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Memphis, TN, United States

Elsner J.J.,Active Implants
Journal of biomechanical engineering | Year: 2010

Allograft or synthetic menisci have been suggested as a means to restore contact pressures following meniscectomy. However, when the natural meniscus is severely damaged/absent, the necessary size cannot be determined according to the recipient size and there is a need to estimate it from magnetic resonance imaging (MRI) of the contralateral knee or the injured knee bones. The use of the contralateral-knee for size matching is problematic due to economic and practical reasons. Hence, there are significant advantages for a sizing algorithm based only on the candidate knee geometry. The aim of this study is to characterize midrange values and variability of knee dimensions and to develop a set of mathematical relations representing knee dimensions using a minimum of imaging-based bone measurements. Tibia, femur, and meniscus measurements were taken in 118 MRI scans and used to develop a representative parametric knee model in which all dimensions are expressed using tibia plateau width. The model was verified by comparing the predicted values to direct MRI measurements for 20 additional subjects by means of the Pearson correlation and Bland and Altman (1986, "Statistical Methods for Assessing Agreement Between Two Methods of Clinical Measurement," Lancet, 1, pp. 307-310) plot. Anatomical parameters in the male knee were significantly larger (∼17%) compared with corresponding female measurements. However, most relations between tibia, femur, and meniscus measurements (43/56) were not significantly different between male and female populations (p ≥ 0.05), indicating that differences between male and female joints are generally related to scaling and not shape. Dimensions predicted by the knee model were in a good agreement with dimensions measured directly from the MRI (R(2)>0.96) and the Bland and Altman plot indicated that ∼95% of data points were well within the ± 2 standard deviation lines of agreement. The model proposed in this study is advantageous in being able to describe typical knee proportions for a given tibial width and can be used to predict the dimensions of a candidate knee based on a single measurement. The anatomical/anthropometric data presented in the study can be utilized in a sizing algorithm for artificial meniscal implants or in the design of artificial meniscus prostheses.

Active Implants | Date: 2010-02-03

Devices, apparatus, and systems for replacing at least some of the functionality of the natural hip joint and associated methods of implantation are disclosed. In one aspect a prosthetic acetabular cup system is provided. The system includes a metal shell comprising an outer surface for securely engaging a prepared portion of an acetabulum and an opposing inner surface. In some instances, portions of the inner and outer surfaces define an anchoring section that is deformable between an insertion configurationwhere the anchoring section projects inwardly from the inner surfaceand an anchoring configurationwhere the anchoring section projects outwardly from the outer surface to define an anchoring protrusion for engaging the prepared portion of the acetabulum. In some embodiments, the system also includes a pliable articulating component having an outer surface including at least one engagement feature sized and shaped to engage with the metal shell. The pliable articulating component includes an inner surface for articulatingly receiving a femoral head.

Active Implants | Date: 2014-06-12

A prosthetic device for use as an artificial meniscus is disclosed. The prosthetic device restores shock absorption, stability, and function to the knee joint after removal of the damaged natural meniscus. In some embodiments, the prosthetic device is pre-tensioned to improve the fit of the prosthetic device within the knee joint and, thereby, maximize the contact area of the load-bearing surfaces to distribute loading through the prosthetic device in a manner substantially similar to that of a healthy natural meniscus. In some embodiments, the pre-tensioned prosthetic device is smaller, or scaled-down, relative to the size of a healthy natural meniscus.

A prosthetic device for use as an artificial meniscus is disclosed. The prosthetic device restores stress distribution, stability, and function to the knee joint after removal of the damaged natural meniscus. In some embodiments, the prosthetic device includes an anti-migration feature that inhibits extreme movement within the joint while permitting free floating over a significant range. In one aspect, the anti-migration feature is an enlarged anterior structure or a posterior meniscus remnant engaging channel while in another aspect, the anti-migration feature includes a tethering member. Still further, removable radiopaque features are provided to enhance trialing of the implant prior to final implantation within the joint.

Methods of selecting and implanting prosthetic devices for use as a replacement meniscus are disclosed. The selection methods include a pre-implantation selection method and a during-implantation selection method. The pre-implantation selection method includes a direct geometrical matching process, a correlation parameters-based matching process, and a finite element-based matching process. The implant identified by the pre-implantation selection method is then confirmed to be a suitable implant in the during-implantation selection method. In some instances, the during-implantation selection method includes monitoring loads and/or pressures applied to the prosthetic device and/or the adjacent anatomy. In some instances, the loads and/or pressures are monitored by a trial prosthetic device comprising one or more sensors. Methods of implanting meniscus prosthetic devices are also disclosed.

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