APPLICATIONS IN VIBROARTHROGRAPHY: ASSESSMENTS OF INSTABILITY IN TOTAL HIP ARTHROPLASTY, CAM-POST ENGAGEMENT IN TOTAL KNEE ARTHROPLASTY, AND VISCOSUPPLEMENTATION IN OSTEOARTHRITIC KNEES

Measurement of joint sounds and vibrations for non-invasive orthopaedic diagnostic purposes has slowly advanced since the 1960s. Most work has been focused in the development of methods for screening of abnormal knees. To date the technique has not gained clinical traction as is it fraught with various obstacles and skepticism. This doctoral thesis is neither an argument in favor of nor against the clinical use of vibroarthrography for musculoskeletal diagnostics in humans, but rather an exploration of its potential in cases of orthopaedic interest. These areas include 1) instability in total hip arthroplasty, 2) cam-post engagement in posterior stabilized total knee arthroplasty, and 3) viscosupplementation in osteoarthritic knees. It was expected that each of these unique cases would be characterized by dynamic phenomena that could be measured in the form of surface vibrations at the skin.Methods previously presented in various vibroarthrography research were adopted, modified, and expounded upon to best suit the needs of each experiment. In a mechanical hip simulator, it was found that vibroarthrography could be effectively used to distinguish the difference between 1 mm and 2 mm of hip separation. In posterior stabilized total knee arthroplasty subjects, it was found that multiple vibroarthrographic features may be used to approximate the occurrence of cam-post engagement, and that vibrations measured at the joint surface may be correlated to cam-post engagement velocity. In osteoarthritic knees, the relationship between clinical evidence, viscosupplementation, and vibroarthrography varied on a case by case basis.To the knowledge of the author, all three of these experiments are the first of their kind. Ultimately, the methods and results presented within provide new foundations for vibroarthrography that may be used to further explore the clinical potential of this noninvasive diagnostic.