A three-dimensional printed patient-specific scaphoid replacement: a cadaveric study

2018 ◽  
Vol 43 (4) ◽  
pp. 407-412 ◽  
Author(s):  
Philipp Honigmann ◽  
Ralf Schumacher ◽  
Romy Marek ◽  
Franz Büttner ◽  
Florian Thieringer ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Three Dimensional ◽  
Cadaveric Study ◽  
Patient Specific ◽  
Test Results ◽  
Physiological Range

We present our first cadaveric test results of a three-dimensional printed patient-specific scaphoid replacement with tendon suspension, which showed normal motion behaviour and preservation of a stable scapholunate interval during physiological range of motion.

Three-dimensional-printed patient-specific Kirschner-wire guide for percutaneous fixation of undisplaced scaphoid fractures: a cadaveric study

2019 ◽  
Vol 44 (7) ◽  
pp. 692-696 ◽  
Author(s):  
Vincent Salabi ◽  
Guillaume Rigoulot ◽  
Alain Sautet ◽  
Adeline Cambon-Binder
Keyword(s):  
Kirschner Wire ◽  
Three Dimensional ◽  
Cadaveric Study ◽  
Ct Scans ◽  
Patient Specific ◽  
Angular Deviation ◽  
Percutaneous Fixation ◽  
Scaphoid Fractures ◽  
Cadaveric Model ◽  
The Ideal

Undisplaced scaphoid waist fractures can be managed by percutaneous fixation. The purpose of this study is to compare percutaneous fixation using a three-dimensional (3-D)-printed guide with the conventional method in a cadaveric study. Twelve wrists were divided into two groups: standard fluroscopic technique group, and a patient-specific 3-D-printed guide group. In the patient-specific group, using high resolution CT scans, we manufactured a mould-guide including a wire guide sleeve aligned with the planned ideal path, and 3-D printed it. On postoperative CT scans we measured the angular deviation of the screw axis from the ideal axis, and compared the two groups. The angular deviation was significantly lower in the patient-specific guide group. We concluded that a 3-D-printed guide for scaphoid percutaneous fixation allows a more accurate placement of the screw than a fluoroscopy guide in our cadaveric model.

Ankylosis and pseudoankylosis of the temporomandibular joint in 10 dogs (1993–2015)

2016 ◽  
Vol 29 (05) ◽  
pp. 409-415 ◽  
Author(s):  
Peter Strøm ◽  
Boaz Arzi ◽  
Derek Cissell ◽  
Frank Verstraete
Keyword(s):  
Surgical Treatment ◽  
Range Of Motion ◽  
Temporomandibular Joint ◽  
Three Dimensional ◽  
Case Series ◽  
Patient Specific ◽  
Three Dimensional Printing ◽  
Temporomandibular Joint Ankylosis ◽  
Dimensional Printing ◽  
Joint Ankylosis

SummaryObjective: To describe the clinical features and results of treatment of true ankylosis and pseudoankylosis of the temporomandibular joint in dogs.Methods: This study was a retrospective case series. Ten client-owned dogs that were presented for inability to open the mouth or a severely decreased range of motion of the temporomandibular joint were included. Information on the surgical procedures performed and the perioperative complications were documented. Three-dimensional printing of the skull was performed in four dogs.Results: Two dogs were diagnosed with temporomandibular joint ankylosis and seven dogs with pseudoankylosis. One dog had evidence of combined temporomandibular joint ankylosis and pseudoankylosis. Of the seven dogs with pseudoankylosis, six had an osseous fusion involving the zygomatic arch and mandible. Surgical treatment was performed in nine dogs and a revision surgery was needed in one dog. Follow-up ranged from five months to eight years (mean: 48.6 months). Eight out of nine dogs that were treated surgically regained the ability to open their mouth, but six dogs never regained a fully normal temporomandibular joint range of motion.Clinical significance: Temporomandibular joint ankylosis and pseudoankylosis are uncommon in the dog. Surgical treatment for temporomandibular joint ankylosis or pseudoankylosis in dogs is a successful option and carries a prognosis dependent on patient-specific abnormalities. Computed tomography complemented with three- dimensional printing is valuable for understanding the extent of abnormalities and for preoperative planning.Supplementary material for this paper is available online at http://dx.doi.org/10.3415/VCOT-15-11-0189.

scholarly journals Corrective Osteotomy of Upper Extremity Malunions Using Three-Dimensional Planning and Patient-Specific Surgical Guides: Recent Advances and Perspectives

2021 ◽  
Vol 8 ◽  
Author(s):  
Babak Saravi ◽  
Gernot Lang ◽  
Rebecca Steger ◽  
Andreas Vollmer ◽  
Jörn Zwingmann
Keyword(s):  
Range Of Motion ◽  
Upper Extremity ◽  
Therapeutic Approach ◽  
Corrective Osteotomy ◽  
Three Dimensional ◽  
Current Evidence ◽  
Patient Specific ◽  
Computer Assisted ◽  
Surgical Guides ◽  
Recent Advances

Malunions of the upper extremity can result in severe functional problems and increase the risk of osteoarthritis. The surgical reconstruction of complex malunions can be technically challenging. Recent advances in computer-assisted orthopedic surgery provide an innovative solution for complex three-dimensional (3-D) reconstructions. This study aims to evaluate the clinical applicability of 3-D computer-assisted planning and surgery for upper extremity malunions. Hence, we provide a summary of evidence on this topic and highlight recent advances in this field. Further, we provide a practical implementation of this therapeutic approach based on three cases of malunited forearm fractures treated with corrective osteotomy using preoperative three-dimensional simulation and patient-specific surgical guides. All three cases, one female (56 years old) and two males (18 and 26 years old), had painful restrictions in range of motion (ROM) due to forearm malunions and took part in clinical and radiologic assessments. Postoperative evaluation of patient outcomes showed a substantial increase in range of motion, reduction of preoperatively reported pain, and an overall improvement of patients' satisfaction. The therapeutic approach used in these cases resulted in an excellent anatomical and functional reconstruction and was assessed as precise, safe, and reliable. Based on current evidence and our results, the 3-D preoperative planning technique could be the new gold standard in the treatment of complex upper extremity malunions in the future.

The influence of selective arthrodesis on three-dimensional range of motion of hindfoot joint: A cadaveric study

2019 ◽  
Vol 69 ◽  
pp. 9-15
Author(s):  
Xiaoyang Jia ◽  
Minfei Qiang ◽  
Yanxi Chen ◽  
Kun Zhang ◽  
Song Chen
Keyword(s):  
Range Of Motion ◽  
Three Dimensional ◽  
Cadaveric Study ◽  
Dimensional Range

scholarly journals Numerical computation of blood flow for a patient-specific hemodialysis shunt model

2021 ◽  
Author(s):  
Surabhi Rathore ◽  
Tomoki Uda ◽  
Viet Q. H. Huynh ◽  
Hiroshi Suito ◽  
Toshitaka Watanabe ◽  
...  
Keyword(s):  
Stokes Equations ◽  
Three Dimensional ◽  
Arteriovenous Shunt ◽  
Navier Stokes ◽  
Patient Specific ◽  
Stabilized Finite Element ◽  
Computed Tomography Scanning ◽  
Outflow Boundary ◽  
Stage Renal Disease ◽  
End Stage

AbstractHemodialysis procedure is usually advisable for end-stage renal disease patients. This study is aimed at computational investigation of hemodynamical characteristics in three-dimensional arteriovenous shunt for hemodialysis, for which computed tomography scanning and phase-contrast magnetic resonance imaging are used. Several hemodynamical characteristics are presented and discussed depending on the patient-specific morphology and flow conditions including regurgitating flow from the distal artery caused by the construction of the arteriovenous shunt. A simple backflow prevention technique at an outflow boundary is presented, with stabilized finite element approaches for incompressible Navier–Stokes equations.

scholarly journals Application of subject-specific adaptive mechanical loading for bone healing in a mouse tail vertebral defect

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Angad Malhotra ◽  
Matthias Walle ◽  
Graeme R. Paul ◽  
Gisela A. Kuhn ◽  
Ralph Müller
Keyword(s):  
Mechanical Loading ◽  
Bone Defect ◽  
Bone Healing ◽  
Three Dimensional ◽  
Patient Specific ◽  
Dependent Manner ◽  
Micro Computed Tomography ◽  
Computed Tomography Images ◽  
Bone Defect Healing ◽  
Subject Specific

AbstractMethods to repair bone defects arising from trauma, resection, or disease, continue to be sought after. Cyclic mechanical loading is well established to influence bone (re)modelling activity, in which bone formation and resorption are correlated to micro-scale strain. Based on this, the application of mechanical stimulation across a bone defect could improve healing. However, if ignoring the mechanical integrity of defected bone, loading regimes have a high potential to either cause damage or be ineffective. This study explores real-time finite element (rtFE) methods that use three-dimensional structural analyses from micro-computed tomography images to estimate effective peak cyclic loads in a subject-specific and time-dependent manner. It demonstrates the concept in a cyclically loaded mouse caudal vertebral bone defect model. Using rtFE analysis combined with adaptive mechanical loading, mouse bone healing was significantly improved over non-loaded controls, with no incidence of vertebral fractures. Such rtFE-driven adaptive loading regimes demonstrated here could be relevant to clinical bone defect healing scenarios, where mechanical loading can become patient-specific and more efficacious. This is achieved by accounting for initial bone defect conditions and spatio-temporal healing, both being factors that are always unique to the patient.

scholarly journals Spine Examination during COVID-19 Pandemic via Video Consultation

2021 ◽  
Author(s):  
Tom Jansen ◽  
Martin Gathen ◽  
Amadeo Touet ◽  
Hans Goost ◽  
Dieter Christian Wirtz ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Range Of Motion ◽  
Test Results ◽  
Risk Of Infection ◽  
Face To Face ◽  
Reliable Tool ◽  
Provocation Tests ◽  
Active Range Of Motion ◽  
Video Consultation ◽  
Good Agreement

Abstract Introduction During the current COVID-19 pandemic video consultations are increasingly common in order to minimize the risk of infection for staff and patients. The aim of this study was to evaluate the feasibility of a spine examination via video. Methods A total of 43 patients were recruited. Each participant underwent a video-based (VB) and a conventional face-to-face (FTF) spine examination. Pain intensity, active range of motion, inspection, a neurophysiologic basic exam and provocations tests were evaluated using video-based and face-to-face methods. Results The intra-rater reliability (IRR) was measured between both examinations. Good to very good IRR values were obtained in inspection (Kappa between 0,752 und 0,944), active range of motion and basic neurophysiological examination (Kappa between 0,659 und 0,969). Only moderate matches were found in specific provocation tests (Kappa between 0,407 und 0,938). A video-based spine examination is a reliable tool for measuring pain intensity, active range of motion and a basic neurophysiologic exam. Conclusion A basic spine examination during a video consultation is possible. A good agreement of the test results between video-based and face-to-face examination could be found.

scholarly journals Effects of intracorneal ring segments implementation technique and design on corneal biomechanics and keratometry in a personalized computational analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Niksa Mohammadi Bagheri ◽  
Mahmoud Kadkhodaei ◽  
Shiva Pirhadi ◽  
Peiman Mosaddegh
Keyword(s):  
Clinical Data ◽  
Three Dimensional ◽  
Element Model ◽  
Von Mises Stress ◽  
Patient Specific ◽  
Average Error ◽  
Constant Thickness ◽  
Arc Length ◽  
Implementation Techniques ◽  
Von Mises

AbstractThe implementation of intracorneal ring segments (ICRS) is one of the successfully applied refractive operations for the treatment of keratoconus (kc) progression. The different selection of ICRS types along with the surgical implementation techniques can significantly affect surgical outcomes. Thus, this study aimed to investigate the influence of ICRS implementation techniques and design on the postoperative biomechanical state and keratometry results. The clinical data of three patients with different stages and patterns of keratoconus were assessed to develop a three-dimensional (3D) patient-specific finite-element model (FEM) of the keratoconic cornea. For each patient, the exact surgery procedure definitions were interpreted in the step-by-step FEM. Then, seven surgical scenarios, including different ICRS designs (complete and incomplete segment), with two surgical implementation methods (tunnel incision and lamellar pocket cut), were simulated. The pre- and postoperative predicted results of FEM were validated with the corresponding clinical data. For the pre- and postoperative results, the average error of 0.4% and 3.7% for the mean keratometry value ($$\text {K}_{\text{mean}}$$ K mean ) were predicted. Furthermore, the difference in induced flattening effects was negligible for three ICRS types (KeraRing segment with arc-length of 355, 320, and two separate 160) of equal thickness. In contrast, the single and double progressive thickness of KeraRing 160 caused a significantly lower flattening effect compared to the same type with constant thickness. The observations indicated that the greater the segment thickness and arc-length, the lower the induced mean keratometry values. While the application of the tunnel incision method resulted in a lower $$\text {K}_{\text{mean}}$$ K mean value for moderate and advanced KC, the induced maximum Von Mises stress on the postoperative cornea exceeded the induced maximum stress on the cornea more than two to five times compared to the pocket incision and the preoperative state of the cornea. In particular, an asymmetric regional Von Mises stress on the corneal surface was generated with a progressive ICRS thickness. These findings could be an early biomechanical sign for a later corneal instability and ICRS migration. The developed methodology provided a platform to personalize ICRS refractive surgery with regard to the patient’s keratoconus stage in order to facilitate the efficiency and biomechanical stability of the surgery.

scholarly journals An MRI-Based Patient-Specific Computational Framework for the Calculation of Range of Motion of Total Hip Replacements

2021 ◽  
Vol 11 (6) ◽  
pp. 2852
Author(s):  
Maeruan Kebbach ◽  
Christian Schulze ◽  
Christian Meyenburg ◽  
Daniel Kluess ◽  
Mevluet Sungu ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Computer Aided Design ◽  
External Rotation ◽  
Patient Specific ◽  
Computational Framework ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Significant Difference ◽  
Hip Replacements

The calculation of range of motion (ROM) is a key factor during preoperative planning of total hip replacements (THR), to reduce the risk of impingement and dislocation of the artificial hip joint. To support the preoperative assessment of THR, a magnetic resonance imaging (MRI)-based computational framework was generated; this enabled the estimation of patient-specific ROM and type of impingement (bone-to-bone, implant-to-bone, and implant-to-implant) postoperatively, using a three-dimensional computer-aided design (CAD) to visualize typical clinical joint movements. Hence, patient-specific CAD models from 19 patients were generated from MRI scans and a conventional total hip system (Bicontact® hip stem and Plasmacup® SC acetabular cup with a ceramic-on-ceramic bearing) was implanted virtually. As a verification of the framework, the ROM was compared between preoperatively planned and the postoperatively reconstructed situations; this was derived based on postoperative radiographs (n = 6 patients) during different clinically relevant movements. The data analysis revealed there was no significant difference between preoperatively planned and postoperatively reconstructed ROM (∆ROM) of maximum flexion (∆ROM = 0°, p = 0.854) and internal rotation (∆ROM = 1.8°, p = 0.917). Contrarily, minor differences were observed for the ROM during maximum external rotation (∆ROM = 9°, p = 0.046). Impingement, of all three types, was in good agreement with the preoperatively planned and postoperatively reconstructed scenarios during all movements. The calculated ROM reached physiological levels during flexion and internal rotation movement; however, it exceeded physiological levels during external rotation. Patients, where implant-to-implant impingement was detected, reached higher ROMs than patients with bone-to-bone impingement. The proposed framework provides the capability to predict postoperative ROM of THRs.

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