University of Twente Student Theses

Knee spacers using 3D printed moulds : Designing and testing 3D printed moulds for knee spacers in two-stage revision arthroplasty in orthopaedic surgery

Tsai, R.E. (2024) Knee spacers using 3D printed moulds : Designing and testing 3D printed moulds for knee spacers in two-stage revision arthroplasty in orthopaedic surgery.

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Abstract:	Total knee arthroplasty (TKA) is a highly dependable and successful treatment for severe osteoarthritis and various arthropathies. In case of periprosthetic joint infections (PJI), a one stage or two-stage revision can be done to remove the infection. In MST, a two-stage revision, utilizing a spacer, is the gold standard for treating PJI. However, MST utilizes the Genesis II® as TKA. There is no commercially available spacer which fits the bone defects of the Genesis II®. Orthopaedic surgeons therefore experience issues, regarding the use of the LinkSpacer®, with insufficient fixation of the spacer, instability of the knee joint and difficult wound closure intraoperatively. To resolve these issues, the study aims to design and test a knee spacer with matching 3D printed mould to fit the bone defects of the Genesis II®. To be able to design such a spacer, an analysis of the extent of clinical issues regarding knee spacers for the Genesis II®️ outside of MST was conducted to further identify the current issues. This analysis showed that other hospitals utilizing the Genesis II®️, do not experience issues with the use of commercially available and handmade spacers. Spacer and mould requirements were then formulated using opinions of experts in both medical and technical fields. After an iterative design process, multiple spacer and mould concepts were assessed. The final spacer and mould design were chosen based on their requirements and expert evaluations. The testing phase of the final designs show a spacer design which met all its requirements, but does have a limited flexion range. The mould tests prove its general functionality. However, tests also highlight a potential mould optimization regarding the improvement of the method in which compression can be applied to the mould during bone cement curing. In conclusion, this study reached its aim by designing a spacer and mould that are deemed ready for use in clinical practice due to conducted tests. However, future recommendations can be to increase the flexion range of the spacer and ensure more sufficient mould compression.
Item Type:	Essay (Master)
Faculty:	TNW: Science and Technology
Subject:	44 medicine
Programme:	Technical Medicine MSc (60033)
Link to this item:	https://purl.utwente.nl/essays/104607
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