Thesis Format
Integrated Article
Degree
Master of Science
Program
Surgery
Supervisor
Lanting, Brent
2nd Supervisor
Willing, Ryan
Co-Supervisor
Abstract
Total knee arthroplasty (TKA) is a very successful surgery providing many patients with increased quality of life. Despite this, some patients are dissatisfied. There are also complications with total knee arthroplasty that lead to the need for revision surgery. Improvements in stability, soft tissue balance, joint kinematics and overall patient satisfaction may lead to a decrease in TKA revisions. It is still unclear what the optimal soft tissue tension, balance or alignment is to provide superior patient outcomes. Computational models provide a means to effectively parameterize ligaments and simulate multiple scenarios of TKA. This work implemented a sophisticated 6-degree of freedom joint motion simulator merged with a virtual soft tissue model, eliciting the soft-tissues properties used to balance TKAs. Through testing joint kinematics and soft tissue laxity through 90° of neutral flexion and extension and simulated Activities of Daily Living (ADLs) we were able to reproduce a model that elicited joint kinematics in a balanced TKA similar to what has been shown in the literature. We also compared mechanically aligned (MA) and kinematically aligned (KA) TKAs. This work offers a baseline computational model that reproduces appropriate TKA joint kinematics and laxities, which can then be used for future studies providing better understanding of total knee arthroplasty.
Summary for Lay Audience
Total knee arthroplasty (TKA) is a very successful surgery providing many patients with increased quality of life. Despite this, some patients are dissatisfied. There are also complications with total knee arthroplasty that lead to the need for revision surgery. Improvements in stability, soft tissue balance, joint kinematics and overall patient satisfaction may lead to a decrease in TKA revisions. It is still unclear what the optimal soft tissue tension, balance or alignment is to provide superior patient outcomes. Computational models provide a means to effectively parameterize ligaments and simulate multiple scenarios of TKA. This work implemented a sophisticated 6-degree of freedom joint motion simulator merged with a virtual soft tissue model, eliciting the soft-tissues properties used to balance TKAs. Through testing joint kinematics and soft tissue laxity through 90° of neutral flexion and extension and simulated Activities of Daily Living (ADLs) we were able to reproduce a model that elicited joint kinematics in a balanced TKA similar to what has been shown in the literature. We also compared mechanically aligned (MA) and kinematically aligned (KA) TKAs. This work offers a baseline computational model that reproduces appropriate TKA joint kinematics and laxities, which can then be used for future studies providing better understanding of total knee arthroplasty.
Recommended Citation
McGale, Jance, "Biomechanical analysis of Total Knee Arthroplasty performed on a 6 degree of freedom joint motion simulator linked to a virtual ligament model in mechanical and kinematic alignments" (2020). Electronic Thesis and Dissertation Repository. 7382.
https://ir.lib.uwo.ca/etd/7382