Towards a Dynamic Tibial Component for Postoperative Fine-tuning Adjustment of Knee Ligament Imbalance
Andrea Collo, Shaban Almouahed, Philippe Poignet, Chafiaa Hamitouche, Eric Stindel
2013
Abstract
During TKA surgery, a correct tibiofemoral alignment of the installed prosthesis can be effectively achieved by means of Computer-Assisted techniques. Unfortunately, the achievement of perfect ligament balance conditions still remains as unsolved problem. Any inaccuracy during the operation may degenerate and lead to prosthesis failure. Our aim is to develop an adaptive knee prosthesis, able to follow the physiological evolution of the body and, potentially, to modify its shape to fit the patient's morphological changes. In this paper, we focus on the actuation of the tibial component in order to compensate for collateral ligament imbalances. We face with severe constraints concerning the available volume, the high-accuracy level and system's solidity and biocompatibility. We discuss a model that we proposed in a previous work and we highlight its drawbacks. We consider then three possible approaches to realise the actuation: the use of a micromotor, the action of a magnetic field and the use of an external tool. After evaluating the pros and cons of each case, the micromotor approach is selected. We conclude by introducing an original design of adaptive tibial implant that we are currently developing.
References
- Almouahed, S., 2011. Etude, mise en oeuvre et évaluation de prothèse autonome et prédictive du genou. Ph.D. Télécom Bretagne - LaTIM INSERM U1101, Brest.
- Almouahed, S., Gouriou, M., Hamitouche, C., Stindel, E., Roux, C., 2010. Design and evaluation of Instrumented Smart Knee Implant. In IEEE Transactions on Biomedical Engineering, vol. 58, n° 4, pp. 971-982.
- Almouahed, S., Gouriou, M., Hamitouche, C., Stindel, E., Roux, C., 2011. The use of piezoceramics as electrical energy harvesters within instrumented knee implant during walking. In IEEE/ASME Transactions on Mechatronics, Focused Section on Sensing Technologies for Biomechatronics, vol. 16, pp. 799- 807.
- Almouahed, S., Hamitouche, C., Stindel, E., Roux, C., 2012. Finite Element Lifetime Prediction of a Miniature Adjustable Orthopedic Device. In 34th Annual International Conference of the IEEE Engineering in Medicine and Biology Society "Engineering Innovation in Global Health" - EMBC'12.
- Crottet, D., Maeder, T., Fritschy, D., Bleuler, H., Nolte, L. P., Pappas, I. P., 2005. Development of a force amplitude- and location-sensing device designed to improve the ligament balancing procedure in TKA. In IEEE Transactions on Biomedical Engineering, vol. 52, pp. 1609-1611.
- International Organisation for Standardization, 2004. ISO 14243-3 Implants for surgery - Wear of total kneejoint prostheses - Part 3: Loading and displacement parameters for wear-testing machines with load control and corresponding environmental conditions for test.
- Lahuec, C., Almouahed, S., Arzel, M., Hamitouche, C., Jézéquel, M., Stindel, E., Roux, C., 2010. A selfpowered telemetry system to estimate the postoperative instability of a knee implant. In IEEE Transactions on Biomedical Engineering, vol. 58, n°3, pp. 822-825.
- Marmignon, C., 2004. Modèle et instruments robotisés pour l'étude de la biomécanique per-opératoire de l'équilibre ligamentaire du genou. Ph.D. Université Joseph Fourier, Grenoble.
- Marmignon, C., Leimnei, A., Cinquin, P., 2004. Robotized distraction device for knee replacement surgery. In Proc. CARS, pp. 638-643.
- Marmignon, C., Leimnei, A., Lavallée, S., Cinquin, P., 2005. Automated hydraulic tensor for Total Knee Arthroplasty. In Int J Med Robot, vol. 1, no 4, pp. 51- 57.
- Scuderi, G. R. and Tria, A. J., 2006. Knee Arthroplasty Handbook: Techniques in Total Knee and Revision Arthroplasty, Springer. New York.
- Vail, T. P., Lang, E., 2006. Surgical techniques and instrumentation in Total Knee Arthroplasty. In: W. N. Scott, Surgery of the Knee, Churchill Livingstone, pp. 1493-1498. New York.
- Winemaker, M. J., 2002. Perfect balance in total knee arthroplasty: the elusive compromise. In Journal of Arthroplasty, vol. 17, no 1, pp. 2-10.
Paper Citation
in Harvard Style
Collo A., Almouahed S., Poignet P., Hamitouche C. and Stindel E. (2013). Towards a Dynamic Tibial Component for Postoperative Fine-tuning Adjustment of Knee Ligament Imbalance . In Proceedings of the International Conference on Biomedical Electronics and Devices - Volume 1: BIODEVICES, (BIOSTEC 2013) ISBN 978-989-8565-34-1, pages 95-102. DOI: 10.5220/0004189000950102
in Bibtex Style
@conference{biodevices13,
author={Andrea Collo and Shaban Almouahed and Philippe Poignet and Chafiaa Hamitouche and Eric Stindel},
title={Towards a Dynamic Tibial Component for Postoperative Fine-tuning Adjustment of Knee Ligament Imbalance},
booktitle={Proceedings of the International Conference on Biomedical Electronics and Devices - Volume 1: BIODEVICES, (BIOSTEC 2013)},
year={2013},
pages={95-102},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0004189000950102},
isbn={978-989-8565-34-1},
}
in EndNote Style
TY - CONF
JO - Proceedings of the International Conference on Biomedical Electronics and Devices - Volume 1: BIODEVICES, (BIOSTEC 2013)
TI - Towards a Dynamic Tibial Component for Postoperative Fine-tuning Adjustment of Knee Ligament Imbalance
SN - 978-989-8565-34-1
AU - Collo A.
AU - Almouahed S.
AU - Poignet P.
AU - Hamitouche C.
AU - Stindel E.
PY - 2013
SP - 95
EP - 102
DO - 10.5220/0004189000950102