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Sample records for exeter long-stem prosthesis

  1. Short- or long-stem prosthesis for intramedullary bypass of proximal humeral fractures with severe metaphyseal bone loss: evaluation of primary stability in a biomechanical model.

    Science.gov (United States)

    Spross, Christian; Ebneter, Lukas; Benninger, Emanuel; Erschbamer, Matthias; Erhardt, Johannes; Jost, Bernhard

    2013-12-01

    Proximal humeral fractures with substantial metaphyseal comminution are challenging to treat. In the elderly with osteoporotic bone, arthroplasty sometimes remains the only valuable option; however, the minimally required length of stem fixation is not known. The aim of this study was to investigate the primary stability of cemented short- and long-stem prostheses with different intramedullary fracture bypass lengths. Osteoporotic composite bone models of the humerus (Synbone, Malans, Switzerland) with 3 different fracture levels (group A, 6 cm distal to surgical neck; group B, 7 cm distal to surgical neck; and group C, 8 cm distal to surgical neck) were prepared with a cemented standard short (S)- or long (L)-stem prosthesis and were tested for torque to failure. As a reference, we used models with intact bone (group R-O) and a short-stem prosthesis implanted at the surgical neck (group R-P). The radiographic bypass index (BI) was calculated before testing (fracture level to stem tip [in millimeters]/outer cortical diameter at fracture level [in millimeters]). The resulting BIs of each group were as follows: 1.7 in group A-S, 3.4 in group A-L, 1.4 in group B-S, 3.2 in group B-L, 1.0 in group C-S, and 2.9 in group C-L. Compared with group R-O, the torques to failure of groups B-S and C-S were significantly lower, whereas only group C-S was significantly weaker than group R-P (P fracture heights, we found that only group C-L showed a significantly higher resistance to torque (P < .01). A short-stem bypass with a BI of 1.7 was sufficient for primary stability tested by torque to failure in this biomechanical setting. For smaller BIs, a long-stem prosthesis should be considered. Basic science study, biomechanics. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  2. Prosthesis

    Science.gov (United States)

    A prosthesis is a device designed to replace a missing part of the body or to make a part of the body work better. Diseased or missing eyes, arms, hands, legs, or joints are commonly replaced by prosthetic devices. False teeth are known as dental prostheses. ...

  3. Riddle Hero: Play and Poetry in the Exeter Book Riddles

    Science.gov (United States)

    Higl, Andrew

    2017-01-01

    The author discusses the Exeter Book riddles, some of the earliest poems in English, specifically Old English, as perfect examples of how play and poetry intersect. Their playfulness, he claims, is most apparent in the original manuscript, but notes that few modern readers read Old English. The orthography of the manuscript also helps to make the…

  4. Empowering Managers, Assuring Governors: The Introduction of Dual Assurance at the University of Exeter

    Science.gov (United States)

    Weale, Gillian

    2010-01-01

    Since the start of the academic session 2007-08, the University of Exeter has been operating a unique system of governance known as dual assurance, which has replaced a more traditional system of committees sitting under Council, the governing body. This paper describes the background to the development of dual assurance at Exeter, and the reasons…

  5. Functional outcome, revision rates and mortality after primary total hip replacement--a national comparison of nine prosthesis brands in England.

    Directory of Open Access Journals (Sweden)

    Mark Pennington

    Full Text Available The number of prosthesis brands used for hip replacement has increased rapidly, but there is little evidence on their effectiveness. We compared patient-reported outcomes, revision rates, and mortality for the three most frequently used brands within each prosthesis type: cemented (Exeter V40 Contemporary, Exeter V40 Duration and Exeter V40 Elite Plus Ogee, cementless (Corail Pinnacle, Accolade Trident, and Taperloc Exceed, and hybrid (Exeter V40 Trilogy, Exeter V40 Trilogy, and CPT Trilogy.We used three national databases of patients who had hip replacements between 2008 and 2011 in the English NHS to compare functional outcome (Oxford Hip Score (OHS ranging from 0 (worst to 48 (best in 43,524 patients at six months. We analysed revisions and mortality in 187,201 patients. We used multiple regression to adjust for pre-operative differences. Prosthesis type had an impact on post-operative OHS and revision rates (both p<0.001. Patients with hybrid prostheses had the best functional outcome (mean OHS 39.4, 95%CI 39.1 to 39.7 and those with cemented prostheses the worst (37.7, 37.3 to 38.1. Patients with cemented prostheses had the lowest reported 5-year revision rates (1.3%, 1.2% to 1.4% and those with cementless prostheses the highest (2.2%, 2.1% to 2.4%. Differences in mortality according to prosthesis type were small and not significant (p = 0.06. Functional outcome varied according to brand among cemented (p = 0.05, with Exeter V40 Duration having the best and cementless prostheses (p = 0.01, with Corail Pinnacle having the best. Revision rates varied according to brand among hybrids (p = 0.05, with Exeter V40 Trident having the lowest.Functional outcomes were better with cementless cups and revision rates were lower with cemented stems, which underlies the good overall performance of hybrids. The hybrid Exeter V40 Trident seemed to produce the best overall results. This brand should be considered as a benchmark in randomised trials.

  6. Functional Outcome, Revision Rates and Mortality after Primary Total Hip Replacement – A National Comparison of Nine Prosthesis Brands in England

    Science.gov (United States)

    Pennington, Mark; Grieve, Richard; Black, Nick; van der Meulen, Jan H.

    2013-01-01

    Background The number of prosthesis brands used for hip replacement has increased rapidly, but there is little evidence on their effectiveness. We compared patient-reported outcomes, revision rates, and mortality for the three most frequently used brands within each prosthesis type: cemented (Exeter V40 Contemporary, Exeter V40 Duration and Exeter V40 Elite Plus Ogee), cementless (Corail Pinnacle, Accolade Trident, and Taperloc Exceed), and hybrid (Exeter V40 Trilogy, Exeter V40 Trilogy, and CPT Trilogy). Methods and Findings We used three national databases of patients who had hip replacements between 2008 and 2011 in the English NHS to compare functional outcome (Oxford Hip Score (OHS) ranging from 0 (worst) to 48 (best)) in 43,524 patients at six months. We analysed revisions and mortality in 187,201 patients. We used multiple regression to adjust for pre-operative differences. Prosthesis type had an impact on post-operative OHS and revision rates (both phybrid prostheses had the best functional outcome (mean OHS 39.4, 95%CI 39.1 to 39.7) and those with cemented prostheses the worst (37.7, 37.3 to 38.1). Patients with cemented prostheses had the lowest reported 5-year revision rates (1.3%, 1.2% to 1.4%) and those with cementless prostheses the highest (2.2%, 2.1% to 2.4%). Differences in mortality according to prosthesis type were small and not significant (p = 0.06). Functional outcome varied according to brand among cemented (p = 0.05, with Exeter V40 Duration having the best) and cementless prostheses (p = 0.01, with Corail Pinnacle having the best). Revision rates varied according to brand among hybrids (p = 0.05, with Exeter V40 Trident having the lowest). Conclusions Functional outcomes were better with cementless cups and revision rates were lower with cemented stems, which underlies the good overall performance of hybrids. The hybrid Exeter V40 Trident seemed to produce the best overall results. This brand should be considered as a

  7. Functional outcome, revision rates and mortality after primary total hip replacement--a national comparison of nine prosthesis brands in England.

    Science.gov (United States)

    Pennington, Mark; Grieve, Richard; Black, Nick; van der Meulen, Jan H

    2013-01-01

    The number of prosthesis brands used for hip replacement has increased rapidly, but there is little evidence on their effectiveness. We compared patient-reported outcomes, revision rates, and mortality for the three most frequently used brands within each prosthesis type: cemented (Exeter V40 Contemporary, Exeter V40 Duration and Exeter V40 Elite Plus Ogee), cementless (Corail Pinnacle, Accolade Trident, and Taperloc Exceed), and hybrid (Exeter V40 Trilogy, Exeter V40 Trilogy, and CPT Trilogy). We used three national databases of patients who had hip replacements between 2008 and 2011 in the English NHS to compare functional outcome (Oxford Hip Score (OHS) ranging from 0 (worst) to 48 (best)) in 43,524 patients at six months. We analysed revisions and mortality in 187,201 patients. We used multiple regression to adjust for pre-operative differences. Prosthesis type had an impact on post-operative OHS and revision rates (both phybrid prostheses had the best functional outcome (mean OHS 39.4, 95%CI 39.1 to 39.7) and those with cemented prostheses the worst (37.7, 37.3 to 38.1). Patients with cemented prostheses had the lowest reported 5-year revision rates (1.3%, 1.2% to 1.4%) and those with cementless prostheses the highest (2.2%, 2.1% to 2.4%). Differences in mortality according to prosthesis type were small and not significant (p = 0.06). Functional outcome varied according to brand among cemented (p = 0.05, with Exeter V40 Duration having the best) and cementless prostheses (p = 0.01, with Corail Pinnacle having the best). Revision rates varied according to brand among hybrids (p = 0.05, with Exeter V40 Trident having the lowest). Functional outcomes were better with cementless cups and revision rates were lower with cemented stems, which underlies the good overall performance of hybrids. The hybrid Exeter V40 Trident seemed to produce the best overall results. This brand should be considered as a benchmark in randomised trials.

  8. Bionic prosthesis

    OpenAIRE

    МЫЛЬНИКОВ А.М.

    2015-01-01

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

  9. Changes in bone mineral density (BMD) around the cemented Exeter stem: a prospective study in 18 women with 5 years follow-up

    DEFF Research Database (Denmark)

    Damborg, Frank Lindhøj; Nissen, Nis; Jørgensen, Hans R I

    2008-01-01

    THA changes the pattern of strain distribution in the proximal femur. We quantified the changes in BMD for 5 years after insertion of the cemented Exeter stem in women.......THA changes the pattern of strain distribution in the proximal femur. We quantified the changes in BMD for 5 years after insertion of the cemented Exeter stem in women....

  10. Challenges in prosthesis classification.

    Science.gov (United States)

    Robertsson, Otto; Mendenhall, Stan; Paxton, Elizabeth W; Inacio, Maria C S; Graves, Stephen

    2011-12-21

    Accurate prosthesis classification is critical for total joint arthroplasty surveillance and assessment of comparative effectiveness. Historically, prosthesis classification was based solely on the names of the prosthesis manufacturers. As a result, prosthesis designs changed without corresponding name changes, and other prostheses' names changed over time without substantial design modifications. As the number of prostheses used in total joint arthroplasty on the market increased, catalog and lot numbers associated with prosthesis descriptions were introduced by manufacturers. Currently, these catalog and lot numbers are not standardized, and there is no consensus on categorization of these numbers into brands or subbrands. Classification of the attributes of a prosthesis also varies, limiting comparisons of prostheses across studies and reports. The development of a universal prosthesis classification system would standardize prosthesis classification and enhance total joint arthroplasty research collaboration worldwide. This is a current area of focus for the International Consortium of Orthopaedic Registries (ICOR).

  11. PREFACE: Workshop on `The Physics of Group IV Materials', 7 10 April 2003, Exeter

    Science.gov (United States)

    Evans-Freeman, Jan, Dr; Mainwood, Alison, Dr

    2003-10-01

    This special issue contains a collection of papers presented at the workshop entitled `The Physics of Group IV Materials' held in Exeter on 7-10 April 2003. The workshop was sponsored by the two EPSRC-funded Research Networks on `Defects in Silicon and Si/Ge' and `Diamond and Diamond-Like Carbon'. It was attended by about 100 delegates, most of them students and postdoctoral researchers from the UK, who heard 17 invited talks from speakers prominent in their fields from all over the world. Eight additional oral presentations selected from the contributed papers and 36 posters were presented at the workshop. The discussions were very illuminating, and we hope that the workshop fulfilled its objective in informing quite a wide, and generally young, audience about the very diverse and excellent current research work on Group IV materials. We would like to thank the local organizers, Professor Bob Jones and his students James Adey and Stephen Sque, for the smooth running of the workshop. We would like to thank the editorial committee: Dr David Carey, Professor Paul Coleman, Professor Phillip John, Dr Mark Newton and Professor Arthur Willoughby for their help with the selection of papers for the workshop and with the proceedings.

  12. Ethical issues and best practice in clinically based genomic research: Exeter Stakeholders Meeting Report.

    Science.gov (United States)

    Carrieri, D; Bewshea, C; Walker, G; Ahmad, T; Bowen, W; Hall, A; Kelly, S

    2016-09-27

    Current guidelines on consenting individuals to participate in genomic research are diverse. This creates problems for participants and also for researchers, particularly for clinicians who provide both clinical care and research to their patients. A group of 14 stakeholders met on 7 October 2015 in Exeter to discuss the ethical issues and the best practice arising in clinically based genomic research, with particular emphasis on the issue of returning results to study participants/patients in light of research findings affecting research and clinical practices. The group was deliberately multidisciplinary to ensure that a diversity of views was represented. This report outlines the main ethical issues, areas of best practice and principles underlying ethical clinically based genomic research discussed during the meeting. The main point emerging from the discussion is that ethical principles, rather than being formulaic, should guide researchers/clinicians to identify who the main stakeholders are to consult with for a specific project and to incorporate their voices/views strategically throughout the lifecycle of each project. We believe that the mix of principles and practical guidelines outlined in this report can contribute to current debates on how to conduct ethical clinically based genomic research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. [Prosthesis replacement in periprosthetic humeral fractures].

    Science.gov (United States)

    Jaeger, M; Maier, D; Izadpanah, K; Südkamp, N P

    2017-12-01

    Stabilization of the humerus with preservation or restoration of the shoulder function. Always in the presence of a loose prosthesis. It may become necessary in conditions of poor bone stock and if osteosynthesis is not possible. Noncompliant patients due to alcohol or drugs. Local infections. The loose implant is removed using an extended anterior deltopectoral approach. After exploration of the fracture and extended soft tissue release, the glenoidal components are implanted with visualization and protection of the axillary nerve. A long stemmed implant is typically needed on the humeral side. It is anchored in the distal fragment over a length of about 6 cm. Soft tissue tension is crucial, especially with reverse shoulder arthroplasty. Postoperatively, the affected limb is immobilized for 6 weeks on a 15° shoulder abduction pillow with active assisted movement therapy up to the horizontal plane. This is followed by gradual pain-adapted increases of movement, muscle coordination, and strength. In 17 patients with periprosthetic fractures of the humerus surgically treated in our institution, 4 underwent revision arthroplasty because of a loose prosthesis. No intra- or postoperative complications were observed. All fractures healed except one.

  14. Combined three-part humeral anterior fracture-dislocation and humeral shaft fracture treated with one-stage long stem shoulder hemiarthroplasty in an active elderly patient

    Directory of Open Access Journals (Sweden)

    Herzberg Guillaume

    2017-01-01

    Full Text Available Introduction: Injuries combining a humeral head fracture-dislocation and a shaft fracture of the ipsilateral humerus are very rare. They should be separated from extended fractures of the humeral head to the shaft [1]. Case report: We present the case of an active 84-year-old man who sustained a three-part fracture-dislocation of the proximal humerus combined with a long spiral humeral middle third diaphyseal fracture, after a ski fall. We were unable to find a similar case in the literature. He was treated with a long stem hemiarthroplasty, associated with screw osteosynthesis of the long spiral shaft fracture. The result after 30 months of follow-up was excellent, with good shoulder range of motion, good bone integration of the prosthesis and uneventful healing of the fracture. Conclusion: This treatment allowed this intrepid elderly patient to recover a normal quality of life, including driving his car and to return to skiing.

  15. 20th ANNIVERSARY OF THE CHILDREN'S HEALTH AND EXERCISE CENTRE, UNIVERSITY OF EXETER, UK

    Directory of Open Access Journals (Sweden)

    Craig Sharp

    2007-09-01

    Full Text Available 20th ANNIVERSARY OF THE CHILDREN'S HEALTH AND EXERCISE CENTRE, UNIVERSITY OF EXETER, UK In recent years, partly because of the ever-younger exten-sion of high quality sport representation and partly, para-doxically, due to ever-increasing levels of obesity in the young, the discipline of paediatric physiology has moved from being an interesting curiosity to an extremely impor-tant area of practical knowledge. For example, children thermoregulate qualitatively and quantitatively differently from adults - before puberty their sweat rate per square metre of skin is less than half their adult level - and they may well have, proportionate to mass, 40% greater body surface area than an adult. On the musculo-skeletal side, they come late into 'kinetic-balance', into an appropriately economic mode of running or walking, so such effort is harder for them. In many other areas children, especially younger children, differ importantly from adults, and those involved in any aspects of their exercise, sport or medicine should be well aware of this. Hence the impor-tance of the discipline, and hence the reason for a very hearty celebration of the 20th anniversary of the Chil-dren's Health and Exercise Centre (CHERC, which, as is demonstrated here, has pioneered and expanded the entire discipline, as one of the world's leading paediatric labora-tories.To celebrate the 20th anniversary of the Children's Health and Exercise Centre (1987-2007 past and present mem-bers of the centre were invited to contribute a review article on paediatric exercise science. The collection of reviews, written by current and former PhD students, visiting research fellows and professors, visiting interns and current members of CHERC, discusses an array of topics, which have helped shaped the work of our centre. We would also like to take the opportunity to acknowl-edge all those associated with CHERC over the past 20 years, in particular the many children who have partici-pated in our

  16. Branding campaign exceeds initial goals for New Hampshire fitness site. Campaign utilizes humor, insights from market research. Synergy Health and Fitness Center, Exeter.

    Science.gov (United States)

    Rees, T

    1998-01-01

    Exeter Health Resources Inc. and agency BBK Communications create a comprehensive brand-building campaign for its centers that combine fitness services and programs under Synergy. With success, the center signed up more than 1,600 members by the time it opened in January.

  17. Type specimens of Mollusca described by Col. George Montagu in the Royal Albert Memorial Museum & Art Gallery, Exeter and The Natural History Museum, London

    Directory of Open Access Journals (Sweden)

    P. Graham Oliver

    2017-11-01

    Full Text Available A complete list of new molluscan taxa introduced by Col. George Montagu (1753–1815 is presented. The available type material of these taxa are itemised and illustrated. The majority are present in the Royal Albert Memorial Museum & Art Gallery, Exeter with a smaller number in the Natural History Museum, London. The historic background of both collections is reviewed with special reference to the many non-British species spuriously introduced into Testacea Britannica and its Supplement.

  18. Massive Femoral Osteolysis Secondary to Loosening of a Cemented Roughened Long Stem: A Case Report

    Directory of Open Access Journals (Sweden)

    Yasuaki Tamaki

    2014-01-01

    Full Text Available The surface finish of a femoral stem plays an important role in the longevity of cemented total hip arthroplasty. In efforts to decrease the rate of aseptic loosening, some prostheses have been designed to have a roughened surface that enhances bonding between the prosthesis and cement, but clinical outcomes remain controversial. We present a rare case of massive osteolysis with extreme femoral expansion that developed after cemented revision total hip arthroplasty. The destructive changes in the femur were attributable to abnormal motion of the stem and were aggravated by the roughened precoated surface of the long femoral component. Revision surgery using a total femur prosthesis was performed because there was insufficient remaining bone to fix the new prosthesis. The surgical technique involved wrapping polypropylene meshes around the prosthesis to create an insertion for the soft tissue, which proved useful for preventing muscular weakness and subsequent dislocation of the hip.

  19. A Case Report of Implant Fracture of Extensively Porous-Coated, Distally Fixated Cementless Long Stem: Detailed Course of Stem Bending Development.

    Science.gov (United States)

    Mimura, Tomohiro

    2015-01-01

    We report the fracture of a cementless long stem in a distally fixated, extensively porous-coated femoral prosthesis used for revisional total hip arthroplasty (THA) 9 years previously in a 48-year-old woman, measuring 58 kg in weight and 155 cm in height. Following resolution of an infection 7 years after the revisional THA, a series of posterior dislocations occurred up until 7 months before sudden stem fracture. Extensive radiographic imaging evidence indicated a gradual progression of bending in the stem, and scanning electron microscope energy dispersive X-ray spectroscopy revealed oxygen in the medial and lateral sections, suspecting in vivo corrosion. We retrospectively examined the detailed course of stem bending development prior to stem fracture. The stem bending immediately after the revisional THA, at the first dislocation, and immediately before the stem fracture was 0°, 1.9°, and 5.2°, respectively. We consider that the cyclic loading with poor proximal bone support, distal fixation, and small diameter were the potential risk of this implant fracture. However, the course of stem bending development suggested that repeated operations and several dislocations might have aggravated the implant fatigue in the present case.

  20. A Case Report of Implant Fracture of Extensively Porous-Coated, Distally Fixated Cementless Long Stem: Detailed Course of Stem Bending Development

    Directory of Open Access Journals (Sweden)

    Tomohiro Mimura

    2015-01-01

    Full Text Available We report the fracture of a cementless long stem in a distally fixated, extensively porous-coated femoral prosthesis used for revisional total hip arthroplasty (THA 9 years previously in a 48-year-old woman, measuring 58 kg in weight and 155 cm in height. Following resolution of an infection 7 years after the revisional THA, a series of posterior dislocations occurred up until 7 months before sudden stem fracture. Extensive radiographic imaging evidence indicated a gradual progression of bending in the stem, and scanning electron microscope energy dispersive X-ray spectroscopy revealed oxygen in the medial and lateral sections, suspecting in vivo corrosion. We retrospectively examined the detailed course of stem bending development prior to stem fracture. The stem bending immediately after the revisional THA, at the first dislocation, and immediately before the stem fracture was 0°, 1.9°, and 5.2°, respectively. We consider that the cyclic loading with poor proximal bone support, distal fixation, and small diameter were the potential risk of this implant fracture. However, the course of stem bending development suggested that repeated operations and several dislocations might have aggravated the implant fatigue in the present case.

  1. Combined three-part humeral anterior fracture-dislocation and humeral shaft fracture treated with one-stage long stem shoulder hemiarthroplasty in an active elderly patient - A case report and review of literature.

    Science.gov (United States)

    Herzberg, Guillaume; Tebaa, Eloise

    2017-01-01

    Injuries combining a humeral head fracture-dislocation and a shaft fracture of the ipsilateral humerus are very rare. They should be separated from extended fractures of the humeral head to the shaft [1]. We present the case of an active 84-year-old man who sustained a three-part fracture-dislocation of the proximal humerus combined with a long spiral humeral middle third diaphyseal fracture, after a ski fall. We were unable to find a similar case in the literature. He was treated with a long stem hemiarthroplasty, associated with screw osteosynthesis of the long spiral shaft fracture. The result after 30 months of follow-up was excellent, with good shoulder range of motion, good bone integration of the prosthesis and uneventful healing of the fracture. This treatment allowed this intrepid elderly patient to recover a normal quality of life, including driving his car and to return to skiing. © The Authors, published by EDP Sciences, 2017.

  2. Magnetically retained silicone facial prosthesis

    African Journals Online (AJOL)

    straps, spectacle frames, extension from the denture, magnets, adhesives and implants material.[4] In this case report using maxillofacial silicone material and magnets, the prosthesis was constructed to camouflage the facial defect more esthetically. Case Report. A 67‑year‑old male patient was referred to the department.

  3. Magnetically retained silicone facial prosthesis

    African Journals Online (AJOL)

    Key words: Magnet retention, oro cutaneous fistula, silicone maxillofacial prosthesis. Date of Acceptance: 09-Jun-2013. Address for correspondence: Dr. Suresh Venugopalan, Department of Prosthodontics,. Saveetha Dental College, Ponamalle High Road,. Chennai ‑ 600 077, Tamil Nadu, India. E‑mail: ...

  4. Elektra prosthesis for trapeziometacarpal osteoarthritis

    DEFF Research Database (Denmark)

    Klahn, A; Nygaard, Mads; Gvozdenovic, R

    2012-01-01

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

  5. The fixed/detachable implant provisional prosthesis.

    Science.gov (United States)

    Cibirka, R M; Linebaugh, M L

    1997-06-01

    Interim modification and management of a complete denture following surgical uncovering of dental implants can be time-intensive and may fail to provide adequate patient benefit until the definitive prosthesis can be completed. Inadequate interim management can result in functional and tissue difficulties. Modification of the conventional complete denture to a fixed/detachable provisional prosthesis in a one-stage procedure provides the patient an opportunity to experience a fixed prosthesis. The incorporation of fixed, provisional cylinders to the existing denture base using autopolymerizing acrylic resin with a closed-mouth technique is described. The peripheral regions are reduced and the distal extension shortened to resemble a fixed/detachable prosthesis. This conversion technique can provide patient satisfaction and comfort until delivery of the definitive prosthesis. Esthetic concerns, home care problems, or patient difficulties with the provisional prosthesis can be rectified in the final prosthesis.

  6. Recognizing the elbow prosthesis on conventional radiographs

    Directory of Open Access Journals (Sweden)

    Kamilcan Oflazoglu

    2016-09-01

    Full Text Available Abstract The objective of this study was to make an overview that can be useful in determining which type and brand of prosthesis a patient has when visiting the emergency department or outpatient clinic with a periprosthetic fracture, dislocation, or implant failure. The commonly used prostheses in Europe are opted for this list. The radiographs used for this list are obtained either from the company or from our own patients. This list contains the Coonrad/Morrey total elbow prosthesis, the Nexel total elbow prosthesis, the GSB III Elbow Prosthesis, the iBP Total Elbow System, the Discovery Elbow System, the NESimplavit Elbow System, the Latitude Elbow prosthesis, the Solar Elbow, and the Souter–Strathclyde total elbow. The characteristics of each prosthesis are described.

  7. Contact dermatitis from a prosthesis.

    Science.gov (United States)

    Munoz, Carla A; Gaspari, Anthony; Goldner, Ronald

    2008-01-01

    Patients wearing a prosthesis face a wide variety of medical problems. Skin complications have long been recognized, but their prevalence is still unknown. The most frequently reported disorders are allergic contact dermatitis (ACD), acroangiodermatitis, epidermoid cysts, epidermal hyperplasia, follicular hyperkeratosis, verrucous hyperplasia, bullous diseases, hyperhidrosis, infections, malignancies, and ulcerations. Contact dermatitis represents one-third of the dermatoses in amputees wearing prostheses. All patients who are suspected of having ACD should be patch tested with standard allergen series as well as materials from the patient's own prosthesis, topical medicaments, moisturizers, and cosmetics. We report a patient with an ACD to mixed dialkyl thiourea present in the rubber parts of his below-the-knee prosthesis. Thiourea derivates are used as accelerators in the manufacture of chloroprene rubber and as fixatives in photography and photocopy paper. Allergy to thiourea is relatively uncommon; different studies have shown a prevalence of 0.7% up to 2.4% in patch-tested patients. Thiourea derivates are often the allergic sources in ACD involving high-grade rubber products made of neoprene such as diving suits, protective goggles, knee braces, and continuous positive airway pressure masks. They are also present in the rubber material of prostheses, as in the case of our patient.

  8. Malrotation of the McGhan Style 510 prosthesis.

    NARCIS (Netherlands)

    Schots, J.M.; Fechner, M.R.; Hoogbergen, M.M.; Tits, H.W.H.J.

    2010-01-01

    BACKGROUND: Anatomically shaped cohesive silicone breast implants are frequently used in aesthetic and reconstructive surgery. After successful results with the Style 410 prosthesis, McGhan (Natrelle, Allergan) introduced the Style 510 prosthesis. After using this novel prosthesis, the authors

  9. Prosthesis infections after orthopedic joint replacement

    DEFF Research Database (Denmark)

    Song, Zhijun; Borgwardt, Lotte; Høiby, Niels

    2013-01-01

    Prosthesis-related infection is a serious complication for patients after orthopedic joint replacement, which is currently difficult to treat with antibiotic therapy. Consequently, in most cases, removal of the infected prosthesis is the only solution to cure the infection. It is, therefore...

  10. Implant complications and failures: the fixed prosthesis.

    Science.gov (United States)

    Tinsley, D; Watson, C J; Preston, A J

    2002-11-01

    The implant-retained fixed prosthesis has been advocated as an effective restoration offering significant benefits over conventional prosthetics. The success of treatment depends on careful pre-surgical planning and prosthesis design. This paper outlines some common complications encountered during the planning, fabrication and maintenance of both large and small fixed prostheses and suggests how these complications can be minimized.

  11. BIORESORBABLE POLYMERIC MENISCAL PROSTHESIS: STUDY IN RABBITS

    Science.gov (United States)

    Cardoso, Tulio Pereira; de Rezende Duek, Eliana Aparecida; Amatuzzi, Marco Martins; Caetano, Edie Benedito

    2015-01-01

    Objective: To induce growth of a neomeniscus into the pores of a prosthesis in order to protect the knee joint cartilage. Methods: 70 knees of 35 New Zealand rabbits were operated. The rabbits were five to seven months old, weighed 2 to 3.8 kilograms, and 22 were male and 13 were female. Each animal underwent medial meniscectomy in both knees during a single operation. A bioabsorbable polymeric meniscal prosthesis composed of 70% polydioxanone and 30% L-lactic acid polymer was implanted in one side. The animals were sacrificed after different postoperative time intervals. The femoral condyles and neomeniscus were subjected to histological analysis. Histograms were used to measure the degradation and absorption of the prosthesis, the growth of meniscal tissue in the prosthesis and the degree of degradation of the femoral condyle joint cartilage. Results: The data obtained showed that tissue growth histologically resembling a normal meniscus occurred, with gradual absorption of the prosthesis, and the percentages of chondrocytes on the control side and prosthesis side. Conclusion: Tissue growth into the prosthesis pores that histologically resembled the normal rabbit meniscus was observed. The joint cartilage of the femoral condyles on the prosthesis side presented greater numbers of chondrocytes in all its layers. PMID:27022549

  12. Nasal prosthesis rehabilitation: a case report

    DEFF Research Database (Denmark)

    Jain, Sumeet; Maru, Kavita; Shukla, Jyotsana

    2011-01-01

    Facial defects resulting from neoplasm, congenital malformation or trauma can be restored with facial prosthesis using different materials and retention methods to achieve life-like look and function. A nasal prosthesis can re-establish esthetic form and anatomic contours for mid-facial defects, ...... a spectacle glass frame without inserting craniofacial implants....

  13. Followup of a Dog with an Intraocular Silicone Prosthesis Combined with an Extraocular Glass Prosthesis

    Directory of Open Access Journals (Sweden)

    Gwendolyna Romkes

    2012-01-01

    Full Text Available Because of unpredictable corneal changes, evisceration and implantation of a silicone prosthesis does not always lead to a satisfying cosmetic result. This paper describes the use of an intraocular silicone prosthesis in combination with an extraocular glass prosthesis and shows a followup of two and a half years in a nonexperimental study. An intraocular silicone prosthesis was implanted after evisceration of the left eye in a five-month-old Bernese mountain dog. A glass prosthesis was fitted four weeks after evisceration. Two and a half years after the operation, the dog is in good health and free of medication. No short-term or long-term complications were seen. The owners do not have trouble with handling the glass prosthesis. The combination of both prostheses shows a perfect solution to retrieve a normal looking and moving eye after evisceration.

  14. Stretch due to Penile Prosthesis Reservoir Migration

    Directory of Open Access Journals (Sweden)

    E. Baten

    2016-03-01

    Full Text Available A 43-year old patient presented to the emergency department with stretch, due to impossible deflation of the penile prosthesis, 4 years after successful implant. A CT-scan showed migration of the reservoir to the left rectus abdominis muscle. Refilling of the reservoir was inhibited by muscular compression, causing stretch. Removal and replacement of the reservoir was performed, after which the prosthesis was well-functioning again. Migration of the penile prosthesis reservoir is extremely rare but can cause several complications, such as stretch.

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

    Science.gov (United States)

    ... Request Permissions Choosing a Breast Prosthesis: A Survivor’s Perspective Andrea Zinn June 16, 2015 · Amber Bauer, ASCO ... body image breast cancer coping decision making patient perspective survivorship tips Related Resources: Breast Cancer - Introduction Talking ...

  16. The Prevalence of Patient-Prosthesis Mismatch Can Be Reduced Using the Trifecta Aortic Prosthesis.

    Science.gov (United States)

    Hernandez-Vaquero, Daniel; Diaz, Rocio; Pascual, Isaac; Rozado, Jose; De la Hera, Jesus M; Leon, Victor; Avanzas, Pablo; Martín, Maria; García-Iglesias, Daniel; Calvo, David; Silva, Jacobo; Moris, César

    2018-01-01

    Some important studies have shown that patient-prosthesis mismatch is a frequent occurrence after surgical aortic valve replacement that impairs survival. The Trifecta valve (St. Jude Medical Inc, St. Paul, MN) has special architecture designed to achieve the best hemodynamic profile. The aim of this study was to determine the prevalence of mismatch when using this prosthesis. This study included 1,302 patients at 3 months postoperatively, 339 patients with a Trifecta prosthesis and 963 patients (the control group) with a Mitroflow aortic valve (Sorin Group Inc, Mitroflow Division, Vancouver, Canada). Multinomial multivariate logistic regression was calculated to estimate the association between the Trifecta prosthesis and moderate or severe patient-prosthesis mismatch. Any degree of mismatch was present in 5.9% of the Trifecta group and in 42.4% in the Mitroflow group. Moderate patient-prosthesis mismatch was present in 3.8% of the patients with a Trifecta valve and in 32.6% in the Mitroflow group. Severe mismatch was present in 2.1% of the patients with a Trifecta prosthesis and in 9.8% of the patients with a Mitroflow valve. All differences were statistically significant (p < 0.001). The odds ratio of the Trifecta prosthesis as protector against mismatch was 16.9 (95% confidence interval, 9.5 to 30.4) and 11.9 (95% confidence interval, 5.3 to 26.7) for moderate or severe mismatch, respectively. The prevalence of patient-prosthesis mismatch using the Trifecta aortic prosthesis is extraordinary low. This finding may have great clinical repercussions in patients undergoing surgical aortic valve replacement. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Different techniques in fabrication of ocular prosthesis.

    Science.gov (United States)

    Cevik, Pinar; Dilber, Erhan; Eraslan, Oguz

    2012-11-01

    Loss of an eye caused by cancer, trauma, or congenital defect creates a deep psychological impact on an individual's life especially social and professional life. Custom-made prosthesis, compared to stock prosthesis, provides a better fit to the eye socket, better cosmetic results, and less discomfort to the patient in the long term. The main objective of this article was to describe 3 different alternative and practical techniques of fabricating custom-made ocular prosthesis. An impression of anophthalmic socket was made with the addition of cured silicone-based precision impression material in all techniques. A master cast was prepared and duplicated with condensation silicone. A self-cure acrylic resin was polymerized in the silicone model and was fitted into the patient's eye socket. A digital photograph of the patient's iris was made using a digital camera and printed on good-quality photo paper in various shades and sizes in the first and the second techniques. Then the photo paper was coated with PVC so as not to allow any color flowing. The proper iris was then inserted to the acrylic base. The prosthesis was final processed using orthodontic heat polymerizing clear acrylic resin.In the other technique, after the trying-in process with wax pattern, an acrylic base was fabricated using heat polymerizing scleral acrylic resin. The prosthetic iris was fabricated from a transparent contact lens by painting the lens with watercolor paints and attaching it to an acrylic resin with tissue conditioner. The final process was made with heat polymerizing transparent acrylic resin. Custom-made prosthesis allows better esthetic and functional results to the patient in comparison to stock prosthesis. Further follow-up is necessary to check the condition and fit of the ocular prosthesis in such patients.

  18. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to be implanted in the temporomandibular...

  19. Middle ear vibrations with SMA prosthesis. Experimental research

    Directory of Open Access Journals (Sweden)

    Rusinek Rafal

    2018-01-01

    Full Text Available The paper focuses on experimental research of a middle ear prosthesis made of shape memory alloy. The prosthesis provides better adjustment to individual patient than classical prosthesis. The shape memory prosthesis is implemented to a fresh temporal bone and vibrations of the round window are recorded by means of the Laser Doppler Vibrometer. Finally, the results are presented in the form of transfer function and compared to the intact and damaged middle ear.

  20. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Science.gov (United States)

    2010-04-01

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

  1. 21 CFR 890.3500 - External assembled lower limb prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External assembled lower limb prosthesis. 890.3500... (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3500 External assembled lower limb prosthesis. (a) Identification. An external assembled lower limb prosthesis...

  2. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Science.gov (United States)

    2010-04-01

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

  3. 21 CFR 888.3780 - Wrist joint polymer constrained prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint polymer constrained prosthesis. 888... SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3780 Wrist joint polymer constrained prosthesis. (a) Identification. A wrist joint polymer constrained prosthesis is a device made of...

  4. Fabrication of a custom ocular prosthesis.

    Science.gov (United States)

    Sethi, Tania; Kheur, Mohit; Haylock, Colin; Harianawala, Husain

    2014-01-01

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

  5. BIORESORBABLE POLYMERIC MENISCAL PROSTHESIS: STUDY IN RABBITS

    OpenAIRE

    Cardoso, Tulio Pereira; de Rezende Duek, Eliana Aparecida; Amatuzzi,Marco Martins; Caetano, Edie Benedito

    2010-01-01

    Objective: To induce growth of a neomeniscus into the pores of a prosthesis in order to protect the knee joint cartilage. Methods: 70 knees of 35 New Zealand rabbits were operated. The rabbits were five to seven months old, weighed 2 to 3.8 kilograms, and 22 were male and 13 were female. Each animal underwent medial meniscectomy in both knees during a single operation. A bioabsorbable polymeric meniscal prosthesis composed of 70% polydioxanone and 30% L-lactic acid polymer was implanted in on...

  6. A running controller for a powered transfemoral prosthesis.

    Science.gov (United States)

    Huff, Amanda M; Lawson, Brian E; Goldfarb, Michael

    2012-01-01

    This paper describes a running controller for a powered knee and ankle prosthesis. The running controller was implemented on a powered prosthesis prototype and evaluated by a transfemoral amputee subject running on a treadmill at a speed of 2.25 m/s (5.0 mph). The ability of the prosthesis and controller to provide the salient features of a running gait was assessed by comparing the kinematics of running provided by the powered prosthesis to the averaged kinematics of five healthy subjects running at the same speed. This comparison indicates that the powered prosthesis and running controller are able to provide essential features of a healthy running gait.

  7. Case Report: Magnetically retained silicone facial prosthesis ...

    African Journals Online (AJOL)

    Prosthetic camouflaging of facial defects and use of silicone maxillofacial material are the alternatives to the surgical retreatment. Silicone elastomers provide more options to clinician for customization of the facial prosthesis which is simple, esthetically good when coupled with bio magnets for retention. Key words: Magnet ...

  8. Fusion around cervical disc prosthesis: case report.

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Donk, R.

    2005-01-01

    OBJECTIVE AND IMPORTANCE: Cervical arthroplasty is a relatively new method to maintain motion after cervical anterior discectomy. Two cases are presented in which bony fusion occurred around a cervical disc prosthesis. CLINICAL PRESENTATION: A 30-year-old man and a 49-year-old woman underwent a

  9. Reading visual Braille with a retinal prosthesis

    Directory of Open Access Journals (Sweden)

    Thomas Zaccarin Lauritzen

    2012-11-01

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

  10. Reading visual braille with a retinal prosthesis.

    Science.gov (United States)

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

    2012-01-01

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

  11. The Phenix expandable prosthesis: early American experience.

    Science.gov (United States)

    Wilkins, R M; Soubeiran, A

    2001-01-01

    One of the major dilemmas in limb preservation in skeletally immature children involves the ability to maintain leg length equality. Many attempts have been made to design a prosthesis that could be expanded easily either nonoperatively or through a minor surgical procedure. Most of these designs have had mechanical difficulty or the lengthening procedure becomes a major surgical endeavor. The Phenix technology has been used in France for several years. The basic principle involves storage of energy in a spring which is maintained compressed by an original locking system. Once implanted, prosthetic lengthening is achieved via exposure to an external electromagnetic field that pilots the locking system and allows controlled release of the spring energy. Seven Phenix prostheses have been implanted in six patients. All patients had been treated for Stage II-B osteosarcoma. Six of the seven prostheses were implanted during revision procedures in salvage situations; one prosthesis was implanted during an index procedure. The surgical procedures were completed without complications. One patient sustained a fracture of the prosthesis in a fall and had an infection develop after implantation of the second prosthesis. Twenty-one expansions have been performed in six patients (mean lengthening at each procedure, 8 mm). There were no acute complications attributable to the lengthening procedure. Prosthetic expansions required an average of 20 to 30 seconds and were accompanied by very mild discomfort, if any. Most patients were given an oral analgesic either before or during the lengthening procedure. The Phenix prosthesis shows promise in handling the difficult problem of limb preservation in a growing child. Additional investigation is underway regarding limb lengthening and other dynamic applications.

  12. Comparison of energy cost in transtibial amputees using "prosthesis" and "crutches without prosthesis" for walking activities.

    Science.gov (United States)

    Mohanty, R K; Lenka, P; Equebal, A; Kumar, R

    2012-05-01

    In a survey of 100 transtibial amputees (TTA) in the study place, it was noticed that nearly 30% of total activities performed by crutches. It was recorded nearly 52% of the amputees were totally independent, 39% had to use a crutch or cane and only 9% need not used any devices simply because they are unaware of current technology or availability. Out of 39 TTA, nine used crutches only for performing daily activities while 30 used both prosthesis and crutch. Walking is a major activity in lower limb amputees and therefore it is imperative to know the energy cost in both the mobility devices (prosthesis and crutches without prosthesis) for walking activities. The purpose of this study was to quantify and compare the difference in energy cost between the two most commonly used assistive devices (prosthesis and axillary crutches) in adults with Transtibial amputation by indirect calorimetric method at the self-selected speed in plane surface walking. Thirty adults who had a unilateral transtibial amputation participated in this study. Oxygen consumption was measured with a Cosmed K4 b(2) oxygen analysis telemetry unit (Rome, Italy) as the participants walked over level ground for 30 meters at a self-selected speed. The variables that were analyzed were VO(2) rate (mL/min), VO(2) cost (mL/kg/m), heart rate (bpm), self-selected walking velocity (m/min) and energy expenditure per minute (Kcal/min). It was observed that VO(2) uptake rate and EE comparisons were highly significant for both prosthesis and crutches without prosthesis walking in adults with transtibial amputation (Ptranstibial amputation using prosthesis walked with 21% more efficient in terms of VO(2) uptake rate and 92% more efficient in terms of EE/min as compared to crutches without prosthesis. The data on energy cost indicates that all below knee amputee groups walk with less effort by using prosthesis. It may be concluded that crutches without prosthesis may not be used as a permanent rehabilitative

  13. Patient satisfaction with Mentor inflatable penile prosthesis.

    Science.gov (United States)

    Whalen, R K; Merrill, D C

    1991-06-01

    Patient satisfaction with the Mentor inflatable penile prosthesis was assessed by sending a thirty-six-item questionnaire to 251 patients who had undergone implantation of the device by the senior author (D.C.M.). A total of 152 (61%) of the patients responded. Recovery time, satisfaction, reasons for dissatisfaction, perceptions of erection quality, and psychosexual parameters were evaluated. Eight-eight percent of the patients were engaging in regular sexual activity. Depending on the definition of satisfaction, 81-89 percent of the respondents reported that they were satisfied with the prosthesis. Sixty-eight percent of the survey group were satisfied with the length, width, and firmness of their prosthetic-induced erection. The majority of patients reported improvement in psychosexual functioning after implantation. Reasons for dissatisfaction included inadequate penile length, insufficient firmness, and difficulty with inflation and deflation of the penile cylinders.

  14. Midterm results of "thrust plate" prosthesis.

    Science.gov (United States)

    Fink, Bernd; Wessel, Stephanie; Deuretzbacher, Georg; Protzen, Michael; Ruther, Wolfgang

    2007-08-01

    The aim of this investigation was to analyze the midterm results obtained with the metaphyseal fixation principle of the thrust plate prosthesis (TPP). Survival of 214 implants in 204 patients was analyzed. Clinical (Harris hip score) and radiologic examinations were carried out on 157 of 190 TPP with a postimplantation follow-up period of at least 5 years. Failure rate was 7.0% (9 aseptic and 6 septic loosening). Harris hip score increased from 36.9 +/- 13.5 points preoperatively to 91.2 +/- 13.1 points at follow-up. Eleven TPPs showed radiolucent lines not indicating prosthetic loosening. Thrust plate prosthesis is not an alternative to stemmed endoprostheses. It may be rarely indicated in very young patients where, because of their age, several revision operations can be expected.

  15. Tracheobronchial Foreign Body Aspiration: Dental Prosthesis

    Directory of Open Access Journals (Sweden)

    Ataman Köse

    2014-01-01

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

  16. [Secondary intervention after hip prosthesis (author's transl)].

    Science.gov (United States)

    Suezawa, Y; Dietschi, C

    1977-04-01

    From 1965-1975 in the orthopedical Univ. Clinic Balgrist, Zurich, there were 177 reoperations after total hip prostheses necessary. In 91 replacements the interval between first and second operation was an average of 4.1 years, in 67 prosthesis-removements 2.1 years. The follow-up showed a relationship between bacteriological culture taken before and during operation and clinical results. The decision to change or remove the prostheses should be made on the positive or negative bacteriological results.

  17. Control of dental prosthesis system with microcontroller.

    Science.gov (United States)

    Kapidere, M; Müldür, S; Güler, I

    2000-04-01

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

  18. Gingival prosthesis: A treatment modality for recession

    Directory of Open Access Journals (Sweden)

    Pallavi Samatha Yalamanchili

    2013-01-01

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

  19. Longitudinal performance of an implantable vestibular prosthesis.

    Science.gov (United States)

    Phillips, Christopher; Ling, Leo; Oxford, Trey; Nowack, Amy; Nie, Kaibao; Rubinstein, Jay T; Phillips, James O

    2015-04-01

    Loss of vestibular function may be treatable with an implantable vestibular prosthesis that stimulates semicircular canal afferents with biphasic pulse trains. Several studies have demonstrated short-term activation of the vestibulo-ocular reflex (VOR) with electrical stimulation. Fewer long-term studies have been restricted to small numbers of animals and stimulation designed to produce adaptive changes in the electrically elicited response. This study is the first large consecutive series of implanted rhesus macaque to be studied longitudinally using brief stimuli designed to limit adaptive changes in response, so that the efficacy of electrical activation can be studied over time, across surgeries, canals and animals. The implantation of a vestibular prosthesis in animals with intact vestibular end organs produces variable responses to electrical stimulation across canals and animals, which change in threshold for electrical activation of eye movements and in elicited slow phase velocities over time. These thresholds are consistently lower, and the slow phase velocities higher, than those obtained in human subjects. The changes do not appear to be correlated with changes in electrode impedance. The variability in response suggests that empirically derived transfer functions may be required to optimize the response of individual canals to a vestibular prosthesis, and that this function may need to be remapped over time. This article is part of a Special Issue entitled . Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Supersizing the penis following penile prosthesis implantation.

    Science.gov (United States)

    Shaeer, Osama

    2010-07-01

    Following implantation of a penile prosthesis, some couples are dissatisfied with penile length, girth, shaft, or glans engorgement. This may be delusional because of the procedure per se or preexisting risk factors such as neglected priapism, Peyronie's disease, radical prostatectomy, or overhanging suprapubic fat. In this work, we try to enhance penile size in patients dissatisfied with its dimensions following implantation of a penile prosthesis, using various augmentation techniques. Eighteen patients who have had penile prostheses implanted were enrolled in this study based on dissatisfaction with penile size. The complaint was relieved by counseling and administration of PDE5 inhibitors in seven patients. Two patients had elongation, girth augmentation, and glans injection; six had elongation and girth augmentation; and two had elongation and glans injection. Penile size, satisfaction, and sexual function. Average preoperative length and girth were 7.87 cm and 11.62 cm, respectively. Mean postoperative length and girth were 11.62 cm and 14.07 cm. The gain in length (47.6%) and girth (21%) were statistically significant (P < 0.005). All patients and partners were satisfied with the results following surgery except one who suffered graft loss. Implantation of a penile prosthesis may improve penile rigidity, yet may confound couple's satisfaction with penile size to variable degrees. Sex education may alleviate those concerns. In refractory cases, penile augmentation may enhance phallic size and increase patient/partner satisfaction.

  1. Immediately Loaded Intraorally Welded Complete-Arch Maxillary Provisional Prosthesis.

    Science.gov (United States)

    Albiero, Alberto Maria; Benato, Renato; Fincato, Andrea

    2015-01-01

    Guided implant surgery is not completely accurate when using computer-designed stereolithographic surgical guides. Complications are frequently reported when combining computer-guided flapless surgery with an immediately loaded prefabricated prosthesis. Achieving passive fit of a prefabricated prosthesis on the inserted implants the same day of the surgery can be difficult. The aim of this report is to show a new treatment approach to immediately loaded implants inserted with computer-guided surgery using an intraoral welded full-arch provisional prosthesis.

  2. Fabrication of a Cranial Prosthesis Combined with an Ocular Prosthesis Using Rapid Prototyping: A Case Report

    Directory of Open Access Journals (Sweden)

    Gayatri Shankaran

    2016-08-01

    Full Text Available Rapid prototyping (RP is a technique of manufacturing parts by the additive layer manufacturing technology; where, a three-dimensional (3D model created in a computer aided design (CAD system is sectioned into 2D profiles, which are further constructed by RP layer by layer. Its use is not limited to industrial or engineering fields and has extended to the medical field for the manufacturing of custom implants and prostheses, the study of anatomy and surgical planning. Nowadays, dentists are more frequently encountered with the individuals affected with craniofacial defects due to trauma. In such cases, the cranio-maxillofacial rehabilitation is a real challenge to bring the patients back to society and promote their well-being. The conventional impression technique for facial prosthesis fabrication has the disadvantage of deforming the soft tissue and causing discomfort for the patient. Herein, we describe the fabrication of a cranial prosthesis combined with an ocular prosthesis with RP and stereolithography.

  3. A Method to Analyze Dynamics Properties of Transfemoral Prosthesis

    Directory of Open Access Journals (Sweden)

    Van Tuan Le

    2016-01-01

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

  4. [Prosthesis use in pediatric patients with fibular hipoplasia].

    Science.gov (United States)

    Aparicio, Omar Carlos González; García, Felipe Haces; Leonori, Romáin Capdevila; García, Víctor Rosas

    2007-01-01

    To assess the prosthesis adaptability at use of pedestal and transtibial prosthesis, recognize the average average age of amputation surgery, and the complications of the amputation in patients with fibular hemimelia. 47 patients were evaluated, initially to adjust pedestal prosthesis and when this was not tolerated, we realize amputation and adaptation of transtibial prosthesis, we valued the average age of amputation surgery, the associate complications and the prosthesis adaptability we use the K system for functional ambulation. Of the 12 patients to actually use pedestal prosthesis 9 (75%) had a K.2 level, 3 (25%) had a K-3 level, of the 35 patients to use transtibial prosthesis 1 (3%) had a K-2 level, 19 (54%) K-3 level, and 15 (43%) in the K-4 level. The average age to amputation surgery was 3.9 years old, one case had a complication. The early prosthesis adaptability provides advantages in the functional ambulation, as demonstrated on the results. The goal of the transtibial amputation is to facilitate the prosthesis adaptability, is due to take advantage of the best functional adaptation the child in the first years of life, circumstance that improves the integral rehabilitation of the patient.

  5. Improved comfort and function of arm prosthesis after implantation of a Humerus-T-Prosthesis in trans-humeral amputees.

    Science.gov (United States)

    Witsø, Eivind; Kristensen, Tomm; Benum, Pål; Sivertsen, Svein; Persen, Leif; Funderud, Are; Magne, Tordis; Aursand, Hans Petter; Aamodt, Arild

    2006-12-01

    The use of arm prosthesis in trans-humeral amputees is limited; due to the cone form of the amputation stump. A Humerus-T-Prosthesis was implanted in three patients to create artificial humerus condyles. Two of the patients were successfully rehabilitated with the application of a new type trans-humeral arm prosthesis. This arm prosthesis had a socket which is suspended and stabilized by the humerus and implant only. Traction and rotational stability were secured by adjustable pressure adaptation around the artificial condyles. The third patient developed a pressure wound over the lateral part of the artificial condyle that later healed. He also was subject to a new trauma with a fracture of the ipsilateral scapula and until now has had limited the use of his new arm prosthesis. It was concluded that this new concept for prosthesis fitting of trans-humeral amputees looks promising, but alternative designs of the implant should be tested.

  6. [Total prosthesis arthroplasty in femur head necrosis].

    Science.gov (United States)

    Elke, R; Morscher, E

    1990-08-01

    In young patients with advanced necrosis of the femoral head, the short- and medium-term results of total prosthesis arthroplasty are the most satisfactory. However, the prospect of aseptic loosening hangs over such arthroplasties like Damocles' sword. Reports from the literature suggest that, in addition to the age of the patient, there is also an endogenous factor that can be responsible not only for the etiology and pathogenesis of the necrosis, but also for the early loosening of the prosthesis. We have followed up 54 patients (73 hip joints) who had total hip replacement as a result of necrosis of the femoral head between 1976 and 1988. Altogether, 3 acetabular and 5 femoral shafts had to be replaced (7 patients). This corresponds to a loosening rate of 10% after an average of 4.9 years. Hence, the prosthesis changing rate is lower than that reported by other authors, but is still higher than in patients with coxarthrosis. Only 2 of 52 cemented shaft prostheses had to be replaced; the average age of these patients was 61.4 years. Of the 21 cement-free shaft implantations, 3 had to be replaced, the average age of these patients being 42.9 years. The fact that the average age of the latter patients was lower may be the reason for the revision rate not being significantly higher for the non-cemented shafts. In view of the fact that necrosis of the femoral head can rapidly result in the patient becoming an invalid if it is allowed to follow its natural course, hip joint prostheses should also be offered to younger patients.

  7. Energy exchange between knee and ankle in a transfemoral prosthesis

    NARCIS (Netherlands)

    Koopman, Hubertus F.J.M.; Behrens, Sebastiaan Maria; Hekman, Edsko E.G.; Ünal, Ramazan

    2013-01-01

    In order to make an energy efficient transfemoral prosthesis, there should be energy exchange between knee and ankle of the prosthesis. A concept containing various spring elements is designed and tested for a single subject. It is shown that the concept of energy exchange can be realized; in this

  8. 21 CFR 872.3970 - Interarticular disc prosthesis (interpositional implant).

    Science.gov (United States)

    2010-04-01

    ... implant). 872.3970 Section 872.3970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... disc prosthesis (interpositional implant). (a) Identification. An interarticular disc prosthesis (interpositional implant) is a device that is intended to be an interface between the natural articulating surface...

  9. Fabrication of custom made ocular prosthesis with three different ...

    African Journals Online (AJOL)

    Loss of eye has a bad effect on the psychology of the patient. Eye prosthesis is fabricated to regain the patient's confidence by meticulous replacement of the missing eye. Immediate fitting of an anophthalmic socket with an artificial eye may not always be possible, and a delayed prosthesis delivery may result in settling and ...

  10. Three-piece Inflatable Penile Prosthesis: Surgical Techniques and ...

    African Journals Online (AJOL)

    implantation of the three-piece inflatable penile prosthesis and point out the major surgical pitfalls accompanying this procedure and their specific management. The psychological outcome of penile prosthesis surgery is also discussed. Different surgical approaches are available when performing the procedure. A number ...

  11. Three-piece Inflatable Penile Prosthesis: Surgical Techniques and ...

    African Journals Online (AJOL)

    Penile prosthesis surgery plays a vital role in the treatment of erectile dysfunction (ED). As far as outcome is concerned, it is one of the most rewarding procedures for both patients and surgeons. We describe our surgical technique for implantation of the three-piece inflatable penile prosthesis and point out the major surgical ...

  12. [Disappointing long-term experiences of patients with penile prosthesis

    NARCIS (Netherlands)

    Meuleman, E.J.H.; Deunk, L.; Schreuders-Bais, C.; Rabsztyn, P.

    2001-01-01

    OBJECTIVE: To describe the long-term experience with the implantation of a penile prosthesis as a last resort treatment for erectile dysfunction. DESIGN: Retrospective and descriptive. METHOD: During the period 1986-1996, 124 men received a penile prosthesis. Basic information was obtained from

  13. Risk factors associated with accidental ingestion of dental prosthesis ...

    African Journals Online (AJOL)

    Results: During the study period, eight patents were see, seven male and one female. Their ages ranged from 35 to 85 years with an average of 61.13 years. All the dental prosthesis retrieved from patients in this study were unsecured. Most of the patients with impacted dental prosthesis did not have the habit of removing ...

  14. Treatment of femoral neck fracture by Moore Prosthesis in Cotonou ...

    African Journals Online (AJOL)

    Treatment of femoral neck fracture by Moore Prosthesis in Cotonou. AHM Akue, M Lawson, S Madougou, R Zannou, J Padonou. Abstract. Keywords: Benin; hip; Moore prosthesis; results. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

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

    NARCIS (Netherlands)

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

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

  16. 21 CFR 878.3750 - External prosthesis adhesive.

    Science.gov (United States)

    2010-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Viet Q. Tran

    2008-01-01

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

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

    Science.gov (United States)

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

    2013-10-03

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

  19. Difficult factors in Management of Impacted Dental Prosthesis in Esophagus

    Directory of Open Access Journals (Sweden)

    Efiaty A. Soepardi

    2005-03-01

    Full Text Available A dental prosthesis which ingested and impacted in esophagus, is an emergency case and life threatening, so require immediate esophagoscopy intervention for removing. The objective of this study is to assess some factors can caused dtfficulties in diagnosing and treating the ingested and impacted dental prosthesis in the esophagus and their complications. This retrospective study analyzed patient’s chart whose underwent esophagoscopy for removing the impacted dental prosthesis in Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia during a period between January 1997 and December 2003. Neck-chest X-ray and esophagoscopy were performed in all patients to identify the existence of the dental prosthesis as a diagnostic and treatment procedure. The length of time for removing the dental prosthesis was recorded and stated as a less difficult esophagoscopy when it takes time less than 60 minutes and as a difficult  esophagoscopy takes 60 minutes or longer. Some risk difficulties factors were statistically analyzed. There were 53 patients of ingested dental prosthesis in esophagus. Only 51 cases were analyzed According to the length of time for removing the dental prosthesis by esophagoscopy, 22 patients were recorded as less difficult cases and 29 patients as difficult cases. Two cases among the cases needed cervicotomy after unsuccessful esophagoscopy removal. The difficulties to diagnose an impacted dental prosthesis in the esophagus caused by unreliable clinical history, unclear signs and symptoms, unable to be detected by X-ray and was not found during esophagoscopy. The difficulties in treating due to mucosal laceration, edema, bleeding, failure of the first extraction and conformity with the size and shape, the wire outside the dental prosthesis and the length of time stayed in the esophagus. (Med J Indones 2005; 14: 33-6Keywords: ingested dental prosthesis, radioluscent foreign body, length of time of esophagoscopy

  20. Removable dental prosthesis as periodontal treatment method

    Directory of Open Access Journals (Sweden)

    Aprilia Adenan

    2007-11-01

    Full Text Available The objectives of prostheses are to restore mastication force, improve esthetics and maintain gingival health. The construction and function of prosthesis restoration are mutually interdependent with condition of periodontal tissues. A properly constructed prosthesis is an integral phase of complete treatment of periodontal disease in order to maintain periodontal tissues health. This paper reports case of a man aged 47 years who came to Dental Specialist Clinic in Oral and Dental Hospital Faculty of Dentistry Universitas Padjadjaran with chief complaint of mobility in almost all his teeth and they seems to look longer. The patient has no systemic disease and did not want his teeth to be extracted. Clinical and panoramic radiographic and laboratoris examinations has been done. During treatment, oclusal adjustment and splinting had been done on tooth 33,34,35 and tooth 44,43 also tooth 43,42 splinting with composite. The following treatment was the acrylic removable partial denture for upper jaw while mandible was fitted a frame denture which functioned as a semi permanent splint. One month post treatment, patien felt comfort and the denture was well functioning.

  1. Malfunctioned and Fractured Penile Prosthesis Caused by Cross Placement: Case Report

    Directory of Open Access Journals (Sweden)

    Nihat Karakoyunlu

    2015-05-01

    Full Text Available Penile prosthesis is a functional option for patients who have erectile dysfunction after failed medical and intracavernosal treatments. Malleable penile prosthesis is a good alternative. Penile prosthesis implantation is a surgical process. Seldomly complications occur. In this study we presented a 61 y old man who has malfunctioned and broken penile prosthesis due to cross implantation.

  2. Categorization of compensatory motions in transradial myoelectric prosthesis users.

    Science.gov (United States)

    Hussaini, Ali; Zinck, Arthur; Kyberd, Peter

    2017-06-01

    Prosthesis users perform various compensatory motions to accommodate for the loss of the hand and wrist as well as the reduced functionality of a prosthetic hand. Investigate different compensation strategies that are performed by prosthesis users. Comparative analysis. A total of 20 able-bodied subjects and 4 prosthesis users performed a set of bimanual activities. Movements of the trunk and head were recorded using a motion capture system and a digital video recorder. Clinical motion angles were calculated to assess the compensatory motions made by the prosthesis users. The video recording also assisted in visually identifying the compensations. Compensatory motions by the prosthesis users were evident in the tasks performed (slicing and stirring activities) as compared to the benchmark of able-bodied subjects. Compensations took the form of a measured increase in range of motion, an observed adoption of a new posture during task execution, and prepositioning of items in the workspace prior to initiating a given task. Compensatory motions were performed by prosthesis users during the selected tasks. These can be categorized into three different types of compensations. Clinical relevance Proper identification and classification of compensatory motions performed by prosthesis users into three distinct forms allows clinicians and researchers to accurately identify and quantify movement. It will assist in evaluating new prosthetic interventions by providing distinct terminology that is easily understood and can be shared between research institutions.

  3. Disassembly and Dislocation of a Bipolar Hip Prosthesis

    Directory of Open Access Journals (Sweden)

    Hsieh-Hsing Lee

    2008-01-01

    Full Text Available Dislocation of a hip prosthesis is a common complication. In usual cases of hip prosthesis dislocation, the prosthetic femoral head comes out from either the natural acetabular cavity in a bipolar hemiarthroplasty or the prosthetic acetabulum in a total hip arthroplasty. Only a few cases of bipolar hip prosthesis dislocation due to dissociation between the polyethylene and inner head of the prosthesis have been reported. We describe a rare case of disassembly of the inner head from the bipolar outer prosthesis in an osteoarthritic acetabulum. A 72-year-old woman had undergone bipolar hemiarthroplasty due to fracture of the left femoral neck about 10 years previously. Recently, she sustained an injury after falling from a chair, and examinations revealed an unusual disassembly−dislocation of the bipolar hip prosthesis. We classified this failure in our patient as a type II failure, representing extreme varus position of the outer head in the acetabulum, dislocation of the inner head from the outer head, and a detached locking ring around the stem neck. This mechanism of failure as shown in our patient rarely occurs in the bipolar prosthesis of the self-centering system. Osteoarthritic change of the acetabulum would place the outer head in the varus position, increasing wear on the beveled rim by impinging the femoral stem neck and causing dislodgment of the inner locking ring and consequent disassembly−dislocation of the inner head.

  4. A new approach towards hip-prosthesis design.

    Science.gov (United States)

    Huggler, A H; Jacob, H A

    1980-01-01

    A new femoral prosthesis with a stemless design, different from conventional types, has been conceived in an effort to preserve the physiological stress distribution in magnitude and direction within the living bone as far as possible. The most important feature is that the hip joint forces are transmitted directly to the cortical bone of the resected femoral neck by means of a thrust plate, which maintains the physiological stress an the proximal end of the femur. The prosthesis, the instruments required for its implantation and the surgical technique are described in detail. Up to now, 3 patients have received this new prosthesis.

  5. The bionic eye (electronic visual prosthesis): a review.

    Science.gov (United States)

    Suaning, G J; Lovell, N H; Schindhelm, K; Coroneo, M T

    1998-08-01

    The concept of a visual prosthesis for the blind or partially sighted is not a new one. Indeed, for more than three decades this technology based treatment for blindness has appeared imminent. Despite the concerted efforts of numerous physicians, scientists and engineers, the successful application of a useful visual prosthesis remains elusive. The present review will endeavour to describe past efforts, investigate the present state of the art and indicate the obstacles that must be overcome in order to bring an electronic visual prosthesis to fruition.

  6. A modified technique for retention of orbital prosthesis

    Directory of Open Access Journals (Sweden)

    Sameera R Shaikh

    2011-01-01

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

  7. Development of a micromachined epiretinal vision prosthesis

    Science.gov (United States)

    Stieglitz, Thomas

    2009-12-01

    Microsystems engineering offers the tools to develop highly sophisticated miniaturized implants to interface with the nervous system. One challenging application field is the development of neural prostheses to restore vision in persons that have become blind by photoreceptor degeneration due to retinitis pigmentosa. The fundamental work that has been done in one approach is presented here. An epiretinal vision prosthesis has been developed that allows hybrid integration of electronics on one part of a thin and flexible substrate. Polyimide as a substrate material is proven to be non-cytotoxic. Non-hermetic encapsulation with parylene C was stable for at least 3 months in vivo. Chronic animal experiments proved spatially selective cortical activation after epiretinal stimulation with a 25-channel implant. Research results have been transferred successfully to companies that currently work on the medical device approval of these retinal vision prostheses in Europe and in the USA.

  8. Natural tooth as an interim prosthesis.

    Science.gov (United States)

    Dhariwal, Neha S; Gokhale, Niraj S; Patel, Punit; Hugar, Shivayogi M

    2016-01-01

    A traumatic injury to primary maxillary anterior tooth is one of the common causes for problems with the succedaneous tooth leading to it noneruption. A missing anterior tooth can be psychologically and socially damaging to the patient. Despite a wide range of treatment options available, sometimes, it is inevitable to save the natural tooth. This paper describes the immediate replacement of a right central incisor using a fiber-composite resin splint with the natural tooth crown as a pontic following surgical extraction of the dilacerated impacted permanent maxillary central incisor. The abutment teeth can be conserved with minimal or no preparation, thus keeping the technique reversible and can be completed at chair side thereby avoiding laboratory costs. It can be used as an interim measure until a definitive prosthesis can be fabricated as the growth is still incomplete.

  9. [Nocardia farcinica infection of a vascular prosthesis].

    Science.gov (United States)

    Babilas, P; Scherer, K; Landthaler, M; Ehrenstein, B; Szeimies, R-M

    2007-04-01

    A 61-year-old woman presented with purple-red subcutaneous nodules on her right leg. She had experienced fever up to 40 degrees C for the past 10 days and felt generally weak over the last two months. Four months earlier, a vascular graft had been implanted in her right femoral artery. Based on the diagnosis of skin infection due to implantation of an infected prosthesis, she was hospitalized and treated with an antibiotic regime. During the initial antibiotic treatment, the symptoms deteriorated, and she developed joint, hepatic and CNS abscesses. Finally, a microbiologic culture with an extended incubation time revealed the diagnosis of an infection with the slowly growing bacterium Nocardia ssp. Hereupon the patient was treated purposefully with Meropenem over six months. This treatment resulted in complete recovery.

  10. [Results after replacement of femoral neck prostheses - thrust plate prosthesis (TPP) versus ESKA cut prosthesis].

    Science.gov (United States)

    Ishaque, B A; Gils, J; Wienbeck, S; Donle, E; Basad, E; Stürz, H

    2009-01-01

    The aim of this study was to analyse and evaluate comparatively loosening mechanisms, failure frequency, surgical changing strategies and results after replacement of thrust plate prostheses (TPP) and ESKA Cut prostheses. Between 1993 und 2007, 465 TPP and in the years 2000 and 2001 82 ESKA Cut prostheses were performed and evaluated prospectively. Until 2007 46 change interventions of the TPP and 35 of the CUT prosthesis became necessary. All patients who received a stem revision procedure in our hospital were included within this study. Besides the evaluation of clinical results according to the criteria of the Harris Hip Score on the average at 15.6 months (+/- 14.4) postoperatively, radiological loosening processes and surgical difficulties were registered. Furthermore, an analysis of perioperative data was performed according to some criteria of the German Federal Office of Quality Assurance (BQS), such as duration of the surgery, intraoperative blood loss and complications. Statistical investigations for comparative analysis as well as survival analysis of both groups were calculated using SPSS for Windows 13.0. The mean age of the 46 patients who had to undergo revision surgery after TPP was 60.1 years, that of 35 patients in whom revision surgery was necessary after receiving an ESKA Cut femoral neck stem was 56.6 years. The survival rate analysis according to Kaplan-Meier at 13 years was 89.4 % (TPP) and 53.6 % at 66 months (ESKA Cut). In all cases the partial osteointegration of the tripod surface of the loosened Cut prosthesis complicated the explantation. It led on the one hand to a significant difference of the surgery duration and on the other hand to an increased frequency of fractures of the trochanteric region. The conversion of the TPP on standard type stems was usually free of problems. The HHS increased significantly to the averages of 86.6 (TPP) or, respectively, 91.69 (ESKA Cut) after revision. In comparison with the usually problem

  11. EVALUTION OF EFFECTIVENESS OF BALANCE TRAINING IN CONVENTIONAL PROSTHESIS VERSUS ULTRAMODERN PROSTHESIS IN UNILATERAL TRANSTIBIAL AMPUTEE BY USING FLAMINGO BALANCE TEST

    OpenAIRE

    Suresh; Vinod Kumar; Bharath Raju; Raja; Ravish; Mandeep; Hari Krishna; Rajeeva

    2014-01-01

    AIM: To estimate the effectiveness of balance training on unilateral transtibal amputee with conventional prosthesis and ultramodern prosthesis. To compare the Effectiveness of balance training in conventional prosthesis versus ultramodern prosthesis in unilateral transtibial amputee by using Flamingo balance test. MATERIALS AND METHODS: After obtaining informed consent from the patients, we studied a total of 40 patients, aged between 30- 60 yrs, where they were randomly ...

  12. 21 CFR 888.3025 - Passive tendon prosthesis.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3025 Passive tendon prosthesis. (a... flexor tendon of the hand. The device is implanted for a period of 2 to 6 months to aid growth of a new...

  13. Towards a Completely Implantable, Light-Sensitive Intraocular Retinal Prosthesis

    National Research Council Canada - National Science Library

    Humayun, M

    2001-01-01

    An electronic retinal prosthesis is under development to treat retinitis pigmentosa and age-related macular degeneration, two presently incurable diseases of the outer retina that afflict millions world-wide...

  14. Characterization of an eye prosthesis using monopoly syrup.

    Science.gov (United States)

    Bankoti, Pinki; Singhal, M K; Nair, Chandana; Chandra, Praveen

    2016-01-01

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

  15. Metabolics of stair ascent with a powered transfemoral prosthesis.

    Science.gov (United States)

    Ledoux, E D; Lawson, B E; Shultz, A H; Bartlett, H L; Goldfarb, M

    2015-01-01

    This paper evaluates the effectiveness of a powered knee and ankle prosthesis for stair ascent through a metabolic assessment comparing energy expenditure of a single transfemoral amputee subject while ascending stairs with the powered prosthesis relative to his passive daily use device, as well as comparing the kinematics and kinetics obtained with the passive prosthesis to healthy biomechanics. The subject wore a portable system that measured pulmonary gaseous exchange rates of oxygen and carbon dioxide while he ascended stairs with each of the prostheses in alternating tests. The results indicated that the amputee's energy expenditure decreased by 32 percent while climbing with the powered prosthesis as compared to his passive one, and the kinematics and kinetics achieved were representative of healthy biomechanics.

  16. Komposit Laminate Rami Epoksi Sebagai Bahan Alternatif Socket Prosthesis

    OpenAIRE

    Irawan, Agustinus P; Soemardi, Tresna P.; Widjajalaksmi K. Widjajalaksmi K.; Agus H.S. Reksoprodjo

    2009-01-01

    pure plant oil, biofuel, coconut oil, palm oil, jatropha oilSocket is the most important component in a prosthesis making. Performance criteria for prosthetic socket material include strength, durability, minimal weight, comfort, and minimal fabrication cost. This research attempts to analyze the strength of ramie fiber reinforced epoxy laminate composite as an alternative of socket prosthesis. The research based on ASTM D 3039/D 3039M for tensile strength and ASTM D 695 for compressive stren...

  17. Komposit Laminate Rami Epoksi Sebagai Bahan Alternatif Socket Prosthesis

    OpenAIRE

    Irawan, Agustinus P; Soemardi, Tresna P.; Widjajalaksmi K., Widjajalaksmi K; Agus H.S. Reksoprodjo

    2009-01-01

    Pure plant oil, biofuel, coconut oil, palm oil, jatropha oilSocket is the most important component in a prosthesis making. Performance criteria for prosthetic socket material include strength, durability, minimal weight, comfort, and minimal fabrication cost. This research attempts to analyze the strength of ramie fiber reinforced epoxy laminate composite as an alternative of socket prosthesis. The research based on ASTM D 3039/D 3039M for tensile strength and ASTM D 695 for compressive stre...

  18. Energy exchange between knee and ankle in a transfemoral prosthesis

    OpenAIRE

    Koopman, Hubertus F.J.M.; Behrens, Sebastiaan Maria; Hekman, Edsko E. G.; Ünal, Ramazan

    2013-01-01

    In order to make an energy efficient transfemoral prosthesis, there should be energy exchange between knee and ankle of the prosthesis. A concept containing various spring elements is designed and tested for a single subject. It is shown that the concept of energy exchange can be realized; in this specific situation up to 76 % of the mechanical energy is restored to support ankle plantar flexion during push-off.

  19. Ethical issues in the development of a vestibular prosthesis

    OpenAIRE

    Poppendieck, Wigand; Hoffmann, Klaus-Peter; Merfeld, Daniel; Guyot, Jean-Philippe; Micera, Silvestro

    2011-01-01

    During the development of a neural prosthesis, various ethical aspects have to be considered. These range from the basic design of the prosthesis and manufacturing of the various components and the system using biocompatible materials to extensive in vitro and in vivo testing and investigations in the animal model, before taking the final step and going to human trials. As medical systems, neural prostheses have to be proven absolutely safe before considering any clinical study. In this work,...

  20. Treatment Using Functionally Fixed Prosthesis: A Case Report

    OpenAIRE

    Chandra, Sumi; Singh, Ajay; Gupta, Himanshu; Chandra, Chetan

    2013-01-01

    Most dental practitioners as well as their patients prefer to have fixed rather than removable prosthesis. However, there are many clinical situations that prohibit the use of the fixed treatment modality. These clinical cases can vary from, simply not having the proper number of healthy teeth and/or implants to, the esthetically challenging cases of high smile lines and severe loss of alveolar support. The approach of using a traditional removable prosthesis in these situations has always be...

  1. Split-Framework in Mandibular Implant-Supported Prosthesis

    OpenAIRE

    Danny Omar Mendoza Marin; Kássia de Carvalho Dias; André Gustavo Paleari; Ana Carolina Pero; João Neudenir Arioli Filho; Marco Antonio Compagnoni

    2015-01-01

    During oral rehabilitation of an edentulous patient with an implant-supported prosthesis, mandibular flexure must be considered an important biomechanical factor when planning the metal framework design, especially if implants are installed posterior to the interforaminal region. When an edentulous mandible is restored with a fixed implant-supported prosthesis connected by a fixed full-arch framework, mandibular flexure may cause needless stress in the overall restorative system and lead to s...

  2. Septic complication following porous hydroxyapatite cranioplasty: prosthesis retention management.

    Science.gov (United States)

    Iaccarino, Corrado; Mattogno, Pier P; Zanotti, Bruno; Bellocchi, Silvio; Verlicchi, Angela; Viaroli, Edoardo; Pastorello, Giulia; SGULò, Francesco; Ghadirpour, Reza; Servadei, Franco

    2016-05-13

    After failing of autologous cranioplasty or when the bone flap is unavailable, the alloplastic (heterologous) materials are the choice for cranial reconstruction. No agreement has been reported about the material with a significant lower risk of septic complications. This is due to extremely heterogeneous prognostic factors related not only to the material used but also to the surgical procedures and/or to the timing of the procedure. More attention should be focused on the material whose characteristic could enable a delay in bacterial colonization, where an antibiotic therapy could be effective, without need of prosthesis removal. Four cases of severe septic complication following cranioplasty with porous hydroxyapatite (HA) prosthesis are presented. Patients were conservatively treated, without heterologous bone flap removal. All of our patients presented reasons for delaying HA cranioplasty removal: Patients 1, 3 and 4 had an associated shunted hydrocephalus and the need for non- removing the prosthesis was related to the predictable recurrence of overshunting and/or sinking skin flap syndrome. In case 4 the revision surgery would have also damaged the microvascular flap with latissimus dorsi muscle used by plastic surgeon for skin reconstruction. In case 2 the patient refused revision surgery. In all cases systemic and/or radiological signs of infection were observed. In Case 2 the infective process surrounded completely the HA prosthesis, while it was located in the epidural region in Case 1 and 4. In Case 3 a surgical curettage of the infected wound was performed over the HA prosthesis. Following prosthesis retention management with antibiotic therapy, all patients revealed systemic and/or radiological signs of sepsis resolution at follow-up. The possibility to avoid a prosthesis removal with effective antibiotic treatment is mainly due to the combination of three factors: targeted antibiotic therapy, good anatomical area revascularization (resulting of an

  3. Kinematic Analysis of a Posterior-stabilized Knee Prosthesis

    Directory of Open Access Journals (Sweden)

    Zhi-Xin Zhao

    2015-01-01

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

  4. A Simplified Technique for Fabrication of Orbital Prosthesis

    OpenAIRE

    Sharma, Neeraj; Thakral, G.K.; Mohapatra, Abhilash; Seth, Jyotsna; Vashisht, Pallavi

    2014-01-01

    Eye is a vital organ not only for vision, but also an important component of facial expression, and over-all personality of a person. Loss of eye, apart from leading to impaired vision has a crippling effect on the psychology of the patient. Prosthodontic rehabilitation of such cases includes fabrication of prosthesis by acrylic resin, silicone and implants. However, not all patients are willing to use implants for maxillofacial rehabilitation. Therefore, a custom made orbital prosthesis serv...

  5. Design and Optimization of Sinusoidal Formed Femur Prosthesis

    Directory of Open Access Journals (Sweden)

    Ahmet Zafer ŞENALP

    2015-01-01

    Full Text Available One of the major problems in hip replacement surgery is the hip replacement loosening. Hip replacement loosening occurs over time after the surgery and it is related to the discretization between the bone cement and prosthesis. The underlying factors of this situation are the stress occurring in the bone cement and the shape of the prosthesis. In this study, cortical and trabecular layers of the femur, bone cement and prosthesis were modeled. The models of bone cement and prosthesis were constructed parametrically and two different sinusoidal formed prostheses were developed unlike the former prostheses shapes. Analyses were conducted for these two different sinusoidal forms by using finite element method and optimization was conducted to obtain the appropriate prosthesis stem shape and bone cement thickness by using parametric modeling in finite element analyses. For finite element analyses and optimization, Ansys Workbench software was used and analyses were conducted for 316LS stainless steel material. Finally, the optimum prosthesis stem shape and bone cement thickness was determined by using the results of the analyses in the first stage

  6. Failed total carpometacarpal joint prosthesis of the thumb

    DEFF Research Database (Denmark)

    Hansen, Torben Bæk; Homilius, Morten

    2010-01-01

    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. T...... 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....... 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...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  8. Prediction model for penile prosthesis implantation for erectile dysfunction management.

    Science.gov (United States)

    Segal, Robert L; Camper, Stephen B; Ma, Larry; Burnett, Arthur L

    2014-10-01

    Penile prosthesis surgery is indicated based on undesirability, contraindication or ineffectiveness of non-surgical options for erectile dysfunction. This definitive treatment is often delayed after initial diagnosis. Our objective was to develop a prediction tool based on a patient's clinical history to determine likelihood of ultimately receiving a penile prosthesis. This retrospective analysis used claims data from Commercial and Medicare supplemental databases. Inclusion criteria were 18 years of age with 1 year of continuous enrollment at the first diagnosis of erectile dysfunction. Patients' demographics, co-morbidities and erectile dysfunction therapy were derived based on enrollment, medical and prescription histories. The Cox proportional hazards model with stepwise selection was used to identify and quantify (using relative risk) factors associated with a future penile prosthesis implant. Co-morbidities and therapies present prior to the index erectile dysfunction diagnosis were analyzed as fixed covariates. Approximately 1% of the dataset's population (N = 310,303 Commercial, N = 74,315 Medicare, respectively) underwent penile prosthesis implantation during the study period (3928 patients in the overall population: 2405 patients [0.78%] in the Commercial and 1523 patients [2.05%] in the Medicare population). Factors with the greatest predictive strength of penile prosthesis implantation included prostate cancer diagnosis (relative risk: 3.93, 2.29; 95% CI, 3.57-4.34, 2.03-2.6), diabetes mellitus (2.31, 1.23; 2.12-2.52, 1.1-1.37) and previous treatment with first-line therapy (1.39, 1.33; 1.28-1.5, 1.2-1.47) (all P prosthesis. Calculating the likelihood of penile prosthesis implantation based on the weight of these factors may assist clinicians with the definition of a care plan and patient counseling. The precision of the model may be limited by factors beyond medical history information that possibly influence the decision to proceed to

  9. Automated estimation of hip prosthesis migration: a feasibility study

    Science.gov (United States)

    Vandemeulebroucke, Jef; Deklerck, Rudi; Temmermans, Frederik; Van Gompel, Gert; Buls, Nico; Scheerlinck, Thierry; de Mey, Johan

    2013-09-01

    A common complication associated with hip arthoplasty is prosthesis migration, and for most cemented components a migration greater than 0.85 mm within the first six months after surgery, are an indicator for prosthesis failure. Currently, prosthesis migration is evaluated using X-ray images, which can only reliably estimate migrations larger than 5 mm. We propose an automated method for estimating prosthesis migration more accurately, using CT images and image registration techniques. We report on the results obtained using an experimental set-up, in which a metal prosthesis can be translated and rotated with respect to a cadaver femur, over distances and angles applied using a combination of positioning stages. Images are first preprocessed to reduce artefacts. Bone and prosthesis are extracted using consecutive thresholding and morphological operations. Two registrations are performed, one aligning the bones and the other aligning the prostheses. The migration is estimated as the difference between the found transformations. We use a robust, multi-resolution, stochastic optimization approach, and compare the mean squared intensity differences (MS) to mutual information (MI). 30 high-resolution helical CT scans were acquired for prosthesis translations ranging from 0.05 mm to 4 mm, and rotations ranging from 0.3° to 3° . For the translations, the mean 3D registration error was found to be 0.22 mm for MS, and 0.15 mm for MI. For the rotations, the standard deviation of the estimation error was 0.18° for MS, and 0.08° for MI. The results show that the proposed approach is feasible and that clinically acceptable accuracies can be obtained. Clinical validation studies on patient images will now be undertaken.

  10. Spatiotemporal interactions in retinal prosthesis subjects.

    Science.gov (United States)

    Horsager, Alan; Greenberg, Robert J; Fine, Ione

    2010-02-01

    Vision loss due to retinitis pigmentosa affects an estimated 15 million people worldwide. Through collaboration between Second Sight Medical Products, Inc., and the Doheny Eye Institute, six blind human subjects underwent implantation with epiretinal 4 x 4 electrode arrays designed to directly stimulate the remaining cells of the retina, with the goal of restoring functional vision by applying spatiotemporal patterns of stimulation. To better understand spatiotemporal interactions between electrodes during synchronous and asynchronous stimulation, the authors investigated how percepts changed as a function of pulse timing across the electrodes. Pulse trains (20, 40, 80, and 160 Hz) were presented on groups of electrodes with 800, 1600, or 2400 microm center-to-center separation. Stimulation was either synchronous (pulses were presented simultaneously across electrodes) or asynchronous (pulses were phase shifted). Using a same-different discrimination task, the authors were able to evaluate how the perceptual quality of the stimuli changed as a function of phase shifts across multiple electrodes. Even after controlling for electric field interactions, subjects could discriminate between spatiotemporal pulse train patterns based on differences of phase across electrodes as small as 3 ms. These findings suggest that the quality of the percept is affected not only by electric field interactions but also by spatiotemporal interactions at the neural level. During multielectrode stimulation, interactions between electrodes have a significant influence on the quality of the percept. Understanding how these spatiotemporal interactions at the neural level influence percepts during multielectrode stimulation is fundamental to the successful design of a retinal prosthesis.

  11. Zirconia in fixed prosthesis. A literature review

    Science.gov (United States)

    Román-Rodríguez, Juan L.; Ferreiroa, Alberto; Solá-Ruíz, María F.; Fons-Font, Antonio

    2014-01-01

    Statement of problem: Evidence is limited on the efficacy of zirconia-based fixed dental prostheses. Objective: To carry out a literature review of the behavior of zirconium oxide dental restorations. Material and Methods: This literature review searched the Pubmed, Scopus, Medline and Cochrane Library databases using key search words “zirconium oxide,” “zirconia,” “non-metal restorations,” “ceramic oxides,” “veneering ceramic,” “zirconia-based fixed dental prostheses”. Both in vivo and in vitro studies into zirconia-based prosthodontic restoration behavior were included. Results: Clinical studies have revealed a high rate of fracture for porcelain-veneered zirconia-based restorations that varies between 6% and 15% over a 3- to 5-year period, while for ceramo-metallic restorations the fracture rate ranges between 4 and 10% over ten years. These results provoke uncertainty as to the long-term prognosis for this material in the oral medium. The cause of veneering porcelain fractures is unknown but hypothetically they could be associated with bond failure between the veneer material and the zirconia sub-structure. Key words:Veneering ceramic, zirconia-based ceramic restoration, crown, zirconia, tooth-supported fixed prosthesis. PMID:24596638

  12. Golf hand prosthesis performance of transradial amputees.

    Science.gov (United States)

    Carey, Stephanie L; Wernke, Matthew M; Lura, Derek J; Kahle, Jason T; Dubey, Rajiv V; Highsmith, M Jason

    2015-06-01

    Typical upper limb prostheses may limit sports participation; therefore, specialized terminal devices are often needed. The purpose of this study was to evaluate the ability of transradial amputees to play golf using a specialized terminal device. Club head speed, X-factor, and elbow motion of two individuals with transradial amputations using an Eagle Golf terminal device were compared to a non-amputee during a golf swing. Measurements were collected pre/post training with various stances and grips. Both prosthesis users preferred a right-handed stance initially; however, after training, one preferred a left-handed stance. The amputees had slower club head speeds and a lower X-factor compared to the non-amputee golfer, but increased their individual elbow motion on the prosthetic side after training. Amputees enjoyed using the device, and it may provide kinematic benefits indicated by the increase in elbow flexion on the prosthetic side. The transradial amputees were able to swing a golf club with sufficient repetition, form, and velocity to play golf recreationally. Increased elbow flexion on the prosthetic side suggests a potential benefit from using the Eagle Golf terminal device. Participating in recreational sports can increase amputees' health and quality of life. © The International Society for Prosthetics and Orthotics 2014.

  13. Metabolic Prosthesis for Oxygenation of Ischemic Tissue

    Energy Technology Data Exchange (ETDEWEB)

    Greenbaum, Elias [ORNL

    2009-01-01

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

  14. Biomedical and psychosocial factors influencing transtibial prosthesis fit: a Delphi survey among health care professionals.

    Science.gov (United States)

    Baars, Erwin C; Schrier, Ernst; Geertzen, Jan H; Dijkstra, Pieter U

    2015-01-01

    We aimed to reach consensus among professionals caring for prosthesis users, on definitions of biomedical and psychosocial factors, to assess their influence on fit of transtibial prosthesis and to identify new factors. A three-round, internet-based, Delphi survey was conducted among experts recruited via the Dutch National Amputee and Prosthesis Work Group. The main outcome measure was consensus among care professionals on statements concerning new and presented biomechanical and psychosocial factors that influence transtibial prosthesis fit. Fifty-four experts participated in the survey, and consensus was reached on 67% (46/69) of all statements. Consensus on statements relevant for good prosthesis fit was reached in most of the statements concerning psychosocial factors and on statements concerning the biomedical factors "prosthesis support and suspension". Least consensus was reached on statements concerning the biomedical factor "skin problems and pain in the residual limb". Biomedical and psychosocial factors influence transtibial prosthesis fit. Consensus was reached among care professionals in a majority of the presented statements concerning these factors. Implications for Rehabilitation Prosthesis fit and comfort is suboptimal in many prosthesis users. Both biomedical and psychosocial factors influence fit. Biomedical and psychosocial factors should be checked during transtibial prosthesis prescription to achieve and maintain an optimal fit. Consensus on many factors influencing prosthesis fit is achieved among care professionals. Consensus was largest regarding prosthesis support and suspension and least regarding skin problems and pain in the residual limb. This consensus contributes to systematic assessment of prosthesis fit.

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

    Science.gov (United States)

    Pillai, Rajath Sasidharan; Mathur, Vijay Prakash; Jain, Veena; Shah, Naseem; Kalra, Sandeep; Kumar, Pravesh; Dey, A B

    2015-12-01

    To determine the effect of prosthesis need on nutritional status and oral health-related quality of life (OHrQoL) in elderly and to check the disparity between prosthesis need and prosthesis want in the Indian elderly. A total of 946 geriatric participants reporting to a geriatric medicine clinic were recruited in the study. Mini-nutritional assessment (MNA), geriatric oral health assessment (GOHAI) indices, prosthesis need according to WHO criteria, and prosthesis want was recorded along with age, gender, socioeconomic status and posterior occluding pair. Significant associations exist between prosthesis need and age (p = 0.005), MNA (p = 0.006) and GOHAI (p = 0.000). Prosthesis demand too was influenced by age (p = 0.004), posterior occluding pairs (p = 0.000), MNA (p = 0.012) and GOHAI (p = 0.000). GOHAI was negatively correlated with upper (r = -0.445) and lower prosthesis need (r = -0.460). Participants with some prosthesis need had significantly lower MNA and GOHAI scores as compared to those with no prosthesis need. Though prosthesis need was high (79.7 %), demand was low (39.3 %). Prosthesis need affects nutritional status and OHrQoL in elderly, and a wide gap exists between need and want of prosthesis.

  16. Gait assessment in patients with thrust plate prosthesis and intramedullary stemmed prosthesis implanted to each hip.

    Science.gov (United States)

    Angin, Salih; Karatosun, Vasfi; Unver, Bayram; Gunal, Izge

    2007-02-01

    There has not been any study regarding comparative gait analysis in patients with intramedullary stemmed prosthesis (ISP) and thrust plate prosthesis (TPP) implanted to each hip. Four patients (three females and one male) who had undergone operation due to coxarthrosis were selected. The mean age was 60.5 (37-78) years. TPP and ISP had been implanted to the left and right hip, respectively, in three patients, and one patient received TPP to the right and ISP to the left hip. Gait was analyzed with a BTS Elite System consisting six cameras and two Kistler force plates using Helen Hayes marker set to assess the gait parameters. The clinical outcome was also evaluated according to Harris hip score (HHS). The average HHS was 95.0 (82-100) points after a mean follow-up of 45.0 (30-50) months for TPP and 94.5 (80-100) points after a follow-up of 60.0 (14-122) months for ISP. Neither of the HHS scores and follow-up time nor gait parameters obtained from the TPP-implanted side were statistically different when compared to those of the ISP-implanted side. TPP and ISP as the implants with their own biomechanical specifications did not produce any remarkable difference in gait.

  17. Design and Testing of a Bionic Dancing Prosthesis.

    Science.gov (United States)

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

    2015-01-01

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

  18. Design and Testing of a Bionic Dancing Prosthesis.

    Directory of Open Access Journals (Sweden)

    Elliott J Rouse

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

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

    Science.gov (United States)

    Colombo, Giorgio; Facoetti, Giancarlo; Rizzi, Caterina

    2013-04-06

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

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

    Science.gov (United States)

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

    1998-12-01

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

  1. Closed-eye orbital prosthesis: a clinical report.

    Science.gov (United States)

    Hatamleh, Muhanad M; Watson, Jason; Srinivasan, Dilip

    2015-03-01

    One of the most challenging prostheses to fabricate is an acceptable orbital prosthesis. Successful reconstruction of the complex missing tissues, the globe, muscle, skin, and bony elements requires time and high levels of practical skill. A good match to the contralateral nondefect side will help mask the underlying defect and give the patient confidence to return to normal, routine life. The contralateral eye opening will commonly dictate the eye opening of such a prosthesis, but because of the expressive nature of the eye and its high levels of mobility, this can be difficult to achieve. This clinical report presents a patient who had an extended orbital exenteration and right maxillectomy to remove a maxillary squamous cell carcinoma. An alternative approach to constructing an orbital prosthesis was undertaken with the eye closed. Compared to the normal method of fabrication, this process was less complex and quicker, made the prosthesis less "staring," camouflaged the defect, and reduced the detection of the prosthesis because of movements in the remaining eye. The patient engaged in his routine daily life, which reinforced his self-esteem, confidence, and reintegration into the community. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  2. Split-Framework in Mandibular Implant-Supported Prosthesis

    Directory of Open Access Journals (Sweden)

    Danny Omar Mendoza Marin

    2015-01-01

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

  3. [Tracheal reconstruction with memory alloy prosthesis coated with collagen].

    Science.gov (United States)

    Lin, Hai-ping; Cao, Zi-ang; Gu, Xu-dong; Pan, Wen-biao; Wu, Xue-jun; Zhang, Gu-lan

    2007-03-01

    To investigate the feasibility of tracheal reconstruction with a prosthesis made of memory alloy coated with collagen sponge in mongrel dogs. The basic skeleton of the prosthesis was knitted with Ni-Ti memory alloy wires. The tubular mesh was sealed with polyurethane membrane and then inner and external walls of the lumen were coated with collagen sponge. Cervical trachea segmental reconstruction was performed in 8 mongrel dogs with these prostheses. The efficacy of the implanted prostheses were periodically evaluated after operation using x-ray, tracheoscopy and specimen microscope examinations. One dog died of prosthesis dislocation 10 days after operation, another was killed 45 days later because of anastomotic stenosis. 6 dogs survived more than 90 days and the longest one lived for 150 days. Its implanted prosthesis was completely incorporated with the recipient tissue, where re-epithelialization occluded on anastomotic sites. The tracheal lumen was patent. This memory alloy tracheal prosthesis has been proved useful for reconstruction of large, circumferential tracheal defects, although its long-term safety and efficiency need to be confirmed.

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

    Science.gov (United States)

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

    2014-01-01

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

  5. Design and Control of a Pneumatically Actuated Transtibial Prosthesis

    Science.gov (United States)

    Zheng, Hao; Shen, Xiangrong

    2015-01-01

    This paper presents the design and control of a pneumatically actuated transtibial prosthesis, which utilizes a pneumatic cylinder-type actuator to power the prosthetic ankle joint to support the user's locomotion. The pneumatic actuator has multiple advantages over the traditional electric motor, such as light weight, low cost, and high power-to-weight ratio. The objective of this work is to develop a compact and lightweight transtibial prosthesis, leveraging the multiple advantages provided by this highly competitive actuator. In this paper, the design details of the prosthesis are described, including the determination of performance specifications, the layout of the actuation mechanism, and the calculation of the torque capacity. Through the authors’ design calculation, the prosthesis is able to provide sufficient range of motion and torque capacity to support the locomotion of a 75 kg individual. The controller design is also described, including the underlying biomechanical analysis and the formulation of the finite-state impedance controller. Finally, the human subject testing results are presented, with the data indicating that the prosthesis is able to generate a natural walking gait and sufficient power output for its amputee user. PMID:26146497

  6. Intermanual Transfer Effects in Below-Elbow Myoelectric Prosthesis Users.

    Science.gov (United States)

    de Boer, Errit; Romkema, Sietske; Cutti, Andrea G; Brouwers, Michael A; Bongers, Raoul M; van der Sluis, Corry K

    2016-11-01

    To determine intermanual transfer effects in patients with a below-elbow amputation using a myoelectric prosthesis and to establish whether laterality affects these effects. Case-control. A standardized setting in a rehabilitation clinic. A convenience sample (N=44) of experienced myoelectric prosthesis users (n=22) and matched controls (n=22). Controls were matched on sex, age (±5y), and hand dominance. Both the experienced group and the control group performed several tasks using a prosthesis simulator attached to their nonaffected arm. Movement time, force control, Box and Block test (BBT) scores, and duration of hand opening. Movement times of myoelectric prosthesis users were shorter, and these users had significantly higher BBT scores and shorter hand opening durations than those of controls. No intermanual transfer effects on force control and no laterality effects were found. Intermanual transfer effects were present in experienced myoelectric prosthesis users with a below-elbow amputation, independent of laterality. These findings support the clinical relevance of intermanual transfer training, which may facilitate persons with an upper limb amputation to start training directly after the amputation. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. Functional improvement with digital prosthesis use after multiple digit amputations.

    Science.gov (United States)

    Lifchez, Scott D; Marchant-Hanson, Judith; Matloub, Hani S; Sanger, James R; Dzwierzynski, William W; Nguyen, Hanh H

    2005-07-01

    Patients who sustain traumatic amputation of multiple fingers suffer both a functional and psychologic loss. Previous studies of prosthesis use for finger amputees have focused primarily on the psychologic benefits. Clinically our group noticed a functional improvement on hand function tests when patients with multiple digit amputations used a prosthesis. Given the expense of multiple finger prostheses we sought to determine if they led to a consistent functional improvement in these patients. Ten consecutive patients performed a battery of hand function tests and rated their ability to perform a variety of activities of daily living both with and without their prosthesis using the Disabilities of the Arm, Shoulder, and Hand questionnaire. Our results show a significant improvement in 3-finger-pinch strength and grip strength and a trend of improvement of tip-pinch, lateral-pinch, and grip strength in dynamometer positions 1, 2, 3, and 4 in these patients when tested with and without their prostheses. Function in activities of daily living, as assessed by the Disabilities of the Arm, Shoulder, and Hand questionnaire, was improved globally with prosthesis use. In addition, significant improvement was noted in several specific activities including opening a jar, writing, and turning a key, among others. These results show that prosthesis use provides a functional benefit to these patients in multiple activities.

  8. The making of indigenous vascular prosthesis

    Directory of Open Access Journals (Sweden)

    Madathipat Unnikrishnan

    2016-01-01

    Full Text Available Background & objectives: Vascular illnesses are on the rise in India, due to increase in lifestyle diseases and demographic transition, requiring intervention to save life, organ or limbs using vascular prosthesis. The aim of this study was to develop indigenous large diameter vascular graft for treatment of patients with vascular pathologies. Methods: The South India Textile Research Association, at Coimbatore, Tamil Nadu, India, developed seamless woven polyester (Polyethylene terephthalate graft at its research wing. Further characterization and testing followed by clinical trials were conducted at Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India. Fifteen in vivo experiments were carried out in 1992-1994 in pigs as animal model. Controlled (phase I clinical trial in ten patients was performed along with control graft. Thereafter, phase II trial involved 22 patients who underwent multi-centre clinical trial in four centres across India. Results: Laboratory testing showed that polyester graft was non-toxic, non-leeching and non-haemolytic with preserved long-term quality, further confirming in pigs by implanting in thoracic aorta, comparable to control Dacron grafts. Perigraft incorporation and smooth neointima formation which are prime features of excellent healing characteristics, were noted at explantation at planned intervals. Subsequently in the phase I and II clinical trials, all patients had excellent recovery without mortality or device-related adverse events. Patients receiving the test graft were followed up for 10 and 5 years, respectively. Serial clinical, duplex scans and CT angiograms performed periodically confirmed excellent graft performance. Interpretation & conclusions: Indigenously developed Chitra vascular graft was comparable to commercially available Dacron graft, ready for clinical use at affordable cost to patients as against costly imported grafts.

  9. Active Bone Conduction Prosthesis: BonebridgeTM

    Directory of Open Access Journals (Sweden)

    Zernotti, Mario E.

    2015-10-01

    Full Text Available Introduction Bone conduction implants are indicated for patients with conductive and mixed hearing loss, as well as for patients with single-sided deafness (SSD. The transcutaneous technology avoids several complications of the percutaneous bone conduction implants including skin reaction, skin growth over the abutment, and wound infection. The Bonebridge (MED-EL, Austria prosthesis is a semi-implantable hearing system: the BCI (Bone Conduction Implant is the implantable part that contains the Bone Conduction-Floating Mass Transducer (BC-FMT, which applies the vibrations directly to the bone; the external component is the audio processor Amadé BB (MED-EL, Austria, which digitally processes the sound and sends the information through the coil to the internal part. Bonebridge may be implanted through three different approaches: the transmastoid, the retrosigmoid, or the middle fossa approach. Objective This systematic review aims to describe the world́s first active bone conduction implant system, Bonebridge, as well as describe the surgical techniques in the three possible approaches, showing results from implant centers in the world in terms of functional gain, speech reception thresholds and word recognition scores. Data Synthesis The authors searched the MEDLINE database using the key term Bonebridge. They selected only five publications to include in this systematic review. The review analyzes 20 patients that received Bonebridge implants with different approaches and pathologies. Conclusion Bonebridge is a solution for patients with conductive/mixed hearing loss and SSD with different surgical approaches, depending on their anatomy. The system imparts fewer complications than percutaneous bone conduction implants and shows proven benefits in speech discrimination and functional gain.

  10. In vivo performance of photovoltaic subretinal prosthesis

    Science.gov (United States)

    Mandel, Yossi; Goetz, George; Lavinsky, Daniel; Huie, Phil; Mathieson, Keith; Wang, Lele; Kamins, Theodore; Manivanh, Richard; Harris, James; Palanker, Daniel

    2013-02-01

    We have developed a photovoltaic retinal prosthesis, in which camera-captured images are projected onto the retina using pulsed near-IR light. Each pixel in the subretinal implant directly converts pulsed light into local electric current to stimulate the nearby inner retinal neurons. 30 μm-thick implants with pixel sizes of 280, 140 and 70 μm were successfully implanted in the subretinal space of wild type (WT, Long-Evans) and degenerate (Royal College of Surgeons, RCS) rats. Optical Coherence Tomography and fluorescein angiography demonstrated normal retinal thickness and healthy vasculature above the implants upon 6 months follow-up. Stimulation with NIR pulses over the implant elicited robust visual evoked potentials (VEP) at safe irradiance levels. Thresholds increased with decreasing pulse duration and pixel size: with 10 ms pulses it went from 0.5 mW/mm2 on 280 μm pixels to 1.1 mW/mm2 on 140 μm pixels, to 2.1 mW/mm2 on 70 μm pixels. Latency of the implant-evoked VEP was at least 30 ms shorter than in response evoked by the visible light, due to lack of phototransduction. Like with the visible light stimulation in normal sighted animals, amplitude of the implant-induced VEP increased logarithmically with peak irradiance and pulse duration. It decreased with increasing frequency similar to the visible light response in the range of 2 - 10 Hz, but decreased slower than the visible light response at 20 - 40 Hz. Modular design of the photovoltaic arrays allows scalability to a large number of pixels, and combined with the ease of implantation, offers a promising approach to restoration of sight in patients blinded by retinal degenerative diseases.

  11. [Ideal total hip prosthesis in 1993].

    Science.gov (United States)

    Delagoutte, J P; Mainard, D

    Although it is a hazardous adventure to define what is an ideal in any field, it would appear that there is a certain consensus about total hip prostheses. The fundamental principle of the total hip replacement was based on the articulation of a spheric segment, a mobile head contained in a hemispheric non-retaining element. To date, the first material is a titanium in a alloy containing 6% aluminum and 4% vanadium. The second material facing the titanium is polyethylene or alumine. Thus the joint couple could be "polyethylene-metal", or "polyethylene-alumine" or even "alumine-alumine". The hemispheric element can be a massive piece of polyethylene or formed by a peripheral metal (an open hemisphere) filled with the joint surface, itself made of polyethylene. This solution offers the possibility of changing the prosthesis in case of wear without interrupting the implant-bone contact. The first type is cemented to the bone with methyl polymethacrylate. With the second, the metallic part need not to be cemented and can be fitted to the bone by simple pressing. Several points are essential in the femoral piece. It should include a removable head so the length of the neck can be adjusted. It must fill the medullary canal as closely as possible and fill the methaphyseal space. It is fixed by a self-fitting system leading to stable secondary long-term fixation-a porous covering, sometimes with hydroxy apatite can also be useful. In certain cases it must be cemented, although the cement must only play the role of adaptation.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Multimodal sensor controlled three Degree of Freedom transradial prosthesis.

    Science.gov (United States)

    Ohnishi, Kengo; Morio, Toshiyuki; Takagi, Tomoo; Kajitani, Isamu

    2013-06-01

    This paper describes the basic concept of our multimodal sensor control system for 3-Degree-of-Freedom transradial prosthesis. The target of developing the controller is to reduce the mental effort of planning operating multiple joints in the conventional multifunctional myoelectric controller and reduce the compensating motion of conventional myoelectric prosthesis. An accelerometer is installed in the socket and the angles of the gravitational force are computed to drive the pronation/spination joint and the palmar flexion/dorsifelxion joint of the prosthesis. A threshold On/Off control using the posture information is implemented with the triggering of a co-contraction EMG signal. Through experiment with able-body subjects, we confirmed that this controller has a potential of reducing compensating shoulder movements for pick-raise-place tasks, when compared to the task conducted with conventional locked-wrist prostheses. Yet modification is required for stability.

  13. Research, design and development project Myoelectric Prosthesis of Upper Limb

    Energy Technology Data Exchange (ETDEWEB)

    Galiano, L; Montaner, E; Flecha, A [Bioparx, J Hernandez 1101, Parana, ERios (Argentina)

    2007-11-15

    A Research Design and Development Project was developed of a myoelectric prosthesis for a pediatric patient presenting congenital amputation of the left forearm below the elbow. A multidisciplinary work-team was formed for this goal, in order to solve the several (/various) aspects regarding this project (mechanical, ergonomics, electronics, physical). The prosthesis as an electromechanical device was divided in several blocks, trying to achieve a focused development for each stage, acording to requisites. A mechanical prototype of the prothesis was designed and built along with the circuitry needed for EMG aquisition, control logic and drivers. Having acomplished the previuos stages, the project is now dealing with the definitions of the interface between the prosthesis and the patient, with promising perspectives.

  14. An electronic prosthesis mimicking the dynamic vestibular function

    Science.gov (United States)

    Shkel, Andrei M.

    2006-03-01

    This paper reports our progress toward development of a unilateral vestibular prosthesis. The sensing element of the prosthesis is a custom designed one-axis MEMS gyroscope. Similarly to the natural semicircular canal, the microscopic gyroscope senses angular motion of the head and generates voltages proportional to the corresponding angular accelerations. Then, voltages are sent to the pulse generating unit where angular motion is translated into voltage pulses. The voltage pulses are converted into current pulses and are delivered through specially designed electrodes, conditioned to stimulate the corresponding vestibular nerve branch. Our preliminary experimental evaluations of the prosthesis on a rate table indicate that the device's output matches the average firing rate of vestibular neurons to those in animal models reported in the literature. The proposed design is scalable; the sensing unit, pulse generator, and the current source can be potentially implemented on a single chip using integrated MEMS technology.

  15. Implant-retained finger prosthesis with modified retention system.

    Science.gov (United States)

    Goiato, Marcelo Coelho; dos Santos, Daniela Micheline; Amoroso, Andressa Paschoal; Gennari Filho, Humberto; Dekon, Stefan Fiuza de Carvalho

    2013-08-01

    Amputations affect both the physical and the psychological aspects of an individual, causing significant impact on self-esteem. The main causes of finger amputations are work-related accidents with dangerous machinery, road traffic accidents, and animal bites, as well as systemic diseases such as diabetes. This report aims to describe a simple technique for fabrication of implant-retained finger prosthesis with a modified base of the retention system. The O-Ring retention system was used with a modified hexagon-shaped base and a metallic capsule adapted to the acrylic resin to attach the prosthesis to the implant. The prosthesis was made with silicone, and after osseointegration, it was installed without complications, leading to a patient satisfied with the end result and encouraged to return to social life. Restoring self-esteem in the patient and static and functional rehabilitation.

  16. Mastication improvement after partial implant-supported prosthesis use.

    Science.gov (United States)

    Gonçalves, T M S V; Campos, C H; Gonçalves, G M; de Moraes, M; Rodrigues Garcia, R C M

    2013-12-01

    Partially edentulous patients may be rehabilitated by the placement of removable dental prostheses, implant-supported removable dental prostheses, or partial implant fixed dental prostheses. However, it is unclear the impact of each prosthesis type over the masticatory aspects, which represents the objective of this paired clinical trial. Twelve patients sequentially received and used each of these 3 prosthesis types for 2 months, after which maximum bite force was assessed by a strain sensor and food comminution index was determined with the sieving method. Masseter and temporal muscle thicknesses during rest and maximal clenching were also evaluated by ultrasonography. Each maxillary arch received a new complete denture that was used throughout the study. Data were analyzed by analysis of variance for repeated measures, followed by the Tukey test (p mastication, and the magnitude of this effect was related to prosthesis type.

  17. [Tests of hand functionality in upper limb amputation with prosthesis].

    Science.gov (United States)

    Bazzini, G; Orlandini, D; Moscato, T A; Nicita, D; Panigazzi, M

    2007-01-01

    The need for standardized instruments for clinical measurements has become pressing in the fields of occupational rehabilitation and ergonomics. This is particularly the case for instruments that allow a quantitative evaluation of upper limb function, and especially hand function in patients who have undergone an amputation and then application of an upper limb prosthesis. This study presents a review of the main tests used to evaluate hand function, with a critical analysis of their use in subjects with an upper limb prosthesis. The tests are divided into: tests to evaluate strength, tests to evaluate co-ordination and dexterity, tests of global or overall function, and tests proposed specifically for subjects with an upper limb prosthesis. Of the various tests presented, the authors give their preference to the Bimanual Functional Assessment, Abilhand and/or the ADL Questionnaire, because of the practical usefulness, clinimetric features, simplicity and ease of administration of these tests.

  18. 21 CFR 888.3810 - Wrist joint ulnar (hemi-wrist) polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint ulnar (hemi-wrist) polymer prosthesis... SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3810 Wrist joint ulnar (hemi-wrist) polymer prosthesis. (a) Identification. A wrist joint ulnar (hemi-wrist) polymer prosthesis...

  19. 21 CFR 888.3770 - Wrist joint carpal trapezium polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal trapezium polymer prosthesis... SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3770 Wrist joint carpal trapezium polymer prosthesis. (a) Identification. A wrist joint carpal trapezium polymer prosthesis is a one...

  20. 21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal scaphoid polymer prosthesis... SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3760 Wrist joint carpal scaphoid polymer prosthesis. (a) Identification. A wrist joint carpal scaphoid polymer prosthesis is a one...

  1. 21 CFR 888.3750 - Wrist joint carpal lunate polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal lunate polymer prosthesis. 888... SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3750 Wrist joint carpal lunate polymer prosthesis. (a) Identification. A wrist joint carpal lunate prosthesis is a one-piece...

  2. A short-term study in sheep with the Groningen temporomandibular joint prosthesis

    NARCIS (Netherlands)

    van Loon, JP; de Bont, LGM; Spijkervet, FKL; Verkerke, GJ; Liem, RSB

    2000-01-01

    As part of the pre-clinical testing process of a newly developed temporomandibular joint (TMJ) prosthesis, animal experiments were performed. In 14 sheep, the right TMJ was replaced by the developed TMJ prosthesis. The prosthesis consisted of a skull part, a mandibular part and an intervening

  3. Aerodynamic characteristics of the Nijdam voice prosthesis in relation to tracheo-esophageal wall thickness.

    Science.gov (United States)

    Veenstra, A; van den Hoogen, F J; Schutte, H K; Nijdam, H F; Manni, J J; Verkerke, G J

    1997-01-01

    Tracheo-esophageal speech using various prostheses is currently the most successful form of voice and speech rehabilitation for laryngectomies. Main inter-device differences are durability and trans-device pressure loss during speech. The valveless indwelling Nijdam voice prosthesis is a new voice prosthesis. A barrier mechanism is created by a combination of the esophageal mucosa and the umbrella-like "hat" of the prosthesis that covers the esophageal side of the tracheo-esophageal fistula. The Nijdam prosthesis can be used clinically for longer periods of time when compared to such other indwelling voice prostheses as the Provox prosthesis and the low-resistance Groningen prosthesis. However, transdevice pressure loss during speech has been unknown. Adjustment of the shft length of the Nijdam voice prosthesis to tracheo-esophageal wall thickness was expected to affect trans-device pressure loss during speech. We report the results of in vitro tests to quantify the effect of tracheo-esophageal wall thickness on trans-device pressure loss. In the present study pressure loss was measured at different air flow rates in relation to tracheo-esophageal wall thickness. Findings demonstrated that when shaft length of the Nijdam prosthesis corresponded exactly to tracheo-esophageal wall thickness, trans-device pressure loss was comparable to that of the Provox prosthesis. If a relatively shorter Nijdam prosthesis was chosen to prevent aspiration from occurring, the pressure loss across the prosthesis increased to that of the low-resistance Groningen prosthesis.

  4. A new total distal radioulnar joint prosthesis: functional outcome.

    Science.gov (United States)

    Schuurman, Arnold H; Teunis, Teun

    2010-10-01

    To present the evolution of design and the short-term functional outcome of our distal radioulnar joint (DRUJ) prosthesis. This total DRUJ prosthesis differs from others in that it consists of 2 parts and attains bony fixation by its hydroxyapatite coating. Nineteen patients received a DRUJ prosthesis after a failed Darrach procedure (n = 10), Sauvé-Kapandji procedure (n = 7), trauma (n = 1), or DRUJ synovitis (n = 1). Indications for the placement were decreased grip, decreased forearm motion, and pain due to ulnar impingement syndrome and instability of the distal ulna. Seven prostheses were removed, 5 due to loosening, 1 due to continuing pain, and 1 at the request of the patient. The 5 prostheses that loosened were an intermediate prototype no longer in use. In 12 remaining cases, range of motion, grip strength, and pinch strength were measured, and patients completed the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Pain was assessed with the visual analog scale (range, 0-10). A paired t-test was performed to assess the significance of the difference between preoperative and postoperative measurements. Statistically significant improvements were seen in forearm pronation, from an average of 79° to 88°; grip strength, from an average of 10 kg to an average of 16 kg; and visual analog scale score, decreased from a mean of 5.3 to a mean of 3.5. The distal ulna was clinically stable in all 12 patients who retained the prosthesis. The intermediate prototype had a high failure rate, 5 out of 5. The early results for the current prosthesis prototype show clinical improvement. Based on these results, we conclude that this prosthesis offers a new treatment option for ulnar instability after distal ulnar resection. Therapeutic IV. Copyright © 2010. Published by Elsevier Inc.

  5. Dynamics of dental implants and orthodontics in today's periodontal prosthesis.

    Science.gov (United States)

    Cheng, Y M

    2000-03-01

    Periodontal prosthesis refers to multidisciplinary efforts to stop disease progression, correct deformities created by dental diseases, and establish a therapeutic occlusion to restore the form and function of the masticatory system. These efforts are critical for the long-term prognosis and maintenance of the guarded teeth and the overall prosthesis. This article presents a functionally and esthetically challenging case, which illustrates a multidisciplinary approach--specifically implantology and orthodontics--and how they impact on each other during treatment. The role and importance of dental implants and orthodontics in setting up a case is illustrated in this article.

  6. Design of an Accessible, Powered Myoelectrically Controlled Hand Prosthesis

    Directory of Open Access Journals (Sweden)

    Osman Onur Akirmak

    2017-08-01

    Full Text Available In this paper we describe accessible myoelectric prosthetic hand design based on modification of existing mechanical prosthesis and off-the-shelf parts and components. Despite significant advances in myoelectric prosthetics, such existing devices remain out of reach of the majority of the patients needing them due to high costs and complexity. We describe a simple design that can be assembled based on existing or readily acquirable parts at approximately 1/100 of the cheapest commercially available alternative. Our design offers wrist disarticulation patients in developing countries an affordable myoelectric prosthesis with significant capacity for improving their quality of life.

  7. Prosthetic Rehabilitation of a Patient with Ocular Defect using Semi-customized Prosthesis: A Case Report.

    Science.gov (United States)

    Putanikar, Nagaraj Y; Patil, Anandkumar G; Shetty, Pavithra K; Nagaral, Suresh; Mithaiwala, Hatimali I

    2015-04-01

    Severe physical and psychological distress occurs due to disfigurement caused by loss of eye. Ocular prosthesis is the only mode of rehabilitation for the missing eye. There are different materials and techniques used for the fabrication of the same. Resin proved to be the better among the available materials. Either using the stock eye or using customized ocular prosthesis has their own advantages and disadvantages. Through our clinical report, we have fabricated a semi-customized ocular prosthesis with stock iris and customized sclera. This prosthesis had the advantages of both stock and custom ocular prosthesis providing functionally and esthetically satisfactory result.

  8. Rehabilitation of orbital defect with silicone orbital prosthesis retained by dental implants

    Directory of Open Access Journals (Sweden)

    Satyabodh Shesharaj Guttal

    2016-01-01

    Full Text Available Orbital defects can result from cancer, birth anomalies, or trauma leading to an onslaught of problems in the function and psyche of the patient. These defects are restored by surgical reconstruction and followed by placement of orbital prosthesis for cosmetic makeup. The use of dental implants in retaining orbital prosthesis improves patient acceptance of the prosthesis owing to better retention and stability than conventional adhesive retained prosthesis. This case report describes a custom-made magnetic retentive assembly anchored by a dental implant which offers the orbital prosthesis the simplicity of self-alignment and ease of use.

  9. Rehabilitation of orbital defect with silicone orbital prosthesis retained by dental implants.

    Science.gov (United States)

    Guttal, Satyabodh Shesharaj; Desai, Jhanvi; Kudva, Adarsh; Patil, Basavaraj R

    2016-01-01

    Orbital defects can result from cancer, birth anomalies, or trauma leading to an onslaught of problems in the function and psyche of the patient. These defects are restored by surgical reconstruction and followed by placement of orbital prosthesis for cosmetic makeup. The use of dental implants in retaining orbital prosthesis improves patient acceptance of the prosthesis owing to better retention and stability than conventional adhesive retained prosthesis. This case report describes a custom-made magnetic retentive assembly anchored by a dental implant which offers the orbital prosthesis the simplicity of self-alignment and ease of use.

  10. Management of long span partially edentulous maxilla with fixed removable denture prosthesis

    Directory of Open Access Journals (Sweden)

    Mahilan I Jeyavalan

    2012-01-01

    Full Text Available Restoration of a long span partially edentulous maxilla with tooth supported prosthesis is challenging because of inherent anatomic limitations and unfavourable biomechanics present after the loss of teeth. A tooth supported fixed-removable prosthesis is a treatment option for restoration of such long span partially edentulous maxillary arches. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favourable biomechanical stress distribution to the remaining natural tooth abutments. This article presents a procedure for fabrication of a fixed-removable prosthesis that has cement-retained custom cast bar metal substructure and a ball attachment retained removable superstructure prosthesis.

  11. Lip Bumper Prosthesis for an Acromegaly Patient: A Clinical Report

    OpenAIRE

    Ashok, V.; Nallaswamy, Deepak; Benazir Begum, S.; Nesappan, Thiyaneswaran

    2013-01-01

    Prosthetic rehabilitation is done to regain function, speech and esthetics. This article describes the treatment for an acromegaly patient with bony defect. Two piece magnet retained hollow lip bumper prosthesis was fabricated to reduce the weight of the denture and to attain esthetics.

  12. Lip Bumper Prosthesis for an Acromegaly Patient: A Clinical Report.

    Science.gov (United States)

    Ashok, V; Nallaswamy, Deepak; Benazir Begum, S; Nesappan, Thiyaneswaran

    2014-12-01

    Prosthetic rehabilitation is done to regain function, speech and esthetics. This article describes the treatment for an acromegaly patient with bony defect. Two piece magnet retained hollow lip bumper prosthesis was fabricated to reduce the weight of the denture and to attain esthetics.

  13. Groningen temporomandibular joint prosthesis. Development and first clinical application

    NARCIS (Netherlands)

    van Loon, JP; de Bont, LGM; Stegenga, B; Spijkervet, FKL; Verkerke, GJ

    Patients with a severely degenerated temporomandibular joint (TMJ) may benefit from an alloplastic TMJ replacement. The aim of the study was to develop a safe and properly functioning TMJ prosthesis. The design was based on imitation of anterior condylar translation by an inferiorly located centre

  14. [Midterm results and revisions of the thrust plate prosthesis (TPP)].

    Science.gov (United States)

    Ishaque, B A; Wienbeck, S; Stürz, H

    2004-01-01

    Although already in use for 20 years, the concept of the metaphyseal anchored thrust plate prosthesis has not yet gained general acceptance. Clinical and radiological follow-up examinations were carried out 5 to 8 years after implantation of a TPP. We tried to answer the question if the metaphyseal anchorage of the cement-less TPP is equal to a diaphyseal anchorage of a cement-less stem prosthesis and to define the advantages of the TPP. We included 170 of the patients from our clinic with an implanted TPP in this study. Furthermore we reviewed the results of 30 revision hip arthroplasties of the TPP. The clinical examination were carried out using the Harris hip score while the radiological examinations were performed on the basis of predefined criteria. We found good clinical results. The preoperative Harris score of 48.7 increased to 93.7 at 24 months postoperatively. Radiolucencies were detected and were of varying relevance in dependence on their localization. The Kaplan-Meier survival analysis at 8 years was 90.5 %. The clinical results after changing the TPP were also good to excellent. The mean Harris hip score was 87.3. Our study suggests that in spite of a slightly higher aseptic loosening rate in comparison to the cement-less stem prosthesis, the thrust plate prosthesis proved to be worthwhile. On the basis of previous experience we assume that the TPP is a good alternative implant especially for young patients.

  15. Task-Oriented Gaming for Transfer to Prosthesis Use

    NARCIS (Netherlands)

    van Dijk, Ludger; Sluis, van der Corry K.; van Dijk, Hylke W.; Bongers, Raoul M.

    2016-01-01

    The aim of this study is to establish the effect of task-oriented video gaming on using a myoelectric prosthesis in a basic activity of daily life (ADL). Forty-one able-bodied right-handed participants were randomly assigned to one of four groups. In three of these groups the participants trained to

  16. 21 CFR 888.3230 - Finger joint polymer constrained prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Finger joint polymer constrained prosthesis. 888.3230 Section 888.3230 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... made from either a silicone elastomer or a combination pf polypropylene and polyester material. The...

  17. Transtibial prosthesis suspension failure during skydiving freefall: a case report.

    Science.gov (United States)

    Gordon, Assaf T; Land, Rebekah M

    2009-01-01

    This report describes the unusual case of an everyday-use prosthesis suspension system failure during the freefall phase of a skydiving jump. The case individual was a 53-year-old male with a left transtibial amputation secondary to trauma. He used his everyday prosthesis, a transtibial endoskeleton with push-button, plunger-releasing, pin-locking silicon liner suction suspension and a neoprene knee suspension sleeve, for a standard recreational tandem skydive. Within seconds of exiting the plane, the suspension systems failed, resulting in the complete prosthesis floating away. Several factors may have led to suspension system failure, including an inadequate seal and material design of the knee suspension sleeve and liner, lack of auxiliary suspension mechanisms, and lack of a safety cover overlying the push-button release mechanism. This is the first report, to our knowledge, to discuss prosthetic issues specifically related to skydiving. While amputees are to be encouraged to participate in this extreme sport, special modifications to everyday components may be necessary to reduce the possibility of prosthesis failure during freefall, parachute deployment, and landing.

  18. [Medial unicompartmental knee prosthesis for patients with unicompartmental gonarthrosis

    NARCIS (Netherlands)

    Kort, N.P.; Deutman, R.; Raay, J.J. van; Horn, J.R. van

    2004-01-01

    The function and survival time of unicompartmental knee prostheses for patients with severe gonarthrosis have been improved the past few years by developments in their design, the instrumentarium and the surgical technique. A medial unicompartmental knee prosthesis may be indicated in patients with

  19. [Ear prosthesis anchored on osseointegrated implants. Experience with 9 cases].

    Science.gov (United States)

    Charles, X; Piller, P; Hemar, P; Herman, D; Kennel, P; Riedinger, A M; Conraux, C

    1995-01-01

    The use of osseointegrated titanium implants has improved the quality of auricle prosthesis fixation. Between december 1993 and july 1994, twenty two titanium fixtures have been surgically implanted in nine patients in the Ear Nose Throat department of the university hospital of Strasbourg. This method of auricle amputation repair achieves a good esthetic result with a low rate of postoperative complications.

  20. Treatment Using Functionally Fixed Prosthesis: A Case Report.

    Science.gov (United States)

    Chandra, Sumi; Singh, Ajay; Gupta, Himanshu; Chandra, Chetan

    2014-12-01

    Most dental practitioners as well as their patients prefer to have fixed rather than removable prosthesis. However, there are many clinical situations that prohibit the use of the fixed treatment modality. These clinical cases can vary from, simply not having the proper number of healthy teeth and/or implants to, the esthetically challenging cases of high smile lines and severe loss of alveolar support. The approach of using a traditional removable prosthesis in these situations has always been met with severe compromises. The functionally fixed restoration is a third modality of treatment that can solve many of the problems of the removable restoration and at the same time provide the same comfort and success of the fixed prosthesis. This restoration has a pontic assembly that is removed by the patient for periodontal maintenance. This article presents a case report which describes a technique for treatment of partially edentulous maxilla with severe loss of alveolar support using a fixed removable prosthesis/Andrew's bridge.

  1. 21 CFR 870.3450 - Vascular graft prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vascular graft prosthesis. 870.3450 Section 870.3450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... animal origin, including human umbilical cords. (b) Classification. Class II (special controls). The...

  2. Design of a Fully-Passive Transfemoral Prosthesis Prototype

    NARCIS (Netherlands)

    Behrens, Sebastiaan Maria; Behrens, S.M.; Ünal, Ramazan; Unal, R.; Hekman, Edsko E.G.; Carloni, Raffaella; Stramigioli, Stefano; Koopman, Hubertus F.J.M.

    In this study, we present the mechanical design of a prototype of a fully-passive transfemoral prosthesis for normal walking. The conceptual working principle at the basis of the design is inspired by the power flow in human gait, with the main purpose of realizing an energy efficient device. The

  3. Design of a fully-passive transfemoral prosthesis prototype

    NARCIS (Netherlands)

    Behrens, S. M.; Unal, R.; Hekman, E. E.G.; Carloni, R.; Stramigioli, S.; Koopman, H. F.J.M.

    2011-01-01

    In this study, we present the mechanical design of a prototype of a fully-passive transfemoral prosthesis for normal walking. The conceptual working principle at the basis of the design is inspired by the power flow in human gait, with the main purpose of realizing an energy efficient device. The

  4. Online adaptive neural control of a robotic lower limb prosthesis

    Science.gov (United States)

    Spanias, J. A.; Simon, A. M.; Finucane, S. B.; Perreault, E. J.; Hargrove, L. J.

    2018-02-01

    Objective. The purpose of this study was to develop and evaluate an adaptive intent recognition algorithm that continuously learns to incorporate a lower limb amputee’s neural information (acquired via electromyography (EMG)) as they ambulate with a robotic leg prosthesis. Approach. We present a powered lower limb prosthesis that was configured to acquire the user’s neural information and kinetic/kinematic information from embedded mechanical sensors, and identify and respond to the user’s intent. We conducted an experiment with eight transfemoral amputees over multiple days. EMG and mechanical sensor data were collected while subjects using a powered knee/ankle prosthesis completed various ambulation activities such as walking on level ground, stairs, and ramps. Our adaptive intent recognition algorithm automatically transitioned the prosthesis into the different locomotion modes and continuously updated the user’s model of neural data during ambulation. Main results. Our proposed algorithm accurately and consistently identified the user’s intent over multiple days, despite changing neural signals. The algorithm incorporated 96.31% [0.91%] (mean, [standard error]) of neural information across multiple experimental sessions, and outperformed non-adaptive versions of our algorithm—with a 6.66% [3.16%] relative decrease in error rate. Significance. This study demonstrates that our adaptive intent recognition algorithm enables incorporation of neural information over long periods of use, allowing assistive robotic devices to accurately respond to the user’s intent with low error rates.

  5. Soft tissue cover for the exposed knee prosthesis

    OpenAIRE

    Fayomi, O.; Patel, J. V.; Percival, N.

    1999-01-01

     This study assess the use of muscle flaps to cover exposed knee prostheses and emphasises the need for early plastic surgery consultation. In five of the six patients studied the wound was successfully covered and the knee prosthesis salvaged with a reasonable functional outcome.

  6. [Possibilities for quantitative gait analysis in evaluation of prosthesis fit].

    Science.gov (United States)

    Tscheuschner, R; Tober, H; Rosenberger, H

    1994-06-01

    Nowadays, the fitting of a lower-limb prosthesis is done mainly on an empirical basis. The main aim of the present study was to provide objective data and presentations to support the subjective data. With the aid of a cybernetic statement, the process of fitting a prosthesis to a human subject was developed as a self-optimizing control cycle. Using this systematic scheme, the walking trial was identified as the process element of this control cycle in which the fitting proper took place. Starting with this systematic scheme, the characteristics of defined changes to the system human-prosthesis during walking were measured with the aid of a specially configured gait analysis system. For the estimation of the characteristics of the measured walking trial, a three stage parameter system based initially only on the angle, velocity and acceleration curves at the knee joint was developed. On the basis of pattern recognition routines, the parameter system permits a very high level of identification of the measurements. The identification of poor fittings not covered by the pattern recognition system is not yet satisfactory. However, with the incorporation of additional gait parameters, it will be possible to further improve the description of the gait, enabling better recognition of disturbances in the human-prosthesis system.

  7. Intermanual transfer effects in below-elbow myoelectric prosthesis users

    NARCIS (Netherlands)

    de Boer, Errit; Romkema, Sietske; Cutti, Andrea G; Brouwers, Michael A H; Bongers, Raoul M; van der Sluis, Corry K

    2016-01-01

    OBJECTIVE: To determine intermanual transfer effects in patients with a below-elbow amputation using a myoelectric prosthesis, and to establish whether laterality affects these effects. DESIGN: Case-control. SETTING: A standardized setting in a rehabilitation clinic. PARTICIPANTS: A convenience

  8. [Consequences of prosthesis on quality of the radiation therapy].

    Science.gov (United States)

    Le Fèvre, C; Buffard, E; Antoni, D; Chaussemy, D; Matter-Parrat, V; Noël, G

    2016-09-01

    Dose prescription, delineation and dose calculation are clearly complicated when a patient have been operated on with insertion of prosthesis. Knowledge of the physical and material characteristics is needed to decrease incertitude of calculations. Recommendations for each step of treatments are proposed in this article allowing to optimization of the treatment safety. Copyright © 2016. Published by Elsevier SAS.

  9. 21 CFR 874.3450 - Partial ossicular replacement prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Partial ossicular replacement prosthesis. 874.3450 Section 874.3450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... composite, absorbable gelatin material, porous polyethylene, or from a combination of these materials. (b...

  10. Inequalities of dental prosthesis use under universal healthcare insurance.

    Science.gov (United States)

    Matsuyama, Yusuke; Aida, Jun; Takeuchi, Kenji; Tsakos, Georgios; Watt, Richard G; Kondo, Katsunori; Osaka, Ken

    2014-04-01

    Social inequalities in oral health exist in various countries. In Japan, a country with universal healthcare insurance policy, people can receive medical and dental care and pay only 10-30% of the total cost of treatment. Additionally, very poor Japanese can receive care without any charge, by the benefit of public assistance. These policies are considered to affect oral health inequalities. This study examined the association between using a dental prosthesis and household income among older Japanese people. Self-administered questionnaires were mailed to subjects as part of the Japan Gerontological Evaluation Study (JAGES) project in 2010. Of the 8576 people aged 65 years or more living in Iwanuma, Japan, 5058 responded. We used 4001 respondents with no missing values. We stratified into two groups by having 20 teeth or not. Then, cross-tabulation, univariate logistic regression, and multivariate logistic regression were conducted for these two groups. The covariates are sex, age, education, and size of household. Of the all respondents included in the analyses, poorer respondents tended to have lower proportions with 20 or more teeth, and 54.6% respondents used dental prostheses. In the respondents with 19 or fewer teeth, higher-income group tended to show significantly higher dental prosthesis use. But the poorest income group showed high prevalence of dental prosthesis use as same as highest income group. Multiple logistic regression among respondents with 19 or fewer teeth showed that after adjustment for sex, age, education, and size of household, compared with the respondents with annual incomes of US$ dental prosthesis (OR = 0.48 [95% CI = 0.28-0.83], 0.56 [95% CI = 0.33-0.95], respectively). The other respondents did not show significant differences. Although universal healthcare insurance covered dental prostheses, a social gradient in dental prosthesis use was still observed. Low-income respondents tended to not use dental prosthesis, but the

  11. Cranioplasty prosthesis manufacturing based on reverse engineering technology

    Science.gov (United States)

    Chrzan, Robert; Urbanik, Andrzej; Karbowski, Krzysztof; Moskała, Marek; Polak, Jarosław; Pyrich, Marek

    2012-01-01

    Summary Background Most patients with large focal skull bone loss after craniectomy are referred for cranioplasty. Reverse engineering is a technology which creates a computer-aided design (CAD) model of a real structure. Rapid prototyping is a technology which produces physical objects from virtual CAD models. The aim of this study was to assess the clinical usefulness of these technologies in cranioplasty prosthesis manufacturing. Material/Methods CT was performed on 19 patients with focal skull bone loss after craniectomy, using a dedicated protocol. A material model of skull deficit was produced using computer numerical control (CNC) milling, and individually pre-operatively adjusted polypropylene-polyester prosthesis was prepared. In a control group of 20 patients a prosthesis was manually adjusted to each patient by a neurosurgeon during surgery, without using CT-based reverse engineering/rapid prototyping. In each case, the prosthesis was implanted into the patient. The mean operating times in both groups were compared. Results In the group of patients with reverse engineering/rapid prototyping-based cranioplasty, the mean operating time was shorter (120.3 min) compared to that in the control group (136.5 min). The neurosurgeons found the new technology particularly useful in more complicated bone deficits with different curvatures in various planes. Conclusions Reverse engineering and rapid prototyping may reduce the time needed for cranioplasty neurosurgery and improve the prosthesis fitting. Such technologies may utilize data obtained by commonly used spiral CT scanners. The manufacturing of individually adjusted prostheses should be commonly used in patients planned for cranioplasty with synthetic material. PMID:22207125

  12. Custom-made silicone hand prosthesis: A case study.

    Science.gov (United States)

    Nayak, S; Lenka, P K; Equebal, A; Biswas, A

    2016-09-01

    Up to now, a cosmetic glove was the most common method for managing transmetacarpal (TMC) and carpometacarpal (CMC) amputations, but it is devoid of markings and body color. At this amputation level, it is very difficult to fit a functional prosthesis because of the short available length, unsightly shape, grafted skin, contracture and lack of functional prosthetic options. A 30-year-old male came to our clinic with amputation at the 1st to 4th carpometacarpal level and a 5th metacarpal that was projected laterally and fused with the carpal bone. The stump had grafted skin, redness, and an unhealed suture line. He complained of pain projected over the metacarpal and suture area. The clinical team members decided to fabricate a custom-made silicone hand prosthesis to accommodate the stump, protect the grafted skin, improve the hand's appearance and provide some passive function. The custom silicone hand prosthesis was fabricated with modified flexible wires to provide passive interphalangeal movement. Basic training, care and maintenance instructions for the prosthesis were given to the patient. The silicone hand prosthesis was able to restore the appearance of the lost digits and provide some passive function. His pain (VAS score) was reduced. Improvement in activities of daily living was found in the DASH questionnaire and Jebsen-Taylor Hand Function test. A silicone glove is a good option for more distal amputations, as it can accommodate any deformity, protect the skin, enhance the appearance and provide functional assistance. This case study provides a simple method to get passively movable fingers after proximal hand amputation. Copyright © 2016. Published by Elsevier Masson SAS.

  13. Prosthesis for open pleurostomy (POP: management for chronic empyemas

    Directory of Open Access Journals (Sweden)

    Luiz Tarcísio Brito Filomeno

    2009-03-01

    Full Text Available OBJECTIVES: We developed a prosthesis for open pleurostomy cases where pulmonary decortication is not indicated, or where post-pneumonectomy space infection occurs. The open pleural window procedure not only creates a large hole in the chest wall that is shocking to patients, also results in a permanent deformation of the thorax. prosthesis for open pleurostomy is a self-retained silicone tube that requires the removal of 3 cm of one rib for insertion, and acts as a mature conventional open pleural window. Herein, we report our 13-year experience with this device in the management of different kinds of pleural empyema. METHODS: Forty-four consecutive patients with chronic empyema were treated. The etiology of empyema was diverse: pneumonia, 20; lung resections, 12 (pneumonectomies, 7; lobectomies, 4; non-anatomical, 1; mixed-tuberculous, 6; and mixed-malignant pleural effusion, 6. After debridment of both pleural surfaces, the prosthesis for open pleurostomy was inserted and attached to a small recipient plastic bag. RESULTS: Infection control was achieved in 20/20 (100% of the parapneumonic empyemas, in 3/4 (75% of post-lobectomies, in 6/7 (85% of post-pneumectomies, in 6/6 (100% of mixed-tuberculous cases, and in 4/6 (83% of mixed-malignant cases. Lung re-expansion was also successful in 93%, 75%, 33%, and 40% of the groups, respectively CONCLUSIONS: Prosthesis for open pleurostomy insertion is a minimally invasive procedure that can be as effective as conventional open pleural window for management of chronic empyemas. Thus, we propose that the use of prosthesis for open pleurostomy should replace the conventional method.

  14. Prosthesis for open pleurostomy (POP): management for chronic empyemas.

    Science.gov (United States)

    Filomeno, Luiz Tarcísio Brito; Campos, José Ribas Milanez de; Machuca, Tiago Noguchi; das Neves-Pereira, João Carlos; Terra, Ricardo Mingarini

    2009-01-01

    We developed a prosthesis for open pleurostomy cases where pulmonary decortication is not indicated, or where post-pneumonectomy space infection occurs. The open pleural window procedure not only creates a large hole in the chest wall that is shocking to patients, also results in a permanent deformation of the thorax. prosthesis for open pleurostomy is a self-retained silicone tube that requires the removal of 3 cm of one rib for insertion, and acts as a mature conventional open pleural window. Herein, we report our 13-year experience with this device in the management of different kinds of pleural empyema. Forty-four consecutive patients with chronic empyema were treated. The etiology of empyema was diverse: pneumonia, 20; lung resections, 12 (pneumonectomies, 7; lobectomies, 4; non-anatomical, 1); mixed-tuberculous, 6; and mixed-malignant pleural effusion, 6. After debridement of both pleural surfaces, the prosthesis for open pleurostomy was inserted and attached to a small recipient plastic bag. Infection control was achieved in 20/20 (100%) of the parapneumonic empyemas, in 3/4 (75%) of post-lobectomies, in 6/7 (85%) of post-pneumonectomies, in 6/6 (100%) of mixed-tuberculous cases, and in 4/6 (83%) of mixed-malignant cases. Lung re-expansion was also successful in 93%, 75%, 33%, and 40% of the groups, respectively Prosthesis for open pleurostomy insertion is a minimally invasive procedure that can be as effective as conventional open pleural window for management of chronic empyemas. Thus, we propose that the use of prosthesis for open pleurostomy should replace the conventional method.

  15. [Medico-ethical considerations when indicating single-tooth fixed prosthesis, multi-teeth fixed prosthesis, and oral implants].

    Science.gov (United States)

    Witter, D J; Brands, W G; Hoefnagel, R A; Creugers, N H J

    2012-12-01

    The question whether a patient needs extensive and invasive treatment, such as single-tooth fixed prosthesis, multi-teeth fixed prosthesis or oral implants, can be established only in a dialogue with mutual respect between the healthcare provider and the patient. With respect to this question, the following principles have to be considered: the patient's autonomy, beneficence, non-maleficence, and justice. These principles are reflected in legislation and are implicitly applied in complaint and disciplinary jurisdiction. When the autonomy of a patient is not sufficiently respected by a healthcare provider, a patient complaint might be the result, such as a complaint of impertinent treatment, lack of informed consent, or poor patient documentation. If beneficence or non-maleficence principles are violated, an intrinsic treatment complaint might be the result, such as a complaint of inadequate treatment planning, often based on inadequate examination, and complications or untimely failure of single-tooth fixed prosthesis, multi-teeth fixed prosthesis or oral implants. Respecting the previously mentioned principles promotes appropriate healthcare to the patient also in complex care with other healthcare providers.

  16. Attachment-retained gingival prosthesis for implant-supported fixed dental prosthesis in the maxilla: a clinical report.

    Science.gov (United States)

    Aparecida de Mattias Sartori, Ivete; Uhlendorf, Yuri; Padovan, Luiz Eduardo Marques; Junior, Paulo Domingos Ribeiro; Melo, Ana Cláudia Moreira; Tiossi, Rodrigo

    2014-12-01

    The rehabilitation of edentulous maxillae is a complex procedure due to the involvement of esthetic and functional requirements. A trial maxillary denture can be used to identify the need for adequate upper lip support when replacing removable complete dentures by implant-fixed dental prostheses. This clinical report describes the outcome of the rehabilitation of an edentulous atrophic maxilla with unfavorable maxillomandibular relationship and deficient upper lip support. A trial denture was fabricated and used to diagnose the need for a prosthesis capable of restoring the upper lip support. The reduced upper lip support was also confirmed by a lateral cephalogram. The patient was rehabilitated by an implant-fixed dental prosthesis associated with an attachment-retained gingival prosthesis. The case presented shows that when loss of upper lip support is detected and the patient does not wish to undergo further surgical reconstruction procedure, the retention of a gingival prosthesis using a ball attachment is a satisfactory treatment option. © 2014 by the American College of Prosthodontists.

  17. A biomechanical comparison of the thrust plate prosthesis and a stemmed prosthesis.

    Science.gov (United States)

    Karatosun, Vasfi; Unver, Bayram; Gultekin, Alper; Gunal, Izge

    2011-01-01

    The thrust plate prosthesis (TPP) is a neck preserving femoral component in total hip arthroplasty (THA) which may facilitate more precise biomechanical reconstruction of the hip. The purpose of this study was to compare the biomechanical results of the TPP with a conventional THA. We compared anteroposterior radiographs from 60 patients who had undergone cementless THA, with 44 who had undergone a TPP. We measured the hip centre of rotation, femoral offset, limb length, and neck-shaft angle. The horizontal hip centre of rotation, vertical femoral offset, limb length and neck-shaft angle measurements showed a significant difference (phip centre of rotation and horizontal femoral offset measurements were different only in TPP patients when compared with preoperative values (phip centre of rotation displayed a significant difference (p=0.003) in favor of the THA. Therefore, we found no difference in restoring the biomechanics of the hip using the two methods, and only the horizontal hip centre of rotation restoration favoured the THA. Our findings indicate that the TPP does not produce more accurate restoration of leg length or offset. Reproduction of hip mechanics after TPP may not be as good as has been suggested.

  18. Sensory feedback prosthesis reduces phantom limb pain: proof of a principle.

    Science.gov (United States)

    Dietrich, Caroline; Walter-Walsh, Katrin; Preissler, Sandra; Hofmann, Gunther O; Witte, Otto W; Miltner, Wolfgang H R; Weiss, Thomas

    2012-01-24

    Constrained functionality and phantom limb pain (PLP) are major concerns for forearm amputees. Neuroscientific investigations of PLP suggest that behaviorally relevant stimulation of the stump can decrease PLP. Furthermore the prosthesis user could use feedback information of the prosthesis hand for optimizing prosthesis motor control when handling soft and fragile objects. Somatosensory feedback information from a prosthetic hand may therefore help to improve prosthesis functionality and reduce phantom limb pain. We wanted to find out whether a two weeks training on a hand prosthesis that provides somatosensory feedback may help to improve prosthesis functionality and reduce phantom limb pain. Eight forearm amputees with phantom limb pain were trained for two weeks to use a hand prosthesis with somatosensory feedback on grip strength. The current study demonstrates a significant increase of functionality of the prosthesis in everyday tasks. Furthermore, the study shows that usage of a prosthesis that provides somatosensory feedback on the grip strength is effective to reduce phantom limb pain. A prosthesis with a feedback function appears to be a promising therapeutic tool to reduce phantom limb pain and to increase functionality in everyday tasks. Future studies should further investigate the scope of application of that principle. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. A new and simple method of fabrication of tracheostomal prosthesis

    Directory of Open Access Journals (Sweden)

    N Vidya Sankari

    2015-01-01

    Full Text Available Patients with a tracheostomy stoma experience compromised speech and function due to the associated changes in airflow patterns. Rehabilitation of a patient with tracheal stoma is a highly challenging task. The main objective is to design an inexpensive, easily fabricated stomal prosthesis for postlaryngectomy patients who require prolonged tracheotomy. This clinical case report describes a 29-year-old male patient who underwent for tracheotomy 3 months before for respiratory distress following a suicidal attempt. Hence tracheotomy was done, and the patient has been with the tracheostomal tube since surgery for the past 3 months. Laryngoscopy examination reported as restricted bilateral vocal cord movements, and the cords were in the adducted position with minimal glottic chink. No history of difficulty in swallowing. On examination, no scar or ulceration is seen around the stoma. The skin around the stoma is healthy. The patient was referred to the oral and maxillofacial Prosthodontics Department from the Department of ENT. The patient′s old tracheostomal tube was used as the dimensions of the custom made tracheal prosthesis without making a functional impression of the mature stoma. A tracheal button was made with 2 mm polyethylene urethane sheet to maintain the airway patency of the mature stoma. Width and length of the old tracheostomal tube were measured and customized with polyurethane sheet by directly flaming over heat. The finished product was thin, flexible, maintains enhanced tear strength, require no tapes or adhesives and less technique sensitive. These properties of the prosthesis make more advantageous than the commercially available tracheal buttons. The result in this patient was excellent with no postoperative complications. An innovative approach for fabrication of tracheostomal prosthesis was discussed to increase its successful use in tracheostomal patients. The patient′s old tracheostomal tube was used as the dimensions

  20. Esthetic and phonetic rehabilitation with combined maxillofacial prosthesis

    Directory of Open Access Journals (Sweden)

    Aline Úrsula Rocha Fernandes

    2016-01-01

    Full Text Available Basal cell carcinoma is the most common malignant neoplasia affecting the skin. Its prevalence is higher in the face, mainly in the nasal and zygomatic areas. In several cases, the treatment requires surgical intervention which causes facial deformities that impair basic functions (i.e., sight and smell, social interaction, and self-esteem of the patient. Maxillofacial prosthesis is an important way to rehabilitate and reintegrate these patients to their private and social life. The present clinical report aimed to present a prosthetic rehabilitation with combined oculopalpebral and nasal prosthesis of a patient to replace the nasal, zygoma, and orbital tissues after basal cell carcinoma surgical treatment. In addition, the patient was treated with conventional complete dentures to replace the lost teeth due to chemotherapy. The present treatment restored the chewing and speech functions and improved the self-esteem, social life, and quality of life of the patient.

  1. Research and development of a versatile portable speech prosthesis

    Science.gov (United States)

    1981-01-01

    The Versatile Portable Speech Prosthesis (VPSP), a synthetic speech output communication aid for non-speaking people is described. It was intended initially for severely physically limited people with cerebral palsy who are in electric wheelchairs. Hence, it was designed to be placed on a wheelchair and powered from a wheelchair battery. It can easily be separated from the wheelchair. The VPSP is versatile because it is designed to accept any means of single switch, multiple switch, or keyboard control which physically limited people have the ability to use. It is portable because it is mounted on and can go with the electric wheelchair. It is a speech prosthesis, obviously, because it speaks with a synthetic voice for people unable to speak with their own voices. Both hardware and software are described.

  2. Mediastinal abscess and esophageal stricture following voice prosthesis insertion.

    Science.gov (United States)

    Bozzo, Corrado; Meloni, Francesco; Trignano, Mario; Profili, Stefano

    2014-04-01

    The use of a tracheo-esophageal voice prosthesis is a well-established procedure to restore the voice in total laryngectomees. The insertion of the prosthesis is not a risk-free procedure, various complications having been reported especially in irradiated patients. Here described is a case of an esophageal rupture after secondary tracheo-esophageal puncture with mediastinal abscess in a patient previously treated with pharyngo-laryngectomy and subsequent radiotherapy for a left pyriform sinus carcinoma, which required immediate surgical drainage through a left cervical approach. Few weeks after surgical drainage an esophageal stricture at the site of the rupture developed, which was only temporarily resolved after the insertion of biodegradable esophageal stents, followed by re-stenosis once the reabsorption of the stent took place. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. An organized start to implant-supported prosthesis

    Directory of Open Access Journals (Sweden)

    Suma Karthigeyan

    2013-01-01

    Full Text Available Various treatment options are available for rehabilitating the complete edentulous patients with implants. However, due consideration for the prosthesis is not given prior to implant surgery. This can result in implant being placed in locations that do not provide the best esthetic and functional result. Incorrect implant localization and angle are the primary cause of non-axial loading and may contribute to loss of Osseo-integration. For predictable outcome, the treatment should begin with visualizing the end result. A step-wise pre-implant surgery evaluation is necessary to achieve the objectives. This is a case report of a completely edentulous patient who was treated with fixed implant prosthesis following various steps in the pre-implant surgery evaluation.

  4. A cognitive prosthesis for complex decision-making.

    Science.gov (United States)

    Tremblay, Sébastien; Gagnon, Jean-François; Lafond, Daniel; Hodgetts, Helen M; Doiron, Maxime; Jeuniaux, Patrick P J M H

    2017-01-01

    While simple heuristics can be ecologically rational and effective in naturalistic decision making contexts, complex situations require analytical decision making strategies, hypothesis-testing and learning. Sub-optimal decision strategies - using simplified as opposed to analytic decision rules - have been reported in domains such as healthcare, military operational planning, and government policy making. We investigate the potential of a computational toolkit called "IMAGE" to improve decision-making by developing structural knowledge and increasing understanding of complex situations. IMAGE is tested within the context of a complex military convoy management task through (a) interactive simulations, and (b) visualization and knowledge representation capabilities. We assess the usefulness of two versions of IMAGE (desktop and immersive) compared to a baseline. Results suggest that the prosthesis helped analysts in making better decisions, but failed to increase their structural knowledge about the situation once the cognitive prosthesis is removed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Hip arthroplasty. Part 1: prosthesis terminology and classification

    Energy Technology Data Exchange (ETDEWEB)

    Pluot, E. [Department of Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham (United Kingdom); Davis, E.T.; Revell, M. [Department of Orthopaedic Surgery, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham (United Kingdom); Davies, A.M. [Department of Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham (United Kingdom); James, S.L.J. [Department of Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham (United Kingdom)], E-mail: steven.james@roh.nhs.uk

    2009-10-15

    Hip arthroplasty is an extremely common orthopaedic procedure and there is a wide array of implants that are in current use in the UK. The follow-up of patients who have undergone insertion of a hip prosthesis is shifting from a consultant-lead hospital service towards primary care. As this change in patient care continues it becomes increasingly important that an accurate description of the radiographic features is communicated to the primary-care practitioner so appropriate specialist input can be triggered. This review focuses on the terminology and classification of hip prostheses. This acts as a precursor for Part 2 of this series, which describes the normal and abnormal radiographic findings following hip prosthesis insertion.

  6. Hip arthroplasty. Part 1: prosthesis terminology and classification.

    Science.gov (United States)

    Pluot, E; Davis, E T; Revell, M; Davies, A M; James, S L J

    2009-10-01

    Hip arthroplasty is an extremely common orthopaedic procedure and there is a wide array of implants that are in current use in the UK. The follow-up of patients who have undergone insertion of a hip prosthesis is shifting from a consultant-lead hospital service towards primary care. As this change in patient care continues it becomes increasingly important that an accurate description of the radiographic features is communicated to the primary-care practitioner so appropriate specialist input can be triggered. This review focuses on the terminology and classification of hip prostheses. This acts as a precursor for Part 2 of this series, which describes the normal and abnormal radiographic findings following hip prosthesis insertion.

  7. Designing and testing a hybrid lightweight shoulder prosthesis.

    Science.gov (United States)

    Sekine, Masashi; Tsuchiya, Nobuto; Kita, Kahori; Yu, Wenwei

    2014-01-01

    Lightweight prostheses are preferred in terms of usability in daily living. However, this is not a property easy to realize, especially for shoulder prostheses. High portability, multiple degrees of freedom (DOFs) with an appropriate ROM (range of motion), sufficient end-effector power, and suitable viscoelasticity for the safe use in daily living, usually result in a heavy weight. In this paper, a hybrid shoulder prosthesis that combined servo motors and pneumatic elastic actuators, with a weight distribution scheme, was designed to meet the requirements. The prosthetic system was preliminarily tested by comparing its ADL (activities of daily living) motion data with that of an intact arm. The experiment results showed that the shoulder prosthesis could reproduce the motion of an intact arm, thus demonstrate its usability in daily living.

  8. Running with a powered knee and ankle prosthesis.

    Science.gov (United States)

    Shultz, Amanda H; Lawson, Brian E; Goldfarb, Michael

    2015-05-01

    This paper presents a running control architecture for a powered knee and ankle prosthesis that enables a transfemoral amputee to run with a biomechanically appropriate running gait and to intentionally transition between a walking and running gait. The control architecture consists firstly of a coordination level controller, which provides gait biomechanics representative of healthy running, and secondly of a gait selection controller that enables the user to intentionally transition between a running and walking gait. The running control architecture was implemented on a transfemoral prosthesis with powered knee and ankle joints, and the efficacy of the controller was assessed in a series of running trials with a transfemoral amputee subject. Specifically, treadmill trials were conducted to assess the extent to which the coordination controller provided a biomechanically appropriate running gait. Separate trials were conducted to assess the ability of the user to consistently and reliably transition between walking and running gaits.

  9. Osseo integrated finger prosthesis with a custom abutment

    Directory of Open Access Journals (Sweden)

    Benny Thomas

    2017-01-01

    Full Text Available One of the most regularly encountered forms of partial hand loss causing physical, psychosocial and financial burden to an individual is the finger amputation followed by trauma. The prosthetic rehabilitation of amputated finger is a good treatment option, when compared to all other means of complex and unaffordable options. Osseointegrated implant retained silicone finger prosthesis with innovative prosthetic designs can provide the patient a life changing experience.

  10. Sealing of small postlaryngectomy pharyngocutaneous fistulas with voice prosthesis.

    Science.gov (United States)

    Karakullukcu, M Baris; Lohuis, Peter J; van den Brekel, Michiel W; Hilgers, Frans J M

    2010-10-01

    Pharyngocutaneous fistulas (PCFs) following total laryngectomy is a common complication. The standard therapy is conservative management, and if this is not successful, surgical closure. There is a group of patients with limited survival chance who have small PCFs. In these patients who are not candidates for surgery, sealing of the PCF with a voice prosthesis can significantly improve the functionality of these patients allowing them to swallow and phonate.

  11. Comminuted fractures of the radial head: resection or prosthesis?

    Science.gov (United States)

    Lópiz, Yaiza; González, Ana; García-Fernández, Carlos; García-Coiradas, Javier; Marco, Fernando

    2016-09-01

    At present, surgical treatment of comminuted radial head fractures without associated instability continues to be controversial. When anatomical reconstruction is not possible, radial head excision is performed. However, the appearance of long-term complications with this technique, along with the development of new radial head implants situates arthroplasty as a promising surgical alternative. The purpose of the present study was to compare the mid-term functional outcomes of both techniques. A retrospective study was performed between 2002 and 2011 on 25 Mason type-III fractures, 11 patients treated with primary radial head resection and 14 who received treatment of the fracture with metal prosthesis. At the end of follow-up, patients were contacted and outcomes evaluated according to: Mayo Elbow Performance Score (MEPS), the Disabilities of the Arm, Shoulder and Hand score (DASH) and strength measurement. Radiographic assessment (proximal migration of the radius, osteoarthritic changes, and signs of prosthesis loosening) was also performed. The average age of the sample was 53.7 years in the resection group, and 54.4 years in the replacement group, with a mean follow-up of 60.3 and 42 months respectively. According to the MEPS scale, there were 6 excellent cases, 3 good and 2 acceptable in the resection group, and 6 excellent cases, 3 good, 3 acceptable, and 2 poor in the prosthesis group. The mean DASH score were 13.5, and 24.8 for the resection and the replacement group respectively. We found one postoperative complication in the resection group (stiffness and valgus instability) and 6 in the replacement group: 3 of joint stiffness, 1 case of prosthesis breakage, and 2 neurological injuries. Although this is a retrospective study, the high complication rate occurring after radial head replacement in comparison with radial head resection, as well as good functional results obtained with this last technique, leads us to recommend it for comminuted radial head

  12. Designing manufacturing and the clinic application of the prosthesis for the patients with large ocular defects.

    Science.gov (United States)

    Xueliang, X; Chengye, W; Shuangzhen, L; Yun, D

    1997-09-01

    To design and manufacture the prosthesis of external type for patients with ocular large defects. Silicon and polymethyl methacrylate (PMMA) were chosen the chief materials: The main procedures are: taking the impression, color mixture, making primitive form of the prosthesis, modification and fixation. Fifty patients with large ocular defects took the prosthesis, the cosmetic results are satisfactory. All the patients give satisfactory comments on the 5 main indexes: color 90%, stereo-feeling 100%, peripheral difference 86%, fidelity 98% and fixation 86%. To make ocular prosthesis, materials with good quality and complicated technology are needed. The prosthesis made by silicon combined with PMMA show good results. Among the procedures of making prosthesis, color mixture and fixation are the most important.

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

    Science.gov (United States)

    Al-Thobity, Ahmad M

    2016-06-22

    The fabrication of an implant-supported fixed complete denture prosthesis involves multiple clinical and laboratory steps. One of the main steps is to provide the patient with an interim fixed prosthesis to evaluate the patient's esthetic and functional needs as well as to enhance the patient's psychology before proceeding to the definitive prosthesis. Different techniques for fabricating interim prostheses have been described in the literature. This report describes an alternative technique that uses a duplicate denture made of self-curing acrylic resin to fabricate an implant-supported fixed interim prosthesis. The interim prosthesis was later used as a blueprint for the definitive implant-supported hybrid prosthesis. © 2016 by the American College of Prosthodontists.

  14. Prosthetic rehabilitation of large mid-facial defect with magnet-retained silicone prosthesis

    Directory of Open Access Journals (Sweden)

    Kirti Jajoo Shrivastava

    2015-01-01

    Full Text Available Rehabilitation of maxillofacial defect patients is a challenging task. The most common prosthetic treatment problem with such patients is, getting adequate retention, stability, and support. In cases of large maxillofacial defect, movement of the prosthesis is inevitable. The primary objectives in rehabilitating the maxillofacial defect patients are to restore the function of mastication, deglutition, speech, and to achieve normal orofacial appearance. This clinical report describes maxillofacial prosthetic rehabilitation of large midfacial defect including orbit along with its contents, zygoma and soft tissues including half of the nose, cheeks, upper lip of left side, accompanying postsurgical microstomia and orofacial communication, which resulted from severe fungal infection mucormycosis. The defect in this case was restored with magnet retained two piece maxillofacial prosthesis having hollow acrylic resin framework and an overlying silicone facial prosthesis. The retention of prosthesis was further enhanced with the use of spectacles. This type of combination prosthesis enhanced the cosmesis and functional acceptability of prosthesis.

  15. Modified cementless total coxofemoral prosthesis: development, implantation and clinical evaluation

    Directory of Open Access Journals (Sweden)

    S.A. Arias

    2013-12-01

    Full Text Available The aim of this study was to modify canine coxofemoral prostheses and the clinical evaluation of the implantation. Fifteen canine hips and femora of cadavers were used in order to study the surface points of modification in prostheses and develop a perforation guide. Femoral stems and acetabular components were perforated and coated with biphasic calcium phosphate layer. Twelve young adult male mongrel dogs were implanted with coxofemoral prostheses. Six were operated upon and implanted with cemented canine modular hip prostheses, establishing the control group. The remaining six were implanted with a novel design of cementless porous tricalcic phosphate-hydroxyapatite coated hip prostheses. Clinical and orthopedic performance, complications, and thigh muscular hypotrophy were assessed up to the 120th post-operatory day. After 120 days, animals with cementless prostheses had similar clinical and orthopedic performance compared to the cemented group despite the increased pain thigh hypotrophy. Animals that underwent cementless hip prosthesis evidenced more pain, compared to animals with cemented hip prosthesis that required longer recuperation time. No luxations, two fractures and two isquiatic neurapraxies were identified in the course of the study. Using both the cemented and the bioactive coated cementless model were suitable to dogs, showing clinical satisfactory results. Osseointegration and biological fixation were observed in the animals with the modified cementless hip prosthesis.

  16. Visual prosthesis wireless energy transfer system optimal modeling.

    Science.gov (United States)

    Li, Xueping; Yang, Yuan; Gao, Yong

    2014-01-16

    Wireless energy transfer system is an effective way to solve the visual prosthesis energy supply problems, theoretical modeling of the system is the prerequisite to do optimal energy transfer system design. On the basis of the ideal model of the wireless energy transfer system, according to visual prosthesis application condition, the system modeling is optimized. During the optimal modeling, taking planar spiral coils as the coupling devices between energy transmitter and receiver, the effect of the parasitic capacitance of the transfer coil is considered, and especially the concept of biological capacitance is proposed to consider the influence of biological tissue on the energy transfer efficiency, resulting in the optimal modeling's more accuracy for the actual application. The simulation data of the optimal model in this paper is compared with that of the previous ideal model, the results show that under high frequency condition, the parasitic capacitance of inductance and biological capacitance considered in the optimal model could have great impact on the wireless energy transfer system. The further comparison with the experimental data verifies the validity and accuracy of the optimal model proposed in this paper. The optimal model proposed in this paper has a higher theoretical guiding significance for the wireless energy transfer system's further research, and provide a more precise model reference for solving the power supply problem in visual prosthesis clinical application.

  17. Middle Ear Prosthesis with Bactericidal Efficacy—In Vitro Investigation

    Directory of Open Access Journals (Sweden)

    Magdalena Ziąbka

    2017-10-01

    Full Text Available Materials used in ossicular replacement prostheses must possess appropriate biological properties, such as biocompatibility, stability, no cytotoxicity. Due to the risk of infection (otitis media and chronic otitis media, it is desirable to use an antibacterial agent for illness prevention during the ossicular reconstruction. The goal of this work was to observe biological properties of a new composite prosthesis made of ABS containing silver nanoparticles (AgNPs 45T. Samples for biological tests and then a prototype of middle ear prosthesis were prepared using injection moulding and extrusion techniques. In vitro experiments were carried out to assess bactericidal efficacy against Staphylococcus aureus and Pseudomona aeruginosa standard strains, cell proliferation, viability and cytotoxicity, using Hs680.Tr. fibroblast cells. Surface parameters of the samples were evaluated, including roughness and wettability. The silver ions were continually released from the polymer in aqueous solution. The silver ions release was measured as increasing with time and concentration of the silver nanoparticles in the polymer matrix. No cytotoxicity effect was observed, while bactericidal efficacy was noticed for silver nanoparticles. The roughness studies showed an increase in roughness for the samples with silver nanoparticles. All polymer and composite materials containing silver nanoparticles showed hydrophilic properties. The composites were found to release silver ions at a concentration level capable of rendering the antimicrobial efficacy even with the lowest concentration of silver nanoparticles in the material. Our results demonstrate that middle ear prosthesis made of polymer and silver nanoparticles may eliminate bacteria during inflammation in the middle ear.

  18. Middle Ear Prosthesis with Bactericidal Efficacy-In Vitro Investigation.

    Science.gov (United States)

    Ziąbka, Magdalena; Dziadek, Michał; Menaszek, Elżbieta; Banasiuk, Rafał; Królicka, Aleksandra

    2017-10-10

    Materials used in ossicular replacement prostheses must possess appropriate biological properties, such as biocompatibility, stability, no cytotoxicity. Due to the risk of infection (otitis media and chronic otitis media), it is desirable to use an antibacterial agent for illness prevention during the ossicular reconstruction. The goal of this work was to observe biological properties of a new composite prosthesis made of ABS containing silver nanoparticles (AgNPs 45T). Samples for biological tests and then a prototype of middle ear prosthesis were prepared using injection moulding and extrusion techniques. In vitro experiments were carried out to assess bactericidal efficacy against Staphylococcus aureus and Pseudomona aeruginosa standard strains, cell proliferation, viability and cytotoxicity, using Hs680.Tr. fibroblast cells. Surface parameters of the samples were evaluated, including roughness and wettability. The silver ions were continually released from the polymer in aqueous solution. The silver ions release was measured as increasing with time and concentration of the silver nanoparticles in the polymer matrix. No cytotoxicity effect was observed, while bactericidal efficacy was noticed for silver nanoparticles. The roughness studies showed an increase in roughness for the samples with silver nanoparticles. All polymer and composite materials containing silver nanoparticles showed hydrophilic properties. The composites were found to release silver ions at a concentration level capable of rendering the antimicrobial efficacy even with the lowest concentration of silver nanoparticles in the material. Our results demonstrate that middle ear prosthesis made of polymer and silver nanoparticles may eliminate bacteria during inflammation in the middle ear.

  19. Reliability of MRI findings in candidates for lumbar disc prosthesis

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Linda; Espeland, Ansgar [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Section for Radiology, Department of Surgical Sciences, Bergen (Norway); Neckelmann, Gesche [Haukeland University Hospital, Department of Radiology, Bergen (Norway); Gjertsen, Oeivind [Oslo University Hospital, Department of Neuroradiology, Oslo (Norway); Hellum, Christian [Oslo University Hospital, Department of Orthopaedics, Oslo (Norway); University of Oslo, Department of Orthopaedics, Oslo (Norway); Johnsen, Lars G. [University Hospital of Trondheim, National Centre for Diseases of the Spine, Trondheim (Norway); University Hospital of Trondheim, Orthopaedic Department, Trondheim (Norway); Eide, Geir E. [Haukeland University Hospital, Centre for Clinical Research, Bergen (Norway); University of Bergen, Department of Public Health and Primary Health Care, Bergen (Norway)

    2012-07-15

    Limited reliability data exist for localised magnetic resonance imaging (MRI) findings relevant to planning of treatment with lumbar disc prosthesis and later outcomes. We assessed the reliability of such findings in chronic low back pain patients who were accepted candidates for disc prosthesis. On pretreatment MRI of 170 patients (mean age 41 years; 88 women), three experienced radiologists independently rated Modic changes, disc findings and facet arthropathy at L3/L4, L4/L5 and L5/S1. Two radiologists rerated 126 examinations. For each MRI finding at each disc level, agreement was analysed using the kappa statistic and differences in prevalence across observers using a fixed effects model. All findings at L3/L4 and facet arthropathy at L5/S1 had a mean prevalence <10% across observers and were not further analysed, ensuring interpretable kappa values. Overall interobserver agreement was generally moderate or good (kappa 0.40-0.77) at L4-S1 for Modic changes, nucleus pulposus signal, disc height (subjective and measured), posterior high-intensity zone (HIZ) and disc contour, and fair (kappa 0.24) at L4/L5 for facet arthropathy. Posterior HIZ at L5/S1 and severely reduced subjective disc height at L4/L5 differed up to threefold in prevalence between observers (p < 0.0001). Intraobserver agreement was mostly good or very good (kappa 0.60-1.00). In candidates for disc prosthesis, mostly moderate interobserver agreement is expected for localised MRI findings. (orig.)

  20. A cortical neural prosthesis for restoring and enhancing memory

    Science.gov (United States)

    Berger, Theodore W.; Hampson, Robert E.; Song, Dong; Goonawardena, Anushka; Marmarelis, Vasilis Z.; Deadwyler, Sam A.

    2011-08-01

    A primary objective in developing a neural prosthesis is to replace neural circuitry in the brain that no longer functions appropriately. Such a goal requires artificial reconstruction of neuron-to-neuron connections in a way that can be recognized by the remaining normal circuitry, and that promotes appropriate interaction. In this study, the application of a specially designed neural prosthesis using a multi-input/multi-output (MIMO) nonlinear model is demonstrated by using trains of electrical stimulation pulses to substitute for MIMO model derived ensemble firing patterns. Ensembles of CA3 and CA1 hippocampal neurons, recorded from rats performing a delayed-nonmatch-to-sample (DNMS) memory task, exhibited successful encoding of trial-specific sample lever information in the form of different spatiotemporal firing patterns. MIMO patterns, identified online and in real-time, were employed within a closed-loop behavioral paradigm. Results showed that the model was able to predict successful performance on the same trial. Also, MIMO model-derived patterns, delivered as electrical stimulation to the same electrodes, improved performance under normal testing conditions and, more importantly, were capable of recovering performance when delivered to animals with ensemble hippocampal activity compromised by pharmacologic blockade of synaptic transmission. These integrated experimental-modeling studies show for the first time that, with sufficient information about the neural coding of memories, a neural prosthesis capable of real-time diagnosis and manipulation of the encoding process can restore and even enhance cognitive, mnemonic processes.

  1. [Clinical analysis of prosthesis replacement for proximal humerus tumors].

    Science.gov (United States)

    Weng, Xiaojun; Liao, Qiande; Li, Xiaosheng; Wang, Jing

    2016-01-01

    To explore surgical strategies, functions and prognosis of artificial prosthesis replacement and soft tissue reconstruction for patients with invasive benign or primary malignant proximal humerus tumor.
 A total of 17 patients with invasive benign or primary malignant proximal humerus tumor underwent prosthetic replacement after segment bone tumor resection and soft tissues reconstruction from April 2007 to April 2014 were enrolled. Based on histological types, tumor stages and surgical procedures, the effects of artificial prosthesis replacement and soft tissue reconstruction on prognosis and shoulder joint function were evaluated.
 All patients were followed up for 8 to 96 months (average time: 58.9 months). Among 11 patients with primary malignant tumor, 5 died of tumor recurrence or metastasis, and 6 showed tumor-free survival for 24 to 91 months (average time: 54.83 months). The 6 patients with aggressive benign tumors survived for 39 to 96 months, with an average of 72.33 months. The shoulder joint function of 17 patients recovered to 64.88% of normal. There were significant differences in the shoulder joint function between the patients who underwent half shoulder replacement and those who underwent total shoulder replacement (56.25% vs 72.56%, Pshoulder joint function between the patients who underwent Type I A excision (retention of abductor muscles and rotator cuff) and those who underwent Type I B excision (68.75% vs 61.44%, Pshoulder joint function is associated with the methods of prosthesis replacement and soft tissue resection.

  2. Literature Review on Needs of Upper Limb Prosthesis Users.

    Science.gov (United States)

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

    2016-01-01

    The loss of one hand can significantly affect the level of autonomy and the capability of performing daily living, working and social activities. The current prosthetic solutions contribute in a poor way to overcome these problems due to limitations in the interfaces adopted for controlling the prosthesis and to the lack of force or tactile feedback, thus limiting hand grasp capabilities. This paper presents a literature review on needs analysis of upper limb prosthesis users, and points out the main critical aspects of the current prosthetic solutions, in terms of users satisfaction and activities of daily living they would like to perform with the prosthetic device. The ultimate goal is to provide design inputs in the prosthetic field and, contemporary, increase user satisfaction rates and reduce device abandonment. A list of requirements for upper limb prostheses is proposed, grounded on the performed analysis on user needs. It wants to (i) provide guidelines for improving the level of acceptability and usefulness of the prosthesis, by accounting for hand functional and technical aspects; (ii) propose a control architecture of PNS-based prosthetic systems able to satisfy the analyzed user wishes; (iii) provide hints for improving the quality of the methods (e.g., questionnaires) adopted for understanding the user satisfaction with their prostheses.

  3. Urinary Incontinence Could Be Controlled by an Inflatable Penile Prosthesis

    Directory of Open Access Journals (Sweden)

    Hyun Min Choi

    2016-04-01

    Full Text Available Purpose: Due to the increasing numbers of radical prostatectomies (RP performed for prostate cancer, a substantial and increasing number of patients suffer from postoperative urinary incontinence and erectile dysfunction (ED. The objective of our study was to see whether an inflatable penile prosthesis implantation could control urinary incontinence for patients with the dual problems of ED and incontinence. Materials and Methods: From March 2010 through May 2015, 25 post-RP patients were referred to our clinic with ED or incontinence. The degree of incontinence was classified according to the International Consultation on Incontinence Questionnaire-Short Form. Inflatable penile prostheses were implanted in all 25 patients. Results: For one month after implantation, partial or full inflation was performed progressively to control urine leakage. Of 18 patients, 13 patients were categorized with mild or moderate stress incontinence. All 13 patients obtained control of incontinence with partial inflation (30% to 60% and all reported satisfactory outcomes. Five out of the 18 patients were categorized with severe total incontinence. Three of the 5 patients could tolerate incontinence with full inflation on and off. Thirteen patients out of the total of 18 (72.2% had their incontinence controlled by an inflating penile prosthesis. Conclusions: An inflatable penile prosthesis is highly recommended as an initial procedure, especially in patients with the dual problems of ED and incontinence.

  4. Nonwoven polypropylene prosthesis in large abdominal wall defects in rats.

    Science.gov (United States)

    Reis, Patrick dos Santos Barros dos; Chagas, Vera Lucia Antunes; Silva, Jéssica Marquet; Silva, Paulo Cesar; Jamel, Nelson; Schanaider, Alberto

    2012-10-01

    To evaluate, in large abdominal wall defects surgically shaped in rats, if a synthetic polypropylene nonwoven prosthesis could be used as a therapeutic option to conventional polypropylene mesh. Twenty four (24) Wistar rats were enrolled into three groups. Group 1 (Simulation group) with an abdominal wall defect of 3 X 3 left untreated and Groups 2 and 3, respectively treated with a conventional polypropylene mesh and a polypropylene nonwoven (NWV) prosthesis to cover the breach. At the 45th postoperatively day, adhesion (area and strength) and vascularization of Groups 2 and 3 were evaluated. The histological preparations with Hematoxylin-Eosin, Tricromium of Masson, Pricrosirius red and polarization with birefringence, and also the structural analysis of the prostheses carried on by Thermogravimetry and Differential Scanning Calorimetry were also assessed. There were no significant differences between the Groups 2 and 3. In rats, the polypropylene nonwoven prosthesis showed to be safe and has to be considered as an alternative to conventional mesh manufactured by weaving in the treatment of great defects of the abdominal wall.

  5. A cortical neural prosthesis for restoring and enhancing memory.

    Science.gov (United States)

    Berger, Theodore W; Hampson, Robert E; Song, Dong; Goonawardena, Anushka; Marmarelis, Vasilis Z; Deadwyler, Sam A

    2011-08-01

    A primary objective in developing a neural prosthesis is to replace neural circuitry in the brain that no longer functions appropriately. Such a goal requires artificial reconstruction of neuron-to-neuron connections in a way that can be recognized by the remaining normal circuitry, and that promotes appropriate interaction. In this study, the application of a specially designed neural prosthesis using a multi-input/multi-output (MIMO) nonlinear model is demonstrated by using trains of electrical stimulation pulses to substitute for MIMO model derived ensemble firing patterns. Ensembles of CA3 and CA1 hippocampal neurons, recorded from rats performing a delayed-nonmatch-to-sample (DNMS) memory task, exhibited successful encoding of trial-specific sample lever information in the form of different spatiotemporal firing patterns. MIMO patterns, identified online and in real-time, were employed within a closed-loop behavioral paradigm. Results showed that the model was able to predict successful performance on the same trial. Also, MIMO model-derived patterns, delivered as electrical stimulation to the same electrodes, improved performance under normal testing conditions and, more importantly, were capable of recovering performance when delivered to animals with ensemble hippocampal activity compromised by pharmacologic blockade of synaptic transmission. These integrated experimental-modeling studies show for the first time that, with sufficient information about the neural coding of memories, a neural prosthesis capable of real-time diagnosis and manipulation of the encoding process can restore and even enhance cognitive, mnemonic processes.

  6. Osseointegrated silicone finger prosthesis using dental implants: a renovated technique.

    Science.gov (United States)

    Vinnakota, Dileep Nag; Sankar, V Vijay; Chirumamilla, Naveen; Reddy, V Vamsikrishna

    2014-11-01

    In clinical practice, we come across patients with traumatically amputated or congenitally missing partial or complete fingers that can be restored using microsurgical replantation or transplantation procedures. However, in some cases this might not be possible due to systemic or local factors and the lost or missing part has to be replaced prosthetically to offer psychological and functional wellbeing. These prostheses can be constructed with various materials like acrylics or silicone retained with the help of auxiliary aids. However, these prostheses cause some hindrance in performing functions like writing, typing, etc. The aim of the present trial was to ameliorate the existing design of implant supported finger prosthesis. Distal phalange of middle finger replaced with implant supported silicone finger prosthesis is modified by utilizing a metal framework to support silicone material to improve rigidity while working. We could achieve a good function, esthetics and tactile sensibility with this modified design. Whenever, feasible this design can improve the performance and patients feel a deep sense of satisfaction and improved self-esteem with this modified prosthesis.

  7. Actinomyces gerencseriae hip prosthesis infection: a case report.

    Science.gov (United States)

    Dubourg, Grégory; Delord, Marion; Gouriet, Frédérique; Fournier, Pierre-Edouard; Drancourt, Michel

    2015-09-28

    Actinomyces bacteria are part of the human oropharyngeal microbiota. They have been associated with abdominal, cervicofacial and thoracic infections and a few cases of joint infections have also been described. In particular, Actinomyces gerencseriae, formerly described as Actinomyces israelii serovar II, has rarely been associated with human infections, mostly involving cervicofacial lesions and periodontal diseases. Here, we report one case of hip prosthesis infection due to A. gerencseriae. A 72-year-old Caucasian male developed an inflammatory collection on the outside of the right thigh where a hip prosthesis had been implanted for 11 years. Culturing a fluid sample from the collection puncture found Staphylococcus hominis and a Gram-positive bacillus unidentified by matrix-assisted laser desorption ionization time-of-flight mass-spectrometry (MALDI-TOF). Sequencing the 16S rRNA gene amplified from both the specimen and the isolate identified A. gerencseriae. Treatment adjusted with amoxicillin and trimethropim-sulfamethoxazole cured the infection. The recently described A. gerencseriae has rarely been involved in human infections. We report the first case of A. gerencseriae joint infection in a hip prosthesis.

  8. Impact of removable partial denture prosthesis on chewing efficiency

    Directory of Open Access Journals (Sweden)

    Marion Bessadet

    2013-09-01

    Full Text Available Removable partial denture prostheses are still being used for anatomic, medical and economic reasons. However, the impact on chewing parameters is poorly described. OBJECTIVES: The objective of this study was to estimate the impact of removable partial denture prosthesis on masticatory parameters. MATERIAL AND METHODS: Nineteen removable partial denture prosthesis (RPDP wearers participated in the study. Among them, 10 subjects were Kennedy Class III partially edentulous and 9 with posterior edentulism (Class I. All presented a complete and full dentate opposing arch. The subjects chewed samples of carrots and peanuts with and without their prosthesis. The granulometry of the expectorated boluses from carrot and peanuts was characterized by median particle size (D50, determined at the natural point of swallowing. Number of chewing cycles (CC, chewing time (CT and chewing frequency (CF=CC/CT were video recorded. RESULTS: With RPDP, the mean D50 values for carrot and peanuts were lower [Repeated Model Procedures (RMP, F=15, p<0.001] regardless of the type of Kennedy Class. For each food, mean CC, CT and CF values recorded decreased (RMP, F=18, F=9, and F=20 respectively, p<0.01. With or without RPD, the boluses' granulometry values were above the masticatory normative index (MNI determined as 4,000 µm. CONCLUSION: RPDP rehabilitation improves the ability to reduce the bolus particle size, but does not reestablish fully the masticatory function. CLINICAL RELEVANCE: This study encourages the clinical improvement of oral rehabilitation procedure.

  9. A fiber-reinforced composite prosthesis restoring a lateral midfacial defect: a clinical report.

    Science.gov (United States)

    Kurunmäki, Hemmo; Kantola, Rosita; Hatamleh, Muhanad M; Watts, David C; Vallittu, Pekka K

    2008-11-01

    This clinical report describes the use of a glass fiber-reinforced composite (FRC) substructure to reinforce the silicone elastomer of a large facial prosthesis. The FRC substructure was shaped into a framework and embedded into the silicone elastomer to form a reinforced facial prosthesis. The prosthesis is designed to overcome the disadvantages associated with traditionally fabricated prostheses; namely, delamination of the silicone of the acrylic base, poor marginal adaptation over time, and poor simulation of facial expressions.

  10. Magnetic resonance imaging compatibility test of a cranial prosthesis with titanium screws

    Science.gov (United States)

    Jimenez, R.; Benavides, A.; Flores, D.; Hidalgo, S. S.; Solis, S. E.; Uribe, E.; Rodriguez, A. O.

    2012-10-01

    The follow-up of patients with skull prosthesis is necessary to provide adequate medical care. Skull prostheses for cranioplasty have been developed at the Faculty of Odontology of Universidad Nacional Autonoma de Mexico. We built a skull prosthesis phantom and tested for compatibility with standard magnetic resonance imaging procedures. Results showed full compatibility but susceptibility artefacts occurred due to titanium used to fix the prosthesis to the skull.

  11. Teicoplanin-Containing Cement Spacers for Treatment of Experimental Staphylococcus aureus Joint Prosthesis Infection

    OpenAIRE

    Ismael, Farid; Bléton, Rémy; Saleh-Mghir, Azzam; Dautrey, Sophie; Massias, Laurent; Crémieux, Anne-Claude

    2003-01-01

    Using a rabbit model of methicillin-resistant Staphylococcus aureus knee-prosthesis infection, we studied the efficacy of teicoplanin cement alone or in combination with systemic intramuscular (i.m.) injections of teicoplanin. Seven days after infection, surgical debridement and removal of the infected prostheses were performed, and five rabbits were randomly assigned to one of five different treatment groups: untreated controls, prosthesis replacement by drug-free cement spacer, prosthesis r...

  12. Prototyping of Cosmetic Prosthesis of Upper Limb Using Additive Manufacturing Technologies

    OpenAIRE

    Aleksandra Radosh; Wiesław Kuczko; Radosław Wichniarek; Filip Górski

    2017-01-01

    This paper describes prototyping of an individualized cosmetic arm prosthesis. Aim of the studies was to obtain an anatomically correct, lightweight prosthesis. It was accomplished using additive manufacturing technology of fused deposition modeling. The data was obtained by 3D scanning. An experimental concept of dual extrusion of two different materials was applied – the prosthesis was divided into an elastic shell and a rigid core, manufactured in one process. Obtained results were positiv...

  13. Prototyping of Cosmetic Prosthesis of Upper Limb Using Additive Manufacturing Technologies

    Directory of Open Access Journals (Sweden)

    Aleksandra Radosh

    2017-09-01

    Full Text Available This paper describes prototyping of an individualized cosmetic arm prosthesis. Aim of the studies was to obtain an anatomically correct, lightweight prosthesis. It was accomplished using additive manufacturing technology of fused deposition modeling. The data was obtained by 3D scanning. An experimental concept of dual extrusion of two different materials was applied – the prosthesis was divided into an elastic shell and a rigid core, manufactured in one process. Obtained results were positive.

  14. The method of manufacture of nylon dental partially removable prosthesis using additive technologies

    Science.gov (United States)

    Kashapov, R. N.; Korobkina, A. I.; Platonov, E. V.; Saleeva, G. T.

    2014-12-01

    The article is devoted to the topic of creating new methods of dental prosthesis. The aim of this work is to investigate the possibility of using additive technology to create nylon prosthesis. As a result of experimental studies, was made a sample of nylon partially removable prosthesis using 3D printing has allowed to simplify, accelerate and reduce the coat of manufacturing high-precision nylon dentures.

  15. Use of Powered Prosthesis for Children with Upper Limb Deficiency at Hyogo Rehabilitation Center.

    Directory of Open Access Journals (Sweden)

    Mitsunori Toda

    Full Text Available There has been no research investigating the use of powered prosthetic for children in Japan.To gain better insight into the state of powered prosthesis usage and identify a ratio of rejection among children.Subjects were 37 unilateral below elbow amputees between the ages of 0 and 16 at the time of their first experienced fitting with a powered prosthesis at our Center. The information was collected from medical records and through face-to-face interviews, and we examined rejection rate and the factors affecting the use of powered prosthesis.The rate of discontinuation was 21.6% as 8 of the 37 children stopped using powered prosthesis. All of them were fitted their prosthesis after 2 years of age, and they rejected prosthesis between 5 to 19 years. We found that the level of amputation had no influence on the use of a powered prosthesis.Children fitted before 2 years of age tend to accept their powered prosthesis than those fitted after 2 years. Multidisciprinary team approach, adequate rehabilitation, detailed follow-up and involvement of parents are quite important for introducing powered prosthesis for children.

  16. Effectiveness of the heat-activated nitinol smart piston stapes prosthesis in stapedectomy surgery.

    Science.gov (United States)

    Cho, John J W; Yunker, Warren K; Marck, Paulette; Marck, Paul A

    2011-02-01

    To compare the SMart piston stapes prosthesis to a standard manual crimp prosthesis on operative time and air-bone gap (ABG) closure in stapedectomy. Retrospective chart review. Tertiary referral centre. The charts of patients undergoing stapedectomy for otosclerosis were analyzed. We compared the results of 76 patients (80 ears) who received the autocrimping SMart piston prosthesis to those of 21 patients (21 ears) who received the conventional manual crimp Fisch-type prosthesis. Data were analyzed using t-test, chi-square, or two-way analysis of variance where appropriate. Operative time with ABG closure as a secondary outcome measure. There was a significant difference in operative time between the Fisch-type prosthesis and the SMart piston prosthesis groups. The operation required 28.9 ± 3.2 minutes when using the Fisch-type prosthesis, whereas 21.2 ± 2.4 minutes were needed when using the SMart piston (p piston (28.1 ± 3.1 to 9.0 ± 1.4, p piston (25.1 ± 3.7 to 8.2 ± 2.5, p piston prosthesis results in ABG closure similar to that of the traditional Fisch-type prosthesis but offers the added advantage of reduced operative time.

  17. Three-part mould technique for fabrication of hollow thumb prosthesis: A case report.

    Science.gov (United States)

    Jain, Ajay; Walker, Fraser S; Ugrappa, Sridevi; Makkad, Sumit; Ugrappa, Vijay Kumar

    2016-12-01

    The purpose of this article is to describe a technique which helps in fabrication of glove-type hollow thumb prosthesis using three-part mould technique. Patient reported to the Department of Private dental clinic, Delhi, India with a chief complaint of missing partial left thumb and wanted to get it replaced. A complete clinical hand examination was carried out, which revealed a residual stump of 1 cm length. After ensuring the medical conditions to be normal, fabrication of hollow thumb prosthesis was planned using three-part mould technique. The prosthesis delivered to the patient was highly retentive because of its glove-type retention and lighter weight; feedback from the patient regarding retention was excellent. The prosthesis was aesthetically pleasing because of its excellent colour matching with the skin, and each and every part of the prosthesis could be colour customized because of easy retrieval of the third part of the mould, as well. A technique of hollow thumb prosthesis has been described in this article which helps in reduction in weight, easy packing of silicone material into the mould and easy colour customization at the knuckles area of the dorsal and ventral aspect of the prosthesis. This three-part mould technique helps to fabricate hollow prosthesis which increases retainability and at the same time allows easy packing of silicone material and easy colour customization at the knuckles area of the prosthesis. © The International Society for Prosthetics and Orthotics 2015.

  18. Isolated pump erosion of an inflatable penile prosthesis through the scrotum in a diabetic patient

    Directory of Open Access Journals (Sweden)

    Raidh A. Talib

    2013-04-01

    Full Text Available Isolated pump erosion is a rare complication in patients with inflatable penile prosthesis. We describe a case of a diabetic patient who underwent inflatable penile prosthesis implantation with subsequent isolated pump erosion. Repeated attempts of conservative repair of the erosion failed. Finally, the inflatable penile prosthesis was replaced with a malleable one to avoid new pump erosion. In case of isolated pump erosion, replacement of the inflatable penile prosthesis with a malleable one looks to be a good alternative salvage treatment for the patient.

  19. Penile prosthesis implant: scientific advances and technological innovations over the last four decades.

    Science.gov (United States)

    Chung, Eric

    2017-02-01

    Despite introduction of oral phosphodiesterase type 5 inhibitors and intracavernosal vasoactive agents, penile prosthesis implant remains a relevant and desired option with sales of penile prostheses continue to stay high, as many men became refractory to medical therapy and/or seeking a more effective and permanent therapy. There are two types of penile prosthesis implants: inflatable and non-inflatable types, and the inflatable penile implants can be subdivided into single-, two- and three-piece devices. Non-inflatable penile prosthesis (non-IPP) may be referred to as semi-rigid rod or malleable prosthesis. IPP is considered a superior option to malleable prosthesis as it produces penile rigidity and flaccidity that closely replicates a normal penile erectile function. Since the introduction of IPP by Scott in 1973, surgical landscape for penile prosthesis implantation has changed dramatically. Advances in prosthesis design, device technologies and surgical techniques have made penile prosthesis implant a more natural, durable and reliable device. The following article reviews the scientific advances and technological innovation in modern penile prosthesis implants over the last four decades.

  20. Treatment of sharp mandibular alveolar process with hybrid prosthesis

    Directory of Open Access Journals (Sweden)

    Sukaedi Sukaedi

    2010-09-01

    Full Text Available Background: Losing posterior teeth for a long time would occasionally lead to the sharpening of alveolar process. The removable partial denture usually have problems when used during mastication, because of the pressure on the mucosa under the alveolar ridge. Purpose: The purpose of this case report was to manage patients with sharp mandibular alveolar process by wearing hybrid prosthesis with extra coronal precision attachment retention and soft liner on the surface base beneath the removable partial denture. Case: A 76 years old woman visited the Prosthodontic Clinic Faculty of Dentistry Airlangga University. The patient had a long span bridge on the upper jaw and a free end acrylic removable partial denture on the lower jaw. She was having problems with mastication. The patient did not wear her lower denture because of the discomfort with it during mastication. Hence, she would like to replace it with a new removable partial denture. Case management: The patient was treated by wearing a hybrid prosthesis with extra coronal precision attachment on the lower jaw. Soft liner was applied on the surface of the removable partial denture. Hybrid prosthesis is a complex denture consisting of removable partial denture and fixed bridge. Conclusion: It concluded that after restoration, the patient had no problems with sharp alveolar process with her new denture, and she was able to masticate well.Latar belakang: Kehilangan geligi posterior dapat menimbulkan processus alveolaris tajam. Gigi tiruan sebagian lepasan mempunyai masalah selama pengunyahan karena adanya tekanan di mukosa di bawah alveolar ridge. Tujuan: Tujuan laporan kasus ini adalah untuk menjelaskan cara menangani pasien yang mempunyai prosesus alveolaris yang tajam di rahang bawah dengan dibuatkan protesis hybrid dengan daya tahan extra coronal precision attachment dan soft liner di permukaan bawah basis gigi tiruan sebagian lepasan. Kasus: Pasien wanita berumur 76 tahun datang di klinik

  1. Stress analysis of different prosthesis materials in implant-supported fixed dental prosthesis using 3D finite element method

    Directory of Open Access Journals (Sweden)

    Pedram Iranmanesh

    2014-01-01

    Full Text Available Introduction: In the present study, the finite element method (FEM was used to investigate the effects of prosthesis material types on stress distribution of the bone surrounding implants and to evaluate stress distribution in three-unit implant-supported fixed dental prosthesis (FDP. Materials and Methods: A three-dimensional (3D finite element FDP model of the maxillary second premolar to the second molar was designed. Three load conditions were statically applied on the functional cusps in horizontal (57.0 N, vertical (200.0 N, and oblique (400.0 N, θ = 120° directions. Four standard framework materials were evaluated: Polymethyl methacrylate (PMMA, base-metal, porcelain fused to metal, andporcelain. Results: The maximum of von Mises stress in the oblique direction was higher than the vertical and horizontal directions in all conditions. In the bone-crestal section, the maximum von Mises stress (53.78 MPa was observed in PMMA within oblique load. In FDPs, the maximum stress was generated at the connector region in all conditions. Conclusion: A noticeable difference was not observed in the bone stress distribution pattern with different prosthetic materials. Although, higher stress value could be seen in polymethyl methacrylate, all types of prosthesis yielded the same stress distribution pattern in FDP. More clinical studies are needed to evaluate the survival rate of these materials.

  2. Prosthesis Prescription Protocol of the Arm (PPP-Arm): The implementation of a national prosthesis prescription protocol.

    Science.gov (United States)

    Wijdenes, Paula; Brouwers, Michael; van der Sluis, Corry K

    2018-02-01

    In order to create more uniformity in the prescription of upper limb prostheses by Dutch rehabilitation teams, the development and implementation of a Prosthesis Prescription Protocol of the upper limb (PPP-Arm) was initiated. The aim was to create a national digital protocol to structure, underpin, and evaluate the prescription of upper limb prostheses for clients with acquired or congenital arm defects. Prosthesis Prescription Protocol of the Arm (PPP-Arm) was developed on the basis of the International Classification of Functioning and consisted of several layers. All stakeholders (rehabilitation teams, orthopedic workshops, patients, and insurance companies) were involved in development and implementation. A national project coordinator and knowledge brokers in each team were essential for the project. PPP-Arm was successfully developed and implemented in nine Dutch rehabilitation teams. The protocol improved team collaboration, structure, and completeness of prosthesis prescriptions and treatment uniformity and might be interesting for other countries as well. Clinical relevance A national protocol to prescribe upper limb prostheses can be helpful to create uniformity in treatment of patients with upper limb defects. Such a protocol improves quality of care for all patients in the country.

  3. The relationship between prosthesis use, phantom pain and psychiatric symptoms in male traumatic limb amputees.

    Science.gov (United States)

    Durmus, Dilek; Safaz, Ismail; Adıgüzel, Emre; Uran, Ayça; Sarısoy, Gökhan; Goktepe, Ahmet Salim; Tan, Arif Kenan

    2015-05-01

    The purpose of this study was to identify psychiatric symptoms by comparing male patients with traumatic leg amputations (LAs) with healthy controls and to determine the association between these psychiatric symptoms and phantom pain and prosthesis use characteristics. One hundred four volunteers, 51 LA patients (group 1) and 53 healthy controls (group 2) were included. Demographic data including age, height, weight, time since amputation, duration of prosthesis use, and Satisfaction with Prosthesis Questionnaire scores were recorded. Phantom pain was measured a visual analog scale (VAS). Psychiatric symptoms were measured using the Symptom Checklist-90-R, Beck Depression Inventory, Pittsburgh Sleep Quality Index, Rosenberg Self-Esteem Scale, and State-Trait Anxiety Inventory. Correlations were determined between time since amputation, duration of prosthesis use and satisfaction with prosthesis questionnaire scores and psychiatric scale scores. Amputee patients had higher phobic anxiety, state anxiety, trait anxiety and sleep disturbance scores (p0.05). There were significant negative correlations between time since amputation, duration of prosthesis use, duration of daily prosthesis use, and satisfaction with prosthesis questionnaire scores and psychiatric symptoms. Apart from anxiety (state, trait or phobic) and disturbed sleep, other psychiatric symptoms in amputee patients undergoing lengthy prosthetic rehabilitation may not differ from those of healthy controls. The presence and severity of phantom pain appear to be unrelated to general psychiatric symptomatology. Length of time since amputation, length of prosthesis use, daily length of prosthesis use and prosthesis satisfaction are negatively correlated with general psychiatric symptoms. These characteristics must be borne in mind in psychiatric and prosthetic rehabilitation. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. A Fixed Telescopic Prosthesis Designed to Retrieve and Convert to Fixed-Removable Combination Case: A Clinical Report.

    Science.gov (United States)

    Zoidis, Panagiotis; Panagiota, Spyropoulou; Polyzois, Gregory

    2015-06-01

    This clinical report describes a fixed maxillary telescopic dental prosthesis (FTDP) employing milled base metal copings and a metal superstructure veneered with composite resin, for the restoration in a periodontally compromised patient with uncontrolled diabetes. The telescopic prosthesis framework design incorporated occlusal rest seats in key positions along the arch in case of future posterior tooth loss, in order to be converted to fixed - removable combination prosthesis. The mandible was restored with a conventional fixed ceramo-metal dental prosthesis.

  5. Long-term follow-up of stentless prosthesis.

    Science.gov (United States)

    Sansone, Fabrizio; Dato, Guglielmo Mario Actis; Zingarelli, Edoardo; Ferrero, Emanuele; Prot, Sara; Ceresa, Fabrizio; Patanè, Francesco; Casabona, Riccardo

    2014-05-01

    Stentless prostheses have an interesting hemodynamic performance when compared to stented prostheses and are recommended in cases of small aortic annulus. From January 1996 to January 2004, 138 patients suffering from aortic disease, underwent aortic valve replacement. • Group A: 93 patients underwent stentless aortic valve implantation [stentless Biocor (Biocor Industria e Pesguisa Ltda, Belo Horizonte, Brazil) and stentless Sorin (Sorin Group, Saluggia, Italy)]. • Group B: 45 patients underwent stented aortic valve implantation (stented Biocor). Patients were assessed by clinical evaluation and echocardiography after a mean follow up of 124.5 ± 58.2 months. There was a significant difference in terms of time of extracorporeal circulation and aortic cross clamp. The actuarial survival at 4, 8, 12, and 15 years is 77%, 50%, 21%, and 18%, respectively. Freedom from reoperation at 4, 8, 12, and 14 years was 92%, 83%, 73%, and 63%, respectively. Freedom from all events, death, and reoperation at 4, 8, 12, and 14 years was 70%, 39%, 13%, and 8%, respectively. There is no statistical difference among the two groups in terms of actuarial survival, freedom from reoperation, and freedom from re-hospitalization for prosthesis-related causes. There was a significantly higher incidence of pacemaker implantation in Group A and the causes are not known. The rate of freedom from reoperation is high in both groups for the patients who remained alive. There was no statistical difference about prosthesis dysfunction between the two groups. The higher incidence of death in Group A cannot be explained by causes related to the prosthesis because there is no difference in terms of causes of death. Rates of reoperation did not differ between the two groups. The results obtained with stentless prostheses are encouraging even in long-term follow-up. Copyright © 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  6. One-stage microvascular mandible reconstruction and alloplastic TMJ prosthesis.

    Science.gov (United States)

    Landes, Constantin; Korzinskas, Tadas; Dehner, Jan-Friedrich; Santo, Gregor; Ghanaati, Shahram; Sader, Robert

    2014-01-01

    Severely deformed or absent temporomandibular joints (TMJ) benefit from total alloplastic joint replacement and large mandibular defects from revascularized free tissue transfer for reconstruction. However no cases of their combined one-stage placement with outcomes can be found in the literature. We present two cases with different indications and reconstruction. The first patient required mandibular body and ascending ramus reconstruction after previous sarcoma resection. This was with a condyle-bearing reconstruction plate which resulted in significant dysfunction, leaving the patient unable to open her mouth. A one-stage vascularized iliac crest free flap and alloplastic TMJ prosthesis was used to reconstruct the mandible. Subsequently, metal removal, soft tissue augmentation by lipotransfer and dental implant placement were performed. At 63 months follow-up patient was pain-free, with mouth opening, protrusion and lateral excursion back to normal. The second patient required mandibular body, ascending ramus and joint reconstruction, performed by transoral vascularized fibula free flap with temporal vessel anastomosis. The traumatic deep bite and posterior facial height were corrected, additional submandibular scars avoided by transoral placement of the fibula transplant and a miniaturized TMJ prosthesis along with the vascularised free flap with 28 months follow-up. A miniaturized TMJ prosthesis may become placed transorally for reconstruction of the TMJ, together with a vascularized free flap for mandibular reconstruction and promises good long-term stability with normal function above all for protrusion and lateral excursion. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  7. Endoscopic management of eroded prosthesis in vertical banded gastroplasty patients.

    Science.gov (United States)

    Karmali, Shahzeer; Snyder, Brad; Wilson, Erik B; Timberlake, Matthew D; Sherman, Vadim

    2010-01-01

    One of the major complications of applying a prosthetic device to facilitate gastric partitioning has been intraluminal erosion of the prosthesis. Removing an eroded gastric band is fraught with difficulty secondary to the extensive inflammatory response around the proximal stomach and left lobe of the liver. As a result, bariatric clinicians have attempted to apply endoscopic technology to facilitate removal of eroded gastric prostheses. Our study reports on our experience of applying endoscopic scissor transection to remove eroded gastric prostheses in a large tertiary-care medical center. A retrospective chart review was conducted to identify all adult (>18 years old) patients managed endoscopically for removal of eroded prosthesis post bariatric surgery at the Baylor College of Medicine Comprehensive Bariatric Surgery Center and the University of Texas-Houston Bariatric Surgery Program. Nine patients, mean body mass index (BMI) 39.5 +/- 7.3 kg/m(2), were managed endoscopically to remove eroded gastric prosthesis post vertical banded gastroplasty. All patients (9/9) reported symptoms consistent with a proximal gastric outlet obstruction (dysphagia, nausea, vomiting). Inadequate weight loss was reported by 67% (6/9) of patients. The mean time for endoscopic band removal was 28.0 +/- 8.8 min. All eroded bands were evident at the end of the gastric pouch and were visualized with either a normal or retroflexed endoscopic view. All nine patients were discharged the same day of their procedure. Mean follow-up of the patients was 9.7 weeks (1-30 weeks). Three patients underwent revisional bariatric surgery following the band removal. Our study demonstrates that endoscopic scissor transaction is a safe and effective modality in removing eroded gastric prostheses after vertical banded gastroplasty and avoids the pitfalls associated with removing the eroded bands surgically. It also allows the patient and surgeon to make an insightful decision regarding a revisional

  8. Aortic valve prosthesis-patient mismatch and exercise capacity in adult patients with congenital heart disease

    NARCIS (Netherlands)

    van Slooten, Ymkje J.; Melle, van Joost P.; Freling, Hendrik G.; Bouma, Berto J.; van Dijk, Arie P. J.; Jongbloed, Monique R. M.; Post, Martijn C.; Sieswerda, Gertjan T.; in 't Veld, Anna Huis; Ebels, Tjark; Voors, Adriaan A.; Pieper, Petronella G.

    Objectives To report the prevalence of aortic valve prosthesis patient mismatch (PPM) in an adult population with congenital heart disease (CHD) and its impact on exercise capacity. Adults with congenital heart disease (ACHD) with a history of aortic valve replacement may outgrow their prosthesis

  9. Design, fabrication, and preliminary results of a novel below knee prosthesis for snowboarding : A case report

    NARCIS (Netherlands)

    Minnoye, A.L.M.; Plettenburg, D.H.

    2010-01-01

    Snowboarding with a below-knee prosthesis is compromised by the limited rotation capabilities of the existing below-knee prostheses, which are designed for use in normal walking. Based on snowboarding range of motion analyses, a novel below-knee prosthesis was designed with the aim to achieve

  10. Biomedical and psychosocial factors influencing transtibial prosthesis fit : a Delphi survey among health care professionals

    NARCIS (Netherlands)

    Baars, Erwin C.; Schrier, Ernst; Geertzen, Jan H.; Dijkstra, Pieter U.

    2015-01-01

    Purpose: We aimed to reach consensus among professionals caring for prosthesis users, on definitions of biomedical and psychosocial factors, to assess their influence on fit of transtibial prosthesis and to identify new factors. Method: A three-round, internet-based, Delphi survey was conducted

  11. 21 CFR 874.3540 - Prosthesis modification instrument for ossicular replacement surgery.

    Science.gov (United States)

    2010-04-01

    ... replacement surgery. 874.3540 Section 874.3540 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... § 874.3540 Prosthesis modification instrument for ossicular replacement surgery. (a) Identification. A prosthesis modification instrument for ossicular replacement surgery is a device intended for use by a...

  12. A multichannel sEMG method for myoelectric control of a forearm prosthesis

    NARCIS (Netherlands)

    van Baal, D.W.; van Baal, D.W.; Muijzer-Witteveen, Heintje Johanna Berendina; Kallenberg, L.A.C.; Hermens, Hermanus J.; Rietman, Johan Swanik; Veltink, P.H.; Eberle, W.

    2009-01-01

    A large number of amputee patients doesn't use their myoelectric prosthesis, mainly due to the limited functionality of the prosthesis. The aim of this study was to investigate if it is possible to distinguish 8 different contractions by using multi-electrode sEMG. We analysed sEMG signals of a grid

  13. Microbial contamination of removable dental prosthesis at different interval of usage: An in vitro study

    National Research Council Canada - National Science Library

    Nair, VijitaVijay; Karibasappa, GN; Dodamani, Arun; Prashanth, VK

    2016-01-01

    ... the quality of life. Though development of implant prosthesis has increased recently, the demand for partial and full dentures is still very high. For those who cannot afford fixed dentures due to very small amount of teeth left, as well as for financial reasons, a removable dental prosthesis remains the only viable solution.[3],[4] Complete den...

  14. Development of a cosmetic knee disarticulation prosthesis : A single-patient case study

    NARCIS (Netherlands)

    de Laat, Fred A.; de Vos, Wouter; Geertzen, Jan; Roorda, Leo D.

    2015-01-01

    Background and aim: If a person does not become ambulant after an amputation, a knee disarticulation (KD) shouldbe considered and the person may then benefit from a cosmetic KD prosthesis. The features of a cosmetic KD prosthesis are, however, seldom described. The aim of this clinical note is to

  15. 21 CFR 888.3590 - Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint tibial (hemi-knee) metallic resurfacing... Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis is a device intended to be implanted...

  16. 21 CFR 888.3500 - Knee joint femorotibial metal/composite semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femorotibial metal/composite semi... § 888.3500 Knee joint femorotibial metal/composite semi-constrained cemented prosthesis. (a) Identification. A knee joint femorotibial metal/composite semi-constrained cemented prosthesis is a two-part...

  17. 21 CFR 888.3530 - Knee joint femorotibial metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femorotibial metal/polymer semi... § 888.3530 Knee joint femorotibial metal/polymer semi-constrained cemented prosthesis. (a) Identification. A knee joint femorotibial metal/polymer semi-constrained cemented prosthesis is a device intended...

  18. 21 CFR 888.3540 - Knee joint patellofemoral polymer/metal semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint patellofemoral polymer/metal semi... § 888.3540 Knee joint patellofemoral polymer/metal semi-constrained cemented prosthesis. (a) Identification. A knee joint patellofemoral polymer/metal semi-constrained cemented prosthesis is a two-part...

  19. 21 CFR 888.3550 - Knee joint patellofemorotibial polymer/metal/metal constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint patellofemorotibial polymer/metal/metal... § 888.3550 Knee joint patellofemorotibial polymer/metal/metal constrained cemented prosthesis. (a) Identification. A knee joint patellofemorotibial polymer/metal/metal constrained cemented prosthesis is a device...

  20. 21 CFR 888.3580 - Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

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

  1. 21 CFR 888.3565 - Knee joint patellofemorotibial metal/polymer porous-coated uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint patellofemorotibial metal/polymer... Devices § 888.3565 Knee joint patellofemorotibial metal/polymer porous-coated uncemented prosthesis. (a) Identification. A knee joint patellofemorotibial metal/polymer porous-coated uncemented prosthesis is a device...

  2. 21 CFR 888.3490 - Knee joint femorotibial metal/composite non-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femorotibial metal/composite non... § 888.3490 Knee joint femorotibial metal/composite non-constrained cemented prosthesis. (a) Identification. A knee joint femorotibial metal/composite non-constrained cemented prosthesis is a device...

  3. 21 CFR 888.3200 - Finger joint metal/metal constrained uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Finger joint metal/metal constrained uncemented... metal/metal constrained uncemented prosthesis. (a) Identification. A finger joint metal/metal... Administration on or before December 26, 1996 for any finger joint metal/metal constrained uncemented prosthesis...

  4. 21 CFR 888.3220 - Finger joint metal/polymer constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Finger joint metal/polymer constrained cemented... metal/polymer constrained cemented prosthesis. (a) Identification. A finger joint metal/polymer..., 1996 for any finger joint metal/polymer constrained cemented prosthesis that was in commercial...

  5. 21 CFR 888.3210 - Finger joint metal/metal constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Finger joint metal/metal constrained cemented... metal/metal constrained cemented prosthesis. (a) Identification. A finger joint metal/metal constrained..., 1996 for any finger joint metal/metal constrained cemented prosthesis that was in commercial...

  6. A "self adhering" prosthesis for hernia repair: experimental study.

    Science.gov (United States)

    Champault, G; Polliand, C; Dufour, F; Ziol, M; Behr, L

    2009-02-01

    Prosthetic reinforcement is now routine in the management of inguinal and incisional hernia, and it significantly reduces the risk of recurrence. After surgery, chronic pain is often attributed to the characteristics of the mesh and to the method of fixation in the wound, with a potential risk of nerve or muscle injuries. To evaluate the properties of a new "self adhering" prosthesis in an experimental animal study. The self adhering prosthesis, a lightweight (40 mg/m(2)) polypropylene mesh coated with a synthetic glue on one side, was implanted laparoscopically in pigs. Removal of the prosthesis was performed at one day, one week and one month post operatively. A macroscopic and microscopic evaluation was performed. The results, using a quantitative score, were compared to those of a control group using the same polypropylene mesh without glue, but fixed by staples. The operative time was significantly lower in the self adhering group: 23 min (15-32) versus 31 min (21-40) (P = 0.01). The average time interval from the introduction of the mesh into the preperitoneal space until the appearance of the first tough adhesion was 3 min (2-4). In the control group, the mesh handling time was 8.3 min (5-14) (P = 0.01). At the time of implantation, the score was at a maximum value in all cases for the self adhering prostheses, especially concerning handling and adhesiveness. Upon removal, this score was noted to be good or very good in 90-100% of the cases. There was a good integration in the muscle confirmed histologically, and there was no shrinkage, no mobilisation and no migration. At one month, the thickness of the fibrosis at the limits of the meshes was significantly higher for the self adhering prostheses (P = 0.02). In this experimental study, the self adhering prosthesis demonstrated its adhesive properties and its ability to be well tolerated, with a good macroscopic and microscopic integration into the abdominal wound. This should allow us to perform a clinical

  7. Definitive magnetic nasal prosthesis for partial nasal defect

    Directory of Open Access Journals (Sweden)

    E Nagaraj

    2011-01-01

    Full Text Available Maxillofacial trauma refers to any injury to the face or jaw caused by physical force, trauma, the presence of foreign objects, animal or human bites, and burns. Facial defects can be devastating in their impact on physical structure and function of the affected individual, leading to potential compromises in quality of life. Restoration of facial defects, especially nasal defects, is a difficult challenge for both the surgeon and the prosthodontist. Here is a case report of partial nasal defect caused by trauma, rehabilitated with a magnetic nasal prosthesis made with silicone elastomers using mechanical and anatomical retentive aids.

  8. Engineering Design of an Adaptive Leg Prosthesis Using Biological Principles

    DEFF Research Database (Denmark)

    Lenau, Torben Anker; Dentel, Andy; Invarsdottir, Thorunn

    2010-01-01

    The biomimetic design process is explored through a design case: An adaptive leg prosthesis. The aim is to investigate if the biomimetic design process can be carried out with a minimum of biological knowledge and without using advanced design methods. In the design case biomimetic design was suc...... was successfully carried out using library search resulting in 14 biological analogies for the design problem 'shape adaption'. It is proposed that search results are handled using special cards describing the biological phenomena and the functional principles....

  9. Histologic analysis of a retrieved hydroxyapatite-coated femoral prosthesis

    DEFF Research Database (Denmark)

    Søballe, K; Gotfredsen, K; Brockstedt-Rasmussen, H

    1991-01-01

    A hydroxyapatite-coated hip hemi-prosthesis was retrieved from a 98-year-old osteoporotic woman 12 weeks after implantation. Histologic analysis revealed bone and fibrous tissue almost evenly distributed around the surface of the implant circumference. Quantitative histologic analysis showed...... that 48% of the hydroxyapatite surface was covered by bone. Fibrous tissue covered 30% of the prosthetic surface, and 20% of the surface had no tissue coverage. Scanning electron microscopy showed direct contact without any clear boundary between the newly formed bone and the hydroxyapatite ceramic....

  10. Rupture of an expander prosthesis mimics axillary cancer recurrence.

    LENUS (Irish Health Repository)

    Ismael, T

    2005-10-01

    Regional silicone gel migration from a ruptured breast implant has been reported at different locations including the upper extremity, chest wall muscles, axilla and back. We report a patient who presented with an axillary mass that mimicked a regional recurrence 5 years after breast cancer reconstruction with a latissimus dorsi musculocutaneous flap and silicon gel expander-prosthesis. Surgical exploration revealed that the mass contained silicone gel around the port of the breast expander that had ruptured. The mass was confluent with an intracapsular silicone leak through a tract along the tube of the expander port.

  11. Potential of an electric prosthesis for dynamic facial reanimation.

    Science.gov (United States)

    Griffin, Garrett R; Kim, Jennifer C

    2011-09-01

    Chronic facial paralysis is a devastating condition with severe functional and emotional consequences. The current surgical armamentarium permits the predictable reestablishment of a protective blink as well as good resting symmetry. Yet the ultimate goal of symmetric, spontaneous emotional expression remains elusive despite significant progress in the areas of peripheral nerve grafting and free tissue transfer. This commentary explores the possibility of an implantable electrical prosthesis for facial reanimation. It reviews animal studies supporting this concept as well as recent human data suggesting that such an implant could rescue denervated facial musculature, thus overcoming a major hurdle for existing reanimation techniques.

  12. Customised attachments retained cheek plumper prosthesis: a case report.

    Science.gov (United States)

    Keni, Nandita N; Aras, Meena A; Chitre, Vidya

    2012-09-01

    Emphasis on facial esthetics has become an integral part of dental treatment. Prosthetic rehabilitation of a completely edentulous patient no longer confines to only replacement of missing teeth. Patients are increasingly demanding improvement in esthetics at the end of treatment. Slumped or hollow cheeks can add years to a person's age. This article has described a simple, effective and noninvasive treatment alternative to improve facial appearance in a completely edentulous patient with hollow cheeks by making use of detachable plumper prosthesis using customised attachments.

  13. An implant versus a conventional fixed prosthesis: a case report.

    Science.gov (United States)

    Windhorn, Richard J; Cuenin, Michael F

    2007-01-01

    The success of endosseous implant dentistry is widely acknowledged. Clinical research and subsequent innovations with both surgical and restorative techniques--as well as improved surface features and restorative components--have made endosseous dental implants a routinely accepted dental treatment modality. Patients and referring clinicians often specifically request dental implant therapy. This article presents an example of such a patient; however, in this case, a surgical ridge augmentation and fabrication of a conventional fixed prosthesis was selected as the treatment modality. The authors believe that all therapeutic modalities should be considered when adapting appropriate treatment plans for individual patients.

  14. Seeing the light: a photonic visual prosthesis for the blind

    Science.gov (United States)

    Degenaar, Patrick; Grossman, Nir; McGovern, Brian; Neil, Mark; Drakakis, Emmanuel; Nikolic, Konstantin

    2009-02-01

    This paper highlights how the genetic incorporation of artificial opsins into the retina can lead to a new class of retinal prosthesis. We demonstrate the efficacy of incorporating channelrhodopsin into neuron cells in-vitro and show how that can be scaled to in-vivo. We show that we need typically 100mW/cm2 of instantaneous light intensity on the neuron in order to stimulate action potentials which results in 10W/cm2 required from the light source. We thus use GaN LED arrays to provide spatially controlled stimulation which is of sufficient brightness to stimulate the cells.

  15. Real-time simulation of hand motion for prosthesis control.

    Science.gov (United States)

    Blana, Dimitra; Chadwick, Edward K; van den Bogert, Antonie J; Murray, Wendy M

    2017-04-01

    Individuals with hand amputation suffer substantial loss of independence. Performance of sophisticated prostheses is limited by the ability to control them. To achieve natural and simultaneous control of all wrist and hand motions, we propose to use real-time biomechanical simulation to map between residual EMG and motions of the intact hand. Here we describe a musculoskeletal model of the hand using only extrinsic muscles to determine whether real-time performance is possible. Simulation is 1.3 times faster than real time, but the model is locally unstable. Methods are discussed to increase stability and make this approach suitable for prosthesis control.

  16. Structural valve deterioration in the Mitroflow biological heart valve prosthesis

    DEFF Research Database (Denmark)

    Issa, Issa Farah; Poulsen, Steen Hvitfeldt; Waziri, Farhad

    2018-01-01

    OBJECTIVES: Concern has been raised regarding the long-term durability of the Mitroflow biological heart valve prosthesis. Our aim was to assess the incidence of structural valve degeneration (SVD) for the Mitroflow bioprosthesis in a nationwide study in Denmark including all patients alive...... in Denmark who had received a Mitroflow aortic bioprosthesis since 2000. METHODS: Patients alive in Denmark with a Mitroflow bioprosthesis implanted since January 2000 were invited to participate in a nationwide cross-sectional study with a predefined definition of SVD. Of 1552 patients, 861 patients had...

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

    OpenAIRE

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

    2013-01-01

    Little is known about whether and how multimodal representations of the body (BRs) and of the space around the body (Peripersonal Space, PPS) adapt to amputation and prosthesis implantation. In order to investigate this issue, we tested BR in a group of upper limb amputees by means of a tactile distance perception task and PPS by means of an audio-tactile interaction task. Subjects performed the tasks with stimulation either on the healthy limb or the stump of the amputated limb, while wearin...

  18. Rehabilitation of orbital cavity after orbital exenteration using polymethyl methacrylate orbital prosthesis

    Directory of Open Access Journals (Sweden)

    Sumeet Jain

    2016-01-01

    Full Text Available Squamous cell carcinoma of the eyelid is the second most common malignant neoplasm of the eye with the incidence of 0.09 and 2.42 cases/100 000 people. Orbital invasion is a rare complication but, if recognized early, can be treated effectively with exenteration. Although with advancements in technology such as computer-aided design and computer-aided manufacturing, material science, and retentive methods like implants, orbital prosthesis with stock ocular prosthesis made of methyl methacrylate retained by anatomic undercuts is quiet effective and should not be overlooked and forgotten. This clinical report describes prosthetic rehabilitation of two male patients with polymethyl methacrylate resin orbital prosthesis after orbital exenteration, for squamous cell carcinoma of the upper eyelid. The orbital prosthesis was sufficiently retained by hard and soft tissue undercuts without any complications. The patients using the prosthesis are quite satisfied with the cosmetic results and felt comfortable attending the social events.

  19. Prosthesis infections after orthopedic joint replacement: the possible role of bacterial biofilms

    Directory of Open Access Journals (Sweden)

    Zhijun Song

    2013-06-01

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

  20. Axial penile rigidity influences patient and partner satisfaction after penile prosthesis implantation

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    Abdulla Al Ansari

    2013-09-01

    Full Text Available Introduction: Penile prosthesis implantation is one of the treatment choices that is kept for patients who were not satisfied with other treatments. Although penile prosthesis satisfaction rates are higher, there are some dissatisfied patients. The patients’ reasons are mostly shortness and softness of implanted prosthesis. It was previously demonstrated that penile axial rigidity of more than 500 grams is enough for successful vaginal intromission. To our knowledge, there is no study comparing axial rigidity of penile prosthesis and satisfaction. Objectives: The aim of this study was to examine whether axial rigidity of penile prosthesis had impact on patient and partner satisfaction. Materials and Methods: We enrolled one hundred patients who were implanted penile prosthesis before to evaluate their penile axial rigidity. We used Rigidometry (by using the digital inflection rigidometer to assess the minimal axial pressure to bend the implanted penis. Results: We demonstrated that mean axial pressure to bend the implanted penis was 984.8 ± 268.7 grams. Overall satisfaction score with the penile prosthesis implant was 4.55 and 4.49 (out of 5 in patients and partners, respectively. In total, seven men were unsatisfied with their implant and reported a mean satisfaction score of 0.6 ± 0.48 (out of 5. All prostheses types showed good and more than 500 grams axial rigidity. The patients with Ambicor type, which were buckled at about 710.5 grams, showed worse satisfaction rates in comparison to other prostheses in two patients. Digital inflection rigidometer results of other penile prosthesis types in unsatisfied patient were 842.0, 872.0, 887.0 and 920 g. in CX700, Titan, Genesis and Titan OTR, respectively. Conclusion: We demonstrated that dissatisfaction rate was highest in Ambicor prosthesis implanted patients. Additionally, patients with 3-piece penile prosthesis were more satisfied than 2-piece or malleable ones, interestingly, although

  1. Axial penile rigidity influences patient and partner satisfaction after penile prosthesis implantation.

    Science.gov (United States)

    Al Ansari, Abdulla; Talib, Raidh A; Canguven, Onder; Shamsodini, Ahmad

    2013-09-26

    Penile prosthesis implantation is one of the treatment choices that is kept for patients who were not satisfied with other treatments. Although penile prosthesis satisfaction rates are higher, there are some dissatisfied patients. The patients’ reasons are mostly shortness and softness of implanted prosthesis. It was previously demonstrated that penile axial rigidity of more than 500 grams is enough for successful vaginal intromission. To our knowledge, there is no study comparing axial rigidity of penile prosthesis and satisfaction. The aim of this study was to examine whether axial rigidity of penile prosthesis had impact on patient and partner satisfaction. We enrolled one hundred patients who were implanted penile prosthesis before to evaluate their penile axial rigidity. We used Rigidometry (by using the digital inflection rigidometer) to assess the minimal axial pressure to bend the implanted penis. We demonstrated that mean axial pressure to bend the implanted penis was 984.8 ± 268.7 grams. Overall satisfaction score with the penile prosthesis implant was 4.55 and 4.49 (out of 5) in patients and partners, respectively. In total, seven men were unsatisfied with their implant and reported a mean satisfaction score of 0.6 ± 0.48 (out of 5). All prostheses types showed good and more than 500 grams axial rigidity. The patients with Ambicor type, which were buckled at about 710.5 grams, showed worse satisfaction rates in comparison to other prostheses in two patients. Digital inflection rigidometer results of other penile prosthesis types in unsatisfied patient were 842.0, 872.0, 887.0 and 920 g. in CX700, Titan, Genesis and Titan OTR, respectively. We demonstrated that dissatisfaction rate was highest in Ambicor prosthesis implanted patients. Additionally, patients with 3-piece penile prosthesis were more satisfied than 2-piece or malleable ones, interestingly, although some cases had lower axial rigidity results.

  2. COMPARISON OF CULTURE OF SYNOVIAL FLUID, PERIPROSTHETIC TISSUE AND PROSTHESIS SONICATE FOR THE DIAGNOSIS OF KNEE PROSTHESIS INFECTION

    Directory of Open Access Journals (Sweden)

    Andrej Trampuž

    2003-03-01

    Full Text Available Background. Synovial fluid and periprosthetic tissue specimens are the standard specimens cultured for the diagnosis of prosthetic joint infection (PJI. We hypothesize that ultrasonication of the explanted prosthesis may improve diagnosis of PJI by dislodging biofilm bacteria from the prosthesis surface and improve the sensitivity and specificity of diagnosis of PJI.Methods. Included were patients undergoing knee prosthesis exchange for septic or biomechanical failure and have not received antimicrobial therapy in the last 2 weeks prior specimen collection. Cultures of synovial fluid and periprosthetic tissue specimens were performed per the usual clinical practice. Additionally, explanted joint components were sonicated for 5 minutes at frequency 40 kHz in sterile Ringer’s solution; aliquots of 0.5 ml sonicate were plated onto five aerobic and five anaerobic blood agar plates, and incubated at 37 °C and examined for the next seven days. The number and identity of each colony morphology was recorded.Results. 35 patients undergoing knee replacement have been studied (24 for aseptic biomechanical failure and 11 for suspected PJI. In patients with PJI, coagulase-negative staphylococci (7 cases, Corynebacterium spp. (2 cases, Staphylococcus aureus (1 case, and viridans group streptococcus (1 case were recovered. Culture sensitivity and specificity were for synovial fluid 88% and 100%, for periprosthetic tissue 83% and 81%, and for explant sonicate 91% and 100%, respectively. In sonicate cultures higher numbers of microorganisms than in periprosthetic tissue cultures were consistently detected.Conclusions. Using synovial fluid, periprosthetic tissue, and explant sonicate cultures, 12%, 17% and 9% of PJI were missed, respectively. Explant sonicate cultures were the most sensitive with respect to the diagnosis of PJI, indicating that explant ultrasonication may improve bacterial recovery. In sonicate cultures, infecting organisms were detected in

  3. MMG-based classification of muscle activity for prosthesis control.

    Science.gov (United States)

    Silva, J; Heim, W; Chau, T

    2004-01-01

    We have previously proposed the use of "muscle sounds" or mechanomyography (MMG) as a reliable alternative measure of muscle activity with the main objective of facilitating the use of more comfortable and functional soft silicone sockets with below-elbow externally powered prosthesis. This work describes an integrated strategy where data and sensor fusion algorithms are combined to provide MMG-based detection, estimation and classification of muscle activity. The proposed strategy represents the first ever attempt to generate multiple output signals for practical prosthesis control using a MMG multisensor array embedded distally within a silicon soft socket. This multisensor fusion strategy consists of two stages. The first is the detection stage which determines the presence or absence of muscle contractions in the acquired signals. Upon detection of a contraction, the second stage, that of classification, specifies the nature of the contraction and determines the corresponding control output. Tests with real amputees indicate that with the simple detection and classification algorithms proposed, MMG is indeed comparable to and may exceed EMG functionally.

  4. Assessment of Lower Limb Prosthesis through Wearable Sensors and Thermography

    Science.gov (United States)

    Cutti, Andrea Giovanni; Perego, Paolo; Fusca, Marcello C.; Sacchetti, Rinaldo; Andreoni, Giuseppe

    2014-01-01

    This study aimed to explore the application of infrared thermography in combination with ambulatory wearable monitoring of temperature and relative humidity, to assess the residual limb-to-liner interface in lower-limb prosthesis users. Five male traumatic transtibial amputees were involved, who reported no problems or discomfort while wearing the prosthesis. A thermal imaging camera was used to measure superficial thermal distribution maps of the stump. A wearable system for recording the temperature and relative humidity in up to four anatomical points was developed, tested in vitro and integrated with the measurement set. The parallel application of an infrared camera and wearable sensors provided complementary information. Four main Regions of Interest were identified on the stump (inferior patella, lateral/medial epicondyles, tibial tuberosity), with good inter-subject repeatability. An average increase of 20% in hot areas (P < 0.05) is shown after walking compared to resting conditions. The sensors inside the cuff did not provoke any discomfort during recordings and provide an inside of the thermal exchanges while walking and recording the temperature increase (a regime value is ∼+1.1 ± 0.7 °C) and a more significant one (∼+4.1 ± 2.3%) in humidity because of the sweat produced. This study has also begun the development of a reference data set for optimal socket/liner-stump construction. PMID:24618782

  5. Rehabilitation with ear prosthesis linked to osseointegrated implants.

    Science.gov (United States)

    Goiato, Marcelo C; dos Santos, Daniela M; Haddad, Marcela F; Moreno, Amália

    2012-06-01

    The absence of an ear, which can be the result of a congenital malformation, surgical tumour resection or traumatic injury, is a significant aesthetic problem. Attachment of ear prostheses with adhesives can cause local irritation for the wearer and affect the colour of the prostheses. Use of implants in craniofacial reconstruction can improve the retention and stability of prostheses giving to patient greater comfort and security relative to adhesive attachment. The aim of this report was to present a clinical case of a mutilated patient who was rehabilitated by means of installing an ear prosthesis fixed through osseointegrated implants. The patient had two implants installed in the mastoid region that were linked by a bar, and a clip-type system was used. The ear prosthesis was constructed from medical-use silicone, pigmented to match the patient's skin colour and linked to the retention system. The patient's rehabilitation was satisfactory from both a functional and an aesthetic point of view, making it possible for the patient to return to a normal social life and regain lost self-esteem. © 2012 The Gerodontology Society and John Wiley & Sons A/S.

  6. Assessment of Lower Limb Prosthesis through Wearable Sensors and Thermography

    Directory of Open Access Journals (Sweden)

    Andrea Giovanni Cutti

    2014-03-01

    Full Text Available This study aimed to explore the application of infrared thermography in combination with ambulatory wearable monitoring of temperature and relative humidity, to assess the residual limb-to-liner interface in lower-limb prosthesis users. Five male traumatic transtibial amputees were involved, who reported no problems or discomfort while wearing the prosthesis. A thermal imaging camera was used to measure superficial thermal distribution maps of the stump. A wearable system for recording the temperature and relative humidity in up to four anatomical points was developed, tested in vitro and integrated with the measurement set. The parallel application of an infrared camera and wearable sensors provided complementary information. Four main Regions of Interest were identified on the stump (inferior patella, lateral/medial epicondyles, tibial tuberosity, with good inter-subject repeatability. An average increase of 20% in hot areas (P < 0.05 is shown after walking compared to resting conditions. The sensors inside the cuff did not provoke any discomfort during recordings and provide an inside of the thermal exchanges while walking and recording the temperature increase (a regime value is ~+1.1 ± 0.7 °C and a more significant one (~+4.1 ± 2.3% in humidity because of the sweat produced. This study has also begun the development of a reference data set for optimal socket/liner-stump construction.

  7. Research on Architecture of the Prosthesis Shaping Equipment Control System

    Directory of Open Access Journals (Sweden)

    Kai Sun

    2014-06-01

    Full Text Available In order to realize a high speed and high accuracy prosthesis shaping equipment (PSE control system, this paper proposes a new software-hardware architecture of a five-axis high performance NC system. The software part of the proposed architecture follows the rules of the hierarchy and modularity. The inheritance, scalability, and stability are ensured on the whole system and local parts. According to the idea of modular design, the framework uses the client-server mode in the communication and scheduling level. With this way, the reliability of the module management is ensured. The hardware part of the proposed architecture consists of two main parts: the controller and I/O module. The controller is based on FPGA and uses PCI bus and IPC interface. The I/O module is based on ARM + CPLD and uses CAN bus to communicate with the controller. This paper also studies some key problems such as the driving signal producing mechanism. The results of prosthesis shaping equipment prototype show that the system which uses the proposed architecture can reach the positioning accuracy up to 0.02 mm and 3D typical surface cutting accuracy up to 0.02 mm, and this accuracy level already leads similar products in market.

  8. A new malleostapedotomy prosthesis. Experimental analysis by laser doppler vibrometer in fresh cadaver temporal bones.

    Science.gov (United States)

    Vallejo, Luis A; Manzano, María T; Hidalgo, Antonio; Hernández, Alberto; Sabas, Juan; Lara, Hugo; Gil-Carcedo, Elisa; Herrero, David

    One of the problems with total ossicular replacement prostheses is their stability. Prosthesis dislocations and extrusions are common in middle ear surgery. This is due to variations in endo-tympanic pressure as well as design defects. The design of this new prosthesis reduces this problem by being joined directly to the malleus handle. The aim of this study is to confirm adequate acoustic-mechanical behaviour in fresh cadaver middle ear of a new total ossicular replacement prosthesis, designed using the finite elements method. Using the doppler vibrometer laser, we analysed the acoustic-mechanical behaviour of a new total ossicular replacement prosthesis in the human middle ear using 10 temporal bones from fresh cadavers. The transfer function of the ears in which we implanted the new prosthesis was superimposed over the non-manipulated ear. This suggests optimum acoustic-mechanical behaviour. The titanium prosthesis analysed in this study demonstrated optimum acoustic-mechanical behaviour. Together with its ease of implantation and post-surgical stability, these factors make it a prosthesis to be kept in mind in ossicular reconstruction. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  9. Muscle and prosthesis contributions to amputee walking mechanics: a modeling study.

    Science.gov (United States)

    Silverman, Anne K; Neptune, Richard R

    2012-08-31

    Unilateral, below-knee amputees have altered gait mechanics, which can significantly affect their mobility. Below-knee amputees lose the functional use of the ankle muscles, which are critical during walking to provide body support, forward propulsion, leg-swing initiation and mediolateral balance. Thus, either muscles must compensate or the prosthesis must provide the functional tasks normally provided by the ankle muscles. Three-dimensional (3D) forward dynamics simulations of amputee and non-amputee walking were generated to identify muscle and prosthesis contributions to amputee walking mechanics, including the subtasks of body support, forward propulsion, leg-swing initiation and mediolateral balance. Results showed that the prosthesis provided body support in the absence of the ankle muscles. The prosthesis contributed to braking from early to mid-stance and propulsion in late stance. The prosthesis also functioned like the uniarticular soleus muscle by transferring energy from the residual leg to the trunk to provide trunk propulsion. The residual-leg vasti and rectus femoris reduced their contributions to braking in early stance, which mitigated braking from the prosthesis during this period. The prosthesis did not replace the function of the gastrocnemius, which normally generates energy to the leg to initiate swing. As a result, lower overall energy was delivered to the residual leg. The prosthesis also acted to accelerate the body laterally in the absence of the ankle muscles. These results provide further insight into muscle and prosthesis function in below-knee amputee walking and can help guide rehabilitation methods and device designs to improve amputee mobility. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. A new cervical artificial disc prosthesis based on physiological curvature of end plate: a finite element analysis.

    Science.gov (United States)

    Yu, Cheng-Cheng; Liu, Peng; Huang, Da-Geng; Jiang, Yong-Hong; Feng, Hang; Hao, Ding-Jun

    2016-11-01

    The study aimed to build a new cervical artificial disc C3-C7 segment prosthesis, and perform a biomechanical comparison between the new prosthesis and the Prestige LP prosthesis using a three-dimensional non-linear finite element (FE) model. The study compared the biomechanical differences between the new cervical artificial disc prosthesis based on the physiological curvature of the end plate and the Prestige LP prosthesis after artificial disc replacement. There has been no prior research on artificial disc prostheses based on the physiological curvature of the end plate; studies of biomechanical changes after cervical disc arthroplasty (CDR) are few. An FE model of the C3-C7 segments was developed and validated. A new cervical artificial disc prosthesis based on the physiological curvature of the end plate and the Prestige LP prosthesis were integrated at the C5-C6 segment into the validated FE model. All models were subjected to a follower load of 73.6 N and a 1 Nm in flexion-extension, lateral bending, and axial torsion. The segmental range of motion (ROM) and stress on the prostheses were analyzed. The ROM in most segments after CDR with new cervical artificial disc prosthesis was more similar to that of the normal cervical spine than the Prestige LP prosthesis. However, there was no significant difference between the two prostheses. The stress on the new artificial disc was significantly less than that in the Prestige LP prosthesis. There was no significant difference in ROM in all segments after CDR for the two prostheses. The stress on the new cervical artificial disc prosthesis based on the physiological curvature of the end plate was significantly less than that in the Prestige LP prosthesis. The new artificial disc prosthesis is feasible and effective, and can reduce the implant-bone interface stress on the end plate, which may be one of the causes of prosthesis subsidence. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Whole Body Awareness for Controlling a Robotic Transfemoral Prosthesis

    Directory of Open Access Journals (Sweden)

    Andrea Parri

    2017-05-01

    Full Text Available Restoring locomotion functionality of transfemoral amputees is essential for early rehabilitation treatment and for preserving mobility and independence in daily life. Research in wearable robotics fostered the development of innovative active mechatronic lower-limb prostheses designed with the goal to reduce the cognitive and physical effort of lower-limb amputees in rehabilitation and daily life activities. To ensure benefits to the users, active mechatronic prostheses are expected to be aware of the user intention and properly interact in a closed human-in-the-loop paradigm. In the state of the art various cognitive interfaces have been proposed to online decode the user's intention. Electromyography in combination with mechanical sensing such as inertial or pressure sensors is a widely adopted solution for driving active mechatronic prostheses. In this framework, researchers also explored targeted muscles re-innervation for an objective-oriented surgical amputation promoting wider usability of active prostheses. However, information kept by the neural component of the cognitive interface deteriorates in a prolonged use scenario due to electrodes-related issues, thereby undermining the correct functionality of the active prosthesis. The objective of this work is to present a novel controller for an active transfemoral prosthesis based on whole body awareness relying on a wireless distributed non-invasive sensory apparatus acting as cognitive interface. A finite-state machine controller based on signals monitored from the wearable interface performs subject-independent intention detection of functional tasks such as ground level walking, stair ascent, and sit-to-stand maneuvres and their main sub-phases. Experimental activities carried out with four transfemoral amputees (among them one dysvascular demonstrated high reliability of the controller capable of providing 100% accuracy rate in treadmill walking even for weak subjects and low walking

  12. Electrotactile EMG feedback improves the control of prosthesis grasping force

    Science.gov (United States)

    Schweisfurth, Meike A.; Markovic, Marko; Dosen, Strahinja; Teich, Florian; Graimann, Bernhard; Farina, Dario

    2016-10-01

    Objective. A drawback of active prostheses is that they detach the subject from the produced forces, thereby preventing direct mechanical feedback. This can be compensated by providing somatosensory feedback to the user through mechanical or electrical stimulation, which in turn may improve the utility, sense of embodiment, and thereby increase the acceptance rate. Approach. In this study, we compared a novel approach to closing the loop, namely EMG feedback (emgFB), to classic force feedback (forceFB), using electrotactile interface in a realistic task setup. Eleven intact-bodied subjects and one transradial amputee performed a routine grasping task while receiving emgFB or forceFB. The two feedback types were delivered through the same electrotactile interface, using a mixed spatial/frequency coding to transmit 8 discrete levels of the feedback variable. In emgFB, the stimulation transmitted the amplitude of the processed myoelectric signal generated by the subject (prosthesis input), and in forceFB the generated grasping force (prosthesis output). The task comprised 150 trials of routine grasping at six forces, randomly presented in blocks of five trials (same force). Interquartile range and changes in the absolute error (AE) distribution (magnitude and dispersion) with respect to the target level were used to assess precision and overall performance, respectively. Main results. Relative to forceFB, emgFB significantly improved the precision of myoelectric commands (min/max of the significant levels) for 23%/36% as well as the precision of force control for 12%/32%, in intact-bodied subjects. Also, the magnitude and dispersion of the AE distribution were reduced. The results were similar in the amputee, showing considerable improvements. Significance. Using emgFB, the subjects therefore decreased the uncertainty of the forward pathway. Since there is a correspondence between the EMG and force, where the former anticipates the latter, the emgFB allowed for

  13. Prosthetic management with a scleral prosthesis: an 'eye on an eye'.

    Science.gov (United States)

    Koralakunte, Pavankumar R; Basavapura, Nandeeshwar D; Budihal, Dhanyakumar H

    2014-04-01

    Eyes are an essential organ not only in terms of vision but also being an important component of facial expression. The loss of an eye has a crippling effect on the psychology of the patient. A natural eye is surgically removed by enucleation, evisceration or exenteration because of trauma, pathology or tumor. Treatment of such rehabilitation cases includes implant-retained and acrylic eye prostheses by a maxillofacial prosthodontist to restore the patient's quality of life. For economic reasons, a removable acrylic prosthesis is preferred over an implant-retained prosthesis. Here, we describe a case of a customized acrylic scleral shell prosthesis which showed excellent retention and esthetics.

  14. Phantom studies of triple photon absorptiometry and bone mineral measurement at a hip prosthesis

    Energy Technology Data Exchange (ETDEWEB)

    Farrell, T.J.; Webber, C.E. (Chedoke McMaster Hospitals, Hamilton, ON (Canada). Dept. of Nuclear Medicine)

    1992-03-01

    The feasibility of using triple photon absorptiometry (TPA) for the measurement of bone mineral mass about a hip prosthesis was examined. A theoretical expression describing the variance of TPA measurements was verified using a triple photon source and phantom materials which simulate the soft tissue-bone mineral-metal prosthesis system. The expression for the variance was used to determine an optimized set of photon energies. It was shown that a precision of 3% could be obtained for reasonable measurement times using this optimized set of energies and that TPA should be a feasible approach for measurement of bone mineral about a hip prosthesis. (orig.).

  15. An innovative impression technique for fabrication of a custom made ocular prosthesis

    Directory of Open Access Journals (Sweden)

    Sunil Chandra Tripuraneni

    2015-01-01

    Full Text Available Various impression and fitting techniques have been described in the past for restoring ocular defects. The present article describes a new direct impression technique for recording and rehabilitating ocular defects, by custom-made ocular prosthesis. All the techniques described in the history, mainly concentrated in recording the tissue surface of the defect, which made it difficult to contour the palpebral surface resulting in the poor esthetics of the prosthesis. The present impression technique uses heavy bodied polyvinyl siloxane impression material, which facilitates accurate recording of the tissue surface and the palpebral surface of the defect, resulting in the fabrication of functionally and esthetically acceptable prosthesis.

  16. Maxillary palatal ramp prosthesis: A prosthodontic solution to manage mandibular deviation following surgery

    Directory of Open Access Journals (Sweden)

    Sampa Ray (Bhattacharya

    2015-01-01

    Full Text Available Mandibular resection following surgical treatment for neoplastic lesions of the oral cavity leads to numerous complications including altered mandibular movements, disfigurement, difficult in swallowing, impaired speech and articulation, and deviation of the mandible towards the resected site. Various prosthetic methods are employed to reduce or minimize mandibular deviation and improve and restore the lost functions and esthetic, like maxillomandibular fixation, implant supported prosthesis, removable mandibular guide flange prosthesis, and palatal based guidance restoration. This clinical report describes the rehabilitation of a patient following segmental mandibulectomy using palatal ramp prosthesis.

  17. Metal release and metal allergy after total hip replacement with resurfacing versus conventional hybrid prosthesis

    DEFF Research Database (Denmark)

    Gustafson, Klas; Jakobsen, Stig Storgaard; Lorenzen, Nina D

    2014-01-01

    BACKGROUND: Metal-on-metal (MOM) total hip arthroplasties were reintroduced because of the problems with osteolysis and aseptic loosening related to polyethylene wear of early metal-on-polyethylene (MOP) arthroplasties. The volumetric wear rate has been greatly reduced with MOM arthroplasties......; however, because of nano-size wear particles, the absolute number has been greatly increased. Thus, a source of metal ion exposure with the potential to sensitize patients is present. We hypothesized that higher amounts of wear particles result in increased release of metal ions and ultimately lead...... to an increased incidence of metal allergy. METHODS: 52 hips in 52 patients (median age 60 (51-64) years, 30 women) were randomized to either a MOM hip resurfacing system (ReCap) or a standard MOP total hip arthoplasty (Mallory Head/Exeter). Spot urine samples were collected preoperatively, postoperatively, after...

  18. Static analysis of C-shape SMA middle ear prosthesis

    Science.gov (United States)

    Latalski, Jarosław; Rusinek, Rafał

    2017-08-01

    Shape memory alloys are a family of metals with the ability to change specimen shape depending on their temperature. This unique property is useful in many areas of mechanical and biomechanical engineering. A new half-ring middle ear prosthesis design made of a shape memory alloy, that is undergoing initial clinical tests, is investigated in this research paper. The analytical model of the studied structure made of nonlinear constitutive material is solved to identify the temperature-dependent stiffness characteristics of the proposed design on the basis of the Crotti-Engesser theorem. The final integral expression for the element deflection is highly complex, thus the solution has to be computed numerically. The final results show the proposed shape memory C-shape element to behave linearly in the analysed range of loadings and temperatures. This is an important observation that significantly simplifies the analysis of the prototype structure and opens wide perspectives for further possible applications of shape memory alloys.

  19. A provisional fixed partial denture for an implant prosthesis.

    Science.gov (United States)

    Hansen, Paul A; Kim, Eunghwan

    2010-01-01

    This article presents a technique for fabricating an esthetic provisional restoration on multiple implants. Fabricating a provisional restoration allows the dentist to make a replica of the desired restoration. The incisal edge can be placed for esthetics and function in the new provisional restoration, allowing patients to evaluate comfort and test their ability to speak with the contour of the provisional restoration. Patients can evaluate both the ease of cleaning the restoration and how tissue esthetics can be duplicated to their satisfaction. By adding acrylic resin to or removing it from the provisional, the dentist can easily change the restoration until the patient is satisfied with the esthetic and functional result. This technique will allow the dentist to fabricate the provisional prosthesis quickly, while the patient is in the chair.

  20. PARS PLANA VITRECTOMY THROUGH A CUSTOM FLEXIBLE IRIS PROSTHESIS.

    Science.gov (United States)

    Toygar, Okan; Snyder, Michael E; Riemann, Christopher D

    2016-08-01

    To demonstrate the outcomes of pars plana vitrectomy in patients with custom flexible iris prosthesis (CFIP). The medical records of patients who underwent CFIP placement were retrospectively reviewed. Patients who underwent pars plana vitrectomy concurrent with or after placement of CFIP were identified. Preoperative, intraoperative, and postoperative parameters were analyzed. Surgeons were surveyed regarding the technical aspects of the vitreoretinal surgery. Outcome measures included: anatomic success, complications, surgeon-rated ease of visualization through CFIP during pars plana vitrectomy, and Snellen best-corrected visual acuity. Twenty-four surgeries were performed in 20 eyes of 20 patients. Postoperative best-corrected visual acuity improved in 11 eyes (55%), remained unchanged in 5 eyes (25%), and declined in 4 eyes (20%) after a mean follow-up of 16.1 ± 16.\

  1. Evaluation of Strength in the ``Toronto'' Osseous-Prosthesis System

    Science.gov (United States)

    Giacomo, R.; Cicciã¹, M.; Dini, R.; Franceschini, G.; Maiorana, C.

    2010-06-01

    Several surgical techniques like are today available in order to recovery large bone defects of the jaw. Aim of the surgeon is to obtain a good tridimensional volume to place dental implant and to recovery the patient’s aesthetics and function. Several prosthetic solution were considered for prosthetic rehabilitation. However after a bone graft surgery Toronto screwed prosthesis on dental implants, following Branemark intuitions, was considered the better prosthetic rehabilitation solution. According to Wölff, the dental implants osteointegration is related to the strengths directed to mandibular bone. Our investigation’s aim is to underline through FEM analysis the stress over the prosthetic elements and over bone surface in order to help the surgeon choice about the dental implant positioning, and at the same time reducing the bone trauma on the patients.

  2. Implantable optrode design for optogenetic visual cortical prosthesis

    Science.gov (United States)

    Dong, Na; Sun, Xiaohan; Degenaar, Patrick

    2012-02-01

    The rise of optogenetic neural stimulation has opened new opportunities for neuroprosthesis such as visual cortical prosthesis, which necessitates an efficient delivery of light into the cortex. New forms of photosensitizing channelrhodopsin are reducing the required light intensities for stimulation, but implantable systems need to be highly efficient. Such efficiency calls for low loss in the transmission path, high coupling efficiency between the optic delivery system and optical emitter, as well as emitting efficiency from the light emitting diode. In this paper, we perform simulation results based on ray optics and illuminating theory as to the best strategy to attachment of optrode structures to Gallium Nitride-μLED arrays so as to maximize the efficiency of light delivery to the target neural tissue.Our results show that it is feasible to connect optrode elements and GaN-μLEDarrays for cortical stimulation and describe the optimisation requirements.

  3. [Infection of a hip prosthesis after dry needling].

    Science.gov (United States)

    Steentjes, Koen; de Vries, Lieke M A; Ridwan, Ben U; Wijgman, A J Jurgen

    2016-01-01

    A 57-year-old patient presented to the orthopaedic department with hip pain 7 months after hip replacement and two weeks after dry needling by a physiotherapist. Dry needling is used by physiotherapists to treat pain and stiffness. In the Netherlands, there are no clear guidelines or contra-indications described for this treatment. The surgical scar of our patient showed signs of inflammation for which debridement and irrigation were performed. Tissue samples showed positive bacterial cultures and the patient was treated with antibiotics. One week after completing this treatment, the infection returned. Debridement and irrigation were repeated and antibiotic treatment was recommenced. Three months later, the patient showed no signs of infection with the prosthesis still in situ. Although there is no strong evidence for a causal relationship between dry needling and the infection, dry needling should be used carefully in patients with a joint replacement, due to the increased risk of infection.

  4. [Multicentre study of infection incidence in knee prosthesis].

    Science.gov (United States)

    Jaén, F; Sanz-Gallardo, M I; Arrazola, M P; García de Codes, A; de Juanes, A; Resines, C

    2012-01-01

    To determine the incidence of surgical site infection in knee prosthesis surgical procedure for a follow-up period of one year in twelve hospitals in Madrid region. A prospective study was carried out from January to December 2009 using a national surveillance system called Indicadores Clínicos de Mejora Continua de Calidad. Primary and revision knee joint replacements in patients operated on in the previous year were included. Criteria used to define surgical site infection and patient risk index categories were those established by the Centers for Disease Control and Prevention and National Nosocomial Infections Surveillance. The incidence rates were worked out crude and adjusted by hazard ratio. 2,088 knee prosthesis procedures were analyzed. The overall incidence of surgical site infection was 2.1%. Sixty-five percent of the infections were organ/space. Sixty percent of the infections were identified in the early postoperative period. Of all surgical site infections, 41.9% were microbiologically confirmed. Antibiotic prophylaxis was implemented correctly in 63.3% of the cases. The most important cause of inappropriate prophylaxis was an unsuitable duration in 85.7% of the cases. The presurgical preparation was carried out correctly in 50.3% of surgical operations. The incidence of knee arthroplasty infection was twice as high as in the National Healthcare Safety Network and similar to national rates. In this study, the incidence of infection was within the range of infection rates in other published European studies. Surveillance and control strategies of health care for associated infections allow us to assess trends and the impact of preventive measures. Copyright © 2011 SECOT. Published by Elsevier Espana. All rights reserved.

  5. Radial head replacement with pyrocarbon prosthesis: early clinical results.

    Science.gov (United States)

    Abdulla, Irfan N; Molony, Diarmuid C; Symes, Michael; Cass, Benjamin

    2015-05-01

    Comminuted radial head fractures are challenging to treat with open reduction and internal fixation. Radial head arthroplasty is a favourable technique for the treatment of complex radial head fractures. The purpose of this study was to evaluate the functional and radiological outcomes of radial head arthroplasty using modular pyrocarbon radial head prosthesis. We retrospectively reviewed 21 consecutive patients requiring radial head arthroplasty for unreconstructible radial head fractures between July 2003 and July 2009. Patients completed a Short Form-36 (SF-36), the Disabilities of the Arm, Shoulder and Hand questionnaire, and the Mayo Elbow Performance Index. Patients were independently physically examined and their post-operative radiographs were reviewed. Twenty-one patients (nine males and 12 females) were reviewed at a minimum of 12 months follow-up. The mean Disabilities of the Arm, Shoulder and Hand score was 10.8 (0-34.1), mean SF-36 physical score was 76.9 (35-96), mean SF-36 mental score was 83.8 (60-94), and their Mayo Elbow Performance Index score was 86.4 (70-100). Patients maintained 90% of their grip strength when compared with their uninjured arm and had 17.5° of fixed flexion in the affected arm. Radiologically, 14 cases had some degree of post-traumatic osteoarthritis, 12 cases had evidence of heterotrophic ossification, five had some evidence of periprosthetic lucency and three patients were radiologically, but not functionally 'overstuffed'. Radial head arthroplasty with pyrocarbon radial head prosthesis is an acceptable option when treating unreconstructable radial head fractures yielding good functional and radiological outcomes. © 2014 Royal Australasian College of Surgeons.

  6. Dorsal Phalloplasty to Preserve Penis Length after Penile Prosthesis Implantation.

    Science.gov (United States)

    Shaeer, Osama; Shaeer, Kamal; Rahman, Islam A

    2017-02-01

    Following penile prosthesis implantation (PPI), patients may complain of a decrease in visible penis length. A dorsal phalloplasty defines the penopubic junction by tacking pubic skin to the pubis, revealing the base of the penis. This study aimed to evaluate the efficacy of a dorsal phalloplasty in increasing the visible penis length following PPI. An inflatable penile prosthesis was implanted in 13 patients with severe erectile dysfunction (ED) at the Kamal Shaeer Hospital, Cairo, Egypt, from January 2013 to May 2014. During the surgery, nonabsorbable tacking sutures were used to pin the pubic skin to the pubis through the same penoscrotal incision. Intraoperative penis length was measured before and after the dorsal phalloplasty. Overall patient satisfaction was measured on a 5-point rating scale and patients were requested to subjectively compare their postoperative penis length with memories of their penis length before the onset of ED. Intraoperatively, the dorsal phalloplasty increased the visible length of the erect penis by an average of 25.6%. The average length before and after tacking was 10.2 ± 2.9 cm and 13.7 ± 2.8 cm, respectively (P <0.002). Postoperatively, seven patients (53.8%) reported a longer penis, five patients (38.5%) reported no change in length and one patient (7.7%) reported a slightly shorter penis. The mean overall patient satisfaction score was 4.9 ± 0.3. None of the patients developed postoperative complications. A dorsal phalloplasty during PPI is an effective method of increasing visible penis length, therefore minimising the impression of a shorter penis after implantation.

  7. Morphologic features of biocompatibility and neoangiogenesis onto a biodegradable tracheal prosthesis in an animal model

    National Research Council Canada - National Science Library

    Brizzola, Stefano; de Eguileor, Magda; Brevini, Tiziana; Grimaldi, Annalisa; Congiu, Terenzio; Neuenschwander, Peter; Acocella, Fabio

    2009-01-01

    ... (Degrapol ® ) tracheal prosthesis in an in-vivo angiogenesis-inducing animal model focusing on the specific tissue reaction, the neo-angiogenesis and also the eventual cathepsin B role during the polymer degradation...

  8. Effect of silicone gel breast prosthesis on electron and photon dose distributions

    Energy Technology Data Exchange (ETDEWEB)

    Krishnan, L.; St. George, F.J.; Mansfield, C.M.; Krishnan, E.C.

    1983-01-01

    The effect of a silicone gel breast prosthesis on the absorbed dose distribution of 9--20 MeV electron beams and 1.25--15 MV photon beams was studied. Compared to water measurements, at depths smaller than the practical range of the electron beams, the central axis depth dose values below the prothesis were lower for all energies by as much as 3.5%. However, at depths near the practical range, the central axis depth dose values for the prosthesis were greater than that of water by as much as 33%. Since this occurs near the end of the electron range, the resultant difference may not be clinically significant. Results of the effect of breast prosthesis on photon depth dose distributions reveal that no clinically significant perturbation is produced by the breast prosthesis using Co-60, 6- and 15-MV radiations.

  9. 21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... humeral (hemi-elbow) metallic uncemented prosthesis is a device intended to be implanted made of alloys, such as cobalt-chromium-molybdenum, that is used to replace the distal end of the humerus formed by the...

  10. Restoration of an atrophic eye socket with custom made eye prosthesis, utilizing digital photography.

    Science.gov (United States)

    Jayaswal, Gaurav P; Dange, S P; Khalikar, A N

    2011-01-01

    Ocular defects may cause several ocular and orbital disorders, which require surgical intervention. These defects are psychologically disturbing for the patients, and therefore, they require immediate management and rehabilitation by a team of specialist. Ocular prosthesis may be either readymade (stock) or custom made. Fabrication of a custom ocular prosthesis allows for a range of variations during construction. The iris can also be custom made by ocular painting or by digital photography. The optimum cosmetic and functional results of a custom-made prosthesis enhance the patient's rehabilitation to a normal life style. This paper elaborates the technique for fabrication of a custom-made ocular prosthesis for an atrophic eye socket utilizing digital photography.

  11. Restoration of an atrophic eye socket with custom made eye prosthesis, utilizing digital photography

    Directory of Open Access Journals (Sweden)

    Gaurav P Jayaswal

    2011-01-01

    Full Text Available Ocular defects may cause several ocular and orbital disorders, which require surgical intervention. These defects are psychologically disturbing for the patients, and therefore, they require immediate management and rehabilitation by a team of specialist. Ocular prosthesis may be either readymade (stock or custom made. Fabrication of a custom ocular prosthesis allows for a range of variations during construction. The iris can also be custom made by ocular painting or by digital photography. The optimum cosmetic and functional results of a custom-made prosthesis enhance the patient′s rehabilitation to a normal life style. This paper elaborates the technique for fabrication of a custom-made ocular prosthesis for an atrophic eye socket utilizing digital photography.

  12. Rehabilitation of a Partial Nasal Defect with Facial Prosthesis: A Case Report

    Directory of Open Access Journals (Sweden)

    Ramin Negahdari

    2014-12-01

    Full Text Available Malignancies of the midface result in cosmetic deformities that make maxillofacial prosthesis as an integral part of the treatment plan. Facial defects can be devastating in their impact on physical structure and function of the affected individual, leading to potentional compromises in quality of life. Reconstruction of nasal defects is a challenge for the prosthodontist because of esthetic and retention problems associated with the facial prosthesis. This paper reports the rehabilitation of a partial nasal defect caused by basal cell carcinoma treatment using a nasal prosthesis made with silicone elastomers and mechanical and anatomical retentive aids. The patient had no problem with the prosthesis, except for a partial loss of extrinsic coloration in the two-year follow-up.

  13. EXPERIENCE WITH IN ON-X PROSTHESIS IN HEART VALVE REPLACEMENT

    Directory of Open Access Journals (Sweden)

    M. A. Sazonenkov

    2010-01-01

    Full Text Available The prosthesis ON-X carcas has advantages in implantation commodity and safety, effective orifice area. We pe- sent results of this prosthesis usage during perioud of 2006–2009 years. This time 792 operations with AC were completed. In mitral position were implanted 132 (91,7% prostheses ON-X. Of them 80 (60,6% valves were sutured with complete or partial preservation of posterior leaflet and 26 (19,7% valves – with total MV preser- vation. In aortic position we implanted 76 (53,9% valves ON-X. Only 3 cases needed posterior aortoplasty for the N 23 prosthesis implantation. In perioperative and late postoperative periods we didn’t meet prostheses thrombosis or dysfunction. Reoperati- ons for high prosthesis gradients didn’t occur in postoperative period. Late postoperatively there were 3 (1,1% cases of embolic events related to the incorrect anticoagulant treatment. 

  14. Design of a power-asymmetric actuator for a transtibial prosthesis.

    Science.gov (United States)

    Bartlett, Harrison L; Lawson, Brian E; Goldfarb, Michael

    2017-07-01

    This paper presents the design and characterization of a power-asymmetric actuator for a transtibial prosthesis. The device is designed to provide the combination of: 1) joint locking, 2) high power dissipation, and 3) low power generation. This actuator functionality allows for a prosthesis to be designed with minimal mass and power consumption relative to a fully-powered robotic prosthesis while maintaining much of the functionality necessary for activities of daily living. The actuator achieves these design characteristics while maintaining a small form factor by leveraging a combination of electromechanical and hydraulic components. The design of the actuator is described herein, and results of an experimental characterization are provided that indicate that the actuator is capable of providing the functional capabilities required of an ankle prosthesis in a compact and lightweight package.

  15. Dual Window Pattern Recognition Classifier for Improved Partial-Hand Prosthesis Control

    National Research Council Canada - National Science Library

    Earley, Eric J; Hargrove, Levi J; Kuiken, Todd A

    2016-01-01

    Although partial-hand amputees largely retain the ability to use their wrist, it is difficult to preserve wrist motion while using a myoelectric partial-hand prosthesis without severely impacting control performance. Electromyogram (EMG...

  16. Visual and Non-Visual Navigation in Blind Patients with a Retinal Prosthesis: e0134369

    National Research Council Canada - National Science Library

    Sara Garcia; Karin Petrini; Gary S Rubin; Lyndon Da Cruz; Marko Nardini

    2015-01-01

    .... Here we asked whether blind individuals treated with a retinal prosthesis could also benefit from using the resultant new visual signal together with non-visual information when navigating. Four patients...

  17. Visual and Non-Visual Navigation in Blind Patients with a Retinal Prosthesis

    National Research Council Canada - National Science Library

    Garcia, Sara; Petrini, Karin; Rubin, Gary S; Da Cruz, Lyndon; Nardini, Marko

    2015-01-01

    .... Here we asked whether blind individuals treated with a retinal prosthesis could also benefit from using the resultant new visual signal together with non-visual information when navigating. Four patients...

  18. Esthetic transformation of a failed implant reconstruction to fixed-supported prosthesis: a case report.

    Science.gov (United States)

    Cascione, Domenico; Nowzari, Hessam; Reshad, Mamaly

    2012-06-01

    This article describes a clinical situation where an ill-fitting prosthesis supported by malpositioned dental implants was esthetically transformed to fixed definitive restorations. Provisional restorations were used as a blueprint for fabrication of definitive restorations.

  19. Microbial contamination of removable dental prosthesis at different interval of usage: An in vitro study

    Directory of Open Access Journals (Sweden)

    Vijita Vijay Nair

    2016-01-01

    Conclusion: There is a linear increase in microbial contamination of removable dental prosthesis as the duration of usage increases and might increase the susceptibility of individuals' to many diseases.

  20. Effects of prosthetic foot forefoot flexibility on gait of unilateral transtibial prosthesis users

    National Research Council Canada - National Science Library

    Klodd, Elizabeth; Hansen, Andrew; Fatone, Stefania; Edwards, Mark

    2010-01-01

    Five solid-ankle experimental prosthetic feet were used in this double-blind randomized crossover study to determine the effects of forefoot flexibility on gait of 14 unilateral transtibial prosthesis users...

  1. Load applied on bone-anchored transfemoral prosthesis: Characterization of a prosthesis—A pilot study

    OpenAIRE

    Laurent Frossard, PhD; Eva Häggström, CPO; Kerstin Hagberg, PhD; Rickard Brånemark, MD, PhD

    2013-01-01

    The objectives of this study were to (1) record the inner-prosthesis loading during activities of daily living (ADLs), (2) present a set of variables comparing loading data, and (3) provide an example of characterization of two prostheses. The load was measured at 200 Hz using a multi-axial transducer mounted between the residuum and the knee of an individual with unilateral transfemoral amputation fitted with a bone-anchored prosthesis. The load was measured while using two different prosthe...

  2. Testicular prosthesis: Patient satisfaction and sexual dysfunctions in testis cancer survivors

    Directory of Open Access Journals (Sweden)

    Francesco Catanzariti

    2016-10-01

    Full Text Available Purpose: We studied patient satisfaction about sexual activity after prosthesis implantation using validated questionnaires with the aim to discover if testicular prosthesis could be responsible of sexual dysfunctions (erectile dysfunction or premature ejaculation. Materials and Methods: We evaluated a total of 67 men who underwent radical orchiectomy for testicular cancer and a silicon testicular prosthesis implantation from January 2008 to June 2014 at our Hospital. These patients completed 5 validated questionnaires the day before orchiectomy and 6 months after surgery: the International Index of Erectile Function 5 (IIEF5, the Premature Ejaculation Diagnostic Tool (PEDT, the Body Exposure during Sexual Activities Questionnaire (BESAQ, the Body-Esteem Scale and the Rosenberg Self- Esteem Scale. We also evaluated 6 months after surgery any defects of the prosthesis complained by the patients. Results: The questionnaires completed by patients didn’t show statistically significant changes for erectile dysfunction (p > 0.05 and premature ejaculation (p > 0.05. On the contrary the psychological questionnaires showed statistically significant change for the BESAQ (p < 0.001 and the Body Esteem Scale (p < 0.001, but not for the Rosenberg Self-Esteem Scale (p > 0,05. A total of 15 patients (22.37% were dissatisfied about the prosthesis: the most frequent complaint (8 patients; 11.94% was that the prosthesis was firmer than the normal testis. Conclusions: Testicular prosthesis implantation is a safe surgical procedure that should be always proposed before orchiectomy for cancer of the testis. The defects complained by patients with testicular prosthesis are few, they don’t influence sexual activity and they aren’t able to cause erectile dysfunction or premature ejaculation.

  3. Implant-supported hybrid prosthesis: Conventional treatment method for borderline cases

    OpenAIRE

    Egilmez, Ferhan; Ergun, Gulfem; Cekic-Nagas, Isil; Bozkaya, Suleyman

    2015-01-01

    An implant-supported hybrid prosthesis is an acrylic resin complete fixed dental prosthesis and supported by implants might be a solution in extreme cases that the need of the restoration for esthetics, function, lip support, and speech. This clinical report aims to present the esthetic and functional prosthetic rehabilitation of three borderline cases with implant-supported hybrid prostheses. Patient 1 (62-year-old man) and Patient 2 (61-year-old man) presented a chief complaint of a comprom...

  4. Thrust plate prosthesis for proximal femoral deformity: a series of 15 patients

    OpenAIRE

    Karatosun, Vasfi; Ünver, Bayram; Gultekin, Alper; Gunal, Izge

    2011-01-01

    Objectives: Patients with coxarthrosis and proximal femoral deformity experience problems with total hip arthroplasty. A custom-made prosthesis or a proximal osteotomy is required for such cases, and these also increase the rate of complications. The purpose of this study was to evaluate the results of the thrust plate prosthesis (TPP) in patients with deformity of the proximal femur. Methods: Fifteen patients (7 females, 8 males) with a mean age of 56.4 years (range 19-75 years) at the...

  5. [Vascular access for haemodyalisis. Comparative analysis of the mechanical behaviour of native vessels and prosthesis].

    Science.gov (United States)

    Bia, D; Zócalo, Y; Armentano, R; Pérez, H; Cabrera, E; Saldías, M; Galli, C; Alvarez, I

    2006-01-01

    The prosthesis nowadays used in the vascular access for haemodialysis have low patency rates, mainly due to the luminal obstruction, determined by the intimal hyperplasia. Several factors have been related to de development of intimal hyperplasia and graft failure. Among them are the differences in the biomechanical properties between the prosthesis and the native vessels. In the searching for vascular prosthesis that overcomes the limitations of the currently used, the cryopreserved vessels (cryografts) appear as an alternative of growing interest. However, it is unknown if the mechanical differences or mismatch between prosthesis and native vessels are lesser when using cryografts. To characterize and compare the biomechanical behaviour of native vessels used in vascular access and cryografts. Additionally, segments of expanded polytetrafluoroethylene (ePTFE) were also evaluated, so as to evaluate the potential biomechanical advantages of the cryografts respect to synthetic prosthesis used in vascular access. Segments from human humeral (n = 12), carotid (n = 12) and femoral (n = 12) arteries, and saphenous vein (n = 12), were obtained from 6 multiorgan donors. The humeral arteries were studied in fresh state. The other segments were divided into two groups, and 6 segments from each vessel were studied in fresh state, while the remaining 6 segments were evaluated after 30 days of criopreservation. For the mechanical evaluation the vascular segments and 6 segments of ePTFE were mounted in a circulation mock and submitted to haemodynamic conditions similar to those of the in vivo. Instantaneous pressure (Konigsberg) and diameter (Sonomicrometry) were measured and used to calculate the viscous and elastic indexes, the compliance, distensibility and characteristic impedance. For each mechanical parameter studied, the mismatch between the prosthesis and the native vessel was evaluated. The ePTFE was the prosthesis with the higher mechanical mismatch (p vascular

  6. Computer modelling of the mechanical behaviour of the cervical spine segment and intervertebral disk prosthesis

    Science.gov (United States)

    Kolmakova, T. V.; Rikun, Y. A.

    2017-10-01

    The article describes the model of intervertebral disc prosthesis and the results of study of mechanical behavior of the cervical spine segment. The results show that degenerative changes in the intervertebral disc lead to a change in the location of the regions of maximum Mises stresses in cervical spine segment. The presented geometric model of the intervertebral disc prosthesis is based on the experimental sample of a ceramic endoprosthesis developed at the Institute of Strength Physics and Materials Science SB RAS.

  7. A Modified Design for Posterior Inlay-Retained Fixed Dental Prosthesis

    OpenAIRE

    Abdulaziz Samran; Mohammad Zakaria Nassani; Marwan Aswad; Amid Abdulkarim

    2015-01-01

    The aim of this paper is to report a clinical case with bilateral missing mandibular second premolars that were restored by metal-ceramic inlay-retained fixed dental prostheses. The first prosthesis was of a traditional design and the second was of a modified design. The suggested design is created by modifying the retainer wings of the traditional resin-bonded inlay-retained fixed dental prosthesis and covering the wings with composite resin. The modified design is relatively conservative, e...

  8. Candida albicans, Staphylococcus aureus and Streptococcus mutans colonization in patients wearing dental prosthesis.

    Science.gov (United States)

    Baena-Monroy, Tania; Moreno-Maldonado, Víctor; Franco-Martínez, Fernando; Aldape-Barrios, Beatriz; Quindós, Guillermo; Sánchez-Vargas, Luis Octavio

    2005-04-01

    Denture stomatitis is associated to Candida albicans, different bacteria and other co-factors such as an acid pH, a carbohydrate ingestion increase, different systemic illnesses and pharmacological treatments. The aim of this study was to determine Candida albicans, Staphylococcus aureus and Streptococcus mutans prevalence in the mucous membrane and prosthesis of patients with and without atrophic denture stomatitis and its relationship with other potential clinical co-factors. Saliva was collected from 105 patients (62 female and 43 male) wearing dental prosthesis in order to measure their pH. Oral samples of the mucous membrane and the internal surface of dental prosthesis were taken with sterile cotton to proceed with the microbiological study. The identification of the isolated microorganisms was performed using conventional microbiological methods. Diabetes and Hypertension were the most frequent systemic illnesses. High carbohydrate ingestion was observed in numerous patients. Atrophic denture stomatitis was reported in 50 patients and the pH average in saliva was of 5.2. The presence of C albicans, S. aureus and S. mutans in the mucous membrane and prosthesis was of 51.4%, 52.4% and 67.6%, respectively. C. albicans was isolated in 66.7% from the prosthesis, whereas S. aureus and S. mutans were isolated in 49.5% of those same prosthesis. C. albicans was isolated in 86% of the patients with atrophic denture stomatitis and S. aureus was isolated in a similar percentage (84% of patients). The isolation of S. mutans was less frequent, and it was observed in 16% of the oral samples of these patients. C. albicans, S. aureus and S. mutans frequently colonize the oral mucous of patients wearing dental prosthesis. This illness-bearing condition is more frequent in patients with denture stomatitis, even though dental prosthesis colonization is lower than in the oral mucous.

  9. Prosthesis-Patient Mismatch After Aortic Valve Replacement: Effect on Long-Term Survival.

    Science.gov (United States)

    Swinkels, Ben M; de Mol, Bas A; Kelder, Johannes C; Vermeulen, Freddy E; ten Berg, Jurriën M

    2016-04-01

    Mean follow-up in previous studies on the effect of prosthesis-patient mismatch on long-term survival after aortic valve replacement (AVR) is confined to a maximum of one decade. This retrospective longitudinal cohort study was performed to determine the effect on long-term survival of prosthesis-patient mismatch after AVR with a mean follow-up of almost two decades. Kaplan-Meier survival analysis was used to determine long-term survival after AVR in a cohort of 673 consecutive patients, divided into 163 patients (24.2%) with prosthesis-patient mismatch (indexed effective orifice area ≤ 0.85 cm(2)/m(2)) and 510 patients (75.8%) without prosthesis-patient mismatch (indexed effective orifice area >0.85 cm(2)/m(2)). Effective orifice area values of the prosthetic valves were retrieved from the literature or obtained from the charts of the prosthetic valve manufacturers. Cox multiple regression analysis was used to identify possible independent predictors, including prosthesis-patient mismatch, of decreased long-term survival. Median sizes of the implanted mechanical (n = 430) and biologic (n = 243) prostheses were 25 and 23 mm, respectively. Mean follow-up after AVR was 17.8 ± 1.8 years. Prosthesis-patient mismatch was not an independent predictor of decreased long-term survival (hazard ratio, 0.828; 95% confidence interval, 0.669 to 1.025; p = 0.083). Severe prosthesis-patient mismatch (indexed effective orifice area ≤ 0.65 cm(2)/m(2)), occurring in only 17 patients (2.5%), showed an insignificant trend toward decreased long-term survival (hazard ratio, 1.68; 95% confidence interval, 0.97 to 2.91; p = 0.066). Prosthesis-patient mismatch was not an independent predictor of decreased long-term survival after AVR. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Mechanical properties of ramie fiber reinforced epoxy lamina composite for socket prosthesis

    OpenAIRE

    Tresna Soemardi; Widjajalaksmi Kusumaningsih; Agustinus Irawan

    2010-01-01

    This paper presents an investigation into the application of natural fiber composite especially ramie fiber reinforced epoxy lamina composite for socket prosthesis. The research focuses on the tensile and shear strength from ramie fiber reinforced epoxy lamina composite which will be applied as alternative material for socket prosthesis. The research based on American Society for Testing Material (ASTM) standard D 3039/D 3039M for tensile strength and ASTM D 4255/D 42...

  11. The reverse shoulder prosthesis: a review of imaging features and complications

    Energy Technology Data Exchange (ETDEWEB)

    McFarland, Edward G.; Sanguanjit, Prakasit; Tasaki, Atsushi [Johns Hopkins University, Department of Orthopedic Surgery, Lutherville, MD (United States); Keyurapan, Ekavit [Mahidol University, Department of Orthopaedic Surgery, Bangkok (Thailand); Fishman, Elliot K.; Fayad, Laura M. [Johns Hopkins Medical Institutions, Johns Hopkins University, Department of Radiology and Radiological Sciences, Baltimore, MD (United States)

    2006-07-15

    The reverse shoulder prosthesis is a prosthesis that has been in clinical use in Europe since 1985 and was approved for use in the United States in 2004. This unique prosthesis has a baseplate attached to the glenoid, which holds a spherical component, while the humeral component includes a polyethylene insert that is flat. This design is the ''reverse'' configuration of that seen with a conventional arthroplasty, in which the spherical component is part of the humeral component. The indications for the reverse prosthesis are: (1) painful arthritis associated with irreparable rotator cuff tears (cuff tear arthropathy), (2) failed hemiarthroplasty with irreparable rotator cuff tears, (3) pseudoparalysis due to massive, irreparable rotator cuff tears, (4) some reconstructions after tumor resection, and (5) some fractures of the shoulder not repairable or reconstructable with other techniques. This prosthesis can produce a significant reduction in pain and some improvement in function for most of the indications mentioned. However, the unique configuration and the challenge of its insertion can result in a high incidence of a wide variety of unusual complications. Some of these complications, such as dislocation of the components, are similar to conventional shoulder replacement. Other complications, such as notching of the scapula and acromial stress fractures, are unique to this prosthesis. (orig.)

  12. Plasticity in the Visual System is Associated with Prosthesis Use in Phantom Limb Pain.

    Science.gov (United States)

    Preißler, Sandra; Dietrich, Caroline; Blume, Kathrin R; Hofmann, Gunther O; Miltner, Wolfgang H R; Weiss, Thomas

    2013-01-01

    The experience of strong phantom limb pain (PLP) in arm amputees was previously shown to be associated with structural neural plasticity in parts of the cortex that belong to dorsal and ventral visual streams. It has been speculated that this plasticity results from the extensive use of a functional prosthesis which is associated with increased visual feedback to control the artificial hand. To test this hypothesis, we reanalyzed data of cortical volumes of 21 upper limb amputees and tested the association between the amount of use of the hand prosthesis and cortical volume plasticity. On the behavioral level, we found no relation between PLP and the amount of prosthesis use for the whole patient group. However, by subdividing the patient group into patients with strong PLP and those with low to medium PLP, stronger pain was significantly associated with less prosthesis use whereas the group with low PLP did not show such an association. Most plasticity of cortical volume was identified within the dorsal stream. The more the patients that suffered from strong PLP used their prosthesis, the smaller was the volume of their posterior parietal cortex. Our data indicate a relationship between prosthesis use and cortical plasticity of the visual stream. This plasticity might present a brain adaptation process to new movement and coordination patterns needed to guide an artificial hand.

  13. The Stout prosthesis: an alternate means of restoring speech in selected laryngectomy patients.

    Science.gov (United States)

    King, Austin I; Stout, Bob E; Ashby, Jon K

    2003-02-01

    We discuss the effectiveness of the Stout prosthesis, a device that was developed more than 30 years ago to restore speech in postlaryngectomy patients. This prosthesis has not been previously described in the literature. The placement of this device entails the creation of a pharyngeal cutaneous fistula that extends to the musculature at the base of the tongue. The prosthesis is then used to connect the fistula and the stoma. Central to this discussion was our evaluation of a patient who had used the Stout prosthesis for 30 years. In this patient, the prosthesis produced excellent long-term voice production with minimal leakage of saliva or other liquids. We conclude that in light of the device's simplicity, low cost, and minimal maintenance requirements with regard to the fistula site, the Stout prosthesis should be considered as an alternative to the standard tracheosophageal puncture method for patients who are unable to comply with the latter's maintenance requirements and for those in poorly developed countries where costs and hygiene are paramount considerations. Moreover, because the Stout technique does not involve the esophagus and does not require invasive procedures around the stoma, it is also practical for patients who have esophageal rigidity or stomal problems.

  14. A custom-made temporomandibular joint prosthesis for fabrication by selective laser melting: Finite element analysis.

    Science.gov (United States)

    Xu, Xiangliang; Luo, Danmei; Guo, Chuanbin; Rong, Qiguo

    2017-08-01

    A novel and custom-made selective laser melting (SLM) 3D-printed alloplastic temporomandibular joint (TMJ) prosthesis is proposed. The titanium-6aluminium-4vanadium (Ti-6Al-4V) condyle component and ultra-high molecular weight polyethylene (UHMWPE) fossa component comprised the total alloplastic TMJ replacement prosthesis. For the condyle component, an optimized tetrahedral open-porous scaffold with combined connection structures, i.e. an inlay rod and an onlay plate, between the prosthesis and remaining mandible was designed. The trajectory of movement of the intact condyle was assessed via kinematic analysis to facilitate the design of the fossa component. The behaviours of the intact mandible and mandible with the prosthesis were compared. The biomechanical behaviour was analysed by assessing the stress distribution on the prosthesis and strain distribution on the mandible. After muscle force was applied, the magnitude of the compressive strain on the condyle neck of the mandible with the prosthesis was lower than that on the condyle neck of the intact mandible, with the exception of the area about the screws; additionally, the magnitude of the strain at the scaffold-bone interface was relatively high. Copyright © 2017. Published by Elsevier Ltd.

  15. Plasticity in the Visual System is Associated with Prosthesis Use in Phantom Limb Pain

    Science.gov (United States)

    Preißler, Sandra; Dietrich, Caroline; Blume, Kathrin R.; Hofmann, Gunther O.; Miltner, Wolfgang H. R.; Weiss, Thomas

    2013-01-01

    The experience of strong phantom limb pain (PLP) in arm amputees was previously shown to be associated with structural neural plasticity in parts of the cortex that belong to dorsal and ventral visual streams. It has been speculated that this plasticity results from the extensive use of a functional prosthesis which is associated with increased visual feedback to control the artificial hand. To test this hypothesis, we reanalyzed data of cortical volumes of 21 upper limb amputees and tested the association between the amount of use of the hand prosthesis and cortical volume plasticity. On the behavioral level, we found no relation between PLP and the amount of prosthesis use for the whole patient group. However, by subdividing the patient group into patients with strong PLP and those with low to medium PLP, stronger pain was significantly associated with less prosthesis use whereas the group with low PLP did not show such an association. Most plasticity of cortical volume was identified within the dorsal stream. The more the patients that suffered from strong PLP used their prosthesis, the smaller was the volume of their posterior parietal cortex. Our data indicate a relationship between prosthesis use and cortical plasticity of the visual stream. This plasticity might present a brain adaptation process to new movement and coordination patterns needed to guide an artificial hand. PMID:23805096

  16. Evaluation of a new composite prosthesis for the repair of abdominal wall defects.

    Science.gov (United States)

    Losi, Paola; Munaò, Antonella; Spiller, Dario; Briganti, Enrica; Martinelli, Ilaria; Scoccianti, Marco; Soldani, Giorgio

    2007-10-01

    The degree of integration of biomaterials used in the repair of abdominal wall defects seems to depend upon the structure of the prosthesis. The present investigation evaluates the behaviour in terms of adhesion formation and integration of a new composite prosthesis that could be employed in this clinical application. Full-thickness abdominal wall defects (7 x 5 cm) were created in 16 anaesthetized New Zealand white rabbits and the prosthesis were placed in direct contact with the visceral peritoneum during the experiment. The defects were repaired with a composite prosthesis or pure polypropylene mesh to establish two study groups (n = 8 each). The composite device was constituted by a polypropylene mesh physically attached to a poly(ether)urethane-polydimethylsiloxane laminar sheet. Animals were sacrificed 7, 14, 21 and 30 days after implant and prosthesis/surrounding tissue specimens subjected to light and electron microscopy. Firm adhesions were detected in the polypropylene implants, while they were not present in the composite implants. The excellent behaviour of the composite prosthesis shown in this study warrants further investigation on its use for the repair of abdominal wall defects when a prosthetic device needs to be placed in contact with the intestinal loops.

  17. Our new tornado-compatible aortic valve prosthesis: notable results of hydrodynamic testing and experimental trials

    Directory of Open Access Journals (Sweden)

    Leo A. Bockeria

    2014-05-01

    Full Text Available Aims A shortcoming common to all existing designs of mechanical cardiac valve prostheses is an increased trombogenicity caused, among other factors, by the lack of hydrodynamic compatibility between the luminal part of the prosthesis and the patterned blood flow. The aim of the study is to design and test our new mechanical aortic valve prosthesis to exclude life-long anticoagulation treatment. Materials and methods Standard hydrodynamic tests of the new prosthetic valve have been carried out for comparing with the other existing valve designs. A new method for the heart valve prosthesis testing in a tornado-like flow has been developed. The valve function has been verified in a swine excluding the anticoagulation treatment during the period of time exceeding six months. Results The significant advantage of the new prosthesis in the standard hydrodynamic tests has been demonstrated. The tests in the tornado-like flow have shown that only this prosthesis allows maintaining the pattern, the head and flow rate characteristics of the tornado-like jet. Upon implanting the new prosthesis in the aortic position in a swine, the good performance of the valve without anticoagulation therapy has been confirmed in the course of more than six months. Conclusion Obtained has been the evidence of the merits of the new mechanical aortic valve owing to the due consideration of the hydrodynamic peculiarities of the aortic blood flow and the creation of the design providing the proper hydrodynamic compatibility.

  18. An Affordable Insole-Sensor-Based Trans-Femoral Prosthesis for Normal Gait

    Directory of Open Access Journals (Sweden)

    Srinivas Pandit

    2018-02-01

    Full Text Available This paper proposes a novel and an affordable lower limb prosthesis to enable normal gait kinematics for trans-femoral amputees. The paper details the design of a passive prosthesis with magneto-rheological (MR damping system and electronic control. A new control approach based on plantar insole feedback was employed here. Strategically placed sensors on the plantar insole provide required information about gait cycle to a finite state controller for suitable action. A proportional integral (PI based current controller controls the required current for necessary damping during gait. The prosthesis was designed and developed locally in India keeping in view the cost, functionality, socio-economic, and aesthetic requirements. The prototype was experimentally tested on a trans-femoral amputee and the results are presented in this work. The implementation of the proposed design and control scheme in the prototype successfully realizes the notion that normal gait kinematics can be achieved at a low cost comparable to passive prostheses. The incurring cost and power expenditure of the proposed prosthesis are evaluated against passive and active prostheses, respectively. The commercial implications for the prosthesis were explored on the basis of recommendations of ISPO Consensus Conference on Appropriate Prosthetic Technology in Developing Countries. The key objective of this work is to enable lucid design for development of an affordable prosthesis in a low-resource setting.

  19. Bionic ankle-foot prosthesis normalizes walking gait for persons with leg amputation.

    Science.gov (United States)

    Herr, Hugh M; Grabowski, Alena M

    2012-02-07

    Over time, leg prostheses have improved in design, but have been incapable of actively adapting to different walking velocities in a manner comparable to a biological limb. People with a leg amputation using such commercially available passive-elastic prostheses require significantly more metabolic energy to walk at the same velocities, prefer to walk slower and have abnormal biomechanics compared with non-amputees. A bionic prosthesis has been developed that emulates the function of a biological ankle during level-ground walking, specifically providing the net positive work required for a range of walking velocities. We compared metabolic energy costs, preferred velocities and biomechanical patterns of seven people with a unilateral transtibial amputation using the bionic prosthesis and using their own passive-elastic prosthesis to those of seven non-amputees during level-ground walking. Compared with using a passive-elastic prosthesis, using the bionic prosthesis decreased metabolic cost by 8 per cent, increased trailing prosthetic leg mechanical work by 57 per cent and decreased the leading biological leg mechanical work by 10 per cent, on average, across walking velocities of 0.75-1.75 m s(-1) and increased preferred walking velocity by 23 per cent. Using the bionic prosthesis resulted in metabolic energy costs, preferred walking velocities and biomechanical patterns that were not significantly different from people without an amputation.

  20. Bionic ankle–foot prosthesis normalizes walking gait for persons with leg amputation

    Science.gov (United States)

    Herr, Hugh M.; Grabowski, Alena M.

    2012-01-01

    Over time, leg prostheses have improved in design, but have been incapable of actively adapting to different walking velocities in a manner comparable to a biological limb. People with a leg amputation using such commercially available passive-elastic prostheses require significantly more metabolic energy to walk at the same velocities, prefer to walk slower and have abnormal biomechanics compared with non-amputees. A bionic prosthesis has been developed that emulates the function of a biological ankle during level-ground walking, specifically providing the net positive work required for a range of walking velocities. We compared metabolic energy costs, preferred velocities and biomechanical patterns of seven people with a unilateral transtibial amputation using the bionic prosthesis and using their own passive-elastic prosthesis to those of seven non-amputees during level-ground walking. Compared with using a passive-elastic prosthesis, using the bionic prosthesis decreased metabolic cost by 8 per cent, increased trailing prosthetic leg mechanical work by 57 per cent and decreased the leading biological leg mechanical work by 10 per cent, on average, across walking velocities of 0.75–1.75 m s−1 and increased preferred walking velocity by 23 per cent. Using the bionic prosthesis resulted in metabolic energy costs, preferred walking velocities and biomechanical patterns that were not significantly different from people without an amputation. PMID:21752817

  1. Plasticity in the visual system is associated with prosthesis use in phantom limb pain

    Directory of Open Access Journals (Sweden)

    Sandra ePreißler

    2013-06-01

    Full Text Available The experience of strong phantom limb pain (PLP in arm amputees was previously shown to be associated with structural neural plasticity in parts of the cortex that belong to dorsal and ventral visual streams. It has been speculated that this plasticity results from the extensive use of a functional prosthesis which is associated with increased visual feedback to control the artificial hand.To test this hypothesis, we reanalyzed data of cortical volumes of 21 upper limb amputees and tested the association between the amount of use of the hand prosthesis and cortical volume plasticity.On the behavioral level, we found no relation between PLP and the amount of prosthesis use for the whole patient group. However, by subdividing the patient group into patients with strong PLP and those with low to medium PLP, stronger pain was significantly associated with less prosthesis use whereas the group with low PLP did not show such an association.Most plasticity of cortical volume was identified within the dorsal stream. The more the patients that suffered from strong PLP used their prosthesis, the smaller was the volume of their posterior parietal cortex.Our data indicate a relationship between prosthesis use and cortical plasticity of the visual stream. This plasticity might present a brain adaption process to new movement and coordination patterns needed to guide an artificial hand.

  2. Immediate placement and loading of implants in anterior maxilla using an altered screw-retained implant fixed prosthesis

    Directory of Open Access Journals (Sweden)

    Baig Mirza

    2010-01-01

    Full Text Available This article describes the immediate placement and loading of implants in the aesthetic zone using an implant-retained, fixed prosthesis with a modified design. One section of the implant prosthesis has cemented crowns and the other section is the conventional screw-retained. This combined approach significantly offsets the unsuitable implant position, alignment or angulation, while ensuring the easy retrievability, repair and maintenance of the prosthesis at the same time.

  3. A Fixed Telescopic Prosthesis Designed to Retrieve and Convert to Fixed-Removable Combination Case: A Clinical Report

    OpenAIRE

    Zoidis, Panagiotis; Panagiota, Spyropoulou; Polyzois, Gregory

    2015-01-01

    This clinical report describes a fixed maxillary telescopic dental prosthesis (FTDP) employing milled base metal copings and a metal superstructure veneered with composite resin, for the restoration in a periodontally compromised patient with uncontrolled diabetes. The telescopic prosthesis framework design incorporated occlusal rest seats in key positions along the arch in case of future posterior tooth loss, in order to be converted to fixed - removable combination prosthesis. The mandible ...

  4. Visualisation of upper limb activity using spirals - a new approach to the 1 assessment of daily prosthesis usage

    OpenAIRE

    Chadwell, AE; Kenney, LPJ; Granat, MH; Thies, SBA; Head, JS; Galpin, AJ

    2017-01-01

    BACKGROUND: Current outcome measures used in upper limb myoelectric prosthesis studies include clinical tests of function and self-report questionnaires on real world prosthesis use. Research in other cohorts has questioned both the validity of self-report as an activity assessment tool and the relationship between clinical functionality and real-world upper limb activity. Previously1 we reported the first results of monitoring upper-limb prosthesis use. \\ud However, the data visualisation te...

  5. Artificial epi-Retinal Prosthesis (AeRP)

    Science.gov (United States)

    Doorish, John F.

    2006-09-01

    There are several research projects going on around the world, which are attempting to develop a prosthetic device to restore sight to the blind. This paper describes the efforts of Second Sight of New York, Inc. The device being developed is called an Artificial epi-Retinal Prosthesis (AeRP), which is basically a small optical computer that fits into the intraocular space of the eye. The AeRP is designed to draw light into the device by specially designed fibre optics. The light is ‘digitized’ by the fibre optic system and then directed to individual photodiode cells making up concentric cylinders thus providing several hundred photodiode cells in the device. The produced electrical stimulation from each cell is then delivered to the retinal ganglion cells by a specially designed delivery system utilizing electrically conducting polymer strands (ECP), which sit on an ‘umbrella’ at the back of the device. The retinal ganglion cells receive the electrical stimulation, which would then be transmitted through the visual system of the brain. There are several innovations in this approach as compared to the other projects. They include, first the design, which will allow for a high number of PC to produce electrical stimulation that will stimulate multiple RGC per PC; the use of the ECP strands has not been used in such an approach before this. Tests have revealed that nerve cells have a good affinity for the material of the ECP. The use of the ECP as well as the fact that the AeRP is completely photovoltaic, with no external power sources, implies that there will not be high heat build-up in the back of the eye, which might damage RGC. A smaller version of the AeRP called the Mini epi-Retinal Prosthesis (MeRP) is the subject of a complimentary paper. It is being built now and will be tested in cell culture studies to determine the efficacy of the design and materials. No actual implants have been performed yet.

  6. Results of uncemented distal locked prosthesis in revision hip arthroplasty with proximal femoral bone loss: A retrospective study

    Directory of Open Access Journals (Sweden)

    Sanjay Agarwala

    2013-01-01

    Conclusion: Uncemented distal locked prosthesis provide adequate stability in revision THA, aiding the reconstruction of bony deficiencies while avoiding the disadvantages of fully porous or cemented implants.

  7. Novel Technique for Proximal Bone Anchoring of Penile Prosthesis After Radial Forearm Free Flap Neophallus.

    Science.gov (United States)

    Cohen, Andrew J; Bhanvadia, Raj R; Pariser, Joseph J; Hatcher, David M; Gottlieb, Lawrence J; Bales, Gregory T

    2017-07-01

    To describe outcomes of bone anchoring of penile implant in a neophallus with an accompanying video focusing on operative technique and salient tips for surgeons performing these procedures. Penile prosthesis insertion allows individuals with a neophallus to achieve erectile function. Lack of corporal bodies to accommodate cylinders makes anchoring of any prosthesis challenging. Anchoring the device to the pubic bone is one strategy to achieve proximal stabilization. A single-institution, retrospective chart review of 10 neophallus patients undergoing penile prosthesis placement from 2006 to 2015 was done. The pubic symphysis is exposed and corticotomy created for placement of the rear tip extender of the implant using a Stryker TPS bone drill. Anchoring sutures through the corticotomy defect, rear tip, and proximal cylinder seat the implant. The remainder of the implantation procedure mirrors that used in native tissue. The overall perioperative complication rate was 20%, with a mean follow-up of 49 months. Seventy percent of the patients required reoperation, with a mean of 1.4 prosthesis revision surgeries per patient. Primary causes of revision included infection, poor fixation of the rear tip, and prosthesis failure. Despite high revision rates, 80% of the patients have fully functioning prosthesis as of last follow-up. Limitations include retrospective study design and the small patient cohort. Penile prosthesis placement in the neophallus is feasible and effective. A bone-anchored rear tip is an option to provide proximal stabilization. Continued efforts to minimize the need for revisions are ongoing and necessary. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Preoperative counseling and expectation management for inflatable penile prosthesis implantation.

    Science.gov (United States)

    Narang, Gopal L; Figler, Bradley D; Coward, Robert M

    2017-11-01

    The inflatable penile prosthesis (IPP) is the gold standard surgical treatment for medical refractory erectile dysfunction (ED). While the modern IPP has enjoyed high satisfaction rates as a product of its continued innovation, reliability, and performance, patient dissatisfaction can still occur. IPP implantation restores physiologic function with cosmetic and psychological consequences, both of which place inherent emphasis on preoperative counseling and expectation management. This review aims to highlight the complex nature of such counseling and provide practitioners with a roadmap to navigate the landscape. Preoperative counseling begins with appropriate patient selection and identification of those patients who are at risk for dissatisfaction as a result of personality characteristics. The informed consent provides a natural framework to discuss the host of complications and risks that are associated with surgery, including infection, device malfunction, damage to nearby structures, and device erosion. Device selection is a nuanced process that merges patient preference with clinical factors and consideration. We address device selection through a description of cylinder construction, pump design, and reservoir placement in the context of preoperative counseling. Lastly, we draw attention to expectation management with a specific focus on possible post-operative changes to penile length and sensation as well as partner involvement. The modern IPP provides excellent results with high patient and partner satisfaction. Ultimately, satisfaction is dependent on multiple factors, but providing accurate, realistic counseling and expectation management prepares patients for the best possible outcomes.

  9. Mid-term Results of Rotating Hinged Knee Prosthesis

    Directory of Open Access Journals (Sweden)

    Abdul Buyuk

    2017-01-01

    Full Text Available Aim: In surgeries on patients with advanced ligament instabilities or severe bone defects rotating hinged knee prostheses are one of a limited number of appropriate options. The objective of our study is to evaluate the mid-term functional results and complications of several surgeries using this form of prothesis. Material and Method: The rotating hinged knee prosthesis (RHKP was applied to 23 knees of 19 patients in primary or revision surgeries at our instution between February 2009 and December 2011. Following their operations, patients underwent several retrospective evaluations to assess surgical success. The average follow-up period for the patients was 54 months. The average age of the patients at their last follow-up was 75. Results: The average Special Surgery Knee Scores, Knee Society Knee Scores, and Knee Society Functional Scores were 44, 27, and 18, respectively, before the surgery; and 83, 92, and 70 in the final post-surgery follow-ups. In addition, the average range of motion increased from the pre-operative level of 76 to 101 degrees at the final evaluation. Two patients had per-operative rupture of the patellar tendon, and four patients had various complications after the surgery, including periprosthetic fracture, deep infection, aseptic loosening, and patellofemoral instability. Discussion: Primary or revision knee arthroplasty using RKHP can be successful in cases with advanced ligament instability or severe bone defects; however, increased complication rates should be kept in mind.

  10. The Appearance of Phosphenes Elicited Using a Suprachoroidal Retinal Prosthesis.

    Science.gov (United States)

    Sinclair, Nicholas C; Shivdasani, Mohit N; Perera, Thushara; Gillespie, Lisa N; McDermott, Hugh J; Ayton, Lauren N; Blamey, Peter J

    2016-09-01

    Phosphenes are the fundamental building blocks for presenting meaningful visual information to the visually impaired using a bionic eye device. The aim of this study was to characterize the size, shape, and location of phosphenes elicited using a suprachoroidal retinal prosthesis. Three patients with profound vision loss due to retinitis pigmentosa were implanted with a suprachoroidal electrode array, which was used to deliver charge-balanced biphasic constant-current pulses at various rates, amplitudes, and durations to produce phosphenes. Tasks assessing phosphene appearance, location, overlap, and the patients' ability to recognize phosphenes were performed using a custom psychophysics setup. Phosphenes were reliably elicited in all three patients, with marked differences in the reported appearances between patients and between electrodes. Phosphene shapes ranged from simple blobs to complex forms with multiple components in both space and time. Phosphene locations within the visual field generally corresponded to the retinotopic position of the stimulating electrodes. Overlap between phosphenes elicited from adjacent electrodes was observed with one patient, which reduced with increasing electrode separation. In a randomized recognition task, two patients correctly identified the electrode being stimulated for 57.2% and 23% of trials, respectively. Phosphenes of varying complexity were successfully elicited in all three patients, indicating that the suprachoroidal space is an efficacious site for electrically stimulating the retina. The recognition scores obtained with two patients suggest that a suprachoroidal implant can elicit phosphenes containing unique information. This information may be useful when combining phosphenes into more complex and meaningful images that provide functional vision.

  11. Functional rehabilitation after total hip arthroplasty with uncemented prosthesis

    Directory of Open Access Journals (Sweden)

    Nicolae-Bogdan Negru-Aman

    2011-12-01

    Full Text Available Arthritis is a disease that acts irreversibly on joint surfaces with significant consequences especially in the third quarter of life. About 7% of our population is affected by arthritis localized at a certain level and stage of development, and this percentage is expected to reach a much higher value in future years. Aim: The aim of this study is to propose a rehabilitation program for functional recovery after total hip arthroplasty and a set of recommendations for post surgery period. Material and methods: There were included 13 subjects (10 female and 3 male aged between 51 and 78 years old, ready for total hip arthroplasty with uncemented prosthesis. The subjects were selected in Orthopaedics and Traumatology department of Military Clinical Emergency Hospital ”Dr. Victor Popescu” Timisoara. The evaluations regarding programs’ efficiency were made using 3 questionnaires (Oxford Hip Score, Harris Hip Score, Outcome Hip Score and goniometry. The subjects were tested initially before the surgery and 3 times after (at one month, at 3 months and at 6 months. Results: The results showed a remarcable increase for the scores of majority, in both questionnaire and goniometry values. Conclusions: functional rehabilitation exercises proved to be particularly important in regaining independence, control of the prosthetic leg, pain reduction and functional and social reintegration.

  12. Intraoperative OCT Imaging of the Argus II Retinal Prosthesis System.

    Science.gov (United States)

    Rachitskaya, Aleksandra V; Yuan, Alex; Marino, Meghan J; Reese, Jamie; Ehlers, Justis P

    2016-11-01

    Optimal placement of the Argus II Retinal Prosthesis System (Second Sight Medical Products, Sylmar, CA) is critical. Intraoperative optical coherence tomography (OCT) allows for intrasurgical visualization and confirmation of array placement. In this study, two different OCT systems were evaluated to assess the feasibility and utility of this technology during Argus II surgery. Intraoperative OCT was performed on five patients undergoing Argus II implantation at Cole Eye Institute from June 2015 to July 2016. The EnVisu portable OCT (Bioptigen, Morrisville, NC) and microscope-integrated RESCAN 700 (Zeiss, Oberkochen, Germany) intraoperative OCT systems were utilized. The EnVisu was used in three patients and the RESCAN 700 in three of the five patients. Following array tacking, intraoperative OCT was performed over the entire array including the edges and tack. Intraoperative OCT allowed for visualization of the array/retina interface. Microscope integration of the OCT system facilitated ease of focusing, real-time feedback, surgeon-directed OCT scanning to the areas of interest, and enhanced image quality at points of interest. Intraoperative imaging of the Argus II electrode array is feasible and provides information about electrode array-retina interface and distance to help guide a surgeon. Microscope integration of OCT appears to provide an optimal and efficient approach to intraoperative OCT during Argus II array placement. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:999-1003.]. Copyright 2016, SLACK Incorporated.

  13. Intelligent Voice Prosthesis Converting Icons into Natural Language Sentences

    CERN Document Server

    Vaillant, P; Vaillant, Pascal; Checler, Michael

    1995-01-01

    The Intelligent Voice Prosthesis is a communication tool which reconstructs the meaning of an ill-structured sequence of icons or symbols, and expresses this meaning into sentences of a Natural Language (French). It has been developed for the use of people who cannot express themselves orally in natural language, and further, who are not able to comply to grammatical rules such as those of natural language. We describe how available corpora of iconic communication by children with Cerebral Palsy has led us to implement a simple and relevant semantic description of the symbol lexicon. We then show how a unification-based, bottom-up semantic analysis allows the system to uncover the meaning of the user's utterances by computing proper dependencies between the symbols. The result of the analysis is then passed to a lexicalization module which chooses the right words of natural language to use, and builds a linguistic semantic network. This semantic network is then generated into French sentences via hierarchizat...

  14. PERSPECTIVE: Toward a wide-field retinal prosthesis

    Science.gov (United States)

    Ameri, Hossein; Ratanapakorn, Tanapat; Ufer, Stefan; Eckhardt, Helmut; Humayun, Mark S.; Weiland, James D.

    2009-06-01

    The purpose of this paper is to present a wide field electrode array that may increase the field of vision in patients implanted with a retinal prosthesis. Mobility is often impaired in patients with low vision, particularly in those with peripheral visual loss. Studies on low vision patients as well as simulation studies on normally sighted individuals have indicated a strong correlation between the visual field and mobility. In addition, it has been shown that an increased visual field is associated with a significant improvement in visual acuity and object discrimination. Current electrode arrays implanted in animals or human vary in size; however, the retinal area covered by the electrodes has a maximum projected visual field of about 10°. We have designed wide field electrode arrays that could potentially provide a visual field of 34°, which may significantly improve the mobility. Tests performed on a mechanical eye model showed that it was possible to fix 10 mm wide flexible polyimide dummy electrode arrays onto the retina using a single retinal tack. They also showed that the arrays could conform to the inner curvature of the eye. Surgeries on an enucleated porcine eye model demonstrated feasibility of implantation of 10 mm wide arrays through a 5 mm eye wall incision.

  15. Real-time control of an interactive impulsive virtual prosthesis.

    Science.gov (United States)

    Bunderson, Nathan E

    2014-03-01

    An interactive virtual dynamic environment for testing control strategies for neural machine interfacing with artificial limbs offers several advantages. The virtual environment is low-cost, easily configured, and offers a wealth of data for post-hoc analysis compared with real physical prostheses and robots. For use with prosthetics and research involving amputee subjects it allows the valuable time with the subject to be spent in experiments rather than fixing hardware issues. The usefulness of the virtual environment increases as the realism of the environment increases. Most tasks performed with limbs require interactions with objects in the environment. To simulate these tasks the dynamics of frictional contact, in addition to inertial limb dynamics must be modeled. Here, subjects demonstrate real-time control of an eight degree-of-freedom virtual prosthesis while performing an interactive box-and-blocks task. With practice, four nonamputee subjects and one shoulder disarticulation subject were able to successfully transfer blocks in the virtual environment at an average rate of just under two blocks per minute. The virtual environment is configurable in terms of the virtual arm design, control strategy, and task.

  16. Experimental effective shape control of a powered transfemoral prosthesis.

    Science.gov (United States)

    Gregg, Robert D; Lenzi, Tommaso; Fey, Nicholas P; Hargrove, Levi J; Sensinger, Jonathon W

    2013-06-01

    This paper presents the design and experimental implementation of a novel feedback control strategy that regulates effective shape on a powered transfemoral prosthesis. The human effective shape is the effective geometry to which the biological leg conforms--through movement of ground reaction forces and leg joints--during the stance period of gait. Able-bodied humans regulate effective shapes to be invariant across conditions such as heel height, walking speed, and body weight, so this measure has proven to be a very useful tool for the alignment and design of passive prostheses. However, leg joints must be actively controlled to assume different effective shapes that are unique to tasks such as standing, walking, and stair climbing. Using our previous simulation studies as a starting point, we model and control the effective shape as a virtual kinematic constraint on the powered Vanderbilt prosthetic leg with a custom instrumented foot. An able-bodied subject used a by-pass adapter to walk on the controlled leg over ground and over a treadmill. These preliminary experiments demonstrate, for the first time, that effective shape (or virtual constraints in general) can be used to control a powered prosthetic leg.

  17. Unidirectional infiltration method to produce crown for dental prosthesis application

    Energy Technology Data Exchange (ETDEWEB)

    Pontes, F.H.D.; Taguchi, S.P. [Universidade de Sao Paulo (EEL/DEMAR/USP), Lorena, SP (Brazil). Escola de Engenharia; Borges Junior, L.A. [Centro Universitario de Volta Redonda, RJ (Brazil); Machado, J.P.B. [Instituto Nacional de Pesquisas Espaciais (INPE), Sao Jose dos Campos, SP (Brazil); Santos, C. [ProtMat Materiais Avancados, Guaratingueta, SP (Brazil)

    2009-07-01

    Alumina ceramics have been used in dental prosthesis because it is inert, presents higher corrosion and shear resistance when compared to metals, excellent aesthetic, and mechanical resistance. In this work it was produced an infrastructure material for applications in dental crowns, obtained by glass infiltration in alumina preform. Various oxides, among that, rare-earth oxide produced by Xenotime, were melted at 1450 deg C and heat treatment at 700 deg C to obtain the glass (REglass). The alumina was pre-sintered at 1100 deg C cut and machined to predetermine format (unidirectional indirect infiltration) and finally conducted to infiltration test. The alumina was characterized by porosity (Hg-porosity and density) and microstructure (SEM). The glass wettability in alumina was determined as function of temperature, and the contact angle presented a low value (θ<90 deg), showing that glass can be infiltrated spontaneously in alumina. The infiltration test was conducted at glass melting temperature, during 30, 60, 180, 360 minutes. After infiltration, the samples were cut in longitudinal section, ground and polished, and analyzed by XRD (crystalline phases), SEM (microstructure) and EDS (composition).The REglass presents higher infiltration height when compared to current processes (direct infiltration), and homogeneous microstructure, showing that it is a promising method used by prosthetics and dentists. (author)

  18. [Masticatory system and maxillofacial prosthesis: From pathology to function recovering].

    Science.gov (United States)

    Vo Quang, S; Dichamp, J

    2016-12-01

    Maxillofacial prosthesis (MFP) can be defined as the art and science of esthetic and functional reconstruction of the facial bones, art because it uses hand-crafted and empirical rules, science because of its technical rigorism and its integration in medicine. MFP aims to multidisciplinary rehabilitate patients presenting with cutaneous and underlying structures defects, It also allows for functional speech and swallowing rehabilitation related to temporo-mandibular joint disorders. Whatever the origin, (traumatic, infectious ortumoral), surgical treatment of these TMJ disorders is usually not indicated in first-line. Functional treatment is often sufficient if started early in an observant patient. The aim of our article was to present the different types devices available for the rehabilitation of the masticatory system according to pathology. The first part will treat about the preservation of the TMJ range of motion in a preventive way. A second part will treat about the possibilities to recover the range of motion in a curative way. A third part will treat about mandibular reposition. At last, we will focus on the devices allowing for mandibular kinetic rehabilitation in adults and in a special pediatric case. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Prototype to product—developing a commercially viable neural prosthesis

    Science.gov (United States)

    Seligman, Peter

    2009-12-01

    The Cochlear implant or 'Bionic ear' is a device that enables people who do not get sufficient benefit from a hearing aid to communicate with the hearing world. The Cochlear implant is not an amplifier, but a device that electrically stimulates the auditory nerve in a way that crudely mimics normal hearing, thus providing a hearing percept. Many recipients are able to understand running speech without the help of lipreading. Cochlear implants have reached a stage of maturity where there are now 170 000 recipients implanted worldwide. The commercial development of these devices has occurred over the last 30 years. This development has been multidisciplinary, including audiologists, engineers, both mechanical and electrical, histologists, materials scientists, physiologists, surgeons and speech pathologists. This paper will trace the development of the device we have today, from the engineering perspective. The special challenges of designing an active device that will work in the human body for a lifetime will be outlined. These challenges include biocompatibility, extreme reliability, safety, patient fitting and surgical issues. It is emphasized that the successful development of a neural prosthesis requires the partnership of academia and industry.

  20. Prototype to product-developing a commercially viable neural prosthesis.

    Science.gov (United States)

    Seligman, Peter

    2009-12-01

    The Cochlear implant or 'Bionic ear' is a device that enables people who do not get sufficient benefit from a hearing aid to communicate with the hearing world. The Cochlear implant is not an amplifier, but a device that electrically stimulates the auditory nerve in a way that crudely mimics normal hearing, thus providing a hearing percept. Many recipients are able to understand running speech without the help of lipreading. Cochlear implants have reached a stage of maturity where there are now 170 000 recipients implanted worldwide. The commercial development of these devices has occurred over the last 30 years. This development has been multidisciplinary, including audiologists, engineers, both mechanical and electrical, histologists, materials scientists, physiologists, surgeons and speech pathologists. This paper will trace the development of the device we have today, from the engineering perspective. The special challenges of designing an active device that will work in the human body for a lifetime will be outlined. These challenges include biocompatibility, extreme reliability, safety, patient fitting and surgical issues. It is emphasized that the successful development of a neural prosthesis requires the partnership of academia and industry.

  1. Relationship between removable prosthesis and some systemics disorders

    Science.gov (United States)

    Le Bars, Pierre; Kouadio, Alain Ayepa; N’goran, Justin Koffi; Badran, Zahi; Soueidan, Assem

    2015-01-01

    This article reviews the dental literature concerning the potential impact of the removable prosthesis (RP) on the health status of patients with certain systemic diseases. Literature was surveyed using Medline/PubMed database resources, as well as a manual search, up to 2015 to identify appropriate articles that addressed the aim of this review. The research used keywords about associations between RP and six pathologies: Human immunodeficiency virus infection, diabetes mellitus, pulmonary diseases, gastric-Helicobacter pylori, cancer, and cardiovascular diseases. Analysis of literature showed that in patients with dentures having one or more of the six general conditions listed, Candida albicans organism is more frequently found in the oral flora compared to healthy denture wearer. Although causality has not been established and pending further research on this topic, the hygienic practices necessary to minimize the risk of numerous pathologies should be strengthened in the case of these patients, all the more in the presence of physical or psychological disability. The relationship between the general diseases and increasing of oral candidiasis denture patients is not explained. Therefore, attention to oral hygiene and professional care for removing C. albicans may be beneficial in these medically compromised patients. PMID:26929530

  2. Adhesive strength of hydroxyl apatite(HA coating and biomechanics behavior of HA-coated prosthesis:an experimental study

    Directory of Open Access Journals (Sweden)

    Tian-yang ZHANG

    2011-05-01

    Full Text Available Objective To explore the influence of adhesive strength of hydroxyapatite(HA coating on the post-implantation stability of HA-coated prosthesis.Methods The adhesive strength and biomechanics behavior of HA coating were studied by histopathological observation,material parameters and biomechanical testing,the titanium(Ti-coated prosthesis was employed as control.Results Scratch test showed that the adhesive strength of HA coating was significantly lower than that of Ti coating(P < 0.01.Histopathological examination and bone morphometry showed that,at the early stage of prosthesis implantation,the bony growth around HA-coated prosthesis was significantly higher than that around Ti-coated prosthesis(P < 0.01,but the ultimate shear strength of HA-coated prosthesis was much lower than that of Ti-coated prosthesis(P < 0.01.After the push-out test with prosthesis,histopathological observation showed that there were accumulations of clump-and strip-like granular residues on the surface of bones that newly grew around the HA-coated prosthesis,and surface energy-dispersive X-ray spectroscopy(EDX analysis also confirmed that the shear stress induced HA decohesion from the substrate of prosthesis.Conclusions Although HA coating showed a satisfactory effect on early bone formation and prosthetic stability,due to the deficiencies of adhesive strength,the early stability of prosthesis may be gradually destroyed by the shear loads of human body and coating degradation.

  3. Visualisation of upper limb activity using spirals: A new approach to the assessment of daily prosthesis usage.

    Science.gov (United States)

    Chadwell, Alix; Kenney, Laurence; Granat, Malcolm; Thies, Sibylle; Head, John S; Galpin, Adam

    2017-06-01

    Current outcome measures used in upper limb myoelectric prosthesis studies include clinical tests of function and self-report questionnaires on real-world prosthesis use. Research in other cohorts has questioned both the validity of self-report as an activity assessment tool and the relationship between clinical functionality and real-world upper limb activity. Previously,(1) we reported the first results of monitoring upper limb prosthesis use. However, the data visualisation technique used was limited in scope. Methodology development. To introduce two new methods for the analysis and display of upper limb activity monitoring data and to demonstrate the potential value of the approach with example real-world data. Upper limb activity monitors, worn on each wrist, recorded data on two anatomically intact participants and two prosthesis users over 1 week. Participants also filled in a diary to record upper limb activity. Data visualisation was carried out using histograms, and Archimedean spirals to illustrate temporal patterns of upper limb activity. Anatomically intact participants' activity was largely bilateral in nature, interspersed with frequent bursts of unilateral activity of each arm. At times when the prosthesis was worn prosthesis users showed very little unilateral use of the prosthesis (≈20-40 min/week compared to ≈350 min/week unilateral activity on each arm for anatomically intact participants), with consistent bias towards the intact arm throughout. The Archimedean spiral plots illustrated participant-specific patterns of non-use in prosthesis users. The data visualisation techniques allow detailed and objective assessment of temporal patterns in the upper limb activity of prosthesis users. Clinical relevance Activity monitoring offers an objective method for the assessment of upper limb prosthesis users' (PUs) activity outside of the clinic. By plotting data using Archimedean spirals, it is possible to visualise, in detail, the temporal

  4. Laminar airflow ceiling size: no impact on infection rates following hip and knee prosthesis.

    Science.gov (United States)

    Breier, Ann-Christin; Brandt, Christian; Sohr, Dorit; Geffers, Christine; Gastmeier, Petra

    2011-11-01

    Laminar airflow (LAF) systems are widely used, at least in orthopedic surgery. However, there is still controversial discussion about the influence of LAF on surgical site infection (SSI) rates. The size of the LAF ceiling is also often a question of debate. Our objective is to determine the effect of this technique under conditions of actual rather than ideal use. Cohort study using multivariate analysis with generalized estimating equations method. Data for hip and knee prosthesis procedures from hospitals participating in the German national nosocomial infection surveillance system (KISS) from July 2004 to June 2009 were used for analysis. A total of 33,463 elective hip prosthesis procedures due to arthrosis (HIP-A) from 48 hospitals, 7,749 urgent hip prosthesis procedures due to fracture (HIP-F) from 41 hospitals, and 20,554 knee prosthesis (KPRO) procedures from 38 hospitals were included. The data were analyzed for hospitals with and without LAF in the operating rooms and by the size of the LAF ceiling. The endpoints were severe SSI rates. The overall severe SSI rate was 0.74 per 100 procedures for HIP-A, 2.39 for HIP-F, and 0.63 for KPRO. For all 3 prosthesis types, neither LAF nor the size of the LAF ceiling was associated with lower infection risk. The data demonstrate consistency and reproducibility with the results from earlier registry studies. Neither LAF nor ceiling size had an impact on severe SSI rates.

  5. Long-term results with the uncemented thrust plate prosthesis (TPP).

    Science.gov (United States)

    Huggler, A H; Jacob, H A; Bereiter, H; Haferkorn, M; Ryf, C; Schenk, R

    1993-01-01

    The long-term clinical results of a novel concept for total joint replacement called the Thrust Plate Prosthesis (TPP) are presented. Only a restricted number of patients were provided with this new prosthesis (115 at the Orthopedic Department, Canton Hospital, Chur, and 47 at the Department of Orthopedic Surgery, University of Zurich). All patients have undergone clinical and radiological follow-up covering a period from 1980 to 1991. The basic feature of the Thrust Plate Prosthesis is the direct load transfer to the medial cortical bone of the femoral neck, and this has been unchanged since 1978. Titanium alloy has been used since 1986. The good clinical and radiological results are confirmed by a histological examination of an 8-year-old implant: In the crucial area of load transfer newly formed bone can be seen in direct contact with the thrust plate without fibrous tissue in between. The clinical results and histological findings have confirmed the validity of the biomechanical principle of the TPP. The TPP is therefore to be considered a true alternative to the conventional hip prosthesis. In contrast to the conventional intramedullary anchored stem prosthesis the TPP requires the removal of a minimum amount of bone stock, which is certainly important in young patients.

  6. Cervical disc prosthesis replacement and interbody fusion — a comparative study

    Science.gov (United States)

    Yu–Hua, Jia

    2006-01-01

    The purpose of this paper is to compare the new functional intervertebral cervical disc prosthesis replacement and the classical interbody fusion operation, including the clinical effect and maintenance of the stability and segmental motion of cervical vertebrae. Twenty-four patients with single C5-6 intervertebral disk hernias were specifically selected and divided randomly into two groups: One group underwent artificial cervical disc replacement and the other group received interbody fusion. All patients were followed up and evaluated. The operation time for the single disc replacement was (130 ± 50) minutes and interbody fusion was (105 ± 53) minutes. Neurological or vascular complications were not observed during or after operation. There was no prosthesis subsidence or extrusion. The JOA score of the group with prosthesis replacement increased from an average of 8.6 to 15.8. The JOA score of the group with interbody fusion increased from an average of 9 to 16.2. The clinical effect and the ROM of the adjacent space of the two groups showed no statistical difference. The short follow-up time does not support the advantage of the cervical disc prosthesis. The clinical effect and the maintenance of the function of the motion of the intervertebral space are no better than the interbody fusion. At least 5 years of follow-up is needed to assess the long-term functionality of the prosthesis and the influence on adjacent levels. PMID:17180356

  7. Analysis of different bicruciate-retaining tibial prosthesis design using a three dimension finite element model.

    Science.gov (United States)

    He, Peiheng; Li, Xing; Huang, Shuai; Liu, Minghao; Chen, Weizhi; Xu, Dongliang

    2017-01-01

    The recent interest in bicruciate-retaining prostheses has aimed to address the need for an implant that can mimic a natural knee. Arguments have always existed about survivorship, including loosening and subsidence, as well as tibial preparation in bicruciate-retaining tibial prostheses. The aim of this study was to investigate the biomechanics of a new modular design and other bicruciate-retaining designs using a three-dimensional finite element model under different load conditions to discover which prosthesis was more suitable. We also evaluated related parameters (the third principal stress, shear stress, micromotion, and von Mises stresses) to compare the characteristics of different bicruciate-retaining designs. The biomechanics of the bicruciate-retaining tibial prosthesis can be influenced by the style of the designed prosthesis and gait loading. The new modular design showed stability and moderated the third principal stress, leading to less shear stress and stress shield, suggesting that this type of design can avoid knee prosthesis loosening and subsidence. Therefore, the new design may be used as a more suitable prosthesis for future bicruciate-retaining implant application.

  8. [Medico legal considerations on prosthesis surgery of the erectile dysfunction in a La Peyronie disease case].

    Science.gov (United States)

    Ricci, S; Massoni, F; Simeone, C; Letizia, P; Alei, G

    2013-04-01

    Peyronie's disease is characterized by the presence of an inelastic fibrous plaque of the penile tunica albuginea affecting 3-10% of the male population. The fibrous scar causes the curvature of the erect penis, which prevents the penetration. In the stabilization phase the plaque can cause a variable degree of erectile dysfunction (20-54%). In the treatment of the chronic disease, surgery is the gold standard and in case of concomitant erectile dysfunction the placement of a penile prosthesis is indicated. This surgery is loaded with an increase of the variables which can affect the outcome, such as individual clinical features and functionality of the device. The present case concerns a patient suffering from erectile dysfunction associated with Peyronie's disease who underwent surgery for implantation of hydraulic three-component penile prosthesis. After surgery a malfunction of the prosthesis was detected, which required unloading measures under sedation and a surgical revision of the scrotal pump. The latter was followed by the displacement of the prosthesis' cylinder and by a new surgical treatment for the reintegration of the prosthesis and the repair of the left corpus cavernosum. After two months a wrong positioning of the two cylinders inserted into the corpora cavernosa, with the left cranial extreme positioned 2 cm below the contralateral, was detected. In this case the failure of surgical treatment highlights a negligent behavior and the responsibility of the doctors by failing to examine adequately the variables, both clinical and not clinical, that might affect the outcome of the intervention.

  9. Incidence and Impact of Patient-Prosthesis Mismatch in Isolated Aortic Valve Surgery.

    Science.gov (United States)

    Dumani, Selman; Likaj, Ermal; Kacani, Andi; Dibra, Laureta; Petrela, Elizana; Beca, Vera; Refatllari, Ali

    2015-12-15

    The mains topics of this work are the incidence of patient-prosthesis mismatch and the influence in the early results of isolated aortic valve surgery. In 193 patients isolated aortic valve surgery was performed. The study population was divided in three subgroups: 20 patients with severe, 131 patients with moderate and 42 patients without patient-prosthesis mismatch. The indexed effective orifice area was used to define the subgroups. Operative mortality and perioperative complications were considered the indicators of the early results of aortic valve surgery. The incidence of severe and moderate patient-prosthesis mismatch was respectively 10.3% and 67.8%. Hospital mortality and perioperative complications were: mortality 5% vs. 3.1% vs. 2.4% (p = 0.855), low cardiac output 5% vs. 6.9% vs. 4.8% (p = 0.861); pulmonary complications 5% vs. 3.1 vs. 0.0% (p = 0.430); exploration for bleeding 5% vs. 0.8% vs. 2.4% (p = 0.319); atrial fibrillation 30% vs. 19.8% vs. 11.9% (p = 0.225); wound infection 5% vs. 0.8% vs. 0.00% (p = 0.165), respectively for the group with severe, moderate and without patient-prosthesis mismatch. Patient-prosthesis mismatch is a common occurrence in aortic valve surgery. This phenomenon does not affect the early results of aortic valve surgery.

  10. Progress towards a high-resolution retinal prosthesis

    Science.gov (United States)

    Butterwick, Alex; Vankov, Alex; Huie, Phil; Vijayraghavan, Karthik; Loudin, Jim; Palanker, Daniel

    2007-02-01

    Electronic retinal prostheses represent a potentially effective approach for restoring some degree of sight in blind patients with retinal degeneration. Functional restoration of sight would require hundreds to thousands of electrodes effectively stimulating remaining neurons in the retina. We present a design of an optoelectronic retinal prosthetic system having 3mm diameter retinal implant with pixel sizes down to 25 micrometers, which allows for natural eye scanning for observing a large field of view, as well as spatial and temporal processing of the visual scene to optimize the patient experience. Information from a head mounted video camera is processed in a portable computer and delivered to the implanted photodiode array by projection from the LCD goggles using pulsed IR (810 nm) light. Each photodiode converts pulsed light (0.5 ms in duration) into electric current with efficiency of 0.3 A/W using common bi-phasic power line. Power is provided by the inductively-coupled RF link from the coil on the goggles into a miniature power supply implanted between the sclera and the conjuctiva, and connected to subretinal implant with a thin 2-wire trans-scleral cable. 3-dimensional structures in the subretinal prosthesis induce retinal migration and thus ensure close proximity between stimulating electrodes and the target retinal neurons. Subretinal implantations of the 3-dimentional pillar and chamber arrays in RCS rats with 2 and 6 week follow-up demonstrate achievement of intimate proximity between the stimulation cites and the inner nuclear layer. In some instances formation of a fibrotic seal has been observed.

  11. Replacement of the infected composite aortic root prosthesis.

    Science.gov (United States)

    Shah, Dipesh K; Li, Zhuo; Park, Soon J; Daly, Richard C; Dearani, Joseph A; Schaff, Hartzell V; Sundt, Thoralf M

    2011-11-01

    We sought to evaluate freedom from reinfection after surgery for infected aortic root replacement (ARR) and the impact of use of synthetic material at reoperation. Adult patients (aged more than 18 years) undergoing surgery for infected composite aortic root prosthesis at our institution were identified and their perioperative outcomes and late survival evaluated. Between January 1, 1993, and December 31, 2009, 15 patients (male, 87%; mean [SD] age, 57 [16] years) underwent surgery. All but 1 patient (6.7%) underwent reconstruction with a homograft. Eight patients (53.3%) required synthetic material to complete the repair, including 4 patients who underwent hemiarch reconstruction. Ten patients (66.7%) had circulatory arrest (mean [SD] time, 23.3 [11.0] minutes) and 3 (20.0%) underwent concomitant coronary artery bypass grafting. The 30-day mortality rate was 13.3% (n = 2). Three patients (20.0%)-2 of whom had positive blood cultures in hospital after redo ARR-had reinfection, for which 2 underwent re-replacement of the aortic root. Survival was 86.7%, 65.0%, and 50.6%, and freedom from reinfection was 90.9%, 79.5%, and 79.5% at 3, 6, and 12 months, respectively. Freedom from reinfection was less for the patients who had positive blood cultures within 2 weeks of redo ARR (p impact. Infected ARR prostheses can be replaced with a homograft with favorable outcomes. Use of synthetic material to complete the repair does not adversely impact outcome. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  12. 3D ultrasound imaging for prosthesis fabrication and diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Morimoto, A.K.; Bow, W.J.; Strong, D.S. [and others

    1995-06-01

    The fabrication of a prosthetic socket for a below-the-knee amputee requires knowledge of the underlying bone structure in order to provide pressure relief for sensitive areas and support for load bearing areas. The goal is to enable the residual limb to bear pressure with greater ease and utility. Conventional methods of prosthesis fabrication are based on limited knowledge about the patient`s underlying bone structure. A 3D ultrasound imaging system was developed at Sandia National Laboratories. The imaging system provides information about the location of the bones in the residual limb along with the shape of the skin surface. Computer assisted design (CAD) software can use this data to design prosthetic sockets for amputees. Ultrasound was selected as the imaging modality. A computer model was developed to analyze the effect of the various scanning parameters and to assist in the design of the overall system. The 3D ultrasound imaging system combines off-the-shelf technology for image capturing, custom hardware, and control and image processing software to generate two types of image data -- volumetric and planar. Both volumetric and planar images reveal definition of skin and bone geometry with planar images providing details on muscle fascial planes, muscle/fat interfaces, and blood vessel definition. The 3D ultrasound imaging system was tested on 9 unilateral below-the- knee amputees. Image data was acquired from both the sound limb and the residual limb. The imaging system was operated in both volumetric and planar formats. An x-ray CT (Computed Tomography) scan was performed on each amputee for comparison. Results of the test indicate beneficial use of ultrasound to generate databases for fabrication of prostheses at a lower cost and with better initial fit as compared to manually fabricated prostheses.

  13. [Total knee and hip prosthesis: variables associated with costs].

    Science.gov (United States)

    Herrera-Espiñeira, Carmen; Escobar, Antonio; Navarro-Espigares, José Luis; Castillo, Juan de Dios Lunadel; García-Pérez, Lidia; Godoy-Montijano, Amparo

    2013-01-01

    The elevated prevalence of osteoarthritis in Western countries, the high costs of hip and knee arthroplasty, and the wide variations in the clinical practice have generated considerable interest in comparing the associated costs before and after surgery. To determine the influence of a number of variables on the costs of total knee and hip arthroplasty surgery during the hospital stay and during the one-year post-discharge. A prospective multi-center study was performed in 15 hospitals from three Spanish regions. Relationships between the independent variables and the costs of hospital stay and postdischarge follow-up were analyzed by using multilevel models in which the "hospital" variable was used to group cases. Independent variables were: age, sex, body mass index, preoperative quality of life (SF-12, EQ-5 and Womac questionnaires), surgery (hip/knee), Charlson Index, general and local complications, number of beds and economic-institutional dependency of the hospital, the autonomous region to which it belongs, and the presence of a caregiver. The cost of hospital stay, excluding the cost of the prosthesis, was 4,734 Euros, and the post-discharge cost was 554 Euros. With regard to hospital stay costs, the variance among hospitals explained 44-46% of the total variance among the patients. With regard to the post-discharge costs, the variability among hospitals explained 7-9% of the variance among the patients. There is considerable potential for reducing the hospital stay costs of these patients, given that more than 44% of the observed variability was not determined by the clinical conditions of the patients but rather by the behavior of the hospitals.

  14. Penetrating multichannel stimulation and recording electrodes in auditory prosthesis research.

    Science.gov (United States)

    Anderson, David J

    2008-08-01

    Microelectrode arrays offer the auditory systems physiologists many opportunities through a number of electrode technologies. In particular, silicon substrate electrode arrays offer a large design space including choice of layout plan, range of surface areas for active sites, a choice of site materials and high spatial resolution. Further, most designs can double as recording and stimulation electrodes in the same preparation. Scala tympani auditory prosthesis research has been aided by mapping electrodes in the cortex and the inferior colliculus to assess the CNS responses to peripheral stimulation. More recently silicon stimulation electrodes placed in the auditory nerve, cochlear nucleus and the inferior colliculus have advanced the exploration of alternative stimulation sites for auditory prostheses. Multiplication of results from experimental effort by simultaneously stimulating several locations, or by acquiring several streams of data synchronized to the same stimulation event, is a commonly sought after advantage. Examples of inherently multichannel functions which are not possible with single electrode sites include (1) current steering resulting in more focused stimulation, (2) improved signal-to-noise ratio (SNR) for recording when noise and/or neural signals appear on more than one site and (3) current source density (CSD) measurements. Still more powerful are methods that exploit closely-spaced recording and stimulation sites to improve detailed interrogation of the surrounding neural domain. Here, we discuss thin-film recording/stimulation arrays on silicon substrates. These electrode arrays have been shown to be valuable because of their precision coupled with reproducibility in an ever expanding design space. The shape of the electrode substrate can be customized to accommodate use in cortical, deep and peripheral neural structures while flexible cables, fluid delivery and novel coatings have been added to broaden their application. The use of

  15. Design, fabrication, and preliminary results of a novel below-knee prosthesis for snowboarding: A case report.

    Science.gov (United States)

    Minnoye, Sander L M; Plettenburg, Dick H

    2009-09-01

    Snowboarding with a below-knee prosthesis is compromised by the limited rotation capabilities of the existing below-knee prostheses, which are designed for use in normal walking. Based on snowboarding range of motion analyses, a novel below-knee prosthesis was designed with the aim to achieve similar range of motions like able-bodied snowboarders. The new prosthesis allows for passive inversion/eversion, passive plantarflexion/dorsiflexion and additional 'voluntary' plantarflexion/dorsiflexion initiated by lateral or medial rotation of the upper leg and knee. A prototype was built and was subsequently tested on a single subject, a highly professional snowboarder and candidate for the Olympic Winter Games. The movements of the subject were recorded on video, analyzed and compared to the recorded movements of an able-bodied snowboarder, and a snowboarder with a traditional below-knee prosthesis. The results indicated an increased similarity of inversion/eversion and plantarflexion/dorsiflexion between the snowboarder with the new below-knee prosthesis and the able-bodied snowboarder, whereas the snowboarder with the traditional below-knee prosthesis and the able-bodied snowboarder differed considerably. These results indicate that snowboarding with the new prosthesis is more comparable to able-bodied snowboarding. On a subjective basis this is confirmed by the test subject who stated that: "snowboarding with the new prosthesis is like it was before the amputation!".

  16. Wear-testing of a temporomandibular joint prosthesis : UHMWPE and PTFE against a metal ball, in water and in serum

    NARCIS (Netherlands)

    Van Loon, JP; Verkerke, GJ; de Bont, LGM; Liem, RSB

    For a temporomandibular joint prosthesis, an estimation of the wear rate was needed, prior to patient application. Therefore, we determined the in vitro wear rate of the ball-socket articulation of this prosthesis, consisting of a metal head and an ultra-high molecular weight polyethylene (UHMWPE)

  17. Development and performance of a new prosthesis system using ultrasonic sensor for wrist movements: a preliminary study.

    Science.gov (United States)

    Abd Razak, Nasrul Anuar; Abu Osman, Noor Azuan; Gholizadeh, Hossein; Ali, Sadeeq

    2014-04-23

    The design and performance of a new development prosthesis system known as biomechatronics wrist prosthesis is presented in this paper. The prosthesis system was implemented by replacing the Bowden tension cable of body powered prosthesis system using two ultrasonic sensors, two servo motors and microcontroller inside the prosthesis hand for transradial user. The system components and hand prototypes involve the anthropometry, CAD design and prototyping, biomechatronics engineering together with the prosthetics. The modeler construction of the system develop allows the ultrasonic sensors that are placed on the shoulder to generate the wrist movement of the prosthesis. The kinematics of wrist movement, which are the pronation/supination and flexion/extension were tested using the motion analysis and general motion of human hand were compared. The study also evaluated the require degree of detection for the input of the ultrasonic sensor to generate the wrist movements. The values collected by the vicon motion analysis for biomechatronics prosthesis system were reliable to do the common tasks in daily life. The degree of the head needed to bend to give the full input wave was about 45°-55° of rotation or about 14 cm-16 cm. The biomechatronics wrist prosthesis gave higher degree of rotation to do the daily tasks but did not achieve the maximum degree of rotation. The new development of using sensor and actuator in generating the wrist movements will be interesting for used list in medicine, robotics technology, rehabilitations, prosthetics and orthotics.

  18. The theoretical optimal center of rotation for a temporomandibular joint prosthesis : A three-dimensional kinematic study

    NARCIS (Netherlands)

    van Loon, JP; Falkenstrom, CH; de Bont, LGM; Verkerke, GJ; Stegenga, B

    A unilateral temporomandibular joint (TMJ) prosthesis may cause dysfunction of the contralateral, natural TMJ because of lack of translatorial movements of the prosthetic side. The natural translatorial capacity of the mandible can be restored in part by a TMJ prosthesis with a fixed center of

  19. 21 CFR 888.3358 - Hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/polymer/metal semi-constrained... Devices § 888.3358 Hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis. (a) Identification. A hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis is a device...

  20. Fabrication of a maxillofacial prosthesis using a computer-aided design and manufacturing system.

    Science.gov (United States)

    Tsuji, Mitsuhiro; Noguchi, Nobuhiro; Ihara, Koichiro; Yamashita, Yoshio; Shikimori, Michio; Goto, Masaaki

    2004-09-01

    Maxillofacial prostheses are usually fabricated on the basis of impressions made with dental-impression material. The extent to which the prosthesis reproduces normal facial morphology depends on the clinical judgment of the individual fabricating the prosthesis. This paper describes a computer-aided design and manufacturing (CAD/CAM) system for the fabrication of maxillofacial prostheses. This system will provide a more consistently accurate reproduction of facial morphology. Facial measurements were taken using a non-contact three-dimensional laser morphological measurement system. The measurements were sent to a computer numerical controlled (CNC) milling machine to generate a cast of the patient's face for the fabrication of prosthesis. Facial contours were measured using a laser. This method minimizes patient discomfort and avoids soft tissue distortion by impression material. Moreover, the digital data obtained is easy to store and transmit, and mirror-images can be readily generated by computer processing. This method offers an objective, quantified approach for fabricating maxillofacial prostheses.

  1. Structural Simulation of a Bone-Prosthesis System of the Knee Joint

    Directory of Open Access Journals (Sweden)

    Aivars Zemitis

    2008-09-01

    Full Text Available In surgical knee replacement, the damaged knee joint is replaced with artificial prostheses. An accurate clinical evaluation must be carried out before applying knee prostheses to ensure optimal outcome from surgical operations and to reduce the probability of having long-term problems. Useful information can be inferred from estimates of the stress acting onto the bone-prosthesis system of the knee joint. This information can be exploited to tailor the prosthesis to the patient’s anatomy. We present a compound system for pre-operative surgical planning based on structural simulation of the bone-prosthesis system, exploiting patient-specific data.

  2. Atraumatic patellar prosthesis dislocation with patellar tendon injury following a total knee arthroplasty: a case report

    Directory of Open Access Journals (Sweden)

    Singh Alka

    2010-01-01

    Full Text Available Abstract Introduction Total knee arthroplasty is a well-established procedure with gratifying results. There is no consensus in the literature whether to routinely resurface the patella while performing total knee arthroplasty or not. Although an extremely rare occurrence in clinical practice, patellar prosthesis dislocation is a possible complication resulting from total knee arthroplasty. Case presentation We report a rare case of atraumatic spontaneous dislocation of patellar prosthesis in a 63-year-old Caucasian man of British origin with patellar tendon injury. The patient was treated successfully through a revision of the patellar component and tendon repair. In two years follow-up the patient is asymptomatic with no sign of loosening of his patellar prosthesis. Conclusions A thorough understanding of knee biomechanics is imperative in performing total knee arthroplasty in order to achieve a better functional outcome and to prevent early prosthetic failure.

  3. Guide flange prosthesis for early management of reconstructed hemimandibulectomy: a case report.

    Science.gov (United States)

    Patil, Pravinkumar Gajanan; Patil, Smita Pravinkumar

    2011-09-01

    Surgical resection of the mandible due to presence of benign or malignant tumor is the most common cause of the mandibular deviation. Depending upon the location and extent of the tumor in the mandible, various surgical treatment modalities like marginal, segmental, hemi, subtotal, or total mandibulectomy can be performed. The clinicians must wait for extensive period of time for completion of healing and acceptance of the osseous graft before considering the definitive prosthesis. During this initial healing period prosthodontic intervention is required for preventing the mandibular deviation. This case report describes early prosthodontic management of a patient who has undergone a reconstructed hemi-mandibulectomy with modified mandibular guide flange prosthesis. The prosthesis helps patient moving the mandible normally without deviation during functions like speech and mastication.

  4. Prosthetic Rehabilitation of Completely Blind Subject with Bilateral Customised Ocular Prosthesis: A Case Report.

    Science.gov (United States)

    Pathak, Chetan; Pawah, Salil; Singh, Gurpreet; Yadav, Ila; Kundra, Shrey

    2017-01-01

    The special sensory organs play significant role in our daily lives. Until one of them is totally or partially lost, its real value is not fully appreciated. The most tragic, yet common loss of sensory organ is that of an eye. Restoration of unilateral ocular defects is very challenging for a maxillofacial prosthodontist and requires great skill to mimic bilateral eye. Restoration of bilateral defects using customized eye prosthesis presents even more difficult task for clinician especially in communication with patient, impression procedures, and patient education regarding insertion, removal and maintenance of prosthesis. Such loss of eyes may have a tremendous emotional and psychological impact on the patient. This article presents a technique for fabrication of bilateral ocular prosthesis of completely blind patient.

  5. Teicoplanin-Containing Cement Spacers for Treatment of Experimental Staphylococcus aureus Joint Prosthesis Infection

    Science.gov (United States)

    Ismael, Farid; Bléton, Rémy; Saleh-Mghir, Azzam; Dautrey, Sophie; Massias, Laurent; Crémieux, Anne-Claude

    2003-01-01

    Using a rabbit model of methicillin-resistant Staphylococcus aureus knee-prosthesis infection, we studied the efficacy of teicoplanin cement alone or in combination with systemic intramuscular (i.m.) injections of teicoplanin. Seven days after infection, surgical debridement and removal of the infected prostheses were performed, and five rabbits were randomly assigned to one of five different treatment groups: untreated controls, prosthesis replacement by drug-free cement spacer, prosthesis replacement by teicoplanin-loaded cement spacer (1.2 g of teicoplanin/40 g of cement), i.m. injections of teicoplanin (20 mg/kg of body weight, twice a day for 7 days), or systemic antibiotic treatment combined with teicoplanin-loaded spacers. The most effective regimen combined systemic teicoplanin and antibiotic spacers. PMID:14506060

  6. Evaluation of salivary DNA obtained from dental prosthesis and its applicability in forensic investigations.

    Science.gov (United States)

    Chauhan, Isha; Sugirtharaj, G; Sathyan, Sanish; Beena, V T; Banerjee, Moinak

    2016-08-01

    This study evaluated the salivary DNA obtained from dental prosthesis after a period of storage and its applicability in human identification. In first phase, DNA was extracted after a span of 1 week and 1 month from the dental prosthesis dipped in whole saliva for 15 min. It was followed by PCR and electrophoresis. In second phase, from extracted DNA samples 15 STRs (short tandem repeats) of human genomic DNA were amplified via polymerase chain reaction. DNA isolated from saliva stained dental prosthesis after a period of storage and the techniques employed are adequate for further forensic analysis. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  7. [Evaluation of the speech outcomes in patients with unilateral maxillary defect rehabilitated with maxillary obturator prosthesis].

    Science.gov (United States)

    Xing, Guo-fang; Jiao, Ting; Sun, Jian; Jiang, Yong-lin

    2005-08-01

    Evaluation of the outcomes in 15 patients with unilateral maxillary defect before and after maxillofacial obturator prosthesis. 15 patients with unilateral maxillary defect were included in this study, who received obturator prosthesis for maxillary rehabilitation. The pronunciation of the examined phonetics such as /a/, /o/, /e/, /i/, /u/ were transferred into CSL4400 before and after treatment. The mean value of the first, second, third formant were measured. Paired t test of SPSS11.0 was used for statistical analysis. There was statistically significant difference on F2 and F3 before and after treatment (Pvowels changed after treatment. Maxillofacial prosthesis can improve the speech function of patients with unilateral maxillary defect effectively.

  8. Implant supported prosthesis in an edentulous boy with Hypohidrotic Ectodermal Dysplasia - "A happy boy"

    DEFF Research Database (Denmark)

    Gjørup, Hans; Nyhuus, Lone; Buhl, Jytte

    2009-01-01

    Implant supported prosthesis in an edentulous boy with Hypohidrotic Ectodermal Dysplasia - "A happy boy". Authors; Gjoerup,H1; Nyhuus,L2; Buhl,J3. 1) Center for Oral Health in Rare Conditions, Aarhus University Hospital 2) Prosthodontic Department, the Dental School, Aarhus University 3) Department...... region. 3. At the age of 10 years a new set of dentures were made. This time the upper denture was made as an overdenture supported and retained by 4 implants and a Dolder bar. The surgical procedure included bone grafting from the anterior ramus mandibulae. The boy's subjective judgement of his oral...... health has been registered. The boy and his family experience great improvement in the functioning as well as the comfort of his prosthesis after insertion of implants. Conclusion The prosthesis for edentulous boys with HED demand several adjustments and revisions, partly due to growth of the jaws...

  9. Multicenter Investigation of the Micro-Organisms Involved in Penile Prosthesis Infection: An Analysis of the Efficacy of the AUA and EAU Guidelines for Penile Prosthesis Prophylaxis.

    Science.gov (United States)

    Gross, Martin S; Phillips, Elizabeth A; Carrasquillo, Robert J; Thornton, Amanda; Greenfield, Jason M; Levine, Laurence A; Alukal, Joseph P; Conners, William P; Glina, Sidney; Tanrikut, Cigdem; Honig, Stanton C; Becher, Edgardo F; Bennett, Nelson E; Wang, Run; Perito, Paul E; Stahl, Peter J; Rosselló Gayá, Mariano; Rosselló Barbará, Mariano; Cedeno, Juan D; Gheiler, Edward L; Kalejaiye, Odunayo; Ralph, David J; Köhler, Tobias S; Stember, Doron S; Carrion, Rafael E; Maria, Pedro P; Brant, William O; Bickell, Michael W; Garber, Bruce B; Pineda, Miguel; Burnett, Arthur L; Eid, J Francois; Henry, Gerard D; Munarriz, Ricardo M

    2017-03-01

    Penile prosthesis infections remain challenging despite advancements in surgical technique, device improvements, and adoption of antibiotic prophylaxis guidelines. To investigate penile prosthesis infection microbiology to consider which changes in practice could decrease infection rates, to evaluate current antibiotic prophylaxis guidelines, and to develop a proposed algorithm for penile prosthesis infections. This retrospective institutional review board-exempt multi-institutional study from 25 centers reviewed intraoperative cultures obtained at explantation or Mulcahy salvage of infected three-piece inflatable penile prostheses (IPPs). Antibiotic usage was recorded at implantation, admission for infection, and explantation or salvage surgery. Cultures were obtained from purulent material in the implant space and from the biofilm on the device. Intraoperative culture data from infected IPPs. Two hundred twenty-seven intraoperative cultures (2002-2016) were obtained at salvage or explantation. No culture growth occurred in 33% of cases and gram-positive and gram-negative organisms were found in 73% and 39% of positive cultures, respectively. Candida species (11.1%), anaerobes (10.5%) and methicillin-resistant Staphylococcus aureus (9.2%) constituted nearly one third of 153 positive cultures. Multi-organism infections occurred in 25% of positive cultures. Antibiotic regimens at initial implantation were generally consistent with American Urological Association (AUA) and European Association of Urology (EAU) guidelines. However, the micro-organisms identified in this study were covered by these guidelines in only 62% to 86% of cases. Antibiotic selection at admissions for infection and salvage or explantation varied widely compared with those at IPP implantation. This study documents a high incidence of anaerobic, Candida, and methicillin-resistant S aureus infections. In addition, approximately one third of infected penile prosthesis cases had negative cultures

  10. Monocular Vision- and IMU-Based System for Prosthesis Pose Estimation During Total Hip Replacement Surgery.

    Science.gov (United States)

    Su, Shaojie; Zhou, Yixin; Wang, Zhihua; Chen, Hong

    2017-06-01

    The average age of population increases worldwide, so does the number of total hip replacement surgeries. Total hip replacement, however, often involves a risk of dislocation and prosthetic impingement. To minimize the risk after surgery, we propose an instrumented hip prosthesis that estimates the relative pose between prostheses intraoperatively and ensures the placement of prostheses within a safe zone. We create a model of the hip prosthesis as a ball and socket joint, which has four degrees of freedom (DOFs), including 3-DOF rotation and 1-DOF translation. We mount a camera and an inertial measurement unit (IMU) inside the hollow ball, or "femoral head prosthesis," while printing customized patterns on the internal surface of the socket, or "acetabular cup." Since the sensors were rigidly fixed to the femoral head prosthesis, measuring its motions poses a sensor ego-motion estimation problem. By matching feature points in images of the reference patterns, we propose a monocular vision based method with a relative error of less than 7% in the 3-DOF rotation and 8% in the 1-DOF translation. Further, to reduce system power consumption, we apply the IMU with its data fused by an extended Kalman filter to replace the camera in the 3-DOF rotation estimation, which yields a less than 4.8% relative error and a 21.6% decrease in power consumption. Experimental results show that the best approach to prosthesis pose estimation is a combination of monocular vision-based translation estimation and IMU-based rotation estimation, and we have verified the feasibility and validity of this system in prosthesis pose estimation.

  11. Maxillary Implant-Supported Fixed Prosthesis: A Survey of Reviews and Key Variables for Treatment Planning.

    Science.gov (United States)

    Gallucci, German O; Avrampou, Marianna; Taylor, James C; Elpers, Julie; Thalji, Ghadeer; Cooper, Lyndon F

    2016-01-01

    This review was conducted to provide information to support the establishment of clinical guidelines for the treatment of maxillary edentulism using implant-supported fixed dental prostheses. Initial efforts were directed toward a systematic review with a defined PICO question: "For maxillary edentulous patients with dental implants treated using a fixed prosthesis, what is the impact of prosthesis design on prosthesis survival and complications?" Following a title search of more than 3,000 titles identified by electronic search of PubMed, 180 articles were identified that addressed the clinical evaluation of maxillary dental implant prostheses. The broad methodologic heterogeneity and clinical variation among reports precluded this approach for a systematic review. The information was extracted using a standardized extraction table by two pairs of investigators, and the reported outcomes were then summarized according to reported outcomes for implant prostheses supported by four, six, or eight implants using unitary or segmented prostheses. This review indicated that high prosthetic survival is observed using all approaches. The advantages of using fewer implants and a unitary prosthesis are revealed in the surgical phases, and complications commonly involve the fracture or detachment of acrylic teeth and reduced access for proper oral hygiene and related biologic complications. Using six implants typically involved grafting of posterior regions with advantages of reduced cantilevers and redundancy of implant support. Reduced prosthesis survival in these cases was associated with poor implant distribution. Segmented prostheses supported by six or more implants offered greater prosthetic survival, perhaps due to posterior implant placement. Advantages of a segmented prosthesis included pragmatic issues of accommodating divergent implants, attaining passive fit, combining prosthetic materials, and relative simplicity of repair. The existing literature demonstrated

  12. Cold Welding in a Trapeziometacarpal Ball and Socket Prosthesis: A Case Report.

    Science.gov (United States)

    Salva-Coll, Guillem; Terrades-Cladera, Xavier

    2017-06-01

    While in revision hip surgery it has been described cold welding of the femoral component in titanium implants, no previous reports have been published in TMC prosthesis. We present a case report of a patient who sustained a TMC ARPE® dislocation 11 months after surgery and during revision surgery, cold welding of the neck with the metacarpal stem was observed. This may represent a problem when revising this prosthesis and alternative procedures should be advised and discussed with the patient when revising these implants.

  13. Fabrication of a hollow bulb prosthesis for the rehabilitation of an acquired total maxillectomy defect

    Science.gov (United States)

    Vamsi Krishna, C H; Babu, Jaya Krishna; Fathima, Tanveer; Reddy, G V K

    2014-01-01

    The prosthodontic rehabilitation of maxillary defects is a challenging and demanding task which requires careful pre-surgical and post-surgical planning. Maxillary defects can be congenital or acquired. Acquired defects include those following trauma or surgical treatment of benign or malignant neoplasms. A prosthodontist encounters problems such as absence of support, poor retention, and lack of prosthesis stability in treating these patients. The present case report describes a procedure to fabricate a definitive hollow bulb obturator prosthesis for the rehabilitation of a total maxillectomy defect. PMID:24671313

  14. Total condylar prosthesis placement in knee arthroplasty. Biomechanic analysis of human knee preparations.

    Science.gov (United States)

    Møller, J T; Boe, S; Vang, P S

    1983-10-01

    Knee replacement using the Total Condylar Prosthesis was carried out on six large cadaveric knees. Tibiofemoral articulation was studied radiographically with the tibial component placed anteriorly as well as posteriorly on the tibial plateau. It is concluded that, in this model, when using the Total Condylar Prosthesis for big-sized knees, a tall, posteriorly placed tibial component gave the best placement of the femoral component and the most central tibio-femoral articulation, entailing optimal distribution of the load on the trabecular bone beneath the tibial component.

  15. Antibiotic embedded absorbable prosthesis for prevention of surgical mesh infection: experimental study in rats.

    Science.gov (United States)

    Suárez-Grau, J M; Morales-Conde, S; González Galán, V; Martín Cartes, J A; Docobo Durantez, F; Padillo Ruiz, F J

    2015-04-01

    Ventral hernias are a common problem in a general surgery and hernioplasty is an integral part of a general surgeon's practice. The use of prosthetic material has drastically reduced the risk of recurrence, but has introduced additional potential complications such as surgical wound infections, adhesion formation, graft rejection, etc. The development of a wound infection in a hernia that is repaired with a prosthetic material is a grave complication, often requiring removal of the prosthesis. This experimental study examined efficacy of completely absorbable, hydrophilic, PGA-TMC (polyglycolic acid-trimethylene carbonate) prosthesis impregnated with antibiotic for reduction of infectious complications. Antibiotic-impregnated PGA-TMC prostheses were placed intraperitoneally in 90 Wistar white rats that were randomized and distributed into four groups. Group 0 (23 rats): there were placed PGA-TMC prosthesis without antibiotic impregnation (control group). Group 1 (25 rats): meshes were placed and infected later with 1 × 10(8) UFC of S. aureus/1 ml/2 cm(2) (Staphylococcus aureus ATCC 6538 American Type Culture Collection, Rockville, MD). Group 2 (21 rats): cefazolin-impregnated prostheses were placed (1 g × 100 ml, at the rate of 1 ml/cm(2) of prosthesis) and were subsequently infected with the same bacterial inoculate. Group 3 (21 rats): cefazolin-impregnated prostheses with double quantity of cefazolin and infected. A week later these animals were killed and specimens were extracted for bacterial quantification and histological studies. Evident decrease of bacterial colonization was observed in series 2 and 3 [the ones impregnated with cefazolin, in comparison with the group 1 (infected without previous antibiotic impregnation)] with statistically significant results (p prosthesis when placing it in contact with intraabdominal viscera. However, cefazolin impregnation of the mesh has reduced an adhesion formation, mostly when the infection reached a

  16. Novel use of an air-filled breast prosthesis to allow radiotherapy to recurrent colonic cancer.

    LENUS (Irish Health Repository)

    O'Duffy, F

    2012-02-01

    AiM: The authors present the novel and successful use of an air-filled breast prosthesis for extra pelvic exclusion of small bowel to facilitate adjuvant radiotherapy following resection of recurrent adenocarcinoma of the ascending bowel. The therapeutic use of radiotherapy in colon cancer can cause acute or chronic radiation enteropathy. Mobile small bowel can be sequestered in \\'dead space\\' or by adhesions exposing it to adjuvant radiotherapy. A variety of pelvic partitioning methods have been described to exclude bowel from radiation fields using both native and prosthetic materials. METHOD: In this case a 68 year old presented with ascending colon adenocarcinoma invading the peritoneum and underwent en bloc peritoneal resection. Thirty-seven months later surveillance CT identified a local recurrence. Subsequent resection resulted in a large iliacus muscle defect which would sequester small bowel loops thus exposing the patient to radiation enteropathy. The lateral position of the defect precluded the use of traditional pelvic partitioning methods which would be unlikely to remain in place long enough to allow radiotherapy. A lightweight air-filled breast prosthesis (Allergan 133 FV 750 cms) secured in place with an omentoplasty was used to fill the defect. RESULTS: Following well tolerated radiotherapy the prosthesis was deflated under ultrasound guidance and removed via a 7-cm transverse incision above the right iliac crest. The patient is disease free 18 months later with no evidence of treatment related morbidity. CONCLUSION: The use of a malleable air-filled prosthesis for pelvic partitioning allows specific tailoring of the prosthesis size and shape for individual patient defects. It is also lightweight enough to be secured in place using an omentoplasty to prevent movement related prosthesis migration. In the absence of adequate omentum a mesh sling may be considered to allow fixation. In this case the anatomy of the prosthesis position allowed for its

  17. Simulation of the filtration mechanism of hyaluronic acid in total knee prosthesis

    Energy Technology Data Exchange (ETDEWEB)

    Paolo, J Di [GBC, Facultad de Ingenieria, Universidad Nacional de Entre Rios, Oro Verde, Ruta 11 km 10, 3101 (Argentina); Berli, M E [GBC, Facultad de Ingenieria, Universidad Nacional de Entre Rios, Oro Verde, Ruta 11 km 10, 3101 (Argentina); Campana, D M [GBC, Facultad de Ingenieria, Universidad Nacional de Entre Rios, Oro Verde, Ruta 11 km 10, 3101 (Argentina); Ubal, S [GBC, Facultad de Ingenieria, Universidad Nacional de Entre Rios, Oro Verde, Ruta 11 km 10, 3101 (Argentina); Cardenes, L D [GBC, Facultad de Ingenieria, Universidad Nacional de Entre Rios, Oro Verde, Ruta 11 km 10, 3101 (Argentina)

    2007-11-15

    Polyethylene (UHMWPE) wear in current knee prosthesis causes prosthesis loosening after no more than 15 years. In this work, a steady state one-dimensional lubrication model with non- Newtonian fluid, porous elastic layer on tibial component, ultra-filtration mechanism of fluid and some features of the surface roughness is studied through a numerical technique based on the Finite Element Method. The results show that the UHMWPE stiffness makes difficult the lubrication mechanism of the artificial joint and promotes abrasive and fatigue wear. Nevertheless, the use of compliant porous materials on the tibial component could reduce friction and wear. Moreover, the ultra-filtration mechanism promotes efficiency on the joint.

  18. A Modified Design for Posterior Inlay-Retained Fixed Dental Prosthesis

    Directory of Open Access Journals (Sweden)

    Abdulaziz Samran

    2015-01-01

    Full Text Available The aim of this paper is to report a clinical case with bilateral missing mandibular second premolars that were restored by metal-ceramic inlay-retained fixed dental prostheses. The first prosthesis was of a traditional design and the second was of a modified design. The suggested design is created by modifying the retainer wings of the traditional resin-bonded inlay-retained fixed dental prosthesis and covering the wings with composite resin. The modified design is relatively conservative, esthetic and provides an extra element for the retention of posterior metal-ceramic inlay-retained fixed dental prostheses.

  19. Bone-preserving prosthesis with a single axis for treating osteonecrosis of the femoral head: midterm results for the thrust plate hip prosthesis.

    Science.gov (United States)

    Yasunaga, Yuji; Goto, Toshihiko; Hisatome, Takashi; Tanaka, Ryuji; Yamasaki, Takuma; Ochi, Mitsuo

    2003-01-01

    We studied 27 patients (31 joints) who underwent total hip arthroplasty (THA) using the thrust plate hip prosthesis (TPP) for osteonecrosis of the femoral head. The mean follow-up period was 56 months (range 38-72 months). Clinical evaluation by the Merle d'Aubigne and Postel system showed a significant improvement from a preoperative mean score of 8.1 to a final mean follow-up score of 16.6. Mechanical loosening developed about 1 year postoperatively in one joint with a bone defect. Grade 1 stress shielding was observed in four joints. Although indications for the TPP are restricted to certain cases, unlike the conventional intramedullary stem, much can be expected of TPP. It is an outstanding prosthesis for osteonecrosis of the femoral head of young patients in terms of bone preservation and physiological load transfer.

  20. The release of gentamicin from acrylic bone cements in a simulated prosthesis-related interfacial gap

    NARCIS (Netherlands)

    Hendriks, JGE; Neut, D; van Horn, [No Value; van der Mei, HC; Busscher, HJ

    2003-01-01

    Gentamicin is added to polymethylmethacrylate bone cements in orthopedics as a measure against infection in total joint arthroplasties. Numerous studies have been published on gentamicin release from bone cements, but none have been able to estimate the local concentrations in the prosthesis-related

  1. Virtual reality environment for simulating tasks with a myoelectric prosthesis: an assessment and training tool.

    Science.gov (United States)

    Lambrecht, Joris M; Pulliam, Christopher L; Kirsch, Robert F

    2011-04-01

    Intuitively and efficiently controlling multiple degrees of freedom is a major hurdle in the field of upper limb prosthetics. A virtual reality myoelectric transhumeral prosthesis simulator has been developed for cost-effectively testing novel control algorithms and devices. The system acquires EMG commands and residual limb kinematics, simulates the prosthesis dynamics, and displays the combined residual limb and prosthesis movements in a virtual reality environment that includes force-based interactions with virtual objects. A virtual Box and Block Test is demonstrated. Three normally-limbed subjects performed the simulated test using a sequential and a synchronous control method. With the sequential method, subjects moved on average 6.7±1.9 blocks in 120 seconds, similar to the number of blocks transhumeral amputees are able to move with their physical prostheses during clinical evaluation. With the synchronous method, subjects moved 6.7±2.2 blocks. The virtual reality prosthesis simulator is thus a promising tool for developing and evaluating control methods, prototyping novel prostheses, and training amputees.

  2. Evaluation of Gait Performance of a Hemipelvectomy Amputation Walking with a Canadian Prosthesis

    Directory of Open Access Journals (Sweden)

    M. T. Karimi

    2014-01-01

    Full Text Available Background. Hemipelvectomy amputation is a surgical procedure in which lower limb and a portion of pelvic are removed. There are a few studies in the literature regarding the performance of subjects with hip disarticulation during walking. However, there is no study on gait analysis of hemipelvectomy subject. Therefore, the aim of this paper was to evaluate the gait and stability of subject with hemipelvectomy amputation. Case Description and Methods. A subject with hemipelvectomy amputation at right side was involved in this study. He used a Canadian prosthesis with single axis ankle joint, 3R21 knee joint, and 7E7 hip joint for more than 10 years. The kinetic and kinematic parameters were collected by a motion analysis system and a Kistler force platform. Findings and Outcomes. There was a significant difference between knee, hip, and ankle range of motions and their moments in the sound and prosthesis sides. In the other side, the stability of the subject in the anteroposterior direction seems to be better than that in the mediolateral direction. Conclusions. There was a significant asymmetry between the kinetic and kinematic performance of the sound and prosthesis sides, which may be due to lack of muscular power and alignment of prosthesis components.

  3. A novel knee prosthesis model of implant-related osteo- myelitis in rats

    DEFF Research Database (Denmark)

    Søe, Niels H.; Jensen, Nina Vendel; Nürnberg, Birgit Meinecke

    2012-01-01

    There have been numerous reports of animal models of osteomyelitis. Very few of these have been prosthesis models that imitate human conditions. We have developed a new rat model of implant-related osteomyelitis that mimics human osteomyelitis, to investigate the pathology of infection after...

  4. Backgrounds of antibiotic-loaded bone cement and prosthesis-related infection

    NARCIS (Netherlands)

    Hendriks, JGE; van Horn, [No Value; van der Mei, HC; Busscher, HJ

    Antibiotic-loaded bone cement has been in use for over 30 years for the fixation of total joint arthroplasties, although its mechanism of action is still poorly understood. This review presents the backgrounds of bone cements, prosthesis-related infection and antibiotic-loaded bone cements. It is

  5. The performance of a hydrogel nucleus pulposus prosthesis in an ex vivo canine model

    NARCIS (Netherlands)

    Bergknut, N.; Smolders, L.A.; Koole, L.H.; Voorhout, G.; Hagman, R.E.; Lagerstedt, A.S.; Saralidze, K.; Hazewinkel, H.A.W.; van der Veen, A.J.; Meij, B.P.

    2010-01-01

    A nucleus pulposus prosthesis (NPP) made of the hydrogel N-vinyl-2-pyrrolidinone copolymerized with 2-(4'-iodobenzoyl)-oxo-ethyl methacrylate has recently been developed. The special features of this NPP, i.e. intrinsic radiopacity and its ability to swell in situ to fill the nucleus cavity and

  6. The performance of a hydrogel nucleus pulposus prosthesis in an ex vivo canine model

    NARCIS (Netherlands)

    Bergknut, N.|info:eu-repo/dai/nl/314418059; Smolders, L.A.; Koole, L.H.; Voorhout, G.|info:eu-repo/dai/nl/073903329; Hagman, R.E.; Lagerstedt, A.S.; Saralidze, K.; Hazewinkel, H.A.W.|info:eu-repo/dai/nl/070975760

    2010-01-01

    Biomaterials. 2010 Sep;31(26):6782-8. Epub 2010 Jun 12. The performance of a hydrogel nucleus pulposus prosthesis in an ex vivo canine model. Bergknut N, Smolders LA, Koole LH, Voorhout G, Hagman RE, Lagerstedt AS, Saralidze K, Hazewinkel HA, van der Veen AJ, Meij BP. Department of Clinical Sciences

  7. Online phase detection using wearable sensors for walking with a robotic prosthesis

    NARCIS (Netherlands)

    Gorsic, M.; Kamnik, R.; Ambrozic, L.; Vitiello, N.; Lefeber, D.J.; Pasquini, G.; Munih, M.

    2014-01-01

    This paper presents a gait phase detection algorithm for providing feedback in walking with a robotic prosthesis. The algorithm utilizes the output signals of a wearable wireless sensory system incorporating sensorized shoe insoles and inertial measurement units attached to body segments. The

  8. [Function of prosthesis components in lower limb amputees with bone-anchored percutaneous implants : Biomechanical aspects].

    Science.gov (United States)

    Blumentritt, S

    2017-05-01

    Bone anchorage of an artificial limb has been proven to be an alternative intervention for amputees when prosthesis use is seriously reduced because of stump problems. Little is known about how prosthesis components interact with bone and joints and which potential the optimum use provides with respect to quality of treatment of leg amputees. Does osseointegration influence the motor activity of residual limbs differently compared with socket prostheses? How should prosthesis components be aligned? What type of prosthetic knee joints should be preferred in transfemoral amputees? Transfer of biomechanical knowledge of socket prosthetics to bone-anchored prostheses. Pilot studies with a limited number of amputees. Force transmission at the interface between the prosthesis and residual limb stump is completely different for osseointegrated fixation and socket design; however, the number of muscles available for control remains unchanged. Because the iliotibial tract is missing, bending moments of the femur are expected to be greater. Prosthetic alignment is very critical for gait pattern and the basic rules seem to be the same as for socket design. The foot position determines the knee function for below-knee amputees. The position of the femur influences the gait pattern of above-knee amputees. The lowest risk of falls and best functional properties are shown by microprocessor controlled knee joints. Osseointegrated leg prostheses have some biomechanical advantages over the socket design. Since rehabilitation quality is clearly affected the prosthetic alignment has to be done carefully and precisely. As a rule microprocessor controlled knee joints are indicated.

  9. Unusual cause of subluxation of Austin Moore prosthesis of the hip ...

    African Journals Online (AJOL)

    Subluxation and dislocation following hip arthroplasty is a well known complication. It can be due to a number of reasons - varying from malrotation of the component, operative approach, previous surgery, previous stroke, loosening and high wear rates of prosthesis, infection to even patient behaviour. In this study, an ...

  10. Ossicular chain reconstruction: a combined prosthesis with organic and synthetic material.

    Science.gov (United States)

    Linden, A; Roithman, R

    1991-04-01

    The surgical techniques to restore the sound pressure transfer mechanism in surgery of chronic otitis media are still in an evolutionary stage. Ossicular interposition is effective and certainly is not controversial. The use of various organic prostheses has been criticized. The prosthesis with a shaft of Teflon and a homograft bone flange is an alternative method which has been successful in our hands.

  11. Image, displacement, prosthesis: reflections on making visual archives of the Armenian genocide

    NARCIS (Netherlands)

    Baronian, M.A.

    2010-01-01

    In the face of the persistent denial of the Armenian genocide, this paper aims to discuss the way in which images can function as a prosthesis for memory. Because there are few images of this violent history and because those that do exist are not circulated in the public visual sphere, it is of

  12. Groningen temporomandibular total joint prosthesis: an 8-year longitudinal follow-up on function and pain.

    Science.gov (United States)

    Schuurhuis, Jennifer M; Dijkstra, Pieter U; Stegenga, Boudewijn; de Bont, Lambert G M; Spijkervet, Fred K L

    2012-12-01

    Total temporomandibular joint replacement is a surgical procedure for patients with severe temporomandibular joint afflictions affecting quality of life, which have not responded beneficially to previous conventional surgery. The aim of this study was to assess the long-term outcome of the Groningen temporomandibular joint (TMJ) prosthesis in patients with chronic pain and mutilated temporomandibular joints following multiple surgical procedures, with respect to prosthesis failure, the patient's postoperative level of satisfaction and longitudinal changes in maximum mouth opening, functional mandibular impairment and pain. Eight female patients were studied in whom Groningen TMJ prostheses were inserted, two unilaterally and six bilaterally. The Groningen TMJ prosthesis was mechanically successful during 8 years of follow-up in seven out of eight patients with a disc dislocation being seen in one patient (7%). Patients were satisfied, despite the limited improvement of the maximum mouth opening, and pain scores. Although the decline of MFIQ scores during 8 years of follow-up was significant compared to baseline (p=0.027), the effects of the prosthesis on maximum mouth opening, function and pain were limited. This may be due to persistent chronic pain and the adverse effects of multiple previous surgical procedures. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  13. Temporomandibular Joint Prosthesis - 3D-CT Reconstruction before and after Treatment

    Czech Academy of Sciences Publication Activity Database

    Feltlová, E.; Dostálová, T.; Kašparová, M.; Daněk, J.; Hliňáková, P.; Hubáček, M.; Nedoma, Jiří

    2010-01-01

    Roč. 6, č. 1 (2010), s. 15-19 ISSN 1801-5603 Institutional research plan: CEZ:AV0Z10300504 Keywords : dentistry * maxillofacial surgery * partial TMJ prosthesis * three-dimensional computed tomography * magnetic resonance imaging * temporomandibular joint Subject RIV: BA - General Mathematics http://www.ejbi.cz/articles/201012/50/1.html

  14. Learning to use a body-powered prosthesis : changes in functionality and kinematics

    NARCIS (Netherlands)

    Huinnk, L.H.B.; Bouwsema, H.; Plettenburg, D.H.; van der Sluis, C.K.; Bongers, R.M.

    2016-01-01

    Background: Little is known about action-perception learning processes underlying prosthetic skills in body-powered prosthesis users. Body-powered prostheses are controlled through a harness connected by a cable that might provide for limited proprioceptive feedback. This study aims to test

  15. Self-crimping superelastic nitinol prosthesis and malleostapedotomy: a temporal bone study.

    Science.gov (United States)

    Magliulo, Giuseppe

    2013-02-01

    The aim of this study was to compare the results of application of 2 types of superelastic nitinol prostheses. Temporal bones study with planned data collection. Tertiary referral center. Malleostapedotomy was performed in 15 human temporal bones implanting 3 different prostheses: manually crimping polytetrafluoroethylene (MC-PTFE) piston, nitinol self-crimping polytetrafluoroethylene (SC-PTFE) piston, and a modified nitinol self-crimping polytetrafluoroethylene (mSC-PTFE) piston. The first 2 have a diameter of 0.4 mm and length of 7 mm, whereas the mSC-PTFE piston has a diameter of 0.4 mm but a length of 7.75 mm. We evaluated various parameters of prosthesis attachment-that is, the time for implantation of SC and mSC nitinol loop pistons and the MC platinum loop piston, the quality of attachment of the prostheses to the malleus, their positions with respect to the center of the stapes footplate, and the protrusion of the piston into the vestibule. The mSC-PTFE superelastic nitinol prosthesis showed a statistically significant difference in mean operation time (mSC vs SC, P piston into the vestibule was highly reproducible in all 3 prostheses. Because of its greater length, the mSC-PTFE allows for management of the most varied anatomical conditions. At the same time, its self-crimping nature prevents the risk of distortion of the prosthesis by the crimping process and reduces the operation time in combination with standardized bending of the prosthesis shaft.

  16. Fat embolism syndrome following bilateral total knee replacement with total condylar prosthesis: report of two cases.

    Science.gov (United States)

    Lachiewicz, P F; Ranawat, C S

    1981-10-01

    This is the first report of fat embolism syndrome after bilateral total knee arthroplasty with the total condylar prosthesis. Cementing techniques and increased systemic monomer may play a role in the etiology of this syndrome. It is reasonable to suppose that fat embolism syndrome often occurs after total knee arthroplasty in an occult form.

  17. [WIll there ever exist the ideal auditive prosthesis for the reconstructive surgery of the middle ear?].

    Science.gov (United States)

    Garzón Calles, J A

    1996-01-01

    The AA. of the paper review the several materials used for the reconstruction of the middle ear ossicular chain. They inform about each material, including the auto- and homologous grafts of ossicles, cortical bone and cartilage. Palavit, Polyethylene-90, Teflon, metallic implants. Porous plastic materials: Proplast, Plastipore and Polycel. Bioactive ceramic prosthesis (ceramics of aluminium oxyde): Frialit and CORP. Bioactive vitroceramic prosthesis: Macor, Bioglass and Ceravital. Also bioactive of phosphate of calcium: Hydroxyapatite and Apaceram. Prosthesic material of nacre, coal-coal and Polymetacrylate (Ossiculoplast). The most important matter is to get an ear in the best conditions in order to accept the prosthesis, that is to say, a bed completely dry with no inflammatory clues in the tympanic cleft and with a correct functionalism of the Eustachian tube. The healthy ossicular rennants of the chain must be spared. The apatites, bioactive ceramica, are the prosthesis of the future owing to its similitude to the bone. Nevertheless will be difficult to obtain an absolutely inert material inside the middle ear, of the stability of the cleft is not secured.

  18. Effect of Feedback during Virtual Training of Grip Force Control with a Myoelectric Prosthesis

    NARCIS (Netherlands)

    Bouwsema, Hanneke; van der Sluis, Corry K.; Bongers, Raoul M.

    2014-01-01

    The aim of this study was to determine whether virtual training improves grip force control in prosthesis use, and to examine which type of augmented feedback facilitates its learning most. Thirty-two able-bodied participants trained grip force with a virtual ball-throwing game for five sessions in

  19. Artificial neural networks for automatic modelling of the pectus excavatum corrective prosthesis

    Science.gov (United States)

    Rodrigues, Pedro L.; Moreira, António H. J.; Rodrigues, Nuno F.; Pinho, ACM; Fonseca, Jaime C.; Correia-Pinto, Jorge; Vilaça, João. L.

    2014-03-01

    Pectus excavatum is the most common deformity of the thorax and usually comprises Computed Tomography (CT) examination for pre-operative diagnosis. Aiming at the elimination of the high amounts of CT radiation exposure, this work presents a new methodology for the replacement of CT by a laser scanner (radiation-free) in the treatment of pectus excavatum using personally modeled prosthesis. The complete elimination of CT involves the determination of ribs external outline, at the maximum sternum depression point for prosthesis placement, based on chest wall skin surface information, acquired by a laser scanner. The developed solution resorts to artificial neural networks trained with data vectors from 165 patients. Scaled Conjugate Gradient, Levenberg-Marquardt, Resilient Back propagation and One Step Secant gradient learning algorithms were used. The training procedure was performed using the soft tissue thicknesses, determined using image processing techniques that automatically segment the skin and rib cage. The developed solution was then used to determine the ribs outline in data from 20 patient scanners. Tests revealed that ribs position can be estimated with an average error of about 6.82+/-5.7 mm for the left and right side of the patient. Such an error range is well below current prosthesis manual modeling (11.7+/-4.01 mm) even without CT imagiology, indicating a considerable step forward towards CT replacement by a 3D scanner for prosthesis personalization.

  20. WalkMECH: design and control of an energy recycling transfemoral prosthesis

    NARCIS (Netherlands)

    Ünal, Ramazan

    2014-01-01

    This study presents the design and realization of an energy-efficient trans-femoral prosthesis called WalkMECH. Trans-femoral amputees consume significant amount of extra metabolic energy (more than 65% extra) during walking compared to the able- bodied person. Therefore, we mainly focused on the

  1. Chronic implantation of newly developed suprachoroidal-transretinal stimulation prosthesis in dogs.

    Science.gov (United States)

    Morimoto, Takeshi; Kamei, Motohiro; Nishida, Kentaro; Sakaguchi, Hirokazu; Kanda, Hiroyuki; Ikuno, Yasushi; Kishima, Haruhiko; Maruo, Tomoyuki; Konoma, Kunihiko; Ozawa, Motoki; Nishida, Kohji; Fujikado, Takashi

    2011-08-29

    To investigate the feasibility of implanting a newly developed suprachoroidal-transretinal stimulation (STS) prosthesis in dogs and to determine its biocompatibility and stability over a 3-month period. The STS prosthesis system consisted of an array of 49 electrodes (nine were active), an intravitreal return electrode, and an extraocular microstimulator. The 49-electrode array was implanted into a scleral pocket of each of three healthy beagle dogs. Color fundus photography, fluorescein angiography, electroretinography, and functional testing of the STS system were performed postoperatively. The dogs were euthanatized 3 months after the implantation, and the retinas were evaluated histologically. All the prostheses were successfully implanted without complications, and no serious complications occurred during the 3-month postoperative period. The fixation of the implant was stable throughout the experimental period. Fluorescein angiography showed that the entire retina, including the area on the electrode array, remained well perfused without intraocular inflammation. Electroretinograms recorded from the eyes with the prosthesis did not differ significantly from those recorded from control eyes. Functional testing of the STS system showed that this system performed well for the 3-month experimental period. Histologic evaluations showed good preservation of the retina over the electrode array. Implantation of a newly developed STS retinal prosthesis into a scleral pocket of beagle dogs is surgically feasible and can be performed without significant damage to the retina or the animal. The biocompatibility and stability of the system were good for the 3-month observation period.

  2. Loading of a unilateral temporomandibular joint prosthesis : A three-dimensional mathematical study

    NARCIS (Netherlands)

    van Loon, JP; Falkenstrom, CH; de Bont, LGM; Verkerke, GJ

    1998-01-01

    The load on the prosthetic side and the influence of the design on the remaining natural contralateral TMJ must be known before a unilateral temporomandibular joint (TMJ) prosthesis can be developed. The aim of the present study was to determine the maximum loading of the TMJ prosthetic side and the

  3. The Effect of Breast Reconstruction Prosthesis on Photon Dose Distribution in Breast Cancer Radiotherapy

    Directory of Open Access Journals (Sweden)

    fatemeh sari

    2017-12-01

    Full Text Available Introduction: Siliconeprosthetic implants are commonlyutilizedfor tissue replacement and breast augmentation after mastectomy. On the other hand, some patients require adjuvant radiotherapy in order to preventlocal-regional recurrence and increment ofthe overall survival. In case of recurrence, the radiation oncologist might have to irradiate the prosthesis.The aim of this study was to evaluate the effect of silicone prosthesis on photon dose distribution in breast radiotherapy. Materials and Methods: The experimental dosimetry was performed using theprosthetic breast phantom and the female-equivalent mathematical chest phantom. A Computerized Tomographybased treatment planning was performedusing a phantom and by CorePlan Treatment Planning System (TPS. For measuring the absorbed dose, thermoluminescent dosimeter(TLD chips (GR-207A were used. Multiple irradiations were completed for all the TLD positions, and the dose absorbed by the TLDs was read by a lighttelemetry (LTM reader. Results: Statistical comparisons were performed between the absorbed dosesassessed by the TLDs and the TPS calculations forthe same sites. Our initial resultsdemonstratedanacceptable agreement (P=0.064 between the treatment planning data and the measurements. The mean difference between the TPS and TLD resultswas 1.99%.The obtained findings showed that radiotherapy is compatible withsilicone gel prosthesis. Conclusion: It could be concludedthat the siliconbreast prosthesis has no clinicallysignificant effectondistribution of a 6 MV photon beam for reconstructed breasts.

  4. Regulation of step frequency in transtibial amputee endurance athletes using a running-specific prosthesis

    NARCIS (Netherlands)

    Oudenhoven, Laura M.; Boes, Judith M.; Hak, Laura; Faber, Gert S.; Houdijk, Han

    2017-01-01

    Running specific prostheses (RSP) are designed to replicate the spring-like behaviour of the human leg during running, by incorporating a real physical spring in the prosthesis. Leg stiffness is an important parameter in running as it is strongly related to step frequency and running economy. To be

  5. [Potential nosocomial disseminated infection due to Nocardia asteroides after a prosthesis insertion in an immunocompetent patient].

    Science.gov (United States)

    Mrozek, N; Hamizi, S; Gourdon, F; Laurichesse, H; Beytout, J; Lesens, O

    2008-12-01

    Nocardia infections are rare and usually occurred in immunocompromised patients with systemic dissemination from a lung infection. We report a case of an immunocompetent patient in whom Nocardia asteroides had cause psoas and cerebral abcess without pulmonary infection, a short period after a hip prosthesis insertion. The clinical history is highly suggestive of a hospital-acquired infection.

  6. Impact of prosthesis-patient mismatch on early and late mortality after aortic valve replacement

    NARCIS (Netherlands)

    Koene, Bart M.; Hamad, Mohamed A. Soliman; Bouma, Wobbe; Mariani, Massimo A.; Peels, Kathinka C.; van Dantzig, Jan-Melle; van Straten, Albert H.

    2013-01-01

    Background: The influence of prosthesis-patient mismatch (PPM) on survival after aortic valve replacement (AVR) remains controversial. In this study, we sought to determine the effect of PPM on early (30 days) after AVR or AVR combined with coronary artery bypass grafting (AVR with CABG). Methods:

  7. 21 CFR 888.3570 - Knee joint femoral (hemi-knee) metallic uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femoral (hemi-knee) metallic uncemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3570 Knee joint femoral (hemi-knee) metallic uncemented prosthesis. (a) Identification. A knee joint femoral (hemi-knee...

  8. Biomechanical evaluation of a novel nucleus pulposus prosthesis in canine cadaveric spines.

    NARCIS (Netherlands)

    Smolders, L.A.; Bergknut, N.; Kingma, I.; van der Veen, A.J.; Smit, T.H.; Koole, L.H.; Hazewinkel, H.A.; Meij, B.P.

    2012-01-01

    Partial disc replacement is a new surgical technique aimed at restoring functionality to degenerated intervertebral discs (IVDs). The aim of the present study was to assess biomechanically the behaviour of a novel nucleus pulposus prosthesis (NPP) in situ and its ability to restore functionality to

  9. Frequency of Prosthetic Complications Related to Implant-Borne Prosthesis in a Sleep Disorder Unit.

    Science.gov (United States)

    Anitua, Eduardo; Saracho, Juan; Almeida, Gabriela Zamora; Duran-Cantolla, Joaquin; Alkhraisat, Mohammad Hamdan

    2017-02-01

    Sleep bruxism and higher clench index have been associated with obstructive sleep apnea (OSA). However, there is no study that reports on the prosthetic complications in patients with OSA. Records of patients who had performed a sleep study to diagnose OSA were examined for the occurrence of prosthetic complications in implant-borne reconstructions. The primary outcome was the frequency of prosthetic complications. The secondary outcomes were anthropometric data, type of complication, type of prosthesis, type of retention, number of supporting implants, number of prosthetic units, and the presence of obstructive sleep apnea. Of the 172 patients, 67 had an implant-supported prosthesis, and all were included in the study. The mean age was 61 ± 10 years, and 36 were female. Thirty complications in 22 prostheses were identified in 16 patients. The complications were porcelain fracture (14 events), screw/implant fracture (8 events), screw loosening (3 events), and decementation (5 events). The follow-up time was 117 ± 90 months after placement of the prosthesis. The average time for complications to occur was 73 ± 65 months after the placement of the prosthesis. According to the apnea-hypopnea index (AHI), 49 patients had OSA. Thirteen of the 16 patients having a prosthetic complication also had OSA. The highest AHI and thus the severity of OSA was identified in patients with a fracture complication related to an implant, a screw, or a porcelain. The frequency of prosthetic complications has been higher in patients with obstructive sleep apnea.

  10. Transapical JenaValve in a patient with mechanical mitral valve prosthesis.

    LENUS (Irish Health Repository)

    O' Sullivan, Katie E

    2014-01-29

    We report the first case of transcatheter aortic valve replacement implantation using JenaValve™ in a patient with mechanical mitral valve prosthesis. We believe that the design features of this valve may be particularly suited for use in this setting. © 2014 Wiley Periodicals, Inc.

  11. Influence of different combinations of bacteria and yeasts in voice prosthesis biofilms on air flow resistance

    NARCIS (Netherlands)

    Elving, GJ; van der Mei, H; Busscher, H; van Weissenbruch, R; Albers, F

    2003-01-01

    Laryngectomized patients use silicone rubber voice prostheses to rehabilitate their voice. However, biofilm formation limits the lifetime of voice prostheses. The presence of particular combinations of bacterial and yeast strains in voice prosthesis biofilms has been suggested to be crucial for

  12. Determining skill level in myoelectric prosthesis use with multiple outcome measures

    NARCIS (Netherlands)

    Bouwsema, Hanneke; Kyberd, Peter J.; Hill, Wendy; van der Sluis, Corry K.; Bongers, Raoul M.

    2012-01-01

    To obtain more insight into how the skill level of an upper-limb myoelectric prosthesis user is composed, the current study aimed to (1) portray prosthetic handling at different levels of description, (2) relate results of the clinical level to kinematic measures, and (3) identify specific

  13. Effect of metal hip prosthesis on the accuracy of electromagnetic localization tracking.

    Science.gov (United States)

    Bittner, Nathan; Butler, Wayne M; Kurko, Brian S; Merrick, Gregory S

    2015-01-01

    To quantify the effect of metal hip prosthesis on the ability to track and localize electromagnetic transponders. Three Calypso Beacon (Varian Medical Systems, Palo Alto, CA) transponders were implanted into 2 prostate phantoms. The geometric center of the transponders were identified on computed tomography and set as the isocenter. With the phantom stationary on the treatment table and the tracking array 14-cm above the isocenter, data were acquired by the Calypso system at 10 Hz to establish the uncertainty in measurements. Transponder positional data were acquired with unilateral hip prostheses of different metallic compositions and then with bilateral hips placed at variable separation from the phantom. Regardless of hip prosthesis composition, the average vector displacement in the presence of a unilateral prosthesis was effect with bilateral hip prosthesis. The greatest average vector displacement was 0.6 mm and occurred when bilateral hip prostheses were placed within 4 cm of the detector array. Unilateral and bilateral hip prostheses did not have any meaningful effect on the ability to accurately track electromagnetic transponders implanted in a prostate phantom. At clinically realistic distances between the hip and detection array, the average tracking error is negligible. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  14. Comparison of the microbial composition of voice prosthesis biofilms from patients requiring frequent versus infrequent replacement

    NARCIS (Netherlands)

    Elving, GJ; Van Der Mei, HC; Van Weissenbruch, R; Busscher, HJ; Albers, FWJ

    This study was performed to establish a possible difference in biofilm composition in patients who require frequent versus infrequent prosthesis replacement. Only Groningen button voice prostheses that were removed because of increased airflow resistance or leakage of food or liquids through the

  15. Aerodynamic characteristics of the Nijdam voice prosthesis in relation to tracheo-esophageal wall thickness

    NARCIS (Netherlands)

    Veenstra, Aalze; van den Hoogen, F. J. A.; Schutte, H.K.; Nijdam, HF; Manni, JJ; Verkerke, GJ

    Tracheo-esophageal speech using various pros theses is currently the most successful form of voice and speech rehabilitation for laryngectomees. Main inter-device differences are durability and trans-device pressure loss during speech. The valveless indwelling Nijdam voice prosthesis is a new voice

  16. Stresses in the normal and diabetic human penis following implantation of an inflatable prosthesis.

    Science.gov (United States)

    Gefen, A; Chen, J; Elad, D

    1999-09-01

    The prevalence of impotence in diabetes mellitus ranges as high as 75%. The implantation of an inflatable penile prosthesis (IPP) is frequently carried out to restore erectile function. However, clinical studies have demonstrated that severe post-implantation penile pain during erection is a common complication in diabetic men. A biomechanical model of the penis/prosthesis complex is developed, based on cross-sectional anatomy, to simulate the internal stress distribution due to interaction of the prosthesis with both normal and diabetic penile tissues. The material properties of the model components are adopted from experimental data. The model is solved by using commercial finite-element software for a characteristic inflation loading of the penile prosthesis. Elevated structural stresses during erection are found in the dorsal aspect of the tunica albuginea (normal 5.1-31.5 kPa, diabetic 5.1-70 kPa post-implantation). Following IPP implantation, stresses in the diabetic penis are almost as twice as high as those in the normal one and can cause a painful sensation owing to nerve stimulation or to ischaemia in regions of compressed vascular tissue.

  17. Long-term tricuspid valve prosthesis-related complications in patients with congenital heart disease.

    Science.gov (United States)

    van Slooten, Ymkje J; Freling, Hendrik G; van Melle, Joost P; Mulder, Barbara J M; Jongbloed, Monique R M; Ebels, Tjark; Voors, Adriaan A; Pieper, Petronella G

    2014-01-01

    In patients with acquired valvar disease, morbidity and mortality rates after tricuspid valve replacement (TVR) are high. However, in adult patients with congenital heart disease, though data concerning outcome after TVR are scarce, even poorer results are suggested in patients with Ebstein anomaly. To investigate the applicability of these results to a broader array of congenital heart disease patients, we report the long-term follow-up of prosthesis-related complications, including re-replacement of patients with a tricuspid valve prosthesis and congenital heart disease. From the Dutch Congenital Corvitia (CONCOR) registry, we identified 20 patients with a biological or mechanical tricuspid valve prosthesis implanted between 1977 and 2012 (total of 31 prostheses). We analysed the tricuspid valve-related complications and mortality. Ten patients with a median age of 16.2 years at the time of surgery (interquartile range 13.2-28.2 years) received a bioprosthesis while 10 patients with a median age of 36.4 years (interquartile range 14.0-47.0) at the time of surgery received a mechanical prosthesis (P = 0.28). During a mean follow-up of 14 years, 50% needed a re-replacement because of valve-related complications (e.g. valve degeneration or valve thrombosis). The yearly percentage of patients with valve-related complications was 4.2% in patients with a bioprosthesis and 2.7% in those with a mechanical prosthesis. Within 20 years of implantation, the median duration of event-free survival was significantly shorter in 3 patients with a prosthesis-patient mismatch (PPM; 1.0 year; interquartile range 0.01-2.6), compared with 7 without mismatch (8.0 years; interquartile range 5.1-12.3; P = 0.02). Compared with previous literature on acquired valvar disease, we found a higher incidence of valve-related complications in patients with congenital heart disease that was unrelated to prosthesis material. Our data suggest that PPM may have a negative effect on the event

  18. Transfemoral amputee recovery strategies following trips to their sound and prosthesis sides throughout swing phase.

    Science.gov (United States)

    Shirota, Camila; Simon, Ann M; Kuiken, Todd A

    2015-09-09

    Recovering from trips is challenging for transfemoral amputees, and attempts often result in falls. Better understanding of the effects of the sensory-motor deficits brought by amputation and the functional limitations of prosthetic devices could help guide therapy and fall prevention mechanisms in prostheses. However, how transfemoral amputees attempt to recover from trips on the sound and prosthesis sides throughout swing phase is poorly understood. We tripped eight able-bodied subjects and eight unilateral transfemoral amputees wearing their prescribed prostheses. The protocol consisted of six repetitions of 6 and 4 points throughout swing phase, respectively. We compared recovery strategies in able-bodied, sound side and prosthesis side limbs. The number of kinematic recovery strategies used, when they were used throughout swing phase, and kinematic characteristics (tripped limb joint angles, bilateral trochanter height and time from foot arrest to foot strike) of each strategy were compared across limb groups. Non-parametric statistical tests with corrections for post-hoc tests were used. Amputees used the same recovery strategies as able-bodied subjects on both sound and prosthesis sides, although not all subjects used all strategies. Compared to able-bodied subjects, amputees used delayed-lowering strategies less often from 30-60 % of swing phase on the sound side, and from 45-60 % of swing phase on the prosthesis side. Within-strategy kinematic differences occurred across limbs; however, these differences were not consistent across all strategies. Amputee-specific recovery strategies-that are not used by control subjects-occurred following trips on both the sound and prosthesis sides in mid- to late swing. Collectively, these results suggest that sensory input from the distal tripped leg is not necessary to trigger able-bodied trip recovery strategies. In addition, the differences between sound and prosthesis side recoveries indicate that the ability of the

  19. Ipsilateral Fracture Shaft Femur with Neglected Dislocation of Prosthesis: A Case Report

    Directory of Open Access Journals (Sweden)

    Mantu Jain

    2013-10-01

    Full Text Available Introduction: Neglected hip dislocation is rare in today’s world and after prosthesis replacement even rarer finding. However such patients may not report to surgeons until they develop secondary complications. Management of such patient’s is a challenge to the treating surgeon and need to be tailored suiting to patient’s demands, expectations and constraints of financial resources. We did not find a similar case in the electronic and print media and therefore report this case which was innovatively managed. Case Report: A 60 year farmer presented with fracture shaft femur and ipsilateral dislocation prosthesis of right hip. He had a hemiarthroplasty done for fracture neck of femur in the past but used to walk with a lurch since he started to ambulate after discharge. However he was satisfied despite “some problems” which had caused shortening of his limb. The patient was informed of the various treatment options and their possible complications. He expressed his inability to afford a Total Hip Arthroplasty (THA at any stage and consented for other options discussed with him. The patient was positioned supine and adductor tenotomy done. Next he was positioned laterally and the fracture was fixed with heavy duty broad dynamic compression plate and screws. The wound was temporarily closed. Now through the previous scar via posterior approach the hip was exposed. The prosthesis was found to be firmly fixed to the proximal femur. The acetabulum was cleared with fibrous tissue. All attempts the prosthesis to relocate the prosthesis failed after several attempts and it was best decided to leave alone. Post operatively period was uneventful. At follow up he refused for any further manoeuvre in future inform of heavy traction and attempts to reduce the same. At one year when he was walking unaided and his X-rays showed that fracture had well united his SF-36 score was PCS – 49.6 and MCS – 51.9. Conclusion: Ipsilateral shaft femur fracture

  20. [Treatment of the complex intraarticular fracture of the distal humerus with the latitude elbow prosthesis].

    Science.gov (United States)

    Burkhart, Klaus Josef; Müller, Lars Peter; Schwarz, Christina; Mattyasovszky, Stefan Georg; Rommens, Pol Maria

    2010-07-01

    Therapy of comminuted intraarticular distal humerus fractures in elderly patients with primary total elbow arthroplasty to achieve stable and painless function. Use of "third-generation" elbow prosthesis with the following options:--linked total elbow arthroplasty,--unlinked total elbow arthroplasty,--either with or without radial head replacement,--hemiarthroplasty. Comminuted intraarticular distal humerus fractures with poor bone quality, in which stable osteosynthesis is impossible. Failure of internal fixation without the technical possibility of revision osteosynthesis. Posttraumatic osteoarthritis or rheumatoid arthritis. Open fractures (Gustilo-Anderson type II or III) or contaminated wounds should not initially be treated with total elbow arthroplasty. Prosthetic replacement may be considered after consolidation of the soft tissue. Low compliance, high functional demands. Paralysis of the biceps muscle. Supine positioning of the patient. Surgical approach after Bryan-Morrey. Anterior transposition of the ulnar nerve. Preparation of the insertion of the triceps at the distal humerus, capsule and proximal ulna. Reflection of the triceps in continuity with the ulnar periosteum and the forearm fascia. Attempt at reconstruction of the epicondyles to achieve ligamentary stability and to implant an unlinked prosthesis. If this is technically not possible, the prosthesis is linked at the end of the operation. Removal of the distal humerus fragments. Determination of the prosthesis size. Detection of the extension-flexion axis. Opening of the humeral intramedullary canal. Determination of the offset. Preparation of the humeral prosthesis repository. Placement of the trial prosthesis. Potential implantation of a hemiprosthesis, if radial head, proximal ulna and ligaments are unaffected. Otherwise preparation of the ulnar prosthesis repository. If the radial head is unaffected, it can be preserved. Otherwise it has to be resected and preferably replaced. Placement of

  1. Bicentric bipolar hip prosthesis: A radiological study of movement at the interprosthetic joint

    Directory of Open Access Journals (Sweden)

    Anil Kumar Rai

    2011-01-01

    Full Text Available Background: The bipolar hip prostheses after some time functions as a unipolar device. There is a need to change the design of bipolar hip prostheses to make it function as a bipolar device over a prolonged period of time. A bicentric bipolar hip prosthesis was used as an implant for various conditions of the hip. We evaluated the movement of this newly developed prosthesis at the interprosthetic joint radiologically at periodic intervals. Materials and Methods: Fifty two cases were operarted with the Bicentric bipolar prosthesis for indications like fracture neck of femur and various other diseases of the hip and were followed up with serial radiographs at periodic intervals to evaluate, what fraction of the total abduction at the hip was occurring at the interprosthetic joint. Results: In cases of intracapsular fracture neck of femur, the percentage of total abduction occurring at the interprosthetic joint at 3 months follow-up was 33.74% (mean value of all the patients, which fell to 25.66% at 1.5 years. In indications for bipolar hemireplacement other than fracture neck of femur, the percentage of total abduction occurring at the interprosthetic joint at 3 months follow-up was 71.71% (mean value and at 1.5 years it was 67.52%. Conclusion: This study shows the relative preservation of inner bearing movement in the bipolar hip prosthesis with time probably due its refined design. Further refinements are needed to make the prosthesis work better in patients of intracapsular fracture neck femur.

  2. A clinical, radiological and computational analysis of the thrust plate prosthesis in young patients.

    Science.gov (United States)

    Gerich, T G; Wilmes, P; Nackenhorst, U; Gösling, T; Ziefle, M; Krettek, C

    2011-01-01

    A thrust plate prosthesis can be used as an alternative to a conventional stem prosthesis, preserving the diaphyseal bone stock. Recent findings however predict a higher rate of aseptic loosening than with intramedullary devices. The purpose of our investigation was to compare the clinical outcome and radiological findings with a finite element analysis of bone remodeling. The hypothesis was that aseptic loosening after thrust plate prosthesis of the hip is inherent to the design. From 1997 to 2001, 58 thrust plates were implanted in 52 patients. Average age at the time of surgery was 40.9 years. Ninety four percent returned for follow up at an average of 26 months. A finite element model of the thrust plate within the femur was developed and stress shielding as well as bone remodeling were analyzed. A total of 4 patients required revision surgery (6.9%). Data from the finite element analysis revealed an inherent failure mechanism to the implant, facilitating stress shielding and loosening. Lacking the ideal total hip prosthesis in young patients, the thrust plate can still be regarded as a feasible implant. However, surgeons and patients should be aware of possible mechanical problems regarding the design of the thrust plate. There is evidence that thrust plate prostheses are prone to early aseptic loosening. Clinical and radiological observations are in agreement with the results from the numerical simulations. Stress concentrations computed at the leash are interpreted as an explanation for leash pain. The authors regard computational methods as an aid to improve existing prosthesis design and future developments.

  3. Validation of the Inverted Pendulum Model in standing for transtibial prosthesis users.

    Science.gov (United States)

    Rusaw, David F; Ramstrand, Simon

    2016-01-01

    Often in balance assessment variables associated with the center of pressure are used to draw conclusions about an individual's balance. Validity of these conclusions rests upon assumptions that movement of the center of pressure is inter-dependent on movement of the center of mass. This dependency is mechanical and is referred to as the Inverted Pendulum Model. The following study aimed to validate this model both kinematically and kinetically, in transtibial prosthesis users and a control group. Prosthesis users (n=6) and matched control participants (n=6) stood quietly while force and motion data were collected under three conditions (eyes-open, eyes-closed, and weight-bearing feedback). Correlation coefficients were used to investigate the relationships between height and excursion of markers and center of masses in mediolateral/anteroposterior-directions, difference between center of pressure and center of mass and the center of mass acceleration in mediolateral/anteroposterior directions, magnitude of mediolateral/anteroposterior-component forces and center of mass acceleration, angular position of ankle and excursion in mediolateral/anteroposterior-directions, and integrated force signals. Results indicate kinematic validity of similar magnitudes (mean (SD) marker-displacement) between prosthesis users and control group for mediolateral- (r=0.77 (0.17); 0.74 (0.19)) and anteroposterior-directions (r=0.88 (0.18); 0.88 (0.19)). Correlation between difference of center of pressure and center of mass and the center of mass acceleration was negligible on the prosthetic side (r = 0.08 (0.06)) vs. control group (r=-0.51(0.13)). Results indicate kinematic validity of the Inverted Pendulum Model in transtibial prosthesis users but kinetic validity is questionable, particularly on the side with a prosthesis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Aortic valve prosthesis-patient mismatch and exercise capacity in adult patients with congenital heart disease.

    Science.gov (United States)

    van Slooten, Ymkje J; van Melle, Joost P; Freling, Hendrik G; Bouma, Berto J; van Dijk, Arie Pj; Jongbloed, Monique Rm; Post, Martijn C; Sieswerda, Gertjan T; Huis In 't Veld, Anna; Ebels, Tjark; Voors, Adriaan A; Pieper, Petronella G

    2016-01-01

    To report the prevalence of aortic valve prosthesis-patient mismatch (PPM) in an adult population with congenital heart disease (CHD) and its impact on exercise capacity. Adults with congenital heart disease (ACHD) with a history of aortic valve replacement may outgrow their prosthesis later in life. However, the prevalence and clinical consequences of aortic PPM in ACHD are presently unknown. From the national Dutch Congenital Corvitia (CONCOR) registry, we identified 207 ACHD with an aortic valve prosthesis for this cross-sectional cohort study. Severe PPM was defined as an indexed effective orifice area ≤0.65 cm2/m2 and moderate PPM as an indexed orifice area ≤0.85 cm2/m2 measured using echocardiography. Exercise capacity was reported as percentage of predicted exercise capacity (PPEC). Of the 207 patients, 68% was male, 71% had a mechanical prosthesis and mean age at inclusion was 43.9 years ±11.4. The prevalence of PPM was 42%, comprising 23% severe PPM and 19% moderate PPM. Prevalence of PPM was higher in patients with mechanical prostheses (pHeart Association (NYHA) class remained stable in most patients. PPM showed no significant effect on death or hospitalisation during follow-up (p=0.218). In this study we report a high prevalence (42%) of PPM in ACHD with an aortic valve prosthesis and an independent association of PPM with diminished exercise capacity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. A prosthesis-specific multi-link segment model of lower-limb amputee sprinting.

    Science.gov (United States)

    Rigney, Stacey M; Simmons, Anne; Kark, Lauren

    2016-10-03

    Lower-limb amputees commonly utilize non-articulating energy storage and return (ESAR) prostheses for high impact activities such as sprinting. Despite these prostheses lacking an articulating ankle joint, amputee gait analysis conventionally features a two-link segment model of the prosthetic foot. This paper investigated the effects of the selected link segment model׳s marker-set and geometry on a unilateral amputee sprinter׳s calculated lower-limb kinematics, kinetics and energetics. A total of five lower-limb models of the Ottobock ® 1E90 Sprinter were developed, including two conventional shank-foot models that each used a different version of the Plug-in-Gait (PiG) marker-set to test the effect of prosthesis ankle marker location. Two Hybrid prosthesis-specific models were then developed, also using the PiG marker-sets, with the anatomical shank and foot replaced by prosthesis-specific geometry separated into two segments. Finally, a Multi-link segment (MLS) model was developed, consisting of six segments for the prosthesis as defined by a custom marker-set. All full-body musculoskeletal models were tested using four trials of experimental marker trajectories within OpenSim 3.2 (Stanford, California, USA) to find the affected and unaffected hip, knee and ankle kinematics, kinetics and energetics. The geometry of the selected lower-limb prosthesis model was found to significantly affect all variables on the affected leg (p amputee gait characteristics, and we therefore recommend the implementation of a MLS model. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Adaptation and prosthesis effects on stride-to-stride fluctuations in amputee gait.

    Directory of Open Access Journals (Sweden)

    Shane R Wurdeman

    Full Text Available Twenty-four individuals with transtibial amputation were recruited to a randomized, crossover design study to examine stride-to-stride fluctuations of lower limb joint flexion/extension time series using the largest Lyapunov exponent (λ. Each individual wore a "more appropriate" and a "less appropriate" prosthesis design based on the subject's previous functional classification for a three week adaptation period. Results showed decreased λ for the sound ankle compared to the prosthetic ankle (F1,23 = 13.897, p = 0.001 and a decreased λ for the "more appropriate" prosthesis (F1,23 = 4.849, p = 0.038. There was also a significant effect for the time point in the adaptation period (F2,46 = 3.164, p = 0.050. Through the adaptation period, a freezing and subsequent freeing of dynamic degrees of freedom was seen as the λ at the ankle decreased at the midpoint of the adaptation period compared to the initial prosthesis fitting (p = 0.032, but then increased at the end compared to the midpoint (p = 0.042. No differences were seen between the initial fitting and the end of the adaptation for λ (p = 0.577. It is concluded that the λ may be a feasible clinical tool for measuring prosthesis functionality and adaptation to a new prosthesis is a process through which the motor control develops mastery of redundant degrees of freedom present in the system.

  7. Effect of oral mucosa transplantation in the treatment of severe contracted conjunctival sac after ocular prosthesis implantation

    Directory of Open Access Journals (Sweden)

    Li-Li Dong

    2014-12-01

    Full Text Available AIM:To observe the clinic effect of oral mucosa transplantation in the treatment of severe contracted conjunctival sac after ocular prosthesis implantation.METHODS: Thirty-three cases(33 eyeswith globe disorders and severe contracted conjunctval sac were operated ocular prosthesis implantation firstly, and conjunctival sac plasty using oral mucosa after 6mo. RESULTS: Thirty-one cases were successful, no complications appeared. One case had primary ptosis and 1 case had recurrent conjunctival sac contracture.CONCLUSION: It is recognised that the methods of oral mucosa transplantation in severe contracted conjunctival sac after ocular prosthesis implantation are effective on those cases.

  8. Assessment of alaryngeal speech using a sound-producing voice prosthesis in relation to sex and pharyngoesophageal segment tonicity

    NARCIS (Netherlands)

    Van der Torn, M; Van Gogh, CDL; Verdonck-de Leeuw, IMD; Festen, JM; Verkerke, GJ; Mahieu, HF

    Background. A pneumatic artificial sound source incorporated in a regular tracheoesophageal shunt valve may improve alaryngeal voice quality. Methods. In 20 laryngectomees categorized for sex and pharyngoesophageal segment tonicity, a prototype sound-producing voice prosthesis (SPVP) is evaluated

  9. Prosthetic Rehabilitation of Mandibular Defects with Fixed-removable Partial Denture Prosthesis Using Precision Attachment: A Twin Case Report.

    Science.gov (United States)

    Munot, Vimal Kantilal; Nayakar, Ramesh P; Patil, Raghunath

    2017-01-01

    The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fixed-removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene, and better postoperative care and maintenance. This article describes rehabilitation of two cases with mandibular defects with an attachment-retained fixed-removable hybrid prosthesis.

  10. Prosthetic rehabilitation of mandibular defects with fixed-removable partial denture prosthesis using precision attachment: A twin case report

    Directory of Open Access Journals (Sweden)

    Vimal Kantilal Munot

    2017-01-01

    Full Text Available The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fixed-removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene, and better postoperative care and maintenance. This article describes rehabilitation of two cases with mandibular defects with an attachment-retained fixed-removable hybrid prosthesis.

  11. Development of a Low Cost, High Function 3D Printed Hand Prosthesis Using the Wrist Extension as Activator

    National Research Council Canada - National Science Library

    de Miranda luzo, Maria Candida; Pereira, Cesar Augusto Martins; Pessa, Mariana Miranda Nicolosi; Mattar, Rames; de Paula, Emygdio Jose Leomil

    2016-01-01

    Objective: The authors have developed a prosthesis for hand amputees or malformations that can be activeted mecanically through the moviment of the wrist using the wrist tenodesis pattern and not the the wrist...

  12. Short- and medium-term results of the thrust plate prosthesis in patients with polyarthritis.

    Science.gov (United States)

    Fink, B; Siegmüller, C; Schneider, T; Conrad, S; Schmielau, G; Rüther, W

    2000-01-01

    The thrust plate prosthesis is an implant with metaphyseal fixation to the proximal femur, which leaves the diaphyseal bone untouched. Therefore, this implant is preferred in younger patients. It is dependent on good bone quality in the proximal femur. Because the bone quality is reduced in patients with polyarthritis, this kind of endoprosthesis may have a higher failure rate than conventional stemmed endoprostheses in these patients. Therefore, in patients with polyarthritis, even short- and medium-term results of the thrust plate prosthesis should be analyzed. In all, 47 thrust plate prostheses were implanted in 42 patients with polyarthritis (29 with rheumatoid arthritis, 6 with juvenile chronic arthritis, and 7 with spondylarthritis) and followed prospectively. The average age at operation was 40.8+/-10.7 years. Each patient was clinically and radiologically examined preoperatively, 3 and 6 months after the operation, and at the end of each postoperative year. The mean follow-up was 26.1+/-10.7 months. The clinical findings were evaluated using the Harris hip score. Radiologically, 8 different zones of the thrust plate prosthesis were analyzed for radiolucencies. During the 1st year, the Harris hip score rose continuously from the preoperative average of 42.4+/-6.5 points to 78.8+/-10.3 points 3 months postoperatively, 82.3+/-9.8 points 6 months postoperatively, and 86.8+/-10.1 points 1 year after the operation. The subsequent examinations showed Harris hip score remained at the same level. Five patients (5 joints, 10.6%) had to undergo a revision of the thrust plate prosthesis due to aseptic loosening in 3 and septic loosening in 2. Six prostheses (12.6%) showed radiolucencies, mostly below the thrust plate in zones 1 and 2. Two of them were certainly radiologically loose, which raised the failure rate to 7 of 47 (14.8%). The thrust plate prosthesis improves function and alleviates pain in patients with polyarthritis to a satisfactory degree. Concerning the

  13. Behavior tests and immunohistochemical retinal response analyses in RCS rats with subretinal implantation of Okayama-University-type retinal prosthesis

    OpenAIRE

    Alamusi; Matsuo, Toshihiko; HOSOYA, OSAMU; Tsutsui, Kimiko M.; Uchida, Tetsuya

    2013-01-01

    We have developed a photoelectric dye-coupled polyethylene film as a prototype of retinal prosthesis, which we named Okayama University-type retinal prosthesis. The purposes of this study are to conduct behavior tests to assess vision in Royal College of Surgeons (RCS) rats that underwent subretinal implantation of the dye-coupled film and to reveal retinal response to the dye-coupled film by immunohistochemistry. Polyethylene films were made of polyethylene powder at refined purity, and phot...

  14. Effects of titanium prosthesis, offset and size of field of view on bone mineral density measurements using quantitative computed tomography.

    Science.gov (United States)

    Feng, Z; Ziv, I; Rho, J; Han, S; Fishkin, Z

    2000-05-01

    To estimate the accuracy of quantitative computed tomography (QCT) as a method to measure bone mineral density (BMD) in the vicinity of a titanium prosthesis, we investigated the effects of (1) titanium prosthesis, (2) offset of the longitudinal axis of the bone to be examined from that of the gantry of the CT scanner, (3) size of the field of view (FOV) and (4) the combination of these effects on CT based measurements of mineral density of cortical and cancellous bone specimens. 14 bovine cortical bone parallelepipeds and 14 bovine cancellous bone parallelepipeds were used in this investigation. The bone specimens were scanned with and without a titanium prosthesis, when centered in the gantry of the CT scanner and offset from the axis of the gantry of the CT scanner at a distance of 14 cm. Image data were then reconstructed separately with a FOV of 10 cm and 30 cm. All BMD values taken from CT images obtained under different scanning condition were compared with the BMD values of the corresponding bone parallelepiped obtained under standard condition (centered in the gantry of the CT scanner, 10 cm FOV, without titanium prosthesis). When centered in the gantry of the CT scanner, the mean relative difference of BMD measurements caused by the presence of the titanium prosthesis was less than 1% for both cortical bone and cancellous bone. Size of the FOV had a negligible effect on BMD measurements. Offset at 14 cm, however, caused a significant difference in BMD measurements (p < 0.001). It was concluded that titanium prosthesis did not interfere with BMD measurements of cortical and cancellous bone when both the specimen and prosthesis were centered in the gantry of the CT scanner. However, the effect on BMD measurements of offset at 14 cm combined with the presence of a titanium prosthesis in bone was significant.

  15. Prosthetic rehabilitation of mandibular defects with fixed-removable partial denture prosthesis using precision attachment: A twin case report

    OpenAIRE

    Vimal Kantilal Munot; Ramesh P Nayakar; Raghunath Patil

    2017-01-01

    The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fix...

  16. Restoration of failing maxillary implant-supported fixed prosthesis with cross arch splinted unilateral zygomatic implant: a clinical report.

    Science.gov (United States)

    Gunaseelan, Rajan; Saravanakumar, Mariappan; Hariharan, Ramasubramanian

    2012-12-01

    Management of one or more failing distal implants in an implant supported fixed prosthesis in a completely edentulous maxilla creates a challenging situation. Restoring immediate function with additional implants in such a situation can be a challenge considering the loss of supporting bone, need for grafting, age, and the patient's desire for immediate fixed dental prosthesis. This clinical report describes a situation where a zygomatic implant has been placed unilaterally and splinted with osseointegrated conventional implants by an immediate fixed provisional restoration.

  17. Introducing transcatheter aortic valve implantation with a?new generation prosthesis: Institutional learning curve and effects on acute outcomes

    OpenAIRE

    D'Ancona, G; Agma, H. U.; Kische, S.; El-Achkar, G.; Di?mann, M.; Ortak, J.; Ince, H.; U. Ketterer; B?risch, A.; ?ner, A.

    2016-01-01

    Objectives We present our single-centre experience with the direct flow medical (DFM) trans-catheter aortic valve implantation (TAVI) prosthesis addressing the impact of learning curve upon outcomes. Background The DFM has been recently introduced for TAVI. The prosthesis presents original design and implantation features. Methods Patients were divided into three groups according to the chronological implantation sequence that reflected technical skills acquisition of the entire team. Results...

  18. Prosthetic Rehabilitation of Mandibular Defects with Fixed-removable Partial Denture Prosthesis Using Precision Attachment: A Twin Case Report

    OpenAIRE

    Munot, Vimal Kantilal; Nayakar, Ramesh P; Patil, Raghunath

    2017-01-01

    The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fix...

  19. Fabricating a Soft Liner-Retained Implant-Supported Palatal Lift Prosthesis for an Edentulous Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Omid Savabi

    2012-01-01

    Full Text Available This case report describes fabrication of a palatal lift prosthesis for a quadriplegic edentulous 30-year-old male with past head traumatic injury. We constructed an implant supported bar and used a soft-lining material for the maxillary palatal lift prosthesis to minimize the possibility of implant overloading and also provide a less complex and less expensive procedure for this patient.

  20. P3-7: On Prototyping a Visual Prosthesis System with Artificial Retina and Optic Nerve Based on Arrayed Microfibers

    OpenAIRE

    Jian Hong Chen; Lon Alex Wang

    2012-01-01

    The traditional visual prosthesis system combines both a camera and a microelectrode array implanted on the visual neural network including retina, optic nerve, and visual cortex. Here, we introduce a new visual prosthesis system in which an artificial retina and optic nerve are demonstrated. The prototype of optic nerve for image transmission is comprised of arrayed PMMA microfibers with both ends connected with two planes, one functioned as retina for light reception and another attached to...

  1. Effect of Framework in an Implant-Supported Full-Arch Fixed Prosthesis: 3D Finite Element Analysis.

    Science.gov (United States)

    Menini, Maria; Pesce, Paolo; Bevilacqua, Marco; Pera, Francesco; Tealdo, Tiziano; Barberis, Fabrizio; Pera, Paolo

    2015-01-01

    The aim of this study was to analyze through a three-dimensional finite element analysis (3D-FEA) stress distribution on four implants supporting a full-arch implant-supported fixed prosthesis (FFP) using different prosthesis designs. A 3D edentulous maxillary model was created and four implants were virtually placed into the maxilla and splinted, simulating an FFP without framework, with a cast metal framework, and with a carbon fiber framework. An occlusal load of 150 N was applied, stresses were transmitted into peri-implant bone, and prosthodontic components were recorded. 3D-FEA revealed higher stresses on the implants (up to +55.16%), on peri-implant bone (up to +56.93%), and in the prosthesis (up to +70.71%) when the full-acrylic prosthesis was simulated. The prosthesis with a carbon fiber framework showed an intermediate behavior between that of the other two configurations. This study suggests that the presence of a rigid framework in full-arch fixed prostheses provides a better load distribution that decreases the maximum values of stress at the levels of implants, prosthesis, and maxillary bone.

  2. Design and experimental analysis of a new malleovestibulopexy prosthesis using a finite element model of the human middle ear.

    Science.gov (United States)

    Vallejo Valdezate, Luis A; Hidalgo Otamendi, Antonio; Hernández, Alberto; Lobo, Fernando; Gil-Carcedo Sañudo, Elisa; Gil-Carcedo García, Luis M

    2015-01-01

    Many designs of prostheses are available for middle ear surgery. In this study we propose a design for a new prosthesis, which optimises mechanical performance in the human middle ear and improves some deficiencies in the prostheses currently available. Our objective was to design and assess the theoretical acoustic-mechanical behaviour of this new total ossicular replacement prosthesis. The design of this new prosthesis was based on an animal model (an iguana). For the modelling and mechanical analysis of the new prosthesis, we used a dynamic 3D computer model of the human middle ear, based on the finite elements method (FEM). The new malleovestibulopexy prosthesis design demonstrates an acoustical-mechanical performance similar to that of the healthy human middle ear. This new design also has additional advantages, such as ease of implantation and stability in the middle ear. This study shows that computer simulation can be used to design and optimise the vibroacoustic characteristics of middle ear implants and demonstrates the effectiveness of a new malleovestibulopexy prosthesis in reconstructing the ossicular chain. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  3. Finite element analysis of stresses in fixed prosthesis and cement layer using a three-dimensional model

    Directory of Open Access Journals (Sweden)

    Arunachalam Sangeetha

    2012-01-01

    Full Text Available Context: To understand the effect of masticatory and parafunctional forces on the integrity of the prosthesis and the underlying cement layer. Aims: The purpose of this study was to evaluate the stress pattern in the cement layer and the fixed prosthesis, on subjecting a three-dimensional finite element model to simulated occlusal loading. Materials and Methods: Three-dimensional finite element model was simulated to replace missing mandibular first molar with second premolar and second molar as abutments. The model was subjected to a range of occlusal loads (20, 30, 40 MPa in two different directions - vertical and 30° to the vertical. The cements (zinc phosphate, polycarboxylate, glass ionomer, and composite were modeled with two cement thicknesses - 25 and 100 μm. Stresses were determined in certain reference points in fixed prosthesis and the cement layer. Statistical Analysis Used: The stress values are mathematic calculations without variance; hence, statistical analysis is not routinely required. Results: Stress levels were calculated according to Von Mises criteria for each node. Maximum stresses were recorded at the occlusal surface, axio-gingival corners, followed by axial wall. The stresses were greater with lateral load and with 100-μm cement thickness. Results revealed higher stresses for zinc phosphate cement, followed by composites. Conclusions: The thinner cement interfaces favor the success of the prosthesis. The stresses in the prosthesis suggest rounding of axio-gingival corners and a well-established finish line as important factors in maintaining the integrity of the prosthesis.

  4. Design and manufacturing of ear prosthesis by means of rapid prototyping technology.

    Science.gov (United States)

    De Crescenzio, F; Fantini, M; Ciocca, L; Persiani, F; Scotti, R

    2011-03-01

    In this paper, the complete procedure to design and construct reusable moulds for implant-based ear prosthesis and manufacture substructures by means of a computer aided design-computer aided manufacturing (CAD-CAM) procedure and rapid prototyping (RP) technology is presented. The scan of the healthy ear, the virtual superimposition of its mirrored image on to the defective side, and the rapid manufacturing of the substructure and of the mould eliminate several steps of traditional procedures (wax, stone, try-in). Moreover, the precise design and customization of the substructure is presented, with the original and engineered shape for the retention of the silicone. The time and cost saving results of this protocol are presented together with a discussion of the main design features that make the prosthesis a stable and reproducible system to improve rehabilitation of patients with auricular defects or absence.

  5. Clinical and radiographic evaluation of a polyester prosthesis in dogs with cranial cruciate ligament rupture

    Directory of Open Access Journals (Sweden)

    Selmi André Luis

    2002-01-01

    Full Text Available Clinical and radiographic findings after intra-articular replacement of cranial cruciate ligament with a polyester prosthesis using a modified over-the-top technique were evaluated in six dogs. Seven surgeries were done due to bilateral involvement of the cranial cruciate ligament in one dog. Clinical evaluation was performed on postoperative days 3, 10 and 40, and radiographic evaluation was done at 5 and 24 months after surgery in five dogs, where signs of progressive degenerative joint disease were confirmed. Resolution of clinical signs was observed from 25 to 68 days after surgery as evaluated by dog owners. Overall function of joint movement after surgery was classified as good. Two dogs presented fraying of the implant after surgery. It was concluded that the polyester prosthesis, as implanted in these dogs, was not a satisfactory replacement for the injured ligament, as better results may be obtained with less invasive and simpler techniques.

  6. Online Phase Detection Using Wearable Sensors for Walking with a Robotic Prosthesis

    Directory of Open Access Journals (Sweden)

    Maja Goršič

    2014-02-01

    Full Text Available This paper presents a gait phase detection algorithm for providing feedback in walking with a robotic prosthesis. The algorithm utilizes the output signals of a wearable wireless sensory system incorporating sensorized shoe insoles and inertial measurement units attached to body segments. The principle of detecting transitions between gait phases is based on heuristic threshold rules, dividing a steady-state walking stride into four phases. For the evaluation of the algorithm, experiments with three amputees, walking with the robotic prosthesis and wearable sensors, were performed. Results show a high rate of successful detection for all four phases (the average success rate across all subjects >90%. A comparison of the proposed method to an off-line trained algorithm using hidden Markov models reveals a similar performance achieved without the need for learning dataset acquisition and previous model training.

  7. On the analysis of using 3-coil wireless power transfer system in retinal prosthesis.

    Science.gov (United States)

    Bai, Shun; Skafidas, Stan

    2014-01-01

    Designing a wireless power transmission system(WPTS) using inductive coupling has been investigated extensively in the last decade. Depending on the different configurations of the coupling system, there have been various designing methods to optimise the power transmission efficiency based on the tuning circuitry, quality factor optimisation and geometrical configuration. Recently, a 3-coil WPTS was introduced in retinal prosthesis to overcome the low power transferring efficiency due to low coupling coefficient. Here we present a method to analyse this 3-coil WPTS using the S-parameters to directly obtain maximum achievable power transferring efficiency. Through electromagnetic simulation, we brought a question on the condition of improvement using 3-coil WPTS in powering retinal prosthesis.

  8. Classification of EMG signals using artificial neural networks for virtual hand prosthesis control.

    Science.gov (United States)

    Mattioli, Fernando E R; Lamounier, Edgard A; Cardoso, Alexandre; Soares, Alcimar B; Andrade, Adriano O

    2011-01-01

    Computer-based training systems have been widely studied in the field of human rehabilitation. In health applications, Virtual Reality presents itself as an appropriate tool to simulate training environments without exposing the patients to risks. In particular, virtual prosthetic devices have been used to reduce the great mental effort needed by patients fitted with myoelectric prosthesis, during the training stage. In this paper, the application of Virtual Reality in a hand prosthesis training system is presented. To achieve this, the possibility of exploring Neural Networks in a real-time classification system is discussed. The classification technique used in this work resulted in a 95% success rate when discriminating 4 different hand movements.

  9. Use of a hydroxyapatite orbital implant in a cosmetic corneoscleral prosthesis after enucleation in a horse.

    Science.gov (United States)

    Gilger, Brian C; Pizzirani, Stefano; Johnston, Lisa C; Urdiales, Nicholas R

    2003-02-01

    A hydroxyapatite orbital implant was used after enucleation of an eye from a 5-year-old performance horse. A custom-made corneoscleral prosthesis was made and fitted over the hydroxyapatite implant. The implant and surgery were well tolerated. Placement of a cosmetic prosthesis is desired after enucleation of equine eyes to allow horses to return to competition. Synthetic spheres consisting of methylmethacrylate or silicone have been used, although reported complications have included extrusion, infection, and poor cosmetic results. Hydroxyapatite orbital implants made from marine coral allow vascular and fibrous tissue growth from the host orbit into the implant, which decreases the possibility of implant extrusion or infection and allows enhanced healing of defects in the overlying conjunctiva. Extraocular muscle fixation onto the implant permits motility and assists in the prevention of implant extrusion.

  10. Vector-controlled alveolar distraction osteogenesis using an implant-fixed provisional prosthesis: a case report.

    Science.gov (United States)

    Kawashima, Wataru; Takayama, Kenichi; Fujii, Ryosuke; Matsubara, Yuuri; Kirita, Tadaaki

    2013-02-01

    This is a case report of anterosuperior alveolar distraction using an implant-fixed provisional prosthesis. Osteotomy and placement of a distraction device were performed in a healthy 69-year-old woman. To avoid lingual inclination during the distraction period, the device's rod was buried in the labial side of a provisional prosthesis supported by posterior implants. The mandibular bone was obliquely distracted by 0.3 mm every 2 days. Implant insertion was performed, and a good prognosis was anticipated. Inclination is thought to be caused by soft tissue on the lingual side. Many reports propose methods to avoid inclination, but these methods require established support from the teeth and cannot be adapted for an edentulous case. The method reported here is useful for distraction osteogenesis because it can be adapted for edentulous cases.

  11. A fully organic retinal prosthesis restores vision in a rat model of degenerative blindness

    Science.gov (United States)

    Antognazza, Maria Rosa; Colombo, Elisabetta; Mete, Maurizio; Feyen, Paul; Desii, Andrea; Buschiazzo, Ambra; Di Paolo, Mattia; Di Marco, Stefano; Ticconi, Flavia; Emionite, Laura; Shmal, Dmytro; Marini, Cecilia; Donelli, Ilaria; Freddi, Giuliano; Maccarone, Rita; Bisti, Silvia; Sambuceti, Gianmario; Pertile, Grazia; Lanzani, Guglielmo; Benfenati, Fabio

    2017-01-01

    The degeneration of photoreceptors in the retina is one of the major causes of adult blindness in humans. Unfortunately, no effective clinical treatments exist for the majority of retinal degenerative disorders. Here we report on the fabrication and functional validation of a fully organic prosthesis for long-term in vivo subretinal implantation in the eye of Royal College of Surgeons rats, a widely recognized model of Retinitis pigmentosa. Electrophysiological and behavioral analyses reveal a prosthesis-dependent recovery of light-sensitivity and visual acuity that persists up to 6-10 months after surgery. The rescue of the visual function is accompanied by an increase in the basal metabolic activity of the primary visual cortex, as demonstrated by positron emission tomography imaging. Our results highlight the possibility of developing a new generation of fully organic, highly biocompatible and functionally autonomous photovoltaic prostheses for subretinal implants to treat degenerative blindness. PMID:28250420

  12. Combined transscleral fixation of an artificial iris prosthesis with an intraocular lens

    Directory of Open Access Journals (Sweden)

    Uzeyır Gunenc

    2016-02-01

    Full Text Available ABSTRACT Post-traumatic aniridia combined with aphakia may be seen after globe injury. Aside from esthetic aspects, partial or total loss of the iris tissue may also be related to various degrees of glare and photophobia. Such patients suffer from severe visual impairment secondary to aphakia. Herein we describe a novel surgical technique for the management of an aphakic eye with traumatic aniridia for a patient who underwent transscleral fixation of a custom-tailored artificial iris prosthesis combined with a rigid intraocular lens (IOL. Tight suturing of the IOL haptic eyelets on the silicone iris prosthesis and fixation of such a complex to the scleral wall may provide excellent cosmetic and functional outcomes in aphakic eyes with aniridia.

  13. A fully organic retinal prosthesis restores vision in a rat model of degenerative blindness

    Science.gov (United States)

    Maya-Vetencourt, José Fernando; Ghezzi, Diego; Antognazza, Maria Rosa; Colombo, Elisabetta; Mete, Maurizio; Feyen, Paul; Desii, Andrea; Buschiazzo, Ambra; di Paolo, Mattia; di Marco, Stefano; Ticconi, Flavia; Emionite, Laura; Shmal, Dmytro; Marini, Cecilia; Donelli, Ilaria; Freddi, Giuliano; Maccarone, Rita; Bisti, Silvia; Sambuceti, Gianmario; Pertile, Grazia; Lanzani, Guglielmo; Benfenati, Fabio

    2017-06-01

    The degeneration of photoreceptors in the retina is one of the major causes of adult blindness in humans. Unfortunately, no effective clinical treatments exist for the majority of retinal degenerative disorders. Here we report on the fabrication and functional validation of a fully organic prosthesis for long-term in vivo subretinal implantation in the eye of Royal College of Surgeons rats, a widely recognized model of retinitis pigmentosa. Electrophysiological and behavioural analyses reveal a prosthesis-dependent recovery of light sensitivity and visual acuity that persists up to 6-10 months after surgery. The rescue of the visual function is accompanied by an increase in the basal metabolic activity of the primary visual cortex, as demonstrated by positron emission tomography imaging. Our results highlight the possibility of developing a new generation of fully organic, highly biocompatible and functionally autonomous photovoltaic prostheses for subretinal implants to treat degenerative blindness.

  14. Case report: aesthetic management of a localised periodontal defect with a gingival veneer prosthesis.

    Science.gov (United States)

    Ellis, S G; Sharma, P; Harris, I R

    2000-03-01

    Traditionally acrylic resin gingival veneer prostheses have been used to disguise aesthetic deficiencies of maxillary anterior teeth following successful periodontal therapy and have been retained by engaging horizontal undercuts distal to the canine teeth. They are, however, versatile prostheses with uses in fixed and removable prosthodontics and therapeutic treatment of gingival conditions. In the case presented a small acrylic resin gingival veneer prosthesis retained by a resilient lining material was used to manage a localised periodontal defect of the mandibular central incisor teeth.

  15. Plasticity in the visual system is associated with prosthesis use in phantom limb pain

    OpenAIRE

    Sandra ePreißler; Caroline eDietrich; Kathrin eBlume; Hofmann, Gunther O; Miltner, Wolfgang H. R.; Thomas eWeiss

    2013-01-01

    The experience of strong phantom limb pain (PLP) in arm amputees was previously shown to be associated with structural neural plasticity in parts of the cortex that belong to dorsal and ventral visual streams. It has been speculated that this plasticity results from the extensive use of a functional prosthesis which is associated with increased visual feedback to control the artificial hand.To test this hypothesis, we reanalyzed data of cortical volumes of 21 upper limb amputees and tested th...

  16. Plasticity in the Visual System is Associated with Prosthesis Use in Phantom Limb Pain

    OpenAIRE

    Preißler, Sandra; Dietrich, Caroline; Blume, Kathrin R.; Hofmann, Gunther O; Miltner, Wolfgang H. R.; Weiss, Thomas

    2013-01-01

    The experience of strong phantom limb pain (PLP) in arm amputees was previously shown to be associated with structural neural plasticity in parts of the cortex that belong to dorsal and ventral visual streams. It has been speculated that this plasticity results from the extensive use of a functional prosthesis which is associated with increased visual feedback to control the artificial hand. To test this hypothesis, we reanalyzed data of cortical volumes of 21 upper limb amputees and tested t...

  17. Non-weight-bearing neural control of a powered transfemoral prosthesis

    OpenAIRE

    Hargrove, Levi J; Simon, Ann M; Lipschutz, Robert; Finucane, Suzanne B; Kuiken, Todd A

    2013-01-01

    Lower limb prostheses have traditionally been mechanically passive devices without electronic control systems. Microprocessor-controlled passive and powered devices have recently received much interest from the clinical and research communities. The control systems for these devices typically use finite-state controllers to interpret data measured from mechanical sensors embedded within the prosthesis. In this paper we investigated a control system that relied on information extracted from my...

  18. Trinity amputation and prosthesis experience scales: a psychometric assessment using classical test theory and rasch analysis.

    Science.gov (United States)

    Gallagher, Pamela; Franchignoni, F; Giordano, A; MacLachlan, M

    2010-06-01

    To perform a detailed psychometric analysis using both classical test theory and Rasch analysis of the three main scales of the Trinity Amputation and Prosthesis Experience Scales (TAPES) in people with a lower-limb amputation. A sample of 498 persons who were prosthesis users with a lower-limb amputation was retrospectively studied, pooled from a number of studies undertaken across the United Kingdom and Ireland in the past decade in which the TAPES had been completed as part of a postal survey. Both factor analysis techniques and Rasch analysis were performed on TAPES data. Dimensionality, item fit to the model, response category performance, and internal construct validity were assessed. Category collapsing and item removal were considered to improve the questionnaire. The analyses suggested to restructure the TAPES as follows: (a) three psychosocial adjustment subscales with a four-point rating scale (and a reworded item); (b) an activity restriction scale based on ten items with their original three-point rating scale; and (c) two satisfaction with the prosthesis subscales using a three-point rating scale. All scales and subscales showed acceptable internal consistency and ability to define a distinct hierarchy of persons along the measured construct. This study empirically identified a revised version of the TAPES (TAPES-R) with a simplified general structure and psychometrically suitable for assessing the complex experience of amputation and adjustment to a lower-limb prosthesis. Additional studies are needed to confirm and further explore its measurement properties in other samples, thereby adding clinical validity to the instrument.

  19. Intensity modulated radiation therapy planning for patients with a metal hip prosthesis based on class solutions.

    Science.gov (United States)

    van der Est, Henrie; Prins, Paulette; Heijmen, Ben J M; Dirkx, Maarten L P

    2012-01-01

    With the aging of the population, an increasing number of patients with metallic hip implants are referred for radiotherapy treatment. Class solutions for intensity modulated radiation therapy (IMRT) treatment planning are generally not applicable for these patients due to the required avoidance of dose delivery through prostheses. In this work a new approach for IMRT planning is presented, allowing the use of a default beam setup. For IMRT planning, Monaco (Elekta; CMS Software, Maryland Heights, MO) was used. In addition to the target and organs at risk, so-called prosthesis avoidance volumes (PAVs) were delineated in the beam's eye view projection for beams in which the prosthesis was partially in front of the target. By putting strict constraints on these virtual organs at risk, entrance dose delivery through a prosthesis is avoided while exit dose delivery is allowed. In this way, uncertainties in the dose delivery to the target and organs at risk, as derived by the treatment planning system, are largely minimized. To show the advantages of this IMRT-PAV technique, for 2 prostate cancer patients, 1 with bilateral and the other with unilateral metallic hip prostheses, obtained IMRT plans were compared with conventional IMRT plans using a prosthesis-avoiding beam setup. For both IMRT techniques a similar planning target volume coverage was achieved, but with the IMRT-PAV technique the mean doses to the bladder and the rectum were reduced by up to 25%. While the IMRT-PAV technique required more time for delineation, the time for treatment planning reduced because the default beam setup could be applied. The number of segments needed for dose delivery was comparable for both techniques. With the new IMRT-PAV technique IMRT class solutions can safely be applied for cancer patients with metallic hip prostheses, generally yielding a reduced dose delivery to organs at risk or improved target coverage. Copyright © 2012 American Society for Radiation Oncology

  20. Thrust plate prosthesis for proximal femoral deformity: a series of 15 patients.

    Science.gov (United States)

    Karatosun, Vasfi; Unver, Bayram; Gültekin, Alper; Günal, Izge

    2010-01-01

    Patients with coxarthrosis and proximal femoral deformity experience problems with total hip arthroplasty. A custom-made prosthesis or a proximal osteotomy is required for such cases, and these also increase the rate of complications. The purpose of this study was to evaluate the results of the thrust plate prosthesis (TPP) in patients with deformity of the proximal femur. Fifteen patients (7 females, 8 males) with a mean age of 56.4 years (range 19-75 years) at the time of the surgery were included in the study. The etiology was traumatic coxarthrosis in 12, and nonunion of a femoral neck fracture with osteonecrosis of the femoral head in the remaining three. While the femoral component was a third-generation TPP in all patients, the acetabular component was a Protek expansion cup in 12, and a cementless standard cup in three patients. All operations were performed through a Hardinge approach. Patients were followed up for at least 3 years (range 36-116 months) and evaluated clinically with the Harris Hip Score. The mean preoperative Harris Hip Score increased from 51.2 (range 15-79) to 92.7 (range 60-100) at the latest assessment. In two cases, loosening of the femoral component was observed in zone 3, both 12 months postoperatively. One was replaced by an intramedullary prosthesis, and the other was asymptomatic. TPP is a good alternative for patients with malformations of the proximal femur. The use of TPP avoids technical difficulties and a custom-made prosthesis.

  1. An intraluminal prosthesis may improve healing of a one-layer colonic anastomosis

    DEFF Research Database (Denmark)

    Buch, N; Glad, H; Svendsen, P

    2002-01-01

    OBJECTIVE: To compare healing of one-layer colonic anastomoses with or without a soluble intraluminal prosthesis (* SBS-tube). DESIGN: Randomised, partly blinded controlled study. SETTING: University hospital, Denmark. SUBJECTS: 16 female Danish country strain pigs, of which 8 had the SBS tube in...... of the anastomosis and may improve healing, possibly because of better apposition of the cut ends and reduced tension in the sutures....

  2. Patient Management with Metallic Valve Prosthesis during Pregnancy and Postpartum Period.

    Science.gov (United States)

    Garcez, Juliane Dantas Seabra; Rosa, Vitor Emer Egypto; Lopes, Antonio Sergio de Santis Andrade; Accorsi, Tarso Augusto Duenhas; Fernandes, João Ricardo Cordeiro; Pomerantzeff, Pablo Maria; Avila, Walkiria Samuel; Tarasoutchi, Flavio

    2015-10-01

    Prosthetic thrombosis is a rare complication, but it has high mortality and morbidity. Young women of childbearing age that have prosthetic heart valves are at increased risk of thrombosis during pregnancy due to changes in coagulation factors. Anticoagulation with adequate control and frequent follow-up if pregnancy occurs must be performed in order to prevent complications related to anticoagulant use. Surgery remains the treatment of choice for prosthetic heart valve thrombosis in most clinical conditions. Patients with metallic prosthetic valves have an estimated 5% risk of thrombosis during pregnancy and maternal mortality of 1.5% related to the event. Anticoagulation with vitamin K antagonists during pregnancy is related to varying degrees of complications at each stage of the pregnancy and postpartum periods. Warfarin sodium crosses the placental barrier and when used in the first trimester of pregnancy is a teratogenic agent, causing 1-3% of malformations characterized by fetal warfarin syndrome and also constitutes a major cause of miscarriage in 10-30% of cases. In the third trimester and at delivery, the use of warfarin is associated with maternal and neonatal bleeding in approximately 5 to 15% of cases, respectively. On the other hand, inadequate anticoagulation, including the suspension of the oral anticoagulants aiming at fetal protection, carries a maternal risk of about 25% of metallic prosthesis thrombosis, particularly in the mitral valve. This fact is also due to the state of maternal hypercoagulability with activation of coagulation factors V, VI, VII, IX, X, platelet activity and fibrinogen synthesis, and decrease in protein S levels. The Registry of Pregnancy and Cardiac Disease (ROPAC), assessing 212 pregnant women with metal prosthesis, showed that prosthesis thrombosis occurred in 10 (4.7%) patients and maternal hemorrhage in 23.1%, concluding that only 58% of patients with metallic prosthesis had a complication-free pregnancy.

  3. An Harmonic Smile Resulted from the Use of Ceramic Prosthesis with Zirconia Structure: A Case Report

    OpenAIRE

    Tavarez,Rudys Rodolfo De Jesus; Goncalves, Leticia Machado; Dias, Ana Paula; Dias, Anna Claudia Pereira; Malheiros,Adriana Santos; Silva, Alice Carvalho; Bandeca, Matheus Coelho

    2014-01-01

    The rehabilitation of patients requiring an esthetic smile demands a multidisciplinary approach. This clinical report describes a treatment plan for recovery aesthetics’ smile of anterior teeth using ceramic prosthesis with zirconia structure. Initially, a review of aesthetic parameters, diagnostic waxing, mock-up and provisional restorations was performed. A contextual assessment of aesthetic, proportion and shape of teeth was done to recreate a natural looking for teeth...

  4. A novel knee prosthesis model of implant-related osteo- myelitis in rats

    OpenAIRE

    Søe, Niels H; Jensen, Nina Vendel; Nürnberg, Birgit Meinecke; Jensen, Asger Lundorff; Koch, Janne; Poulsen, Steen Seier; Pier, Gerald B.; Johansen, Helle Krogh

    2013-01-01

    Background and purpose: There have been numerous reports of animal models of osteomyelitis. Very few of these have been prosthesis models that imitate human conditions. We have developed a new rat model of implant-related osteomyelitis that mimics human osteomyelitis, to investigate the pathology of infection after orthop edic implant surgery. Methods: 2 wild-type strains of Staphylococcus aureus, MN8 and UAMS-1, and their corresponding mutants that are unable to produce poly-N-acetyl glucosa...

  5. Panacea to lost gingival tissue architecture and spacing: Silicone gingival prosthesis.

    Science.gov (United States)

    Tomar, Brajendra S; Chandu, G S; Singh, Shubhra; Goutam, Manish

    2016-01-01

    The positive psychological effects of improving patients' smile often contribute to an improved self-image and enhanced self-esteem. Periodontal disease may lead to tooth and tissue loss that can result in esthetic problems. Combined periodontal/prosthodontic treatment for patients with advanced disease is well documented. This case report illustrates a method of treatment for an advanced tissue loss in an esthetic area using a removable silicone gingival prosthesis/mask.

  6. Chronic post-operative iris prosthesis endophthalmitis in a patient with traumatic aniridia: a case report.

    Science.gov (United States)

    Firl, Kevin C; Montezuma, Sandra R

    2016-11-09

    Post-operative endophthalmitis is a serious complication of intraocular surgery which may present acutely or chronically. Chronic post-operative endophthalmitis is characterized by decreased visual acuity, mild pain, and low-grade uveitis several weeks or months after intraocular surgery which may be responsive to corticosteroids, but recur upon tapering. Low virulence organisms such as Propionibacterium acnes are the most common culprit organisms, and treatment most often consists of both intravitreal antibiotic injections and surgery. Aniridia is a condition defined by total or partial loss of the iris and leads to decreased visual quality marked by glare and photophobia. Treatment of complex or severe cases of traumatic aniridia in which surgical repair is difficult may consist of implantation of iris prostheses, devices designed to reduce symptoms of aniridia. Though chronic, post-operative endophthalmitis has been associated with most intraocular surgeries including intraocular lens implantation after cataract removal, it has never been described in a patient with an iris prosthesis. In this case report, we describe the case of a 49 year old, male construction worker with traumatic aniridia who experienced chronic, recurrent low-grade intraocular inflammation and irritation for months after implantation of the Ophtec 311 prosthetic iris. Symptoms and signs of inflammation improved temporarily with sub-Tenon's capsule triamcinolone injections. Ultimately after more than 2 post-operative years, the iris prosthesis was explanted, and intravitreal cultures showed P. acnes growth after 5 days. Intravitreal antibiotics treated the infection successfully. To our knowledge, this is the first reported case of chronic, post-operative endophthalmitis in a patient with an iris prosthesis. Chronic, post-operative endophthalmitis may be a difficult to identify in the context of traumatic aniridia and iris prosthesis implantation due to other potential etiologies of

  7. Progress toward development of a multichannel vestibular prosthesis for treatment of bilateral vestibular deficiency.

    Science.gov (United States)

    Fridman, Gene Y; Della Santina, Charles C

    2012-11-01

    This article reviews vestibular pathology and the requirements and progress made in the design and construction of a vestibular prosthesis. Bilateral loss of vestibular sensation is disabling. When vestibular hair cells are injured by ototoxic medications or other insults to the labyrinth, the resulting loss of sensory input disrupts vestibulo-ocular reflexes (VORs) and vestibulo-spinal reflexes that normally stabilize the eyes and body. Affected individuals suffer poor vision during head movement, postural instability, chronic disequilibrium, and cognitive distraction. Although most individuals with residual sensation compensate for their loss over time, others fail to do so and have no adequate treatment options. A vestibular prosthesis analogous to cochlear implants but designed to modulate vestibular nerve activity during head movement should improve quality of life for these chronically dizzy individuals. We describe the impact of bilateral loss of vestibular sensation, animal studies supporting feasibility of prosthetic vestibular stimulation, the current status of multichannel vestibular sensory replacement prosthesis development, and challenges to successfully realizing this approach in clinical practice. In bilaterally vestibular-deficient rodents and rhesus monkeys, the Johns Hopkins multichannel vestibular prosthesis (MVP) partially restores the three-dimensional (3D) VOR for head rotations about any axis. Attempts at prosthetic vestibular stimulation of humans have not yet included the 3D eye movement assays necessary to accurately evaluate VOR alignment, but these initial forays have revealed responses that are otherwise comparable to observations in animals. Current efforts now focus on refining electrode design and surgical technique to enhance stimulus selectivity and preserve cochlear function, optimizing stimulus protocols to improve dynamic range and reduce excitation-inhibition asymmetry, and adapting laboratory MVP prototypes into devices

  8. Panacea to lost gingival tissue architecture and spacing: Silicone gingival prosthesis

    Directory of Open Access Journals (Sweden)

    Brajendra S Tomar

    2016-01-01

    Full Text Available The positive psychological effects of improving patients' smile often contribute to an improved self-image and enhanced self-esteem. Periodontal disease may lead to tooth and tissue loss that can result in esthetic problems. Combined periodontal/prosthodontic treatment for patients with advanced disease is well documented. This case report illustrates a method of treatment for an advanced tissue loss in an esthetic area using a removable silicone gingival prosthesis/mask.

  9. Consequence of patient substitution of nattokinase for warfarin after aortic valve replacement with a mechanical prosthesis

    OpenAIRE

    Elahi, Maqsood M.; Choi, Charles H.; Konda, Subbareddy; Shake, Jay G.

    2015-01-01

    This report describes a patient's self-substitution of nattokinase for the vitamin K antagonist warfarin after aortic valve replacement with a mechanical prosthesis. Nattokinase is an enzyme derived from a popular fermented soybean preparation in Japan (natto), which has fibrinolytic properties and is gaining popularity in nontraditional health journals and nonmedical health websites as an over-the-counter thrombolytic. After nearly a year of use of nattokinase without warfarin, the patient d...

  10. Fracture of a veneered-ZrO2 dental prosthesis from an inner thermal crack

    Directory of Open Access Journals (Sweden)

    Ulrich Lohbauer

    2014-10-01

    Full Text Available Here we describe the fractographic analysis of a veneer-ZrO2 single-unit dental prosthesis that fractured in a shell-like manner. Analysis of the retrieved fragment revealed that the crack originated in the bulk of the veneer from a thermal flaw located between two layers of the veneering material. Using the measured flaw plane we showed that the conditions of loading at fracture were complex and probably involved important tangential components.

  11. Bionic ankle–foot prosthesis normalizes walking gait for persons with leg amputation

    OpenAIRE

    Herr, Hugh M; Grabowski, Alena M.

    2011-01-01

    Over time, leg prostheses have improved in design, but have been incapable of actively adapting to different walking velocities in a manner comparable to a biological limb. People with a leg amputation using such commercially available passive-elastic prostheses require significantly more metabolic energy to walk at the same velocities, prefer to walk slower and have abnormal biomechanics compared with non-amputees. A bionic prosthesis has been developed that emulates the function of a biolog...

  12. 10-year follow-up after implantation of the Bryan Cervical Disc Prosthesis.

    Science.gov (United States)

    Dejaegher, Joost; Walraevens, Joris; van Loon, Johannes; Van Calenbergh, Frank; Demaerel, Philippe; Goffin, Jan

    2017-04-01

    Cervical arthroplasty is being used as an alternative for cervical fusion, but long-term follow-up results have rarely been reported. In this paper, we present 10-year follow-up results after implantation of the Bryan Cervical Disc Prosthesis in a single center. 89 patients underwent implantation of a single-level Bryan Cervical Disc Prosthesis to treat radiculopathy and/or myelopathy. Clinical (Neurological Success, Neck Disability Index (NDI), Neck- and Arm-Pain, and SF-36) and radiological follow-up was prospectively organized up to 10 years after surgery. Adverse events and second surgeries were recorded and evaluated. Ten-year follow-up data were available for 72 (81%) patients. Maintenance or improvement of the neurological state was seen in 89% of patients after 10-year follow-up. SF-36 PCS scores improved significantly at all follow-up points. SF-36 MCS improvement was significant at 4 and 6 year, but not at 8- and 10-year follow-up. Significant improvement for NDI, and Neck- and Arm-Pain scores was found for the subgroup of patients in whom these data were available. Mean angular motion of the prosthesis at 10-year follow-up was 8.6°. Mobility of the device, defined as >2° of angular motion, was reached in 81% of patients. During the study period, 21 patients (24%) developed new or recurrent radiculopathy or myelopathy, the majority of these being treated conservatively. Seven patients (8%) required 8 additional spine surgeries to treat persistent or recurrent symptoms. Of these, 2 patients (2%) were reoperated at the index level and at 5 (6%) an adjacent level. In this study, favorable long-term clinical outcome after implantation of the Bryan Cervical Disc Prosthesis was seen, with the majority of prostheses remaining mobile after 10-year follow-up. However, still 6% of patients required adjacent level surgery.

  13. The ProDisc-C prosthesis: clinical and radiological experience 1 year after surgery.

    Science.gov (United States)

    Nabhan, Abdullah; Ahlhelm, Frank; Shariat, Kaveh; Pitzen, Tobias; Steimer, Oliver; Steudel, Wolf-Ingo; Pape, Dietrich

    2007-08-15

    This is a prospective randomized and controlled study, approved by the local ethical committee of Saarland (Germany). The aim of the current study was to analyze segmental motion following artificial disc replacement using disc prosthesis over 1 year. A second aim was to compare both segmental motion as well as clinical result to the current gold standard (anterior cervical discectomy and fusion [ACDF]). ACDF may be considered to be the gold standard for treatment of symptomatic degenerative disc disease within the cervical spine. However, fusion may result in progressive degeneration of the adjacent segments. Therefore, disc arthroplasty has been introduced. Among these, artificial disc replacement seems to be promising. However, segmental motion should be preserved. This, again, is very difficult to judge and has not yet been proven. A total of 49 patients with cervical disc herniation were enrolled and assigned to either study group (receiving a disc prosthesis) or control group (receiving ACDF, using a cage with bone graft and an anterior plate). Roentgen stereometric analysis (RSA) was used to quantify intervertebral motion immediately as well as 3, 6, 12, 24, and 52 weeks after surgery. Also, clinical results were judged using visual analog scale and neuro-examination at even RSA follow-up. Cervical spine segmental motion decreased over time in the presence of disc prosthesis or fusion device. However, the loss segmental motion is significantly higher in the fusion group, when looked at 3, 6, 12, 24, and 52 weeks after surgery. We observed significant pain reduction in neck and arm after surgery, without significant difference between both groups. Cervical spine disc prosthesis remains cervical spine segmental motion within the first 1 year after surgery. The clinical results are the same when compared with the early results following ACDF.

  14. [The endo-exo prosthesis treatment concept : Improvement in quality of life after limb amputation].

    Science.gov (United States)

    Hoffmeister, T; Schwarze, F; Aschoff, H H

    2017-05-01

    Osseointegrated, percutaneous implants as the force bearer for exoprosthetics after limb amputation have been used in individual cases for clinical rehabilitation of amputees during the past years. Most experience in this field in Germany has been accumulated at the Sana Klinik in Lübeck with the so-called endo-exo prosthesis (EEP) system. The two-step implantation procedure can now be considered as reliable. Following a well-documented learning curve initial soft tissue problems concerning the cutaneous stoma can now be regarded as exceptions. The retrospective examination of the results concerning by now more than 100 patients provided with an endo-exo femoral prosthesis (EEFP) showed a very satisfying outcome concerning objective as well as subjective values, such as duration of daily use and wearing comfort of the exoprosthesis. Regaining the ability of osseoperception due to the intraosseous fixation is described by the patients as a great advantage. The step from a socket prosthesis to an EEP is felt to be a big increase in quality of life by nearly all patients included into the follow-up. Nearly all of the patients questioned would choose an endo-exo prosthesis again. Meanwhile, the success of the EEP resulted in the broadening of indications from above-knee amputations to transtibial as well as transhumeral amputations. The results are likewise encouraging. The use of EEP for the upper limbs leads to substantial improvement in the range of motion of the shoulder joint with the intramedullary anchored percutaneous implant. Furthermore, new pathbreaking possibilities in the fixation of myoelectrically controlled arm prostheses may arise from the EEP technique.

  15. THR Simulator – the software for generating radiographs of THR prosthesis

    Directory of Open Access Journals (Sweden)

    Hou Sheng-Mou

    2009-01-01

    Full Text Available Abstract Background Measuring the orientation of acetabular cup after total hip arthroplasty is important for prognosis. The verification of these measurement methods will be easier and more feasible if we can synthesize prosthesis radiographs in each simulated condition. One reported method used an expensive mechanical device with an indeterminable precision. We thus develop a program, THR Simulator, to directly synthesize digital radiographs of prostheses for further analysis. Under Windows platform and using Borland C++ Builder programming tool, we developed the THR Simulator. We first built a mathematical model of acetabulum and femoral head. The data of the real dimension of prosthesis was adopted to generate the radiograph of hip prosthesis. Then with the ray tracing algorithm, we calculated the thickness each X-ray beam passed, and then transformed to grey scale by mapping function which was derived by fitting the exponential function from the phantom image. Finally we could generate a simulated radiograph for further analysis. Results Using THR Simulator, the users can incorporate many parameters together for radiograph synthesis. These parameters include thickness, film size, tube distance, film distance, anteversion, abduction, upper wear, medial wear, and posterior wear. These parameters are adequate for any radiographic measurement research. This THR Simulator has been used in two studies, and the errors are within 2° for anteversion and 0.2 mm for wearing measurement. Conclusion We design a program, THR Simulator that can synthesize prosthesis radiographs. Such a program can be applied in future studies for further analysis and validation of measurement of various parameters of pelvis after total hip arthroplasty.

  16. Rehabilitation with full of metal-ceramic crowns and conventional removable partial prosthesis

    OpenAIRE

    Lara Téllez, Lourdes; Docentes del Departamento Académico de Estomatología Rehabilitadora, Facultad de Odontología de la UNMSM. Lima, Perú.; Ochoa Tataje, Jesús; Docentes del Departamento Académico de Estomatología Rehabilitadora, Facultad de Odontología de la UNMSM. Lima, Perú.; Gaitán Velásquez, Jorge; Docentes del Departamento Académico de Estomatología Rehabilitadora, Facultad de Odontología de la UNMSM. Lima, Perú.; Herrera Cisneros, Marcos; Docentes del Departamento Académico de Estomatología Rehabilitadora, Facultad de Odontología de la UNMSM. Lima, Perú.

    2014-01-01

    The treatment was performed in a female patient 67 years old, with good health status, who came wearing an uncomfortable, for their physiological and aesthetics functions, removable partial dental prosthesis. At initial examination the patients shows an upper removable partial dentures with a great incisal and occlusal wear, poor support and retention, with loss of vertical occlusal dimension, loss of facial contour, Class II Kennedy 2 edentulism, with preserved alveolar ridge and f 1.7 1.3 a...

  17. Customized iliac prosthesis for reconstruction in giant cell tumour: A unique treatment approach.

    Science.gov (United States)

    Verma, Tarun; Sharma, Ankur; Sharma, Amit; Maini, Lalit

    2016-01-01

    Giant cell tumour (GCT) of flat bones of pelvis is extremely rare. GCT of the ilium and ischium represent less than 0.05% of all GCT. Iliac bone GCT has been treated traditionally by intra-lesion curettage with bone grafting, wide resection with or without reconstruction and hemi-pelvectomy in very aggressive tumours. None of the above treatments were without morbidities. Reconstruction using bone grafts and bone cement has also been inadequate. In GCT, where life expectancy is not decreased significantly, surgical treatment should be aimed at giving optimum functional outcome. We are reporting here a rare case of giant cell tumour of ilium bone in a 25-year-old female and its unique treatment approach. We designed a computed tomography (CT) based customized iliac prosthesis using Materialise Mimics and 3-Matic software. 3D model of pelvis was generated from the CT. After deciding the extent of resection on affected side, we virtually mirrored an identical portion of opposite ilium to the affected side. Connecting plates were made over the mirrored part and merged with it. Multiple relevant holes were made to attach various muscles to the prosthesis. Prosthesis was made in medical grade titanium by using Computerized Numerical Control (CNC) machine. The method is called as computer based subtractive manufacturing. Wide resection was done and the prosthesis was placed using multiple 3.5 millimetres screws through the connecting plates. Muscles were stitched to relevant holes using ethibond suture. Post-operative course was unremarkable. Patient was made to walk with full weight bearing after 5 weeks. Powers of abductors at 6 months is 4/5 and patient walks normally without a limp.

  18. Pre-surgical Provisional Prosthesis for Immediate Non-occlusal-loaded Flapless Implant

    OpenAIRE

    Inbarajan, Athiban; Banu, Fathima; TV, Padmanabhan; Kumar, Anand; Seenivasan, Madhan

    2017-01-01

    A 49-year-old patient reported for immediate replacement of missing maxillary anterior teeth with implant-retained prosthesis. Elevation of flap alters the mucosal level, causes discomfort, and delays the restorative procedure. To maintain the esthetics, flapless surgery was planned. Since placement of an implant is pre-planned in a predetermined site, fabrication of the prostheses before commencement of the surgery, especially when replacing the teeth in the anterior region, could be a viabl...

  19. Good quality of life outcomes after treatment of prosthetic joint infection with debridement and prosthesis retention.

    Science.gov (United States)

    Aboltins, Craig; Dowsey, Michelle; Peel, Trish; Lim, Wen K; Choong, Peter

    2016-05-01

    Patients treated for early prosthetic joint infection (PJI) with surgical debridement and prosthesis retention have a rate of successful infection eradication that is similar to patients treated with the traditional approach of prosthesis exchange. It is therefore important to consider other outcomes after prosthetic joint infection treatment that may influence management decisions, such as quality of life (QOL). Our aim was to describe infection cure rates and quality of life for patients with prosthetic joint infection treated with debridement and prosthesis retention and to determine if treatment with this approach was a risk factor for poor quality of life outcomes. Prospectively collected pre and post-arthroplasty data were available for 2,134 patients, of which PJI occurred in 41. For patients treated for prosthetic joint infection, the 2-year survival free of treatment failure was 87% (95%CI 84-89). Prosthetic joint infection cases treated with debridement and retention had a similar improvement from pre-arthroplasty to 12-months post-arthroplasty as patients without PJI in QOL according to the SF-12 survey. Prosthetic joint infection treated with debridement and retention was not a risk factor for poor quality of life on univariate or multivariate analysis. Prosthetic joint infection treated with debridement and prosthesis retention results in good cure rates and quality of life. Further studies are required that directly compare quality of life for different surgical approaches for prosthetic joint infection to better inform management decisions. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:898-902, 2016. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  20. Autoinflation Leading to Failure of Two-Piece Ambicor Implantable Penile Prosthesis: An Outcome from a Methodical Treatment of Recalcitrant Stuttering Priapism

    Directory of Open Access Journals (Sweden)

    R. Charles Welliver

    2014-01-01

    Full Text Available Introduction. We present the case of a patient who received a two-piece Ambicor penile prosthesis for idiopathic recurrent “stuttering” priapism refractory to other treatment options. The patient returned unable to deflate the device due to an interesting anatomically induced mechanical failure. Aims. To describe the method and findings of this inflatable prosthesis failure. Results. Prosthesis failure occurred due to restrictive corporal diameter and the unique characteristics of fluid reservoir location in the two-piece inflatable prosthesis. The patient was successfully converted to a semirigid prosthesis with resolution of the pain that was due to his prosthesis autoinflation. Conclusion. Stuttering priapism remains a challenging clinical problem. Penile implantation is a reasonable long-term solution in a patient refractory to less invasive options. In patients with fibrotic corpora, a malleable device should be considered (at least temporarily if unable to dilate comfortably to 13 mm.

  1. [Experimental study on a novel esophageal prosthesis made of composite biomaterials].

    Science.gov (United States)

    Qin, Xiong; Xu, Zhi-fei; Shi, Hong-can; Zhao, Xue-wei; Sun, Kang; Gao, Xiang-yang

    2003-07-01

    To design and develop a novel esophageal prosthesis by selecting appropriate biomaterials, developing special manufacturing techniques, and investigating the feasibility of replacement of cervical esophagus in mongrel dogs. In accordance with the requirements of ideal esophageal substitutes, we designed a new type of esophageal prostheses. The inner stent were made with polyurethane of medical grade, and the outer surface of the prosthesis was coated with collagen-chitosan sponge. The silicone tube was used as a control. Thirteen adult mongrel dogs that were divided into two groups were used to establish the experimental models. In the experimental group (n = 8), the esophageal prostheses were completely incorporated with the native esophagus and adherent to the surrounding host connective tissues. Epithelial linings of varying degrees were formed on the luminal surface, and complete epithelization was seen in 1 month postoperatively. The granulation at the sites of the anastomosis in this group was less significant than that of the control group. One dog has been surviving for 12 months up to now without any complications. In the control group (n = 5), esophageal epithelial was not observed on the luminal surface, constriction of the regenerated esophagus progressed and all the dogs died within 2 months after operation. These observations suggest that this esophageal prosthesis made of composite biomaterials has high biocompatibility and potential for long-segment esophageal reconstruction, which is promising for the clinical repair of esophageal defects.

  2. Prediction of facial deformation after complete denture prosthesis using BP neural network.

    Science.gov (United States)

    Cheng, Cheng; Cheng, Xiaosheng; Dai, Ning; Jiang, Xiaotong; Sun, Yuchun; Li, Weiwei

    2015-11-01

    With the accelerated aging of world population, complete denture prosthesis plays an increasingly important role in mouth rehabilitation. In addition to recovering stomatognathic system function, restoring the appearance of a third of the area under the face has become a great challenge in complete denture prosthesis. This study analyzes the interactive relationship between the appearance of a third of the area under the face and complete denture, and proposes a new method to predict facial deformation after complete denture prosthesis. Firstly, to improve computational efficiency, the feature template is constructed to replace the deformed facial region. Secondly, a forecast model of elastic deformation is constructed using BP neural network and predicts elastic deformation amount because of the inhomogeneous, anisotropic and nonlinear material properties of soft tissue. Finally, a new feature template is calculated using deformation amount, and the deformation of preoperative model is simulated using Laplacian deformation technique. The average error rates of different hidden layer nodes in the neural network are analysed. Deformation and postoperative models are superimposed for match analysis. Experimental results show that this method can predict facial soft tissue deformation quickly and accurately. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Simultaneous treatment of temporomandibular joint ankylosis with severe mandibular deficiency by standard TMJ prosthesis.

    Science.gov (United States)

    Hu, YiHui; Zhang, LuZhu; He, DongMei; Yang, Chi; Chen, MinJie; Zhang, ShanYong; Li, Hui; Ellis Iii, Edward

    2017-03-24

    Temporomandibular joint (TMJ) ankylosis is a refractory disease that is difficult to predictably treat. This study evaluated the prognosis of using standard alloplastic TMJ prostheses for the treatment of TMJ ankylosis in Chinese patients with severe mandibular deficiency. Patients treated from 2013 to 2015 were reviewed. The computer-aided design and manufacture (CAD/CAM) technique was used to guide bony mass removal and locate the TMJ prosthesis (Biomet, USA). Eleven patients were included in this study. All prostheses were successfully installed and stabilized intraoperatively. In 4 patients with severe mandibular deficiency, their mandibular ramus was elongated by the TMJ prosthesis and 2 patients were combined with Le Fort I osteotomy guided by digital templates. Their mean chin advancement was 10.19 mm. Their SNB and ramus heights were also significantly improved after operation (P TMJ reconstruction with standard alloplastic prosthesis is a reliable treatment for ankylosis, especially in recurrent cases. By CAD/CAM technique, it can correct jaw deformities simultaneously and produce stable results.

  4. Energy cost of walking: comparison of "intelligent prosthesis" with conventional mechanism.

    Science.gov (United States)

    Buckley, J G; Spence, W D; Solomonidis, S E

    1997-03-01

    To determine physiological energy cost with Blatchford's "Intelligent Prosthesis" (IP) compared to energy cost with a conventional pneumatic swing phase control (PSPC) mechanism. Before-After trial: subjects fitted with IP walked on programmable treadmill at speeds: 6 min slow, 6 min fast, 8 min while speed changed, between slow, normal, and fast, every minute, and 6 min normal. Breath-by-breath analysis of subject's expired air determined average Vo2 (L/min) within each period. Procedure repeated after 1-week interval using PSPC prosthesis. Testing sessions supervised by experienced prosthetist. Rehabilitation centre. Volunteer sample. Three men, unilateral transfemoral traumatic amputee patients, ages 39 to 59 years. Normally used ischial containment socket, Blatchford Endolite Stabilised Stance Flex knee with PSPC and Multiflex foot and ankle. Fitting, programming, and alignment of IP (own socket) by Bioengineering Unit's resident prosthetist, IP's microprocessor programmed to facilitate five walking speeds. Physiological energy cost (Vo2), of using IP compared to using PSPC mechanism. Two subjects displayed reduced Vo2 of between 5.6% and 9.0% using IP compared to PSPC prosthesis at a pace either faster or slower than their normal pace. Third subject showed no significant change in oxygen consumption despite IP unit being heavier. All subjects displayed reduced Vo2 (averaging 4.1%) using IP for period of variable speed walking. Although differences were small, they tend to indicate that use of the heavier IP unit lowered the energy cost of walking at speeds other than the amputee's normal pace.

  5. Non-weight-bearing neural control of a powered transfemoral prosthesis.

    Science.gov (United States)

    Hargrove, Levi J; Simon, Ann M; Lipschutz, Robert; Finucane, Suzanne B; Kuiken, Todd A

    2013-06-19

    Lower limb prostheses have traditionally been mechanically passive devices without electronic control systems. Microprocessor-controlled passive and powered devices have recently received much interest from the clinical and research communities. The control systems for these devices typically use finite-state controllers to interpret data measured from mechanical sensors embedded within the prosthesis. In this paper we investigated a control system that relied on information extracted from myoelectric signals to control a lower limb prosthesis while amputee patients were seated. Sagittal plane motions of the knee and ankle can be accurately (>90%) recognized and controlled in both a virtual environment and on an actuated transfemoral prosthesis using only myoelectric signals measured from nine residual thigh muscles. Patients also demonstrated accurate (~90%) control of both the femoral and tibial rotation degrees of freedom within the virtual environment. A channel subset investigation was completed and the results showed that only five residual thigh muscles are required to achieve accurate control. This research is the first step in our long-term goal of implementing myoelectric control of lower limb prostheses during both weight-bearing and non-weight-bearing activities for individuals with transfemoral amputation.

  6. [Experimental study on Yougui recipe in preventing osteolysis surrounding artificial prosthesis].

    Science.gov (United States)

    Cai, Yun-Huo; Zhao, Peng; Mao, Qiang; Bao, Hang-Xing; Wang, Jin-Fa; Hu, Miao-Feng; Xiao, Lu-Wei; Tong, Pei-Jian

    2012-12-01

    To explore effects of Yougui recipe (see text) and salmon calcitonin acetate in preventing osteolysis surrounding artificial prosthesis. Thirty-two SD male rats with weighted (250 +/- 20) g, aged 8 weeks, were randomly divided into four groups: blank group, model group, salmon calcitonin acetate group and Yougui recipe (see text) group, and 8 rats in each group. Blank group did not undergo any process, other 24 rats underwent anesthesia by chloral hydrate, their knee joints were exposed through medial patellar side,drilling from fermoral condyle nest to marrow cavity,high density of polythlene particles were injected into hole, titanium nail were put into, bone wax closed the window, then suturing step by step. After the molding, saline were used to gavaged in blank group and model group, Yougui recipe (see text) for Yougui recipe (see text) group, salmon calcitonin maximus injection for calcitonin group. After 10 weeks' mediation, rats were executed, and arterial blood and bilateral femoral organization were collected to biochemical, imaging morphology, tissue pathology and molecular biology detection. The key gene expression of activiting osteoclast were inhibited in Yougui recipe (see text) group and calcitonin group. The level of OPG, Ca, ALP in Yougui recipe group were higher than calcitonin group (Partificial joint prosthesis, and Yougui recipe (see text) has better effect in promoting bone formation. The effect of Yougui recipe (see text) in promoting bone formation, inhibiting osteoclasts to provide a new method to treating surrounding osteolysis of artificial joint prosthesis.

  7. Assessing the results of thrust plate prosthesis: a comparison of four different rating systems.

    Science.gov (United States)

    Unver, Bayram; Karatosun, Vasfi; Gunal, Izge

    2005-09-01

    To evaluate four rating systems designed to assess patients following provision of a thrust plate prosthesis. Sixty-one patients undergoing total hip replacement with thrust plate prosthesis. Patients were evaluated preoperatively and six months postoperatively by four different hip rating systems (Harris, Iowa, Charnley and Merle d'Aubigne), both on a categorical and on a numerical basis. Department of orthopaedics and traumatology in a university hospital. Patients were evaluated by four rating systems preoperatively and postoperatively either on a categorical or a numerical basis. All patients showed significant improvement after surgery in all rating systems. Although preoperative categorical evaluation revealed that the strongest correlation was between Charnley and Merle d'Aubigne scores (r = 0.876), numerical comparison of the rating systems showed strong correlation among all systems, both pre- and postoperatively. Responsiveness analysis revealed larger effect size for the Iowa and Harris hip scores. Our results suggest that hip rating systems should be compared numerically rather than by categorical evaluation and that the Iowa and Harris hip scores are more convenient in evaluating thrust plate prosthesis patients because they have larger effect sizes without floor and ceiling effects.

  8. Total Hip Arthroplasty Using the S-ROM-A Prosthesis for Anatomically Difficult Asian Patients.

    Science.gov (United States)

    Hozumi, Akira; Kobayashi, Kyousuke; Tsuru, Nobuhisa; Miyamoto, Chikara; Maeda, Jyunichiro; Chiba, Ko; Goto, Hisataka; Osaki, Makoto

    2015-01-01

    The S-ROM-A prosthesis has been designed for the Asian proximal femur with a small deformed shape and narrow canal. In this study, the clinical and radiological results using the S-ROM-A prosthesis for Japanese patients with severe deformity due to dysplasia and excessive posterior pelvic tilt were examined. 94 hips were followed up for a mean of 55 months, with a mean age at surgery of 61 years. The primary diagnoses were 94 coxarthritis cases, including 51 dysplasia and 37 primary OA, 1 avascular necrosis, 2 traumatic arthritis, and 3 Perthes disease. Thirty-one hips had been treated with osteotomy of the hip joints. Preoperative intramedullary canal shapes were stovepipe in 23 hips, normal in 51 hips, and champagne-flute in 5 hips. The maximum pelvic inclination angle was 56°. The mean JOA score improved from 46 points preoperatively to 80 points at final follow-up. On radiological evaluation of the fixation of the implants according to the Engh classification, 92 (97%) hips were classified as "bone ingrown fixation." In primary THA, using the S-ROM-A prosthesis for Asian patients with proximal femoral deformity, even after osteotomy and with posterior pelvic tilt, provided good short- to midterm results.

  9. Transition from a failing dentition to a removable implant-supported prosthesis: a staged approach.

    Science.gov (United States)

    Cordaro, Luca; Torsello, Ferruccio; Ribeiro, Carlos Accorsi

    2010-05-01

    Patients with hopeless dentition often present difficulties in the management of the transitional phase to the final restoration. This article describes a staged approach to achieve a full-arch, implant-supported, removable prosthesis in patients with a hopeless dentition. The approach described allows the clinician to proceed in a staged manner and facilitate prosthetic steps by keeping fixed references for vertical dimension. This technique includes initial conservative periodontal care and, afterward, extraction of some strategic teeth, while others are temporarily maintained. At this point, the implants are positioned, and during the healing period, the remaining natural abutments are used for occlusal reference and to stabilize the removable provisional prosthesis. After osseointegration of the implants, the residual teeth are extracted and the final prosthesis is delivered. The main advantages of the technique include maintenance of function during treatment, stabilization of the removable provisional (especially in the mandibular arch), prosthetic-guided insertion of implants, and easier retrieval of prosthetic references. The main drawbacks are longer treatment time and the need for two surgical steps.

  10. Noncontact Electrical Permittivity Mapping and pH-Sensitive Films for Osseointegrated Prosthesis and Infection Monitoring.

    Science.gov (United States)

    Gupta, Sumit; Loh, Kenneth J

    2017-11-01

    The objective of this paper is to develop a noncontact, noninvasive system for detecting and monitoring subcutaneous infection occurring at the tissue and osseointegrated prosthesis interface. It is known that the local pH of tissue can change due to infection. Therefore, the sensing system integrates two parts, namely, pH-sensitive thin films that can be coated onto prosthesis surfaces prior to them being implanted and an electrical capacitance tomography (ECT) algorithm that can reconstruct the spatial permittivity distribution of a region of space in a noncontact fashion. First, a thin film pH sensor was fabricated by spray coating, and tests confirmed that the film exhibited changes in its permittivity due to pH. Second, the ECT forward and inverse problems were implemented. Third, an aluminum rod was employed as a representative phantom of an osseointegrated prosthesis and then spray coated with the pH sensor. Finally, the film-coated phantom was immersed in different pH buffers, dried, and subjected to ECT interrogation and spatial permittivity reconstruction. The results validated that ECT was able to detect and localize permittivity variations correlated to pH changes.

  11. Clinical and echocardiographic assessment of the Medtronic Advantage aortic valve prosthesis: the Scandinavian multicentre, prospective study

    DEFF Research Database (Denmark)

    Haaverstad, Rune; Vitale, Nicola; Karevold, Asbjørn

    2006-01-01

    OBJECTIVE: The aim of this report is the prospective, multicentre evaluation of clinical results and haemodynamic performance of the Medtronic Advantage aortic valve prosthesis. METHODS: From April 2001 to June 2003, 166 patients (male:female 125:41; mean (SD) age 61.8 (11.8) years) received an a...... echocardiography. CONCLUSIONS: Haemodynamic performance and early clinical results of Medtronic advantage in the aortic position were satisfactory and comparable with those of other bileaflet valves in current clinical use.......OBJECTIVE: The aim of this report is the prospective, multicentre evaluation of clinical results and haemodynamic performance of the Medtronic Advantage aortic valve prosthesis. METHODS: From April 2001 to June 2003, 166 patients (male:female 125:41; mean (SD) age 61.8 (11.8) years) received...... an aortic advantage valve prosthesis. Complete cumulative follow-up was 242.7 patient-years (maximum 3.2; mean 1.6 years). Postoperatively, patients underwent early (within 30 days) and 1 year transthoracic echocardiography. RESULTS: 30 day mortality was 2.4% (n = 4). Kaplan-Meier estimates of freedom from...

  12. Long-term results following cranial hydroxyapatite prosthesis implantation in a large skull defect model.

    Science.gov (United States)

    Martini, Lucia; Staffa, Guido; Giavaresi, Gianluca; Salamanna, Francesca; Parrilli, Annapaola; Serchi, Elena; Pressato, Daniele; Arcangeli, Elena; Fini, Milena

    2012-04-01

    A large skull defect may occur after different events such as trauma, tumor resection, and vascular injuries. There is still some doubt about the best material to use for reconstruction. Hydroxyapatite ceramic is one of the materials in use, and its biocompatibility and osteoconductivity are well established. This study evaluated the interaction of a commercial hydroxyapatite custom-made prosthesis implanted in a large skull defect, to assess its osteointegration and its habitability with newly formed bone over time. Ten sheep underwent craniectomy and reconstruction of the skull defect with a porous hydroxyapatite cranial prosthesis. The animals were divided into two groups: animals in group A were euthanized after 6 months and animals in group B were euthanized after 12 months. At the end of the experimental periods, each implant was evaluated macroscopically and radiologically, and analyzed by micro-computed tomography, histology, histomorphometry, and microhardness techniques. During the study, no adverse events occurred, and there was no evidence of inflammation or negative tissue reactions. Histology and histomorphometry showed new bone formation inside the implant in both experimental periods; newly formed bone had increased significantly (p prosthesis showed its osteoconductivity and good biocompatibility. A low rate of fibrous tissue formation and a high rate of bony regeneration were found.

  13. In vivo operation of the Boston 15-channel wireless subretinal visual prosthesis

    Science.gov (United States)

    Shire, Douglas B.; Doyle, Patrick; Kelly, Shawn K.; Gingerich, Marcus D.; Chen, Jinghua; Cogan, Stuart F.; Drohan, William A.; Mendoza, Oscar; Theogarajan, Luke; Wyatt, John; Rizzo, Joseph F.

    2010-02-01

    This presentation concerns the engineering development of the Boston visual prosthesis for restoring useful vision to patients blind with degenerative retinal disease. A miniaturized, hermetically-encased, 15-channel wirelessly-operated retinal prosthetic was developed for implantation and pre-clinical studies in Yucatan mini-pig animal models. The prosthesis conforms to the eye and drives a microfabricated polyimide stimulating electrode array having sputtered iridium oxide electrodes. This array is implanted into the subretinal space using a specially-designed ab externo surgical technique; the bulk of the prosthesis is on the surface of the sclera. The implanted device includes a hermetic titanium case containing a 15-channel stimulator chip; secondary power/data receiving coils surround the cornea. Long-term in vitro pulse testing was also performed on the electrodes to ensure their stability over years of operation. Assemblies were first tested in vitro to verify wireless operation of the system in biological saline using a custom RF transmitter circuit and primary coils. Stimulation pulse strength, duration and frequency were programmed wirelessly using a computer with a custom graphical user interface. Operation of the retinal implant was verified in vivo in 3 minipigs for more than three months by measuring stimulus artifacts on the eye surface using contact lens electrodes.

  14. A review of in vivo animal studies in retinal prosthesis research.

    Science.gov (United States)

    Bertschinger, Dimiter R; Beknazar, Evgueny; Simonutti, Manuel; Safran, Avinoam B; Sahel, José A; Rosolen, Serge G; Picaud, Serge; Salzmann, Joel

    2008-11-01

    The development of a functional retinal prosthesis for acquired blindness is a great challenge. Rapid progress in the field over the last 15 years would not have been possible without extensive animal experimentation pertaining to device design and fabrication, biocompatibility, stimulation parameters and functional responses. This paper presents an overview of in vivo animal research related to retinal prosthetics, and aims to summarize the relevant studies. A Pubmed search of the English language literature was performed. The key search terms were: retinal implant, retinal prosthesis, artificial vision, rat, rabbit, cat, dog, sheep, pig, minipig. In addition a manual search was performed based on references quoted in the articles retrieved through Pubmed. We identified 50 articles relevant to in vivo animal experimentation directly related to the development of a retinal implant. The highest number of publications related to the cat (n = 18). The contribution of animal models to the development of retinal prosthetic devices has been enormous, and has led to human feasibility studies. Grey areas remain regarding long-term tissue-implant interactions, biomaterials, prosthesis design and neural adaptation. Animals will continue to play a key role in this rapidly evolving field.

  15. Experimental study of sutureless vascular anastomosis with use of glued prosthesis in rabbits.

    Science.gov (United States)

    Vokrri, Lulzim; Qavdarbasha, Arsim; Rudari, Hajriz; Ahmetaj, Halil; Manxhuka-Kërliu, Suzana; Hyseni, Nexhmi; Porcu, Paolo; Cinquin, Philippe; Sessa, Carmine

    2015-01-01

    The objective of this study is to explore the feasibility and efficacy of a new technique for sutureless vascular anastomosis, using glued prosthesis, as a sole anastomosis fixation method in rabbits. Ten rabbits were randomly selected to conduct the experiment. Five rabbits underwent direct anastomosis of infrarenal abdominal aorta, with glued prosthesis. In five other rabbits, reconstruction was done by sutured anastomosis. All animals were immediately examined by echo-Doppler for patency of anastomosis. The burst pressure of the glued anastomosis was measured and compared with that of a sutured artery. The animals were euthanized, and tissue samples were taken for histological examination immediately after the experiment. Compared to conventional anastomoses, sutureless vascular anastomoses required shorter time of creation and significantly reduced blood loss (Pprosthesis, examined by echo-Doppler, were patent at the anastomotic site, except one, which was stenosed immediately after surgery. In the control group, except one with stenosis, all conventional anastomoses were patent. Mean burst pressure at the anastomotic site for sutureless anastomoses was lower than in control group. Macroscopically, the BioGlue did not demonstrate any adhesion to the surrounding tissue as it was covered by the vascular prosthesis. Histological examination showed low-grade inflammatory reaction in glued anastomoses versus no inflammatory reaction at the sutured anastomoses. This technique may provide a feasible and successful alternative in vascular surgery. However, further long-term studies are necessary to elucidate the break pressure and degree of inflammation at the anastomotic site.

  16. Effect of veneering material on the deformation suffered by implant-supported fixed prosthesis framework

    Science.gov (United States)

    GRANDO, Antônio Francisco; REZENDE, Carlos Eduardo Edwards; SOUSA, Edson Antônio Capello; RUBO, José Henrique

    2014-01-01

    Knowing how stresses are dissipated on the fixed implant-supported complex allows adequate treatment planning and better choice of the materials used for prosthesis fabrication. Objectives The aim of this study was to evaluate the deformation suffered by cantilevered implant-supported fixed prostheses frameworks cast in silver-palladium alloy and coated with two occlusal veneering materials: acrylic resin or porcelain. Material and Methods Two strain gauges were bonded to the inferior surface of the silver-palladium framework and two other were bonded to the occlusal surface of the prosthesis framework covered with ceramic and acrylic resin on each of its two halves. The framework was fixed to a metallic master model and a 35.2 N compression force was applied to the cantilever at 10, 15 and 20 mm from the most distal implant. The measurements of deformation by compression and tension were obtained. The statistical 2-way ANOVA test was used for individual analysis of the experiment variables and the Tukey test was used for the interrelation between all the variables (material and distance of force application). Results The results showed that both variables had influence on the studied factors (deformation by compression and tension). Conclusion The ceramic coating provided greater rigidity to the assembly and therefore less distortion compared with the uncoated framework and with the resin-coated framework. The cantilever arm length also influenced the prosthesis rigidity, causing higher deformation the farther the load was applied from the last implant. PMID:25025562

  17. Effect of veneering material on the deformation suffered by implant-supported fixed prosthesis framework

    Directory of Open Access Journals (Sweden)

    Antônio Francisco GRANDO

    2014-06-01

    Full Text Available Knowing how stresses are dissipated on the fixed implant-supported complex allows adequate treatment planning and better choice of the materials used for prosthesis fabrication. Objectives: The aim of this study was to evaluate the deformation suffered by cantilevered implant-supported fixed prostheses frameworks cast in silver-palladium alloy and coated with two occlusal veneering materials: acrylic resin or porcelain. Material and Methods: Two strain gauges were bonded to the inferior surface of the silver-palladium framework and two other were bonded to the occlusal surface of the prosthesis framework covered with ceramic and acrylic resin on each of its two halves. The framework was fixed to a metallic master model and a 35.2 N compression force was applied to the cantilever at 10, 15 and 20 mm from the most distal implant. The measurements of deformation by compression and tension were obtained. The statistical 2-way ANOVA test was used for individual analysis of the experiment variables and the Tukey test was used for the interrelation between all the variables (material and distance of force application. Results: The results showed that both variables had influence on the studied factors (deformation by compression and tension. Conclusion: The ceramic coating provided greater rigidity to the assembly and therefore less distortion compared with the uncoated framework and with the resin-coated framework. The cantilever arm length also influenced the prosthesis rigidity, causing higher deformation the farther the load was applied from the last implant.

  18. Aesthethic and masticatory rehabilitation on post mandibular resection with combination of hollow obturator and hybrid prosthesis

    Directory of Open Access Journals (Sweden)

    Arif Rachman

    2009-06-01

    Full Text Available Background: Replacing tooth lost caused by caries, periodontal disease, trauma and neoplasm including ameloblastoma which requires mandibular resection is important. Purpose: The aim of the study to rehabilitation of post mandibular resection with combination of hollow obturator and hybrid prosthesis. Case: A patient 25 years old, male, for having prosthesis to cover defect due to post right mandibular resection. Case Management: In this presented case, mandibular plate was applied due to spreading defect with losing almost a half body of mandible (class II modification 2 according to cantor and curtis classification. The design of therapy was mandibular obturator using hybrid prosthesis (removable partial denture metal frame and fixed splint crown with precision attachment with hollow obturator. The application was based on several advantages: good aesthetic performance, retention, stability, lighter weight and equal share of vertical load for teeth on non surgical site. The result of control I, II, III, showed that aesthetic performance, masticatory function, speech and swallowing were in good condition. Conclusion: The design of mandibular obturator using hybrid denture with hollow obturator could rehabilitate aesthetic performance, masticatory function, speech and swallowing for patient with post mandibular resection.

  19. Extended long term functional outcome of inflatable penile prosthesis in a single institution.

    LENUS (Irish Health Repository)

    Thomas, A Z

    2011-02-01

    We sought to evaluate the extended long term functional outcome of the AMS700 three piece inflatable prosthesis in men with erectile dysfunction in a single urological department and assess our revision rates. Patients that underwent first-time insertion or revision of an AMS700 3 piece inflatable penile prosthesis between 1984-2007 were included. Data was obtained from medical records and long term follow up of patients was conducted by telephone interview. The medical records of 38 patients were available for review. Of these 38 men, 56 prostheses were inserted. The mean follow up was 8.4 years (101 months). The revision rate at 50 months postoperatively was 7\\/38 (18%). The overall revision rate was 18\\/38 (47%). The mean time to revision in these 18 patients was 72 months (12-156 months) after initial insertion of AMS700 penile prosthesis. This study highlights that with longer follow u revision rates markedly increase after 72 months.

  20. Design and Development of a Novel Upper-Limb Cycling Prosthesis.

    Science.gov (United States)

    Tiele, Akira; Soni-Sadar, Shivam; Rowbottom, Jack; Patel, Shilen; Mathewson, Edward; Pearson, Samuel; Hutchins, David; Head, John; Hutchins, Stephen

    2017-11-16

    The rise in popularity of the Paralympics in recent years has created a need for effective, low-cost sports-prosthetic devices for upper-limb amputees. There are various opportunities for lower-limb amputees to participate in cycling; however, there are only few options for those with upper-limb amputations. If the individual previously participated in cycling, a cycling-specific prosthesis could allow these activities to be integrated into rehabilitation methods. This article describes the processes involved with designing, developing and manufacturing such a prosthesis. The fundamental needs of people with upper-limb amputation were assessed and realised in the prototype of a transradial terminal device with two release mechanisms, including a sliding mechanism (for falls and minor collisions) and clamping mechanism (for head-on collisions). The sliding mechanism requires the rider to exert approximately 200 N, while the clamping mechanism requires about 700 N. The force ranges can be customised to match rider requirements. Experiments were conducted in a controlled environment to demonstrate stability of the device during normal cycling. Moreover, a volunteer test-rider was able to successfully activate the release mechanism during a simulated emergency scenario. The development of this prosthesis has the potential to enable traumatic upper-limb amputees to participate in cycling for rehabilitation or recreation.