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Sample records for atraumatic patellar prosthesis

  1. 21 CFR 888.3580 - Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint patellar (hemi-knee) metallic... § 888.3580 Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis is a device made...

  2. Effect of bone block removal and patellar prosthesis on stresses in the human patella.

    Science.gov (United States)

    Friis, E A; Cooke, F W; McQueen, D A; Henning, C E

    1994-01-01

    Thermoelastic stress analysis was used to examine stresses on the anterior surface of patellae after patellar bone block excision for autogenous graft anterior cruciate ligament reconstruction. Complications of anterior cruciate ligament injury often lead to degenerative changes in the knee that can require total knee joint replacement. It was hypothesized that stresses in a bone block-compromised patella may be increased even further by insertion of a patellar prosthesis. All patellae were first tested intact and then were retested after a sequence of surgical modifications including patellar prosthesis implantation, tapered bone block excision, square bone block excision, and both shapes of excised bone blocks with a patellar prosthesis in place. Stresses in patellae with bone blocks excised were significantly greater than stresses in intact patellae. The anterior surface stress pattern in the loaded patella was significantly altered by excision of a bone block. There were no significant differences between maximum stress in patellae with tapered and square bone blocks excised. A finite element analysis showed that excision of a larger trapezoid-shaped bone block greatly increased maximum stress levels. Insertion of a patellar prosthesis did not significantly alter stress patterns or maximum stress levels in the patella.

  3. Atraumatic First Rib Fracture

    Directory of Open Access Journals (Sweden)

    Koray Aydogdu

    2014-12-01

    Full Text Available Rib fractures are usually seen after a trauma, while atraumatic spontaneous rib fractures are quite rare. A first rib fracture identified in our 17 years old female patient who had not a history of trauma except lifting a heavy weight was examined in details in terms of the potential complications and followed-up for a long time. We presented our experience on this case with atraumatic first rib fracture that has different views for the etiology in light of the literature.

  4. Spontaneous Atraumatic Mediastinal Hemorrhage

    Directory of Open Access Journals (Sweden)

    Morkos Iskander BSc, BMBS, MRCS, PGCertMedEd

    2013-04-01

    Full Text Available Spontaneous atraumatic mediastinal hematomas are rare. We present a case of a previously fit and well middle-aged lady who presented with acute breathlessness and an increasing neck swelling and spontaneous neck bruising. On plain chest radiograph, widening of the mediastinum was noted. The bruising was later confirmed to be secondary to mediastinal hematoma. This life-threatening diagnostic conundrum was managed conservatively with a multidisciplinary team approach involving upper gastrointestinal and thoracic surgeons, gastroenterologists, radiologists, intensivists, and hematologists along with a variety of diagnostic modalities. A review of literature is also presented to help surgeons manage such challenging and complicated cases.

  5. Imaging patellar complications after knee arthroplasty

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    Melloni, Pietro [Unitat de Imatge d' Alta Tecnologia, Centre Diagnostic, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)], E-mail: pmelloni@cspt.es; Valls, Rafael; Veintemillas, Maite [Unitat de Imatge d' Alta Tecnologia, Centre Diagnostic, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)

    2008-03-15

    The purpose of this study is to describe complications affecting the patella in patients with total or partial knee arthroplasty. We respectively analysed plain-film radiographs, as well as ultrasound images when acquired, in a consecutive series of 1272 patients. The mean interval from knee replacement to patellar complications was 5 years and 7 months (range, 5 months to 14 years). The complications described include fracture, instability, dislocation or luxation, necrosis of the patella, infection of the patella, erosion of the patella, patellar impingement on the prosthesis and patellar or quadricipital tendon tear. We discuss the pathological imaging findings in the patella and their differential diagnosis after knee arthroplasty. Patellar complications after knee arthroplasty are uncommon but often potentially serious.

  6. Quick, painless, and atraumatic gingival retraction: An overview of advanced materials.

    Science.gov (United States)

    Rajambigai, M Aarti; Raja, S Ramesh; Soundar, S I Joephin; Kandasamy, M

    2016-10-01

    The success of any fixed prosthesis depends on the accuracy of impressions. Finish line exposure has to be adequate during impression making. The goal of gingival retraction is to atraumatically displace gingival tissues to allow access for impression material to record the finish line and provide sufficient thickness of gingival sulcus so that the impression does not tear off during removal. Numerous advanced materials are available for gingival retraction. This article describes the different advanced materials available.

  7. Quick, painless, and atraumatic gingival retraction: An overview of advanced materials

    OpenAIRE

    M Aarti Rajambigai; S Ramesh Raja; S I. Joephin Soundar; Kandasamy, M

    2016-01-01

    The success of any fixed prosthesis depends on the accuracy of impressions. Finish line exposure has to be adequate during impression making. The goal of gingival retraction is to atraumatically displace gingival tissues to allow access for impression material to record the finish line and provide sufficient thickness of gingival sulcus so that the impression does not tear off during removal. Numerous advanced materials are available for gingival retraction. This article describes the differe...

  8. Atraumatic restorative treatment in atypical cavities

    Directory of Open Access Journals (Sweden)

    Letícia Simino Carvalho

    2009-10-01

    Full Text Available The atraumatic restorative treatment has been widely divulged among professionals in the area of Pediatric Dentistry. This restorative technique is included in the philosophy of Minimal Intervention and is considered one of the most conservative treatments, because only the layer of infected dentin caries is removed. Moreover, the atraumatic restorative treatment has been shown to be less painful than conventional approaches, and local anesthesia is rarely required. After the removal of the infected dentin, the cavities are filled with glass ionomer cement, a material that has antimicrobial capacity, good marginal sealing and constant fluorine release and recharge. In spite of the increasing number of studies about atraumatic restorative treatment, only studies related to restorations in occlusal cavities have shown scientific evidences about the technique. The aim of this study was to evaluate the feasibility of atraumatic restorative treatment in cavities with 3 or more surfaces involved, by means of a clinical case report of a patient with extensive dstruction in primary teeth, who was submitted to atraumatic restorative treatment, and observe the result of the treatment after one year of clinical and radiographic control.

  9. ATRAUMATIC RESTORATIVE TREATMENT – A REVIEW

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    Sangameshwar

    2013-01-01

    Full Text Available ABASTRACT: Atraumatic Restorative Treatment (ART was origina lly developed in field settings in African subcontinent (Tanzania by Univ ersity of Dar el Salaam in 1980s; subsequently World Health Organization (WHO promote s the use of ART especially with children. As the name indicates Atraumatic Restorat ive Treatment (ART is basically a minimally invasive procedure that involves removing of softened carious dentine using hand instruments and then restoring the cavity with an a dhesive material usually the Glass Ionomer Cement [1]. ART is based on the maximum preservation of sound tooth tissue and the minimum feeling of discomfort and pain, since there is use o f hand instruments it perhaps also reduces pain due to reduced vibrations as occurs while use o f rotary dental instruments. This technique is gaining popularity and acceptability especially in c hildren, elderly and with those individuals who have fear and anxiety about dental treatment [2 , 3]. ART requires use of very minimal portable dental equipment and was designed to use in field/community settings. It was developed for use in less developed countries of the world, where art was seen as an affordable option for patents who can’t afford to pay for more s ophisticated treatments, but with improved technique and use of improved restorative materials its use has considerable expanded to developed countries as well [4-6]. This article give s a brief overview of ART and its uses in the present scenario. KEY WORDS: ART = Atraumatic Restorative Technique, GIC = Glas s Ionomer Cement

  10. Jumper's Knee (Patellar Tendonitis) (For Parents)

    Science.gov (United States)

    ... Preventing Jumper's Knee en español Rodilla de saltador (tendinitis rotuliana) Jumper's knee — also known as patellar tendonitis or patellar tendinopathy — is an inflammation or injury of the patellar ...

  11. Patellar osteochondroma: case report,

    Directory of Open Access Journals (Sweden)

    Frederico Barra de Moraes

    2014-04-01

    Full Text Available The aim was to report on a rare case of patellar osteochondroma. A 60-year-old man presented a tumor on his left patella that had developed over a 10-year period, which is a rare occurrence, considering the patient's age and the site at which the tumor appeared. The clinical condition comprised mild pain and the presence of a mass, without limitation of flexion-extension or any neurovascular deficit. The tumor dimensions were 8 cm longitudinally × 6 cm transversally × 3 cm anteroposteriorly. It was hardened and was adhering to the patellar bone plane. On radiographs and tomographic scans, we observed areas of greater density corresponding to bone and other less dense areas that could correspond to slow-growing cartilage, with irregularities on the patellofemoral joint surface. Simple resection of the tumor was performed, and the anatomopathological examination confirmed that it was a patellar osteochondroma. Osteochondroma, or osteocartilaginous exostosis, includes a large proportion of the benign bone tumors. It results from cell alterations that trigger unregulated production of spongy bone. It is basically treated by means of surgical removal of the tumor mass. This is not essential, but is recommended in order to avoid lesions caused by contiguity and the risk of malignant transformation.

  12. Injection treatments for patellar tendinopathy

    NARCIS (Netherlands)

    van Ark, Mathijs; Zwerver, Johannes; van den Akker-Scheek, Inge

    2011-01-01

    Objective Injection treatments are increasingly used as treatment for patellar tendinopathy. The aim of this systematic review is to describe the different injection treatments, their rationales and the effectiveness of treating patellar tendinopathy. Methods A computerised search of the Medline, Em

  13. [Quadriceps and patellar tendon ruptures].

    Science.gov (United States)

    Grim, C; Lorbach, O; Engelhardt, M

    2010-12-01

    Ruptures of the quadriceps or patellar tendon are uncommon but extremely relevant injuries. Early diagnosis and surgical treatment with a stable suture construction are mandatory for a good postoperative clinical outcome. The standard methods of repair for quadriceps and patellar tendon injuries include the placement of suture loops through transpatellar tunnels. Reinforcement with either a wire cerclage or a PDS cord is used in patellar tendon repair. The PDS cord can also be applied as augmentation in quadriceps tendon repair. In secondary patellar tendon repair an autologous semitendinosus graft can be used. For chronic quadriceps tendon defects a V-shaped tendon flap with a distal footing is recommended. The different methods of repair should lead to early functional postoperative treatment. The clinical outcome after surgical treatment of patellar and quadriceps tendon ruptures is mainly good.

  14. Sonosurgery for atraumatic tooth extraction: a clinical report.

    Science.gov (United States)

    Papadimitriou, Dimitrios E V; Geminiani, Alessandro; Zahavi, Thomas; Ercoli, Carlo

    2012-12-01

    The preservation of an intact labial plate during tooth extraction is a critical determinant of whether an immediate implant can be placed and is also an important predictor of the esthetic result. The purpose of this clinical report was to present a method for atraumatic tooth extraction by using an air-driven sonic instrument with specially designed inserts. This surgical technique provides the clinician with an efficient method for atraumatic tooth extraction and preservation of an intact labial plate.

  15. Atraumatic femoral neck fracture secondary to prolonged lactation induced osteomalacia

    Directory of Open Access Journals (Sweden)

    Dhammapal Sahebrao Bhamare

    2013-01-01

    Full Text Available Presenting a case of atraumatic fracture neck femur secondary to 2 years of prolonged lactation. A 26-year-old lactating mother presented with pain in left hip from last 12 months. She was apparently alright before and during pregnancy. Plain radiograph showed a complete undisplaced fracture of femoral neck. Osteomalacia was diagnosed by radiological and serological investigations. The fracture was fixed using AO type cannulated cancellous screws. The fracture showed good clinical and radiological union at 3 months. Literature review shows that this is a first case of atraumatic fracture of neck femur due to prolonged lactational osteomalacia. It showed that even apparently healthy Indians are susceptible to osteomalacia, more so during pregnancy and lactation and can be presented as atraumatic fracture. Although considered relatively stable, a compression type incomplete fracture neck femur may progress to a complete fracture if not treated in time.

  16. Bionic prosthesis

    OpenAIRE

    МЫЛЬНИКОВ А.М.

    2015-01-01

    The real achievement in the prosthetics has become artificial joints that function as well as natural joints. Bionic limbs are the most advanced type of prosthesis at the moment. These electronic devices are made from synthetic materials, but the person can manage them using his/her own nervous system through the targeted muscle reinnervation (recovery disturbed innervation of organs and tissues surgically).Principle of operation of bionic prosthesis. After the amputation because of a serious...

  17. Quadriceps and patellar tendon rupture.

    Science.gov (United States)

    Ramseier, L E; Werner, C M L; Heinzelmann, M

    2006-06-01

    Ruptures of the patellar and/or quadriceps tendon are rare injuries that require immediate repair to re-establish knee extensor continuity and to allow early motion. We evaluated 36 consecutive patients with quadriceps or patellar tendon rupture between 1993 and 2000. There were 37 primary ruptures, 3 reruptures, 21 quadriceps and 19 patellar tendon ruptures. Follow up examination (>24 months postoperatively) included the patient's history, assessment of risk factors, clinical examination of both knees, isometric muscle strength measurements and three specific knee scores, Hospital for Special Surgery Score, Knee Society Score and Turba Score, and a short form SF-36. We evaluated 29 patients (26 men) with 33 ruptures (16 patellar tendon, 17 quadriceps tendon). Seven patients were lost to follow up. We found no difference between the range of motion and muscle strength when the injured leg was compared to the non-injured leg. Risk factors did not influence the four scores, patient satisfaction, pain, muscle strength or range of motion. Multiple injured patients had a significant reduction in muscle strength and circumference, however patient satisfaction did not differ to the non-multiple injured patient group.

  18. Tendinopatia patelar Patellar tendinopathy

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    Moisés Cohen

    2008-08-01

    Full Text Available A tendinopatia do patelar ou jumper's knee (joelho do saltador é uma afecção que acomete freqüentemente atletas praticantes de atividades de salto ou aquelas que exigem força de impacto repetitivo. Histologicamente, a sobrecarga excessiva no tendão pode provocar alterações na matriz extracelular, resultando em pequenas lesões que, cronicamente, poderão levar a um quadro de tendinose, principalmente na região do pólo inferior da patela. A dor na região anterior do joelho é o primeiro sintoma relatado pelo paciente portador dessa afecção. Seu início é insidioso e gradual, principalmente após atividade física, mas, com a progressão da doença, pode tornar-se freqüente durante ou já no início da atividade. O diagnóstico de tendinopatia do patelar é eminentemente clínico, caracterizado por dor à palpação no pólo inferior da patela e adjacências e, nos casos mais avançados, nódulo palpável e edema associado podem ser visualizados. Exames complementares, como radiografia, ultra-sonografia (US e ressonância magnética (RM auxiliam no diagnóstico. O US e a RM são os mais indicados, pois podem definir o local exato da lesão, sua extensão, como também identificar a presença ou não de alterações degenerativas, sendo a RM o que fornece melhor resolução. O tratamento inicial da tendinopatia é clínico, com repouso relativo, correção dos fatores etiológicos, além de crioterapia e medidas fisioterápicas. A utilização da medicação analgésica e antiinflamatória é controversa. Nos casos que não respondem ao tratamento clínico, o cirúrgico é opção, e várias técnicas são descritas, a literatura demonstrando índices variados de bons resultados.Patellar tendinopathy, or jumper's knee, is often seen in athletes that practice jumping modalities, or modalities that require repetitive impact strength. Histologically, the excessive load on the tendon may cause changes in the extracellular matrix and

  19. Incidence and Epidemiology of Patellar Fractures

    DEFF Research Database (Denmark)

    Larsen, Peter; Court-Brown, Charles M; Vedel, Julie Odgaard;

    2016-01-01

    The literature lacks large-scale, up-to-date, population-based epidemiology studies on the incidence of patellar fractures based on complete populations. The purpose of this study was to provide up-to-date information concerning the incidence of patellar fractures in a large and complete population...

  20. Routine patellar resurfacing using an inset patellar technique.

    LENUS (Irish Health Repository)

    Hurson, Conor

    2012-02-01

    The management of the patella in total knee arthroplasty still causes controversy. Whether or not to resurface the patella in primary total knee arthroplasty remains unclear. In this study we examined 220 consecutive total knee replacements, by a single surgeon, where the patella was routinely resurfaced using the inset technique. All patellae were suitable for resurfacing. Patellar thickness was not altered in 54.5% of patellae. In 97.2% the patella was within 2 mm of the original thickness. There were no significant complications. In this study we have found that the inset technique of patella resurfacing in total knee replacement is a simple and safe resurfacing procedure.

  1. Spontaneous atraumatic dislocation of sternoclavicular joint in Reiter's syndrome

    Institute of Scientific and Technical Information of China (English)

    Vijay Kumar Digge; Sanjay Meena; Sheh Alam Khan; Ravi Mittal

    2012-01-01

    Reactive arthritis or Reiter's syndrome characteristically affects the joint of the lower limb in an asymmetrical pattern.Usually it does not affect the axial skeleton or upper limbs.Although cases of atraumatic atlantoaxial subluxations have been reported,no case of spontaneous sternoclavicular dislocation in Reiter's syndrome has been reported.This paper describes a case of a 26 year old male patient who developed a spontaneous posterior sternoclavicular joint dislocation.No attempt of reduction was made and the patient was managed conservatively with good results.

  2. Patellar Dislocations and Reduction Procedure.

    Science.gov (United States)

    Ramponi, Denise

    2016-01-01

    Acute patellar dislocations are a common injury occurring in adolescents involved in sports and dancing activities. This injury usually occurs when the knee is in full extension and sustains a valgus stress on the knee. The medial patellofemoral ligament is the medial restraint that assists in stabilizing the patella from lateral dislocations. The patella usually dislocates laterally and is usually not difficult to reduce after patient evaluation and prereduction radiographs. After postreduction radiographs confirm proper position of the patella postreduction and the absence of fractures, the patient is usually treated conservatively with initial immobilization, orthopedic referral, and physical therapy.

  3. Quadriceps and patellar tendon ruptures.

    Science.gov (United States)

    Lee, Dennis; Stinner, Daniel; Mir, Hassan

    2013-10-01

    The diagnosis of quadriceps and patellar tendon ruptures requires a high index of suspicion and thorough history-taking to assess for medical comorbidities that may predispose patients to tendon degeneration. Radiographic assessment with plain films supplemented by ultrasound and magnetic resonance imaging when the work-up is equivocal further aids diagnosis; however, advanced imaging is often unnecessary in patients with functional extensor mechanism deficits. Acute repair is preferred, and transpatellar bone tunnels serve as the primary form of fixation when the tendon rupture occurs at the patellar insertion, with or without augmentation depending on surgeon preference. Chronic tears and disruptions following total knee arthroplasty are special cases requiring reconstructions with allograft, synthetic mesh, or autograft. Rehabilitation protocols generally allow immediate weight-bearing with the knee locked in extension and crutch support. Limited arc motion is started early with active flexion and passive extension and then advanced progressively, followed by full active range of motion and strengthening. Complications are few but include quadriceps atrophy, knee stiffness, and rerupture. Outcomes are excellent if repair is done acutely, with poorer outcomes associated with delayed repair.

  4. Magnetic resonance images of chronic patellar tendinitis

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    Bodne, D.; Quinn, S.F.; Murray, W.T.; Cochran, C.; Bolton, T.; Rudd, S.; Lewis, K.; Daines, P.; Bishop, J.

    1988-01-01

    Chronic patellar tendinitis can be a frustrating diagnostic and therapeutic problem. This report evaluates seven tendons in five patients with chronic patellar tendinitis. The etiologies included 'jumper's knee' and Osgood-Schlatter disease. In all cases magnetic resonance images (MRI) showed thickening of the tendon. Some of the tendons had focal areas of thickening which helped establish the etiology. All cases had intratendinous areas of increased signal which, in four cases, proved to be chronic tendon tears. MRI is useful in evaluating chronic patellar tendinitis because it establishes the diagnosis, detects associated chronic tears, and may help determine appropriate rehabilitation. (orig.)

  5. Treating patellar tendinopathy with Fascial Manipulation.

    Science.gov (United States)

    Pedrelli, Alessandro; Stecco, Carla; Day, Julie Ann

    2009-01-01

    According to Fascial Manipulation theory, patellar tendon pain is often due to uncoordinated quadriceps contraction caused by anomalous fascial tension in the thigh. Therefore, the focus of treatment is not the patellar tendon itself, but involves localizing the cause of this incoordination, considered to be within the muscular fascia of the thigh region. Eighteen patients suffering from patellar tendon pain were treated with the Fascial Manipulation technique. Pain was assessed (in VAS) before (VAS 67.8/100) and after (VAS 26.5/100) treatment, plus a follow-up evaluation at 1 month (VAS 17.2/100). Results showed a substantial decrease in pain immediately after treatment (p<0.0001) and remained unchanged or improved in the short term. The results show that the patellar tendon may be only the zone of perceived pain and that interesting results can be obtained by treating the muscular fascia of the quadriceps muscle, whose alteration may cause motor incoordination and subsequent pathology.

  6. Dislocation of a constrained total knee arthroplasty with patellar tendon rupture after trivial trauma

    Institute of Scientific and Technical Information of China (English)

    Raju Vaishya; Vipul Vijay; Abhishek Vaish

    2015-01-01

    Constrained total knee prostheses are used in knees with severe deformities and insufficiency of collaterals to provide stable and mobile knees.Dislocation after constrained knee prosthesis is an extremely rare and dreaded complication.When dislocation is associated with patellar tendon rupture,the management includes restoration of the extensor apparatus along with a stable knee.Repair of the patellar tendon is challenging due to poor soft tissue coverage in the area and a bulky repair can put tension on the wound closure.Ideal method of restoration of the extensor apparatus is a matter of debate.There are various modalities used ranging from primary end-to-end repair,augmentation by medial gastrocnemius flap,semitendinosus and synthetic implants and allograft tendoachilles.We report a rare case of a posterior dislocation of a constrained total knee arthroplasty in association with patellar tendon rupture due to a minor fall after a few weeks of surgery.The first episode was managed by reposition of the dislocation and V-Y plasty of the quadriceps and primary repair.The second episode of dislocation with re-rupture needed augmentation by semitendinosus along with the insertion of the thicker insert.The management of this complex problem along with the review of literature is discussed in this case report.

  7. [Diagnosis and treatment of patellar chondroblastoma].

    Science.gov (United States)

    Cheng, Qiang; Huang, Wei

    2013-12-01

    Chondroblastoma of the patella, rare occurred in patellar,is a kind of an uncommon benign bone tumor. Compared with giant cell tumor, the morbidity of chondroblastoma is lower. Meanwhile, its clinical manifestations are various, and images are very complicated. Therefore, the understanding of this kind of tumors may be limited even to the orthopedist. The differences of patellar chondroblastoma between other tumor in X-ray, CT and MRI is a spot in recent years. Sometimes patellar chondroblastoma coexists with aneurysmal bone cyst, which is a challenge to obtain an accurate pathological and radiological diagnosis. For the treatment, curettage and bone grafting is one the most popular method, but whether to perform a biopsy before surgery still remain controversy. Some new technique still has an unknown prospect for the treatment such as radiofrequency ablation.

  8. Simultaneous bilateral patellar tendon rupture without

    Directory of Open Access Journals (Sweden)

    LU Hua-ding

    2012-04-01

    Full Text Available 【Abstract】There is a dearth of case reports de-scribing simultaneous bilateral patellar tendon ruptures in the medical literature. These ruptures are often associated with systemic disorders such as lupus erythematosus or chronic steroid use. The author describes a case of a 24-year-old man who sustained traumatic bilateral patellar ten-don ruptures without any history of systemic disease or steroidal medication. We repaired and reattached the rup-tured tendons to the patella and augmented our procedure with allogeneic tendon followed by wire loop reinforcement. One year after operation, the patient regained a satisfactory range of motion of both knees with good quadriceps strength and no extensor lag. The recurrent microtrauma from a history of intense sports activity and a high body mass index may have played an important role in this trauma event. Key words: Patella; Patellar ligament; Rupture; Ten-don injuries; Knee

  9. Achilles and Patellar Tendinopathy Loading Programmes

    DEFF Research Database (Denmark)

    Malliaras, Peter; Barton, Christian J; Reeves, Neil D;

    2013-01-01

    INTRODUCTION: Achilles and patellar tendinopathy are overuse injuries that are common among athletes. Isolated eccentric muscle training has become the dominant conservative management strategy for Achilles and patellar tendinopathy but, in some cases, up to 45 % of patients may not respond....... Eccentric-concentric progressing to eccentric (Silbernagel combined) and eccentric-concentric isotonic (heavy-slow resistance; HSR) loading have also been investigated. In order for clinicians to make informed decisions, they need to be aware of the loading options and comparative evidence. The mechanisms...... of loading also need to be elucidated in order to focus treatment to patient deficits and refine loading programmes in future studies. OBJECTIVES: The objectives of this review are to evaluate the evidence in studies that compare two or more loading programmes in Achilles and patellar tendinopathy...

  10. Gastrocnemius myotendinous flap for patellar or quadriceps tendon repair, or both.

    Science.gov (United States)

    Rhomberg, M; Schwabegger, A H; Ninkovic, M; Bauer, T; Ninkovic, M

    2000-08-01

    The authors' experience with simultaneous reconstruction of the quadriceps femoris or patellar tendon or both and soft tissue defect using a musculotendinous unit of the gastrocnemius muscle is presented. Five patients with a partial or complete defect of the quadriceps or patellar tendon or both and additional large soft tissue defects underwent reconstruction applying this technique as a one-stage surgical procedure in different variations. In cases with a partial defect of the tendon or loss of tendon thickness, the thick aponeurosis from the deeper aspect of the gastrocnemius was dissected and transferred as a pedicled tendon flap to reconstruct the tendon defect. In cases with a complete defect of the tendon, the superficial layer of the Achilles tendon together with the deep aponeurotic layer of the gastrocnemius muscle served to reconstruct the tendon. In both procedures the gastrocnemius muscle belly provided soft tissue coverage and was covered with a split thickness skin graft. One patient had a marginal deep necrosis develop that had to be covered with the other gastrocnemius muscle in a second operation. One patient with chronic polyarthritis and infection of his knee prosthesis declined additional reconstruction surgery and had the leg amputated. The average followup was 3.5 years. All patients achieved good results in active extension of the knee with an extension deficit of only 5 degrees to 15 degrees. The range of flexion was at least 90 degrees. The surgical technique described in this report provides functional tendon reconstruction and adequate soft tissue repair simultaneously.

  11. Acceptance and discomfort from atraumatic restorative treatment in secondary school students in Egypt.

    NARCIS (Netherlands)

    Farag, A.; Frencken, J.E.F.M.

    2009-01-01

    OBJECTIVES: To assess the level of acceptance and discomfort experienced by secondary school students when undergoing an atraumatic restorative treatment (ART) restoration. SUBJECTS AND METHODS: Ninety secondary school students, aged 14 and 15 years, were included in the study. The ART restorations

  12. Twenty-five-year atraumatic restorative treatment (ART) approach: a comprehensive overview

    NARCIS (Netherlands)

    Frencken, J.E.; Leal, S.C.; Navarro, M.F.

    2012-01-01

    BACKGROUND: The atraumatic restorative treatment (ART) approach was born 25 years ago in Tanzania. It has evolved into an essential caries management concept for improving quality and access to oral care globally. RESULTS: Meta-analyses and systematic reviews have indicated that the high effectivene

  13. Atraumatic restorative treatment and dental anxiety in outpatients attending public oral health clinics in South Africa.

    NARCIS (Netherlands)

    Mickenautsch, S.; Frencken, J.E.F.M.; Hof, M.A. van 't

    2007-01-01

    OBJECTIVES: This study was undertaken to test the hypotheses that using the atraumatic restorative treatment (ART) approach results in lower patient anxiety and that lower anxiety leads to higher restoration/extraction ratios. METHODS: The test group of dental operators (n = 9) was trained in ART Th

  14. Anuric renal failure after same-session bilateral atraumatic flexible ureteroscopy

    Directory of Open Access Journals (Sweden)

    Gaurav Bandi

    2007-04-01

    Full Text Available We report the first known case of anuric renal failure after same-session bilateral atraumatic flexible ureteroscopy for renal calculi. Although, there is no consensus about stenting patients who undergo same-session bilateral ureteroscopy due to the lack of prospective randomized studies; strong consideration should be given to stenting the ureter at least one side to avoid this complication.

  15. Caries experience of Egyptian adolescents: does the atraumatic restorative treatment approach offer a solution?

    NARCIS (Netherlands)

    Mobarak, E.H.; Shabayek, M.M.; Mulder, J.; Reda, A.H.; Frencken, J.E.F.M.

    2011-01-01

    OBJECTIVES: To assess the prevalence and severity of dental caries amongst Egyptian adolescents and the prevalence of carious lesions treatable through the atraumatic restorative treatment (ART) approach. SUBJECTS AND METHODS: Using a convenient sample procedure, two secondary schools with a dental

  16. The aesthetic hand prosthesis.

    Science.gov (United States)

    Pillet, J

    1981-10-01

    The high-quality aesthetic prosthesis can be equally helpful to those with acquired amputation and to those whose loss is due to agenesis. Restoring near-normal appearance improves patients' function in a global sense, enabling them to better utilize what they have in the complex socioeconomic environment of today's mobile society. The aesthetic prosthesis often also gives some prehensile assistance, providing an opposition part for remaining digits or thumb. The needs of each patient must be carefully considered, and the prosthesis must conform to the high standards of quality outlined. Its use is primarily for the unilateral amputee who is making a good adjustment to the loss with realistic expectations.

  17. T2 mapping in patellar chondromalacia

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Santiago, Fernando, E-mail: ferusan12@gmail.com [Department of Radiology, Traumatology Hospital, University Hospital Virgen de las Nieves, Granada (Spain); Pozuelo Calvo, Rocío [Department of Rehabilitation and Physical therapy, Traumatology Hospital, University Hospital Virgen de las Nieves, Granada (Spain); Almansa López, Julio [Department of Physic, University Hospital Virgen de las Nieves, Granada (Spain); Guzmán Álvarez, Luis; Castellano García, María del Mar [Department of Radiology, Traumatology Hospital, University Hospital Virgen de las Nieves, Granada (Spain)

    2014-06-15

    Objective: To study the correlation between the T2 relaxation times of the patellar cartilage and morphological MRI findings of chondromalacia. Methods: This prospective study comprises 50 patients, 27 men and 23 women suffering of anterior knee pain (mean age: 29.7, SD 8.3 years; range: 16–45 years). MRI of 97 knees were performed in these patients at 1.5 T magnet including sagittal T1, coronal intermediate, axial intermediate fat sat and T2 mapping. Chondromalacia was assessed using a modified version of Noyes classification. The relaxation time, T2, was studied segmenting the full thickness of the patellar cartilage in 12 areas: 4 proximal (external facet–proximal–lateral (EPL), external facet–proximal–central (EPC), internal facet–proximal–central (IPC), internal facet–proximal–medial (IPM), 4 in the middle section (external facet–middle–lateral (EML), external facet–middle–central (EMC), internal facet–middle–central (IMC), internal facet–middle–medial (IMM) and 4 distal (external facet–distal–lateral (EDL), external facet–distal–central (EDC), internal facet–distal–central (IDC), internal facet–distal–medial (IDM). Results: T2 values showed a significant increase in mild chondromalacia regarding normal cartilage in most of the cartilage areas (p < 0.05), except in the internal distal facet (IDC and IDM), EPC, EDL, and IMM. Severe chondromalacia was characterized by a fall of T2 relaxation times with loss of statistical significant differences in comparison with normal cartilage, except in EMC and IMC, where similar values as mild chondromalacia were maintained (p < 0.05). Conclusions: Steepest increase in T2 values of patellar cartilage occurs in early stages of patellar cartilage degeneration. Progression of morphologic changes of chondromalacia to more severe degrees is associated to a new drop of T2 relaxation times approaching basal values in most of the areas of the patellar cartilage, except in the

  18. Epidemiology of Patellar Tendinopathy in Elite Male Soccer Players

    NARCIS (Netherlands)

    Hägglund, Martin; Zwerver, Johannes; Ekstrand, Jan

    2011-01-01

    Background: Patellar tendinopathy is common among athletes in jumping sports and in sports with prolonged repetitive stress of the knee extensor apparatus. The epidemiology in soccer is not well described. Purpose: This study was undertaken to investigate and describe the epidemiology of patellar te

  19. MEDIAL PATELLAR DESMOTOMY BY BLIND METHOD IN LARGE RUMINANTS DURING UPWARD PATELLAR FIXATION

    Directory of Open Access Journals (Sweden)

    S.Mondal

    2013-12-01

    Full Text Available A total number of 21 cases were reported with the clinical history of locked stifle joint. All cases were operated by medial patellar desmotomy using blind (closed method. Cases were recovered 100% with immediate relief. This blind method may be followed for operation of upward fixation of patella.

  20. The effect of a patellar strap on knee joint proprioception in healthy participants and athletes with patellar tendinopathy

    NARCIS (Netherlands)

    de Vries, Astrid J.; van den Akker-Scheek, Inge; Diercks, Ron L.; Zwerver, Johannes; van der Worp, Henk

    2016-01-01

    Objectives: The primary aim of this study is to investigate the effect of the use of a patellar strap on knee joint proprioception in both healthy participants and in patients with patellar tendinopathy (PT). Secondary aims are to examine whether there is a difference in effectiveness of the use of

  1. Use of computed tomography to determine the risk of patellar dislocation in 921 patients with patellar instability

    Directory of Open Access Journals (Sweden)

    Schueda MA

    2015-03-01

    Full Text Available Marco Antonio Schueda,1 Diego Costa Astur,2 Rodrigo Schueda Bier,3 Debora Schueda Bier,4 Nelson Astur,5 Moisés Cohen2 1Serviço de Pós Graduação em Cirurgia do Joelho e Artroscopia do IOT e Traumasports de Joinville, Joinville, Santa Catarina, 2Departamento de Ortopedia e Traumatologia da Escola Paulista de Medicina, São Paulo, 3Serviço de Cirurgia do Joelho e Artroscopia do IOT e Traumasports de Joinville, Joinville, Santa Catarina, 4Pontifícea Universidade Católica, Curitiba, 5Faculdade de Ciencias Médicas da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil Abstract: The purpose of this research was to identify reliable tomographic measurements that can detect patellofemoral abnormality and allow quantification of the risk of patellar dislocation in patients with potential patellar instability. A cross-sectional study in 921 patients with anterior pain or knee instability of at least 6 months' duration was conducted from July 2001 to December 2009. All subjects were clinically evaluated and underwent radiography and computed tomography of their knees. According to their degree of dislocating patellar dysplasia, the subjects were classified into groups for statistical comparison. There was a statistically significant difference in all measurements when the groups were compared, except for external tibial torsion angle. The most sensitive and specific measurements for determining patellar instability were the trochlear groove angle, tibial tubercle-trochlear groove distance, average patellar tilt, and average patellar height. Patients with potential patellar instability, increased tibial tubercle-trochlear groove distance, and patellar height, tilt, and deviation measurements had a greater risk for patellar dislocation. The clinical relevance of this study is to determine measurements that are able to tell us about patellar dislocation risk. Keywords: patellofemoral instability, knee, patellofemoral syndrome

  2. Atraumatic splenic rupture as a complication of acute exacerbation of chronic pancreatitis, an unusual disease.

    Science.gov (United States)

    Moya Sánchez, Elena; Medina Benítez, Antonio

    2017-02-27

    We report the case of a patient with acute exacerbation of chronic pancreatitis and he suffered an atraumatic splenic rupture. Splenic rupture not associated with trauma is a rare entity that can occurs in normal spleen (spontaneous) or damaged spleen (pathological). This entity may be associated with local inflammatory processes, such as pancreatitis. Ultrasound is a non-invasive technique which is used in unstable patients. CT is useful for making a diagnosis of extension in patients with hemodynamic stability. Atraumatic splenic rupture as a complication of chronic pancreatitis is an unusual disease that requires a high index of suspicion which allows us an early diagnosis because it is a treatable entity that compromises the patient's life.

  3. Atraumatic extraction and immediate implant installation: The importance of maintaining the contour gingival tissues

    Science.gov (United States)

    Tavarez, Rudys Rodolfo De Jesus; dos Reis, Washigton Luís Machado; Rocha, Adrycila Teixeira; Firoozmand, Leily Macedo; Bandéca, Matheus Coêlho; Tonetto, Mateus Rodrigues; Malheiros, Adriana Santos

    2013-01-01

    There is an accelerated resorption in the first six months after the extraction of the dental element, both horizontally and vertically. These clinical changes normally undertake the aesthetic result of prosthetic rehabilitation, and implant installation after the extraction can be a resource to decrease resorption. The clinical case described in this paper demonstrates a sequence of clinical atraumatic extraction, and then the Immediate installation provisionalization. It is concluded that when carefully indicated and planned, this technique can provide an immediate result promising with maintaining the tooth gingival contour. How to cite this article: Tavarez RR, Machado dos Reis WL, Rocha AT, Firoozmand LM, Bandéca MC, Tonetto MR, Malheiros AS. Atraumatic extraction and immediate implant installation: The importance of maintaining the contour gingival tissues. J Int Oral Health 2013; 5(6):113-8 . PMID:24453455

  4. To Compare the Effect of Pre and Post Weight Bearing Anxiety, Depression in Conventional and Modular Prosthesis on Unilateral Transtibial Amputees

    Directory of Open Access Journals (Sweden)

    R. Raja

    2014-01-01

    Full Text Available Aims and Objectives: To compare the effect of anxiety and depression on unilateral trans tibial amputees those who are using conventional and modular patellar tendon bearing (PTB prosthesis with stump exercises. Material and Methods: A sample of 40 persons with below knee amputation who were trained to wear prosthesis were studied with an experimental comparative study design. Patients who were admitted at Kempegowda Institute of Medical Sciences and Research Centre, Bangalore, K. S. Hegde Medical Academy and Research Centre Mangalore, (N=150 who underwent unilateral transtibial, transfemoral and other amputations between August 2009 - December 2011. To find out peri and postoperative prosthetic fitting, anxiety and depression level of transtibial amputees who wear conventional and modular PTB prosthesis. 3 years of experimental comparative study reveals that the outcome measures of peri and post-operative anxiety and depression level while using conventional PTB prosthesis with stump exercises and modular PTB prosthesis with stump exercises on unilateral transtibial amputees. Results: The unilateral transtibial amputees who were trained with modular prosthesis along with stump exercises group patients anxiety and depression levels are reduced as compared to the unilateral transtibial amputees who were trained with conventional PTB prosthesis along with stump exercises. There is no significant difference seen in both the groups while giving stump exercises alone. Conclusion: The unilateral transtibial amputees who were trained with modular prosthesis along with stump exercises group, patient’s anxiety and depression levels are reduced drastically.

  5. Twenty-five-year atraumatic restorative treatment (ART) approach: a comprehensive overview

    OpenAIRE

    Frencken, Jo E.; Leal, Soraya Coelho; Navarro,Maria Fidela

    2012-01-01

    Background The atraumatic restorative treatment (ART) approach was born 25 years ago in Tanzania. It has evolved into an essential caries management concept for improving quality and access to oral care globally. Results Meta-analyses and systematic reviews have indicated that the high effectiveness of ART sealants using high-viscosity glass ionomers in carious lesion development prevention is not different from that of resin fissure sealants. ART using high-viscosity glass ionomer can safely...

  6. Stomatitis sub-prosthesis in patients with superior dental prosthesis

    Directory of Open Access Journals (Sweden)

    Antonia Martina Francisco Local

    2009-04-01

    Full Text Available Background: The stomatitis sub-prosthesis is one of the most frequent changes in hard palate mucous membrane in patients with mucous-supported dental prosthesis. It can be caused by multiple factors, which makes its study and prognosis more difficult. Objective: To describe the occurrence of stomatitis sub-prosthesis and its causes in patients with superior dental prosthesis. Method: Descriptive study including all the patients with superior dental prosthesis examined in the odontology consultation “Barrio Adentro” in the state of Miranda, Venezuela, from November, 2005 to March, 2006. The analysed variables were: age, sex, stomatitis level, teeth brushing frequency, prosthesis condition and use, palate mucous condition and frequency of odontology consultations. Results: 89 patients were attended, more 50% of them had superior dental prosthesis and presented stomatitis sub-prosthesis; the group between 35 and 59 years was the most affected, mainly females. Sub-prosthesis stomatitis type II was the most common and the main causes included constant use of the prosthesis and loose prosthesis. Buccal hygiene was not adequate in these patients. Most of them declared never attending to the dentist, or just when presenting some particular problem. Conclusion: Stomatitis prevalence was related with incorrect hygiene habits and lack of knowledge; it shows the importance of performing educative tasks to reduce this disease incidence.  

  7. Aesthetic finger prosthesis.

    Science.gov (United States)

    Shanmuganathan, N; Maheswari, M Uma; Anandkumar, V; Padmanabhan, T V; Swarup, Shailee; Jibran, Ahmed Hasan

    2011-12-01

    Complete or partial fingers are the most commonly encountered forms of partial hand losses. Though finger amputations are commonly due to traumatic injuries, digit loss may also be attributed to congenital malformations and disease. Irrespective of the etiology, the loss of a finger has a considerable functional and psychological impact on an individual. In order to alleviate these problems, partial or complete finger prosthesis may be fabricated. This clinical report portrays a method to fabricate silicone rubber prosthesis for a patient who has a partial finger loss caused due to trauma.

  8. Patellar Articular Overlap on MRI Is a Simple Alternative to Conventional Measurements of Patellar Height

    Science.gov (United States)

    Munch, Jacqueline L.; Sullivan, Jaron P.; Nguyen, Joseph T.; Mintz, Douglas; Green, Daniel W.; Shubin Stein, Beth E.; Strickland, Sabrina

    2016-01-01

    Background: Patella alta describes an abnormally high-riding patella in relationship to the femur and has been shown to correlate with patellofemoral pain, instability, chondromalacia, and arthrosis. Conventional measurements of patella alta involve multiple measurements and are often not defined on cross-sectional imaging as related to radiographs. Hypothesis: Patellar articular overlap on sagittal magnetic resonance imaging (MRI) will correlate well with conventional measurements of patella alta as measured by a standardized technique defined by our group. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: MRIs of 239 knees were reviewed by 3 attending surgeons with practices focusing on patellofemoral disease, as well as 2 sports medicine fellows and 1 musculoskeletal radiologist. Measurements included articular overlap, percentage of articular coverage, Caton-Deschamps index, Blackburne-Peel index, and modified Insall-Salvati index. Results: Interrater reliability was high for Caton-Deschamps, Blackburne-Peel, and modified Insall-Salvati indices (intraclass correlation coefficient [ICC], 0.877, 0.828, and 0.787, respectively). Articular overlap and percentage articular coverage correlated well with each other (ICC, 0.961; P < .001) and with the Caton-Deschamps (overlap r = –0.271, P < .001; coverage r = –0.131, P = .037) and Blackburne-Peel (overlap r = 0.343, P < .001; coverage r = –0.238, P < .001) indices. Articular overlap and percentage coverage failed to correlate with the modified Insall-Salvati index (overlap r = –0.117, P = .091; coverage r = 0.007, P = .918). Conclusion: Patellar articular overlap and percentage of patellar articular coverage show promise as a simpler alternative to conventional, ratio-based measurements of patellar height. Future studies are needed to evaluate the range of normal and the relationship to our traditionally used measurements. PMID:27482530

  9. Influence of autograft removal on rabbit patellar tendon length.

    Science.gov (United States)

    Monllau, J C; Hinarejos, P; Alvarez, P; Alameda, F; Ballester, J

    2004-02-01

    Twelve adult New Zealand white rabbits were randomly divided into two groups. In group 1, 30% of the central mass of the right patellar tendon was removed. In group 2, 60% was removed. The left knees served as controls. The animals were killed 1 year later. The patella-patellar tendon-tibial tuberosity units of all knees were studied using histological and morphometric analysis. In both groups, the tendons had lengthened. Lengthening average was 2.50 mm in group 1 and 8.17 mm in group 2. In both groups, histology revealed poor alignment of the collagen fibres and high cellularity, although the findings in group 1 were nearer the normal histological pattern. The results suggest that removal of significant portions of the patellar tendon leads to lengthening of the resulting tendon. In clinical practice, it seems prudent to pay attention to the dimensions of the patellar tendon when harvesting a graft.

  10. [Neglected ipsilateral simultaneous ruptures of patellar and quadriceps tendon].

    Science.gov (United States)

    Karahasanoğlu, İlker; Yoloğlu, Osman; Kerimoğlu, Servet; Turhan, Ahmet Uğur

    2015-01-01

    Neglected patellar and quadriceps tendon rupture is a rare injury, but ipsilateral simultaneous patellar and quadriceps tendon rupture was not described in the literature to our knowledge. In this article, we report a 40-year-old healthy male patient with neglected ipsilateral patellar and quadriceps tendon ruptures treated by peroneus longus tendon autograft. Patient had received some conservative and surgical treatments for patellar fracture before applying to our clinic. After our treatment using peroneus longus autograft and interference nails, patient was immobilized for six weeks in cylindrical cast. Flexion exercises and full weight bearing were started after cast removal. Patient had no complaint at postoperative second year. Patient was a neglected case. Surgical repair and early rehabilitation enabled us to achieve a satisfactory outcome.

  11. Patellar calcar: MRI appearance of a previously undescribed anatomical entity

    Energy Technology Data Exchange (ETDEWEB)

    Collins, Mark S.; Tiegs-Heiden, Christin A. [Department of Radiology, Mayo Clinic, Rochester, Minnesota (United States); Stuart, Michael J. [Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota (United States)

    2014-02-15

    The femoral calcar is a constant anatomical structure within the proximal femur representing a condensation of bone trabeculae. It is our impression that a similar structure is present within the patella. The purpose of this retrospective study was to define the prevalence, appearance, location, and configuration of the patellar calcar on MRI examinations. One hundred consecutive unenhanced knee MRIs were retrospectively reviewed by two readers who were blinded to the clinical indication. The patellar calcar was defined as a dark signaling, linear or curvilinear structure subjacent to the patellar articular surface. If present, the patellar calcar was assigned to a ''well seen,'' ''moderately well seen,'' or ''faintly seen'' category. Location of the calcar within the patella, orientation, configuration, and thickness were recorded. Confounding variables, such as marrow edema, patellar chondromalacia, bipartite patella, or postoperative changes were also recorded. The patellar calcar was visualized in 81 out of 100 (81 %) MRIs. When detected, the calcar was well seen in 20 out of 81 (25 %), moderately well seen in 35 out of 81 (43 %), and faintly seen in 26 out of 81 (32 %). The anteroposterior width of the calcar measured at its thickest segment was: < 1 mm in 43 out of 81 (53 %), 1 mm in 28 out of 81 (35 %), and >1 mm in 10 out of 81 (12 %). The patellar calcar was seen in the majority of knee MRIs and had a consistent imaging appearance. The calcar may be obscured by degenerative arthrosis of the patella and rarely may mimic patellar stress fracture or osteochondritis dissecans. Radiologists and clinicians should be familiar with this normal anatomical structure. (orig.)

  12. Direct Repair without Augmentation of Patellar Tendon Avulsion following TKA

    Directory of Open Access Journals (Sweden)

    Ravi Mittal

    2015-01-01

    Full Text Available Complications involving the extensor mechanism after TKA are potentially disastrous. We are reporting a case of patellar tendon rupture from tibial tuberosity following total knee arthroplasty. We managed it by direct repair with fiberwire using Krackow suture technique without augmentation. Our long term result has been very encouraging. Our method is a safe and better method of management of patellar tendon avulsion following TKA when it happens without any tissue loss.

  13. Direct Repair without Augmentation of Patellar Tendon Avulsion following TKA

    OpenAIRE

    2015-01-01

    Complications involving the extensor mechanism after TKA are potentially disastrous. We are reporting a case of patellar tendon rupture from tibial tuberosity following total knee arthroplasty. We managed it by direct repair with fiberwire using Krackow suture technique without augmentation. Our long term result has been very encouraging. Our method is a safe and better method of management of patellar tendon avulsion following TKA when it happens without any tissue loss.

  14. [Simultaneous rupture of a patellar tendon and contralateral quadriceps tendon].

    Science.gov (United States)

    Horas, U; Ernst, S; Meyer, C; Halbsguth, A; Herbst, U

    2006-09-01

    The simultaneous bilateral rupture of the quadriceps tendon is a rare injury; only occasional reports exist about the bilateral simultaneous rupture of the patellar tendon. Degenerative changes of the tendon due to drugs or diseases lead to the rupture. We describe two cases of simultaneous rupture of the patellar and contralateral quadriceps tendons; only one patient had special risks. We report the management of therapy and the functional results using the Lysholm score and Knee Rating Scale.

  15. Computer-assisted patellar resection system: development and insights.

    Science.gov (United States)

    Fu, Chun Kit; Wai, Jeff; Lee, Estee; Hutchison, Carol; Myden, Curtis; Batuyong, Eldridge; Anglin, Carolyn

    2012-04-01

    Incorrect resection of the patella during total knee arthroplasty (TKA) can lead to anterior knee pain (AKP), patellar maltracking, patellofemoral impingement, patellar fracture, component loosening, and reduced range of motion. Computer-assisted surgery (CAS) systems for the tibia and femur improve cut accuracy, but no CAS system is available for patellar resection. We developed a system that included an optoelectronic localizer, marker arrays on the patella and instruments, and navigation software. Three users performed resections on artificial patellae mounted in a simulated surgical setup using five techniques (two CAS, three conventional), each repeated at least three times in randomized order. Computer-assisted patellar resection produced better or equal cut symmetry compared to conventional techniques, particularly superoinferiorly. Using CAS with a sawguide produced better results than using CAS freehand with an oscillating saw. This study showed the feasibility of computer-assisted patellar resection, which could lead to reduced pain and complications after TKA. The feedback provided could also make patellar CAS a valuable training tool.

  16. Long-term Results of Primary Total Knee Arthroplasty with and without Patellar Resurfacing

    Directory of Open Access Journals (Sweden)

    Park,Se-Jin

    2010-10-01

    Full Text Available Among patients that underwent total knee arthroplasty from June, 1990 to January, 1999, 61 cases (44 patients that could be followed for more than 10 years were included in this study. The patients were divided into a patellar retention group and a patellar resurfacing group, and were compared with regard to their clinical and radiological outcomes. In patients undergoing primary TKA, a selective patellar resurfacing protocol was used. The indications for patellar retention were a small patella, nearly normal articular cartilage, minimal preoperative patellofemoral pain, poor patellar bone quality, and young patient age. When patellar retention was performed, osteophytes of the patella were removed and marginal electrocauterization was carried out. There were 25 cases (20 patients in the patellar retention group and 36 cases (29 patients in the patellar resurfacing group. The mean follow-up period was 140.7 months in the patellar retention group and 149.0 months in the patellar resurfacing group. The selective patellar resurfacing with total knee arthroplasty had a favorable outcome;there were a significant difference noted between the 2 groups in the functional scores, which showed better outcomes in the patellar resurfacing group than in the patellar retention group.

  17. Patellar Taping, Patellofemoral Pain Syndrome, Lower Extremity Kinematics, and Dynamic Postural Control

    OpenAIRE

    Aminaka, Naoko; Gribble, Phillip A

    2008-01-01

    Context: Patellar taping has been a part of intervention for treatment of patellofemoral pain syndrome (PFPS). However, research on the efficacy of patellar taping on lower extremity kinematics and dynamic postural control is limited.

  18. Aesthetic Finger Prosthesis

    OpenAIRE

    2011-01-01

    Complete or partial fingers are the most commonly encountered forms of partial hand losses. Though finger amputations are commonly due to traumatic injuries, digit loss may also be attributed to congenital malformations and disease. Irrespective of the etiology, the loss of a finger has a considerable functional and psychological impact on an individual. In order to alleviate these problems, partial or complete finger prosthesis may be fabricated. This clinical report portrays a method to fab...

  19. Does the adolescent patellar tendon respond to 5 days of cumulative load during a volleyball tournament?

    NARCIS (Netherlands)

    van Ark, Mathijs; Docking, Sean I.; van den Akker-Scheek, Inge; Rudavsky, A; Rio, Ebonie; Zwerver, Johannes; Cook, Jill L.

    2016-01-01

    Patellar tendinopathy (jumper's knee) has a high prevalence in jumping athletes. Excessive load on the patellar tendon through high volumes of training and competition is an important risk factor. Structural changes in the tendon are related to a higher risk of developing patellar tendinopathy. The

  20. Decline eccentric squats increases patellar tendon loading compared to standard eccentric squats

    DEFF Research Database (Denmark)

    Kongsgaard, M; Aagaard, P; Roikjaer, S

    2006-01-01

    Recent studies have shown excellent clinical results using eccentric squat training on a 25 degrees decline board to treat patellar tendinopathy. It remains unknown why therapeutic management of patellar tendinopathy using decline eccentric squats offer superior clinical efficacy compared...... to standard horizontal eccentric squats. This study aimed to compare electromyography activity, patellar tendon strain and joint angle kinematics during standard and decline eccentric squats....

  1. The Effects of Patellar Taping on Knee Joint Proprioception.

    Science.gov (United States)

    Callaghan, Michael J; Selfe, James; Bagley, Pam J; Oldham, Jacqueline A

    2002-03-01

    OBJECTIVE: To evaluate the effects of patellar taping on knee joint proprioception. DESIGN AND SETTING: In a research unit, 3 proprioceptive tests were performed. For each of the tests, a standardized patellar taping technique was applied in random order. SUBJECTS: Fifty-two healthy volunteers (27 women, 25 men; age, 23.2 +/- 4.6 years; body mass index, 23.3 +/- 3.7). MEASUREMENTS: We measured active angle reproduction, passive angle reproduction, and threshold to detection of passive movement on an isokinetic dynamometer. RESULTS: We found no significant differences between the tape and no-tape conditions in any of the 3 proprioceptive tests (P >.05). However, when the subjects' results for active angle reproduction and passive angle reproduction were graded as good (5 degrees ), taping was found to improve significantly those with poor proprioceptive ability (P proprioception did not benefit from patellar taping. However, in those healthy subjects with poor proprioceptive ability as measured by active and passive ankle reproduction, patellar taping provided proprioceptive enhancement. Further studies are needed to investigate the effect of patellar taping on the proprioceptive status of patients with patellofemoral pain syndrome.

  2. Factors of patellar instability: an anatomic radiographic study.

    Science.gov (United States)

    Dejour, H; Walch, G; Nove-Josserand, L; Guier, C

    1994-01-01

    We analyzed the radiographs and computed tomography (CT) scans of 143 knees operated on for symptomatic patellar instability and 67 contralateral asymptomatic knees, together with 190 control knee radiographs and 27 control knee scans, to determine the factors affecting patellar instability. Four factors were relevant in knees with symptomatic patellar instability: (1) Trochlear dysplasia (85%), as defined by the crossing sign (96%) and quantitatively expressed by the trochlear bump, pathological above 3 mm or more (66%), and the trochlear depth, pathologic at 4 mm or less. (2) Quadriceps dysplasia (83%), defined a present when the patellar tilt in extension is more than 20% on the CT scans. (3) Patella alta (Caton-Deschamps) index greater than or equal to 1.2 (24%). (4) Tibial tuberosity-trochlear groove, pathological when greater than or equal to 20 mm (56%). The factors appeared in only 3%-6.5% of the control knees. The etiology of patellar instability is multifactorial. Determination of the factors permits an effective elective therapeutic plan which aims at correcting the anomalies present.

  3. Clinical signs and anatomical correlation of patellar tendinitis

    Directory of Open Access Journals (Sweden)

    Rath Ehud

    2010-01-01

    Full Text Available Background: Patellar tendinitis is one of the several differential diagnosis of anterior knee pain. The clinical diagnosis of patellar tendinitis is based on tenderness to palpation at the inferior pole of the patella. The tenderness has been noted to be maximal when the knee is extended and the quadriceps relaxed, but a definite clinical sign for diagnosis is lacking. The accuracy of two clinical signs was assesed by a two-stage study which included physical examination, MRI and a cadaveric study. Materials and Methods: Two clinical signs, the "passive flexion-extension sign" and the "standing active quadriceps sign" were assessed in 10 consecutive patients with presumed patellar tendinitis. Five patients had an MRI, showed focal abnormality in the tendon. The location of the MRI finding corresponded, to the region of maximal tenderness. A cadaveric dissection was undertaken to describe the anatomy of the patella and the patellar tendon during these tests. Results: Both tests showed a significant decrease in tenderness at the area of inflammation when the patellar tendon was under tension. The cadaveric dissection showed that when the knee is flexed to 90΀ or when the quadriceps is tensioned the deep fibers of the tendon do not deform to anteriorly applied pressure. Conclusion: We suggest using these studies routinely in the evaluation of patients with anterior knee pain.

  4. The atraumatic restorative treatment (ART) approach for the management of dental caries.

    Science.gov (United States)

    Smales, Roger J; Yip, Hak-Kong

    2002-06-01

    There is worldwide interest in and increasing usage of the conservative atraumatic restorative treatment technique or approach for the restoration of primary and permanent teeth. However, most published data on the clinical performance of the newer, high-strength esthetic conventional glass-ionomer restorative cements marketed for the procedure have been derived from short-term studies. There have been very few reports comparing different types of restorative materials and methods of cavity preparation. In primary teeth, after 1 year, success rates have been approximately 80% to 95% for Class I and Class V single-surface restorations, 55% to 75% for Class II multisurface restorations, and 35% to 55% for Class III and Class IV restorations. In permanent teeth, after 2 to 3 years, success rates have been approximately 90% for Class I and Class V single-surface restorations, but little data have been reported for other restoration classes. Failures usually result from restoration losses, fractures, and wear. Further improvements in the design of hand instruments and in the mechanical properties of the newer glass-ionomer cements are required. Currently, use of the atraumatic restorative treatment approach should be restricted to restoration of single-surface caries lesions, especially in permanent teeth, and to sealing of occlusal fissures in selected teeth.

  5. The stump and the prosthesis.

    Science.gov (United States)

    Day, H J

    1980-03-01

    In performing amputations the surgeon must bear in mind the biomechanical and other constraints of the prosthesis likely to be fitted and, so far as possible, should fashion the stump accordingly. The various types of prosthesis and their features are discussed in relation to amputations of the lower and upper limbs at all levels.

  6. Inferior patellar pole fragmentation in children: just a normal variant?

    Energy Technology Data Exchange (ETDEWEB)

    Kan, J.H.; Vogelius, Esben S.; Orth, Robert C.; Guillerman, R.P.; Jadhav, Siddharth P. [Texas Children' s Hospital, E.B. Singleton Pediatric Radiology, Houston, TX (United States)

    2015-06-15

    Fragmentary ossification of the inferior patella is often dismissed as a normal variant in children younger than 10 years of age. The purpose of this study was to determine whether fragmentary inferior patellar pole ossification is a normal variant or is associated with symptoms or signs of pathology using MRI and clinical exam findings as reference. A retrospective review was performed on 150 patients ages 5-10 years who underwent 164 knee radiography and MRI exams (45.1% male, mean age: 7.8 years). The presence or absence of inferior patellar pole fragmentation on radiography was correlated with the presence or absence of edema-like signal on MR images. Clinical notes were reviewed for the presence of symptoms or signs referable to the inferior patellar pole. These data were compared with a 1:1 age- and sex-matched control group without inferior pole fragmentation. Statistical analysis was performed using two-tailed t-tests. Forty of 164 (24.4%) knee radiographs showed fragmentary ossification of the inferior patella. Of these 40 knees, 62.5% (25/40) had edema-like signal of the inferior patellar bone marrow compared with 7.5% (3/40) of controls (P = 0.035). Patients with fragmentary ossification at the inferior patella had a significantly higher incidence of documented focal inferior patellar pain compared with controls (20% vs. 2.5%, P = 0.015). Inferior patellar pole fragmentation in children 5 to 10 years of age may be associated with localized symptoms and bone marrow edema-like signal and should not be routinely dismissed as a normal variant of ossification. (orig.)

  7. Two-year evaluation of the atraumatic restorative treatment approach in primary molars class I and II restorations

    NARCIS (Netherlands)

    da Franca, C.; Colares, V.; van Amerongen, E.

    2011-01-01

    Background.  Atraumatic restorative treatment (ART) has the advantages of reducing pain and fear and of being more cost-effective than the traditional approach. Aim.  The aim of this study was to investigate the survival of ART class I and II restorations in primary molars at 2 years. Design.  The s

  8. [Damage to large tendons: Achilles, patellar and quadriceps tendons].

    Science.gov (United States)

    Amlang, M H; Zwipp, H

    2006-07-01

    The etiology and mechanisms of Achilles, patellar and quadriceps tendon ruptures are very similar. Age dependent changes in tendon structure and disorders such gout, diabetes, rheumatic diseases and chronic renal failure are associated causes. The main mechanism of rupture is indirect trauma. Although clinical diagnosis is easy, ruptures are still frequently missed. Sonography is the main standard diagnostic tool. MRI is indicated only in special cases. Open operative repair is the most common treatment for quadriceps and patellar tendon ruptures. Treatment of Achilles tendon ruptures is moving towards an individualized choice of therapy. Percutaneous and other "minimally invasive" techniques will play an increasingly important role.

  9. Joint prosthesis and method of bone fixation

    NARCIS (Netherlands)

    Oosterom, R.; Van der Pijl, A.J; Bersee, H.E.N.; Van der Helm, F.C.; Herder, J.L

    2006-01-01

    The invention relates to a joint prosthesis (10), for example, a knee joint or shoulder joint prosthesis comprising a first, socket-holding prosthesis part (11) for attachment to a first bone (12) and a second, ball-holding prosthesis part (13) for attachment to a second bone (14) that intermates wi

  10. Conus hip prosthesis.

    Science.gov (United States)

    Wagner, H; Wagner, M

    2001-01-01

    50 years ago, prosthetic replacement of the hip joint ushered in a new epoch in orthopaedics. Total hip replacement made it possible to remove a severely diseased, painful hip and restore normal function and a normal quality of life to the afflicted patient. The early results of total hip replacement are almost all spectacular and hip replacement has become the most successful type of orthopaedic surgery. These good results using an approach that was technically relatively simple resulted in a temptation to implant prosthetic hip joints with ever increasing frequency in ever younger patients. This led to the emergence of new problems, which were not so clearly recognised at the outset: it emerged that the stability of prosthetic hip joints was of limited duration. This had the following consequence: If a total hip prosthesis is implanted in an elderly person whose remaining life-expectancy is shorter than the longevity of the prosthesis, hip replacement is a life-long solution. We can therefore say that, for a patient who has only 10 to 15 years left to live, their hip problem is solved by total hip replacement. For young people, who still have a long life expectancy in front of them, it is different. They will experience failure of the artificial joint and require further surgery. The commonest and most important type of failure in total hip prostheses is aseptic loosening, which is associated with resorption of bone at the site of the prosthesis. The cause of this phenomenon has only gradually been recognised in the course of the years. Initially, the unanimous opinion was that the methacrylate cement, used to fix the components of the prosthesis in the bone, was the definitive cause of aseptic loosening because fissures and fractures of the cement were almost always found during surgical revision of loosened joints. There was talk of "cement disease" and great efforts were made to improve the quality of the cement and the cementing technique. Moreover, even

  11. Is proprioception diminished in patients with patellar tendinopathy?

    NARCIS (Netherlands)

    Groot, H. E.; van der Worp, H.; Nijenbanning, L.; Diercks, R. L.; Zwerver, J.; van den Akker-Scheek, I.

    2016-01-01

    Purpose: Patellar tendinopathy is a highly prevalent overuse injury, and most treatments are only effective to some extent. This persistence of complaints could be linked to changed proprioception. One study showed diminished proprioception in athletes with lateral epicondylitis. Aim of this study w

  12. Sex Variation in Patellar Tendon Kinetics During Running

    Directory of Open Access Journals (Sweden)

    Sinclair Jonathan

    2015-06-01

    Full Text Available Purpose. The aim of the current investigation was to determine whether female recreational runners exhibit distinct patellar tendon loading patterns in relation to their male counterparts. Methods. Twelve male (age 26.55 ± 4.11 years, height 1.78 ± 0.11 m, mass 77.11 ± 5.06 kg and twelve female (age 26.67 ± 5.34 years, height 1.67 ± 0.12 m, mass 63.28 ± 9.75 kg runners ran over a force platform at 4.0 m · s-1. Lower limb kinematics were collected using an eight-camera optoelectric motion capture system which operated at 250 Hz. Patellar tendon loads were examined using a predictive algorithm. Sex differences in limb, knee and ankle joint stiffness were examined statistically using independent samples t tests. Results. The results indicate that patellar tendon force (male = 6.49 ± 2.28, female = 7.03 ± 1.35 and patelllar tendon loading rate (male = 92.41 ± 32.51, female = 111.05 ± 48.58 were significantly higher in female runners. Conclusions. Excessive tendon loading in female runners indicates that female runners may be at increased risk of patellar tendon pathologies.

  13. Foot posture and patellar tendon pain among adult volleyball players

    NARCIS (Netherlands)

    Groot, R. de; Malliaras, P.; Munteanu, S.; Payne, C.; Morrissey, D.; Maffulli, N.

    2012-01-01

    OBJECTIVE: We hypothesized that individuals with a normal foot posture would be less likely to experience patellar tendon pain and pathology than those with a pronated or supinated foot. DESIGN: Observational study. SETTING: Field-based study among competing athletes. PARTICIPANTS: Volleyball player

  14. Foot Posture and Patellar Tendon Pain Among Adult Volleyball Players

    NARCIS (Netherlands)

    de Groot, Reinier; Malliaras, Peter; Munteanu, Shannon; Payne, Craig; Morrissey, Dylan; Maffulli, Nicola

    2012-01-01

    Objective: We hypothesized that individuals with a normal foot posture would be less likely to experience patellar tendon pain and pathology than those with a pronated or supinated foot. Design: Observational study. Setting: Field-based study among competing athletes. Participants: Volleyball player

  15. Is proprioception diminished in patients with patellar tendinopathy?

    NARCIS (Netherlands)

    Groot, H.E.; van der Worp, H.; Nijenbanning, L.; Diercks, R.L.; Zwerver, J.; van den Akker-Scheek, I.

    2016-01-01

    PURPOSE: Patellar tendinopathy is a highly prevalent overuse injury, and most treatments are only effective to some extent. This persistence of complaints could be linked to changed proprioception. One study showed diminished proprioception in athletes with lateral epicondylitis. Aim of this study w

  16. Normal values of patellar and ankle tendon reflex latencies

    NARCIS (Netherlands)

    Frijns, CJM; Laman, DM; vanDuijn, MAJ; vanDuijn, H

    1997-01-01

    The clinical value of latency measurement of tendon reflexes in neurological patients has been reported by several authors. However, normal values are not readily comparable. In the present study, latencies and amplitudes of patellar (PTR) and ankle tendon reflexes (ATR) were measured at rest and af

  17. Relationship between landing strategy and patellar tendinopathy in volleyball

    NARCIS (Netherlands)

    Bisseling, Rob W.; Hof, At L.; Bredeweg, Steef W.; Zwerver, Johannes; Mulder, Theo

    2007-01-01

    Objective: The aetiology of patellar tendinopathy ( jumper's knee) remains unclear. To see whether landing strategy might be a risk factor for the development of this injury, this study examined whether landing dynamics from drop jumps differed among healthy volleyball players ( CON) and volleyball

  18. Atraumatic intracapsular neck of femur fractures after prolonged bisphosphonate treatment: a new atypical variant?

    Science.gov (United States)

    Khan, Sameer Khalid; Savaridas, Terence; Hemers, Jennifer S.; Maarouf, Zouheir; Orgee, Jane M.; Orr, Michael M.

    2016-01-01

    Summary We present 2 cases of elderly females presenting with atraumatic, near-vertical (Pauwells grade 3), intracapsular neck of femur fractures. Following diagnosis of osteoporosis on DEXA scans, they had received alendronic acid for 7 and 10 years respectively. Routine blood tests and serum estimations of calcium, vitamin-D and thyroid-stimulating hormone, done at admission, were within the normal ranges. These patients were managed with a hemiarthroplasty and a dynamic hip screw (DHS) respectively, following discontinuation of bisphosphonates. We present these 2 cases in light of emerging evidence that associates long-term bisphosphonate use with atypical low energy femoral fractures. Only subtrochanteric/diaphyseal fractures have been reported to date. We present a new variant of atypical femoral neck fractures in metaphyseal bone related to prolonged bisphosphonate therapy. PMID:27252743

  19. A Novel Atraumatic Tourniquet Technique for Excessive Bleeding during Cesarean Sections

    Science.gov (United States)

    Buke, Baris; Akkaya, Hatice; Akercan, Fuat

    2017-01-01

    Objective. Controlling excessive bleeding in cesarean sections which may cause a life-threatening event even under well-prepared conditions. We used a novel atraumatic tourniquet technique to temporary arrest blood flow through the uterine and ovarian vessels and compare with other techniques. Toothless vascular clamps were used as clamp. Methods. Tourniquet technique performed postpartum hemorrhage (PPH) cases (19 out of 37) were compared with 18 other cases with PPH. Results. The difference between preoperative and postoperative hemoglobin values was significantly lower in the study group as well as the number of blood products needed during and after surgery. Conclusions. This technique not only prevented massive bleeding from the uterus but also allowed physicians time to consider the necessity of further interventions.

  20. Bioelectronic retinal prosthesis

    Science.gov (United States)

    Weiland, James D.

    2016-05-01

    Retinal prosthesis have been translated to clinical use over the past two decades. Currently, two devices have regulatory approval for the treatment of retinitis pigmentosa and one device is in clinical trials for treatment of age-related macular degeneration. These devices provide partial sight restoration and patients use this improved vision in their everyday lives to navigate and to detect large objects. However, significant vision restoration will require both better technology and improved understanding of the interaction between electrical stimulation and the retina. In particular, current retinal prostheses do not provide peripheral visions due to technical and surgical limitations, thus limiting the effectiveness of the treatment. This paper reviews recent results from human implant patients and presents technical approaches for peripheral vision.

  1. Survival rate of Atraumatic Restorative Treatment (ART) restorations using a glass ionomer bilayer technique with a nanofilled coating: a bi-center randomized clinical trial

    NARCIS (Netherlands)

    Hesse, D.; Bonifácio, C.C.; Bönecker, M.; A.B. Guglielmi, C. de; da Franca, C.; van Amerongen, W.E.; Colares, V.; Raggio, D.P.

    2016-01-01

    Purpose: The high-viscosity consistency of glass ionomer cement (GIC) contributes to its inappropriate adaptation, while the material's premature exposure to humidity decreases its mechanical properties. This study's purposes were to: (1) investigate approximal atraumatic restorative treatment (ART)

  2. [Fracture of macroporous hydroxyapatite prosthesis].

    Science.gov (United States)

    Adetchessi, A T; Pech-Gourg, G; Metellus, P; Fuentes, S

    2012-12-01

    Different prosthesis implants are offered to perform a cranioplasty after a decompressive craniectomy when autologous bone graft cannot be used. The authors report the case of a 25-year-old man who benefited a unilateral decompressive craniectomy after a severe head trauma. Seven months later, a cranioplasty using custom macroporous hydroxyapatite prosthesis was performed. The postoperative course was marked by a generalized seizure leading to a traumatic head injury. The CT-scan showed a comminutive fracture of the prosthesis and an extradural hematoma. The patient underwent a removal of the fractured prosthesis and an evacuation of the extradural clot. The postoperative course was uneventful with a Glasgow outcome scale score at 5. A second cranioplasty using a polyether ether ketone (PEEK) implant was performed. Among cranioplasty prosthesis solutions, hydroxyapatite implants seem to have similar property to the bone. However, its weak mechanic resistance is an actual problem in patients susceptible to present generalized seizures with consecutive head impact. Hence, in patients with decompressive craniectomy who are exposed to potential brain injury, we favor the use of more resistant implant as PEEK prosthesis.

  3. Atraumatic Restoration of Vertical Food Impaction with an Open Contact Using Flowable Composite Resin Aided by Cerclage Wire under Tension.

    Science.gov (United States)

    Li, Quan-Li; Ying Cao, Chris; Xu, Qiang-Jian; Xu, Xiao-Hua; Yin, Jia-Li

    2016-01-01

    To date, treating vertical food impaction with open contact effectively, especially with an atraumatic therapy, remains a challenge. In this study, we developed a simple, atraumatic, and economic therapeutic measure to treat vertical food impaction. The scientific rationale of our therapeutic technique is to restore an intact and firm proximal contact with proper location and form relationships to prevent forceful interproximal wedging of food, which in turn protects interdental papilla. We performed the procedure using flowable composite resin or composite resin cement with the aid of a cerclage wire under tension to rebuild the contact area. The reported method is especially useful for some challenging clinical cases, such as food impaction after crown and inlay on onlay restoration, and some conventional treatment methods, such as contouring the marginal ridge and developmental grooves, are ineffective.

  4. Atraumatic Restoration of Vertical Food Impaction with an Open Contact Using Flowable Composite Resin Aided by Cerclage Wire under Tension

    Directory of Open Access Journals (Sweden)

    Quan-Li Li

    2016-01-01

    Full Text Available To date, treating vertical food impaction with open contact effectively, especially with an atraumatic therapy, remains a challenge. In this study, we developed a simple, atraumatic, and economic therapeutic measure to treat vertical food impaction. The scientific rationale of our therapeutic technique is to restore an intact and firm proximal contact with proper location and form relationships to prevent forceful interproximal wedging of food, which in turn protects interdental papilla. We performed the procedure using flowable composite resin or composite resin cement with the aid of a cerclage wire under tension to rebuild the contact area. The reported method is especially useful for some challenging clinical cases, such as food impaction after crown and inlay on onlay restoration, and some conventional treatment methods, such as contouring the marginal ridge and developmental grooves, are ineffective.

  5. Atraumatic Restoration of Vertical Food Impaction with an Open Contact Using Flowable Composite Resin Aided by Cerclage Wire under Tension

    Science.gov (United States)

    Ying Cao, Chris; Xu, Qiang-Jian; Xu, Xiao-Hua; Yin, Jia-Li

    2016-01-01

    To date, treating vertical food impaction with open contact effectively, especially with an atraumatic therapy, remains a challenge. In this study, we developed a simple, atraumatic, and economic therapeutic measure to treat vertical food impaction. The scientific rationale of our therapeutic technique is to restore an intact and firm proximal contact with proper location and form relationships to prevent forceful interproximal wedging of food, which in turn protects interdental papilla. We performed the procedure using flowable composite resin or composite resin cement with the aid of a cerclage wire under tension to rebuild the contact area. The reported method is especially useful for some challenging clinical cases, such as food impaction after crown and inlay on onlay restoration, and some conventional treatment methods, such as contouring the marginal ridge and developmental grooves, are ineffective. PMID:27579217

  6. In Vivo Noninvasive Evaluation of Abnormal Patellar Tracking During Squatting in Patients with Patellofemoral Pain

    OpenAIRE

    Wilson, Nicole A.; Press, Joel M.; Koh, Jason L.; Hendrix, Ronald W.; Zhang, Li-Qun

    2009-01-01

    Background: Patellofemoral pain syndrome is one of the most common knee problems and may be related to abnormal patellar tracking. Our purpose was to compare, in vivo and noninvasively, the patellar tracking patterns in symptomatic patients with patellofemoral pain and those in healthy subjects during squatting. We tested the hypothesis that patients with patellofemoral pain exhibit characteristic patterns of patellar tracking that are different from those of healthy subjects.

  7. Outcome measures of bipolar hip arthroplasty for atraumatic hip disorders - A preliminary report

    Directory of Open Access Journals (Sweden)

    Dudani Baldev

    2005-01-01

    Full Text Available Background: Bipolar hip arthroplasty was devised for fracture neck femur in elderly patients. Subsequently, indications have been expanded to include conditions affecting acetabulum like rheumatoid arthritis, osteoarthritis and avascular necrosis of femoral head. Materials and methods: We have studied the results of bipolar hip arthroplasty in 38 such patients, with severely involved acetabulum due to rheumatoid arthritis, avascular necrosis of femoral head and primary osteoarthritis. Acetabulum was reamed to get a tight ′equatorial′ or ′rim′ fit of the prosthesis. Prosthesis selected was 1 mm bigger than the maximum size of reamer used. Cement was used in femur whenever there was marked osteoporosis or wide medullary canal. Post operatively all patients were regularly screened for pain, range of movement, protrusio acetabuli, loosening / sinking of prosthesis and radiographic assessment of movement in the two bearings of prosthesis. Results: Overall results achieved were good to excellent in 80% of patients. Conclusions: The ultimate outcome is comparable to total hip arthroplasty. The added advantage is of low cost, simplicity of procedure and easy future revision.

  8. Ultrasound-Guided Scraping for Chronic Patellar Tendinopathy: A Case Presentation.

    Science.gov (United States)

    Hall, Mederic M; Rajasekaran, Sathish

    2016-06-01

    Chronic patellar tendinopathy is a common complaint among athletes who repetitively stress the extensor mechanism of the knee. Multiple treatment options have been described, but evidence is lacking, specifically when eccentric loading has failed. Debate continues regarding the patho-etiology of chronic patellar tendon pain. There has been recent interest regarding the neurogenic influences involved in chronic tendinopathy, and interventions targeting neovessels and accompanying neonerves have shown promise. This is the first description of an ultrasound-guided technique in which the neovessels and accompanying neonerves in patellar tendinopathy were targeted using a needle scraping technique of the posterior surface of the patellar tendon.

  9. Posterior Dislocation of the Hinge-Post Extension in a Rotating Hinge Total Knee Prosthesis

    Directory of Open Access Journals (Sweden)

    Givenchy Manzano

    2013-01-01

    Full Text Available The rotating hinge knee prosthesis is a popular intervention in patients lacking stability with highly constrained total knee arthroplasty. Despite improvements in design, nonmechanical and mechanical complications continue to be a problem. Dislocation of the hinge has been widely described, mainly due to the component fracture. Few reports describe isolated dislocation of the rotating stem. We report a case of isolated disengagement of the rotating hinge mechanism, due to severe flexion gap imbalance, leading to subsequent posterior dislocation of the hinge and anterior knee dislocation, in a patient with a history of multiple total knee arthroplasty revisions. This case suggests the importance of the soft tissue balancing, the adequate patellar tracking, and use of a long cylindrical, minimally tapered rotating stem in hinge arthroplasty to minimize hinge dislocation.

  10. Complications in Brief: Quadriceps and Patellar Tendon Tears

    OpenAIRE

    2013-01-01

    Effective treatment of knee extensor mechanism disruptions requires prompt diagnosis and thoughtful decision-making with surgical and nonsurgical approaches. When surgery is chosen, excellent surgical technique can result in excellent outcomes. Complications and failures arise from missed or delayed diagnoses and from technical problems in the operating room. In particular, inappropriate surgical timing (especially late surgery), misplaced patellar drill holes, and failure to address concomit...

  11. 21 CFR 878.3550 - Chin prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Chin prosthesis. 878.3550 Section 878.3550 Food... DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3550 Chin prosthesis. (a) Identification. A chin prosthesis is a silicone rubber solid device intended to be implanted to augment...

  12. 21 CFR 878.3720 - Tracheal prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Tracheal prosthesis. 878.3720 Section 878.3720...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3720 Tracheal prosthesis. (a) Identification. The tracheal prosthesis is a rigid, flexible, or expandable tubular device made of a...

  13. 21 CFR 878.3610 - Esophageal prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Esophageal prosthesis. 878.3610 Section 878.3610...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3610 Esophageal prosthesis. (a) Identification. An esophageal prosthesis is a rigid, flexible, or expandable tubular device...

  14. 21 CFR 878.3680 - Nose prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nose prosthesis. 878.3680 Section 878.3680 Food... DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3680 Nose prosthesis. (a) Identification. A nose prosthesis is a silicone rubber solid device intended to be implanted to augment...

  15. 21 CFR 878.3590 - Ear prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear prosthesis. 878.3590 Section 878.3590 Food and... GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3590 Ear prosthesis. (a) Identification. An ear prosthesis is a silicone rubber solid device intended to be implanted to reconstruct the...

  16. 21 CFR 876.3750 - Testicular prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Testicular prosthesis. 876.3750 Section 876.3750...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Prosthetic Devices § 876.3750 Testicular prosthesis. (a) Identification. A testicular prosthesis is an implanted device that consists of a solid or gel-filled...

  17. Choosing a Breast Prosthesis: A Survivor's Perspective

    Science.gov (United States)

    ... Choosing a Breast Prosthesis: A Survivor’s Perspective Choosing a Breast Prosthesis: A Survivor’s Perspective Andrea Zinn June 16, 2015 · Amber ... preferences. Q: Why did you decide to wear a breast form/prosthesis rather than have a reconstruction? ...

  18. A Case of a Chronic Pancreatic Pseudocyst Causing Atraumatic Splenic Rupture without Evidence of Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    P. Moori

    2016-01-01

    Full Text Available Atraumatic splenic rupture is a rare complication of a pancreatic pseudocyst (PP, described in the setting of chronic pancreatitis. There is common understanding, within the literature, that an inflammatory process at the tail of the pancreas may disrupt the spleen and result in such splenic complications. The authors present a case report of a 29-year-old male with a PP, associated with chronic pancreatitis. The patient had a history of excessive alcohol intake and presented to the emergency department with a short history of abdominal pain and vomiting. He denied any significant history of trauma and serum amylase levels were normal. An admission computed tomography (CT scan of the abdomen confirmed the presence of a PP in direct contact with the spleen. The CT also demonstrated a heterogenous hypodense area of the splenic hilum, along with perisplenic fluid. The patient was admitted for observation. His abdominal pain progressed, and he became haemodynamically unstable. An emergency ultrasound scan (USS at this time revealed intra-abdominal haemorrhage. A subsequent CT confirmed splenic rupture, which was managed surgically with a full recovery. Few such cases are documented within the literature and more understanding of preempting such events is needed.

  19. [Atraumatic bone expansion: Interest of piezo-surgery, conicals expanders and immediate implantation combination].

    Science.gov (United States)

    Iraqui, O; Lakhssassi, N; Berrada, S; Merzouk, N

    2016-06-01

    The durability of dental implants depends on the presence of a 1mm coating bone sheath all around the fixture. Therefore, bone resorption represents a challenge for the practitioner. Bone expansion is a surgical technique that allows the management of horizontal bone atrophy. Cortical bone splitting allows for an enlargement of the residual crest by displacement of the vestibular bone flap. The immediate placement of implants secures the widening and allows for a 97% survival rate. However, bone expansion is hard to undertake in sites with high bone density. Furthermore, the use of traditional instruments increases patient's stress and the risk for an interruptive fracture during bone displacement. Non-traumatic bone expansion is one solution to this problem. The combination of piezo-surgery and conical expanders allows for a secured displacement of the selected bone flap as well as an immediate implant placement, avoiding the risk of slipping, overheating, or fracture, all within an undeniable operative comfort. Non-traumatic bone expansion is a reliable, reproducible, conservative, and economical in time and cost procedure. We describe our atraumatic bone expension and immediate implant placement technique in high bone density sites and illustrate it by a clinical case.

  20. Evaluation Of Patellar Tracking During Knee Range Of Motion In Patients With Patellar Lateralization And Normal Subjects

    Directory of Open Access Journals (Sweden)

    Goharpei S

    2004-08-01

    Full Text Available Background: Patellofemoral joint disorders are the most common cause of anterior knee pain in patients who referred to orthopedic clinics. Patellar lateralization cause anterior knee pain due to weakness of vastus medialis oblique muscle or tightness of lateral structures like lateral retinaculum or iliotibial band muscle. Materials and Methods: For evaluation of this abnormality, plane radiography, CT scan and MRI are useful. In plane radiography only one view in a single joint position can be obtained, because of that it is not a good method to detect abnormal tracking during knee range of motion. The purpose of this study was to evaluate patellar tracking by kinematics MRI during five serial degrees of knee range of motion (40, 30, 20, 10, 0 degrees in 30 patients with patellar lateralization and 10 normal subjects, aged 18-30 years. Results and Conclusion: tistical analysis showed that in patients group, patella had the most stability in 40 degree of knee flexion and this stability reduced when knee reached to full extension. At this point, patella moved laterally and the most instability was seen during 20 to 0 degree of knee extension.

  1. Effect of patellar strap and sports tape on jumper's knee symptoms : Protocol of a randomised controlled trial

    NARCIS (Netherlands)

    De Vries, Astrid J.; den Akker-Scheek, Inge van; Diercks, Ronald; Zwerver, Johannes; der Worp, Henk van

    2013-01-01

    INTRODUCTION: Patellar straps or sports tapes are commonly used by athletes with patellar tendinopathy in order to reduce pain and to continue sports participation. Currently, there is no scientific evidence for the effectiveness of a patellar strap or sports tape in the management of this common in

  2. Feasibility and reliability of pain pressure threshold measurements in patellar tendinopathy

    NARCIS (Netherlands)

    van Wilgen, Paul; van der Noord, Robert; Zwerver, Johannes

    2011-01-01

    Patellar tendinopathy is a common and often difficult to treat overuse injury which is characterized by activity-related anterior knee and focal palpation tenderness of the patellar tendon. The clinical diagnosis is mainly based on clinical examination, in which the yardstick is a non-standardized m

  3. Clinical and molecular characterisation of human syndromes with congenital patellar malformations

    NARCIS (Netherlands)

    Bongers, M.H.F.

    2006-01-01

    In this thesis the results are described of clinical and molecular investigation of human syndromes with congenital patellar malformations as a hallmark feature, with emphasis on nail patella syndrome, small patella syndrome, isolated patellar aplasia or hypoplasia, and Meier-Gorlin syndrome. The el

  4. Extracorporeal shockwave therapy for patellar tendinopathy : a review of the literature

    NARCIS (Netherlands)

    van Leeuwen, M. T.; Zwerver, J.; van den Akker-Scheek, I.

    2009-01-01

    Background and purpose: Extracorporeal shockwave therapy (EWST) has become a popular treatment for patellar tendinopathy. The purpose of this review was to study the effectiveness of ESWT treatment for patellar tendinopathy; to draft guidelines for an effective treatment protocol of ESWT treatment;

  5. Joint line and patellar height restoration after revision total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Jong-Keun Seon

    2016-01-01

    Conclusions: JL position can be sufficiently restored with appropriate distal femoral augment reconstruction after revision TKA, but the patellar height cannot be well improved, especially in the septic revision with obvious PT contracture. No correlation was found between the JL position and patellar height to the knee function post revision TKA.

  6. Elektra prosthesis for trapeziometacarpal osteoarthritis

    DEFF Research Database (Denmark)

    Klahn, A; Nygaard, Mads; Gvozdenovic, R

    2012-01-01

    We present a prospective follow-up of 39 Elektra prostheses in 37 patients (32 women and five men), with a mean age of 56.5 (range 46-71) years; 34 patients had osteoarthritis and three had rheumatoid arthritis. Patients were followed using clinical examination, including measurement of pain...... be the key problem in treating trapeziometacarpal osteoarthritis using a total prosthesis....

  7. Patellar subluxation syndrome. Observation of the patellofemoral joint using CT-scan

    Energy Technology Data Exchange (ETDEWEB)

    Yagi, Tomonori; Sasaki, Tetsuto; Susuda, Koichi; Moji, Junichi (Hokkaido Univ., Sapporo (Japan). School of Medicine)

    1983-10-01

    Clinical symptoms of patellar subluxation syndrome associated with pain were investigated for 24 knees of 20 patients, and the state of patella dislocation was observed by CT-scan. The patients had high incidence of an apprehension sign, showing their fear of patellar luxation. Many of them complained of patello-femoral joint pain due to chondromalacia patellae. In order to derive patellar subluxation, the method of CT-Q-contraction was carried out at the extended position of the patellar joint. In patients with patellar subluxation syndrome, the rate of shift in the diseased side was significantly higher than that of the other side, suggesting decreased muscular strength of the musculus vastus of the diseased side. Improvement of the symptoms was seen in all except one of 12 knees operated by the combined method of Green's method with Blauth's more than 6 months before. Availability of this operation was verified by the CT-Q-contraction.

  8. Comparative validation of the radiographic and tomographic measurement of patellar height

    Directory of Open Access Journals (Sweden)

    Marco Antonio Schueda

    2013-09-01

    Full Text Available OBJECTIVE: To evaluate and validate the radiographic measurement of patellar height with computerized tomography scans. METHODS: Measured the patellar height through the lateral radiographic image supported by one foot and sagittal tomographic view of the knee in extension, flexion of 20°, and quadriceps contraction of 40 patients (80 knees, asymptomatic and no history of knee injuries using Insall-Salvati index. There were 20 adult females and 20 adult males. RESULTS: The height patellar index was higher in women of all images taken, in proportion. There was no statistical difference of patellar height index between the radiographics and tomographics images. CONCLUSION: The Insall-Salvati index in females was higher in all cases evaluated. Furthermore, it is possible to measure the patellar height index during tomographic study without distorting the results obtained, using to define the presence of patella alta or patella baja.

  9. Re-revision of a patellar tendon rupture in a young professional martial arts athlete.

    Science.gov (United States)

    Vadalà, A; Iorio, R; Bonifazi, A M; Bolle, G; Ferretti, A

    2012-09-01

    A 27-year-old professional martial arts athlete experienced recurrent right knee patellar tendon rupture on three occasions. He underwent two operations for complete patellar tendon rupture: an end-to-end tenorrhaphy the first time, and revision with a bone-patellar-tendon (BPT) allograft. After the third episode, he was referred to our department, where we performed a surgical reconstruction with the use of hamstring pro-patellar tendon, in a figure-of-eight configuration, followed by a careful rehabilitation protocol. Clinical and radiological follow-ups were realized at 1, 3, and 6 months and 1 and 2 years postop, with an accurate physical examination, the use of recognized international outcome scores, and radiograph and MRI studies. As far as we know, this is the first paper to report a re-revision of a patellar tendon rupture.

  10. Mutans streptococci strains prevalence before and after cavity preparation during Atraumatic Restorative Treatment.

    Science.gov (United States)

    Toi, C S; Bönecker, M; Cleaton-Jones, P E

    2003-06-01

    Critics argue that all carious dentine is not removed from the hand-prepared cavity during the Atraumatic Restorative Treatment (ART) procedure, and that the caries process is soon resumed. The aim of this study was to determine the effectiveness of ART in removing carious tissue, by investigating the numbers of mutans streptococci and lactobacilli, with emphasis on the prevalence of Streptococcus mutans and Streptococcus sobrinus strains before, and after ART treatment of dental caries. Two microbiology samples were collected. The first sample was removed from the centre of the carious lesion at the enamel-dentine junction, and the second was collected from the centre of the hard cavity wall above the pulp, after the soft infected dentine had been manually removed. A total of 71 mutans streptococci isolates from 31 children and 40 carious teeth were subcultured, biochemically characterised and genotyped by the arbitrarily primed polymerase chain reaction (AP-PCR). Results showed a significant decrease in TVC (Ppreparation. AP-PCR identified S. mutans strains that were undetectable during biotyping, and divided clinical isolates into two main clusters. In all, 63% (45/71) of isolates from the carious lesions comprised S. mutans strains. After cavity preparation, this was reduced to 35% (25/71), of which 30% (21/71) were S. mutans and the remaining 6% (4/71) S. sobrinus strains. The number of mutans streptococci strains was below detectable levels in 19 of the prepared cavities. The significant decrease in bacteria after manual cavity preparation demonstrates the reliability of a standardized ART technique, yet the presence of S. mutans strains shows that the effectiveness of the ART procedure can vary during treatment and between dental practitioners.

  11. Chondromalacia induced by patellar subluxation in the rabbit

    DEFF Research Database (Denmark)

    Møller, B.N.; Møller-Larsen, F.; Frich, Lars Henrik

    1989-01-01

    A unilateral patellar malalignment was induced in 20 young and 20 mature rabbits by lateral displacement of the tibial tuberosity, the other knee serving as osteotomized in situ control. At 6 weeks, all the knees appeared macroscopically normal, but histologically definite cartilage degeneration...... was found on the experimental side. At 3 months, macroscopic changes occurred in 5 of 10 mature rabbits, and histologic cartilage degeneration was found in all the experimental knees, most pronounced in mature animals, and particularly in joint facets submitted to high pressure. This experimental model...

  12. Bilateral patellar tendon rupture associated with statin use

    OpenAIRE

    2016-01-01

    Patellar tendon rupture is an uncommon clinical presentation, which generally affects the under 40s who are active in sport. Bilateral rupture of both tendons is much rarer. It occurs most frequently in patients with predisposing factors such as corticosteroid use or systemic diseases. The authors present the case of a 56-year-old male on long-term statin therapy who sustained this injury following a fall on ice. He had no known risk factors for tendon rupture. Surgical treatment involved ten...

  13. Reconstruction of neglected patellar tendon ruptures using the quadriceps graft.

    Science.gov (United States)

    Gomes, João Luiz Ellera; de Oliveira Alves, Jairo André; Zimmermann, José Mauro

    2014-08-01

    Several techniques using different grafts have been described for reconstruction of the patellar tendon after a neglected rupture. Retraction of the quadriceps tendon may compromise repair integrity due to progressive stretching of the graft. The authors present a surgical technique using the central one-third of the quadriceps tendon. This is supported by the fact that the resistance to traction of this segment of the quadriceps tendon equals that of a double-looped semitendinosus graft and that the harvesting of this specific graft promotes muscle inhibition, thus protecting the reconstruction during the recovery period.

  14. Tracheostomy cannulas and voice prosthesis.

    Science.gov (United States)

    Kramp, Burkhard; Dommerich, Steffen

    2009-01-01

    Cannulas and voice prostheses are mechanical aids for patients who had to undergo tracheotomy or laryngectomy for different reasons. For better understanding of the function of those artificial devices, first the indications and particularities of the previous surgical intervention are described in the context of this review. Despite the established procedure of percutaneous dilatation tracheotomy e.g. in intensive care units, the application of epithelised tracheostomas has its own position, especially when airway obstruction is persistent (e.g. caused by traumata, inflammations, or tumors) and a longer artificial ventilation or special care of the patient are required. In order to keep the airways open after tracheotomy, tracheostomy cannulas of different materials with different functions are available. For each patient the most appropriate type of cannula must be found. Voice prostheses are meanwhile the device of choice for rapid and efficient voice rehabilitation after laryngectomy. Individual sizes and materials allow adaptation of the voice prostheses to the individual anatomical situation of the patients. The combined application of voice prostheses with HME (Head and Moisture Exchanger) allows a good vocal as well as pulmonary rehabilitation. Precondition for efficient voice prosthesis is the observation of certain surgical principles during laryngectomy. The duration of the prosthesis mainly depends on material properties and biofilms, mostly consisting of funguses and bacteries. The quality of voice with valve prosthesis is clearly superior to esophagus prosthesis or electro-laryngeal voice. Whenever possible, tracheostoma valves for free-hand speech should be applied. Physicians taking care of patients with speech prostheses after laryngectomy should know exactly what to do in case the device fails or gets lost.

  15. 髌骨合理设计在全膝关节置换中的临床效果%Clinical effect of suitable patellar design in total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    鲁木; 马子君; 史然利; 柏文昆; 周庆全; 张大海; 戴栋栋

    2016-01-01

    Objective To investigate the clinical effect of suitable patellar design in total knee arthroplasty(TKA). Methods Total 56 cases(72 knees) were received TKA with the patellar movement design based on the shape and the movement track of patellar, the range of motion and the feeling of pain of knee joint was observed. The Knee Soci-ety Rating System score ( KSS) was used to evaluate the TKA surgery effect. Results All 56 cases obtained follow-up time of ranging from 6 months to 18 months. Only one patient had the worse range of flexion motion within 70°,but the pain was reduced obviously;the other patients had improved the flexion and extension function and reduced the pain postoperatively. The range of flexion motion was within 0° ~110°, The KSS socres showed that 69 knees were excellent,2 knees good,1 fair,the excellent-good rate reached 98. 6%. Conclusions It can obtain satisfied thera-peutic effect by rebuilding the patellar movement based on the femur prosthesis track rather than doing patellar surface replacement during the TKA surgery.%目的:探讨髌骨合理设计后重塑在全膝关节置换( TKA)中的临床效果。方法根据股骨假体滑动轨迹及所需置换髌骨的形态,对56例TKA患者(72膝)术中进行髌骨合理设计并重塑,观察患者术后的关节活动度及疼痛情况,用KSS膝关节评分系统评定治疗效果。结果56例均获得随访,时间6~18个月。仅1例患者膝关节活动度70°,活动较差,但疼痛明显减轻;其余患者屈曲活动度在0°~110°。 KSS评分:优69膝,良2膝,中1膝,优良率达到98.6%。结论术中根据股骨假体滑动轨迹对髌骨合理设计并重塑,可以使未进行髌骨置换的TKA患者取得满意的治疗效果。

  16. Five patellar proximodistal positioning indices compared in clinically normal Greenland sled dogs

    DEFF Research Database (Denmark)

    Miles, James E; Dickow, Marlene; Nielsen, Dorte H

    2012-01-01

    Patellar luxation in large-breed dogs is associated with abnormal proximodistal patellar positioning. Using a clinically normal population of Greenland sled dogs, measurement reliability and the effect of limb position were compared for five patellar proximodistal positioning indices based...... on the Insall-Salvati (IS), modified Insall-Salvati (mIS), de Carvalho (dC), patellotrochlear (PT) and Blackburne-Peel (BP) indices. Indices were measured at one knee angle in 44 dogs and two knee angles in 10 dogs. Index susceptibility to error was modelled for different errors in knee angle estimation. Two...

  17. Fibril morphology and tendon mechanical properties in patellar tendinopathy: effects of heavy slow resistance training

    DEFF Research Database (Denmark)

    Kongsgaard, Mads; Qvortrup, Klaus; Larsen, Jytte;

    2010-01-01

    BACKGROUND: Patellar tendinopathy is characterized by pathologic abnormalities. Heavy slow resistance training (HSR) is effective in the management of patellar tendinopathy, but the underlying functional mechanisms remain elusive. PURPOSE: To investigate fibril morphology and mechanical properties...... area decreased (-26% +/- 21%, P = .04) in tendinopathic tendons after HSR. CONCLUSION: Fibril morphology is abnormal in tendinopathy, but tendon mechanical properties are not. Clinical improvements after HSR were associated with changes in fibril morphology toward normal fibril density and mean fibril...... area. Heavy slow resistance training improved the clinical outcome of patellar tendinopathy, and these improvements were associated with normalization of fibril morphology, most likely due to a production of new fibrils....

  18. Differences in tendon properties in elite badminton players with or without patellar tendinopathy

    DEFF Research Database (Denmark)

    Couppé, C; Kongsgaard, M; Aagaard, P;

    2012-01-01

    The aim of this study was to examine the structural and mechanical properties of the patellar tendon in elite male badminton players with and without patellar tendinopathy. Seven players with unilateral patellar tendinopathy (PT group) on the lead extremity (used for forward lunge) and nine players......) normalized for body weight (mm(2) /kg(2/3) ) was lower in the PT group compared with the CT group on both the non-lead extremity (6.1 ± 0.3 vs 7.4 ± 0.2, P ...

  19. MR arthrography including abduction and external rotation images in the assessment of atraumatic multidirectional instability of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Schaeffeler, Christoph [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Kantonsspital Graubuenden, Musculoskeletal Imaging, Chur (Switzerland); Waldt, Simone; Bauer, Jan S.; Rummeny, Ernst J.; Woertler, Klaus [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Kirchhoff, Chlodwig [Technische Universitaet Muenchen, Department of Traumatology, Munich (Germany); Haller, Bernhard [Technische Universitaet Muenchen, Institute for Medical Statistics and Epidemiology, Munich (Germany); Schroeder, Michael [Center for Sports Orthopedics and Medicine, Orthosportiv, Munich (Germany); Imhoff, Andreas B. [Technische Universitaet Muenchen, Department of Orthopedic Sports Medicine, Munich (Germany)

    2014-06-15

    To evaluate diagnostic signs and measurements in the assessment of capsular redundancy in atraumatic multidirectional instability (MDI) of the shoulder on MR arthrography (MR-A) including abduction/external rotation (ABER) images. Twenty-one MR-A including ABER position of 20 patients with clinically diagnosed MDI and 17 patients without instability were assessed by three radiologists. On ABER images, presence of a layer of contrast between the humeral head (HH) and the anteroinferior glenohumeral ligament (AIGHL) (crescent sign) and a triangular-shaped space between the HH, AIGHL and glenoid (triangle sign) were evaluated; centring of the HH was measured. Anterosuperior herniation of the rotator interval (RI) capsule and glenoid version were determined on standard imaging planes. The crescent sign had a sensitivity of 57 %/62 %/48 % (observers 1/2/3) and specificity of 100 %/100 %/94 % in the diagnosis of MDI. The triangle sign had a sensitivity of 48 %/57 %/48 % and specificity of 94 %/94 %/100 %. The combination of both signs had a sensitivity of 86 %/90 %/81 % and specificity of 94 %/94 %/94 %. A positive triangle sign was significantly associated with decentring of the HH. Measurements of RI herniation, RI width and glenoid were not significantly different between both groups. Combined assessment of redundancy signs on ABER position MR-A allows for accurate differentiation between patients with atraumatic MDI and patients with clinically stable shoulders; measurements on standard imaging planes appear inappropriate. (orig.)

  20. Behaviour of Sub Prosthesis Stomatitis in Patients with Upper Dental Prosthesis

    Directory of Open Access Journals (Sweden)

    Yoel González Beriau

    2017-02-01

    Full Text Available Foundation: Sub prosthesis stomatitis is one of the most frequent affections in patients who wear dental prosthesis and constitutes a risk factor for the appearance of pre malignant and malignant lesions in the oral cavity.Objective: To describe the behaviour of sub prosthesis stomatitis in patients with upper dental prosthesis.Methods: A descriptive study was carried out, of all the patients who wear upper dental prosthesis (N=61 who came to the consultation due to sub prosthesis stomatitis, in the period from September 2014 to September 2015. The variables analyzed were: Age groups, sex, degree of the lesion, state of the prosthesis, toxic habits, location of the lesion and frequency of visits to the dentist.Results: Old adults predominated (54.1% and sub prosthesis Stomatitis degree II, represented by 77%. Unadjusted prosthesis was observed in most patients and the lesions were located more frequently in mix zones. The most frequent toxic habits were continuous use and deficient oral hygiene. 85.2% of the patients reported to have visited the dentist only when they felt discomforts.Conclusion: Some results show patients ignorance about this ailment, among them a high frequency of toxic habits so as the use of continuous use of prosthesis and deficient oral hygiene, factors which condition the appearance of sub prosthesis stomatitis.

  1. Two-year survival rates of proximal atraumatic restorative treatment restorations in relation to glass ionomer cements and postrestoration meals consumed

    NARCIS (Netherlands)

    Kemoli, A.M.; Opinya, G.N.; van Amerongen, W.E.; Mwalili, S.M.

    2011-01-01

    Purpose: The purpose of this study was to investigate the influence of 3 glass ionomer cement (GIC) brands and the postrestoration meal consumed on the survival rate of proximal atraumatic restorative treatment (ART) restorations. Methods: A total of 804 proximal restorations were placed in primary

  2. The results of adductor magnus tenodesis in adolescents with recurrent patellar dislocation.

    Science.gov (United States)

    Malecki, Krzysztof; Fabis, Jaroslaw; Flont, Pawel; Niedzielski, Kryspin Ryszard

    2015-01-01

    Recurrent dislocation of the patella is a common orthopaedic problem which occurs in about 44% of cases after first-time dislocation. In most cases of first-time patellar dislocation, the medial patellofemoral ligament (MPFL) becomes damaged. Between 2010 and 2012, 33 children and adolescents (39 knees) with recurrent patellar dislocation were treated with MPFL reconstruction using the adductor magnus tendon. The aim of our study is to assess the effectiveness of this surgical procedure. The outcomes were evaluated functionally (Lysholm knee scale, the Kujala Anterior Knee Pain Scale, and isokinetic examination) and radiographically (Caton index, sulcus angle, congruence angle, and patellofemoral angle). Four patients demonstrated redislocation with MPFL graft failure, despite the fact that patellar tracking was found to be normal before the injury, and the patients had not reported any symptoms. Statistically significant improvements in Lysholm and Kujala scales, in patellofemoral and congruence angle, were seen (P magnus tendon in children and adolescents with recurrent patellar dislocation.

  3. Previously identified patellar tendinopathy risk factors differ between elite and sub-elite volleyball players.

    Science.gov (United States)

    Janssen, I; Steele, J R; Munro, B J; Brown, N A T

    2015-06-01

    Patellar tendinopathy is the most common knee injury incurred in volleyball, with its prevalence in elite athletes more than three times that of their sub-elite counterparts. The purpose of this study was to determine whether patellar tendinopathy risk factors differed between elite and sub-elite male volleyball players. Nine elite and nine sub-elite male volleyball players performed a lateral stop-jump block movement. Maximum vertical jump, training history, muscle extensibility and strength, three-dimensional landing kinematics (250 Hz), along with lower limb neuromuscular activation patterns (1500 Hz), and patellar tendon loading were collected during each trial. Multivariate analyses of variance (P volleyball players. Interventions designed to reduce landing frequency and improve quadriceps extensibility are recommended to reduce patellar tendinopathy prevalence in volleyball players.

  4. Femoral neuropathy due to patellar dislocation in a theatrical and jazz dancer: a case report.

    Science.gov (United States)

    Shin, Chris S; Davis, Brian A

    2005-06-01

    This case report describes a teenage female, high-level modern dancer who suffered multiple left patellar dislocations. Her history is atypical in that after her fifth dislocation, her recovery was hindered secondary to persistent weakness and atrophy of her quadriceps out of proportion to disuse alone. Electrodiagnostic studies and magnetic resonance imaging showed evidence of a subacute femoral neuropathy correlating chronologically with her most recent patellar dislocation. This case suggests that further diagnostic study may be warranted in patients with persistent quadriceps weakness or atrophy after a patellar dislocation, because this may suggest the presence of a femoral neuropathy. This is important because the strength training goals and precautions differ in disuse atrophy and a neuropathy. We believe this is the first reported case of a femoral neuropathy associated with the mechanism of a patellar dislocation.

  5. Penile prosthesis implantation: past, present and future.

    Science.gov (United States)

    Simmons, M; Montague, D K

    2008-01-01

    Penile prosthesis implantation is the oldest effective treatment for erectile dysfunction. This review examines the past, present and future of penile prosthesis implantation. Advances in prosthetic design and implantation techniques have resulted today in devices that produce nearly normal flaccid and erect states, and have remarkable freedom from mechanical failure. The future of prosthetic design holds promises for even more improvements.

  6. Nasal prosthesis rehabilitation: a case report

    DEFF Research Database (Denmark)

    Jain, Sumeet; Maru, Kavita; Shukla, Jyotsana

    2011-01-01

    Facial defects resulting from neoplasm, congenital malformation or trauma can be restored with facial prosthesis using different materials and retention methods to achieve life-like look and function. A nasal prosthesis can re-establish esthetic form and anatomic contours for mid-facial defects...

  7. Parametric modelling of a knee joint prosthesis.

    Science.gov (United States)

    Khoo, L P; Goh, J C; Chow, S L

    1993-01-01

    This paper presents an approach for the establishment of a parametric model of knee joint prosthesis. Four different sizes of a commercial prosthesis are used as an example in the study. A reverse engineering technique was employed to reconstruct the prosthesis on CATIA, a CAD (computer aided design) system. Parametric models were established as a result of the analysis. Using the parametric model established and the knee data obtained from a clinical study on 21 pairs of cadaveric Asian knees, the development of a prototype prosthesis that suits a patient with a very small knee joint is presented. However, it was found that modification to certain parameters may be inevitable due to the uniqueness of the Asian knee. An avenue for rapid modelling and eventually economical production of a customized knee joint prosthesis for patients is proposed and discussed.

  8. Smartphone supported upper limb prosthesis

    Directory of Open Access Journals (Sweden)

    Hepp D.

    2015-09-01

    Full Text Available State of the art upper limb prostheses offer up to six active DoFs (degrees of freedom and are controlled using different grip patterns. This low number of DoFs combined with a machine-human-interface which does not provide control over all DoFs separately result in a lack of usability for the patient. The aim of this novel upper limb prosthesis is both offering simplified control possibilities for changing grip patterns depending on the patients’ priorities and the improvement of grasp capability. Design development followed the design process requirements given by the European Medical Device Directive 93/42 ECC and was structured into the topics mechanics, software and drive technology. First user needs were identified by literature research and by patient feedback. Consequently, concepts were evaluated against technical and usability requirements. A first evaluation prototype with one active DoF per finger was manufactured. In a second step a test setup with two active DoF per finger was designed. The prototype is connected to an Android based smartphone application. Two main grip patterns can be preselected in the software application and afterwards changed and used by the EMG signal. Three different control algorithms can be selected: “all-day”, “fine” and “tired muscle”. Further parameters can be adjusted to customize the prosthesis to the patients’ needs. First patient feedback certified the prosthesis an improved level of handling compared to the existing devices. Using the two DoF test setup, the possibilities of finger control with a neural network are evaluated at the moment. In a first user feedback test, the smartphone based software application increased the device usability, e.g. the change within preselected grip patterns and the “tired muscle” algorithm. Although the overall software application was positively rated, the handling of the prosthesis itself needs to be proven within a patient study to be

  9. Total Knee Arthroplasty in a Patient with Neglected Congenital Patellar Dislocation

    Directory of Open Access Journals (Sweden)

    Emrah Kovalak

    2013-08-01

    Full Text Available Congenital patellar dislocation is a rare deformity and late presentation is usually with knee osteoarthritis. Total knee arthroplasty (TKA is also a treatment choice of this rare pathology. There are few cases reported gonarthrosis with congenital patellar dislocation treated with TKA. And there are some contradictions in the written literature. This article presents a case of a 55 years old woman who had left knee pain for 8 years that was worsened in last 2 years with gonarthrosis and congenital patellar dislocation treated by cruciate retaining TKA with proximal and distal patellar alignment without patellar resurfacing. At the final follow-up after 1 year ROM was 5°-100°. There was no patellar maltracking or instability. The Knee Society score and functional scores were 55 and 15 preoperatively, improved to 83 and 55 respectively at the postoperative period. Congenital patella dislocation with gonarthrosis is hard to manage by TKA, but it can be handled with a good pre-operative planning with meticulous attention.

  10. Does the adolescent patellar tendon respond to 5 days of cumulative load during a volleyball tournament?

    Science.gov (United States)

    van Ark, M; Docking, S I; van den Akker-Scheek, I; Rudavsky, A; Rio, E; Zwerver, J; Cook, J L

    2016-02-01

    Patellar tendinopathy (jumper's knee) has a high prevalence in jumping athletes. Excessive load on the patellar tendon through high volumes of training and competition is an important risk factor. Structural changes in the tendon are related to a higher risk of developing patellar tendinopathy. The critical tendon load that affects tendon structure is unknown. The aim of this study was to investigate patellar tendon structure on each day of a 5-day volleyball tournament in an adolescent population (16-18 years). The right patellar tendon of 41 players in the Australian Volleyball Schools Cup was scanned with ultrasound tissue characterization (UTC) on every day of the tournament (Monday to Friday). UTC can quantify structure of a tendon into four echo types based on the stability of the echo pattern. Generalized estimating equations (GEE) were used to test for change of echo type I and II over the tournament days. Participants played between eight and nine matches during the tournament. GEE analysis showed no significant change of echo type percentages of echo type I (Wald chi-square = 4.603, d.f. = 4, P = 0.331) and echo type II (Wald chi-square = 6.070, d.f. = 4, P = 0.194) over time. This study shows that patellar tendon structure of 16-18-year-old volleyball players is not affected during 5 days of cumulative loading during a volleyball tournament.

  11. MRI appearances of the asymptomatic patellar tendon on gradient echo imaging

    Energy Technology Data Exchange (ETDEWEB)

    Reiff, D.B. [Dept. of Diagnostic Radiology, St. George`s Hospital, London (United Kingdom); Heenan, S.D. [Dept. of Diagnostic Radiology, St. George`s Hospital, London (United Kingdom); Heron, C.W. [Dept. of Diagnostic Radiology, St. George`s Hospital, London (United Kingdom)

    1995-02-01

    Thickening of the patellar tendon and foci of increased signal intensity have been described as characteristic features of ``jumper`s knee`` (chronic patellar tendinitis) on magnetic resonance imaging (MRI). It was our impression that such appearances may be seen in the patellar tendons of patients without symptoms referable to the anterior part of the knee when using gradient echo images. The appearances of the asymptomatic patellar tendon on three-dimensional gradient echo sequences were studied by retrospectively reviewing the images of 60 patients, none of whom had symptoms related to the anterior part of the knee. The anteroposterior width of the patellar tendon was measured at three levels (superior, middle and inferior) on the central sagittal image of a gradient echo sequence. The relative signal intensities at the same levels were recorded. In 97% of subjects the superior part of the tendon was wider than the midpoint, and in 97% the inferior part was wider than the midpoint. The range of widths was wide, and there was no significant difference between sexes. Focal increased signal intensity in the superior part was shown in 75%, and in the inferior part in 43%. The asymptomatic patellar tendon shows uniform thickness throughout most of its length, but there are focal expansions at the proximal and distal ends. It usually demonstrates low signal on MRI, but may contain foci of increased signal intensity at either or both ends when imaged on gradient-echo sequences. (orig.)

  12. Surgical Correction of Patellar Luxation in a Rabbit

    Directory of Open Access Journals (Sweden)

    J. Riggs

    2013-01-01

    Full Text Available A two-and-a-half-year-old giant lop-eared rabbit, weighing 5.1 kg, presented with a one-month history of intermittent right hind limb lameness. The limb locked in extension during hopping. On examination, a grade-2 medial patellar luxation of the right hind was diagnosed, with associated stifle joint swelling. Radiographic findings of the right stifle comprised periarticular osteophyte formation consistent with mild degenerative joint disease and joint effusion. Surgical correction involving right trochlear wedge recession sulcoplasty and lateral imbrication was carried out to stabilise the patella in the trochlear groove. The right hind limb lameness resolved, and the patella was stable at a 6-month postoperative examination. One year postoperatively, the right patella was luxating again concurrent with bilateral stifle effusions. Euthanasia was performed twenty months after surgery due to recurrent lameness in the right hind limb.

  13. The role of tendon microcirculation in Achilles and patellar tendinopathy.

    Science.gov (United States)

    Knobloch, Karsten

    2008-04-30

    Tendinopathy is of distinct interest as it describes a painful tendon disease with local tenderness, swelling and pain associated with sonographic features such as hypoechogenic texture and diameter enlargement. Recent research elucidated microcirculatory changes in tendinopathy using laser Doppler flowmetry and spectrophotometry such as at the Achilles tendon, the patellar tendon as well as at the elbow and the wrist level. Tendon capillary blood flow is increased at the point of pain. Tendon oxygen saturation as well as tendon postcapillary venous filling pressures, determined non-invasively using combined Laser Doppler flowmetry and spectrophotometry, can quantify, in real-time, how tendon microcirculation changes over with pathology or in response to a given therapy. Tendon oxygen saturation can be increased by repetitive, intermittent short-term ice applications in Achilles tendons; this corresponds to 'ischemic preconditioning', a method used to train tissue to sustain ischemic damage. On the other hand, decreasing tendon oxygenation may reflect local acidosis and deteriorating tendon metabolism. Painful eccentric training, a common therapy for Achilles, patellar, supraspinatus and wrist tendinopathy decreases abnormal capillary tendon flow without compromising local tendon oxygenation. Combining an Achilles pneumatic wrap with eccentric training changes tendon microcirculation in a different way than does eccentric training alone; both approaches reduce pain in Achilles tendinopathy. The microcirculatory effects of measures such as extracorporeal shock wave therapy as well as topical nitroglycerine application are to be studied in tendinopathy as well as the critical question of dosage and maintenance. Interestingly it seems that injection therapy using color Doppler for targeting the area of neovascularisation yields to good clinical results with polidocanol sclerosing therapy, but also with a combination of epinephrine and lidocaine.

  14. 21 CFR 878.3530 - Silicone inflatable breast prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Silicone inflatable breast prosthesis. 878.3530... inflatable breast prosthesis. (a) Identification. A silicone inflatable breast prosthesis is a silicone... inflatable breast prosthesis that was in commercial distribution before May 28, 1976, or that has, on...

  15. 21 CFR 878.3800 - External aesthetic restoration prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External aesthetic restoration prosthesis. 878... External aesthetic restoration prosthesis. (a) Identification. An external aesthetic restoration prosthesis... external prosthesis adhesive. The device is not intended to be implanted. (b) Classification. Class...

  16. MR imaging findings of patellar tendon after anterior cruciate ligament reconstruction with bone-tendon-bone autograft

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hyoung; Kim, Hyoung Rae; Kim, Baek Hyun; Seol, Hae Young; Cha, In ho; Im, Hong Cheol [College of Medicine, Korea Univ., Seoul (Korea, Republic of); Kim, Hyoung Seuk [College of Medicine, Inje Univ., Kimhae (Korea, Republic of); Lee, Chang Hee [College of Medicine, Konkuk Univ., Seoul (Korea, Republic of)

    2002-01-01

    To evaluate the postoperative changes occurring in the patellar tendon after reconstruction of the anterior cruciate ligament (ACL) using the central one-third of the patellar tendon together with patellar and tibial bony plugs. Ten patients with ACL injury underwent sagittal and coronal T1- weighted MR imaging of both postoperative and normal knee joints. In all cases, reconstruction of the ACL was performed using the central one-third of the patellar tendon, together with patellar and tibial bony plugs. During the follow-up period of 6-27 months, patient were clinically stable. We compared the length, signal intensity and contour of both patellar tendons, as seen on MR images. No defects was found in harvested patellar tendons, and MR images showed high signal intensity within harvested tendons in six of the ten patients. In seven of ten, patellar tendons had irregular margins and were poorly delineated from adjacent tissue. The mean length of patellar tendons was 44.2 {+-}2.0 mm in normal knee and 43.9 {+-}3.1 mm in postoperative knee, while their mean thickness in postoperative knee, measured at mid-portion averaged 4.3{+-}1.2 mm. There were no statistically significant differences (p>0.05). The greatest mean thickness of patellar tendon was 6.9 {+-}1.2 mm and 4.3 {+-}0.5 mm in normal and postoperative knee, respectively. Thus, on average, postoperative patellar tendon was 161% thickner than normal tendon (p<0.05). In clinically stable patients, patellar tendons after graft harvesting had a higher signal intensity, worse-defined margins and a greater thickness than normal. We suggest that these are the normal postoperative findings.

  17. Retinal prosthesis for the blind.

    Science.gov (United States)

    Margalit, Eyal; Maia, Mauricio; Weiland, James D; Greenberg, Robert J; Fujii, Gildo Y; Torres, Gustavo; Piyathaisere, Duke V; O'Hearn, Thomas M; Liu, Wentai; Lazzi, Gianluca; Dagnelie, Gislin; Scribner, Dean A; de Juan, Eugene; Humayun, Mark S

    2002-01-01

    Most of current concepts for a visual prosthesis are based on neuronal electrical stimulation at different locations along the visual pathways within the central nervous system. The different designs of visual prostheses are named according to their locations (i.e., cortical, optic nerve, subretinal, and epiretinal). Visual loss caused by outer retinal degeneration in diseases such as retinitis pigmentosa or age-related macular degeneration can be reversed by electrical stimulation of the retina or the optic nerve (retinal or optic nerve prostheses, respectively). On the other hand, visual loss caused by inner or whole thickness retinal diseases, eye loss, optic nerve diseases (tumors, ischemia, inflammatory processes etc.), or diseases of the central nervous system (not including diseases of the primary and secondary visual cortices) can be reversed by a cortical visual prosthesis. The intent of this article is to provide an overview of current and future concepts of retinal and optic nerve prostheses. This article will begin with general considerations that are related to all or most of visual prostheses and then concentrate on the retinal and optic nerve designs. The authors believe that the field has grown beyond the scope of a single article so cortical prostheses will be described only because of their direct effect on the concept and technical development of the other prostheses, and this will be done in a more general and historic perspective.

  18. Pulp response in primary teeth with deep residual caries treated with silver fluoride and glass ionomer cement ('atraumatic' technique)

    Science.gov (United States)

    Gotjamanos, T

    1996-10-01

    Histological assessment of the dental pulps of 55 carious primary teeth was carried out 3 to 58 months after treatment by the 'atraumatic' technique involving application of 40 per cent silver fluoride to residual caries followed by restoration with glass ionomer cement. Fifty of the 55 teeth examined showed a favourable pulpal response, inducing presence of abundant reparative dentine and a wide odontoblast layer. Histological comparisons were made between these teeth and others not treated with silver fluoride but restored with glass ionomer cement, amalgam or zinc oxide and eugenol. Possible mechanisms of the action of silver fluoride in arresting residual caries are discussed. The question of whether or not treatment of carious dentine with silver fluoride represents a biologically acceptable clinical procedure cannot be answered on the basis of pulpal histology alone. The very high concentration of fluoride in commercial preparations of silver fluoride raises several questions concerning its clinical safety.

  19. Lower limb prosthesis utilisation by elderly amputees.

    Science.gov (United States)

    Bilodeau, S; Hébert, R; Desrosiers, J

    2000-08-01

    The goal of prosthetic rehabilitation is to compensate for the loss of a limb by amputation by, in the case of a lower limb, encouraging walking, and to achieve the same level of autonomy as prior to the amputation. However, because of difficulties walking, elderly amputees may use their prosthesis to a greater or lesser degree or simply stop using it during the rehabilitation period. The objective of this research was to study factors such as physical and mental health, rehabilitation, physical independence and satisfaction with the prosthesis to understand why amputees use their prosthesis or not. The sample was composed of 65 unilateral vascular amputees 60 years old or over living at home. The information was collected from medical records, by telephone interview and by mail questionnaire. Prosthesis use was measured by a questionnaire on amputee activities developed by Day (1981). Eighty-one per cent (81%) of the subjects wore their prosthesis every day and 89% of this group wore it 6 hours or more per day. Less use of the prosthesis was significantly related to age, female gender, possession of a wheelchair, level of physical disability, cognitive impairment, poorer self-perceived health and the amputee's dissatisfaction. A multiple regression analysis showed that satisfaction, not possessing a wheelchair and cognitive integrity explained 46% of the variance in prosthesis use.

  20. Prosthesis infections after orthopedic joint replacement

    DEFF Research Database (Denmark)

    Song, Zhijun; Borgwardt, Lotte; Høiby, Niels;

    2013-01-01

    Prosthesis-related infection is a serious complication for patients after orthopedic joint replacement, which is currently difficult to treat with antibiotic therapy. Consequently, in most cases, removal of the infected prosthesis is the only solution to cure the infection. It is, therefore...... and the host immune responses. The authors reviewed the related literature in the context of their clinical experience, and discussed the possible etiology and mechanism leading to the infections, especially problems related to bacterial biofilm, and prophylaxis and treatment of infection, including both...... microbiological and surgical measures. Recent progress in research into bacterial biofilm and possible future treatment options of prosthesis-related infections are discussed....

  1. Stemless shoulder prosthesis versus conventional anatomic shoulder prosthesis in patients with osteoarthritis

    OpenAIRE

    Berth, Alexander; Pap, Géza

    2012-01-01

    Background The stemless shoulder prosthesis is a new concept in shoulder arthroplasty. To date, only a few studies have investigated the results of this prosthesis. The aim of this study was to investigate the clinical and radiological midterm results of this implant in comparison with a standard anatomic stemmed shoulder prosthesis. Materials and methods The Constant score, the DASH score, the active range of motion (abduction, anteversion, external rotation), and the radiological results we...

  2. FUNCTIONAL OUTCOME OF ARTHROSCOPY ASSISTED ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING BONE PATELLAR TENDON BONE AUTOGRAFT

    Directory of Open Access Journals (Sweden)

    Vinod Kumar

    2015-04-01

    Full Text Available INTRODUCTION: The anterior cruciate ligament (ACL is one of the most frequently injured ligaments in the human body. 1 The Anterior Cruciate ligament (ACL is the primary stabilizer of the knee and prevents the knee against anterior translation. 2 It is also important in counteracting rotational and valgus stress. 1 The middle third of the patellar tendon autograft for ACL reconstruction can be readily procured and firmly fixed. 3 It can tolerate the loads produced by an intensive rehabilitation programme. 3 Fixation of bone plugs using interference screws provides sufficient stability to meet the demand of a vigorous postoperative protocol. 3 It remains the gold standard for ACL reconstruction. 3 This study is to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone patellar tendon bone autograft. METHODS: This study was conducted in Kempegowda Institute of Medical Sciences Hospital from November 2012 to April 2014. During this period 20 cases of adult patients with ACL deficient patients were selected according to the inclusion criteria. Study aims to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone - patellar tendon - bone autograft in terms of range of motion, postoperative knee stability, graft site morbidity and subjective knee functions. RESULTS: Results of our study showed that arthroscopy assisted anterior cruciate ligament reconstruction with bone - patellar tendon - bone autograft could effectively improve knee stability and functions after surgery without any complication. CONCLUSION : Arthroscopy assisted anterior cruciate l igament reconstruction with bone - patellar tendon - bone autograft is an excellent treatment option for anterior cruciate ligament deficient knees. It provides a stable knee and reduces postoperative morbidity and enables early rehabilitation. The functional outcome of arthroscopy assisted anterior

  3. Custom ocular prosthesis: A palliative approach

    Directory of Open Access Journals (Sweden)

    Prachi Thakkar

    2015-04-01

    Full Text Available The goal of palliative care is the achievement of the best quality of life for patients and their families. Eyes are generally the first features of the face to be noticed. Loss of an eye is a traumatic event which has a crippling effect on the psychology of the patient. Several ocular and orbital disorders require surgical intervention that may result in ocular defects. An ocular prosthesis is fabricated to restore the structure, function, and cosmetics of the defects created by such conditions. Although an implant eye prosthesis has a superior outcome, due to economic factors it may not be a feasible option for all patients. Therefore, a custom-made ocular prosthesis is a good alternative. This case report presents a palliative treatment for a patient with an enucleated eye by fabricating a custom ocular prosthesis which improved his psychological, physical, social, functional, emotional and spiritual needs.

  4. Penile prosthesis implantation in a transsexual neophallus

    Institute of Scientific and Technical Information of China (English)

    Hui-MengTAN

    2000-01-01

    Reconstruction surgery for a female to male transsexual usually involves mastectomy, hysterectomy and creating an aesthetically appealing neophallus. We have successfully inserted an inflatable prosthesis using the AMS CX prosthesis in a 45 year old transsexual, who had a large bulky neophallus constructed from the anterior abdominal subcutaneous fat, about 9 years ago. The single cylinder CX prosthesis was well anchored to the symphysis pubis using a dacron windsock tubing, the activation pump was placed in the dependent pouch of the right labium and the reservior in the usual perivesical space. The patient subsequently had debulking procedure using liposuction to create a more aesthetic and functional phallus. To date, the inflatable neophallus prosthesis is functioning well. (Asian J Androl 2000 Dec;2:304-306)

  5. Aesthetic finger prosthesis with silicone biomaterial

    Science.gov (United States)

    Raghu, K M; Gururaju, C R; Sundaresh, K J; Mallikarjuna, Rachappa

    2013-01-01

    The fabrication of finger prosthesis is as much an art as it is science. The ideally constructed prosthesis must duplicate the missing structures so precisely that patients can appear in public without fear of attracting unwanted attraction. A 65-years-old patient reported with loss of his right index finger up to the second phalanx and wanted to get it replaced. An impression of the amputated finger and donor were made. A wax pattern of the prosthesis was fabricated using the donor impression; a trial was performed and flasked. Medical grade silicone was intrinsically stained to match the skin tone, following which it was packed, processed and finished. This clinical report describes a method of attaining retention by selective scoring of the master cast of partially amputated finger to enhance the vacuum effect at par with the proportional distribution of the positive forces on the tissues exerted by the prosthesis. PMID:23975917

  6. Finger prosthesis: a boon to handicapped.

    Science.gov (United States)

    Gupta, Ridhima; Kumar, Lakshya; Rao, Jitendra; Singh, Kamleshwar

    2013-08-29

    This is a clinical case report of a 52-year-old male patient with four partially missing fingers of the left hand. The article describes the clinical and laboratory procedure of making prosthesis with modern silicone material. A wax pattern was fabricated using the right hand of the patient. A special type of wax was formulated to make the pattern so that it can be easily moulded and carved. Intrinsic and extrinsic staining was also performed to match the adjacent skin colour. The patient was given the finger prosthesis and was asked to use a half glove (sports) to mask the junction between the prosthesis and the normal tissue. It also provides additional retention to the artificial fingers. The patient felt his social acceptance improved after wearing the finger prosthesis.

  7. The impact of physically demanding work of basketball and volleyball players on the risk for patellar tendinopathy and on work limitations

    NARCIS (Netherlands)

    Van Der Worp, H.; Zwerver, J.; Kuijer, P.P.F.M.; Frings-Dresen, M.H.W.; Van Den Akker-Scheek, I.

    2011-01-01

    Patellar tendinopathy is a common injury in jumping athletes. Little is known about work-related etiological factors for patellar tendinopathy and related work limitations. The aim of this study was to identify work-related etiological factors for patellar tendinopathy and to determine the relation

  8. Updating upper extremity temporary prosthesis: thermoplastics.

    Science.gov (United States)

    Fletchall, S; Tran, T; Ungaro, V; Hickerson, W

    1992-01-01

    Since 1989 amputees with upper-extremity burns have been fitted with a temporary prosthesis fabricated from low-temperature thermoplastic. Before 1989 conventional temporary prostheses were fabricated with plaster. The use of the thermoplastic material has produced a lightweight, cost-effective, modular system. No patients exhibited skin breakdown with the thermoplastic material. It appears that thermoplastics may be the next major breakthrough in terms of a design for a temporary upper-extremity prosthesis.

  9. Patellar tendon-lateral femoral condyle friction syndrome: MR imaging in 42 patients

    Energy Technology Data Exchange (ETDEWEB)

    Chung, C.B.; Skaf, A.; Campos, J.; Stump, X.; Resnick, D. [Dept. of Radiology, University of California, San Diego (United States); Roger, B. [Service de Radiologie Polyvalente, Groupe Hospitalier Pitie-Salpetriere, Paris (France)

    2001-12-01

    Objective: To demonstrate the MR imaging findings that occur between the posterior inferolateral patellar tendon and the lateral femoral condyle in patients with chronic anterior and or lateral knee pain. Patients and design: A retrospective review of the MR images in 42 patients who presented with chronic anterior or lateral knee pain was performed by two musculoskeletal radiologists. In 15 patients, post-contrast images were available. Results: Sagittal and axial imaging planes best demonstrated the patellar tendon and its relationship with the lateral femoral condyle. In 40 patients, there was obliteration of the fat planes and abnormal signal intensity in the lateral soft tissues of the inferior patellofemoral joint. Enhancement after administration of gadolinium was noted in all cases in which contrast was administered. Eighteen patients showed cystic changes in the soft tissues adjacent to the lateral femoral condyle in addition to fat plane obliteration. In two patients, only cystic changes were noted in the lateral soft tissues. Abnormal patellar alignment was noted in 37 patients. Patellar tendon pathology was seen in nine patients. Conclusion: In evaluating anterior knee symptoms, MR imaging allows identification of changes that may be related to patellar tendon-lateral femoral condyle friction syndrome and that should be distinguished from other causes of anterior or lateral knee pain. (orig.)

  10. Tibial tubercle osteotomy in patello-femoral instability and in patellar height abnormality.

    Science.gov (United States)

    Caton, Jacques H; Dejour, David

    2010-02-01

    The aim of this study was to present the different surgical procedures of tibial tubercle osteotomies for patellar instability or patellar mispositioning such as patella alta or patella infera. This study analysed the Caton-Deschamps index used for assessment of vertical patella height in order to make a precise plan for tibial tuberosity osteotomies. This study included 61 knees (50 patients) treated for patellar instability with patella alta and 24 patients treated for patella infera of mechanical origin. The results of medial transfer of the tibial tuberosity, with or without distal transfer in cases of patellar instability with patella alta, gives excellent results for stability in 76.8% of the cases. The results of the proximal transfer of the tibial tuberosity in cases of patella infera were excellent or good in 80% of the cases in our series of 24 patients. A precise preoperative plan is needed with determination of the vertical patellar height using the Caton-Deschamps index and the situation of the tibial tuberosity and the Tibial Tubercle to Trochlear Groove distance (TT-TG) of the knee on CT scan in order to obtain satisfactory results.

  11. PLATEAU-PATELLA ANGLE: AN OPTION FOR ASSESSING PATELLAR HEIGHT ON PROXIMAL TIBIA OSTEOTOMY

    Science.gov (United States)

    BONADIO, MARCELO BATISTA; TORRES, JÚLIO AUGUSTO DO PRADO; MAZZARO, VICENTE; HELITO, CAMILO PARTEZANI; GOBBI, RICCARDO GOMES; DEMANGE, MARCO KAWAMURA

    2016-01-01

    ABSTRACT Objective: To compare the plateau-patella angle method to the methods already established for patellar height measurement in patients undergoing high tibial osteotomy. Methods: This is a retrospective study of 13 patients undergoing medial opening tibial osteotomy. The patellar height was measured in pre and post-operative radiographs by the methods from Insall-Salvati, Caton-Deschamps, Blackburne-Peel and patella-plateau angle, as well as the tibial slope and length of the patellar tendon. Measurements were performed by two knee surgeons at two different times. Results: The mean age was 41.33 ± 01.09 years old. The average rates of Caton-Deschamps, Blackburne-Peel, Insall-Salvati and plateau-patella angle were, respectively, 1.00; 0.89; 1.10; and 23.15° preoperatively, and 0.89; 0.78; 1.11; and 20.46°, postoperatively. The correlation of Caton-Deschamps, Blackburne-Pell, and Insall-Salvati indexes and plateau-patellar angle interobserver was 0.72 (p <0.001), 0:54 (p <0.001), 0.65 (p <0.001), and 0.67 (w <0.001), respectively. Conclusion: The plateau-patella angle method undergoes changes that are correlated with changes in tibial slope after osteotomy, unlike the classical methods. This fact may lead to overestimate the reduction of patellar height after osteotomy. Level of evidence IV. Case Series. PMID:27217812

  12. The wrinkled patellar tendon: An indication of abnormality in the extensor mechanism of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Berlin, R.C.; Levinsohn, E.M. (State Univ. of New York, Syracuse, NY (USA). Dept. of Radiology); Chrisman, H. (State Univ. of New York, Syracuse, NY (USA). Coll. of Medicine)

    1991-04-01

    Rupture of the quadriceps tendon is an uncommon condition which requires early diagnosis and treatment to avert prolonged disability. In four patients who had surgically confirmed quadriceps tendon rupture, lateral radiographs of the knee and/or sagittal magnetic resonance (MR) images demonstrated a corrugated appearance to the patellar tendon. Sagittal MR images of the knee following patellectomy in one patient and radiographs of a transverse fracture of the patella in another also demonstrated this appearance. MRI has superb contrast resolution which provides optimal visualization of the contour of the patellar tendon on sagittal images. A retrospective review of 50 consecutive knee MRI examinations was carried out to evaluate the appearance of the normal patellar tendon. In 49 of 50 patients, the sagittal images demonstrated a straight or nearly straight patellar tendon. A corrugated appearance of the patellar tendon on sagittal images indicates a reduction in the normal tensile force applied to it and indicates the need for careful evaluation of the patella and quadriceps tendon mechanism. (orig.).

  13. The evolution of eccentric training as treatment for patellar tendinopathy (jumper's knee): a critical review of exercise programmes

    OpenAIRE

    Visnes, Håvard; Bahr, Roald

    2007-01-01

    Background and aim: Eccentric training has become a popular treatment for patellar tendinopathy. Our purpose was to review the evolution of eccentric strength training programmes for patellar tendinopathy with a focus on the exercise prescriptions used, to help clinicians make appropriate choices and identify areas needing further research.

  14. Risk factors for patellar tendinopathy in volleyball and basketball players: : A survey-based prospective cohort study

    NARCIS (Netherlands)

    de Vries, A.J.; van der Worp, H.; Diercks, R.L.; van den Akker-Scheek, I.; Zwerver, J.

    2015-01-01

    Patellar tendinopathy (PT) is a common overuse injury of the patellar tendon in jumping athletes. In a recent large cross-sectional study from 2008 several factors were identified that may be associated with the etiology of PT. However, because of the study design no conclusions could be drawn about

  15. Jumper's Knee or Lander's Knee? : A Systematic Review of the Relation between Jump Biomechanics and Patellar Tendinopathy

    NARCIS (Netherlands)

    van der Worp, Henk; de Poel, H. J.; Diercks, R. L.; van den Akker-Scheek, I.; Zwerver, J.

    2014-01-01

    Patellar tendinopathy (jumper's knee) is a common injury in sports that comprise jump actions. This article systematically reviews the literature examining the relation between patellar tendinopathy and take-off and landing kinematics in order to uncover risk factors and potential prevention strateg

  16. No effect of extracorporeal shockwave therapy on patellar tendinopathy in jumping athletes during the competitive season : A randomized clinical trial

    NARCIS (Netherlands)

    Zwerver, Johannes; Hartgens, Fred; Verhagen, Evert; van der Worp, Henk; van den Akker-Scheek, Inge; Diercks, Ronald

    2011-01-01

    Background: Patellar tendinopathy is a common overuse injury among jumping athletes. No evidence-based treatment guidelines exist. Extracorporeal shockwave therapy (ESWT) appears to be a promising treatment but its effectiveness has not been studied in athletes with patellar tendinopathy who have sy

  17. Patient guided Piezo-electric Extracorporeal Shockwave Therapy as treatment for chronic severe patellar tendinopathy : A pilot study

    NARCIS (Netherlands)

    Zwerver, J.; Dekker, F.; Pepping, G.J.

    2010-01-01

    Background and purpose: Patellar tendinopathy is a common overuse injury for which no evidence-based treatment guidelines exist. Extracorporeal Shock Wave Therapy (ESWT) seems to be an effective treatment for patellar tendinopathy but the most beneficial treatment strategies still need to be ascerta

  18. Assessment of patellar maltracking using combined static and dynamic MRI

    Energy Technology Data Exchange (ETDEWEB)

    McNally, E.G.; Ostlere, S.J.; Pal, C.; Phillips, A.; Reid, H. [Department of Radiology, Nuffield Orthopaedic Centre, Headington, Oxford OX3 9JW (United Kingdom); Dodd, C. [Department of Orthopaedic Surgery, Nuffield Orthopaedic Centre, Headington, Oxford OX3 9JW (United Kingdom)

    2000-07-01

    Between January 1995 and Jul 1997, 474 patients with anterior knee pain resistant to conservative treatment were referred for MR of the knee. The MR examination consisted of routine sequences with an additional patellofemoral dynamic examination using a technique that has been developed at this institution. The dynamic study examines both knees simultaneously, with the patient supine and the quadriceps loaded. No gating or restraint apparatus is needed. Patellar subluxation or tilt was present in 188(40%) of cases, bilateral in 104 and unilateral in 84 cases (right 39, left 45). It was classified as mild in 51%, moderate in 39% and severe in 10%. Subluxation was more prevalent in females than males (42% vs. 37%) and this was most obvious in the severe group where 68% were female. In 90 knees selected at random, four measurements of patellofemoral morphology were obtained using reconstructed images from a volume gradient echo sequence. These measurements were correlated with the degree of subluxation or tilt. A tibial tubercle distance greater than 20 mm, a femoral sulcus angle greater than 150 degrees, sulcus depth less than 4 mm were specific for subluxation but no measurement proved to be sufficiently sensitive to preclude a tracking study. MRI can be used to define more precisely the anatomy of the extensor mechanism and its relationship to the femur and tibia, in both a static and dynamic setting. In this way, patients with anterior knee pain can be classified more accurately and the outcomes of treatment more reliably assessed. (orig.)

  19. Evaluation of chronic patellar tendinitis by ultrasonography and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Sa, Eun Jin; Song, In Sup; Park, Hyo Jin; Kim, Hyeon Joo; Kim, Yang Soo; Lee, Yong Chul; Kim, Kun Sang; Seo, Kyung Ho; Seo, Kyung Mook [Chungang University, Seoul (Korea, Republic of). Coll. of Medicine

    1998-06-01

    The purpose of this study is to evaluate the usefulness of magnetic resonance imaging (MRI) and ultrasonography (US) for the diagnosis of jumper`s knee in high school basketball players. In order to detect clinical cases of jumper`s knee, 40 sites of patellar tendon in 20 knees of ten basketball players were assessed by an evaluation of personal history and physical examination. US and MRI were used for detecting compatible findings of this condition; the diagnostic criteria were hypoechoic focus with focal thickening as seen on US, and increased signal intensity with focal thickening as seen on MRI. As an early finding of jumper`s knee a new sonographic criterion of focal hypoechoic focus with or without focal thickening, was also applied. At 19 of 40 sites (48 %), clinical jumper`s knee was diagnosed. For the detection of this condition according to known cliteria, sensitivity and specificity were, respectively, 63 % and 100 % (US) and 32 % and 90 % (MRI). Using the new criterion, the sensitivity and specificity of US were 84 % and 76 %, respectively. On the basis of known US and MRI criteria for jumper`s knee, the sensitivity and specificity of US were higher than those of MRI. We suggest that hypoechoic focus without focal thickening oas seen on US, is an early finding of jumper`s knee. (author). 10 refs., 3 tabs., 5 figs.

  20. An Isolated Medial Patellofemoral Ligament Reconstruction with Patellar Tendon Autograft

    Directory of Open Access Journals (Sweden)

    Dariusz Witoński

    2013-01-01

    Full Text Available The aim of the study was to evaluate the results of the medial patellofemoral ligament reconstruction with a medial strip of patellar tendon autograft after a minimum 2-year followup. Ten patients (10 knees were operated on by one surgeon, according to the modified technique, described by Camanho, without any bone plug at free graft end. The mean age of the patients was 27.2 years (ranging from 18 to 42 years. The mean follow-up period was 3 years and 7 months. All patients were reviewed prospectively. At the last follow-up visit, all the patients demonstrated a significant improvement in terms of patellofemoral joint stability, all aspects of the KOOS questionnaire, and Kujala et al.’s score (59.7 points preoperatively and 84.4 points at the last followup. No patient revealed recurrent dislocation. The SF-36 score revealed a significant improvement in bodily pain, general health, physical role functioning, social role functioning, and physical functioning domains. The described MPFL reconstruction with the use of the medial 1/3rd of patella tendon is an effective procedure that gives satisfactorily patellofemoral joint functions, improves the quality of life, and provides much pain relief. It is relatively simple, surgically not extensive, and economically cost-effective procedure.

  1. Imaging assessment of patellar instability and its treatment in children and adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Meyers, Arthur B.; Sharafinski, Mark [Children' s Hospital of Wisconsin, Medical College of Wisconsin, Department of Radiology, P.O. Box 1997, Milwaukee, WI (United States); Laor, Tal; Zbojniewicz, Andrew M. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2016-05-15

    Transient patellar dislocation is a common entity in children and adolescents, characterized by lateral dislocation of the patella, usually with spontaneous reduction. Many predisposing conditions have been described, including trochlear dysplasia, excessive lateral patellar tilt, patella alta and lateralization of the tibial tuberosity. Associated injuries are bone bruises of the patella and lateral femoral condyle, tears of the medial retinaculum that include the medial patellofemoral ligament (MPFL), tears of the vastus medialis obliquus muscle, injuries of articular cartilage, and intra-articular bodies. Children who are refractory to conservative management, have a large cartilage defect, or are at substantial risk for recurrent dislocations are candidates for surgical procedures to prevent future dislocations. Procedures can include MPFL repair or reconstruction, tibial tubercle repositioning and lateral retinacular release. The purpose of this review is to illustrate the imaging findings of transient patellar dislocation in the acute setting, the normal imaging appearance after surgical intervention, and post-surgical complications. (orig.)

  2. Total knee arthroplasty with subvastus approach in patient with chronic post-traumatic patellar dislocation

    Directory of Open Access Journals (Sweden)

    Jader Joel Machado Junqueira

    Full Text Available ABSTRACT Chronic lateral dislocation of the patella is a rare condition and acquired causes are usually secondary to knee trauma. The neglected chronic dislocation leads to progressive genu valgum and external tibial torsion deformities with subsequent gonarthrosis, which becomes painful and debilitating. There is no consensus regarding treatment of these patients, but total knee arthroplasty (TKA is a useful therapy in cases of painful symptomatic gonarthrosis. Few reports have shown that subvastus approach and lateral release may be a valid option for TKA, since it allows the correction of valgus deformity and patellar tracking without interrupting vascular blood supply of patella. This article reports a case of TKA and extensor mechanism realignment without patellar resurfacing in a patient with genu valgum and chronic post-traumatic patellar dislocation with satisfactory results after two years of follow-up.

  3. In vivo Evaluation of Patellar Tendon Stiffness in Individuals with Patellofemoral Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Hsin-Yi Liu

    2008-01-01

    Full Text Available The objective of this study was to utilise an ultrasonic technique to assess the effect of patellofemoral pain syndrome (PFPS on the mechanical properties of the patellar tendon. Seven subjects with PFPS and seven matched control subjects volunteered to participate in this study. Subjects were asked to perform isometric maximal voluntary contractions of the knee extensors while their knee extension torque was monitored and the displacement of the patellar tendon was recorded with an ultrasonic system. Our results showed significantly lower tendon stiffness (by ∼30% in the PFPS subjects. Although tendon secant modulus was lower by 34% in the PFPS subjects, the difference was not statistically significant. Therefore, we conclude that the ultrasonic technique was able to detect a decrease in the structural stiffness of the patellar tendon associated with PFPS. The decrease in tendon stiffness was moderately correlated with the length of symptoms in these individuals.

  4. Patellar tendon adaptation in relation to load-intensity and contraction type

    DEFF Research Database (Denmark)

    Malliaras, Peter; Kamal, Beenish; Nowell, Alastair;

    2013-01-01

    BACKGROUND: Loading leads to tendon adaptation but the influence of load-intensity and contraction type is unclear. Clinicians need to be aware of the type and intensity of loading required for tendon adaptation when prescribing exercise. The aim of this study was to investigate the influence...... of contraction type and load-intensity on patellar tendon mechanical properties. METHOD: Load intensity was determined using the 1 repetition maximum (RM) on a resistance exercise device at baseline and fortnightly intervals in four randomly allocated groups of healthy, young males: (1) control (no training); (2...... maximum torque, patellar tendon CSA and length were measured with dynamometry and ultrasound imaging. Patellar tendon force, stress and strain were calculated at 25%, 50%, 75% and 100% of maximum torque during isometric knee extension contractions, and stiffness and modulus at torque intervals of 50...

  5. Mechanical properties of human patellar tendon at the hierarchical levels of tendon and fibril

    DEFF Research Database (Denmark)

    Svensson, René B; Hansen, Philip; Hassenkam, Tue;

    2012-01-01

    Tendons are strong hierarchical structures, but how tensile forces are transmitted between different levels remains incompletely understood. Collagen fibrils are thought to be primary determinants of whole tendon properties, and therefore we hypothesized that the whole human patellar tendon and its...... distinct collagen fibrils would display similar mechanical properties. Human patellar tendons (n = 5) were mechanically tested in vivo by ultrasonography. Biopsies were obtained from each tendon, and individual collagen fibrils were dissected and tested mechanically by atomic force microscopy. The Young......'s modulus was 2.0 ± 0.5 GPa, and the toe region reached 3.3 ± 1.9% strain in whole patellar tendons. Based on dry cross-sectional area, the Young's modulus of isolated collagen fibrils was 2.8 ± 0.3 GPa, and the toe region reached 0.86 ± 0.08% strain. The measured fibril modulus was insufficient to account...

  6. Total knee arthroplasty with subvastus approach in patient with chronic post-traumatic patellar dislocation.

    Science.gov (United States)

    Junqueira, Jader Joel Machado; Helito, Camilo Partezani; Bonadio, Marcelo Batista; Pécora, Jose Ricardo; Demange, Marco Kawamura

    2016-01-01

    Chronic lateral dislocation of the patella is a rare condition and acquired causes are usually secondary to knee trauma. The neglected chronic dislocation leads to progressive genu valgum and external tibial torsion deformities with subsequent gonarthrosis, which becomes painful and debilitating. There is no consensus regarding treatment of these patients, but total knee arthroplasty (TKA) is a useful therapy in cases of painful symptomatic gonarthrosis. Few reports have shown that subvastus approach and lateral release may be a valid option for TKA, since it allows the correction of valgus deformity and patellar tracking without interrupting vascular blood supply of patella. This article reports a case of TKA and extensor mechanism realignment without patellar resurfacing in a patient with genu valgum and chronic post-traumatic patellar dislocation with satisfactory results after two years of follow-up.

  7. Tubular manipulators: a new concept for intracochlear positioning of an auditory prosthesis

    Directory of Open Access Journals (Sweden)

    Rau Thomas S.

    2015-09-01

    Full Text Available The aim of this study was to investigate the applicability of tubular manipulators as an actuator mechanism for intracochlear positioning of the electrode array (EA of a cochlear implant (CI. This is motivated by the vision of an atraumatic insertion of the EA into the inner ear (cochlea without any damage to the intracochlear structures in combination with a well-defined final position. To realize this, an actuator mechanism is required which allows consideration of the patient-specific anatomy. We propose a tubular manipulator for this task. It consists of three concentric tubes: A straight outer tube serves as a guiding sleeve to enter the inner ear (cochlea and two additional telescoping, superelastic, helically precurved tubes. By selecting helical tube parameters of both tubes prior insertion, a patient-specific curling behaviour of the tubular manipulator can be achieved. For preliminary investigation, segmentation and skeletonization of 5 human scala tympani were performed to determine their centrelines. These centrelines were considered as individual ideal insertion paths. An optimization algorithm was developed to identify suitable tube set parameters (curvature, diameter, length, torsion, stiffness as well as configuration parameters (translation and rotation of the 2 inner tubes. Different error values describing the deviation of the shape of the tubes with respect to the insertion path were used to quantify the optimization results. In all cases tube set parameters for a final position within the cochlea were found, while keeping the maximum error below 1mm. These preliminary results are promising in terms of the potential applicability of tubular manipulators for positioning auditory prosthesis inside the scala tympani of the inner ear.

  8. Correlation of patellar tracking pattern with trochlear and retropatellar surface topographies.

    Science.gov (United States)

    Ahmed, A M; Duncan, N A

    2000-12-01

    The study was aimed to test the hypothesis that in the knee extension range 100 to 30 deg, the patellar "out-of-plane" tracking pattern is controlled by the passive restraint provided by the topographic interaction of the patellofemoral contacting surfaces. The out-of-plane tracking pattern, i.e., the pattern of patellar displacements not in the plane of knee extension/flexion, consists of translation in the medial-lateral direction, and rotations about the anterior-posterior axis (spin) and the proximal-distal axis (tilt). Using 15 fresh-frozen knees subjected to extensor moment magnitudes comparable to those in the "static-lifting" activity (foot-ground reaction = 334 N), the patellar displacements were measured using a calibrated six-degree-of-freedom electromechanical goniometer. The topographies of the trochlear and retropatellar surfaces were then measured using a calibrated traveling dial-gage arrangement and the same coordinate system used for the displacement measurements. Three indices were defined to quantify particular natural features of the three-dimensional topographies that are expected to control the patellar displacements. Correlation of the indices with their corresponding displacements showed that topographic interaction was significant in the control of all three displacements. However, for patellar spin, unlike for the other two displacements, the direction of the active quadriceps tension vector was also a significant controlling factor. Patellar medial-lateral translation was found to be controlled dominantly by the trochlear topography, while retropatellar topography also had a significant role in the control of the other two displacements.

  9. Suture anchor repair of patellar tendon rupture after total knee arthroplasty.

    Science.gov (United States)

    Kamath, Atul F; Shah, Roshan P; Summers, Nathan; Israelite, Craig L

    2013-12-01

    Extensor mechanism disruption after total knee arthroplasty (TKA) is a complex problem that often requires surgical repair for functional deficits. We present a brief technical note on suture anchor fixation of a patellar tendon rupture after TKA. A surgical technique and literature review follows. Although suture anchor fixation is well described for tendinous repairs in other areas of orthopedic surgery, no study has discussed the use of suture anchors in patellar tendon repair after TKA. The technique must be evaluated in more patients with longer follow-up before adoption.

  10. Anterior cruciate ligament reconstruction with fresh-frozen patellar tendon allografts.

    Science.gov (United States)

    Valenti, J R; Sala, D; Schweitzer, D

    1994-01-01

    A prospective study was performed on 30 patients who underwent an anterior cruciate ligament reconstruction with fresh-frozen patellar tendon allograft. An arthroscopic technique alone was used in 10 patients, and in the other 20 patients this was combined with a miniarthrotomy. After a mean follow up of 35 months, the overall functional results were satisfactory in 85%. There were no cases of infection, disease transmission or tissue rejection. Fresh-frozen patellar tendon allografts are a good method of anterior cruciate reconstruction.

  11. BELOW-ELBOW COSMETIC CONDYLE-SUSPENDED PROSTHESIS

    Science.gov (United States)

    particular appeal to those amputees who desire a prosthesis for cosmetic reasons. However this type of prosthesis can be so built to provide a means for operating the active mechanical terminal device. (Author)

  12. Long term follow up of clinical outcome between patellar resurfacing and nonresurfacing in total knee arthroplasty: Chinese experience

    Institute of Scientific and Technical Information of China (English)

    Feng Bin; Weng Xisheng; Lin Jin; Jin Jin; Qian Wenwei; Wang Wei; Qiu Guixing

    2014-01-01

    Background The long term outcome of patellar resurfacing in Chinese has not been well described.This study evaluated more than 10-year clinical outcomes and survivorship of patellar resurfacing or nonresurfacing in total knee arthroplasty.Methods From January 1993 to December 2002,265 patients accepted total knee arthroplasty in Department of Orthopaedic Surgery,Peking Union Medical College Hospital.Among them,226 patients (246 knees) were successfully followed up,with 176 knees for patellar resurfacing and 70 knees for nonresurfacing.The survivorship of total knee arthroplasty between two groups and the hospital for special surgery knee score (HSS),patellar score,patellar related complication and radiological results were studied at the latest follow-up.Results The HSS knee score increased from 55.9±12.2 preoperatively to 92.0±10.9 postoperatively for patellar resurfacing group and from 56.6±9.9 to 94.2±11.4 for nonresurfacing group after average 11.4-year follow-up.Patellar score increased from 13.93±2.42 preoperatively to 28.33±2.20 for resurfacing group and from 13.55±2.73 to 27.8±2.37 for nonresurfacing group.There was no statistically significant difference for both HSS score,patellar score between the two groups with higher rate of anterior knee pain for nonresurfacing group.Patellar nonresurfacing had higher lateral subluxation than resurfacing group according to radiological evaluation.Patients with rheumatoid arthritis had 5.5 fold patellar related complication than patients with osteoarthritis.The 10-year survival rate was not statistically significant different between the two groups (P=0.12).Conclusions There was no significant difference of long-term clinical outcome and survivorship between patellar resurfacing and nonresurfacing.Patellar nonresurfacing can be advisable during primary total knee arthroplasty especially in Chinese patients with osteoarthritis.Selective patellar resurfacing for patients with rheumatoid arthritis can achieve

  13. Life Estimation of Hip Joint Prosthesis

    Science.gov (United States)

    Desai, C.; Hirani, H.; Chawla, A.

    2014-11-01

    Hip joint is one of the largest weight-bearing structures in the human body. In the event of a failure of the natural hip joint, it is replaced with an artificial hip joint, known as hip joint prosthesis. The design of hip joint prosthesis must be such so as to resist fatigue failure of hip joint stem as well as bone cement, and minimize wear caused by sliding present between its head and socket. In the present paper an attempt is made to consider both fatigue and wear effects simultaneously in estimating functional-life of the hip joint prosthesis. The finite element modeling of hip joint prosthesis using HyperMesh™ (version 9) has been reported. The static analysis (load due to the dead weight of the body) and dynamic analysis (load due to walking cycle) have been described. Fatigue life is estimated by using the S-N curve of individual materials. To account for progressive wear of hip joint prosthesis, Archard's wear law, modifications in socket geometry and dynamic analysis have been used in a sequential manner. Using such sequential programming reduction in peak stress has been observed with increase in wear. Finally life is estimated on the basis of socket wear.

  14. THE ENDO-EXO-FEMORAL PROSTHESIS

    Directory of Open Access Journals (Sweden)

    H. Aschoff

    2011-01-01

    Full Text Available Patients with above knee amputation (AKA face many challenges to mobility including difficulty with socket fit and fatigue due to high energy consumption. The aim of the Endo-Exo-Femur Prosthesis (EEFP is to avoid problems at the interface between the sleeve of the socket-prosthesis and the soft tissue coat of the femur stump which often impedes an inconspicuous and harmonic gait. In 1999 we began using a transcutaneous, press-fit distal femoral intramedullary device whose most distal external aspect serves as a hard point for AKA prosthesis attachment. The bone guided prosthesis enables an advanced gait via osseoperception and leads to a decreased oxygen consumption of the patient. Thirty two patients underwent the procedure between 1999 and 2008. Their indication for surgery was persistent AKA prosthesis difficulties with a history of AKA for trauma. The paper presents the patient data regarding the design of the implant, the operative procedure, patient satisfaction, gait analysis and oxygen consumption.

  15. Atraumatic restorative treatment - glass ionomer sealants survival after a postgraduate training program in Ecuador: 2-year follow-up

    Directory of Open Access Journals (Sweden)

    Edisson Lopez Rios

    2015-02-01

    Full Text Available This study aimed to evaluate the survival of atraumatic restorative treatment high-viscosity glass ionomer sealants (ART-hvGIS and its relationship with carious lesions incidence in underserved communities of Ecuador. A total of 483 first permanent molars with ART-hvGIS were included after treatment, in which fifteen students of the First Preventive Dentistry Post Graduate Program of Universidad Central del Ecuador assisted 176 schoolchildren, from 5 to 12 year-old. All the students had previously participated in a training course in ART approach. After one and two years follow-up, schoolchildren were reevaluated in relation to sealants retention and new carious lesions development. After first year of evaluation ART-hvGIS retention rate was about 30% and after second year 20%. Incidence of carious lesions was 4.0 and 3.4% after first and second periods, respectively. Although there was an extensive ART-hvGIS loss, carious lesions incidence was low in both the periods of evaluation. ART-hvGIS might be an important key to prevent tooth decay in underserved communities.

  16. A field-trial of two restorative materials used with atraumatic restorative treatment in rural Turkey: 24-month results

    Directory of Open Access Journals (Sweden)

    Ertugrul Ercan

    2009-08-01

    Full Text Available OBJECTIVE: The purpose of this study was to investigate the clinical performance of high-strength glass ionomer cement (HSGIC and resin-modified glass ionomer (RMGIC in single and multiple surface carious cavities in the field conditions. MATERIAL AND METHODS: A split-mouth design, including ninety-one fillings placed on contra lateral molar pairs of 37 children, was used in permanent dentition. As filling materials, a HSGIC (Ketac Molar/3M ESPE and a RMGIC (Vitremer/ 3M ESPE were used with the Atraumatic Restorative Treatment (ART. Baseline and 6, 12 and 24-month evaluations of the fillings were made with standard-ART and USPHS criteria by two examiners with kappa values of 0.92 and 0.87 for both criteria. RESULTS: According to the USPHS criteria, the retention rates of RMGIC and HSGIC restorations were 100% and 80.9% for single surface, and 100% and 41.2% for multiple surface restorations after 24 months, respectively. Irrespective of surface number, RMGIC was significantly superior to HSGIC (p= 0.004, according to both standard-ART and USPHS criteria. CONCLUSION: The results indicate that RMGIC may be an alternative restorative technique in comparison to high-strength GIC applications in ART-field-trials. However, further clinical and field trials are needed to support this conclusion.

  17. Teaching atraumatic restorative treatment in U.S. dental schools: a survey of predoctoral pediatric dentistry program directors.

    Science.gov (United States)

    Kateeb, Elham T; Warren, John J; Damiano, Peter; Momany, Elizabeth; Kanellis, Michael; Weber-Gasparoni, Karin; Ansley, Tim

    2013-10-01

    The International Dental Federation and World Health Organization have promoted the use of Atraumatic Restorative Treatment (ART) in modern clinical settings worldwide. In the United States, the practice of ART is not believed to be widely used, which may be a result of little attention given to ART training in predoctoral pediatric dentistry curricula in U.S. dental schools. This study investigated the extent of clinical and didactic instruction on ART provided in U.S. dental schools by surveying the predoctoral pediatric dentistry programs in 2010. Of the fifty-seven directors asked to complete the survey, forty-four responded for a response rate of 77 percent. Of these forty-four programs, 66 percent reported providing clinical training on ART, though only 14 percent provide this training often or very often. The types of ART training provided often or very often included interim treatment (18 percent) and single-surface cavities (14 percent) in primary teeth. However, ART was said to be rarely taught as a definitive treatment in permanent teeth (2 percent). Attitude was a major predictor, for clinical training provided and using professional guidelines in treatment decisions were associated with a positive attitude towards ART. These predoctoral pediatric dentistry programs used ART mainly in primary, anterior, and single-surface cavities and as interim treatment. As ART increases access of children to dental care, the incorporation of the ART approach into the curricula of U.S. dental schools should be facilitated by professional organizations.

  18. ATRAUMATIC SURGICAL EXTRUSION OF COMPLETE CROWN FRACTURED TOOTH USING PERIOTOME IN ESTHETIC ZONE: REPORT OF THREE CASES

    Directory of Open Access Journals (Sweden)

    Prashant

    2014-06-01

    Full Text Available BACKGROUND: Restoring traumatically injured teeth is a clinical challenge and often requires a multidisciplinary approach for predictable esthetic outcome. Although a number of techniques have been proposed for clinical crown lengthening procedures, all have some limitations in terms of function and esthetic. AIM: This report presents the clinical and radiographic results of surgical extrusion technique for clinical crown lengthening. MATERIAL & METHODS: Atraumatic surgical extrusion using a specially designed instrument (Periotome was performed in three cases in which it was expected that extensive respective osseous surgery would have to be used for crown lengthening. After luxation the teeth were extruded to the desired position and stabilized with sutures without rigid splinting. Two months after stabilization the teeth were treated by root canal treatment and firmly restored after 4months. RESULTS: Clinical examination performed after 6 months revealed probing depth ≤3mm around the teeth at all sites without bleeding on probing. Radiographs showed normal periodontal contour with new bone formation in periapical region without any evidence of root or crestal bone resorption or endodontic problems. CONCLUSION: The outcome of the treatment within a short duration has very good results without any esthetic and functional deformities.

  19. Acceptability, feasibility and perceived satisfaction of the use of the Atraumatic Restorative Treatment approach for people with disability.

    Science.gov (United States)

    Molina, Gustavo Fabián; Faulks, Denise; Frencken, Joannes

    2015-01-01

    Unmet caries treatment need is prevalent among people with disability, partly due to difficulties cooperating with conventional dental treatment. This study compared Atraumatic Restorative Treatment (ART) with conventional restorative treatment (CRT) in the clinic and under general anaesthesia (GA), in terms of feasibility, acceptability and respondent satisfaction in patients referred for special care dentistry. Patients referred for dental restorative care were treated using either ART or CRT approach. Acceptance, feasibility and level of satisfaction with the treatment provided were assessed. ANOVA with Bonferroni correction and Chi-square tests investigated differences in age, gender and Visual Analogue Scale satisfaction scores. A total of 66 patients (mean 13.6 ± 7.8 years) were included and 43 respondents chose ART. ART was feasible for 47 patients, with optimal placement of restorations for 79% of all patients receiving ART. CRT in the clinic was chosen by 15 respondents and was feasible for 5 (33%). Local anaesthesia was required for 4 of the 47 patients receiving ART and for 3 of the 5 patients receiving CRT in the clinic. Neither ART nor CRT could be performed in the clinic for 14 patients who were treated under GA (21%). Respondent satisfaction was higher for those receiving ART than CRT (in the clinic and under GA). It was concluded that ART is a satisfactory, feasible, acceptable and effective approach to restorative dental treatment in patients with disability who have difficulty coping with conventional treatment. More research is now required to confirm these results in a larger study population.

  20. Comparative evaluation of patellar height methods in the Brazilian population

    Directory of Open Access Journals (Sweden)

    Christian Behrendt

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: The methods most used for patellar height measurement were compared with the plateau-patella angle method. METHODS: A cross-sectional study was conducted, in which lateral-view radiographs of the knee were evaluated using the three methods already established in the literature: Insall-Salvati (IS, Blackburne-Peel (BP and Caton-Deschamps (CD. These were compared with the plateau-patella angle method. One hundred and ninety-six randomly selected patients were included in the sample. RESULTS: The data were initially evaluated using the chi-square test. This analysis was deemed to be positive with p < 0.0001. We compared the traditional methods with the plateau-patella angle measurement, using Fisher's exact test. In comparing the IS index with the plateau-patella angle, we did not find any statistically significant differences in relation to the proportion of altered cases between the two groups. The traditional methods were compared with the plateau-patella angle with regard to the proportions of cases of high and low patella, by means of Fisher's exact test. This analysis showed that the plateau-patella angle identified fewer cases of high patella than did the IS, BP and CD methods, but more cases of low patella. In comparing pairs, we found that the IS and CD indices were capable of identifying more cases of high patella than was the plateau-patella angle. In relation to the cases of low patella, the plateau-patella angle was capable of identifying more cases than were the other three methods. CONCLUSIONS: The plateau-patella angle found more patients with low patella than did the classical methods and showed results that diverged from those of the other indices studied.

  1. Comparative evaluation of patellar height methods in the Brazilian population☆

    Science.gov (United States)

    Behrendt, Christian; Zaluski, Alexandre; e Albuquerque, Rodrigo Pires; de Sousa, Eduardo Branco; Cavanellas, Naasson

    2015-01-01

    Objective The methods most used for patellar height measurement were compared with the plateau–patella angle method. Methods A cross-sectional study was conducted, in which lateral-view radiographs of the knee were evaluated using the three methods already established in the literature: Insall–Salvati (IS), Blackburne–Peel (BP) and Caton–Deschamps (CD). These were compared with the plateau–patella angle method. One hundred and ninety-six randomly selected patients were included in the sample. Results The data were initially evaluated using the chi-square test. This analysis was deemed to be positive with p < 0.0001. We compared the traditional methods with the plateau–patella angle measurement, using Fisher's exact test. In comparing the IS index with the plateau–patella angle, we did not find any statistically significant differences in relation to the proportion of altered cases between the two groups. The traditional methods were compared with the plateau–patella angle with regard to the proportions of cases of high and low patella, by means of Fisher's exact test. This analysis showed that the plateau–patella angle identified fewer cases of high patella than did the IS, BP and CD methods, but more cases of low patella. In comparing pairs, we found that the IS and CD indices were capable of identifying more cases of high patella than was the plateau–patella angle. In relation to the cases of low patella, the plateau–patella angle was capable of identifying more cases than were the other three methods. Conclusions The plateau–patella angle found more patients with low patella than did the classical methods and showed results that diverged from those of the other indices studied. PMID:26962492

  2. Robotic lower limb prosthesis design through simultaneous computer optimizations of human and prosthesis costs

    Science.gov (United States)

    Handford, Matthew L.; Srinivasan, Manoj

    2016-02-01

    Robotic lower limb prostheses can improve the quality of life for amputees. Development of such devices, currently dominated by long prototyping periods, could be sped up by predictive simulations. In contrast to some amputee simulations which track experimentally determined non-amputee walking kinematics, here, we explicitly model the human-prosthesis interaction to produce a prediction of the user’s walking kinematics. We obtain simulations of an amputee using an ankle-foot prosthesis by simultaneously optimizing human movements and prosthesis actuation, minimizing a weighted sum of human metabolic and prosthesis costs. The resulting Pareto optimal solutions predict that increasing prosthesis energy cost, decreasing prosthesis mass, and allowing asymmetric gaits all decrease human metabolic rate for a given speed and alter human kinematics. The metabolic rates increase monotonically with speed. Remarkably, by performing an analogous optimization for a non-amputee human, we predict that an amputee walking with an appropriately optimized robotic prosthesis can have a lower metabolic cost – even lower than assuming that the non-amputee’s ankle torques are cost-free.

  3. 21 CFR 870.3450 - Vascular graft prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vascular graft prosthesis. 870.3450 Section 870... prosthesis. (a) Identification. A vascular graft prosthesis is an implanted device intended to repair... Prostheses 510(k) Submissions.”...

  4. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Glenoid fossa prosthesis. 872.3950 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to be implanted in the...

  5. 21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Toe joint polymer constrained prosthesis. 888.3720 Section 888.3720 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of...

  6. 21 CFR 890.3500 - External assembled lower limb prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External assembled lower limb prosthesis. 890.3500... External assembled lower limb prosthesis. (a) Identification. An external assembled lower limb prosthesis... the lower extremity. Examples of external assembled lower limb prostheses are the following:...

  7. 21 CFR 888.3780 - Wrist joint polymer constrained prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint polymer constrained prosthesis. 888.3780 Section 888.3780 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... constrained prosthesis. (a) Identification. A wrist joint polymer constrained prosthesis is a device made...

  8. 21 CFR 874.3450 - Partial ossicular replacement prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Partial ossicular replacement prosthesis. 874.3450 Section 874.3450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... replacement prosthesis. (a) Identification. A partial ossicular replacement prosthesis is a device intended...

  9. 21 CFR 884.3650 - Fallopian tube prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Fallopian tube prosthesis. 884.3650 Section 884.3650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.3650 Fallopian tube prosthesis. (a) Identification. A fallopian tube prosthesis is a...

  10. 21 CFR 888.3230 - Finger joint polymer constrained prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Finger joint polymer constrained prosthesis. 888... constrained prosthesis. (a) Identification. A finger joint polymer constrained prosthesis is a device intended... generic type of device includes prostheses that consist of a single flexible across-the-joint...

  11. 21 CFR 874.3495 - Total ossicular replacement prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Total ossicular replacement prosthesis. 874.3495 Section 874.3495 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... replacement prosthesis. (a) Identification. A total ossicular replacement prosthesis is a device intended...

  12. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mandibular implant facial prosthesis. 874.3695... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant facial prosthesis. (a) Identification. A mandibular implant facial prosthesis is a device that...

  13. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the...

  14. 21 CFR 888.3025 - Passive tendon prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Passive tendon prosthesis. 888.3025 Section 888...) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3025 Passive tendon prosthesis. (a) Identification. A passive tendon prosthesis is a device intended to be implanted made of silicon elastomer or...

  15. Jumper's knee or lander's knee? A systematic review of the relation between jump biomechanics and patellar tendinopathy.

    Science.gov (United States)

    Van der Worp, H; de Poel, H J; Diercks, R L; van den Akker-Scheek, I; Zwerver, J

    2014-07-01

    Patellar tendinopathy (jumper's knee) is a common injury in sports that comprise jump actions. This article systematically reviews the literature examining the relation between patellar tendinopathy and take-off and landing kinematics in order to uncover risk factors and potential prevention strategies. A systematic search of the Pubmed, Embase and Amed databases was performed to identify studies that reported kinematics of sport specific jumps in relation to patellar tendinopathy. A quantitative analysis was performed on 4 indentified studies. Differences were found only between controls and asymptomatic subjects with patellar tendon abnormalities. Most differences were found during horizontal landing after forward acceleration. A synthesis of the literature suggests that horizontal landing poses the greatest threat for developing patellar tendinopathy. A stiff movement pattern with a small post-touchdown range of motion and short landing time is associated with the onset of patellar tendinopathy. Accordingly, employing a flexible landing pattern seems to be an expedient strategy for reducing the risk for (re-) developing patellar tendinopathy. Together, these findings indicate that improving kinetic chain functioning, performing eccentric exercises and changing landing patterns are potential tools for preventive and/or therapeutic purposes.

  16. Contact dermatitis to a limb prosthesis.

    Science.gov (United States)

    Sood, Apra; Taylor, James S; Billock, John N

    2003-09-01

    PROSTHESIS USERS commonly develop various skin problems on the residual limb, directly under the prosthetic device when the device is in direct contact with the skin. Prolonged occlusion and humidity increase the likelihood of developing contact sensitivity to moisturizing creams, medicaments, and materials in the prosthesis itself.1 Allergic contact dermatitis to various prosthetic design materials is uncommon, and the relevance of positive patch-test results to chemicals present in prostheses may be difficult to establish. Most reports of allergic contact dermatitis to prostheses have been concerned with surgical amputees and not congenital amputees. We report a 5-year-old boy with a transverse partial hemimelia who developed allergic contact dermatitis to an adhesive used in his myoelectric prosthesis. Unlike most prostheses, myoelectric prostheses are worn directly against the skin, for surface electromyography electrode contact.

  17. Groningen prosthesis for voice rehabilitation after laryngectomy.

    Science.gov (United States)

    Annyas, A A; Nijdam, H F; Escajadillo, J R; Mahieu, H F; Leever, H

    1984-02-01

    Singer and Blom's endoscopic technique, using a single valved silicone prosthesis, constituted a dramatic advance in speech rehabilitation following total laryngectomy. Since 1980, we have developed a silicone biflanged prosthesis that overcomes some of the inconveniences of previous prostheses. Insertion via the mouth and the oesophagus, or as a primary procedure during total laryngectomy is easily done with the use of specially developed instruments. The success rate in 36 patients in which the voice button was inserted at the time of total laryngectomy was 86.2%.

  18. Fabrication of a custom ocular prosthesis

    Directory of Open Access Journals (Sweden)

    Tania Sethi

    2014-01-01

    Full Text Available Defects of the eye may follow removal of a part of or the entire orbit. This results in the patient becoming visually, esthetically and psychologically handicapped. Restoring the defect with a silicone- or acrylic-based prosthesis not only restores esthetics but also gives back the lost confidence to the patient. This is a case report of a patient with a `pthisical eye` and details the steps in fabrication of an ocular prosthesis. Particular attention has been given to the laboratory process in this technique to minimize the residual monomer content in the artificial eye.

  19. Capitate pyrocarbon prosthesis in radiocarpal osteoarthritis.

    Science.gov (United States)

    Goubier, Jean-Noël; Vogels, Jérome; Teboul, Frédéric

    2011-03-01

    Scapholunate dissociation or scaphoid pseudarthrosis may lead to osteoarthritis of the wrist. When osteoarthritis affects the midcarpal joint, proximal row carpectomy is no longer possible and only 4 corners fusion or capitolunate arthrodesis may be indicated. However, in some cases, osteoarthritis or bone necrosis may involve the lunatum, making partial arthrodeses impossible. Total arthrodesis may be proposed in such cases, but with a loss of range-of-motion. Total prosthesis may be considered but the results of this procedure are not always encouraging. Consequently, in these situations, we perform pyrocarbon prosthesis implant, replacing the head of the capitatum. This article describes the procedure and the results of a preliminary study.

  20. 髌骨置换治疗严重髌股关节炎在膝关节置换术中的临床应用分析%Patellar Replacement to Treat Severe Patellofemoral Arthritis in the Knee Arthroplasty Clinical Analysis

    Institute of Scientific and Technical Information of China (English)

    代宏杰; 王立涛; 靳宪辉; 崔胜杰

    2014-01-01

    目的:探讨髌骨置换针对严重髌股关节炎在膝关节置换术中的应用及临床疗效。方法:2004年2月-2010年11月间行膝关节表面置换的126例(149例膝关节)。术前查X线(负重侧位、45°Rosenberg相、Merchant轴位相),对髌股关节炎分级并测量髌骨厚度和髌股间隙,从而预测出髌骨假体厚度,使重建后的髌股间隙不大于原间隙。均采用统一膝关节假体(smith&nephew ),由同一组医生完成。术中行髌骨截骨后假体置换,并在置换前后测量髌骨的运动轨迹。术后随访。膝关节评分(HSS评分),髌骨评分(Feller评分),结果应用SPSS13.0软件行统计学分析。结果:术中股骨和胫骨假体试模安装完成后,行髌骨截骨安装假体,140例均髌骨轨迹良好,可以达到“no thumb test”,9例采用了外侧支持带松解等操作,后髌骨轨迹良好。术后126患者均获得随访12个月,膝关节屈伸活动度平均110.5°(90°~125°),出现19髌前疼痛口服非甾体类药物逐渐缓解,无1例出现髌骨脱位、半脱位、髌骨坏死、髌骨坏死、髌骨骨折及皮肤坏死等。结论:对于严重的髌股关节炎行髌骨置换后可以更好的重建髌股关节,改善关节屈伸功能,减少髌骨的相关并发症。%Objective :To discuss serious patellofemoral arthritis in patella replacement in the application and clinical curative effect of knee arthroplasty .Methods :In February 2004 to November 2010 ,126 cases of knee joint surface re-placement (149 cases of knee joints ) .Preoperative X-ray check (lateral load-bearing ,45°Rosenberg phase ,phase break shaft) ,classification and measurement of patellofemoral arthritis patellar thickness and patellofemoral gap ,so as to predict the thickness of the patellar prosthesis ,the reconstruction of patellofemoral clearance is not more than the origi-nal clearance .After intraoperative osteotomy patella

  1. Revision Surgery in Permanent Patellar Dislocation in DiGeorge Syndrome

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    Massimo Berruto

    2015-01-01

    Full Text Available A 29-year-old patient, suffering from DiGeorge syndrome, came to our attention with a history of persistent pain and patellar instability in the left knee after failure of arthroscopic lateral release and Elmslie-Trillat procedure. The patient was unable to walk without crutches and severely limited in daily living activities. Because of arthritic changes of the patellofemoral joint and the failure of previous surgeries it was decided to perform only an open lateral release and medial patellofemoral ligament (MPFL reconstruction using a biosynthetic ligament in order to obtain patellofemoral stability. At one year post-op range of motion (ROM was 0–120 with a firm end point at medial patellar mobilization; patella was stable throughout the entire ROM. All the scores improved and she could be able to perform daily activity without sensation of instability. Bilateral patellar subluxation and systemic hyperlaxity are characteristics of syndromic patients and according to literature can be also present in DiGeorge syndrome. MPFL reconstruction with lateral release was demonstrated to be the correct solution in the treatment of patellar instability in this complex case. The choice of an artificial ligament to reconstruct the MPFL was useful in this specific patient with important tissue laxity due to her congenital syndrome.

  2. Anterior Cruciate Ligament Reconstruction using Bone Patellar Tendon Bone autograft in ACL deficient Knee

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    Navin Kumar Karn

    2015-12-01

    Full Text Available Background & Objectives: Injury to Anterior Cruciate Ligament (ACL reconstruction has increased because of increased interest in sports. There are various grafts used for reconstruction of ACL, for example, Bone Patellar Tendon Bone, Hamstring etc. The study was conducted to evaluate the results of Bone Patellar Tendon Bone graft used for reconstruction of Anterior Cruciate Ligament.Materials & Methods: 40 patients with chronic ACL deficient knee presenting to Neuro Hospital from July 2011 to June 2013 were included in the study. The patients with intraarticular fracture of knee, severe OA knee, local active or suspected infection and systemic disease that might influence the study results were excluded from the study. Bone patellar tendon bone graft was harvested from ipsilateral knee in all the cases. The patient was followed till 2 year with specified programme of rehabilitation. The pain was assessed using VAS and the function of the knee was assessed using Modified WOMAC knee index.Results: The long term satisfactory results in terms of functional stability, symptom relief and return to preinjury level of activity was seen in 32 cases (80%. Two knees got infected out of which one required arthroscopic debridement. Mean visual analogue scale was 8 and modified WOMAC knee score was 3 at 2 year follow up.Conclusion: Bone patellar tendon bone graft is useful in high demand patients and cost effective option with high patient satisfaction rate for reconstruction of ACL.JCMS Nepal. 2015;11(3:12-15.

  3. Medium-term evaluation of total knee arthroplasty without patellar replacement

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    José Wanderley Vasconcelos

    2013-06-01

    Full Text Available OBJECTIVE: To mid-term evaluate patients who were submitted to total knee arthroplasty without patellar resurfacing. METHODS: It was realized a retrospective cross-sectional study of patients who were submitted to total knee arthroplasty without patellar resurfacing. In all patients clinical examination was done based on the protocol of the Knee Society Scoring System, which assessed pain, range of motion, stability, contraction, knee alignment and function, and radiological evaluation. RESULTS: A total of 36 patients were evaluated. Of these, 07 were operated only on left knee, 12 only on right knee and 17 were operated bilaterally, totaling 53 knees. Ages ranged from 26 to 84 years. Of the 53 knees evaluated, 33 (62.26% had no pain. The maximum flexion range of motion averaged 104.7°. No knee had difficulty in active extension. As to the alignment for anatomical axis twelve knees (22.64% showed deviation between 0° and 4° varus. Thirty-nine (75.49% knees showed pace without restriction and the femorotibial angle ranged between 3° varus and 13° valgus with an average of 5° valgus. The patellar index ranged from 0.2 to 1.1. CONCLUSION: Total knee arthroplasty whitout patellar resurfacing provides good results in mid-term evaluation.

  4. Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy

    DEFF Research Database (Denmark)

    Kongsgaard, M.; Kovanen, V.; Aagaard, P.

    2009-01-01

    A randomized-controlled single-blind trial was conducted to investigate the clinical, structural and functional effects of peritendinous corticosteroid injections (CORT), eccentric decline squat training (ECC) and heavy slow resistance training (HSR) in patellar tendinopathy. Thirty-nine male...

  5. Patellar hypomobility and the flexibility of the iliotibial band and the femoral quadriceps.

    Science.gov (United States)

    Getka, Aleksandra

    2005-12-30

    Background. The aim of our study was to determine whether or not the flexibility of the iliotibial band and femoral quadriceps have an impact on patellar hypomobility, due to their connections with the patellar stabilizers. Material and methods. We examined 62 patients (44 females, 18 males) with a median age of 15 years (range 9-19). All these patients had patellofemoral dysfunction in the tested knees (101). The medial and distal glide of the patella were tested with a manual test according to Kaltenborn's scale. Ober's test was performed to test the tightness of the iliotibial band. The flexibility of the quadriceps femoris was tested while the patient was lying prone with the tested leg on the couch and the other beside it. Results. Statistical analysis based on the c2 test (P=0.05) found no dependence between the flexibility parameters of the iliotibial band or the femoral quadriceps and the parameters of patellar hypomobility. Of the tested joints, 37.6% showed hypomobile patella and positive Ober's test, while 34.7% had hypomobile patella and a positive test for femoral quadriceps flexibility. Conclusions. The flexibility of the iliotibial band and femoral quadriceps has no direct influence on passive patellar hypomobility, but can affect the biomechanics of the patellofemoral joint and the location of the point of contact on articular surfaces during dynamic knee work. The flexibility of these muscles should be a diagnostic factor in patients with patellofemoral dysfunction.

  6. Risk factors for patellar tendinopathy in basketball and volleyball players : A cross-sectional study

    NARCIS (Netherlands)

    Van der Worp, H.; Van Ark, M.; Zwerver, J.; Van den Akker-Scheek, I.

    2012-01-01

    Patellar tendinopathy (PT) has a multifactorial etiology, and many possible risk factors have been described in the literature. The findings are conflicting, though, and most research has been conducted on elite athletes. The aim of the current study is to determine the risk factors for PT in a larg

  7. Patellar ligament rupture in the dog: repair methods and patient outcomes in 43 cases.

    Science.gov (United States)

    Das, S; Thorne, R; Lorenz, N D; Clarke, S P; Madden, M; Langley-Hobbs, S J; Perry, K L; Burton, N J; Moores, A L; Mosley, J R

    2014-10-18

    The medical records of dogs receiving surgery for unilateral patellar ligament rupture between 1999 and 2012 at 12 multidisciplinary referral centres were reviewed. Forty-three cases were identified; 26 were traumatic in origin; almost one-third were iatrogenic, of which over three-quarters occurred as a complication following surgical stabilisation of patellar luxation. Treatment involved primary reapposition of the ligament (36 cases). The repair was protected by circumpatellar and/or transpatellar loop(s) of orthopaedic wire, nylon, polypropylene or polydioxanone suture (34 cases). Wire loops were more likely to require surgical removal compared with loops of other materials (P=0.0014). The stifle joint was immobilised postoperatively by the applications of a transarticular external skeletal fixator (taESF) in 17 cases and by external coaptation (EC) in 8 cases; in 18 cases, no postoperative joint immobilisation was provided. Complications specific to the method of immobilisation occurred in seven of the cases with taESF and six of the cases with EC. Revision surgery to address failure of repair was required in five cases. Outcome was classified as acceptable or good in over three-quarters of the cases (31/40) and poor in less than a quarter (9/40). These data highlight patellar ligament rupture as a complication of surgical stabilisation of patellar luxation.

  8. Treatment of Chronic Patellar Tendinopathy with Autologous Bone Marrow Stem Cells: A 5-Year-Followup

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    Cecilia Pascual-Garrido

    2012-01-01

    Full Text Available The purpose of this study is to determine if patients with chronic patellar tendinopathy will improve clinically after the inoculation of bone marrow mononuclear cells (BM-MNCs. Eight patients with chronic patellar tendinopathy were included. Patients averaged 24 years old (range 14–35. All patients were refractory to conservative treatment for at least 6 months before the procedure. BM-MNCs were harvested from the iliac bone crest and inoculated under ultrasound guide in the patellar tendon lesion. Improvement was assessed through established clinical scores and ultrasound. At 5-year followup, statistically significant improvement was seen for most clinical scores. Seven of eight patients said they would have the procedure again if they had the same problem in the opposite knee and were completely satisfied with the procedure. Seven of 8 patients thought that the results of the procedure were excellent. According to our results, inoculation of BM-MNCs could be considered as a potential therapy for those patients with chronic patellar tendinopathy refractory to nonoperative treatments.

  9. Prevalence, genetics, and surgical treatment of patellar luxation in purebred dogs

    NARCIS (Netherlands)

    Wangdee, C.

    2014-01-01

    Patellar luxation (PL) is a common cause of lameness in small-breed dogs. The aims of the study are to investigate the outcome of surgical treatment of medial PL (MPL) using standard techniques, and a novel surgical technique in Pomeranians for treating bidirectional PL (BPL), and to study the preva

  10. Risk factors for patellar tendinopathy : A systematic review of the literature

    NARCIS (Netherlands)

    van der Worp, Henk; van Ark, Mathijs; Roerink, Saskia; Pepping, Gert-Jan; van den Akker-Scheek, Inge; Zwerver, Johannes

    2011-01-01

    Patellar tendinopathy (PT) is an injury with a high prevalence in sports. Knowledge of risk factors is essential for developing preventive measures and rehabilitation programmes. However, risk factors associated with PT have not yet been systematically studied. This review was undertaken to identify

  11. MRI evaluation of patellar tendon defect after harvesting its central third

    Energy Technology Data Exchange (ETDEWEB)

    Koseoglu, Kutsi E-mail: kutsikoseoglu@yahoo.com; Memis, Aysenur; Argin, Mehmet; Arkun, Remide

    2004-06-01

    Purpose: the purpose of this study was to evaluate defect width of patellar tendon after harvest for anterior cruciate ligament reconstruction. Materials and methods: we performed MRI at various time interval after graft harvest (2-96 months) on 28 patients who had had reconstruction of the anterior cruciate ligament using mid-third patellar tendon. T1 and T2 weighted axial images were obtained to assess donor site defect of the patellar tendon. Measurement of the defect width was performed at the level of menisci on the axial images. The patients were divided into two groups according to the time interval between operation and imaging. The defect width of patients with short time interval (2-12 months) was compared to the defect width of patients with long time interval (12-96 months). Results: the average defect width of patients with short time interval was 6.4 mm and it was 2.2 mm for the patients with long time interval. Decreased defect width was obtained from MRI images in the patients with long time interval. Closed donor site defect was detected in 1 out of 14 patients with short time interval and 6 out of 14 patients with long time interval. Discussion and conclusion: these results show that there is no complete closure of donor site defect up to 1 year. However, it seems to be nearly complete closure of patellar tendon defect in the long time period.

  12. Arthroscopy-assisted anterior cruciate ligament reconstruction with patellar tendon or hamstring autografts.

    Science.gov (United States)

    Doral, M N; Leblebicioglu, G; Atay, O A; Baydar, M L; Tetik, O; Atik, S

    2000-01-01

    Isolated ACL reconstructions were performed in 138 patients between 1994 and 1998. Patellar bone-patellar tendon-bone, and hamstring tendon autografts were used in 88 patients, and allografts were used in 50 patients. Eighty-eight knees of 88 patients with autograft reconstructions (17 female, 71 male) were included in this study and evaluation of the patients with allograft reconstruction reported separately. The mean age at the time of the operation was 32 years. All ACL reconstructions were performed arthroscopically. Twenty-seven bone-patellar tendon-bone, and 61 hamstring tendon autografts were used. The mean follow-up was 29 months. In the postoperative course the Lachman test was negative in 62 patients, 1+ in 22 patients, and 2+ in 4 patients. In 17 patients, anterior drawer sign were 1+ in comparison to the contralateral side. Pivot shift test was moderately positive only in 5 cases in the bone-patellar tendon-bone and hamstring tendon autograft groups postoperatively. There were 3 patients with subjective "giving way" symptoms. Second look arthroscopy revealed rupture of the neo-ligament. Arthroscopic washout and debridement were performed, and no revision ligamentoplasties were performed. Two of these patients improved with accelerated proprioceptive physical therapy, and one had to decrease his previous level of activity. There were no cases of arthrofibrosis, infection, or extension lag. Clinical results of patellar bone-tendon-bone and hamstring groups did not show any significant clinical difference. Avoiding the disturbance of the extensor mechanism of the knee is probably the most significant advantage of the hamstring autograft.

  13. Evolution of the patellar sesamoid bone in mammals

    Science.gov (United States)

    Samuels, Mark E.; Regnault, Sophie

    2017-01-01

    The patella is a sesamoid bone located in the major extensor tendon of the knee joint, in the hindlimb of many tetrapods. Although numerous aspects of knee morphology are ancient and conserved among most tetrapods, the evolutionary occurrence of an ossified patella is highly variable. Among extant (crown clade) groups it is found in most birds, most lizards, the monotreme mammals and almost all placental mammals, but it is absent in most marsupial mammals as well as many reptiles. Here, we integrate data from the literature and first-hand studies of fossil and recent skeletal remains to reconstruct the evolution of the mammalian patella. We infer that bony patellae most likely evolved between four and six times in crown group Mammalia: in monotremes, in the extinct multituberculates, in one or more stem-mammal genera outside of therian or eutherian mammals and up to three times in therian mammals. Furthermore, an ossified patella was lost several times in mammals, not including those with absent hindlimbs: once or more in marsupials (with some re-acquisition) and at least once in bats. Our inferences about patellar evolution in mammals are reciprocally informed by the existence of several human genetic conditions in which the patella is either absent or severely reduced. Clearly, development of the patella is under close genomic control, although its responsiveness to its mechanical environment is also important (and perhaps variable among taxa). Where a bony patella is present it plays an important role in hindlimb function, especially in resisting gravity by providing an enhanced lever system for the knee joint. Yet the evolutionary origins, persistence and modifications of a patella in diverse groups with widely varying habits and habitats—from digging to running to aquatic, small or large body sizes, bipeds or quadrupeds—remain complex and perplexing, impeding a conclusive synthesis of form, function, development and genetics across mammalian evolution

  14. 垫片设计对TKA术后髌骨倾斜和胫骨旋转运动的影响%Influence of the insert design on tibial internal rotation and patellar tilt of the knee after TKA

    Institute of Scientific and Technical Information of China (English)

    及松洁; 周一新; 刘庆华; 李玉军; 周乙雄; 李为

    2011-01-01

    目的 探讨膝关节假体垫片设计对于全膝关节置换术(TKA)后膝关节运动学的影响.方法 选取使用GENESISⅡ型假体行TKA的28位膝关节骨关节炎的患者,共42膝,平均随访27.7个月.按照使用垫片的种类分为高屈曲垫片组(23膝)和标准垫片组(19膝),采用循环透视的方法对两组病例屈伸活动进行观察并储存DICOM数据.通过Image J医学影像处理软件对数据进行分析,使用CorelDRAW作图软件进行测量.通过对比两组病例在膝关节屈伸活动时胫骨内旋和髌骨倾斜等参数来分析垫片设计关节置换术后膝关节运动的影响.结果 标准垫片组和高屈曲垫片组在术后活动度无差异(P=0.789).两组在0°~120°范围活动时髌骨倾斜角无差异,活动范围达到130°时,两组有统计学差异(P=0.034).两组在胫骨旋转活动上无差异.结论 本研究结果表明垫片设计对TKA术后髌骨倾斜角有一定影响,对股胫旋转运动没有影响.%Objective To investigate the influence of the insert design of knee prosthesis on the kinematics of knee after total knee arthroplasty ( TKA ) . Methods Forty-two knees in 28 patients with knee osteoarthritis undergoing TKA using the GENESIS Ⅱ were included in this study, mean follow-up of 27.7 months. The cases were divided into two groups according to the type of insert, one was high flexion insert group (23 knees) and the other was standard insert group (19 knees ). The motion of flexion and extension of the two groups was observed by cyclic fluoroscopy and stored as DICOM data. The DICOM data was analyzed by Image J medical image processing software and measured by CorelDRAW mapping software. To investigate the influence of the insert design of knee prosthesis on kinematics of the knee after TKA by comparing the parameters of the two groups during the movement of knee joint, including tibial internal rotation and patellar tilt. Results The ROM of standard insert group and high

  15. Comparison of Range of Motion After Total Knee Prosthesis According to Different Type of Prosthesis

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    Firat Seyfettinoglu

    2016-07-01

    Full Text Available Aim: The aim of this study is to determine the effectiveness and range of motion of different type of knee prosthesis. Material and Method: This study includes 180 of 225 patients (139 F, 41 M, average age: 65, range of age: 51-82 between April 2005 and September 2007 with the diagnosis of gonarthrosis. All patients underwent to primary total knee arthroplasty. Primary osteoartrhritis is the reason of gonarthrosis. The patients with secondary osteoartrhritis were excluded from the study. All the patients were operated by the same surgical team and rehabilitated after surgery. Patella didnt change any patient. PCL was protected in some of the patients and cut some of patients. Totally seven type prosthesis in 16 subgroup were applied to the patients. All measurement were done by the same surgeon. Average follow up period was 31 months (24-49 months. Results: Patients without subgrouping were tested according to the range of motion before and after surgery to the type of the prosthesis trademark. Range of motion was decreased with the usage of Rotaglide and LCS® type of prosthesis. Range of motion didnt change with the usage of Maxim and Kinemax type. The range of motion increased in the other trademark of prosthesis. Flexion angle was increased statistically significant with nexgen® and scorpio® prosthesis (p

  16. Acceptability, feasibility and perceived satisfaction of the use of the Atraumatic Restorative Treatment approach for people with disability

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    Gustavo Fabián MOLINA

    2015-01-01

    Full Text Available Unmet caries treatment need is prevalent among people with disability, partly due to difficulties cooperating with conventional dental treatment. This study compared Atraumatic Restorative Treatment (ART with conventional restorative treatment (CRT in the clinic and under general anaesthesia (GA, in terms of feasibility, acceptability and respondent satisfaction in patients referred for special care dentistry. Patients referred for dental restorative care were treated using either ART or CRT approach. Acceptance, feasibility and level of satisfaction with the treatment provided were assessed. ANOVA with Bonferroni correction and Chi-square tests investigated differences in age, gender and Visual Analogue Scale satisfaction scores. A total of 66 patients (mean 13.6 ± 7.8 years were included and 43 respondents chose ART. ART was feasible for 47 patients, with optimal placement of restorations for 79% of all patients receiving ART. CRT in the clinic was chosen by 15 respondents and was feasible for 5 (33%. Local anaesthesia was required for 4 of the 47 patients receiving ART and for 3 of the 5 patients receiving CRT in the clinic. Neither ART nor CRT could be performed in the clinic for 14 patients who were treated under GA (21%. Respondent satisfaction was higher for those receiving ART than CRT (in the clinic and under GA. It was concluded that ART is a satisfactory, feasible, acceptable and effective approach to restorative dental treatment in patients with disability who have difficulty coping with conventional treatment. More research is now required to confirm these results in a larger study population.

  17. Microperforation prolotherapy: a novel method for successful nonsurgical treatment of atraumatic spontaneous anterior sternoclavicular subluxation, with an illustrative case

    Directory of Open Access Journals (Sweden)

    Stein A

    2011-06-01

    Full Text Available Alvin Stein1, Scott McAleer2, Marty Hinz31Stein Orthopedic Associates, PA, Plantation, FL, USA; 2University of Central Florida, Orlando, FL, USA; 3Clinical Research, Neuroresearch Clinics, Inc, Cape Coral, FL, USABackground: Surgical repair of an atraumatic spontaneous anterior subluxation of the sternoclavicular joint (herein referred to as the “SCJ” is often associated with poor outcome expectations. With traditional treatment, successful conservative therapy usually incorporates major lifestyle alterations. This manuscript discusses a novel approach known as “microperforation prolotherapy”. To illustrate the technique, the care of a patient who benefitted from this treatment is reviewed.Purpose: To present a novel form of treatment with an illustrative case that demonstrates the potential efficacy of microperforation prolotherapy of the SCJ.Patient and methods: A novel approach to treatment of bilateral subluxation of the sternoclavicular joint with microperforation prolotherapy is discussed. The clinical course of a 21-year-old male with bilateral subluxation of the SCJ, which seriously hampered the patient's athletic and daily living activities, is used as a backdrop to the discussion.Results: Following microperforation prolotherapy, the instability of the SCJ was replaced by full stability, complete range of motion, and the opportunity to engage in all of the athletic endeavors previously pursued. There is no scar or other cosmetic defect resulting from the treatment received.Conclusion: Anterior sternoclavicular joint subluxation has a poor record of complete recovery with surgical procedures or conservative measures with regard to providing restoration of full lifestyle function. This manuscript documents a novel microperforation prolotherapy treatment that induced healing and restored full stability to the ligament structures responsible for the condition in a completely safe and effective fashion, allowing the patient to resume

  18. Does prosthesis design affect the need for secondary resurfacing in total knee arthroplasty?

    Science.gov (United States)

    Rotigliano, Niccolò; Hirschmann, Michael T.

    2016-01-01

    Aims and Objectives: The purpose of this retrospective consecutive study was to compare the rate of secondary resurfacing in consecutive series of five different TKA systems. It was our hypothesis that different brands of TKA show different rates of secondary resurfacing. Materials and Methods: A retrospective study was performed on data from patients who underwent TKA without primary patellar resurfacing from 2004 to 2012 in an university affiliated hospital. The study cohort included 784 patients (m:f=302:482, mean age at surgery±SD 71±10) operated with TKA during this period. Five different cruciate-retaining TKA systems were used in consecutives series. These were the following: A) Triathlon, Stryker, Switzerland (n=296), B) PFC Sigma, DepuySynthes, Switzerland (n=215), C) LCS, DepuySynthes, Switzerland (n=80), D) Balansys, Mathys, Bettlach, Switzerland (n=129), E) Duracon, Stryker, Switzerland (n=64). Data was retrospectively obtained from our different hospital archives. Patients demographics, age at surgery, type of total knee arthroplasty were noted. In addition, the data were screened for a secondary resurfacing in each patient. On anterior-posterior, lateral and skyline view radiographs different measurements were performed. TKA component position was assessed on radiographs with respect to "The knee society total knee arthroplasty roentgenographic evaluation and scoring system (TKA-RESS). Pearson Chi square test was used to compare differences between groups (p<0.05). There was no significant difference between the groups in terms of age, gender, and radiological outcomes. Results: Twenty-six of 784 patients (3.3%) underwent secondary resurfacing due to patellofemoral pain during follow-up. In group A four of 296 patients (1.4%), in group B fifteen of 215 patients (7%), in group C four of 80 patients (5%), in group D two of 129 patients (1.6%), in group E one of 64 patients (1.6%) underwent secondary patellar resurfacing during follow-up. There was a

  19. Simplified, low cost below-knee prosthesis.

    Science.gov (United States)

    Kijkusol, D

    1986-08-01

    Problems are encountered in using standard prostheses in developing countries, especially when the prostheses need repair and the amputees cannot come back to the workshop. Very simple, low cost and durable prostheses can solve this problem. The solution described has worked well with villagers in some rural areas of Thailand, where the inexpensive prosthesis permits walking bare-foot and through water and mud.

  20. Prosthesis fabrication using electrical discharge machining.

    Science.gov (United States)

    Van Roekel, N B

    1992-01-01

    Fixed-removable implant prostheses provide solutions for some of the problems associated with implant dentistry, especially in the maxilla. The technique for using electrical discharge machining to create a precise passive fit between the substructure bar and the removable suprastructure is presented. The advantages, disadvantages, and complications associated with this type of prosthesis are discussed.

  1. Movement Control of a Prosthesis Forefinger

    Directory of Open Access Journals (Sweden)

    CHIVU, C.

    2007-04-01

    Full Text Available The present paper approaches the problem of hand prostheses. Designing of hand prostheses implies the use of many types of mechanisms. One of them is the anti-quadrilateral mechanism. The control method chosen and presented in this paper is fuzzy method, applied to a dc motor that actuates each finger of the prosthesis.

  2. Catastrophic failure of a monolithic zirconia prosthesis.

    Science.gov (United States)

    Chang, Jae-Seung; Ji, Woon; Choi, Chang-Hoon; Kim, Sunjai

    2015-02-01

    Recently, monolithic zirconia restorations have received attention as an alternative to zirconia veneered with feldspathic porcelain to eliminate chipping failures of veneer ceramics. In this clinical report, a patient with mandibular edentulism received 4 dental implants in the interforaminal area, and a screw-retained monolithic zirconia prosthesis was fabricated. The patient also received a maxillary complete removable dental prosthesis over 4 anterior roots. At the 18-month follow-up, all of the zirconia cylinders were seen to be fractured, and the contacting abutment surfaces had lost structural integrity. The damaged abutments were replaced with new abutments, and a new prosthesis was delivered with a computer-assisted design and computer-assisted manufacturing fabricated titanium framework with denture teeth and denture base resins. At the 6-month recall, the patient did not have any problems. Dental zirconia has excellent physical properties; however, care should be taken to prevent excessive stresses on the zirconia cylinders when a screw-retained zirconia restoration is planned as a definitive prosthesis.

  3. Argus II retinal prosthesis system: An update.

    Science.gov (United States)

    Rachitskaya, Aleksandra V; Yuan, Alex

    2016-09-01

    This review focuses on a description of the Argus II retinal prosthesis system (Argus II; Second Sight Medical Products, Sylmar, CA) that was approved for humanitarian use by the FDA in 2013 in patients with retinitis pigmentosa with bare or no light perception vision. The article describes the components of Argus II, the studies on the implant, and future directions.

  4. Clinical Outcomes of Penile Prosthesis Implantation Surgery

    Directory of Open Access Journals (Sweden)

    Onur Dede

    2016-06-01

    Full Text Available Objective: We aimed to evaluating the outcomes of in­flatable penile prosthesis implantations and partner sat­isfaction. Methods: Data of 52 patients who underwent penile prosthesis implantation in single center between May 2010 and December 2015 were retrospectively analyzed. Types of prosthesis, complication and satisfaction rates of patients were recorded by EDITS (Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire was used. Results: The mean age was 49.2±14.7 years for patients. The mean follow-up durations for 34.3±12.5 months. The mean hospital stay was 3.84±1.52 days. Evaluating of the couples satisfaction revealed that 44 (84% of the patient were very satisfied. There was not any complication and no patient need to underwent revision surgery. Conclusion: Inflatable penile prosthesis implants, with high levels of treatment success, patient and partner sat­isfaction, are effective and safe options for treatment of organic erectile dysfunction with acceptable complication and revision rates.

  5. Reading visual braille with a retinal prosthesis.

    Science.gov (United States)

    Lauritzen, Thomas Z; Harris, Jordan; Mohand-Said, Saddek; Sahel, Jose A; Dorn, Jessy D; McClure, Kelly; Greenberg, Robert J

    2012-01-01

    Retinal prostheses, which restore partial vision to patients blinded by outer retinal degeneration, are currently in clinical trial. The Argus II retinal prosthesis system was recently awarded CE approval for commercial use in Europe. While retinal prosthesis users have achieved remarkable visual improvement to the point of reading letters and short sentences, the reading process is still fairly cumbersome. This study investigates the possibility of using an epiretinal prosthesis to stimulate visual braille as a sensory substitution for reading written letters and words. The Argus II retinal prosthesis system, used in this study, includes a 10 × 6 electrode array implanted epiretinally, a tiny video camera mounted on a pair of glasses, and a wearable computer that processes the video and determines the stimulation current of each electrode in real time. In the braille reading system, individual letters are created by a subset of dots from a 3 by 2 array of six dots. For the visual braille experiment, a grid of six electrodes was chosen out of the 10 × 6 Argus II array. Groups of these electrodes were then directly stimulated (bypassing the camera) to create visual percepts of individual braille letters. Experiments were performed in a single subject. Single letters were stimulated in an alternative forced choice (AFC) paradigm, and short 2-4-letter words were stimulated (one letter at a time) in an open-choice reading paradigm. The subject correctly identified 89% of single letters, 80% of 2-letter, 60% of 3-letter, and 70% of 4-letter words. This work suggests that text can successfully be stimulated and read as visual braille in retinal prosthesis patients.

  6. Reading visual Braille with a retinal prosthesis

    Directory of Open Access Journals (Sweden)

    Thomas Zaccarin Lauritzen

    2012-11-01

    Full Text Available Retinal prostheses, which restore partial vision to patients blinded by outer retinal degeneration, are currently in clinical trial. The Argus II retinal prosthesis system was recently awarded CE approval for commercial use in Europe. While retinal prosthesis users have achieved remarkable visual improvement to the point of reading letters and short sentences, the reading process is still fairly cumbersome. This study investigates the possibility of using an epiretinal prosthesis to stimulate visual Braille as a sensory substitution for reading written letters and words. The Argus II retinal prosthesis system, used in this study, includes a 10 x 6 electrode array implanted epiretinally, a tiny video camera mounted on a pair of glasses, and a wearable computer that processes the video and determines the stimulation current of each electrode in real time. In the Braille reading system, individual letters are created by a subset of dots from a 3 by 2 array of six dots. For the visual Braille experiment, a grid of six electrodes was chosen out of the 10 x 6 Argus II array. Groups of these electrodes were then directly stimulated (bypassing the camera to create visual percepts of individual Braille letters. Experiments were performed in a single subject. Single letters were stimulated in an alternative forced choice (AFC paradigm, and short 2-4-letter words were stimulated (one letter at a time in an open-choice reading paradigm. The subject correctly identified 89% of single letters, 80% of 2-letter, 60% of 3-letter, and 70% of 4-letter words. This work suggests that text can successfully be stimulated and read as visual Braille in retinal prosthesis patients.

  7. Use of a turndown quadriceps tendon flap for rupture of the patellar tendon after total knee arthroplasty.

    Science.gov (United States)

    Lin, Po-Chun; Wang, Jun-Wen

    2007-09-01

    Patellar tendon rupture is a devastating complication after total knee arthroplasty. The results of surgical treatment of this complication were discouraging in most of the reports. We describe a case of rupture of patellar tendon 7 weeks after total knee arthroplasty treated with a turndown quadriceps flap and circumferential wiring. Two years and 6 months after operation, the patient had no extension lag of the knee and knee flexion to 110 degrees .

  8. Spontaneous Rupture of the Patellar Tendon and the Contralateral Quadriceps Tendon, Associated with Lupus Erythematosus: Analysis of the Literature

    Directory of Open Access Journals (Sweden)

    Efthimios J. Karadimas

    2011-01-01

    Full Text Available Bilateral rupture of the patellar tendon is a rare injury. A case of a 67-year-old man with systemic lupus erythematosus under corticosteroid treatment for the last 10 years, who sustained spontaneous rupture of the patellar tendon and the contralateral quadriceps tendon, is herein presented. The patient was operated bilaterally, had an optimal outcome considering his age and the comorbidities, and was followed up for 24 months.

  9. Is latero-medial patellar mobility related to the range of motion of the knee joint after total knee arthroplasty?

    Science.gov (United States)

    Ota, Susumu; Nakashima, Takeshi; Morisaka, Ayako; Omachi, Takaaki; Ida, Kunio; Kawamura, Morio

    2010-12-01

    Diminished range of motion (ROM) of the knee joint after total knee arthroplasty (TKA) is thought to be related to reduced patellar mobility. This has not been confirmed clinically due to a lack of quantitative methods adequate for measuring patellar mobility. We investigated the relationship between patellar mobility by a reported quantitative method and knee joint ROM after TKA. Forty-nine patients [osteoarthritis--OA: 29 knees; rheumatoid arthritis--RA: 20 knees] were examined after TKA. Respective medial and lateral patellar mobility was measured 1 and 6 months postoperatively using a patellofemoral arthrometer (PFA). Knee joint ROM was also measured in each of those 2 sessions. Although the flexion and extension of the knee joints improved significantly from 1 to 6 months after TKA, the medial and lateral patellar displacements (LPDs) failed to improve during that same period. Moreover, only the changes in knee flexion and medial patellar displacement (MPD) between the two sessions were positively correlated (r = 0.31, p knee ROM after TKA.

  10. Changes in morphological and elastic properties of patellar tendon in athletes with unilateral patellar tendinopathy and their relationships with pain and functional disability.

    Directory of Open Access Journals (Sweden)

    Zhi Jie Zhang

    Full Text Available BACKGROUND: Patellar tendinopathy (PT is one of the most common knee disorders among athletes. Changes in morphology and elasticity of the painful tendon and how these relate to the self-perceived pain and dysfunction remain unclear. OBJECTIVES: To compare the morphology and elastic properties of patellar tendons between athlete with and without unilateral PT and to examine its association with self-perceived pain and dysfunction. METHODS: In this cross-sectional study, 33 male athletes (20 healthy and 13 with unilateral PT were enrolled. The morphology and elastic properties of the patellar tendon were assessed by the grey and elastography mode of supersonic shear imaging (SSI technique while the intensity of pressure pain, self-perceived pain and dysfunction were quantified with a 10-lb force to the most painful site and the Victorian Institute of Sport Assessment-patella (VISA-P questionnaire, respectively. RESULTS: In athletes with unilateral PT, the painful tendons had higher shear elastic modulus (SEM and larger tendon than the non-painful side (p<0.05 or the dominant side of the healthy athletes (p<0.05. Significant correlations were found between tendon SEM ratio (SEM of painful over non-painful tendon and the intensity of pressure pain (rho  = 0.62; p = 0.024, VISA-P scores (rho  = -0.61; p = 0.026, and the sub-scores of the VISA-P scores on going down stairs, lunge, single leg hopping and squatting (rho ranged from -0.63 to -0.67; p<0.05. CONCLUSIONS: Athletes with unilateral PT had stiffer and larger tendon on the painful side than the non-painful side and the dominant side of healthy athletes. No significant differences on the patellar tendon morphology and elastic properties were detected between the dominant and non-dominant knees of the healthy control. The ratio of the SEM of painful to non-painful sides was associated with pain and dysfunction among athletes with unilateral PT.

  11. An Atraumatic Symphysiolysis with a Unilateral Injured Sacroiliac Joint in a Patient with Cushing’s Disease: A Loss of Pelvic Stability Related to Ligamentous Insufficiency?

    Directory of Open Access Journals (Sweden)

    Andreas Höch

    2016-01-01

    Full Text Available Glucocorticoids are well known for altering bone structure and elevating fracture risk. Nevertheless, there are very few reports on pelvic ring fractures, compared to other bones, especially with a predominantly ligamentous insufficiency, resulting in a rotationally unstable pelvic girdle. We report a 39-year-old premenopausal woman suffering from an atraumatic symphysiolysis and disruption of the left sacroiliac joint. She presented with external rotational pelvic instability and immobilization. Prior to the injury, she received high-dose glucocorticoids for a tentative diagnosis of rheumatoid arthritis over two months. This diagnosis was not confirmed. Other causes leading to the unstable pelvic girdle were excluded by several laboratory and radiological examinations. Elevated basal cortisol and adrenocorticotropic hormone levels were measured and subsequent corticotropin-releasing hormone stimulation, dexamethasone suppression test, and petrosal sinus sampling verified the diagnosis of adrenocorticotropic hormone-dependent Cushing’s disease. The combination of adrenocorticotropic hormone-dependent Cushing’s disease and the additional application of exogenous glucocorticoids is the most probable cause of a rare atraumatic rotational pelvic instability in a premenopausal patient. To the authors’ knowledge, this case presents the first description of a rotationally unstable pelvic ring fracture involving a predominantly ligamentous insufficiency in the context of combined exogenous and endogenous glucocorticoid elevation.

  12. Development and clinical application of a new testicular prosthesis

    Institute of Scientific and Technical Information of China (English)

    Ye Ning; Zhikang Cai; Huixing Chen; Ping Ping; Peng Li; Zhong Wang; Zheng Li

    2011-01-01

    A new type of testicular prosthesis made of silastic with an elliptical shape to mimic a normal testis was developed by our team and submitted for patenting in China.The prosthesis was produced in different sizes to imitate the normal testis of the patient.To investigate the effects and safety of the testicular prosthesis,20 patients receiving testicular prosthesis implantation were recruited for this study.Follow-up after 6 months revealed no complications in the patients.All the patients answered that they were satisfied with their body image and the position of the implants,19 patients were satisfied with the size and 16 patients were satisfied with the weight.These results show that the testicular prosthesis used in this study can meet patient's expectations.Patients undergoing orchiectomy should be offered the option to receive a testicular prosthesis implantation.The dimensions and weight of the available prosthetic implants should be further addressed to improve patient satisfaction.

  13. Design and Control of a Powered Transfemoral Prosthesis.

    Science.gov (United States)

    Sup, Frank; Bohara, Amit; Goldfarb, Michael

    2008-02-01

    The paper describes the design and control of a transfemoral prosthesis with powered knee and ankle joints. The initial prototype is a pneumatically actuated powered-tethered device, which is intended to serve as a laboratory test bed for a subsequent self-powered version. The prosthesis design is described, including its kinematic optimization and the design of a three-axis socket load cell that measures the forces and moments of interaction between the socket and prosthesis. A gait controller is proposed based on the use of passive impedance functions that coordinates the motion of the prosthesis with the user during level walking. The control approach is implemented on the prosthesis prototype and experimental results are shown that demonstrate the promise of the active prosthesis and control approach in restoring fully powered level walking to the user.

  14. Keblish's lateral surgical approach enhances patellar tilt in valgus knee arthroplasty

    Directory of Open Access Journals (Sweden)

    José Roberto Tonelli Filho

    Full Text Available ABSTRACT OBJECTIVE: To compare the clinical and radiological outcomes of conventional medial and lateral approaches for total knee replacement in the valgus osteoarthritic knee. METHODS: In this randomized controlled trial, 21 patients with valgus knee osteoarthritis were randomized to total knee replacement through medial or lateral approach. The primary outcome was radiographic patellar tilt. Secondary outcomes were visual analog scale of pain, postoperative levels of hemoglobin, and clinical aspect of the operative wound. RESULTS: There were no differences between the groups regarding other clinical variables. Mean lateral tilt of the patella was 3.1 degrees (SD ± 5.3 in the lateral approach group and 18 degrees (SD ± 10.2 in the medial approach group (p = 0.02. There were no differences regarding the secondary outcomes. CONCLUSION: Lateral approach provided better patellar tilt following total knee replacement in valgus osteoarthritic knee.

  15. Tensile force transmission in human patellar tendon fascicles is not mediated by glycosaminoglycans

    DEFF Research Database (Denmark)

    Svensson, René B; Hassenkam, Tue; Hansen, Philip;

    2011-01-01

    change the tendon modulus, relative energy dissipation, peak stress, or peak strain. The effect of deformation rate was not modulated by the treatment either, indicating no effect on viscosity. These results suggest that GAGs cannot be considered mediators of tensile force transmission in the human...... the mechanical properties of fascicles from human patellar tendon at two different deformation rates before and after removal of GAGs by treatment with chondroitinase ABC. Efficiency of enzyme treatment was quantified using dimethylmethylene blue assay. Removal of at least 79% of the GAGs did not significantly...... patellar tendon, and as such, force transmission must either take place through other matrix components or the fibrils must be mechanically continuous at least to the tested length of 7 mm....

  16. Simultaneous bilateral patellar tendon rupture without predisposing systemic disease or steroid use: a case report

    Institute of Scientific and Technical Information of China (English)

    LU Hua-ding; CAI Dao-zhang; WANG Kun; ZENG Chun

    2012-01-01

    There is a dearth of case reports describing simultaneous bilateral patellar tendon ruptures in the medical literature.These ruptures are often associated with systemic disorders such as lupus erythematosus or chronic steroid use.The author describes a case of a 24-year-old man who sustained traumatic bilateral patellar tendon ruptures without any history of systemic disease or steroidal medication.We repaired and reattached the ruptured tendons to the patella and augmented our procedure with allogeneic tendon followed by wire loop reinforcement.One year after operation,the patient regained a satisfactory range of motion of both knees with good quadriceps strength and no extensor lag.The recurrent microtrauma from a history of intense sports activity and a high body mass index may have played an important role in this trauma event.

  17. Local trauma in human patellar tendon leads to widespread changes in the tendon gene expression

    DEFF Research Database (Denmark)

    Heinemeier, Katja Maria; Lorentzen, Marc P; Kildevang Jensen, Jacob;

    2016-01-01

    Low cellular activity and slow tissue turnover in human tendon may prolong resolution of tendinopathy. This may be stimulated by moderate localized traumas such as needle penetrations, but whether this results in a widespread cellular response in tendons is unknown. In an initial hypothesis......-generating study, a trauma-induced tendon cell activity (increased total RNA and collagen I mRNA) was observed after repeated patellar tendon biopsies in young men. In a subsequent controlled study, 25 young men were treated with two 0.8 mm diameter needle penetrations (n=13, needle-group (NG)) or one 2.1 mm...... diameter needle biopsy (n=12, biopsy-group (BG)) in one patellar tendon. Four weeks later biopsies were taken from treated (5 mm lateral from trauma site) and contralateral tendons for analyses of RNA content (ribogreen assay), DNA content (PCR based), and gene expression for relevant target genes (Real...

  18. Tracheobronchial Foreign Body Aspiration: Dental Prosthesis

    Directory of Open Access Journals (Sweden)

    Ataman Köse

    2014-01-01

    Full Text Available It is important to extract foreign bodies for avoiding life-threatening complications. They can lead to death if they are not treated. Different signs and symptoms could occur according to the complete or partial airway obstruction. Foreign body aspiration is a rare incident in adults. The organic foreign materials such as foods are found to be aspirated more commonly and are usually settled in the right bronchial system. However, dental prosthesis and teeth aspirations are rare in literature. In our study, a 52-year-old male patient who had aspirated the front part of his lower dental prosthesis accidentally is presented and the foreign body is extracted by using rigid bronchoscopy. There are many causes of aspiration but dental prosthetic aspirations should be kept in mind during sleep. For this reason, dental apparatus must be taken out while asleep.

  19. Design and Control of a Powered Transfemoral Prosthesis

    OpenAIRE

    Sup, Frank; Bohara, Amit; Goldfarb, Michael

    2008-01-01

    The paper describes the design and control of a transfemoral prosthesis with powered knee and ankle joints. The initial prototype is a pneumatically actuated powered-tethered device, which is intended to serve as a laboratory test bed for a subsequent self-powered version. The prosthesis design is described, including its kinematic optimization and the design of a three-axis socket load cell that measures the forces and moments of interaction between the socket and prosthesis. A gait controll...

  20. Correlation analysis between the interface membrane and loose hip prosthesis

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Objective To analyze the cause of prosthesis loosening by observing the interface membranes harvested during the hip restoration operation. Methods A total of 28 specimens of interface membrane around the loose prosthesis were harvested from 28 patients undergoing the restoration of total hip replacement. All the specimens underwent the observation of appearance, light microscopy and scanning electronic microscopy(SEM). Results All the gaps around the loose prosthesis were filled with interface membrane of ...

  1. Dental prosthesis and buccal lesions in the elderly

    OpenAIRE

    Beatriz García Alpizar; Mikhail Benet Rodíguez; Eduardo Enrique Castillo Betancourt

    2010-01-01

    Fundament: Buccal lesions in the elderly are very frequent and they constitute a problem of health due to the consequences that cause. Objective: to describe the characteristics of the removable prosthesis used by the population of 60 and more years age and their relationship with the lesions of the oral mucosa. Methods: We carried out a study descriptive of cross section in 125 elderly with oral prosthesis. The characteristics of the removable prosthesis were described and their relationship...

  2. Ischemic Gangrene of the Glans following Penile Prosthesis Implantation

    OpenAIRE

    Borja García Gómez; Javier Romero Otero; Laura Díez Sicilia; Estibaliz Jiménez Alcaide; Eduardo García-Cruz; Alfredo Rodríguez Antolín

    2013-01-01

    The development of ischemic gangrene of the penis following implantation of prosthesis is unusual, and very few cases are available in the literature. As a result, no established treatment protocol is available. We report our experience within a case of gangrene of the glans following implantation of a three-component prosthesis. We present a 53-year-old male, smoker with diabetes and hypercholesterolemia, who underwent surgery for the insertion of a penile prosthesis with 3 components to cor...

  3. Fixation of an osteochondral fragment after acute patellar dislocation in an immature skeleton,

    Directory of Open Access Journals (Sweden)

    Rodrigo Pires e Albuquerque

    2014-04-01

    Full Text Available Fixation of an osteochondral fracture after acute patellar dislocation is an infrequent form of treatment. Likewise, the location of this fragment in the lateral region of the lateral femoral condyle, functioning as a free body, is uncommon. The aim of this study was to present a case of osteochondral fracture of the patella at an unusual site, along with the therapy used and the clinical follow-up.

  4. Corrective surgery for canine patellar luxation in 75 cases (107 limbs): landmark for block recession

    OpenAIRE

    Mitsuhiro Isaka; Masahiko Befu; Nami Matsubara; Mayuko Ishikawa; Yurie Arase; Toshiyuki Tsuyama; Akiko Doi; Shinichi Namba

    2014-01-01

    Canine medial patellar luxation (MPL) is a very common orthopedic disease in small animals. Because the pathophysiology of this disease involves various pathways, the surgical techniques and results vary according to the veterinarian. Further, the landmark for block recession is not completely clear. We retrospectively evaluated 75 dogs (107 limbs) with MPL in whom our landmark for block recession was used from July 2008 to May 2013. Information regarding the breed, age, sex, body weight, bod...

  5. Control of dental prosthesis system with microcontroller.

    Science.gov (United States)

    Kapidere, M; Müldür, S; Güler, I

    2000-04-01

    In this study, a microcontroller-based electronic circuit was designed and implemented for dental prosthesis curing system. Heater, compressor and valve were controlled by 8-bit PIC16C64 microcontroller which is programmed using MPASM package. The temperature and time were controlled automatically by preset values which were inputted from keyboard while the pressure was kept constant. Calibration was controlled and the working range was tested. The test results showed that the system provided a good performance.

  6. Orofacial Space Infection Due to Faulty Prosthesis

    OpenAIRE

    Pramod Krishna, B.; Batra, Ranmeet; Chopra, Sumit; Sethi, Nitin

    2011-01-01

    Orofacial space infections are commonly treated by oral and maxillofacial surgeons, even in the post antibiotic era. Pre existing systemic conditions such as diabetes mellitus makes a person more vulnerable to space infection. A prosthesis which is poorly designed often jeopardises the oral health and makes a person susceptible to ulcers of mucosa, which can result in necrosis of mucosa. The sequel of such ulcerations and necrosis would be life threatening Orofacial space infections in medica...

  7. Gingival prosthesis: A treatment modality for recession

    Directory of Open Access Journals (Sweden)

    Pallavi Samatha Yalamanchili

    2013-01-01

    Full Text Available Gingival recession caused due to periodontal disease disturbs patients because of sensitivity and esthetics. Gingival prosthesis may be fixed or removable and can be made from silicones, acrylics, composite resins or ceramics according to what is best suited for the case. The gingival veneer is esthetically appealing and easy to maintain. This case report describes the use of gingival veneer as a treatment modality for recession.

  8. Gingival prosthesis: A treatment modality for recession

    OpenAIRE

    Pallavi Samatha Yalamanchili; Hemchand Surapaneni; Arunima Padmakumar Reshmarani

    2013-01-01

    Gingival recession caused due to periodontal disease disturbs patients because of sensitivity and esthetics. Gingival prosthesis may be fixed or removable and can be made from silicones, acrylics, composite resins or ceramics according to what is best suited for the case. The gingival veneer is esthetically appealing and easy to maintain. This case report describes the use of gingival veneer as a treatment modality for recession.

  9. A Method to Analyze Dynamics Properties of Transfemoral Prosthesis

    Directory of Open Access Journals (Sweden)

    Van Tuan Le

    2016-01-01

    Full Text Available Abstract.The methodto compute gait cycle forces and moments acting on the hip and knee joints of a lower limb with a trans-femoral prosthesis were investigated. A 3D model of the lower limb with prosthesis was created using CAD software and based on MRI data and real size dimension. The transfemoral prosthesis was modelled as a coupled of links with two revolution joints at hip and knee joint. This coupled link was connected to a bar with translation joint to description the distance walked of people in gait cycle. All parts of the prosthesis were measured and a full-size 3D model was created.The kinematics parameters of a lower limb with a prosthesis were determined from motion-captured system data. The reaction force was measured with a force sensor in the footplate. The 3D model of the prosthesis was exported to MatlabSimmechanics. The input data which are kinematic parameters were applied to calculate the forces and moments acting on the joints. The results of this study present a method to analyse the dynamic properties of transfemoral prosthesis including speed of the gait. It could be used to calculate the load transferred from the socket to the residual limb. They could also be used to design the structure of a prosthesis and optimize the dynamic characteristics of such a prosthesis.

  10. Development of Receiver Stimulator for Auditory Prosthesis

    Directory of Open Access Journals (Sweden)

    K. Raja Kumar

    2010-05-01

    Full Text Available The Auditory Prosthesis (AP is an electronic device that can provide hearing sensations to people who are profoundly deaf by stimulating the auditory nerve via an array of electrodes with an electric current allowing them to understand the speech. The AP system consists of two hardware functional units such as Body Worn Speech Processor (BWSP and Receiver Stimulator. The prototype model of Receiver Stimulator for Auditory Prosthesis (RSAP consists of Speech Data Decoder, DAC, ADC, constant current generator, electrode selection logic, switch matrix and simulated electrode resistance array. The laboratory model of speech processor is designed to implement the Continuous Interleaved Sampling (CIS speech processing algorithm which generates the information required for electrode stimulation based on the speech / audio data. Speech Data Decoder receives the encoded speech data via an inductive RF transcutaneous link from speech processor. Twelve channels of auditory Prosthesis with selectable eight electrodes for stimulation of simulated electrode resistance array are used for testing. The RSAP is validated by using the test data generated by the laboratory prototype of speech processor. The experimental results are obtained from specific speech/sound tests using a high-speed data acquisition system and found satisfactory.

  11. Effects of Low-Level Laser Therapy and Eccentric Exercises in the Treatment of Patellar Tendinopathy

    Directory of Open Access Journals (Sweden)

    Xiao-Guang Liu

    2014-01-01

    Full Text Available The study aims to investigate if low-level laser therapy (LLLT combined with eccentric exercises could more effectively treat patellar tendinopathy than LLLT alone and eccentric exercises alone. Twenty-one patients with patellar tendinopathy were randomized to three groups: laser alone, exercise alone, or laser plus exercise, with seven in each group. Laser irradiations were administered at the inferior pole of the patella and the two acupoints of Extra 36 (Xiyan with the intensity of 1592 mW/cm2. Eccentric training program consisted of three sets of 15 repetitions of unilateral squat on level ground. All patients received six treatments per week for four weeks. Knee pain and function and quadriceps muscle strength and endurance were evaluated at baseline and the end of treatment. After the 4-week intervention, all groups showed significant improvements in all the outcomes (P<0.01. The laser + exercise group had significantly greater improvements in all the outcomes than the other two groups (P<0.05, except nonsignificant difference in pain relief between the laser + exercise group and the laser group. In conclusion, LLLT combined with eccentric exercises is superior to LLLT alone and eccentric exercises alone to reduce pain and improve function in patients with patellar tendinopathy.

  12. Rehabilitation protocol for patellar tendinopathy applied among 16- to 19-year old volleyball players.

    Science.gov (United States)

    Biernat, Ryszard; Trzaskoma, Zbigniew; Trzaskoma, Lukasz; Czaprowski, Dariusz

    2014-01-01

    The aim of the study was to investigate the efficacy of rehabilitation protocol applied during competitive period for the treatment of patellar tendinopathy. A total of 28 male volleyball players were divided into two groups. Fifteen from experimental group (E) and 13 from control group (C) fulfilled the same tests 3 times: before the training program started (first measurement), after 12 weeks (second measurement) and after 24 weeks (third measurement). The above-mentioned protocol included the following: USG imagining with color Doppler function, clinical testing, pain intensity evaluation with VISA-P questionnaire, leg muscle strength and power and jumping ability measurements. The key element of the rehabilitation program was eccentric squat on decline board with additional unstable surface. The essential factor of the protocol was a set of preventive functional exercises, with focus on eccentric exercises of hamstrings. Patellar tendinopathy was observed in 18% of the tested young volleyball players. Implementation of the presented rehabilitation protocol with eccentric squat on decline board applied during sports season lowered the pain level of the young volleyball players. Presented rehabilitation protocol applied without interrupting the competitive period among young volleyball players together with functional exercises could be an effective method for the treatment of patellar tendinopathy.

  13. Description of patellar movement by 3D parameters obtained from dynamic CT acquisition

    Science.gov (United States)

    de Sá Rebelo, Marina; Moreno, Ramon Alfredo; Gobbi, Riccardo Gomes; Camanho, Gilberto Luis; de Ávila, Luiz Francisco Rodrigues; Demange, Marco Kawamura; Pecora, Jose Ricardo; Gutierrez, Marco Antonio

    2014-03-01

    The patellofemoral joint is critical in the biomechanics of the knee. The patellofemoral instability is one condition that generates pain, functional impairment and often requires surgery as part of orthopedic treatment. The analysis of the patellofemoral dynamics has been performed by several medical image modalities. The clinical parameters assessed are mainly based on 2D measurements, such as the patellar tilt angle and the lateral shift among others. Besides, the acquisition protocols are mostly performed with the leg laid static at fixed angles. The use of helical multi slice CT scanner can allow the capture and display of the joint's movement performed actively by the patient. However, the orthopedic applications of this scanner have not yet been standardized or widespread. In this work we present a method to evaluate the biomechanics of the patellofemoral joint during active contraction using multi slice CT images. This approach can greatly improve the analysis of patellar instability by displaying the physiology during muscle contraction. The movement was evaluated by computing its 3D displacements and rotations from different knee angles. The first processing step registered the images in both angles based on the femuŕs position. The transformation matrix of the patella from the images was then calculated, which provided the rotations and translations performed by the patella from its position in the first image to its position in the second image. Analysis of these parameters for all frames provided real 3D information about the patellar displacement.

  14. Knee function after anterior cruciate ligament reconstruction with patellar or hamstring tendon: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    SHI Dong-liang; YAO Zhen-jun

    2011-01-01

    Background There is currently no consensus regarding the best graft type for anterior cruciate ligament reconstruction.Therefore,the aim of this study was to investigate the effects of patellar and hamstring tendon grafts on long-term knee function after anterior cruciate ligament reconstruction.Methods This meta-analysis was conducted according to the methodological guidelines outlined by the Cochrane Collaboration.An electronic search of the literature was performed and all trials published between January 1966 and August 2011 comparing knee function after anterior cruciate ligament reconstruction using patellar tendon grafts with knee function after reconstruction with hamstring tendon grafts were pooled.Six studies were included in the final meta-analysis.Results Anterior cruciate ligament reconstruction using hamstring tendon grafts resulted in greater pain upon kneeling than reconstruction using pateliar tendon grafts (P=0.001).However,both grafts resulted in similar levels of anterior tibial translation,and similar results regarding isokinetic extension/flexion tests,Lysholm scores,and the stair-hop test (P >0.05).Conclusion Anterior cruciate ligament reconstruction using patellar or hamstring tendon grafts results in similar long-term knee function.

  15. Effects of In-Season Inertial Resistance Training With Eccentric Overload in a Sports Population at Risk for Patellar Tendinopathy.

    Science.gov (United States)

    Gual, Gabriel; Fort-Vanmeerhaeghe, Azahara; Romero-Rodríguez, Daniel; Tesch, Per A

    2016-07-01

    Gual, G, Fort-Vanmeerhaeghe, A, Romero-Rodríguez, D, and Tesch, PA. Effects of in-season inertial resistance training with eccentric overload in a sports population at risk for patellar tendinopathy. J Strength Cond Res 30(7): 1834-1842, 2016-Volleyball and basketball players can be considered as a population at risk for patellar tendinopathy. Given the paradox that eccentric training elicits therapeutic benefits yet might provoke such injury, we investigated the influence of a weekly bout of inertial squat resistance exercise offering eccentric overload on lower limb muscle power and patellar tendon complaints. Players of 8 (4 basketball and 4 volleyball) teams (38 women and 43 men) were randomly assigned to either the intervention (IG) or control (CG) group. Although IG and CG maintained scheduled in-season training routines over 24 weeks, IG, in addition, performed 1 weekly session of eccentric overload by 4 sets of 8 repetitions of the squat using flywheel inertial resistance. Victorian Institute of Sports Assessment patellar tendinopathy questionnaire (VISA-p), vertical countermovement jump, and squat power, both concentric (Squat-Con) and eccentric (Squat-Ecc), tests were performed before (T1), during (T2), and after (T3) the 24 weeks of intervention. Neither group suffered from patellar tendinopathy during the study period. VISA-p displayed no differences across groups at any measurement period. Countermovement jump scores significantly (p ≤ 0.05) differed between groups in favor of the IG. Both Squat-Con and Squat-Ecc mean scores from the IG were significantly (p training bout to a regular basketball and volleyball exercise routine enhances lower limb muscle power without triggering patellar tendon complaints. Future studies, using the current exercise paradigm, aim to explore its efficacy to prevent or combat patellar tendinopathy in sports calling for frequent explosive jumps.

  16. Modular Tumor Resection Prosthesis in Osteosarcoma Treatment

    Directory of Open Access Journals (Sweden)

    Alper Cirakli

    2016-07-01

    Full Text Available Aim: The aim of the study is to evaluate the cases who underwent tumor resection prosthesis due to osteosarcoma. Material and Method: 14 cases who underwent tumor resection prosthesis due to osteosarcoma in our clinic between 2000 and 2012 and who had sufficient follow-ups were evaluated. The cases were examined in terms of gender, age, direction, tumor location, follow-up time, success of the treatment, complication, recurrence, and survival. The data obtained were transferred to the SPSS 15.0 program and analyzed. Normality distributions of the data were analyzed with the Shapiro-Wilk test. Results: 8 of the 14 cases were male, 6 were female, and the average age of the cases was 21.9±7.02. Osteosarcoma was in the distal femur in 9 (64.3% of the patients, in the proximal tibia in 5 (35.7% of the patients, in the right lower extremity in 5 of the patients, and in the left lower extremity in 9 of the patients. Average follow-up time was 33 months (3-144 months range. Average MSTS score was found as 81.9 (53-96 range, perfect results were taken in 11 (78.6% patients while insufficient results were taken in 3 (21.4% patients. As for complications, aseptic softening was observed in 3 cases, peroneal nerve paralysis was observed in 2 cases, skin necrosis was observed in 2 cases, periprostatic fracture was observed in 2 cases, prosthesis infection was observed in 1 case, and local recurrence was observed in 1 case. Except for the two cases with peroneal nerve paralysis, cases with complications recovered without any problems. The patient who developed local recurrence was lost due to lung metastasis. Discussion: Treatment of osteosarcoma through tumor resection prosthesis raises question marks due to possible complications that can affect the survival of the prosthesis in the long term. However, this treatment method is favorable in terms of stability, early load efficiency, and causing less anxiety than osteosynthesis; it is also psychologically

  17. 镍钛-聚髌器配合功能锻炼促进髌骨骨折功能恢复%Functional recovery of patellar fracture following applying of nickel titanium convergencing patella plus functional training

    Institute of Scientific and Technical Information of China (English)

    徐泽孔; 王树德; 李明

    2002-01-01

    @@ Background: Patellar fracture is a common kind of fracture in clinic.Preservation of patella,early functional exercise, effectively fixation and anatomical reduction were necessary for rehabilitation of knee movement.Nickel titanium patellar convergence (NT PC) make early functional exercise and favorable prognosis become available . Objective:To discuss impact of NT PC on rehabilitation following patellar fracture.

  18. The effect of patellar taping on EMG activity of vasti muscles during squatting in individuals with patellofemoral pain syndrome.

    Science.gov (United States)

    Mostamand, Javid; Bader, Dan L; Hudson, Zöe

    2011-01-01

    Although patellar taping has been shown to reduce pain in participants with patellofemoral pain syndrome, the mechanisms of pain reduction have not completely been established following its application. The purpose of this study was to evaluate EMG activity of vastus medialis and vastus lateralis following the application of patellar taping during a functional single leg squat. Both vastus medialis obliquus-vastus lateralis onset and vastus medialis obliquus/vastus lateralis amplitude of 18 participants with patellofemoral pain syndrome and 18 healthy participants as controls were measured using an EMG unit. This procedure was performed on the affected knee of participants with patellofemoral pain syndrome, before, during, and after patellar taping during unilateral squatting. The same procedure was also performed on the unaffected knees of both groups. The mean values of vastus medialis obliquus-vastus lateralis onset prior to taping (2.54 ms, s = 4.35) were decreased significantly following an immediate application of tape (-3.22 ms, s = 3.45) and after a prolonged period of taping (-6.00 ms, s = 3.40 s) (P patellofemoral pain syndrome prior to taping (P patellofemoral pain syndrome and controls during different conditions of taping (P > 0.05). Decreased values of vastus medialis obliquus-vastus lateralis onset may contribute to patellar realignment and explain the mechanism of pain reduction following patellar taping in participants with patellofemoral pain syndrome.

  19. Surgical versus non-surgical management for primary patellar dislocations: an up-to-date meta-analysis.

    Science.gov (United States)

    Zheng, Xiaozuo; Kang, Kai; Li, Tong; Lu, Bo; Dong, Jiangtao; Gao, Shijun

    2014-12-01

    The aim of this up-to-date meta-analysis was to compare the effects of surgical versus non-surgical treatment of patients following primary patellar dislocation and to provide the best evidence currently available. A comprehensive literature search was conducted using multiple databases, including Medline, Embase, and Cochrane Registry of Clinical Trials. All databases were searched from the earliest records to May 2013. Eligible studies were selected, and data were extracted by two independent investigators. The primary outcome variable was the frequency of recurrent patellar dislocation. The other outcomes included knee function scores, patient-rated outcomes, and radiographic examination. If appropriate, meta-analysis of these variables was performed. Nine independent trials were found to match the inclusion criteria. The pooled results demonstrated that the incidence of recurrent patellar dislocation and Hughston visual analog scale was significantly lower in the surgical treatment group than that in the non-surgical treatment group (P 0.05). This up-to-date meta-analysis indicates that surgical treatment was associated with a lower risk of recurrent patellar dislocation, but a lower Hughston VAS than non-surgical treatment for primary patellar dislocation. More large high-quality trials and further studies are needed to overcome the limitations of small sample sizes, and varieties of different surgical procedures or non-surgical management strategies adopted in the included trials.

  20. Comparison of reliability of five patellar position indices at various stifle joint angles in pelvic limbs obtained from cadavers of red foxes (Vulpes vulpes)

    DEFF Research Database (Denmark)

    Miles, James E; Nielsen, Dorte H; Jensen, Bente Rona

    2012-01-01

    To compare 5 patellar position indices at various stifle joint angles in cadavers of red foxes, determine measurement reliability, and assess the suitability of these indices for clinical use.......To compare 5 patellar position indices at various stifle joint angles in cadavers of red foxes, determine measurement reliability, and assess the suitability of these indices for clinical use....

  1. 旋转活动平台假体在老年全膝关节置换术中的应用研究%Study on the Rotating-platform Prosthesis in Elderly Total Knee Replacement

    Institute of Scientific and Technical Information of China (English)

    蔡炜; 唐旭东; 敬文波

    2014-01-01

    Objective To discuss the recent clinical efficacy of rotating-platform prosthesis and fixed-bearing prosthesis in elderly total knee replacement.Methods 60 patients were divided randomly into observation group(30 cases) and control group (30 cases). The observation group was treated with rotating-platform prosthesis, the control group was treated with fixed-bearing prosthesis, then clinical efficacy was compared.Results All patients' postoperative incision wereIhealing, and without serious complications.After 1 year, scores of knee, function, pain, patellar in two groups were significantly improved(P0.05 ); The angle of knee joint straight and flexion in two groups were significantly improved ( P0.05), the flexion angle in the observation group was bet-ter than the control group(P0.05)。术后1年,两组患者膝关节伸直角度及屈曲角度较同组治疗前均显著改善,差异均有统计学意义(P0.05),但是观察组患者屈曲角度优于对照组,差异有统计学意义(P<0.05)。结论老年膝骨性关节炎全膝关节置换术应用旋转活动平台假体或固定平台型假体近期临床疗效相似,但旋转活动平台假体能够更好地改善关节屈曲角度,更符合膝关节原本的生理学运动特征。

  2. Design and wear testing of a temporomandibular joint prosthesis articulation

    NARCIS (Netherlands)

    van Loon, JP; Verkerke, GJ; de Vries, MP; de Bont, LGM

    2000-01-01

    As part of the development of a total temporomandibular joint prosthesis, a prosthesis articulation was designed. The articulation consists of a spherical head (ball) of the mandibular part, rotating against an enveloping ultra-high-molecular-weight polyethylene (UHMWPE) disc with a flat cranial sid

  3. Linking of total elbow prosthesis during surgery; a biomechanical analysis

    NARCIS (Netherlands)

    Vos, M.J. de; Wagener, M.L.; Hendriks, J.C.M.; Eygendaal, D.; Verdonschot, N.J.J.

    2013-01-01

    BACKGROUND: Presently, 2 types of elbow prostheses are used: unlinked and linked. The Latitude total elbow prosthesis allows the surgeon to decide during the implantation whether the prosthesis is placed unlinked or linked, and whether the native radial head is retained, resected, or replaced. The p

  4. Novel knee joint mechanism of transfemoral prosthesis for stair ascent.

    Science.gov (United States)

    Inoue, Koh; Wada, Takahiro; Harada, Ryuchi; Tachiwana, Shinichi

    2013-06-01

    The stability of a transfemoral prosthesis when walking on flat ground has been established by recent advances in knee joint mechanisms and their control methods. It is, however, difficult for users of a transfemoral prosthesis to ascend stairs. This difficulty is mainly due to insufficient generation of extension moment around the knee joint of the prosthesis to lift the body to the next step on the staircase and prevent any unexpected flexion of the knee joint in the stance phase. Only a prosthesis with an actuator has facilitated stair ascent using a step-over-step gait (1 foot is placed per step). However, its use has issues associated with the durability, cost, maintenance, and usage environment. Therefore, the purpose of this research is to develop a novel knee joint mechanism for a prosthesis that generates an extension moment around the knee joint in the stance phase during stair ascent, without the use of any actuators. The proposed mechanism is based on the knowledge that the ground reaction force increases during the stance phase when the knee flexion occurs. Stair ascent experiments with the prosthesis showed that the proposed prosthesis can realize stair ascent without any undesirable knee flexion. In addition, the prosthesis is able to generate a positive knee joint moment power in the stance phase even without any power source.

  5. 21 CFR 878.3750 - External prosthesis adhesive.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External prosthesis adhesive. 878.3750 Section 878.3750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... adhesive. (a) Identification. An external prosthesis adhesive is a silicone-type adhesive intended to...

  6. A multidisciplinary approach including the use of platelet-rich plasma to treat an elite athlete with patellar tendinopathy – a case report

    Science.gov (United States)

    Rowan, Tracy L.; Drouin, Jillian L.

    2013-01-01

    Objective: Patellar tendinopathy affects a substantial proportion of athletes involved in jumping or kicking activities. Platelet rich plasma (PRP) injections may be a promising treatment used in conjunction with common traditional therapies. Clinical Features: Patellar tendinopathy is often the result of repetitive or excessive overload on the patellar tendon. Activity modification, cryotherapy, eccentric exercises, shockwave therapy, and PRP have been indicated as treatment options during various stages of this condition. Intervention and Outcome: A 23 year old female, elite track and field athlete was managed for patellar tendinopathy with a combination of traditional therapeutic interventions as well as a PRP injection. This athlete returned to pre-injury level of competition six months post-injection. Conclusion: Emerging literature on PRP appears to be promising for patellar tendinopathy, however, it remains unclear which patients may benefit most and whether the stage of the disorder has an impact on the clinical outcome. PMID:24302777

  7. Amputation and prosthesis implantation shape body and peripersonal space representations.

    Science.gov (United States)

    Canzoneri, Elisa; Marzolla, Marilena; Amoresano, Amedeo; Verni, Gennaro; Serino, Andrea

    2013-10-03

    Little is known about whether and how multimodal representations of the body (BRs) and of the space around the body (Peripersonal Space, PPS) adapt to amputation and prosthesis implantation. In order to investigate this issue, we tested BR in a group of upper limb amputees by means of a tactile distance perception task and PPS by means of an audio-tactile interaction task. Subjects performed the tasks with stimulation either on the healthy limb or the stump of the amputated limb, while wearing or not wearing their prosthesis. When patients performed the tasks on the amputated limb, without the prosthesis, the perception of arm length shrank, with a concurrent shift of PPS boundaries towards the stump. Conversely, wearing the prosthesis increased the perceived length of the stump and extended the PPS boundaries so as to include the prosthetic hand, such that the prosthesis partially replaced the missing limb.

  8. Penile Corporeal Reconstruction during Difficult Placement of a Penile Prosthesis

    Directory of Open Access Journals (Sweden)

    Viet Q. Tran

    2008-01-01

    Full Text Available For some patients with impotence and concomitant severe tunical/corporeal tissue fibrosis, insertion of a penile prosthesis is the only option to restore erectile function. Closing the tunica over an inflatable penile prosthesis in these patients can be challenging. We review our previous study which included 15 patients with severe corporeal or tunical fibrosis who underwent corporeal reconstruction with autologous rectus fascia to allow placement of an inflatable penile prosthesis. At a mean follow-up of 18 months (range 12 to 64, all patients had a prosthesis that was functioning properly without evidence of separation, herniation, or erosion of the graft. Sexual activity resumed at a mean time of 9 weeks (range 8 to 10. There were no adverse events related to the graft or its harvest. Use of rectus fascia graft for coverage of a tunical defect during a difficult penile prosthesis placement is surgically feasible, safe, and efficacious.

  9. Minimal intervention dentistry: part 5. Atraumatic restorative treatment (ART)--a minimum intervention and minimally invasive approach for the management of dental caries.

    Science.gov (United States)

    Holmgren, C J; Roux, D; Doméjean, S

    2013-01-01

    While originally developed in response to a need to provide effective restorative and preventive treatment in underserved communities where running water and electricity might not always be available, over the past two decades, the atraumatic restorative treatment (ART) approach has become a worldwide phenomenon; used not only in some of the poorest developing countries but also in some of the most wealthy. The ART approach involves the removal of infected dentine with hand-instruments followed by the placement of a restoration where the adjacent pits and fissures are sealed simultaneously using high viscosity glass-ionomer inserted under finger pressure. Reliable results can only be obtained if the treatment protocol, as described in this article, is closely followed. ART should be considered as a therapeutic option especially in children, anxious patients and those with special needs.

  10. EFFECT OF DAILY FLUORIDE EXPOSURE ON FLUORIDE RELEASE BY HIGH STRENGTH GLASS IONOMER RESTORATIVE MATERIAL USED WITH ATRAUMATIC RESTORATIVE TECHNIQUE: AN IN VITRO STUDY

    Directory of Open Access Journals (Sweden)

    Hegde Mithra N.

    2012-04-01

    Full Text Available An in-vitro study was done to evaluate the effect of fluoride exposure, fluoride release and recharging capability by High strength Glass Ionomer restorative material used with Atraumatic restorative technique. 20 specimens were divided into four groups of five specimens each. The results showed that High strength Glass ionomer cements (Fuji IX release fluoride, the greatest release takes place between 24- 48 hours.High viscous High Strength Glass ionomer cements have the ability to recharge by external sources like fluoridated dentifrices and varnishes and thus acts as a fluoride reservoir. The recommendation that individuals with a high caries rate and glass ionomer restoration should have fluoride treatment with dentifrice and varnish seems appropriate.

  11. [Aortoenteric fistula secondary to aortobifemoral prosthesis infection].

    Science.gov (United States)

    Gabriel Botella, F; Labiós Gómez, M; Ibáñez Gadea, L; Fácila Rubio, L; Carbonell Cantí, C

    2002-05-01

    We present the case of a 76 year-old man, intervened of an obstruction bilateral iliac by means of placement of a prosthesis aortobifemoral that presented pain in the grave left iliac and fever in needles of 39 degrees C to the five years of the intervention. In the physical exploration it highlighted a painful abdomen in the grave left iliac with signs of peritoneal irritation. In the laboratory tests a leukocytosis was detected with neutrophilia and negative culture. The computed thomography (CT) show the presence of gas bubbles around the prosthesis, as well as a liquid collection with areas necrotics in their interior that affected to the psoas and iliac muscles. In the same exploration the aspirative puncture with drainage of the absces demonstrated in the cultivations carried out in aerobic means the presence of Enterococcus faecalis and Enterobacter cloacae. When presenting a high gastrointestinal hemorrhage abruptly, he was practiced and gastroduodenal endoscope in which a aortoduodenal fistula was evidenced with having bled active. When a bypass extra-anatomic, the sick person will practice it died when presenting a shock abrupt hipovolemic that he didn't respond to the pertinent treatment. We analyze the approaches current diagnoses of infection of the vascular prosthesis and their more serious complication, the aortoenteric fistula (AEF) that either appears in the 0.3-5.9% of the patients who undergo prosthetic reconstruction of the abdominal aorta, for occlusive or aneurismal disease. We highlight the importance of carrying out a precocious diagnosis of the infection of the portion retroperitoneal of the vascular graft that, often, it is manifested with subtle and not specific clinical signs, with the techniques at the moment available as: the CT, fine needle aspiration guided by her, and to diminish the rates of mortality, from the current of 43%, until the most optimistic estimated in 19%.

  12. The Nijdam voice prosthesis: A self-retaining valveless voice prosthesis for vocal rehabilitation after total laryngectomy

    NARCIS (Netherlands)

    Hoogen, F.J.A. van den; Nijdam, H.F.; Veenstra, A.; Manni, J.J.

    1996-01-01

    Voice prosthesis-assisted speech rehabilitation after total laryngectomy has proven to be successful in the majority of patients and exceeds the results of traditional oesophageal speech. Nevertheless 10 -30% failure rates are still reported. in part this is due to prosthesis-related problems, in pa

  13. The Nijdam voice prosthesis : A self-retaining valveless voice prosthesis for vocal rehabilitation after total laryngectomy

    NARCIS (Netherlands)

    van den Hoogen, Frank J. A.; Nijdam, Hoite F.; Veenstra, Aalze; Manni, JJ

    1996-01-01

    Voice prosthesis-assisted speech rehabilitation after total laryngectomy has proven to be successful in the majority of patients and exceeds the results of traditional oesophageal speech. Nevertheless 10-30% failure rates are still reported. In part this is due to prosthesis-related problems, in par

  14. Reconstruction and restoration of neglected ruptured patellar tendon using semitendinosus and gracilis tendons with preserved distal insertions: two case reports.

    Science.gov (United States)

    Chen, Bin; Li, Runguang; Zhang, Sheng

    2012-08-01

    Neglected rupture of the patellar tendon is rare but becomes more difficult to repair the longer it is left untreated. The most common rupture sites are the inferior pole of the patella and distal insertion. Proximal retraction of the patella and extensor mechanism adhesions makes the treatment more difficult than acute tendon rupture. We report two patients with neglected patellar tendon rupture treated by reconstruction and restoration using semitendinosus-gracilis (STG) tendons with preserved distal insertions. Preserved distal insertion provided sufficient blood supply to accelerate healing, while combined fixation with tension-reducing wire, offered the initial stability of the closed-loop sutured tendon. Both patients reacquired near normal strength and stability of the patellar tendon and restoration of function after operation and rehabilitation.

  15. Successful conservative management of symptomatic bilateral dorsal patellar defects presenting with cartilage involvement and bone marrow edema: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Sonneveld, Heleen [Meander Medical Center, Department of Orthopaedics, Amersfoort (Netherlands); Nix, Maarten [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands)

    2016-05-15

    The dorsal patellar defect is a relatively rare entity that involves the superolateral quadrant of the patella. It is usually considered to represent a delayed ossification process, although its exact origin remains unclear. Because of its usually innocuous nature and clinical course, invasive interventions are generally deemed unnecessary, although curretage has been successfully performed on symptomatic cases. This case report presents a rather unusual case of symptomatic bilateral dorsal patellar defects with cartilage involvement and widespread surrounding bone marrow edema as demonstrated by magnetic resonance imaging (MRI). Both cartilage involvement and bone marrow edema should be considered part of the spectrum of associated MRI findings that can be encountered in this entity. Furthermore, the presented case shows that symptomatic dorsal patellar defects can be treated conservatively with success and that (decrease of) pain symptoms are likely related to (decrease of) bone marrow edema. (orig.)

  16. 21 CFR 878.3540 - Silicone gel-filled breast prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Silicone gel-filled breast prosthesis. 878.3540...-filled breast prosthesis. (a) Identification—(1) Single-lumen silicone gel-filled breast prosthesis. A single-lumen silicone gel-filled breast prosthesis is a silicone rubber shell made of...

  17. The reliability and validity of radiological assessment for patellar instability. A systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Toby O. [University of East Anglia, Faculty of Health, Norwich (United Kingdom); Davies, Leigh [Norfolk and Norwich University Hospital, Norwich (United Kingdom); Toms, Andoni P.; Donell, Simon T. [University of East Anglia, Faculty of Health, Norwich (United Kingdom); Norfolk and Norwich University Hospital, Norwich (United Kingdom); Hing, Caroline B. [St George' s Hospital, London (United Kingdom)

    2011-04-15

    To determine the discriminative validity and reliability of the evidence base using meta-analysis. A review of published sources using the databases AMED, CINHAL, EMBASE, MEDLINE, Scopus and the Cochrane Library, and for unpublished material was conducted. All studies assessing the reliability, validity, sensitivity or specificity of magnetic resonance imaging (MRI), computed tomography (CT) or ultrasound (US) of the patellofemoral joint of patients following patellar dislocation, subluxation or instability, were included. A meta-analysis was performed to assess the difference in radiological measurements between healthy controls and subjects with patellar instability in order to assess discrimination validity. A narrative assessment was used to evaluate the inter- and intra-observer reliability as well as the sensitivity and specificity of specific radiological measurements. A total of 27 studies were reviewed. The findings indicated that there was acceptable inter-observer and intra-observer reliability and validity for different methods of assessing patellar height and the sulcus angle with X-ray, MRI and CT methods, and the tibial tubercle-trochlear groove (TT-TG) assessed using CT. There was poor reliability or validity for the assessment of severity of trochlear dysplasia and the sulcus angle using US. There is insufficient evidence to determine the reliability, validity, sensitivity or specificity of tests such as the congruence angle, lateral patellar displacement, lateral patellar tilt, trochlear depth, boss height, the crossing sign or Wiberg patellar classification. A critical appraisal of the literature identified a number of recurrent methodological limitations. Further study is recommended to evaluate the reliability and validity of these radiological outcomes using well-designed radiological trials. (orig.)

  18. Tehran Silicon Partial Foot Prosthesis New Method of Making Silicon Partial Foot Prosthesis

    Directory of Open Access Journals (Sweden)

    Alireza Khaghani

    2016-12-01

    Full Text Available Partial foot amputation includes many surfaces from severing toe to Chopart amputation, and each surface has its own characteristic and creates a particular level of disability, which would require prosthesis to compensate the missing functionality and aesthetics. On the other hand, with regard to materials and style of structure according to the facilities of clinics and the experience of prosthetists a vast scope of prostheses are made for patients, and practically the process of prescription and Production of a prosthesis is an interaction between the patient and the prosthetist ,based on the needs and expectations of the patient and the ability of prosthetist to reach a point of equilibrium which often requires employing the maximum ability of prosthetist in the construction technique. The resulting diversity is the outcome of successful experiences of various prosthetists over the years, and it is natural that when considering the extent of various materials used in the making of prostheses and also the methods of their synthesis and linkage, and also better understanding of the developed biomechanical disorder, we can achieve new designs that would bring better performance and comfort to patients, as well as more aestheticism in appearance. If the amputation is proximal to the metatarsal heads, the individual will lose tolerance for weight bearing of fore foot and will face difficulty in the terminal stance stage for doing the push-off. For Trans-metatarsal and Lisfranc areas which are considered mid foot area, high profile prosthesis have not been well acceptance by patients because a rigid prosthesis continues till near tibia tuberose and more important than that, creates restriction of movement in ankle and subtalar joints, despite having biomechanical advantages in restoring the lever arm for doing the push off .Perimalleolar prostheses which enjoy great variety with regard to design and material used in their structure, mostly are not

  19. Influence of acetaminophen and ibuprofen on in vivo patellar tendon adaptations to knee extensor resistance exercise in older adults

    DEFF Research Database (Denmark)

    Carroll, C C; Dickinson, J M; LeMoine, J K

    2011-01-01

    training. Thirty-six individuals were randomly assigned to a placebo (67 ± 2 yr old), acetaminophen (64 ± 1 yr old; 4,000 mg/day), or ibuprofen (64 ± 1 yr old; 1,200 mg/day) group in a double-blind manner and completed 12 wk of knee extensor resistance training. Before and after training in vivo patellar...... adults induces modest changes in the mechanical properties of the patellar tendon. Over-the-counter doses of acetaminophen, but not ibuprofen, have a strong influence on tendon mechanical and material property adaptations to resistance training. These findings add to a growing body of evidence...

  20. Simultaneous rupture of the quadriceps tendon and contralateral patellar tendon in a patient with chronic renal failure.

    Science.gov (United States)

    Muratli, Hasan Hilmi; Celebi, Levent; Hapa, Onur; Biçimoğlu, Ali

    2005-01-01

    Simultaneous quadriceps and patellar tendon rupture is rare. Mechanical factors and coexisting systemic and local factors are taken into consideration in the pathogenesis of these ruptures. In patients with some chronic systemic diseases, simultaneous rupture can occur spontaneously or with minor traumas. We present a case of simultaneous quadriceps and patellar tendon rupture in a 21-year-old man with chronic renal failure in this report. He was treated surgically by osseotendinous repair with suture anchors and supplemental cerclage wire fixation on both sides. He regained his normal knee joint functions 18 months after the operation.

  1. Horizontal intra-articular patellar dislocation resulting in quadriceps avulsion and medial patellofemoral ligament tear: a case report.

    Science.gov (United States)

    Kramer, Dennis E; Simoni, Michael K

    2013-07-01

    Intra-articular patellar dislocations are rare. We present a 13-year-old boy who sustained a complete horizontal intra-articular patellar dislocation following blunt trauma to the flexed knee. Closed reduction was unsuccessful and open reduction indicated a repairable quadriceps avulsion and medial patellofemoral ligament tear. He is the youngest patient to sustain a quadriceps rupture and the only patient to sustain a medial patellofemoral ligament tear to date. His flexed knee and the horizontally positioned patella (seen on lateral radiograph) were indicative of a complete rotational injury with extensor mechanism involvement. Open reduction allowed for the repair of both injuries and a favorable outcome.

  2. THE EFFECT OF PLASMA PREPARATION RICH IN GROWTH FACTORS ON PATELLAR STABILITY AFTER MEDIAL PATELLOFEMORAL LIGAMENT REEFING

    Directory of Open Access Journals (Sweden)

    Andonovski Alan

    2016-07-01

    Full Text Available Introduction: Although more than 100 operative procedures have been described for the treatment of patellar instability, there is no single universally successful procedure. For the most patients with lateral patellar instability medial patellofemoral ligament (MPFL reefing is recommended. When we perform MPFL reefing we are not aware of the quality and strength of the MPFL tissue. In the presence of recurrent patellar instability,the quality and strength of MPFL tissue is often compromised and it disturbs patellar stability after MPFL reefing. Biomedicine development,recognizing the ligament healing process show us that autologous blood products, particularly PRP can enhance healing in soft tissue injuries. Purpose: The purpose of this study was to determine the potential effect of Plasma preparation rich in growth factorson patellar stability after MPFL reefing. Material and methods: Plasma preparationrich in growth factors was produced from a unit of autologous whole blood using Arthrex ACP double syringe system.Platelet gel was prepared by adding bovine thrombin and 10% solution of calcium chloride.The platelet gel was applied locally into the place where suturing of the MPFL was performed. In this prospective, randomized and double blindstudy12 patients were included:6 patients in the PG group who received platelet gel and 6 patients in the control group who were not treated with platelet gel. Patellar stability was evaluated before surgery and 3 months after surgery with Axial stress radiographs. Results: The calculated 3 month improvement was 12.67 ± 2.51 in the control group and 17.33 ± 1.52 in the PG group, (p=0.064.Although there was greater improvement in patellar stability in PG group comparing to the control group, the difference was not statistically significant (p>0.05.The main reason for this was probably the small number of patients included in the study. Conclusion: Results showed that growth factors from the plasma

  3. The modified bone-patellar tendon-bone allograft in single-bundle anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Kang, Huijun; Wang, Fei

    2011-06-01

    Bone-patellar tendon-bone graft has been an attractive option for single-bundle anterior cruciate ligament reconstruction in clinical practice. However, the graft-tunnel mismatch in the proximal part of the tibial tunnel and the ultimate strength after postoperative ligamentization process have been potential problems for the traditional 10-mm wide graft. We modified the traditional bone-patellar tendon-bone allograft to make it double-layer, as an ideal substitute graft for single-bundle anterior cruciate ligament reconstruction with better graft-tunnel match and higher initial graft strength.

  4. Multimodality correlations of patellar height measurement on X-ray, CT, and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Pearlene P.; Chalian, Majid; Carrino, John A.; Eng, John; Chhabra, Avneesh [Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States)

    2012-10-15

    To investigate whether the universally accepted range of normal patellar height ratios derived from radiography for the Insall-Salvati (IS) and Blackburne-Peel (BP) methods could be similarly applied to both CT and MRI. Institutional review board approval was obtained with waiver of informed consent for this HIPPA-compliant study. A total of 45 knees in 42 patients (15 men, 27 women; age range 11 to 75 years, mean age 39 {+-} 20 years) who underwent tri-modality (radiograph, CT, and MRI) examinations were selected. All patients had knee imaging obtained for a variety of reasons and measurements were performed by two independent readers who were blinded to each other's measurements or the respective measurements derived from each of the methods. Paired t test was used to compare the mean values among the modalities. Inter-observer and inter-method agreements were assessed using intra-class correlation coefficients. Statistically significant, but small quantitative differences are noted between tri-modality patellar height ratios. For comparable results, the small addition of 0.13 and 0.10 are needed for the Insall-Salvati measurements on MRI and CT respectively, compared with radiographs. For the Blackburne-Peel ratio, an additional adjustment of 0.09 is needed between radiographs and MRI, but not between radiographs and CT. These adjustments are independent of gender. The interobserver reproducibility was excellent (ICC {>=} 0.94) for both the Insall-Salvati and Blackburne-Peel methods for all modalities. The results indicate that cut-off values for patella alta and baja derived from radiographs should not be directly transposed to CT and MRI; however, the adjustments are relatively minor. These measurements show excellent reproducibility for all modalities currently used for patellar height measurements. (orig.)

  5. Heated lidocaine/tetracaine patch for treatment of patellar tendinopathy pain

    Directory of Open Access Journals (Sweden)

    Gammaitoni AR

    2013-07-01

    Full Text Available Arnold R Gammaitoni,1 Henry T Goitz,2 Stephanie Marsh,2 Thomas B Marriott,3 Bradley S Galer1 1Pain Group, Nuvo Research US, West Chester, PA, USA; 2Sports Medicine, Detroit Medical Center, Warren, MI, USA; 3Pain Group, Nuvo Research US, Salt Lake City, UT, USA Introduction: The pain of patellar tendinopathy (PT may be mediated by neuronal glutamate and sodium channels. Lidocaine and tetracaine block both of these channels. This study tested the self-heated lidocaine-tetracaine patch (HLT patch in patients with PT confirmed by physical examination to determine if the HLT patch might relieve pain and improve function. Methods: Thirteen patients with PT pain of ≥14 days' duration and baseline average pain scores ≥4 (on a 0–10 scale enrolled in and completed this prospective, single-center pilot study. Patients applied one HLT patch to the affected knee twice daily for 2–4 hours for a total of 14 days. Change in average pain intensity and interference (Victorian Institute of Sport Assessment [VISA] scores from baseline to day 14 were assessed. No statistical inference testing was performed. Results: Average pain scores declined from 5.5 ± 1.3 (mean ± standard deviation at baseline to 3.8 ± 2.5 on day 14. Similarly, VISA scores improved from 45.2 ± 14.4 at baseline to 54.3 ± 24.5 on day 14. A clinically important reduction in pain score (≥30% was demonstrated by 54% of patients. Conclusion: The results of this pilot study suggest that topical treatment that targets neuronal sodium and glutamate channels may be useful in the treatment of PT. Keywords: patellar tendinopathy, patellar tendinosis, heated lidocaine/tetracaine patch, topical analgesic patch, knee pain

  6. THE EFFECTS OF EXTRACORPOREAL SHOCKWAVE THERAPY (ESWT AND CRYOTHERAPY IN TREATING PATELLAR TENDINOPATHIES IN PROFESSIONAL ATHLETES

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    Dobreci Iulian

    2014-03-01

    Full Text Available Aim: this paper tries to optimize the existent classical treatments for patellar tendinopathies that are resistant to classical forms of therapy, in professional athletes. Hypotheses: this research wants to highlight the effectiveness of the ESWT and cryotherapy in treating patellar tendinopathies in professional athletes who previously underwent classical treatments that had no positive results. Material: the research was conducted at the Bacau Spinal Care Rehabilitation Clinic, where the systems BTL 6000 and Cryo 6 Zimmer were used. Method: the study comprised 38 male athletes, of which 12 volleyball players, 13 handball players, 5 badminton players, 5 tennis players, and 3 football players, who were subjected over the course of 3 months (previous to this experiment to steroidal and non-steroidal anti-inflammatory treatment, cortical injections and electrotherapy, without any results. The present treatment span over 3 weeks, with two sessions per week, during which ESWT and cryotherapy (-30°C were applied. The pain was assessed using the Visual Analogue Scale (VAS for Pain. Results and conclusions: at the end of the research, out of the total 38 subjects, 32 recorded very good results both during the study, and during the intermediary assessments, one month, two and three months after the treatment ended; 4 of them, at the 3 months assessment still felt a slight pain during training, while 2 of them did not respond favorably to the treatment, at the end of which they were send to the orthopedist for PRP infiltrations. After analyzing the results, one can say that the ESWT, combined with locally administered cryotherapy of -30°C, has very good results in treating the patellar tendinopathies that are resistant to other forms of therapy. Another positive aspect that can be said after this study is that the positive effects of the applied therapy have maintained also 3 months after its end.

  7. Photovoltaic retinal prosthesis with high pixel density

    Science.gov (United States)

    Mathieson, Keith; Loudin, James; Goetz, Georges; Huie, Philip; Wang, Lele; Kamins, Theodore I.; Galambos, Ludwig; Smith, Richard; Harris, James S.; Sher, Alexander; Palanker, Daniel

    2012-06-01

    Retinal degenerative diseases lead to blindness due to loss of the `image capturing' photoreceptors, while neurons in the `image-processing' inner retinal layers are relatively well preserved. Electronic retinal prostheses seek to restore sight by electrically stimulating the surviving neurons. Most implants are powered through inductive coils, requiring complex surgical methods to implant the coil-decoder-cable-array systems that deliver energy to stimulating electrodes via intraocular cables. We present a photovoltaic subretinal prosthesis, in which silicon photodiodes in each pixel receive power and data directly through pulsed near-infrared illumination and electrically stimulate neurons. Stimulation is produced in normal and degenerate rat retinas, with pulse durations of 0.5-4 ms, and threshold peak irradiances of 0.2-10 mW mm-2, two orders of magnitude below the ocular safety limit. Neural responses were elicited by illuminating a single 70 µm bipolar pixel, demonstrating the possibility of a fully integrated photovoltaic retinal prosthesis with high pixel density.

  8. Effect of prostaglandin E2 injection on the structural properties of the rat patellar tendon

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    Ferry Scott T

    2012-01-01

    Full Text Available Abstract Background Increased tendon production of the inflammatory mediator prostaglandin E2 (PGE2 has been suggested to be a potential etiologic agent in the development of tendinopathy. Repeated injection of PGE2 into tendon has been proposed as a potential animal model for studying treatments for tendinopathy. In contrast, nonsteroidal anti-inflammatory drugs (NSAIDs which inhibit PGE2 production and are commonly prescribed in treating tendinopathy have been shown to impair the healing of tendon after acute injury in animal models. The contradictory literature suggests the need to better define the functional effects of PGE2 on tendon. Our objective was to characterize the effects of PGE2 injection on the biomechanical and biochemical properties of tendon and the activity of the animals. Our hypothesis was that weekly PGE2 injection to the rat patellar tendon would lead to inferior biomechanical properties. Methods Forty rats were divided equally into four groups. Three groups were followed for 4 weeks with the following peritendinous injection procedures: No injection (control, 4 weekly injections of saline (saline, 4 weekly injections of 800 ng PGE2 (PGE2-4 wks. The fourth group received 4 weekly injections of 800 ng PGE2 initially and was followed for a total of 8 weeks. All animals were injected bilaterally. The main outcome measurements included: the structural and material properties of the patellar tendon under tensile loading to failure, tendon collagen content, and weekly animal activity scores. Results The ultimate load of PGE2-4 wks tendons at 4 weeks was significantly greater than control or saline group tendons. The stiffness and elastic modulus of the PGE2 injected tendons at 8 weeks was significantly greater than the control or saline tendons. No differences in animal activity, collagen content, or mean fibril diameter were observed between groups. Conclusions Four weekly peritendinous injections of PGE2 to the rat patellar

  9. Chondropathia patellae - preoperative and postoperative demonstration of the patellar structure in plain roentgenography

    Energy Technology Data Exchange (ETDEWEB)

    Schumacher, K.A.; Mutschler, W.; Bargon, G.

    1982-07-01

    The study is based on 86 patients surgically treated for chondromalacia patellae, who in a 2 year follow-up were controlled by defile-radiographs and clinical examination. While there was an improvement of all clinical symptoms examined, no significant change in the radiologic appearance of the patellar structure was observed as compared with the pre-operative status. This includes that neither significant changes indicating development of arthrosis nor aggravation of pre-existing arthrotic lesions could be found. However, it is commonly suggested from roentgenographic findings with type 3 lesions, that severe chondromalacia patellae may be a precursor of osteoarthrosis.

  10. Buttress plating for a rare case of comminuted medial condylar Hoffa fracture associated with patellar fracture

    Institute of Scientific and Technical Information of China (English)

    Ashwani Soni; Ramesh K Sen; Uttam Chand Saini; Dajjit Singh; Sushil Chaudhary

    2012-01-01

    Hoffa fracture is an uncommon injury.In the literature,lateral condylar Hoffa fracture is mentioned as a more common injury pattern than medial condylar Hoffa fracture.The mechanism of injury and method of treatment is not very well described in the literature.We are presenting a rare case of comminuted medial condylar Hoffa fracture with ipsitateral patellar fracture.The mechanism of injury has not been described in the literature.Lag screw fixation,which is the most acceptable method of treatment,is not possible due to comminution.We explain the possible mechanism of injury and fix the fracture with L-buttress plate.

  11. Influence of aging on the in vivo properties of human patellar tendon

    DEFF Research Database (Denmark)

    Carroll, CC; Dickinson, J M; Haus, J M

    2008-01-01

    .05), respectively, in men compared with women. After normalization of mechanical properties to a common force, no age differences were apparent; however, stress and strain were 26 and 22% higher, respectively, in women compared with men (P ...Tendons are important for optimal muscle force transfer to bone and play a key role in functional ability. Changes in tendon properties with aging could contribute to declines in physical function commonly associated with aging. We investigated the in vivo mechanical properties of the patellar......, with aging (P aging are more related to force output rather than an age effect. In contrast, the decrease in signal intensity indirectly suggests that the internal milieu...

  12. [Displacement of the tibial tuberosity in retropatellar cartilage damage and recurrent patellar dislocation].

    Science.gov (United States)

    Krause, R; Paar, O; Bernett, P; Mayr, B

    1989-02-01

    In our hospital in the years 1980 till 1986 37 displacements of the tuberositas tibiae were performed in chondropathia patellae and recurrent luxation of the patella. The follow-up examination took into consideration the radiological and clinical findings, the subjective complaints and the ability of going in for sports. These clinical experiences and pressure measurements in the femoro-patellar joint show the best results after the displacement of the tuberositas tibiae according to Blauth. Additionally we recommend an accurate indication for chondropathia patellae and recurrent luxation of the patella and accompanying surgical measures.

  13. [Chondropathia patellae--preoperative and postoperative demonstration of the patellar structure in plain roentgenography (author's transl)].

    Science.gov (United States)

    Schumacher, K A; Mutschler, W; Bargon, G

    1982-07-01

    The study is based on 86 patients surgically treated for chondromalacia patellae, who in a 2 year follow-up were controlled by défilé-radiographs and clinical examination. While there was an improvement of all clinical symptoms examined, no significant change in the radiologic appearance of the patellar structure was observed as compared with the pre-operative status. This includes that neither significant changes indicating development of arthrosis nor aggravation of pre-existing arthrotic lesions could be found. However, it is commonly suggested from roentgenographic findings with type 3 lesions, that severe chondromalacia patellae may be precursor of osteoarthrosis.

  14. Lesions in canine stifle joints due to trochleoplasties as treatment for medial patellar luxation

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    Johannes Hans van der Zee

    2015-03-01

    Full Text Available Lesions in canine stifle joints after previous trochleoplasty surgery were documented. Infour clinical cases arthrotomies were performed due to stifle pain after previous trochleardeepening procedures. A small area of hyaline cartilage remained in the groove of the stiflesin cases where previous wedge trochleoplasties had been performed. All of the stifles hadsignificant areas of eburnation on the axial aspect of the medial trochlear ridge. The stifle jointsof a dog that was euthanased due to severe irreversible osteo-arthritis were photographed.The dog had undergone previous surgery for patellar luxation and cranial cruciate ligamentruptures. The trochlear grooves in this dog had almost no visible articular cartilage left.

  15. PHYSICAL THERAPY INTERVENTION FOR MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION AFTER REPEATED LATERAL PATELLAR SUBLUXATION/DISLOCATION

    Science.gov (United States)

    Mooney, Brianne; Vitale, Ashley; Apergis, Demitra; Wirth, Stephen; Grossman, Mark G.

    2016-01-01

    ABSTRACT Background The incidence of patellar subluxation or dislocation has been documented up to 43/100,000 with females more prevalent then males. There are many contributing factors involving the hip, knee, and ankle that lead to patellar subluxation. A patellar position of lateral tilt with lateral glide may indicate weakness of the vastus medialis oblique (VMO) and adductors, increased tightness in the iliotibial band, and overpowering of the vastus lateralis. Patella alta can predispose an individual to lateral dislocation due to the patella placement outside of the femoral trochlear groove with a disadvantage of boney stability. Other factors that may cause the patella to laterally sublux or dislocate during a functional activity or sporting activity include a position of femoral external rotation, tibial internal rotation, and excessive contraction of the vastus lateralis. The medial patellofemoral ligament (MPFL) aids in the prevention of a lateral patellar subluxation or dislocation. In cases where there is recurrent subluxation/dislocation and Magnetic Resonance Imaging confirms a MPFL tear, a reconstruction may be the treatment of choice. Purpose The purpose of this case series is to describe the post-surgical physical therapy management of MPFL reconstructions, outcomes using the Modified Cincinnati Knee Outcome Measure (MCKOM) and to propose staged physical therapy interventions for this pathology in the form of a treatment progression. Methods Post-operative management data and outcomes were retrospectively collected using a detailed chart review methodology from seven subjects who underwent MPFL reconstruction. Findings The Modified Cincinnati Knee Outcome Measure (MCKOM) was analyzed for each participant in four sections that were most important to the return and maintenance of participation in sport. At follow-up the mean scores for the seven subjects in Section 3 (instability) was 19.3/20, Section 4 (overall activity level) was 17.3/20, Section

  16. Tratamento cirúrgico da tendinite distal da patela Surgical treatment of the distal patellar tendinitis

    Directory of Open Access Journals (Sweden)

    Marco Martins Amatuzzi

    2005-01-01

    Full Text Available A tendinite distal da patela é uma doença que acomete principalmente jovens esportistas e caracteriza-se por dor referida na extremidade distal da patela junto à inserção do ligamento patelar. O tratamento inicial preconizado é sempre conservador com fisioterapia. A grande maioria tem boa resposta a este tipo de conduta, mas em alguns raros casos os sintomas não regridem exigindo uma mudança de conduta. Para este grupo usamos o tratamento cirúrgico com técnica derivada de Trillat que se baseia na utilização de um enxerto de parte do tendão do músculo Grácil implantado dentro do ligamento patelar, inserido intra-ósseo na patela e fixado na tuberosidade anterior da tíbia. Foram operados seis pacientes, sendo que em dois casos a operação foi bilateral, totalizando oito joelhos. O seguimento mínimo foi de três anos, com avaliação final dentro do índice considerado como EXCELENTE, conforme a cotação ARPÉGE, para todos os joelhos.Distal patellar tendinitis is a young athlete's disease characterized by pain at the distal patellar pole, near the patellar ligament insertion. Early treatment recommended is generally conservative, with physical therapy. The great majority of patients present favorable responses to this approach, but, in some cases, the remission of symptoms does not occur, requiring a different approach. For this group, surgical treatment with a technique derived from that of Trillat was used, which is based on the use of a graft removed from a portion of gracillis muscle tendon into patellar ligament, intraosseously inserted in the patella and fixed at the tibial anterior tuberosity. Six patients were operated, bilaterally in two cases, totaling eight knees. The minimum follow-up time was three years, with all knees presenting an EXCELLENT score, according to ARPÉGE evaluation.

  17. Simultaneous traumatic rupture of the patellar tendon and the contralateral quadriceps tendon in a healthy individual.

    Science.gov (United States)

    Kumar, S; Rachakatla, N; Kerin, C; Kumar, R

    2010-11-05

    A simultaneous traumatic complete rupture of the patellar tendon and the contralateral quadriceps tendon is reported to occur in patients with renal failure and other inflammatory diseases, but is extremely rare in a healthy individual because of the different contributory factors and mechanisms of injury. We present a rare case report of such a combination of injuries in a 48-year-old healthy man. To our knowledge only three such cases have been reported in the English literature. This is an unusual combination and hence there is potential for missed diagnosis leading to suboptimal treatment.

  18. Simultaneous MPFL and LPFL reconstruction for recurrent lateral patellar dislocation with medial patellofemoral instability

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    Masashi Kusano

    2014-01-01

    Full Text Available We report an extremely rare case of both recurrent lateral patella dislocation and medial patellofemoral instability, following prior operations to correct patella maltracking. Manual translation of the patella revealed medial and lateral instability with a positive apprehension sign. 3-D computer modelling of kinematics based on MRI data demonstrated that the patella deviated laterally at full extension and translated medially with knee flexion. The medial and lateral patellofemoral ligaments were reconstructed simultaneously with hamstring tendons, alleviating peripatellar pain and patellar instability in both directions.

  19. Dental prosthesis and buccal lesions in the elderly

    Directory of Open Access Journals (Sweden)

    Beatriz García Alpizar

    2010-02-01

    Full Text Available Fundament: Buccal lesions in the elderly are very frequent and they constitute a problem of health due to the consequences that cause. Objective: to describe the characteristics of the removable prosthesis used by the population of 60 and more years age and their relationship with the lesions of the oral mucosa. Methods: We carried out a study descriptive of cross section in 125 elderly with oral prosthesis. The characteristics of the removable prosthesis were described and their relationship with the lesions of the oral mucosa. The square chi tests and the analysis of relative risk were use to determine the association between the variables, also we used a logistical regression model to determine the independent relationship of each factor with the presence of the lesions. Results: We was a 12% of the people with stomatitis sub prosthesis, 8% presented lesions growth hyperplasic and 5,6% they were have angular queilitis. The lesions in the oral mucosa increased in people with prosthesis in not well state, bad hygiene this and in the female sex. Conclusion: the chronic lesions were the more prevalence in this study and they were very related with factors like: state of the conservation the prosthesis, time use, hygiene this and sex of the individual; but when determining the independent influence from each factor with the presence lesions, we established that only the state of conservation of the prosthesis and their hygiene affected of the important way to the old men of this study.

  20. Active upper limb prosthesis based on natural movement trajectories.

    Science.gov (United States)

    Ramírez-García, Alfredo; Leija, Lorenzo; Muñoz, Roberto

    2010-03-01

    The motion of the current prostheses is sequential and does not allow natural movements. In this work, complex natural motion patterns from a healthy upper limb were characterized in order to be emulated for a trans-humeral prosthesis with three degrees of freedom at the elbow. Firstly, it was necessary to define the prosthesis workspace, which means to establish a relationship using an artificial neural network (ANN), between the arm-forearm (3-D) angles allowed by the prosthesis, and its actuators length. The 3-D angles were measured between the forearm and each axis of the reference system attached at the elbow. Secondly, five activities of daily living (ADLs) were analyzed by means of the elbow flexion (EF), the forearm prono-supination (FPS) and the 3-D angles, from healthy subjects, by using a video-based motion analysis system. The 3-D angles were fed to the prosthesis model (ANN) in order to analyze which ADLs could be emulated by the prosthesis. As a result, a prosthesis kinematics approximation was obtained. In conclusion, in spite of the innovative mechanical configuration of the actuators, it was possible to carry out only three of the five ADLs considered. Future work will include improvement of the mechanical configuration of the prosthesis to have greater range of motion.

  1. Microbial colonization of Provox voice prosthesis in the Indian scenario

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    P Chaturvedi

    2014-01-01

    Full Text Available Introduction: Tracheoesophageal speech using the voice prosthesis is considered to be the "gold standard" with success rates as high as 90%. Despite significant developments, majority eventually develop dysfunction due to microbial deterioration. We did a pilot study of 58 laryngectomy patients who developed prosthesis dysfunction. Materials and Methods: A total of 58 laryngectomy patients who had their dysfunctional prosthesis removed were included in this study. Dysfunctional prostheses were removed and examined. Esophageal and tracheal flanges were examined separately. After obtaining pure fungal and bacterial cultures, the yeast strains were identified. Bacteria were identified with the light microscope and gram staining. We analyzed prosthesis lifespan and probable factors affecting it. Results: Central leak was found in 43% cases while in 57% peri-prosthetic leakage was the most common reason for prosthesis replacement. Microbial analysis revealed a combination of yeast and bacteria in approximately 55% culture samples. Out of these, almost 90% had the presence of single yeast species with bacteria. Pure fungal culture was identified in rest of the 45% cultures while none detected pure bacterial forms. Candida tropicalis was the solitary yeast in 81% while Candida albicans was seen in 10% as the solitary yeast. Bacterial isolates revealed Klebsiella pneumonia in 19%, Escherichia coli in 8% while Staphylococcus aureus was grown in 1% cultures. The consumption of curd (P = 0.036, 95% confidence intervals [CI]: 2.292-64.285 to have a significant correlation of the mean prosthesis lifespan. Consumption of curd (P = 0.001, 95% CI: 0.564-2.008 and history of prior radiotherapy (P = 0.015, 95% CI: 0.104-0.909 had a significant bearing on the Provox prosthesis lifespan. Conclusions: Candida is the most common organism grown on voice prosthesis in Indian scenario. Consumption of curd and history of prior radiotherapy significantly affect Provox

  2. 全膝关节置换过程中的假体旋转对位%Prosthesis rotational alignment in total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    吴昊

    2012-01-01

    背景:在全膝关节置换过程中对假体旋转对位争论的焦点目前仍集中在旋转对位的参照地标如何设定.目的:综述全膝关节置换手术中假体旋转对位的相关临床和基础研究进展.方法:广泛查阅全膝关节置换手术中假体旋转对位的解剖定位标志、定位方法、旋转对位的匹配、手术精确度等临床上遇到的相关文献.结果与结论:许多研究表明,旋转对位不良,会导致膝前痛,胫股骨和髌股关节间的稳定性失衡,髌骨的运动轨迹失调,步态异常,胫骨侧聚乙烯平台的磨损加速,假体过早松动,出现关节半脱位和脱位,甚至需进一步手术翻修等问题.术中胫股骨侧假体的旋转对位时要综合利用所获得的各种信息,个别校正,必要时结合置换前的CT扫描来进行,以改善全膝关节置换疗效和远期生存率.%BACKGROUND: Currently, studies about prosthesis rotational alignment of total knee arthroplasty (TKA) are focused on the rotational landmark location.OBJECTIVE: To summarize the clinical and basic research progress related to prosthesis rotational alignment in TKA.METHODS: Clinical articles related to anatomic landmark, location method, matching in rotational alignment and operational precision of prosthesis rotational alignment in TKA were extensively reviewed.RESULTS AND CONCLUSION: Many studies show that malrotation may lead to various complications, such as anterior knee pain, femoro -tibial and patellofemoral instability, maladjustment of patellar movement trajectory, abnormal gait, accelerated polyethylene wear, premature loosening, subluxation or dislocation, and even need for further revision. All derived data from various sources should be used in prosthesis rotational alignment at tibial and femoral side when operation, individual corrections should be made appropriately, and preoperative CT scan can be used if necessary, so as to improve the TKA outcome and longevity.

  3. A modified technique for retention of orbital prosthesis

    Directory of Open Access Journals (Sweden)

    Sameera R Shaikh

    2011-01-01

    Full Text Available An orbital defect (congenital or acquired causes severe facial asymmetry and disfigurement, which results in psychological and social disturbances to the patient. It becomes a challenging task for a maxillofacial prosthodontist to fabricate a prosthesis that replicates the healthy side of the face. Success of the prosthesis depends primarily on satisfactory retention of the same. This clinical report illustrates rehabilitation of a patient with an orbital defect by fabricating a hollow orbital prosthesis, utilizing anatomical undercuts for retention using an acrylic resin template relined by a resilient denture liner.

  4. THE EFFECT OF PATELLAR TAPING ON KNEE JOINT PROPRIOCEPTION IN PATIENTS WITH PATELLOFEMORAL PAIN SYNDROME

    Directory of Open Access Journals (Sweden)

    H. Mokhtarinia

    2008-06-01

    Full Text Available Proprioception has been found to have a relation to subjective knee function and patients with patellofemoral pain syndrome (PFPS seem to have larger deficits than asymptomatic individuals little is known about whether taping can restore defects in proprioception or by which mechanisms it can improve anterior knee pain. To determine the effect of patellar taping on knee joint proprioception a pre and post intervention repeated measures design was conducted on 25 male with PFPS (23.6 ± 3.04 years and 25 healthy male (23.5 ± 3.1 years. Active angle reproduction, passive angle reproduction, and threshold to detection of passive movement tests were measured. Each of the tests was done under taped and no-taped conditions in 20 and 60 degree of knee flexion. We found significant difference between taped and no-taped conditions in active angle reproduction test for both groups (P < 0.05. The other tests did not show any significant difference (P > 0.05. Obtained results suggest that patellar taping may improve knee proprioception during active angle reproduction. Two groups could benefit from taping but further researches are needed to determine whether the present results are applicable to other situations or not.

  5. [Successive ruptures of patellar and Achilles tendons. Anabolic steroids in competitive sports].

    Science.gov (United States)

    Isenberg, J; Prokop, A; Skouras, E

    2008-01-01

    Derivatives of testosterone or of 19-nor-testosterone are used as anabolics for the purpose of improving performance although the effect of anabolics is known still to be under discussion. The use of anabolic steroids continues among competitive athletes despite increased controls and increasingly frequent dramatic incidents connected with them. Whereas metabolic dysfunction during anabolic use is well documented, ruptures of the large tendons are rarely reported. Within 18 months, a 29-year-old professional footballer needed surgery for rupture of the patellar tendon and of both Achilles tendons. Carefully directed questioning elicited confirmation that he had taken different anabolic steroids regularly for 3 years with the intention of improving his strength. After each operation anabolic steroids were taken again at a high dosage during early convalescence and training. Minimally invasive surgery and open suturing techniques led to complete union of the Achilles tendons in good time. Training and anabolic use (metenolon 300 mg per week) started early after suturing of the patellar tendon including bone tunnels culminated in histologically confirmed rerupture after 8 weeks. After a ligament reconstruction with a semitendinosus tendon graft with subsequent infection, the tendon and reserve traction apparatus were lost. Repeated warnings of impaired healing if anabolic use was continued had been given without success. In view of the high number of unrecorded cases in competitive and athletic sports, we can assume that the use of anabolic steroids is also of quantitative relevance in the operative treatment of tendon ruptures.

  6. Press-fit Femoral Fixation in ACL Reconstruction using Bone-Patellar Tendon-Bone Graft

    Directory of Open Access Journals (Sweden)

    Kaseb Mohammad Hasan

    2009-05-01

    Full Text Available Bone-patellar tendon auto graft is probably the most widely used graft for ACL reconstruction. Several methods for graft fixation have been described. To avoid intra-articular hardware we adopt biological fixation with a femoral trapezoidal press-fit fixation. A prospective study was performed on 30 consecutive active people who underwent ACL reconstruction with this technique by two surgeons between september2004 and march2007 (mean follow-up 15.2 months. Results were evaluated by an independent examiner using radiography, subjective and objective evaluation. Assessment using the IKDC knee scoring revealed 92% of the patients with a normal or nearly normal knee joint. Lysholm's score was 63.6(40- 86 preoperatively and 91.88(73-100 at the latest follow up (P < 0.005. No patient complained of instability at latest follow up. The quadriceps muscle showed mild atrophy at 3 and 6 months and at final follow-up. Five Patients complained of anterior knee pain and had a positive kneeling test. We found no graft displacement on follow up radiographs. All cases showed radiological evidence of graft osteointegration at last follow up. Our results show that press-fit fixation of trapezoidal bone graft in femoral tunnel is a simple, reliable, and cost-effective alternative for ACL recon-struction using bone-patellar tendon-bone graft.

  7. Isometric Contractions Are More Analgesic Than Isotonic Contractions for Patellar Tendon Pain : An In-Season Randomized Clinical Trial

    NARCIS (Netherlands)

    Rio, Ebonie; van Ark, Mathijs; Docking, Sean; Moseley, G Lorimer; Kidgell, Dawson; Gaida, Jamie E; van den Akker-Scheek, Inge; Zwerver, Johannes; Cook, Jill

    2016-01-01

    OBJECTIVE: This study aimed to compare the immediate analgesic effects of 2 resistance programs in in-season athletes with patellar tendinopathy (PT). Resistance training is noninvasive, a principle stimulus for corticospinal and neuromuscular adaptation, and may be analgesic. DESIGN: Within-season

  8. Effectiveness of Shockwave Treatment Combined With Eccentric Training for Patellar Tendinopathy : A Double-Blinded Randomized Study

    NARCIS (Netherlands)

    Thijs, Karin M; Zwerver, Johannes; Backx, Frank J G; Steeneken, Victor; Rayer, Stephan; Groenenboom, Petra; Moen, Maarten H

    2016-01-01

    OBJECTIVE: To evaluate the effectiveness of a combined treatment of focused shockwave therapy (ESWT) and eccentric training compared with sham-shockwave therapy (placebo) and eccentric training in participants with patellar tendinopathy (PT) after 24 weeks. DESIGN: Randomized controlled trial. SETTI

  9. An exercise-based physical therapy program for patients with patellar tendinopathy after platelet-rich plasma injection

    NARCIS (Netherlands)

    van Ark, Mathijs; van den Akker-Scheek, Inge; Meijer, L.T.B.; Zwerver, Hans

    2013-01-01

    Objectives: To describe a post platelet-rich plasma (PRP) injection, exercise-based physical therapy program, investigate feasibility and report the first results of patellar tendinopathy patients treated with PRP injection combined with the physical therapy program. Study Design: Case-series. Setti

  10. Do isometric and isotonic exercise programs reduce pain in athletes with patellar tendinopathy in-season? A randomised clinical trial

    NARCIS (Netherlands)

    van Ark, Mathijs; Cook, Jill L.; Docking, Sean I.; Zwerver, Johannes; Gaida, James E.; van den Akker-Scheek, Inge; Rio, Ebonie

    2016-01-01

    Objectives: Many athletes with patellar tendinopathy participate in sports with symptoms during or after activities. Current treatments do not decrease pain in-season; eccentric exercises in-season result in an increase in pain. This study examined if isometric and isotonic exercises relieved pain i

  11. Topical glyceryl trinitrate treatment of chronic patellar tendinopathy : a randomised, double-blind, placebo-controlled clinical trial

    NARCIS (Netherlands)

    Steunebrink, Mirjam; Zwerver, Johannes; Brandsema, Ruben; Groenenboom, Petra; van den Akker-Scheek, Inge; Weir, Adam

    2013-01-01

    Objectives To assess if continuous topical glyceryl trinitrate (GTN) treatment improves outcome in patients with chronic patellar tendinopathy when compared with eccentric training alone. Methods Randomised double-blind, placebo-controlled clinical trial comparing a 12-week programme of using a GTN

  12. Do isometric and isotonic exercise programs reduce pain in athletes with patellar tendinopathy in-season? : A randomised clinical trial

    NARCIS (Netherlands)

    van Ark, Mathijs; Cook, Jill L; Docking, Sean I; Zwerver, Hans; Gaida, James E; van den Akker-Scheek, Inge; Rio, Ebonie

    2016-01-01

    Objectives: Many athletes with patellar tendinopathy participate in sports with symptoms during or after activities. Current treatments do not decrease pain in-season; eccentric exercises in-season result in an increase in pain. This study examined if isometric and isotonic exercises relieved pain i

  13. Avulsion fracture of the posterior cruciate ligament in an uncommon location associated with distal injury to the patellar ligament

    Directory of Open Access Journals (Sweden)

    Rodrigo Pires e Albuquerque

    2015-12-01

    Full Text Available ABSTRACT Avulsion fractures of the posterior cruciate ligament in unusual locations are rare injuries. We report the first case in the literature of an avulsion fracture of the posterior cruciate ligament associated with distal injury to the patellar ligament. The aim of this study was to present a novel case, the therapy used and the clinical follow-up.

  14. Are the take-off and landing phase dynamics of the volleyball spike jump related to patellar tendinopathy?

    NARCIS (Netherlands)

    Bisseling, R.W.; Hof, A.L.; Bredeweg, S.W.; Zwerver, J.; Mulder, T.

    2008-01-01

    Objective: The causal mechanism of the chronic sports injury patellar tendinopathy is not well understood. The aim of the present study was to compare ankle and knee joint dynamics during the performance of the volleyball spike jump between healthy volleyball players (n = 8) and asymptomatic volleyb

  15. Bifocal osseous avulsion of the patellar tendon from the distal patella and tibial tuberosity in a child.

    Science.gov (United States)

    Hermansen, Lars L; Freund, Knud G

    2016-03-01

    This case report describes a 12-year-old boy, who suffered an injury to the right knee in a skateboard accident. Radiographs and surgery confirmed the extremely rare bifocal avulsion fracture including the distal patellar pole and tibial tuberosity. Open reduction and internal fixation was accomplished, and 4-month follow-up demonstrated a good outcome.

  16. Recurrent patellar tendon rupture in a patient after intramedullary nailing of the tibia: reconstruction using an Achilles tendon allograft.

    Science.gov (United States)

    Jagow, Devin M; Garcia, Branden J; Yacoubian, Stephan V; Yacoubian, Shahan V

    2015-05-01

    Various complications after intramedullary (IM) nailing of the tibia have been reported, the most common of which are anterior knee pain and symptoms similar to patella tendonitis. Complete rupture of the patellar tendon after IM nailing of the tibia has been reported on 2 occasions, in conjunction with predisposing patient factors, such as systemic disease or a proud tibial nail. Patellar tendon ruptures are disabling injuries that can be technically difficult to repair because of the poor quality of remaining tendon tissue, quadriceps muscle atrophy and/or contracture, and scar-tissue formation. Many methods have described the surgical reconstruction of the knee extensor mechanism, which is most commonly performed after total knee arthroplasty. We report the successful surgical and clinical outcome of patellar tendon reconstruction using an Achilles tendon allograft in a patient subject to late and recurrent ruptures after IM nailing of the tibia through a mid-patellar tendon-splitting approach. Seven months after tendon reconstruction, the patient exhibited full knee flexion, an extension lag of 10º, 4/5 quadriceps strength, and return to her baseline ambulatory status.

  17. Relationship between bony tunnel and knee function in patients after patellar dislocation triple surgeries—a CT-based study

    Science.gov (United States)

    Qin, Le; Li, Mei; Yao, Weiwu; Shen, Ji

    2017-01-01

    We aimed to assess the CT-based bony tunnel valuations and their correlation with knee function after patellar dislocation triple surgeries. A retrospective study was performed on 66 patients (70 knees) who underwent patellar dislocation triple surgeries. The surgery was MPFL reconstruction primarily, combined with lateral retinaculum release and tibial tubercle osteotomy. CT examinations were performed to determine the femoral tunnel position, along with the patellar and femoral tunnel width 3 days and more than 1 year after operation for follow-up. Functional evaluation based on Kujala and Lysholm scores was also implemented. We compared tunnel width of the first and last examinations and correlated femoral tunnel position of the last examination with knee function. At the last follow-up, femoral tunnel position in the anterior-posterior direction was moderately correlated with knee function. Femoral tunnel position in the proximal-distal direction was not associated with postoperative knee function. Patellar and femoral tunnel width increased significantly at the last follow-up. However, no significant functional difference was found between patients with and without femoral tunnel enlargement. Our results suggested that the tunnel malposition in anterior-posterior position based on CT was related to impaired knee function during the follow-ups.

  18. Treatment of Patellar Tendinopathy Refractory to Surgical Management Using Percutaneous Ultrasonic Tenotomy and Platelet-Rich Plasma Injection: A Case Presentation.

    Science.gov (United States)

    Nanos, Katherine N; Malanga, Gerard A

    2015-12-01

    Chronic proximal patellar tendinopathy is a common condition in sports medicine that may be refractory to nonoperative treatments, including activity modification, medications, and comprehensive rehabilitation. Percutaneous ultrasonic tenotomy is a recently developed technique designed to cut and debride tendinopathic tissue, thus promoting pain relief and functional recovery. We present a case of a collegiate athlete with chronic proximal patellar tendinopathy who was effectively treated with percutaneous ultrasonic tenotomy after not responding to extensive nonoperative treatment, surgical debridement, and platelet-rich plasma injections. Percutaneous ultrasonic tenotomy can be considered as a treatment option in patients presenting with refractory proximal patellar tendinopathy, including those who do not respond to previous operative intervention.

  19. Electronic stimulators for surface neural prosthesis

    Directory of Open Access Journals (Sweden)

    Broderick Barry J.

    2008-01-01

    Full Text Available This paper presents the technological advancements in neural prosthesis devices using Functional Electrical Stimulation (FES. FES refers to the restoration of motor functions lost due to spinal cord injury (SCI, stroke, head injury, or diseases such as Cerebral Palsy or Multiple Sclerosis by eliciting muscular contractions through the use of a neuromuscular electrical stimulator device. The field has developed considerably since its inception, with the miniaturisation of circuity, the development of programmable and adaptable stimulators and the enhancement of sensors used to trigger the application of stimulation to suit a variety of FES applications. This paper discusses general FES system design requirements in the context of existing commercial and research FES devices, focusing on surface stimulators for the upper and lower limbs. These devices have demonstrated feasible standing and stepping in a clinical setting with paraplegic patients, improvements in dropped foot syndrome with hemiplegic patients and aided in the restoration of grasping function in patients with upper limb motor dysfunction.

  20. Galvanic gold plating for fixed dental prosthesis.

    Science.gov (United States)

    Ozcelik, Tuncer Burak; Yilmaz, Burak

    2013-07-01

    Metal ceramic partial fixed dental prostheses have been commonly used for the replacement of missing teeth for many years. Because of an increase in the price of gold, base metal alloys have been the choice of alloy for the fabrication of metal ceramic restorations in many dental clinics. Some major disadvantages of base metals are their corrosion and the dark coloration they may cause at the crown margins. This article describes a galvanic gold-plating technique, which is used to minimize corrosion and improve the esthetics of metal ceramic restorations fabricated with Cr-Co base metal alloys. This technique involves the deposition of a 6 μm to 8 μm 24 K gold layer directly onto the Cr-Co cast prosthesis framework. The technique improves metal surface properties, making them more biocompatible and usable, however, requires additional equipment and experienced laboratory technicians. Clinical studies should be performed to corroborate the long term success of this technique.

  1. A laboratory silicone for preclinical training in ear prosthesis

    Science.gov (United States)

    Anand, Vijay; Haribabu; Vimala; Gnanasamband, Vimala

    2013-01-01

    This article describes an industrial elastic silicone as a material for the laboratory fabrication of ear prosthesis. It has been tested for toxicity in lab animals by the SGS India Pvt. Ltd and approved as a material to pass the parameter of abnormal toxicity. This material therefore can be safely recommended for laboratory exercise to fabricate facial prosthesis. The high cost of the maxillo facial silicone materials prohibits their use for facial prosthesis in pre-clinical training of post-graduate students in maxillofacial prosthodontics. For this reason, pre-clinical laboratory exercise in facial prosthesis is inadequate. A few institutions use polymethyl methacrylate resins which are rigid and do not have elastic characteristics of silicone, which is used for facial defects. This cost-effective industrial silicone material which mimics the elastic and color characteristics of the conventional silicones can be recommended for preclinical exercises. PMID:23956609

  2. Failed total carpometacarpal joint prosthesis of the thumb

    DEFF Research Database (Denmark)

    Hansen, Torben Bæk; Homilius, Morten

    2010-01-01

    . The male:female ratio was 1:4 and the mean duration of observation 32 months (range 6-52). In three patients the revised implant was a MOJE uncemented carpometacarpal joint prosthesis and in seven patients an Elektra uncemented one. At follow-up grip strength was reduced to less than 90% of the other hand...... in eight of 10 patients, but the mean Disabilities of the arm, shoulder, and hand (DASH) scores, self-reported pinch-grip-related function, and pain were comparable with our earlier published results with the Elektra carpometacarpal total joint prosthesis.......Total joint prosthesis in carpometacarpal joint arthritis of the thumb often fails. Loosening of the implant is often treated by resection arthroplasty, and we reviewed 10 patients, mean age 54 years (range 47-63) who were treated by resection arthroplasty after a failed total joint prosthesis...

  3. Characterization of an eye prosthesis using monopoly syrup

    Directory of Open Access Journals (Sweden)

    Pinki Bankoti

    2016-01-01

    Full Text Available The eye is a vital organ and an important component of facial expression. Loss of an eye has a crippling effect on the psychology of the patient. Maxillofacial prostheses restore and replace stomatognathic and associated facial structures with artificial substitutes. The objectives of eye prosthesis is to improve the patient esthetics, restore and maintain the health of the remaining associated structures, consequently provide physical and mental well-being. The primary purpose of an ocular prosthesis is to maintain the volume of eye socket and create the illusion of a healthy eye and surrounding tissue. A custom ocular prosthesis is a good option when reconstruction is done by plastic surgery, and osseointegrated implants are either not possible or not desired. A case of a custom-made ocular acrylic prosthesis is presented with acceptable fit, good retention, and esthetics.

  4. Retinal Prosthesis: A Potential Benefit for the Blind

    Institute of Scientific and Technical Information of China (English)

    YANG Xiao-jie

    2009-01-01

    Retinal degenerative diseases may induce the degeneration of outer retina and in turn, blindness. Nevertheless, due to the maintenance of inner retina, the coding and processing of visual neurons responses are still able to be executed naturally. Therefore,an effective retinal prosthesis device may be developed by mimicking the function of outer retina: transferring the visual light into artificial stimulus and delivering the stimulus to the retina aiming to evoke the neural responses. As two main developing directions for current retinal prosthesis,epiretinal (ER) and subretinal (SR) prosthesis are both undergoing experimental stage and possessing advantages and limitations. Further investigations in power supply, biocompatibility, etc.are still required. Additionally, suprachoroidal transretinal stimulation (STS) and neurotransmitter-induced stimulation as some other alternatives in retinal prosthesis are also considered as promising research directions, although they are not mature enough to be applied commercially, either.

  5. Association between dental prosthesis need, nutritional status and quality of life of elderly subjects

    DEFF Research Database (Denmark)

    Pillai, Rajath; Mathur, Vijay Prakash; Jain, Veena;

    2015-01-01

    To determine the effect of prosthesis need on nutritional status and oral health-related quality of life (OHrQoL) in elderly and to check the disparity between prosthesis need and prosthesis want in the Indian elderly. METHODS: A total of 946 geriatric participants reporting to a geriatric medicine...... need (r = -0.460). Participants with some prosthesis need had significantly lower MNA and GOHAI scores as compared to those with no prosthesis need. Though prosthesis need was high (79.7 %), demand was low (39.3 %). CONCLUSION: Prosthesis need affects nutritional status and OHrQoL in elderly...... clinic were recruited in the study. Mini-nutritional assessment (MNA), geriatric oral health assessment (GOHAI) indices, prosthesis need according to WHO criteria, and prosthesis want was recorded along with age, gender, socioeconomic status and posterior occluding pair. RESULTS: Significant associations...

  6. Biocompatible membrane of PDMS for the new chamber prosthesis stapes.

    Science.gov (United States)

    Banasik, Katarzyna; Kwacz, Monika

    2016-06-30

    Stapes protheses are designed for patients with otosclerosis resulting immobilization or significant reduction of the stapes mobility. All currently used prostheses are called - piston prosthesis. However, its use to stimulate the cochlea is still imperfect. New chamber stapes prosthesis allows the perilymph excitation more effective than the piston prothesis. Moreover, the chamber prosthesis eliminates the common causes of piston-stapedotomy failures. The most important element of the new prosthesis is a flexible membrane. The membrane stiffness should be close to the stiffness of normal annular ligament. This work presents the process of selection of the membrane's thickness and its manufacturing technology. Method A 3D model of the chamber stapes prosthesis was build using Autodesk Inventor 2015. The model was imported to Abacus 6.13 computing environment. During numerical simulations, displacements corresponding to applied loads were calculated and the membrane thickness was adjusted so that its stiffness was the same as the ligament stiffness (~ 120 N/m). The compliance ratios calculated from the load-displacement curves for the membrane and the annular ligament were verified using linear regression analysis. After determining the thickness, the manufacturing technology of the membrane was developed. Results The best similarity between the membrane's and annular ligament's stiffness was achieved for PDMS membrane with the 0,15- mm thickness (similarity ratio R2=0,997752). In this work, the technological parameters of spin-coating process for membrane manufacture are also presented. Summary The proper functioning of the chamber stapes prosthesis requires the PDMS membrane with a thickness of 0,15 mm. The 0,15-mm membrane has the tiffness close to the stiffness of the normal annular ligament. Therefore, the chamber stapes prosthesis provides the perilymph stimulation at the level comparable to the healthy ear. New prosthesis is currently under pre

  7. Kinematic Analysis of a Posterior-stabilized Knee Prosthesis

    Directory of Open Access Journals (Sweden)

    Zhi-Xin Zhao

    2015-01-01

    Full Text Available Background: The goal of total knee arthroplasty (TKA is to restore knee kinematics. Knee prosthesis design plays a very important role in successful restoration. Here, kinematics models of normal and prosthetic knees were created and validated using previously published data. Methods: Computed tomography and magnetic resonance imaging scans of a healthy, anticorrosive female cadaver were used to establish a model of the entire lower limbs, including the femur, tibia, patella, fibula, distal femur cartilage, and medial and lateral menisci, as well as the anterior cruciate, posterior cruciate, medial collateral, and lateral collateral ligaments. The data from the three-dimensional models of the normal knee joint and a posterior-stabilized (PS knee prosthesis were imported into finite element analysis software to create the final kinematic model of the TKA prosthesis, which was then validated by comparison with a previous study. The displacement of the medial/lateral femur and the internal rotation angle of the tibia were analyzed during 0-135° flexion. Results: Both the output data trends and the measured values derived from the normal knee′s kinematics model were very close to the results reported in a previous in vivo study, suggesting that this model can be used for further analyses. The PS knee prosthesis underwent an abnormal forward displacement compared with the normal knee and has insufficient, or insufficiently aggressive, "rollback" compared with the lateral femur of the normal knee. In addition, a certain degree of reverse rotation occurs during flexion of the PS knee prosthesis. Conclusions: There were still several differences between the kinematics of the PS knee prosthesis and a normal knee, suggesting room for improving the design of the PS knee prosthesis. The abnormal kinematics during early flexion shows that the design of the articular surface played a vital role in improving the kinematics of the PS knee prosthesis.

  8. Intraoral-extraoral combination prosthesis: improving retention using interconnecting magnets.

    Science.gov (United States)

    Engelen, Marloes; van Heumen, Celeste C M; Merkx, Matthias A W; Meijer, Gert J

    2014-01-01

    Osseointegrated implants have been well documented for retaining an obturator prosthesis as well as a facial prosthesis. However, when the defect extends to both the facial area and the maxilla, it is difficult to rehabilitate those defects to the satisfaction of the patient, especially in cases where implants cannot be placed on both sites. This case report describes the use of magnets to connect two prostheses, thereby increasing retention and patient comfort.

  9. Penile prosthesis surgery in the management of erectile dysfunction

    OpenAIRE

    2013-01-01

    Introduction We reviewed retrospectively the use of penile prostheses, including the indications and complications of penile prosthesis surgery. Methods We identified publications and the reported advances in penile prosthesis surgery between 1987 and 2012 in Pub-Med, and published information from American Medical Systems, Inc. (Minnetonka, MN, USA) and Coloplast Corporation (Humlebaek, Denmark), using the keywords ‘penile prosthesis’, ‘erectile dysfunction’, ‘mechanical reliability’, ‘compl...

  10. Kinematic Analysis of a Posterior-stabilized Knee Prosthesis

    Institute of Scientific and Technical Information of China (English)

    Zhi-Xin Zhao; Liang Wen; Tie-Bing Qu; Li-Li Hou; Dong Xiang; Jia Bin

    2015-01-01

    Background:The goal of total knee arthroplasty (TKA) is to restore knee kinematics.Knee prosthesis design plays a very important role in successful restoration.Here,kinematics models of normal and prosthetic knees were created and validated using previously published data.Methods:Computed tomography and magnetic resonance imaging scans of a healthy,anticorrosive female cadaver were used to establish a model of the entire lower limbs,including the femur,tibia,patella,fibula,distal femur cartilage,and medial and lateral menisci,as well as the anterior cruciate,posterior cruciate,medial collateral,and lateral collateral ligaments.The data from the three-dimensional models of the normal knee joint and a posterior-stabilized (PS) knee prosthesis were imported into finite element analysis software to create the final kinematic model of the TKA prosthesis,which was then validated by comparison with a previous study.The displacement of the medial/lateral femur and the internal rotation angle of the tibia were analyzed during 0-135° flexion.Results:Both the output data trends and the measured values derived from the normal knee's kinematics model were very close to the results reported in a previous in vivo study,suggesting that this model can be used for further analyses.The PS knee prosthesis underwent an abnormal forward displacement compared with the normal knee and has insufficient,or insufficiently aggressive,"rollback" compared with the lateral femur of the normal knee.In addition,a certain degree of reverse rotation occurs during flexion of the PS knee prosthesis.Conclusions:There were still several differences between the kinematics of the PS knee prosthesis and a normal knee,suggesting room for improving the design of the PS knee prosthesis.The abnormal kinematics during early flexion shows that the design of the articular surface played a vital role in improving the kinematics of the PS knee prosthesis.

  11. Cosmetic effect of knee joint in a knee disarticulation prosthesis

    OpenAIRE

    2015-01-01

    Despite numerous advantages, knee disarticulations (KDs) are rarely performed because of the anticipated KD prosthesis fitting problems that include the positioning of the knee joint distally from the KD socket. This results in lengthening of the thigh and subsequent shortening of the shank. The objective of this study was to assess the cosmetic effect of the knee joint in a KD prosthesis by determining the extent of the lengthening of the thigh and the shortening of the shank. This lengtheni...

  12. Design and Control of a Pneumatically Actuated Transtibial Prosthesis

    OpenAIRE

    Zheng, Hao; Shen, Xiangrong

    2015-01-01

    This paper presents the design and control of a pneumatically actuated transtibial prosthesis, which utilizes a pneumatic cylinder-type actuator to power the prosthetic ankle joint to support the user's locomotion. The pneumatic actuator has multiple advantages over the traditional electric motor, such as light weight, low cost, and high power-to-weight ratio. The objective of this work is to develop a compact and lightweight transtibial prosthesis, leveraging the multiple advantages provided...

  13. A digital patient for computer-aided prosthesis design

    OpenAIRE

    Colombo, Giorgio; Facoetti, Giancarlo; Rizzi, Caterina

    2013-01-01

    This article concerns the design of lower limb prosthesis, both below and above knee. It describes a new computer-based design framework and a digital model of the patient around which the prosthesis is designed and tested in a completely virtual environment. The virtual model of the patient is the backbone of the whole system, and it is based on a biomechanical general-purpose model customized with the patient's characteristics (e.g. anthropometric measures). The software platform adopts com...

  14. Literature Review on Needs of Upper Limb Prosthesis Users

    OpenAIRE

    Cordella, Francesca; Ciancio, Anna Lisa; Sacchetti, Rinaldo; Davalli, Angelo; Cutti, Andrea Giovanni; Guglielmelli, Eugenio; Zollo, Loredana

    2016-01-01

    The loss of one hand can significantly affect the level of autonomy and the capability of performing daily living, working and social activities. The current prosthetic solutions contribute in a poor way to overcome these problems due to limitations in the interfaces adopted for controlling the prosthesis and to the lack of force or tactile feedback, thus limiting hand grasp capabilities. This paper presents a literature review on needs analysis of upper limb prosthesis users, and points out ...

  15. 乳磨牙龋非创伤性修复技术应用%Application of Milk Teeth Caries Atraumatic Restorative Technique

    Institute of Scientific and Technical Information of China (English)

    王萍

    2015-01-01

    目的:探讨乳磨牙龋非创伤性修复技术应用。方法随机选取2012年1月~2014年12月我院收治的双侧同名乳磨牙龋患儿50例,共100颗牙齿,根据患儿就诊时间先后,分为对照组与观察组,每组25例,给予观察组患儿乳磨牙龋非创伤性修复技术治疗,给予对照组患儿纳米树脂填充治疗,随访比较两组患儿6个月后、1年及2年后治疗的成功率。结果观察组患儿6个月、1年及2年成功率分别为96%、88%及84%高于对照组6个月、1年及2年后成功率88%、72%及68%,存在差异(P<0.05),具有统计学意义。结论给予乳磨牙龋患儿ART技术治疗,临床疗效显著。%Objective To explore carious primary molars atraumatic restorative technique.Methods Randomly selected period January 2012~December 2014 bilateral namesake milk teeth caries in our hospital, 50 cases of children, a total of 100 teeth, according to the chronological treatment of children, divided into a control group and the observation group, each 25 patients given observation group of children in primary molars caries atraumatic restorative treatment of given group of children routine nano resin iflling treatment, follow-up between the two groups of children 6 months, 1 year and 2 years after treatment success rate.Results The study group of children 6 months, 1 year and 2 harvest power were 96%, 88% and 84% was signiifcantly higher than 6 months, 1 year and 2 years after the success rate was 88%, 72% and 68%, the difference was significantly (P<0.05), with statistical significance.Conclusion To give children with milk teeth caries (ART) treatment, signiifcant clinical effect.

  16. Ischemic Gangrene of the Glans following Penile Prosthesis Implantation

    Science.gov (United States)

    García Gómez, Borja; Romero Otero, Javier; Díez Sicilia, Laura; Jiménez Alcaide, Estibaliz; García-Cruz, Eduardo; Rodríguez Antolín, Alfredo

    2013-01-01

    The development of ischemic gangrene of the penis following implantation of prosthesis is unusual, and very few cases are available in the literature. As a result, no established treatment protocol is available. We report our experience within a case of gangrene of the glans following implantation of a three-component prosthesis. We present a 53-year-old male, smoker with diabetes and hypercholesterolemia, who underwent surgery for the insertion of a penile prosthesis with 3 components to correct his erectile dysfunction and severe Peyronie's disease. The procedure was carried out without incidents. During the postoperative period, the patient began to complain from penile and perineal pain. He developed avascular necrosis of the glans. The necrosed area was excised. Four weeks later, he developed fever and perineal pain arriving to the emergency room with the prosthesis extruding through the glans. He had emergency surgery to remove the prosthesis plus surgical lavage and was prescribed broad-spectrum antibiotic therapy. Four weeks later, the penis was completely revascularized and reepithelialized. Ischemic gangrene following penile prosthesis implantation takes place in patients with poor peripheral vascularisation. Diabetes mellitus has been the common denominator to all of the reported cases. PMID:23956919

  17. Ischemic Gangrene of the Glans following Penile Prosthesis Implantation

    Directory of Open Access Journals (Sweden)

    Borja García Gómez

    2013-01-01

    Full Text Available The development of ischemic gangrene of the penis following implantation of prosthesis is unusual, and very few cases are available in the literature. As a result, no established treatment protocol is available. We report our experience within a case of gangrene of the glans following implantation of a three-component prosthesis. We present a 53-year-old male, smoker with diabetes and hypercholesterolemia, who underwent surgery for the insertion of a penile prosthesis with 3 components to correct his erectile dysfunction and severe Peyronie's disease. The procedure was carried out without incidents. During the postoperative period, the patient began to complain from penile and perineal pain. He developed avascular necrosis of the glans. The necrosed area was excised. Four weeks later, he developed fever and perineal pain arriving to the emergency room with the prosthesis extruding through the glans. He had emergency surgery to remove the prosthesis plus surgical lavage and was prescribed broad-spectrum antibiotic therapy. Four weeks later, the penis was completely revascularized and reepithelialized. Ischemic gangrene following penile prosthesis implantation takes place in patients with poor peripheral vascularisation. Diabetes mellitus has been the common denominator to all of the reported cases.

  18. Ideas on the suspension of the below-knee prosthesis.

    Science.gov (United States)

    Grevsten, S

    1978-04-01

    Comparative studies with the PTB-suction prosthesis and the ordinary PTB prosthesis have provided opportunities to analyze and understand some functional differences in the suspension of below-knee prostheses. In a roentgenological study of the stump-socket contact signficantly less vertical displacement in the PTB-suction prosthesis has been shown. A study of the pressure variations in the suction socket verified the theory of the necessary pressure gradient in the PTB-suction socket. Added negative pressure by muscle action was also observed. An electromyographic study suggested a muscular activity pattern in the suction prosthesis similar to that of a normal leg, as a contrast to the ordinary PTB prosthesis where simultaneous contractions of antagonistic muscles seemed to be the usual pattern. The latter is interpreted as a defence reaction. An optimal prosthesis has been deduced. It shall have a soft prosthetic socket with a perfect fit, a suction, adhesion and friction fixation and a pressure gradient between the skin and the socket wall with minimum compression distally. The plaster casting shall be done in a downward modelling manner making available space for soft tissue without compression.

  19. A new porous tracheal prosthesis sealed with collagen sponge.

    Science.gov (United States)

    Teramachi, M; Kiyotani, T; Takimoto, Y; Nakamura, T; Shimizu, Y

    1995-01-01

    We have designed a new tracheal prosthesis to overcome problems with an earlier device, which included stenosis and exposure of its constituent mesh. A polypropylene mesh cylinder, reinforced with a polypropylene spiral, is sealed with collagen sponge made from porcine dermal collagen. Using this prosthesis, we performed cervical tracheal reconstructions on 11 dogs. Three dogs died within 3 months of reconstruction. Their causes of death were anesthetic accident, diarrhea, and suffocation, respectively. Bronchoscopically, the inner surface of the prosthesis was almost covered with host tissue by 2 months. However, in one dog, a relatively large area of the mesh was exposed in the tracheal lumen at 6 months; a smaller area was exposed in two other dogs. The appearance of the inner surface rapidly became lustrous, and central stenosis was not significant, even after 12 months. Histologically, an incomplete epithelial lining at 6 months was seen on the reconstructed surface and included ciliated columnar, cuboidal, and squamous epithelium. These observations have revealed that this prosthesis has high biocompatibility and the potential to overcome problems of stenosis of the prosthesis lumen. However, because ulceration persists with this prosthesis, additional improvement is needed to reduce the incidence of mesh exposure.

  20. Fabrication of an Implant-Supported Fixed Interim Prosthesis Using a Duplicate Denture: An Alternative Technique.

    Science.gov (United States)

    Al-Thobity, Ahmad M

    2016-06-22

    The fabrication of an implant-supported fixed complete denture prosthesis involves multiple clinical and laboratory steps. One of the main steps is to provide the patient with an interim fixed prosthesis to evaluate the patient's esthetic and functional needs as well as to enhance the patient's psychology before proceeding to the definitive prosthesis. Different techniques for fabricating interim prostheses have been described in the literature. This report describes an alternative technique that uses a duplicate denture made of self-curing acrylic resin to fabricate an implant-supported fixed interim prosthesis. The interim prosthesis was later used as a blueprint for the definitive implant-supported hybrid prosthesis.

  1. ADVANCEMENT OF ROTATIONAL ALIGNMENT OF FEMORAL PROSTHESIS IN TOTAL KNEE ARTHROPLASTY%人工全膝关节置换术中股骨假体旋转的研究进展

    Institute of Scientific and Technical Information of China (English)

    王平; 赵志江; 付卫杰; 许红生

    2011-01-01

    Objective To introduce the concept and clinical applications of rotational alignment of the femoral prosthesis in total knee arthroplasty (TKA) so as to avoide the postoperative complications caused by rotational alignment. Methods The clinical and experimental research literature about rotational alignment of the femoral prosthesis in TKA was extensively reviewed and analyzed. Results Femoral prosthesis malrotation can lead to flexion gap unbalanced and undesirable patellar track. Rotation alignment of the femoral prosthesis is defined with radiological and computer assisted technique at pre- and post-operation, which can make the rotation alignment of the femoral prosthesis and the function of the knee favorable. Conclusion In recent years, many surgical skills and new techniques of defining the rotational alignment are developed, and good clinical results are achieved.%目的 综述人工全膝关节置换术(total knee arthroplasty,TKA)中股骨假体旋转评估研究进展,以减少假体旋转不良导致的术后并发症. 方法 查阅近年TKA术中股骨假体旋转定位参考轴线的基础及临床研究相关文献,并进行综合分析. 结果 股骨假体旋转不良可造成屈曲间隙不平衡和髌骨轨迹不良,术前应采用不同方法确定股骨假体旋转力线,并通过影像学技术及计算机导航技术进行手术前后评估,保证股骨假体的旋转位置良好,使术后膝关节功能获得最大程度的恢复. 结论 近年发展了多种手术技巧和新技术以确定股骨假体旋转力线,临床应用并获得较好效果.

  2. Ultrasound imaging of the patellar tendon attachment to the tibia during puberty: a 12-month follow-up in tennis players.

    Science.gov (United States)

    Ducher, G; Cook, J; Spurrier, D; Coombs, P; Ptasznik, R; Black, J; Bass, S

    2010-02-01

    This longitudinal study investigated the ultrasound appearance of the patellar tendon attachment to the tibia throughout puberty in young tennis players with and without Osgood-Schlatter disease (OSD). Twenty-eight competitive players (17 boys), aged 10.6-15.3 years, had bilateral ultrasound imaging of the patellar tendon attachment to the tibia at baseline and 1 year later. On each occasion, anthropometric measurements, pubertal status and injury history were recorded. Ultrasound appearance of the patellar tendon attachment was categorized into three stages: cartilage attachment, insertional cartilage and mature attachment. Stage 1 appearance, a large anechoic region with or without ossicles and irregularity of the apophysis that are classically associated with OSD, was found in eight players, seven of them were pain free. A majority (62%) of the patellar tendons in stage 1 at baseline progressed toward stage 2 or stage 3 1 year later. Likewise the patellar tendon attachment in most athletes with cartilage insertion showed progression to a mature enthesis over 1 year. The imaging appearance that is classically interpreted as OSD was common in asymptomatic knees. This ultrasonographic description of the patellar tendon attachment to the tibia during growth provides a reference for the assessment of bone tendon attachments in adolescents.

  3. Dry arthroscopy with a retraction system for matrix-aided cartilage repair of patellar lesions.

    Science.gov (United States)

    Sadlik, Boguslaw; Wiewiorski, Martin

    2014-02-01

    Several commercially available cartilage repair techniques use a natural or synthetic matrix to aid cartilage regeneration (e.g., autologous matrix-induced chondrogenesis or matrix-induced cartilage implantation). However, the use of matrix-aided techniques during conventional knee joint arthroscopy under continuous irrigation is challenging. Insertion and fixation of the matrix can be complicated by the presence of fluid and the confined patellofemoral joint space with limited access to the lesion. To overcome these issues, we developed a novel arthroscopic approach for matrix-aided cartilage repair of patellar lesions. This technical note describes the use of dry arthroscopy assisted by a minimally invasive retraction system. An autologous matrix-induced chondrogenesis procedure is used to illustrate this novel approach.

  4. Equivalence of online and clinician administration of a patellar tendinopathy risk factor and severity questionnaire

    DEFF Research Database (Denmark)

    Morton, S; Morrissey, D; Valle, X;

    2015-01-01

    The VISA-P is a questionnaire for assessing the severity of patellar tendinopathy (PT). Our study aim was to evaluate the equivalence of self-administration of the VISA-P online with the addition of risk factor questions to develop a tool suitable for high-volume remote use. A crossover study...... design with 107 subjects was used to determine equivalence between online and clinician administration. Three population groups were used to ensure construct validity. Online vs clinician administration revealed an intraclass correlation (ICC) of 0.79 [confidence interval (CI): 0.68-0.86] for the VISA...... for risk factor questions was excellent at 0.89 (CI: 0.84-0.93) with no mean difference (P = 1.00). The online questionnaire enables equivalent collection of VISA-P data and risk factor information and may well improve further with the suggested modifications to the instructions for questions 7 and 8...

  5. Magnetic resonance evaluation of anterior cruciate ligament repair using the patellar tendon double bone block technique

    Energy Technology Data Exchange (ETDEWEB)

    Autz, G.; Singson, R.D. (St. Luke' s Roosevelt Hospital Center, New York, NY (United States). Dept. of Radiology); Goodwin, C. (St. Luke' s Roosevelt Hospital Center, New York, NY (United States). Dept. of Orthopedics)

    1991-11-01

    The magnetic resonance (MR) appearance of the anterior cruciate ligament reconstruction was determined in 20 clinically stable and 2 clinically unstable knees for a total of 22 examinations. All patients studied had undergone knee reconstruction using the patellar tendon as graft material. The reconstructed anterior cruciate ligament varies in appearance. It appeared as a thick, well-defined, low signal band on T1- and T2-weighted sagittal and coronal images in 14 of 22 examinations. The remaining 8 knees showed a graft having one or more thin and attenuated, low signal intensity bands in the sagittal and/or coronal plane. Arthroscopy confirmed an intact but lax graft in the clinically unstable knees. (orig.).

  6. Histological comparison of patellar cartilage degeneration between chondromalacia in youth and osteoarthritis in aging.

    Science.gov (United States)

    Mori, Y; Kubo, M; Okumo, H; Kuroki, Y

    1995-01-01

    The histological findings of the patellar cartilage were compared between cases of chondromalacia, which occurs predominantly in young persons (22 patients, average age 19.8 years) and cases of osteoarthritis, which is common among the elderly (21 patients, average age 65.4 years). The histological findings of cartilage in the chondromalacia were characterized by increased density and vigorous fibrous metaplasia of chondrocytes. These findings may be considered to represent a reactive change in the chondrocyte. Cartilage degeneration in osteoarthritis, by contrast, is regressive and presents a clearly different histological picture from that of chondromalacia patellae. We conclude that chondromalacia does not easily lead to osteoarthritis. On the other hand, the cartilage was characteristically softened, as observed by gross inspection, and showed rarefaction of the cartilage matrix. It should be noted that the change was not observed in aging, but showed a pattern of cartilage degeneration peculiar to young patients with chondromalacia patellae.

  7. Bilateral traumatic patellar fracture: a case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Gupta Vinay; Kundu Zile; Garg Rakesh; Sanjay Gaurav

    2012-01-01

    Simultaneous isolated bilateral patellar fractures are very rare injuries and most often associated with systemic disorders such as hyperparathyroidism,osteoporosis,stress fracture and kidney failure.Isolated bilateral traumatic fracture of patella following an unusual mode of injury is seldomly reported in the literature.We reported such a case following a road traffic accident without any associated injuries or co-morbid condition.The patella on the right side had transverse open fracture which was fixed with two Kirschner wires following tension band principle,and that on the left side sustained upper pole comminution which was treated by partial patellectomy.The patient achieved good outcome:at 6 months he was able to squat and sit cross legged; at one year he obtained nearly normal muscle strength and full range of motion.We discussed the injury mechanism,management and rehabilitation in such a case and reviewed the available literature regarding such a presentation.

  8. Mechanical properties and collagen cross-linking of the patellar tendon in old and young men

    DEFF Research Database (Denmark)

    Couppé, C; Hansen, P; Kongsgaard, M

    2009-01-01

    Age-related loss in muscle mass and strength impairs daily life function in the elderly. However, it remains unknown whether tendon properties also deteriorate with age. Cross-linking of collagen molecules provides structural integrity to the tendon fibrils and has been shown to change with age...... in animals but has never been examined in humans in vivo. In this study, we examined the mechanical properties and pyridinoline and pentosidine cross-link and collagen concentrations of the patellar tendon in vivo in old (OM) and young men (YM). Seven OM (67 +/- 3 years, 86 +/- 10 kg) and 10 YM (27 +/- 2...... contractions. Percutaneous tendon biopsies were taken and analyzed for hydroxylysyl pyridinoline (HP), lysyl pyridinoline (LP), pentosidine, and collagen concentrations. We found no significant differences in the dimensions or mechanical properties of the tendon between OM and YM. Collagen concentrations were...

  9. The impact of joint line restoration on functional results after hinged knee prosthesis

    Directory of Open Access Journals (Sweden)

    Serdar Yilmaz

    2016-01-01

    Conclusion: RHKA is an effective salvage procedure for serious instability and large bone defects. Restoration of the joint line improves the patellar score although it had no effect on the clinical outcome.

  10. Patellar resurfacing versus nonresurfacing in total knee arthroplasty for osteoarthritis: experience at a tertiary care institution in Pakistan

    Directory of Open Access Journals (Sweden)

    Lakdawala RH

    2012-02-01

    Full Text Available Akil Fazal1, Riaz H Lakdawala21Clinical Fellow, NYU Hospital for Joint Disease, New York, US; 2Associate Professor and Chief, Section of Orthopedics, Department of Surgery, The Aga Khan University Hospital, Karachi, PakistanObjective: To determine the effect of patellar resurfacing in patients offered total knee arthroplasty for osteoarthritis.Design: Randomized control study.Place and duration of study: The Aga Khan University Hospital, Karachi, Pakistan from January 3, 2005 to January 9, 2010.Patients and methods: Patients undergoing primary total knee arthroplasty for osteoarthritis were assigned to either the patellar resurfacing or nonresurfacing arm using systematic sampling. This consisted of patients undergoing unilateral and bilateral knee arthroplasty. Preoperatively, Knee Society Knee and Function Scores were calculated. After a minimum of 3 years postoperatively Knee Society Knee and Function Scores as well as the Clinical Anterior Knee Pain Rating were calculated and analysis done to check for differences.Results: Seventy-five patients were recruited in each arm; 135 patients had bilateral and 15 had unilateral knee arthroplasty. The mean preoperative knee score was 40.4 for the resurfacing group and 40.60 for the nonresurfacing group (P = 0.45. This improved postoperatively to 93.67 and 94.23 respectively, with no difference between the two groups (P = 0.67. The mean preoperative function score was 45.50 for resurfaced patellae and 45.83 for nonresurfaced. This improved to 89.67 and 90.50, respectively, again with no difference (P = 0.51. Postoperative Clinical Anterior Knee Pain Rating was a mean of 0.1 for resurfaced and 0.13 for nonresurfaced patellas, with no difference on analysis (P = 0.06. However, patients who had bilateral knee arthroplasty had a slightly higher Clinical Anterior Knee Pain Rating than those who had single knee surgery (P = 0.046 irrespective of whether the patellar was resurfaced or not.Conclusion: In

  11. The paratenon contributes to scleraxis-expressing cells during patellar tendon healing.

    Directory of Open Access Journals (Sweden)

    Nathaniel A Dyment

    Full Text Available The origin of cells that contribute to tendon healing, specifically extrinsic epitenon/paratenon cells vs. internal tendon fibroblasts, is still debated. The purpose of this study is to determine the location and phenotype of cells that contribute to healing of a central patellar tendon defect injury in the mouse. Normal adult patellar tendon consists of scleraxis-expressing (Scx tendon fibroblasts situated among aligned collagen fibrils. The tendon body is surrounded by paratenon, which consists of a thin layer of cells that do not express Scx and collagen fibers oriented circumferentially around the tendon. At 3 days following injury, the paratenon thickens as cells within the paratenon proliferate and begin producing tenascin-C and fibromodulin. These cells migrate toward the defect site and express scleraxis and smooth muscle actin alpha by day 7. The thickened paratenon tissue eventually bridges the tendon defect by day 14. Similarly, cells within the periphery of the adjacent tendon struts express these markers and become disorganized. Cells within the defect region show increased expression of fibrillar collagens (Col1a1 and Col3a1 but decreased expression of tenogenic transcription factors (scleraxis and mohawk homeobox and collagen assembly genes (fibromodulin and decorin. By contrast, early growth response 1 and 2 are upregulated in these tissues along with tenascin-C. These results suggest that paratenon cells, which normally do not express Scx, respond to injury by turning on Scx and assembling matrix to bridge the defect. Future studies are needed to determine the signaling pathways that drive these cells and whether they are capable of producing a functional tendon matrix. Understanding this process may guide tissue engineering strategies in the future by stimulating these cells to improve tendon repair.

  12. ggstThe role of tendon microcirculation in Achilles and patellar tendinopathy

    Directory of Open Access Journals (Sweden)

    Knobloch Karsten

    2008-04-01

    Full Text Available Abstract Tendinopathy is of distinct interest as it describes a painful tendon disease with local tenderness, swelling and pain associated with sonographic features such as hypoechogenic texture and diameter enlargement. Recent research elucidated microcirculatory changes in tendinopathy using laser Doppler flowmetry and spectrophotometry such as at the Achilles tendon, the patellar tendon as well as at the elbow and the wrist level. Tendon capillary blood flow is increased at the point of pain. Tendon oxygen saturation as well as tendon postcapillary venous filling pressures, determined non-invasively using combined Laser Doppler flowmetry and spectrophotometry, can quantify, in real-time, how tendon microcirculation changes over with pathology or in response to a given therapy. Tendon oxygen saturation can be increased by repetitive, intermittent short-term ice applications in Achilles tendons; this corresponds to 'ischemic preconditioning', a method used to train tissue to sustain ischemic damage. On the other hand, decreasing tendon oxygenation may reflect local acidosis and deteriorating tendon metabolism. Painful eccentric training, a common therapy for Achilles, patellar, supraspinatus and wrist tendinopathy decreases abnormal capillary tendon flow without compromising local tendon oxygenation. Combining an Achilles pneumatic wrap with eccentric training changes tendon microcirculation in a different way than does eccentric training alone; both approaches reduce pain in Achilles tendinopathy. The microcirculatory effects of measures such as extracorporeal shock wave therapy as well as topical nitroglycerine application are to be studied in tendinopathy as well as the critical question of dosage and maintenance. Interestingly it seems that injection therapy using color Doppler for targeting the area of neovascularisation yields to good clinical results with polidocanol sclerosing therapy, but also with a combination of epinephrine and

  13. Intraoral framework pick-up technique to improve fit of a metal-resin implant prosthesis

    Directory of Open Access Journals (Sweden)

    Mirza Rustum Baig

    2012-01-01

    Full Text Available The achievement of passive fit is an important prerequisite for the prevention of complications in full-arch screw-retained implant prosthesis. With cemented prosthesis, the cementation compensates for the discrepancies in the cast framework, but the lack of retrievability seems undesirable. The aim of this paper is to propose a modified screw-retained prosthesis design for complete arch implant fixed rehabilitation. A technique for the fabrication of a full-arch metal-resin implant-supported screw-retained prosthesis is described. Cementation of the framework to the abutments intraorally improves the passivity of fit of the prosthesis on the implants. Maintenance of screw-access channels in the final prosthesis ensures retrievability. The metal-resin design allows for easy repair and maintenance. The prosthesis is cost-effective compared to conventional options and can be employed as a viable treatment alternative when considering metal-acrylic resin complete arch fixed prosthesis.

  14. Cortical bone total ossicular replacement prosthesis

    Directory of Open Access Journals (Sweden)

    Manu Malhotra

    2014-01-01

    Full Text Available Objectives: Evaluate an autologous cortical bone total ossicular replacement prosthesis (B TORP made of cortical bone for cost effective and sustainable hearing results. Materials and Methods: A prospective study was undertaken in the patients who underwent tympanoplasty with new B-TORP from January 2011 to December 2011. All patients had an absent superstructure of the stapes and long process of the incus due to chronic otitis media. Totally 40 patients were evaluated. Hearing results were evaluated using four-frequency average pure tone air conduction and air-bone gap (ABG measured at 0.5, 1, 2, and 3 kHz after a period of 12 months. Pre- and post-operative continuous variables were compared using a paired t-test and data from unequal groups were assessed for significant differences using unpaired t-test. Results: Successful rehabilitation of the ABG to 20 dB or less was achieved in 95% of patients. Overall mean improvement in ABG was 25.8 ± 5.6 dB, which was statistically significant (t = 26.8, P 0.5. Conclusion: The new autologous B-TORP provides sustainable hearing improvement and is bio-compatible, stable, and magnetic resonance imaging compatible.

  15. [Avoidance of patient-prosthesis mismatch].

    Science.gov (United States)

    Sakamoto, Y; Hashimoto, K

    2006-04-01

    To minimize the incidence of patient-prosthesis mismatch (PPM), we have routinely adopted aortic root enlargement to avoid PPM for patients with small aortic annulus. The aim of this study was to review our strategy of avoiding PPM. The Carpentier-Edwards Perimount (CEP) valves were implanted in 53 patients who were mostly aged over 65 and the St. Jude Medical (SJM) mechanical valves were used in 128 patients aged under 65. A standard 21-mm SJM valve was used in only 3 patients and no 19-mm valves were employed. However, 19-mm CEP valves were used in 12 patients with a small body surface area (1.43 +/- 0.14 m2). Of these, 26 patients (14.4%) who had a small aortic annulus and 24 patients aged under 65 underwent aortic root enlargement. No patient receiving an SJM valve had an projected indexed effective orifice area (EOAI) small annulus, the first choice for avoiding PPM is aortic annular enlargement, which may be avoided by high performance mechanical valves with larger EOA.

  16. Boston ocular surface prosthesis: An Indian experience

    Directory of Open Access Journals (Sweden)

    Varsha Madanlal Rathi

    2011-01-01

    Full Text Available Context: Boston ocular surface prosthesis (BOSP is a scleral contact lens used in the management of patients who are rigid gas permeable (RGP failures as with corneal ectasias such as keratoconus and in those patients who have ocular surface disease such as Stevens-Johnson syndrome (SJS. Aim: To report utilization of BOSP in a tertiary eye care center in India. Materials and Methods: We retrospectively reviewed charts of 32 patients who received BOSP from July 2008 to May 2009. Indications for fitting these lenses, improvement in visual acuity (VA before and after lens fitting and relief of symptoms of pain and photophobia were noted. Paired t-test was used for statistical analysis using SPSS version 16.0 for Windows. Results: Thirty-two patients (43 eyes received these lenses. These consisted of 23 eyes of 17 patients who failed RGP trials for irregular astigmatism and corneal ectasia such as keratoconus and post radial keratotomy and scar and 20 eyes of 15 patients with SJS. Mean age of RGP failures was 27.94 years. Pre- and post-BOSP wear mean LogMAR VA was 1.13 and 0.29, respectively, in RGP failures. The P value was statistically significant (P 2 lines in 7/20 eyes (35% with SJS, with improvement in symptoms. Conclusion: BOSP improves VA in patients who have irregular astigmatism as in ectasias and RGP failures and improves vision and symptoms in patients with SJS.

  17. Metabolic Prosthesis for Oxygenation of Ischemic Tissue

    Energy Technology Data Exchange (ETDEWEB)

    Greenbaum, Elias [ORNL

    2009-01-01

    This communication discloses new ideas and preliminary results on the development of a "metabolic prosthesis" for local oxygenation of ischemic tissue under physiological neutral conditions. We report for the first time the selective electrolysis of physiological saline by repetitively pulsed charge-limited electrolysis for the production of oxygen and suppression of free chlorine. For example, using 800 A amplitude current pulses and <200 sec pulse durations, we demonstrated prompt oxygen production and delayed chlorine production at the surface of a shiny 0.85 mm diameter spherical platinum electrode. The data, interpreted in terms of the ionic structure of the electric double layer, suggest a strategy for in situ production of metabolic oxygen via a new class of "smart" prosthetic implants for dealing with ischemic disease such as diabetic retinopathy. We also present data indicating that drift of the local pH of the oxygenated environment can be held constant using a feedback-controlled three electrode electrolysis system that chooses anode and cathode pair based on pH data provided by local microsensors. The work is discussed in the context of diabetic retinopathy since surgical techniques for multielectrode prosthetic implants aimed at retinal degenerative diseases have been developed.

  18. Finite element modeling of retinal prosthesis mechanics

    Science.gov (United States)

    Basinger, B. C.; Rowley, A. P.; Chen, K.; Humayun, M. S.; Weiland, J. D.

    2009-10-01

    Epiretinal prostheses used to treat degenerative retina diseases apply stimulus via an electrode array fixed to the ganglion cell side of the retina. Mechanical pressure applied by these arrays to the retina, both during initial insertion and throughout chronic use, could cause sufficient retinal damage to reduce the device's effectiveness. In order to understand and minimize potential mechanical damage, we have used finite element analysis to model mechanical interactions between an electrode array and the retina in both acute and chronic loading configurations. Modeling indicates that an acute tacking force distributes stress primarily underneath the tack site and heel edge of the array, while more moderate chronic stresses are distributed more evenly underneath the array. Retinal damage in a canine model chronically implanted with a similar array occurred in correlating locations, and model predictions correlate well with benchtop eyewall compression tests. This model provides retinal prosthesis researchers with a tool to optimize the mechanical electrode array design, but the techniques used here represent a unique effort to combine a modifiable device and soft biological tissues in the same model and those techniques could be extended to other devices that come into mechanical contact with soft neural tissues.

  19. [The treatment of abdominal aortic aneurysms by use of endovascular prosthesis and classic vascular prosthesis].

    Science.gov (United States)

    Pupka, Artur; Szyber, Przemysław P; Janczak, Dariusz; Pawłowski, Stanisław; Szyber, Piotr

    2006-01-01

    The abdominal aortic aneurysm is a dilatation of infrarenal part of aorta. Its ethiology is still unknown. An infection and congenital disorders of conjunctive tissue are regarded as the main risc factors. Other factors could be a perimural thrombus and elastin and colagen degradation. It's not proved that atheromatosis is a risc factor. The disease concerns mainly the old males. Not treated aneurysm grows until rupture. The aneurysms are usually asympthomatic. Majority of them are found incidentally. Ultrasonography and computed tomography are used to extended diagnosis. The open surgery or endovascular surgery are only possible ways of treatment. The aneurysm with diameter over 55 milimeters, sympthomatic or rupted is an indication for surgery. The aim of the open surgery is implantation of the vascular prosthesis into retroperitoneal space. Endovascular method consist in placement of stent-graft in the lumen of aneurysm through small incision in a peripherial vessel. Stent-graft consists of metal chassis covered by classic vascular prosthesis. This method still requires the long-term assessment.

  20. Design and Testing of a Bionic Dancing Prosthesis.

    Directory of Open Access Journals (Sweden)

    Elliott J Rouse

    Full Text Available Traditionally, prosthetic leg research has focused on improving mobility for activities of daily living. Artistic expression such as dance, however, is not a common research topic and consequently prosthetic technology for dance has been severely limited for the disabled. This work focuses on investigating the ankle joint kinetics and kinematics during a Latin-American dance to provide unique motor options for disabled individuals beyond those of daily living. The objective of this study was to develop a control system for a bionic ankle prosthesis that outperforms conventional prostheses when dancing the rumba. The biomechanics of the ankle joint of a non-amputee, professional dancer were acquired for the development of the bionic control system. Subsequently, a professional dancer who received a traumatic transtibial amputation in April 2013 tested the bionic dance prosthesis and a conventional, passive prosthesis for comparison. The ability to provide similar torque-angle behavior of the biological ankle was assessed to quantify the biological realism of the prostheses. The bionic dancing prosthesis overlapped with 37 ± 6% of the non-amputee ankle torque and ankle angle data, compared to 26 ± 2% for the conventional, passive prosthesis, a statistically greater overlap (p = 0.01. This study lays the foundation for quantifying unique, expressive activity modes currently unavailable to individuals with disabilities. Future work will focus on an expansion of the methods and types of dance investigated in this work.

  1. Design and Testing of a Bionic Dancing Prosthesis

    Science.gov (United States)

    Rouse, Elliott J.; Villagaray-Carski, Nathan C.; Emerson, Robert W.; Herr, Hugh M.

    2015-01-01

    Traditionally, prosthetic leg research has focused on improving mobility for activities of daily living. Artistic expression such as dance, however, is not a common research topic and consequently prosthetic technology for dance has been severely limited for the disabled. This work focuses on investigating the ankle joint kinetics and kinematics during a Latin-American dance to provide unique motor options for disabled individuals beyond those of daily living. The objective of this study was to develop a control system for a bionic ankle prosthesis that outperforms conventional prostheses when dancing the rumba. The biomechanics of the ankle joint of a non-amputee, professional dancer were acquired for the development of the bionic control system. Subsequently, a professional dancer who received a traumatic transtibial amputation in April 2013 tested the bionic dance prosthesis and a conventional, passive prosthesis for comparison. The ability to provide similar torque-angle behavior of the biological ankle was assessed to quantify the biological realism of the prostheses. The bionic dancing prosthesis overlapped with 37 ± 6% of the non-amputee ankle torque and ankle angle data, compared to 26 ± 2% for the conventional, passive prosthesis, a statistically greater overlap (p = 0.01). This study lays the foundation for quantifying unique, expressive activity modes currently unavailable to individuals with disabilities. Future work will focus on an expansion of the methods and types of dance investigated in this work. PMID:26285201

  2. [Design and study of carbon fiber tracheal prosthesis].

    Science.gov (United States)

    Qi, L; Liu, D; Han, Z; Wang, F

    1998-12-01

    32 healty adult dogs were selected for this experiment. 10 of them were subjected to the tracheal biomechanics test using indices including the relation between stretcher ratio (lambda) and stress (T), the squeeze stress (delta jy) of medical silk thread on trachea, the side stress (Ts) inducing the tracheal collapse, the functional maximum angle (psi max) of tracheal, and the sever area torsion angle (theta max) of tracheal functional maximum curved. According to the indices measured, two types of tracheal prosthesis were designed, and were made of carbon fiber and silicon. They were the straight tube type tracheal prosthesis and the bifurcate type tracheal prosthesis. The straight tube type tracheal prosthesis was studied with a design of two groups comprising a total of 11 dogs. In the experiment group (n = 6), the outer surface of the tube was not coated with silicon, the average survival period was 379.8 days. In the control group (n = 5), the outer surface of the tube was coated with silicon, the average survival period was 90.4 days. The bifurcate type tracheal prosthesis was studied in 11 dogs, the average survival period was 4.32 days. The main causes of death in the experiment were infection and anastomotic dehiscent.

  3. Estimation of crank angle for cycling with a powered prosthesis.

    Science.gov (United States)

    Lawson, B E; Shultz, A; Ledoux, E; Goldfarb, M

    2014-01-01

    In order for a prosthesis to restore power generation during cycling, it must supply torque in a manner that is coordinated with the motion of the bicycle crank. This paper outlines an algorithm for the real time estimation of the angular position of a bicycle crankshaft using only measurements internal to an intelligent knee and ankle prosthesis. The algorithm assumes that the rider/prosthesis/bicycle system can be modeled as a four-bar mechanism. Assuming that a prosthesis can generate two independent angular measurements of the mechanism (in this case the knee angle and the absolute orientation of the shank), Freudenstein's equation can be used to synthesize the mechanism continuously. A recursive least-squares algorithm is implemented to estimate the Freudenstein coefficients, and the resulting link lengths are used to reformulate the equation in terms of input-output relationships mapping both measured angles to the crank angle. Using two independent measurements allows the algorithm to uniquely determine the crank angle from multi-valued functions. In order to validate the algorithm, a bicycle was mounted on a trainer and configured with the prosthesis using an artificial hip joint attached to the seat post. Motion capture was used to monitor the mechanism for forward and backward pedaling and the results are compared to the output of the presented algorithm. Once the parameters have converged, the algorithm is shown to predict the crank angle within 15° of the externally measured value throughout the entire crank cycle during forward rotation.

  4. Design and Testing of a Bionic Dancing Prosthesis.

    Science.gov (United States)

    Rouse, Elliott J; Villagaray-Carski, Nathan C; Emerson, Robert W; Herr, Hugh M

    2015-01-01

    Traditionally, prosthetic leg research has focused on improving mobility for activities of daily living. Artistic expression such as dance, however, is not a common research topic and consequently prosthetic technology for dance has been severely limited for the disabled. This work focuses on investigating the ankle joint kinetics and kinematics during a Latin-American dance to provide unique motor options for disabled individuals beyond those of daily living. The objective of this study was to develop a control system for a bionic ankle prosthesis that outperforms conventional prostheses when dancing the rumba. The biomechanics of the ankle joint of a non-amputee, professional dancer were acquired for the development of the bionic control system. Subsequently, a professional dancer who received a traumatic transtibial amputation in April 2013 tested the bionic dance prosthesis and a conventional, passive prosthesis for comparison. The ability to provide similar torque-angle behavior of the biological ankle was assessed to quantify the biological realism of the prostheses. The bionic dancing prosthesis overlapped with 37 ± 6% of the non-amputee ankle torque and ankle angle data, compared to 26 ± 2% for the conventional, passive prosthesis, a statistically greater overlap (p = 0.01). This study lays the foundation for quantifying unique, expressive activity modes currently unavailable to individuals with disabilities. Future work will focus on an expansion of the methods and types of dance investigated in this work.

  5. Correlation analysis between the interface membrane and loose hip prosthesis

    Institute of Scientific and Technical Information of China (English)

    Jian-bing Ma; Yu-ming Zhang; Xiang-dong Meng; Miao Liu

    2009-01-01

    Objective To analyze the cause of prosthesis loosening by observing the interface membranes harvested during the hip restoration operation. Methods A total of 28 specimens of interface membrane around the loose prosthesis were harvested from 28 patients undergoing the restoration of total hip replacement. All the specimens underwent the observation of appearance, light microscopy and scanning electronic microscopy(SEM). Results All the gaps around the loose prosthesis were filled with interface membrane of different thickness. The color of the most interface membrane was madder red, and the other one third of membrane was black. The comparatively thicker membrane was similar to scar connective tissue while the thinner was similar to fiber membrane. A large number of wear debris, macrophages and foreign-body giant cells were found under light microscope. With SEM observation a large number of different diameter collagen fibra structures that looked like scar tissues were arranged disorderly in a great mass, foreign particles and bone debris of different size were distributed unevenly, and the fibroblast was distributed in the collagen fiber. Conclusion Wear debris is related to inflammatory cell response around the interface membrane of the loose prosthesis. The wear debris engulfed by macrophage stimulates the interface membrane to release bone resorption factors (such as TNF) which lead to osteolysis, and this is one of the most important causes of the prosthesis loosening.

  6. A digital patient for computer-aided prosthesis design.

    Science.gov (United States)

    Colombo, Giorgio; Facoetti, Giancarlo; Rizzi, Caterina

    2013-04-06

    This article concerns the design of lower limb prosthesis, both below and above knee. It describes a new computer-based design framework and a digital model of the patient around which the prosthesis is designed and tested in a completely virtual environment. The virtual model of the patient is the backbone of the whole system, and it is based on a biomechanical general-purpose model customized with the patient's characteristics (e.g. anthropometric measures). The software platform adopts computer-aided and knowledge-guided approaches with the goal of replacing the current development process, mainly hand made, with a virtual one. It provides the prosthetics with a set of tools to design, configure and test the prosthesis and comprehends two main environments: the prosthesis modelling laboratory and the virtual testing laboratory. The first permits the three-dimensional model of the prosthesis to be configured and generated, while the second allows the prosthetics to virtually set up the artificial leg and simulate the patient's postures and movements, validating its functionality and configuration. General architecture and modelling/simulation tools for the platform are described as well as main aspects and results of the experimentation.

  7. Split-Framework in Mandibular Implant-Supported Prosthesis

    Directory of Open Access Journals (Sweden)

    Danny Omar Mendoza Marin

    2015-01-01

    Full Text Available During oral rehabilitation of an edentulous patient with an implant-supported prosthesis, mandibular flexure must be considered an important biomechanical factor when planning the metal framework design, especially if implants are installed posterior to the interforaminal region. When an edentulous mandible is restored with a fixed implant-supported prosthesis connected by a fixed full-arch framework, mandibular flexure may cause needless stress in the overall restorative system and lead to screw loosening, poor fit of prosthesis, loss of the posterior implant, and patient’s discomfort due to deformation properties of the mandible during functional movements. The use of a split-framework could decrease the stress with a precise and passive fit on the implants and restore a more natural functional condition of the mandible, helping in the longevity of the prosthesis. Therefore, the present clinical report describes the oral rehabilitation of an edentulous patient by a mandibular fixed implant-supported prosthesis with a split-framework to compensate for mandibular flexure. Clinical Significance. The present clinical report shows that the use of a split-framework reduced the risk of loss of the posterior implants or screws loosening with acceptable patient comfort over the period of a year. The split-framework might have compensated for the mandibular flexure during functional activities.

  8. Patellar Tendinitis

    Science.gov (United States)

    ... tendons and make them more likely to rupture. Platelet-rich plasma injection. This type of injection has been tried ... Joint Diseases. 2014;72:217. AskMayoExpert. When are platelet-rich plasma (PRP) peripheral injections indicated for tendinopathy? Rochester, Minn.: ...

  9. Maxillary cement retained implant supported monolithic zirconia prosthesis in a full mouth rehabilitation: a clinical report

    OpenAIRE

    Sadid-Zadeh, Ramtin; Liu, Perng-Ru; Aponte-Wesson, Ruth; O'Neal, Sandra J

    2013-01-01

    This clinical report presents the reconstruction of a maxillary arch with a cement retained implant supported fixed prosthesis using a monolithic zirconia generated by CAD/CAM system on eight osseointegrated implants. The prosthesis was copy milled from an interim prosthesis minimizing occlusal adjustments on the definitive prosthesis at the time of delivery. Monolithic zirconia provides high esthetics and reduces the number of metal alloys used in the oral cavity.

  10. Maxillary cement retained implant supported monolithic zirconia prosthesis in a full mouth rehabilitation: a clinical report.

    Science.gov (United States)

    Sadid-Zadeh, Ramtin; Liu, Perng-Ru; Aponte-Wesson, Ruth; O'Neal, Sandra J

    2013-05-01

    This clinical report presents the reconstruction of a maxillary arch with a cement retained implant supported fixed prosthesis using a monolithic zirconia generated by CAD/CAM system on eight osseointegrated implants. The prosthesis was copy milled from an interim prosthesis minimizing occlusal adjustments on the definitive prosthesis at the time of delivery. Monolithic zirconia provides high esthetics and reduces the number of metal alloys used in the oral cavity.

  11. 21 CFR 888.3100 - Ankle joint metal/composite semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3100 Section 888.3100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Ankle joint metal/composite semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/composite semi-constrained cemented prosthesis is a device intended to be implanted to replace...

  12. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3400 Section 888.3400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic resurfacing prosthesis is a device intended to be implanted to replace a portion of the hip...

  13. 21 CFR 888.3790 - Wrist joint metal constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint metal constrained cemented prosthesis... constrained cemented prosthesis. (a) Identification. A wrist joint metal constrained cemented prosthesis is a... as cobalt-chromium-molybdenum, and is limited to those prostheses intended for use with bone...

  14. 21 CFR 888.3170 - Elbow joint radial (hemi-elbow) polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Elbow joint radial (hemi-elbow) polymer prosthesis... (hemi-elbow) polymer prosthesis. (a) Identification. An elbow joint radial (hemi-elbow) polymer prosthesis is a device intended to be implanted made of medical grade silicone elastomer used to replace...

  15. 21 CFR 888.3220 - Finger joint metal/polymer constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3220 Section 888.3220 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... metal/polymer constrained cemented prosthesis. (a) Identification. A finger joint metal/polymer constrained cemented prosthesis is a device intended to be implanted to replace a metacarpophalangeal...

  16. 21 CFR 888.3690 - Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented prosthesis. 888.3690 Section 888.3690 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis is a device made of alloys, such as...

  17. 21 CFR 888.3210 - Finger joint metal/metal constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3210 Section 888.3210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... metal/metal constrained cemented prosthesis. (a) Identification. A finger joint metal/metal constrained cemented prosthesis is a device intended to be implanted to replace a metacarpophalangeal (finger)...

  18. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3370 Section 888.3370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip) acetabular metal cemented prosthesis is a device intended to be implanted to replace a portion of the hip...

  19. 21 CFR 888.3350 - Hip joint metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3350 Section 888.3350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... metal/polymer semi-constrained cemented prosthesis. (a) Identification. A hip joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a hip joint. The device...

  20. 21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal scaphoid polymer prosthesis. 888.3760 Section 888.3760 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... scaphoid polymer prosthesis. (a) Identification. A wrist joint carpal scaphoid polymer prosthesis is a...

  1. 21 CFR 888.3800 - Wrist joint metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3800 Section 888.3800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Wrist joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A wrist joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a wrist...

  2. 21 CFR 888.3300 - Hip joint metal constrained cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3300 Section 888.3300 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... metal constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal constrained cemented or uncemented prosthesis is a device intended to be implanted to replace a hip joint. The...

  3. 21 CFR 888.3770 - Wrist joint carpal trapezium polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal trapezium polymer prosthesis. 888.3770 Section 888.3770 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... trapezium polymer prosthesis. (a) Identification. A wrist joint carpal trapezium polymer prosthesis is a...

  4. 21 CFR 888.3750 - Wrist joint carpal lunate polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal lunate polymer prosthesis. 888.3750 Section 888.3750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... lunate polymer prosthesis. (a) Identification. A wrist joint carpal lunate prosthesis is a...

  5. 21 CFR 888.3340 - Hip joint metal/composite semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3340 Section 888.3340 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Hip joint metal/composite semi-constrained cemented prosthesis. (a) Identification. A hip joint metal/composite semi-constrained cemented prosthesis is a two-part device intended to be implanted to replace...

  6. 21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3110 Section 888.3110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Ankle joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

  7. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented prosthesis. 888.3360 Section 888.3360 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  8. 21 CFR 888.3680 - Shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3680 Section 888.3680 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis. (a) Identification. A shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis is a device that has a glenoid (socket)...

  9. 21 CFR 888.3160 - Elbow joint metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3160 Section 888.3160 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Elbow joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An elbow joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

  10. 21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented prosthesis. 888.3180 Section 888.3180 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis. (a) Identification. An elbow joint humeral (hemi-elbow) metallic uncemented prosthesis is a device intended to be implanted made of...

  11. 21 CFR 888.3120 - Ankle joint metal/polymer non-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3120 Section 888.3120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... metal/polymer non-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer non-constrained cemented prosthesis is a device intended to be implanted to replace an ankle joint. The...

  12. 21 CFR 888.3660 - Shoulder joint metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3660 Section 888.3660 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Shoulder joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A shoulder joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace...

  13. 21 CFR 888.3200 - Finger joint metal/metal constrained uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3200 Section 888.3200 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... metal/metal constrained uncemented prosthesis. (a) Identification. A finger joint metal/metal constrained uncemented prosthesis is a device intended to be implanted to replace a metacarpophalangeal...

  14. 78 FR 79308 - Dental Devices; Reclassification of Temporary Mandibular Condyle Prosthesis

    Science.gov (United States)

    2013-12-30

    ... Temporary Mandibular Condyle Prosthesis AGENCY: Food and Drug Administration, HHS. ACTION: Final order... mandibular condyle prosthesis, a preamendments class III device, into class II (special controls), and rename... section 513(b) of the FD&C Act with respect to temporary mandibular condyle prosthesis (the 1997...

  15. 21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented prosthesis. 888.3310 Section 888.3310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal/polymer constrained cemented or uncemented prosthesis is a device intended to be implanted...

  16. Changes in performance over time while learning to use a myoelectric prosthesis

    NARCIS (Netherlands)

    Bouwsema, Hanneke; van der Sluis, Corry K.; Bongers, Raoul M.

    2014-01-01

    Background: Training increases the functional use of an upper limb prosthesis, but little is known about how people learn to use their prosthesis. The aim of this study was to describe the changes in performance with an upper limb myoelectric prosthesis during practice. The results provide a basis t

  17. A short-term study in sheep with the Groningen temporomandibular joint prosthesis

    NARCIS (Netherlands)

    van Loon, JP; de Bont, LGM; Spijkervet, FKL; Verkerke, GJ; Liem, RSB

    2000-01-01

    As part of the pre-clinical testing process of a newly developed temporomandibular joint (TMJ) prosthesis, animal experiments were performed. In 14 sheep, the right TMJ was replaced by the developed TMJ prosthesis. The prosthesis consisted of a skull part, a mandibular part and an intervening polyet

  18. Patellar position in weight-bearing radiographs compared with non-weight-bearing: significance for the detection of osteoarthritis.

    Science.gov (United States)

    Skou, Nikolaj; Egund, Niels

    2017-03-01

    Background Diagnosis and treatment of patellofemoral disorders including osteoarthritis are currently often based on imaging and clinical assessment with patients in the supine position. Purpose To evaluate differences in patellar position in the trochlear groove and to assess the detection of medial and lateral patellofemoral (PF) osteoarthritis (OA) on axial radiographs in supine and standing positions, respectively. Material and Methods Thirty-five women and 23 men (mean age, 56 years; age range, 18-87 years) referred for routine radiographic examinations of the knees were included. Axial radiographs of the PF joint in both supine non-weight-bearing and standing weight-bearing position in 30° knee flexion were obtained of 111 knees. Measurements performed on the radiographs: patellar tilt, patellar displacement, joint space width, and grade of OA according to Ahlbäck. Results From supine to standing position the patella moved medially and medial joint space width and lateral patellar tilt angle decreased ( P < 0.0001 for the three measured parameters). In the standing position, medial PF OA was observed in 19 knees compared to three knees in the supine position. Fourteen knees had lateral PF OA with almost unchanged grade of OA irrespective of position. Conclusion In weight-bearing positions, the patella is positioned medially in the trochlear groove compared to supine non-weight-bearing positions. Therefore, this study suggests that the common occurrence of medial PF OA can generally not be detected on axial radiographs in supine non-weight-bearing positions and confirms the importance of imaging the PF joint in standing weight-bearing positions.

  19. Increased serum cartilage oligomeric matrix protein levels and decreased patellar bone mineral density in patients with chondromalacia patellae.

    OpenAIRE

    2002-01-01

    BACKGROUND: Chondromalacia patellae is a potentially disabling disorder characterised by features of patellar cartilage degradation. OBJECTIVE: To evaluate markers of cartilage and bone turnover in patients with chondromalacia patellae. METHODS: 18 patients with chondromalacia patellae were studied. Serum cartilage oligomeric matrix protein (s-COMP) and bone sialoprotein (s-BSP) levels were measured by enzyme linked immunosorbent assay (ELISA) and compared with those of age and sex matched he...

  20. Research, design & development project Myoelectric Prosthesis of Upper Limb

    Science.gov (United States)

    Galiano, L.; Montaner, E.; Flecha, A.

    2007-11-01

    A Research Design and Development Project was developed of a myoelectric prosthesis for a pediatric patient presenting congenital amputation of the left forearm below the elbow. A multidisciplinary work-team was formed for this goal, in order to solve the several (/various) aspects regarding this project (mechanical, ergonomics, electronics, physical). The prosthesis as an electromechanical device was divided in several blocks, trying to achieve a focused development for each stage, acording to requisites. A mechanical prototype of the prothesis was designed and built along with the circuitry needed for EMG aquisition, control logic and drivers. Having acomplished the previuos stages, the project is now dealing with the definitions of the interface between the prosthesis and the patient, with promising perspectives.

  1. Preliminary functional assessment of a multigrasp myoelectric prosthesis.

    Science.gov (United States)

    Dalley, Skyler A; Bennett, Daniel A; Goldfarb, Michael

    2012-01-01

    The authors have previously described a multigrasp hand prosthesis prototype, and a two-site surface EMG based multigrasp control interface for its control. In this paper, the authors present a preliminary assessment of the efficacy of the prosthesis and multigrasp controller in performing tasks requiring interaction and manipulation. The authors use as a performance measure the Southampton Hand Assessment Procedure (SHAP), which entails manipulation of various objects designed to emulate activities of daily living, and provides a set of scores that indicate level of functionality in various types of hand function. In this preliminary assessment, a single non-amputee subject performed the SHAP while wearing the multigrasp prosthesis via an able-bodied adaptor. The results from this testing are presented, and compared to recently published SHAP results obtained with commercially available single-grasp and multigrasp prosthetic hands.

  2. Nasal prosthesis for a patient with xeroderma pigmentosum

    Science.gov (United States)

    Kumar, Suresh; Rajtilak, G.; Rajasekar, V.; Kumar, Muthu

    2013-01-01

    Acquired facial defects caused by extirpation of neoplasms, congenital malformations or traumatic injury results in a huge functional, cosmetic and psychological handicap in those patients. These defects can be restored by facial prosthesis using different materials and retention methods to achieve a lifelike appearance and function. This clinical report describes a treatment schedule using silicone nasal prosthesis, which is mechanically retained for a patient who has undergone a partial rhinectomy due to basal cell carcinoma of the nose. The prosthesis was made to restore the esthetic appearance of patient with a mechanically retained design using a spectacle glass frame without any prosthetic adhesives so that the patient is more comfortable and confident to resume daily activities. PMID:23956602

  3. Komposit Laminate Rami Epoksi Sebagai Bahan Alternatif Socket Prosthesis

    Directory of Open Access Journals (Sweden)

    Agustinus P. Irawan

    2009-01-01

    Full Text Available pure plant oil, biofuel, coconut oil, palm oil, jatropha oilSocket is the most important component in a prosthesis making. Performance criteria for prosthetic socket material include strength, durability, minimal weight, comfort, and minimal fabrication cost. This research attempts to analyze the strength of ramie fiber reinforced epoxy laminate composite as an alternative of socket prosthesis. The research based on ASTM D 3039/D 3039M for tensile strength and ASTM D 695 for compressive strength. The ramie fiber used was a continuous fiber 100 % Ne14'S, with Epoxy Resin Bakelite EPR 174 and Epoxy Hardener V-140. The sample test was created using a hand lay-up method. The result of this research is presented in a correlation of finsile strength (st, compression strength (sc, elasticity modulus (E versus fraction volume of fiber (Vf. The result is then being compared with some of the prosthesis material’s strength produced by Otto Bock. The analysis was completed with the mode of the failure observation by using Scanning Electron Microscope (SEM. The result concludes that the ramie fiber reinforced epoxy laminate composite is potentially developed further as a socket prosthesis material on Vf 40 – 50 %. Tensile strength and specific strength that has been generated was higher than that of several materias for socket prosthesis, including fiberglass. The mode of the failure found were a brittle failure on Vf: 10-30%, debonding and delamination on Vf: 40-50%. Abstract in Bahasa Indonesia: Socket merupakan bagian terpenting dalam pembuatan prosthesis. Kriteria bahan socket prosthesis antara lain kekuatan, ketahanan, ringan, kenyamanan dan biaya produksi yang rendah. Penelitian ini bertujuan menganalisis kekuatan komposit laminate berpenguat serat rami epoksi sebagai bahan alternatif socket prosthesis. Pengujian kekuatan mengacu standar ASTM D 3039/D 3039M uji tarik dan ASTM D 695 uji tekan. Serat rami yang digunakan berupa serat kontinyu jenis

  4. [Tests of hand functionality in upper limb amputation with prosthesis].

    Science.gov (United States)

    Bazzini, G; Orlandini, D; Moscato, T A; Nicita, D; Panigazzi, M

    2007-01-01

    The need for standardized instruments for clinical measurements has become pressing in the fields of occupational rehabilitation and ergonomics. This is particularly the case for instruments that allow a quantitative evaluation of upper limb function, and especially hand function in patients who have undergone an amputation and then application of an upper limb prosthesis. This study presents a review of the main tests used to evaluate hand function, with a critical analysis of their use in subjects with an upper limb prosthesis. The tests are divided into: tests to evaluate strength, tests to evaluate co-ordination and dexterity, tests of global or overall function, and tests proposed specifically for subjects with an upper limb prosthesis. Of the various tests presented, the authors give their preference to the Bimanual Functional Assessment, Abilhand and/or the ADL Questionnaire, because of the practical usefulness, clinimetric features, simplicity and ease of administration of these tests.

  5. An electronic prosthesis mimicking the dynamic vestibular function

    Science.gov (United States)

    Shkel, Andrei M.

    2006-03-01

    This paper reports our progress toward development of a unilateral vestibular prosthesis. The sensing element of the prosthesis is a custom designed one-axis MEMS gyroscope. Similarly to the natural semicircular canal, the microscopic gyroscope senses angular motion of the head and generates voltages proportional to the corresponding angular accelerations. Then, voltages are sent to the pulse generating unit where angular motion is translated into voltage pulses. The voltage pulses are converted into current pulses and are delivered through specially designed electrodes, conditioned to stimulate the corresponding vestibular nerve branch. Our preliminary experimental evaluations of the prosthesis on a rate table indicate that the device's output matches the average firing rate of vestibular neurons to those in animal models reported in the literature. The proposed design is scalable; the sensing unit, pulse generator, and the current source can be potentially implemented on a single chip using integrated MEMS technology.

  6. Comparison of Titanium vs. Polycel Total Ossicular Replacement Prosthesis

    Directory of Open Access Journals (Sweden)

    Mohammad Faramarzi

    2016-01-01

    Full Text Available Introduction: Even though modern technology progresses so rapidly, annals of otology are replete with so many challenging article, which often compare various types of prosthesis. Since there has not been a prospective randomized clinical trial study which compares the hearing result of total ossicular replacement prosthesis made of Titanium with omega connector and Polycel in the literature, we decided to perform a study encompassing this issue.   Materials and Methods: 105 patients, who were in the 2nd stage of their operation and who needed total ossicular replacement prosthesis, were included in this prospective single blind randomized clinical trial study. Patients were classified in two groups: titanium Kurz (TTP™ -Vario system, Kurz GmbH, Dusslingen, Germany with omega connector and Polycel (Sheehy Plastipore Polycel, Medtronic Xomed Inc. The duration of the follow up was 6-12 months. In order to evaluate hearing results, pure tone audiometric in 0.5, 1, 2, and 4 kHz were checked. In addition, speech reception threshold was recorded. A successful surgery was defined as having a postoperative air–bone gap within 20 dB.   Results: We accomplished successful hearing in 64.4% of patients with titanium and 65% of patients with a Polycel prosthesis.Improvement in speech reception threshold was 11.5 dB in the titanium group and 13 dB in the Polycel group. In other words, there was no significant difference between the two groups. In addition, air-bone gap improvement after ossiculoplasty was 11.2 dB in the patients with a titanium prosthesis and 12.4 dB in the Polycel group. In fact, the difference was not significant.   Conclusion: We found that both the titanium and the Polycel prosthesis improve speech reception threshold and air-bone gap closure in a similar manner.

  7. Circumferential electrocautery of the patella in primary total knee replacement without patellar replacement: a meta-analysis and systematic review

    Science.gov (United States)

    Fan, Lihong; Ge, Zhaogang; Zhang, Chen; Li, Jia; Yu, Zefeng; Dang, Xiaoqian; Wang, Kunzheng

    2015-03-01

    The purpose of this meta-analysis and systematic review was to identify and assess whether circumferential electrocautery is useful for improving outcomes after primary total knee replacement(TKR). We searched MEDLINE, EMBASE, PubMed, SpringerLink, Web of Knowledge, OVID CINAHL, OVID EBM and Google Scholar and included articles published through January 2014. A total of 6 articles met the inclusion criteria. Of the 776 cases included in the analysis, 388 cases involved patellar denervation, and 388 cases were designated as the control group. The meta-analysis revealed no significant difference in the incidence of anterior knee pain (AKP, p = 0.18) or in the visual analogue scale score (VAS, p = 0.23) between the two groups. In addition, AKSS Function Score indicated no significant difference between the two groups (p = 0.28). However, the OKS (p = 0.02), patellar score (p = 0.01), AKSS-Knee Score (p = 0.004), range of motion (ROM, p < 0.0001) and WOMAC Score (p = 0.0003) indicated that circumpatellarelectrocautery improved clinical outcomes compared with non-electrocautery. The results indicate that circumferential electrocautery of the patella does not significantly improve AKP compared with non-electrocautery techniques but that circumferential electrocautery significantly improves patients' knee function after surgery. Therefore, we believe that circumferential electrocautery is beneficial to the outcome of primary TKR surgery without patellar replacement.

  8. Long-Term Follow-Up of Nonoperatively and Operatively Treated Acute Primary Patellar Dislocation in Skeletally Immature Patients

    Directory of Open Access Journals (Sweden)

    Eva Bengtsson Moström

    2014-01-01

    Full Text Available Purpose. The present study reports a long-term follow-up of acute primary patellar dislocation in patients with open physes. The purpose of the study was to evaluate knee function and recurrence rates after surgical and nonsurgical treatment of patellar dislocation. Methods. A total of 51 patients, including 29 girls and 22 boys, who were 9–14 years of age at the time of injury, were retrospectively evaluated. The minimum follow-up time was 5 years. Thigh muscle torque, range of motion, the squat test, the knee injury and osteoarthritis outcome score (KOOS, the Kujala score, and the recurrence rate were registered. Radiological predisposing factors at the time of injury were determined. Results. Quality of life and sports/recreation were the most affected subscales, according to KOOS, and a reduced Kujala score was also observed in all treatment groups. The surgically treated patients had a significantly lower recurrence rate. Those patients also exhibited reduced muscle performance, with a hamstring to quadriceps ratio (H/Q of 1.03. The recurrence rate was not correlated with knee function. Conclusions. Patellar dislocation in children influences subjective knee function in the long term. Surgery appears to reduce the recurrence rate, but subjective knee function was not restored.

  9. Anterior cruciate ligament reconstruction with fresh-frozen patellar tendon allografts: sixty cases with 2 years' minimum follow-up.

    Science.gov (United States)

    Nín, J R; Leyes, M; Schweitzer, D

    1996-01-01

    A prospective study was performed on 101 patients who underwent an arthroscopic anterior cruciate ligament (ACL) reconstruction with fresh-frozen patellar tendon allograft (bone-patellar tendon-bone). We present the results of the first 60 patients with a minimum follow-up of 2 years. Thirty-four were men and 26 women with a mean age of 23. In 45 patients, a postoperative arthroscopy was performed, and tissue biopsies of the reconstructed ACL were obtained. Patients were evaluated according to the International Knee Documentation Committee evaluation form. After a mean follow-up of 47 months, the overall results were normal or nearly normal in 85%. Under postoperative arthroscopy, the macroscopic appearance of the implant was similar to that of a normal ligament. The ACL allograft was covered with a normal, well-vascularized synovium. There were no cases of infection, disease transmission or tissue rejection. We conclude that the use of fresh-frozen patellar tendon allografts is a good method of ACL reconstruction.

  10. Simultaneous reconstruction of anterior cruciate ligament and posterior cruciate ligament by using allogeneic patellar tendon under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    ZHOU Li-ping; ZHEN Min-qing; XU Zhong-he

    2005-01-01

    Objective: To evaluate operative effects of a new method to reconstruct anterior crucial ligament (ACL) and posterior crucial ligament (PCL) simultaneously by using patellar tendon under arthroscopy.Methods: From November 1999 to November 2003,the injured ACL and PCL of 11 patients were fixated with compressed screws and reconstructed under arthroscopy with the bone-patellar tendon-bone treated with deep hypothermia and T radiation. At the same time, 2 patients were treated with medial collateral ligament (MCL)reconstruction, 3 with lateral collateral ligament (LCL)reconstruction, 1 with meniscus suture and 4 with whole or partial resection.Results: All patients were followed up for 12-26months (average 16.5 months ). The Lysholm score method was employed to evaluate the knee function. The average preoperative score was 45.3 and the postoperative score was 86.4. Anterior drawer test (ADT) was positive in 11 knees preoperatively and feeble positive in one knee postoperatively. Lachman test was positive in 11 knees preoperatively and in one postoperatively, and feebly positive in two postoperatively. Posterior drawer test was positive in 11 knees preoperatively and feebly positive in 2postoperatively. There were 2 knees with tolerable pain and 2 with knee flexion of 5°-20°.Conclusions: As for simultaneous reconstruction of ACL and PCL under arthroscopy, ailogeneic bone-patellar tendon-bone can not only avoid injury and complication caused by autografting, but also help rehabilitation of the knee function.

  11. [Ankle joint prosthesis for bone defects].

    Science.gov (United States)

    Lampert, C

    2011-11-01

    Large defects of the talus, i.e. due to tumors, large areas of osteolysis in total ankle replacement (TAR) and posttraumatic talus body necrosis are difficult to manage. The gold standard in these circumstances is still tibiocalcaneal arthrodesis with all the negative aspects of a completely rigid hindfoot. We started 10 years ago to replace the talus by a custom-made, all cobalt-chrome implant (laser sintering). The first patient with a giant cell tumor did very well but the following patients showed all subsidence of the metal talus into the tibia due to missing bony edges. Therefore, we constructed a custom-made talus (mirrored from the healthy side) and combined it with a well functioning total ankle prosthesis (Hintegra). So far we have implanted this custom-made implant into 3 patients: the first had a chondrosarcoma of the talus (1 year follow-up), the second had massive osteolysis/necrosis of unknown origin (6 months follow-up) and the third massive osteolysis following a correct TAR (2 months follow-up). The results are very encouraging as all of the patients are practically pain free and have a good range of movement (ROM): D-P flexion 15°-0-20° but less motion in the lower ankle joint: ROM P-S 5°-0-5°. No subsidence was detected in the tibia or the calcaneus. The custom-made talus combined with the Hintegra total ankle replacement will probably be an interesting alternative to a tibiocalcaneal arthrodesis in selected cases with massive defects of the talus.

  12. Heterotopic ossification associated with myelopathy following cervical disc prosthesis implantation.

    Science.gov (United States)

    Wenger, Markus; Markwalder, Thomas-Marc

    2016-04-01

    This case report presents a 37-year-old man with clinical signs of myelopathy almost 9 years after implantation of a Bryan disc prosthesis (Medtronic Sofamor Danek, Memphis, TN, USA) for C5/C6 soft disc herniation. As demonstrated on MRI and CT scan, spinal cord compression was caused by bony spurs due to heterotopic ossification posterior to the still moving prosthesis. The device, as well as the ectopic bone deposits, had to be removed because of myelopathy and its imminent aggravation. Conversion to anterior spondylodesis was performed.

  13. Improving esthetics of finger prosthesis by glove silicone

    Directory of Open Access Journals (Sweden)

    Laxman Singh Kaira

    2014-01-01

    Full Text Available Finger and partial finger amputations are some of the most frequently encountered forms of partial hand loss. A high quality esthetic prosthesis with passive function can be helpful to the patient since loss or congenital absence or malformation have both a social and psychological impact on the patient. Prosthetics is an art and science, which provides lifelike appearance to the lost structures of the patient. This case report presents the fabrication of a silicone finger prosthesis, which had good suspension, adequate function, was comfortable to use and esthetically acceptable to the patient.

  14. [Prosthetic treatment of mandibular pseudarthrosis using an articulated prosthesis].

    Science.gov (United States)

    Sidibe, C A; Razouk, O; Dichamp, J; Bertrand, J C; Vaillant, J M

    1994-01-01

    Two cases with complete loss of the tooth-bearing portion of the mandible were repaired with a prosthesis. This type of defect can involve the loss of a large number of teeth and aggression to the remaining teeth must be limited as much as possible. A two-part "articulated" prosthesis with two rings appears to be the best adapted system. This method takes into account the requirements of for additional conventional prostheses and thus makes it possible to save the remaining teeth.

  15. Design and characterization of a powered elbow prosthesis.

    Science.gov (United States)

    Bennett, Daniel A; Mitchell, Jason; Goldfarb, Michael

    2015-01-01

    This paper describes the design of a powered elbow prosthesis, which incorporates a belt and cable drive transmission with a brushless DC motor to achieve an output torque of approximately 18.4 Nm, a backdrive torque of 1.5 Nm, and a speed of up to 360 deg/s while remaining within the anthropomorphic envelope with regard to mass and size. The measured torque and speed of the prosthesis is commensurate with nominal capability of the natural limb (for purposes of performing activities of daily living).

  16. Aspiration of tracheoesophageal prosthesis in a laryngectomized patient

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    Conte Sergio C

    2012-08-01

    Full Text Available Abstract Background The voice prosthesis inserted into a tracheoesophageal fistula has become the most widely used device for voice rehabilitation in patients with total laryngectomy. Case presentation We describe a case of tracheoesophageal prosthesis’ (TEP aspiration in a laryngectomized patient, with permanent tracheal stoma, that appeared during standard cleaning procedure, despite a programme of training for the safe management of patients with voice prosthesis. Conclusions The definitive diagnosis and treatment were performed by flexible bronchoscopy, that may be considered the procedure of choice in these cases, also on the basis of the literature.

  17. Changes in oral health related knowledge, attitudes and behaviours following school based oral health education and atraumatic restorative treatment in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Anne Nordrehaug Åstrøm

    2012-05-01

    Full Text Available Objectives: The following questions were addressed; to what extent is sugar consumption, tooth brushing, and oral health related attitudes and knowledge subject to change following a combined atraumatic restorative treatment (ART /oral health education (OHE program? Are changes in intended sugar avoidance associated with changes in cognitions as specified by the Theory of Planned Behaviour (TPB? Are changes in oral health related knowledge associated with changes in attitudes and oral health behaviour?Method: A total of 1306 (follow-up prevalence 73.8% primary school students in Kilwa, Tanzania completed interviews before and after a combined ART/OHE program. Post intervention at 6 months follow-up assessed changes in oral health related knowledge, attitudes, and behaviours. Complete baseline and follow-up interviews were obtained from 221 and 1085 students who received ART/OHE and OHE only at schools, respectively.Results: Improvement was obtained with attitudes towards sugar avoidance, knowledge, and tooth brushing (effect sizes in the range 0.1-0.3. Within individual changes did not differ significantly between students receiving ART/ OHE and OHE only. Change scores of intended sugar avoidance associated in the expected direction with changes in sugar consumption. Attitudes and norms with respect to sugar avoidance deteriorated and improved among subjects who respectively decreased and increased intended sugar avoidance. Tooth brushing increased in students who improved oral knowledge.Conclusion: School based ART/OHE improved pupils’ tooth brushing, knowledge, and attitudes, but had no effect on sugar consumption. This study provided support for the validity of the TPB in predicting changes in intended sugar avoidance and reported sugar intake.

  18. A new atraumatic method of removing fractured palatal root using endodontic H-files luted with resin modified glass ionomercement: A pilot study

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    V Sadesh Kannan

    2014-01-01

    Full Text Available Purpose: The purpose of this study is to evaluate the efficacy of using endodontic H-files luted with Resin modified glass ionomer cement (RMGIC in removing fractured palatal root. Materials and Methods: This study consists of 30 patients, of which 16 were males and 14 were females with a mean age of 36 years. In which, 19 were maxillary first molar and 11 were maxillary second molar. In that, 18 were fractured at the level of apical 1/3 rd and 12 were at the level of apical 2/3 rd . All cases were first tried with endodontic H-files, within few attempts, it was wedged tightly in the remaining pulp chamber with one or two clockwise direction and using sudden jerk with a downward pull the remnant part was removed. The cases, which fail to deliver after several attempts were taken up for study. After sufficient isolation with a rubber dam and the socket was dried using sterile gauze, under good lighting and vision again the same file was introduced, which was now luted with RMGIC, after 5 min of setting time, the same attempt using sudden jerk with a downward pull was given. Results: In those 30 cases, 20 cases were removed in the first few attempts using endodontic H-files. The 10 cases (7 cases were apical 2/3 rd and 3 cases were of apical 1/3 rd , which fails to come out were tried using endodontic H-files luted with RMGIC, in which 9 cases were successfully removed (90% and 1 case of apical 1/3 rd was again failed to come out. Conclusion: Even though, the number of cases were too small to come to a definitive conclusion, the encouraging result (90% and technically easy, this is a novel method of removing fractured palatal root atraumatically and devoid of any complication.

  19. Penile prosthesis implantation in the era of medical treatment for erectile dysfunction.

    Science.gov (United States)

    Montague, Drogo K

    2011-05-01

    Penile prosthesis implantation, the oldest of the modern treatments for erectile dysfunction (ED), still plays an important role despite the advent of less invasive alternatives. For some men with ED, penile prosthesis implantation is the only effective or acceptable treatment. Penile prosthesis implantation remains a viable option in the contemporary management of ED as evidenced by annual penile prosthesis implantation cases in the United States rising from 17,540 in 2000 to 22,420 in 2009. Improvements in prosthesis design and implantation techniques have resulted in significant increases in device survival and patient satisfaction.

  20. Percutaneous Revision of a Testicular Prosthesis is Safe, Cost-effective, and Provides Good Patient Satisfaction

    Directory of Open Access Journals (Sweden)

    Eugene B. Cone

    2015-09-01

    Full Text Available Office-based percutaneous revision of a testicular prosthesis has never been reported. A patient received a testicular prosthesis but was dissatisfied with the firmness of the implant. In an office setting, the prosthesis was inflated with additional fluid via a percutaneous approach. Evaluated outcomes included patient satisfaction, prosthesis size, recovery time, and cost savings. The patient was satisfied, with no infection, leak, or complication after more than 1 year of follow-up, at significantly less cost than revision surgery. Percutaneous adjustment of testicular prosthesis fill-volume can be safe, inexpensive, and result in good patient satisfaction.

  1. Management of long span partially edentulous maxilla with fixed removable denture prosthesis

    Directory of Open Access Journals (Sweden)

    Mahilan I Jeyavalan

    2012-01-01

    Full Text Available Restoration of a long span partially edentulous maxilla with tooth supported prosthesis is challenging because of inherent anatomic limitations and unfavourable biomechanics present after the loss of teeth. A tooth supported fixed-removable prosthesis is a treatment option for restoration of such long span partially edentulous maxillary arches. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favourable biomechanical stress distribution to the remaining natural tooth abutments. This article presents a procedure for fabrication of a fixed-removable prosthesis that has cement-retained custom cast bar metal substructure and a ball attachment retained removable superstructure prosthesis.

  2. Rehabilitation of orbital defect with silicone orbital prosthesis retained by dental implants

    Science.gov (United States)

    Guttal, Satyabodh Shesharaj; Desai, Jhanvi; Kudva, Adarsh; Patil, Basavaraj R

    2016-01-01

    Orbital defects can result from cancer, birth anomalies, or trauma leading to an onslaught of problems in the function and psyche of the patient. These defects are restored by surgical reconstruction and followed by placement of orbital prosthesis for cosmetic makeup. The use of dental implants in retaining orbital prosthesis improves patient acceptance of the prosthesis owing to better retention and stability than conventional adhesive retained prosthesis. This case report describes a custom-made magnetic retentive assembly anchored by a dental implant which offers the orbital prosthesis the simplicity of self-alignment and ease of use. PMID:26953033

  3. [An obturator prosthesis in a patient with perfect dentition. Functional, esthetic approach].

    Science.gov (United States)

    Razouk, O; Sidibe, C A; Dichamp, J; Bertrand, J C

    1994-01-01

    A prosthesis was implanted immediately after operation for a velo-palatal tissue defect in an active young female patient in order to avoid function, psychological and social complications involved with this mutilation. The three classical steps of the process were performed: immediate implantation of the prosthesis, temporary prosthesis, definitive prosthesis. Anchoring to the teeth maintained the prosthesis in position. A functional print is always needed to obtain perfect closure. A metallic bridge links the retention part and the obstructive part. The device is effective, discrete, functional and well-tolerated by the patient.

  4. [Choice of hip prosthesis in patients younger than 50 years

    NARCIS (Netherlands)

    Schreurs, B.W.; Busch, V.J.; Veth, R.P.H.

    2007-01-01

    There is no agreement about the most ideal type of hip prosthesis to be used in patients younger than 50 years. The most commonly used hip prostheses in patients younger than 50 years are uncemented or resurfacing prostheses and to a lesser extent cemented prostheses. A good result of a hip prosthes

  5. Transfemoral prosthesis suspension systems: a systematic review of the literature.

    Science.gov (United States)

    Gholizadeh, Hossein; Abu Osman, Noor Azuan; Eshraghi, Arezoo; Ali, Sadeeq

    2014-09-01

    The purpose of this study was to find the scientific evidence pertaining to various transfemoral suspension systems to provide selection criteria for clinicians. To this end, databases of PubMed, Web of Science, and ScienceDirect were explored. The following key words, as well as their combinations and synonyms, were used for the search: transfemoral prosthesis, prosthetic suspension, lower limb prosthesis, above-knee prosthesis, prosthetic liner, transfemoral, and prosthetic socket. The study design, research instrument, sampling method, outcome measures, and protocols of articles were reviewed. On the basis of the selection criteria, 16 articles (11 prospective studies and 5 surveys) were reviewed. The main causes of reluctance to prosthesis, aside from energy expenditure, were socket-related problems such as discomfort, perspiration, and skin problems. Osseointegration was a suspension option, yet it is rarely applied because of several drawbacks, such as extended rehabilitation process, risk for fracture, and infection along with excessive cost. In conclusion, no clinical evidence was found as a "standard" system of suspension and socket design for all transfemoral amputees. However, among various suspension systems for transfemoral amputees, the soft insert or double socket was favored by most users in terms of function and comfort.

  6. Task-Oriented Gaming for Transfer to Prosthesis Use

    NARCIS (Netherlands)

    van Dijk, Ludger; Sluis, van der Corry K.; van Dijk, Hylke W.; Bongers, Raoul M.

    2016-01-01

    The aim of this study is to establish the effect of task-oriented video gaming on using a myoelectric prosthesis in a basic activity of daily life (ADL). Forty-one able-bodied right-handed participants were randomly assigned to one of four groups. In three of these groups the participants trained to

  7. Verge of Collapse: The Pros/thesis of Art Research

    Science.gov (United States)

    Garoian, Charles R.

    2008-01-01

    This article explores "prosthesis" as a metaphor of embodiment in art-based research to challenge the utopian myth of wholeness and normality in art and the human body. Bearing in mind the correspondences between amputated bodies and the cultural dislocations of art, I propose "prosthetic epistemology" and "prosthetic ontology" as embodied knowing…

  8. Intermanual transfer effects in below-elbow myoelectric prosthesis users

    NARCIS (Netherlands)

    de Boer, Errit; Romkema, Sietske; Cutti, Andrea G; Brouwers, Michael A H; Bongers, Raoul M; van der Sluis, Corry K

    2016-01-01

    OBJECTIVE: To determine intermanual transfer effects in patients with a below-elbow amputation using a myoelectric prosthesis, and to establish whether laterality affects these effects. DESIGN: Case-control. SETTING: A standardized setting in a rehabilitation clinic. PARTICIPANTS: A convenience samp

  9. [Medial unicompartmental knee prosthesis for patients with unicompartmental gonarthrosis

    NARCIS (Netherlands)

    Kort, N.P.; Deutman, R.; Raay, J.J. van; Horn, J.R. van

    2004-01-01

    The function and survival time of unicompartmental knee prostheses for patients with severe gonarthrosis have been improved the past few years by developments in their design, the instrumentarium and the surgical technique. A medial unicompartmental knee prosthesis may be indicated in patients with

  10. Transtibial prosthesis suspension failure during skydiving freefall: a case report.

    Science.gov (United States)

    Gordon, Assaf T; Land, Rebekah M

    2009-01-01

    This report describes the unusual case of an everyday-use prosthesis suspension system failure during the freefall phase of a skydiving jump. The case individual was a 53-year-old male with a left transtibial amputation secondary to trauma. He used his everyday prosthesis, a transtibial endoskeleton with push-button, plunger-releasing, pin-locking silicon liner suction suspension and a neoprene knee suspension sleeve, for a standard recreational tandem skydive. Within seconds of exiting the plane, the suspension systems failed, resulting in the complete prosthesis floating away. Several factors may have led to suspension system failure, including an inadequate seal and material design of the knee suspension sleeve and liner, lack of auxiliary suspension mechanisms, and lack of a safety cover overlying the push-button release mechanism. This is the first report, to our knowledge, to discuss prosthetic issues specifically related to skydiving. While amputees are to be encouraged to participate in this extreme sport, special modifications to everyday components may be necessary to reduce the possibility of prosthesis failure during freefall, parachute deployment, and landing.

  11. Development of an underactuated hand prosthesis with compliant control

    NARCIS (Netherlands)

    Peerdeman, Bart

    2014-01-01

    The main subjects of this thesis are the mechanical design and control of a new hand prosthesis prototype: the UT Hand I. The functionality of modern hand prostheses is mainly limited by the size and weight of their actuators. The UT Hand I features a minimal actuation system, where all finger joint

  12. Fitting a temporomandibular joint prosthesis to the skull

    NARCIS (Netherlands)

    van Loon, JP; de Bont, LGM; Stegenga, B; Verkerke, GJ

    2000-01-01

    Fitting a temporomandibular joint (TMJ) prosthesis to the skull by using stock prostheses seems to be an appropriate method. However, fitting the skull with one stock part requires many differently shaped parts. Therefore, we fitted the skull with two connected stock parts. The aim of the study was

  13. Groningen temporomandibular joint prosthesis. Development and first clinical application

    NARCIS (Netherlands)

    van Loon, JP; de Bont, LGM; Stegenga, B; Spijkervet, FKL; Verkerke, GJ

    2002-01-01

    Patients with a severely degenerated temporomandibular joint (TMJ) may benefit from an alloplastic TMJ replacement. The aim of the study was to develop a safe and properly functioning TMJ prosthesis. The design was based on imitation of anterior condylar translation by an inferiorly located centre o

  14. Biomechanical conceptual design of a passive transfemoral prosthesis

    NARCIS (Netherlands)

    Ünal, R.; Carloni, R.; Hekman, E.E.G.; Stramigioli, S.; Koopman, H.F.J.M.

    2010-01-01

    In this study, we present the conceptual design of a fully-passive transfemoral prosthesis. The proposed design is inspired by the analysis of the musculo-skeletal activity of the healthy human leg. In order to realize an energy efficient device, we introduce three storage elements, which are respon

  15. 21 CFR 872.3970 - Interarticular disc prosthesis (interpositional implant).

    Science.gov (United States)

    2010-04-01

    ... implant). 872.3970 Section 872.3970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3970 Interarticular disc prosthesis (interpositional implant). (a) Identification. An interarticular disc...

  16. 21 CFR 874.3730 - Laryngeal prosthesis (Taub design).

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Laryngeal prosthesis (Taub design). 874.3730 Section 874.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... pulmonary air flow to the pharynx in the absence of the larynx, thereby permitting esophageal speech....

  17. Cosmetic effect of knee joint in a knee disarticulation prosthesis

    NARCIS (Netherlands)

    de laat, Fred A.; van der Pluijm, Mark J.; van Kuijk, Annette A.; Geertzen, Jan H.; Roorda, Leo D.

    2014-01-01

    Despite numerous advantages, knee disarticulations (KDs) are rarely performed because of the anticipated KD prosthesis fitting problems that include the positioning of the knee joint distally from the KD socket. This results in lengthening of the thigh and subsequent shortening of the shank. The obj

  18. AUTOLOGOUS VEIN SUPPORTED WITH A BIODEGRADABLE PROSTHESIS FOR ARTERIAL GRAFTING

    NARCIS (Netherlands)

    ZWEEP, HP; SATOH, S; VANDERLEI, B; HINRICHS, WLJ; DIJK, F; FEIJEN, J; WILDEVUUR, CRH

    1993-01-01

    To evaluate the potential of a supporting, compliant, biodegradable prosthesis to function as a temporary protective scaffold for autologous vein grafts in the arterial circulation, we implanted vein grafts into the carotid arteries of rabbits, either with (composite grafts) or without (control graf

  19. Palatal lifting prosthesis and velopharyngeal insufficiency: Preliminary report

    Directory of Open Access Journals (Sweden)

    Ali Ibrahim Aboloyoun

    2013-05-01

    Full Text Available Objectives. Our study aimed to highlight the effectiveness of palatal lift prosthesis in patients with velopharyngeal insufficiency with previous operated cleft palate. Methods. This study was done undertaken January 2008 to December of 2009 in the Phoniatic unit of Alnoor Specialist Hospital, Makkah, Saudi Arabia. Ten patients of ≥ 8 years to ≤ 10 years of age, who had previously undergone surgery for cleft palate, with or without cleft lip, with no other systemic illness and normal intelligent quotient level, were selected and managed by palatal lift prosthesis. All the study subjects were subjected to auditory perceptual speech evaluation for assessment of the degree of hypernasality, compensatory articulator mechanisms, glottal and pharyngeal articulation, audible nasal emission, facial grimace and overall intelligibility of speech. Data were analyzed using SPSS version 16. Results. The study included 10 subjects whose mean ± standard deviation of age was (8.9±0.9. On auditory speech perceptual evaluation after prosthesis application, significant improvement was found in glottal articulation 6 (85.7%, p=0.04, facial grimace 6 (85.7% p=0.04, hyper nasality 10 (10% p=0.008, and speech intelligibility 9 (90% p=0.008. Conclusion. Young patients with repaired palatal cleft have significant improvement after application of palatal lift prosthesis.

  20. Development of an internally braced prosthesis for total talus replacement.

    Science.gov (United States)

    Regauer, Markus; Lange, Mirjam; Soldan, Kevin; Peyerl, Steffen; Baumbach, Sebastian; Böcker, Wolfgang; Polzer, Hans

    2017-03-18

    Total loss of talus due to trauma or avascular necrosis, for example, still remains to be a major challenge in foot and ankle surgery with severely limited treatment options. Implantation of a custom made total talar prosthesis has shown promising results so far. Most important factors for long time success are degree of congruence of articular surfaces and ligamentous stability of the ankle. Therefore, our aim was to develop an optimized custom made prosthesis for total talus replacement providing a high level of primary stability. A custom made hemiprosthesis was developed using computed tomography and magnetic resonance imaging data of the affected and contralateral talus considering the principles and technology for the development of the S.T.A.R. prosthesis (Stryker). Additionally, four eyelets for fixation of artificial ligaments were added at the correspondent footprints of the most important ligaments. Two modifications can be provided according to the clinical requirements: A tri-articular hemiprosthesis or a bi-articular hemiprosthesis combined with the tibial component of the S.T.A.R. total ankle replacement system. A feasibility study was performed using a fresh frozen human cadaver. Maximum range of motion of the ankle was measured and ligamentous stability was evaluated by use of standard X-rays after application of varus, valgus or sagittal stress with 150 N. Correct implantation of the prosthesis was technically possible via an anterior approach to the ankle and using standard instruments. Malleolar osteotomies were not required. Maximum ankle dorsiflexion and plantarflexion were measured as 22-0-28 degrees. Maximum anterior displacement of the talus was 6 mm, maximum varus tilt 3 degrees and maximum valgus tilt 2 degrees. Application of an internally braced prosthesis for total talus replacement in humans is technically feasible and might be a reasonable procedure in carefully selected cases with no better alternatives left.

  1. Prosthesis for open pleurostomy (POP: management for chronic empyemas

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    Luiz Tarcísio Brito Filomeno

    2009-03-01

    Full Text Available OBJECTIVES: We developed a prosthesis for open pleurostomy cases where pulmonary decortication is not indicated, or where post-pneumonectomy space infection occurs. The open pleural window procedure not only creates a large hole in the chest wall that is shocking to patients, also results in a permanent deformation of the thorax. prosthesis for open pleurostomy is a self-retained silicone tube that requires the removal of 3 cm of one rib for insertion, and acts as a mature conventional open pleural window. Herein, we report our 13-year experience with this device in the management of different kinds of pleural empyema. METHODS: Forty-four consecutive patients with chronic empyema were treated. The etiology of empyema was diverse: pneumonia, 20; lung resections, 12 (pneumonectomies, 7; lobectomies, 4; non-anatomical, 1; mixed-tuberculous, 6; and mixed-malignant pleural effusion, 6. After debridment of both pleural surfaces, the prosthesis for open pleurostomy was inserted and attached to a small recipient plastic bag. RESULTS: Infection control was achieved in 20/20 (100% of the parapneumonic empyemas, in 3/4 (75% of post-lobectomies, in 6/7 (85% of post-pneumectomies, in 6/6 (100% of mixed-tuberculous cases, and in 4/6 (83% of mixed-malignant cases. Lung re-expansion was also successful in 93%, 75%, 33%, and 40% of the groups, respectively CONCLUSIONS: Prosthesis for open pleurostomy insertion is a minimally invasive procedure that can be as effective as conventional open pleural window for management of chronic empyemas. Thus, we propose that the use of prosthesis for open pleurostomy should replace the conventional method.

  2. Comparison of grafts for anatomical reconstruction of the ACL: patellar versus semitendinosus/gracilis

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    Patrícia Barros Bitun

    2015-02-01

    Full Text Available OBJECTIVE: To compare the functional results from surgical treatment for anatomical reconstruction of the anterior cruciate ligament (ACL with a single band, using two types of autologous grafts.METHODS: Twenty-seven patients who underwent anatomical reconstruction of the ACL by means of the Chambat technique were evaluated prospectively. They were divided into two groups: A, with 14 patients, using grafts from flexor tendons; and B, with 13 patients, using grafts from the patellar tendon. In both groups, fixation was performed using an absorbable interference screw.RESULTS: Based on the Lysholm score, group A presented a mean score of 71.6 in the first month, while B presented 75. At the end of the sixth month, both groups presented 96.6. Evaluation of the total IKDC showed that in the first month, the majority of the patients, both in group A (85.7% and in group B (76.9%, presented a knee assessment that was close to normal. In the sixth month, 92.9% of group A had normal presentations, and 100% of group B.CONCLUSION: According to the Lysholm functional evaluation and the IKDC subjective assessment, there was no statistically significant difference in the results between the groups, and the results were better in the sixth month.

  3. Risk factors for patellar tendinopathy in basketball and volleyball players: a cross-sectional study.

    Science.gov (United States)

    van der Worp, H; van Ark, M; Zwerver, J; van den Akker-Scheek, I

    2012-12-01

    Patellar tendinopathy (PT) has a multifactorial etiology, and many possible risk factors have been described in the literature. The findings are conflicting, though, and most research has been conducted on elite athletes. The aim of the current study is to determine the risk factors for PT in a large representative sample of basketball and volleyball players. Separate risk factors for men and women, basketball and volleyball players, and athletes with unilateral and bilateral PT were identified. All basketball and volleyball players between ages 18 and 35 from the Dutch Basketball Association and the Dutch Volleyball Association were invited to complete an online questionnaire on knee complaints and risk factors for PT. The logistic regression analyses included 2224 subjects. The risk factors for PT were age, playing at the national level, being male and playing volleyball (compared with playing basketball). The risk factors for men and women were comparable. Among volleyball players, outside hitters and middle blockers/hitters had an increased risk compared with setters. For basketball players, no risk factors could be identified. No differences in the risk factors were found between athletes with unilateral and bilateral PT. These findings should be taken into account for prevention and rehabilitation purposes.

  4. Recovery of gait pattern after medial patellofemoral ligament reconstruction for objective patellar instability.

    Science.gov (United States)

    Carnesecchi, O; Philippot, R; Boyer, B; Farizon, F; Edouard, P

    2016-01-01

    Gait pattern alterations were previously reported in association with objective patellar instability (OPI). Gait pattern comparison between a series of patients having undergone medial patellofemoral ligament (MPFL) reconstruction and a sample of control subjects. Thirty patients at 6 months postoperatively after MPFL reconstruction and thirty control subjects were enrolled in the study for a clinical and biomechanical assessment including gait analysis at three selected walking rates using the GAITRite(®) system. The mean raw IKDC score was 73 (± 19), and the mean Kujala knee function was 84 (± 17.5). The study of gait did not demonstrate any significant difference between the two groups at a normal and fast walking rate. At a 10 km/h running speed, the single-support phase was significantly shortened by a mean 2.33% (p clinical results in the management of OPI. At 6 months postoperatively, the patient gait pattern was similar to that observed in healthy subjects at a normal and fast walking speed. However, our study revealed persistent gait abnormalities at a 10 km/h running speed. These gait alterations seemed to be related to the ligament reconstruction in itself due to the higher strain applied on the reconstructed MPFL during running cycle (10 km/h). Level of evidence IV.

  5. Assessment of Patellar Tendon Reflex Responses Using Second-Order System Characteristics

    Directory of Open Access Journals (Sweden)

    Brett D. Steineman

    2016-01-01

    Full Text Available Deep tendon reflex tests, such as the patellar tendon reflex (PTR, are widely accepted as simple examinations for detecting neurological disorders. Despite common acceptance, the grading scales remain subjective, creating an opportunity for quantitative measures to improve the reliability and efficacy of these tests. Previous studies have demonstrated the usefulness of quantified measurement variables; however, little work has been done to correlate experimental data with theoretical models using entire PTR responses. In the present study, it is hypothesized that PTR responses may be described by the exponential decay rate and damped natural frequency of a theoretical second-order system. Kinematic data was recorded from both knees of 45 subjects using a motion capture system and correlation analysis found that the mean R2 value was 0.99. Exponential decay rate and damped natural frequency ranges determined from the sample population were −5.61 to −1.42 and 11.73 rad/s to 14.96 rad/s, respectively. This study confirmed that PTR responses strongly correlate to a second-order system and that exponential decay rate and undamped natural frequency are novel measurement variables to accurately measure PTR responses. Therefore, further investigation of these measurement variables and their usefulness in grading PTR responses is warranted.

  6. MRI of anterior cruciate ligament repair with patellar and hamstring tendon autografts

    Energy Technology Data Exchange (ETDEWEB)

    Jansson, K.A.; Karjalainen, P.T. [Dept. of Radiology, Helsinki University Central Hospital (Finland); Harilainen, A.; Sandelin, J.; Tallroth, K. [ORTON Hospital, Helsinki (Finland); Soila, K. [Dept. of Radiology, Mount Sinai Medical Center, Miami Beach, FL (United States); Aronen, H.J. [Dept. of Radiology, Helsinki University Central Hospital (Finland); Dept. of Diagnostic Radiology, Kuopio University Hospital (Finland)

    2001-01-01

    Objective. Several MRI sequences were used to evaluate the 2-year postoperative appearance of asymptomatic knee with a torn anterior cruciate ligament (ACL) reconstructed with bone-patellar tendon-bone (BTB) and semitendinosus and gracilis (STG) tendon autografts.Design and patients. Two groups with successful repair of ACL tear with BTB (n=10) or STG (n=10) autografts were imaged at 1.5 T with sagittal and oblique coronal proton density-, T2-weighted and sagittal STIR sequences and plain and contrast-enhanced oblique coronal T1-weighted sequences. The appearance of the graft and periligamentous tissues was evaluated.Results. In all 20 cases, the ACL graft showed homogeneous, low signal intensity with periligamentous streaks of intermediate signal intensity on T2-weighted images. In 10 cases, localised areas of intermediate signal intensity were seen in the intra-articular segment of the graft on proton density- and T1-weighted images. The graft itself did not show enhancement in either of the two groups, but mild to moderate periligamentous enhancement was detected in 10 cases.Conclusion. The MRI appearance of ACL autograft is variable on proton density- and T1-weighted images. Periligamentous tissue showing contrast enhancement is a typical MRI finding after clinically successful ACL reconstruction. (orig.)

  7. Treatment of chronic patellar ligament lesion with autograft and v-y quadricepsplasty

    Directory of Open Access Journals (Sweden)

    Marco Túlio Lopes Caldas

    2013-06-01

    Full Text Available OBJECTIVE: Review of the literature concerning the subject and to compare the results of the technique we have been using with the ones reported on the literature. METHODS: This is a retrospective, cross-sectional and observational study. We evaluated the records of patients treated surgically at the Hospital from Hospital Maria Amelia Lins January 1997 to January 2011.The following variables were considered: age, gender, side, degree of injury, mechanism of trauma, associated injuries, time elapsed between injury and surgical procedure, complications, range of motion and muscle strength. RESULTS: Five patients underwent surgical treatment with the use of autograft semitendinosus and gracilis tendons and V-Y quadricepsplasty. Regarding gender, there was a male predominance (80%. The average age was 35.2 years old. The right side was the most affected (60%. The predominant mechanism of injury was motorcycle accident (80%. All patients had a complete tendon lesion. Time between injury and surgery averaged 10.4 months. Four patients (80% had had associated injuries. In all patients muscle strength was satisfactory (M4/M5. Wound dehiscence was observed in 01 patient. Average postoperative range of motion was 110°. CONCLUSIONS: These are rare lesions. Stretching the quadriceps is essential to decrease the tension to the reconstructed patellar ligament and patellofemoral joint. Use of a quadriceps transtendon tunnel is an option to prevent fractures. Hypotrophy of the quadriceps is inevitable, however, the resulting force is sufficient for daily living activities.

  8. Volumetric characterization of human patellar cartilage matrix on phase contrast x-ray computed tomography

    Science.gov (United States)

    Abidin, Anas Z.; Nagarajan, Mahesh B.; Checefsky, Walter A.; Coan, Paola; Diemoz, Paul C.; Hobbs, Susan K.; Huber, Markus B.; Wismüller, Axel

    2015-03-01

    Phase contrast X-ray computed tomography (PCI-CT) has recently emerged as a novel imaging technique that allows visualization of cartilage soft tissue, subsequent examination of chondrocyte patterns, and their correlation to osteoarthritis. Previous studies have shown that 2D texture features are effective at distinguishing between healthy and osteoarthritic regions of interest annotated in the radial zone of cartilage matrix on PCI-CT images. In this study, we further extend the texture analysis to 3D and investigate the ability of volumetric texture features at characterizing chondrocyte patterns in the cartilage matrix for purposes of classification. Here, we extracted volumetric texture features derived from Minkowski Functionals and gray-level co-occurrence matrices (GLCM) from 496 volumes of interest (VOI) annotated on PCI-CT images of human patellar cartilage specimens. The extracted features were then used in a machine-learning task involving support vector regression to classify ROIs as healthy or osteoarthritic. Classification performance was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC). The best classification performance was observed with GLCM features correlation (AUC = 0.83 +/- 0.06) and homogeneity (AUC = 0.82 +/- 0.07), which significantly outperformed all Minkowski Functionals (p GLCM-derived statistical features can distinguish between healthy and osteoarthritic tissue with high accuracy.

  9. Whole-body vibration training induces hypertrophy of the human patellar tendon.

    Science.gov (United States)

    Rieder, F; Wiesinger, H-P; Kösters, A; Müller, E; Seynnes, O R

    2016-08-01

    Animal studies suggest that regular exposure to whole-body vibration (WBV) induces an anabolic response in bone and tendon. However, the effects of this type of intervention on human tendon properties and its influence on the muscle-tendon unit function have never been investigated. The aim of this study was to investigate the effect of WBV training on the patellar tendon mechanical, material and morphological properties, the quadriceps muscle architecture and the knee extension torque-angle relationship. Fifty-five subjects were randomized into either a vibration, an active control, or an inactive control group. The active control subjects performed isometric squats on a vibration platform without vibration. Muscle and tendon properties were measured using ultrasonography and dynamometry. Vibration training induced an increase in proximal (6.3%) and mean (3.8%) tendon cross-sectional area, without any appreciable change in tendon stiffness and modulus or in muscle architectural parameters. Isometric torque at a knee angle of 90° increased in active controls (6.7%) only and the torque-angle relation remained globally unchanged in all groups. The present protocol did not appreciably alter knee extension torque production or the musculo-tendinous parameters underpinning this function. Nonetheless, this study shows for the first time that WBV elicits tendon hypertrophy in humans.

  10. THE EFFECT OF PATELLAR TAPING ON SOME LANDING CHARACTERISTICS DURING COUNTER MOVEMENT JUMPS IN HEALTHY SUBJECTS

    Directory of Open Access Journals (Sweden)

    Jesús Cámara

    2011-12-01

    Full Text Available The aim of the present study was to determine the effect of patellar taping (PT on landing characteristics of the vertical ground reaction force (VGRF and on flight time during a counter movement jump (CMJ. Eleven healthy male subjects (age: 31.1 ± 4.2 years volunteered for the study. Each subject performed six CMJs under two different jumping conditions: with PT and without PT (WPT. The order of the two conditions was randomized. All of the measured variables had fair-to-good reliability (intra-class correlation coefficient > 0.75. When we compared the PT and WPT groups, we did not find a significant difference in the magnitude of the first (F1 and second (F2 peaks of the VGRF. We also did not find a significant difference in the time to production of these peaks (T1 and T2, and the time to stabilization (TTS (p < 0. 05. Furthermore, the flight time was similar in the two groups (0.475 ± 0.046 and 0.474 ± 0.056 s, respectively, for PT and WPT. These results suggest that PT does not jeopardize performance during CMJ. Furthermore, it also does not soften the VGRF generated during the landing, indicating that PT may be of limited utility in preventing injuries associated with this type of movement.

  11. Bone-patellar tendon-bone autograft versus LARS artificial ligament for anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Pan, Xiaoyun; Wen, Hong; Wang, Lide; Ge, Tichi

    2013-10-01

    The optimized graft for use in anterior cruciate ligament (ACL) reconstruction is still in controversy. The bone-patellar tendon-bone (BPTB) autograft has been accepted as the gold standard for ACL reconstruction. However, donor site morbidities cannot be avoided after this treatment. The artificial ligament of ligament advanced reinforcement system (LARS) has been recommended for ACL reconstruction. The purpose of this study is to compare the midterm outcome of ACL reconstruction using BPTB autografts or LARS ligaments. Between July 2004 and March 2006, the ACL reconstruction using BPTB autografts in 30 patients and LARS ligaments in 32 patients was performed. All patients were followed up for at least 4 years and evaluated using the Lysholm knee score, Tegner score, International Knee Documentation Committee (IKDC) score, and KT-1000 arthrometer test. There were no significant differences between the two groups with respect to the data of Lysholm scores, Tegner scores, IKDC scores, and KT-1000 arthrometer test at the latest follow-up. Our study demonstrates that the similarly good clinical results are obtained after ACL reconstruction using BPTB autografts or LARS ligaments at midterm follow-up. In addition to BPTB autografts, the LARS ligament may be a satisfactory treatment option for ACL rupture.

  12. [The endo-exo prosthesis for patients with a problematic amputation stump].

    Science.gov (United States)

    Frölke, Jan Paul M; van de Meent, Henk

    2010-01-01

    Following lower limb amputation, quality of life is highly related to the ability to use a prosthetic limb. The conventional way to attach a prosthetic limb to the body is with a socket. Many patients experience serious discomfort wearing a conventional prosthesis because of pain, instability during walking, pressure sores, bad smell or skin irritation. In addition, sitting is uncomfortable and pelvic and lower back pain due to unstable gait is often seen in these patients. The main disadvantage of the current prosthesis is the attachment of a rigid prosthesis socket to a soft and variable body. The socket must fit tightly for stability during walking but should also be comfortable for sitting. The implantation of an osseointegrated, intramedullary, transcutaneously conducted prosthesis is a new procedure for attaching a limb prosthesis to the human body without the disadvantages of the conventional prosthesis. The intramedullary prosthesis is designed with a rough surface resembling cancellous bone to enable a secure solid integration with the long bone. We treated two patients with this new prosthesis, a 44-year-old man after a transfemoral amputation, and a 32-year-old woman after a lower leg amputation; both amputations were necessary because of trauma. Those two patients are now, more than one year after the operation, showing excellent functional results without infectious complications. We assume that endo-exo prosthesis may be a promising option for selected patients unable to use a conventional prosthesis because of a problematic amputation stump.

  13. Powered ankle-foot prosthesis for the improvement of amputee ambulation.

    Science.gov (United States)

    Au, Samuel K; Herr, Hugh; Weber, Jeff; Martinez-Villalpando, Ernesto C

    2007-01-01

    This paper presents the mechanical design, control scheme, and clinical evaluation of a novel, motorized ankle-foot prosthesis, called MIT Powered Ankle-Foot Prosthesis. Unlike a conventional passive-elastic ankle-foot prosthesis, this prosthesis can provide active mechanical power during the stance period of walking. The basic architecture of the prosthesis is a unidirectional spring, configured in parallel with a force-controllable actuator with series elasticity. With this architecture, the anklefoot prosthesis matches the size and weight of the human ankle, and is also capable of delivering high mechanical power and torque observed in normal human walking. We also propose a biomimetic control scheme that allows the prosthesis to mimic the normal human ankle behavior during walking. To evaluate the performance of the prosthesis, we measured the rate of oxygen consumption of three unilateral transtibial amputees walking at self-selected speeds to estimate the metabolic walking economy. We find that the powered prosthesis improves amputee metabolic economy from 7% to 20% compared to the conventional passive-elastic prostheses (Flex-Foot Ceterus and Freedom Innovations Sierra), even though the powered system is twofold heavier than the conventional devices. This result highlights the benefit of performing net positive work at the ankle joint to amputee ambulation and also suggests a new direction for further advancement of an ankle-foot prosthesis.

  14. Imaging the femoral sulcus with ultrasound, CT, and MRI: reliability and generalizability in patients with patellar instability

    Energy Technology Data Exchange (ETDEWEB)

    Toms, Andoni P.; Cahir, John [Norfolk and Norwich University Hospital, Departments of Radiology, Norwich, Norfolk (United Kingdom); Swift, Louise [University of East Anglia, School of Medicine, Health Policy and Practice, Norwich, Norfolk (United Kingdom); Donell, Simon T. [Norfolk and Norwich University Hospital, Institute of Orthopedics, Norwich, Norfolk (United Kingdom)

    2009-04-15

    Recent advances in surgical intervention for patellar instability have led to a need for long-term radiological monitoring. The aim of this study is to determine whether or not magnetic resonance imaging (MRI) or ultrasound (US) can replace computed tomography (CT) as the standard of care for the evaluation of the femoral sulcus. This was a prospective study comparing the reliability of CT, magnetic resonance (MR), and US for measuring the femoral sulcus in patients with patellar instability. Twenty-four patients were recruited to undergo a CT, MR, and US examination of each knee. Two observers independently measured femoral sulcus angles from subchondral bone and hyaline cartilage on two occasions. Intraclass correlations and generalizability coefficients were calculated to measure the reliability of each of the techniques. Thereafter, two observers measured the femoral sulcus angle from ultrasound images recorded by two independent operators to estimate interobserver and interoperator reliability. Forty-seven knees were examined with CT and US and 44 with MRI. The sulcus angle was consistently smaller when measured from subchondral bone compared to cartilage (5-7 ). Interobserver reliability for CT, MR, and US measurements from subchondral bone were 0.87, 0.80, and 0.82 and from cartilage 0.80, 0.81, and 0.50. Generalizability coefficients of measurements from subchondral bone for CT, MR, and US were 0.87, 0.76, and 0.81 and for cartilage 0.76, 0.73, and 0.05. Most of the variability in the US occurred at image acquisition rather than measurement. In patients with patellar instability, CT and MR are reliable techniques for measuring the femoral sulcus angle but US, particularly of the articular cartilage, is not. MR is therefore the most suitable tool for longitudinal studies of the femoral sulcus. (orig.)

  15. A follow-up study of arthroscopic combined reconstruction of anterior and posterior cruciate ligaments with allograft patellar tendon

    Institute of Scientific and Technical Information of China (English)

    XIE Feng; YANG Liu; GUO Lin; DAI Can; HAN Xue-song

    2007-01-01

    Objective: To evaluate the therapeutic effect of combined reconstruction of anterior cruciate ligament( ACL ) and posterior cruciate ligament ( PCL )simultaneously by using allograft patellar tendon under arthroscopy.Methods: From May 2003 to November 2005, 10 cases of ruptured ACL and PCL were fixated with compressed screws and reconstructed under arthroscopy with allograft patellar tendon simultaneously. The clinical results were evaluated according to IKDC, Lysholm, and Tegner clinical rating scales.Results: All patients were followed up for 12-30 months (mean: 18 months). At the last follow-up, there was no knee extension limitation and knee flexion was between 120° and 135°, with an average of 128.38°. The Lysholm score of the 10 cases was 66. 5 ± 5. 6 before operation and 89.8 ± 3.4 at last follow up. The difference was statistically significant (P < 0.01 ). The average Tegner activity score decreased from 6.9 ± 1.7 ( range: 4-9 ) before injury to 5.5 ± 1. 6 (rang: 2-9 ) at the follow-up(P =0.53 ). At the end of follow-up, IKDC score was graded as A in 4 cases (40.0%), B in 5 (50.0 % ), and C in 1 (10.0%). Of the 10 patients, 8 returned to the same sports level as before injury and 2 were under the level.Conclusion: Arthroscopic combined reconstruction of ACL and PCL with allograft patellar tendon has the advantages of minimal trauma in surgery and reliable satisfactory outcome.

  16. Reconstruction of medial patellofemoral ligament using quadriceps tendon combined with reconstruction of medial patellotibial ligament using patellar tendon: initial experience

    Directory of Open Access Journals (Sweden)

    Betina Bremer Hinckel

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To describe a surgical technique for anatomical reconstruction of the medial patellofemoral ligament using the quadriceps tendon, combined with reconstruction of the medial patellotibial ligament using the patellar tendon; and to present the initial results from a case series. METHOD: The proposed technique was used on a series of cases of patients with diagnoses of patellofemoral instability and indications for surgical treatment, who were attended by the Knee Group of HC-IOT, University of São Paulo. The following were evaluated before and after the operation: range of motion (ROM, apprehension test, lateral translation test, patellar inclination test, inverted J sign, subluxation upon extension, pain from compression of the patella and pain from contraction of the quadriceps. After the operation, the patients were asked whether any new episode of dislocation had occurred, what their degree of satisfaction with the surgery was (on a scale from 0 to 10 and whether they would be prepared to go through this operation again. RESULTS: Seven knees were operated, in seven patients, with a mean follow-up of 5.46 months (±2.07. Four patients who presented apprehension before the operation did not show this after the operation. The lateral translation test became normal for all the patients, while the patellar inclination test remained positive for two patients. The patients with an inverted J sign continued to be positive for this sign. Five patients were positive for subluxation upon extension before the operation, but all patients were negative for this after the operation. None of the patients presented any new episode of dislocation of the patella. All of them stated that they were satisfied: five gave a satisfaction score of 9 and two, a score of 10. All of them said that they would undergo the operation again. Only one patient presented a postoperative complication: dehiscence of the wound. CONCLUSION: Reconstruction of the

  17. Quadriceps and patellar tendon pie-crusting as a treatment for limited flexion in total knee arthroplasty.

    Science.gov (United States)

    Burge, J Ross; Sanchez, Hugo B; Wagner, Russell A

    2014-04-01

    The pie-crusting method of ligament and tendon lengthening has been used successfully in various tissues but is not reported in the literature as an option for patellar or quadriceps tendons to address flexion limitation. Our case report discusses a patient with longstanding flexion limitation who underwent primary total knee arthroplasty. The report reviews the literature on intraoperative treatments, which primarily pertains to the condition of patella baja, and demonstrates that the pie-crusting technique should be included as a treatment option for a tight extensor mechanism while having some advantages over tibial tubercle osteotomy or Z-plasty.

  18. The Results of Applying Chondroprotectors in the Integrated Rehabilitation Treatment of Athletes with Post-Traumatic Patellar Chondropathy

    Directory of Open Access Journals (Sweden)

    Natal'ya V. Kapustina

    2014-06-01

    Full Text Available This study has investigated the effect of chondroitin sulfate on the course of post-traumatic patellar chondropathy in 60 athletes. It has been established that the application of chondroprotective therapy in the integrated rehabilitation treatment of athletes with post-traumatic chondropathy reduces the pain syndrome and improves the functional condition of knee joints and facilitates boosting one’s sports activity and improving one’s quality of life, based on the Knee Injury and Osteoarthritis Outcome Score (KOOS questionnaire data.

  19. Reconstruction of medial patellofemoral ligament using quadriceps tendon combined with reconstruction of medial patellotibial ligament using patellar tendon: initial experience☆

    Science.gov (United States)

    Hinckel, Betina Bremer; Gobbi, Riccardo Gomes; Bonadio, Marcelo Batista; Demange, Marco Kawamura; Pécora, José Ricardo; Camanho, Gilberto Luis

    2016-01-01

    Objective To describe a surgical technique for anatomical reconstruction of the medial patellofemoral ligament using the quadriceps tendon, combined with reconstruction of the medial patellotibial ligament using the patellar tendon; and to present the initial results from a case series. Method The proposed technique was used on a series of cases of patients with diagnoses of patellofemoral instability and indications for surgical treatment, who were attended by the Knee Group of HC-IOT, University of São Paulo. The following were evaluated before and after the operation: range of motion (ROM), apprehension test, lateral translation test, patellar inclination test, inverted J sign, subluxation upon extension, pain from compression of the patella and pain from contraction of the quadriceps. After the operation, the patients were asked whether any new episode of dislocation had occurred, what their degree of satisfaction with the surgery was (on a scale from 0 to 10) and whether they would be prepared to go through this operation again. Results Seven knees were operated, in seven patients, with a mean follow-up of 5.46 months (±2.07). Four patients who presented apprehension before the operation did not show this after the operation. The lateral translation test became normal for all the patients, while the patellar inclination test remained positive for two patients. The patients with an inverted J sign continued to be positive for this sign. Five patients were positive for subluxation upon extension before the operation, but all patients were negative for this after the operation. None of the patients presented any new episode of dislocation of the patella. All of them stated that they were satisfied: five gave a satisfaction score of 9 and two, a score of 10. All of them said that they would undergo the operation again. Only one patient presented a postoperative complication: dehiscence of the wound. Conclusion Reconstruction of the medial patellofemoral ligament

  20. Lower strength of the human posterior patellar tendon seems unrelated to mature collagen cross-linking and fibril morphology

    DEFF Research Database (Denmark)

    Hansen, Philip; Haraldsson, Bjarki Thor; Aagaard, Per

    2010-01-01

    The human patellar tendon is frequently affected by tendinopathy, but the etiology of the condition is not established, although differential loading of the anterior and posterior tendon may be associated with the condition. We hypothesized that changes in fibril morphology and collagen cross......-linking would parallel differences in material strength between the anterior and posterior tendon. Tendon fascicles were obtained from elective ACL surgery patients and tested micromechanically. Transmission electron microscopy was used to assess fibril morphology, and collagen cross-linking was determined...

  1. Revision anterior cruciate ligament reconstruction with bone-patellar tendon-bone allograft and extra-articular iliotibial band tenodesis.

    Science.gov (United States)

    Mascarenhas, Randy; McConkey, Mark O; Forsythe, Brian; Harner, Christopher D

    2015-04-01

    Revision anterior cruciate ligament (ACL) reconstruction is a technically demanding procedure with outcomes that generally fail to reach those seen with primary ACL reconstruction. With most index procedures using autograft tissue, it is not uncommon for allograft tissue to be required for revision ACL reconstruction. Compared with autografts, allografts take longer to incorporate and lead to more episodes of instability. In this article, we describe ipsilateral iliotibial band tenodesis performed to augment use of bone-patellar tendon-bone allograft in revision ACL reconstruction. This technique adds rotational stability to protect the allograft tissue while it incorporates.

  2. Floating patella: combined quadriceps tendon, retinacula, and patellar tendon ruptures in a high-performance elite athlete.

    Science.gov (United States)

    Langer, Phillip R; Selesnick, F Harlan

    2010-09-01

    Simultaneous quadriceps and patellar tendon rupture is rare. To our knowledge, we present the first known case of simultaneous quadriceps tendon, patella tendon, and retinacula rupture in the ipsilateral knee of a high-performance elite athlete. This disabling injury in the active person results in an inability to actively obtain and maintain full knee extension. When the tendons do not heal properly, at the correct length and tension, knee range of motion and strength can become significantly altered, leading to early fatigue, patellofemoral pain, and possibly instability, preventing return to preinjury status. Immediate surgical repair is recommended for optimal return of knee function and power.

  3. Influence of Manufacturing Process of Warp-knitted Vascular Prosthesis on the Wall Homogeneity

    Institute of Scientific and Technical Information of China (English)

    王璐; 丁辛

    2003-01-01

    This paper reports the evolution of textile structure and mechanical properties of vascular prosthesis in the level of the whole prosthesis and the constituent filaments with respect to the manufacturing process.The tubular wall of the prosthesis is divided circumferentially into three zones: basic line (BL),remeshing line (RL) and guide line (GL). Some heterogeneity has been observed on the tubular wall in :erms of stitch structure of the prosthesis and linear density of the constituent filaments. The breaking position of the prosthesis under circumferential tensile localizes preferentially in remeshing line that is the weakest zone by warp knitting with double needle bed. Furthermore, the statistical differences of the mechanical properties of the filaments of zone RL, GL and BL have been confirmed too. It is predictable that the deterioration of prosthesis, under physiological loads (periodical pulse blood pressure etc.), could happen firstly in the weaker zone in vivo.

  4. Manufacturer-provided effective orifice area index charts and the prevention of prosthesis-patient mismatch.

    Science.gov (United States)

    House, Chad M; Nelson, William B; Kroshus, Timothy J; Dahiya, Ranjan; Pibarot, Philippe

    2012-01-01

    Prosthesis-patient mismatch (PPM) occurs when an implanted prosthesis is too small relative to the patient's body surface area (BSA). However, mismatch can often be prevented by indexing the expected effective orifice area (EOA) of a prosthesis to the patient's BSA and then selecting the largest implantable prosthesis to avoid mismatch. Previously, prosthesis manufacturers have attempted to simplify this process by providing charts that include the expected EOA for their prosthesis, already indexed into an array of BSA values. One caveat with these charts is that the expected EOA data must truly be reliable, or the charts will misguide the implanting surgeon. Manufacturer-provided charts could be improved by standardizing the EOA data, with one potential source being the hemodynamic data submitted to the United States Food and Drug Administration. This review discusses PPM, manufacturer-provided EOA charts, and the regulation of EOA data.

  5. [Mammary prosthesis: considerations about a choreography of the surgical procedure].

    Science.gov (United States)

    Grolleau, J-L; Gangloff, D; Garrido, I; Chavoin, J-P

    2005-10-01

    Breast augmentation offers a high rate of satisfaction but the local complications remain frequent. These are mainly capsular contracture, malpositions of implant, acute or infraclinical infections. The causes of these complications are multifactorials. The goal of this chapter is to determine the effect of the surgical technique on the result. We think that if no routine procedure can be proposed, a reflexion on the objectives of the breast augmentation and the adaptation of the surgical technique is necessary for each surgeon. We identify twelve aims and discuss them: rigorous preoperative planning, determination of the position of the implant, creation of an adapted implant pocket, as much atraumatic as possible dissection, no bacterial contamination, no foreign particles, respect of the implant, drainage or not, efficient suture, pain and discomfort control, need for contension and clear postoperative advices. These objectives being precised, we integrate them in a chronological surgical process under the form of questions. Each surgeon can then choose his answers by evaluating the arguments, which led to his choices.

  6. Proteomic differences between male and female anterior cruciate ligament and patellar tendon.

    Directory of Open Access Journals (Sweden)

    Dianne Little

    Full Text Available The risk of anterior cruciate ligament (ACL injury and re-injury is greater for women than men. Among other factors, compositional differences may play a role in this differential risk. Patellar tendon (PT autografts are commonly used during reconstruction. The aim of the study was to compare protein expression in male and female ACL and PT. We hypothesized that there would be differences in key structural components between PT and ACL, and that components of the proteome critical for response to mechanical loading and response to injury would demonstrate significant differences between male and female. Two-dimensional liquid chromatography-tandem mass spectrometry and a label-free quantitative approach was used to identify proteomic differences between male and female PT and ACL. ACL contained less type I and more type III collagen than PT. There were tissue-specific differences in expression of proteoglycans, and ACL was enriched in elastin, tenascin C and X, cartilage oligomeric matrix protein, thrombospondin 4 and periostin. Between male and female donors, alcohol dehydrogenase 1B and complement component 9 were enriched in female compared to male. Myocilin was the major protein enriched in males compared to females. Important compositional differences between PT and ACL were identified, and we identified differences in pathways related to extracellular matrix regulation, complement, apoptosis, metabolism of advanced glycation end-products and response to mechanical loading between males and females. Identification of proteomic differences between male and female PT and ACL has identified novel pathways which may lead to improved understanding of differential ACL injury and re-injury risk between males and females.

  7. AMS 700 inflatable penile prosthesis with InhibiZone.

    Science.gov (United States)

    McKim, Stephen E; Carson, Culley C

    2010-05-01

    Inflatable penile prostheses are the definitive therapy for erectile dysfunction refractory to medical therapy. For years mechanical malfunction was the most common cause of device failure, but recent advances in design have largely eliminated this, and now infection is the most significant problem with these implants. Antibiotic-coated medical devices, such as central venous and bladder catheters, have proven effective in reducing bacterial colonization and biofilm formation, leading to decreased rates of infection. In 2001, American Medical Systems (AMS) released its AMS 700 series penile prosthesis impregnated with a proprietary combination of the antibiotics rifampin and minocycline, called InhibiZone. Multiple studies have found that this device significantly reduces infection rates in men receiving penile prostheses. In July 2009, the US FDA approved the AMS 700 with InhibiZone as the only inflatable penile prosthesis with clinical evidence showing significant reduction in the rate of revision surgery due to infection.

  8. Running with a powered knee and ankle prosthesis.

    Science.gov (United States)

    Shultz, Amanda H; Lawson, Brian E; Goldfarb, Michael

    2015-05-01

    This paper presents a running control architecture for a powered knee and ankle prosthesis that enables a transfemoral amputee to run with a biomechanically appropriate running gait and to intentionally transition between a walking and running gait. The control architecture consists firstly of a coordination level controller, which provides gait biomechanics representative of healthy running, and secondly of a gait selection controller that enables the user to intentionally transition between a running and walking gait. The running control architecture was implemented on a transfemoral prosthesis with powered knee and ankle joints, and the efficacy of the controller was assessed in a series of running trials with a transfemoral amputee subject. Specifically, treadmill trials were conducted to assess the extent to which the coordination controller provided a biomechanically appropriate running gait. Separate trials were conducted to assess the ability of the user to consistently and reliably transition between walking and running gaits.

  9. A cognitive prosthesis for complex decision-making.

    Science.gov (United States)

    Tremblay, Sébastien; Gagnon, Jean-François; Lafond, Daniel; Hodgetts, Helen M; Doiron, Maxime; Jeuniaux, Patrick P J M H

    2017-01-01

    While simple heuristics can be ecologically rational and effective in naturalistic decision making contexts, complex situations require analytical decision making strategies, hypothesis-testing and learning. Sub-optimal decision strategies - using simplified as opposed to analytic decision rules - have been reported in domains such as healthcare, military operational planning, and government policy making. We investigate the potential of a computational toolkit called "IMAGE" to improve decision-making by developing structural knowledge and increasing understanding of complex situations. IMAGE is tested within the context of a complex military convoy management task through (a) interactive simulations, and (b) visualization and knowledge representation capabilities. We assess the usefulness of two versions of IMAGE (desktop and immersive) compared to a baseline. Results suggest that the prosthesis helped analysts in making better decisions, but failed to increase their structural knowledge about the situation once the cognitive prosthesis is removed.

  10. FABRICATION OF CUSTOM OCULAR PROSTHESIS USING A GRAPH GRID.

    Directory of Open Access Journals (Sweden)

    Nidhi Dinesh Sinha

    2009-03-01

    Full Text Available Patients requiring treatment with custom ocular prosthesis are those who have lost ocular structures through orbital evisceration or orbital enucleation which was necessary as a surgical intervention for a congenital defect, pathology or an accident. The disfigurement associated with eye loss can cause significant physical and emotional disturbance. As iris placement is a technique sensitive procedure,visual assessment alone may not be accurate.The present article is an illustration of a case report of a lady chosen for a custom ocular prosthesis. The method described here uses a transparent grid template from which the iris is traced. An attempt is also made to mimick the shade and colour of the sclera in the wax pattern itself; using white paraffin wax. This gives an accurate registration of the position and alignment of iris disc assembly, giving a natural look.

  11. A Blue Tooth – Auricular Prosthesis: A Case Report

    Science.gov (United States)

    H. Naveen, Bandlar; R. Kashinath, Korapathi; B. Shankargouda, Swapnil

    2014-01-01

    The absence of an ear is a considerable aesthetic problem which affects the patient’s psychology and social behaviour. We are describing a case of 25-year-old male reporting to the Department of Prosthodontics, with a chief complaint of deficient left auricular tissue. This can be corrected surgically, prosthetically or through a combination of these approaches; but the choice of treatment depends on patient. The patient chose prosthetic rehabilitation over surgical procedures & retention becomes a critical issue in this approach. Out of many types of retentive methods, we selectively incorporated new materials and used the latest technology to ensure the highest quality prosthesis. Creative approach for each patient with a focus on their individual needs was considered as it gives more satisfaction to the patient. This article describes a new, simple and cost effective technique by embedding Bluetooth-headset device into the silicone elastomer of a mechanically-retained auricular prosthesis. PMID:25302281

  12. Tridimensional Treatment Planning and Rapid Prototyping for Maxillofacial Prosthesis

    Institute of Scientific and Technical Information of China (English)

    ZHANGWen-qiang; YUANJian-bing; YEMing; HUANGXue-mei; WANGCheng-tao

    2004-01-01

    The currert stmulation planing systmes for maxillofacial prosthesis surgery were used to extrapolate 3D surgical movements and outcomes based on the 2D radiographs,which were inadequate for complex surgical movements A 3D treatmenl planning system based on the computerized tomography(CT)data was presented A 3D data field was costructed out of the sectional image stack through linear interpolation after objectire tissue segmentation and using the marching cubes algorithm method,the triangular mesh model and 3D geometric model of diseased facial skeleton were reconstructed then the model was cut,the segments were moved or totated to their predicted positions,and angles and distances were measured after triangular mesh model was decimaled a RP model was manufactured for surgical simulation and prosthesis design The system was used in clinic with more than fifty cases and technically wilidated with success.

  13. The method of manufacture of nylon dental partially removable prosthesis using additive technologies

    Science.gov (United States)

    Kashapov, R. N.; Korobkina, A. I.; Platonov, E. V.; Saleeva, G. T.

    2014-12-01

    The article is devoted to the topic of creating new methods of dental prosthesis. The aim of this work is to investigate the possibility of using additive technology to create nylon prosthesis. As a result of experimental studies, was made a sample of nylon partially removable prosthesis using 3D printing has allowed to simplify, accelerate and reduce the coat of manufacturing high-precision nylon dentures.

  14. Patient satisfaction and penile morphology changes with postoperative penile rehabilitation 2 years after Coloplast Titan prosthesis

    OpenAIRE

    2016-01-01

    A common complaint after inflatable penile prosthesis surgery is reduced penile length. We previously reported how using the Coloplast Titan inflatable penile prosthesis with aggressive new length measurement technique (NLMT) coupled with postoperative IPP rehabilitation of the implant for 1-year helped to improve patient satisfaction and erectile penile measurements. This is a 2 years follow-up of a prospective, three-center, study of 40 patients who underwent Titan prosthesis placement, wit...

  15. Magnetic resonance imaging compatibility test of a cranial prosthesis with titanium screws

    Science.gov (United States)

    Jimenez, R.; Benavides, A.; Flores, D.; Hidalgo, S. S.; Solis, S. E.; Uribe, E.; Rodriguez, A. O.

    2012-10-01

    The follow-up of patients with skull prosthesis is necessary to provide adequate medical care. Skull prostheses for cranioplasty have been developed at the Faculty of Odontology of Universidad Nacional Autonoma de Mexico. We built a skull prosthesis phantom and tested for compatibility with standard magnetic resonance imaging procedures. Results showed full compatibility but susceptibility artefacts occurred due to titanium used to fix the prosthesis to the skull.

  16. Determining skill level in myoelectric prosthesis use with multiple outcome measures

    OpenAIRE

    Hanneke Bouwsema, MSc; Peter J. Kyberd, PhD; Wendy Hill, BScOT; Corry K. van der Sluis, MD, PhD; Raoul M. Bongers, PhD

    2012-01-01

    To obtain more insight into how the skill level of an upper-limb myoelectric prosthesis user is composed, the current study aimed to (1) portray prosthetic handling at different levels of description, (2) relate results of the clinical level to kinematic measures, and (3) identify specific parameters in these measures that characterize the skill level of a prosthesis user. Six experienced transradial myoelectric prosthesis users performed a clinical test (Southampton Hand Assessment Procedure...

  17. Intraoral framework pick-up technique to improve fit of a metal-resin implant prosthesis

    OpenAIRE

    Mirza Rustum Baig; Rajan Gunaseelan

    2012-01-01

    The achievement of passive fit is an important prerequisite for the prevention of complications in full-arch screw-retained implant prosthesis. With cemented prosthesis, the cementation compensates for the discrepancies in the cast framework, but the lack of retrievability seems undesirable. The aim of this paper is to propose a modified screw-retained prosthesis design for complete arch implant fixed rehabilitation. A technique for the fabrication of a full-arch metal-resin implant-supported...

  18. Transcatheter aortic valve prosthesis surgically replaced 4 months after implantation

    DEFF Research Database (Denmark)

    Thyregod, Hans Gustav; Lund, Jens Teglgaard; Engstrøm, Thomas;

    2010-01-01

    Transcatheter aortic valve implantation is a new and rapidly evolving treatment option for high-risk surgical patients with degenerative aortic valve stenosis. Long-term results with these new valve prostheses are lacking, and potential valve dysfunction and failure would require valve replacement....... We report the first case of surgical valve replacement in a patient with a dysfunctional transcatheter-implanted aortic valve prosthesis 4 months after implantation....

  19. Engineering Design of an Adaptive Leg Prosthesis Using Biological Principles

    DEFF Research Database (Denmark)

    Lenau, Torben Anker; Dentel, Andy; Invarsdottir, Thorunn

    2010-01-01

    The biomimetic design process is explored through a design case: An adaptive leg prosthesis. The aim is to investigate if the biomimetic design process can be carried out with a minimum of biological knowledge and without using advanced design methods. In the design case biomimetic design...... was successfully carried out using library search resulting in 14 biological analogies for the design problem 'shape adaption'. It is proposed that search results are handled using special cards describing the biological phenomena and the functional principles....

  20. Cochlear implantation: a biomechanical prosthesis for hearing loss.

    Science.gov (United States)

    Yawn, Robert; Hunter, Jacob B; Sweeney, Alex D; Bennett, Marc L

    2015-01-01

    Cochlear implants are a medical prosthesis used to treat sensorineural deafness, and one of the greatest advances in modern medicine. The following article is an overview of cochlear implant technology. The history of cochlear implantation and the development of modern implant technology will be discussed, as well as current surgical techniques. Research regarding expansion of candidacy, hearing preservation cochlear implantation, and implantation for unilateral deafness are described. Lastly, innovative technology is discussed, including the hybrid cochlear implant and the totally implantable cochlear implant.

  1. Penile Enhancement Procedures with Simultaneous Penile Prosthesis Placement

    Directory of Open Access Journals (Sweden)

    Tariq S. Hakky

    2012-01-01

    Full Text Available Here we present an overview of various techniques performed concomitantly during penile prosthesis surgery to enhance penile length and girth. We report on the technique of ventral phalloplasty and its outcomes along with augmentation corporoplasty, suprapubic lipectomy, suspensory ligament release, and girth enhancement procedures. For the serious implanter, outcomes can be improved by combining the use of techniques for each scar incision. These adjuvant procedures are a key addition in the armamentarium for the serious implant surgeon.

  2. Penile prosthesis implant: scientific advances and technological innovations over the last four decades

    Science.gov (United States)

    2017-01-01

    Despite introduction of oral phosphodiesterase type 5 inhibitors and intracavernosal vasoactive agents, penile prosthesis implant remains a relevant and desired option with sales of penile prostheses continue to stay high, as many men became refractory to medical therapy and/or seeking a more effective and permanent therapy. There are two types of penile prosthesis implants: inflatable and non-inflatable types, and the inflatable penile implants can be subdivided into single-, two- and three-piece devices. Non-inflatable penile prosthesis (non-IPP) may be referred to as semi-rigid rod or malleable prosthesis. IPP is considered a superior option to malleable prosthesis as it produces penile rigidity and flaccidity that closely replicates a normal penile erectile function. Since the introduction of IPP by Scott in 1973, surgical landscape for penile prosthesis implantation has changed dramatically. Advances in prosthesis design, device technologies and surgical techniques have made penile prosthesis implant a more natural, durable and reliable device. The following article reviews the scientific advances and technological innovation in modern penile prosthesis implants over the last four decades. PMID:28217449

  3. Using a Visible Light-Polymerized Resin to Fabricate an Interim Partial Removable Dental Prosthesis.

    Science.gov (United States)

    Segal, Aaron; Yu, Hui Wen; Elkassaby, Heba

    2017-02-01

    An interim partial removable dental prosthesis (RDP) is any dental prosthesis that replaces some teeth in a partially dentate arch designed to enhance esthetics, stabilization, and/or function for a limited period of time, after which it is to be replaced by a definitive dental prosthesis. This article describes a technique that uses a visible light-polymerized (VLP) resin as the base material for an interim partial RDP. This technique can be easily accomplished in a dental office or laboratory and results in a predictable dental prosthesis. This technique eliminates the need for laboratory processing.

  4. Isolated pump erosion of an inflatable penile prosthesis through the scrotum in a diabetic patient

    Directory of Open Access Journals (Sweden)

    Raidh A. Talib

    2013-04-01

    Full Text Available Isolated pump erosion is a rare complication in patients with inflatable penile prosthesis. We describe a case of a diabetic patient who underwent inflatable penile prosthesis implantation with subsequent isolated pump erosion. Repeated attempts of conservative repair of the erosion failed. Finally, the inflatable penile prosthesis was replaced with a malleable one to avoid new pump erosion. In case of isolated pump erosion, replacement of the inflatable penile prosthesis with a malleable one looks to be a good alternative salvage treatment for the patient.

  5. Rehabilitation of digital defect with silicone finger prosthesis: a case report.

    Science.gov (United States)

    Saxena, Deepesh; Jurel, Sunit; Gupta, Ajay; Dhillon, Manu; Tomar, Divya

    2014-08-01

    Patients with acquired defects often had severe trauma which leads to psychological instability, functional loss and poor aesthetics. Digital defects threaten the integrity of one's self esteem and also leads to a reduced and compromised function. A well fitted and colour matched finger prosthesis can make a patient feel a capable person and not a handicap. This article describes a technique for fabrication of custom made finger prosthesis with a silicone elastomer. The customization of the prosthesis leads to a better fit and retention. An excellent shade matching is achieved by the use of intrinsic colours. The other advantages of using silicone as a material of choice for prosthesis fabrication are also discussed.

  6. Use of Powered Prosthesis for Children with Upper Limb Deficiency at Hyogo Rehabilitation Center.

    Directory of Open Access Journals (Sweden)

    Mitsunori Toda

    Full Text Available There has been no research investigating the use of powered prosthetic for children in Japan.To gain better insight into the state of powered prosthesis usage and identify a ratio of rejection among children.Subjects were 37 unilateral below elbow amputees between the ages of 0 and 16 at the time of their first experienced fitting with a powered prosthesis at our Center. The information was collected from medical records and through face-to-face interviews, and we examined rejection rate and the factors affecting the use of powered prosthesis.The rate of discontinuation was 21.6% as 8 of the 37 children stopped using powered prosthesis. All of them were fitted their prosthesis after 2 years of age, and they rejected prosthesis between 5 to 19 years. We found that the level of amputation had no influence on the use of a powered prosthesis.Children fitted before 2 years of age tend to accept their powered prosthesis than those fitted after 2 years. Multidisciprinary team approach, adequate rehabilitation, detailed follow-up and involvement of parents are quite important for introducing powered prosthesis for children.

  7. Abiotrophia defectiva knee prosthesis infection: A case report

    Directory of Open Access Journals (Sweden)

    Levy Pierre-Yves

    2011-09-01

    Full Text Available Abstract Background Abiotrophia species have rarely been implicated in osteoarticular infections. We report one case of an A. defectiva knee prosthesis infection. Case presentation A 71-year-old man of Italian origin presented with pain and swelling of the knee four years after the implantation of a total knee replacement prosthesis. While standard culturing of the synovial fluid resulted in no isolation of microorganisms, the direct inoculation of the synovial fluid into a rich culture medium resulted in the identification of A. defectiva by polymerase chain reaction sequencing. Repeated attempts of culturing microorganisms from blood were negative, and echocardiograms and colonoscopies were unremarkable. High-dose amoxicillin for nine months and a two-stage replacement of the knee prosthesis led to full patient recovery by the time of the 12-month follow-up examination. Conclusions Because Abiotrophia spp. are fastidious microorganisms, it is likely that cases of Abiotrophia orthopedic infection are misdiagnosed as culture-negative infections. Direct inoculation of synovial fluids into rich broth medium and further polymerase chain reaction-based detection of culture-negative synovial fluids are key tests for accurate documentation and detection of these infections.

  8. A multiaxial force-sensing implantable tibial prosthesis.

    Science.gov (United States)

    Kirking, Bryan; Krevolin, Janet; Townsend, Christopher; Colwell, Clifford W; D'Lima, Darryl D

    2006-01-01

    Accurate in vivo measurement of tibiofemoral forces is important in total knee arthroplasty. These forces determine polyethylene stresses and cold-flow, stress distribution in the implant, and stress transfer to the underlying implant bone interface. Theoretic estimates of tibiofemoral forces have varied widely depending on the mathematical models used. The six degrees of freedom of motion, complex articular surface topography, changing joint-contact position, intra- and extra-articular ligaments, number of muscles crossing the knee joint, and the presence of the patellofemoral joint contribute to the difficulty in developing reliable models of the knee. A prototype instrumented total knee replacement tibial prosthesis was designed, manufactured, and tested. This prosthesis accurately measured all six components of tibial forces (R2>0.997). The prosthesis was also instrumented with an internal microtransmitter for wireless data transmission. Remote powering of the sealed implanted electronics was achieved using magnetic coil induction. This device can be used to validate existing models of the knee that estimate these forces or to develop more accurate models. In conjunction with kinematic data, accurate tibiofemoral force data may be used to design more effective knee-testing rigs and wear simulators. Additional uses are intraoperative measurement of forces to determine soft-tissue balancing and to evaluate the effects of rehabilitation, external bracing, and athletic activities, and activities of daily living.

  9. Dental prosthesis aspiration: An uncommon cause of respiratory distress.

    Science.gov (United States)

    De Wilde, Belphine A L; Malfait, Thomas L; Bonte, Katrien; Malfait, Thomas L A

    2016-12-01

    We present a case of a 66-year-old Caucasian man with acute respiratory distress. The patient had a history of multiple cerebrovascular accidents which resulted in left hemiplegia, swallowing problems, and aphasia. He was tentatively diagnosed with aspiration pneumonia. However, because of clinical deterioration further investigations concluded to the aspiration of a dental prosthesis. After intubation and stabilization, the prosthesis could be manually extracted. However, the patient developed a Staphylococcus epidermidis sepsis and despite adequate antibiotic therapy, he eventually died. Dental prosthesis aspiration is a medical situation associated with a higher morbidity and mortality rate compared to ingested foreign bodies. It requires a high level of suspicion to ensure a timely diagnosis and life-saving treatment. Thorough history taking is of great importance in case of tracheobronchial aspiration, which is in the adult population mostly secondary to an underlying disorder. In impaired adults with missing dental prostheses there should be extra awareness for this problem. This case report illustrates the importance of a detailed history in case of tracheobronchial aspiration and shows the limitations in the diagnostic usefulness of bedside chest radiography.

  10. Reconstruction of chronic acromioclavicular joint disruption with artificial ligament prosthesis

    Institute of Scientific and Technical Information of China (English)

    Devendra Kumar Chouhan; Uttam Chand Saini; Mandeep Singh Dhillon

    2013-01-01

    Objective:Management of Rockwood type 3 acromioclavicular disruptions is a matter of debate.Should we adopt conservative or operative measures at first presentation? It is not clear but most of the evidences are in favour of conservative management.We present our experience in managing these patients surgically.Methods:We present a prospective series of eight cases of chronic Rockwood type 3 acromioclavicular joint disruptions treated surgically.Anatomical reconstruction of the coracoclavicular ligament was done by artificial braided polyester ligament prosthesis.Results:All the patients were able to perform daily activities from an average of the 14th postoperative day.All patients felt an improvement in pain,with decrease in average visual analogue scale from preoperative 6.5 points (range 3-9 points) to 2.0 points (range 0-5 points),Constant score from 59% to 91% and American Shoulder and Elbow Surgeons shoulder score from 65 to 93 points postoperatively.These results improved or at least remained stationary on midterm follow-up,and no deterioration was recorded at an average follow-up of 46 months.Conclusion:This midterm outcome analysis of the artificial ligament prosthesis is the first such follow-up study with prosthesis.Our results are encouraging and justify the further use and evaluation of this relatively new and easily reproducible technique.

  11. A cortical neural prosthesis for restoring and enhancing memory

    Science.gov (United States)

    Berger, Theodore W.; Hampson, Robert E.; Song, Dong; Goonawardena, Anushka; Marmarelis, Vasilis Z.; Deadwyler, Sam A.

    2011-08-01

    A primary objective in developing a neural prosthesis is to replace neural circuitry in the brain that no longer functions appropriately. Such a goal requires artificial reconstruction of neuron-to-neuron connections in a way that can be recognized by the remaining normal circuitry, and that promotes appropriate interaction. In this study, the application of a specially designed neural prosthesis using a multi-input/multi-output (MIMO) nonlinear model is demonstrated by using trains of electrical stimulation pulses to substitute for MIMO model derived ensemble firing patterns. Ensembles of CA3 and CA1 hippocampal neurons, recorded from rats performing a delayed-nonmatch-to-sample (DNMS) memory task, exhibited successful encoding of trial-specific sample lever information in the form of different spatiotemporal firing patterns. MIMO patterns, identified online and in real-time, were employed within a closed-loop behavioral paradigm. Results showed that the model was able to predict successful performance on the same trial. Also, MIMO model-derived patterns, delivered as electrical stimulation to the same electrodes, improved performance under normal testing conditions and, more importantly, were capable of recovering performance when delivered to animals with ensemble hippocampal activity compromised by pharmacologic blockade of synaptic transmission. These integrated experimental-modeling studies show for the first time that, with sufficient information about the neural coding of memories, a neural prosthesis capable of real-time diagnosis and manipulation of the encoding process can restore and even enhance cognitive, mnemonic processes.

  12. Modified cementless total coxofemoral prosthesis: development, implantation and clinical evaluation

    Directory of Open Access Journals (Sweden)

    S.A. Arias

    2013-12-01

    Full Text Available The aim of this study was to modify canine coxofemoral prostheses and the clinical evaluation of the implantation. Fifteen canine hips and femora of cadavers were used in order to study the surface points of modification in prostheses and develop a perforation guide. Femoral stems and acetabular components were perforated and coated with biphasic calcium phosphate layer. Twelve young adult male mongrel dogs were implanted with coxofemoral prostheses. Six were operated upon and implanted with cemented canine modular hip prostheses, establishing the control group. The remaining six were implanted with a novel design of cementless porous tricalcic phosphate-hydroxyapatite coated hip prostheses. Clinical and orthopedic performance, complications, and thigh muscular hypotrophy were assessed up to the 120th post-operatory day. After 120 days, animals with cementless prostheses had similar clinical and orthopedic performance compared to the cemented group despite the increased pain thigh hypotrophy. Animals that underwent cementless hip prosthesis evidenced more pain, compared to animals with cemented hip prosthesis that required longer recuperation time. No luxations, two fractures and two isquiatic neurapraxies were identified in the course of the study. Using both the cemented and the bioactive coated cementless model were suitable to dogs, showing clinical satisfactory results. Osseointegration and biological fixation were observed in the animals with the modified cementless hip prosthesis.

  13. Literature Review on Needs of Upper Limb Prosthesis Users.

    Science.gov (United States)

    Cordella, Francesca; Ciancio, Anna Lisa; Sacchetti, Rinaldo; Davalli, Angelo; Cutti, Andrea Giovanni; Guglielmelli, Eugenio; Zollo, Loredana

    2016-01-01

    The loss of one hand can significantly affect the level of autonomy and the capability of performing daily living, working and social activities. The current prosthetic solutions contribute in a poor way to overcome these problems due to limitations in the interfaces adopted for controlling the prosthesis and to the lack of force or tactile feedback, thus limiting hand grasp capabilities. This paper presents a literature review on needs analysis of upper limb prosthesis users, and points out the main critical aspects of the current prosthetic solutions, in terms of users satisfaction and activities of daily living they would like to perform with the prosthetic device. The ultimate goal is to provide design inputs in the prosthetic field and, contemporary, increase user satisfaction rates and reduce device abandonment. A list of requirements for upper limb prostheses is proposed, grounded on the performed analysis on user needs. It wants to (i) provide guidelines for improving the level of acceptability and usefulness of the prosthesis, by accounting for hand functional and technical aspects; (ii) propose a control architecture of PNS-based prosthetic systems able to satisfy the analyzed user wishes; (iii) provide hints for improving the quality of the methods (e.g., questionnaires) adopted for understanding the user satisfaction with their prostheses.

  14. TOTAL ANKLE ARTHROPLASTY: BRAZILIAN EXPERIENCE WITH THE HINTEGRA PROSTHESIS.

    Science.gov (United States)

    Nery, Caio; Fernandes, Túlio Diniz; Réssio, Cibele; Fuchs, Mauro Luiz; Godoy Santos, Alexandre Leme de; Ortiz, Rafael Trevisan

    2010-01-01

    Ankle arthrosis is becoming more and more common. The search for solutions that preserve joint function has led to a new generation of prosthesis with three components and more degrees of freedom. This paper presents the results achieved for ten patients treated with the HINTEGRA Prosthesis (Integra, New Deal), through collaborative action between the Foot and Ankle Groups of the Orthopedics and Traumatology divisions of Escola Paulista de Medicina, Unifesp, and the School of Medicine of the University of São Paulo (USP). The ten patients (six women and four men, aged between 29 and 66 years), underwent a surgical procedure consisting of Hintermann's technique, between January and June 2005. They were evaluated at prearranged intervals, and the data were subjected to statistical analysis. The surgery led to a significant improvement in ankle mobility. Radiological evaluation showed no signs of loosening or failure in the prosthetic components in any of the patients studied. Although the complication rate in our sample was high, it was equivalent to the rates found by other authors, and directly represents the learning curve associate with this kind of procedure. Four years after the procedure, it was found that the patients pain levels had significantly decreased, and that their functional patterns had significantly improved, with AOFAS and Hintermann scores indicating results that were excellent for 20%, good for 70% and poor for 10%. Treatment of ankle arthritis by means of total arthroplasty using the HINTEGRA prosthesis was capable of providing good results over an average observation period of four years.

  15. Impact of removable partial denture prosthesis on chewing efficiency

    Directory of Open Access Journals (Sweden)

    Marion Bessadet

    2013-09-01

    Full Text Available Removable partial denture prostheses are still being used for anatomic, medical and economic reasons. However, the impact on chewing parameters is poorly described. OBJECTIVES: The objective of this study was to estimate the impact of removable partial denture prosthesis on masticatory parameters. MATERIAL AND METHODS: Nineteen removable partial denture prosthesis (RPDP wearers participated in the study. Among them, 10 subjects were Kennedy Class III partially edentulous and 9 with posterior edentulism (Class I. All presented a complete and full dentate opposing arch. The subjects chewed samples of carrots and peanuts with and without their prosthesis. The granulometry of the expectorated boluses from carrot and peanuts was characterized by median particle size (D50, determined at the natural point of swallowing. Number of chewing cycles (CC, chewing time (CT and chewing frequency (CF=CC/CT were video recorded. RESULTS: With RPDP, the mean D50 values for carrot and peanuts were lower [Repeated Model Procedures (RMP, F=15, p<0.001] regardless of the type of Kennedy Class. For each food, mean CC, CT and CF values recorded decreased (RMP, F=18, F=9, and F=20 respectively, p<0.01. With or without RPD, the boluses' granulometry values were above the masticatory normative index (MNI determined as 4,000 µm. CONCLUSION: RPDP rehabilitation improves the ability to reduce the bolus particle size, but does not reestablish fully the masticatory function. CLINICAL RELEVANCE: This study encourages the clinical improvement of oral rehabilitation procedure.

  16. Reliability of MRI findings in candidates for lumbar disc prosthesis

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Linda; Espeland, Ansgar [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Section for Radiology, Department of Surgical Sciences, Bergen (Norway); Neckelmann, Gesche [Haukeland University Hospital, Department of Radiology, Bergen (Norway); Gjertsen, Oeivind [Oslo University Hospital, Department of Neuroradiology, Oslo (Norway); Hellum, Christian [Oslo University Hospital, Department of Orthopaedics, Oslo (Norway); University of Oslo, Department of Orthopaedics, Oslo (Norway); Johnsen, Lars G. [University Hospital of Trondheim, National Centre for Diseases of the Spine, Trondheim (Norway); University Hospital of Trondheim, Orthopaedic Department, Trondheim (Norway); Eide, Geir E. [Haukeland University Hospital, Centre for Clinical Research, Bergen (Norway); University of Bergen, Department of Public Health and Primary Health Care, Bergen (Norway)

    2012-07-15

    Limited reliability data exist for localised magnetic resonance imaging (MRI) findings relevant to planning of treatment with lumbar disc prosthesis and later outcomes. We assessed the reliability of such findings in chronic low back pain patients who were accepted candidates for disc prosthesis. On pretreatment MRI of 170 patients (mean age 41 years; 88 women), three experienced radiologists independently rated Modic changes, disc findings and facet arthropathy at L3/L4, L4/L5 and L5/S1. Two radiologists rerated 126 examinations. For each MRI finding at each disc level, agreement was analysed using the kappa statistic and differences in prevalence across observers using a fixed effects model. All findings at L3/L4 and facet arthropathy at L5/S1 had a mean prevalence <10% across observers and were not further analysed, ensuring interpretable kappa values. Overall interobserver agreement was generally moderate or good (kappa 0.40-0.77) at L4-S1 for Modic changes, nucleus pulposus signal, disc height (subjective and measured), posterior high-intensity zone (HIZ) and disc contour, and fair (kappa 0.24) at L4/L5 for facet arthropathy. Posterior HIZ at L5/S1 and severely reduced subjective disc height at L4/L5 differed up to threefold in prevalence between observers (p < 0.0001). Intraobserver agreement was mostly good or very good (kappa 0.60-1.00). In candidates for disc prosthesis, mostly moderate interobserver agreement is expected for localised MRI findings. (orig.)

  17. Effects of gamma irradiation on the initial mechanical and material properties of goat bone-patellar tendon-bone allografts

    Energy Technology Data Exchange (ETDEWEB)

    Gibbons, M.J.; Butler, D.L.; Grood, E.S.; Bylski-Austrow, D.I.; Levy, M.S.; Noyes, F.R. (Univ. of Cincinnati, OH (USA))

    1991-03-01

    The effects of {sup 60}Co gamma irradiation on the initial mechanical properties of the composite bone-patellar tendon-bone unit (CU) and the tendon midsubstance (TM) were studied. Frozen specimens were exposed to either 2 or 3 Mrad of gamma irradiation. Paired frozen specimens served as intraanimal controls. Treatment effects on the CU were assessed using four mechanical parameters. Effects on the TM were assessed using four material parameters measured using an optical surface-strain analysis system. The maximum force and strain energy to maximum force of the composite unit were significantly reduced 27% and 40%, respectively, after 3 Mrad of irradiation (p less than .05). Mechanical properties of the CU were not significantly altered, however, following 2 Mrad of irradiation. Based on individual paired contrasts between treatment and control, significant differences were also found in the material properties of the tendon midsubstance. The maximum stress, maximum strain, and strain energy density to maximum stress were significantly reduced following 3 Mrad, but not 2 Mrad, of irradiation. The results provide important time zero material property data, which will be useful for later anterior cruciate ligament reconstruction studies using irradiated allograft patellar tendons in the goat model and other animal models as well.

  18. Risk factors for patellar tendinopathy in volleyball and basketball players: A survey-based prospective cohort study.

    Science.gov (United States)

    de Vries, A J; van der Worp, H; Diercks, R L; van den Akker-Scheek, I; Zwerver, J

    2015-10-01

    Patellar tendinopathy (PT) is a common overuse injury of the patellar tendon in jumping athletes. In a recent large cross-sectional study from 2008 several factors were identified that may be associated with the etiology of PT. However, because of the study design no conclusions could be drawn about causal relations. The primary aim of the current study is to investigate whether the factors identified in the previous 2008 study can also be prospectively recognized as predictors of symptomatic PT in 2011. Nine hundred twenty-six Dutch elite and non-elite basketball and volleyball players from the previous study were invited again to complete an online survey about knee complaints and risk factors for PT in 2011. The logistic regression included 385 athletes of which 51 (13%) developed PT since 2008. Male gender [odds ratio (OR) 2.0, 95% confidence interval (CI) 1.1-3.5] was found to be a risk factor for developing PT. No sports-related variables could be identified to increase the risk of developing PT, but some evidence was found for performing heavy physically demanding work, like being a nurse or a physical education teacher (OR 2.3, 95% CI 0.9-6.3). These findings indicate that, when considering preventive measures, it is important to take into account the total tendon load.

  19. Phase contrast imaging X-ray computed tomography: quantitative characterization of human patellar cartilage matrix with topological and geometrical features

    Science.gov (United States)

    Nagarajan, Mahesh B.; Coan, Paola; Huber, Markus B.; Diemoz, Paul C.; Wismüller, Axel

    2014-03-01

    Current assessment of cartilage is primarily based on identification of indirect markers such as joint space narrowing and increased subchondral bone density on x-ray images. In this context, phase contrast CT imaging (PCI-CT) has recently emerged as a novel imaging technique that allows a direct examination of chondrocyte patterns and their correlation to osteoarthritis through visualization of cartilage soft tissue. This study investigates the use of topological and geometrical approaches for characterizing chondrocyte patterns in the radial zone of the knee cartilage matrix in the presence and absence of osteoarthritic damage. For this purpose, topological features derived from Minkowski Functionals and geometric features derived from the Scaling Index Method (SIM) were extracted from 842 regions of interest (ROI) annotated on PCI-CT images of healthy and osteoarthritic specimens of human patellar cartilage. The extracted features were then used in a machine learning task involving support vector regression to classify ROIs as healthy or osteoarthritic. Classification performance was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC). The best classification performance was observed with high-dimensional geometrical feature vectors derived from SIM (0.95 ± 0.06) which outperformed all Minkowski Functionals (p analysis of chondrocyte patterns in human patellar cartilage matrix involving SIM-derived geometrical features can distinguish between healthy and osteoarthritic tissue with high accuracy.

  20. Ocular prosthesis incorporating IPS e-max press scleral veneer and a literature review on non-integrated ocular prosthesis

    Science.gov (United States)

    Da Costa, Godwin Clovis; Aras, Meena Ajay; Chalakkal, Paul; Da Costa, Michelle Clovis

    2017-01-01

    The article highlights a new method for the fabrication of an ocular prosthesis by the incorporation of a ceramic scleral veneer. The steps of fabrication include impression making, wax try-in, performing a “cut-back” on a selected stock eye, insertion of the IPS e-max press scleral veneer, finishing and insertion. It also includes a detailed review on non-integrated ocular prostheses. PMID:28149792