Yersinia enterocolitica Infection of a Prosthetic Knee Joint.Case Report and Review of the Literature on Deep Sited Infections Caused by Y.enterocolitica

Prosthetic joint infection is a rare manifestation of Yersinia enterocolitica. We report a case of a patient presenting with fever and a purulent infection in his prosthetic knee joint caused by Y. enterocolitica. He had been operated in 1990 for arthrosis of the right knee. Re-operation was performed in 2007 for loosening of the prosthesis. Seven months later, following progressively increasing knee pain, he became acutely febrile and a purulent knee joint infection was diagnosed. Y. enterocolitica was isolated from the joint fluid. Serum antibodies against Y. enterocolitica were also positive. He was treated with debridement, replacement of the liner component of the prosthesis and a long course of intravenous antimicrobial therapy. The infection was thought to be in a chronic suppressive state. The final outcome after all therapy was good.

Hybrid Active–Passive Prosthetic Knee:A Gait Kinematics and Muscle Activity Comparison with Mechanical and Microprocessor-Controlled Passive Prostheses

Existing microprocessor-controlled passive prosthetic knees(PaPKs)and active prosthetic knees(AcPKs)cannot truly simulate the muscle activity characteristics of the active–passive hybrid action of the knee during the normal gait.Differences in EMG between normal and different prosthetic gait for different phases were never separately analyzed.In this study,a novel hybrid active–passive prosthetic knee(HAPK)is proposed and if and how muscle activity and kinematics changes in different prosthetic gait are analyzed.The hybrid hydraulic-motor actuator is adopted to fully integrate the advantages of hydraulic compliance damping and motor efficiency,and the hierarchical control strategy is adopted to realize the adaptive predictive control of the HAPK.The kinematic data and EMG data of normal gait and different prosthetic gait were compared by experiments,so as to analyze the changes in the muscle activity and spatio-temporal data per phase compared to normal walking and the adaptations of amputees when walking with a different kind of prosthesis(the mechanical prosthesis(MePK),the PaPK and the HAPK).The results show that changes in prosthetic gait mainly consisted of decreased self-selected walking speed,gait symmetry and maximum knee flexion,increased first double support phase duration,muscle activation in both opposed and prosthetic limb and inter-subject variability.The differences between controls and MePK,PaPK and HAPK decreases sequentially.These results indicate that the hybrid active–passive actuating mode can have positive effects on improving the approximation of healthy gait characteristics.

Terrain Identification for Prosthetic Knees Based on Electromyographic Signal Features

The features of electromyographic （EMG） signals were investigated while people walking on different terrains, including up and down slopes, up and down stairs, and during level walking at different speeds, The features were used to develop a terrain identification method. The technology can be used to develop an intelligent transfemoral prosthetic limb with terrain identification capability, The EMG signals from 8 hip muscles of 13 healthy persons were recorded as they walked on the different terrains. The signals from the sound side of a transfemoral amputee were also recorded. The features of these signals were obtained using data processing techniques with an identification process developed for the identification of the terrain type. The procedure was simplified by using only the signals from three muscles. The identification process worked well in an intelligent prosthetic knee in a laboratory setting.

Review of Recent Progress in Robotic Knee Prosthesis Related Techniques:Structure,Actuation and Control

As 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.