Journal articles on the topic 'Orthopaedic device development'
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Kennedy, Darragh G., Aoife M. O’Mahony, Eamonn P. Culligan, Caitriona M. O’Driscoll, and Katie B. Ryan. "Strategies to Mitigate and Treat Orthopaedic Device-Associated Infections." Antibiotics 11, no. 12 (December 15, 2022): 1822. http://dx.doi.org/10.3390/antibiotics11121822.
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Orthopaedic device implants play a crucial role in restoring functionality to patients suffering from debilitating musculoskeletal diseases or to those who have experienced traumatic injury. However, the surgical implantation of these devices carries a risk of infection, which represents a significant burden for patients and healthcare providers. This review delineates the pathogenesis of orthopaedic implant infections and the challenges that arise due to biofilm formation and the implications for treatment. It focuses on research advancements in the development of next-generation orthopaedic medical devices to mitigate against implant-related infections. Key considerations impacting the development of devices, which must often perform multiple biological and mechanical roles, are delineated. We review technologies designed to exert spatial and temporal control over antimicrobial presentation and the use of antimicrobial surfaces with intrinsic antibacterial activity. A range of measures to control bio-interfacial interactions including approaches that modify implant surface chemistry or topography to reduce the capacity of bacteria to colonise the surface, form biofilms and cause infections at the device interface and surrounding tissues are also reviewed.
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Szeverényi, Csenge, and Marcell Varga. "Orthopaedic relevance of baby carrying." Orvosi Hetilap 154, no. 30 (July 2013): 1172–79. http://dx.doi.org/10.1556/oh.2013.29673.
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Recently, various ways of carrying a baby have become popular again. Different methods and options of infant carrying are largely influenced by current fashion trends. The term of baby carrying refers to carrying the infant close to the caregiver’s body with special devices, which aid attachment parenting. The authors often face the question in the pediatric orthopedic clinic: what kind of carrying method to recommend to the parents. In this article the authors briefly present the different means of carrying devices and they review the literature regarding orthopedic consequences of baby carrying. For the healthy development of a child, position and correct support of the hips and the spine are essential, whereas the carrier’s spinal protection is also an important aspect. After reviewing the literature, the authors conclude that baby carrying with an adequate device has advantages from orthopaedic point of view. Orv. Hetil., 2013, 154, 1172–1179.
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Hofmann, G. O., F. D. Wagner, and T. Hackhofer. "Biodegradable polymer device in orthopaedic surgery — Development of new implant designs." Journal of Biomechanics 27, no. 6 (January 1994): 833. http://dx.doi.org/10.1016/0021-9290(94)91422-2.
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Scialla, Stefania, Giorgia Martuscelli, Francesco Nappi, Sanjeet Singh Avtaar Singh, Adelaide Iervolino, Domenico Larobina, Luigi Ambrosio, and Maria Grazia Raucci. "Trends in Managing Cardiac and Orthopaedic Device-Associated Infections by Using Therapeutic Biomaterials." Polymers 13, no. 10 (May 12, 2021): 1556. http://dx.doi.org/10.3390/polym13101556.
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Over the years, there has been an increasing number of cardiac and orthopaedic implanted medical devices, which has caused an increased incidence of device-associated infections. The surfaces of these indwelling devices are preferred sites for the development of biofilms that are potentially lethal for patients. Device-related infections form a large proportion of hospital-acquired infections and have a bearing on both morbidity and mortality. Treatment of these infections is limited to the use of systemic antibiotics with invasive revision surgeries, which had implications on healthcare burdens. The purpose of this review is to describe the main causes that lead to the onset of infection, highlighting both the biological and clinical pathophysiology. Both passive and active surface treatments have been used in the field of biomaterials to reduce the impact of these infections. This includes the use of antimicrobial peptides and ionic liquids in the preventive treatment of antibiotic-resistant biofilms. Thus far, multiple in vivo studies have shown efficacious effects against the antibiotic-resistant biofilm. However, this has yet to materialize in clinical medicine.
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Anderson, William D., Sydney L. M. Wilson, and David W. Holdsworth. "Development of a Wireless Telemetry Sensor Device to Measure Load and Deformation in Orthopaedic Applications." Sensors 20, no. 23 (November 27, 2020): 6772. http://dx.doi.org/10.3390/s20236772.
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Due to sensor size and supporting circuitry, in-vivo load and deformation measurements are currently restricted to applications within larger orthopaedic implants. The objective of this study is to repurpose a commercially available low-power, miniature, wireless, telemetric, tire-pressure sensor (FXTH87) to measure load and deformation for future use in orthopaedic and biomedical applications. The capacitive transducer membrane was modified, and compressive deformation was applied to the transducer to determine the sensor signal value and the internal resistive force. The sensor package was embedded within a deformable enclosure to illustrate potential applications of the sensor for monitoring load. To reach the maximum output signal value, sensors required compressive deformation of 350 ± 24 µm. The output signal value of the sensor was an effective predictor of the applied load on a calibrated plastic strain member, over a range of 35 N. The FXTH87 sensor can effectively sense and transmit load-induced deformations. The sensor does not have a limit on loads it can measure, as long as deformation resulting from the applied load does not exceed 350 µm. The proposed device presents a sensitive and precise means to monitor deformation and load within small-scale, deformable enclosures.
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Salie, Faatiema, Kylie de Jager, Carsten Dreher, and Tania S. Douglas. "The scientific base for orthopaedic device development in South Africa: spatial and sectoral evolution of knowledge development." Scientometrics 119, no. 1 (February 23, 2019): 31–54. http://dx.doi.org/10.1007/s11192-019-03041-y.
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Sirivisoot, Sirinrath, and Thomas J. Webster. "Nanotechnology Enabled In Situ Orthopaedic Sensors for Personalized Medicine." Advances in Science and Technology 86 (September 2012): 40–50. http://dx.doi.org/10.4028/www.scientific.net/ast.86.40.
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Although improvements have been made in implant design to increase bone formation and promote successful osseointegration using nanotechnology, the clinical diagnosis of early bone growth surrounding implants remains problematic. The development of a device allowing doctors to monitor the healing cascade and to diagnose potential infection or inflammation is necessary. Biological detection can be examined by the electrochemical analysis of electron transfer (or redox) reactions of extracellular matrix proteins involved in bone deposition and resorption. The use of nanomaterials as signal amplifiers in electrochemical sensors has greatly improved the sensitivity of detection. Nanotechnology-enabled electrochemical sensors that can be placed on the implant surface itself show promise as self-diagnosing devices in situ, possibly to detect new bone growth surrounding the implant and other cellular events to ensure implant success.
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Persaud-Sharma, Dharam, and Anthony McGoron. "Biodegradable Magnesium Alloys: A Review of Material Development and Applications." Journal of Biomimetics, Biomaterials and Tissue Engineering 12 (February 2012): 25–39. http://dx.doi.org/10.4028/www.scientific.net/jbbte.12.25.
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Magnesium Based Alloys Possess a Natural Ability to Biodegrade due to Corrosion when Placed within Aqueous Substances, which Is Promising for Cardiovascular and Orthopaedic Medical Device Applications. these Materials Can Serve as a Temporary Scaffold when Placed in Vivo, which Is Desirable for Treatments when Temporary Supportive Structures Are Required to Assist in the Wound Healing Process. the Nature of these Materials to Degrade Is Attributed to the High Oxidative Corrosion Rates of Magnesium. in this Review, a Summary Is Presented for Magnesium Material Development, Biocorrosion Characteristics, as Well as a Biological Translation for these Results.
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Bettoni, Elisa, Giorgio Ferriero, Hadeel Bakhsh, Elisabetta Bravini, Giuseppe Massazza, and Franco Franchignoni. "A systematic review of questionnaires to assess patient satisfaction with limb orthoses." Prosthetics and Orthotics International 40, no. 2 (November 26, 2014): 158–69. http://dx.doi.org/10.1177/0309364614556836.
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Background:Assessment of patient satisfaction with orthosis is a key point for clinical practice and research, requiring questionnaires with robust psychometric properties.Objectives:To identify which validated questionnaires are used to investigate patient satisfaction with orthosis in limb orthotics and to analyse (1) their main fields of clinical application, (2) the orthosis-related features analysed by the questionnaires and (3) the strength of their psychometric properties.Study design:Systematic review.Methods:A literature search using MEDLINE (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus databases for original articles published within the last 20 years was performed.Results:A total of 106 papers pertaining to various clinical fields were selected. The main features of patient satisfaction with orthosis analysed were as follows: aesthetic, ease in donning and doffing the device, time of orthotic use and comfort.Conclusion:Of the questionnaires used to investigate patient satisfaction with orthosis, only four are adequately validated for this purpose: two for generic orthotic use (Quebec User Evaluation of Satisfaction with assistive Technology 2.0 and Client Satisfaction with Device of Orthotics and Prosthetic Users’ Survey) and two for specific application with orthopaedic shoes (Questionnaire for the Usability Evaluation of orthopaedic shoes and Monitor Orthopaedic Shoes). Further development, refinement and validation of outcome measures in this field are warranted.Clinical relevanceGiven the importance of analysing patient satisfaction with orthosis (PSwO), appropriate instruments to assess outcome are needed. This article reviews the currently available instruments and reflects on how future studies could be focused on the development, refinement and validation of outcome measures in this field.
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Riva, Giuseppe. "Virtual Reality In Paraplegia: A Test Bed Applicationn." International Journal of Virtual Reality 5, no. 1 (January 1, 2001): 146–56. http://dx.doi.org/10.20870/ijvr.2001.5.1.2676.
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The paper presents an overview of the ergonomic/design issues of a VR-enhanced orthopaedic appliance to be used in rehabilitation of patients with Spinal Cord Injury. First, some design considerations are described and an outline of aims which the tool should pursue are given. Finally, the design issues are described focusing both on the development of a test-bed rehabilitation device and on the description of a preliminary study detailing the use of the device with a long-term SCI patient. The basis for this approach is that physical therapy and motivation are crucial for maintaining flexibility and muscle strength and for reorganizing the nervous system after SCIs.
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Skerlavaj, Barbara, and Gerard Boix-Lemonche. "The Potential of Surface-Immobilized Antimicrobial Peptides for the Enhancement of Orthopaedic Medical Devices: A Review." Antibiotics 12, no. 2 (January 19, 2023): 211. http://dx.doi.org/10.3390/antibiotics12020211.
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Due to the well-known phenomenon of antibiotic resistance, there is a constant need for antibiotics with novel mechanisms and different targets respect to those currently in use. In this regard, the antimicrobial peptides (AMPs) seem very promising by virtue of their bactericidal action, based on membrane permeabilization of susceptible microbes. Thanks to this feature, AMPs have a broad activity spectrum, including antibiotic-resistant strains, and microbial biofilms. Additionally, several AMPs display properties that can help tissue regeneration. A possible interesting field of application for AMPs is the development of antimicrobial coatings for implantable medical devices (e.g., orthopaedic prostheses) to prevent device-related infection. In this review, we will take note of the state of the art of AMP-based coatings for orthopaedic prostheses. We will review the most recent studies by focusing on covalently linked AMPs to titanium, their antimicrobial efficacy and plausible mode of action, and cytocompatibility. We will try to extrapolate some general rules for structure–activity (orientation, density) relationships, in order to identify the most suitable physical and chemical features of peptide candidates, and to optimize the coupling strategies to obtain antimicrobial surfaces with improved biological performance.
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Shubkin, V. N., R. R. Gatiatulin, T. V. Boldireva, and V. M. Myasoedov. "Evolution of surgical management for scoliosis with endocorrectors." N.N. Priorov Journal of Traumatology and Orthopedics 3, no. 1 (March 15, 1996): 10–12. http://dx.doi.org/10.17816/vto64060.
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The stages of the development of surgical treatment for scoliosis with endocorrectors in traumatologic and orthopaedic Clinic of Krasnoyarsk Medical Academy are retraced. The treatment method with use of perfected design of Rodnyansky-Gupalov endocorrector is described. It is shown that new device allows to avoid the majority complications that occur when previously endocorrectors have been used as well as to preserve the achieved deformity correction at longterm follow up after operation. The data on 59 patients with II-III degree scoliosis are presented.
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Nicholson, Thomas, Lauren Davis, Edward T. Davis, Matthew Newton Ede, Aaron Scott, and Simon W. Jones. "e-Cigarette Vapour Condensate Reduces Viability and Impairs Function of Human Osteoblasts, in Part, via a Nicotine Dependent Mechanism." Toxics 10, no. 9 (August 28, 2022): 506. http://dx.doi.org/10.3390/toxics10090506.
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Cigarette consumption negatively impacts bone quality and is a risk-factor for the development of multiple bone associated disorders, due to the highly vascularised structure of bone being exposed to systemic factors. However, the impact on bone to electronic cigarette (e-cigarette) use, which contains high doses of nicotine and other compounds including flavouring chemicals, metal particulates and carbonyls, is poorly understood. Here, we present the first evidence demonstrating the impact of e-cigarette vapour condensate (replicating changes in e-cigarette liquid chemical structure that occur upon device usage), on human primary osteoblast viability and function. 24 h exposure of osteoblasts to e-cigarette vapour condensate, generated from either second or third generation devices, significantly reduced osteoblast viability in a dose dependent manner, with condensate generated from the more powerful third generation device having greater toxicity. This effect was mediated in-part by nicotine, since exposure to nicotine-free condensate of an equal concentration had a less toxic effect. The detrimental effect of e-cigarette vapour condensate on osteoblast viability was rescued by co-treatment with the antioxidant N-Acetyl-L-cysteine (NAC), indicating toxicity may also be driven by reactive species generated upon device usage. Finally, non-toxic doses of either second or third generation condensate significantly blunted osteoblast osteoprotegerin secretion after 24 h, which was sustained for up to 7 days. In summary we demonstrate that e-cigarette vapour condensate, generated from commonly used second and third generation devices, can significantly reduce osteoblast viability and impair osteoblast function, at physiologically relevant doses. These data highlight the need for further investigation to inform users of the potential risks of e-cigarette use on bone health, including, accelerating bone associated disease progression, impacting skeletal development in younger users and to advise patients following orthopaedic surgery, dental surgery, or injury to maximise bone healing.
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Chan, Chester, Edward Sihler, Theresa Kijek, Bruce S. Miller, and Richard E. Hughes. "A MOBILE COMPUTING TOOL FOR COLLECTING CLINICAL OUTCOMES DATA FROM SHOULDER PATIENTS." Journal of Musculoskeletal Research 13, no. 03 (September 2010): 127–36. http://dx.doi.org/10.1142/s0218957710002521.
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The collection of outcomes data is critical for conducting clinical studies in orthopaedic surgery. Both subjective outcome data [e.g. Short Form-12 (SF-12) and Western Ontario Rotator Cuff (WORC) index] and objective data (e.g. range of motion) are necessary. Numerous studies have been conducted on the collection of patient survey data through electronic means (e.g. personal digital assistant and tablet PC), but none of these studies have made use of a device with an intuitive touch-screen interface. Studies have also been conducted on the collection of physical examination data through research-grade accelerometers but few have focused on the use of commercially available electronic devices. The goal of our project was to develop a mobile computing touch-screen system for capturing subjective and objective outcome data for the assessment of patients with rotator cuff tears. We were able to accomplish this goal through the development of a novel iPad/iPod Touch tool. Intra-rater and inter-rater reliability of shoulder flexion and external rotation measurements were good.
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Schulz, Arndt P., Nils Reimers, Felix Wipf, Michel Vallotton, Serena Bonaretti, Nina Kozic, Mauricio Reyes, and Benjamin J. Kienast. "Evidence Based Development of a Novel Lateral Fibula Plate (VariAx Fibula) Using a Real CT Bone Data Based Optimization Process During Device Development." Open Orthopaedics Journal 6, no. 1 (January 19, 2012): 1–7. http://dx.doi.org/10.2174/1874325001206010001.
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Development of novel implants in orthopaedic trauma surgery is based on limited datasets of cadaver trials or artificial bone models. A method has been developed whereby implants can be constructed in an evidence based method founded on a large anatomic database consisting of more than 2.000 datasets of bones extracted from CT scans. The aim of this study was the development and clinical application of an anatomically pre-contoured plate for the treatment of distal fibular fractures based on the anatomical database. 48 Caucasian and Asian bone models (left and right) from the database were used for the preliminary optimization process and validation of the fibula plate. The implant was constructed to fit bilaterally in a lateral position of the fibula. Then a biomechanical comparison of the designed implant to the current gold standard in the treatment of distal fibular fractures (locking 1/3 tubular plate) was conducted. Finally, a clinical surveillance study to evaluate the grade of implant fit achieved was performed. The results showed that with a virtual anatomic database it was possible to design a fibula plate with an optimized fit for a large proportion of the population. Biomechanical testing showed the novel fibula plate to be superior to 1/3 tubular plates in 4-point bending tests. The clinical application showed a very high degree of primary implant fit. Only in a small minority of cases further intra-operative implant bending was necessary. Therefore, the goal to develop an implant for the treatment of distal fibular fractures based on the evidence of a large anatomical database could be attained. Biomechanical testing showed good results regarding the stability and the clinical application confirmed the high grade of anatomical fit.
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Dichio, Giancarlo, Michele Calì, Mara Terzini, Giovanni Putame, Elisabetta Maria Zanetti, Piero Costa, and Alberto Luigi Audenino. "Engineering and Manufacturing of a Dynamizable Fracture Fixation Device System." Applied Sciences 10, no. 19 (September 29, 2020): 6844. http://dx.doi.org/10.3390/app10196844.
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The present work illustrates the dynamization of an orthopaedic plate for internal fracture fixation which is thought to shorten healing times and enhance the quality of the new formed bone. The dynamization is performed wirelessly thanks to a magnetic coupling. The paper shows the peculiarities of the design and manufacturing of this system: it involves two components, sliding with respect to each other with an uncertain coefficient of friction, and with a specific compounded geometry; there are stringent limits on component size, and on the required activation energy. Finally, the device belongs to medical devices and, as such, it must comply with the respective regulation (EU 2017/745, ASTM F382). The design of the dynamizable fracture fixation plate has required verifying the dynamic of the unlocking mechanism through the development of a parametric multibody model which has allowed us to fix the main design variables. As a second step, the fatigue strength of the device and the static strength of the whole bone-plate system was evaluated by finite element analysis. Both analyses have contributed to defining the final optimized geometry and the constitutive materials of the plate; finally, the respective working process was set up and its performance was tested experimentally on a reference fractured femur. As a result of these tests, the flexural stiffness of the bone-plate system resulted equal to 370 N/mm, while a maximum bending moment equal to 75.3 kN·mm can be withstood without plate failure. On the whole, the performance of this dynamic plate was proved to be equal or superior to those measured for static plates already on the market, with excellent clinical results. At the same time, pre-clinical tests will be an interesting step of the future research, for which more prototypes are now being produced.
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Portan, Diana V., Despina D. Deligianni, George C. Papanicolaou, Vassilis Kostopoulos, Georgios C. Psarras, and Minos Tyllianakis. "Combined Optimized Effect of a Highly Self-Organized Nanosubstrate and an Electric Field on Osteoblast Bone Cells Activity." BioMed Research International 2019 (March 21, 2019): 1–8. http://dx.doi.org/10.1155/2019/7574635.
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The effect of an electric field within specific intensity limits on the activity of human cells has been previously investigated. However, there are a considerable number of factors that influence the in vitro development of cell populations. In biocompatibility studies, the nature of the substrate and its topography are decisive in osteoblasts bone cells development. Further on, electrical field stimulation may activate biochemical paths that contribute to a faster, more effective self-adjustment and proliferation of specific cell types on various nanosubstrates. Within the present research, an electrical stimulation device has been manufactured and optimum values of parameters that led to enhanced osteoblasts activity, with respect to the alkaline phosphatase and total protein levels, have been found. Homogeneous electric field distribution induced by a highly organized titanium dioxide nanotubes substrate had an optimum effect on cell response. Specific substrate topography in combination with appropriate electrical stimulation enhanced osteoblasts bone cells capacity to self-adjust the levels of their specific biomarkers. The findings are of importance in the future design and development of new advanced orthopaedic materials for hard tissue replacement.
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Schlégl, Ádám Tibor, Kinga Szuper, Szabolcs Somoskeöy, and Péter Than. "Evaluation of the usefulness of the EOS 2D/3D system for the measurement of lower limbs anatomical and biomechanical parameters in children." Orvosi Hetilap 155, no. 43 (October 2014): 1701–12. http://dx.doi.org/10.1556/oh.2014.30009.
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Introduction: Lower limbs anatomical and biomechanical parameters are essential in several paediatric orthopaedic disease, which makes their exact measurement necessary. Aim: The aim of the author was to evaluate the reliability of the EOS 2D/3D System, a 3D reconstruction capable imaging device in children. Method: 3D reconstructions were performed in 523 cases aged between 2 and 16 years in whom no abnormality influencing lower limbs biomechanics was observed. For statistical analysis intraclass correlation, paired-samples t-test, Spearman-correlation and Welch-test were used. Results: Excellent results were found for all parameters in reliability test used by the operator. The step-forward position used during the examination influenced the sagittal tibiofemoral angle only. All examined parameters showed significant correlation with age and gender. Height correlated with neck-shaft angle, hip-knee shift, femoral and tibial torsion only. Conclusions: The EOS technology proved to be an appropriate method to measure lower limbs anatomical parameters in children. Changes in these parameters during development correlated with age and gender. Orv., Hetil., 2014, 155(43), 1701–1711.
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Abramovic, Dusan, Radivoj Brdar, and Marko Vidosavljevic. "Closed reduction and percutaneous fixation offemoral neck fractures in children." Srpski arhiv za celokupno lekarstvo 132, suppl. 1 (2004): 72–76. http://dx.doi.org/10.2298/sarh04s1072a.
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Fracture of the femoral neck is a rare injury in children but remains difficult problem and challenge with high rate of complications. Having in mind recommendations of the American Academy of Orthopaedic Surgeons, our effort was to improve treatment approach. In the period 1999 to 2004, five patients, aged 5 to 14 years, were treated by closed reduction and percutaneous pinning. All patients sustained high energy trauma and displaced femoral neck fractures, out of which two were transcervical, two cervicotrochanteric and one intertrochanteric. Procedures were performed under image amplifier. Hip decompression was achieved by needle aspiration via a subadductor approach. Three smooth Kirschner wires appeared to be stable and least aggressive fixation device, easy for applying and subsequent removal. We insisted on urgent treatment, anatomic alignment, stabile fixation and hip decompression. Excellent results were obtained in four patients who had undergone immediate treatment. Poor outcome with vascular necrosis in a five-year-old girl was attributed to five-day treatment delay. Suggested treatment, simple and applicable in practice, is aimed at reducing pathologic mechanisms crucial for development of complications.
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Popkov, A. V., L. A. Grebenyuk, G. N. Filimonova, and D. A. Popkov. "Anatomic and Functional Characteristics of Muscles at Transosseous Distraction Osteosynthesis (clinics, experiment - facts, hypothesis)." N.N. Priorov Journal of Traumatology and Orthopedics 11, no. 3 (September 15, 2004): 67. http://dx.doi.org/10.17816/vto200411367.
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Analysis of clinical and experimental data related to biomechanical, functional and morphological changes of skeletal muscles in surgical crus lengthening by transosseous distraction osteosynthesis was presented. It was electrophysiological proved that muscle activity decreased starting from the first days of lengthening while muscle tonus significantly increased. Sonography showed that muscle bands reoriented parallel to distraction forces. In fixation period local thickening of muscle bands was detected. After device removal muscle structure and muscle conractivity of the lengthened segment restored. Morphological studies showed that during distraction the volumetrical density of connective tissue in muscles increased and simultaneously destruction and reparative regeneration of muscle fibers were noticed. It was shown that after single-step compression of bone regenerate, stroma-parenchyma relationship was shifted to parenchyma. Active training of muscles was stipulated because inner tension of the muscles prevented the development of destructive processes, stimulated regeneration of muscles fibers. All those processes made up the base for functional rehabilitation of loco-motor system both in patients with orthopaedic pathology and in healthy subjects at surgical increasing of height with cosmetic purpose.
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Samokhin, A. G., Yu N. Kozlova, E. A. Fyodorov, and V. V. Pavlov. "Prospective for the Development of Infectious Complications Prevention Methods after Large Joints Arthroplasty." Vestnik travmatologii i ortopedii imeni N.N. Priorova, no. 4 (December 30, 2017): 62–66. http://dx.doi.org/10.32414/0869-8678-2017-4-62-66.
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The review gives the characteristics of the general status of the problem of infection in the zone of surgical intervention including the field of traumatology and orthopaedics. The shortcomings of antibiotic use and methods of their local delivery for surgical and orthopaedic needs are considered. The conception of local use of antibacterial agents and the requirements for the current “ideal” antibacterial agent are given. Classification of the local antibiotic delivery systems on the basis of their physicochemical properties is presented as well as the number of prospective methods for the prevention of microorganisms’ adhesion on the surface of the implanted devices and systems that could be used in traumatology and orthopaedics are examined.
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Samokhin, Aleksandr G., Yu N. Kozlova, E. A. Fyodorov, and V. V. Pavlov. "Prospective for the development of infectious complications prevention methods after large joints arthroplasty." N.N. Priorov Journal of Traumatology and Orthopedics 24, no. 4 (December 15, 2017): 62–66. http://dx.doi.org/10.17816/vto201724462-66.
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The review gives the characteristics of the general status of the problem of infection in the zone of surgical intervention including the field of traumatology and orthopaedics. The shortcomings of antibiotic use and methods of their local delivery for surgical and orthopaedic needs are considered. The conception of local use of antibacterial agents and the requirements for the current “ideal” antibacterial agent are given. Classification of the local antibiotic delivery systems on the basis of their physicochemical properties is presented as well as the number of prospective methods for the prevention of microorganisms’ adhesion on the surface of the implanted devices and systems that could be used in traumatology and orthopaedics are examined.
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Hamati, Mary C., Atlee Witt, Michaele Francesco Corbisiero, Michael Tuffiash, and Kenneth J. Hunt. "Tracking Patient Reported Outcomes in Orthopaedic Surgical Patients at a Single Institution." Foot & Ankle Orthopaedics 7, no. 1 (January 2022): 2473011421S0022. http://dx.doi.org/10.1177/2473011421s00225.
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Category: Ankle; Other Introduction/Purpose: As the American healthcare system evolves into a value-based reimbursement model, emphasis on tracking and reporting healthcare outcomes has expounded. Patient reported outcome Measures (PROMs) are exceedingly valuable to orthopedists as a means to measure improvement and satisfy regulatory requirements. The NIH Patient-Reported Outcomes Measurement Information System (PROMIS) surveys are favored due to their accessibility, efficiency, and minimal floor and ceiling effects. Furthermore, they have been shown to predict outcomes after orthopedic surgeries. Psychosocial factors have also become increasingly important in predicting surgical outcomes. We aim to report the development and implementation of an institutional PRO data collection platform, including PRO completion rates and improvements in PROs for patients undergoing orthopaedic surgery. Methods: We implemented a secure, HIPAA compliant, automated and EHR integrated, institutional platform to collect PROMs using a cloud-based tool. Patients undergoing surgery by sports medicine and foot and ankle surgeons were included and organized into four surgical pathways: (1) foot and ankle, (2) sports-knee, (3) sports-hip, and (4) sports-shoulder. PROMIS Physical Function (PF), PROMIS Pain interference (PI), site-specific (foot and ankle, knee, hip, and shoulder) Single Assessment Numeric Evaluation (SANE), and the brief resiliency scale (BRS) were collected at the patient's pre-operative visit. The PROMIS and SANE surveys were again collected at 3-, 6-, and 12-month post-operative visits. Surveys were disseminated automatically and patients were able to complete PROMs onsite on secure tablets or remotely through their personal device. Primary outcomes included compliance rates, baseline PRO scores, and change in scores at the various post-operative timepoints for patients in the four surgical pathways. Results: More than 6,000 patients were included, with majority of patients from the sports-knee (47%), followed by sports- shoulder (27%), foot and ankle (23%), and sports-hip (4%) pathways. Average completion rate was highest at the pre-operative timepoint for all pathways (81%), with completion rates of 62% at 50% at 6 months and 45% at 12MO. Compliance rates were lowest highest in the foot and ankle pathway at 12 months (62%). Average baseline scores for all patients were 40.8 for PROMIS PF, 61.1 PROMIS PI, 41 SANE, and 3.9 for BRS. Baseline scores didn't significantly vary between the surgical pathways. Scores improved for all patient pathways at all timepoints for PROMIS PF, PI and SANE PROMs (Table 1). No workflow disruptions were noted for survey administration. Conclusion: Tracking PROs using an automated platform is feasible in orthopaedic clinics. Compliance rates are very good and dependent on provider, staff, and patient buy-in. Patients undergoing surgery had an average baseline PROMIS PI scores >=1 standard deviation from the normal population and all scores improved after surgery. Importantly, statistical significance doesn't always reflect minimum clinically important differences (MCIDs). MCIDs for PROMIS PF and PI have been reported to fall between 5-10 points depending on range of values and methods of calculation. Further investigation into outcomes by procedure type and patient factors is warranted to identify predictive factors of surgical outcomes.
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Lin, Denise, Enrica Papi, and Alison H. McGregor. "Exploring the clinical context of adopting an instrumented insole: a qualitative study of clinicians’ preferences in England." BMJ Open 9, no. 4 (April 2019): e023656. http://dx.doi.org/10.1136/bmjopen-2018-023656.
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ObjectivesThis study explores clinicians’ views of the clinical uptake of a smart pressure-sensing insole, named Flexifoot, to enhance the care and management of patients with osteoarthritis (OA). Clinicians are key users of wearable technologies, and can provide appropriate feedback for a specific device for successful clinical implementation.DesignQualitative study with in-depth, semi-structured interviews, analysed using inductive analysis to generate key themes.SettingConducted in a University setting.Participants30 clinicians were interviewed (11 physiotherapists, 11 orthopaedic surgeons, 5 general practitioners, 3 podiatrists).ResultsAll clinicians regarded Flexifoot to be useful for the care and management of patients in adjunction to current methods. Responses revealed four main themes: use, data presentation, barriers to use and future development. Flexifoot data were recognised as capable of enhancing information exchange between clinicians and patients, and also between clinicians themselves. Participants supported the use of feedback for rehabilitation, screening and evaluation of treatment progress/success purposes. Flexifoot use by patients was encouraged as a self-management tool that may motivate them by setting attainment goals. The data interface should be secure, concise and visually appealing. The measured parameters of Flexifoot, its duration of wear and frequency of data output would all depend on the rationale for its use. The clinicians and patients must collaborate to optimise the use of Flexifoot for long-term monitoring of disease for patient care in clinical practice. Many identified potential other uses for Flexifoot.ConclusionsClinicians thought that Flexifoot may complement and improve current methods of long-term patient management for OA or other conditions in clinical settings. Flexifoot was recognised to be useful for objective measures and should be tailored carefully for each person and condition to maximise compliance. Adopting the device, and other similar technologies, requires reducing the main barriers to use (time, cost, patient compliance) before its successful implementation.
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Biggs, M. J. P., R. G. Richards, S. McFarlane, C. D. W. Wilkinson, R. O. C. Oreffo, and M. J. Dalby. "Adhesion formation of primary human osteoblasts and the functional response of mesenchymal stem cells to 330 nm deep microgrooves." Journal of The Royal Society Interface 5, no. 27 (March 18, 2008): 1231–42. http://dx.doi.org/10.1098/rsif.2008.0035.
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The surface microtexture of an orthopaedic device can regulate cellular adhesion, a process fundamental in the initiation of osteoinduction and osteogenesis. Advances in fabrication techniques have evolved to include the field of surface modification; in particular, nanotechnology has allowed for the development of experimental nanoscale substrates for investigation into cell nanofeature interactions. Here primary human osteoblasts (HOBs) were cultured on ordered nanoscale groove/ridge arrays fabricated by photolithography. Grooves were 330 nm deep and either 10, 25 or 100 μm in width. Adhesion subtypes in HOBs were quantified by immunofluorescent microscopy and cell–substrate interactions were investigated via immunocytochemistry with scanning electron microscopy. To further investigate the effects of these substrates on cellular function, 1.7 K gene microarray analysis was used to establish gene regulation profiles of mesenchymal stem cells cultured on these nanotopographies. Nanotopographies significantly affected the formation of focal complexes (FXs), focal adhesions (FAs) and supermature adhesions (SMAs). Planar control substrates induced widespread adhesion formation; 100 μm wide groove/ridge arrays did not significantly affect adhesion formation yet induced upregulation of genes involved in skeletal development and increased osteospecific function; 25 μm wide groove/ridge arrays were associated with a reduction in SMA and an increase in FX formation; and 10 μm wide groove/ridge arrays significantly reduced osteoblast adhesion and induced an interplay of up- and downregulation of gene expression. This study indicates that groove/ridge topographies are important modulators of both cellular adhesion and osteospecific function and, critically, that groove/ridge width is important in determining cellular response.
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Lübbeke, Anne, James A. Smith, Daniel Prieto-Alhambra, and Andrew J. Carr. "The case for an academic discipline of medical device science." EFORT Open Reviews 6, no. 3 (March 2021): 160–63. http://dx.doi.org/10.1302/2058-5241.6.200094.
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Medical devices are a very important but largely under-recognized and fragmented component of healthcare. The limited regulation of the past and the lack of systematic rigorous evaluation of devices leading to numerous high-profile failures will now be replaced by stricter legal requirements and more transparent evaluation processes. This constitutes an unprecedented opportunity, but it also uncovers urgent needs in landscaping, methodology development, and independent comprehensive assessment of device risks and benefits for individual patients and society, especially in the context of increasingly complex devices. We argue that an academic discipline of ‘medical device science’ is well placed to lead and coordinate the efforts necessary to achieve much needed improvement in the medical device sector. Orthopaedics and traumatology could contribute and benefit considerably as one of the medical specialties with the highest use of medical devices. Cite this article: EFORT Open Rev 2021;6:160-163. DOI: 10.1302/2058-5241.6.200094
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Izzo, R., A. A. Diano, and M. Muto. "Biomechanics of the Spine." Rivista di Neuroradiologia 15, no. 6 (December 2002): 715–26. http://dx.doi.org/10.1177/197140090201500609.
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Biomechanics of the spine is a vast area of research that has generated numerous studiesin recent years on the part of doctors (mainly orthopaedic surgeons), bioengineers and physicists. This paper is a short introduction to some of the topics of major interest in spine biomechanics. The first topic is the development of the spine with a “mechanical” explanation of the physiological curvatures. As the spine is a multiarticular complex structure, understanding the mechanism responsible for its dynamics requires in-depth knowledge of the spine's basic components: the vertebrae and their architecture, the intervertebral joints, the ligaments and muscles. A short morphofunctional description of each of these anatomical parts is given mentioning their biomechanical features. Of particular interest, in relation to spinal trauma, is the architecture of the cancellous bone of the vertebrae responsible for most resistance to compressive weight loads. This specific characteristic is gradually lost over the years either due to disease or to a progressive resorption of the horizontal lamellae and thinning of the vertical columns typical of osteoporosis. Numerous studies have been conducted in vivo and in vitro to shed light on the mechanisms leading to particular traumatic lesions or degenerative arthrosis. These have given rise to various theories formulated to account for the distribution of loads and strength in the elements making up the functional spinal unit. These theories include the old “two vertical columns” theory, subsequently replaced by the “three columns theory”, and the latest “four columns” model which divides the spine longitudinally depending on carrying strength. The latest theory was formulated in the wake of in vivo CT studies using an axial loading device which allows axial loads to be applied even though patients are in a supine position. A short mention is made of the possible biomechanical applications of neuroradiological techniques, namely cine-MR scans, which allow detailed study of the ligaments, muscles and disc, especially the cervical spine under dynamic conditions. Lastly, the controversial concept of spinal stability and instability is discussed. Further studies are necessary to establish appropriate criteria for treatment of traumatic or degenerative lesions since an impairment to spine statics can result in permanent neurological damage.
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Feerick, Emer M., and Patrick J. McGarry. "Using Computational Simulation for Analysis and Development of Next-generation Orthopaedic Devices." Journal of the American Academy of Orthopaedic Surgeons 21, no. 7 (July 2013): 440–42. http://dx.doi.org/10.5435/00124635-201307000-00010.
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Feerick, E. M., and J. P. McGarry. "Using Computational Simulation for Analysis and Development of Next-generation Orthopaedic Devices." Journal of the American Academy of Orthopaedic Surgeons 21, no. 7 (June 30, 2013): 440–42. http://dx.doi.org/10.5435/jaaos-21-07-440.
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Galonsky, Vladislav, El'vira Surdo, Vladimir Chernov, Maria Mirzoeva, and Anisat Karnaeva. "DIGITAL TECHNOLOGIES IN ORTHOPAEDIC DENTISTRY: THE MODERN STATE OF THE ART IN RUSSIA. THE STAGES OF EVOLUTION IN DEVELOPMENT AND PERFECTION OF TECHNOLOGIES FOR DENTURE MANUFACTURING (A LITERATURE REVIEW)." Actual problems in dentistry 18, no. 1 (May 17, 2022): 5–18. http://dx.doi.org/10.18481/2077-7566-22-18-1-5-18.
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Subject. The possibilities provided by digital technology in clinical practice of orthopaedic dentistry in Russia is being quite successfully integrated into activity of healthcare facilities, which makes it possible to optimise diagnostic and treatment processes as well as to increase the competitiveness in the market of medical services including the international level. The main stages of evolution and perfection of technologies for denture manufacturing have been considered with detailed characterisation of the corresponding advantages and disadvantages of the developed technologies. The main directions for perfection of these processes based on digital technology have been determined, structural components of these advanced technologies, their advantages and development methods in modern conditions have been described.
The aim of the study. To study and analyse the modern development of digital technology in clinical practice of orthopaedic dentistry applied in Russia.
Materials and methods. The study was carried out based on the search and analysis of original articles on the issues in development and perfection of digital technologies in clinical practice in the ELIBRARY, PubMed and Cyberleninka databases. A total of 73 sources have been analysed (52 Russian and 21 foreign papers).
Conclusion. The use of modern digital possibilities in dentistry with application of computed tomography scanners, intraoral and extraoral scanning devices as well as innovative software integrating the obtained diagnostic data into practical implementation of subtractive and additive technologies in the process of manufacturing orthopaedic dental constructions occupies a certain niche within practical activity of dentists. The evolution of technologies for manufacturing of orthopaedic dental constructions has a vast and rich history. Each of the developed technologies has made a great scientific and practical clinical contribution to the development of orthopaedic dentistry. In modern conditions, the most promising digital technologies in clinical practice of orthopaedic dentistry from the standpoint of scientific and technical progress are additive technologies.
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DeFroda, Steven F., Joseph A. Gil, Brad D. Blankenhorn, and Alan H. Daniels. "Variability in Foot and Ankle Case Volume in Orthopaedic Residency Training." Foot & Ankle Specialist 10, no. 6 (January 16, 2017): 531–37. http://dx.doi.org/10.1177/1938640016687371.
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Surgical case volume during orthopaedic surgical residency is a concern among trainees and program directors alike. With an ongoing trend toward further subspecialization and the rapid development of new techniques and devices, the breadth of procedures that residents are exposed to continues to increase. Accreditation Council for Graduate Medical Education surgical case logs from 2009 to 2013 for graduating orthopaedic surgery residents were examined to assess the national averages of orthopaedic procedures logged by graduating orthopaedic surgery residents in the leg/ankle and foot/toes categories. This investigation revealed that there was an 8% increase in the total number of leg/ankle cases and 12% increase in foot/toes cases performed by graduating orthopaedic surgery residents, which has not significantly increased from 2009 to 2013. Across years examined in this study, significant variability existed between the 10th and 90th percentiles for total foot and ankle resident case exposure (P < .05), particularly within ankle arthroscopy, where there was a 15-fold difference in the number of arthroscopy cases performed by residents in the 90th percentile compared with the 10th percentile. The overall volume of foot and ankle cases performed by graduating orthopaedic surgery residents has increased despite not being statistically significantly from 2009 to 2013. Levels of Evidence: Level III: Cohort study
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Wiechert, Bernd Udo. "Applied Biomechanics: Prosthetic and Orthopaedics." Proceeding International Conference on Science and Engineering 1 (October 31, 2017): xiii. http://dx.doi.org/10.14421/icse.v1.315.
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Biomechanics is closely related to engineering, because it often uses traditional engineering sciences to analyze biological systems. Some simple applications of Newtonian mechanics and/or materials sciences can supply correct approximations to the mechanics of many biological systems. Applied mechanics, most notably mechanical engineering disciplines such as continuum mechanics, mechanism analysis, structural analysis, kinematics and dynamics play prominent roles in the study of biomechanics. Usually biological systems are much more complex than man-built systems. Numerical methods are hence applied in almost every biomechanical study. Research is done in an iterative process of hypothesis and verification, including several steps of modeling, computer simulation and experimental measurements. Prosthetics and orthotics are clinical disciplines that deal with artificial limbs (prostheses) for people with amputations and supportive devices (orthoses) for people with musculoskeletal weakness or neurological disorders and some disability person. The development of prosthetics and orthotics disciplines is depend on development of science and engineering. The understanding of this multidiscipline field is important the advancement in this field. In this session i will overview the current development in prosthetics and orthotics field, expl ain a brief survey on its method, and discuss perspective for future trend and development.
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Fraser, Alan G., Rob G. H. H. Nelissen, Per Kjærsgaard-Andersen, Piotr Szymański, Tom Melvin, and Paul Piscoi. "Improved clinical investigation and evaluation of high-risk medical devices: the rationale and objectives of CORE–MD (Coordinating Research and Evidence for Medical Devices)." EFORT Open Reviews 6, no. 10 (October 2021): 839–49. http://dx.doi.org/10.1302/2058-5241.6.210081.
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In the European Union (EU), the delivery of health services is a national responsibility but there are concerted actions between member states to protect public health. Approval of pharmaceutical products is the responsibility of the European Medicines Agency, while authorising the placing on the market of medical devices is decentralised to independent ‘conformity assessment’ organisations called notified bodies. The first legal basis for an EU system of evaluating medical devices and approving their market access was the Medical Device Directive, from the 1990s. Uncertainties about clinical evidence requirements, among other reasons, led to the EU Medical Device Regulation (2017/745) that has applied since May 2021. It provides general principles for clinical investigations but few methodological details – which challenges responsible authorities to set appropriate balances between regulation and innovation, pre- and post-market studies, and clinical trials and real-world evidence. Scientific experts should advise on methods and standards for assessing and approving new high-risk devices, and safety, efficacy, and transparency of evidence should be paramount. The European Commission recently awarded a Horizon 2020 grant to a consortium led by the European Society of Cardiology and the European Federation of National Associations of Orthopaedics and Traumatology, that will review methodologies of clinical investigations, advise on study designs, and develop recommendations for aggregating clinical data from registries and other real-world sources. The CORE–MD project (Coordinating Research and Evidence for Medical Devices) will run until March 2024. Here, we describe how it may contribute to the development of regulatory science in Europe. Cite this article: EFORT Open Rev 2021;6:839-849. DOI: 10.1302/2058-5241.6.210081
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Vucetic, Cedomir, Borislav Dulic, Sonja Vuckovic, Milica Prostran, Zoran Todorovic, Zorica Nesic, and Radan Stojanovic. "Antibiotics in the prevention of the surgical site infection in orthopedic surgery." Acta chirurgica Iugoslavica 50, no. 4 (2003): 123–28. http://dx.doi.org/10.2298/aci0304123v.
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Surgical site infection is an actual problem of orthopaedic surgery. Despite considerable efforts that have been done during last several decades (e.g. improvements in surgical techniques, preoperative preparation of the surgical site, infection-control practice, use of preventive antibiotics) surgical site infection still affects about 0,5-2% of patients after closed fracture surgery or insertion of prosthetic devices. They are associated with substantial morbidity and mortality. The adherence to the principles of rationale preventive antibiotic therapy has an important role in the prevention of the surgical infection. In addition, it is well known that inappropriate use of antibiotic promote development of resistance, superinfections and increase the cost of the treatment. This paper focuses on the basic principles of rational use of antibiotics, i.e. appropriate selection of drug, dose, and duration of treatment in the prevention of surgical site infections in orthopaedic surgery.
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Garrido-Ardila, Elisa Maria, Berta Caro-Puertolas, Maria Jiménez-Palomares, Jesús Montanero-Fernández, Trinidad Rodríguez-Domínguez, and Juan Rodríguez-Mansilla. "Orthopaedic Disorders in Cerebral Palsy in International Cooperation Projects: A Descriptive Cross-Sectional Study." International Journal of Environmental Research and Public Health 18, no. 15 (July 25, 2021): 7872. http://dx.doi.org/10.3390/ijerph18157872.
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Background: In international cooperation projects that are carried out in less developed and developing countries, a large number of children with disabilities present cerebral palsy (CP). Orthopaedic disorders are frequent complications associated with this disorder. Their prevention and early intervention are essential to achieve an appropriate therapeutic approach for children with PC and to improve their quality of life. Objective: To describe the treatment approach that is currently used in international cooperation projects for the rehabilitation management of the orthopaedic disorders in children with cerebral palsy. Methods: This is an observational, descriptive, cross-sectional study, carried out by means of an online questionnaire to professionals in the field of Physiotherapy and Rehabilitation working in international cooperation projects. The inclusion criteria were professionals working in the rehabilitation field in development aid, humanitarian action or emergency projects that provided rehabilitation services, working with children with cerebral palsy from 0 to 18 years old. Results: Ninety-eight questionnaires were analysed. The average age of the participants was 33.2 years, they were mainly working in development cooperation projects (83.33%) that were implemented in rehabilitation centres and through community-based rehabilitation services (60%). The projects were located in countries all over the world but mainly on the Asian continent (71.4%). Physiotherapists and orthopaedic technicians (72.22%) were the main professionals working in these projects, followed by occupational therapists and social workers (55.56%). The results indicated that the orthopaedic disorders were very frequent in the sample (66.67%), with hip subluxation (50%), scoliosis (77.78%), kyphosis (61.1%), clubfoot (88.7%) and varus foot (61.11%) standing out. The most commonly used treatment approaches were positioning (88.89%) and the Bobath concept (83.33%). The technical aids that were used by the professionals were ankle foot orthosis (AFO) (94.44%), bracing (66.67%), standing frames (83.33%), moulded seats (100%), corner seats (93.75%) and adapted seats (92.85%). Conclusions: In international cooperation projects, the rehabilitation treatment of children with cerebral palsy is based on a holistic approach. This is reflected in the interventions that are carried out to treat their orthopaedic disorders and in locally produced devices, awareness raising and community education. However, the professionals surveyed considered that the aids or orthoses used are insufficient in the treatment and prevention of orthopaedic disorders in cerebral palsy.
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Cho, Woojin, Alan Varkey Job, Jing Chen, and Jung Hwan Baek. "A Review of Current Clinical Applications of Three-Dimensional Printing in Spine Surgery." Asian Spine Journal 12, no. 1 (February 28, 2018): 171–77. http://dx.doi.org/10.4184/asj.2018.12.1.171.
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<p>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.</p>
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Barrios-Muriel, Jorge, Francisco Javier Alonso Sánchez, David Rodríguez Salgado, and Francisco Romero-Sánchez. "A new methodology to identify minimum strain anatomical lines based on 3-D digital image correlation." Mechanical Sciences 8, no. 2 (November 16, 2017): 337–47. http://dx.doi.org/10.5194/ms-8-337-2017.
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Abstract. Today there is continuous development of wearable devices in various fields such as sportswear, orthotics and personal gadgets, among others. The design of these devices involves the human body as a support environment. Based on this premise, the development of wearable devices requires an improved understanding of the skin strain field of the body segment during human motion. This paper presents a methodology based on a three dimensional digital image correlation (3D-DIC) system to measure the skin strain field and to estimate anatomical lines with minimum deformation as design criteria for the aforementioned wearable devices. The errors of displacement and strain measurement related to 3-D reconstruction and out-of-plane motion are investigated and the results are acceptable in the case of large deformation. This approach can be an effective tool to improve the design of wearable devices in the clinical orthopaedics and ergonomics fields, where comfort plays a key role in supporting the rehabilitation process.
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Shitoev, I. D., S. V. Muravev, Yu V. Karakulova, V. I. Pecherskiy, V. N. Nikitin, and G. Z. Kloyan. "Evolution of optical diagnosis of spinal deformity. Methods and future development (literature review)." Genij Ortopedii 28, no. 5 (October 2022): 734–44. http://dx.doi.org/10.18019/1028-4427-2022-28-5-734-744.
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Introduction Diagnosis of spinal deformities in children and adolescents is important for continuous development of modern traumatology and orthopaedics. Methods of optical diagnosis of scoliosis and postural disorders have been rapidly improving along with optical and digital assessment technologies over the past centuries and required a structural analysis of the accumulated data. The purpose was to explore clinical and technical aspects of optical diagnosis of spinal deformities. Material and methods The original literature search was conducted on key resources including the National Library of Medicine (PubMed) and Scientific Electronic eLibrary. The search depth was 10 years. Results The article presents a review of the methods historically developed in optical diagnosis of spinal deformities. Major methods and systems of optical diagnosis presented included moire topography, the ISIS system, modern methods of computer optical topography (raster stereography) photogrammetric methods used in clinical medicine and in trauma and orthopaedics. Characteristics of the methods and systems are described with advantages and disadvantages discussed. The article reports evaluated accuracy, reliability and reproducibility of optical diagnostic methods. The article presents the latest information about the possibilities of introducing technology for assessing spinal deformity using modern personal telecommunication devices. Conclusion The evolution of modern trends in optical diagnosis of spinal deformity is important for medicine to facilitate safety, greater accuracy, ease of operation, digitalization and development of the Internet of Medical Things.
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Umranikar, Salil A., Sarvpreet S. Ubee, Masilamani Selvan, and Peter Cooke. "Barbed suture tissue closure device in urological surgery – a comprehensive review." Journal of Clinical Urology 10, no. 5 (April 7, 2017): 476–84. http://dx.doi.org/10.1177/2051415817702315.
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The development and implementation of barbed sutures has transformed the technique of tissue closure with increasing application across multiple surgical disciplines. Changes in design and handling such as the introduction of absorbable and non-absorbable bidirectional barbed sutures reflect an increasing applicability in tissues of varying qualities. We undertook a comprehensive review of available literature to provide an evidence-based rationale for the clinical use of barbed suture tissue closure devices. We summarise uses along with advantages and disadvantages reported across a number of surgical specialties such as urology, orthopaedics, gynaecology and plastic surgery. Tangible benefits noted were faster closure speed, maintenance of suture integrity, improved efficiency in closure, avoidance of knots and possibly a cost-benefit effect. In terms of complications, the barbed sutures compared equally with standard sutures with no significant differences. In conclusion, barbed sutures have demonstrated versatility and safety across surgical specialties and compares favourably with standard sutures. There appears to be an increasing popularity in the use of barbed sutures with clear advantages to both surgeon and patient.
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Nag, Dharmaraj. "A Comparative Study on Functional Outcomes of Fixed Versus Adjustable Length-Loop Device for Femoral Fixation of Graft in Anterior Cruciate Ligament Reconstruction." Odisha Journal of Orthopaedics and Trauma 3, no. 1 (2022): 44–49. http://dx.doi.org/10.13107/ojot.2022.v03i01.033.
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Background: ACL injury is one of the most common injuries of knee among high level athletes and also common in young and non-sports people. Intra-articular anatomical ACL reconstruction (ACLR) with a biologic graft has become the gold standard for the treatment of ACL tear. The use of the semitendinosus and gracilis (STG) tendons is becoming the choice method in anterior cruciate ligament (ACL) reconstruction. Cortical suspensory fixation is the current preferred Femoral fixation method & is in wide-spread use. Cortical suspension device available in two varieties – 1. Fixed Loop-Length device (FLD) e.g. Endobutton; 2. Adjustable Loop-Length device (ALD) e.g. Tightrope, Toggleloc, ZipLoop. We conducted this prospective study to find out which device fared better in terms of functional outcomes and laxity measurements at a final follow up of 1 year. Study design: prospective study Material and methods: This is prospective study conducted in the PG Department of Orthopaedics in S.C.B medical college & hospital from June 2018 to February 2020. There were 53 patients included in our study. All patients presenting with history of trauma to the knee in the Orthopaedics emergency and outpatient departments in SCB Medical College were evaluated by a thorough general and local examination of the knee. Routine radiographs in antero-posterior view and lateral view of the affected knee were taken. MRI of the knee was done in all suspected ACL torn cases for confirmation. Patients who have chosen to undergo ACL repair surgery are then randomly selected and allocated to two groups, group 1 are the patients operated with fixed loop suspension devices and group 2 patients are operated with adjustable loop suspension devices. All patients underwent ACLR with 4 strand, autologous hamstring grafts and fixed in the tibial side with a bio-degradable interference screw. Study center: SCB medical college &hospital, Cuttack between June 2018- February 2020. Results: Tegner Lysholm Score shows no difference between both the groups at any point of time. At last follow up of 12 months the Tegner Lysholm score was 93.05±4.04 in Fixed loop group and 92.81±2.96 in Adjustable Loop group. The difference is not significant at 3 months, 6 months and 12 months with p values 0.726, 0.572 and 0.805 respectively. KOOS Score for pain shows no difference between both the groups at any point of time. At last follow up of 12 months the KOOS score for pain was 91.86±3.73 in Fixed loop group and 91.79±3.46 in Adjustable Loop group. The difference is not significant at 3 months, 6 months and 12 months with p values 0.545, 0.490 and 0.949 respectively. KOOS Score for symptoms shows no difference between both the groups at any point of time. At last follow up of 12 months the KOOS score for symptoms was 95.90±3.73 in Fixed loop group and 96.16±3.46 in Adjustable Loop group. The difference is not significant at 3 months, 6 months and 12 months with p values 0.968, 0.626 and 0.797 respectively. KOOS Score for Activities for Daily Living shows no difference between both the groups at any point of time. At last follow up of 12 months the KOOS score for activities for daily living was 91.59±2.49 in Fixed loop group and 91.22±1.99 in Adjustable Loop group. The difference is not significant at 3 months, 6 months and 12 months with p values 0.757, 0.566 and 0.549 respectively. KOOS Score for sports and recreations shows no difference between both the groups at any point of time. At last follow up of 12 months the KOOS score for pain was 85.00±6.54 in Fixed loop group and 85.65±7.15 in Adjustable Loop group. The difference is not significant at 3 months, 6 months and 12 months with p values 0.545, 0.781 and 0.739 respectively. KOOS Score for quality of life shows no difference between both the groups at any point of time. At last follow up of 12 months the KOOS score for pain was 86.64±9. 10 in Fixed loop group and 88.30±7.17 in Adjustable Loop group. The difference is not significant at 3 months, 6 months and 12 months with p values 0.876, 0.790 and 0.462 respectively. Conclusions: Arthroscopic ACL reconstruction using fixed loop or adjustable loop suspensory devices are equally effective fixation alternatives. It gives equal functional outcome in both cases, in terms of Tegner-Lysholm score & Knee-injury & Osteoarthritis Outcomes Score. Proper technique with appropriate tunnel positioning are the main factors of ACL reconstruction. Although many in vitro studies have shown that adjustable loop devices are biomechanically inferior to fixed loop devices, previous clinical studies as well as our study fail to corroborate this. The logical step forward would be to conduct well designed Randomized Control Trials comparing the two devices. Until further evidence clearly shows the superiority of one device over the other, it can be expected to yield similar results. Keywords: ACL reconstruction, Adjustable length loop device, Fixed loop device
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Kutepov, S. M., and S. V. Gulnazarova. "To the history of the method of transosseous osteosynthesis in the Middle Urals." Genij Ortopedii 27, no. 3 (June 2021): 307–12. http://dx.doi.org/10.18019/1028-4427-2021-27-3-307-312.
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Background The article reviews the history of the study, development and application of the method of transosseous osteosynthesis in the Middle Urals. G.A. Ilizarov first presented his device and the results of its use in fracture repair at a meeting of the Trauma and Orthopedic Scientific Society in Sverdlovsk in December 1952. The report was met with great interest. Prof. F.R. Bogdanov invited him to conduct research on bone regeneration during compression osteosynthesis at the Ural Research Institute for Trauma and Orthopaedics. The work initiated by G.A. Ilizarov and V.I. Stetsula gave rise to a large and longterm research on transosseous osteosynthesis at the Institute. The study focused on regeneration of bone, muscles, blood vessels and nerves, development and justification of compression-distraction osteosynthesis in fractures, limb shortening, nonunions, bone deformities, severe injuries to the pelvis, spine and spinal cord. Basic research was conducted to explore the role of the blood system and immune reactions involved in bone formation during limb lengthening. Material and methods Databases of scientific works and technical solutions registered with authorship certificates and patents of the USSR and the Russian Federation by fellow workers of the VOSKHITO, SNIITO, the Ural Research Institute for Trauma and Orthopaedics, the holdings of the Institute's scientific archive facility were used for the article. The search depth is 68 years. Results The Ural V.D. Chaklin Research Institute for Trauma and Orthopaedics has been studying and using the method of G.A. Ilizarov for many years and has made a significant contribution through theoretical rationale, development of new technologies of transosseous osteosynthesis, introduction and spread of the techniques over the vast territory of the Middle Urals and neighboring regions. Conclusion Despite the fact that in the recent years, transosseous osteosynthesis has to a certain extent been replaced in Russia by modern techniques with constructs of internal osteosynthesis, but there is no alternative to the method of G.A. Ilizarov in the treatment of gunshot wounds, open fractures, polytrauma, extensive bone defects, achondroplasia and many other disorders of the musculoskeletal system.
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Cavalu, Simona. "Acrylic Bone Cements: New Insight and Future Perspective." Key Engineering Materials 745 (July 2017): 39–49. http://dx.doi.org/10.4028/www.scientific.net/kem.745.39.
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The history of acrylic bone cement comprise a long period of time, Sir John Charnley being considered the founder of modern artificial joint replacement, as he started to develop the cementing in the late 1950s. Acrylic bone cements (ACB) are polymer-ceramic composites based on polymethyl metacrylate (PMMA), widely used in orthopaedics as suture materials and fixation devices. The main features of these materials are: 1) biocompatibility and ability to support new bone growth (osteoconductive) and 2) bioactivity (ability to form a calcium phosphate layer on its surface). The main function of the cement is to serve as interfacial phase between the high modulus metallic implant and the bone, thereby assisting to transfer and distribute loads. During years of follow up, cemented prosthesis with acrylic bone cements (ABC) demonstrated a good primary fixation and load distribution between implant and bone, along with the advantage of fast recovery of the patient. However, several problems are still persisting, as the orthopedic acrylic bone cements have to meet several medical requirements, such as low values of maximum cure temperature in order to avoid thermal necrosis of the bone tissue during the setting time, appropriate setting time (so that cement does not cure too fast or too slowly) and high values of compressive strength in order to withstand the compressive loads involved by normal daily activities. Generally, the improvement mechanical properties can be realized in three directions: 1) by searching alternative material to PMMA acrylic bone cements; 2) chemical modification of PMMA; and 3) the reinforcement of PMMA by adding different bioactive particles, antimicrobials, vitamins. The aim of this rewiew is to explore the development of bone cements in the last decade, to highlight the role of bone cement additives with respect to mechanical properties and limitations of polymethylmethacrylate in orthopaedic surgery. The behavior of antibiotic-loaded bone cement is discussed, compared with other alternative additives including nanofillers, together with areas of research that are now open to explore new insights and applications of this well known biomaterial.
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Plazas Bonilla, Clara Eugenia, and Jairo Ernesto Perilla. "The past, present and near future of materials for use in biodegradable orthopaedic implants." Ingeniería e Investigación 31, no. 2 (May 1, 2011): 124–33. http://dx.doi.org/10.15446/ing.investig.v31n2.23471.
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The aim of bone replacement or fracture treatment methodologies is to induce tissue regeneration respecting anatomy and try to recover functionality. This goal was initially achieved in the 17th century by using animal or human grafts and several medical devices made of natural and synthetic materials are currently used having a whole range of chemical and physical properties. Research in this field continues to seek a solution to the disadvantages usually found when using grafts: immunological reactions, the risk of microbiological contamination, the absence of donors, the need for several surgical interventions and the risk of disease transmission. Basic and applied research must thus be carried out not only in the development of biology and studies about embryonic stem cells but also in the field of new material development. This tendency may be clearly detected by looking at the vast numbers of studies related to using metallic, polymer and ceramic materials and, at present, compound or hybrid materials having potential use in orthopaedic implants. Most of them fulfil conditions regarding biocompatibility and non-toxicity and could be considered when designing biodegradable materials thereby making it feasible to identify a range of research subjects on biomaterials. This paper starts by identifying material development periods and then establishes the advantages and disadvantages of groups which have been considered for bone regeneration and identifies some guidelines which should be taken into account in the field of biodegradable materials in the near future. There is still a long way to go in this subject, especially regarding the field of materials science and technology
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Tirosh, Oren, Phong Tran, Jesse Renouf, Nicholas Pergaminelis, Christa Noelle Purdie, Andy Ho, and Amy Gibbens. "PROMsBase: Web-based repository portal for patient-reported outcome measures in orthopaedics." Health Informatics Journal 25, no. 3 (August 25, 2017): 867–77. http://dx.doi.org/10.1177/1460458217725904.
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Patient-reported outcome measures lead to better communication and decision-making between clinicians and patients. Applying a web-based repository system for data collection was previously suggested, but such system is not available. This article introduces the development and implementation of a new web-based application, PROMsBase, in orthopaedics clinical practice. PROMsBase was developed using a web interface, allows access using both desktop and mobile devices. Between 2013 and 2016, a total of 3192 pre-surgery questionnaires were collected. In total, 238 patients completed their post-surgery questionnaire online from home. PROMsBase was well embedded into routine practice without disrupting clinical workflow and overloading clinicians’ and researchers’ workload. Tablets were not more useful and only 37 per cent of the patients completed the questionnaire online. PROMsBase provided a platform to easily collect and store data in clinical practice. If properly integrated, this could promote better care and communication between providers and patients.
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Childs, Benjamin, Mary Breslin, Anna Swetz, Mai Nguyen, Natasha Simske, Paul Whiting, Vasireddy Vasireddy, Eleanor Wilson, and Heather Vallier. "Use, Refine, Repeat: Implementation of a mobile application for patient education." Journal of Orthopaedic Business 2, no. 3 (July 1, 2022): 12–17. http://dx.doi.org/10.55576/job.v2i3.14.
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Objectives: To identify how implementation strategies impact adoption of a patient education application by orthopaedic trauma providers and patients. Design: Unstructured narrative interview and retrospective review Setting: Four Level 1 Trauma Centers Participants: Seven researchers responsible for enrolling orthopaedic trauma patients Intervention: Development and implementation of a mobile application (app) (http://bit.ly/traumaapp) for patient education regarding orthopaedic trauma at three hospital sites. Main outcome measurements: Unstructured narrative interviews were gathered from seven investigators (attendings n = 3, research personnel n = 4). Standard usage statistics were obtained from the google play and apple app stores including active users, time in app, user download geographic region. Download ratios were calculated from investigator logs of approaches and success. Results: In the 39 months between January 2017 to April 2020, there were 144 downloads by patients at the original center. In the three other centers added in October 2018, there were 404, 109, and 34 downloads over an 18-month period until April 2020. The mean number of downloads per center was 173±161. Quotes from unstructured narrative interviews by investigators described promotional materials as “effective” and the app as “easy to use” with “relevant content.” Additionally, all investigators reported that patients were able to find the app easily and that a majority of patients had devices capable of using the app. Four investigators report that they believe intentional provider interaction with the patient and app increased the download ratio, which ranged from 0.7% to 9.8% of all trauma admissions at each center. Active champions were referenced by all investigators as leading to increased downloads regardless of provider level of the champion. All centers struggled to influence providers beyond the study investigators to adopt the app. All investigators reported poor cell reception and problems with internet connection in hospitals as barriers to facilitating patient downloads. Conclusion: This study documents the successes and challenges of implementing patient education app for orthopaedic trauma patients presenting to four Level 1 trauma centers in the US and UK. At our institutions, downloads were driven by organizational champions at each center who actively promoted the app to patients using standard promotional materials. However, organizational challenges and unreceptive healthcare workers remain a challenge and adoption was not widespread among non-participant providers at each institution. Ultimately, our experience identified iteratively improving implementation strategies and empowering an organizational champion who can lead iterations of implementation, improve relevant technology, and prepare the organization for app adoption as strategies critical to our success. Level of Evidence: IV Keywords: Patient education, technology, mobile application, app, trauma, orthopaedic, champion, iteration, multicenter (J Ortho Business 2022; Volume 2, Issue 3:pages 12-17)
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Ahrendt, Dustin, and Arturo Romero Karam. "Development of a computer-aided engineering–supported process for the manufacturing of customized orthopaedic devices by three-dimensional printing onto textile surfaces." Journal of Engineered Fibers and Fabrics 15 (January 2020): 155892502091762. http://dx.doi.org/10.1177/1558925020917627.
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Today, additive manufacturing, also called three-dimensional printing, is used for producing prototypes as well as other products for various industrial sectors. Although this technology is already well established in the automotive, aviation and space travel, building, dental and medical sectors, its integration in the textile and ready-made industry is still in progress. At present, there is a lack of specific application scenarios for the combination of three-dimensional printing and textile materials, apart from fashion and shoe design. Hence, this article presents a digital computer-aided engineering–supported process to manufacture customized orthopaedic devices by three-dimensional printing directly onto a textile fabric. State-of-the-art fabrication methods for orthoses are typically labour intensive. The combination of three-dimensional scanning, computer-aided design modelling and three-dimensional printing onto textile materials open up new possibilities for producing custom-made products. After three-dimensional scanning of a patient’s individual body shape, the surface is prepared for constructing the textile pattern cuts by reverse engineering. The transformation of the designed three-dimensional patterns into two-dimensional is software supported. Additional positioning lines in accordance with specific body measurements are transferred onto the two-dimensional pattern cuts, which are then used as the basis for the design of the three-dimensional printed functional elements. Subsequently, the design is saved in STL (Standard Triangulation/Tessellation Language) file format, prepared by slicing and directly printed onto textile pattern cuts by means of fused deposition modelling. The last manufacturing step involves the assembly of the textile fabric. The proposed process is demonstrated by an example application scenario, thus proving its potential for industrial use in the textile and ready-made industry.
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Chen, Long, Xinyu Song, Fei Xing, Yanan Wang, Yuanzheng Wang, Zhiyu He, and Li Sun. "A Review on Antimicrobial Coatings for Biomaterial Implants and Medical Devices." Journal of Biomedical Nanotechnology 16, no. 6 (June 1, 2020): 789–809. http://dx.doi.org/10.1166/jbn.2020.2942.
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Biomaterial implants and medical devices have been utilized extensively in medical treatment with the development of modern medicine, especially in orthopaedics and stomatology. Along with their applications, biomaterial-associated infections (BAIs) have grown to be one of the main postoperative complications. Antimicrobial coating strategies have been reported to effectively inhibit bacterial adhesion and proliferation on implant surface, extending their lifespan. In this review, the most topical antimicrobial coating designs have been chosen from literature studies. Their antimicrobial mechanisms and antimicrobial activity assessments in literature studies have been presented and compared. Based on their active ingredients, antimicrobial coatings are categories into (i) inorganic agents, including Ag, Cu, ZnO, MoS2 and nitride compound; (ii) organic agents including antibiotic, antimicrobial peptides, polymer, essential oils etc. The review has provided various and detailed options of antimicrobial coating designs for consulting according to their specific application. It is noted that the research of antimicrobial coatings is mostly in vitro and in vivo animal models study. It is thus in need for more preclinical or clinical studies, especially finding the direct connection between the utilization of antimicrobial coated implants and the reduction in BAIs incidence. Furthermore, future antimicrobial coating designs shall respect also biocompatibility, functionality, and durability apart from their antimicrobial activity.
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Beers, Kimberly, Debashish Sur, and G. Bahar Basim. "Chemical Mechanical Surface Nano-Structuring (CMNS) Implementation on Titanium Based Implants to Enhance Corrosion Resistance and Control Biocompatibility." MRS Advances 5, no. 43 (2020): 2209–19. http://dx.doi.org/10.1557/adv.2020.325.
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AbstractTitanium is the metal of choice for many implantable devices including dental prostheses, orthopaedic devices and cardiac pacemakers. Titanium and its alloys are favoured for hard tissue replacement because of their high strength to density ratio providing excellent mechanical properties and biocompatible surface characteristics promoting in-vivo passivation due to spontaneous formation of a native protective oxide layer in the presence of an oxidizer. This study focuses on the development of a three-dimensional chemical, mechanical, surface nano-structuring (CMNS) process to induce smoothness or controlled nano-roughness on the bio-implant surfaces, particularly for applications in dental implants. CMNS is an extension of the chemical mechanical polishing (CMP) process. CMP is utilized in microelectronics manufacturing for planarizing the wafer surfaces to enable photolithography and multilayer metallization. In biomaterials applications, the same approach can be utilized to induce controlled surface nanostructure on three-dimensional implantable objects to promote or demote cell attachment. As a synergistic method of nano-structuring on the implant surfaces, CMNS also makes the titanium surface more adaptable for the bio-compatible coatings as well as the cell and tissue growth as demonstrated by the electrochemical and surface wettability evaluations on implants prepared by DI-water machining versus oil based machining.
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Ernst, Jennifer, Murat Tanyeli, Thomas Borchardt, Moses Ojugo, Andreas Helmke, Wolfgang Viöl, Arndt F. Schilling, and Gunther Felmerer. "Effect on healing rates of wounds treated with direct cold atmospheric plasma: a case series." Journal of Wound Care 30, no. 11 (November 2, 2021): 904–14. http://dx.doi.org/10.12968/jowc.2021.30.11.904.
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Objective: The response of different critical acute and hard-to-heal wounds to an innovative wound care modality—direct application of cold atmospheric plasma (CAP)—was investigated in this clinical case series. Method: Over an observation period of two years, acute wounds with at least one risk factor for chronification, as well as hard-to-heal wounds were treated for 180 seconds three times per week with CAP. CAP treatment was additional to standard wound care. Photographs were taken for wound documentation. The wound sizes before the first CAP treatment, after four weeks, after 12 weeks and at wound closure/end of observation time were determined using image processing software, and analysed longitudinally for the development of wound size. Results: A total of 27 wounds (19 hard-to-heal and eight acute wounds) with a mean wound area of 15cm2 and a mean wound age of 49 months were treated with CAP and analysed. All (100%) of the acute wounds and 68% of the hard-to-heal wounds healed after an average treatment duration of 14.2 weeks. At the end of the observation period, 21% of hard-to-heal wounds were not yet closed but were reduced in size by >80%. In 11% of the hard-to-heal wounds (n=2) therapy failed. Conclusion: The results suggested a beneficial effect of additional CAP therapy on wound healing. Declaration of interest: This work was carried out within the research projects ‘Plasma for Life’ (funding reference no. 13FH6I04IA) with financial support from the German Federal Ministry of Education and Research (BMBF). In the past seven years AFS has provided consulting services to Evonik and has received institutional support by Heraeus, Johnson & Johnson and Evonik. There are no royalties to disclose. The Department for Trauma Surgery, Orthopaedics and Plastic Surgery received charitable donations by CINOGY GmbH. CINOGY GmbH released the di_CAP devices and electrodes for the study. WV and AH were involved in the development of the used di_CAP device (Plasmaderm, CINOGY GmbH). WV is shareholder of the outsourced start-up company CINOGY GmbH.
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Evans, Samuel, Eric Jones, Peter Fox, and Chris Sutcliffe. "Photogrammetric analysis of additive manufactured metallic open cell porous structures." Rapid Prototyping Journal 24, no. 8 (November 12, 2018): 1380–91. http://dx.doi.org/10.1108/rpj-05-2017-0082.
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PurposeThis paper aims to introduce a novel method for the analysis of open cell porous components fabricated by laser-based powder bed metal additive manufacturing (AM) for the purpose of quality control. This method uses photogrammetric analysis, the extraction of geometric information from an image through the use of algorithms. By applying this technique to porous AM components, a rapid, low-cost inspection of geometric properties such as material thickness and pore size is achieved. Such measurements take on greater importance, as the production of porous additive manufactured orthopaedic devices increases in number, causing other, slower and more expensive methods of analysis to become impractical.Design/methodology/approachHere the development of the photogrammetric method is discussed and compared to standard techniques including scanning electron microscopy, micro computed tomography scanning and the recently developed focus variation (FV) imaging. The system is also validated against test graticules and simple wire geometries of known size, prior to the more complex orthopaedic structures.FindingsThe photogrammetric method shows an ability to analyse the variability in build fidelity of AM porous structures for use in inspection purposes to compare component properties. While measured values for material thickness and pore size differed from those of other techniques, the new photogrammetric technique demonstrated a low deviation when repeating measurements, and was able to analyse components at a much faster rate and lower cost than the competing systems, with less requirement for specific expertise or training.Originality/valueThe advantages demonstrated by the image-based technique described indicate the system to be suitable for implementation as a means of in-line process control for quality and inspection applications, particularly for high-volume production where existing methods would be impractical.