Based on the building principle of additive manufacturing,printing orientation mainly determines the tribological properties of joint prostheses.In this study,we created a polyether-ether-ketone(PEEK)joint prosthesis ...Based on the building principle of additive manufacturing,printing orientation mainly determines the tribological properties of joint prostheses.In this study,we created a polyether-ether-ketone(PEEK)joint prosthesis using fused filament fabrication and investigated the effects of printing orientation on its tribological properties using a pin-on-plate tribometer in 25% newborn calf serum.An ultrahigh molecular weight polyethylene transfer film is formed on the surface of PEEK due to the mechanical capture of wear debris by the 3D-printed groove morphology,which is significantly impacted by the printing orientation of PEEK.When the printing orientation was parallel to the sliding direction of friction,the number and size of the transfer film increased due to higher steady stress.This transfer film protected the matrix and reduced the friction coefficient and wear rate of friction pairs by 39.13%and 74.33%,respectively.Furthermore,our findings provide a novel perspective regarding the role of printing orientation in designing knee prostheses,facilitating its practical applications.展开更多
It is important for surgeons performing sarcoma surgery to know that bone resection and tumor prosthesis applications in soft tissue sarcomas(STS)have unique features in terms of indication,surgical approach and follo...It is important for surgeons performing sarcoma surgery to know that bone resection and tumor prosthesis applications in soft tissue sarcomas(STS)have unique features in terms of indication,surgical approach and follow-up,in terms of the management of these cases.Some STS are associated with bone and major neurovascular structures.Bone-associated STS are generally relatively large and relatively deep-seated.Additionally,the tendency for metastasis is high.In some cases,the decision about which structures to resect is difficult.These cases are often accompanied by poor oncological and surgical outcomes.Management of cases should be done by a multidisciplinary team in advanced centers specialized in this field.The surgical team must have sufficient knowledge and experience in the field of limb-sparing surgery.Preoperative evaluation and especially good planning of bone and soft tissue reconstruction are vital.展开更多
Researchers have proposed various linkage mechanisms to connect knee and ankle joints for above-knee prosthe-ses,but most of them only offer natural walking.However,studies have shown that people assume a squatting po...Researchers have proposed various linkage mechanisms to connect knee and ankle joints for above-knee prosthe-ses,but most of them only offer natural walking.However,studies have shown that people assume a squatting posture during daily activities.This paper introduces a novel mechanism that connects the knee joint with the foot-ankle joint to enable both squatting and walking.The prosthetic knee used is the well-known 3R36,while the energy storing and return(ESAR)prosthetic foot is used for the ankle-foot joint.To coordinate knee and ankle joint movements,a six-bar linkage mechanism structure is proposed.Simulation results demonstrate that the proposed modular transfemoral prosthesis accurately mimics the motion patterns of a natural human leg during walking and squatting.For instance,the prosthesis allows a total knee flexion of more than 140°during squatting.The new prosthesis design also incorporates energy-storing mechanisms to reduce energy expenditure during walking for amputees.展开更多
Objective The present study was aimed to determine the effect of penile prosthesis implantation(PPI)surgery on penile sensation by evaluating the penile electromyography(EMG)variables.Methods The research was designed...Objective The present study was aimed to determine the effect of penile prosthesis implantation(PPI)surgery on penile sensation by evaluating the penile electromyography(EMG)variables.Methods The research was designed as a prospective study.Thirty patients who were diagnosed with organic erectile dysfunction and had underwent PPI surgery between January 2017 and January 2018 in the Urology Clinic of Antalya Training and Research Hospital were included in this study.Penile sensory EMG was performed on each patient 1 day prior to the surgery by the Physical Therapy and Rehabilitation clinic.Additionally,the control EMG study was also performed in the 3rd and 6th postoperative months.Results We included 27 patients in this study who attended regular follow-ups and had complete EMG results.Out of the 27 patients,23(85.2%)patients had received malleable(ProMedon)penile prosthesis,one(3.7%)patient had received a two-piece inflatable(Ambicor)penile prosthesis,and three(11.1%)patients had received a three-piece inflatable(AMS 700 CXR)penile prosthesis.The mean nerve conduction value(NCV)of the patients was 29.85(standard derivation:22.54;range:0-78.4)m/s during the preoperative period,whereas it was 27.64(standard derivation:24.72;range:0-83.3)m/s in the 3rd postoperative month and 24.80(standard derivation:22.31;range:0-88.4)m/s in the 6th postoperative month.There was no significant difference between preoperative NCV and 3rd postoperative month NCV(p=0.607).Similarly,no significant difference was observed between preoperative NCV and 6th postoperative month NCV(p=0.276).Additionally,the change between NCV values at postoperative 3rd and 6th months was not statistically significant(p=0.553).Conclusion Significant loss of penile sensation does not occur in patients who undergo PPI surgery.展开更多
Introduction: Gait analysis of an adult man after trans-metatarsal unilateral amputation is described. Objective: Instrumental gait analysis of a subject 15 years after trans-metatarsal unilateral amputation in two fo...Introduction: Gait analysis of an adult man after trans-metatarsal unilateral amputation is described. Objective: Instrumental gait analysis of a subject 15 years after trans-metatarsal unilateral amputation in two footwear conditions: while walking barefoot and with prosthesis. Materials and Methods: In a movement analysis laboratory, locomotion studies were carried out at freely chosen walking speed by a 65-year-old subject, obtaining kinematic, kinetic and surface electromyographic data in time and space. Gait analysis was performed using instrumental technologies from a digital eco-system applying walking protocols. Results: When the patient wore the prosthesis, several positive improvements were observed in various aspects of gait. These included enhancements in the base of support, gait speed, and joint range of movements. Additionally, there was a slight improvement in the vertical ground reaction forces pattern, indicating a positive effect of the assistive technology. Furthermore, the use of the prosthesis led to a more organized pattern of muscle activity, which further supports its beneficial impact. However, it is worth noting that some challenges still persisted, particularly regarding stabilizing the body during the double support phase. Despite this difficulty, the overall findings suggest that the use of the prosthesis offers valuable improvements to the patient’s gait dynamics. Conclusions: After conducting a thorough analysis of the parameters related to the gait of a subject who underwent a trans-metatarsal unilateral amputation fifteen years ago, it was found that the use of prosthesis had a positive impact. This study demonstrated important improvements in some kinematic and kinetic parameters, including muscle activation patterns, indicating an increase in comfort and confidence while utilizing the prosthetic device.展开更多
Facial prostheses have developed significantly in the last 10 years,especially between 2016 and 2021.This development is mainly due to the great progress made in the fields of biocompatible materials,digital technolog...Facial prostheses have developed significantly in the last 10 years,especially between 2016 and 2021.This development is mainly due to the great progress made in the fields of biocompatible materials,digital technology,and three-dimensional printing technology,which provides guarantee for low allergy,high biosimulation,comfort,and satisfactory usability.Treatment teams typically consist of plastic surgeons,material experts,engineers,and computer scientists who have extensive clinical experience.These teams successfully implement an integrated,multidisciplinary model by prioritizing the reasonable expectations of both the physician and patient,leading to improved patient satisfaction and compliance with prosthetic constraints.This study aimed to review the concept,development status,existing problems,and future of facial prosthesis.展开更多
Artificial intelligence can be indirectly applied to the repair of peripheral nerve injury.Specifically,it can be used to analyze and process data regarding peripheral nerve injury and repair,while study findings on p...Artificial intelligence can be indirectly applied to the repair of peripheral nerve injury.Specifically,it can be used to analyze and process data regarding peripheral nerve injury and repair,while study findings on peripheral nerve injury and repair can provide valuable data to enrich artificial intelligence algorithms.To investigate advances in the use of artificial intelligence in the diagnosis,rehabilitation,and scientific examination of peripheral nerve injury,we used CiteSpace and VOSviewer software to analyze the relevant literature included in the Web of Science from 1994–2023.We identified the following research hotspots in peripheral nerve injury and repair:(1)diagnosis,classification,and prognostic assessment of peripheral nerve injury using neuroimaging and artificial intelligence techniques,such as corneal confocal microscopy and coherent anti-Stokes Raman spectroscopy;(2)motion control and rehabilitation following peripheral nerve injury using artificial neural networks and machine learning algorithms,such as wearable devices and assisted wheelchair systems;(3)improving the accuracy and effectiveness of peripheral nerve electrical stimulation therapy using artificial intelligence techniques combined with deep learning,such as implantable peripheral nerve interfaces;(4)the application of artificial intelligence technology to brain-machine interfaces for disabled patients and those with reduced mobility,enabling them to control devices such as networked hand prostheses;(5)artificial intelligence robots that can replace doctors in certain procedures during surgery or rehabilitation,thereby reducing surgical risk and complications,and facilitating postoperative recovery.Although artificial intelligence has shown many benefits and potential applications in peripheral nerve injury and repair,there are some limitations to this technology,such as the consequences of missing or imbalanced data,low data accuracy and reproducibility,and ethical issues(e.g.,privacy,data security,research transparency).Future research should address the issue of data collection,as large-scale,high-quality clinical datasets are required to establish effective artificial intelligence models.Multimodal data processing is also necessary,along with interdisciplinary collaboration,medical-industrial integration,and multicenter,large-sample clinical studies.展开更多
BACKGROUND Elderly patients maintaining functional independence can now be candidates for primary wrist hemiarthroplasty to manage acute irreparable distal radius fractures(DRFs).However,further investigation with lon...BACKGROUND Elderly patients maintaining functional independence can now be candidates for primary wrist hemiarthroplasty to manage acute irreparable distal radius fractures(DRFs).However,further investigation with long-term follow-up is required to validate these initial findings.AIM To review the literature on the outcomes of distal radius hemiarthroplasty with available implants to assess its viability as a treatment option.METHODS A comprehensive review of the literature was conducted using electronic databases,including PubMed,Medline,and Scopus.The search terms employed were"distal radius fracture","hemiarthroplasty","wrist arthroplasty",and related terminology.The search was restricted to articles published in English from 1980 until June 2023.Inclusion criteria encompassed cases or case series of DRF treated with hemiarthroplasty,providing clinical or radiographic outcomes,and published in peer-reviewed journals.RESULTS A total of 2508 articles from PubMed and 883 from Scopus were identified initially.Following screening and removal of duplicates,13 articles met the inclusion criteria.These articles,predominantly clinical retrospective studies,provided insights into hemiarthroplasty outcomes,including functional improvements and complications.Hemiarthroplasty was a treatment option for complex DRF,particularly those cases with severe comminution,intraarticular involvement,or severe osteoporosis.Functional outcomes demonstrated improvements in pain relief,wrist mobility,and grip strength,with variability across studies.Complications included implant loosening,infection,nerve injury,and stiffness,with varying incidence rates influenced by surgical techniques and implant choice.Long-term outcomes were inadequately documented,warranting further research.CONCLUSION Hemiarthroplasty is a promising treatment for irreparable DRF in the elderly.Long-term outcomes and complications require further study.展开更多
基金This study was supported by the following funds:National Key R&D Program of China(No.2018YFE0207900)Program for Innovation Team of Shaanxi Province(No.2023-CXTD-17)+5 种基金Program of the National Natural Science Foundation of China(No.51835010)Key R&D Program of Guangdong Province(No.2018B090906001)Natural Science Basic Research Program of Shaanxi Province(No.2022JQ-378)China Postdoctoral Science Foundation(No.2020M683458)Fundamental Research Funds for the Central Universities(8)Youth Innovation Team of Shaanxi Universities.
文摘Based on the building principle of additive manufacturing,printing orientation mainly determines the tribological properties of joint prostheses.In this study,we created a polyether-ether-ketone(PEEK)joint prosthesis using fused filament fabrication and investigated the effects of printing orientation on its tribological properties using a pin-on-plate tribometer in 25% newborn calf serum.An ultrahigh molecular weight polyethylene transfer film is formed on the surface of PEEK due to the mechanical capture of wear debris by the 3D-printed groove morphology,which is significantly impacted by the printing orientation of PEEK.When the printing orientation was parallel to the sliding direction of friction,the number and size of the transfer film increased due to higher steady stress.This transfer film protected the matrix and reduced the friction coefficient and wear rate of friction pairs by 39.13%and 74.33%,respectively.Furthermore,our findings provide a novel perspective regarding the role of printing orientation in designing knee prostheses,facilitating its practical applications.
文摘It is important for surgeons performing sarcoma surgery to know that bone resection and tumor prosthesis applications in soft tissue sarcomas(STS)have unique features in terms of indication,surgical approach and follow-up,in terms of the management of these cases.Some STS are associated with bone and major neurovascular structures.Bone-associated STS are generally relatively large and relatively deep-seated.Additionally,the tendency for metastasis is high.In some cases,the decision about which structures to resect is difficult.These cases are often accompanied by poor oncological and surgical outcomes.Management of cases should be done by a multidisciplinary team in advanced centers specialized in this field.The surgical team must have sufficient knowledge and experience in the field of limb-sparing surgery.Preoperative evaluation and especially good planning of bone and soft tissue reconstruction are vital.
文摘Researchers have proposed various linkage mechanisms to connect knee and ankle joints for above-knee prosthe-ses,but most of them only offer natural walking.However,studies have shown that people assume a squatting posture during daily activities.This paper introduces a novel mechanism that connects the knee joint with the foot-ankle joint to enable both squatting and walking.The prosthetic knee used is the well-known 3R36,while the energy storing and return(ESAR)prosthetic foot is used for the ankle-foot joint.To coordinate knee and ankle joint movements,a six-bar linkage mechanism structure is proposed.Simulation results demonstrate that the proposed modular transfemoral prosthesis accurately mimics the motion patterns of a natural human leg during walking and squatting.For instance,the prosthesis allows a total knee flexion of more than 140°during squatting.The new prosthesis design also incorporates energy-storing mechanisms to reduce energy expenditure during walking for amputees.
文摘Objective The present study was aimed to determine the effect of penile prosthesis implantation(PPI)surgery on penile sensation by evaluating the penile electromyography(EMG)variables.Methods The research was designed as a prospective study.Thirty patients who were diagnosed with organic erectile dysfunction and had underwent PPI surgery between January 2017 and January 2018 in the Urology Clinic of Antalya Training and Research Hospital were included in this study.Penile sensory EMG was performed on each patient 1 day prior to the surgery by the Physical Therapy and Rehabilitation clinic.Additionally,the control EMG study was also performed in the 3rd and 6th postoperative months.Results We included 27 patients in this study who attended regular follow-ups and had complete EMG results.Out of the 27 patients,23(85.2%)patients had received malleable(ProMedon)penile prosthesis,one(3.7%)patient had received a two-piece inflatable(Ambicor)penile prosthesis,and three(11.1%)patients had received a three-piece inflatable(AMS 700 CXR)penile prosthesis.The mean nerve conduction value(NCV)of the patients was 29.85(standard derivation:22.54;range:0-78.4)m/s during the preoperative period,whereas it was 27.64(standard derivation:24.72;range:0-83.3)m/s in the 3rd postoperative month and 24.80(standard derivation:22.31;range:0-88.4)m/s in the 6th postoperative month.There was no significant difference between preoperative NCV and 3rd postoperative month NCV(p=0.607).Similarly,no significant difference was observed between preoperative NCV and 6th postoperative month NCV(p=0.276).Additionally,the change between NCV values at postoperative 3rd and 6th months was not statistically significant(p=0.553).Conclusion Significant loss of penile sensation does not occur in patients who undergo PPI surgery.
文摘Introduction: Gait analysis of an adult man after trans-metatarsal unilateral amputation is described. Objective: Instrumental gait analysis of a subject 15 years after trans-metatarsal unilateral amputation in two footwear conditions: while walking barefoot and with prosthesis. Materials and Methods: In a movement analysis laboratory, locomotion studies were carried out at freely chosen walking speed by a 65-year-old subject, obtaining kinematic, kinetic and surface electromyographic data in time and space. Gait analysis was performed using instrumental technologies from a digital eco-system applying walking protocols. Results: When the patient wore the prosthesis, several positive improvements were observed in various aspects of gait. These included enhancements in the base of support, gait speed, and joint range of movements. Additionally, there was a slight improvement in the vertical ground reaction forces pattern, indicating a positive effect of the assistive technology. Furthermore, the use of the prosthesis led to a more organized pattern of muscle activity, which further supports its beneficial impact. However, it is worth noting that some challenges still persisted, particularly regarding stabilizing the body during the double support phase. Despite this difficulty, the overall findings suggest that the use of the prosthesis offers valuable improvements to the patient’s gait dynamics. Conclusions: After conducting a thorough analysis of the parameters related to the gait of a subject who underwent a trans-metatarsal unilateral amputation fifteen years ago, it was found that the use of prosthesis had a positive impact. This study demonstrated important improvements in some kinematic and kinetic parameters, including muscle activation patterns, indicating an increase in comfort and confidence while utilizing the prosthetic device.
文摘Facial prostheses have developed significantly in the last 10 years,especially between 2016 and 2021.This development is mainly due to the great progress made in the fields of biocompatible materials,digital technology,and three-dimensional printing technology,which provides guarantee for low allergy,high biosimulation,comfort,and satisfactory usability.Treatment teams typically consist of plastic surgeons,material experts,engineers,and computer scientists who have extensive clinical experience.These teams successfully implement an integrated,multidisciplinary model by prioritizing the reasonable expectations of both the physician and patient,leading to improved patient satisfaction and compliance with prosthetic constraints.This study aimed to review the concept,development status,existing problems,and future of facial prosthesis.
基金supported by the Capital’s Funds for Health Improvement and Research,No.2022-2-2072(to YG).
文摘Artificial intelligence can be indirectly applied to the repair of peripheral nerve injury.Specifically,it can be used to analyze and process data regarding peripheral nerve injury and repair,while study findings on peripheral nerve injury and repair can provide valuable data to enrich artificial intelligence algorithms.To investigate advances in the use of artificial intelligence in the diagnosis,rehabilitation,and scientific examination of peripheral nerve injury,we used CiteSpace and VOSviewer software to analyze the relevant literature included in the Web of Science from 1994–2023.We identified the following research hotspots in peripheral nerve injury and repair:(1)diagnosis,classification,and prognostic assessment of peripheral nerve injury using neuroimaging and artificial intelligence techniques,such as corneal confocal microscopy and coherent anti-Stokes Raman spectroscopy;(2)motion control and rehabilitation following peripheral nerve injury using artificial neural networks and machine learning algorithms,such as wearable devices and assisted wheelchair systems;(3)improving the accuracy and effectiveness of peripheral nerve electrical stimulation therapy using artificial intelligence techniques combined with deep learning,such as implantable peripheral nerve interfaces;(4)the application of artificial intelligence technology to brain-machine interfaces for disabled patients and those with reduced mobility,enabling them to control devices such as networked hand prostheses;(5)artificial intelligence robots that can replace doctors in certain procedures during surgery or rehabilitation,thereby reducing surgical risk and complications,and facilitating postoperative recovery.Although artificial intelligence has shown many benefits and potential applications in peripheral nerve injury and repair,there are some limitations to this technology,such as the consequences of missing or imbalanced data,low data accuracy and reproducibility,and ethical issues(e.g.,privacy,data security,research transparency).Future research should address the issue of data collection,as large-scale,high-quality clinical datasets are required to establish effective artificial intelligence models.Multimodal data processing is also necessary,along with interdisciplinary collaboration,medical-industrial integration,and multicenter,large-sample clinical studies.
文摘BACKGROUND Elderly patients maintaining functional independence can now be candidates for primary wrist hemiarthroplasty to manage acute irreparable distal radius fractures(DRFs).However,further investigation with long-term follow-up is required to validate these initial findings.AIM To review the literature on the outcomes of distal radius hemiarthroplasty with available implants to assess its viability as a treatment option.METHODS A comprehensive review of the literature was conducted using electronic databases,including PubMed,Medline,and Scopus.The search terms employed were"distal radius fracture","hemiarthroplasty","wrist arthroplasty",and related terminology.The search was restricted to articles published in English from 1980 until June 2023.Inclusion criteria encompassed cases or case series of DRF treated with hemiarthroplasty,providing clinical or radiographic outcomes,and published in peer-reviewed journals.RESULTS A total of 2508 articles from PubMed and 883 from Scopus were identified initially.Following screening and removal of duplicates,13 articles met the inclusion criteria.These articles,predominantly clinical retrospective studies,provided insights into hemiarthroplasty outcomes,including functional improvements and complications.Hemiarthroplasty was a treatment option for complex DRF,particularly those cases with severe comminution,intraarticular involvement,or severe osteoporosis.Functional outcomes demonstrated improvements in pain relief,wrist mobility,and grip strength,with variability across studies.Complications included implant loosening,infection,nerve injury,and stiffness,with varying incidence rates influenced by surgical techniques and implant choice.Long-term outcomes were inadequately documented,warranting further research.CONCLUSION Hemiarthroplasty is a promising treatment for irreparable DRF in the elderly.Long-term outcomes and complications require further study.