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https://www.readbyqxmd.com/read/28198595/free-microvascular-rotationplasty-with-nerve-repair-for-rhabdomyosarcoma-in-a-18-month-old-patient
#1
Alberto Pérez-García, Marta Salom, María Eloísa Villaverde-Doménech, Francisco Baixauli, Eduardo Simón-Sanz
Rotationplasty is a limb-sparing surgical option in lower limb malignancies. Sciatic or tibial nerve encasement has been considered an absolute contraindication to this procedure. We report a case of an 18-month-old girl with a rhabdomyosarcoma that affected the leg and popliteal fossa, with neurovascular involvement. Knee and proximal leg intercalary resection was performed followed by reconstruction with free microvascular rotationplasty and neurorraphy from tibial division of sciatic nerve to sural and tibial nerves, and from saphenous nerve to superficial peroneal nerve...
February 15, 2017: Microsurgery
https://www.readbyqxmd.com/read/28196036/a-prospective-study-of-four-total-ankle-arthroplasty-implants-by-non-designer-investigators
#2
Tina Lefrancois, Alastair Younger, Kevin Wing, Murray J Penner, Peter Dryden, Hubert Wong, Timothy Daniels, Mark Glazebrook
BACKGROUND: There are several types of prostheses available to surgeons when performing a total ankle arthroplasty (TAA). The main objective of this study was to summarize the clinical and functional outcomes of 4 TAA prostheses: the Hintegra implant (Integra LifeSciences), the Agility implant (DePuy), the Mobility implant (DePuy), and the Scandinavian Total Ankle Replacement (STAR) implant (Small Bone Innovations [SBi]). METHODS: Patients were prospectively recruited...
February 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28122388/clinical-study-of-3d-imaging-and-3d-printing-technique-for-patient-specific-instrumentation-in-total-knee-arthroplasty
#3
Bing Qiu, Fei Liu, Bensen Tang, Biyong Deng, Fang Liu, Weimin Zhu, Dong Zhen, Mingyuan Xue, Mingjiao Zhang
Patient-specific instrumentation (PSI) was designed to improve the accuracy of preoperative planning and postoperative prosthesis positioning in total knee arthroplasty (TKA). However, better understanding needs to be achieved due to the subtle nature of the PSI systems. In this study, 3D printing technique based on the image data of computed tomography (CT) has been utilized for optimal controlling of the surgical parameters. Two groups of TKA cases have been randomly selected as PSI group and control group with no significant difference of age and sex (p > 0...
January 25, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28113980/delaying-ambulation-mode-transition-decisions-improves-accuracy-of-a-flexible-control-system-for-powered-knee-ankle-prosthesis
#4
Ann M Simon, Kimberly A Ingraham, John Spanias, Aaron J Young, Suzanne B Finucane, Elizabeth G Halsne, Levi J Hargrove
Powered lower limb prostheses can assist users in a variety of ambulation modes by providing knee and/or ankle joint power. This study's goal was to develop a flexible control system to allow users to perform a variety of tasks in a natural, accurate, and reliable way. Six transfemoral amputees used a powered knee-ankle prosthesis to ascend/descend a ramp, climb a 3- and 4-step staircase, perform walking and standing transitions to and from the staircase, and ambulate at various speeds. A mode-specific classification architecture was developed to allow seamless transitions at four discrete gait events...
September 22, 2016: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28113346/control-and-evaluation-of-a-powered-transfemoral-prosthesis-for-stair-ascent
#5
Elissa D Ledoux, Michael Goldfarb
This paper assesses the metabolic effort exerted by three transfemoral amputees when using a powered knee and ankle prosthesis for stair ascent, relative to ascending stairs with passive knee and ankle prostheses. The paper describes a controller that provides step-over stair ascent behavior reflective of healthy stair ascent biomechanics, and describes its implementation in a powered prosthesis prototype. Stair ascent experiments were performed with three unilateral transfemoral amputee subjects, comparing the oxygen consumption required to ascend stairs using the powered prosthesis (with a step-over gait), relative to using their daily-use energetically passive prostheses (with a step-to gait)...
January 20, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28105948/active-lower-limb-prosthetics-a-systematic-review-of-design-issues-and-solutions
#6
REVIEW
Michael Windrich, Martin Grimmer, Oliver Christ, Stephan Rinderknecht, Philipp Beckerle
This paper presents a review on design issues and solutions found in active lower limb prostheses. This review is based on a systematic literature search with a methodical search strategy. The search was carried out across four major technical databases and the retrieved records were screened for their relevance. A total of 21 different active prostheses, including 8 above-knee, 9 below-knee and 4 combined knee-ankle prostheses were identified. While an active prosthesis may help to restore the functional performance of an amputee, the requirements regarding the actuation unit as well as for the control system are high and the development becomes a challenging task...
December 19, 2016: Biomedical Engineering Online
https://www.readbyqxmd.com/read/27989336/a-review-of-399-total-ankle-replacements-analysis-of-ipsilateral-subtalar-joint-arthrodesis-and-associated-talar-component-subsidence
#7
Mark A Prissel, Christopher F Hyer, Gregory C Berlet
Total ankle replacement (TAR) is an accepted treatment for end-stage ankle arthritis. When concurrent subtalar joint pathologic features exist, ipsilateral subtalar joint arthrodesis (STJA) can be performed either simultaneous with TAR or as a staged procedure. Limited data exist on the effect of talar component subsidence and prosthesis survivorship. The present study purpose was to evaluate the effect of STJA on talar component subsidence after primary TAR and its effect on TAR survivorship. All patients, a minimum of 18 years old, from a single institution with modern-generation TAR and 1-year minimum follow-up data available were evaluated...
January 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27881551/comparison-of-the-otto-bock-solid-ankle-cushion-heel-foot-with-wooden-keel-to-the-low-cost-cr-equipements%C3%A2-solid-ankle-cushion-heel-foot-with-polypropylene-keel-a-randomized-prospective-double-blind-crossover-study-assessing-patient-satisfaction-and-energy
#8
Alain Lacraz, Stéphane Armand, Katia Turcot, Gorki Carmona, Richard Stern, Olivier Borens, Mathieu Assal
BACKGROUND: The International Committee of the Red Cross supports a worldwide program of prosthetic fitting and rehabilitation. In this context, a prosthetic foot was developed and widely distributed in least developed countries. STUDY DESIGN: Prospective, randomized, double-blind, controlled study. OBJECTIVE: To compare patient satisfaction and energy expenditure during ambulation between a low-cost prosthetic foot designed with a polypropylene keel (CR-Equipements(™) solid ankle cushion heel, International Committee of the Red Cross) to a well-recognized solid ankle cushion heel foot with a wooden keel (solid ankle cushion heel foot, Otto Bock)...
November 22, 2016: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/27866037/preoperative-preparation-of-a-patient-with-grade-ii-leg-lymphedema-for-his-third-hip-replacement-surgery
#9
Maria de Fátima Guerreiro Godoy, Livia Maria Pereira de Godoy, Renata Lopes Pinto, Jose Maria Pereira de Godoy
INTRODUCTION: The treatment of lymphedema remains a challenge to modern medicine, due to the characteristics of the disease. CASE PRESENTATION: Report on the case of a 75-year-old patient with lower limb lymphedema for treatment prior to surgery. At age 45, he made the first hip replacement surgery in the left leg. One year later he performed the same surgery on the right leg. At that time his legs had slight ankle edema mainly of the left leg and the entire left leg was affected by lymphedema...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27846395/mid-term-functional-outcome-of-a-total-arthroplasty-of-the-first-metatarsophalangeal-joint
#10
Corina Nüesch, Annegret Mündermann, Monika Horisberger
BACKGROUND: Arthroplasty of the first metatarsophalangeal joint is an alternative treatment option for end-stage hallux rigidus to the current gold standard of arthrodesis. The aim of this study was to investigate the mid-term functional outcome of an anatomically shaped prosthesis for the first metatarsophalangeal joint using pedobarography. METHODS: Ten patients (12 affected feet; age at surgery: 62.1 (SD: 7.2) years) were investigated preoperatively and 52 (SD: 3) months postoperatively using pedobarography (EMED, novel GmbH, Munich, Germany)...
January 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/27826906/amputation-and-rotationplasty-in-children-with-limb-deficiencies-current-concepts
#11
REVIEW
Ralph Sakkers, Iris van Wijk
PURPOSE: Amputations and fitting surgery have a long history in children with limb deficiencies. With the current developments in limb reconstruction and new techniques in prosthetics, the indications for amputation and fitting surgery might have shifted, but still have a very important role in creating high functional performance, optimal participation and quality of life. The purpose of this current concepts article is to give an overview of the indications, dilemmas and technical considerations in the decision-making for amputation and fitting surgery...
December 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27746585/prosthetic-leg-control-in-the-nullspace-of-human-interaction
#12
Robert D Gregg, Anne E Martin
Recent work has extended the control method of virtual constraints, originally developed for autonomous walking robots, to powered prosthetic legs for lower-limb amputees. Virtual constraints define desired joint patterns as functions of a mechanical phasing variable, which are typically enforced by torque control laws that linearize the output dynamics associated with the virtual constraints. However, the output dynamics of a powered prosthetic leg generally depend on the human interaction forces, which must be measured and canceled by the feedback linearizing control law...
July 2016: Proceedings of the ... American Control Conference
https://www.readbyqxmd.com/read/27702444/increasing-ankle-push-off-work-with-a-powered-prosthesis-does-not-necessarily-reduce-metabolic-rate-for-transtibial-amputees
#13
Roberto E Quesada, Joshua M Caputo, Steven H Collins
Amputees using passive ankle-foot prostheses tend to expend more metabolic energy during walking than non-amputees, and reducing this cost has been a central motivation for the development of active ankle-foot prostheses. Increased push-off work at the end of stance has been proposed as a way to reduce metabolic energy use, but the effects of push-off work have not been tested in isolation. In this experiment, participants with unilateral transtibial amputation (N=6) walked on a treadmill at a constant speed while wearing a powered prosthesis emulator...
October 3, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27685013/knee-rotationplasty-motion-of-the-body-centre-of-mass-during-walking
#14
Viviana Rota, Maria Grazia Benedetti, Yusuke Okita, Marco Manfrini, Luigi Tesio
Knee rotationplasty (KRP) is a type of surgery in which the rotated ankle serves as a new knee after being removed for bone tumor. Although this limb salvage surgery is rarely indicated in properly selected patients, it may offer functional advantages over transfemoral amputation, and more durable results compared with a prosthesis. The walking mechanics of adult patients after KRP is believed to be close to that of below-knee amputees. In this study, we evaluated steady-state walking of KRP patients from the viewpoint of the overall muscle power needed to keep the body centre of mass in motion...
December 2016: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/27676893/articulated-vs-fixed-carbon-fiber-prosthesis-in-individual-with-partial-foot-amputation-study-case
#15
Marie Laberge-Malo, Reggie C Hamdy, Laurent Ballaz, Audrey Parent, Annie Pouliot
OBJECTIVE: Toe filler combined to ankle-foot orthosis (AFO) can be used to improve gait after a partial foot amputation. The AFO supports the plantar aspect of the foot, and the toe filler gives a longer lever arm that helps for pivoting over the lost metatarsals. However, the AFO type can influence gait parameters. The objective of this study case was to evaluate the effect of prosthesis with toe filler combined to: - an articulated AFO; - a fixed carbon-fiber AFO on gait. PATIENTS AND METHODS: A gait analysis was practiced on a 20-year-old male with a partial foot amputation...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27676772/prosthesis-alignment-and-knee-valgus-in-individual-with-fibula-hemimelia-study-case
#16
Marie Laberge-Malo, Xavier Rodrigue, Céline Goyette, Annie Pouliot-Laforte, Audrey Parent, Isabelle Marcoux, Laurent Ballaz
OBJECTIVE: Fibula hemimelia is a congenital malformation of the lower limbs that is associated to aplasia or hypoplasia of the fibula. This condition is characterized by knee valgus which tends to increase over years in children walking with a below knee prosthesis. However, few recommendations are available regarding the optimal prosthesis alignment for amputated children with fibula hemimelia. The aim of this case study was to compare different prosthesis alignments and to assess their impact on knee joint moment in the frontal plane during walking...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27670646/whole-body-angular-momentum-during-sloped-walking-using-passive-and-powered-lower-limb-prostheses
#17
Nathaniel T Pickle, Jason M Wilken, Jennifer M Aldridge Whitehead, Anne K Silverman
Sloped walking requires altered strategies for maintaining dynamic balance relative to level-ground walking, as evidenced by changes in sagittal-plane whole-body angular momentum (H) in able-bodied individuals. The ankle plantarflexor muscles are critical for regulating H, and functional loss of these muscles from transtibial amputation affects this regulation. However, it is unclear if a powered prosthesis, which more closely emulates intact ankle function than a passive energy-storage-and-return prosthesis, affects H differently during sloped walking...
October 3, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27570639/informing-ankle-foot-prosthesis-prescription-through-haptic-emulation-of-candidate-devices
#18
Joshua M Caputo, Peter G Adamczyk, Steven H Collins
Robotic prostheses can improve walking performance for amputees, but prescription of these devices has been hindered by their high cost and uncertainty about the degree to which individuals will benefit. The typical prescription process cannot well predict how an individual will respond to a device they have never used because it bases decisions on subjective assessment of an individual's current activity level. We propose a new approach in which individuals 'test drive' candidate devices using a prosthesis emulator while their walking performance is quantitatively assessed and results are distilled to inform prescription...
May 2015: IEEE International Conference on Robotics and Automation: ICRA: [proceedings]
https://www.readbyqxmd.com/read/27550190/subsidence-of-total-ankle-component-associated-with-deterioration-of-an-ankle-scale-in-non-inflammatory-arthritis-but-not-in-rheumatoid-arthritis
#19
Takahiro Iwata, Hiromu Ito, Moritoshi Furu, Masahiro Ishikawa, Masayuki Azukizawa, Hiroyuki Yoshitomi, Takayuki Fujii, Haruhiko Akiyama, Shuichi Matsuda
OBJECTIVES: Modern three-component total ankle arthroplasty (TAA) has favorable clinical results and survival rates. However, radiographic deterioration and worsening of clinical symptoms may occur in patients with rheumatoid arthritis (RA) or non-inflammatory arthritis (NA). The associations between outcomes and clinical and radiological factors are not clear. We compared midterm clinical and radiographic outcomes after TAA between patients with RA and those with NA. METHODS: Twenty-six TAAs were performed using a three-component prosthesis, the FINE Total Ankle System during the study period...
August 23, 2016: Modern Rheumatology
https://www.readbyqxmd.com/read/27547456/short-term-effect-of-prosthesis-transforming-sensory-modalities-on-walking-in-stroke-patients-with-hemiparesis
#20
Dai Owaki, Yusuke Sekiguchi, Keita Honda, Akio Ishiguro, Shin-Ichi Izumi
Sensory impairments caused by neurological or physical disorders hamper kinesthesia, making rehabilitation difficult. In order to overcome this problem, we proposed and developed a novel biofeedback prosthesis called Auditory Foot for transforming sensory modalities, in which the sensor prosthesis transforms plantar sensations to auditory feedback signals. This study investigated the short-term effect of the auditory feedback prosthesis on walking in stroke patients with hemiparesis. To evaluate the effect, we compared four conditions of auditory feedback from plantar sensors at the heel and fifth metatarsal...
2016: Neural Plasticity
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