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https://www.readbyqxmd.com/read/28105948/active-lower-limb-prosthetics-a-systematic-review-of-design-issues-and-solutions
#1
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/28097422/novel-alignment-measurement-technique-for-total-knee-arthroplasty-using-patient-specific-instrumentation
#2
Kazumasa Yamamura, Yukihide Minoda, Shigekazu Mizokawa, Yoichi Ohta, Ryo Sugama, Suguru Nakamura, Hideki Ueyama, Hiroaki Nakamura
INTRODUCTION: This study was designed to evaluate the true accuracy of patient specific instrumentation (PSI) for total knee arthroplasty (TKA) using a new 3D measurement method. MATERIALS AND METHODS: Consecutive 21 patients (30 knees) who underwent TKA using computed tomography (CT)-based PSI were retrospectively evaluated. Mean patient age was 69.2 years (62 to 77). The postoperative three-dimensional (3D) CT image were superimposed onto the preoperative 3D CT plan and measured the absolute difference in the prosthetic alignment using six parameters: coronal, sagittal, and axial alignment of the femoral and tibial prostheses...
January 17, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28094687/successful-management-of-femoral-trauma-in-a-through-knee-amputee-with-a-previous-malunited-fracture-implications-and-functional-outcome
#3
Beth Lineham, Paul Harwood, Peter Giannoudis
BACKGROUND: After amputation patients are more likely to injure their residual limb. An injury of a previously amputated limb, especially if the residuum is not anatomically normal, poses a dilemma for management. Case Description and Methods: This case report discusses a femoral fracture sustained proximal to a through-knee amputation. Findings and outcomes: The fracture was at the site of a malunited fracture. A shortening osteotomy with bone graft was undertaken to improve alignment and prosthetic fit and remove poor-quality bone...
January 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28089667/periprosthetic-fractures-of-the-distal-femur-after-total-knee-arthroplasty-plate-versus-nail-fixation
#4
REVIEW
Sara Shippee Wallace, Daniel Bechtold, Adam Sassoon
: The incidence of periprosthetic fractures about a TKA is increasing. Traditionally these fractures are classified by their location and prosthesis integrity. In the setting of a supracondyar fracture about a well-fixed prosthesis, both plate and nail fixation of the fracture present themselves as options, each with unique benefits and pitfalls. Through review and discussion of the literature, we aim to describe some of the patient, fracture, and implant related factors that should be considered when planning fixation of periprosthetic fractures about a TKA...
January 12, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28070650/revision-total-knee-arthroplasty-due-to-bone-cement-and-metal-hypersensitivity
#5
Ioannis P Stathopoulos, Nicolaos Andrianopoulos, Dimitrios Paschaloglou, Ioannis Tsarouchas
INTRODUCTION: Hypersensitivity to implants is a rare complication of total knee arthroplasty (TKA). Metal and, less frequently, bone cement can produce allergic symptomatology that if unresponsive to conservative treatment could lead to revision. MATERIALS AND METHODS: We present the case of a patient with generalized pruritus and metal taste starting during the first postoperative month after TKA. Dermal allergy exams revealed that the patient had hypersensitivity to nickel sulphate and cobalt chloride and bone cement...
January 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28068847/case-study-survey-of-patient-satisfaction-with-prosthesis-quality-and-design-among-below-knee-prosthetic-leg-socket-users
#6
Nurhanisah Mohd Hawari, Mohammad Jawaid, Paridah Md Tahir, Raja Ahmad Azmeer
The aim of this case study was to explore patient satisfaction with the quality of prosthetic leg sockets intended for persons with lower limb amputations. A qualitative study based on in-depth interviews, preceded by a questionnaire session, was carried out with patients from the Rehabilitation Center and Hospital in Malaysia. Twelve out-patient and in-patient amputees with lower limb amputations, specifically below-knee amputations, were chosen randomly. The analysis of patients' narratives aimed to identify the functional and esthetic characteristics of currently used prosthetic leg sockets and any problems related to them...
January 10, 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28066524/bioenergetic-differences-during-walking-and-running-in-transfemoral-amputee-runners-using-articulating-and-non-articulating-knee-prostheses
#7
M Jason Highsmith, Jason T Kahle, Rebecca M Miro, Larry J Mengelkoch
Transfemoral amputation (TFA) patients require considerably more energy to walk and run than non-amputees. The purpose of this study was to examine potential bioenergetic differences (oxygen uptake (VO2), heart rate (HR), and ratings of perceived exertion (RPE)) for TFA patients utilizing a conventional running prosthesis with an articulating knee mechanism versus a running prosthesis with a non-articulating knee joint. Four trained TFA runners (n = 4) were accommodated to and tested with both conditions. VO2 and HR were significantly lower (p ≤ 0...
September 2016: Technology and Innovation
https://www.readbyqxmd.com/read/28064219/active-and-passive-immunization-against-staphylococcus-aureus-periprosthetic-osteomyelitis-in-rats
#8
Niels H Søe, Nina Vendel Jensen, Asger Lundorff Jensen, Janne Koch, Steen Seier Poulsen, Gerald B Pier, Helle Krogh Johansen
BACKGROUND/AIM: Staphylococcus aureus infection associated with orthopedic implants cannot always be controlled. We used a knee prosthesis model with implant-related osteomyelitis in rats to explore induction of an effective immune response with active and passive immunization. MATERIALS AND METHODS: Fifty-two Sprague-Dawley rats were divided into active (N=28) and passive immunization groups (N=24). A bacterial inoculum of 10(3) S. aureus MN8 was injected into the tibia and the femur marrow before insertion of a non-constrained knee prosthesis in each rat...
January 2017: In Vivo
https://www.readbyqxmd.com/read/28057096/-medial-anterior-flange-overhang-related-to-the-prosthesis-selection-determined-by-femoral-sizer-in-total-knee-arthroplasty
#9
Z H Sun, N Li, J Y Xin, J Liu, Z S Ren, H J Sun
Objective: To evaluate the medial anterior flange overhang related to the femoral prosthesis size determined by femoral sizer in total knee arthroplasty. Methods: Sixty one cases of varus knee osteoarthritis (61 knees) were analyzed from January 2014 to January 2015, 14 males and 47 females, aged (66.8±6.8) year old. 3D models of distal femur were established by Mimics, total knee arthroplasty surgeries were simulated and the medial and lateral femoral condylar anteroposterior diameter were measured. According to the AP diameter of lateral femoral condyle (lateral condyle group) and femoral sizer (sizer group), different size of the PFC Sigma femoral prosthesis models were imported to mimics, and the coverage of medial anterior femoral flange were compared...
December 20, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28049004/microcirculatory-assessment-of-arterial-below-knee-stumps-near-infrared-spectroscopy-vs-transcutaneous-oxygen-tension-a-preliminary-study-in-prosthesis-users
#10
Davy Laroche, José-Luis Barnay, Bastien Tourlonias, Cyril Orta, Christine Obert, Jean-Marie Casillas
OBJECTIVES: To examine metrological properties of near-infrared spectroscopy (NIRS) vs. transcutaneous oxygen tension (TcPO2) for microcirculatory assessment of vascular transtibial stumps at the stabilized period of prosthesis fitting, as a preliminary step before exploring its ability to predict stump healing, considering the previously identified limits of TcPO2 (borderline area between 15 and 35 mmHg). DESIGN: Prospective single-centre observational study. SETTING: University-based rehabilitation center...
December 31, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28039023/determination-of-the-accuracy-of-navigated-kinematic-unicompartmental-knee-arthroplasty-a-2-year-follow-up
#11
Andrea L Grant, Kenji D Doma, Kaushik Hazratwala
BACKGROUND: Unicompartmental knee arthroplasty (UKA) lacks history of patient satisfaction and research addressing technique validity. The aim of this study was to determine minimally invasive navigated kinematic UKA accuracy by comparing postoperative limb alignment with preoperative stress values. METHODS: A single-center retrospective study was conducted on 53 consecutive patients (postoperative alignment: varus n = 51, valgus n = 2) who underwent computer navigation assisted UKA...
November 29, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28032700/management-of-acute-hematogenous-infection-following-total-knee-arthroplasty-a-case-series-of-11-patients
#12
Rui He, Liu Yang, Lin Guo, Hao Chen, Ying Zhang, Dian-Ming Jiang
OBJECTIVE: Acute hematogenous infection is a devastating complication that can occur after total knee arthroplasty (TKA). The best strategies for management of this infection remain controversial. Two-stage revision has been well described as the gold standard for the management of chronic late infections. However, there is a paucity of information presently available on the management and outcomes of patients treated for acute hematogenous infections. The purpose of the present study was to report the outcome of acute hematogenous infections following TKA with the treatment of irrigation, debridement, and retention of the prosthetic components...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28032122/predictors-of-outcome-after-manipulation-under-anaesthesia-in-patients-with-a-stiff-total-knee-arthroplasty
#13
L Vanlommel, T Luyckx, G Vercruysse, J Bellemans, H Vandenneucker
PURPOSE: Flexion in a stiff total knee arthroplasty (TKA) can be improved by manipulation under anaesthesia (MUA). Although this intervention usually results in an improvement in range of motion, the expected result is not always achieved. The purpose of this study is to determine which factors affect range of motion after manipulation in patients with a stiff total knee. METHODS: After exclusion (n = 22), the data of 158 patients (138 knees) with a stiff knee after TKA who received a manipulation under anaesthesia between 2004 and 2014 were retrospectively analysed...
December 29, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28031494/outcome-in-total-knee-arthroplasty-with-a-medial-lateral-balanced-versus-unbalanced-gap
#14
Ahmed Jawhar, Karolin Hutter, Hanns-Peter Scharf
PURPOSE: To evaluate the clinical outcome in 108 total knee arthroplasty (TKA) patients with a medial-lateral balanced versus unbalanced gap after a mean follow-up of 34 months. METHODS: 64 women and 44 men (mean age, 69.5 years) underwent computer-assisted TKA for osteoarthritis using a cemented fixed-bearing cruciate-retaining prosthesis. The medial-lateral gap difference (measured with the prosthesis in situ and the patella reduced) was balanced (≤2 mm) in 81 patients and unbalanced (>2 mm) in 27 patients...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28026733/long-term-function-following-periprosthetic-fractures
#15
J Zwingmann, M Krieg, F Thielemann, N Südkamp, P Helwig
PURPOSE OF THE STUDY Clinical results of long-term follow-up after traumatic periprosthetic femur fractures and different therapies (ORIF vs. revision arthroplasty) MATERIAL AND METHODS The Visual Analog Scale (VAS), Harris-Hip-Score (HHS), Oxford-Hip-Score (OHS), Oxford-Knee-Score (OKS), Knee-Society-Score (KSS), SF-36 Questionnaire and Funktionsfragebogen Hannover (FFH) were used to evaluate outcome and functionality. Radiological examinations were performed and the Vancouver (THA) and Lewis and Rorabeck (TKA) classifications used...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28004988/biosynthetic-grafts-to-replace-infected-prosthetic-vascular-bypasses-a-single-center-experience
#16
Ingolf Töpel, Theresa Stigler, Isabelle Ayx, Thomas Betz, Christian Uhl, Markus Steinbauer
BACKGROUND: There are only a few options to replace infected infrainguinal synthetic vascular grafts in the absence of suitable autologous veins. To use a biosynthetic vascular graft (Omniflow(®)II) might be a valuable alternative. METHODS: We retrospectively analyzed the clinical course of 29 patients who underwent replacement of an infected infrainguinal vascular prosthesis (Szilagyi 3) by an Omniflow(®)II graft. RESULTS: Because of the lack of suitable autologous veins, 15 above-knee femoro-popliteal, 5 below-knee femoro-popliteal, and 9 femoro-tibial bypasses were replaced with biosynthetic grafts...
December 22, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27984831/-total-joint-replacement-and-return-to-sports
#17
N Oehler, T Schmidt, A Niemeier
Background: An increasing number of physically active patients not only need to know if they will basically be able to engage in sports after undergoing arthroplasty. They also would like to know whether or not they will be able to resume their preoperative activity levels. This article aims to provide an overview of recent data regarding the following questions on hip, knee and shoulder arthroplasty: (1) What is the impact of physical activity on an endoprosthesis? (2) What level of sports can be achieved after an arthroplasty procedure? (3) What types of sport are recommended for patients with an endoprosthesis? Methods: PubMed-based review of the literature...
December 2016: Sportverletzung Sportschaden: Organ der Gesellschaft Für Orthopädisch-Traumatologische Sportmedizin
https://www.readbyqxmd.com/read/27966179/-endoprostheses-in-geriatric-traumatology
#18
B Buecking, D Eschbach, C Bliemel, M Knobe, R Aigner, S Ruchholtz
BACKGROUND: Geriatric traumatology is increasing in importance due to the demographic transition. In cases of fractures close to large joints it is questionable whether primary joint replacement is advantageous compared to joint-preserving internal fixation. OBJECTIVE: The aim of this study was to describe the importance of prosthetic joint replacement in the treatment of geriatric patients suffering from frequent periarticular fractures in comparison to osteosynthetic joint reconstruction and conservative methods...
December 13, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27920813/densitometric-evaluation-of-bone-prosthetic-counterface-in-hip-and-knee-arthroplasty-with-modern-implants
#19
Andrea Cozzi Lepri, Marco Giorgini, Carla Signorini, Christian Carulli, Roberto Civinini, Maria Luisa Brandi, Massimo Innocenti
INTRODUCTION: Recent acquisitions of the complex mechanisms of osseointegration between implants and host bone have gained attention, accordingly to the methods of evaluation of these interactions. DEXA analysis is considered an useful tool to assess such phenomena, in order to analyse in a quantitative manner the local metabolic activity of the bone, and to evaluate over the time the integration between host bone and prosthetic components. The purpose of the present study is to report about a preliminary experience in the analysis of osseointegration processes of patients undergoing a primary Total Hip Arthroplasty (THA) or a revision Total Knee Arthroplasty (rTKA)...
May 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/27916042/-diagnosis-and-treatment-of-recurrent-hemarthrosis-after-total-knee-arthroplasty
#20
Y Li, H Tian, K Zhang
Recurrent hemarthrosis is a relatively rare complication after total knee arthroplasty with the incidence estimated between 0.3% and 1.6%. There are various causes of this complication which can be broadly divided into general and local reasons. If the blood coagulation function was normal, the most common reason of hemarthrosis is the impingement of proliferative synovium between the articulating components of the knee prosthesis. However, some causes are not well understood which make diagnosis and treatment more difficult...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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