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This page provides specifications of knee specimen '''OKS002'''. This is a (possibly osteoarthritic) elderly female specimen candidate.
<<TableOfContents>>
== Specimen Characteristics ==
Right knee
'''Gender:''' ''Female''
'''Age:''' ''67 years''
'''Race:''' ''White ''
'''Height:''' ''1.55 m''
'''Weight:''' ''45.3 kg''
'''BMI:''' ''18.9''
'''Serologically tested:''' ''Yes''
'''X-Ray:'''
{{attachment:oks002_2.png}}
== Experimentation ==
-- [[aerdemir]] <<DateTime(2014-11-03T14:19:24Z)>> All, please complete relevant sections of this page during and after experimentation.
=== Specimen ===
'''Reference Specification:''' [[Specifications/Specimens]] - [[http://wiki.simtk.org/openknee/Specifications/Specimens?action=recall&rev=40|Revision as of November 2, 2014]]
'''Leading Team Member:''' Snehal Chokhandre
'''Supporting Team Members:''' Ahmet Erdemir
'''Timeline:''' November 2, 2014 @ ~ 9:00 AM (specimen pulled out of freezer)
'''Data Location:''' In this page.
'''Protocol Deviations:'''
1. None.
'''Notes:'''
1. None.
=== Specimen Preparation ===
'''Reference Specification:''' [[Specifications/SpecimenPreparation]] - [[http://wiki.simtk.org/openknee/Specifications/SpecimenPreparation?action=recall&rev=130|Revision as of November 3, 2014]]
'''Leading Team Member:''' Tara Bonner
'''Supporting Team Members:''' Snehal Chokhandre, Craig Bennetts, Ahmet Erdemir, Eryn Merico
'''Timeline:'''
. Thawing: ~9:00 AM November 2, 2014 - ~9:00 AM November 3, 2014
. Dissection: ~9:00 AM - ~10:00 AM November 3, 2014
. Assembly of Optotrak Base Plugs: ~10:00 AM - 11:00 AM November 3, 2014
. Assembly of Registration Markers: ~11:00 AM - 12:00 AM November 3, 2014
. Probing of Anatomical Landmarks: ~12:00 AM - 1:00 PM November 3, 2014
. Probing of Registration Markers: ~12:00 AM - 1:00 PM November 3, 2014
'''Data Location:'''
'''Protocol Deviations:'''
1. In specimen dissection, proximal and distal tissue regions (for femur and tibia, respectively) were marked as 4.5 inches. This is needed to accommodate symmetric bone cutting levels, which was recently incorporated in the specifications. THIS IS A SPECIFICATION UPDATE to accommodate flipping of the joint between tibiofemoral and patellofemoral testing.
'''Notes:'''
1. A soft copy of serological testing for this specimen and all others should be placed in the in-house data management system in the appropriate specimen folder.
1. Specimen was thawed for 24 hours unwrapped. This may be a good guideline to update specimen preparation specifications.
1. For patella registration and Optotrak marker alignments, brass base plugs were used. Note that the use of a plug simply ensures referencing of the marker sets to the same position and orientation.
1. For patella registration and Optotrak marker alignments, the order of divot probing was the same as oks001. A picture is available to denote this order, which should be included in specimen preparation specifications.
1. One of the femur registration markers was placed anterolaterally rather than anterior or anteromedially.
1. Data from coordinate system optimization (passive flexion) and pre-conditioning are also collected if needed.
=== Joint Imaging ===
==== Specimen Preparation ====
'''Reference Specification:''' [[Specifications/SpecimenPreparation]] - [[http://wiki.simtk.org/openknee/Specifications/SpecimenPreparation?action=recall&rev=130|Revision as of November 3, 2014]]
'''Leading Team Member:''' Craig Bennetts
'''Supporting Team Members:''' Snehal Chokhandre
'''Timeline:''' ~1:00 PM - 2:00 PM November 3, 2014 (patella registration marker will be placed next day)
'''Data Location:'''
'''Protocol Deviations:'''
1. None.
'''Notes:'''
1. None.
==== Imaging ====
'''Reference Specification:''' [[Specifications/ExperimentationAnatomicalImaging]] - [[http://wiki.simtk.org/openknee/Specifications/ExperimentationAnatomicalImaging?action=recall&rev=120|Revision as of November 4, 2014]]
'''Leading Team Member:''' Craig Bennetts
'''Supporting Team Members:''' Snehal Chokhandre, Ahmet Erdemir
'''Timeline:'''
. Specimen Placement in Transportation Fixture: 8:30 AM - 9:20 AM November 4, 2014
. Imaging: 10:00 AM - ~12:00 PM November 4, 2014
'''Data Location:'''
Data was received from the imaging facilities and uploaded to in-house data management server (http://cobicore.lerner.ccf.org/midas; only accessible within Cleveland Clinic network). Raw DICOM files were stored in the folder Open Knee(s) --> Private --> oks002 --> MRI --> DICOM
DICOM files were converted to NIfTI files, stored in the folder Open Knee(s) --> Private --> oks002 --> MRI --> NIFTI of the in-house data management server. NIfTI files were also disseminated to the public in the 'Downloads' section of the project website, https://simtk.org/home/openknee, under the package oks002.
Data storage and dissemination were accomplished based on the updated imaging specifications, see [[http://wiki.simtk.org/openknee/Specifications/ExperimentationAnatomicalImaging?action=recall&rev=118|Revision as of April 16, 2015]].
'''Protocol Deviations:'''
1. Specimen was inserted tibia first in scanner.
1. DICOM to NIfTI conversion was accomplished manually using 3D Slicer.
'''Notes:'''
* General purpose imaging
{{attachment:general-purpose.png}}
* Cartilage imaging
{{attachment:cartilage.png}}
* Connective tissue imaging
{{attachment:connective-tissue.png}}
=== Joint Mechanics ===
==== Equipment Preparation ====
'''Reference Specification:''' [[Specifications/PressureCalibration]] - [[http://wiki.simtk.org/openknee/Specifications/PressureCalibration?action=recall&rev=17|Revision as of November 4, 2014]]
'''Leading Team Member:''' Robb Colbrunn
'''Supporting Team Members:''' Ahmet Erdemir
'''Timeline:''' 9:30 AM - 11:40 AM November 4, 2014
'''Data Location:'''
'''Protocol Deviations:'''
1. None.
'''Notes:'''
1. Sensor model is 5051, label is 5051-P1-16813DT1-1200.
1. Equilibration pressure is 6.21 bars. Equilibration is done with Equilibration-1 and Equilibration-2; files are saved as single pass and double pass accordingly. Equilibration files are available in the oks002 folder of pressure sensor measurement laptop.
1. Calibration used single pass equilibration as double pass was problematic (maybe double pass equilibration needs two distinct loading). Calibration file is available in the oks002 folder of pressure sensor measurement laptop.
==== Specimen Preparation ====
'''Reference Specification:''' [[Specifications/SpecimenPreparation]] - [[http://wiki.simtk.org/openknee/Specifications/SpecimenPreparation?action=recall&rev=130|Revision as of November 4, 2014]]
'''Leading Team Member:''' Tara Bonner
'''Supporting Team Members:'''
'''Timeline:'''
. Specimen preparation for TFJ testing: 11:45 PM - 1:00 PM November 4, 2014
. Specimen preparation for PFJ testing: 7:00 AM - ~8:00 AM November 5, 2014
'''Data Location:'''
'''Protocol Deviations:'''
1. For patellofemoral joint testing, grommets were not used for placement of the pressure sensor. The knee was small. To place the sensor, the cavity of the patellofemoral joint was exposed. Without disrupting the surrounding capsular structure, the sensor insertion area was cleaned up. The sensor was curved transversely, which gave it some stiffness along the insertion direction, and pushed through the joint as far as possible. This may be a specification change to expedite preparation. The sensor was actually placed on the robot.
'''Notes:'''
1. A woodscrew was used to fix fibula to the tibia. The bone quality of the specimen seemed low and a drill bit passed through these bones were loose. Therefore the drill bit was pulled out and a woodscrew was used to secure
1. During potting bottoms of the tubes were 7.5 inches away from epicondylar axis. This needs to be updated in the specifications.
1. During tibiofemoral joint mounting, the specimen appeared to be a valgus knee.
1. For patellofemoral joint testing, the specifications need to provide the location of quadriceps tendon clamp attachment. The loop of the clamp should be slightly above the bottom plane of femur pot.
==== Testing ====
'''Reference Specification:''' [[Specifications/ExperimentationJointMechanics]] - [[http://wiki.simtk.org/openknee/Specifications/ExperimentationJointMechanics?action=recall&rev=91|Revision as of November 4, 2014]]
'''Leading Team Member:''' Tara Bonner
'''Supporting Team Members:''' Robb Colbrunn
'''Timeline:'''
. Specimen Mounting for TFJ testing: 1:00 PM November 4, 2014
. Testing of TFJ: 1:30 AM - 4:00 PM November 4, 2014
. Specimen Mounting for PFJ testing: 8:30 AM - 9:30 AM November 5, 2014
. Testing of PFJ: 9:30 AM - 10:30 AM November 5, 2014
'''Data Location:'''
Data was received from the robotics testing facility and uploaded to in-house data management server (http://cobicore.lerner.ccf.org/midas; only accessible within Cleveland Clinic network). Zipped folders were stored in the folder Open Knee(s) --> Private --> oks002 --> !JointMechanics under relevant joint related folders.
Zipped folders were extracted and organized in the dissemination folder under Open Knee(s) --> Private --> oks002 --> !JointMechanics --> DISSEMINATION of the in-house data management server. DISSEMINATION folder was downloaded and disseminated to the public in the 'Downloads' section of the project website, https://simtk.org/home/openknee, under the package oks002.
Data storage and dissemination were accomplished based on the updated joint mechanics testing specifications, see [[http://wiki.simtk.org/openknee/Specifications/ExperimentationJointMechanics?action=recall&rev=102|Revision as of September 16, 2015]].
'''Protocol Deviations:'''
1. None.
'''Notes:'''
1. Reproducibility tests (AP laxity at 30 degrees) used 5 seconds wait instead of 10 seconds wait of the actual laxity tests. This seem to be the case in all previous specimens and causes an issue at low forces only. The specifications may need to be updated to refer this test as reproducibility test and indicate its wait time.
1. Quadriceps line of action was digitized in the order of inferior then mid then superior. This may need to be described in the specifications in more detail.
1. Version of simVITRO software used was unreleased revision 3024 of the repository. The files can be found in svn://dev.lerner.ccf.org/data1/svn/repos/colbrunn-svn/Projects/Numbered Projects/2013CB-031 Open Knee/Original simVITRO-Tested on oks001 oks002 oks003 oks004
=== Tissue Mechanics ===
==== Specimen Preparation ====
'''Reference Specification:'''
'''Leading Team Member:'''
'''Supporting Team Members:'''
'''Timeline:'''
'''Data Location:'''
'''Protocol Deviations:'''
1. None.
'''Notes:'''
1. Semitendinosus tendon was dissected and stored.
1. Medial and lateral capsular components were dissected and stored.
1. Fat bursa under patellar ligament was dissected and stored.
1. ACL and PCL had fibrous and fatty connections, which were dissected.
1. Fibula was dissected and stored.
1. Femoral cartilage was divided into 9 regions (3 for medial condyle, 3 for lateral condyle, 3 for patellar groove) with 3 targeted for dissection (femoral grove, medial condyle - mid section, lateral condyle - mid section.
1. Medial and lateral tibial cartilage was targeted to be dissected as a whole.
1. Patellar cartilage had significant wear. The medial half that exhibited less wear was targeted for dissection.
==== Testing ====
'''Reference Specification:'''
'''Leading Team Member:'''
'''Supporting Team Members:'''
'''Timeline:'''
'''Data Location:'''
'''Protocol Deviations:'''
1. None.
'''Notes:'''
1. None.
== Data Analysis ==
=== Registration ===
==== Spherical Markers ====
1. Femur
1. <Posterior>oks002_MRG_FMR-P_AGS_01.stl
1. <Lateral>oks002_MRG_FMR-L_AGS_01.stl
1. <Medial>oks002_MRG_FMR-M_AGS_01.stl
1. Tibia
1. <Posterior>oks002_MRG_TBR-P_AGS_01.stl
1. <Lateral>oks002_MRG_TBR-L_AGS_01.stl
1. <Medial>oks002_MRG_TBR-M_AGS_01.stl
1. Patella
1. <Superior>oks002_MRG_PTR-S_AGS_01.stl
1. <Lateral>oks002_MRG_PTR-L_AGS_01.stl
1. <Medial>oks002_MRG_PTR-M_AGS_01.stl
==== Digitizing Order ====
1. Tibia:
* Sphere 1 = Lateral
* Sphere 2 = Medial
* Sphere 3 = Posterior
1. Femur:
* Sphere 1 = Lateral
* Sphere 2 = Medial
* Sphere 3 = Posterior
=== Joint Mechanical Testing ===
Pictured below are the Anterior Posterior laxity graph, the IR/ER laxity graph, and the Varus/Valgus laxity graph.
{{attachment:oks002_2LaxityGraphs.png}}
== Modeling & Simulation ==