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A comparison between electromechanical and pneumatic-controlled knee simulators for the investigation of wear of total knee replacements

机译：机电式和气动式膝关节模拟器之间的比较用于研究全膝关节置换术的磨损情况

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More robust preclinical experimental wear simulation methods are required in order to simulate a wider range of activities, observed in different patient populations such as younger more active patients, as well as to fully meet and be capable of going well beyond the existing requirements of the relevant international standards. A new six-station electromechanically driven simulator (Simulation Solutions, UK) with five fully independently controlled axes of articulation for each station, capable of replicating deep knee bending as well as other adverse conditions, which can be operated in either force or displacement control with improved input kinematic following, has been developed to meet these requirements. This study investigated the wear of a fixed-bearing total knee replacement using this electromechanically driven fully independent knee simulator and compared it to previous data from a predominantly pneumatically controlled simulator in which each station was not fully independently controlled. In addition, the kinematic performance and the repeatability of the simulators have been investigated and compared to the international standard requirements. The wear rates from the electromechanical and pneumatic knee simulators were not significantly different, with wear rates of 2.6 ± 0.9 and 2.7 ± 0.9 mm3/million cycles (MC; mean ± 95% confidence interval, p = 0.99) and 5.4 ± 1.4 and 6.7 ± 1.5 mm3/MC (mean ± 95 confidence interval, p = 0.54) from the electromechanical and pneumatic simulators under intermediate levels (maximum 5 mm) and high levels (maximum 10 mm) of anterior–posterior displacements, respectively. However, the output kinematic profiles of the control system, which drive the motion of the simulator, followed the input kinematic profiles more closely on the electromechanical simulator than the pneumatic simulator. In addition, the electromechanical simulator was capable of following kinematic and loading input cycles within the tolerances of the international standard requirements (ISO 14243-3). The new-generation electromechanical knee simulator with fully independent control has the potential to be used for a much wider range of kinematic conditions, including high-flexion and other severe conditions, due to its improved capability and performance in comparison to the previously used pneumatic-controlled simulators.
机译：需要更强大的临床前实验磨损模拟方法，以模拟在不同患者群体（例如，年轻的活跃患者）中观察到的更广泛的活动，并完全满足并能够超越相关要求的现有要求国际标准。一个新的六工位机电驱动模拟器（英国Simulation Solutions），每个工位具有五个完全独立控制的关节运动轴，能够复制深膝弯曲以及其他不利条件，可以在力或位移控制下操作为了满足这些要求，已经开发了改进的输入运动学跟踪。这项研究调查了使用这种机电驱动的完全独立的膝部模拟器进行固定支撑全膝关节置换的磨损，并将其与主要由气动控制的模拟器中以前的数据进行了比较，在该系统中，每个工作站并非完全独立地控制。此外，还对模拟器的运动性能和可重复性进行了研究，并将其与国际标准要求进行了比较。机电式和气动式膝部模拟器的磨损率无显着差异，磨损率为2.6±0.9和2.7±0.9 mm 3 /百万次循环（MC；平均±95％置信区间，p =机电仿真器和气动仿真器的0.99）和5.4±1.4和6.7±1.5 mm 3 / MC（平均±95置信区间，p = 0.54）在中等水平（最大5mm）和高水平（最大10 mm）的前后位移。然而，驱动系统的运动的控制系统的输出运动曲线，与气动模拟器相比，在机电模拟器上更紧密地跟随输入运动曲线。此外，机电模拟器能够在国际标准要求（ISO 14243-3）的公差范围内跟踪运动和负载输入循环。具有完全独立控制功能的新一代电动膝关节模拟器由于与以前使用的气动膝关节相比具有改进的性能和性能，因此有可能用于更广泛的运动条件，包括高屈曲和其他恶劣条件受控模拟器。

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