scholarly journals Conformable and robust force sensors to enable precision joint replacement surgery

2021 ◽  
Author(s):  
Liam Ives ◽  
Alizee Pace ◽  
Fabian Bor ◽  
Qingshen Jing ◽  
Tom Wade ◽  
...  

Balancing forces within weight-bearing joints such as the hip during joint replacement surgeries is essential for implant longevity. Minimising implant failure is vital to improve patient wellbeing and alleviate pressure on healthcare systems. With improvements in surgery, hip replacement patients are now often younger and more active than in previous generations, and their implants correspondingly need to survive higher stresses. However, force balancing currently depends entirely on surgical skill: no sensors can provide quantitative force feedback within the small, complex geometry of the hip joint. Here, we solve this unmet clinical need by presenting a thin and conformable microfluidic force sensor, which is compatible with the standard surgical process. We optimised the design using finite element modelling, then incorporated and calibrated our sensor in a model hip implant. Using a bespoke testing rig, we demonstrated high sensitivity at typical forces experienced during hip replacements. We anticipate that these sensors will aid implant positioning, increasing the lifetime of hip replacements, and represent a powerful new surgical tool for a range of orthopaedic procedures where force balancing is crucial.

2014 ◽  
Vol 96 (6) ◽  
pp. 434-436 ◽  
Author(s):  
D Makki ◽  
K Deierl ◽  
A Pandit ◽  
S Trakru

Introduction The aim of this prospective study was to investigate the risk of contamination of surgical gloves during preparation and draping in joint replacement surgery. Methods During 46 hip and knee replacement procedures, the gloves of orthopaedic consultants (n=5) and registrars (n=3) were assessed for contamination immediately after draping by impression of gloved fingers on blood agar. Contamination was evaluated by the surgeon’s grade, the type of procedure, the role of the assistant and the dominance of the hand. Results A total of 125 pairs of top gloves were examined (79 pairs from registrars and 46 pairs from consultants). Bacterial contamination was isolated on 19 pairs (15.2%) (16 pairs from registrars and 3 pairs from consultants, p=0.04). Coagulase negative staphylococci were the main isolates and contamination was considered low in all cases (1–5 colonies). Contamination was seen more on the dominant hand (16 gloves from dominant hands and 6 from non-dominant hands, p=0.04), on the index finger and thumb. More contaminated gloves were seen in hip arthroplasty procedures (16 pairs from total hip replacements vs 3 pairs from total knee replacements, p=0.02). Conclusions Contamination of glove fingertips during draping in joint replacement procedures is more likely to occur among junior surgeons, in hip rather than knee arthroplasty procedures and on the dominant hand. It is therefore essential that surgeons of different grades replace gloves used in draping to avoid exposing patients to the risk of infection.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Marco S. Caicedo ◽  
Vianey Flores ◽  
Alicia Padilla ◽  
Samelko Lauryn ◽  
Joshua J. Jacobs ◽  
...  

Abstract Background Recent studies indicate that, in addition to antibody production, lymphocyte responses to SARS-CoV-2 may play an important role in protective immunity to COVID-19 and a percentage of the general population may exhibit lymphocyte memory due to unknown/asymptomatic exposure to SARS-CoV-2 or cross-reactivity to other more common coronaviruses pre-vaccination. Total joint replacement (TJR) candidates returning to elective surgeries (median age 68 years) may exhibit similar lymphocyte and/or antibody protection to COVID-19 prior to vaccination Methods In this retrospective study, we analyzed antibody titters, lymphocyte memory, and inflammatory biomarkers specific for the Spike and Nucleocapsid proteins of the SARS-CoV-2 virus in a cohort of n=73 returning TJR candidates (knees and/or hips) pre-operatively. Results Peripheral blood serum of TJR candidate patients exhibited a positivity rate of 18.4% and 4% for IgG antibodies specific for SARS-CoV-2 nucleocapsid and spike proteins, respectively. 13.5% of TJR candidates exhibited positive lymphocyte reactivity (SI > 2) to the SARS-CoV-2 nucleocapsid protein and 38% to the spike protein. SARS-CoV-2 reactive lymphocytes exhibited a higher production of inflammatory biomarkers (i.e., IL-1β, IL-6, TNFα, and IL-1RA) compared to non-reactive lymphocytes. Conclusions A percentage of TJR candidates returning for elective surgeries exhibit pre-vaccination positive SARS-CoV-2 antibodies and T cell memory responses with associated pro-inflammatory biomarkers. This is an important parameter for understanding immunity, risk profiles, and may aid pre-operative planning. Trial registration Retrospectively registered.


2015 ◽  
Vol 68 (1) ◽  
pp. 73-79 ◽  
Author(s):  
David J. Beard ◽  
Kristina Harris ◽  
Jill Dawson ◽  
Helen Doll ◽  
David W. Murray ◽  
...  

2015 ◽  
Vol 42 ◽  
pp. S32
Author(s):  
J.E. Naili ◽  
A.C. Esbjörnsson ◽  
M.D. Iversen ◽  
M.H. Schwartz ◽  
C. Häger ◽  
...  

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