Clemson University Implant Retrieval Program
Kevin Keith, Riley Csernica, Nicole Durig, Christine Stamer, Alison Lamb,
Ryan Quinn, Kathleen Parker, Estefania Alvarez, Melinda Harman, John D. DesJardins
Department of Bioengineering, Clemson University, Clemson, SC 29634
Introduction
International Translational Research
Community Outreach
The Clemson University Implant Retrieval Program is a student
led creative inquiry program created in 2008, and currently led by
Dr. John DesJardins and Dr. Melinda Harman. This program
provides an exciting opportunity for students to work with
orthopedic surgical teams from around the state to collect and
process explanted devices. Students are able to explore clinical
and experimental problems associated with surgical and patient
variables, implant designs, biomaterials and implant failure. This
semester the program collected its 250th implant, and now has
cooperative partnerships with 11 hospitals in South Carolina,
from which it collects implants. It is one of only a few implant
retrieval programs in the country, and distinguishes itself by
incorporating undergraduate education, biomaterials research
and community outreach its mission.
The Implant Retrieval Program collects explants from every region of
South Carolina. Merging with the BioMotion Foundation of West Palm
Beach, Florida in 2011, the program has expanded to include implants
from throughout the United States and Europe.
On March 28, 2012, high school students from Project Lead The
Way, a co-curricular STEM based educational program based in
Anderson, SC visited our program to begin mini research projects
with members of the retrieval team. CI members shared the
program’s mission with these
students,
sparking
potential
research proposals. By the end of
this month the high school student
teams will return to the lab for
hands-on processing of implant
retrievals and college preparatory
research; including implant data
logging, cleaning, photographing,
analyzing and storing. The students
will conclude their visit by giving a
brief presentation about the implant
they will conduct research on, to
demonstrate
and
share
the
knowledge they gained from the
hands on experience.
Retrieval Protocol
Explantation
Analysis
Orthopedics Today, www.slackinc.com/
Transportation
Figure 2: Geographic distribution of our partnerships throughout South Carolina
Evaluation
Implant Statistics
Cleaning
The total number of implants received from our SC partners as of April
10, 2012 was 257. Below is a breakdown from our main contributors.
CI and Program Dissemination
The Implant retrieval program is committed to educating
students in the areas of biomaterials and orthopaedic devices, and
to the dissemination of student research and educational
outcomes. To date, we have had 27 students participate in our
program, with over 14 undergraduate research presentations at
national and regional conferences. A few are listed below:
M.E. Wabler, C.J. Wright-Walker, E. Alvarez, J.D. DesJardins, Exploration, Development, and
Implementation of the Clemson University Retrieval of Explants Program in Orthopaedics (CUREPO), Southeast Biomedical Engineering Career Conference, 2009, Washington, DC.
Implant of the Month:
Implant number 85 was retrieved from a 76 year old obese, diabetic
patient in South Carolina in February of 2011. It was a LCS total knee
replacement designed by DePuy Orthopaedics. All three pieces (femoral
component, polyethylene insert, and tibial component) were removed
and replaced due to “loosening of the components”. This was the patients
second revision. The LCS stands for Low Contact Stress, in which the joint
load is distributed over a higher surface contact area. This implant
design was marketed to function more like a “normal knee”, because it
allows for rotation, unlike fixed bearing implants. Rotational implants are
often marketed toward young and active patients in an effort to provide
greater and more natural rotation during daily activities.
differences in hip anatomy. The
20mm plastic insert is much
thicker than a normal insert, and
is an indication that the patient is
losing more and more available
bone with each subsequent
revision.
Figure 1: Picture of Implant 85
J.D. DesJardins, E. Alvarez, M. Wabler, Exploration, Development and Implementation of the Retrieval
of Explants in Orthopaedics (REPO), ASEE, 2010, Louisville, KY.
E. Alvarez, M.E. Elpers, H.M. Cash, M.E. Wabler, J.D. DesJardins, Assessment of New Damage
Scoring Methodology for Total Knee Replacement Retrieval Analysis, Southeast Biomedical
Engineering Career Conference, 2010, Clemson, SC
M. Elpers, E. Alvarez, H. Cash, M. Wabler, B. Burnikel, J. Rodrigo, J. DesJardins, Comparative
Analysis of Damage to Retrieved Femoral and Tibial NexGen PS Components, Biomedical
Engineering Society, 2010 Austin, TX
E. Sloan, E. Alvarez, M. Elpers, H. Cash, M. Wabler, J. DesJardins, Analysis and Damage
Characterization of PS Total Knee Joint Replacement Posts, Biomedical Engineering Society,
2010, Austin, TX.
L. Nunez, M.K. Harman, Training for Non-Destructive Analysis of Ultra-High Molecular Weight
Polyethylene Joint Replacement Bearings. Biomaterials Day, 2012, Memphis, TN.
E. Alvarez, MK Harman, JD DesJardins: Development and Assessment of Knee Femoral Components
Surface Damage Classification and Training Method, Orthopaedic Research Society, 2012, San
Francisco, CA.
Acknowledgements
TOTAL
257
We would like to thank the Clemson University Creative Inquiry program for supporting
this work through funding and administrative assistance. We would like to thank our
collaborating physicians and their institutions contributions in time and resources, and
the Implant Retrieval Creative Inquiry Students, past and present.
For further information on this CI program, please contact:
Dr. John DesJardins (jdesjar@clemson.edu) or Dr. Melinda Harman (harman2@clemson.edu), Department of Bioengineering