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1
Bernal-Torres, Mario G., Hugo I. Medellín-Castillo, and Juan C. Arellano-González. "Design and Control of a New Biomimetic Transfemoral Knee Prosthesis Using an Echo-Control Scheme." Journal of Healthcare Engineering 2018 (2018): 1–16. http://dx.doi.org/10.1155/2018/8783642.
Повний текст джерелаАнотація:
Passive knee prostheses require a significant amount of additional metabolic energy to carry out a gait cycle, therefore affecting the natural human walk performance. Current active knee prostheses are still limited because they do not reply with accuracy of the natural human knee movement, and the time response is relatively large. This paper presents the design and control of a new biomimetic-controlled transfemoral knee prosthesis based on a polycentric-type mechanism. The aim was to develop a knee prosthesis able to provide additional power and to mimic with accuracy of the natural human knee movement using a stable control strategy. The design of the knee mechanism was obtained from the body-guidance kinematics synthesis based on real human walking patterns obtained from computer vision and 3D reconstruction. A biomechanical evaluation of the synthesized prosthesis was then carried out. For the activation and control of the prosthesis, an echo-control strategy was proposed and developed. In this echo-control strategy, the sound side leg is sensed and synchronized with the activation of the knee prosthesis. An experimental prototype was built and evaluated in a test rig. The results revealed that the prosthetic knee is able to mimic the biomechanics of the human knee.
2
Eberly, Valerie J., Sara J. Mulroy, JoAnne K. Gronley, Jacquelin Perry, William J. Yule, and Judith M. Burnfield. "Impact of a stance phase microprocessor-controlled knee prosthesis on level walking in lower functioning individuals with a transfemoral amputation." Prosthetics and Orthotics International 38, no. 6 (October 17, 2013): 447–55. http://dx.doi.org/10.1177/0309364613506912.
Повний текст джерелаАнотація:
Background: For individuals with transfemoral amputation, walking with a prosthesis presents challenges to stability and increases the demand on the hip of the prosthetic limb. Increasing age or comorbidities magnify these challenges. Computerized prosthetic knee joints improve stability and efficiency of gait, but are seldom prescribed for less physically capable walkers who may benefit from them. Objective: To compare level walking function while wearing a microprocessor-controlled knee (C-Leg Compact) prosthesis to a traditionally prescribed non-microprocessor-controlled knee prosthesis for Medicare Functional Classification Level K-2 walkers. Study design: Crossover. Methods: Stride characteristics, kinematics, kinetics, and electromyographic activity were recorded in 10 participants while walking with non-microprocessor-controlled knee and Compact prostheses. Results: Walking with the Compact produced significant increase in velocity, cadence, stride length, single-limb support, and heel-rise timing compared to walking with the non-microprocessor-controlled knee prosthesis. Hip and thigh extension during late stance improved bilaterally. Ankle dorsiflexion, knee extension, and hip flexion moments of the prosthetic limb were significantly improved. Conclusions: Improvements in walking function and stability on the prosthetic limb were demonstrated by the K-2 level walkers when using the C-Leg Compact prosthesis. Clinical relevance Understanding the impact of new prosthetic designs on gait mechanics is essential to improve prescription guidelines for deconditioned or older persons with transfemoral amputation. Prosthetic designs that improve stability for safety and walking function have the potential to improve community participation and quality of life.
3
Wang, Xiaoming, Qiaoling Meng, Zhewen Zhang, Jinyue Sun, Jie Yang, and Hongliu Yu. "Design and evaluation of a hybrid passive–active knee prosthesis on energy consumption." Mechanical Sciences 11, no. 2 (November 6, 2020): 425–36. http://dx.doi.org/10.5194/ms-11-425-2020.
Повний текст джерелаАнотація:
Abstract. The existing lower limb prostheses with passive knees have disadvantages, causing an asymmetric gait and higher metabolic cost during level walking which is in contrast with a normal gait. However, most existing active knee prostheses need a significant amount of energy. In this paper, a novel hybrid passive–active knee prosthesis (HPAK) that allows passive and active operating modes is proposed, which contains an active motor unit and a novel hydraulic damper with an electrically controlled valve that adjusts the damping torque dynamically during each gait cycle. An energy consumption model was built to evaluate the energy consumption when walking on level ground in three different simulation conditions to, respectively, simulate the complete HPAK, an ordinary active prosthesis (AKP) and an ordinary passive prosthesis (PKP). The results show that, in a cycle, the HPAK consumes only 16.19 J, which is 3.6 times lower than the AKP (58.95 J), and the PKP consumes only 1.24 J due to the novel spring–hydraulic damper structure designed and presented in this paper. These results indicate that the proposed novel hybrid passive–active knee prosthesis can have a positive effect on reducing energy consumption and improving the approximation of healthy gait characteristics when walking on level ground, contrasting with active or passive knee prostheses.
4
Sánchez Otero, John, Roque J. Hernández, and Jaime E. Torres S. "The mechanical design of a transfemoral prosthesis using computational tools and design methodology." Ingeniería e Investigación 32, no. 3 (September 1, 2012): 14–18. http://dx.doi.org/10.15446/ing.investig.v32n3.35934.
Повний текст джерелаАнотація:
Artificial limb replacement with lower limb prostheses has been widely reported in current scientific literature. There are many lower limb prosthetic designs ranging from a single-axis knee mechanism to complex mechanisms involving microcontrollers, made from many materials ranging from lightweight, high specific strength ones (e.g., carbon fibre) to traditional forms (e.g., stainless steel). However, the challenge is to design prostheses whose movement resembles the human body's natural movement as closely as possible. Advances in prosthetics have enabled many amputees to return to their everyday activities; however, such prostheses are expensive, some costing as much as $60,000. Many of the affected population in Colombia have scarce economic resources; there is therefore a need to develop affordable functional prostheses. The Universidad del Norte's Materials, Processes and Design Research Group and the Robotics and Intelligent Systems Group have been working on this line of research to develop modular prostheses which can be adjusted to each patient's requirements. This research represents an initial methodological approach to developing a prosthesis in which software tools have been used (the finite element method) with a criteria relationship matrix for selecting the best alternative while considering different aspects such as modularity, cost, stiffness and weight.
5
Budaker, Bernhard, and Alexander Verl. "Design, Development and Realisation of an Active Driven Knee-Prosthesis with Bevel Helical Gearbox." Advanced Materials Research 907 (April 2014): 225–39. http://dx.doi.org/10.4028/www.scientific.net/amr.907.225.
Повний текст джерелаАнотація:
This paper presents the development of an active driven prosthesis for transfemoral amputees. At the beginning of the development process gait parameters are analyzed. Defined boundary conditions help to get the right technical parameters for a structured development process. During the following development process, different concepts for active driven knee prostheses are discussed. Essential components for active driven prosthesis systems are presented. The focus during the scientific work is the development of an active drive system for an active driven knee prosthesis. A first prototype of an active driven knee prosthesis is shown.
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Kesavapuram, Sreya Reddy, and M. Dhanalakshmi. "Design of transfemoral prosthesis for above the knee amputees." Journal of Physics: Conference Series 2318, no. 1 (August 1, 2022): 012032. http://dx.doi.org/10.1088/1742-6596/2318/1/012032.
Повний текст джерелаАнотація:
Abstract Transfemoral amputation is a condition where the person above the knee area is amputated due to some infection, cancer or trauma. Due to this their mobility is eminently compromised, their lifestyle gets affected and also the individual’s self-confidence is distraught. The only way to aid this condition is to provide a prosthetic to provide support and mitigate easy movement. Usually, prosthetics are not selected due to high cost. In India there are around two lakh thirty thousand amputees in need of prosthetic care but are hesitant to opt for one, for the reason that they are expensive. Most of them go for cosmesis due to this demographic. In this work, we focus on developing a mechanical knee joint prosthesis where the pylon or the shank is replaced by a shock absorber in order to reduce the transient mechanical force acting on the artificial leg. By replacing the basic design with the shock absorber, it also enables the subject to perform other activities such as jumping and jogging with ease as the force is dispersed evenly on the prosthesis. In this we also perform von mises analysis, strain analysis and displacement analysis and carry through a comparative analysis between two commonly used materials in making the prosthetic against carbon fibre and prove the efficacy of carbon fibre.
7
Liu, Ming, Philip Datseris, and He Helen Huang. "A Prototype for Smart Prosthetic Legs-Analysis and Mechanical Design." Advanced Materials Research 403-408 (November 2011): 1999–2006. http://dx.doi.org/10.4028/www.scientific.net/amr.403-408.1999.
Повний текст джерелаАнотація:
In this paper, we designed a prototype of powered above-knee prosthesis. Compared with other prototypes available in the literature, our designed prosthetic leg employs a redundant actuator concept to overcome the challenge faced by the single-motor transmission systems. The redundant actuator also enables the prosthesis to be partially functional when the prosthesis loses power. Finally, in order to provide optimal control parameters for designed above-knee prosthesis to perform a smooth level-ground walking task, an inverse dynamic model based on Kane’s method is constructed.
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Minnoye, Sander L. M., and Dick H. Plettenburg. "Design, Fabrication, and Preliminary Results of a Novel Below-Knee Prosthesis for Snowboarding: A Case Report." Prosthetics and Orthotics International 33, no. 3 (January 2009): 272–83. http://dx.doi.org/10.1080/03093640903089576.
Повний текст джерелаАнотація:
Snowboarding with a below-knee prosthesis is compromised by the limited rotation capabilities of the existing below-knee prostheses, which are designed for use in normal walking. Based on snowboarding range of motion analyses, a novel below-knee prosthesis was designed with the aim to achieve similar range of motions like able-bodied snowboarders. The new prosthesis allows for passive inversion/eversion, passive plantarflexion/dorsiflexion and additional ‘voluntary’ plantarflexion/dorsiflexion initiated by lateral or medial rotation of the upper leg and knee. A prototype was built and was subsequently tested on a single subject, a highly professional snowboarder and candidate for the Olympic Winter Games. The movements of the subject were recorded on video, analyzed and compared to the recorded movements of an able-bodied snowboarder, and a snowboarder with a traditional below-knee prosthesis. The results indicated an increased similarity of inversion/eversion and plantarflexion/dorsiflexion between the snowboarder with the new below-knee prosthesis and the able-bodied snowboarder, whereas the snowboarder with the traditional below-knee prosthesis and the able-bodied snowboarder differed considerably. These results indicate that snowboarding with the new prosthesis is more comparable to able-bodied snowboarding. On a subjective basis this is confirmed by the test subject who stated that: “snowboarding with the new prosthesis is like it was before the amputation!”.
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Sun, Yuanxi, Hao Tang, Yuntao Tang, Jia Zheng, Dianbiao Dong, Xiaohong Chen, Fuqiang Liu, et al. "Review of Recent Progress in Robotic Knee Prosthesis Related Techniques: Structure, Actuation and Control." Journal of Bionic Engineering 18, no. 4 (July 2021): 764–85. http://dx.doi.org/10.1007/s42235-021-0065-4.
Повний текст джерелаАнотація:
AbstractAs the essential technology of human-robotics interactive wearable devices, the robotic knee prosthesis can provide above-knee amputations with functional knee compensations to realize their physical and psychological social regression. With the development of mechanical and mechatronic science and technology, the fully active knee prosthesis that can provide subjects with actuating torques has demonstrated a better wearing performance in slope walking and stair ascent when compared with the passive and the semi-active ones. Additionally, with intelligent human-robotics control strategies and algorithms, the wearing effect of the knee prosthesis has been greatly enhanced in terms of stance stability and swing mobility. Therefore, to help readers to obtain an overview of recent progress in robotic knee prosthesis, this paper systematically categorized knee prostheses according to their integrated functions and introduced related research in the past ten years (2010–2020) regarding (1) mechanical design, including uniaxial, four-bar, and multi-bar knee structures, (2) actuating technology, including rigid and elastic actuation, and (3) control method, including mode identification, motion prediction, and automatic control. Quantitative and qualitative analysis and comparison of robotic knee prosthesis-related techniques are conducted. The development trends are concluded as follows: (1) bionic and lightweight structures with better mechanical performance, (2) bionic elastic actuation with energy-saving effect, (3) artificial intelligence-based bionic prosthetic control. Besides, challenges and innovative insights of customized lightweight bionic knee joint structure, highly efficient compact bionic actuation, and personalized daily multi-mode gait adaptation are also discussed in-depth to facilitate the future development of the robotic knee prosthesis.
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Huang, Chun-Hsiung, Cheng-Kung Cheng, Jiann-Jong Liau, and Ye-Ming Lee. "MORPHOMETRICAL COMPARISON BETWEEN THE RESECTED SURFACES IN OSTEOARTHRITIC KNEES AND POROUS-COATED ANATOMIC KNEE PROSTHESIS." Journal of Musculoskeletal Research 04, no. 01 (March 2000): 39–46. http://dx.doi.org/10.1142/s0218957700000069.
Повний текст джерелаАнотація:
In total knee replacement, a good match of the prosthesis to bone is very important. Most knees that require total knee replacement are deformed. However, most of the design parameters of knee prosthesis were based on the normal knee. In this series, the dimensions of the resected surfaces in 77 osteoarthritic knees were measured intraoperatively and compared with the corresponding surfaces of the porous-coated anatomic (PCA) (Howmedica, Rutherford, NJ, USA) knee prosthesis. The results showed that the medial femoral condyle was wider than the lateral femoral condyle (p < 0.05) in the resected surfaces. The intercondylar notch of the resected femur was wider than that of the prosthesis (p < 0.05). In the resected tibial plateau, the ratio of the anteroposterior length to the mediolateral width was larger than that of the prosthesis (p < 0.05). The length and width of the resected patella were greater than those of the implant (p < 0.05). According to the difference in morphometrical parameters between the resected surfaces and the knee prosthesis, we suggest that the dimensions of the resected surfaces of the osteoarthritic knee should be important design parameters in total knee prosthesis.
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Lenzi, Tommaso, Marco Cempini, Levi Hargrove, and Todd Kuiken. "Design, development, and testing of a lightweight hybrid robotic knee prosthesis." International Journal of Robotics Research 37, no. 8 (July 2018): 953–76. http://dx.doi.org/10.1177/0278364918785993.
Повний текст джерелаАнотація:
We present a lightweight robotic knee prosthesis with a novel hybrid actuation system that enables passive and active operation modes. The proposed hybrid knee uses a spring-damper system in combination with an electric motor and transmission system, which can be engaged to provide a stair ambulation capability. In comparison to fully powered prostheses that power all ambulation activities, a hybrid knee prosthesis can achieve significant weight reduction by focusing the design of the actuator on a subset of activities without losing the ability to produce equivalent torque and mechanical power in the active mode. The hybrid knee prototype weighs 1.7 kg, including battery and control, and can provide up to 125 Nm of repetitive torque. Experiments with two transfemoral amputee subjects show that the proposed hybrid knee prosthesis can support walking on level ground in the passive mode, as well as stair ambulation with a reciprocal gait pattern in the active mode.
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Bratianu, Constantin, and Lucian Gruionu. "Computational Simulation of a Total Knee Prosthesis Mechanical Behaviour." Key Engineering Materials 306-308 (March 2006): 1265–70. http://dx.doi.org/10.4028/www.scientific.net/kem.306-308.1265.
Повний текст джерелаАнотація:
The design of knee prostheses can be improved by computer aided design and structural analysis based on the finite element simulation. Our assumption is that by knowing the stress patterns between the knee prosthesis components and between this implant and its surroundings, we can better evaluate the wear performances and improve its design. The geometry of mobile bearing knee prosthesis with a polyethylene insert was used to predict peak and average contact pressures in several explicit dynamics finite elements analyses. The contact pressure, shear stress distribution and shear movements at the interface implant-cement and bone-cement are important for prostheses life and were computed. Rigid body dynamics analysis was used to predict body positions and orientations. Numerical modeling and simulations are used to predict contact pressures between three-dimensional surfaces. Our computational results showed a positive matching with experimental data from literature. This modeling approach is sufficiently fast and accurate to be used in design sensitivity and optimization studies of knee implant mechanics.
13
Das, Saubhik, Arkesh M., and Rajkumar Selvanayagam. "Constraints in total knee arthroplasty: current status and review of literature." International Journal of Research in Medical Sciences 5, no. 2 (January 23, 2017): 374. http://dx.doi.org/10.18203/2320-6012.ijrms20170132.
Повний текст джерелаАнотація:
Appropriate selection of prosthesis is critical for success of total knee arthroplasty. It is a daunting task of arthroplasty surgeon to choose from a wide array of implant design for a given situation to confer optimal stability, which translates into satisfactory outcome. Contemporary evolution of prosthetic design with various levels of constraints has revolutionized the approach to total knee arthroplasty. This paper deals with the succinct review of the level of constrained prosthesis available for knee arthroplasty.
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Ramstrand, Nerrolyn, David F. Rusaw, and Saffran Filippa Möller. "Transitioning to a microprocessor-controlled prosthetic knee: Executive functioning during single and dual-task gait." Prosthetics and Orthotics International 44, no. 1 (December 11, 2019): 27–35. http://dx.doi.org/10.1177/0309364619892773.
Повний текст джерелаАнотація:
Background: Walking with a prosthesis requires substantial concentration on behalf of the user and places increased demands on executive functions. Little is known of the effects that prosthetic knee joint prescription may have on executive functioning. Objectives: Evaluate executive functioning in trans-femoral prosthesis users during single and dual-task walking, before and after they transition to a Microprocessor-controlled prosthetic knee unit. Study Design: Multiple case-study design. Methods: Single and dual task gait was evaluated while recording cortical brain activity. Testing occasion 1 occurred prior to participants receiving their microprocessor-controlled prosthetic knee, while testing occasion 2 was conducted a minimum of 8 months after they had been fitted with an microprocessor-controlled prosthetic knee. Results: During single-task level walking and walking while performing a dual-task key finding test, executive functions, measured as the relative haemodynamic response in the frontal cortex, reduced for most, but not all participants after transitioning to an Microprocessor-controlled prosthetic knee. There did not appear to be any difference when participants performed a trail walk test. Conclusions: Results suggest Microprocessor-controlled prosthetic knee prosthetic knees may have a positive effect on executive functioning for some individuals who have undergone a lower-limb amputation. A larger, longitudinal study with careful control of extraneous variables (e.g. age, training) is needed to confirm results and determine causality. Clinical relevance This article provides some evidence to suggest that prosthetic prescription may influence executive functioning and that microprocessor-controlled prosthetic knee mechanisms may reduce cognitive effort when walking.
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Zhang, Hao-ran. "Application and Development of Megaprostheses in Limb Salvage for Bone Tumors Around the Knee Joint." Cancer Control 29 (January 2022): 107327482210992. http://dx.doi.org/10.1177/10732748221099219.
Повний текст джерелаАнотація:
In recent decades, limb-salvage surgery has replaced amputation as the first choice for the treatment of bone tumors around knee. After tumor resection, there are a variety of reconstruction methods for us to choose, including autograft or allograft, inactivation and reimplantation, artificial prosthesis replacement, and allograft-prosthesis compound reconstruction. Compared with other reconstruction methods, artificial prosthesis reconstruction has some advantages: relatively simple, early weight bearing, fewer early complications, and good function in the early and mid-term follow-up. After decades of continuous improvements, the design of tumor prosthesis has reached a relatively mature stage, and the failure rate of prosthesis has also been declining year by year. However, artificial prostheses also have multiple complications such as infection, aseptic loosening, prosthetic breakage, and patients sometimes face the risk of revision or amputation. Therefore, clinicians need to deeply understand the characteristics of related complications and the principles of treatment.
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Möller, Saffran, David Rusaw, Kerstin Hagberg, and Nerrolyn Ramstrand. "Reduced cortical brain activity with the use of microprocessor-controlled prosthetic knees during walking." Prosthetics and Orthotics International 43, no. 3 (October 30, 2018): 257–65. http://dx.doi.org/10.1177/0309364618805260.
Повний текст джерелаАнотація:
Background: Individuals using a lower-limb prosthesis indicate that they need to concentrate on every step they take. Despite self-reports of increased cognitive demand, there is limited understanding of the link between cognitive processes and walking when using a lower-limb prosthesis. Objective: The objective was to assess cortical brain activity during level walking in individuals using different prosthetic knee components and compare them to healthy controls. It was hypothesized that the least activity would be observed in the healthy control group, followed by individuals using a microprocessor-controlled prosthetic knee and finally individuals using a non-microprocessor-controlled prosthetic knee. Study design: Cross-sectional study. Methods: An optical brain imaging system was used to measure relative changes in concentration of oxygenated and de-oxygenated haemoglobin in the frontal and motor cortices during level walking. The number of steps and time to walk 10 m was also recorded. The 6-min walk test was assessed as a measure of functional capacity. Results: Individuals with a transfemoral or knee-disarticulation amputation, using non-microprocessor-controlled prosthetic knee ( n = 14) or microprocessor-controlled prosthetic knee ( n = 15) joints and healthy controls ( n = 16) participated in the study. A significant increase was observed in cortical brain activity of individuals walking with a non-microprocessor-controlled prosthetic knee when compared to healthy controls ( p < 0.05) and individuals walking with an microprocessor-controlled prosthetic knee joint ( p < 0.05). Conclusion: Individuals walking with a non-microprocessor-controlled prosthetic knee demonstrated an increase in cortical brain activity compared to healthy individuals. Use of a microprocessor-controlled prosthetic knee was associated with less cortical brain activity than use of a non-microprocessor-controlled prosthetic knee. Clinical relevance Increased understanding of cognitive processes underlying walking when using different types of prosthetic knees can help to optimize selection of prosthetic components and provide an opportunity to enhance functioning with a prosthesis.
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Yan, Gongxing, Jialing Li, Hui Xie, and Minggui Zhou. "Adaptive Control System of Intelligent Lower Limb Prosthesis Based on 5G Virtual Reality." Wireless Communications and Mobile Computing 2022 (March 18, 2022): 1–12. http://dx.doi.org/10.1155/2022/4572503.
Повний текст джерелаАнотація:
With the rapid development of computer science and technology in our country, especially the advent of the 5G network era, the emergence of smart prostheses makes it possible for disabled, injured, or amputee people with lower limbs to walk and exercise like normal people. However, due to the different selection of prosthetic materials, the final lower limb prostheses produced will also have different performance differences. How to select prosthetic materials to optimize the performance of the intelligent lower limb prosthesis is the focus of extensive discussion in the medical community. For this reason, this article takes the research of the adaptive control system of intelligent lower limb prosthesis based on 5G virtual reality as the research object. By using the current advanced 5G communication technology and virtual reality technology, a high-performance intelligent lower limb prosthesis is produced. Provide assistance with basic walking and motor abilities in daily life of patients with lower limb disabilities. This article first gives a systematic theoretical introduction to 5G virtual reality technology, expounds the current status of patients with lower limb disabilities, and proposes to use intelligent lower limb prosthetics to replace healthy lower limbs to solve the basic walking and sports needs of disabled patients in daily life and then use 5G virtual reality technology. The selection of human knee joints and ankle joints and structural system design were carried out. Finally, it was decided to use the four-bar linkage structure as the knee joint structure of the three-dimensional modeling of the intelligent lower limb prosthesis. At the end of this article, the application and simulation of the intelligent lower limb prosthesis to the human body were also carried out. The results of the experiment found that after 45 weeks of wearing exercises, the gait of the intelligent lower limb prosthesis is consistent with the expected effect whether it is walking on level ground and up and down the stairs or uphill. Due to the strong adaptiveness of the intelligent lower limb prosthesis sexual control, it can well assist the basic life movement ability of patients with lower limb disabilities.
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Zhang, Xiufeng, Huiqun Fu, Xitai Wang, Guanglin Li, Rong Yang, and Ying Liu. "Design of a novel bionic prosthetic knee joint." Assembly Automation 36, no. 4 (September 5, 2016): 398–404. http://dx.doi.org/10.1108/aa-08-2015-066.
Повний текст джерелаАнотація:
Purpose This paper aims to find a new method that could be applied to the high and mid-grade prosthesis knee joint. Design/methodology/approach Based on analysis, calculation, modeling, simulation and experimental study of the motion law of knee joint, this paper not only determines the structure and parameters of the knee joint and calculates the instantaneous center but also analyzes the stance stability and completes the optimization. With the help of experimental tests (fatigue test and gait curve test), the quality and performance of the designed knee joint is verified. Findings The experimental results show that the gait curve of the designed knee joint is much closer to health people. The designed prosthesis knee joint, with adjustable swing speed and gait curve which are close to health limb, has a better performance when compared to the ordinary knee joint with four-bar linkage structure. Originality/value This paper developed a prosthesis knee joint based on a novel design method that could be applied to the “high and mid” grade prosthesis knee joint and verified its function on an amputee performed the lower amputation, which could provide theoretical support for researches and designs related to prosthesis knee joint in future.
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Phruetthiphat, Ong-art. "Increasing posterior condyle cut for high-flex knee prosthesis may injure popliteus tendon origin: a cadaveric study." Journal of Orthopaedics & Bone Disorders 4, no. 1 (2020): 1–5. http://dx.doi.org/10.23880/jobd-16000193.
Повний текст джерелаАнотація:
Background: High-flex total knee prosthesis designs were proposed to improve flexion in total knee replacement (TKA). One of high-flex features is increasing posterior condyle cut which put popliteal tendon in higher risk of injury and may result in gap changes. Methods: Thirty-six popliteal origin sites from eighteen fresh cadavers were measured distances between the posterior rim of popliteal tendon origin and posterior border of the lateral femoral condyle (distance A) using digital “Vernier caliper”. The mean distances were compared to posterior condyle thickness of different prosthesis designs. Results: The mean of distance A on the right knee was 9.59 ±1.66 mm (6.03-12.70) while the mean of distance A on the left knee was 9.13 ± 1.78 mm (5.80-11.07). Posterior condyle thickness of the femoral prostheses varies upon their design and size from 7.4 to 10 mm for standard model and from 8.2 to 12.5 mm for high-flex design. Possibilities of popliteal tendon injury during posterior condyle bone cut were 16.7% to 66.7% for standard model and 27.8% to 97.2% for the high-flex design. Conclusion: High-flex TKA prosthesis with thicker posterior condyle relates to higher possibility of popliteal tendon origin injury compared to standard one.
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Zhang, Yonghong, Erliang Wang, Miao Wang, Sizhe Liu, and Wenjie Ge. "Design and Experimental Research of Knee Joint Prosthesis Based on Gait Acquisition Technology." Biomimetics 6, no. 2 (May 7, 2021): 28. http://dx.doi.org/10.3390/biomimetics6020028.
Повний текст джерелаАнотація:
Whether the lower limb prosthesis can better meet the needs of amputees, the biomimetic performance of the knee joint is particularly important. In this paper, Nokov(metric) optical 3D motion capture system was used to collect motion data of normal human lower limbs, and the motion instantaneous center of multi-gait knee joint was obtained. Taking the error of knee joint motion instantaneous center line as the objective function, a set of six-bar mechanism prosthetic knee joint was designed based on a genetic algorithm. The experimental results show that the movement trajectory of the instantaneous center of the knee joint is basically similar to that of the human knee joint, so it can help amputees complete a variety of gaits and has good biomimetic performance. Gait acquisition technology can provide important data for prosthetic designers and it will be widely used in prosthetic design and other fields.
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Verheul, Floor Jacoba Marie-Georgette, Olaf Verschuren, Maremka Zwinkels, Mariska Herwegh, Anka Michielsen, Marieke de Haan, and Iris van Wijk. "Effectiveness of a crossover prosthetic foot in active children with a congenital lower limb deficiency: an explorative study." Prosthetics and Orthotics International 44, no. 5 (May 6, 2020): 305–13. http://dx.doi.org/10.1177/0309364620912063.
Повний текст джерелаАнотація:
Background: Children with lower limb prostheses cannot always keep up with their peers during active play. A pediatric crossover foot may be a promising prosthetic alternative for children engaging in high-intensity movements necessary for active play. Objectives: To compare children’s walking performance, running performance, experienced competence, and cosmesis using their prescribed prosthesis compared with the crossover foot. Study Design: Pretest-posttest study. Methods: Children with lower limb amputation or deficiency were recruited. Measurements were taken at baseline with the prescribed prosthesis and 6 weeks later with the crossover foot. Walking speed, energy cost of walking, anaerobic muscle power, stair climbing speed, ankle power, and cosmesis were evaluated. Results: Four children participated in the study. Two children had increased walking speed with the same energy cost, one child had decreased speed with increased energy cost, and one child had the same speed with decreased energy cost. Muscle power increased for three of the four children and ankle power increased for all children while using the crossover foot compared to the prescribed prosthesis. Two children reported knee pain or feeling excessive knee flexion when running with the crossover foot. One child reported negative feelings toward cosmesis of the crossover foot. Conclusions: This study suggests crossover foot may benefit active children by improving walking and running performance, and decreasing energy cost. However, knee pain reports or negative feelings toward the atypical design suggest the crossover foot may not be ideal for every child. Further research is needed to determine which pediatric users would benefit from this type of prosthetic foot. Clinical relevance Children with lower limb deficiencies are active prosthetic users who often switch between low- and high-intensity movements in their daily activities. Therefore, they might benefit from a crossover prosthetic design. The preliminary findings of this study suggest the crossover foot (XF) may be a promising foot for active children.
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Azocar, Alejandro F., Luke M. Mooney, Jean-François Duval, Ann M. Simon, Levi J. Hargrove, and Elliott J. Rouse. "Design and clinical implementation of an open-source bionic leg." Nature Biomedical Engineering 4, no. 10 (October 2020): 941–53. http://dx.doi.org/10.1038/s41551-020-00619-3.
Повний текст джерелаАнотація:
Abstract In individuals with lower-limb amputations, robotic prostheses can increase walking speed, and reduce energy use, the incidence of falls and the development of secondary complications. However, safe and reliable prosthetic-limb control strategies for robust ambulation in real-world settings remain out of reach, partly because control strategies have been tested with different robotic hardware in constrained laboratory settings. Here, we report the design and clinical implementation of an integrated robotic knee–ankle prosthesis that facilitates the real-world testing of its biomechanics and control strategies. The bionic leg is open source, it includes software for low-level control and for communication with control systems, and its hardware design is customizable, enabling reduction in its mass and cost, improvement in its ease of use and independent operation of the knee and ankle joints. We characterized the electromechanical and thermal performance of the bionic leg in benchtop testing, as well as its kinematics and kinetics in three individuals during walking on level ground, ramps and stairs. The open-source integrated-hardware solution and benchmark data that we provide should help with research and clinical testing of knee–ankle prostheses in real-world environments.
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Cheng, Cheng-Kung, Colin J. McClean, Yu-Shu Lai, Wen-Chuan Chen, Chang-Hung Huang, Kun-Jhih Lin, and Chia-Ming Chang. "Biomechanical Considerations in the Design of High-Flexion Total Knee Replacements." Scientific World Journal 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/205375.
Повний текст джерелаАнотація:
Typically, joint arthroplasty is performed to relieve pain and improve functionality in a diseased or damaged joint. Total knee arthroplasty (TKA) involves replacing the entire knee joint, both femoral and tibial surfaces, with anatomically shaped artificial components in the hope of regaining normal joint function and permitting a full range of knee flexion. In spite of the design of the prosthesis itself, the degree of flexion attainable following TKA depends on a variety of factors, such as the joint’s preoperative condition/flexion, muscle strength, and surgical technique. High-flexion knee prostheses have been developed to accommodate movements that require greater flexion than typically achievable with conventional TKA; such high flexion is especially prevalent in Asian cultures. Recently, computational techniques have been widely used for evaluating the functionality of knee prostheses and for improving biomechanical performance. To offer a better understanding of the development and evaluation techniques currently available, this paper aims to review some of the latest trends in the simulation of high-flexion knee prostheses.
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Khoo, L. P., J. C. H. Goh, and S. L. Chow. "Parametric Modelling of a Knee Joint Prosthesis." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 207, no. 2 (June 1993): 115–20. http://dx.doi.org/10.1243/pime_proc_1993_207_279_02.
Повний текст джерелаАнотація:
This paper presents an approach for the establishment of a parametric model of knee joint prosthesis. Four different sizes of a commercial prosthesis are used as an example in the study. A reverse engineering technique was employed to reconstruct the prosthesis on CATIA, a CAD (computer aided design) system. Parametric models were established as a result of the analysis. Using the parametric model established and the knee data obtained from a clinical study on 21 pairs of cadaveric Asian knees, the development of a prototype prosthesis that suits a patient with a very small knee joint is presented. However, it was found that modification to certain parameters may be inevitable due to the uniqueness of the Asian knee. An avenue for rapid modelling and eventually economical production of a customized knee joint prosthesis for patients is proposed and discussed.
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Fuchs, Susanne, Guido Schuette, Hartmut Witte,, and Carsten Oliver Tibesku. "Patellofemoral Contact Characteristics in Total Knee Prostheses with and Without Anterior Patellar Flange." Journal of Applied Biomechanics 20, no. 2 (May 2004): 144–52. http://dx.doi.org/10.1123/jab.20.2.144.
Повний текст джерелаАнотація:
A new design of total knee prosthesis without anterior patellar flange was developed to preserve the anatomical shape of the patellofemoral joint. The aim of the current study was to experimentally compare patellofemoral contact area and pressure in a nonreplaced knee, in a knee after implantation of a conventionally designed total knee arthroplasty, and in a knee after implantation of the newly designed total knee arthroplasty without patellar flange. Six cadaveric legs were examined before and after implantation of either a conventional or a newly developed total knee arthroplasty, both without patellar replacement. The essential change in design is the absence of an anterior patellar flange. Contact area and pressure were measured using pressure sensitive films in 45°, 60°, 90°, and 120° of flexion and the results were compared between the different prosthesis designs and with the nonreplaced knee. The prosthesis without patellar flange showed less average and maximum pressure than the conventional prosthesis. Compared with the nonreplaced knee, the conventional prosthesis led to increased average and maximum pressure and decreased contact area. In an experimental test setup, the newly developed total knee arthroplasty without patellar flange showed reduced patello-femoral contact pressure in comparison with a total knee prosthesis with conventional patellofemoral design. This could possibly lead to a lower incidence of anterior knee complaints in patients.
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Rigas, C. "Active plantar-flexion above-knee prosthesis: Concept and preliminary design." Prosthetics and Orthotics International 9, no. 3 (December 1985): 141–44. http://dx.doi.org/10.3109/03093648509164726.
Повний текст джерелаАнотація:
Lower limb prostheses produced so far do not replace the function of the musculature, which provides the necessary amount and the proper distribution of energy to the ambulatory mechanism. Provision of external power to lower limb prostheses has been hindered by the fact that the large amount of energy needed at a lower limb necessitates the use of external power sources of unacceptably high mass and volume. Self energized mechanisms offer a promising alternative to the problem. Normally a large part of energy output during locomotion appears at the ankle joint. It seems therefore desirable to develop an above-knee prosthesis featuring active plantar-flexion at the ankle. Energy may be offered by a self energized system. The system, described here, accumulates energy during the passive movements of the knee and ankle joints and stores it for later use at the ankle.
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Shin, Hyunjun, Jinkuk Park, Huitae Lee, Sungyoon Jung, Mankee Jeon, and Sehoon Park. "Selective Passive/Active Switchable Knee Prosthesis Based on Multifunctional Rotary Hydraulic Cylinder for Transfemoral Amputees." Actuators 12, no. 3 (March 9, 2023): 118. http://dx.doi.org/10.3390/act12030118.
Повний текст джерелаАнотація:
Significant advances have been made in prostheses with the aim of enhancing the quality of life for transfemoral amputees. While commercially available transfemoral prostheses mainly focus on the developing passive prostheses that act only as dampers, academic research is centered round powered prostheses that can provide net-positive knee torque. Although recent active-powered prostheses have made excellent progress in terms of weight and battery life, it remains unclear if these prostheses can be effectively used in everyday life. This study presents a rotary hybrid prosthesis based on the combination of a multifunctional rotary hydraulic cylinder that is designed to operate as a brake, clutch, and damper with a 100 W active motor system. This prosthesis enables long-term level ground walking while supplying active power as needed. The passive and active components of this hybrid prosthesis are designed such that they can be decoupled when operated independently, allowing for quick switching between passive and active modes in 50–100 ms. The study outlines the aims and procedures for the design of rotary hybrid prostheses, as well as the feasibility tests for each module and the amputee’s clinical test on the developed knee prosthesis.
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Geil, Mark, and Colleen Coulter. "Analysis of locomotor adaptations in young children with limb loss in an early prosthetic knee prescription protocol." Prosthetics and Orthotics International 38, no. 1 (May 17, 2013): 54–61. http://dx.doi.org/10.1177/0309364613487546.
Повний текст джерелаАнотація:
Background: Traditionally, clinical protocols for the treatment of young children who require a knee prosthesis have favored stability, with the prosthetic knee locked into full extension until after the child has learned to walk. Recently, an Early Knee protocol has been investigated, in which children receive an articulating knee in their first prosthesis and use it while learning to crawl and walk. Objectives: This study investigated the presence of swing phase clearance adaptations in the walking gait of seven young children aged 18–92 months, who had been fitted according to the Early Knee protocol. Study design: Before-and-after experimental design. Methods: Each subject completed walking trials with the knee freely flexing and trials with the knee locked into full extension to mimic a traditional knee protocol. Results: Subjects utilized the articulating knee in walking, with an average of 70.4° of peak swing phase knee flexion. Some clearance adaptations were present with the flexing knee; more were present and their magnitude was increased when the knee was locked. In particular, there was a statistically significant increase in circumduction. Conclusions: These results suggest that the Early Knee protocol can reduce the adoption of clearance adaptations while walking is developing. Clinical relevance Treatment of young children who require a knee prosthesis is inconsistent. Traditionally, no knee is provided until independent walking is achieved. A newer Early Knee protocol provides an articulating knee in the first prosthesis. This study found that children use the articulating knee in walking and develop fewer clearance adaptations.
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FANTOZZI, SILVIA, ALBERTO LEARDINI, ANDREA ENSINI, ANGELO CAPPELLO, and FABIO CATANI. "POSTERIOR STABILIZED AND CRUCIATE RETAINING KNEE PROSTHESES: COMPARISON OF IN VIVO 3D KINEMATICS USING FLUOROSCOPY." Journal of Mechanics in Medicine and Biology 05, no. 02 (June 2005): 391–95. http://dx.doi.org/10.1142/s0219519405001539.
Повний текст джерелаАнотація:
Accurate measurement of in vivo kinematics of total joint replacement is fundamental to improve prosthesis design and clinical outcome. In fluoroscopic analysis, the 3D relative pose of joint prosthesis components is reconstructed from the knowledge of the 3D geometry of each component and from a single plane projection. This is achieved with an accuracy of a few millimetres and a few degrees. Twenty-three patients with cruciate retaining and posterior stabilized prostheses were analyzed in order to assess the in vivo performance of the spine-cam mechanism. The posterior stabilized design exhibits a more physiological pattern of the anteroposterior motion of the condyles during flexion. This result is well-suited with the larger active knee flexion exhibited by the posterior stabilized knees.
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Colombo, Giorgio, Giancarlo Facoetti, and Caterina Rizzi. "A digital patient for computer-aided prosthesis design." Interface Focus 3, no. 2 (April 6, 2013): 20120082. http://dx.doi.org/10.1098/rsfs.2012.0082.
Повний текст джерелаАнотація:
This article concerns the design of lower limb prosthesis, both below and above knee. It describes a new computer-based design framework and a digital model of the patient around which the prosthesis is designed and tested in a completely virtual environment. The virtual model of the patient is the backbone of the whole system, and it is based on a biomechanical general-purpose model customized with the patient's characteristics (e.g. anthropometric measures). The software platform adopts computer-aided and knowledge-guided approaches with the goal of replacing the current development process, mainly hand made, with a virtual one. It provides the prosthetics with a set of tools to design, configure and test the prosthesis and comprehends two main environments: the prosthesis modelling laboratory and the virtual testing laboratory. The first permits the three-dimensional model of the prosthesis to be configured and generated, while the second allows the prosthetics to virtually set up the artificial leg and simulate the patient's postures and movements, validating its functionality and configuration. General architecture and modelling/simulation tools for the platform are described as well as main aspects and results of the experimentation.
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Zhang, Jun, Erhu Li, and Yuan Zhang. "Prostheses option in revision total knee arthroplasty, from the bench to the bedside: (1) basic science and principles." EFORT Open Reviews 7, no. 2 (February 1, 2022): 174–87. http://dx.doi.org/10.1530/eor-21-0089.
Повний текст джерелаАнотація:
The number of primary and revision total knee arthroplasties (rTKAs) continues to increase annually. To date, most of the literature has focused on the surgical technique and outcome of revision prostheses. Thanks to the contributions of surgeons, engineers, and researchers, the design of prostheses has reached a prominent milestone. However, very limited discussion regarding the design, rationale and constitution of prostheses has been documented at present. An electronic search of four online databases (Embase, MEDLINE, PubMed, and Google Scholar) was conducted to identify eligible resources. Forty-four review articles were acquired by searching the terms ‘prosthesis selection’, ‘prosthesis option’, and ‘prosthesis determination’ in rTKA. Sixty-eight research articles investigating the factors affecting prosthesis options in rTKA were screened and integrated with the authors’ perspective to reach a final recommendation. This article first discusses the pathological, individual, and other factors affecting prosthesis options in rTKA and further illustrates the classification, geometry, biomechanics, and constitution of the revision system from the authors’ perspective. An evidence-based recommendation in the form of a matching algorithm was formulated. This review offers special value for decision-making regarding prosthesis options in rTKA. Particularly, it presents specific recommendations regarding unclear practical issues, such as the optimal level of constraint, individualized design, length, and fixation of extension stem, as well as the pros and cons of modularity.
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Zuo, Qiang, Jinpeng Zhao, Xin Mei, Feng Yi, and Guoliang Hu. "Design and Trajectory Tracking Control of a Magnetorheological Prosthetic Knee Joint." Applied Sciences 11, no. 18 (September 7, 2021): 8305. http://dx.doi.org/10.3390/app11188305.
Повний текст джерелаАнотація:
This paper developed a new magnetorheological (MR) prosthetic knee joint using an MR damper as the brake. According to the gait data of healthy people walking on flat ground, the structure of a MR prosthetic knee joint was expounded in detail, and its motion and dynamic model was also established. In addition, an MR damper was developed according to the specific needs of an MR prosthesis. The forward and reverse mechanical models of the MR damper were established, and its damping performance was obtained through experimental tests. In addition, to solve the problems of uncertainty and external interference in the MR prosthetic knee joint system, a second-order sliding mode controller was proposed. The experimental test results show the maximum positive error of the knee joint swing trajectory is 9.4°, which effectively tracks the reference swing trajectory.
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CHONG, DESMOND Y. R., ULRICH N. HANSEN, and ANDREW A. AMIS. "CEMENTLESS MIS MINI-KEEL PROSTHESIS REDUCES INTERFACE MICROMOTION VERSUS STANDARD STEMMED TIBIAL COMPONENTS." Journal of Mechanics in Medicine and Biology 16, no. 05 (August 2016): 1650070. http://dx.doi.org/10.1142/s0219519416500706.
Повний текст джерелаАнотація:
Fixation strength of the cementless knee prostheses is dependent on the initial stability of the fixation and minimal relative motion across the prosthesis–bone interface. Broad mini-keels have been developed for tibial components to allow minimally invasive knee arthroplasty, but the effect of the change in fixation design is unknown. In this study, bone–prosthesis interface micromotions of the mini-keel tibial components (consisting of two designs; one is stemless and another with a stem extension of 45[Formula: see text]mm) induced by walking and stair climbing were investigated by finite element modeling and compared with standard stemmed design. The prosthesis surface area amenable for bone ingrowth for the mini-keel tibial components (both stemmed and unstemmed) was predicted to be at least 67% larger than the standard stemmed implant, thereby reducing the risk of long-term aseptic loosening. It was also found that while different load patterns may have led to diverse predictions of the magnitude of the interface micromotions and the extent of osseointegration onto the prosthesis, the outcome of design change evaluation in cementless tibial fixations remains unchanged. The mini-keel tibial components were predicted to anchor onto the periprosthetic bone better than the standard stemmed design under all loading conditions investigated.
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Prodanovic, Nikola, Suzana Petrovic-Savic, Goran Devedzic, Aleksandar Matic, Dragce Radovanovic, and Branko Ristic. "Comparative gait analysis of patients with different design of total knee arthroplasty." Srpski arhiv za celokupno lekarstvo, no. 00 (2021): 46. http://dx.doi.org/10.2298/sarh200706046p.
Повний текст джерелаАнотація:
Introduction/Objective. The essence of the treatment of degenerative knee joint diseases is pain relief, restoring motion range and stability of knee joints. Methods. In this study, 35 patients participated after having surgery of the knee joint. The patients had a posterior - stabilized (PS) endoprosthesis in one joint, and a posterior cruciate ligament retaining (CR) endoprosthesis in the other. Kinematic data was collected using a 3D optical system for tracking fluorescent markers in time. Based on these data, the following parameters were determined: degree of flexion, medio - lateral (ML) translation, lateral gap, medial gap and the angle of change between the transtibial and transfemoral axes. Results. The results show a more pronounced flexion degree with the PS prosthesis compared to the CR prosthesis. Also, the results show negligible values of the ML translation, lateral gap and medial gap in both types of prostheses. Using the non-parameter Wilcoxon test, a substantial difference in the angle change between the transtibial and transfemoral axes was confirmed, that is, in the flexion angles on the CR and PS prostheses. Conclusion. This study shows that there is no great difference in the use of the PS or CR designs of endoprostheses. Better behavior and range of motion in the knee joint were established with the implantation of the PS endoprosthesis. This conclusion is confirmed by the substantial difference in the degree of flexion of the knee joint and in the position of the transversal axes of the tibia and femur
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Chavoix, Jean-Baptiste. "Functionality and Safety of an Ultra-Congruent Rotating Platform Knee Prosthesis at 5.6 Years: More than 5- Year Follow-Up of the e.motion® UC-TKA." Open Orthopaedics Journal 7, no. 1 (May 17, 2013): 152–57. http://dx.doi.org/10.2174/1874325001307010152.
Повний текст джерелаАнотація:
Background: Mobile bearing TKA prostheses were designed to minimize polyethylene wear by increasing implant conformity and reducing stresses between the articulating prosthesis components. It is the purpose of this study to assess the mid-term functionality and clinical outcome associated with a highly congruent mobile platform design, the e.motion® UC total knee prosthesis. Material and Methods: Functional and clinical outcomes were assessed after an average of 5.6 years (5.1 – 6.0 years) after total knee arthroplasty in 28 patients (24 women), aged 77.8±7.5 years. The Knee injury and Osteoarthritis Outcome Score (KOOS) was assessed. Secondary outcomes included the Knee Society Score (KSS), radiological evaluation of radiolucent lines and recording of adverse events. Results: The average KOOS subscore for the activities of daily life was 77.8 points after 5.6 years. Both the clinical and functional KSS improved at 2.4 and 5.6 years. Two patients showed radiolucent lines at 5.6 years. Adverse events over 5.6 years included 3 subluxations, 1 tilting and 1 misalignment of the patella. None of the prostheses were revised. Conclusion: This pilot study shows promising outcomes for the e.motion® UC prosthesis. In the small sample, the implant performed comparably to the LCS prosthesis (the gold standard). There were no loosenings or revisions observed at 5.6 years.
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Tsai, C. S., and J. M. Mansour. "Swing Phase Simulation and Design of Above Knee Prostheses." Journal of Biomechanical Engineering 108, no. 1 (February 1, 1986): 65–72. http://dx.doi.org/10.1115/1.3138582.
Повний текст джерелаАнотація:
A detailed dynamic model of the stump-prosthesis system for an above knee amputee was developed. The model was used to examine the influence of controls and design parameters on the limb system performance during the swing phase of gait. The model duplicated the clinically known fact that hydraulic knee controllers allow the amputee to change walking speed while mechanical knee controllers limit the amputee to a single walking speed. Contrary to current practice, the simulations suggest that light weight prosthesis designs do not perform as well as heavier designs. A simple design based on a constant friction knee is shown to yield good overall performance.
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Worlicek, Michael, Jens Schaumburger, Robert Springorum, Guenther Maderbacher, Florian Zeman, Joachim Grifka, and Clemens Baier. "In vivo knee kinematics of an innovative prosthesis design." Open Medicine 17, no. 1 (January 1, 2022): 1318–24. http://dx.doi.org/10.1515/med-2022-0518.
Повний текст джерелаАнотація:
Abstract Up to 20% of patients after total knee arthroplasty (TKA) are not satisfied with the result. Several designs of new implants try to rebuild natural knee kinematics. We hypothesized that an innovative implant design leads to better results concerning femoral rollback compared to an established implant design. For this pilot study, 21 patients were examined during TKA, receiving either an innovative (ATTUNETM Knee System (DePuy Inc.), n = 10) or an established (PFCTM (DePuy Inc.), n = 11) knee system. All patients underwent computer navigation. Knee kinematics was assessed after implantation. Outcome measure was anterior–posterior translation between femur and tibia. We were able to demonstrate a significantly higher femoral rollback in the innovative implant group (p < 0.001). The mean rollback of the innovative system was 11.00 mm (95%-confidence interval [CI], 10.77–11.24), of the established system 8.12 mm (95%-CI, 7.84–8.42). This study revealed a significantly increased lateral as well as medial femoral rollback of knees with the innovative prosthesis design. Our intraoperative finding needs to be confirmed using fluoroscopic or radiographic three-dimensional matching under full-weight-bearing conditions after complete recovery from surgery.
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Schvirtz, Erica, Laurent Bensoussan, Bertrand Tourret Couderc, Jean-Michel Viton, Alain Delarque, and Marjorie Kerzoncuf. "Return to surfing using an adapted prosthesis: A case report." Prosthetics and Orthotics International 42, no. 4 (February 14, 2018): 455–59. http://dx.doi.org/10.1177/0309364618757785.
Повний текст джерелаАнотація:
Background: Surfing with transfemoral knee prosthesis requires flexion of the hip, knee, and ankle and balance between flexibility and stiffness of the prosthetic limb. We report on Mr D, a transfemoral amputee, who wanted to surf again. Case Description and Methods: Technical specifications were based on Mr D’s complaint. The prosthesis is salt water resistant and combines a shock absorber associated with elastic tendons to permit the knee to bend easily and to facilitate eccentric braking. Surfing was observed using videos of movements and subjective analysis of compensations. Findings and Outcomes: Mr D uses this prosthesis for surfing with good results and got back to his former level using compensations. During the takeoff, he cannot shorten his left leg. He makes a circumduction movement to put his leg in front of the board. Conclusion: This prosthesis is adapted for surfing and allows precise adjustments to surfing conditions. Clinical relevance Appropriate prosthesis design can enable return to surfing for a transfemoral amputee.
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Haider, Saif M. J., Ayad M. Takhakh, and Muhannad Al-Waily. "Designing a 3D virtual test platform for evaluating prosthetic knee joint performance during the walking cycle." Open Engineering 12, no. 1 (January 1, 2022): 590–604. http://dx.doi.org/10.1515/eng-2022-0017.
Повний текст джерелаАнотація:
Abstract This article introduced a three-dimension CAD model of a prosthesis testing platform using SolidWorks software to conduct a kinematic and dynamic analysis of the transfemoral prosthesis of the virtual model. Concurrently, the event-based motion simulation (EBMS) procedure was carried out on the CAD model. The concept of the operational strategy of the test platform was clarified through the machine’s real-life experience before being constructed in vitro. The platform model is capable of reproducing two active movements to simulate the locomotion of the thigh angle and hip vertical displacement for assessing the artificial knee angle motion during the gait cycle. These motions were controlled by two rotary forces (motors) that are utilized to implement control actions in EBMS. The prosthetic knee joint was built with a single axis that performs flexion and extension via the axial force of the spring. The simulation results of the thigh angle motion ranged from 2 0 ° 2{0}^{^\circ } to − 1 5 ° -1{5}^{^\circ } , while the maximum flexion of the prosthetic knee joint was ( 4 6 ° 4{6}^{^\circ } ). The mean absolute error was ( 2.72 7 ° 2.72{7}^{^\circ } ) and ( 8.33 8 ° 8.33{8}^{^\circ } ) for the thigh and knee joints, respectively. In conclusion, the findings can be utilized to facilitate the design and development of prostheses.
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Bertels, Thomas, Thomas Schmalz, and Eva Ludwigs. "Biomechanical influences of shoulder disarticulation prosthesis during standing and level walking." Prosthetics and Orthotics International 36, no. 2 (February 21, 2012): 165–72. http://dx.doi.org/10.1177/0309364611435499.
Повний текст джерелаАнотація:
Background: Modern prosthetic systems with more degrees of freedom offer the patient clearly improved functions. However, the influence of functional arm prostheses on body posture and gait have never been quantified.Objectives: The purpose of this investigation was to observe the impact of a functional arm prosthesis on body posture and gait of shoulder disarticulation patients.Study Design: Experimental, biomechanical.Methods: Eight patients with unilateral shoulder disarticulation were enrolled. Static posture and gait analyses were conducted with and without using a functional arm prosthesis. Static posture analysis using the L.A.S.A.R. Posture device as well as kinematic and kinetic gait analysis using an optoelectronic camera system combined with force plates were conducted with and without prosthesis in eight unilateral shoulder disarticulation patients.Results: Static analysis confirmed that an arm prosthesis improves body posture of amputees. Gait analysis revealed that compensatory movements during walking as well as external knee moments on the prosthetic side leg are significantly reduced when using a free swinging shoulder joint.Conclusions: An arm prosthesis does not only offer functional and cosmetic benefits. The results confirm that unilateral shoulder disarticulation patients benefit from a functional arm prosthesis with a free swinging shoulder joint in terms of optimized posture and gait dynamics.Clinical relevanceThis study demonstrates that shoulder disarticulation patients benefit from a functional prosthesis with a free swinging shoulder joint. Such prosthesis significantly improves body posture and gait characteristics, reduces compensatory movements and relieves distress to the musculoskeletal system. This should be considered when prescribing a prosthesis for shoulder disarticulation amputees.
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SUN, CHANGNING, LING WANG, ZHEN WANG, LEI GENG, DICHEN LI, MIAO SUI, and ZHONGMIN JIN. "FINITE ELEMENT ANALYSIS OF A RETRIEVED CUSTOM-MADE KNEE PROSTHESIS." Journal of Mechanics in Medicine and Biology 15, no. 03 (June 2015): 1550020. http://dx.doi.org/10.1142/s0219519415500207.
Повний текст джерелаАнотація:
Custom-made knee prostheses have been widely used to reconstruct the function of the lower limb in bone tumor resections. A custom-made tumor knee prosthesis was retrieved on account of prosthesis loosening post-surgery. Misalignment between the anatomical axis of the femur and the axis of the femoral stem as well as the material loss at the posterior region of the tibial plateau were considered to be the primary causes of the failure. Based on this hypothesis, finite element analysis was performed to investigate the contact mechanics of the prosthesis while implanted in vivo. The maximum deformation at the femur was 0.59 and 1.17 mm when the misalignment angle was 3° and 6°, respectively. Besides, the maximum contact pressure at the tibial plateau was 44.88 MPa at an extremely high flexion of angle 135° during squatting or kneeling. Uneven stress distribution at the femur, which came from the misalignment, was the main cause of loosening, which was aggravated indirectly with the material loss at the posterior region of the tibial plateau. Optimized prosthesis design and appropriate selection, with accurate surgical positioning and targeted rehabilitation training programme are important considerations for prolonging life-span of prostheses in vivo.
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Piyasin, Surasith, Kriengkrai Nabudda, and Suwipong Hemathulin. "The Design of Total Knee Replacement Prosthesis Suitable for Anteroposterior Movement for Thai Female." Advanced Materials Research 931-932 (May 2014): 1122–28. http://dx.doi.org/10.4028/www.scientific.net/amr.931-932.1122.
Повний текст джерелаАнотація:
Nowadays, patients with osteoarthritis in Thailand are likely to increase in number every year. There are approximately 462,000 people and most are females than males. The treatment is surgery knee replacement implants which must be imported from abroad and cost is expensive.Total knee prosthesis used in Thailand would not fit with the body of the Thai women because of the design total knee prosthesis use anatomical data of Europe and designed for both male and female, which is different in the knee structure. This research aims to study the size and shape of knee for Thai women and design total knee replacement. The using of finite elements is to assist in the analysis which focuses on the influence of the force active on and the effects of stress distribution on the part of the knee at different stages of gait cycle. The results of the study can measure the average size of Thai knee women base on analytical data. Anthropometric data on the proximal tibia and distal femur of 55 female knees were obtained using three dimensional computer tomographic measurements. The parametric studies are dimension analysis of the femoral mediolateral (fML) and femoral anteroposterior (fAP) dimension on distal femur surface and tibial mediolateral (tML), tibial anteroposterior (tAP) on proximal tibia surface. The measuring average values are 65, 60, 67 and 45 mm respectively. All parameters were compared to the size of the total knee prosthesis which currently used in Thailand. It is found that values are 70, 62, 68 and 48 mm respectively which is larger than the average Thai woman.The study of finite elements can be made aware of the stress distribution and stress in the area of artificial knee while walking and leading to the design of artificial knee joint to have size and shape suitable for Thai women.
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Samuelsson, Kersti AM, Outi Töytäri, Anna-Liisa Salminen, and Åse Brandt. "Effects of lower limb prosthesis on activity, participation, and quality of life: a systematic review." Prosthetics and Orthotics International 36, no. 2 (February 3, 2012): 145–58. http://dx.doi.org/10.1177/0309364611432794.
Повний текст джерелаАнотація:
Background: Effects presented on the use of assistive devices such as prosthesis are often based on laboratory findings (i.e. efficacy). Objectives: To summarise and evaluate findings from studies on effectiveness of lower limb prostheses for adults in real life contexts, primarily in terms of activity, participation, and quality of life (QoL) and secondarily in terms of user satisfaction, use/non-use, and/or cost-effectiveness. Study Design: Systematic review. Methods: We included controlled studies and non-controlled follow-up studies including both baseline and follow-up data. Using 14 different databases supplemented with manual searches, we searched for studies published from 1998 until June 2009. Results: Out of an initial 818 identified publications, eight met the inclusion criteria. Four studies reported on the effectiveness of a microprocessor-controlled knee (MP-knee) compared to a non-microprocessor-controlled knee (NMP-knee). Results were inconsistent except for quality of life and use/non-use, where the authors reported an improvement with the MP-knee compared to the NMP-knee. The remaining four studies included a diversity of prosthetic intervention measures and types of endpoints. Conclusions: Overall, there was an inconsistency in results and study quality. This review highlights the need for high-quality research studies that reflect the effectiveness of different prosthesis interventions in terms of users’ daily living and QoL. Clinical relevance Clinical guidelines are important to every practitioner. Information on expected effectiveness from assistive devices should be well founded and contain both facts about the device quality and its contribution to users’ daily lives. Thus, studies based on users’ experiences from prosthetic use in everyday life activities are of great importance.
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Zhang, Yibin, Wujing Cao, Hongliu Yu, Qiaoling Meng, and Jie Lv. "A four-bar knee joint measurement walking system for prosthesis design." Technology and Health Care 29, no. 4 (July 9, 2021): 823–28. http://dx.doi.org/10.3233/thc-202667.
Повний текст джерелаАнотація:
BACKGROUND: Gait analysis is important for the lower limb prosthesis design. Simulating the natural motion of the human knee in different terrains is useful for the design and performance assessment of the prosthetic knee. OBJECTIVE: This study aimed to propose a four-bar knee joint measurement system which can simulate the natural knee motions to collect the kinetic parameters precisely and analyze the walking characteristics under different terrain conditions. METHODS: A low-cost four-bar knee joint mechanism was proposed and gait characteristics were assessed on level ground, ascending and descending stairs, and ascending and descending ramp. RESULTS: The initial knee flexion angle during stair ascent at heel strike is obviously larger than in other walking scenes. The stance phase accounts for 53% of a single gait cycle during stair descent, which is slightly lower than other walking scenarios. The period that both the hindfoot and forefoot contact the ground in ramp descent accounts for 18%, which is less than for the others. While the forefoot contacts the ground in ramp ascent, the maximum vertical ground reaction force of the forefoot occurs when the hindfoot and forefoot simultaneously contact the ground, whereas in other scenarios the forefoot contacts the ground solely. CONCLUSIONS: The four-bar knee joint can simulate the natural motion of the human knee accurately. The gait characteristics analysis of different walking scenarios indicated that the low-cost four-bar knee joint exoskeleton was suitable for human knee joint simulation.
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Al Kouzbary, Mouaz, Hamza Al Kouzbary, Jingjing Liu, Taha Khamis, Zaina Al-Hashimi, Hanie Nadia Shasmin, Nooranida Arifin, and Noor Azuan Abu Osman. "Robotic Knee Prosthesis with Cycloidal Gear and Four-Bar Mechanism Optimized Using Particle Swarm Algorithm." Actuators 11, no. 9 (September 1, 2022): 253. http://dx.doi.org/10.3390/act11090253.
Повний текст джерелаАнотація:
A powered transfemoral prosthesis is needed as people with transfemoral amputation show 60 percent extra metabolic cost when compared to people with no amputation. Recently, as illustrated in the literature, the most high-torque robotic knee prosthesis utilize harmonic reducers. Despite the advantage of high reduction ratio and efficiency, the harmonic drive cannot be back-driven. Therefore, the harmonic drive is not an optimal solution for prosthetic systems with direct and indirect contact with the environment. In this paper, we outline an initial design of robotic knee prosthesis. The proposed robotic knee prosthesis consists of BLDC motor, cycloidal gear with reduction ratio 13:1, four-bar mechanism, and timing belt transmission with 4:1 reduction ratio. To optimize the torque transmission and range of motion (RoM), a multiobjective optimization problem must be undertaken. The end-effector motion depends on each bar length in the four-bar mechanism. The four-bar mechanism was optimized using particle swarm optimization (PSO). To complete the optimization, a set of 50 steps was collected using wearable sensors. Then, the data of sagittal plan were processed to identify the target profile for PSO. The prototype’s computer-aided manufacturing (CAM) was completed using a MarkTwo 3D printer with carbon fiber composite. The overall design can achieve a maximum torque of 84 N.m. However, the current design lacks the elastic component (no spring is added on the actuator output), which is necessary for a functional prosthesis; this limitation will be addressed in future study.
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Lee, Jin-Ah, Yong-Gon Koh, and Kyoung-Tak Kang. "Biomechanical and Clinical Effect of Patient-Specific or Customized Knee Implants: A Review." Journal of Clinical Medicine 9, no. 5 (May 21, 2020): 1559. http://dx.doi.org/10.3390/jcm9051559.
Повний текст джерелаАнотація:
(1) Background: Although knee arthroplasty or knee replacement is already an effective clinical treatment, it continues to undergo clinical and biomechanical improvements. For an increasing number of conditions, prosthesis based on an individual patient’s anatomy is a promising treatment. The aims of this review were to evaluate the clinical and biomechanical efficacy of patient-specific knee prosthesis, explore its future direction, and summarize any published comparative studies. (2) Methods: We searched the PubMed, MEDLINE, Embase, and Scopus databases for articles published prior to 1 February 2020, with the keywords “customized knee prosthesis” and “patient-specific knee prosthesis”. We excluded patient-specific instrument techniques. (3) Results: Fifty-seven articles met the inclusion criteria. In general, clinical improvement was greater with a patient-specific knee prosthesis than with a conventional knee prosthesis. In addition, patient-specific prosthesis showed improved biomechanical effect than conventional prosthesis. However, in one study, patient-specific unicompartmental knee arthroplasty showed a relatively high rate of aseptic loosening, particularly femoral component loosening, in the short- to medium-term follow-up. (4) Conclusions: A patient-specific prosthesis provides a more accurate resection and fit of components, yields significant postoperative improvements, and exhibits a high level of patient satisfaction over the short to medium term compared with a conventional prosthesis. However, the tibial insert design of the current patient-specific knee prosthesis does not follow the tibial plateau curvature.
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Simmelink, Elisabeth K., Gerardus M. Rommers, Jean W. M. Gardeniers, and Henk Zijlstra. "Prosthetic fitting in a patient with a transtibial amputation due to a congenital vascular malformation of the right leg." Prosthetics and Orthotics International 38, no. 2 (August 28, 2013): 167–70. http://dx.doi.org/10.1177/0309364613496110.
Повний текст джерелаАнотація:
Background: The problems of prescribing a prosthesis for a young girl with severe congenital vascular malformation deformity leading to a transtibial amputation. Case description and methods: Due to the high risk of recurrent bleeding and limitations regarding full weight bearing of the stump, a normal socket fitting process was not possible. Using a multidisciplinary approach, a prosthesis was designed to enable full weight bearing in a flexed knee position with ischial tuberosity support to prevent full weight bearing on the tibial part of the stump. Findings and outcomes: After training and adjustments to the design, a definitive prosthesis with a free motion mechanical knee joint could be used. During the training with this prosthesis, no skin problems were observed, and at the end of the rehabilitation, the patient had a high level of activities of daily living and sports. Conclusion: The above prosthetic solution with an adjusted socket design proved to be successful in this case. Clinical relevance In a patient with severe congenital vascular malformation deformity leading to a transtibial amputation, fitting of a good prosthesis without full weight bearing of the stump proved to be successful.
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Krishnan, Ahilan Anantha, Rupesh Ghyar, and Bhallamudi Ravi. "Comparison of Stresses in Four Modular Total Knee Arthroplasty Prosthesis Designs." International Journal of Biomedical and Clinical Engineering 5, no. 2 (July 2016): 1–16. http://dx.doi.org/10.4018/ijbce.2016070101.
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The current study, compares the mechanical performance of four modular TKA prostheses based on von Mises stress distribution in the tibial insert. Three-dimensional finite element (FE) models of a cruciate retaining type modular prosthesis and three posterior stabilized (PS) type modular prostheses namely: anterior slide, modular post and double cam, were developed. A compressive load of 2600 N was applied to the FE models at flexion angles of 00, 150, 300, 600 and 900. Von Mises stress was evaluated on all the modular parts of the prostheses and compared with the yield strength of the corresponding material. Von Mises stress in all the parts were below the yield strength of their corresponding material except for tibial insert of anterior slide design at high flexion angle. Von Mises stress above the yield strength in the tibial insert of anterior slide design, was due to edge loading in the post and it demonstrates the likelihood of mechanical failure by delamination type of wear.
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Islam, Md Rokibul, ANM Mushfiqul Haque, SN Amin, and KS Rabbani. "Design and Development of an EMG Driven Microcontroller Based Prosthetic Leg." Bangladesh Journal of Medical Physics 4, no. 1 (April 20, 2013): 107–14. http://dx.doi.org/10.3329/bjmp.v4i1.14695.
Повний текст джерелаАнотація:
Over the past years prosthetic legs have become much improved although complex. However their costs are high and are not within the reach of most people in the Third World. Low-cost fixed prostheses are available in the Third world countries of Asia and Africa, but these offer very basic movement with unnatural gait; climbing stairs gets quite difficult. The prosthesis being worked upon in the present work are for amputees with legs removed above the knee, and would offer a limited rotational movement of the knee joint under voluntary control of the wearer, driven by the EMG signals extracted from thigh muscles. The aim is to make it at a low cost, may be at a cost slightly higher than the passive ones, but allowing a better gait in walking, and in climbing stairs. An initial work was done in this direction by our extended group earlier; the present work gives further improvements. This involves redesigning of the motor and the gear system and that of the electronic circuitry for processing the EMG signals extracted from thigh muscles, interfacing the output to the microcontroller, rotating the motor in two directions thereby accomplishing the movement of the knee joint. The motor, geared down, is mounted horizontally and a pulley system drives the artificial knee joint. When complete, this will benefit a large number of handicapped people in the Third World. DOI: http://dx.doi.org/10.3329/bjmp.v4i1.14695 Bangladesh Journal of Medical Physics Vol.4 No.1 2011 107-114
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Bhakta, Krishan, Jonathan Camargo, Pratik Kunapuli, Lee Childers, and Aaron Young. "Impedance Control Strategies for Enhancing Sloped and Level Walking Capabilities for Individuals with Transfemoral Amputation Using a Powered Multi-Joint Prosthesis." Military Medicine 185, Supplement_1 (December 9, 2019): 490–99. http://dx.doi.org/10.1093/milmed/usz229.
Повний текст джерелаАнотація:
ABSTRACT Introduction Powered prostheses are a promising new technology that may help people with lower-limb loss improve their ability to perform locomotion tasks. Developing active prostheses requires robust design methodologies and intelligent controllers to appropriately provide assistance to the user for varied tasks in different environments. The purpose of this study was to validate an impedance control strategy for a powered knee and ankle prosthesis using an embedded sensor suite of encoders and a six-axis load cell that would aid an individual in performing common locomotion tasks, such as level walking and ascending/descending slopes. Materials and Methods Three amputees walked on a treadmill and four amputees walked on a ramp circuit to test whether a dual powered knee and ankle prosthesis could generate appropriate device joint kinematics across users. Results Investigators found that tuning 2–3 subject-specific parameters per ambulation mode was necessary to render individualized assistance. Furthermore, the kinematic profiles demonstrate invariance to walking speeds ranging from 0.63 to 1.07 m/s and incline/decline angles ranging from 7.8° to 14°. Conclusion This work presents a strategy that requires minimal tuning for a powered knee & ankle prosthesis that scales across a nominal range of both walking speeds and ramp slopes.