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Quantitative measurement of soft tissue knee balance after TKA using ultrasound elastography

Award Number: F32AR069459
ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS
PERIOD OF PERFORMANCE START DATE: 05/10/2016
PERIOD OF PERFORMANCE END DATE: 08/13/2017

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Quantitative measurement of soft tissue knee balance after TKA using ultrasound elastography - ¿ DESCRIPTION (provided by applicant): Total knee arthroplasty (TKA) has become one of the most widely used procedures for restoring knee function and relieving pain in the advanced stages of knee osteoarthritis; yet early TKA failure (<10 years post-surgery) remains a large-scale problem. Although knee instability is known to be a major cause of early failures, current methods for measuring knee balance are largely subjective and user-dependent. Ultrasound elastography (UE) is an innovative technology that enables the noninvasive quantification of soft tissue displacements and strains, which are important indicators of balance. We have recently developed such a technique for the evaluation of Achilles tendon deformation, and believe that this approach could provide important insight into knee soft tissue mechanics. The premise of this study is to use this noninvasive UE approach to measure knee balance in situ and then in patient populations to better understand the effects of TKA on altered knee balance, with the overall goal to pave the way toward intra-operative integration of this approach. In Aim 1, ultrasound data will be collected from cadaveric knee soft tissues (medial and lateral collateral ligament, patellar tendon) while functionally loaded in a kinematic knee rig. Tissue displacements and strains will then be computed using our UE approach. Results from UE will be compared with the current gold standard approach (digital image correlation; DIC) to enable calibration and then accuracy assessment. TKAs will then be performed on the specimens by an orthopedic surgeon, and altered knee balance will be imposed by overstuffing the medial or lateral components of the knee. The sensitivity of UE measurements to these altered balance conditions will be assessed. An important outcome of this aim will also be the public sharing of the validation dataset (ultrasound data, DIC and kinematics). In Aim 2, soft tissue mechanics will be evaluated in healthy adults (n=20), and adults with a prior TKA demonstrating acceptable (n=20) and unacceptable (n=20) stability. Comparison of UE- computed displacements and strains will provide insight into the effects of TKA on knee stability. Finally, in Aim 3, these results will be compiled and discriminant function analysis will be used to determine which tasks and measures provide the best discriminating power for clinical assessment. These data will be paired with clinical insight to provide recommendations for clinical integration of UE for the assessment of soft tissue knee balance. Successful completion of these aims will contribute to improving the outcomes of TKA for the more than 600,000 Americans who annually undergo this procedure, and will point to specific intra-operative techniques that can improve TKA outcomes.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2019 ( Subtotal = -$3,980 )
2019	2016	KATHOLIEKE UNIVERSITEIT TE LEUVEN	OUDE MARKT 13	LEUVEN	LEUVEN	3000		BEL	Arthritis, Musculoskeletal and Skin Diseases Research	000	1	6/20/2019	NEW	-$3,980
														Subtotal = -$3,980

Issue Date FY: 2018 ( Subtotal = -$40,345 )
2018	2017	UNIVERSITY OF WISCONSIN SYSTEM	21 N PARK ST STE 6401	MADISON	WI	53715	DANE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	2	1/18/2018	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	-$40,345
														Subtotal = -$40,345

Issue Date FY: 2017 ( Subtotal = $59,166 )
2017	2017	UNIVERSITY OF WISCONSIN SYSTEM	21 N PARK ST STE 6401	MADISON	WI	53715	DANE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	002	2	7/7/2017	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$59,166
2017	2016	KATHOLIEKE UNIVERSITEIT TE LEUVEN	OUDE MARKT 13	LEUVEN	LEUVEN	3000		BEL	Arthritis, Musculoskeletal and Skin Diseases Research	001	1	7/7/2017	NEW	$0
														Subtotal = $59,166

Grand Total All Awards = $14,841

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Quantitative measurement of soft tissue knee balance after TKA using ultrasound elastography

Award Number: F32AR069459

ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS

PERIOD OF PERFORMANCE START DATE: 05/10/2016

PERIOD OF PERFORMANCE END DATE: 08/13/2017

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