title: Design and evaluation of an actuated knee implant for postoperative ligament imbalance correction.
abstract: In Total Knee Arthroplasty (TKA), the collateral ligament tensioning stage cannot be standardised for all patients and relies heavily on the surgeon's experience and perception. Intraoperative inaccuracies are practically unavoidable and may give rise to severe postoperative complications, leading to the need for revision surgery already a few years after primary TKA. This work proposes a novel instrumented tibial component able to detect collateral ligament laxity conditions right after primary TKA and, if needed, to compensate for them in the postoperative period. A miniaturised actuation system, designed to be embedded in the tibial baseplate, was initially evaluated by means of 3D simulations and then fabricated as a full-scale prototype. Stability and force sensors tests carried out on a knee simulator allowed to assess the effectiveness of the proposed design under normal working conditions and provided valuable insights for future work and improvements.
authors.affiliation: LIRMM, CNRS UMR 5506 UM2, 161 rue Ada, Montpellier 34095, France. Electronic address: andrea.collo@lirmm.fr.
authors.forename: A
authors.initials: A
authors.lastname: Collo
authors.affiliation: LaTIM, INSERM-UBO UMR 1101, CHRU Morvan, 2 av. Foch, Brest 29609, France. Electronic address: shaban.almouahed@telecom-bretagne.eu.
authors.forename: S
authors.initials: S
authors.lastname: Almouahed
authors.affiliation: LIRMM, CNRS UMR 5506 UM2, 161 rue Ada, Montpellier 34095, France. Electronic address: poignet@lirmm.fr.
authors.forename: P
authors.initials: P
authors.lastname: Poignet
authors.affiliation: LaTIM, INSERM-UBO UMR 1101, CHRU Morvan, 2 av. Foch, Brest 29609, France. Electronic address: chafiaa.hamitouche@telecom-bretagne.eu.
authors.forename: C
authors.initials: C
authors.lastname: Hamitouche
authors.affiliation: LaTIM, INSERM-UBO UMR 1101, CHRU Morvan, 2 av. Foch, Brest 29609, France. Electronic address: eric.stindel@univ-brest.fr.
authors.forename: E
authors.initials: E
authors.lastname: Stindel
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D001696:Biomechanical Phenomena; D017076:Computer-Aided Design; D007720:Knee Prosthesis; D008022:Ligaments / Q000601:surgery; D055595:Mechanical Phenomena; D011183:Postoperative Complications / Q000517:prevention & control* / Q000601:surgery; D011474:Prosthesis Design; D012086:Reoperation
keywords: Actuation system; Instrumented knee prosthesis; Knee ligament imbalance; Miniaturised mechanical device