A Systematic Review of Compliant Mechanisms as Orthopedic Implants

2021 ◽  
Author(s):  
Connor Huxman ◽  
Jared Butler
Keyword(s):  
Systematic Review ◽  
Compliant Mechanisms ◽  
Orthopedic Implants ◽  
Patient Specific ◽  
Implant Loosening ◽  
Design Considerations ◽  
Complex Patient ◽  
Mechanical Compliance ◽  
Wear Reduction ◽  
Device Lifetime

Abstract Currently available motion-preserving orthopedic implants offer many advantages but have several limitations to their use, including short device lifetime, high part count, loss of natural kinematics and wear-induced osteolysis and implant loosening. Compliant mechanisms have been used to address some of these problems as they offer several potential advantages - namely wear reduction, reduced part count, and the ability to achieve complex, patient-specific motion profiles. This article provides a systematic review of compliant mechanisms as orthopedic implants. Based on the PRISMA guidelines for an efficient review, this work identified fourteen implantable orthopedic devices that seek to restore anatomical motion by utilizing mechanical compliance. From reviewing these implants and their results, advantages and consequences for each are summarized. Trends were also identified in how these devices are capable of mitigating common challenges found in orthopedic design. Design considerations for the development of future compliant orthopedic implants are proposed and discussed.

scholarly journals Risk Factors for Failure in Conservatively Treated Osteoporotic Vertebral Fractures: A Systematic Review

2021 ◽  
pp. 219256822098227
Author(s):  
Max J. Scheyerer ◽  
Ulrich J. A. Spiegl ◽  
Sebastian Grueninger ◽  
Frank Hartmann ◽  
Sebastian Katscher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Treatment Failure ◽  
Patient Specific ◽  
Mineral Density ◽  
Radiographic Findings ◽  
Specific Risk ◽  
Fracture Development ◽  
Predict Treatment Failure

Study Design: Systematic review. Objectives: Osteoporosis is one of the most common diseases of the elderly, whereby vertebral body fractures are in many cases the first manifestation. Even today, the consequences for patients are underestimated. Therefore, early identification of therapy failures is essential. In this context, the aim of the present systematic review was to evaluate the current literature with respect to clinical and radiographic findings that might predict treatment failure. Methods: We conducted a comprehensive, systematic review of the literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) checklist and algorithm. Results: After the literature search, 724 potentially eligible investigations were identified. In total, 24 studies with 3044 participants and a mean follow-up of 11 months (range 6-27.5 months) were included. Patient-specific risk factors were age >73 years, bone mineral density with a t-score <−2.95, BMI >23 and a modified frailty index >2.5. The following radiological and fracture-specific risk factors could be identified: involvement of the posterior wall, initial height loss, midportion type fracture, development of an intravertebral cleft, fracture at the thoracolumbar junction, fracture involvement of both endplates, different morphological types of fractures, and specific MRI findings. Further, a correlation between sagittal spinal imbalance and treatment failure could be demonstrated. Conclusion: In conclusion, this systematic review identified various factors that predict treatment failure in conservatively treated osteoporotic fractures. In these cases, additional treatment options and surgical treatment strategies should be considered in addition to follow-up examinations.

A systematic review of psychosocial design considerations for the next generation of mechanical circulatory support

Heart & Lung ◽  
2021 ◽  
Vol 50 (3) ◽  
pp. 397-406
Author(s):  
Dr. Sean Peel ◽  
Kimmi Keum Hee Ko ◽  
Dr. Erez Nusem ◽  
Dr. Karla Straker ◽  
Professor Cara Wrigley
Keyword(s):  
Systematic Review ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Next Generation ◽  
Design Considerations

A New Self-Adjusting CVT Configuration Using Compliant Mechanisms

2002 ◽  
Author(s):  
Myles T. Christensen ◽  
Spencer P. Magleby ◽  
Larry L. Howell ◽  
Robert H. Todd ◽  
Clint Mortensen
Keyword(s):  
Analytical Model ◽  
Compliant Mechanisms ◽  
Compliant Mechanism ◽  
Continuously Variable Transmission ◽  
Special Design ◽  
Design Considerations ◽  
Variable Transmission

This paper introduces a new configuration of a Continuously Variable Transmission (CVT) that is self-adjusting and designed as a compliant mechanism. This new configuration is called the Pivot-Arm CVT. The criteria for classification as a Pivot-Arm CVT is discussed. An analytical model describing the performance of the Pivot-Arm CVT is developed. Special design considerations which may be useful in implementing Pivot-Arm CVTs are introduced and explained. The Pivot-Arm CVT model is validated through controlled testing of two Pivot-Arm CVT prototypes.

scholarly journals Rates, predictors and mortality of sepsis-associated acute kidney injury: systematic review and meta-analysis

2020 ◽  
Author(s):  
Jie feng Liu ◽  
Hebin Xie ◽  
ziwei ye ◽  
Lesan Wang
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Septic Shock ◽  
Acute Kidney Injury ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Predisposing Factors ◽  
Cochrane Library ◽  
Patient Specific ◽  
Cumulative Number

Abstract Objective:The incidence and mortality of sepsis-induced acute kidney injury is high. Many studies have explored the causes of sepsis-induced acute kidney injury (AKI). However, its predictors are still uncertain; additionally, a complete overview is missing. A systematic review and a meta-analysis were performed to determine the predisposing factors for sepsis-induced AKI. Method: A systematic literature search was performed in the Medline, Embase, Cochrane Library, PubMed and Web of Science databases, with an end date parameter of May 25, 2019. Valid data were retrieved in compliance with the inclusion and exclusion criteria. Result: Forty-seven observational studies were included for analysis. A cumulative number of 55911sepsis patients were evaluated. The incidence of AKI caused by septic shock is the highest. 30 possible risk factors were included in the meta-analysis. The results showed that 20 factors were found to be significant. The odds ratio(OR),95% confidence interval (CI) and Prevalence of the most prevalent predisposing factors for sepsis-induced AKI were as the following: Septic shock[2.88(2.36-3.52), 60.47%], Hypertension[1.43(1.20-1.70),38.39%), Diabetes mellitus[1.59(1.47-1.71),27.57%],Abdominal infection[1.44(1.32-1.58),30.87%], Vasopressors use[2.95(1.67-5.22),64.61%],vasoactive drugs use [3.85(1.89-7.87),63.22%], Mechanical ventilation[1.64(1.24-2.16),68.00%), Positive blood culture[1.60(1.35-1.89), 41.19%], Smoke history[1.60(1.09-2.36),43.09%]. Other risk factors include cardiovascular, coronary artery disease, liver disease, unknow infection, diuretics use, ACEI or ARB, gram-negative bacteria and organ transplant. Conclusion: A large number of factors are associated with AKI development in sepsis patients. Our review can guide risk-reducing interventions, clinical prediction rules, and patient-specific treatment and management strategies for sepsis-induced acute kidney injury.

Design of Micro-Gripper With Topology Optimal Compliant Mechanisms

2004 ◽  
Author(s):  
Shyh-Chour Huang ◽  
Chien-Ching Chiu
Keyword(s):  
Linear Programming ◽  
Compliant Mechanisms ◽  
Compliant Mechanism ◽  
New Method ◽  
Sequential Linear Programming ◽  
Analysis Method ◽  
Electrothermal Actuator ◽  
Design Considerations ◽  
Micro Gripper

The objective of this paper describes a new method to design a micro-gripper. In the paper, we use compliant mechanism actuated by micro combined V-shape electrothermal actuator to design a microgripper that the claw can clip the micro object. The compliant mechanism employs flexible to generate movement without any hinge; therefore, it is suitable for MEMS manufacture. The design of micro-gripper is accomplished in compliant mechanism with topology optimum and solved by sequential linear programming (SLP) methods. The design considerations, the analysis method, and the design results are discussed.

scholarly journals A systematic review of the effects of strength training in patients with fibromyalgia: clinical outcomes and design considerations

2018 ◽  
Vol 58 (1) ◽  
Author(s):  
Alexandro Andrade ◽  
Ricardo de Azevedo Klumb Steffens ◽  
Sofia Mendes Sieczkowska ◽  
Leonardo Alexandre Peyré Tartaruga ◽  
Guilherme Torres Vilarino
Keyword(s):  
Systematic Review ◽  
Strength Training ◽  
Clinical Outcomes ◽  
Design Considerations

scholarly journals P140: Risk factors for adverse outcomes in hyperglycemic patients presenting to the emergency department: a systematic review

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S106-S107
Author(s):  
L. Siddiqi ◽  
K. Van Aarsen ◽  
A. Iansavitchene ◽  
J. W. Yan
Keyword(s):  
Systematic Review ◽  
Protective Factors ◽  
Quality Assessment ◽  
Research Question ◽  
Age Groups ◽  
Adverse Outcomes ◽  
Assessment Scale ◽  
Patient Specific ◽  
Diabetic Patients ◽  
The Past

Introduction: Hyperglycemia is a significant cause of morbidity and mortality, often resulting in adverse outcomes such as recurrent ED visits, hospitalization or death. The objective of this study was to perform a systematic review to identify predictors of these adverse outcomes among patients who present to the ED with hyperglycemia. Methods: Electronic searches of Medline and EMBASE were conducted for studies published in English between the years 1946 and June 2017. Studies with patients presenting to the ED with hyperglycemia were eligible for inclusion. Both adult and pediatric populations were included, as were diabetic and non-diabetic patients. Two reviewers independently screened all titles and abstracts for relevance to the research question. If consensus could not be reached, full-length manuscripts were reviewed. For any discrepancy, a third reviewer was consulted, and disagreement was resolved through discussion. Study quality was assessed using the Newcastle-Ottawa Quality Assessment Scale. Study- and patient-specific data were then extracted and presented descriptively in the systematic review. Results: Thirteen observational studies were included, with a combined total of 664,829 patients. The studies scored between 5 to 8 on the Quality Assessment Scale out of a possible total of 8. Predictors of adverse outcomes included patients in both older and younger (< 25) age groups, history of diabetes, multiple comorbidities, patients requiring insulin, sepsis and hyperlactatemia, access to a family physician, a sentinel hyperglycemia visit in the past month, and triage glucose level > 20 mmol/L. Protective factors included no admissions in the past year, care from a diabetes team while in hospital, systolic blood pressure between 90-150 mmHg and heart rate > 110 bpm. Conclusion: This systematic review found eight predictors and four protective factors for adverse outcomes in patients presenting to the ED with hyperglycemia. These factors should be considered for easier identification of higher-risk patients for adverse outcomes in order to guide management and follow-up.

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