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Bioengineering
Special Issues
Innovative Medical Technology and Surgical Techniques: Focus on Joint Arthroplasty
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Innovative Medical Technology and Surgical Techniques: Focus on Joint Arthroplasty

A special issue of Bioengineering (ISSN 2306-5354).

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 9419

Special Issue Editors

Dr. Chadd Clary

E-Mail Website
Guest Editor
Ritchie School of Engineering and Computer Science, University of Denver, Denver, CO, USA
Interests: orthopaedic biomechanics; total joint replacement
Dr. Dennis Janssen

E-Mail Website
Guest Editor
Orthopaedic Research Laboratory, Radboud University Medical Center, Nijmegen, The Netherlands
Interests: orthopaedic biomechanics; total knee arthroplasty; knee biomechanics

Special Issue Information

Dear Colleagues,

Innovation is at the heart of improving outcomes for patients suffering from osteoarthritis. Recent developments in biomaterials and additive manufacturing have led to improvements in implant fixation, durability, and infection resistance.  Enhancement of implant designs continue to address common failure modes like instability, dislocation, and pain. Advancements in surgical technology, including pre-operative planning, robotics, and augmented reality provide surgeons with tools to reliably execute surgical plans. The introduction of wearables and smart implants promises early identification of complications and improved patient rehabilitation. Together, these innovations bolster outcomes and improve the lives of millions of arthroplasty patients worldwide every year.   

This special issue of Bioengineering, "Innovative Medical Technology and Surgical Techniques: Focus on Joint Arthroplasty," will highlight cutting-edge collaborative work between surgeons, scientists, and engineers that drives this innovation. The journal encourages the submission of original research articles and comprehensive reviews in the following areas pertaining to joint arthroplasty of the ankle, knee, hip, and shoulder:

  • Biomaterials and manufacturing methods
  • Implant design
  • Pre-operative planning
  • Robotic surgery
  • Augmented reality
  • Patient monitoring, including wearables and smart implants

Dr. Chadd Clary
Dr. Dennis Janssen
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Bioengineering is an international peer-reviewed open access monthly journal published by MDPI.

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Published Papers (5 papers)

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11 pages, 14638 KiB  
Article
The Effect of Patient-Related Factors on the Primary Fixation of PEEK and Titanium Tibial Components: A Population-Based FE Study
by Corine E. Post, Thom Bitter, Adam Briscoe, Inger van Langen, René Fluit, Nico Verdonschot and Dennis Janssen
Bioengineering 2024, 11(2), 116; https://doi.org/10.3390/bioengineering11020116 - 25 Jan 2024
Viewed by 1302
Abstract
Polyetheretherketone (PEEK) is of interest as implant material for cementless tibial total knee arthroplasty (TKA) components due to its potential advantages. One main advantage is that the stiffness of PEEK closely resembles the stiffness of bone, potentially avoiding peri-prosthetic stress-shielding. When introducing a [...] Read more.
Polyetheretherketone (PEEK) is of interest as implant material for cementless tibial total knee arthroplasty (TKA) components due to its potential advantages. One main advantage is that the stiffness of PEEK closely resembles the stiffness of bone, potentially avoiding peri-prosthetic stress-shielding. When introducing a new implant material for cementless TKA designs, it is essential to study its effect on the primary fixation. The primary fixation may be influenced by patient factors such as age, gender, and body mass index (BMI). Therefore, the research objectives of this finite element (FE) study were to investigate the effect of material (PEEK vs. titanium) and patient characteristics on the primary fixation (i.e., micromotions) of a cementless tibial tray component. A total of 296 FE models of 74 tibiae were created with either PEEK or titanium material properties, under gait and squat loading conditions. Overall, the PEEK models generated larger peak micromotions than the titanium models. Differences were seen in the micromotion distributions between the PEEK and titanium models for both the gait and squat models. The micromotions of all tibial models significantly increased with BMI, while gender and age did not influence micromotions. Full article
(This article belongs to the Special Issue Innovative Medical Technology and Surgical Techniques: Focus on Joint Arthroplasty)
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20 pages, 23941 KiB  
Article
Feasibility of a Shape-Memory-Alloy-Actuator System for Modular Acetabular Cups
by Christian Rotsch, Karoline Kemter-Esser, Johanna Dohndorf, Marcel Knothe, Welf-Guntram Drossel and Christoph-Eckhard Heyde
Bioengineering 2024, 11(1), 75; https://doi.org/10.3390/bioengineering11010075 - 12 Jan 2024
Cited by 2 | Viewed by 1588
Abstract
Hip implants have a modular structure which enables patient-specific adaptation but also revision of worn or damaged friction partners without compromising the implant-bone connection. To reduce complications during the extraction of ceramic inlays, this work presents a new approach of a shape-memory-alloy-actuator which [...] Read more.
Hip implants have a modular structure which enables patient-specific adaptation but also revision of worn or damaged friction partners without compromising the implant-bone connection. To reduce complications during the extraction of ceramic inlays, this work presents a new approach of a shape-memory-alloy-actuator which enables the loosening of ceramic inlays from acetabular hip cups without ceramic chipping or damaging the metal cup. This technical in vitro study exam-ines two principles of heating currents and hot water for thermal activation of the shape-memory-alloy-actuator to generate a force between the metal cup and the ceramic inlay. Mechanical tests concerning push-in and push-out forces, deformation of the acetabular cup according to international test standards, and force generated by the actuator were generated to prove the feasibility of this new approach to ceramic inlay revision. The required disassembly force for a modular acetabular device achieved an average value of 602 N after static and 713 N after cyclic loading. The actuator can provide a push-out force up to 1951 N. In addition, it is shown that the necessary modifications to the implant modules for the implementation of the shape-memory-actuator-system do not result in any change in the mechanical properties compared to conventional systems. Full article
(This article belongs to the Special Issue Innovative Medical Technology and Surgical Techniques: Focus on Joint Arthroplasty)
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17 pages, 5722 KiB  
Article
Differences in Trochlear Morphology of a New Femoral Component Designed for Kinematic Alignment from a Mechanical Alignment Design
by Maury L. Hull, Alexander Simileysky and Stephen M. Howell
Bioengineering 2024, 11(1), 62; https://doi.org/10.3390/bioengineering11010062 - 8 Jan 2024
Cited by 3 | Viewed by 1593
Abstract
Because kinematic alignment (KA) aligns femoral components in greater valgus and with less external rotation than mechanical alignment (MA), the trochlear groove of an MA design used in KA is medialized, which can lead to complications. Hence, a KA design has emerged. In [...] Read more.
Because kinematic alignment (KA) aligns femoral components in greater valgus and with less external rotation than mechanical alignment (MA), the trochlear groove of an MA design used in KA is medialized, which can lead to complications. Hence, a KA design has emerged. In this study, our primary objective was to quantify differences in trochlear morphology between the KA design and the MA design from which the KA design evolved. The KA and MA designs were aligned in KA on ten 3D femur-cartilage models. Dependent variables describing the morphology of the trochlea along the anterior flange, which extends proximal to the native trochlea, and along the arc length of the native trochlea, were determined, as was flange coverage. Along the anterior flange, the KA groove was significantly lateral proximally by 10 mm and was significantly wider proximally by 5 mm compared to the MA design (p < 0.0001). Along the arc length of the native trochlea, the KA groove was significantly lateral to the MA design by 4.3 mm proximally (p ≤ 0.0001) and was significantly wider proximally by 19 mm than the MA design. The KA design reduced lateral under-coverage of the flange from 4 mm to 2 mm (p < 0.0001). The KA design potentially mitigates risk of patellofemoral complications by lateralizing and widening the groove to avoid medializing the patella for wide variations in the lateral distal femoral angle, and by widening the flange laterally to reduce under-coverage. This information enables clinicians to make informed decisions regarding use of the KA design. Full article
(This article belongs to the Special Issue Innovative Medical Technology and Surgical Techniques: Focus on Joint Arthroplasty)
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13 pages, 2201 KiB  
Article
Hip Joint Angles and Moments during Stair Ascent Using Neural Networks and Wearable Sensors
by Megan V. McCabe, Douglas W. Van Citters and Ryan M. Chapman
Bioengineering 2023, 10(7), 784; https://doi.org/10.3390/bioengineering10070784 - 30 Jun 2023
Cited by 3 | Viewed by 2438
Abstract
End-stage hip joint osteoarthritis treatment, known as total hip arthroplasty (THA), improves satisfaction, life quality, and activities of daily living (ADL) function. Postoperatively, evaluating how patients move (i.e., their kinematics/kinetics) during ADL often requires visits to clinics or specialized biomechanics laboratories. Prior work [...] Read more.
End-stage hip joint osteoarthritis treatment, known as total hip arthroplasty (THA), improves satisfaction, life quality, and activities of daily living (ADL) function. Postoperatively, evaluating how patients move (i.e., their kinematics/kinetics) during ADL often requires visits to clinics or specialized biomechanics laboratories. Prior work in our lab and others have leveraged wearables and machine learning approaches such as artificial neural networks (ANNs) to quantify hip angles/moments during simple ADL such as walking. Although level-ground ambulation is necessary for patient satisfaction and post-THA function, other tasks such as stair ascent may be more critical for improvement. This study utilized wearable sensors/ANNs to quantify sagittal/frontal plane angles and moments of the hip joint during stair ascent from 17 healthy subjects. Shin/thigh-mounted inertial measurement units and force insole data were inputted to an ANN (2 hidden layers, 10 total nodes). These results were compared to gold-standard optical motion capture and force-measuring insoles. The wearable-ANN approach performed well, achieving rRMSE = 17.7% and R2 = 0.77 (sagittal angle/moment: rRMSE = 17.7 ± 1.2%/14.1 ± 0.80%, R2 = 0.80 ± 0.02/0.77 ± 0.02; frontal angle/moment: rRMSE = 26.4 ± 1.4%/12.7 ± 1.1%, R2 = 0.59 ± 0.02/0.93 ± 0.01). While we only evaluated healthy subjects herein, this approach is simple and human-centered and could provide portable technology for quantifying patient hip biomechanics in future investigations. Full article
(This article belongs to the Special Issue Innovative Medical Technology and Surgical Techniques: Focus on Joint Arthroplasty)
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10 pages, 3440 KiB  
Brief Report
Three-Dimensional Preoperative Planning Software for Hip Resurfacing Arthroplasty
by M. Abdulhadi Alagha, Kartik Logishetty, Ciaran O’Hanlon, Alexander D. Liddle and Justin Cobb
Bioengineering 2023, 10(8), 939; https://doi.org/10.3390/bioengineering10080939 - 7 Aug 2023
Cited by 4 | Viewed by 1758
Abstract
Three-dimensional planning of hip arthroplasty is associated with better visualisation of anatomical landmarks and enhanced mapping for preoperative implant sizing, which can lead to a decrease in surgical time and complications. Despite the advantages of hip resurfacing arthroplasty (HRA), it is considered a [...] Read more.
Three-dimensional planning of hip arthroplasty is associated with better visualisation of anatomical landmarks and enhanced mapping for preoperative implant sizing, which can lead to a decrease in surgical time and complications. Despite the advantages of hip resurfacing arthroplasty (HRA), it is considered a technically challenging procedure and associated with inaccurate implant placement. This study aimed to examine the validity, reliability, and usability of preoperative 3D Hip Planner software for HRA. Fifty random cases of various hip osteoarthritis severity were planned twice by two junior trainees using the 3D Hip Planner within a one-month interval. Outcome measures included femoral/cup implant size, stem-shaft angle, and cup inclination angle, and were assessed by comparing outcomes from 2D and 3D planning. An adapted unified theory of acceptance and use of technology (UTAUT) survey was used for software usability. Bland–Altman plots between 3D and 2D planning for stem-shaft and inclination angles showed mean differences of 0.7 and −0.6, respectively (r = 0.93, p < 0.001). Stem-shaft and inclination angles showed inter-rater reliability biases of around −2° and 3°, respectively. Chi-square and Pearson’s correlation for femoral implant size showed a significant association between the two assessors (r = 0.91, p < 0.001). The 3D test–retest coefficient of repeatability for stem-shaft and inclination angles were around ±2° and ±3°, respectively, with a strong significant association for femoral implant size (r = 0.98, p < 0.001). Survey analyses showed that 70–90% agreed that 3D planning improved expectancy in four domains. 3D hip planner appears to be valid and reliable in preoperative HRA and shows significant potential in optimising the quality and accuracy of surgical planning. Full article
(This article belongs to the Special Issue Innovative Medical Technology and Surgical Techniques: Focus on Joint Arthroplasty)
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