Development and validation of a biomechanically fidelic surgical training knee model

Knee arthroplasty technique is constantly evolving and the opportunity for surgeons to practice new techniques is currently highly dependent on the availability of cadaveric specimens requiring certified facilities. The high cost, limited supply, and heterogeneity of cadaveric specimens has increase...

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Bibliographic Details
Published in:	Journal of orthopaedic research Vol. 42; no. 10; pp. 2181 - 2188
Main Authors:	Bennett, Kieran J., Foroutan, Parham, Fairweather, Ella, Al‐Dirini, Rami M. A., Sobey, Sammuel A., Litchfield, Nick, Roe, Mark, Reynolds, Karen J., Costi, John J., Taylor, Mark
Format:	Journal Article
Language:	English
Published:	United States 01-10-2024
Subjects:	Arthroplasty, Replacement, Knee - education Biomechanical Phenomena biomechanics Cadaver Finite Element Analysis Humans knee Knee Joint - anatomy & histology Knee Joint - physiology Knee Joint - surgery knee joint mechanics ligament Models, Anatomic orthopedics knee joint mechanics knee orthopedics biomechanics ligament
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Summary:	Knee arthroplasty technique is constantly evolving and the opportunity for surgeons to practice new techniques is currently highly dependent on the availability of cadaveric specimens requiring certified facilities. The high cost, limited supply, and heterogeneity of cadaveric specimens has increased the demand for synthetic training models, which are currently limited by a lack of biomechanical fidelity. Here, we aimed to design, manufacture, and experimentally validate a synthetic knee surgical training model which reproduces the flexion dependent varus‐valgus (VV) and anterior‐posterior (AP) mechanics of cadaveric knees, while maintaining anatomic accuracy. A probabilistic finite element modeling approach was employed to design physical models to exhibit passive cadaveric VV and AP mechanics. Seven synthetic models were manufactured and tested in a six‐degree‐of‐freedom hexapod robot. Overall, the synthetic models exhibited cadaver‐like VV and AP mechanics across a wide range of flexion angles with little variation between models. In the extended position, two models showed increased valgus rotation (<0.5°), and three models showed increased posterior tibial translation (<1.7 mm) when compared to the 95% confidence interval (CI) of cadaveric measurements. At full flexion, all models showed VV and AP mechanics within the 95% CI of cadaveric measurements. Given the repeatable mechanics exhibited, the knee models developed in this study can be used to reduce the current reliance on cadaveric specimens in surgical training.
Bibliography:	Kieran J. Bennett and Parham Foroutan contributed equally to the publication of the manuscript. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	0736-0266 1554-527X 1554-527X
DOI:	10.1002/jor.25873