Contact pressure measurements in total knee replacements are often made using a discretized sensor such as the Tekscan K-Scan sensor.  However, no method currently exists for predicting the magnitude of sensor discretization errors in contact force, peak pressure, average pressure, and contact area, making it difficult to evaluate the accuracy or such measurements.  This study identifies a non-dimensional area variable, defined as the ratio of the number of perimeter elements to the total number of elements with pressure, which can be used to predict these errors.  The variable was evaluated by simulating discrete pressure sensors subjected to Hertzian and uniform pressure distributions with two different calibration procedures.  The simulations systematically varied the size of the sensor elements, the contact ellipse aspect ratio, and the ellipse's location on the sensor grid.  In addition, contact pressure measurements made with a K-Scan sensor on four different total knee designs were used to evaluate the magnitude of discretization errors under practical conditions.  The simulations predicted a strong power law relationship (r²>0.89) between worst-case discretization errors and the proposed non-dimensional area variable.  In the total knee experiments, predicted discretization errors were on the order of 1-4% for contact force and peak pressure, and 3-9% for average pressure and contact area.  These errors are comparable to those arising from inserting a sensor into the joint space or truncating pressures with pressure sensitive film.  The reported power law regression coefficients provide a simple way to estimate the accuracy of experimental measurements made with discrete pressure sensors when the contact patch is approximately elliptical.   

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Journal of Biomechanics 36
(2003) pp 609-613