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  4. Imaging the implant-soft tissue interactions in total knee arthroplasty
 
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Imaging the implant-soft tissue interactions in total knee arthroplasty
File(s)
Imaging soft tissie implant interactions Bonnin et al J Exp Orthop 2016 40634_2016_Article_61.pdf (2.11 MB)
Published version
Author(s)
Bonnin, MP
Van Hoof, T
De Kok, A
Verstraete, M
Van der Straeten, C
more
Type
Journal Article
Abstract
BACKGROUND: In Total Knee Arthroplasty (TKA), residual pain may be secondary to soft tissue impingements, which are difficult to visualize around chromium-cobalt implants using medical imaging, so their interactions remain poorly understood. The goal of this work was to establish a protocol for in-vitro imaging of the soft tissues around TKA, usable during throughout the range of motion (ROM). METHODS: The full size range of a commercially available TKA prosthesis was manufactured by 3D-printing in non-magnetic and non-radiopaque polymer and implanted in 12 cadaveric knees. The relations between these implants and the soft tissues (Popliteus tendon, Medial and Lateral Collateral Ligament, Patellar and Quadriceps tendons) were analyzed, using MRI (5 embalmed specimens) and CT scans after injection of the tissues with barium-sulfate (3 embalmed and 4 fresh-frozen specimens). RESULTS: Both MRI and CT scans enabled good identification of the soft tissues before TKA implantation. MRI produced minimal loss in signal and contrast, and neither the low temperature nor the embalming fluids compromised image quality. CT scans were more precise after TKA implantation, particularly the borders of the implant and the differentiation of soft tissues. Full ROM investigation, manual segmentation and three-dimensional reconstructions were possible only with the CT scan. CONCLUSION: The experimental approach described in this study was successful in visualizing the interactions between the soft tissue and the implants before and after TKA and during the full ROM. The coordinate system allows to localize precisely the different anatomic structures and to quantify any change due to prosthetic implantation.
Date Issued
2016-10-03
Date Acceptance
2016-09-22
Citation
Journal of Experimental Orthopaedics, 2016, 3 (1)
URI
http://hdl.handle.net/10044/1/49517
DOI
https://www.dx.doi.org/10.1186/s40634-016-0061-5
ISSN
2197-1153
Publisher
Springer
Journal / Book Title
Journal of Experimental Orthopaedics
Volume
3
Issue
1
Copyright Statement
© 2016 The Author(s). Open Access.
This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/27699662
PII: 10.1186/s40634-016-0061-5
Subjects
3D printing
Painful TKA
Popliteus tendon
Soft tissue impingement
Publication Status
Published
Coverage Spatial
Germany
Article Number
24
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