A new twist on an age-old problem: Making knee replacements last

ts' long-term progress to assess the model's predictions. "Just as suits can be fitted to business executives, orthopedic surgeries will be custom tailored to the patient," Fregly said.

Fregly's group also is seeking to improve the success of a surgical procedure called tibial osteotomy, which involves realigning one of the lower leg bones to redistribute loads on the knees of patients suffering from arthritis. The problem is the procedure is successful only in some cases, Fregly said. "Many doctors today feel that the variability is so large that the operation is not worth it," he said. As part of the procedure, surgeons essentially have to make an educated guess about how much to rotate the lower leg bone, Fregly said. By recording how patients walk normally and with heel wedges that approximate the effects of the surgery, Fregly and fellow researchers, including Rafi Haftka, a professor of mechanical and aerospace engineering, are creating a computer model that could predict more accurately the correct rotation, he said. Now in the second of a three-year project funded with a $240,000 grant from the Whitaker Foundation, the research eventually could make the surgery more effective, he said.

Fregly's third project probes the causes of knee arthritis itself an area that has long proven mysterious because it is so difficult to determine what is happening inside the knee as a person walks. The team is seeking to predict inner forces on the knee using computer models, CT scans and reverse-engineering software produced by Research Triangle Park-based Raindrop Geomagic. One result of the three-year project, funded with a $210,000 grant from the National Institutes of Health, may be a better understanding of how to guard against developing arthritis.

"It may be that we can identify load thresholds that are bad, or types of loading that are bad, so we can train people to avoid doing these things," Fregly said.


Contact: B.J. Fregly
University of Florida

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