System for intraoperative evaluation of soft-tissue-generated forces during total hip arthroplasty by measurement of the pressure distribution in artificial joints.
ABSTRACT A system for evaluating the soft-tissue-generated forces at the hip joint was developed. The system enabled measurement of contact pressure distribution at hip joint surfaces, as well as evaluation of the artificial hip joint condition during total hip arthroplasty (THA). First, a pressure sensor module that forms part of the artificial joint was constructed. Eight small pressure sensors were installed in the spherical head component of the ball-and-socket joint. Next, software for recording and visualizing the detected pressures at 1-millisecond intervals was developed. The pressure distribution was displayed in real time via 3D computer graphics on a monitor. The system enabled intuitive recognition of the direction of soft-tissue-generated forces and pressure distribution in three dimensions. Accuracy tests were conducted using a high-accuracy 6-degree-of-freedom positioning device and digital force gauge. The error between the applied loads and measured forces was 3.42 +/- 3.26 N (mean +/- standard deviation) for each coordinate in 10 trials involving load application from 10 different directions. Next, a clinical evaluation was conducted during THA. The relative positions of the cup and stem component were measured using a surgical navigation system simultaneously with the pressure measurement. The system allowed real-time acquisition of information regarding the artificial hip joint, as well as comparison of the differences in the hip condition when several types of neck were used. Further improvements to the calibration method should enable more accurate measurements. We believe this system will be a useful tool for selecting an appropriate implant that fits a patient's hip joint or for estimating the risk of complications following surgery.