Mohsen Akbari Shandiz, Paul Boulos, Stefan Karl Saevarsson, Sam Yoo, Stephen Miller and Carolyn Anglin

For their paper entitled: ‘Changes in knee kinematics following total knee arthroplasty’, published in the Proceedings Part H, Journal of Engineering in Medicine 2016, Vol 230(4) 265-278. Mohsen Shandiz THGM2017

The aim of this paper was to investigate a fundamental reason why some knee replacement operations are successful and others are not, namely, the abnormal motion of the knee. This long-term study investigated the joint kinematics before the operation and then again at least a year afterwards. The research is at the cutting edge of the subject, and is therefore early in its genesis, but has the potential to have far-reaching consequences for people requiring knee joint surgery. As one reviewer put it, "…this work may only be opening the door on improving knee joints but it is a very important door to be opening".

The authors studied the knee joint’s contact biomechanics, and the weightbearing and rotational movements before and after total knee arthroplasty (or knee joint replacement). The study used computed tomography and radiographic imaging, which are both available in the normal hospital environment. The authors had to overcome several technical problems not least of which was the precise study of the motion of the kneecap, or patella, which is often hidden by the metallic component of the artificial joint.  

Key aspects of this paper were to look at how the kinematics change due to surgery, rather than just after the surgery, and to highlight individual variability rather than the average. Focusing on the individual’s joint demonstrated a wide variability in knee pivoting behaviour, which may be overlooked when looking at averages. A large amount of high-quality information was obtained. The methods have the potential to help doctors understand the reasons for success, or not, of the procedure and to improve implant design.

“This is an important piece of work,” says Mohsen Akbari Shandiz. “This study provides data previously unavailable concerning changes in knee joint before and after total knee arthroplasty. This will help improve surgical techniques, implants and instruments, leading to improved patient outcomes and satisfaction.  Such comprehensive kinematic data are rarely reported. In this study, clinically available imaging systems were used, which means that in the future the same protocol can be used for preplanning the surgery based on the results of broader studies with more subjects, from more surgeons, and different implant designs.

“We are thrilled and honoured to win the Thomas Hawksley Gold Medal. We would like to thank the Institution of Mechanical Engineers for recognising our work. I also wish to thank all the people involved in this study, for all their effort, motivation, and support.”

Find out more about the Thomas Hawksley Gold Medal Award.

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