首页 > 最新文献

Journal of Bone and Joint Surgery-british Volume最新文献

英文 中文
Elbow Arthroplasty Using Inter-Positional JK Membrane in the Era of Biologics: A Report of Two Cases 生物制剂时代用JK膜置换术治疗肘关节:附2例报告
Pub Date : 2013-12-01 DOI: 10.11551/JSJD.31.487
C. Weijia, R. Nagamine
Objective: Total elbow joint arthroplasty has limited longevity and is therefore not appropriate for younger rheumatoid arthritis patients. Arthroplasty using an inter-positional membrane may be another surgical option for this population. However, clinical results for joint arthroplasty using the inter-positional membrane have not traditionally been favorable because rheumatoid activity could not be controlled. Today, rheumatoid activity can be controlled with biologics; therefore, the utility of the inter-positional membrane procedure was re-evaluated. Methods: An 8×6 cm sheet of fascia was detached from the patient9s tensor fascia lata muscle to produce a JK membrane. The fascia was stretched on a frame and kept in a 2% chromic acid potassium solution for 24 hours. Then, the fascia was exposed to direct sunlight in order to reduce the dichromic acid. The fascia was washed out in running water for 24 hours and was then stored in phenol with the addition of 70% alcohol. Elbow arthroplasties were performed on three elbow joints in two young female patients. The first case had a significantly damaged right elbow joint with severe joint dysfunction. A JK membrane arthroplasty was done for the first case in 2003, when this patient was 34 years old. Biologics were administered with methotrexate after the surgery. The second case demonstrated bilateral ankylosed elbows due to idiopathic juvenile arthritis. Bilateral JK membrane arthroplasties were performed in 2010, when this patient was 32 years old. Several operative and manual manipulations were necessary in order to increase the range of motion following surgery. Biologics were administered with cyclosporine. Results: Joint function was significantly improved in all three joints without pain after the JK membrane elbow arthroplasties. In case one, the JOA (Japan Orthopaedic Association) elbow score improved from 21 points before surgery to 85 points after surgery and active elbow flexion improved to 110 degrees following surgery. In case two, the JOA elbow score was 55 and 82 points in the right elbow and 52 and 83 points in left elbow before and after surgery, respectively. In case two, active flexion improved to 120 degrees for the right elbow and 110 degrees for the left elbow following surgery. RA was well controlled in both patients. Conclusion: Elbow arthroplasty using an inter-positional membrane appears to be useful in young patients when RA activity is controlled with biologics.
目的:全肘关节置换术的寿命有限,因此不适合年轻的类风湿关节炎患者。使用位置间膜的关节成形术可能是该人群的另一种手术选择。然而,使用位置间膜进行关节置换术的临床结果传统上并不理想,因为类风湿活动无法控制。今天,类风湿活动可以用生物制剂控制;因此,重新评估了位置间膜手术的效用。方法:从患者的阔筋膜张肌上剥离8×6 cm的筋膜,制成JK膜。筋膜在支架上拉伸,在2%铬酸钾溶液中保存24小时。然后,将筋膜暴露在阳光直射下,以减少重铬酸。将筋膜在自来水中冲洗24小时,然后在苯酚中添加70%的酒精保存。对2例年轻女性患者的3个肘关节进行了肘关节置换术。第一例患者右肘关节明显受损,伴有严重的关节功能障碍。第一例患者于2003年进行了JK膜关节置换术,当时患者34岁。术后给予生物制剂和甲氨蝶呤。第二个病例显示双侧强直肘部由于特发性幼年关节炎。于2010年行双侧JK膜置换手术,患者32岁。为了增加手术后的活动范围,一些手术和手动操作是必要的。生物制剂与环孢素一起使用。结果:JK膜肘关节置换术后关节功能明显改善,无疼痛。病例一,JOA(日本骨科协会)肘关节评分从术前的21分提高到术后的85分,术后肘关节活动度提高到110度。病例二,手术前后右肘JOA评分分别为55分和82分,左肘JOA评分分别为52分和83分。病例二,手术后右肘主动屈曲度提高到120度,左肘主动屈曲度提高到110度。两例患者RA均得到良好控制。结论:在使用生物制剂控制RA活动的年轻患者中,使用位置间膜的肘关节置换术似乎是有用的。
{"title":"Elbow Arthroplasty Using Inter-Positional JK Membrane in the Era of Biologics: A Report of Two Cases","authors":"C. Weijia, R. Nagamine","doi":"10.11551/JSJD.31.487","DOIUrl":"https://doi.org/10.11551/JSJD.31.487","url":null,"abstract":"Objective: Total elbow joint arthroplasty has limited longevity and is therefore not appropriate for younger rheumatoid arthritis patients. Arthroplasty using an inter-positional membrane may be another surgical option for this population. However, clinical results for joint arthroplasty using the inter-positional membrane have not traditionally been favorable because rheumatoid activity could not be controlled. Today, rheumatoid activity can be controlled with biologics; therefore, the utility of the inter-positional membrane procedure was re-evaluated. Methods: An 8×6 cm sheet of fascia was detached from the patient9s tensor fascia lata muscle to produce a JK membrane. The fascia was stretched on a frame and kept in a 2% chromic acid potassium solution for 24 hours. Then, the fascia was exposed to direct sunlight in order to reduce the dichromic acid. The fascia was washed out in running water for 24 hours and was then stored in phenol with the addition of 70% alcohol. Elbow arthroplasties were performed on three elbow joints in two young female patients. The first case had a significantly damaged right elbow joint with severe joint dysfunction. A JK membrane arthroplasty was done for the first case in 2003, when this patient was 34 years old. Biologics were administered with methotrexate after the surgery. The second case demonstrated bilateral ankylosed elbows due to idiopathic juvenile arthritis. Bilateral JK membrane arthroplasties were performed in 2010, when this patient was 32 years old. Several operative and manual manipulations were necessary in order to increase the range of motion following surgery. Biologics were administered with cyclosporine. Results: Joint function was significantly improved in all three joints without pain after the JK membrane elbow arthroplasties. In case one, the JOA (Japan Orthopaedic Association) elbow score improved from 21 points before surgery to 85 points after surgery and active elbow flexion improved to 110 degrees following surgery. In case two, the JOA elbow score was 55 and 82 points in the right elbow and 52 and 83 points in left elbow before and after surgery, respectively. In case two, active flexion improved to 120 degrees for the right elbow and 110 degrees for the left elbow following surgery. RA was well controlled in both patients. Conclusion: Elbow arthroplasty using an inter-positional membrane appears to be useful in young patients when RA activity is controlled with biologics.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"8 1","pages":"581-581"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82836275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Open Reduction by Fenestration to the Ilium for Central Acetabular Depression Fracture: A Case Report and Operative Technique 髂骨开窗切开复位治疗髋臼中央凹陷骨折1例及手术技巧
Pub Date : 2013-12-01 DOI: 10.4236/OJO.2016.68029
M. Maruyama, Kazushige Yoshida, K. Kitagawa
We reported a case of the acetabular depression fracture in conjunction with a central fracture dislocation of the hip that was treated with a unique surgical technique. CASE REPORT: A 76-year-old man suffered a left acetabular fracture with severe left hip joint pain and walking disability. Acetabular fracture was not apparent on the initial radiographs including anteroposterior and oblique views of the pelvis. However, computed tomography (CT) scanning showed displaced acetabular depression fracture (a third fracture fragment) in the center of the weight-bearing area with fracture of the ilium and spontaneous reposition of central dislocation of the hip (Fig. 1, 2). It seemed that this fracture fragment created incongruity of the acetabular articular surface and the potential for hip joint instability. Therefore, the patient was treated with open reduction and internal fixation. SURGICAL TECHNIQUE: To perform the procedure, the patient was placed in the lateral decubitus position. A direct lateral approach to the hip was used for exposure. The vastus lateralis was released 1 cm distal from its origin, trochanteric osteotomy was done by the Gigli saw. To observe the hip articular surface and to identify the fracture fragment, the femoral head was posterior dislocated with excision of teres ligamentum after T-shaped capsulotomy. The depressed fragment in the acetabulum was identified under direct vision but could not be reduced. Therefore, the outer cortex of the ilium was fenestrated in a size of 2 × 2 cm so that a 1-cm-wide levator was inserted to the depressed fragment at 2 cm proximal from the hip articular surface through the fenestrated window (Fig. 3). Subsequently, the displaced bone fragment was pushed down by using the levator to the adequate articular joint level. The fragment was stabilized with packed cancellous bone graft harvested from the osteotomized greater trochanter. The removed outer cortex of the ilium from fenestrated site was repositioned and fixed by a reconstruction plate and screws. The osteotomized greater trochanter was reattached and fixed with two cannulated cancellous hip screws. RESULTS: At 9-month follow-up, he was pain-free and continued to function well without the use of external supports. The acetabular depression fracture was completely reduced and healed in the CT scanning evaluation. The patient had no signs of posttraumatic osteoarthritis in radiographs. DISCUSSION and CONCLUSION: In acetabular fracture dislocations of the hip joint, the precise pathological anatomy is not easily demonstrated by routine radiographs with classification of acetabular fractures. In our case, however, details of acetabular fracture were not well visible on conventional radiographs. It has been shown that computed tomography is useful method in precise evaluation of the fracture type with bone damage and integrity of joint configuration. Concerning approach to the fracture fragment which existed in the center of the weight bea
我们报告一例髋臼凹陷性骨折合并髋关节中央骨折脱位,采用独特的手术技术治疗。病例报告:一名76岁男性左髋臼骨折,伴有严重的左髋关节疼痛和行走障碍。髋臼骨折在最初的x线片上不明显,包括骨盆正位和斜位片。然而,计算机断层扫描(CT)显示,在负重区中心有移位的髋臼凹陷骨折(第三个骨折碎片),并伴有髂骨骨折和髋关节中央脱位的自发性复位(图1,2)。该骨折碎片似乎造成了髋臼关节面不一致,并可能导致髋关节不稳定。因此,患者接受切开复位内固定治疗。手术技术:将患者置于侧卧位。采用髋关节直接外侧入路进行暴露。将股外侧肌从其原点远端1 cm处释放,用Gigli锯行股骨粗隆截骨。为观察髋关节关节面,识别骨折碎片,采用t型囊切开术后股骨头后路脱位,切除股骨头韧带。在直视下发现髋臼凹陷碎片,但无法复位。因此,髂骨外皮质开2 × 2 cm的孔,通过开孔窗将1 cm宽的提肛肌插入距髋关节关节面近2 cm处的凹陷碎片(图3)。随后,用提肛肌将移位的骨碎片推下至适当的关节水平。从截骨的大转子上取下的填充松质骨移植物来稳定碎片。将从开窗部位取出的髂骨外皮质重新定位,用重建钢板和螺钉固定。将截骨的大转子重新连接并用两枚空心松质髋关节螺钉固定。结果:随访9个月,患者无疼痛,在不使用外支架的情况下功能良好。CT扫描评价髋臼凹陷骨折完全复位愈合。患者在x线片上没有创伤后骨关节炎的迹象。讨论与结论:在髋关节髋臼骨折脱位中,常规x线片很难精确地显示病理解剖结构和髋臼骨折的分类。然而,在我们的病例中,髋臼骨折的细节在常规x线片上不能很好地看到。研究表明,计算机断层扫描是一种精确评估骨折类型和关节结构完整性的有效方法。对于存在于髋臼负重区中心的骨折碎片入路,我们在骨折部位近端的完整髂骨骨皮质上进行开窗手术。虽然没有关于这种“开窗”方法的报道,但这种方法对于髋臼中央凹陷骨折的复位是方便和有用的。
{"title":"Open Reduction by Fenestration to the Ilium for Central Acetabular Depression Fracture: A Case Report and Operative Technique","authors":"M. Maruyama, Kazushige Yoshida, K. Kitagawa","doi":"10.4236/OJO.2016.68029","DOIUrl":"https://doi.org/10.4236/OJO.2016.68029","url":null,"abstract":"We reported a case of the acetabular depression fracture in conjunction with a central fracture dislocation of the hip that was treated with a unique surgical technique. CASE REPORT: A 76-year-old man suffered a left acetabular fracture with severe left hip joint pain and walking disability. Acetabular fracture was not apparent on the initial radiographs including anteroposterior and oblique views of the pelvis. However, computed tomography (CT) scanning showed displaced acetabular depression fracture (a third fracture fragment) in the center of the weight-bearing area with fracture of the ilium and spontaneous reposition of central dislocation of the hip (Fig. 1, 2). It seemed that this fracture fragment created incongruity of the acetabular articular surface and the potential for hip joint instability. Therefore, the patient was treated with open reduction and internal fixation. SURGICAL TECHNIQUE: To perform the procedure, the patient was placed in the lateral decubitus position. A direct lateral approach to the hip was used for exposure. The vastus lateralis was released 1 cm distal from its origin, trochanteric osteotomy was done by the Gigli saw. To observe the hip articular surface and to identify the fracture fragment, the femoral head was posterior dislocated with excision of teres ligamentum after T-shaped capsulotomy. The depressed fragment in the acetabulum was identified under direct vision but could not be reduced. Therefore, the outer cortex of the ilium was fenestrated in a size of 2 × 2 cm so that a 1-cm-wide levator was inserted to the depressed fragment at 2 cm proximal from the hip articular surface through the fenestrated window (Fig. 3). Subsequently, the displaced bone fragment was pushed down by using the levator to the adequate articular joint level. The fragment was stabilized with packed cancellous bone graft harvested from the osteotomized greater trochanter. The removed outer cortex of the ilium from fenestrated site was repositioned and fixed by a reconstruction plate and screws. The osteotomized greater trochanter was reattached and fixed with two cannulated cancellous hip screws. RESULTS: At 9-month follow-up, he was pain-free and continued to function well without the use of external supports. The acetabular depression fracture was completely reduced and healed in the CT scanning evaluation. The patient had no signs of posttraumatic osteoarthritis in radiographs. DISCUSSION and CONCLUSION: In acetabular fracture dislocations of the hip joint, the precise pathological anatomy is not easily demonstrated by routine radiographs with classification of acetabular fractures. In our case, however, details of acetabular fracture were not well visible on conventional radiographs. It has been shown that computed tomography is useful method in precise evaluation of the fracture type with bone damage and integrity of joint configuration. Concerning approach to the fracture fragment which existed in the center of the weight bea","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"57 1","pages":"599-599"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74872845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
John Mark Hamilton Paterson (1954 to 2013) 约翰·马克·汉密尔顿·帕特森(1954 - 2013)
Pub Date : 2013-12-01 DOI: 10.1302/0301-620X.95B12.33421
Joint Surgery
![][1] Mark Paterson was a key figure in developing Children’s Orthopaedic services in East London. He was born in Hong Kong to a family with a history of missionary service. His father Edward Hamilton Paterson was a surgeon with an interest in the correction of cleft palate, who
[][1]马克·帕特森是东伦敦发展儿童骨科服务的关键人物。他出生在香港一个有传教历史的家庭。他的父亲爱德华·汉密尔顿·帕特森是一位对腭裂矫正很感兴趣的外科医生
{"title":"John Mark Hamilton Paterson (1954 to 2013)","authors":"Joint Surgery","doi":"10.1302/0301-620X.95B12.33421","DOIUrl":"https://doi.org/10.1302/0301-620X.95B12.33421","url":null,"abstract":"![][1] \u0000\u0000Mark Paterson was a key figure in developing Children’s Orthopaedic services in East London. He was born in Hong Kong to a family with a history of missionary service. His father Edward Hamilton Paterson was a surgeon with an interest in the correction of cleft palate, who","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"464 1","pages":"1726-1726"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83911673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
BIOMECHANICAL TESTING OF A SPINAL ALIGNMENT CUSHION (‘ROPHI™’ CUSHION) IN ADULTS WITH LOWER BACK PAIN 脊柱对准垫(“rophi™”缓冲垫)治疗成人下背部疼痛的生物力学测试
Pub Date : 2013-11-01 DOI: 10.1016/J.GAITPOST.2013.07.211
Ambreen Chohan, Katherine Payne, J. Selfe, J. Richards
{"title":"BIOMECHANICAL TESTING OF A SPINAL ALIGNMENT CUSHION (‘ROPHI™’ CUSHION) IN ADULTS WITH LOWER BACK PAIN","authors":"Ambreen Chohan, Katherine Payne, J. Selfe, J. Richards","doi":"10.1016/J.GAITPOST.2013.07.211","DOIUrl":"https://doi.org/10.1016/J.GAITPOST.2013.07.211","url":null,"abstract":"","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"3 1","pages":"12-12"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74396263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Exam Corner – October 2013 考试角- 2013年10月
Pub Date : 2013-10-01 DOI: 10.1302/0301-620X.95B10.33053
V. Khanduja
{"title":"Exam Corner – October 2013","authors":"V. Khanduja","doi":"10.1302/0301-620X.95B10.33053","DOIUrl":"https://doi.org/10.1302/0301-620X.95B10.33053","url":null,"abstract":"","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"57 Suppl 1","pages":"1439-1440"},"PeriodicalIF":0.0,"publicationDate":"2013-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87649980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative Study of Caucasian and Chinese Femur Shapes for Evidence-Based Implant Design 白种人与中国人股骨形态在基于证据的植入物设计中的比较研究
Pub Date : 2013-09-11 DOI: 10.1115/FMD2013-16151
Mike Lawrenchuk, L. Vigneron, Sebastian DeBoodt
With the increasing use of 3D medical imaging, it is possible to analyze 3D patient anatomy to extract features, trends and population specific shape information. This is applied to the development of ‘standard implants’ targeted to specific population groups. INTRODUCTION Human beings are diverse in their physical makeup while implants are often designed based on some key measurements taken from the literature or a limited sampling of patient data. The different implant sizes are often scaled versions of the ‘average’ implant, although in reality, the shape of anatomy changes as a function of the size of patient. The implant designs are often developed based on a certain demographic and ethnicity and then, simply applied to others, which can result in poor design fitment [1]. Today, with the increasing use of 3D medical imaging (e.g. CT or MRI), it is possible to analyze 3D patient anatomy to extract features, trends and population specific shape information. This can be applied to the development of new ‘standard implants’ targeted to a specific population group [2]. PATIENTS & METHODS Our population analysis was performed by creating a Statistical Shape Model (SSM) [3] of the dataset. In this study, 40 full Chinese cadaver femurs and 100 full Caucasian cadaver femurs were segmented from CT scans using Mimics®. Two different SSMs, specific to each population, were built using in-house software tools. These SSMs were validated using leave-one-out experiments, and then analyzed and compared in order to enhance the two population shape differences. RESULTS An SSM is typically represented by an average model and a few independent modes of variation that capture most of the inherent variations in the data. Based on these main modes of variations, the shape features, e.g. length, thickness, curvature neck angle and femoral version, presenting largest variations were determined, and correlations between these features were calculated. Figure 1 represents the Caucasian and Chinese average models, and shows that while the length of these two models was significantly different, the AP and ML dimensions were similar, indicating a difference of morphology (other than a scaling) between the two populations. Figure 2 represents the first mode of variation that illustrates the variation of Chinese femur shape with size. As an example, the neck angle increases of 26° with an increase of 139 mm in femur length, indicative of the effect of changes in loading conditions on geometry as a function of size. CONCLUSION The advantage of using more advanced statistical analyses is that the 3D data are probed in an unbiased fashion, allowing the most important parameters of variation to be determined. These analyses are thus particularly effective to compare different populations, to evaluate how well existing implant designs fit specific populations, and to highlight the design parameters that need to be adapted for good fitment of specific populations.
随着越来越多地使用3D医学成像,可以分析3D患者解剖结构以提取特征、趋势和人口特定形状信息。这适用于针对特定人群的“标准植入物”的开发。人类的身体构成是多种多样的,而植入物的设计通常是基于从文献中获得的一些关键测量值或有限的患者数据样本。不同的植入物尺寸通常是“平均”植入物的缩放版本,尽管在现实中,解剖结构的形状会随着患者尺寸的变化而变化。植入物的设计通常是基于特定的人口统计学和种族,然后简单地应用于其他人,这可能导致设计契合度差[1]。如今,随着3D医学成像(如CT或MRI)的使用越来越多,可以分析3D患者解剖结构以提取特征、趋势和人群特定形状信息。这可以应用于针对特定人群开发新的“标准植入物”[2]。我们通过创建数据集的统计形状模型(SSM)[3]进行总体分析。在这项研究中,使用Mimics®从CT扫描中分割了40个完整的中国人尸体股骨和100个完整的高加索人尸体股骨。两个不同的ssm,特定于每个人群,使用内部软件工具构建。通过留一实验验证了这些ssm,然后进行了分析和比较,以增强两种种群形状的差异。SSM通常由一个平均模型和几个独立的变化模式表示,这些模式捕获了数据中的大部分固有变化。基于这些主要的变化模式,确定了变化最大的形状特征,如长度、厚度、曲率、颈角和股型,并计算了这些特征之间的相关性。图1代表了高加索人和中国人的平均模型,并显示,虽然这两个模型的长度有显著差异,但AP和ML维度相似,表明两个种群之间存在形态差异(除了缩放)。图2代表了中国人股骨形状随大小变化的第一种变异模式。例如,颈角增加了26°,股骨长度增加了139 mm,表明加载条件的变化对几何形状的影响是尺寸的函数。结论采用更先进的统计分析的优势在于,三维数据以一种无偏的方式进行探测,允许确定最重要的变异参数。因此,这些分析对于比较不同的人群,评估现有种植体设计适合特定人群的程度以及突出需要适应特定人群的设计参数特别有效。
{"title":"Comparative Study of Caucasian and Chinese Femur Shapes for Evidence-Based Implant Design","authors":"Mike Lawrenchuk, L. Vigneron, Sebastian DeBoodt","doi":"10.1115/FMD2013-16151","DOIUrl":"https://doi.org/10.1115/FMD2013-16151","url":null,"abstract":"With the increasing use of 3D medical imaging, it is possible to analyze 3D patient anatomy to extract features, trends and population specific shape information. This is applied to the development of ‘standard implants’ targeted to specific population groups. INTRODUCTION Human beings are diverse in their physical makeup while implants are often designed based on some key measurements taken from the literature or a limited sampling of patient data. The different implant sizes are often scaled versions of the ‘average’ implant, although in reality, the shape of anatomy changes as a function of the size of patient. The implant designs are often developed based on a certain demographic and ethnicity and then, simply applied to others, which can result in poor design fitment [1]. Today, with the increasing use of 3D medical imaging (e.g. CT or MRI), it is possible to analyze 3D patient anatomy to extract features, trends and population specific shape information. This can be applied to the development of new ‘standard implants’ targeted to a specific population group [2]. PATIENTS & METHODS Our population analysis was performed by creating a Statistical Shape Model (SSM) [3] of the dataset. In this study, 40 full Chinese cadaver femurs and 100 full Caucasian cadaver femurs were segmented from CT scans using Mimics®. Two different SSMs, specific to each population, were built using in-house software tools. These SSMs were validated using leave-one-out experiments, and then analyzed and compared in order to enhance the two population shape differences. RESULTS An SSM is typically represented by an average model and a few independent modes of variation that capture most of the inherent variations in the data. Based on these main modes of variations, the shape features, e.g. length, thickness, curvature neck angle and femoral version, presenting largest variations were determined, and correlations between these features were calculated. Figure 1 represents the Caucasian and Chinese average models, and shows that while the length of these two models was significantly different, the AP and ML dimensions were similar, indicating a difference of morphology (other than a scaling) between the two populations. Figure 2 represents the first mode of variation that illustrates the variation of Chinese femur shape with size. As an example, the neck angle increases of 26° with an increase of 139 mm in femur length, indicative of the effect of changes in loading conditions on geometry as a function of size. CONCLUSION The advantage of using more advanced statistical analyses is that the 3D data are probed in an unbiased fashion, allowing the most important parameters of variation to be determined. These analyses are thus particularly effective to compare different populations, to evaluate how well existing implant designs fit specific populations, and to highlight the design parameters that need to be adapted for good fitment of specific populations.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"6 1","pages":"116-116"},"PeriodicalIF":0.0,"publicationDate":"2013-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87559956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Exam Corner – September 2013 考试角- 2013年9月
Pub Date : 2013-09-01 DOI: 10.1302/0301-620X.95B9.32854
V. Khanduja
{"title":"Exam Corner – September 2013","authors":"V. Khanduja","doi":"10.1302/0301-620X.95B9.32854","DOIUrl":"https://doi.org/10.1302/0301-620X.95B9.32854","url":null,"abstract":"","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"40 1","pages":"1295-1296"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78742818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
TOOL BRACING FOR PERFORMANCE IMPROVEMENT IN SIMULATED FEMORAL HEAD-NECK OSTEOCHONDROPLASTY 工具支撑在模拟股骨头颈骨软骨成形术中的应用
Pub Date : 2013-08-01 DOI: 10.14288/1.0074229
J. Kooyman, A. Hodgson
Introduction Bracing, a strategy employed by humans and robotic devices, can be generally described as a parallel mechanical link between the actor, the environment, and/or the workpiece that alters the mechanical impedance between the tool and workpiece in order to improve task performance. In this study we investigated the potential value of bracing in the context of bone milling to treat cam-type femoroacetabular impingement (FAI) lesions. The goal of this study was to evaluate whether a proposed bracing technique could enable a user to perform a cam resection more accurately and quickly than a currently employed arthroscopic technique. Materials/Methods Test samples consisted of white urethane plastic reproductions of a commercially available adult proximal femur, which were laser scanned to obtain ground-truth surface information. A black cam lesion was then cast onto the surface of the femur in the anterosuperior region of the femoral neck, creating a clear visual resection boundary for the simulated osteochondroplasty. Test subjects were 4 adult males (25 +/− 3 years) with no surgical experience. Test conditions included two binary factors: (1) Braced vs. Unbraced – The braced case introduced a spherical bearing tool support mounted in the approximate anterolateral arthroscopic portal position. (2) Speed vs. Accuracy – The subject was instructed to perform the resection as quickly as possible or as accurately as possible with a moderate regard for time. Following the removal of the lesion, femurs were laser scanned to acquire the post-resection surface geometry, with accuracy being reported as RMS deviation between the pre- and post-resection scans over the anterosuperior neck region. Results In both accuracy and speed cases, bracing tended to reduce errors (on the order of 7–14%) and task duration (on the order of 32–52%), although given the small number of subjects in this pilot study, these differences were not statistically significant. Conclusion These results provide some encouragement that our hypothesis that bracing can improve both speed and accuracy of cam lesion resection by untrained subjects may be true. The standard deviations between subjects are high and are likely due to both the difficulty of the task and differences in experience using handheld power tools, so additional subjects would be needed to verify the trends identified here.
支撑是人类和机器人设备采用的一种策略,通常可以描述为参与者、环境和/或工件之间的平行机械联系,它改变了工具和工件之间的机械阻抗,以提高任务性能。在这项研究中,我们研究了在骨研磨的背景下支具治疗凸轮型股髋臼撞击(FAI)病变的潜在价值。本研究的目的是评估拟议的支撑技术是否能够使用户比目前使用的关节镜技术更准确、更快速地进行凸轮切除术。材料/方法测试样品由市售成人近端股骨的白色聚氨酯塑料复制品组成,激光扫描以获得真实的表面信息。然后在股骨颈前上区域的股骨表面上放置一个黑色凸轮病变,为模拟骨软骨成形术创造一个清晰的视觉切除边界。试验对象为4名无手术经验的成年男性(25±3岁)。测试条件包括两个二元因素:(1)支架与非支架-支架病例引入了一个球形轴承工具支撑,安装在关节镜门静脉的大约前外侧位置。(2)速度与准确性-受试者被指示在适度考虑时间的情况下尽可能快或尽可能准确地进行切除。在切除病变后,对股骨进行激光扫描以获得切除后的表面几何形状,准确度报告为前上颈区域切除前后扫描的RMS偏差。结果在准确性和速度两种情况下,支具都倾向于减少错误(约7-14%)和任务持续时间(约32-52%),尽管考虑到本初步研究的受试者数量较少,这些差异没有统计学意义。结论支具可以提高未经训练的受试者切除凸轮病变的速度和准确性,这一假设是正确的。受试者之间的标准偏差很高,可能是由于任务的难度和使用手持电动工具的经验差异,因此需要额外的受试者来验证这里确定的趋势。
{"title":"TOOL BRACING FOR PERFORMANCE IMPROVEMENT IN SIMULATED FEMORAL HEAD-NECK OSTEOCHONDROPLASTY","authors":"J. Kooyman, A. Hodgson","doi":"10.14288/1.0074229","DOIUrl":"https://doi.org/10.14288/1.0074229","url":null,"abstract":"Introduction Bracing, a strategy employed by humans and robotic devices, can be generally described as a parallel mechanical link between the actor, the environment, and/or the workpiece that alters the mechanical impedance between the tool and workpiece in order to improve task performance. In this study we investigated the potential value of bracing in the context of bone milling to treat cam-type femoroacetabular impingement (FAI) lesions. The goal of this study was to evaluate whether a proposed bracing technique could enable a user to perform a cam resection more accurately and quickly than a currently employed arthroscopic technique. Materials/Methods Test samples consisted of white urethane plastic reproductions of a commercially available adult proximal femur, which were laser scanned to obtain ground-truth surface information. A black cam lesion was then cast onto the surface of the femur in the anterosuperior region of the femoral neck, creating a clear visual resection boundary for the simulated osteochondroplasty. Test subjects were 4 adult males (25 +/− 3 years) with no surgical experience. Test conditions included two binary factors: (1) Braced vs. Unbraced – The braced case introduced a spherical bearing tool support mounted in the approximate anterolateral arthroscopic portal position. (2) Speed vs. Accuracy – The subject was instructed to perform the resection as quickly as possible or as accurately as possible with a moderate regard for time. Following the removal of the lesion, femurs were laser scanned to acquire the post-resection surface geometry, with accuracy being reported as RMS deviation between the pre- and post-resection scans over the anterosuperior neck region. Results In both accuracy and speed cases, bracing tended to reduce errors (on the order of 7–14%) and task duration (on the order of 32–52%), although given the small number of subjects in this pilot study, these differences were not statistically significant. Conclusion These results provide some encouragement that our hypothesis that bracing can improve both speed and accuracy of cam lesion resection by untrained subjects may be true. The standard deviations between subjects are high and are likely due to both the difficulty of the task and differences in experience using handheld power tools, so additional subjects would be needed to verify the trends identified here.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"1 1","pages":"11-11"},"PeriodicalIF":0.0,"publicationDate":"2013-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89592449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism 代谢性骨病及矿物质代谢紊乱入门
Pub Date : 2013-07-19 DOI: 10.1002/9781119266594
J. Bilezikian, Roger Bouillon, Thomas L. Clemens, J. Compston, D. C. Bauer, Peter R. Ebeling, Klaus Engelke, David Goltzman, Theresa A. Guise, S. J. Beur, H. Jüppner, Karen Lyons, Laurie K. McCauley, Michael R Mcclung, Paul D. Miller, S. Papapoulos, G. David Roodman, Clifford J. Rosen, Ego Seeman, Rajesh V. Thakker, Michael P. Whyte, Mone Zaidi
{"title":"Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism","authors":"J. Bilezikian, Roger Bouillon, Thomas L. Clemens, J. Compston, D. C. Bauer, Peter R. Ebeling, Klaus Engelke, David Goltzman, Theresa A. Guise, S. J. Beur, H. Jüppner, Karen Lyons, Laurie K. McCauley, Michael R Mcclung, Paul D. Miller, S. Papapoulos, G. David Roodman, Clifford J. Rosen, Ego Seeman, Rajesh V. Thakker, Michael P. Whyte, Mone Zaidi","doi":"10.1002/9781119266594","DOIUrl":"https://doi.org/10.1002/9781119266594","url":null,"abstract":"","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"51 1","pages":"1087-1087"},"PeriodicalIF":0.0,"publicationDate":"2013-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86637327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 531
Exam Corner – July 2013 考试角- 2013年7月
Pub Date : 2013-07-01 DOI: 10.1302/0301-620X.95B7.32457
V. Khanduja
{"title":"Exam Corner – July 2013","authors":"V. Khanduja","doi":"10.1302/0301-620X.95B7.32457","DOIUrl":"https://doi.org/10.1302/0301-620X.95B7.32457","url":null,"abstract":"","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"18 1","pages":"1007-1008"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85177669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Bone and Joint Surgery-british Volume
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1