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Limb prosthesis

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https://www.readbyqxmd.com/read/29338761/is-total-femoral-replacement-for-non-oncologic-and-oncologic-indications-a-safe-procedure-in-limb-preservation-surgery-a-single-center-experience-of-22-cases
#1
Andreas Toepfer, Norbert Harrasser, Isabel Petzschner, Florian Pohlig, Ulrich Lenze, Ludger Gerdesmeyer, Ruediger von Eisenhart-Rothe, Heinrich Mühlhofer, Christian Suren
BACKGROUND: Several surgical options for the reconstruction of massive bone defects have been described and include biologic methods with autografts and allografts, and the use of tumor endoprostheses (total femoral replacement, TFR). Several types of modular TFR are available, but nevertheless unpredictable outcomes and high complication rates have been described from most authors. The present study aims to compare results after TFR performed with modular total femur prosthesis MML (Fa...
January 16, 2018: European Journal of Medical Research
https://www.readbyqxmd.com/read/29329344/maintenance-of-muscle-strength-retains-a-normal-metabolic-cost-in-simulated-walking-after-transtibial-limb-loss
#2
Elizabeth Russell Esposito, Ross H Miller
Recent studies on relatively young and fit individuals with limb loss suggest that maintaining muscle strength after limb loss may mitigate the high metabolic cost of walking typically seen in the larger general limb loss population. However, these data are cross-sectional and the muscle strength prior to limb loss is unknown, and it is therefore difficult to draw causal inferences on changes in strength and gait energetics. Here we used musculoskeletal modeling and optimal control simulations to perform a longitudinal study (25 virtual "subjects") of the metabolic cost of walking pre- and post-limb loss (unilateral transtibial)...
2018: PloS One
https://www.readbyqxmd.com/read/29327257/biomechanical-characterisation-of-bone-anchored-implant-systems-for-amputation-limb-prostheses-a-systematic-review
#3
REVIEW
Alexander Thesleff, Rickard Brånemark, Bo Håkansson, Max Ortiz-Catalan
Bone-anchored limb prostheses allow for the direct transfer of external loads from the prosthesis to the skeleton, eliminating the need for a socket and the associated problems of poor fit, discomfort, and limited range of movement. A percutaneous implant system for direct skeletal attachment of an external limb must provide a long-term, mechanically stable interface to the bone, along with an infection barrier to the external environment. In addition, the mechanical integrity of the implant system and bone must be preserved despite constant stresses induced by the limb prosthesis...
January 11, 2018: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29324410/decoding-motor-unit-activity-from-forearm-muscles-perspectives-for-myoelectric-control
#4
Tamas Kapelner, Francesco Negro, Oskar C Aszmann, Dario Farina
We prove the feasibility of decomposing high density surface EMG signals from forearm muscles in non-isometric wrist motor tasks of normally limbed and limb-deficient individuals with the perspective of using the decoded neural information for prosthesis control. For this purpose, we recorded surface EMG signals during motions of three degrees of freedom of the wrist in seven normally limbed subjects and two patients with limb deficiency. The signals were decomposed into individual motor unit activity with a convolutive blind source separation algorithm...
January 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/29322812/adjustment-to-finger-amputation-and-silicone-finger-prosthesis-use
#5
Zala Kuret, Helena Burger, Gaj Vidmar, Tomaz Maver
PURPOSE: Finger amputations are the most common amputations of upper limbs. They influence hand function, general functioning and quality of life. One of the possibilities for rehabilitation after finger amputation is fitting a silicone finger prosthesis. We wanted to evaluate the adjustment to amputation and prosthesis use in patients after finger amputation. METHODS: We included 42 patients with partial or complete single or multiple finger amputation of one hand who visited the outpatient clinic for prosthetics and orthotics at our institute and received a silicone prosthesis...
January 11, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29321625/cerebellar-grey-matter-modifications-in-lower-limb-amputees-not-using-prosthesis
#6
Antonella Di Vita, Maddalena Boccia, Liana Palermo, Federico Nemmi, Marco Traballesi, Stefano Brunelli, Roberto De Giorgi, Gaspare Galati, Cecilia Guariglia
Plastic brain changes following peripheral deafferentation, in particular those following limb amputations, are well-documented, with significant reduction of grey matter (GM) in the sensory-motor cerebral areas representing the amputated limb. However, few studies have investigated the role played by the use of a prosthesis in these structural brain modifications. Here we hypothesized that using a functional prosthesis that allows individuals to perform actions may reduce grey matter reduction. We investigated the brain structural reorganization following lower limb amputation by using a Voxel Based Morphometry (VBM) analysis of structural magnetic resonance imaging (MRI) in 8 right-handed individuals with lower limb amputation (LLA) fitted with prostheses (LLAwp), compared to 6 LLA who had never used a prosthesis (LLAnp)...
January 10, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29320640/syme-amputation-a-systematic-review
#7
Rudwina Braaksma, Pieter U Dijkstra, Jan H B Geertzen
BACKGROUND: In the decision-making process toward an amputation of the lower extremity, knowledge about patient-related outcomes after amputation and rehabilitation is important. We have not found a systematic review that provides this knowledge for Syme amputation. The aim of this study was to present an overview of outcomes after a Syme amputation grouped according to the International Classification of Functioning, Disability and Health (ICF) model, focusing on body structures and functions, activities, and participation...
January 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29308374/alcohol-devitalization-and-replantation-for-primary-malignant-bone-tumors-of-the-knee-joint
#8
Xihai Zhang, Ge Chen, Jun Wang, Lian Tang, Yiran Yin
Background: This paper is aimed at studying the therapeutic effects of in situ replantation of alcohol-devitalized bone segments to treat malignant bone tumors of the knee joint. Methods: We retrospectively analyzed clinical data for 45 patients from January 2013 to January 2016 who underwent replantation following alcohol-devitalization of bone segments and 40 who underwent prosthesis implantation. The two groups were comparable in basal clinical biometric data, including gender, age, tumor type and location, Enneking staging, and maximum tumor diameter...
October 2017: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/29305098/is-clavicular-reconstruction-imperative-for-total-and-subtotal-claviculectomy-a-systematic-review
#9
REVIEW
Yu Chen, Xiuchun Yu, Weimin Huang, Bing Wang
BACKGROUND: The effects of clavicular reconstruction on total and subtotal claviculectomy are controversial. The aim of this study is to disclose the impact of clavicular reconstruction on the efficacy of this rare surgical procedure. METHODS: This is a systematic review of multiple medical databases for level I through IV evidence. RESULTS: Eleven studies (level IV) with a mean follow-up duration of 53 months (range, 12-156 months) met the inclusion criteria...
January 2, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29301461/prosthesis-prescription-protocol-of-the-arm-ppp-arm-the-implementation-of-a-national-prosthesis-prescription-protocol
#10
Paula Wijdenes, Michael Brouwers, Corry K van der Sluis
BACKGROUND AND AIM: In order to create more uniformity in the prescription of upper limb prostheses by Dutch rehabilitation teams, the development and implementation of a Prosthesis Prescription Protocol of the upper limb (PPP-Arm) was initiated. The aim was to create a national digital protocol to structure, underpin, and evaluate the prescription of upper limb prostheses for clients with acquired or congenital arm defects. TECHNIQUE: Prosthesis Prescription Protocol of the Arm (PPP-Arm) was developed on the basis of the International Classification of Functioning and consisted of several layers...
January 1, 2018: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29276305/stable-robust-hybrid-zero-dynamics-control-of-powered-lower-limb-prostheses
#11
Anne E Martin, Robert D Gregg
To improve the quality of life for lower-limb amputees, powered prostheses are being developed. Advanced control schemes from the field of bipedal robots, such as hybrid zero dynamics (HZD), may provide great performance. HZD-based control specifies the motion of the actuated joints using output functions to be zeroed, and the required torques are calculated using input-output linearization. For one-step periodic gaits, there is an analytic metric of stability. To apply HZD-based control on a powered prosthesis, several modifications must be made...
August 2017: IEEE Transactions on Automatic Control
https://www.readbyqxmd.com/read/29269103/dynamic-elastic-response-prostheses-alter-approach-angles-and-ground-reaction-forces-but-not-leg-stiffness-during-a-start-stop-task
#12
Cassandra Kay Haber, Laura J Ritchie, Siobhan C Strike
In a dynamic elastic response prosthesis (DERP), spring-like properties aim to replace the loss of musculature and soft tissues and optimise dynamic movement biomechanics, yet higher intact limb (IL) loading exists. It is unknown how amputees wearing a DERP will perform in start-stop movements and how altering the prosthetic stiffness will influence the performance and loading. This study assessed movement dynamics through comparisons in spatiotemporal, kinematic and kinetic variables and leg stiffness of intact, prosthetic and control limbs...
December 18, 2017: Human Movement Science
https://www.readbyqxmd.com/read/29252086/first-and-second-step-characteristics-of-amputee-and-able-bodied-sprinters
#13
Gerda Strutzenberger, Adam Brazil, Timothy Exell, Hans von Lieres Und Wilkau, John Davies, Steffen Willwacher, Johannes Funken, Ralf Mueller, Kai Heinrich, Hermann Schwameder, Wolfgang Potthast, Gareth Irwin
PURPOSE: In the sprint events, the first two steps are used to accelerate the center of mass horizontally and vertically. Amputee athletes cannot actively generate energy with their running specific prosthesis. It is likely that sprint acceleration mechanics, including step asymmetry, are altered compared to able-bodied athletes. Therefore, the aim of this study was to investigate spatio-temporal and kinetic variables of amputee compared to able-bodied sprinters. METHODS: Kinematic and kinetic data of the first and second stance were collected from 15 able-bodied and 7 amputee sprinters (2 unilateral-transfemoral, 4 unilateral-transtibial, 1 bilateral-transtibial) with a motion-capture system (250 Hz) and two force plates (1000 Hz), additionally bilateral asymmetry was quantified and compared between groups...
December 18, 2017: International Journal of Sports Physiology and Performance
https://www.readbyqxmd.com/read/29242066/external-polytetrafluoroethylene-reinforcement-of-varicose-autologous-vein-grafts-in-peripheral-bypass-surgery-produces-durable-bypass-function
#14
Achim Neufang, Christine Espinola-Klein, Savvas Savvidis, Walther Schmiedt, Alicia Poplawski, Christian Friedrich Vahl, Bernhard Dorweiler
OBJECTIVE: Use of autologous veins as peripheral bypass graft may become critical in the presence of significant varicose degeneration of the harvested vein. External support of such dilated veins with standard polytetrafluoroethylene (PTFE) prostheses was recommended as an option to use these veins for peripheral bypass. A single-center experience with this technique regarding long-term graft function, secondary reinterventions, and potential graft degeneration is presented. METHODS: Between January 1995 and January 2006, there were 54 patients with varicose veins who underwent 57 consecutive infrainguinal vein bypass operations with PTFE reinforcement in 57 limbs...
December 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29235055/a-finite-element-model-to-assess-transtibial-prosthetic-sockets-with-elastomeric-liners
#15
John C Cagle, Per G Reinhall, Kate J Allyn, Jake McLean, Paul Hinrichs, Brian J Hafner, Joan E Sanders
People with transtibial amputation often experience skin breakdown due to the pressures and shear stresses that occur at the limb-socket interface. The purpose of this research was to create a transtibial finite element model (FEM) of a contemporary prosthesis that included complete socket geometry, two frictional interactions (limb-liner and liner-socket), and an elastomeric liner. Magnetic resonance imaging scans from three people with characteristic transtibial limb shapes (i.e., short-conical, long-conical, and cylindrical) were acquired and used to develop the models...
December 13, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29229405/instrumented-socket-inserts-for-sensing-interaction-at-the-limb-socket-interface
#16
Eric C Swanson, Jake B McLean, Katheryn J Allyn, Christian B Redd, Joan E Sanders
The objective of this research was to investigate a strategy for designing and fabricating computer-manufactured socket inserts that were embedded with sensors for field monitoring of limb-socket interactions of prosthetic users. An instrumented insert was fabricated for a single trans-tibial prosthesis user that contained three sensor types (proximity sensor, force sensing resistor, and inductive sensor), and the system was evaluated through a sequence of laboratory clinical tests and two days of field use...
December 8, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/29217446/the-use-of-the-profunda-femoral-artery-as-the-sole-target-vessel-to-bypass-aorto-iliac-disease-in-patients-with-critical-limb-ischemia-and-concomitant-unreconstructable-infra-inguinal-disease
#17
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 aorto-iliac disease (AOID), with no further option for infra-inguinal 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...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29215082/the-myokinetic-control-interface-tracking-implanted-magnets-as-a-means-for-prosthetic-control
#18
S Tarantino, F Clemente, D Barone, M Controzzi, C Cipriani
Upper limb amputation deprives individuals of their innate ability to manipulate objects. Such disability can be restored with a robotic prosthesis linked to the brain by a human-machine interface (HMI) capable of decoding voluntary intentions, and sending motor commands to the prosthesis. Clinical or research HMIs rely on the interpretation of electrophysiological signals recorded from the muscles. However, the quest for an HMI that allows for arbitrary and physiologically appropriate control of dexterous prostheses, is far from being completed...
December 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29201828/hand-functions-of-myoelectric-and-3d-printed-pressure-sensored-prosthetics-a-comparative-study
#19
Kyu Ho Lee, Hobeom Bin, KeunBae Kim, So Young Ahn, Bong-Ok Kim, Soo-Kyung Bok
The loss of an upper limb significantly limits the functional activities of daily living. A huge emphasis is placed on the manipulation, shape, weight, and comfort of a prosthesis, to enable its use as an inherent body part. Even with technological advances, customized upper-extremity myoelectric prosthesis remain heavy and expensive. The high cost of upper-extremity prosthesis is an especially steep economic barrier for patients. Three-dimensional (3D) printing is a promising avenue for reducing the cost of prosthesis...
October 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29199518/improvement-on-upper-limb-body-powered-prostheses-1921-2016-a-systematic-review
#20
Nur Afiqah Hashim, Nasrul Anuar Abd Razak, Noor Azuan Abu Osman, Hossein Gholizadeh
Body-powered prostheses are known for their advantages of cost, reliability, training period, maintenance, and proprioceptive feedback. This study primarily aims to analyze the work related to the improvement of upper limb body-powered prostheses prior to 2016. A systematic review conducted via the search of the Web of Science electronic database, Google Scholar, and Google Patents identified 155 papers from 1921 to 2016. Sackett's initial rules of evidence were used to determine the levels of evidence, and only papers categorized in the design and development category and patents were analyzed...
December 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
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