Acoustic Emission Studies of Posterior Stabilized and Cruciate Retaining Knee Arthroplasties

ABSTRACT

Different acoustic frequencies have been used to diagnose progression of osteoarthritis, gross pathology, and wear in knee prostheses. It is possible that detailed analysis of higher frequencies could detect and quantify the smaller geometric changes (asperities) that develop in articular prosthetic wear. In this study we evaluated the feasibility of using ultrasonic emission to determine total knee arthroplasty (TKA) type and time from implantation using a simple, handheld measurement system. We examined the ultrasound emission generated by similar designs of posterior stabilized (PS) and cruciate retaining (CR) total knee prostheses and native knees of 58 patients and 10 controls. The subjects were asked to sit, rise, sit again, and take five steps while recording the acoustic data from both knees. Acoustic emission analysis examined frequency distributions and power spectrums of the recorded signals, and their relations to prosthesis type and time from implantation. We screened 44 CR and 48 PS TKAs, as well as 24 native knees. Analysis of this data suggested a possibility of differentiating between type of implants, and a relation to time since implantation. Our data suggest that we might be able to assess the status and time from implantation of a TKA by acoustic emission signals. Further in vitro analysis of the relationship of wear to ultrasonic emission data are needed for accurate quantification of arthroplasty wear. A simple, in-office screening tool for TKA patients could indicate which patients require closer follow-up and monitoring due to risk of potential problems.

KEYWORDS

Total knee arthroplasty - ultrasonic emissions - posterior stabilized - cruciate retaining

REFERENCES

• 1 Jiang C C, Lee J H, Yuan T T. Vibration arthrometry in the patients with failed total knee replacement.  IEEE Trans Biomed Eng. 2000;  47 (2) 219-227
• 2 Kernohan W G, Beverland D E, McCoy G F, Hamilton A, Watson P, Mollan R. Vibration arthrometry. A preview.  Acta Orthop Scand. 1990;  61 (1) 70-79
• 3 Kernohan W G, Beverland D E, McCoy G F et al.. The diagnostic potential of vibration arthrography.  Clin Orthop Relat Res. 1986;  (210) 106-112
• 4 Nagata Y. Joint-sounds in gonoarthrosis—clinical application of phonoarthrography for the knees.  J UOEH. 1988;  10 (1) 47-58
• 5 Huang X, Kwong K, Cheng J. The development and clinical application of acoustical technique in hip joint.  J Huazhong Univ Sci Technolog Med Sci. 2002;  22 (4) 362-366
• 6 Bassiouni M, Bassiouni H, el-Feki M. Sensitivity versus specificity of phonoarthrography as an indicator for cartilage degeneration.  Clin Rheumatol. 1995;  14 (2) 135-142
• 7 Prior J, Mascaro B, Shark L K et al.. Analysis of high frequency acoustic emission signals as a new approach for assessing knee osteoarthritis.  Ann Rheum Dis. 2010;  69 (5) 929-930
• 8 Davies J P, Tse M K, Harris W H. Monitoring the integrity of the cement-metal interface of total joint components in vitro using acoustic emission and ultrasound.  J Arthroplasty. 1996;  11 (5) 594-601
• 9 Roques A, Browne M, Thompson J, Rowland C, Taylor A. Investigation of fatigue crack growth in acrylic bone cement using the acoustic emission technique.  Biomaterials. 2004;  25 (5) 769-778
• 10 Glaser D, Komistek R D, Cates H E, Mahfouz M R. Clicking and squeaking: in vivo correlation of sound and separation for different bearing surfaces.  J Bone Joint Surg Am. 2008;  90 (Suppl 4) 112-120
• 11 Tavathia S, Rangayyan R M, Frank C B, Bell G D, Ladly K O, Zhang Y-T. Analysis of knee vibration signals using linear prediction.  IEEE Trans Biomed Eng. 1992;  39 (9) 959-970
• 12 Shen Y, Rangayyan R M, Bell G D, Frank C B, Zhang Y T, Ladly K O. Localization of knee joint cartilage pathology by multichannel vibroarthrography.  Med Eng Phys. 1995;  17 (8) 583-594
• 13 Rangayyan R M, Krishnan S, Bell G D, Frank C B, Ladly K O. Parametric representation and screening of knee joint vibroarthrographic signals.  IEEE Trans Biomed Eng. 1997;  44 (11) 1068-1074
• 14 Umapathy K, Krishnan S. Modified local discriminant bases algorithm and its application in analysis of human knee joint vibration signals.  IEEE Trans Biomed Eng. 2006;  53 (3) 517-523
• 15 Li G, Papannagari R, Most E et al.. Anterior tibial post impingement in a posterior stabilized total knee arthroplasty.  J Orthop Res. 2005;  23 (3) 536-541
• 16 Hamai S, Miura H, Matsuda S, Shimoto T, Higaki H, Iwamoto Y. Contact stress at the anterior aspect of the tibial post in posterior-stabilized total knee replacement.  J Bone Joint Surg Am. 2010;  92 (8) 1765-1773
• 17 Taylor S, Manley M T, Sutton K. The role of stripe wear in causing acoustic emissions from alumina ceramic-on-ceramic bearings.  J Arthroplasty. 2007;  22 (7, Suppl 3) 47-51
• 18 Mascaro B, Prior J, Shark L K, Selfe J, Cole P, Goodacre J. Exploratory study of a non-invasive method based on acoustic emission for assessing the dynamic integrity of knee joints.  Med Eng Phys. 2009;  31 (8) 1013-1022