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Aseptic loosening, or loss of implant fixation, is a common complicationfollowing total joint replacement. Revision surgeries cost the healthcaresystem over $8 billion annually in the US. Despite the prevalence of asepticloosening, timely and accurate detection remains a challenge becausetraditional imaging modalities such as plain radiographs struggle to reliablydetect the early stages of implant loosening. Motivated by this challenge, wepresent a novel approach for in vivo monitoring and failure detection ofcemented joint replacements. Poly(methyl methacrylate) (PMMA) bone cement ismodified with low volume fractions of chopped carbon fiber (CF) to impartpiezoresistive-based self-sensing. Electrical impedance tomography (EIT) isthen used to detect and monitor load-induced deformation and fracture ofCF/PMMA in a phantom tank. We therefore show that EIT indeed is able to adeptlydetect loading force on a prosthetic surrogate, distinguish between increasingload magnitudes, detect failure of implant fixation, and even distinguishbetween cement cracking and cement de-bonding. Because EIT is a low-cost,physiologically benign, and potentially real-time imaging modality, thefeasibility study herein presented has potential to transform the standard ofcare for post-operative monitoring of implant conditions. Beyond clinicalrelevance, this technique could positively impact orthopedic researchers byproviding, via in vivo monitoring, insight into the factors that initiateaseptic loosening.

Interfacial Load Monitoring and Failure Detection in Total Joint Replacements via Piezoresistive Bone Cement and Electrical Impedance Tomography