L Webber,et al.  Application of TACT to the evaluation of total joint arthroplasty. , 2003, Medical physics.

[35]  H Nägerl,et al.  Spatial micromovements of uncemented femoral components after torsional loads. , 2002, Journal of biomechanical engineering.

[36]  David Feeny,et al.  Comparison of Total Hip Arthroplasty Performed with and without Cement: A Randomized Trial , 2002, The Journal of bone and joint surgery. American volume.

[37]  M. J. Hall,et al.  2000 National Hospital Discharge Survey. , 2002, Advance data.

[38]  Young-Hoo Kim,et al.  Total Hip Replacement with a Cementless Acetabular Component and a Cemented Femoral Component in Patients Younger than Fifty Years of Age , 2002, The Journal of bone and joint surgery. American volume.

[39]  A. Timperley,et al.  The Exeter universal cemented femoral component at 8 to 12 years. A study of the first 325 hips. , 2002, The Journal of bone and joint surgery. British volume.

[40]  P J Prendergast,et al.  Discriminating the loosening behaviour of cemented hip prostheses using measurements of migration and inducible displacement. , 2002, Journal of biomechanics.

[41]  J O Galante,et al.  Second-Generation Cementless Total Hip Arthroplasty: Eight to Eleven-Year Results , 2001, The Journal of bone and joint surgery. American volume.

[42]  P. Sharkey,et al.  Primary Cementless Total Hip Arthroplasty in Octogenarians: Two to Eleven-Year Follow-up , 2001, The Journal of bone and joint surgery. American volume.

[43]  D C Voaklander,et al.  Health related quality of life outcomes after total hip and knee arthroplasties in a community based population. , 2000, The Journal of rheumatology.

[44]  C. Milgrom,et al.  In-vivo strain measurements to evaluate the strengthening potential of exercises on the tibial bone. , 2000, The Journal of bone and joint surgery. British volume.

[45]  C. Moran,et al.  Total knee replacement: the joint of the decade , 2000, BMJ : British Medical Journal.

[46]  Michael Dunbar,et al.  Patient satisfaction after knee arthroplasty: A report on 27,372 knees operated on between 1981 and 1995 in Sweden , 2000, Acta orthopaedica Scandinavica.

[47]  Johan Bellemans,et al.  Bone ingrowth in total knee arthroplasty: the impact of HA-coatings and the relation with mechanical stability , 1998 .

[48]  P.-A. Besse,et al.  High-resolution miniaturized inductive proximity sensor: characterization and application for step-motor control , 1998 .

[49]  T Hansson,et al.  Life Expectancy and Cost Utility After Total Hip Replacement , 1998, Clinical orthopaedics and related research.

[50]  M. A. R. Freeman,et al.  Early radiological observations may predict the long-term survival of femoral hip prostheses , 1997 .

[51]  G. Scuderi**,et al.  Total Knee Replacement in Young, Active Patients. Long-Term Follow-up and Functional Outcome* , 1997, The Journal of bone and joint surgery. American volume.

[52]  D. W. Bühler,et al.  Design and evaluation of a device for measuring three-dimensional micromotions of press-fit femoral stem prostheses. , 1997, Medical engineering & physics.

[53]  R. Chang,et al.  A cost-effectiveness analysis of total hip arthroplasty for osteoarthritis of the hip. , 1997, JAMA.

[54]  V. Goldberg,et al.  Hybrid total hip arthroplasty: a 7- to 11-year followup. , 1996, Clinical orthopaedics and related research.

[55]  J. Galante,et al.  Hybrid total hip arthroplasty: 7- to 10-year results. , 1996, Clinical orthopaedics and related research.

[56]  W. Harris,et al.  Total hip arthroplasty with use of so-called second-generation cementing techniques. A fifteen-year-average follow-up study. , 1995, The Journal of bone and joint surgery. American volume.

[57]  P S Walker,et al.  Prediction of clinical outcome of THR from migration measurements on standard radiographs. A study of cemented Charnley and Stanmore femoral stems. , 1995, The Journal of bone and joint surgery. British volume.

[58]  J Kärrholm,et al.  Micromotion of femoral stems in total hip arthroplasty. A randomized study of cemented, hydroxyapatite-coated, and porous-coated stems with roentgen stereophotogrammetric analysis. , 1994, The Journal of bone and joint surgery. American volume.

[59]  J. Kärrholm,et al.  Does early micromotion of femoral stem prostheses matter? 4-7-year stereoradiographic follow-up of 84 cemented prostheses. , 1994, The Journal of bone and joint surgery. British volume.

[60]  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.

[61]  R. Barrack,et al.  Improved cementing techniques and femoral component loosening in young patients with hip arthroplasty. A 12-year radiographic review. , 1992, The Journal of bone and joint surgery. British volume.

[62]  W H Harris,et al.  The effect of improved cementing techniques on component loosening in total hip replacement. An 11-year radiographic review. , 1990, The Journal of bone and joint surgery. British volume.

[63]  C. Sledge,et al.  Results of revision total knee arthroplasty performed for aseptic loosening. , 1990, Clinical orthopaedics and related research.

[64]  G. Vértesy,et al.  Magnetoinductive position sensor , 1990, International Conference on Magnetics.

[65]  W. Maloney,et al.  Hybrid total hip arthroplasty. , 1989, Clinical orthopaedics and related research.

[66]  J. M. Lee,et al.  Observations on the Effect of Movement on Bone Ingrowth into Porous‐Surfaced Implants , 1986, Clinical orthopaedics and related research.

[67]  G. Hunter,et al.  Failure in total knee arthroplasty: mechanisms, revisions, and results. , 1982, Clinical orthopaedics and related research.

[68]  P Ducheyne,et al.  Failure of total knee arthroplasty due to loosening and deformation of the tibial component. , 1978, The Journal of bone and joint surgery. American volume.

[69]  C. Ranawat,et al.  Duo-condylar knee arthroplasty: hospital for special surgery design. , 1976, Clinical orthopaedics and related research.

[70]  C. Ranawat,et al.  Total condylar knee replacment: preliminary report. , 1976, Clinical orthopaedics and related research.

[71]  Scott A Banks,et al.  In vivo weight-bearing kinematics with medial rotation knee arthroplasty. , 2010, The Knee.

[72]  Gandikota Girish,et al.  The adult hip , 2008 .

[73]  Cato T. Laurencin,et al.  Nanotechnology and Tissue Engineering: The Scaffold , 2008 .

[74]  J. N. Navarro Espigares,et al.  Cost-outcome analysis of joint replacement: evidence from a Spanish public hospital. , 2008, Gaceta sanitaria.

[75]  K. Tallroth,et al.  Cementless total hip arthroplasty in patients with high congenital hip dislocation. , 2006, The Journal of bone and joint surgery. American volume.

[76]  H. Malchau,et al.  The Well-Cemented Total Hip Arthroplasty , 2005 .

[77]  J. Morcuende,et al.  Early attempts at hip arthroplasty--1700s to 1950s. , 2005, The Iowa orthopaedic journal.

[78]  D. M. Dall,et al.  A scoring system to determine radiological loosening in cemented total hip arthroplasty , 2004, International Orthopaedics.

[79]  M. Huo,et al.  What's new in hip arthroplasty. , 2004, The Journal of bone and joint surgery. American volume.

[80]  D. Albert A physician's guide to health care management , 2002 .

[81]  C. Bombardier,et al.  Health-related quality of life after knee replacement. , 1998, The Journal of bone and joint surgery. American volume.

[82]  K. C. Chan,et al.  5- to 18-year follow-up study of cemented total knee arthroplasty for patients 55 years old or younger. , 1997, The Journal of arthroplasty.

[83]  Robert G. Meyer,et al.  Analysis and Design of Analog Integrated Circuits , 1993 .

[84]  W H Harris,et al.  Micromotion of cemented and uncemented femoral components. , 1991, The Journal of bone and joint surgery. British volume.

[85]  J. Moreland Mechanisms of failure in total knee arthroplasty. , 1988, Clinical orthopaedics and related research.

[86]  P. Lotke,et al.  Influence of positioning of prosthesis in total knee replacement. , 1977, The Journal of bone and joint surgery. American volume.

[87]  M. J. Kingma [Total hip replacement]. , 1971, Nederlands tijdschrift voor geneeskunde.