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Ankle prosthesis

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
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
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
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...
February 17, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
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
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
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
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
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)
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
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
Travis J Dekker, Kamran S Hamid, Andrew E Federer, John R Steele, Mark E Easley, James A Nunley, Samuel B Adams
BACKGROUND: The proposed benefit of total ankle replacement (TAR) over ankle fusion is preserved ankle motion, thus we hypothesized that an increase in range of motion (ROM) is positively correlated with validated patient-reported outcome measures (PROMs) in individuals receiving TAR. METHODS: Patients undergoing TAR at a single academic medical center between 2007 and 2013 were evaluated in this study. In addition to a minimum of 2-year follow-up, complete preoperative and postoperative outcome measures for the Foot and Ankle Disability Index (FADI), Short Musculoskeletal Function Assessment (SMFA) Bother and Function Indices, Visual Analog Scale (VAS), and 36-Item Short Form Health Survey (SF-36) were requisite for inclusion...
December 1, 2017: Foot & Ankle Specialist
Nikolaos Kontopodis, Stella Lioudaki, Christos Chronis, Paris Kalogerakos, George Lazopoulos, Alexandra Papaioannou, Christos V Ioannou
BACKGROUND: Critical limb ischemia (CLI) often results from multilevel occlusive disease. There are occasions where a patent profunda femoral artery (PFA) is the only target artery that can be used as outflow during reconstruction to bypass aortoiliac disease (AOID), with no further option for infrainguinal revascularization. We aim to report results of the use of PFA as the sole target vessel for the treatment of these patients. METHODS: This is a retrospective, single-center study including CLI patients treated during 36 months...
April 2018: Annals of Vascular Surgery
Elizabeth Russell Esposito, Delbert H Lipe, Christopher A Rábago
BACKGROUND: Walking in high heels presents biomechanical challenges, yet they remain part of many women's attire. However, women with a lower limb amputation are limited in available footwear options. Case description and methods: This case study is in response to one patient's assertion that she walked better and more symmetrically in heels than flat shoes with her below-knee prosthesis. She underwent gait analysis in athletic shoes and 10-cm stiletto high heels worn with a pediatric running foot to determine if these claims could be substantiated through biomechanical measures...
November 1, 2017: Prosthetics and Orthotics International
Sandrine Mariaux, Ulrika Furustrand Tafin, Olivier Borens
Introduction: When treating periprosthetic joint infections with a two-stage procedure, antibiotic-impregnated spacers are used in the interval between removal of prosthesis and reimplantation. According to our experience, cultures of sonicated spacers are most often negative. The objective of our study was to investigate whether PCR analysis would improve the detection of bacteria in the spacer sonication fluid. Methods: A prospective monocentric study was performed from September 2014 to January 2016. Inclusion criteria were two-stage procedure for prosthetic infection and agreement of the patient to participate in the study...
2017: Journal of Bone and Joint Infection
Nicola Maffulli, Umile Giuseppe Longo, Joel Locher, Giovanni Romeo, Giuseppe Salvatore, Vincenzo Denaro
Introduction: In advanced stages of ankle osteoarthritis (OA), ankle arthrodesis (AA) or total ankle arthroplasty (TAR) may be necessary. Our purpose is to compare AA and total ankle replacement for the surgical management of end stage ankle OA. Sources of data: We conducted a literature search of PubMed, Medline, CINAHL, Cochrane, Embase and Google Scholar databases using the terms 'ankle' in combination with 'OA', 'arthrodesis', 'arthroplasty', 'joint fusion', 'joint replacement'...
December 1, 2017: British Medical Bulletin
Myunghee Kim, Steven H Collins
Below-knee amputation is associated with higher energy expenditure during walking, partially due to difficulty maintaining balance. We previously found that once-per-step push-off work control can reduce balance-related effort, both in simulation and in experiments with human participants. Simulations also suggested that changing ankle inversion/eversion torque on each step, in response to changes in body state, could assist with balance. In this study, we investigated the effects of ankle inversion/eversion torque modulation on balance-related effort among amputees ( N = 5) using a multi-actuated ankle-foot prosthesis emulator...
2017: Frontiers in Neurorobotics
Nienke M Kosse, Petra J C Heesterbeek, Janneke J P Schimmel, Gijs G van Hellemondt, Ate B Wymenga, Koen C Defoort
PURPOSE: The primary aim of the study was to examine stability and alignment after total knee arthroplasty (TKA) using patient-specific instrumentation (PSI) and conventional instrumentation (CI). The hypothesis was that stability and alignment would be better using PSI than CI, 12 months postoperatively. The secondary aim included the evaluation of clinical outcomes after TKA. METHODS: In this prospective randomized controlled trial, 42 patients with knee osteoarthritis received a Genesis II PS prosthesis with either PSI or CI...
November 28, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Nicolo Martinelli, Silvia Baretta, Jenny Pagano, Alberto Bianchi, Tomaso Villa, Gloria Casaroli, Fabio Galbusera
BACKGROUND: Mobile-bearing ankle implants with good clinical results continued to increase the popularity of total ankle arthroplasty to address endstage ankle osteoarthritis preserving joint movement. Alternative solutions used fixed-bearing designs, which increase stability and reduce the risk of bearing dislocation, but with a theoretical increase of contact stresses leading to a higher polyethylene wear. The purpose of this study was to investigate the contact stresses, pressure and area in the polyethylene component of a new total ankle replacement with a fixed-bearing design, using 3D finite element analysis...
November 25, 2017: BMC Musculoskeletal Disorders
Florian Wanivenhaus, Jacqueline Fust, Matthias Erschbamer, Andreas Schirm
This study examined function, pain, satisfaction, and radiologic outcomes among patients treated with first metatarsophalangeal hemiarthroplasty. Patients were invited to participate in an outcome study conducted with questionnaires on subjective and objective outcomes and clinical and radiographic follow-up. A total of 12 patients (12 feet; mean patient age, 58.8±12.3 years) agreed to participate. Mean follow-up was 22.3±19.8 months. Of these patients, 7 were satisfied with the postoperative result. The mean visual analog scale pain score decreased significantly from 7...
November 20, 2017: Orthopedics
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