Optimized Bone Coverage Research Study

Proprioception is the involuntary neurologic function which provides joint sense and balance, leading to locomotor stability and control.

Dr. Rosenberg, Steven Swanson, PhDc and William McDermott, PhD are currently conducting research to determine the neurologic (proprioceptive) benefit of posterior cruciate ligament (PCL) preservation on Athletic Knee Implant (AKI) recipients. The study is designed to evaluate the changes in proprioceptive function in athletic knee implant (AKI) recipients. Phase I of the study is being conducted in healthy patients to validate the advanced testing methods and Phase II involves the testing of patients who have received Athletic Knee Implants.

The results of the study may advance new methods for testing proprioceptive function, before and after surgery. For more information about this study or to find out if you may be eligible to enroll in the study, please call William McDermott at 801-314-4146.

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Figure 1.Measuring uncovered bone, lateral to trial implant.

The need for improved, male gender-specific implants is important for advancing short-term and especially long-term implant performance. Improved bone integration, hemostatis, and complete elimination of pain are important objectives.

*Unpublished study of 50 women and 50 men.

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Figure 2.Result of gender-specific measurements in 50 female and 50 male patients.

Proprioceptive Function Research Study

Full bone coverage or capping by an implant improves bone integration and reseals the bone environment. As a rule, male bone structure requires broader coverage patterns than female. As a result, male preference implants are broader than female. A range of 1 mm overcapping to 2 mm undercapping is optimal (Figure 4).

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Figure 3.Patient performs advanced testing for proprioception, also called locomotor stability.

Biological Factors Research Study

The purpose of this study is to explore correlations between biomarkers for inflammatory conditions (i.e. coronary artery disease and osteoarthritis) and changes in bone and synovial tissue in patients undergoing knee replacement surgery. Biomarkers measured in the study include serum high sensitivity C-reactive protein (hs-CRP), synovial fluid cytokines, and urinary pyridinoline. Bone and synovial tissue that is normally discarded during surgery is collected for histological analysis. Figures 4 and 5 show synovial tissue in a patient with low hs-CRP and in a patient with high hs-CRP, respectively. Table 1 lists the biomarkers and tissue histology measurements that have been obtained from patients enrolled in the study. Patients with unhealthy hsCRP's (>4.0) are studied relative to patients with healthy hsCRP (<0.7). Pain scores, range of motion, and time to achieve rehab milestones are compared. Nutritional profiles are also studied between the two groups.

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Figure 4.Synovial tissue in a patient with low hs-CRP. Inflammation is not present.
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Figure 5.Synovial tissue in a patient with high hs-CRP. Chronic inflammatory tissue and increased temperature are routinely present.

Table 1. Biomarkers and tissue histology measurements taken in the biological factors research study.

Biomarkers Tissue histology
Synovial fluid cytokines

Urinary pyridinoline

Serum hs-CRP

Bone tissue histology

Synovial tissue histology

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