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Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_IV | Pages 558 - 559
1 Nov 2011
Teeter MG Naudie DD McErlain DD Brandt J Yuan X MacDonald SJ Holdsworth DW
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Purpose: This study develops and validates a technique to quantify polyethylene wear in tibial inserts using micro-computed tomography (micro-CT), a nondestructive high resolution imaging technique that provides detailed images of surface geometry in addition to volumetric measurements.

Method: Six unworn and six wear-simulated Anatomic Modular Knee (DePuy Inc, Warsaw, IN) tibial inserts were evaluated. Each insert was scanned three times using micro-CT at a resolution of 50 μm. The insert surface was reconstructed for each scan through automatic segmentation and the insert volume was calculated. Gravimetric analysis was also performed for all inserts, and the micro-CT and gravimetric volumes were compared to determine accuracy. The utility of surface deviation maps derived from micro-CT was demonstrated by co-registering a worn and unworn insert. 3D deviations were measured continuously across the entire insert surface, including the articular and backside surfaces.

Results: The mean percent volume difference between the micro-CT and gravimetric techniques was 0.04% for the unworn inserts and 0.03% for the worn inserts. No significant difference was found between the micro-CT and gravimetric volumes for the unworn or worn inserts (P = 0.237 and P = 0.135, respectively). The mean coefficient of variation for volume between scans was 0.07% for both unworn and worn inserts. The map of surface deviations between the worn and unworn insert revealed focal deviations exceeding 750 μm due to wear.

Conclusion: Micro-CT provides precise and accurate volumetric measurements of polyethylene tibial inserts. Quantifiable 3D articular and backside surface deviation maps can be created from the detailed geometry provided by the technique. Compared to coordinate mapping, micro-CT provides 10 times greater surface sampling resolution (50 μm vs 500 μm) across the entire insert surface. Micro-CT is a useful analysis tool for wear simulator and retrieval studies of the polyethylene components used in total knee replacement.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_III | Pages 248 - 248
1 Jul 2011
Innes M Tschirhart CE McErlain DD Holdsworth DW Gordon KD Hurtig M
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Purpose: The mechanical function and strain behavior of the knee meniscus is not fully understood, due to multiple tissues with disparate properties, as well as complex contact patterns and intricate loading mechanisms. More comprehensive understanding of joint mechanics may contribute to improved treatment options for patients with injuries and osteoarthritis. There is very limited information available on the 3D strain of the intact meniscus. The objective of this work was to use mCT with copper microsphere markers to quantify three-dimensional strain of the meniscus under physiologic loading.

Method: Two healthy fresh frozen ovine knee specimens were harvested. Copper microspheres (0.5mm) were injected into anterior and posterior tetrahedral clusters in the medial meniscus using 20-gauge hypodermic needles. Needle cavities were sealed with ovine tendon tissue. Joints were loaded to 100% body weight in a 4 DOF CT-compatible pneumatically-driven device with flexion angles ranging from 62–98°. Images were acquired with an eXplore Locus Ultra mCT scanner and reconstructed with commercial software. A time series of images were acquired with the joint unloaded, during static loading, and at a reduced load (25% BW).

Results: The average maximum principle strains in the anterior element of the two specimens at 62o of flexion increased by 21% during loading and decreased by 13% during unloading. The maximum principle strains were 28% larger in the anterior element than the posterior. The strains in the anterior element decreased by 6.5% with time following load application, and decreased by 16% with load reduction, yielding relatively low residual strain. Strains were 2% larger in the anterior portion with larger flexion angles.

Conclusion: The objective of this work was to develop a reliable method for quantifying 3D strains in the meniscus. Results support the notion that mCT imaging with copper microspheres in the meniscus may be a viable technique for more comprehensive 3D strain analysis. The relatively low residual strains measured in this study indicate that copper microspheres are stable markers in this application. This technique may be useful in directing future studies aimed at understanding the impact of meniscal pathologies and the success of repair techniques.