Pub Date : 2023-12-23DOI: 10.3390/prosthesis6010004
V. Ciriello, M. Saracco, Enrico Leonardi, L. Piovani, Allison Fetz-Palazola, Chase Mareno, G. Logroscino
Background: Prosthetic hip replacement is a widely practiced surgical procedure with excellent results. Hip stems based on the Zweymüller design have a long history and their philosophy focuses on achieving long-term stability promoting physiological load transfer. The aim of this study is to evaluate outcomes, survivorship, and complication rates in a cohort of patients treated with this stem. Methods: A retrospective review was conducted to identify patients who underwent primary THA with Zweymüller stems. A total of 86 hips (43%) were implanted in men, and 114 hips (57%) in women. The mean follow-up time was 5.4 years. Patient charts were reviewed for adverse events occurring after primary THA as well as for revision and indication for revision. Patients still implanted with the hip stem were asked to complete the HOOS JR survey. Results: Ten hips (5.0%) were lost to follow up. The mean HOOS JR score at final evaluation was 96.3 points (range, 60.0–100.0). Two revisions were performed during the study for femoral stem loosening due to a periprosthetic Vancouver B2 fracture and for multiple hip dislocations. Conclusions: The Zweymüller design hip stem showed excellent survivorship and favorable clinical outcomes at a mean follow-up of 5.4 years.
{"title":"Mid-Term Outcomes of a Modern Zweymüller Monolithic Femoral Stem in Primary Total Hip Arthroplasty","authors":"V. Ciriello, M. Saracco, Enrico Leonardi, L. Piovani, Allison Fetz-Palazola, Chase Mareno, G. Logroscino","doi":"10.3390/prosthesis6010004","DOIUrl":"https://doi.org/10.3390/prosthesis6010004","url":null,"abstract":"Background: Prosthetic hip replacement is a widely practiced surgical procedure with excellent results. Hip stems based on the Zweymüller design have a long history and their philosophy focuses on achieving long-term stability promoting physiological load transfer. The aim of this study is to evaluate outcomes, survivorship, and complication rates in a cohort of patients treated with this stem. Methods: A retrospective review was conducted to identify patients who underwent primary THA with Zweymüller stems. A total of 86 hips (43%) were implanted in men, and 114 hips (57%) in women. The mean follow-up time was 5.4 years. Patient charts were reviewed for adverse events occurring after primary THA as well as for revision and indication for revision. Patients still implanted with the hip stem were asked to complete the HOOS JR survey. Results: Ten hips (5.0%) were lost to follow up. The mean HOOS JR score at final evaluation was 96.3 points (range, 60.0–100.0). Two revisions were performed during the study for femoral stem loosening due to a periprosthetic Vancouver B2 fracture and for multiple hip dislocations. Conclusions: The Zweymüller design hip stem showed excellent survivorship and favorable clinical outcomes at a mean follow-up of 5.4 years.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":"12 2‐3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139161309","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}
Pub Date : 2023-11-30DOI: 10.3390/prosthesis5040089
F. Pera, M. Carossa, Francesco Bagnasco, Armando Crupi, Giulia Ambrogio, G. Isola, M. Menini, P. Pesce
The objective of the present retrospective multi-center study was to analyze the outcomes of bone-level (BL) implants and tissue-level (TL) implants in immediate-loading full-arch rehabilitations. Patients who were previously rehabilitated with full-arch immediate-loading rehabilitations with either BL or TL implants were considered. Data regarding implant survival rate, marginal bone loss (MBL), peri-implant probing depth (PPD), plaque index (PI), and bleeding on probing (BOP) were recorded, and the 1-year follow-up data were statistically analyzed between the two groups. In total, 38 patients were evaluated for a total implant number of 156 (n = 80 TL implants and n = 76 BL implants). An implant survival rate of 97.37% was recoded for the BL group while an implant survival rate of 100% was noted for the TL group. A total MBL of 1.324 ± 0.64 mm was recorded for BL implants, while a total MBL of 1.194 ± 0.30 mm was recorded for TL implants. A statistically significant difference was highlighted regarding MBL at the mesial aspect (p = 0.01552) of the implants, with BL implants presenting with higher MBL. Within the range of acceptable healthy values, a statistically significant difference was also highlighted regarding BOP (p < 0.00001), with TL implants presenting higher values. No statistically significant difference (p > 0.05) was recorded for any of the other variables analyzed. Within the limitations of the present retrospective study, both TL and BL implants seem to provide good clinical outcomes after a 12-month observational period when employed in immediate-loading full-arch rehabilitation.
{"title":"Comparison between Bone-Level and Tissue-Level Implants in Immediate-Loading Full-Arch Rehabilitations: A Retrospective Multi-Center 1-Year Follow-Up Study","authors":"F. Pera, M. Carossa, Francesco Bagnasco, Armando Crupi, Giulia Ambrogio, G. Isola, M. Menini, P. Pesce","doi":"10.3390/prosthesis5040089","DOIUrl":"https://doi.org/10.3390/prosthesis5040089","url":null,"abstract":"The objective of the present retrospective multi-center study was to analyze the outcomes of bone-level (BL) implants and tissue-level (TL) implants in immediate-loading full-arch rehabilitations. Patients who were previously rehabilitated with full-arch immediate-loading rehabilitations with either BL or TL implants were considered. Data regarding implant survival rate, marginal bone loss (MBL), peri-implant probing depth (PPD), plaque index (PI), and bleeding on probing (BOP) were recorded, and the 1-year follow-up data were statistically analyzed between the two groups. In total, 38 patients were evaluated for a total implant number of 156 (n = 80 TL implants and n = 76 BL implants). An implant survival rate of 97.37% was recoded for the BL group while an implant survival rate of 100% was noted for the TL group. A total MBL of 1.324 ± 0.64 mm was recorded for BL implants, while a total MBL of 1.194 ± 0.30 mm was recorded for TL implants. A statistically significant difference was highlighted regarding MBL at the mesial aspect (p = 0.01552) of the implants, with BL implants presenting with higher MBL. Within the range of acceptable healthy values, a statistically significant difference was also highlighted regarding BOP (p < 0.00001), with TL implants presenting higher values. No statistically significant difference (p > 0.05) was recorded for any of the other variables analyzed. Within the limitations of the present retrospective study, both TL and BL implants seem to provide good clinical outcomes after a 12-month observational period when employed in immediate-loading full-arch rehabilitation.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139202230","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}
Pub Date : 2023-11-28DOI: 10.3390/prosthesis5040088
Bolivar Núñez Montoya, Edwin Valarezo Añazco, Sara Guerrero, Mauricio Valarezo-Añazco, Daniela Espin-Ramos, Carlos Jiménez Farfán
The evolution of anthropomorphic robotic hands (ARH) in recent years has been sizable, employing control techniques based on machine learning classifiers for myoelectric signal processing. This work introduces an innovative multi-channel bio-signal transformer (MuCBiT) for surface electromyography (EMG) signal recognition and classification. The proposed MuCBiT is an artificial neural network based on fully connected layers and transformer architecture. The MuCBiT recognizes and classifies EMG signals sensed from electrodes patched over the arm’s surface. The MuCBiT classifier was trained and validated using a collected dataset of four hand gestures across ten users. Despite the smaller size of the dataset, the MuCBiT achieved a prediction accuracy of 86.25%, outperforming traditional machine learning models and other transformer-based classifiers for EMG signal classification. This integrative transformer-based gesture recognition promises notable advancements for ARH development, underscoring prospective improvements in prosthetics and human–robot interaction.
{"title":"Myo Transformer Signal Classification for an Anthropomorphic Robotic Hand","authors":"Bolivar Núñez Montoya, Edwin Valarezo Añazco, Sara Guerrero, Mauricio Valarezo-Añazco, Daniela Espin-Ramos, Carlos Jiménez Farfán","doi":"10.3390/prosthesis5040088","DOIUrl":"https://doi.org/10.3390/prosthesis5040088","url":null,"abstract":"The evolution of anthropomorphic robotic hands (ARH) in recent years has been sizable, employing control techniques based on machine learning classifiers for myoelectric signal processing. This work introduces an innovative multi-channel bio-signal transformer (MuCBiT) for surface electromyography (EMG) signal recognition and classification. The proposed MuCBiT is an artificial neural network based on fully connected layers and transformer architecture. The MuCBiT recognizes and classifies EMG signals sensed from electrodes patched over the arm’s surface. The MuCBiT classifier was trained and validated using a collected dataset of four hand gestures across ten users. Despite the smaller size of the dataset, the MuCBiT achieved a prediction accuracy of 86.25%, outperforming traditional machine learning models and other transformer-based classifiers for EMG signal classification. This integrative transformer-based gesture recognition promises notable advancements for ARH development, underscoring prospective improvements in prosthetics and human–robot interaction.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139226175","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}
Pub Date : 2023-11-22DOI: 10.3390/prosthesis5040087
S. Giannotti, N. Crippa Orlandi, E. Troiano, Matteo Cacioppo, T. Giacché, T. Greco, C. Perisano, N. Mondanelli
The number of performed total knee arthroplasty (TKA) operations is constantly growing. This study proposes an evaluation of a series of patients undergoing medial pivot (MP) TKA surgery from a subjective, clinical and biomechanical point of view. A consecutive series of 100 TKAs implanted in a single centre, by the same surgeon, with a medial parapatellar approach with the sacrifice of the posterior cruciate ligament and cemented components were evaluated. All patients underwent standardized radiographic and functional clinical evaluation, with standing antero-posterior, lateral and patellar axial views; pre-operatively and post-operatively at 1, 3, 6 and 12 months; and then annually. Results were evaluated using three different patient-related outcome measurement scores (PROMs): the Knee Osteoarthritis Outcome Score (KOOS), the new Knee Society Score (nKSS) and the Short Form Health Survey 36 (SF-36). Excellent results in all treated knees were documented using the PROMs: the mean nKSS was 199.8, the mean KOOS was good to excellent in every subscale, and the mean was SF-36 82%. There were no cases of septic or aseptic loosening, vascular damage, neurological damage, or revision surgery for any reason. According to the experience gained, MP implants demonstrated excellent results, being clinically functional in both objective and subjective terms as well as radiographic evaluations, thus resulting in a winning strategy for obtaining a TKA that makes the patient satisfied and able to perform their daily life activities.
{"title":"Medial Ball-in-Socket Posterior Cruciate-Sacrificing Total Knee Arthroplasty: Clinical, Functional and Radiographic Evaluation of 100 Consecutive Implants","authors":"S. Giannotti, N. Crippa Orlandi, E. Troiano, Matteo Cacioppo, T. Giacché, T. Greco, C. Perisano, N. Mondanelli","doi":"10.3390/prosthesis5040087","DOIUrl":"https://doi.org/10.3390/prosthesis5040087","url":null,"abstract":"The number of performed total knee arthroplasty (TKA) operations is constantly growing. This study proposes an evaluation of a series of patients undergoing medial pivot (MP) TKA surgery from a subjective, clinical and biomechanical point of view. A consecutive series of 100 TKAs implanted in a single centre, by the same surgeon, with a medial parapatellar approach with the sacrifice of the posterior cruciate ligament and cemented components were evaluated. All patients underwent standardized radiographic and functional clinical evaluation, with standing antero-posterior, lateral and patellar axial views; pre-operatively and post-operatively at 1, 3, 6 and 12 months; and then annually. Results were evaluated using three different patient-related outcome measurement scores (PROMs): the Knee Osteoarthritis Outcome Score (KOOS), the new Knee Society Score (nKSS) and the Short Form Health Survey 36 (SF-36). Excellent results in all treated knees were documented using the PROMs: the mean nKSS was 199.8, the mean KOOS was good to excellent in every subscale, and the mean was SF-36 82%. There were no cases of septic or aseptic loosening, vascular damage, neurological damage, or revision surgery for any reason. According to the experience gained, MP implants demonstrated excellent results, being clinically functional in both objective and subjective terms as well as radiographic evaluations, thus resulting in a winning strategy for obtaining a TKA that makes the patient satisfied and able to perform their daily life activities.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":"22 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139250671","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}
Pub Date : 2023-11-21DOI: 10.3390/prosthesis5040085
Omar A. Gonzales-Huisa, Gonzalo Oshiro, Victoria E. Abarca, Jorge G. Chavez-Echajaya, Dante A. Elias
Despite recent advancements in prosthetic technology, lower-limb amputees often remain limited to passive prostheses, which leads to an asymmetric gait and increased energy expenditure. Developing active prostheses with effective control systems is important to improve mobility for these individuals. This study presents a machine-learning-based approach to classify five distinct locomotion tasks: ground-level walking (GWL), ramp ascent (RPA), ramp descent (RPD), stairs ascent (SSA), and stairs descent (SSD). The dataset comprises fused electromyographic (EMG) and inertial measurement unit (IMU) signals from twenty non-amputated and five transtibial amputated participants. EMG sensors were strategically positioned on the thigh muscles, while IMU sensors were placed on various leg segments. The performance of two classification algorithms, support vector machine (SVM) and long short-term memory (LSTM), were evaluated on segmented data. The results indicate that SVM models outperform LSTM models in accuracy, precision, and F1 score in the individual evaluation of amputee and non-amputee datasets for 80–20 and 50–50 data distributions. In the 80–20 distribution, an accuracy of 95.46% and 95.35% was obtained with SVM for non-amputees and amputees, respectively. An accuracy of 93.33% and 93.30% was obtained for non-amputees and amputees by using LSTM, respectively. LSTM models show more robustness and inter-population generalizability than SVM models when applying domain-adaptation techniques. Furthermore, the average classification latency for SVM and LSTM models was 19.84 ms and 37.07 ms, respectively, within acceptable limits for real-time applications. This study contributes to the field by comprehensively comparing SVM and LSTM classifiers for locomotion tasks, laying the foundation for the future development of real-time control systems for active transtibial prostheses.
{"title":"EMG and IMU Data Fusion for Locomotion Mode Classification in Transtibial Amputees","authors":"Omar A. Gonzales-Huisa, Gonzalo Oshiro, Victoria E. Abarca, Jorge G. Chavez-Echajaya, Dante A. Elias","doi":"10.3390/prosthesis5040085","DOIUrl":"https://doi.org/10.3390/prosthesis5040085","url":null,"abstract":"Despite recent advancements in prosthetic technology, lower-limb amputees often remain limited to passive prostheses, which leads to an asymmetric gait and increased energy expenditure. Developing active prostheses with effective control systems is important to improve mobility for these individuals. This study presents a machine-learning-based approach to classify five distinct locomotion tasks: ground-level walking (GWL), ramp ascent (RPA), ramp descent (RPD), stairs ascent (SSA), and stairs descent (SSD). The dataset comprises fused electromyographic (EMG) and inertial measurement unit (IMU) signals from twenty non-amputated and five transtibial amputated participants. EMG sensors were strategically positioned on the thigh muscles, while IMU sensors were placed on various leg segments. The performance of two classification algorithms, support vector machine (SVM) and long short-term memory (LSTM), were evaluated on segmented data. The results indicate that SVM models outperform LSTM models in accuracy, precision, and F1 score in the individual evaluation of amputee and non-amputee datasets for 80–20 and 50–50 data distributions. In the 80–20 distribution, an accuracy of 95.46% and 95.35% was obtained with SVM for non-amputees and amputees, respectively. An accuracy of 93.33% and 93.30% was obtained for non-amputees and amputees by using LSTM, respectively. LSTM models show more robustness and inter-population generalizability than SVM models when applying domain-adaptation techniques. Furthermore, the average classification latency for SVM and LSTM models was 19.84 ms and 37.07 ms, respectively, within acceptable limits for real-time applications. This study contributes to the field by comprehensively comparing SVM and LSTM classifiers for locomotion tasks, laying the foundation for the future development of real-time control systems for active transtibial prostheses.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":"291 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139252026","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}
Pub Date : 2023-11-21DOI: 10.3390/prosthesis5040086
Antonino Cantivalli, Umberto Cottino, D. Bonasia, F. Rosso, Roberto Rossi
Total knee arthroplasty (TKA) is a successful and highly effective procedure in most patients with tricompartmental knee arthritis. Despite the innovations in surgical techniques due to planning software and technological innovations, patients’ dissatisfaction after TKA is still high, at up to 20%. Robotic-assisted surgery (RAS) could be considered as a future option for improving outcomes due to its higher accuracy, precision, and reliability. Robotic systems can be classified as fully active, semi-active, or passive depending on the surgeon’s involvement during the procedure, and as imageless or image-based according to the necessity of radiological exams for the pre-operative planning. Three of the most well-known robotic systems for knee surgery are MAKO® (Stryker Ltd., Kalamazoo, MI, USA), NAVIO® (Smith & Nephew, Andover, TX, USA), and ROSA® (Zimmer Inc., Warsaw, IN, USA). These systems show differences in terms of surgeon involvement, the use of CT scans or X-rays for pre-operative planning, the possibility to perform both unicompartmental knee arthroplasty (UKA) and TKA (or even total hip arthroplasty THA), and in the different kinds of knee prosthesis that can be implanted. This article aims to describe the features of the most used robotic systems for knee arthroplasty, to examine their outcomes and analyze their cost-effectiveness, and to evaluate future perspectives.
{"title":"Robotic Systems in Knee Surgery: Current Concepts and Future Perspectives","authors":"Antonino Cantivalli, Umberto Cottino, D. Bonasia, F. Rosso, Roberto Rossi","doi":"10.3390/prosthesis5040086","DOIUrl":"https://doi.org/10.3390/prosthesis5040086","url":null,"abstract":"Total knee arthroplasty (TKA) is a successful and highly effective procedure in most patients with tricompartmental knee arthritis. Despite the innovations in surgical techniques due to planning software and technological innovations, patients’ dissatisfaction after TKA is still high, at up to 20%. Robotic-assisted surgery (RAS) could be considered as a future option for improving outcomes due to its higher accuracy, precision, and reliability. Robotic systems can be classified as fully active, semi-active, or passive depending on the surgeon’s involvement during the procedure, and as imageless or image-based according to the necessity of radiological exams for the pre-operative planning. Three of the most well-known robotic systems for knee surgery are MAKO® (Stryker Ltd., Kalamazoo, MI, USA), NAVIO® (Smith & Nephew, Andover, TX, USA), and ROSA® (Zimmer Inc., Warsaw, IN, USA). These systems show differences in terms of surgeon involvement, the use of CT scans or X-rays for pre-operative planning, the possibility to perform both unicompartmental knee arthroplasty (UKA) and TKA (or even total hip arthroplasty THA), and in the different kinds of knee prosthesis that can be implanted. This article aims to describe the features of the most used robotic systems for knee arthroplasty, to examine their outcomes and analyze their cost-effectiveness, and to evaluate future perspectives.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":"17 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139251630","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}
Pub Date : 2023-11-20DOI: 10.3390/prosthesis5040084
P. Bishay, Jack Wilgus, RunRun Chen, Diego Valenzuela, Victor Medina, Calvin Tan, Taylor Ittner, Miguel Caldera, Cristina Rubalcava, Shaghik Safarian, Gerbert Funes Alfaro, Alfredo Gonzalez-Martinez, Matthew Gosparini, Jose Fuentes-Perez, Andy Lima, Jonnathan Villalobos, Abrahan Solis
Nowadays there are various prosthetic arm designs in the literature, the market, and CAD design websites, with different shapes, sizes, and degrees of freedom. Only limited options are available for controlling such prostheses. Prosthetic arm users reported muscle fatigue and unreliability when using the market-dominated myoelectric sensors. This work presents the “Infinity Foot Controller” as a new approach to control a five-finger below-the-elbow prosthetic arm with wrist rotation and bending capabilities. This foot control system receives user input from a custom insole and a sensor-controller unit placed alongside the user’s shoe to perform various hand grips, gestures, and/or rotations. To demonstrate the new foot controller, a design of a 3D-printed below-the-elbow prosthetic arm, called the “Infinity Arm”, is presented. This arm is suitable for gripping relatively lightweight objects and making hand gestures. It includes a wrist actuation system that permits 120° wrist rotation and 70° wrist extension and flexion. It also includes a haptic feedback system that utilizes fingertip force sensors to relay a vibratory response in an armband placed on the user’s arm, giving the user a sense of touch. A proof-of-concept model was built to demonstrate the system and a testing procedure was proposed.
目前，文献、市场和 CAD 设计网站上有各种假肢设计，其形状、尺寸和自由度各不相同。但可用于控制这些假肢的选项却非常有限。假肢使用者表示，在使用市场上主流的肌电传感器时，会出现肌肉疲劳和不可靠的情况。这项研究提出的 "无限脚部控制器 "是一种控制肘下五指义肢的新方法，具有手腕旋转和弯曲功能。该脚部控制系统接收用户从定制鞋垫和放置在用户鞋边的传感器控制器单元输入的信息，从而执行各种手部抓握、手势和/或旋转动作。为了展示新的脚部控制器，我们展示了一种 3D 打印的肘部以下假肢（称为 "无限臂"）的设计。这种手臂适用于抓取相对较轻的物体并做出手势。它包括一个腕部驱动系统，允许腕部旋转 120°，腕部伸展和弯曲 70°。它还包括一个触觉反馈系统，利用指尖力传感器在用户手臂上的臂章中传递振动响应，给用户带来触感。我们制作了一个概念验证模型来演示该系统，并提出了一个测试程序。
{"title":"Controlling a Below-the-Elbow Prosthetic Arm Using the Infinity Foot Controller","authors":"P. Bishay, Jack Wilgus, RunRun Chen, Diego Valenzuela, Victor Medina, Calvin Tan, Taylor Ittner, Miguel Caldera, Cristina Rubalcava, Shaghik Safarian, Gerbert Funes Alfaro, Alfredo Gonzalez-Martinez, Matthew Gosparini, Jose Fuentes-Perez, Andy Lima, Jonnathan Villalobos, Abrahan Solis","doi":"10.3390/prosthesis5040084","DOIUrl":"https://doi.org/10.3390/prosthesis5040084","url":null,"abstract":"Nowadays there are various prosthetic arm designs in the literature, the market, and CAD design websites, with different shapes, sizes, and degrees of freedom. Only limited options are available for controlling such prostheses. Prosthetic arm users reported muscle fatigue and unreliability when using the market-dominated myoelectric sensors. This work presents the “Infinity Foot Controller” as a new approach to control a five-finger below-the-elbow prosthetic arm with wrist rotation and bending capabilities. This foot control system receives user input from a custom insole and a sensor-controller unit placed alongside the user’s shoe to perform various hand grips, gestures, and/or rotations. To demonstrate the new foot controller, a design of a 3D-printed below-the-elbow prosthetic arm, called the “Infinity Arm”, is presented. This arm is suitable for gripping relatively lightweight objects and making hand gestures. It includes a wrist actuation system that permits 120° wrist rotation and 70° wrist extension and flexion. It also includes a haptic feedback system that utilizes fingertip force sensors to relay a vibratory response in an armband placed on the user’s arm, giving the user a sense of touch. A proof-of-concept model was built to demonstrate the system and a testing procedure was proposed.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":"136 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139255270","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}
Pub Date : 2023-11-16DOI: 10.3390/prosthesis5040082
Giuseppe Marongiu, A. Capone, Marco Verona, G. Piovan, Claudio Zorzi, Daniel Kendoff, Marta Bandino
Worldwide, the number of revisions to total knee arthroplasty procedures is increasing. Revision surgery is a challenging procedure, required for the management of bone loss after removal of the first implant. Although further long-term follow-up studies are needed, the use of cones in revisions of total knee arthroplasty yields reliability in fixation and stability to restore joint lines, especially in challenging surgeries with poor bone stock. The introduction of 3D-printed cones in revision surgery seems to be advantageous for AORI type III bone defects, especially in reducing intraoperative complications and procedure times. The aim of this study is to review the currently available literature to analyse clinical outcomes, complications, and radiographical results with the use of metaphyseal tantalum cones and new 3D-printed cones for the management of bone defects in the revision of total knee arthroplasty.
在全球范围内，全膝关节置换术的翻修次数不断增加。翻修手术是一项极具挑战性的手术，需要处理首次植入物移除后的骨质流失问题。虽然还需要进一步的长期随访研究，但在全膝关节置换术翻修中使用锥体可以获得可靠的固定和稳定性，从而恢复关节线，尤其是在骨量较差的高难度手术中。在翻修手术中引入 3D 打印锥体似乎对 AORI III 型骨缺损很有利，尤其是在减少术中并发症和手术时间方面。本研究旨在回顾现有文献，分析在全膝关节翻修手术中使用骺钽锥体和新型 3D 打印锥体治疗骨缺损的临床效果、并发症和放射学结果。
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Pub Date : 2023-11-16DOI: 10.3390/prosthesis5040083
C. Gentile, E. Gruppioni
The human hand is a complex and versatile organ that enables humans to interact with the environment, communicate, create, and use tools. The control of the hand by the brain is a crucial aspect of human cognition and behaviour, but also a challenging problem for both neuroscience and engineering. The aim of this study is to review the current state of the art in hand and grasp control from a neuroscientific perspective, focusing on the brain mechanisms that underlie sensory integration for hand control and the engineering implications for developing artificial hands that can mimic and interface with the human brain. The brain controls the hand by processing and integrating sensory information from vision, proprioception, and touch, using different neural pathways. The user’s intention can be obtained to control the artificial hand by using different interfaces, such as electromyography, electroneurography, and electroencephalography. This and other sensory information can be exploited by different learning mechanisms that can help the user adapt to changes in sensory inputs or outputs, such as reinforcement learning, motor adaptation, and internal models. This work summarizes the main findings and challenges of each aspect of hand and grasp control research and highlights the gaps and limitations of the current approaches. In the last part, some open questions and future directions for hand and grasp control research are suggested by emphasizing the need for a neuroscientific approach that can bridge the gap between the brain and the hand.
{"title":"A Perspective on Prosthetic Hands Control: From the Brain to the Hand","authors":"C. Gentile, E. Gruppioni","doi":"10.3390/prosthesis5040083","DOIUrl":"https://doi.org/10.3390/prosthesis5040083","url":null,"abstract":"The human hand is a complex and versatile organ that enables humans to interact with the environment, communicate, create, and use tools. The control of the hand by the brain is a crucial aspect of human cognition and behaviour, but also a challenging problem for both neuroscience and engineering. The aim of this study is to review the current state of the art in hand and grasp control from a neuroscientific perspective, focusing on the brain mechanisms that underlie sensory integration for hand control and the engineering implications for developing artificial hands that can mimic and interface with the human brain. The brain controls the hand by processing and integrating sensory information from vision, proprioception, and touch, using different neural pathways. The user’s intention can be obtained to control the artificial hand by using different interfaces, such as electromyography, electroneurography, and electroencephalography. This and other sensory information can be exploited by different learning mechanisms that can help the user adapt to changes in sensory inputs or outputs, such as reinforcement learning, motor adaptation, and internal models. This work summarizes the main findings and challenges of each aspect of hand and grasp control research and highlights the gaps and limitations of the current approaches. In the last part, some open questions and future directions for hand and grasp control research are suggested by emphasizing the need for a neuroscientific approach that can bridge the gap between the brain and the hand.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":"30 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139270304","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}
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