WorldWideScience

Sample records for orthopaedic implant applications

  1. Gelatin functionalised porous titanium alloy implants for orthopaedic applications

    Energy Technology Data Exchange (ETDEWEB)

    Vanderleyden, E. [Polymer Chemistry and Biomaterials Research Group, Department of Organic Chemistry, University of Ghent, Krijgslaan 281 S4, 9000 Ghent (Belgium); Van Bael, S. [Prometheus, Division of Skeletal Tissue Engineering, Katholieke Universiteit Leuven, O and N 1, Herestraat 49, Box 813, 3000 Leuven (Belgium); Department of Mechanical Engineering, Division of Production Engineering, Machine Design and Automation, Katholieke Universiteit Leuven, Celestijnenlaan 300b, 3001 Leuven (Belgium); Department of Mechanical Engineering, Division of Biomechanics and Engineering Design, Katholieke Universiteit Leuven, Celestijnenlaan 300c, Box 2419, 3001 Heverlee (Belgium); Chai, Y.C. [Prometheus, Division of Skeletal Tissue Engineering, Katholieke Universiteit Leuven, O and N 1, Herestraat 49, Box 813, 3000 Leuven (Belgium); Tissue Engineering Laboratory, Skeletal Biology and Engineering Research Center, Katholieke Universiteit Leuven, O and N 1, Herestraat 49, Box 813, 3000 Leuven (Belgium); Kruth, J.-P. [Department of Mechanical Engineering, Division of Production Engineering, Machine Design and Automation, Katholieke Universiteit Leuven, Celestijnenlaan 300b, 3001 Leuven (Belgium); Schrooten, J. [Prometheus, Division of Skeletal Tissue Engineering, Katholieke Universiteit Leuven, O and N 1, Herestraat 49, Box 813, 3000 Leuven (Belgium); Department of Metallurgy and Materials Engineering, Katholieke Universiteit Leuven, Kasteelpark Arenberg 44, Bus 2450, 3001 Leuven (Belgium); Dubruel, P., E-mail: pbmugent@gmail.com [Polymer Chemistry and Biomaterials Research Group, Department of Organic Chemistry, University of Ghent, Krijgslaan 281 S4, 9000 Ghent (Belgium)

    2014-09-01

    In the present work, we studied the immobilisation of the biopolymer gelatin onto the surface of three dimensional (3D) regular Ti6Al4V porous implants to improve their surface bio-activity. The successful immobilisation of the gelatin coating was made possible by a polydopamine interlayer, a polymer coating inspired by the adhesive nature of mussels. The presence of both coatings was first optimised on two dimensional titanium (2D Ti) substrates and confirmed by different techniques including X-ray photelectron spectroscopy, contact angle measurements, atomic force microscopy and fluorescence microscopy. Results showed homogeneous coatings that are stable for at least 24 h in phosphate buffer at 37 °C. In a next step, the coating procedure was successfully transferred to 3D Ti6Al4V porous implants, which indicates the versatility of the applied coating procedure with regard to complex surface morphologies. Furthermore, the bio-activity of these stable gelatin coatings was enhanced by applying a third and final coating using the cell-attractive protein fibronectin. The reproducible immobilisation process allowed for a controlled biomolecule presentation to the surrounding tissue. This newly developed coating procedure outperformed the previously reported silanisation procedure for immobilising gelatin. In vitro cell adhesion and culture studies with human periosteum-derived cells showed that the investigated coatings did not compromise the biocompatible nature of Ti6Al4V porous implants, but no distinct biological differences between the coatings were found. - Highlights: • Ti6Al4V porous implants were produced by selective laser melting. • A procedure to obtain a stable gelatin coating was developed. • Successful transfer of the coating procedure from 2D to 3D Ti6Al4V porous implants. • In vitro cell studies showed that the developed coatings supported cell growth.

  2. Application of micro beam PIXE to detection of titanium ion release from dental and orthopaedic implants

    International Nuclear Information System (INIS)

    Ektessabi, A.M.; Otsuka, T.; Tsuboi, Y.; Yokoyama, K.; Albrektsson, T.; Sennerby, L.; Johansson, C.

    1994-01-01

    In the past two decades the utilization of dental and orthopaedic implants in reconstructive surgery has been spread widely. Most of these implants are inserted in the corrosive environment of the human body for long periods of time. The level of dissolution, release, and transport of metal ions as a result of corrosion of these materials are not fully known at present. We report the results of application of micro ion beam PIXE spectroscopy to detect release of titanium from titanium and titanium alloy implants inserted in the tibiae of rabbits for three months. It was found that titanium ions could be detected in the surrounding tissues, with high precision, as a gradient from the implant surface and in higher amounts in the bone tissue as compared with the soft tissues. It is concluded that application of micro ion beam PIXE spectroscopy for detection of metal ion release, and distribution of the released material around the implants with high special resolution and accuracy may be used to further investigate the mechanism of metal release, and the relation between surface micromorphology and corrosion resistance of the implant materials. (author)

  3. [The Development and Application of the Orthopaedics Implants Failure Database Software Based on WEB].

    Science.gov (United States)

    Huang, Jiahua; Zhou, Hai; Zhang, Binbin; Ding, Biao

    2015-09-01

    This article develops a new failure database software for orthopaedics implants based on WEB. The software is based on B/S mode, ASP dynamic web technology is used as its main development language to achieve data interactivity, Microsoft Access is used to create a database, these mature technologies make the software extend function or upgrade easily. In this article, the design and development idea of the software, the software working process and functions as well as relative technical features are presented. With this software, we can store many different types of the fault events of orthopaedics implants, the failure data can be statistically analyzed, and in the macroscopic view, it can be used to evaluate the reliability of orthopaedics implants and operations, it also can ultimately guide the doctors to improve the clinical treatment level.

  4. Antimicrobial and Osseointegration Properties of Nanostructured Titanium Orthopaedic Implants

    OpenAIRE

    Jäger, Marcus; Jennissen, Herbert P.; Dittrich, Florian; Fischer, Alfons; Köhling, Hedda Luise

    2017-01-01

    The surface design of titanium implants influences not only the local biological reactions but also affects at least the clinical result in orthopaedic application. During the last decades, strong efforts have been made to improve osteointegration and prevent bacterial adhesion to these surfaces. Following the rule of “smaller, faster, cheaper”, nanotechnology has encountered clinical application. It is evident that the hierarchical implant surface micro- and nanotopography orchestrate the bi...

  5. Antimicrobial and Osseointegration Properties of Nanostructured Titanium Orthopaedic Implants.

    Science.gov (United States)

    Jäger, Marcus; Jennissen, Herbert P; Dittrich, Florian; Fischer, Alfons; Köhling, Hedda Luise

    2017-11-13

    The surface design of titanium implants influences not only the local biological reactions but also affects at least the clinical result in orthopaedic application. During the last decades, strong efforts have been made to improve osteointegration and prevent bacterial adhesion to these surfaces. Following the rule of "smaller, faster, cheaper", nanotechnology has encountered clinical application. It is evident that the hierarchical implant surface micro- and nanotopography orchestrate the biological cascades of early peri-implant endosseous healing or implant loosening. This review of the literature gives a brief overview of nanostructured titanium-base biomaterials designed to improve osteointegration and prevent from bacterial infection.

  6. Characterization of cellular solids in Ti6Al4V for orthopaedic implant applications: Trabecular titanium.

    Science.gov (United States)

    Marin, E; Fusi, S; Pressacco, M; Paussa, L; Fedrizzi, L

    2010-07-01

    EBM (Electron Beam Melting) technology can be used successfully to obtain cellular solids in metallic biomaterials that can greatly increase osseointegration in arthroprothesis and at the same time maintain good mechanical properties. The investigated structures, called Trabecular Titanium, usually cannot be obtained by traditional machining. Two samples: (A) with a smaller single cell area and, (B) with a bigger single cell area, were produced and studied in this project. They have been completely characterized and compared with the results in similar literature pertinent to Ti6Al4V EBM structures. Relative density was evaluated using different methods, the mean diameter of the open porosities was calculated by Scanning Electron Microscope images; the composition was evaluated using Energy-Dispersive X-Ray Spectroscopy; the microstructure (alpha-beta) was investigated using chemical etching and, the mechanical proprieties were investigated using UMTS. The mean porosity values resulted comparable with spongy bone (63% for A and 72% for B). The mean diameter of the single porosity (650 mum for A and 1400 mum for B) resulted compatible with the osseointegration data from the literature, in particular for sample A. The Vickers micro-hardness tests and the chemical etching demonstrated that the structure is fine, uniform and well distributed. The mechanical test proved that sample (A) was more resistant than sample (B), but sample (B) showed an elastic modulus almost equal to the value of spongy bone. The results of this study suggest that the two Ti6Al4V cellular solids can be used in biomedical applications to promote osseointegration demonstrating that they maybe successfully used in prosthetic implants. Additional implant results will be published in the near future. Copyright 2010 Elsevier Ltd. All rights reserved.

  7. Bone Adaptation Around Orthopaedic Implants of Varying Materials

    DEFF Research Database (Denmark)

    Bagge, Mette

    1998-01-01

    The bone adaptation around orthopaedic implants is simulated using a three-dimensional finite element model. The remodeling scheme has its origin in optimization methods, and includes anisotropy and time-dependent loading......The bone adaptation around orthopaedic implants is simulated using a three-dimensional finite element model. The remodeling scheme has its origin in optimization methods, and includes anisotropy and time-dependent loading...

  8. Reading the small print - labelling recommendations for orthopaedic implants.

    Science.gov (United States)

    Haene, Roger A; Sandhu, Ranbir S; Baxandall, Richard

    2009-11-01

    There exist, currently, no clear guidelines regarding standards for surgical implant labelling. Dimensions of the laminar flow canopies in orthopaedic use fixes the distance at which implant labels can be read. Mistakes when reading the label on an implant box can pose health risks for patients, and financial consequences for medical institutions. Using scientifically validated tools such as the Snellen Chart Formula, a theoretical minimum standard for text on implant labels was reached. This theoretical standard was then tested under real operating conditions. After discovering a minimum practical standard for implant labels, the authors then audited current labels in use on a wide range of orthopaedic implant packages. Furthermore, other non-text-related labelling problems were also noted. There is a definite minimum standard which should be observed when implant labels are manufactured. Implants in current use bear labels on the packaging that are of an insufficient standard to ensure patient safety in theatre. The authors have established text parameters that will increase the legibility of implant labels. In the interests of improving risk management in theatre, therefore, the authors propose a standard for orthopaedic implant labelling, and believe this will provide a useful foundation for further discussion between the orthopaedic community and implant manufacturers.

  9. Battlefield-Acquired Immunogenicity to Metals Affects Orthopaedic Implant Outcome

    Science.gov (United States)

    2015-10-01

    Award Number: W81XWH-10-2-0138 TITLE: Battlefield-Acquired Immunogenicity to Metals Affects Orthopaedic Implant Outcome PRINCIPAL INVESTIGATOR...Immunogenicity to Metals Affects Orthopaedic pla t Outcome 5b. GRANT NUMBER W91ZSQ0135N646 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Nadim James...DISTRIBUTION / AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEM ENTARY NOTES 14. ABSTRACT The effects of battlefield

  10. Biodegradable Implants in Orthopaedics and Traumatology

    OpenAIRE

    YETKIN, Haluk

    2014-01-01

    Biodegradable implants are an alternative to metallic implants and have the advantage of not being necessary to remove once the fracture has healed. Twenty-two patients with fractures were treated with biodegradable implants. There were osteolysis in eleven patients; however, no serious complication was encountered. Although biodegradable implants are expensive, a second surgical procedure to remove the implants is not necessary, relieving the patient of the related costs and risks.

  11. Orthopaedic Implants And Prosthesis: Economic Costs Of Post ...

    African Journals Online (AJOL)

    OBJECTIVE: To assess the economic impact of post-operative wound infection in trauma patients who had open reduction and internal fixation with implants and prostheses following fractures of the femur. METHOD: This is a 2-year case controlled prospective study carried out at the National Orthopaedic Hospital, Lagos.

  12. Biocompatibility of orthopaedic implants on bone forming cells

    OpenAIRE

    Kapanen, A. (Anita)

    2002-01-01

    Abstract Reindeer antler was studied for its possible use as a bone implant material. A molecular biological study showed that antler contains a growth factor promoting bone formation. Ectopic bone formation assay showed that antler is not an equally effective inducer as allogenic material. Ectopic bone formation assay was optimised for biocompatibility studies of orthopaedic NiTi implants. Ti-6Al-4V and stainless steel were used as reference materials. The assay...

  13. Management of Patients with Orthopaedic Implants Undergoing Dental Procedures.

    Science.gov (United States)

    Quinn, Robert H; Murray, Jayson N; Pezold, Ryan; Sevarino, Kaitlyn S

    2017-07-01

    The American Academy of Orthopaedic Surgeons, in collaboration with the American Dental Association, has developed Appropriate Use Criteria (AUC) for the Management of Patients with Orthopaedic Implants Undergoing Dental Procedures. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The Management of Patients with Orthopaedic Implants Undergoing Dental Procedures AUC clinical patient scenarios were derived from indications of patients with orthopaedic implants presenting for dental procedures, as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of the use of prophylactic antibiotics. The 64 patient scenarios and 1 treatment were developed by the writing panel, a group of clinicians who are specialists in this AUC topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3).

  14. Nanostructured diamond coatings for orthopaedic applications

    Science.gov (United States)

    CATLEDGE, S.A.; THOMAS, V.; VOHRA, Y.K.

    2013-01-01

    With increasing numbers of orthopaedic devices being implanted, greater emphasis is being placed on ceramic coating technology to reduce friction and wear in mating total joint replacement components, in order to improve implant function and increase device lifespan. In this chapter, we consider ultra-hard carbon coatings, with emphasis on nanostructured diamond, as alternative bearing surfaces for metallic components. Such coatings have great potential for use in biomedical implants as a result of their extreme hardness, wear resistance, low friction and biocompatibility. These ultra-hard carbon coatings can be deposited by several techniques resulting in a wide variety of structures and properties. PMID:25285213

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

    DEFF Research Database (Denmark)

    Babiker, Hassan

    2013-01-01

    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many...... orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include...... the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking...

  16. Conductive polymer sensor arrays for smart orthopaedic implants

    Science.gov (United States)

    Micolini, Carolina; Holness, F. B.; Johnson, James A.; Price, Aaron D.

    2017-04-01

    This study proposes and demonstrates the design, implementation, and characterization of a 3D-printed smartpolymer sensor array using conductive polyaniline (PANI) structures embedded in a polymeric substrate. The piezoresistive characteristics of PANI were studied to evaluate the efficacy of the manufacturing of an embedded pressure sensor. PANI's stability throughout loading and unloading cycles together with the response to incremental loading cycles was investigated. It is demonstrated that this specially developed multi-material additive manufacturing process for polyaniline is a good candidate for the manufacture of implant components with smart-polymer sensors embedded for the analysis of joint loads in orthopaedic implants.

  17. Overview of Implant Infections in Orthopaedics Department: Retrospective Study

    Directory of Open Access Journals (Sweden)

    Tugrul Bulut

    2014-12-01

    Full Text Available In this study, our aim was to evaluate the antibiotic susceptibility of bacteria isolated from orthopedic implant infections. Within two years operated 1996 patients in an orthopedics and traumatology clinic were retrospectively investigated. Seventy-six (76/1996, 3.8% orthopedic implant infections were detected. Isolated bacteria and their antibiotic susceptibility patterns were analyzed. The bacteries isolated from implant related infections and antibiotic sensitivity patterns were evaluated retrospectively in our orthopaedics and traumatology clinic. Staphylococcus aureus was the predominant organism (30.3%. Gram negative bacterias were isolated in 65.8% of our patients. No resistance was determined against vancomycin and linezolid in gram positive bacterias. Imipenem, amicasin and cefepim was seen as the most effective antibiotics for gram negative bacterias.

  18. Cinnamon Oil and Chitosan Coating on Orthopaedic Implant Surface for Prevention of Staphylococcus Epidermidis Biofilm Formation

    OpenAIRE

    R Magetsari; P Dewo; BK Saputro; Z Lanodiyu

    2014-01-01

    S. Epidermidis is among the most frequently isolated microorganisms found in -infection related to implanted devices and the formation of biofilm will be more resistantcompared to the planktonic form. This study was carried out determine the effect of coating on stainless steel orthopaedic implants surfaces with cinnamon oil and chitosan as bioadhesive to prevent biofilms formation of S. Epidermidis.The rod shaped stainless steel 316 L orthopaedic implant with 5 mm diameters was coated 2 t...

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

    Directory of Open Access Journals (Sweden)

    Bill G. X. Zhang

    2014-07-01

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

  20. The Placenta: Applications in Orthopaedic Sports Medicine.

    Science.gov (United States)

    McIntyre, James Alexander; Jones, Ian A; Danilkovich, Alla; Vangsness, C Thomas

    2018-01-01

    of administration, and treatment regimens, which prohibits making any definitive conclusions. Currently, the clinical use of placenta is limited to only commercial placental tissue allografts, as there are no placenta-derived biological drugs approved for the treatment of orthopaedic sports medicine conditions in the United States. However, this review shows that the application of placental cells or tissue allografts appears to be safe and has potential to improve outcomes for orthopaedic sports medicine indications.

  1. New orthopaedic implant management tool for computer-assisted planning, navigation, and simulation: from implant CAD files to a standardized XML-based implant database.

    Science.gov (United States)

    Sagbo, S; Blochaou, F; Langlotz, F; Vangenot, C; Nolte, L-P; Zheng, G

    2005-01-01

    Computer-Assisted Orthopaedic Surgery (CAOS) has made much progress over the last 10 years. Navigation systems have been recognized as important tools that help surgeons, and various such systems have been developed. A disadvantage of these systems is that they use non-standard formalisms and techniques. As a result, there are no standard concepts for implant and tool management or data formats to store information for use in 3D planning and navigation. We addressed these limitations and developed a practical and generic solution that offers benefits for surgeons, implant manufacturers, and CAS application developers. We developed a virtual implant database containing geometrical as well as calibration information for orthopedic implants and instruments, with a focus on trauma. This database has been successfully tested for various applications in the client/server mode. The implant information is not static, however, because manufacturers periodically revise their implants, resulting in the deletion of some implants and the introduction of new ones. Tracking these continuous changes and keeping CAS systems up to date is a tedious task if done manually. This leads to additional costs for system development, and some errors are inevitably generated due to the huge amount of information that has to be processed. To ease management with respect to implant life cycle, we developed a tool to assist end-users (surgeons, hospitals, CAS system providers, and implant manufacturers) in managing their implants. Our system can be used for pre-operative planning and intra-operative navigation, and also for any surgical simulation involving orthopedic implants. Currently, this tool allows addition of new implants, modification of existing ones, deletion of obsolete implants, export of a given implant, and also creation of backups. Our implant management system has been successfully tested in the laboratory with very promising results. It makes it possible to fill the current gap

  2. Biodegradable magnesium alloys for orthopaedic applications: A review on corrosion, biocompatibility and surface modifications

    Energy Technology Data Exchange (ETDEWEB)

    Agarwal, Sankalp [Centre for Research in Engineering and Surface Technology, FOCAS Institute, Dublin Institute of Technology (Ireland); School of Food Science and Environmental Health, Cathal Brugha Street, Dublin Institute of Technology (Ireland); Curtin, James [School of Food Science and Environmental Health, Cathal Brugha Street, Dublin Institute of Technology (Ireland); Duffy, Brendan [Centre for Research in Engineering and Surface Technology, FOCAS Institute, Dublin Institute of Technology (Ireland); Jaiswal, Swarna, E-mail: swarna.jaiswal@dit.ie [Centre for Research in Engineering and Surface Technology, FOCAS Institute, Dublin Institute of Technology (Ireland)

    2016-11-01

    Magnesium (Mg) and its alloys have been extensively explored as potential biodegradable implant materials for orthopaedic applications (e.g. Fracture fixation). However, the rapid corrosion of Mg based alloys in physiological conditions has delayed their introduction for therapeutic applications to date. The present review focuses on corrosion, biocompatibility and surface modifications of biodegradable Mg alloys for orthopaedic applications. Initially, the corrosion behaviour of Mg alloys and the effect of alloying elements on corrosion and biocompatibility is discussed. Furthermore, the influence of polymeric deposit coatings, namely sol-gel, synthetic aliphatic polyesters and natural polymers on corrosion and biological performance of Mg and its alloy for orthopaedic applications are presented. It was found that inclusion of alloying elements such as Al, Mn, Ca, Zn and rare earth elements provides improved corrosion resistance to Mg alloys. It has been also observed that sol-gel and synthetic aliphatic polyesters based coatings exhibit improved corrosion resistance as compared to natural polymers, which has higher biocompatibility due to their biomimetic nature. It is concluded that, surface modification is a promising approach to improve the performance of Mg-based biomaterials for orthopaedic applications. - Highlights: • The Mg based alloys are promising candidates for orthopaedic applications. • The rapid corrosion of Mg can affect human cells, and causes infection and implant failure. • The various physiological factors and Mg alloying elements affect the corrosion and mechanical properties of implants. • The polymeric deposit coatings enhance the corrosion resistance and biocompatibility.

  3. Biodegradable magnesium alloys for orthopaedic applications: A review on corrosion, biocompatibility and surface modifications

    International Nuclear Information System (INIS)

    Agarwal, Sankalp; Curtin, James; Duffy, Brendan; Jaiswal, Swarna

    2016-01-01

    Magnesium (Mg) and its alloys have been extensively explored as potential biodegradable implant materials for orthopaedic applications (e.g. Fracture fixation). However, the rapid corrosion of Mg based alloys in physiological conditions has delayed their introduction for therapeutic applications to date. The present review focuses on corrosion, biocompatibility and surface modifications of biodegradable Mg alloys for orthopaedic applications. Initially, the corrosion behaviour of Mg alloys and the effect of alloying elements on corrosion and biocompatibility is discussed. Furthermore, the influence of polymeric deposit coatings, namely sol-gel, synthetic aliphatic polyesters and natural polymers on corrosion and biological performance of Mg and its alloy for orthopaedic applications are presented. It was found that inclusion of alloying elements such as Al, Mn, Ca, Zn and rare earth elements provides improved corrosion resistance to Mg alloys. It has been also observed that sol-gel and synthetic aliphatic polyesters based coatings exhibit improved corrosion resistance as compared to natural polymers, which has higher biocompatibility due to their biomimetic nature. It is concluded that, surface modification is a promising approach to improve the performance of Mg-based biomaterials for orthopaedic applications. - Highlights: • The Mg based alloys are promising candidates for orthopaedic applications. • The rapid corrosion of Mg can affect human cells, and causes infection and implant failure. • The various physiological factors and Mg alloying elements affect the corrosion and mechanical properties of implants. • The polymeric deposit coatings enhance the corrosion resistance and biocompatibility.

  4. PCR IN TRAUMATOLOGY AND ORTHOPAEDICS: METHOD DESCRIPTION AND APPLICABILITY

    Directory of Open Access Journals (Sweden)

    E. M. Polyakova

    2014-01-01

    Full Text Available Review brief presents description of polymerase chain reaction method (PCR and its most common variants. Three PCR-based lines of research, carried out in the traumatology and orthopaedics, include identifying a causative agents of the implant-associated infection after orthopaedic surgery; detection of antibiotic resistance genes and biofilm forming genes. It was shown that PCR can be used as additional method for detection of genetic disorders, significant for traumatology and orthopaedics, and for investigation of cartilage and bone regeneration.

  5. Cinnamon Oil and Chitosan Coating on Orthopaedic Implant Surface for Prevention of Staphylococcus Epidermidis Biofilm Formation

    Directory of Open Access Journals (Sweden)

    R Magetsari

    2014-11-01

    Full Text Available S. Epidermidis is among the most frequently isolated microorganisms found in -infection related to implanted devices and the formation of biofilm will be more resistantcompared to the planktonic form. This study was carried out determine the effect of coating on stainless steel orthopaedic implants surfaces with cinnamon oil and chitosan as bioadhesive to prevent biofilms formation of S. Epidermidis.The rod shaped stainless steel 316 L orthopaedic implant with 5 mm diameters was coated 2 times using a mixture of cinnamon oil and chitosan 3% and 2% respectively with serial concentration of cinnamon from 0.125% to 2%. The coated implants were then put into tubes that contained bacterial suspension and incubated. Subsequently, the implants were washed with PBS solution followed by MTT soulution and isopropanol acid solution that related to biofilm formation. The results were expressed in numbers which represents the absorbance level at ELISA readings on 575 nm (A575 wavelength.The stainless steel implant coated with chitosan and cinnamon oil 2% and 1% has lower absorbance level compared with the absorbance level of S.Epidermidis biofilm only. This study showed that mixture of cinnamon oil and chitosan coated on the surface of stainless steel orthopaedic implant has an effect against S.Epidermidis biofilm formation with minimum cinnamon oil concentration of 1%.

  6. Customizable orthopaedic oncology implants: one institution's experience with meeting current IRB and FDA requirements.

    Science.gov (United States)

    Willis, Alexander R; Ippolito, Joseph A; Patterson, Francis R; Benevenia, Joseph; Beebe, Kathleen S

    2016-01-01

    Customizable orthopaedic implants are often needed for patients with primary malignant bone tumors due to unique anatomy or complex mechanical problems. Currently, obtaining customizable orthopaedic implants for orthopaedic oncology patients can be an arduous task involving submitting approval requests to the Institutional Review Board (IRB) and the Food and Drug Administration (FDA). There is great potential for the delay of a patient's surgery and unnecessary paperwork if the submission pathways are misunderstood or a streamlined protocol is not in place. The objective of this study was to review the existing FDA custom implant approval pathways and to determine whether this process was improved with an institutional protocol. An institutional protocol for obtaining IRB and FDA approval for customizable orthopaedic implants was established with the IRB at our institution in 2013. This protocol was approved by the IRB, such that new patients only require submission of a modification to the existing protocol with individualized patient information. During the two-year period of 2013-2014, eight patients were retrospectively identified as having required customizable implants for various orthopaedic oncology surgeries. The dates of request for IRB approval, request for FDA approval, and total time to surgery were recorded, along with the specific pathway utilized for FDA approval. The average patient age was 12 years old (7-21 years old). The average time to IRB approval of a modification to the pre-approved protocol was 14 days (7-21 days). Average time to FDA approval after submission of the IRB approval to the manufacturer was 12.5 days (7-19 days). FDA approval was obtained for all implants as compassionate use requests in accordance with Section 561 of the Federal Food Drug and Cosmetic Act's expanded access provisions. Establishment of an institutional protocol with pre-approval by the IRB can expedite the otherwise time-consuming and complicated

  7. Characterization of Ti6Al4V implant surface treated by Nd:YAG laser and emery paper for orthopaedic applications

    International Nuclear Information System (INIS)

    Khosroshahi, M.E.; Mahmoodi, M.; Tavakoli, J.

    2007-01-01

    A more noble and biocompatible Ti alloy was achieved at fluence of 140 J cm -2 where the implant indicated a higher degree of hardness (825HV), higher corrosion resistance (-0.21 V) and highest hydrophilicity (i.e. θ c = 37 o ) compared with 70 o of the control sample. These values corresponded to 58 and 39 mN m -1 of surface tension respectively. The laser treated samples at 140 J cm -2 showed higher wettability characteristics than mechanically roughened surface. Cell growth and their spreading condition in a specific area were analyzed by SEM and Image J Program software. Clearly, more cells were attached (1.2 x 10 5 ) to and spread (488 μm 2 ) over the surface at 140 J cm -2 than in any other condition. Pathologically, the treated samples indicated no sign of infection

  8. Biodegradable magnesium alloys for orthopaedic applications: A review on corrosion, biocompatibility and surface modifications.

    Science.gov (United States)

    Agarwal, Sankalp; Curtin, James; Duffy, Brendan; Jaiswal, Swarna

    2016-11-01

    Magnesium (Mg) and its alloys have been extensively explored as potential biodegradable implant materials for orthopaedic applications (e.g. Fracture fixation). However, the rapid corrosion of Mg based alloys in physiological conditions has delayed their introduction for therapeutic applications to date. The present review focuses on corrosion, biocompatibility and surface modifications of biodegradable Mg alloys for orthopaedic applications. Initially, the corrosion behaviour of Mg alloys and the effect of alloying elements on corrosion and biocompatibility is discussed. Furthermore, the influence of polymeric deposit coatings, namely sol-gel, synthetic aliphatic polyesters and natural polymers on corrosion and biological performance of Mg and its alloy for orthopaedic applications are presented. It was found that inclusion of alloying elements such as Al, Mn, Ca, Zn and rare earth elements provides improved corrosion resistance to Mg alloys. It has been also observed that sol-gel and synthetic aliphatic polyesters based coatings exhibit improved corrosion resistance as compared to natural polymers, which has higher biocompatibility due to their biomimetic nature. It is concluded that, surface modification is a promising approach to improve the performance of Mg-based biomaterials for orthopaedic applications. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. DIY 3D printing of custom orthopaedic implants: a proof of concept study.

    Science.gov (United States)

    Frame, Mark; Leach, William

    2014-03-01

    3D printing is an emerging technology that is primarily used for aiding the design and prototyping of implants. As this technology has evolved it has now become possible to produce functional and definitive implants manufactured using a 3D printing process. This process, however, previously required a large financial investment in complex machinery and professionals skilled in 3D product design. Our pilot study's aim was to design and create a 3D printed custom orthopaedic implant using only freely available consumer hardware and software.

  10. Diabetic mouse model of orthopaedic implant-related Staphylococcus aureus infection.

    Science.gov (United States)

    Lovati, Arianna B; Drago, Lorenzo; Monti, Lorenzo; De Vecchi, Elena; Previdi, Sara; Banfi, Giuseppe; Romanò, Carlo L

    2013-01-01

    Periprosthetic bacterial infections represent one of the most challenging orthopaedic complications that often require implant removal and surgical debridement and carry high social and economical costs. Diabetes is one of the most relevant risk factors of implant-related infection and its clinical occurrence is growing worldwide. The aim of the present study was to test a model of implant-related infection in the diabetic mouse, with a view to allow further investigation on the relative efficacy of prevention and treatment options in diabetic and non-diabetic individuals. A cohort of diabetic NOD/ShiLtJ mice was compared with non-diabetic CD1 mice as an in vivo model of S. aureus orthopaedic infection of bone and soft tissues after femur intramedullary pin implantation. We tested control and infected groups with 1×10(3) colony-forming units of S. aureus ATCC 25923 strain injected in the implant site. At 4 weeks post-inoculation, host response to infection, microbial biofilm formation, and bone damage were assessed by traditional diagnostic parameters (bacterial culture, C-reactive protein and white blood cell count), histological analysis and imaging techniques (micro computed tomography and scanning electron microscopy). Unlike the controls and the CD1 mice, all the diabetic mice challenged with a single inoculum of S. aureus displayed severe osteomyelitic changes around the implant. Our findings demonstrate for the first time that the diabetic mouse can be successfully used in a model of orthopaedic implant-related infection. Furthermore, the same bacteria inoculum induced periprosthetic infection in all the diabetic mice but not in the controls. This animal model of implant-related infection in diabetes may be a useful tool to test in vivo treatments in diabetic and non-diabetic individuals.

  11. Diabetic mouse model of orthopaedic implant-related Staphylococcus aureus infection.

    Directory of Open Access Journals (Sweden)

    Arianna B Lovati

    Full Text Available BACKGROUND: Periprosthetic bacterial infections represent one of the most challenging orthopaedic complications that often require implant removal and surgical debridement and carry high social and economical costs. Diabetes is one of the most relevant risk factors of implant-related infection and its clinical occurrence is growing worldwide. The aim of the present study was to test a model of implant-related infection in the diabetic mouse, with a view to allow further investigation on the relative efficacy of prevention and treatment options in diabetic and non-diabetic individuals. METHODOLOGY: A cohort of diabetic NOD/ShiLtJ mice was compared with non-diabetic CD1 mice as an in vivo model of S. aureus orthopaedic infection of bone and soft tissues after femur intramedullary pin implantation. We tested control and infected groups with 1×10(3 colony-forming units of S. aureus ATCC 25923 strain injected in the implant site. At 4 weeks post-inoculation, host response to infection, microbial biofilm formation, and bone damage were assessed by traditional diagnostic parameters (bacterial culture, C-reactive protein and white blood cell count, histological analysis and imaging techniques (micro computed tomography and scanning electron microscopy. RESULTS: Unlike the controls and the CD1 mice, all the diabetic mice challenged with a single inoculum of S. aureus displayed severe osteomyelitic changes around the implant. CONCLUSIONS: Our findings demonstrate for the first time that the diabetic mouse can be successfully used in a model of orthopaedic implant-related infection. Furthermore, the same bacteria inoculum induced periprosthetic infection in all the diabetic mice but not in the controls. This animal model of implant-related infection in diabetes may be a useful tool to test in vivo treatments in diabetic and non-diabetic individuals.

  12. High strength, surface porous polyether-ether-ketone for load-bearing orthopaedic implants

    Science.gov (United States)

    Evans, Nathan T.; Torstrick, F. Brennan; Lee, Christopher S.D.; Dupont, Kenneth M.; Safranski, David L.; Chang, W. Allen; Macedo, Annie E.; Lin, Angela; Boothby, Jennifer M.; Whittingslow, Daniel C.; Carson, Robert A.; Guldberg, Robert E.; Gall, Ken

    2015-01-01

    Despite its widespread clinical use in load-bearing orthopaedic implants, polyether-ether-ketone (PEEK) is often associated with poor osseointegration. In this study, a surface porous PEEK material (PEEK-SP) was created using a melt extrusion technique. The porous layer thickness was 399.6±63.3 µm and possessed a mean pore size of 279.9±31.6 µm, strut spacing of 186.8±55.5 µm, porosity of 67.3±3.1%, and interconnectivity of 99.9±0.1%. Monotonic tensile tests showed that PEEK-SP preserved 73.9% of the strength (71.06±2.17 MPa) and 73.4% of the elastic modulus (2.45±0.31 GPa) of as-received, injection molded PEEK. PEEK-SP further demonstrated a fatigue strength of 60.0 MPa at one million cycles, preserving 73.4% of the fatigue resistance of injection molded PEEK. Interfacial shear testing showed the pore layer shear strength to be 23.96±2.26 MPa. An osseointegration model in the rat revealed substantial bone formation within the pore layer at 6 and 12 weeks via µCT and histological evaluation. Ingrown bone was more closely apposed to the pore wall and fibrous tissue growth was reduced in PEEK-SP when compared to non-porous PEEK controls. These results indicate that PEEK-SP could provide improved osseointegration while maintaining the structural integrity necessary for load-bearing orthopaedic applications. PMID:25463499

  13. Similarities and differences in coatings for magnesium-based stents and orthopaedic implants

    Directory of Open Access Journals (Sweden)

    Jun Ma

    2014-07-01

    Full Text Available Magnesium (Mg-based biodegradable materials are promising candidates for the new generation of implantable medical devices, particularly cardiovascular stents and orthopaedic implants. Mg-based cardiovascular stents represent the most innovative stent technology to date. However, these products still do not fully meet clinical requirements with regards to fast degradation rates, late restenosis, and thrombosis. Thus various surface coatings have been introduced to protect Mg-based stents from rapid corrosion and to improve biocompatibility. Similarly, different coatings have been used for orthopaedic implants, e.g., plates and pins for bone fracture fixation or as an interference screw for tendon-bone or ligament-bone insertion, to improve biocompatibility and corrosion resistance. Metal coatings, nanoporous inorganic coatings and permanent polymers have been proved to enhance corrosion resistance; however, inflammation and foreign body reactions have also been reported. By contrast, biodegradable polymers are more biocompatible in general and are favoured over permanent materials. Drugs are also loaded with biodegradable polymers to improve their performance. The key similarities and differences in coatings for Mg-based stents and orthopaedic implants are summarized.

  14. Assessment of Embedded Conjugated Polymer Sensor Arrays for Potential Load Transmission Measurement in Orthopaedic Implants

    Directory of Open Access Journals (Sweden)

    Carolina Micolini

    2017-11-01

    Full Text Available Load transfer through orthopaedic joint implants is poorly understood. The longer-term outcomes of these implants are just starting to be studied, making it imperative to monitor contact loads across the entire joint implant interface to elucidate the force transmission and distribution mechanisms exhibited by these implants in service. This study proposes and demonstrates the design, implementation, and characterization of a 3D-printed smart polymer sensor array using conductive polyaniline (PANI structures embedded within a polymeric parent phase. The piezoresistive characteristics of PANI were investigated to characterize the sensing behaviour inherent to these embedded pressure sensor arrays, including the experimental determination of the stable response of PANI to continuous loading, stability throughout the course of loading and unloading cycles, and finally sensor repeatability and linearity in response to incremental loading cycles. This specially developed multi-material additive manufacturing process for PANI is shown be an attractive approach for the fabrication of implant components having embedded smart-polymer sensors, which could ultimately be employed for the measurement and analysis of joint loads in orthopaedic implants for in vitro testing.

  15. Preclinical trial of a novel surface architecture for improved primary fixation of cementless orthopaedic implants.

    Science.gov (United States)

    Harrison, Noel; Field, John R; Quondamatteo, Fabio; Curtin, William; McHugh, Peter E; Mc Donnell, Pat

    2014-09-01

    A new surface architecture for cementless orthopaedic implants (OsteoAnchor), which incorporates a multitude of tiny anchor features for enhancing primary fixation, was tested in an ovine hemi-arthroplasty pilot study. Test animals were implanted with a hip stem component incorporating the OsteoAnchor surface architecture produced using additive layer manufacturing and control animals were implanted with stems containing a standard plasma sprayed titanium coating. Intra-operative surgeon feedback indicated that superior primary fixation was achieved for the OsteoAnchor stems and rapid return to normal gait and load bearing was observed post-operation. Following a 16-week recovery time, histological evaluation of the excised femurs revealed in-growth of healthy bone into the porous structure of the OsteoAnchor stems. Bone in-growth was not achieved for the plasma sprayed stems. These results indicate the potential for the OsteoAnchor surface architecture to enhance both the initial stability and long term lifetime of cementless orthopaedic implants. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Engineered Protein Coatings to Improve the Osseointegration of Dental and Orthopaedic Implants

    Science.gov (United States)

    Raphel, Jordan; Karlsson, Johan; Galli, Silvia; Wennerberg, Ann; Lindsay, Christopher; Haugh, Matthew; Pajarinen, Jukka; Goodman, Stuart B.; Jimbo, Ryo; Andersson, Martin; Heilshorn, Sarah C.

    2016-01-01

    Here we present the design of an engineered, elastin-like protein (ELP) that is chemically modified to enable stable coatings on the surfaces of titanium-based dental and orthopaedic implants by novel photocrosslinking and solution processing steps. The ELP includes an extended RGD sequence to confer bio-signaling and an elastin-like sequence for mechanical stability. ELP thin films were fabricated on cp-Ti and Ti6Al4V surfaces using scalable spin and dip coating processes with photoactive covalent crosslinking through a carbene insertion mechanism. The coatings withstood procedures mimicking dental screw and hip replacement stem implantations, a key metric for clinical translation. They promoted rapid adhesion of MG63 osteoblast-like cells, with over 80% adhesion after 24 hours, compared to 38% adhesion on uncoated Ti6Al4V. MG63 cells produced significantly more mineralization on ELP coatings compared to uncoated Ti6Al4V. Human bone marrow mesenchymal stem cells (hMSCs) had an earlier increase in alkaline phosphatase activity, indicating more rapid osteogenic differentiation and mineral deposition on adhesive ELP coatings. Rat tibia and femur in vivo studies demonstrated that cell-adhesive ELP-coated implants increased bone-implant contact area and interfacial strength after one week. These results suggest that ELP coatings withstand surgical implantation and promote rapid osseointegration, enabling earlier implant loading and potentially preventing micromotion that leads to aseptic loosening and premature implant failure. PMID:26790146

  17. Enhancing the antibacterial performance of orthopaedic implant materials by fibre laser surface engineering

    DEFF Research Database (Denmark)

    Chan, Chi-Wai; Carson, Louise; Smith, Graham C.

    2017-01-01

    to the effort on enhancing osseointegration, wear and corrosion resistance of implant materials. In this study, the effects of laser surface treatment on enhancing the antibacterial properties of commercially pure (CP) Ti (Grade 2), Ti6Al4V (Grade 5) and CoCrMo alloy implant materials were studied and compared...... for the first time. Laser surface treatment was performed by a continuous wave (CW) fibre laser with a near-infrared wavelength of 1064 nm in a nitrogen-containing environment. Staphylococcus aureus, commonly implicated in infection associated with orthopaedic implants, was used to investigate the antibacterial...... properties of the laser-treated surfaces. The surface roughness and topography of the laser-treated materials were analysed by a 2D roughness testing and by AFM. The surface morphologies before and after 24 h of bacterial cell culture were captured by SEM, and bacterial viability was determined using live...

  18. Enhancing the antibacterial performance of orthopaedic implant materials by fibre laser surface engineering

    Science.gov (United States)

    Chan, Chi-Wai; Carson, Louise; Smith, Graham C.; Morelli, Alessio; Lee, Seunghwan

    2017-05-01

    Implant failure caused by bacterial infection is extremely difficult to treat and usually requires the removal of the infected components. Despite the severe consequence of bacterial infection, research into bacterial infection of orthopaedic implants is still at an early stage compared to the effort on enhancing osseointegration, wear and corrosion resistance of implant materials. In this study, the effects of laser surface treatment on enhancing the antibacterial properties of commercially pure (CP) Ti (Grade 2), Ti6Al4V (Grade 5) and CoCrMo alloy implant materials were studied and compared for the first time. Laser surface treatment was performed by a continuous wave (CW) fibre laser with a near-infrared wavelength of 1064 nm in a nitrogen-containing environment. Staphylococcus aureus, commonly implicated in infection associated with orthopaedic implants, was used to investigate the antibacterial properties of the laser-treated surfaces. The surface roughness and topography of the laser-treated materials were analysed by a 2D roughness testing and by AFM. The surface morphologies before and after 24 h of bacterial cell culture were captured by SEM, and bacterial viability was determined using live/dead staining. Surface chemistry was analysed by XPS and surface wettability was measured using the sessile drop method. The findings of this study indicated that the laser-treated CP Ti and Ti6Al4V surfaces exhibited a noticeable reduction in bacterial adhesion and possessed a bactericidal effect. Such properties were attributable to the combined effects of reduced hydrophobicity, thicker and stable oxide films and presence of laser-induced nano-features. No similar antibacterial effect was observed in the laser-treated CoCrMo.

  19. Immunotoxicity evaluation of novel bioactive composites in male mice as promising orthopaedic implants

    Directory of Open Access Journals (Sweden)

    Gehan T. El-Bassyouni

    2017-05-01

    Full Text Available Objective : In orthopaedics, novel bioactive composites are largely needed to improve the synthetic achievement of the implants. In this work, semiconducting metal oxides such as SiO 2 , TiO 2 , and ZrO 2 particles (Ps were used individually and in different ratios to obtain different biphasic composites. The immunotoxicity of these composites was tested to inspect the potential toxicity prior to their use in further medical applications. Materials and methods : In vitro mineralisation ability was inspected by soaking the composites in simulated body fluid (SBF. Additionally, in vivo experiments were performed consuming male mice using ISSR-PCR, micronucleus (MN test, comet assay, glutathione peroxidase activity, and determination of albumin, globulin, lymphocyte population, ALT, and AST levels. Several groups of adult male albino mice were treated with 100, 200, and 400 mg/kg body weight of SiO 2 , TiO 2 , and ZrO 2 -Ps in pure or mixed forms. Results : Our findings revealed that treatment of mice with low and medium doses of SiO 2 , TiO 2 , and ZrO 2 -Ps in pure or mixed form revealed values relatively similar to the control group. However, using 400 mg/kg especially from TiO 2 -Ps in genuine form or mixed with SiO 2 showed proliferation in the toxicity rates compared with the high dose of SiO 2 and ZrO 2 -Ps. Conclusions : The results suggest that TiO 2 composite induced in vivo toxicity, oxidative DNA damage, bargain of the antioxidant enzymes, and variations in the levels of albumin, globulin, lymphocyte population, ALT, and AST in a dose-dependent manner. However, SiO 2 , and ZrO 2 composites revealed a lower toxicity in mice compared with that of TiO 2 .

  20. Biodegradable Ceramics Consisting of Hydroxyapatite for Orthopaedic Implants

    Directory of Open Access Journals (Sweden)

    Thomas K. Monsees

    2017-11-01

    Full Text Available This study aims to analyze hydroxyapatite (HAP coatings enriched with Mg and Ti prepared by a magnetron sputtering technique on Ti6Al4V substrate. For preparation of the coatings, three magnetron targets (HAP, MgO and TiO2 were simultaneously co-worked. The concentration of Mg added was varied by modifying the power applied to the MgO target. In all coatings, the Ti concentration was maintained constant by keeping the same cathode power fed during the whole deposition. The influence of different Mg dopant contents on the formation of phase, microstructure and morphology of the obtained Ti-doped HAP coatings were characterized by Fourier transform infrared spectroscopy (FTIR and scanning electron microscopy (SEM. Moreover, the effects of Mg addition upon corrosion, mechanical and biological properties were also investigated. Mg- and Ti-doped HAP coating obtained at low radio-frequency (RF power fed to the MgO target provided material with high corrosion resistance compared to other coatings and bare alloy. A slight decrease in hardness of the coatings was found after the Mg addition, from 8.8 to 5.7 GPa. Also, the values of elastic modulus were decreased from 87 to 53 GPa, this being an advantage for biomedical applications. The coatings with low Mg concentration proved to have good deformation to yielding and higher plastic properties. Biological test results showed that the novel surfaces exhibited excellent properties for the adhesion and growth of bone cells. Moreover, early adherent vital cell numbers were significantly higher on both coatings compared to Ti6Al4V, suggesting that Mg ions may accelerate initial osteoblast adhesion and proliferation.

  1. Regenerative Medicine Will Make Orthopaedic Implants Obsolete In Our Time Orthopaedic Research Society First Annual Meeting Debate, San Diego, March 21st , 2017.

    Science.gov (United States)

    Johnstone, Brian; Jacobs, Joshua J; Sandell, Linda J; Wilkinson, J Mark

    2018-05-10

    The mission of the Orthopaedic Research Society is to promote and advance musculoskeletal research worldwide. With this in mind, the Annual Meeting Program Committee sought to establish a debate as a key component of the meeting. Our purpose was to provoke discussion on topics that are core to our mission and to engage all constituencies within the society by examining questions of broad relevance. To this end, the topic "Regenerative medicine will make orthopaedic implants obsolete in our time" was selected as the title of the inaugural debate. The arguments for and against the motion are presented in this perspectives article. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  2. Topological design and additive manufacturing of porous metals for bone scaffolds and orthopaedic implants: A review.

    Science.gov (United States)

    Wang, Xiaojian; Xu, Shanqing; Zhou, Shiwei; Xu, Wei; Leary, Martin; Choong, Peter; Qian, M; Brandt, Milan; Xie, Yi Min

    2016-03-01

    One of the critical issues in orthopaedic regenerative medicine is the design of bone scaffolds and implants that replicate the biomechanical properties of the host bones. Porous metals have found themselves to be suitable candidates for repairing or replacing the damaged bones since their stiffness and porosity can be adjusted on demands. Another advantage of porous metals lies in their open space for the in-growth of bone tissue, hence accelerating the osseointegration process. The fabrication of porous metals has been extensively explored over decades, however only limited controls over the internal architecture can be achieved by the conventional processes. Recent advances in additive manufacturing have provided unprecedented opportunities for producing complex structures to meet the increasing demands for implants with customized mechanical performance. At the same time, topology optimization techniques have been developed to enable the internal architecture of porous metals to be designed to achieve specified mechanical properties at will. Thus implants designed via the topology optimization approach and produced by additive manufacturing are of great interest. This paper reviews the state-of-the-art of topological design and manufacturing processes of various types of porous metals, in particular for titanium alloys, biodegradable metals and shape memory alloys. This review also identifies the limitations of current techniques and addresses the directions for future investigations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Managing design excellence tools during the development of new orthopaedic implants.

    Science.gov (United States)

    Défossez, Henri J P; Serhan, Hassan

    2013-11-01

    Design excellence (DEX) tools have been widely used for years in some industries for their potential to facilitate new product development. The medical sector, targeted by cost pressures, has therefore started adopting them. Numerous tools are available; however only appropriate deployment during the new product development stages can optimize the overall process. The primary study objectives were to describe generic tools and illustrate their implementation and management during the development of new orthopaedic implants, and compile a reference package. Secondary objectives were to present the DEX tool investment costs and savings, since the method can require significant resources for which companies must carefully plan. The publicly available DEX method "Define Measure Analyze Design Verify Validate" was adopted and implemented during the development of a new spinal implant. Several tools proved most successful at developing the correct product, addressing clinical needs, and increasing market penetration potential, while reducing design iterations and manufacturing validations. Cost analysis and Pugh Matrix coupled with multi generation planning enabled developing a strong rationale to activate the project, set the vision and goals. improved risk management and product map established a robust technical verification-validation program. Design of experiments and process quantification facilitated design for manufacturing of critical features, as early as the concept phase. Biomechanical testing with analysis of variance provided a validation model with a recognized statistical performance baseline. Within those tools, only certain ones required minimum resources (i.e., business case, multi generational plan, project value proposition, Pugh Matrix, critical To quality process validation techniques), while others required significant investments (i.e., voice of customer, product usage map, improved risk management, design of experiments, biomechanical testing

  4. The use of Roentgen stereophotogrammetry to study micromotion of orthopaedic implants

    Science.gov (United States)

    Valstar, Edward R.; Nelissen, Rob G. H. H.; Reiber, Johan H. C.; Rozing, Piet M.

    Roentgen stereophotogrammetry is the most accurate Roentgen technique for three-dimensional assessment of micromotion of orthopaedic implants. The reported accuracy of Roentgen Stereophotogrammetric Analysis (RSA) ranges between 0.05 and 0.5 mm for translations and between 0.15° and 1.15° for rotations. Because of the high accuracy of RSA, small patient groups are in general sufficient to study the effect on prosthetic fixation due to changes in implant design, addition of coatings, or new bone cements. By assessing micromotion of a prosthesis in a short-term (i.e. 2 years) clinical RSA study, a prediction can be made on the chance of long-term (i.e. 10 years) loosening of the prosthesis. Therefore, RSA is an important measurement tool to screen new developments in prosthetic design, and to prevent large groups of patients from being exposed to potentially inferior designs. In this article, the basics of the RSA technique are explained, and the importance of clinical RSA studies is illustrated with two examples of clinical RSA studies which RSA delivered very valuable information. Thereafter, two recent developments in RSA that have been implemented at Leiden University Medical Center are presented: digital automated measurements in RSA radiographs and model-based RSA.

  5. Flash autoclave settings may influence eradication but not presence of well-established biofilms on orthopaedic implant material.

    Science.gov (United States)

    Williams, Dustin L; Taylor, Nicholas B; Epperson, Richard T; Rothberg, David L

    2017-10-04

    Flash autoclaving is one of the most frequently utilized methods of sterilizing devices, implants or other materials. For a number of decades, it has been common practice for surgeons to remove implantable devices, flash autoclave and then reimplant them in a patient. Data have not yet indicated the potential for biofilms to survive or remain on the surface of orthopaedic-relevant materials following flash autoclave. In this study, monomicrobial and polymicrobial biofilms were grown on the surface of clinically relevant titanium materials and exposed to flash autoclave settings that included varying times and temperatures. Data indicated that when the sterilization and control temperatures of an autoclave were the same, biofilms were able to survive flash autoclaving that was performed for a short duration. Higher temperature and increased duration rendered biofilms non-viable, but none of the autoclave settings had the ability to remove or disperse the presence of biofilms from the titanium surfaces. These findings may be beneficial for facilities, clinics, or hospitals to consider if biofilms are suspected to be present on materials or devices, in particular implants that have had associated infection and are considered for re-implantation. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  6. Early staphylococcal biofilm formation on solid orthopaedic implant materials: in vitro study.

    Directory of Open Access Journals (Sweden)

    Hironobu Koseki

    Full Text Available Biofilms forming on the surface of biomaterials can cause intractable implant-related infections. Bacterial adherence and early biofilm formation are influenced by the type of biomaterial used and the physical characteristics of implant surface. In this in vitro research, we evaluated the ability of Staphylococcus epidermidis, the main pathogen in implant-related infections, to form biofilms on the surface of the solid orthopaedic biomaterials, oxidized zirconium-niobium alloy, cobalt-chromium-molybdenum alloy (Co-Cr-Mo, titanium alloy (Ti-6Al-4V, commercially pure titanium (cp-Ti and stainless steel. A bacterial suspension of Staphylococcus epidermidis strain RP62A (ATCC35984 was added to the surface of specimens and incubated. The stained biofilms were imaged with a digital optical microscope and the biofilm coverage rate (BCR was calculated. The total amount of biofilm was determined with the crystal violet assay and the number of viable cells in the biofilm was counted using the plate count method. The BCR of all the biomaterials rose in proportion to culture duration. After culturing for 2-4 hours, the BCR was similar for all materials. However, after culturing for 6 hours, the BCR for Co-Cr-Mo alloy was significantly lower than for Ti-6Al-4V, cp-Ti and stainless steel (P0.05. These results suggest that surface properties, such as hydrophobicity or the low surface free energy of Co-Cr-Mo, may have some influence in inhibiting or delaying the two-dimensional expansion of biofilm on surfaces with a similar degree of smoothness.

  7. Implantation for tribological applications

    International Nuclear Information System (INIS)

    Leutenecker, R.; Cao-Minh, U.; Overbeck, R.

    1992-08-01

    Empirical results on the strength enhancement of steels by N- and B-implantation should be explained from a materials science point of view. The methods applied were X-ray diffractometry and element depth profiling. The investigations of N-implanted steels focussed on the nitride formation in selected model materials and, with respect to applications, in: X90 CrMoV and S 6-5-2 tool steels, austenite X10 CrNiTi189 as well as in hard chromium plates. Main topic in B-implanted steels were the transformations: crystalline Fe-phase - amorphous Fe-B-phase - crystalline boride phases. The result is an improvement in process control by first an insight into the strength enhancing mechanisms and second in into their generation depending on the materials microstructure and the process parameter. (orig.). 101 figs., 16 tabs., 15 refs [de

  8. Nanostructured glass–ceramic coatings for orthopaedic applications

    Science.gov (United States)

    Wang, Guocheng; Lu, Zufu; Liu, Xuanyong; Zhou, Xiaming; Ding, Chuanxian; Zreiqat, Hala

    2011-01-01

    Glass–ceramics have attracted much attention in the biomedical field, as they provide great possibilities to manipulate their properties by post-treatments, including strength, degradation rate and coefficient of thermal expansion. In this work, hardystonite (HT; Ca2ZnSi2O7) and sphene (SP; CaTiSiO5) glass–ceramic coatings with nanostructures were prepared by a plasma spray technique using conventional powders. The bonding strength and Vickers hardness for HT and SP coatings are higher than the reported values for plasma-sprayed hydroxyapatite coatings. Both types of coatings release bioactive calcium (Ca) and silicon (Si) ions into the surrounding environment. Mineralization test in cell-free culture medium showed that many mushroom-like Ca and phosphorus compounds formed on the HT coatings after 5 h, suggesting its high acellular mineralization ability. Primary human osteoblasts attach, spread and proliferate well on both types of coatings. Higher proliferation rate was observed on the HT coatings compared with the SP coatings and uncoated Ti-6Al-4V alloy, probably due to the zinc ions released from the HT coatings. Higher expression levels of Runx2, osteopontin and type I collagen were observed on both types of coatings compared with Ti-6Al-4V alloy, possibly due to the Ca and Si released from the coatings. Results of this study point to the potential use of HT and SP coatings for orthopaedic applications. PMID:21292725

  9. Multi-Disciplinary Antimicrobial Strategies for Improving Orthopaedic Implants to Prevent Prosthetic Joint Infections in Hip and Knee

    Science.gov (United States)

    Getzlaf, Matthew A.; Lewallen, Eric A.; Kremers, Hilal M.; Jones, Dakota L.; Bonin, Carolina A.; Dudakovic, Amel; Thaler, Roman; Cohen, Robert C.; Lewallen, David G.; van Wijnen, Andre J.

    2016-01-01

    Like any foreign object, orthopaedic implants are susceptible to infection when introduced into the human body. Without additional preventative measures, the absolute number of annual prosthetic joint infections will continue to rise, and may exceed the capacity of health care systems in the near future. Bacteria are difficult to eradicate from synovial joints due to their exceptionally diverse taxonomy, complex mechanistic attachment capabilities, and tendency to evolve antibiotic resistance. When a primary orthopaedic implant fails from prosthetic joint infection, surgeons are generally challenged by limited options for intervention. In this review, we highlight the etiology and taxonomic groupings of bacteria known to cause prosthetic joint infections, and examine their key mechanisms of attachment. We propose that antimicrobial strategies should focus on the most harmful bacteria taxa within the context of occurrence, taxonomic diversity, adhesion mechanisms, and implant design. Patient-specific identification of organisms that cause prosthetic joint infections will permit assessment of their biological vulnerabilities. The latter can be targeted using a range of antimicrobial techniques that exploit different colonization mechanisms including implant surface attachment, biofilm formation, and/or hematogenous recruitment. We anticipate that customized strategies for each patient, joint, and prosthetic component will be most effective at reducing prosthetic joint infections, including those caused by antibiotic-resistant and polymicrobial bacteria. PMID:26449208

  10. Pragmatic approach to the clinical work-up of patients with putative allergic disease to metallic orthopaedic implants before and after surgery

    DEFF Research Database (Denmark)

    Thyssen, J P; Menné, T; Schalock, P C

    2011-01-01

    on in the work-up of patients with putative allergic complications following surgery. Few studies have investigated whether subjects with metal contact allergy have increased risk of developing complications following orthopaedic implant insertion. Metal allergy might in a minority increase the risk...... testing prior to surgery unless the patient has already had implant surgery with complications suspected to be allergic or has a history of clinical metal intolerance of sufficient magnitude to be of concern to the patient or a health provider. The clinical work-up of a patient suspected of having......Allergic complications following insertion of metallic orthopaedic implants include allergic dermatitis reactions but also extracutaneous complications. As metal-allergic patients and/or surgeons may ask dermatologists and allergologists for advice prior to planned orthopaedic implant surgery...

  11. Bacteriophage Mediated Killing of Staphylococcus aureus In Vitro on Orthopaedic K Wires in Presence of Linezolid Prevents Implant Colonization

    Science.gov (United States)

    Kaur, Sandeep; Harjai, Kusum; Chhibber, Sanjay

    2014-01-01

    Background Infections of bone and joint tissues following arthroplasty surgeries remain a major challenge in orthopaedic settings. Methicillin resistant Staphylococcus aureus (MRSA) is recognised as an established pathogen in such infections. Combination therapy using linezolid and bacteriophage impregnated in biopolymer was investigated in the present study as an alternative strategy to prevent MRSA colonisation on the orthopaedic implant surface. Methodology Coating of stainless steel orthopaedic grade K-wires was achieved using hydroxypropylmethlycellulose (HPMC) mixed with phage alone, linezolid alone and phage and linezolid together. The potential of these agents to inhibit adhesion of S.aureus (MRSA) 43300 on K-wires was assessed. Coated and naked wires were analysed by scanning electron microscopy (SEM) and fluorescent staining. Result Significant reduction in bacterial adhesion was achieved on phage/linezolid wires in comparison to naked as well as HPMC coated wires. However, maximum reduction in bacterial adherence (∼4 log cycles) was observed on the wires coated with phage-linezolid combination. The frequency of emergence of resistant mutants was also negligible in presence of both the agents. Conclusion This study provides evidence to confirm that local delivery system employing linezolid (a potent protein synthesis inhibitor) along with a broad spectrum lytic bacteriophage (capable of self-multiplication) is able to attack the adhered as well as surrounding bacteria present near the implant site. Unlike other antibiotic based therapies, this combination has the potential to significantly restrict the emergence of resistant mutants, thus paving the way for effective treatment of MRSA associated infection of medical implants. PMID:24594764

  12. "Is There An App For That?" Orthopaedic Patient Preferences For A Smartphone Application.

    Science.gov (United States)

    Datillo, Jonathan R; Gittings, Daniel J; Sloan, Matthew; Hardaker, William M; Deasey, Matthew J; Sheth, Neil P

    2017-08-16

    Patients are seeking out medical information on the Internet and utilizing smartphone health applications ("apps"). Smartphone use has exponentially increased among orthopaedic surgeons and patients. Despite this increase, patients are rarely directed to specific apps by physicians. No study exists querying patient preferences for a patient-centered, orthopaedic smartphone application. The purpose of this study is to 1) determine Internet use patterns amongst orthopaedic patients; 2) ascertain access to and use of smartphones; and 3) elucidate what features orthopaedic patients find most important in a smartphone application. We surveyed patients in an orthopaedic practice in an urban academic center to assess demographics, access to and patterns of Internet and Smartphone use, and preferences for features in a smartphone app. A total of 310 surveys were completed. Eighty percent of patients reported Internet access, and 62% used the Internet for health information. Seventy-seven percent owned smartphones, 45% used them for health information, and 28% owned health apps. Only 11% were referred to an app by a physician. The highest ranked features were appointment reminders, ability to view test results, communication with physicians, and discharge instructions. General orthopaedic information and pictures or videos explaining surgery were the 2 lowest ranked features. Seventy-one percent of patients felt an app with some of the described features would improve their healthcare experiences, and 40% would pay for the app. The smartphone is an under-utilized tool to enhance patient-physician communication, increase satisfaction, and improve quality of care. Patients were enthusiastic about app features that are often included in patient health portals, but ranked orthopaedic educational features lowest. Further study is required to elucidate how best to use orthopaedic apps as physician-directed educational opportunities to promote patient satisfaction and quality of

  13. Welded-woven fabrics for use as synthetic, minimally invasive orthopaedic implants

    Science.gov (United States)

    Rodts, Timothy W.

    The treatment of osteoarthritis in healthcare today focuses on minimizing pain and retaining mobility. Osteoarthritis of the knee is a common disease and known to be associated with traumatic injuries, among other factors. An identified trend is that patients are younger and have expectations of life with the preservation of an active lifestyle. As a result, great strain is placed on the available offerings of healthcare professionals and device manufacturers alike. This results in numerous design challenges for managing pain and disease over an extended period of time. The available treatments are being extended into younger populations, which increasingly suffer traumatic knee injuries. However, these patients are not good candidates for total joint replacement. A common problem for young patients is localized cartilage damage. This can heal, but often results in a painful condition that requires intervention. A welded-woven three-dimensional polymer fabric was developed to mimic the properties of articular cartilage. A process for the laser welding reinforcement of the surface layers of three-dimensional fabrics was investigated. Confined compression creep and pin-on-disc wear studies were conducted to characterize the contribution of the surface welding reinforcement. All materials used in the studies have previously been used in orthopaedic devices or meet the requirements for United States Pharmacopeial Convention (USP) Class VI biocompatibility approval. The compressive behavior of three-dimensional fabrics was tailored by the inclusion of surface welds. The compressive properties of the welded-woven fabrics were shown to better approximate articular cartilage compressive properties than conventional woven materials. The wear performance was benchmarked against identical fabrics without welding reinforcement. The wear rates were significantly reduced and the lifespan of the fabrics was markedly improved due to surface welding. Welding reinforcement offers a

  14. Pragmatic approach to the clinical work-up of patients with putative allergic disease to metallic orthopaedic implants before and after surgery.

    Science.gov (United States)

    Thyssen, J P; Menné, T; Schalock, P C; Taylor, J S; Maibach, H I

    2011-03-01

    Allergic complications following insertion of metallic orthopaedic implants include allergic dermatitis reactions but also extracutaneous complications. As metal-allergic patients and/or surgeons may ask dermatologists and allergologists for advice prior to planned orthopaedic implant surgery, and as surgeons may refer patients with complications following total joint arthroplasty for diagnostic work-up, there is a continuous need for updated guidelines. This review presents published evidence for patch testing prior to surgery and proposes tentative diagnostic criteria which clinicians can rely on in the work-up of patients with putative allergic complications following surgery. Few studies have investigated whether subjects with metal contact allergy have increased risk of developing complications following orthopaedic implant insertion. Metal allergy might in a minority increase the risk of complications caused by a delayed-type hypersensitivity reaction. At present, we do not know how to identify the subgroups of metal contact allergic patients with a potentially increased risk of complications following insertion of a metal implant. We recommend that clinicians should refrain from routine patch testing prior to surgery unless the patient has already had implant surgery with complications suspected to be allergic or has a history of clinical metal intolerance of sufficient magnitude to be of concern to the patient or a health provider. The clinical work-up of a patient suspected of having an allergic reaction to a metal implant should include patch testing and possibly in vitro testing. We propose diagnostic criteria for allergic dermatitis reactions as well as noneczematous complications caused by metal implants. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.

  15. In vivo bioactivity of titanium and fluorinated apatite coatings for orthopaedic implants: a vibrational study

    Science.gov (United States)

    Taddei, Paola; Tinti, Anna; Reggiani, Matteo; Monti, Patrizia; Fagnano, Concezio

    2003-06-01

    The bone integration of implants is a complex process which depends on chemical composition and surface morphology. To accelerate osteointegration, metal implants are coated with porous metal or apatites which have been reported to increase mineralisation, improving prosthesis fixation. To study the influence of composition and morphology on the in vivo bioactivity, titanium screws coated by Plasma Flame Spraying (PFS) with titanium or fluorinated apatite (K690) were implanted in sheep tibia and femur for 10 weeks and studied by micro-Raman and IR spectroscopy. The same techniques, together with thermogravimetry, were used for characterising the pre-coating K690 powder. Contrary to the manufacturer report, the K690 pre-coating revealed to be composed of a partially fluorinated apatite containing impurities of Ca(OH) 2 and CaCO 3. By effect of PFS, the impurities were decomposed and the crystallinity degree of the coating was found to decrease. The vibrational spectra recorded on the implanted screws revealed the presence of newly formed bone; for the K690-coated screws at least, a high level of osteointegration was evidenced.

  16. PATIENTS’ LIFE QUALITY DYNAMICS UPON OPTIMIZING THE IMPLANT PROSTHODONTICS AND THEIR ATTITUDE TO THE RESULTS OF DENTAL ORTHOPAEDIC TREATMENT (SOCIOLOGIC ANALYSIS

    Directory of Open Access Journals (Sweden)

    V. N. Trezubov

    2017-01-01

    Full Text Available The life quality estimation of dental patients, especially with total adentia, before and after implant treatment is highly topical. A direct or immediate implant prosthodontics contributes to prompt restoration of impaired aesthetic and functional standards while urgently converting patients from a disability level to a high life quality category. However, mistakes and complications occurring in this treatment stage often result in patients’ discomfort and worsen their physical and psycho-emotional state. All these are not conductive to securely provided favourable results of dental implant prosthetics, and thus require further improvement of the clinical and conceptual approaches aimed at further optimization of the above specialized medical care. The authors succeeded in improving efficacy of immediate implant prosthodontics with extended orthopaedic constructions by means of optimizing the diagnostic and therapeutic resources, as well as the hygiene protocol.

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

    Directory of Open Access Journals (Sweden)

    Sandeep Kaur

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

  18. Clinical application of helical CT 3D reconstruction for the dental orthopaedics

    International Nuclear Information System (INIS)

    Han Benyi; Jiang Xiaolu; Li Hongru

    2005-01-01

    Objective: To evaluate the clinical application of helical CT 3D reconstruction technique in the dental orthopaedics. Methods: The helical CT was performed with 3.0 mm slice thickness and 1.0 pitch in 41 patients with dental orthopaedics. The 3D reconstructions, including maximum intensity projection (MIP), surface shaded display (SSD), and multiplanar reconstructions (MPR), were made for all the cases. Results: Thirty-seven of the 41 patients showed malalignment, tilt, rotation, overlap of the teeth and the different space between the longitudinal axes of the teeth. Twenty-five cases of them have shown 36 buried teeth in all. The axial images covered all the information. SSD demonstrated the external contours and entire morphologies of the teeth and the mandible with the relationship of the teeth alignment and the mandible. MIP clearly manifested the full view and the longitudinal alignment of the teeth. Among the 36 buried teeth, there were 29 palatally and 7 labially presented teeth, and they were morphologically delineated on MIP through various angles. Conclusion: The helical CT 3D reconstruction is a new technique to display the stereoscopic configuration of teeth. The combination of axial images and MIP, SSD, and MPR provides valuable anatomic and diagnostic information helpful for the surgeons to structure and determine the treatment protocol for the dental orthopaedics. (authors)

  19. Advances in Porous Biomaterials for Dental and Orthopaedic Applications

    Directory of Open Access Journals (Sweden)

    Arndt F. Schilling

    2010-04-01

    Full Text Available The connective hard tissues bone and teeth are highly porous on a micrometer scale, but show high values of compression strength at a relatively low weight. The fabrication of porous materials has been actively researched and different processes have been developed that vary in preparation complexity and also in the type of porous material that they produce. Methodologies are available for determination of pore properties. The purpose of the paper is to give an overview of these methods, the role of porosity in natural porous materials and the effect of pore properties on the living tissues. The minimum pore size required to allow the ingrowth of mineralized tissue seems to be in the order of 50 µm: larger pore sizes seem to improve speed and depth of penetration of mineralized tissues into the biomaterial, but on the other hand impair the mechanical properties. The optimal pore size is therefore dependent on the application and the used material.

  20. EXPERIMENTAL AND CLINICAL STUDY OF PHENOTYPIC FEATURES OF S. EPIDERMIDIS STRAINS AND THEIR ROLE IN THE EMERGENCE AND DEVELOPMENT OF IMPLANT-ASSOCIATED INFECTION AFTER ORTHOPAEDIC SURGERY

    Directory of Open Access Journals (Sweden)

    S. A. Bozhkova

    2014-01-01

    Full Text Available S. epidermidis is one of the most common cause of implant-associated infections. Infections due to S. epidermidis rarely develops into life-threatening, however, its prevalence and the difficulties in treating constitute a serious financial burden to the health care system. This study is based on the investigation of phenotypic features (ability to biofilm formation and resistance to antibiotics of S. epidermidis strains isolated from patients with deep surgical site infection after implantation of orthopaedic devices, and on the investigation of the dynamics of clinical and morphological changes during the development of implant-associated infection due to S. epidermidis based on in vivo experimental models. Multidrug-resistance was found in 23% MSSE isolates and 97,3% - MRSE. Vancomycin, linezolid and fosfomycin were the most active in relation to these pathogens. About 40% of the tested isolates were strong biofilm-producing strains. 43,2% of MRSE strains and only 21,4% of MSSE isolates demonstrated strong biofilm production. The proposed experimental model shows that intra-operative infection of implant by multidrug-resistant clinical MRSE strain led to the development of osteomyelitis in rats for 4 weeks after surgery, in spite of the revision operation and installation of antimicrobial cement spacer in the area of bone defect. Thus, S. epidermidis is a clinically significant aetiological factor with high risk of development of infections after major orthopaedic surgery.

  1. Wear and Damage of Articular Cartilage with Friction Against Orthopaedic Implant Materials

    Science.gov (United States)

    Oungoulian, Sevan R.; Durney, Krista M.; Jones, Brian K.; Ahmad, Christopher S.; Hung, Clark T.; Ateshian, Gerard A.

    2015-01-01

    The objective of this study was to measure the wear response of immature bovine articular cartilage tested against glass or alloys used in hemiarthroplasties. Two cobalt chromium alloys and a stainless steel alloy were selected for these investigations. The surface roughness of one of the cobalt chromium alloys was also varied within the range considered acceptable by regulatory agencies. Cartilage disks were tested in a configuration that promoted loss of interstitial fluid pressurization to accelerate conditions believed to occur in hemiarthroplasties. Results showed that considerably more damage occurred in cartilage samples tested against stainless steel (10 nm roughness) and low carbon cobalt chromium alloy (27 nm roughness) compared to glass (10 nm) and smoother low or high carbon cobalt chromium (10 nm). The two materials producing the greatest damage also exhibited higher equilibrium friction coefficients. Cartilage damage occurred primarily in the form of delamination at the interface between the superficial tangential zone and the transitional middle zone, with much less evidence of abrasive wear at the articular surface. These results suggest that cartilage damage from frictional loading occurs as a result of subsurface fatigue failure leading to the delamination. Surface chemistry and surface roughness of implant materials can have a significant influence on tissue damage, even when using materials and roughness values that satisfy regulatory requirements. PMID:25912663

  2. Effects of surface coating on reducing friction and wear of orthopaedic implants

    International Nuclear Information System (INIS)

    Ching, Hee Ay; Choudhury, Dipankar; Nine, Md Julker; Abu Osman, Noor Azuan

    2014-01-01

    Coatings such as diamond-like carbon (DLC) and titanium nitride (TiN) are employed in joint implants due to their excellent tribological properties. Recently, graphite-like carbon (GLC) and tantalum (Ta) have been proven to have good potential as coating as they possess mechanical properties similar to bones—high hardness and high flexibility. The purpose of this systematic literature review is to summarize the coating techniques of these four materials in order to compare their mechanical properties and tribological outcomes. Eighteen studies published between January 2000 and February 2013 have met the inclusion criteria for this review. Details of their fabrication parameters, material and mechanical properties along with the tribological outcomes, such as friction and wear rate, were identified and are presented in a systematic way. Although experiment conditions varied, we conclude that Ta has the lowest wear rate compared to DLC, GLC and TiN because it has a lower wear rate with high contact pressure as well as higher hardness to elasticity ratio. However, a further tribology test is needed in an environment which replicates artificial joints to confirm the acceptability of these findings. (review)

  3. Effects of surface coating on reducing friction and wear of orthopaedic implants.

    Science.gov (United States)

    Ching, Hee Ay; Choudhury, Dipankar; Nine, Md Julker; Abu Osman, Noor Azuan

    2014-02-01

    Coatings such as diamond-like carbon (DLC) and titanium nitride (TiN) are employed in joint implants due to their excellent tribological properties. Recently, graphite-like carbon (GLC) and tantalum (Ta) have been proven to have good potential as coating as they possess mechanical properties similar to bones-high hardness and high flexibility. The purpose of this systematic literature review is to summarize the coating techniques of these four materials in order to compare their mechanical properties and tribological outcomes. Eighteen studies published between January 2000 and February 2013 have met the inclusion criteria for this review. Details of their fabrication parameters, material and mechanical properties along with the tribological outcomes, such as friction and wear rate, were identified and are presented in a systematic way. Although experiment conditions varied, we conclude that Ta has the lowest wear rate compared to DLC, GLC and TiN because it has a lower wear rate with high contact pressure as well as higher hardness to elasticity ratio. However, a further tribology test is needed in an environment which replicates artificial joints to confirm the acceptability of these findings.

  4. Helical Rosette Nanotubes as a Potentially More Effective Orthopaedic Implant Material

    National Research Council Canada - National Science Library

    Chun, Ai Lin; Fenniri, Hicham; Webster, Thomas J

    2005-01-01

    .... They possess intriguing properties for various bionanotechnology applications since they can be designed to mimic the nanostructured constituent components in bone such as collagen fibers and hydroxyapatite (Ca5PO4SUB 3OH...

  5. Bacterial adhesion to orthopaedic implant materials and a novel oxygen plasma modified PEEK surface

    NARCIS (Netherlands)

    Rochford, E. T. J.; Poulsson, A. H. C.; Salavarrieta Varela, J.; Lezuo, P.; Richards, R. G.; Moriarty, T. F.

    2014-01-01

    Despite extensive use of polyetheretherketone (PEEK) in biomedical applications, information about bacterial adhesion to this biomaterial is limited. This study investigated Staphylococcus aureus and Staphylococcus epidermidis adhesion to injection moulded and machined PEEK OPTIMA (R) using a

  6. Plasma-deposited fluorocarbon polymer films on titanium for preventing cell adhesion: a surface finishing for temporarily used orthopaedic implants

    Science.gov (United States)

    Finke, B.; Testrich, H.; Rebl, H.; Walschus, U.; Schlosser, M.; Zietz, C.; Staehlke, S.; Nebe, J. B.; Weltmann, K. D.; Meichsner, J.; Polak, M.

    2016-06-01

    The design of a titanium implant surface should ideally support its later application in clinical use. Temporarily used implants have to fulfil requirements different from permanent implants: they should ensure the mechanical stabilization of the bone stock but in trauma surgery they should not be integrated into the bone because they will be removed after fracture healing. Finishing of the implant surface by a plasma-fluorocarbon-polymer (PFP) coating is a possible approach for preventing cell adhesion of osteoblasts. Two different low pressure gas-discharge plasma processes, microwave (MW 2.45 GHz) and capacitively coupled radio frequency (RF 13.56 MHz) plasma, were applied for the deposition of the PFP film using a mixture of the precursor octafluoropropane (C3F8) and hydrogen (H2). The thin films were characterized by x-ray photoelectron spectroscopy, Fourier transform infrared reflection absorption spectroscopy, and water contact angle measurements. Cell culture experiments show that cell adhesion and spreading of MG-63 osteoblasts were clearly reduced or nonexistent on these surfaces, also after 24 h of storage in the cell culture medium. In vivo data demonstrated that the local inflammatory tissue response for the PFP films deposited in MW and RF plasma were comparable to uncoated controls.

  7. Development of wear resistant NFSS-HA novel biocomposites and study of their tribological properties for orthopaedic applications.

    Science.gov (United States)

    Younesi, M; Bahrololoom, M E; Fooladfar, H

    2010-02-01

    Implants made of nickel free austenitic stainless steel can reduce the toxic effect of released nickel ion and compounds from the conventional stainless steels. On the other hand, hydroxyapatite is a ceramic which has been used in orthopaedic applications due to its good osteoconductivity, biocompatibility and bioactivity. However, there is no evidence in the literature up to now on producing composites based on nickel free stainless steel and hydroxyapatite and study of their tribology. The aim of this work was to produce novel biocomposites made up of nickel free stainless steel with hydroxyapatite (prepared by heat treating bone ash) and studying their tribology under various loads in air and in Ringer's physiological solution. Different amounts of hydroxyapatite powder (10, 20, 30 and 40% Vol.) were added to this nickel free stainless steel powder to get the biocomposites. Variation of their density, hardness, wear resistance and friction with the ceramic (hydroxyapatite) content and wear load were investigated in air and in Ringer's solution. The density of the composites was decreased by increasing the volume percentage of the hydroxyapatite, while wear resistance of the composites was increased. The wear mechanism of these composites was changed by increasing the wear load and consequently the volume loss was enhanced dramatically. Furthermore, by increasing the sliding distance, the rate of volume loss was decreased slightly. The friction coefficient of the composites was also decreased by increasing the weight percentage of hydroxyapatite. Effect of the physiological Ringer's solution on wear resistance and friction coefficient of the composites was nearly negligible. The wear mechanisms of the samples were identified by studying the SEM images of the worn surfaces of the tested samples in different wear loads and HA contents. Copyright 2009 Elsevier Ltd. All rights reserved.

  8. Semiconductor applications of plasma immersion ion implantation ...

    Indian Academy of Sciences (India)

    Home; Journals; Bulletin of Materials Science; Volume 25; Issue 6. Semiconductor applications of plasma immersion ion implantation technology ... Department of Electronic Science, Kurukshetra University, Kurukshetra 136 119, India ...

  9. Implantable biomedical microsystems design principles and applications

    CERN Document Server

    Bhunia, Swarup; Sawan, Mohamad

    2015-01-01

    Research and innovation in areas such as circuits, microsystems, packaging, biocompatibility, miniaturization, power supplies, remote control, reliability, and lifespan are leading to a rapid increase in the range of devices and corresponding applications in the field of wearable and implantable biomedical microsystems, which are used for monitoring, diagnosing, and controlling the health conditions of the human body. This book provides comprehensive coverage of the fundamental design principles and validation for implantable microsystems, as well as several major application areas. Each co

  10. [Autologous chondrocyte implantation (ACI) for cartilage defects of the knee: a guideline by the working group "Tissue Regeneration" of the German Society of Orthopaedic Surgery and Traumatology (DGOU)].

    Science.gov (United States)

    Niemeyer, P; Andereya, S; Angele, P; Ateschrang, A; Aurich, M; Baumann, M; Behrens, P; Bosch, U; Erggelet, C; Fickert, S; Fritz, J; Gebhard, H; Gelse, K; Günther, D; Hoburg, A; Kasten, P; Kolombe, T; Madry, H; Marlovits, S; Meenen, N M; Müller, P E; Nöth, U; Petersen, J P; Pietschmann, M; Richter, W; Rolauffs, B; Rhunau, K; Schewe, B; Steinert, A; Steinwachs, M R; Welsch, G H; Zinser, W; Albrecht, D

    2013-02-01

    Autologous chondrocyte transplantation/implantation (ACT/ACI) is an established and recognised procedure for the treatment of localised full-thickness cartilage defects of the knee. The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Traumatology (DGOU) describes the biology and function of healthy articular cartilage, the present state of knowledge concerning potential consequences of primary cartilage lesions and the suitable indication for ACI. Based on current evidence, an indication for ACI is given for symptomatic cartilage defects starting from defect sizes of more than 3-4 cm2; in the case of young and active sports patients at 2.5 cm2. Advanced degenerative joint disease is the single most important contraindication. The review gives a concise overview on important scientific background, the results of clinical studies and discusses advantages and disadvantages of ACI. Georg Thieme Verlag KG Stuttgart · New York.

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

    Energy Technology Data Exchange (ETDEWEB)

    Schubert, M.

    2008-07-01

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

  12. The use of three-dimensional printing technology in orthopaedic surgery.

    Science.gov (United States)

    Wong, Tak Man; Jin, Jimmy; Lau, Tak Wing; Fang, Christian; Yan, Chun Hoi; Yeung, Kelvin; To, Michael; Leung, Frankie

    2017-01-01

    Three-dimensional (3-D) printing or additive manufacturing, an advanced technology that 3-D physical models are created, has been wildly applied in medical industries, including cardiothoracic surgery, cranio-maxillo-facial surgery and orthopaedic surgery. The physical models made by 3-D printing technology give surgeons a realistic impression of complex structures, allowing surgical planning and simulation before operations. In orthopaedic surgery, this technique is mainly applied in surgical planning especially revision and reconstructive surgeries, making patient-specific instruments or implants, and bone tissue engineering. This article reviews this technology and its application in orthopaedic surgery.

  13. Porous Titanium for Dental Implant Applications

    Directory of Open Access Journals (Sweden)

    Zena J. Wally

    2015-10-01

    Full Text Available Recently, an increasing amount of research has focused on the biological and mechanical behavior of highly porous structures of metallic biomaterials, as implant materials for dental implants. Particularly, pure titanium and its alloys are typically used due to their outstanding mechanical and biological properties. However, these materials have high stiffness (Young’s modulus in comparison to that of the host bone, which necessitates careful implant design to ensure appropriate distribution of stresses to the adjoining bone, to avoid stress-shielding or overloading, both of which lead to bone resorption. Additionally, many coating and roughening techniques are used to improve cell and bone-bonding to the implant surface. To date, several studies have revealed that porous geometry may be a promising alternative to bulk structures for dental implant applications. This review aims to summarize the evidence in the literature for the importance of porosity in the integration of dental implants with bone tissue and the different fabrication methods currently being investigated. In particular, additive manufacturing shows promise as a technique to control pore size and shape for optimum biological properties.

  14. SWOT analysis: The analytical method in the process of planning and its application in the development of orthopaedic hospital department

    Directory of Open Access Journals (Sweden)

    Terzić Zorica

    2010-01-01

    Full Text Available Introduction. SWOT analysis is a managerial tool used to evaluate internal and external environment through strengths and weaknesses, opportunities and threats. Objective. The aim was to demonstrate the application of the SWOT analysis on the example of the Department for Paediatric Orthopaedics and Traumatology at the Institute of Orthopaedic Surgery 'Banjica' in Belgrade. Methods. Qualitative research was conducted during December 2008 at the Department for Paediatric Orthopaedics and Traumatology of the Institute of Orthopaedic Surgery 'Banjica' by applying the focus group technique. Participants were members of the medical staff and patients. In the first phase of the focus group brainstorming was applied to collect the factors of internal and external environment, and to identify strengths and weaknesses, opportunities and threats, respectively. In the second phase the nominal group technique was applied in order to reduce the list of factors. The factors were assessed according to their influence on the Department. Factors ranked by the three point Likert scale from 3 (highest impact to 1 (lowest impact. Results. The most important strengths of the Department are competent and skilled staff, high quality of services, average hospital bed utilization, the Department providing the educational basis of the School of Medicine, satisfied patients, pleasant setting, and additional working hours. The weaknesses are: poor spatial organization, personnel unmotivated to refresh knowledge, lack of specifically trained personnel, inadequate sanitary facilities, and uncovered services by the Insurance Fund, long average hospital stay, and low economic status of patients. The opportunities are: legislative regulations, formed paediatric traumatology service at the City level, good regional position of the Institute, and extension of referral areas. The threats are: absent Department autonomy in the personnel policy of the Institute, competitions within

  15. [SWOT analysis: the analytical method in the process of planning and its application in the development of orthopaedic hospital department].

    Science.gov (United States)

    Terzić, Zorica; Vukasinović, Zoran; Bjegović-Mikanović, Vesna; Jovanović, Vesna; Janicić, Radmila

    2010-01-01

    SWOT analysis is a managerial tool used to evaluate internal and external environment through strengths and weaknesses, opportunities and threats. The aim was to demonstrate the application of the SWOT analysis on the example of the Department for Paediatric Orthopaedics and Traumatology at the Institute of Orthopaedic Surgery "Banjica" in Belgrade. Qualitative research was conducted during December 2008 at the Department for Paediatric Orthopaedics and Traumatology of the Institute of Orthopaedic Surgery "Banjica" by applying the focus group technique. Participants were members of the medical staff and patients. In the first phase of the focus group brainstorming was applied to collect the factors of internal and external environment, and to identify strengths and weaknesses, opportunities and threats, respectively. In the second phase the nominal group technique was applied in order to reduce the list of factors. The factors were assessed according to their influence on the Department. Factors ranked by the three point Likert scale from 3 (highest impact) to 1 (lowest impact). The most important strengths of the Department are competent and skilled staff, high quality of services, average hospital bed utilization, the Department providing the educational basis of the School of Medicine, satisfied patients, pleasant setting, and additional working hours. The weaknesses are: poor spatial organization, personnel unmotivated to refresh knowledge, lack of specifically trained personnel, inadequate sanitary facilities, and uncovered services by the Insurance Fund, long average hospital stay, and low economic status of patients. The opportunities are: legislative regulations, formed paediatric traumatology service at the City level, good regional position of the Institute, and extension of referral areas. The threats are: absent Department autonomy in the personnel policy of the Institute, competitions within the Institute, impossibility to increase the Department

  16. Origins of eponymous orthopaedic equipment.

    Science.gov (United States)

    Meals, Clifton; Wang, Jeffrey

    2010-06-01

    Orthopaedists make great use of eponymous equipment, however the origins of these tools are unknown to many users. This history enriches, enlightens, and enhances surgical education, and may inspire modern innovation. We explored the origins of common and eponymous orthopaedic equipment. We selected pieces of equipment named for their inventors and in the broadest use by modern orthopaedists. We do not describe specialized orthopaedic implants and instruments owing to the overwhelming number of these devices. The history of this equipment reflects the coevolution of orthopaedics and battlefield medicine. Additionally, these stories evidence the primacy of elegant design and suggest that innovation is often a process of revision and refinement rather than sudden inspiration. Their history exposes surgical innovators as brilliant, lucky, hardworking, and sometimes odd. These stories amuse, enlighten, and may inspire modern orthopaedists to develop creative solutions of their own. The rich history of the field's eponymous instruments informs an ongoing tradition of innovation in orthopaedics.

  17. Does PGE₁ vasodilator prevent orthopaedic implant-related infection in diabetes? Preliminary results in a mouse model.

    Science.gov (United States)

    Lovati, Arianna B; Romanò, Carlo L; Monti, Lorenzo; Vassena, Christian; Previdi, Sara; Drago, Lorenzo

    2014-01-01

    Implant-related infections are characterized by bacterial colonization and biofilm formation on the prosthesis. Diabetes represents one of the risk factors that increase the chances of prosthetic infections because of related severe peripheral vascular disease. Vasodilatation can be a therapeutic option to overcome diabetic vascular damages and increase the local blood supply. In this study, the effect of a PGE₁ vasodilator on the incidence of surgical infections in diabetic mice was investigated. A S. aureus implant-related infection was induced in femurs of diabetic mice, then differently treated with a third generation cephalosporin alone or associated with a PGE₁ vasodilator. Variations in mouse body weight were evaluated as index of animal welfare. The femurs were harvested after 28 days and underwent both qualitative and quantitative analysis as micro-CT, histological and microbiological analyses. The analysis performed in this study demonstrated the increased host response to implant-related infection in diabetic mice treated with the combination of a PGE₁ and antibiotic. In this group, restrained signs of infections were identified by micro-CT and histological analysis. On the other hand, the diabetic mice treated with the antibiotic alone showed a severe infection and inability to successfully respond to the standard antimicrobial treatment. The present study revealed interesting preliminary results in the use of a drug combination of antibiotic and vasodilator to prevent implant-related Staphylococcus aureus infections in a diabetic mouse model.

  18. Does PGE1 Vasodilator Prevent Orthopaedic Implant-Related Infection in Diabetes? Preliminary Results in a Mouse Model

    Science.gov (United States)

    Lovati, Arianna B.; Romanò, Carlo L.; Monti, Lorenzo; Vassena, Christian; Previdi, Sara; Drago, Lorenzo

    2014-01-01

    Background Implant-related infections are characterized by bacterial colonization and biofilm formation on the prosthesis. Diabetes represents one of the risk factors that increase the chances of prosthetic infections because of related severe peripheral vascular disease. Vasodilatation can be a therapeutic option to overcome diabetic vascular damages and increase the local blood supply. In this study, the effect of a PGE1 vasodilator on the incidence of surgical infections in diabetic mice was investigated. Methodology A S. aureus implant-related infection was induced in femurs of diabetic mice, then differently treated with a third generation cephalosporin alone or associated with a PGE1 vasodilator. Variations in mouse body weight were evaluated as index of animal welfare. The femurs were harvested after 28 days and underwent both qualitative and quantitative analysis as micro-CT, histological and microbiological analyses. Results The analysis performed in this study demonstrated the increased host response to implant-related infection in diabetic mice treated with the combination of a PGE1 and antibiotic. In this group, restrained signs of infections were identified by micro-CT and histological analysis. On the other hand, the diabetic mice treated with the antibiotic alone showed a severe infection and inability to successfully respond to the standard antimicrobial treatment. Conclusions The present study revealed interesting preliminary results in the use of a drug combination of antibiotic and vasodilator to prevent implant-related Staphylococcus aureus infections in a diabetic mouse model. PMID:24718359

  19. Does PGE₁ vasodilator prevent orthopaedic implant-related infection in diabetes? Preliminary results in a mouse model.

    Directory of Open Access Journals (Sweden)

    Arianna B Lovati

    Full Text Available BACKGROUND: Implant-related infections are characterized by bacterial colonization and biofilm formation on the prosthesis. Diabetes represents one of the risk factors that increase the chances of prosthetic infections because of related severe peripheral vascular disease. Vasodilatation can be a therapeutic option to overcome diabetic vascular damages and increase the local blood supply. In this study, the effect of a PGE₁ vasodilator on the incidence of surgical infections in diabetic mice was investigated. METHODOLOGY: A S. aureus implant-related infection was induced in femurs of diabetic mice, then differently treated with a third generation cephalosporin alone or associated with a PGE₁ vasodilator. Variations in mouse body weight were evaluated as index of animal welfare. The femurs were harvested after 28 days and underwent both qualitative and quantitative analysis as micro-CT, histological and microbiological analyses. RESULTS: The analysis performed in this study demonstrated the increased host response to implant-related infection in diabetic mice treated with the combination of a PGE₁ and antibiotic. In this group, restrained signs of infections were identified by micro-CT and histological analysis. On the other hand, the diabetic mice treated with the antibiotic alone showed a severe infection and inability to successfully respond to the standard antimicrobial treatment. CONCLUSIONS: The present study revealed interesting preliminary results in the use of a drug combination of antibiotic and vasodilator to prevent implant-related Staphylococcus aureus infections in a diabetic mouse model.

  20. From the printer: Potential of three-dimensional printing for orthopaedic applications

    Directory of Open Access Journals (Sweden)

    Sze-Wing Mok

    2016-07-01

    Full Text Available Three-dimensional (3D printers can create complex structures based on digital models. The combination of medical diagnostic imaging with 3D printing has great potential in day-to-day clinics for patient-specific solutions and applications. In the musculoskeletal system, 3D printing is used to create custom-made implants, patient-specific instrumentation, and to regenerate tissues, in particular bone and cartilage. The major limiting factors for bioprinting include the lack of printing techniques with optimal printing resolution and materials with ideal mechanical strengths while maintaining cellular functionality. Before “tissues from the printer” can be widely applied, further research and development on improving and optimising printing techniques and biomaterials, and knowledge on the development of printed constructs into living tissues, is essential for future clinical application of this technology.

  1. Metallic powder-bed based 3D printing of cellular scaffolds for orthopaedic implants: A state-of-the-art review on manufacturing, topological design, mechanical properties and biocompatibility.

    Science.gov (United States)

    Tan, X P; Tan, Y J; Chow, C S L; Tor, S B; Yeong, W Y

    2017-07-01

    Metallic cellular scaffold is one of the best choices for orthopaedic implants as a replacement of human body parts, which could improve life quality and increase longevity for the people needed. Unlike conventional methods of making cellular scaffolds, three-dimensional (3D) printing or additive manufacturing opens up new possibilities to fabricate those customisable intricate designs with highly interconnected pores. In the past decade, metallic powder-bed based 3D printing methods emerged and the techniques are becoming increasingly mature recently, where selective laser melting (SLM) and selective electron beam melting (SEBM) are the two representatives. Due to the advantages of good dimensional accuracy, high build resolution, clean build environment, saving materials, high customisability, etc., SLM and SEBM show huge potential in direct customisable manufacturing of metallic cellular scaffolds for orthopaedic implants. Ti-6Al-4V to date is still considered to be the optimal materials for producing orthopaedic implants due to its best combination of biocompatibility, corrosion resistance and mechanical properties. This paper presents a state-of-the-art overview mainly on manufacturing, topological design, mechanical properties and biocompatibility of cellular Ti-6Al-4V scaffolds via SLM and SEBM methods. Current manufacturing limitations, topological shortcomings, uncertainty of biocompatible test were sufficiently discussed herein. Future perspectives and recommendations were given at the end. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Piezoelectric surgery in implant dentistry: clinical applications

    Directory of Open Access Journals (Sweden)

    Lydia Masako Ferreira

    2009-01-01

    Full Text Available Pizosurgery has therapeutic characteristics in osteotomies, such as extremely precise, selective and millimetric cuts and a clear operating field. Piezoelectricity uses ultrasonic frequencies, which cause the points specially designed for osteotomy to vibrate. The points of the instrument oscillate, allowing effective osteotomy with minimal or no injury to the adjacent soft tissues, membranes and nerve tissues. This article presents the various applications of piezoelectricity in oral implant surgery such as: removal of autogenous bone; bone window during elevation of the sinus membrane and removal of fractured implants. The cavitational effect caused by the vibration of the point and the spray of physiological solution, provided a field free of bleeding and easy to visualize. The study showed that the piezoelectric surgery is a new surgical procedurethat presents advantages for bone cutting in many situations in implant dentistry, with great advantages in comparison with conventional instrumentation. Operating time is longer when compared with that of conventional cutters.

  3. 42 Editorial ADVOCACY IN ORTHOPAEDICS

    African Journals Online (AJOL)

    2017-09-11

    Sep 11, 2017 ... East African Orthopaedic Journal. Advocacy may be ... taxation of medical equipment and implants in Kenya. In 2013 a change ... Asia countries especially India were doing the opposite. They reduced ... Most developing countries have been dealing with communicable ... The role of advocacy is huge here.

  4. PEEK with Reinforced Materials and Modifications for Dental Implant Applications

    Directory of Open Access Journals (Sweden)

    Fitria Rahmitasari

    2017-12-01

    Full Text Available Polyetheretherketone (PEEK is a semi-crystalline linear polycyclic thermoplastic that has been proposed as a substitute for metals in biomaterials. PEEK can also be applied to dental implant materials as a superstructure, implant abutment, or implant body. This article summarizes the current research on PEEK applications in dental implants, especially for the improvement of PEEK surface and body modifications. Although various benchmark reports on the reinforcement and surface modifications of PEEK are available, few clinical trials using PEEK for dental implant bodies have been published. Controlled clinical trials, especially for the use of PEEK in implant abutment and implant bodies, are necessary.

  5. Application of ion implantation in stevia breeding

    International Nuclear Information System (INIS)

    Wang Cailian; Chen Qiufang; Jin Wei; Lu Ting; Shu Shizhen

    1999-08-01

    Dry seed of stevia were implanted with 60-100 keV nitrogen ion and 75 keV carbon ion of various doses, and the effects of the composition and yield of stevioside were studied. The results showed that ion beam could induce variation in total stevioside yield and the composition of the plant. The best treatment was 75 keV nitrogen ion with 5 x 10 14 N + /cm 2 , the stevioside yield and Rebaudioside A (R-A) content were increased by 4.74% and 14.08% respectively. The effects induced by implantation of carbon ion were higher than those induced by implantation of nitrogen ion. Effects of Feng 1 x Ri Yuan and Ri Yuan x Feng 2 are higher than those of Ji Ning and Feng 2 . Seven mutation lines were selected from the mutation progenies. The stevioside composition of these lines were previously improved. The results suggest a potential application of ion implantation in stevia breeding

  6. [Clinical application of individualized three-dimensional printing implant template in multi-tooth dental implantation].

    Science.gov (United States)

    Wang, Lie; Chen, Zhi-Yuan; Liu, Rong; Zeng, Hao

    2017-08-01

    To study the value and satisfaction of three-dimensional printing implant template and conventional implant template in multi-tooth dental implantation. Thirty cases (83 teeth) with missing teeth needing to be implanted were randomly divided into conventional implant template group (CIT group, 15 cases, 42 teeth) and 3D printing implant template group (TDPIT group, 15 cases, 41 teeth). Patients in CIT group were operated by using conventional implant template, while patients in TDPIT group were operated by using three-dimensional printing implant template. The differences of implant neck and tip deviation, implant angle deviation and angle satisfaction between the two groups were compared. The difference of probing depth and bone resorption of implant were compared 1 year after operation between the two groups. The difference of success rate and satisfaction of dental implantation were compared 1 year after operation between the two groups. SPSS19.0 software package was used for statistical analysis. The deviation direction of the neck and the tip in disto-mesial, bucco-palatal, vertical direction and angle of implants in disto-mesial and bucco-palatal direction in TDPIT group were significantly lower than in CIT group (P0.05). The difference of the cumulative success rate in dental implantation at 3 months and 6 months between the two groups were not significant (P>0.05), but the cumulative success rate of TDPIT group was significantly higher than CIT group at 9 months and 1 year (90.48% vs 100%,P=0.043). The patients' satisfaction rate of dental implantation in TDPIT group was significantly higher than in CIT group (86.67% vs 53.33%, P=0.046). Using three-dimensional printing implant template can obtain better accuracy of implant, higher implant success rate and better patients' satisfaction than using conventional implant template. It is suitable for clinical application.

  7. Smartphones in orthopaedics.

    Science.gov (United States)

    Al-Hadithy, Nawfal; Gikas, Panagiotis D; Al-Nammari, Shafic Said

    2012-08-01

    With the introduction of the European Working Time Directive, surgical trainees are facing limited training opportunities and doctors are required to maximise their training opportunities. Smartphone sales have been rapidly increasing over the last five years and can be used as a training tool for the orthopaedic trainee and surgeon. Common uses include applications (AO, eLogbook and PubMed), Ebooks, online Logbooks, Guidelines and surgical techniques. In addition, smartphones can be used to immediately complete work-based assessments, in the absence of computers, hopefully increasing completion rates and reliability. Some journals now provide podcasts and video tutorials which may be accessed on smartphones, which is useful for higher examinations. Smartphones can also be used in the clinical setting to take photographs of wounds. Smartphones are enjoying increased uptake and application in the workplace and we review their use for orthopaedic surgeons and trainees to allow them to make the most out of their training opportunities.

  8. Generating 3D tissue constructs with mesenchymal stem cells and a cancellous bone graft for orthopaedic applications

    International Nuclear Information System (INIS)

    Arca, Turkan; Genever, Paul; Proffitt, Joanne

    2011-01-01

    Bone matrix (BM) is an acellular crosslinked porcine-derived cancellous bone graft, and therefore may provide advantages over other synthetic and naturally derived materials for use in orthopaedic surgery. Here, we analysed the potential of BM to support the growth and differentiation of primary human multipotent stromal cells/mesenchymal stem cells (MSCs) in order to predict in vivo bone regeneration events. Imaging with laser scanning confocal microscopy and scanning electron microscopy showed that 1 day after static seeding, a dense population of viable MSCs could be achieved on scaffolds suggesting they could be used for in vivo delivery of cells to the implant site. Long-term growth analysis by confocal imaging and histology demonstrated that BM was permissive to the growth and the 3D population of primary MSCs and an enhanced green fluorescent protein expressing osteosarcoma cell line, eGFP.MG63s, over several days in culture. Measurement of alkaline phosphatase (ALP) activities and mRNA expression levels of osteogenic markers (Runx-2, ALP, collagen type I, osteonectin, osteocalcin and osteopontin) indicated that BM supported osteogenesis of MSCs when supplemented with osteogenic stimulants. Upregulation of some of these osteogenic markers on BM, but not on tissue culture plastic, under non-osteogenic conditions suggested that BM also had osteoinductive capacities.

  9. Generating 3D tissue constructs with mesenchymal stem cells and a cancellous bone graft for orthopaedic applications

    Energy Technology Data Exchange (ETDEWEB)

    Arca, Turkan; Genever, Paul [Department of Biology, University of York, York, YO10 5DD (United Kingdom); Proffitt, Joanne, E-mail: paul.genever@york.ac.uk [TSL Centre of Biologics, Covidien, Allerton Bywater, Castleford, WF10 2DB (United Kingdom)

    2011-04-15

    Bone matrix (BM) is an acellular crosslinked porcine-derived cancellous bone graft, and therefore may provide advantages over other synthetic and naturally derived materials for use in orthopaedic surgery. Here, we analysed the potential of BM to support the growth and differentiation of primary human multipotent stromal cells/mesenchymal stem cells (MSCs) in order to predict in vivo bone regeneration events. Imaging with laser scanning confocal microscopy and scanning electron microscopy showed that 1 day after static seeding, a dense population of viable MSCs could be achieved on scaffolds suggesting they could be used for in vivo delivery of cells to the implant site. Long-term growth analysis by confocal imaging and histology demonstrated that BM was permissive to the growth and the 3D population of primary MSCs and an enhanced green fluorescent protein expressing osteosarcoma cell line, eGFP.MG63s, over several days in culture. Measurement of alkaline phosphatase (ALP) activities and mRNA expression levels of osteogenic markers (Runx-2, ALP, collagen type I, osteonectin, osteocalcin and osteopontin) indicated that BM supported osteogenesis of MSCs when supplemented with osteogenic stimulants. Upregulation of some of these osteogenic markers on BM, but not on tissue culture plastic, under non-osteogenic conditions suggested that BM also had osteoinductive capacities.

  10. Smartphones in orthopaedics

    OpenAIRE

    Al-Hadithy, Nawfal; Gikas, Panagiotis D; Al-Nammari, Shafic Said

    2012-01-01

    With the introduction of the European Working Time Directive, surgical trainees are facing limited training opportunities and doctors are required to maximise their training opportunities. Smartphone sales have been rapidly increasing over the last five years and can be used as a training tool for the orthopaedic trainee and surgeon. Common uses include applications (AO, eLogbook and PubMed), Ebooks, online Logbooks, Guidelines and surgical techniques. In addition, smartphones can be used to ...

  11. Corrosion mechanism applicable to biodegradable magnesium implants

    Energy Technology Data Exchange (ETDEWEB)

    Atrens, Andrej, E-mail: Andrejs.Atrens@uq.edu.au [University of Queensland, Division of Materials, Brisbane, Qld 4072 (Australia); Liu Ming; Zainal Abidin, Nor Ishida [University of Queensland, Division of Materials, Brisbane, Qld 4072 (Australia)

    2011-12-15

    Much of our understanding of the Mg corrosion mechanism is based on research using aggressive chloride based solutions like 3% NaCl, which are appropriate for understand the corrosion for applications such as auto construction. The chloride ions tend to cause break down of the partly protective surface film on the Mg alloy surface. The corrosion rate increases with exposure time until steady state is reached, which may take several weeks. An overview is provided of the aspects which determine the corrosion of Mg alloys: (i) measurement details; (ii) impurity elements Fe, Ni, Cu and Co; (iii) second phases; (iv) surface films and surface condition and (v) stress corrosion cracking (SCC). This understanding is used to help understand Mg corrosion for Mg as a biodegradable implant for medical applications. Solutions that elucidate these applications tend to form surface films and the corrosion rate tends to decrease with immersion time.

  12. Comparison of the thermomechanical characteristics of porcher carbon fabric-based composites for orthopaedic applications

    Science.gov (United States)

    Molchanov, E. S.; Yudin, V. E.; Kydralieva, K. A.; Elokhovskii, V. Yu.

    2012-07-01

    Prepregs of fiber-reinforced plastics based on a PORCHER-43200 carbon twill-weave fabric and two types of binders — thermoreactive and thermoplastic — were fabricated using electrostatic spraying, followed by rolling the prepregs in temperature-controlled calenders. A solid epoxy olygomer with dicyandiamine as a hardener and Fortron® polyphenylene sulfide were used as the thermoreactive and thermoplastic binders. The thermomechanical properties of carbon-fiber-reinforced plastics processed from these prepregs, as well as commercial Sigranex® PREPREGCE8201-200-45 S prepregs as model ones, and composites manufactured from them were investigated for comparison. The latter ones are being used for the design of orthopaedic products. It is shown that the composites based on polyphenylene sulfide are characterized by higher values of flexural strength, flexural and shear moduli, and interlaminar fracture toughness ( G IC), the latter being the most important parameter.

  13. Biomaterials in orthopaedics

    Science.gov (United States)

    Navarro, M; Michiardi, A; Castaño, O; Planell, J.A

    2008-01-01

    At present, strong requirements in orthopaedics are still to be met, both in bone and joint substitution and in the repair and regeneration of bone defects. In this framework, tremendous advances in the biomaterials field have been made in the last 50 years where materials intended for biomedical purposes have evolved through three different generations, namely first generation (bioinert materials), second generation (bioactive and biodegradable materials) and third generation (materials designed to stimulate specific responses at the molecular level). In this review, the evolution of different metals, ceramics and polymers most commonly used in orthopaedic applications is discussed, as well as the different approaches used to fulfil the challenges faced by this medical field. PMID:18667387

  14. Hyaluronic Acid-Based Hydrogel Coating Does Not Affect Bone Apposition at the Implant Surface in a Rabbit Model

    NARCIS (Netherlands)

    Boot, W.; Gawlitta, Debby; Nikkels, P. G J; Pouran, B.; van Rijen, M. H P; Dhert, W. J A; Vogely, H. C.

    Background: Uncemented orthopaedic implants rely on the bone-implant interface to provide stability, therefore it is essential that a coating does not interfere with the bone-forming processes occurring at the implant interface. In addition, local application of high concentrations of antibiotics

  15. Hyaluronic Acid-Based Hydrogel Coating Does Not Affect Bone Apposition at the Implant Surface in a Rabbit Model

    NARCIS (Netherlands)

    Boot, W; Gawlitta, D; Nikkels, P G J; Pouran, B; van Rijen, M H P; Dhert, W J A|info:eu-repo/dai/nl/10261847X; Vogely, H Ch

    BACKGROUND: Uncemented orthopaedic implants rely on the bone-implant interface to provide stability, therefore it is essential that a coating does not interfere with the bone-forming processes occurring at the implant interface. In addition, local application of high concentrations of antibiotics

  16. Miniscrew implant applications in contemporary orthodontics

    Directory of Open Access Journals (Sweden)

    Hong-Po Chang

    2014-03-01

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

  17. Evaluation of the stiffness characteristics of square pore CoCrMo cellular structures manufactured using laser melting technology for potential orthopaedic applications

    International Nuclear Information System (INIS)

    Hazlehurst, Kevin; Wang, Chang Jiang; Stanford, Mark

    2013-01-01

    Highlights: • The compressive properties of CoCrMo cellular structures were investigated. • CoCrMo cellular structures with bone like properties have been presented. • An expression has been proposed to predict the effective elastic modulus. • Structural variation and heterogeneities were modelled within a cellular structure. - Abstract: In order to improve the stress shielding characteristics of orthopaedic devices implants that mimic the mechanical behaviour of bone need to be considered. Additive layer manufacturing processes provide a capability to produce orthopaedic implants with tailored mechanical properties. In this work cobalt chrome molybdenum cellular structures have been designed and manufactured using selective laser melting, with volume based porosity ranging between 25% and 95%. The effective mechanical properties have been determined through uniaxial compression testing and compared to numerical and analytical predictions where differences were observed. Cellular structures have been presented that exhibit similar stiffness and strength characteristics when compared to cortical and cancellous bone in the human femur. An expression has been proposed to predict the effective elastic modulus of cobalt chrome molybdenum cellular structures with volumetric porosity of 65% and above. A finite element modelling technique has been used to demonstrate that structural variation and heterogeneities that are associated with the manufacture of cellular structures can significantly decrease the effective stiffness

  18. Three-dimensional image display by CT data processing and clinical applications in orthopaedics and craniofacial surgery

    International Nuclear Information System (INIS)

    Zonneveld, F.W.; Akkerveeken, P.F. van; Koornneef, L.

    1988-01-01

    The methods of generating three-dimensional images from two-dimensional CT data are described. Four cases are reported explaining its use in the planning of orthopaedic and craniofacial surgery. (orig.) [de

  19. Computational radiology for orthopaedic interventions

    CERN Document Server

    Li, Shuo

    2016-01-01

    This book provides a cohesive overview of the current technological advances in computational radiology, and their applications in orthopaedic interventions. Contributed by the leading researchers in the field, this volume covers not only basic computational radiology techniques such as statistical shape modeling, CT/MRI segmentation, augmented reality and micro-CT image processing, but also the applications of these techniques to various orthopaedic interventional tasks. Details about following important state-of-the-art development are featured: 3D preoperative planning and patient-specific instrumentation for surgical treatment of long-bone deformities, computer assisted diagnosis and planning of periacetabular osteotomy and femoroacetabular impingement, 2D-3D reconstruction-based planning of total hip arthroplasty, image fusion for  computer-assisted bone tumor surgery, intra-operative three-dimensional imaging in fracture treatment, augmented reality based orthopaedic interventions and education, medica...

  20. Synthesis and characterization of hydroxyapatite-gelatine composite materials for orthopaedic application

    Energy Technology Data Exchange (ETDEWEB)

    Yanovska, A., E-mail: biophy@yandex.ru [Institute of Applied Physics, National Academy of Sciences of Ukraine, 58 Petropavlovskaya Str., 40000, Sumy (Ukraine); Sumy State University, Ministry of Education and Science of Ukraine, 2 R. Korsakova Str., 40007, Sumy (Ukraine); Kuznetsov, V. [Institute of Applied Physics, National Academy of Sciences of Ukraine, 58 Petropavlovskaya Str., 40000, Sumy (Ukraine); Sumy State University, Ministry of Education and Science of Ukraine, 2 R. Korsakova Str., 40007, Sumy (Ukraine); Stanislavov, A. [Institute of Applied Physics, National Academy of Sciences of Ukraine, 58 Petropavlovskaya Str., 40000, Sumy (Ukraine); Husak, E. [Institute of Applied Physics, National Academy of Sciences of Ukraine, 58 Petropavlovskaya Str., 40000, Sumy (Ukraine); Sumy State University, Ministry of Education and Science of Ukraine, 2 R. Korsakova Str., 40007, Sumy (Ukraine); Pogorielov, M. [Sumy State University, Ministry of Education and Science of Ukraine, 2 R. Korsakova Str., 40007, Sumy (Ukraine); Starikov, V. [National Technical University ”Kharkov Polytechnic Institute”, 21 Frunze Str., 61002, Kharkov (Ukraine); Bolshanina, S. [Sumy State University, Ministry of Education and Science of Ukraine, 2 R. Korsakova Str., 40007, Sumy (Ukraine); Danilchenko, S. [Institute of Applied Physics, National Academy of Sciences of Ukraine, 58 Petropavlovskaya Str., 40000, Sumy (Ukraine)

    2016-11-01

    The composite materials based on hydroxyapatite (HA) and gelatine (Gel) with addition of silver and zirconium oxide were obtained. The study investigates a combination of low powered ultrasonic irradiation and low concentration of gelatine in the co-precipitation synthesis. These composites have different weight ratios of organic/inorganic components and may be synthesized in two ways: simple mixing and co-precipitation. Both of which were compared. The estimation of porosity, in vivo testing, surface morphology and phase composition as well as the IR-analysis were provided. Hydroxyapatite was the main crystalline phase in obtained composites. While around powdered HA-Gel composite the connective tissue capsule is formed without bone tissue formation, HA-Gel-Ag porous composite implantation leads to formation of new bone tissue and activation of cell proliferation. Addition of silver ions into composite material allows decreasing inflammation on the first stage of implantation and has positive effect on bone tissue formation. Some of the obtained composite materials containing silver or ZrO{sub 2} are biocompatible. bio-resorbable and osteoconductive with high level of porosity (75–85%). - Highlights: • Hydroxyapatite-gelatine composites with addition of Ag{sup +} and ZrO{sub 2} were obtained. • Composites were synthesized in two ways: simple mixing and co-precipitation. • Co-precipitation synthesis combined ultrasonic treatment and low concentration of gelatine. • Obtained composites have different weight ratios of organic/inorganic components. • Some composites are osteoconductive and all of them have high level of porosity (75–85%).

  1. Synthesis and characterization of hydroxyapatite-gelatine composite materials for orthopaedic application

    International Nuclear Information System (INIS)

    Yanovska, A.; Kuznetsov, V.; Stanislavov, A.; Husak, E.; Pogorielov, M.; Starikov, V.; Bolshanina, S.; Danilchenko, S.

    2016-01-01

    The composite materials based on hydroxyapatite (HA) and gelatine (Gel) with addition of silver and zirconium oxide were obtained. The study investigates a combination of low powered ultrasonic irradiation and low concentration of gelatine in the co-precipitation synthesis. These composites have different weight ratios of organic/inorganic components and may be synthesized in two ways: simple mixing and co-precipitation. Both of which were compared. The estimation of porosity, in vivo testing, surface morphology and phase composition as well as the IR-analysis were provided. Hydroxyapatite was the main crystalline phase in obtained composites. While around powdered HA-Gel composite the connective tissue capsule is formed without bone tissue formation, HA-Gel-Ag porous composite implantation leads to formation of new bone tissue and activation of cell proliferation. Addition of silver ions into composite material allows decreasing inflammation on the first stage of implantation and has positive effect on bone tissue formation. Some of the obtained composite materials containing silver or ZrO_2 are biocompatible. bio-resorbable and osteoconductive with high level of porosity (75–85%). - Highlights: • Hydroxyapatite-gelatine composites with addition of Ag"+ and ZrO_2 were obtained. • Composites were synthesized in two ways: simple mixing and co-precipitation. • Co-precipitation synthesis combined ultrasonic treatment and low concentration of gelatine. • Obtained composites have different weight ratios of organic/inorganic components. • Some composites are osteoconductive and all of them have high level of porosity (75–85%).

  2. Effect of hydroxyapatite on the biodegradation and biomechanical stability of polyester nanocomposites for orthopaedic applications.

    Science.gov (United States)

    Jayabalan, M; Shalumon, K T; Mitha, M K; Ganesan, K; Epple, M

    2010-03-01

    The effect of hydroxyapatite (HAP) on the performance of nanocomposites of an unsaturated polyester, i.e., hydroxy-terminated high molecular weight poly(proplyene fumarate) (HT-PPFhm), was investigated. A thermoset nanocomposite was prepared with nanoparticles of calcined HAP (<100 nm, rod-like shape, filler content 30 wt.%), HT-PPFhm and N-vinyl pyrrolidone, dibenzoyl peroxide and N,N-dimethyl aniline. Two more nanocomposites were prepared with precipitated HAP nanoparticles (<100 nm rod-like shape) and commercially available HAP nanoparticles (<200 nm spherical shape), respectively. Calcined HAP nanoparticles resulted in very good crosslinking in the resin matrix with high crosslinking density and interfacial bonding with the polymer, owing to the rod-like shape of the nanoparticles; this gave improved biomechanical strength and modulus and also controlled degradation of the nanocomposite for scaffold formation. The tissue compatibility and osteocompatibility of the nanocomposite containing calcined HAP nanoparticles was evaluated. The tissue compatibility was studied by intramuscular implantation in a rabbit animal model for 3 months as per ISO standard 10993/6. The in vivo femoral bone repair was also carried out in the rabbit animal model as per ISO standard 10993/6. The nanocomposite containing calcined HAP nanoparticles is both biocompatible and osteocompatible. Copyright 2009 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  3. Current status and progress of digital orthopaedics in China

    Directory of Open Access Journals (Sweden)

    Guo-Xian Pei

    2014-07-01

    Full Text Available Based on the development of digital medicine and digital anatomy, the concept of “digital orthopaedics” was raised by Pei Guo-Xian in China in 2006. The most striking feature of digital orthopaedics is the combination of basic and clinical orthopaedic knowledge with digital technology. In this review, we summarised the development of digital orthopaedics in China in recent years with respect to: the foundation of the Chinese Association of Digital Orthopedics, virtual human project (VHP, three-dimensional (3D reconstruction, finite element simulation, navigation in orthopaedic operations, and robot-assisted orthopaedic operations. In addition, we briefly reviewed digital orthopaedics in world leading institutes. We also looked into the future of digital orthopaedics in China and proposed the major challenges in digital technology and application in orthopaedics.

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

    Directory of Open Access Journals (Sweden)

    Jonathan Lueke

    2011-01-01

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

  5. MEMS-based power generation techniques for implantable biosensing applications.

    Science.gov (United States)

    Lueke, Jonathan; Moussa, Walied A

    2011-01-01

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

  6. Long-term Conventionally Dosed Vancomycin Therapy In Patients With Orthopaedic Implant-related Infections Seems As Effective And Safe As Long-term Penicillin Or Clindamycin Therapy. A Retrospective Cohort Study Of 103 Patients.

    Science.gov (United States)

    Aleman, Jacomien; Moojen, Dirk Jan F; van Ogtrop, Marc L; Poolman, Rudolf W; Franssen, Eric J F

    2018-01-01

    Objectives : Antimicrobial therapy is one of the cornerstones of orthopaedic implant-related infections (OIRI) treatment. Infections with Gram-positive bacteria are often treated with vancomycin, penicillin or clindamycin. A recent IDSA guideline suggests increasing the dose of vancomycin to increase the trough vancomycin target serum concentrations. This is deemed necessary because of an observed decrease in vancomycin susceptibility among Gram-positive bacteria. However, elevated vancomycin concentrations are correlated with the risk of nephrotoxicity, especially with prolonged therapy. Compared to most countries, rates of resistance against antibiotics among bacteria in the Netherlands are lower for currently available antibiotics, therefore lower target concentrations of vancomycin are probably efficacious for the treatment of infections. In this study we evaluated the efficacy and safety of long-term conventionally dosed vancomycin therapy, as an initial therapy for OIRI, and compared this with long-term penicillin and clindamycin therapy, as initial therapy, in patients with Gram-positive orthopaedic implant-related infections. Methods : A retrospective, observational study was conducted in 103 adult patients treated for OIRI, with vancomycin, penicillin or clindamycin for at least 10 days. The target trough serum concentration of vancomycin was 10-15 mg/l. Results : 74% of our patients were treated successfully with vancomycin, as initial therapy, (no reinfection within 1 year) versus 55% of our patients treated with either an antibiotic of the penicillin class (mostly flucloxacillin) or clindamycin (p=0.08), as initial therapy. For patients treated with vancomycin we observed a serum creatinine increase of 6 μmol/l, for patients treated with either an antibiotic of the penicillin class or clindamycin the serum creatinine increase was 4 μmol/l (p=0.395). Conclusions : In our population of patients with OIRI long-term treatment with conventionally dosed

  7. Electrodeposited silk coatings for functionalized implant applications

    Science.gov (United States)

    Elia, Roberto

    The mechanical and morphological properties of titanium as well as its biocompatibility and osteoinductive characteristics have made it the material of choice for dental implant systems. Although the success rate of titanium implants exceeds 90% in healthy individuals, a large subset of the population has one or more risk factors that inhibit implant integration. Treatments and coatings have been developed to improve clinical outcomes via introduction of appropriate surface topography, texture and roughness or incorporation of bioactive molecules. It is essential that the coatings and associated deposition techniques are controllable and reproducible. Currently, methods of depositing functional coatings are dictated by numerous parameters (temperature, particle size distribution, pH and voltage), which result in variable coating thickness, strength, porosity and weight, and hinder or preclude biomolecule incorporation. Silk is a highly versatile protein with a unique combination of mechanical and physical properties, including tunable degradation, biocompatibility, drug stabilizing capabilities and mechanical properties. Most recently an electrogelation technique was developed which allows for the deposition of gels which dry seamlessly over the contoured topography of the conductive substrate. In this work we examine the potential use of silk electrogels as mechanically robust implant coatings capable of sequestering and releasing therapeutic agents. Electrodeposition of silk electrogels formed in uniform electric fields was characterized with respect to field intensity and deposition time. Gel formation kinetics were used to derive functions which allowed for the prediction of coating deposition over a range of process and solution parameters. Silk electrogel growth orientation was shown to be influenced by the applied electric field. Coatings were reproducible and tunable via intrinsic silk solution properties and extrinsic process parameters. Adhesion was

  8. From the printer: Potential of three-dimensional printing for orthopaedic applications

    NARCIS (Netherlands)

    Mok, Sze-Wing; Nizak, Razmara; Fu, Sai-Chuen; Ho, Ki-Wai Kevin; Qin, Ling; Saris, Daniel B. F.; Chan, Kai-Ming; Malda, J

    Three-dimensional (3D) printers can create complex structures based on digital models. The combination of medical diagnostic imaging with 3D printing has great potential in day-to-day clinics for patient-specific solutions and applications. In the musculoskeletal system, 3D printing is used to

  9. From the printer: Potential of three-dimensional printing for orthopaedic applications

    NARCIS (Netherlands)

    Mok, S.; Nizak, R.; Fu, S.C.; Ho, K.K.; Qin, L.; Saris, Daniël B.F.; Chan, K.; Malda, J.

    2016-01-01

    Three-dimensional (3D) printers can create complex structures based on digital models. The combination of medical diagnostic imaging with 3D printing has great potential in day-to-day clinics for patient-specific solutions and applications. In the musculoskeletal system, 3D printing is used to

  10. Surgical simulation in orthopaedic skills training.

    Science.gov (United States)

    Atesok, Kivanc; Mabrey, Jay D; Jazrawi, Laith M; Egol, Kenneth A

    2012-07-01

    Mastering rapidly evolving orthopaedic surgical techniques requires a lengthy period of training. Current work-hour restrictions and cost pressures force trainees to face the challenge of acquiring more complex surgical skills in a shorter amount of time. As a result, alternative methods to improve the surgical skills of orthopaedic trainees outside the operating room have been developed. These methods include hands-on training in a laboratory setting using synthetic bones or cadaver models as well as software tools and computerized simulators that enable trainees to plan and simulate orthopaedic operations in a three-dimensional virtual environment. Laboratory-based training offers potential benefits in the development of basic surgical skills, such as using surgical tools and implants appropriately, achieving competency in procedures that have a steep learning curve, and assessing already acquired skills while minimizing concerns for patient safety, operating room time, and financial constraints. Current evidence supporting the educational advantages of surgical simulation in orthopaedic skills training is limited. Despite this, positive effects on the overall education of orthopaedic residents, and on maintaining the proficiency of practicing orthopaedic surgeons, are anticipated.

  11. Sintering and robocasting of beta-tricalcium phosphate scaffoldsfor orthopaedic applications

    Energy Technology Data Exchange (ETDEWEB)

    Miranda, Pedro; Saiz, Eduardo; Gryn Karol; Tomsia, Antoni P.

    2005-11-01

    {beta}-tricalcium phosphate ({beta}-TCP) scaffolds with designed, three-dimensional (3-D) geometry and mesoscale porosity have been fabricated by direct-write assembly (robocasting) techniques. Concentrated {beta}-TCP inks with suitable viscoelastic properties were developed to enable the fabrication of the complex 3-D structures. A comprehensive study of the sintering behavior of TCP as a function of the calcium content in the starting powder was also carried out, and the optimal heat treatment for fabricating scaffolds with dense {beta}-TCP rods has been determined. Such analysis provides clues to controlling the microstructure of the fabricated structures and, therefore, enabling the fabrication by robocasting of TCP scaffolds with tailored performance for bone tissue engineering applications.

  12. Industrial applications of ion implantation into metal surfaces

    International Nuclear Information System (INIS)

    Williams, J.M.

    1987-07-01

    The modern materials processing technique, ion implantation, has intriguing and attractive features that stimulate the imaginations of scientists and technologists. Success of the technique for introducing dopants into semiconductors has resulted in a stable and growing infrastructure of capital equipment and skills for use of the technique in the economy. Attention has turned to possible use of ion implantation for modification of nearly all surface related properties of materials - optical, chemical and corrosive, tribological, and several others. This presentation provides an introduction to fundamental aspects of equipment, technique, and materials science of ion implantation. Practical and economic factors pertaining to the technology are discussed. Applications and potential applications are surveyed. There are already available a number of ion-implanted products, including ball-and-roller bearings and races, punches-and-dies, injection screws for plastics molding, etc., of potential interest to the machine tool industry

  13. Computer Assisted Orthopaedic Surgery – CAOS

    Directory of Open Access Journals (Sweden)

    Enes M. Kanlić

    2006-02-01

    Full Text Available The use of computer navigation in orthopedic surgery allows for real time intraoperative feedback resulting in higher precision of bone cuts, better alignment of implants and extremities, easier fracture reductions, less radiation and better documentation than what is possible in classical orthopaedic procedures. There is no need for direct and repeated visualization of many anatomical landmarks (classical method in order to have good intraoperative orientation. Navigation technology depicts anatomy and position of "smart tools" on the screen allowing for high surgical precision (smaller number of outliers from desired goal and with less soft tissue dissection (minimally invasive surgery - MIS. As a result, there are more happy patients with less pain, faster recovery, better functional outcome and well positioned, long lasting implants. In general, navigation cases are longer on the average 10 to 20 minutes, special training is required and equipment is relatively expensive. CAOS applications in knee and hip joint replacement are discussed.

  14. Synthesis and Characterization of Calcium Phosphate Powders for Biomedical Applications by Plasma Spray Coating

    OpenAIRE

    Sasidharan Pillai, Rahul

    2015-01-01

    This PhD work mainly focus on the synthesis and characterization of calcium phosphate powders for plasma spray coating. The preparation of high temperature phase stabilized βTCP and HA/βTCP powders for plasma spray coating applications has been the topic of investigation. Nowadays plasma sprayed coatings are widely used for biomedical applications especially in the dental and orthopaedic implantation field. Previously Ti based alloys were widely used for the orthopaedic and dental implant ap...

  15. Mechanical compatibility of sol-gel annealing with titanium for orthopaedic prostheses.

    Science.gov (United States)

    Greer, Andrew I M; Lim, Teoh S; Brydone, Alistair S; Gadegaard, Nikolaj

    2016-01-01

    Sol-gel processing is an attractive method for large-scale surface coating due to its facile and inexpensive preparation, even with the inclusion of precision nanotopographies. These are desirable traits for metal orthopaedic prostheses where ceramic coatings are known to be osteoinductive and the effects may be amplified through nanotexturing. However there are a few concerns associated with the application of sol-gel technology to orthopaedics. Primarily, the annealing stage required to transform the sol-gel into a ceramic may compromise the physical integrity of the underlying metal. Secondly, loose particles on medical implants can be carcinogenic and cause inflammation so the coating needs to be strongly bonded to the implant. These concerns are addressed in this paper. Titanium, the dominant material for orthopaedics at present, is examined before and after sol-gel processing for changes in hardness and flexural modulus. Wear resistance, bending and pull tests are also performed to evaluate the ceramic coating. The findings suggest that sol-gel coatings will be compatible with titanium implants for an optimum temperature of 500 °C.

  16. Application of ion implantation in metals and alloys

    International Nuclear Information System (INIS)

    Dearnaley, G.

    1981-01-01

    Ion implantation first became established as a precise method of introducing dopant elements into semiconductors. It is now appreciated that there may be equally important applications in metallic tools or components with the purpose of improving their resistance to wear, fatigue or corrosion. Nitrogen ions implanted into steels pin dislocations and thereby harden the metal. Some metallic ions such as yttrium reduce the tendency for oxidative wear. There is a fairly good understanding of how both treatments can provide a long-lasting protection that extends to many times the original depth of implantation. Nitrogen implantation also improves the wear resistance of Co-cemented tungsten carbide and of hard chromium electroplated coatings. These treatments have wide application in press tools, molds, dies and other metal-forming tools as well as in a more limited variety of cutting tools. Some striking improvements can be achieved in the corrosion field, but there are economic and technical reasons for concluding that practical applications of ion implantation will be more restricted and specialized in this area. The most promising area is that in which mechanical stress and oxidation coexist. When a metallic species has to be introduced, a promising new development is to bombard a thin coating of the metal at an elevated temperature. Several powerful mechanisms of radiation-enhanced diffusion can bring about a complete intermixing. Examples of how this has been used to produce wear resistant surfaces in titanium are given. Finally, the equipment developed for the large scale application of the ion implantation process in the engineering field is described

  17. Application of TXRF for ion implanter dose matching experiments

    Science.gov (United States)

    Frost, M. R.; French, M.; Harris, W.

    2004-06-01

    Secondary ion mass spectrometry (SIMS) has been utilized for many years to measure the dose of ion implants in silicon for the purpose of verifying the ability of ion implantation equipment to accurately and reproducibly implant the desired species at the target dose. The development of statistically and instrumentally rigorous protocols has lead to high confidence levels, particularly with regard to accuracy and short-term repeatability. For example, high-dose, high-energy B implant dosimetry can be targeted to within ±1%. However, performing dose determination experiments using SIMS does have undesirable aspects, such as being highly labor intensive and sample destructive. Modern total reflection X-ray fluorescence (TXRF) instruments are equipped with capabilities for full 300 mm wafer handling, automated data acquisition software and intense X-ray sources. These attributes enable the technique to overcome the SIMS disadvantages listed above, as well as provide unique strengths that make it potentially highly amenable to implanter dose matching. In this paper, we report on data collected to date that provides confidence that TXRF is an effective and economical method to perform these measurements within certain limitations. We have investigated a number of ion implanted species that are within the "envelope" of TXRF application. This envelope is defined by a few important parameters. Species: For the anode materials used in the more common X-ray sources on the market, each has its own set of elements that can be detected. We have investigated W and Mo X-ray sources, which are the most common in use in commercial instrumentation. Implant energy: In general, if the energy of the implanted species is too high (or more specifically, the distribution of the implanted species is too deep), the amount of dopant not detected by TXRF may be significant, increasing the error of the measurement. Therefore, for each species investigated, the implant energy cannot exceed a

  18. Application of nitrogen plasma immersion ion implantation to titanium nasal implants with nanonetwork surface structure

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Ying-Sui; Yang, Wei-En [Department of Dentistry, National Yang-Ming University, Taipei 112, Taiwan (China); Zhang, Lan [State Key Laboratory for Mechanical Behavior of Materials, Xi' an Jiaotong University, Xi' an 710049 (China); Zhu, Hongqin [State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050 (China); Lan, Ming-Ying [Division of Rhinology, Department of Otolaryngology Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan and School of Medicine, National Yang-Ming University, Taipei 112, Taiwan (China); Lee, Sheng-Wei [Institute of Materials Science and Engineering, National Central University, Taoyuan 320, Taiwan (China); Huang, Her-Hsiung, E-mail: hhhuang@ym.edu.tw [Department of Dentistry, National Yang-Ming University, Taipei 112, Taiwan (China); Institute of Oral Biology, National Yang-Ming University, Taipei 112, Taiwan (China); Graduate Institute of Basic Medical Science, China Medical University, Taichung 404, Taiwan (China); Department of Medical Research, China Medical University Hospital, Taichung 407, Taiwan (China); Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413, Taiwan (China); Department of Stomatology, Taipei Veterans General Hospital, Taipei 112, Taiwan (China)

    2016-07-15

    In nasal reconstruction, the response of cells to titanium (Ti) implants is mainly determined by surface features of the implant. In a pilot study, the authors applied electrochemical anodization to Ti surfaces in an alkaline solution to create a network of nanoscale surface structures. This nanonetwork was intended to enhance the responses of primary human nasal epithelial cell (HNEpC) to the Ti surface. In this study, the authors then treated the anodized, nanonetwork-structured Ti surface using nitrogen plasma immersion ion implantation (NPIII) in order to further improve the HNEpC response to the Ti surface. Subsequently, surface characterization was performed to elucidate morphology, roughness, wettability, and chemistry of specimens. Cytotoxicity, blood, and HNEpC responses were also evaluated. Our results demonstrate that NPIII treatment led to the formation of a noncytotoxic TiN-containing thin film (thickness <100 nm) on the electrochemically anodized Ti surface with a nanonetwork-structure. NPIII treatment was shown to improve blood clotting and the adhesion of platelets to the anodized Ti surface as well as the adhesion and proliferation of hNEpC. This research spreads our understanding of the fact that a TiN-containing thin film, produced using NPIII treatment, could be used to improve blood and HNEpC responses to anodized, nanonetwork-structured Ti surfaces in nasal implant applications.

  19. Orthopaedic training in Kenya

    African Journals Online (AJOL)

    Background: Orthopaedic training in Kenya, like in other East, central and .... quite a number of good facilities that would train an ... provide a forum for exchange of ideas and training. (2,3) ... administrators purely interested in service provision,.

  20. View-Angle Tilting and Slice-Encoding Metal Artifact Correction for Artifact Reduction in MRI: Experimental Sequence Optimization for Orthopaedic Tumor Endoprostheses and Clinical Application.

    Directory of Open Access Journals (Sweden)

    Pia M Jungmann

    Full Text Available MRI plays a major role in follow-up of patients with malignant bone tumors. However, after limb salvage surgery, orthopaedic tumor endoprostheses might cause significant metal-induced susceptibility artifacts.To evaluate the benefit of view-angle tilting (VAT and slice-encoding metal artifact correction (SEMAC for MRI of large-sized orthopaedic tumor endoprostheses in an experimental model and to demonstrate clinical benefits for assessment of periprosthetic soft tissue abnormalities.In an experimental setting, tumor endoprostheses (n=4 were scanned at 1.5T with three versions of optimized high-bandwidth turbo-spin-echo pulse sequences: (i standard, (ii VAT and (iii combined VAT and SEMAC (VAT&SEMAC. Pulse sequences included coronal short-tau-inversion-recovery (STIR, coronal T1-weighted (w, transverse T1-w and T2-w TSE sequences. For clinical evaluation, VAT&SEMAC was compared to conventional metal artifact-reducing MR sequences (conventional MR in n=25 patients with metal implants and clinical suspicion of tumor recurrence or infection. Diameters of artifacts were measured quantitatively. Qualitative parameters were assessed on a five-point scale (1=best, 5=worst: "image distortion", "artificial signal changes at the edges" and "diagnostic confidence". Imaging findings were correlated with pathology. T-tests and Wilcoxon-signed rank tests were used for statistical analyses.The true size of the prostheses was overestimated on MRI (P<0.05. A significant reduction of artifacts was achieved by VAT (P<0.001 and VAT&SEMAC (P=0.003 compared to the standard group. Quantitative scores improved in the VAT and VAT&SEMAC group (P<0.05. On clinical MR images, artifact diameters were significantly reduced in the VAT&SEMAC-group as compared with the conventional-group (P<0.001. Distortion and artificial signal changes were reduced and diagnostic confidence improved (P<0.05. In two cases, tumor-recurrence, in ten cases infection and in thirteen cases other

  1. Multiscale Inorganic Hierarchically Materials: Towards an Improved Orthopaedic Regenerative Medicine.

    Science.gov (United States)

    Ruso, Juan M; Sartuqui, Javier; Messina, Paula V

    2015-01-01

    Bone is a biologically and structurally sophisticated multifunctional tissue. It dynamically responds to biochemical, mechanical and electrical clues by remodelling itself and accordingly the maximum strength and toughness are along the lines of the greatest applied stress. The challenge is to develop an orthopaedic biomaterial that imitates the micro- and nano-structural elements and compositions of bone to locally match the properties of the host tissue resulting in a biologically fixed implant. Looking for the ideal implant, the convergence of life and materials sciences occurs. Researchers in many different fields apply their expertise to improve implantable devices and regenerative medicine. Materials of all kinds, but especially hierarchical nano-materials, are being exploited. The application of nano-materials with hierarchical design to calcified tissue reconstructive medicine involve intricate systems including scaffolds with multifaceted shapes that provides temporary mechanical function; materials with nano-topography modifications that guarantee their integration to tissues and that possesses functionalized surfaces to transport biologic factors to stimulate tissue growth in a controlled, safe, and rapid manner. Furthermore materials that should degrade on a timeline coordinated to the time that takes the tissues regrow, are prepared. These implantable devices are multifunctional and for its construction they involve the use of precise strategically techniques together with specific material manufacturing processes that can be integrated to achieve in the design, the required multifunctionality. For such reasons, even though the idea of displacement from synthetic implants and tissue grafts to regenerative-medicine-based tissue reconstruction has been guaranteed for well over a decade, the reality has yet to emerge. In this paper, we examine the recent approaches to create enhanced bioactive materials. Their design and manufacturing procedures as well

  2. High dose implantations of antimony for buried layer applications

    International Nuclear Information System (INIS)

    Gailliard, J.P.; Dupuy, M.; Garcia, M.; Roussin, J.C.

    1978-01-01

    Electrical and physical properties of high dose implantations of antimony in silicon have been studied for use in buried layer applications. The results have been obtained both on and oriented silicon wafers. Following implantations which lead to amorphization we perform an annealing at 600 0 C for 10 mn in order to recrystallize the layer. The observed electrical properties (μ, R) show that the concentration of electrically active antimony ions is greater than that predicted from the solubility of antimony in silicon. Further annealing (in the range 1050 0 - 1200 0 ) induces: firstly a precipitation of the Sb and secondly a diffusion and dissolution of the precipitates. There is a different evolution of the defects in the and silicon slices. T.E.M. reveals no defects in the wafers after one hour annealing at 1200 0 C, whereas defects and twins remain in wafers. Having obtained the evolution of R with time and temperature it is then determined the implantation and annealing conditions which lead to the low resistivity (R = 10) needed for buried layer applications. Results with very many industrially made devices are discussed

  3. American Academy of Orthopaedic Surgeons

    Science.gov (United States)

    ... Research Research Tools Research Roadmap Facts and Figures Unified Orthopaedic Research Agenda Sex and Gender in Research ... Career Center Clinician Scholar Career Development Clinician-Patient Communication Leadership Fellows Program Medical Student Resources Postgraduate Orthopaedic ...

  4. Plasma ion implantation technology for broad industrial application

    International Nuclear Information System (INIS)

    Deb, D.; Siambis, J.; Symons, R.

    1994-01-01

    The recently invented Plasma Ion Implantation (PII) process (1987) [J. R. Conrad, U.S. Patent No. 764394 (August 16, 1988)] is currently under intense industrial engineering investigation and development. A critical component of PII for broad industrial utilization is the availability of an efficient modulator system that applies the high voltage pulse to the workpiece. A modulator technology assessment and selection is carried out. The requirements of the PII process favor the selection of a hard-tube modulator. The PII process favors the application of beam switch tube technology such as the Litton L-5012 and L-5097. These Litton tubes have already been selected by LANL and utilized in their pilot engineering demonstration experiment with GM and the University of Wisconsin. The performance, physical operation, and potential enhancements of the Litton beam switch tubes L-5012 and L-5097 will be discussed in connection with the requirements of the emerging plasma ion implantation industrial modulator technology

  5. The orthopaedic error index: development and application of a novel national indicator for assessing the relative safety of hospital care using a cross-sectional approach.

    Science.gov (United States)

    Panesar, Sukhmeet S; Netuveli, Gopalakrishnan; Carson-Stevens, Andrew; Javad, Sundas; Patel, Bhavesh; Parry, Gareth; Donaldson, Liam J; Sheikh, Aziz

    2013-11-21

    The Orthopaedic Error Index for hospitals aims to provide the first national assessment of the relative safety of provision of orthopaedic surgery. Cross-sectional study (retrospective analysis of records in a database). The National Reporting and Learning System is the largest national repository of patient-safety incidents in the world with over eight million error reports. It offers a unique opportunity to develop novel approaches to enhancing patient safety, including investigating the relative safety of different healthcare providers and specialties. We extracted all orthopaedic error reports from the system over 1 year (2009-2010). The Orthopaedic Error Index was calculated as a sum of the error propensity and severity. All relevant hospitals offering orthopaedic surgery in England were then ranked by this metric to identify possible outliers that warrant further attention. 155 hospitals reported 48 971 orthopaedic-related patient-safety incidents. The mean Orthopaedic Error Index was 7.09/year (SD 2.72); five hospitals were identified as outliers. Three of these units were specialist tertiary hospitals carrying out complex surgery; the remaining two outlier hospitals had unusually high Orthopaedic Error Indexes: mean 14.46 (SD 0.29) and 15.29 (SD 0.51), respectively. The Orthopaedic Error Index has enabled identification of hospitals that may be putting patients at disproportionate risk of orthopaedic-related iatrogenic harm and which therefore warrant further investigation. It provides the prototype of a summary index of harm to enable surveillance of unsafe care over time across institutions. Further validation and scrutiny of the method will be required to assess its potential to be extended to other hospital specialties in the UK and also internationally to other health systems that have comparable national databases of patient-safety incidents.

  6. Orthopaedic Footwear Design

    Science.gov (United States)

    1992-01-01

    Although the need for orthopaedic shoes is increasing, the number of skilled shoemakers has declined. This has led to the development of a CAD/CAM system to design and fabricate, orthopaedic footwear. The NASA-developed RIM database management system is the central repository for CUSTOMLAST's information storage. Several other modules also comprise the system. The project was initiated by Langley Research Center and Research Triangle Institute in cooperation with the Veterans Administration and the National Institute for Disability and Rehabilitation Research. Later development was done by North Carolina State University and the University of Missouri-Columbia. The software is licensed by both universities.

  7. East African Orthopaedic Journal: Submissions

    African Journals Online (AJOL)

    Author Guidelines. The East African Orthopaedic Journal is published biannually by the Kenya Orthopaedics Association. Its primary objective is to give researchers in orthopaedics and ... Format should be as follows; Details of authors as for original articles, summary of not more than 200 words, introduction, case report,

  8. 21 CFR 1308.25 - Exclusion of a veterinary anabolic steroid implant product; application.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Exclusion of a veterinary anabolic steroid implant... OF JUSTICE SCHEDULES OF CONTROLLED SUBSTANCES Excluded Veterinary Anabolic Steroid Implant Products § 1308.25 Exclusion of a veterinary anabolic steroid implant product; application. (a) Any person seeking...

  9. Application of High Entropy Alloys in Stent Implants

    Science.gov (United States)

    Alagarsamy, Karthik

    High entropy alloys (HEAs) are alloys with five or more principal elements. Due to these distinct concept of alloying, the HEA exhibits unique and superior properties. The outstanding properties of HEA includes higher strength/hardness, superior wear resistance, high temperature stability, higher fatigue life, good corrosion and oxidation resistance. Such characteristics of HEA has been significant interest leading to researches on these emerging field. Even though many works are done to understand the characteristic of these HEAs, very few works are made on how the HEAs can be applied for commercial uses. This work discusses the application of High entropy alloys in biomedical applications. The coronary heart disease, the leading cause of death in the United States kills more than 350,000 persons/year and it costs $108.9 billion for the nation each year in spite of significant advancements in medical care and public awareness. A cardiovascular disease affects heart or blood vessels (arteries, veins and capillaries) or both by blocking the blood flow. As a surgical interventions, stent implants are deployed to cure or ameliorate the disease. However, the high failure rate of stents has lead researchers to give special attention towards analyzing stent structure, materials and characteristics. Many works related to alternate material and/or design are carried out in recent time. This paper discusses the feasibility of CoCrFeNiMn and Al0.1CoCrFeNi HEAs in stent implant application. This work is based on the speculation that CoCrFeNiMn and Al0.1CoCrFeNi HEAs are biocompatible material. These HEAs are characterized to determine the microstructure and mechanical properties. Computational modeling and analysis were carried out on stent implant by applying CoCrFeNiMn and Al0.1CoCrFeNi HEAs as material to understand the structural behavior.

  10. [Orthopaedics' megalomania - myth or mobbing?

    Science.gov (United States)

    Gundtoft, Per Hviid; Brand, Eske; Klit, Jakob; Weisskirchner, Kristoffer Barfod

    2016-12-12

    It is a general impression in the world of medicine that orthopaedic surgeons differ from doctors of other specialities in terms of intellect and self-confidence. The purpose of this study was to evaluate the self-confidence of orthopaedics. We asked doctors from 30 different specialities to fill out a questionnaire. In addition to this, the participating orthopaedics were asked to rate their self-perceived surgical skills. In all, 120 orthopaedics and 416 non-orthopaedic doctors completed the questionnaire. There was no difference in GSE scores between orthopaedics and other doctors (p = 0.58). 98% of young orthopaedics estimated that their surgical talent was average or above average when compared with their colleagues on the same level of education. 72% believed that they were "equally talented", "more talented", or "far more talented" than their colleagues on a higher level of education. 76% believed that when assisting a senior surgeon the patients would "sometimes" (60%), "often" (14%) or "always" (2%) be better off if they were the ones performing the operation. More orthopaedics than non-orthopaedics believed that their speciality was regarded as one of the least important specialities in the world of medicine (p = 0.001). Orthopaedic surgeons in general are not more self-confident than other doctors or the average population, but young orthopaedic surgeons have a very high level of confidence in their own operation skills. none. none.

  11. Application and measurement properties of EQ-5D to measure quality of life in patients with upper extremity orthopaedic disorders: a systematic literature review.

    Science.gov (United States)

    Grobet, Cécile; Marks, Miriam; Tecklenburg, Linda; Audigé, Laurent

    2018-04-13

    The EuroQol-5 Dimension (EQ-5D) is the most widely used generic instrument to measure quality of life (QoL), yet its application in upper extremity orthopaedics as well as its measurement properties remain largely undefined. We implemented a systematic literature review to provide an overview of the application of EQ-5D in patients with upper extremity disorders and analyse its measurement properties. We searched Medline, EMBASE, Cochrane and Scopus databases for clinical studies including orthopaedic patients with surgical interventions of the upper extremity who completed the EQ-5D. For all included studies, the use of EQ-5D and quantitative QoL data were described. Validation studies of EQ-5D were assessed according to COSMIN guidelines and standard measurement properties were examined. Twenty-three studies were included in the review, 19 of which investigated patients with an intervention carried out at the shoulder region. In 15 studies, EQ-5D assessed QoL as the primary outcome. Utility index scores in non-trauma patients generally improved postoperatively, whereas trauma patients did not regain their recalled pre-injury QoL levels. EQ-5D measurement properties were reported in three articles on proximal humerus fractures and carpal tunnel syndrome. Positive ratings were seen for construct validity (Spearman correlation coefficient ≥ 0.70 with the Short Form (SF)-12 or SF-6D health surveys) and reliability (intraclass correlation coefficient ≥ 0.77) with intermediate responsiveness (standardised response means: 0.5-0.9). However, ceiling effects were identified with 16-48% of the patients scoring the maximum QoL. The methodological quality of the three articles varied from fair to good. For surgical interventions of the upper extremity, EQ-5D was mostly applied to assess QoL as a primary outcome in patients with shoulder disorders. Investigations of the measurement properties were rare, but indicate good reliability and validity as well as

  12. Evaluation of free or anchored antimicrobial peptides as candidates for the prevention of orthopaedic device-related infections.

    Science.gov (United States)

    D'Este, Francesca; Oro, Debora; Boix-Lemonche, Gerard; Tossi, Alessandro; Skerlavaj, Barbara

    2017-10-01

    The prevention of implant-associated infection, one the most feared complications in orthopaedic surgery, remains a major clinical challenge and urges development of effective methods to prevent bacterial colonization of implanted devices. Alpha-helical antimicrobial peptides (AMPs) may be promising candidates in this respect due to their potent and broad-spectrum antimicrobial activity, their low tendency to elicit resistance and possible retention of efficacy in the immobilized state. The aim of this study was to evaluate the potential of five different helical AMPs, the cathelicidins BMAP-27 and BMAP-28, their (1-18) fragments and the rationally designed, artificial P19(9/G7) peptide, for the prevention of orthopaedic implant infections. Peptides were effective at micromolar concentrations against 22 Staphylococcus and Streptococcus isolates from orthopaedic infections, while only BMAP-28 and to a lesser extent BMAP-27 were active against Enterococcus faecalis. Peptides in solution showed activities comparable to those of cefazolin and linezolid, on a molar basis, and also a variable capacity to neutralize bacterial lipopolysaccharide, while devoid of adverse effects on MG-63 osteoblast cells at concentrations corresponding to the MIC. The (1-18) BMAP fragments and P19(9/G7) were selected for further examination, based on better selectivity indices, and showed effectiveness in the presence of hyaluronic acid and in synovial fluid, while human serum affected their activity to variable extents, with BMAP-27(1-18) best retaining activity. This peptide was immobilized on streptavidin-resin beads and retained activity against reference Staphylococcus epidermidis and Staphylococcus aureus strains, with negligible toxicity towards osteoblasts, underlining its potential for the development of infection-resistant biomaterials for orthopaedic application. Copyright © 2017 European Peptide Society and John Wiley & Sons, Ltd. Copyright © 2017 European Peptide Society and

  13. Lighter, greener and strong: developing light metals for application in the aerospace industry

    CSIR Research Space (South Africa)

    Du Preez, W

    2010-08-01

    Full Text Available per SR-71 Drivers of the South African Titanium Industry SA’s Space Programme (mid ’80s – mid ’90s): Titanium (Ti-6Al-4V) in satellites Medical applications (’90s – present): Titanium orthopaedic implants Titanium dental implants © CSIR 2010...

  14. Ion implantation

    International Nuclear Information System (INIS)

    Dearnaley, Geoffrey

    1975-01-01

    First, ion implantation in semiconductors is discussed: ion penetration, annealing of damage, gettering, ion implanted semiconductor devices, equipement requirements for ion implantation. The importance of channeling for ion implantation is studied. Then, some applications of ion implantation in metals are presented: study of the corrosion of metals and alloys; influence or ion implantation on the surface-friction and wear properties of metals; hyperfine interactions in implanted metals

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

    Science.gov (United States)

    Cao, Shaoping; Yin, Chunguang; Zhao, Zhenying

    2013-03-01

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

  16. Preparation of Chitin-PLA laminated composite for implantable application

    Directory of Open Access Journals (Sweden)

    Romana Nasrin

    2017-12-01

    Full Text Available The present study explores the possibilities of using locally available inexpensive waste prawn shell derived chitin reinforced and bioabsorbable polylactic acid (PLA laminated composites to develop new materials with excellent mechanical and thermal properties for implantable application such as in bone or dental implant. Chitin at different concentration (1–20% of PLA reinforced PLA films (CTP were fabricated by solvent casting process and laminated chitin-PLA composites (LCTP were prepared by laminating PLA film (obtained by hot press method with CTP also by hot press method at 160 °C. The effect of variation of chitin concentration on the resulting laminated composite's behavior was investigated. The detailed physico-mechanical, surface morphology and thermal were assessed with different characterization technique such as FT-IR, XRD, SEM and TGA. The FTIR spectra showed the characteristic peaks for chitin and PLA in the composites. SEM images showed an excellent dispersion of chitin in the films and composites. Thermogravimetric analysis (TGA showed that the complete degradation of chitin, PLA film, 5% chitin reinforced PLA film (CTP2 and LCTP are 98%, 95%, 87% and 98% respectively at temperature of 500 °C. The tensile strength of the LCTP was found 25.09 MPa which is significantly higher than pure PLA film (18.55 MPa and CTP2 film (8.83 MPa. After lamination of pure PLA and CTP2 film, the composite (LCTP yielded 0.265–1.061% water absorption from 30 min to 24 h immerse in water that is much lower than PLA and CTP. The increased mechanical properties of the laminated films with the increase of chitin content indicated good dispersion of chitin into PLA and strong interfacial actions between the polymer and chitin. The improvement of mechanical properties and the results of antimicrobial and cytotoxicity of the composites also evaluated and revealed the composite would be a suitable candidate for implant application in biomedical

  17. Preparation of Chitin-PLA laminated composite for implantable application.

    Science.gov (United States)

    Nasrin, Romana; Biswas, Shanta; Rashid, Taslim Ur; Afrin, Sanjida; Jahan, Rumana Akhter; Haque, Papia; Rahman, Mohammed Mizanur

    2017-12-01

    The present study explores the possibilities of using locally available inexpensive waste prawn shell derived chitin reinforced and bioabsorbable polylactic acid (PLA) laminated composites to develop new materials with excellent mechanical and thermal properties for implantable application such as in bone or dental implant. Chitin at different concentration (1-20% of PLA) reinforced PLA films (CTP) were fabricated by solvent casting process and laminated chitin-PLA composites (LCTP) were prepared by laminating PLA film (obtained by hot press method) with CTP also by hot press method at 160 °C. The effect of variation of chitin concentration on the resulting laminated composite's behavior was investigated. The detailed physico-mechanical, surface morphology and thermal were assessed with different characterization technique such as FT-IR, XRD, SEM and TGA. The FTIR spectra showed the characteristic peaks for chitin and PLA in the composites. SEM images showed an excellent dispersion of chitin in the films and composites. Thermogravimetric analysis (TGA) showed that the complete degradation of chitin, PLA film, 5% chitin reinforced PLA film (CTP2) and LCTP are 98%, 95%, 87% and 98% respectively at temperature of 500 °C. The tensile strength of the LCTP was found 25.09 MPa which is significantly higher than pure PLA film (18.55 MPa) and CTP2 film (8.83 MPa). After lamination of pure PLA and CTP2 film, the composite (LCTP) yielded 0.265-1.061% water absorption from 30 min to 24 h immerse in water that is much lower than PLA and CTP. The increased mechanical properties of the laminated films with the increase of chitin content indicated good dispersion of chitin into PLA and strong interfacial actions between the polymer and chitin. The improvement of mechanical properties and the results of antimicrobial and cytotoxicity of the composites also evaluated and revealed the composite would be a suitable candidate for implant application in biomedical sector.

  18. Designing biocompatible Ti-based metallic glasses for implant applications

    International Nuclear Information System (INIS)

    Calin, Mariana; Gebert, Annett; Ghinea, Andreea Cosmina; Gostin, Petre Flaviu; Abdi, Somayeh; Mickel, Christine; Eckert, Jürgen

    2013-01-01

    Ti-based metallic glasses show high potential for implant applications; they overcome in several crucial respects their well-established biocompatible crystalline counterparts, e.g. improved corrosion properties, higher fracture strength and wear resistance, increased elastic strain range and lower Young's modulus. However, some of the elements required for glass formation (e.g. Cu, Ni) are harmful for the human body. We critically reviewed the biological safety and glass forming tendency in Ti of 27 elements. This can be used as a basis for the future designing of novel amorphous Ti-based implant alloys entirely free of harmful additions. In this paper, two first alloys were developed: Ti 75 Zr 10 Si 15 and Ti 60 Nb 15 Zr 10 Si 15 . The overheating temperature of the melt before casting can be used as the controlling parameter to produce fully amorphous materials or bcc-Ti-phase reinforced metallic glass nano-composites. The beneficial effect of Nb addition on the glass-formation and amorphous phase stability was assessed by X-ray diffraction, transmission electron microscopy and differential scanning calorimetry. Crystallization and mechanical behavior of ribbons are influenced by the amount and distribution of the nano-scaled bcc phase existing in the as-cast state. Their electrochemical stability in Ringer's solution at 310 K was found to be significantly better than that of commercial Ti-based biomaterials; no indication for pitting corrosion was recorded. Highlights: ► Link between biocompatibility and glass-forming ability of alloying additions in Ti ► Selection of Ti–Zr–Si and Ti–Zr–Nb–Si glass-forming alloys ► Two novel glassy alloys were developed: Ti 75 Zr 10 Si 15 and Ti 60 Nb 15 Zr 10 Si 15. ► Glass-formation, thermal stability, corrosion and mechanical behavior were studied. ► Assessing the suitability for orthopedic applications.

  19. Ion Implantation of Calcium and Zinc in Magnesium for Biodegradable Implant Applications

    Directory of Open Access Journals (Sweden)

    Sahadev Somasundaram

    2018-01-01

    Full Text Available In this study, magnesium was implanted with calcium-ion and zinc-ion at fluences of 1015, 1016, and 1017 ion·cm−2, and its in vitro degradation behaviour was evaluated using electrochemical techniques in simulated body fluid (SBF. Rutherford backscattering spectrometry (RBS revealed that the implanted ions formed layers within the passive magnesium-oxide/hydroxide layers. Electrochemical impedance spectroscopy (EIS results demonstrated that calcium-ion implantation at a fluence of 1015 ions·cm−2 increased the polarisation resistance by 24%, but higher fluences showed no appreciable improvement. In the case of zinc-ion implantation, increase in the fluence decreased the polarisation resistance. A fluence of 1017 ion·cm−2 decreased the polarisation resistance by 65%, and fluences of 1015 and 1016 showed only marginal effect. Similarly, potentiodynamic polarisation results also suggested that low fluence of calcium-ion decreased the degradation rate by 38% and high fluence of zinc-ion increased the degradation rate by 61%. All the post-polarized ion-implanted samples and the bare metal revealed phosphate and carbonate formation. However, the improved degradative behaviour in calcium-ion implanted samples can be due to a relatively better passivation, whereas the reduction in degradation resistance in zinc-ion implanted samples can be attributed to the micro-galvanic effect.

  20. [Application of endosseous screw implants. Indications and planning].

    Science.gov (United States)

    Pajarola, G F; Sailer, H F

    1991-01-01

    To achieve long term positive results for endosseous dental implants, three points have to be considered: the osséointegration, the correct indication and the suprastructural planification designed for the spécific type of implant. If the surgery part is done by a different practitioner as the prosthetic part, tight coworking for planning is necessary and the responsibility in each step has to be cleared in advance. The planification in implant cases is divided into three stages: clearing of contraindications, choice of the suprastructure, and the surgery planning. Aids for exact localisation of the implants are presented.

  1. Laser and electron-beam powder-bed additive manufacturing of metallic implants: A review on processes, materials and designs.

    Science.gov (United States)

    Sing, Swee Leong; An, Jia; Yeong, Wai Yee; Wiria, Florencia Edith

    2016-03-01

    Additive manufacturing (AM), also commonly known as 3D printing, allows the direct fabrication of functional parts with complex shapes from digital models. In this review, the current progress of two AM processes suitable for metallic orthopaedic implant applications, namely selective laser melting (SLM) and electron beam melting (EBM) are presented. Several critical design factors such as the need for data acquisition for patient-specific design, design dependent porosity for osteo-inductive implants, surface topology of the implants and design for reduction of stress-shielding in implants are discussed. Additive manufactured biomaterials such as 316L stainless steel, titanium-6aluminium-4vanadium (Ti6Al4V) and cobalt-chromium (CoCr) are highlighted. Limitations and future potential of such technologies are also explored. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  2. Targeted drug delivery to magnetic implants for therapeutic applications

    International Nuclear Information System (INIS)

    Yellen, Benjamin B.; Forbes, Zachary G.; Halverson, Derek S.; Fridman, Gregory; Barbee, Kenneth A.; Chorny, Michael; Levy, Robert; Friedman, Gary

    2005-01-01

    A new method for locally targeted drug delivery is proposed that employs magnetic implants placed directly in the cardiovascular system to attract injected magnetic carriers. Theoretical simulations and experimental results support the assumption that using magnetic implants in combination with externally applied magnetic field will optimize the delivery of magnetic drug to selected sites within a subject

  3. Bionic mechanics of customized cellular bio-magnesium scaffolds for large-area defects of femoral shafts and implants for orthopaedics surgery%股骨干大面积缺损多孔生物镁支架和骨科植入物的仿生力学

    Institute of Scientific and Technical Information of China (English)

    赵为民; 李秉哲; 唐六丁; Peter Paul Müler

    2014-01-01

    financial y by German Academic Exchange Service, visiting the Department of Molecule Biotechnology, German Helmholtz Center of Infection Research, Braunschweig, Germany, creating the cooperation relation to research into the project“Fundament and Application of Biomimetic Technology for Customized cellular Biomagnesium Scaffolds of Loaded Tissue Engineering Bones”, finishing the present work and“Investigation on the Nanosize and Zeta(ξ)-potential of Polyelectrolytes for Biomimetic Coating Technology”. OBJECTIVE:To focus on studying bionic mechanics between cellular scaffolds, customized for large area defects of femoral shafts, and new ingrown bones, as wel as bionic mechanics between host bones and platelike implants for orthopaedics surgery, by means of elastic mechanics and stereo-quantitative metal ographic analysis, and proposing the principle of bionic mechanics and the design criterion for above mentioned two types of problems, also some directions for research and development. METHODS:Different types of micro-volume models for two types of composites, i.e., cellular scaffolds/new-growing bones bio-composites, as wel as plate-like implants/host bones layered composites were created, as wel as different modulus mixing rules and mechanical stresses, i.e., stimuli, were presented, respectively. RESULTS AND CONCLUSION:Under the different modulus and volume fractions of scaffold materials, the mechanical stimuli of new ingrown bones are compared:(1) except cellular tantalum, the strength of cellular metal ic scaffolds/new ingrown bones composites is obviously much higher than that of original host bones, to enable resolving the problem on insufficient mechanical strengths in early period of implanting the compound between partial demineralized bone scaffolds and autogenous human bone marrow mesenchymal stem cells, as wel as other organic or inorganic scaffolds for tissue engineering. (2) The less the modulus and volume fraction of materials for cellular scaffold

  4. A Batteryless Sensor ASIC for Implantable Bio-Impedance Applications.

    Science.gov (United States)

    Rodriguez, Saul; Ollmar, Stig; Waqar, Muhammad; Rusu, Ana

    2016-06-01

    The measurement of the biological tissue's electrical impedance is an active research field that has attracted a lot of attention during the last decades. Bio-impedances are closely related to a large variety of physiological conditions; therefore, they are useful for diagnosis and monitoring in many medical applications. Measuring living tissues, however, is a challenging task that poses countless technical and practical problems, in particular if the tissues need to be measured under the skin. This paper presents a bio-impedance sensor ASIC targeting a battery-free, miniature size, implantable device, which performs accurate 4-point complex impedance extraction in the frequency range from 2 kHz to 2 MHz. The ASIC is fabricated in 150 nm CMOS, has a size of 1.22 mm × 1.22 mm and consumes 165 μA from a 1.8 V power supply. The ASIC is embedded in a prototype which communicates with, and is powered by an external reader device through inductive coupling. The prototype is validated by measuring the impedances of different combinations of discrete components, measuring the electrochemical impedance of physiological solution, and performing ex vivo measurements on animal organs. The proposed ASIC is able to extract complex impedances with around 1 Ω resolution; therefore enabling accurate wireless tissue measurements.

  5. Decoronation followed by dental implants placement: fundamentals, applications and explanations

    Science.gov (United States)

    Consolaro, Alberto; Ribeiro, Paulo Domingos; Cardoso, Maurício A.; Miranda, Dario A. Oliveira; Salfatis, Monica

    2018-01-01

    ABSTRACT Dental arches areas with teeth presenting dentoalveolar ankylosis and replacement root resorption can be considered as presenting normal bone, in full physiological remodeling process; and osseointegrated implants can be successfully placed. Bone remodeling will promote osseointegration, regardless of presenting ankylosis and/or replacement root resorption. After 1 to 10 years, all dental tissues will have been replaced by bone. The site, angulation and ideal positioning in the space to place the implant should be dictated exclusively by the clinical convenience, associated with previous planning. One of the advantages of decoronation followed by dental implants placement in ankylosed teeth with replacement resorption is the maintenance of bone volume in the region, both vertical and horizontal. If possible, the buccal part of the root, even if thin, should be preserved in the preparation of the cavity for the implant, as this will maintain gingival tissues looking fully normal for long periods. In the selection of cases for decoronation, the absence of microbial contamination in the region - represented by chronic periapical lesions, presence of fistula, old unconsolidated root fractures and active advanced periodontal disease - is important. Such situations are contraindications to decoronation. However, the occurrence of dentoalveolar ankylosis and replacement resorption without contamination should neither change the planning for implant installation, nor the criteria for choosing the type and brand of dental implant to be used. Failure to decoronate and use dental implants has never been reported. PMID:29791693

  6. Development of vertical compact ion implanter for gemstones applications

    Science.gov (United States)

    Intarasiri, S.; Wijaikhum, A.; Bootkul, D.; Suwannakachorn, D.; Tippawan, U.; Yu, L. D.; Singkarat, S.

    2014-08-01

    Ion implantation technique was applied as an effective non-toxic treatment of the local Thai natural corundum including sapphires and rubies for the enhancement of essential qualities of the gemstones. Energetic oxygen and nitrogen ions in keV range of various fluences were implanted into the precious stones. It has been thoroughly proved that ion implantation can definitely modify the gems to desirable colors together with changing their color distribution, transparency and luster properties. These modifications lead to the improvement in quality of the natural corundum and thus its market value. Possible mechanisms of these modifications have been proposed. The main causes could be the changes in oxidation states of impurities of transition metals, induction of charge transfer from one metal cation to another and the production of color centers. For these purposes, an ion implanter of the kind that is traditionally used in semiconductor wafer fabrication had already been successfully applied for the ion beam bombardment of natural corundum. However, it is not practical for implanting the irregular shape and size of gem samples, and too costly to be economically accepted by the gem and jewelry industry. Accordingly, a specialized ion implanter has been requested by the gem traders. We have succeeded in developing a prototype high-current vertical compact ion implanter only 1.36 m long, from ion source to irradiation chamber, for these purposes. It has been proved to be very effective for corundum, for example, color improvement of blue sapphire, induction of violet sapphire from low value pink sapphire, and amelioration of lead-glass-filled rubies. Details of the implanter and recent implantation results are presented.

  7. Development of vertical compact ion implanter for gemstones applications

    International Nuclear Information System (INIS)

    Intarasiri, S.; Wijaikhum, A.; Bootkul, D.; Suwannakachorn, D.; Tippawan, U.; Yu, L.D.; Singkarat, S.

    2014-01-01

    Ion implantation technique was applied as an effective non-toxic treatment of the local Thai natural corundum including sapphires and rubies for the enhancement of essential qualities of the gemstones. Energetic oxygen and nitrogen ions in keV range of various fluences were implanted into the precious stones. It has been thoroughly proved that ion implantation can definitely modify the gems to desirable colors together with changing their color distribution, transparency and luster properties. These modifications lead to the improvement in quality of the natural corundum and thus its market value. Possible mechanisms of these modifications have been proposed. The main causes could be the changes in oxidation states of impurities of transition metals, induction of charge transfer from one metal cation to another and the production of color centers. For these purposes, an ion implanter of the kind that is traditionally used in semiconductor wafer fabrication had already been successfully applied for the ion beam bombardment of natural corundum. However, it is not practical for implanting the irregular shape and size of gem samples, and too costly to be economically accepted by the gem and jewelry industry. Accordingly, a specialized ion implanter has been requested by the gem traders. We have succeeded in developing a prototype high-current vertical compact ion implanter only 1.36 m long, from ion source to irradiation chamber, for these purposes. It has been proved to be very effective for corundum, for example, color improvement of blue sapphire, induction of violet sapphire from low value pink sapphire, and amelioration of lead-glass-filled rubies. Details of the implanter and recent implantation results are presented

  8. Development of vertical compact ion implanter for gemstones applications

    Energy Technology Data Exchange (ETDEWEB)

    Intarasiri, S., E-mail: saweat@gmail.com [Science and Technology Research Institute, Chiang Mai University, Chiang Mai 50200 (Thailand); Thailand Center of Excellence in Physics, Commission on Higher Education, 328 Si Ayutthaya Road, Bangkok 10400 (Thailand); Wijaikhum, A. [Plasma and Beam Physics Research Facility, Department of Physics and Materials Science, Faculty of Science, Chiang Mai University, Chiang Mai 50200 (Thailand); Bootkul, D., E-mail: mo_duangkhae@hotmail.com [Department of General Science (Gems and Jewelry), Faculty of Science, Srinakharinwirot University, Bangkok 10110 (Thailand); Thailand Center of Excellence in Physics, Commission on Higher Education, 328 Si Ayutthaya Road, Bangkok 10400 (Thailand); Suwannakachorn, D.; Tippawan, U.; Yu, L.D.; Singkarat, S. [Plasma and Beam Physics Research Facility, Department of Physics and Materials Science, Faculty of Science, Chiang Mai University, Chiang Mai 50200 (Thailand); Thailand Center of Excellence in Physics, Commission on Higher Education, 328 Si Ayutthaya Road, Bangkok 10400 (Thailand)

    2014-08-15

    Ion implantation technique was applied as an effective non-toxic treatment of the local Thai natural corundum including sapphires and rubies for the enhancement of essential qualities of the gemstones. Energetic oxygen and nitrogen ions in keV range of various fluences were implanted into the precious stones. It has been thoroughly proved that ion implantation can definitely modify the gems to desirable colors together with changing their color distribution, transparency and luster properties. These modifications lead to the improvement in quality of the natural corundum and thus its market value. Possible mechanisms of these modifications have been proposed. The main causes could be the changes in oxidation states of impurities of transition metals, induction of charge transfer from one metal cation to another and the production of color centers. For these purposes, an ion implanter of the kind that is traditionally used in semiconductor wafer fabrication had already been successfully applied for the ion beam bombardment of natural corundum. However, it is not practical for implanting the irregular shape and size of gem samples, and too costly to be economically accepted by the gem and jewelry industry. Accordingly, a specialized ion implanter has been requested by the gem traders. We have succeeded in developing a prototype high-current vertical compact ion implanter only 1.36 m long, from ion source to irradiation chamber, for these purposes. It has been proved to be very effective for corundum, for example, color improvement of blue sapphire, induction of violet sapphire from low value pink sapphire, and amelioration of lead-glass-filled rubies. Details of the implanter and recent implantation results are presented.

  9. Biofunctionalization of surfaces by energetic ion implantation: Review of progress on applications in implantable biomedical devices and antibody microarrays

    Science.gov (United States)

    Bilek, Marcela M. M.

    2014-08-01

    Despite major research efforts in the field of biomaterials, rejection, severe immune responses, scar tissue and poor integration continue to seriously limit the performance of today's implantable biomedical devices. Implantable biomaterials that interact with their host via an interfacial layer of active biomolecules to direct a desired cellular response to the implant would represent a major and much sought after improvement. Another, perhaps equally revolutionary, development that is on the biomedical horizon is the introduction of cost-effective microarrays for fast, highly multiplexed screening for biomarkers on cell membranes and in a variety of analyte solutions. Both of these advances will rely on effective methods of functionalizing surfaces with bioactive molecules. After a brief introduction to other methods currently available, this review will describe recently developed approaches that use energetic ions extracted from plasma to facilitate simple, one-step covalent surface immobilization of bioactive molecules. A kinetic theory model of the immobilization process by reactions with long-lived, mobile, surface-embedded radicals will be presented. The roles of surface chemistry and microstructure of the ion treated layer will be discussed. Early progress on applications of this technology to create diagnostic microarrays and to engineer bioactive surfaces for implantable biomedical devices will be reviewed.

  10. In vitro biological outcome of laser application for modification or processing of titanium dental implants.

    Science.gov (United States)

    Hindy, Ahmed; Farahmand, Farzam; Tabatabaei, Fahimeh Sadat

    2017-07-01

    There are numerous functions for laser in modern implant dentistry including surface treatment, surface coating, and implant manufacturing. As laser application may potentially improve osseointegration of dental implants, we systematically reviewed the literature for in vitro biological responses to laser-modified or processed titanium dental implants. The literature was searched in PubMed, ISI Web, and Scopus, using keywords "titanium dental implants," "laser," "biocompatibility," and their synonyms. After screening the 136 references obtained, 28 articles met the inclusion criteria. We found that Nd:YAG laser was the most commonly used lasers in the treatment or processing of titanium dental implants. Most of the experiments used cell attachment and cell proliferation to investigate bioresponses of the implants. The most commonly used cells in these assays were osteoblast-like cells. Only one study was conducted in stem cells. These in vitro studies reported higher biocompatibility in laser-modified titanium implants. It seems that laser radiation plays a vital role in cell response to dental implants; however, it is necessary to accomplish more studies using different laser types and parameters on various cells to offer a more conclusive result.

  11. Annealing behavior and selected applications of ion-implanted alloys

    International Nuclear Information System (INIS)

    Myers, S.M.

    Thermally activated processes cause ion-implanted metals to evolve from the initial state toward thermodynamic equilibrium. The degree of equilibration is strongly dependent upon temperature and is considered for three temperature regimes which are distinguished by the varying mobilities of interstitial and substitutional atoms. In addition, perturbations resulting from the irradiation environment are discussed. Examples are given of the use of implanted and annealed alloys in studies of diffusion, phase diagrams, and solute trapping

  12. An information revolution in orthopaedics.

    Science.gov (United States)

    Goldberg, A J; MacGregor, A; Spencer, S A

    2012-04-01

    With the established success of the National Joint Registry and the emergence of a range of new national initiatives for the capture of electronic data in the National Health Service, orthopaedic surgery in the United Kingdom has found itself thrust to the forefront of an information revolution. In this review we consider the benefits and threats that this revolution poses, and how orthopaedic surgeons should marshal their resources to ensure that this is a force for good.

  13. Smartphone apps for orthopaedic sports medicine - a smart move?

    Science.gov (United States)

    Wong, Seng Juong; Robertson, Greg A; Connor, Katie L; Brady, Richard R; Wood, Alexander M

    2015-01-01

    With the advent of smartphones together with their downloadable applications (apps), there is increasing opportunities for doctors, including orthopaedic sports surgeons, to integrate such technology into clinical practice. However, the clinical reliability of these medical apps remains questionable. We reviewed available apps themed specifically towards Orthopaedic Sports Medicine and related conditions and assessed the level of medical professional involvement in their design and content, along with a review of these apps. The most popular smartphone app stores (Android, Apple, Blackberry, Windows, Samsung, Nokia) were searched for Orthopaedic Sports medicine themed apps, using the search terms; Orthopaedic Sports Medicine, Orthopaedics, Sports medicine, Knee Injury, Shoulder Injury, Anterior Cruciate Ligament Tear, Medial Collateral Ligament Tear, Rotator Cuff Tear, Meniscal Tear, Tennis Elbow. All English language apps related to orthopaedic sports medicine were included. A total of 76 individual Orthopaedic Sports Medicine themed apps were identified. According to app store classifications, there were 45 (59 %) medical themed apps, 28 (37 %) health and fitness themed apps, 1 (1 %) business app, 1 (1 %) reference app and 1 (1 %) sports app. Forty-nine (64 %) apps were available for download free of charge. For those that charged access, the prices ranged from £0.69 to £69.99. Only 51 % of sports medicine apps had customer satisfaction ratings and 39 % had named medical professional involvement in their development or content. We found the majority of Orthopaedic Sports Medicine apps had no named medical professional involvement, raising concerns over their content and evidence-base. We recommend increased regulation of such apps to improve the accountability of app content.

  14. East African Orthopaedic Journal

    African Journals Online (AJOL)

    Anthropometry of the distal femur in a Kenyan population and its correlation with total knee replacement implants · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. K.C. Lakati, B.M. Ndeleva, C.K. Kibet, S.M. Odhiambo, V.B. Sokobe, 67-72 ...

  15. Porous metal for orthopedics implants

    OpenAIRE

    Matassi, Fabrizio; Botti, Alessandra; Sirleo, Luigi; Carulli, Christian; Innocenti, Massimo

    2013-01-01

    Porous metal has been introduced to obtain biological fixation and improve longevity of orthopedic implants. The new generation of porous metal has intriguing characteristics that allows bone healing and high osteointegration of the metallic implants. This article gives an overview about biomaterials properties of the contemporary class of highly porous metals and about the clinical use in orthopaedic surgery.

  16. Application and Curative Effect of Micro-implant Anchorage in ...

    African Journals Online (AJOL)

    research hot spot in the Department of. Stomatology. Instead of taking teeth as the basis, as was previously the case, this new anchorage exerts the counteracting force of orthodontics on the jaw, thus completely avoiding the displacement of teeth. It solves a lot of problems existing in clinical anchorage. Micro - implant.

  17. Applicability of existing magnesium alloys as biomedical implant materials

    NARCIS (Netherlands)

    Erinc, M.; Sillekens, W.H.; Mannens, R.G.T.M.; Werkhoven, R.J.

    2009-01-01

    Being biocompatible and biodegradable, magnesium alloys are considered as the new generation biomedical implant materials, such as for stents, bone fixtures, plates and screws. A major drawback is the poor chemical stability of metallic magnesium; it corrodes at a pace that is too high for most

  18. Orthopaedic Trauma Care Capacity Assessment and Strategic Planning in Ghana: Mapping a Way Forward.

    Science.gov (United States)

    Stewart, Barclay T; Gyedu, Adam; Tansley, Gavin; Yeboah, Dominic; Amponsah-Manu, Forster; Mock, Charles; Labi-Addo, Wilfred; Quansah, Robert

    2016-12-07

    Orthopaedic conditions incur more than 52 million disability-adjusted life years annually worldwide. This burden disproportionately affects low and middle-income countries, which are least equipped to provide orthopaedic care. We aimed to assess orthopaedic capacity in Ghana, describe spatial access to orthopaedic care, and identify hospitals that would most improve access to care if their capacity was improved. Seventeen perioperative and orthopaedic trauma care-related items were selected from the World Health Organization's Guidelines for Essential Trauma Care. Direct inspection and structured interviews with hospital staff were used to assess resource availability and factors contributing to deficiencies at 40 purposively sampled facilities. Cost-distance analyses described population-level spatial access to orthopaedic trauma care. Facilities for targeted capability improvement were identified through location-allocation modeling. Orthopaedic trauma care assessment demonstrated marked deficiencies. Some deficient resources were low cost (e.g., spinal immobilization, closed reduction capabilities, and prosthetics for amputees). Resource nonavailability resulted from several contributing factors (e.g., absence of equipment, technology breakage, lack of training). Implants were commonly prohibitively expensive. Building basic orthopaedic care capacity at 15 hospitals without such capacity would improve spatial access to basic care from 74.9% to 83.0% of the population (uncertainty interval [UI] of 81.2% to 83.6%), providing access for an additional 2,169,714 Ghanaians. The availability of several low-cost resources could be better supplied by improvements in organization and training for orthopaedic trauma care. There is a critical need to advocate and provide funding for orthopaedic resources. These initiatives might be particularly effective if aimed at hospitals that could provide care to a large proportion of the population.

  19. Allergies in orthopaedic and trauma surgery.

    Science.gov (United States)

    Lohmann, C H; Hameister, R; Singh, G

    2017-02-01

    Hypersensitivity reactions to implants in orthopaedic and trauma surgery are a rare but devastating complication. They are considered as a delayed-type of hypersensitivity reaction (type IV), characterized by an antigen activation of sensitized T-lymphocytes releasing various cytokines and may result in osteoclast activation and bone resorption. Potential haptens are originated from metal alloys or bone-cement. A meta-analysis has confirmed a higher probability of developing a metal hypersensitivity postoperatively and noted a greater risk of failed replacements compared to stable implants. Hypersensitivity to implants may present with a variety of symptoms such as pain, joint effusion, delayed wound/bone healing, persistent secretion, allergic dermatitis (localized or systemic), clicking noises, loss of joint function, instability and failure of the implant. Various diagnostic options have been offered, including patch testing, metal alloy patch testing, histology, lymphocyte transformation test (LTT), memory lymphocyte immunostimulation assay (MELISA), leukocyte migration inhibition test (LIF) and lymphocyte activation test (LAT). No significant differences between in vivo and in vitro methods have been found. Due to unconvincing evidence for screening methods, predictive tests are not recommended for routine performance. Infectious aetiology always needs to be excluded. As there is a lack of evidence on large-scale studies with regards to the optimal treatment option, management currently relies on individual case-by-case decisions. Several options for patients with (suspected) metal-related hypersensitivity exist and may include materials based on ceramic, titanium or oxinium or modified surfaces. Promising results have been reported, but long-term experience is lacking. More large-scaled studies are needed in this context. In patients with bone-cement hypersensitivity, the component suspected for hypersensitivity should be avoided. The development of

  20. April 2006. 32 Major Orthopaedic Procedures

    African Journals Online (AJOL)

    user

    2006-04-01

    Apr 1, 2006 ... Major Orthopaedic Procedures: 17 Year Trends. Biruk Lambisso Wamisho1 ... financial and logistic constraints with poor compliance of ... Modern orthopaedic surgery is very expensive. A highly ..... Case management. Tribury.

  1. Implanted strontium titanate single crystals for energy storage applications

    Energy Technology Data Exchange (ETDEWEB)

    Stoeber, Max; Cherkouk, Charaf; Walter, Juliane; Strohmeyer, Ralph; Leisegang, Tilmann; Meyer, Dirk Carl [TU Bergakademie, Freiberg (Germany); Schelter, Matthias; Zosel, Jens [Kurt Schwabe Institute, Meinsberg (Germany); Prucnal, Slawomir [Institute of Ion Beam Physics and Materials Research, Helmholtz-Zentrum Dresden-Rossendorf (Germany)

    2016-07-01

    A rapid increase of the demand on efficient energy storage solutions requires new approaches beyond the Li-ion technology. In particular, metal-air batteries as well as solid-state fuel cells offer a great potential for high-energy-density storage devices. Since the efficiency of such devices is significantly limited by the activation of both the oxygen reduction reaction (ORR) and the ionic and electronic conductivities, an adequate porosity as well as a controlled doping are required. The ion implantation is a key technology to achieve this goal. In this work, p- and n-doped strontium titanate (SrTiO{sub 3}) single crystals were used as oxidic materials. The oxygen exchange kinetics as well as the structural changes of the SrTiO{sub 3} crystal surface induced by the ion implantation were investigated. On one hand, the depth profile of dopant concentration and dopant valence state were determined using sputtered X-ray photoelectron spectroscopy (XPS). On the other hand, the overall oxygen exchange kinetic of the implanted SrTiO{sub 3} crystal was quantitatively described by means of coulometric titration using Zirox system (ZIROX GmbH, Germany). Furthermore, the surface morphology of the samples was investigated using atomic force microscopy (AFM).

  2. Developmental orthopaedic diseases in foals

    International Nuclear Information System (INIS)

    Şİrİn, Özlem; Alkan, Zeki

    2010-01-01

    Developmental Orthopaedic Diseases (DOD) is seen frequently in horses which completed their maturity. Osteochondrosis, physitis, angular limb deformities, flexural deformities, juvenil arthritis, cervical vertebral anomalies, cuboidal bone abnormalities are problems investigated under Developmental Orthopaedic Diseases title. This diseases can develop single or some together in fast growing, heavy animals (especially Arabian and English Thoroughbreds). Multifactorial causes of this diseases etiopathogenesis can be listed as genetic predisposition, trauma, nutrition, vitamins/minerals and endocrine disorders. But the exact causes of these diseases are not known. In this review detailed information are given about the diseases mentioned above

  3. Numerical Investigation of a Chip Printed Antenna Performances for Wireless Implantable Body Area Network Applications

    Science.gov (United States)

    Ramli, N. H.; Jaafar, H.; Lee, Y. S.

    2018-03-01

    Recently, wireless implantable body area network (WiBAN) system become an active area of research due to their various applications such as healthcare, support systems for specialized occupations and personal communications. Biomedical sensors networks mounted in the human body have drawn greater attention for health care monitoring systems. The implantable chip printed antenna for WiBAN applications is designed and the antenna performances is investigated in term of gain, efficiency, return loss, operating bandwidth and radiation pattern at different environments. This paper is presents the performances of implantable chip printed antenna in selected part of human body (hand, chest, leg, heart and skull). The numerical investigation is done by using human voxel model in built in the CST Microwave Studio Software. Results proved that the chip printed antenna is suitable to implant in the human hand model. The human hand model has less complex structure as it consists of skin, fat, muscle, blood and bone. Moreover, the antenna is implanted under the skin. Therefore the signal propagation path length to the base station at free space environment is considerably short. The antenna’s gain, efficiency and Specific Absorption Rate (SAR) are - 13.62dBi, 1.50 % and 0.12 W/kg respectively; which confirms the safety of the antenna usage. The results of the investigations can be used as guidance while designing chip implantable antenna in future.

  4. Orthopaedic training in Kenya | Mulimba | East African Orthopaedic ...

    African Journals Online (AJOL)

    Objective: To do a survey of the current orthopaedic specialists in Kenya's training since their first medical degrees. Determine the duration, facilities and methods of training. Methods: A number of doctors trained under different arrangements were identified, interviewed and where curriculum was available this was read.

  5. Patient compliance and effect of orthopaedic shoes

    DEFF Research Database (Denmark)

    Philipsen, A B; Ellitsgaard, N; Krogsgaard, M R

    1999-01-01

    Orthopaedic shoes are individually handmade after a prescription from an orthopaedic surgeon, hence relatively expensive. Bad compliance is mentioned in the literature but not investigated. In order to evaluate patient compliance and the effect of orthopaedic shoes, 85 patients who were prescribed...

  6. Multilayer scaffolds in orthopaedic tissue engineering.

    Science.gov (United States)

    Atesok, Kivanc; Doral, M Nedim; Karlsson, Jon; Egol, Kenneth A; Jazrawi, Laith M; Coelho, Paulo G; Martinez, Amaury; Matsumoto, Tomoyuki; Owens, Brett D; Ochi, Mitsuo; Hurwitz, Shepard R; Atala, Anthony; Fu, Freddie H; Lu, Helen H; Rodeo, Scott A

    2016-07-01

    The purpose of this study was to summarize the recent developments in the field of tissue engineering as they relate to multilayer scaffold designs in musculoskeletal regeneration. Clinical and basic research studies that highlight the current knowledge and potential future applications of the multilayer scaffolds in orthopaedic tissue engineering were evaluated and the best evidence collected. Studies were divided into three main categories based on tissue types and interfaces for which multilayer scaffolds were used to regenerate: bone, osteochondral junction and tendon-to-bone interfaces. In vitro and in vivo studies indicate that the use of stratified scaffolds composed of multiple layers with distinct compositions for regeneration of distinct tissue types within the same scaffold and anatomic location is feasible. This emerging tissue engineering approach has potential applications in regeneration of bone defects, osteochondral lesions and tendon-to-bone interfaces with successful basic research findings that encourage clinical applications. Present data supporting the advantages of the use of multilayer scaffolds as an emerging strategy in musculoskeletal tissue engineering are promising, however, still limited. Positive impacts of the use of next generation scaffolds in orthopaedic tissue engineering can be expected in terms of decreasing the invasiveness of current grafting techniques used for reconstruction of bone and osteochondral defects, and tendon-to-bone interfaces in near future.

  7. No influence of simultaneous bone-substitute application on the success of immediately loaded dental implants: a retrospective cohort study.

    Science.gov (United States)

    Kopp, Sigmar; Behrend, Detlef; Kundt, Günther; Ottl, Peter; Frerich, Bernhard; Warkentin, Mareike

    2013-06-01

    To examine the influence of bone-substitute application during implantation on the success of immediately placed and loaded dental implants. A total of 147 consecutive patients (age, 16.5-80.4 years) were provided with 696 immediately loaded implants. The mean follow-up time was 34.1 months. Of these implants, 50.4% (n=351) were immediately placed into extraction sockets. A total of 119 implants were added by simultaneous bone-substitute application (NanoBone, Artoss GmbH, Rostock Germany), whereas the other implants were placed in healed bone. Univariate and multivariate analysis was performed using IBM SPSS V.20. The overall implant success rate was 96.1%. Implants with simultaneous bone replacement had a hazard ratio of 0.877 (p=0.837); 95% CI, 0.253-3.04). Factors found to be statistically significant modifiers of success on multivariate analysis (p<0.05) included type of superstructure (p<0.001), implant-abutment connection (p<0.001), membrane use (p=0.010), and jaw (p=0.026). None of the other factors investigated were significant modifiers. The present study demonstrates high success rates for immediately loaded implants and their superstructures independent of the simultaneous application of bone substitute. The declared aim of socket preservation, the prevention avoiding bone loss, is achieved in the immediate implant placement scenario under immediate-loading conditions.

  8. Hand dominance in orthopaedic surgeons.

    LENUS (Irish Health Repository)

    Lui, Darren F

    2012-08-01

    Handedness is perhaps the most studied human asymmetry. Laterality is the preference shown for one side and it has been studied in many aspects of medicine. Studies have shown that some orthopaedic procedures had poorer outcomes and identified laterality as a contributing factor. We developed a questionnaire to assess laterality in orthopaedic surgery and compared this to an established scoring system. Sixty-two orthopaedic surgeons surveyed with the validated Waterloo Handedness Questionnaire (WHQ) were compared with the self developed Orthopaedic Handedness Questionnaire (OHQ). Fifty-eight were found to be right hand dominant (RHD) and 4 left hand dominant (LHD). In RHD surgeons, the average WHQ score was 44.9% and OHQ 15%. For LHD surgeons the WHQ score was 30.2% and OHQ 9.4%. This represents a significant amount of time using the non dominant hand but does not necessarily determine satisfactory or successful dexterity transferable to the operating room. Training may be required for the non dominant side.

  9. Do Orthopaedic Surgeons Acknowledge Uncertainty?

    NARCIS (Netherlands)

    Teunis, Teun; Janssen, Stein; Guitton, Thierry G.; Ring, David; Parisien, Robert

    2016-01-01

    Much of the decision-making in orthopaedics rests on uncertain evidence. Uncertainty is therefore part of our normal daily practice, and yet physician uncertainty regarding treatment could diminish patients' health. It is not known if physician uncertainty is a function of the evidence alone or if

  10. The 25 most cited articles in arthroscopic orthopaedic surgery.

    Science.gov (United States)

    Cassar Gheiti, Adrian J; Downey, Richard E; Byrne, Damien P; Molony, Diarmuid C; Mulhall, Kevin J

    2012-04-01

    The purpose of this study was to use Web of Knowledge to determine which published arthroscopic surgery-related articles have been cited most frequently by other authors by ranking the 25 most cited articles. We furthermore wished to determine whether there is any difference between a categorical "journal-by-journal" analysis and an "all-database" analysis in arthroscopic surgery and whether such a search methodology would alter the results of previously published lists of "citation classics" in the field. We analyzed the characteristics of these articles to determine what qualities make an article important to this subspecialty of orthopaedic surgery. Web of Knowledge was searched on March 7, 2011, using the term "arthroscopy" for citations to articles related to arthroscopy in 61 orthopaedic journals and using the all-database function. Each of the 61 orthopaedic journals was searched separately for arthroscopy-related articles to determine the 25 most cited articles. An all-database search for arthroscopy-related articles was carried out and compared with a journal-by-journal search. Each article was reviewed for basic information including the type of article, authorship, institution, country, publishing journal, and year published. The number of citations ranged from 189 to 567 in a journal-by-journal search and from 214 to 1,869 in an all-database search. The 25 most cited articles on arthroscopic surgery were published in 11 journals: 8 orthopaedic journals and 3 journals from other specialties. The most cited article in arthroscopic orthopaedic surgery was published in The New England Journal of Medicine, which was not previously identified by a journal-by-journal search. An all-database search in Web of Knowledge gives a more in-depth methodology of determining the true citation ranking of articles. Among the top 25 most cited articles, autologous chondrocyte implantation/transplantation is currently the most cited and most popular topic in arthroscopic

  11. Industrial plasma immersion ion implanter and its applications

    CERN Document Server

    Tong Hong Hui; Huo Yan Feng; Wang Ke; Mu Li Lan; Feng Tie Min; Zhao Jun; Yan Bing; Geng Man

    2002-01-01

    A new generation industrial plasma immersion ion implanter was developed recently in South-western Institute of Physics and some experimental results are reported. The vacuum chamber with 900 mm in diameter and 1050 mm in height stands vertically. The pumping system includes turbo -pump and mechanical pump and it can be automatically controlled by PLC. The background pressure is less than 4 x 10 sup - sup 4 Pa. The plasma in the chamber can be generated by hot-filament discharge and three high-efficiency magnetic filter metal plasma sources, so that the plasma immersion ion implantation and enhanced deposition can be done. The maximum pulse voltage output is 80 kV, maximum pulse current is 60 A, repetition frequency is 50-500 Hz, and the pulse rise time is less than 2 mu s. The power modulator can operate in the pulse bunching mode if necessary. In general, the plasma density is 10 sup 8 -10 sup 1 sup 0 cm sup - sup 3 , the film deposition rate is 0.1-0.5 nm/s

  12. Application of ion implantation RBS to the study of electrocatalysis

    International Nuclear Information System (INIS)

    Kelly, E.J.; Vallet, C.E.; White, C.W.

    1990-01-01

    Ir-implanted titanium near-surface alloys were prepared by ion implantation, characterized (Ir concentration/depth profiles) by Rutherford backscattering (RBS), and subsequently anodically oxidized to form electrocatalytically active Ir x Ti 1-x O 2 /Ti electrodes. The electrochemical behavior of the metallic-like Ir 4 Ti 1-x O 2 /Ti electrodes in acidic chloride, sulfate, and perchlorate solutions was investigated, and the results compared with those previously obtained with similarly prepared Ru x Ti 1-x O 2 /Ti electrodes. For both electrodes, M x Ti 1-x O 2 /Ti (M equals Ir or Ru), the Tafel slope for the Cl 2 evolution reaction is 40 mV, i.e.,δE/δlog i equals 2.303 (2RT/3F). The reaction order (n) with respect to chloride ion concentration δlogi/δlog[Cl - ] + 1, where K 9 equals 54.9 dm 3 mol -1 for Ir x Ti 1-x O 2 /Ti and K 9 equals 40 dm 3 mol -1 for Ru x Ti 1-x O 2 /Ti. A modified Volmer-Heyrovsky mechanism, one in which the role of absorbed chloride ions is taken into account, is shown to be consistent with aforementioned diagnostic parameters

  13. Potential applications of biphosphonates in dental surgical implants.

    Science.gov (United States)

    Berardi, D; Carlesi, T; Rossi, F; Calderini, M; Volpi, R; Perfetti, G

    2007-01-01

    Biphosphonates are largely used for their unquestionable properties of inhibiting bone resorption by osteoclasts in the treatment of various osteometabolic illnesses such as osteoporosis, multiple myeloma, tumors which metastasize to the bone and malignant hypercalcemia. In this literature review the physico-chemical properties, biologic activities and the mechanisms of action of biphosphonates are described. The use of these drugs is discussed, analyzing the quantity of results which have emerged through in vitro and in vivo experiments on animal models. In this study the efficiency of these drugs is demonstrated in contrasting the osteolitic processes of the alveolar bone, in promoting the neoformation and in bettering the quality of bone implants. However, it is important to draw attention to a worrying correlation which has emerged during the last 3-4 years, between osteonecrosis of the jaw (ONJ) and the systemic administration of aminobiphosphonates. This collateral effect did not emerge following the use of non-aminobiphosphonates. The aim of this review is to identify the guidelines for the use of biphosphonates in oral implant surgery.

  14. Communication skills training in orthopaedics.

    Science.gov (United States)

    Lundine, Kristopher; Buckley, Richard; Hutchison, Carol; Lockyer, Jocelyn

    2008-06-01

    Communication skills play a key role in many aspects of both medical education and clinical patient care. The objectives of this study were to identify the key components of communication skills from the perspectives of both orthopaedic residents and their program directors and to understand how these skills are currently taught. This study utilized a mixed methods design. Quantitative data were collected with use of a thirty-item questionnaire distributed to all Canadian orthopaedic residents. Qualitative data were collected through focus groups with orthopaedic residents and semistructured interviews with orthopaedic program directors. One hundred and nineteen (37%) of 325 questionnaires were completed, twelve residents participated in two focus groups, and nine of sixteen program directors from across the country were interviewed. Both program directors and residents identified communication skills as being the accurate and appropriate use of language (i.e., content skills), not how the communication was presented (i.e., process skills). Perceived barriers to effective communication included time constraints and the need to adapt to the many personalities and types of people encountered daily in the hospital. Residents rarely have explicit training in communication skills. They rely on communication training implicitly taught through observation of their preceptors and clinical experience interacting with patients, peers, and other health-care professionals. Orthopaedic residents and program directors focus on content and flexibility within communication skills as well as on the importance of being concise. They value the development of communication skills in the clinical environment through experiential learning and role modeling. Education should focus on developing residents' process skills in communication. Care should be taken to avoid large-group didactic teaching sessions, which are perceived as ineffective.

  15. Treating natural disaster victims is dealing with shortages: An orthopaedics perspective.

    NARCIS (Netherlands)

    Dewo, Punto; Magetsari, Rahadyan; Busscher, Henk J.; van Horn, Jim R.; Verkerke, Gijsbertus Jacob

    2008-01-01

    During natural disasters such as earthquakes or tsunamis, most of the casualties are known to suffer from musculoskeletal injuries. This leads to an enormous need of orthopaedic (surgical) implants such as osteosynthesis plates, which are difficult to provide in developing countries that rely on

  16. Interstitial vaginal needle implantation in gynecological tumors : design and construction of applicator

    International Nuclear Information System (INIS)

    Kang, Seung Hee; Chun, Mi Son; Kang, Hae Jin; Jung, Chil; Son, Jeong Hyae

    1998-01-01

    It is not a simple task to achieve the ideal isodose curve with a standard vaginal applicator or single plane needle impant in the paravaginal tissue when primary or recurrent gynecological neoplasms(cervical cancers, vaginal cancers and vulvar cancers) are treated as a boost following external beam radiotherapy. The authors introduce the development and construction of a simple, inexpensive, customized applicator for volume implant to maximize the radiation dose to the tumor while minimizing the dose to the rectum and the bladder. Nine patients underwent Ir-192 transperineal interstitial implantation for either recurrent(5 cases)or primary(3 cases) cervical cancers or primary vaginal cancer(1 case) between August 1994 and February 1998 at Ajou university hospital. First 3 cases were performed with a single plane implant guided by digital palpation. Because of inadequate isodose coverage in the tumor volume in first 3 cases, we designed and constructed interstitial vaginal applicator for volume implant to mprove tumor dose distribution and homogeneity while sparing the surrounding normal tissue. Our applicators consist of vaginal obturator and perineal template that made of the clear acrylamide and dental mold material(Provil). The applicators were customized individually according to the tumor size and its location. Both HDR and LDR irradiation were given with these applicators accomodating 6 Fr needles(Microselectron, Nucletron). The pretreatment planning prior to actual implant was performed whenever possible. Needles can be inserted easily and evenly into the tumor volume through the holes of templates, requiring less efforts and time for the implant prodecure. Our applicators made of materials available from commercial vendors. These have an advantage that require easy procedure, and spend relatively short time to construct. Also it was possible to fabricate applicators to individualize according to the tumor size and its location and to achieve the ideal

  17. A Preliminary Study to Enhance the Tribological Performance of CoCrMo Alloy by Fibre Laser Remelting for Articular Joint Implant Applications

    Directory of Open Access Journals (Sweden)

    Chi-Wai Chan

    2018-03-01

    Full Text Available CoCrMo alloy has long been used as a pairing femoral head material for articular joint implant applications because of its biocompatibility and reliable tribological performance. However, friction and wear issues are still present for CoCrMo (metal/CoCrMo (metal or CoCrMo (metal/ultrahigh molecular weight polyethylene (UHMWPE (plastic pairs in clinical observations. The particulate wear debris generated from the worn surfaces of CoCrMo or UHMWPE can pose a severe threat to human tissues, eventually resulting in the failure of implants and the need for revision surgeries. As a result, a further improvement in tribological properties of this alloy is still needed, and it is of great interest to both the implant manufacturers and clinical surgeons. In this study, the surface of CoCrMo alloy was laser-treated by a fibre laser system in an open-air condition (i.e., no gas chamber required. The CoCrMo surfaces before and after laser remelting were analysed and characterised by a range of mechanical tests (i.e., surface roughness measurement and Vickers micro-hardness test and microstructural analysis (i.e., XRD phase detection. The tribological properties were assessed by pin-on-disk tribometry and dynamic light scattering (DLS. Our results indicate that the laser-treated surfaces demonstrated a friction-reducing effect for all the tribopairs (i.e., CoCrMo against CoCrMo and CoCrMo against UHHMWPE and enhanced wear resistance for the CoCrMo/CoCrMo pair. Such beneficial effects are chiefly attributable to the presence of the laser-formed hard coating on the surface. Laser remelting possesses several competitive advantages of being a clean, non-contact, fast, highly accurate and automated process compared to other surface coating methods. The promising results of this study point to the possibility that laser remelting can be a practical and effective surface modification technique to further improve the tribological performance of Co

  18. TH-B-204-02: Application of Implanted Markers in Proton Therapy

    International Nuclear Information System (INIS)

    Park, S.

    2016-01-01

    Implanted markers as target surrogates have been widely used for treatment verification, as they provide safe and reliable monitoring of the inter- and intra-fractional target motion. The rapid advancement of technology requires a critical review and recommendation for the usage of implanted surrogates in current field. The symposium, also reporting an update of AAPM TG 199 - Implanted Target Surrogates for Radiation Treatment Verification, will be focusing on all clinical aspects of using the implanted target surrogates for treatment verification and related issues. A wide variety of markers available in the market will be first reviewed, including radiopaque markers, MRI compatible makers, non-migrating coils, surgical clips and electromagnetic transponders etc. The pros and cons of each kind will be discussed. The clinical applications of implanted surrogates will be presented based on different anatomical sites. For the lung, we will discuss gated treatments and 2D or 3D real-time fiducial tracking techniques. For the prostate, we will be focusing on 2D-3D, 3D-3D matching and electromagnetic transponder based localization techniques. For the liver, we will review techniques when patients are under gating, shallow or free breathing condition. We will review techniques when treating challenging breast cancer as deformation may occur. Finally, we will summarize potential issues related to the usage of implanted target surrogates with TG 199 recommendations. A review of fiducial migration and fiducial derived target rotation in different disease sites will be provided. The issue of target deformation, especially near the diaphragm, and related suggestions will be also presented and discussed. Learning Objectives: Knowledge of a wide variety of markers Knowledge of their application for different disease sites Understand of issues related to these applications Z. Wang: Research funding support from Brainlab AG Q. Xu: Consultant for Accuray; Q. Xu, I am a consultant

  19. TH-B-204-02: Application of Implanted Markers in Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Park, S. [McLaren-Flint, Flint, MI (United States)

    2016-06-15

    Implanted markers as target surrogates have been widely used for treatment verification, as they provide safe and reliable monitoring of the inter- and intra-fractional target motion. The rapid advancement of technology requires a critical review and recommendation for the usage of implanted surrogates in current field. The symposium, also reporting an update of AAPM TG 199 - Implanted Target Surrogates for Radiation Treatment Verification, will be focusing on all clinical aspects of using the implanted target surrogates for treatment verification and related issues. A wide variety of markers available in the market will be first reviewed, including radiopaque markers, MRI compatible makers, non-migrating coils, surgical clips and electromagnetic transponders etc. The pros and cons of each kind will be discussed. The clinical applications of implanted surrogates will be presented based on different anatomical sites. For the lung, we will discuss gated treatments and 2D or 3D real-time fiducial tracking techniques. For the prostate, we will be focusing on 2D-3D, 3D-3D matching and electromagnetic transponder based localization techniques. For the liver, we will review techniques when patients are under gating, shallow or free breathing condition. We will review techniques when treating challenging breast cancer as deformation may occur. Finally, we will summarize potential issues related to the usage of implanted target surrogates with TG 199 recommendations. A review of fiducial migration and fiducial derived target rotation in different disease sites will be provided. The issue of target deformation, especially near the diaphragm, and related suggestions will be also presented and discussed. Learning Objectives: Knowledge of a wide variety of markers Knowledge of their application for different disease sites Understand of issues related to these applications Z. Wang: Research funding support from Brainlab AG Q. Xu: Consultant for Accuray; Q. Xu, I am a consultant

  20. In vivo heating pattern of an implantable single loop applicator measured at S-band

    International Nuclear Information System (INIS)

    Feldman, A.; Roelofs, T.; Weaver, P.; Maturan, A.

    1984-01-01

    The authors have measured the temperatures achieved by an implantable applicator buried in both normal and tumor tissue. The temperature distribution correlated with that measured in phantom material; high temperatures were achieved at the center of the coil, lower temperatures near the edges but within the coil, and much lower temperatures outside the coil. Sheathed in PTFE teflon the coil is compatible with tissue for long-term implantation. This device appeared well-suited for long-term invasive hyperthermia since it delivered a heat dose to a specific tumor volume while sparing the surrounding normal tissue and was found to be biocompatible with normal tissue

  1. Application of triple-crystal diffractometry for study of ion implanted layer defects

    International Nuclear Information System (INIS)

    Shcherbachev, K.D.; Bublik, V.T.

    2000-01-01

    Application of a triple-crystal arrangement, unlike traditionally used double-crystal one, allowed one to separate coherent and incoherent scattering components and to improve a resolution significantly. Advantages of the triple-crystal X-ray diffractometry to study defects in ion-implanted layers are demonstrated by example of characterisation of Si-GaAs(100) wafers doped by Si + with energy of 50 keV and does of 1x10 15 and 1x10 14 cm -2 . To explain a behaviour of point defects after implantation and annealing the analysis of strain depth profile was used. Two processes are shown to play a key role in formation of the distorted layer during implantation. The first one is an annihilation of Frenkel pairs components that decreases the total point defects concentration. Another one is a sink of more mobile interstitials to the surface that leads to formation of the thin subsurface layer enriched by vacancies [ru

  2. Ti-13Nb-13Zr production for implant applications

    International Nuclear Information System (INIS)

    Henriques, V.A.R.; Cairo, C.A.A.

    2009-01-01

    Powder metallurgy (P/M) of titanium alloys may lead to the obtainment of components having weak-to-absent textures, uniform grain structure and higher homogeneity compared with conventional wrought products. The production of the Ti-13Nb-13Zr alloy by P/M starting from blended elemental (BE) powders is a cost-effective route considering its versatility and also for allowing the manufacture of complex parts. This alloy due its high biocompatibility and lower modulus of elasticity is a promising candidate for implants fabrication. Samples were produced by mixing of initial metallic powders followed by uniaxial and cold isostatic pressing with subsequent densification by sintering in order to identify the microstructural evolution. Sintered samples were characterized for phase composition, microstructure, microhardness and density. The surface topography of the samples was studied by means of atomic force microscopy (AFM). It was shown that the route is adequate to reach high densities with homogeneous microstructure. Representative AFM images allowed distinguishing a lamellar structure caused by the different phases that are present in the surface of the specimens. (author)

  3. Planning for life after orthopaedics.

    Science.gov (United States)

    Barr, Joseph S; McCaslin, Michael J; Hinds, Cynthia K

    2014-01-01

    The word retirement is going out of fashion. Many orthopaedic surgeons want to work in some capacity when they stop performing surgery. Making a smooth transition from a busy orthopaedic practice to alternative work demands advanced planning. The surgeon must consider personal issues that involve how to use human capital (his or her accumulated knowledge and experience). New ventures, hobbies, travel, and spending time with family and friends are some possibilities. Plans for slowing down or leaving the practice should be discussed and agreed on well ahead of time. Agreements for buyouts may be difficult to work out and will require creative thinking. The solo practitioner can close the practice or hire a successor. Financial planning is perhaps the most important consideration and should be started by approximately age 40. It is recommended that the surgeon develop a portfolio of secure investments and annuities to provide adequate income for as long as is needed and then to turn the residual income to one's family, favorite charities, or other desired cause. A team of competent advisors is needed to help develop and achieve one's goals, create financial security, and provide the discipline to carry out the needed planning for life after orthopaedics.

  4. Evolution and acceptability of medical applications of RFID implants among early users of technology.

    Science.gov (United States)

    Smith, Alan D

    2007-01-01

    RFID as a wireless identification technology that may be combined with microchip implants have tremendous potential in today's market. Although these implants have their advantages and disadvantages, recent improvements how allowed for implants designed for humans. Focus was given to the use of RFID tags and its effects on technology and CRM through a case study on VeriChip, the only corporation to hold the rights and the patent to the implantable chip for humans, and an empirically based study on working professionals to measure perceptions by early adopters of such technology. Through hypotheses-testing procedures, it was found that although some resistance to accept microchip implants was found in several applications, especially among gender, it was totally expected that healthcare and medical record keeping activities would be universally treated in a positive light and the use of authorities (namely governmental agencies) would be equally treated in a negative light by both sexes. Future trends and recommendations are presented along with statistical results collected through personal interviews.

  5. Factors driving physician-hospital alignment in orthopaedic surgery.

    Science.gov (United States)

    Page, Alexandra E; Butler, Craig A; Bozic, Kevin J

    2013-06-01

    The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging. Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals. We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physician-hospital alignment. Literature searches were performed in both MEDLINE(®) and Health Business™ Elite. Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services. Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care.

  6. Regenerative orthopaedics: in vitro, in vivo...in silico.

    Science.gov (United States)

    Geris, Liesbet

    2014-09-01

    In silico, defined in analogy to in vitro and in vivo as those studies that are performed on a computer, is an essential step in problem-solving and product development in classical engineering fields. The use of in silico models is now slowly easing its way into medicine. In silico models are already used in orthopaedics for the planning of complicated surgeries, personalised implant design and the analysis of gait measurements. However, these in silico models often lack the simulation of the response of the biological system over time. In silico models focusing on the response of the biological systems are in full development. This review starts with an introduction into in silico models of orthopaedic processes. Special attention is paid to the classification of models according to their spatiotemporal scale (gene/protein to population) and the information they were built on (data vs hypotheses). Subsequently, the review focuses on the in silico models used in regenerative orthopaedics research. Contributions of in silico models to an enhanced understanding and optimisation of four key elements-cells, carriers, culture and clinics-are illustrated. Finally, a number of challenges are identified, related to the computational aspects but also to the integration of in silico tools into clinical practice.

  7. Social Media in Pediatric Orthopaedics.

    Science.gov (United States)

    Lander, Sarah T; Sanders, James O; Cook, Peter C; O'Malley, Natasha T

    Internet searches and social media utilization in health care has exploded over the past 5 years, and patients utilize it to gain information on their health conditions and physicians. Social media has the potential to serve as a means for education, communication, and marketing in all health care specialties. Physicians are sometimes reluctant to engage because of concerns of privacy, litigation, and lack of experience with this modality. Many surgical subspecialties have capitalized on social media but no study to date has examined the specific footprint of pediatric orthopaedic surgeons in this realm. We aim to quantify the utilization of individual social media platforms by pediatric orthopaedic surgeons, and identify any differences between private and hospital-based physicians, but also regional differences. Using the Pediatric Orthopaedic Society of North America Member Directory, each active member's social media presence was reviewed through an Internet search. Members were stratified on the basis of practice model and geographic location. Individual Internet searches, social media sites, and number of publications were reviewed for social media presence. Of 987 Pediatric Orthopaedic Society of North America members, 95% had a professional webpage, 14.8% a professional Facebook page, 2.2% a professional Twitter page, 36.8% a LinkedIn profile, 25.8% a ResearchGate profile, 33% at least 1 YouTube. Hospital-based physicians had a lower mean level of utilization of social media compared with their private practice peers, and a higher incidence of Pubmed publications. Private practice physicians had double the social media utilization. Regional differences reveal that practicing Pediatric Orthopaedists in the Northeast had increased utilization of ResearchGate and LinkedIn and the West had the lowest mean social media utilization levels. The rapid expansion of social media usage by patients and their family members is an undeniable force affecting the health

  8. Tribology considerations for hip joint articulations in relation to the "new orthopaedic patient".

    Science.gov (United States)

    Rieker, C B

    2006-01-01

    The purpose of this review is to examine alternative bearings used in total hip arthroplasty (THA) and discuss the specific tribologic needs of the "New Orthopaedic Patient". As orthopaedic patients today are younger and more active, there is a clear need for hip joint implants and articulations minimising the amount of wear and guarantying better stability. Recent modern developments in tribology with highly cross-linked polyethylenes and hard-on-hard bearings allow the safe and effective use of larger diameter articulations in THA.

  9. Plasma Immersion Ion Implantation with Solid Targets for Space and Aerospace Applications

    International Nuclear Information System (INIS)

    Oliveira, R. M.; Goncalves, J. A. N.; Ueda, M.; Silva, G.; Baba, K.

    2009-01-01

    This paper describes successful results obtained by a new type of plasma source, named as Vaporization of Solid Targets (VAST), for treatment of materials for space and aerospace applications, by means of plasma immersion ion implantation and deposition (PIII and D). Here, the solid element is vaporized in a high pressure glow discharge, being further ionized and implanted/deposited in a low pressure cycle, with the aid of an extra electrode. First experiments in VAST were run using lithium as the solid target. Samples of silicon and aluminum alloy (2024) were immersed into highly ionized lithium plasma, whose density was measured by a double Langmuir probe. Measurements performed with scanning electron microscopy (SEM) showed clear modification of the cross-sectioned treated silicon samples. X-ray photoelectron spectroscopy (XPS) analysis revealed that lithium was implanted/deposited into/onto the surface of the silicon. Implantation depth profiles may vary according to the condition of operation of VAST. One direct application of this treatment concerns the protection against radiation damage for silicon solar cells. For the case of the aluminum alloy, X-ray diffraction analysis indicated the appearance of prominent new peaks. Surface modification of A12024 by lithium implantation/deposition can lower the coefficient of friction and improve the resistance to fatigue of this alloy. Recently, cadmium was vaporized and ionized in VAST. The main benefit of this element is associated with the improvement of corrosion resistance of metallic substrates. Besides lithium and cadmium, VAST allows to performing PIII and D with other species, leading to the modification of the near-surface of materials for distinct purposes, including applications in the space and aerospace areas.

  10. Transcription factor and bone marrow stromal cells in osseointegration of dental implants

    Directory of Open Access Journals (Sweden)

    SG Yan

    2018-05-01

    Full Text Available Titanium implants are widely used in dental clinics and orthopaedic surgery. However, bone formation surrounding the implant is relatively slow after inserting the implant. The current study assessed the effects of bone marrow stromal cells (BMSCs with forced expression of special AT-rich sequence-binding protein 2 (SATB2 on the osseointegration of titanium implants. To determine whether SATB2 overexpression in BMSCs can enhance the osseointegration of implants, BMSCs were infected with the retrovirus encoding Satb2 (pBABE-Satb2 and were locally applied to bone defects before implanting the titanium implants in the mouse femur. Seven and twenty-one days after implantation, the femora were isolated for immunohistochemical (IHC staining, haematoxylin eosin (H&E staining, real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR, and micro-computed tomography (μCT analysis. IHC staining analysis revealed that SATB2-overexpressing BMSCs were intensely distributed in the bone tissue surrounding the implant. Histological analysis showed that SATB2-overexpressing BMSCs significantly enhanced new bone formation and bone-to-implant contact 3 weeks after implantation. Real-time qRT-PCR results showed that the local delivery of SATB2-overexpressing BMSCs enhanced expression levels of potent osteogenic transcription factors and bone matrix proteins in the implantation sites. μCT analysis demonstrated that SATB2-overexpressing BMSCs significantly increased the density of the newly formed bone surrounding the implant 3 weeks post-operatively. These results conclude that local delivery of SATB2-overexpressing BMSCs significantly accelerates osseointegration of titanium implants. These results provide support for future pharmacological and clinical applications of SATB2, which accelerates bone regeneration around titanium implants.

  11. Plasma-based ion implantation and deposition: A review of physics,technology, and applications

    Energy Technology Data Exchange (ETDEWEB)

    Pelletier, Jacques; Anders, Andre

    2005-05-16

    After pioneering work in the 1980s, plasma-based ion implantation (PBII) and plasma-based ion implantation and deposition (PBIID) can now be considered mature technologies for surface modification and thin film deposition. This review starts by looking at the historical development and recalling the basic ideas of PBII. Advantages and disadvantages are compared to conventional ion beam implantation and physical vapor deposition for PBII and PBIID, respectively, followed by a summary of the physics of sheath dynamics, plasma and pulse specifications, plasma diagnostics, and process modeling. The review moves on to technology considerations for plasma sources and process reactors. PBII surface modification and PBIID coatings are applied in a wide range of situations. They include the by-now traditional tribological applications of reducing wear and corrosion through the formation of hard, tough, smooth, low-friction and chemically inert phases and coatings, e.g. for engine components. PBII has become viable for the formation of shallow junctions and other applications in microelectronics. More recently, the rapidly growing field of biomaterial synthesis makes used of PBII&D to produce surgical implants, bio- and blood-compatible surfaces and coatings, etc. With limitations, also non-conducting materials such as plastic sheets can be treated. The major interest in PBII processing originates from its flexibility in ion energy (from a few eV up to about 100 keV), and the capability to efficiently treat, or deposit on, large areas, and (within limits) to process non-flat, three-dimensional workpieces, including forming and modifying metastable phases and nanostructures. We use the acronym PBII&D when referring to both implantation and deposition, while PBIID implies that deposition is part of the process.

  12. The Core Competencies for General Orthopaedic Surgeons.

    Science.gov (United States)

    Kellam, James F; Archibald, Douglas; Barber, James W; Christian, Eugene P; D'Ascoli, Richard J; Haynes, Richard J; Hecht, Suzanne S; Hurwitz, Shepard R; Kellam, James F; McLaren, Alexander C; Peabody, Terrance D; Southworth, Stephen R; Strauss, Robert W; Wadey, Veronica M R

    2017-01-18

    With the changing delivery of orthopaedic surgical care, there is a need to define the knowledge and competencies that are expected of an orthopaedist providing general and/or acute orthopaedic care. This article provides a proposal for the knowledge and competencies needed for an orthopaedist to practice general and/or acute care orthopaedic surgery. Using the modified Delphi method, the General Orthopaedic Competency Task Force consisting of stakeholders associated with general orthopaedic practice has proposed the core knowledge and competencies that should be maintained by orthopaedists who practice emergency and general orthopaedic surgery. For relevancy to clinical practice, 2 basic sets of competencies were established. The assessment competencies pertain to the general knowledge needed to evaluate, investigate, and determine an overall management plan. The management competencies are generally procedural in nature and are divided into 2 groups. For the Management 1 group, the orthopaedist should be competent to provide definitive care including assessment, investigation, initial or emergency care, operative or nonoperative care, and follow-up. For the Management 2 group, the orthopaedist should be competent to assess, investigate, and commence timely non-emergency or emergency care and then either transfer the patient to the appropriate subspecialist's care or provide definitive care based on the urgency of care, exceptional practice circumstance, or individual's higher training. This may include some higher-level procedures usually performed by a subspecialist, but are consistent with one's practice based on experience, practice environment, and/or specialty interest. These competencies are the first step in defining the practice of general orthopaedic surgery including acute orthopaedic care. Further validation and discussion among educators, general orthopaedic surgeons, and subspecialists will ensure that these are relevant to clinical practice. These

  13. Aarhus Regenerative Orthopaedics Symposium (AROS)

    DEFF Research Database (Denmark)

    Foldager, Casper B.; Bendtsen, Michael; Berg, Lise C.

    2016-01-01

    to musculoskeletal pain and disability. The Aarhus Regenerative Orthopaedics Symposium (AROS) 2015 was motivated by the need to address regenerative challenges in an ageing population by engaging clinicians, basic scientists, and engineers. In this position paper, we review our contemporary understanding of societal......, patient-related, and basic science-related challenges in order to provide a reasoned roadmap for the future to deal with this compelling and urgent healthcare problem. © 2017 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation....

  14. In-situ photopolymerized and monitored implants: successful application to an intervertebral disc replacement

    Science.gov (United States)

    Schmocker, Andreas M.; Khoushabi, Azadeh; Bourban, Pierre-Etienne; Schizas, Constantin; Pioletti, Dominique; Moser, Christophe

    2016-02-01

    Photopolymerization is a common method to harden materials initially in a liquid state. A surgeon can directly trigger the solidification of a dental implant or a bone or tissue filler by using ultra-violet light. Traditionally, photopolymerization has been used mainly in dentistry. Over the last decade advances in material development including a wide range of biocompatible gel- and cement-systems open up a new avenue for in-situ photopolymerization. We designed a miniaturized light probe where a photoactive material can be 1) mixed, pressurized and injected 2) photopolymerized or photoactivated and 3) monitored during the chemical reaction. The device enables surgeries to be conducted through a hole smaller than 500 μm in diameter. Using a combination of Raman and fluorescence spectroscopy, the current state of the photopolymerization was inferred and monitored in real time within an in-vitro tissue model. It was also possible to determine roughly the position of the probe within the tissue cavity by analysing the fluorescence signal. Using the technique hydrogels were successfully implanted into a bovine intervertebral disc model. Mechanical tests could not obstruct the functionality of the implant. Finally, the device was also used for other application such as the implantation of a hydrogel into an aneurysm tissue cavity which will be presented at the conference.

  15. Application and further development of ion implantation for very large scale integration. Pt. 2

    International Nuclear Information System (INIS)

    Haberger, K.; Ryssel, H.; Hoffmann, K.

    1982-08-01

    Ion implantation, used as a dopant technology, provides very well-controlled doping but is dependent on the usual masking techniques. For purposes of pattern generation, it would be desirable to utilize the digital controllability of a finely-focused ion beam. In this report, the suitability of a finely-focused ion beam for the purpose of direct writing implantation has been investigated. For this study, an ion accelerator was equipped with a computer-controlled fine-focusing system. Using this system it was possible to implant Van-der-Pauw test structures, resistors, and bipolar transistors, which were then electrically measured. The smallest line width was approx. 1 μm. A disadvantage is represented by the long implantation times resulting with present ion sources. Another VLSI-relevant area of application for this finely-focused ion-beam-writing system is photoresist exposure, as an alternative to electron-beam lithography, making possible the realization of very small structures without proximity effects and with a significantly higher resist sensitivity. (orig.) [de

  16. International Combined Orthopaedic Research Societies: A model for international collaboration to promote orthopaedic and musculoskeletal research

    Directory of Open Access Journals (Sweden)

    Theodore Miclau

    2014-10-01

    Full Text Available In October 2013, the International Combined Orthopaedic Research Societies (ICORS; http://i-cors.org was founded with inaugural member organisations from the previous Combined Orthopaedic Research Society, which had sponsored combined meetings for more than 2 decades. The ICORS is dedicated to the stimulation of orthopaedic and musculoskeletal research in fields such as biomedical engineering, biology, chemistry, and veterinary and human clinical research. The ICORS seeks to facilitate communication with member organisations to enhance international research collaborations and to promote the development of new international orthopaedic and musculoskeletal research organisations. Through new categories of membership, the ICORS represents the broadest coalition of orthopaedic research organisations globally.

  17. Fibre laser nitriding of titanium and its alloy in open atmosphere for orthopaedic implant applications: Investigations on surface quality, microstructure and tribological properties

    DEFF Research Database (Denmark)

    Chan, Chi-Wai; Lee, Seunghwan; Smith, Graham C.

    2017-01-01

    surfaces, such as the tapered surfacein a femoral stemor the ball-shaped surface in a femoral head. To tackle this problem, a direct laser nitridingprocess in open atmosphere was performed on commercially pure titanium (grade 2, TiG2) and Ti6Al4V alloy(grade 5, TiG5) using a continuous-wave (CW) fibre...... distribution of wear debris, were carefully characterized and compared. The experimental resultsshowed that TiG2 and TiG5 reacted differently with the laser radiation at 1.06 μm wavelength in laser nitridingas evidenced by substantial differences in the microstructure, and surface colour and morphology....... Furthermore,both friction andwear properties were strongly affected by the hardness and microstructure of titaniumsamplesand direct laser nitriding led to substantial improvements in their wear resistant properties. Between the twotypes of titanium samples, bare TiG2 showed higher friction forces and wear...

  18. 1 venous thromboembolism in orthopaedics references

    African Journals Online (AJOL)

    2008-05-23

    2004; 126: 338-400S. 3. American Academy of Orthopaedic Surgeons. American Academy of orthopaedic Surgeons clinical guidelines on prevention of symptomatic pulmonary embolism in patients undergoing total hip or knee arthroplasty.www.aaos.org/Research/ guidelines/PE_guideline. Pdf (accessed May 23, 2008). 4.

  19. Mentorship in orthopaedic and trauma residency training ...

    African Journals Online (AJOL)

    Background: Mentorship is important in residency training as it is necessary for personal and professional development of the resident trainees. Objectives: This study documents mentorship in orthopaedic residency training programme in Nigeria by assessing the awareness of orthopaedic residents on the role of a mentor, ...

  20. Orthopaedic research and education foundation and industry.

    Science.gov (United States)

    Wurth, Gene R; Sherr, Judy H; Coffman, Thomas M

    2003-07-01

    Members of orthopaedic industry commit a significant amount of funds each year to support research and education programs that are directly related to their product(s). In addition, industry supports organizations such as the Orthopaedic Research and Education Foundation. The relationship between the Orthopaedic Research and Education Foundation and industry began in the early 1980s. The support to the Orthopaedic Research and Education Foundation from industry primarily has come in the form of unrestricted grants. These grants best can be looked at as an investment rather than a contribution. This form of giving, once called corporate philanthropy is more accurately referred to as strategic philanthropy. Members of industry make these investments to enhance their reputations, build brand awareness, market their products and services, improve employee morale, increase customer loyalty, and establish strategic alliances. The specialty of orthopaedics is among the leaders in medicine in the amount of funding raised within the specialty for research and education programs. This is because of the amount of support from members of industry and the surgeons. During the past 15 years, 40% of the annual support to the Orthopaedic Research and Education Foundation has come from industry and the balance has come from surgeons and members of lay public. Future industry support of the Orthopaedic Research and Education Foundation and other organizations within the specialty of orthopaedics will be dependent on the continued demonstration of tangible returns in areas described.

  1. Nigerian Journal of Orthopaedics and Trauma

    African Journals Online (AJOL)

    The Nigerian Journal of Orthopaedics and Trauma publishes original papers, review articles and case reports on pathology, anaesthesia, orthopaedics and trauma. Vol 12, No 1 (2013). DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or Fee Access. Table of Contents. Articles. Management of ...

  2. Surgical site infection among patients undergone orthopaedic ...

    African Journals Online (AJOL)

    Surgical site infection among patients undergone orthopaedic surgery at Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania. ... of surgical site infection at Muhimbili Orthopedic Institute was high. This was associated with more than 2 hours length of surgery, lack of prophylaxis use, and pre-operative hospital stay.

  3. Do Orthopaedic Surgeons Acknowledge Uncertainty?

    Science.gov (United States)

    Teunis, Teun; Janssen, Stein; Guitton, Thierry G; Ring, David; Parisien, Robert

    2016-06-01

    Much of the decision-making in orthopaedics rests on uncertain evidence. Uncertainty is therefore part of our normal daily practice, and yet physician uncertainty regarding treatment could diminish patients' health. It is not known if physician uncertainty is a function of the evidence alone or if other factors are involved. With added experience, uncertainty could be expected to diminish, but perhaps more influential are things like physician confidence, belief in the veracity of what is published, and even one's religious beliefs. In addition, it is plausible that the kind of practice a physician works in can affect the experience of uncertainty. Practicing physicians may not be immediately aware of these effects on how uncertainty is experienced in their clinical decision-making. We asked: (1) Does uncertainty and overconfidence bias decrease with years of practice? (2) What sociodemographic factors are independently associated with less recognition of uncertainty, in particular belief in God or other deity or deities, and how is atheism associated with recognition of uncertainty? (3) Do confidence bias (confidence that one's skill is greater than it actually is), degree of trust in the orthopaedic evidence, and degree of statistical sophistication correlate independently with recognition of uncertainty? We created a survey to establish an overall recognition of uncertainty score (four questions), trust in the orthopaedic evidence base (four questions), confidence bias (three questions), and statistical understanding (six questions). Seven hundred six members of the Science of Variation Group, a collaboration that aims to study variation in the definition and treatment of human illness, were approached to complete our survey. This group represents mainly orthopaedic surgeons specializing in trauma or hand and wrist surgery, practicing in Europe and North America, of whom the majority is involved in teaching. Approximately half of the group has more than 10 years

  4. Radiologic examination of orthopaedics. Methods and techniques

    International Nuclear Information System (INIS)

    Hafner, E.; Meuli, H.C.

    1976-01-01

    This volume describes in detail radiological examinations of the skeleton modern procedures in orthopaedic surgery. Special emphasis is given to functional examination techniques based upon the authors' extensive work on standardized radiological examinations best suited to the needs of orthopaedic surgeons. These techniques were developed at the Radiodiagnostic Department of the Central Radiological Clinic, Bern University, in cooperation with the University Clinic of Orthopaedics and Surgery of the Locomotor System. Exposure techniques are explained concisely, yet with extraordinary precision and attention to detail. They have proved highly successful in teaching programs for X-ray technicians and as standard examination techniques for many hospitals, X-ray departments, orthopaedic units, and private clinics. Recommended for orthopaedic surgeons, radiologists, general surgeons, and X-ray technicians, this definitive treatise, with its superb X-ray reproductions and complementary line drawings, explains how to achieve improved diagnoses and standardized control with the least possible radiation exposure to the patient

  5. Rapid Prototyping in Orthopaedic Surgery: A User's Guide

    OpenAIRE

    Frame, Mark; Huntley, James S.

    2012-01-01

    Rapid prototyping (RP) is applicable to orthopaedic problems involving three dimensions, particularly fractures, deformities, and reconstruction. In the past, RP has been hampered by cost and difficulties accessing the appropriate expertise. Here we outline the history of rapid prototyping and furthermore a process using open-source software to produce a high fidelity physical model from CT data. This greatly mitigates the expense associated with the technique, allowing surgeons to produce pr...

  6. A review of virtual reality based training simulators for orthopaedic surgery.

    Science.gov (United States)

    Vaughan, Neil; Dubey, Venketesh N; Wainwright, Thomas W; Middleton, Robert G

    2016-02-01

    This review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 hip replacements pre-operative planning tools were analysed, plus 9 hip trauma fracture training simulators. Additionally 9 knee arthroscopy simulators and 8 other orthopaedic simulators were included for comparison. The findings are that for orthopaedic surgery simulators in general, there is increasing use of patient-specific virtual models which reduce the learning curve. Modelling is also being used for patient-specific implant design and manufacture. Simulators are being increasingly validated for assessment as well as training. There are very few training simulators available for hip replacement, yet more advanced virtual reality is being used for other procedures such as hip trauma and drilling. Training simulators for hip replacement and orthopaedic surgery in general lag behind other surgical procedures for which virtual reality has become more common. Further developments are required to bring hip replacement training simulation up to date with other procedures. This suggests there is a gap in the market for a new high fidelity hip replacement and resurfacing training simulator. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

  7. Chiron Vision files FDA application to market intraocular implant for CMV retinitis. Food and Drug Administration.

    Science.gov (United States)

    1995-07-01

    Chiron Corporation and Hoffman-LaRoche announced a filing of a New Drug Application with the Food and Drug Administration (FDA) to market Vitrasert, its intraocular implant which delivers ganciclovir directly to the eye for treatment of CMV retinitis. Clinical trials show that Vitrasert offers a clinical improvement versus intravenous ganciclovir in further delaying progression of CMV retinitis in the treated eye. One study reported that the median time to progression of CMV retinitis was 186 days for eyes receiving Vitrasert compared to 72 days for eyes receiving intravenous ganciclovir therapy. Chiron's intraocular implant contains ganciclovir embedded in a polymer-based system that slowly releases the drug into the eye for up to eight months. Two additional trials are underway. For further information contact the Professional Services Group at Chiron Corporation at (800) 244-7668, select 2.

  8. High energy ion implantation for semiconductor application at Fraunhofer-AIS, Erlangen

    International Nuclear Information System (INIS)

    Frey, L.; Bogen, S.; Gong, L.; Jung, W.; Ryssel, H.; Gyulai, J.

    1992-01-01

    A new high energy ion implanter for research and development in semiconductor technology was put into operation at the Fraunhofer Institute in Erlangen. The system is used for generation of ion beams in the energy range from 100 keV to more than 6 MeV with currents up to 100 μA. A large variety of ion species can be implanted into silicon wafers with diameters up to 200 mm (with cassette-to-cassette loading up to 150 mm). The performance characteristics of the system are described with special emphasis on the end stations. In a first series of experiments, the range distributions of boron, phosphorus and arsenic in silicon have been measured for energies from 0.2 MeV to 10 MeV in order to get a data set for future applications. The profiles are compared to simulated data. First experimental results on lateral distribution of the dopant species are presented. (orig.)

  9. A hardware-algorithm co-design approach to optimize seizure detection algorithms for implantable applications.

    Science.gov (United States)

    Raghunathan, Shriram; Gupta, Sumeet K; Markandeya, Himanshu S; Roy, Kaushik; Irazoqui, Pedro P

    2010-10-30

    Implantable neural prostheses that deliver focal electrical stimulation upon demand are rapidly emerging as an alternate therapy for roughly a third of the epileptic patient population that is medically refractory. Seizure detection algorithms enable feedback mechanisms to provide focally and temporally specific intervention. Real-time feasibility and computational complexity often limit most reported detection algorithms to implementations using computers for bedside monitoring or external devices communicating with the implanted electrodes. A comparison of algorithms based on detection efficacy does not present a complete picture of the feasibility of the algorithm with limited computational power, as is the case with most battery-powered applications. We present a two-dimensional design optimization approach that takes into account both detection efficacy and hardware cost in evaluating algorithms for their feasibility in an implantable application. Detection features are first compared for their ability to detect electrographic seizures from micro-electrode data recorded from kainate-treated rats. Circuit models are then used to estimate the dynamic and leakage power consumption of the compared features. A score is assigned based on detection efficacy and the hardware cost for each of the features, then plotted on a two-dimensional design space. An optimal combination of compared features is used to construct an algorithm that provides maximal detection efficacy per unit hardware cost. The methods presented in this paper would facilitate the development of a common platform to benchmark seizure detection algorithms for comparison and feasibility analysis in the next generation of implantable neuroprosthetic devices to treat epilepsy. Copyright © 2010 Elsevier B.V. All rights reserved.

  10. The 2007 ABJS Marshall Urist Award: The impact of direct-to-consumer advertising in orthopaedics.

    Science.gov (United States)

    Bozic, Kevin J; Smith, Amanda R; Hariri, Sanaz; Adeoye, Sanjo; Gourville, John; Maloney, William J; Parsley, Brian; Rubash, Harry E

    2007-05-01

    Direct-to-consumer advertising (DTCA) has become an influential factor in healthcare delivery in the United States. We evaluated the influence of DTCA on surgeon and patient opinions and behavior in orthopaedics by surveying orthopaedic surgeons who perform hip and knee arthroplasties and patients who were scheduled to have hip or knee arthro-plasty. Respondents were asked for their opinions of and experiences with DTCA, including the influence of DTCA on surgeon and patient decision making. Greater than 98% of surgeon respondents had experience with patients who were exposed to DTCA. The majority of surgeon respondents reported DTCA had an overall negative impact on their practice and their interaction with patients (74%), and their patients often were confused or misinformed about the appropriate treatment for their condition based on an advertisement (77%). Fifty-two percent of patient respondents recalled seeing or hearing advertisements related to hip or knee arthroplasty. These patients were more likely to request a specific type of surgery or brand of implant from their surgeon and to see more than one surgeon before deciding to have surgery. Direct-to-consumer advertising seems to play a substantial role in surgeon and patient decision making in orthopaedics. Future efforts should be aimed at improving the quality and accuracy of information contained in consumer-directed advertisements related to orthopaedic implants and procedures.

  11. Does Residency Selection Criteria Predict Performance in Orthopaedic Surgery Residency?

    Science.gov (United States)

    Raman, Tina; Alrabaa, Rami George; Sood, Amit; Maloof, Paul; Benevenia, Joseph; Berberian, Wayne

    2016-04-01

    goal in analyzing these data was to provide residency programs at large a sense of which criteria may be "high yield" in ranking applicants by analyzing data from within our own pool of residents. Similar studies across a broader scope of programs are warranted to confirm applicability of our findings. The continually emerging complexities of the field of orthopaedic surgery lend increasing importance to future work on the appropriate selection and training of orthopaedic residents.

  12. Where Are the Women in Orthopaedic Surgery?

    Science.gov (United States)

    Rohde, Rachel S; Wolf, Jennifer Moriatis; Adams, Julie E

    2016-09-01

    Although women account for approximately half of the medical students in the United States, they represent only 13% of orthopaedic surgery residents and 4% of members of the American Academy of Orthopaedic Surgeons (AAOS). Furthermore, a smaller relative percentage of women pursue careers in orthopaedic surgery than in any other subspecialty. Formal investigations regarding the gender discrepancy in choice of orthopaedic surgery are lacking. (1) What reasons do women orthopaedic surgeons cite for why they chose this specialty? (2) What perceptions do women orthopaedic surgeons think might deter other women from pursuing this field? (3) What role does early exposure to orthopaedics and mentorship play in this choice? (4) What professional and personal choices do women in orthopaedics make, and how might this inform students who are choosing a career path? A 21-question survey was emailed to all active, candidate, and resident members of the Ruth Jackson Orthopaedic Society (RJOS, n = 556). RJOS is the oldest surgical women's organization incorporated in the United States. An independent orthopaedic specialty society, RJOS supports leadership training, mentorship, grant opportunities, and advocacy for its members and promotes sex-related musculoskeletal research. Although not all women in orthopaedic practice or training belong to RJOS, it is estimated that 42% of women AAOS fellows are RJOS members. Questions were formulated to determine demographics, practice patterns, and lifestyle choices of women who chose orthopaedic surgery as a specialty. Specifically, we evaluated the respondents' decisions about their careers and their opinions of why more women do not choose this field. For the purpose of this analysis, the influences and dissuaders were divided into three major categories: personal attributes, experience/exposure, and work/life considerations. The most common reasons cited for having chosen orthopaedic surgery were enjoyment of manual tasks (165 of 232

  13. Developing a mobile application to better inform patients and enable effective consultation in implant dentistry

    Directory of Open Access Journals (Sweden)

    Erokan Canbazoglu

    2016-01-01

    Full Text Available The field of dentistry lacks satisfactory tools to help visualize planned procedures and their potential results to patients. Dentists struggle to provide an effective image in their patient's mind of the end results of the planned treatment only through verbal explanations. Thus, verbal explanations alone often cannot adequately help the patients make a treatment decision. Inadequate attempts are frequently made by dentists to sketch the procedure for the patient in an effort to depict the treatment. These attempts however require an artistic ability not all dentists have. Real case photographs are sometimes of help in explaining and illustrating treatments. However, particularly in implant cases, real case photographs are often ineffective and inadequate. The purpose of this study is to develop a mobile application with an effective user interface design to support the dentist–patient interaction by providing the patient with illustrative descriptions of the procedures and the end result. Sketching, paper prototyping, and wire framing were carried out with the actual user's participation. Hard and soft dental tissues were modeled using three dimensional (3D modeling programs and real cases. The application enhances the presentation to the patients of potential implants and implant supported prosthetic treatments with rich 3D illustrative content. The application was evaluated in terms of perceived ease of use and perceived usefulness through an online survey. The application helps improve the information sharing behavior of dentists to enhance the patients' right to make informed decisions. The paper clearly demonstrates the relevance of interactive communication technologies for dentist–patient communication.

  14. Implantation of xenon in amorphous carbon and silicon for brachytherapy application

    International Nuclear Information System (INIS)

    Marques, F.C.; Barbieri, P.F.; Viana, G.A.; Silva, D.S. da

    2013-01-01

    We report a procedure to implant high dose of xenon atoms (Xe) in amorphous carbon, a-C, and amorphous silicon, a-Si, for application in brachytherapy seeds. An ion beam assisted deposition (IBAD) system was used for the deposition of the films, where one ion gun was used for sputtering a carbon (or silicon) target, while the other ion gun was used to simultaneously bombard the growing film with a beam of xenon ion Xe + in the 0–300 eV range. Xe atoms were implanted into the film with concentration up to 5.5 at.%, obtained with Xe bombardment energy in the 50–150 eV range. X-ray absorption spectroscopy was used to investigate the local arrangement of the implanted Xe atoms through the Xe L III absorption edge (4.75 keV). It was observed that Xe atoms tend to agglomerate in nanoclusters in a-C and are dispersed in a-Si.

  15. History of orthopaedics in China: a brief review.

    Science.gov (United States)

    Li, Jia; Zhang, Yingze

    2018-03-01

    Chinese orthopaedic surgeons have made a substantial contribution to the development of orthopaedics worldwide, and traditional Chinese medicine (TCM) in orthopaedics has a very long history in China. We make a brief review of the development of orthopaedics in China, intending to pave the way for further understanding of Chinese orthopaedics for scholars all over the world. The description of fractures firstly appeared in 3600 years ago in China, and the theories, experience, and treatment strategies of TCM still play important roles in clinical diagnosis and treatment of orthopaedic disorders in our country. Western orthopaedics was first introduced into China in the early twentieth century. After decades of development, Chinese scholars have made some gratifying achievements in orthopaedics. Orthopaedics is constantly evolving, and we need to strengthen the ability of independent innovation to achieve orthopaedic surgeons' Chinese dream, and better serve our patients.

  16. Virtual interactive musculoskeletal system (VIMS in orthopaedic research, education and clinical patient care

    Directory of Open Access Journals (Sweden)

    Yoshida Hiroaki

    2007-03-01

    Full Text Available Abstract The ability to combine physiology and engineering analyses with computer sciences has opened the door to the possibility of creating the "Virtual Human" reality. This paper presents a broad foundation for a full-featured biomechanical simulator for the human musculoskeletal system physiology. This simulation technology unites the expertise in biomechanical analysis and graphic modeling to investigate joint and connective tissue mechanics at the structural level and to visualize the results in both static and animated forms together with the model. Adaptable anatomical models including prosthetic implants and fracture fixation devices and a robust computational infrastructure for static, kinematic, kinetic, and stress analyses under varying boundary and loading conditions are incorporated on a common platform, the VIMS (Virtual Interactive Musculoskeletal System. Within this software system, a manageable database containing long bone dimensions, connective tissue material properties and a library of skeletal joint system functional activities and loading conditions are also available and they can easily be modified, updated and expanded. Application software is also available to allow end-users to perform biomechanical analyses interactively. Examples using these models and the computational algorithms in a virtual laboratory environment are used to demonstrate the utility of these unique database and simulation technology. This integrated system, model library and database will impact on orthopaedic education, basic research, device development and application, and clinical patient care related to musculoskeletal joint system reconstruction, trauma management, and rehabilitation.

  17. Virtual Interactive Musculoskeletal System (VIMS) in orthopaedic research, education and clinical patient care.

    Science.gov (United States)

    Chao, Edmund Y S; Armiger, Robert S; Yoshida, Hiroaki; Lim, Jonathan; Haraguchi, Naoki

    2007-03-08

    The ability to combine physiology and engineering analyses with computer sciences has opened the door to the possibility of creating the "Virtual Human" reality. This paper presents a broad foundation for a full-featured biomechanical simulator for the human musculoskeletal system physiology. This simulation technology unites the expertise in biomechanical analysis and graphic modeling to investigate joint and connective tissue mechanics at the structural level and to visualize the results in both static and animated forms together with the model. Adaptable anatomical models including prosthetic implants and fracture fixation devices and a robust computational infrastructure for static, kinematic, kinetic, and stress analyses under varying boundary and loading conditions are incorporated on a common platform, the VIMS (Virtual Interactive Musculoskeletal System). Within this software system, a manageable database containing long bone dimensions, connective tissue material properties and a library of skeletal joint system functional activities and loading conditions are also available and they can easily be modified, updated and expanded. Application software is also available to allow end-users to perform biomechanical analyses interactively. Examples using these models and the computational algorithms in a virtual laboratory environment are used to demonstrate the utility of these unique database and simulation technology. This integrated system, model library and database will impact on orthopaedic education, basic research, device development and application, and clinical patient care related to musculoskeletal joint system reconstruction, trauma management, and rehabilitation.

  18. Types of wear and tear of biomaterials used in orthopaedic surgery

    OpenAIRE

    L. Klimek; E. Wołowiec; B. Majkowska

    2013-01-01

    Purpose: Purpose of this paper is presentation of observations on different kinds of wear and tear of biomaterials used in contemporary orthopaedic surgery.Design/methodology/approach: Types of prosthesis damage, encountered in medical practice, and their causes have been described. Results of many clinical studies were analysed to review prosthesis damage from the stage of implanting (such as intrusion of a foreign object between its components) to their natural wear and tear after many year...

  19. The burden of gunshot injuries on orthopaedic healthcare resources in South Africa.

    Science.gov (United States)

    Martin, Case; Thiart, Gerhard; McCollum, Graham; Roche, Stephen; Maqungo, Sithombo

    2017-06-30

    Injuries inflicted by gunshot wounds (GSWs) are an immense burden on the South African (SA) healthcare system. In 2005, Allard and Burch estimated SA state hospitals treated approximately 127 000 firearm victims annually and concluded that the cost of treating an abdominal GSW was approximately USD1 467 per patient. While the annual number of GSW injuries has decreased over the past decade, an estimated 54 870 firearm-related injuries occurred in SA in 2012. No study has estimated the burden of these GSWs from an orthopaedic perspective. To estimate the burden and average cost of treating GSW victims requiring orthopaedic interventions in an SA tertiary level hospital. This retrospective study surveyed more than 1 500 orthopaedic admissions over a 12-month period (2012) at Groote Schuur Hospital, Cape Town, SA. Chart review subsequently yielded data that allowed analysis of cost, theatre time, number and type of implants, duration of admission, diagnostic imaging studies performed, blood products used, laboratory studies ordered and medications administered. A total of 111 patients with an average age of 28 years (range 13 - 74) were identified. Each patient was hit by an average of 1.69 bullets (range 1 - 7). These patients sustained a total of 147 fractures, the majority in the lower extremities. Ninety-five patients received surgical treatment for a total of 135 procedures, with a cumulative surgical theatre time of >306 hours. Theatre costs, excluding implants, were in excess of USD94 490. Eighty of the patients received a total of 99 implants during surgery, which raised theatre costs an additional USD53 381 cumulatively, or USD667 per patient. Patients remained hospitalised for an average of 9.75 days, and total ward costs exceeded USD130 400. Individual patient costs averaged about USD2 940 (ZAR24 945) per patient. This study assessed the burden of orthopaedic firearm injuries in SA. It was estimated that on average, treating an orthopaedic GSW patient

  20. A miniaturized micro strip antenna based on sinusoidal patch geometry for implantable biomedical applications

    Science.gov (United States)

    Ibrahim, Omar A.; Elwi, Taha A.; Islam, Naz E.

    2012-11-01

    A miniaturized microstrip antenna is analyzed for implantable biomedical applications. The antenna is designed using two different commercial software packages, CST Microwave Studio and HFSS, to validate the results. The proposed design operates in the WMTS frequency band. The antenna performance is tested inside the human body, Hugo model. The antenna design is readjusted to get the desired resonant frequency. The resonant frequency, bandwidth, gain, and radiation pattern of the proposed antenna are provided in this paper. Furthermore, the effect of losses inside human body due to the fat layer is recognized.

  1. American Orthopaedic Society for Sports Medicine

    Science.gov (United States)

    ... Upcoming Meetings Online Education Archived Meetings Faculty Resources Sports Medicine Fellowships Traveling Fellowship Submit an Abstract Submit ... Support AOSSM Research Publications Toggle American Journal of Sports Medicine Sports Health: A Multidisciplinary Approach Orthopaedic Journal ...

  2. The financial impact of orthopaedic fellowship training.

    Science.gov (United States)

    Gaskill, Trevor; Cook, Chad; Nunley, James; Mather, R Chad

    2009-07-01

    Previous reports have compared the expected financial return of a medical education with those expected in other professions. However, we know of no published report estimating the financial return of orthopaedic training. The purpose of this study was to estimate the financial incentives that may influence the decision to invest an additional year of training in each of the major orthopaedic fellowships. With survey data from the American Academy of Orthopaedic Surgeons and using standard financial techniques, we calculated the estimated return on investment of an additional year of orthopaedic training over a working lifetime. The net present value, internal rate of return, and the break-even point were estimated. Eight fellowships were examined and compared with general orthopaedic practice. Investment in an orthopaedic fellowship yields variable returns. Adult spine, shoulder and elbow, sports medicine, hand, and adult arthroplasty may yield positive returns. Trauma yields a neutral return, while pediatrics and foot and ankle have negative net present values. On the basis of mean reported incomes, the break-even point was two years for spine, seven years for hand, eight years for shoulder and elbow, twelve years for adult arthroplasty, thirteen years for sports medicine, and twenty-seven years for trauma. Fellowship-trained pediatric and foot and ankle surgeons did not break even following the initial investment. When working hours were controlled for, the returns for adult arthroplasty and trauma became negative. The financial return of an orthopaedic fellowship varies on the basis of the specialty chosen. While reasons to pursue fellowship training vary widely, and many are not financial, there are positive and negative financial incentives. Therefore, the decision to pursue fellowship training is best if it is not made on the basis of financial incentives. This information may assist policy makers in analyzing medical education economics to ensure the

  3. Physiotherapy following elective orthopaedic procedures.

    Science.gov (United States)

    De Kleijn, P; Blamey, G; Zourikian, N; Dalzell, R; Lobet, S

    2006-07-01

    As haemophilic arthropathy and chronic synovitis are still the most important clinical features in people with haemophilia, different kinds of invasive and orthopaedic procedures have become more common during the last decades. The availability of clotting factor has made arthroplasty of one, or even multiple joints possible. This article highlights the role of physiotherapy before and after such procedures. Synovectomies are sometimes advocated in people with haemophilia to stop repetitive cycles of intra-articular bleeds and/or chronic synovitis. The synovectomy itself, however, does not solve the muscle atrophy, loss of range of motion (ROM), instability and poor propriocepsis, often developed during many years. The key is in taking advantage of the subsequent, relatively safe, bleed-free period to address these important issues. Although the preoperative ROM is the most important variable influencing the postoperative ROM after total knee arthroplasty, there are a few key points that should be considered to improve the outcome. Early mobilization, either manual or by means of a continuous passive mobilization machine, can be an optimal solution during the very first postoperative days. Muscle isometric contractions and light open kinetic chain exercises should also be started in order to restore the quadriceps control. Partial weight bearing can be started shortly after, because of quadriceps inhibition and to avoid excessive swelling. The use of continuous clotting factor replacement permits earlier and intensive rehabilitation during the postoperative period. During the rehabilitation of shoulder arthroplasty restoring the function of the rotator cuff is of utmost importance. Often the rotator cuff muscles are inhibited in the presence of pain and loss of ROM. Physiotherapy also assists in improving pain and maintaining ROM and strength. Functional weight-bearing tasks, such as using the upper limbs to sit and stand, are often discouraged during the first 6

  4. Validation of the Osteopenia Sheep Model for Orthopaedic Biomaterial Research

    DEFF Research Database (Denmark)

    Ding, Ming

    2009-01-01

    months. This suggests that a prolonged administration of GC is needed for a long-term observation to keep osteopenic bone.                 In conclusion, after 7 months of GC treatments with restricted diet, the microarchitectural characteristics, mechanical competence, mineralization of the bone tissues...... resemble osteoporosis in humans. This study aimed to validate glucocorticoid-induced osteopenia sheep model for orthopaedic implant and biomaterial research. We hypothesized that a 7-month GC treatment together with restricted diet but without OVX would induce osteopenia. Materials and Methods: Eighteen...... for 7 months. The sheep were housed outdoors in paddocks, and received restricted diet with low calcium and phosphorus (0.55% calcium and 0.35% phosphorus) and hay. After sacrifice, cancellous bone specimens from the 5th lumbar vertebra, bilateral distal femur, and bilateral proximal tibia, and cortical...

  5. A PLZT Novel Sensor with Pt Implanted for Biomedical Application: Cardiac Micropulses Detection on Human Skin

    Directory of Open Access Journals (Sweden)

    Carlos O. González-Morán

    2017-01-01

    Full Text Available Advances in sensors for biomedical applications have been a great motivation. In this research, a PLZT (lead lanthanum zirconate titanate novel sensor with platinum wire implanted in its longitudinal section was developed through of the synthesis process based on powder technology. The raw materials as lead (PbO, lanthanum (La2O3, zircon (ZrO2, and titanium (TiO2 were used in the formation of the chemical composition (62.8% PbO, 4.5% La2O3, 24.2% ZrO2, and 8.5% TiO2. Then, these powders were submitted to mix-mechanical milling at high energy; cylindrical samples with the implant of the platinum wire were obtained with the load application. Finally, the compacted samples were sintered at 1200°C for 2 hours, then followed by a polarization potential of 1500 V/mm at 60°C to obtain a novel sensor. The density and porosity were evaluated using the Archimedes’ principle, while the mechanical properties such as fracture toughness value and Young’s modulus were determined by indentation and ultrasonic methods, respectively. A microscopic examination was also carried out to investigate the structural properties of the material. The PLZT novel sensor is electronically arranged for monitoring the cardiac pulses through a data acquisition system. The results obtained in this research are analyzed and discussed.

  6. Anodization: a promising nano-modification technique of titanium implants for orthopedic applications.

    Science.gov (United States)

    Yao, Chang; Webster, Thomas J

    2006-01-01

    Anodization is a well-established surface modification technique that produces protective oxide layers on valve metals such as titanium. Many studies have used anodization to produce micro-porous titanium oxide films on implant surfaces for orthopedic applications. An additional hydrothermal treatment has also been used in conjunction with anodization to deposit hydroxyapatite on titanium surfaces; this is in contrast to using traditional plasma spray deposition techniques. Recently, the ability to create nanometer surface structures (e.g., nano-tubular) via anodization of titanium implants in fluorine solutions have intrigued investigators to fabricate nano-scale surface features that mimic the natural bone environment. This paper will present an overview of anodization techniques used to produce micro-porous titanium oxide structures and nano-tubular oxide structures, subsequent properties of these anodized titanium surfaces, and ultimately their in vitro as well as in vivo biological responses pertinent for orthopedic applications. Lastly, this review will emphasize why anodized titanium structures that have nanometer surface features enhance bone forming cell functions.

  7. Orthopaedic complications of osteogenesis imperfecta

    International Nuclear Information System (INIS)

    Azrak, S.; Ksyar, R.; Ben Rais, N.

    2009-01-01

    Osteogenesis imperfecta is a genetic disease characterized by bone frailty. It is generally caused by an abnormal production of collagen, which is the main fibrous protein of the bone. Collagen is also present in the skin, tendons, the sclera of the eye and dentin. The most frequent manifestation of osteogenesis imperfecta is the occurrence of multiple fractures without major trauma. Severity and timing of the attack varies widely: some patients sustain a significant number of fractures during early childhood which may have a serious impact on growth, while others will have some fractures separated by a few years. In all cases, the bone strength improves in adulthood. The bone fractures cause pain and bone deformities sometimes result in a smaller size. Scoliosis is frequent and associated with painful vertebral collapses. We present a case of osteogenesis imperfecta in a 40-year-old adult and we describe the various orthopaedic complications of the disease, stressing the role of bone scintigraphy in the diagnosis and monitoring of these complications. (authors)

  8. Audit of Orthopaedic Surgical Documentation

    Directory of Open Access Journals (Sweden)

    Fionn Coughlan

    2015-01-01

    Full Text Available Introduction. The Royal College of Surgeons in England published guidelines in 2008 outlining the information that should be documented at each surgery. St. James’s Hospital uses a standard operation sheet for all surgical procedures and these were examined to assess documentation standards. Objectives. To retrospectively audit the hand written orthopaedic operative notes according to established guidelines. Methods. A total of 63 operation notes over seven months were audited in terms of date and time of surgery, surgeon, procedure, elective or emergency indication, operative diagnosis, incision details, signature, closure details, tourniquet time, postop instructions, complications, prosthesis, and serial numbers. Results. A consultant performed 71.4% of procedures; however, 85.7% of the operative notes were written by the registrar. The date and time of surgery, name of surgeon, procedure name, and signature were documented in all cases. The operative diagnosis and postoperative instructions were frequently not documented in the designated location. Incision details were included in 81.7% and prosthesis details in only 30% while the tourniquet time was not documented in any. Conclusion. Completion and documentation of operative procedures were excellent in some areas; improvement is needed in documenting tourniquet time, prosthesis and incision details, and the location of operative diagnosis and postoperative instructions.

  9. Insight of magnesium alloys and composites for orthopedic implant applications – a review

    Directory of Open Access Journals (Sweden)

    R Radha

    2017-09-01

    Full Text Available Magnesium (Mg and its alloys have been widely researched for orthopedic applications recently. Mg alloys have stupendous advantages over the commercially available stainless steel, Co-Cr-Ni alloy and titanium implants. Till date, extensive mechanical, in-vitro and in-vivo studies have been done to improve the biomedical performance of Mg alloys through alloying, processing conditions, surface modification etc. This review comprehensively describes the strategies for improving the mechanical and degradation performance of Mg alloys through properly tailoring the composition of alloying elements, reinforcements and processing techniques. It also highlights the status and progress of research in to (i the selection of nutrient elements for alloying, reinforcement and its effects (ii type of Mg alloy system (binary, ternary and quaternary and composites (iii grain refinement for strengthening through severe plastic deformation techniques. Furthermore it also emphasizes on the importance of Mg composites with regard to hard tissue applications.

  10. A metrology solution for the orthopaedic industry

    International Nuclear Information System (INIS)

    Bills, P; Brown, L; Jiang, X; Blunt, L

    2005-01-01

    Total joint replacement is one of the most common elective surgical procedures performed worldwide, with an estimate of 1.5 million operations performed annually. Currently joint replacements are expected to function for 10-15 years, however, with an increase in life expectancy, and a greater call for knee replacement due to increased activity levels, there is a requirement to improve their function to offer longer term improved quality of life for patients. The amount of wear that a joint incurs is seen as a good indicator of performance, with higher wear rates typically leading to reduced function and premature failure. New technologies and materials are pushing traditional wear assessment methods to their limits, and novel metrology solutions are required to assess wear of joints following in vivo and in vitro use. This paper presents one such measurement technique; a scanning co-ordinate metrology machine for geometrical assessment. A case study is presented to show the application of this technology to a real orthopaedic measurement problem: the wear of components in total knee replacement. This technique shows good results and provides a basis for further developing techniques for geometrical wear assessment of total joint replacements

  11. Design and evaluation of carbon nanofiber and silicon materials for neural implant applications

    Science.gov (United States)

    McKenzie, Janice L.

    Reduction of glial scar tissue around central nervous system implants is necessary for improved efficacy in chronic applications. Design of materials that possess tunable properties inspired by native biological tissue and elucidation of pertinent cellular interactions with these materials was the motivation for this study. Since nanoscale carbon fibers possess the fundamental dimensional similarities to biological tissue and have attractive material properties needed for neural biomaterial implants, this present study explored cytocompatibility of these materials as well as modifications to traditionally used silicon. On silicon materials, results indicated that nanoscale surface features reduced astrocyte functions, and could be used to guide neurite extension from PC12 cells. Similarly, it was determined that astrocyte functions (key cells in glial scar tissue formation) were reduced on smaller diameter carbon fibers (125 nm or less) while PC12 neurite extension was enhanced on smaller diameter carbon fibers (100 nm or less). Further studies implicated laminin adsorption as a key mechanism in enhancing astrocyte adhesion to larger diameter fibers and at the same time encouraging neurite extension on smaller diameter fibers. Polycarbonate urethane (PCU) was then used as a matrix material for the smaller diameter carbon fibers (100 and 60 nm). These composites proved very versatile since electrical and mechanical properties as well as cell functions and directionality could be influenced by changing bulk and surface composition and features of these matrices. When these composites were modified to be smooth at the micronscale and only rough at the nanoscale, P19 cells actually submerged philopodia, extensions, or whole cells bodies beneath the PCU in order to interact with the carbon nanofibers. These carbon nanofiber composites that have been formulated are a promising material to coat neural probes and thereby enhance functionality at the tissue interface. This

  12. Battlefield-Acquired Immunogenicity to Metals Affects Orthopaedic Implant Outcome

    Science.gov (United States)

    2016-12-01

    bodies in soft tissue causing plumbism 36-38. There are no strict guidelines as to when patients with gunshot or other metal fragment wounds should...Immunological changes in patients with primary osteoarthritis of the hip after total joint rep lacement. J Bone Joint Surg Br 2003 Jul;85(5):758-64

  13. Battlefield Acquired Immunogenicity to Metals Affects Orthopaedic Implant Outcome

    Science.gov (United States)

    2014-10-01

    36-38 . There are no strict guidelines as to when patients with gunshot or other metal fragment wounds should be tested to determine serum lead...Immunological changes in patients with primary osteoarthritis of the hip after total joint replacement. J Bone Joint Surg Br 2003 Jul;85(5):758-64. (52

  14. Battlefield-Acquired Immunogenicity to Metals Affects Orthopaedic Implant Outcome

    Science.gov (United States)

    2012-10-01

    Attending Physician #N/A Control cpm 1308.0 Positive control (PHA) cpm 38247.3 29.2 Mildly Reactive 2 to 4 Reactive 4 to 8 Highly Reactive above 8...Kyron, The Veterans Health Administration has to follow Handbook 1200.05, which states: VHA HANDBOOK 1200.05 October 15, 2010 n. Advertising ...The facility Director is responsible for ensuring that recruiting documents, flyers, and advertisements for non-VA research are not posted within or

  15. Implant removal after fracture healing : facts and fiction

    NARCIS (Netherlands)

    Vos, D.I.

    2013-01-01

    A frequently asked question to trauma and orthopaedic surgeons is whether and if yes, when an implant will be removed? Although implant removal after fracture healing is daily practice, a scientific basis doesn’t exist. All studies in this thesis were performed to unravel the facts and fiction of

  16. Applications of Mesenchymal Stem Cells in Sinus Lift Augmentation as a Dental Implant Technology

    Directory of Open Access Journals (Sweden)

    Feridoun Parnia

    2018-01-01

    Full Text Available The potential application of stem cell biology in human dentistry is a new and emerging field of research. The objective of the current review was to study the efficiency of mesenchymal stem cells (MSCs in sinus lift augmentation (SLA. A literature review was performed in PubMed Central using MeSH keywords such as sinus lift, MSCs, dental implants, and augmentation. The searches involved full-text papers written in English, published in the past 10 years (2007–2017. The review included in vitro and in vivo studies on the use of MSCs in SLA. Electronic searching provided 45 titles, and among them, 8 papers were chosen as suitable based on the inclusion requirements of this review. The reviewed studies have revealed the potential of MSCs in SLA. According to these papers, stem cell therapy combined with different biomaterials may considerably improve bone regeneration in previous steps of dental implantation and may veritably lead to efficient clinical usages in the recent future. However, the identification of an ideal source of stem cells as well as long-term studies is vital to assess the success rate of this technology. Further clinical trials are also needed to approve the potential of MSCs in SLA.

  17. A Novel Transdermal Power Transfer Device for the Application of Implantable Microsystems

    Directory of Open Access Journals (Sweden)

    Jing-Quan Liu

    2015-03-01

    Full Text Available This paper presents a transdermal power transfer device for the application of implantable devices or systems. The device mainly consists of plug and socket. The power transfer process can be started after inserting the plug into the socket with an applied potential on the plug. In order to improve the maneuverability and reliability of device during power transfer process, the metal net with mesh structure were added as a part of the socket to serve as intermediate electrical connection layer. The socket was encapsulated by polydimethylsiloxane (PDMS with good biocompatibility and flexibility. Two stainless steel hollow needles placed in the same plane acted as the insertion part of the needle plug, and Parylene C thin films were deposited on needles to serve as insulation layers. At last, the properties of the transdermal power transfer device were tested. The average contact resistance between needle and metal mesh was 0.454 Ω after 50 random insertions, which showed good electrical connection. After NiMH (nickel-metal hydride batteries were recharged for 10 min with current up to 200 mA, the caused resistive heat was less than 0.6 °C, which also demonstrated the low charging temperature and was suitable for charging implantable devices.

  18. Optical effects of ion implantation

    International Nuclear Information System (INIS)

    Townsend, P.D.

    1987-01-01

    The review concerns the effects of ion implantation that specifically relate to the optical properties of insulators. Topics which are reviewed include: ion implantation, ion range and damage distributions, colour centre production by ion implantation, high dose ion implantation, and applications for integrated optics. Numerous examples are presented of both diagnostic and industrial examples of ion implantation effects in insulators. (U.K.)

  19. Finite Element Analysis of Bone Stress around Micro-Implants of Different Diameters and Lengths with Application of a Single or Composite Torque Force.

    Science.gov (United States)

    Lu, Ying-juan; Chang, Shao-hai; Ye, Jian-tao; Ye, Yu-shan; Yu, Yan-song

    2015-01-01

    Stress on the bone surrounding dental micro-implants affects implant success. To compare the stress on the bone surrounding a micro-implant after application of a single force (SF) of 200 g or a composite force (CF) of 200 g and 6 N.mm torque. Finite element models were developed for micro-implant diameters of 1.2, 1.6, and 2.0 mm, and lengths of 6, 8, 10, and 12 mm and either a SF or CF was applied. The maximum equivalent stress (Max EQS) of the bone surrounding the micro-implant was determined, and the relationships among type of force, diameter, and length were evaluated. The Max EQS of the CF exceeded that of the SF (Pimplant diameter, but not to implant length. The larger CF led to greater instability of the micro-implant and the effect was most pronounced at an implant diameter of 1.2 mm. The use of implant diameters of 1.6 mm and 2.0 mm produced no significant difference in implant stability when either a CF or SF was applied. When considering the use of an implant to perform three-dimensional control on the teeth, the implant diameter chosen should be > 1.2 mm.

  20. Biocompatibility of 17-4 PH stainless steel foam for implant applications.

    Science.gov (United States)

    Mutlu, Ilven; Oktay, Enver

    2011-01-01

    In this study, biocompatibility of 17-4 PH stainless steel foam for biomedical implant applications was investigated. 17-4 PH stainless steel foams having porosities in the range of 40-82% with an average pore size of around 600 μm were produced by space holder-sintering technique. Sintered foams were precipitation hardened for times of 1-6 h at temperatures between 450-570 °C. Compressive yield strength and Young's modulus of aged stainless steel foams were observed to vary between 80-130 MPa and 0.73-1.54 GPa, respectively. Pore morphology, pore size and the mechanical properties of the 17-4 PH stainless steel foams were close to cancellous bone. In vitro evaluations of cytotoxicity of the foams were investigated by XTT and MTT assays and showed sufficient biocompatibility. Surface roughness parameters of the stainless steel foams were also determined to characterize the foams.

  1. Synthesis of bioactive and machinable miserite glass-ceramics for dental implant applications.

    Science.gov (United States)

    Saadaldin, Selma A; Dixon, S Jeffrey; Costa, Daniel O; Rizkalla, Amin S

    2013-06-01

    To synthesize and characterize machinable, bioactive glass-ceramics (GCs) suitable for dental implant applications. A glass in the SiO2-Al2O3-CaO-CaF2-K2O-B2O3-La2O3 system was synthesized by wet chemical methods, followed by calcination, melting and quenching. Crystallization kinetics were determined by differential thermal analysis (DTA). GC discs were produced by cold pressing of the glass powder and sintered using schedules determined by DTA. The crystalline phases and microstructure of GC samples were characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM), respectively. Dynamic Young's modulus (E), true hardness (Ho), fracture toughness (KIC) and brittleness index (BI) were evaluated. Bioactivity was studied by examining the formation of hydroxyapatite (HA) on the GC surfaces after soaking in simulated body fluid (SBF). Attachment and proliferation of MC3T3-E1 osteoblastic cells were assessed in vitro. Miserite [KCa5(Si2O7)(Si6O15)(OH)F] was the main crystalline phase of the GC with additional secondary phases. Microstructural studies revealed interlocking lath-like crystalline morphology. E, Ho, and KIC values for the GCs were 96±3 GPa, 5.27±0.26 GPa and 4.77±0.27 MPa m(0.5), respectively. The BI was found to be 1.11±0.05 μm(-0.5), indicating outstanding machinability. An HA surface layer was formed on the GC surfaces when soaked in SBF, indicating potential bioactivity. MC3T3-E1 cells exhibited attachment, spreading and proliferation on GC surfaces, demonstrating excellent biocompatibility. We present a novel approach for the synthesis of miserite GC with the physical and biological properties required for non-metallic dental implant applications. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  2. Evaluation of the orthopaedics and traumatology resident education in Turkey: A descriptive study.

    Science.gov (United States)

    Huri, Gazi; Cabuk, Yusuf Sertan; Gursoy, Safa; Akkaya, Mustafa; Ozkan, Secil; Oztuna, Volkan; Aydingoz, Onder; Senkoylu, Alparslan

    2016-10-01

    The objective of this study is to describe the current situation regarding the training, working conditions, future plans, fields of interest and satisfaction of orthopaedics and traumatology residents in Turkey. A descriptive survey questionnaire consisting of 24 questions was designed to identify the problems and solution suggestions concerning training of orthopaedic residents. All orthopaedics and traumatology residents who took the 2013 Progress Testing for Speciality in Medicine (UEGS) held by Turkish Orthopaedics and Traumatology Education Council (TOTEK) were surveyed in the class at the end thereof as well as the young orthopaedic surgeons who were reached through the email groups of Turkish Society of Orthopaedics and Traumatology - Residents and Young Attendings Council (TOTBID-AGUH). A total of 725 residents and 132 young attendings were surveyed. The most outstanding answers are as follows: 62,7% of the respondents replied to the question "Is there a training program/Is it being applied" as "yes/yes". It was found out that 94,3% of the respondents wanted to be involved in a rotation abroad. The "patient care" was the most common answer, with a ratio of 36,9%, to the question "What's the priority of the department you are studying in?". Regarding work conditions, "many emergency on-calls" was found to be the most important parameter affecting life conditions (p traumatology residents in Turkey face as regards their training, this survey stands as a pioneering study with a high participation rate. Analysis of survey data highlights the importance of several key factors such as the development of training programs and increasing the time spent with academicians as well as spreading and promotion of log book application. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

  3. Clinical application of single-tooth replacement with ankylos implant system

    International Nuclear Information System (INIS)

    Yang Xu; Liu Xue; Zhang Heng; Deng Yan; Guo Zhaozhong; Zhang Yufeng

    2011-01-01

    Objective: To evaluate the clinical effects of Ankylos implant system to restore the loss of single-tooth. Methods: 90 cases with loss of single-tooth were selected and treated with routinely two-stage surgery. When the patients presented with deficient alveolar ridge, guided bone regeneration (GBR), osteotome sinus floor elevation, lateral antrostomy surgery with simultaneous placement of implant were applied. They were restored with platinum ceramic crown. All the implants were followed up, and the records were kept about stability of the implant and abutment, the status of surrounding soft tissue, sealability of implant abutment junction and the marginal bone lossing through X-ray checking,and satisfaction of the patients to mastication and aspect of the restorations. The follow-up time was 1-2.5 years. Results: Among the cases,one case had peri-implant inflammation, and one case had porcelain dropped. No loosening occurred in the other implants and abuments. Implant abutment junction was sealed well. The marginal bone loss 1 year after final restoration was less than 1 mm. Soft tissue surrounding implants was healthy. The satisfaction rate was 98.9% (89/90). According to standard of implant success, 88 cases were successful, the 2.5-year cumulative success rate was 97.8%, 2 cases failed, and the failure rate was 2.2 %. Conclusion: A satisfactory treatment effects could be gotten by using Ankylos implant system to restore the loss of single-tooth. (authors)

  4. Rapid Prototyping in Orthopaedic Surgery: A User's Guide

    Science.gov (United States)

    Frame, Mark; Huntley, James S.

    2012-01-01

    Rapid prototyping (RP) is applicable to orthopaedic problems involving three dimensions, particularly fractures, deformities, and reconstruction. In the past, RP has been hampered by cost and difficulties accessing the appropriate expertise. Here we outline the history of rapid prototyping and furthermore a process using open-source software to produce a high fidelity physical model from CT data. This greatly mitigates the expense associated with the technique, allowing surgeons to produce precise models for preoperative planning and procedure rehearsal. We describe the method with an illustrative case. PMID:22666160

  5. Applications of ion implantation for modifying the interactions between metals and hydrogen gas

    Science.gov (United States)

    Musket, R. G.

    1989-04-01

    Ion implantations into metals have been shown recently to either reduce or enhance interactions with gaseous hydrogen. Published studies concerned with modifications of these interactions are reviewed and discussed in terms of the mechanisms postulated to explain the observed changes. The interactions are hydrogenation, hydrogen permeation, and hydrogen embrittlement. In particular, the results of the reviewed studies are (a) uranium hydriding suppressed by implantation of oxygen and carbon, (b) hydrogen gettered in iron and nickel using implantation of titanium, (c) hydriding of titanium catalyzed by implanted palladium, (d) tritium permeation of 304L stainless steel reduced using selective oxidation of implanted aluminum, and (e) hydrogen attack of a low-alloy steel accelerated by implantation of helium. These studies revealed ion implantation to be an effective method for modifying the interactions of hydrogen gas with metals.

  6. Applications of ion implantation for modifying the interactions between metals and hydrogen gas

    International Nuclear Information System (INIS)

    Musket, R.G.

    1989-01-01

    Ion implantations into metals have been shown recently to either reduce or enhance interactions with gaseous hydrogen. Published studies concerned with modifications of these interactions are reviewed and discussed in terms of the mechanisms postulated to explain the observed changes. The interactions are hydrogenation, hydrogen permeation and hydrogen embrittlement. In particular, the results of the reviewed studies are 1. uranium hydriding suppressed by implantation of oxygen and carbon, 2. hydrogen gettered in iron and nickel using implantation of titanium, 3. hydriding of titanium catalyzed by implanted palladium, 4. tritium permeation of 304L stainless steel reduced using selective oxidation of implanted aluminum, and 5. hydrogen attack of a low-alloy steel accelerated by implantation of helium. These studies revealed ion implantation to be an effective method for modifying the interactions of hydrogen gas with metals. (orig.)

  7. Development and implantation of application systems for reduction and analysis of experimental data in Nuclear Physics area

    International Nuclear Information System (INIS)

    Cardoso Junior, J.L.; Schelin, H.R.; Lemos, B.J.K.C.; Tanaka, E.H.; Castro, A.T.C.G.

    1984-01-01

    Several application systems for reduction and analysis of experimental data are described. These codes were development and/or implanted in tee IEAv/CTA CYBER 170/750 system. A brief description of the experimental data acquisition modes and the necessary reduction for analysis is given. Information on the purposes, uses and access of the codes are given [pt

  8. Inpatient consultations to an orthopaedic service: the hidden workload.

    LENUS (Irish Health Repository)

    O'Malley, N T

    2011-12-01

    While the quality and efficiency of out-patient orthopaedic referrals are well documented in the literature, there is little on the standard and appropriateness of inpatient orthopaedic consultations.

  9. Establishing a children's orthopaedic hospital for Malawi: A review ...

    African Journals Online (AJOL)

    ordinate the MNCP since 2007. At present the program has a total of 29 clinics, which have treated 5748 patients. Furthermore, BCIH has overseen the full or partial training of 5 orthopaedic surgeons and 82 orthopaedic clinical officers in Malawi.

  10. Radiation safety knowledge and practices among Irish orthopaedic trainees.

    LENUS (Irish Health Repository)

    Nugent, M

    2014-04-23

    Fluoroscopy is frequently used in orthopaedic surgery, particularly in a trauma setting. Exposure of patients and staff to ionising radiation has been studied extensively; however, little work has been done to evaluate current knowledge and practices among orthopaedic trainees.

  11. Application of polymer nanocomposites in the nanomedicine landscape: envisaging strategies to combat implant associated infections.

    Science.gov (United States)

    Dwivedi, Poushpi; Narvi, Shahid S; Tewari, Ravi P

    2013-12-16

    This review article presents an overview of the potential biomedical application of polymer nanocomposites arising from different chemistries, compositions, and constructions. The interaction between the chosen matrix and the filler is of critical importance. The existing polymer used in the biomedical arena includes aliphatic polyesters such as polylactide (PLA), poly(ε-caprolactone) (PCL), poly(p-dioxanone) (PPDO), poly(butylenes succinate) (PBS), poly(hydroxyalkanoate)s, and natural biopolymers such as starch, cellulose, chitin, chitosan, lignin, and proteins. The nanosized fillers utilized to fabricate the nanocomposites are inorganic, organic, and metal particles such as clays, magnetites, hydroxyapatite, nanotubes chitin whiskers, lignin, cellulose, Au, Ag, Cu, etc. These nanomaterials are taking root in a variety of diverse healthcare applications in the sector of nanomedicine including the domain of medical implants and devices. Despite sterilization and aseptic procedures the use of these biomedical devices and prosthesis to improve the patient's 'quality of life' is facing a major impediment because of bacterial colonization causing nosocomial infection, together with the multi-drug-resistant 'super-bugs' posing a serious threat to its utility. This paper discusses the current efforts and key research challenges in the development of self-sterilizing nanocomposite biomaterials for potential application in this area.

  12. Automatic Frequency Controller for Power Amplifiers Used in Bio-Implanted Applications: Issues and Challenges

    Directory of Open Access Journals (Sweden)

    Mahammad A. Hannan

    2014-12-01

    Full Text Available With the development of communication technologies, the use of wireless systems in biomedical implanted devices has become very useful. Bio-implantable devices are electronic devices which are used for treatment and monitoring brain implants, pacemakers, cochlear implants, retinal implants and so on. The inductive coupling link is used to transmit power and data between the primary and secondary sides of the biomedical implanted system, in which efficient power amplifier is very much needed to ensure the best data transmission rates and low power losses. However, the efficiency of the implanted devices depends on the circuit design, controller, load variation, changes of radio frequency coil’s mutual displacement and coupling coefficients. This paper provides a comprehensive survey on various power amplifier classes and their characteristics, efficiency and controller techniques that have been used in bio-implants. The automatic frequency controller used in biomedical implants such as gate drive switching control, closed loop power control, voltage controlled oscillator, capacitor control and microcontroller frequency control have been explained. Most of these techniques keep the resonance frequency stable in transcutaneous power transfer between the external coil and the coil implanted inside the body. Detailed information including carrier frequency, power efficiency, coils displacement, power consumption, supplied voltage and CMOS chip for the controllers techniques are investigated and summarized in the provided tables. From the rigorous review, it is observed that the existing automatic frequency controller technologies are more or less can capable of performing well in the implant devices; however, the systems are still not up to the mark. Accordingly, current challenges and problems of the typical automatic frequency controller techniques for power amplifiers are illustrated, with a brief suggestions and discussion section concerning

  13. Automatic Frequency Controller for Power Amplifiers Used in Bio-Implanted Applications: Issues and Challenges

    Science.gov (United States)

    Hannan, Mahammad A.; Hussein, Hussein A.; Mutashar, Saad; Samad, Salina A.; Hussain, Aini

    2014-01-01

    With the development of communication technologies, the use of wireless systems in biomedical implanted devices has become very useful. Bio-implantable devices are electronic devices which are used for treatment and monitoring brain implants, pacemakers, cochlear implants, retinal implants and so on. The inductive coupling link is used to transmit power and data between the primary and secondary sides of the biomedical implanted system, in which efficient power amplifier is very much needed to ensure the best data transmission rates and low power losses. However, the efficiency of the implanted devices depends on the circuit design, controller, load variation, changes of radio frequency coil's mutual displacement and coupling coefficients. This paper provides a comprehensive survey on various power amplifier classes and their characteristics, efficiency and controller techniques that have been used in bio-implants. The automatic frequency controller used in biomedical implants such as gate drive switching control, closed loop power control, voltage controlled oscillator, capacitor control and microcontroller frequency control have been explained. Most of these techniques keep the resonance frequency stable in transcutaneous power transfer between the external coil and the coil implanted inside the body. Detailed information including carrier frequency, power efficiency, coils displacement, power consumption, supplied voltage and CMOS chip for the controllers techniques are investigated and summarized in the provided tables. From the rigorous review, it is observed that the existing automatic frequency controller technologies are more or less can capable of performing well in the implant devices; however, the systems are still not up to the mark. Accordingly, current challenges and problems of the typical automatic frequency controller techniques for power amplifiers are illustrated, with a brief suggestions and discussion section concerning the progress of

  14. Novel nanocomposite coating for dental implant applications in vitro and in vivo evaluation.

    Science.gov (United States)

    Mehdikhani-Nahrkhalaji, M; Fathi, M H; Mortazavi, V; Mousavi, S B; Hashemi-Beni, B; Razavi, S M

    2012-02-01

    This study aimed at preparation and in vitro and in vivo evaluation of novel bioactive, biodegradable, and antibacterial nanocomposite coating for the improvement of stem cells attachment and antibacterial activity as a candidate for dental implant applications. Poly (lactide-co-glycolide)/bioactive glass/hydroxyapatite (PBGHA) nanocomposite coating was prepared via solvent casting process. The nanoparticle amounts of 10, 15, and 20 weight percent (wt%) were chosen in order to determine the optimum amount of nanoparticles suitable for preparing an uniform coating. Bioactivity and degradation of the coating with an optimum amount of nanoparticles were evaluated by immersing the prepared samples in simulated body fluid and phosphate buffer saline (PBS), respectively. The effect of nanocomposite coating on the attachment and viability of human adipose-derived stem cells (hASCs) was investigated. Kirschner wires (K-wires) of stainless steel were coated with the PBGHA nanocomposite coating, and mechanical stability of the coating was studied during intramedullary implantation into rabbit tibiae. The results showed that using 10 wt% nanoparticles (5 wt% HA and 5 wt% BG) in the nanocomposite could provide the desired uniform coating. The study of in vitro bioactivity showed rapid formation of bone-like apatite on the PBGHA coating. It was degraded considerably after about 60 days of immersion in PBS. The hASCs showed excellent attachment and viability on the coating. PBGHA coating remained stable on the K-wires with a minimum of 96% of the original coating mass. It was concluded that PBGHA nanocomposite coating provides an ideal surface for the stem cells attachment and viability. In addition, it could induce antibacterial activity, simultaneously.

  15. [Orthopaedic day surgery in Emilia-Romagna].

    Science.gov (United States)

    Rolli, M; Rodler, M; Petropulacos, K; Baldi, R

    2001-09-01

    It is well known that the organizational model of day surgery, concerning surgical problems defined by the literature as minor, has the aim of optimising the use of hospital resources and facilitating patients and their families, from a psychological and social point of view, by reducing hospitalisation time and the associated complications, and ensuring the same efficacy and more appropriateness of treatment. This study is firstly aimed at analysing the impact that the healthcare policy of the Emilia Romagna Region has had on the development of day surgery practice. Secondly, it compares the patients treated in orthopaedic day surgery in the hospitals of Bologna, Modena, Ferrara, Parma, Reggio Emilia, Maggiore hospital of Bologna and Rizzoli Orthopaedic Institute of Bologna (II.OO.R). In the period 1997-2000 there was a marked increase in the number of operations carried out in day surgery in all of the above-mentioned hospitals. Also in the unispecialistic orthopaedic hospital there was a surprising increase in the percentage of operations carried out in day surgery with respect to the total number of operations performed. The aim of the Rizzoli Orthopaedic Institute and the Emilia Romagna Region is to further implement this form of healthcare, contextually potentiating the appropriateness of hospital admission and avoiding, when not necessary, other forms of healthcare.

  16. Intimate partner violence in orthopaedic trauma patients

    NARCIS (Netherlands)

    Sprague, S.A.

    2013-01-01

    Intimate partner violence (IPV) or domestic violence is a common and serious public health problem around the globe. Victims of IPV frequently present to health care practitioners including orthopaedic surgeons. Substantial research has been conducted on IPV over the past few decades, but very

  17. The orthopaedic management of myelomeningocele | Horn | South ...

    African Journals Online (AJOL)

    The orthopaedic management of myelomeningocele. A Horn, S Dix-Peek, S Mears, EB Hoffman. Abstract. Despite improvement in antenatal care and screening, myelomeningocele remains the most common congenital birth defect, with a reported incidence of 1 - 2.5/1000 patients in the Western Cape, South Africa.

  18. Nigerian Journal of Orthopaedics and Trauma: Submissions

    African Journals Online (AJOL)

    The Nigerian Journal of Orthopaedics and Trauma is a peer reviewed journal publishing original research articles on all aspects of trauma, musculoskeletal ... initials and surnames of all authors, their highest academic degrees, affiliations / institutions and the name, address and e-mail address of the corresponding author.

  19. Additively manufactured custom load-bearing implantable devices: grounds for caution

    Directory of Open Access Journals (Sweden)

    Elisabetta M Zanetti

    2017-08-01

    Full Text Available Background Additive manufacturing technologies are being enthusiastically adopted by the orthopaedic community since they are providing new perspectives and new possibilities. First applications were finalised for educational purposes, pre-operative planning, and design of surgical guides; recent applications also encompass the production of implantable devices where 3D printing can bring substantial benefits such as customization, optimization, and manufacturing of very complex geometries. The conceptual smoothness of the whole process may lead to the idea that any medical practitioner can use a 3D printer and her/his imagination to design and produce novel products for personal or commercial use. Aims Outlining how the whole process presents more than one critical aspects, still demanding further research in order to allow a safe application of this technology for fully-custom design, in particular confining attention to orthopaedic/orthodontic prostheses defined as components responding mainly to a structural function. Methods Current knowledge of mechanical properties of additively manufactured components has been examined along with reasons why the behaviour of these components might differ from traditionally manufactured components. The structural information still missing for mechanical design is outlined. Results Mechanical properties of additively manufactured components are not completely known, and especially fatigue limit needs to be examined further. Conclusion At the present stage, with reference to load-bearing implants subjected to many loading cycles, the indication of custom-made additively manufactured medical devices should be restricted to the cases with no viable alternative.

  20. Silicon-Doped Titanium Dioxide Nanotubes Promoted Bone Formation on Titanium Implants.

    Science.gov (United States)

    Zhao, Xijiang; Wang, Tao; Qian, Shi; Liu, Xuanyong; Sun, Junying; Li, Bin

    2016-02-26

    While titanium (Ti) implants have been extensively used in orthopaedic and dental applications, the intrinsic bioinertness of untreated Ti surface usually results in insufficient osseointegration irrespective of the excellent biocompatibility and mechanical properties of it. In this study, we prepared surface modified Ti substrates in which silicon (Si) was doped into the titanium dioxide (TiO₂) nanotubes on Ti surface using plasma immersion ion implantation (PIII) technology. Compared to TiO₂ nanotubes and Ti alone, Si-doped TiO₂ nanotubes significantly enhanced the expression of genes related to osteogenic differentiation, including Col-I, ALP, Runx2, OCN, and OPN, in mouse pre-osteoblastic MC3T3-E1 cells and deposition of mineral matrix. In vivo, the pull-out mechanical tests after two weeks of implantation in rat femur showed that Si-doped TiO₂ nanotubes improved implant fixation strength by 18% and 54% compared to TiO₂-NT and Ti implants, respectively. Together, findings from this study indicate that Si-doped TiO₂ nanotubes promoted the osteogenic differentiation of osteoblastic cells and improved bone-Ti integration. Therefore, they may have considerable potential for the bioactive surface modification of Ti implants.

  1. Flexible Near-Field Wireless Optoelectronics as Subdermal Implants for Broad Applications in Optogenetics.

    Science.gov (United States)

    Shin, Gunchul; Gomez, Adrian M; Al-Hasani, Ream; Jeong, Yu Ra; Kim, Jeonghyun; Xie, Zhaoqian; Banks, Anthony; Lee, Seung Min; Han, Sang Youn; Yoo, Chul Jong; Lee, Jong-Lam; Lee, Seung Hee; Kurniawan, Jonas; Tureb, Jacob; Guo, Zhongzhu; Yoon, Jangyeol; Park, Sung-Il; Bang, Sang Yun; Nam, Yoonho; Walicki, Marie C; Samineni, Vijay K; Mickle, Aaron D; Lee, Kunhyuk; Heo, Seung Yun; McCall, Jordan G; Pan, Taisong; Wang, Liang; Feng, Xue; Kim, Tae-Il; Kim, Jong Kyu; Li, Yuhang; Huang, Yonggang; Gereau, Robert W; Ha, Jeong Sook; Bruchas, Michael R; Rogers, John A

    2017-02-08

    In vivo optogenetics provides unique, powerful capabilities in the dissection of neural circuits implicated in neuropsychiatric disorders. Conventional hardware for such studies, however, physically tethers the experimental animal to an external light source, limiting the range of possible experiments. Emerging wireless options offer important capabilities that avoid some of these limitations, but the current size, bulk, weight, and wireless area of coverage is often disadvantageous. Here, we present a simple but powerful setup based on wireless, near-field power transfer and miniaturized, thin, flexible optoelectronic implants, for complete optical control in a variety of behavioral paradigms. The devices combine subdermal magnetic coil antennas connected to microscale, injectable light-emitting diodes (LEDs), with the ability to operate at wavelengths ranging from UV to blue, green-yellow, and red. An external loop antenna allows robust, straightforward application in a multitude of behavioral apparatuses. The result is a readily mass-producible, user-friendly technology with broad potential for optogenetics applications. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. A Smartphone Application for Customized Frequency Table Selection in Cochlear Implants.

    Science.gov (United States)

    Jethanamest, Daniel; Azadpour, Mahan; Zeman, Annette M; Sagi, Elad; Svirsky, Mario A

    2017-09-01

    A novel smartphone-based software application can facilitate self-selection of frequency allocation tables (FAT) in postlingually deaf cochlear implant (CI) users. CIs use FATs to represent the tonotopic organization of a normal cochlea. Current CI fitting methods typically use a standard FAT for all patients regardless of individual differences in cochlear size and electrode location. In postlingually deaf patients, different amounts of mismatch can result between the frequency-place function they experienced when they had normal hearing and the frequency-place function that results from the standard FAT. For some CI users, an alternative FAT may enhance sound quality or speech perception. Currently, no widely available tools exist to aid real-time selection of different FATs. This study aims to develop a new smartphone tool for this purpose and to evaluate speech perception and sound quality measures in a pilot study of CI subjects using this application. A smartphone application for a widely available mobile platform (iOS) was developed to serve as a preprocessor of auditory input to a clinical CI speech processor and enable interactive real-time selection of FATs. The application's output was validated by measuring electrodograms for various inputs. A pilot study was conducted in six CI subjects. Speech perception was evaluated using word recognition tests. All subjects successfully used the portable application with their clinical speech processors to experience different FATs while listening to running speech. The users were all able to select one table that they judged provided the best sound quality. All subjects chose a FAT different from the standard FAT in their everyday clinical processor. Using the smartphone application, the mean consonant-nucleus-consonant score with the default FAT selection was 28.5% (SD 16.8) and 29.5% (SD 16.4) when using a self-selected FAT. A portable smartphone application enables CI users to self-select frequency allocation

  3. Orthopaedic Sports Medicine Fellowship Interviews: Structure and Organization of the Interview Day.

    Science.gov (United States)

    Haislup, Brett D; Kraeutler, Matthew J; Baweja, Rishi; McCarty, Eric C; Mulcahey, Mary K

    2017-12-01

    Over the past few decades, there has been a trend toward an increasing subspecialization in orthopaedic surgery, with orthopaedic sports medicine being one of the most competitive subspecialties. Information regarding the application and interview process for sports medicine fellowships is currently lacking. To survey orthopaedic sports medicine fellowship program directors (PDs) to better define the structure of the sports medicine fellowship interview and to highlight important factors that PDs consider in selecting fellows. Cross-sectional study. A complete list of accredited programs was obtained from the American Orthopaedic Society for Sports Medicine (AOSSM) website. An anonymous survey was distributed to fellowship PDs of all Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic sports medicine fellowships in the United States. The survey included 12 questions about the fellowship interview and selection process. Of the 95 orthopaedic sports medicine fellowship PDs surveyed, 38 (40%) responded. Of these, 16 (42.1%) indicated that they interview between 21 and 30 applicants per year. Eleven of the 38 fellowship programs (28.9%) have only 1 fellow per year at their respective program. Most programs (27/37, 73%) reported that between 0 and 5 faculty members interview applicants, and 29 of the 38 programs (76.3%) arrange for applicants to have ≥4 interviews during their interview day. Large group interviews are conducted at 36 of 38 (94.7%) sports medicine fellowship programs, and most programs (24/38, 63.2%) hold individual interviews that last between 5 and 15 minutes. The most important applicant criterion taken into account by PDs was the quality of the interview, with an average score of 8.68 of 10. The most significant factor taken into account by PDs when deciding how to rank applicants was the quality of the interview. Many orthopaedic sports medicine fellowship programs interview between 21 and 30 applicants per year

  4. Implant isolation of plasma-assisted MBE grown GaInAsN for opto-telecommunication applications

    International Nuclear Information System (INIS)

    Ahmed, S.; Lin, J.; Haq, A.; Sealy, B.

    2005-01-01

    The material system GaInAsN is considered to be one of the key materials for next generation telecommunication applications providing high data transmission and lower power consumption. The strong dependence of the band gap on the nitrogen content has made this material important for a variety of applications. We report on the effects of ion implantation on the achieved electrical isolation in GaInAsN layers. GaInAsN was grown using either a direct nitrogen beam or dispersive nitrogen radicals by a RF activated nitrogen source. Proton and iron implants were performed at RT and 77 K, respectively in order to effectively isolate the as-grown silicon (n-type) GaInAsN layers. Results show that the sheet resistance of n-type layers can be increased by about four and five orders of magnitude by proton and iron implantation, respectively. The study of annealing temperature dependence of sheet resistivity in proton-isolated samples shows that the electrical isolation can be preserved up to 450 deg. C. The thermally stable high resistivity region persists up to 600 deg. C when the implantation is performed with iron at 77 K. These results are novel and have ramifications for device engineers

  5. Effectiveness of the AAOS Leadership Fellows Program for Orthopaedic Surgeons.

    Science.gov (United States)

    Day, Charles S; Tabrizi, Shervin; Kramer, Jeffrey; Yule, Arthur C; Ahn, Brian S

    2010-11-17

    Effective physician leadership is critical to the future success of healthcare organizations. The American Academy of Orthopaedic Surgeons (AAOS) Leadership Fellows Program is a one-year program designed to train young orthopaedic surgeons to become future leaders in orthopaedics. The purpose of this study was to evaluate the impact of the AAOS Leadership Fellows Program on the leadership skills and achievements of its participants. Graduates of the Leadership Fellows Program were compared with a control group of previous applicants who were not accepted to the program (applicants) in a retrospective cohort comparison study. A subjective survey of leadership skills was used to assess the confidence of the two cohorts in eight areas of leadership. In addition, an updated curriculum vitae from each of sixty leadership fellows from the classes of 2003 through 2009 and from each of forty-seven applicants was retrospectively reviewed for evidence of leadership. The updated curriculum vitae of the leadership fellows was evaluated for leadership activity attained prior to and following participation in the program, while the updated curriculum vitae of applicants was evaluated for leadership activity attained prior to and following the last year of application to the program. Curricula vitae were assessed for demonstration of national leadership, academic rank, hospital administrative rank, and research experience. On the leadership survey, the graduates of the Leadership Fellows Program scored higher than the applicants in seven of eight categories. The review of the curricula vitae demonstrated that, prior to the Leadership Fellows Program, the leadership fellows were more likely than the applicants to have an academic practice and hold an academic rank. The difference between the two cohorts in administrative rank and leadership of national committees was not significant. Following the program, the leadership fellows were more likely to chair national committees (p

  6. Magnesium alloys for temporary implant applications: stress corrosion cracking and biocompatible coating

    OpenAIRE

    Choudhary, Lokesh Kumar

    2017-01-01

    Magnesium (Mg) alloys have emerged as potential candidate materials for construction of biodegradable temporary implant devices particularly due to advantages of favourable mechanical properties, biodegradability and biocompatibility. However, the poor corrosion resistance of Mg alloys in the physiological environment presents a major challenge to their use as biodegradable temporary implants. Furthermore, complex interaction of mechanical loading and aggressive physiological environment may ...

  7. Implantable electronic medical devices

    CERN Document Server

    Fitzpatrick, Dennis

    2014-01-01

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

  8. Critical roles of orthopaedic surgeon leadership in healthcare systems to improve orthopaedic surgical patient safety.

    Science.gov (United States)

    Kuo, Calvin C; Robb, William J

    2013-06-01

    The prevention of medical and surgical harm remains an important public health problem despite increased awareness and implementation of safety programs. Successful introduction and maintenance of surgical safety programs require both surgeon leadership and collaborative surgeon-hospital alignment. Documentation of success of such surgical safety programs in orthopaedic practice is limited. We describe the scope of orthopaedic surgical patient safety issues, define critical elements of orthopaedic surgical safety, and outline leadership roles for orthopaedic surgeons needed to establish and sustain a culture of safety in contemporary healthcare systems. We identified the most common causes of preventable surgical harm based on adverse and sentinel surgical events reported to The Joint Commission. A comprehensive literature review through a MEDLINE(®) database search (January 1982 through April 2012) to identify pertinent orthopaedic surgical safety articles found 14 articles. Where gaps in orthopaedic literature were identified, the review was supplemented by 22 nonorthopaedic surgical references. Our final review included 36 articles. Six important surgical safety program elements needed to eliminate preventable surgical harm were identified: (1) effective surgical team communication, (2) proper informed consent, (3) implementation and regular use of surgical checklists, (4) proper surgical site/procedure identification, (5) reduction of surgical team distractions, and (6) routine surgical data collection and analysis to improve the safety and quality of surgical patient care. Successful surgical safety programs require a culture of safety supported by all six key surgical safety program elements, active surgeon champions, and collaborative hospital and/or administrative support designed to enhance surgical safety and improve surgical patient outcomes. Further research measuring improvements from such surgical safety systems in orthopaedic care is needed.

  9. Application of Coaxial Ion Gun for Film Generation and Ion Implantation

    Science.gov (United States)

    Takatsu, Mikio; Asai, Tomohiko; Kurumi, Satoshi; Suzuki, Kaoru; Hirose, Hideharu; Masutani, Shigeyuki

    A magnetized coaxial plasma gun (MCPG) is here utilized for deposition on high-melting-point metals. MCPGs have hitherto been studied mostly in the context of nuclear fusion research, for particle and magnetic helicity injection and spheromak formation. During spheromak formation, the electrode materials are ionized and mixed into the plasmoid. In this study, this ablation process by gun-current sputtering is enhanced for metallic thin-film generation. In the proposed system geometry, only ionized materials are electromagnetically accelerated by the self-Lorentz force, with ionized operating gas as a magnetized thermal plasmoid, contributing to the thin-film deposition. This reduces the impurity and non-uniformity of the deposited thin-film. Furthermore, as the ions are accelerated in a parallel direction to the injection axis, vertical implantation of the ions into the substrate surface is achieved. To test a potential application of the developed system, experiments were conducted involving the formation of a buffer layer on hard ceramics, for use in dental materials.

  10. A Single-Chip Solar Energy Harvesting IC Using Integrated Photodiodes for Biomedical Implant Applications.

    Science.gov (United States)

    Chen, Zhiyuan; Law, Man-Kay; Mak, Pui-In; Martins, Rui P

    2017-02-01

    In this paper, an ultra-compact single-chip solar energy harvesting IC using on-chip solar cell for biomedical implant applications is presented. By employing an on-chip charge pump with parallel connected photodiodes, a 3.5 × efficiency improvement can be achieved when compared with the conventional stacked photodiode approach to boost the harvested voltage while preserving a single-chip solution. A photodiode-assisted dual startup circuit (PDSC) is also proposed to improve the area efficiency and increase the startup speed by 77%. By employing an auxiliary charge pump (AQP) using zero threshold voltage (ZVT) devices in parallel with the main charge pump, a low startup voltage of 0.25 V is obtained while minimizing the reversion loss. A 4 V in gate drive voltage is utilized to reduce the conduction loss. Systematic charge pump and solar cell area optimization is also introduced to improve the energy harvesting efficiency. The proposed system is implemented in a standard 0.18- [Formula: see text] CMOS technology and occupies an active area of 1.54 [Formula: see text]. Measurement results show that the on-chip charge pump can achieve a maximum efficiency of 67%. With an incident power of 1.22 [Formula: see text] from a halogen light source, the proposed energy harvesting IC can deliver an output power of 1.65 [Formula: see text] at 64% charge pump efficiency. The chip prototype is also verified using in-vitro experiment.

  11. Munich Music Questionnaire: adaptation into Brazilian Portuguese and application in cochlear implant users.

    Science.gov (United States)

    Frederigue-Lopes, Natália Barreto; Bevilacqua, Maria Cecilia; Costa, Orozimbo Alves

    2015-01-01

    To translate the Munich Music Questionnaire (MUMU) to Brazilian Portuguese, to adapt it culturally, and to describe the results obtained among adult users of cochlear implant (CI). We translated the questionnaire to Brazilian Portuguese, reviewed the grammatical and idiomatic equivalences (back-translation), and adapted it from a linguistic and cultural perspective. The resulting version of this process was applied among adult CI users through direct interviews. The Brazilian Portuguese version of MUMU was applied to 19 adult CI users with postlingual hearing loss, who had been users of the device for at least one year. The answers to the questionnaire were analyzed by distribution of frequency and percentage of occurrence in each question. The results showed a decrease in the frequency of CI users that listen to music, comparing the period before hearing loss and after the CI. Regarding the role that music played in the life of each participant, the responses did not score change, so the music remained being an important factor in the life of the evaluated subjects, even after the CI. The subjective evaluation tool MUMU was translated and culturally adapted to the population studied. In Brazilian Portuguese, it was called Questionário de Música de Munique. The study showed its applicability in the daily monitoring of CI users, thus providing a profile of the activities related to music in everyday life.

  12. Advanced bredigite-containing magnesium-matrix composites for biodegradable bone implant applications.

    Science.gov (United States)

    Dezfuli, Sina Naddaf; Huan, Zhiguang; Mol, Arjan; Leeflang, Sander; Chang, Jiang; Zhou, Jie

    2017-10-01

    The present research was aimed at developing magnesium-matrix composites that could allow effective control over their physiochemical and mechanical responses when in contact with physiological solutions. A biodegradable, bioactive ceramic - bredigite was chosen as the reinforcing phase in the composites, based on the hypothesis that the silicon- and magnesium-containing ceramic could protect magnesium from fast corrosion and at the same time stimulate cell proliferation. Methods to prepare composites with integrated microstructures - a prerequisite to achieve controlled biodegradation were developed. A systematic experimental approach was taken in order to elucidate the in vitro biodegradation mechanisms and kinetics of the composites. It was found that the composites with 20-40% homogenously dispersed bredigite particles, prepared from powders, could indeed significantly decrease the degradation rate of magnesium by up to 24 times. Slow degradation of the composites resulted in the retention of the mechanical integrity of the composites within the strength range of cortical bone after 12days of immersion in a cell culture medium. Cell attachment, cytotoxicity and bioactivity tests confirmed the stimulatory effects of bredigite embedded in the composites on the attachment, viability and differentiation of bone marrow stromal cells. Thus, the multiple benefits of adding bredigite to magnesium in enhancing degradation behavior, mechanical properties, biocompatibility and bioactivity were obtained. The results from this research showed the excellent potential of the bredigite-containing composites for bone implant applications, thus warranting further in vitro and in vivo research. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Glass-ceramic coated Mg-Ca alloys for biomedical implant applications.

    Science.gov (United States)

    Rau, J V; Antoniac, I; Fosca, M; De Bonis, A; Blajan, A I; Cotrut, C; Graziani, V; Curcio, M; Cricenti, A; Niculescu, M; Ortenzi, M; Teghil, R

    2016-07-01

    Biodegradable metals and alloys are promising candidates for biomedical bone implant applications. However, due to the high rate of their biodegradation in human body environment, they should be coated with less reactive materials, such, for example, as bioactive glasses or glass-ceramics. Fort this scope, RKKP composition glass-ceramic coatings have been deposited on Mg-Ca(1.4wt%) alloy substrates by Pulsed Laser Deposition method, and their properties have been characterized by a number of techniques. The prepared coatings consist of hydroxyapatite and wollastonite phases, having composition close to that of the bulk target material used for depositions. The 100μm thick films are characterized by dense, compact and rough morphology. They are composed of a glassy matrix with various size (from micro- to nano-) granular inclusions. The average surface roughness is about 295±30nm due to the contribution of micrometric aggregates, while the roughness of the fine-texture particulates is approximately 47±4nm. The results of the electrochemical corrosion evaluation tests evidence that the RKKP coating improves the corrosion resistance of the Mg-Ca (1.4wt%) alloy in Simulated Body Fluid. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. A study on the applicability of implantable microchip transponders for body temperature measurements in pigs

    Directory of Open Access Journals (Sweden)

    Enøe Claes

    2010-05-01

    Full Text Available Abstract Background The applicability of an electronic monitoring system using microchip transponders for measurement of body temperatures was tested in 6-week-old conventional Danish weaners infected with classical swine fever virus (CSFV. Subcutaneous tissue temperatures obtained by the implantable transponders were compared with rectal temperatures, recorded by a conventional digital thermometer. Methods In a preliminary study, transponders were inserted subcutaneously at 6 different positions of the body of 5 pigs. The transponders positioned by the ear base provided the best correlation to rectal temperature. To test the stability of the monitoring system in a larger group of pigs, transponders were therefore inserted by the left ear base in a subsequent infection experiment with 30 pigs. Results Generally, the microchip transponders measured a subcutaneous tissue temperature, which was about 1°C lower than the rectal temperature. However, a simple linear relationship between the measures of the two methods was found. Conclusions Our study showed that the tested body monitoring system may represent a promising tool to obtain an approximate correlate of body temperatures in groups of pigs. In contrast, however, the tested system did not constitute a suitable tool to measure body temperatures of individual animals in the present pig infection experiment.

  15. Application of a 3D printed customized implant for canine cruciate ligament treatment by tibial tuberosity advancement

    International Nuclear Information System (INIS)

    Castilho, Miguel; Dias, Marta; Fernandes, Paulo; Pires, Inês; Gouveia, Barbara; Rodrigues, Jorge; Vorndran, Elke; Gbureck, Uwe; Armés, Henrique; Pires, Eduardo

    2014-01-01

    Fabrication of customized implants based on patient bone defect characteristics is required for successful clinical application of bone tissue engineering. Recently a new surgical procedure, tibial tuberosity advancement (TTA), has been used to treat cranial cruciate ligament (CrCL) deficient stifle joints in dogs, which involves an osteotomy and the use of substitutes to restore the bone. However, limitations in the use of non-biodegradable implants have been reported. To overcome these limitations, this study presents the development of a bioceramic customized cage to treat a large domestic dog assigned for TTA treatment. A cage was designed using a suitable topology optimization methodology in order to maximize its permeability whilst maintaining the structural integrity, and was manufactured using low temperature 3D printing and implanted in a dog. The cage material and structure was adequately characterized prior to implantation and the in vivo response was carefully monitored regarding the biological response and patient limb function. The manufacturing process resulted in a cage composed of brushite, monetite and tricalcium phosphate, and a highly permeable porous morphology. An overall porosity of 59.2% was achieved by the combination of a microporosity of approximately 40% and a designed interconnected macropore network with pore sizes of 845 μm. The mechanical properties were in the range of the trabecular bone although limitations in the cage's reliability and capacity to absorb energy were identified. The dog's limb function was completely restored without patient lameness or any adverse complications and also the local biocompatibility and osteoconductivity were improved. Based on these observations it was possible to conclude that the successful design, fabrication and application of a customized cage for a dog CrCL treatment using a modified TTA technique is a promising method for the future fabrication of patient-specific bone implants

  16. [Manufacture method and clinical application of minimally invasive dental implant guide template based on registration technology].

    Science.gov (United States)

    Lin, Zeming; He, Bingwei; Chen, Jiang; D u, Zhibin; Zheng, Jingyi; Li, Yanqin

    2012-08-01

    To guide doctors in precisely positioning surgical operation, a new production method of minimally invasive implant guide template was presented. The mandible of patient was scanned by CT scanner, and three-dimensional jaw bone model was constructed based on CT images data The professional dental implant software Simplant was used to simulate the plant based on the three-dimensional CT model to determine the location and depth of implants. In the same time, the dental plaster models were scanned by stereo vision system to build the oral mucosa model. Next, curvature registration technology was used to fuse the oral mucosa model and the CT model, then the designed position of implant in the oral mucosa could be determined. The minimally invasive implant guide template was designed in 3-Matic software according to the design position of implant and the oral mucosa model. Finally, the template was produced by rapid prototyping. The three-dimensional registration technology was useful to fuse the CT data and the dental plaster data, and the template was accurate that could provide the doctors a guidance in the actual planting without cut-off mucosa. The guide template which fabricated by comprehensive utilization of three-dimensional registration, Simplant simulation and rapid prototyping positioning are accurate and can achieve the minimally invasive and accuracy implant surgery, this technique is worthy of clinical use.

  17. Application of the 2-piece orthodontic C-implant for provisional restoration with laser welded customized coping: a case report.

    Science.gov (United States)

    Paek, Janghyun; Ahn, Hyo-Won; Jeong, Do-Min; Shim, Jeong-Seok; Kim, Seong-Hun; Chung, Kyu-Rhim

    2015-03-25

    This article presents the application of laser welding technique to fabricate an orthodontic mini-implant provisional restoration in missing area after limited orthodontic treatment. A 15-year-old boy case is presented. Two-piece orthodontic C-implant was placed after regaining space for missing right mandibular central incisor. Due to angular deviation of implant, customized abutment was required. Ready-made head part was milled and lingual part of customized abutment was made with non-precious metal. Two parts then were laser welded (Master 1000, Elettrolaser Italy, Verona, Italy) and indirect lab composite (3 M ESPE Sinfony, St. Paul, MN, USA) was built up. The patient had successful result, confirmed by clinical and radiographic examinations. Before the patient is ready to get a permanent restoration later on, this provisional restoration will be used. This case shows that a two-piece orthodontic C-implant system can be used to maintain small edentulous space after orthodontic treatment.

  18. Application of interconnected porous hydroxyapatite ceramic block for onlay block bone grafting in implant treatment: A case report.

    Science.gov (United States)

    Ohta, Kouji; Tada, Misato; Ninomiya, Yoshiaki; Kato, Hiroki; Ishida, Fumi; Abekura, Hitoshi; Tsuga, Kazuhiro; Takechi, Masaaki

    2017-12-01

    Autogenous block bone grafting as treatment for alveolar ridge atrophy has various disadvantages, including a limited availability of sufficiently sized and shaped grafts, donor site morbidity and resorption of the grafted bone. As a result, interconnected porous hydroxyapatite ceramic (IP-CHA) materials with high porosity have been developed and used successfully in orthopedic cases. To the best of the author's knowledge, this is the first report of clinical application of an IP-CHA block for onlay grafting for implant treatment in a patient with horizontal alveolar atrophy. The present study performed onlay block grafting using an IP-CHA block to restore bone volume for implant placement in the alveolar ridge area without collecting autogenous bone. Dental X-ray findings revealed that the border of the IP-CHA block became increasingly vague over the 3-year period, whereas CT scanning revealed that the gap between the block and bone had a smooth transition, indicating that IP-CHA improved the process of integration with host bone. In follow-up examinations over a period of 5 years, the implants and superstructures had no problems. An IP-CHA block may be useful as a substitute for onlay block bone grafting in implant treatment.

  19. Planar self-aligned ion implanted InP MISFETS for fast logic applications

    International Nuclear Information System (INIS)

    Cameron, D.C.; Irving, L.D.; Whitehouse, C.R.; Woodward, J.; Lee, D.

    1983-01-01

    The first successful use of ion implantation to fabricate truly self-aligned planar n-channel enhancement-mode indium phosphide MISFITS is reported. The transistors have been fabricated on iron-doped semi-insulating material using PECVD-deposited SiO 2 as the gate dielectric and molybdenum gate electrodes. The self-aligned source and drain contact regions were produced by Si 29 ion implantation using each gate stripe as an implant mask. The devices fabricated to date have exhibited channel mobilities up to value of 2400 cm 2 v -1 s -1 , with excellent uniformity and stability of the device characteristics also being observed. (author)

  20. Application of high resolution synchrotron micro-CT radiation in dental implant osseointegration

    DEFF Research Database (Denmark)

    Neldam, Camilla Albeck; Lauridsen, Torsten; Rack, Alexander

    2015-01-01

    The purpose of this study was to describe a refined method using high-resolution synchrotron radiation microtomography (SRmicro-CT) to evaluate osseointegration and peri-implant bone volume fraction after titanium dental implant insertion. SRmicro-CT is considered gold standard evaluating bone...... microarchitecture. Its high resolution, high contrast, and excellent high signal-to-noise-ratio all contribute to the highest spatial resolutions achievable today. Using SRmicro-CT at a voxel size of 5 μm in an experimental goat mandible model, the peri-implant bone volume fraction was found to quickly increase...

  1. Leadership and business education in orthopaedic residency training programs.

    Science.gov (United States)

    Kiesau, Carter D; Heim, Kathryn A; Parekh, Selene G

    2011-01-01

    Leadership and business challenges have become increasingly present in the practice of medicine. Orthopaedic residency programs are at the forefront of educating and preparing orthopaedic surgeons. This study attempts to quantify the number of orthopaedic residency programs in the United States that include leadership or business topics in resident education program and to determine which topics are being taught and rate the importance of various leadership characteristics and business topics. A survey was sent to all orthopaedic department chairpersons and residency program directors in the United States via e-mail. The survey responses were collected using a survey collection website. The respondents rated the importance of leadership training for residents as somewhat important. The quality of character, integrity, and honesty received the highest average rating among 19 different qualities of good leaders in orthopaedics. The inclusion of business training in resident education was also rated as somewhat important. The topic of billing and coding received the highest average rating among 14 different orthopaedically relevant business topics. A variety of topics beyond the scope of clinical practice must be included in orthopaedic residency educational curricula. The decreased participation of newly trained orthopaedic surgeons in leadership positions and national and state orthopaedic organizations is concerning for the future of orthopaedic surgery. Increased inclusion of leadership and business training in resident education is important to better prepare trainees for the future.

  2. Quality of life during orthopaedic training and academic practice. Part 1: orthopaedic surgery residents and faculty.

    Science.gov (United States)

    Sargent, M Catherine; Sotile, Wayne; Sotile, Mary O; Rubash, Harry; Barrack, Robert L

    2009-10-01

    A pilot study of two academic training programs revealed concerning levels of resident burnout and psychological dysfunction. The purpose of the present study was to determine the quality of life of orthopaedic residents and faculty on a national scale and to identify risk factors for decompensation. Three hundred and eighty-four orthopaedic residents and 264 full-time orthopaedic faculty members completed a voluntary, anonymous survey consisting of three validated instruments (the Maslach Burnout Inventory, the General Health Questionnaire-12, and the Revised Dyadic Adjustment Scale) and question sets assessing demographic information, relationship issues, stress reactions/management, and work/life balance. High levels of burnout were seen in 56% of the residents and 28% of the faculty members. Burnout risk was greatest among second-postgraduate-year residents and residents in training programs with six or more residents per postgraduate year. Sixteen percent of residents and 19% of faculty members reported symptoms of psychological distress. Sleep deprivation was common among the residents and correlated positively with every distress measure. Faculty reported greater levels of stress but greater satisfaction with work and work/life balance. A number of factors, such as making time for hobbies and limiting alcohol use, correlated with decreased dysfunction for both residents and faculty. Despite reporting high levels of job satisfaction, orthopaedic residents and faculty are at risk for burnout and distress. Identification of protective factors and risk factors may provide guidance to improve the quality of life of academic orthopaedic surgeons in training and beyond.

  3. The 2016 American Orthopaedic Association-Japanese Orthopaedic Association Traveling Fellowship.

    Science.gov (United States)

    Nandi, Sumon; Cho, Samuel K; Freedman, Brett A; Firoozabadi, Reza

    2017-06-07

    The American Orthopaedic Association-Japanese Orthopaedic Association (AOA-JOA) Traveling Fellowship, which began in 1992 as a collaborative effort between the 2 orthopaedic communities, is aimed at fostering leadership among early-career surgeons through clinical, academic, and cultural exchange. Over 3 weeks, we experienced an extraordinary journey that led us across nearly 800 miles of the picturesque Japanese countryside, with stops at 6 distinguished academic centers. The opportunity to become personally acquainted with orthopaedic leaders in Japan, learn from their experiences, and immerse ourselves in the ancient and storied culture of a beautiful country was one that we will not soon forget. Along the way, we accumulated a wealth of information while enjoying the legendary hospitality of the Japanese people. There is a ubiquitous challenge in delivering cost-effective, accessible health care while maintaining a commitment to education and research. The U.S. orthopaedic community may take solace in the fact that our Japanese colleagues stand with us as partners in this pursuit, and our relationship with them continues to grow stronger through endeavors such as the AOA-JOA Traveling Fellowship. We look forward to honoring our Japanese colleagues in 2017 when we host them in the United States.

  4. Orthopaedic Rehabilitation Device Actuated with Pneumatic Muscles

    Directory of Open Access Journals (Sweden)

    Ioana Petre

    2014-07-01

    Full Text Available Year after year recovery clinics worldwide report significant numbers of lower limb bearing joint disabilities. An effective method for the speedy rehabilitation of patients with such afflictions is Continuous Passive Motion (CPM, drawing upon a range of specific equipment. This paper presents an innovative constructive solution for such orthopaedic rehabilitation equipment, designed to ensure a swift reintegration of patients at as low a cost as possible. The absolute novelty consists in the utilization of the linear pneumatic muscle as actuator of the orthopaedic rehabilitation equipment, thus achieving a light and highly compliant construction that satisfies safety requirements related to man-machine interaction. Pneumatic muscles are bio-inspired actuation systems characterized by a passive variable compliant behaviour. This property, deployed in rehabilitation systems, enables the development of human friendly devices, which are comfortable for the patients, and capable of safe interaction. This paper presents the constructive schematic of the orthopaedic rehabilitation equipment, the structure of the actuation and positioning system, and several of its functional characteristics.

  5. Quality of online pediatric orthopaedic education materials.

    Science.gov (United States)

    Feghhi, Daniel P; Komlos, Daniel; Agarwal, Nitin; Sabharwal, Sanjeev

    2014-12-03

    Increased availability of medical information on the Internet empowers patients to look up answers to questions about their medical conditions. However, the quality of medical information available on the Internet is highly variable. Various tools for the assessment of online medical information have been developed and used to assess the quality and accuracy of medical web sites. In this study we used the LIDA tool (Minervation) to assess the quality of pediatric patient information on the AAOS (American Academy of Orthopaedic Surgeons) and POSNA (Pediatric Orthopaedic Society of North America) web sites. The accessibility, usability, and reliability of online medical information in the "Children" section of the AAOS web site and on the POSNA web site were assessed with use of the LIDA tool. Flesch-Kincaid (FK) and Flesch Reading Ease (FRE) values were also calculated to assess the readability of the pediatric education material. Patient education materials on each web site scored in the moderate range in assessments of accessibility, usability, and reliability. FK and FRE values indicated that the readability of each web site remained at a somewhat higher (more difficult) level than the recommended benchmark. The quality and readability of online information for children on the AAOS and POSNA web sites are acceptable but can be improved further. The quality of online pediatric orthopaedic patient education materials may affect communication with patients and their caregivers, and further investigation and modification of quality are needed. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

  6. The Subcutaneous Implantable Cardioverter-Defibrillator: A Practical Review and Real-World Use and Application

    Directory of Open Access Journals (Sweden)

    Mark E. Panna Jr, MD, FACC, FHRS

    2016-02-01

    Full Text Available The subcutaneous implantable cardioverter-defibrillator (ICD is a novel technology using a subcutaneous (extrathoracic system for treatment of potential lethal ventricular arrhythmias. It avoids many of the risks of transvenous ICD implantation. It may be considered in patients having an ICD indication who do not have a pacing and/or cardiac resynchronization therapy indication, and who are unlikely to benefit from antitachycardia pacing therapy. We review patient selection, system components, the implantation technique, and screening considerations for subcutaneous ICD implantation. Its uses in specific patient populations, including children, patients with congenital heart disease, hypertrophic cardiomyopathy, or end-stage renal disease, and patients with preexisting pacemakers, are highlighted. Areas of future investigation are reviewed, including potential use with leadless pacing and magnetic resonance imaging.

  7. Two-year clinical outcomes following non-surgical mechanical therapy of peri-implantitis with adjunctive diode laser application.

    Science.gov (United States)

    Mettraux, Gérald R; Sculean, Anton; Bürgin, Walter B; Salvi, Giovanni E

    2016-07-01

    Non-surgical mechanical therapy of peri-implantitis (PI) with/without adjunctive measures yields limited clinical improvements. To evaluate the clinical outcomes following non-surgical mechanical therapy of PI with adjunctive application of a diode laser after an observation period ≥2 years. At baseline (BL), 15 patients with 23 implants with a sandblasted and acid-etched (SLA) surface diagnosed with PI were enrolled and treated. PI was defined as presence of probing pocket depths (PPD) ≥5 mm with bleeding on probing (BoP) and/or suppuration and ≥2 threads with bone loss after delivery of the restoration. Implant sites were treated with carbon fiber and metal curettes followed by repeated application of a diode laser 3x for 30 s (settings: 810 nm, 2.5 W, 50 Hz, 10 ms). This procedure was performed at Day 0 (i.e., baseline), 7 and 14. Adjunctive antiseptics or adjunctive systemic antibiotics were not prescribed. All implants were in function after 2 years. The deepest PPD decreased from 7.5 ± 2.6 mm to 3.6 ± 0.7 mm at buccal (P surgical mechanical therapy of PI with adjunctive repeated application of a diode laser yielded significant clinical improvements after an observation period of at least 2 years. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Tunnel oxide passivated contacts formed by ion implantation for applications in silicon solar cells

    International Nuclear Information System (INIS)

    Reichel, Christian; Feldmann, Frank; Müller, Ralph; Hermle, Martin; Glunz, Stefan W.; Reedy, Robert C.; Lee, Benjamin G.; Young, David L.; Stradins, Paul

    2015-01-01

    Passivated contacts (poly-Si/SiO x /c-Si) doped by shallow ion implantation are an appealing technology for high efficiency silicon solar cells, especially for interdigitated back contact (IBC) solar cells where a masked ion implantation facilitates their fabrication. This paper presents a study on tunnel oxide passivated contacts formed by low-energy ion implantation into amorphous silicon (a-Si) layers and examines the influence of the ion species (P, B, or BF 2 ), the ion implantation dose (5 × 10 14  cm −2 to 1 × 10 16  cm −2 ), and the subsequent high-temperature anneal (800 °C or 900 °C) on the passivation quality and junction characteristics using double-sided contacted silicon solar cells. Excellent passivation quality is achieved for n-type passivated contacts by P implantations into either intrinsic (undoped) or in-situ B-doped a-Si layers with implied open-circuit voltages (iV oc ) of 725 and 720 mV, respectively. For p-type passivated contacts, BF 2 implantations into intrinsic a-Si yield well passivated contacts and allow for iV oc of 690 mV, whereas implanted B gives poor passivation with iV oc of only 640 mV. While solar cells featuring in-situ B-doped selective hole contacts and selective electron contacts with P implanted into intrinsic a-Si layers achieved V oc of 690 mV and fill factor (FF) of 79.1%, selective hole contacts realized by BF 2 implantation into intrinsic a-Si suffer from drastically reduced FF which is caused by a non-Ohmic Schottky contact. Finally, implanting P into in-situ B-doped a-Si layers for the purpose of overcompensation (counterdoping) allowed for solar cells with V oc of 680 mV and FF of 80.4%, providing a simplified and promising fabrication process for IBC solar cells featuring passivated contacts

  9. Synthesis and characterization of wollastonite glass-ceramics for dental implant applications.

    Science.gov (United States)

    Saadaldin, Selma A; Rizkalla, Amin S

    2014-03-01

    To synthesize a glass-ceramic (GC) that is suitable for non-metallic one-piece dental implant application. Three glasses in a SiO2-Al2O3-CaO-CaF2-K2O-B2O3-P2O5-CeO2-Y2O3 system were produced by wet chemistry. Differential thermal analysis (DTA) was carried out to determine the glass crystallization kinetic parameters and the heating schedules that were used for sintering of GCs. Crystalline phases and crystal morphologies were studied by X-ray diffraction (XRD) and scanning electron microscopy (SEM), respectively. Mechanical properties of the GCs were determined by ultrasonic and indentation tests and its machinability were evaluated. Chemical durability was carried out according to ISO 6872, whereas testing chemical degradation in tris buffered solution was executed according to ISO 10993-14. XRD of the GC specimens showed that wollastonite was the main crystalline with other secondary phases; GC2 had cristobalite as an additional phase. SEM of the GCs revealed dense acicular interlocking crystals. Young's modulus of elasticity (E), true hardness (Ho) and fracture toughness (KIC) of the GCs were 89-100GPa, 4.85-5.17GPa and 4.62-5.58MPam(0.5), respectively. All GCs were demonstrated excellent machinability. The GCs exhibited various chemical durability and degradation rates. KIC values of the GCs following chemical durability testing were not significantly different from those of the original materials (p>0.05). GC2 exhibited significantly higher KIC value compared with GC1 and GC3 (pmachinability and chemical durability. Copyright © 2014. Published by Elsevier Ltd.

  10. Mechanical properties, corrosion, and biocompatibility of Mg-Zr-Sr-Dy alloys for biodegradable implant applications.

    Science.gov (United States)

    Ding, Yunfei; Lin, Jixing; Wen, Cuie; Zhang, Dongmei; Li, Yuncang

    2017-11-28

    This study investigates the microstructure, mechanical properties, corrosion behavior, and biocompatibility of magnesium (Mg)-based Mg1Zr2SrxDy (x = 0, 1, 1.63, 2.08 wt %) alloys for biodegradable implant applications. The corrosion behavior of the Mg-based alloys has been evaluated in simulated body fluid using an electrochemical technique and hydrogen evolution. The biocompatibility of the Mg-based alloys has been assessed using SaSO2 cells. Results indicate that the addition of Dy to Mg-Zr-Sr alloy showed a positive impact on the corrosion behavior and significantly decreased the degradation rates of the alloys. The degradation rate of Mg1Zr2Sr1.0Dy decreased from 17.61 to 12.50 mm year -1 of Mg1Zr2Sr2.08Dy based on the hydrogen evolution. The ultimate compressive strength decreased from 270.90 MPa for Mg1Zr2Sr1Dy to 236.71 MPa for Mg1Zr2Sr2.08Dy. An increase in the addition of Dy to the Mg-based alloys resulted in an increase in the volume fraction of the Mg 2 Dy phase, which mitigated the galvanic effect between the Mg 17 Sr 2 phase and the Mg matrix, and led to an increase in the corrosion resistance of the base alloy. The biocompatibility of the Mg-based alloys was enhanced with decreasing corrosion rates. Mg1Zr2Sr2.08Dy exhibited the lowest corrosion rate and the highest biocompatibility compared with the other Mg-based alloys. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2017. © 2017 Wiley Periodicals, Inc.

  11. Ultra thin layer activation by recoil implantation of radioactive heavy ions. Applicability in wear and corrosion studies

    International Nuclear Information System (INIS)

    Lacroix, O.; Sauvage, T.; Blondiaux, G.; Guinard, L.

    1997-07-01

    A new calibration procedure is proposed for the application of recoil implantation of radioactive heavy ions (energies between a few hundred keV and a few MeV) into the near surface of materials as part of a research programme on sub-micrometric wear or corrosion phenomena. The depth profile of implanted radioelements is performed by using ultra thin deposited films obtained by cathode sputtering under argon plasma. Two curves for 56 Co ion in nickel have been determined for implantation depths of 110 and 200 nm, respectively, and stress the feasibility and reproducibility of this method for such activated depths. The achieved surface loss detection sensitivities are about 1 and 2 nm respectively. The on line detection mode is performed directly on the sample of interest. A general description of the method is presented. A study of the reaction kinematics followed by a general treatment on the irradiation parameters to be adopted are also developed with the intention of using the ultra thin layer activation method (UTLA) to further applications in research and industry. (author)

  12. External fixation of femoral defects in athymic rats: Applications for human stem cell implantation and bone regeneration

    Directory of Open Access Journals (Sweden)

    Terasa Foo

    2013-01-01

    Full Text Available An appropriate animal model is critical for the research of stem/progenitor cell therapy and tissue engineering for bone regeneration in vivo. This study reports the design of an external fixator and its application to critical-sized femoral defects in athymic rats. The external fixator consists of clamps and screws that are readily available from hardware stores as well as Kirschner wires. A total of 35 rats underwent application of the external fixator with creation of a 6-mm bone defect in one femur of each animal. This model had been used in several separate studies, including implantation of collagen gel, umbilical cord blood mesenchymal stem cells, endothelial progenitor cells, or bone morphogenetic protein-2. One rat developed fracture at the proximal pin site and two rats developed deep tissue infection. Pin loosening was found in nine rats, but it only led to the failure of external fixation in two animals. In 8 to 10 weeks, various degrees of bone growth in the femoral defects were observed in different study groups, from full repair of the bone defect with bone morphogenetic protein-2 implantation to fibrous nonunion with collagen gel implantation. The external fixator used in these studies provided sufficient mechanical stability to the bone defects and had a comparable complication rate in athymic rats as in immunocompetent rats. The external fixator does not interfere with the natural environment of a bone defect. This model is particularly valuable for investigation of osteogenesis of human stem/progenitor cells in vivo.

  13. A model for calculating EM field in layered medium with application to biological implants

    International Nuclear Information System (INIS)

    Salehi-Reyhani, S.M.

    2001-01-01

    Modern wireless telecommunication devices (GSM Mobile system) (cellular telephones and wireless modems on laptop computers) have the potential to interfere with implantable medical devices/prostheses and cause possible malfunction. An implant of resonant dimensions within a homogeneous dielectric lossy sphere can enhance local values of SAR (the specific absorption rate). Also antenna radiation pattern and other characteristics are significantly altered by the presence of the composite dielectric entities such as the human body. Besides, the current safety limits do not take into account the possible effect of hot spots arising from metallic implants resonant at mobile phone frequencies. Although considerable attention has been given to study and measurement of scattering from a dielectric sphere, no rigorous treatment using electromagnetic theory has been given to the implanted dielectric spherical head/cylindrical body. This thesis aims to deal with the scattering of a plane electromagnetic wave from a perfectly conducting or dielectric spherical/cylindrical implant of electrically small radius (of resonant length), embedded eccentrically into a dielectric spherical head model. The method of dyadic Green's function (DGF) for spherical vector wave functions is used. Analytical expressions for the scattered fields of both cylindrical and spherical implants as well as layered spherical head and cylindrical torso models are obtained separately in different chapters. The whole structure is assumed to be uniform along the propagation direction. To further check the accuracy of the proposed solution, the numerical results from the analytical expressions computed for the problem of implanted head/body are compared with the numerical results from the Finite-Difference Time-Domain (FDTD) method using the EMU-FDTD Electromagnetic simulator. Good agreement is observed between the numerical results based on the proposed method and the FDTD numerical technique. This research

  14. Application of high resolution synchrotron micro-CT radiation in dental implant osseointegration.

    Science.gov (United States)

    Neldam, Camilla Albeck; Lauridsen, Torsten; Rack, Alexander; Lefolii, Tore Tranberg; Jørgensen, Niklas Rye; Feidenhans'l, Robert; Pinholt, Else Marie

    2015-06-01

    The purpose of this study was to describe a refined method using high-resolution synchrotron radiation microtomography (SRmicro-CT) to evaluate osseointegration and peri-implant bone volume fraction after titanium dental implant insertion. SRmicro-CT is considered gold standard evaluating bone microarchitecture. Its high resolution, high contrast, and excellent high signal-to-noise-ratio all contribute to the highest spatial resolutions achievable today. Using SRmicro-CT at a voxel size of 5 μm in an experimental goat mandible model, the peri-implant bone volume fraction was found to quickly increase to 50% as the radial distance from the implant surface increased, and levelled out to approximately 80% at a distance of 400 μm. This method has been successful in depicting the bone and cavities in three dimensions thereby enabling us to give a more precise answer to the fraction of the bone-to-implant contact compared to previous methods. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  15. Decellularized Tissue and Cell-Derived Extracellular Matrices as Scaffolds for Orthopaedic Tissue Engineering

    Science.gov (United States)

    Cheng, Christina W.; Solorio, Loran D.; Alsberg, Eben

    2014-01-01

    The reconstruction of musculoskeletal defects is a constant challenge for orthopaedic surgeons. Musculoskeletal injuries such as fractures, chondral lesions, infections and tumor debulking can often lead to large tissue voids requiring reconstruction with tissue grafts. Autografts are currently the gold standard in orthopaedic tissue reconstruction; however, there is a limit to the amount of tissue that can be harvested before compromising the donor site. Tissue engineering strategies using allogeneic or xenogeneic decellularized bone, cartilage, skeletal muscle, tendon and ligament have emerged as promising potential alternative treatment. The extracellular matrix provides a natural scaffold for cell attachment, proliferation and differentiation. Decellularization of in vitro cell-derived matrices can also enable the generation of autologous constructs from tissue specific cells or progenitor cells. Although decellularized bone tissue is widely used clinically in orthopaedic applications, the exciting potential of decellularized cartilage, skeletal muscle, tendon and ligament cell-derived matrices has only recently begun to be explored for ultimate translation to the orthopaedic clinic. PMID:24417915

  16. The surgeon and his tools-the case for a focused orthopaedic theatre induction programme

    Directory of Open Access Journals (Sweden)

    Wong Shaun KS

    2008-10-01

    Full Text Available Abstract Background Induction programme for trainee doctors in the UK generally do not focus on the surgical aspects of their jobs. In this context we decided to conduct a telephonic survey among the hospitals belonging to three orthopaedic training regions in the UK from the point of view of the diversity of instrumentations and implants used for index procedures. Results We chose four index trauma & orthopaedic procedures (Total hip replacement, total knee replacement, intramedullary nailing and external fixator systems for long bone fractures. A telephonic survey was done in six NHS trust hospitals which were part of an orthopaedic training rotation (2 from England, 2 from Wales and 2 from Scotland. In total there were 39 different instrumentation systems for these 4 index procedures in the 6 trusts (see table 1. These comprise 12 Total hip replacement (THR systems, 14 total knee replacement (TKR systems, 9 intra-medullary nailing systems, and 4 external fixator systems. The number of different systems for each trust ranged from 7 to 19. There is a vast array of implants and instrumentation systems in each trust, as highlighted by our survey. The surgical tools are not the same in each hospitals. This situation is more complicated when trainees move to new hospitals as part of training rotations. Table 1 Number of implants/instrumentations used in each of the 6 UK trusts (3 training regions. IMPLANT E1 E2 W1 W2 S1 S2 Total Knee Replacement 4 5 2 4 3 2 Total Hip Replacement 3 4 3 6 3 3 Intramnedullary nailing 2 1 1 6 2 3 External fixators 2 3 2 2 1 1 TOTAL 11 13 8 18 9 9 E = England, W = Wales, S = Scotland Conclusion In view of this we feel that more focused theatre based induction programmes for higher surgical trainees is advocated in each hospital trust so trainees can familiarise themselves with the tools available to them. This could include discussion with the consultants and senior theatre staff along with representatives from the

  17. Toward the Development of Virtual Surgical Tools to Aid Orthopaedic FE Analyses

    Directory of Open Access Journals (Sweden)

    Srinivas C. Tadepalli

    2010-01-01

    Full Text Available Computational models of joint anatomy and function provide a means for biomechanists, physicians, and physical therapists to understand the effects of repetitive motion, acute injury, and degenerative diseases. Finite element models, for example, may be used to predict the outcome of a surgical intervention or to improve the design of prosthetic implants. Countless models have been developed over the years to address a myriad of orthopaedic procedures. Unfortunately, few studies have incorporated patient-specific models. Historically, baseline anatomic models have been used due to the demands associated with model development. Moreover, surgical simulations impose additional modeling challenges. Current meshing practices do not readily accommodate the inclusion of implants. Our goal is to develop a suite of tools (virtual instruments and guides which enable surgical procedures to be readily simulated and to facilitate the development of all-hexahedral finite element mesh definitions.

  18. Clinical application of permanent implantation of iodine 125 seeds for osseous metastases

    International Nuclear Information System (INIS)

    Li Jinxin; Zhang Qizhou; Li Guoliang

    2010-01-01

    Objective: To evaluate the clinical efficacy of permanent implantation of iodine 125 seeds in the treatment of osseous metastases. Methods: Radioactive iodine 125 seeds were implanted permanently in 32 lesions of 25 patients with osseous metastases of different origins. The ostalgia-relieving degree and the imaging alterations of the osseous metastasis lesions were observed. Results: The effective pain-relieving rate was 92% caused by permanent implantation of iodine 125 seeds. Of al 1 the patients, 15 patients achieved complete response, 8 patients obtained partial response (PR), and 2 patients had no change. The pain grade was decreased significantly after the treatment (P 125 I seeds has a definite effect on tumor metastasis and caused minimal damage and few complications. It is worthy of popularization in clinic. (authors)

  19. Very broad beam metal ion source for large area ion implantation application

    International Nuclear Information System (INIS)

    Brown, I.; Anders, S.; Dickinson, M.R.; MacGill, R.A.; Yao, X.

    1993-01-01

    The authors have made and operated a very broad beam version of vacuum arc ion source and used it to carry out high energy metal ion implantation of a particularly large substrate. A multiple-cathode vacuum arc plasma source was coupled to a 50 cm diameter beam extractor (multiple aperture, accel-decel configuration) operated at a net extraction voltage of up to 50 kV. The metal ion species chosen were Ni and Ta. The mean ion charge state for Ni and Ta vacuum arc plasmas is 1.8 and 2.9, respectively, and so the mean ion energies were up to about 90 and 145 keV, respectively. The ion source was operated in a repetitively pulsed mode with pulse length 250 μs and repetition rate several pulses per second. The extracted beam had a gaussian profile with FWHM about 35 cm, giving a nominal beam area of about 1,000 cm 2 . The current of Ni or Ta metal ions in the beam was up to several amperes. The targets for the ion implantation were a number of 24-inch long, highly polished Cu rails from an electromagnetic rail gun. The rails were located about 80 cm away from the ion source extractor grids, and were moved across a diameter of the vessel in such a way as to maximize the uniformity of the implant along the rail. The saturation retained dose for Ta was limited to about 4 x 10 16 cm -2 because of the rather severe sputtering, in accordance with the theoretical expectations for these implantation conditions. Here they describe the ion source, the implantation procedure, and the kinds of implants that can be produced in this way

  20. Clinical application of micro-implant anchorage in initial orthodontic retraction.

    Science.gov (United States)

    Wahabuddin, Shaji; Mascarenhas, Rohan; Iqbal, Mahamad; Husain, Akhter

    2015-02-01

    Micro-implant is a device that is temporarily fixed to bone for the purpose of enhancing orthodontic anchorage either by supporting the teeth of the reactive unit or by obviating the need for the reactive unit altogether, and which is subsequently removed after use. The purpose of this study was to evaluate the clinical efficiency of micro-implants in reinforcing anchorage during the initial retraction of anterior teeth, check the rate of initial retraction for 8 weeks, and assess the stability of micro-implants during this period. Eighteen micro-implants were placed (10 in the maxilla and 8 in the mandible) and immediately loaded with 200-250 g of force using 9-mm closed coil Nitinol springs. The amount of space closure was measured every 2 weeks until the eighth week. Cephalometric measurements were made at the end of the study to evaluate anchor loss, if any. Micro-implant stability was also assessed. The rate of initial retraction in the maxilla at the end of 8 weeks was 1.65 mm/quadrant and 1.51 mm/quadrant in the mandible. The amount of retraction on the left side of the arches was 1.66 mm/quadrant and 1.49 mm/quadrant on the right side. The average initial retraction for both arches per month was 0.78 mm. An anchor loss of 0.1 mm (0.06%) was observed in the maxilla while no mandibular anchor loss was recorded. The rate of initial retraction observed in the maxilla was more than that achieved in the mandible. Initial retraction was also more on the left side of the arches. There was no anchor loss in the mandible. The micro-implant-reinforced anchorage was helpful in minimizing anchor loss and accepted heavy traction forces but did not bring about a faster rate of retraction.

  1. Application of RI power sources to cardiac pacemakers and aftercare in its implantation

    International Nuclear Information System (INIS)

    Hori, Motokazu

    1974-01-01

    RI power sources have long life when they are implanted into human bodies together with cardiac pacemakers, as compared with e.g. mercury batteries. Therefore, the frequency of their replacement can be by far less. However, there are the problems of radiation protection, high cost, availability, etc. The following matters are described: The cardiac pacemaker and its power supply, implantation into human body, problems with patients and conventional power sources; the current state of RI power sources for cardiac pacemakers, including plutonium-238 RTG and 147 Pm and 3 H batteries; and problems with the RI power sources. (Mori, K.)

  2. Reno Orthopaedic Trauma Fellowship business curriculum.

    Science.gov (United States)

    Althausen, Peter L; Bray, Timothy J; Hill, Austin D

    2014-07-01

    The Reno Orthopaedic Center (ROC) Trauma Fellowship business curriculum is designed to provide the fellow with a graduate level business practicum and research experience. The time commitments in a typical 12-month trauma fellowship are significant, rendering a traditional didactic master's in business administration difficult to complete during this short time. An organized, structured, practical business education can provide the trauma leaders of tomorrow with the knowledge and experience required to effectively navigate the convoluted and constantly changing healthcare system. The underlying principle throughout the curriculum is to provide the fellow with the practical knowledge to participate in cost-efficient improvements in healthcare delivery. Through the ROC Trauma Fellowship business curriculum, the fellow will learn that delivering healthcare in a manner that provides better outcomes for equal or lower costs is not only possible but a professional and ethical responsibility. However, instilling these values without providing actionable knowledge and programs would be insufficient and ineffective. For this reason, the core of the curriculum is based on individual teaching sessions with a wide array of hospital and private practice administrators. In addition, each section is equipped with a suggested reading list to maximize the learning experience. Upon completion of the curriculum, the fellow should be able to: (1) Participate in strategic planning at both the hospital and practice level based on analysis of financial and clinical data, (2) Understand the function of healthcare systems at both a macro and micro level, (3) Possess the knowledge and skills to be strong leaders and effective communicators in the business lexicon of healthcare, (4) Be a partner and innovator in the improvement of the delivery of orthopaedic services, (5) Combine scientific and strategic viewpoints to provide an evidence-based strategy for improving quality of care in a

  3. A Review of Current Clinical Applications of Three-Dimensional Printing in Spine Surgery.

    Science.gov (United States)

    Cho, Woojin; Job, Alan Varkey; Chen, Jing; Baek, Jung Hwan

    2018-02-01

    Three-dimensional (3D) printing is a transformative technology with a potentially wide range of applications in the field of orthopaedic spine surgery. This article aims to review the current applications, limitations, and future developments of 3D printing technology in orthopaedic spine surgery. Current preoperative applications of 3D printing include construction of complex 3D anatomic models for improved visual understanding, preoperative surgical planning, and surgical simulations for resident education. Intraoperatively, 3D printers have been successfully used in surgical guidance systems and in the creation of patient specific implantable devices. Furthermore, 3D printing is revolutionizing the field of regenerative medicine and tissue engineering, allowing construction of biocompatible scaffolds suitable for cell growth and vasculature. Advances in printing technology and evidence of positive clinical outcomes are needed before there is an expansion of 3D printing applied to the clinical setting.

  4. Kinetic Monte Carlo simulations for transient thermal fields: Computational methodology and application to the submicrosecond laser processes in implanted silicon.

    Science.gov (United States)

    Fisicaro, G; Pelaz, L; Lopez, P; La Magna, A

    2012-09-01

    Pulsed laser irradiation of damaged solids promotes ultrafast nonequilibrium kinetics, on the submicrosecond scale, leading to microscopic modifications of the material state. Reliable theoretical predictions of this evolution can be achieved only by simulating particle interactions in the presence of large and transient gradients of the thermal field. We propose a kinetic Monte Carlo (KMC) method for the simulation of damaged systems in the extremely far-from-equilibrium conditions caused by the laser irradiation. The reference systems are nonideal crystals containing point defect excesses, an order of magnitude larger than the equilibrium density, due to a preirradiation ion implantation process. The thermal and, eventual, melting problem is solved within the phase-field methodology, and the numerical solutions for the space- and time-dependent thermal field were then dynamically coupled to the KMC code. The formalism, implementation, and related tests of our computational code are discussed in detail. As an application example we analyze the evolution of the defect system caused by P ion implantation in Si under nanosecond pulsed irradiation. The simulation results suggest a significant annihilation of the implantation damage which can be well controlled by the laser fluence.

  5. Surface modification of materials by ion implantations for industrial and medical applications. Final report of a co-ordinated research project

    International Nuclear Information System (INIS)

    2000-07-01

    The objectives of the Co-ordinated Research Project on Modification of Materials by Ion Treatment for Industrial Applications were to develop economically acceptable surface modification techniques leading to thick treated layers, to predict ion beam mixing and impurity atom migration during and after implantation, and to evaluate the tribological post-implantation properties and performance of treated components. This TECDOC summarises the current status and prospects in surface modification by ion implantation methodology and technology, providing new information in basic and applied research

  6. Surface modification of materials by ion implantations for industrial and medical applications. Final report of a co-ordinated research project

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    The objectives of the Co-ordinated Research Project on Modification of Materials by Ion Treatment for Industrial Applications were to develop economically acceptable surface modification techniques leading to thick treated layers, to predict ion beam mixing and impurity atom migration during and after implantation, and to evaluate the tribological post-implantation properties and performance of treated components. This TECDOC summarises the current status and prospects in surface modification by ion implantation methodology and technology, providing new information in basic and applied research.

  7. On depth profiling of hydrogen and helium isotopes and its application to ion-implantation studies

    International Nuclear Information System (INIS)

    Boettiger, J.

    1979-01-01

    The thesis is divided into two parts, the first being a general review of the experimental methods for depth profiling of light isotopes, where ion beams are used. In the second part, studies of ion implantation of hydrogen and helium isotopes, applying the techniques discussed in the first part, are described. The paper summarizes recent experimental results and discusses recent developments. (Auth.)

  8. Application of computer graphics in the design of custom orthopedic implants.

    Science.gov (United States)

    Bechtold, J E

    1986-10-01

    Implementation of newly developed computer modelling techniques and computer graphics displays and software have greatly aided the orthopedic design engineer and physician in creating a custom implant with good anatomic conformity in a short turnaround time. Further advances in computerized design and manufacturing will continue to simplify the development of custom prostheses and enlarge their niche in the joint replacement market.

  9. Thermal Cycle Annealing and its Application to Arsenic-Ion Implanted HgCdTe

    Science.gov (United States)

    2014-06-26

    Rao Mulpuri Sina Simingalam, Priyalal Wijewarnasuriya, Mulpuri V. Rao 1720BH c. THIS PAGE The public reporting burden for this collection of...Implanted HgCdTe Sina Simingalama,b,c, Priyalal Wijewarnasuriyab, Mulpuri V. Raoc a. School of Physics, Astronomy and Computational Sciences, George

  10. Immunocompatibility evaluation of hydrogel-coated polyimide implants for applications in regenerative medicine

    Czech Academy of Sciences Publication Activity Database

    Šírová, Milada; van Vlierberghe, S.; Matyášová, V.; Rossmann, Pavel; Schacht, E.; Dubruel, P.; Říhová, Blanka

    2014-01-01

    Roč. 102, č. 6 (2014), s. 1982-1990 ISSN 1549-3296 R&D Projects: GA ČR GAP301/12/1254 Institutional support: RVO:61388971 Keywords : methacrylamide-modified gelatin * hydrogel * polyimide implant Subject RIV: EC - Immunology Impact factor: 3.369, year: 2014

  11. Influence of Physicochemical Aspects of Substratum Nano surface on Bacterial Attachment for Bone Implant Applications

    International Nuclear Information System (INIS)

    Mediaswanti, K.

    2016-01-01

    Biofilm formation on implant materials is responsible for peri prosthetic infections. Bacterial attachment is important as the first stage in biofilm formation. It is meaningful to understand the influence of nano structured surface on bacterial attachment. This review discusses the influence of physicochemical aspects of substratum nano surface on bacterial attachment.

  12. Hydroxyapatite coating on cobalt alloys using electrophoretic deposition method for bone implant application

    Science.gov (United States)

    Aminatun; M, Shovita; I, Chintya K.; H, Dyah; W, Dwi

    2017-05-01

    Damage on bone due to osteoporosis and cancer triggered high demand for bone implant prosthesis which is a permanent implant. Thus, a prosthesis coated with hydroxyapatite (HA) is required because it is osteoconductive that can trigger the growth of osteoblast cells. The purpose of this study is to determine the optimum concentration of HA suspension in terms of the surface morphology, coating thickness, adhesion strength and corrosion rate resulting in the HA coating with the best characteristics for bone implant. Coating using electrophoretic deposition (EPD) method with concentrations of 0.02M, 0.04M, 0.06M, 0.08M, and 0.1M was performed on the voltage and time of 120V and 30 minutes respectively. The process was followed by sintering at the temperature of 900 °C for 10 minutes. The results showed that the concentration of HA suspension influences the thickness and the adhesion of layer of HA. The higher the concentration of HA-ethanol suspension the thicker the layer of HA, but its coating adhesion strength values became lower. The concentration of HA suspension of 0.04 M is the best concentration, with characteristics that meet the standards of the bone implant prosthesis. The characteristics are HA coating thickness of 199.93 ± 4.85 μm, the corrosion rate of 0.0018 mmpy and adhesion strength of 4.175 ± 0.716 MPa.

  13. Application of low-energy ionic implantation for creation of geteroepitaxial nanofilms and nanostructures

    International Nuclear Information System (INIS)

    Tashmukhamedova, D.A.; Umirzakov, B.E.; Kurbanov, Kh.Kh.

    2010-01-01

    The optimum regimes of ion-implantation and annealing for obtaining the nanocrystals and nanofilms of metal silicides are determined. For the first time, it is shown that quantum character of silicide nanocrystals appears, when their sizes are less than 25 -30 nm. (authors)

  14. Material synthesis for silicon integrated-circuit applications using ion implantation

    Science.gov (United States)

    Lu, Xiang

    As devices scale down into deep sub-microns, the investment cost and complexity to develop more sophisticated device technologies have increased substantially. There are some alternative potential technologies, such as silicon-on-insulator (SOI) and SiGe alloys, that can help sustain this staggering IC technology growth at a lower cost. Surface SiGe and SiGeC alloys with germanium peak composition up to 16 atomic percent are formed using high-dose ion implantation and subsequent solid phase epitaxial growth. RBS channeling spectra and cross-sectional TEM studies show that high quality SiGe and SiGeC crystals with 8 atomic percent germanium concentration are formed at the silicon surface. Extended defects are formed in SiGe and SiGeC with 16 atomic percent germanium concentration. X-ray diffraction experiments confirm that carbon reduces the lattice strain in SiGe alloys but without significant crystal quality improvement as detected by RBS channeling spectra and XTEM observations. Separation by plasma implantation of oxygen (SPIMOX) is an economical method for SOI wafer fabrication. This process employs plasma immersion ion implantation (PIII) for the implantation of oxygen ions. The implantation rate for Pm is considerably higher than that of conventional implantation. The feasibility of SPIMOX has been demonstrated with successful fabrication of SOI structures implementing this process. Secondary ion mass spectrometry (SIMS) analysis and cross-sectional transmission electron microscopy (XTEM) micrographs of the SPIMOX sample show continuous buried oxide under single crystal overlayer with sharp silicon/oxide interfaces. The operational phase space of implantation condition, oxygen dose and annealing requirement has been identified. Physical mechanisms of hydrogen induced silicon surface layer cleavage have been investigated using a combination of microscopy and hydrogen profiling techniques. The evolution of the silicon cleavage phenomenon is recorded by a series

  15. Impact of implanted phosphorus on the diffusivity of boron and its applicability to silicon solar cells

    International Nuclear Information System (INIS)

    Schrof, Julian; Müller, Ralph; Benick, Jan; Hermle, Martin; Reedy, Robert C.

    2015-01-01

    Boron diffusivity reduction in extrinsically doped silicon was investigated in the context of a process combination consisting of BBr 3 furnace diffusion and preceding Phosphorus ion implantation. The implantation of Phosphorus leads to a substantial blocking of Boron during the subsequent Boron diffusion. First, the influences of ion implantation induced point defects as well as the initial P doping on B diffusivity were studied independently. Here, it was found that not the defects created during ion implantation but the P doping itself results in the observed B diffusion retardation. The influence of the initial P concentration was investigated in more detail by varying the P implantation dose. A secondary ion mass spectrometry (SIMS) analysis of the BSG layer after the B diffusion revealed that the B diffusion retardation is not due to potential P content in the BSG layer but rather caused by the n-type doping of the crystalline silicon itself. Based on the observations the B diffusion retardation was classified into three groups: (i) no reduction of B diffusivity, (ii) reduced B diffusivity, and (iii) blocking of the B diffusion. The retardation of B diffusion can well be explained by the phosphorus doping level resulting in a Fermi level shift and pairing of B and P ions, both reducing the B diffusivity. Besides these main influences, there are probably additional transient phenomena responsible for the blocking of boron. Those might be an interstitial transport mechanism caused by P diffusion that reduces interstitial concentration at the surface or the silicon/BSG interface shift due to oxidation during the BBr 3 diffusion process. Lifetime measurements revealed that the residual (non-blocked) B leads to an increased dark saturation current density in the P doped region. Nevertheless, electrical quality is on a high level and was further increased by reducing the B dose as well as by removing the first few nanometers of the silicon surface after the BBr 3

  16. Prevalence and pattern of small animal orthopaedic conditions at ...

    African Journals Online (AJOL)

    Small animal orthopaedic case records of a 20-year period were surveyed to obtain the prevalence and pattern of orthopaedic conditions presented to the Veterinary Teaching Hospital (VTH), University of Ibadan, Nigeria, with the objective of providing data for planning on small animal healthcare facilities, policy ...

  17. Social Competence and Temperament in Children with Chronic Orthopaedic Disability

    Science.gov (United States)

    Yagmurlu, Bilge; Yavuz, H. Melis

    2015-01-01

    The aim of the study was to investigate social competence in children with orthopaedic disability and its concurrent relations to child's temperament, health condition, and maternal warmth. Participants were 68 Turkish children (mean = 5.94 years) with chronic orthopaedic disability and their mothers coming from disadvantaged backgrounds. Mother…

  18. The older orthopaedic patient: general considerations.

    Science.gov (United States)

    Potter, Jane F

    2004-08-01

    People older than 65 years are more likely to need elective and emergent orthopaedic surgery compared with younger persons. They also experience significant benefits. Although age-related changes increase the risk of perioperative complications, understanding those changes allows prevention or at least early recognition and treatment when problems arise. Because of comorbidities, older persons take more medications that need to be managed in the perioperative period. Care could be simplified if patients were to bring their medications to the preoperative evaluation. Central nervous system sensitivity to certain pain medications (meperidine and propoxyphene) means that these drugs are best avoided as good alternatives exist (morphine and oxycodone). Adverse reactions to drugs are an important cause of acute confusion (delirium) that often complicates orthopaedic care. Early mobilization after surgery, avoiding certain drugs, avoiding restraints (including Foley catheters), attending to hydration, promoting normal sleep, compensating for sensory disorders, and stimulating daytime activities can prevent delirium. Patients with dementia are more likely to have delirium develop and, like many older people, will present special challenges in communication and decision making. Including family members in discussions may be helpful in ensuring truly informed consent.

  19. Clinical features of anaerobic orthopaedic infections.

    Science.gov (United States)

    Lebowitz, Dan; Kressmann, Benjamin; Gjoni, Shpresa; Zenelaj, Besa; Grosgurin, Olivier; Marti, Christophe; Zingg, Matthieu; Uçkay, Ilker

    2017-02-01

    Some patient populations and types of orthopaedic surgery could be at particular risk for anaerobic infections. In this retrospective cohort study of operated adult patients with infections from 2004 to 2014, we assessed obligate anaerobes and considered first clinical infection episodes. Anaerobes, isolated from intra-operative samples, were identified in 2.4% of 2740 surgical procedures, of which half (33/65; 51%) were anaerobic monomicrobial infections. Propionibacterium acnes, a penicillin and vancomycin susceptible pathogen, was the predominantly isolated anaerobe. By multivariate analysis, the presence of fracture fixation plates was the variable most strongly associated with anaerobic infection (odds ratio: 2.1, 95% CI: 1.3-3.5). Anaerobes were also associated with spondylodesis and polymicrobial infections. In contrast, it revealed less likely in native bone or prosthetic joint infections and was not related to prior antibiotic use. In conclusion, obligate anaerobes in our case series of orthopaedic infections were rare, and mostly encountered in infections related to trauma with open-fracture fixation devices rather than clean surgical site infection. Anaerobes were often co-pathogens, and cultures most frequently recovered P. acnes. These observations thus do not support changes in current practices such as broader anaerobe coverage for perioperative prophylaxis.

  20. A Clinico- Epidemiological Study Of Filarial Related Orthopaedic Manifestations

    Directory of Open Access Journals (Sweden)

    Patond K.R

    1992-01-01

    Full Text Available An epidemiological study was undertaken to study the incidence and distribution of orthopaedic manifestations of filariasis in an endemic area. A total of 207 cases were clinically examined and investigated. Patients were divided into three groups , viz., Group A: Orthopaedic manifestations with no history of filariasis . Group B: Orthopaedic manifestations with history of filariasis such as microfilaraemia or filarial fevers etc., Group C: Orthopaedic manifestations with chronic manifestations such as elephantiasis, hydrocele etc. To confirm filarial etiology, all the cases were examined for the presence of filarial antibody by indirect ELISA using wuchereda bancrofti microfilarial excretory- secretary antigen (wd Mf ESAg . A total of 61 of 102 patients of Group A, 14 of 21 patients of group B, and 73 of 84 patients of Group C were positive for filarial antibody. This study showed the prevalence of filarial antibody in about 71.4% of various orthopaedic manifestations.

  1. Development of a generally applicable morphokinetic algorithm capable of predicting the implantation potential of embryos transferred on Day 3

    Science.gov (United States)

    Petersen, Bjørn Molt; Boel, Mikkel; Montag, Markus; Gardner, David K.

    2016-01-01

    STUDY QUESTION Can a generally applicable morphokinetic algorithm suitable for Day 3 transfers of time-lapse monitored embryos originating from different culture conditions and fertilization methods be developed for the purpose of supporting the embryologist's decision on which embryo to transfer back to the patient in assisted reproduction? SUMMARY ANSWER The algorithm presented here can be used independently of culture conditions and fertilization method and provides predictive power not surpassed by other published algorithms for ranking embryos according to their blastocyst formation potential. WHAT IS KNOWN ALREADY Generally applicable algorithms have so far been developed only for predicting blastocyst formation. A number of clinics have reported validated implantation prediction algorithms, which have been developed based on clinic-specific culture conditions and clinical environment. However, a generally applicable embryo evaluation algorithm based on actual implantation outcome has not yet been reported. STUDY DESIGN, SIZE, DURATION Retrospective evaluation of data extracted from a database of known implantation data (KID) originating from 3275 embryos transferred on Day 3 conducted in 24 clinics between 2009 and 2014. The data represented different culture conditions (reduced and ambient oxygen with various culture medium strategies) and fertilization methods (IVF, ICSI). The capability to predict blastocyst formation was evaluated on an independent set of morphokinetic data from 11 218 embryos which had been cultured to Day 5. PARTICIPANTS/MATERIALS, SETTING, METHODS The algorithm was developed by applying automated recursive partitioning to a large number of annotation types and derived equations, progressing to a five-fold cross-validation test of the complete data set and a validation test of different incubation conditions and fertilization methods. The results were expressed as receiver operating characteristics curves using the area under the

  2. II Italian intersociety consensus statement on antithrombotic prophylaxis in orthopaedics and traumatology: arthroscopy, traumatology, leg immobilization, minor orthopaedic procedures and spine surgery.

    Science.gov (United States)

    Randelli, F; Romanini, E; Biggi, F; Danelli, G; Della Rocca, G; Laurora, N R; Imberti, D; Palareti, G; Prisco, D

    2013-03-01

    Pharmacological prophylaxis for preventing venous thromboembolism (VTE) is a worldwide established procedure in hip and knee replacement surgery, as well as in the treatment of femoral neck fractures, but few data exist in other fields of orthopaedics and traumatology. Thus, no guidelines or recommendations are available in the literature except for a limited number of weak statements about knee arthroscopy and lower limb fractures. In any case, none of them are a multidisciplinary effort as the one here presented. The Italian Society for Studies on Haemostasis and Thrombosis (SISET), the Italian Society of Orthopaedics and Traumatology (SIOT), the Association of Orthopaedic Traumatology of Italian Hospitals (OTODI), together with the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) and the Italian Society of General Medicine (SIMG) have set down easy and quick suggestions for VTE prophylaxis in a number of surgical conditions for which only scarce evidence is available. This inter-society consensus statement aims at simplifying the approach to VTE prophylaxis in the single patient with the goal to improve its clinical application.

  3. Ion implantation in semiconductors

    International Nuclear Information System (INIS)

    Gusev, V.; Gusevova, M.

    1980-01-01

    The historical development is described of the method of ion implantation, the physical research of the method, its technological solution and practical uses. The method is universally applicable, allows the implantation of arbitrary atoms to an arbitrary material, ensures high purity of the doping element. It is linked with sample processing at low temperatures. In implantation it is possible to independently change the dose and energy of the ions thereby affecting the spatial distribution of the ions. (M.S.)

  4. Ion implantation in semiconductors

    Energy Technology Data Exchange (ETDEWEB)

    Gusev, V; Gusevova, M

    1980-06-01

    The historical development of the method of ion implantation, the physical research of the method, its technological solution and practical uses is described. The method is universally applicable, allows the implantation of arbitrary atoms to an arbitrary material and ensures high purity of the doping element. It is linked with sample processing at low temperatures. In implantation it is possible to independently change the dose and energy of the ions thereby affecting the spatial distribution of the ions.

  5. Micro-arc oxidation as a tool to develop multifunctional calcium-rich surfaces for dental implant applications.

    Science.gov (United States)

    Ribeiro, A R; Oliveira, F; Boldrini, L C; Leite, P E; Falagan-Lotsch, P; Linhares, A B R; Zambuzzi, W F; Fragneaud, B; Campos, A P C; Gouvêa, C P; Archanjo, B S; Achete, C A; Marcantonio, E; Rocha, L A; Granjeiro, J M

    2015-09-01

    Titanium (Ti) is commonly used in dental implant applications. Surface modification strategies are being followed in last years in order to build Ti oxide-based surfaces that can fulfill, simultaneously, the following requirements: induced cell attachment and adhesion, while providing a superior corrosion and tribocorrosion performance. In this work micro-arc oxidation (MAO) was used as a tool for the growth of a nanostructured bioactive titanium oxide layer aimed to enhance cell attachment and adhesion for dental implant applications. Characterization of the surfaces was performed, in terms of morphology, topography, chemical composition and crystalline structure. Primary human osteoblast adhesion on the developed surfaces was investigated in detail by electronic and atomic force microscopy as well as immunocytochemistry. Also an investigation on the early cytokine production was performed. Results show that a relatively thick hybrid and graded oxide layer was produced on the Ti surface, being constituted by a mixture of anatase, rutile and amorphous phases where calcium (Ca) and phosphorous (P) were incorporated. An outermost nanometric-thick amorphous oxide layer rich in Ca was present in the film. This amorphous layer, rich in Ca, improved fibroblast viability and metabolic activity as well as osteoblast adhesion. High-resolution techniques allowed to understand that osteoblasts adhered less in the crystalline-rich regions while they preferentially adhere and spread over in the Ca-rich amorphous oxide layer. Also, these surfaces induce higher amounts of IFN-γ cytokine secretion, which is known to regulate inflammatory responses, bone microarchitecture as well as cytoskeleton reorganization and cellular spreading. These surfaces are promising in the context of dental implants, since they might lead to faster osseointegration. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Fringe-shifting single-projector moiré topography application for cotyle implantate abrasion measurement

    Science.gov (United States)

    Rössler, Tomáš; Hrabovský, Miroslav; Pluháček, František

    2005-08-01

    The cotyle implantate is abraded in the body of patient and its shape changes. Information about the magnitude of abrasion is contained in the result contour map of the implantate. The locations and dimensions of abraded areas can be computed from the contours deformation. The method called the single-projector moire topography was used for the contour lines determination. The theoretical description of method is given at first. The design of the experimental set-up follows. The light grating projector was developed to realize the periodic structure on the measured surface. The method of fringe-shifting was carried out to increase the data quantity. The description of digital processing applied to the moire grating images is introduced at the end together with the examples of processed images.

  7. The Pearson IV distribution and its application to ion implanted depth profiles

    International Nuclear Information System (INIS)

    Wilson, R.G.

    1980-01-01

    The Pearson IV distribution system is analyzed to determine the regions of validity for the values of the moments that produce convex, concave, more pointed than Gaussian, and more flat-topped than Gaussian distributions; the limits beyond which no significant change in distribution is produced; and excluded regions. These regions are illustrated in a figure that can be used to facilitate the determination of the Pearson IV moments for experimental ion implanted depth distributions. Examples are given of Pearson IV distributions to illustrate the effects of the ranges of skewness, kurtosis, and standard deviation, for both more pointed and more flat-topped than Gaussian distributions. A procedure is described for matching experimental ion implanted depth distributions to computer plotted Pearson IV modified Gaussian distributions. A few experimental curves are given to illustrate the different types of Pearson IV curves, and accuracies of moments are discussed. (author)

  8. Study of TiO{sub 2} nanotubes as an implant application

    Energy Technology Data Exchange (ETDEWEB)

    Hazan, Roshasnorlyza, E-mail: roshasnorlyza@nm.gov.my; Sreekantan, Srimala [School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia, 14300, Nibong Tebal, Pulau Pinang (Malaysia); Mydin, Rabiatul Basria S. M. N.; Mat, Ishak [Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200, Kepala Batas, Pulau Pinang (Malaysia); Abdullah, Yusof [Materials Technology Group, Industrial Technology Division, Nuclear Malaysia Agency, Bangi, 43000, Kajang, Selangor. Malaysia (Malaysia)

    2016-01-22

    Vertically aligned TiO{sub 2} nanotubes have become the primary candidates for implant materials that can provide direct control of cell behaviors. In this work, 65 nm inner diameters of TiO{sub 2} nanotubes were successfully prepared by anodization method. The interaction of bone marrow stromal cells (BMSC) in term of cell adhesion and cell morphology on bare titanium and TiO{sub 2} nanotubes is reported. Field emission scanning electron microscopy (FESEM) analysis proved interaction of BMSC on TiO{sub 2} nanotubes structure was better than flat titanium (Ti) surface. Also, significant cell adhesion on TiO{sub 2} nanotubes surface during in vitro study revealed that BMSC prone to attach on TiO{sub 2} nanotubes. From the result, it can be conclude that TiO{sub 2} nanotubes are biocompatible to biological environment and become a new generation for advanced implant materials.

  9. Study of TiO2 nanotubes as an implant application

    International Nuclear Information System (INIS)

    Hazan, Roshasnorlyza; Sreekantan, Srimala; Mydin, Rabiatul Basria S. M. N.; Mat, Ishak; Abdullah, Yusof

    2016-01-01

    Vertically aligned TiO 2 nanotubes have become the primary candidates for implant materials that can provide direct control of cell behaviors. In this work, 65 nm inner diameters of TiO 2 nanotubes were successfully prepared by anodization method. The interaction of bone marrow stromal cells (BMSC) in term of cell adhesion and cell morphology on bare titanium and TiO 2 nanotubes is reported. Field emission scanning electron microscopy (FESEM) analysis proved interaction of BMSC on TiO 2 nanotubes structure was better than flat titanium (Ti) surface. Also, significant cell adhesion on TiO 2 nanotubes surface during in vitro study revealed that BMSC prone to attach on TiO 2 nanotubes. From the result, it can be conclude that TiO 2 nanotubes are biocompatible to biological environment and become a new generation for advanced implant materials

  10. Application of a narrow-diameter implant in a limited space

    Directory of Open Access Journals (Sweden)

    Chia-Yun Tsai

    2010-06-01

    Full Text Available This report presents a case of inadequate space distribution after orthodontic treatment, when a narrow-diameter implant was placed in a limited mandibular anterior space (ridge and prosthetic. A 26-year-old female patient presented with a purulent discharge from the mandibular right posterior area. Radiographic and clinical evaluations revealed a four-unit bridge spanning teeth 42 to 43 and acute apical periodontitis with root resorption around tooth 42. After careful evaluation, tooth 42 was extracted, and orthodontic treatment was performed to align the posterior teeth and create a dimensionally appropriate space between teeth 41 and 43. A 3i MicroMiniplant with dimensions of 3.25 mm (diameter × 11.5 mm was implanted in the edentulous area of tooth 42 because of the small size of tooth 42. Autogenous bone particles were placed on the buccal crestal defect, and a healing abutment was attached. After an 8-month healing phase, a final impression was made and an all-ceramic crown was delivered. This case demonstrates that osseous sites with significant dimensional space limitations can be successfully utilized to receive and integrate a narrow-diameter implant that will satisfy esthetic, phonetic and functional requirements.

  11. Pulsed Laser Deposition Processing of Improved Titanium Nitride Coatings for Implant Applications

    Science.gov (United States)

    Haywood, Talisha M.

    Recently surface coating technology has attracted considerable attention of researchers to develop novel coatings with enhanced functional properties such as hardness, biocompatibility, wear and corrosion resistance for medical devices and surgical tools. The materials currently being used for surgical implants include predominantly stainless steel (316L), cobalt chromium (Co-Cr), titanium and its alloys. Some of the limitations of these implants include improper mechanical properties, corrosion resistance, cytotoxicity and bonding with bone. One of the ways to improve the performance and biocompatibility of these implants is to coat their surfaces with biocompatible materials. Among the various coating materials, titanium nitride (TiN) shows excellent mechanical properties, corrosion resistance and low cytotoxicity. In the present work, a systematic study of pulsed laser ablation processing of TiN coatings was conducted. TiN thin film coatings were grown on commercially pure titanium (Ti) and stainless steel (316L) substrates at different substrate temperatures and different nitrogen partial pressures using the pulsed laser deposition (PLD) technique. Microstructural, surface, mechanical, chemical, corrosion and biological analysis techniques were applied to characterize the TiN thin film coatings. The PLD processed TiN thin film coatings showed improvements in mechanical strength, corrosion resistance and biocompatibility when compared to the bare substrates. The enhanced performance properties of the TiN thin film coatings were a result of the changing and varying of the deposition parameters.

  12. Engineering of bone fixation metal implants biointerface-Application of parylene C as versatile protective coating

    Energy Technology Data Exchange (ETDEWEB)

    Cieslik, Monika, E-mail: cieslik@chemia.uj.edu.pl [Faculty of Chemistry, Jagiellonian University, Ingardena 3, 30-060 Krakow (Poland); Institute of Metallurgy and Materials Science, PAS, W. Reymonta 25, 30-059 Krakow (Poland); Zimowski, Slawomir [AGH University of Science and Technology, Faculty of Mechanical Engineering and Robotics, Al. Mickiewicza 30, 30-059 Krakow (Poland); Golda, Monika [Faculty of Chemistry, Jagiellonian University, Ingardena 3, 30-060 Krakow (Poland); Institute of Metallurgy and Materials Science, PAS, W. Reymonta 25, 30-059 Krakow (Poland); Engvall, Klas [KTH Royal Institute of Technology, Department of Chemical Engineering and Technology, Division of Chemical Technology, Drottning Kristinas vaeg. 42, SE-100 44 Stockholm (Sweden); Pan, Jinshan [KTH Royal Institute of Technology, Department of Chemistry, Division of Surface and Corrosion Science, Drottning Kristinas vaeg. 51, SE-100 44 Stockholm (Sweden); Rakowski, Wieslaw [AGH University of Science and Technology, Faculty of Mechanical Engineering and Robotics, Al. Mickiewicza 30, 30-059 Krakow (Poland); Kotarba, Andrzej, E-mail: kotarba@chemia.uj.edu.pl [Faculty of Chemistry, Jagiellonian University, Ingardena 3, 30-060 Krakow (Poland)

    2012-12-01

    The tribological and protective properties of parylene C coatings (2-20 {mu}m) on stainless steel 316L implant materials were investigated by means of electrochemical measurements and wear tests. The thickness and morphology of the CVD prepared coatings were characterized by scanning electron and laser confocal microscopy. The stability of the coatings was examined in contact with Hanks' solution and H{sub 2}O{sub 2} (simulating the inflammatory response). It was concluded that silane-parylene C coating with the optimum thickness of 8 {mu}m exhibits excellent wear resistance properties and limits the wear formation. The engineered versatile coating demonstrates sufficient elastomer properties, essential to sustain the implantation surgery strains and micromotions during long-term usage in the body. - Highlights: Black-Right-Pointing-Pointer A versatile coating for protection of metal implant surface is proposed. Black-Right-Pointing-Pointer The protective properties of 2-20 {mu}m silane-parylene C coating were examined. Black-Right-Pointing-Pointer The engineered material proves its high anticorrosive and wear resistance. Black-Right-Pointing-Pointer The practical implications of the coating properties were discussed.

  13. Clinical applications of the sustained-release dexamethasone implant for treatment of macular edema

    Directory of Open Access Journals (Sweden)

    Rocío Herrero-Vanrell, Jose Augusto Cardillo

    2011-02-01

    Full Text Available Rocío Herrero-Vanrell1, Jose Augusto Cardillo2, Baruch D Kuppermann31Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, Complutense University, Madrid, Spain; 2Hospital de Olhos de Araraquara, Araraquara, São Paulo, Brazil; 3Gavin Herbert Eye Institute, University of California, Irvine, CA, USAAbstract: Macular edema is one of the leading causes of vision loss among patients with retinal vein occlusion, diabetic retinopathy, and posterior chamber inflammatory disease. However, the treatment of macular edema is considerably limited by the difficulty in delivering effective doses of therapeutic agents into the vitreous cavity. In recent years, the development of a sustained-release dexamethasone intravitreal implant (Ozurdex® has enabled more controlled drug release at a stable rate over a long period of time, with a potentially lower rate of adverse events. Clinical studies indicate that this dexamethasone implant is a promising new treatment option for patients with persistent macular edema resulting from retinal vein occlusion, diabetic retinopathy, and uveitis or Irvine-Gass syndrome.Keywords: diabetic retinopathy, macular edema, Ozurdex®, posterior-segment inflammatory disease, retinal vein occlusion, sustained-release dexamethasone implant

  14. The clinical application of the implantation of retrievable filters in superior vena cava

    International Nuclear Information System (INIS)

    Tian Yulong; Zhang Xitong; Hong Duo

    2011-01-01

    Objective: To investigate the safety of the placement of Tulip retrievable filter in superior vena cava and to discuss the prevention of pulmonary embolism (PE). Methods: Implantation of Tulip retrievable filter in superior vena cava was performed in ten patients (6 males and 4 females, aged 42-60 years) with acute or subacute deep venous thrombosis in upper extremity or cephalo-cervical region. After the placement of filter, the local via-catheter thrombolysis was conducted. The clinical results, such as the improvement of venous obstructed symptoms at upper extremity or cephalo-cervical region, were recorded. The filter's shape and location were checked. The possible occurrence of pulmonary embolism was observed. Results: The filter was successfully implanted in supper vena cava in all patients, and the deep venous thrombosis at upper extremity and cephalo-cervical region responded well to the local via-catheter thrombolysis. The filters showed no displacement or tilting. The swelling at upper extremity and cephalo-cervical region was markedly faded away. No symptomatic pulmonary embolism occurred. the filter was successfully retrieved via the femoral vein in four patients. Conclusion: Tulip filter can be safety implanted in superior vena cava and can be smoothly retrieved. The occurrence of pulmonary embolism can be effectively prevented if corresponding local via-catheter thrombolysis is carried out. (authors)

  15. Scanning electron microscopical observation of an osteoblast/osteoclast co-culture on micropatterned orthopaedic ceramics.

    Science.gov (United States)

    Halai, Mansur; Ker, Andrew; Meek, Rm Dominic; Nadeem, Danish; Sjostrom, Terje; Su, Bo; McNamara, Laura E; Dalby, Matthew J; Young, Peter S

    2014-01-01

    In biomaterial engineering, the surface of an implant can influence cell differentiation, adhesion and affinity towards the implant. On contact with an implant, bone marrow-derived mesenchymal stromal cells demonstrate differentiation towards bone forming osteoblasts, which can improve osteointegration. The process of micropatterning has been shown to improve osteointegration in polymers, but there are few reports surrounding ceramics. The purpose of this study was to establish a co-culture of bone marrow-derived mesenchymal stromal cells with osteoclast progenitor cells and to observe the response to micropatterned zirconia toughened alumina ceramics with 30 µm diameter pits. The aim was to establish whether the pits were specifically bioactive towards osteogenesis or were generally bioactive and would also stimulate osteoclastogenesis that could potentially lead to osteolysis. We demonstrate specific bioactivity of micropatterns towards osteogenesis, with more nodule formation and less osteoclastogenesis compared to planar controls. In addition, we found that that macrophage and osteoclast-like cells did not interact with the pits and formed fewer full-size osteoclast-like cells on the pitted surfaces. This may have a role when designing ceramic orthopaedic implants.

  16. Silver oxide-containing hydroxyapatite coating supports osteoblast function and enhances implant anchorage strength in rat femur.

    Science.gov (United States)

    Eto, Shuichi; Miyamoto, Hiroshi; Shobuike, Takeo; Noda, Iwao; Akiyama, Takayuki; Tsukamoto, Masatsugu; Ueno, Masaya; Someya, Shinsuke; Kawano, Shunsuke; Sonohata, Motoki; Mawatari, Masaaki

    2015-09-01

    Antibacterial silver with hydroxyapatite (Ag-HA) is a promising coating material for imparting antibacterial properties to implants. We previously reported that 3% (w/w) silver with HA (3% Ag-HA) has both antibacterial activity and osteoconductivity. In this study, we investigated the effects of Ag-HA on the in vitro osteoblast function and the in vivo anchorage strength and osteoconductivity of implants. Production of the osteoblast marker alkaline phosphatase, but not cytotoxicity, was observed in cells of the osteoblast cell line MC3T3-E1 cultured on the 3% Ag-HA-coated surface. These results were similar to those observed with silver-free HA coating. In contrast, a significant high level of cytotoxicity was observed when the cells were cultured on a 50% Ag-HA-coated surface. The anchorage strength of implants inserted into the femur of Sprague-Dawley (SD) rats was enhanced by coating the implants with 3% Ag-HA. On the 3% Ag-HA-coated surface, both metaphyseal and diaphyseal areas were largely covered with new bone and had adequate osteoconductivity. These results suggest that 3% Ag-HA, like conventional HA, promotes osteogenesis by supporting osteoblast viability and function and thereby contributes to sufficient anchorage strength of implants. Application of 3% Ag-HA, which combines the osteoconductivity of HA and the antibacterial activity of silver, to prosthetic joints will help prevent postoperative infections. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  17. Evaluation of the content and accessibility of web sites for accredited orthopaedic sports medicine fellowships.

    Science.gov (United States)

    Mulcahey, Mary K; Gosselin, Michelle M; Fadale, Paul D

    2013-06-19

    The Internet is a common source of information for orthopaedic residents applying for sports medicine fellowships, with the web sites of the American Orthopaedic Society for Sports Medicine (AOSSM) and the San Francisco Match serving as central databases. We sought to evaluate the web sites for accredited orthopaedic sports medicine fellowships with regard to content and accessibility. We reviewed the existing web sites of the ninety-five accredited orthopaedic sports medicine fellowships included in the AOSSM and San Francisco Match databases from February to March 2012. A Google search was performed to determine the overall accessibility of program web sites and to supplement information obtained from the AOSSM and San Francisco Match web sites. The study sample consisted of the eighty-seven programs whose web sites connected to information about the fellowship. Each web site was evaluated for its informational value. Of the ninety-five programs, fifty-one (54%) had links listed in the AOSSM database. Three (3%) of all accredited programs had web sites that were linked directly to information about the fellowship. Eighty-eight (93%) had links listed in the San Francisco Match database; however, only five (5%) had links that connected directly to information about the fellowship. Of the eighty-seven programs analyzed in our study, all eighty-seven web sites (100%) provided a description of the program and seventy-six web sites (87%) included information about the application process. Twenty-one web sites (24%) included a list of current fellows. Fifty-six web sites (64%) described the didactic instruction, seventy (80%) described team coverage responsibilities, forty-seven (54%) included a description of cases routinely performed by fellows, forty-one (47%) described the role of the fellow in seeing patients in the office, eleven (13%) included call responsibilities, and seventeen (20%) described a rotation schedule. Two Google searches identified direct links for

  18. Radiation exposure to the eye lens of orthopaedic surgeons during various orthopaedic procedures

    International Nuclear Information System (INIS)

    Romanova, K.; Alyakov, M.; Vassileva, J.

    2015-01-01

    The aim of the present study was to assess the radiation dose to the eye lens of orthopaedic surgeons during various orthopaedic procedures and to make efforts to ensure that radiation protection is optimised. The study was performed for Fractura femoris and Fractura cruris procedures performed in orthopaedic operating theatres, as well as for fractures of wrist, ankle and hand/ shoulder performed in the emergency trauma room. The highest mean value of the eye lens dose of 47.2 μSv and higher mean fluoroscopy time of 3 min, as well as the corresponding highest maximum values of 77.1 μSv and 5.0 min were observed for the Fractura femoris procedure performed with the Biplanar 500e fluoroscopy systems. At a normal workload, the estimated mean annual dose values do not exceed the annual occupational dose limit for the lens of eye, but at a heavy workload in the department, this dose limit could be achieved or exceeded. The use of protective lead glasses is recommended as they could reduce the radiation exposure of the lens of the eye. The phantom measurements demonstrated that the use of half-dose mode could additionally reduce dose to the operator's eye lens. (authors)

  19. Thromboembolism prophylaxis practices in orthopaedic arthroplasty patients.

    LENUS (Irish Health Repository)

    Cawley, D

    2010-10-01

    Thromboembolic events are a post-operative complication of arthroplasty surgery for up to 3 months. The incidence however, is not fully known. Some form of prophylaxis should be provided to all arthroplasty patients. Clinicians are wary of side effects, compliance profile and the associated cost. The objective of this study is to investigate practice patterns and their relevance to 3 risk groups. Ninety questionnaires were sent to orthopaedic surgeons with 3 hypothetical clinical scenarios and 10 prophylaxis regimes for thromboembolism across different risk groups. The response rate was 81\\/90 (90%). The most popular options in all 3 cases were early mobilisation, thrombo-embolism deterrant (TED) stockings and low molecular weight heparin (LMWH) (51\\/81, 62% of all cases). An inconsistent relationship exists between preferred practice and relevant guidelines. Preferred practice does not correlate with each level of risk.

  20. Ion implantation technology

    CERN Document Server

    Downey, DF; Jones, KS; Ryding, G

    1993-01-01

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

  1. Pitting corrosion studies on nitrogen implanted 316L SS for biomedical applications

    International Nuclear Information System (INIS)

    Subbaiyan, M.; Veerabadran, K.M.; Thampi, N.S.; Kanwar Krishnan; Kamachi Mudali, U.; Dayal, R.K.

    1997-01-01

    Traditionally, human bone fracture and defects have been corrected using metal and alloy fixing devices. Austenitic stainless steels (such as 316L alloy studied here) are favoured because of low cost, compared to titanium alloys, ease of fabrication and fair corrosion resistance. Localized attack on 316l stainless steel, however, results in iron, chromium and nickel ions leaching into surrounding body fluids. This study reports on the successful use of nitrogen ion implantation into 316lSS to evaluate the optimum dose needed to minimise this localised attack, in a physiological saline solution. (UK)

  2. Application of digital diagnostic impression, virtual planning, and computer-guided implant surgery for a CAD/CAM-fabricated, implant-supported fixed dental prosthesis: a clinical report.

    Science.gov (United States)

    Stapleton, Brandon M; Lin, Wei-Shao; Ntounis, Athanasios; Harris, Bryan T; Morton, Dean

    2014-09-01

    This clinical report demonstrated the use of an implant-supported fixed dental prosthesis fabricated with a contemporary digital approach. The digital diagnostic data acquisition was completed with a digital diagnostic impression with an intraoral scanner and cone-beam computed tomography with a prefabricated universal radiographic template to design a virtual prosthetically driven implant surgical plan. A surgical template fabricated with computer-aided design and computer-aided manufacturing (CAD/CAM) was used to perform computer-guided implant surgery. The definitive digital data were then used to design the definitive CAD/CAM-fabricated fixed dental prosthesis. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  3. Programme and abstracts of the seventh International Conference on Ion Implantation and other Applications of Ions and Electrons (ION 2008)

    International Nuclear Information System (INIS)

    2008-01-01

    The conference is organized on the biennial basis by the Institute of Physics, Maria Curie-Sklodowska University, Lublin in cooperation with the Wroclaw University of Technology and Technical University of Lublin. This biennial conferences has created a unique opportunity for scientists from Eastern and Western Europe together with their Polish colleagues, to discuss in a most agreeable environment, some of the fundamental questions in their field and develop new perspectives through the mutual exchange of ideas. ION 2008 has been focused mainly on ion implantation, a powerful tool for the modification of the subsurface layers of solid materials. Although the technique has been in use in the electronic industry for a few decades, there still remain many phenomena involved in the implantation process that are not well understood and are of considerable interest, for both fundamental science and also for new developments in applied materials science. One can highlight, in particular, mechanisms of ion energy loss in the bombarded material, creation of radiation defects, the formation of latent tracks, and many other phenomena that researchers are now intensively investigating. An improved understanding of such processes is essential for the effective application of analytical techniques like RBS, ERD, SIMS, PIPE and others

  4. Towards a closed-loop cochlear implant system: application of embedded monitoring of peripheral and central neural activity.

    Science.gov (United States)

    Mc Laughlin, Myles; Lu, Thomas; Dimitrijevic, Andrew; Zeng, Fan-Gang

    2012-07-01

    Although the cochlear implant (CI) is widely considered the most successful neural prosthesis, it is essentially an open-loop system that requires extensive initial fitting and frequent tuning to maintain a high, but not necessarily optimal, level of performance. Two developments in neuroscience and neuroengineering now make it feasible to design a closed-loop CI. One development is the recording and interpretation of evoked potentials (EPs) from the peripheral to the central nervous system. The other is the embedded hardware and software of a modern CI that allows recording of EPs. We review EPs that are pertinent to behavioral functions from simple signal detection and loudness growth to speech discrimination and recognition. We also describe signal processing algorithms used for electric artifact reduction and cancellation, critical to the recording of electric EPs. We then present a conceptual design for a closed-loop CI that utilizes in an innovative way the embedded implant receiver and stimulators to record short latency compound action potentials ( ~1 ms), auditory brainstem responses (1-10 ms) and mid-to-late cortical potentials (20-300 ms). We compare EPs recorded using the CI to EPs obtained using standard scalp electrodes recording techniques. Future applications and capabilities are discussed in terms of the development of a new generation of closed-loop CIs and other neural prostheses.

  5. The ion implanter of the Institute of Nuclear Physics and its application in the ion engineering; Implantator jonow IFJ i jego wykorzystanie w inzynierii jonowej

    Energy Technology Data Exchange (ETDEWEB)

    Drwiega, M.; Lipinska, E.; Lazarski, S.; Wierba, M.

    1993-09-01

    The device used for ion implantation is described in detail. It is built with the use of electromagnetic ion separator and consists of: ion source, ion beam system, ion mass analyzer and target chamber. The device parameters are also given. 14 refs, 5 figs, 2 tabs.

  6. Risk factors for surgical site infections following clean orthopaedic ...

    African Journals Online (AJOL)

    Risk factors for surgical site infections following clean orthopaedic operations. ... the host and environmental risk factors for surgical site infections following clean ... Materials and Methods: Consecutive patients who satisfied the inclusion ...

  7. Surgical site infection in orthopedic implants and its common bacteria with their sensitivities to antibiotics, in open reduction internal fixation

    International Nuclear Information System (INIS)

    Shah, M.Q.; Zardad, M.S.; Khan, A.; Ahmed, S.; Awan, A. S.; Mohammad, T.

    2017-01-01

    Surgical site infection in orthopaedic implants is a major problem, causing long hospital stay, cost to the patient and is a burden on health care facilities. It increases rate of non-union, osteomyelitis, implant failure, sepsis, multiorgan dysfunction and even death. Surgical site infection is defined as pain, erythema, swelling and discharge from wound site. Surgical site infection in orthopaedic implants is more challenging to the treating orthopaedic surgeon as the causative organism is protected by a biofilm over the implant's surface. Antibiotics cannot cross this film to reach the bacteria's, causing infection. Method: This descriptive case series study includes 132 patients of both genders with ages between 13 years to 60 years conducted at Orthopaedic Unit, Ayub Medical College, Abbottabad from 1st October 2015 to 31st March 2016. Patients with close fractures of long bones were included in the study to determine the frequency of surgical site infection in orthopaedic implants and the type of bacteria involved and their sensitivity to various antibiotics. All implants were of stainless steel. The implants used were Dynamic hip screws, Dynamic compression screws, plates, k-wires, Interlocking nails, SIGN nails, Austin Moore prosthesis and tension band wires. Pre-op and post-op antibiotics used were combination of Sulbactum and Cefoperazone which was given 1 hour before surgery and continued for 72 hours after surgery. Patients were followed up to 4 weeks. Pus was taken on culture stick, from those who developed infection. Results were entered in the pro forma. Results: A total of 132 patients of long bone fractures, who were treated with open reduction and internal fixation, were studied. Only 7 patients developed infection. Staphylococcus Aureus was isolated from all 7 patients. Staphylococcus aureus was sensitive to Linezolid, Fusidic Acid, and vancomycin. Cotrimoxazole, tetracycline, Gentamycin and Clindamycin were partially effective. Conclusion

  8. A basic introduction to statistics for the orthopaedic surgeon.

    Science.gov (United States)

    Bertrand, Catherine; Van Riet, Roger; Verstreken, Frederik; Michielsen, Jef

    2012-02-01

    Orthopaedic surgeons should review the orthopaedic literature in order to keep pace with the latest insights and practices. A good understanding of basic statistical principles is of crucial importance to the ability to read articles critically, to interpret results and to arrive at correct conclusions. This paper explains some of the key concepts in statistics, including hypothesis testing, Type I and Type II errors, testing of normality, sample size and p values.

  9. Monte Carlo study of LDR seed dosimetry with an application in a clinical brachytherapy breast implant.

    Science.gov (United States)

    Furstoss, C; Reniers, B; Bertrand, M J; Poon, E; Carrier, J-F; Keller, B M; Pignol, J P; Beaulieu, L; Verhaegen, F

    2009-05-01

    A Monte Carlo (MC) study was carried out to evaluate the effects of the interseed attenuation and the tissue composition for two models of 125I low dose rate (LDR) brachytherapy seeds (Medi-Physics 6711, IBt InterSource) in a permanent breast implant. The effect of the tissue composition was investigated because the breast localization presents heterogeneities such as glandular and adipose tissue surrounded by air, lungs, and ribs. The absolute MC dose calculations were benchmarked by comparison to the absolute dose obtained from experimental results. Before modeling a clinical case of an implant in heterogeneous breast, the effects of the tissue composition and the interseed attenuation were studied in homogeneous phantoms. To investigate the tissue composition effect, the dose along the transverse axis of the two seed models were calculated and compared in different materials. For each seed model, three seeds sharing the same transverse axis were simulated to evaluate the interseed effect in water as a function of the distance from the seed. A clinical study of a permanent breast 125I implant for a single patient was carried out using four dose calculation techniques: (1) A TG-43 based calculation, (2) a full MC simulation with realistic tissues and seed models, (3) a MC simulation in water and modeled seeds, and (4) a MC simulation without modeling the seed geometry but with realistic tissues. In the latter, a phase space file corresponding to the particles emitted from the external surface of the seed is used at each seed location. The results were compared by calculating the relevant clinical metrics V85, V100, and V200 for this kind of treatment in the target. D90 and D50 were also determined to evaluate the differences in dose and compare the results to the studies published for permanent prostate seed implants in literature. The experimental results are in agreement with the MC absolute doses (within 5% for EBT Gafchromic film and within 7% for TLD-100

  10. Resistance of Magnesium Alloys to Corrosion Fatigue for Biodegradable Implant Applications: Current Status and Challenges

    Science.gov (United States)

    Raman, R. K. Singh; Harandi, Shervin Eslami

    2017-01-01

    Magnesium (Mg) alloys are attracting increasing interest as the most suitable metallic materials for construction of biodegradable and bio-absorbable temporary implants. However, Mg-alloys can suffer premature and catastrophic fracture under the synergy of cyclic loading and corrosion (i.e., corrosion fatigue (CF)). Though Mg alloys are reported to be susceptible to CF also in the corrosive human body fluid, there are very limited studies on this topic. Furthermore, the in vitro test parameters employed in these investigations have not properly simulated the actual conditions in the human body. This article presents an overview of the findings of available studies on the CF of Mg alloys in pseudo-physiological solutions and the employed testing procedures, as well as identifying the knowledge gap. PMID:29144428

  11. Resistance of Magnesium Alloys to Corrosion Fatigue for Biodegradable Implant Applications: Current Status and Challenges.

    Science.gov (United States)

    Raman, R K Singh; Harandi, Shervin Eslami

    2017-11-16

    Magnesium (Mg) alloys are attracting increasing interest as the most suitable metallic materials for construction of biodegradable and bio-absorbable temporary implants. However, Mg-alloys can suffer premature and catastrophic fracture under the synergy of cyclic loading and corrosion (i.e., corrosion fatigue (CF)). Though Mg alloys are reported to be susceptible to CF also in the corrosive human body fluid, there are very limited studies on this topic. Furthermore, the in vitro test parameters employed in these investigations have not properly simulated the actual conditions in the human body. This article presents an overview of the findings of available studies on the CF of Mg alloys in pseudo-physiological solutions and the employed testing procedures, as well as identifying the knowledge gap.

  12. Micro-arc oxidation as a tool to develop multifunctional calcium-rich surfaces for dental implant applications

    Energy Technology Data Exchange (ETDEWEB)

    Ribeiro, A.R., E-mail: arribeiro@inmetro.gov.br [Department of Periodontology, Araraquara Dental School, University Estadual Paulista, Rua Humaitá 1680, 14801-903 Araraquara, São Paulo (Brazil); Directory of Metrology Applied to Life Science, National Institute of Metrology Quality and Technology, Av. N. S. das Graças 50, Xerém, Duque de Caxias, Rio de Janeiro (Brazil); Brazilian Branch of Institute of Biomaterials, Tribocorrosion and Nanomedicine (IBTN/Br) (Brazil); Oliveira, F., E-mail: fernando@dem.uminho.pt [Brazilian Branch of Institute of Biomaterials, Tribocorrosion and Nanomedicine (IBTN/Br) (Brazil); Centre for Mechanical and Materials Technologies, University of Minho, Campus de Azurém, 4800-058 Guimarães (Portugal); Boldrini, L.C., E-mail: lcboldrini@inmetro.gov.br [Directory of Metrology Applied to Life Science, National Institute of Metrology Quality and Technology, Av. N. S. das Graças 50, Xerém, Duque de Caxias, Rio de Janeiro (Brazil); Leite, P.E., E-mail: leitepec@gmail.com [Directory of Metrology Applied to Life Science, National Institute of Metrology Quality and Technology, Av. N. S. das Graças 50, Xerém, Duque de Caxias, Rio de Janeiro (Brazil); Falagan-Lotsch, P., E-mail: prifalagan@gmail.com [Directory of Metrology Applied to Life Science, National Institute of Metrology Quality and Technology, Av. N. S. das Graças 50, Xerém, Duque de Caxias, Rio de Janeiro (Brazil); Linhares, A.B.R., E-mail: adrianalinhares@hotmail.com [Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niterói (Brazil); and others

    2015-09-01

    Titanium (Ti) is commonly used in dental implant applications. Surface modification strategies are being followed in last years in order to build Ti oxide-based surfaces that can fulfill, simultaneously, the following requirements: induced cell attachment and adhesion, while providing a superior corrosion and tribocorrosion performance. In this work micro-arc oxidation (MAO) was used as a tool for the growth of a nanostructured bioactive titanium oxide layer aimed to enhance cell attachment and adhesion for dental implant applications. Characterization of the surfaces was performed, in terms of morphology, topography, chemical composition and crystalline structure. Primary human osteoblast adhesion on the developed surfaces was investigated in detail by electronic and atomic force microscopy as well as immunocytochemistry. Also an investigation on the early cytokine production was performed. Results show that a relatively thick hybrid and graded oxide layer was produced on the Ti surface, being constituted by a mixture of anatase, rutile and amorphous phases where calcium (Ca) and phosphorous (P) were incorporated. An outermost nanometric-thick amorphous oxide layer rich in Ca was present in the film. This amorphous layer, rich in Ca, improved fibroblast viability and metabolic activity as well as osteoblast adhesion. High-resolution techniques allowed to understand that osteoblasts adhered less in the crystalline-rich regions while they preferentially adhere and spread over in the Ca-rich amorphous oxide layer. Also, these surfaces induce higher amounts of IFN-γ cytokine secretion, which is known to regulate inflammatory responses, bone microarchitecture as well as cytoskeleton reorganization and cellular spreading. These surfaces are promising in the context of dental implants, since they might lead to faster osseointegration. - Highlights: • A nanometric-structured calcium-rich amorphous layer with improved bioactivity was produced on titanium surfaces.

  13. Micro-arc oxidation as a tool to develop multifunctional calcium-rich surfaces for dental implant applications

    International Nuclear Information System (INIS)

    Ribeiro, A.R.; Oliveira, F.; Boldrini, L.C.; Leite, P.E.; Falagan-Lotsch, P.; Linhares, A.B.R.

    2015-01-01

    Titanium (Ti) is commonly used in dental implant applications. Surface modification strategies are being followed in last years in order to build Ti oxide-based surfaces that can fulfill, simultaneously, the following requirements: induced cell attachment and adhesion, while providing a superior corrosion and tribocorrosion performance. In this work micro-arc oxidation (MAO) was used as a tool for the growth of a nanostructured bioactive titanium oxide layer aimed to enhance cell attachment and adhesion for dental implant applications. Characterization of the surfaces was performed, in terms of morphology, topography, chemical composition and crystalline structure. Primary human osteoblast adhesion on the developed surfaces was investigated in detail by electronic and atomic force microscopy as well as immunocytochemistry. Also an investigation on the early cytokine production was performed. Results show that a relatively thick hybrid and graded oxide layer was produced on the Ti surface, being constituted by a mixture of anatase, rutile and amorphous phases where calcium (Ca) and phosphorous (P) were incorporated. An outermost nanometric-thick amorphous oxide layer rich in Ca was present in the film. This amorphous layer, rich in Ca, improved fibroblast viability and metabolic activity as well as osteoblast adhesion. High-resolution techniques allowed to understand that osteoblasts adhered less in the crystalline-rich regions while they preferentially adhere and spread over in the Ca-rich amorphous oxide layer. Also, these surfaces induce higher amounts of IFN-γ cytokine secretion, which is known to regulate inflammatory responses, bone microarchitecture as well as cytoskeleton reorganization and cellular spreading. These surfaces are promising in the context of dental implants, since they might lead to faster osseointegration. - Highlights: • A nanometric-structured calcium-rich amorphous layer with improved bioactivity was produced on titanium surfaces.

  14. Oxygen-implanted induced formation of oxide layer enhances blood compatibility on titanium for biomedical applications

    Energy Technology Data Exchange (ETDEWEB)

    Hung, Wei-Chiang [School of Oral Hygiene, Taipei Medical University, Taipei 110, Taiwan (China); Department of Dentistry, Taipei Medical University Hospital, Taipei 110, Taiwan (China); Chang, Fang-Mo [School of Dentistry, Taipei Medical University, Taipei 110, Taiwan (China); Yang, Tzu-Sen [Master Program in Graduate Institute of Nanomedicine and Medical Engineering, Taipei Medical University, Taipei 110, Taiwan (China); Ou, Keng-Liang [School of Dentistry, Taipei Medical University, Taipei 110, Taiwan (China); Research Center for Biomedical Implants and Microsurgery Devices, Taipei Medical University, Taipei 110, Taiwan (China); Department of Dentistry, Taipei Medical University-Shuang-Ho Hospital, Taipei 235, Taiwan (China); Lin, Che-Tong [School of Dentistry, Taipei Medical University, Taipei 110, Taiwan (China); Peng, Pei-Wen, E-mail: apon@tmu.edu.tw [School of Dental Technology, Taipei Medical University, Taipei 110, Taiwan (China)

    2016-11-01

    Titanium dioxide (TiO{sub 2}) layers were prepared on a Ti substrate by using oxygen plasma immersion ion implantation (oxygen PIII). The surface chemical states, structure, and morphology of the layers were studied using X-ray photoelectron spectroscopy, X-ray diffraction, Raman microscopy, atomic force microscopy and scanning electron microscope. The mechanical properties, such as the Young's modulus and hardness, of the layers were investigated using nanoindentation testing. The Ti{sup 4+} chemical state was determined to be present on oxygen-PIII-treated surfaces, which consisted of nanocrystalline TiO{sub 2} with a rutile structure. Compared with Ti substrates, the oxygen-PIII-treated surfaces exhibited decreased Young's moduli and hardness. Parameters indicating the blood compatibility of the oxygen-PIII-treated surfaces, including the clotting time and platelet adhesion and activation, were studied in vitro. Clotting time assays indicated that the clotting time of oxygen-PIII-treated surfaces was longer than that of the Ti substrate, which was associated with decreased fibrinogen adsorption. In conclusion, the surface characteristics and the blood compatibility of Ti implants can be modified and improved using oxygen PIII. - Highlights: • The Ti{sup 4+} chemical state was determined to be present on oxygen-PIII-treated surfaces. • The nanocrystalline TiO{sub 2} with a rutile structure was formed on titanium surfaces. • A nanoporous TiO{sub 2} layer in the rutile phase prepared using oxygen PIII treatment can be used to prolong blood clot formation.

  15. Enhanced osteointegration of medical titanium implant with surface modifications in micro/nanoscale structures

    Directory of Open Access Journals (Sweden)

    Liwen Lin

    2014-01-01

    Full Text Available Biomimetic design and substrate-based surface modification of medical implants will help to improve the integration of tissue to its material interfaces. Surface energy, composition, roughness, and topography all influence the biological responses of the implants, such as protein adsorption and cell adhesion, proliferation and differentiation. In the current study, different surface structures of Ti implants were constructed using facile surface techniques to create various micro-, nano-, and nano/micro composite scale topography. We have fabricated three types of hierarchical structures of TiO2 coating on Ti implants, including nanotube structure, nano sponge-like structure, and nano/micro nest-like structure. The osteointegration and biomechanical performance of the coated Ti screws were evaluated by histology and removal of torque force test in vivo. We found that the nano/micro nest-like and nanotube structured surface possessed better osteointegration ability. It indicated that the alkaline hydrothermally treated Ti substrate was the best for bone-implant integration in terms of all in vitro and in vivo testing parameters. The alkaline hydrothermally treated surface displayed a hydrophilic (contact angle value 5.92 ± 1.2, higher roughness (Ra value 911.3 ± 33.8 nm, higher specific surface area (8.26 ± 1.051 m2/g, and greater apatite inductivity. The electrochemical surface modification may become a powerful approach to enhance metal implant to bone integration in orthopaedic applications.

  16. Laser microtexturing of implant surfaces for enhanced tissue integration

    Energy Technology Data Exchange (ETDEWEB)

    Ricci, J.L. [Univ. of Medicine and Dentistry of New Jersey, Newark, NJ (United States). Dept. of Orthodontics; Alexander, H. [Orthogen Corp., Springfield, NJ (United States)

    2001-07-01

    The success or failure of bone and soft tissue-fixed medical devices, such as dental and orthopaedic implants, depends on a complex combination of biological and mechanical factors. These factors are intimately associated with the interface between the implant surface and the surrounding tissue, and are largely determined by the composition, surface chemistry, and surface microgeometry of the implant. The relative contributions of these factors are difficult to assess. This study addresses the contribution of surface microtexture, on a controlled level, to tissue integration. (orig.)

  17. Barriers and strategies for the clinical translation of advanced orthopaedic tissue engineering protocols.

    Science.gov (United States)

    Madry, H; Alini, M; Stoddart, M J; Evans, C; Miclau, T; Steiner, S

    2014-05-06

    Research in orthopaedic tissue engineering has intensified over the last decade and new protocols continue to emerge. The clinical translation of these new applications, however, remains associated with a number of obstacles. This report highlights the major issues that impede the clinical translation of advanced tissue engineering concepts, discusses strategies to overcome these barriers, and examines the need to increase incentives for translational strategies. The statements are based on presentations and discussions held at the AO Foundation-sponsored symposium "Where Science meets Clinics 2013" held at the Congress Center in Davos, Switzerland, in September, 2013. The event organisers convened a diverse group of over one hundred stakeholders involved in clinical translation of orthopaedic tissue engineering, including scientists, clinicians, healthcare industry professionals and regulatory agency representatives. A major point that emerged from the discussions was that there continues to be a critical need for early trans-disciplinary communication and collaboration in the development and execution of research approaches. Equally importantly was the need to address the shortage of sustained funding programs for multidisciplinary teams conducting translational research. Such detailed discussions between experts contribute towards the development of a roadmap to more successfully advance the clinical translation of novel tissue engineering concepts and ultimately improve patient care in orthopaedic and trauma surgery.

  18. Barriers and strategies for the clinical translation of advanced orthopaedic tissue engineering protocols

    Directory of Open Access Journals (Sweden)

    H Madry

    2014-05-01

    Full Text Available Research in orthopaedic tissue engineering has intensified over the last decade and new protocols continue to emerge. The clinical translation of these new applications, however, remains associated with a number of obstacles. This report highlights the major issues that impede the clinical translation of advanced tissue engineering concepts, discusses strategies to overcome these barriers, and examines the need to increase incentives for translational strategies. The statements are based on presentations and discussions held at the AO Foundation-sponsored symposium "Where Science meets Clinics 2013" held at the Congress Center in Davos, Switzerland, in September, 2013. The event organisers convened a diverse group of over one hundred stakeholders involved in clinical translation of orthopaedic tissue engineering, including scientists, clinicians, healthcare industry professionals and regulatory agency representatives. A major point that emerged from the discussions was that there continues to be a critical need for early trans-disciplinary communication and collaboration in the development and execution of research approaches. Equally importantly was the need to address the shortage of sustained funding programs for multidisciplinary teams conducting translational research. Such detailed discussions between experts contribute towards the development of a roadmap to more successfully advance the clinical translation of novel tissue engineering concepts and ultimately improve patient care in orthopaedic and trauma surgery.

  19. (Mis)perceptions about intimate partner violence in women presenting for orthopaedic care: a survey of Canadian orthopaedic surgeons.

    Science.gov (United States)

    Bhandari, Mohit; Sprague, Sheila; Tornetta, Paul; D'Aurora, Valerie; Schemitsch, Emil; Shearer, Heather; Brink, Ole; Mathews, David; Dosanjh, Sonia

    2008-07-01

    Domestic violence is the most common cause of nonfatal injury to women in North America. In a review of 144 such injuries, the second most common manifestation of intimate partner violence was musculoskeletal injuries (28%). The American Academy of Orthopaedic Surgeons is explicit that orthopaedic surgeons should play a role in the screening and appropriate identification of victims. We aimed to identify the perceptions, attitudes, and knowledge of Canadian orthopaedic surgeons with regard to intimate partner violence. We surveyed members of the Canadian Orthopaedic Association to identify attitudes toward intimate partner violence. With use of a systematic random sample, 362 surgeons were mailed questionnaires. The questionnaire consisted of three sections: (1) the general attitude of the orthopaedic surgeon toward intimate partner violence, (2) the attitude of the orthopaedic surgeon toward victims and batterers, and (3) the clinical relevance of intimate partner violence in orthopaedic surgery. Up to three follow-up mailings were performed to enhance response rates. A total of 186 orthopaedic surgeons responded (a response rate of 51%), and 167 (91%) of them were men. Most orthopaedic surgeons (95%) estimated that <10% of their patients were victims of intimate partner violence, and most respondents (80%) believed that it was exceedingly rare (a prevalence of <1%). The concept of mandatory screening for intimate partner violence was met with uncertainty by 116 surgeons (64%). Misconceptions were perpetuated by surgeons who believed that inquiring about intimate partner violence was an invasion of the victim's privacy, that investigating intimate partner violence was not part of their duty, that victims choose to be a victim, and that victims play a proactive role in causing their abuse. By the completion of the survey, the majority of surgeons (91%) believed that knowledge about intimate partner violence was relevant to their surgical practice. Discomfort with

  20. Laser-induced modification of structure and shape of cartilage in otolaryngology and orthopaedics

    Science.gov (United States)

    Sobol', E. N.; Baum, O. I.; Omel'chenko, A. I.; Soshnikova, Yu. M.; Yuzhakov, A. V.; Kas'yanenko, E. M.; Tokareva, A. V.; Baskov, A. V.; Svistushkin, V. M.; Selezneva, L. V.; Shekhter, A. B.

    2017-11-01

    We present the results of basic research in laser modification of tissues in otolaryngology (correcting the shape of nasal septum and larynx cartilages), cosmetology (correcting ear and nose shape), orthopaedics and spinal surgery (treatment of diseases of spine disc and joints). The physical processes and mechanisms of laser-induced relaxation of stresses and regeneration of tissues are considered. New results of studies in this fast-developing field of laser surgery are presented, in particular, the results of laser correction of costal cartilage shape in the process of making implants for the treatment of larynx stenosis and controlled regeneration of the hyaline articular cartilage. Presented at the Fundamentals of Laser Assisted Micro- and Nanotechnologies (FLAMN-2016) International Symposium (Pushkin, Leningrad oblast, 27 June to 1 July 2016).

  1. Racial and ethnic diversity in orthopaedic surgery residency programs.

    Science.gov (United States)

    Okike, Kanu; Utuk, Mekeme E; White, Augustus A

    2011-09-21

    Although the U.S. population is increasingly diverse, the field of orthopaedic surgery has historically been less diverse. The purpose of this study was to quantify the representation of racial and ethnic minorities among orthopaedic surgery residents compared with those in other fields of medicine and to determine how these levels of diversity have changed over time. We determined the representation of minorities among residents in orthopaedic surgery and in other fields by analyzing the Graduate Medical Education reports published annually by the Journal of the American Medical Association (JAMA), which provided data for African-Americans from 1968 to 2008, Hispanics from 1990 to 2008, Asians from 1995 to 2008, and American Indians/Alaskan Natives and Native Hawaiians/Pacific Islanders from 2001 to 2008. During the 1990s and 2000s, representation among orthopaedic residents increased rapidly for Asians (+4.53% per decade, p < 0.0001) and gradually for Hispanics (+1.37% per decade, p < 0.0001) and African-Americans (+0.68% per decade, p = 0.0003). Total minority representation in orthopaedics averaged 20.2% during the most recent years studied (2001 to 2008), including 11.7% for Asians, 4.0% for African-Americans, 3.8% for Hispanics, 0.4% for American Indians/Alaskan Natives, and 0.3% for Native Hawaiians/Pacific Islanders. However, orthopaedic surgery was significantly less diverse than all of the other residencies examined during this time period (p < 0.001). This was due primarily to the lower representation of Hispanics and Asians in orthopaedic surgery than in any of the other fields of medicine. Minority representation in orthopaedic residency programs has increased over time for Asians, Hispanics, and African-Americans. In spite of these gains, orthopaedic surgery has remained the least diverse of the specialty training programs considered in this study. While further efforts are needed to determine the factors underlying this lack of representation, we

  2. 3D printed Ti6Al4V implant surface promotes bone maturation and retains a higher density of less aged osteocytes at the bone-implant interface.

    Science.gov (United States)

    Shah, Furqan A; Snis, Anders; Matic, Aleksandar; Thomsen, Peter; Palmquist, Anders

    2016-01-01

    For load-bearing orthopaedic applications, metal implants having an interconnected pore structure exhibit the potential to facilitate bone ingrowth and the possibility for reducing the stiffness mismatch between the implant and bone, thus eliminating stress-shielding effects. 3D printed solid and macro-porous Ti6Al4V implants were evaluated after six-months healing in adult sheep femora. The ultrastructural composition of the bone-implant interface was investigated using Raman spectroscopy and electron microscopy, in a correlative manner. The mineral crystallinity and the mineral-to-matrix ratios of the interfacial tissue and the native bone were found to be similar. However, lower Ca/P ratios, lower carbonate content, but higher proline, phenylalanine and tyrosine levels indicated that the interfacial tissue remained less mature. Bone healing was more advanced at the porous implant surface (vs. the solid implant surface) based on the interfacial tissue ν1 CO3(2-)/ν2 PO4(3-) ratio, phenylalanine and tyrosine levels approaching those of the native bone. The mechanosensing infrastructure in bone, the osteocyte lacuno-canalicular network, retained ∼40% more canaliculi per osteocyte lacuna, i.e., a 'less aged' morphology at the interface. The osteocyte density per mineralised surface area was ∼36-71% higher at the interface after extended healing periods. In osseointegration research, the success of an implant surface or design is commonly determined by quantifying the amount of new bone, rather than its maturation, composition and structure. This work describes a novel correlative methodology to investigate the ultrastructure and composition of bone formed around and within 3D printed Ti6Al4V implants having an interconnected open-pore structure. Raman spectroscopy demonstrates that the molecular composition of the interfacial tissue at different implant surfaces may vary, suggesting differences in the extent to which bone maturation occurs even after long

  3. Security Mechanism Based on Hospital Authentication Server for Secure Application of Implantable Medical Devices

    Science.gov (United States)

    2014-01-01

    After two recent security attacks against implantable medical devices (IMDs) have been reported, the privacy and security risks of IMDs have been widely recognized in the medical device market and research community, since the malfunctioning of IMDs might endanger the patient's life. During the last few years, a lot of researches have been carried out to address the security-related issues of IMDs, including privacy, safety, and accessibility issues. A physician accesses IMD through an external device called a programmer, for diagnosis and treatment. Hence, cryptographic key management between IMD and programmer is important to enforce a strict access control. In this paper, a new security architecture for the security of IMDs is proposed, based on a 3-Tier security model, where the programmer interacts with a Hospital Authentication Server, to get permissions to access IMDs. The proposed security architecture greatly simplifies the key management between IMDs and programmers. Also proposed is a security mechanism to guarantee the authenticity of the patient data collected from IMD and the nonrepudiation of the physician's treatment based on it. The proposed architecture and mechanism are analyzed and compared with several previous works, in terms of security and performance. PMID:25276797

  4. Security Mechanism Based on Hospital Authentication Server for Secure Application of Implantable Medical Devices

    Directory of Open Access Journals (Sweden)

    Chang-Seop Park

    2014-01-01

    Full Text Available After two recent security attacks against implantable medical devices (IMDs have been reported, the privacy and security risks of IMDs have been widely recognized in the medical device market and research community, since the malfunctioning of IMDs might endanger the patient’s life. During the last few years, a lot of researches have been carried out to address the security-related issues of IMDs, including privacy, safety, and accessibility issues. A physician accesses IMD through an external device called a programmer, for diagnosis and treatment. Hence, cryptographic key management between IMD and programmer is important to enforce a strict access control. In this paper, a new security architecture for the security of IMDs is proposed, based on a 3-Tier security model, where the programmer interacts with a Hospital Authentication Server, to get permissions to access IMDs. The proposed security architecture greatly simplifies the key management between IMDs and programmers. Also proposed is a security mechanism to guarantee the authenticity of the patient data collected from IMD and the nonrepudiation of the physician’s treatment based on it. The proposed architecture and mechanism are analyzed and compared with several previous works, in terms of security and performance.

  5. Security mechanism based on Hospital Authentication Server for secure application of implantable medical devices.

    Science.gov (United States)

    Park, Chang-Seop

    2014-01-01

    After two recent security attacks against implantable medical devices (IMDs) have been reported, the privacy and security risks of IMDs have been widely recognized in the medical device market and research community, since the malfunctioning of IMDs might endanger the patient's life. During the last few years, a lot of researches have been carried out to address the security-related issues of IMDs, including privacy, safety, and accessibility issues. A physician accesses IMD through an external device called a programmer, for diagnosis and treatment. Hence, cryptographic key management between IMD and programmer is important to enforce a strict access control. In this paper, a new security architecture for the security of IMDs is proposed, based on a 3-Tier security model, where the programmer interacts with a Hospital Authentication Server, to get permissions to access IMDs. The proposed security architecture greatly simplifies the key management between IMDs and programmers. Also proposed is a security mechanism to guarantee the authenticity of the patient data collected from IMD and the nonrepudiation of the physician's treatment based on it. The proposed architecture and mechanism are analyzed and compared with several previous works, in terms of security and performance.

  6. Value and clinical application of orthopedic metal artifact reduction algorithm in CT scans after orthopedic metal implantation

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Yi; Pan, Shinong; Zhao, Xudong; Guo, Wenli; He, Ming; Guo, Qiyong [Shengjing Hospital of China Medical University, Shenyang (China)

    2017-06-15

    To evaluate orthopedic metal artifact reduction algorithm (O-MAR) in CT orthopedic metal artifact reduction at different tube voltages, identify an appropriate low tube voltage for clinical practice, and investigate its clinical application. The institutional ethical committee approved all the animal procedures. A stainless-steel plate and four screws were implanted into the femurs of three Japanese white rabbits. Preoperative CT was performed at 120 kVp without O-MAR reconstruction, and postoperative CT was performed at 80–140 kVp with O-MAR. Muscular CT attenuation, artifact index (AI) and signal-to-noise ratio (SNR) were compared between preoperative and postoperative images (unpaired t test), between paired O-MAR and non-O-MAR images (paired Student t test) and among different kVp settings (repeated measures ANOVA). Artifacts' severity, muscular homogeneity, visibility of inter-muscular space and definition of bony structures were subjectively evaluated and compared (Wilcoxon rank-sum test). In the clinical study, 20 patients undertook CT scan at low kVp with O-MAR with informed consent. The diagnostic satisfaction of clinical images was subjectively assessed. Animal experiments showed that the use of O-MAR resulted in accurate CT attenuation, lower AI, better SNR, and higher subjective scores (p < 0.010) at all tube voltages. O-MAR images at 100 kVp had almost the same AI and SNR as non-O-MAR images at 140 kVp. All O-MAR images were scored ≥ 3. In addition, 95% of clinical CT images performed at 100 kVp were considered satisfactory. O-MAR can effectively reduce orthopedic metal artifacts at different tube voltages, and facilitates low-tube-voltage CT for patients with orthopedic metal implants.

  7. Value and clinical application of orthopedic metal artifact reduction algorithm in CT scans after orthopedic metal implantation

    International Nuclear Information System (INIS)

    Hu, Yi; Pan, Shinong; Zhao, Xudong; Guo, Wenli; He, Ming; Guo, Qiyong

    2017-01-01

    To evaluate orthopedic metal artifact reduction algorithm (O-MAR) in CT orthopedic metal artifact reduction at different tube voltages, identify an appropriate low tube voltage for clinical practice, and investigate its clinical application. The institutional ethical committee approved all the animal procedures. A stainless-steel plate and four screws were implanted into the femurs of three Japanese white rabbits. Preoperative CT was performed at 120 kVp without O-MAR reconstruction, and postoperative CT was performed at 80–140 kVp with O-MAR. Muscular CT attenuation, artifact index (AI) and signal-to-noise ratio (SNR) were compared between preoperative and postoperative images (unpaired t test), between paired O-MAR and non-O-MAR images (paired Student t test) and among different kVp settings (repeated measures ANOVA). Artifacts' severity, muscular homogeneity, visibility of inter-muscular space and definition of bony structures were subjectively evaluated and compared (Wilcoxon rank-sum test). In the clinical study, 20 patients undertook CT scan at low kVp with O-MAR with informed consent. The diagnostic satisfaction of clinical images was subjectively assessed. Animal experiments showed that the use of O-MAR resulted in accurate CT attenuation, lower AI, better SNR, and higher subjective scores (p < 0.010) at all tube voltages. O-MAR images at 100 kVp had almost the same AI and SNR as non-O-MAR images at 140 kVp. All O-MAR images were scored ≥ 3. In addition, 95% of clinical CT images performed at 100 kVp were considered satisfactory. O-MAR can effectively reduce orthopedic metal artifacts at different tube voltages, and facilitates low-tube-voltage CT for patients with orthopedic metal implants

  8. Clinical Application of Screening for GJB2 Mutations before Cochlear Implantation in a Heterogeneous Population with High Rate of Autosomal Recessive Nonsyndromic Hearing Loss

    Directory of Open Access Journals (Sweden)

    Masoud Motasaddi Zarandy

    2011-01-01

    Full Text Available Clinical application of mutation screening and its effect on the outcome of cochlear implantation is widely debated. We investigated the effect of mutations in GJB2 gene on the outcome of cochlear implantation in a population with a high rate of consanguineous marriage and autosomal recessive nonsyndromic hearing loss. Two hundred and one children with profound prelingual sensorineural hearing loss were included. Forty-six patients had 35delG in GJB2. Speech awareness thresholds (SATs and speech recognition thresholds (SRTs improved following implantation, but there was no difference in performance between patients with GJB2-related deafness versus control (all >0.10. Both groups had produced their first comprehensible words within the same period of time following implantation (2.27 months in GJB2-related deaf versus 2.62 months in controls, =0.22. Although our findings demonstrate the need to uncover unidentified genetic causes of hereditary deafness, they do not support the current policy for genetic screening before cochlear implantation, nor prove a prognostic value.

  9. Safety syringes and anti-needlestick devices in orthopaedic surgery.

    Science.gov (United States)

    Sibbitt, Wilmer L; Band, Philip A; Kettwich, Lawrence G; Sibbitt, Cristina R; Sibbitt, Lori J; Bankhurst, Arthur D

    2011-09-07

    The American Academy of Orthopaedic Surgery (AAOS), The Joint Commission, the Occupational Safety and Health Administration (OSHA), and the Needlestick Safety and Prevention Act encourage the integration of safety-engineered devices to prevent needlestick injuries to health-care workers and patients. We hypothesized that safety syringes and needles could be used in outpatient orthopaedic injection and aspiration procedures. The study investigated the orthopaedic uses and procedural idiosyncrasies of safety-engineered devices, including (1) four safety needles (Eclipse, SafetyGlide, SurGuard, and Magellan), (2) a mechanical safety syringe (RPD), (3) two automatic retractable syringes (Integra, VanishPoint), (4) three manual retractable syringes (Procedur-SF, Baksnap, Invirosnap), and (5) three shielded syringes (Safety-Lok, Monoject, and Digitally Activated Shielded [DAS] Syringe). The devices were first tested ex vivo, and then 1300 devices were used for 425 subjects undergoing outpatient arthrocentesis, intra-articular injections, local anesthesia, aspiration biopsy, and ultrasound-guided procedures. During the clinical observation, there were no accidental needlesticks (0 needlesticks per 1300 devices). Safety needles could be successfully used on a Luer syringe but were limited to ≤1.5 in (≤3.81 cm) in length and the shield could interfere with sonography. The mechanical safety syringes functioned well in all orthopaedic procedures. Automatic retractable syringes were too small for arthrocentesis of the knee, and the plunger blew out and prematurely collapsed with high-pressure injections. The manual retractable syringes and shielded syringes could be used with conventional needles for most orthopaedic procedures. The most effective and reliable safety devices for orthopaedic syringe procedures are shielded safety needles, mechanical syringes, manual retractable syringes, and shielded syringes, but not automatic retractable syringes. Even when adopting

  10. Skeletal metastases - the role of the orthopaedic and spinal surgeon.

    Science.gov (United States)

    Eastley, Nicholas; Newey, Martyn; Ashford, Robert U

    2012-09-01

    Developments in oncological and medical therapies mean that life expectancy of patients with metastatic bone disease (MBD) is often measured in years. Complications of MBD may dramatically and irreversibly affect patient quality of life, making the careful assessment and appropriate management of these patients essential. The roles of orthopaedic and spinal surgeons in MBD generally fall into one of four categories: diagnostic, the prophylactic fixation of metastatic deposits at risk of impending fracture (preventative surgery), the stabilisation or reconstruction of bones affected by pathological fractures (reactive surgery), or the decompression and stabilisation of the vertebral column, spinal cord, and nerve roots. Several key principals should be adhered to whenever operating on skeletal metastases. Discussions should be held early with an appropriate multi-disciplinary team prior to intervention. Detailed pre-assessment is essential to gauge a patient's suitability for surgery - recovery from elective surgery must be shorter than the anticipated survival. Staging and biopsies provide prognostic information. Primary bone tumours must be ruled out in the case of a solitary bone lesion to avoid inappropriate intervention. Prophylactic surgical fixation of a lesion prior to a pathological fracture reduces morbidity and length of hospital stay. Regardless of a lesion or pathological fracture's location, all regions of the affected bone must be addressed, to reduce the risk of subsequent fracture. Surgical implants should allow full weight bearing or return to function immediately. Post-operative radiotherapy should be utilised in all cases to minimise disease progression. Spinal surgery should be considered for those with spinal pain due to potentially reversible spinal instability or neurological compromise. The opinion of a spinal surgeon should be sought early, as delays in referral directly correlate to worse functional recovery following intervention

  11. Cochlear Implants

    Science.gov (United States)

    ... implant, including: • How long a person has been deaf, •The number of surviving auditory nerve fibers, and • ... Implant, Severe Sensoryneurial Hearing Loss Get Involved Professional Development Practice Management ENT Careers Marketplace Privacy Policy Terms ...

  12. Surface modification of NiTi by plasma based ion implantation for application in harsh environments

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, R.M., E-mail: rogerio@plasma.inpe.br [Instituto Nacional de Pesquisas Espaciais (INPE), S. J. Campos, SP (Brazil); Fernandes, B.B.; Carreri, F.C.; Goncalves, J.A.N.; Ueda, M.; Silva, M.M.N.F. [Instituto Nacional de Pesquisas Espaciais (INPE), S. J. Campos, SP (Brazil); Silva, M.M. [Instituto Tecnologico de Aeronautica (ITA), S. J. Campos, SP (Brazil); Pichon, L. [Laboratoire de Metallurgie Physique, University of Poitiers, Poitiers (France); Camargo, E.N.; Otubo, J. [Instituto Tecnologico de Aeronautica (ITA), S. J. Campos, SP (Brazil)

    2012-12-15

    Highlights: Black-Right-Pointing-Pointer New nitrogen PBII set up was used to treat samples of NiTi in moderate temperature of 450 Degree-Sign C. Black-Right-Pointing-Pointer A very rich nitrogen atomic concentration was achieved on the top surface. Black-Right-Pointing-Pointer Nitrogen diffused at least for 11 {mu}m depth. Black-Right-Pointing-Pointer Improved tribological and corrosion properties were achieved. Black-Right-Pointing-Pointer A concentration dependent diffusion coefficient was calculated. - Abstract: The substitution of conventional components for NiTi in distinct devices such as actuators, valves, connectors, stents, orthodontic arc-wires, e.g., usually demands some kind of treatment to be performed on the surface of the alloy. A typical case is of biomaterials made of NiTi, in which the main drawback is the Ni out-diffusion, an issue that has been satisfactorily addressed by plasma based ion implantation (PBII). Even though PBII can tailor selective surface properties of diverse materials, usually, only thin modified layers are attained. When NiTi alloys are to be used in the harsh space environment, as is the case of devices designed to remotely release the solar panels and antenna arrays of satellites, e.g., superior mechanical and tribological properties are demanded. For this case the thickness of the modified layer must be larger than the one commonly achieved by conventional PBII. In this paper, new nitrogen PBII set up was used to treat samples of NiTi in moderate temperature of 450 Degree-Sign C, with negative voltage pulses of 7 kV/250 Hz/20 {mu}s, in a process lasting 1 h. A rich nitrogen atomic concentration of 85 at.% was achieved on the near surface and nitrogen diffused at least for 11 {mu}m depth. Tribological properties as well as corrosion resistance were evaluated.

  13. Evaluation of Ni-free Zr–Cu–Fe–Al bulk metallic glass for biomedical implant applications

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Ying-Sui [Institute of Oral Biology, National Yang-Ming University, Taipei, Taiwan (China); Zhang, Wei [School of Materials Science and Engineering, Dalian University of Technology, Dalian (China); Kai, Wu [Institute of Materials Engineering, National Taiwan Ocean University, Keelung, Taiwan (China); Liaw, Peter K. [Department of Materials Science and Engineering, The University of Tennessee, Knoxville, TN (United States); Huang, Her-Hsiung, E-mail: hhhuang@ym.edu.tw [Institute of Oral Biology, National Yang-Ming University, Taipei, Taiwan (China); Department of Dentistry, National Yang-Ming University, Taipei, Taiwan (China); Department of Dentistry, Taipei City Hospital, Taipei, Taiwan (China); Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan (China)

    2014-02-15

    Highlights: ► A Zr{sub 62.5}Cu{sub 22.5}Fe{sub 5}Al{sub 10} bulk metallic glass (BMG) with 50 GPa elastic modulus was used. ► This Ni-free Zr-based BMG had lower metal ion release rate than the commercial Ti. ► This Ni-free Zr-based BMG had better proteins adsorption than the commercial Ti. ► This Ni-free Zr-based BMG has a high potential for biomedical implant applications. -- Abstract: This study was conducted to investigate the surface characteristics, including the chemical composition, metal ion release, protein adsorption, and cell adhesion, of a Ni-free Zr-based (Zr{sub 62.5}Cu{sub 22.5}Fe{sub 5}Al{sub 10}) bulk metallic glass (BMG) with low elastic modulus for biomedical implant applications. X-ray photoelectron spectroscopy was used to identify the surface chemical composition and the protein (albumin and fibronectin) adsorption of the specimen. The metal ions released from the specimen in simulated blood plasma and artificial saliva solutions were measured using an inductively coupled plasma-mass spectrometer. The cell adhesion, in terms of the morphology, focal adhesion complex, and skeletal arrangement, of human bone marrow mesenchymal stem cells was evaluated using scanning electron microscope observations and immunofluorescent staining. For comparison purposes, the above-mentioned tests were also carried out on the widely used biomedical metal, Ti. The results showed that the main component on the outermost surface of the amorphous Zr{sub 62.5}Cu{sub 22.5}Fe{sub 5}Al{sub 10} BMG was ZrO{sub 2} with small amounts of Cu, Al, and Fe oxides. The released metal ions from Zr{sub 62.5}Cu{sub 22.5}Fe{sub 5}Al{sub 10} BMG were well below the critical concentrations that cause negative biological effects. The Zr{sub 62.5}Cu{sub 22.5}Fe{sub 5}Al{sub 10} BMG had a greater adsorption capacity for albumin and fibronectin than that of commercial biomedical Ti. The Zr{sub 62.5}Cu{sub 22.5}Fe{sub 5}Al{sub 10} BMG surface showed an attached cell number similar

  14. Orthopaedic admissions due to sports and recreation injuries.

    LENUS (Irish Health Repository)

    Delaney, R A

    2009-02-01

    The health benefits of exercise may be attenuated by sports and recreation related injury (SRI). Though the majority of SRI are mild and self-limiting, a significant number are serious and require orthopaedic intervention. The aims of this study were to assess the burden of these serious injuries on the orthopaedic inpatient service, and to investigate potential target areas for injury prevention. All 1,590 SRI seen in the ED over a 3-month period were analysed using the Patient Information Management System to determine which patients received inpatient orthopaedic care. The medical records of those 63 patients who required inpatient care under orthopaedics were reviewed and data collected on demographic features, history, operative procedure and theatre resources, and length of hospital stay. Data were analyzed using SPSS. SRI accounted for 12.3% of all ED presentations. The principal activities resulting in injury requiring orthopaedic care were soccer, hurling and informal play e.g. trampoline. Falls made up 37% of the overall mechanism of injury but 68% of the injuries severe enough to require operative management. Most operative procedures were performed as part of a routine day trauma list but 20% were performed out of hours. This group of injuries places a significant burden on a busy trauma service. Injury prevention measures such as public education regarding falls in sport may have a role in reducing this burden.

  15. Are the claims made in orthopaedic print advertisements valid?

    Science.gov (United States)

    Davidson, Donald J; Rankin, Kenneth S; Jensen, Cyrus D; Moverley, Robert; Reed, Mike R; Sprowson, Andrew P

    2014-05-01

    Advertisements are commonplace in orthopaedic journals and may influence the readership with claims of clinical and scientific fact. Since the last assessment of the claims made in orthopaedic print advertisements ten years ago, there have been legislative changes and media scrutiny which have shaped this practice. The purpose of this study is to re-evaluate these claims. Fifty claims from 50 advertisements were chosen randomly from six highly respected peer-reviewed orthopaedic journals (published July-December 2011). The evidence supporting each claim was assessed and validated by three orthopaedic surgeons. The assessors, blinded to product and company, rated the evidence and answered the following questions: Does the evidence as presented support the claim made in the advertisement and what is the quality of that evidence? Is the claim supported by enough evidence to influence your own clinical practice? Twenty-eight claims cited evidence from published literature, four from public presentations, 11 from manufacturer "data held on file" and seven had no supporting evidence. Only 12 claims were considered to have high-quality evidence and only 11 were considered well supported. A strong correlation was seen between the quality of evidence and strength of support (Spearman r = 0.945, p advertisements. High-quality evidence is required by orthopaedic surgeons to influence clinical practice and this evidence should be sought by manufacturers wishing to market a successful product.

  16. Characterization of drug-release kinetics in trabecular bone from titania nanotube implants

    Directory of Open Access Journals (Sweden)

    Aw MS

    2012-09-01

    Full Text Available Moom Sinn Aw,1 Kamarul A Khalid,2,3 Karan Gulati,1 Gerald J Atkins,2 Peter Pivonka,4 David M Findlay,2 Dusan Losic11School of Chemical Engineering, 2Discipline of Orthopaedics and Trauma, The University of Adelaide, Adelaide, SA, Australia; 3Department of Orthopaedics, Traumatology and Rehabilitation, Faculty of Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia; 4Engineering Computational Biology Group, School of Computer Science and Software Engineering, The University of Western Australia, Perth, WA, AustraliaPurpose: The aim of this study was to investigate the application of the three-dimensional bone bioreactor for studying drug-release kinetics and distribution of drugs in the ex vivo cancellous bone environment, and to demonstrate the application of nanoengineered titanium (Ti wires generated with titania nanotube (TNT arrays as drug-releasing implants for local drug deliveryMethods: Nanoengineered Ti wires covered with a layer of TNT arrays implanted in bone were used as a drug-releasing implant. Viable bovine trabecular bone was used as the ex vivo bone substrate embedded with the implants and placed in the bone reactor. A hydrophilic fluorescent dye (rhodamine B was used as the model drug, loaded inside the TNT–Ti implants, to monitor drug release and transport in trabecular bone. The distribution of released model drug in the bone was monitored throughout the bone structure, and concentration profiles at different vertical (0–5 mm and horizontal (0–10 mm distances from the implant surface were obtained at a range of release times from 1 hour to 5 days.Results: Scanning electron microscopy confirmed that well-ordered, vertically aligned nanotube arrays were formed on the surface of prepared TNT–Ti wires. Thermogravimetric analysis proved loading of the model drug and fluorescence spectroscopy was used to show drug-release characteristics in-vitro. The drug release from implants inserted into bone ex

  17. Ion implantation for microelectronics

    International Nuclear Information System (INIS)

    Dearnaley, G.

    1977-01-01

    Ion implantation has proved to be a versatile and efficient means of producing microelectronic devices. This review summarizes the relevant physics and technology and assesses the advantages of the method. Examples are then given of widely different device structures which have been made by ion implantation. While most of the industrial application has been in silicon, good progress continues to be made in the more difficult field of compound semiconductors. Equipment designed for the industrial ion implantation of microelectronic devices is discussed briefly. (Auth.)

  18. Ion implantation - an introduction

    International Nuclear Information System (INIS)

    Townsend, P.D.

    1986-01-01

    Ion implantation is a widely used technique with a literature that covers semiconductor production, surface treatments of steels, corrosion resistance, catalysis and integrated optics. This brief introduction outlines advantages of the technique, some aspects of the underlying physics and examples of current applications. Ion implantation is already an essential part of semiconductor technology while in many other areas it is still in an early stage of development. The future scope of the subject is discussed. (author)

  19. Long-term outcome of accelerated partial breast irradiation using a multilumen balloon applicator in a patient with existing breast implants.

    Science.gov (United States)

    Akhtari, Mani; Nitsch, Paige L; Bass, Barbara L; Teh, Bin S

    2015-01-01

    Accelerated partial breast irradiation is now an accepted component of breast-conserving therapy. However, data regarding long-term outcomes of patients treated with multilumen catheter systems who have existing breast implants are limited. We report the treatment and outcome of our patient who had existing bilateral silicone subpectoral implants at the time of presentation. Ultrasound-guided core needle biopsy of the right breast showed infiltrating mucinous carcinoma. Right breast lumpectomy revealed an 8 mm area of infiltrating ductal carcinoma with mucinous features and nuclear grade 1. A 4-5 cm Contura (Bard Biopsy Systems, Tempe, AZ) device was placed, and she was treated over the course of 5 days twice daily to a dose of 34 Gy using a high-dose-rate iridium-192 source. The planning target volume for evaluation was 73.9 cc. The percentage of the planning target volume for evaluation receiving 90%, 95%, and 100% of the prescribed dose was 99.9%, 99.3%, and 97.8%, respectively. The total implant volume was 234.5 cc and received a mean dose of 15.4 Gy and a maximum dose of 72.8 Gy. The percentage of implant volume receiving 50%, 75%, 100%, and 200% of the prescribed dose was 31.1%, 16.5%, 8.6%, 2.0%, and 0%, respectively. Maximum skin dose was 97% of the prescribed dose. With a followup of nearly 5 years, she continues to be cancer free with minimal late toxicities and good to excellent cosmetic outcome. Accelerated partial breast irradiation using a multilumen balloon applicator in patients with existing breast implants can safely be performed with excellent long-term cosmetic outcome. Further studies are needed to establish the absolute dosimetric tolerance of breast implants. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  20. Using financial incentives to improve value in orthopaedics.

    Science.gov (United States)

    Lansky, David; Nwachukwu, Benedict U; Bozic, Kevin J

    2012-04-01

    A variety of reforms to traditional approaches to provider payment and benefit design are being implemented in the United States. There is increasing interest in applying these financial incentives to orthopaedics, although it is unclear whether and to what extent they have been implemented and whether they increase quality or reduce costs. We reviewed and discussed physician- and patient-oriented financial incentives being implemented in orthopaedics, key challenges, and prerequisites to payment reform and value-driven payment policy in orthopaedics. We searched the MEDLINE database using as search terms various provider payment and consumer incentive models. We retrieved a total of 169 articles; none of these studies met the inclusion criteria. For incentive models known to the authors to be in use in orthopaedics but for which no peer-reviewed literature was found, we searched Google for further information. Provider financial incentives reviewed include payments for reporting, performance, and patient safety and episode payment. Patient incentives include tiered networks, value-based benefit design, reference pricing, and value-based purchasing. Reform of financial incentives for orthopaedic surgery is challenged by (1) lack of a payment/incentive model that has demonstrated reductions in cost trends and (2) the complex interrelation of current pay schemes in today's fragmented environment. Prerequisites to reform include (1) a reliable and complete data infrastructure; (2) new business structures to support cost sharing; and (3) a retooling of patient expectations. There is insufficient literature reporting the effects of various financial incentive models under implementation in orthopaedics to know whether they increase quality or reduce costs. National concerns about cost will continue to drive experimentation, and all anticipated innovations will require improved collaboration and data collection and reporting.

  1. Teleconsultation in paediatric orthopaedics in Djibouti: evaluation of response performance.

    Science.gov (United States)

    Bertani, A; Launay, F; Candoni, P; Mathieu, L; Rongieras, F; Chauvin, F

    2012-11-01

    Djibouti has no paediatric orthopaedics department and three options are available for difficult cases: transfer of the patient to another country; overseas mission transfer to Djibouti by a specialised surgical team; and management by a local orthopaedic surgeon receiving guidance from an expert. The extreme poverty of part of the population of Djibouti often precludes the first two options. Telemedecine can allow the local orthopaedic surgeon to receive expert advice. HYPOTHESES AND STUDY DESIGN: We prospectively recorded all the paediatric orthopaedics teleconsultations that occurred between November 2009 and November 2011. Our objective was to assess the performance of the teleconsultations. We hypothetized that this option was influential in decision making. We assessed the influence of the teleconsultation on patient management (i.e., change in the surgical indication and/or procedure). We then used the electronic patient records to compare the actual management to that recommended retrospectively by two independent orthopaedic surgeon consultants who had experience working overseas. Finally, we assessed the clinical outcomes in the patients. Of 48 teleconsultations for 39 patients, 13 dealt with diagnostic problems and 35 with therapeutic problems. The teleconsultation resolved the diagnostic uncertainties in 90% of cases. Advice from the expert modified the management in 37 (77%) teleconsultations; the change was related to the surgical indication in 18 cases, the surgical technique in 13 cases, and both in six cases. Agreement between the advice from the independent consultants and the treatment delivered by the local surgeon was 2.2/3. Clinical outcomes were good or very good in 31 (81%) of the 38 treated patients. This study establishes the feasibility and usefulness of paediatric orthopaedics teleconsultations in Djibouti. The introduction of telemedicine has changed our approach to challenges raised by patients in remote locations or precarious

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

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren

    Best Poster 5Demineralized bone matrix and human cancellous bone enhance fixation of titanium implants AuthorsBabiker , H.; Ding M.; Overgaard S.InstitutionOrthopaedic Research Laboratory, Department of Orthopaedic Surgery, Odense University Hospital, Clinical Institute, University of Southern...... from human tissue were included (IsoTis OrthoBiologics, Inc. USA). Both materials are commercially available. Titanium alloy implants (Biomet Inc.) of 10 mm in length and 10 mm in diameter were inserted bilaterally into the femoral condyles of 8 skeletally mature sheep. Thus four implants...... with a concentric gap of 2 mm were implanted in each sheep. The gap was filled with: DBM; DBM/CB with ratio of 1/3; DBM/allograft with ratio of 1/3; or allograft (Gold standard), respectively. Standardised surgical procedure was used1. At sacrifice, 6 weeks after surgery, both distal femurs were harvested...

  3. Comparison of multiple linear regression and artificial neural network in developing the objective functions of the orthopaedic screws.

    Science.gov (United States)

    Hsu, Ching-Chi; Lin, Jinn; Chao, Ching-Kong

    2011-12-01

    Optimizing the orthopaedic screws can greatly improve their biomechanical performances. However, a methodical design optimization approach requires a long time to search the best design. Thus, the surrogate objective functions of the orthopaedic screws should be accurately developed. To our knowledge, there is no study to evaluate the strengths and limitations of the surrogate methods in developing the objective functions of the orthopaedic screws. Three-dimensional finite element models for both the tibial locking screws and the spinal pedicle screws were constructed and analyzed. Then, the learning data were prepared according to the arrangement of the Taguchi orthogonal array, and the verification data were selected with use of a randomized selection. Finally, the surrogate objective functions were developed by using either the multiple linear regression or the artificial neural network. The applicability and accuracy of those surrogate methods were evaluated and discussed. The multiple linear regression method could successfully construct the objective function of the tibial locking screws, but it failed to develop the objective function of the spinal pedicle screws. The artificial neural network method showed a greater capacity of prediction in developing the objective functions for the tibial locking screws and the spinal pedicle screws than the multiple linear regression method. The artificial neural network method may be a useful option for developing the objective functions of the orthopaedic screws with a greater structural complexity. The surrogate objective functions of the orthopaedic screws could effectively decrease the time and effort required for the design optimization process. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  4. Hybrid coating on a magnesium alloy for minimizing the localized degradation for load-bearing biodegradable mini-implant applications

    Energy Technology Data Exchange (ETDEWEB)

    Kannan, M. Bobby, E-mail: bobby.mathan@jcu.edu.au; Liyanaarachchi, S.

    2013-10-01

    The effect of a hybrid coating, calcium phosphate (CaP) + polylactic acid (PLA), on a magnesium alloy on its in vitro degradation (general and localized) behaviour was studied for potential load-bearing biodegradable mini-implant applications. CaP was coated on a magnesium alloy, AZ91, using an electrochemical deposition method. A spin coating method was used to coat PLA on the CaP coated alloy. In vitro degradation performance of the alloy with hybrid coating was evaluated using electrochemical impedance spectroscopy (EIS) in simulated body fluid (SBF). The EIS results showed that the hybrid coating enhanced the degradation resistance of the alloy by more than two-order of magnitude as compared to the bare alloy and one-order of magnitude higher than that of the CaP coated alloy, after 1 h exposure in simulated body fluid (SBF). Long-term (48 h) EIS results also confirmed that the hybrid coating performed better than the bare alloy and the CaP coated alloy. Importantly, the hybrid coating improved the localized degradation resistance of the alloy significantly, which is critical for better in service mechanical integrity. - Highlights: • A hybrid coating (CaP + PLA) was applied on a magnesium-based alloy. • The hybrid coating enhanced the in vitro degradation resistance of the alloy. • Localized degradation resistance was also improved by the hybrid coating.

  5. Hybrid coating on a magnesium alloy for minimizing the localized degradation for load-bearing biodegradable mini-implant applications

    International Nuclear Information System (INIS)

    Kannan, M. Bobby; Liyanaarachchi, S.

    2013-01-01

    The effect of a hybrid coating, calcium phosphate (CaP) + polylactic acid (PLA), on a magnesium alloy on its in vitro degradation (general and localized) behaviour was studied for potential load-bearing biodegradable mini-implant applications. CaP was coated on a magnesium alloy, AZ91, using an electrochemical deposition method. A spin coating method was used to coat PLA on the CaP coated alloy. In vitro degradation performance of the alloy with hybrid coating was evaluated using electrochemical impedance spectroscopy (EIS) in simulated body fluid (SBF). The EIS results showed that the hybrid coating enhanced the degradation resistance of the alloy by more than two-order of magnitude as compared to the bare alloy and one-order of magnitude higher than that of the CaP coated alloy, after 1 h exposure in simulated body fluid (SBF). Long-term (48 h) EIS results also confirmed that the hybrid coating performed better than the bare alloy and the CaP coated alloy. Importantly, the hybrid coating improved the localized degradation resistance of the alloy significantly, which is critical for better in service mechanical integrity. - Highlights: • A hybrid coating (CaP + PLA) was applied on a magnesium-based alloy. • The hybrid coating enhanced the in vitro degradation resistance of the alloy. • Localized degradation resistance was also improved by the hybrid coating

  6. The promising application of graphene oxide as coating materials in orthopedic implants: preparation, characterization and cell behavior

    International Nuclear Information System (INIS)

    Zhao, Changhong; Lu, Xiuzhen; Liu, Johan; Zanden, Carl

    2015-01-01

    To investigate the potential application of graphene oxide (GO) in bone repair, this study is focused on the preparation, characterization and cell behavior of graphene oxide coatings on quartz substrata. GO coatings were prepared on the substrata using a modified dip-coating procedure. Atomic force microscopy (AFM), scanning electron microscopy (SEM) and Raman spectroscopy results demonstrated that the as-prepared coatings in this study were homogeneous and had an average thickness of ∼67 nm. The rapid formation of a hydroxyapatite (HA) layer in the simulated body fluid (SBF) on GO coated substrata at day 14, as proved by SEM and x-ray diffraction (XRD), strongly indicated the bioactivity of coated substrata. In addition, MC3T3-E1 cells were cultured on the coated substrata to evaluate cellular activities. Compared with the non-coated substrata and tissue culture plates, no significant difference was observed on the coated substrata in terms of cytotoxicity, viability, proliferation and apoptosis. However, interestingly, higher levels of alkaline phosphatase (ALP) activity and osteocalcin (OC) secretion were observed on the coated substrata, indicating that GO coatings enhanced cell differentiation compared with non-coated substrata and tissue culture plates. This study suggests that GO coatings had excellent biocompatibility and more importantly promoted MC3T3-E1 cell differentiation and might be a good candidate as a coating material for orthopedic implants. (paper)

  7. Promising Ta-Ti-Zr-Si metallic glass coating without cytotoxic elements for bio-implant applications

    Science.gov (United States)

    Lai, J. J.; Lin, Y. S.; Chang, C. H.; Wei, T. Y.; Huang, J. C.; Liao, Z. X.; Lin, C. H.; Chen, C. H.

    2018-01-01

    Tantalum (Ta) is considered as one of the most promising metal due to its high corrosion resistance, excellent biocompatibility and cell adhesion/in-growth capabilities. Although there are some researches exploring the biomedical aspects of Ta and Ta based alloys, systematic characterizations of newly developed Ta-based metallic glasses in bio-implant applications is still lacking. This study employs sputtering approach to produced thin-film Ti-based metallic glasses due to the high melting temperature of Ta (3020 °C). Two fully amorphous Ta-based metallic glasses composed of Ta57Ti17Zr15Si11 and Ta75Ti10Zr8Si7 are produced and experimentally characterized in terms of their mechanical properties, bio-corrosion properties, surface hydrophilic characteristics, and in-vitro cell viability and cells attachment tests. Compare to conventional pure Ti and Ta metals, the developed Ta-based metallic glasses exhibit higher hardness and lower modulus which are better match to the mechanical properties of bone. MTS assay results show that Ta-based metallic glasses show comparable cell viability and cell attachment rate compared to that of pure Ti and Ta surface in a 72 h in-vitro test.

  8. The spectrum of orthopaedics at Chris Hani Baragwanath Academic Hospital

    OpenAIRE

    Pillay, J; Ramokgopa, MT

    2013-01-01

    Chris Hani Baragwanath Academic Hospital (CHBAH) is the third largest hospital in the world and is the largest in the Southern hemisphere, serving a population of more than 3.5 million people.¹ The purpose of this review is to identify the orthopaedic-related health events that occur within the population being serviced by the hospital, and in doing so provide a tool to be used for improving orthopaedic-related patient care and outcomes in public health services.² We also took special interes...

  9. Orthopaedic nurses' perception of research utilization - A cross sectional survey

    DEFF Research Database (Denmark)

    Berthelsen, Connie Bøttcher; Hølge-Hazelton, Bibi

    2015-01-01

    The call for evidence-based knowledge in clinical nursing practice has increased during recent decades and research in orthopaedic nursing is needed to improve patients' conditions, care and treatment. A descriptive cross-sectional survey was conducted to determine the self-perceived theoretical....... The results indicated that despite the majority of orthopaedic nurses having low self-perceived theoretical knowledge and practical research competencies, their interest and motivation to improve these were high, especially their inner motivation. However, the nurses' inner motivation was inhibited by a lack...

  10. The Two-Beam-Line Ion Implanter and Review of its Application to Creation of Complex Layers by the IBAD Method

    International Nuclear Information System (INIS)

    Rajchel, B.; Drwiega, M.; Lipinska, E.; Hajduk, R.

    1998-12-01

    The present status of the two-beam-line ion implanter its basic specifications after the upgrading and the possibilities of its application to ion engineering methods is presented. The examples of created layers (DLC, TiN x , SiC x ) and research methods applied to find out the features of the ion beam assisted deposited coatings are presented in order to prove the suitability of the device to scientific studies

  11. Implants for orthodontic anchorage

    Science.gov (United States)

    Zheng, Xiaowen; Sun, Yannan; Zhang, Yimei; Cai, Ting; Sun, Feng; Lin, Jiuxiang

    2018-01-01

    Abstract Implantanchorage continues to receive much attention as an important orthodontic anchorage. Since the development of orthodontic implants, the scope of applications has continued to increase. Although multiple reviews detailing implants have been published, no comprehensive evaluations have been performed. Thus, the purpose of this study was to comprehensively evaluate the effects of implants based on data published in review articles. An electronic search of the Cochrane Library, Medline, Embase, Ebsco and Sicencedirect for reviews with “orthodontic” and “systematic review or meta analysis” in the title, abstract, keywords, or full text was performed. A subsequent manual search was then performed to identify reviews concerning orthodontic implants. A manual search of the orthodontic journals American Journal of Orthodontics and Dentofacial Orthopedics (AJODO), European Journal of Orthodontics (EJO), and Angle Othodontist was also performed. Such systematic reviews that evaluated the efficacy and safety of orthodontic implants were used to indicate success rates and molar movements. A total of 23 reviews were included in the analysis. The quality of each review was assessed using a measurement tool for Assessment of Multiple Systematic Reviews (AMSTAR), and the review chosen to summarize outcomes had a quality score of >6. Most reviews were less than moderate quality. Success rates of implants ranged in a broad scope, and movement of the maxillary first molar was superior with implants compared with traditional anchorage. PMID:29595673

  12. The personal interview: assessing the potential for personality similarity to bias the selection of orthopaedic residents.

    Science.gov (United States)

    Quintero, Andres J; Segal, Lee S; King, Tonya S; Black, Kevin P

    2009-10-01

    The selection of medical students for training in orthopaedic surgery consists of an objective screening of cognitive skills to secure interviews for the brightest candidates, followed by subjective measures of candidates to confirm whether applicants are worthy of further consideration. The personal interview and its potential biased impact on the orthopaedic workforce were evaluated. During 2004-2006 at the Penn State College of Medicine, the authors performed a prospective cohort study in which 30 consenting interviewers and 135 interviewees completed the Myers-Briggs Type Indicator before the interviews. Completed surveys were evaluated after submitting the resident selection list to the National Residency Matching Program, and candidate rankings based solely on the personal interview were analyzed. Clinicians ranked candidates more favorably when they shared certain personality preferences (P = .044) and when they shared the preference groupings of the quadrant extrovert-sensing and either the function pair sensing-thinking (P = .007) or the temperament sensing-judging (P = .003), or the function pair sensing-feeling and the temperament sensing-judging (P = .029). No associations existed between personality preferences and interviewee rankings performed by basic scientists and resident interviewers. The results support the hypothesis that, within the department studied, there was a significant association between similarities in personality type and the rankings that individual faculty interviewers assigned to applicants at the completion of each interview session. The authors believe that it is important for the faculty member to recognize that this tendency exists. Finally, promoting diversity within the admission committee may foster a diverse resident body and orthopaedic workforce.

  13. Radiation doses to the personnel at insertion of gynaecological implants and cleaning of radioactive applicators

    International Nuclear Information System (INIS)

    Lax, I.

    1975-11-01

    The measurements of the radiation doses to the personnel consisted of dose measurements on the fingers and on the body. The radiation doses to the fingers and to different parts of the body at on one hand the insertion of gynecological implanta and on the other the cleaning of them have been measured before at the wards of gynecological application at the department of oncology (Radiumhemmet), the Caroline Institute. Thermoluminescent dosemeters were used to measure the radiation doses to the finger tips. The dimensions of these dosemeters are nowadays so small that they are no hindrance to the work. (M.S.)

  14. Modelling of the Human Inner Ear Anatomy and Variability for Cochlear Implant Applications

    DEFF Research Database (Denmark)

    Kjer, Hans Martin

    of statistical deformation models. The thesis results in a series of applications relating to CIs. The shape model can be used by CI-manufacturers for virtual product development and testing. At the same time, it can be applied to estimate the detailed inner ear shape from a clinical patient CT scan. This opens...... several challenges concerning data processing and analysis. Our approach is to describe the inner ear as a statistical shape model. The thesis covers our work with regards to data segmentation, shape characterization, development of image registration model suited for the inner ear and construction...

  15. Radiation doses to the personnel at insertion of gynaecological implants and cleaning of radioactive applicators

    Energy Technology Data Exchange (ETDEWEB)

    Lax, I

    1975-11-01

    The measurements of the radiation doses to the personnel consisted of dose measurements on the fingers and on the body. The radiation doses to the fingers and to different parts of the body at on one hand the insertion of gynecological implanta and on the other the cleaning of them have been measured before at the wards of gynecological application at the department of oncology (Radiumhemmet), the Caroline Institute. Thermoluminescent dosemeters were used to measure the radiation doses to the finger tips. The dimensions of these dosemeters are nowadays so small that they are no hindrance to the work.

  16. Dental implant surgery: planning and guidance

    International Nuclear Information System (INIS)

    Lobregt, S.; Schillings, J.J.; Vuurberg, E.

    2001-01-01

    A prototype application has been developed for interactive planning of dental implants on the EasyVision workstation. The user is led step by step via virtual positioning of the implant to the design of a customized drill guide. (orig.)

  17. 77 FR 66848 - Minimum Clinically Important Difference: An Outcome Metric in Orthopaedic Device Science and...

    Science.gov (United States)

    2012-11-07

    ...] Minimum Clinically Important Difference: An Outcome Metric in Orthopaedic Device Science and Regulation... Clinically Important Difference: An Outcome Metric in Orthopaedic Device Science and Regulation.'' FDA is co... (MCID) for patient-reported outcome (PRO) instruments used in orthopaedic extremity device-related...

  18. Molecular Identification of Bacteria from Aseptically Loose Implants

    Science.gov (United States)

    Kobayashi, Naomi; Procop, Gary W.; Krebs, Viktor; Kobayashi, Hideo

    2008-01-01

    Polymerase chain reaction (PCR) assays have been used to detect bacteria adherent to failed orthopaedic implants, but some PCR assays have had problems with probable false-positive results. We used a combination of a Staphylococcus species-specific PCR and a universal PCR followed by DNA sequencing to identify bacteria on implants retrieved from 52 patients (92 implants) at revision arthroplasty. We addressed two questions in this study: (1) Is this method able to show the existence of bacterial DNA on presumed aseptic loosed implants?; and (2) What proportion of presumed aseptic or culture-negative implants was positive for bacterial DNA by PCR? Fourteen implants (15%) were believed infected, whereas 74 implants (85%) were believed aseptic. Each implant was sonicated and the resulting solution was submitted for dual real-time PCR assay and culture. All implants believed aseptically loose were culture-negative, but nine of the 74 (12%) had bacterial DNA by PCR; two (2.7%) were PCR-positive and also showed histologic findings suggestive of infection. Uniquely developed PCR and bacterial sequencing assays showed bacterial DNA on 12% of implants removed for presumed aseptic loosening. Additional studies are needed to determine the clinical importance of bacterial DNA detected by PCR but not by conventional culture. Level of Evidence: Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18438724

  19. Ion Implantation of Polymers

    DEFF Research Database (Denmark)

    Popok, Vladimir

    2012-01-01

    The current paper presents a state-of-the-art review in the field of ion implantation of polymers. Numerous published studies of polymers modified by ion beams are analysed. General aspects of ion stopping, latent track formation and changes of structure and composition of organic materials...... are discussed. Related to that, the effects of radiothermolysis, degassing and carbonisation are considered. Specificity of depth distributions of implanted into polymers impurities is analysed and the case of high-fluence implantation is emphasised. Within rather broad topic of ion bombardment, the focus...... is put on the low-energy implantation of metal ions causing the nucleation and growth of nanoparticles in the shallow polymer layers. Electrical, optical and magnetic properties of metal/polymer composites are under the discussion and the approaches towards practical applications are overviewed....

  20. Adhesive strength of bone-implant interfaces and in-vivo degradation of PHB composites for load-bearing applications.

    Science.gov (United States)

    Meischel, M; Eichler, J; Martinelli, E; Karr, U; Weigel, J; Schmöller, G; Tschegg, E K; Fischerauer, S; Weinberg, A M; Stanzl-Tschegg, S E

    2016-01-01

    Aim of this study was to evaluate the response of bone to novel biodegradable polymeric composite implants in the femora of growing rats. Longitudinal observation of bone reaction at the implant site (BV/TV) as well as resorption of the implanted pins were monitored using in vivo micro-focus computed tomography (µCT). After 12, 24 and 36 weeks femora containing the implants were explanted, scanned with high resolution ex vivo µCT, and the surface roughness of the implants was measured to conclude on the ingrowth capability for bone tissue. Scanning electron microscope (SEM) and energy dispersive X-ray spectroscopy (EDX) were used to observe changes on the surface of Polyhydroxybutyrate (PHB) during degradation and cell ingrowth. Four different composites with zirconium dioxide (ZrO2) and Herafill(®) were compared. After 36 weeks in vivo, none of the implants did show significant degradation. The PHB composite with ZrO2 and a high percentage (30%) of Herafill® as well as the Mg-alloy WZ21 showed the highest values of bone accumulation (increased BV/TV) around the implant. The lowest value was measured in PHB with 3% ZrO2 containing no Herafill®. Roughness measurements as well as EDX and SEM imaging could not reveal any changes on the PHB composites׳ surfaces. Biomechanical parameters, such as the adhesion strength between bone and implant were determined by measuring the shear strength as well as push-out energy of the bone-implant interface. The results showed that improvement of these mechanical properties of the studied PHBs P3Z, P3Z10H and P3Z30H is necessary in order to obtain appropriate load-bearing material. The moduli of elasticity, tensile strength and strain properties of the PHB composites are close to that of bone and thus promising. Compared to clinically used PLGA, PGA and PLA materials, their additional benefit is an unchanged local pH value during degradation, which makes them well tolerated by cells and immune system. They might be used

  1. Development and application of a direct method to observe the implant/bone interface using simulated bone.

    Science.gov (United States)

    Yamaguchi, Yoko; Shiota, Makoto; FuJii, Masaki; Sekiya, Michi; Ozeki, Masahiko

    2016-01-01

    Primary stability after implant placement is essential for osseointegration. It is important to understand the bone/implant interface for analyzing the influence of implant design on primary stability. In this study rigid polyurethane foam is used as artificial bone to evaluate the bone-implant interface and to identify where the torque is being generated during placement. Five implant systems-Straumann-Standard (ST), Straumann-Bone Level (BL), Straumann-Tapered Effect (TE), Nobel Biocare-Brånemark MKIII (MK3), and Nobel Biocare-Brånemark MKIV (MK4)-were used for this experiment. Artificial bone blocks were prepared and the implant was installed. After placement, a metal jig and one side artificial bone block were removed and then the implant embedded in the artificial bone was exposed for observing the bone-implant interface. A digital micro-analyzer was used for observing the contact interface. The insertion torque values were 39.35, 23.78, 12.53, 26.35, and 17.79 N cm for MK4, BL, ST, TE, and MK3, respectively. In ST, MK3, TE, MK4, and BL the white layer areas were 61 × 103 μm(2), 37 × 103 μm(2), 103 × 103 μm(2) in the tapered portion and 84 × 03 μm(2) in the parallel portion, 134 × 103 μm(2), and 98 × 103 μm(2) in the tapered portion and 87 × 103 μm(2) in the parallel portion, respectively. The direct observation method of the implant/artificial bone interface is a simple and useful method that enables the identification of the area where implant retention occurs. A white layer at the site of stress concentration during implant placement was identified and the magnitude of the stress was quantitatively estimated. The site where the highest torque occurred was the area from the thread crest to the thread root and the under and lateral aspect of the platform. The artificial bone debris created by the self-tapping blade accumulated in both the cutting chamber and in the space between the threads and artificial bone.

  2. Synthesis of Ag ion-implanted TiO{sub 2} thin films for antibacterial application and photocatalytic performance

    Energy Technology Data Exchange (ETDEWEB)

    Hou, Xinggang, E-mail: hou226@mail.tjnu.edu.cn [Department of Physics, Tianjin Normal University, Tianjin 300387 (China); Ma, Huiyan; Liu, Feng; Deng, Jianhua; Ai, Yukai; Zhao, Xinlei; Mao, Dong; Li, Dejun [Department of Physics, Tianjin Normal University, Tianjin 300387 (China); Liao, Bin [Key Laboratory of Beam Technology and Material Modification of Ministry of Education, Beijing Normal University, Beijing 100875 (China)

    2015-12-15

    Highlights: • Implanted TiO{sub 2} films with excellent antibacterial and photocatalytic ability was prepared. • Bactericidal effect of released Ag ions was confirmed using VC as radical scavenger. • Excitation of TiO{sub 2} to visible region is attributed to subtitutional Ag. • Synergetic effect of Ag{sup 3+} and Ag{sup +} accounts for the enhanced ability of TiO{sub 2}. - Abstract: TiO{sub 2} thin films were deposited by spin coating method. Silver ions were implanted into the films using a Metal Vapor Vacuum Arc implanter. The antibacterial ability of implanted films was tested using Escherichia coli removal under fluorescent irradiation and in the dark. The concentration of E. coli was evaluated by plating technique. The photocatalytic efficiency of the implanted films was studied by degradation of methyl orange under fluorescent illumination. The surface free energy of the implanted TiO{sub 2} films was calculated by contact angle testing. Vitamin C was used as radical scavengers to explore the antibacterial mechanism of the films. The results supported the model that both generation of reactive oxygen species and release of silver ions played critical roles in the toxic effect of implanted films against E. coli. XPS experimental results demonstrated that a portion of the Ag(Ag{sup 3+}) ions were doped into the crystalline lattice of TiO{sub 2}. As demonstrated by density functional theory calculations, the impurity energy level of subtitutional Ag was responsible for enhanced absorption of visible light. Ag ion-implanted TiO{sub 2} films with excellent antibacterial efficiency against bacteria and decomposed ability against organic pollutants could be potent bactericidal surface in moist environment.

  3. Design of a nitrogen-implanted titanium-based superelastic alloy with optimized properties for biomedical applications

    International Nuclear Information System (INIS)

    Gordin, D.M.; Busardo, D.; Cimpean, A.; Vasilescu, C.; Höche, D.; Drob, S.I.; Mitran, V.; Cornen, M.; Gloriant, T.

    2013-01-01

    In this study, a superelastic Ni-free Ti-based biomedical alloy was treated in surface by the implantation of nitrogen ions for the first time. The N-implanted surface was characterized by X-ray diffraction, X-ray photoelectron spectroscopy, and secondary ion mass spectroscopy, and the superficial mechanical properties were evaluated by nano-indentation and by ball-on-disk tribological tests. To investigate the biocompatibility, the corrosion resistance of the N-implanted Ti alloy was evaluated in simulated body fluids (SBF) complemented by in-vitro cytocompatibility tests on human fetal osteoblasts. After implantation, surface analysis methods revealed the formation of a titanium-based nitride on the substrate surface. Consequently, an increase in superficial hardness and a significant reduction of friction coefficient were observed compared to the non-implanted sample. Also, a better corrosion resistance and a significant decrease in ion release rates have been obtained. Cell culture experiments indicated that the cytocompatibility of the N-implanted Ti alloy was superior to that of the corresponding non-treated sample. Thus, this new functional N-implanted titanium-based superelastic alloy presents the optimized properties that are required for various medical devices: superelasticity, high superficial mechanical properties, high corrosion resistance and excellent cytocompatibility. - Highlights: • A superelastic Ni-free Ti-based biomedical alloy was treated in surface by implantation of nitrogen ions. • Much higher superficial hardness and wear resistance were obtained. • A clear enhancement of the corrosion resistance in SBF was observed. • In-vitro tests performed on human fetal osteoblasts indicated an excellent level of cytocompatibility

  4. Design of a nitrogen-implanted titanium-based superelastic alloy with optimized properties for biomedical applications

    Energy Technology Data Exchange (ETDEWEB)

    Gordin, D.M. [INSA de Rennes, Laboratoire Chimie-Métallurgie, UMR CNRS 6226 Institut des Sciences Chimiques de Rennes, 20 avenue des Buttes de Coësmes, 35708 Rennes Cedex 7 (France); Busardo, D. [Quertech Ingénierie, 9 rue de la Girafe, 14000 Caen (France); Cimpean, A. [University of Bucharest, Department of Biochemistry and Molecular Biology, Spl. Independentei 91-95, 050095 Bucharest (Romania); Vasilescu, C. [Institute of Physical Chemistry «Ilie Murgulescu» of Romanian Academy, Spl. Independentei 202, 060021 Bucharest (Romania); Höche, D. [Institute of Materials Research, Helmholtz-Zentrum Geesthacht -Zentrum für Material- und Küstenforschung GmbH Max-Planck-Straße 1, D-21502 Geesthacht (Germany); Drob, S.I. [Institute of Physical Chemistry «Ilie Murgulescu» of Romanian Academy, Spl. Independentei 202, 060021 Bucharest (Romania); Mitran, V. [University of Bucharest, Department of Biochemistry and Molecular Biology, Spl. Independentei 91-95, 050095 Bucharest (Romania); Cornen, M. [INSA de Rennes, Laboratoire Chimie-Métallurgie, UMR CNRS 6226 Institut des Sciences Chimiques de Rennes, 20 avenue des Buttes de Coësmes, 35708 Rennes Cedex 7 (France); Gloriant, T., E-mail: Thierry.Gloriant@insa-rennes.fr [INSA de Rennes, Laboratoire Chimie-Métallurgie, UMR CNRS 6226 Institut des Sciences Chimiques de Rennes, 20 avenue des Buttes de Coësmes, 35708 Rennes Cedex 7 (France)

    2013-10-15

    In this study, a superelastic Ni-free Ti-based biomedical alloy was treated in surface by the implantation of nitrogen ions for the first time. The N-implanted surface was characterized by X-ray diffraction, X-ray photoelectron spectroscopy, and secondary ion mass spectroscopy, and the superficial mechanical properties were evaluated by nano-indentation and by ball-on-disk tribological tests. To investigate the biocompatibility, the corrosion resistance of the N-implanted Ti alloy was evaluated in simulated body fluids (SBF) complemented by in-vitro cytocompatibility tests on human fetal osteoblasts. After implantation, surface analysis methods revealed the formation of a titanium-based nitride on the substrate surface. Consequently, an increase in superficial hardness and a significant reduction of friction coefficient were observed compared to the non-implanted sample. Also, a better corrosion resistance and a significant decrease in ion release rates have been obtained. Cell culture experiments indicated that the cytocompatibility of the N-implanted Ti alloy was superior to that of the corresponding non-treated sample. Thus, this new functional N-implanted titanium-based superelastic alloy presents the optimized properties that are required for various medical devices: superelasticity, high superficial mechanical properties, high corrosion resistance and excellent cytocompatibility. - Highlights: • A superelastic Ni-free Ti-based biomedical alloy was treated in surface by implantation of nitrogen ions. • Much higher superficial hardness and wear resistance were obtained. • A clear enhancement of the corrosion resistance in SBF was observed. • In-vitro tests performed on human fetal osteoblasts indicated an excellent level of cytocompatibility.

  5. Transcatheter aortic valve implantation for failing surgical aortic bioprosthetic valve: from concept to clinical application and evaluation (part 2).

    Science.gov (United States)

    Piazza, Nicolo; Bleiziffer, Sabine; Brockmann, Gernot; Hendrick, Ruge; Deutsch, Marcus-André; Opitz, Anke; Mazzitelli, Domenico; Tassani-Prell, Peter; Schreiber, Christian; Lange, Rüdiger

    2011-07-01

    This study sought to review the acute procedural outcomes of patients who underwent transcatheter aortic valve (TAV)-in-surgical aortic valve (SAV) implantation at the German Heart Center, Munich, and to summarize the existing literature on TAV-in-SAV implantation (n = 47). There are several case reports and small case series describing transcatheter aortic valve implantation for a failing surgical aortic valve bioprosthesis (TAV-in-SAV implantation). From January 2007 to March 2011, 20 out of 556 patients underwent a TAV-in-SAV implantation at the German Heart Center Munich. Baseline characteristics and clinical outcome data were prospectively entered into a dedicated database. The mean patient age was 75 ± 13 years, and the mean logistic European System for Cardiac Operative Risk Evaluation and Society of Thoracic Surgeons' Risk Model scores were 27 ± 13% and 7 ± 4%, respectively. Of the 20 patients, 14 had stented and 6 had stentless surgical bioprostheses. Most cases (12 of 20) were performed via the transapical route using a 23-mm Edwards Sapien prosthesis (Edwards Lifesciences, Irvine, California). Successful implantation of a TAV in a SAV with the patient leaving the catheterization laboratory alive was achieved in 18 of 20 patients. The mean transaortic valve gradient was 20.0 ± 7.5 mm Hg. None-to-trivial, mild, and mild-to-moderate paravalvular aortic regurgitation was observed in 10, 6, and 2 patients, respectively. We experienced 1 intraprocedural death following pre-implant balloon aortic valvuloplasty ("stone heart") and 2 further in-hospital deaths due to myocardial infarction. TAV-in-SAV implantation is a safe and feasible treatment for high-risk patients with failing aortic bioprosthetic valves and should be considered as part of the armamentarium in the treatment of aortic bioprosthetic valve failure. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  6. Orthopaedic Section Poster Presentations (Abstracts OPO1-OPO300).

    Science.gov (United States)

    2018-01-01

    These abstracts are presented here as prepared by the authors. The accuracy and content of each abstract remain the responsibility of the authors. In the identification number above each abstract, OPO designates an Orthopaedic Section poster presentation. J Orthop Sports Phys Ther 2018;48(1):A67-A202. doi:10.2519/jospt.2018.48.1.A67.

  7. Transient aphasia following spinal anaesthesia in an orthopaedic ...

    African Journals Online (AJOL)

    A 50-year-old male [American Society of Anesthesiologists (ASA) grade II] was scheduled for lower limb orthopaedic surgery. The subarachnoid space was localised with difficulty at L3/4 interspace and 3 ml of hyperbaric bupivacaine was given. Within a few minutes, the patient developed aphasia with a very high sensory ...

  8. Establishing a children's orthopaedic hospital for Malawi: A review ...

    African Journals Online (AJOL)

    At present the program has a total of 29 clinics, which .... Thus a total of 1154 paediatric orthopaedic operations were known to have taken place in Malawi during the 10th year of operational services with 53% of cases being performed at BCIH. ... regional hip replacement course, 1 regional knee replacement course for ...

  9. Compliance in Antibiotic Prophylaxis in Orthopaedics and Trauma ...

    African Journals Online (AJOL)

    Compliance in Antibiotic Prophylaxis in Orthopaedics and Trauma: Surgical Practice in a Tertiary Hospital, North-West Nigeria. ... or international guide lines, to reap the expected benefit of prophylactic antibiotics and avoid unwanted adverse effects like emergence of resistant bacteria strains and extra cost of healthcare.

  10. 99m Tc-labeled heparin test in orthopaedic surgery

    International Nuclear Information System (INIS)

    Bouvier, J.F.; Lafon, J.C.; Colin, M.; Chatelut, J.; Beaubatie, F.

    1983-01-01

    99m Tc-labeled heparin test was performed for early detection of phlebitis or pulmonary embolism after orthopaedic prothesis. Heparinic treatment and surgery per se were demonstrated to have no effect on the results. If this test demonstrates a statistical difference for pathologic patients, it is of greater value to consider ratio between rates before and after intervention [fr

  11. Bone Graft Substitutes : Developed for Trauma and Orthopaedic Surgery

    NARCIS (Netherlands)

    J. van der Stok (Johan)

    2015-01-01

    markdownabstract__Abstract__ Bone grafting was established in the 19th century and has become a common procedure in which bone defects are filled with bone grafts or bone graft substitutes. Bone defects that require bone grafting are encountered in approximately 10% of trauma and orthopaedic

  12. Non-Steroidal Anti Inflammatory Drugs Usage In Orthopaedics And ...

    African Journals Online (AJOL)

    Background: Non steroidal anti-inflammatory drugs NSAIDs) are a group of heterogeneous compounds with nti inflammatory, analgesic and often times anti pyretic roperties. They are weak organic acids and are the most commonly used drugs in Orthopaedic/Trauma practice. hey provide mild to moderate pain relief.

  13. Orthopaedic injuries in children: Federal Medical Centre, Umuahia ...

    African Journals Online (AJOL)

    Background: Worldwide, trauma is a recognized leading cause of childhood morbidity, mortality and disability. Aim: To review the causes and consequences of orthopaedic injuries in children. Methods: A retrospective study of all injuries in children 14 years and below seen at the Federal Medical Centre Umuahia from 1st ...

  14. Infections in orthopaedic surgery : clinical and experimental studies

    NARCIS (Netherlands)

    Vogely, Henri Charles

    2000-01-01

    The diagnostic difficulties, variability in outcome and the heterogeinity of the problem of orthopaedic infections stimulated the author to a study of the literature, and several clinical and experimental studies. The diagnosis prosthesis-related infection can only be reached with an acceptable

  15. Find an Orthopaedic Foot and Ankle MD/DO

    Science.gov (United States)

    ... All Site Content AOFAS / FootCareMD / Find a Surgeon Find a Foot & Ankle Orthopaedic Surgeon Page Content Who ... your prescribed treatment (surgical and/or non-surgical) ​ Find a Surgeon ​ Click here to find a foot ...

  16. Motives for seeking a second opinion in orthopaedic surgery.

    NARCIS (Netherlands)

    Dalen, I. van; Groothoff, J.; Stewart, R.; Spreeuwenberg, P.; Groenewegen, P.; Horn, J. van

    2001-01-01

    The number of second opinions in orthopaedic surgery is increading rapidly, yet the grounds on which patients and their doctors decide to seek a second opinion have been little studied. The goal of the study was to identify patient and consultant factors that appeared to contribute to a second

  17. Local corticosteroid injections: Rational use in common orthopaedic ...

    African Journals Online (AJOL)

    The use of local corticosteroid injections in orthopaedic practice is common due to their anti- inflammatory and analgesic effect. However, the use may result in local or systemic complications. Moreover, the conflicting reports on their benefits versus side effects, throws the average user in confusion or fear. This review ...

  18. Machine learning techniques for the optimization of joint replacements: Application to a short-stem hip implant.

    Science.gov (United States)

    Cilla, Myriam; Borgiani, Edoardo; Martínez, Javier; Duda, Georg N; Checa, Sara

    2017-01-01

    Today, different implant designs exist in the market; however, there is not a clear understanding of which are the best implant design parameters to achieve mechanical optimal conditions. Therefore, the aim of this project was to investigate if the geometry of a commercial short stem hip prosthesis can be further optimized to reduce stress shielding effects and achieve better short-stemmed implant performance. To reach this aim, the potential of machine learning techniques combined with parametric Finite Element analysis was used. The selected implant geometrical parameters were: total stem length (L), thickness in the lateral (R1) and medial (R2) and the distance between the implant neck and the central stem surface (D). The results show that the total stem length was not the only parameter playing a role in stress shielding. An optimized implant should aim for a decreased stem length and a reduced length of the surface in contact with the bone. The two radiuses that characterize the stem width at the distal cross-section in contact with the bone were less influential in the reduction of stress shielding compared with the other two parameters; but they also play a role where thinner stems present better results.

  19. Misfit of Three Different Implant-Abutment Connections Before and After Cyclic Load Application: An In Vitro Study.

    Science.gov (United States)

    Gehrke, Sergio Alexandre; Delgado-Ruiz, Rafael Arcesio; Prados Frutos, Juan Carlos; Prados-Privado, María; Dedavid, Berenice Anina; Granero Marín, Jose Manuel; Calvo Guirado, José Luiz

    This study aimed to evaluate the misfit of three different implant-abutment connections before and after cycling load. One hundred twenty dental implants and correspondent prefabricated titanium abutments were used. Three different implant-abutment connections were evaluated: Morse taper (MT group), external hexagon (EH group), and internal hexagon (IH group). Forty implants and 40 abutments were used per group. The parameters for the mechanical evaluation were set as: 360,000 cycles, load of 150 N, and frequency of 4 Hz. Samples were sectioned in their longitudinal and transversal axes, and the misfit of the implant-abutment connection was evaluated by scanning electron microscopy analysis. One-way analyses of variance, Tukey post hoc analyses (α = .05), and t test (P .05). Transversally, only the MT group showed full fitting after cycling load compared with the other groups (EH and IH) (P abutment connection in internal, external, and Morse taper connections. In the longitudinal direction, the accommodation decreases and/or eliminates the gap observed initially (before load). In the horizontal direction, Morse cone implant-abutment connections experience a complete accommodation with the elimination of the gap.

  20. Transition Metal Ion Implantation into Diamond-Like Carbon Coatings: Development of a Base Material for Gas Sensing Applications

    Directory of Open Access Journals (Sweden)

    Andreas Markwitz

    2015-01-01

    Full Text Available Micrometre thick diamond-like carbon (DLC coatings produced by direct ion deposition were implanted with 30 keV Ar+ and transition metal ions in the lower percentage (<10 at.% range. Theoretical calculations showed that the ions are implanted just beneath the surface, which was confirmed with RBS measurements. Atomic force microscope scans revealed that the surface roughness increases when implanted with Ar+ and Cu+ ions, whereas a smoothing of the surface from 5.2 to 2.7 nm and a grain size reduction from 175 to 93 nm are measured for Ag+ implanted coatings with a fluence of 1.24×1016 at. cm−2. Calculated hydrogen and carbon depth profiles showed surprisingly significant changes in concentrations in the near-surface region of the DLC coatings, particularly when implanted with Ag+ ions. Hydrogen accumulates up to 32 at.% and the minimum of the carbon distribution is shifted towards the surface which may be the cause of the surface smoothing effect. The ion implantations caused an increase in electrical conductivity of the DLC coatings, which is important for the development of solid-state gas sensors based on DLC coatings.

  1. Quantitative ion implantation

    International Nuclear Information System (INIS)

    Gries, W.H.

    1976-06-01

    This is a report of the study of the implantation of heavy ions at medium keV-energies into electrically conducting mono-elemental solids, at ion doses too small to cause significant loss of the implanted ions by resputtering. The study has been undertaken to investigate the possibility of accurate portioning of matter in submicrogram quantities, with some specific applications in mind. The problem is extensively investigated both on a theoretical level and in practice. A mathematical model is developed for calculating the loss of implanted ions by resputtering as a function of the implanted ion dose and the sputtering yield. Numerical data are produced therefrom which permit a good order-of-magnitude estimate of the loss for any ion/solid combination in which the ions are heavier than the solid atoms, and for any ion energy from 10 to 300 keV. The implanted ion dose is measured by integration of the ion beam current, and equipment and techniques are described which make possible the accurate integration of an ion current in an electromagnetic isotope separator. The methods are applied to two sample cases, one being a stable isotope, the other a radioisotope. In both cases independent methods are used to show that the implantation is indeed quantitative, as predicted. At the same time the sample cases are used to demonstrate two possible applications for quantitative ion implantation, viz. firstly for the manufacture of calibration standards for instrumental micromethods of elemental trace analysis in metals, and secondly for the determination of the half-lives of long-lived radioisotopes by a specific activity method. It is concluded that the present study has advanced quantitative ion implantation to the state where it can be successfully applied to the solution of problems in other fields

  2. Patient Perspectives of Midlevel Providers in Orthopaedic Sports Medicine.

    Science.gov (United States)

    Manning, Blaine T; Bohl, Daniel D; Hannon, Charles P; Redondo, Michael L; Christian, David R; Forsythe, Brian; Nho, Shane J; Bach, Bernard R

    2018-04-01

    Midlevel providers (eg, nurse practitioners and physician assistants) have been integrated into orthopaedic systems of care in response to the increasing demand for musculoskeletal care. Few studies have examined patient perspectives toward midlevel providers in orthopaedic sports medicine. To identify perspectives of orthopaedic sports medicine patients regarding midlevel providers, including optimal scope of practice, reimbursement equity with physicians, and importance of the physician's midlevel provider to patients when initially selecting a physician. Cross-sectional study; Level of evidence, 3. A total of 690 consecutive new patients of 3 orthopaedic sports medicine physicians were prospectively administered an anonymous questionnaire prior to their first visit. Content included patient perspectives regarding midlevel provider importance in physician selection, optimal scope of practice, and reimbursement equity with physicians. Of the 690 consecutive patients who were administered the survey, 605 (87.7%) responded. Of these, 51.9% were men and 48.1% were women, with a mean age of 40.5 ± 15.7 years. More than half (51.2%) perceived no differences in training levels between physician assistants and nurse practitioners. A majority of patients (62.9%) reported that the physician's midlevel provider is an important consideration when choosing a new orthopaedic sports medicine physician. Patients had specific preferences regarding which services should be physician provided. Patients also reported specific preferences regarding those services that could be midlevel provided. There lacked a consensus on reimbursement equity for midlevel practitioners and physicians, despite 71.7% of patients responding that the physician provides a higher-quality consultation. As health care becomes value driven and consumer-centric, understanding patient perspectives on midlevel providers will allow orthopaedic sports medicine physicians to optimize efficiency and patient

  3. Application of 5-Fluorouracil-Polycaprolactone Sustained-Release Film in Ahmed Glaucoma Valve Implantation Inhibits Postoperative Bleb Scarring in Rabbit Eyes.

    Science.gov (United States)

    Bi, Xiu-Zeng; Pan, Wei-Hua; Yu, Xin-Ping; Song, Zong-Ming; Ren, Zeng-Jin; Sun, Min; Li, Cong-Hui; Nan, Kai-Hui

    2015-01-01

    This study was designed to investigate whether 5-fluorouracil (5-Fu)-polycaprolactone sustained-release film in Ahmed glaucoma valve implantation inhibits postoperative bleb scarring in rabbit eyes. Eighteen New Zealand white rabbits were randomly divided into three groups (A, B and C; n = 6 per group). Group A received combined 5-Fu-polycaprolactone sustained-release film application and Ahmed glaucoma valve implantation, group B received local infiltration of 5-Fu and Ahmed glaucoma valve implantation, and group C received Ahmed glaucoma valve implantation. Postoperative observations were made of the anterior segment, intraocular pressure, central anterior chamber depth, blebs, drainage tube, and accompanying ciliary body detachment. The pathology of the blebs and surrounding tissues were observed at month 3 postoperatively. We revealed that the 5-Fu-polycaprolactone sustained-release film maintained a release concentration range of 13.7 ± 0.12 to 37.41 ± 0.47 μg/ml over three months in vitro. Postoperatively, diffuse blebs with ridges were found in all eyes in group A, two blebs were observed in group B, and no bleb formation was present in group C. The postoperative central anterior chamber depth in group A was significantly less than that of the other two groups. The postoperative intraocular pressure of group A stabilized at 6.33-8.67 mmHg, whereas that of group C gradually remained at 7.55-10.02 mmHg. The histopathology showed that the fibrous tissue thickness of the blebs in group A was significantly thinner than that of the other groups. We conclude that the 5-Fu-polycaprolactone sustained-release film had a sustained drug release effect, which promoted the inhibition of bleb scarring after Ahmed glaucoma valve implantation.

  4. Processing and characterization of amorphous magnesium based alloy for application in biomedical implants

    Directory of Open Access Journals (Sweden)

    Telma Blanco Matias

    2014-07-01

    Full Text Available Magnesium-based bulk metallic glasses are attractive due to their single-phase, chemically homogeneous alloy system and the absence of second-phase, which could impair the mechanical properties and corrosion resistance. However, one of the unsolved problems for the manufacturability and the applications of bulk metallic glasses is that their glass-forming ability is very sensitive to the preparation techniques and impurity of components since oxygen in the environment would markedly deteriorate the glass-forming ability. Therefore, the aim of this study was to establish proper processing conditions to obtain a magnesium-based amorphous ternary alloy and its characterization. The final composition was prepared using two binary master alloys by melting in an induction furnace. Carbon steel crucible was used in argon atmosphere with and without addition of SF6 gas in order to minimize the oxygen contamination. The microstructure, amorphous nature, thermal properties and chemical analysis of samples were investigated by scanning electron microscopy (SEM, X-ray diffraction (XRD, differential scanning calorimetry (DSC and inductively coupled plasma emission spectrometry, respectively. The oxygen content of the as-cast samples was chemically analyzed by using carrier gas hot extraction (O/N Analyzer TC-436/LECO and was kept bellow 25 ppm (without SF6 and 10 ppm (with SF6. Bulk samples were produced by rapid cooling in a cooper mold until 1.5 mm thickness, with amorphous structures being observed up to 2.5 mm.

  5. Understanding how orthopaedic surgery practices generate value for healthcare systems.

    Science.gov (United States)

    Olson, Steven A; Mather, Richard C

    2013-06-01

    Orthopaedic surgery practices can provide substantial value to healthcare systems. Increasingly, healthcare administrators are speaking of the need for alignment between physicians and healthcare systems. However, physicians often do not understand what healthcare administrators value and therefore have difficulty articulating the value they create in discussions with their hospital or healthcare organization. Many health systems and hospitals use service lines as an organizational structure to track the relevant data and manage the resources associated with a particular type of care, such as musculoskeletal care. Understanding service lines and their management can be useful for orthopaedic surgeons interested in interacting with their hospital systems. We provide an overview of two basic types of value orthopaedic surgeons create for healthcare systems: financial or volume-driven benefits and nonfinancial quality or value-driven patient care benefits. We performed a search of PubMed from 1965 to 2012 using the term "service line." Of the 351 citations identified, 18 citations specifically involved the use of service lines to improve patient care in both nursing and medical journals. A service line is a structure used in healthcare organizations to enable management of a subset of activities or resources in a focused area of patient care delivery. There is not a consistent definition of what resources are managed within a service line from hospital to hospital. Physicians can positively impact patient care through engaging in service line management. There is increasing pressure for healthcare systems and hospitals to partner with orthopaedic surgeons. The peer-reviewed literature demonstrates there are limited resources for physicians to understand the value they create when attempting to negotiate with their hospital or healthcare organization. To effectively negotiate for resources to provide the best care for patients, orthopaedic surgeons need to claim and

  6. Orthopaedic podiatry triage: process outcomes of a skill mix initiative.

    Science.gov (United States)

    Homeming, Lyndon J; Kuipers, Pim; Nihal, Aneel

    2012-11-01

    The Orthopaedic Podiatry Triage Clinic (OPodTC) is a 'skill mix' model of care developed in Queensland Health to address the problem of lengthy waiting times for orthopaedic surgery on foot and ankle pathologies. It is based on the recognition that many orthopaedic surgery referrals can be identified early and treated conservatively with podiatry, averting the need for more costly and invasive surgical interventions. The model is collaborative and relies on screening and triage by the podiatrist, rather than delegation by the orthopaedic surgeon. Screening and triage through OPodTC was trialled at three Queensland Health hospital facilities during 2009 and 2010 to improve service timeliness. Patients identified by the OPodTC podiatrist as suitable for conservative management were provided with non-surgical podiatry interventions and discharged if appropriate. Those identified as still requiring surgical intervention after the benefit of interim conservative treatment provided by the podiatrist (or who chose to remain on the list) were returned to their previous place on the orthopaedic waiting list. This paper presents a summary and description of waiting list changes in association with this trial. The OPodTC intervention resulted in a reduction in the non-urgent category of the waiting list across the three hospitals of between 23.3% and 49.7%. Indications from wait-list service data demonstrated increased timeliness and improved patient flow, which are core goals of these skill mix initiatives. This study highlights the potential of screening and triage functions in the skill mix debate. In this example, conservative treatment options were considered first, suitable patients did not have to wait long periods to receive timely and appropriate interventions, and those for whom surgery was indicated, were provided with a more targeted service.

  7. Does sleep deprivation impair orthopaedic surgeons' cognitive and psychomotor performance?

    Science.gov (United States)

    O'Brien, Michael J; O'Toole, Robert V; Newell, Mary Zadnik; Lydecker, Alison D; Nascone, Jason; Sciadini, Marcus; Pollak, Andrew; Turen, Clifford; Eglseder, W Andrew

    2012-11-07

    Sleep deprivation may slow reaction time, cloud judgment, and impair the ability to think. Our purpose was to study the cognitive and psychomotor performances of orthopaedic trauma surgeons on the basis of the amount of sleep that they obtained. We prospectively studied the performances of thirty-two orthopaedic trauma surgeons (residents, fellows, and attending surgeons) over two four-week periods at an urban academic trauma center. Testing sessions used handheld computers to administer validated cognitive and psychomotor function tests. We conducted a multivariate analysis to examine the independent association between test performance and multiple covariates, including the amount of sleep the night before testing. Our analysis demonstrated that orthopaedic surgeons who had slept four hours or less the night before the test had 1.43 times the odds (95% confidence interval, 1.04 to 1.95; p = 0.03) of committing at least one error on an individual test compared with orthopaedic surgeons who had slept more than four hours the previous night. The Running Memory test, which assesses sustained attention, concentration, and working memory, was most sensitive to deterioration in performance in participants who had had four hours of sleep or less; when controlling for other covariates, the test demonstrated a 72% increase in the odds of making at least one error (odds ratio, 1.72 [95% confidence interval, 1.02 to 2.90]; p = 0.04). No significant decrease in performance with sleep deprivation was shown with the other three tests. Orthopaedic trauma surgeons showed deterioration in performance on a validated cognitive task when they had slept four hours or less the previous night. It is unknown how performance on this test relates to surgical performance.

  8. Bone attachment to glass-fibre-reinforced composite implant with porous surface.

    Science.gov (United States)

    Mattila, R H; Laurila, P; Rekola, J; Gunn, J; Lassila, L V J; Mäntylä, T; Aho, A J; Vallittu, P K

    2009-06-01

    A method has recently been developed for producing fibre-reinforced composites (FRC) with porous surfaces, intended for use as load-bearing orthopaedic implants. This study focuses on evaluation of the bone-bonding behaviour of FRC implants. Three types of cylindrical implants, i.e. FRC implants with a porous surface, solid polymethyl methacrylate (PMMA) implants and titanium (Ti) implants, were inserted in a transverse direction into the intercondular trabeculous bone area of distal femurs and proximal tibias of New Zealand White rabbits. Animals were sacrificed at 3, 6 and 12 weeks post operation, and push-out tests (n=5-6 per implant type per time point) were then carried out. At 12 weeks the shear force at the porous FRC-bone interface was significantly higher (283.3+/-55.3N) than the shear force at interfaces of solid PMMA/bone (14.4+/-11.0 N; pshielding effect.

  9. Influence of Si addition on the microstructure and mechanical properties of Ti-35Nb alloy for applications in orthopedic implants.

    Science.gov (United States)

    Tavares, A M G; Ramos, W S; de Blas, J C G; Lopes, E S N; Caram, R; Batista, W W; Souza, S A

    2015-11-01

    In the development of new materials for orthopedic implants, special attention has been given to Ti alloys that show biocompatible alloy elements and that are capable of reducing the elastic modulus. Accordingly, Ti-Nb-Si alloys show great potential for application. Thus, this is a study on the microstructures and properties of Ti-35Nb-xSi alloys (x=0, 0.15, 0.35 and 0.55) (wt%) which were thermally treated and cooled under the following conditions: furnace cooling (FC), air cooling (AC), and water quenching (WQ). The results showed that Si addition is effective to reduce the density of omega precipitates making beta more stable, and to produce grain refinement. Silicides, referred as (Ti,Nb)3Si, were formed for alloys containing 0.55% Si, and its formation presumably occurred during the heating at 1000°C. In all cooling conditions, the hardness values increased with the increasing of Si content, as a result from the strong Si solid solution strengthening effect, while the elastic modulus underwent a continuous reduction due to the reduction of omega precipitates in beta matrix. Lower elastic moduli were observed in water-quenched alloys, which concentration of 0.15% Si was more effective in their reduction, with value around 65 GPa. Regarding Ti-35Nb-xSi alloys (x=0, 0.15 and 0.35), the "double yield point" phenomenon, which is typical of alloys with shape memory effect, was observed. The increase in Si concentration also produced an increase from 382 MPa to 540 MPa in the alloys' mechanical strength. Ti-35Nb-0.55Si alloy, however, showed brittle mechanical behavior which was related to the presence of silicides at the grain boundary. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Microstructures, mechanical properties and corrosion resistance of the Zr−xTi (Ag) alloys for dental implant application

    Energy Technology Data Exchange (ETDEWEB)

    Cui, W.F., E-mail: cuiwf@atm.neu.edu.cn; Liu, N.; Qin, G.W.

    2016-06-15

    The Zr−xTi (Ag) alloys were designed for the application of dental implants. The microstructures of Zr−20Ti and Zr−40Ti alloy were observed using optical microscope and transmission electronic microscope. The hardness and compressive tests were performed to evaluate the mechanical properties of the Zr−xTi alloys. The electrochemical behavior of the Zr−xTi alloys with and without 6% Ag was investigated in the acidified artificial saliva containing 0.1% NaF (pH = 4). For comparison, the electrochemical behavior of cp Ti was examined in the same condition. The results show that the quenched Zr−20Ti and Zr−40Ti alloy exhibit acicular martensite microstructures containing twin substructure. They display good mechanical properties with the hardness of ∼330HV, the yield strength of ∼1000 MPa and the strain to fracture of ∼25% at room temperature. Adding 6% Ag to Zr−20Ti alloy enhances the passivity breakdown potential and the self-corrosion potential, but hardly affects the corrosion current density and the impedance modulus. 6% Ag in Zr−40Ti alloy distinctly increases pitting corrosion resistance, which is attributed the formation of thick, dense and stable passive film under the joint action of titanium and silver. In comparison with cp Ti, Zr−40Ti−6Ag alloy possesses the same good corrosion resistance in the rigorous oral environment as well as the superior mechanical properties. - Highlights: • The quenched Zr20Ti and Zr40Ti obtain acicular martensite microstructure. • Zr20Ti and Zr40Ti possess high hardness, strength and strain to fracture. • Increasing Ti content decreases corrosion current density. • Adding Ag enhances passivation breakdown potentials of Zr20Ti and Zr40Ti. • Zr40Ti6Ag has optimum mechanical properties and pitting corrosion resistance.

  11. iPadagogy 101: Using Clinical ORthopedic Exam (C.O.R.E.) to Facilitate Evidence-Based Practice in the Orthopaedic Evaluation Classroom

    Science.gov (United States)

    Hamson-Utley, J. Jordan; Stiller-Ostrowski, Jennifer L.

    2013-01-01

    Evidence-based practice (EBP) and educational technology have become fundamental skills within athletic training programs. The objective of this article is to share experiences implementing clinical orthopaedic evaluation applications ("apps") that can be integrated into classroom and clinical education to enhance students' proficiency…

  12. Ion implantation

    International Nuclear Information System (INIS)

    Johnson, E.

    1986-01-01

    It is the purpose of the present paper to give a review of surface alloy processing by ion implantation. However, rather than covering this vast subject as a whole, the survey is confined to a presentation of the microstructures that can be found in metal surfaces after ion implantation. The presentation is limited to alloys processed by ion implantation proper, that is to processes in which the alloy compositions are altered significantly by direct injection of the implanted ions. The review is introduced by a presentation of the processes taking place during development of the fundamental event in ion implantation - the collision cascade, followed by a summary of the various microstructures which can be formed after ion implantation into metals. This is compared with the variability of microstructures that can be achieved by rapid solidification processing. The microstructures are subsequently discussed in the light of the processes which, as the implantations proceed, take place during and immediately after formation of the individual collision cascades. These collision cascades define the volumes inside which individual ions are slowed down in the implanted targets. They are not only centres for vigorous agitation but also the sources for formation of excess concentrations of point defects, which will influence development of particular microstructures. A final section presents a selection of specific structures which have been observed in different alloy systems. (orig./GSCH)

  13. Implants delivering bisphosphonate locally increase periprosthetic bone density in an osteoporotic sheep model. A pilot study

    Directory of Open Access Journals (Sweden)

    GVA Stadelmann

    2008-07-01

    Full Text Available It is a clinical challenge to obtain a sufficient orthopaedic implant fixation in weak osteoporotic bone. When the primary implant fixation is poor, micromotions occur at the bone-implant interface, activating osteoclasts, which leads to implant loosening. Bisphosphonate can be used to prevent the osteoclastic response, but when administered systemically its bioavailability is low and the time it takes for the drug to reach the periprosthetic bone may be a limiting factor. Recent data has shown that delivering bisphosphonate locally from the implant surface could be an interesting solution. Local bisphosphonate delivery increased periprosthetic bone density, which leads to a stronger implant fixation, as demonstrated in rats by the increased implant pullout force. The aim of the present study was to verify the positive effect on periprosthetic bone remodelling of local bisphosphonate delivery in an osteoporotic sheep model. Four implants coated with zoledronate and two control implants were inserted in the femoral condyle of ovariectomized sheep for 4 weeks. The bone at the implant surface was 50% higher in the zoledronate-group compared to control group. This effect was significant up to a distance of 400µm from the implant surface. The presented results are similar to what was observed in the osteoporotic rat model, which suggest that the concept of releasing zoledronate locally from the implant to increase the implant fixation is not species specific. The results of this trial study support the claim that local zoledronate could increase the fixation of an implant in weak bone.

  14. The clinical application of TACE together with RFA and 125I seed implantation in treating hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Xie Xiaoxi; Lu Yinxiang; Zhang Hongxin; Zhang Shengchu; Zhou Jianwei; Zhang Guodong; Wang Xiaowei; Yang Liping

    2011-01-01

    Objective: to assess the clinical value of the combined treatment of transcatheter arterial chemoembolization (TACE), CT-guided radiofrequency ablation (RFA) and radioactive 125 I seed implantation for hepatocellular carcinoma (HCC). Methods: During the period from March 2008 to Dec. 2010, 15 patients with HCC were admitted to the hospital. A total of 25 hepatic lesions were detected with the size of 1-8 cm. TACE was carried out first, which was followed by CT-guided RFA and radioactive 125 I seed implantation. With the help of treat plan system (TPS), the radioactive 125 I seed implantation was conducted to make additional management for the same lesion when RFA was finished, or the radioactive 125 I seeds were directly implanted into the areas where RFA could not reach. The radioactive dose was 60-100 Gy. All the patients were followed up and were kept under observation for the signs of related complications. The therapeutic results were evaluated. Results: The combined treatment was successfully accomplished in all patients. All patients were followed up for 3-28 months (mean of 10.6 months). The complete necrosis rate of the tumor was 96%. No serious complications occurred except the immigration of 125 I seeds in 1 case. Conclusion: The combined treatment of TACE and CT-guided RFA together with 125 I seed implantation is a safe, reliable and effective therapy for HCC with excellent short-term result. (authors)

  15. New Coating Technique of Ceramic Implants with Different Glass Solder Matrices for Improved Osseointegration-Mechanical Investigations.

    Science.gov (United States)

    Mick, Enrico; Markhoff, Jana; Mitrovic, Aurica; Jonitz, Anika; Bader, Rainer

    2013-09-11

    Ceramics are a very popular material in dental implant technology due to their tribological properties, their biocompatibility and their esthetic appearance. However, their natural surface structure lacks the ability of proper osseointegration, which constitutes a crucial process for the stability and, thus, the functionality of a bone implant. We investigated the application of a glass solder matrix in three configurations-consisting mainly of SiO₂, Al₂O₃, K₂O and Na₂O to TZP-A ceramic specimens. The corresponding adhesive strength and surface roughness of the coatings on ceramic specimens have been analyzed. Thereby, high adhesive strength (70.3 ± 7.9 MPa) was found for the three different coatings. The obtained roughness (R z ) amounted to 18.24 ± 2.48 µm in average, with significant differences between the glass solder configurations. Furthermore, one configuration was also tested after additional etching which did not lead to significant increase of surface roughness (19.37 ± 1.04 µm) or adhesive strength (57.2 ± 5.8 MPa). In conclusion, coating with glass solder matrix seems to be a promising surface modification technique that may enable direct insertion of ceramic implants in dental and orthopaedic surgery.

  16. New Coating Technique of Ceramic Implants with Different Glass Solder Matrices for Improved Osseointegration-Mechanical Investigations

    Directory of Open Access Journals (Sweden)

    Rainer Bader

    2013-09-01

    Full Text Available Ceramics are a very popular material in dental implant technology due to their tribological properties, their biocompatibility and their esthetic appearance. However, their natural surface structure lacks the ability of proper osseointegration, which constitutes a crucial process for the stability and, thus, the functionality of a bone implant. We investigated the application of a glass solder matrix in three configurations—consisting mainly of SiO2, Al2O3, K2O and Na2O to TZP-A ceramic specimens. The corresponding adhesive strength and surface roughness of the coatings on ceramic specimens have been analyzed. Thereby, high adhesive strength (70.3 ± 7.9 MPa was found for the three different coatings. The obtained roughness (Rz amounted to 18.24 ± 2.48 µm in average, with significant differences between the glass solder configurations. Furthermore, one configuration was also tested after additional etching which did not lead to significant increase of surface roughness (19.37 ± 1.04 µm or adhesive strength (57.2 ± 5.8 MPa. In conclusion, coating with glass solder matrix seems to be a promising surface modification technique that may enable direct insertion of ceramic implants in dental and orthopaedic surgery.

  17. Negative differential resistance effect induced by metal ion implantation in SiO2 film for multilevel RRAM application

    Science.gov (United States)

    Wu, Facai; Si, Shuyao; Shi, Tuo; Zhao, Xiaolong; Liu, Qi; Liao, Lei; Lv, Hangbing; Long, Shibing; Liu, Ming

    2018-02-01

    Pt/SiO2:metal nanoparticles/Pt sandwich structure is fabricated with the method of metal ion (Ag) implantation. The device exhibits multilevel storage with appropriate R off/R on ratio, good endurance and retention properties. Based on transmission electron microscopy and energy dispersive spectrometer analysis, we confirm that Pt nanoparticles are spurted into SiO2 film from Pt bottom electrode by Ag implantation; during electroforming, the local electric field can be enhanced by these Pt nanoparticles, meanwhile the Ag nanoparticles constantly migrate toward the Pt nanoparticles. The implantation induced nanoparticles act as trap sites in the resistive switching layer and play critical roles in the multilevel storage, which is evidenced by the negative differential resistance effect in the current-voltage (I-V) measurements.

  18. Ireland's contribution to orthopaedic literature: a bibliometric analysis.

    Science.gov (United States)

    Kennedy, C; O Sullivan, P; Bilal, M; Walsh, A

    2013-10-01

    Bibliometric analysis of scientific performance within a country or speciality, facilitate the recognition of factors that may further enhance research activity and performance. Our aim was to illicit the current state of Irelands orthopaedic research output in terms of quantity and quality. We performed a retrospective bibliometric analysis of all Irish orthopaedic publications over the past 5 years, in the top 20 peer-reviewed orthopaedic journals. Utilising the MEDLINE database, each journal was evaluated for articles that were published over the study period. Reviews, editorials, reports and letters were excluded. Each article abstract was analysed for research content, and country of origin. A nation's mean IF was defined by multiplying each journal's IF by the number of articles. Publications per million (PmP) was calculated by dividing the total number of publications by the population of each country. We analysed a total of 25,595 article abstracts. Ireland contributed 109 articles in total (0.42% of all articles), however ranking according to population per million was 10th worldwide. Ireland ranked 18th worldwide in relation to mean impact factor, which was 2.91 over the study period. Ireland published in 16 of the top 20 journals, 9 of these were of European origin, and 1 of the top 5 was of American origin. In total, 61 Irish articles were assignable to clinical orthopaedic units. Clinical based studies (randomised controlled trials, observational, and epidemiology/bibliometric articles) and research based studies (In vivo, In vitro, and biomechanical) numbered 76 (69.7%) and 33 (30.2%) articles, respectively. This study provides a novel overview of current Irish orthopaedic related research, and how our standards translate to the worldwide orthopaedic community. In order to maintain our publication productivity, academic research should continue to be encouraged at post graduate level. Copyright © 2013 Royal College of Surgeons of Edinburgh

  19. The application of low angle Rutherford backscattering and channelling techniques to determine implantation induced disorder profile distributions in semiconductors

    International Nuclear Information System (INIS)

    Ahmed, N.A.G.; Christodoulides, C.E.; Carter, G.; Nobes, M.J.; Titov, A.I.

    1980-01-01

    Low angle exit (9 0 ) Rutherford backscattering geometry and channelling of 2 MeV 4 He + are employed to investigate the disorder depth profiles created by 40 keV N + implantation in (111) silicon and (100) GaAs targets. Parameters which can influence the disordering rate and its spatial distribution, such as ion fluence flux, substrate type and substrate temperature are examined. Under certain implantation conditions, the damage profile distributions are asymmetric - exhibiting a bimodal form in silicon targets or confined much closer to the GaAs surface than the normally expected mean range of 40 keV N + ions. (orig.)

  20. Approaches and Challenges of Engineering Implantable Microelectromechanical Systems (MEMS Drug Delivery Systems for in Vitro and in Vivo Applications

    Directory of Open Access Journals (Sweden)

    Ken-Tye Yong

    2012-11-01

    Full Text Available Despite the advancements made in drug delivery systems over the years, many challenges remain in drug delivery systems for treating chronic diseases at the personalized medicine level. The current urgent need is to develop novel strategies for targeted therapy of chronic diseases. Due to their unique properties, microelectromechanical systems (MEMS technology has been recently engineered as implantable drug delivery systems for disease therapy. This review examines the challenges faced in implementing implantable MEMS drug delivery systems in vivo and the solutions available to overcome these challenges.

  1. A ten years experience with allograft implantation

    International Nuclear Information System (INIS)

    Thanya Subhadrabandha; Sommart Keorochana; Yongyudh Vajaradul

    1999-01-01

    Since 1986 the Department of Orthopaedics, Ramathibodi Hospital has performed 30 resections and fresh frozen allograft implantations for the management of tumourous bone conditions. All allografts were provided by Bangkok Biomaterial Center, Siriraj Hospital. Following resection of the tumor, the selected part was implanted and held with plates and screws, intramedullary rods or prostheses and the patients were observed closely for alterations suggestive of rejection, relationship of complications to outcome, functional status of the part and presence of recurrences or metastases. Thirty patients were followed up for two or more years, the graft performed acceptably (excellent or good function result) in 70%. The results were better when the allografts were used in upper extremities or combined with prostheses. Local recurrence and severe infection were the major factors in determining outcome

  2. Application of Ti6Al7Nb Alloy for the Manufacture of Biomechanical Functional Structures (BFS) for Custom-Made Bone Implants.

    Science.gov (United States)

    Szymczyk, Patrycja; Ziółkowski, Grzegorz; Junka, Adam; Chlebus, Edward

    2018-06-08

    Unlike conventional manufacturing techniques, additive manufacturing (AM) can form objects of complex shape and geometry in an almost unrestricted manner. AM’s advantages include higher control of local process parameters and a possibility to use two or more various materials during manufacture. In this work, we applied one of AM technologies, selective laser melting, using Ti6Al7Nb alloy to produce biomedical functional structures (BFS) in the form of bone implants. Five types of BFS structures (A1, A2, A3, B, C) were manufactured for the research. The aim of this study was to investigate such technological aspects as architecture, manufacturing methods, process parameters, surface modification, and to compare them with such functional properties such as accuracy, mechanical, and biological in manufactured implants. Initial in vitro studies were performed using osteoblast cell line hFOB 1.19 (ATCC CRL-11372) (American Type Culture Collection). The results of the presented study confirm high applicative potential of AM to produce bone implants of high accuracy and geometric complexity, displaying desired mechanical properties. The experimental tests, as well as geometrical accuracy analysis, showed that the square shaped (A3) BFS structures were characterized by the lowest deviation range and smallestanisotropy of mechanical properties. Moreover, cell culture experiments performed in this study proved that the designed and obtained implant’s internal porosity (A3) enhances the growth of bone cells (osteoblasts) and can obtain predesigned biomechanical characteristics comparable to those of the bone tissue.

  3. Biomimetic novel nanoporous niobium oxide coating for orthopaedic applications

    Science.gov (United States)

    Pauline, S. Anne; Rajendran, N.

    2014-01-01

    Niobium oxide was synthesized by sol-gel methodology and a crystalline, nanoporous and adherent coating of Nb2O5 was deposited on 316L SS using the spin coating technique and heat treatment. The synthesis conditions were optimized to obtain a nanoporous morphology. The coating was characterized using attenuated total reflectance-Infrared spectroscopy (ATR-IR), X-ray diffraction analysis (XRD), scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDX), atomic force microscopy (AFM) and transmission electron microscopy (TEM) and the formation of crystalline Nb2O5 coating with nanoporous morphology was confirmed. Mechanical studies confirmed that the coating has excellent adherence to the substrate and the hardness value of the coating was excellent. Contact angle analysis showed increased hydrophilicity for the coated substrate. In vitro bioactivity test confirmed that the Nb2O5 coating with nanoporous morphology facilitated the growth of hydroxyapatite (HAp). This was further confirmed by the solution analysis test where increased uptake of calcium and phosphorous ions from simulated body fluid (SBF) was observed. Electrochemical evaluation of the coating confirmed that the crystalline coating is insulative and protective in nature and offered excellent corrosion protection to 316L SS. Thus, this study confirmed that the nanoporous crystalline Nb2O5 coating conferred bioactivity and enhanced corrosion resistance on 316L SS.

  4. Biomimetic novel nanoporous niobium oxide coating for orthopaedic applications

    Energy Technology Data Exchange (ETDEWEB)

    Pauline, S. Anne; Rajendran, N., E-mail: nrajendran@annauniv.edu

    2014-01-30

    Niobium oxide was synthesized by sol–gel methodology and a crystalline, nanoporous and adherent coating of Nb{sub 2}O{sub 5} was deposited on 316L SS using the spin coating technique and heat treatment. The synthesis conditions were optimized to obtain a nanoporous morphology. The coating was characterized using attenuated total reflectance-Infrared spectroscopy (ATR-IR), X-ray diffraction analysis (XRD), scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDX), atomic force microscopy (AFM) and transmission electron microscopy (TEM) and the formation of crystalline Nb{sub 2}O{sub 5} coating with nanoporous morphology was confirmed. Mechanical studies confirmed that the coating has excellent adherence to the substrate and the hardness value of the coating was excellent. Contact angle analysis showed increased hydrophilicity for the coated substrate. In vitro bioactivity test confirmed that the Nb{sub 2}O{sub 5} coating with nanoporous morphology facilitated the growth of hydroxyapatite (HAp). This was further confirmed by the solution analysis test where increased uptake of calcium and phosphorous ions from simulated body fluid (SBF) was observed. Electrochemical evaluation of the coating confirmed that the crystalline coating is insulative and protective in nature and offered excellent corrosion protection to 316L SS. Thus, this study confirmed that the nanoporous crystalline Nb{sub 2}O{sub 5} coating conferred bioactivity and enhanced corrosion resistance on 316L SS.

  5. Bio-Corrosion of Magnesium Alloys for Orthopaedic Applications

    Directory of Open Access Journals (Sweden)

    Emily K. Brooks

    2017-09-01

    Full Text Available Three Mg alloys, Mg–1.34% Ca–3% Zn (MCZ, Mg–1.34% Ca–3% Zn–0.2% Sr (MCZS, and Mg–2% Sr (MS, were examined to understand their bio-corrosion behavior. Electrochemical impedance spectroscopy and polarization scans were performed after 6 days of immersion in cell culture medium, and ion release and changes in media pH were tracked over a 28 day time period. Scanning electron microscopy (SEM of alloy microstructure was performed to help interpret the results of the electrochemical testing. Results indicate that corrosion resistance of the alloys is as follows: MCZ > MCZS > MS.

  6. Bio-Corrosion of Magnesium Alloys for Orthopaedic Applications

    Science.gov (United States)

    Brooks, Emily K.; Ehrensberger, Mark T.

    2017-01-01

    Three Mg alloys, Mg–1.34% Ca–3% Zn (MCZ), Mg–1.34% Ca–3% Zn–0.2% Sr (MCZS), and Mg–2% Sr (MS), were examined to understand their bio-corrosion behavior. Electrochemical impedance spectroscopy and polarization scans were performed after 6 days of immersion in cell culture medium, and ion release and changes in media pH were tracked over a 28 day time period. Scanning electron microscopy (SEM) of alloy microstructure was performed to help interpret the results of the electrochemical testing. Results indicate that corrosion resistance of the alloys is as follows: MCZ > MCZS > MS. PMID:28862647

  7. Biomaterials approaches to treating implant-associated osteomyelitis.

    Science.gov (United States)

    Inzana, Jason A; Schwarz, Edward M; Kates, Stephen L; Awad, Hani A

    2016-03-01

    Orthopaedic devices are the most common surgical devices associated with implant-related infections and Staphylococcus aureus (S. aureus) is the most common causative pathogen in chronic bone infections (osteomyelitis). Treatment of these chronic bone infections often involves combinations of antibiotics given systemically and locally to the affected site via a biomaterial spacer. The gold standard biomaterial for local antibiotic delivery against osteomyelitis, poly(methyl methacrylate) (PMMA) bone cement, bears many limitations. Such shortcomings include limited antibiotic release, incompatibility with many antimicrobial agents, and the need for follow-up surgeries to remove the non-biodegradable cement before surgical reconstruction of the lost bone. Therefore, extensive research pursuits are targeting alternative, biodegradable materials to replace PMMA in osteomyelitis applications. Herein, we provide an overview of the primary clinical treatment strategies and emerging biodegradable materials that may be employed for management of implant-related osteomyelitis. We performed a systematic review of experimental biomaterials systems that have been evaluated for treating established S. aureus osteomyelitis in an animal model. Many experimental biomaterials were not decisively more efficacious for infection management than PMMA when delivering the same antibiotic. However, alternative biomaterials have reduced the number of follow-up surgeries, enhanced the antimicrobial efficacy by delivering agents that are incompatible with PMMA, and regenerated bone in an infected defect. Understanding the advantages, limitations, and potential for clinical translation of each biomaterial, along with the conditions under which it was evaluated (e.g. animal model), is critical for surgeons and researchers to navigate the plethora of options for local antibiotic delivery. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Competency-based education: a new model for teaching orthopaedics.

    Science.gov (United States)

    Alman, Benjamin A; Ferguson, Peter; Kraemer, William; Nousiainen, Markku T; Reznick, Richard K

    2013-01-01

    The current methods used to train residents to become orthopaedic surgeons are based on tradition, not evidence-based models. Educators have only a limited ability to assess trainees for competency using validated tests in various domains. The reduction in resident work hours limits the time available for clinical training, which has resulted in some calls for lengthening the training process. Another approach to address limited training hours is to focus training in a program that allows residents to graduate from a rotation based on demonstrated competency rather than on time on a service. A pilot orthopaedic residency curriculum, which uses a competency-based framework of resident training and maximizes the use of available training hours, has been designed and is being implemented.

  9. Computer-assisted Orthopaedic Surgery: Current State and Future Perspective

    Directory of Open Access Journals (Sweden)

    Guoyan eZheng

    2015-12-01

    Full Text Available Introduced about two decades ago, computer-assisted orthopaedic surgery (CAOS has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopaedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined.

  10. What Orthopaedic Operating Room Surfaces Are Contaminated With Bioburden? A Study Using the ATP Bioluminescence Assay.

    Science.gov (United States)

    Richard, Raveesh Daniel; Bowen, Thomas R

    2017-07-01

    Contaminated operating room surfaces can increase the risk of orthopaedic infections, particularly after procedures in which hardware implantation and instrumentation are used. The question arises as to how surgeons can measure surface cleanliness to detect increased levels of bioburden. This study aims to highlight the utility of adenosine triphosphate (ATP) bioluminescence technology as a novel technique in detecting the degree of contamination within the sterile operating room environment. What orthopaedic operating room surfaces are contaminated with bioburden? When energy is required for cellular work, ATP breaks down into adenosine biphosphate (ADP) and phosphate (P) and in that process releases energy. This process is inherent to all living things and can be detected as light emission with the use of bioluminescence assays. On a given day, six different orthopaedic surgery operating rooms (two adult reconstruction, two trauma, two spine) were tested before surgery with an ATP bioluminescence assay kit. All of the cases were considered clean surgery without infection, and this included the previously performed cases in each sampled room. These rooms had been cleaned and prepped for surgery but the patients had not been physically brought into the room. A total of 13 different surfaces were sampled once in each room: the operating room (OR) preparation table (both pre- and postdraping), OR light handles, Bovie machine buttons, supply closet countertops, the inside of the Bair Hugger™ hose, Bair Hugger™ buttons, right side of the OR table headboard, tourniquet machine buttons, the Clark-socket attachment, and patient positioners used for total hip and spine positioning. The relative light units (RLUs) obtained from each sample were recorded and data were compiled and averaged for analysis. These values were compared with previously published ATP benchmark values of 250 to 500 RLUs to define cleanliness in both the hospital and restaurant industries. All

  11. Hydroxyapatite nanocrystals functionalized with alendronate as bioactive components for bone implant coatings to decrease osteoclastic activity

    Science.gov (United States)

    Bosco, Ruggero; Iafisco, Michele; Tampieri, Anna; Jansen, John A.; Leeuwenburgh, Sander C. G.; van den Beucken, Jeroen J. J. P.

    2015-02-01

    The integration of bone implants within native bone tissue depends on periprosthetic bone quality, which is severely decreased in osteoporotic patients. In this work, we have synthesized bone-like hydroxyapatite nanocrystals (nHA) using an acid-base neutralization reaction and analysed their physicochemical properties. Subsequently, we have functionalized the nHA with alendronate (nHAALE), a well-known bisphosphonate drug used for the treatment of osteoporosis. An in vitro osteoclastogenesis test was carried out to evaluate the effect of nHAALE on the formation of osteoclast-like cells from monocytic precursor cells (i.e. RAW264.7 cell line) showing that nHAALE significantly promoted apoptosis of osteoclast-like cells. Subsequently, nHA and nHAALE were deposited on titanium disks using electrospray deposition (ESD), for which characterisation of the deposited coatings confirmed the presence of alendronate in nHAALE coatings with nanoscale thickness of about 700 nm. These results indicate that alendronate linked to hydroxyapatite nanocrystals has therapeutic potential and nHAALE can be considered as an appealing coating constituent material for orthopaedic and oral implants for application in osteoporotic patients.

  12. Image guidance in orthopaedics and traumatology: A historical perspective.

    Science.gov (United States)

    Székely, Gabor; Nolte, Lutz-P

    2016-10-01

    In this note we summarize the history of computer aided surgery in orthopaedics and traumatology from the end of the nineteenth century to currently observable future trends. We concentrate on the two major components of such systems, pre-operative planning and intra-operative execution. The evolution of the necessary technological components, the numerous platforms and components offered commercially as well as their clinical use are surveyed. Copyright © 2016. Published by Elsevier B.V.

  13. Adverse Effects of Smoking on Outcomes of Orthopaedic Surgery

    OpenAIRE

    Sheung-tung Ho

    2017-01-01

    Smoking has many adverse effects on the musculoskeletal system, particularly on the outcomes after orthopaedic surgery. Smoking is associated with surgical site infection and postoperative wound complications after spine surgery, total joint arthroplasty, and fracture fixation; nonunion after spinal fusion, ankle fusion, osteotomy, and internal fixation and bone grafting for scaphoid nonunion; worse outcomes after lumbar disc prolapse, spinal stenosis, and cervical myelopathy surgery; peripro...

  14. Surgical skills simulation in trauma and orthopaedic training

    OpenAIRE

    Stirling, Euan RB; Lewis, Thomas L; Ferran, Nicholas A

    2014-01-01

    Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in orde...

  15. Vancouver winters: Environmental influences on inpatient adult orthopaedic trauma demographics

    International Nuclear Information System (INIS)

    Noordin, S.; Masri, B. A.

    2014-01-01

    Objective: To compare the pattern of adult inpatient orthopaedic injuries admitted at three Vancouver hospitals following one of the worst winter snowstorms in the region with the preceding control winter period. Methods: The surveillance study was conducted at the University of British Columbia, Vancouver, Canada, 2007 to 2010. Inpatient adult admissions for orthopaedic injuries at three hospitals were recorded, including age, gender, anatomic location of injury, type of fracture (open or closed), fixation method (internal versus external fixation), and length of acute care hospital stay. Comparisons between admissions during this weather pattern and admission during a previous winter with minimal snow were made. SPSS 19 was used for statistical analysis. Results: Of the 511 patients admitted under Orthopaedic trauma service during the significant winter snowstorms of December 2008 - January 2009, 100 (19.6%) (CI: 16.2%-23.2%) were due to ice and snow, whereas in the preceding mild winter only 18 of 415 (4.3%) (CI: 2.5%-6.8%) cases were related to snow (p<0.05). Ankle and wrist fractures were the most frequent injuries during the index snow storm period (p<0.05). At all the three institutions, 97 (96.5%) fractures were closed during the snowstorm as opposed to 17 (95%) during the control winter period. Internal fixation in 06 (89%) fractures as opposed to external fixation in 12 (11%) patients was the predominant mode of fixation across the board during both time periods. Conclusion: The study demonstrated a significantly higher inpatient orthopaedic trauma volume during the snowstorm more rigorous prospective studies need to be designed to gain further insight to solving these problems from a public health perspective. (author)

  16. Carmustine Implant

    Science.gov (United States)

    ... works by slowing or stopping the growth of cancer cells in your body. ... are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while receiving carmustine implant, call your doctor. Carmustine may harm the fetus.

  17. Cochlear Implants

    Science.gov (United States)

    ... NIDCD A cochlear implant is a small, complex electronic device that can help to provide a sense ... Hearing Aids Retinitis Pigmentosa - National Eye Institute Telecommunications Relay Services Usher Syndrome Your Baby's Hearing Screening News ...

  18. Neuroengineering tools/applications for bidirectional interfaces, brain computer interfaces, and neuroprosthetic implants - a review of recent progress

    Directory of Open Access Journals (Sweden)

    Ryan M Rothschild

    2010-10-01

    Full Text Available The main focus of this review is to provide a holistic amalgamated overview of the most recent human in vivo techniques for implementing brain-computer interfaces (BCIs, bidirectional interfaces and neuroprosthetics. Neuroengineering is providing new methods for tackling current difficulties; however neuroprosthetics have been studied for decades. Recent progresses are permitting the design of better systems with higher accuracies, repeatability and system robustness. Bidirectional interfaces integrate recording and the relaying of information from and to the brain for the development of BCIs. The concepts of non-invasive and invasive recording of brain activity are introduced. This includes classical and innovative techniques like electroencephalography (EEG and near-infrared spectroscopy (NIRS. Then the problem of gliosis and solutions for (semi- permanent implant biocompatibility such as innovative implant coatings, materials and shapes are discussed. Implant power and the transmission of their data through implanted pulse generators (IPGs and wireless telemetry are taken into account. How sensation can be relayed back to the brain to increase integration of the neuroengineered systems with the body by methods such as micro-stimulation and transcranial magnetic stimulation (TMS are then addressed. The neuroprosthetic section discusses some of the various types and how they operate. Visual prosthetics are discussed and the three types, dependant on implant location, are examined. Auditory prosthetics, being cochlear or cortical, are then addressed. Replacement hand and limb prosthetics are then considered. These are followed by sections concentrating on the control of wheelchairs, computers and robotics directly from brain activity as recorded by non-invasive and invasive techniques.

  19. Does application of the Rosiwal principle to lunar soils require that concentrations of solar-wind-implanted species be grain-size independent

    International Nuclear Information System (INIS)

    Becker, R.H.

    1977-01-01

    A reconsideration of the application of the Rosiwal Principle to lunar soils indicates a flaw in arguments put forth previously by Criswell. Specifically, by introducing a boundary condition which must exist at the lunar surface, it is shown that concentrations of solar-wind-implanted species showing a dependence on grain size may be able to develop in soils at concentration levels below those required for saturation of grain surfaces. As a result, observed grain-size-dependent concentrations of solar-wind species in lunar soils do not necessarily require the exposure time scales or solar-wind fluxes deduced from the arguments of Criswell. (Auth.)

  20. Professional liability in orthopaedics and traumatology in Italy.

    Science.gov (United States)

    Tarantino, Umberto; Giai Via, Alessio; Macrì, Ernesto; Eramo, Alessandro; Marino, Valeria; Marsella, Luigi Tonino

    2013-10-01

    Interest in medical errors has increased during the last few years owing to the number of medical malpractice claims. Reasons for the increasing number of claims may be related to patients' higher expectations, iatrogenic injury, and the growth of the legal services industry. Claims analysis provides helpful information in specialties in which a higher number of errors occur, highlighting areas where orthopaedic care might be improved. We determined: (1) the number of claims involving orthopaedics and traumatology in Rome; (2) the risk of litigation in elective and trauma surgery; (3) the most common surgical procedures involved in claims and indemnity payments; (4) the time between the adverse medical event and the judgment date; and (5) issues related to informed consent. We analyzed 1925 malpractice judgments decided in the Civil Court of Rome between 2004 and 2010. In total, 243 orthopaedics claims were filed, and in 75% of these cases surgeons were found liable; 149 (61%) of these resulted from elective surgery. Surgical teams were sued in 30 claims and found liable in 22. The total indemnity payment ordered was more than €12,350,000 (USD 16,190,000). THA and spinal surgery were the most common surgical procedures involved. Inadequate informed consent was reported in 5.3% of cases. Our study shows that careful medical examination, accurate documentation in medical records, and adequate informed consent might reduce the number of claims. We suggest monitoring of court judgments would be useful to develop prevention strategies to reduce claims.

  1. State Variation in Medicaid Reimbursements for Orthopaedic Surgery.

    Science.gov (United States)

    Lalezari, Ramin M; Pozen, Alexis; Dy, Christopher J

    2018-02-07

    Medicaid reimbursements are determined by each state and are subject to variability. We sought to quantify this variation for commonly performed inpatient orthopaedic procedures. The 10 most commonly performed inpatient orthopaedic procedures, as ranked by the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample, were identified for study. Medicaid reimbursement amounts for those procedures were benchmarked to state Medicare reimbursement amounts in 3 ways: (1) ratio, (2) dollar difference, and (3) dollar difference divided by the relative value unit (RVU) amount. Variability was quantified by determining the range and coefficient of variation for those reimbursement amounts. The range of variability of Medicaid reimbursements among states exceeded $1,500 for all 10 procedures. The coefficients of variation ranged from 0.32 (hip hemiarthroplasty) to 0.57 (posterior or posterolateral lumbar interbody arthrodesis) (a higher coefficient indicates greater variability), compared with 0.07 for Medicare reimbursements for all 10 procedures. Adjusted as a dollar difference between Medicaid and Medicare per RVU, the median values ranged from -$8/RVU (total knee arthroplasty) to -$17/RVU (open reduction and internal fixation of the femur). Variability of Medicaid reimbursement for inpatient orthopaedic procedures among states is substantial. This variation becomes especially remarkable given recent policy shifts toward focusing reimbursements on value.

  2. Surgical skills simulation in trauma and orthopaedic training.

    Science.gov (United States)

    Stirling, Euan R B; Lewis, Thomas L; Ferran, Nicholas A

    2014-12-19

    Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in order to compensate for the reduction in 'hands-on' experience. Simulation training provides the opportunity to develop surgical skills in a controlled environment whilst minimising risks to patient safety, operating theatre usage and financial expenditure. Many options for simulation exist within orthopaedics from cadaveric or prosthetic models, to arthroscopic simulators, to advanced virtual reality and three-dimensional software tools. There are limitations to this form of training, but it has significant potential for trainees to achieve competence in procedures prior to real-life practice. The evidence for its direct transferability to operating theatre performance is limited but there are clear benefits such as increasing trainee confidence and familiarity with equipment. With progressively improving methods of simulation available, it is likely to become more important in the ongoing and future training and assessment of orthopaedic surgeons.

  3. Neoprene Orthopaedic Supports: An Underrecognised Cause of Allergic Contact Dermatitis

    Directory of Open Access Journals (Sweden)

    S. Hawkey

    2015-01-01

    Full Text Available Thioureas, often contained within neoprene to provide water resistance, are an important cause of allergic contact dermatitis (ACD in those who use neoprene products. We wish to present three cases of thiourea-induced ACD from three different orthopaedic supports containing neoprene. The first case was a 67-year-old woman who developed an itchy rash on her heel three weeks after using a neoprene insole for plantar fasciitis. The second case was a 47-year-old man who developed an itchy rash on his wrist after wearing neoprene wrist splints for psoriatic arthropathy. The third case was a 77-year-old woman who experienced a severe erythematous rash with blistering from a neoprene elbow brace she received following a humeral fracture. All patients were patch tested to the British Society of Cutaneous Allergy Standard and rubber series and a cut piece from all the relevant supports. At 96 hours, all patients had a + reaction to mixed dialkylthiourea, diethylthiourea, and the supports’ material. No other positive patch test reactions were identified. As neoprene is fast becoming one of the most popular materials used for orthopaedic supports, awareness of this reaction and close liaison between dermatologists and orthopaedic surgeons are therefore essential to allow for early recognition of this complication.

  4. Analysis of scientific articles published in two general orthopaedic journals.

    Science.gov (United States)

    Holzer, Lukas A; Holzer, Gerold

    2013-01-01

    To give an overview of the behaviour and scientific contributions of the Journal of Bone and Joint Surgery American (JBJS-A) and British Volume (JBJS-B). 480 original articles published in 2009 were identified through a combined comprehensive computer and manual library search. Articles were assigned to 11 orthopaedic categories and by country, type and specialty of the institution. Possible grants and citations were analysed. USA led all countries in published articles (36,87%), followed by UK (20,62%) and South Korea (5,83%). Most studies published were performed at academic institutions (65,83 %), only 4,16% at private practices. Almost half of the articles (46,24%) were published in three categories: hip (19.16%), knee (13.75%) and trauma (13.33%). In both journals 47.15% articles had at least one funding source. A review of articles published in major journals allows to show how research in orthopaedics is distributed worldwide. This study shows that a variety of different journals is neccessary to reflect the broad spectrum of orthopaedics in depth. Level of Evidence III, Retrospective Comparative Study.

  5. Long range implantation by MEVVA metal ion source

    International Nuclear Information System (INIS)

    Zhang Tonghe; Wu Yuguang; Ma Furong; Liang Hong

    2001-01-01

    Metal vapor vacuum arc (MEVVA) source ion implantation is a new technology used for achieving long range ion implantation. It is very important for research and application of the ion beam modification of materials. The results show that the implanted atom diffusion coefficient increases in Mo implanted Al with high ion flux and high dose. The implanted depth is 311.6 times greater than that of the corresponding ion range. The ion species, doses and ion fluxes play an important part in the long-range implantation. Especially, thermal atom chemistry have specific effect on the long-range implantation during high ion flux implantation at transient high target temperature

  6. The Role of 3D Modelling and Printing in Orthopaedic Tissue Engineering: A Review of the Current Literature.

    Science.gov (United States)

    Shaunak, Shalin; Dhinsa, Baljinder S; Khan, Wasim S

    2017-01-01

    Orthopaedic surgery lends itself well to advances in technology. An area of interest and ongoing research is that of the production of scaffolds for use in trauma and elective surgery. 3D printing provides unprecedented accuracy in terms of micro- and macro-structure and geometry for scaffold production. It can also be utilised to construct scaffolds of a variety of different materials and more recently has allowed for the construction of bio-implants which recapitulate bone and cartilage tissue. This review seeks to look at the various methods of 3DP, the materials used, elements of functionality and design, as well as modifications to increase the biomechanics and bioactivity of 3DP scaffolds. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  7. A chlorhexidine-releasing epoxy-based coating on titanium implants prevents Staphylococcus aureus experimental biomaterial-associated infection

    NARCIS (Netherlands)

    Riool, M.; Dirks, A. J.; Jaspers, V.; de Boer, L.; Loontjens, T. J.; van der Loos, C. M.; Florquin, S.; Apachitei, I.; Rijk, L. N.; Keul, H. A.; Zaat, S. A.

    2017-01-01

    Prevention of biomaterial-associated infections (BAI) remains a challenging problem, in particular due to the increased risk of resistance development with the current antibiotic-based strategies. Metallic orthopaedic devices, such as non-cemented implants, are often inserted under high mechanical

  8. Predictors of clinical outcome in total hip and knee replacement : a methodological appraisal of implants and patient factors

    NARCIS (Netherlands)

    Keurentjes, Johan Christiaan

    2014-01-01

    In this thesis, we studied both implants and patient and surgeon factors as predictors of clinical outcome after total hip and knee replacement. Additionally, we studied a number of methodological aspects of orthopaedic research, such as competing risks in estimating the probability of revision

  9. A Paradigm for the Development and Evaluation of Novel Implant Topologies for Bone Fixation: In Vivo Evaluation

    OpenAIRE

    Long, Jason P.; Hollister, Scott J.; Goldstein, Steven A.

    2012-01-01

    While contemporary prosthetic devices restore some function to individuals who have lost a limb, there are efforts to develop bio-integrated prostheses to improve functionality. A critical step in advancing this technology will be to securely attach the device to remnant bone. To investigate mechanisms for establishing robust implant fixation in bone while undergoing loading, we previously used a topology optimization scheme to develop optimized orthopaedic implants and then fabricated select...

  10. “In vitro” Implantation Technique Based on 3D Printed Prosthetic Prototypes

    Science.gov (United States)

    Tarnita, D.; Boborelu, C.; Geonea, I.; Malciu, R.; Grigorie, L.; Tarnita, D. N.

    2018-06-01

    In this paper, Rapid Prototyping ZCorp 310 system, based on high-performance composite powder and on resin-high strength infiltration system and three-dimensional printing as a manufacturing method are used to obtain physical prototypes of orthopaedic implants and prototypes of complex functional prosthetic systems directly from the 3D CAD data. These prototypes are useful for in vitro experimental tests and measurements to optimize and obtain final physical prototypes. Using a new elbow prosthesis model prototype obtained by 3D printing, the surgical technique of implantation is established. Surgical implantation was performed on male corpse elbow joint.

  11. PIXE microbeam analysis of the metallic debris release around endosseous implants

    International Nuclear Information System (INIS)

    Buso, G.P.; Galassini, S.; Moschini, G.; Passi, P.; Zadro, A.; Uzunov, N.M.; Doyle, B.L.; Rossi, P.; Provencio, P.

    2005-01-01

    The mechanical friction that occurs during the surgical insertion of endosseous implants, both in dentistry and orthopaedics, may cause the detachment of metal debris which are dislodged into the peri-implant tissues and can lead to adverse clinical effects. This phenomenon more likely happens with coated or roughened implants that are the most widely employed. In the present study were studied dental implants screws made of commercially pure titanium and coated using titanium plasma-spray (TPS) technique. The implants were inserted in the tibia of rabbits, and removed 'en bloc' with the surrounding bone after one month. After proper processing and mounting on plastic holders, samples from bones were analysed by EDXRF setup at of National Laboratories of Legnaro, INFN, Italy, and consequently at 3 MeV proton microbeam setup at Sandia National Laboratories. Elemental maps were drawn, showing some occasional presence of metal particles in the peri-implant bone

  12. Ion implantation in metals

    International Nuclear Information System (INIS)

    Vook, F.L.

    1977-02-01

    The application of ion beams to metals is rapidly emerging as a promising area of research and technology. This report briefly describes some of the recent advances in the modification and study of the basic properties of metals by ion implantation techniques. Most of the research discussed illustrates some of the new and exciting applications of ion beams to metals which are under active investigation at Sandia Laboratories, Albuquerque

  13. Dermatitis de contacto por prótesis ortopédicas Contact dermatitis for orthopaedic prostheses

    Directory of Open Access Journals (Sweden)

    C.A. Danielo

    2007-09-01

    Full Text Available Diversas aleaciones son utilizadas en la fabricación de prótesis ortopédicas (ej: titanio, vitalio, etc, dentro de las cuales la más utilizada es la de acero inoxidable. El níquel, parte importante de esta aleación, es capaz de liberarse y provocar sensibilización, desencadenando reacciones cutáneas locales y sistémicas. De los materiales que componen la aleación para formar acero inoxidable, el níquel es el que más frecuentemente se ve implicado en reacciones cutáneas por sensibilidad, en tanto que otros como el cromo y cobalto, la posibilidad de pérdida de material a partir de la prótesis es discutida. Presentamos el caso de una paciente con dermatitis alérgica al níquel con lesiones generalizadas, que aparecieron luego del implante de prótesis ortopédicas de acero inoxidable, dando positivo para níquel sulfato en las pruebas epicutáneas.Several alloys are used in the manufacture of orthopaedics prostheses (ie: titanium, vitalium. Stainless steel is the most frequently used among them. Nickel is an important component of this alloy and may release and provoke sensitivity. Arising local and systemic cutaneous reactions. Nickel is the material composing stainless steel that ordinary is implicated in cutaneous reactions of sensitivity; the role of chrome or cobalt is still uncertain. Our patient is a woman affected of nickel contact dermatitis, with generalized reactions that appear after an implant of a stainless steel orthopaedic prosthesis. Epicutaneous tests were performed, confirming a strong sensitivity to nickel sulphate.

  14. BEDVH--A method for evaluating biologically effective dose volume histograms: Application to eye plaque brachytherapy implants

    International Nuclear Information System (INIS)

    Gagne, Nolan L.; Leonard, Kara L.; Huber, Kathryn E.; Mignano, John E.; Duker, Jay S.; Laver, Nora V.; Rivard, Mark J.

    2012-01-01

    Purpose: A method is introduced to examine the influence of implant duration T, radionuclide, and radiobiological parameters on the biologically effective dose (BED) throughout the entire volume of regions of interest for episcleral brachytherapy using available radionuclides. This method is employed to evaluate a particular eye plaque brachytherapy implant in a radiobiological context. Methods: A reference eye geometry and 16 mm COMS eye plaque loaded with 103 Pd, 125 I, or 131 Cs sources were examined with dose distributions accounting for plaque heterogeneities. For a standardized 7 day implant, doses to 90% of the tumor volume ( TUMOR D 90 ) and 10% of the organ at risk volumes ( OAR D 10 ) were calculated. The BED equation from Dale and Jones and published α/β and μ parameters were incorporated with dose volume histograms (DVHs) for various T values such as T = 7 days (i.e., TUMOR 7 BED 10 and OAR 7 BED 10 ). By calculating BED throughout the volumes, biologically effective dose volume histograms (BEDVHs) were developed for tumor and OARs. Influence of T, radionuclide choice, and radiobiological parameters on TUMOR BEDVH and OAR BEDVH were examined. The nominal dose was scaled for shorter implants to achieve biological equivalence. Results: TUMOR D 90 values were 102, 112, and 110 Gy for 103 Pd, 125 I, and 131 Cs, respectively. Corresponding TUMOR 7 BED 10 values were 124, 140, and 138 Gy, respectively. As T decreased from 7 to 0.01 days, the isobiologically effective prescription dose decreased by a factor of three. As expected, TUMOR 7 BEDVH did not significantly change as a function of radionuclide half-life but varied by 10% due to radionuclide dose distribution. Variations in reported radiobiological parameters caused TUMOR 7 BED 10 to deviate by up to 46%. Over the range of OAR α/β values, OAR 7 BED 10 varied by up to 41%, 3.1%, and 1.4% for the lens, optic nerve, and lacrimal gland, respectively. Conclusions: BEDVH permits evaluation of the

  15. Rehabilitation robotics for the upper extremity: review with new directions for orthopaedic disorders.

    Science.gov (United States)

    Hakim, Renée M; Tunis, Brandon G; Ross, Michael D

    2017-11-01

    The focus of research using technological innovations such as robotic devices has been on interventions to improve upper extremity function in neurologic populations, particularly patients with stroke. There is a growing body of evidence describing rehabilitation programs using various types of supportive/assistive and/or resistive robotic and virtual reality-enhanced devices to improve outcomes for patients with neurologic disorders. The most promising approaches are task-oriented, based on current concepts of motor control/learning and practice-induced neuroplasticity. Based on this evidence, we describe application and feasibility of virtual reality-enhanced robotics integrated with current concepts in orthopaedic rehabilitation shifting from an impairment-based focus to inclusion of more intense, task-specific training for patients with upper extremity disorders, specifically emphasizing the wrist and hand. The purpose of this paper is to describe virtual reality-enhanced rehabilitation robotic devices, review evidence of application in patients with upper extremity deficits related to neurologic disorders, and suggest how this technology and task-oriented rehabilitation approach can also benefit patients with orthopaedic disorders of the wrist and hand. We will also discuss areas for further research and development using a task-oriented approach and a commercially available haptic robotic device to focus on training of grasp and manipulation tasks. Implications for Rehabilitation There is a growing body of evidence describing rehabilitation programs using various types of supportive/assistive and/or resistive robotic and virtual reality-enhanced devices to improve outcomes for patients with neurologic disorders. The most promising approaches using rehabilitation robotics are task-oriented, based on current concepts of motor control/learning and practice-induced neuroplasticity. Based on the evidence in neurologic populations, virtual reality-enhanced robotics

  16. Bio-functionalisation of polyether ether ketone using plasma immersion ion implantation

    Science.gov (United States)

    Wakelin, Edgar; Yeo, Giselle; Kondyurin, Alexey; Davies, Michael; McKenzie, David; Weiss, Anthony; Bilek, Marcela

    2015-12-01

    Plasma immersion ion implantation (PIII) is used here to improve the surface bioactivity of polyether ether ketone (PEEK) by modifying the chemical and mechanical properties and by introducing radicals. Modifications to the chemical and mechanical properties are characterised as a function of ion fluence (proportional to treatment time) to determine the suitability of the treated surfaces for biological applications. Radical generation increases with treatment time, where treatments greater than 400 seconds result in a high concentration of long-lived radicals. Radical reactions are responsible for oxidation of the surface, resulting in a permanent increase in the polar surface energy. The nano-scale reduced modulus was found to increase with treatment time at the surface from 4.4 to 5.2 GPa. The macromolecular Young's modulus was also found to increase, but by an amount corresponding to the volume fraction of the ion implanted region. The treated surface layer exhibited cracking under cyclical loads, associated with an increased modulus due to dehydrogenation and crosslinking, however it did not show any sign of delamination, indicating that the modified layer is well integrated with the substrate - a critical factor for bioactive surface coatings to be used in-vivo. Protein immobilisation on the PIII treated surfaces was found to saturate after 240 seconds of treatment, indicating that there is room to tune surface mechanical properties for specific applications without affecting the protein coverage. Our findings indicate that the modification of the chemical and mechanical properties by PIII treatments as well as the introduction of radicals render PEEK well suited for use in orthopaedic implantable devices.

  17. Implantation, recoil implantation, and sputtering

    International Nuclear Information System (INIS)

    Kelly, R.

    1984-01-01

    The implantation and sputtering mechanisms which are relevant to ion bombardment of surfaces are described. These are: collision, thermal, electronic and photon-induced sputtering. 135 refs.; 36 figs.; 9 tabs

  18. Clinical application of transvenous temporary cardiac pacemaker in performing extra-cranial carotid angiography and stent implantation

    International Nuclear Information System (INIS)

    Liu Juan; Yao Guoen; Zhou Huadong; Jiang Xiaojiang; Chen Qiao

    2012-01-01

    Objective: To assess the safety and effectiveness of transvenous temporary cardiac pacemaker in preventing hemodynamic instability occurred during the perioperative period of extra-cranial carotid angiography and stent implantation. Methods: Preoperative install of temporary cardiac pacemaker via left femoral vein was carried out in 41 patients who were at high risk for developing hemodynamic instability, which was followed by extra-cranial carotid angiography and stent implantation. The pacing rhythm of the pacemaker was fixed at 60 beats/min. During and after the procedure the patients were under close observation for the signs of discomfort symptoms as well as the changes in blood pressure and heart rate. The working condition of the pacemaker was also monitored. Results: All the installed pacemakers were technically and hemodynamically effective in producing electrical ventricular responses in all 25 patients who had received balloon dilatation of carotid in advance. Transient pacemaker activation appeared in 25 patients. The longest activation time was one day. During pacemaker activation, one patient developed symptomatic hypotension. The longest duration of hypotension lasted for 4 days. No pacemaker-related or procedure-related complications occurred. Conclusion: Hemodynamic instability is a common complication occurred during perioperative period of extra-cranial carotid angiography and stent implantation. As a prophylactic measure, preoperative placement of temporary cardiac pacemaker can promptly and effectively correct the hemodynamic disorders and prevent perioperative complications such as stroke, etc. Therefore, this technique is worth employing in clinical practice, and it is especially useful for patients with high risks. (authors)

  19. Systematic analysis and experiment of inductive coupling and induced voltage for inductively coupled wireless implantable neurostimulator application

    International Nuclear Information System (INIS)

    Xue, Ning; Cho, Sung-Hoon; Chang, Sung-Pil; Lee, Jeong-Bong

    2012-01-01

    The main strategy for wireless power transfer to implantable devices is to use inductive coupling technology. The induced voltage of implanted devices highly depends on factors such as mutual inductance between the external transmitter coil and the receiver coil, quality factor of the receiver circuit and operation frequency. In this paper, the mutual inductance under a variety of geometries of external coil and under the condition of different vertical distances, lateral displacements and angular misalignments between two coils were theoretically calculated and simulated. To ascertain the condition of maximum power transmission for certain coils’ position requirements, an LC tank (2.7 mm × 2 mm) consisting of a microfabricated gold inductor coil and a small surface mounted capacitor was designed and fabricated as the telemetric part of a neurostimulator. The induced voltage of the LC tank was measured in both air and artificial tissue media under different sizes of power coil and operation frequencies. As a result, the optimum size of a transmitter coil is selected to be of 4 mm inner radius with six turns of coil, while the whole coupling system operates at 94 MHz resonant frequency within 5–11 mm vertical distance, 0–4 mm lateral and 0°–50° angular misalignment between two coils. With the change of the above coils’ positions, the measured induced voltage drops within 30%, satisfying the surgical requirement for neurostimulator implantation. (paper)

  20. A functionalized surface modification with vanadium nanoparticles of various valences against implant-associated bloodstream infection

    Directory of Open Access Journals (Sweden)

    Wang J

    2017-04-01

    Full Text Available Jiaxing Wang,1,* Huaijuan Zhou,2,* Geyong Guo,1 Tao Cheng,1 Xiaochun Peng,1 Xin Mao,1 Jinhua Li,2–4 Xianlong Zhang1 1Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University, 2State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 3Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, 4University of Chinese Academy of Sciences, Beijing, China *These authors contributed equally to this work Abstract: Bloodstream infection, especially with implants involved, is an often life-threatening condition with high mortality rates, imposing a heavy burden on patients and medical systems. Herein, we firstly deposited homogeneous vanadium metal, V2O3, VO2, and V2O5 nanofilms on quartz glass by magnetron sputtering. Using these platforms, we further investigated the potential antimicrobial efficiency of these nano-VOx films and the interactions of human erythrocytes and bacteria (methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa with our samples in a novel cell–bacteria coculture model. It was demonstrated that these nano-VOx precipitated favorable antibacterial activity on both bacteria, especially on S. aureus, and this effect increased with higher vanadium valence. A possible mechanism accountable for these results might be elevated levels of vanadium-induced intracellular reactive oxygen species. More importantly, based on hemolysis assays, our nano-VOx films were found to be able to kill prokaryotic cells but were not toxic to mammalian cells, holding the potential for the prevention of implant-related hematogenous infections. As far as we know, this is the first report wherein such nano-VOx films have assisted human erythrocytes to combat bacteria in a valence-dependent manner. Additionally, vanadium

  1. Antibiotic-impregnated calcium phosphate cement as part of a comprehensive treatment for patients with established orthopaedic infection.

    Science.gov (United States)

    Niikura, Takahiro; Lee, Sang Yang; Iwakura, Takashi; Sakai, Yoshitada; Kuroda, Ryosuke; Kurosaka, Masahiro

    2016-07-01

    The treatment of established orthopaedic infection is challenging. While the main focus of treatment is wide surgical debridement, systemic and local antibiotic administration are important adjuvant therapies. Several reports have described the clinical use of antibiotic-impregnated calcium phosphate cement (CPC) to provide local antibiotic therapy for bone infections. However, these were all individual case reports, and no case series have been reported. We report a case series treated by a single surgeon using antibiotic-impregnated CPC as part of a comprehensive treatment plan in patients with established orthopaedic infection. We enrolled 13 consecutive patients with osteomyelitis (n = 6) or infected non-union (n = 7). Implantation of antibiotic-impregnated CPC was performed to provide local antibiotic therapy as part of a comprehensive treatment plan that also included wide surgical debridement, systemic antibiotic therapy, and subsequent second-stage reconstruction surgery. We investigated the rate of successful infection eradication and systemic/local complications. The concentration of antibiotics in the surgical drainage fluids, blood, and recovered CPC (via elution into a phosphate-buffered saline bath) were measured. The mean follow-up period after surgery was 50.4 (range, 27-73) months. There were no cases of infection recurrence during follow-up. No systemic toxicity or local complications from the implantation of antibiotic-impregnated CPC were observed. The vancomycin concentration in the fluid from surgical drainage (n = 6) was 527.1 ± 363.9 μg/mL on postoperative day 1 and 224.5 ± 198.4 μg/mL on postoperative day 2. In patients who did not receive systemic vancomycin therapy (n = 3), the maximum serum vancomycin level was antibiotic-impregnated CPC is an option to provide local antibiotic therapy as part of a comprehensive treatment plan. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights

  2. A dual-task design of corrosion-controlling and osteo-compatible hexamethylenediaminetetrakis- (methylene phosphonic acid) (HDTMPA) coating on magnesium for biodegradable bone implants application.

    Science.gov (United States)

    Zhao, Sheng; Chen, Yingqi; Liu, Bo; Chen, Meiyun; Mao, Jinlong; He, Hairuo; Zhao, Yuancong; Huang, Nan; Wan, Guojiang

    2015-05-01

    Magnesium as well as its alloys appears increasingly as a revolutionary bio-metal for biodegradable implants application but the biggest challenges exist in its too fast bio-corrosion/degradation. Both corrosion-controllable and bio-compatible Mg-based bio-metal is highly desirable in clinic. In present work, hexamethylenediaminetetrakis (methylenephosphonic acid) [HDTMPA, (H2 O3 P-CH2 )2 -N-(CH2 )6 -N-(CH2 -PO3 H2 )2 ], as a natural and bioactive organic substance, was covalently immobilized and chelating-deposited onto Mg surface by means of chemical conversion process and dip-coating method, to fullfill dual-task performance of corrosion-protective and osteo-compatible functionalities. The chemical grafting of HDTMPA molecules, by participation of functional groups on pretreated Mg surface, ensured a firmly anchored base layer, and then sub-sequential chelating reactions of HDTMPA molecules guaranteed a homogenous and dense HDTMPA coating deposition on Mg substrate. Electrochemical corrosion and immersion degradation results reveal that the HDTMPA coated Mg provides a significantly better controlled bio-corrosion/degradation behavior in phosphate buffer saline solution as compared with untreated Mg from perspective of clinic requirement. Moreover, the HDTMPA coated Mg exhibits osteo-compatible in that it induces not only bioactivity of bone-like apatite precipitation but also promotes osteoblast cells adhesion and proliferation. Our well-controlled biodegradable and biocompatible HDTMPA modified Mg might bode well for next generation bone implant application. © 2014 Wiley Periodicals, Inc.

  3. The efficacy of an extended scope physiotherapy clinic in paediatric orthopaedics.

    LENUS (Irish Health Repository)

    O Mir, Marie

    2016-04-01

    The demand for paediatric orthopaedic care is growing, and providing the service required is an increasingly challenging task. Physiotherapist-led triage clinics are utilised in adult orthopaedics to enable the provision of care to patients who may not require a surgical consult. The Physiotherapy Orthopaedic Triage Clinic (POTC) was established in Our Lady\\'s Children\\'s Hospital Crumlin in response to increasing demands on the paediatric orthopaedic service. The clinic is run by physiotherapists working in an advanced practice role (APP), and is the first paediatric clinic of its type and scale in the Republic of Ireland.

  4. Basic research on maxillofacial implants

    Energy Technology Data Exchange (ETDEWEB)

    Matsui, Yoshiro [Showa Univ., Tokyo (Japan). School of Dentistry

    2001-11-01

    Osseointegrated implants have begun to be used not only in general practice in dentistry but also in various clinical situations in the maxillofacial region. The process has yielded three problems: the spread of application, new materials and diagnostic methods, and management for difficult situations. This paper presents basic data and clinical guidelines for new applications, it investigates the characteristics of the materials and the usefulness of a new diagnostic method, and it studies effective techniques for difficult cases. The results obtained are as follows: Investigations into the spreading application. The lateral and superior orbital rim have sufficient bone thickness and width for the implant body to be placed. Osseointegrated implants, especially by the fixed bridge technique, are not recommended in the craniofacial bone and jaws of young children. Implant placement into bone after/before irradiation must be performed in consideration of impaired osteogenesis, the decrease of trabecular bone, and the time interval between implantation and irradiation. Investigations into materials and diagnostic methods. Hydroxyapatite-coated and titanium implants should be selected according to the characteristics of the materials. A dental simulating soft may also be applicable in the craniofacial region. Investigations into the management of difficult cases. Hyperbaric oxygen therapy (HBO), bone morphogenetic protein (BMP), and tissue engineering should be useful for improving the quality and increasing the quantity of bone where implants are placed. Soft tissue around implants placed in the reconstructed area should be replaced with mucosal tissue. The data obtained here should be useful for increasing the efficiency of osseointegrated implants, but further basic research is required in the future. (author)

  5. Basic research on maxillofacial implants

    International Nuclear Information System (INIS)

    Matsui, Yoshiro

    2001-01-01

    Osseointegrated implants have begun to be used not only in general practice in dentistry but also in various clinical situations in the maxillofacial region. The process has yielded three problems: the spread of application, new materials and diagnostic methods, and management for difficult situations. This paper presents basic data and clinical guidelines for new applications, it investigates the characteristics of the materials and the usefulness of a new diagnostic method, and it studies effective techniques for difficult cases. The results obtained are as follows: Investigations into the spreading application. The lateral and superior orbital rim have sufficient bone thickness and width for the implant body to be placed. Osseointegrated implants, especially by the fixed bridge technique, are not recommended in the craniofacial bone and jaws of young children. Implant placement into bone after/before irradiation must be performed in consideration of impaired osteogenesis, the decrease of trabecular bone, and the time interval between implantation and irradiation. Investigations into materials and diagnostic methods. Hydroxyapatite-coated and titanium implants should be selected according to the characteristics of the materials. A dental simulating soft may also be applicable in the craniofacial region. Investigations into the management of difficult cases. Hyperbaric oxygen therapy (HBO), bone morphogenetic protein (BMP), and tissue engineering should be useful for improving the quality and increasing the quantity of bone where implants are placed. Soft tissue around implants placed in the reconstructed area should be replaced with mucosal tissue. The data obtained here should be useful for increasing the efficiency of osseointegrated implants, but further basic research is required in the future. (author)

  6. Ion implantation: an annotated bibliography

    International Nuclear Information System (INIS)

    Ting, R.N.; Subramanyam, K.

    1975-10-01

    Ion implantation is a technique for introducing controlled amounts of dopants into target substrates, and has been successfully used for the manufacture of silicon semiconductor devices. Ion implantation is superior to other methods of doping such as thermal diffusion and epitaxy, in view of its advantages such as high degree of control, flexibility, and amenability to automation. This annotated bibliography of 416 references consists of journal articles, books, and conference papers in English and foreign languages published during 1973-74, on all aspects of ion implantation including range distribution and concentration profile, channeling, radiation damage and annealing, compound semiconductors, structural and electrical characterization, applications, equipment and ion sources. Earlier bibliographies on ion implantation, and national and international conferences in which papers on ion implantation were presented have also been listed separately

  7. Progress in application of magnesium alloys in the implanted medical devices%镁合金在植入医疗器械中的应用进展

    Institute of Scientific and Technical Information of China (English)

    范仲雄; 智丽丽; 郭富强; 侯振清

    2015-01-01

    Magnesium alloys have been a hotspot in the field of implanted medical devices due to their biodegradable absorbability, excellent mechanical properties and good biocompatibility.The reduction in their rapid corrosion rates becomes the key to the application of implant medical device materials.In this paper, the latest research progress and the existing problems of magnesium alloys as the material for implantation of medical devices in the fracture internal fixation, bone tissue porous scaffold, and cardiovascular stent are reviewed.Improving corrosion resistant of magnesium alloys by means of alloying, improving purity, surface modification,rapid solidification, deformation processing, non crystallization and preparation of nano alloy technology in body fluid are expounded, and research direction and application prospect of magnesium alloys in the field of implanted medical devices are also expected.%镁合金因具有可降解吸收性、优良的力学性能和生物相容性等优点成为植入医疗器械领域的研究热点,降低镁合金过快的腐蚀速度成为其作为植入医疗器械材料应用的关键.综述了镁合金作为植入医疗器械材料在骨折内固定件、骨组织多孔支架和心血管支架等方面应用的最新研究进展及存在的问题,阐述了通过合金化、提高纯度、表面改性、快速凝固、变形加工、非晶化和制备纳米合金等方法提高镁合金材料耐体液腐蚀性能,并展望了镁合金在植入医疗器械领域中的研究方向和应用前景.

  8. Development of Osseointegrated Implants for Soldier Amputees Following Orthopaedic Extremity Trauma

    Science.gov (United States)

    2008-08-01

    6321625021,725 65(3257 180%(5 6 6(&85,7<&/$66,),&$7,212) E7(/(3+21(180%(5 ,QFOXGHDUHDFRGH Table of Contents ...before surgery) to reduce bacterial activity in the rumen . To determine baseline skin, nose, and throat flora, swabs were obtained from these...0.5-5% to effect) in oxygen. A rumen tube was placed as needed to control regurgitation. Lactated Ringer’s solution was administered via the IV

  9. Inhibition of Orthopaedic Implant Infections by Immunomodulatory Effects of Host Defense Peptides

    Science.gov (United States)

    2014-12-01

    Microbiol. 2004;2:497–504. 16. Franchi L, Munoz-Planillo R, Nunez G. Sensing and reacting to microbes through the inflammasomes. Nat Immunol. 2012;13... Global challenge of multidrug-resistant Acinetobacter bau- mannii. Antimicrob Agents Chemother. 2007;51:3471–3484. 34. Pribaz JR, BernthalNM,Billi F

  10. Detection, prevention and direct post-operative intervention in orthopaedic implant infection

    NARCIS (Netherlands)

    Maathuis, Patrick Gerardus Maria

    2007-01-01

    In modern medicine, biomaterials are increasingly used to support or restore human body function. A biomaterial can be defined as man-made material designed to interact with living tissue or with body fluid. Joint prostheses, heart valves, external fixator pins, catheters, and contact lenses can all

  11. Evaluation of measures to decrease intra-operative bacterial contamination in orthopaedic implant surgery

    NARCIS (Netherlands)

    Knobben, BAS; van Horn, [No Value; van der Mei, HC; Busscher, HJ

    The aim of this study was to evaluate whether behavioural and systemic measures wilt decrease intra-operative contamination during total hip or knee replacements. The influence of these measures on subsequent prolonged wound discharge, superficial surgical site infection and deep periprosthetic

  12. Hip Implant Systems

    Science.gov (United States)

    ... Implants and Prosthetics Metal-on-Metal Hip Implants Hip Implants Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Hip implants are medical devices intended to restore mobility ...

  13. Breast reconstruction - implants

    Science.gov (United States)

    Breast implants surgery; Mastectomy - breast reconstruction with implants; Breast cancer - breast reconstruction with implants ... harder to find a tumor if your breast cancer comes back. Getting breast implants does not take as long as breast reconstruction ...

  14. Metallic implants and exposure to radiofrequency radiation

    International Nuclear Information System (INIS)

    Joyner, K.H.; Fleming, A.H.F.; MacFarlane, I.P.; Hocking, B.

    1988-01-01

    There is increasing use of radiofrequency radiation (RFR) in industry for communications, welding, security, radio, medicine, navigation etc. It has been recognised for some years that RFR may interact with cardiac pacemakers and steps have been taken to prevent this interference. It is less well recognised that other metallic implants may also act as antennas in an RFR field and possibly cause adverse health effects by heating local tissues. There are a large and increasing number of implants having metal components which may be found in RFR workers. These implants include artificial joints, rods and plates used in orthopaedics, rings in heart valves, wires in sutures, bionic ears, subcutaneous infusion systems and (external) transdermal drug delivery patches 1 . The physician concerned with job placement of such persons requires information on the likelihood of an implant interacting with RFR so as to impair health. The following outlines the approach developed in Telecom Australia, beginning with the general principles and then presenting a specific example discussion of a specific example

  15. Computer aided planning of orthopaedic surgeries: the definition of generic planning steps for bone removal procedures.

    Science.gov (United States)

    Putzer, David; Moctezuma, Jose Luis; Nogler, Michael

    2017-11-01

    An increasing number of orthopaedic surgeons are using computer aided planning tools for bone removal applications. The aim of the study was to consolidate a set of generic functions to be used for a 3D computer assisted planning or simulation. A limited subset of 30 surgical procedures was analyzed and verified in 243 surgical procedures of a surgical atlas. Fourteen generic functions to be used in 3D computer assisted planning and simulations were extracted. Our results showed that the average procedure comprises 14 ± 10 (SD) steps with ten different generic planning steps and four generic bone removal steps. In conclusion, the study shows that with a limited number of 14 planning functions it is possible to perform 243 surgical procedures out of Campbell's Operative Orthopedics atlas. The results may be used as a basis for versatile generic intraoperative planning software.

  16. Engineering complex orthopaedic tissues via strategic biomimicry.

    Science.gov (United States)

    Qu, Dovina; Mosher, Christopher Z; Boushell, Margaret K; Lu, Helen H

    2015-03-01

    The primary current challenge in regenerative engineering resides in the simultaneous formation of more than one type of tissue, as well as their functional assembly into complex tissues or organ systems. Tissue-tissue synchrony is especially important in the musculoskeletal system, wherein overall organ function is enabled by the seamless integration of bone with soft tissues such as ligament, tendon, or cartilage, as well as the integration of muscle with tendon. Therefore, in lieu of a traditional single-tissue system (e.g., bone, ligament), composite tissue scaffold designs for the regeneration of functional connective tissue units (e.g., bone-ligament-bone) are being actively investigated. Closely related is the effort to re-establish tissue-tissue interfaces, which is essential for joining these tissue building blocks and facilitating host integration. Much of the research at the forefront of the field has centered on bioinspired stratified or gradient scaffold designs which aim to recapitulate the structural and compositional inhomogeneity inherent across distinct tissue regions. As such, given the complexity of these musculoskeletal tissue units, the key question is how to identify the most relevant parameters for recapitulating the native structure-function relationships in the scaffold design. Therefore, the focus of this review, in addition to presenting the state-of-the-art in complex scaffold design, is to explore how strategic biomimicry can be applied in engineering tissue connectivity. The objective of strategic biomimicry is to avoid over-engineering by establishing what needs to be learned from nature and defining the essential matrix characteristics that must be reproduced in scaffold design. Application of this engineering strategy for the regeneration of the most common musculoskeletal tissue units (e.g., bone-ligament-bone, muscle-tendon-bone, cartilage-bone) will be discussed in this review. It is anticipated that these exciting efforts will

  17. Engineering Complex Orthopaedic Tissues via Strategic Biomimicry

    Science.gov (United States)

    Qu, Dovina; Mosher, Christopher Z.; Boushell, Margaret K.; Lu, Helen H.

    2014-01-01

    The primary current challenge in regenerative engineering resides in the simultaneous formation of more than one type of tissue, as well as their functional assembly into complex tissues or organ systems. Tissue-tissue synchrony is especially important in the musculoskeletal system, whereby overall organ function is enabled by the seamless integration of bone with soft tissues such as ligament, tendon, or cartilage, as well as the integration of muscle with tendon. Therefore, in lieu of a traditional single-tissue system (e.g. bone, ligament), composite tissue scaffold designs for the regeneration of functional connective tissue units (e.g. bone-ligament-bone) are being actively investigated. Closely related is the effort to re-establish tissue-tissue interfaces, which is essential for joining these tissue building blocks and facilitating host integration. Much of the research at the forefront of the field has centered on bioinspired stratified or gradient scaffold designs which aim to recapitulate the structural and compositional inhomogeneity inherent across distinct tissue regions. As such, given the complexity of these musculoskeletal tissue units, the key question is how to identify the most relevant parameters for recapitulating the native structure-fun