Naslov
Use of robotic testing of the canine cadavers for studying knee biomechanics in order to improve joint preservation surgery

Autori
Bonačić Bartolin, Petra ; Sutcliffe, Michael ; Allen Matthew

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
South East European Forum on Orthopaedics and Traumatology (SEEFORT)

Mjesto i datum
Dubrovnik, Hrvatska, 24.04.2019. - 26.04.2019

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
robotic testing, knee joint, biomechanics, canine, joint preservation surgery

Sažetak
OBJECTIVES: Osteoarthritis (OA) is one of the most frequent causes of the knee joint dysfunction and disability in the community. More than 8.75 million people in the UK and 27 million people in US have clinical OA and it is estimated in the next 25 years at least 300 million people will be diagnosed with knee OA. OA leads to pain, disability and reduced quality of life. While total knee replacement (TKR) provides relief for many patients, implants have a finite lifespan, leading to a significant economic burden of revision surgery. For patients with less severe disease, a joint preservation procedure may be more effective. The goal of the current study was to develop an ex-vivo testing pathway that could be used as a preclinical screening system for determining the effects of reconstructive or joint replacement procedures on knee joint function in a canine model. METHODS: For the purpose of biomechanical testing, a 6-degrees- of-freedom industrial robot manipulator (Model KR-60 ; KUKA Robotics) was used to compare joint laxity and kinematics in intact canine knees and in canine knees that had undergone TKR. Hind limbs were harvested from a series of research dogs that had undergone unilateral TKR under a protocol approved by the institutional animal care and use committee. Soft tissues were stripped from and tibia, taking care to preserve the joint capsule, collateral ligaments, patellar tendon and part of the quadriceps muscle. The bones were embedded in polymer resin and connected to the robot, which was controlled with custom designed software (simVITRO ; Cleveland Clinic BioRobotics Laboratory). The software optimises loading trajectories according to user-defined inputs that are based on kinematic data from healthy dogs. The experiment was performed at a different angle of flexion and extensions of knee joints and knee motion was tracked during both laxity testing and a simulated gait cycle using a motion capture system (Polaris VICRA ; Northern Digital Inc.). RESULTS: Tests confirmed that although TKR partially restores knee stability and kinematics, it is unable to completely recapitulate the functionality of the normal (intact) knee. This was especially true for rotational stability, which was found to be very different, especially in flexion. CONCLUSION: While TKR is generally well tolerated by patients and leads to measurable reductions in pain and disability, the prosthetic knee does not restore native knee function. Given the cost of knee replacement and, in particular, knee revision, there is a pressing need for better techniques to reconstruct the damaged knee and to delay or even prevent OA. The robotic method described here provides a sensitive, reproducible and clinically relevant test of knee joint function for cadaveric tissues. It can be used either to assess the impact of surgical procedures and implants used in cadavers, or it can be used as a post-mortem measure of knee joint function in patients or research animals that underwent knee surgeries in life. Data derived from the robot should facilitate the design and clinical introduction of new procedures to preserve joint health and joint function in both humans and animals.

Izvorni jezik
Engleski

Znanstvena područja
Interdisciplinarne tehničke znanosti

POVEZANOST RADA