Safety of orthopedic implants: implant migration analysis a must

Hasan, S. (2024)

Doctoral Thesis

The aim of the thesis was to contribute to a better understanding of the influence of differences in implant design and surgical techniques on the migration of total knee arthroplasties (TKAs) and, more broadly, the effect of using Radiostereometric Analysis (RSA) and other markers to detect early loosening. In this thesis, we compared various types of TKAs in different randomized controlled trials. Additionally, we investigated whether the positioning of TKAs relative to the patient's specific leg axis (e.g., neutral, varus, or valgus alignment) affects the stability of the prosthesis. We also analyzed, by combining registry data with data from a meta-analysis, whether TKAs evaluated with migration analysis (radiostereometric analysis; RSA) yield better results than TKAs that have not been previously examined with RSA. Finally, we conducted a systematic review to explore whether there are markers that can indicate loosening/failure of a prosthesis.

• Total knee arthroplasty
• Radiostereometric Analysis
• Aseptic loosening

• All authors: Hasan, S.
• Supervisor: Nelissen, R.G.H.H.; Marang-van de Mheen, P.J.
• Co-supervisor: Kaptein, B.L.
• Committee: Poolman, R.W.; Schipper, I.B.; Nolten, P.A.; Eygendaal, D.; Toksvig-Larsen, S.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2024-06-04
• ISBN (print): 9789464698435
• Sponsorship: Universiteit Leiden; Nederlandse Orthopaedische Vereniging; Anna Fonds; ABN Amro; Chipsoft