scholarly journals Gambaran Proses Pembuatan Transfemoral Prosthesis Menggunakan Polycentric Knee Joint Untuk Pasien Amputasi Atas Lutut

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Ismi Dwi Syafitri ◽  
Nur Rachmat
Keyword(s):  
Knee Joint ◽  
Lower Limbs ◽  
World Health ◽  
Knee Joints ◽  
Transfemoral Amputation ◽  
Prosthetic Knee ◽  
Gait Abnormality ◽  
Gait Abnormalities ◽  
Health Organization ◽  
Transfemoral Prosthesis

Abstract : Transfemoral Amputasi, Transfemoral Prosthesis, Polycentric Knee Joint. World Health Organization (WHO) estimated that there are 40 million amputees throughout the developing countries. Amputation in the lower limbs reached 85% -90% of all amputations. Transfemoral amputation because of this amputation occurs in the thigh that passed through the femur bone. Amputation causes significant gait abnormalities. amputation levels increased, the functional level is reduced, and the characteristic of the gait abnormality is immediately apparent. Transfemoral Prosthesis is artificial limb that made for above knee amputation. making process of transfemoral prosthesis includes assessment, measurement, casting, fabrication, fitting, finishing. Of all components for transfemoral patients, prosthetic knee joints are the most important components that can affect to gait stability. The choice for the type of popular passive knee mechanism is polycentric knee. The polycentric knee joint mechanism, linkage of 4 and 6 bar mechanisms have been used to increase stability during the stance and kinematic phase of the swing phase.

Biomechanical responses of young adults with unilateral transfemoral amputation using two types of mechanical stance control prosthetic knee joints

2020 ◽  
Vol 44 (5) ◽  
pp. 314-322
Author(s):  
Jan Andrysek ◽  
Daniela García ◽  
Claudio Rozbaczylo ◽  
Carlos Alvarez-Mitchell ◽  
Rebeca Valdebenito ◽  
...  
Keyword(s):  
Young Adults ◽  
Knee Joint ◽  
Stance Phase ◽  
Pelvic Tilt ◽  
Swing Phase ◽  
Knee Joints ◽  
Transfemoral Amputation ◽  
Phase Duration ◽  
Prosthetic Knee ◽  
Stance Control

Background: Prosthetic knee joint function is important in the rehabilitation of individuals with transfemoral amputation. Objectives: The objective of this study was to assess the gait patterns associated with two types of mechanical stance control prosthetic knee joints—weight-activated braking knee and automatic stance-phase lock knee. It was hypothesized that biomechanical differences exist between the two knee types, including a prolonged swing-phase duration and exaggerated pelvic movements for the weight-activated braking knee during gait. Study design: Prospective crossover study. Methods: Spatiotemporal, kinematic, and kinetic parameters were obtained via instrumented gait analysis for 10 young adults with a unilateral transfemoral amputation. Discrete gait parameters were extracted based on their magnitudes and timing. Results: A 1.01% ± 1.14% longer swing-phase was found for the weight-activated braking knee (p < 0.05). The prosthetic ankle push-off also occurred earlier in the gait cycle for the weight-activated braking knee. Anterior pelvic tilt was 3.3 ± 3.0 degrees greater for the weight-activated braking knee. This range of motion was also higher (p < 0.05) and associated with greater hip flexion angles. Conclusions: Stance control affects biomechanics primarily in the early and late stance associated with prosthetic limb loading and unloading. The prolonged swing-phase time for the weight-activated braking knee may be associated with the need for knee unloading to initiate knee flexion during gait. The differences in pelvic tilt may be related to knee stability and possibly the different knee joint stance control mechanisms. Clinical relevance Understanding the influence of knee function on gait biomechanics is important in selecting and improving treatments and outcomes for individuals with lower-limb amputations. Weight-activated knee joints may result in undesired gait deviations associated with stability in early stance-phase, and swing-phase initiation in the late stance-phase of gait.

An Architecture for Direct Measurement of Transfemoral Prosthesis Gait Beyond the Gait Laboratory Setting

2014 ◽  
Author(s):  
Jonathan A. Gacioch ◽  
Kevin B. Fite ◽  
Adam K. Arabian ◽  
Toshiki Kobayashi ◽  
David A. Boone ◽  
...  
Keyword(s):  
Knee Kinematics ◽  
Knee Joints ◽  
Single Subject ◽  
Laboratory Setting ◽  
Transfemoral Amputation ◽  
Kinetic Measurements ◽  
Prosthetic Knee ◽  
Rapid Acquisition ◽  
Composite Energy ◽  
Transfemoral Prosthesis

The work presented here details the development of a wireless instrumentation architecture for direct gait measurement in a transfemoral prosthesis. The system comprises a pair of multi-axis load cells located proximal to the ankle and knee joints of the prosthesis that provide a measure of moments and axial force above and below the prosthetic knee. The kinetic measurements are supplemented with knee kinematics measured using a modular goniometer attached lateral to the prosthetic knee and ground contact as indicated with a pneumatic sensor at the prosthetic heel. Each instrument wirelessly transmits collected data to host PCs, enabling direct gait measurements free of the constraints of a conventional gait laboratory setting. The data acquisition system was evaluated with a single subject with unilateral transfemoral amputation walking with a polycentric knee, composite energy-return foot, and daily-use socket. Experimental results were collected for the subject walking through a theater, enabling the rapid acquisition of gait data for level-ground walking and incline ascent/descent without the need for a motion-capture camera array or floor-embedded force plates.

A comparative evaluation of the Adaptive® knee and Catech® knee joints: A preliminary study

2008 ◽  
Vol 32 (1) ◽  
pp. 84-92 ◽  
Author(s):  
F. Jepson ◽  
D. Datta ◽  
I. Harris ◽  
B. Heller ◽  
J. Howitt ◽  
...  
Keyword(s):  
Knee Joint ◽  
Knee Joints ◽  
Hydraulic Control ◽  
Cost Index ◽  
Pneumatic Control ◽  
Prosthetic Knee ◽  
Physiological Cost ◽  
Hybrid Controller ◽  
Preliminary Study ◽  
Force Time

The Adaptive® knee joint is a microprocessor-controlled prosthetic knee that incorporates both pneumatic and hydraulic control in one electronic unit. Pneumatic control is said to provide control during swing phase and the hydraulic control during the stance phase of the gait. This hybrid controller is triggered by a computer contained within the knee that responds to input from force, time and angle sensors. The microprocessor then selects an appropriate speed and stability setting. The Catech® knee joint is a conventional hydraulic knee joint. The aim of this study was to compare the Adaptive® and Catech® knee joints in established trans-femoral amputees. The patients meeting the inclusion criteria were all established trans-femoral amputees using the Catech® knee joint. The study was carried out by performing gait analysis, assessing energy requirements using the Physiological Cost Index (PCI) and using questionnaires. There was no significant benefit gained from the use of the Adaptive® knee over the Catech® knee joint in our small study group.

The Effect of Flexion Angle and Sagittal Radius on Femorotibial Contact Stresses

2011 ◽  
Vol 421 ◽  
pp. 388-391
Author(s):  
C S Ramesh ◽  
C Shashishekar
Keyword(s):  
Knee Joint ◽  
High Performance ◽  
Fiber Composite ◽  
Three Dimensional ◽  
Flexion Angle ◽  
Knee Joints ◽  
Three Dimensional Model ◽  
Carbon Fiber Composite ◽  
Prosthetic Knee ◽  
Design Requirements

The artificial knee joint need to satisfy and meet certain design requirements in addition to being biocompatible. These being the design of the flexion angle and sagittal radius of the prosthetic knee for specific activities such as walking and exercising. Day to day physical activities do result in generating frequent contacts between the femur and tibia leading to stresses at the interface of the femorotibial joint. These stresses on exceeding certain limit do result in damage of the tibia which acts as bearing surface carrying loads during each of the knee activity. Hence, prediction and minimization of the stresses at the knee interfaces is the key issue to ensure high performance knee joints. In the light of the above, the stresses at the knee interfaces are computed using commercially available FEA software (ANSYS 10). The three dimensional model was developed using PRO E software for sagittal radius of 40, 50 and 60 mm. The flexion angles considered are 0, 20 and 40 degrees. A load of 500N was considered. It is observed that the stress intensity increases with increase in flexion angle and sagittal radius for all the material combinations of the prosthetic knee joint. Further, alumina ceramic femur and polyethylene chopped carbon fiber composite tibia exhibits the least stress levels at all the studied sagittal radius and flexion angles.

Injuries and overloads in combat sports exemplified by Thai boxing and judo

2016 ◽  
Vol 7 (2) ◽  
pp. 89-96
Author(s):  
Bartosz Bolach ◽  
Kazimierz Witkowski ◽  
Paweł Adam Piepiora ◽  
Robert Sokólski ◽  
Eugeniusz Bolach
Keyword(s):  
Knee Joint ◽  
The Other ◽  
Lower Limbs ◽  
Knee Joints ◽  
Training Period ◽  
Combat Sports ◽  
Sports Activity ◽  
Shoulder Joints ◽  
Joint Injuries ◽  
Sports Club

Background: and study aim: Each sports activity, particularly combat sports, involves various injuries and overloads. Injuries are a result of impact of sudden large for ceson tissues, while overloads are caused by small but repetitive forces, which lead to some dysfunction, pain. The aim of this study was to compare injuries and overloads in two combat sports, namely judo and Thai boxing. Material and methods: The study was conducted on 34 judokas (from MaKo Judo Wrocław Sports Club) and 34 Thai boxers (from Puncher Wrocław Sports Club). The group of Thai boxers consisted of 29 men and 5 women, where as the judoka group was comprised of 23 men and 11 women. The average age of participants was 22.6 years. Internship competes patients was 3 years. The training period was similar for Thai boxers and judokas: Thai boxers trained on average for 8.5hper week, while judokas trained for 6.9h per week. Results: The study demonstrated that the most common injuries in Thai boxers occurred in lower limbs, while in judokas– in shoulder joints, knee joints and the spine. Thai boxers most frequently developed overloads in lower limbs, whereas judokas– in shoulder joints and the spine. Conclusions: Thai boxers considerably more frequently sustained injuries of feet, elbow joints and thighs, compared to judokas, who sustained more knee joint injuries. Judokas considerably more frequently suffered from injuries of shoulder joints and the spine compared to Thai boxers. Thai boxers more often developed overloads of lower limbs and elbow joints compared to judokas. On the other hand, judokas considerably more frequently sustained overloads of the spine and shoulder joints compared to Thai boxers.

scholarly journals Rotationplasty with Vascular Reconstruction for Prosthetic Knee Joint Infection

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Masahide Fujiki ◽  
Shimpei Miyamoto ◽  
Fumihiko Nakatani ◽  
Akira Kawai ◽  
Minoru Sakuraba
Keyword(s):  
Knee Joint ◽  
Joint Infection ◽  
Vascular Reconstruction ◽  
Knee Joints ◽  
Surgical Removal ◽  
Salvage Procedure ◽  
Prosthetic Knee ◽  
Prosthetic Joint ◽  
The Mean ◽  
Prosthetic Knee Joint

Rotationplasty is used most often as a function-preserving salvage procedure after resection of sarcomas of the lower extremity; however, it is also used after infection of prosthetic knee joints. Conventional vascular management during rotationplasty is to preserve and coil major vessels, but recently, transection and reanastomosis of the major vessels has been widely performed. However, there has been little discussion regarding the optimal vascular management of rotationplasty after infection of prosthetic knee joints because rotationplasty is rarely performed for this indication. We reviewed four patients who had undergone resection of osteosarcomas of the femur, placement of a prosthetic knee joint, and rotationplasty with vascular reconstruction from 2010 to 2013. The mean interval between prosthetic joint replacement and rotationplasty was 10.4 years and the mean interval between the diagnosis of prosthesis infection and rotationplasty was 7.9 years. Rotationplasty was successful in all patients; however, in one patient, arterial thrombosis developed and necessitated urgent surgical removal and arterial reconstruction. All patients were able to walk independently with a prosthetic limb after rehabilitation. Although there is no consensus regarding the most appropriate method of vascular management during rotationplasty for revision of infected prosthetic joints, vascular transection and reanastomosis is a useful option.

scholarly journals Possibilities of rehabilitation in atherosclerosis of arteries of the lower limbs in combination with diabetes

2021 ◽  
Vol 24 (2) ◽  
pp. 29-32
Author(s):  
Vera S. Spiridonova ◽  
Rimma T. Sklyarenko ◽  
Oleg A. Churzin ◽  
Dmitry V. Antonov ◽  
Magomed S. Omarov
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Interdisciplinary Approach ◽  
The Body ◽  
Lower Limbs ◽  
World Health ◽  
Industrialized Countries ◽  
Surgical Interventions ◽  
The World ◽  
Health Organization

BACKGROUND: According to the World Health Organization, more than 17 million people die from cardiovascular diseases every year in the world. Coronary heart disease is the leading cause of death in industrialized countries. AIMS: To evaluate the immediate result of treatment by revascularization of the limb and organ-preserving surgical interventions for purulent-necrotic lesions of the feet, neuropathic form of diabetic foot with osteoarthropathy in chronic arterial insufficiency of the IV degree. MATERIAL AND METHODS: In the paper, the authors investigated possible treatments with different limb lesions in patients diagnosed with diabetes mellitus. Since in this disease there are complications on the cardiovascular system, most people are diagnosed with obliterating atherosclerosis, which leads to slow necrosis of the limbs. This causes diabetes patients, not only severe pain and an aesthetically unsightly state of the body, but also noticeably worsens the quality of life. RESULTS: With a consolidated approach to this problem, endocrinologists and cardiovascular surgeons developed and tested the method of endascular surgery. Patients diagnosed with obliterating lower extremity vascular atherosclerosis against the background of diabetes mellitus with trophic and necrotic lesions of the peripheral lower extremities underwent enduscular surgery to revascularize the limb, which showed not just positive immediate treatment results, but gave opportunities to preserve patients limbs. CONCLUSION: Timely recognition and treatment of purulent-necrotic lesions of the feet, the neuropathic form of diabetic foot with osteoarthropathy requires an interdisciplinary approach and close cooperation of doctors of different specialties - endocrinologists, surgeons, podiatrists, orthopedists, general practitioners, etc. Only if these conditions are met, it is possible to achieve significant success and minimize the number of irreversible deformities and amputations of the feet, the weighting of disability groups.

scholarly journals USE OF AMPHOTERICIN B IN THE SIMULTANEOUS TREATMENT OF CHROMOBLASTOMYCOSIS AND AMERICAN TEGUMENTARY LEISHMANIASIS: A CASE REPORT

2018 ◽  
Vol 5 (1) ◽  
pp. 46
Author(s):  
Gustavo Carneiro Resstel ◽  
Eduardo Bernardo Chaves Neto ◽  
Flávia Chaves Lacerda ◽  
Rafael Ramalho Vale Cavalcante ◽  
Carlos Alberto Rodrigues Junior ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Neglected Tropical Diseases ◽  
Close Contact ◽  
Fungal Disease ◽  
Lower Limbs ◽  
World Health ◽  
Simultaneous Treatment ◽  
Tegumentary Leishmaniasis ◽  
American Tegumentary Leishmaniasis ◽  
Health Organization

ABSTRACT Chromoblastomycosis (CMB) is a polymorphic fungal disease that usually affects the lower limbs and manifests as verrucous nodules or plaques that may ulcerate. American Tegumentary Leishmaniasis (ATL) is an infectious parasitic disease caused by digenetic protozoa of the genus Leishmania sp. which affects the skin and/or mucous membranes of man and various species of wild and domestic animals. Both are part of the World Health Organization (WHO) neglected tropical diseases portfolio, mostly affecting economically vulnerable populations without adequate sanitation and in close contact with infectious vectors. We present the report of a 59-year-old male patient, referred to the Hospital Geral Público de Palmas (HGPP) in December 2017, carrying a positive result from a direct parasitological detection test for Leishmania sp., in addition to multiple previously biopsied lesions caused by CMB. It was observed that the patient had an important improvement of the CMB lesions with the use of amphotericin B in combination with itraconazole, thus demonstrating the role that the former can play in the therapy of this fungal disease.   Keywords: Chromoblastomycosis; American Tegumentary leishmaniasis; Amphotericin B. RESUMO A cromoblastomicose (CBM) é uma doença fúngica polimórfica, que acomete normalmente os membros inferiores e que se manifesta como nódulos ou placas verrucosas que podem ulcerar. A leishmaniose tegumentar (LT) é uma doença infectoparasitária causada por protozoários digenéticos do gênero Leishmania sp. que acomete a pele e/ou mucosas do homem e de várias espécies de animais silvestres e domésticos. Ambas fazem parte do portfólio de doenças negligenciadas da Organização Mundial da Saúde (OMS), afetando em sua maioria pessoas economicamente vulneráveis, sem saneamento adequado e em contato próximo com vetores infecciosos. Apresentamos neste trabalho o relato de um paciente, masculino, 59 anos, encaminhado ao Hospital Geral Público de Palmas (HGPP) em dezembro de 2017, portando exame parasitológico direto positivo para Leishmania sp., além de múltiplas lesões causadas por CBM previamente biopsiadas. Foi observado que o paciente teve importante melhora das lesões de CBM com uso da anfotericina B em associação ao itraconazol, demonstrando o papel que essa droga pode exercer na terapêutica desta doença fúngica. Palavras-chave: Cromoblastomicose; Leishmaniose Tegumentar; Anfotericina B.

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