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Sample records for carpometacarpal joint implants

  1. Finite element analysis of thumb carpometacarpal joint implants

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, C.

    1995-11-01

    The thumb carpometacarpal joint is frequently replaced in women who have developed severe osteoarthritis of the hand. A new, privately developed implant design consists of two components, trapezial and metacarpal, each with a saddle-shaped articulating surface. A three dimensional finite element model of this implant has been developed to analyze stresses on the device. The first simulations using the model involve loading the implant with forces normal to the trapezial component. Preliminary results show contact stress distributions at the particulating surfaces of the implant.

  2. Early outcomes of arthroplasty of the first carpometacarpal joint using pyrocarbon spherical implants

    Science.gov (United States)

    Bengezi, Omar; Vo, Anthony

    2014-01-01

    The first carpometacarpal joint (CMC) is the most common hand joint to develop osteoarthritis. A survey found that many hand surgeons have revisited implant arthroplasty because it preserves critical structures. However, there is currently no implant with an ideal design and material composition. The present study was the first to use and evaluate early outcomes of pyrocarbon spherical implants for arthroplasty of the first CMC in patients with Eaton-Littler stage II and III osteoarthritis. A single surgeon performed 24 arthroplasties (23 patients [20 women, three men] with a mean age of 56 years [range 46 to 75 years]) of the first CMC (nine right hands and 15 left hands) using pyrocarbon spherical implants from May 2010 to April 2013. All patients failed conservative management. At a mean (± SD) of 18.5±11.16 months postoperatively (range 4.3 to 38.9 months), the mean Kapandji score was 8.8 of 10 (range 7 to 10), the average pre- and postoperative values on the visual pain scale were 8.96±0.64 of 10 (range 8 to 10) and 1.13±1.22 of 10 (range 0 to 4), respectively. All patients were either very satisfied (score = 5) or satisfied (score = 4) with the procedure, with a mean satisfaction score of 4.76±0.44 of 5.00 (range 4 to 5). The mean postoperative Disabilities of the Arm, Shoulder and Hand (DASH) score was 11.79±14.29 (range 0 to 49.17). The most recent radiographic evaluations confirmed that all implants were stable with no erosion of nearby cancellous bone. There were no implant subluxations, dislocations or revisions. Early outcomes show promising results and support continued use of this implant for arthroplasty. However, longer-term follow-up will be needed to confirm these results. PMID:25114617

  3. 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...

  4. Divergent dislocation of the ring and little finger carpometacarpal joints--a rare injury pattern.

    LENUS (Irish Health Repository)

    Dillon, John

    2012-02-03

    Hand injuries due to longitudinal forces in the line of the metacarpals demonstrate unusual dislocation patterns. We describe a case of volar intra-articular fracture dislocation of the ring finger carpometacarpal joint in association with a pure dorsal dislocation of the little finger carpometacarpal joint. Open reduction supplemented with Kirschner wire fixation restored normal carpometacarpal joint anatomical relations and achieved an excellent clinical result.

  5. First Carpometacarpal Joint Dislocation and Review of Literatures

    Directory of Open Access Journals (Sweden)

    Farivar Lahiji

    2015-09-01

    Full Text Available Dislocation of the first carpometacarpal (CMC is a rare occurrence. Treatment of this dislocation varies from closed reduction and casting to ligament repair. Neglected dislocation or incomplete reduction of the 1st CMC cause chronic instability and painful arthritis, muscle imbalance and decreased grip force. In our study 6 patients is evaluated that were visited in less than 24 hours from their injury. All were primarily reduced and except one patient later injured ligament were repaired. All patient after 6 months had normal range of motion without pain and they had not any complaint. Stability at the 1st CMC joint is dependent on static and dynamic forces. However, dislocation of the 1st CMC occur rare, but important function of the thumb specially in gripping and grasping makes it a significant problem. Injured ligament should repair for increased stability of 1st CMC joint, because neglected dislocation or incomplete reduction cause chronic instability and painful arthritis.

  6. Men and women have similarly shaped carpometacarpal joint bones.

    Science.gov (United States)

    Schneider, M T Y; Zhang, J; Crisco, J J; Weiss, A P C; Ladd, A L; Nielsen, P; Besier, T

    2015-09-18

    Characterizing the morphology of the carpometacarpal (CMC) joint bones and how they vary across the population is important for understanding the functional anatomy and pathology of the thumb. The purpose of this paper was to develop a statistical shape model of the trapezium and first metacarpal bones to characterize the size and shape of the whole bones across a cohort of 50. We used this shape model to investigate the effects of sex and age on the size and shape of the CMC joint bones and the articulating surface area of the CMC joint. We hypothesized that women have similar shape trapezium and first metacarpal bones compared to men, following scaling for overall size. We also hypothesized that age would be a significant predictor variable for CMC joint bone changes. CT image data and segmented point clouds of 50 CMC bones from healthy adult men and women were obtained from an ongoing study and used to generate two statistical shape models. Statistical analysis of the principal component weights of both models was performed to investigate morphological sex and age differences. We observed sex differences, but were unable to detect any age differences. Between men and women the only difference in morphology of the trapezia and first metacarpal bones was size. These findings confirm our first hypothesis, and suggest that the women have similarly shaped trapezium and first metacarpal bones compared to men. Furthermore, our results reject our second hypothesis, indicating that age is a poor predictor of CMC joint morphology.

  7. Trapeziometacarpal narrow pseudarthrosis: a new surgical technique to treat thumb carpometacarpal joint arthritis.

    Science.gov (United States)

    Rubino, M; Civani, A; Pagani, D; Sansone, V

    2013-10-01

    We describe a technique that arose from the observation of the clinical outcome of failed arthrodeses of the thumb carpometacarpal joint. In these cases a pseudoarthrosis developed which, surprisingly, rarely lead to a poor clinical outcome. Thus we developed a simple technique which deliberately caused the formation of a narrow pseudoarthrosis in the carpometacarpal joint. We present a retrospective review of 248 consecutive patients treated for Eaton stages II and III osteoarthritis. We observed a statistically significant improvement in mean appositional and oppositional pinch strength, mean DASH score (63.8 pre-operatively to 10.5 at final follow-up), and the mean pain score (8.3 to 0.2). We conclude that trapeziometacarpal limited excision arthroplasty is a simple and reliable alternative to existing surgical techniques for treating Stage II or III thumb carpometacarpal joint arthritis.

  8. [Systematization of the articular surfaces of the carpometacarpal joints (author's transl)].

    Science.gov (United States)

    el Bacha, A; Maillot, C

    1977-01-01

    A study, done on 100 hands, of the systematization of the articular surfaces of the carpometacarpal joints, clearly delineates the variability of circumference, dimesions, and relief of the articular facets. An attempt to draw general conclusions from this morphological study, in terms of arthrokinetics, leads to an understanding of the nature of the joints and the movements that are performed at this site.

  9. Multiple volar dislocations of the carpometacarpal joints with an associated fracture of the first metacarpal base

    Institute of Scientific and Technical Information of China (English)

    Latif Zafar Jilani; Mazhar Abbas; Siddharth Goel; Mohammad Nasim Akhtar

    2014-01-01

    Multiple volar dislocations of carpometacarpal (CMC) joints are uncommon and have been reported rarely.A 25 years old male presented with injury to his left hand 6 days following a road traffic accident.Clinical examination revealed gross swelling of the hand and diffuse tenderness over the carpometacarpal area.His radiographs of the hand showed volar dislocation of the second,third and fourth CMC joints in association with an extra-articular fracture of the base of thumb metacarpal.He was treated by open reduction and percutaneous fixation using Kirschner wires.The functional results were excellent at one year follow-up.

  10. Work-related bilateral osteoarthritis of the first carpometacarpal joints

    DEFF Research Database (Denmark)

    Jensen, Jens Christian; Sherson, David

    2007-01-01

    conditions, with photos and videos. The literature concerning first carpometacarpal OA was reviewed using PubMed. RESULTS: The observation of work conditions demonstrated unusual forceful and repetitive ulnar flexion of both first fingers. No competing causes of OA could be identified. CONCLUSION...

  11. Design and construction of custom-made neoprene thumb carpo-metacarpal orthosis with thermoplastic stabilization for first carpo-metacarpal joint osteoarthritis.

    Science.gov (United States)

    Bani, Monireh Ahmadi; Arazpour, Mokhtar; Curran, Sarah

    2013-01-01

    Individuals with first carpo-metacarpal (CMC) osteoarthritis (OA) often experience pain and difficulty with functional activities. Thus, designing orthotics to improve function and decrease pain is common practice. These therapists designed an orthosis using a combination of neoprene and thermoplastic materials to create a soft orthosis that provides support to the first CMC joint - Victoria Priganc, PhD, OTR, CHT, CLT.

  12. Multiple carpometacarpal dislocations.

    OpenAIRE

    Kumar, A.; Olney, D B

    1994-01-01

    We present a case of dislocations of the carpometacarpal joints without associated fractures. Although carpometacarpal injuries are relatively uncommon, it is rare for multiple carpometacarpal dislocations to occur without associated fractures. The injury is difficult to diagnose because of swelling of the hand. A lateral radiograph of the wrist has been found to be mandatory to its precise diagnosis if suspected. In the case presented here early diagnosis and closed manipulation in the accid...

  13. Volar dislocation of the index carpometacarpal joint in association with a Bennett's fracture of the thumb: a rare injury pattern.

    LENUS (Irish Health Repository)

    Dillon, J P

    2012-02-03

    We describe a case of volar dislocation of the index carpometacarpal (CMC) joint in association with a Bennett\\'s fracture of the thumb following a motorcycle accident. Volar dislocation of the index carpometacarpal joint is an exceedingly rare but easily missed injury, with only a few reported cases in the literature. This report highlights the importance of a true lateral radiograph and close scrutiny of the film to detect this injury. Closed reduction supplemented with Kirschner wire fixation restored normal anatomical relations and achieved an excellent clinical result.

  14. Ligament reconstruction with tendon interposition arthroplasty for first carpometacarpal joint osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    Yang Yong; Huey Y.Tien; Kannan K.Kumar; Chen Shanlin; Li Zhongzhe; Tian Wen; Tian Guanglei

    2014-01-01

    Background Ligament reconstruction tendon interposition (LRTI) is the most commonly performed surgical procedure for first carpometacarpal joint osteoarthdtis.The purpose of this study was to examine the radiographic and clinical outcomes of LRTI arthroplasty and document the clinical results based on metacarpal subsidence.Methods From January 2008 to January 2011,19 patients (21 thumbs) underwent surgery for thumb carpometacarpal arthritis using ligament reconstruction tendon interposition arthroplasty with flexor carpi radialis (FCR) in Kleinert Kutz Hand Care Center of Louisville University,USA.The follow-up period was an average of 13.9 months.Pain,grip strength,tip pinch strength,range of motion,and radiographic measurements were recorded.Based on first metacarpal subsidence,the cases were classified in to mild,moderate,and severe.Clinical outcomes of the groups were evaluated and compared.Results Grip strength improved from 18.6 kg to 20.5 kg,and tip pinch strength increased from 4.4 kg to 4.5 kg after the surgery.Radial abduction and palmar abduction improved after surgery.Radial abduction increased from 55.7° to 60.6° and palmar abduction improved from 56.7° to 63.5° after the procedure.Visual analogue scores (VAS) were significantly reduced,from 6.6 to 0.5.Compared with the preoperative radiographs the first metacarpal had subsided about 54.6% of the arthroplasty space.The height of arthroplasty space and index of the arthroplasty space significantly decreased from 12.4 mm to 5.6 mm and from 0.27 to 0.12 respectively.Between the various groups (mild,moderate and severe metacarpal subsidence),there was no difference in grip strength,tip pinch strength,thumb range of motion,and VAS.Conclusions Ligament reconstruction tendon interposition arthroplasty resulted in excellent relief of pain and increase in range of motion.However,LRTI cannot maintain the arthroplasty space.Compared with the preoperative radiographs,the metacarpal subsided more than 50

  15. Osteoarthritis of the carpometacarpal joint of the thumb: a new MR imaging technique for the standardized detection of relevant ligamental lesions

    Energy Technology Data Exchange (ETDEWEB)

    Dumont, Clemens [University Medical Center Goettingen, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Georg-August-Universitaet, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Lerzer, Sebastian; Tezval, Mohammad; Stuermer, Klaus Michael [University Medical Center Goettingen, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Vafa, Morad Ali; Lotz, Joachim [University Medical Center Goettingen, Department of Diagnostic Radiology and Interventional Radiology, Goettingen (Germany); Dechent, Peter [University Medical Center Goettingen, MR-Research in Neurology and Psychiatry, Department of Cognitive Neurology, Goettingen (Germany)

    2014-10-15

    To assess ligament lesions and subluxations of the carpometacarpal joints of the thumbs (CMC I) of asymptomatic volunteers and of patients with CMC I osteoarthritis using advanced magnetic resonance imaging (MRI). A total of 20 CMC I joints of 14 asymptomatic volunteers (6 x both sides) and 28 CMC I joints of 22 patients (6 x both sides) with symptomatic and X-ray-diagnosed osteoarthritis of CMC I joints were studied. During extension, flexion, abduction and adduction of the thumb, the anterior oblique (AOL), intermetacarpal (IML), posterior oblique (POL) and dorsal radial (DRL) ligaments were evaluated using 3-T MRI on two standard planes, and translation of metacarpal I (MC I) was assessed. The MRI demonstrated that ligament lesions of the AOL and IML are frequent. Isolated rupture of the AOL was found in 6 of 28 (21 %), combined rupture of the AOL + IML in 5 of 28 (18 %) and isolated IML rupture in 4 of 28 (14 %) joints. The patients had a significantly increased dorsal translation of MC I during extension with a median of 6.4 mm vs. 5.4 mm in asymptomatic volunteers (p < 0.05). MRIs of CMC I in two standardized planes frequently show combined ligament ruptures. The dorsal subluxation of MC I, which is increased in patients, correlates with OA severity based on X-ray and can be quantified by MRI. For joint-preserving surgical procedures and for prosthesis implantation of the CMC I, we recommend performing an MRI in two planes of the thumb - extension and abduction - to evaluate the ligaments and dorsal subluxation of MC I. (orig.)

  16. Outcome of uncemented trapeziometacarpal prosthesis for treatment of thumb carpometacarpal joint arthritis

    Directory of Open Access Journals (Sweden)

    Manish Chug

    2014-01-01

    Conclusion: The use of uncemented prosthesis in treatment of Questionnaire Score. Range of motion joint osteoarthritis gives excellent short term results in improving hand function in terms of strength and stability and achieving pain relief.

  17. Osteoarthritis of the first carpometacarpal joint: a study of radiology and clinical epidemiology:

    DEFF Research Database (Denmark)

    Sonne-Holm, Stig; Jacobsen, J

    2006-01-01

    Epidemiological studies show an increased prevalence of osteoarthritis of the knee and hand with increased body mass index [BMI]. Osteoarthritis of the hip joint is not related to BMI. The connection between obesity and osteoarthritis cannot exclusively be explained by genetic factors or by the a...

  18. Total carpometacarpal joint dislocation combined with trapezium fracture, trapezoid dislocation and hamate fracture

    DEFF Research Database (Denmark)

    Gvozdenovic, R; Vadstrup, Lars Soelberg

    2015-01-01

    Multiple metacarpal dislocations combined with carpal fracture - dislocations are rare injuries. We report a new combination of these injuries where fracture-dislocation of the base of the 1st metacarpal bone occurred simultaneously with a comminuted fracture of the trapezium, dislocation...... of the trapezoid and metacarpal joints (2nd to 5th) and an avulsion fracture of the hamate. This specific carpal injury has not been previously described and our description will contribute to understanding the mechanism of these complex injuries. The injury pattern in the case featured here was multifaceted...... and resulted from rupture of both transverse and longitudinal carpal columns. According to the Garcia-Elias classification of axial carpal disruptions, this particular injury mechanism was a combined axial-radial-ulnar type injury. These injuries are extremely rare and are only sporadically described...

  19. Treatment of thumb carpometacarpal osteoarthritis; quo vadis?

    NARCIS (Netherlands)

    Spaans, AJ

    2016-01-01

    The unique prehensile ability of the human hand is largely due to the biomechanical function of its complex first carpometacarpal (CMC1) joint. This makes the thumb the most important digit of the hand. The unique demands placed on the thumb regarding mobility, stability and transmission of force ma

  20. Fixation of trapezial implants in a trapeziometacarpal total joint prosthesis tested in a model of porcine bone.

    Science.gov (United States)

    Hansen, Torben Bæk; Hengst, David; Mortensen, Jesper; Amstrup, Anders Læssøe

    2011-12-01

    High aseptic loosening rates have been reported in total joint prostheses of the carpometacarpal joint of the thumb, particularly in the trapezial component. The primary fixation of new implants may be tested in cadaver bones, but the anatomy of the pig is in many ways similar to that of the human, so we compared the central carpal bone from the forefoot of 6-month-old pigs, which has a saddle joint surface similar to the trapezium, to the trapezium in patients with carpometacarpal osteoarthritis. The mean (SD) bone mineral density of the 13 pig forefoot bones was 0.88 (0.12) g/cm(2) compared with 0.63 (0.16) g/cm(2) in the 31 human trapeziums. The measured size of the porcine bones was slightly larger than that of the human trapeziums. The similarity in form, size, and bone mineral density means that the central bone of the forefoot of 6-month-old pigs may be used for fixation tests in trapezial implants.

  1. [Considerations for optimizing joint implants].

    Science.gov (United States)

    Tensi, H M; Orloff, S; Gese, H; Hooputra, H

    1994-09-01

    Despite the increasing use of orthopaedic implants, there is still a lack of adequate testing procedures and legal guidelines. Examples of the consequences of this neglect are given. Modern techniques for the calculation of stresses (finite element method [FEM]) and the prediction of life cycle duration are presented. Such methods, applied in the development and manufacturing phases of standard and special implants, may ensure an adequate prosthetic life cycle, with particular emphasis being placed on the biomedical optimization of the implant/bone interface and surrounding bone.

  2. Multiple Volar Carpometacarpal Dislocations with Associated Carpal Tunnel Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    C Fletcher

    2015-09-01

    Full Text Available We report a rare injury involving volar fracture dislocations of the second to fifth carpometacarpal dislocations. Carpometacarpal dislocations are usually dorsally displaced and most commonly only involve the fourth and fifth joints. An associated carpal tunnel syndrome adds another dimension to the complexity and rarity of the injury in this index case. A high index of clinical suspicion and subsequent emergent management is of utmost importance to treat this unusual combination of injuries in order to avoid significant morbidity.

  3. Artrodese do punho com fixação mínima preservando as articulações carpometacarpianas Wrist arthrodesis with minimal internal fixation preserving the carpometacarpal joints

    Directory of Open Access Journals (Sweden)

    Arlindo Gomes Pardini Júnior

    2010-01-01

    structures. In general, the results are very satisfactory, particularly for pain relief, and in the majority of cases, there is considerable functional improvement. Various techniques are described, with different methods of internal fixation, most of which include the carpometacarpal joints (CMJ in the fusion. The objective of this study is to evaluate the results of wrist arthrodesis through a technique which is simpler, more biological, more inexpensive, and does not involve the carpometacarpal joints. METHODS: 15 patients with wrist arthrodesis were evaluated (6 with sequelae of trauma, 4 Rheumatoid Arthritis, 3 Kienbock's grade IV, 1 Preiser and 1 panarthrosis. The technique consisted of the use of an iliac bone plate and internal fixation with Kirschner wires, avoiding the carpometacarpal joints. RESULTS: The evaluation was based on consolidation time (93% in 7 weeks; movements of the fingers and pronosupination; pinch and grasp strength; functional evaluation through the DASH questionnaire, pain and patient satisfaction. In general, the results were similar to those of other, more aggressive techniques, and the non-inclusion of the carpometacarpal joints did not affect the final result. CONCLUSION: wrist arthrodesis with fixation using Kirschner wires and the use of an iliac bone plate, preserving the carpometacarpal joints, gives good or excellent results which are similar to those of other techniques described. However it presents major advantages over other methods: it is less aggressive, less expensive, and does not have the inconvenience and complications associated the use of plates and screws.

  4. Implant arthroplasty for the distal radioulnar joint.

    Science.gov (United States)

    Scheker, Luis R

    2008-11-01

    The distal radioulnar joint (DRUJ) is a weight-bearing joint; the ulnar head is frequently excised either totally or partially and in some cases is fused because of degenerative, rheumatoid, or posttraumatic arthritis and treated with a "salvage procedure." The result of these procedures is the inability of those patients to lift even minor weight. Articles about these procedures report the ability to pronate and supinate, but they rarely discuss grip strength or lifting capacity. We present an alternative to the salvage procedures that allows full range of motions as well as the ability to grip and lift weights encountered in daily living, such as a gallon of milk. The Aptis total DRUJ replacement prosthesis (Aptis Medical, Louisville, KY), a bipolar self-stabilizing DRUJ endoprosthesis, restores the forearm function. The technique of implantation is presented here.

  5. A computational method for comparing the behavior and possible failure of prosthetic implants

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, C.; Hollerbach, K.; Perfect, S.; Underhill, K.

    1995-05-01

    Prosthetic joint implants currently in use exhibit high Realistic computer modeling of prosthetic implants provides an opportunity for orthopedic biomechanics researchers and physicians to understand possible in vivo failure modes, without having to resort to lengthy and costly clinical trials. The research presented here is part of a larger effort to develop realistic models of implanted joint prostheses. The example used here is the thumb carpo-metacarpal (cmc) joint. The work, however, can be applied to any other human joints for which prosthetic implants have been designed. Preliminary results of prosthetic joint loading, without surrounding human tissue (i.e., simulating conditions under which the prosthetic joint has not yet been implanted into the human joint), are presented, based on a three-dimensional, nonlinear finite element analysis of three different joint implant designs.

  6. Synthetic Versus Tissue-Engineered Implants for Joint Replacement

    Directory of Open Access Journals (Sweden)

    Duncan E. T. Shepherd

    2007-01-01

    Full Text Available Human synovial joints are remarkable as they can last for a lifetime. However, they can be affected by disease that may lead to destruction of the joint surface. The most common treatment in the advanced stages of joint disease is artificial joint replacement, where the diseased synovial joint is replaced with an artificial implant made from synthetic materials, such as metals and polymers. A new technique for repairing diseased synovial joints is tissue engineering where cells are used to grow replacement tissue. This paper explores the relative merits of synthetic and tissue-engineered implants, using joint replacement as an example. Synthetic joint replacement is a well-established procedure with the advantages of early mobilisation, pain relief and high patient satisfaction. However, synthetic implants are not natural tissues; they can cause adverse reactions to the body and there could be a mismatch in mechanical properties compared to natural tissues. Tissue-engineered implants offer great potential and have major advantages over synthetic implants as they are natural tissue, which should ensure that they are totally biocompatible, have the correct mechanical properties and integrate well with the existing tissue. However, there are still many limitations to be addressed in tissue engineering such as scaling up for production, bioreactor design, appropriate regulation and the potential for disease to attack the new tissue-engineered implant.

  7. A Mastication Mechanism Designed for Testing Temporomandibular Joint Implants

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    Ryan J. Frayne

    2012-01-01

    Full Text Available The development of temporomandibular joint implants has involved simplified mechanical tests that apply pure vertical forces or pure rotational movements to the implant. The aim of this study was to develop a biological based mastication mechanism and conduct preliminary testing of a novel temporomandibular joint implant. The mechanism was designed to mimic temporomandibular joint loads by performing compression and anterior/posterior translation. Pilot testing was performed on six implant/joint specimens for seven consecutive hours, completing approximately 22,000 cycles at a frequency of approximately 1 Hz. Each cycle had a joint compression phase (67.3 N over 0.15 s followed by a translation phase (8.67 N over 0.43 s that was similar to joint loads/motions that have been reported in vivo. This new mastication mechanism incorporates both anatomical and mechanical variability. The use of biological specimens is an important approach that can help bridge the gap between traditional synthetic implant materials/mechanical testing and in vivo testing.

  8. Experimental and failure analysis of the prosthetic finger joint implants

    Science.gov (United States)

    Naidu, Sanjiv H.

    Small joint replacement arthroplasty of the hand is a well accepted surgical procedure to restore function and cosmesis in an individual with a crippled hand. Silicone elastomers have been used as prosthetic material in various small hand joints for well over three decades. Although the clinical science aspects of silicone elastomer failure are well known, the physical science aspects of prosthetic failure are scant and vague. In the following thesis, using both an animal model, and actual retrieved specimens which have failed in human service, experimental and failure analysis of silicone finger joints are presented. Fractured surfaces of retrieved silicone trapezial implants, and silicone finger joint implants were studied with both FESEM and SEM; the mode of failure for silicone trapezium is by wear polishing, whereas the finger joint implants failed either by fatigue fracture or tearing of the elastomer, or a combination of both. Thermal analysis revealed that the retrieved elastomer implants maintained its viscoelastic properties throughout the service period. In order to provide for a more functional and physiologic arthroplasty a novel finger joint (Rolamite prosthesis) is proposed using more recently developed thermoplastic polymers. The following thesis also addresses the outcome of the experimental studies of the Rolamite prosthesis in a rabbit animal model, in addition to the failure analysis of the thermoplastic polymers while in service in an in vivo synovial environment. Results of retrieved Rolamite specimens suggest that the use for thermoplastic elastomers such as block copolymer based elastomers in a synovial environment such as a mammalian joint may very well be limited.

  9. Detection of biomaterial-associated infections in orthopaedic joint implants

    NARCIS (Netherlands)

    Neut, D; van Horn, [No Value; van Kooten, TG; van der Mei, HC; Busscher, HJ

    2003-01-01

    Biomaterial-associated infection of orthopaedic joint replacements is the second most common cause of implant failure. Yet, the microbiologic detection rate of infection is relatively low, probably because routine hospital cultures are made only of swabs or small pieces of excised tissue and not of

  10. Distal interphalangeal joint implant arthroplasty in a musician.

    Science.gov (United States)

    Schwartz, D A; Peimer, C A

    1998-01-01

    Degenerative joint disease commonly affects the distal interphalangeal (DIP) joints, causing articular destruction and marginal bone formation. Treatment for pain relief and function is most often done through arthrodesis. The case of a 70-year-old concert violinist with left index finger DIP joint osteoarthritis is presented. Arthritis in the involved joint caused pain and deformity and interfered with the patient's ability to play music. Trial arthrodesis with K-wires proved impossible because of the patient's need for continued mobility. Swanson hinge implant arthroplasty was performed on the affected DIP joint. The patient eventually achieved an excellent result and was able to return to playing the violin professionally. Treatment and therapy guidelines are presented.

  11. Instrumented knee joint implants: innovations and promising concepts.

    Science.gov (United States)

    Torrão, João N D; Dos Santos, Marco P Soares; Ferreira, Jorge A F

    2015-01-01

    This article focuses on in vivo implementations of instrumented knee implants and recent prototypes with highly innovative potential. An in-depth analysis of the evolution of these systems was conducted, including three architectures developed by two research teams for in vivo operation that were implanted in 13 patients. The specifications of their various subsystems: sensor/transducers, power management, communication and processing/control units are presented, and their features are compared. These systems were designed to measure biomechanical quantities to further assist in rehabilitation and physical therapy, to access proper implant placement and joint function and to help predicting aseptic loosening. Five prototype systems that aim to improve their operation, as well as include new abilities, are also featured. They include technology to assist proper ligament tensioning and ensure self-powering. One can conclude that the concept of instrumented active knee implant seems the most promising trend for improving the outcomes of knee replacements.

  12. A personalized 3D-printed prosthetic joint replacement for the human temporomandibular joint: From implant design to implantation.

    Science.gov (United States)

    Ackland, David C; Robinson, Dale; Redhead, Michael; Lee, Peter Vee Sin; Moskaljuk, Adrian; Dimitroulis, George

    2017-05-01

    Personalized prosthetic joint replacements have important applications in cases of complex bone and joint conditions where the shape and size of off-the-shelf components may not be adequate. The objective of this study was to design, test and fabricate a personalized 3D-printed prosthesis for a patient requiring total joint replacement surgery of the temporomandibular joint (TMJ). The new 'Melbourne' prosthetic TMJ design featured a condylar component sized specifically to the patient and fixation screw positions that avoid potential intra-operative damage to the mandibular nerve. The Melbourne prosthetic TMJ was developed for a 58-year-old female recipient with end-stage osteoarthritis of the TMJ. The load response of the prosthesis during chewing and a maximum-force bite was quantified using a personalized musculoskeletal model of the patient's masticatory system developed using medical images. The simulations were then repeated after implantation of the Biomet Microfixation prosthetic TMJ, an established stock device. The maximum condylar stresses, screw stress and mandibular stress at the screw-bone interface were lower in the Melbourne prosthetic TMJ (259.6MPa, 312.9MPa and 198.4MPa, respectively) than those in the Biomet Microfixation device (284.0MPa, 416.0MPa and 262.2MPa, respectively) during the maximum-force bite, with similar trends also observed during the chewing bite. After trialing surgical placement and evaluating prosthetic TMJ stability using cadaveric specimens, the prosthesis was fabricated using 3D printing, sterilized, and implanted into the female recipient. Six months post-operatively, the prosthesis recipient had a normal jaw opening distance (40.0 mm), with no complications identified. The new design features and immediate load response of the Melbourne prosthetic TMJ suggests that it may provide improved clinical and biomechanical joint function compared to a commonly used stock device, and reduce risk of intra-operative nerve damage

  13. Implant survivorship analysis after minimally invasive sacroiliac joint fusion using the iFuse Implant System®

    Directory of Open Access Journals (Sweden)

    Cher DJ

    2015-11-01

    Full Text Available Daniel J Cher,1 W Carlton Reckling,2 Robyn A Capobianco1 1Department of Clinical Affairs, SI-BONE, Inc., 2Department of Medical Affairs, SI-BONE, Inc., San Jose, CA, USA Introduction: Surgical revision rate is a key outcome with all permanent implants. The iFuse Implant System® is a permanent implant used to perform minimally invasive sacroiliac joint fusion. The purpose of this study is to determine the surgical revision rate after sacroiliac joint fusion surgery with this system. Methods: Using two internal sources of information, revision surgeries were identified and linked to index surgeries. The likelihood of revision surgery was calculated using the Kaplan–Meier life table approach. Predictors of revision were explored. Results: Four-year survivorship free from implant revision was 96.46%. Revision rate did not differ by sex and was lower for age >65. In all, 24% of revisions occurred within the first 30 days after surgery; 63.5% occurred within year 1. Implant survivorship has improved annually since the device was introduced in 2009. Conclusion: The survivorship rate with this implant is high and improving; the rate is somewhat higher than total hip replacement but lower than that of lumbar spine procedures. Keywords: safety, sacroiliac joint fusion, iFuse Implant System, revision

  14. Outcome Assessment after Aptis Distal Radioulnar Joint (DRUJ) Implant Arthroplasty

    Science.gov (United States)

    Kachooei, Amir Reza; Chase, Samantha M; Jupiter, Jesse B

    2014-01-01

    Background: Conventional treatments after complicated injuries of the distal radioulnar joint (DRUJ) such as Darrach and Kapandji-Sauvé procedures have many drawbacks, which may eventually lead to a painful unstable distal ulna. The development of DRUJ prosthesis has significantly evolved over the past years. In this study, we assessed the outcome results of patients after DRUJ implant arthroplasty using the Aptis (Scheker) prosthesis. Methods: We identified 13 patients with 14 prosthesis during the past 10 years. Patients underwent DRUJ arthroplasty due to persistent symptoms of instability, chronic pain, and stiffness. Records and follow-up visits were reviewed to find the final post-operative symptoms, pain, range of motion, and grip strength with a mean follow-up of 12 months (range: 2-25 months). Also, patients were contacted prospectively by phone in order to administer the disabilities of the arm shoulder and hand (DASH), patient rated wrist evaluation (PRWE), and visual analogue scale (VAS), and to interview regarding satisfaction and progress in daily activities. Eleven patients out of 13 could be reached with a median follow-up time of 60 months (range: 2 to 102 months). Results: No patient required removal of the prosthesis. Only two patients underwent secondary surgeries in which both required debridement of the screw tip over the radius. The median DASH score, PRWE score, VAS, and satisfaction were 1.3, 2.5, 0, and 10, respectively. The mean range of flexion, extension, supination, and pronation was 62, 54, 51, and 64, respectively. Conclusions: Distal radioulnar joint injuries are disabling and patients usually undergo one or more salvage surgeries prior to receiving an arthroplasty. The Scheker prosthesis has shown satisfactory results with 100% survival rate in all reports. The constrained design of this prosthesis gives enough stability to prevent painful subluxation. PMID:25386579

  15. Outcome Assessment after Aptis Distal Radioulnar Joint (DRUJ Implant Arthroplasty

    Directory of Open Access Journals (Sweden)

    Amir Reza Kachooei

    2014-09-01

    Full Text Available Background:  Conventional treatments after complicated injuries of the distal radioulnar joint (DRUJ such as Darrach and Kapandji-Sauvé procedures have many drawbacks, which may eventually lead to a painful unstable distal ulna.  The development of DRUJ prosthesis has significantly evolved over the past years. In this study, we assessed the outcome results of patients after DRUJ implant arthroplasty using the Aptis (Scheker prosthesis. Methods: We identified 13 patients with 14 prosthesis during the past 10 years. Patients underwent DRUJ arthroplasty due to persistent symptoms of instability, chronic pain, and stiffness. Records and follow-up visits were reviewed to find the final post-operative symptoms, pain, range of motion, and grip strength with a mean follow-up of 12 months (range: 2-25 months. Also, patients were contacted prospectively by phone in order to  minister the disabilities of the armshoulder and hand (DASH, patient rated wrist evaluation (PRWE, and visual analogue scale (VAS, and to interview regarding satisfaction and progress in daily activities. Eleven patients out of 13 could be reached with a median followup time of 60 months (range: 2 to 102 months.  Results: No patient required removal of the prosthesis. Only two patients underwent secondary surgeries in which both required debridement of the screw tip over the radius. The median DASH score, PRWE score, VAS, and satisfaction were 1.3, 2.5, 0, and 10, respectively. The mean range of flexion, extension, supination, and pronation was 62, 54, 51, and 64, respectively. Conclusions: Distal radioulnar joint injuries are disabling and patients usually undergo one or more salvage surgeries prior to receiving an arthroplasty. The Scheker prosthesis has shown satisfactory results with 100% survival rate in all reports. The constrained design of this prosthesis gives enough stability to prevent painful subluxation.

  16. The Functional Anatomy of the Carpometacarpal Complex in Anthropoids and Its Implications for the Evolution of the Hominoid Hand.

    Science.gov (United States)

    Selby, Michael S; Simpson, Scott W; Lovejoy, C Owen

    2016-05-01

    Previously, we described several features of the carpometacarpal joints in extant large-bodied apes that are likely adaptations to the functional demands of vertical climbing and suspension. We observed that all hominids, including modern humans and the 4.4-million-year-old hominid Ardipithecus ramidus, lacked these features. Here, we assess the uniqueness of these features in a large sample of monkey, ape, and human hands. These new data provide additional insights into the functional adaptations and evolution of the anthropoid hand. Our survey highlights a series of anatomical adaptations that restrict motion between the second and third metacarpals (MC2 and MC3) and their associated carpals in extant apes, achieved via joint reorganization and novel energy dissipation mechanisms. Their hamate-MC4 and -MC5 joint surface morphologies suggest limited mobility, at least in Pan. Gibbons and spider monkeys have several characters (angled MC3, complex capitate-MC3 joint topography, variably present capitate-MC3 ligaments) that suggest functional convergence in response to suspensory locomotion. Baboons have carpometacarpal morphology suggesting flexion/extension at these joints beyond that observed in most other Old World monkeys, probably as an energy dissipating mechanism minimizing collision forces during terrestrial locomotion. All hominids lack these specializations of the extant great apes, suggesting that vertical climbing was never a central feature of our ancestral locomotor repertoire. Furthermore, the reinforced carpometacarpus of vertically climbing African apes was likely appropriated for knuckle-walking in concert with other novel potential energy dissipating mechanisms. The most parsimonious explanation of the structural similarity of these carpometacarpal specializations in great apes is that they evolved independently.

  17. Trapezial topography in thumb carpometacarpal arthritis.

    Science.gov (United States)

    Van Nortwick, Sarah; Berger, Aaron; Cheng, Robert; Lee, Julia; Ladd, Amy L

    2013-08-01

    Objective Contradictory reported arthritic patterns of the metacarpal surface of the trapezium include preferential volar wear, radial wear, and dorsal-ulnar sparing. We investigated whether a predominant wear pattern exists in surgical trapeziectomy for advanced thumb carpometacarpal (CMC) arthritis. Methods We examined 36 intact trapezia from 34 thumb CMC arthroplasty patients over an 18-month period. The first metacarpal articular surface revealed three consistent morphology patterns: (1) saddle, (2) dish, and (3) cirque. The saddle represented cartilage loss with preservation of the normal trapezial morphology. The dish shape represented concave curvature, with loss of the normal saddle configuration. The cirque shape represented preferential volar concave wear, disrupting the convex volardorsal arc. Two surgeons classified the randomized specimens twice, blinded to patient identity and each other's categorization. Radiographic Eaton staging was correlated retrospectively for 35 of 36 of the trapezial specimens. Eight specimens were further quantified with micro-computed tomography (micro-CT). Results Thirty-six trapezia were classified as follows: 17 (47%) saddle, 12 (33%) dish, and 7 (19%) cirque. Intra-rater reliability was 0.97 and 0.95; inter-rater reliability in the second round was 0.95. The 36 trapezia represented 27 female (75%) and 9 male (25%) patients; 18 (50%) represented the dominant hand. Age at surgery averaged 64 (33-76). Complete cartilage loss of the entire metacarpal surface was seen in 15 (42%) of all specimens. Osteophyte presence was typically minimal in the saddle group; the dish group had characteristic extensive rimming osteophytes in a 91% female population (11/12), and the cirque group had volar osteophytes. Radiographic severity ranged from Eaton stage II to IV; less severe radiographic staging (Eaton II) predominated in the saddle configuration; advanced Eaton III-IV disease predominated in both cirque and dish shapes. Micro

  18. Can physical joint simulators be used to anticipate clinical wear problems of new joint replacement implants prior to market release?

    Science.gov (United States)

    Medley, John B

    2016-05-01

    One of the most important mandates of physical joint simulators is to provide test results that allow the implant manufacturer to anticipate and perhaps avoid clinical wear problems with their new products. This is best done before market release. This study gives four steps to follow in conducting such wear simulator testing. Two major examples involving hip wear simulators are discussed in which attempts had been made to predict clinical wear performance prior to market release. The second one, involving the DePuy ASR implant systems, is chosen for more extensive treatment by making it an illustrative example to explore whether wear simulator testing can anticipate clinical wear problems. It is concluded that hip wear simulator testing did provide data in the academic literature that indicated some risk of clinical wear problems prior to market release of the ASR implant systems. This supports the idea that physical joint simulators have an important role in the pre-market testing of new joint replacement implants.

  19. The biomechanics of a thumb carpometacarpal immobilization splint: design and fitting.

    Science.gov (United States)

    Colditz, J C

    2000-01-01

    Splinting for the common osteoarthritis of the carpometacarpal (CMC) joint of the thumb is infrequently described in the literature, but the few splints that are described include one or both adjacent joints. This paper describes the design and biomechanics of a custom-molded thumb CMC immobilization splint that excludes the thumb metacarpophalangeal and wrist joints. The problem of the imbalance of extrinsic extensor/abductor forces against the intrinsic flexor/adductor forces is described. The accompanying weakening of the thumb CMC capsule allows dorsal shifting of the proximal end of the metacarpal, producing pain. The splint described in this paper 1) prevents motion of the first metacarpal in relation to the other metacarpals, 2) prevents tilting (flexion) of the first metacarpal during pinch, and 3) allows unrestricted thumb metacarpal and wrist joint motion. Attention to detail during construction is required for an accurate pattern, precise positioning of the CMC joint during molding, accurate molding around the first metacarpal, and well-distributed pressure. This design may also be used for protection following thumb CMC arthroplasty or thumb CMC sprain or strain and as a base for thumb metacarpophalangeal and/or interphalangeal mobilization splinting.

  20. Management of osteoarthrosis of the thumb joints.

    Science.gov (United States)

    Berger, Aaron J; Meals, Roy A

    2015-04-01

    We present current concepts and evidence to optimize diagnosis and management of osteoarthritis in the thumb joints. Numerous options and controversies exist for surgical treatment of carpometacarpal joint arthritis. Fewer options exist for metacarpophalangeal joint arthritis. Surgical treatment for interphalangeal arthritis is mainly arthrodesis.

  1. Triangular Titanium Implants for Minimally Invasive Sacroiliac Joint Fusion: A Prospective Study.

    Science.gov (United States)

    Duhon, Bradley S; Cher, Daniel J; Wine, Kathryn D; Kovalsky, Don A; Lockstadt, Harry

    2016-05-01

    Study Design Prospective multicenter single-arm interventional clinical trial. Objective To determine the degree of improvement in sacroiliac (SI) joint pain, disability related to SI joint pain, and quality of life in patients with SI joint dysfunction who undergo minimally invasive SI joint fusion using triangular-shaped titanium implants. Methods Subjects (n = 172) underwent minimally invasive SI joint fusion between August 2012 and January 2014 and completed structured assessments preoperatively and at 1, 3, 6, and 12 months postoperatively, including a 100-mm SI joint and back pain visual analog scale (VAS), Oswestry Disability Index (ODI), Short Form-36 (SF-36), and EuroQOL-5D. Patient satisfaction with surgery was assessed at 6 and 12 months. Results Mean SI joint pain improved from 79.8 at baseline to 30.0 and 30.4 at 6 and 12 months, respectively (mean improvements of 49.9 and 49.1 points, p joint fusion resulted in improvement of pain, disability, and quality of life in patients with SI joint dysfunction due to degenerative sacroiliitis and SI joint disruption.

  2. Outcome Assessment after Aptis Distal Radioulnar Joint (DRUJ Implant Arthroplasty

    Directory of Open Access Journals (Sweden)

    Amir Reza Kachooei

    2014-09-01

    Distal radioulnar joint injuries are disabling and patients usually undergo one or more salvage surgeries prior to receiving an arthroplasty. The Scheker prosthesis has shown satisfactory results with 100% survival rate in all reports. The constrained design of this prosthesis gives enough stability to prevent painful subluxation.

  3. The KineSpring® Knee Implant System: an implantable joint-unloading prosthesis for treatment of medial knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    Clifford AG

    2013-05-01

    Full Text Available Anton G Clifford,1 Stefan M Gabriel,1 Mary O’Connell,1 David Lowe,1 Larry E Miller,2,3 Jon E Block31Moximed, Inc, Hayward, CA, USA; 2Miller Scientific Consulting, Inc, Arden, NC, USA; 3The Jon Block Group, San Francisco, CA, USAAbstract: Symptomatic medial compartment knee osteoarthritis (OA is the leading cause of musculoskeletal pain and disability in adults. Therapies intended to unload the medial knee compartment have yielded unsatisfactory results due to low patient compliance with conservative treatments and high complication rates with surgical options. There is no widely available joint-unloading treatment for medial knee OA that offers clinically important symptom alleviation, low complication risk, and high patient acceptance. The KineSpring® Knee Implant System (Moximed, Inc, Hayward, CA, USA is a first-of-its-kind, implantable, extra-articular, extra-capsular prosthesis intended to alleviate knee OA-related symptoms by reducing medial knee compartment loading while overcoming the limitations of traditional joint-unloading therapies. Preclinical and clinical studies have demonstrated excellent prosthesis durability, substantial reductions in medial compartment and total joint loads, and clinically important improvements in OA-related pain and function. The purpose of this report is to describe the KineSpring System, including implant characteristics, principles of operation, indications for use, patient selection criteria, surgical technique, postoperative care, preclinical testing, and clinical experience. The KineSpring System has potential to bridge the gap between ineffective conservative treatments and irreversible surgical interventions for medial compartment knee OA.Keywords: KineSpring, knee, medial, osteoarthritis, prosthesis

  4. Implants composed of carbon fiber mesh and bone-marrow-derived, chondrocyte-enriched cultures for joint surface reconstruction.

    Science.gov (United States)

    Robinson, D; Efrat, M; Mendes, D G; Halperin, N; Nevo, Z

    1993-01-01

    The current study integrates two distinct approaches in joint resurfacing into a combined type of implant, composed of carbon fiber mesh impregnated and coated with a hyaluronic-acid-based delivery substance containing cultured cells. Rabbit autogeneic chondrocyte-enriched cultures obtained from mesenchymal stem cells (chondroprogenitor cells) derived from adult rabbit bone marrow were grown in vitro under conditions favoring chondrogenesis. The improvement in quality of repair when a combined implant containing both cells and a carbon scaffold was used, in comparison to the utilization of carbon fiber mesh alone, was clearly demonstrated using clinical, histological, biochemical, and biomechanical examinations. Evaluations of the joints were performed at 6 weeks and 6 months after implantation. The repair tissue in the cell-implanted joints consisted of a typical hyaline cartilage, which was more cellular and thicker than the repair tissue in the hyaluronic-acid-impregnated carbon-fiber-implanted control joints. The hyaline cartilage in the experimental group formed a superficial layer above the carbon fibers, flush with the joint surface. In the controls, in which carbon fiber and the delivery substance alone were implanted, a histologically and biochemically fibrous tissue that was inferior biomechanically to the new cartilage was formed by the cells containing implants.

  5. Effect of Vertical Misfit on Screw Joint Stability of Implant-Supported Crowns

    Science.gov (United States)

    Assunção, Wirley Gonçalves; Delben, Juliana Aparecida; Tabata, Lucas Fernando; Barão, Valentim Adelino Ricardo; Gomes, Érica Alves

    2011-08-01

    The passive fit between prosthesis and implant is a relevant factor for screw joint stability and treatment success. The aim of this study was to evaluate the influence of vertical misfit in abutment-implant interface on preload maintenance of retention screw of implant-supported crowns. The crowns were fabricated with different abutments and veneering materials and divided into 5 groups ( n = 12): Gold UCLA abutments cast in gold alloy veneered with ceramic (Group I) and resin (Group II), UCLA abutments cast in titanium veneered with ceramic (Group III) and resin (Group IV), and zirconia abutments with ceramic veneering (Group V). The crowns were attached to implants by gold retention screws with 35-N cm insertion torque. Specimens were submitted to mechanical cycling up to 106 cycles. Measurements of detorque and vertical misfit in abutment-implant interface were performed before and after mechanical cycling. ANOVA revealed statistically significant difference ( P 0.05) between vertical misfit and detorque value. It was concluded that vertical misfit did not influence torque maintenance and the abutments cast in titanium exhibited the highest misfit values.

  6. Evaluation of predicted knee-joint muscle forces during gait using an instrumented knee implant.

    Science.gov (United States)

    Kim, Hyung J; Fernandez, Justin W; Akbarshahi, Massoud; Walter, Jonathan P; Fregly, Benjamin J; Pandy, Marcus G

    2009-10-01

    Musculoskeletal modeling and optimization theory are often used to determine muscle forces in vivo. However, convincing quantitative evaluation of these predictions has been limited to date. The present study evaluated model predictions of knee muscle forces during walking using in vivo measurements of joint contact loading acquired from an instrumented implant. Joint motion, ground reaction force, and tibial contact force data were recorded simultaneously from a single subject walking at slow, normal, and fast speeds. The body was modeled as an 8-segment, 21-degree-of-freedom articulated linkage, actuated by 58 muscles. Joint moments obtained from inverse dynamics were decomposed into leg-muscle forces by solving an optimization problem that minimized the sum of the squares of the muscle activations. The predicted knee muscle forces were input into a 3D knee implant contact model to calculate tibial contact forces. Calculated and measured tibial contact forces were in good agreement for all three walking speeds. The average RMS errors for the medial, lateral, and total contact forces over the entire gait cycle and across all trials were 140 +/- 40 N, 115 +/- 32 N, and 183 +/- 45 N, respectively. Muscle coordination predicted by the model was also consistent with EMG measurements reported for normal walking. The combined experimental and modeling approach used in this study provides a quantitative framework for evaluating model predictions of muscle forces in human movement.

  7. The field size matters: low dose external beam radiotherapy for thumb carpometacarpal osteoarthritis : Importance of field size.

    Science.gov (United States)

    Kaltenborn, Alexander; Bulling, Elke; Nitsche, Mirko; Carl, Ulrich Martin; Hermann, Robert Michael

    2016-08-01

    The purpose of this work was to evaluate the efficacy of low-dose radiotherapy (RT) for thumb carpometacarpal osteoarthritis (rhizarthrosis). The responses of 84 patients (n = 101 joints) were analyzed 3 months after therapy (n = 65) and at 12 months (n = 27). Patients were treated with 6 fractions of 1 Gy, two times a week, with a linear accelerator. At the end of therapy, about 70 % of patients reported a response (partial remission or complete remission), 3 months later about 60 %, and 1 year after treatment 70 %. In univariate regression analysis, higher patient age and field size greater than 6 × 4 cm were associated with response to treatment, while initial increase of pain under treatment was predictive for treatment failure. Duration of RT series (more than 18 days), gender, time of symptoms before RT, stress pain or rest pain, or prior ortheses use, injections, or surgery of the joint were not associated with treatment efficacy. In multivariate regression analysis, only field size and initial pain increase were highly correlated with treatment outcome. In conclusion, RT represents a useful treatment option for patients suffering from carpometacarpal osteoarthritis. In contrast to other benign indications, a larger field size (>6 × 4 cm) seems to be more effective than smaller fields and should be evaluated in further prospective studies.

  8. Revision of Minimally Invasive Sacroiliac Joint Fixation: Technical Considerations and Case Studies Using Decortication and Threaded Implant Fixation

    Science.gov (United States)

    Fielding, Louis C

    2017-01-01

    Background Sacroiliac joint (SIJ) disease is increasingly recognized as a common source of low back pain. Arthrodesis of the SIJ has been shown to be clinically effective for this condition. In the last decade, minimally invasive (MI) SIJ fusion procedures have been developed to achieve the clinical effectiveness of open fusion procedures, with lower operative morbidity and faster recovery. However, SIJ fusion patients occasionally present with symptomatic nonunions necessitating revision. Methods Four patients who previously underwent MI SIJ arthrodesis returned with complaints of SIJ related pain confirmed by examination. Radiographic assessment showed lucency after fixation with triangular titanium interference implants. Loose implants were removed, and the patients were revised with a different MI SIJ fusion system that utilizes decortication, placement of autograft and graft extender, and fixation with cannulated threaded implants. The trajectory of the revision implants was in a more ventral-to-dorsal and caudal-to-cranial trajectory to place the implants perpendicularly through the articular portion of the SIJ. Results The triangular implants typically exhibited haloing lucency on radiographs and CT scans, and most were easily removed using the manufacturer’s instrumentation; only one implant was left in place as it was well-fixed. The removed implants exhibited little or no bony ongrowth. Decortication of the SIJ was performed, followed by placement of local autograft and fixation with 12.5 mm or 14.5mm diameter implants, as required. A more ventral-todorsal and caudal-to-cranial trajectory was established for the revision implants through the center of the articular region of the joint in order to maximize implant purchase in residual bone stock and achieve bony fusion through the articular portion of the SIJ. By six to twelve months post-revision, the presenting symptoms were successfully resolved in all patients. Conclusions Patients demonstrating

  9. Evaluating Joint Morbidity after Chondral Harvest for Autologous Chondrocyte Implantation (ACI)

    Science.gov (United States)

    McCarthy, Helen S.; Richardson, James B.; Parker, Jane C. E.; Roberts, Sally

    2016-01-01

    Objective To establish if harvesting cartilage to source chondrocytes for autologous chondrocyte implantation (ACI) results in donor site morbidity. Design Twenty-three patients underwent ACI for chondral defects of either the ankle or the hip. This involved cartilage harvest from the knee (stage I), chondrocyte expansion in the laboratory and implantation surgery (stage II) into the affected joint. Prior to chondral harvest, no patient had sought treatment for their knee. Lysholm knee scores were completed prior to chondral harvest and annually post-ACI. Histological analyses of the donor site were performed at 12.3 ± 1.5 months for 3 additional patients who had previously had ACI of the knee. Results The median preoperative Lysholm score was 100, with no significant differences observed at either 13.7±1.7 months or 4.8±1.8 years postharvest (median Lysholm scores 91.7 and 87.5, respectively). Patients whose cartilage was harvested from the central or medial trochlea had a significantly higher median Lysholm score at latest follow-up (97.9 and 93.4, respectively), compared with those taken from the intercondylar notch (median Lysholm score 66.7). The mean International Cartilage Repair Society (ICRS) II histological score for the biopsies taken from the donor site of 3 additional knee ACI patients was 117 ± 10 (maximum score 140). Conclusions This study suggests that the chondral harvest site in ACI is not associated with significant joint morbidity, at least up to 5 years postharvest. However, one should carefully consider the location for chondral harvest as this has been shown to affect knee function in the longer term. PMID:26958313

  10. A study of functional outcomes following implantation of a total distal radioulnar joint prosthesis.

    Science.gov (United States)

    Laurentin-Pérez, L A; Goodwin, A N; Babb, B A; Scheker, L R

    2008-02-01

    This paper reports a long-term follow-up measuring pain, range of motion and weight-bearing ability, following implantation of a total distal radioulnar joint prosthesis. This prosthesis differs from excision arthroplasties and ulnar head replacements by replacing all three components of the distal radioulnar joint, viz. the sigmoid notch, the ulnar head and the triangular fibrocartilage. The design allows longitudinal migration of the radius throughout pronation and supination, as well as load bearing of the wrist. Thirty-one patients receiving the prosthesis returned or were interviewed by telephone at a mean of 5.9 (range 4-9) years. Pronation increased from a mean of 65.5 degrees (range 5-90 degrees ) to 74 degrees (range 20-90 degrees ) and supination from 53 degrees (range 5-90 degrees ) to 70 degrees (range 20-90 degrees ) while greatly diminishing and/or eliminating pain. Grip increased from a mean of 10 kg (22 lbs) to 24 kg (52 lbs). Weight bearing was restored or increased in 29 of 31 patients.

  11. Recoil-Implantation Of Multiple Radioisotopes Towards Wear Rate Measurements And Particle Tracing In Prosthetic Joints

    Science.gov (United States)

    Warner, Jacob A.; Smith, Paul N.; Scarvell, Jennifer M.; Gladkis, Laura; Timmers, Heiko

    2011-06-01

    This study demonstrates a new method of radioisotope labeling of ultra-high molecular weight polyethylene inserts in prosthetic joints for wear studies. The radioisotopes 97Ru, 100Pd, 100Rh, and 101mRh are produced in fusion evaporation reactions induced by 12C ions in a 92Zr target foil. The fusion products recoil-implant into ultra-high molecular weight polyethylene plugs, machined to fit into the surface of the inserts. During laboratory simulations of the joint motion, a wear rate of the labeled polyethylene may be measured and the pathways of wear debris particles can be traced by detecting characteristic gamma-rays. The concentration profiles of the radioisotopes extend effectively uniformly from the polyethylene surface to a depth of about 4 μm. The multiplicity of labeling and the use of several gamma-ray lines aids with avoiding systematic measurement uncertainties. Two polyethylene plugs were labeled and one was fitted into the surface of the tibial insert of a knee prosthesis, which had been worn in. Actuation over close to 100,000 cycles with a 900 N axial load and a 24° flexion angle removed (14±1)% of the gamma-ray activity from the plug. Most of this activity dispersed into the serum lubricant identifying this as the important debris pathway. Less than 1% activity was transferred to the femoral component of the prosthesis and the measured activity on the tibial tray was insignificant. Assuming uniform wear across the superior surface of the insert, a wear rate of (12±3) mm3/Megacycle was determined. This is consistent with wear rate measurements under similar conditions using other techniques.

  12. Prosthesis of the wrist-joint

    Energy Technology Data Exchange (ETDEWEB)

    Feldmeier, C.

    1983-02-25

    Function of the hand-joint and the well-being of patients can be severely affected by arthrosis of the wrist-joint. Therapeutically, arthrodesis usually results in a painfree status of stiffness. A painless and well functioning joint can be achieved by alloplastic joint replacement or resurfacing. The possibilities and clinical results in cases of arthrosis of the carpo-metacarpal joint of the thumb, pseudarthrosis of the scaphoid, aseptic necrosis of the Lunate and severe arthrosis of the radio-carpal joint are demonstrated.

  13. Fretting corrosion behaviour of ball-and-socket joint on dental implants with different prosthodontic alloys.

    Science.gov (United States)

    Gil, F J; Canedo, R; Padrós, A; Bañeres, M V; Arano, J M

    2003-01-01

    The fretting corrosion of five materials for implant suprastructures (cast-titanium, machined-titanium, gold alloy, silver-palladium alloy and chromium-nickel alloy), was investigated in vitro, the materials being galvanically coupled to a titanium ball-and-socket-joint with tetrafluoroethylene under mechanical load. Various electrochemical parameters (E(corr), i(corr), Evans diagrams, polarization resistance and Tafel slopes) were analyzed. The microstructure of the different dental materials was observed before and after corrosion processes by optical and electron microscopy. It can be observed that the mechanical load produces an important decrease of the corrosion resistance. The cast and machined titanium had the most passive current density at a given potential and chromium-nickel alloy had the most active critical current density values. The high gold content alloys have excellent resistance corrosion, although this decreases when the gold content is lower in the alloy. The palladium alloy had a low critical current density due to the presence of gallium in this composition but a selective dissolution of copper-rich phases was observed through energy dispersive X-ray analysis.

  14. Prediction of in vivo joint mechanics of an artificial knee implant using rigid multi-body dynamics with elastic contacts.

    Science.gov (United States)

    Chen, Zhenxian; Zhang, Xuan; Ardestani, Marzieh M; Wang, Ling; Liu, Yaxiong; Lian, Qin; He, Jiankang; Li, Dichen; Jin, Zhongmin

    2014-06-01

    Lower extremity musculoskeletal computational models play an important role in predicting joint forces and muscle activation simultaneously and are valuable for investigating functional outcomes of the implants. However, current computational musculoskeletal models of total knee replacement rarely consider the bearing surface geometry of the implant. Therefore, these models lack detailed information about the contact loading and joint motion which are important factors for evaluating clinical performances. This study extended a rigid multi-body dynamics simulation of a lower extremity musculoskeletal model to incorporate an artificial knee joint, based upon a novel force-dependent kinematics method, and to characterize the in vivo joint contact mechanics during gait. The developed musculoskeletal total knee replacement model integrated the rigid skeleton multi-body dynamics and the flexible contact mechanics of the tibiofemoral and patellofemoral joints. The predicted contact forces and muscle activations are compared against those in vivo measurements obtained from a single patient with good agreements for the medial contact force (root-mean-square error = 215 N, ρ = 0.96) and lateral contact force (root-mean-square error = 179 N, ρ = 0.75). Moreover, the developed model also predicted the motion of the tibiofemoral joint in all degrees of freedom. This new model provides an important step toward the development of a realistic dynamic musculoskeletal total knee replacement model to predict in vivo knee joint motion and loading simultaneously. This could offer a better opportunity to establish a robust virtual modeling platform for future pre-clinical assessment of knee prosthesis designs, surgical procedures and post-operation rehabilitation.

  15. The proprioception and neuromuscular stability of the basal thumb joint

    OpenAIRE

    Mobargha, Nathalie

    2015-01-01

    OBJECTIVES The basal thumb joint, or the first carpometacarpal joint (CMC1) is an enigmatic construction. The concavo-convex shape of the CMC1 and wide range of movement, allows for both precision and power grips and is particularly susceptible to the development of osteoarthritis. Previous theories regarding the development of CMC1 osteoarthritis have focused on the role of gender, excessive joint load and ligament laxity as causative factors. An emerging theory is the role o...

  16. Patient and implant survival following joint replacement because of metastatic bone disease

    DEFF Research Database (Denmark)

    Sørensen, Michala S; Gregersen, Kristine G; Grum-Schwensen, Tomas

    2013-01-01

    Patients suffering from a pathological fracture or painful bony lesion because of metastatic bone disease often benefit from a total joint replacement. However, these are large operations in patients who are often weak. We examined the patient survival and complication rates after total joint...

  17. [Strength of muscles surrounding the hip joint and gait in patients following implantation of a cementless hip endoprosthesis].

    Science.gov (United States)

    Horstmann, T; Martini, F; Mayer, F; Sell, S; Knak, J; Zacher, J

    1995-01-01

    There are only a few studies which could support conclusions concerning the strength of the muscles surrounding the hip joint and especially concerning the strength relationships following implantation of endoprotheses. The aim of this study was to examine the pre- and postoperative course of strength deficits in this musculature compared to clinical parameters and the uninvolved side. Fifty-eight patients between 30 and 67 years of age, in whom individual total hip protheses were implanted were clinically examined prior, 9 weeks and 6 months after surgery. Moreover, the maximum isometric strength of abductors, flexors, and rotator muscles as well as maximum isokinetic strength of the extensors and flexor musculature at 60% and 120%/s were measured. The flexor and extensor musculature already showed a clear increase in maximum strength after 9 weeks and 6 months (90-124%). By contrast, the isometric strengths of the rotators increased only slightly, the abductor strength decreased after 6 weeks to below the preoperative baseline level and attained this level again only after 6 months. The clinical parameters Trendelenburg sign, limping and walking capacity were clearly improved after 6 months, but no correlation to the abductor strength could be demonstrated. It is concluded that limp-free gait can be attained even without maximum strength increase in the abductors, which are important for fluid gait, at least for short distances. The importance of regular training of the rotator and abductor musculature in coxarthrosis is emphasized to delay limitation of movement and decreased strength in the sense of capsule pattern.

  18. The influence of footwear on knee joint loading during walking--in vivo load measurements with instrumented knee implants.

    Science.gov (United States)

    Kutzner, Ines; Stephan, Daniel; Dymke, Jörn; Bender, Alwina; Graichen, Friedmar; Bergmann, Georg

    2013-02-22

    Since footwear is commonly used every day, its influence on knee joint loading and thereby on the development and progression of osteoarthritis may be crucial. So far the influence of footwear has been examined only indirectly. The aim of this study was to directly measure the effect of footwear on tibiofemoral contact loads during walking. Instrumented knee implants with telemetric data transmission were used to measure the tibiofemoral contact forces and moments in six subjects. The loads during walking with four different shoes (basic running shoes, advanced running shoes, classical dress shoes and shoes with a soft rounded sole in the sagittal plane (MBT)) were compared to those during barefoot walking. Peak values of all six load components were analyzed. In general, footwear tended to increase knee joint loading slightly, with the dress shoe being the most unfavorable type of footwear. At the early stance phase all load components were increased by all shoe types. The resultant force rose by 2-5%, the internal adduction moment by 7-12% and the forces on the medial compartment by 3-5%. Significant reductions of the resultant force were solely observed for the advanced running shoe (-6%) and the MBT (-9%) shoe at late stance. Also the medial compartment force was slightly yet non-significantly reduced by 2-5% with the two shoes. It is questionable whether such small load changes have an influence on the progression of gonarthrosis. Future research is necessary to examine which factors regarding the shoe design, such as heel height, arch support or flexibility are most decisive for a reduction of knee joint loading.

  19. A mouse model of post-arthroplasty Staphylococcus aureus joint infection to evaluate in vivo the efficacy of antimicrobial implant coatings.

    Directory of Open Access Journals (Sweden)

    Nicholas M Bernthal

    Full Text Available BACKGROUND: Post-arthroplasty infections represent a devastating complication of total joint replacement surgery, resulting in multiple reoperations, prolonged antibiotic use, extended disability and worse clinical outcomes. As the number of arthroplasties in the U.S. will exceed 3.8 million surgeries per year by 2030, the number of post-arthroplasty infections is projected to increase to over 266,000 infections annually. The treatment of these infections will exhaust healthcare resources and dramatically increase medical costs. METHODOLOGY/PRINCIPAL FINDINGS: To evaluate novel preventative therapeutic strategies against post-arthroplasty infections, a mouse model was developed in which a bioluminescent Staphylococcus aureus strain was inoculated into a knee joint containing an orthopaedic implant and advanced in vivo imaging was used to measure the bacterial burden in real-time. Mice inoculated with 5x10(3 and 5x10(4 CFUs developed increased bacterial counts with marked swelling of the affected leg, consistent with an acute joint infection. In contrast, mice inoculated with 5x10(2 CFUs developed a low-grade infection, resembling a more chronic infection. Ex vivo bacterial counts highly correlated with in vivo bioluminescence signals and EGFP-neutrophil fluorescence of LysEGFP mice was used to measure the infection-induced inflammation. Furthermore, biofilm formation on the implants was visualized at 7 and 14 postoperative days by variable-pressure scanning electron microscopy (VP-SEM. Using this model, a minocycline/rifampin-impregnated bioresorbable polymer implant coating was effective in reducing the infection, decreasing inflammation and preventing biofilm formation. CONCLUSIONS/SIGNIFICANCE: Taken together, this mouse model may represent an alternative pre-clinical screening tool to evaluate novel in vivo therapeutic strategies before studies in larger animals and in human subjects. Furthermore, the antibiotic-polymer implant coating

  20. [Orthopedic surgical implants and allergies: joint statement by the implant allergy working group (AK 20) of the DGOOC (German association of orthopedics and orthopedic surgery), DKG (German contact dermatitis research group) and dgaki (German society for allergology and clinical immunology)].

    Science.gov (United States)

    Thomas, P; Schuh, A; Ring, J; Thomsen, M

    2008-01-01

    Materials used in osteosynthesis or artificial joint replacement are usually well tolerated. Complaints after such operations are mostly related to infection or mechanical problems but may also be caused by allergic reactions. The latter encompass skin changes, e.g., eczema, delayed wound/bone healing, recurrent effusion, pain, or implant loosening. In contrast to the high incidence of cutaneous metal contact allergy, allergies associated with implants are a rare condition. However, epidemiological data on the incidence of implant-related allergic reactions are still missing. Typical elicitors are nickel, chromium, cobalt, and constituents of bone cement (acrylates und additives such as gentamicin or benzoyl peroxide). After exclusion of the most common differential diagnoses, allergy diagnostic procedures are primarily based on patch tests including a metal and bone cement component series. Additional analysis of periimplant tissue is recommended. However, further studies are necessary to show the significance of the histologic findings and the role of the lymphocyte transformation test (LTT). Which combinations of factors will induce allergic sensitization to implants or trigger periimplant allergic reactions in the case of preexisting cutaneous metal allergy is still unknown. Titanium-based osteosynthesis materials are recommended for metal allergic patients. In elective hip replacements, a ceramic/polyethylene (PE) articulation should be used, and in knee replacements "alternative materials". If a regular, potentially applicable CoCr/PE articulation is preferred, the patient must be well informed and must give his/her written consent.

  1. [Orthopedic surgical implants and allergies. Joint statement by the Implant Allergy Working Group (AK 20) of the DGOOC (German Association of Orthopedics and Orthopedic Surgery), DKG (German Contact Dermatitis Research Group) and DGAKI (German Society for Allergology and Clinical Immunology)].

    Science.gov (United States)

    Thomas, P; Schuh, A; Ring, J; Thomsen, M

    2008-03-01

    Materials used in osteosynthesis or artificial joint replacement are usually well tolerated. Complaints after such operations are mostly related to infection or mechanical problems but may also be caused by allergic reactions. The latter encompass skin changes, e.g., eczema, delayed wound/bone healing, recurrent effusion, pain, or implant loosening. In contrast to the high incidence of cutaneous metal contact allergy, allergies associated with implants are a rare condition. However, epidemiological data on the incidence of implant-related allergic reactions are still missing. Typical elicitors are nickel, chromium, cobalt, and constituents of bone cement (acrylates und additives such as gentamicin or benzoyl peroxide). After exclusion of the most common differential diagnoses, allergy diagnostic procedures are primarily based on patch tests including a metal and bone cement component series. Additional analysis of periimplant tissue is recommended. However, further studies are necessary to show the significance of the histologic findings and the role of the lymphocyte transformation test (LTT). Which combinations of factors will induce allergic sensitization to implants or trigger periimplant allergic reactions in the case of preexisting cutaneous metal allergy is still unknown. Titanium-based osteosynthesis materials are recommended for metal allergic patients. In elective hip replacements, a ceramic/polyethylene (PE) articulation should be used, and in knee replacements "alternative materials". If a regular, potentially applicable CoCr/PE articulation is preferred, the patient must be well informed and must give his/her written consent.

  2. Treatment of osteochondral defects in the rabbit's knee joint by implantation of allogeneic mesenchymal stem cells in fibrin clots.

    Science.gov (United States)

    Berninger, Markus T; Wexel, Gabriele; Rummeny, Ernst J; Imhoff, Andreas B; Anton, Martina; Henning, Tobias D; Vogt, Stephan

    2013-05-21

    The treatment of osteochondral articular defects has been challenging physicians for many years. The better understanding of interactions of articular cartilage and subchondral bone in recent years led to increased attention to restoration of the entire osteochondral unit. In comparison to chondral lesions the regeneration of osteochondral defects is much more complex and a far greater surgical and therapeutic challenge. The damaged tissue does not only include the superficial cartilage layer but also the subchondral bone. For deep, osteochondral damage, as it occurs for example with osteochondrosis dissecans, the full thickness of the defect needs to be replaced to restore the joint surface (1). Eligible therapeutic procedures have to consider these two different tissues with their different intrinsic healing potential (2). In the last decades, several surgical treatment options have emerged and have already been clinically established (3-6). Autologous or allogeneic osteochondral transplants consist of articular cartilage and subchondral bone and allow the replacement of the entire osteochondral unit. The defects are filled with cylindrical osteochondral grafts that aim to provide a congruent hyaline cartilage covered surface (3,7,8). Disadvantages are the limited amount of available grafts, donor site morbidity (for autologous transplants) and the incongruence of the surface; thereby the application of this method is especially limited for large defects. New approaches in the field of tissue engineering opened up promising possibilities for regenerative osteochondral therapy. The implantation of autologous chondrocytes marked the first cell based biological approach for the treatment of full-thickness cartilage lesions and is now worldwide established with good clinical results even 10 to 20 years after implantation (9,10). However, to date, this technique is not suitable for the treatment of all types of lesions such as deep defects involving the subchondral

  3. One-year outcomes after minimally invasive sacroiliac joint fusion with a series of triangular implants: a multicenter, patient-level analysis

    Directory of Open Access Journals (Sweden)

    Sachs D

    2014-08-01

    Full Text Available Donald Sachs,1 Robyn Capobianco,2 Daniel Cher,2 Timothy Holt,3 Mukund Gundanna,4 Timothy Graven,5 A Nick Shamie,6 John Cummings Jr7 1Center for Spinal Stenosis and Neurologic Care, Lakeland, FL, 2SI-BONE, Inc., San Jose, CA, 3Montgomery Spine Center, Montgomery, AL, 4Brazos Spine, College Station, TX, 5SSM Orthopedics, Wentzville, MO, 6UCLA Spine Center, Santa Monica, CA, 7Community Neurosurgical Care, Indianapolis, IN, USA Background: Sacroiliac joint (SI pain is an often-overlooked cause of lower-back pain, due in part to a lack of specific findings on radiographs and a symptom profile similar to other back-related disorders. A minimally invasive surgical (MIS approach to SI joint fusion using a series of triangular, titanium plasma spray-coated implants has shown favorable outcomes in patients with SI joint pain refractory to conservative care. The aim of this study was to provide a multicenter experience of MIS SI joint fusion using a patient-level analysis. Patients and methods: We report a patient-level analysis from 144 patients with a mean of 16 months postoperative follow-up. Demographic information, perioperative measures, complications, and clinical outcomes using a visual analog scale for pain were collected prospectively. Random-effects regression models were used to account for intersite variability. Results: The mean age was 58 years, 71% of patients were female, and 62% had a history of lumbar spinal fusion. Mean (95% confidence interval [CI] operative time was 73 minutes (25.4–118, blood loss was minimal, and hospital stay was 0.8 days (0.1–1.5. At follow-up, mean (95% CI visual analog scale pain scores improved by 6.1 points (5.7–6.6. Substantial clinical benefit, defined as a decrease in pain by >2.5 points or a score of 3.5 or less, was achieved in 91.9% of patients (95% CI 83.9%–96.1%, and 96% (95% CI 86.3%–98.8% of patients indicated they would have the same surgery again. Conclusion: When conservative measures

  4. Trapezium excision and suture suspensionplasty (TESS) for the treatment of thumb carpometacarpal arthritis.

    Science.gov (United States)

    Putnam, Matthew D; Meyer, Nicholas J; Baker, Daniel; Brehmer, Jess; Carlson, Brent D

    2014-06-01

    Basilar thumb arthritis, or first carpometacarpal arthritis, is a common condition affecting older women and some men. It is estimated that as many as one third of postmenopausal woman are affected. Surgical treatment of this condition includes options ranging from arthrodesis to prosthetic arthroplasty. Intermediate options include complete or partial trapezial excision with or without interposition of a cushioning/stabilizing material (auto source, allo source, synthetic source). A multitude of methods appear to offer similar end results, although some methods definitely involve more surgical work and perhaps greater patient risk. Through retrospective evaluation of a cohort of patients who underwent suture suspensionplasty, we determined the postoperative effect on strength, motion, patient satisfaction, complications, and radiographic maintenance of the scaphoid-metacarpal distance. This review shows the method to be clinically effective and, by comparison with a more traditional ligament reconstruction trapezial interposition arthroplasty, the method does not require use of autograft or allograft tendon and has fewer surgical steps. Forty-four patients were included in this retrospective study. The results showed that 91% of patients were satisfied with the procedure. Pinch and grip strength remained the same preoperatively and postoperatively. A Disabilities of the Arm, Shoulder, and Hand patient-reported outcome instrument (DASH) scores averaged 30 at final follow-up. Three patients developed a late complication requiring further surgical intervention. In summary, this technique appears to be technically reproducible, requires no additional tendon material, and achieves objectively and subjectively similar results to other reported procedures used to manage first CMC Arthritis.

  5. Modelling of the mechanical behavior of a polyurethane finger interphalangeal joint endoprosthesis after surface modification by ion implantation

    Science.gov (United States)

    Beliaev, A.; Svistkov, A.; Iziumov, R.; Osorgina, I.; Kondyurin, A.; Bilek, M.; McKenzie, D.

    2016-04-01

    Production of biocompatible implants made of polyurethane treated with plasma is very perspective. During plasma treatment the surface of polyurethane acquires unique physic-chemical properties. However such treatment may change the mechanical properties of polyurethane which may adversely affect the deformation behaviour of the real implant. Therefore careful study of the mechanical properties of the plasma-modified polyurethane is needed. In this paper, experimental observations of the elastic characteristics of plasma treated polyurethane and modelling of the deformation behaviour of polyurethane bio-implants are reported.

  6. Splinting the degenerative basal joint: custom-made or prefabricated neoprene?

    Science.gov (United States)

    Weiss, Susan; Lastayo, Paul; Mills, Amy; Bramlet, Dale

    2004-01-01

    The purpose of this study was to compare the objective, subjective, and radiographic responses of patients with carpometacarpal joint osteoarthritis (CMCJ-OA) wearing a prefabricated neoprene splint (PFN), which crosses the CMCJ and metacarpophalangeal joint, with those of patients wearing a custom-made thermoplastic short opponens splint (CMT), which crosses only the CMCJ. Patients ( N = 25) with first CMCJ stage I and II osteoarthritis were assigned randomly to wear either the PFN splint or the CMT splint for one week. After one week, the subjects rated their function in the splint and their satisfaction and pain levels on visual analogue scales. Pinch measurements were performed and x-rays were taken to assess carpometacarpal subluxation. The second splint was then applied for one week and all measures were repeated. The subjects rated the PFN splint significantly higher, and most reported that they would choose the PFN splint over the CMT splint for daily and long-term use. Both pain and function were improved with splinting, but the effect was amplified with the PFN splint compared with the CMT splint. Both splints reduced subluxation at the first carpometacarpal joint, but the CMT effect was greater. This study further supports current evidence that subjects with stage I and II first CMCJ-OA will have pain relief with thumb splinting. In addition, the PFN splint will provide greater relief when compared with the CMT splint. Furthermore, this study reveals that patients prefer the PFN splint to the CMT splint.

  7. Results of Abductor Pollicis Longus Suspension Ligamentoplasty for Treatment of Advanced First Carpometacarpal Arthritis

    Science.gov (United States)

    Lee, Hyun-Joo; Kim, Poong-Taek; Deslivia, Maria Florencia; Lee, Suk-Joong; Nam, Sang-Jin

    2015-01-01

    Background Suspension ligamentoplasty using abductor pollicis longus (APL) tendon without bone tunneling, was introduced as one of the techniques for treatment of advanced first carpometacarpal (CMC) arthritis. The purpose of this study was to evaluate the radiologic and clinical results of APL suspension ligamentoplasty. Methods The medical records of 19 patients who underwent APL suspension ligamentoplasty for advanced first CMC arthritis between January 2008 and May 2012 were reviewed retrospectively. The study included 13 female and 6 male patients, whose mean age was 62 years (range, 43 to 82 years). For clinical evaluation, we assessed the grip and pinch power, radial and volar abduction angle, thumb adduction (modified Kapandji index), including visual analogue scale (VAS) and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Radiologic evaluation was performed using simple radiographs. Results The mean follow-up was 36 months (range, 19 to 73.7 months). Mean power improved from 18.3 to 27 kg for grip power, from 2.8 to 3.5 kg for tip pinch, and from 4.3 to 5.4 kg for power pinch. All patients showed decreased VAS from 7.2 to 1.7. Radial abduction improved from 71° preoperatively to 82° postoperatively. The modified Kapandji index showed improvement from 6 to 7.3, and mean DASH was improved from 41 to 17.8. The height of the space decreased from 10.8 to 7.1 mm. Only one case had a complication involving temporary sensory loss of the first dorsal web space, which resolved spontaneously. Conclusions The APL suspension ligamentoplasty for treatment of advanced first CMC arthritis yielded satisfactory functional results. PMID:26330961

  8. A neural network approach for determining gait modifications to reduce the contact force in knee joint implant.

    Science.gov (United States)

    Ardestani, Marzieh Mostafavizadeh; Chen, Zhenxian; Wang, Ling; Lian, Qin; Liu, Yaxiong; He, Jiankang; Li, Dichen; Jin, Zhongmin

    2014-10-01

    There is a growing interest in non-surgical gait rehabilitation treatments to reduce the loading in the knee joint. In particular, synergetic kinematic changes required for joint offloading should be determined individually for each subject. Previous studies for gait rehabilitation designs are typically relied on a "trial-and-error" approach, using multi-body dynamic (MBD) analysis. However MBD is fairly time demanding which prevents it to be used iteratively for each subject. This study employed an artificial neural network to develop a cost-effective computational framework for designing gait rehabilitation patterns. A feed forward artificial neural network (FFANN) was trained based on a number of experimental gait trials obtained from literature. The trained network was then hired to calculate the appropriate kinematic waveforms (output) needed to achieve desired knee joint loading patterns (input). An auxiliary neural network was also developed to update the ground reaction force and moment profiles with respect to the predicted kinematic waveforms. The feasibility and efficiency of the predicted kinematic patterns were then evaluated through MBD analysis. Results showed that FFANN-based predicted kinematics could effectively decrease the total knee joint reaction forces. Peak values of the resultant knee joint forces, with respect to the bodyweight (BW), were reduced by 20% BW and 25% BW in the midstance and the terminal stance phases. Impulse values of the knee joint loading patterns were also decreased by 17% BW*s and 24%BW*s in the corresponding phases. The FFANN-based framework suggested a cost-effective forward solution which directly calculated the kinematic variations needed to implement a given desired knee joint loading pattern. It is therefore expected that this approach provides potential advantages and further insights into knee rehabilitation designs.

  9. 肩锁关节脱位重建:金属植入物的选择%Reconstruction of acromioclavicular joint dislocation: Selection of metal implants

    Institute of Scientific and Technical Information of China (English)

    蔡宇; 王凯; 梁晶峰

    2011-01-01

    OBJECTIVE: To introduce the metal implant internal fixation methods and implant selection of acromioclavicular joint dislocation,to evaluate the efficacy of clavicular hook plate in treatment of acromioclavicular joint dislocation.METHODS: Using "clavicular hook plate; acromioclavicular joint dislocation; internal fixation" as the key words, a computer-based online search of PubMed database and VIP database from 1996 to 2010 was performed for articles about metal implants fixation for the dislocation of acromioclavicular joint, focusing on the acromioclavicular joint dislocation treatments and the choice of internal fixation implant, and clinical validation was conducted. Patients who were treated with AO/ASIF clavicular hook plate for acromioclavicular joint dislocation and distal clavicle fractures in accordance with type Ⅲ- Ⅴ of Rockwood classification, were involved. Lazzcano score was applied to determine function.RESULTS : The present method of treating acromioclavicular joint dislocation includes a simple Kirschner wire internal fixation,Kirschner wire and tension band fixation, Bosworth method, coracoclavicular fixation between the wire, titanium wire cable instead of the wire fixation method, modified Weaver method, tendon or artificial ligament for coracoclavicular ligament reconstruction,clavicular hook plate and so on, each has their advantages and disadvantages. Clinical validation showed that, 34 patients after treatment of AO/ASIF clavicular hook plate were visited for 12 months as a follow-up. No plate or screw loosed and broken. At 6-12 months, the implants were taken out, 2 cases exhibited acromioclavicular subluxation, coracoclavicular ligament repair was not performed. Assessment criteria was in accordance with Lazzcano scores, 30 cases were excellent and 4 cases were good.CONCLUSION: The clavicular hook plate for acromioclavicular joint dislocation and distal clavicle fracture is a simple operation,with reliable fixation, less trauma, rapid

  10. Literacy skills in children with cochlear implants: the importance of early oral language and joint storybook reading.

    Science.gov (United States)

    DesJardin, Jean L; Ambrose, Sophie E; Eisenberg, Laurie S

    2009-01-01

    The goal of this study was to longitudinally examine relationships between early factors (child and mother) that may influence children's phonological awareness and reading skills 3 years later in a group of young children with cochlear implants (N = 16). Mothers and children were videotaped during two storybook interactions, and children's oral language skills were assessed using the "Reynell Developmental Language Scales, third edition." Three years later, phonological awareness, reading skills, and language skills were assessed using the "Phonological Awareness Test," the "Woodcock-Johnson-III Diagnostic Reading Battery," and the "Oral Written Language Scales." Variables included in the data analyses were child (age, age at implant, and language skills) and mother factors (facilitative language techniques) and children's phonological awareness and reading standard scores. Results indicate that children's early expressive oral language skills and mothers' use of a higher level facilitative language technique (open-ended question) during storybook reading, although related, each contributed uniquely to children's literacy skills. Individual analyses revealed that the children with expressive standard scores below 70 at Time 1 also performed below average (reading tasks 3 years later. Guidelines for professionals are provided to support literacy skills in young children with cochlear implants.

  11. Infectious prosthetic hip joint loosening: bacterial species involved in its aetiology and their antibiotic resistance profiles against antibiotics recommended for the therapy of implant-associated infections.

    Science.gov (United States)

    Bogut, Agnieszka; Niedźwiadek, Justyna; Strzelec-Nowak, Dagmara; Blacha, Jan; Mazurkiewicz, Tomasz; Marczyński, Wojciech; Kozioł-Montewka, Maria

    2014-04-01

    Reliable microbiological diagnosis along with surgery and prolonged antibiotic therapy are key elements in the management of prosthetic-joint infections (PJIs). The purpose of this study was to characterize antibiotic resistance profiles of bacteria involved in the aetiology of PJIs. A total of 33 bacterial isolates cultured from 31 patients undergoing exchange of total hip prostheses were analyzed. The diagnostic approach toward isolation of prosthesis- associated microorganisms included sonication of retrieved implants and conventional cultures of periprosthetic tissues and synovial fluid. The in vitro resistance profiles of bacterial isolates were determined in relation to antibiotics recommended for the therapy of PJIs using the disc diffusion method, E-tests(®) and broth microdilution system. Coagulase-negative staphylococci (CNS) were predominant microorganisms followed by Staphylococcus aureus, Enterobacter cloacae, Streptococcus mitis, and Propionibacterium acnes. Twenty out of 30 and 12 out of 30 staphylococcal isolates were methicillin- and multi-drug resistant, respectively. Only two isolates were rifampicinresistant. All staphylococci were susceptible to glycopeptides and linezolid. This paper stresses the pathogenic role of staphylococci in patients suffering from implant loosening and reports high methicillin- and multidrug-resistance rates in these bacteria. Hence, antimicrobial susceptibility tests of individual bacterial isolates must always be performed to guide selection of the optimal therapeutic option.

  12. Durable intermediate- to long-term outcomes after minimally invasive transiliac sacroiliac joint fusion using triangular titanium implants

    Directory of Open Access Journals (Sweden)

    Sachs D

    2016-07-01

    Full Text Available Donald Sachs,1 Don Kovalsky,2 Andy Redmond,3 Robert Limoni,4 S Craig Meyer,5 Charles Harvey,6 Dimitriy Kondrashov7 1Center for Spinal Stenosis and Neurologic Care, Lakeland, FL, 2Orthopaedic Center of Southern Illinois, Mount Vernon, IL, 3Precision Spine Care, Tyler, TX, 4BayCare Clinic, Green Bay, WI, 5Columbia Orthopaedic Group, Columbia, MO, 6Riverside Medical Center, Kankakee, IL, 7SF Spine Group at St Mary’s Spine Center, San Francisco, CA, USA Background: Sacroiliac joint (SIJ fusion (SIJF, first performed 95 years ago, has become an increasingly accepted surgical option for chronic SIJ dysfunction. Few studies have reported intermediate- or long-term outcomes after SIJF.Objective: The objective of this study is to determine patient-based outcomes after SIJF for chronic SIJ dysfunction due to degenerative sacroiliitis or SIJ disruption at ≥3 years of follow-up.Methods: Consecutive patients who underwent SIJF prior to December 2012 were contacted over phone or through email. Participants completed questionnaires in clinic, over phone or by email, regarding SIJ pain, activities related to SIJ dysfunction, and the Oswestry Disability Index. Charts were reviewed to extract baseline parameters and the clinical course of follow-up.Results: One hundred seven patients were eligible and participated in this study. Mean (standard deviation preoperative SIJ pain score was 7.5 (1.7. At mean follow-up of 3.7 years, the mean SIJ pain score was 2.6 (representing a 4.8-point improvement from baseline, P<0.0001 and the mean Oswestry Disability Index was 28.2. The ability to perform activities commonly impaired by SIJ dysfunction showed positive improvements in most patients. SIJ revision surgery was uncommon (five patients, 4.7%. Fourteen patients (13.1% underwent contralateral SIJF during follow-up, 25.2% of patients had additional non-SIJ-related lumbar spine or hip surgeries during follow-up.Conclusion: In intermediate- to long-term follow

  13. HA-Coated Implant

    DEFF Research Database (Denmark)

    Daugaard, Henrik; Søballe, Kjeld; Bechtold, Joan E

    2014-01-01

    The goal of osseointegration of orthopedic and dental implants is the rapid achievement of a mechanically stable and long lasting fixation between living bone and the implant surface. In total joint replacements of cementless designs, coatings of calcium phosphates were introduced as a means...... of improving the fixation of implants. Of these, hydroxyapatite (HA) is the most widely used and most extensively investigated. HA is highly osseoconductive, and the positive effect is well documented in both basic and long-term clinical research [1–6]. This chapter describes experimental and clinical studies...... evaluating bone-implant fixation with HA coatings....

  14. Breast Implants

    Science.gov (United States)

    ... Medical Procedures Implants and Prosthetics Breast Implants Breast Implants Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Breast implants are medical devices that are implanted under the ...

  15. Penile Implants

    Science.gov (United States)

    ... the discussion with your doctor. Types of penile implants There are two main types of penile implants: ... might help reduce the risk of infection. Comparing implant types When choosing which type of penile implant ...

  16. Advances of atlantoaxial joint implant and its biomechanical analysis%寰枢关节置入物的研究进展及生物力学分析

    Institute of Scientific and Technical Information of China (English)

    时雨; 游路宽; 李军

    2009-01-01

    背景:寰枢关节作为连接头颅和脊柱的节点,在维持头颈部的运动、保持脑部和脊髓的联系上有着重要的作用.寰枢关节的生物力学特性与外部损伤性因素共同决定了寰枢关节骨折、脱位的部位、类型和性质,也影响着寰枢关节损伤后的治疗方法.随着材料技术的进展和临床操作经验的积累,各种新型的置入物不断被研制并应用于临床实践,使寰枢椎的手术方式和治疗策略得到了极大的丰富.目前置入物的应用目的大都是促进寰枢椎的融合或加强寰枢椎之间的联系和固定,它们在加强寰枢关节稳定性的同时,都不同程度地限制了头颈部的活动.如何处理好稳定性和灵活性的关系,在保证寰枢关节稳定的基础之上最大限度地恢复其生理功能,是今后新型人工置入物的研究方向.%As a node between the skull and the spine, atlantoaxial joint plays a pivotal role in the maintenance of head and neck activities, as well as the connection between the brains and the spine. The biomechanical characteristics of stlantoaxial joint, together with traumatic factors, contribute to determine the site, type and character of atlantoaxial joint fracture and dislocation, they also affect the treatment of atlantoaxial joint injury. With the materials technique development and accumulated experience of clinical operations, various types of new implants are increasing and used for clinical practice, accordingly the surgical approach and therapy regimen of atlantoaxial disease have been greatly enriched. At present, the use of implant mainly aims to promote the atlantoaxial fusion or enhance the connection and fixation between atlantoaxial joints. However, the head and neck activities are also limited simultaneously while the implant enhances the atlantoaxial joint stability. Further studies require to handle the correlation between joint stability and joint flexibility and to maximize the

  17. Particle migration and gap healing around trabecular metal implants

    DEFF Research Database (Denmark)

    Rahbek, O; Kold, S; Zippor, B;

    2005-01-01

    Bone on-growth and peri-implant migration of polyethylene particles were studied in an experimental setting using trabecular metal and solid metal implants. Cylindrical implants of trabecular tantalum metal and solid titanium alloy implants with a glass bead blasted surface were inserted either...... in an exact surgical fit or with a peri-implant gap into a canine knee joint. We used a randomised paired design. Polyethylene particles were injected into the knee joint. In both types of surgical fit we found that the trabecular metal implants had superior bone ongrowth in comparison with solid metal...... implants (exact fit: 23% vs. 7% [p=0.02], peri-implant gap: 13% vs. 0% [p=0.02]. The number of peri-implant polyethylene particles was significantly reduced around the trabecular metal implants with a peri-implant gap compared with solid implants....

  18. Superelastic Orthopedic Implant Coatings

    Science.gov (United States)

    Fournier, Eric; Devaney, Robert; Palmer, Matthew; Kramer, Joshua; El Khaja, Ragheb; Fonte, Matthew

    2014-07-01

    The demand for hip and knee replacement surgery is substantial and growing. Unfortunately, most joint replacement surgeries will fail within 10-25 years, thereby requiring an arduous, painful, and expensive revision surgery. To address this issue, a novel orthopedic implant coating material ("eXalt") has been developed. eXalt is comprised of super elastic nitinol wire that is knit into a three-dimensional spacer fabric structure. eXalt expands in vivo to conform to the implantation site and is porous to allow for bone ingrowth. The safety and efficacy of eXalt were evaluated through structural analysis, mechanical testing, and a rabbit implantation model. The results demonstrate that eXalt meets or exceeds the performance of current coating technologies with reduced micromotion, improved osseointegration, and stronger implant fixation in vivo.

  19. Excision Arthroplasty for First CMC Joint Tuberculous Osteomyelitis

    Science.gov (United States)

    Vora, Harshil J.; Patil, Sanjay; latkar, Chintamani; Sawant, Sarvesh

    2015-01-01

    Introduction: Tuberculous involvement of metacarpals and phalanges is a rare presentation of extrapulmonary tuberculosis in adult. Tuberculous infection of the metacarpals, metatarsal and phalanges of hands and feet is known as tubercular dactylitis. Case Report: A 65 years old female with history of pain and swelling at 1st metacarpal of left hand, since 3 months which gradual in onset and progressive in nature associated with multiple cervical swellings. While radiographs showed a pathological fracture of the 1st carpo-metacarpal joint (CMCJ) with soft tissue swelling, MRI revealed a large heterogenous lesion at the carpo-metacarpal joint of the thumb with bony erosions of the trapezium and 1st metacarpal base on T2W-STIR images. The lesion was extending upto the palmar aspect of the hand and displacing flexor pollicis longus tendon medially. During surgery, there was caseous material seen which was debrided and the fractured fragment was excised and sent for biopsy. The CMCJ was found to be unstable and a kirschner wire was used to stabilize the 1st CMCJ and immobilized in a POP splint. The biopsy of the fragment revealed tuberculous osteomyeltis. On follow-up the K-wire had backed out partially at the end of 5 weeks which was then removed and range of motion was started. At end of 1 year follow up the patient had little restriction of movement as compared to the opposite hand with no pain and hindrance in daily activity. Conclusion: The swelling subsided once Anti-Tubercular Treatment was started. The cervical lymphadenopathy also resolved over a period of 1 month. PMID:27299036

  20. [Design and application of implantable medical device information management system].

    Science.gov (United States)

    Cao, Shaoping; Yin, Chunguang; Zhao, Zhenying

    2013-03-01

    Through the establishment of implantable medical device information management system, with the aid of the regional joint sharing of resources, we further enhance the implantable medical device traceability management level, strengthen quality management, control of medical risk.

  1. Research and Technology Transfer Ion Implantation Technology for Specialty Materials: Proceedings of a Joint Workshop Held in Knoxville, Tennessee on 26-27 October 1989

    Science.gov (United States)

    1991-02-01

    Options from the Perspective of a SWall Business, Dr. Ralph B. Alexander, President, Ion Surface Tecnology , Inc. 9:45 &wort MedAniwm for Standards D[vel...implantation technologies, including the technology push /pull issue, psychological issues, competing technologies and relative costs; (2) implementation options...most advantageous method would depend on the specific ap- plication. The issue of technology push /pull, i.e. push from the develo- pers/researchers/ion

  2. Arthroscopic Fixation of Cell Free Polymer-Based Cartilage Implants with a Bioinspired Polymer Surface on the Hip Joint: A Cadaveric Pilot Study

    Directory of Open Access Journals (Sweden)

    Matthias Lahner

    2014-01-01

    Full Text Available This study investigates the adhesion capacity of a polyglycolic acid- (PGA- hyaluronan scaffold with a structural modification based on a planar polymer (PM surface in a cadaver cartilage defect model. Two cadaver specimens were used to serially test multiple chondral matrices. In a cadaver hip model, cell free polymer-based cartilage implants with a planar bioinspired PM surface (PGA-PM-scaffolds were implanted arthroscopically on 10 mm × 15 mm full-thickness femoral hip cartilage lesions. Unprocessed cartilage implants without a bioinspired PM surface were used as control group. The cartilage implants were fixed without and with the use of fibrin glue on femoral hip cartilage defects. After 50 movement cycles and removal of the distraction, a rearthroscopy was performed to assess the outline attachment and integrity of the scaffold. The fixation techniques without and with fibrin fixation showed marginal differences for outline attachment, area coverage, scaffold integrity, and endpoint fixation after 50 cycles. The PGA-PM-scaffolds with fibrin fixation achieved a higher score in terms of the attachment, integrity, and endpoint fixation than the PGA-scaffold on the cartilage defect. Relating to the outline attachment, area coverage, scaffold integrity, and endpoint fixation, the fixation with PGA-PM-scaffolds accomplished significantly better results compared to the PGA-scaffolds (P=0.03752, P=0.03078, P=0.00512, P=0.00512. PGA-PM-scaffolds demonstrate increased observed initial fixation strength in cadaver femoral head defects relative to PGA-scaffold, particularly when fibrin glue is used for fixation.

  3. Remoção da cartilagem articular associada ou não a implante homógeno ou enxerto autógeno de osso esponjoso em cães submetidos à artrodese atlantoaxial Joint cartilage removal associated or not to homologous implant or autologous cancellous bone graft in dogs submitted to atlantoaxial arthrodesis

    Directory of Open Access Journals (Sweden)

    Rafael Festugatto

    2013-03-01

    Full Text Available O objetivo deste estudo foi avaliar o grau de fusão articular e formação óssea na articulação atlantoaxial de cães submetidos à artrodese após a remoção da cartilagem articular associada ou não ao implante homógeno ou enxerto autógeno de osso esponjoso. Foram utilizados 12 cães, adultos, distribuídos aleatoriamente em três grupos iguais. Grupo I (GI: realizada apenas a remoção da cartilagem articular e imobilização articular com pinos e resina acrílica. Grupo II (GII: feita a remoção da cartilagem articular e imobilização da articulação, seguida da colocação e modelagem do implante ósseo esponjoso homógeno entre as superfícies articulares. Grupo III (GIII: foi realizado o mesmo procedimento do GII, mais o enxerto ósseo esponjoso autógeno no local determinado. Realizaram-se exames radiográficos em todos os animais aos 30, 60 e 90 dias de pós-operatório (PO. Aos 90 dias de PO foi feita a eutanásia para o emprego do teste de palpação manual, avaliação tomográfica e histopatológica. Para análise estatística da associação entre o grau de fusão articular, aplicou-se o Teste Qui-quadrado de independência. Os resultados dos testes foram avaliados pela significância exata e considerados significantes a 5% (PThe aim of this study was to evaluate the degree of joint fusion and bone formation in dogs undergoing atlantoaxial arthrodesis after removal of articular cartilage associated or not to implant homogenous or autogenous cancellous bone. Twelve dogs, weighing between 8 and 12kg were randomly divided into three groups. Group I (GI performed only the removal of joint cartilage and joint immobilization with acrylic resin and pins. Group II (GII: after removel of joint cartilage and articular immobilization was performed modeling and placement of homogenous cancellous bone at the given location. The volume of homograft placed in the joint was measured using a precision balance and all animals received the

  4. Cochlear Implants

    Science.gov (United States)

    A cochlear implant is a small, complex electronic device that can help to provide a sense of sound. People who are ... of-hearing can get help from them. The implant consists of two parts. One part sits on ...

  5. 关节融合术治疗第一腕掌关节炎%Treatment of thumb carpometacarpal osteoarthritis by joint fusion

    Institute of Scientific and Technical Information of China (English)

    许玉本; 夏雷; 李鹏; 黄良库; 白杰

    2015-01-01

    目的:探讨关节融合术治疗第一腕掌关节骨性关节炎的临床疗效.方法:分析2012年1月至2015年1月,应用关节融合术治疗第一腕掌关节骨性关节炎患者24例,男8例,女16例;年龄47~66岁,平均年龄56岁;左手7例,右手17例.术前根据影像学Eaton-Glickel分期:Ⅱ期6例,Ⅲ期18例;分别测量握力、指尖捏力、拇指活动度、疼痛视觉模拟评分(visual analogue scale,VAS)及Kapandji score,并对上述结果进行统计学分析.结果:24例患者均获得随访,平均11个月,最短随访者7个月.经过平均11个月,手术前后握力平均为6.9kg/17kg,捏力平均2.1kg/3.4kg,疼痛VAS分级7.3/1.5,Kapandji score平均为5.5/8.1,24例患者全部愈合.术后随访,效果优良率达到92.1%.术前与术后比较差异均有统计学意义(P<0.05).结论:关节融合术操作简单,疗效可靠,是治疗第一腕掌骨性关节炎的可靠法.

  6. Preserving the Posttrapeziectomy Space with a Human Acellular Dermal Matrix Spacer: A Pilot Case Series of Patients with Thumb Carpometacarpal Joint Arthritis

    Directory of Open Access Journals (Sweden)

    Caroline A. Yao, MD

    2013-10-01

    Conclusions: HADM has been used extensively in other forms of reconstruction and has been shown to incorporate into surrounding tissues through neovascularization. Our early results illustrate that HADM can safely fill the dead space left by trapeziectomy.

  7. Cementable implant-supported prosthesis, serial extraction, and serial implant installation: case report.

    Science.gov (United States)

    Rosen, Harry; Gornitsky, Mervyn

    2004-12-01

    Cement-retained implant-supported prostheses are particularly indicated where access for screw placement is limited or impossible like in posterior locations or where there is limited jaw opening. The patient in this case report suffered from limited jaw opening as a result of a long history of temporomandibular joint ankylosis related to hemophilia. Cement-retained implant-supported prostheses coupled with serial extraction, serial implant installations, and chairside provisional restorations made uneventful treatment possible.

  8. [Fractures of the elbow joint].

    Science.gov (United States)

    Nowak, T E; Dietz, S O; Burkhart, K J; Müller, L P; Rommens, P M

    2012-02-01

    Fractures around the elbow joint comprise fractures of the distal humerus, the radial head, the olecranon and the coronoid process. Combined lesions are particularly demanding for the surgeon. Accurate knowledge of the anatomy and of the biomechanics is an essential requirement for a specific diagnosis and therapy. A stable and painless movable elbow joint is essential for most of the activities of daily living. Risk factors for the development of posttraumatic elbow joint arthrosis are non-anatomically reconstructed joint surfaces, axial malalignment of the joint axis and untreated concomitant injuries. Modern angular stable and anatomically preshaped implants facilitate a biomechanically adequate osteosynthesis and avoid or decrease functional impairment. In consideration of an increasing number of osteoporotic elbow joint fractures, endoprosthetic replacement has gained significance.

  9. 种植术与分根术联合治疗术后牙体可靠性分析%Reliability analysis of dental implantation and split-root technique joint repaired postoperative dental

    Institute of Scientific and Technical Information of China (English)

    陈玲; 门玉涛; 王加江

    2016-01-01

    Obtaining experimental models by the method of model reverse.In order to Study on reliability of dental im-plantation and split-root technique joint repaired postoperative dental,analysis of factors which affect the success rate of treatment,and calculating the limit load when reliability reached 80%,combining with the reliability theory to obtain the desired number of samples test and performing finite element simulation and analysis to the model.Numerical simu-lations show that the stress direction and bone properties are the most important factors to influence the long-term success rate of treatment,and after treatment the tooth can be competent for the daily chewing and biting tasks,but should try to avoid oblique stress and bite hard food.%通过模型反求的方法得到实验模型;结合可靠性理论进行大量采样试验,对模型进行有限元数值模拟和分析,以此研究种植术与分根术联合治疗术后牙体的可靠性,分析影响手术远期治疗成功率的因素,并得出在可靠度达到80%时牙体的极限载荷。通过分析计算得知牙体受力情况以及骨质性能是影响种植术与分根术联合治疗远期成功率的最关键因素,且经过种植术与分根术联合治疗后的牙体完全可以胜任日常咀嚼及咬合任务,但应尽量避免斜向受力及咬合过硬食物。

  10. Cochlear Implant

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    In this text, the authors recall the main principles and data ruling cochlear implants. Then, a first circle of technical equipment for assistance is presented. This circle includes: device setting (DS), Electrically evoked Auditory Brainstem Responses (EABR), Neural Response Telemetry (NRT), Stapedial Reflex (SR) and Electrodogram Acquisition (EA). This first cycle becomes more and more important as children are implanted younger and younger; the amount of data available with this assistance makes necessary the use of models (implicit or explicit) to handle this information. Consequently, this field is more open than ever.

  11. Joint ventures

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig

    Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret......Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret...

  12. Joint swelling

    Science.gov (United States)

    ... chap 275. Raftery AT, Lim E, Ostor AJK. Joint disorders. In: Raftery AT, Lim E, Ostor AJK, eds. ... A.M. Editorial team. Related MedlinePlus Health Topics Joint Disorders Browse the Encyclopedia A.D.A.M., Inc. ...

  13. Dissipated energy as a method to characterize the cartilage damage in large animal joints: an in vitro testing model.

    Science.gov (United States)

    Walter, Christian; Leichtle, Ulf; Lorenz, Andrea; Mittag, Falk; Wülker, Nikolaus; Müller, Otto; Bobrowitsch, Evgenij; Rothstock, Stephan

    2013-09-01

    Several quantitative methods for the in vitro characterization of cartilage quality are available. However, only a few of these methods allow surgical cartilage manipulations and the subsequent analysis of the friction properties of complete joints. This study introduces an alternative approach to the characterization of the friction properties of entire joint surfaces using the dissipated energy during motion of the joint surfaces. Seven sheep wrist joints obtained post mortem were proximally and distally fixed to a material testing machine. With the exception of the carpometacarpal articulation surface, all joint articulations were fixed with 'Kirschner' wires. Three cartilage defects were simulated with a surgically introduced groove (16 mm(2), 32 mm(2), 300 mm(2)) and compared to intact cartilage without an artificial defect. The mean dissipated energy per cycle was calculated from the hysteresis curve during ten torsional motion cycles (±10°) under constant axial preload (100-900 N). A significant increase in dissipated energy was observed with increasing cartilage defect size and axial load (p0.073), while all other defect conditions were significantly different (p=0.015). All defect sizes were significantly different (p=0.049) at 900 N axial load. We conclude that the method introduced here could be an alternative for the study of cartilage damage, and further applications based on the principles of this method could be developed for the evaluation of different cartilage treatments.

  14. Tophaceous Gout simulating infected Ankle Implants

    Directory of Open Access Journals (Sweden)

    Ioannis K

    2016-11-01

    Full Text Available Gout is a well known metabolic disorder characterized by the formation of urate crystals in joints resulting in recurrent attacks of acute inflammatory arthritis following which tophi can occur in joints or subcutaneous tissues. We report a rare localization of gouty tophi in a 52 years old male. The tophi had formed over the stainless steel implant used for the fixation of a lateral malleolus fracture 20 years ago.

  15. Joint ventures

    NARCIS (Netherlands)

    M.N. Hoogendoorn (Martin)

    2009-01-01

    textabstractEen veel voorkomende wijze van samenwerking tussen ondernemingen is het uitvoeren van activiteiten in de vorm van een joint venture. Een joint venture is bijna altijd een afzonderlijke juridische entiteit. De partners in de joint venture voeren gezamenlijk de zeggenschap uit. In internat

  16. Standardized Loads Acting in Hip Implants.

    Directory of Open Access Journals (Sweden)

    Georg Bergmann

    Full Text Available With the increasing success of hip joint replacements, the average age of patients has decreased, patients have become more active and their expectations of the implant durability have risen. Thus, pre-clinical endurance tests on hip implants require defining realistic in vivo loads from younger and more active patients. These loads require simplifications to be applicable for simulator tests and numerical analyses. Here, the contact forces in the joint were measured with instrumented hip implants in ten subjects during nine of the most physically demanding and frequent activities of daily living. Typical levels and directions of average and high joint loads were extracted from the intra- and inter-individually widely varying individual data. These data can also be used to analyse bone remodelling at the implant-bone interface, evaluate tissue straining in finite element studies or validate analytical loading predictions, among other uses. The current ISO standards for endurance tests of implant stems and necks are based on historic analytical data from the 1970s. Comparisons of these test forces with in vivo loads unveiled that their unidirectional orientations deviate from the time-dependent in vivo directions during walking and most other activities. The ISO force for testing the stem is substantially too low while the ISO force for the neck better matches typical in vivo magnitudes. Because the magnitudes and orientations of peak forces substantially vary among the activities, load scenarios that reflect a collection of time-dependent high forces should be applied rather than using unidirectional forces. Based on data from ten patients, proposals for the most demanding activities, the time courses of the contact forces and the required cycle numbers for testing are given here. Friction moments in the joint were measured in addition to the contact forces. The moment data were also standardized and can be applied to wear tests of the implant

  17. Standardized Loads Acting in Hip Implants.

    Science.gov (United States)

    Bergmann, Georg; Bender, Alwina; Dymke, Jörn; Duda, Georg; Damm, Philipp

    2016-01-01

    With the increasing success of hip joint replacements, the average age of patients has decreased, patients have become more active and their expectations of the implant durability have risen. Thus, pre-clinical endurance tests on hip implants require defining realistic in vivo loads from younger and more active patients. These loads require simplifications to be applicable for simulator tests and numerical analyses. Here, the contact forces in the joint were measured with instrumented hip implants in ten subjects during nine of the most physically demanding and frequent activities of daily living. Typical levels and directions of average and high joint loads were extracted from the intra- and inter-individually widely varying individual data. These data can also be used to analyse bone remodelling at the implant-bone interface, evaluate tissue straining in finite element studies or validate analytical loading predictions, among other uses. The current ISO standards for endurance tests of implant stems and necks are based on historic analytical data from the 1970s. Comparisons of these test forces with in vivo loads unveiled that their unidirectional orientations deviate from the time-dependent in vivo directions during walking and most other activities. The ISO force for testing the stem is substantially too low while the ISO force for the neck better matches typical in vivo magnitudes. Because the magnitudes and orientations of peak forces substantially vary among the activities, load scenarios that reflect a collection of time-dependent high forces should be applied rather than using unidirectional forces. Based on data from ten patients, proposals for the most demanding activities, the time courses of the contact forces and the required cycle numbers for testing are given here. Friction moments in the joint were measured in addition to the contact forces. The moment data were also standardized and can be applied to wear tests of the implant. It was shown that

  18. Short Implants: New Horizon in Implant Dentistry.

    Science.gov (United States)

    Jain, Neha; Gulati, Manisha; Garg, Meenu; Pathak, Chetan

    2016-09-01

    The choice of implant length is an essential factor in deciding the survival rates of these implants and the overall success of the prosthesis. Placing an implant in the posterior part of the maxilla and mandible has always been very critical due to poor bone quality and quantity. Long implants can be placed in association with complex surgical procedures such as sinus lift and bone augmentation. These techniques are associated with higher cost, increased treatment time and greater morbidity. Hence, there is need for a less invasive treatment option in areas of poor bone quantity and quality. Data related to survival rates of short implants, their design and prosthetic considerations has been compiled and structured in this manuscript with emphasis on the indications, advantages of short implants and critical biomechanical factors to be taken into consideration when choosing to place them. Studies have shown that comparable success rates can be achieved with short implants as those with long implants by decreasing the lateral forces to the prosthesis, eliminating cantilevers, increasing implant surface area and improving implant to abutment connection. Short implants can be considered as an effective treatment alternative in resorbed ridges. Short implants can be considered as a viable treatment option in atrophic ridge cases in order to avoid complex surgical procedures required to place long implants. With improvement in the implant surface geometry and surface texture, there is an increase in the bone implant contact area which provides a good primary stability during osseo-integration.

  19. Bioactive Coatings for Orthopaedic Implants—Recent Trends in Development of Implant Coatings

    OpenAIRE

    Zhang, Bill G. X.; Myers, Damian E.; Gordon G. Wallace; Milan Brandt; Choong, Peter F. M.

    2014-01-01

    Joint replacement is a major orthopaedic procedure used to treat joint osteoarthritis. Aseptic loosening and infection are the two most significant causes of prosthetic implant failure. The ideal implant should be able to promote osteointegration, deter bacterial adhesion and minimize prosthetic infection. Recent developments in material science and cell biology have seen the development of new orthopaedic implant coatings to address these issues. Coatings consisting of bioceramics, extracell...

  20. Cochlear Implant

    Directory of Open Access Journals (Sweden)

    Mehrnaz Karimi

    1992-04-01

    Full Text Available People with profound hearing loss are not able to use some kinds of conventional amplifiers due to the nature of their loss . In these people, hearing sense is stimulated only when the auditory nerve is activated via electrical stimulation. This stimulation is possible through cochlear implant. In fact, for the deaf people who have good mental health and can not use surgical and medical treatment and also can not benefit from air and bone conduction hearing aids, this device is used if they have normal central auditory system. The basic parts of the device included: Microphone, speech processor, transmitter, stimulator and receiver, and electrode array.

  1. Hernia Surgical Mesh Implants

    Science.gov (United States)

    ... Prosthetics Hernia Surgical Mesh Implants Hernia Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine) ...

  2. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... Prosthetics Urogynecologic Surgical Mesh Implants Urogynecologic Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine). ...

  3. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint... implanted in the human jaw to replace the mandibular condyle and augment the glenoid fossa to...

  4. Systemic alendronate treatment improves fixation of press-fit implants: a canine study using nonloaded implants

    DEFF Research Database (Denmark)

    Jensen, Thomas B; Bechtold, Joan E; Chen, Xinqian;

    2007-01-01

    Bone resorption associated with local trauma occurring during insertion of joint prostheses is recognized as an early event. Being an osteoclastic inhibitor, alendronate is a potential candidate means to decrease early periprosthetic bone resorption and thereby improve implant fixation. We......) was inserted into each proximal tibia of 16 dogs. On one side the implant was inserted press-fit whereas on the contralateral side, the implants were surrounded by a 2 mm concentric gap. Oral alendronate (0.5 mg/kg/day) was given 2 weeks following surgery to eight dogs. The dogs were euthanized after 10 weeks...... early implant stability is an important predictor of longevity, systemic alendronate treatment could be an important clinical tool to positively influence the early stages of implant incorporation. Udgivelsesdato: 2007-Jun...

  5. Complications after cardiac implantable electronic device implantations

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;

    2014-01-01

    Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient...

  6. Joint Interdiction

    Science.gov (United States)

    2016-09-09

    exercise of authority by combatant commanders and other joint force commanders (JFCs), and prescribes joint doctrine for operations and training. It...interdiction requirements and dependable, interoperable, and secure communications architecture to exercise control. The JFC exercises C2 through...moving across open desert terrain were more vulnerable to interdiction by coalition airpower than dispersed Serbian forces that benefited from trees

  7. Hand osteoarthritis: Differential diagnosis with inflammatory joint diseases and treatment policy

    Directory of Open Access Journals (Sweden)

    Yu. A. Olyunin

    2015-01-01

    Full Text Available Osteoarthritis (OA usually affects certain joint groups selectively and the hand joints (HJ are one of its classical locations. Hand OA is widespread in the population. In their practice rheumatologists encounter HJ injury in OA in 38% of cases. It is conventional to identify three main types of hand OA. These are 1 interphalangeal OA that may or may not be accompanied by nodulation; 2 first carpometacarpal OA; and 3 erosive OA. At the same time, the rate of clinical forms ranges from 2.0 to 6.2%; it is 4.7 to 20.4% in the elderly. Nonsteroidal antiinflammatory drugs (NSAIDs are most commonly used to relieve pain that is the main manifestation of the disease. The risk for NSAID-related adverse gastrointestinal (GI events is substantially reduced by the drugs that exert their effects mainly on cyclooxygenase 2. These include nimesulide in particular. Undesirable GI effects may be also considerably minimized by using NSAIDs that have both their gastroprotective and antiinflammatory activities. By suppressing pain and inflammatory changes, the recently designed NSAID amtolmetin guacil simultaneously exerts a protective effect on the GI mucosa, by elevating its nitric oxide levels.

  8. [Bilateral cochlear implantation].

    Science.gov (United States)

    Kronenberg, Jona; Migirov, Lela; Taitelbaum-Swead, Rikey; Hildesheimer, Minka

    2010-06-01

    Cochlear implant surgery became the standard of care in hearing rehabilitation of patients with severe to profound sensorineural hearing loss. This procedure may alter the lives of children and adults enabling them to integrate with the hearing population. In the past, implantation was performed only in one ear, despite the fact that binaural hearing is superior to unilateral, especially in noisy conditions. Cochlear implantation may be performed sequentially or simultaneously. The "sensitive period" of time between hearing loss and implantation and between the two implantations, when performed sequentially, significantly influences the results. Shorter time spans between implantations improve the hearing results after implantation. Hearing success after implantation is highly dependent on the rehabilitation process which includes mapping, implant adjustments and hearing training. Bilateral cochlear implantation in children is recommended as the proposed procedure in spite of the additional financial burden.

  9. Standardized loads acting in knee implants.

    Directory of Open Access Journals (Sweden)

    Georg Bergmann

    Full Text Available The loads acting in knee joints must be known for improving joint replacement, surgical procedures, physiotherapy, biomechanical computer simulations, and to advise patients with osteoarthritis or fractures about what activities to avoid. Such data would also allow verification of test standards for knee implants. This work analyzes data from 8 subjects with instrumented knee implants, which allowed measuring the contact forces and moments acting in the joint. The implants were powered inductively and the loads transmitted at radio frequency. The time courses of forces and moments during walking, stair climbing, and 6 more activities were averaged for subjects with I average body weight and average load levels and II high body weight and high load levels. During all investigated activities except jogging, the high force levels reached 3,372-4,218N. During slow jogging, they were up to 5,165N. The peak torque around the implant stem during walking was 10.5 Nm, which was higher than during all other activities including jogging. The transverse forces and the moments varied greatly between the subjects, especially during non-cyclic activities. The high load levels measured were mostly above those defined in the wear test ISO 14243. The loads defined in the ISO test standard should be adapted to the levels reported here. The new data will allow realistic investigations and improvements of joint replacement, surgical procedures for tendon repair, treatment of fractures, and others. Computer models of the load conditions in the lower extremities will become more realistic if the new data is used as a gold standard. However, due to the extreme individual variations of some load components, even the reported average load profiles can most likely not explain every failure of an implant or a surgical procedure.

  10. Standardized loads acting in knee implants.

    Science.gov (United States)

    Bergmann, Georg; Bender, Alwina; Graichen, Friedmar; Dymke, Jörn; Rohlmann, Antonius; Trepczynski, Adam; Heller, Markus O; Kutzner, Ines

    2014-01-01

    The loads acting in knee joints must be known for improving joint replacement, surgical procedures, physiotherapy, biomechanical computer simulations, and to advise patients with osteoarthritis or fractures about what activities to avoid. Such data would also allow verification of test standards for knee implants. This work analyzes data from 8 subjects with instrumented knee implants, which allowed measuring the contact forces and moments acting in the joint. The implants were powered inductively and the loads transmitted at radio frequency. The time courses of forces and moments during walking, stair climbing, and 6 more activities were averaged for subjects with I) average body weight and average load levels and II) high body weight and high load levels. During all investigated activities except jogging, the high force levels reached 3,372-4,218N. During slow jogging, they were up to 5,165N. The peak torque around the implant stem during walking was 10.5 Nm, which was higher than during all other activities including jogging. The transverse forces and the moments varied greatly between the subjects, especially during non-cyclic activities. The high load levels measured were mostly above those defined in the wear test ISO 14243. The loads defined in the ISO test standard should be adapted to the levels reported here. The new data will allow realistic investigations and improvements of joint replacement, surgical procedures for tendon repair, treatment of fractures, and others. Computer models of the load conditions in the lower extremities will become more realistic if the new data is used as a gold standard. However, due to the extreme individual variations of some load components, even the reported average load profiles can most likely not explain every failure of an implant or a surgical procedure.

  11. Implant success!!!.....simplified

    Directory of Open Access Journals (Sweden)

    Luthra Kaushal

    2009-01-01

    Full Text Available The endeavor towards life-like restoration has helped nurture new vistas in the art and science of implant dentistry. The protocol of "restoration-driven implant placement" ensures that the implant is an apical extension of the ideal future restoration and not the opposite. Meticulous pre-implant evaluation of soft and hard tissues, diagnostic cast and use of aesthetic wax-up and radiographic template combined with surgical template can simplify the intricate roadmap for appropriate implant treatment. By applying the harmony of artistic skill, scientific knowledge and clinical expertise, we can simply master the outstanding implant success in requisites of aesthetics, phonetics and function.

  12. New approach to orthopedic implant design

    Energy Technology Data Exchange (ETDEWEB)

    Hollerbach, K; Perfect, S; Martz, H; Ashby, E

    1999-07-03

    This report describes the accomplishments of a three year LDRD project, aimed at developing computational models and methodologies for improving prosthetic joint design. The investigators developed human models as well as prosthetic joint models. Input data came both from high resolution scans performed at Lawrence Livermore National Laboratory (LLNL) and from data provided by collaborators. Results of the approach, in addition to being presented at scientific meetings, are being used to obtain US Food and Drug Administration (FDA) approval in the process of putting new implant designs on the market.

  13. Bone graft materials in fixation of orthopaedic implants in sheep

    DEFF Research Database (Denmark)

    Babiker, Hassan

    2013-01-01

    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many...... the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking...... bone and includes bone collagen, morphogenetic proteins and growth factors. The combination of DBM with CB and with allograft might improve the healing potential of these grafts around non-cemented orthopaedic implants and thereby the implant fixation. Study I investigates the effect of HA...

  14. Breast Implants: Saline vs. Silicone

    Science.gov (United States)

    ... differ in material and consistency, however. Saline breast implants Saline implants are filled with sterile salt water. ... of any age for breast reconstruction. Silicone breast implants Silicone implants are pre-filled with silicone gel — ...

  15. Morse taper dental implants and platform switching: The new paradigm in oral implantology

    Science.gov (United States)

    Macedo, José Paulo; Pereira, Jorge; Vahey, Brendan R.; Henriques, Bruno; Benfatti, Cesar A. M.; Magini, Ricardo S.; López-López, José; Souza, Júlio C. M.

    2016-01-01

    The aim of this study was to conduct a literature review on the potential benefits with the use of Morse taper dental implant connections associated with small diameter platform switching abutments. A Medline bibliographical search (from 1961 to 2014) was carried out. The following search items were explored: “Bone loss and platform switching,” “bone loss and implant-abutment joint,” “bone resorption and platform switching,” “bone resorption and implant-abutment joint,” “Morse taper and platform switching.” “Morse taper and implant-abutment joint,” Morse taper and bone resorption,” “crestal bone remodeling and implant-abutment joint,” “crestal bone remodeling and platform switching.” The selection criteria used for the article were: meta-analysis; randomized controlled trials; prospective cohort studies; as well as reviews written in English, Portuguese, or Spanish languages. Within the 287 studies identified, 81 relevant and recent studies were selected. Results indicated a reduced occurrence of peri-implantitis and bone loss at the abutment/implant level associated with Morse taper implants and a reduced-diameter platform switching abutment. Extrapolation of data from previous studies indicates that Morse taper connections associated with platform switching have shown less inflammation and possible bone loss with the peri-implant soft tissues. However, more long-term studies are needed to confirm these trends. PMID:27011755

  16. Estudo comparativo entre ressecção do trapézio e interposição tendinosa com e sem ligamentoplastia no tratamento da artrose carpometacarpiana do polegar Comparative study between trapezium resection and tendon interposition with and without ligament plasty in the management of carpometacarpal arthrosis of the thumb

    Directory of Open Access Journals (Sweden)

    Arlindo Gomes Pardini Junior

    2008-03-01

    opponency, movements of the metacarpophalangeal joint, pinching and pressure strength, radiographic measurement of the distance between the first metacarpian and the scaphoid, and measurement of the angle between the first and the second metacarpian. Subjective evaluation was done with a DASH questionnaire, an analogical-digital scale to evaluate pain and patient satisfaction. RESULTS AND CONCLUSION: After application of the criteria described and using Student t test for statistical analysis, the authors concluded that the ligament reconstruction has no advantage over the simple tendon interposition in carpometacarpal arthrosis of the thumb.

  17. Utility of Intraoperative Neuromonitoring during Minimally Invasive Fusion of the Sacroiliac Joint

    OpenAIRE

    Michael Woods; Denise Birkholz; Regina MacBarb; Robyn Capobianco; Adam Woods

    2014-01-01

    Study Design. Retrospective case series. Objective. To document the clinical utility of intraoperative neuromonitoring during minimally invasive surgical sacroiliac joint fusion for patients diagnosed with sacroiliac joint dysfunction (as a direct result of sacroiliac joint disruptions or degenerative sacroiliitis) and determine stimulated electromyography thresholds reflective of favorable implant position. Summary of Background Data. Intraoperative neuromonitoring is a well-accepted adjunct...

  18. Implantable Medical Devices

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Implantable Medical Devices Updated:Sep 16,2016 For Rhythm Control ... a Heart Attack Introduction Medications Surgical Procedures Implantable Medical Devices • Life After a Heart Attack • Heart Attack ...

  19. Urinary incontinence - collagen implants

    Science.gov (United States)

    ... gov/ency/article/007373.htm Urinary incontinence - injectable implant To use the sharing features on this page, please enable JavaScript. Injectable implants are injections of material into the urethra to ...

  20. Investigations of Titanium Implants Covered with Hydroxyapatite Layer

    OpenAIRE

    Świeczko – Żurek B.; Bartmański M.

    2016-01-01

    To reduce unfavorable phenomena occurring after introducing an implant into human body various modifications of the surface are suggested. Such modifications may have significant impact on biocompatibility of metallic materials. The titanium and it's alloys are commonly used for joint and dental implants due to their high endurance, low plasticity modulus, good corrosion resistance as well as biocompatibility. Special attention should be given to titanium alloys containing zirconium, tantalum...

  1. Implantable electronic medical devices

    CERN Document Server

    Fitzpatrick, Dennis

    2014-01-01

    Implantable Electronic Medical Devices provides a thorough review of the application of implantable devices, illustrating the techniques currently being used together with overviews of the latest commercially available medical devices. This book provides an overview of the design of medical devices and is a reference on existing medical devices. The book groups devices with similar functionality into distinct chapters, looking at the latest design ideas and techniques in each area, including retinal implants, glucose biosensors, cochlear implants, pacemakers, electrical stimulation t

  2. Joint purpose?

    DEFF Research Database (Denmark)

    Pristed Nielsen, Helene

    2013-01-01

    Starting from Crenshaw´s point that antiracism often fails to interrogate patriarchy and that feminism often reproduces racist practices (1991: 1252), this paper asks: What are the theoretical reasons for believing that feminism and anti-racism can be regarded as fighting for the joint purpose of...

  3. Antibacterial Surface Treatment for Orthopaedic Implants

    Directory of Open Access Journals (Sweden)

    Jiri Gallo

    2014-08-01

    Full Text Available It is expected that the projected increased usage of implantable devices in medicine will result in a natural rise in the number of infections related to these cases. Some patients are unable to autonomously prevent formation of biofilm on implant surfaces. Suppression of the local peri-implant immune response is an important contributory factor. Substantial avascular scar tissue encountered during revision joint replacement surgery places these cases at an especially high risk of periprosthetic joint infection. A critical pathogenic event in the process of biofilm formation is bacterial adhesion. Prevention of biomaterial-associated infections should be concurrently focused on at least two targets: inhibition of biofilm formation and minimizing local immune response suppression. Current knowledge of antimicrobial surface treatments suitable for prevention of prosthetic joint infection is reviewed. Several surface treatment modalities have been proposed. Minimizing bacterial adhesion, biofilm formation inhibition, and bactericidal approaches are discussed. The ultimate anti-infective surface should be “smart” and responsive to even the lowest bacterial load. While research in this field is promising, there appears to be a great discrepancy between proposed and clinically implemented strategies, and there is urgent need for translational science focusing on this topic.

  4. Antibacterial surface treatment for orthopaedic implants.

    Science.gov (United States)

    Gallo, Jiri; Holinka, Martin; Moucha, Calin S

    2014-08-11

    It is expected that the projected increased usage of implantable devices in medicine will result in a natural rise in the number of infections related to these cases. Some patients are unable to autonomously prevent formation of biofilm on implant surfaces. Suppression of the local peri-implant immune response is an important contributory factor. Substantial avascular scar tissue encountered during revision joint replacement surgery places these cases at an especially high risk of periprosthetic joint infection. A critical pathogenic event in the process of biofilm formation is bacterial adhesion. Prevention of biomaterial-associated infections should be concurrently focused on at least two targets: inhibition of biofilm formation and minimizing local immune response suppression. Current knowledge of antimicrobial surface treatments suitable for prevention of prosthetic joint infection is reviewed. Several surface treatment modalities have been proposed. Minimizing bacterial adhesion, biofilm formation inhibition, and bactericidal approaches are discussed. The ultimate anti-infective surface should be "smart" and responsive to even the lowest bacterial load. While research in this field is promising, there appears to be a great discrepancy between proposed and clinically implemented strategies, and there is urgent need for translational science focusing on this topic.

  5. Autologous chondrocyte implantation for treatment of cartilage defects of the knee

    DEFF Research Database (Denmark)

    Jungmann, Pia M; Salzmann, Gian M; Schmal, Hagen;

    2012-01-01

    BACKGROUND: Autologous chondrocyte implantation (ACI) is a well-established treatment option for isolated cartilage defects of the knee joint, providing satisfying outcome. However, cases of treatment failure with the need for surgical reintervention are reported; typical patient's individual and...

  6. Failures of the RM finger prosthesis joint replacement system.

    Science.gov (United States)

    Middleton, A; Lakshmipathy, R; Irwin, L R

    2011-09-01

    In our unit a high failure rate of the RM finger prosthesis joint replacement system was noted, prompting a review of cases. A series of patients underwent implantation under the care of one surgeon and the results were monitored. Twenty-one devices were implanted of which 16 were inserted for rheumatoid disease. Patients were reviewed regularly and the implant performance was assessed critically along with survival of the implant to revision, infection or death of the patient. The mean follow-up was 32 months. Unacceptable failure rates at early and medium term stages were identified, with 15 of the implants revised by 2 years. Loosening was the commonest mode of failure. The authors do not recommend the use of this implant, especially in cases of rheumatoid arthritis.

  7. Principles of human joint replacement design and clinical application

    CERN Document Server

    Buechel, Frederick F

    2015-01-01

    This book is written for the users and designers of joint replacements. In its second extended edition it conveys to the reader the knowledge accumulated by the authors during their forty year effort on the development of replacement devices for the lower limb for the purpose of aiding the reader in their design and evaluation of joint replacement devices. The early chapters describe the engineering, scientific and medical principles needed for replacement joint evaluation. One must understand the nature and performance of the materials involved and their characteristics in vivo, i.e. the response of the body to implant materials. It is also essential to understand the response of the implants to applied loading and motion, particularly in the hostile physiological environment. A chapter describes the design methodology now required for joint replacement in the USA and EU countries. The remaining chapters provide a history of joint replacement, an evaluation of earlier and current devices and sample case hist...

  8. COCHLEAR IMPLANTATION: MY EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Shankar

    2015-12-01

    Full Text Available Cochlear implant is a small, surgically implanted complex electronic device that can help to provide a sense of sound to a person with severe to profound sensorineural hearing loss. This type of hearing loss, typically involves damage to hair cells in the cochlea, as a result sound cannot reach the auditory nerve which usually receives information from hair cells. A cochlear implant skips the damaged hair cells and to stimulate the auditory nerve directly. An implant does not restore normal hearing, instead it can give a deaf person a useful representation of sounds in the environment and help him or her to understand speech. I am here presenting this article in relation to the indications, intraoperative and postoperative complications of cochlear implantation in our institute since January 2013. Children who receive implants at earlier age, outperform their peers who are implanted at a later age. This is reflected in all the areas of speech and language development.

  9. Brandon Research, Inc. Orthopedic Implant Cooperative Research and Development Agreement (CRADA) Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Freeman, W.R.

    1999-04-22

    The project was a joint research effort between the U. S. Department of Energy's (DOE) Kansas City Plant (KCP) and Brandon Research, Inc. to develop ways to improve implants used for orthopedic surgery for joint replacement. The primary product produced by this study is design information, which may be used to develop implants that will improve long-term fixation and durability in the host bone environment.

  10. Osteomyelitis of sternum and rib after breast prosthesis implantation: A rare or underestimated infection?

    Science.gov (United States)

    Seng, Piseth; Alliez, Antoine; Honnorat, Estelle; Menard, Amelie; Casanova, Dominique; Stein, Andreas

    2014-01-01

    Sternum and rib osteomyelitis complicated from breast implant infection is rare. We report a case of early sternum and rib osteomyelitis occurred during breast implant infection managed in an inter-regional referral center for bone/joint infections in the south of France. PMID:26793446

  11. Osteomyelitis of sternum and rib after breast prosthesis implantation: A rare or underestimated infection?

    Directory of Open Access Journals (Sweden)

    Piseth Seng

    2015-01-01

    Full Text Available Sternum and rib osteomyelitis complicated from breast implant infection is rare. We report a case of early sternum and rib osteomyelitis occurred during breast implant infection managed in an inter-regional referral center for bone/joint infections in the south of France.

  12. Implantes transcigomáticos Traszygomatic implants

    Directory of Open Access Journals (Sweden)

    B. Fernández Ateca

    2004-12-01

    Full Text Available Los implantes cigomáticos, originariamente diseñados por Branemark en 1989, son implantes de cabeza en 45 grados, de 4'5 milímetros de diámetro en su parte más ancha, y que pueden medir entre 30 y 50 milímetros de longitud. Se insertan desde la parte palatina del proceso alveolar, siguiendo la cresta cigomática-alveolar hasta anclarse en el cuerpo del malar, y en el caso de pacientes maxilectomizados, entrando directamente en el cuerpo del malar. Estos implantes ofrecen una alternativa más al cirujano en el momento de planificar un tratamiento protésico-rehabilitador implantosoportado. Sobretodo, en aquellos pacientes con un maxilar superior atrófico en el que no se pueden realizar injertos óseos o estos han fracasado. El objetivo de este artículo es proponer el protocolo quirúrgico de colocación de los implantes trascigomáticos y revisar la literatura actual sobre la evolución clínica de estos implantes.The zygomatic implants, originally designed by Branemark in 1989, are implants with a 45 degree inclined head, 4'5 millimetre diameter at their widest part and measuring between 30 and 50 millimetres in length. They are inserted from the palatine side of the alveolar process, following the zygomatic-alveolar edge and anchor in the body of the zygomatic bone. In the case of maxillectomized patients, they are inserted directly in the body of the malar bone. These implants offer an additional alternative to the surgeon when planning an implant supported rehabilitation treatment; specially in those patients with an atrophic maxilla in which osseous grafts cannot be realized or these grafts have failed. The objective of this article is to propose the surgical,protocol of placement of traszygomatic implants and to check the current literature on the clinical evolution of these implants.

  13. Minimally invasive arthrodesis for chronic sacroiliac joint dysfunction using the SImmetry SI Joint Fusion system.

    Science.gov (United States)

    Miller, Larry E; Block, Jon E

    2014-01-01

    Chronic sacroiliac (SI) joint-related low back pain (LBP) is a common, yet under-diagnosed and undertreated condition due to difficulties in accurate diagnosis and highly variable treatment practices. In patients with debilitating SI-related LBP for at least 6 months duration who have failed conservative management, arthrodesis is a viable option. The SImmetry(®) SI Joint Fusion System is a novel therapy for SI joint fusion, not just fixation, which utilizes a minimally invasive surgical approach, instrumented fixation for immediate stability, and joint preparation with bone grafting for a secure construct in the long term. The purpose of this report is to describe the minimally invasive SI Joint Fusion System, including patient selection criteria, implant characteristics, surgical technique, postoperative recovery, and biomechanical testing results. Advantages and limitations of this system will be discussed.

  14. Transfixation cast technique for arthrodesis of the distal interphalangeal joint of horses.

    Science.gov (United States)

    Easter, J L; Schumacher, J; Watkins, J P

    2011-01-01

    Surgical arthrodesis of the distal interphalangeal (DIP) joint by transfixation casting was used to salvage a three-year-old filly and a yearling filly that were chronically lame because of infection of the DIP joint for breeding. Unlike previously described techniques for arthrodesis of the DIP joint, the technique used did not require insertion of implants across the joint, which may have contributed to the successful outcome.

  15. Implant treatment planning considerations.

    Science.gov (United States)

    Kao, Richard T

    2008-04-01

    As dental implants become a more accepted treatment modality, there is a need for all parties involved with implant dentistry to be familiar with various treatment planning issues. Though the success can be highly rewarding, failure to forecast treatment planning issues can result in an increase of surgical needs, surgical cost, and even case failure. In this issue, the focus is on implant treatment planning considerations.

  16. Implants in adolescents.

    Science.gov (United States)

    Shah, Rohit A; Mitra, Dipika K; Rodrigues, Silvia V; Pathare, Pragalbha N; Podar, Rajesh S; Vijayakar, Harshad N

    2013-07-01

    Implants have gained tremendous popularity as a treatment modality for replacement of missing teeth in adults. There is extensive research present on the use of implants in adults, but there is a dearth of data available on the same in adolescents. The treatment planning and execution of implant placement in adolescents is still in its infancy. This review article is an attempt to bring together available literature.

  17. Implants in adolescents

    Directory of Open Access Journals (Sweden)

    Rohit A Shah

    2013-01-01

    Full Text Available Implants have gained tremendous popularity as a treatment modality for replacement of missing teeth in adults. There is extensive research present on the use of implants in adults, but there is a dearth of data available on the same in adolescents. The treatment planning and execution of implant placement in adolescents is still in its infancy. This review article is an attempt to bring together available literature.

  18. Ion implantation technology

    CERN Document Server

    Downey, DF; Jones, KS; Ryding, G

    1993-01-01

    Ion implantation technology has made a major contribution to the dramatic advances in integrated circuit technology since the early 1970's. The ever-present need for accurate models in ion implanted species will become absolutely vital in the future due to shrinking feature sizes. Successful wide application of ion implantation, as well as exploitation of newly identified opportunities, will require the development of comprehensive implant models. The 141 papers (including 24 invited papers) in this volume address the most recent developments in this field. New structures and possible approach

  19. Silver-based antibacterial surfaces for bone implants

    NARCIS (Netherlands)

    Necula, B.S.

    2013-01-01

    Total hip arthroplasty (THA) is the most effective and safest method for treating severe degenerative, post-traumatic and other diseases of the joints. With an aging population that is increasingly active, the use of biomedical implants will continue to rise. It is estimated that more than 1,000,000

  20. Chemokines Associated with Pathologic Responses to Orthopedic Implant Debris

    Science.gov (United States)

    Hallab, Nadim J.; Jacobs, Joshua J.

    2017-01-01

    Despite the success in returning people to health saving mobility and high quality of life, the over 1 million total joint replacements implanted in the US each year are expected to eventually fail after approximately 15–25 years of use, due to slow progressive subtle inflammation to implant debris compromising the bone implant interface. This local inflammatory pseudo disease state is primarily caused by implant debris interaction with innate immune cells, i.e., macrophages. This implant debris can also activate an adaptive immune reaction giving rise to the concept of implant-related metal sensitivity. However, a consensus of studies agree the dominant form of this response is due to innate reactivity by macrophages to implant debris danger signaling (danger-associated molecular pattern) eliciting cytokine-based and chemokine inflammatory responses. This review covers implant debris-induced release of the cytokines and chemokines due to activation of the innate (and the adaptive) immune system and how this leads to subsequent implant failure through loosening and osteolysis, i.e., what is known of central chemokines (e.g., IL-8, monocyte chemotactic protein-1, MIP-1, CCL9, CCL10, CCL17, and CCL22) associated with implant debris reactivity as related to the innate immune system activation/cytokine expression, e.g., danger signaling (e.g., IL-1β, IL-18, IL-33, etc.), toll-like receptor activation (e.g., IL-6, tumor necrosis factor α, etc.), bone catabolism (e.g., TRAP5b), and hypoxia responses (HIF-1α). More study is needed, however, to fully understand these interactions to effectively counter cytokine- and chemokine-based orthopedic implant-related inflammation.

  1. Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures.

    Science.gov (United States)

    Watters, William; Rethman, Michael P; Hanson, Nicholas Buck; Abt, Elliot; Anderson, Paul A; Carroll, Karen C; Futrell, Harry C; Garvin, Kevin; Glenn, Stephen O; Hellstein, John; Hewlett, Angela; Kolessar, David; Moucha, Calin; O'Donnell, Richard J; O'Toole, John E; Osmon, Douglas R; Evans, Richard Parker; Rinella, Anthony; Steinberg, Mark J; Goldberg, Michael; Ristic, Helen; Boyer, Kevin; Sluka, Patrick; Martin, William Robert; Cummins, Deborah S; Song, Sharon; Woznica, Anne; Gross, Leeaht

    2013-03-01

    The Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures evidence-based clinical practice guideline was codeveloped by the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association. This guideline replaces the previous AAOS Information Statement, "Antibiotic Prophylaxis in Bacteremia in Patients With Joint Replacement," published in 2009. Based on the best current evidence and a systematic review of published studies, three recommendations have been created to guide clinical practice in the prevention of orthopaedic implant infections in patients undergoing dental procedures. The first recommendation is graded as Limited; this recommendation proposes that the practitioner consider changing the long-standing practice of routinely prescribing prophylactic antibiotic for patients with orthopaedic implants who undergo dental procedures. The second, graded as Inconclusive, addresses the use of oral topical antimicrobials in the prevention of periprosthetic joint infections. The third recommendation, a Consensus statement, addresses the maintenance of good oral hygiene.

  2. Intra-articular distribution pattern after ultrasound-guided injections in wrist joints of patients with rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Boesen, Mikael [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark)], E-mail: parker@frh.regioh.dk; Jensen, Karl Erik [State Hospital, Department of Radiology, MRI Division, Copenhagen (Denmark)], E-mail: karl.erik.Jensen@rh.regionh.dk; Torp-Pedersen, Soren [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark); Cimmino, Marco A. [Rheumatologic Clinic, Department of Internal Medicine, University of Genoa (Italy)], E-mail: cimmino@unige.it; Danneskiold-Samsoe, Bente; Bliddal, Henning [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark)

    2009-02-15

    Objective: To investigate the distribution of an ultrasound-guided intra-articular (IA) injection in the wrist joint of patients with rheumatoid arthritis (RA). Methods: An ultrasound-guided IA drug injection into the wrist joint was performed in 17 patients with 1 ml methylprednisolone (40 mg/ml), 0.5 ml Lidocaine (5 mg/ml) and 0.15 ml gadolinium (Omniscan 0.5 mmol/ml). The drug solution was placed in the central proximal part of the wrist between the distal radius and the lunate bone. Coronal and axial MRI sequences were performed after the injection to visualize the distribution. Carpal distribution (radio-carpal, inter-carpal, and carpo-metacarpal) as well as radio-ulnar distribution was recorded. Full distribution in one compartment was given the value 1, partial distribution 0.5 and no distribution 0. A sum of the total distribution for all four compartments was calculated and correlated to the clinical parameters and the MRI OMERACT scores. Results: No uniform pattern was seen in the distribution of the contrast. Only two patients had full contrast distribution to all four compartments, and the mean distribution count for all patients was 2.4 (range 0.5-4). The distribution count correlated with the MRI OMERACT synovitis score (r = 0.60, p = 0.014), but not with the erosions, bonemarrow oedema scores or any clinical parameters. Conclusion: The distribution of contrast on MRI showed patient specific and random patterns after IA injections in active RA wrist joints. The degree of distribution increased with the MRI synovitis score, while no association was found with the erosion- and bonemarrow oedema score. These results indicate that a single injection into a standard injection site in the proximal part of the wrist cannot be assumed to distribute - and treat - the whole joint.

  3. Hip implants - Paper VI - Ion concentrations

    Energy Technology Data Exchange (ETDEWEB)

    Sargeant, A. [Department of Biological Sciences, Ohio Northern University, Ada, OH 45810 (United States); Goswami, T. [Department of Mechanical Engineering, Ohio Northern University, Ada, OH 45810 (United States)]. E-mail: t-goswami@onu.edu

    2007-07-01

    Total hip-joint arthroplasty is performed in increasing numbers where it translates to about 0.16-0.2% of population per year in industrial countries. In most cases, an implant is a metallic component articulating with a metal, ceramic or poly-ethylene liner as seen in the case of hip, knee and spine. The metal implants release ions in vivo. Therefore, there is a need to study metallic implants and ions released as a result. Toxic concentrations of ions can lead to many adverse physiological effects, including cytotoxicity, genotoxicity, carcinogenicity, and metal sensitivity. There is a need to map ion concentrations establishing boundaries between normal and toxic levels; which however, does not exist. Reference levels of ion concentrations in body fluids and tissues determined by many studies are compiled, reviewed, and presented in this paper. The concentrations of ions released from different alloys, including cobalt, chromium, nickel, molybdenum titanium, aluminum, and vanadium, are presented in this paper. This paper reviews the literature pertaining to clinical data on metal ion concentrations in patients with metal joint prostheses, and laboratory data on the physiological effects of the metals.

  4. Management of peri-implantitis

    OpenAIRE

    Jayachandran Prathapachandran; Neethu Suresh

    2012-01-01

    Peri-implantitis is a site-specific infectious disease that causes an inflammatory process in soft tissues, and bone loss around an osseointegrated implant in function. The etiology of the implant infection is conditioned by the status of the tissue surrounding the implant, implant design, degree of roughness, external morphology, and excessive mechanical load. The microorganisms most commonly associated with implant failure are spirochetes and mobile forms of Gram-negative anaerobes, unless ...

  5. Principles of Human Joint Replacement Design and Clinical Application

    CERN Document Server

    Buechel, Frederick F

    2012-01-01

    Drs. Buechel, an orthopaedic surgeon, and Pappas, a professor of Mechanical Engineering, are the designers of several successful joint replacement systems. The most well-known of these is the pioneering LCS knee replacement. They have written this book for the users and designers of joint replacements. It is an attempt to convey to the reader the knowledge accumulated by the authors during their thirty five year effort on the development of replacement devices for the lower limb for the purpose of aiding the reader in their design and evaluation of joint replacement devices. The early chapters describe the engineering, scientific and medical principles needed for replacement joint evaluation. One must understand the nature and performance of the materials involved and their characteristics in vivo, i.e. the response of the body to implant materials. It is also essential to understand the response of the implants to applied loading and motion, particularly in the hostile physiological environment. A chapter de...

  6. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne;

    2012-01-01

    We evaluated the association between radiation therapy and severe capsular contracture or reoperation after 717 delayed breast implant reconstruction procedures (288 1- and 429 2-stage procedures) identified in the prospective database of the Danish Registry for Plastic Surgery of the Breast during...... reconstruction approaches other than implants should be seriously considered among women who have received radiation therapy....

  7. Ion Implantation of Polymers

    DEFF Research Database (Denmark)

    Popok, Vladimir

    2012-01-01

    are discussed. Related to that, the effects of radiothermolysis, degassing and carbonisation are considered. Specificity of depth distributions of implanted into polymers impurities is analysed and the case of high-fluence implantation is emphasised. Within rather broad topic of ion bombardment, the focus...

  8. MUSIC AND COCHLEAR IMPLANTS

    Institute of Scientific and Technical Information of China (English)

    Mao Yitao; Xu Li

    2013-01-01

    Currently, most people with modern multichannel cochlear implant systems can understand speech in qui-et environment very well. However, studies in recent decades reported a lack of satisfaction in music percep-tion with cochlear implants. This article reviews the literature on music ability of cochlear implant users by presenting a systematic outline of the capabilities and limitations of cochlear implant recipients with regard to their music perception as well as production. The review also evaluates the similarities and differences be-tween electric hearing and acoustic hearing regarding music perception. We summarize the research results in terms of the individual components of music (e.g., rhythm, pitch, and timbre). Finally, we briefly intro-duce the vocal singing of prelingually-deafened children with cochlear implants as evaluated by acoustic measures.

  9. Bioactive Coatings for Orthopaedic Implants—Recent Trends in Development of Implant Coatings

    Directory of Open Access Journals (Sweden)

    Bill G. X. Zhang

    2014-07-01

    Full Text Available Joint replacement is a major orthopaedic procedure used to treat joint osteoarthritis. Aseptic loosening and infection are the two most significant causes of prosthetic implant failure. The ideal implant should be able to promote osteointegration, deter bacterial adhesion and minimize prosthetic infection. Recent developments in material science and cell biology have seen the development of new orthopaedic implant coatings to address these issues. Coatings consisting of bioceramics, extracellular matrix proteins, biological peptides or growth factors impart bioactivity and biocompatibility to the metallic surface of conventional orthopaedic prosthesis that promote bone ingrowth and differentiation of stem cells into osteoblasts leading to enhanced osteointegration of the implant. Furthermore, coatings such as silver, nitric oxide, antibiotics, antiseptics and antimicrobial peptides with anti-microbial properties have also been developed, which show promise in reducing bacterial adhesion and prosthetic infections. This review summarizes some of the recent developments in coatings for orthopaedic implants.

  10. Implantable titanium nail traction between the jaw joint micro titanium plate internal ifxation in trea-ting jaw fracture%植入式钛钉颌间牵引联合微型钛板内固定在颌骨骨折治疗中的作用

    Institute of Scientific and Technical Information of China (English)

    叶珊珊

    2014-01-01

    Objective To study the implantable titanium nail traction between the jaw joint micro titanium plate internal fixation for the treatment of jaw fracture effect. Method From November 2012 to November 2012 treated 136 cases of jaw fracture patients as the research object, randomly divided into observation group and control group. Between the control group with the traditional jaw traction-dental arch splints;observation group with implantable titanium nail traction between the jaw joint micro titanium plate internal ifxation method. Compare two groups of treatment. Result Observation group and control group, no signiifcant difference (P>0.05), but the observation group of fracture healing time was (1.98±0.76) months, signiifcantly faster than the control group (3.62±1.25) months, and signiifcant difference, statistically signiifcant (P0.05), after the operation, both of the above indexes had varying degrees of change, various functions to improve observation group were signiifcantly better than the control group, and signiifcant difference, statistically signiifcant (P<0.01);postoperative observation group, ifne rate was 92.65%;compared to control group was 80.88%, postoperative both statistically signiifcant difference (P < 0.05). Conclusion Implantable titanium nail traction between the jaw joint micro titanium plate internal ifxation for jaw fractures of good curative effect, high cure rate, compared with the traditional operation method, the patient's chewing function, opening function recover quickly, facial symmetry, no deformity, has a certain clinical value.%目的:研究植入式钛钉颌间牵引联合微型钛板内固定对于颌骨骨折的治疗效果。方法将本院2012年11月至2013年11月收治的136例颌骨骨折患者作为研究对象,随机均分为观察组与对照组。对照组患者采用传统颌间牵引术-牙弓夹板治疗;观察组患者采用植入式钛钉颌间牵引联合微型钛板内固定治疗。比较两组患

  11. Alendronate treatment in the revision setting, with and without controlled implant motion

    DEFF Research Database (Denmark)

    Søballe, Kjeld; Chen, Xinqian; Jensen, Thomas B;

    2007-01-01

    . The other half of the implants continued pistoning. Half of the dogs were exposed to alendronate (oral). Results Stabilization of the revision implant was more effective at improving fixation (higher shear strength) than administering alendronate. As expected, the fibrous membrane remained under unstable...... model with controlled motion to evaluate the relative effects of implant motion and bisphosphonate. We implemented our established 8-week experimental revision protocol to obtain a bony and soft tissue setting of revision joint replacement in 16 dogs. At 8 weeks, we had stabilized half of the implants...

  12. Benefits and Risks of Cochlear Implants

    Science.gov (United States)

    ... Prosthetics Cochlear Implants Benefits and Risks of Cochlear Implants Share Tweet Linkedin Pin it More sharing options ... Cochlear Implants What are the Benefits of Cochlear Implants? For people with implants: Hearing ranges from near ...

  13. High incidence and treatment of flexor carpi radialis tendinitis after trapeziectomy and abductor pollicis longus suspensionplasty for basal joint arthritis.

    Science.gov (United States)

    Low, T H; Hales, P F

    2014-10-01

    We reviewed the incidence and treatment of flexor carpi radialis tendinitis in 77 patients (81 thumbs) who had trapeziectomy and abductor pollicis longus suspensionplasty for thumb carpometacarpal joint arthritis. Eighteen patients, 20 wrists (25%) had flexor carpi radialis tendinitis. The onset was 2-10 months (mean 4.7) after surgery. Two cases had preceding trauma. Eight cases (40%) responded to splinting and steroid injection. Ten patients, 12 wrists (60%) underwent surgery after failing non-operative treatment. Eleven wrists had frayed or partially torn flexor carpi radialis tendon and one had a complete tendon rupture with pseudotendon formation. Flexor carpi radialis tenotomy and pseudotendon excision were performed. All operated patients obtained good pain relief initially post-operatively. However, the pain recurred in two patients after 8 months. One required a local steroid injection for localized tenderness at the site of the proximal tendon stump. The other patient required a revision operation for scaphotrapezoid impingement. Both obtained complete pain relief. Our study has shown a high incidence of flexor carpi radialis tendinitis following trapeziectomy and abductor pollicis longus suspensionplasty. Patients should be warned about this potential complication.

  14. Elbow joint biomechanics for preclinical evaluation of total elbow prostheses.

    Science.gov (United States)

    Kincaid, Brian L; An, Kai-Nan

    2013-09-27

    Total elbow arthroplasty is a clinically successful procedure, yet long-term implant survival rates have historically lagged behind those reported for total hips and knees. Clinical complications associated with implant wear, osteolysis, stem loosening and device fracture have been implicated as reasons for limited long-term survivorship. Unfortunately, there is little published information on the biomechanics and method(s) for preclinical evaluation of total elbow prostheses that could provide insight into the mechanisms of failure. Additionally, there are no consensus testing standards or summaries of loading profiles of the humero-ulnar joint associated with a range of activities of daily living. Such data would facilitate the standardized preclinical assessment of total elbow devices such is commonplace for other large joints. The objective of the work here is therefore to provide a comprehensive review of elbow joint biomechanics as it relates to preclinical evaluation of total elbow implants. This summary includes a review of elbow joint forces, kinematics, the types and frequency of humero-ulnar joint motions associated with activities of daily living and clinical outcomes, as well as proposing a methodology for deriving humero-ulnar joint reaction force magnitudes and vector orientations as a function of a known mass/force at the hand. From these data, a scalable, bi-axial loading profile is proposed as a foundation for the development of clinically relevant, laboratory simulations for assessment of total elbow prostheses performance.

  15. Reliability of Tubular Joints

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard; Thoft-Christensen, Palle

    In this paper the preliminary results obtained by tests on tubular joints are presented. The joints are T-joints and the loading is static. It is the intention in continuation of these tests to perform tests on other types of joints (e.g. Y-joints) and also with dynamic loading. The purpose...... of the test is partly to obtain empirical data for the ultimate load-carrying capacity of tubular T-joints and partly to obtain some experience in performing tests with tubular joints. It is well known that tubular joints are usually designed in offshore engineering on the basis of empirical formulas obtained...

  16. Spacesuit mobility knee joints

    Science.gov (United States)

    Vykukal, H. C. (Inventor)

    1979-01-01

    Pressure suit mobility joints are for use in interconnecting adjacent segments of an hermetically sealed spacesuit in which low torques, low leakage and a high degree of reliability are required. Each of the joints is a special purpose joint characterized by substantially constant volume and low torque characteristics and includes linkages which restrain the joint from longitudinal distension and includes a flexible, substantially impermeable diaphragm of tubular configuration spanning the distance between pivotally supported annuli. The diaphragms of selected joints include rolling convolutions for balancing the joints, while various joints include wedge-shaped sections which enhance the range of motion for the joints.

  17. Osseointegration Implant Post Coupling With External Prosthetic Limb – Continuation of Previous Case Reports “Stage III”

    Directory of Open Access Journals (Sweden)

    Ronald Hillock, MD

    2014-07-01

    Acknowledgement: Design concept by Concept Design & Development, LLC (CDD,LLC; Development and Manufacturing by Signature Orthopaedics, LTD; Centennial Hills Hospital Medical Center, Las Vegas, NV; and Institutional Review Board (IRB by Joint Implant Surgery & Research Foundation.

  18. Implant fixation of tibial avulsion fracture of the posterior cruciate ligament:knee joint range of motion and functional evaluation%植入物固定后交叉韧带胫骨止点撕脱骨折:膝关节活动度及功能评价

    Institute of Scientific and Technical Information of China (English)

    王良勇; 李建刚; 张春; 张俊; 杜红军; 崔操; 田大为

    2015-01-01

    BACKGROUND:From the biological structure, the posterior cruciate ligament is surrounded by the synovial folds of posterior capsule, arising from the inner side of the medial femoral condyle to the posterior part of tibial intercondyloid spine. The main traditional treatment method for posterior cruciate ligament tibial avulsion fracture is open operation, but it is difficult in anatomic reduction, cannot ful y restore knee joint stability and has a great negative impact on the normal function of posterior cruciate ligament. OBJECTIVE:To investigate the effects of arthroscopic implant internal fixation in the treatment of tibial avulsion fracture of the posterior cruciate ligament. METHODS:120 patients with tibial avulsion fracture of the posterior cruciate ligament were randomly assigned into treatment group and control group, with 60 cases in each group. The control group was given the traditional open surgery, and the treatment group was given the arthroscopic surgery. After 3 months, International Knee Documentation Committee (IKDC) scores and Lysholm scores were detected in the two groups;the knee joint range of motion was determined before and 3 months after treatment. RESULTS AND CONCLUSION:Wounds were healed at stage I in al patients with no serious complications. There was no difference in the knee joint range of motion between the two groups before treatment, but the range of motion was increased significantly in both two groups at 3 months after treatment (P<0.05), meanwhile which was higher in the treatment group than the control group (P<0.05). At 3 months after treatment, the excel ent knee function rate was significantly higher in the treatment group (97%) than the control group (88%) according to the Lysholm scores;the IKDC scores were significantly higher in the treatment than the control group in terms of claudication, support, pain, swel ing, and squat (P<0.05). These results indicate that the arthroscopic implant fixation of tibial avulsion

  19. Dental Implant Systems

    Directory of Open Access Journals (Sweden)

    Yoshiki Oshida

    2010-04-01

    Full Text Available Among various dental materials and their successful applications, a dental implant is a good example of the integrated system of science and technology involved in multiple disciplines including surface chemistry and physics, biomechanics, from macro-scale to nano-scale manufacturing technologies and surface engineering. As many other dental materials and devices, there are crucial requirements taken upon on dental implants systems, since surface of dental implants is directly in contact with vital hard/soft tissue and is subjected to chemical as well as mechanical bio-environments. Such requirements should, at least, include biological compatibility, mechanical compatibility, and morphological compatibility to surrounding vital tissues. In this review, based on carefully selected about 500 published articles, these requirements plus MRI compatibility are firstly reviewed, followed by surface texturing methods in details. Normally dental implants are placed to lost tooth/teeth location(s in adult patients whose skeleton and bony growth have already completed. However, there are some controversial issues for placing dental implants in growing patients. This point has been, in most of dental articles, overlooked. This review, therefore, throws a deliberate sight on this point. Concluding this review, we are proposing a novel implant system that integrates materials science and up-dated surface technology to improve dental implant systems exhibiting bio- and mechano-functionalities.

  20. MEMS-Based Power Generation Techniques for Implantable Biosensing Applications

    Directory of Open Access Journals (Sweden)

    Jonathan Lueke

    2011-01-01

    Full Text Available Implantable biosensing is attractive for both medical monitoring and diagnostic applications. It is possible to monitor phenomena such as physical loads on joints or implants, vital signs, or osseointegration in vivo and in real time. Microelectromechanical (MEMS-based generation techniques can allow for the autonomous operation of implantable biosensors by generating electrical power to replace or supplement existing battery-based power systems. By supplementing existing battery-based power systems for implantable biosensors, the operational lifetime of the sensor is increased. In addition, the potential for a greater amount of available power allows additional components to be added to the biosensing module, such as computational and wireless and components, improving functionality and performance of the biosensor. Photovoltaic, thermovoltaic, micro fuel cell, electrostatic, electromagnetic, and piezoelectric based generation schemes are evaluated in this paper for applicability for implantable biosensing. MEMS-based generation techniques that harvest ambient energy, such as vibration, are much better suited for implantable biosensing applications than fuel-based approaches, producing up to milliwatts of electrical power. High power density MEMS-based approaches, such as piezoelectric and electromagnetic schemes, allow for supplemental and replacement power schemes for biosensing applications to improve device capabilities and performance. In addition, this may allow for the biosensor to be further miniaturized, reducing the need for relatively large batteries with respect to device size. This would cause the implanted biosensor to be less invasive, increasing the quality of care received by the patient.

  1. Nanotechnology for dental implants.

    Science.gov (United States)

    Tomsia, Antoni P; Lee, Janice S; Wegst, Ulrike G K; Saiz, Eduardo

    2013-01-01

    With the advent of nanotechnology, an opportunity exists for the engineering of new dental implant materials. Metallic dental implants have been successfully used for decades, but they have shortcomings related to osseointegration and mechanical properties that do not match those of bone. Absent the development of an entirely new class of materials, faster osseointegration of currently available dental implants can be accomplished by various surface modifications. To date, there is no consensus regarding the preferred method(s) of implant surface modification, and further development will be required before the ideal implant surface can be created, let alone become available for clinical use. Current approaches can generally be categorized into three areas: ceramic coatings, surface functionalization, and patterning on the micro- to nanoscale. The distinctions among these are imprecise, as some or all of these approaches can be combined to improve in vivo implant performance. These surface improvements have resulted in durable implants with a high percentage of success and long-term function. Nanotechnology has provided another set of opportunities for the manipulation of implant surfaces in its capacity to mimic the surface topography formed by extracellular matrix components of natural tissue. The possibilities introduced by nanotechnology now permit the tailoring of implant chemistry and structure with an unprecedented degree of control. For the first time, tools are available that can be used to manipulate the physicochemical environment and monitor key cellular events at the molecular level. These new tools and capabilities will result in faster bone formation, reduced healing time, and rapid recovery to function.

  2. High-tech hip implant for wireless temperature measurements in vivo.

    Directory of Open Access Journals (Sweden)

    Georg Bergmann

    Full Text Available When walking long distances, hip prostheses heat up due to friction. The influence of articulating materials and lubricating properties of synovia on the final temperatures, as well as any potential biological consequences, are unknown. Such knowledge is essential for optimizing implant materials, identifying patients who are possibly at risk of implant loosening, and proving the concepts of current joint simulators. An instrumented hip implant with telemetric data transfer was developed to measure the implant temperatures in vivo. A clinical study with 100 patients is planned to measure the implant temperatures for different combinations of head and cup materials during walking. This study will answer the question of whether patients with synovia with poor lubricating properties may be at risk for thermally induced bone necrosis and subsequent implant failure. The study will also deliver the different friction properties of various implant materials and prove the significance of wear simulator tests. A clinically successful titanium hip endoprosthesis was modified to house the electronics inside its hollow neck. The electronics are powered by an external induction coil fixed around the joint. A temperature sensor inside the implant triggers a timer circuit, which produces an inductive pulse train with temperature-dependent intervals. This signal is detected by a giant magnetoresistive sensor fixed near the external energy coil. The implant temperature is measured with an accuracy of 0.1°C in a range between 20°C and 58°C and at a sampling rate of 2-10 Hz. This rate could be considerably increased for measuring other data, such as implant strain or vibration. The employed technique of transmitting data from inside of a closed titanium implant by low frequency magnetic pulses eliminates the need to use an electrical feedthrough and an antenna outside of the implant. It enables the design of mechanically safe and simple instrumented implants.

  3. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne;

    2011-01-01

    the period 1999 to 2006; 239 one-stage procedures and 353 two-stage procedures. The postoperative course through November 2009 was evaluated by cumulative incidence adjusting for competing risks for the selected outcomes; hematoma, infection, seroma, implant rupture, severe capsular contracture (modified.......7% for severe capsular contracture, 32.3% for displacement/asymmetry of the implant and 38.6% for reoperation. When comparing one- and two-stage procedures, we observed significantly higher risk estimates for infection, seroma and extrusion of the implant following two-stage procedures, whereas the risk...

  4. Bioceramics for implant coatings

    Directory of Open Access Journals (Sweden)

    Allison A Campbell

    2003-11-01

    Early research in this field focused on understanding the biomechanical properties of metal implants, but recent work has turned toward improving the biological properties of these devices. This has led to the introduction of calcium phosphate (CaP bioceramics as a bioactive interface between the bulk metal impart and the surrounding tissue. The first CaP coatings were produced via vapor phase processes, but more recently solution-based and biomimetic methods have emerged. While each approach has its own intrinsic materials and biological properties, in general CaP coatings promise to improve implant biocompatibility and ultimately implant longevity.

  5. Biomedical implantable microelectronics.

    Science.gov (United States)

    Meindl, J D

    1980-10-17

    Innovative applications of microelectronics in new biomedical implantable instruments offer a singular opportunity for advances in medical research and practice because of two salient factors: (i) beyond all other types of biomedical instruments, implants exploit fully the inherent technical advantages--complex functional capability, high reliability, lower power drain, small size and weight-of microelectronics, and (ii) implants bring microelectronics into intimate association with biological systems. The combination of these two factors enables otherwise impossible new experiments to be conducted and new paostheses developed that will improve the quality of human life.

  6. Christensen vs Biomet Microfixation alloplastic TMJ implant: Are there improvements? A numerical study.

    Science.gov (United States)

    Ramos, António; Mesnard, Mesnard

    2015-10-01

    The objective of this study was to compare the load transfer mechanism and behavior of two total temporomandibular joint (TMJ) prostheses: Biomet and Christensen TMJ models were simulated. Computed tomography (CT) images from a specific patient were used to generate two models for use in simulation of implantation for the total temporomandibular prostheses. Three finite element models were created in all. One considered the intact temporomandibular joint and two received a temporomandibular implant. In the simulation we considered the five most important muscles acting on the mandible and incisor teeth support. The Christensen model reduced strain in the opposite condyle by around 50% while increasing strain in the implanted condyle. The changes in the posterior side of the implanted condyle present an increase of five times the minimum principal strain, suggesting some bone fatigue. With the Biomet implant, the reduction in strain in the implanted condyle on the posterior side was around 100%, suggesting the possibility of some bone loss proximally near the resection plane. Based on our results, we conclude that in both models the implants influence the behavior of the mandible by improving the symmetry of the mandible and strain distribution. The Biomet implant modifies the behavior of the mandible slightly and presents some improvements over the Christensen TMJ model in strain distribution and tensions in the opposite intact disc similar to the non-implanted situation.

  7. Dealing with dental implant failures

    Directory of Open Access Journals (Sweden)

    Liran Levin

    2008-06-01

    Full Text Available An implant-supported restoration offers a predictable treatment for tooth replacement. Reported success rates for dental implants are high. Nevertheless, failures that mandate immediate implant removal do occur. The consequences of implant removal jeopardize the clinician's efforts to accomplish satisfactory function and esthetics. For the patient, this usually involves further cost and additional procedures. The aim of this paper is to describe different methods and treatment modalities to deal with dental implant failure. The main topics for discussion include identifying the failing implant, implants replacing failed implants at the exact site, and the use of other restorative options.When an implant fails, a tailor made treatment plan should be provided to each patient according to all relevant variables. Patients should be informed regarding all possible treatment modalities following implant failure and give their consent to the most appropriate treatment option for them.

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. [Minimally invasive approaches to hip and knee joints for total joint replacement].

    Science.gov (United States)

    Rittmeister, M; König, D P; Eysel, P; Kerschbaumer, F

    2004-11-01

    The manuscript features the different minimally invasive approaches to the hip for joint replacement. These include medial, anterior, anterolateral, and posterior approaches. The concept of minimally invasive hip arthroplasty makes sense if it is an integral part of a larger concept to lower postoperative morbidity. Besides minimal soft tissue trauma, this concept involves preoperative patient education, preemptive analgesia, and postoperative physiotherapy. It is our belief that minimal incision techniques for the hip are not suited for all patients and all surgeons. The different minimally invasive approaches to the knee joint for implantation of a knee arthroplasty are described and discussed. There have been no studies published yet that fulfill EBM criteria. The data so far show that minimally invasive approaches and implantation techniques for total knee replacements lead to quicker rehabilitation of patients.

  1. MEMS biomedical implants

    Institute of Scientific and Technical Information of China (English)

    Tai Yuchong

    2012-01-01

    The field of micro-electro-mechanical systems (MEMS) has advanced tremendously for the last 20 years. Most commercially noticeably, the field has successfully advanced from pressure sensors to micro physical sensors, such as accelerometers and gyros, for handheld electronics application. In parallel, MEMS has also advanced into micro total analysis system(TAS) and/or lab-on-a-chip applications. This article would discuss a relatively new but promising future direction towards MEMS biomedical implants. Specifically, Parylene C has been explored to be used as a good MEMS implant material and will be discussed in detail. Demonstrated implant devices, such as retinal and spinal cord implants, are presented in this article.

  2. Risks of Breast Implants

    Science.gov (United States)

    ... an infection or injury. Demonstrated by redness, swelling, warmth, pain and or/loss of function. Lymphedema or ... Overfilling or underfilling of saline-filled breast implants Physical stresses such as trauma or intense physical pressure ...

  3. New biomaterials for orthopedic implants

    Directory of Open Access Journals (Sweden)

    Ong KL

    2015-09-01

    Full Text Available Kevin L Ong, Brian Min Yun, Joshua B WhiteExponent, Inc., Philadelphia, PA, USAAbstract: With the increasing use of orthopedic implants worldwide, there continues to be great interest in the development of novel technologies to further improve the effective clinical performance of contemporary treatment modalities and devices. Continuing research interest also exists in developing novel bulk biomaterials (eg, polycarbonate urethanes, silicon or novel formulations of existing but less widely used biomaterials (eg, polyaryletherketones, polyetheretherketone. There is also growing focus on customizing the material properties of bioabsorbables and composite materials with fillers such as bioactive ceramics. In terms of tissue engineering, more recent developments have focused on basic engineering and biological fundamentals to use cells, signaling factors, and the scaffold material itself to better restore tissue and organ structure and function. There has also been recent controversy with the use of injectables as a nonsurgical approach to treat joint disorders, but more attention is being directed toward the development of newer formulations with different molecular weights. The industry has also continuously sought to improve coatings to supplement the function of existing implants, with the goal of improving their osseointegrative qualities and incorporating antimicrobial properties. These include the use of bone morphogenetic protein, bisphosphonates, calcium phosphate, silicon nitride, and iodine. Due to the widespread use of bone graft materials, recent developments in synthetic graft materials have explored further development of bioactive glass, ceramic materials, and porous titanium particles. This review article provides an overview of ongoing efforts in the above research areas.Keywords: coatings, scaffolds, bioabsorbables, bone graft, injectables

  4. Cochlear Implant in Adults

    Directory of Open Access Journals (Sweden)

    Jaleh Samadi

    2003-09-01

    Full Text Available Cochlear implant is the result of a great combination and collaboration of engineering and medicine. It is mainly because it has the most conflict with the human nervous system among all prosthesis. Cochlear implant helps a child with profound hearing loss to understand and articulate speech and let an adult person with hearing loss communicate with people by phone. Although these wonderful results could not be seen in all patients, will let us know about the great scientific findings.

  5. International joint ventures

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig

    2001-01-01

    The article analysis problems connected with corporate joint ventures. Among others the possible conflicts between the joint venture agreement and the statutes of the companies is examined, as well as certain problems connected to the fact that the joint venture partners have created commen control...... over their joint company....

  6. Contraceptive implants: current perspectives

    Directory of Open Access Journals (Sweden)

    Rowlands S

    2014-09-01

    Full Text Available Sam Rowlands,1,2 Stephen Searle3 1Centre of Postgraduate Medical Research and Education, School of Health and Social Care, Bournemouth University, Bournemouth, United Kingdom; 2Dorset HealthCare, Bournemouth, United Kingdom; 3Sexual Health Services, Chesterfield, United KingdomAbstract: Progestin-only contraceptive implants are a highly cost-effective form of long-acting reversible contraception. They are the most effective reversible contraceptives and are of a similar effectiveness to sterilization. Pregnancies are rare in women using this method of contraception, and those that do occur must be fully investigated, with an ultrasound scan of the arm and serum etonogestrel level if the implant cannot be located. There are very few contraindications to use of implants, and they have an excellent safety profile. Both acceptability and continuation with the method are high. Noncontraceptive benefits include improvements in dysmenorrhea, ovulatory pain, and endometriosis. Problematic bleeding is a relatively common adverse effect that must be covered in preinsertion information-giving and supported adequately if it occurs. Recognized training for both insertion and removal should be undertaken. Care needs to be taken at both insertion and removal to avoid neurovascular injury. Implants should always be palpable; if they are not, noninsertion should be assumed until disproven. Etonogestrel implants are now radiopaque, which aids localization. Anticipated difficult removals should be performed by specially trained experts. Keywords: contraceptive, subdermal implant, etonogestrel, levonorgestrel, progestin-only, long-acting reversible contraception

  7. Biomaterials in cochlear implants

    Directory of Open Access Journals (Sweden)

    Lenarz, Thomas

    2009-01-01

    Full Text Available The cochlear implant (CI represents, for almost 25 years now, the gold standard in the treatment of children born deaf and for postlingually deafened adults. These devices thus constitute the greatest success story in the field of ‘neurobionic’ prostheses. Their (now routine fitting in adults, and especially in young children and even babies, places exacting demands on these implants, particularly with regard to the biocompatibility of a CI’s surface components. Furthermore, certain parts of the implant face considerable mechanical challenges, such as the need for the electrode array to be flexible and resistant to breakage, and for the implant casing to be able to withstand external forces. As these implants are in the immediate vicinity of the middle-ear mucosa and of the junction to the perilymph of the cochlea, the risk exists – at least in principle – that bacteria may spread along the electrode array into the cochlea. The wide-ranging requirements made of the CI in terms of biocompatibility and the electrode mechanism mean that there is still further scope – despite the fact that CIs are already technically highly sophisticated – for ongoing improvements to the properties of these implants and their constituent materials, thus enhancing the effectiveness of these devices. This paper will therefore discuss fundamental material aspects of CIs as well as the potential for their future development.

  8. Biocompatible implant surface treatments.

    Science.gov (United States)

    Pattanaik, Bikash; Pawar, Sudhir; Pattanaik, Seema

    2012-01-01

    Surface plays a crucial role in biological interactions. Surface treatments have been applied to metallic biomaterials in order to improve their wear properties, corrosion resistance, and biocompatibility. A systematic review was performed on studies investigating the effects of implant surface treatments on biocompatibility. We searched the literature using PubMed, electronic databases from 1990 to 2009. Key words such as implant surface topography, surface roughness, surface treatment, surface characteristics, and surface coatings were used. The search was restricted to English language articles published from 1990 to December 2009. Additionally, a manual search in the major dental implant journals was performed. When considering studies, clinical studies were preferred followed by histological human studies, animal studies, and in vitro studies. A total of 115 articles were selected after elimination: clinical studies, 24; human histomorphometric studies, 11; animal histomorphometric studies, 46; in vitro studies, 34. The following observations were made in this review: · The focus has shifted from surface roughness to surface chemistry and a combination of chemical manipulations on the porous structure. More investigations are done regarding surface coatings. · Bone response to almost all the surface treatments was favorable. · Future trend is focused on the development of osteogenic implant surfaces. Limitation of this study is that we tried to give a broader overview related to implant surface treatments. It does not give any conclusion regarding the best biocompatible implant surface treatment investigated till date. Unfortunately, the eventually selected studies were too heterogeneous for inference of data.

  9. Influence of Thickness and Contact Surface Geometry of Condylar Stem of TMJ Implant on Its Stability

    Science.gov (United States)

    Arabshahi, Zohreh; Kashani, Jamal; Kadir, Mohammed Rafiq Abdul; Azari, Abbas

    The aim of this study is to examine the effect thickness and contact surface geometry of condylar stem of TMJ implant on its stability in total reconstruction system and evaluate the micro strain resulted in bone at fixation screw holes in jaw bone embedded with eight different designs of temporomandibular joint implants. A three dimensional model of a lower mandible of an adult were developed from a Computed Tomography scan images. Eight different TMJ implant designs and fixation screws were modeled. Three dimensional finite element models of eight implanted mandibles were analyzed. The forces assigned to the masticatory muscles for incisal clenching were applied consisting of nine important muscular loads. In chosen loading condition, The results indicated that the anatomical curvature contact surface design of TMJ implant can moderately improve the stability and the strain resulted in fixation screw holes in thinner TMJ implant was diminished in comparison with other thicknesses.

  10. Bone compaction enhances fixation of weight-bearing hydroxyapatite-coated implants

    DEFF Research Database (Denmark)

    Kold, Søren; Rahbek, Ole; Vestermark, Marianne;

    2006-01-01

    The effect of bone compaction vs conventional drilling on the fixation of hydroxyapatite-coated implants was examined in a weight-bearing canine model. In each dog, one knee joint had the implant cavity prepared with drilling, the other with compaction. Eight dogs were euthanized after 2 weeks...... and 8 dogs after 4 weeks. Femoral condyles from additional 7 dogs represented time 0. Compacted specimens had significantly higher bone implant contact and energy absorption at time 0. Compaction significantly increased ultimate shear strength at 0 and 2 weeks. There was no significant difference...... in implant fixation after 4 weeks. The results of this study suggest that compaction may be beneficial in optimizing the crucial initial implant stability, even when hydroxyapatite-coated implants with osteoconductive properties are inserted in vivo....

  11. 中空多孔髋关节假体联合植入式输液港系统在治疗人工关节感染翻修中的意义%The significance of the “hollow porous hip prosthesis combined with implantable infusion port system” in the revision for infected joint arthroplasty

    Institute of Scientific and Technical Information of China (English)

    陈松; 符培亮; 丛锐军; 李晓华

    2013-01-01

      目的建立兔髋关节置换术后感染模型,探讨中空多孔髋关节假体联合植入式输液港系统在治疗髋关节置换术后感染二期翻修术中的意义.方法(1)日本大耳兔10只,处死后取右股骨,据此设计出1组为股骨头及柄中空且带孔的假体,1组为股骨头及柄实体的假体.(2)新西兰白兔100只(10只为备用),行右侧股骨假体置换术,术毕将含有1×108 CFU 耐甲氧西林金表皮葡萄球菌的菌液注入右侧髋关节内,术后4周时,兔人工股骨头置换后感染模型建立.(3)模型建立后清创,实验组45只兔植入中空多孔髋关节假体联合植入式输液港系统,分别于术后第1、3周初在输液港中注入万古霉素,其中22只于第4周末处死,另外23只于第5、7周初再次于输液港中注入万古霉素后,于第8周末处死.对照组45只兔植入用1∶20的 VCM-PMMA 固定的临时人工股骨头假体系统,其中22只于第4周末处死,另外23只于第8周末处死.观察两组感染控制率、关节周围软组织病理变化及假体位置.结果耐甲氧西林表皮葡萄球菌接种后4周所有动物的右侧髋关节均感染.实验组在植入中空假体后第4、8周末的感染数是4只和1只;对照组在植入 VCM-PMMA 临时假体后第4、8周末的感染数是7只和6只.中空多孔髋关节假体联合植入式输液港系统较 VCM-PMMA 临时假体系统在感染控制率方面具有优越性(χ2=4.44,P respectively at the end of the 4th and 8th weeks after the implantation of hollow prostheses, and the number of infected rabbits of the control group was 7 and 6 at the end of the 4th and 8th week respectively after the implantation of VCM-PMMA temporary prostheses. The “hollow porous hip prosthesis combined with implantable infusion port system” was superior in the infection rate when compared with the VCM-PMMA temporary prosthesis system (χ2=4.44, P<0.05). Conclusions The “hollow porous hip joint prosthesis

  12. Investigations of Titanium Implants Covered with Hydroxyapatite Layer

    Directory of Open Access Journals (Sweden)

    Świeczko – Żurek B.

    2016-06-01

    Full Text Available To reduce unfavorable phenomena occurring after introducing an implant into human body various modifications of the surface are suggested. Such modifications may have significant impact on biocompatibility of metallic materials. The titanium and it's alloys are commonly used for joint and dental implants due to their high endurance, low plasticity modulus, good corrosion resistance as well as biocompatibility. Special attention should be given to titanium alloys containing zirconium, tantalum and niobium elements. These new generation alloys are used by worldwide engineering specialists. The experiments were performed with hydroxyapatite layer on titanium specimens with the use of electrophoresis method (different voltage and time.

  13. Utility of Intraoperative Neuromonitoring during Minimally Invasive Fusion of the Sacroiliac Joint.

    Science.gov (United States)

    Woods, Michael; Birkholz, Denise; MacBarb, Regina; Capobianco, Robyn; Woods, Adam

    2014-01-01

    Study Design. Retrospective case series. Objective. To document the clinical utility of intraoperative neuromonitoring during minimally invasive surgical sacroiliac joint fusion for patients diagnosed with sacroiliac joint dysfunction (as a direct result of sacroiliac joint disruptions or degenerative sacroiliitis) and determine stimulated electromyography thresholds reflective of favorable implant position. Summary of Background Data. Intraoperative neuromonitoring is a well-accepted adjunct to minimally invasive pedicle screw placement. The utility of intraoperative neuromonitoring during minimally invasive surgical sacroiliac joint fusion using a series of triangular, titanium porous plasma coated implants has not been evaluated. Methods. A medical chart review of consecutive patients treated with minimally invasive surgical sacroiliac joint fusion was undertaken at a single center. Baseline patient demographics and medical history, intraoperative electromyography thresholds, and perioperative adverse events were collected after obtaining IRB approval. Results. 111 implants were placed in 37 patients. Sensitivity of EMG was 80% and specificity was 97%. Intraoperative neuromonitoring potentially avoided neurologic sequelae as a result of improper positioning in 7% of implants. Conclusions. The results of this study suggest that intraoperative neuromonitoring may be a useful adjunct to minimally invasive surgical sacroiliac joint fusion in avoiding nerve injury during implant placement.

  14. Utility of Intraoperative Neuromonitoring during Minimally Invasive Fusion of the Sacroiliac Joint

    Directory of Open Access Journals (Sweden)

    Michael Woods

    2014-01-01

    Full Text Available Study Design. Retrospective case series. Objective. To document the clinical utility of intraoperative neuromonitoring during minimally invasive surgical sacroiliac joint fusion for patients diagnosed with sacroiliac joint dysfunction (as a direct result of sacroiliac joint disruptions or degenerative sacroiliitis and determine stimulated electromyography thresholds reflective of favorable implant position. Summary of Background Data. Intraoperative neuromonitoring is a well-accepted adjunct to minimally invasive pedicle screw placement. The utility of intraoperative neuromonitoring during minimally invasive surgical sacroiliac joint fusion using a series of triangular, titanium porous plasma coated implants has not been evaluated. Methods. A medical chart review of consecutive patients treated with minimally invasive surgical sacroiliac joint fusion was undertaken at a single center. Baseline patient demographics and medical history, intraoperative electromyography thresholds, and perioperative adverse events were collected after obtaining IRB approval. Results. 111 implants were placed in 37 patients. Sensitivity of EMG was 80% and specificity was 97%. Intraoperative neuromonitoring potentially avoided neurologic sequelae as a result of improper positioning in 7% of implants. Conclusions. The results of this study suggest that intraoperative neuromonitoring may be a useful adjunct to minimally invasive surgical sacroiliac joint fusion in avoiding nerve injury during implant placement.

  15. Implant interactions with orthodontics.

    Science.gov (United States)

    Celenza, Frank

    2012-09-01

    Many situations arise in which orthodontic therapy in conjunction with implant modalities is beneficial, relevant or necessary. These situations might entail orthodontic treatment preparatory to the placement of an implant, such as in the site preparation for implant placement. Traditionally, this has been somewhat well understood, but there are certain guidelines that must be adhered to as well as diagnostic steps that must be followed. Provision of adequate space for implant placement is of paramount importance, but there is also the consideration of tissue manipulation and remodeling which orthodontic therapy can achieve very predictably and orthodontists should be well versed in harnessing and employing this modality of site preparation. In this way, hopeless teeth that are slated for extraction can still be utilized by orthodontic extraction to augment tissues, both hard and soft, thereby facilitating site development. On the corollary, and representing a significant shift in treatment sequencing, there are many situations in which orthodontic mechanotherapy can be simplified, expedited, and facilitated by the placement of an implant and utilization as an integral part of the mechanotherapy. Implants have proven to provide excellent anchorage, and have resulted in a new class of anchorage known as "absolute anchorage". Implants can be harnessed as anchors both in a direct and indirect sense, depending upon the dictates of the case. Further, this has led to the development of orthodontic miniscrew systems and techniques, which can have added features such as flexibility in location and placement, as well as ease of use and removal. As orthodontic appliances evolve, the advent of aligner therapy has become mainstream and well accepted, and many of the aforementioned combined treatment modalities can and should be incorporated into this relatively new treatment modality as well.

  16. Iatrogenic Tumor Implantation

    Institute of Scientific and Technical Information of China (English)

    Ying Ma; Ping Bai

    2008-01-01

    Iatrogenic tumor implantation is a condition that results from various medical procedures used during diagnosis or treatment of a malignancy. It involves desquamation and dissemination of tumor cells that develop into a local recurrence or distant metastasis from the tumor under treatment. The main clinical feature of the condition is nodules at the operation's porous channel or incision, which is easily diagnosed in accordance with the case history. Final diagnosis can be made based on pathological examination. Tumor implantation may occur in various puncturing porous channels, including a laparoscopic port, abdominal wall incision, and perineal incision, etc. Besides a malignant tumor,implantation potential exists with diseases, such as a borderline tumor and endometriosis etc. Once a tumor implantation is diagnosed, or suspected, surgical resection is usually conducted.During the diagnosis and treatment of diseases, avoiding and reducing iatrogenic implantation and dissemination has been regarded as an important principle for surgical treatment of tumors. In a clinical practice setting, if possible, excisional biopsy should be employed, if a biopsy is needed. Repeated puncturing should be avoided during a paracentesis. In a laparoscopic procedure, the tissue is first put into a sample bag and then is taken out from the point of incision. After a laparoscopic procedure, the peritoneum, abdominal muscular fasciae, and skin should be carefully closed, and/or the punctured porous channel be excised. In addition, the sample/tissue should be rinsed with distilled water before surgical closure of the abdominal cavity,allowing the exfoliated tumor cells to swell and rupture in the hypo-osmolar solution. Then surgical closure can be conducted following a change of gloves and equipment. The extent of hysteromyomectomy should as far as possible be away from the uterine cavity. The purpose of this study is to make clinicians aware of the possibility of tumor implantation

  17. Wear analysis and finishing of bioceramic implant surfaces.

    Science.gov (United States)

    Denkena, Berend; Reichstein, Martin; van der Meer, Marijke; Ostermeier, Sven; Hurschler, Christof

    2008-01-01

    A primary cause for revision operations of joint replacements is the implant loosening, due to immune reactions resulting from the agglomeration of polyethylene wear debris. Motivated by the successful application of bioceramic materials in hip joint prostheses, a trend towards the development of hard implant materials has occurred. Nonetheless in the area of total knee arthroplasty (TKA), modern efforts have still utilized polyethylene as the tibial-inlay joint component. The use of bioceramic hard-hard-pairings for total knee arthroplasty has been prevented by the complex kinematics and geometries required. Ceramics cannot cope with non-uniform loads, which suggests the need for new designs appropriate to the material. Furthermore, biomechanical requirements should be considered. A rolling-gliding wear simulator, which reproduces the movements and stresses of the knee joint on specimens of simplified geometry, has therefore been developed. High-precision machining processes for free formed bioceramic surfaces, with suitable grinding and polishing tools which adjust to constantly changing contact conditions, are essential. The goal is to put automated finishing in one clamping with five simultaneous controlled axes into practice. The developed manufacturing technologies will allow the advantageous bioceramic materials to be applied and accepted for more complex joint replacements such as knee prostheses.

  18. Dental Implant Complications.

    Science.gov (United States)

    Liaw, Kevin; Delfini, Ronald H; Abrahams, James J

    2015-10-01

    Dental implants have increased in the last few decades thus increasing the number of complications. Since many of these complications are easily diagnosed on postsurgical images, it is important for radiologists to be familiar with them and to be able to recognize and diagnose them. Radiologists should also have a basic understanding of their treatment. In a pictorial fashion, this article will present the basic complications of dental implants which we have divided into three general categories: biomechanical overload, infection or inflammation, and other causes. Examples of implant fracture, loosening, infection, inflammation from subgingival cement, failure of bone and soft tissue preservation, injury to surround structures, and other complications will be discussed as well as their common imaging appearances and treatment. Lastly, we will review pertinent dental anatomy and important structures that are vital for radiologists to evaluate in postoperative oral cavity imaging.

  19. Modeling of Human Joint Structures.

    Science.gov (United States)

    1982-09-01

    Radial Lateral " epicondyle Olecranon Radius Ulna Figure 3. Lateral aspect of the right elbow joint. -17- Annular Ligament This strong band encircles... elbow joint, knee joint, human joints, shoulder joint, ankle joint, joint models, hip joint, ligaments. 20. ABSTRACT (Continue on reverse side If...ligaments. -A rather extended discussion of the articulations and anatomical descriptions of the elbow , shoulder, hip, knee and ankle joints are

  20. Osseointegration of Immediate Transalveolar Implants

    Directory of Open Access Journals (Sweden)

    Yoel González Beriau

    2016-02-01

    Full Text Available Background: osseointegration is critical to start prosthetic rehabilitation. Objective: to describe osseointegration of immediate transalveolar implants. Methods: a prospective case series study was conducted from January 2012 to December 2013. It included all patients (75 patients with 79 implants who attended the Prosthodontics service. Age, sex, osseointegration, cause of tooth loss, region of the implant, specific tooth, bone level and keratinized gingiva around the implant, were the variables studied. Frequency distribution and statistical analysis were used for data analysis. Results: females and patients aged 31 to 45 years predominated. Osseointegration was observed in 97.4% of the implants. Nearly all implants were placed in the premaxilla and posterior maxilla, specifically in the first bicuspids. In most patients, osseointegration with bone formation occurred at the implant collar and in the presence of completely keratinized tissue, with a statistically significant association between the two variables. Conclusion: rehabilitation treatment with this type of implant led to successful osseointegration in most cases studied.

  1. Culture - joint fluid

    Science.gov (United States)

    Joint fluid culture ... fungi, or viruses grow. This is called a culture. If these germs are detected, other tests may ... is no special preparation needed for the lab culture. How to prepare for the removal of joint ...

  2. Sacroiliac joint pain - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000610.htm Sacroiliac joint pain - aftercare To use the sharing features on this page, please enable JavaScript. The sacroiliac joint (SIJ) is a term used to describe the ...

  3. Knee joint replacement - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100088.htm Knee joint replacement - series—Normal anatomy To use the ... to slide 4 out of 4 Overview The knee is a complex joint. It contains the distal ...

  4. [Carbon fiber-reinforced plastics as implant materials].

    Science.gov (United States)

    Bader, R; Steinhauser, E; Rechl, H; Siebels, W; Mittelmeier, W; Gradinger, R

    2003-01-01

    Carbon fiber-reinforced plastics have been used clinically as an implant material for different applications for over 20 years.A review of technical basics of the composite materials (carbon fibers and matrix systems), fields of application,advantages (e.g., postoperative visualization without distortion in computed and magnetic resonance tomography), and disadvantages with use as an implant material is given. The question of the biocompatibility of carbon fiber-reinforced plastics is discussed on the basis of experimental and clinical studies. Selected implant systems made of carbon composite materials for treatments in orthopedic surgery such as joint replacement, tumor surgery, and spinal operations are presented and assessed. Present applications for carbon fiber reinforced plastics are seen in the field of spinal surgery, both as cages for interbody fusion and vertebral body replacement.

  5. Battlefield Acquired Immunogenicity to Metals Affects Orthopedic Implant Outcome

    Science.gov (United States)

    2013-10-01

    3a- 3d for lymphocyte and monocyte responses at a single time point (6month-5 years post-operative). Subgroups Subjects in Group Subject Recruited...49) Hercus B, Revell PA. Phenotypic characteristics of T lymphocytes in the interfacial tissue of aseptically loosened prosthetic joints. J Mater...mechanism for implant debris reactivity. J Orthop Res 2008;(epub ahead of print ). BODY: Current Status: The Study is finalizing the recruitment

  6. Hip Implant Systems

    Science.gov (United States)

    ... made of metal or ceramic, and the socket (acetabulum) is removed and replaced with a prosthetic cup. ... its socket in the hip bone (pelvis) Bone fracture Joint infection Local nerve damage with numbness/weakness ...

  7. Untreated silicone breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse M; Conrad, Carsten;

    2004-01-01

    Implant rupture is a well-known complication of breast implant surgery that can pass unnoticed by both patient and physician. To date, no prospective study has addressed the possible health implications of silicone breast implant rupture. The aim of the present study was to evaluate whether untre...

  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. Hip Resurfacing Implants.

    Science.gov (United States)

    Cadossi, Matteo; Tedesco, Giuseppe; Sambri, Andrea; Mazzotti, Antonio; Giannini, Sandro

    2015-08-01

    EDUCATIONAL OBJECTIVES As a result of reading this article, physicians should be able to: 1. Describe the advantages of hip resurfacing. 2. Describe the disadvantages of hip resurfacing. 3. Identify the population in which hip resurfacing is most often indicated. 4. Demonstrate how to properly postoperatively manage patients with metal-on-metal prostheses. Hip resurfacing offers a suitable solution for young patients affected by hip disease who have high function demands and good bone quality. Bone stock preservation, restoration of the normal proximal femur anatomy, the lack of stress shielding, and the possibility of resuming sporting activity are proven advantages of hip resurfacing. However, there are some disadvantages, such as fracture of the femoral neck, onset of neck narrowing, and possible complications due to the metal-on-metal bearings, including pseudotumors, peri-implant osteolysis, and chronic elevation of metal ions in serum levels. Recent data suggest that the ideal candidate for hip resurfacing is an active male, younger than 65 years, with primary or posttraumatic osteoarthritis, and with a femoral head diameter larger than 50 to 54 mm. Based on these selection criteria, the literature reports implant survival to be similar to that of total hip arthroplasty. The current authors' experience confirms a low failure rate and excellent functional outcomes, with metal ion serum levels becoming stable over time in well-functioning implants. Proper surgical technique, correct patient selection, and the right choice of a well-established prosthetic model are essential elements for the long-term success of these implants.

  10. Semiconductor Ion Implanters

    Science.gov (United States)

    MacKinnon, Barry A.; Ruffell, John P.

    2011-06-01

    In 1953 the Raytheon CK722 transistor was priced at 7.60. Based upon this, an Intel Xeon Quad Core processor containing 820,000,000 transistors should list at 6.2 billion! Particle accelerator technology plays an important part in the remarkable story of why that Intel product can be purchased today for a few hundred dollars. Most people of the mid twentieth century would be astonished at the ubiquity of semiconductors in the products we now buy and use every day. Though relatively expensive in the nineteen fifties they now exist in a wide range of items from high-end multicore microprocessors like the Intel product to disposable items containing `only' hundreds or thousands like RFID chips and talking greeting cards. This historical development has been fueled by continuous advancement of the several individual technologies involved in the production of semiconductor devices including Ion Implantation and the charged particle beamlines at the heart of implant machines. In the course of its 40 year development, the worldwide implanter industry has reached annual sales levels around 2B, installed thousands of dedicated machines and directly employs thousands of workers. It represents in all these measures, as much and possibly more than any other industrial application of particle accelerator technology. This presentation discusses the history of implanter development. It touches on some of the people involved and on some of the developmental changes and challenges imposed as the requirements of the semiconductor industry evolved.

  11. Corrosion of bio implants

    Indian Academy of Sciences (India)

    U Kamachi Mudali; T M Sridhar; Baldev Raj

    2003-06-01

    Chemical stability, mechanical behaviour and biocompatibility in body fluids and tissues are the basic requirements for successful application of implant materials in bone fractures and replacements. Corrosion is one of the major processes affecting the life and service of orthopaedic devices made of metals and alloys used as implants in the body. Among the metals and alloys known, stainless steels (SS), Co–Cr alloys and titanium and its alloys are the most widely used for the making of biodevices for extended life in human body. Incidences of failure of stainless steel implant devices reveal the occurrence of significant localised corroding viz., pitting and crevice corrosion. Titanium forms a stable TiO2 film which can release titanium particles under wear into the body environment. To reduce corrosion and achieve better biocompatibility, bulk alloying of stainless steels with titanium and nitrogen, surface alloying by ion implantation of stainless steels and titanium and its alloys, and surface modification of stainless steel with bioceramic coatings are considered potential methods for improving the performance of orthopaedic devices. This review discusses these issues in depth and examines emerging directions.

  12. Ion implantation in polymers

    Science.gov (United States)

    Wintersgill, M. C.

    1984-02-01

    An introductory overview will be given of the effects of ion implantation on polymers, and certain areas will be examined in more detail. Radiation effects in general and ion implantation in particular, in the field of polymers, present a number of contrasts with those in ionic crystals, the most obvious difference being that the chemical effects of both the implanted species and the energy transfer to the host may profoundly change the nature of the target material. Common effects include crosslinking and scission of polymer chains, gas evolution, double bond formation and the formation of additional free radicals. Research has spanned the chemical processes involved, including polymerization reactions achievable only with the use of radiation, to applied research dealing both with the effects of radiation on polymers already in commercial use and the tailoring of new materials to specific applications. Polymers are commonly divided into two groups, in describing their behavior under irradiation. Group I includes materials which form crosslinks between molecules, whereas Group II materials tend to degrade. In basic research, interest has centered on Group I materials and of these polyethylene has been studied most intensively. Applied materials research has investigated a variety of polymers, particularly those used in cable insulation, and those utilized in ion beam lithography of etch masks. Currently there is also great interest in enhancing the conducting properties of polymers, and these uses would tend to involve the doping capabilities of ion implantation, rather than the energy deposition.

  13. Remote actuated valve implant

    Energy Technology Data Exchange (ETDEWEB)

    McKnight, Timothy E.; Johnson, Anthony; Moise, Kenneth J.; Ericson, Milton Nance; Baba, Justin S.; Wilgen, John B.; Evans, Boyd Mccutchen

    2016-05-10

    Valve implant systems positionable within a flow passage, the systems having an inlet, an outlet, and a remotely activatable valve between the inlet and outlet, with the valves being operable to provide intermittent occlusion of the flow path. A remote field is applied to provide thermal or magnetic activation of the valves.

  14. Implantable Impedance Plethysmography

    OpenAIRE

    2014-01-01

    We demonstrate by theory, as well as by ex vivo and in vivo measurements that impedance plethysmography, applied extravascularly directly on large arteries, is a viable method for monitoring various cardiovascular parameters, such as blood pressure, with high accuracy. The sensor is designed as an implant to monitor cardiac events and arteriosclerotic progression over the long term.

  15. Bone graft materials in fixation of orthopaedic implants in sheep.

    Science.gov (United States)

    Babiker, Hassan

    2013-07-01

    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking skeletal bones. The osteoconductive properties of the composite might be improved by adding bone marrow aspirate (BMA), which can be harvested during surgery. Other alternatives to bone graft are demineralised bone matrix (DBM) and human cancellous bone (CB). DBM is prepared by acid extraction of human bone and includes bone collagen, morphogenetic proteins and growth factors. The combination of DBM with CB and with allograft might improve the healing potential of these grafts around non-cemented orthopaedic implants and thereby the implant fixation. Study I investigates the effect of HA/Collagen composite alone and in combination with BMA on the early fixation of porous coated titanium implants. In addition, the study compares also the effect of autograft with the gold standard allograft. By using a sheep model, the implants were inserted in the trabecular bone of femoral condyles. The test biomaterials were placed in a well defined peri-implant gap. After the observation period, the bone-implant specimens were harvested and evaluated mechanically by a destructive push

  16. Focal anatomic resurfacing implantation for bilateral humeral and femoral heads’ avascular necrosis in a patient with Hodgkin’s lymphoma and literature review

    Directory of Open Access Journals (Sweden)

    Onur Bilge

    2015-01-01

    Conclusion: This study is the first report to present the three-years’ clinical result of a single, relevant case, who was treated with sequential focal anatomic resurfacing implantations (HemiCAP® in four aforementioned joints.

  17. A contact mechanics model for ankle implants with inclusion of surface roughness effects

    Science.gov (United States)

    Hodaei, M.; Farhang, K.; Maani, N.

    2014-02-01

    Total ankle replacement is recognized as one of the best procedures to treat painful arthritic ankles. Even though this method can relieve patients from pain and reproduce the physiological functions of the ankle, an improper design can cause an excessive amount of metal debris due to wear, causing toxicity in implant recipient. This paper develops a contact model to treat the interaction of tibia and talus implants in an ankle joint. The contact model describes the interaction of implant rough surfaces including both elastic and plastic deformations. In the model, the tibia and the talus surfaces are viewed as macroscopically conforming cylinders or conforming multi-cylinders containing micrometre-scale roughness. The derived equations relate contact force on the implant and the minimum mean surface separation of the rough surfaces. The force is expressed as a statistical integral function of asperity heights over the possible region of interaction of the roughness of the tibia and the talus implant surfaces. A closed-form approximate equation relating contact force and minimum separation is used to obtain energy loss per cycle in a load-unload sequence applied to the implant. In this way implant surface statistics are related to energy loss in the implant that is responsible for internal void formation and subsequent wear and its harmful toxicity to the implant recipient.

  18. A comparative study of zirconium and titanium implants in rat: osseointegration and bone material quality.

    Science.gov (United States)

    Hoerth, Rebecca M; Katunar, María R; Gomez Sanchez, Andrea; Orellano, Juan C; Ceré, Silvia M; Wagermaier, Wolfgang; Ballarre, Josefina

    2014-02-01

    Permanent metal implants are widely used in human medical treatments and orthopedics, for example as hip joint replacements. They are commonly made of titanium alloys and beyond the optimization of this established material, it is also essential to explore alternative implant materials in view of improved osseointegration. The aim of our study was to characterize the implant performance of zirconium in comparison to titanium implants. Zirconium implants have been characterized in a previous study concerning material properties and surface characteristics in vitro, such as oxide layer thickness and surface roughness. In the present study, we compare bone material quality around zirconium and titanium implants in terms of osseointegration and therefore characterized bone material properties in a rat model using a multi-method approach. We used light and electron microscopy, micro Raman spectroscopy, micro X-ray fluorescence and X-ray scattering techniques to investigate the osseointegration in terms of compositional and structural properties of the newly formed bone. Regarding the mineralization level, the mineral composition, and the alignment and order of the mineral particles, our results show that the maturity of the newly formed bone after 8 weeks of implantation is already very high. In conclusion, the bone material quality obtained for zirconium implants is at least as good as for titanium. It seems that the zirconium implants can be a good candidate for using as permanent metal prosthesis for orthopedic treatments.

  19. Gold Bead Implantation in Acupoints for Coxofemoral Arthrosis in Dogs: Method Description and Adverse Effects

    Directory of Open Access Journals (Sweden)

    Lars Moe

    2012-09-01

    Full Text Available Gold bead implantation has been used for years as an alternative method to improve function in chronic joint disease both in humans and dogs. The aims of the present study were to describe the technique of implanting 24-karat gold beads around the hip joints of dogs with chronic hip dysplasia, and to record any side effects or complications of such treatment. A prospective placebo-controlled double-blinded clinical trial was performed. Eighty dogs were randomly allocated to treatment or placebo, with 38 in the gold implantation group and 42 in the placebo group, and followed intensely for six months. The implantation technique was simple to perform, using fluoroscopy and with the dogs under inhalation anesthesia for about 30 minutes. Adverse effects, measured as pain or discomfort, were seen for a period of up to four weeks in 15 of the dogs in the gold implantation group, compared to six dogs in the placebo group. During implantation, a technical difficulty occurred as 82% of the dogs showed leakage of blood and/or synovia from the needles. The dogs in the gold implantation group were radiographed 18 months later. Of the 30 dogs that were radiographed at both inclusion and 24 months, 80% (24 dogs showed a deterioration of the coxofemoral arthrosis, the other six had stable disease evaluated by radiography. Migration of gold beads was only observed in one dog.

  20. Engineered porous metals for implants

    Science.gov (United States)

    Vamsi Krishna, B.; Xue, Weichang; Bose, Susmita; Bandyopadhyay, Amit

    2008-05-01

    Interest is significant in patient-specific implants with the possibility of guided tissue regeneration, particularly for load-bearing implants. For such implants to succeed, novel design approaches and fabrication technologies that can achieve balanced mechanical and functional performance in the implants are necessary. This article is focused on porous load-bearing implants with tailored micro-as well as macrostructures using laser-engineered net shaping (LENS™), a solid freeform fabrication or rapid prototyping technique that can be used to manufacture patient-specific implants. This review provides an insight into LENS, some properties of porous metals, and the potential applications of this process to fabricate unitized structures which can eliminate longstanding challenges in load-bearing implants to increase their in-vivo lifetime, such as in a total hip prosthesis.

  1. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented acetabular component, prosthesis. 888.3320 Section 888.3320 Food and Drugs FOOD AND DRUG..., prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip joint. The...

  2. 21 CFR 888.3353 - Hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented or nonporous uncemented prosthesis. 888.3353 Section 888.3353 Food and Drugs FOOD AND DRUG... prosthesis. (a) Identification. A hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis is a device intended to be implanted to replace a hip joint. This device...

  3. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented acetabular component, prosthesis. 888.3330 Section 888.3330 Food and Drugs FOOD AND DRUG..., prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip joint. The...

  4. Efter cochlear implant

    DEFF Research Database (Denmark)

    Højen, Anders

    Dit barn har netop fået et cochlear implant. Hvad nu? Skal barnet fokusere udelukkende på at lære talt sprog, eller skal det også lære/fortsætte med tegnsprog eller støttetegn? Det er et vanskeligt spørgsmål, og før valget foretages, er det vigtigt at vurdere hvilke konsekvenser valget har, dels...... for den sproglige udvikling isoleret set, og dels for barnets udvikling ud fra en helhedsbetragtning. Dette indlæg fokuserer på, hvilke forventninger man kan have til cochlear implant-brugeres sproglige udvikling med talt sprog alene, hhv. med to sprog (tale og tegn). Disse forventninger er baseret på...

  5. Efter cochlear implant

    DEFF Research Database (Denmark)

    Højen, Anders

    2007-01-01

      Dit barn har netop fået et cochlear implant. Hvad nu? Skal barnet fokusere udelukkende på at lære talt sprog, eller skal det også lære/fortsætte med tegnsprog eller støttetegn? Det er et vanskeligt spørgsmål, og før valget foretages, er det vigtigt at vurdere hvilke konsekvenser valget har, dels...... for den sproglige udvikling isoleret set, og dels for barnets udvikling ud fra en helhedsbetragtning. Dette indlæg fokuserer på, hvilke forventninger man kan have til cochlear implant-brugeres sproglige udvikling med talt sprog alene, hhv. med to sprog (tale og tegn). Disse forventninger er baseret på...

  6. Peri-implant hastalıklar

    OpenAIRE

    Dilsiz, Alparslan; Zihni, Meltem; Yavuz, M Selim

    2011-01-01

    The treatment of partially or totally edentulous subjects with oral implants is a common procedure. Biological complications are occur around implants which are peri-implant mucositis and periimplantitis. Peri-implant mucositis is pathological condition which is normally localized in the soft tissues surrounding an oral implant. Peri-implantitis surrounding oral implants is an inflammatory process affecting the soft and hard tissues resulting in rapid loss of supporting bone associated with b...

  7. Opaque intraocular lens implantation

    OpenAIRE

    Yusuf IH; Patel CK

    2013-01-01

    Imran H Yusuf, CK Patel The Oxford Eye Hospital, West Wing, John Radcliffe Hospital, Headley Way, Headington, Oxford, United KingdomWe read with great interest the recent article by Lee et al,1 who described their clinical experience with three patients who underwent primary implantation of Morcher (Stuttgart, Germany) occlusive intraocular lenses (IOLs) across a variety of neuro-ophthalmic indications. We hope to offer some further insight into these clinical observations in the context of o...

  8. Human knee joint anatomy revisited: morphometry in the light of sex-specific total knee arthroplasty.

    Science.gov (United States)

    Dargel, Jens; Michael, Joern W P; Feiser, Janna; Ivo, Roland; Koebke, Juergen

    2011-04-01

    This study investigates differences in the anatomy of male and female knee joints to contribute to the current debate on sex-specific total knee implants. Morphometric data were obtained from 60 human cadaver knees, and sex differences were calculated. All data were corrected for height, and male and female specimens presenting with an identical length of the femur were analyzed as matched pairs. Male linear knee joint dimensions were significantly larger when compared with females. When corrected for differences in height, medial-lateral dimensions of male knees were significantly larger than female; however, matched paired analysis did not prove these differences to be consistent. Although implant design should focus interindividual variations in knee joint anatomy, our data do not support the concept of a female-specific implant design.

  9. Minimally invasive arthrodesis for chronic sacroiliac joint dysfunction using the SImmetry SI Joint Fusion system

    Directory of Open Access Journals (Sweden)

    Miller LE

    2014-05-01

    Full Text Available Larry E Miller,1,2 Jon E Block21Miller Scientific Consulting, Inc., Asheville, NC, USA; 2The Jon Block Group, San Francisco, CA, USA Abstract: Chronic sacroiliac (SI joint-related low back pain (LBP is a common, yet under-diagnosed and undertreated condition due to difficulties in accurate diagnosis and highly variable treatment practices. In patients with debilitating SI-related LBP for at least 6 months duration who have failed conservative management, arthrodesis is a viable option. The SImmetry® SI Joint Fusion System is a novel therapy for SI joint fusion, not just fixation, which utilizes a minimally invasive surgical approach, instrumented fixation for immediate stability, and joint preparation with bone grafting for a secure construct in the long term. The purpose of this report is to describe the minimally invasive SI Joint Fusion System, including patient selection criteria, implant characteristics, surgical technique, postoperative recovery, and biomechanical testing results. Advantages and limitations of this system will be discussed. Keywords: arthrodesis, fusion, minimally invasive, sacroiliac, SImmetry

  10. [Neurotology and cochlear implants].

    Science.gov (United States)

    Merchán, Miguel A

    2015-05-01

    In this review we analyse cochlear implantation in terms of the fundamental aspects of the functioning of the auditory system. Concepts concerning neuronal plasticity applied to electrical stimulation in perinatal and adult deep hypoacusis are reviewed, and the latest scientific bases that justify early implantation following screening for congenital deafness are discussed. Finally, this review aims to serve as an example of the importance of fostering the sub-specialty of neurotology in our milieu, with the aim of bridging some of the gaps between specialties and thus improving both the knowledge in the field of research on auditory pathologies and in the screening of patients. The objectives of this review, targeted above all towards specialists in the field of otorhinolaryngology, are to analyse some significant neurological foundations in order to reach a better understanding of the clinical events that condition the indications and the rehabilitation of patients with cochlear implants, as well as to use this means to foster the growth of the sub-specialty of neurotology.

  11. Bone Substitutes for Peri-Implant Defects of Postextraction Implants

    Directory of Open Access Journals (Sweden)

    Pâmela Letícia Santos

    2013-01-01

    Full Text Available Placement of implants in fresh sockets is an alternative to try to reduce physiological resorption of alveolar ridge after tooth extraction. This surgery can be used to preserve the bone architecture and also accelerate the restorative procedure. However, the diastasis observed between bone and implant may influence osseointegration. So, autogenous bone graft and/or biomaterials have been used to fill this gap. Considering the importance of bone repair for treatment with implants placed immediately after tooth extraction, this study aimed to present a literature review about biomaterials surrounding immediate dental implants. The search included 56 articles published from 1969 to 2012. The results were based on data analysis and discussion. It was observed that implant fixation immediately after extraction is a reliable alternative to reduce the treatment length of prosthetic restoration. In general, the biomaterial should be used to increase bone/implant contact and enhance osseointegration.

  12. Managing Joint Production Motivation

    DEFF Research Database (Denmark)

    Lindenberg, Siegwart; Foss, Nicolai Juul

    2011-01-01

    We contribute to the microfoundations of organizational performance by proffering the construct of joint production motivation. Under such motivational conditions individuals see themselves as part of a joint endeavor, each with his or her own roles and responsibilities; generate shared represent...... representations of actions and tasks; cognitively coordinate cooperation; and choose their own behaviors in terms of joint goals. Using goal-framing theory, we explain how motivation for joint production can be managed by cognitive/symbolic management and organizational design.......We contribute to the microfoundations of organizational performance by proffering the construct of joint production motivation. Under such motivational conditions individuals see themselves as part of a joint endeavor, each with his or her own roles and responsibilities; generate shared...

  13. Quantification of in vitro wear of a synthetic meniscus implant using gravimetric and micro-CT measurements.

    Science.gov (United States)

    Elsner, Jonathan J; Shemesh, Maoz; Shefy-Peleg, Adaya; Gabet, Yankel; Zylberberg, Eyal; Linder-Ganz, Eran

    2015-09-01

    A synthetic meniscus implant was recently developed for the treatment of patients with mild to moderate osteoarthritis with knee pain associated with medial joint overload. The implant is distinctively different from most orthopedic implants in its pliable construction, and non-anchored design, which enables implantation through a mini-arthrotomy without disruption to the bone, cartilage, and ligaments. Due to these features, it is important to show that the material and design can withstand knee joint conditions. This study evaluated the long-term performance of this device by simulating loading for a total of 5 million gait cycles (Mc), corresponding to approximately five years of service in-vivo. All five implants remained in good condition and did not dislodge from the joint space during the simulation. Mild abrasion was detected by electron microscopy, but µ-CT scans of the implants confirmed that the damage was confined to the superficial surfaces. The average gravimetric wear rate was 14.5 mg/Mc, whereas volumetric changes in reconstructed µ-CT scans point to an average wear rate of 15.76 mm(3)/Mc (18.8 mg/Mc). Particles isolated from the lubricant had average diameter of 15 µm. The wear performance of this polycarbonate-urethane meniscus implant concept under ISO-14243 loading conditions is encouraging.

  14. Surface modification of ultra-high molecular weight polyethylene for joint prosthesis and sports applications

    Institute of Scientific and Technical Information of China (English)

    H.Dong

    2004-01-01

    The recent progresses in the surfaee modification of ultra high molecular weight polyethylene (UHMWPE) using such advanced surface modification technologies as conventional ion implantation (CⅡ), new plasma immersion ion implantation (PⅢ) and novel active screen plasma (ASP), were all reported. Significantly improved wear resistance was achieved, which has great potential for extending the life-span of joint replacement prostheses and enhancing the performance of such sports equipment as skis and snowboards.

  15. Jointly Poisson processes

    CERN Document Server

    Johnson, D H

    2009-01-01

    What constitutes jointly Poisson processes remains an unresolved issue. This report reviews the current state of the theory and indicates how the accepted but unproven model equals that resulting from the small time-interval limit of jointly Bernoulli processes. One intriguing consequence of these models is that jointly Poisson processes can only be positively correlated as measured by the correlation coefficient defined by cumulants of the probability generating functional.

  16. Joint Program Management Handbook

    Science.gov (United States)

    1994-12-01

    the Engieermg and Manufacuring Devopment Phase. Nfilestoae HI- Develommen Annros Devopment approval marks a significant step for any program, but it is...to review concept formulaton. Systems Engilneertn As with service programs, systems engineering in joint program management is an essential tool . I...MANAGEMENT HANDBOOK On=e wd Umawtaiutt As discussed in Chapter 7, systems analysis of relationships is a usef tool for joint program managers. The joint

  17. Sub-meninges implantation reduces immune response to neural implants.

    Science.gov (United States)

    Markwardt, Neil T; Stokol, Jodi; Rennaker, Robert L

    2013-04-15

    Glial scar formation around neural interfaces inhibits their ability to acquire usable signals from the surrounding neurons. To improve neural recording performance, the inflammatory response and glial scarring must be minimized. Previous work has indicated that meningeally derived cells participate in the immune response, and it is possible that the meninges may grow down around the shank of a neural implant, contributing to the formation of the glial scar. This study examines whether the glial scar can be reduced by placing a neural probe completely below the meninges. Rats were implanted with sets of loose microwire implants placed either completely below the meninges or implanted conventionally with the upper end penetrating the meninges, but not attached to the skull. Histological analysis was performed 4 weeks following surgical implantation to evaluate the glial scar. Our results found that sub-meninges implants showed an average reduction in reactive astrocyte activity of 63% compared to trans-meninges implants. Microglial activity was also reduced for sub-meninges implants. These results suggest that techniques that isolate implants from the meninges offer the potential to reduce the encapsulation response which should improve chronic recording quality and stability.

  18. BIOLOGIC JOINT RECONSTRUCTION: ALTERNATIVES TO ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Brian J. Cole

    2009-06-01

    Full Text Available A comprehensive source of information in the management of cartilage lesions of major joints using nonoperative or surgical techniques other than total joint replacement. The text also includes chapters in basic sciences, imaging and rehabilitation.The editors are aiming to provide a reference about the latest concepts and techniques in the treatment of cartilage lesions including future aspects by a comprehensive approach to the alternative joint restoration procedures such as biological, pharmacological and surgical techniques of cartilage repairing and partial resurfacing etc.Orthopedic surgeons in sports medicine, orthopedic surgeons performing joint replacements, orthopedic resident and fellows will be the main audiences.The text is 349 pages, divided into 34 chapters in 7 sections. Section I is "Background-articular cartilage and allograft processing" including chapters about pathology, patient evaluation, imaging and allograft processing. Section II is "Nonoperative treatment" including chapters about neutraceuticals, pharmacological treatment and rehabilitation. Section III is "Operative treatment-knee" including chapters about arthroscopic debridment, microfracture, osteochondral autograft transplantation, mosaicplasty, osteochondral autograft transfer, osteochondral allografts, autologous chondrocyte implantation, existing cell-based technologies, minimally invasive second-generation autologous chondrocyte implantation, future development in cartilage repair, meniscus transplantation, management of OCD, patellafemoral chondral disease, proximal tibial and distal femoral osteotomies, unicompartmental arthritis current techniques, unicompartmental knee replacement. Section IV is "Operative treatment-Hip" including chapters about hip arthroscopy and arthroscopic partial resurfacing, related osteotomies. Section V is "operative treatment-shoulder" including chapters about arthroscopic debridment and release, biologic resurfacing and

  19. Contact mechanics of reverse engineered distal humeral hemiarthroplasty implants.

    Science.gov (United States)

    Willing, Ryan; King, Graham J W; Johnson, James A

    2015-11-26

    Erosion of articular cartilage is a concern following distal humeral hemiarthroplasty, because native cartilage surfaces are placed in contact with stiff metallic implant components, which causes decreases in contact area and increases in contact stresses. Recently, reverse engineered implants have been proposed which are intended to promote more natural contact mechanics by reproducing the native bone or cartilage shape. In this study, finite element modeling is used in order to calculate changes in cartilage contact areas and stresses following distal humeral hemiarthroplasty with commercially available and reverse engineered implant designs. At the ulna, decreases in contact area were -34±3% (p=0.002), -27±1% (pengineered and cartilage reverse engineered designs, respectively. Peak contact stresses increased by 461±57% (p=0.008), 387±127% (p=0.229) and 165±16% (p=0.003). At the radius, decreases in contact area were -21±3% (p=0.013), -13±2% (p0.999), 241±32% (p=0.010) and 61±10% (p=0.021). Between the three different implant designs, the cartilage reverse engineered design yielded the largest contact areas and lowest contact stresses, but was still unable to reproduce the contact mechanics of the native joint. These findings align with a growing body of evidence indicating that although reverse engineered hemiarthroplasty implants can provide small improvements in contact mechanics when compared with commercially available designs, further optimization of shape and material properties is required in order reproduce native joint contact mechanics.

  20. The collagen meniscus implant.

    NARCIS (Netherlands)

    Buma, P.; Tienen, T.G. van; Veth, R.P.H.

    2007-01-01

    Lesions in the meniscus occur particularly in young, active patients in the nonvascularized area which, consequently have a bad intrinsic healing capacity. This has a large impact on the mobility and function of the knee joint. Lesions, and partial lesions, lead to the progression of osteoarthritis

  1. Current trends in dental implants

    OpenAIRE

    Gaviria, Laura; Salcido, John Paul; Guda, Teja; Ong, Joo L.

    2014-01-01

    Tooth loss is very a very common problem; therefore, the use of dental implants is also a common practice. Although research on dental implant designs, materials and techniques has increased in the past few years and is expected to expand in the future, there is still a lot of work involved in the use of better biomaterials, implant design, surface modification and functionalization of surfaces to improve the long-term outcomes of the treatment. This paper provides a brief history and evoluti...

  2. Dental Implants: Dual Stabilization Technology

    OpenAIRE

    Saini, Rajiv

    2015-01-01

    More recent epidemiological data seem to show an increasing trend of tooth loss due to periodontal reasons rather than caries; the presence of initial attachment loss, bone height and the habit of smoking significantly increase the risk of tooth mortality. A dental implant is a titanium screw which is placed into bone to replace missing teeth. The implant mimics the root of a tooth in function. Dental Implants have changed the face of dentistry over the last three decades. Success of dental i...

  3. Mechanics of Sheeting Joints

    Science.gov (United States)

    Martel, S. J.

    2015-12-01

    Physical breakdown of rock across a broad scale spectrum involves fracturing. In many areas large fractures develop near the topographic surface, with sheeting joints being among the most impressive. Sheeting joints share many geometric, textural, and kinematic features with other joints (opening-mode fractures) but differ in that they are (a) discernibly curved, (b) open near the topographic surface, and (c) form subparallel to the topographic surface. Where sheeting joints are geologically young, the surface-parallel compressive stresses are typically several MPa or greater. Sheeting joints are best developed beneath domes, ridges, and saddles; they also are reported, albeit rarely, beneath valleys or bowls. A mechanism that accounts for all these associations has been sought for more than a century: neither erosion of overburden nor high lateral compressive stresses alone suffices. Sheeting joints are not accounted for by Mohr-Coulomb shear failure criteria. Principles of linear elastic fracture mechanics, together with the mechanical effect of a curved topographic surface, do provide a basis for understanding sheeting joint growth and the pattern sheeting joints form. Compressive stresses parallel to a singly or doubly convex topographic surface induce a tensile stress perpendicular to the surface at shallow depths; in some cases this alone could overcome the weight of overburden to open sheeting joints. If regional horizontal compressive stresses, augmented by thermal stresses, are an order of magnitude or so greater than a characteristic vertical stress that scales with topographic amplitude, then topographic stress perturbations can cause sheeting joints to open near the top of a ridge. This topographic effect can be augmented by pressure within sheeting joints arising from water, ice, or salt. Water pressure could be particularly important in helping drive sheeting joints downslope beneath valleys. Once sheeting joints have formed, the rock sheets between

  4. Dental implants in growing children

    Directory of Open Access Journals (Sweden)

    S K Mishra

    2013-01-01

    Full Text Available The replacement of teeth by implants is usually restricted to patients with completed craniofacial growth. The aim of this literature review is to discuss the use of dental implants in normal growing patients and in patients with ectodermal dysplasia and the influence of maxillary and mandibular skeletal and dental growth on the stability of those implants. It is recommended that while deciding the optimal individual time point of implant insertion, the status of skeletal growth, the degree of hypodontia, and extension of related psychological stress should be taken into account, in addition to the status of existing dentition and dental compliance of a pediatric patient.

  5. Cochlear implants in genetic deafness

    Institute of Scientific and Technical Information of China (English)

    Xuezhong Liu

    2014-01-01

    Genetic defects are one of the most important etiologies of severe to profound sensorineural hearing loss and play an important role in determining cochlear implantation outcomes. While the pathogenic mutation types of a number of deafness genes have been cloned, the pathogenesis mechanisms and their relationship to the outcomes of cochlear implantation remain a hot research area. The auditory performance is considered to be affected by the etiology of hearing loss and the number of surviving spiral ganglion cells, as well as others. Current research advances in cochlear implantation for hereditary deafness, especially the relationship among clinic-types, genotypes and outcomes of cochlear implantation, will be discussed in this review.

  6. Microstimulation at the bone-implant interface upregulates osteoclast activation pathways.

    Science.gov (United States)

    Stadelmann, Vincent A; Terrier, Alexandre; Pioletti, Dominique P

    2008-02-01

    Peri-implant bone resorption after total joint arthroplasty is a key parameter in aseptic loosening. Implant wear debris and biomechanical aspects have both been demonstrated to be part of the bone resorption process. However, neither of these two parameters has been clearly identified as the primary initiator of peri-implant bone resorption. For the biomechanical parameters, micromotions were measured at the bone-implant interface during normal gait cycles. The amplitude of the micromotions was shown to trigger differentiation of bone tissues. So far no data exists directly quantifying the effect of micromotion and compression on human bone. We hypothesize that micromotion and compression at the bone-implant interface may induce direct activation of bone resorption around the implant through osteoblasts-osteoclasts cell signaling in human bone. This hypothesis was tested with an ex vivo loading system developed to stimulate trabecular bone cores and mimic the micromotions arising at the bone-implant interface. Gene expression of RANKL, OPG, TGFB2, IFNG and CSF-1 was analyzed after no mechanical stimulation (control), exposure to compression or exposure to micromotions. We observed an 8-fold upregulation of RANKL after exposure to micromotions, and downregulation of OPG, IFNG and TGFB2. The RANKL:OPG ratio was upregulated 24-fold after micromotions. This suggests that the micromotions arising at the bone-implant interface during normal gait cycles induce a bone resorption response after only 1 h, which occurs before any wear debris particles enter the system.

  7. Failure of total hip implants: metals and metal release in 52 cases

    DEFF Research Database (Denmark)

    Jakobsen, Stig Storgaard; Lidén, Carola; Søballe, Kjeld;

    2014-01-01

    Background . The pathogenesis of total joint replacement failure is multifactorial. One hypothesis suggests that corrosion and wear of alloys result in metal ion release, which may then cause sensitization and even implant failure, owing to the acquired immune reactivity. Objectives . To assess c...

  8. Parental Involvement in the Habilitation Process Following Children's Cochlear Implantation: An Action Theory Perspective

    Science.gov (United States)

    Zaidman-Zait, Anat; Young, Richard A.

    2008-01-01

    Action theory and the qualitative action-project method are used in this study to address and illustrate the complexity of parenting children who have received cochlear implants (CIs) as well as the intentionality of parents engaged in that process. "Action" refers to individual and joint goal-directed and intentional behaviors. Action theory has…

  9. Influence of cell quality on clinical outcome after autologous chondrocyte implantation

    DEFF Research Database (Denmark)

    Niemeyer, Philipp; Pestka, Jan M; Salzmann, Gian M;

    2012-01-01

    BACKGROUND: Several factors influence clinical outcome after autologous chondrocyte implantation (ACI) for the treatment of cartilage defects of the knee joint. HYPOTHESIS/PURPOSE: The aim of the present study was to investigate the influence of cell quality on clinical outcome after ACI. The hyp...

  10. Strengthening of defected beam-column joints using CFRP.

    Science.gov (United States)

    Mahmoud, Mohamed H; Afefy, Hamdy M; Kassem, Nesreen M; Fawzy, Tarek M

    2014-01-01

    This paper presents an experimental study for the structural performance of reinforced concrete (RC) exterior beam-column joints rehabilitated using carbon-fiber-reinforced polymer (CFRP). The present experimental program consists of testing 10 half-scale specimens divided into three groups covering three possible defects in addition to an adequately detailed control specimen. The considered defects include the absence of the transverse reinforcement within the joint core, insufficient bond length for the beam main reinforcement and inadequate spliced implanted column on the joint. Three different strengthening schemes were used to rehabilitate the defected beam-column joints including externally bonded CFRP strips and sheets in addition to near surface mounted (NSM) CFRP strips. The failure criteria including ultimate capacity, mode of failure, initial stiffness, ductility and the developed ultimate strain in the reinforcing steel and CFRP were considered and compared for each group for the control and the CFRP-strengthened specimens. The test results showed that the proposed CFRP strengthening configurations represented the best choice for strengthening the first two defects from the viewpoint of the studied failure criteria. On the other hand, the results of the third group showed that strengthening the joint using NSM strip technique enabled the specimen to outperform the structural performance of the control specimen while strengthening the joints using externally bonded CFRP strips and sheets failed to restore the strengthened joints capacity.

  11. Strengthening of defected beam–column joints using CFRP

    Directory of Open Access Journals (Sweden)

    Mohamed H. Mahmoud

    2014-01-01

    Full Text Available This paper presents an experimental study for the structural performance of reinforced concrete (RC exterior beam–column joints rehabilitated using carbon-fiber-reinforced polymer (CFRP. The present experimental program consists of testing 10 half-scale specimens divided into three groups covering three possible defects in addition to an adequately detailed control specimen. The considered defects include the absence of the transverse reinforcement within the joint core, insufficient bond length for the beam main reinforcement and inadequate spliced implanted column on the joint. Three different strengthening schemes were used to rehabilitate the defected beam–column joints including externally bonded CFRP strips and sheets in addition to near surface mounted (NSM CFRP strips. The failure criteria including ultimate capacity, mode of failure, initial stiffness, ductility and the developed ultimate strain in the reinforcing steel and CFRP were considered and compared for each group for the control and the CFRP-strengthened specimens. The test results showed that the proposed CFRP strengthening configurations represented the best choice for strengthening the first two defects from the viewpoint of the studied failure criteria. On the other hand, the results of the third group showed that strengthening the joint using NSM strip technique enabled the specimen to outperform the structural performance of the control specimen while strengthening the joints using externally bonded CFRP strips and sheets failed to restore the strengthened joints capacity.

  12. Strengthening of defected beam–column joints using CFRP

    Science.gov (United States)

    Mahmoud, Mohamed H.; Afefy, Hamdy M.; Kassem, Nesreen M.; Fawzy, Tarek M.

    2013-01-01

    This paper presents an experimental study for the structural performance of reinforced concrete (RC) exterior beam–column joints rehabilitated using carbon-fiber-reinforced polymer (CFRP). The present experimental program consists of testing 10 half-scale specimens divided into three groups covering three possible defects in addition to an adequately detailed control specimen. The considered defects include the absence of the transverse reinforcement within the joint core, insufficient bond length for the beam main reinforcement and inadequate spliced implanted column on the joint. Three different strengthening schemes were used to rehabilitate the defected beam–column joints including externally bonded CFRP strips and sheets in addition to near surface mounted (NSM) CFRP strips. The failure criteria including ultimate capacity, mode of failure, initial stiffness, ductility and the developed ultimate strain in the reinforcing steel and CFRP were considered and compared for each group for the control and the CFRP-strengthened specimens. The test results showed that the proposed CFRP strengthening configurations represented the best choice for strengthening the first two defects from the viewpoint of the studied failure criteria. On the other hand, the results of the third group showed that strengthening the joint using NSM strip technique enabled the specimen to outperform the structural performance of the control specimen while strengthening the joints using externally bonded CFRP strips and sheets failed to restore the strengthened joints capacity. PMID:25685473

  13. MR diagnosis of temporomandibular joint. A study of joint effusion

    Energy Technology Data Exchange (ETDEWEB)

    Kaneda, Takashi; Yamashiro, Mitsuaki; Ozawa, Kaoru; Suzuki, Hiromi; Okada, Hiroyuki; Yamamoto, Hirotsugu [Nihon Univ., Matsudo, Chiba (Japan). School of Dentistry

    1998-03-01

    The purposes of this study were to evaluate the relationship between correlation of MR joint effusion of the temporomandibular joint and disk position, to evaluate the relationship between joint effusion and aging, and to assess the frequency of MR joint effusion of bilateral temporomandibular joints. The temporomandibular joints of 192 patients with clinical symptoms of temporomandibular joint disorders were imaged bilaterally using high field, surface-coil MR imaging. Oblique sagittal and coronal proton density-weighted and T2-weighted images were obtained. Imaging findings of joint effusion were correlated with disk position, aging, and bilateral temporomandibular joints. MR showed effusion in 4% of the joints with normal superior disk position, 36% of the joints with disk displacement with reduction, and 45% of the joints with disk displacement without reduction. There were significant differences in the incidence of joint effusion between normal disk position and anterior disk displacement with or without reduction. Younger patients less than 40 years were significant higher the incidence of joint effusion than those of older patients. A significant association was seen between joint effusion and aging. MR showed effusion in 17% of the unilateral temporomandibular joint, 24% of the bilateral temporomandibular joints. There was no significant difference between unilateral and bilateral case. These results indicated that joint effusion using MR imaging was associated with varied temporomandibular joint pathologic states. (author)

  14. Acromioclavicular Joint Separations

    Science.gov (United States)

    2013-01-01

    Published online: 16 December 2012 # Springer Science+Business Media New York 2012 Abstract Acromioclavicular (AC) joint separations are common...injuries. The sports most likely to cause AC joint dislocations are football, soccer , hockey, rugby, and skiing, among others [9, 28, 29]. The major cause

  15. Life expectancy of modular Ti6Al4V hip implants: Influence of stress and environment

    DEFF Research Database (Denmark)

    Chandra, A.; Ryu, J.J.; Karra, P.;

    2011-01-01

    body weight, as well as proximity of the joint fluid to its iso-electric point play key roles in determining wear rates and associated life expectancies of modular hip implants. Sustained aeration of joint fluid, as well as proper tolerancing of mating surfaces, along with a proper choice of material......Stress dependent electrochemical dissolution is identified as one of the key mechanisms governing surface degradation in fretting and crevice corrosion of biomedical implants. The present study focuses on delineating the roles of mechanical stress and chemical conditions on the life expectancy...... views these scratches as initial notches and utilizes a mixed-mode fatigue crack propagation model to estimate the critical crack length for onset of instability. The number of loading cycles needed to reach this critical crack length is then labeled as the expected life of the implant under given...

  16. The effect of ion implantation on the tribomechanical properties of carbon fibre reinforced polymers

    Energy Technology Data Exchange (ETDEWEB)

    Mistica, R.; Sood, D.K. [Royal Melbourne Inst. of Tech., VIC (Australia); Janardhana, M.N. [Deakin University, Geelong, VIC (Australia). School of Engineering and Technology

    1993-12-31

    Graphite fibre reinforced epoxy composite material (GFRP) is used extensively in the aerospace and other industries for structural application. The trend is to address the 20 to 30 year life endurance of this material in service. Mechanical joints in air crafts are exposed to dynamic loads during service and wear may be experienced by the composite material joint. Generally it has been shown that graphite fibre reinforced polymers have superior wear and friction properties as compared with the unfilled polymers. In the described experiment, ion implantation was used as a novel surface treatment. Wear and friction of a polymer composite material (GFRP) was studied and ion implantation was used in order to observe the effect on the tribomechanical properties of the material. It was found that ion implantation of C on GFRP sliding against Ti changes the tribological properties of the system, and in particular decreases the coefficient of friction and wear. 4 refs., 2 figs.

  17. Psychological intervention following implantation of an implantable defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; van den Broek, Krista C; Sears, Samuel F

    2007-01-01

    The medical benefits of the implantable cardioverter defibrillator (ICD) are unequivocal, but a subgroup of patients experiences emotional difficulties following implantation. For this subgroup, some form of psychological intervention may be warranted. This review provides an overview of current...... evidence on the efficacy of psychological intervention in ICD patients and recommendations for future research....

  18. Metal-on-metal hip joint tribology.

    Science.gov (United States)

    Dowson, D; Jin, Z M

    2006-02-01

    The basic tribological features of metal-on-metal total hip replacements have been reviewed to facilitate an understanding of the engineering science underpinning the renaissance of these hard-on-hard joints. Metal-on-polymer hip replacements operate in the boundary lubrication regime, thus leading to the design guidance to reduce the femoral head diameter as much as is feasible to minimize frictional torque and volumetric wear. This explains why the gold-standard implant of this form from the past half-century had a diameter of only 22.225 mm (7/8 in). Metal-on-metal implants can operate in the mild mixed lubrication regime in which much of the applied load is supported by elastohydrodynamic films. Correct tribological design leads to remarkably low steady state wear rates. Promotion of the most effective elastohydrodynamic films calls for the largest possible head diameters and the smallest clearances that can reasonably be adopted, consistent with fine surface finishes, good sphericity and minimal structural elastic deformation of the cup on its foundations. This guidance, which is opposite in form to that developed for metal-on-polymer joints, is equally valid for solid (monolithic) metallic heads on metallic femoral stems and surface replacement femoral shells. Laboratory measurements of friction and wear in metal-on-metal joints have confirmed their potential to achieve a very mild form of mixed lubrication. The key lies in the generation of effective elastohydrodynamic lubricating films of adequate thickness compared with the composite roughness of the head and cup. The calculation of the film thickness is by no means easy, but the full procedure is outlined and the use of an empirical formula that displays good agreement with calculations based upon the full numerical solutions is explained. The representation of the lambda ratio, lambda, embracing both film thickness and composite roughness, is described.

  19. Jointness for the Rest of Us: Reforming Joint Professional Development

    Science.gov (United States)

    2016-06-10

    service members for joint employment . Similar to their enlisted counterparts, the training, education and professional development of DOD civilian...the U.S. Armed forces sought by Congressional legislators and Defense leaders is not possible as long as joint education and training are limited to a...SUBJECT TERMS joint training, joint education , Goldwater Nichols Act, jointness, joint development reform analytics 16. SECURITY CLASSIFICATION OF

  20. Scientists Design Heat-Activated Penis Implant

    Science.gov (United States)

    ... news/fullstory_162815.html Scientists Design Heat-Activated Penis Implant Device an improvement on current implants, researchers ... News) -- Doctors report that they have crafted a penis implant that becomes erect when heated. Dubbed by ...

  1. The results of application of anterior cruciate ligament two-bundle plastics by synthetic implant in its complete tears

    Directory of Open Access Journals (Sweden)

    Shormanov A.M.

    2015-12-01

    Full Text Available Objective: to improve surgical results of patients with complete tears of anterior cruciate ligament by synthetic implant Don-M. Materials and Methods. 7 patients with ACL complete tear who underwent two-bundle plastics with synthetic en-doprosthetic implant Don-M were investigated. Results. The application of ACL two-bundle plastics with synthetic Don-M implant allowed reaching complete knee joint stability during the first several hours after surgery and completely restore knee joint motion range in the course of 6 months. Conclusion. The application of ACL two-bundle plastics is anatomically justified and provides knee joint stability as well as early activation and rehabilitation opportunities.

  2. Implant periapical lesion: diagnosis and treatment

    OpenAIRE

    Peñarrocha Diago, María; Maestre Ferrín, Laura; Cervera Ballester, Juan; Peñarrocha Oltra, David

    2012-01-01

    The implant periapical lesion is the infectious-inflammatory process of the tissues surrounding the implant apex. It may be caused by different factors: contamination of the implant surface, overheating of bone during drilling, preparation of a longer implant bed than the implant itself, and pre-existing bone disease. Diagnosis is achieved by studying the presence of symptoms and signs such us pain, swelling, suppuration or fistula; in the radiograph an implant periapical radiolucency may app...

  3. Piezosurgery in implant dentistry

    Directory of Open Access Journals (Sweden)

    Stübinger S

    2015-11-01

    Full Text Available Stefan Stübinger,1 Andres Stricker,2 Britt-Isabelle Berg3,4 1Hightech Research Center of Cranio-maxillofacial Surgery, University of Basel, Allschwil, Switzerland; 2Private Practice, Konstanz, Germany; 3Department of Cranio-maxillofacial Surgery, University Hospital Basel, Basel, Switzerland; 4Division of Oral and Maxillofacial Radiology, Columbia University Medical Center, New York, NY, USA Abstract: Piezosurgery, or the use of piezoelectric devices, is being applied increasingly in oral and maxillofacial surgery. The main advantages of this technique are precise and selective cuttings, the avoidance of thermal damage, and the preservation of soft-tissue structures. Through the application of piezoelectric surgery, implant-site preparation, bone grafting, sinus-floor elevation, edentulous ridge splitting or the lateralization of the inferior alveolar nerve are very technically feasible. This clinical overview gives a short summary of the current literature and outlines the advantages and disadvantages of piezoelectric bone surgery in implant dentistry. Overall, piezoelectric surgery is superior to other methods that utilize mechanical instruments. Handling of delicate or compromised hard- and soft-tissue conditions can be performed with less risk for the patient. With respect to current and future innovative surgical concepts, piezoelectric surgery offers a wide range of new possibilities to perform customized and minimally invasive osteotomies. Keywords: implantology, piezoelectric device, piezosurgery, maxillary sinus elevation, bone grafting, osteotomy, edentulous ridge splitting

  4. Endometrium implantation and ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    LIU Yixun

    2004-01-01

    Embryo in uterine implantation is a complex and multifactor-related process and is a downstream and ideal point for woman fertility control.Understanding the cellular and molecular mechanism of implantation is a prerequisite for development of anti-implantation contraceptives.In spite of considerable accumulation of information from the laboratory animals that has been achieved,it is difficult to generate such information in human due to ethical restriction and experimental limitation,and the present knowledge for understanding the definitive mechanisms which control these events remains elusive.Embryo implantation can also occur outside uterus.Some women with abdominal pregnancies could successfully complete the processes of gestation and bear normal babies,implying that implantation itself may be not an endometrium-specific process.Reproductive biologists should cooperate with gynecologists to further comparatively study the molecular and cellular mechanisms of implantation normally occurring in endometrium and abnormally appearing outside uterine cavity.Such collaborative studies may generate new important information for developing anti-implantation contraceptive and for techniques of accurate diagnosis of ectopic pregnancy.A specially designed GnRH-2 analog and a combination use of Iow dose RU486 and gossypol as anti-implantation contraceptives have been suggested.

  5. The Stress Distribution on the Zygapophyseal Joint of Lumbar Vertebra by ANSYS Program

    Directory of Open Access Journals (Sweden)

    Summer S. M. Mukhtar

    2010-01-01

    Full Text Available Zygapophyseal joints (or facet joints, are a plane synovial joint which located between the articular facet processes of the vertebral arch which is freely guided movable joints. Ten dried vertebrae were used for the lumbar region and taking (L4 as a sample to reveal stress pathways across the joints by using ANSYS program under different loading conditions which used Finite Elements Analysis model. Results obtained from the ANSYS program are important in understanding the boundary conditions for load analysis and the points of stress concentration which explained from the anatomical point of view and linked to muscle and ligament attachments. This model used as a computational tool to joint biomechanics and to prosthetic implant analysis.

  6. Short implants in oral rehabilitation

    Directory of Open Access Journals (Sweden)

    Emmanuel Panobianco Chizolini

    2011-07-01

    Full Text Available Introduction and objective: The placement of short dental implants is used as an alternative treatment modality to bone grafting procedures. The aim of this study was to discuss, through a literature review, the features, indications and biomechanical aspects of short implants, as well as to report the clinical factors that influence on their indication. Literature review and conclusion: It was found that short implants osseointegration can be compromised by risk factors that must be controlled to achieve treatment success. In conclusion, the main indication of short implants is to avoid an invasive surgery at atrophic areas of maxilla and mandible. Furthermore, implant design associated with surface treatment are factors that compensate its short length.

  7. Guidelines for the diagnosis, prevention and management of implantable cardiac electronic device infection. Report of a joint Working Party project on behalf of the British Society for Antimicrobial Chemotherapy (BSAC, host organization), British Heart Rhythm Society (BHRS), British Cardiovascular Society (BCS), British Heart Valve Society (BHVS) and British Society for Echocardiography (BSE).

    Science.gov (United States)

    Sandoe, Jonathan A T; Barlow, Gavin; Chambers, John B; Gammage, Michael; Guleri, Achyut; Howard, Philip; Olson, Ewan; Perry, John D; Prendergast, Bernard D; Spry, Michael J; Steeds, Richard P; Tayebjee, Muzahir H; Watkin, Richard

    2015-02-01

    Infections related to implantable cardiac electronic devices (ICEDs), including pacemakers, implantable cardiac defibrillators and cardiac resynchronization therapy devices, are increasing in incidence in the USA and are likely to increase in the UK, because more devices are being implanted. These devices have both intravascular and extravascular components and infection can involve the generator, device leads and native cardiac structures or various combinations. ICED infections can be life-threatening, particularly when associated with endocardial infection, and all-cause mortality of up to 35% has been reported. Like infective endocarditis, ICED infections can be difficult to diagnose and manage. This guideline aims to (i) improve the quality of care provided to patients with ICEDs, (ii) provide an educational resource for all relevant healthcare professionals, (iii) encourage a multidisciplinary approach to ICED infection management, (iv) promote a standardized approach to the diagnosis, management, surveillance and prevention of ICED infection through pragmatic evidence-rated recommendations, and (v) advise on future research projects/audit. The guideline is intended to assist in the clinical care of patients with suspected or confirmed ICED infection in the UK, to inform local infection prevention and treatment policies and guidelines and to be used in the development of educational and training material by the relevant professional societies. The questions covered by the guideline are presented at the beginning of each section.

  8. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications.

  9. Joint Robotics Program

    Science.gov (United States)

    2008-04-23

    Åèìáëáíáçå= oÉëÉ~êÅÜ=póãéçëáìã= JOINT ROBOTICS PROGRAM Published: 23 April 2008 by Joel Brown and Paul Varian 5th Annual Acquisition Research...3. DATES COVERED 00-00-2008 to 00-00-2008 4. TITLE AND SUBTITLE Joint Robotics Program 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM...ëóåÉêÖó=Ñçê=áåÑçêãÉÇ=ÅÜ~åÖÉ=======- 464 - = = Joint Robotics Program Presenter: Joel Brown, Defense Acquisition University Author: Paul Varian

  10. Joints in steel buildings

    Directory of Open Access Journals (Sweden)

    Gabriel F. Valencia Clement

    2010-04-01

    Full Text Available Masonry and steel components used in constructing buildings are in a constant state of motion. Volumetric changes are produced by temperature variation and deformation resulting from static or dynamic loading and in some materials, such as masonry, due to moisture content. This article addresses means of determining when expansion and seismic joints are required and how to proportion and design appropriate joints, specifically in steel buildings. It does not cover the study of expansion joints in concrete structures, in masonry construction or in non-structural (architectural elements.

  11. Study of Endometrial Receptivity during Implantation in Implantation Dysfunction Mouse

    Institute of Scientific and Technical Information of China (English)

    Yan-juan LIU; Guang-ying HUANG; Ming-wei YANG; Fu-er LU

    2008-01-01

    Objective To establish the mice model of implantation dysfunction and to study the endometrial receptivity during implantation in implantation dysfunction mouse. Methods Sexually mature female virgin, Kunming mice were randomly assigned to the control group and the model group postcoitally. The model mice at 9 : 00 AM on d 4 of pregnancy(d 4) were injected subcutaneously with mifepristone. All animals were sacrificed at 9:00 PM on d 4 and their uterine horns were examined for the presence of implanted embryos. Histopathology of uterine endometrium was observed by light-microscope. The endometrial expressions of estrogen receptor (ER) and progesterone receptor (PR) assessed by immunnohistochemical SP method. The endometrial expressions of ER mRNA and PR mRNA were assessed by semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR).Results Compared with control group, implantation rates and average embryo number significently decreased in model group, the development of endometrium was inhibited. In model group, absorbency and area rate of ER and PR in the gland and stroma were lower than those in control group (P<0.05). Expressions of ER mRNA and PR mRNA in model uterus were significantly lower than those in the control.Conclusion The endometrial receptivity and implantation decreased in mifepristoneinduced implantation dysfunction mouse.

  12. A review of ceramic bearing materials in total joint arthroplasty.

    Science.gov (United States)

    Bal, B S; Garino, J; Ries, M; Rahaman, M N

    2007-01-01

    Bearings made of ceramics have ultra-low wear properties that make them suitable for total hip arthroplasty (THA) and total knee arthroplasty (TKA). When compared to cobalt chrome (CoCr)-on-polyethylene (PE) articulations, ceramics offer drastic reductions in bearing wear rates. Lower wear rates result in fewer wear particles produced by the articulating surfaces. In theory, this should reduce the risk of periprosthetic osteolysis and premature implant loosening, thereby contributing to the longevity of total joints. In addition to ceramics, other alternative bearing couples, such as highly cross-linked PE (XLPE) and metal-on-metal also offer less wear than CoCr-on-PE articulations in total joint arthroplasty. Alumina and zirconia ceramics are familiar to orthopaedic surgeons since both materials have been used in total joints for several decades. While not new in Europe, alumina-on-alumina ceramic total hips have only recently become available for widespread use in the United States from various orthopaedic implant manufacturers. As the search for the ideal total joint bearing material continues, composite materials of existing ceramics, metal-on-ceramic articulations, and new ceramic technologies will offer more choices to the arthroplasty surgeon. The objective of this paper is to present an overview of material properties, clinical applications, evolution, and limitations of ceramic materials that are of interest to the arthroplasty surgeon.

  13. The design and development of a finger joint simulator.

    Science.gov (United States)

    Joyce, Thomas J

    2016-05-01

    Artificial finger joints lack the long-term clinical success seen with hip and knee prostheses. In part, this can be explained by the challenges of rheumatoid arthritis, a progressive disease which attacks surrounding tissues as well as the joint itself. Therefore, the natural finger joints' biomechanics are adversely affected, and consequently, this imbalance due to subluxing forces further challenges any prosthesis. Many different designs of finger prosthesis have been offered over a period of greater than 50 years. Most of these designs have failed, and it is likely that many of these failures could have been identified had the prostheses been appropriately tested prior to implantation into patients. While finger joint simulators have been designed, arguably only those from a single centre have been able to reproduce clinical-type failures of the finger prostheses tested in them. This article describes the design and development of a finger simulator at Durham University, UK. It explains and justifies the engineering decisions made and thus the evolution of the finger simulator. In vitro results and their linkage to clinical-type failures are outlined to help to show the effectiveness of the simulator. Failures of finger implants in vivo continue to occur, and the need for appropriate in vitro testing of finger prostheses remains strong.

  14. REGENERATION OF ARTICULAR CARTILAGE UNDER THE IMPLANTATION OF BONE MATRIX

    Directory of Open Access Journals (Sweden)

    Yuri M. Iryanov, Nikolay A. Kiryanov, Olga V. Dyuriagina , Tatiana Yu. Karaseva, Evgenii A. Karasev

    2015-07-01

    Full Text Available Background: The damage or loss of articular cartilage is costly medical problem. The purpose of this work – morphological analysis of reparative chondrogenesis when implanted in the area of the knee joint cartilage of granulated mineralized bone matrix. Material and Methods: The characteristic features of the knee cartilage regeneration studied experimentally in pubertal Wistar rats after modeling a marginal perforated defect and implantation of granulated mineralized bone matrix obtained according to original technology without heat and demineralizing processing into the injury zone. Results: This biomaterial established to have pronounced chondro- and osteoinductive properties, and to provide prolonged activation of reparative process, accelerated organotypical remodeling and restoration of the articular cartilage injured. Conclusion: The data obtained demonstrate the efficacy of МВМ in clinical practice for the treatment of diseases and injuries of the articular cartilage.

  15. Stabilization of the sacroiliac joint.

    Science.gov (United States)

    Shaffrey, Christopher I; Smith, Justin S

    2013-07-01

    Lower back pain and pain involving the area of the posterior iliac spine are extremely common. Degeneration of the sacroiliac joint (SIJ) is one potential cause for lower back pain and pain radiating into the groin or buttocks. Degenerative changes to the lumbar spine and sacroiliac joints are common. A recent study evaluating SIJ abnormalities in a primary low back pain population demonstrated 31.7% of patients demonstrated SI joint abnormalities. (4) As is the case for the evaluation and management of isolated lower back pain, the evaluation, management, and role for surgical intervention in SIJ pain is very controversial. Many patients have degenerative changes of the disc, facet joints, and SIJs. A recent systematic review performed to determine the diagnostic accuracy of tests available to clinicians to identify the disc, facet joint, or SIJ as the source of low back pain concluded that tests do exist that change the probability of the disc or SIJ (but not the facet joint) as the source of low back pain. (3) It was also concluded that the usefulness of these tests in clinical practice, particularly for guiding treatment selection, remains unclear. (3) Although there is general agreement that SIJ pathological changes are a potential cause of pain, there is far less agreement about the optimal management of these conditions. A variety of conditions can cause SIJ dysfunction including degenerative and inflammatory arthritis, trauma, prior lumbosacral fusion, hip arthritis, limb length inequality, infections, and neoplasia. (8) There is increasing evidence that image intensifier-guided single periarticular injection can correctly localize pain to the SIJ but the optimal management strategy remains controversial. Recent publications have compared surgical versus injection treatments and fusion versus denervation procedures. (1 , 8) A systematic review found improvement regardless of the treatment, with most studies reporting over 40% improvement in pain as measured

  16. Temporomandibular joint ankylosis fixation technique with ultra thin silicon sheet

    Directory of Open Access Journals (Sweden)

    G S Kalra

    2011-01-01

    Full Text Available Background: Temporomandibular joint ankylosis is a highly distressing condition in which the joint space is obliterated by scar tissue and the patient has an inability to open the mouth. Different autogenous and alloplastic interposition materials have been used after the resection of the ankylotic bone to achieve desirable and long lasting results. The recurrence of disease is most distressing for both patients and surgeon. We have been using ultra thin silicon sheet as our preferred material for providing proper fixation and cover to the joint. We have been encouraged by good patient compliance, no implant extrusion and favourable outcome. Materials and Methods: The clinical study included 80 patients with temporomandibular joint ankylosis, treated between April 2001 and March 2009. In all patients, temporomandibular joint ankylosis had resulted following trauma. Diagnosis was based on clinical assessment supplemented by radiographic examination consisting of a panoramic radiograph, axial and coronal computer tomography. The technique of using ultra thin silicon sheet covering whole of the joint space fixed with non-absorbable nylon 3-0 suture both medially to medial pterygoid muscle and laterally to periosteum of zygomatic arch was employed in all patients. Results: A total of 80 patients were in this study (59 males and 21 females. The aetiology of temporomandibular joint ankylosis was post-traumatic in all cases. The patients′ age ranged from 5 to 45 years. The disease was unilateral in 61 cases and bilateral in 19 cases. Twelve patients, who had previous surgery done in the form of gap arthroplasty in 6 cases, costochondral graft in 4 cases and temporalis muscle in 2 cases, presented with recurrence on the same side. The pre-op inter-incisal mouth opening ranged from 4 to 12 mm. The intraoperative inter-incisal mouth opening ranged from 28 to 46 mm. An additional procedure was done in 13 patients, including placement of costochondral

  17. Joint Quantum Institute

    Data.gov (United States)

    Federal Laboratory Consortium — The Joint Quantum Institute (JQI) is pursuing that goal through the work of leading quantum scientists from the Department of Physics of the University of Maryland...

  18. Healthy Joints Matter

    Science.gov (United States)

    ... my joints more healthy? Definitions What can go wrong? Although you might think arthritis affects only older ... Discovery Into Health ® Home | Health Information | Research | Funding | News & Events | About Us | Portal en español | Asian-Language ...

  19. Improved orthopedic arm joint

    Science.gov (United States)

    Dane, D. H.

    1971-01-01

    Joint permits smooth and easy movement of disabled arm and is smaller, lighter and less expensive than previous models. Device is interchangeable and may be used on either arm at the shoulder or at the elbow.

  20. Osseointegration of titanium implants by addition of recombinant bone morphogenetic protein 2 (rhBMP-2)

    Energy Technology Data Exchange (ETDEWEB)

    Lichtinger, T.K.; Mueller, R.T.; Schuermann, N.; Oldenburg, M. [Essen Univ. (Germany). Dept. of Orthopaedic Surgery; Wiemann, M. [Inst. of Physiology, Univ. of Essen (Germany); Chatzinikolaidou, M.; Jennissen, H.P. [Inst. of Physiological Chemistry, Univ. of Essen (Germany); Rumpf, H.M.

    2001-12-01

    The osseointegration of long-term implants is often incomplete such that gaps remain between the implant surface and the surrounding hard tissue. This study examines the effect of soluble recombinant human bone morphogenic protein 2 (rhBMP-2) on gap healing and osseous integration. The effect of a single, intraoperative application of soluble rhBMP-2 on the formation of new bone around titanium implants was studied. A total of 8 titanium-alloy cylinders (Ti-6Al-4V) with a plasma spray coating (TPS; 400 {mu}m thickness) were implanted into femoral condyles of mature sheep: rhBMP-2 solution (1 {mu}g) was pipetted into the 1 mm wide cleft around 4 implants; 4 further implants served as rhBMP-2-free controls. Two of these controls exhibited an additional calciumphosphate-coating. The cleft around the implants served as testing zone to study the formation of new bone by microradiographical and histological analyses. The follow-up periods were 4 and 9 weeks, respectively. A significant amount of new bone contacting the implants' surface was detected where rhBMP-2-solution had been used: In 50% a circumferential osseoinduction occurred within 4 weeks and a nearly complete osseointegration was observed after 9 weeks. In all cases bone formation was exaggerated and filled the spongiosa with compact bone. Time matched TPS-controls and controls with calciumphosphate coating showed no notable formation of new bone. The results suggest that a single administration of soluble rhBMP-2 into a bone cavity can augment bone formation and also osseointegration of titanium implants. Further investigations based on these findings are necessary to develop long-term implants (e.g. joint replacements) with rhBMP-2-biocoating for humans. (orig.)

  1. Concrete Pavement Joint Deterioration

    OpenAIRE

    2016-01-01

    Concrete pavements are an important part of our national infrastructure. In recent years the relatively small number of reported joints deteriorating prematurely in concrete pavements around Indiana has increased. Changes over the past 45 years in INDOT specification, pavement materials, designs and construction practices, and current de-icing materials were examined and related to the durability of concrete at the joints of existing pavements. A survey of concrete pavements across the state ...

  2. Implant materials modified by colloids

    Directory of Open Access Journals (Sweden)

    Zboromirska-Wnukiewicz Beata

    2016-03-01

    Full Text Available Recent advances in general medicine led to the development of biomaterials. Implant material should be characterized by a high biocompatibility to the tissue and appropriate functionality, i.e. to have high mechanical and electrical strength and be stable in an electrolyte environment – these are the most important properties of bioceramic materials. Considerations of biomaterials design embrace also electrical properties occurring on the implant-body fluid interface and consequently the electrokinetic potential, which can be altered by modifying the surface of the implant. In this work, the surface of the implants was modified to decrease the risk of infection by using metal colloids. Nanocolloids were obtained using different chemical and electrical methods. It was found that the colloids obtained by physical and electrical methods are more stable than colloids obtained by chemical route. In this work the surface of modified corundum implants was investigated. The implant modified by nanosilver, obtained by electrical method was selected. The in vivo research on animals was carried out. Clinical observations showed that the implants with modified surface could be applied to wounds caused by atherosclerotic skeleton, for curing the chronic and bacterial inflammations as well as for skeletal reconstruction surgery.

  3. Biofilm Disrupting Technology on Orthopedic Implants: What’s on the Horizon?

    Directory of Open Access Journals (Sweden)

    Alexander eConnaughton

    2014-08-01

    Full Text Available The use of orthopedic implants in joints has revolutionized the treatment of patients with many debilitating chronic musculoskeletal diseases such as osteoarthritis. However, the introduction of foreign material into the human body predisposes the body to infection. The treatment of these infections has become very complicated since the orthopedic implants serve as a surface for multiple species of bacteria to grow at a time into a resistant biofilm layer. This biofilm layer serves as a protectant for the bacterial colonies on the implant making them more resistant and difficult to eradicate when using standard antibiotic treatment. In some cases the use of antibiotics alone has even made the bacteria more resistant to treatment. (1-2 Thus, there has been surge in the creation of non-antibiotic anti-biofilm agents to help disrupt the biofilms on the orthopedic implants to help eliminate the infections. In this study we discuss infections of orthopedic implants in the shoulder then we review the main categories of anti-biofilm agents that have been used for the treatment of infections on orthopedic implants. Then we introduce some of the newer biofilm disrupting technology that has been studied in the past few years that may advance the treatment options for orthopedic implants in the future.

  4. High pressure ceramic joint

    Science.gov (United States)

    Ward, Michael E.; Harkins, Bruce D.

    1993-01-01

    Many recuperators have components which react to corrosive gases and are used in applications where the donor fluid includes highly corrosive gases. These recuperators have suffered reduced life, increased service or maintenance, and resulted in increased cost. The present joint when used with recuperators increases the use of ceramic components which do not react to highly corrosive gases. Thus, the present joint used with the present recuperator increases the life, reduces the service and maintenance, and reduces the increased cost associated with corrosive action of components used to manufacture recuperators. The present joint is comprised of a first ceramic member, a second ceramic member, a mechanical locking device having a groove defined in one of the first ceramic member and the second ceramic member. The joint and the mechanical locking device is further comprised of a refractory material disposed in the groove and contacting the first ceramic member and the second ceramic member. The present joint mechanically provides a high strength load bearing joint having good thermal cycling characteristics, good resistance to a corrosive environment and good steady state strength at elevated temperatures.

  5. COCHLEAR IMPLANTATION PREVALENCE IN ELDERLY

    Directory of Open Access Journals (Sweden)

    A. V. Starokha

    2014-01-01

    Full Text Available Current paper describes an experience of cochlear implantation in elderly. Cochlear implantation has become a widely accepted intervention in the treatment of individuals with severe-to-profound sensorineural hearing loss. Cochlear implants are now accepted as a standard of care to optimize hearing and subsequent speech development in children and adults with deafness. But cochlear implantation affects not only hearing abilities, speech perception and speech production; it also has an outstanding impact on the social life, activities and self-esteem of each patient. The aim of this study was to evaluate the cochlear implantation efficacy in elderly with severe to profound sensorineural hearing loss. There were 5 patients under our observation. Surgery was performed according to traditional posterior tympanotomy and cochleostomy for cochlear implant electrode insertion for all observed patients. The study was conducted in two stages: before speech processor’s activation and 3 months later. Pure tone free field audiometry was performed to each patient to assess the efficiency of cochlear implantation in dynamics. The aim of the study was also to evaluate quality of life in elderly with severe to profound sensorineural hearing loss after unilateral cochlear implantation. Each patient underwent questioning with 36 Item Short Form Health Survey (SF-36. SF-36 is a set of generic, coherent, and easily administered quality-of-life measures. The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The eight sections are: physical functioning; physical role functioning; emotional role functioning; vitality; emotional well-being; social role functioning; bodily pain; general health perceptions. Our results demonstrate that cochlear implantation in elderly consistently improved quality of life

  6. Demineralized bone matrix and human cancellous bone enhance fixation of porous-coated titanium implants in sheep

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren

    2016-01-01

    Allogenic bone graft has been considered the gold standard in connection with bone graft material in revision joint arthroplasty. However, the lack of osteogenic potential and the risk of disease transmission are clinical challenges. The use of osteoinductive materials, such as demineralized bone...... of DBM alone, DBM with CB, or allograft on the fixation of porous-coated titanium implants. DBM100 and CB produced from human tissue were included. Both materials are commercially available. DBM granules are placed in pure DBM and do not contain any other carrier. Titanium alloy implants, 10 mm long × 10...... (gold standard), respectively. A standardized surgical procedure was used. At sacrifice 6 weeks after implantation, both distal femurs were harvested. The implant fixation was evaluated by mechanical push-out testing to test shear mechanical properties between implant and the host bone...

  7. Cluster Implantation and Deposition Apparatus

    DEFF Research Database (Denmark)

    Hanif, Muhammad; Popok, Vladimir

    2015-01-01

    In the current report, a design and capabilities of a cluster implantation and deposition apparatus (CIDA) involving two different cluster sources are described. The clusters produced from gas precursors (Ar, N etc.) by PuCluS-2 can be used to study cluster ion implantation in order to develop...... contributions to the theory of cluster stopping in matter as well as for practical applications requiring ultra-shallow implantation and modification of surfaces on the nanoscale. Metal clusters from the magnetron cluster source are of interest for the production of optical sensors to detect specific biological...

  8. A subcutaneous channeling probe for implanting long leads

    Science.gov (United States)

    Lund, G. F.; Simmonds, R. C.; Williams, B. A.

    1977-01-01

    The channeling probe described in the present paper was designed to overcome surgical problems of the type that were encountered when a multichannel radio transmitter had to be implanted in a cow. The probe was made of a flexible but sufficiently stiff 9.5-mm-diam nylon rod, consisting of 46-cm sections for convenience in sterilization and surgical handling. Stainless steel sleaves reinforced the threaded connecting joints. At one end, arrowhead-shaped channeling heads could be attached to produce wide channels for large sensors. The other end was tapered for narrow channels. Postoperative problems were not encountered in the use of this probe in cows, sheep, and dogs.

  9. Porous polymers for repair and replacement of the knee joint meniscus and articular cartilage

    NARCIS (Netherlands)

    Klompmaker, Jan

    1992-01-01

    The studies presented here were initiated to answer a variety of questions concerning firstly the repair and replacement of the knee joint meniscus and, secondly, the repair of full-thickness defects of articular cartilage. AIMS OF THE STUDIES I To assess the effect of implantation of a porous polym

  10. 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...

  11. 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...

  12. 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)...

  13. 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...

  14. 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...

  15. Proximal Tibiofibular Joint: An overview

    Directory of Open Access Journals (Sweden)

    Tze Wang Chan

    2016-06-01

    Full Text Available Proximal tibiofibular joint is a frequently neglected joint which can be a source of lateral knee pain. Open surgery is the current mainstay of surgical management of proximal tibiofibular joint disorders. The proximal tibiofibular arthroscopy allows access to the joint and adjacent important ligamentous structures. This forms the basis of further development of arthroscopic procedures for a variety of pathologies.

  16. An introduction to single implant abutments.

    LENUS (Irish Health Repository)

    Warreth, Abdulhadi

    2013-01-01

    This article is an introduction to single implant abutments and aims to provide basic information about abutments which are essential for all dental personnel who are involved in dental implantology. Clinical Relevance: This article provides a basic knowledge of implants and implant abutments which are of paramount importance, as replacement of missing teeth with oral implants has become a well-established clinical procedure.

  17. Immediate implant loading: A case report

    OpenAIRE

    Dhamankar, Dilip; Gupta, Arun R.; Mahadevan, Janani

    2010-01-01

    Dental implants have long provided an excellent treatment option to restore edentulous spaces. Successful formation of a direct bone to implant interface is the goal in implant therapy. Immediate loading is an alternative to two stage surgical procedure. Improved surgical instrumentation implants design, and surface topography changes the concept of two stages surgical to one stage surgical procedure.

  18. Occlusion on oral implants: current clinical guidelines.

    Science.gov (United States)

    Koyano, K; Esaki, D

    2015-02-01

    Proper implant occlusion is essential for adequate oral function and the prevention of adverse consequences, such as implant overloading. Dental implants are thought to be more prone to occlusal overloading than natural teeth because of the loss of the periodontal ligament, which provides shock absorption and periodontal mechanoreceptors, which provide tactile sensitivity and proprioceptive motion feedback. Although many guidelines and theories on implant occlusion have been proposed, few have provided strong supportive evidence. Thus, we performed a narrative literature review to ascertain the influence of implant occlusion on the occurrence of complications of implant treatment and discuss the clinical considerations focused on the overloading factors at present. The search terms were 'dental implant', 'dental implantation', 'dental occlusion' and 'dental prosthesis'. The inclusion criteria were literature published in English up to September 2013. Randomised controlled trials (RCTs), prospective cohort studies and case-control studies with at least 20 cases and 12 months follow-up interval were included. Based on the selected literature, this review explores factors related to the implant prosthesis (cantilever, crown/implant ratio, premature contact, occlusal scheme, implant-abutment connection, splinting implants and tooth-implant connection) and other considerations, such as the number, diameter, length and angulation of implants. Over 700 abstracts were reviewed, from which more than 30 manuscripts were included. We found insufficient evidence to establish firm clinical guidelines for implant occlusion. To discuss the ideal occlusion for implants, further well-designed RCTs are required in the future.

  19. Bone response to machined and resorbable blast material titanium implants: an experimental study in rabbits.

    Science.gov (United States)

    Piattelli, Maurizio; Scarano, Antonio; Paolantonio, Michele; Iezzi, Giovanna; Petrone, Giovanna; Piattelli, Adriano

    2002-01-01

    The aim of the present study was a comparison of implants' responses to a machined surface and to a surface sandblasted with hydroxyapatite (HA) particles (resorbable blast material [RBM]). Threaded machined and RBM, grade 3, commercially pure, titanium, screw-shaped inplants were used in this study. Twenty-four New Zealand white mature male rabbits were used. The inplants were inserted into the articular femoral knee joint according to a previously described technique. Each rabbit received 2 inplants, 1 test (RBM) and 1 control (machined). A total of 48 implants (24 control and 24 test) were inserted. The rabbits were anesthetized with intramuscular injections of fluanisone (0.7 mg/ kg body weight) and diazepam (1.5 mg/kg b.wt.), and local anesthesia was given using 1 mL of 2% lidocaine/adrenalin solution. Two rabbits died in the postoperative course. Four animals were euthanatized with an overdose of intravenous pentobarbital after 1, 2, 3, and 4 weeks; 6 rabbits were euthanatized after 8 weeks. A total of 44 implants were retrieved. The specimens were processed with the Precise 1 Automated System to obtain thin ground sections. A total of 3 slides were obtained for each implant. The slides were stained with acid and basic fuchsin and toluidine blue. The slides were observed in normal transmitted light under a Leitz Laborlux microscope, and histomorphometric analysis was performed. With the machined implants, it was possible to observe the presence of bone trabeculae near the implant surface at low magnification. At higher magnification many actively secreting alkaline phosphatasepositive (ALP+) osteoblasts were observed. In many areas, a not yet mineralized matrix was present. After 4 to 8 weeks, mature bone appeared in direct contact with the implant surface, but in many areas a not yet mineralized osteoid matrix was interposed between the mineralized bone and implant surface. In the RBM implants, many ALP+ osteoblasts were present and in direct contact with

  20. Nanometric Finishing on Biomedical Implants by Abrasive Flow Finishing

    Science.gov (United States)

    Subramanian, Kavithaa Thirumalai; Balashanmugam, Natchimuthu; Shashi Kumar, Panaghra Veeraiah

    2016-01-01

    Abrasive flow finishing (AFF) is a non-conventional finishing technique that offers better accuracy, efficiency, consistency, economy in finishing of complex/difficult to machine materials/components and provides the possibility of effective automation as aspired by the manufacturing sector. The present study describes the finishing of a hip joint made of ASTM grade Co-Cr alloy by Abrasive Flow Machining (AFM) process. The major input parameters of the AFF process were optimized for achieving nanometric finishing of the component. The roughness average (Ra) values were recorded during experimentation using surface roughness tester and the results are discussed in detail. The surface finished hip joints were characterized using Scanning Electron Microscopy (SEM), Atomic Force Microscopy (AFM) and residual stress analysis using X-Ray Diffraction (XRD). The discussion lays emphasis on the significance, efficacy and versatile nature of the AFF process in finishing of bio-medical implants.

  1. [Biomechanics of the ankle joint].

    Science.gov (United States)

    Zwipp, H

    1989-03-01

    According to Fick, the tree-dimensional patterns of foot motion are best characterized as jawlike movement. Anatomically and biomechanically, this process represents conjoined, synchronous motion within the three mobile segments of the hindfoot: the ankle joint, the posterior subtalar joint, and the anterior subtalar joint. Foot kinematics can be described more completely if the anterior subtalar joint is defined not only as the talocalcaneal navicular joint, but as including the calcaneocuboid joint, thus representing the transverse joint of the tarsus, i.e., the Chopart joint. The axes of these three joints can be defined precisely. In some parts they represent a screwlike motion, clockwise or counter-clockwise, around the central ligamentous structures (fibulotibial ligament, talocalcaneal interosseous ligament, bifurcate ligament). The individual anatomy and structure of these ligaments provide variations in the degree and direction of foot motion. A precise knowledge of foot kinematics is important in surgical ligament and joint reconstruction and in selective foot arthrodeses.

  2. Miniscrew implant applications in contemporary orthodontics.

    Science.gov (United States)

    Chang, Hong-Po; Tseng, Yu-Chuan

    2014-03-01

    The need for orthodontic treatment modalities that provide maximal anchorage control but with minimal patient compliance requirements has led to the development of implant-assisted orthodontics and dentofacial orthopedics. Skeletal anchorage with miniscrew implants has no patient compliance requirements and has been widely incorporated in orthodontic practice. Miniscrew implants are now routinely used as anchorage devices in orthodontic treatment. This review summarizes recent data regarding the interpretation of bone data (i.e., bone quantity and quality) obtained by preoperative diagnostic computed tomography (CT) or by cone-beam computed tomography (CBCT) prior to miniscrew implant placement. Such data are essential when selecting appropriate sites for miniscrew implant placement. Bone characteristics that are indications and contraindications for treatment with miniscrew implants are discussed. Additionally, bicortical orthodontic skeletal anchorage, risks associated with miniscrew implant failure, and miniscrew implants for nonsurgical correction of occlusal cant or vertical excess are reviewed. Finally, implant stability is compared between titanium alloy and stainless steel miniscrew implants.

  3. Joint ventures in medical services.

    Science.gov (United States)

    Rublee, D A

    1987-01-01

    This paper is an overview of joint-venture activity in healthcare, describing trends in joint ventures and raising issues for physicians. The purposes are to discuss the major current facets of joint-venture alliances in healthcare and to identify policy issues that arise from the trend to use joint ventures as an organizational tool. Speculation is made about the future role of joint ventures in the organization of healthcare.

  4. Simple facet joint repair with dynamic pedicular system: Technical note and case series

    Directory of Open Access Journals (Sweden)

    Ali Fahir Ozer

    2015-01-01

    Full Text Available Purpose: Facet joints are important anatomical structures for the stability of spine. Surgical or degenerative damage to a facet joint may lead to spinal instability and causes clinical problems. This article explains the importance of facet joints, reviews facet replacement systems, and describes a simple and effective method for facet replacement after surgical removal of facet joints. Materials and Methods: Ten patients were operated with the diagnosis of unilateral nerve root compression secondary to facet degeneration. The hypertrophic facet joints were removed with microsurgical techniques and the roots were decompressed. Then, a unilateral artificial facet joint was created using two hinged screws and a dynamic rod. Results: The clinical outcome of all the patients was determined good or excellent at second and last follow-up (mean 13.3 months controls using visual analog scale (VAS and Oswestry Disability Index (ODI scores. Radiological evaluations also demonstrated no implant-related complications. Conclusions: The authors suggest that, if removal of a facet joint is necessary to decompress the nerve roots, the joint can be replaced by a construct composed of two hinged screws connected by a dynamic rod. This simple system mimics the function of a normal facet joint and is an effective technique for unilateral facet joint replacement.

  5. Surgical Tooth Implants, Combat and Field.

    Science.gov (United States)

    1985-11-15

    placed over the top of the implant. Both anterior maxillary and posterior mandibular sites were included in this third group. I I 10 RESULTS Parametric...Twenty-nine patients ~ p 19. Abstract (Cont’d.) . .. .. were implanted/with posterior mandibular or anterior maxillary area implants. Eighteen or 62...placed flush with or below the alveolar crest. Twenty-nine patients were implanted with posterior mandibular or anterior maxillary area implants

  6. Implant rehabilitation in bruxism patient

    OpenAIRE

    Goiato, Marcelo Coelho; Sonego, Mariana Vilela; dos Santos, Daniela Micheline [UNESP; da Silva, Emily Vivianne Freitas

    2014-01-01

    A white female patient presented to the university clinic to obtain implant retained prostheses. She had an edentulous maxillary jaw and presented three teeth with poor prognosis (33, 34 and 43). The alveolar bone and the surrounding tissues were healthy. The patient did not report any relevant medical history contraindicating routine dental treatment or implant surgery, but self-reported a dental history of asymptomatic nocturnal bruxism. The treatment plan was set and two Branemark protocol...

  7. Analyzer-based imaging technique in tomography of cartilage and metal implants: A study at the ESRF

    Energy Technology Data Exchange (ETDEWEB)

    Coan, Paola [European Synchrotron Radiation Facility (ESRF), 6 rue Jules Horowitz, BP220, 38043 Grenoble (France)], E-mail: coan@esrf.fr; Mollenhauer, Juergen [Naturwissenschaftliches und Medizinisches Institut (NMI) an der Universitaet Tuebingen, Markwiesenstr. 55, D-72770 Reutlingen (Germany); TETEC AG, Aspenhaustr. 25, D-72770 Reutlingen (Germany); Department of Biochemistry, Rush University Medical Center, 1653 W. Congress Parkway, Chicago, IL 60612 (United States)], E-mail: Juergen.Mollenhauer@nmi.de; Wagner, Andreas [Department of Orthopaedics of the University of Jena, Rudolf-Elle-Hospital Eisenberg, Klosterlausnitzer Strasse 81, 07607 Eisenberg (Germany)], E-mail: a.wagner@krankenhaus-eisenberg.de; Muehleman, Carol [Department of Biochemistry, Rush University Medical Center, 1653 W. Congress Parkway, Chicago, IL 60612 (United States)], E-mail: carol_muehleman@rush.edu; Bravin, Alberto [European Synchrotron Radiation Facility (ESRF), 6 rue Jules Horowitz, BP220, 38043 Grenoble (France)], E-mail: bravin@esrf.fr

    2008-12-15

    Monitoring the progression of osteoarthritis (OA) and the effects of therapy during clinical trials is still a challenge for present clinical imaging techniques since they present intrinsic limitations and can be sensitive only in case of advanced OA stages. In very severe cases, partial or complete joint replacement surgery is the only solution for reducing pain and restoring the joint functions. Poor imaging quality in practically all medical imaging technologies with respect to joint surfaces and to metal implant imaging calls for the development of new techniques that are sensitive to stages preceding the point of irreversible damage of the cartilage tissue. In this scenario, X-ray phase contrast modalities could play an important role since they can provide improved contrast compared to conventional absorption radiography, with a similar or even reduced tissue radiation dose. In this study, the analyzer-based imaging (ABI), a technique sensitive to the X-ray refraction and permitting a high scatter rejection, has been successfully applied in vitro on excised human synovial joints and sheep implants. Pathological and healthy joints as well as metal implants have been imaged in projection and computed tomography ABI mode at high resolution and clinically compatible doses (<10 mGy). Volume rendering and segmentation permitted visualization of the cartilage from volumetric CT-scans. The results demonstrate that ABI can provide an unequivocal non-invasive diagnosis of the state of disease of the joint and be considered a new tool in orthopaedic research.

  8. Temporomandibular joint examination reviewed

    Directory of Open Access Journals (Sweden)

    L. Guarda Nardini

    2011-09-01

    Full Text Available The temporo-mandibular joint (TMJ it’s a joint closely related to the skull base, the spine, and the jaws; all these anatomical structures must be taken in consideration when evaluating pain involving the tmj. In order to detect patients affected by pathology or dysfunctions of the tmj, physical examination is of great value in orienting the diagnosis. Inspection must consider the symmetry of the body, the dental status and the type of occlusion. Palpation is a way to assess contractiont involving the muscles of the masticatory system and of the neck. Auscultation, based on articular noise provides means to determine whether we are dealing with degeneration of the joint or a dislocation of the intrarticular disc. In order to confirm the diagnosis obtained with the clinical evaluation, it’s useful to perform imaging techniques as opt, tomography and TC of the tmj and electromyokineosiography – index of the mandibular functionality and of the muscles status. MRI and dynamic MRI are among the non invasive exams which give the greatest amount of information, regarding the disc position and the joint degeneration. Arthroscopy is an invasive technique that allows early diagnosis of degeneration and is helpful to reveal early inflammatory processes of the joint.

  9. Temporomandibular joint disorders.

    Science.gov (United States)

    Buescher, Jennifer J

    2007-11-15

    Temporomandibular joint disorders are common in adults; as many as one third of adults report having one or more symptoms, which include jaw or neck pain, headache, and clicking or grating within the joint. Most symptoms improve without treatment, but various noninvasive therapies may reduce pain for patients who have not experienced relief from self-care therapies. Physical therapy modalities (e.g., iontophoresis, phonophoresis), psychological therapies (e.g., cognitive behavior therapy), relaxation techniques, and complementary therapies (e.g., acupuncture, hypnosis) are all used for the treatment of temporomandibular joint disorders; however, no therapies have been shown to be uniformly superior for the treatment of pain or oral dysfunction. Noninvasive therapies should be attempted before pursuing invasive, permanent, or semi-permanent treatments that have the potential to cause irreparable harm. Dental occlusion therapy (e.g., oral splinting) is a common treatment for temporomandibular joint disorders, but a recent systematic review found insufficient evidence for or against its use. Some patients with intractable temporomandibular joint disorders develop chronic pain syndrome and may benefit from treatment, including antidepressants or cognitive behavior therapy.

  10. Distal radioulnar joint injuries

    Directory of Open Access Journals (Sweden)

    Binu P Thomas

    2012-01-01

    Full Text Available Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint , forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments.The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis.

  11. Nanostructured Surfaces of Dental Implants

    Directory of Open Access Journals (Sweden)

    Stefano Sivolella

    2013-01-01

    Full Text Available The structural and functional fusion of the surface of the dental implant with the surrounding bone (osseointegration is crucial for the short and long term outcome of the device. In recent years, the enhancement of bone formation at the bone-implant interface has been achieved through the modulation of osteoblasts adhesion and spreading, induced by structural modifications of the implant surface, particularly at the nanoscale level. In this context, traditional chemical and physical processes find new applications to achieve the best dental implant technology. This review provides an overview of the most common manufacture techniques and the related cells-surface interactions and modulation. A Medline and a hand search were conducted to identify studies concerning nanostructuration of implant surface and their related biological interaction. In this paper, we stressed the importance of the modifications on dental implant surfaces at the nanometric level. Nowadays, there is still little evidence of the long-term benefits of nanofeatures, as the promising results achieved in vitro and in animals have still to be confirmed in humans. However, the increasing interest in nanotechnology is undoubted and more research is going to be published in the coming years.

  12. Ion implanted dielectric elastomer circuits

    Science.gov (United States)

    O'Brien, Benjamin M.; Rosset, Samuel; Anderson, Iain A.; Shea, Herbert R.

    2013-06-01

    Starfish and octopuses control their infinite degree-of-freedom arms with panache—capabilities typical of nature where the distribution of reflex-like intelligence throughout soft muscular networks greatly outperforms anything hard, heavy, and man-made. Dielectric elastomer actuators show great promise for soft artificial muscle networks. One way to make them smart is with piezo-resistive Dielectric Elastomer Switches (DES) that can be combined with artificial muscles to create arbitrary digital logic circuits. Unfortunately there are currently no reliable materials or fabrication process. Thus devices typically fail within a few thousand cycles. As a first step in the search for better materials we present a preliminary exploration of piezo-resistors made with filtered cathodic vacuum arc metal ion implantation. DES were formed on polydimethylsiloxane silicone membranes out of ion implanted gold nano-clusters. We propose that there are four distinct regimes (high dose, above percolation, on percolation, low dose) in which gold ion implanted piezo-resistors can operate and present experimental results on implanted piezo-resistors switching high voltages as well as a simple artificial muscle inverter. While gold ion implanted DES are limited by high hysteresis and low sensitivity, they already show promise for a range of applications including hysteretic oscillators and soft generators. With improvements to implanter process control the promise of artificial muscle circuitry for soft smart actuator networks could become a reality.

  13. The vestibular implant: Quo vadis?

    Directory of Open Access Journals (Sweden)

    Raymond eVan De Berg

    2011-08-01

    Full Text Available AbstractObjective: to assess the progress of the development of the vestibular implant and its feasibility short-term. Data sources: a search was performed in Pubmed, Medline and Embase. Key words used were vestibular prosth* and vestibular implant. The only search limit was language: English or Dutch. Additional sources were medical books, conference lectures and our personal experience with per-operative vestibular stimulation in patients selected for cochlear implantation.Study selection: all studies about the vestibular implant and related topics were included and evaluated by two reviewers. No study was excluded since every study investigated different aspects of the vestibular implant. Data extraction and synthesis: data was extracted by the first author from selected reports, supplemented by additional information, medical books conference lectures. Since each study had its own point of interest with its own outcomes, it was not possible to compare data of different studies. Conclusion: to use a basic vestibular implant in humans seems feasible in the very near future. Investigations show that electric stimulation of the canal nerves induces a nystagmus which corresponds to the plane of the canal which is innervated by the stimulated nerve branch. The brain is able to adapt to a higher baseline stimulation, while still reacting on a dynamic component. The best response will be achieved by a combination of the optimal stimulus (stimulus profile, stimulus location, precompensation, complemented by central vestibular adaptation. The degree of response will probably vary between individuals, depending on pathology and their ability to adapt.

  14. Retinal implants: a systematic review.

    Science.gov (United States)

    Chuang, Alice T; Margo, Curtis E; Greenberg, Paul B

    2014-07-01

    Retinal implants present an innovative way of restoring sight in degenerative retinal diseases. Previous reviews of research progress were written by groups developing their own devices. This systematic review objectively compares selected models by examining publications describing five representative retinal prostheses: Argus II, Boston Retinal Implant Project, Epi-Ret 3, Intelligent Medical Implants (IMI) and Alpha-IMS (Retina Implant AG). Publications were analysed using three criteria for interim success: clinical availability, vision restoration potential and long-term biocompatibility. Clinical availability: Argus II is the only device with FDA approval. Argus II and Alpha-IMS have both received the European CE Marking. All others are in clinical trials, except the Boston Retinal Implant, which is in animal studies. Vision restoration: resolution theoretically correlates with electrode number. Among devices with external cameras, the Boston Retinal Implant leads with 100 electrodes, followed by Argus II with 60 electrodes and visual acuity of 20/1262. Instead of an external camera, Alpha-IMS uses a photodiode system dependent on natural eye movements and can deliver visual acuity up to 20/546. Long-term compatibility: IMI offers iterative learning; Epi-Ret 3 is a fully intraocular device; Alpha-IMS uses intraocular photosensitive elements. Merging the results of these three criteria, Alpha-IMS is the most likely to achieve long-term success decades later, beyond current clinical availability.

  15. Explant analysis of the Biomet Magnum/ReCap metal-on-metal hip joint

    Science.gov (United States)

    Hunt, B. J.; Richardson, V. M.; Langton, D. J.; Smith, E.; Joyce, T. J.

    2017-01-01

    Objectives The high revision rates of the DePuy Articular Surface Replacement (ASR) and the DePuy ASR XL (the total hip arthroplasty (THA) version) have led to questions over the viability of metal-on-metal (MoM) hip joints. Some designs of MoM hip joint do, however, have reasonable mid-term performance when implanted in appropriate patients. Investigations into the reasons for implant failure are important to offer help with the choice of implants and direction for future implant designs. One way to assess the performance of explanted hip prostheses is to measure the wear (in terms of material loss) on the joint surfaces. Methods In this study, a coordinate measuring machine (CMM) was used to measure the wear on five failed cementless Biomet Magnum/ReCap/ Taperloc large head MoM THAs, along with one Biomet ReCap resurfacing joint. Surface roughness measurements were also taken. The reason for revision of these implants was pain and/or adverse reaction to metal debris (ARMD) and/or elevated blood metal ion levels. Results The mean wear rate of the articulating surfaces of the heads and acetabular components of all six joints tested was found to be 6.1 mm3/year (4.1 to 7.6). The mean wear rate of the femoral head tapers of the five THAs was 0.054 mm3/year (0.021 to 0.128) with a mean maximum wear depth of 5.7 µm (4.3 to 8.5). Conclusion Although the taper wear was relatively low, the wear from the articulating surfaces was sufficient to provide concern and was potentially large enough to have been the cause of failure of these joints. The authors believe that patients implanted with the ReCap system, whether the resurfacing prosthesis or the THA, should be closely monitored. Cite this article: S. C. Scholes, B. J. Hunt, V. M. Richardson, D. J. Langton, E. Smith, T. J. Joyce. Explant analysis of the Biomet Magnum/ReCap metal-on-metal hip joint. Bone Joint Res 2017;6:113–122. DOI: 10.1302/2046-3758.62.BJR-2016-0130.R2. PMID:28246095

  16. Estimating total knee replacement joint load ratios from kinematics.

    Science.gov (United States)

    Fitzpatrick, Clare K; Rullkoetter, Paul J

    2014-09-22

    Accurate prediction of loads acting at the joint in total knee replacement (TKR) patients is key to developing experimental or computational simulations which evaluate implant designs under physiological loading conditions. In vivo joint loads have been measured for a small number of telemetric TKR patients, but in order to assess device performance across the entire patient population, a larger patient cohort is necessary. This study investigates the accuracy of predicting joint loads from joint kinematics. Specifically, the objective of the study was to assess the accuracy of internal-external (I-E) and anterior-posterior (A-P) joint load predictions from I-E and A-P motions under a given compressive load, and to evaluate the repeatability of joint load ratios (I-E torque to compressive force (I-E:C), and A-P force to compressive force (A-P:C)) for a range of compressive loading profiles. A tibiofemoral finite element model was developed and used to simulate deep knee bend, chair-rise and step-up activities for five patients. Root-mean-square (RMS) differences in I-E:C and A-P:C load ratios between telemetric measurements and model predictions were less than 1.10e-3 Nm/N and 0.035 N/N for all activities. I-E:C and A-P:C load ratios were consistently reproduced regardless of the compressive force profile applied (RMS differences less than 0.53e-3 Nm/N and 0.010 N/N, respectively). When error in kinematic measurement was introduced to the model, joint load predictions were forgiving to kinematic measurement error when conformity between femoral and tibial components was low. The prevalence of kinematic data, in conjunction with the analysis presented here, facilitates determining the scope of A-P and I-E joint loading ratios experienced by the TKR population.

  17. Minimally Invasive Sacroiliac Joint Fusion: One-Year Outcomes in 40 Patients

    Directory of Open Access Journals (Sweden)

    Donald Sachs

    2013-01-01

    Full Text Available Background. SI joint pain is difficult to diagnose due to overlapping symptoms of the lumbar spine, and until recently, treatment options have been limited. The purpose of this retrospective study is to report on the safety and effectiveness of MIS SI joint arthrodesis using a series of triangular, porous plasma coated implants in patients refractory to conservative care. Methods. We report on the first 40 consecutive patients with one-year follow-up data that underwent MIS SI joint fusion with the iFuse Implant System (SI-BONE, Inc., San Jose, CA by a single surgeon. Medical charts were reviewed for demographics, perioperative metrics, complications, pain scores, and satisfaction. Results. Mean age was 58 years (range 30–81 and 75% of patients were female. Postoperative complications were minimal and included transient trochanteric bursitis (5%, facet joint pain (20%, and new low back pain (2.5%. There were no reoperations at one year. Mean pain score improved from 8.7 (1.5 SD at baseline to 0.9 (1.6 at 12 months, a 7.8-point improvement (P<.001. Patient satisfaction was very high. Conclusions. The results of this case series reveal that MIS SI joint fusion using the iFuse Implant System is a safe and effective treatment option in carefully selected patients.

  18. [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.

  19. Characterization of cell cultures in contact with different orthopedic implants biomaterials

    Science.gov (United States)

    Ouenzerfi, G.; Hannoun, A.; Hassler, M.; Brizuela, L.; Youjil, S.; Bougault, C.; Trunfio-Sfarghiu, A.-M.

    2016-08-01

    The aim of this study is to identify the role of biological and mechanical constraints (at the cellular level) surrounding living tissues (cartilage and bone) in the presence of different joint implant biomaterials. In this fact, cells cultures in the presence of different types of biomaterials (pyrolytic carbon, cobalt-Chromium, titanium) has been performed. These cell cultures were subjected to biological characterization tests and mechanical characterization. The obtained results correlate with the in vivo observations (a promotion of the creation of a neocartilagical tissue in contact with the Pyrolytic Carbon implants).

  20. Imaging of common breast implants and implant-related complications: A pictorial essay

    Directory of Open Access Journals (Sweden)

    Amisha T Shah

    2016-01-01

    Full Text Available The number of women undergoing breast implant procedures is increasing exponentially. It is, therefore, imperative for a radiologist to be familiar with the normal and abnormal imaging appearances of common breast implants. Diagnostic imaging studies such as mammography, ultrasonography, and magnetic resonance imaging are used to evaluate implant integrity, detect abnormalities of the implant and its surrounding capsule, and detect breast conditions unrelated to implants. Magnetic resonance imaging of silicone breast implants, with its high sensitivity and specificity for detecting implant rupture, is the most reliable modality to asses implant integrity. Whichever imaging modality is used, the overall aim of imaging breast implants is to provide the pertinent information about implant integrity, detect implant failures, and to detect breast conditions unrelated to the implants, such as cancer.

  1. Why are mini-implants lost: The value of the implantation technique!

    Science.gov (United States)

    Romano, Fabio Lourenço; Consolaro, Alberto

    2015-01-01

    The use of mini-implants have made a major contribution to orthodontic treatment. Demand has aroused scientific curiosity about implant placement procedures and techniques. However, the reasons for instability have not yet been made totally clear. The aim of this article is to establish a relationship between implant placement technique and mini-implant success rates by means of examining the following hypotheses: 1) Sites of poor alveolar bone and little space between roots lead to inadequate implant placement; 2) Different sites require mini-implants of different sizes! Implant size should respect alveolar bone diameter; 3) Properly determining mini-implant placement site provides ease for implant placement and contributes to stability; 4) The more precise the lancing procedures, the better the implant placement technique; 5) Self-drilling does not mean higher pressures; 6) Knowing where implant placement should end decreases the risk of complications and mini-implant loss. PMID:25741821

  2. Fabrication and evaluation of SixNy coatings for total joint replacements.

    Science.gov (United States)

    Olofsson, J; Pettersson, M; Teuscher, N; Heilmann, A; Larsson, K; Grandfield, K; Persson, C; Jacobson, S; Engqvist, H

    2012-08-01

    Wear particles from the bearing surfaces of joint implants are one of the main limiting factors for total implant longevity. Si(3)N(4) is a potential wear resistant alternative for total joint replacements. In this study, Si(x)N(y)-coatings were deposited on cobalt chromium-discs and Si-wafers by a physical vapour deposition process. The tribological properties, as well as surface appearance, chemical composition, phase composition, structure and hardness of these coatings were analysed. The coatings were found to be amorphous or nanocrystalline, with a hardness and coefficient of friction against Si(3)N(4) similar to that found for bulk Si(3)N(4). The low wear rate of the coatings indicates that they have a potential as bearing surfaces of joint replacements. The adhesion to the substrates remains to be improved.

  3. 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.

  4. Studies of welded joints

    Directory of Open Access Journals (Sweden)

    J. M. Krupa

    2010-07-01

    Full Text Available Studies of a welded joint were described. The joint was made as a result of the reconstruction of a truss and one of the possible means to make a repair. The studies were of a simulation character and were targeted at the detection of welding defects and imperfections thatshould be eliminated in a real structure. A model was designed and on this model the tests and examinations were carried out. The modelwas made under the same conditions as the conditions adopted for repair. It corresponded to the real object in shape and dimensions, and in the proposed technique of welding and welding parameters. The model was composed of five plates joined together with twelve beads.The destructive and non-destructive tests were carried out; the whole structure and the respective welds were also examined visually. Thedefects and imperfections in welds were detected by surface methods of inspection, penetration tests and magnetic particle flaw detection.The model of the welded joint was prepared by destructive methods, a technique that would never be permitted in the case of a realstructure. For the investigations it was necessary to cut out the specimens from the welded joint in direction transverse to the weld run. The specimens were subjected to metallographic examinations and hardness measurements. Additionally, the joint cross-section was examined by destructive testing methods to enable precise determination of the internal defects and imperfections. The surface methods were applied again, this time to determine the severity of welding defects. The analysis has proved that, fabricated under proper conditions and with parameters of the welding process duly observed, the welded joint has good properties and repairs of this type are possible in practice.

  5. The Pathology of Orthopedic Implant Failure Is Mediated by Innate Immune System Cytokines

    Directory of Open Access Journals (Sweden)

    Stefan Landgraeber

    2014-01-01

    Full Text Available All of the over 1 million total joint replacements implanted in the US each year are expected to eventually fail after 15–25 years of use, due to slow progressive subtle inflammation at the bone implant interface. This inflammatory disease state is caused by implant debris acting, primarily, on innate immune cells, that is, macrophages. This slow progressive pathological bone loss or “aseptic loosening” is a potentially life-threatening condition due to the serious complications in older people (>75 yrs of total joint replacement revision surgery. In some people implant debris (particles and ions from metals can influence the adaptive immune system as well, giving rise to the concept of metal sensitivity. However, a consensus of studies agrees that the dominant form of this response is due to innate reactivity by macrophages to implant debris where both danger (DAMP and pathogen (PAMP signalling elicit cytokine-based inflammatory responses. This paper discusses implant debris induced release of the cytokines and chemokines due to activation of the innate (and the adaptive immune system and the subsequent formation of osteolysis. Different mechanisms of implant-debris reactivity related to the innate immune system are detailed, for example, danger signalling (e.g., IL-1β, IL-18, IL-33, etc., toll-like receptor activation (e.g., IL-6, TNF-α, etc., apoptosis (e.g., caspases 3–9, bone catabolism (e.g., TRAP5b, and hypoxia responses (Hif1-α. Cytokine-based clinical and basic science studies are in progress to provide diagnosis and therapeutic intervention strategies.

  6. Transversely Compressed Bonded Joints

    DEFF Research Database (Denmark)

    Hansen, Christian Skodborg; Schmidt, Jacob Wittrup; Stang, Henrik

    2012-01-01

    The load capacity of bonded joints can be increased if transverse pressure is applied at the interface. The transverse pressure is assumed to introduce a Coulomb-friction contribution to the cohesive law for the interface. Response and load capacity for a bonded single-lap joint was derived using...... non-linear fracture mechanics. The results indicated a good correlation between theory and tests. Furthermore, the model is suggested as theoretical base for determining load capacity of bonded anchorages with transverse pressure, in externally reinforced concrete structures....

  7. Joint for deployable structures

    Science.gov (United States)

    Craighead, N. D., II; Preliasco, R. J.; Hult, T. D. (Inventor)

    1985-01-01

    A joint is described for connecting a pair of beams to pivot them between positions in alignment or beside one another, which is of light weight and which operates in a controlled manner. The joint includes a pair of fittings and at least one center link having opposite ends pivotally connected to opposite fittings and having axes that pass through centerplates of the fittings. A control link having opposite ends pivotally connected to the different fittings controls their relative orientations, and a toggle assemly holds the fittings in the deployed configuration wherein they are aligned. The fittings have stops that lie on one side of the centerplane opposite the toggle assembly.

  8. Materials for endosseous dental implants.

    Science.gov (United States)

    Wataha, J C

    1996-02-01

    The goal of placement of endosseous dental implants is to achieve osseointegration or biointegration of the bone with the implant. A wide variety of materials has been used for these implants, but only a few promote osseointegration and biointegration. Titanium and titanium alloy (Ti6A14V) have been the most widely used of these materials. The surface oxide of titanium appears to be central to the ability of this material to osseointegrate. The oxide limits dissolution of elements and promotes the deposition of biological molecules which allow bone to exist as close as 30 A to the surface of the implant. The details of the ultrastructure of the gap between the implant and bone remain undefined, and the consequences of elements which are released on the interface over time are not known. These areas of investigation are particularly important in defining the differences between commercially pure titanium implants and those made of titanium, aluminium and vanadium. The epithelial interface between the gingiva and titanium appears to contain many of the structural characteristics of the native tooth-gingiva interface, but details are still vague. The connective tissue interface with the titanium appears to be one of tightly fitting tissues rather than adhesion. Ceramic coatings appear to improve the ingrowth of bone and promote chemical integration of the implant with the bone. The characteristics of these coatings are complex and affect the bony response, but the mechanisms remain obscure. The degradation of the coatings is an issue of particular controversy. Progress in dental implantology is likely to continue as the interface between the material and bone is more clearly understood, and biological molecules and artificial tissues are developed.

  9. Development and application of biomimetic electrospun nanofibers in total joint replacement

    Science.gov (United States)

    Song, Wei

    Failure of osseointegration (direct anchorage of an implant by bone formation at the bone-implant surface) and implant infection (such as that caused by Staphylococcus aureus, S. aureus) are the two main causes of implant failure and loosening. There is a critical need for orthopedic implants that promote rapid osseointegration and prevent bacterial colonization, particularly when placed in bone compromised by disease or physiology of the patients. A better understanding of the key factors that influence cell fate decisions at the bone-implant interface is required. Our study is to develop a class of "bone-like" nanofibers (NFs) that promote osseointegration while preventing bacterial colonization and subsequent infections. This research goal is supported by our preliminary data on the preparation of coaxial electrospun NFs composed of polycaprolactone (PCL) and polyvinyl alcohol (PVA) polymers arranged in a core-sheath shape. The PCL/PVA NFs are biocompatible and biodegradable with appropriate fiber diameter, pore size and mechanical strength, leading to enhanced cell adhesion, proliferation and differentiation of osteoblast precursor cells. The objective is to develop functionalized "bone-like" PCL/PVA NFs matrix embedded with antibiotics (doxycycline (Doxy), bactericidal and anti-osteoclastic) on prosthesis surface. Through a rat tibia implantation model, the Doxy incorporated coaxial NFs has demonstrated excellent in promoting osseointegration and bacteria inhibitory efficacy. NFs coatings significantly enhanced the bonding between implant and bone remodeling within 8 weeks. The SA-induced osteomyelitis was prevented by the sustained release of Doxy from NFs. The capability of embedding numerous bio-components including proteins, growth factors, drugs, etc. enables NFs an effective solution to overcome the current challenged issue in Total joint replacement. In summary, we proposed PCL/PVA electrospun nanofibers as promising biomaterials that can be applied on

  10. Falha prematura em implantes orais = Early oral implant failures

    Directory of Open Access Journals (Sweden)

    Fadanelli, Alexandro Bianchi

    2005-01-01

    Full Text Available Atualmente, ainda há uma percentagem significativa de fracassos de implantes na prática clínica, causando transtorno para o profissional e para o paciente. O objetivo deste estudo foi avaliar a bibliografia disponível sobre o assunto, apresentar um caso clínico e discutir os aspectos relacionados aos insucessos na terapia com implantes ocorridos durante o período de osteointegração. A avaliação da literatura mostrou haverem múltiplos fatores possivelmente envolvidos nas falhas de implantes, sendo que através do estudo das falhas pode-se minimizar sua ocorrência

  11. Medical implants and methods of making medical implants

    Science.gov (United States)

    Shaw, Wendy J; Yonker, Clement R; Fulton, John L; Tarasevich, Barbara J; McClain, James B; Taylor, Doug

    2014-09-16

    A medical implant device having a substrate with an oxidized surface and a silane derivative coating covalently bonded to the oxidized surface. A bioactive agent is covalently bonded to the silane derivative coating. An implantable stent device including a stent core having an oxidized surface with a layer of silane derivative covalently bonded thereto. A spacer layer comprising polyethylene glycol (PEG) is covalently bonded to the layer of silane derivative and a protein is covalently bonded to the PEG. A method of making a medical implant device including providing a substrate having a surface, oxidizing the surface and reacting with derivitized silane to form a silane coating covalently bonded to the surface. A bioactive agent is then covalently bonded to the silane coating. In particular instances, an additional coating of bio-absorbable polymer and/or pharmaceutical agent is deposited over the bioactive agent.

  12. Joint Custody and Coparenting.

    Science.gov (United States)

    Sell, Kenneth D.

    Results are presented of an intensive search of U.S. newspapers and periodicals on the joint custody of children after divorce, where both parents have continued responsibility for parenting and where the children spend part of each week, month, or year with both of the parents. Areas of concern addressed by these materials include the following:…

  13. Jointness: A Selected Bibliography

    Science.gov (United States)

    2010-12-01

    Leavenworth: U.S. Army Combined Arms Center, Combat Studies Institute, 2008. 428pp. (UA25 .C55 2008) http://www.cgsc.edu/ carl /download/csipubs...SMARTbook: Guide to Joint, Multinational & Interagency Operations. 2nd ed., rev. Lakeland, FL: Lightning Press, 2009. 302pp. (U260 .W33 2009) Whittaker

  14. Keyed shear joints

    DEFF Research Database (Denmark)

    Hansen, Klaus

    This report gives a summary of the present information on the behaviour of vertical keyed shear joints in large panel structures. An attemp is made to outline the implications which this information might have on the analysis and design of a complete wall. The publications also gives a short...

  15. Jointness, A Selected Bibliography.

    Science.gov (United States)

    1997-02-01

    The Services’ Judge Advocates and Lawyers Move Toward the Next Century. Study Project. Car- lisle Barracks: US Army War College, 5 April 1993. 57pp...Shaping America’s Future Mili- tary." Parameters 24 (Winter 1994-1995): 19-29. Barlow, Jason B. "Interservice Rivalry in the Pacific." Joint Force

  16. Implant Optimisation for Primary Hip Replacement in Patients over 60 Years with Osteoarthritis: A Cohort Study of Clinical Outcomes and Implant Costs Using Data from England and Wales.

    Directory of Open Access Journals (Sweden)

    Simon S Jameson

    Full Text Available Hip replacement is one of the most commonly performed surgical procedures worldwide; hundreds of implant configurations provide options for femoral head size, joint surface material and fixation method with dramatically varying costs. Robust comparative evidence to inform the choice of implant is needed. This retrospective cohort study uses linked national databases from England and Wales to determine the optimal type of replacement for patients over 60 years undergoing hip replacement for osteoarthritis.Implants included were the commonest brand from each of the four types of replacement (cemented, cementless, hybrid and resurfacing; the reference prosthesis was the cemented hip procedure. Patient reported outcome scores (PROMs, costs and risk of repeat (revision surgery were examined. Multivariable analyses included analysis of covariance to assess improvement in PROMs (Oxford hip score, OHS, and EQ5D index (9159 linked episodes and competing risks modelling of implant survival (79,775 procedures. Cost of implants and ancillary equipment were obtained from National Health Service procurement data.EQ5D score improvements (at 6 months were similar for all hip replacement types. In females, revision risk was significantly higher in cementless hip prostheses (hazard ratio, HR = 2.22, p<0.001, when compared to the reference hip. Although improvement in OHS was statistically higher (22.1 versus 20.5, p<0.001 for cementless implants, this small difference is unlikely to be clinically important. In males, revision risk was significantly higher in cementless (HR = 1.95, p = 0.003 and resurfacing implants, HR = 3.46, p<0.001, with no differences in OHS. Material costs were lowest with the reference implant (cemented, range £1103 to £1524 and highest with cementless implants (£1928 to £4285. Limitations include the design of the study, which is intrinsically vulnerable to omitted variables, a paucity of long-term implant survival data (reflecting the

  17. Occlusal considerations for dental implant restorations.

    Science.gov (United States)

    Bergmann, Ranier H

    2014-01-01

    When placed, dental implants are put into an ever-changing oral environment in which teeth can continue to migrate. Yet, the implants themselves are ankylosed. This can lead to occlusal instability. Teeth may continue to erupt, leaving the implants in infraocclusion. Teeth may move mesially away from an implant, requiring modification to close an open contact point. Friction in the connection between teeth and implants can lead to intrusion of teeth and damage to the periodontal attachment apparatus. Implant occlusion with shallow incisal guidance minimizes lateral and tipping forces. Cross-arch stabilization allows the best distribution of occlusal forces. The choice of restorative materials influences long-term occlusal stability.

  18. Implantable biomedical devices on bioresorbable substrates

    Science.gov (United States)

    Rogers, John A; Kim, Dae-Hyeong; Omenetto, Fiorenzo; Kaplan, David L; Litt, Brian; Viventi, Jonathan; Huang, Yonggang; Amsden, Jason

    2014-03-04

    Provided herein are implantable biomedical devices, methods of administering implantable biomedical devices, methods of making implantable biomedical devices, and methods of using implantable biomedical devices to actuate a target tissue or sense a parameter associated with the target tissue in a biological environment. Each implantable biomedical device comprises a bioresorbable substrate, an electronic device having a plurality of inorganic semiconductor components supported by the bioresorbable substrate, and a barrier layer encapsulating at least a portion of the inorganic semiconductor components. Upon contact with a biological environment the bioresorbable substrate is at least partially resorbed, thereby establishing conformal contact between the implantable biomedical device and the target tissue in the biological environment.

  19. Implantes transcigomáticos

    Directory of Open Access Journals (Sweden)

    B. Fernández Ateca

    Full Text Available Los implantes cigomáticos, originariamente diseñados por Branemark en 1989, son implantes de cabeza en 45 grados, de 4'5 milímetros de diámetro en su parte más ancha, y que pueden medir entre 30 y 50 milímetros de longitud. Se insertan desde la parte palatina del proceso alveolar, siguiendo la cresta cigomática-alveolar hasta anclarse en el cuerpo del malar, y en el caso de pacientes maxilectomizados, entrando directamente en el cuerpo del malar. Estos implantes ofrecen una alternativa más al cirujano en el momento de planificar un tratamiento protésico-rehabilitador implantosoportado. Sobretodo, en aquellos pacientes con un maxilar superior atrófico en el que no se pueden realizar injertos óseos o estos han fracasado. El objetivo de este artículo es proponer el protocolo quirúrgico de colocación de los implantes trascigomáticos y revisar la literatura actual sobre la evolución clínica de estos implantes.

  20. Contact dermatitis after implantable cardiac defibrillator implantation for ventricular tachycardia.

    Science.gov (United States)

    Dogan, Pinar; Inci, Sinan; Kuyumcu, Mevlut Serdar; Kus, Ozgur

    2016-02-01

    Pacemaker contact sensitivity is a rare condition. Less than 30 reports of pacemaker skin reactions have been described. We report a 57-year-old woman who underwent an implantable cardiac defibrillator (ICD) implantation for ventricular tachycardia. A skin patch test was positive on almost all components of the pacemaker system. She was treated with topical corticosteroids and skin lesions resolved within 2 weeks. Because of widespread use of various devices, we will see this more often and therefore it is important to recognize this problem and its effective management.

  1. PROPERTIES OF DEFECTS AND IMPLANTS IN Mg+ IMPLANTED SILICON CARBIDE

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Weilin; Zhu, Zihua; Varga, Tamas; Bowden, Mark E.; Manandhar, Sandeep; Roosendaal, Timothy J.; Hu, Shenyang Y.; Henager, Charles H.; Kurtz, Richard J.; Wang, Yongqiang

    2013-09-25

    As a candidate material for fusion reactor designs, silicon carbide (SiC) under high-energy neutron irradiation undergoes atomic displacement damage and transmutation reactions that create magnesium as one of the major metallic products. The presence of Mg and lattice disorder in SiC is expected to affect structural stability and degrade thermo-mechanical properties that could limit SiC lifetime for service. We have initiated a combined experimental and computational study that uses Mg+ ion implantation and multiscale modeling to investigate the structural and chemical effects in Mg implanted SiC and explore possible property degradation mechanisms.

  2. Surgical Revision after Sacroiliac Joint Fixation or Fusion

    Science.gov (United States)

    Holt, Timothy

    2017-01-01

    Background Minimally invasive sacroiliac joint (SIJ) fusion has been shown to be safe and effective for the treatment of SIJ dysfunction. Multiple devices are available to perform SIJ fixation or fusion. Surgical revision rates after these procedures have not been directly compared. Methods We retrospectively identified all patients in our practice who underwent SIJ fixation or fusion between 2003 and 2015. Using both chart review and focused contact with individual patients, we determined the likelihood of surgical revision. Revision rates were compared using Kaplan-Meier survival analysis. Results Thirty-eight patients underwent SIJ fixation with screws and 274 patients underwent SIJ fusion using triangular titanium implants. Four-year cumulative revision rates were 30.8% for fixation and 5.7% for fusion. Conclusions In our study, SIJ fixation with screws had a much higher revision rate compared to SIJ fusion with triangular titanium implants designed for bone adherence.

  3. One year successful outcomes for novel sacroiliac joint arthrodesis system

    Directory of Open Access Journals (Sweden)

    Sachs Donald

    2012-12-01

    Full Text Available Abstract Background SI joint pain can mimic discogenic low back pain or even radicular pain. Patient presentations vary considerably and conditions may include low back, groin, and/or radicular pain, leading to the potential for inaccurate diagnosis and treatment. Despite the large number of patients with SI joint pain, treatment options have been limited to conservative care involving physical therapy and joint injections, radiofrequency rhizotomy, or traditional open SI joint arthrodesis surgery. The purpose of this retrospective study is to evaluate the safety and effectiveness of MIS SI joint arthrodesis via an ileosacral approach in patients refractory to conservative care. Methods We report on the first 11 consecutive patients treated with a novel MIS SI joint fusion system by a single surgeon. Medical charts were reviewed for perioperative metrics and baseline pain scores recorded using a 0-10 numerical rating scale. Results Ninety one percent (91% of patients were female and the average patient age was 65 years (range 45-82. Mean baseline pain score (SD was 7.9 (± 2.2. Mean pain score at the 12 month follow up interval was 2.3 (±3.1, resulting in an average improvement of 6.2 points from baseline, representing a clinically and statistically significant (p=0.000 improvement. Patient satisfaction was very high with 100% indicating that they would have the same surgery again for the same result. Conclusions The results of this small case series illustrate the safety and effectiveness of minimally invasive SI joint fusion using a series of triangular porous plasma coated titanium implants in carefully selected patients. Larger multi centered studies are warranted.

  4. Micromotion of Dental Implants: Basic Mechanical Considerations

    Directory of Open Access Journals (Sweden)

    Werner Winter

    2013-01-01

    Full Text Available Micromotion of dental implants may interfere with the process of osseointegration. Using three different types of virtual biomechanical models, varying contact types between implant and bone were simulated, and implant deformation, bone deformation, and stress at the implant-bone interface were recorded under an axial load of 200 N, which reflects a common biting force. Without friction between implant and bone, a symmetric loading situation of the bone with maximum loading and displacement at the apex of the implant was recorded. The addition of threads led to a decrease in loading and displacement at the apical part, but loading and displacement were also observed at the vertical walls of the implants. Introducing friction between implant and bone decreased global displacement. In a force fit situation, load transfer predominantly occurred in the cervical area of the implant. For freshly inserted implants, micromotion was constant along the vertical walls of the implant, whereas, for osseointegrated implants, the distribution of micromotion depended on the location. In the cervical aspect some minor micromotion in the range of 0.75 μm could be found, while at the most apical part almost no relative displacement between implant and bone occurred.

  5. Ion implantation of superhard ceramic cutting tools

    Science.gov (United States)

    Chou, Y. Kevin; Liu, Jie

    2004-08-01

    Despite numerous reports of tool life increase by ion implantation in machining operations, ion implantation applications of cutting tools remain limited, especially for ceramic tools. Mechanisms of tool-life improvement by implantation are not clearly established due to complexity of both implantation and tool-wear processes. In an attempt to improve performance of cubic boron nitride (CBN) tools for hard machining by ion implantation, a literature survey of ion-implanted cutting tools was carried out with a focus on mechanisms of tool-wear reduction by ion implantation. Implantation and machining experiments were then conducted to investigate implantation effects on CBN tools in hard machining. A batch of CBN tools was implanted with nitrogen ions at 150 keV and 2.5×1017 ions/cm2 and further used to cut 61 HRc AISI 52100 steel at different conditions. Results show that ion implantation has strong effects on partsurface finish, moderate effect on cutting forces, but an insignificant impact on tool wear. Friction coefficients, estimated from measured cutting forces, are possibly reduced by ion implantation, which may improve surface finish. However, surprisingly, 2-D orthogonal cutting to evaluate tribological loading in hard machining showed no difference on contact stresses and friction coefficients between implanted and nonimplanted CBN tools.

  6. Implant rehabilitation in bruxism patient

    Science.gov (United States)

    Goiato, Marcelo Coelho; Sonego, Mariana Vilela; dos Santos, Daniela Micheline; da Silva, Emily Vivianne Freitas

    2014-01-01

    A white female patient presented to the university clinic to obtain implant retained prostheses. She had an edentulous maxillary jaw and presented three teeth with poor prognosis (33, 34 and 43). The alveolar bone and the surrounding tissues were healthy. The patient did not report any relevant medical history contraindicating routine dental treatment or implant surgery, but self-reported a dental history of asymptomatic nocturnal bruxism. The treatment plan was set and two Branemark protocols supported by six implants in each arch were installed after a 6-month healing period. A soft occlusal splint was made due to the patient's history of bruxism, and the lack of its use by the patient resulted in an acrylic fracture. The prosthesis was repaired and the importance of using the occlusal splint was restated. In the 4-year follow-up no fractures were reported. PMID:24907215

  7. Tinting of intraocular lens implants

    Energy Technology Data Exchange (ETDEWEB)

    Zigman, S.

    1982-06-01

    Intraocular lens (IOL) implants of polymethyl methacrylate (PMMA) lack an important yellow pigment useful as a filter in the visual process and in the protection of the retina from short-wavelength radiant energy. The ability to produce a yellow pigment in the PMMA used in IOL implants by exposure to near-ultraviolet (UV) light was tested. It was found that the highly cross-linked material in Copeland lens blanks was tinted slightly because of this exposure. The absorptive properties of lens blanks treated with near-UV light in this way approached that of the absorptive properties of human lenses. This finding shows that it is possible to alter IOL implants simply so as to induce a pale-yellow pigment in them to improve the visual process and to protect the retinas of IOL users.

  8. Surgical Complications of Cochlear Implantation

    Directory of Open Access Journals (Sweden)

    Basir Hashemi

    2010-03-01

    Full Text Available Cochlear implantation is a method used for the treatment ofpatients with profound hearing loss. This procedure may theaccompanied by some major or minor complications. Weevaluated the surgical complications of cochlear implantationin Fars province (south of Iran. A total of 150 patients withcochlear implantation were enrolled in the present study. Mostof the patients were pre-lingual children and most of our deviceswere nucleus prosthesis. We had three device failuresand four major complications, including one misplaced electrode,one case of meningitis, one case of foreign body reactionto suture and one case with extensive hematoma. Thesecomplications were managed successfully by surgical interventionor re-implantation. Facial nerve damage or woundbreakdown was not seen. Minor complications including smallhematoma, edema, stitch infection and dizziness were found in15 cases, which were managed medically. In our center, therate of minor complications was comparable to other centersin the world. But the rate of major surgical complications waslower than other centers.

  9. MRI of orbital hydroxyapatite implants

    Energy Technology Data Exchange (ETDEWEB)

    Flanders, A.E. [Dept. of Radiology, Thomas Jefferson Univ. Hospital, Philadelphia, PA (United States); De Potter, P. [Dept. of Ophthalmology, Wills Eye Inst., Philadelphia, PA (United States); Rao, V.M. [Dept. of Radiology, Thomas Jefferson Univ. Hospital, Philadelphia, PA (United States); Tom, B.M. [Dept. of Radiology, Thomas Jefferson Univ. Hospital, Philadelphia, PA (United States); Shields, C.L. [Dept. of Ophthalmology, Wills Eye Inst., Philadelphia, PA (United States); Shields, J.A. [Dept. of Ophthalmology, Wills Eye Inst., Philadelphia, PA (United States)

    1996-04-01

    Our aim was to use MRI for the postsurgical assessment of a new form of integrated orbital implant composed of a porous calcium phosphate hydroxyapatite substrate. We studied ten patients 24-74 years of age who underwent enucleation and implantation of a hydroxyapatite ball; 5-13 months after surgery, each patient was examined by spin-echo MRI, with fat suppression and gadolinium enhancement. Fibrovascular ingrowth was demonstrated in all ten patients as areas of enhancement at the periphery of the hydroxyapatite sphere that extended to the center to a variable degree. The radiologist should aware of the MRI appearances of the coralline hydroxyapatite orbital implant since it is now widely used following enucleation. MRI is a useful means to determine successful incorporation of the substrate into the orbital tissues. The normal pattern of contrast enhancement should not be mistaken for recurrent tumor or infection. (orig.)

  10. Carbon Fiber Biocompatibility for Implants

    Directory of Open Access Journals (Sweden)

    Richard Petersen

    2016-01-01

    Full Text Available Carbon fibers have multiple potential advantages in developing high-strength biomaterials with a density close to bone for better stress transfer and electrical properties that enhance tissue formation. As a breakthrough example in biomaterials, a 1.5 mm diameter bisphenol-epoxy/carbon-fiber-reinforced composite rod was compared for two weeks in a rat tibia model with a similar 1.5 mm diameter titanium-6-4 alloy screw manufactured to retain bone implants. Results showed that carbon-fiber-reinforced composite stimulated osseointegration inside the tibia bone marrow measured as percent bone area (PBA to a great extent when compared to the titanium-6-4 alloy at statistically significant levels. PBA increased significantly with the carbon-fiber composite over the titanium-6-4 alloy for distances from the implant surfaces of 0.1 mm at 77.7% vs. 19.3% (p < 10−8 and 0.8 mm at 41.6% vs. 19.5% (p < 10−4, respectively. The review focuses on carbon fiber properties that increased PBA for enhanced implant osseointegration. Carbon fibers acting as polymer coated electrically conducting micro-biocircuits appear to provide a biocompatible semi-antioxidant property to remove damaging electron free radicals from the surrounding implant surface. Further, carbon fibers by removing excess electrons produced from the cellular mitochondrial electron transport chain during periods of hypoxia perhaps stimulate bone cell recruitment by free-radical chemotactic influences. In addition, well-studied bioorganic cell actin carbon fiber growth would appear to interface in close contact with the carbon-fiber-reinforced composite implant. Resulting subsequent actin carbon fiber/implant carbon fiber contacts then could help in discharging the electron biological overloads through electrochemical gradients to lower negative charges and lower concentration.

  11. Long-Acting Reversible Contraception (LARC): IUD and Implant

    Science.gov (United States)

    ... of use of the IUD? • What is the birth control implant? • How does the birth control implant work? • What are the benefits of the birth control implant? • How is the birth control implant inserted? • ...

  12. Sound localization ability of young children with bilateral cochlear implants.

    NARCIS (Netherlands)

    Beijen, J.W.; Snik, A.F.M.; Mylanus, E.A.M.

    2007-01-01

    OBJECTIVE: To evaluate the benefit of bilateral cochlear implantation in young children. STUDY DESIGN: Clinical trial comparing a group of bilaterally implanted children with a group of unilaterally implanted children. SETTING: Tertiary referral center. PATIENTS: Five bilaterally implanted children

  13. Radioactive implants for medical applications; Radioaktive Implantate fuer medizinische Anwendungen

    Energy Technology Data Exchange (ETDEWEB)

    Schubert, M.

    2008-07-01

    The long-term success of surgery is often diminished by excessive wound healing, which makes another intervention necessary. Locally applied radionuclides with short range radiation can prevent such benign hyperproliferation. As pure electron emitter with a half-life of 14.3 days and a mean energy of 694.9 keV (E{sub max}=1710.48 keV) {sup 32}P is a suitable radionuclide which can be produced from the stable {sup 31}P by the capture of thermal neutrons (1 x 10{sup 14} /s/cm{sup 2}) in a nuclear reactor. After a typical irradiation time (14 days) the ratio of {sup 32}P to {sup 31}P is 1.4 x 10{sup -5} to 1. Implants made of polymer and/or bioabsorbable material functioning as a carrier of the radioactive emitter allow - as opposed to metallic implants - for new applications for this type of radiotherapy. In this thesis a manufacturing method for previously not available organic, radioactive implants has been developed and a corresponding dosimetry system has been established. By means of ion implantation, {sup 32}P ions with up to 180 keV can be shot some 100 nm deep into organic implant materials. For a typical dose (15 Gy over 7 days, 1 mm distance from the implant) an activity of 75 kBq is needed corresponding to 1.3 x 10{sup 11} {sup 32}P ions. The sputter ion gun, which has been optimized for this application, creates an ion beam with high beam current (> 14 {mu}A P{sup -}) and low emittance (< 4 {pi} mm mrad {radical}(MeV)). Because of the good beam quality also small implants (<1 mm{sup 2}) can be manufactured with high efficiency. The unintentionally co-implanted portion of molecules and nuclides of the same mass (e.g. {sup 31}PH, {sup 16}O{sub 2} and {sup 32}S) could be reduced from approximately 500 to 50 by an improvement of the isotope selection at {sup 32}P beam creation. Hence, in comparison with the best hitherto existing implantation methods, the radiation dose of the implant could be reduced by an order of magnitude. With regard to the beta

  14. Who Needs an Implantable Cardioverter Defibrillator?

    Science.gov (United States)

    ... this page from the NHLBI on Twitter. Who Needs an Implantable Cardioverter Defibrillator? Implantable cardioverter defibrillators (ICDs) ... before. Some people who have heart failure may need a CRT-D device. This device combines a ...

  15. Neutrophil Responses to Sterile Implant Materials.

    Directory of Open Access Journals (Sweden)

    Siddharth Jhunjhunwala

    Full Text Available In vivo implantation of sterile materials and devices results in a foreign body immune response leading to fibrosis of implanted material. Neutrophils, one of the first immune cells to be recruited to implantation sites, have been suggested to contribute to the establishment of the inflammatory microenvironment that initiates the fibrotic response. However, the precise numbers and roles of neutrophils in response to implanted devices remains unclear. Using a mouse model of peritoneal microcapsule implantation, we show 30-500 fold increased neutrophil presence in the peritoneal exudates in response to implants. We demonstrate that these neutrophils secrete increased amounts of a variety of inflammatory cytokines and chemokines. Further, we observe that they participate in the foreign body response through the formation of neutrophil extracellular traps (NETs on implant surfaces. Our results provide new insight into neutrophil function during a foreign body response to peritoneal implants which has implications for the development of biologically compatible medical devices.

  16. Achieving joint benefits from joint implementation

    Energy Technology Data Exchange (ETDEWEB)

    Moomaw, W.R. [Tufts Univ., Medford, MA (United States)

    1995-11-01

    Joint Implementation (JI) appears to have been born with Applied Energy Services Guatemala project in 1988. That project, to plant 52 million trees, protect existing forests from cutting and fire, and enhance rural development, is being implemented by CARE Guatemala to offset 120 per cent of the emissions of a small coal burning power plant that has been built in Connecticut. Since that time, several utilities and governments have initiated additional projects. Not all of these necessarily consist of tree planting in other countries, but may consist of energy efficiency or energy conservation programs designed to reduce carbon emissions by at least as much as the additional releases from a new facility. All JI projects share the characteristic of linking the release of greenhouse gases in an industrial country with an offset that reduces or absorbs a comparable amount in another country. The emitter in the industrial country is willing to pay for the reduction elsewhere because costs are less than they would be at home.

  17. Demineralized bone matrix and human cancellous bone enhance fixation of titanium implants

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren

    Denmark, DenmarkAbstractReplacement of extensive local bone loss especially in revision joint arthroplasty and spine fusion is a significant clinical challenge. Allograft and autograft have been considered as gold standard for bone replacement. However, there are several disadvantages such as donor site...... from human tissue were included (IsoTis OrthoBiologics, Inc. USA). Both materials are commercially available. Titanium alloy implants (Biomet Inc.) of 10 mm in length and 10 mm in diameter were inserted bilaterally into the femoral condyles of 8 skeletally mature sheep. Thus four implants...... with a concentric gap of 2 mm were implanted in each sheep. The gap was filled with: DBM; DBM/CB with ratio of 1/3; DBM/allograft with ratio of 1/3; or allograft (Gold standard), respectively. Standardised surgical procedure was used1. At sacrifice, 6 weeks after surgery, both distal femurs were harvested...

  18. Hip arthroplasty for treatment of advanced osteonecrosis: comprehensive review of implant options, outcomes and complications

    Directory of Open Access Journals (Sweden)

    Waewsawangwong W

    2016-06-01

    Full Text Available Warit Waewsawangwong, Pirapat Ruchiwit, James I Huddleston, Stuart B Goodman Department of Orthopedic Surgery, Stanford University, Stanford, CA, USA Abstract: Surgical treatment for late stage (post-collapse osteonecrosis of the femoral head is controversial. In these situations, the outcome of joint preservation procedures is poor. There are several arthroplasty options for late-stage disease. The clinical outcomes of hemiarthroplasty and hemiresurfacing are unpredictable because of progressive acetabular cartilage degeneration. Total hip resurfacing may be associated with further vascular insult to the femoral head and early failure of the implant. Total hip replacement with metal-on-conventional polyethylene bearing surfaces has been the gold standard, but implant survivorship is limited in young active patients due to wear and osteolysis. Newer alternative bearing surfaces may have improved wear characteristics, but their durability must be confirmed in longer-term studies. Keywords: hip arthroplasty, advanced osteonecrosis, implant options, outcomes, complications

  19. Randomised controlled trial of extraarticular gold bead implantation for treatment of knee osteoarthritis: a pilot study

    DEFF Research Database (Denmark)

    Nejrup, Kirsten; Olivarius, Niels de Fine; Jacobsen, Judith L.

    2008-01-01

    The primary objective of this double-blind, randomised, controlled trial was to determine if implanting gold beads at five acupuncture points around the knee joint improves 1-year outcomes for patients with osteoarthritis (OA) of the knee. Participants were 43 adults aged 18-80 years with pain...... and stiffness from non-specific OA of the knee for over a year. The intervention was blinded implantation of gold beads at five acupuncture points around the affected knee through a hypodermic needle, or needle insertion alone. Primary outcome measures were knee pain, stiffness and function assessed...... acupuncture had greater relative improvements in self-assessed outcomes. The treatment was well tolerated. This 1-year pilot study indicates that extraarticular gold bead implantation is a promising treatment modality for patients with OA of the knee. The new treatment should be tested in a larger trial...

  20. Impact of cone-beam computed tomography on implant planning and on prediction of implant size

    Energy Technology Data Exchange (ETDEWEB)

    Pedroso, Ludmila Assuncao de Mello; Silva, Maria Alves Garcia Santos, E-mail: ludmilapedroso@hotmail.com [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Fac. de Odontologia; Garcia, Robson Rodrigues [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Fac. de Odontologia. Dept. de Medicina Oral; Leles, Jose Luiz Rodrigues [Universidade Paulista (UNIP), Goiania, GO (Brazil). Fac. de Odontologia. Dept. de Cirurgia; Leles, Claudio Rodrigues [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Fac. de Odontologia. Dept. de Prevencao e Reabilitacao Oral

    2013-11-15

    The aim was to investigate the impact of cone-beam computed tomography (CBCT) on implant planning and on prediction of final implant size. Consecutive patients referred for implant treatment were submitted to clinical examination, panoramic (PAN) radiography and a CBCT exam. Initial planning of implant length and width was assessed based on clinical and PAN exams, and final planning, on CBCT exam to complement diagnosis. The actual dimensions of the implants placed during surgery were compared with those obtained during initial and final planning, using the McNemmar test (p < 0.05). The final sample comprised 95 implants in 27 patients, distributed over the maxilla and mandible. Agreement in implant length was 50.5% between initial and final planning, and correct prediction of the actual implant length was 40.0% and 69.5%, using PAN and CBCT exams, respectively. Agreement in implant width assessment ranged from 69.5% to 73.7%. A paired comparison of the frequency of changes between initial or final planning and implant placement (McNemmar test) showed greater frequency of changes in initial planning for implant length (p < 0.001), but not for implant width (p = 0.850). The frequency of changes was not influenced by implant location at any stage of implant planning (chi-square test, p > 0.05). It was concluded that CBCT improves the ability of predicting the actual implant length and reduces inaccuracy in surgical dental implant planning. (author)

  1. Effect of Implantation Machine Parameters on N+ ion Implantation for Upland Cotton (Gossypium hirsutum L.) Pollen

    Institute of Scientific and Technical Information of China (English)

    YUE Jieyu; YU Lixiang; WU Yuejin; TANG Canming

    2008-01-01

    Effect of parameters of ion implantation machine,including ion energy,total dose,dose rate,impulse energy and implantation interval on the pollen grains of upland cotton implanted with nitrogen ion beam were studied.The best parameters were screened out.The results also showed that the vacuum condition before the nitrogen ion implantation does not affect the pollen viability.

  2. Surface Functionalization of Orthopedic Titanium Implants with Bone Sialoprotein.

    Directory of Open Access Journals (Sweden)

    Andreas Baranowski

    Full Text Available Orthopedic implant failure due to aseptic loosening and mechanical instability remains a major problem in total joint replacement. Improving osseointegration at the bone-implant interface may reduce micromotion and loosening. Bone sialoprotein (BSP has been shown to enhance bone formation when coated onto titanium femoral implants and in rat calvarial defect models. However, the most appropriate method of BSP coating, the necessary level of BSP coating, and the effect of BSP coating on cell behavior remain largely unknown. In this study, BSP was covalently coupled to titanium surfaces via an aminosilane linker (APTES, and its properties were compared to BSP applied to titanium via physisorption and untreated titanium. Cell functions were examined using primary human osteoblasts (hOBs and L929 mouse fibroblasts. Gene expression of specific bone turnover markers at the RNA level was detected at different intervals. Cell adhesion to titanium surfaces treated with BSP via physisorption was not significantly different from that of untreated titanium at any time point, whereas BSP application via covalent coupling caused reduced cell adhesion during the first few hours in culture. Cell migration was increased on titanium disks that were treated with higher concentrations of BSP solution, independent of the coating method. During the early phases of hOB proliferation, a suppressive effect of BSP was observed independent of its concentration, particularly when BSP was applied to the titanium surface via physisorption. Although alkaline phosphatase activity was reduced in the BSP-coated titanium groups after 4 days in culture, increased calcium deposition was observed after 21 days. In particular, the gene expression level of RUNX2 was upregulated by BSP. The increase in calcium deposition and the stimulation of cell differentiation induced by BSP highlight its potential as a surface modifier that could enhance the osseointegration of orthopedic implants

  3. Laundry joint venture.

    Science.gov (United States)

    Giancola, D; Voyvodich, M

    1984-12-01

    Many hospitals are concerned about the loss of control which is associated with contracting for linen service. On the the hand, many laundries do not have the resources or experience to serve hospitals in a comprehensive and trouble-free manner. In many communities a joint venture, such as the one described here, can successfully combine the interests of the hospital and laundry communities without causing the hospitals to lose control of the service and without requiring the laundry operator to have detailed knowledge of hospital operations. As more hospitals opt for contract service, and if this service is to be provided at the lowest total cost, the hospitals and the laundries must come to grips with the problems surrounding the laundry-hospital interface. A joint venture, such as that described here, is one way to accomplish this.

  4. Joint International Accelerator School

    CERN Multimedia

    CERN Accelerator School

    2014-01-01

    The CERN and US Particle Accelerator Schools recently organised a Joint International Accelerator School on Beam Loss and Accelerator Protection, held at the Hyatt Regency Hotel, Newport Beach, California, USA from 5-14 November 2014. This Joint School was the 13th in a series of such schools, which started in 1985 and also involves the accelerator communities in Japan and Russia.   Photo courtesy of Alfonse Pham, Michigan State University.   The school attracted 58 participants representing 22 different nationalities, with around half from Europe and the other half from Asia and the Americas. The programme comprised 26 lectures, each of 90 minutes, and 13 hours of case study. The students were given homework each day and had an opportunity to sit a final exam, which counted towards university credit. Feedback from the participants was extremely positive, praising the expertise and enthusiasm of the lecturers, as well as the high standard and quality of their lectures. Initial dis...

  5. Bone manipulation procedures in dental implants

    OpenAIRE

    Mittal, Yuvika; Jindal, Govind; Garg, Sandeep

    2016-01-01

    The use of dental implants for the rehabilitation of missing teeth has broadened the treatment options for patients and clinicians equally. As a result of advances in research in implant design, materials, and techniques, the use of dental implants has increased dramatically in the past two decades and is expected to expand further in the future. Success of dental implants depends largely on the quality and quantity of the available bone in the recipient site. This however may be compromised ...

  6. Environmental standards for intraocular lens implantation.

    Science.gov (United States)

    Crawford, B A; Kaufman, D V

    1984-02-01

    Successful implantation of prosthetic devices depends upon their freedom from postoperative inflammation and infection. Techniques and lessons learned in orthopaedic and other implant surgery should be applied to intraocular lens implantation. The avoidance of contamination by particles and micro-organisms is one essential principle of the surgical procedure. Practical steps are described to reduce both types of contamination. These measures taken together are recommended for adoption as a standard of environmental safety for lens implantation.

  7. Detailed spectral analysis of decellularized skin implants

    Science.gov (United States)

    Timchenko, E. V.; Timchenko, P. E.; Volova, L. T.; Dolgushkin, D. A.; Shalkovsky, P. Y.; Pershutkina, S. V.

    2016-08-01

    The resutls of detailed analysis of donor skin implants using Raman spectroscopy method are presented. Fourier-deconvolution method was used to separate overlapping spectrum lines and to improve its informativeness. Based on the processed spectra were introduced coefficients that represent changes in relative concentration of implant components, which determines the quality of implants. It was established that Raman spectroscopy method can be used in assessment of skin implants.

  8. Neutrophil Responses to Sterile Implant Materials

    OpenAIRE

    Siddharth Jhunjhunwala; Stephanie Aresta-DaSilva; Katherine Tang; David Alvarez; Webber, Matthew J.; Tang, Benjamin C.; Lavin, Danya M.; Omid Veiseh; Doloff, Joshua C; Suman Bose; Arturo Vegas; Minglin Ma; Gaurav Sahay; Alan Chiu; Andrew Bader

    2015-01-01

    In vivo implantation of sterile materials and devices results in a foreign body immune response leading to fibrosis of implanted material. Neutrophils, one of the first immune cells to be recruited to implantation sites, have been suggested to contribute to the establishment of the inflammatory microenvironment that initiates the fibrotic response. However, the precise numbers and roles of neutrophils in response to implanted devices remains unclear. Using a mouse model of peritoneal microcap...

  9. Joint Forces Capabilities

    Science.gov (United States)

    2007-11-02

    for countering the proliferation of weapons of mass destruction (WMD) in space. The Space Operations Center ( SPOC ), USSPACECOM is the single point...of contact for assessing space capabilities. Combatant commanders, subordinate JFCs, and Services can access this information from the SPOC via the...special operations forces SPOC Space Operations Center SSBN fleet ballistic missile submarine SST space support team UJTL Universal Joint Task List UN

  10. Australias Joint Approach

    Science.gov (United States)

    2015-09-01

    the early nineties as well. 219 Systems Thinking and Systems Engineering for Defence Strategic Planning, Richard Hodge , Kym Hendrickson and Geoff...Head Capability Systems, dated 9 December 2013. 272 Private communications with LTCOL Nick Floyd, Deputy Director Joint Concepts, JCC, March...with LTCOL Nick Floyd, 29 October 2014. 307 Pathway to Change: Evolving Defence Culture, 2012, p1. 308 Ibid, p3. 309 Communication with Dr Irena Ali

  11. Nonarthritic hip joint pain.

    Science.gov (United States)

    Enseki, Keelan; Harris-Hayes, Marcie; White, Douglas M; Cibulka, Michael T; Woehrle, Judith; Fagerson, Timothy L; Clohisy, John C

    2014-06-01

    The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these clinical practice guidelines is to describe the peer-reviewed literature and make recommendations related to nonarthritic hip joint pain.

  12. The international joint commission

    OpenAIRE

    Clamens, Murray

    2005-01-01

    For over 92 years the International Joint Commission (IJC), United States and Canada, has effectively served the two nations in approving and providing continuous oversight of water resource projects along the 5000-mile common border, in assisting the governments in preventing and resolving issues and disagreements regarding the use of these waters, and in addressing other environmental issues affecting or potentially affecting one or both of the countries. During the first years of the 20th...

  13. Joint Urban Operations

    Science.gov (United States)

    2009-11-08

    in Kosovo , the Red Cross provided the most accurate figures on the number of Kosovo refugees, helping US and other coalition services to estimate the...Port-au-Prince, Ramadi, Fallujah, and cities in Bosnia, Serbia, and Kosovo ). This clearly indicates an increase in the frequency of US joint...areas perhaps including shantytowns, and military areas. Buildings may range from single-story wooden or mud dwellings to high-rise apartments and

  14. Successfully Developing Joint Leaders

    Science.gov (United States)

    2010-07-26

    officer’s pyramid representing his career, there is merely the word “joint”. Therefore, unless the officer adamantly pursues a joint assignment it...had the chance to participate in Bosnia stability operations. It is how we were taught to work with locals and the experiences I took with me that...Drug Ops, OAF, OEF, OIF, Bosnia , Unconventional) - When you participated in an operation was there any “joint” involvement? If “yes”, did you feel

  15. Primary Clinical Evaluation of the Joint Replacement for the Treatment of the First Metatarsophalangeal Arthritis

    Institute of Scientific and Technical Information of China (English)

    Qi-yi Li; Jin Jin; Xi-sheng Weng; Jin Lin; Yi-dan Zhang; Gui-xing Qiu

    2011-01-01

    Objective To retrospectively assess the primary clinical results of a cohort of the first metatarsophalangeal joint replacement with double-stemmed hinge silicone implant. Methods A total of 12 patients (15 feet) received the joint replacement with double-stemmed hinge silicone implant. There were 2 males and 10 females with a mean age of 61.4 (range, 56-75) years old. Of them, 9 cases (11 feet) were hallux valgus with osteoarthritis; 1 case (2 feet) was rheumatic arthritis; 2 cases (2 feet) were traumatic arthritis. The subjective and objective results were evaluated during follow-up.Results All of the patients were followed up regularly with an average of 24.7 months, ranging from 12 to 38 months. Ten patients were completely satisfied with the operation; 1 patient showed partial satisfaction, and 1 patient was not satisfied because of the first matatarsophalangeal joint pain due to severe hyperosteogeny surrounding the cut bone surface 3 years after the operation. Osteolysis around the implant occurred in 2 cases without clinical symptoms, and no special treatment was given.Conclusion The joint replacement is a preferable method in alleviating pain and improving walking function with proper indication.

  16. Design optimization of functionally graded dental implant.

    Science.gov (United States)

    Hedia, H S; Mahmoud, Nemat-Alla

    2004-01-01

    The continuous increase of man's life span, and the growing confidence in using artificial materials inside the human body necessities introducing more effective prosthesis and implant materials. However, no artificial implant has biomechanical properties equivalent to the original tissue. Recently, titanium and bioceramic materials, such as hydroxyapatite are extensively used as fabrication materials for dental implant due to their high compatibility with hard tissue and living bone. Titanium has reasonable stiffness and strength while hydroxyapatite has low stiffness, low strength and high ability to reach full integration with living bone. In order to obtain good dental implantation of the biomaterial; full integration of the implant with living bone should be satisfied. Minimum stresses in the implant and the bone must be achieved to increase the life of the implant and prevent bone resorption. Therefore, the aim of the current investigation is to design an implant made from functionally graded material (FGM) to achieve the above advantages. The finite element method and optimization technique are used to reach the required implant design. The optimal materials of the FGM dental implant are found to be hydroxyapatite/titanium. The investigations have shown that the maximum stress in the bone for the hydroxyapatite/titanium FGM implant has been reduced by about 22% and 28% compared to currently used titanium and stainless steel dental implants, respectively.

  17. 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.

  18. 21 CFR 522.1350 - Melatonin implant.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Melatonin implant. 522.1350 Section 522.1350 Food... Melatonin implant. (a) Specifications. The drug is a silicone rubber elastomer implant containing 2.7 milligrams of melatonin. (b) Sponsor. See No. 053923 in § 510.600(c) of this chapter. (c) Conditions of...

  19. Using Aerospace Technology To Design Orthopedic Implants

    Science.gov (United States)

    Saravanos, D. A.; Mraz, P. J.; Davy, D. T.

    1996-01-01

    Technology originally developed to optimize designs of composite-material aerospace structural components used to develop method for optimizing designs of orthopedic implants. Development effort focused on designing knee implants, long-term goal to develop method for optimizing designs of orthopedic implants in general.

  20. The Case for a Generic Implant Processor

    NARCIS (Netherlands)

    Strydis, C.; Gaydadjiev, G.N.

    2008-01-01

    A more structured and streamlined design of implants is nowadays possible. In this paper we focus on implant processors located in the heart of implantable systems. We present a real and representative biomedical-application scenario where such a new processor can be employed. Based on a suitably se

  1. [The elementary discussion on digital implant dentistry].

    Science.gov (United States)

    Su, Y C

    2016-04-09

    It is a digital age today. Exposed to all kinds of digital products in many fields. Certainly, implant dentistry is not exception. Digitalization could improve the outcomes and could decrease the complications of implant dentistry. This paper introduces the concepts, definitions, advantages, disadvantages, limitations and errors of digital implant dentistry.

  2. The endometrial factor in human embryo implantation

    NARCIS (Netherlands)

    Boomsma, C.M.

    2009-01-01

    The studies presented in this thesis aimed to explore the role of the endometrium in the implantation process. At present, embryo implantation is the major rate-limiting step for success in fertility treatment. Clinicians have sought to develop clinical interventions aimed at enhancing implantation

  3. Regenerative strategies for the treatment of knee joint disabilities

    CERN Document Server

    Reis, Rui

    2017-01-01

    This book presents regenerative strategies for the treatment of knee joint disabilities. The book is composed of four main sections totaling 19 chapters which review the current knowledge on the clinical management and preclinical regenerative strategies. It examines the role of different natural-based biomaterials as scaffolds and implants for addressing different tissue lesions in the knee joint. Section one provides an updated and comprehensive discussion on articular cartilage tissue regeneration. Section two focuses on the important contributions for bone and osteochondral tissue engineering. Section three overview the recent advances on meniscus repair/regeneration strategies. Finally, section four further discusses the current strategies for treatment of ligament lesions. Each chapter is prepared by world know expert on their fields, so we do firmly believe that the proposed book will be a reference in the area of biomaterials for regenerative medicine.

  4. Biomechanical Aspects of Shoulder and Hip Articulations: A Comparison of Two Ball and Socket Joints

    Directory of Open Access Journals (Sweden)

    Mustafa Qusay Ismael

    2006-01-01

    different for the two joints. Results obtained from the finite element analysis were important in understanding the areas of stress concentration and were thoroughly explained from the anatomical point of view and linked to muscle and joint capsule attachments. The model of the joints developed in this study can be used as a computational tool to joint biomechanics and to prosthetic implant analysis. Keywords: hip joint, shoulder joint, finite element analysis, biomechanics.

  5. Laboratory characterization of rock joints

    Energy Technology Data Exchange (ETDEWEB)

    Hsiung, S.M.; Kana, D.D.; Ahola, M.P.; Chowdhury, A.H.; Ghosh, A. [Southwest Research Inst., San Antonio, TX (United States). Center for Nuclear Waste Regulatory Analyses

    1994-05-01

    A laboratory characterization of the Apache Leap tuff joints under cyclic pseudostatic and dynamic loads has been undertaken to obtain a better understanding of dynamic joint shear behavior and to generate a complete data set that can be used for validation of existing rock-joint models. Study has indicated that available methods for determining joint roughness coefficient (JRC) significantly underestimate the roughness coefficient of the Apache Leap tuff joints, that will lead to an underestimation of the joint shear strength. The results of the direct shear tests have indicated that both under cyclic pseudostatic and dynamic loadings the joint resistance upon reverse shearing is smaller than that of forward shearing and the joint dilation resulting from forward shearing recovers during reverse shearing. Within the range of variation of shearing velocity used in these tests, the shearing velocity effect on rock-joint behavior seems to be minor, and no noticeable effect on the peak joint shear strength and the joint shear strength for the reverse shearing is observed.

  6. Reading skills after cochlear implantation

    NARCIS (Netherlands)

    Vermeulen, Agnes Maria

    2007-01-01

    It has frequently been found that profoundly deaf children with conventional hearing aids have difficulties with the comprehension of written text. Cochlear Implants (CIs) were expected to enhance the reading comprehension of these profoundly deaf children because they provide auditory access to spo

  7. Immediate loading of dental implants.

    Science.gov (United States)

    Henry, P J; Liddelow, G J

    2008-06-01

    The purpose of this review is to explore the concept of immediate loading as it pertains to dental implants and the indications for clinical practice. The definition of immediate loading will be considered together with a review of the relevant literature in an attempt to provide evidence-based guidelines for successful implementation into practice. A search of electronic databases including Medline, PubMed and the Cochrane Database of Systematic Reviews was undertaken using the terms "immediate loading'', "dental implants'', "immediate function'', "early loading'', "oral implants'', "immediate restoration'' and "systematic review''. This was supplemented by handsearching in peer-reviewed journals and cross-referenced with the articles accessed. Emphasis was given to systematic reviews and controlled clinical trials. A definition of immediate loading was suggested pertinent to the realities of logistics in clinical practice with respect to application and time frame. The literature was evaluated and shown to be limited with significant shortcomings. Guidelines and recommendations for clinical protocols were suggested and illustrated by examples of case types with a minimum of 1-3 years follow-up. A list of additional references for further reading was provided. Within the limitations of this review, there is evidence to suggest that immediate loading protocols have demonstrated high implant survival rates and may be cautiously recommended for certain clinical situations. However, more high level evidence studies, preferably randomized controlled trials (RCTs), over a long time frame are required to show a clear benefit over more conventional loading protocols.

  8. Cortical plasticity after cochlear implantation

    DEFF Research Database (Denmark)

    Petersen, B; Gjedde, A; Wallentin, M;

    2013-01-01

    The most dramatic progress in the restoration of hearing takes place in the first months after cochlear implantation. To map the brain activity underlying this process, we used positron emission tomography at three time points: within 14 days, three months, and six months after switch-on. Fifteen...

  9. Bioceramic Coatings for Orthopaedic Implants

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, Allison A.

    2003-11-02

    During the past century, man-made materials and devices have been developed to the point at which they have been used successfully to replace and/or restore function to diseased or damaged tissues. In the field of orthopaedics, the use of metal implants has significantly improved the quality of life for countless individuals. Critical factors for implant success include proper design, material selection, and biocompatibility. While early research focused on the understanding biomechanical properties of the metal device, recent work has turned toward improving the biological properties of these devices. This has lead to the introduction of calcium phosphate (CaP) bioceramics as a bioactive interface between the bulk metal impart and the surrounding tissue. The first calcium phosphate coatings where produced via vapor phase routes but more recently, there has been the emergence of solution based and biomimetic methods. While each approach has its own intrinsic materials and biological properties, in general CaP coatings have the promise to improve implant biocompatibility and ultimately implant longevity.

  10. [Combined treatment of long tubular bone fractures and false joints using the bioplastic material collapan (Russia)].

    Science.gov (United States)

    Kesian, G A; Berchenko, G N; Urazgil'deev, R Z; Arsen'ev, I G; Mikelaishvili, D S; Karapetian, G S

    2008-01-01

    This experimental morphological study on 32 dogs was designed to evaluate the efficiency of hydroxyapatite containing preparation collapan used to promote healing of segmented femur defects. Implantation of collapan was shown to greatly contribute to the formation, maturation and remodelling of bone callus. Combined treatment of 165 patients with comminuted fractures and 148 ones with false joints of long tubular bones using collapan implants proved to efficaciously promote bone consolidation in 99.4% of the total 313 subjects. Collapan activated reparative osteogenesis, reduced the duration of hospitalization, the frequency of inflammatory complications, and the requirement of secondary inpatient care.

  11. In-vivo degradation mechanism of Ti-6Al-4V hip joints

    DEFF Research Database (Denmark)

    Lomholt, Trine Colding; Pantleon, Karen; Somers, Marcel A. J.

    2011-01-01

    In-vivo exposed Ti-6Al-4V implants were investigated to determine the degradation mechanism occurring during the articulating movements of the hip joint in the human body. Failed implants were compared to Ti-6Al-4V samples, which were tested in the laboratory for their tribocorrosion performance....... was concluded to be of combined mechanical and chemical nature. Wear debris is formed and accumulated in large flakes (>100μm). Upon further sliding the flakes are pressed into the surface and ultimately crushed into small, brittle particulate debris (...

  12. Investigation of the Effects of Abutment and Implant Length on Stability of Short Dental Implants

    OpenAIRE

    OZYILMAZ, Eda; Aykul, Halil; OZYILMAZ, Emre; Dalkiz, Mehmet; M. Burak BİLGİN

    2015-01-01

    The use of dental implants to solve different problems in dentistry has been growing rapidly. The success rates of dental implants are also very important for patients. Depending on the bone level of patients, short dental implants are very popular and widely used by many dentists. Although many dentists are using short dental implants frequently, It can be guessed that there can be stability problems because of crown to implant ratios. In this study, it is aimed to find out...

  13. Impact of cone-beam computed tomography on implant planning and on prediction of implant size

    OpenAIRE

    Ludmila Assunção de Mello Pedroso; Robson Rodrigues Garcia; José Luiz Rodrigues Leles; Cláudio Rodrigues Leles; Maria Alves Garcia Santos Silva

    2014-01-01

    The aim was to investigate the impact of cone-beam computed tomography (CBCT) on implant planning and on prediction of final implant size. Consecutive patients referred for implant treatment were submitted to clinical examination, panoramic (PAN) radiography and a CBCT exam. Initial planning of implant length and width was assessed based on clinical and PAN exams, and final planning, on CBCT exam to complement diagnosis. The actual dimensions of the implants placed during surgery were compare...

  14. Dental implants with versus without peri-implant bone defects treated with guided bone regeneration

    OpenAIRE

    Aloy Prósper, Amparo; Peñarrocha Oltra, David; Peñarrocha Diago, María; Peñarrocha Diago, Miguel

    2015-01-01

    Background The guided bone regeneration (GBR) technique is highly successful for the treatment of peri-implant bone defects. The aim was to determine whether or not implants associated with GBR due to peri-implant defects show the same survival and success rates as implants placed in native bone without defects. Material and Methods Patients with a minimum of two submerged dental implants: one suffering a dehiscence or fenestration defect during placement and undergoing simultaneous guided bo...

  15. Melatonin plus porcine bone on discrete calcium deposit implant surface stimulates osteointegration in dental implants.

    Science.gov (United States)

    Calvo-Guirado, José Luis; Gómez-Moreno, Gerardo; Barone, Antonio; Cutando, Antonio; Alcaraz-Baños, Miguel; Chiva, Fernando; López-Marí, Laura; Guardia, Javier

    2009-09-01

    The aim of this study was to evaluate the effect of the topical application of melatonin mixed with collagenized porcine bone to accelerate the osteointegration on the rough discrete calcium deposit (DCD) surface implants in Beagle dogs 3 months after their insertion. In preparation for subsequent insertion of dental implants, lower premolars and molars were extracted from 12 Beagle dogs. Each mandible received three parallel wall implants with discrete calcium deposit (DCD) surface of 4 mm in diameter and 10 mm in length. The implants were randomly assigned to the distal sites on each side of the mandible in three groups: group I implants alone, group II implants with melatonin and group III implants with melatonin and porcine bone. Prior to implanting, 5 mg lyophylized powdered melatonin was applied to one bone hole at each side of the mandible. None was applied at the control sites. Ten histological sections per implant were obtained for histomorphometric studies. After a 4-wk treatment period, melatonin significantly increased the perimeter of bone that was in direct contact with the treated implants (P implants. Topical application of melatonin on DCD surface may act as a biomimetic agent in the placement of endo-osseous dental implants and enhance the osteointegration. Melatonin combined with porcine bone on DCD implants reveals more bone to implant contact at 12 wk (84.5 +/- 1.5%) compared with melatonin treated (75.1 +/- 1.4%) and nonmelatonin treated surface implants (64 +/- 1.4%).

  16. Choice of a dental implant system.

    Science.gov (United States)

    Hunt, Peter R; Gartner, Judith L; Norkin, Frederic J

    2005-04-01

    Many dentists are bewildered by the intricacies and complexities of dental implants. They are constantly besieged by product advertisements and can find it difficult to choose which systems to work with. Some dentists are so intimidated by the subject that they choose to avoid getting involved with implants and instead stick to traditional tooth replacement systems. By breaking implants down into 4 main components, the body, collar, connection, and restorative post, it is easier to understand the structure and function of dental implants. Each portion should be designed to achieve certain objectives. Once these structural components are understood, it is easier to compare and contrast differing implant systems.

  17. Current Concepts in Restorative Implant Dentistry

    Institute of Scientific and Technical Information of China (English)

    Prof.Marchack

    2009-01-01

    Patients today are incteasingly aware of dental implants.and their expectations are for esthetically and functionally pleasingimplant restorations that mimic natural teeth.This presentation will give both the experienced and novice practitioner a better understand-ing of how restorative implant dentistry has evolved.Treatment planning and restorative options for single implants.multiple implants andfully edentulons arches will be discussed,and the use of modern materials and CADCAM technology in fabricating the most contemporaryfixed implant supported prostheses will be demonstrated.

  18. Surface biotechnology for refining cochlear implants.

    Science.gov (United States)

    Tan, Fei; Walshe, Peter; Viani, Laura; Al-Rubeai, Mohamed

    2013-12-01

    The advent of the cochlear implant is phenomenal because it is the first surgical prosthesis that is capable of restoring one of the senses. The subsequent rapid evolution of cochlear implants through increasing complexity and functionality has been synchronized with the recent advancements in biotechnology. Surface biotechnology has refined cochlear implants by directly influencing the implant–tissue interface. Emerging surface biotechnology strategies are exemplified by nanofibrous polymeric materials, topographical surface modification, conducting polymer coatings, and neurotrophin-eluting implants. Although these novel developments have received individual attention in the recent literature, the time has come to investigate their collective applications to cochlear implants to restore lost hearing.

  19. Lipoxins: A Novel Regulator in Embryo Implantation

    Directory of Open Access Journals (Sweden)

    Jing Xiong

    2011-01-01

    Full Text Available Embryo implantation is essential for mammalian pregnancy, which involves intricate cross-talk between the blastocyst and the maternal endometrium. Recent advances have identified various molecules crucial to implantation and endometrial receptivity, including leukemia inhibitory factor, calcitonin, and homeobox A10. There is a close relationship between implantation and inflammation. Lipoxins, important in the resolution of inflammation, may be a potential regulator in implantation. Here we discuss the hypothesis that lipoxins may work as a novel regulator in embryo implantation and the possible molecular mechanisms.

  20. A Biomechanical Comparison of Two Intramedullary Implants for Subtrochanteric Fracture in Two Healing Stages: A Finite Element Analysis

    Directory of Open Access Journals (Sweden)

    Xinlei Wu

    2015-01-01

    Full Text Available Background. The biomechanical effect of two implants, namely, proximal femoral nail antirotation for Asia (PFNA-II and Expert Asian Femoral Nail (A2FN, for treating subtrochanteric fracture during healing stages, is still unclear. Methods. A 3D finite element model of an intact femur was constructed and validated. The fractured and postoperative models were accordingly produced. The postoperative models were loaded with the peak joint forces during gait for the soft and hard callus stages. The effects of stress distribution on the implants, femoral head and callus, and the deformation of the proximal femur were examined. Results. Both implants showed similar biomechanical effect in two healing stages. As the healing duration increased, the von Mises stress of two implants and the tensile stress of the femoral head decreased, whereas the compressive stress of the femoral head increased. However, the PFNA-II operation resulted in higher stress on the implant, lower stress on the proximal femur, and lower compressive stress and higher tensile stress on the callus than A2FN operation. Conclusions. The A2FN implant may provide a biomechanically superior construct for subtrochanteric fracture healing. However, the upper screw of the A2FN implant may be more likely to be loose in the healing process.

  1. Development of Joint Engagement in Young Deaf and Hearing Children: Effects of Chronological Age and Language Skills

    Science.gov (United States)

    Cejas, Ivette; Barker, David H.; Quittner, Alexandra L.; Niparko, John K.

    2014-01-01

    Purpose: To evaluate joint engagement (JE) in age-matched children with and without hearing and its relationship to oral language skills. Method: Participants were 180 children with severe-to-profound hearing loss prior to cochlear implant surgery, and 96 age-matched children with normal hearing; all parents were hearing. JE was evaluated in a…

  2. 21 CFR 888.3410 - Hip joint metal/polymer or ceramic/polymer semiconstrained resurfacing cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... semiconstrained resurfacing cemented prosthesis. 888.3410 Section 888.3410 Food and Drugs FOOD AND DRUG... prosthesis. (a) Identification. A hip joint metal/polymer or ceramic/polymer semi-constrained resurfacing cemented prosthesis is a two-part device intended to be implanted to replace the articulating surfaces...

  3. Computed tomography of human joints and radioactive waste drums

    Energy Technology Data Exchange (ETDEWEB)

    Ashby, E; Bernardi, R; Hollerbach, K; Logan, C; Martz, H; Roberson, G P

    1999-06-01

    X- and gamma-ray imaging techniques in nondestructive evaluation (NDE) and assay (NDA) have been increasing use in an array of industrial, environmental, military, and medical applications. Much of this growth in recent years is attributed to the rapid development of computed tomography (CT) and the use of NDE throughout the life-cycle of a product. Two diverse examples of CT are discussed. (1) The computational approach to normal joint kinematics and prosthetic joint analysis offers an opportunity to evaluate and improve prosthetic human joint replacements before they are manufactured or surgically implanted. Computed tomography data from scanned joints are segmented, resulting in the identification of bone and other tissues of interest, with emphasis on the articular surfaces. (2) They are developing NDE and NDE techniques to analyze closed waste drums accurately and quantitatively. Active and passive computed tomography (A and PCT) is a comprehensive and accurate gamma-ray NDA method that can identify all detectable radioisotopes present in a container and measure their radioactivity.

  4. Glenohumeral Joint Preservation: A Review of Management Options for Young, Active Patients with Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Olivier A. van der Meijden

    2012-01-01

    Full Text Available The management of osteoarthritis of the shoulder in young, active patients is a challenge, and the optimal treatment has yet to be completely established. Many of these patients wish to maintain a high level of activity, and arthroplasty may not be a practical treatment option. It is these patients who may be excellent candidates for joint-preservation procedures in an effort to avoid or delay joint replacement. Several palliative and restorative techniques are currently optional. Joint debridement has shown good results and a combination of arthroscopic debridement with a capsular release, humeral osteoplasty, and transcapsular axillary nerve decompression seems promising when humeral osteophytes are present. Currently, microfracture seems the most studied reparative treatment modality available. Other techniques, such as autologous chondrocyte implantation and osteochondral transfers, have reportedly shown potential but are currently mainly still investigational procedures. This paper gives an overview of the currently available joint preserving surgical techniques for glenohumeral osteoarthritis.

  5. Dynamics of bone graft healing around implants

    Directory of Open Access Journals (Sweden)

    Narayan Venkataraman

    2015-01-01

    A few questions arise pertaining to the use of bone grafts along with implants are whether these are successful in approximation with implant. Do they accelerate bone regeneration? Are all defects ultimately regenerated with new viable bone? Is the bone graft completely resorbed or integrated in new bone? Does the implant surface characteristic positively affect osseointegration when used with a bone graft? What type of graft and implant surface can be used that will have a positive effect on the healing type and time? Finally, what are the dynamics of bone graft healing around an implant? This review discusses the cellular and molecular mechanisms of bone graft healing in general and in vicinity of another foreign, avascular body, namely the implant surface, and further, the role of bone grafts in osseointegration and/or clinical success of the implants.

  6. Mineralization kinetics of various implanted bioceramics

    Energy Technology Data Exchange (ETDEWEB)

    Derrien, A.C.; Oudadesse, H. E-mail: hassane.oudadesse@univ-rennes1.fr; Martin, S.; Lucas-Girot, A.; Cathelineau, G.; Sauvage, T.; Blondiaux, G

    2004-11-01

    Proton induced X-ray emission was used for a multi-element analysis of three biomaterials implanted in ovine thighbone: one tri-tricalcic phosphate and two calcium carbonates with different percentages of porosity. The proton PIXE analysis method allowed the simultaneous quantification of several elements to get profiles of concentrations versus implantation delay. We focused on calcium and phosphorous which were major elements of the bony matrix and strontium, a trace element characteristic of the mineralization of the implants. Concentrations of calcium (constitutive of CaCO{sub 3} and TCP) and phosphorous (constitutive of TCP) were known and differed from the bony matrix concentrations. The analysis of each sample for various times after implantation (1, 3, 6 and 12 months) by PIXE permitted to observe the evolution of the concentration of Ca, P and Sr in the implant area and at the interface implant/bone and to compare the different biomaterials implanted.

  7. Congenitally Deafblind Children and Cochlear Implants

    DEFF Research Database (Denmark)

    Dammeyer, Jesper Herup

    2008-01-01

    There has been much research conducted demonstrating the positive benefits of cochlear implantation (CI) in children who are deaf. Research on cochlear implantation in children who are both deaf and blind, however, is lacking. The purpose of this article is to present a study of 5 congenitally...... deafblind children who received cochlear implants between 2.2 and 4.2 years of age.  Ratings of video observations were used to measure the children's early communication development with and without the use of their cochlear implants. In addition, parental interviews were used to assess the benefits...... parents perceived regarding their children's cochlear implants. Two examples are included in this article to illustrate the parents' perspectives about cochlear implantation in their deafblind children. Benefits of cochlear implantation in this cohort of children included improved attention and emotional...

  8. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Human Resources Division

    2002-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Serge Peraire with regard to exceptional advancement. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 17 to 31 May 2002. Human Resources Division Tel. 74128

  9. Joint Advisory Appeals Board

    CERN Multimedia

    2003-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mrs Judith Igo-Kemenes concerning the application of procedures foreseen by Administrative Circular N§ 26 (Rev. 3). As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 6 to 20 June 2003. Human Resources Division Tel. 74128

  10. Joint Advisory Appeals Board

    CERN Multimedia

    2004-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mrs Maria DIMOU with regard to a periodic one-step increase. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 30 April to 14 May 2004. Human Resources Department Tel. 74128

  11. Joint Advisory Appeals Board

    CERN Multimedia

    2003-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Aloïs Girardoz with regard to classification and advancement. As the appellant has not objected, the Board's report and the Director-General's decision will be brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 15 to 29 August 2003. Human Resources Division Tel. 74128

  12. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Human Resources Division

    2002-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Bertrand Nicquevert with regard to the non-resident allowance. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 29 November to 13 December 2002. Human Resources Division Tel. 74128

  13. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Human Resources Division

    2002-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Jack Blanchard with regard to 'non recognition of specific functions'. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 12th to 26th April 2002. Human Resources Division Tel. 74128

  14. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Human Resources Division

    2002-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Antonio Millich with regard to advancement. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 27 September to 11 October 2002. Human Resources Division Tel. 74128

  15. Joint Advisory Appeals Board

    CERN Multimedia

    2003-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Poul Frandsen concerning his assimilation into the new career structure. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 13 to 24 January 2003. Human Resources Division Tel. 74128

  16. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Human Resources Division

    2002-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Luc Vos with regard to advancement. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 14 to 28 June 2002. Human Resources Division Tel. 74128

  17. Surgery center joint ventures.

    Science.gov (United States)

    Zasa, R J

    1999-01-01

    Surgery centers have been accepted as a cost effective, patient friendly vehicle for delivery of quality ambulatory care. Hospitals and physician groups also have made them the vehicles for coming together. Surgery centers allow hospitals and physicians to align incentives and share benefits. It is one of the few types of health care businesses physicians can own without anti-fraud and abuse violation. As a result, many surgery center ventures are now jointly owned by hospitals and physician groups. This article outlines common structures that have been used successfully to allow both to own and govern surgery centers.

  18. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Personnel Division

    1999-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Joào Bento with regard to residential category. As the appellant has not objected, the recommendations of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article RÊVIÊ1.20 of the Staff Regulations.The relevant documents will therefore be posted on the notice boards of the Administration Building (N¡ 60) from 29 October to 12 November 1999.Personnel DivisionTel. 74128

  19. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2006-01-01

    The Joint Advisory Appeals Board was convened to examine an appeal lodged by a member of the personnel with regard to advancement. The person concerned has requested that the report of the Board and the final decision of the Director-General be brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (No. 60) from 24 March to 10 April 2006. Human Resources Department Tel. 74128

  20. Bones and joints

    Energy Technology Data Exchange (ETDEWEB)

    Runge, M.

    1987-01-01

    This exercise book guides the student and the radiologist wishing to review his knowledge to rapid and correct analysis and interpretation of radiologic findings in bone and joint disorders. The first part of the volume demonstrates the radiologic findings without going into the clinical and pathological aspects. In the second part, the reader then learns to analyse and diagnose systematically the case examples by means of a complete description of the X-ray images. Contents: Introduction; iconography; commentary with corresponding schemata; references and subject index.

  1. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel with regard to the decision not to award him a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main building (Bldg. 500) from 17 March to 30 March 2008. Human Resources Department Tel. 73911

  2. Joint Advisory Appeals Board

    CERN Document Server

    2013-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a former member of the personnel, a beneficiary of the CERN Pension Fund, against the calculation of his pension in the framework of the Progressive Retirement Programme.   The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be available from 26 July to 11 August 2013 at the following link. HR Department Head Office

  3. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel against the decision to grant him only a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main Building (Bldg. 500) from 1 September to 14 September 2008. Human Resources Department (73911)

  4. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main Building (Bldg. 500) from 26 May to 6 June 2008. Human Resources Department (73911)

  5. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2007-01-01

    The Joint Advisory Appeals Board was convened to examine an internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has requested that the report of the Board and the final decision of the Director-General be brought to the notice of the members of the personnel, in accordance with Article R VI 1.18 of the Staff Regulations. The relevant documents will therefore be posted on the notice board of the Main building (Bldg. 60) from 24 September to 7 October 2007. Human Resources Department

  6. Joint Advisory Appeals Board

    CERN Document Server

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board was convened to examine an internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel, in accordance with Article R VI 1.18 of the Staff Regulations. These documents will therefore be posted on the notice board of the Main Building (Bldg. 60) from 21 January to 3 February 2008. Human Resources Department (73911)

  7. Joint Advisory Appeals Board

    CERN Document Server

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel against the decision to grant him only a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main building (bldg. 500) from 1 September to 14 September 2008. Human Resources Department (73911)

  8. Lisfranc Joint Injuries

    Institute of Scientific and Technical Information of China (English)

    Lisa Chinn

    2009-01-01

    @@ The ankle and foot are the most common sites for athletic injuries.[1]Midfoot,or Lisfranc,injuries are the second most common foot injury and have a high in cidence in particular sports.They account for 4% of all football injuries per year,occurring frequently in linemen.[2]They are also common in equestrians,surfers,and windsurfers.[2]Lisfranc injuries are often misdiagnosed and if not treated properly can have lingering symptoms.It is estimated that Lisfranc joint injuries occur in 1 in every 55,000 persons every year.[3,4

  9. Effects of Delayed Second Cochlear Implant

    Institute of Scientific and Technical Information of China (English)

    XIA Rui-ming; WU Xi-hong; JANG Zi-gang; JING Yuan-yuan; LIN Yun-juan; YU Li-sheng

    2006-01-01

    Objective Since Helms' successful bilateral cochlear implantation with good results in 1996, there have been increasing number of reports on bilateral cochlear implantation. Most second device have been implantated within one year after the first. Considering effects of long time auditory deprivation, it is not clear whether a delayed second cochlear implant serves to add additional benefits and how it may interact with central nervous system plasticity. Methods Three cases who received delayed second cochlear implants at People's Hospital of Peking University from 2002 to 2005 were reviewed. The interval between the first and second implants was longer than 2 years in all three patients. Sound perception, and unilateral/bilateral speech discrimination in quiet and noise were evaluated. In addition, GAP detection test was conducted in one patient. Results In one case,having both implants on provided improved performance compared to using only one implant both in quiet and noise. Presumably due to visual interference from lip-reading or short interval between second implant and testing,one patient showed no improvement from using the second implant either in quiet or noise, while the last case demonstrated additional benefits from the second implant only in quiet. In all three patients, performance in recognizing the four tones in Mandarin was superior over word recognition. Conclusions Considerable plasticity in the cerebral auditory center is preserved, despite long acoustic deprivation in some children who have received unilateral cochlear implant. Delayed second implants can result in significant improvements in some of these children. Visual interference from lip-reading may be an obstacle during retraining. The better recognition of tones in the Mandarin language may represent a different sound discrimination mechanism in the auditory system,although it may also be related to the signal processing mechanisms of the implant used (MED-EL COMBI 40+).

  10. ['Which breast implant do I have?'; the importance of the Dutch Breast Implant Registry].

    Science.gov (United States)

    Hommes, Juliëtte; Mureau, Marc A M; Harmsen, Manuel; Rakhorst, Hinne

    2015-01-01

    About 1 in 300 women in the Netherlands has a breast implant but many patients do not know what type of implant was inserted. The quality of breast implants is currently monitored by the implant manufacturers. Sufficient incidents have occurred to show that an independent registry is required to measure the quality of breast implants and to facilitate a national recall, if necessary. Good national and international collaboration with the government, the manufacturers and other specialist associations is crucial for setting up an implant registry. Since April 2015, data about patients and their implants have been collected, independently and prospectively, in the Dutch Breast Implant Registry to increase patient safety in cases of breast implant surgery in the Netherlands.

  11. Successful rehabilitation of partial edentulous maxilla and mandible with new type of implants: molecular precision implants.

    Science.gov (United States)

    Danza, Matteo; Lauritano, Dorina; Carinci, Francesco

    2014-01-01

    The extraction of teeth results in rapid bone resorption both vertically and horizontally in the first month. The loss of alveolar ridge reduces the chance of implant rehabilitation. Atraumatic extraction, implant placement in extraction socket, and an immediate prosthesis have been proposed as alternative therapies to maintain the volume and contours tissue and reduce time and cost of treatment. The immediate load of implants is a universally practiced procedure; nevertheless a successful procedure requires expertise in both the clinical and the reconstructive stages using a solid implant system. Excellent primary stability and high bone-implant contact are only minimal requirements for any type of implant procedure. In this paper we present a case report using a new type of implants. The new type of implants, due to its sophisticated control system of production, provides to the implantologist a safe and reliable implant, with a macromorphology designed to ensure a close contact with the surrounding bone.

  12. Successful Rehabilitation of Partial Edentulous Maxilla and Mandible with New Type of Implants: Molecular Precision Implants

    Directory of Open Access Journals (Sweden)

    Matteo Danza

    2014-01-01

    Full Text Available The extraction of teeth results in rapid bone resorption both vertically and horizontally in the first month. The loss of alveolar ridge reduces the chance of implant rehabilitation. Atraumatic extraction, implant placement in extraction socket, and an immediate prosthesis have been proposed as alternative therapies to maintain the volume and contours tissue and reduce time and cost of treatment. The immediate load of implants is a universally practiced procedure; nevertheless a successful procedure requires expertise in both the clinical and the reconstructive stages using a solid implant system. Excellent primary stability and high bone-implant contact are only minimal requirements for any type of implant procedure. In this paper we present a case report using a new type of implants. The new type of implants, due to its sophisticated control system of production, provides to the implantologist a safe and reliable implant, with a macromorphology designed to ensure a close contact with the surrounding bone.

  13. Assessment of Stability of Craniofacial Implants by Resonant Frequency Analysis.

    Science.gov (United States)

    Ivanjac, Filip; Konstantinović, Vitomir S; Lazić, Vojkan; Dordević, Igor; Ihde, Stefan

    2016-03-01

    Implant stability is a principal precondition for the success of implant therapy. Extraoral implants (EO) are mainly used for anchoring of maxillofacial epithesis. However, assessment of implant stability is mostly based on principles derived from oral implants. The aim of this study was to investigate clinical stability of EO craniofacial disk implants (single, double, and triple) by resonance frequency analysis at different stages of the bone's healing. Twenty patients with orbital (11), nasal (5), and auricular (4) defects with 50 EO implants placed for epithesis anchorage were included. Implant stability was measured 3 times; after implant placement, at 3 months and at least after 6 months. A significant increase in implant stability values was noted between all of the measurements, except for triple-disk implants between third and sixth months, and screw implants between 0 and third months. Disk implants showed lower implant stability quotient (ISQ) values compared with screw implants. Triple-disk implants showed better stability compared with single and double-disk implants. Based on resonance frequency analysis values, disk implants could be safely loaded when their ISQ values are 38 (single disks), 47 (double disks), and 48 (triple disks). According to resonance frequency analysis, disk implant stability increased over time, which showed good osseointegration and increasing mineralization. Although EO screw implants showed higher ISQ values than disk implants, disk-type implants can be safely loaded even if lower values of stability are measured.

  14. Experimental and numerical predictions of Biomet(®) alloplastic implant in a cadaveric mandibular ramus.

    Science.gov (United States)

    Mesnard, M; Ramos, A

    2016-05-01

    The purpose of this study was to evaluate experimentally the behaviors of an intact and an implanted cadaveric ramus, to compare and analyze load mechanism transfers between two validated finite element models. The intact, clean cadaveric ramus was instrumented with four rosettes and loaded with the temporal reaction load. Next, the Biomet microfixation implant was fixed to the same cadaveric mandibular ramus after resection. The mandibular ramus was reconstructed from computed tomographic images, and two finite element models were developed. The experimental results for the mandibular ramus present a linear behavior of up to 300 N load in the condyle, with the Biomet implant influencing strain distribution; the maximum influence was near the implant (rosette #4) and approximately 59%. The experimental and numerical results present a good correlation, with the best correlation in the intact ramus condition, where R(2) reaches 0.935 and the slope of the regression line is 1.045. The numerical results show that screw #1 is the most critical, with maximum principal strains in the bone around 21,000 με, indicating possible bone fatigue and fracture. The experimental results show that the Biomet temporomandibular joint mandibular ramus implant changes the load transfer in the ramus, compared to the intact ramus, with its strain-shielding effect. The numerical results demonstrate that only three screws are important for the Biomet TMJ fixation. These results indicate that including two proximal screws should reduce stresses in the first screws and strains in the bone.

  15. Factors influencing success of cement versus screw-retained implant restorations: a clinical review

    Directory of Open Access Journals (Sweden)

    Ahmad Manawar

    2012-10-01

    Full Text Available Aim: As more and more dental practitioners are focusing on implant-supported fixed restorations, some clinicians favor the use of cement retained restorations while others consider screw retained prosthesis to be the best choice. Discussion: In screw-retained restorations, the fastening screw provides a solid joint between the restoration and the implant abutment, while in cement-retained prostheses the restorative screw is eliminated to enhance esthetics, occlusal stability, and passive fit of the restorations. The factors that influence the type of fixation of the prostheses to the implants like passivity of the framework, ease of fabrication, occlusion, esthetics, accessibility, retention and retrievability are discussed in this article with scientific studies demonstrating superior outcomes of one technique over another. Screwretained implant restorations have an advantage of predictable retention, retrievability and lack of potentially retained subgingival cement. However, a few disadvantages exist such as precise placement of the implant for optimal and esthetic location of the screw access hole and obtaining passive fit. On the other hand, cement retained restorations eliminate unesthetic screw access holes, have passive fit of castings, reduced complexity of clinical and lab procedures, enhanced esthetics, reduced cost factors and non disrupted morphology of the occlusal table. Conclusion: This article compares the advantages, potential disadvantages and limitations of screw and cement retained restorations and their specific implications in the most common clinical situation.

  16. Joint collaborative technology experiment

    Science.gov (United States)

    Wills, Michael; Ciccimaro, Donny; Yee, See; Denewiler, Thomas; Stroumtsos, Nicholas; Messamore, John; Brown, Rodney; Skibba, Brian; Clapp, Daniel; Wit, Jeff; Shirts, Randy J.; Dion, Gary N.; Anselmo, Gary S.

    2009-05-01

    Use of unmanned systems is rapidly growing within the military and civilian sectors in a variety of roles including reconnaissance, surveillance, explosive ordinance disposal (EOD), and force-protection and perimeter security. As utilization of these systems grows at an ever increasing rate, the need for unmanned systems teaming and inter-system collaboration becomes apparent. Collaboration provides a means of enhancing individual system capabilities through relevant data exchange that contributes to cooperative behaviors between systems and enables new capabilities not possible if the systems operate independently. A collaborative networked approach to development holds the promise of adding mission capability while simultaneously reducing the workload of system operators. The Joint Collaborative Technology Experiment (JCTE) joins individual technology development efforts within the Air Force, Navy, and Army to demonstrate the potential benefits of interoperable multiple system collaboration in a force-protection application. JCTE participants are the Air Force Research Laboratory, Materials and Manufacturing Directorate, Airbase Technologies Division, Force Protection Branch (AFRL/RXQF); the Army Aviation and Missile Research, Development, and Engineering Center Software Engineering Directorate (AMRDEC SED); and the Space and Naval Warfare Systems Center - Pacific (SSC Pacific) Unmanned Systems Branch operating with funding provided by the Joint Ground Robotics Enterprise (JGRE). This paper will describe the efforts to date in system development by the three partner organizations, development of collaborative behaviors and experimentation in the force-protection application, results and lessons learned at a technical demonstration, simulation results, and a path forward for future work.

  17. Phytomedicine in Joint Disorders

    Directory of Open Access Journals (Sweden)

    Dorin Dragos

    2017-01-01

    Full Text Available Chronic joint inflammatory disorders such as osteoarthritis and rheumatoid arthritis have in common an upsurge of inflammation, and oxidative stress, resulting in progressive histological alterations and disabling symptoms. Currently used conventional medication (ranging from pain-killers to biological agents is potent, but frequently associated with serious, even life-threatening side effects. Used for millennia in traditional herbalism, medicinal plants are a promising alternative, with lower rate of adverse events and efficiency frequently comparable with that of conventional drugs. Nevertheless, their mechanism of action is in many cases elusive and/or uncertain. Even though many of them have been proven effective in studies done in vitro or on animal models, there is a scarcity of human clinical evidence. The purpose of this review is to summarize the available scientific information on the following joint-friendly medicinal plants, which have been tested in human studies: Arnica montana, Boswellia spp., Curcuma spp., Equisetum arvense, Harpagophytum procumbens, Salix spp., Sesamum indicum, Symphytum officinalis, Zingiber officinalis, Panax notoginseng, and Whitania somnifera.

  18. Phytomedicine in Joint Disorders

    Science.gov (United States)

    Dragos, Dorin; Gilca, Marilena; Gaman, Laura; Vlad, Adelina; Iosif, Liviu; Stoian, Irina; Lupescu, Olivera

    2017-01-01

    Chronic joint inflammatory disorders such as osteoarthritis and rheumatoid arthritis have in common an upsurge of inflammation, and oxidative stress, resulting in progressive histological alterations and disabling symptoms. Currently used conventional medication (ranging from pain-killers to biological agents) is potent, but frequently associated with serious, even life-threatening side effects. Used for millennia in traditional herbalism, medicinal plants are a promising alternative, with lower rate of adverse events and efficiency frequently comparable with that of conventional drugs. Nevertheless, their mechanism of action is in many cases elusive and/or uncertain. Even though many of them have been proven effective in studies done in vitro or on animal models, there is a scarcity of human clinical evidence. The purpose of this review is to summarize the available scientific information on the following joint-friendly medicinal plants, which have been tested in human studies: Arnica montana, Boswellia spp., Curcuma spp., Equisetum arvense, Harpagophytum procumbens, Salix spp., Sesamum indicum, Symphytum officinalis, Zingiber officinalis, Panax notoginseng, and Whitania somnifera.

  19. Jointly Sponsored Research Program

    Energy Technology Data Exchange (ETDEWEB)

    Everett A. Sondreal; John G. Hendrikson; Thomas A. Erickson

    2009-03-31

    U.S. Department of Energy (DOE) Cooperative Agreement DE-FC26-98FT40321 funded through the Office of Fossil Energy and administered at the National Energy Technology Laboratory (NETL) supported the performance of a Jointly Sponsored Research Program (JSRP) at the Energy & Environmental Research Center (EERC) with a minimum 50% nonfederal cost share to assist industry in commercializing and effectively applying highly efficient, nonpolluting energy systems that meet the nation's requirements for clean fuels, chemicals, and electricity in the 21st century. The EERC in partnership with its nonfederal partners jointly performed 131 JSRP projects for which the total DOE cost share was $22,716,634 (38%) and the nonfederal share was $36,776,573 (62%). Summaries of these projects are presented in this report for six program areas: (1) resource characterization and waste management, (2) air quality assessment and control, (3) advanced power systems, (4) advanced fuel forms, (5) value-added coproducts, and (6) advanced materials. The work performed under this agreement addressed DOE goals for reductions in CO{sub 2} emissions through efficiency, capture, and sequestration; near-zero emissions from highly efficient coal-fired power plants; environmental control capabilities for SO{sub 2}, NO{sub x}, fine respirable particulate (PM{sub 2.5}), and mercury; alternative transportation fuels including liquid synfuels and hydrogen; and synergistic integration of fossil and renewable resources.

  20. Arthrography of the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Keyl, W.; Jaeger, M.

    1981-10-01

    The standardized examination technique and the clinical problems of the arthrographic mehtod applied on the knee joint is explained by the results obtained in 3000 examinations. Whereas the accuracy of the knee-joint arthrography provides a high degree in cases of meniscus lesions, computer tomography presents in chondral and capsular ligament lesions, and sonography in popliteal cysts better diagnostic information; but in any case arthroscopy gains more and more importance in knee-joint diagnostics.

  1. OIG targets contractual joint ventures.

    Science.gov (United States)

    O'Hare, Patrick K

    2003-09-01

    A recent OIG Special Advisory Bulletin raises questions for providers involved in joint ventures. The Bulletin describes several characteristics that the OIG views as potentially suspect, including a referral stream controlled by the provider initiating the joint venture and the use of a wholly owned subsidiary of the provider to bill and collect for services. According to the OIG, profits paid by the subsidiary to the provider owner in such "suspect contractual joint ventures" could constitute illegal remuneration for referrals.

  2. Silver Nanocoating Technology in the Prevention of Prosthetic Joint Infection

    Directory of Open Access Journals (Sweden)

    Jiri Gallo

    2016-05-01

    Full Text Available Prosthetic joint infection (PJI is a feared complication of total joint arthroplasty associated with increased morbidity and mortality. There is a growing body of evidence that bacterial colonization and biofilm formation are critical pathogenic events in PJI. Thus, the choice of biomaterials for implanted prostheses and their surface modifications may significantly influence the development of PJI. Currently, silver nanoparticle (AgNP technology is receiving much interest in the field of orthopaedics for its antimicrobial properties and a strong anti-biofilm potential. The great advantage of AgNP surface modification is a minimal release of active substances into the surrounding tissue and a long period of effectiveness. As a result, a controlled release of AgNPs could ensure antibacterial protection throughout the life of the implant. Moreover, the antibacterial effect of AgNPs may be strengthened in combination with conventional antibiotics and other antimicrobial agents. Here, our main attention is devoted to general guidelines for the design of antibacterial biomaterials protected by AgNPs, its benefits, side effects and future perspectives in PJI prevention.

  3. Implant periapical lesion. Case report

    Directory of Open Access Journals (Sweden)

    Gregory Venetis, Fotis Iordanidis, Paraskevi Giovani, Lambros Zouloumis

    2011-04-01

    Full Text Available Ιmplant periapical lesion (IPL is probably not a uniform entity in all cases presented in the literature. Asseptic bone necrosis may be a cause for some of the IPLs, whilst the presence of microorganisms is not always detectable with conventional methods. A case of IPL in a male patient who underwent an extraction of 12 tooth and an immediate implantation at this site is presented. Eight months postoperatively, an IPL was revealed on radiologic examination. After surgical exploration, the IPL was removed and examined histologically and microbiologically. The implant was replaced with a longer one and a bone regeneration procedure was simultaneously carried out. From the study of the lesion and the patient’s followup, infection cannot be considered as primary cause information of presented IPL, but literature data suggests that classic histology and microbiology cannot exclude infection from IPL causatives.

  4. [Implantation of the artificial retina].

    Science.gov (United States)

    Yagi, T; Hayashida, Y

    1999-05-01

    In some degenerative retinal diseases, e.g., retinitis pigmentosa and age-related macular degeneration, the photoreceptors are destroyed to cause serious visual defects. Recent studies on blind human subjects revealed that a large number of ganglion cells remains intact and is capable of transmitting signals to the brain to evoke partial visual perception. This provided hope to compensate for the visual defects with retinal prostheses. The recent progress of microfabrication technique made it possible to implement the Vary Large Scale Integrated circuit, the artificial retina, which emulates a part of retinal function. The idea of implanting the artificial retina to the patients was proposed recently and experiments using animals have been put into practice. This article surveys the front line of the artificial retina implantation.

  5. Magnesium as Biodegradable Implant Material

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Drawbacks associated with permanent metallic implants lead to the search for degradable metallic biomaterials. Magnesium alloys have been highly considered as Mg has a high biocorrosion potential and is essential to bodies. In this study, corrosion behaviour of pure magnesium and magnesium alloy AZ31 in both static and dynamic physiological conditions (Hank's solution) has been investigated. It is found that the materials degrade fast at beginning, then stabilize after 5 days of immersion. High purity in th...

  6. Design of an implantable micropump

    OpenAIRE

    Smal, Olivier; Merken, Patrick; Croquet, Vincent; Raucent, Benoît; Debongnie, Jean-François; Delchambre, Alain

    2004-01-01

    The implantable programmable micropump is an interesting solution to treat chronic diseases such as diabetes with regular micro-injections of medicine. However, current applications of micropumps are limited by their rather expensive cost. The challenge is therefore to develop a low cost alternative by reducing the number of parts and by simplifying the assembly. As the pump and its tank will be placed under the skin in order to increase comfort, such a system should be small and reliable. In...

  7. Imaging in cochlear implant patients [

    OpenAIRE

    Aschendorff, Antje

    2012-01-01

    [english] Imaging procedures are a mainstream tool in the daily ENT workflow. Cochlear Implant patients are representing a special population with specific demands for imaging. There are different imaging techniques available for pre-operative evaluation, surgery and postoperative controls with different indications and consequences. High-resolution computed tomography and magnetic resonance imaging are mainly used in the evaluation process. New procedures, as digital volume tomography, are i...

  8. Joint audits - benefit or burden?

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    In this paper we examine whether there are perceived and observed benefits or burdens from using two audit firms instead of one. In 2005 the mandatory joint audit requirement was abolished in Denmark. This provides a unique setting for studying the consequences and implications of going from...... a joint audit regime to a single auditor/voluntary joint audit regime. The dataset used in this paper has been collected for the full population of non-financial Danish companies listed on the Copenhagen Stock Exchange (CSE) in the years 2004 and 2005. We find that a majority of firms perceive joint...

  9. Sacroiliac joint dysfunction in athletes.

    Science.gov (United States)

    Brolinson, P Gunnar; Kozar, Albert J; Cibor, Greg

    2003-02-01

    The sacroiliac (SI) joint is a common source of low back pain in the general population. Because it is the link between the lower extremities and the spine, it sustains even higher loads during athletic activity, predisposing athletes to a greater probability of joint dysfunction and pain. The diagnosis and treatment of SI joint dysfunction remains controversial, due to complex anatomy and biomechanics, and a lack of universally accepted nomenclature and terminology, consistently reliable clinical tests and imaging studies, and consistently effective treatments. This article clarifies these issues by presenting a model of SI joint anatomy and function, a systematic approach to the diagnosis of dysfunction, and a comprehensive treatment plan.

  10. Induction brazing of complex joints

    DEFF Research Database (Denmark)

    Henningsen, Poul; Zhang, Wenqi; Bay, Niels

    2003-01-01

    Induction brazing is a fast and appropriate method for industrial joining of complex geometries and metal combinations. In all types of brazing processes it is important to heat the joint interface of the two materials to the same, high temperature. If one of the specimens is warmer than the other......, or if the hottest area is located outside the joint interface, a number of defects may appear: the braze metal may flow away from the joint, the flux may burn off, poor binding of the braze metal may appear or the braze metal may be overheated. Joint geometry as well as electro-magnetic properties of the work piece...

  11. Variable Joint Elasticities in Running

    Science.gov (United States)

    Peter, Stephan; Grimmer, Sten; Lipfert, Susanne W.; Seyfarth, Andre

    In this paper we investigate how spring-like leg behavior in human running is represented at joint level. We assume linear torsion springs in the joints and between the knee and the ankle joint. Using experimental data of the leg dynamics we compute how the spring parameters (stiffness and rest angles) change during gait cycle. We found that during contact the joints reveal elasticity with strongly changing parameters and compare the changes of different parameters for different spring arrangements. The results may help to design and improve biologically inspired spring mechanisms with adjustable parameters.

  12. Comparison of Biocompatibility of Cemented vs. Cementless Hip Joint Endoprostheses Based on Postoperative Evaluation of Proinflammatory Cytokine Levels

    Science.gov (United States)

    Szypuła, Jan; Cabak, Anna; Kiljański, Marek; Boguszewski, Dariusz; Tomaszewski, Wiesław

    2016-01-01

    Background The yearly increase in the number of procedures involving implantation of hip joint endoprostheses forces prosthetics manufacturers to search for biologically neutral implants. The goal of this study was to assess the concentration of Interleukin-6 (IL-6) and its correlation with C-reactive protein (CRP), depending on the type of hip joint endoprosthesis (cemented or cementless endoprosthesis) in order to determine implant biotolerance during the early postoperative period. Material/Methods The sample comprised 200 patients [mean age=64 (31–81) years] with coxarthrosis. All patients underwent hip joint arthroplasty using a cemented or cementless endoprosthesis. Blood samples were collected 3 times: before the procedure, on the first day after the procedure, and after 6 weeks. IL-6 and CRP levels were assayed using immunoenzymatic methods. The results were subjected to statistical analysis using the Shapiro-Wilk test. Results On the 1st day after the procedure, CRP and IL-6 concentration increased rapidly after implantation of both cemented and cementless endoprostheses. At 6 weeks postoperatively, the CRP value remained at a similar level in patients after cemented arthroplasty and was almost 2-fold lower in patients who underwent cementless arthroplasty. The IL-6 value returned to the baseline level in patients after cementless arthroplasty and showed an ongoing increasing tendency in patients after cemented arthroplasty. Conclusions 1. The measurement of C-reactive protein and Interleukin-6 is a high-sensitivity test, assessing implant biotolerance. 2. The implantation of a cemented endoprosthesis induces a higher increase in the level of proinflammatory cytokines as compared with a cementless endoprosthesis. 3. For a complete assessment of both early and later body responses to implantation and the related surgical procedure, further studies using available approaches and tools are recommended. PMID:27935873

  13. Miniaturized neural interfaces and implants

    Science.gov (United States)

    Stieglitz, Thomas; Boretius, Tim; Ordonez, Juan; Hassler, Christina; Henle, Christian; Meier, Wolfgang; Plachta, Dennis T. T.; Schuettler, Martin

    2012-03-01

    Neural prostheses are technical systems that interface nerves to treat the symptoms of neurological diseases and to restore sensory of motor functions of the body. Success stories have been written with the cochlear implant to restore hearing, with spinal cord stimulators to treat chronic pain as well as urge incontinence, and with deep brain stimulators in patients suffering from Parkinson's disease. Highly complex neural implants for novel medical applications can be miniaturized either by means of precision mechanics technologies using known and established materials for electrodes, cables, and hermetic packages or by applying microsystems technologies. Examples for both approaches will be introduced and discussed. Electrode arrays for recording of electrocorticograms during presurgical epilepsy diagnosis have been manufactured using approved materials and a marking laser to achieve an integration density that is adequate in the context of brain machine interfaces, e.g. on the motor cortex. Microtechnologies have to be used for further miniaturization to develop polymer-based flexible and light weighted electrode arrays to interface the peripheral and central nervous system. Polyimide as substrate and insulation material will be discussed as well as several application examples for nerve interfaces like cuffs, filament like electrodes and large arrays for subdural implantation.

  14. Management of peri-implant infections

    Directory of Open Access Journals (Sweden)

    K L Vandana

    2015-01-01

    Full Text Available The ever-increasing popularity of dental implants in recent years has been associated with the reported incidence of short-term and long-term complications such as peri-implant mucositis and peri-implantitis. Therapies proposed for treating peri-implantitis are based on the evidence available for the treatment of periodontitis, and are aimed at reducing the bacterial load within peri-implant pockets and decontaminating implant surfaces, and, in some cases, attempting afterward to bring about bone regeneration. The treatment of peri-implant infections comprises conservative (nonsurgical and surgical approaches. This paper reviews various treatment strategies used for the treatment of peri-implant diseases. There are many approaches suggested by various authors for the treatment of peri-implant diseases, but there is no “ideal peri-implant therapy” that has been described in the literature. There is no consensus regarding the treatment protocol as the studies conducted so far have had varying study designs, small sample sizes, and short follow-up periods.

  15. Computerized implant-dentistry: Advances toward automation

    Directory of Open Access Journals (Sweden)

    Minkle Gulati

    2015-01-01

    Full Text Available Advancements in the field of implantology such as three-dimensional imaging, implant-planning software, computer-aided-design/computer-aided-manufacturing (CAD/CAM technology, computer-guided, and navigated implant surgery have led to the computerization of implant-dentistry. This three-dimensional computer-generated implant-planning and surgery has not only enabled accurate preoperative evaluation of the anatomic limitations but has also facilitated preoperative planning of implant positions along with virtual implant placement and subsequently transferring the virtual treatment plans onto the surgical phase via static (guided or dynamic (navigated systems aided by CAD/CAM technology. Computerized-implant-dentistry being highly predictable and minimally invasive in nature has also allowed implant placement in patients with medical comorbidities (e.g. radiation therapy, blood dyscrasias, in patients with complex problems following a significant alteration of the bony anatomy as a result of benign or malignant pathology of the jaws or trauma and in patients with other physical and emotional problems. With significant achievements accomplished in the field of computerized implant-dentistry, attempts are now been made toward complete automation of implant-dentistry.

  16. Exposed Dental Implant? Local Autograft A Saviour!

    Science.gov (United States)

    Rai, Raj; Punde, Prashant A; Suryavanshi, Harshal; Shree, Swetha

    2015-01-01

    Implant exposure due to faulty placement, posses as the most common reason for implant failure. The implant placed too close to buccal or lingual cortex have lead to such failure on numerous occasions. Also, anatomic variations like the thin buccolingual width of alveolar ridge predispose exposure of the implant. 25-year-old female patient had undergone surgical placement of implants in mandibular anterior region 2 months back in the private dental clinic. The clinician noted Grade I mobility in one of the implants placed. The case was referred to the author. Thin overlying gingiva depicted an entire buccal aspect of the implant, which suggested more than 90 % loss of buccal cortex. According to literature and review of similar case reports, the only way suggested was to surgically remove the implant and wait for 12-24 months for the bone to heal for subsequent placement. Rather than the removal of implants as suggested, the author followed a naval approach of reinforcing buccal cortex using an autogenous cortical block from mandibular symphysis. The reinforcement surgery had certainly saved patients time, money and most importantly limits a crucial period of edentulism, which may be enforced on a patient in case the implant was removed. PMID:26668490

  17. Computerized implant-dentistry: Advances toward automation

    Science.gov (United States)

    Gulati, Minkle; Anand, Vishal; Salaria, Sanjeev Kumar; Jain, Nikil; Gupta, Shilpi

    2015-01-01

    Advancements in the field of implantology such as three-dimensional imaging, implant-planning software, computer-aided-design/computer-aided-manufacturing (CAD/CAM) technology, computer-guided, and navigated implant surgery have led to the computerization of implant-dentistry. This three-dimensional computer-generated implant-planning and surgery has not only enabled accurate preoperative evaluation of the anatomic limitations but has also facilitated preoperative planning of implant positions along with virtual implant placement and subsequently transferring the virtual treatment plans onto the surgical phase via static (guided) or dynamic (navigated) systems aided by CAD/CAM technology. Computerized-implant-dentistry being highly predictable and minimally invasive in nature has also allowed implant placement in patients with medical comorbidities (e.g. radiation therapy, blood dyscrasias), in patients with complex problems following a significant alteration of the bony anatomy as a result of benign or malignant pathology of the jaws or trauma and in patients with other physical and emotional problems. With significant achievements accomplished in the field of computerized implant-dentistry, attempts are now been made toward complete automation of implant-dentistry. PMID:25810585

  18. Tooth Retained Implant: No More an Oxymoron

    Directory of Open Access Journals (Sweden)

    Divya Bhat

    2011-03-01

    Full Text Available Introduction: Periodontally af-fected teeth are treated in one of the two ways. (1 Tooth retention after periodontal surgery, in which the degree of regeneration achieved is unpredictable. (2 Tooth extrac-tion and implant placement. Implants have an osseointegrated surface which does not provide adequate shock absorption. Regeneration can be achieved by resecting the crown of the affected tooth and submerging the root. This technique has not had a clinical application so far as the tooth becomes difficult to restore. Placing an implant within the root can make the retained root restorable. At the same time, as the implant is placed within the root surface it achieves a periodontal integration which dampens occlusal forces better than osseointegration. Therefore, such a “tooth retained implant” may serve as an additional treatment option with significant benefits over tooth retention and implant placement alone. The hypothesis: Implants placed within retained roots have shown cementum deposition and attachment of periodontal ligament fibers over their surface. This periodontal attachment may be able to dam-pen forces better than in an osseointegrated implant. Moreover, since an implant is being placed, the crown of the tooth can be resected and submerged. This prevents epithelial migration, allows for the periodontal ligament cells to populate the wound and favors regeneration.Evaluation of the hypothesis: The technique of placing implants within cavities prepared in the root and then submerging them are simple for any practitioner placing implants routinely.

  19. In Vivo Assessment of Phage and Linezolid Based Implant Coatings for Treatment of Methicillin Resistant S. aureus (MRSA Mediated Orthopaedic Device Related Infections.

    Directory of Open Access Journals (Sweden)

    Sandeep Kaur

    Full Text Available Staphylococcus comprises up to two-thirds of all pathogens in orthopaedic implant infections with two species respectively Staphylococcus aureus and Staphylococcus epidermidis, being the predominate etiological agents isolated. Further, with the emergence of methicillin-resistant S. aureus (MRSA, treatment of S. aureus implant infections has become more difficult, thus representing a devastating complication. Use of local delivery system consisting of S.aureus specific phage along with linezolid (incorporated in biopolymer allowing gradual release of the two agents at the implant site represents a new, still unexplored treatment option (against orthopaedic implant infections that has been studied in an animal model of prosthetic joint infection. Naked wire, hydroxypropyl methylcellulose (HPMC coated wire and phage and /or linezolid coated K-wire were surgically implanted into the intra-medullary canal of mouse femur bone of respective groups followed by inoculation of S.aureus ATCC 43300(MRSA. Mice implanted with K-wire coated with both the agents i.e phage as well as linezolid (dual coated wires showed maximum reduction in bacterial adherence, associated inflammation of the joint as well as faster resumption of locomotion and motor function of the limb. Also, all the coating treatments showed no emergence of resistant mutants. Use of dual coated implants incorporating lytic phage (capable of self-multiplication as well as linezolid presents an attractive and aggressive early approach in preventing as well as treating implant associated infections caused by methicillin resistant S. aureus strains as assessed in a murine model of experimental joint infection.

  20. TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND GENERALIZED JOINT HYPERMOBILITY

    NARCIS (Netherlands)

    DIJKSTRA, PU; DEBONT, LGM; STEGENGA, B; BOERING, G

    1992-01-01

    Peripheral joint mobility of temporomandibular joint (TMJ) osteoarthrosis and internal derangement patients (n = 25) and of a control group (n = 29) was measured according to a rigidly standardized protocol, in order to study the relationships between TMJ osteoarthrosis and internal derangement and

  1. Index of Joint Condition for PVC push-fit joints

    NARCIS (Netherlands)

    Arsenio, A.M.; Vreeburg, J.H.G.; Rietveld, L.

    2014-01-01

    The Index of Joint Condition (IJC) for polyvinyl chloride (PVC) push-fit joints, discussed in this article, was derived from installation guidelines and from destructive laboratory tests. The IJC is presented in a graphical framework and is a powerful tool to employ in order to visualize and compare

  2. 3D perfusion bioreactor-activated porous granules on implant fixation and early bone formation in sheep

    DEFF Research Database (Denmark)

    Ding, Ming; Snoek Henriksen, Susan; Martinetti, Roberta

    2017-01-01

    Early fixation of total joint arthroplasties is crucial for ensuring implant survival. An alternative bone graft material in revision surgery is needed to replace the current gold standard, allograft, seeing that the latter is associated with several disadvantages. The incubation of such a constr......, bone formation was observed in all groups, while the bioreactor-activated graft material did not reveal additional effects on early implant fixation comparable to allograft in this model. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2016....

  3. Selective left ventricular sensing lead implantation to overcome undersensing of ventricular fibrillation during implantable cardioverter defibrillator implantation.

    Science.gov (United States)

    Steinberg, Christian; Philippon, François; O'Hara, Gilles; Molin, Franck

    2013-06-01

    Accurate sensing of malignant arrhythmia is critical for the appropriate delivery of therapy from implantable cardioverter defibrillators, and undersensing of ventricular tachyarrhythmias can have catastrophic consequences. Here, we present an unusual case of ventricular fibrillation undersensing from the right ventricular lead at multiple different implantation sites because of very low amplitude voltage signals during induced ventricular fibrillation. A left ventricular sensing electrode was implanted to allow correct sensing and therapy delivery.

  4. 7-Be Implantation in Plastics for Prosthesis Wear Studies

    Science.gov (United States)

    Greife, Uwe; Erikson, L.; Patel, N.; Wimmer, M.; Dwiwedi, Y.; Laurent, M.; Chipps, K.; Blackmon, J.; Kozub, R.; Bardayan, D.; Gross, C.; Stracener, D.; Smith, M.; Nesaraya, C.; Rehm, E.; Ahmed, I.; Greene, J.

    2010-11-01

    The current generation of highly cross linked ultrahigh molecular weight polyethylenes (PE) for hip and knee joint replacement have achieved such low in vitro wear rates that efforts have been underway to develop more sensitive methods to measure polyethylene wear. The most widely used technique, the gravimetric method, suffers from the notable disadvantage that mass gain by fluid absorption can considerably exceed mass loss by wear, making the wear measurement inaccurate, sometimes even leading to negative ``wear'' values. The purpose of this experiment was to investigate the use of a radioactive tracer, beryllium-7 (7-Be), to circumvent the problem of fluid absorption and thereby achieve a much more sensitive and accurate wear measurement. This proof of principle study demonstrated the general feasibility of 7-Be implantation (performed at the Holifield Radioactive Ion Beam Facility of Oak Ridge National Laboratory) for PE wear analysis.

  5. Treatment concepts for the posterior maxilla and mandible: short implants versus long implants in augmented bone

    Science.gov (United States)

    2017-01-01

    The aim of this narrative review is to describe treatment options for the posterior regions of the mandible and the maxilla, comparing short implants vs. longer implants in an augmented bone. The dental literature was screened for treatment options enabling the placement of dental implants in posterior sites with a reduced vertical bone height in the maxilla and the mandible. Short dental implants have been increasingly used recently, providing a number of advantages including reduced patient morbidity, shorter treatment time, and lower costs. In the posterior maxilla, sinus elevation procedures were for long considered to be the gold standard using various bone substitute materials and rendering high implant survival rates. More recently, implants were even placed without any further use of bone substitute materials, but the long-term outcomes have yet to be documented. Vertical bone augmentation procedures in the mandible require a relatively high level of surgical skill and allow the placement of standard-length dental implants by the use of autogenous bone blocks. Both treatment options, short dental implants, and standard-length implants in combination with vertical bone augmentation procedures, appear to result in predictable outcomes in terms of implant survival rates. According to recent clinical studies comparing the therapeutic options of short implants vs. long implants in augmented bone, the use of short dental implants leads to a number of advantages for the patients and the clinician. PMID:28261519

  6. Treatment concepts for the posterior maxilla and mandible: short implants versus long implants in augmented bone.

    Science.gov (United States)

    Thoma, Daniel Stefan; Cha, Jae-Kook; Jung, Ui-Won

    2017-02-01

    The aim of this narrative review is to describe treatment options for the posterior regions of the mandible and the maxilla, comparing short implants vs. longer implants in an augmented bone. The dental literature was screened for treatment options enabling the placement of dental implants in posterior sites with a reduced vertical bone height in the maxilla and the mandible. Short dental implants have been increasingly used recently, providing a number of advantages including reduced patient morbidity, shorter treatment time, and lower costs. In the posterior maxilla, sinus elevation procedures were for long considered to be the gold standard using various bone substitute materials and rendering high implant survival rates. More recently, implants were even placed without any further use of bone substitute materials, but the long-term outcomes have yet to be documented. Vertical bone augmentation procedures in the mandible require a relatively high level of surgical skill and allow the placement of standard-length dental implants by the use of autogenous bone blocks. Both treatment options, short dental implants, and standard-length implants in combination with vertical bone augmentation procedures, appear to result in predictable outcomes in terms of implant survival rates. According to recent clinical studies comparing the therapeutic options of short implants vs. long implants in augmented bone, the use of short dental implants leads to a number of advantages for the patients and the clinician.

  7. Exploring Effectiveness of Computer-Aided Planning in Implant Positioning for a Single Immediate Implant Placement.

    Science.gov (United States)

    Edelmann, Alexander R; Hosseini, Bashir; Byrd, Warren C; Preisser, John S; Tyndall, Donald A; Nguyen, Tung; Bencharit, Sompop

    2016-06-01

    The value of computer-aided implant planning using cone-beam computerized tomography (CBCT) for single immediate implants was explored. Eighteen patients requiring extraction of a tooth followed by a single immediate implant were enrolled. Small volume preoperative CBCT scans were used to plan the position of the implant. A taper screwed-type implant was immediately placed into a fresh socket using only the final 1 or 2 drills for osteotomy. Postoperative CBCTs were used for the analysis of actual implant placement positioning. Measurements of the planned and the actual implant position were made with respect to their position relative to the adjacent teeth. Mesio-distal displacements and the facial-lingual deviation of the implant from the planned position were determined. Changes in the angulation of the planned and actual implant position in relation to the clinical crown were also measured. To statistically summarize the results, box plots and 95% CIs for means of paired differences were used. The analysis showed no statistical difference between the planned position and final implant placement position in any measurement. The CBCT scans coupled with the computer-aided implant planning program along with a final 1-to-2 drill protocol may improve the accuracy of single immediate implant placement for taper screwed-type implants.

  8. The History, Technical Specifications and Efficacy of Plasma Spray Coatings Applied to Joint Replacement Prostheses

    Directory of Open Access Journals (Sweden)

    Andrew McCabe

    2016-12-01

    Full Text Available Thermal plasma sprayed coatings are designed to improve both the biocompatibility and durability of implantable medical devices, and include pure titanium, cobalt/chrome alloy and hydroxyapatite.  Coated joint replacements have now been in continuous clinical use for thirty years and are applied to products manufactured or used in Europe, North America, South America, Africa, Asia and Australasia. Prostheses incorporating such coatings have been successfully implanted into several million of patients worldwide and to date there have been very few reports of any failure of an implant which could be attributed to problems with, or failure of, the coating. This paper summarises the early history of cementless prostheses and subsequent development, specification, validation, regulatory requirements and clinical performance of thermal plasma spray coatings provided by Accentus Medical.

  9. Ion implantation in crystalline and amorphous materials

    Science.gov (United States)

    Tasch, Al F.

    1998-05-01

    Ion implantation continues to be the selective doping technique of choice in silicon integrated circuit (IC) manufacturing, and its applications continue to grow in doping, damage gettering, and process simplification. However, in both technology and manufacturing equipment development there is a rapidly increasing need to understand in detail the dependence of implanted impurity profiles and implant-induced damage profiles in silicon on all key implant parameters. These reasons include largely reduced thermal budgets in IC processing, heavy emphasis on control of equipment and process costs, and the need for rigid manufacturing control. Towards this end, accurate, comprehensive, and computationally efficient models for ion implanted profiles (impurity and damage) in silicon are indispensable. These models greatly facilitate more timely technology development and implementation in manufacturing, improved manufacturing process control; and the development of new ion implantation tools can be executed more efficiently. This talk describes ion implant models and simulators developed in the ion implant modeling research/education project at the University of Texas at Austin. Physically based models for ion implantation into single-crystal Si have been developed for the commonly used implant species B, BF(2), As, P, and Si for the most commonly used implant energy ranges. These models have explicit dependence on the major implant parameters (energy, dose, tilt angle and rotation angle). In addition, the models have been extensively verified by the vast amount of experimental data which has been obtained in the experimental part of this project. The models have been extended down to ultra-low implant energies (model has been developed which accurately predicts as-implanted profiles for B and P up to at least 2.5 and 5 MeV, respectively. In addition, for energies below 200keV (the most commonly used energies), a rigorous physically based implant-induced damage model has

  10. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Human Resources Division

    2001-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Neil Calder, Mrs Sudeshna Datta Cockerill, Mrs Andrée Fontbonne, Mrs Moniek Laurent and Mr Ulrich Liptow with regard to membership in the Pension Fund under the period with a Paid Associate contract, appeals dealt with on a collective basis. As the appellants have not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 10 to 31 August 2001.

  11. Ambulatory estimation of knee-joint kinematics in anatomical coordinate system using accelerometers and magnetometers.

    Science.gov (United States)

    Kun, Liu; Inoue, Yoshio; Shibata, Kyoko; Enguo, Cao

    2011-02-01

    Knee-joint kinematics analysis using an optimal sensor set and a reliable algorithm would be useful in the gait analysis. An original approach for ambulatory estimation of knee-joint angles in anatomical coordinate system is presented, which is composed of a physical-sensor-difference-based algorithm and virtual-sensor-difference-based algorithm. To test the approach, a wearable monitoring system composed of accelerometers and magnetometers was developed and evaluated on lower limb. The flexion/extension (f/e), abduction/adduction (a/a), and inversion/extension (i/e) rotation angles of the knee joint in the anatomical joint coordinate system were estimated. In this method, since there is no integration of angular acceleration or angular velocity, the result is not distorted by offset and drift. The three knee-joint angles within the anatomical coordinate system are independent of the orders, which must be considered when Euler angles are used. Besides, since there are no physical sensors implanted in the knee joint based on the virtual-sensor-difference-based algorithm, it is feasible to analyze knee-joint kinematics with less numbers and types of sensors than those mentioned in some others methods. Compared with results from the reference system, the developed wearable sensor system is available to do gait analysis with fewer sensors and high degree of accuracy.

  12. Implanted electrodes for multi-month EEG.

    Science.gov (United States)

    Jochum, Thomas; Engdahl, Susannah; Kolls, Brad J; Wolf, Patrick

    2014-01-01

    An implanted electroencephalogram (EEG) recorder would help diagnose infrequent seizure-like events. A proof-of-concept study quantified the electrical characteristics of the electrodes planned for the proposed recorder. The electrodes were implanted in an ovine model for eight weeks. Electrode impedance was less than 800 Ohms throughout the study. A frequency-domain determination of sedation performed similarly for surface versus implanted electrodes throughout the study. The time-domain correlation between an implanted electrode and a surface electrode was almost as high as between two surface electrodes (0.86 versus 0.92). EEG-certified clinicians judged that the implanted electrode quality was adequate to excellent and that the implanted electrodes provided the same clinical information as surface electrodes except for a noticeable amplitude difference. No significant issues were found that would stop development of the EEG recorder.

  13. Immediate Implants: Clinical Guidelines for Esthetic Outcomes

    Directory of Open Access Journals (Sweden)

    Mohammad A. Javaid

    2016-06-01

    Full Text Available Research has shown that tooth loss results in morphological changes in alveolar ridge that may influence the subsequent implant placement. Immediate implant placement was introduced as a possible means to limit bone resorption and reduce the number of surgical procedures following tooth extraction. Histological and clinical evidence from human clinical studies showing efficacy of immediate implants has come to light over the last decade or so. However, immediate implant placement is a challenging surgical procedure and requires proper case selection and surgical technique. Furthermore, there appears to be a lack of clinical guidelines for immediate implant placement case selection. Therefore, the aim of this mini-review is to analyze critical evidence from human studies in order to establish clinical guidelines which may help clinicians in case selection when considering immediate implant placement protocol.

  14. Peri-implant hastalıklar

    Directory of Open Access Journals (Sweden)

    M Selim Yavuz

    2011-11-01

    Full Text Available

    The treatment of partially or totally edentulous subjects with oral implants is a common procedure. Biological complications are occur around implants which are peri-implant mucositis and periimplantitis.

    Peri-implant mucositis is pathological condition which is normally localized in the soft tissues surrounding an oral implant. Peri-implantitis surrounding oral implants is an inflammatory process affecting the soft and hard tissues resulting in rapid loss of supporting bone associated with bleeding and suppuration. The diagnosis of peri-implant diseases is usually established by assessing probing depth, gingival index, bleeding on probing and radiographic bone resorption examinations. The etiopathogenesis of peri-implant diseases is related to the periimplant environment and to the soft tissues/implant interface, to patient-related factors (smoke, systemic diseases, plaque control and to host-parasite equilibrium.

    Peri-implant diseases can be controlled successfully by providing mechanical, antiseptic, antibiotic and surgical supportive therapy, individually or combined.

     

    ÖZET

    Tam veya kısmi dişsiz hastaların tedavisinde yaygın prosedürlerden biride oral implantlardır. İmplantların etrafında peri-implant mukositis ve peri-implantitis diye biyolojik komplikasyonlar meydana gelir. Peri-implant mukositis bir oral implantın etrafındaki normalde yumuşak dokuda lokalize patolojik bir durumdur. Oral implantların çevresindeki peri-implantitis süpürasyon ve kanama ile ilişkili destek kemiğin hızlı kaybı ile sonuçlanan, sert ve yumuşak dokuları etkileyen inflamatuar bir süreçtir.

    Peri-implant hastalıkların teşhisi genellikle sondalama cep derinliği, gingival indeks, sondalamada kanama ve radyografik kemik rezorbsiyon muayenesi ile kanıtlanır. Peri-implant hastalıkların etiyopatogenezi, peri-implant çevre ve yumuşak doku-implant yüzleşmesi, hasta ile ili

  15. The diagnosis of breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse; Conrad, Carsten;

    2005-01-01

    STUDY OBJECTIVE: The aim of this study was to evaluate the accuracy of Magnetic Resonance Imaging (MRI) as performed according to a strict study protocol in diagnosing rupture of silicone breast implants. MATERIAL AND METHODS: The study population consisted of 64 women with 118 implants, who had...... participated in either one or two study MRI examinations, aiming at determining the prevalence and incidence of silent implant rupture, respectively, and who subsequently underwent explantation. Implant rupture status was determined by four independent readers and a consensus diagnosis of either rupture...... (intracapsular or extracapsular), possible rupture or intact implant was then obtained. Strict predetermined rupture criteria were applied as described in this report and findings at surgery were abstracted in a standardised manner and results compared. RESULTS: At MRI, 66 implants were diagnosed as ruptured...

  16. Treatment strategies for infraoccluded dental implants.

    Science.gov (United States)

    Zitzmann, Nicola U; Arnold, Dario; Ball, Judith; Brusco, Daniel; Triaca, Albino; Verna, Carlalberta

    2015-03-01

    Single-tooth implants in the maxillary anterior region have the highest risk of esthetic complications from infrapositioning due to continuing maxillary growth and the eruption of adjacent teeth. Although the placement of anterior single-tooth implants should normally be postponed, particularly girls and young women with a hyperdivergent growth pattern, if an infraposition of an implant is present, then thorough examination and strategic planning are required. According to the severity, the strategic treatment options are as follows: simple retention; adjustment or replacement of the implant restoration, possibly including adjacent teeth; surgical implant repositioning by segmental osteotomy combined with osseodistraction; or submergence or removal of the implant. With the patient presented, an interdisciplinary approach that combined orthodontic alignment, surgical segmental osteotomy, distraction osteogenesis, and restorative features offered the opportunity to realign the adjacent teeth into the arch and to harmonize the gingival contour by means of continuous soft tissue enlargement and adaptation.

  17. Methods to measure stability of dental implants

    Directory of Open Access Journals (Sweden)

    Shruti Digholkar

    2014-01-01

    Full Text Available Dental implant treatment is an excellent option for prosthetic restoration that is associated with high success rates. Implant stability is essential for a good outcome. The clinical assessment of osseointegration is based on mechanical stability rather than histological criteria, considering primary stability (absence of mobility in bone bed after implant insertion and secondary stability (bone formation and remodeling at implant-bone interface. However, due to the invasive nature of the histological methods various other methods have been proposed: Radiographs, the surgeon′s perception, Insertion torque (cutting torque analysis, seating torque, reverse torque testing, percussion testing, impact hammer method, pulsed oscillation waveform, implant mobility checker, Periotest, resonance frequency analysis. This review focuses on the methods currently available for the evaluation of implant stability.

  18. 37 CFR 1.45 - Joint inventors.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Joint inventors. 1.45 Section... Patent § 1.45 Joint inventors. (a) Joint inventors must apply for a patent jointly and each must make the... patent for an invention invented by them jointly, except as provided in § 1.47. (b) Inventors may...

  19. 38 CFR 4.45 - The joints.

    Science.gov (United States)

    2010-07-01

    ..., ratable on a parity with major joints. The lumbosacral articulation and both sacroiliac joints are... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false The joints. 4.45 Section... DISABILITIES Disability Ratings The Musculoskeletal System § 4.45 The joints. As regards the joints the...

  20. One-stage explant-implant procedure of exposed porous orbital implants

    DEFF Research Database (Denmark)

    Toft, Peter B; Rasmussen, Marie L Roed; Prause, Jan Ulrik

    2011-01-01

    ) orbital implant from January 2000 to February 2009 were included. The patient records were reviewed; patients were interviewed by telephone and invited for a clinical examination. Histopathological examination was carried out on the removed implants. Main outcome measures were: presence of exposure......Purpose:  To investigate the risks of implant exposure after a combined explant-implant procedure in patients with an exposed porous orbital implant. Methods:  Twenty-four consecutive patients who had a combined explant-implant procedure of an exposed hydroxyapatite (21) or porous polyethylene (3...... of the new implant or not, patient graded satisfaction with the cosmetic result, and presence of poor motility. Results:  None of the new implants became exposed or infected in the follow-up period of 25 [3-94] months (median [range]). The patients scored their satisfaction with the cosmetic result...

  1. Structuring managed care joint ventures.

    Science.gov (United States)

    Williams, L

    1995-08-01

    Providers that undertake joint ventures to secure managed care contracts must understand the important governance, operational, legal, and political issues involved. Careful planning in all these areas can help ensure that the joint venture will meet its goals and avoid problems such as inappropriately negotiated contracts and legal violations.

  2. Steroid injections - tendon, bursa, joint

    Science.gov (United States)

    ... PA: Elsevier Mosby; 2014:chap 71. Schrank KS. Joint disorders. In: Adams JG, ed. Emergency Medicine. 2nd ed. ... A.M. Editorial team. Related MedlinePlus Health Topics Joint Disorders Steroids Browse the Encyclopedia A.D.A.M., ...

  3. Clinical management of implant prostheses in patients with bruxism

    NARCIS (Netherlands)

    Komiyama, O.; Lobbezoo, F.; de Laat, A.; Iida, T.; Kitagawa, T.; Murakami, H.; Kato, T.; Kawara, M.

    2012-01-01

    There is general agreement that excessive stress to the bone-implant interface may result in implant overload and failure. Early failure of the implant due to excessive loading occurs shortly after uncovering the implant. Excess load on a final restoration after successful implant integration can re

  4. Ion sources for energy extremes of ion implantation.

    Science.gov (United States)

    Hershcovitch, A; Johnson, B M; Batalin, V A; Kropachev, G N; Kuibeda, R P; Kulevoy, T V; Kolomiets, A A; Pershin, V I; Petrenko, S V; Rudskoy, I; Seleznev, D N; Bugaev, A S; Gushenets, V I; Litovko, I V; Oks, E M; Yushkov, G Yu; Masunov, E S; Polozov, S M; Poole, H J; Storozhenko, P A; Svarovski, A Ya

    2008-02-01

    For the past four years a joint research and development effort designed to develop steady state, intense ion sources has been in progress with the ultimate goal to develop ion sources and techniques that meet the two energy extreme range needs of meV and hundreads of eV ion implanters. This endeavor has already resulted in record steady state output currents of high charge state of antimony and phosphorus ions: P(2+) [8.6 pmA (particle milliampere)], P(3+) (1.9 pmA), and P(4+) (0.12 pmA) and 16.2, 7.6, 3.3, and 2.2 pmA of Sb(3+)Sb(4+), Sb(5+), and Sb(6+) respectively. For low energy ion implantation, our efforts involve molecular ions and a novel plasmaless/gasless deceleration method. To date, 1 emA (electrical milliampere) of positive decaborane ions was extracted at 10 keV and smaller currents of negative decaborane ions were also extracted. Additionally, boron current fraction of over 70% was extracted from a Bernas-Calutron ion source, which represents a factor of 3.5 improvement over currently employed ion sources.

  5. ION SOURCES FOR ENERGY EXTREMES OF ION IMPLANTATION.

    Energy Technology Data Exchange (ETDEWEB)

    HERSCHCOVITCH,A.; JOHNSON, B.M.; BATALIN, V.A.; KROPACHEV, G.N.; KUIBEDA, R.P.; KULEVOY, T.V.; KOLOMIETS, A.A.; PERSHIN, V.I.; PETRENKO, S.V.; RUDSKOY, I.; SELEZNEV, D.N.; BUGAEV, A.S.; GUSHENETS, V.I.; LITOVKO, I.V.; OKS, E.M.; YUSHKOV, G. YU.; MASEUNOV, E.S.; POLOZOV, S.M.; POOLE, H.J.; STOROZHENKO, P.A.; SVAROVSKI, YA.

    2007-08-26

    For the past four years a joint research and development effort designed to develop steady state, intense ion sources has been in progress with the ultimate goal to develop ion sources and techniques, which meet the two energy extreme range needs of mega-electron-volt and 100's of electron-volt ion implanters. This endeavor has already resulted in record steady state output currents of high charge state of Antimony and Phosphorous ions: P{sup 2+} (8.6 pmA), P{sup 3+} (1.9 pmA), and P{sup 4+} (0.12 pmA) and 16.2, 7.6, 3.3, and 2.2 pmA of Sb{sup 3+} Sb{sup 4+}, Sb{sup 5+}, and Sb{sup 6+} respectively. For low energy ion implantation our efforts involve molecular ions and a novel plasmaless/gasless deceleration method. To date, 1 emA of positive Decaborane ions were extracted at 10 keV and smaller currents of negative Decaborane ions were also extracted. Additionally, Boron current fraction of over 70% was extracted from a Bemas-Calutron ion source, which represents a factor of 3.5 improvement over currently employed ion sources.

  6. Wear Behavior of an Unstable Knee: Stabilization via Implant Design?

    Directory of Open Access Journals (Sweden)

    Jörn Reinders

    2014-01-01

    Full Text Available Background. Wear-related failures and instabilities are frequent failure mechanisms of total knee replacements. High-conforming designs may provide additional stability for the joint. This study analyzes the effects of a ligamentous insufficiency on the stability and the wear behavior of a high-conforming knee design. Methods. Two simulator wear tests were performed on a high-conforming total knee replacement design. In the first, a ligamentous-stable knee replacement with a sacrificed anterior cruciate ligament was simulated. In the second, a ligamentous-unstable knee with additionally insufficient posterior cruciate ligament and medial collateral ligament was simulated. Wear was determined gravimetrically and wear particles were analyzed. Implant kinematics was recorded during simulation. Results. Significantly higher wear rates (P≤0.001 were observed for the unstable knee (14.58±0.56 mg/106 cycles compared to the stable knee (7.97 ± 0.87 mg/106 cycles. A higher number of wear particles with only small differences in wear particle characteristics were observed. Under unstable knee conditions, kinematics increased significantly for translations and rotations (P≤0.01. This increase was mainly attributed to higher tibial posterior translation and internal rotations. Conclusion. Higher kinematics under unstable test conditions is a result of insufficient stabilization via implant design. Due to the higher kinematics, increased wear was observed in this study.

  7. Posterior iliac offset: description of a new radiological measurement of sacroiliac joint instability.

    Science.gov (United States)

    Tonne, B M; Kempton, L B; Lack, W D; Karunakar, M A

    2014-11-01

    The purpose of this study was to describe the radiological characteristics of a previously unreported finding: posterior iliac offset at the sacroiliac joint and to assess its association with pelvic instability as measured by initial displacement and early implant loosening or failure. Radiographs from 42 consecutive patients with a mean age of 42 years (18 to 77; 38 men, four women) and mean follow-up of 38 months (3 to 96) with Anteroposterior Compression II injuries, were retrospectively reviewed. Standardised measurements were recorded for the extent of any diastasis of the pubic symphysis, widening of the sacroiliac joint, static vertical ramus offset and a novel measurement (posterior offset of the ilium at the sacroiliac joint identified on axial CT scan). Pelvic fractures with posterior iliac offset exhibited greater levels of initial displacement of the anterior pelvis (anterior sacroiliac widening, pubic symphysis diastasis and static vertical ramus offset, p < 0.001,0.034 and 0.028, respectively). Pelvic fractures with posterior ilium offset also demonstrated higher rates of implant loosening regardless of fixation method (p = 0.05). Posterior offset of the ilium was found to be a reliable and reproducible measurement with substantial inter-observer agreement (kappa = 0.70). Posterior offset of the ilium on axial CT scan is associated with greater levels of initial pelvic displacement and early implant loosening.

  8. Improving electric contacts by ion implantation

    Energy Technology Data Exchange (ETDEWEB)

    Xu Shiru; Zhang Ying; Zheng Tiampi

    1989-01-01

    This article studies the improvement of electric contacts by ion implantation. 1 x 10/sup 17/ cm/sup -2/ of N/sup +/ and N/sub 2//sup +/ was implanted into two kinds of electric contacts, then a make-and-break test was made with the low voltage electrical apparatus. The weight loss of the contacts, temperature rise, contact resistance and transfer of material between the two contacts were measured. The contacts implanted by ions have improved electrical erosion properties.

  9. Antimicrobial technology in orthopedic and spinal implants

    Science.gov (United States)

    Eltorai, Adam EM; Haglin, Jack; Perera, Sudheesha; Brea, Bielinsky A; Ruttiman, Roy; Garcia, Dioscaris R; Born, Christopher T; Daniels, Alan H

    2016-01-01

    Infections can hinder orthopedic implant function and retention. Current implant-based antimicrobial strategies largely utilize coating-based approaches in order to reduce biofilm formation and bacterial adhesion. Several emerging antimicrobial technologies that integrate a multidisciplinary combination of drug delivery systems, material science, immunology, and polymer chemistry are in development and early clinical use. This review outlines orthopedic implant antimicrobial technology, its current applications and supporting evidence, and clinically promising future directions. PMID:27335811

  10. VENTRAL SPONDYLODESIS BYTITAN IMPLANTS AT SPINE TUMORS

    Directory of Open Access Journals (Sweden)

    A. V. Babkin

    2010-01-01

    Full Text Available At RSPC of traumatology and orthopaedic surgery and Institute of powders metallurgic porous implants are working out which allow complitely replace alio- and autotranplants and improve the surgical technology of interbody spondylodesis. Porous implants, made from mechanic durabilities, are bioinert or biocompatible materials, provide durabilities prime spondylodesis. It doesn't need an additional fixation, realize a possibility to grow a bone matter in powder structure of implants.

  11. Surrogate Modeling of Deformable Joint Contact using Artificial Neural Networks

    Science.gov (United States)

    Eskinazi, Ilan; Fregly, Benjamin J.

    2016-01-01

    Deformable joint contact models can be used to estimate loading conditions for cartilage-cartilage, implant-implant, human-orthotic, and foot-ground interactions. However, contact evaluations are often so expensive computationally that they can be prohibitive for simulations or optimizations requiring thousands or even millions of contact evaluations. To overcome this limitation, we developed a novel surrogate contact modeling method based on artificial neural networks (ANNs). The method uses special sampling techniques to gather input-output data points from an original (slow) contact model in multiple domains of input space, where each domain represents a different physical situation likely to be encountered. For each contact force and torque output by the original contact model, a multi-layer feed-forward ANN is defined, trained, and incorporated into a surrogate contact model. As an evaluation problem, we created an ANN-based surrogate contact model of an artificial tibiofemoral joint using over 75,000 evaluations of a fine-grid elastic foundation (EF) contact model. The surrogate contact model computed contact forces and torques about 1000 times faster than a less accurate coarse grid EF contact model. Furthermore, the surrogate contact model was seven times more accurate than the coarse grid EF contact model within the input domain of a walking motion. For larger input domains, the surrogate contact model showed the expected trend of increasing error with increasing domain size. In addition, the surrogate contact model was able to identify out-of-contact situations with high accuracy. Computational contact models created using our proposed ANN approach may remove an important computational bottleneck from musculoskeletal simulations or optimizations incorporating deformable joint contact models. PMID:26220591

  12. A Review of Dental Implant Treatment Planning and Implant Design Based on Bone Density

    OpenAIRE

    Torkzaban; Moradi Haghgoo; khoshhal; Arabi; Razaghi

    2013-01-01

    Context A key determinant for clinical success is the diagnosis of the bone density in a potential implant site. The percentage of bone-implant contact is related to bone density, and the axial stress contours around an implant are affected by the density of bone. Evidence Acquisition A number of reports have emphasized the importance of the quality of bone on the survival of dental implants. The volume and density of the recipien...

  13. Effectiveness of Implant Therapy Analyzed in a Swedish Population: Early and Late Implant Loss

    OpenAIRE

    Derks, J.; Håkansson, J.; Wennström, J.L.; Tomasi, C.; Larsson, M.; Berglundh, T

    2015-01-01

    Treatment outcomes in implant dentistry have been mainly assessed as implant survival rates in small, selected patient groups of specialist or university clinical settings. This study reports on loss of dental implants assessed in a large and randomly selected patient sample. The results were aimed at representing evaluation of effectiveness of implant dentistry. Using the national data register of the Swedish Social Insurance Agency, 4,716 patients were randomly selected. All had been provid...

  14. Trajectory surgical guide stent for implant placement.

    Science.gov (United States)

    Adrian, E D; Ivanhoe, J R; Krantz, W A

    1992-05-01

    This article describes a new implant placement surgical guide that gives both implant location and trajectory to the surgeon. Radiopaque markers are placed on diagnostic dentures and a lateral cephalometric radiograph is made that shows the osseous anatomy at the symphysis and the anterior tooth location. The ideal implant location and trajectory data are transferred to a surgical stent that programs the angle and location of the fixtures at time of surgery. The stent has the additional benefit of acting as an occlusion rim, a mouth prop, and tongue retractor. Use of this stent has resulted in consistently programming the placement of implant fixtures that are prosthodontically ideal.

  15. The modification behaviour for Si implanted PET

    Institute of Scientific and Technical Information of China (English)

    吴瑜光; 张通和; 刘安东; 张旭; 周固

    2003-01-01

    Polyethylene terephthalate (PET) has been modified by Si ion implantation with a dose ranging from 1 × 1016 to 2 × 1017 ions /cm2 using a metal vapor vacuum arc(MEVVA)source. The surface morphology was observed by atomic force microscopy (AFM). The change in the microstructure of Si implanted PET was observed with a transmission electron microscope (TEM). It is believed that the change would improve the conductive properties and wear resistance. The electrical properties of PET have been improved via Si ion implantation. The resistivity of implanted PET decreased obviously with an increase in ion dose. When Si ion dose was 2 × 1017 cm?2, the resistivity of PET could be less than 7.9 Ω@m. The surface hardness and modulus increased obviously. The mechanical property of the implanted PET has been modified greatly. The hardness and modulus of Si implanted PET with a dose of 2 × 1017/cm2 are 12.5 and 2.45 times greater than those of pristine PET, respectively. The area of cutting groove for Si implanted PET is narrower and shallower than those of the unimplanted PET. So the wear resistance is greatly raised. In comparison with metal ion implantation, the improvement of mechanical properties is obvious in ion implantation into PET. Si ion beam modification mechanism of PET is discussed.

  16. Thoracic Outlet Syndrome Following Breast Implant Rupture

    Directory of Open Access Journals (Sweden)

    Raakhi Mistry, MBChB

    2015-03-01

    Full Text Available Summary: We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient.

  17. Thoracic outlet syndrome following breast implant rupture.

    Science.gov (United States)

    Mistry, Raakhi; Caplash, Yugesh; Giri, Pratyush; Kearney, Daniel; Wagstaff, Marcus

    2015-03-01

    We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient.

  18. Physical modification of polyetheretherketone for orthopedic implants

    Science.gov (United States)

    Du, Ya-Wei; Zhang, Li-Nan; Hou, Zeng-Tao; Ye, Xin; Gu, Hong-Sheng; Yan, Guo-Ping; Shang, Peng

    2014-12-01

    Polyetheretherketone (PEEK) is regarded as one of the most potential candidates for replacing current implant applications. To obtain good bone-implant interfaces, many modification methods have been developed to enable PEEK and PEEK-based composites from bio-inert to bioactive. Among them, physical methods have aroused significant attention and been widely used to modify PEEK for orthopedic implants. This review summarizes current physical modification techniques of PEEK for orthopedic applications, which include composite strategies, surface coating methods and irradiation treatments. The positive consequences of those modification methods will encourage continuing investigations and stimulate the wide range of applications of PEEK-based implants in orthopedics.

  19. The case for a generic implant processor.

    Science.gov (United States)

    Strydis, Christos; Gaydadjiev, Georgi N

    2008-01-01

    A more structured and streamlined design of implants is nowadays possible. In this paper we focus on implant processors located in the heart of implantable systems. We present a real and representative biomedical-application scenario where such a new processor can be employed. Based on a suitably selected processor simulator, various operational aspects of the application are being monitored. Findings on performance, cache behavior, branch prediction, power consumption, energy expenditure and instruction mixes are presented and analyzed. The suitability of such an implant processor and directions for future work are given.

  20. Determining factors for implant referral rates.

    Science.gov (United States)

    Levin, Roger P

    2002-01-01

    The research findings indicate that the field of implant dentistry will only grow at a moderately low level unless certain changes are made. Findings indicated that the effort by the implant companies has been nothing short of dramatic, and yet almost 60% of restorative doctors do not participate annually in any implant case. There was no clear indication that younger restorative doctors will significantly increase the number of implant referrals, as their overall implant education has not dramatically differed from those dentists who graduated in earlier years. Once the research was completed, it became obvious to Levin Group that the driving force behind implant referral growth will be implant surgeons, because of their one-to-one relationship with restorative doctors. The Levin Group Implant Management and Marketing Consulting Program is based on approaching restorative doctors in several different levels, starting with awareness all the way through to case facilitation and long-term tracking and communication. Finally, a continuing marketing/education effort needs to be consistently in place with effective materials, not only to create a high level of awareness, but also to motivate restorative doctors to refer cases and then work through the case with the implant surgeon to a satisfactory completion for the restorative doctor, implant surgeon, and patient. While the surgical insertion of implants may seem to carry a high-profit margin relative to the restoration of implants, the truth is that the restoration of implants usually provides a 40% higher profit margin for the restorative doctor than traditional dental services. One of the key issues is that referring doctors have not necessarily learned how to set fees and present cases with regard to implant dentistry. The key factor here is to ensure that the patient understands that implant services involve higher fees than traditional services, because of the necessarily higher levels of experience, education