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https://www.readbyqxmd.com/read/29762278/comparison-of-intermediate-to-long-term-outcomes-of-total-ankle-arthroplasty-in-ankles-with-preoperative-varus-valgus-and-neutral-alignment
#1
Gun-Woo Lee, Shao-Hua Wang, Keun-Bae Lee
BACKGROUND: Preoperative ankle coronal malalignment has been considered as a risk factor for poor outcomes and failure after total ankle arthroplasty. The present study evaluated whether intermediate to long-term outcomes of total ankle arthroplasty in ankles with preoperative varus and valgus malalignment (5° to 20°) are comparable with those with neutral alignment (<5°). METHODS: We enrolled 144 consecutive ankles that underwent primary total ankle arthroplasty (140 patients) using a mobile-bearing HINTEGRA prosthesis with a minimum follow-up of 4 years; the mean overall follow-up duration was 89 months (51 to 145 months)...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29752234/a-stair-ascent-and-descent-controller-for-a-powered-ankle-prosthesis
#2
Steven Culver, Harrison Bartlett, Amanda Shultz, Michael Goldfarb
This paper presents a control system for a powered transtibial prosthesis that provides stair ascent and descent capability, as well as ability for user-controlled transitions between walking, standing, stair ascent, and stair descent. The control system was implemented on a powered prosthesis and evaluated on a single unilateral transtibial amputee subject. The ability of the prosthesis to provide appropriate functionality during stair ascent and descent was assessed by comparing gait kinematics and kinetics of the prosthesis to those of a passive dynamic elastic response prosthesis and those of a set of non-amputee subjects...
May 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/29723652/kinetic-differences-between-level-walking-and-ramp-descent-in-individuals-with-unilateral-transfemoral-amputation-using-a-prosthetic-knee-without-a-stance-control-mechanism
#3
Yusuke Okita, Nobuya Yamasaki, Takashi Nakamura, Tsutomu Kubo, Atsuko Mitsumoto, Toru Akune
BACKGROUND: Individuals with transfemoral amputation (TFA) have difficulty in descending ramps. Although individuals with TFA who descend ramps are speculated to have greater biomechanical demands, this has not been quantified. RESEARCH QUESTION: How do individuals with TFA wearing a prosthetic knee without a stance control mechanism adapt their gait biomechanics to a slightly declined surface? METHODS: We retrospectively analyzed data of level walking and ramp descent (5° decline) from six subjects with TFA who used a prosthesis without a stance control mechanism...
April 26, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29716723/experimental-evaluation-of-current-and-novel-approximations-of-articular-surfaces-of-the-ankle-joint
#4
Claudio Belvedere, Sorin Siegler, Andrea Ensini, Jason Toy, Paolo Caravaggi, Ramya Namani, Luca Giuseppe Princi, Stefano Durante, Alberto Leardini
Kinematics and flexibility properties of both natural and replaced ankle joints are affected by the geometry of the articulating surfaces. Recent studies proposed an original saddle-shaped, skewed, truncated cone with laterally oriented apex, as tibiotalar contact surfaces for ankle prosthesis. The goal of this study was to compare in vitro this novel design with traditional cylindrical or medially centered conic geometries in terms of their ability to replicate the natural ankle joint mechanics. Ten lower limb cadaver specimens underwent a validated process of custom design for the replacement of the natural ankle joint...
April 24, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29668534/comparison-between-three-types-of-prosthetic-feet-a-randomized-double-blind-single-subject-multiple-rater-trial
#5
Helena Burger, Gaj Vidmar, Branko Zdovc, Dominik Erzar, Metka Zalar
There are many prosthetic feet (Pfeet) on the market, and those in the same category do not necessarily have the same properties. We assessed three different Pfeet in terms of gait patterns on various terrains, balance and walking speed in a randomized double-blind controlled single-subject multiple-rater clinical trial. The patient was a 43-year old man who was an active prosthesis user and was amputated at transtibial level because of injury 17 years ago. One Solid Ankle Cushion Heel and two Dynamic Elastic Response (DER) Pfeet were tried six times in random order...
April 17, 2018: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/29662779/finite-element-analysis-of-biomechanical-effects-of-total-ankle-arthroplasty-on-the-foot
#6
Yan Wang, Zengyong Li, Duo Wai-Chi Wong, Cheng-Kung Cheng, Ming Zhang
Background: Total ankle arthroplasty is gaining popularity as an alternation to ankle arthrodesis for end-stage ankle arthritis. Owing to the complex anatomical characteristics of the ankle joint, total ankle arthroplasty has higher failure rates. Biomechanical exploration of the effects of total ankle arthroplasty on the foot and ankle is imperative for the precaution of postoperative complications. The objectives of this study are (1) to investigate the biomechanical differences of the foot and ankle between the foot with total ankle arthroplasty and the intact foot and (2) to investigate the performance of the three-component ankle prosthesis...
January 2018: Journal of Orthopaedic Translation
https://www.readbyqxmd.com/read/29623812/the-efficacy-of-the-ankle-mimicking-prosthetic-foot-prototype-4-0-during-walking-physiological-determinants
#7
Kevin De Pauw, Pierre Cherelle, Bart Roelands, Dirk Lefeber, Romain Meeusen
BACKGROUND: Evaluating the effectiveness of a novel prosthetic device during walking is an important step in product development. OBJECTIVE: To investigate the efficacy of a novel quasi-passive ankle prosthetic device, Ankle Mimicking Prosthetic Foot 4.0, during walking at different speeds, using physiological determinants in transtibial and transfemoral amputees. STUDY DESIGN: Nonrandomized crossover design for amputees. METHODS: Six able-bodied subjects, six unilateral transtibial amputees, and six unilateral transfemoral amputees underwent a 6-min walk test at normal speed, followed by series of 2-min walking at slow, normal, and fast speeds...
April 1, 2018: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29623025/impact-of-powered-knee-ankle-prosthesis-on-low-back-muscle-mechanics-in-transfemoral-amputees-a-case-series
#8
Chandrasekaran Jayaraman, Shenan Hoppe-Ludwig, Susan Deems-Dluhy, Matt McGuire, Chaithanya Mummidisetty, Rachel Siegal, Aileen Naef, Brian E Lawson, Michael Goldfarb, Keith E Gordon, Arun Jayaraman
Regular use of prostheses is critical for individuals with lower limb amputations to achieve everyday mobility, maintain physical and physiological health, and achieve a better quality of life. Use of prostheses is influenced by numerous factors, with prosthetic design playing a critical role in facilitating mobility for an amputee. Thus, prostheses design can either promote biomechanically efficient or inefficient gait behavior. In addition to increased energy expenditure, inefficient gait behavior can expose prosthetic user to an increased risk of secondary musculoskeletal injuries and may eventually lead to rejection of the prosthesis...
2018: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29560526/total-ankle-replacement-leads-to-high-revision-rates-in-post-traumatic-end-stage-arthrosis
#9
Yves Gramlich, Oliver Neun, Alexander Klug, Johannes Buckup, Thomas Stein, Arvid Neumann, Sebastian Fischer, Hans-Peter Abt, Reinhard Hoffmann
INTRODUCTION: Extremely heterogeneous revision rates in total ankle arthroplasty (TAA) of the upper ankle joint are reported and result to heterogeneous collectives and to short follow-up times. The aim is to investigate revision rates and the underlying reasons, as well as treatment outcome and quality of life after TAA in post-traumatic cases with sufficient follow-up. METHODS: In 2008-2013, 74 patients with post-traumatic arthrosis were treated using TAA with a Tornier Salto prosthesis, and 60 (35 males and 25 females; mean age 56) were followed-up (mean: 59 months; range 24-91 months)...
March 20, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29538382/a-systematic-review-of-randomised-controlled-trials-assessing-effectiveness-of-prosthetic-and-orthotic-interventions
#10
Aoife Healy, Sybil Farmer, Anand Pandyan, Nachiappan Chockalingam
BACKGROUND: Assistive products are items which allow older people and people with disabilities to be able to live a healthy, productive and dignified life. It has been estimated that approximately 1.5% of the world's population need a prosthesis or orthosis. OBJECTIVE: The objective of this study was to systematically identify and review the evidence from randomized controlled trials assessing effectiveness and cost-effectiveness of prosthetic and orthotic interventions...
2018: PloS One
https://www.readbyqxmd.com/read/29451922/identifying-classifier-input-signals-to-predict-a-cross-slope-during-transtibial-amputee-walking
#11
Courtney E Shell, Glenn K Klute, Richard R Neptune
Advanced prosthetic foot designs often incorporate mechanisms that adapt to terrain changes in real-time to improve mobility. Early identification of terrain (e.g., cross-slopes) is critical to appropriate adaptation. This study suggests that a simple classifier based on linear discriminant analysis can accurately predict a cross-slope encountered (0°, -15°, 15°) using measurements from the residual limb, primarily from the prosthesis itself. The classifier was trained and tested offline using motion capture and in-pylon sensor data collected during walking trials in mid-swing and early stance...
2018: PloS One
https://www.readbyqxmd.com/read/29441817/return-to-surfing-using-an-adapted-prosthesis-a-case-report
#12
Erica Schvirtz, Laurent Bensoussan, Bertrand Tourret Couderc, Jean-Michel Viton, Alain Delarque, Marjorie Kerzoncuf
BACKGROUND: Surfing with transfemoral knee prosthesis requires flexion of the hip, knee, and ankle and balance between flexibility and stiffness of the prosthetic limb. We report on Mr D, a transfemoral amputee, who wanted to surf again. Case Description and Methods: Technical specifications were based on Mr D's complaint. The prosthesis is salt water resistant and combines a shock absorber associated with elastic tendons to permit the knee to bend easily and to facilitate eccentric braking...
February 1, 2018: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29409218/use-of-masquelet-s-technique-for-treating-the-first-metatarsophalangeal-joint-in-cases-of-gout-combined-with-a-massive-bone-defect
#13
Feng Liu, Ruo-Kun Huang, Ming Xie, Hao Pan, Jing-Jing Zhao, Bo Lei
BACKGROUND: To examine the safety and efficacy of Masquelet's technique as a surgical method for treating the first metatarsophalangeal joint in cases of gout accompanied by a massive bone defect. METHODS: From January 2010 to January 2016, eleven patients (7 males and 4 females; mean age 33.1 years; range, 23-43 years) received surgical treatment for a first metatarsophalangeal joint tophus which caused a serious bone defect. The first metatarsophalangeal bone defects ranged from 3-6cm, or nearly 50% of the length of normal bone...
April 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29409180/conversion-of-painful-tibiotalocalcaneal-arthrodesis-to-total-ankle-replacement-using-a-3-component-mobile-bearing-prosthesis
#14
Markus Preis, Travis Bailey, Lucas S Marchand, Maxwell W Weinberg, Matthijs Jacxsens, Alexej Barg
BACKGROUND: The aim of this study was to assess the short-term clinical and radiographic outcomes in patients who underwent conversion of a painful tibiotalocalcaneal arthrodesis to a total ankle replacement. METHODS: Six patients with painful ankle arthrodesis after tibiotalocalcaneal arthrodesis were included in this study. In all patients, conversion to total ankle replacement was performed using a 3rd -generation, non-constrained, cementless three-component prosthesis...
December 17, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29403259/toward-unified-control-of-a-powered-prosthetic-leg-a-simulation-study
#15
David Quintero, Anne E Martin, Robert D Gregg
This brief presents a novel control strategy for a powered knee-ankle prosthesis that unifies the entire gait cycle, eliminating the need to switch between controllers during different periods of gait. A reduced-order Discrete Fourier Transformation (DFT) is used to define virtual constraints that continuously parameterize periodic joint patterns as functions of a mechanical phasing variable. In order to leverage the provable stability properties of Hybrid Zero Dynamics (HZD), hybrid-invariant Bézier polynomials are converted into unified DFT virtual constraints for various walking speeds...
January 2018: IEEE Transactions on Control Systems Technology: a Publication of the IEEE Control Systems Society
https://www.readbyqxmd.com/read/29389250/scandinavian-total-ankle-replacement-15-year-follow-up
#16
Ariel Palanca, Roger A Mann, Jeffrey A Mann, Andrew Haskell
BACKGROUND: Over the past decade, total ankle arthroplasty (TAA) has become a mainstay in the treatment of end-stage ankle arthritis. Currently in its fourth generation, the Scandanavian Total Ankle Replacement (STAR) is the only 3-piece mobile bearing ankle prosthesis available in the United States. Our current study reports implant survivorship at 15 years and patient outcomes for a subset of these survivors available for study. METHODS: Eighty-four TAAs were performed between 1998 and 2000...
February 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29386704/negative-pressure-wound-therapy-in-the-management-of-mine-blast-injuries-of-lower-limbs-lessons-learnt-at-a-tertiary-care-center
#17
Sanjay Maurya, N Srinath, P S Bhandari
Background: Mine blast injuries of foot are devastating injuries that result in composite tissue loss or amputations. Negative pressure wound therapy has helped in the management of such combat-related wounds. The aim of this study was to report experiences gained in managing such injuries at a tertiary care center. Methods: 17 combatants who sustained mine blast injuries were included in this study. Severity of foot injury was assessed as per Foot and Ankle Severity Score...
October 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/29384949/compound-grafting-of-residual-vascularized-fibular-head-flap-to-reconstruct-contralateral-lateral-malleolus-a-case-report
#18
Peiji Wang, Man-Yi Cui, Jiaju Zhao, Jun Lv
RATIONALE: Serious external ankle injuries caused by high-energy trauma are often associated not only with bone defect but also with a loss of skin and soft tissue that seriously affects ankle function. Therefore, it is particularly important to reconstruct the external ankle. PATIENT CONCERNS: The patient was a 64-year-old man with destructive injury of both lower extremities due to a machine accident. His left ankle and heel bone, along with the soft tissue, were torn off, and the peripheral blood supply and sensation to the toes of the left foot were lost concerns...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29374491/prosthetic-energy-return-during-walking-increases-after-3-weeks-of-adaptation-to-a-new-device
#19
Samuel F Ray, Shane R Wurdeman, Kota Z Takahashi
BACKGROUND: There are many studies that have investigated biomechanical differences among prosthetic feet, but not changes due to adaptation over time. There is a need for objective measures to quantify the process of adaptation for individuals with a transtibial amputation. Mechanical power and work profiles are a primary focus for modern energy-storage-and-return type prostheses, which strive to increase energy return from the prosthesis. The amount of energy a prosthesis stores and returns (i...
January 27, 2018: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/29298695/vub-cyberlegs-cybathlon-2016-beta-prosthesis-case-study-in-control-of-an-active-two-degree-of-freedom-transfemoral-prosthesis
#20
Louis L Flynn, Joost Geeroms, Tom van der Hoeven, Bram Vanderborght, Dirk Lefeber
BACKGROUND: Here we present how the CYBERLEGs Beta-Prosthesis was modified with a new control system to participate in the Powered Leg Prosthesis event, and to report on our experience at the CYBATHLON 2016 which was held in Zurich, Switzerland in October 2016. The prosthesis has two active degrees of freedom which assist the user with extra joint power at the knee and ankle to complete tasks. The CYBATHLON is a championship for people with disabilities competing in six disciplines, using advanced assistive devices...
January 3, 2018: Journal of Neuroengineering and Rehabilitation
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