|Titel på arbejdet
|Kinematic investigation of knee osteoarthritis and arthroplasty designs - employing dynamic radiostereometry
|Emil Toft Petersen
|Afdeling / Sted
|University Clinic for Hand, Hip, and Knee Surgery, Holstebro Regional Hospital and Department of Orthopaedics, Aarhus University Hospital
|Abstract / Summary
Osteoarthritis is a highly prevalent chronic disorder causing degenerative joint changes often associated with joint pain and disability limiting daily activities.1 The knee is the most commonly affected weightbearing joint in osteoarthritis. The prevalence of painful and disabling knee osteoarthritis (KOA) in adults over 55 years of age is 10%, and a quarter of those affected are severely disabled. Thus, KOA has a considerable impact on the patients’ physical and psychosocial health and well-being, but also generates a significant financial burden on the healthcare systems. In Denmark, with 60,000-65,000 patients consulting their general practitioner for KOA annually, and with half of these being allocated surgery, the present Danish arthritis- related expenses accrue to 11 billion DKK annually. In step with the increasing life expectancy and demographic changes, an increase is expected in the number of patients with disabling KOA and in the ensuing financial healthcare burden.
End-stage KOA can be treated surgically with total knee arthroplasty (TKA), which is a well-documented and successful treatment. However, up to 20% of patients are dissatisfied with the outcome. Considerable efforts have been devoted to reducing the number of dissatisfied patients; however, these efforts have not yet been successful. The search for ways to enhance patients’ health-related quality-of-life, performance and satisfaction have resulted in the widespread application of various TKA implant designs. However, for development of naturally functioning implants, it is fundamental to first understand the normal knee kinematics, the underlying pathomechanics of the osteoarthritis affected knees and the implant designs’ influence on knee mechanics.
The overall aim was two-fold: A methodological aim was to evaluate the accuracy of automated dynamic radiostereometric (dRSA) image registration methods; and a clinical aim was to investigate knee pathomechanics in osteoarthritic knees and the mechanical influence of knee arthroplasty designs during gait as a daily activity utilizing dRSA.
The four studies together contribute to an enhanced understanding of the native and the artificial knee joint, which may inspire the development of improved and more patient-specific treatment strategies in the future. Furthermore, a method to aid clinicians to evaluate the implant fixation in any TKA patient was developed.