A comparison between electromechanical and pneumatic-controlled knee simulators for the investigation of wear of total knee replacements.
A comparison between electromechanical and pneumatic-controlled knee simulators for the investigation of wear of total knee replacements.
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DOI：
10.1177/0954411917696519
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发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Jennings LM
中科院分区：
文献类型：
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作者：
Abdelgaied A;Fisher J;Jennings LM
需要更稳健的临床前实验性磨损模拟方法，以模拟在不同患者人群（如更年轻、更活跃的患者）中观察到的更广泛的活动，以及完全满足并能够远远超出相关国际标准的现有要求。一个新的六站机电驱动的模拟器（模拟解决方案，英国）与五个完全独立控制的关节轴，为每个站，能够复制深膝弯曲以及其他不利条件，它可以在任何一个力或位移控制与改进的输入运动学以下操作，已经开发，以满足这些要求。本研究使用这种机电驱动的完全独立膝关节模拟器研究了固定平台全膝关节置换术的磨损，并将其与之前来自主要受控模拟器的数据进行了比较，其中每个工作站都没有完全独立控制。此外，运动学性能和模拟器的重复性进行了研究，并与国际标准要求进行了比较。电动和气动膝关节模拟器的磨损率无显著差异，磨损率分别为2.6 ± 0.9和2.7 ± 0.9 mm 3/百万次循环（MC;平均值± 95%置信区间，p = 0.99）和5.4 ± 1.4和6.7 ± 1.5 mm 3/MC（平均值± 95置信区间，p = 0.54），分别来自中等水平（最大5 mm）和高水平（最大10 mm）前后位移下的机电和气动模拟器。然而，控制系统的输出运动学曲线，其驱动模拟器的运动，在机电模拟器上比在气动模拟器上更紧密地跟随输入运动学曲线。此外，机电模拟器能够在国际标准要求（ISO 14243-3）的公差范围内跟踪运动学和载荷输入循环。具有完全独立控制的新一代机电膝关节模拟器有可能用于更广泛的运动学条件，包括高屈曲和其他严重条件，因为与以前使用的运动学控制模拟器相比，其功能和性能有所改善。
More robust preclinical experimental wear simulation methods are required in order to simulate a wider range of activities, observed in different patient populations such as younger more active patients, as well as to fully meet and be capable of going well beyond the existing requirements of the relevant international standards. A new six-station electromechanically driven simulator (Simulation Solutions, UK) with five fully independently controlled axes of articulation for each station, capable of replicating deep knee bending as well as other adverse conditions, which can be operated in either force or displacement control with improved input kinematic following, has been developed to meet these requirements. This study investigated the wear of a fixed-bearing total knee replacement using this electromechanically driven fully independent knee simulator and compared it to previous data from a predominantly pneumatically controlled simulator in which each station was not fully independently controlled. In addition, the kinematic performance and the repeatability of the simulators have been investigated and compared to the international standard requirements. The wear rates from the electromechanical and pneumatic knee simulators were not significantly different, with wear rates of 2.6 ± 0.9 and 2.7 ± 0.9 mm3/million cycles (MC; mean ± 95% confidence interval, p = 0.99) and 5.4 ± 1.4 and 6.7 ± 1.5 mm3/MC (mean ± 95 confidence interval, p = 0.54) from the electromechanical and pneumatic simulators under intermediate levels (maximum 5 mm) and high levels (maximum 10 mm) of anterior–posterior displacements, respectively. However, the output kinematic profiles of the control system, which drive the motion of the simulator, followed the input kinematic profiles more closely on the electromechanical simulator than the pneumatic simulator. In addition, the electromechanical simulator was capable of following kinematic and loading input cycles within the tolerances of the international standard requirements (ISO 14243-3). The new-generation electromechanical knee simulator with fully independent control has the potential to be used for a much wider range of kinematic conditions, including high-flexion and other severe conditions, due to its improved capability and performance in comparison to the previously used pneumatic-controlled simulators.