Quantitative measurement of soft tissue knee balance after TKA using ultrasound elastography

利用超声弹性成像定量测量全膝关节置换术后膝关节软组织平衡

• 批准号: 9379794
• 负责人: Laura A Slane
• 金额: $ 1.88万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-05-10 至 2017-08-13
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9379794
• 关键词: Adult; American; Articular Range of Motion; Biomechanics; Cadaver; Calibration; Clinical; Clinical assessments; Collection; Communities; Custom; Data; Data Set; Degenerative Disorder; Discrimination; Emerging Technologies; Equilibrium; Evaluation; Failure; Goals; Gold; Health; Implant; In Situ; Incidence; Individual; Knee; Knee Osteoarthritis; Lateral; Ligaments; Measurement; Measures; Mechanics; Medial; Methods; Modeling; Motion; Operative Surgical Procedures; Orthopedics; Outcome; Outcome Study; Pain; Population; Procedures; Recommendation; Resources; Schedule; Specimen; Stress; Surgeon; Techniques; Testing; Tissues; Ultrasonography; Validation; Variant; Work; achilles tendon; balance testing; base; collateral ligament; digital imaging; elastography; improved; improved outcome; in vivo; innovative technologies; insight; interest; kinematics; knee replacement arthroplasty; novel; patellar tendon; patient population; public health relevance; quantitative ultrasound; radiofrequency; soft tissue; success; survivorship; task analysis; tool

 DESCRIPTION (provided by applicant): Total knee arthroplasty (TKA) has become one of the most widely used procedures for restoring knee function and relieving pain in the advanced stages of knee osteoarthritis; yet early TKA failure (<10 years post-surgery) remains a large-scale problem. Although knee instability is known to be a major cause of early failures, current methods for measuring knee balance are largely subjective and user-dependent. Ultrasound elastography (UE) is an innovative technology that enables the noninvasive quantification of soft tissue displacements and strains, which are important indicators of balance. We have recently developed such a technique for the evaluation of Achilles tendon deformation, and believe that this approach could provide important insight into knee soft tissue mechanics. The premise of this study is to use this noninvasive UE approach to measure knee balance in situ and then in patient populations to better understand the effects of TKA on altered knee balance, with the overall goal to pave the way toward intra-operative integration of this approach. In Aim 1, ultrasound data will be collected from cadaveric knee soft tissues (medial and lateral collateral ligament, patellar tendon) while functionally loaded in a kinematic knee rig. Tissue displacements and strains will then be computed using our UE approach. Results from UE will be compared with the current gold standard approach (digital image correlation; DIC) to enable calibration and then accuracy assessment. TKAs will then be performed on the specimens by an orthopedic surgeon, and altered knee balance will be imposed by overstuffing the medial or lateral components of the knee. The sensitivity of UE measurements to these altered balance conditions will be assessed. An important outcome of this aim will also be the public sharing of the validation dataset (ultrasound data, DIC and kinematics). In Aim 2, soft tissue mechanics will be evaluated in healthy adults (n=20), and adults with a prior TKA demonstrating acceptable (n=20) and unacceptable (n=20) stability. Comparison of UE- computed displacements and strains will provide insight into the effects of TKA on knee stability. Finally, in Aim 3, these results will be compiled and discriminant function analysis will be used to determine which tasks and measures provide the best discriminating power for clinical assessment. These data will be paired with clinical insight to provide recommendations for clinical integration of UE for the assessment of soft tissue knee balance. Successful completion of these aims will contribute to improving the outcomes of TKA for the more than 600,000 Americans who annually undergo this procedure, and will point to specific intra-operative techniques that can improve TKA outcomes.

 描述(申请人提供)：全膝关节置换术(TKA)已成为恢复膝关节功能和缓解晚期膝骨性关节炎疼痛的最广泛使用的手术之一；然而，早期的TKA失败(术后10年)仍然是一个大问题。虽然膝关节不稳定被认为是早期失败的主要原因，但目前测量膝关节平衡的方法在很大程度上是主观的和用户依赖的。超声弹性成像(UE)是一种创新的技术，它能够无创地量化软组织的位移和应变，这是衡量平衡的重要指标。我们最近开发了一种评估跟腱变形的技术，并相信这种方法可以为膝关节软组织力学提供重要的见解。这项研究的前提是使用这种非侵入性的UE方法在原位测量膝关节平衡，然后在患者群体中测量，以更好地了解TKA对膝关节平衡改变的影响，总体目标是为该方法的术中整合铺平道路。在目标1中，超声数据将从身体膝关节软组织(内侧和外侧副韧带、膝腱)中收集，同时在运动性膝关节试验台上进行功能加载。然后将使用我们的UE方法计算组织位移和应变。UE的结果将与当前的黄金标准方法(数字图像相关；DIC)进行比较，以便进行校准，然后进行精度评估。然后，骨科医生将对标本进行全膝关节置换术，并通过填充膝关节内侧或外侧部分来改变膝关节平衡。将评估UE测量对这些改变的平衡条件的敏感性。这一目标的一个重要成果还将是公开共享验证数据集(超声数据、DIC和运动学)。在目标2中，软组织力学将在健康成人(n=20)和既往有TKA表现出可接受(n=20)和不可接受(n=20)稳定性的成年人中进行评估。UE计算的位移和应变的比较将有助于深入了解全膝关节置换术对膝关节稳定性的影响。最后，在目标3中，这些结果将被汇编，并将使用判别函数分析来确定哪些任务和措施为临床评估提供最好的区分能力。这些数据将与临床洞察力配对，为评估软组织膝关节平衡的UE的临床整合提供建议。这些目标的成功完成将有助于改善每年接受TKA手术的60多万美国人的结果，并将指明可以改善TKA结果的具体术中技术。

项目成果

Patellar tendon buckling is altered with age.

髌腱屈曲随着年龄的增长而改变。

• DOI: 10.1016/j.medengphy.2018.04.024
• 发表时间: 2018
• 期刊: Medical engineering & physics
• 影响因子: 2.2
• 作者: Slane,LauraChernak;Dandois,Félix;Bogaerts,Stijn;Vandenneucker,Hilde;Scheys,Lennart
• 通讯作者: Scheys,Lennart

Patellar tendon buckling in post-operative total knee arthroplasty patients is more prominent than in healthy controls.

术后全膝关节置换术患者的髌腱屈曲比健康对照组更为突出。

• DOI: 10.1016/j.medengphy.2019.06.005
• 发表时间: 2019
• 期刊: Medical engineering & physics
• 影响因子: 2.2
• 作者: Slane,LauraChernak;Dandois,Félix;Bogaerts,Stijn;Scheys,Lennart;Vandenneucker,Hilde
• 通讯作者: Vandenneucker,Hilde

The measurement of medial knee gap width using ultrasound.

• DOI: 10.1007/s00402-017-2740-9
• 发表时间: 2017-08
• 期刊: Archives of orthopaedic and trauma surgery
• 影响因子: 2.3
• 作者: Slane LC;Slane JA;Scheys L
• 通讯作者: Scheys L