Quantitative assessment of compress-type osseointegrated prosthetic implants in human bone using electromechanical impedance spectroscopic methods
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Osseointegrated (OI) prostheses are a promising alternative to traditional socket prostheses. They can enhance the quality of life of amputees by avoiding fit and comfort issues commonly associated with sockets. The main structural element of the OI prosthesis is a biocompatible metallic implant that is surgically implanted into the bone of the residual limb. The implant is designed to provide a conducive surface for the host bone to osseointegrate with. The osseointegration process of the implant is difficult to clinically evaluate, leading to conservative postoperative rehabilitation approaches. Elastic stress waves generated in an OI prosthesis have been previously proposed to interrogate the implant-bone interface for quantitative assessment of the osseointegration process. This paper provides a detailed overview of the various elastic stress wave methods previously explored for in situ characterization of OI implants. Specifically, the paper explores the use of electromechanical impedance spectroscopy (EIS) to assess the OI process in compress-type OI prostheses. The EIS approach measures the electrical impedance spectrum of lead zirconate titanate elements bonded to the free end of the implant. The research utilizes both numerical simulation and experimental verification to establish that the electromechanical impedance spectrum is sensitive (between 400 and 460 kHz) to both the degree and location of osseointegration. A baseline-free OI index is proposed to quantify the degree of osseointegration at the implant-bone interface and to assess the stability of the OI implant for clinical decision making.
KeywordsProsthesis Osseointegration Electrical impedance spectroscopy Guided waves Bone Piezoelectric
This study is financially supported by the Office of Naval Research under Grant N00014-18-1-2477. The authors also wish to acknowledge the guidance provided by Dr. Liming Salvino (Office of Naval Research) and Dr. Jonathan Forsberg (Walter Reed National Military Medical Center).
Compliance with ethical standards
Conflict of interest
The author declares that there is no conflict of interest regarding the publication of this paper. The compress-type OI implant system presented in this study is similar to the commercial Compress® implant from Zimmer-Biomet but was independently designed and manufactured by the paper authors. The authors have no financial relationship with Zimmer-Biomet.
This article does not contain any studies with human participants or animals performed by any of the authors.
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