SMART IMPLANTS FOR ORTHOPAEDICS

SURGERY (SImOS)
Peter Ryser

General objectives
More than 1 Mio / year hip and knee prosthesis are
implanted in EU and US

General objectives
3

To design innovative tools partly implanted partly

external to measure in vivo biomechanical parameters
of knee prosthesis
To record and analyze in clinical environment and
during daily activity pertinent biomechanical
information in order to improve medical treatments:
During surgery: to help surgeon with the positioning phase
After surgery: to detect early migration of the prosthesis
and to avoid later complications
During rehabilitation: to evaluate in vivo joint function

General objectives

Physician / Surgeon
Better

control during operation

Evaluation of healing process
Rapid reaction in case of problems

Patient
Improvement

of quality of life

Project
Implanted

prosthesis at the end of the project

A multidisciplinary consortium
5

Principal Investigator
Peter Ryser

Co-Investigators
Kamiar Aminian, Philippe Renaud, Catherine Dehollain, Pierre-Andr
Farine

Co-Investigator
Brigitte Jolles

Co-Investigator
Vincent Leclercq

Challenge
6

Communication

Packaging

Surgical
implantation

Force
sensors

Biomechanical
modeling

Electronics
Sensors interface

Collaborative nature
7

EPFL-RFiC

CHUV-DAL
Symbios

Wireless comm.
Remote powering
Load modulation
Magnetic coupling

Prosthesis with
SImOS system
Surgery and
SImOS implantation

3D kinematics vs. 3D kinetics

Prosthesis loosening
and wear
Soft tissue artifact
Fusion algorithm
Multiparametric evaluation
EPFL-LMAM

Ultra thin flexible

printed circuit
Flexible thin film
energy storage
In vivo Sensors
interconnection

EPFL-LPM2

EPFL-LMIS4
Strain gage array
Micro-fabricated
Process
Biocompatibility
EPFL-ESPLAB
Low power/low noise
sensors interface
Accelerometer & ASIC
A /D & signal conditioning

External kinematics measurement

8

Two 3D inertial sensors (3D accelerometer /3D gyroscope)

3D knee rotation measurement

Issue: soft tissue artifact

Optimal Internal/External fusion to remove soft tissue artifact

Internal Kinematics Measurement

9

Joint Angles
Objectives:

Rotation

Measurement of Knee Joint Angles

Measurement of Knee Translation

3D knee rotation measurement

Comparison with a reference

Translation
Evolution of Joint Angle

sensors

Feature
Extraction

Reference sensor

Artificial
Neural
Network

+-

Joint Angle (degree)

80
60

Reference Joint Angle

Estimated Joint Angle via
internal sensors and ANN

angle rms
error during
Rot. : 0.6 deg
Trans. : 0.8 deg

40
20
0
0

100

200

300
400
Sample

500

600

Mechanical Simulator 1
10

This is the first prototype of the demonstrator (simulator of the knee movements)

To demonstrate the feasibility of the measurements

To validate the motion and forces, using motion captures (Vicon cameras) and
reference force sensors

Vicon cameras
Vicon cameras

Reference Force sensors

Squat Movement
11

Simulations by Laboratory of Biomechanical Orthopedics (LBO)

Prof. Dr. Alexandre Terrier and Silvio Ramondetti

11

The pictures should not be published

without permission of LBO

Squat Movement
12

Simulations by Laboratory of Biomechanical Orthopedics (LBO)

Prof. Dr. Alexandre Terrier and Silvio Ramondetti

12

The pictures should not be published

without permission of LBO

EE22 Strain Component

13

Changeinsurfacecongruence
betweenfemoralcomponent
andtibialinsert.

Kneeflexion
angleincreasing

Simulations by Laboratory of Biomechanical Orthopedics (LBO)

Prof. Dr. Alexandre Terrier and Silvio Ramondetti

The pictures should not be published

without permission of LBO

EE22 Strain Component

14

Simulations by Laboratory of Biomechanical Orthopedics (LBO)

Prof. Dr. Alexandre Terrier and Silvio Ramondetti

The pictures should not be published

without permission of LBO

Strain Gauge Positioning & Wiring

15

ELECTRONICS

ELECTRONICS

Prototype
16

Sensor Fabrication Stack-up

17

Ti
Pt
Ti
PI
Al
TiW

Si

Remote Powering & Communication

18
Downlink
&
Power

Reader
Power
Amplifier

L1

External Part

Mod &
Demodulator

L2
Uplink

Rectifier

Regulator

Remote
Electronics

Internal Part

Mod &
Demodulator

The remote powering & communication system will

consist of above elements
Design flow started by realizing the inductive link
by generating suitable coils
Target frequency is going to be one ISM band
higher than 1 MHz (6.78 MHz, 13.56 MHz or 27
MHz)

Reader
Antenna
Implanted
Antenna
Image source:
http://healthtopics.hcf.com.au/
TotalKneeReplacement.aspx

Configuration 1
19

Internal
coil inside
the insert

External coil
circumferences
the knee

Configuration 2
20

Internal
coil inside
the insert

External coil in
front of the knee
just lower than
the patella bone

Primary
Inductance
(L1 in uH)

Secondary
Inductance
(L2 in uH)

Coupling
factor (k)

Figure of
merit
(

(Higher is
better)
Conf. 1

7.4

0.9

0.02

0.46

Conf. 2

7.42

0.338

0.034

7.4

QL1 and QL2 is the quality factor of primary and secondary coils

AFE, Large-scale demonstrator to ASIC

21

From Sensors

From large-scale demonstrator

FPGA

MCU

RFID
TX

To ASIC
ADC

LPF

uP

From Sensors

AMPS

CAL & CTRL

SPIIF

ASIC TBD

22

Analog Front-End Electronics (AFE)

Specifications

Sensor Type
Force
(Strain Gauge)

Provider

Interface

Sample Rate
[Sample /s]

Accuracy
[Bit]

Number of
Sensors

EPFL

Analog

2000

12

Honeywell

Analog

200

12

Bosch

Digital

2000

12

Temperature
(Proprietary)

ADI

Digital

100

12

Gyroscope
(Proprietary)

Honeywell

Digital

2000

12

Magnetic
(Mag. resist)
Accelerometer
(Proprietary)

Additional Required Functionality For ASIC

Sensor calibration routines
Sensor powering control (duty cycle)
Data processing (event detection, compression)
Data storage and retrieval

Outlook
23

First set of specifications established after 6 months

Large scale demonstrator architecture defined
New generations of magnetometers and gyroscope
under evaluation
First measurements to be performed with the
mechanical simulator

Team
Labs

Supervisors

PhD Students

Prof. Ryser

E. Meurville

Matteo Simoncini

Prof Aminian

H. Dejnabi

Arami Arasch

Dr. Dehollain

Oguz Atasoy

Prof. Renaud

A. Bertsch

Willyan Hasenkamp

Prof. Farine

S. Tanner

Ali Shafqat

Prof. Jolles-Hberli

Symbios

V. Leclerq

25

Thank you!