Robotic cadaver testing of a new total ankle prosthesis model (German Ankle System).
BACKGROUND
An investigation was carried out into possible increased forces, torques, and altered motions during load-bearing ankle motion after implantation of two different total ankle prostheses. We hypothesized that the parameters investigated would not differ in relation to the two implants compared.


METHODS
We included two different ankle prostheses (Hintegra, Newdeal, Vienne, France; German Ankle System, R-Innovation, Coburg, Germany). The prostheses were implanted in seven paired cadaver specimens. The specimens were mounted on an industrial robot that enables complex motion under predefined conditions (RX 90, Stäubli, Bayreuth, Germany). The robot detected the load-bearing (30 kg) motion of the 100(th) cycle of the specimens without prostheses as the baseline for the later testing, and mimicked that exact motion during 100 cycles after the prostheses were implanted. The resulting forces, torques, and bone motions were recorded and the differences between the prostheses compared.


RESULTS
The Hintegra and German Ankle System, significantly increased the forces and torques in relation to the specimen without a prosthesis with one exception (one-sample-t-test, each p < or = 0.01; exception, parameter lateral force measured with the German Ankle System, p = 0.34). The force, torque, and motion differences between the specimens before and after implantation of the prostheses were lower with the German Ankle System than with the Hintegra (unpaired t-test, each p < or = 0.05).


CONCLUSIONS
The German Ankle System prosthesis had less of an effect on resulting forces and torques during partial weightbearing passive ankle motion than the Hintegra prosthesis. This might improve function and minimize loosening during the clinical use.
Richter
Martinus
M
Klinik Für Unfallchirurgie, Orthopädie und Fusschirurgie, Klinikum Coburg, Ketschendorfer Strasse 33, 96450 Coburg, Germany. info@foot-trauma.org
Zech
Stefan
S
Westphal
Ralf
R
Klimesch
Yvone
Y
Gosling
Thomas
T
D000369:Aged, 80 and over; D000843:Ankle Joint / Q000502:physiology / Q000601:surgery; D019643:Arthroplasty, Replacement; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D005360:Fibula / Q000502:physiology; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D011474:Prosthesis Design; D016059:Range of Motion, Articular / Q000502:physiology; D012371:Robotics / Q000295:instrumentation; D012399:Rotation; D013314:Stress, Mechanical; D013977:Tibia / Q000502:physiology; D019415:Torque; D016474:Weight-Bearing / Q000502:physiology