University of Washington, Seattle, Washington, USA.
J Biomech. 2010 Jun 18;43(9):1840-3. doi: 10.1016/j.jbiomech.2010.02.019. Epub 2010 Mar 1.
Arthritis is a chronic, debilitating disease affecting one in six people in the United States annually. One of the most promising surgical treatments is total joint replacement. After decades of development, some joint replacement (arthroplasty) systems such as the hip and knee enjoy high success rates while others, particularly newer ones for the ankle, have disappointing survival rates. The goal of this study was to investigate, develop, and test a methodology to assess implant osteointegration, specifically for the talar component of a total ankle prosthesis. A vibrometry technique using Doppler ultrasound was developed to non-invasively determine osteointegration clinically. This methodology was evaluated via preliminary experimentation, along with another validation methodology, to access whether design criteria have been met in order to initiate a clinical study of the technique. Bench-top and cadaveric testing demonstrated that the Doppler ultrasound technique could distinguish the level of osteointegration between loose and fixed implant components. The laser vibrometry technique, used for the validation of the ultrasound technique intraoperatively, was also shown to be functional and indicative of the ultrasound technique's testing results. This methodology can provide a much needed tool to determine the integration of implants non-invasively in the clinical and surgical setting, thus allowing each patient's rehabilitation program to be monitored and tailored to maximize the osteointegration and survival rate of their total joint replacement.
关节炎是一种慢性、使人虚弱的疾病，每年影响美国六分之一的人。最有前途的手术治疗之一是全关节置换。经过几十年的发展，一些关节置换（关节成形术）系统，如髋关节和膝关节，成功率很高，而其他一些系统，特别是用于踝关节的更新系统，存活率却令人失望。本研究的目的是研究、开发和测试一种评估植入物骨整合的方法，特别是用于全踝关节假体的距骨部件。使用多普勒超声的振动测量技术已被开发用于非侵入性地临床确定骨整合。该方法通过初步实验以及另一种验证方法进行了评估，以确定是否符合设计标准，从而启动该技术的临床研究。台架和尸体测试表明，多普勒超声技术可以区分松动和固定植入物组件之间的骨整合水平。激光振动测量技术用于术中验证超声技术，也被证明是功能的，并指示超声技术的测试结果。该方法可以提供一种非常需要的工具，用于在临床和手术环境中确定植入物的整合情况，从而可以监测每位患者的康复计划，并针对每个患者的情况进行调整，以最大程度地提高其全关节置换的骨整合和存活率。
