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Measuring Short-Term Wear in Total Knee Replacement Using Model-Based RSA

RSA analysis 3

The Concordia Joint Replacement Group (CJRG) is an orthopaedic surgical group specializing in primary and revision hip and knee replacement and is affiliated with the Concordia Hospital, the University of Manitoba, and the Orthopaedic Innovation Centre (OIC).  As part of their surgical services, CJRG takes an active role in research and quality of care initiatives to improve patient experiences.  CJRG is also directly involved in the improvement of healthcare delivery and continues to work to reduce surgical wait times in Manitoba.

Previous work by CJRG and OIC determined that if wear in total knee replacement (TKR) was to be accurately measured, one must take sequential measurements of patient’s TKRs over a longitudinal time period.  The idea being that any errors which may be present in the initial (reference) measurement, would be cancelled out in subsequent measurements by only looking at the difference in wear measured between the two exams.

Sara ParashinOIC hires a number of University of Manitoba Biosystems Engineering students each year to work on term projects such as this.  This year, Sara Parashin, a recent Biosystems Engineering graduate and EiT will be analyzing over 100 patients TKRs.  These 100+ patients had undergone a diagnostic process known as radiostereometric analysis (RSA) during the first 2 years following their joint replacement surgery.  RSA allows researchers to measure small movements of the joint within the body with high accuracy. The RSA data for this large group of patients was graciously shared by the Orthopaedic Academic Research group in Halifax, Nova Scotia for the purposes of this study.

The method of wear measurement is relatively straightforward; the position of the TKR is accurately captured using model-based RSA, this data is then taken and applied to computer models of the TKR components to virtually reconstruct the TKR – but in 3D space. Overlaying the components, we are able to see how much wear has occurred on the polyethylene bearing.

This research aims to determine the accuracy of short-term (<2 years) wear measurement in TKRs such that this process can be applied to new and less well tested TKR products to ensure they perform as well or better than previous products. All in all, this ensures patient safety and well-being in the long term.

To discuss this or other research underway at OIC, contact us.

 

Wear analysis 1 Wear analysis 2

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