Science.gov

Sample records for manipulation orthopedic

  1. Orthopedic services

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/007455.htm Orthopedic services To use the sharing features on this page, please enable JavaScript. Orthopedics, or orthopedic services, is the medical specialty that involves the treatment ...

  2. Orthopedic surgery.

    PubMed

    Gehrig, Laura M B

    2011-09-01

    Orthopedic surgery is a specialty of surgery dedicated to the prevention, diagnosis, and treatment of diseases and injuries of the musculoskeletal system in all age groups. Careers in orthopedic surgery span the spectrum from general orthopedics to those of subspecialty expertise in orthopedic trauma, hand, pediatrics, total joint, foot and ankle, sports medicine, and oncology to name a few. PMID:21871990

  3. Orthopedic evaluation

    NASA Technical Reports Server (NTRS)

    Walden, T.

    1978-01-01

    The clinical performance of the Lixiscope in orthopedics was compared with routine radiography. Portability and size were the major advantages of the Lixiscope. The main disadvantage at this point in time was the Lixiscope's inability to study large areas.

  4. Orthopedic services

    MedlinePlus

    ... foot: Bunions Fasciitis Foot and ankle deformities Fractures Hammer toe Heel pain Heel spurs Joint pain and ... of orthopedics include: Amputation Arthroscopic surgeries Bunionectomy and hammer toe repair Cartilage repair or resurfacing procedures Cartilage ...

  5. Medical Issues: Orthopedics

    MedlinePlus

    ... support & care > living with sma > medical issues > orthopedics Orthopedics In SMA, muscle weakness can cause several complications. ... difficulty sitting, standing, or performing normal daily activities. Orthopedic Considerations Doctors and therapists classify individuals with SMA ...

  6. Orthopedic aspects of separation.

    PubMed

    Jones, David

    2015-10-01

    In the management of conjoined twins the orthopedic surgeon may be involved directly, as part of the surgical team at operation or indirectly, in dealing with associated anomalies or the sequelae of surgery. The overwhelming indication for orthopedic involvement is ischiopagus, either tripus or tetrapus. The main role of the orthopedic surgeon is to facilitate midline closure through the use of pelvic osteotomies, which allow the symphysis pubis to be approximated. PMID:26382266

  7. Orthopedic Prosthetic Infections: Diagnosis and Orthopedic Salvage.

    PubMed

    Kaufman, Matthew G; Meaike, Jesse D; Izaddoost, Shayan A

    2016-05-01

    Orthopedic hardware infections are much feared and costly complications that can occur when these devices are implemented both in traumatic cases as well as in joint replacement surgery. Because these infections can lead to great morbidity, it is important to understand their pathophysiology as well as the principles behind their diagnosis and initial treatment. Plastic surgeons are frequently consulted as part of a multidisciplinary team to provide stable soft tissue coverage of the associated defects that result from these infections. A review of the existing literature was performed to identify the potential causes of these infections, to provide established diagnostic criteria guidelines, and to explain how these prosthetic infections are managed from an orthopedic surgery perspective prior to consulting the plastic surgery team. PMID:27152098

  8. Lasers in orthopedics

    NASA Astrophysics Data System (ADS)

    Sherk, Henry H.; Rhodes, Anthony L.; Meller, Menachem M.

    1990-06-01

    Orthopedic Surgery is that surgical discipline which deals with the musculoskeletal system. Orthopedists therefore operate on joints, the spine and long bones and engage in such subsecialities as sports medicine, hand surgery, trauma surgery, and joint replacements. Since they must cut and shape bone, cartilage, tendon, and ligament, orthopedists have developed a number of mechanical techniques to achieve these ends and surgical lasers have found few applications in orthopedics because until now they have not been useful for cutting bone. In the past several years, however, there has been considerable interest in several areas within the field of orthopedic surgery that do not entail actual bone surgery and it is expected that as newer and more powerful lasers become available laser osteotomy may become feasible and even routine.

  9. [Orthopedic shoe treatment : Inserts].

    PubMed

    Schuh, R; Windhager, R

    2016-03-01

    The use of inserts and orthopedic shoe adjustment represents an essential component of the conservative therapy of degenerative diseases and deformities of the musculoskeletal system. Inserts can have supportive, bedding and corrective effects and are used in particular for complaints of the feet and ankles. The combination of diverse materials allows a high level of cushioning and supporting features and corresponding longevity to be accomplished. The production is carried out on an individual basis and if necessary computer-assisted in order to achieve an optimal fit. For severe and rigid deformities the formation of pressure ulcers can be prevented by orthopedic shoe adjustment and by the use of orthopedic tailor-made shoes. PMID:26861757

  10. Sarcopenia in Orthopedic Surgery.

    PubMed

    Bokshan, Steven L; DePasse, J Mason; Daniels, Alan H

    2016-01-01

    Sarcopenia is a loss of skeletal muscle mass in the elderly that is an independent risk factor for falls, disability, postoperative complications, and mortality. Although its cause is not completely understood, sarcopenia generally results from a complex bone-muscle interaction in the setting of chronic disease and aging. Sarcopenia cannot be diagnosed by muscle mass alone. Diagnosis requires 2 of the following 3 criteria: low skeletal muscle mass, inadequate muscle strength, and inadequate physical performance. Forty-four percent of elderly patients undergoing orthopedic surgery and 24% of all patients 65 to 70 years old are sarcopenic. Although dual-energy x-ray absorptiometry and bioelectrical impedance analysis may be used to measure sarcopenia and are relatively inexpensive and accessible, they are generally considered less specific for sarcopenia compared with computed tomography and magnetic resonance imaging. Sarcopenia has been shown to predict poor outcomes within the medical and surgical populations and has been directly correlated with increases in taxpayer costs. Strengthening therapy and nutritional supplementation have become the mainstays of sarcopenia treatment. Specifically, the American Medical Directors Association has released guidelines for nutritional supplementation. Although sarcopenia frequently occurs with osteoporosis, it is an independent predictor of fragility fractures. Initiatives to diagnose, treat, and prevent sarcopenia in orthopedic patients are needed. Further investigation must also explore sarcopenia as a predictor of surgical outcomes in orthopedic patients. PMID:26913764

  11. Tissue bioengineering in orthopedics.

    PubMed

    Hernigou, Philippe; Homma, Yasuhiro

    2012-01-01

    The use of cells for the purpose of orthopedic tissue engineering started more than 300 years ago. The first attempt of bone grafting was reported in 1668 by the Dutch surgeon Job-Van Meek'ren. In 1867, Ollier performed a series of experiments using transplanted periosteum and concluded that transplanted periosteum and bone remained alive and formed new bone. The osteogenic potential of transplanted bone marrow was later documented by Goujon in 1869, then by Macewen in 1881. Efforts of Albee and Phemister highlighted further the utility of bone transplantation for the healing of fractures and bone defects. The techniques for autografting pioneered by these individuals remained largely unchanged until today. Advances in understanding of the biology of osteogenic cells, the availability of many highly purified peptide growth factors, and the capacity to create highly specialized implantable materials have launched an explosion of new advances in bone grafting and bone regeneration, all under the banner of tissue engineering. This new field is rapidly expanding the armamentarium of orthopedic surgeons in every setting in which bone healing is required. Composites of cells and matrices are at the core of this revolution. PMID:22783330

  12. Orthopedic Injury in Pregnancy.

    PubMed

    Gross, Gilad A; George, James W

    2016-09-01

    There are many reasons why a woman's pregnancy can put her at risk for orthopedic pain and injury. Given the high percentage of pregnant patients experiencing some degree of musculoskeletal pain, it is surprising that this is not an area of wider study. This chapter takes an evidence based approach to help the reader understand the implications of the numerous anatomic and physiologic changes associated with the gravid state, and how they act to promote both discomfort and injury. One-third of pregnant women in America are obese, further increasing risk. Exercise in most pregnancies is recommended and regarded as safe and thus obstetric care providers need to understand risk, diagnostic techniques and treatments. PMID:27403586

  13. Orthopedic prosthesis fixation.

    PubMed

    Park, J B

    1992-01-01

    The fixation of orthopedic implants has been one of the most difficult and challenging problems. The fixation can be achieved via: (a) direct mechanical fixation using screws, pins, wires, etc.; (b) passive or interference mechanical fixation where the implants are allowed to move or merely positioned onto the tissue surfaces; (c) bone cement fixation which is actually a grouting material; (d) biological fixation by allowing tissues to grow into the interstices of pores or textured surfaces of implants; (e) direct chemical bonding between implant and tissues; or (f) any combination of the above techniques. This article is concerned with various fixation techniques including the potential use of electrical, pulsed electromagnetic field, chemical stimulation using calcium phosphates for the enhancement of tissue ingrowth, direct bonding with bone by glass-ceramics and resorbable particle impregnated bone cement to take advantages of both the immediate fixation offered by the bone cement and long term fixation due to tissue ingrowth. PMID:1449228

  14. Superelastic Orthopedic Implant Coatings

    NASA Astrophysics Data System (ADS)

    Fournier, Eric; Devaney, Robert; Palmer, Matthew; Kramer, Joshua; El Khaja, Ragheb; Fonte, Matthew

    2014-07-01

    The demand for hip and knee replacement surgery is substantial and growing. Unfortunately, most joint replacement surgeries will fail within 10-25 years, thereby requiring an arduous, painful, and expensive revision surgery. To address this issue, a novel orthopedic implant coating material ("eXalt") has been developed. eXalt is comprised of super elastic nitinol wire that is knit into a three-dimensional spacer fabric structure. eXalt expands in vivo to conform to the implantation site and is porous to allow for bone ingrowth. The safety and efficacy of eXalt were evaluated through structural analysis, mechanical testing, and a rabbit implantation model. The results demonstrate that eXalt meets or exceeds the performance of current coating technologies with reduced micromotion, improved osseointegration, and stronger implant fixation in vivo.

  15. Commonly missed orthopedic problems.

    PubMed

    Ballas, M T; Tytko, J; Mannarino, F

    1998-01-15

    When not diagnosed early and managed appropriately, common musculoskeletal injuries may result in long-term disabling conditions. Anterior cruciate ligament tears are some of the most common knee ligament injuries. Slipped capital femoral epiphysis may present with little or no hip pain, and subtle or absent physical and radiographic findings. Femoral neck stress fractures, if left untreated, may result in avascular necrosis, refractures and pseudoarthrosis. A delay in diagnosis of scaphoid fractures may cause early wrist arthrosis if nonunion results. Ulnar collateral ligament tears are a frequently overlooked injury in skiers. The diagnosis of Achilles tendon rupture is missed as often as 25 percent of the time. Posterior tibial tendon tears may result in fixed bony planus if diagnosis is delayed, necessitating hindfoot fusion rather than simple soft tissue repair. Family physicians should be familiar with the initial assessment of these conditions and, when appropriate, refer patients promptly to an orthopedic surgeon. PMID:9456991

  16. Roentgen Stereophotogrammetry In Orthopedics

    NASA Astrophysics Data System (ADS)

    Selvik, Goran

    1983-07-01

    A system for roentgen stereophotogrammetry has been used in Lund, Sweden, since August 1972 and by August 1982 ten thousand stereo films have been evaluated using this method. Patient investigations started March 1973 and of the more than 500 patients investigated 300 have been referred by orthopedic surgeons. The skeletal parts investigated had been permanently marked with tantalum balls 0.5 or 0.8 mm in diameter. The causes for the investigation have been bone growth disorders in the Lower extremity (134 patients), spinal fusions (35 patients), high tibial osteotomies for gonarthrosis (21 patients) and endoprosthetic replacement of the knee (68 patients) or hip (42 patients) joint. By the roentgen stereophotogrammetric analysis (RSA), information on for instance the development of angular deformities and staple loosening in the leg, the healing process of the intended fusion in the spine or at the knee, and on the migration and stability of prosthetic components have been obtained. RSA is of value both for prognostic and followup purposes, and is versatile enough in proper setting to be used as a routine clinical investigation.

  17. Plasma Biomedicine in Orthopedics

    NASA Astrophysics Data System (ADS)

    Hamaguchi, Satsohi

    2012-10-01

    Various effects of plasmas irradiation on cells, tissues, and biomaterials relevant for orthopedic applications have been examined. For direct application of plasmas to living cells or tissues, dielectric barrier discharges (DBDs) with helium flows into ambient air were used. For biomaterial processing, on the other hand, either helium DBDs mentioned above or low-pressure discharges generated in a chamber were used. In this presentation, plasma effects on cell proliferation and plasma treatment for artificial bones will be discussed. First, the conditions for enhanced cell proliferation in vitro by plasma applications have been examined. The discharge conditions for cell proliferation depend sensitively on cell types. Since cell proliferation can be enhanced even when the cells are cultured in a plasma pre-treated medium, long-life reactive species generated in the medium by plasma application or large molecules (such as proteins) in the medium modified by the plasma are likely to be the cause of cell proliferation. It has been found that there is strong correlation between (organic) hydroperoxide generation and cell proliferation. Second, effects of plasma-treated artificial bones made of porous hydroxyapatite (HA) have been examined in vitro and vivo. It has been found that plasma treatment increases hydrophilicity of the surfaces of microscopic inner pores, which directly or indirectly promotes differentiation of mesenchymal stem cells introduced into the pores and therefore causes faster bone growth. The work has been performed in collaboration with Prof. H. Yoshikawa and his group members at the School of Medicine, Osaka University.

  18. Moral Dilemmas in Pediatric Orthopedics.

    PubMed

    Mercuri, John J; Vigdorchik, Jonathan M; Otsuka, Norman Y

    2015-12-01

    All orthopedic surgeons face moral dilemmas on a regular basis; however, little has been written about the moral dilemmas that are encountered when providing orthopedic care to pediatric patients and their families. This article aims to provide surgeons with a better understanding of how bioethics and professionalism apply to the care of their pediatric patients. First, several foundational concepts of both bioethics and professionalism are summarized, and definitions are offered for 16 important terms within the disciplines. Next, some of the unique aspects of pediatric orthopedics as a subspecialty are reviewed before engaging in a discussion of 5 common moral dilemmas within the field. Those dilemmas include the following: (1) obtaining informed consent and assent for either surgery or research from pediatric patients and their families; (2) performing cosmetic surgery on pediatric patients; (3) caring for pediatric patients with cognitive or physical impairments; (4) caring for injured pediatric athletes; and (5) meeting the demand for pediatric orthopedic care in the United States. Pertinent considerations are reviewed for each of these 5 moral dilemmas, thereby better preparing surgeons for principled moral decision making in their own practices. Each of these dilemmas is inherently complex with few straightforward answers; however, orthopedic surgeons have an obligation to take the lead and better define these kinds of difficult issues within their field. The lives of pediatric patients and their families will be immeasurably improved as a result. PMID:26652336

  19. Medical photography: principles for orthopedics

    PubMed Central

    2014-01-01

    Background Medical photography is used clinically for patient evaluation, treatment decisions, and scientific documentation. Although standards for medical photography exist in many branches of medicine, we have not encountered such criteria in publications in the area of orthopedics. Purpose This study aims to (1) assess the quality of medical images used in an orthopedic publication and (2) to propose standards for medical photography in this area. Methods Clinical photographs were reviewed from all issues of a journal published between the years 2008 and 2012. A quality of clinical images was developed based on the criteria published for the specialties of dermatology and cosmetic surgery. All images were reviewed on the appropriateness of background, patient preparation, and technique. Results In this study, only 44.9% of clinical images in an orthopedic publication adhered to the proposed conventions. Conclusions Standards have not been established for medical photography in orthopedics as in other specialty areas. Our results suggest that photographic clinical information in orthopedic publications may be limited by inadequate presentation. We propose that formal conventions for clinical images should be established. PMID:24708703

  20. [The beginnings of orthopedic surgery in Israel].

    PubMed

    Tauber, Chanan

    2013-08-01

    In early mandatory Israel, orthopedics was mainly conservative, The first modern orthopedic surgeon was Ernst Spira from Czechoslovakia who established an orthopedic service at the Beilinson Hospital in Petah Tikva and left in 1948 to establish the Orthopedic Department and the Rehabilitation Center in Tel Hashomer, which treated the War of Independence casualties including amputees and victims of spinal cord injuries. A second orthopedic department was opened in Tel Hashomer by Shmuel Weissman who left in 1961 to open the Orthopedic Department at the Ichilov hospital in Tel Aviv. Shmuel Weissman became the first Chairman of Orthopedic Surgery at the Tel Aviv University medical school. In 1955, Myer Makin opened a modern orthopedic department in the Hadassah Hospital in Jerusalem and the Alyn Hospital for crippled children. In 1951, Assaf Harofeh Hospital opened the Department of Orthopedic Surgery headed by Anatol Axer who specialized in the treatment and rehabilitation of polio patients. The majority of the second generation of orthopedic department directors was trained by these four surgeons. Major developments in the 1960s and 1970s were the introduction of the AO system revolutionizing fracture treatment from conservative to operative treatment, the advent of total hip and knee replacements, Harrington instrumentation in spinal surgery and arthroscopy were major advances in orthopedic patient care brought to Israel by the aforementioned second generation of orthopedic surgeons. Hand surgery became an independent subspecialty of orthopedics and was lead by the internationally renowned hand surgeon, Isidore Kessler. PMID:24167938

  1. Growth factors in orthopedic surgery

    PubMed Central

    Zaharia, C; Despa, N; Simionescu, M; Jinga, V; Fleseriu, I

    2010-01-01

    Growth factors have represented an essential issue of interest for the researchers and clinicians in orthopedics and trauma over the last 40 years. In the last 10 to 15 years, the advances registered in this field have permitted the identification of the most active cellular and humoral factors as well as the improvement of their use in the orthopedic and trauma surgery. Their domain of application has been continuously enlarged and the results have been visible from the beginning. The authors present their appreciation on the actual state of this subject as well as their experience with results and related conclusions. PMID:20302195

  2. A robot-assisted orthopedic telesurgery system.

    PubMed

    Kong, M; Du, Z; Sun, L; Fu, L; Jia, Z; Wu, D

    2005-01-01

    A robot-assisted orthopedic telesurgery system, named HIT-RAOTS, has been developed according to Chinese conventional operation method. Its main function includes obtaining images with information of position and orientation of fracture, providing fracture information for doctors, assisting the doctors to complete the reposition of fracture and locking operation of intramedullary nail. In this system, a 6-dof force-reflecting master device, with a pantographic parallelogram mechanisms driven by harmonic DC servomotors, is used to control the slave manipulator movement and to translate the force from the operating room to the surgeon console; A slave robot system integrated a 6-dof force sensor, with a parallel manipulator actuated by six AC servomotors, is applied for the accurate repositioning; A virtual simulation system and human-machine interface are also developed. PI controller based on local network is used to realize the teleoperation. Only little irradiation is issued during the reposition. It can assist surgeons to perform bone-setting more safely by reducing irradiation damage to both surgeries and patients, more easily by releasing the surgeons from the heavy operation and more perfect by improving accuracy of reposition. PMID:17282120

  3. Orthopedic Management of Spina Bifida

    ERIC Educational Resources Information Center

    Thomson, Jeffrey D.; Segal, Lee S.

    2010-01-01

    The management of orthopedic problems in spina bifida has seen a dramatic change over the past 10 years. The negative effects of spasticity, poor balance, and the tethered cord syndrome on ambulatory function are better appreciated. There is less emphasis on the hip radiograph and more emphasis on the function of the knee and the prevention of…

  4. Porous metal for orthopedics implants

    PubMed Central

    Matassi, Fabrizio; Botti, Alessandra; Sirleo, Luigi; Carulli, Christian; Innocenti, Massimo

    2013-01-01

    Summary Porous metal has been introduced to obtain biological fixation and improve longevity of orthopedic implants. The new generation of porous metal has intriguing characteristics that allows bone healing and high osteointegration of the metallic implants. This article gives an overview about biomaterials properties of the contemporary class of highly porous metals and about the clinical use in orthopaedic surgery. PMID:24133527

  5. FLUOROSCOPY DURATION IN ORTHOPEDIC SURGERY

    PubMed Central

    Salvia, Joao Caron La; de Moraes, Pablo Reis; Ammar, Tiago Yossef; Schwartsmann, Carlos Roberto

    2015-01-01

    Objective: To ascertain the mean length of radiation emission from fluoroscopic devices during several types of orthopedic surgery and which of these required greater use of radiation. Methods: The times taken to perform sixteen different types of surgery (total of 80 procedures) were measured. At the end of each procedure, the length of time for which fluoroscopy was used directly from the image intensifier was ascertained. Results: The mean time required for fluoroscopy per operation was 61 seconds. The procedures that demanded greatest mean duration of radiation use were bilateral proximal femoral epiphysiodesis (5.1 minutes) and femoral shaft osteosynthesis using a locked intramedullary nail (3.33 min). Conclusion: The mean duration of fluoroscopy use in orthopedic operations was 61 seconds. The procedures using an intramedullary device were the ones that required greatest radiation emission. PMID:27027000

  6. Vascular Injury in Orthopedic Trauma.

    PubMed

    Mavrogenis, Andreas F; Panagopoulos, George N; Kokkalis, Zinon T; Koulouvaris, Panayiotis; Megaloikonomos, Panayiotis D; Igoumenou, Vasilios; Mantas, George; Moulakakis, Konstantinos G; Sfyroeras, George S; Lazaris, Andreas; Soucacos, Panayotis N

    2016-07-01

    Vascular injury in orthopedic trauma is challenging. The risk to life and limb can be high, and clinical signs initially can be subtle. Recognition and management should be a critical skill for every orthopedic surgeon. There are 5 types of vascular injury: intimal injury (flaps, disruptions, or subintimal/intramural hematomas), complete wall defects with pseudoaneurysms or hemorrhage, complete transections with hemorrhage or occlusion, arteriovenous fistulas, and spasm. Intimal defects and subintimal hematomas with possible secondary occlusion are most commonly associated with blunt trauma, whereas wall defects, complete transections, and arteriovenous fistulas usually occur with penetrating trauma. Spasm can occur after either blunt or penetrating trauma to an extremity and is more common in young patients. Clinical presentation of vascular injury may not be straightforward. Physical examination can be misleading or initially unimpressive; a normal pulse examination may be present in 5% to 15% of patients with vascular injury. Detection and treatment of vascular injuries should take place within the context of the overall resuscitation of the patient according to the established principles of the Advanced Trauma Life Support (ATLS) protocols. Advances in the field, made mostly during times of war, have made limb salvage the rule rather than the exception. Teamwork, familiarity with the often subtle signs of vascular injuries, a high index of suspicion, effective communication, appropriate use of imaging modalities, sound knowledge of relevant technique, and sequence of surgical repairs are among the essential factors that will lead to a successful outcome. This article provides a comprehensive literature review on a subject that generates significant controversy and confusion among clinicians involved in the care of trauma patients. [Orthopedics. 2016; 39(4):249-259.]. PMID:27322172

  7. Locking mechanism for orthopedic braces

    NASA Technical Reports Server (NTRS)

    Chao, J. I.; Epps, C. H., Jr.

    1981-01-01

    An orthopedic brace locking mechanism is described which under standing or walking conditions cannot be unlocked, however under sitting conditions the mechanism can be simply unlocked so as to permit bending of the patient's knee. Other features of the device include: (1) the mechanism is rendered operable, and inoperable, dependent upon the relative inclination of the brace with respect to the ground; (2) the mechanism is automatically locked under standing or walking conditions and is manually unlocked under sitting conditions; and (3) the mechanism is light in weight and is relatively small in size.

  8. Locking mechanism for orthopedic braces

    NASA Technical Reports Server (NTRS)

    I-Lechao, J.; Epps, C. H., Jr. (Inventor)

    1976-01-01

    A locking mechanism for orthopedic braces is described which automatically prevents or permits the relative pivotable movement between a lower brace member and an upper brace member. The upper and lower brace members are provided with drilled bores within which a slidable pin is disposed, and depending upon the inclination of the brace members with respect to a vertical plane, the slidable pin will be interposed between both brace members. The secondary or auxiliary latching device includes a spring biased, manually operable lever bar arrangement which is manually unlatched and automatically latched under the influence of the spring.

  9. Thromboembolic Disease After Orthopedic Trauma.

    PubMed

    Whiting, Paul S; Jahangir, A Alex

    2016-04-01

    Orthopedic trauma results in systemic physiologic changes that predispose patients to venous thromboembolism (VTE). In the absence of prophylaxis, VTE incidence may be as high as 60%. Mechanical and pharmacologic thromboprophylaxis are effective in decreasing rates of VTE. Combined mechanical and pharmacologic thromboprophylaxis is more efficacious for decreasing VTE incidence than either regimen independently. If pharmacologic thromboprophylaxis is contraindicated, mechanical prophylaxis should be used. Patients with isolated lower extremity fractures who are ambulatory, or those with isolated upper extremity trauma, do not require pharmacologic prophylaxis in the absence of other VTE risk factors. PMID:26772942

  10. Orthopedics

    SciTech Connect

    Stoker, D.J.; Tilley, E.A.

    1988-01-01

    This book presents a method of assessing a variety of entities with pathologic impact on the skeleton. The book covers 97 skeletal abnormalities or diseases. Each case is presented as a question (consisting of a radiography followed by a short clinical history and a query such as What is the abnormality '') followed by an answer (consisting of additional radiographs, an explanation of the radiographic abnormality and causative disease process, and one or two references).

  11. Orthopedic surgery in ancient Egypt

    PubMed Central

    Blomstedt, Patric

    2014-01-01

    Background — Ancient Egypt might be considered the cradle of medicine. The modern literature is, however, sometimes rather too enthusiastic regarding the procedures that are attributed an Egyptian origin. I briefly present and analyze the claims regarding orthopedic surgery in Egypt, what was actually done by the Egyptians, and what may have been incorrectly ascribed to them. Methods — I reviewed the original sources and also the modern literature regarding surgery in ancient Egypt, concentrating especially on orthopedic surgery. Results — As is well known, both literary sources and the archaeological/osteological material bear witness to treatment of various fractures. The Egyptian painting, often claimed to depict the reduction of a dislocated shoulder according to Kocher’s method, is, however, open to interpretation. Therapeutic amputations are never depicted or mentioned in the literary sources, while the specimens suggested to demonstrate such amputations are not convincing. Interpretation — The ancient Egyptians certainly treated fractures of various kinds, and with varying degrees of success. Concerning the reductions of dislocated joints and therapeutic amputations, there is no clear evidence for the existence of such procedures. It would, however, be surprising if dislocations were not treated, even though they have not left traces in the surviving sources. Concerning amputations, the general level of Egyptian surgery makes it unlikely that limb amputations were done, even if they may possibly have been performed under extraordinary circumstances. PMID:25140982

  12. Strategies for achieving orthopedic service line success.

    PubMed

    Lang, Stacey; Powers, Kristi

    2013-12-01

    Healthcare finance leaders can work with orthopedic surgeons to support better outcomes, clinically and financially, by: Establishing innovative partnerships among hospital leaders, orthopedic surgeons, and implant vendors. Developing and enforcing expectations around contracting and vendor behavior. Establishing a forum for open communication. Building a bundled payment structure. Finding ways to differentiate from the competition. PMID:24380256

  13. Using Aerospace Technology To Design Orthopedic Implants

    NASA Technical Reports Server (NTRS)

    Saravanos, D. A.; Mraz, P. J.; Davy, D. T.

    1996-01-01

    Technology originally developed to optimize designs of composite-material aerospace structural components used to develop method for optimizing designs of orthopedic implants. Development effort focused on designing knee implants, long-term goal to develop method for optimizing designs of orthopedic implants in general.

  14. Sawbones laboratory in orthopedic surgical training

    PubMed Central

    Hetaimish, Bandar M.

    2016-01-01

    Sawbones are artificial bones designed to simulate the bone architecture, as well as the bone’s physical properties. The incorporation of sawbones simulation laboratories in many orthopedic training programs has provided the residents with flexibility in learning and scheduling that align with their working hour limitations. This review paper deliberates the organization of sawbones simulation in orthopedic surgical training to enhance trainee’s future learning. In addition, it explores the implications of sawbones simulation in orthopedic surgical teaching and evaluation. It scrutinizes the suitability of practicing on sawbones at the simulation laboratory to improve orthopedic trainee’s learning. This will be followed with recommendations for future enhancement of sawbones simulation-based learning in orthopedic surgical training. PMID:27052276

  15. [Tranexamic acid in orthopedic surgery].

    PubMed

    Aguilera-Roig, X; Jordán-Sales, M; Natera-Cisneros, L; Monllau-García, J C; Martínez-Zapata, M J

    2014-01-01

    Perioperative bleeding may require blood transfusions, which are sometimes not without complications and risks, with the subsequent increase in health care costs. Among other prevention methods, treatment with tranexamic acid (ATX) has shown to be effective in reducing surgical blood loss, especially in the immediate postoperative period. In this regard, studies evaluating ATX in orthopedic surgery show that it is effective and safe when administered intravenously or intra-articularly. The usual evaluated intravenous doses range between 10mg/Kg and 20mg/kg or a fixed dose of 1g to 2g; while intra-articularly, it varies between 250 mg and 3g. ATX, as an anti-fibrinolytic has a potential thrombotic effect, thus it is contraindicated in those patients at risk or with a history of thrombosis. Its topical administration may be safer, but studies are needed to confirm this. PMID:24126146

  16. [Bone grafts in orthopedic surgery].

    PubMed

    Zárate-Kalfópulos, Barón; Reyes-Sánchez, Alejandro

    2006-01-01

    In orthopedic surgery the demand for the use of bone grafts increases daily because of the increasing quantity and complexity of surgical procedures. At present, the gold standard is the autologous bone graft but the failure rate, morbidity of the donor site and limited availability have stimulated a proliferation for finding materials that work as bone graft substitutes. In order to have good success, we must know the different properties of these choices and the environment where the graft is going to be used. As bone graft substitutes and growth factors become clinical realities, a new gold standard will be defined. Tissue engineering and gene therapy techniques have the objective to create an optimum bone graft substitute with a combination of substances with properties of osteconduction, osteogenesis and osteoinduction. PMID:16875525

  17. Physical modification of polyetheretherketone for orthopedic implants

    NASA Astrophysics Data System (ADS)

    Du, Ya-Wei; Zhang, Li-Nan; Hou, Zeng-Tao; Ye, Xin; Gu, Hong-Sheng; Yan, Guo-Ping; Shang, Peng

    2014-12-01

    Polyetheretherketone (PEEK) is regarded as one of the most potential candidates for replacing current implant applications. To obtain good bone-implant interfaces, many modification methods have been developed to enable PEEK and PEEK-based composites from bio-inert to bioactive. Among them, physical methods have aroused significant attention and been widely used to modify PEEK for orthopedic implants. This review summarizes current physical modification techniques of PEEK for orthopedic applications, which include composite strategies, surface coating methods and irradiation treatments. The positive consequences of those modification methods will encourage continuing investigations and stimulate the wide range of applications of PEEK-based implants in orthopedics.

  18. Orthopedic Prosthetic Infections: Plastic Surgery Management.

    PubMed

    Meaike, Jesse D; Kaufman, Matthew G; Izaddoost, Shayan A

    2016-05-01

    Orthopedic prosthetic infections are potentially devastating complications. Plastic surgeons are frequently consulted to aid in the management of the soft tissue defects that are created by these infections. A review of the existing literature was performed to identify established treatment methods for soft tissue coverage of orthopedic hardware infections for a variety of anatomic locations. The following treatment guidelines and soft tissue reconstructive options were identified as viable options for the management of exposed or infected orthopedic hardware. This review provides descriptions of the various soft tissue reconstructive options available as well as adjunctive treatment methods. PMID:27152099

  19. 21 CFR 888.4540 - Orthopedic manual surgical instrument.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Orthopedic manual surgical instrument. 888.4540... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4540 Orthopedic manual surgical instrument. (a) Identification. An orthopedic manual surgical instrument is a nonpowered hand-held...

  20. Antimicrobial technology in orthopedic and spinal implants.

    PubMed

    Eltorai, Adam Em; Haglin, Jack; Perera, Sudheesha; Brea, Bielinsky A; Ruttiman, Roy; Garcia, Dioscaris R; Born, Christopher T; Daniels, Alan H

    2016-06-18

    Infections can hinder orthopedic implant function and retention. Current implant-based antimicrobial strategies largely utilize coating-based approaches in order to reduce biofilm formation and bacterial adhesion. Several emerging antimicrobial technologies that integrate a multidisciplinary combination of drug delivery systems, material science, immunology, and polymer chemistry are in development and early clinical use. This review outlines orthopedic implant antimicrobial technology, its current applications and supporting evidence, and clinically promising future directions. PMID:27335811

  1. Antimicrobial technology in orthopedic and spinal implants

    PubMed Central

    Eltorai, Adam EM; Haglin, Jack; Perera, Sudheesha; Brea, Bielinsky A; Ruttiman, Roy; Garcia, Dioscaris R; Born, Christopher T; Daniels, Alan H

    2016-01-01

    Infections can hinder orthopedic implant function and retention. Current implant-based antimicrobial strategies largely utilize coating-based approaches in order to reduce biofilm formation and bacterial adhesion. Several emerging antimicrobial technologies that integrate a multidisciplinary combination of drug delivery systems, material science, immunology, and polymer chemistry are in development and early clinical use. This review outlines orthopedic implant antimicrobial technology, its current applications and supporting evidence, and clinically promising future directions. PMID:27335811

  2. Core Concepts: Orthopedic Intern Curriculum Boot Camp.

    PubMed

    Seeley, Mark A; Kazarian, Erick; King, Brandon; Biermann, Janet S; Carpenter, James E; Caird, Michelle S; Irwin, Todd A

    2016-01-01

    Orthopedic surgical interns must gain a broad array of clinical skills in a short time. However, recent changes in health care have limited resident-patient exposures. With the reported success of simulation training in the surgical literature, the American Board of Orthopaedic Surgery (ABOS) and Residency Review Committee for Orthopaedic Surgery have required that surgical simulation training be a component of the intern curricula in orthopedic surgical residencies. This study examined the short-term effectiveness of an orthopedic "intern boot camp" covering 7 of 17 simulation training concept modules published by the ABOS. Eight orthopedic post-graduate year 1 (PGY-1) residents (study group) completed a structured 3-month curriculum and were compared with 7 post-graduate year 2 (PGY-2) residents (comparison group) who had just completed their orthopedic surgical internship. Seven core skills were assessed using both task-specific and global rating scales. The PGY-1 residents demonstrated a statistically significant improvement in all 7 modules with respect to their task-specific pre-test scores: sterile technique (P=.001), wound closure (P<.001), knot tying (P=.017), casting and splinting (P<.001), arthrocentesis (P=.01), basics of internal fixation (P<.001), and compartment syndrome evaluation (P=.004). After the camp, PGY-1 and -2 scores in task-specific measures were not significantly different. A 3-month simulation-based boot camp instituted early in orthopedic internship elevated a variety of clinical skills to levels exhibited by PGY-2 residents. PMID:26730688

  3. Orthopedic issues in vascular anomalies.

    PubMed

    Spencer, Samantha A; Sorger, Joel

    2014-08-01

    Vascular malformations impact the musculoskeletal system depending on the tissue involved (skin, subcutis, muscle, cartilage, or bone), the extent of involvement, and the type of anomalous vessels (arteries, capillaries, veins, or lymphatics). These malformations can cause a multitude of musculoskeletal problems for the patient and their Orthopedic Surgeon to manage. Leg-length discrepancy, intra-articular involvement, muscular lesions, and primary or secondary scoliosis are just to name a few. All of these problems can cause pain, deformity, and a range of functional limitations. Surgical and nonsurgical treatment plans both have a role in the care of these patients. Patients with vascular malformations may also suffer from life-threatening cardiovascular and hematologic abnormalities. For those patients who undergo surgery, thromboembolic risk is elevated, wound breakdown and infection are much more common, and bleeding risk continues well into the postoperative course. Because of the complex nature of these disorders, the clinician must have a full understanding of the types of lesions, their natural history, appropriate diagnostic studies, associated medical problems, indications for treatment, and all the treatment options. For severe malformations, especially syndromes such as CLOVES and Klippel-Trenaunay syndrome, interdisciplinary team management is essential for the best outcomes. PMID:25241103

  4. Robot Manipulators

    NASA Technical Reports Server (NTRS)

    1988-01-01

    Space Shuttle's Remote Manipulator System (Canadarm) is a 50 foot robot arm used to deploy, retrieve or repair satellites in orbit. Initial spinoff version is designed to remove, inspect and replace large components of Ontario Hydro's CANDU nuclear reactors, which supply 50 percent of Ontario Hydro's total power reduction. CANDU robot is the first of SPAR's Remote Manipulator Systems intended for remote materials handling operations in nuclear servicing, chemical processing, smelting and manufacturing. Inco Limited used remote manipulator for remote control mining equipment to enhance safety and productivity of Inco's hardrock mining operations. System not only improves safety in a hazardous operation that costs more than a score of lives annually, it also increases productivity fourfold. Remote Manipulator System Division is also manufacturing a line of industrial robots and developing additional system for nuclear servicing, mining, defense and space operations.

  5. Nanosurfaces and nanostructures for artificial orthopedic implants.

    PubMed

    Streicher, Robert M; Schmidt, Martin; Fiorito, Silvana

    2007-12-01

    Nanomaterials and structures, such as nanoparticles, nanofibers, nanosurfaces, nanocoatings, nanoscaffolds and nanocomposites, are considered for various applications in orthopedics and traumatology. This review looks at proposed nanotechnology inspired applications for implants from the perspective of the orthopedic industry. Investigations support consistently the theory that most nanomaterials in various physical forms are able to enhance the cell response selectively for biological tissue integration or increase the strength and wear resistance of current orthopedic materials. At this stage, most of the studies are at the laboratory scale or in early in vivo testing. Significant basic and applied research and development is needed to realize their full clinical potential and biological, manufacturing, economic and regulatory issues have to be addressed. Nevertheless, a crucial factor for success is well-coordinated multimethod and multidiscipline teamwork with profound industrial and medical expertise. PMID:18095851

  6. ORTHOPEDIC SURGERY AMONG THE ELDERLY: CLINICAL CHARACTERISTICS

    PubMed Central

    Leme, Luiz Eugênio Garcez; Sitta, Maria do Carmo; Toledo, Manuella; da Silva Henriques, Simone

    2015-01-01

    Care for elderly patients undergoing orthopedic surgery, particularly for those requiring emergency surgery, needs to take into account an analysis of physical capacity and risks specific to elderly individuals, in an attempt to reduce the risks. Nevertheless, these remain high in this group. Despite the risks, procedures developed promptly have a positive effect on these patients’ evolution. Coordinated care, composed of teams of specialists within clinical medicine, geriatrics, orthopedics, anesthesiology and critical care, along with other healthcare professionals, may be highly beneficial for this group of patients. PMID:27027017

  7. Concepts of orthopedic disorders in Avicenna's Canon of Medicine.

    PubMed

    Afshar, Ahmadreza

    2011-03-01

    This manuscript offers a brief review of the orthopedic subjects in the Canon of Medicine. Highlights include, but are not limited to, the anatomy of the musculoskeletal system, fractures and dislocations, nerve and tendon injuries, different types of wounds and ulcers, and bone infections. Some of the concepts regarding musculoskeletal disorders remain relevant to current orthopedic knowledge. Reviewing the orthopedic subjects in the Canon of Medicine reveals that Avicenna has made a significant contribution to the evolution of orthopedic knowledge. PMID:21361728

  8. Billing and coding knowledge: a comparative survey of professional coders, practicing orthopedic surgeons, and orthopedic residents.

    PubMed

    Wiley, Kevin F; Yousuf, Tariq; Pasque, Charles B; Yousuf, Khalid

    2014-06-01

    Medical knowledge and surgical skills are necessary to become an effective orthopedic surgeon. To run an efficient practice, the surgeon must also possess a basic understanding of medical business practices, including billing and coding. In this study, we surveyed and compared the level of billing and coding knowledge among current orthopedic residents PGY3 and higher, academic and private practice attending orthopedic surgeons, and orthopedic coding professionals. According to the survey results, residents and fellows have a similar knowledge of coding and billing, regardless of their level of training or type of business education received in residency. Most residents would like formal training in coding, billing, and practice management didactics; this is consistent with data from previous studies. PMID:24945481

  9. Molecular imaging promotes progress in orthopedic research.

    PubMed

    Mayer-Kuckuk, Philipp; Boskey, Adele L

    2006-11-01

    Modern orthopedic research is directed towards the understanding of molecular mechanisms that determine development, maintenance and health of musculoskeletal tissues. In recent years, many genetic and proteomic discoveries have been made which necessitate investigation under physiological conditions in intact, living tissues. Molecular imaging can meet this demand and is, in fact, the only strategy currently available for noninvasive, quantitative, real-time biology studies in living subjects. In this review, techniques of molecular imaging are summarized, and applications to bone and joint biology are presented. The imaging modality most frequently used in the past was optical imaging, particularly bioluminescence and near-infrared fluorescence imaging. Alternate technologies including nuclear and magnetic resonance imaging were also employed. Orthopedic researchers have applied molecular imaging to murine models including transgenic mice to monitor gene expression, protein degradation, cell migration and cell death. Within the bone compartment, osteoblasts and their stem cells have been investigated, and the organic and mineral bone phases have been assessed. These studies addressed malignancy and injury as well as repair, including fracture healing and cell/gene therapy for skeletal defects. In the joints, molecular imaging has focused on the inflammatory and tissue destructive processes that cause arthritis. As described in this review, the feasibility of applying molecular imaging to numerous areas of orthopedic research has been demonstrated and will likely result in an increase in research dedicated to this powerful strategy. Molecular imaging holds great promise in the future for preclinical orthopedic research as well as next-generation clinical musculoskeletal diagnostics. PMID:16843078

  10. Imaging of orthopedic trauma and surgery

    SciTech Connect

    Berquist, T.H.

    1986-01-01

    This book discusses imaging of orthopedia trauma and surgery. A review of the pertinent anatomy, mechanism of injury, and radiology and orthopedic classification is provided for each topic discussed. The book employs recent advances in technique and focuses on adult skeletal trauma, and joint replacement.

  11. Acne mechanica due to an orthopedic crutch.

    PubMed

    Kang, Y C; Choi, E H; Hwang, S M; Lee, W S; Lee, S H; Ahn, S K

    1999-08-01

    Acne mechanica describes local irritation due to the skin being pressured, occluded, rubbed, squeezed, stretched, or heated. Examples of various physical traumas that provoke lesions in acne patients are given. Users of orthopedic crutches are at particular risk for such conditions. A crutch is another extrinsic factor to be added to the list of causes of acne mechanica. PMID:10467500

  12. Orthopedically Handicapped Children in Ohio Public Schools.

    ERIC Educational Resources Information Center

    Naples, Victor J.; Todd, Joseph H.

    The historical development of programs for orthopedically handicapped children, class units and hospital classes approved during 1967-68, and the number of therapy units established are presented. Tables give data on program population: enrollment for years 1962-68, percent of handicaps enrolled, and IQ distributions. Aspects of occupational…

  13. Underwater manipulator

    SciTech Connect

    Schrum, P.B.; Cohen, G.H.

    1993-04-20

    Self-contained, waterproof, water-submersible, remote-controlled apparatus is described for manipulating a device, such as an ultrasonic transducer for measuring crack propagation on an underwater specimen undergoing shock testing. The subject manipulator includes metal bellows for transmittal of angular motions without the use of rotating shaft seals or O-rings. Inside the manipulator, a first stepper motor controls angular movement. In the preferred embodiment, the bellows permit the first stepper motor to move an ultrasonic transducer [plus minus]45 degrees in a first plane and a second bellows permit a second stepper motor to move the transducer [plus minus]10 degrees in a second plane orthogonal to the first. In addition, an XY motor-driven table provides XY motion.

  14. Underwater manipulator

    SciTech Connect

    Schrum, P.B.; Cohen, G.H.

    1992-12-31

    This invention is comprised of a self-contained, waterproof, water-submersible, remote-controlled apparatus provided for manipulating a device, such as an ultrasonic transducer for measuring crack propagation on an underwater specimen undergoing shock testing. The subject manipulator includes metal bellows for transmittal of angular motions without the use of rotating shaft seals or O-rings. Inside the manipulator, a first stepper motor controls angular movement. In the preferred embodiment, the bellows permit the first stepper motor to move an ultrasonic transducer {plus_minus} 45 degrees in a first plane and a second bellows permit a second stepper motor to move the transducer {plus_minus} 10 degrees in a second plane orthogonal to the first. In addition, an XY motor-driven table provides XY motion.

  15. Underwater manipulator

    DOEpatents

    Schrum, Phillip B.; Cohen, George H.

    1993-01-01

    Self-contained, waterproof, water-submersible, remote-controlled apparatus is provided for manipulating a device, such as an ultrasonic transducer for measuring crack propagation on an underwater specimen undergoing shock testing. The subject manipulator includes metal bellows for transmittal of angular motions without the use of rotating shaft seals or O-rings. Inside the manipulator, a first stepper motor controls angular movement. In the preferred embodiment, the bellows permit the first stepper motor to move an ultrasonic transducer .+-.45 degrees in a first plane and a second bellows permit a second stepper motor to move the transducer .+-.10 degrees in a second plane orthogonal to the first. In addition, an XY motor-driven table provides XY motion.

  16. Characteristics of highly successful orthopedic surgeons: a survey of orthopedic chairs and editors

    PubMed Central

    Klein, Guy; Hussain, Nasir; Sprague, Sheila; Mehlman, Charles T.; Dogbey, Godwin; Bhandari, Mohit

    2013-01-01

    Background Highly successful orthopedic surgeons are a small group of individuals who exert a large influence on the orthopedic field. However, the characteristics of these leaders have not been well-described or studied. Methods Orthopedic surgeons who are departmental chairs, journal editors, editorial board members of the Journal of Bone and Joint Surgery (British edition), or current or past presidents of major orthopedic associations were invited to complete a survey designed to provide insight into their motivations, academic backgrounds and accomplishments, emotional and physical health, and job satisfaction. Results In all, 152 surgeons completed the questionnaire. We identified several characteristics of highly successful surgeons. Many have contributed prolific numbers of publications and book chapters and obtained considerable funding for research. They were often motivated by a “desire for personal development (interesting challenge, new opportunities),” whereas “relocating to a new institution, financial gain, or lack of alternative candidates” played little to no role in their decisions to take positions of leadership. Most respondents were happy with their specialty choice despite long hours and high levels of stress. Despite challenges to their time, successful orthopedic surgeons made a strong effort to maintain their health; compared with other physicians, they exercise more, are more likely to have a primary care physician and feel better physically. Conclusion Departmental chairs, journal editors and presidents of orthopedic associations cope with considerable demands of clinical, administrative, educational and research duties while maintaining a high level of health, happiness and job satisfaction. PMID:23706848

  17. Between psychology and pedagogy: "moral orthopedics" and case studies of children in fin-de-siècle French medicine.

    PubMed

    Rose, Anna Christina

    2011-02-01

    In the latter decades of the 19th century, European physicians debated a controversial practice that mixed placebos with suggestion therapy to treat children diagnosed with neurotic disorders and behavioral problems. Designed to optimize suggestibility in juvenile patients, this "moral orthopedics" offered parents and therapists the message that children could be saved from becoming victims of their own personalities, of familial neuroses, or even of public health problems. Case studies, published in medical journals and books, circulated accounts of innovative strategies to treat childhood hysteria and to change habits that were considered destructive. Moral orthopedics actualized the insight that suggestibility could be therapeutically productive for juvenile subjects. However, because its adherents sought to manipulate patients' behavior and health by influencing unconscious thought, moral orthopedics provoked questions of expertise and disciplinary propriety among domains of medicine, law, and philosophy. This article reconstructs the controversy surrounding moral orthopedics by examining case studies. I argue that adherents of moral orthopedics did overcome philosophical objections raised against the method, and that they did so through what physician Edgar B6rillon referred to as "education of the will." PMID:21688751

  18. Remote Manipulator

    NASA Technical Reports Server (NTRS)

    1986-01-01

    SPAR Aerospace Limited's "Canadarm," Canada's contribution to the space shuttle. It is a crane which can operate as a 50 foot extension of an astronaut's arm. It can lift 65,000 pounds in space and retrieve satellites for repair, etc. Redesigned versions have energy and mining applications. Some of its hardware has been redeveloped for use as a Hydro manipulator in a nuclear reactor where it is expected to be extremely cost effective.

  19. Redefining the Economics of Geriatric Orthopedics

    PubMed Central

    Nacca, Christopher; Paller, David; Daniels, Alan H

    2014-01-01

    Introduction: The heath care system in the United States is in the midst of a transition, in large part to help accommodate an older and more medically complex population. Central to the current evolution is the reassessment of value based on the cost utility of a particular procedure compared to alternatives. The existing contribution of geriatric orthopedics to the societal burden of disease is substantial, and literature focusing on the economic value of treating elderly populations with musculoskeletal injuries is growing. Materials and Methods: A literature review of peer-reviewed publications and abstracts related to the cost-effectiveness of treating geriatric patients with orthopedic injuries was carried out. Results: In our review, we demonstrate that while cost-utility studies generally demonstrate net society savings for most orthopedic procedures, geriatric populations often contribute to negative net society savings due to decreased working years and lower salaries while in the workforce. However, the incremental cost-effective ratio for operative intervention has been shown to be below the financial willingness to treat threshold for common procedures including joint replacement surgery of the knee (ICER US$8551), hip (ICER US$17 115), and shoulder (CE US$957) as well as for spinal procedures and repair of torn rotator cuffs (ICER US$12 024). We also discuss the current trends directed toward improving institutional value and highlight important complementary next steps to help overcome the growing demands of an older, more active society. Conclusion: The geriatric population places a significant burden on the health care system. However, studies have shown that treating this demographic for orthopedic-related injuries is cost effective and profitable for providers under certain scenarios. PMID:26246943

  20. The orthopedic management of Rett syndrome.

    PubMed

    Hennessy, M J; Haas, R H

    1988-01-01

    Musculoskeletal deformity sufficiently severe to require orthopedic surgery is a significant problem in Rett syndrome. Preliminary results from the study of 16 patients suggest deformity in nearly all patients. Eight patients in stage III and seven patients in stage IV showed clinical evidence of scoliosis. Radiographic studies confirmed a structural curve in nine of ten patients studied. Heel cord tightening was seen in nine of 16 patients. Hip instability was identified as an area of potential concern in the Rett patient. PMID:3198902

  1. Proximal spinal muscular atrophy: current orthopedic perspective

    PubMed Central

    Haaker, Gerrit; Fujak, Albert

    2013-01-01

    Spinal muscular atrophy (SMA) is a hereditary neuromuscular disease of lower motor neurons that is caused by a defective “survival motor neuron” (SMN) protein that is mainly associated with proximal progressive muscle weakness and atrophy. Although SMA involves a wide range of disease severity and a high mortality and morbidity rate, recent advances in multidisciplinary supportive care have enhanced quality of life and life expectancy. Active research for possible treatment options has become possible since the disease-causing gene defect was identified in 1995. Nevertheless, a causal therapy is not available at present, and therapeutic management of SMA remains challenging; the prolonged survival is increasing, especially orthopedic, respiratory and nutritive problems. This review focuses on orthopedic management of the disease, with discussion of key aspects that include scoliosis, muscular contractures, hip joint disorders, fractures, technical devices, and a comparative approach of conservative and surgical treatment. Also emphasized are associated complications including respiratory involvement, perioperative care and anesthesia, nutrition problems, and rehabilitation. The SMA disease course can be greatly improved with adequate therapy with established orthopedic procedures in a multidisciplinary therapeutic approach. PMID:24399883

  2. Prevention of VTE in Orthopedic Surgery Patients

    PubMed Central

    Francis, Charles W.; Johanson, Norman A.; Curley, Catherine; Dahl, Ola E.; Schulman, Sam; Ortel, Thomas L.; Pauker, Stephen G.; Colwell, Clifford W.

    2012-01-01

    Background: VTE is a serious, but decreasing complication following major orthopedic surgery. This guideline focuses on optimal prophylaxis to reduce postoperative pulmonary embolism and DVT. Methods: The methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement. Results: In patients undergoing major orthopedic surgery, we recommend the use of one of the following rather than no antithrombotic prophylaxis: low-molecular-weight heparin; fondaparinux; dabigatran, apixaban, rivaroxaban (total hip arthroplasty or total knee arthroplasty but not hip fracture surgery); low-dose unfractionated heparin; adjusted-dose vitamin K antagonist; aspirin (all Grade 1B); or an intermittent pneumatic compression device (IPCD) (Grade 1C) for a minimum of 10 to 14 days. We suggest the use of low-molecular-weight heparin in preference to the other agents we have recommended as alternatives (Grade 2C/2B), and in patients receiving pharmacologic prophylaxis, we suggest adding an IPCD during the hospital stay (Grade 2C). We suggest extending thromboprophylaxis for up to 35 days (Grade 2B). In patients at increased bleeding risk, we suggest an IPCD or no prophylaxis (Grade 2C). In patients who decline injections, we recommend using apixaban or dabigatran (all Grade 1B). We suggest against using inferior vena cava filter placement for primary prevention in patients with contraindications to both pharmacologic and mechanical thromboprophylaxis (Grade 2C). We recommend against Doppler (or duplex) ultrasonography screening before hospital discharge (Grade 1B). For patients with isolated lower-extremity injuries requiring leg immobilization, we suggest no thromboprophylaxis (Grade 2B). For patients undergoing knee arthroscopy without a history

  3. Orthopedic Resident Anatomy Review Course: A Collaboration between Anatomists and Orthopedic Surgeons

    ERIC Educational Resources Information Center

    DeFriez, Curtis B.; Morton, David A.; Horwitz, Daniel S.; Eckel, Christine M.; Foreman, K. Bo; Albertine, Kurt H.

    2011-01-01

    A challenge for new residents and senior residents preparing for board examinations is refreshing their knowledge of basic science disciplines, such as human gross anatomy. The Department of Orthopaedics at the University of Utah School of Medicine has for many years held an annual Orthopedic Resident Anatomy Review Course during the summer months…

  4. Three-Dimensional Printing in Orthopedic Surgery.

    PubMed

    Eltorai, Adam E M; Nguyen, Eric; Daniels, Alan H

    2015-11-01

    Three-dimensional (3D) printing is emerging as a clinically promising technology for rapid prototyping of surgically implantable products. With this commercially available technology, computed tomography or magnetic resonance images can be used to create graspable objects from 3D reconstructed images. Models can enhance patients' understanding of their pathology and surgeon preoperative planning. Customized implants and casts can be made to match an individual's anatomy. This review outlines 3D printing, its current applications in orthopedics, and promising future directions. PMID:26558661

  5. Imaging of orthopedic trauma and surgery

    SciTech Connect

    Berquist, T.H.

    1985-01-01

    This book presents papers on imaging techniques for diagnosis of trauma of bones. A comparative evaluation is presented for planning of proper diagnosis and treatment. Various techniques discussed are routine radiography; computerized tomography, NMR imaging, angiography, ultrasonography; and use of radioisotopes. The mechanism of injury of bone joints of upper and lower limbs and spine is discussed after discussing the anatomy of each in the beginning of each paper. Topics titled are healing of fractures; fractures of pelvis; knee; shoulder; foot and ankle; fractures of humerus; stress fractures; and orthopedic radiology. Prosthesis use and plastic surgery of joints is also discussed.

  6. Hunting stand-related injuries in orthopedics.

    PubMed

    Lebus, George F; Krueger, Chad A; Stinner, Daniel J; Mir, Hassan R

    2014-09-01

    Hunting remains an extremely popular recreational activity, with nearly 15 million Americans receiving a hunting license annually. Precautions have helped decrease accidents, but hunting-related injuries remain relatively common. The majority of severe, hunting-related accidents involve either a fall from a hunting platform or an accidental shooting. Both of these mechanisms frequently result in orthopedic injuries, many of which require operative care. Although firearms-associated injury has seemingly decreased, hunting platform falls and their sequelae are increasing. Understanding the mechanisms of these injuries and increasing awareness of them may minimize their morbidity and mortality or help prevent them altogether. PMID:25188622

  7. Legal issues affecting ancillaries and orthopedic practice.

    PubMed

    Glaser, David M

    2008-01-01

    The federal and state governments have imposed significant regulations on health care generally and on ancillary services in particular. This article focuses on how state and federal laws shape the ability of an orthopedic physician to offer ancillary services, whether as an individual, through a group practice, or as part of a joint venture. It focuses on how the Stark law, the Medicare anti-kickback statute, state anti-kickback, fee-splitting provisions, certificate of need laws, and various Medicare billing and supervision requirements impact the provision of ancillary services. It also briefly discusses how physicians should prepare for and respond to government investigations. PMID:18061773

  8. Computer assisted 3D pre-operative planning tool for femur fracture orthopedic surgery

    NASA Astrophysics Data System (ADS)

    Gamage, Pavan; Xie, Sheng Quan; Delmas, Patrice; Xu, Wei Liang

    2010-02-01

    Femur shaft fractures are caused by high impact injuries and can affect gait functionality if not treated correctly. Until recently, the pre-operative planning for femur fractures has relied on two-dimensional (2D) radiographs, light boxes, tracing paper, and transparent bone templates. The recent availability of digital radiographic equipment has to some extent improved the workflow for preoperative planning. Nevertheless, imaging is still in 2D X-rays and planning/simulation tools to support fragment manipulation and implant selection are still not available. Direct three-dimensional (3D) imaging modalities such as Computed Tomography (CT) are also still restricted to a minority of complex orthopedic procedures. This paper proposes a software tool which allows orthopedic surgeons to visualize, diagnose, plan and simulate femur shaft fracture reduction procedures in 3D. The tool utilizes frontal and lateral 2D radiographs to model the fracture surface, separate a generic bone into the two fractured fragments, identify the pose of each fragment, and automatically customize the shape of the bone. The use of 3D imaging allows full spatial inspection of the fracture providing different views through the manipulation of the interactively reconstructed 3D model, and ultimately better pre-operative planning.

  9. RAPID MANUFACTURING SYSTEM OF ORTHOPEDIC IMPLANTS

    PubMed Central

    Relvas, Carlos; Reis, Joana; Potes, José Alberto Caeiro; Fonseca, Fernando Manuel Ferreira; Simões, José Antonio Oliveira

    2015-01-01

    This study, aimed the development of a methodology for rapid manufacture of orthopedic implants simultaneously with the surgical intervention, considering two potential applications in the fields of orthopedics: the manufacture of anatomically adapted implants and implants for bone loss replacement. This work innovation consists on the capitation of the in situ geometry of the implant by direct capture of the shape using an elastomeric material (polyvinylsiloxane) which allows fine detail and great accuracy of the geometry. After scanning the elastomeric specimen, the implant is obtained by machining using a CNC milling machine programmed with a dedicated CAD/CAM system. After sterilization, the implant is able to be placed on the patient. The concept was developed using low cost technology and commercially available. The system has been tested in an in vivo hip arthroplasty performed on a sheep. The time increase of surgery was 80 minutes being 40 minutes the time of implant manufacturing. The system developed has been tested and the goals defined of the study achieved enabling the rapid manufacture of an implant in a time period compatible with the surgery time. PMID:27004181

  10. Osteoanabolic Implant Materials for Orthopedic Treatment.

    PubMed

    Ding, Yun-Fei; Li, Rachel W; Nakai, Masaaki; Majumdar, Trina; Zhang, Dong-Hai; Niinomi, Mitsuo; Birbilis, Nick; Smith, Paul N; Chen, Xiao-Bo

    2016-07-01

    Osteoporosis is becoming more prevalent due to the aging demographics of many populations. Osteoporotic bone is more prone to fracture than normal bone, and current orthopedic implant materials are not ideal for the osteoporotic cases. A newly developed strontium phosphate (SrPO4 ) coating is reported herein, and applied to Ti-29Nb-13Ta-4.6Zr (wt%), TNTZ, an implant material with a comparative Young's modulus to that of natural bone. The SrPO4 coating is anticipated to modulate the activity of osteoblast (OB) and osteoclast (OC) cells, in order to promote bone formation. TNTZ, a material with excellent biocompatibility and high bioinertness is pretreated in a concentrated alkaline solution under hydrothermal conditions, followed by a hydrothermal coating growth process to achieve complete SrPO4 surface coverage with high bonding strength. Owing to the release of Sr ions from the SrPO4 coating and its unique surface topography, OB cells demonstrate increased proliferation and differentiation, while the cellular responses of OC are suppressed, compared to the control case, i.e., bare TNTZ. This TNTZ implant with a near physiologic Young's modulus and a functional SrPO4 coating provides a new direction in the design and manufacture of implantable devices used in the management of orthopedic conditions in osteoporotic individuals. PMID:27113724

  11. The orthopedic characterization of Goltz syndrome.

    PubMed

    Smith, Amanda; Hunt, Thomas R

    2016-03-01

    Focal dermal hypoplasia (FDH), also known as Goltz syndrome, is a rare condition in which congenital anomalies result in a multitude of defects that affect many systems of the body. These defects can involve the eyes, skin, teeth, and cardiovascular, skeletal, and gastrointestinal systems. There have been many associated abnormalities reported in the literature. An appreciation of the clinical presentation of Goltz syndrome is important because physicians rely heavily on recognition of key physical characteristics in order to help make a diagnosis. In this report, we summarize the clinical findings observed when we were afforded the unique opportunity to interview and physically examine 19 patients, the largest group of individuals with Goltz syndrome brought together in one place to date. The findings are intended to characterize the orthopedic phenotypic manifestations of Goltz syndrome. This collection of data revealed that the most common orthopedic findings were syndactyly (68%), ectrodactyly (68%), leg length discrepancy (57%), and reduction defects of long bones (52%). Nail irregularities were present in 89% of the patients seen. PMID:26867035

  12. RAPID MANUFACTURING SYSTEM OF ORTHOPEDIC IMPLANTS.

    PubMed

    Relvas, Carlos; Reis, Joana; Potes, José Alberto Caeiro; Fonseca, Fernando Manuel Ferreira; Simões, José Antonio Oliveira

    2009-01-01

    This study, aimed the development of a methodology for rapid manufacture of orthopedic implants simultaneously with the surgical intervention, considering two potential applications in the fields of orthopedics: the manufacture of anatomically adapted implants and implants for bone loss replacement. This work innovation consists on the capitation of the in situ geometry of the implant by direct capture of the shape using an elastomeric material (polyvinylsiloxane) which allows fine detail and great accuracy of the geometry. After scanning the elastomeric specimen, the implant is obtained by machining using a CNC milling machine programmed with a dedicated CAD/CAM system. After sterilization, the implant is able to be placed on the patient. The concept was developed using low cost technology and commercially available. The system has been tested in an in vivo hip arthroplasty performed on a sheep. The time increase of surgery was 80 minutes being 40 minutes the time of implant manufacturing. The system developed has been tested and the goals defined of the study achieved enabling the rapid manufacture of an implant in a time period compatible with the surgery time. PMID:27004181

  13. Delay to orthopedic consultation for isolated limb injury

    PubMed Central

    Rouleau, Dominique M.; Feldman, Debbie Ehrmann; Parent, Stefan

    2009-01-01

    ABSTRACT OBJECTIVE To describe referral mechanisms for referral to orthopedic surgery for isolated limb injuries in a public health care system and to identify factors affecting access. DESIGN Cross-sectional survey. SETTING Orthopedic surgery service in a level 1 trauma centre in Montreal, Que. PARTICIPANTS We conducted a prospective study of 166 consecutive adults (mean age 48 years) referred to orthopedic surgery for isolated limb injuries during a 4-month period. MAIN OUTCOME MEASURES Self-reported data on the nature of the trauma, the elapsed time between injury and orthopedic consultation, the number and type of previous primary care consultations, sociodemographic characteristics, and the level of satisfaction with care. RESULTS Average time between the injury and orthopedic consultation was 89 hours (range 3 to 642), with an average of 68 hours (range 0 to 642) for delay between primary care consultation and orthopedic consultation. A total of 36% of patients with time-sensitive diagnoses had unacceptable delays to orthopedic consultation according to the Quebec Orthopaedic Association guidelines. Lower limb injury, consulting first at another hospital, living far from the trauma centre, patient perception of low severity, and having a soft tissue injury were associated with longer delays. CONCLUSION Identifying gaps and risk factors for slower access might help improve referral mechanisms for orthopedic consultation. PMID:19826162

  14. Young Children's Attitudes toward Orthopedic and Sensory Disabilities.

    ERIC Educational Resources Information Center

    DeGrella, Lanier H.; Green, Virginia P.

    1984-01-01

    Attitudes of 64 nondisabled children (three to seven years old) toward orthopedic and sensory disabilities were examined via the Test of Early Attitudes toward Disability. Responses indicated that bias against orthopedic and sensory disabilities increases with age but is not present among three-year-olds. (Author/CL)

  15. Improving Response Rates among Students with Orthopedic and Multiple Disabilities

    ERIC Educational Resources Information Center

    Wilkens, Christian P.; Kuntzler, Patrice M.; Cardenas, Shaun; O'Malley, Eileen; Phillips, Carolyn; Singer, Jacqueline; Stoeger, Alex; Kindler, Keith

    2014-01-01

    One challenge teachers of students with orthopedic and multiple disabilities face is providing sufficient time and opportunity to communicate. This challenge is universal across countries, schools, and settings: teachers want students to communicate because communication lies at the core of what makes us human. Yet students with orthopedic and…

  16. Manipulating Representations.

    PubMed

    Recchia-Luciani, Angelo N M

    2012-04-01

    The present paper proposes a definition for the complex polysemic concepts of consciousness and awareness (in humans as well as in other species), and puts forward the idea of a progressive ontological development of consciousness from a state of 'childhood' awareness, in order to explain that humans are not only able to manipulate objects, but also their mental representations. The paper builds on the idea of qualia intended as entities posing regular invariant requests to neural processes, trough the permanence of different properties. The concept of semantic differential introduces the properties of metaphorical qualia as an exclusively human ability. Furthermore this paper proposes a classification of qualia, according to the models-with different levels of abstraction-they are implied in, in a taxonomic perspective. This, in turn, becomes a source of categorization of divergent representations, sign systems, and forms of intentionality, relying always on biological criteria. New emerging image-of-the-world-devices are proposed, whose qualia are likely to be only accessible to humans: emotional qualia, where emotion accounts for the invariant and dominant property; and the qualic self where continuity, combined with the oneness of the self, accounts for the invariant and dominant property. The concept of congruence between different domains in a metaphor introduces the possibility of a general evaluation of truth and falsity of all kinds of metaphorical constructs, while the work of Matte Blanco enables us to classify conscious versus unconscious metaphors, both in individuals and in social organizations. PMID:22347988

  17. Biomaterial systems for orthopedic tissue engineering

    NASA Astrophysics Data System (ADS)

    Spoerke, Erik David

    2003-06-01

    The World Health Organization has estimated that one out of seven Americans suffers from a musculoskeletal impairment, annually incurring 28.6 million musculoskeletal injuries---more than half of all injuries. Bone tissue engineering has evolved rapidly to address this continued health concern. In the last decade, the focus of orthopedic biomaterials design has shifted from the use of common engineering metals and plastics to smart materials designed to mimic nature and elicit favorable bioresponse. Working within this new paradigm, this thesis explores unique chemical and materials systems for orthopedic tissue engineering. Improving on current titanium implant technologies, porous titanium scaffolds were utilized to better approximate the mechanical and structural properties of natural bone. These foam scaffolds were enhanced with bioactive coatings, designed to enhance osteoblastic implant colonization. The biopolymer poly(L-lysine) was incorporated into both hydroxypatite and octacalcium phosphate mineral phases to create modified organoapatite and pLys-CP coatings respectively. These coatings were synthesized and characterized on titanium surfaces, including porous structures such as titanium mesh and titanium foam. In addition, in vitro osteoblastic cell culture experiments probed the biological influences of these coatings. Organoapatite (OA) accelerated preosteoblastic colonization of titanium mesh and improved cellular ingrowth into titanium foam. Alternatively, the thin, uniform pLys-CP coating demonstrated significant potential as a substrate for chemically binding biological molecules and supramolecular assemblies. Biologically, pLys-CP demonstrated enhanced cellular attachment over titanium and inorganic calcium phosphate controls. Supramolecular self-assembled nanofiber assemblies were also explored both as stand-alone tissue engineering gels and as titanium coatings. Self-supporting nanofiber gels induced accelerated, biomimetic mineralization

  18. Co-Management Arrangements in Orthopedic Surgery.

    PubMed

    Bushnell, Brandon D

    2015-06-01

    A co-management arrangement (CMA) is a contractual relationship between physicians and a hospital that results in a shared-responsibility management structure for a specific service line. In orthopedic surgery, CMAs are becoming increasingly popular as stakeholders in the health care market seek increased value (ie, higher-quality care at lower costs). A CMA can significantly improve the efficiency and the outcomes of a musculoskeletal service line if it adheres to the basic principles of a focus on the patient, evidence-based decision-making, physician leadership, appropriate physician compensation, transparency, reasonable and modifiable goals, and accountability. While the specifics of each CMA will vary, all CMAs have common operational elements that include the arrangement's legal structure, legal compliance, leadership and reporting structure, facilities management, personnel management, clinical data management, financial data management, and quality and effectiveness reporting. PMID:26047000

  19. Bioactive glass coatings for orthopedic metallic implants

    SciTech Connect

    Lopez-Esteban, Sonia; Saiz, Eduardo; Fujino, Sigheru; Oku, Takeo; Suganuma, Katsuaki; Tomsia, Antoni P.

    2003-06-30

    The objective of this work is to develop bioactive glass coatings for metallic orthopedic implants. A new family of glasses in the SiO2-Na2O-K2O-CaO-MgO-P2O5 system has been synthesized and characterized. The glass properties (thermal expansion, softening and transformation temperatures, density and hardness) are in line with the predictions of established empirical models. The optimized firing conditions to fabricate coatings on Ti-based and Co-Cr alloys have been determined and related to the glass properties and the interfacial reactions. Excellent adhesion to alloys has been achieved through the formation of 100-200 nm thick interfacial layers (Ti5Si3 on Ti-based alloys and CrOx on Co-Cr). Finally, glass coatings, approximately 100 mu m thick, have been fabricated onto commercial Ti alloy-based dental implants.

  20. Orthopedic applications of silicon nitride ceramics.

    PubMed

    Bal, B S; Rahaman, M N

    2012-08-01

    Silicon nitride (Si(3)N(4)) is a ceramic material developed for industrial applications that demand high strength and fracture resistance under extreme operating conditions. Recently, Si(3)N(4) has been used as an orthopedic biomaterial, to promote bone fusion in spinal surgery and to develop bearings that can improve the wear and longevity of prosthetic hip and knee joints. Si(3)N(4) has been implanted in human patients for over 3 years now, and clinical trials with Si(3)N(4) femoral heads in prosthetic hip replacement are contemplated. This review will provide background information and data relating to Si(3)N(4) ceramics that will be of interest to engineering and medical professionals. PMID:22542731

  1. Caring for the incarcerated: an orthopedic perspective.

    PubMed

    Munns, Justin; Samora, Julie Balch; Granger, Jeffrey F; Ng, Vincent Y

    2013-12-01

    According to the 1976 Supreme Court case of Estelle v Gamble, the government is required to provide prisoners access to the necessary care for known, serious medical needs. Failure to do so violates the Eighth Amendment prohibiting the imposition of "cruel and unusual punishment." Currently, more than 2.5 million Americans are imprisoned, the highest per capita rate in the world. In the current fiscal climate and with burgeoning health care costs for society as a whole, providing care for prisoners poses both moral and logistical challenges. From an orthopedic standpoint, caring for the incarcerated raises uniquely challenging issues due to the nature of this patient population and their types of musculoskeletal conditions. PMID:24309118

  2. Regenerative treatments to enhance orthopedic surgical outcome.

    PubMed

    Murrell, William D; Anz, Adam W; Badsha, Humeira; Bennett, William F; Boykin, Robert E; Caplan, Arnold I

    2015-04-01

    In orthopedic surgery there has been a never-ending quest to improve surgical outcome and the patient's experience. Progression has been marked by the refinement of surgical techniques and instruments and later by enhanced diagnostic imaging capability, specifically magnetic resonance. Over time implant optimization was achieved, along with the development of innovative minimally invasive arthroscopic technical skills to leverage new versions of classic procedures and implants to improve short-term patient morbidity and initial, mid-term, and long-term patient outcomes. The use of regenerative and/or biological adjuncts to aid the healing process has followed in the drive for continual improvement, and major breakthroughs in basic science have significantly unraveled the mechanisms of key healing and regenerative pathways. A wide spectrum of primary and complementary regenerative treatments is becoming increasingly available, including blood-derived preparations, growth factors, bone marrow preparations, and stem cells. This is a new era in the application of biologically active material, and it is transforming clinical practice by providing effective supportive treatments either at the time of the index procedure or during the postoperative period. Regenerative treatments are currently in active use to enhance many areas of orthopedic surgery in an attempt to improve success and outcome. In this review we provide a comprehensive overview of the peer-reviewed evidence-based literature, highlighting the clinical outcomes in humans both with preclinical data and human clinical trials involving regenerative preparations within the areas of rotator cuff, meniscus, ligament, and articular cartilage surgical repair. PMID:25864660

  3. Orthopedic surgical analyzer for percutaneous vertebroplasty

    NASA Astrophysics Data System (ADS)

    Tack, Gye Rae; Choi, Hyung Guen; Lim, Do H.; Lee, Sung J.

    2001-05-01

    Since the spine is one of the most complex joint structures in the human body, its surgical treatment requires careful planning and high degree of precision to avoid any unwanted neurological compromises. In addition, comprehensive biomechanical analysis can be very helpful because the spine is subject to a variety of load. In case for the osteoporotic spine in which the structural integrity has been compromised, it brings out the double challenges for a surgeon both clinically and biomechanically. Thus, we have been developing an integrated medical image system that is capable of doing the both. This system is called orthopedic surgical analyzer and it combines the clinical results from image-guided examination and the biomechanical data from finite element analysis. In order to demonstrate its feasibility, this system was applied to percutaneous vertebroplasty. Percutaneous vertebroplasty is a surgical procedure that has been recently introduced for the treatment of compression fracture of the osteoporotic vertebrae. It involves puncturing vertebrae and filling with polymethylmethacrylate (PMMA). Recent studies have shown that the procedure could provide structural reinforcement for the osteoporotic vertebrae while being minimally invasive and safe with immediate pain relief. However, treatment failures due to excessive PMMA volume injection have been reported as one of complications. It is believed that control of PMMA volume is one of the most critical factors that can reduce the incidence of complications. Since the degree of the osteoporosis can influence the porosity of the cancellous bone in the vertebral body, the injection volume can be different from patient to patient. In this study, the optimal volume of PMMA injection for vertebroplasty was predicted based on the image analysis of a given patient. In addition, biomechanical effects due to the changes in PMMA volume and bone mineral density (BMD) level were investigated by constructing clinically

  4. Insights into Avicenna's knowledge of the science of orthopedics.

    PubMed

    Dalfardi, Behnam; Yarmohammadi, Hassan; Meibodi, Mohammad Kalantari

    2014-01-18

    The art of orthopedics traces its history back to ancient civilizations like those of the Egyptians. The evolution of this branch of medicine is indebted to investigations of many scientists, including Greek, Roman and Persian scholars. The Persian physician Avicenna (980-1037 AD) is one such scientist who investigated different aspects of orthopedics. It is possible to analyze Avicenna's knowledge of orthopedics and his contributions to this branch of medicine by an examination of his epic encyclopedia of medicine, Al-Qanun fi al-Tibb (The Canon of Medicine). PMID:24649417

  5. The Effects of Standardized Feedback on Orthopedic Patient Evaluation Skills.

    ERIC Educational Resources Information Center

    DaRosa, Debra A.; And Others

    1984-01-01

    A study examined whether there are performance differences between surgery clerks provided corrective reinforcement on orthopedic history and physical examination write-ups and those assessed by traditional feedback means when both groups are exposed to the feedback instrument. (MLW)

  6. Orthopedic Health: Osteoarthritis— What You Should Know (quiz)

    MedlinePlus

    ... Bar Home Current Issue Past Issues Orthopedic Health Osteoarthritis— What You Should Know Past Issues / Spring 2009 ... Javascript on. How much do you know about osteoarthritis, its causes, and its therapies? Take this quiz ...

  7. Orthopedic Health: Joint Health and Care: Prevention, Symptoms, Diagnosis & Treatment

    MedlinePlus

    ... Orthopedic Health Joint Health and Care: Prevention, Symptoms, Diagnosis & Treatment Past Issues / Spring 2009 Table of Contents ... or the sound of bone rubbing on bone Diagnosis No single test can diagnose osteoarthritis. It is ...

  8. Clostridial orthopedic infections: case reports and review of the literature.

    PubMed

    Lazzarini, L; Conti, E; Ditri, L; Turi, G; de Lalla, F

    2004-02-01

    Clostridia are anaerobic Gram-positive bacilli that can be isolated from the soil and the intestinal tract of humans. These microorganisms are recognized as the cause of devastating soft tissue infections, such as cellulitis, myositis, and gas gangrene. However, such bacteria may also be involved in various postoperative orthopedic infections, including prosthetic joint infection. We present three clinical cases of clostridial orthopedic infection and review the related medical literature. PMID:15078006

  9. Modern Orthopedic Inpatient Care of the Orthopedic Patient With Diabetic Foot Disease.

    PubMed

    Bateman, Antony H; Bradford, Sara; Hester, Thomas W; Kubelka, Igor; Tremlett, Jennifer; Morris, Victoria; Pendry, Elizabeth; Kavarthapu, Venu; Edmonds, Michael E

    2015-12-01

    In this article, we describe emergency and elective pathways within our orthopedic multidisciplinary inpatient care of patients with diabetic foot problems. We performed a retrospective cohort review of 19 complex patients requiring orthopedic surgical treatment of infected ulceration or Charcot feet or deformity at our institution. A total of 30 admissions (19 emergency, 11 elective) were included. The pathways were coordinated by a multidisciplinary team and comprised initial assessment and investigation and a series of key events, which consisted of emergency and elective surgery together with the introduction, and change of intravenous antibiotics when indicated. Patients had rigorous microbiological assessment, in the form of deep ulcer swabs, operative tissue specimens, joint aspirates, and blood cultures according to their clinical presentation as well as close clinical and biochemical surveillance, which expedited the prompt institution of key events. Outcomes were assessed using amputation rates and patient satisfaction. In the emergency group, there were 5.6 ± 3.0 (mean ± SD) key events per admission, including 4.2 ± 2.1 antibiotic changes. In the elective group, there were 4.8 ± 1.4 key events per inpatient episode, with 3.7 ± 1.3 antibiotic changes. Overall, there were 3 minor amputations, and no major amputations. The podiatric and surgical tissue specimens showed a wide array of Gram-positive, Gram-negative, aerobic and anaerobic isolates and 15% of blood cultures showed bacteremia. When 9 podiatric specimens were compared with 9 contemporaneous surgical samples, there was concordance in 2 out of 9 pairs. We have described the successful modern care of the orthopedic diabetic foot patient, which involves close clinical, microbiological, and biochemical surveillance by the multidisciplinary team directing patients through emergency and elective pathways. This has enabled successful surgical intervention involving debridement, pressure relief, and

  10. Orthopedic surgery and its complication in systemic lupus erythematosus

    PubMed Central

    Mak, Anselm

    2014-01-01

    Systemic lupus erythematosus (SLE) is a multi-systemic immune-complex mediated autoimmune condition which chiefly affects women during their prime year. While the management of the condition falls into the specialty of internal medicine, patients with SLE often present with signs and symptoms pertaining to the territory of orthopedic surgery such as tendon rupture, carpal tunnel syndrome, osteonecrosis, osteoporotic fracture and infection including septic arthritis, osteomyelitis and spondylodiscitis. While these orthopedic-related conditions are often debilitating in patients with SLE which necessitate management by orthopedic specialists, a high index of suspicion is necessary in diagnosing these conditions early because lupus patients with potentially severe orthopedic conditions such as osteomyelitis frequently present with mild symptoms and subtle signs such as low grade fever, mild hip pain and back tenderness. Additionally, even if these orthopedic conditions can be recognized, complications as a result of surgical procedures are indeed not uncommon. SLE per se and its various associated pharmacological treatments may pose lupus patients to certain surgical risks if they are not properly attended to and managed prior to, during and after surgery. Concerted effort of management and effective communication among orthopedic specialists and rheumatologists play an integral part in enhancing favorable outcome and reduction in postoperative complications for patients with SLE through thorough pre-operative evaluation, careful peri-operative monitoring and treatment, as well as judicious postoperative care. PMID:24653977

  11. Are academic orthopedic surgeons interested in global health?

    PubMed

    Makhni, Melvin C; Miao, Diana; Zurakowski, David; Day, Charles S

    2014-03-01

    Two thirds of the world's population lack orthopedic services. Natural disasters such as the 2010 Haiti earthquake temporarily increased volunteering, but the decision to volunteer regularly is likely multifactorial. In the study reported here, we investigated whether academic orthopedic surgeons are interested in volunteering abroad and identified factors that influence participation. Academic orthopedic surgeons were identified through the faculty listings of all 154 orthopedic residency programs listed by the Association of American Medical Colleges (AAMC) Electronic Residency Application Service and were sent surveys by e-mail. Of the 3,697 eligible academic orthopedic surgeons, 600 were randomly selected, and 109 completed the survey. Of the 109 respondents, 52% had volunteered abroad previously, and 62% said they were highly likely to volunteer abroad in the future. The most common barriers were scheduling, and family and social commitments (65% and 66%, respectively), followed by lack of specialty-specific opportunities (40%). In a multivariate model, the only barrier significantly decreasing likelihood to volunteer abroad was concern for medical safety (P = .015). Altruistic motivations (P = .005), religious sentiments (P = .006), international networking (P = .004), and fulfilling the true medical creed (P = .015) significantly increased likelihood. Academic orthopedic surgeons are interested in volunteering abroad. Addressing common motivations and barriers may help improve care in the developing world. PMID:24660182

  12. Plasma engineered surfaces for orthopedic devices.

    PubMed

    Farhat, Susan; Gilliam, Mary; Samaniego, Cheryl; Dwarshuis, Nate; Carson, Julia; Peterson, Benjamin; Zand, Ali

    2016-06-01

    Atmospheric pressure plasma was used to graft various biocompatible polymers to the surface of ultra-high molecular weight polyethylene (UHMWPE). Polymers used as grafts in this study were poly(2-hydroxyethylmethacrylate) (PHEMA) and polyethylene glycol (PEG). A significant decrease in contact angle was noted for grafted surfaces, indicating increased hydrophilicity. Surface functionalities were verified using Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy. The wear properties of the coatings were determined by weight loss under conditions of a random motion pin-on-plate apparatus with the coated polyethylene plaques immersed in DI water. Based on these tests, the grafted surfaces exhibited an improved resistance to wear, compared to UHMWPE. Cell viability studies were used to confirm that the plasma treatment had no negative effects on the surface bio-toxicity. Based on the results, it is anticipated that the incorporation of these biocompatible polymer-grafted UHMWPE surfaces in metal-on-plastic orthopedic implants should improve their performance and longevity. PMID:26999407

  13. The white blood cell scan in orthopedics

    SciTech Connect

    Propst-Proctor, S.L.; Dillingham, M.F.; McDougall, I.R.; Goodwin, D.

    1982-08-01

    A new nuclear scanning technique was found more specific for bone, joint, and soft tissue infections than any previously described scanning technique. The leukocyte scan, whereby a patient's own cells are labeled with a radioactive tagging agent (/sup 111/In oxine), can distinguish an active infectious process from other pain-inducing conditions. Ninety-seven /sup 111/In labeled autologous leukocyte scans were performed in 88 patients. The findings in 17 of 40 patients scanned for possible acute osteomyelitis, six of nine for suspected septic arthritis, and six for possible soft tissue infections, were positive. Subsequent clinical courses verified the infectious nature of these processes in all patients. Patients who had chronic osteomyelitis (14), bony metastases (four patients), heterotopic ossification (three), and degenerative arthritis (two) demonstrated negative findings. Of the seven patients scanned for acute long-bone fractures, one demonstrated positive findings. Nine scans demonstrated positive findings without determined causes. The leukocyte scan is a useful addition to the diagnostic tools of the orthopedic surgeon.

  14. Physician-Hospital Alignment in Orthopedic Surgery.

    PubMed

    Bushnell, Brandon D

    2015-09-01

    The concept of "alignment" between physicians and hospitals is a popular buzzword in the age of health care reform. Despite their often tumultuous histories, physicians and hospitals find themselves under increasing pressures to work together toward common goals. However, effective alignment is more than just simple cooperation between parties. The process of achieving alignment does not have simple, universal steps. Alignment will differ based on individual situational factors and the type of specialty involved. Ultimately, however, there are principles that underlie the concept of alignment and should be a part of any physician-hospital alignment efforts. In orthopedic surgery, alignment involves the clinical, administrative, financial, and even personal aspects of a surgeon's practice. It must be based on the principles of financial interest, clinical authority, administrative participation, transparency, focus on the patient, and mutual necessity. Alignment can take on various forms as well, with popular models consisting of shared governance and comanagement, gainsharing, bundled payments, accountable care organizations, and other methods. As regulatory and financial pressures continue to motivate physicians and hospitals to develop alignment relationships, new and innovative methods of alignment will also appear. Existing models will mature and evolve, with individual variability based on local factors. However, certain trends seem to be appearing as time progresses and alignment relationships deepen, including regional and national collaboration, population management, and changes in the legal system. This article explores the history, principles, and specific methods of physician-hospital alignment and its critical importance for the future of health care delivery. PMID:26375539

  15. Managing orthopedics and neurosciences costs through standard treatment protocols.

    PubMed

    McGinnity, E S; Pluth, T E

    1994-06-01

    High-cost, high-volume specialty programs such as orthopedics and neurosciences find themselves in a position of evaluating the costs and in some cases the appropriateness of medical practices in response to payer scrutiny and provider selection processes. Orthopedics and neurosciences programs are at a stage of development analogous to that of cardiovascular care several years ago. Many of the same trends have come into play, such as payer "carve-outs" for orthopedic services, payer selection of centers of excellence based on cost and quality, reduction of Medicare reimbursement, greater use of high-cost technology, the decline of profitability due to "older, sicker, and tougher" patients, and the recent emergence of national orthopedic specialty networks oriented to national contracts for care. In an era in which payers demand value on both sides of the cost-plus-quality equation, programs are challenged to maximize the return on a patient population rife with "no-win" situations. In the orthopedic service line these include a high proportion of Medicare patients and chronic conditions such as workers' compensation medical back cases or repetitive motion injuries, which can be elusive to diagnose and expensive to treat. Many hospitals continue to lose money on joint replacement surgeries, the largest-volume orthopedic inpatient service, primarily because of the high Medicare population and the cost of implants. Neuroservices, while still relatively well reimbursed, face a rising proportion of Medicare payments as patients live longer and develop chronic, degenerative conditions. Inpatient days are decreasing due to payer pressures to limit hospital stays and to shift inpatient care to outpatient services. Some hospitals "have lost interest in (the orthopedic) service line during the last five years because of recent trends in orthopedic-related inpatient volume and payment." But by managing costs strategically, both the neurosciences and orthopedics service lines

  16. The Economic Burden of Orthopedic Surgery Residency Interviews on Applicants

    PubMed Central

    Fogel, Harold A.; Finkler, Elissa S.; Wu, Karen; Schiff, Adam P.; Nystrom, Lukas M.

    2016-01-01

    Background The intense competition for orthopedic surgery residency positions influences the interview process. The financial impact on residency applicants is less well understood. The purpose of the present study was to define the economic burden of the orthopedic surgery residency interview process while additionally describing how applicants finance the expense. Methods We distributed surveys to 48 nonrotating applicants at our institution’s residency interview days for the 2015 match year. The survey consisted of eleven questions specific to the costs of interviewing for orthopedic surgery residency positions. Results The survey response rate was 90% (43/48). Applicants applied to a median of 65 orthopedic surgery residency programs (range 21-88) and targeted a median of 15 interviews (range 12-25). The mean cost estimate for a single interview was $450 (range $200-800) and the cost estimate for all interviews was $7,119 (range $2,500-15,000). Applicants spent a mean of $344 (range $0-750) traveling to our interview. Seventy-two percent borrowed money to finance their interview costs and 28% canceled interviews for financial reasons. Conclusions The financial cost of interviewing for orthopedic surgery is substantial and a majority of applicants add to their educational debt by taking out loans to finance interviews. Future considerations should be made to minimize these costs for an already financially burdened population. PMID:27528831

  17. Does thromboprophylaxis prevent venous thromboembolism after major orthopedic surgery?*,**

    PubMed Central

    Akpinar, Evrim Eylem; Hosgün, Derya; Akan, Burak; Ates, Can; Gülhan, Meral

    2013-01-01

    OBJECTIVE: Pulmonary embolism (PE) is an important complication of major orthopedic surgery. The aim of this study was to evaluate the incidence of venous thromboembolism (VTE) and factors influencing the development of VTE in patients undergoing major orthopedic surgery in a university hospital. METHODS: Patients who underwent major orthopedic surgery (hip arthroplasty, knee arthroplasty, or femur fracture repair) between February of 2006 and June of 2012 were retrospectively included in the study. The incidences of PE and deep vein thrombosis (DVT) were evaluated, as were the factors influencing their development, such as type of operation, age, and comorbidities. RESULTS: We reviewed the medical records of 1,306 patients. The proportions of knee arthroplasty, hip arthroplasty, and femur fracture repair were 63.4%, 29.9%, and 6.7%, respectively. The cumulative incidence of PE and DVT in patients undergoing major orthopedic surgery was 1.99% and 2.22%, respectively. Most of the patients presented with PE and DVT (61.5% and 72.4%, respectively) within the first 72 h after surgery. Patients undergoing femur fracture repair, those aged ≥ 65 years, and bedridden patients were at a higher risk for developing VTE. CONCLUSIONS: Our results show that VTE was a significant complication of major orthopedic surgery, despite the use of thromboprophylaxis. Clinicians should be aware of VTE, especially during the perioperative period and in bedridden, elderly patients (≥ 65 years of age). PMID:23857692

  18. Orthostetrics: Management of Orthopedic Conditions in the Pregnant Patient.

    PubMed

    Matthews, Leslie J; McConda, David B; Lalli, Trapper A J; Daffner, Scott D

    2015-10-01

    Managing orthopedic conditions in pregnant patients leads to challenges that must be carefully considered so that the safety of both the mother and the fetus is maintained. Both perioperative and intraoperative considerations must be made based on physiologic changes during pregnancy, risks of radiation, and recommendations for monitoring. Operative timing, imaging, and medication selection are also factors that may vary based on trimester and clinical scenario. Pregnancy introduces unique parameters that can result in undesirable outcomes for both mother and fetus if not handled appropriately. Ultimately, pregnant patients offer a distinct challenge to the orthopedic surgeon in that the well-being of 2 patients must be considered in all aspects of care. In addition, not only does pregnancy affect the management of orthopedic conditions but the pregnant state also causes physiologic changes that may actually induce various pathologies. These pregnancy-related orthopedic conditions can interfere with an otherwise healthy pregnancy and should be recognized as possible complications. Although the management of orthopedic conditions in pregnancy is often conservative, pregnancy does not necessarily preclude safely treating pathologies operatively. When surgery is considered, regional anesthesia provides less overall drug exposure to the fetus and less variability in fetal heart rate. Intraoperative fluoroscopy can be used when appropriate, with 360° fetal shielding if possible. Lateral decubitus positioning is ideal to prevent hypotension associated with compression of the inferior vena cava. PMID:26488781

  19. Mobile Remote Manipulator

    NASA Technical Reports Server (NTRS)

    Coryell, S.; Olsen, R. E.

    1986-01-01

    Turret, roll arm, and trolley enhance manipulator dexterity. Remote manipulator moves on trolley base along structure. Roll-axis arm positions manipulator arm so it can extend end effector under structure. Yaw-axis rotation gives added reach to arm above structure. Designed for handling, inspecting, and maintaining modules of space station. Manipulators having such capabilities useful on Earth; robots in manufacturing, erection of large structures, or performing complicated tasks in hazardous locations.

  20. Orthopedic Manifestations of Mobius Syndrome: Case Series and Survey Study.

    PubMed

    McClure, Philip; Booy, David; Katarincic, Julia; Eberson, Craig

    2016-01-01

    Background. Mobius Syndrome is a rare disease defined by bilateral congenital 7th nerve palsy. We focus on reporting the prevalence of orthopedic disease in this population. Methods. Twenty-three individuals with Mobius Syndrome underwent orthopedic physical examination, and additional 96 patients filled out a survey for self-reported orthopedic diagnoses. Results. Clubfoot was present in 60% of individuals in the physical exam series and 42% of those in the survey. Scoliosis was present in 26% and 28%, respectively. Poland's Syndrome was present in 17% and 30%. In addition to these findings, 27% of patients reported having difficulty with anesthesia, including difficulty in intubation and airway problems. Conclusion. An increased prevalence of scoliosis, clubfoot, transverse limb deficiencies, and Poland's Syndrome is identified in the setting of Mobius Syndrome. In the setting of several deformities often requiring surgical correction, a high incidence of anesthetic difficulty is noted and should be discussed with patients and other providers during surgical planning. PMID:26977161

  1. Orthopedic Manifestations of Mobius Syndrome: Case Series and Survey Study

    PubMed Central

    McClure, Philip; Booy, David; Katarincic, Julia; Eberson, Craig

    2016-01-01

    Background. Mobius Syndrome is a rare disease defined by bilateral congenital 7th nerve palsy. We focus on reporting the prevalence of orthopedic disease in this population. Methods. Twenty-three individuals with Mobius Syndrome underwent orthopedic physical examination, and additional 96 patients filled out a survey for self-reported orthopedic diagnoses. Results. Clubfoot was present in 60% of individuals in the physical exam series and 42% of those in the survey. Scoliosis was present in 26% and 28%, respectively. Poland's Syndrome was present in 17% and 30%. In addition to these findings, 27% of patients reported having difficulty with anesthesia, including difficulty in intubation and airway problems. Conclusion. An increased prevalence of scoliosis, clubfoot, transverse limb deficiencies, and Poland's Syndrome is identified in the setting of Mobius Syndrome. In the setting of several deformities often requiring surgical correction, a high incidence of anesthetic difficulty is noted and should be discussed with patients and other providers during surgical planning. PMID:26977161

  2. Evidence-based orthopedic surgery: is it possible?

    PubMed

    Suk, Michael; Hanson, Beate; Helfet, David L

    2010-04-01

    The promise of evidence-based medicine is to integrate the highest levels of clinical data with patient outcomes. After framing the question and identifying appropriate studies, evaluating their relevance to clinical practice is highly dependent on the instruments and measures selected to demonstrate outcomes. Currently, there are hundreds of outcomes measures available in the orthopedic literature evaluating these treatments, and it is not uncommon for different measures to produce conflicting results. Consequently, the ability to evaluate an outcomes measure is critical in determining the value of a specific treatment intervention. Similarly, selecting the appropriate outcomes measure for research or clinical purposes is an important decision that may have far reaching implications on reimbursement, surgeon reputation, and patient treatment success. Evidence-based orthopedic surgery is indeed possible, but demands a detailed understanding of why appropriate outcomes selection is important, the difference between clinician-based and patient-reported outcomes (PROs), and potential future directions in orthopedics outcomes research. PMID:20399353

  3. Progress in nonprehensile manipulation

    SciTech Connect

    Mason, M.T.

    1999-11-01

    This paper reviews my recent research in robotic manipulation and speculates on potentially fruitful directions for future work. My recent work is focused on nonprehensile manipulation: manipulating objects without grasping them. In particular, the paper surveys work on a single joint robot that orients parts on a conveyor belt; a robot that uses dynamics to snatch, roll, or throw objects; hitting things to position them; manipulating things whose shapes are not completely known; and integration of manipulation with locomotion. In the future, a broad view of robotics will allow us to focus on fundamental principles and at the same time address a variety of new applications.

  4. [Technical orthopedics. Importance in an increasingly operatively oriented faculty].

    PubMed

    Greitemann, B; Maronna, U

    2013-10-01

    The foundation of the German Society for Orthopedics in 1901 was due to a separation from the faculty of surgery because a surgical approach alone did not adequately deal with the symptoms. Orthopedists were initially considered as a fringe group. The conservative treatment approach was initially at the forefront and operative measures were a side line. The main aim was the rehabilitation of patients into a normal life as best as possible. In the conservative area treatment with orthopedic technical aids and appliances rapidly came to play an important role and a great multitude of technical appliances were developed with sometimes very different possible applications. Despite the clearly improved operative treatment approaches in orthopedics and trauma surgery, technical orthopedics still plays a substantial role even today. Healing and supportive aids and appliances are of decisive importance for the treatment of a multitude of diseases and handicaps. They stabilize and improve operative treatment results and often result in new approaches. This depends on cooperation between technicians, therapists and physicians in a team, even in the scientific field. Evidence-based studies on the effectiveness of technical aids are currently still uncommon but recently some clear evidence for effectiveness could be shown. Scientifically this is a very varied field of work. The demographic development presents new requirements which must be dealt with. Technical solutions are often very promising especially in this field. Technical orthopedics remains an important component of the specialty of orthopedics and trauma surgery and with an increasing tendency due to more recent research and development. PMID:23955523

  5. Applications of Metal Additive Manufacturing in Veterinary Orthopedic Surgery

    NASA Astrophysics Data System (ADS)

    Harrysson, Ola L. A.; Marcellin-Little, Denis J.; Horn, Timothy J.

    2015-03-01

    Veterinary medicine has undergone a rapid increase in specialization over the last three decades. Veterinarians now routinely perform joint replacement, neurosurgery, limb-sparing surgery, interventional radiology, radiation therapy, and other complex medical procedures. Many procedures involve advanced imaging and surgical planning. Evidence-based medicine has also become part of the modus operandi of veterinary clinicians. Modeling and additive manufacturing can provide individualized or customized therapeutic solutions to support the management of companion animals with complex medical problems. The use of metal additive manufacturing is increasing in veterinary orthopedic surgery. This review describes and discusses current and potential applications of metal additive manufacturing in veterinary orthopedic surgery.

  6. Nanomedicine applications in orthopedic medicine: state of the art

    PubMed Central

    Mazaheri, Mozhdeh; Eslahi, Niloofar; Ordikhani, Farideh; Tamjid, Elnaz; Simchi, Abdolreza

    2015-01-01

    The technological and clinical need for orthopedic replacement materials has led to significant advances in the field of nanomedicine, which embraces the breadth of nanotechnology from pharmacological agents and surface modification through to regulation and toxicology. A variety of nanostructures with unique chemical, physical, and biological properties have been engineered to improve the functionality and reliability of implantable medical devices. However, mimicking living bone tissue is still a challenge. The scope of this review is to highlight the most recent accomplishments and trends in designing nanomaterials and their applications in orthopedics with an outline on future directions and challenges. PMID:26451110

  7. [Orthopedic aspects in interdisciplinary multimodal therapy of chronic back pain].

    PubMed

    Weh, L; Marnitz, U

    2011-06-01

    The effect of interdisciplinary multimodal therapy of chronic back pain is well documented. With elapsing time changing diagnostic focuses, therapeutic strategies and objectives have to be considered. The chronicity leads to a modification of the relevance of structure-related diagnosis and therapy and changes the significance of the classic orthopedic instruments. The requirement of a rational causal therapy in chronic back pain still remains but the focal points shift to the consideration of somatic, psychological and social disposing and supporting factors.The aim of this paper is to reflect the necessary orthopedic expertise in the context of the pathomechanics of chronic back pain and the interdisciplinary teamwork. PMID:21523420

  8. Use of lasers in orthopedic surgery: current concepts.

    PubMed

    Abelow, S P

    1993-05-01

    A surgical laser is a new, multipurpose tool that can cut, coagulate, and vaporize tissues. It utilizes a low profile handpiece that allows easy access to tight places and small joints. The holmium laser at 2.1 microns wavelength is gaining wide acceptance among orthopedic surgeons as a useful arthroscopic surgical tool. It has a minimal amount of thermal necrosis and is able to cut and ablate tissues with great ease. Current investigation with laser tissue--agglutination and tissue welding--may make it possible to repair torn tissues with laser energy. The future will bring minimally invasive and minimally damaging laser orthopedic surgery. PMID:8327382

  9. Computer-assisted diagnosis of orthopedic gait disorders.

    PubMed

    Tracy, K B; Montague, E C; Gabriel, R P; Kent, B E

    1979-03-01

    A computer program was developed to help diagnose orthopedic gait disorders. Designing and implementing the program, as well as the program's method of operation are described. The main features of the program include: a knowledge base of facts about orthopedic gait, organized into premise-conclusion pairs; a goal-directed reasoning chain that causally relates the facts; and a symbolic structure that allows limited English discourse between the user and the computer. Results of the project indicate that the complex area of gait analysis does lend itself to diagnosis by computer and that this prototype has potential as an aid to physical therapists in the classroom and in the clinic. PMID:84393

  10. [Means of developing personnel potentials of dental orthopedic service in southern regions of Tiumen' oblast].

    PubMed

    Voznyĭ, A V; Dolgintsev, V I; Semeniuk, V M; Ivanova, L A

    2005-01-01

    The article exposes overall analysis and objective evaluation of personnel potential of orthopedic dental service in southern region of Tyumen oblast. Actual issues of enhancement of orthopedic dental service in this region are discussed. PMID:16821315

  11. Orthopedic Health: Healthy Joints for a Lifetime / Keep Your Moving Parts Moving

    MedlinePlus

    Skip Navigation Bar Home Current Issue Past Issues Orthopedic Health Healthy Joints for a Lifetime Past Issues / ... being made every day in the world of orthopedic health and disease treatment —our bones, muscles, tendons, ...

  12. Telediagnosis system for orthopedic deformity analysis based on 3D medical imaging

    NASA Astrophysics Data System (ADS)

    Kim, Myoung-Hee; Hong, Helen; Kim, Min-A.

    2000-04-01

    Due to the structural complexity of the bone, it is difficult to diagnose and make a treatment plan for injuries and diseases in bones. In this paper, we designed and implemented a telediagnosis system for orthopedic deformity analysis based on 3D medical imaging. In order to define the intersseous relationships in each bone and to evaluate a deformity without invasions, the system produces volumetric images by reconstructing the planar images spatially and provides deformity analysis by measuring distance, area, volume and angle among the bones. The reconstructed volumetric images are freely manipulated to simulate surgical operations such as translation, scaling, rotation and so on. Our system integrates three main components: server, clients and communication subsystem. It is also composed of three main functions including the information control manager for event and message process used between client and server, and surgical simulation manager for object visualization and manipulation in individual bones, and the medical database manager for patient information. The system also supports user-friendly graphical user interface and simultaneous use by multiple users.

  13. 21 CFR 888.5850 - Nonpowered orthopedic traction apparatus and accessories.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonpowered orthopedic traction apparatus and accessories. 888.5850 Section 888.5850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.5850 Nonpowered orthopedic traction apparatus and...

  14. Left-Handed Preschool Children with Orthopedic Disabilities.

    ERIC Educational Resources Information Center

    Banham, Katharine M.

    1983-01-01

    The mental development of 332 preschool-age children with orthopedic disabilities was assessed at a children's hospital over a 10-year period, and comparisons were made for right-handed and left-handed. The left-handed children were slower than right-handed children in learning speech and language skills (Author/SEW)

  15. 45 CFR 1308.12 - Eligibility criteria: Orthopedic impairment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Eligibility criteria: Orthopedic impairment. 1308.12 Section 1308.12 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD...

  16. The Special Orthopedic Hospital—Past and Present

    PubMed Central

    Platt, Harry

    1964-01-01

    Pioneer orthopedic institutions established in Europe in the late 18th and early 19th centuries, and in the U.S.A. in the second half of the 19th and the first decade of the 20th century, can trace their ancestry in ideas back to the practice and teachings of Hippocrates. Experience in treatment of great numbers of injured soldiers in the First World War opened a new era in reconstructive surgery of the locomotor system. After the Second World War, in advanced nations the pattern of crippling diseases showed a spectacular change. Problems that justify the existence of large special orthopedic hospitals are, in children, the more complex congenital deformities, cerebral palsies, and the increasing number of injuries due to hazards of modern life; in the adult, the reconstructive surgery of trauma and of arthritis. In modern orthopedic hospitals physicians have joined orthopedic surgeons in the study of the natural history of the various forms of arthritis. These centres provide facilities for biomechanical research and postgraduate training which acute general hospitals cannot offer. PMID:14228224

  17. 45 CFR 1308.12 - Eligibility criteria: Orthopedic impairment.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Eligibility criteria: Orthopedic impairment. 1308.12 Section 1308.12 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD...

  18. Higher Education and Students with Orthopedic Disabilities: A Survey Instrument.

    ERIC Educational Resources Information Center

    Singh, Delar K.

    A survey instrument is presented that was used in a national survey of 160 colleges and universities to explore facilities and services to students with orthopedic disabilities. The survey contains 33 items that focus on the following areas: structural accessibility, academic accessibility, dorm-living, and recreational opportunities. The total…

  19. Supporting the Educational Needs of Students with Orthopedic Impairments.

    ERIC Educational Resources Information Center

    Heller, Kathryn Wolff; Swinehart-Jones, Dawn

    2003-01-01

    This article provides information on orthopedic impairments and the unique knowledge and skills required to provide these students with an appropriate education. Information on current practice is provided, as well as training and technical assistance models that can be used to help provide teachers with the necessary training. (Contains…

  20. Office orthopedics: thumb spica casting for scaphoid fractures.

    PubMed

    Richard, J R

    1995-09-15

    Fracture of the scaphoid bone of the wrist is a common orthopedic problem and is accurately diagnosed by determining the mechanism of injury based on the history, performing a specific physical examination maneuvers and interpreting radiographic findings. Skill in the application of the thumb spica cast enables the family physician to provide appropriate and definitive care for many of these patients. PMID:7668203

  1. 76 FR 20690 - International Consortium of Orthopedic Registries; Public Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-13

    ... be on a first- come, first-served basis. Non-U.S. citizens are subject to additional security... the performance of orthopedic devices. II. Who is the target audience for this public workshop? Who should attend this public workshop? This workshop is open to all interested parties. The target...

  2. 45 CFR 1308.12 - Eligibility criteria: Orthopedic impairment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Eligibility criteria: Orthopedic impairment. 1308.12 Section 1308.12 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD...

  3. 45 CFR 1308.12 - Eligibility criteria: Orthopedic impairment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Eligibility criteria: Orthopedic impairment. 1308.12 Section 1308.12 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD...

  4. Looking at the Social Activity for Adolescents with Orthopedic Impairments

    ERIC Educational Resources Information Center

    Biastro, Leslie; Frank, Heather; Larwin, Karen H.

    2015-01-01

    Adolescents with identified orthopedic impairments are often less likely to participate in social activities outside of the school setting. However, the adolescents who are able to participate in activities have higher social skills, more academic successes, and show more satisfaction in their roles as family member or friend. The aim of this…

  5. Outpatient parenteral antimicrobial therapy for orthopedic infections - a successful public healthcare experience in Brazil.

    PubMed

    Oliveira, Priscila Rosalba; Felix, Cassia da Silva; Carvalho, Vladimir Cordeiro de; Giovani, Arlete Mazzini; Reis, Rosangela Suarti Dos; Beraldo, Marisa; Albuquerque, Edmir Peralta; Ferreira, Walter Cintra; Silva, Jorge Dos Santos; Lima, Ana Lucia Lei

    2016-01-01

    Treatment of orthopedic infections usually requires prolonged antimicrobial therapy, ranging from 14 days up to 6 months. Nowadays, rising levels of antimicrobial resistance demands parenteral therapy for many patients. Outpatient parenteral antimicrobial therapy (OPAT) is a modality that allows treatment out of hospital in these situations. In Brazil, where a public universal healthcare system allows full coverage for all citizens, implantation and dissemination of OPAT programs would be beneficial for patients and for the system, because it would allow a better allocation of health resources. The Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da USP (IOT) started, in July 2013, a partnership with municipal health authorities in Sao Paulo, Brazil, in order to initiate an OPAT program in which patients discharged from that hospital would be able to continue antimicrobial therapy at primary care facilities. When necessary, patients could also receive their therapy at the day-hospital located at IOT. Primary care nursing and physician staff were trained about antimicrobial infusion and peripherally inserted central catheter manipulation. An OPAT specific antimicrobial protocol was designed and a special reference and counter-reference organized. As a result, 450 primary healthcare professionals were trained. In the first year of this program, 116 patients were discharged for OPAT. Chronic and acute osteomyelitis were most frequent diagnosis. Teicoplanin, ertapenem and tigecycline were the most used drugs. Duration of treatment varied from 10 to 180 days (average 101, median 42). Total sum of days in OPAT regimen was 11,698. Only 3 patients presented adverse effects. Partnership between services of different levels of complexity allowed implantation of a safe and effective public healthcare OPAT program for treatment of orthopedic infections. This program can serve as a model for developing similar strategies in other regions

  6. Mainstreaming Preschoolers: Children with Orthopedic Handicaps. A Guide for Teachers, Parents, and Others Who Work with Orthopedically Handicapped Preschoolers.

    ERIC Educational Resources Information Center

    Kieran, Shari Stokes; And Others

    This guide to mainstreaming preschoolers with orthopedic handicaps is one of a series of eight manuals on mainstreaming preschoolers developed by Project Head Start. The guide is addressed to parents, teachers, and other professionals and paraprofessionals. Chapter I presents information on the meaning, benefits and implementation of…

  7. Direct Manipulation Interfaces.

    ERIC Educational Resources Information Center

    Hutchins, Edwin L.; And Others

    This paper presents a cognitive account of both the advantages and disadvantages of direct manipulation interfaces, i.e., the use of icons to manipulate and interact directly with data rather than writing programs or calling on a set of statistical subroutines. Two underlying phenomena that give rise to the sensation of directness are identified.…

  8. Revisiting Mathematics Manipulative Materials

    ERIC Educational Resources Information Center

    Swan, Paul; Marshall, Linda

    2010-01-01

    It is over 12 years since "APMC" published Bob Perry and Peter Howard's research on the use of mathematics manipulative materials in primary mathematics classrooms. Since then the availability of virtual manipulatives and associated access to computers and interactive whiteboards have caused educators to rethink the use of mathematics manipulative…

  9. Manipulator comparative testing program

    SciTech Connect

    Draper, J.V.; Handel, S.J.; Sundstrom, E.; Herndon, J.N.; Fujita, Y.; Maeda, M.

    1986-01-01

    The Manipulator Comparative Testing Program examined differences among manipulator systems from the United States and Japan. The manipulator systems included the Meidensha BILARM 83A, the Model M-2 of Central Research Laboratories Division of Sargent Industries (CRL), and the GCA Corporation PaR Systems Model 6000. The site of testing was the Remote Operations Maintenance Demonstration (ROMD) facility, operated by the Fuel Recycle Division in the Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory (ORNL). In all stages of testing, operators using the CRL Model M-2 manipulator had consistently lower times to completion and error rates than they did using other machines. Performance was second best with the Meidensha BILARM 83A in master-slave mode. Performance with the BILARM in switchbox mode and the PaR 6000 manipulator was approximately equivalent in terms of criteria recorded in testing. These data show no impact of force reflection on task performance.

  10. Osteopathic Manipulative Treatment

    PubMed Central

    Campbell, Shannon M.; Walkowski, Stevan

    2012-01-01

    Dermatological diseases, such as dysesthesia syndromes, stasis dermatoses, and hyperhidrosis are difficult to treat due to their complex etiologies. Current theories suggest these diseases are caused by physiological imbalances, such as nerve impingement, localized tissue congestion, and impaired autonomic regulation. Osteopathic manipulative therapy targets these physiological dysfunctions and may serve as a beneficial therapeutic option. Osteopathic manipulative therapy techniques include high velocity low amplitude, muscle energy, counterstrain, myofascial release, craniosacral, and lymphatic drainage. An osteopathic manipulative therapy technique is chosen based on its physiological target for a particular disease. Osteopathic manipulative therapy may be useful alone or in combination with standard therapeutic options. However, due to the lack of standardized trials supporting the efficacy of osteopathic manipulative therapy treatment for dermatological disease, randomized, well-controlled studies are necessary to confirm its therapeutic value. PMID:23125887

  11. Computer-Assisted Orthopedic Surgery: Current State and Future Perspective

    PubMed Central

    Zheng, Guoyan; Nolte, Lutz P.

    2015-01-01

    Introduced about two decades ago, computer-assisted orthopedic surgery (CAOS) has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined. PMID:26779486

  12. Radiation exposure from fluoroscopy during orthopedic surgical procedures

    SciTech Connect

    Riley, S.A. )

    1989-11-01

    The use of fluoroscopy has enabled orthopedic surgeons to become technically more proficient. In addition, these surgical procedures tend to have less associated patient morbidity by decreasing operative time and minimizing the area of the operative field. The trade-off, however, may be an increased risk of radiation exposure to the surgeon on an annual or lifetime basis. The current study was designed to determine the amount of radiation received by the primary surgeon and the first assistant during selected surgical procedures involving the use of fluoroscopy. Five body sites exposed to radiation were monitored for dosage. The results of this study indicate that with appropriate usage, (1) radiation exposure from fluoroscopy is relatively low; (2) the surgeon's dominant hand receives the most exposure per case; and (3) proper maintenance and calibration of fluoroscopic machines are important factors in reducing exposure risks. Therefore, with proper precautions, the use of fluoroscopy in orthopedic procedures can remain a safe practice.

  13. Computer-Assisted Orthopedic Surgery: Current State and Future Perspective.

    PubMed

    Zheng, Guoyan; Nolte, Lutz P

    2015-01-01

    Introduced about two decades ago, computer-assisted orthopedic surgery (CAOS) has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined. PMID:26779486

  14. Online reviews of orthopedic surgeons: an emerging trend.

    PubMed

    Frost, Chelsea; Mesfin, Addisu

    2015-04-01

    Various websites are dedicated to rating physicians. The goals of this study were to: (1) evaluate the prevalence of orthopedic surgeon ratings on physician rating websites in the United States and (2) evaluate factors that may affect ratings, such as sex, practice sector (academic or private), years of practice, and geographic location. A total of 557 orthopedic surgeons selected from the 30 most populated US cities were enrolled. The study period was June 1 to July 31, 2013. Practice type (academic vs private), sex, geographic location, and years since completion of training were evaluated. For each orthopedic surgeon, numeric ratings from 7 physician rating websites were collected. The ratings were standardized on a scale of 0 to 100. Written reviews were also collected and categorized as positive or negative. Of the 557 orthopedic surgeons, 525 (94.3%) were rated at least once on 1 of the physician rating websites. The average rating was 71.4. The study included 39 female physicians (7.4%) and 486 male physicians (92.6%). There were 204 (38.9%) physicians in academic practice and 321 (61.1%) in private practice. The greatest number of physicians, 281 (50.4%), practiced in the South and Southeast, whereas 276 (49.6%) practiced in the West, Midwest, and Northeast. Those in academic practice had significantly higher ratings (74.4 vs 71.1; P<.007). No significant difference based on sex (72.5 male physicians vs 70.2 female physicians; P=.17) or geographic location (P=.11) were noted. Most comments (64.6%) were positive or extremely positive. Physicians who were in practice for 6 to 10 years had significantly higher ratings (76.9, P<.01) than those in practice for 0 to 5 years (70.5) or for 21 or more years (70.7). PMID:25901617

  15. Pediatric orthopedic surgical simulation at Boston Children's Hospital.

    PubMed

    Bae, Donald S; Waters, Peter M

    2016-07-01

    Orthopedic surgical simulation has become an increasing valuable means for optimizing patient care, promoting patient safety, improving education, and fostering clinical research. The purpose of this review was to discuss the rationale for simulation training, describe current simulation efforts within the Department of Orthopaedic Surgery at Boston Children's Hospital, and provide an example of how these simulation efforts touch both patient care and clinical research. PMID:27058820

  16. Blood conservation strategies in orthopedic surgeries: A review

    PubMed Central

    Sambandam, Balaji; Batra, Sahil; Gupta, Rajat; Agrawal, Nidhi

    2013-01-01

    In orthopedics management of surgical blood loss is an important aspect which has evolved along with modern surgeries. Replacement of lost blood by transfusion alone is not the answer as was considered earlier. Complications like infection and immune reaction due to blood transfusion are a major concern. Today numerous techniques are available in place of allogenic blood transfusion which can be employed safely and effectively. In this article we have reviewed these techniques, their merits and demerits. PMID:26403876

  17. Orthopedic cellular therapy: An overview with focus on clinical trials

    PubMed Central

    Noh, Moon Jong; Lee, Kwan Hee

    2015-01-01

    In this editorial, the authors tried to evaluate the present state of cellular therapy in orthopedic field. The topics the authors try to cover include not only the clinical trials but the various research areas as well. Both the target diseases for cellular therapy and the target cells were reviewed. New methods to activate the cells were interesting to review. Most advanced clinical trials were also included because several of them have advanced to phase III clinical trials. In the orthopedic field, there are many diseases with a definite treatment gap at this time. Because cellular therapies can regenerate damaged tissues, there is a possibility for cellular therapies to become disease modifying drugs. It is not clear whether cellular therapies will become the standard of care in any of the orthopedic disorders, however the amount of research being performed and the number of clinical trials that are on-going make the authors believe that cellular therapies will become important treatment modalities within several years. PMID:26601056

  18. Clinical conundrums and challenges during geriatric orthopedic emergency surgeries

    PubMed Central

    Bajwa, Sukhminder Jit Singh

    2015-01-01

    Despite so many advancements and innovations in anesthetic techniques, expectations and challenges have also grown in plenty. Cardiac, pediatric, obstetric and neuro-anesthesia have perfectly developed to fulfill the desired needs of respective patient population. However, geriatric anesthesia has been shown a lesser interest in teaching and clinical practices over the years as compared with other anesthetic sub-specialties. The large growing geriatric population globally is also associated with an increase number of elderly patients presenting for orthopedic emergency surgeries. Orthopedic emergency surgery in geriatric population is not only a daunting clinical challenge but also has numerous socio-behavioral and economic ramifications. Decision making in anesthesia is largely influenced by the presence of co-morbidities, neuro-cognitive functions and the current socio-behavioral status. Pre-anesthetic evaluation and optimization are extremely important for a better surgical outcome but is limited by time constraints during emergency surgery. The current review aims to highlight comprehensively the various clinical, social, behavioral and psychological aspects during pre-anesthetic evaluation associated with emergency orthopedic surgery in geriatric population. PMID:25810963

  19. Student opinions on orthopedic residency selection, education, and work hours.

    PubMed

    Hussain, Waqas; Hussain, Haroon; Manning, David W

    2013-08-01

    Other articles have been written about resident selection, musculoskeletal education, work hours, and call coverage, but none has described orthopedic applicants' opinions on these issues. We conducted a study to gain insight into applicants' attitudes about issues relevant to the specialty. We distributed a survey to 53 applicants interviewing for an orthopedic residency. The survey used both a multiple-choice format and a Likert scale ranging from 1 (strongly disagree or least important) to 5 (strongly agree or most important). Respondents rated the adequacy of musculoskeletal education in medical school a mean standard deviation (SD) of 2.00 (0.8) on the Likert scale. Ranking the factors most valuable to an orthopedic surgery application, they rated United States Medical Licensing Examination (USMLE) Step 1 board examination scores a mean (SD) of 4.26 (0.9). In addition, of the 53 respondents, 46 (87%) anticipated working as a resident more than 80 hours per week, and 36 (68%) anticipated working as an attending 60 to 70 hours per week or less. Respondents also agreed that they should receive compensation for call coverage. Therefore, students agreed that medical school education is insufficient, rated USMLE scores the most important application factor, anticipated working more than 80 hours per week, and agreed that call coverage should be compensated. PMID:24078953

  20. Anesthetic considerations in orthopedic patients with or without trauma.

    PubMed

    Chohan, Amandeep S

    2010-05-01

    Anesthetic management of orthopedic patients could vary from normal routine management to more challenging critical management depending on the state in which the patient is presented. Multimodal pain management strategies incorporating opioids, which are the mainstay drugs for pain management, along with adjunctive drugs like local anesthetics (eg, lidocaine), dissociative anesthetics (eg, ketamine), and alpha-2 agonists (eg, dexmedetomidine), could improve overall patient comfort and help prevent establishment of chronic pain pathways. Also, use of local nerve blocks can prevent nociception right at the point of origin. Orthopedic patients with multiple organ traumas like head injuries, spinal injuries, pulmonary fat embolism, compartment syndrome, or thoracic injuries are high-risk patients in which any life-threatening organ pathology should be addressed before the patient is put under general anesthesia. Interactions of various drugs like antibiotics and neuromuscular blocking agents used in the perioperative period in orthopedic patients should warrant a careful consideration with respect to their interactions with each other and other anesthetic drugs used. PMID:20515674

  1. Update: Biochemistry of Genetic Manipulation.

    ERIC Educational Resources Information Center

    Barker, G. R.

    1983-01-01

    Various topics on the biochemistry of genetic manipulation are discussed. These include genetic transformation and DNA; genetic expression; DNA replication, repair, and mutation; technology of genetic manipulation; and applications of genetic manipulation. Other techniques employed are also considered. (JN)

  2. Osteopathic Manipulative Treatment

    MedlinePlus

    ... what patients really need is a healing touch. Osteopathic physicians haven't forgotten. Osteopathic manipulative treatment, or OMT, ... and prevent illness or injury. Using OMT, your osteopathic physician will move your muscles and joints using techniques ...

  3. Dielectrophoresis for bioparticle manipulation.

    PubMed

    Qian, Cheng; Huang, Haibo; Chen, Liguo; Li, Xiangpeng; Ge, Zunbiao; Chen, Tao; Yang, Zhan; Sun, Lining

    2014-01-01

    As an ideal method to manipulate biological particles, the dielectrophoresis (DEP) technique has been widely used in clinical diagnosis, disease treatment, drug development, immunoassays, cell sorting, etc. This review summarizes the research in the field of bioparticle manipulation based on DEP techniques. Firstly, the basic principle of DEP and its classical theories are introduced in brief; Secondly, a detailed introduction on the DEP technique used for bioparticle manipulation is presented, in which the applications are classified into five fields: capturing bioparticles to specific regions, focusing bioparticles in the sample, characterizing biomolecular interaction and detecting microorganism, pairing cells for electrofusion and separating different kinds of bioparticles; Thirdly, the effect of DEP on bioparticle viability is analyzed; Finally, the DEP techniques are summarized and future trends in bioparticle manipulation are suggested. PMID:25310652

  4. Classifying human manipulation behavior.

    PubMed

    Bullock, Ian M; Dollar, Aaron M

    2011-01-01

    This paper presents a taxonomy for detailed classification of human and anthropomorphic manipulation behavior. This hand-centric, motion-centric taxonomy differentiates tasks based on criteria such as object contact, prehension, and the nature of object motion relative to a hand frame. A sub-classification of the most dexterous categories, within-hand manipulation, is also presented, based on the principal axis of object rotation or translation in the hand frame. Principles for categorizing complex, multi-faceted tasks are also presented, along with illustrative examples. We hope that the proposed taxonomy will both establish a standard language around human and anthropomorphic manipulation as well as enable improved understanding of the differences in hand use for a wide variety of behavior. Although designed for human and anthropomorphic hands, the taxonomy might easily be extended to a wide range of robot manipulators and end-effectors. PMID:22275611

  5. Dielectrophoresis for Bioparticle Manipulation

    PubMed Central

    Qian, Cheng; Huang, Haibo; Chen, Liguo; Li, Xiangpeng; Ge, Zunbiao; Chen, Tao; Yang, Zhan; Sun, Lining

    2014-01-01

    As an ideal method to manipulate biological particles, the dielectrophoresis (DEP) technique has been widely used in clinical diagnosis, disease treatment, drug development, immunoassays, cell sorting, etc. This review summarizes the research in the field of bioparticle manipulation based on DEP techniques. Firstly, the basic principle of DEP and its classical theories are introduced in brief; Secondly, a detailed introduction on the DEP technique used for bioparticle manipulation is presented, in which the applications are classified into five fields: capturing bioparticles to specific regions, focusing bioparticles in the sample, characterizing biomolecular interaction and detecting microorganism, pairing cells for electrofusion and separating different kinds of bioparticles; Thirdly, the effect of DEP on bioparticle viability is analyzed; Finally, the DEP techniques are summarized and future trends in bioparticle manipulation are suggested. PMID:25310652

  6. Dexterous manipulator flight demonstration

    NASA Technical Reports Server (NTRS)

    Carter, Edward L.

    1989-01-01

    The Dexterous Manipulator Flight Experiment, an outgrowth of the Dexterous End Effector project, is an experiment to demonstrate newly developed equipment and methods that make for a dexterous manipulator which can be used on the Space Shuttle or other space missions. The goals of the project, the objectives of the flight experiment, the experiment equipment, and the tasks to be performed during the demonstration are discussed.

  7. Remote manipulator dynamic simulation

    NASA Technical Reports Server (NTRS)

    Wild, E. C.; Donges, P. K.; Garand, W. A.

    1972-01-01

    A simulator to generate the real time visual scenes required to perform man in the loop investigations of remote manipulator application and design concepts for the space shuttle is described. The simulated remote manipulator consists of a computed display system that uses a digital computer, the electronic scene generator, an operator's station, and associated interface hardware. A description of the capabilities of the implemented simulation is presented. The mathematical models and programs developed for the simulation are included.

  8. Micro manipulator motion control to counteract macro manipulator structural vibrations

    SciTech Connect

    Lew, J.Y.; Trudnowski, D.J.; Evans, M.S.; Bennett, D.W.

    1995-02-01

    Inertial force damping control by micro manipulator modulation is proposed to suppress the vibrations of a micro/macro manipulator system. The proposed controller, developed using classical control theory, is added to the existing control system. The proposed controller uses real-time measurements of macro manipulator flexibility to adjust the motion of the micro manipulator to counteract structural vibrations. Experimental studies using an existing micro/macro flexible link manipulator testbed demonstrate the effectiveness of the proposed approach to suppression of vibrations in the macro/micro manipulator system using micro-manipulator-based inertial active damping control.

  9. Trends in the orthopedic job market and the importance of fellowship subspecialty training.

    PubMed

    Morrell, Nathan T; Mercer, Deana M; Moneim, Moheb S

    2012-04-01

    Previous studies have examined possible incentives for pursuing orthopedic fellowship training, but we are unaware of previously published studies reporting the trends in the orthopedic job market since the acceptance of certain criteria for fellowship programs by the Accreditation Council for Graduate Medical Education (ACGME) in 1985. We hypothesized that, since the initiation of accredited postresidency fellowship programs, job opportunities for fellowship-trained orthopedic surgeons have increased and job opportunities for nonfellowship-trained orthopedic surgeons have decreased. We reviewed the job advertisements printed in the Journal of Bone and Joint Surgery, American Volume, for the years 1984, 1994, 2004, and 2009. We categorized the job opportunities as available for either a general (nonfellowship-trained) orthopedic surgeon or a fellowship-trained orthopedic surgeon. Based on the advertisements posted in the Journal of Bone and Joint Surgery, American Volume, a trend exists in the orthopedic job market toward seeking fellowship-trained orthopedic surgeons. In the years 1984, 1994, 2004, and 2009, the percentage of job opportunities seeking fellowship-trained orthopedic surgeons was 16.7% (95% confidence interval [CI], 13.1%-20.3%), 40.6% (95% CI, 38.1%-43.1%), 52.2% (95% CI, 48.5%-55.9%), and 68.2% (95% CI, 65.0%-71.4%), respectively. These differences were statistically significant (analysis of variance, P<.05). Fellowship training is thus a worthwhile endeavor. PMID:22495859

  10. Manipulator comparative testing program

    SciTech Connect

    Draper, J.V.; Handel, S.J.; Sundstrom, E.; Herndon, J.N.; Fujita, Y.; Maida, M.

    1986-01-01

    The Manipulator Comparative Testing Program compared performance of selected manipulator systems under typical remote handling conditions. The site of testing was the Remote Operations and Maintenance Demonstration Facility operated by the Consolidated Fuel Reprocessing Program of the Oak Ridge National Laboratory. Three experiment examined differences among manipulator systems from the US and Japan. The manipulator systems included the Meidensha BILARM 83A, Central Research Laboratories' (CRL's) Model M-2, and GCA PaR systems Model 6000. Six manipulator and control mode combinations were evaluated: (a) the BILARM in master-slave mode without force reflection; (b) the BILARM in master-slave mode with force reflection; (c) the Model M-2 in master-slave mode without force reflection; (d) the Model M-2 in master-slave mode with force reflection; (e) the BILARM with switchbox controls; and (f) the PaR 6000 with switchbox controls. The experiments also examined differences between master-slave systems with and without force reflections, and differences between master-slave systems and switchbox-controlled systems.

  11. Simulation of robot manipulators

    SciTech Connect

    Kress, R.L.; Babcock, S.M.; Bills, K.C.; Kwon, D.S.; Schoenwald, D.A.

    1995-03-01

    This paper describes Oak Ridge National Laboratory`s development of an environment for the simulation of robotic manipulators. Simulation includes the modeling of kinematics, dynamics, sensors, actuators, control systems, operators, and environments. Models will be used for manipulator design, proposal evaluation, control system design and analysis, graphical preview of proposed motions, safety system development, and training. Of particular interest is the development of models for robotic manipulators having at least one flexible link. As a first application, models have been developed for the Pacific Northwest Laboratories` Flexible Beam Testbed which is a one-Degree-Of-Freedom, flexible arm with a hydraulic base actuator. Initial results show good agreement between model and experiment.

  12. Venting during prophylactic nailing for femoral metastases: current orthopedic practice

    PubMed Central

    Dalgorf, Dustin; Borkhoff, Cornelia M.; Stephen, David J.G.; Finkelstein, Joel; Kreder, Hans J.

    2003-01-01

    Introduction Reamed intramedullary nailing, recommended for impending fracture of a femur weakened by bone metastases, causes a rise in intramedullary pressure and increases the risk of a fat embolism syndrome. The pressure can be equalized by the technique of venting — drilling a hole into the distal cortex of the femur. Our objective was to study the current practice of orthopedic surgeons in Ontario with respect to venting during prophylactic intramedullary nailing for an impending femoral fracture due to bone metastases. Methods We mailed a questionnaire to all orthopedic surgeons from the Province of Ontario listed in the 1999 Canadian Medical Directory or on the Canadian Orthopaedic Association membership list, asking if they vent when prophylactically nailing an impending pathologic femoral fracture. The responses were modelled as a function of surgeon volume and year of graduation. Results Of the 415 surveys mailed, 223 (54%) surgeons responded. Of these, 81% reported having prophylactically treated a femoral metastatic lesion during the previous year; 67% treated 1 to 3 metastatic lesions and 14% treated more than 3; 19% did not treat a metastatic femoral lesion prophylactically. Over two-thirds of surgeons had never considered venting, whereas one-third always or sometimes vented the femoral canal. More recent graduates were 3 times more likely to vent than earlier (before 1980) graduates (odds ratio [OR] = 3.2, 95% confidence interval [CI] 1.6–6.5) as were those who treat a greater number of impending fractures (OR = 1.4, 95% CI 1.1–1.7). Conclusions Although there is a theoretical rationale for routine venting, there is disagreement among Ontario orthopedic surgeons regarding the use of this technique during prophylactic nailing for femoral metastatic lesions. Prospective evidence will be required to warrant a change in the standard of care. PMID:14680349

  13. Minocycline-Induced Cutaneous Hyperpigmentation in an Orthopedic Patient Population

    PubMed Central

    Hanada, Yuri; Berbari, Elie F.; Steckelberg, James M.

    2016-01-01

    Background. The objectives of this study were to estimate the incidence and evaluate risk factors for development of minocycline-induced cutaneous hyperpigmentation in patients with orthopedic infections. Methods. Patients with orthopedic infections evaluated at Mayo Clinic (Rochester, MN) and treated with minocycline from 1 January 2002 to 31 December 2011 were retrospectively identified. Long-term minocycline suppression was defined as daily minocycline use for at least 3 months. A proportional hazards model was used to evaluate potential risk factors. Results. Of 291 patients receiving long-term minocycline suppression, 54% (156 of 291) developed hyperpigmentation after a mean follow-up of 4.8 years (range, 0.3–13.2 years); 88% involved blue-gray pigmentation of normal skin that appeared most commonly in the lower (75%) and upper extremities (44%). The mean duration of minocycline therapy before hyperpigmentation was 1.5 years (range, 0.1–9 years) with a mean cumulative dosage of 107.3 g (range, 8.6–657 g). Notable risk factors include a history of vitamin D deficiency (relative risk [RR], 6.29; 95% confidence interval [CI], 1.91–15.27; P = .0052), presence of a shoulder prosthesis (RR, 3.2; 95% CI, 1.23–6.56; P = .0062), noncirrhotic liver pathology (RR, 3.63; 95% CI, 1.11–8.75; P = .0359), and use of a concurrent medication also known to cause hyperpigmentation (RR, 4.75; 95% CI, 1.83–10.1; P = .0029). Conclusions. Hyperpigmentation associated with the use of long-term minocycline suppression in patients with orthopedic infections is common. PMID:26835479

  14. ELECTRONIC MASTER SLAVE MANIPULATOR

    DOEpatents

    Goertz, R.C.; Thompson, Wm.M.; Olsen, R.A.

    1958-08-01

    A remote control manipulator is described in which the master and slave arms are electrically connected to produce the desired motions. A response signal is provided in the master unit in order that the operator may sense a feel of the object and may not thereby exert such pressures that would ordinarily damage delicate objects. This apparatus will permit the manipulation of objects at a great distance, that may be viewed over a closed TV circuit, thereby permitting a remote operator to carry out operations in an extremely dangerous area with complete safety.

  15. Model based manipulator control

    NASA Technical Reports Server (NTRS)

    Petrosky, Lyman J.; Oppenheim, Irving J.

    1989-01-01

    The feasibility of using model based control (MBC) for robotic manipulators was investigated. A double inverted pendulum system was constructed as the experimental system for a general study of dynamically stable manipulation. The original interest in dynamically stable systems was driven by the objective of high vertical reach (balancing), and the planning of inertially favorable trajectories for force and payload demands. The model-based control approach is described and the results of experimental tests are summarized. Results directly demonstrate that MBC can provide stable control at all speeds of operation and support operations requiring dynamic stability such as balancing. The application of MBC to systems with flexible links is also discussed.

  16. Endoscopic Management of Free Lying Migratory Orthopedic Screw in Bladder.

    PubMed

    P, Puvai Murugan; M, Ramalingam

    2016-09-01

    75-year old gentleman presented with acute urinary retention. He had met with road traffic accident 15 years back and sustained pelvic fracture and bladder rupture, underwent bladder repair and open reduction and internal fixation of pubic symphsis. Imaging studies showed the free lying encrusted orthopedic screw in the bladder, which was removed per urethra using nephroscope. Migratory foreign bodies in the urinary bladder are rare. However there is a possibility of longstanding foreign bodies in adjacent structures to erode and perforate into the bladder. Inside the bladder these foreign bodies act as nidus for stone formation. PMID:27500087

  17. [Orthokin as new therapeutic option for orthopedic diseases].

    PubMed

    Heyll, U

    2004-03-01

    The synthesis and introduction of interleukin-1 receptor antagonists established a promising strategy in the treatment of inflammatory diseases. This kind of therapy is claimed now to be available for osteoarthritis and other orthopedic disorders also. In the case of "orthokin", the interleukin-1 receptor antagonist is produced by stimulation of own blood-cells. It is not possible, to evaluate the practicability of this therapeutic approach because there are no published experimental data. We also found no results of clinical studies, which would allow an estimation of the effectiveness and the risks of this method. Therefore treatment with "orthokin" cannot be recommended at present. PMID:15049471

  18. RANDOMIZED CONTROLLED CLINICAL TRIALS IN ORTHOPEDICS: DIFFICULTIES AND LIMITATIONS

    PubMed Central

    Malavolta, Eduardo Angeli; Demange, Marco Kawamura; Gobbi, Riccardo Gomes; Imamura, Marta; Fregni, Felipe

    2015-01-01

    Randomized controlled clinical trials (RCTs) are considered to be the gold standard for evidence-based medicine nowadays, and are important for directing medical practice through consistent scientific observations. Steps such as patient selection, randomization and blinding are fundamental for conducting a RCT, but some additional difficulties are presented in trials that involve surgical procedures, as is common in orthopedics. The aim of this article was to highlight and discuss some difficulties and possible limitations on RCTs within the field of surgery. PMID:27027037

  19. Presurgical Dentofacial Orthopedic Management of the Cleft Patient.

    PubMed

    Smith, Kevin S; Henry, Byron T; Scott, Michelle A

    2016-05-01

    Over the last decade, presurgical orthopedic molding for the patient with cleft lip and palate has become much more common; it is even reasonable to assume it may be the standard of care for those wide unilateral and bilateral clefts with substantial dentofacial deformities. In 2013, there was a comparative study of nasoalveolar molding methods, comparing the Grayson-NAM device and DynaCleft. The results showed the 2 to be equivocal with both methods significantly reducing the cleft width and improving the nasal asymmetry. PMID:27150304

  20. Surface evaluation of orthopedic hip implants marketed in Brazil

    NASA Astrophysics Data System (ADS)

    Souza, M. M.; Trommer, R. M.; Maru, M. M.; Roesler, C. R. M.; Barros, W. S.; Dutra, M. S.

    2016-07-01

    One of the factors that contribute to the quality of total hip prostheses is the degree of accuracy in the manufacturing of the joint surfaces. The dimensional control of joint components is important because of its direct influence on the durability and, consequently, in the patients’ life quality. This work presents studies on the form and roughness of orthopedic hip prostheses marketed in Brazil. The results provide data for quality control of the surfaces of the femoral heads and acetabular components of hip prostheses and indicate the need of improvement in the procedures used to this control.

  1. Manipulating Combinatorial Structures.

    ERIC Educational Resources Information Center

    Labelle, Gilbert

    This set of transparencies shows how the manipulation of combinatorial structures in the context of modern combinatorics can easily lead to interesting teaching and learning activities at every level of education from elementary school to university. The transparencies describe: (1) the importance and relations of combinatorics to science and…

  2. Manipulating the Gradient

    ERIC Educational Resources Information Center

    Gaze, Eric C.

    2005-01-01

    We introduce a cooperative learning, group lab for a Calculus III course to facilitate comprehension of the gradient vector and directional derivative concepts. The lab is a hands-on experience allowing students to manipulate a tangent plane and empirically measure the effect of partial derivatives on the direction of optimal ascent. (Contains 7…

  3. Trust versus Manipulation

    ERIC Educational Resources Information Center

    Lewis, Anne C.

    2005-01-01

    This article discusses the issue of trust in the education system. What is different about the issue of trust in the education system is the assault upon it, sometimes overt but most often subtle. There is a difference between strong criticism and willful manipulation. The nation's schools are responding to the former--perhaps too slowly for…

  4. Kinematically redundant robot manipulators

    NASA Technical Reports Server (NTRS)

    Baillieul, J.; Hollerbach, J.; Brockett, R.; Martin, D.; Percy, R.; Thomas, R.

    1987-01-01

    Research on control, design and programming of kinematically redundant robot manipulators (KRRM) is discussed. These are devices in which there are more joint space degrees of freedom than are required to achieve every position and orientation of the end-effector necessary for a given task in a given workspace. The technological developments described here deal with: kinematic programming techniques for automatically generating joint-space trajectories to execute prescribed tasks; control of redundant manipulators to optimize dynamic criteria (e.g., applications of forces and moments at the end-effector that optimally distribute the loading of actuators); and design of KRRMs to optimize functionality in congested work environments or to achieve other goals unattainable with non-redundant manipulators. Kinematic programming techniques are discussed, which show that some pseudo-inverse techniques that have been proposed for redundant manipulator control fail to achieve the goals of avoiding kinematic singularities and also generating closed joint-space paths corresponding to close paths of the end effector in the workspace. The extended Jacobian is proposed as an alternative to pseudo-inverse techniques.

  5. Computer Algebra versus Manipulation

    ERIC Educational Resources Information Center

    Zand, Hossein; Crowe, David

    2004-01-01

    In the UK there is increasing concern about the lack of skill in algebraic manipulation that is evident in students entering mathematics courses at university level. In this note we discuss how the computer can be used to ameliorate some of the problems. We take as an example the calculations needed in three dimensional vector analysis in polar…

  6. Door breaching robotic manipulator

    NASA Astrophysics Data System (ADS)

    Schoenfeld, Erik; Parrington, Lawrence; von Muehlen, Stephan

    2008-04-01

    As unmanned systems become more commonplace in military, police, and other security forces, they are tasked to perform missions that the original hardware was not designed for. Current military robots are built for rough outdoor conditions and have strong inflexible manipulators designed to handle a wide range of operations. However, these manipulators are not well suited for some essential indoor tasks, including opening doors. This is a complicated kinematic task that places prohibitively difficult control challenges on the robot and the operator. Honeybee and iRobot have designed a modular door-breaching manipulator that mechanically simplifies the demands upon operator and robot. The manipulator connects to the existing robotic arm of the iRobot PackBot EOD. The gripper is optimized for grasping a variety of door knobs, levers, and car-door handles. It works in conjunction with a compliant wrist and magnetic lock-out mechanism that allows the wrist to remain rigid until the gripper has a firm grasp of the handle and then bend with its rotation and the swing of the door. Once the door is unlatched, the operator simply drives the robot through the doorway while the wrist compensates for the complex, multiple degree-of-freedom motion of the door. Once in the doorway the operator releases the handle, the wrist pops back into place, and the robot is ready for the next door. The new manipulator dramatically improves a robot's ability to non-destructively breach doors and perform an inspection of a room's content, a capability that was previously out of reach of unmanned systems.

  7. Angiogenesis and osteogenesis in an orthopedically expanded suture

    NASA Technical Reports Server (NTRS)

    Chang, H. N.; Garetto, L. P.; Potter, R. H.; Katona, T. R.; Lee, C. H.; Roberts, W. E.

    1997-01-01

    The purpose of this study was to examine the angiogenic and the subsequent osteogenic responses during a 96-hour time-course after sutural expansion. Fifty rats were divided into: (1) a control group that received only angiogenic induction through injection of 5 ng/gm recombinant human endothelial cell growth factor (rhECGF); (2) an experimental group that received orthopedic expansion and rhECGF; (3) a sham group that received expansion and sodium chloride (NaCl) injection; and (4) a baseline group that received no expansion or injection. All rats were injected with 3H-thymidine (1.0 microCi/gm) 1 hour before death to label the DNA of S-phase cells. Demineralized sections (4 microm thick) were stained with hematoxylin and eosin. Angiogenesis and cell migration were analyzed with a previously established cell kinetics model. Analysis of variance was used to test the hypothesis that enhancement of angiogenesis stimulates reestablishment of osteogenic capability. Blood vessel number, area, and endothelial cell-labeled index significantly increased in experimental groups, but no difference was found between control and baseline groups. Labeled-pericyte index and activated pericyte numbers in the experimental group were also higher than in the sham groups. These results show that supplemental rhECGF enhances angiogenesis in expanded sutures but not in nonexpanded sutures. Data also suggest that pericytes are the source of osteoblasts in an orthopedically expanded suture.

  8. Experimental and clinical performance of porous tantalum in orthopedic surgery.

    PubMed

    Levine, Brett Russell; Sporer, Scott; Poggie, Robert A; Della Valle, Craig J; Jacobs, Joshua J

    2006-09-01

    Porous tantalum, a new low modulus metal with a characteristic appearance similar to cancellous bone, is currently available for use in several orthopedic applications (hip and knee arthroplasty, spine surgery, and bone graft substitute). The open-cell structure of repeating dodecahedrons is produced via carbon vapor deposition/infiltration of commercially pure tantalum onto a vitreous carbon scaffolding. This transition metal maintains several interesting biomaterial properties, including: a high volumetric porosity (70-80%), low modulus of elasticity (3MPa), and high frictional characteristics. Tantalum has excellent biocompatibility and is safe to use in vivo as evidenced by its historical and current use in pacemaker electrodes, cranioplasty plates and as radiopaque markers. The bioactivity and biocompatibility of porous tantalum stems from its ability to form a self-passivating surface oxide layer. This surface layer leads to the formation of a bone-like apatite coating in vivo and affords excellent bone and fibrous in-growth properties allowing for rapid and substantial bone and soft tissue attachment. Tantalum-chondrocyte composites have yielded successful early results in vitro and may afford an option for joint resurfacing in the future. The development of porous tantalum is in its early stages of evolution and the following represents a review of its biomaterial properties and applications in orthopedic surgery. PMID:16737737

  9. An orthopedic tissue adhesive for targeted delivery of intraoperative biologics.

    PubMed

    Simson, Jacob; Crist, Joshua; Strehin, Iossif; Lu, Qiaozhi; Elisseeff, Jennifer H

    2013-03-01

    Tissue adhesives can bind together damaged tissues and serve as tools to deliver and localize therapeutics to facilitate regeneration. One emerging therapeutic trend in orthopedics is the use of intraoperative biologics (IOB), such as bone marrow (BM) and platelet-rich plasma (PRP), to stimulate healing. Here, we introduce the application of the biomaterial chondroitin sulfate succinimidyl succinate (CS-NHS) to deliver IOB in a hydrogel adhesive. We demonstrate the biomaterial's ability to bind various tissue types and its cellular biocompatibility with encapsulated human mesenchymal stem cells (hMSCs). Further, we examine in detail the CS-NHS adhesive combined with BM aspirate for use in bone applications. hMSCs were encapsulated in CS-BM and cultured for 5 weeks in osteogenic medium. Quantitative RT-PCR demonstrated osteogenesis via upregulation of the osteogenic transcription factor Runx2 and bone markers alkaline phosphatase and osteocalcin. Significant deposition of calcium and osteocalcin was detected using biochemical, histological, and immunohistochemical techniques. Shear testing demonstrated that the CS-BM adhesive exhibited an adhesive strength approximately an order of magnitude stronger than fibrin glue and approaching that of a cyanoacrylate adhesive. These results indicate that CS-NHS is a promising delivery tool for IOB in orthopedic applications requiring a strong, degradable, and biocompatible adhesive that supports bone growth. PMID:23097279

  10. Dynamic Patterns of Expertise: The Case of Orthopedic Medical Diagnosis

    PubMed Central

    Marwan, Norbert; Neuman, Yair; Salai, Moshe; Rath, Ehud

    2016-01-01

    The aim of this study was to analyze dynamic patterns for scanning femoroacetabular impingement (FAI) radiographs in orthopedics, in order to better understand the nature of expertise in radiography. Seven orthopedics residents with at least two years of expertise and seven board-certified orthopedists participated in the study. The participants were asked to diagnose 15 anteroposterior (AP) pelvis radiographs of 15 surgical patients, diagnosed with FAI syndrome. Eye tracking data were recorded using the SMI desk-mounted tracker and were analyzed using advanced measures and methodologies, mainly recurrence quantification analysis. The expert orthopedists presented a less predictable pattern of scanning the radiographs although there was no difference between experts and non-experts in the deterministic nature of their scan path. In addition, the experts presented a higher percentage of correct areas of focus and more quickly made their first comparison between symmetric regions of the pelvis. We contribute to the understanding of experts’ process of diagnosis by showing that experts are qualitatively different from residents in their scanning patterns. The dynamic pattern of scanning that characterizes the experts was found to have a more complex and less predictable signature, meaning that experts’ scanning is simultaneously both structured (i.e. deterministic) and unpredictable. PMID:27414794

  11. Dynamic Patterns of Expertise: The Case of Orthopedic Medical Diagnosis.

    PubMed

    Assaf, Dan; Amar, Eyal; Marwan, Norbert; Neuman, Yair; Salai, Moshe; Rath, Ehud

    2016-01-01

    The aim of this study was to analyze dynamic patterns for scanning femoroacetabular impingement (FAI) radiographs in orthopedics, in order to better understand the nature of expertise in radiography. Seven orthopedics residents with at least two years of expertise and seven board-certified orthopedists participated in the study. The participants were asked to diagnose 15 anteroposterior (AP) pelvis radiographs of 15 surgical patients, diagnosed with FAI syndrome. Eye tracking data were recorded using the SMI desk-mounted tracker and were analyzed using advanced measures and methodologies, mainly recurrence quantification analysis. The expert orthopedists presented a less predictable pattern of scanning the radiographs although there was no difference between experts and non-experts in the deterministic nature of their scan path. In addition, the experts presented a higher percentage of correct areas of focus and more quickly made their first comparison between symmetric regions of the pelvis. We contribute to the understanding of experts' process of diagnosis by showing that experts are qualitatively different from residents in their scanning patterns. The dynamic pattern of scanning that characterizes the experts was found to have a more complex and less predictable signature, meaning that experts' scanning is simultaneously both structured (i.e. deterministic) and unpredictable. PMID:27414794

  12. Inferior vena cava filter placement in orthopedic surgery.

    PubMed

    Bass, Anne R; Mattern, Christopher J; Voos, James E; Peterson, Margaret G E; Trost, David W

    2010-09-01

    Inferior vena cava (IVC) filters were developed for the treatment of venous thromboembolism but in high-risk patients are often used for prophylaxis instead. In the study reported here, we reviewed all the orthopedic surgery cases in which IVC filters were used at our institution in 2005. Charts were analyzed and patients contacted by telephone for long-term follow-up. IVC filters were used in 90 (0.96%) of the 9,348 inpatient orthopedic surgeries. Sixty-one percent of filters were placed for prophylaxis, though only 42% of patients with prophylactic filters had a contraindication to anticoagulation. Eighty-one percent of patients with prophylactic filters who received anticoagulation received warfarin. Ratios of prophylactic-to-treatment filters were 3.25 for fracture surgeries, 2.1 for arthroplasties, and 0.89 for spine surgeries. Five percent of patients with prophylactic filters developed deep vein thrombosis. Fifty-two percent of filters were retrievable, but only 40% of those were removed a mean of 5.1 months (SD, 3.9 months) after placement. Filter removal was associated with complications in 11% of patients, and in another 10% the filter could not be removed. Forty-one patients were contacted a mean of 21 months (SD, 3 months) after filter placement. Only 32% of those who still had filters were on anticoagulation at follow-up. PMID:21290021

  13. Guidelines for the Implementation of Programs for Pupils Who Are Orthopedically Handicapped.

    ERIC Educational Resources Information Center

    Black, Robert S.; Fusco, Carol B.

    Guidelines are provided for the development of programs in South Carolina for orthopedically handicapped (OH) pupils. Basic information is given concerning the definition of orthopedic handicap, the legal mandates on the education of OH pupils, funding sources, authorized programs (whether self-contained programs, resource rooms, or itinerant…

  14. The Orthopedically Disabled Child: Psychological Implications with an Individual Basis. July 1984 Revision.

    ERIC Educational Resources Information Center

    Sigmon, Scott B.

    This study describes the implications of the Individual Psychology of Alfred Adler and field theory associated with Kurt Lewin in understanding orthopedically disabled children and points out that orthopedically disabled youngsters have a remarkable range of individual differences both in type of disability as well as level of adjustment.…

  15. Military Curricula for Vocational & Technical Education. Orthopedic Specialist, Classroom Course 10-13.

    ERIC Educational Resources Information Center

    Brooke Army Medical Center, Fort Sam Houston, TX. Health Care Research Div.

    These military-developed curriculum materials for a course for orthopedic specialists are targeted for students from grades 11 through the adult level. The course is designed to provide a working knowledge of the application of casts, traction, and splints to orthopedic patients and the removal of these devices; a working knowledge of assisting in…

  16. Age, Physical Activity, Physical Fitness, Body Composition, and Incidence of Orthopedic Problems.

    ERIC Educational Resources Information Center

    Research Quarterly for Exercise and Sport, 1989

    1989-01-01

    Effects of age, physical activity, physical fitness, and body mass index (BMI) on the occurrence of orthopedic problems were examined. For men, physical fitness, BMI, and physical activity were associated with orthopedic problems; for women, physical activity was the main predictor. Age was not a factor for either gender. (JD)

  17. Dance for Students with Orthopedic Conditions--Popular, Square, Folk, Modern, [and] Ballet.

    ERIC Educational Resources Information Center

    Harris, Cordelia Graves

    1979-01-01

    Preparation for teaching dance to orthopedically handicapped students is discussed in addition to specific suggestions for teaching popular dance, square dance, folk dance, modern dance, and ballet. Dancing is seen as a way to give orthopedically handicapped students physical education success without competition. Recommended music for each type…

  18. Factors affecting interest in orthopedics among female medical students: a prospective analysis.

    PubMed

    Baldwin, Keith; Namdari, Surena; Bowers, Andrea; Keenan, Mary Ann; Levin, L Scott; Ahn, Jaimo

    2011-12-01

    The field of orthopedics has a limited ability to recruit high-quality female applicants. The purpose of this study was to determine whether early exposure to the field affects a woman's decision to pursue orthopedics. We performed a prospective, nonrandomized cohort study between academic years 2005 and 2009 and compared interest in orthopedic surgery among female (n=271) and male (n=71) medical students at 2 urban teaching institutions. Elective lectures and orthopedic literature were distributed via e-mail to the study participants. These materials included articles published in the medical literature, materials produced and distributed by the American Academy of Orthopaedic Surgeons, and Web sites providing educational materials. The primary outcome was the likelihood of application for orthopedic residency. We studied the influence of demographics, exposure, and attitudes on interest in pursuing an orthopedic career. Men had a significantly higher baseline level of interest in orthopedic surgery than women (P=.005). Younger age (P<.001) and personal (P<.001), independent (P<.001), and school (P=.023) exposures to orthopedics were significantly related to interest among women. At final follow-up, total personal exposures (P=.003) and total independent exposures (P<.001) in the form of our literature and lectures were correlated with final interest in women. Female interest was decreased by the long hours, physical demands, and predominantly male nature of the field. Early exposure to orthopedic educational resources may be useful in generating female interest. Perceptions and attitudes regarding orthopedic surgery must to be changed to attract the best and brightest minds, regardless of sex. PMID:22146211

  19. Level of billing as a function of resident documentation and orthopedic subspecialty at an academic multispecialty orthopedic surgery practice.

    PubMed

    Dezfuli, Bobby; Smith, Jordan L

    2012-11-01

    Documentation, coding, and billing for physician-patient encounters have evolved over time and have significant variability. Appropriate and complete documentation of these encounters can contribute to the financial viability of private and academic medical centers. The objectives of this study were to assess the financial effect of documentation on billing and to compare the authors' institution's distribution of billing level compared with Medicare normative data. Four orthopedic surgery subspecialty clinics were evaluated at a university outpatient clinic over a 1-year period. A single full-day clinic per week was used for each subspecialty. Residents dictated the majority of the reports. All reports were transcribed by medical transcriptionists and coded by certified professional coders. The sports medicine subspecialty generated the highest volume of patient clinic visits, followed by foot and ankle, trauma, and spine (P<.01). The majority of the reports were billed at level 3 (P<.05). Significant differences existed between subspecialty and percentage distribution of billing level (P<.05). Compared with Medicare normative data, a significantly greater percentage of level 3 reports and a lower percentage of level 2 and 4 reports existed in the orthopedic practice (P<.01). The estimated loss of revenue from the fewer level 4 reports was $81,281.11 for 1 year. These findings highlight the need for greater educational interventions to improve provider documentation, coding, and billing. The effect of new electronic medical record systems that prompt providers to include key evaluation and management components will likely affect practices and warrant further analysis. PMID:23127460

  20. REMOTELY OPERATED MANIPULATOR

    DOEpatents

    Hutto, E.L.

    1961-08-15

    A manipulator is described for performing, within an entirely enclosed cell containling radioactive materials, various mechanical operations. A rod with flexible fingers is encompassed by a tubular sleeve shorter than the rod. Relative movement between the rod and sleeve causes the fingers to open and close. This relative movement is effected by relative movement of permanent magnets in magnetic coupling relation to magnetic followers affixed to the ends of the rod and sleeve. The rod and its sleeve may be moved as a unit axially or may be rotated by means of the magnetic couplings. The manipulator is enclosed within a tubular member which is flexibly sealed to an opening in the cell. (AEC)

  1. Computer aided manipulator control

    NASA Technical Reports Server (NTRS)

    Bejczy, A. K.; Zawacki, R. L.

    1980-01-01

    This paper describes the hardware and software system of a dedicated mini- and microcomputer network developed at the JPL teleoperator project to aid the operator in real-time control of remote manipulators. The operator can be in series or in parallel with the control computer during operation. The purpose of the project is to develop, demonstrate and evaluate advanced supervisory control concepts and techniques for space applications. The paper concludes with a brief outline of future development plans and issues.

  2. Manipulation of quantum evolution

    NASA Technical Reports Server (NTRS)

    Cabera, David Jose Fernandez; Mielnik, Bogdan

    1994-01-01

    The free evolution of a non-relativistic charged particle is manipulated using time-dependent magnetic fields. It is shown that the application of a programmed sequence of magnetic pulses can invert the free evolution process, forcing an arbitrary wave packet to 'go back in time' to recover its past shape. The possibility of more general operations upon the Schrodinger wave packet is discussed.

  3. Microradiographic microsphere manipulator

    DOEpatents

    Singleton, Russell M.

    1980-01-01

    A method and apparatus for radiographic characterization of small hollow spherical members (microspheres), constructed of either optically transparent or opaque materials. The apparatus involves a microsphere manipulator which holds a batch of microspheres between two parallel thin plastic films for contact microradiographic characterization or projection microradiography thereof. One plastic film is translated to relative to and parallel to the other to roll the microspheres through any desired angle to allow different views of the microspheres.

  4. Microradiographic microsphere manipulator

    DOEpatents

    Singleton, R.M.

    A method and apparatus is disclosed for radiographic characterization of small hollow spherical members (microspheres), constructed of either optically transparent or opaque materials. The apparatus involves a microsphere manipulator which holds a batch of microspheres between two parallel thin plastic films for contact microradiographic characterization or projection microradiography thereof. One plastic film is translated relative to and parallel to the other to roll the microspheres through any desired angle to allow different views of the microspheres.

  5. MANIPULATOR FOR SLAVE ROBOT

    DOEpatents

    Goertz, R.C.; Grimson, J.H.; Kohut, F.A.

    1961-04-01

    A remote-control manipulator comprising two stationary master units, two slave units on a movable vehicle, and electrical connections between the master and slave units is reported. The slave units are side by side with a minimum over-all width, which is made feasible by an arrangement of transducers producing most movements of each slave unit to one side of the support of said slave unit.

  6. Endocavity Ultrasound Probe Manipulators.

    PubMed

    Stoianovici, Dan; Kim, Chunwoo; Schäfer, Felix; Huang, Chien-Ming; Zuo, Yihe; Petrisor, Doru; Han, Misop

    2013-06-01

    We developed two similar structure manipulators for medical endocavity ultrasound probes with 3 and 4 degrees of freedom (DoF). These robots allow scanning with ultrasound for 3-D imaging and enable robot-assisted image-guided procedures. Both robots use remote center of motion kinematics, characteristic of medical robots. The 4-DoF robot provides unrestricted manipulation of the endocavity probe. With the 3-DoF robot the insertion motion of the probe must be adjusted manually, but the device is simpler and may also be used to manipulate external-body probes. The robots enabled a novel surgical approach of using intraoperative image-based navigation during robot-assisted laparoscopic prostatectomy (RALP), performed with concurrent use of two robotic systems (Tandem, T-RALP). Thus far, a clinical trial for evaluation of safety and feasibility has been performed successfully on 46 patients. This paper describes the architecture and design of the robots, the two prototypes, control features related to safety, preclinical experiments, and the T-RALP procedure. PMID:24795525

  7. Welding nozzle position manipulator

    NASA Technical Reports Server (NTRS)

    Gilbert, Jeffrey L. (Inventor); Gutow, David A. (Inventor)

    1994-01-01

    The present invention is directed to a welding nozzle position manipulator. The manipulator consists of an angle support to which the remaining components of the device are attached either directly or indirectly. A pair of pivotal connections attach a weld nozzle holding link to the angle support and provide a two axis freedom of movement of the holding link with respect to the support angle. The manipulator is actuated by a pair of adjusting screws angularly mounted to the angle support. These screws contact a pair of tapered friction surfaces formed on the upper portion of the welding nozzle holding link. A spring positioned between the upper portions of the support angle and the holding link provides a constant bias engagement between the friction surfaces of the holding link and the adjustment screws, so as to firmly hold the link in position and to eliminate any free play in the adjustment mechanism. The angular relationships between the adjustment screws, the angle support and the tapered friction surfaces of the weld nozzle holding link provide a geometric arrangement which permits precision adjustment of the holding link with respect to the angle support and also provides a solid holding link mount which is resistant to movement from outside forces.

  8. Endocavity Ultrasound Probe Manipulators

    PubMed Central

    Stoianovici, Dan; Kim, Chunwoo; Schäfer, Felix; Huang, Chien-Ming; Zuo, Yihe; Petrisor, Doru; Han, Misop

    2014-01-01

    We developed two similar structure manipulators for medical endocavity ultrasound probes with 3 and 4 degrees of freedom (DoF). These robots allow scanning with ultrasound for 3-D imaging and enable robot-assisted image-guided procedures. Both robots use remote center of motion kinematics, characteristic of medical robots. The 4-DoF robot provides unrestricted manipulation of the endocavity probe. With the 3-DoF robot the insertion motion of the probe must be adjusted manually, but the device is simpler and may also be used to manipulate external-body probes. The robots enabled a novel surgical approach of using intraoperative image-based navigation during robot-assisted laparoscopic prostatectomy (RALP), performed with concurrent use of two robotic systems (Tandem, T-RALP). Thus far, a clinical trial for evaluation of safety and feasibility has been performed successfully on 46 patients. This paper describes the architecture and design of the robots, the two prototypes, control features related to safety, preclinical experiments, and the T-RALP procedure. PMID:24795525

  9. Validity of subjective smoking status in orthopedic patients

    PubMed Central

    Bender, Daniel; Haubruck, Patrick; Boxriker, Sonja; Korff, Sebastian; Schmidmaier, Gerhard; Moghaddam, Arash

    2015-01-01

    Purpose In this level 1 diagnostic study, we analyzed the validity of subjective smoking status and, as secondary research question, the smoking cessation adherence in orthopedic patients during a routine hospital stay of nonunion patients by measuring serum cotinine. Methods We included patients undergoing revision surgery due to nonunion of long bones. Patients were interviewed about their smoking status. Blood samples were taken from all the patients prior to surgery and for an additional 6 weeks following surgery. Serum levels of cotinine were measured, and coherence between subjective smoking status and objective cotinine analysis was evaluated. Results Between March 2012 and August 2014, we enrolled 136 patients. Six of the 26 “previous smokers” (23%) and four of the 65 “nonsmokers” (6%) had serum cotinine above cutoff levels. In self-labeled smokers, serum cotinine levels averaged at 2,367.4±14,885.9 ng/mL (with a median of 100 ng/mL), whereas in previous smokers the levels averaged at 4,270±19,619.4 ng/mL (with a median of 0 ng/mL) and in the nonsmokers group the levels averaged at 12±53.9 ng/mL (with a median of 0.03 ng/mL). Overall, the subjective smoking status matched serum cotinine testing in 88% of the cases. Sensitivity was 79.6% and specificity was 93.1%. Ninety-one percent of the patients with preoperative positive serum values were still positive at follow-up. Conclusion In this study, we could show that subjective smoking status in orthopedic patients is predominantly reliable as validated by objective cotinine measurements; however, patients who declare themselves as “previous smokers” are at elevated risk for underreporting continued smoking and patients who smoked preoperatively are at high risk for continuing their habit. In the future, caregivers should consider introducing effective treatments for smoking cessation to smokers and furthermore offer effective treatments to maintain smoking cessation in previous smokers during

  10. Direct Manipulation and Procedural Reasoning.

    ERIC Educational Resources Information Center

    Owen, David

    Arguing that understanding what lies behind the apparent usability of direct manipulation style interfaces might not only help in building better interfaces, but can also draw attention to possible side effects, this paper uses examples from a prototype data manipulation system to pursue a characterization of direct manipulation interfaces as…

  11. Regulatory perspective on characterization and testing of orthopedic bone cements.

    PubMed

    Demian, H W; McDermott, K

    1998-09-01

    This paper provides a general regulatory background of acrylic bone cements, chemical composition information on several commercially available bone cements, physical and chemical methods of analyses, mechanical test methods, and risks and failure mechanisms of acrylic bone cements. Suggestions and recommendations presented in Tables 2 and 3 are not mandatory requirements but reflect data and methodologies which the FDA's Orthopedic Devices Branch (ORDB) believes to be acceptable to evaluate most pre-clinical data. FDA may require information in addition to that contained in this paper. In some instances, a sponsor may be able to sufficiently justify the omission of some tests. Although this paper describes certain administrative requirements, it does not take the place of the requirements contained in Title 21 of the Code of Federal Regulations (21 CFR) Parts 801, 807, 812, and 814 or those found in the statute. PMID:9830987

  12. ADVANCES IN THE USE OF STEM CELLS IN ORTHOPEDICS

    PubMed Central

    Cristante, Alexandre Fogaça; Narazaki, Douglas Kenji

    2015-01-01

    Primordial cells or stem cells are multipotent undifferentiated cells with the capacity to originate any type of cell in the organism. They may have their origins in the blastocyst and thus are classified as embryonic, or tissues developed in fetuses, newborns or adults and thus are known as somatic stem cells. Bone marrow is one of the main locations for isolating primordial cells, and there are two lineages: hematopoietic and mesenchymal progenitor cells. There are several uses for these undifferentiated cells in orthopedics, going from cartilaginous lesions in osteoarthrosis, osteochondritis dissecans and patellar chondromalacia, to bone lesions like in pseudarthrosis or bone losses, or nerve lesions like in spinal cord trauma. Studying stem cells is probably the most promising field of study of all within medicine, and this is shortly going to revolutionize all medical specialties (both clinical and surgical) and thus provide solutions for diseases that today are difficult to deal with. PMID:27027022

  13. Cultural Nuance in Orthopedic Foreign Aid: Differences in Patient Concerns.

    PubMed

    Kavolus, Joseph J; Ritter, Merrill A; Claverie, J Guillermo; Salas, Marcos D; Kavolus, Christopher H; Trousdale, Robert T

    2016-01-01

    Orthopedic aid to developing nations is expanding and becoming a unique facet of the specialty. This investigation seeks to compare patient impressions and concerns regarding the care patients receive as part of an itinerant surgical aid trip in 2 nations. In 2013 and 2014, patients from 2 separate nations completed a Likert scale survey assessing impressions of the care they received at the hands of a surgical team from abroad. Mean response scores were calculated and compared using a t test. This is the first investigation to compare patient concerns across 2 nations in a surgical aid trip setting. The results highlight the importance of culture in understanding patients and the impressions of the care they receive. PMID:26350258

  14. Barriers to the Clinical Translation of Orthopedic Tissue Engineering

    PubMed Central

    2011-01-01

    Tissue engineering and regenerative medicine have been the subject of increasingly intensive research for over 20 years, and there is concern in some quarters over the lack of clinically useful products despite the large sums of money invested. This review provides one perspective on orthopedic applications from a biologist working in academia. It is suggested that the delay in clinical application is not atypical of new, biologically based technologies. Some barriers to progress are acknowledged and discussed, but it is also noted that preclinical studies have identified several promising types of cells, scaffolds, and morphogenetic signals, which, although not optimal, are worth advancing toward human trials to establish a bridgehead in the clinic. Although this transitional technology will be replaced by more sophisticated, subsequent systems, it will perform valuable pioneering functions and facilitate the clinical development of the field. Some strategies for achieving this are suggested. PMID:21682607

  15. Congenital and acquired orthopedic abnormalities in patients with myelomeningocele.

    PubMed

    Westcott, M A; Dynes, M C; Remer, E M; Donaldson, J S; Dias, L S

    1992-11-01

    This article presents a radiologic review of the spectrum of acquired and congenital orthopedic abnormalities found in patients with myelomeningocele. These abnormalities are caused predominantly by muscle imbalance, paralysis, and decreased sensation in the lower extremity. Iatrogenic injury, such as a postoperative tethered cord, may also cause bone abnormalities. Selected images were obtained from more than 800 children. Important entities presented include spinal curvatures such as kyphosis, scoliosis, and lordosis; subluxation and dislocation of the hip, coxa valga, contractures of the hip, and femoral torsion; knee deformities; rotational abnormalities of the lower extremity and external and internal torsion; ankle and foot abnormalities such as ankle valgus, calcaneus foot, congenital vertical talus (rocker-bottom deformity), and talipes equinovarus; and metaphyseal, diaphyseal, and physeal fractures. Familiarity with congenital abnormalities and an understanding of the pathogenesis of acquired disorders in patients with myelomeningocele are essential for proper radiologic interpretation and timely therapy. PMID:1439018

  16. Power harvesting using PZT ceramics embedded in orthopedic implants.

    PubMed

    Chen, Hong; Liu, Ming; Jia, Chen; Wang, Zihua

    2009-09-01

    Battery lifetime has been the stumbling block for many power-critical or maintenance-free real-time embedded applications, such as wireless sensors and orthopedic implants. Thus a piezoelectric material that could convert human motion into electrical energy provides a very attractive solution for clinical implants. In this work, we analyze the power generation characteristics of stiff lead zirconate titanate (PZT) ceramics and the equivalent circuit through extensive experiments. Our experimental framework allows us to explore many important design considerations of such a PZT-based power generator. Overall we can achieve a PZT element volume of 0.5 x 0.5 x 1.8 cm, which is considerably smaller than the results reported so far. Finally, we outline the application of our PZT elements in a total knee replacement (TKR) implant. PMID:19812004

  17. Barriers to the clinical translation of orthopedic tissue engineering.

    PubMed

    Evans, Christopher H

    2011-12-01

    Tissue engineering and regenerative medicine have been the subject of increasingly intensive research for over 20 years, and there is concern in some quarters over the lack of clinically useful products despite the large sums of money invested. This review provides one perspective on orthopedic applications from a biologist working in academia. It is suggested that the delay in clinical application is not atypical of new, biologically based technologies. Some barriers to progress are acknowledged and discussed, but it is also noted that preclinical studies have identified several promising types of cells, scaffolds, and morphogenetic signals, which, although not optimal, are worth advancing toward human trials to establish a bridgehead in the clinic. Although this transitional technology will be replaced by more sophisticated, subsequent systems, it will perform valuable pioneering functions and facilitate the clinical development of the field. Some strategies for achieving this are suggested. PMID:21682607

  18. Orthopedic correction of growing hyperdivergent, retrognathic patients with miniscrew implants.

    PubMed

    Buschang, Peter H; Carrillo, Roberto; Rossouw, P Emile

    2011-03-01

    Traditional orthodontic treatments do not adequately address the skeletal problems of retrognathic, hyperdivergent, Class II adolescents; the few approaches that do address them require long-term patient compliance. This article introduces a novel approach using miniscrew implants (MSIs) and growth to treat retrognathic, hyperdivergent adolescents. Nine consecutive patients were evaluated at the start of treatment (aged 13.2 ± 1.1 years) and again at the end of the orthopedic phase (after 1.9 ± 0.3 years). Each patient had 2 MSIs placed in either side of the palate. Coil springs (150 g) extended from the MSIs to a rapid palatal expander, which served as a rigid segment for intruding the maxillary premolar and molars. Two additional MSIs were placed between the first mandibular molars and second premolars; coil spring (150 g) extended from the MSIs to hold or intrude the mandibular molars. Before treatment, the patients exhibited substantial and significant mandibular retrusion (Z score = -1.0), facial convexity (Z score = 0.7), and hyperdivergence (Z score = 1.6). Treatment produced consistent and substantial orthopedic effects. The chin was advanced by a mean of 2.4 mm, the sella-nasion-basion (SNB) angle increased by 2.1°, the mandibular plane angle decreased by 3.9°, and facial convexity decreased by approximately 3.2°. Questionnaires showed that this treatment approach was not painful or uncomfortable; the majority of the patients indicated that they were very likely to recommend the treatment to others. Treatment was accomplished by titrating the amount of orthodontic intrusion performed based on the individual's growth potential. PMID:21236539

  19. Prevalence of Internet and Social Media Usage in Orthopedic Surgery

    PubMed Central

    Curry, Emily; Nguyen, Joseph; Matzkin, Elizabeth

    2014-01-01

    Prior studies in other specialties have shown that social networking and Internet usage has become an increasingly important means of patient communication and referral. The purpose of this study is to evaluate the prevalence of Internet or social media usage in new patients referred to a major academic orthopedics center and to identify new avenues to optimize patient recruitment and communication. New patients were surveyed (n=752) between December 2012 to January 2013 in a major academic orthopaedic center to complete a 15-item questionnaire including social media and Internet usage information. Data was collected for all orthopaedic sub-specialties and statistical analysis was performed. Fifty percent of patients use social networking sites, such as Facebook. Sports medicine patients tend to be higher social networking users (35.9%) relative to other services (9.8-17.9%) and was statistically higher when compared to the joints/tumor service (P<0.0001). Younger age was the biggest indicator predicting the use of social media. Patients that travelled between 120 to 180 miles from the hospital for their visits were significantly more likely to be social media users, as were patients that did research on their condition prior to their new patient appointment. We conclude that orthopedic patients who use social media/Internet are more likely to be younger, researched their condition prior to their appointment and undergo a longer average day’s travel (120-180 miles) to see a physician. In an increasingly competitive market, surgeons with younger patient populations will need to utilize social networking and the Internet to capture new patient referrals. PMID:25317312

  20. Perioperative coagulation assessment of patients undergoing major elective orthopedic surgery.

    PubMed

    Spiezia, Luca; Vasques, Francesco; Behr, Astrid; Campello, Elena; Maggiolo, Sara; Berizzi, Antonio; Gavasso, Sabrina; Woodhams, Barry; Biancari, Fausto; Simioni, Paolo

    2016-09-01

    Traditional coagulative parameters are of limited use in identifying perioperative coagulopathy occurring in patients undergoing major elective orthopedic surgery (MEOS). The aim of our study was to evaluate the coagulation changes in patients undergoing MEOS and to facilitate an early detection of perioperative coagulopathy in patients experiencing major intraoperative bleeding. We enrolled 40 consecutive patients (M/F 10/30, age range 34-90 years) who underwent MEOS at the Orthopedic Unit of the Padua University Hospital, Italy, between January 2014 and January 2015. Blood samples were obtained at the following time points: T0-pre: 30 min before surgery; T0-post: 30 min after the end of the procedure; T1: morning of the first postoperative day; T2: 7 ± 2 days after surgery. Patients who experienced an intraoperative blood loss ≥250 mL/h were considered as cases. Routine coagulative parameters, thromboelastometry and thrombin generation (TG) profiles were evaluated. At baseline, a significantly lower platelet count and FIBTEM MCF/AUC were observed in patents with excessive bleeding (p < 0.05 and 0.02/0.01, respectively). At T0-post and T1 intervals, cases showed hypocoagulation characterized by a significantly low platelet count (p = 0.001), prolonged CFT INTEM/EXTEM, reduction of alpha-angle and MaxV INTEM/EXTEM, MCF and AUC INTEM/EXTEM/FIBTEM (p < 0.05 in all comparisons). The only TG parameter standing out between study groups was time to peak at T0-pre. A low platelet count and fibrinogen activity were associated with significant intraoperative bleeding in patients undergoing MEOS. Thromboelastometry performed by ROTEM(®) identifies patients with coagulopathy. PMID:26951189

  1. Orthopedic Correction of Growing Hyperdivergent, Retrognathic, Patients with Miniscrew Implants

    PubMed Central

    Buschang, Peter H.; Carrillo, Roberto; Rossouw, P. Emile

    2010-01-01

    Traditional orthodontic treatments do not adequately address the skeletal problems of retrognathic, hyperdivergent, Class II adolescents; the few approaches that do require long-term patient compliance. This paper introduces a novel approach using miniscrew implants (MSIa) and growth to treat retrognathic hyperdivergent adolescents. Nine consecutive patients were evaluated at the start of treatment (13.2 ±1.1 years of age) and again at the end of the orthopedic phase (after 1.9 ±0.3 years). Each patient had two MSIs placed in either side of the palate. Coil springs (150 g) extended from the MSIs to a RPE, which served as a rigid segment for intruding the maxillary premolar and molars. Two additional MSIs were placed between the first mandibular molars and second premolars; coil spring (150 g) extended from the MSIs to hold or intrude the mandibular molars. Prior to treatment, the patients exhibited substantial and significant mandibular retrusion (Z-score=−1.0), facial convexity (Z-score=0.7), and hyperdivergence (Z-score=1.6). Treatment produced consistent and substantial orthopedic effects. The chin was advanced an average of 2.4 mm, the SNB angle increased by 2.1°, the mandibular plane angle decreased 3.9°, and facial convexity decreased by approximately 3.2°. Questionnaires showed that this treatment approach was not painful or uncomfortable; the majority of the patients indicated that they were very likely to recommend the treatment to others. Treatment was accomplished by titrating the amount of orthodontic intrusion performed based on the individuals’ growth potential. PMID:21236539

  2. Surface Functionalization of Orthopedic Titanium Implants with Bone Sialoprotein

    PubMed Central

    Ritz, Ulrike; Ackermann, Angelika; Anthonissen, Joris; Kaufmann, Kerstin B.; Brendel, Christian; Götz, Hermann; Rommens, Pol M.; Hofmann, Alexander

    2016-01-01

    Orthopedic implant failure due to aseptic loosening and mechanical instability remains a major problem in total joint replacement. Improving osseointegration at the bone-implant interface may reduce micromotion and loosening. Bone sialoprotein (BSP) has been shown to enhance bone formation when coated onto titanium femoral implants and in rat calvarial defect models. However, the most appropriate method of BSP coating, the necessary level of BSP coating, and the effect of BSP coating on cell behavior remain largely unknown. In this study, BSP was covalently coupled to titanium surfaces via an aminosilane linker (APTES), and its properties were compared to BSP applied to titanium via physisorption and untreated titanium. Cell functions were examined using primary human osteoblasts (hOBs) and L929 mouse fibroblasts. Gene expression of specific bone turnover markers at the RNA level was detected at different intervals. Cell adhesion to titanium surfaces treated with BSP via physisorption was not significantly different from that of untreated titanium at any time point, whereas BSP application via covalent coupling caused reduced cell adhesion during the first few hours in culture. Cell migration was increased on titanium disks that were treated with higher concentrations of BSP solution, independent of the coating method. During the early phases of hOB proliferation, a suppressive effect of BSP was observed independent of its concentration, particularly when BSP was applied to the titanium surface via physisorption. Although alkaline phosphatase activity was reduced in the BSP-coated titanium groups after 4 days in culture, increased calcium deposition was observed after 21 days. In particular, the gene expression level of RUNX2 was upregulated by BSP. The increase in calcium deposition and the stimulation of cell differentiation induced by BSP highlight its potential as a surface modifier that could enhance the osseointegration of orthopedic implants. Both

  3. Hydroxyapatite-nanotube composites and coatings for orthopedic applications

    NASA Astrophysics Data System (ADS)

    Lahiri, Debrupa

    Hydroxyapatite (HA) has received wide attention in orthopedics, due to its biocompatibility and osseointegration ability. Despite these advantages, the brittle nature and low fracture toughness of HA often results in rapid wear and premature fracture of implant. Hence, there is a need to improve the fracture toughness and wear resistance of HA without compromising its biocompatibility. The aim of the current research is to explore the potential of nanotubes as reinforcement to HA for orthopedic implants. HA- 4 wt.% carbon nanotube (CNT) composites and coatings are synthesized by spark plasma sintering and plasma spraying respectively, and investigated for their mechanical, tribological and biological behavior. CNT reinforcement improves the fracture toughness (>90%) and wear resistance (>66%) of HA for coating and free standing composites. CNTs have demonstrated a positive influence on the proliferation, differentiation and matrix mineralization activities of osteoblasts, during in-vitro biocompatibility studies. In-vivo exposure of HA-CNT coated titanium implant in animal model (rat) shows excellent histocompatibility and neobone integration on the implant surface. The improved osseointegration due to presence of CNTs in HA is quantified by the adhesion strength measurement of single osteoblast using nano-scratch technique. Considering the ongoing debate about cytotoxicity of CNTs in the literature, the present study also suggests boron nitride nanotube (BNNT) as an alternative reinforcement. BNNT with the similar elastic modulus and strength as CNT, were added to HA. The resulting composite having 4 wt.% BNNTs improved the fracture toughness (˜85%) and wear resistance (˜75%) of HA in the similar range as HA-CNT composites. BNNTs were found to be non-cytotoxic for osteoblasts and macrophages. In-vitro evaluation shows positive role of BNNT in osteoblast proliferation and viability. Apatite formability of BNNT surface in ˜4 days establishes its osseointegration

  4. Orthopedic specialty hospitals: centers of excellence or greed machines?

    PubMed

    Badlani, Neil; Boden, Scott; Phillips, Frank

    2012-03-01

    Orthopedic specialty hospitals have recently been the subject of debate. They are patient-centered, physician-friendly health care alternatives that take advantage of the economic efficiencies of specialization. Medically, they provide a higher quality of care and increase patient and physician satisfaction. Economically, they are more efficient and profitable than general hospitals. They also positively affect society through the taxes they pay and the beneficial aspects of the competition they provide to general hospitals. Their ability to provide a disruptive innovation to the existing hospital industry will lead to lower costs and greater access to health care. However, critics say that physician ownership presents potential conflicts of interest and leads to overuse of medical care. Some general hospitals are suffering as a result of unfair specialty hospital practices, and a few drastic medical complications have occurred at specialty hospitals. Specialty hospitals have been scrutinized for increasing the inequality of health care and continue to be a target of government regulations. In this article, the pros and cons are examined, and the Emory Orthopaedics and Spine Hospital is analyzed as an example. Orthopedic specialty hospitals provide excellent care and are great assets to society. Competition between specialty and general hospitals has provided added value to patients and taxpayers. However, physicians must take more responsibility in their appropriate and ethical leadership. It is critical to recognize financial conflicts of interest, disclose ownership, and act ethically. Patient care cannot be compromised. With thoughtful and efficient leadership, specialty hospitals can be an integral part of improving health care in the long term. PMID:22385456

  5. Applications of finite element simulation in orthopedic and trauma surgery.

    PubMed

    Herrera, Antonio; Ibarz, Elena; Cegoñino, José; Lobo-Escolar, Antonio; Puértolas, Sergio; López, Enrique; Mateo, Jesús; Gracia, Luis

    2012-04-18

    Research in different areas of orthopedic and trauma surgery requires a methodology that allows both a more economic approach and the ability to reproduce different situations in an easy way. Simulation models have been introduced recently in bioengineering and could become an essential tool in the study of any physiological unity, regardless of its complexity. The main problem in modeling with finite elements simulation is to achieve an accurate reproduction of the anatomy and a perfect correlation of the different structures, in any region of the human body. Authors have developed a mixed technique, joining the use of a three-dimensional laser scanner Roland Picza captured together with computed tomography (CT) and 3D CT images, to achieve a perfect reproduction of the anatomy. Finite element (FE) simulation lets us know the biomechanical changes that take place after hip prostheses or osteosynthesis implantation and biological responses of bone to biomechanical changes. The simulation models are able to predict changes in bone stress distribution around the implant, so allowing preventing future pathologies. The development of a FE model of lumbar spine is another interesting application of the simulation. The model allows research on the lumbar spine, not only in physiological conditions but also simulating different load conditions, to assess the impact on biomechanics. Different degrees of disc degeneration can also be simulated to determine the impact on adjacent anatomical elements. Finally, FE models may be useful to test different fixation systems, i.e., pedicular screws, interbody devices or rigid fixations compared with the dynamic ones. We have also developed models of lumbar spine and hip joint to predict the occurrence of osteoporotic fractures, based on densitometric determinations and specific biomechanical models, including approaches from damage and fracture mechanics. FE simulations also allow us to predict the behavior of orthopedic splints

  6. Value Added: the Case for Point-of-View Camera use in Orthopedic Surgical Education

    PubMed Central

    Thomas, Geb W.; Taylor, Leah; Liu, Xiaoxing; Anthony, Chris A.; Anderson, Donald D.

    2016-01-01

    Abstract Background Orthopedic surgical education is evolving as educators search for new ways to enhance surgical skills training. Orthopedic educators should seek new methods and technologies to augment and add value to real-time orthopedic surgical experience. This paper describes a protocol whereby we have started to capture and evaluate specific orthopedic milestone procedures with a GoPro® point-of-view video camera and a dedicated video reviewing website as a way of supplementing the current paradigm in surgical skills training. We report our experience regarding the details and feasibility of this protocol. Methods Upon identification of a patient undergoing surgical fixation of a hip or ankle fracture, an orthopedic resident places a GoPro® point-of-view camera on his or her forehead. All fluoroscopic images acquired during the case are saved and later incorporated into a video on the reviewing website. Surgical videos are uploaded to a secure server and are accessible for later review and assessment via a custom-built website. An electronic survey of resident participants was performed utilizing Qualtrics software. Results are reported using descriptive statistics. Results A total of 51 surgical videos involving 23 different residents have been captured to date. This includes 20 intertrochanteric hip fracture cases and 31 ankle fracture cases. The average duration of each surgical video was 1 hour and 16 minutes (range 40 minutes to 2 hours and 19 minutes). Of 24 orthopedic resident surgeons surveyed, 88% thought capturing a video portfolio of orthopedic milestones would benefit their education Conclusions There is a growing demand in orthopedic surgical education to extract more value from each surgical experience. While further work in development and refinement of such assessments is necessary, we feel that intraoperative video, particularly when captured and presented in a non-threatening, user friendly manner, can add significant value to the

  7. Manipulation of thermal phonons

    NASA Astrophysics Data System (ADS)

    Hsu, Chung-Hao

    Developing materials that can conduct electricity easily, but block the motion of phonons is necessary in the applications of thermoelectric devices, which can generate electricity from temperature differences. In converse, a key requirement as chips get faster is to obtain better ways to dissipate heat. Controlling heat transfer in these crystalline materials devices --- such as silicon --- is important. The heat is actually the motion or vibration of atoms known as phonons. Finding ways to manipulate the behavior of phonons is crucial for both energy applications and the cooling of integrated circuits. A novel class of artificially periodic structured materials --- phononic crystals --- might make manipulation of thermal phonons possible. In many fields of physical sciences and engineering, acoustic wave propagation in solids attracts many researchers. Wave propagation phenomena can be analyzed by mathematically solving the acoustic wave equation. However, wave propagation in inhomogeneous media with various geometric structures is too complex to find an exact solution. Hence, the Finite Difference Time Domain method is developed to investigate these complicated problems. In this work, the Finite-Difference Time-Domain formula is derived from acoustic wave equations based on the Taylor's expansion. The numerical dispersion and stability problems are analyzed. In addition, the convergence conditions of numerical acoustic wave are stated. Based on the periodicity of phononic crystal, the Bloch's theorem is applied to fulfill the periodic boundary condition of the FDTD method. Then a wide-band input signal is used to excite various acoustic waves with different frequencies. In the beginning of the calculation process, the wave vector is chosen and fixed. By means of recording the displacement field and taking the Fourier transformation, we can obtain the eigenmodes from the resonance peaks of the spectrum and draw the dispersion relation curve of acoustic waves

  8. Spatial Manipulation with Microfluidics

    PubMed Central

    Lin, Benjamin; Levchenko, Andre

    2015-01-01

    Biochemical gradients convey information through space, time, and concentration, and are ultimately capable of spatially resolving distinct cellular phenotypes, such as differentiation, proliferation, and migration. How these gradients develop, evolve, and function during development, homeostasis, and various disease states is a subject of intense interest across a variety of disciplines. Microfluidic technologies have become essential tools for investigating gradient sensing in vitro due to their ability to precisely manipulate fluids on demand in well-controlled environments at cellular length scales. This review will highlight their utility for studying gradient sensing along with relevant applications to biology. PMID:25905100

  9. Spatial manipulation with microfluidics.

    PubMed

    Lin, Benjamin; Levchenko, Andre

    2015-01-01

    Biochemical gradients convey information through space, time, and concentration, and are ultimately capable of spatially resolving distinct cellular phenotypes, such as differentiation, proliferation, and migration. How these gradients develop, evolve, and function during development, homeostasis, and various disease states is a subject of intense interest across a variety of disciplines. Microfluidic technologies have become essential tools for investigating gradient sensing in vitro due to their ability to precisely manipulate fluids on demand in well-controlled environments at cellular length scales. This review will highlight their utility for studying gradient sensing along with relevant applications to biology. PMID:25905100

  10. Performance measurement of mobile manipulators

    NASA Astrophysics Data System (ADS)

    Bostelman, Roger; Hong, Tsai; Marvel, Jeremy

    2015-05-01

    This paper describes a concept for measuring the reproducible performance of mobile manipulators to be used for assembly or other similar tasks. An automatic guided vehicle with an onboard robot arm was programmed to repeatedly move to and stop at a novel, reconfigurable mobile manipulator artifact (RMMA), sense the RMMA, and detect targets on the RMMA. The manipulator moved a laser retroreflective sensor to detect small reflectors that can be reconfigured to measure various manipulator positions and orientations (poses). This paper describes calibration of a multi-camera, motion capture system using a 6 degree-of-freedom metrology bar and then using the camera system as a ground truth measurement device for validation of the reproducible mobile manipulator's experiments and test method. Static performance measurement of a mobile manipulator using the RMMA has proved useful for relatively high tolerance pose estimation and other metrics that support standard test method development for indexed and dynamic mobile manipulator applications.

  11. The beginnings of Orthopedic Surgery at the Mayo Clinic: A Review of the First Orthopedic Patients who Presented Over 100 Years Ago

    PubMed Central

    Camp, Christopher L.; Morrey, Bernard F; Trousdale, Robert T

    2016-01-01

    Background Formalized training in the specialty of orthopedic surgery began at the Mayo Clinic nearly 100 years ago, and treatment of patients with musculoskeletal injuries and disease began even earlier. A robust historical patient database provides the opportunity for review of the first recorded orthopedic cases at our institution, which date back to 1907. Methods The first 400 sequential medical charts of the Mayo Clinic’s patient record database were comprehensively reviewed in order to identify the first documented orthopedic cases. Results Of the first 400 patients reviewed, 15 (4%) received specific orthopedic diagnoses. All presented during a three week period in 1907, and they traveled from all over the region for evaluation. The diagnoses included skeletal tuberculosis (n=6), traumatic fracture (n=3), osteomyelitis (n=2), syphilitic pathologic fracture (n=1), syphilitic ostitis of the tibia and radius (n=1), painful flat foot (n=1), and Morton’s toe (n=1). Included with the records are patient demographics, diagnoses, symptoms, physical examination findings, radiograph reports, operative reports, and detailed drawings of symptomatology. Conclusion Although the technology and science has advanced since the early practice of orthopedic surgery that took place over a century ago, we consider ourselves to be merely an extension of those who established the field before us. Just as the past relies on the future for the continuation of what it began so many years ago, we rely on our founders for the groundwork that they laid in creating this field of surgical medicine PMID:27528834

  12. Parasites and supernormal manipulation.

    PubMed

    Holen, Ø H; Saetre, G P; Slagsvold, T; Stenseth, N C

    2001-12-22

    Social parasites may exploit their hosts by mimicking other organisms that the hosts normally benefit from investing in or responding to in some other way. Some parasites exaggerate key characters of the organisms they mimic, possibly in order to increase the response from the hosts. The huge gape and extreme begging intensity of the parasitic common cuckoo chick (Cuculus canorus) may be an example. In this paper, the evolutionary stability of manipulating hosts through exaggerated signals is analysed using game theory. Our model indicates that a parasite's signal intensity must be below a certain threshold in order to ensure acceptance and that this threshold depends directly on the rate of parasitism. The only evolutionarily stable strategy (ESS) combination is when hosts accept all signallers and parasites signal at their optimal signal intensity, which must be below the threshold. Supernormal manipulation by parasites is only evolutionarily stable under sufficiently low rates of parasitism. If the conditions for the ESS combination are not satisfied, rejector hosts can invade using signal intensity as a cue for identifying parasites. These qualitative predictions are discussed with respect to empirical evidence from parasitic mimicry systems that have been suggested to involve supernormal signalling, including evicting avian brood parasites and insect-mimicking Ophrys orchids. PMID:11749709

  13. Hydraulic manipulator research at ORNL

    SciTech Connect

    Kress, R.L.; Jansen, J.F.; Love, L.J.

    1997-03-01

    Recently, task requirements have dictated that manipulator payload capacity increase to accommodate greater payloads, greater manipulator length, and larger environmental interaction forces. General tasks such as waste storage tank cleanup and facility dismantlement and decommissioning require manipulator life capacities in the range of hundreds of pounds rather than tens of pounds. To meet the increased payload capacities demanded by present-day tasks, manipulator designers have turned once again to hydraulics as a means of actuation. In order to successfully design, build, and deploy a new hydraulic manipulator (or subsystem), sophisticated modeling, analysis, and control experiments are usually needed. Oak Ridge National Laboratory (ORNL) has a history of projects that incorporate hydraulics technology, including mobile robots, teleoperated manipulators, and full-scale construction equipment. In addition, to support the development and deployment of new hydraulic manipulators, ORNL has outfitted a significant experimental laboratory and has developed the software capability for research into hydraulic manipulators, hydraulic actuators, hydraulic systems, modeling of hydraulic systems, and hydraulic controls. The purpose of this article is to describe the past hydraulic manipulator developments and current hydraulic manipulator research capabilities at ORNL. Included are example experimental results from ORNL`s flexible/prismatic test stand.

  14. Rational design of nanofiber scaffolds for orthopedic tissue repair and regeneration

    PubMed Central

    Ma, Bing; Xie, Jingwei; Jiang, Jiang; Shuler, Franklin D; Bartlett, David E

    2013-01-01

    This article reviews recent significant advances in the design of nanofiber scaffolds for orthopedic tissue repair and regeneration. It begins with a brief introduction on the limitations of current approaches for orthopedic tissue repair and regeneration. It then illustrates that rationally designed scaffolds made up of electrospun nanofibers could be a promising solution to overcome the problems that current approaches encounter. The article also discusses the intriguing properties of electrospun nanofibers, including control of composition, structures, orders, alignments and mechanical properties, use as carriers for topical drug and/or gene sustained delivery, and serving as substrates for the regulation of cell behaviors, which could benefit musculoskeletal tissue repair and regeneration. It further highlights a few of the many recent applications of electrospun nanofiber scaffolds in repairing and regenerating various orthopedic tissues. Finally, the article concludes with perspectives on the challenges and future directions for better design, fabrication and utilization of nanofiber scaffolds for orthopedic tissue engineering. PMID:23987110

  15. 78 FR 17940 - Certain Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-25

    ... COMMISSION Certain Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof..., Software, Implants, and Components Thereof, DN 2945; the Commission is soliciting comments on any public... devices, software, implants, and components thereof. The complaint names as respondents Stanmore...

  16. [Progresses in the orthopedic-reconstructive surgery by microsurgery (author's transl)].

    PubMed

    Friedebold, G; Zilch, H; Gaudin, B

    1979-04-01

    After a short description of the microsurgical technique for operations of periphere nerves and small vessels, the possibilities for reconstructive operations in orthopedic surgery are demonstrated. The actual experiences allow a critical but also cautious prospective statement. PMID:463213

  17. Nanophase hydroxyapatite coatings for dental and orthopedic applications

    NASA Astrophysics Data System (ADS)

    Sato, Michiko

    In order to improve dental and orthopedic implant performance, the objective of this study was to synthesize nanocrystalline hydroxyapatite (HA) powders to coat metals (specifically, titanium and tantalum). Precipitated HA powders were either sintered in order to produce UltraCaP HA (or microcrystalline size HA) or were treated hydrothermally to produce nanocrystalline HA. Some of the UltraCaP and nanocrystalline HA powders were doped with yttrium (Y) since previous in vitro studies demonstrated that Y-doped HA in bulk improved osteoblast (or bone-forming cell) function over undoped HA. The nanocrystalline HA powders were also mixed with nanophase titania powders because previous studies demonstrated that titania/HA composite coatings increased coating adhesive strength and HA nucleation. These powders were then deposited onto titanium by a novel room-temperature process, called IonTiteT(TM). The results demonstrated that the chemical properties and crystallite size of the original HA powders were maintained in the coatings. More importantly, in vitro studies showed increased osteoblast (bone-forming cell) adhesion on the single phase nanocrystalline HA and nano-titania/HA coatings compared to traditionally used plasma-sprayed HA coatings and uncoated metals. Results further demonstrated greater amounts of calcium deposition by osteoblasts cultured on nanocrystalline HA coatings compared to UltraCaP coatings and conventionally used plasma-sprayed HA coatings. To elucidate mechanisms that influenced osteoblast functions on the HA coatings, the amount of proteins (fibronectin and vitronectin) onto the HA powders and the adsorbed fibronectin conformation were investigated. Exposure of cell integrin binding domains (in fibronectin III10 segments) was greater in fibronectin adsorbed onto 1.2 mole% Y-doped UltraCaP HA coatings compared to nanocrystalline HA coatings tested. However, 1.2 mole% Y-doped UltraCaP HA coatings did not increase mineralization by osteoblasts

  18. Interactive protein manipulation

    SciTech Connect

    SNCrivelli@lbl.gov

    2003-07-01

    We describe an interactive visualization and modeling program for the creation of protein structures ''from scratch''. The input to our program is an amino acid sequence -decoded from a gene- and a sequence of predicted secondary structure types for each amino acid-provided by external structure prediction programs. Our program can be used in the set-up phase of a protein structure prediction process; the structures created with it serve as input for a subsequent global internal energy minimization, or another method of protein structure prediction. Our program supports basic visualization methods for protein structures, interactive manipulation based on inverse kinematics, and visualization guides to aid a user in creating ''good'' initial structures.

  19. Vacuum tool manipulator

    DOEpatents

    Zollinger, William T.

    1993-01-01

    Apparatus for manipulating a vacuum hose in a reactor vessel comprises a housing with two opposing openings, an arm carried by the housing and deployable from a stowed position essentially completely within the housing to an extended position where the arm extends through the two openings in a generally horizontal position. The arm preferably has a two-fingered gripping device for gripping the vacuum hose but may carry a different end effector such as a grinding wheel. The fingers are opened and closed by one air cylinder. A second air cylinder extends the device. A third air cylinder within the housing pivotally pulls the opposing end of the arm into the housing via a pivoting member pivotally connected between the third air cylinder shaft and the arm.

  20. Simple, efficient UHV manipulator

    SciTech Connect

    Thiel, P.A.; Anderegg, J.W.

    1984-10-01

    A simple manipulator is described for use in ultrahigh vacuum. Unhindered rotation within vacuum is provided by a commercial differentially pumped adapter to which the entire XYZ stage is attached. The combination of movements provided by the XYZ stage, the rotating vacuum flange, and a gimbal permits alignment of the sample with any of the peripheral view ports. The resistively heated sample support, mounted through a cold finger, permits rapid variation of sample temperature from several hundred degrees Kelvin to near cryogenic. It is anticipated that this design could be easily used with many existing types of commercial vacuum systems, with the consequent advantage of increased ease and simplicity of both mechanical motion and cryogenic cooling.

  1. Ion manipulation device

    DOEpatents

    Anderson, Gordon A; Smith, Richard D; Ibrahim, Yehia M; Baker, Erin M

    2014-09-16

    An ion manipulation method and device is disclosed. The device includes a pair of substantially parallel surfaces. An array of inner electrodes is contained within, and extends substantially along the length of, each parallel surface. The device includes a first outer array of electrodes and a second outer array of electrodes. Each outer array of electrodes is positioned on either side of the inner electrodes, and is contained within and extends substantially along the length of each parallel surface. A DC voltage is applied to the first and second outer array of electrodes. A RF voltage, with a superimposed electric field, is applied to the inner electrodes by applying the DC voltages to each electrode. Ions either move between the parallel surfaces within an ion confinement area or along paths in the direction of the electric field, or can be trapped in the ion confinement area.

  2. Advanced servo manipulator

    DOEpatents

    Holt, W.E.; Kuban, D.P.; Martin, H.L.

    1988-10-25

    An advanced servo manipulator has modular parts. Modular motor members drive individual input gears to control shoulder roll, shoulder pitch, elbow pitch, wrist yaw, wrist pitch, wrist roll, and tong spacing. The modules include a support member, a shoulder module for controlling shoulder roll, and a sleeve module attached to the shoulder module in fixed relation thereto. The shoulder roll sleeve module has an inner cylindrical member rotatable relative to the outer cylindrical member, and upon which a gear pod assembly is mounted. A plurality of shafts are driven by the gears, which are in turn driven by individual motor modules to transmit rotary power to control elbow pitch as well as to provide four different rotary shafts across the bendable elbow joint to supply rotary motive power to a wrist member and tong member. 41 figs.

  3. Advanced servo manipulator

    DOEpatents

    Holt, William E.; Kuban, Daniel P.; Martin, H. Lee

    1988-01-01

    An advanced servo manipulator has modular parts. Modular motor members drive individual input gears to control shoulder roll, shoulder pitch, elbow pitch, wrist yaw, wrist pitch, wrist roll, and tong spacing. The modules include a support member, a shoulder module for controlling shoulder roll, and a sleeve module attached to the shoulder module in fixed relation thereto. The shoulder roll sleeve module has an inner cylindrical member rotatable relative to the outer cylindrical member, and upon which a gear pod assembly is mounted. A plurality of shafts are driven by the gears, which are in turn driven by individual motor modules to transmit rotary power to control elbow pitch as well as to provide four different rotary shafts across the bendable elbow joint to supply rotary motive power to a wrist member and tong member.

  4. Vacuum tool manipulator

    DOEpatents

    Zollinger, W.T.

    1993-11-23

    Apparatus for manipulating a vacuum hose in a reactor vessel comprises a housing with two opposing openings, an arm carried by the housing and deployable from a stowed position essentially completely within the housing to an extended position where the arm extends through the two openings in a generally horizontal position. The arm preferably has a two-fingered gripping device for gripping the vacuum hose but may carry a different end effector such as a grinding wheel. The fingers are opened and closed by one air cylinder. A second air cylinder extends the device. A third air cylinder within the housing pivotally pulls the opposing end of the arm into the housing via a pivoting member pivotally connected between the third air cylinder shaft and the arm. 6 figures.

  5. Adaptive control of robotic manipulators

    NASA Technical Reports Server (NTRS)

    Seraji, H.

    1987-01-01

    The author presents a novel approach to adaptive control of manipulators to achieve trajectory tracking by the joint angles. The central concept in this approach is the utilization of the manipulator inverse as a feedforward controller. The desired trajectory is applied as an input to the feedforward controller which behaves as the inverse of the manipulator at any operating point; the controller output is used as the driving torque for the manipulator. The controller gains are then updated by an adaptation algorithm derived from MRAC (model reference adaptive control) theory to cope with variations in the manipulator inverse due to changes of the operating point. An adaptive feedback controller and an auxiliary signal are also used to enhance closed-loop stability and to achieve faster adaptation. The proposed control scheme is computationally fast and does not require a priori knowledge of the complex dynamic model or the parameter values of the manipulator or the payload.

  6. A History of Manipulative Therapy

    PubMed Central

    Pettman, Erland

    2007-01-01

    Manipulative therapy has known a parallel development throughout many parts of the world. The earliest historical reference to the practice of manipulative therapy in Europe dates back to 400 BCE. Over the centuries, manipulative interventions have fallen in and out of favor with the medical profession. Manipulative therapy also was initially the mainstay of the two leading alternative health care systems, osteopathy and chiropractic, both founded in the latter part of the 19th century in response to shortcomings in allopathic medicine. With medical and osteopathic physicians initially instrumental in introducing manipulative therapy to the profession of physical therapy, physical therapists have since then provided strong contributions to the field, thereby solidifying the profession's claim to have manipulative therapy within in its legally regulated scope of practice. PMID:19066664

  7. Do Astronauts Havbe a Higher Rate of Orthopedic Shoulder Conditions Than a Cohort of Working Professionals

    NASA Technical Reports Server (NTRS)

    Laughlin, M. S.; Murray, J. D.; Young, M.; Wear, M. L.; Van Baalen, M.; Tarver, W. J.

    2016-01-01

    Occupational surveillance of astronaut shoulder injuries began with operational concerns at the Neutral Buoyancy Laboratory (NBL) during Extra Vehicular Activity (EVA) training. Orthopedic shoulder injury and surgery rates were calculated [1], but classifying the rates as normal, high or low was highly dependent on the comparison group. Thus, the purpose of this study was to identify a population of working professionals and compare orthopedic shoulder consultation and surgery rates.

  8. Biofilm Disrupting Technology for Orthopedic Implants: What’s on the Horizon?

    PubMed Central

    Connaughton, Alexander; Childs, Abby; Dylewski, Stefan; Sabesan, Vani J.

    2014-01-01

    The use of orthopedic implants in joints has revolutionized the treatment of patients with many debilitating chronic musculoskeletal diseases such as osteoarthritis. However, the introduction of foreign material into the human body predisposes the body to infection. The treatment of these infections has become very complicated since the orthopedic implants serve as a surface for multiple species of bacteria to grow at a time into a resistant biofilm layer. This biofilm layer serves as a protectant for the bacterial colonies on the implant making them more resistant and difficult to eradicate when using standard antibiotic treatment. In some cases, the use of antibiotics alone has even made the bacteria more resistant to treatment. Thus, there has been surge in the creation of non-antibiotic anti-biofilm agents to help disrupt the biofilms on the orthopedic implants to help eliminate the infections. In this study, we discuss infections of orthopedic implants in the shoulder then we review the main categories of anti-biofilm agents that have been used for the treatment of infections on orthopedic implants. Then, we introduce some of the newer biofilm disrupting technology that has been studied in the past few years that may advance the treatment options for orthopedic implants in the future. PMID:25705632

  9. Orthopedic disorders of the knee in hemophilia: A current concept review

    PubMed Central

    Rodriguez-Merchan, E Carlos; Valentino, Leonard A

    2016-01-01

    The knee is frequently affected by severe orthopedic changes known as hemophilic arthropathy (HA) in patients with deficiency of coagulation factor VIII or IX and thus this manuscript seeks to present a current perspective of the role of the orthopedic surgeon in the management of these problems. Lifelong factor replacement therapy (FRT) is optimal to prevent HA, however adherence to this regerous treatment is challenging leading to breakthrough bleeding. In patients with chronic hemophilic synovitis, the prelude to HA, radiosynovectomy (RS) is the optimal to ameliorate bleeding. Surgery in people with hemophilia (PWH) is associated with a high risk of bleeding and infection, and must be performed with FRT. A coordinated effort including orthopedic surgeons, hematologists, physical medicine and rehabilitation physicians, physiotherapists and other team members is key to optimal outcomes. Ideally, orthopedic procedures should be performed in specialized hospitals with experienced teams. Until we are able to prevent orthopedic problems of the knee in PWH will have to continue performing orthopedic procedures (arthrocentesis, RS, arthroscopic synovectomy, hamstring release, arthroscopic debridement, alignment osteotomy, and total knee arthroplasty). By using the aforementioned procedures, the quality of life of PWH will be improved. PMID:27335812

  10. Greater osteoblast functions on multiwalled carbon nanotubes grown from anodized nanotubular titanium for orthopedic applications

    NASA Astrophysics Data System (ADS)

    Sirivisoot, Sirinrath; Yao, Chang; Xiao, Xingcheng; Sheldon, Brian W.; Webster, Thomas J.

    2007-09-01

    Titanium (Ti) is the most widely implanted orthopedic material. However, current formulations of Ti have an average orthopedic implant functional lifetime of only 10-15 years. While there are many reasons why orthopedic implants fail, one is a lack of initial and sustained integration into juxtaposed bone. To improve the cytocompatibility properties of Ti for orthopedic applications, parallel multiwalled carbon nanotubes (CNTs) were grown from the pores of anodized nanotubular Ti by a chemical vapor deposition process in the present study. The results of this study provided evidence, for the first time, that osteoblast (bone forming cell) functions (specifically, alkaline phosphatase activity and calcium deposition) were significantly greater on CNTs grown from anodized Ti than on anodized Ti without CNTs and currently-used Ti in orthopedics for up to 21 days. In summary, this study showed that bone growth could possibly be enhanced on currently-used Ti implants with protruding CNTs and, thus, they should be further studied for orthopedic applications.

  11. Orthopedic disorders of the knee in hemophilia: A current concept review.

    PubMed

    Rodriguez-Merchan, E Carlos; Valentino, Leonard A

    2016-06-18

    The knee is frequently affected by severe orthopedic changes known as hemophilic arthropathy (HA) in patients with deficiency of coagulation factor VIII or IX and thus this manuscript seeks to present a current perspective of the role of the orthopedic surgeon in the management of these problems. Lifelong factor replacement therapy (FRT) is optimal to prevent HA, however adherence to this regerous treatment is challenging leading to breakthrough bleeding. In patients with chronic hemophilic synovitis, the prelude to HA, radiosynovectomy (RS) is the optimal to ameliorate bleeding. Surgery in people with hemophilia (PWH) is associated with a high risk of bleeding and infection, and must be performed with FRT. A coordinated effort including orthopedic surgeons, hematologists, physical medicine and rehabilitation physicians, physiotherapists and other team members is key to optimal outcomes. Ideally, orthopedic procedures should be performed in specialized hospitals with experienced teams. Until we are able to prevent orthopedic problems of the knee in PWH will have to continue performing orthopedic procedures (arthrocentesis, RS, arthroscopic synovectomy, hamstring release, arthroscopic debridement, alignment osteotomy, and total knee arthroplasty). By using the aforementioned procedures, the quality of life of PWH will be improved. PMID:27335812

  12. Academic characteristics of orthopedic team physicians affiliated with high school, collegiate, and professional teams.

    PubMed

    Makhni, Eric C; Buza, John A; Byram, Ian; Ahmad, Christopher S

    2015-11-01

    We conducted a study to determine the academic involvement and research productivity of orthopedic team physicians at high school, college, and professional levels of sport. Through Internet and telephone queries, we identified 1054 team physicians from 362 institutions, including 120 randomly selected high schools and colleges and 122 professional teams (baseball, basketball, football, hockey). For all physicians included in the study, we performed a comprehensive search of the Internet and of a citation database to determine academic affiliations, number of publications, and h-index values. Of the 1054 physicians, 678 (64%) were orthopedic surgeons. Percentage of orthopedic team physicians affiliated with an academic medical center was highest in professional sports (64%; 173/270) followed by collegiate sports (36%; 98/275) and high school sports (20%; 27/133). Median number of publications per orthopedic team physician was significantly higher in professional sports (30.6) than in collegiate sports (10.7) or high school sports (6). Median number of publications by orthopedic physicians also varied by sport, with the highest number in Major League Baseball (37.9; range, 0-225) followed by the National Basketball Association (32.0; range, 0-227) and the National Football League (30.4; range, 0-460), with the lowest number within the National Hockey League (20.7; range, 0-144). Academic affiliation and research productivity of orthopedic team physicians vary by competition level and professional sporting league. PMID:26566551

  13. Manipulation hardware for microgravity research

    SciTech Connect

    Herndon, J.N.; Glassell, R.L.; Butler, P.L.; Williams, D.M. ); Rohn, D.A. . Lewis Research Center); Miller, J.H. )

    1990-01-01

    The establishment of permanent low earth orbit occupation on the Space Station Freedom will present new opportunities for the introduction of productive flexible automation systems into the microgravity environment of space. The need for robust and reliable robotic systems to support experimental activities normally intended by astronauts will assume great importance. Many experimental modules on the space station are expected to require robotic systems for ongoing experimental operations. When implementing these systems, care must be taken not to introduce deleterious effects on the experiments or on the space station itself. It is important to minimize the acceleration effects on the experimental items being handled while also minimizing manipulator base reaction effects on adjacent experiments and on the space station structure. NASA Lewis Research Center has been performing research on these manipulator applications, focusing on improving the basic manipulator hardware, as well as developing improved manipulator control algorithms. By utilizing the modular manipulator concepts developed during the Laboratory Telerobotic Manipulator program, Oak Ridge National Laboratory has developed an experimental testbed system called the Microgravity Manipulator, incorporating two pitch-yaw modular positioners to provide a 4 dof experimental manipulator arm. A key feature in the design for microgravity manipulation research was the use of traction drives for torque transmission in the modular pitch-yaw differentials.

  14. Torque-Limiting Manipulation Device

    NASA Technical Reports Server (NTRS)

    Moetteli, John B. (Inventor)

    1999-01-01

    A device for manipulating a workpiece in space includes a fixture, a stanchion assembly, a manipulation mechanism, an actuation mechanism, and a reaction mechanism. The fixture has an end onto which the workpiece affixes. The stanchion assembly has an upper and a lower end. The manipulation mechanism connects the fixture and the upper end of the stanchion assembly. The lower end of the stanchion assembly mounts, via probe and a socket, to a structure. The actuation mechanism operably connects to the manipulation mechanism, and moves the fixture in space. The reaction mechanism provides a point through which force inputs into the actuation mechanism may react.

  15. Preoperative Planning of Orthopedic Procedures using Digitalized Software Systems.

    PubMed

    Steinberg, Ely L; Segev, Eitan; Drexler, Michael; Ben-Tov, Tomer; Nimrod, Snir

    2016-06-01

    The progression from standard celluloid films to digitalized technology led to the development of new software programs to fulfill the needs of preoperative planning. We describe here preoperative digitalized programs and the variety of conditions for which those programs can be used to facilitate preparation for surgery. A PubMed search using the keywords "digitalized software programs," "preoperative planning" and "total joint arthroplasty" was performed for all studies regarding preoperative planning of orthopedic procedures that were published from 1989 to 2014 in English. Digitalized software programs are enabled to import and export all picture archiving communication system (PACS) files (i.e., X-rays, computerized tomograms, magnetic resonance images) from either the local working station or from any remote PACS. Two-dimension (2D) and 3D CT scans were found to be reliable tools with a high preoperative predicting accuracy for implants. The short learning curve, user-friendly features, accurate prediction of implant size, decreased implant stocks and low-cost maintenance makes digitalized software programs an attractive tool in preoperative planning of total joint replacement, fracture fixation, limb deformity repair and pediatric skeletal disorders. PMID:27468530

  16. Substance P and Acute Pain in Patients Undergoing Orthopedic Surgery

    PubMed Central

    Lisowska, Barbara; Siewruk, Katarzyna; Lisowski, Aleksander

    2016-01-01

    Objective There is a limited information about the role of Substance P (SP) in acute pain nociception following surgical stimulation in patients with a chronic inflammatory state not to mention the link between this neuropeptide level changes and intensity of pain. The goal of the research was to find the correlation between SP level changes and acute pain intensity in patients with rheumatoid arthritis undergoing elective orthopedic surgery. Material and Methods Patients with rheumatoid arthritis (RA) were enrolled in the study. The correlation between acute pain intensity and concentration of SP in serum as well as in drainage fluid from postoperative wound was assessed in patients with RA who underwent Total Knee Replacement (TKA) under spinal anesthesia. Results In patients with RA a correlation between intensity of acute pain and serum SP was found postoperatively, whereas there was no correlation between intensity of acute pain and concentration of SP in drainage fluid. Conclusions 1. The correlation between acute pain intensity and SP serum concentration was found postoperatively in patients with RA. 2. The correlation between acute pain intensity and SP concentration in drainage fluid was not found postoperatively in patients with RA. PMID:26731421

  17. Parametric analysis of orthopedic screws in relation to bone density.

    PubMed

    Zanetti, Elisabetta M; Salaorno, Massimiliano; Grasso, Giovanni; Audenino, Alberto L

    2009-01-01

    A global study of geometry and material properties of orthopedic screws was performed, considering not only the effect of each single factor (screw pitch, number of threads, fillet angle, etc.) but also their interactions with respect to bone density.The stress patterns resulting from different screw geometries and bone densities were analyzed using finite element techniques, taking into account different levels of osseointegration between the screw and the bone. These numerical models where validated through experimental pull-out tests, where a pull out force of 120 N produced localized failure of the last thread (stresses above 0.42 MPa). The results of the numerical simulations were then summarised using a multi-factorial parametric analysis. This demonstrated the great relevance of the interaction between bone density and screw pitch, showing that the optimal screw pitch can vary by more than 25% for different densities (0.35 g/cm(3) and 0.47 g/cm(3), respectively).The parameters calculated by means of the multi-factorial analysis allow the pull out force to be estimated for different osseointegration levels, different screw geometries and material properties, and for different bone densities. The final objective is to determine the best choice of implant for each individual patient. PMID:19587807

  18. PEEK Biomaterials in Trauma, Orthopedic, and Spinal Implants

    PubMed Central

    Kurtz, S. M.; Devine, J. N.

    2007-01-01

    Since the 1980s, polyaryletherketones (PAEKs) have been increasingly employed as biomaterials for trauma, orthopedic, and spinal implants. We have synthesized the extensive polymer science literature as it relates to structure, mechanical properties, and chemical resistance of PAEK biomaterials. With this foundation, one can more readily appreciate why this family of polymers will be inherently strong, inert, and biocompatible. Due to its relative inertness, PEEK biomaterials are an attractive platform upon which to develop novel bioactive materials, and some steps have already been taken in that direction, with the blending of HA and TCP into sintered PEEK. However, to date, blended HA-PEEK composites have involved a trade-off in mechanical properties in exchange for their increased bioactivity. PEEK has had the greatest clinical impact in the field of spine implant design, and PEEK is now broadly accepted as a radiolucent alternative to metallic biomaterials in the spine community. For mature fields, such as total joint replacements and fracture fixation implants, radiolucency is an attractive but not necessarily critical material feature. PMID:17686513

  19. Biomaterials for orthopedics: a roughness analysis by atomic force microscopy.

    PubMed

    Covani, Ugo; Giacomelli, Luca; Krajewski, Adriano; Ravaglioli, Antonio; Spotorno, Lorenza; Loria, Patrizia; Das, Saradindu; Nicolini, Claudio

    2007-09-01

    We conducted an AFM analysis of roughness on 7 materials widely used in bone reconstruction. Roughness was evaluated by measuring Root Mean Square (RMS) values and RMS/average height (AH) ratio, in different dimensional ranges, varying from 100 microns square to a few hundreds of nanometers. The results showed that Titanium presented a lower roughness than the other materials analyzed, frequently reaching statistical significance. On the contrary, bioactive materials, such as hydroxyapatite (HA) and bioactive glasses, demonstrated an overall higher roughness. In particular, this study focuses attention on AP40 and especially RKKP, which proved to have a significant higher roughness at low dimensional ranges. This determines a large increase in surface area, which is strongly connected with osteoblast adhesion and growth and to protein absorption. Therefore, the biointegration properties of bioactive glasses can also be given as answer in terms of surface structures in which chemical composition can influence directly the biological system (e.g. with chemical exchanges and development of specific surface electrical charge) and indirectly, via the properties induced on tribological behavior that expresses itself during the smoothing of the surfaces. We also test two new bioactive glasses, RBP1 and RBP2, with a chemical composition similar to AP40, but with some significant small additions and substitutions of components, in order to make preliminary considerations on their potential role in orthopedics. PMID:17326227

  20. Amino acid containing glass-ionomer cement for orthopedic applications

    NASA Astrophysics Data System (ADS)

    Wu, Wei

    Amino acid containing glass-ionomer cements were synthesized, formulated, and evaluated for orthopedic application. The formulation of different amino acid containing glass-ionomer bone cements was optimized, and conventional and resin-modified glass-ionomer bone cements were compared. Properties of interest included handling characteristics, physical and chemical properties, and mechanical strength of the bone cement. The study was based on the synthesis of different vinyl containing amino acids, different polyelectrolytes containing these amino acid residues, and different resin-modified polyelectrolytes, as well as formulation and evaluation of conventional and resin-modified glass-ionomer bone cements using these polyelectrolytes. Systematic preparation of polyelectrolytes and formulation of glass-ionomer bone cements were essential features of this work, since we anticipated that the mechanical properties of the glass-ionomer bone cements could be strongly affected by the nature of the polyelectrolytes and formulation. Mechanical properties were evaluated in a screw driven mechanical testing machine, and structure-property relationships were determined by scanning electron microscopic (SEM) observation of the fracture surface of the specimens. How the structure of polyelectrolytes, such as different amino acid residues, molecular weight, different modifying resin, and formulation of glass-ionomer bone cement, affected the mechanical properties was also studied.

  1. Traumatic Finger Injuries: What the Orthopedic Surgeon Wants to Know.

    PubMed

    Wieschhoff, Ged G; Sheehan, Scott E; Wortman, Jeremy R; Dyer, George S M; Sodickson, Aaron D; Patel, Ketan I; Khurana, Bharti

    2016-01-01

    Traumatic finger injuries account for a substantial number of emergency visits every year. Imaging plays an important role in diagnosis and in directing management of these injuries. Although many injuries can be managed conservatively, some require more invasive interventions to prevent complications and loss of function. Accurate diagnosis of finger injuries can often be difficult, given the complicated soft-tissue anatomy of the hand and the diverse spectrum of injuries that can occur. To best serve the patient and the treating physician, radiologists must have a working knowledge of finger anatomy, the wide array of injury patterns that can occur, the characteristic imaging findings of different finger injuries, and the most appropriate treatment options for each type of injury. This article details the intricate anatomy of the hand as it relates to common finger injuries, illustrates the imaging findings of a range of injuries, presents optimal imaging modalities and imaging parameters for the diagnosis of different injury types, and addresses which findings have important management implications for the patient and the orthopedic surgeon. With this fund of knowledge, radiologists will be able to recommend the most appropriate imaging studies, make accurate diagnoses, convey clinically relevant imaging findings to the referring physician, and suggest appropriate follow-up examinations. In this way, the radiologist will help improve patient care and outcomes. Online supplemental material is available for this article. (©)RSNA, 2016. PMID:27399238

  2. Why medical students choose orthopedic surgery as a specialty?

    PubMed Central

    Erraji, Moncef; Kharraji, Abdessamad; Abbasi, Najib; Najib, Abdeljawad; Yacoubi, Hicham

    2015-01-01

    Before the crisis announced the Moroccan surgery, the objectives of this study were to analyze the choice of specialties newly appointed to the internal review and the guidance of medical students and to determine the factors influencing this choice. Data on specialty choice students were analyzed and a questionnaire was offered to students of Morocco at the beginning of academic year 2013-20014 The form consisted of questions on the year of study. sex, professional guidelines and reasons for choice. candidates were male, the average age of our residents was 28 years. We also noted the importance of the passage as well as external service trauma. Care provided to patients, lifestyle and income reported by 85% of respondents to be the most important factors to pursue orthopedics as a career. The TR-Orth is now a specialty that responds to a positive choice. The choice of TR-Orth by students at the end of medical school curriculum is reinforced by teaching and practicing the specialty during the internship. The overall training is unsatisfactory overall. Students would deepen in some areas. This study confirms that there is currently a shift in trauma surgery, mostly induced by an a priori negative for particular workloads. PMID:26185556

  3. Infection Mitigation Efficacy of Photoactive Titania on Orthopedic Implant Materials

    PubMed Central

    Azad, Abdul-Majeed; Hershey, Ryan; Aboelzahab, Asem; Goel, Vijay

    2011-01-01

    In order to impede infection and achieve accelerated wound healing in the postorthopaedic surgery patients, a simple and benign procedure for creating nanotubular or nanofibrillar structure of photoactive TiO2 on the surface of Ti plates and wires is described. The nanoscale TiO2 films on titanium were grown by hydrothermal processing in one case and by anodization in the presence of dilute mineral acids under mild and benign conditions in the other. Confocal microscopy results demonstrated at least 50% reduction in the population of E. coli colonies (concentration 2.15 × 107 cells/mL) on TiO2-coated implants upon an IR exposure of up to 30 s; it required ∼20 min of exposure to UV beam for the same effect. These findings suggest the probability of eliminating wound infection during and after orthopedic surgical procedures by brief illumination of photoactive titania films on the implants with an IR beam. PMID:21994891

  4. Hydroxyapatite electrodeposition on anodized titanium nanotubes for orthopedic applications

    NASA Astrophysics Data System (ADS)

    Parcharoen, Yardnapar; Kajitvichyanukul, Puangrat; Sirivisoot, Sirinrath; Termsuksawad, Preecha

    2014-08-01

    Nanotubes modification for orthopedic implants has shown interesting biological performances (such as improving cell adhesion, cell differentiation, and enhancing osseointegration). The purpose of this study is to investigate effect of titanium dioxide (TiO2) nanotube feature on performance of hydroxyapatite-coated titanium (Ti) bone implants. TiO2 nanotubes were prepared by anodization using ammonium fluoride electrolyte (NH4F) with and without modifiers (PEG400 and Glycerol) at various potential forms, and times. After anodization, the nanotubes were subsequently annealed. TiO2 nanotubes were characterized by scanning electron microscope and X-ray diffractometer. The amorphous to anatase transformation due to annealing was observed. Smooth and highly organized TiO2 nanotubes were found when high viscous electrolyte, NH4F in glycerol, was used. Negative voltage (-4 V) during anodization was confirmed to increase nanotube thickness. Length of the TiO2 nanotubes was significantly increased by times. The TiO2 nanotube was electrodeposited with hydroxyapatite (HA) and its adhesion was estimated by adhesive tape test. The result showed that nanotubes with the tube length of 560 nm showed excellent adhesion. The coated HA were tested for biological test by live/dead cell straining. HA coated on TiO2 nanotubes showed higher cells density, higher live cells, and more spreading of MC3T3-E1 cells than that growing on titanium plate surface.

  5. EARLY COMPLICATIONS IN THE ORTHOPEDIC TREATMENT OF BONE METASTASES

    PubMed Central

    Teixeira, Luiz Eduardo Moreira; Miranda, Ricardo Horta; Ghedini, Daniel Ferreira; Aguilar, Rafael Bazílio; Novais, Eduardo Nilo Vasconcelos; de Abreu e Silva, Guilherme Moreira; Araújo, Ivana Duval; de Andrade, Marco Antônio Percope

    2015-01-01

    Objective: To assess the early complications in the orthopedic treatment of metastatic bone lesions and the factors associated with these complications. Method: There were assessed, retrospectively, 64 patients that underwent surgical treatment for bone metastases, analyzing the complications that occurred in the pre-operative and early post- operative period and associating them with the tumor origin, type of procedure done, the need of blood reposition before the surgery, the need of new surgical procedures and the mortality due to the complications. Results: Early complications in the treatment were observed in 17 (26.6%) patients, of which six (35.2%) ended up dying due to these complications. Regarding the type, 15 (23.8%) cases were due to surgical complications, four (6.3%) clinical and three (4.7%) patients showed clinical and surgical complications. There was no significant difference in the frequency of complications or mortality when assessed the type of reconstruction or affected region. The tumors with a renal origin needed more blood reposition and showed a bigger frequency of complications. Conclusion: The complications occurred in 26.6%. The complications are not related to the kind of treatment performed or to the region affected. The renal origin tumors showed a higher risk of hemorrhage. PMID:27077063

  6. Manipulating and Visualizing Proteins

    SciTech Connect

    Simon, Horst D.

    2003-12-05

    ProteinShop Gives Researchers a Hands-On Tool for Manipulating, Visualizing Protein Structures. The Human Genome Project and other biological research efforts are creating an avalanche of new data about the chemical makeup and genetic codes of living organisms. But in order to make sense of this raw data, researchers need software tools which let them explore and model data in a more intuitive fashion. With this in mind, researchers at Lawrence Berkeley National Laboratory and the University of California, Davis, have developed ProteinShop, a visualization and modeling program which allows researchers to manipulate protein structures with pinpoint control, guided in large part by their own biological and experimental instincts. Biologists have spent the last half century trying to unravel the ''protein folding problem,'' which refers to the way chains of amino acids physically fold themselves into three-dimensional proteins. This final shape, which resembles a crumpled ribbon or piece of origami, is what determines how the protein functions and translates genetic information. Understanding and modeling this geometrically complex formation is no easy matter. ProteinShop takes a given sequence of amino acids and uses visualization guides to help generate predictions about the secondary structures, identifying alpha helices and flat beta strands, and the coil regions that bind them. Once secondary structures are in place, researchers can twist and turn these pre-configurations until they come up with a number of possible tertiary structure conformations. In turn, these are fed into a computationally intensive optimization procedure that tries to find the final, three-dimensional protein structure. Most importantly, ProteinShop allows users to add human knowledge and intuition to the protein structure prediction process, thus bypassing bad configurations that would otherwise be fruitless for optimization. This saves compute cycles and accelerates the entire process, so

  7. Image Manipulation: Then and Now.

    ERIC Educational Resources Information Center

    Sutton, Ronald E.

    The images of photography have been manipulated almost from the moment of their discovery. The blending together in the studio and darkroom of images not found in actual scenes from life has been a regular feature of modern photography in both art and advertising. Techniques of photograph manipulation include retouching; blocking out figures or…

  8. Modeling Manipulation in Medical Education

    ERIC Educational Resources Information Center

    Dailey, Jason I.

    2010-01-01

    As residents and medical students progress through their medical training, they are presented with multiple instances in which they feel they must manipulate the healthcare system and deceive others in order to efficiently treat their patients. This, however, creates a culture of manipulation resulting in untoward effects on trainees' ethical and…

  9. Smart Hand For Manipulators

    NASA Astrophysics Data System (ADS)

    Fiorini, Paolo

    1987-10-01

    Sensor based, computer controlled end effectors for mechanical arms are receiving more and more attention in the robotics industry, because commonly available grippers are only adequate for simple pick and place tasks. This paper describes the current status of the research at JPL on a smart hand for a Puma 560 robot arm. The hand is a self contained, autonomous system, capable of executing high level commands from a supervisory computer. The mechanism consists of parallel fingers, powered by a DC motor, and controlled by a microprocessor embedded in the hand housing. Special sensors are integrated in the hand for measuring the grasp force of the fingers, and for measuring forces and torques applied between the arm and the surrounding environment. Fingers can be exercised under position, velocity and force control modes. The single-chip microcomputer in the hand executes the tasks of communication, data acquisition and sensor based motor control, with a sample cycle of 2 ms and a transmission rate of 9600 baud. The smart hand described in this paper represents a new development in the area of end effector design because of its multi-functionality and autonomy. It will also be a versatile test bed for experimenting with advanced control schemes for dexterous manipulation.

  10. Stereoscopically Observing Manipulative Actions

    PubMed Central

    Ferri, S.; Pauwels, K.; Rizzolatti, G.; Orban, G. A.

    2016-01-01

    The purpose of this study was to investigate the contribution of stereopsis to the processing of observed manipulative actions. To this end, we first combined the factors “stimulus type” (action, static control, and dynamic control), “stereopsis” (present, absent) and “viewpoint” (frontal, lateral) into a single design. Four sites in premotor, retro-insular (2) and parietal cortex operated specifically when actions were viewed stereoscopically and frontally. A second experiment clarified that the stereo-action-specific regions were driven by actions moving out of the frontoparallel plane, an effect amplified by frontal viewing in premotor cortex. Analysis of single voxels and their discriminatory power showed that the representation of action in the stereo-action-specific areas was more accurate when stereopsis was active. Further analyses showed that the 4 stereo-action-specific sites form a closed network converging onto the premotor node, which connects to parietal and occipitotemporal regions outside the network. Several of the specific sites are known to process vestibular signals, suggesting that the network combines observed actions in peripersonal space with gravitational signals. These findings have wider implications for the function of premotor cortex and the role of stereopsis in human behavior. PMID:27252350

  11. Stereoscopically Observing Manipulative Actions.

    PubMed

    Ferri, S; Pauwels, K; Rizzolatti, G; Orban, G A

    2016-08-01

    The purpose of this study was to investigate the contribution of stereopsis to the processing of observed manipulative actions. To this end, we first combined the factors "stimulus type" (action, static control, and dynamic control), "stereopsis" (present, absent) and "viewpoint" (frontal, lateral) into a single design. Four sites in premotor, retro-insular (2) and parietal cortex operated specifically when actions were viewed stereoscopically and frontally. A second experiment clarified that the stereo-action-specific regions were driven by actions moving out of the frontoparallel plane, an effect amplified by frontal viewing in premotor cortex. Analysis of single voxels and their discriminatory power showed that the representation of action in the stereo-action-specific areas was more accurate when stereopsis was active. Further analyses showed that the 4 stereo-action-specific sites form a closed network converging onto the premotor node, which connects to parietal and occipitotemporal regions outside the network. Several of the specific sites are known to process vestibular signals, suggesting that the network combines observed actions in peripersonal space with gravitational signals. These findings have wider implications for the function of premotor cortex and the role of stereopsis in human behavior. PMID:27252350

  12. Risks associated with spinal manipulation.

    PubMed

    Stevinson, Clare; Ernst, Edzard

    2002-05-01

    The aim of this systematic review was to summarize the evidence about the risks of spinal manipulation. Articles were located through searching three electronic databases (MEDLINE, EMBASE, Cochrane Library), contacting experts (n =9), scanning reference lists of relevant articles, and searching departmental files. Reports in any language containing data relating to risks associated with spinal manipulation were included, irrespective of the profession of the therapist. Where available, systematic reviews were used as the basis of this article. All papers were evaluated independently by the authors. Data from prospective studies suggest that minor, transient adverse events occur in approximately half of all patients receiving spinal manipulation. The most common serious adverse events are vertebrobasilar accidents, disk herniation, and cauda equina syndrome. Estimates of the incidence of serious complications range from 1 per 2 million manipulations to 1 per 400,000. Given the popularity of spinal manipulation, its safety requires rigorous investigation. PMID:12015249

  13. R + C Factors and Sacro Occipital Technique Orthopedic Blocking: a pilot study using pre and post VAS assessment

    PubMed Central

    Blum, Charles L.

    2015-01-01

    Introduction: The concept of a systematic or predictive relationship between distant vertebral levels distinct from accumulative functional compensatory mechanisms, such as in scoliosis, has been perpetuated within chiropractic technique systems based on clinical observation and experience. This study seeks to investigate this relationship between the cervical and lumbar vertebrae. Methods: Patients (experimental group n=26 and control group n=12) were selected from the patient base of one office, and were limited to patients that had sensitivity at specific cervical reflex points. Using a pre and post outcome measurement and sacro occipital technique R + C protocols, the related lumbar vertebra was adjusted in the direction indicated by the cervical vertebral sensitivity. Results: Statistical analysis revealed there was a statistically significant difference between pre- and post-VAS measurements and found that the notable difference in mean change in VAS scores were statistically significantly different between the experimental and control groups (p < .001). Conclusion: The findings of this study suggest that further research into cervical and lumbar vertebra interrelationships, and the efficacy of orthopedic block treatment, may be warranted. Further studies are needed to confirm whether a causal relationship exists between lumbar manipulation and decreased cervical spine sensitivity. PMID:26136605

  14. Postoperative Risk of Hepatic Decompensation after Orthopedic Surgery in Patients with Cirrhosis

    PubMed Central

    Nyberg, Eric M.; Batech, Michael; Cheetham, T. Craig; Pio, Jose R.; Caparosa, Susan L.; Chocas, Mary Alice; Singh, Anshuman

    2016-01-01

    Abstract Background and Aims: Previous studies have shown increased hepatic decompensation in patients with cirrhosis undergoing surgery. However, there are little data available in cirrhotics undergoing orthopedic surgery compared to cirrhotics who did not undergo surgery. The aim of this study was to examine the demographics, comorbid conditions, and clinical factors associated with hepatic decompensation within 90 days in cirrhotics who underwent orthopedic surgery. Methods: This is a retrospective matched cohort study. Inclusion criteria were cirrhosis diagnosis, age > 18 years, ≥ 6 months continuous health plan membership, and a procedure code for orthopedic surgery. Up to five cirrhotic controls without orthopedic surgery were matched on age, gender, and cirrhosis diagnosis date. Data abstraction was performed for demographics, socioeconomics, clinical, and decompensation data. Chart review was performed for validation. Multivariable analysis estimated relative risk of decompensation. Results: Eight hundred fifty-three orthopedic surgery cases in cirrhotics were matched with 4,263 cirrhotic controls. Among the cases and matched controls, the mean age was 60.5 years, and 52.2% were female. Within 90 days after surgery, cases had more decompensation compared to matched controls (12.8% vs 4.9%). Using multivariable analysis, orthopedic surgery, a 0.5 g/dL decrease in serum albumin, and a 1-unit increase in Charlson Comorbidity Index were associated with a significant increase in decompensation within 90 days of surgery. Diabetes, chronic obstructive pulmonary disease, and chronic kidney disease were seen with increased frequency in cases vs. matched controls. Conclusions: Cirrhotics who underwent orthopedic surgery had a significant increase in hepatic decompensation within 90 days of surgery compared to matched controls. An incremental decrease in serum albumin and an incremental increase in the Charlson Comorbidity Index were significantly associated with

  15. Orthopedic manifestations in patients with mucopolysaccharidosis type II (Hunter syndrome) enrolled in the Hunter Outcome Survey

    PubMed Central

    Link, Bianca; de Camargo Pinto, Louise Lapagesse; Giugliani, Roberto; Wraith, James Edmond; Guffon, Nathalie; Eich, Elke; Beck, Michael

    2010-01-01

    Mucopolysaccharidosis type II (MPS II or Hunter syndrome) is a rare, inherited disorder caused by deficiency of the lysosomal enzyme iduronate-2-sulfatase. As a result of this deficiency, glycosaminoglycans accumulate in lysosomes in many tissues, leading to progressive multisystemic disease. The cardiopulmonary and neurological problems associated with MPS II have received considerable attention. Orthopedic manifestations are common but not as well characterized. This study aimed to characterize the prevalence and severity of orthopedic manifestations of MPS II and to determine the relationship of these signs and symptoms with cardiovascular, pulmonary and central nervous system involvement. Orthopedic manifestations of MPS II were studied using cross-sectional data from the Hunter Outcome Survey (HOS). The HOS is a global, physician-led, multicenter observational database that collects information on the natural history of MPS II and the long-term safety and effectiveness of enzyme replacement therapy. As of January 2009, the HOS contained baseline data on joint range of motion in 124 males with MPS II. In total, 79% of patients had skeletal manifestations (median onset, 3.5 years) and 25% had abnormal gait (median onset, 5.4 years). Joint range of motion was restricted for all joints assessed (elbow, shoulder, hip, knee and ankle). Extension was the most severely affected movement: the exception to this was the shoulder. Surgery for orthopedic problems was rare. The presence of orthopedic manifestations was associated with the presence of central nervous system and pulmonary involvement, but not so clearly with cardiovascular involvement. Orthopedic interventions should be considered on an individual-patient basis. Although some orthopedic manifestations associated with MPS II may be managed routinely, a good knowledge of other concurrent organ system involvement is essential. A multidisciplinary approach is required. PMID:21808707

  16. Manipulability, force, and compliance analysis for planar continuum manipulators.

    PubMed

    Gravagne, Ian A; Walker, Ian D

    2002-06-01

    Continuum manipulators, inspired by the natural capabilities of elephant trunks and octopus tentacles, may find niche applications in areas like human-robot interaction, multiarm manipulation, and unknown environment exploration. However, their true capabilities will remain largely inaccessible without proper analytical tools to evaluate their unique properties. Ellipsoids have long served as one of the foremost analytical tools available to the robotics researcher, and the purpose of this paper is to first formulate, and then to examine, three types of ellipsoids for continuum robots: manipulability, force, and compliance. PMID:12492083

  17. Manipulability, force, and compliance analysis for planar continuum manipulators

    NASA Technical Reports Server (NTRS)

    Gravagne, Ian A.; Walker, Ian D.

    2002-01-01

    Continuum manipulators, inspired by the natural capabilities of elephant trunks and octopus tentacles, may find niche applications in areas like human-robot interaction, multiarm manipulation, and unknown environment exploration. However, their true capabilities will remain largely inaccessible without proper analytical tools to evaluate their unique properties. Ellipsoids have long served as one of the foremost analytical tools available to the robotics researcher, and the purpose of this paper is to first formulate, and then to examine, three types of ellipsoids for continuum robots: manipulability, force, and compliance.

  18. Updating memory after mild traumatic brain injury and orthopedic injuries.

    PubMed

    Hanten, Gerri; Li, Xiaoqi; Ibarra, Alyssa; Wilde, Elisabeth A; Barnes, Amanda; McCauley, Stephen R; McCarthy, James; Hoxhaj, Shkelzen; Mendez, Donna; Hunter, Jill V; Levin, Harvey S; Smith, Douglas H

    2013-04-15

    Few studies have examined the trajectory of recovery of executive function (EF) after mild TBI (mTBI). Therefore, consensus has not been reached on the incidence and extent of EF impairment after mTBI. The present study investigated trajectory of change in executive memory over 3 months after mTBI on 59 right-handed participants with mTBI, as defined by Centers for Disease Control criteria, ages 14-30 years, recruited within 96 hours post-injury and tested <1 week (baseline), 1 month, and 3 months after injury. Also included were 58 participants with orthopedic injury (OI) and 27 typically developing (TD) non-injured participants with similar age, socioeconomic status, sex, and ethnicity. MRI data were acquired at baseline and 3 months. Although criteria included a normal CT scan, lesions were detected by MRI in 19 mTBI patients. Participants completed the KeepTrack task, a verbal recall task placing demands on goal maintenance, semantic memory, and memory updating. Scores reflected items recalled and semantic categories maintained. The mTBI group was divided into two groups: high (score ≥12) or low (score <12) symptoms based on the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). Mixed model analyses revealed the trajectory of change in mTBI patients (high and low RPQ), OI patients, and TD subjects were similar over time (although the TD group differed from other groups at baseline), suggesting no recovery from mTBI up to 90 days. For categories maintained, differences in trajectory of recovery were discovered, with the OI comparison group surprisingly performing similar to those in the mTBI group with high RPQ symptoms, and different from low RPQ and the TD groups, bringing up questions about utility of OIs as a comparison group for mTBI. Patients with frontal lesions (on MRI) were also found to perform worse than those without lesions, a pattern that became more pronounced with time. PMID:23227898

  19. Corrosion behavior of a welded stainless-steel orthopedic implant.

    PubMed

    Reclaru, L; Lerf, R; Eschler, P Y; Meyer, J M

    2001-02-01

    The corrosion behavior of combinations of materials used in an orthopedic implant: the spherical part (forged or forged and annealed) constituting the head, the weld (tungsten inert gas (TIG) or electron beam (EB) techniques), and the cylindrical part (annealed) constituting the shaft of a femoral prosthesis - has been investigated. Open-circuit potentials, potentiodynamic curves, Tafel slope, mixed potential theory and susceptibility to intergranular attack are electrochemical and chemical procedures selected for this work. Electrochemical measurements using a microelectrode have been made in the following zones: spherical part, cylindrical part, weld, and weld/sphere, and weld/shaft interfaces. To detect intergranular attack, the Strauss test has been used. At the interfaces, corrosion currents, measured (Icorr) and predicted (Icouple) are low, in the order of the pico- to nanoampere. The electrochemical behavior of the electron beam (EB) weld is better than that of the tungsten inert gas (TIG). Welds at interfaces can behave either anodically or cathodically. It is better if welds, which are sensitive parts of the femoral prosthesis, behave cathodically. In this way, the risk of starting localized corrosion (pitting, crevice or intergranular corrosion) from a galvanic couple, remains low. From this point of view, the sample with the EB weld offers the best behavior. All the other samples containing a TIG type of weld exhibit a less favorable behavior. The mechanical treatments (forged, and forged and annealed) of the steel sphere did not show any difference in the corrosion behavior. No intergranular corrosion has been observed at the weld/steel interface for unsensitized samples. With sensitized samples, however, a TIG sample has exhibited some localized intergranular corrosion at a distance of 500 microm along the weld/stainless steel (sphere) interface. PMID:11197502

  20. Sarcopenia and Sarcopenic Obesity in Patients Undergoing Orthopedic Surgery

    PubMed Central

    Ji, Hyung-Min; Han, Jun; Jin, Dong San; Suh, Hyunseok; Chung, Yoon-Sok

    2016-01-01

    Background The purpose of this retrospective study was to determine the prevalence of sarcopenia and sarcopenic obesity among patients who underwent orthopedic surgery (OS). Methods A total of 222 patients were reviewed immediately after or prior to OS. In the control group, 364 patients from outpatient departments (OPDs) who did not have any OS were enrolled. Whole-body dual-energy X-ray absorptiometry was used to analyze body composition. Skeletal muscle mass was adjusted for height squared, total body weight, and height and fat mass (residuals). Obesity was defined as body mass index (BMI) > 25.0 kg/m2. Results The prevalence of sarcopenia in the OS group was 25.7%, 44.1%, and 26.6%, respectively, according to the 3 different criteria. The prevalence was significantly lower in the OPD group (6.0%, 33.1%, and 14.8%, respectively). The highest rates of sarcopenia with height-adjusted definition were seen in patients with a femoral neck fracture. In the multivariate analysis, factors associated with sarcopenia were male gender, older age, and lower BMI (odds ratio [OR]: 28.38, 1.03, and 1.83, respectively) when muscle mass was adjusted for height, whereas male gender, older age, and higher BMI were associated with sarcopenia (OR: 1.04, 2.57, and 1.83, respectively) when adjusted for weight. When residuals were used as a cutoff, decreased BMI and total hip bone mineral density (0.1 g/cm2) were independent risk factors associated with sarcopenia (OR: 1.09 and 1.05). The prevalence of sarcopenic obesity ranged from 1.8% to 21.2%. Conclusions Our study demonstrated a high prevalence of sarcopenia among OS patients. PMID:27247746

  1. Chitosan for gene delivery and orthopedic tissue engineering applications.

    PubMed

    Raftery, Rosanne; O'Brien, Fergal J; Cryan, Sally-Ann

    2013-01-01

    Gene therapy involves the introduction of foreign genetic material into cells in order exert a therapeutic effect. The application of gene therapy to the field of orthopaedic tissue engineering is extremely promising as the controlled release of therapeutic proteins such as bone morphogenetic proteins have been shown to stimulate bone repair. However, there are a number of drawbacks associated with viral and synthetic non-viral gene delivery approaches. One natural polymer which has generated interest as a gene delivery vector is chitosan. Chitosan is biodegradable, biocompatible and non-toxic. Much of the appeal of chitosan is due to the presence of primary amine groups in its repeating units which become protonated in acidic conditions. This property makes it a promising candidate for non-viral gene delivery. Chitosan-based vectors have been shown to transfect a number of cell types including human embryonic kidney cells (HEK293) and human cervical cancer cells (HeLa). Aside from its use in gene delivery, chitosan possesses a range of properties that show promise in tissue engineering applications; it is biodegradable, biocompatible, has anti-bacterial activity, and, its cationic nature allows for electrostatic interaction with glycosaminoglycans and other proteoglycans. It can be used to make nano- and microparticles, sponges, gels, membranes and porous scaffolds. Chitosan has also been shown to enhance mineral deposition during osteogenic differentiation of MSCs in vitro. The purpose of this review is to critically discuss the use of chitosan as a gene delivery vector with emphasis on its application in orthopedic tissue engineering. PMID:23676471

  2. Interpretation time in an ethnically diverse pediatric orthopedic clinic.

    PubMed

    Lee, Moon; Sobralske, Mary; Raney, Ellen; Carino, Brian

    2016-06-20

    Purpose - The purpose of this paper is to determine whether there were differences in clinical encounter time between patients who speak English and those who require an interpretation service in an ethnically diverse pediatric clinic. Design/methodology/approach - Encounter time with patients requiring interpretation was compared to encounter time with patients who spoke English. The sample consisted of 310 encounters at a pediatric orthopedic clinic where patients spoke over 18 primary languages. Data were analyzed using ANOVA to compare four types of encounters. Findings - Approximately 12 percent (n=38) required interpretation and encounters requiring interpretation took 30 percent (nine minutes) longer than those that did not, p < 0.01(25 vs 16 minutes). Furthermore, this difference was mainly among new patients: Approximately, 53 percent increase in time for new patient encounters requiring interpretation (36 vs 23 minutes) while only 25 percent increase in encounter time for established patients (20 vs 16 minutes) was detected. Research limitations/implications - Preventing problems due to language barriers requires time for interpretation which places demands on staff resources and presents clinical challenges. However, long-term benefits of quality health care outweigh the costs associated with interpretation service. Originality/value - To the knowledge, this is the first study to investigate actual encounter time differences in a pediatric clinical setting. The authors found that clinical encounters requiring interpretation took approximately nine minutes longer in general and four minutes longer for established patients. These findings could give much needed information for hospital administrators to allocate appropriate amounts of time and resources to care for those who need interpretation services. However, they also indicate a broader concern of the reduction of clinical encounter time for overall health care system in the country that might need

  3. Direct Manipulation in Virtual Reality

    NASA Technical Reports Server (NTRS)

    Bryson, Steve

    2003-01-01

    Virtual Reality interfaces offer several advantages for scientific visualization such as the ability to perceive three-dimensional data structures in a natural way. The focus of this chapter is direct manipulation, the ability for a user in virtual reality to control objects in the virtual environment in a direct and natural way, much as objects are manipulated in the real world. Direct manipulation provides many advantages for the exploration of complex, multi-dimensional data sets, by allowing the investigator the ability to intuitively explore the data environment. Because direct manipulation is essentially a control interface, it is better suited for the exploration and analysis of a data set than for the publishing or communication of features found in that data set. Thus direct manipulation is most relevant to the analysis of complex data that fills a volume of three-dimensional space, such as a fluid flow data set. Direct manipulation allows the intuitive exploration of that data, which facilitates the discovery of data features that would be difficult to find using more conventional visualization methods. Using a direct manipulation interface in virtual reality, an investigator can, for example, move a data probe about in space, watching the results and getting a sense of how the data varies within its spatial volume.

  4. Autonomous Object Manipulation Using a Soft Planar Grasping Manipulator

    PubMed Central

    Katzschmann, Robert K.; Marchese, Andrew D.

    2015-01-01

    Abstract This article presents the development of an autonomous motion planning algorithm for a soft planar grasping manipulator capable of grasp-and-place operations by encapsulation with uncertainty in the position and shape of the object. The end effector of the soft manipulator is fabricated in one piece without weakening seams using lost-wax casting instead of the commonly used multilayer lamination process. The soft manipulation system can grasp randomly positioned objects within its reachable envelope and move them to a desired location without human intervention. The autonomous planning system leverages the compliance and continuum bending of the soft grasping manipulator to achieve repeatable grasps in the presence of uncertainty. A suite of experiments is presented that demonstrates the system's capabilities. PMID:27625916

  5. Manipulator control by exact linearization

    NASA Technical Reports Server (NTRS)

    Kruetz, K.

    1987-01-01

    Comments on the application to rigid link manipulators of geometric control theory, resolved acceleration control, operational space control, and nonlinear decoupling theory are given, and the essential unity of these techniques for externally linearizing and decoupling end effector dynamics is discussed. Exploiting the fact that the mass matrix of a rigid link manipulator is positive definite, a consequence of rigid link manipulators belonging to the class of natural physical systems, it is shown that a necessary and sufficient condition for a locally externally linearizing and output decoupling feedback law to exist is that the end effector Jacobian matrix be nonsingular. Furthermore, this linearizing feedback is easy to produce.

  6. Kinematic sensitivity of robot manipulators

    NASA Technical Reports Server (NTRS)

    Vuskovic, Marko I.

    1989-01-01

    Kinematic sensitivity vectors and matrices for open-loop, n degrees-of-freedom manipulators are derived. First-order sensitivity vectors are defined as partial derivatives of the manipulator's position and orientation with respect to its geometrical parameters. The four-parameter kinematic model is considered, as well as the five-parameter model in case of nominally parallel joint axes. Sensitivity vectors are expressed in terms of coordinate axes of manipulator frames. Second-order sensitivity vectors, the partial derivatives of first-order sensitivity vectors, are also considered. It is shown that second-order sensitivity vectors can be expressed as vector products of the first-order sensitivity vectors.

  7. OrthoEvidence™: A Clinical Resource for Evidence-Based Orthopedics

    PubMed Central

    Sprague, Sheila; Smith, Chris; Bhandari, Mohit

    2015-01-01

    The prevalence of musculoskeletal issues in clinical practice, and the limited focus placed upon musculoskeletal conditions by current electronic summary resources, highlights the need for a resource that provides access to simple and concise summaries of top-quality orthopedic literature for orthopedic surgeons and allied healthcare professionals. OrthoEvidence™ is an online clinical resource that addresses the paucity of adequate evidence-based summary tools in the field of orthopedic surgery. OrthoEvidence™ uses a rigorous, transparent, and unique process to review, evaluate, and summarize high quality research studies and their implications for orthopedic clinical practice. Randomized controlled trials and meta-analyses are identified and reviewed by an expert medical writing team, who prepare Advanced Clinical Evidence (ACETM) reports: one or two detailed pages including critical appraisals and synopses of key research. These timely and targeted reports provide a clear understanding about the quality of evidence associated with each summarized study, and can be organized by users to identify trending information. OrthoEvidence™ allows members to use their time efficiently and to stay current by having access to a breadth of timely, high-quality research output. OrthoEvidence™ is easily accessible through the internet and is available at the point-of-care, which allows treating orthopedic surgeons and allied health professionals to easily practice the principles of evidence-based medicine within their clinical practices.. PMID:26330990

  8. Opioid use for Chronic Pain Management in Italy: Results from the Orthopedic Instant Pain Survey Project

    PubMed Central

    Fanelli, Guido; Cherubino, Paolo; Compagnone, Christian

    2014-01-01

    Pain is a common symptom in orthopedic patients, but is managed sub-optimally, partly due to scarce opioid use in severe cases. The aim of the Orthopedic Instant Pain Survey (POIS) was to evaluate changes in pain management in Italian orthopedic practice 2 years after a legislative change (Law 38/2010) simplifying opioid access for pain control. A web-based survey on the knowledge of this law and trends observed in clinical practice for severe pain treatment was administered to 143 Italian orthopedic specialists. In total, 101 (70%) respondents showed a high level of knowledge. Nevertheless, 54.5% stated that they do not use opioids for severe osteo-articular pain management. Main barriers to opioid use are fear of adverse events (61.4%), especially nausea/vomiting and constipation, and patient resistance (29.7%). A modest knowledge of pain classification was also demonstrated. Opioid use remains very limited in Italian orthopedic practice. Physicians’ fear of side effects showed poor knowledge of strategies for effective management of opioid-related adverse events, such as combined oral prolonged-release oxycodone/naloxone. Continuing educational programs could improve delivery of evidence-based pain management. PMID:25002934

  9. Biological Strategies for Improved Osseointegration and Osteoinduction of Porous Metal Orthopedic Implants

    PubMed Central

    Riester, Scott M.; Bonin, Carolina A.; Kremers, Hilal Maradit; Dudakovic, Amel; Kakar, Sanjeev; Cohen, Robert C.; Westendorf, Jennifer J.

    2015-01-01

    The biological interface between an orthopedic implant and the surrounding host tissue may have a dramatic effect upon clinical outcome. Desired effects include bony ingrowth (osseointegration), stimulation of osteogenesis (osteoinduction), increased vascularization, and improved mechanical stability. Implant loosening, fibrous encapsulation, corrosion, infection, and inflammation, as well as physical mismatch may have deleterious clinical effects. This is particularly true of implants used in the reconstruction of load-bearing synovial joints such as the knee, hip, and the shoulder. The surfaces of orthopedic implants have evolved from solid-smooth to roughened-coarse and most recently, to porous in an effort to create a three-dimensional architecture for bone apposition and osseointegration. Total joint surgeries are increasingly performed in younger individuals with a longer life expectancy, and therefore, the postimplantation lifespan of devices must increase commensurately. This review discusses advancements in biomaterials science and cell-based therapies that may further improve orthopedic success rates. We focus on material and biological properties of orthopedic implants fabricated from porous metal and highlight some relevant developments in stem-cell research. We posit that the ideal primary and revision orthopedic load-bearing metal implants are highly porous and may be chemically modified to induce stem cell growth and osteogenic differentiation, while minimizing inflammation and infection. We conclude that integration of new biological, chemical, and mechanical methods is likely to yield more effective strategies to control and modify the implant–bone interface and thereby improve long-term clinical outcomes. PMID:25348836

  10. Parametric study of orthopedic insole of valgus foot on partial foot amputation.

    PubMed

    Guo, Jun-Chao; Wang, Li-Zhen; Chen, Wei; Du, Cheng-Fei; Mo, Zhong-Jun; Fan, Yu-Bo

    2016-01-01

    Orthopedic insole was important for partial foot amputation (PFA) to achieve foot balance and avoid foot deformity. The inapposite insole orthosis was thought to be one of the risk factors of reamputation for foot valgus patient, but biomechanical effects of internal tissues on valgus foot had not been clearly addressed. In this study, plantar pressure on heel and metatarsal regions of PFA was measured using F-Scan. The three-dimensional finite element (FE) model of partial foot evaluated different medial wedge angles (MWAs) (0.0°-10.0°) of orthopedic insole on valgus foot. The effect of orthopedic insole on the internal bone stress, the medial ligament tension of ankle, plantar fascia tension, and plantar pressure was investigated. Plantar pressure on medial heel region was about 2.5 times higher than that of lateral region based on the F-Scan measurements. FE-predicted results showed that the tension of medial ankle ligaments was the lowest, and the plantar pressure was redistributed around the heel, the first metatarsal, and the lateral longitudinal arch regions when MWA of orthopedic insole ranged from 7.5° to 8.0°. The plantar fascias maintained about 3.5% of the total load bearing on foot. However, the internal stresses from foot bones increased. The simulation in this study would provide the suggestion of guiding optimal design of orthopedic insole and therapeutic planning to pedorthist. PMID:26291149

  11. Mobile Device Trends in Orthopedic Surgery: Rapid Change and Future Implications.

    PubMed

    Andrawis, John P; Muzykewicz, David A; Franko, Orrin I

    2016-01-01

    Mobile devices are increasingly becoming integral communication and clinical tools. Monitoring the prevalence and utilization characteristics of surgeons and trainees is critical to understanding how these new technologies can be best used in practice. The authors conducted a prospective Internet-based survey over 7 time points from August 2010 to August 2014 at all nationwide American Council for Graduate Medical Education-accredited orthopedic programs. The survey questionnaire was designed to evaluate the use of devices and mobile applications (apps) among trainees and physicians in the clinical setting. Results were analyzed and summarized for orthopedic surgeons and trainees. During the 48-month period, there were 7 time points with 467, 622, 329, 223, 237, 111, and 134 responses. Mobile device use in the clinical setting increased across all fields and levels of training during the study period. Orthopedic trainees increased their use of Smartphone apps in the clinical setting from 60% to 84%, whereas attending use increased from 41% to 61%. During this time frame, use of Apple/Android platforms increased from 45%/13% to 85%/15%, respectively. At all time points, 70% of orthopedic surgeons believed their institution/hospital should support mobile device use. As measured over a 48-month period, mobile devices have become an ubiquitous tool in the clinical setting among orthopedic surgeons and trainees. The authors expect these trends to continue and encourage providers and trainees to be aware of the limitations and risks inherent with new technology. PMID:26730684

  12. Machine intelligence for autonomous manipulation.

    NASA Technical Reports Server (NTRS)

    Bejczy, A. K.

    1973-01-01

    Survey of the present technological development status of machine intelligence for autonomous manipulation in the U.S., Japan, USSR, and England. The extent of task-performance autonomy is examined that machine intelligence gives the manipulator by eliminating the need for a human operator to close continuously the control loop, or to rewrite control programs for each different task. Surveyed research projects show that the development of some advanced automation systems for manipulator control are within the state of the art. Yet, many more realistic breadboard systems and experimental work are needed before further progress can be made in the design of advanced automation systems for manipulator control suitable for new major practical applications. Specific research areas of promise are pointed out.

  13. Optodynamic description of optical manipulation

    NASA Astrophysics Data System (ADS)

    Požar, Tomaž; Možina, Janez

    2015-08-01

    Optodynamics treats optical manipulation as a superposition of time-developing wave motion induced by a light-matter interaction. When an opaque solid object is manipulated by a pulse of light, various types of mechanical waves are launched from the illuminated surface: ablation-induced waves (AIWs) resulting from material recoil, thermoelastic waves (TEWs), and the light-pressure-induced waves (LIWs) emanating exclusively due to radiation pressure. The manipulated object's boundaries experience staircase-like displacements with discrete steps caused either by AIWs or LIWs each time these waves are reflected from the interfaces. On the contrary, TEWs cannot translate the center of mass of the manipulated object, but their presence can be inferred from the transient, bi-polar displacements around the equilibrium position.

  14. Building Fractal Models with Manipulatives.

    ERIC Educational Resources Information Center

    Coes, Loring

    1993-01-01

    Uses manipulative materials to build and examine geometric models that simulate the self-similarity properties of fractals. Examples are discussed in two dimensions, three dimensions, and the fractal dimension. Discusses how models can be misleading. (Contains 10 references.) (MDH)

  15. Chaos motion in robot manipulators

    NASA Technical Reports Server (NTRS)

    Lokshin, A.; Zak, M.

    1987-01-01

    It is shown that a simple two-link planar manipulator exhibits a phenomenon of global instability in a subspace of its configuration space. A numerical example, as well as results of a graphic simulation, is given.

  16. Task Board Tests Manipulator Performance

    NASA Technical Reports Server (NTRS)

    Hill, J. W.

    1983-01-01

    Task board constructed to facilitate time-and-motion studies for remote manipulators. Apparatus equipped with holes, objects of various shapes to be grasped and sensors with switches to indicate contact. Useful in industrial robots programmed to assemble parts.

  17. Computer navigation in orthopedic trauma: safer surgeries with less irradiation and more precision.

    PubMed

    Akins, Ralitsa; Abdelgawad, Amr A; Kanlic, Enes M

    2012-01-01

    Exposure of patients and practitioners to ionizing radiation for diagnostic and therapeutic purposes has become the norm rather than the exception. This article discusses the findings from a literature review of intraoperative risks from ionizing radiation to patients and surgeons and the validity of substituting the conventional intraoperative fluoroscopy with computer-assisted orthopedic surgery (CAOS) in orthopedic trauma surgery. Diversity of study designs and measurements exists in reporting intraoperative ionizing radiation, making direct study comparisons difficult. CAOS can effectively reduce the amount of radiation exposure. There are definite advantages and disadvantages for using CAOS in the field of orthopedic trauma. Implementation of CAOS may hold the answer to better patient and surgeon intraoperative radiation safety with decreased operative time and increased procedure precision. The increased safety for patients and surgeons is a critical consideration in recommending CAOS in trauma surgery. PMID:23327842

  18. Alternative procedures for reducing allogeneic blood transfusion in elective orthopedic surgery.

    PubMed

    Kleinert, Kathrin; Theusinger, Oliver M; Nuernberg, Johannes; Werner, Clément M L

    2010-09-01

    Perioperative blood loss is a major problem in elective orthopedic surgery. Allogeneic transfusion is the standard treatment for perioperative blood loss resulting in low postoperative hemoglobin, but it has a number of well-recognized risks, complications, and costs. Alternatives to allogeneic blood transfusion include preoperative autologous donation and intraoperative salvage with postoperative autotransfusion. Orthopedic surgeons are often unaware of the different pre- and intraoperative possibilities of reducing blood loss and leave the management of coagulation and use of blood products completely to the anesthesiologists. The goal of this review is to compare alternatives to allogeneic blood transfusion from an orthopedic and anesthesia point of view focusing on estimated costs and acceptance by both parties. PMID:21886535

  19. Postoperative infection in patients undergoing inspection of orthopedic damage due to external fixation☆

    PubMed Central

    Foni, Noel Oizerovici; Batista, Felipe Augusto Ribeiro; Rossato, Luís Henrique Camargo; Hungria, José Octavio Soares; Mercadante, Marcelo Tomanik; Christian, Ralph Walter

    2015-01-01

    Objective To conduct a retrospective analysis on cases undergoing inspection of orthopedic damage, at an orthopedic emergency service in a teaching hospital, with the aim of evaluating patients with postoperative infection after conversion to internal osteosynthesis. Methods This was a retrospective analysis covering the period from June 2012 to June 2013, on patients who underwent inspection of orthopedic damage due to external fixation and subsequently were converted to definitive osteosynthesis using a nail or plate. Results We found an infection rate of 13.3% in our sample and, furthermore, found that there had been technical errors in setting up the fixator in 60.4% of the cases. Conclusion We found an infection rate that we considered high, along with inadequacies in constructing the external fixator. We emphasize that this procedure is not risk-free and that training for physicians who perform this procedure should be mandatory.

  20. The TROJAN Project: Creating a Customized International Orthopedic Training Program for Junior Doctors

    PubMed Central

    Kalraiya, Ashish; Buddhdev, Pranai

    2015-01-01

    Musculoskeletal problems account for a vast proportion of presentations encountered by doctors globally, with figures ranging from 15-36%. However, the time medical schools allocate to learning orthopedics is by no means proportional to this. This study aims to bridge this gap by developing an international orthopedic teaching program tailored to the specific knowledge and skills required by junior doctors in different countries. This prospective study asked fifty junior doctors, who had recently completed an orthopedics job, what three orthopedic teaching topics taught retrospectively would have benefitted their clinical practice. The most requested topics were used to design educational workshops for junior doctors and these consequently comprised the TROJAN (Teaching Requested by Orthopaedic Juniors And Novices) training program. Data was collected from twenty-five junior doctors in KwaZulu-Natale State, South Africa, and twenty-five in London, UK. It is therefore in these two countries that the TROJAN program was subsequently made available. Participants who selected topics were within two years of graduating medical school and had worked an orthopedic or Accident and Emergency job within the last year. 49% of topics chosen by SA doctors were practical skills such as wrist and ankle fracture reduction techniques, and management of open fractures. The most requested topic by UK doctors (11 out of 25) was management of neck of femur fractures. This is rationalized by the fact South African doctors require more hands-on responsibility in their daily practice whereas in the UK greater emphasis is placed on optimizing patients for theatre and making sound management plans. TROJAN currently develops orthopedic skills and knowledge in junior doctors in South Africa and United Kingdom with teaching customized based upon location. Feedback has been exceptionally positive with every candidate thus far rating the usefulness of TROJAN as the highest option, very useful

  1. High Disparity Between Orthopedic Resident Interest and Participation in International Health Electives.

    PubMed

    Zhang, Steven; Shultz, Paul; Daniels, Alan; Ackelman, Edward; Kamal, Robin N

    2016-07-01

    Few orthopedic surgical residency programs offer international health electives (IHEs). Efforts to expand these programs have been increasing across medical disciplines. Whether orthopedic residents will participate remains unknown. This study quantified and characterized orthopedic resident interest and barriers to IHEs in US residency programs. A web-based survey was administered to residents from 154 US orthopedic residency programs accredited by the Accreditation Council for Graduate Medical Education 2014 to 2015. Questions assessed demographics and program background, previous medical experience abroad, barriers to participation, and level of interest in participating in an international health elective during their training and beyond. Twenty-seven (17.5%) residency programs responded. Chi-square analysis showed that residents who expressed interest in participating were significantly more likely to have experience abroad compared with those who expressed no interest (P<.004). Analysis using Mann-Whitney U test suggested that those who expressed interest were more likely to believe IHEs are important to resident training (P<.0011; mean Likert scale score of 3.7 vs 2.6), provide valuable experience (P<.001; mean Likert scale score of 4.2 vs 3.2), and should be required for orthopedic residencies (P<.001; mean Likert scale score of 2.8 vs 1.9). Residents are strongly interested in participating in IHEs during their training, and many may integrate global health into future practices. Residents perceive lack of funding and scheduling flexibility as barriers preventing them from participating. Prior experience abroad influences level of interest, and international clinical experience may enhance future perception of its value. [Orthopedics. 2016; 39(4):e680-e686.]. PMID:27111074

  2. Thirty-Day Readmission Rates in Orthopedics: A Systematic Review and Meta-Analysis

    PubMed Central

    Bernatz, James T.; Tueting, Jonathan L.; Anderson, Paul A.

    2015-01-01

    Background Hospital readmission rates are being used to evaluate performance. A survey of the present rates is needed before policies can be developed to decrease incidence of readmission. We address three questions: What is the present rate of 30-day readmission in orthopedics? How do factors such as orthopedic specialty, data source, patient insurance, and time of data collection affect the 30-day readmission rate? What are the causes and risk factors for 30-day readmissions? Methods/Findings A review was first registered with Prospero (CRD42014010293, 6/17/2014) and a meta-analysis was performed to assess the current 30-day readmission rate in orthopedics. Studies published after 2006 were retrieved, and 24 studies met the inclusion criteria. The 30-day readmission rate was extrapolated from each study along with the orthopedic subspecialty, data source, patient insurance, time of collection, patient demographics, and cause of readmission. A sensitivity analysis was completed on the stratified groups. The overall 30-day readmission rate across all orthopedics was 5.4 percent (95% confidence interval: 4.8,6.0). There was no significant difference between subspecialties. Studies that retrieved data from a multicenter registry had a lower 30-day readmission rate than those reporting data from a single hospital or a large national database. Patient populations that only included Medicare patients had a higher 30-day readmission rate than populations of all insurance. The 30-day readmission rate has decreased in the past ten years. Age, length of stay, discharge to skilled nursing facility, increased BMI, ASA score greater than 3, and Medicare/Medicaid insurance showed statistically positive correlation with increased 30-day readmissions in greater than 75 percent of studies. Surgical site complications accounted for 46 percent of 30-day readmissions. Conclusions This meta-analysis shows the present rate of 30-day readmissions in orthopedics. Demonstrable

  3. Risk Factors for the Postoperative Transfusion of Allogeneic Blood in Orthopedics Patients With Intraoperative Blood Salvage

    PubMed Central

    Tang, Jia-Hua; Lyu, Yi; Cheng, Li-Ming; Li, Ying-Chuan; Gou, Da-Ming

    2016-01-01

    Abstract The purpose of this study is to explore the risk factors affecting the postoperative transfusion of allogeneic blood in patients undergoing orthopedics surgery with intraoperative blood salvage (IBS). A retrospective study of 279 patients undergoing orthopedic surgeries with IBS from May 2013 to May 2015 was enrolled. The binary logistic regression was used to find out the risk factors associated with postoperative transfusion of allogeneic blood in orthopedics patients with IBS, and then receiver operating characteristic (ROC) curve was drawn to determine the optimal threshold of the regression model. Single factor analysis showed that age, American Society of Anesthesiologists (ASA) grade, preoperative hemoglobin, operation time, received autologous blood, the laying time of autologous blood, bleeding volume, and postoperative drainage volume had significant effects on postoperative allogeneic blood transfusion. In binary logistic regression analysis, the independent factors predicting orthopedic patients with IBS need to transfuse allogeneic blood after surgeries were age (odds ratio [OR] = 0.415, P = 0.006), ASA grade (OR = 2.393, P = 0.035), preoperative hemoglobin (OR = 0.532, P = 0.022), and postoperative drainage volume (OR = 4.279, P = 0.000). The area under ROC curve was 0.79 and the predicted accuracy rate of the model was 81.58%. After operation, the orthopedic patients with IBS still have a high allogeneic blood transfusion rate, and IBS is not a perfect blood protection method. The logistic regression model of our study provides a reliable prediction for postoperative transfusion of allogeneic blood in orthopedic patients with IBS, which have a certain reference value. PMID:26937919

  4. Do Astronauts have a Higher Rate of Orthopedic Shoulder Conditions than a Cohort of Working Professionals?

    NASA Technical Reports Server (NTRS)

    Laughlin, Mitzi S.; Murray, Jocelyn D.; Young, Millenia; Wear, Mary L.; Tarver, W. J.; Van Baalen, Mary

    2016-01-01

    Occupational surveillance of astronaut shoulder injuries began with operational concerns at the Neutral Buoyancy Laboratory (NBL) during Extra Vehicular Activity (EVA) training. NASA has implemented several occupational health initiatives during the past 20 years to decrease the number and severity of injuries, but the individual success rate is unknown. Orthopedic shoulder injury and surgery rates were calculated, but classifying the rates as normal, high or low was highly dependent on the comparison group. The purpose of this study was to identify a population of working professionals and compare orthopedic shoulder consultation and surgery rates.

  5. Third year Evaluation of a Model Home-Based Program for Severely Orthopedically Impaired/Mentally Retarded Children & Youth.

    ERIC Educational Resources Information Center

    Meehan, Merrill L.

    The Orthopedic Homebound Program was meant to prevent the institutionalization of orthopedically impaired, mentally retarded children and to involve parents in their training. The program was proposed and managed by the Shawnee Hills Community Mental Health/Mental Retardation Center in rural West Virginia. Each child's developmental needs were…

  6. [The construction of a medical discipline and its challenges: Orthopedics in Switzerland during the 19th and 20th centuries].

    PubMed

    Kaba, Mariama

    2015-07-01

    During the 19th century, numerous figures, with different qualifications, claimed to practice orthopedics: doctors, surgeons, inventors of equipment and instruments, and other empiricists. They performed certain types of techniques, massages, surgical operationsand/or fitted prostheses. The polysemous notion of orthopedics had created conflicts of interest that would reach their height at the end of the 19th century. The integration of orthopedics into the training at the university level enhanced its proximity to surgery, a discipline that has dominated the so-called modern medicine. During the 20th century, various medical branches defend the legitimacy of certain orthopedic practices, thereby threating to a degree the title itself of this specialization. By examining the challenges that have shaped the history of orthopedics in Switzerland, this article also seeks to shed light on the strategies that were implemented in adopting a medical and technical discipline within a transforming society. PMID:26111839

  7. Mobile camera-space manipulation

    NASA Technical Reports Server (NTRS)

    Seelinger, Michael J. (Inventor); Yoder, John-David S. (Inventor); Skaar, Steven B. (Inventor)

    2001-01-01

    The invention is a method of using computer vision to control systems consisting of a combination of holonomic and nonholonomic degrees of freedom such as a wheeled rover equipped with a robotic arm, a forklift, and earth-moving equipment such as a backhoe or a front-loader. Using vision sensors mounted on the mobile system and the manipulator, the system establishes a relationship between the internal joint configuration of the holonomic degrees of freedom of the manipulator and the appearance of features on the manipulator in the reference frames of the vision sensors. Then, the system, perhaps with the assistance of an operator, identifies the locations of the target object in the reference frames of the vision sensors. Using this target information, along with the relationship described above, the system determines a suitable trajectory for the nonholonomic degrees of freedom of the base to follow towards the target object. The system also determines a suitable pose or series of poses for the holonomic degrees of freedom of the manipulator. With additional visual samples, the system automatically updates the trajectory and final pose of the manipulator so as to allow for greater precision in the overall final position of the system.

  8. High precision redundant robotic manipulator

    DOEpatents

    Young, K.K.D.

    1998-09-22

    A high precision redundant robotic manipulator for overcoming contents imposed by obstacles or imposed by a highly congested work space is disclosed. One embodiment of the manipulator has four degrees of freedom and another embodiment has seven degrees of freedom. Each of the embodiments utilize a first selective compliant assembly robot arm (SCARA) configuration to provide high stiffness in the vertical plane, a second SCARA configuration to provide high stiffness in the horizontal plane. The seven degree of freedom embodiment also utilizes kinematic redundancy to provide the capability of avoiding obstacles that lie between the base of the manipulator and the end effector or link of the manipulator. These additional three degrees of freedom are added at the wrist link of the manipulator to provide pitch, yaw and roll. The seven degrees of freedom embodiment uses one revolute point per degree of freedom. For each of the revolute joints, a harmonic gear coupled to an electric motor is introduced, and together with properly designed based servo controllers provide an end point repeatability of less than 10 microns. 3 figs.

  9. High precision redundant robotic manipulator

    DOEpatents

    Young, Kar-Keung David

    1998-01-01

    A high precision redundant robotic manipulator for overcoming contents imposed by obstacles or imposed by a highly congested work space. One embodiment of the manipulator has four degrees of freedom and another embodiment has seven degreed of freedom. Each of the embodiments utilize a first selective compliant assembly robot arm (SCARA) configuration to provide high stiffness in the vertical plane, a second SCARA configuration to provide high stiffness in the horizontal plane. The seven degree of freedom embodiment also utilizes kinematic redundancy to provide the capability of avoiding obstacles that lie between the base of the manipulator and the end effector or link of the manipulator. These additional three degrees of freedom are added at the wrist link of the manipulator to provide pitch, yaw and roll. The seven degrees of freedom embodiment uses one revolute point per degree of freedom. For each of the revolute joints, a harmonic gear coupled to an electric motor is introduced, and together with properly designed based servo controllers provide an end point repeatability of less than 10 microns.

  10. Selective laser sintering of calcium phosphate materials for orthopedic implants

    NASA Astrophysics Data System (ADS)

    Lee, Goonhee

    control of micro and macro pore structure, to maximize bone healing and provide sufficient mechanical strength. It also permits the complete removal of the polymeric binders that are resided in the SLS process. In collaboration with the University of Texas Health Science Center at San Antonio and BioMedical Enterprises, Inc., porous implants based on anatomical geometry have been successfully implanted in rabbits and dogs. These histologic animal studies reveal excellent biocompatibility and show its great potential for commercial custom-fit implant manufacture. The second research effort involves fabrication of fully dense bone for application in dental restoration and load-bearing orthopedic functions. Calcium phosphate glass melts, proven to be biocompatible in the first effort, were cast into carbon molds. Processes were developed for preparing the molds. These carbon molds of anatomic shape can be prepared from either Computer Numerical Control (CNC) milling of slab stock or SLS processing of thermoset-coated graphite powder. The CNC milling method provides accurate dimension of the molds in a short period of time, however, the capable geometries are limited; generally two pieces of molds are required for complex shapes. The SLS method provides very complex shape green molds. However, they need to go through pyrolysis of thermoset binder to provide the high temperature capability reached at calcium phosphate melt temperatures (1100°C) and noticeable shrinkage was observed during pyrolysis. The cast glass was annealed to develop polycrystalline calcium phosphate. This process also exhibits great potential.

  11. Manipulation strategies for massive space payloads

    NASA Technical Reports Server (NTRS)

    Book, Wayne J.

    1991-01-01

    Motion planning and control for the joints of flexible manipulators are discussed. Specific topics covered include control of a flexible braced manipulator, control of a small working robot on a large flexible manipulator to suppress vibrations, control strategies for ensuring cooperation among disparate manipulators, and motion planning for robots in free-fall.

  12. Learning Area and Perimeter with Virtual Manipulatives

    ERIC Educational Resources Information Center

    Bouck, Emily; Flanagan, Sara; Bouck, Mary

    2015-01-01

    Manipulatives are considered a best practice for educating students with disabilities, but little research exists which examines virtual manipulatives as tool for supporting students in mathematics. This project investigated the use of a virtual manipulative through the National Library of Virtual Manipulatives--polynominoes (i.e., tiles)--as a…

  13. A grid quality manipulation system

    NASA Technical Reports Server (NTRS)

    Lu, Ning; Eiseman, Peter R.

    1991-01-01

    A grid quality manipulation system is described. The elements of the system are the measures by which quality is assessed, the computer graphic display of those measures, and the local grid manipulation to provide a response to the viewed quality indication. The display is an overlaid composite where the region is first covered with colors to reflect the values of the quality indicator, the grid is then placed on top of those colors, and finally a control net is placed on top of everything. The net represents the grid in terms of the control point form of algebraic grid generation. As a control point is moved, both the grid and the colored quality measures also move. This is a real time dynamic action so that the consequences of the manipulation are continuously seen.

  14. Manipulating Complex Light with Metamaterials

    PubMed Central

    Zeng, Jinwei; Wang, Xi; Sun, Jingbo; Pandey, Apra; Cartwright, Alexander N.; Litchinitser, Natalia M.

    2013-01-01

    Recent developments in the field of metamaterials have revealed unparalleled opportunities for “engineering” space for light propagation; opening a new paradigm in spin- and quantum-related phenomena in optical physics. Here we show that unique optical properties of metamaterials (MMs) open unlimited prospects to “engineer” light itself. We propose and demonstrate for the first time a novel way of complex light manipulation in few-mode optical fibers using optical MMs. Most importantly, these studies highlight how unique properties of MMs, namely the ability to manipulate both electric and magnetic field components of electromagnetic (EM) waves, open new degrees of freedom in engineering complex polarization states of light at will, while preserving its orbital angular momentum (OAM) state. These results lay the first steps in manipulating complex light in optical fibers, likely providing new opportunities for high capacity communication systems, quantum information, and on-chip signal processing. PMID:24084836

  15. Mapping and Manipulating Facial Expression

    PubMed Central

    Theobald, Barry-John; Matthews, Iain; Mangini, Michael; Spies, Jeffrey R.; Brick, Timothy R.; Cohn, Jeffrey F.; Boker, Steven M.

    2009-01-01

    Non-verbal visual cues accompany speech to supplement the meaning of spoken words, signify emotional state, indicate position in discourse, and provide back-channel feedback. This visual information includes head movements, facial expressions and body gestures. In this paper we describe techniques for manipulating both verbal and non-verbal facial gestures in video sequences of people engaged in conversation. We are developing a system for use in psychological experiments, where the effects of manipulating individual components of non-verbal visual behaviour during live face-to-face conversation can be studied. In particular, the techniques we describe operate in real-time at video frame-rate and the manipulation can be applied so both participants in a conversation are kept blind to the experimental conditions. PMID:19624037

  16. Late orthopedic effects in children with Wilms' tumor treated with abdominal irradiation

    SciTech Connect

    Rate, W.R.; Butler, M.S.; Robertson, W.W. Jr.; D'Angio, G.J. )

    1991-01-01

    Between 1970 and 1984, 31 children with biopsy-proven Wilms' tumor received nephrectomy, chemotherapy, and abdominal irradiation and were followed beyond skeletal maturity. Three patients (10%) developed late orthopedic abnormalities requiring intervention. Ten children received orthovoltage irradiation, and all cases requiring orthopedic intervention or developing a scoliotic curve of greater than 20 degrees were confined to this group, for a complication frequency of 50%. Those children who developed a significant late orthopedic abnormality (SLOA) as defined were treated to a higher median dose (2,890 cGy) and a larger field size (150 cm2) than those who did not (2,580 cGy and 120 cm2). Age at irradiation, sex, and initial stage of disease did not appear to influence the risk of developing an SLOA. No child who received megavoltage irradiation developed an SLOA despite treatment up to 4,000 cGy or to field sizes of 400 cm2. We conclude that modern radiotherapy techniques rarely lead to significant late orthopedic abnormalities previously associated with abdominal irradiation in children with Wilms' tumor.

  17. The Physical Fitness of Sensory and Orthopedically Impaired Youth: Project UNIQUE. Final Report.

    ERIC Educational Resources Information Center

    Winnick, Joseph P.; Short, Francis X.

    The report summarizes findings from an examination of the physical fitness of orthopedically and sensory impaired students (10-17 years old). Physical fitness was hypothesized to include six areas: body composition, muscular strength/endurance, speed, agility, flexibility, and cardiorespiratory endurance. A chapter on methods details subject…

  18. A Survey on Transfusion Status in Orthopedic Surgery at a Trauma Center

    PubMed Central

    Soleimanha, Mehran; Haghighi, Mohammad; Mirbolook, Ahmadreza; Sedighinejad, Abbas; Mardani-Kivi, Mohsen; Naderi-Nabi, Bahram; Chavoshi, Tahereh; Mehrnoosh, Mehrnoosh Ghandili

    2016-01-01

    Background: Increased costs and mortality associated with inappropriate blood transfusions have led to investigations about blood request and blood transfusion techniques. We investigated the transfusion status in patients who underwent orthopedic surgery in Poursina Hospital (Rasht, Iran) to optimizing blood usage and determine if a scheduled transfusion program for every orthopedic surgery could improve blood transfusion management. Method: In this descriptive-prospective study, all orthopedic surgeries in Poursina Hospital, Rasht, between April to June 2013 were reviewed. All patient information was recorded, including: demographics, type of surgery, hemoglobin level, cross-match test, duration of surgery, and blood loss, and transfusion. Based on the one-way ANOVA and independent samples test analysis, cross-match to transfusion ratio and transfusion possibility, the transfusion index, and maximal surgical blood order schedule were calculated to determine blood transfusion status. Results: Among 872 selected orthopedic surgery candidates, 318 of them were cross-matched and among those, 114 patients received a blood transfusion. In this study, the cross-match to transfusion ratio was 6.4, transfusion possibility 36.47%, transfusion index 0.6, and maximal surgical blood order schedule 0.9. Conclusion: We found that blood ordering was moderately higher than the standard; so it is highly recommended to focus on the knowledge of evidence based on transfusion and standard guidelines for blood transfusion to avoid over-ordering. PMID:26894223

  19. An Evaluation Design for the Educational Programs for Pupils Who Are Orthopedically Handicapped.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Education, Columbia. Office of Programs for the Handicapped.

    The booklet provides forms for the teacher of the orthopedically handicapped to use in systematically collecting data and designing an appropriate educational blueprint for each student. Pupil development assessment sheets include columns for recording assessment date, date of mastery, level of achievement, and comments for each behavioral…

  20. The Effect of Orthopedic Advertising and Self-Promotion on a Naïve Population.

    PubMed

    Mohney, Stephen; Lee, Daniel J; Elfar, John C

    2016-01-01

    There has been a marked increase in the number of physicians marketing themselves directly to patients and consumers. However, it is unclear how different promotional styles affect patients' perceptions of their physicians. We hypothesized that self-promoting orthopedic surgeons enjoy a more positive impact on nonphysician patients as compared to non-self-promoting surgeons, as well as a corresponding negative impact on their peer-surgeons. Surgeon websites were selected from the 5 largest population centers in the United States. Subjects with varying degrees of familiarity with orthopedic surgery evaluated Internet profiles of surgeons on a forced choice Likert scale to measure the amount of self-promotion. The naïve subjects judged self-promoting surgeons more favorably than the orthopedic surgeons. In contrast, board-certified orthopedic surgeons viewed self-promoting surgeons more negatively than did their nonphysician counterparts. In summary, the present study revealed that the potential for self-promotion to unduly influence potential patients is real and should be a considerable concern to surgeons, patients, and the profession. PMID:27327932

  1. Orthopedic Surgery in Rural American Hospitals: A Survey of Rural Hospital Administrators

    ERIC Educational Resources Information Center

    Weichel, Derek

    2012-01-01

    Rural American residents prefer to receive their medical care locally. Lack of specific medical services in the local community necessitates travel to a larger center which is less favorable. This study was done to identify how rural hospitals choose to provide orthopedic surgical services to their communities. Methods: All hospitals in 5 states…

  2. Social Networking as a Tool for Lifelong Learning with Orthopedically Impaired Learners

    ERIC Educational Resources Information Center

    Ersoy, Metin; Güneyli, Ahmet

    2016-01-01

    This paper discusses how Turkish Cypriot orthopedically impaired learners who are living in North Cyprus use social networking as a tool for leisure and education, and to what extent they satisfy their personal development needs by means of these digital platforms. The case study described, conducted in North Cyprus in 2015 followed a qualitative…

  3. Aging and orthopedics: how a lifespan development model can inform practice and research

    PubMed Central

    Gautreau, Sylvia; Gould, Odette N.; Forsythe, Michael E.

    2016-01-01

    Orthopedic surgical care, like all health care today, is in flux owing to an aging population and to chronic medical conditions leading to an increased number of people with illnesses that need to be managed over the lifespan. The result is an ongoing shift from curing acute illnesses to the management and care of chronic illness and conditions. Theoretical models that provide a useful and feasible vision for the future of health care and health care research are needed. This review discusses how the lifespan development model used in some disciplines within the behavioural sciences can be seen as an extension of the biopsychosocial model. We posit that the lifespan development model provides useful perspectives for both orthopedic care and research. We present key concepts and recommendations, and we discuss how the lifespan development model can contribute to new and evolving perspectives on orthopedic outcomes and to new directions for research. We also offer practical guidelines on how to implement the model in orthopedic practice. PMID:27240129

  4. A Review of the Design Process for Implantable Orthopedic Medical Devices

    PubMed Central

    Aitchison, G.A; Hukins, D.W.L; Parry, J.J; Shepherd, D.E.T; Trotman, S.G

    2009-01-01

    The design process for medical devices is highly regulated to ensure the safety of patients. This paper will present a review of the design process for implantable orthopedic medical devices. It will cover the main stages of feasibility, design reviews, design, design verification, manufacture, design validation, design transfer and design changes. PMID:19662153

  5. High energy devices versus low energy devices in orthopedics treatment modalities

    NASA Astrophysics Data System (ADS)

    Schultheiss, Reiner

    2003-10-01

    The orthopedic consensus group defined in 1997 the 42 most likely relevant parameters of orthopedic shock wave devices. The idea of this approach was to correlate the different clinical outcomes with the physical properties of the different devices with respect to their acoustical waves. Several changes in the hypothesis of the dose effect relationship have been noticed since the first orthopedic treatments. The relation started with the maximum pressure p+, followed by the total energy, the energy density; and finally the single treatment approach using high, and then the multiple treatment method using low energy. Motivated by the reimbursement situation in Germany some manufacturers began to redefine high and low energy devices independent of the treatment modality. The OssaTron as a high energy, single treatment electro hydraulic device gained FDA approval as the first orthopedic ESWT device for plantar fasciitis and, more recently, for lateral epicondylitis. Two low energy devices have now also gained FDA approval based upon a single treatment. Comparing the acoustic data, differences between the OssaTron and the other devices are obvious and will be elaborated upon. Cluster analysis of the outcomes and the acoustical data are presented and new concepts will be suggested.

  6. The Effectiveness of Active and Traditional Teaching Techniques in the Orthopedic Assessment Laboratory

    ERIC Educational Resources Information Center

    Nottingham, Sara; Verscheure, Susan

    2010-01-01

    Active learning is a teaching methodology with a focus on student-centered learning that engages students in the educational process. This study implemented active learning techniques in an orthopedic assessment laboratory, and the effects of these teaching techniques. Mean scores from written exams, practical exams, and final course evaluations…

  7. Combined regional and general anesthesia for ambulatory peripheral orthopedic surgery in children.

    PubMed

    Khoury, Claudine E L; Dagher, Christine; Ghanem, Ismat; Naccache, Nicole; Jawish, Dolly; Yazbeck, Patricia

    2009-01-01

    Pediatric orthopedic surgery is rarely done in an outpatient setting because of the postoperative pain. The purpose of this study was to evaluate the children's comfort and parents' satisfaction after ambulatory peripheral pediatric orthopedic surgery performed under general anesthesia combined with regional anesthesia (RA). Sixty consecutive children were enrolled in this prospective study. All children fulfilled inclusion criteria for outpatient and for RA and parents received proper information regarding their child postoperative care. Postoperative pain control was sustained for 48 h using routine paracetamol, ibuprofen, and oral tramadol if needed. A telephone survey was conducted on day 1 and day 2 to evaluate pain scores, limb motor function, occurrence of postoperative nausea and vomiting, and feeding, sleep or play disturbance. The parents were also asked about their overall satisfaction rate and the choice of ambulatory mode versus inpatient admission in case of future orthopedic procedure. A total of 34 soft tissue procedures and 26 bony procedures were performed. 63.3% recovered motor function before discharge from the postanesthesia care unit. Low pain scores and good postoperative comfort were observed. Parents' satisfaction was greater than eight out of 10 in 88.3% of the cases, and 85% of the parents would choose ambulatory surgery in case of a second procedure. RA used with level I or II analgesics is compatible with ambulatory peripheral pediatric orthopedic surgery. Resulting good analgesia and postoperative comfort render the ambulatory mode to be favored by the parents. PMID:19020468

  8. A Prototype Robotic Arm for Use by Severely Orthopedically Handicapped Students. Final Report.

    ERIC Educational Resources Information Center

    Howell, Richard

    This 18-month pilot project, which ran from October 1, 1987 to March 31, 1989, developed a prototype robotic arm for educational use by students with severe orthopedic disabilities in the Columbus (Ohio) Public Schools. The developmental effort was intended first, to provide direct access to currently available instructional materials and, second,…

  9. Stem Cells in Orthopedics: A Comprehensive Guide for the General Orthopedist.

    PubMed

    Saltzman, Bryan M; Kuhns, Benjamin D; Weber, Alexander E; Yanke, Adam; Nho, Shane J

    2016-01-01

    The use of biologic adjuvants in the treatment of operative and nonoperative orthopedic injuries continues to expand in concert with our understanding of the acute and chronic healing process of musculoskeletal injuries. Stem cell treatments in orthopedics are among the most commonly explored options, and have found varying levels of success in promoting osseous and soft tissue healing. Basic science and translational studies have demonstrated the potential for broad application of stem cells in the treatment of a growing number of musculoskeletal injuries. Emerging clinical studies have also provided promising results, although the vast majority of studies have featured small sample sizes and limited duration of follow-up. In addition, a number of important questions remain regarding the clinical safety, treatment delivery, and overall efficacy of stem cell augmentation of injured tissue in orthopedics. The objective of the current review is to present a broad overview of the current state of stem cell treatments in orthopedic surgery, with an emphasis on soft tissue healing. This review of stem cell treatment covers the basic science behind biologic augmentation, advantages of the various stem cell sources, preclinical results, and current and future clinical applications. PMID:27552451

  10. Perceptions of Practice Problems Encountered by Family Physicians, Pediatricians, and Orthopedic Surgeons.

    ERIC Educational Resources Information Center

    Xu, Gang; And Others

    1993-01-01

    Information about practice problems was solicited through a structured questionnaire completed by 59 family physicians, 101 pediatricians, and 102 orthopedic surgeons. Across all three groups, a lack of personal time was the major concern. Practice concerns vary among the specialties, a finding of interest to physician education. (SLD)

  11. Enhanced osteoblast adhesion on nanostructured selenium compacts for anti-cancer orthopedic applications

    PubMed Central

    Tran, Phong; Webster, Thomas J

    2008-01-01

    Metallic bone implants possess numerous problems limiting their long-term efficacy, such as poor prolonged osseointegration, stress shielding, and corrosion under in vivo environments. Such problems are compounded for bone cancer patients since numerous patients receive orthopedic implants after cancerous bone resection. Unfortunately, current orthopedic materials were not originally developed to simultaneously increase healthy bone growth (as in traditional orthopedic implant applications) while inhibiting cancerous bone growth. The long-term objective of the present research is to investigate the use of nano-rough selenium to prevent bone cancer from re-occurring while promoting healthy bone growth for this select group of cancer patients. Selenium is a well known anti-cancer chemical. However, what is not known is how healthy bone cells interact with selenium. To determine this, selenium, spherical or semispherical shots, were pressed into cylindrical compacts and these compacts were then etched using 1N NaOH to obtain various surface structures ranging from the micron, submicron to nano scales. Changes in surface chemistry were also analyzed. Through these etching techniques, results of this study showed that biologically inspired surface roughness values were created on selenium compacts to match that of natural bone roughness. Moreover, results showed that healthy bone cell adhesion increased with greater nanometer selenium roughness (more closely matching that of titanium). In this manner, this study suggests that nano-rough selenium should be further tested for orthopedic applications involving bone cancer treatment. PMID:18990948

  12. Aging and orthopedics: how a lifespan development model can inform practice and research.

    PubMed

    Gautreau, Sylvia; Gould, Odette N; Forsythe, Michael E

    2016-08-01

    Orthopedic surgical care, like all health care today, is in flux owing to an aging population and to chronic medical conditions leading to an increased number of people with illnesses that need to be managed over the lifespan. The result is an ongoing shift from curing acute illnesses to the management and care of chronic illness and conditions. Theoretical models that provide a useful and feasible vision for the future of health care and health care research are needed. This review discusses how the lifespan development model used in some disciplines within the behavioural sciences can be seen as an extension of the biopsychosocial model. We posit that the lifespan development model provides useful perspectives for both orthopedic care and research. We present key concepts and recommendations, and we discuss how the lifespan development model can contribute to new and evolving perspectives on orthopedic outcomes and to new directions for research. We also offer practical guidelines on how to implement the model in orthopedic practice. PMID:27240129

  13. Understanding pharmaceutical research manipulation in the context of accounting manipulation.

    PubMed

    Brown, Abigail

    2013-01-01

    The problem of the manipulation of data that arises when there is both opportunity and incentive to mislead is better accepted and studied - though by no means solved - in financial accounting than in medicine. This article analyzes pharmaceutical company manipulation of medical research as part of a broader problem of corporate manipulation of data in the creation of accounting profits. The article explores how our understanding of accounting fraud and misinformation helps us understand the risk of similar information manipulation in the medical sciences. This understanding provides a framework for considering how best to improve the quality of medical research and analysis in light of the current system of medical information production. I offer three possible responses: (1) use of the Dodd-Frank whistleblower provisions to encourage reporting of medical research fraud; (2) a two-step academic journal review process for clinical trials; and (3) publicly subsidized trial-failure insurance. These would improve the release of negative information about drugs, thereby increasing the reliability of positive information. PMID:24088151

  14. Quantitative analysis of the orthodontic and orthopedic effects of maxillary traction.

    PubMed

    Baumrind, S; Korn, E L; Isaacson, R J; West, E E; Molthen, R

    1983-11-01

    This article analyzes differences in displacement of ANS and of the upper first molar when different vectors of force are delivered to the maxilla in non-full-banded Phase I mixed-dentition treatment of Class II malocclusion. The sample is identical to that for which we have previously reported differences in change in several key measures of mandibular and facial shape. It includes a cervical-traction group, a high-pull-to-upper-molar group, a modified-activator group, and an untreated Class II control group. Using newly developed computer-conducted procedures, which are described, we have been able to partition the orthodontic and orthopedic components of upper molar displacement and also to isolate treatment effects from those attributable to spontaneous growth and development. In the region of ANS, small but statistically significant and clinically meaningful differences were noted between treatments. When the intercurrent effects of growth and development had been factored out (Table III), orthopedic distal displacement of ANS was significantly greater in the high-pull and cervical groups than in the activator group. Orthopedic downward displacement of ANS was seen to be significantly greater in the cervical group than in the high-pull and activator groups. In the region of the first molar cusp, mean distal displacement of the tooth as an orthopedic effect was found to be almost identical in the cervical and high-pull groups (although variability was greater in the cervical group), but the mean orthodontic effect was significantly greater in the high-pull group than in the cervical group. In the cervical group, where relatively light forces were used for relatively long treatment periods on average, more of the total distal displacement of the upper molar was of an orthopedic character than of an orthodontic character. Conversely, in the high-pull group, in which relatively heavier forces tended to be used for briefer treatment periods, most of the distal

  15. Developing a Minimum Data Set of the Information Management System for Orthopedic Injuries in Iran

    PubMed Central

    Ahmadi, Maryam; Mohammadi, Ali; Chraghbaigi, Ramin; Fathi, Taimur; Shojaee Baghini, Mahdieh

    2014-01-01

    Background: Orthopedic injuries are the most common types of injuries. To identify the main causes of injuries, collecting data in a standard manner at the national level are needed, which justifies necessity of making a minimum data set (MDS). Objectives: The aim of this study was to develop an MDS of the information management system for orthopedic injuries in Iran. Materials and Methods: This descriptive cross-sectional study was performed in 2013. Data were collected from hospitals affiliated with Tehran University of Medical Sciences that had orthopedic department, medical documents centers, legal medicine centers, emergency centers, internet access, and library. Investigated documents were orthopedic injury records in 2012, documents that retrieved from the internet, and printed materials. Records with Random sampling by S22-S99 categories from ICD-10 were selected and the related internet-sourced data were evaluated entirely. Data were collected using a checklist. In order to make a consensus about the data elements, the decision Delphi technique was applied by a questionnaire. The content validity and reliability of the questionnaire were assessed by expert’s opinions and test-retest method, respectively. Results: An MDS of orthopedic injuries were assigned to two categories: administrative category with six classes including 142 data elements, and clinical category with 17 classes including 250 data elements. Conclusions: This study showed that some of the essential data elements included in other country’s MDS or required for organizations and healthcare providers were not included. Therefore, a complete list of an MDS elements was created. Existence of comprehensive data concerning the causes and mechanisms of injuries informs public health policy-makers about injuries occurrence and enables them to take rationale measures to deal with these problems. PMID:25237576

  16. Adherent lipopolysaccharide inhibits the osseointegration of orthopedic implants by impairing osteoblast differentiation.

    PubMed

    Bonsignore, Lindsay A; Anderson, J Robert; Lee, Zhenghong; Goldberg, Victor M; Greenfield, Edward M

    2013-01-01

    Osseointegration is the process by which an orthopedic implant makes direct bone-to-implant contact and is crucial for the long-term function of the implant. Surface contaminants, such as bacterial debris and manufacturing residues, may remain on orthopedic implants after sterilization and impair osseointegration. For example, specific lots of implants that were associated with impaired osseointegration and high failure rates were discovered to have contaminants including bacterial debris. Therefore, the goals of this study were to determine if bacterial debris exists on sterile orthopedic implants and if adherent bacterial debris inhibits the osseointegration of orthopedic implants. We found that debris containing lipopolysaccharide (LPS) from Gram-negative bacteria exists on both sterile craniofacial implants and wrist implants. Levels of bacterial debris vary not only between different lots of implants but within an individual lot. Using our murine model of osseointegration, we found that ultrapure LPS adherent to the implants inhibited bone-to-implant contact and biomechanical pullout measures. Analysis of osseointegration in knock-out mice demonstrated that adherent LPS inhibited osseointegration by signaling through its primary receptor, Toll-like receptor 4, and not by signaling through Toll-like receptor 2. Ultrapure LPS adherent to titanium alloy discs had no detectable effect on early stages of MC3T3-E1 osteogenesis in vitro such as attachment, spreading or growth. However, later stages of osteogenic differentiation and mineralization were inhibited by adherent LPS. Thus, LPS may inhibit osseointegration in part through cell autonomous effects on osteoblasts. These results highlight bacterial debris as a type of surface contaminant that can impair the osseointegration of orthopedic implants. PMID:22995462

  17. Safety, Efficacy, and Cost-effectiveness of Tranexamic Acid in Orthopedic Surgery.

    PubMed

    Lin, Zilan X; Woolf, Shane K

    2016-03-01

    Perioperative bleeding and postsurgical hemorrhage are common in invasive surgical procedures, including orthopedic surgery. Tranexamic acid (TXA) is a pharmacologic agent that acts through an antifibrinolytic mechanism to stabilize formed clots and reduce active bleeding. It has been used successfully in orthopedics to reduce perioperative blood loss, particularly in total hip and knee arthroplasty and spine surgery. Numerous research studies have reported favorable safety and efficacy in orthopedic cases, although there is no universal standard on its administration and its use has not yet become the standard of practice. Reported administration methods often depend on the surgeon's preference, with both topical and intravenous routes showing efficacy. The type and anatomic site of the surgery seem to influence the decision making but also result in conflicting opinions. Reported complication rates with TXA use are low. The incidence of both arterial and venous thromboembolic events, particularly deep venous thrombosis and pulmonary embolism, has not been found to be significantly different with TXA use for healthy patients. The route of administration and dosage do not appear to affect complication rates either. However, data on patients with higher-risk conditions are deficient. In addition, TXA has shown potential to reduce blood loss, transfusion rates and volumes, perioperative hemoglobin change, and hospital-related costs at various degrees among the published studies. Conservation of blood products, reduced laboratory costs, and shorter hospital stays are likely the major factors driving the cost savings associated with TXA use. This article reviews current data supporting the safety, efficacy, and cost-effectiveness of TXA in orthopedic surgery. [Orthopedics. 2016; 39(2):119-130.]. PMID:26942474

  18. Factors influencing the number of applications submitted per applicant to orthopedic residency programs

    PubMed Central

    Finkler, Elissa S.; Fogel, Harold A.; Kroin, Ellen; Kliethermes, Stephanie; Wu, Karen; Nystrom, Lukas M.; Schiff, Adam P.

    2016-01-01

    Background From 2002 to 2014, the orthopedic surgery residency applicant pool increased by 25% while the number of applications submitted per applicant rose by 69%, resulting in an increase of 109% in the number of applications received per program. Objective This study aimed to identify applicant factors associated with an increased number of applications to orthopedic surgery residency programs. Design An anonymous survey was sent to all applicants applying to the orthopedic surgery residency program at Loyola University. Questions were designed to define the number of applications submitted per respondent as well as the strength of their application. Of 733 surveys sent, 140 (19.1%) responses were received. Setting An academic institution in Maywood, IL. Participants Fourth-year medical students applying to the orthopedic surgery residency program at Loyola University. Results An applicant's perception of how competitive he or she was (applicants who rated themselves as ‘average’ submitted more applications than those who rated themselves as either ‘good’ or ‘outstanding’, p=0.001) and the number of away rotations (those who completed >2 away rotations submitted more applications, p=0.03) were significantly associated with an increased number of applications submitted. No other responses were found to be associated with an increased number of applications submitted. Conclusion Less qualified candidates are not applying to significantly more programs than their more qualified counterparts. The increasing number of applications represents a financial strain on the applicant, given the costs required to apply to more programs, and a time burden on individual programs to screen increasing numbers of applicants. In order to stabilize or reverse this alarming trend, orthopedic surgery residency programs should openly disclose admission criteria to prospective candidates, and medical schools should provide additional guidance for candidates in this process

  19. Effect of the Mandibular Orthopedic Repositioning Appliance on Trunk and Upper Limb Muscle Activation during Maximum Isometric Contraction

    PubMed Central

    Lee, Sang-Yeol; Hong, Min-Ho; Park, Min-Chull; Choi, Sung-Min

    2013-01-01

    [Purpose] The purpose of this study was to measure the muscle activities of the trunk muscles and upper limb muscles during maximum isometric contraction when temporomandibular joint alignment was achieved with a mandibular orthopedic repositioning appliance in order provide basic data on the effects of mandibular orthopedic repositioning appliance on the entire body. [Subjects] The present study was conducted with healthy Korean adults in their 20s (males=10, females=10). [Methods] An 8 channel surface electromyography system was used to measure the muscle activities of the upper limb muscles and neck muscles of the subjects during maximum isometric contraction with and without use of a mandibular orthopedic repositioning appliance. [Results] The maximum isometric contractions of the trunk and upper limb muscles when mandibular orthopedic repositioning appliance were used were compared with those when no mandibular orthopedic repositioning appliance was used. The results showed that the sternocleidomastoid muscle, cervical and lumbar erector spinae, upper trapezius, biceps, triceps, rectus abdominis and internal oblique and external oblique muscles all showed significant increases in maximum isometric contractions with a mandibular orthopedic repositioning appliance. [Conclusion] The use of a mandibular orthopedic repositioning appliance is considered to be a method for normal adults to improve the stability of the entire body with the improvement of the stability of the TMJ. The proximal improvement in stability improves of the proximal thereby improving not only muscle strength with increased muscle activation but also stability during exercises. PMID:24396194

  20. Manipulating Genetic Material in Bacteria

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Lisa Crawford, a graduate research assistant from the University of Toledo, works with Laurel Karr of Marshall Space Flight Center (MSFC) in the molecular biology laboratory. They are donducting genetic manipulation of bacteria and yeast for the production of large amount of desired protein. Photo credit: NASA/Marshall Space Flight Center (MSFC)

  1. Master/slave manipulator system

    NASA Technical Reports Server (NTRS)

    Vykukal, H. C.; King, R. F.; Vallotton, W. C.

    1973-01-01

    System capabilities are equivalent to mobility, dexterity, and strength of human arm. Arrangement of torque motor, harmonic drive, and potentiometer combination allows all power and control leads to pass through center of slave with position-transducer arrangement of master, and "stovepipe joint" is incorporated for manipulator applications.

  2. DATACUBE: A datacube manipulation package

    NASA Astrophysics Data System (ADS)

    Allan, Alasdair; Currie, Malcolm J.

    2014-05-01

    DATACUBE is a command-line package for manipulating and visualizing data cubes. It was designed for integral field spectroscopy but has been extended to be a generic data cube tool, used in particular for sub-millimeter data cubes from the James Clerk Maxwell Telescope. It is part of the Starlink software collection (ascl:1110.012).

  3. COGNITION, ACTION, AND OBJECT MANIPULATION

    PubMed Central

    Rosenbaum, David A.; Chapman, Kate M.; Weigelt, Matthias; Weiss, Daniel J.; van der Wel, Robrecht

    2012-01-01

    Although psychology is the science of mental life and behavior, it has paid little attention to the means by which mental life is translated into behavior. One domain where links between cognition and action have been explored is the manipulation of objects. This article reviews psychological research on this topic, with special emphasis on the tendency to grasp objects differently depending on what one plans to do with the objects. Such differential grasping has been demonstrated in a wide range of object manipulation tasks, including grasping an object in a way that reveals anticipation of the object's future orientation, height, and required placement precision. Differential grasping has also been demonstrated in a wide range of behaviors, including one-hand grasps, two-hand grasps, walking, and transferring objects from place to place as well as from person to person. The populations in whom the tendency has been shown are also diverse, including nonhuman primates as well as human adults, children, and babies. Meanwhile, the tendency is compromised in a variety of clinical populations and in children of a surprisingly advanced age. Verbal working memory is compromised as well if words are memorized while object manipulation tasks are performed; the recency portion of the serial position curve is reduced in this circumstance. In general, the research reviewed here points to rich connections between cognition and action as revealed through the study of object manipulation. Other implications concern affordances, Donders' Law, and naturalistic observation and the teaching of psychology. PMID:22448912

  4. Ants: the supreme soil manipulators

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This review focuses on the semiochemical interactions between ants and their soil environment. Ants occupy virtually every ecological niche and have evolved mechanisms to not just cope with, but also manipulate soil organisms. The metapleural gland, specific to ants was thought to be the major sourc...

  5. Adaptive Control Of Remote Manipulator

    NASA Technical Reports Server (NTRS)

    Seraji, Homayoun

    1989-01-01

    Robotic control system causes remote manipulator to follow closely reference trajectory in Cartesian reference frame in work space, without resort to computationally intensive mathematical model of robot dynamics and without knowledge of robot and load parameters. System, derived from linear multivariable theory, uses relatively simple feedforward and feedback controllers with model-reference adaptive control.

  6. Advanced action manipulator system (ADAMS)

    NASA Technical Reports Server (NTRS)

    Kugath, D. A.; Dane, D. H.; Blaise, H. T.

    1973-01-01

    Manipulator offers improved performance over other models in its category. It features larger force and reach capabilities and is readily convertible for underwater use. Unique kinematic arrangement provides extremely large working envelope. System has six degrees of motion: azimuth joint, shoulder joint, upper arm rotating joint, elbow joint, wrist pitch, and wrist twist.

  7. Teaching Integration Applications Using Manipulatives

    ERIC Educational Resources Information Center

    Bhatia, Kavita; Premadasa, Kirthi; Martin, Paul

    2014-01-01

    Calculus students' difficulties in understanding integration have been extensively studied. Research shows that the difficulty lies with students understanding of the definition of the definite integral as a limit of a Riemann sum and with the idea of accumulation inherent in integration. We have created a set of manipulatives and activities…

  8. Mapping and Manipulating Facial Expression

    ERIC Educational Resources Information Center

    Theobald, Barry-John; Matthews, Iain; Mangini, Michael; Spies, Jeffrey R.; Brick, Timothy R.; Cohn, Jeffrey F.; Boker, Steven M.

    2009-01-01

    Nonverbal visual cues accompany speech to supplement the meaning of spoken words, signify emotional state, indicate position in discourse, and provide back-channel feedback. This visual information includes head movements, facial expressions and body gestures. In this article we describe techniques for manipulating both verbal and nonverbal facial…

  9. MODULAR MANIPULATOR FOR ROBOTICS APPLICATIONS

    SciTech Connect

    Joseph W. Geisinger, Ph.D.

    2001-07-31

    ARM Automation, Inc. is developing a framework of modular actuators that can address the DOE's wide range of robotics needs. The objective of this effort is to demonstrate the effectiveness of this technology by constructing a manipulator from these actuators within a glovebox for Automated Plutonium Processing (APP). At the end of the project, the system of actuators was used to construct several different manipulator configurations, which accommodate common glovebox tasks such as repackaging. The modular nature and quickconnects of this system simplify installation into ''hot'' boxes and any potential modifications or repair therein. This work focused on the development of self-contained robotic actuator modules including the embedded electronic controls for the purpose of building a manipulator system. Both of the actuators developed under this project contain the control electronics, sensors, motor, gear train, wiring, system communications and mechanical interfaces of a complete robotics servo device. Test actuators and accompanying DISC{trademark}s underwent validation testing at The University of Texas at Austin and ARM Automation, Inc. following final design and fabrication. The system also included custom links, an umbilical cord, an open architecture PC-based system controller, and operational software that permitted integration into a completely functional robotic manipulator system. The open architecture on which this system is based avoids proprietary interfaces and communication protocols which only serve to limit the capabilities and flexibility of automation equipment. The system was integrated and tested in the contractor's facility for intended performance and operations. The manipulator was tested using the full-scale equipment and process mock-ups. The project produced a practical and operational system including a quantitative evaluation of its performance and cost.

  10. Genetic manipulation of francisella tularensis.

    PubMed

    Zogaj, Xhavit; Klose, Karl E

    2010-01-01

    Francisella tularensis is a facultative intracellular pathogen that causes the disease tularemia. F. tularensis subsp. tularensis causes the most severe disease in humans and has been classified as a Category A select agent and potential bioweapon. There is currently no vaccine approved for human use, making genetic manipulation of this organism critical to unraveling the genetic basis of pathogenesis and developing countermeasures against tularemia. The development of genetic techniques applicable to F. tularensis have lagged behind those routinely used for other bacteria, primarily due to lack of research and the restricted nature of the biocontainment required for studying this pathogen. However, in recent years, genetic techniques, such as transposon mutagenesis and targeted gene disruption, have been developed, that have had a dramatic impact on our understanding of the genetic basis of F. tularensis virulence. In this review, we describe some of the methods developed for genetic manipulation of F. tularensis. PMID:21607086

  11. Genetic Manipulation of Francisella Tularensis

    PubMed Central

    Zogaj, Xhavit; Klose, Karl E.

    2011-01-01

    Francisella tularensis is a facultative intracellular pathogen that causes the disease tularemia. F. tularensis subsp. tularensis causes the most severe disease in humans and has been classified as a Category A select agent and potential bioweapon. There is currently no vaccine approved for human use, making genetic manipulation of this organism critical to unraveling the genetic basis of pathogenesis and developing countermeasures against tularemia. The development of genetic techniques applicable to F. tularensis have lagged behind those routinely used for other bacteria, primarily due to lack of research and the restricted nature of the biocontainment required for studying this pathogen. However, in recent years, genetic techniques, such as transposon mutagenesis and targeted gene disruption, have been developed, that have had a dramatic impact on our understanding of the genetic basis of F. tularensis virulence. In this review, we describe some of the methods developed for genetic manipulation of F. tularensis. PMID:21607086

  12. Noncontact Acoustic Manipulation in Air

    NASA Astrophysics Data System (ADS)

    Kozuka, Teruyuki; Yasui, Kyuichi; Tuziuti, Toru; Towata, Atsuya; Iida, Yasuo

    2007-07-01

    A noncontact manipulation technique is useful for micromachine technology, biotechnology, and new materials processing. In this paper, we describe an advanced manipulation technique for transporting small objects in air. A standing wave field was generated by two sound beams crossing each other generated by bolted Langevin transducers. Expanded polystyrene particles were trapped at the nodes of the sound pressure in the standing wave field. The position of a trapped particle was shifted by changing the phase difference between the two sound beams. When the trapped particle is transported, it spatially oscillate periodically in a direction perpendicular to that of particle transportation. The numerical calculation of an acoustic field revealed that it is caused by the reflection of an ultrasonic wave at each transducer surface.

  13. The laboratory telerobotic manipulator program

    NASA Technical Reports Server (NTRS)

    Herndon, J. N.; Babcock, S. M.; Butler, P. L.; Costello, H. M.; Glassell, R. L.; Kress, R. L.; Kuban, D. P.; Rowe, J. C.; Williams, D. M.

    1989-01-01

    New opportunities for the application of telerobotic systems to enhance human intelligence and dexterity in the hazardous environment of space are presented by the NASA Space Station Program. Because of the need for significant increases in extravehicular activity and the potential increase in hazards associated with space programs, emphasis is being heightened on telerobotic systems research and development. The Laboratory Telerobotic Manipulator (LTM) program is performed to develop and demonstrate ground-based telerobotic manipulator system hardware for research and demonstrations aimed at future NASA applications. The LTM incorporates traction drives, modularity, redundant kinematics, and state-of-the-art hierarchical control techniques to form a basis for merging the diverse technological domains of robust, high-dexterity teleoperations and autonomous robotic operation into common hardware to further NASA's research.

  14. Control of robot manipulator compliance

    NASA Technical Reports Server (NTRS)

    Nguyen, Charles C.; Pooran, Farhad J.; Premack, Timothy

    1986-01-01

    Robotic assembly operations such as mating and fastening of parts are more successful if the robot manipulator compliance can be controlled so that various coordinates are free to comply with external constraints. This paper presents the design of a hybrid controller to provide active compliance to a six-degree-of-freedom robot built at NASA/GSFC using force and position feedback. Simulation results of a 2 degree-of-freedom model is presented and discussed.

  15. Detection and manipulation of phosphoinositides☆

    PubMed Central

    Idevall-Hagren, Olof; Camilli, Pietro De

    2016-01-01

    Phosphoinositides (PIs) are minor components of cell membranes, but play key roles in cell function. Recent refinements in techniques for their detection, together with imaging methods to study their distribution and changes, have greatly facilitated the study of these lipids. Such methods have been complemented by the parallel development of techniques for the acute manipulation of their levels, which in turn allow bypassing the long-term adaptive changes implicit in genetic perturbations. Collectively, these advancements have helped elucidate the role of PIs in physiology and the impact of the dysfunction of their metabolism in disease. Combining methods for detection and manipulation enables the identification of specific roles played by each of the PIs and may eventually lead to the complete deconstruction of the PI signaling network. Here, we review current techniques used for the study and manipulation of cellular PIs and also discuss advantages and disadvantages associated with the various methods. This article is part of a Special Issue entitled Phosphoinositides. PMID:25514766

  16. Manipulation of Biofilm Microbial Ecology

    SciTech Connect

    White, D.C.; Palmer, R.J., Jr.; Zinn, M.; Smith, C.A.; Burkhalter, R.; Macnaughton, S.J.; Whitaker, K.W.; Kirkegaard, R.D.

    1998-08-15

    The biofilm mode of growth provides such significant advantages to the members of the consortium that most organisms in important habitats are found in biofilms. The study of factors that allow manipulation of biofilm microbes in the biofilm growth state requires that reproducible biofilms be generated. The most effective monitoring of biofilm formation, succession and desaturation is with on-line monitoring of microbial biofilms with flowcell for direct observation. The biofilm growth state incorporates a second important factor, the heterogeneity in distribution in time and space of the component members of the biofilm consortium. This heterogeneity is reflected not only in the cellular distribution but in the metabolic activity within a population of cells. Activity and cellular distribution can be mapped in four dimensions with confocal microscopy, and function can be ascertained by genetically manipulated reporter functions for specific genes or by vital stains. The methodology for understanding the microbial ecology of biofilms is now much more readily available and the capacity to manipulate biofilms is becoming an important feature of biotechnology.

  17. Oral factor Xa inhibitors for thromboprophylaxis in major orthopedic surgery: a review.

    PubMed

    Imberti, Davide; Dall'Asta, Chiara; Pierfranceschi, Matteo Giorgi

    2009-12-01

    Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is a major cause of morbidity and mortality in patients undergoing major orthopedic surgery. Routine thromboprophylaxis has been the standard of care over the last 20 years. Currently available options for the prevention of VTE in major orthopedic surgery include low molecular weight heparins, vitamin K antagonists, and, more recently, the synthetic pentasaccharide fondaparinux. Although effective, all these drugs have several limitations and new oral antithrombotics offering predictable, effective and safe anticoagulation are strongly needed. This overview focuses on the most advanced oral direct inhibitors to factor Xa rivaroxaban, apixaban, LY517717 and YM150; specifically, the results of phase II and III studies and the designs of ongoing clinical trials in patients undergoing elective hip and knee replacement are reviewed. PMID:19696978

  18. Oral factor Xa inhibitors for venous thromboembolism prevention in major orthopedic surgery: a review.

    PubMed

    Imberti, Davide; Prisco, Domenico

    2008-01-01

    Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is a major cause of morbidity and mortality in patients undergoing major orthopedic surgery, and routine thromboprophylaxis has been the standard of care over the last 20 years. Currently available options for the prevention of VTE in major orthopedic surgery include low-molecular-weight heparins, vitamin K antagonists and, more recently, the synthetic pentasaccharide fondaparinux. Although effective, these drugs have several limitations, and new oral antithrombotics offering predictable, effective and safe anticoagulation are strongly needed. This overview focuses on the most advanced oral direct inhibitors of factor Xa, rivaroxaban, apixaban, LY517717, YM150 and betrixaban. Specifically, the results of phase II and III studies and the designs of ongoing clinical trials in patients undergoing elective hip and knee replacement are reviewed. PMID:19996630

  19. [SGTB orthopedic regime to correct protrusive skeletal anomalies: a developmental path through evolution, renovation and innovation].

    PubMed

    Shen, Gang

    2015-10-01

    Sagittal-guidance Twin-block appliance (SGTB), an orthopedic therapy that has been widely implemented in orthodontic practice since it was introduced by the author a decade ago. This overview was aimed to clarify the fundamental mechanism of SGTB in correction of skeletal malocclusions, i.e., retraction of the maxilla triggered by the muscular force generated from mandibular forward positioning. This overview was also designed to summarize the evolutionary pathway through which SGTB regime originated and developed from removable, bonded and to the latest form of clear aligner SGTB. It was concluded that SGTB promised to be an efficient orthopedic approach to manage complicated and severe dentofacial anomalies with skeletal element. PMID:26598180

  20. Priming the Surface of Orthopedic Implants for Osteoblast Attachment in Bone Tissue Engineering

    PubMed Central

    Chan, Kiat Hwa; Zhuo, Shuangmu; Ni, Ming

    2015-01-01

    The development of better orthopedic implants is incessant. While current implants can function reliably in the human body for a long period of time, there are still a significant number of cases for which the implants can fail prematurely due to poor osseointegration of the implant with native bone. Increasingly, it is recognized that it is extremely important to facilitate the attachment of osteoblasts on the implant so that a proper foundation of extracellular matrix (ECM) can be laid down for the growth of new bone tissue. In order to facilitate the osseointegration of the implant, both the physical nanotopography and chemical functionalization of the implant surface have to be optimized. In this short review, however, we explore how simple chemistry procedures can be used to functionalize the surfaces of three major classes of orthopedic implants, i.e. ceramics, metals, and polymers, so that the attachment of osteoblasts on implants can be facilitated in order to promote implant osseointegration. PMID:26392807

  1. The Medical Education and Best Practice in Orthopedic Patient Care in Poland.

    NASA Astrophysics Data System (ADS)

    Rosiek, Anna; Leksowski, Krzysztof

    2012-07-01

    The leadership organization focuses on education, teamwork, customer relationship and developing strategy which help in building added value, in managing activities, time and quality. Everyday orthopedic experience shows that medical education is a mixture of: specific knowledge, skills and attitudes of people working together, and that creates effective teamwork in a hospital environment. Apart from the main reason of medical education, teaching about disease treatment and health problem solving, medical education should also concentrate on human factors and behavioral aspects of patient treatment in hospital.Assessment of an organization and medical education process by cultural and teamwork criteria, offers a powerful new way to think about performance at the frontlines of healthcare and in the future it could be gold standard for assessing the success of an organization, and standards in medical education, not only in orthopedics.

  2. [Thoughts and proposals for quality assurance in orthopedics in the community pharmacy].

    PubMed

    Callanquin, J; Labrude, P; Rouyer, A

    2007-05-01

    This review begins with an examination of the notion of quality in the industrial setting, its definition and the steps taken to achieve quality assurance. The review then considers what is meant by quality in the field of health, and in particular for orthopedic devices dispensed in a community pharmacy. Special attention is given to dispensing standard orthopedic devices; five aspects are considered: organization, personal competence, products, services, and relationship with the patient. The first aspect, organization, involves the selling area, stocks, different sizes and sale prices, and the introduction of new devices. Dispensing involves, reception and physical examination of the patient, information delivery, decision-making on the choice of an orthesis, measurement, trial and application, as well as complementary advice and completion of the patient's file. Quality is measured in terms of patient needs. PMID:17489074

  3. Orthopedic management of spina bifida. Part I: hip, knee, and rotational deformities.

    PubMed

    Swaroop, Vineeta T; Dias, Luciano

    2009-12-01

    Children with spina bifida develop a wide variety of congenital and acquired orthopedic deformities. Among these are hip deformities such as contracture, subluxation, or dislocation. Patients may also have problems with the knee joint, such as knee flexion or extension contracture, knee valgus deformity, or late knee instability and pain. In addition, rotational deformities of the lower extremities, either internal or external torsion, are common as well. This paper will review both the overall orthopedic care of a patient with spina bifida and provide a focused review of the diagnosis and management of the above deformities. In addition, this paper will review the incidence, etiology, classification, and prognosis of spina bifida. The use of gait analysis and orthoses will be covered as well. The forthcoming Part II will cover foot and ankle deformities in spina bifida. PMID:19856195

  4. Clinical applicability of nursing outcomes in the evolution of orthopedic patients with Impaired Physical Mobility 1

    PubMed Central

    da Silva, Marcos Barragan; Almeida, Miriam de Abreu; Panato, Bruna Paulsen; Siqueira, Ana Paula de Oliveira; da Silva, Mariana Palma; Reisderfer, Letícia

    2015-01-01

    AIM: to evaluate the clinical applicability of outcomes, according to the Nursing Outcomes Classification (NOC) in the evolution of orthopedic patients with Impaired Physical Mobility METHOD: longitudinal study conducted in 2012 in a university hospital, with 21 patients undergoing Total Hip Arthroplasty, evaluated daily by pairs of trained data collectors. Data were collected using an instrument containing five Nursing Outcomes, 16 clinical indicators and a five point Likert scale, and statistically analyzed. RESULTS: The outcomes Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity, and Fall Prevention Behavior presented significant increases in mean scores when comparing the first and final evaluations (p<0.001) and (p=0.035). CONCLUSION: the use of the NOC outcomes makes it possible to demonstrate the clinical progression of orthopedic patients with Impaired Physical Mobility, as well as its applicability in this context. PMID:25806631

  5. Brandon Research, Inc. Orthopedic Implant Cooperative Research and Development Agreement (CRADA) Final Report

    SciTech Connect

    Freeman, W.R.

    1999-04-22

    The project was a joint research effort between the U. S. Department of Energy's (DOE) Kansas City Plant (KCP) and Brandon Research, Inc. to develop ways to improve implants used for orthopedic surgery for joint replacement. The primary product produced by this study is design information, which may be used to develop implants that will improve long-term fixation and durability in the host bone environment.

  6. In-vivo orthopedic implant diagnostic device for sensing load, wear, and infection

    DOEpatents

    Evans, III, Boyd McCutchen; Thundat, Thomas G.; Komistek, Richard D.; Dennis, Douglas A.; Mahfouz, Mohamed

    2006-08-29

    A device for providing in vivo diagnostics of loads, wear, and infection in orthopedic implants having at least one load sensor associated with the implant, at least one temperature sensor associated with the implant, at least one vibration sensor associated with the implant, and at least one signal processing device operatively coupled with the sensors. The signal processing device is operable to receive the output signal from the sensors and transmit a signal corresponding with the output signal.

  7. Accessibility and Availability of Online Information for Orthopedic Surgery Residency Programs

    PubMed Central

    Davidson, Austin R.; Loftis, Christopher M.; Throckmorton, Thomas W.

    2016-01-01

    Abstract Background Prospective orthopedic residency applicants commonly use one of three databases to identify potential programs: Accreditation Council of Graduate Medical Education (ACGME), American Medical Association (FREIDA), or Orthogate. org. In addition, institutional websites are typically the primary source of information once programs are identified. We sought to evaluate the databases and websites used by prospective orthopedic surgery applicants for content and accessibility. We hypothesized that information would be more available in comparison to previous studies but would still fail to provide complete, up to date program information for the prospective applicant. Methods Three online databases were queried in December 2014 to compile a list of orthopedic residency programs in the United States. This combined list was used as a basis for evaluating individual institution websites. Previously described criteria were used to evaluate the availability of information contained within orthopedic surgery residency websites. Results At the time of online review, 157 programs were identified. Depending on the database in question, up to 33% of programs either did not provide a link or listed a non-functioning link. Among the variety of evaluated criteria, inclusion of the information varied between 12% and 97% for the individual program websites. Conclusions Online databases are useful in listing programs, but individual program details and direct functional links are lacking. Most program websites contain varying degrees of desired information; however, not all programs maintain websites which consistently provide information to satisfy the evaluated criteria in this study. Improved online accessibility and availability of information for residency programs would increase their visibility and utility for prospective applicants. PMID:27528832

  8. Melior Via: A Better Way to Integrate and Restore Movement into Orthopedic Rehabilitation.

    PubMed

    Hetzler, Brandon; Mahaffey, Brian

    2016-01-01

    Movement develops uniformly and predictably in all normal newborns and infants. The genetic roadmap for every complex movement that will ever be performed is written intoevery infant's nervous system and develops from these basic ingredients: unlimited mobility, an undeveloped nervous system, primal reflexes, and breathing. Following an injury, surgery or trauma, restoring movement is the same as learning movement only with slightly differing parameters. The principles, however, remain the same and can be used to improve orthopedic rehabilitation. PMID:27443044

  9. Interval prevalence of and factors associated with colic in horses hospitalized for ocular or orthopedic disease.

    PubMed

    Scherrer, Nicole M; Lassaline, Mary; Richardson, Dean W; Stefanovski, Darko

    2016-07-01

    OBJECTIVE To determine interval (1-year) prevalence of and factors associated with colic in horses hospitalized for ocular or orthopedic disease. DESIGN Cross-sectional study. ANIMALS 105 horses with ocular disease and 197 horses with orthopedic disease admitted to a veterinary teaching hospital between July 1, 2011, and June 30, 2012. PROCEDURES Medical records were reviewed to determine whether colic (abnormal behavior prompting abdominal palpation per rectum or nasogastric intubation) was observed during hospitalization. Data were collected on putative risk factors for colic, including reason for admission, signalment, and medical or surgical interventions received. RESULTS No significant difference in interval prevalence of colic was identified between horses with ocular disease (8/105 [8%]) or orthopedic disease (9/197 [5%]). However, horses with ocular disease differed significantly from other horses in median age (10 vs 3 years, respectively); proportions of sexually intact males (3% vs 30%), Thoroughbreds (28% vs 62%), and those receiving general anesthesia (65% vs 80%); and median duration of hospitalization (3 vs 2 days). For every 1 mg/kg increase in daily NSAID dose, the odds of colic increased by 98%. No difference between groups was identified in median duration of colic (1 day), hospitalization (7 vs 3 days), or systemic NSAID administration (7 vs 5 days). Colic in both groups resolved with medical management for all but 1 horse with ocular disease. CONCLUSIONS AND CLINICAL RELEVANCE Horses hospitalized for ocular disease were at no greater odds for colic than were horses hospitalized for orthopedic disease. Medical management of colic appeared adequate for most horses. PMID:27308887

  10. Adaptation of NASA technology for the optimum design of orthopedic knee implants.

    PubMed

    Saravanos, D A; Mraz, P J; Davy, D T; Hopkins, D A

    1991-03-01

    NASA technology originally developed for designing aircraft turbine-engine blades has been adapted and applied to orthopedic knee implants. This article describes a method for tailoring an implant for optimal interaction with the environment of the tibia. The implant components are designed to control stresses in the bone for minimizing bone degradation and preventing failures. Engineers expect the tailoring system to improve knee prosthesis design and allow customized implants for individual patients. PMID:10150099

  11. A survey of recently published papers on orthopedics in the Brazilian scientific press

    PubMed Central

    Rocha-e-Silva, Mauricio; Gomes, Ariane Maris

    2012-01-01

    This paper is a review of articles published in Brazilian scientific periodicals in recent years. Its main purpose is to bring to the attention of the readership of Acta Ortopedica Brasileira original contributions to the field published in non-specialized journals. We hope that this will serve as a general scientific update for readers. The review includes works published in six ISI indexed non-orthopedic journals, following a literature search conducted in fourteen such journals. PMID:24453633

  12. Use of carbon-fiber-reinforced composite implants in orthopedic surgery.

    PubMed

    Hak, David J; Mauffrey, Cyril; Seligson, David; Lindeque, Bennie

    2014-12-01

    Carbon-fiber-reinforced polyetheretherketone implants offer several benefits over traditional metal implants. Their radiolucent property permits improved, artifact-free radiographic imaging. Their lower modulus of elasticity better matches that of bone. Their fatigue strength is greater than most metal implants. This article reviews the use of these implants in orthopedic surgery, including treatment of conditions involving the spine, trauma, tumor, and infection. PMID:25437074

  13. Iterative inverse kinematics with manipulator configuration control

    SciTech Connect

    Grudic, G.Z.; Lawrence, P.D.

    1993-08-01

    A new method, termed the offset modification method (OM method), for solving the manipulator inverse kinematics problem is presented. The OM method works by modifying the link offset values of a manipulator until it is possible to derive closed-form inverse kinematics equations for the resulting manipulator (termed the model manipulator). This procedure allows one to derive a set of three nonlinear equations in three unknowns that, when numerically solved, give an inverse kinematics solution for the original manipulator. The OM method can be applied to manipulators with any number of degrees of freedom, as long as the manipulator satisfies a given set of conditions (Theorem 1). The OM method is tested on a 6-degree-of-freedom manipulator that has no known closed-form inverse kinematics equations. It is shown that the OM method is applicable to real-time manipulator control, can be used to guarantee convergence to a desired endpoint position and orientation (if it exists), and allows one to directly choose which inverse kinematics solution the algorithm will converge to (as specified in the model manipulator closed-form inverse kinematics equations). Applications of the method to other 6-DOF manipulator geometries and to redundant manipulators (i.e. greater than 6 DOF geometries) are discussed.

  14. Manipulative therapy (Feldenkrais, massage, chiropractic manipulation) for neck pain.

    PubMed

    Plastaras, Christopher; Schran, Seth; Kim, Natasha; Darr, Deborah; Chen, Mary Susan

    2013-07-01

    Neck pain is an extremely common symptom with many possible etiologies. A substantial number of patients are turning to complementary and alternative medicine (CAM). Low-quality evidence supports the beneficial effects of CAM. Feldenkrais, massage therapy, and spinal manipulation are discussed in detail. Complications are generally benign and self-limited, although occasional catastrophic consequences have been documented. Despite the favorable opinion many rheumatologists have of some CAM therapy, many patients are not disclosing CAM use to their medical providers. By expressing interest, asking questions, and taking a shared-decision-making approach, providers can encourage disclosure and provide valuable input. PMID:23666468

  15. Orthopedic Injuries and Their Treatment in Children During Earthquakes: A Systematic Review.

    PubMed

    Morelli, Ilaria; Sabbadini, Maria Grazia; Bortolin, Michelangelo

    2015-10-01

    Orthopedic injuries commonly affect children during earthquakes, but reports about them are rare. This setting may lead to different standards of care, but guidelines are still missing in this field. A systematic review was performed to: (1) assess type and body distribution of pediatric earthquake-related injuries, treatment performed, length of stay, and complications; and (2) identify starting points to define standards of care. PubMed database was researched for papers (1999-2014 period) in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Inclusion criteria were: English, French, Spanish, or Italian language and data reported about orthopedic lesions in children (≤18 years old). Reviews, letters, commentaries, editorials, and single case reports were excluded. Two independent reviewers selected articles after abstract and full-text reading. Traumatic injuries caused child hospital admissions ranging from 46.9% to 100.0%; 16% to 53% suffered fractures. Lower limbs mostly were involved. Soft-tissue injuries affected 55% of patients. Debridement and external fixation (EF) were the most frequent surgical treatments. Amputation rates varied from 5% to 11%. This study revealed that field hospitals should be prepared to: (1) treat mainly lower extremities fractures in children; and (2) use especially EF techniques. The presence of orthopedic surgeons familiar with pediatric traumatology should be considered. PMID:26286704

  16. Orthopedic Surgeon's Awareness Can Improve Osteoporosis Treatment Following Hip Fracture: A Prospective Cohort Study

    PubMed Central

    Kim, Sang-Rim; Park, Yong-Geun; Lee, Sung-Rak; Koo, Kyung-Hoi

    2011-01-01

    Through retrospective Jeju-cohort study at 2005, we found low rates of detection of osteoporosis (20.1%) and medication for osteoporosis (15.5%) in those who experienced hip fracture. This study was to determine the orthopedic surgeons' awareness could increase the osteoporosis treatment rate after a hip fracture and the patient barriers to osteoporosis management. We prospectively followed 208 patients older than 50 yr who were enrolled for hip fractures during 2007 in Jeju-cohort. Thirty four fractures in men and 174 in women were treated at the eight hospitals. During the study period, orthopedic surgeons who worked at these hospitals attended two education sessions and were provided with posters and brochures. Patients were interviewed 6 months after discharge using an evaluation questionnaire regarding their perceptions of barriers to osteoporosis treatment. The patients were followed for a minimum of one year. Ninety-four patients (45.2%) underwent detection of osteoporosis by dual energy x-ray absorptiometry and 67 (32.2%) were prescribed medication for osteoporosis at the time of discharge. According to the questionnaire, the most common barrier to treatment for osteoporosis after a hip fracture was patients reluctance. The detection and medication rate for osteoporosis after hip fracture increased twofold after orthopedic surgeons had attended the intervention program. Nevertheless, the osteoporosis treatment rate remains inadequate. PMID:22065908

  17. The Use of Carbon-Fiber-Reinforced (CFR) PEEK Material in Orthopedic Implants: A Systematic Review.

    PubMed

    Li, Chuan Silvia; Vannabouathong, Christopher; Sprague, Sheila; Bhandari, Mohit

    2015-01-01

    Carbon-fiber-reinforced polyetheretherketone (CFR-PEEK) has been successfully used in orthopedic implants. The aim of this systematic review is to investigate the properties, technical data, and safety of CFR-PEEK biomaterial and to evaluate its potential for new innovation in the design of articulating medical devices. A comprehensive search in PubMed and EMBASE was conducted to identify articles relevant to the outcomes of CFR-PEEK orthopedic implants. The search was also expanded by reviewing the reference sections of selected papers and references and benchmark reports provided by content experts. A total of 23 articles were included in this review. There is limited literature available assessing the performance of CFR-PEEK, specifically as an implant material for arthroplasty systems. Nevertheless, available studies strongly support CFR-PEEK as a promising and suitable material for orthopedic implants because of its biocompatibility, material characteristics, and mechanical durability. Future studies should continue to investigate CFR-PEEK's potential benefits. PMID:25780341

  18. Prevalence of musculoskeletal disorders among orthopedic trauma surgeons: an OTA survey

    PubMed Central

    AlQahtani, Saad M.; Alzahrani, Mohammad M.; Harvey, Edward J.

    2016-01-01

    Background Occupational injuries and hazards have gained increased attention in the surgical community in general and in the orthopedic literature specifically. The aim of this study was to assess prevalence and characteristics of musculoskeletal disorders among orthopedic trauma surgeons and the impact of these injuries on the surgeons’ practices. Methods We sent a modified version of the physical discomfort survey to surgeon members of the Orthopaedic Trauma Association (OTA) via email. Data were collected and descriptive statistics were analyzed. Results A total of 86 surgeons completed the survey during the period of data collection; 84.9% were men, more than half were 45 years or older and 40.6% were in practice for 10 years or more. More than 66% of respondents reported a musculoskeletal disorder that was related to work; the most common was low back pain (29.3%). The number of body regions involved and disorders diagnosed was associated with increasing age and number of years in practice (p = 0.033). Time off work owing to these disorders was associated with working in a private setting (p = 0.045) and working in more than 1 institute (p = 0.009). Conclusion To our knowledge, our study is the first to report a high percentage of orthopedic trauma surgeons sustaining occupational injuries some time in their careers. The high cost of management and rehabilitation of these injuries in addition to the related number of missed work days indicate the need for increased awareness and implementation of preventive measures. PMID:26812408

  19. A touch probe method of operating an implantable RFID tag for orthopedic implant identification.

    PubMed

    Liu, Xiaoyu; Berger, J Lee; Ogirala, Ajay; Mickle, Marlin H

    2013-06-01

    The major problem in operating an implantable radio-frequency identification (RFID) tag embedded on an orthopedic implant is low efficiency because of metallic interference. To improve the efficiency, this paper proposes a method of operating an implantable passive RFID tag using a touch probe at 13.56 MHz. This technology relies on the electric field interaction between two pairs of electrodes, one being a part of the touch probe placed on the surface of tissue and the other being a part of the tag installed under the tissue. Compared with using a conventional RFID antenna such as a loop antenna, this method has a better performance in the near field operation range to reduce interference with the orthopedic implant. Properly matching the touch probe and the tag to the tissue and the implant reduces signal attenuation and increases the overall system efficiency. The experiments have shown that this method has a great performance in the near field transcutaneous operation and can be used for orthopedic implant identification. PMID:23853323

  20. Intravenous Paracetamol Reduces Postoperative Opioid Consumption after Orthopedic Surgery: A Systematic Review of Clinical Trials

    PubMed Central

    Khanna, Puneet

    2013-01-01

    Postoperative pain management is one of the most challenging jobs in orthopedic surgical population as it comprises of patients from extremes of ages and with multiple comorbidities. Though effective, opioids may contribute to serious adverse effects particularly in old age patients. Intravenous paracetamol is widely used in the postoperative period with the hope that it may reduce opioid consumption and produce better pain relief. A brief review of human clinical trials where intravenous paracetamol was compared with placebo or no treatment in postoperative period in orthopedic surgical population has been done here. We found that four clinical trials reported that there is a significant reduction in postoperative opioid consumption. When patients received an IV injection of 2 g propacetamol, reduction of morphine consumption up to 46% has been reported. However, one study did not find any reduction of opioid requirement after spinal surgery in children and adolescent. Four clinical trials reported better pain scores when paracetamol has been used, but other three trials denied. We conclude that postoperative intravenous paracetamol is a safe and effective adjunct to opioid after orthopedic surgery, but at present there is no data to decide whether paracetamol reduces opioid related adverse effects or not. PMID:24307945

  1. Intravenous paracetamol reduces postoperative opioid consumption after orthopedic surgery: a systematic review of clinical trials.

    PubMed

    Jebaraj, Bright; Maitra, Souvik; Baidya, Dalim Kumar; Khanna, Puneet

    2013-01-01

    Postoperative pain management is one of the most challenging jobs in orthopedic surgical population as it comprises of patients from extremes of ages and with multiple comorbidities. Though effective, opioids may contribute to serious adverse effects particularly in old age patients. Intravenous paracetamol is widely used in the postoperative period with the hope that it may reduce opioid consumption and produce better pain relief. A brief review of human clinical trials where intravenous paracetamol was compared with placebo or no treatment in postoperative period in orthopedic surgical population has been done here. We found that four clinical trials reported that there is a significant reduction in postoperative opioid consumption. When patients received an IV injection of 2 g propacetamol, reduction of morphine consumption up to 46% has been reported. However, one study did not find any reduction of opioid requirement after spinal surgery in children and adolescent. Four clinical trials reported better pain scores when paracetamol has been used, but other three trials denied. We conclude that postoperative intravenous paracetamol is a safe and effective adjunct to opioid after orthopedic surgery, but at present there is no data to decide whether paracetamol reduces opioid related adverse effects or not. PMID:24307945

  2. Sol-Gel Derived Hydroxyapatite Coating on Mg-3Zn Alloy for Orthopedic Application

    NASA Astrophysics Data System (ADS)

    Singh, Sanjay; Manoj Kumar, R.; Kuntal, Kishor Kumar; Gupta, Pallavi; Das, Snehashish; Jayaganthan, R.; Roy, Partha; Lahiri, Debrupa

    2015-04-01

    In recent years, magnesium and its alloys have gained a lot of interest as orthopedic implant constituents because their biodegradability and mechanical properties are closer to that of human bone. However, one major concern with Mg in orthopedics is its high corrosion rate that results in the reduction of mechanical integrity before healing the bone tissue. The current study evaluates the sol-gel-derived hydroxyapatite (HA) coating on a selected Mg alloy (Mg-3Zn) for decreasing the corrosion rate and increasing the bioactivity of the Mg surface. The mechanical integrity of the coating is established as a function of the surface roughness of the substrate and the sintering temperature of the coating. Coating on a substrate roughness of 15-20 nm and sintering at 400°C shows the mechanical properties in similar range of bone, thus making it suitable to avoid the stress-shielding effect. The hydroxyapatite coating on the Mg alloy surface also increases corrosion resistance very significantly by 40 times. Bone cells are also found proliferating better in the HA-coated surface. All these benefits together establish the candidature of sol-gel HA-coated Mg-3Zn alloy in orthopedic application.

  3. Perioperative management of patients with severe pulmonary hypertension in major orthopedic surgery: experience-based recommendations

    PubMed Central

    Seyfarth, Hans-Jürgen; Gille, Jochen; Sablotzki, Armin; Gerlach, Stefan; Malcharek, Michael; Gosse, Andreas; Gahr, Ralf H.; Czeslick, Elke

    2015-01-01

    Introduction: It is known that pulmonary hypertension is associated with worse outcome in both cardiac and non-cardiac surgery. The aims of our retrospective analysis were to evaluate the outcomes of our patients with pulmonary hypertension undergoing major orthopedic surgery and to give experience-based recommendations for the perioperative management. Material and methods: From 92 patients with pulmonary hypertension undergoing different kinds of surgical procedures from 2011–2014 in a tertiary academic hospital we evaluated 16 patients with major orthopedic surgery for perioperative morbidity and mortality. Results: Regarding the in-hospital morbidity and mortality, one patient died postoperatively due to pulmonary infection and right heart failure (6.25%) and 6 patients suffered significant postoperative complications (37.5%; bleeding = 1, infection = 1, wound healing deficits = 3; dysrhythmia = 1). Conclusion: Our data show that major orthopedic surgery is feasible with satisfactory outcome even in cases of severe pulmonary hypertension by an individualized, disease-adapted interdisciplinary treatment concept. PMID:26504732

  4. Harmful lifestyles on orthopedic implantation surgery: a descriptive review on alcohol and tobacco use.

    PubMed

    Fini, Milena; Giavaresi, Gianluca; Salamanna, Francesca; Veronesi, Francesca; Martini, Lucia; De Mattei, Monica; Tschon, Matilde

    2011-11-01

    Alcohol abuse and smoking habits have adverse effects on bone health and are a risk factor for osteoporosis, fractures and impaired fracture repair. Osteointegration processes around implanted biomaterials involve a coordinated cascade of complex events that are very similar to those occurring during fracture repair and require a suitable microenvironment and the coordinated action of cells and signal molecules. Therefore, diseases and harmful lifestyles that impair the normal bone healing process can reduce the success of implant surgery and may negatively influence the osteointegration of prostheses and implant devices for fracture fixation such as screws, nails and plates. Understanding the effects of harmful lifestyles on bone implant osteointegration is important for successful implant therapy, orthopedic reconstructive surgery and tissue-engineered-based therapies. However, the mechanisms by which smoking and alcoholism affect bone metabolism, bone mass and the balance of bone resorption and formation, also in the presence of an orthopedic implant, are not completely understood and remain inadequately elucidated. This review aims to analyze in vitro and in vivo studies regarding orthopedic implant integration in the presence of tobacco smoking and alcohol consumption with a focus on pathophysiology and local or systemic mechanisms of action on bone. PMID:21898177

  5. Endovascular Treatment in Emergency Setting of Acute Arterial Injuries After Orthopedic Surgery

    SciTech Connect

    Carrafiello, Gianpaolo Fontana, Federico Mangini, Monica Ierardi, Anna Maria Lagana, Domenico; Piacentino, Filippo Vizzari, Francesco Alberto Spano, Emanuela Fugazzola, Carlo

    2012-06-15

    Purpose: To assess the feasibility and effectiveness of emergency endovascular treatment of acute arterial injuries after orthopedic surgery. Materials and Methods: Fifteen patients (mean age 68.3 years) with acute arterial injuries after orthopedic surgery were observed, in particular, 5 patients with pseudoaneurysm, 9 patients with active bleeding, and 1 patient with arterial dissection. Transarterial embolization (TAE) and positioning of covered and noncovered stents were the treatments performed. Follow-up after stent implantation (mean 36 months) was performed with color Doppler US (CDU) at 1, 3, 6, and 12 months and yearly thereafter. Plain X-ray was performed to evidence dislodgment or fracture of the graft. A minimum of 12 months' follow-up is available after TAE. Results: Immediate technical success was obtained in all cases. No major complications occurred. Overall clinical success rate was 100%. During mean follow-up, stent-graft occlusions did not occurred. No recurrence and/or consequence of TAE was registered during a minimum follow-up of 12 months. Conclusions: Percutaneous treatment is a feasible and safe tool for treating arterial injuries because it can provide fast and definitive resolution of the damage. This low-invasiveness approach can be proposed as first-line treatment in patients with acute injuries after orthopedic surgery.

  6. LASER Additive Manufacturing of Titanium-Tantalum Alloy Structured Interfaces for Modular Orthopedic Devices

    NASA Astrophysics Data System (ADS)

    Fuerst, Jacob; Medlin, Dana; Carter, Michael; Sears, James; Vander Voort, George

    2015-04-01

    Tantalum is recognized to have better biocompatibility and osseointegrative properties than other more commonly used orthopedic grade alloys. There are several novel methods that tantalum or tantalum-titanium could be used to augment orthopedic implants. A tantalum or tantalum-titanium alloy at the bone/implant or modular component interfaces would substantially increase the longevity and performance of modular devices. Bonding a functional tantalum coating to a titanium orthopedic device is inherently difficult because of the small difference between the melting temperature of tantalum, 3017°C, and the boiling point of titanium, 3287°C. LASER powder deposition (LPD) is a fusion operation using an Nd:YAG to melt a small volume of substrate into which metal powder is sprayed achieving high temperature with a high solidification rate. LPD of Ti-Ta onto a Ti-6Al-4V substrate produced both a solid surface and structured coating with a pore size in the optimal 350-500 μm range.

  7. Optical manipulation for optogenetics: otoliths manipulation in zebrafish (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Favre-Bulle, Itia A.; Scott, Ethan; Rubinsztein-Dunlop, Halina

    2016-03-01

    Otoliths play an important role in Zebrafish in terms of hearing and sense of balance. Many studies have been conducted to understand its structure and function, however the encoding of its movement in the brain remains unknown. Here we developed a noninvasive system capable of manipulating the otolith using optical trapping while we image its behavioral response and brain activity. We'll also present our tools for behavioral response detection and brain activity mapping. Acceleration is sensed through movements of the otoliths in the inner ear. Because experimental manipulations involve movements, electrophysiology and fluorescence microscopy are difficult. As a result, the neural codes underlying acceleration sensation are poorly understood. We have developed a technique for optically trapping otoliths, allowing us to simulate acceleration in stationary larval zebrafish. By applying forces to the otoliths, we can elicit behavioral responses consistent with compensation for perceived acceleration. Since the animal is stationary, we can use calcium imaging in these animals' brains to identify the functional circuits responsible for mediating responses to acceleration in natural settings.

  8. Earth orbital teleoperator manipulator system evaluation program

    NASA Technical Reports Server (NTRS)

    Brye, R. G.; Frederick, P. N.; Kirkpatrick, M., III; Shields, N. L., Jr.

    1977-01-01

    The operator's ability to perform five manipulator tip movements while using monoptic and stereoptic video systems was assessed. Test data obtained were compared with previous results to determine the impact of camera placement and stereoptic viewing on manipulator system performance. The tests were performed using the NASA MSFC extendible stiff arm Manipulator and an analog joystick controller. Two basic manipulator tasks were utilized. The minimum position change test required the operator to move the manipulator arm to touch a target contract. The dexterity test required removal and replacement of pegs.

  9. Failure tolerant operation of kinematically redundant manipulators

    NASA Technical Reports Server (NTRS)

    Lewis, Christopher L.; Maciejewski, Anthony A.

    1994-01-01

    Redundant manipulators may compensate for failed joints with their additional degrees of freedom. In this paper such a manipulator is considered fault tolerant if it can guarantee completion of a task after any one of its joints has failed. This fault tolerance of kinematically redundant manipulators is insured here. Methods to analyze the manipulator's work space find regions inherently suitable for critical tasks because of their high level of failure tolerance. Constraints are then placed on the manipulator's range of motion to guarantee completion of a task.

  10. Technology for concrete pipe manipulator

    NASA Astrophysics Data System (ADS)

    Li, Bin; Wang, Dan; Lin, Renzhi

    2009-12-01

    The pipe manipulator is a developing mechatronic system to enhance productivity and protects workers from cave-ins in the trench while excavating and laying pipe. The pipe manipulator is for installing concrete pipe into the trench. It is an optical-electro-mechanical system. The mechanism is make up of two parts, the upside and underside. The upside is for lifting the equipment by backhoe and rotating the underside mechanism. It includes rigidity lift beams, holding pad, four-bar linkages, hydraulic cylinder, rotating support, and rotating mechanism. Holding pad will press the bucket back to keep the bucket hooking the pipe man safely and stably. The underside mechanism is for lifting, holding and adjusting the pipe section's stance. The underside mechanism includes support trolley, and lift fork. The support trolley is driven by hydraulic cylinder for moving the fork forward or backward while laying a pipe into trench. The fork is with a self-lock mechanism for preventing the pipe from slide out of the prongs. A new photoelectric locating system is developed for auto-measuring the installing pipe section's stance within the work area. The laser target has been developed as a key part in the photoelectric locating systems. The photoelectric target is a rotating polar coordinate. Photodiodes are used for making the polar radius. There is an angular displacement sensor sitting on the heart-axis of the target for measuring angle of the target rotating. The pipe manipulator can be located by the system, and the locating methods have been presented at last of the paper.

  11. Technology for concrete pipe manipulator

    NASA Astrophysics Data System (ADS)

    Li, Bin; Wang, Dan; Lin, Renzhi

    2010-01-01

    The pipe manipulator is a developing mechatronic system to enhance productivity and protects workers from cave-ins in the trench while excavating and laying pipe. The pipe manipulator is for installing concrete pipe into the trench. It is an optical-electro-mechanical system. The mechanism is make up of two parts, the upside and underside. The upside is for lifting the equipment by backhoe and rotating the underside mechanism. It includes rigidity lift beams, holding pad, four-bar linkages, hydraulic cylinder, rotating support, and rotating mechanism. Holding pad will press the bucket back to keep the bucket hooking the pipe man safely and stably. The underside mechanism is for lifting, holding and adjusting the pipe section's stance. The underside mechanism includes support trolley, and lift fork. The support trolley is driven by hydraulic cylinder for moving the fork forward or backward while laying a pipe into trench. The fork is with a self-lock mechanism for preventing the pipe from slide out of the prongs. A new photoelectric locating system is developed for auto-measuring the installing pipe section's stance within the work area. The laser target has been developed as a key part in the photoelectric locating systems. The photoelectric target is a rotating polar coordinate. Photodiodes are used for making the polar radius. There is an angular displacement sensor sitting on the heart-axis of the target for measuring angle of the target rotating. The pipe manipulator can be located by the system, and the locating methods have been presented at last of the paper.

  12. Spin-manipulating polarized deuterons

    SciTech Connect

    Morozov, V S; Krisch, A D; Leonova, M A; Raymond, R S; Sivers, D W; Wong, V K; Hinterberger, F; Kondratenko, A M; Stephenson, E J

    2011-03-01

    Spin dynamics of polarized deuteron beams near depolarization resonances, including a new polarization preservation concept based on specially-designed multiple resonance crossings, has been tested in a series of experiments in the COSY synchrotron. Intricate spin dynamics with sophisticated pre-programmed patterns as well as effects of multiple crossings of a resonance were studied both theoretically and experimentally with excellent agreement. Possible applications of these results to preserve, manipulate and spin-flip polarized beams in synchrotrons and storage rings are discussed.

  13. Tumor Stroma Manipulation By MSC.

    PubMed

    Grisendi, Giulia; Spano, Carlotta; Rossignoli, Filippo; D Souza, Naomi; Golinelli, Giulia; Fiori, Agnese; Horwitz, Edwin M; Guarneri, Valentina; Piacentini, Federico; Paolucci, Paolo; Dominici, Massimo

    2016-01-01

    Tumor stroma (TS) plays relevant roles in all steps of cancer development. We here address several fundamental aspects related with the interaction between cancer cells and their stromal counterparts. Dissecting these players is of pivotal importance to understand oncogenesis, immunoescape and drug resistance. In addition, this better comprehension will allow the introduction of novel and more effective therapeutic approaches where manipulated stromal elements may become detrimental for tumor growth. Our group and others rely on the use of multipotent mesenchymal stromal/stem cells (MSC) as anti-cancer tools, since these putative TS cell precursors can deliver potent apoptosis-inducing agents. Multimodal-armed MSC can target a variety of cancers in vitro and, when injected in vivo, they localize into tumors mediating cell death without evident toxicities to normal tissues. While several aspects of these strategies shall require further investigations, these approaches collectively indicate how TS manipulation by MSC represents a tool to influence the fate of cancer cells, creating a new generation of anti-cancer strategies. PMID:26953248

  14. Manipulating expression of tonoplast transporters.

    PubMed

    Li, Zhigang; Zhou, Man; Hu, Qian; Reighard, Shane; Yuan, Shuangrong; Yuan, Ning; San, Bekir; Li, Dayong; Jia, Haiyan; Luo, Hong

    2012-01-01

    Plant vacuoles have multifaceted roles including turgor maintenance, cytosolic pH and ionic homeostasis, plant protection against environmental stress, detoxification, pigmentation, and cellular signaling. These roles are achieved through the coordinated activities of many proteins in the tonoplast (vacuolar membrane), of which the proton pumps and ion transporters have been modified for improved abiotic stress tolerance in transgenic plants. Here we describe a method to manipulate vacuolar H(+)-pyrophosphatase in turfgrass and evaluate the impact of the modified tonoplast on the phenotype, biochemistry, and physiology of the transgenics. Creeping bentgrass (Agrostis stolonifera L.) plants overexpressing an Arabidopsis vacuolar H(+)-pyrophosphatase AVP1 exhibited improved growth and enhanced salt tolerance, likely associated with increased photosynthesis, relative water content, proline production, and Na(+) uptake. These transgenic plants also had decreased solute leakage in the leaf tissues and increased concentrations of Na(+), K(+), Cl(-), and total phosphorus in the root tissues. Similar strategies can be employed to manipulate other tonoplast transporters and in other plant species to produce transgenic plants with improved performance under various abiotic stresses. PMID:22895772

  15. Actuators for a space manipulator

    NASA Technical Reports Server (NTRS)

    Chun, W.; Brunson, P.

    1987-01-01

    The robotic manipulator can be decomposed into distinct subsytems. One particular area of interest of mechanical subsystems is electromechanical actuators (or drives). A drive is defined as a motor with an appropriate transmission. An overview is given of existing, as well as state-of-the-art drive systems. The scope is limited to space applications. A design philosophy and adequate requirements are the initial steps in designing a space-qualified actuator. The focus is on the d-c motor in conjunction with several types of transmissions (harmonic, tendon, traction, and gear systems). The various transmissions will be evaluated and key performance parameters will be addressed in detail. Included in the assessment is a shuttle RMS joint and a MSFC drive of the Prototype Manipulator Arm. Compound joints are also investigated. Space imposes a set of requirements for designing a high-performance drive assembly. Its inaccessibility and cryogenic conditions warrant special considerations. Some guidelines concerning these conditions are present. The goal is to gain a better understanding in designing a space actuator.

  16. Mobile remote manipulator vehicle system

    NASA Technical Reports Server (NTRS)

    Bush, Harold G. (Inventor); Mikulas, Martin M., Jr. (Inventor); Wallsom, Richard E. (Inventor); Jensen, J. Kermit (Inventor)

    1987-01-01

    A mobile remote manipulator system is disclosed for assembly, repair and logistics transport on, around and about a space station square bay truss structure. The vehicle is supported by a square track arrangement supported by guide pins integral with the space station truss structure and located at each truss node. Propulsion is provided by a central push-pull drive mechanism that extends out from the vehicle one full structural bay over the truss and locks drive rods into the guide pins. The draw bar is now retracted and the mobile remote manipulator system is pulled onto the next adjacent structural bay. Thus, translation of the vehicle is inchworm style. The drive bar can be locked onto two guide pins while the extendable draw bar is within the vehicle and then push the vehicle away one bay providing bidirectional push-pull drive. The track switches allow the vehicle to travel in two orthogonal directions over the truss structure which coupled with the bidirectional drive, allow movement in four directions on one plane. The top layer of this trilayered vehicle is a logistics platform. This platform is capable of 369 degees of rotation and will have two astronaut foot restraint platforms and a space crane integral.

  17. Optical proximity sensors for manipulators

    NASA Technical Reports Server (NTRS)

    Johnson, A. R.

    1973-01-01

    A breadboard optical proximity sensor intended for application to remotely operated manipulators has been constructed and evaluated in the laboratory. The sensing head was 20 mm x 15 mm x 10 mm in size, and could be made considerably smaller. Several such devices could be conveniently mounted on a manipulator hand, for example, to align the hand with an object. Type 1 and Type 2 optical configurations are discussed, Type 1 having a sharply defined sensitive volume, Type 2 an extended one. The sensitive volume can be placed at any distance between 1 cm and approximately 1 m by choice of a replaceable prism. The Type 1 lateral resolution was 0.5 mm on one axis and 5 mm perpendicular to it for a unit focused at 7.5 cm. The corresponding resolution in the axial direction was 2.4 cm, but improvement to 0.5 cm is possible. The effect of surface reflectivity is discussed and possible modes of application are suggested.

  18. Semantics of directly manipulating spatializations.

    PubMed

    Hu, Xinran; Bradel, Lauren; Maiti, Dipayan; House, Leanna; North, Chris; Leman, Scotland

    2013-12-01

    When high-dimensional data is visualized in a 2D plane by using parametric projection algorithms, users may wish to manipulate the layout of the data points to better reflect their domain knowledge or to explore alternative structures. However, few users are well-versed in the algorithms behind the visualizations, making parameter tweaking more of a guessing game than a series of decisive interactions. Translating user interactions into algorithmic input is a key component of Visual to Parametric Interaction (V2PI) [13]. Instead of adjusting parameters, users directly move data points on the screen, which then updates the underlying statistical model. However, we have found that some data points that are not moved by the user are just as important in the interactions as the data points that are moved. Users frequently move some data points with respect to some other 'unmoved' data points that they consider as spatially contextual. However, in current V2PI interactions, these points are not explicitly identified when directly manipulating the moved points. We design a richer set of interactions that makes this context more explicit, and a new algorithm and sophisticated weighting scheme that incorporates the importance of these unmoved data points into V2PI. PMID:24051771

  19. Self mobile space manipulator project

    NASA Astrophysics Data System (ADS)

    Brown, H. Ben; Friedman, Mark; Xu, Yangsheng; Kanade, Takeo

    1992-01-01

    A relatively simple, modular, low mass, low cost robot is being developed for space EVA that is large enough to be independently mobile on a space station or platform exterior, yet versatile enough to accomplish many vital tasks. The robot comprises two long flexible links connected by a rotary joint, with 2-DOF 'wrist' joints and grippers at each end. It walks by gripping pre-positioned attachment points, such as trusswork nodes, and alternately shifting its base of support from one foot (gripper) to the other. The robot can perform useful tasks such as visual inspection, material transport, and light assembly by manipulating objects with one gripper, while stabilizing itself with the other. At SOAR '90, we reported development of 1/3 scale robot hardware, modular trusswork to serve as a locomotion substrate, and a gravity compensation system to allow laboratory tests of locomotion strategies on the horizontal face of the trusswork. In this paper, we report on project progress including the development of: (1) adaptive control for automatic adjustment to loads; (2) enhanced manipulation capabilities; (3) machine vision, including the use of neural nets, to guide autonomous locomotion; (4) locomotion between orthogonal trusswork faces; and (5) improved facilities for gravity compensation and telerobotic control.

  20. In Vitro Corrosion and Cytocompatibility of a Microarc Oxidation Coating and Poly(l-lactic acid) Composite Coating on Mg-1Li-1Ca Alloy for Orthopedic Implants.

    PubMed

    Zeng, Rong-Chang; Cui, Lan-Yue; Jiang, Ke; Liu, Rui; Zhao, Bao-Dong; Zheng, Yu-Feng

    2016-04-20

    Manipulating the degradation rate of biomedical magnesium alloys poses a challenge. The characteristics of a microarc oxidation (MAO), prepared in phytic acid, and poly(l-lactic acid) (PLLA) composite coating, fabricated on a novel Mg-1Li-1Ca alloy, were studied through field emission scanning electron microscopy (FE-SEM), electron probe X-ray microanalysis (EPMA), energy dispersive X-ray spectroscopy (EDS) and X-ray diffraction (XRD). The corrosion behaviors of the samples were evaluated via hydrogen evolution, potentiodynamic polarization and electrochemical impedance spectroscopy in Hanks' solution. The results indicated that the MAO/PLLA composite coatings significantly enhanced the corrosion resistance of the Mg-1Li-1Ca alloy. MTT and ALP assays using MC3T3 osteoblasts indicated that the MAO/PLLA coatings greatly improved the cytocompatibility, and the morphology of the cells cultured on different samples exhibited good adhesion. Hemolysis tests showed that the composite coatings endowed the Mg-1Li-1Ca alloys with a low hemolysis ratio. The increased solution pH resulting from the corrosion of magnesium could be tailored by the degradation of PLLA. The degradation mechanism of the composite coatings was discussed. The MAO/PLLA composite coating may be appropriate for applications on degradable Mg-based orthopedic implants. PMID:27022831

  1. Autonomous manipulation on a robot: Summary of manipulator software functions

    NASA Technical Reports Server (NTRS)

    Lewis, R. A.

    1974-01-01

    A six degree-of-freedom computer-controlled manipulator is examined, and the relationships between the arm's joint variables and 3-space are derived. Arm trajectories using sequences of third-degree polynomials to describe the time history of each joint variable are presented and two approaches to the avoidance of obstacles are given. The equations of motion for the arm are derived and then decomposed into time-dependent factors and time-independent coefficients. Several new and simplifying relationships among the coefficients are proven. Two sample trajectories are analyzed in detail for purposes of determining the most important contributions to total force in order that relatively simple approximations to the equations of motion can be used.

  2. Incretin manipulation in diabetes management

    PubMed Central

    Pappachan, Joseph M; Raveendran, AV; Sriraman, Rajagopalan

    2015-01-01

    Incretin-based therapies have revolutionized the medical management of type 2 diabetes mellitus (T2DM) in the 21st century. Glucagon-like peptide-1 (GLP-1) suppresses appetite and gastric motility, and has trophic effects on pancreas, cardio-protective and renal effects. GLP-1 analogues and dipeptidyl peptidase-4 inhibitors form the incretin-based therapies. Significant reduction of hemoglobin A1c when used as monotherapy and in combination regimens, favorable effects on body weight, and low risk of hypoglycemia are their unique therapeutic benefits. Their safety and tolerability are comparable to other anti-diabetic medications. Concern about elevated risk of pancreatitis has been discarded by two recent meta-analyses. This article discusses the therapeutic manipulation of incretin system for the management of T2DM. PMID:26131320

  3. Incretin manipulation in diabetes management.

    PubMed

    Pappachan, Joseph M; Raveendran, A V; Sriraman, Rajagopalan

    2015-06-25

    Incretin-based therapies have revolutionized the medical management of type 2 diabetes mellitus (T2DM) in the 21(st) century. Glucagon-like peptide-1 (GLP-1) suppresses appetite and gastric motility, and has trophic effects on pancreas, cardio-protective and renal effects. GLP-1 analogues and dipeptidyl peptidase-4 inhibitors form the incretin-based therapies. Significant reduction of hemoglobin A1c when used as monotherapy and in combination regimens, favorable effects on body weight, and low risk of hypoglycemia are their unique therapeutic benefits. Their safety and tolerability are comparable to other anti-diabetic medications. Concern about elevated risk of pancreatitis has been discarded by two recent meta-analyses. This article discusses the therapeutic manipulation of incretin system for the management of T2DM. PMID:26131320

  4. Genetic Manipulation of Stenotrophomonas maltophilia

    PubMed Central

    Welker, Elliott; Domfeh, Yayra; Tyagi, Deepti; Sinha, Sanjivni; Fisher, Nathan

    2015-01-01

    Stenotrophomonas maltophilia is a Gram-negative, aerobic, motile, environmental bacterium that is emerging as an important nosocomial pathogen (Brooke, 2012; Looney, Narita, & Mühlemann, 2009) with high rates of attributable mortality in severely ill patients (Falagas et al., 2009; Paez & Costa, 2008; Sattler, Mason, & Kaplan, 2000; Senol, DesJardin, Stark, Barefoot, & Snydman, 2002; Weber et al., 2007). S. maltophilia is of particular concern to patients suffering from cystic fibrosis (CF) as it has been shown to colonize airway epithelial and establish a chronic infection (Goncalves-Vidigal et al., 2011). Here we describe several molecular techniques for the genetic manipulation of this bacterium, including DNA extraction, RNA extraction, conjugation of plasmids from E. coli and allelic exchange. PMID:26344220

  5. Genetic manipulation of Porphyromonas gingivalis.

    PubMed

    Bélanger, Myriam; Rodrigues, Paulo; Progulske-Fox, Ann

    2007-06-01

    Porphyromonas gingivalis, an oral anaerobic bacterium, is an important etiological agent of periodontal disease and may contribute to cardiovascular disease, preterm birth, and diabetes as well. Therefore, genetic studies are of crucial importance in investigating molecular mechanisms of P. gingivalis virulence. Although molecular genetic tools have been available for many bacterial species for some time, genetic manipulations of Porphyromonas species were not developed until more recently and remain limited. In this unit, current molecular genetic approaches for mutant construction in P. gingivalis using the suicide vector pPR-UF1 and the transposon Tn4351 are described, as are protocols for performing electroporation and conjugation. Furthermore, a technique to restore the wild-type phenotype of the mutant by complementation using vector pT-COW is provided. Finally, a description of a noninvasive reporter system allowing the study of gene expression and regulation in P. gingivalis completes this unit. PMID:18770611

  6. Manipulating crystallization with molecular additives.

    PubMed

    Shtukenberg, Alexander G; Lee, Stephanie S; Kahr, Bart; Ward, Michael D

    2014-01-01

    Given the importance of organic crystals in a wide range of industrial applications, the chemistry, biology, materials science, and chemical engineering communities have focused considerable attention on developing methods to control crystal structure, size, shape, and orientation. Tailored additives have been used to control crystallization to great effect, presumably by selectively binding to particular crystallographic surfaces and sites. However, substantial knowledge gaps still exist in the fundamental mechanisms that govern the formation and growth of organic crystals in both the absence and presence of additives. In this review, we highlight research discoveries that reveal the role of additives, either introduced by design or present adventitiously, on various stages of formation and growth of organic crystals, including nucleation, dislocation spiral growth mechanisms, growth inhibition, and nonclassical crystal morphologies. The insights from these investigations and others of their kind are likely to guide the development of innovative methods to manipulate crystallization for a wide range of materials and applications. PMID:24579880

  7. Controlling multiple manipulators using RIPS

    NASA Technical Reports Server (NTRS)

    Wang, Yulun; Jordan, Steve; Mangaser, Amante; Butner, Steve

    1989-01-01

    A prototype of the RIPS architecture (Robotic Instruction Processing System) was developed. A two arm robot control experiment is underway to characterize the architecture as well as research multi-arm control. This experiment uses two manipulators to cooperatively position an object. The location of the object is specified by the host computer's mouse. Consequently, real time kinematics and dynamics are necessary. The RIPS architecture is specialized so that it can satisfy these real time constraints. The two arm experimental set-up is discussed. A major part of this work is the continued development of a good programming environment for RIPS. The C++ language is employed and favorable results exist in the targeting of this language to the RIPS hardware.

  8. Research on a reconfigurable modular manipulator system

    NASA Astrophysics Data System (ADS)

    Khosla, P. K.; Kanade, T.

    Research has been conducted on developing the theoretical basis and the technology for a Reconfigurable Modular Manipulation System (RMMS). Unlike a conventional manipulator which has a fixed configuration, the RMMS consists of a set of interchangeable modules that can be rapidly assembled into a system of manipulators with appropriate configurations depending on the specific task requirement. For effective development and use of such a versatile and flexible system a program of theoretical and experimental research has been pursued aimed at developing the basis for next generation of autonomous manipulator systems. The RMMS concept extends the idea of autonomy from sensor-based to configuration based autonomy. One of the important components is the development of design methodologies for mapping tasks into manipulator configurations and for automatic generation of manipulator specific algorithms (e.g., kinematics and dynamics) in order to make the hardware transparent to the user.

  9. Research on a Reconfigurable Modular Manipulator System

    SciTech Connect

    Khosla, P.K.; Kanade, T.

    1992-01-01

    Research has been conducted on developing the theoretical basis and the technology for a Reconfigurable Modular Manipulation System (RMMS). Unlike a conventional manipulator which has a fixed configuration, the RMMS consists of a set of interchangeable modules that can be rapidly assembled into a system of manipulators with appropriate configurations depending on the specific task requirement. For effective development and use of such a versatile and flexible system a program of theoretical and experimental research has been pursued aimed at developing the basis for next generation of autonomous manipulator systems. The RMMS concept extends the idea of autonomy from sensor-based to configuration based autonomy. One of the important components is the development of design methodologies for mapping tasks into manipulator configurations and for automatic generation of manipulator specific algorithms (e.g., kinematics and dynamics) in order to make the hardware transparent to the user.(JDB)

  10. Bracing micro/macro manipulators control

    SciTech Connect

    Lew, J.Y.; Book, W.J.

    1994-05-01

    This paper proposes a bracing strategy for micro/macro manipulators. The bracing micro/macro manipulator can provide advantages in accurate positioning, large work-space, and contact-task capability however, in exchange for improvement in performance one must accept the complex control problem along wit the complex dynamics. This research develops a control scheme for a bracing manipulator which makes multiple contacts with the environment. Experimental results show the feasibility of the proposed ideas for real world applications.

  11. Seismic qualification of existing safety class manipulators

    SciTech Connect

    Wu, Ting-shu; Moran, T.J.

    1992-05-01

    There are two bridge type electromechanical manipulators within a nuclear fuel handling facility which were constructed over twenty-five years ago. At that time, there were only minimal seismic considerations. These manipulators together with the facility are being reactivated. Detailed analyses have shown that the manipulators will satisfy the requirements of ANSI/AISC N690-1984 when they are subjected to loadings including the site specific design basis earthquake. 4 refs.

  12. Seismic qualification of existing safety class manipulators

    SciTech Connect

    Wu, Ting-shu; Moran, T.J.

    1992-01-01

    There are two bridge type electromechanical manipulators within a nuclear fuel handling facility which were constructed over twenty-five years ago. At that time, there were only minimal seismic considerations. These manipulators together with the facility are being reactivated. Detailed analyses have shown that the manipulators will satisfy the requirements of ANSI/AISC N690-1984 when they are subjected to loadings including the site specific design basis earthquake. 4 refs.

  13. Algorithmic formulation of control problems in manipulation

    NASA Technical Reports Server (NTRS)

    Bejczy, A. K.

    1975-01-01

    The basic characteristics of manipulator control algorithms are discussed. The state of the art in the development of manipulator control algorithms is briefly reviewed. Different end-point control techniques are described together with control algorithms which operate on external sensor (imaging, proximity, tactile, and torque/force) signals in realtime. Manipulator control development at JPL is briefly described and illustrated with several figures. The JPL work pays special attention to the front or operator input end of the control algorithms.

  14. Spatial-Operator Algebra For Robotic Manipulators

    NASA Technical Reports Server (NTRS)

    Rodriguez, Guillermo; Kreutz, Kenneth K.; Milman, Mark H.

    1991-01-01

    Report discusses spatial-operator algebra developed in recent studies of mathematical modeling, control, and design of trajectories of robotic manipulators. Provides succinct representation of mathematically complicated interactions among multiple joints and links of manipulator, thereby relieving analyst of most of tedium of detailed algebraic manipulations. Presents analytical formulation of spatial-operator algebra, describes some specific applications, summarizes current research, and discusses implementation of spatial-operator algebra in the Ada programming language.

  15. Validation of the four-dimensional symptom questionnaire (4DSQ) and prevalence of psychological symptoms in orthopedic shoulder patients.

    PubMed

    Koorevaar, Rinco C T; Terluin, Berend; van 't Riet, Esther; Madden, Kim; Bulstra, Sjoerd K

    2016-04-01

    Psychological problems are common in shoulder patients. A validated psychological questionnaire measuring clinically relevant psychological symptoms (including distress, depression, anxiety, and somatization) in shoulder patients is lacking. The Four-Dimensional Symptom Questionnaire (4DSQ) is a self-report questionnaire to identify distress, depression, anxiety, and somatization which has been validated in primary care populations. The aim of this study was to validate the 4DSQ in orthopedic shoulder patients. We assessed whether the 4DSQ measures these four constructs the same way in an orthopedic population with shoulder problems compared to a general practice population. We also investigated the prevalence of psychological symptoms in shoulder patients. The shoulder group consisted of 200 consecutive patients and the general practice group comprised 368 patients, matched for gender and age. Differential item functioning analysis showed that the 4DSQ measures the different psychological symptoms in orthopedic shoulder patients the same way as in general practice patients. The shoulder patients tended to score higher on the somatization scale, resulting in a new cut-off point for somatization. The prevalence of distress, somatization, anxiety, and depression in the shoulder group was 23%, 14%, 10%, and 8%, respectively. It can be concluded from this study that the 4DSQ in orthopedic shoulder patients measures the same constructs as in general practice patients and can therefore be used in orthopedic practice to measure psychological symptoms in patients with shoulder complaints. PMID:26379216

  16. Factors Contributing to Satisfaction with Changes in Physical Function after Orthopedic Surgery for Musculoskeletal Dysfunction in Patients with Cerebral Palsy

    PubMed Central

    Kusumoto, Yasuaki; Nitta, Osamu; Matsuo, Atsushi; Takaki, Kenji; Matsuda, Tadamitsu

    2016-01-01

    Background The recognition of required treatments for cerebral palsy (CP) patients, including orthopedic surgery, differs according to region. This study was performed to identify factors associated with satisfactory changes in physical function after orthopedic surgery. Methods 358 patients were selected for the questionnaire survey. The following information was collected: gender, primary disease, age of initial surgery, total procedural count, operated sites, satisfaction of postoperative rehabilitation frequency, ideal amount of postoperative rehabilitation sessions per week, frequency of voluntary home training per week, satisfaction of the timing of surgery and the current satisfaction with the changes in physical function after the orthopedic surgery. We classified the patients into the satisfied and dissatisfied group according to satisfactory changes in physical function after the surgery. We performed unpaired t-tests and chi-square tests to determine the variables that differed significantly between the groups. Variables with a p value of <0.2 were included in the multivariate logistic regression analysis. Results The logistic model was revised and summed up to two potential predictors of postsurgical satisfaction with physical function: satisfaction with the frequency of postoperative rehabilitation sessions and the orthopedic surgery of the hip (distinction hit ratio, 75.4%). Conclusions This study demonstrated that the frequency of postoperative rehabilitation and history of hip surgery seemed to be related to the satisfaction with the changes in physical function after orthopedic surgery. PMID:27135609

  17. Locus of pain control associated with medication adherence behaviors among patients after an orthopedic procedure

    PubMed Central

    Porto, Thaisy Mendes; Machado, Daniele Caferatti; Martins, Rafael Olívio; Galato, Dayani; Piovezan, Anna Paula

    2014-01-01

    Background Locus of pain control (LPC) is characterized by the behavior of people coping with their health problems, as a result of their own actions (internal control) or external factors or other people (external control). This parameter can be associated with medication adherence, in addition to other psychosocial factors that may also influence this behavior. This study was performed to investigate the influence of the LPC on medication adherence in patients undergoing an orthopedic procedure. Subjects and methods We conducted a prospective cohort study on patients who attended an orthopedic clinic for arthroscopy treatment. The patients’ LPC and pain intensity data were obtained on the day of admission through the use of the LPC scale and the visual analog scale (VAS), respectively, both being validated tools. After arthroscopic surgery, the patients received drug prescriptions and were reassessed after 15 days regarding treatment adherence, using the Morisky test. A P-value <0.05 was considered statistically significant. Results We assessed 79 individuals from both the internal LPC group (n=35) and external LPC group (n=44) and found that there were no group differences in sex, affected limb, cause of injury, repetitive strain injury, duration of pain, or pain intensity. However, there was a higher proportion of patients in the external LPC group that adhered to the prescribed medication compared with the internal LPC group (P<0.01). Conclusion The results showed that among patients who underwent an orthopedic procedure, there was a higher adherence rate to prescribed medication in the external LPC group compared with the internal LPC group. PMID:25075178

  18. Active Ankle Movements Prevent Formation of Lower-Extremity Deep Venous Thrombosis After Orthopedic Surgery.

    PubMed

    Li, Ye; Guan, Xiang-Hong; Wang, Rui; Li, Bin; Ning, Bo; Su, Wei; Sun, Tao; Li, Hong-Yan

    2016-01-01

    BACKGROUND The aim of this study was to assess the preventive value of active ankle movements in the formation of lower-extremity deep venous thrombosis (DVT), attempting to develop a new method for rehabilitation nursing after orthopedic surgery. MATERIAL AND METHODS We randomly assigned 193 patients undergoing orthopedic surgery in the lower limbs into a case group (n=96) and a control group (n=97). The control group received routine nursing while the case group performed active ankle movements in addition to receiving routine nursing. Maximum venous outflow (MVO), maximum venous capacity (MVC), and blood rheology were measured and the incidence of DVT was recorded. RESULTS On the 11th and 14th days of the experiment, the case group had significantly higher MVO and MVC than the control group (all P<0.05). The whole-blood viscosity at high shear rate and the plasma viscosity were significantly lower in the case group than in the control group on the 14th day (both P<0.05). During the experiment, a significantly higher overall DVT incidence was recorded in the control group (8 with asymptomatic DVT) compared with the case group (1 with asymptomatic DVT) (P=0.034). During follow-up, the case group presented a significantly lower DVT incidence (1 with symptomatic DVT and 4 with asymptomatic DVT) than in the control group (5 with symptomatic DVT and 10 with asymptomatic DVT) (P=0.031). CONCLUSIONS Through increasing MVO and MVC and reducing blood rheology, active ankle movements may prevent the formation of lower-extremity DVT after orthopedic surgery. PMID:27600467

  19. Centers of excellence: an assessment tool for cardiovascular and orthopedic programs.

    PubMed

    Ronning, P L; Meyer, J W

    1996-10-01

    As payers place more weight on contracting with hospital/health system programs that can differentiate themselves in the market as a "true" center of excellence (COE), it becomes imperative that hospitals/health systems understand the payer perspective about those programmatic attributes that can truly differentiate them from other programs. This report describes an evaluation and rating methodology for hospital/health system subspecialty programs, particularly cardiovascular and orthopedic programs, that can be used as a self-assessment tool. Using as its core a Rating Scale and Ranking Taxonomy, the evaluation and rating methodology presented here allow cardiovascular and orthopedic programs to do the following: Understand the differentiating characteristic of COE. Rate itself against detailed criteria that are being used by payers. Compare aspects of its program to premier or benchmark programs. Interpret the results to assist with strategic and operational direction. Allocate scarce resources to implement a subspecialty program that will attract payers. The Rating Scale and Ranking Taxonomy has 20 criteria for assessing cardiovascular programs and 18 criteria for orthopedic programs. The assessment process is designed to produce two important results: dialogue and action. The underpinnings of any action is a solid business plan that clarifies the program's vision, values, and mission. They are important because most programs will ultimately pursue very similar strategies and tactics; however, the most successful subspecialty programs and practices will be the ones that can execute the strategies and tactics quickly and effectively. In addition, the changes that are engendered by this targeted yet comprehensive assessment process can lead to improved clinical and functional outcomes for patients, as well as systemic improvements in the delivery of care. PMID:10162427

  20. The Use of Finite Element Analysis to Enhance Research and Clinical Practice in Orthopedics.

    PubMed

    Pfeiffer, Ferris M

    2016-02-01

    Finite element analysis (FEA) is a very powerful tool for the evaluation of biomechanics in orthopedics. Finite element (FE) simulations can effectively and efficiently evaluate thousands of variables (such as implant variation, surgical techniques, and various pathologies) to optimize design, screening, prediction, and treatment in orthopedics. Additionally, FEA can be used to retrospectively evaluate and troubleshoot complications or failures to prevent similar future occurrences. Finally, FE simulations are used to evaluate implants, procedures, and techniques in a time- and cost-effective manner. In this work, an overview of the development of FE models is provided and an example application is presented to simulate knee biomechanics for a specimen with medial meniscus insufficiency. FE models require the development of the geometry of interest, determination of the material properties of the tissues simulated, and an accurate application of a numerical solver to produce an accurate solution and representation of the field variables. The objectives of this work are to introduce the reader to the application of FEA in orthopedic analysis of the knee joint. A brief description of the model development process as well as a specific application to the investigation of knee joint stability in geometries with normal or compromised medial meniscal attachment is included. Significant increases in stretch of the anterior cruciate ligament were predicted in specimens with medial meniscus insufficiency (such behavior was confirmed in corresponding biomechanical testing). It can be concluded from this work that FE analysis of the knee can provide significant new information with which more effective clinical decisions can be made. PMID:26745731

  1. Low-power circuits for the bidirectional wireless monitoring system of the orthopedic implants.

    PubMed

    Hong Chen; Ming Liu; Wenhan Hao; Yi Chen; Chen Jia; Chun Zhang; Zihua Wang

    2009-12-01

    This paper proposes an architecture of the wireless monitoring system for the real-time monitoring of the orthopedic implants, which monitors the implant duty cycle, detects abnormal asymmetry, high amounts of force, and other conditions of the orthopedic implants. Data for diagnosis are communicated wirelessly by the radio-frequency (RF) signal between the embedded chip and the remote circuit. In different working modes, the system can be powered by the RF signal or stiff lead zirconate-titanate (PZT) ceramics which are able to convert mechanical energy inside the orthopedic implant into electrical energy. The power circuits with a variable ratio switched-capacitor (SC) dc-dc converter have been taped out with 0.35-mum complementary metal-oxide semiconductor (CMOS) technology. The test results show that the SC converter can transfer the input voltage that ranges from 5 V to 14 V from the PZT ceramics into the voltage ranging from 2 V to 2.5 V which will be dealt with by a low drop-out circuit in the future work. The total efficiency of the SC converter is from 28% to 42% at full-time working mode. The analog-to-digital converter (ADC) circuits have been fabricated in a 0.18-mum 1P6M CMOS process. The test results show that the ADC chip consumes only 12.5 muW in working mode and 150 nW in the sleep mode. The circuits, including RF circuits, ADC, and the microcontrol unit, have been implemented in a 0.18-mu m CMOS process. Future work includes some clinical experiments test in the application where PZT elements are used for power generation in total knee-replacement implants. PMID:23853291

  2. Functionally graded materials for orthopedic applications - an update on design and manufacturing.

    PubMed

    Sola, Antonella; Bellucci, Devis; Cannillo, Valeria

    2016-01-01

    Functionally graded materials (FGMs) are innovative materials whose composition and/or microstructure gradually vary in space according to a designed law. As a result, also the properties gradually vary in space, so as to meet specific non-homogeneous service requirements without any abrupt interface at the macroscale. FGMs are emerging materials for orthopedic prostheses, since the functional gradient can be adapted to reproduce the local properties of the original bone, which helps to minimize the stress shielding effect and, at the same time, to reduce the shear stress between the implant and the surrounding bone tissue, two critical prerequisites for a longer lifespan of the graft. After a brief introduction to the origin of the FGM concept, the review surveys some representative examples of graded systems which are present in nature and, in particular, in the human body, with a focus on bone tissue. Then the rationale for using FGMs in orthopedic devices is discussed more in detail, taking into account both biological and biomechanical requirements. The core of the paper is dedicated to two fundamental topics, which are essential to benefit from the use of FGMs for orthopedic applications, namely (1) the computational tools for materials design and geometry optimization, and (2) the manufacturing techniques currently available to produce FGM-based grafts. This second part, in its turn, is structured to consider the production of functionally graded coatings (FGCs), of functionally graded 3D parts, and of special devices with a gradient in porosity (functionally graded scaffolds). The inspection of the literature on the argument clearly shows that the integration of design and manufacturing remains a critical step to overpass in order to achieve effective FGM-based implants. PMID:26757264

  3. Orthodontic and dentofacial orthopedic management of juvenile idiopathic arthritis: a systematic review of the literature.

    PubMed

    von Bremen, J; Ruf, S

    2011-08-01

    To systematically review the literature published on orthodontic treatment principles in patients with juvenile idiopathic arthritis (JIA). Several electronic databases (PubMed, Medpilot, Web of Science, and DIMDI) and orthodontic and rheumatologic literature were systematically searched for studies published until May 2010. The articles were rated by two independent reviewers and included after three selection steps (title-abstract-full text). Articles had to be studies performed on ≥ 5 patients with a disease onset before the age of 16. The selection process resulted in the inclusion of three publications on dentofacial orthopedics and six on combined surgical orthodontic therapy. The three studies on dentofacial orthopedics aimed to improve the mandibular retrusion by means of removable functional appliances (activator). Whereas these orthodontic approaches comprised relatively large and homogeneous patient samples (14, 22, and 72 subjects, aged 6-16), the surgical studies were basically case series with a large age span of the patients (5-12 subjects, aged 10-44). In these surgical treatment approaches, orthodontics was limited to pre-surgical leveling and post-surgical finishing, while the skeletal discrepancy was treated surgically by a variety of techniques (costochondral grafts, bilateral sagittal spilt osteotomy, Le Fort I, and genioplasty). The treatment goals of both approaches were improvement of esthetics and function and/or pain reduction, and both approaches showed satisfactory results. Because of the heterogeneity of the subject material and the low level of evidence of the papers, it is difficult to draw any conclusions on the orthodontic/dentofacial orthopedic management of JIA. It appears as if removable functional appliances may be beneficial in adolescent patients with JIA. PMID:21771266

  4. Research on reconfigurable and reliable manipulators

    SciTech Connect

    Khosla, P.K.; Kanade, T.

    1993-01-01

    We have proposed the concept of reconfigurable manipulators as a solution to tasks that require varied configurations of manipulators. Using modules of varying sizes and performance specifications, it is possible to build manipulators to suit the task at hand. Our research is not only addressing the issue of creating such manipulators but also the interesting theoretical challenges posed in mapping tasks to manipulators. We have developed strategies that allow us to determine the kinematic and dynamic configuration of a non-redundant manipulator from task specifications such as reachability, obstacle avoidance, manipulability, joint, limits, and joint velocities and accelerations. We are presently extending this design methodology for design of redundant and fault tolerant manipulator systems. Further, we are also addressing issues in automatic generation of software for kinematics, dynamics, and controllers for the configured manipulators. During the next year, we will be demonstrating automatic generation of software on the prototype system that we are building. We expect to have 4 joint and link modules available for this demonstration. The joint and link modules will also incorporate concepts for making power and data connections when the mechanical connection is made. Further, they will also include electronics, housed within the module, for communication and real-time control.

  5. Research on reconfigurable and reliable manipulators

    NASA Astrophysics Data System (ADS)

    Khosla, P. K.; Kanade, T.

    We have proposed the concept of reconfigurable manipulators as a solution to tasks that require varied configurations of manipulators. Using modules of varying sizes and performance specifications, it is possible to build manipulators to suit the task at hand. Our research is not only addressing the issue of creating such manipulators but also the interesting theoretical challenges posed in mapping tasks to manipulators. We have developed strategies that allow us to determine the kinematic and dynamic configuration of a non-redundant manipulator from task specifications such as reachability, obstacle avoidance, manipulability, joint, limits, and joint velocities and accelerations. We are presently extending this design methodology for design of redundant and fault tolerant manipulator systems. Further, we are also addressing issues in automatic generation of software for kinematics, dynamics, and controllers for the configured manipulators. During the next year, we will be demonstrating automatic generation of software on the prototype system that we are building. We expect to have 4 joint and link modules available for this demonstration. The joint and link modules will also incorporate concepts for making power and data connections when the mechanical connection is made. Further, they will also include electronics, housed within the module, for communication and real-time control.

  6. Culture and Manipulation of Embryonic Cells

    PubMed Central

    Edgar, Lois G.; Goldstein, Bob

    2012-01-01

    The direct manipulation of embryonic cells is an important tool for addressing key questions in cell and developmental biology. C. elegans is relatively unique among genetic model systems in being amenable to manipulation of embryonic cells. Embryonic cell manipulation has allowed the identification of cell interactions by direct means, and it has been an important technique for dissecting mechanisms by which cell fates are specified, cell divisions are oriented, and morphogenesis is accomplished. Here, we present detailed methods for isolating, manipulating and culturing embryonic cells of C. elegans. PMID:22226523

  7. Social Manipulation of Online Recommender Systems

    NASA Astrophysics Data System (ADS)

    Lang, Juan; Spear, Matt; Wu, S. Felix

    Online recommender systems are a common target of attack. Existing research has focused on automated manipulation of recommender systems through the creation of shill accounts, and either do not consider attacks by coalitions of real users, downplay the impact of such attacks, or state that such attacks are difficult to impossible to detect. In this study, we examine a recommender system that is part of an online social network, show that users successfully induced other users to manipulate their recommendations, that these manipulations were effective, and that most such manipulations are detectable even when performed by ordinary, non-automated users.

  8. Non-Osteotomy and Osteotomy Large Animal Fracture Models in Orthopedic Trauma Research

    PubMed Central

    Decker, Sebastian; Reifenrath, Janin; Omar, Mohamed; Krettek, Christian; Müller, Christian W.

    2014-01-01

    Large animal fracture models are important in the field of orthopedic trauma research. New implants are tested in animals before being implanted into humans. Large animals like sheep or swine often are more properly to simulate conditions in humans, e.g. biomechanical demands, compared to rodents. Cited articles mainly analyze shock or fracture healing. Both osteotomy and non-osteotomy fracture models have been used in the past. However, comparative studies are rare and clear recommendation when to use which model are missing. This review will summarize large animal fracture models putting special emphasis on non-osteotomy fracture models. PMID:25568730

  9. Orthopedic and orthodontic treatment in central giant cell granuloma treated with calcitonin.

    PubMed

    Romero, Martín; Romance, Ana; Garcia-Recuero, José Ismael; Fernández, Álvaro

    2011-09-01

    Central giant cell granuloma of the jaw is a benign lesion of unknown etiology that occurs with very low frequency. It mainly occurs in children and young adults and is more common in the mandible. The most common treatment is surgical removal; however, alternative therapies (intralesional injections of corticosteroids, interferon alpha, and calcitonin) have been used in order to avoid undesirable damage to the jaws and teeth. The lesion may cause root resorption, tooth germ displacement, and other dental problems, as well as malocclusion that must be treated orthodontically. The orthodontic, orthopedic, and calcitonin-based treatments of one of these cases is presented. PMID:20815718

  10. iPhone and iPad Use in Orthopedic Surgery

    PubMed Central

    Duncan, Scott F. M.; Hendawi, Tariq K.; Sperling, John; Kakinoki, Ryosuke; Hartsock, Landon

    2015-01-01

    Background Thousands of healthcare mobile applications (apps) are available, and physicians are increasingly recognizing that mobile technology can improve their workflow and allow them to practice medicine in a better and/or more efficient manner. Methods This article highlights apps compatible with the iPhone and iPad and their utility to the busy orthopedic surgeon. Results Currently available apps address every aspect of healthcare: patient management, reference, education, and research. Conclusion Key aspects of helpful apps include low cost (preferably free), a user-friendly interface, and simplicity. PMID:25829881

  11. Klebsiella pneumoniae carrying blaNDM-1 gene in orthopedic practice

    PubMed Central

    Gupta, Varsha; Bansal, Neha; Gupta, Ravi; Chander, Jagdish

    2014-01-01

    Emergence and spread of carbapenemases in Enterobacteriaceae is a cause of concern worldwide, the latest threat being New Delhi metallo-β-lactamase (NDM-1). This report is of an orthopedic case with fracture femur managed with internal fixation and bone grafting, who subsequently developed secondary infection with Klebsiella pneumoniae harboring blaNDM-1 gene. Minimum inhibitory concentration (MIC) of imipenem was ≥8 μg/ml by E-test, suggestive of carbapenemase production. Phenotypic and further genotypic detection confirmed the presence of blaNDM-1 gene. The isolate remained susceptible only to tigecycline, colistin, and polymyxin B. PMID:25298566

  12. Removal of a Penile Constriction Device with a Large Orthopedic Pin Cutter

    PubMed Central

    Wenzler, David; Fischer, Melissa

    2014-01-01

    Penile strangulation is an infrequent clinical condition that has widely been reported. It usually results following placement of a constriction device to enhance sexual stimulation. Early treatment is essential to avoid potential complications, including ischemic necrosis and autoamputation. We describe the use of a Large Orthopedic Pin Cutter to remove a metal penile constriction device in the Emergency Department (ED). This case report describes the relatively safe technique of using an instrument available in many hospitals that can be added to the physician's arsenal in the removal of metal constriction devices. PMID:24707434

  13. Osteoanabolic Implants: Osteoanabolic Implant Materials for Orthopedic Treatment (Adv. Healthcare Mater. 14/2016).

    PubMed

    Ding, Yun-Fei; Li, Rachel W; Nakai, Masaaki; Majumdar, Trina; Zhang, Dong-Hai; Niinomi, Mitsuo; Birbilis, Nick; Smith, Paul N; Chen, Xiao-Bo

    2016-07-01

    On page 1740, Xiao-Bo Chen and co-workers report an orthopedic implant material specifically designed for osteoporotic bone fractures. A newl strontium phosphate coating applied to a bone-mimicking low elastic titanium alloy with a comparative Young's modulus to that of natural bone results in upregulating the growth of osteoblasts and downregulating that of osteoclasts. Such a promising osteoanabolic effect reveals a suitability in particular for patients who suffer from low quality bone organism and slow fracture recovery. PMID:27436105

  14. Differences in the Clinical Outcome of Osteomyelitis by Treating Specialty: Orthopedics or Infectology

    PubMed Central

    Cardona Arango, Doris; Capataz Taffur, Cesar Antonio; Correa Prada, Edgar

    2015-01-01

    Osteomyelitis is a heterogeneous infection with regard to etiology and treatment, and currently no single management protocol exists. Management of the condition is typically an interdisciplinary approach between orthopedics and infectious disease; however, the orthopedist is often the person who manages treatment. The aim of the study was to determine differences in the outcome of osteomyelitis according to its treating specialty and to identify factors associated with the recurrence of the disease. An ambispective cohort study of 129 patients with osteomyelitis was conducted and the proportions for qualitative variables and central tendency and dispersion measures for quantitative variables were calculated; the latter were tested for normality using the Shapiro-Wilk test. A bivariate analysis was conducted with measures of association based on the chi square test and crude relative risk. A logistic regression model was applied and statistical significance was set at p < 0.05, including the model of relevant clinical variables that fit the Hosmer-Lemeshow test. We found that 70% of patients were treated either by orthopedics or infectious disease. Patients who were treated by an orthopedist alone presented a greater risk of relapse or reinfection (RR = 4.6; 95% CI 2.3;8.9). Risk factors of osteomyelitis recurrence as determined in the regression model included the following: age of 57 years or older (RR = 1.3; 95% 0.3;5.2), long bones (RR = 1.9; 95% CI 0.5;7.1), fracture (RR = 5.0; 95% CI 0.4;51.4), monotherapy (RR = 3.0; 95% CI 0.6;14.5), receiving less than 4 weeks of antibiotics (RR = 1.5; 95% CI 0.2;10.1), inadequate treatment (RR = 3.1; 95% CI 0.4;20.1), and receiving orthopedics treatment (RR = 5.5; 95% CI 1.6;18.2). Most patients evaluated jointly by orthopedics and infectious disease received adequate treatment for osteomyelitis and had fewer relapses. PMID:26678551

  15. Sudden Sensorineural Hearing Loss after Orthopedic Surgery under Combined Spinal and Epidural Anesthesia

    PubMed Central

    Vilhena, Ditza; Pereira, Luís; Duarte, Delfim; Oliveira, Nuno

    2016-01-01

    Postoperative hearing loss following nonotologic surgery is rare. For patients undergoing subarachnoid anesthesia, the loss of cerebral spinal fluid and hence the drop in intracranial pressure can result in hearing loss and cranial nerve palsy. We report a case in which a patient sustained orthopedic surgery under combined spinal and epidural anesthesia complicated by severe and persistent sensorineural hearing loss. This report is a reminder that postoperative sudden sensorineural hearing loss is a poorly understood complication. A high index of suspicion is required for early diagnosis of this complication, although prompt treatment does not guarantee a good outcome. PMID:26904339

  16. Giant benign nodular hidradenoma of the shoulder: A rare tumor in orthopedic practice

    PubMed Central

    Singhal, Vibhore; Sharma, Sansar C.; Anil, Juyal; Sachan, P. K.; Harsh, Meena; Singhal, Surina; Raghuvanshi, Shailendra

    2010-01-01

    A clear cell hidradenoma is a rare dermal tumor, which is believed to originate from the apical portion of the sweat glands. The usual size reported is 5–30 mm. It is generally found in the head, face, and upper extremity regions. This lesion has not been reported to be large enough to impinge a joint range of motion. Hence, its description in the orthopedic literature is extremely rare. We present a giant benign nodular hidradenoma presenting as painful restriction of the right shoulder joint in a 35-year-old male. PMID:21655004

  17. Adaptation of NASA technology for the optimization of orthopedic knee implants

    NASA Technical Reports Server (NTRS)

    Saravanos, D. A.; Mraz, P. J.; Hopkins, D. A.

    1991-01-01

    The NASA technology originally developed for the optimization of composite structures (engine blades) is adapted and applied to the optimization of orthopedic knee implants. A method is developed enabling the tailoring of the implant for optimal interaction with the environment of the tibia. The shape of the implant components are optimized, such that the stresses in the bone are favorably controlled to minimize bone degradation and prevent failures. A pilot tailoring system is developed and the feasibility of the concept is elevated. The optimization system is expected to provide the means for improving knee prosthesis and individual implant tailoring for each patient.

  18. Perioperative substance use disorder, opioid diversion, and opioid misuse by a medical professional undergoing orthopedic surgery.

    PubMed

    Maher, Dermot P; Kissen, Michael; Danovitch, Itai; Yumul, Roya; Louy, Charles

    2014-01-01

    Patients with substance use disorders can present challenges for effective perioperative pain management. Healthcare professionals with substance abuse disorders requiring medical treatment and pain management represent a unique subpopulation. The authors present a case of a nurse undergoing an orthopedic surgical procedure who was found with two large, organized tackle boxes of opioid medication in her hospital room. Although the incidence of substance use disorders in healthcare professionals is thought to be equivalent to the general population, the presentation, substances of choice, and inciting factors are unique. Further, treatment options available to such individuals have been established and proven successful. PMID:25531961

  19. Sudden Sensorineural Hearing Loss after Orthopedic Surgery under Combined Spinal and Epidural Anesthesia.

    PubMed

    Vilhena, Ditza; Pereira, Luís; Duarte, Delfim; Oliveira, Nuno

    2016-01-01

    Postoperative hearing loss following nonotologic surgery is rare. For patients undergoing subarachnoid anesthesia, the loss of cerebral spinal fluid and hence the drop in intracranial pressure can result in hearing loss and cranial nerve palsy. We report a case in which a patient sustained orthopedic surgery under combined spinal and epidural anesthesia complicated by severe and persistent sensorineural hearing loss. This report is a reminder that postoperative sudden sensorineural hearing loss is a poorly understood complication. A high index of suspicion is required for early diagnosis of this complication, although prompt treatment does not guarantee a good outcome. PMID:26904339

  20. Kinematics and Control of Robot Manipulators

    NASA Astrophysics Data System (ADS)

    Paden, Bradley Evan

    This dissertation focuses on the kinematics and control of robot manipulators. The contribution to kinematics is a fundamental theorem on the design of manipulators with six revolute joints. The theorem states, roughly speaking, that manipulators which have six revolute joints and are modeled after the human arm are optimal and essentially unique. In developing the mathematical framework to prove this theorem, we define precisely the notions of length of a manipulator, well-connected-workspace, and work-volume. We contribute to control a set of analysis techniques for the design of variable structure (sliding mode) controllers for manipulators. The organization of the dissertation is the following. After introductory remarks in chapter one, the group of proper rigid motions, G, is introduced in chapter two. The tangent bundle of G is introduced and it is shown that the velocity of a rigid body can be represented by an element in the Lie algebra of G (commonly called a twist). Further, rigid motions which are exponentials of twists are used to describe four commonly occurring subproblems in robot kinematics. In chapter three, the exponentials of twists are used to write the forward kinematic map of robot manipulators and the subproblems of chapter two are used to solve the Stanford manipulator and an elbow manipulator. Chapter four focuses on manipulator singularities. Twist coordinates are used to find critical points of the forward kinematic map. The contribution to kinematics is contained in chapter five where a mathematical framework for studying the relationship between the design of 6R manipulators and their performance is developed. Chapter seven contains the contribution to control. The work of A. F. Filippov on differential equations with discontinuous right-hand-side and the work of F. H. Clarke on generalized gradients are combined to obtain a calculus for analyzing nonsmooth gradient systems. The techniques developed are applied to design a simple

  1. Educational impact of a clinical anatomy workshop on 1st-year orthopedic and rheumatology fellows in Mexico City.

    PubMed

    Saavedra, M A; Villaseñor-Ovies, P; Harfush, L A; Navarro-Zarza, J E; Canoso, J J; Cruz-Domínguez, P; Vargas, A; Hernández-Díaz, C; Chiapas-Gasca, K; Camacho-Galindo, J; Alvarez-Nemegyei, J; Kalish, R A

    2016-05-01

    We aim to study the educational impact of a clinical anatomy workshop in 1st-year orthopedic and rheumatology fellows. First-year rheumatology fellows (N = 17) and a convenience sample of 1st-year orthopedic fellows (N = 14) from Mexico City in the 9th month of training participated in the study. The pre- and the post- workshop tests included the same 20 questions that had to be answered by identification or demonstration of relevant anatomical items. The questions, arranged by anatomical regions, were asked in five dynamic stations. Overall, the 31 participants showed an increase of correct answers, from a median of 6 (range 1 to 12) in the pre-workshop test, to a median of 14 (range 7 to 19) in the post-workshop test. In the pre-workshop test, the correct median answers were 7 (range 2 to 12) in the orthopedic fellows and 5 (range 1 to 10) in the rheumatology fellows (p = 0.297). Corresponding scores in the post-workshop were 15 (range 10 to 19) and 12 (range 7 to 18) (p = 0.026) showing a significant difference favoring the orthopedic group. Our clinical anatomy workshop was efficacious, in the short term, as a teaching instrument for 1st-year orthopedic and rheumatology fellows. The post-workshop scores, although significantly improved in both groups, particularly in the orthopedic fellows, were still suboptimal. Further refinements of our workshop might yield better results. PMID:26400643

  2. Orthopedic radiology

    SciTech Connect

    Renton, P.

    1989-01-01

    The book is divided into seven major sections on Decrease in bone density, Osteosclerosis, Localized lesions in bone, Lesions affecting the epiphyses, Abnormalities in the region of the metaphysis, Periosteal reactions, and Abnormalities in size and modelling of bone.

  3. The Stealth Curriculum: Manipulating America's History Teachers

    ERIC Educational Resources Information Center

    Stotsky, Sandra

    2004-01-01

    The purpose of this report is: (1) To point out the features of a number of manipulative supplemental resources for history and social studies teachers; and (2) to show how similarly manipulative professional development workshops propagate the distorted content and recommended teaching practices of such materials to teachers and their…

  4. Welding torch and wire feed manipulator

    NASA Technical Reports Server (NTRS)

    Williams, R. T.

    1967-01-01

    Welding torch and wire feed manipulator increase capability for performing automatic welding operations. The manipulator rotates on its horizontal axis to avoid obstacles as they approach the torch. The initial individual attitudes of the torch and wire guide are set with respect to the general configuration of the part.

  5. Teachers' Beliefs and Teaching Mathematics with Manipulatives

    ERIC Educational Resources Information Center

    Golafshani, Nahid

    2013-01-01

    To promote the implementation of manipulatives into mathematics instruction, this research project examined how the instructional practices of four Grade 9 applied mathematics teachers related to their beliefs about the use of manipulatives in teaching mathematics, its effects on students' learning, and enabling and disabling factors. Teacher…

  6. Count on It: Congruent Manipulative Displays

    ERIC Educational Resources Information Center

    Morin, Joe; Samelson, Vicki M.

    2015-01-01

    Representations that create informative visual displays are powerful tools for communicating mathematical concepts. The National Council of Teachers of Mathematics encourages the use of manipulatives (NCTM 2000). Manipulative materials are often used to present initial representations of basic numerical principles to young children, and it is…

  7. Medicated hydrogels of hyaluronic acid derivatives for use in orthopedic field.

    PubMed

    Pitarresi, Giovanna; Palumbo, Fabio Salvatore; Calascibetta, Filippo; Fiorica, Calogero; Di Stefano, Mauro; Giammona, Gaetano

    2013-06-01

    Physical hydrogels have been obtained from hyaluronic acid derivatized with polylactic acid in the presence or in the absence of polyethylene glycol chains. They have been extemporarily loaded with antibacterial agents, such as vancomycin and tobramycin. These medicated hydrogels have been used to coat titanium disks (chosen as simple model of orthopedic prosthesis) and in vitro studies in simulated physiological fluid have been performed as a function of time and for different drug loading and polymer concentration values. Sterilization process performed on the hydrogels does not change their rheological behavior and release properties as well as the chemical structure of starting copolymers. A preliminary test has been performed by coating with the hydrogel a prosthesis that has been inserted in a seat of a lyophilized human femur, to confirm the ability of the hydrogel to adhere to the prosthesis surface also after its insertion in the implant seat. Cell compatibility of obtained hydrogels has been confirmed in vitro by using human dermal fibroblasts chosen as a model cell line. Obtained results suggest the potential use of these hydrogels in the orthopedic field, in particular for the production of antibacterial coatings of prostheses for implant in the human or animal body in the prevention and/or treatment of post surgical infections. PMID:23587968

  8. Venous thromboembolism prophylaxis after total hip or knee arthroplasty: a survey of Canadian orthopedic surgeons

    PubMed Central

    Gross, Michael; Anderson, David R.; Nagpal, Seema; O’Brien, Bernie

    1999-01-01

    Objective To determine the pharmacologic and physical modalities used by orthopedic surgeons in Canada to prevent venous thromboembolism (deep venous thrombosis and pulmonary embolism) after total hip or knee arthroplasty. Design Mail survey sent to all members of the Canadian Orthopaedic Association. Setting A nation-wide study. Methods A total of 828 questionnaires, designed to identify the type and frequency of prophylaxis against venous thromboembolism that were used after hip and knee arthroplasty were mailed to orthopedic surgeons. Outcome measures Demographic data and the frequency and type of thromboprophylaxis. Results Of the 828 surveys mailed 445 (54%) were returned, and 397 were included in this analysis. Of the respondents, 97% used prophylaxis routinely for patients who undergo total hip or knee arthroplasty. Three of the 397 (0.8%) did not use any method of prophylaxis. Warfarin was the most common agent used (46%), followed by low-molecular-weight heparin (LMWH) (36%). Combination therapy with both mechanical and pharmacologic methods were used in 39% of patients. Objective screening tests were not frequently performed before discharge. Extended prophylaxis beyond the duration of hospitalization was used by 36% of physicians. Conclusion Prophylaxis for venous thromboembolism with warfarin or LMWH has become standard care after total hip or knee arthroplasty in Canada. PMID:10593248

  9. History of computer-assisted orthopedic surgery (CAOS) in sports medicine.

    PubMed

    Jackson, Douglas W; Simon, Timothy M

    2008-06-01

    Computer-assisted orthopedic surgery and navigation applications have a history rooted in the desire to link imaging technology with real-time anatomic landmarks. Although applications are still evolving in the clinical and research setting, computer-assisted orthopedic surgery has already demonstrated in certain procedures its potential for improving the surgeon's accuracy, reproducibility (once past the learning curve), and in reducing outlier outcomes. It is also being used as an educational tool to assist less experienced surgeons in interpreting measurements and precision placements related to well defined anatomic landmarks. It also can assist experienced surgeons, in real-time, plan their bony cuts, tunnel placement, and with ligament balancing. Presently, the additional time, the expense to acquire the needed software and hardware, and restricted reimbursement have slowed the widespread use of navigation. Its current applications have been primarily in joint replacement surgery, spine surgery, and trauma. It has not been widely used in the clinical setting for sports medicine procedures. Sports medicine applications such as individualizing tunnel placement in ligament surgery, opening wedge osteotomy with and without accompanying ligament reconstruction, and balancing and tensioning of the ligaments during the procedure (allowing real-time corrections if necessary) are currently being evaluated and being used on a limited clinical basis. PMID:18480724

  10. Psychological Distress After Orthopedic Trauma: Prevalence in Patients and Implications for Rehabilitation.

    PubMed

    Vincent, Heather K; Horodyski, MaryBeth; Vincent, Kevin R; Brisbane, Sonya T; Sadasivan, Kalia K

    2015-09-01

    Orthopedic trauma is an unforeseen life-changing event. Serious injuries include multiple fractures and amputation. Physical rehabilitation has traditionally focused on addressing functional deficits after traumatic injury, but important psychological factors also can dramatically affect acute and long-term recovery. This review presents the effects of orthopedic trauma on psychological distress, potential interventions for distress reduction after trauma, and implications for participation in rehabilitation. Survivors commonly experience post-traumatic stress syndrome, depression, and anxiety, all of which interfere with functional gains and quality of life. More than 50% of survivors have psychological distress that can last decades after the physical injury has been treated. Early identification of patients with distress can help care teams provide the resources and support to offset the distress. Several options that help trauma patients navigate their short-term recovery include holistic approaches, pastoral care, coping skills, mindfulness, peer visitation, and educational resources. The long-term physical and mental health of the trauma survivor can be enhanced by strategies that connect the survivor to a network of people with similar experiences or injuries, facilitate support groups, and social support networking (The Trauma Survivors Network). Rehabilitation specialists can help optimize patient outcomes and quality of life by participating in and advocating these strategies. PMID:25772720

  11. Short-Term and Long-Term Effects of Orthopedic Biodegradable Implants

    PubMed Central

    Amini, Ami R.; Wallace, James S.; Nukavarapu, Syam P.

    2012-01-01

    Presently, orthopedic and oral/maxillofacial implants represent a combined $2.8 billion market, a figure expected to experience significant and continued growth. Although traditional permanent implants have been proved clinically efficacious, they are also associated with several drawbacks, including secondary revision and removal surgeries. Non-permanent, biodegradable implants offer a promising alternative for patients, as they provide temporary support and degrade at a rate matching tissue formation, and thus, eliminate the need for secondary surgeries. These implants have been in clinical use for nearly 25 years, competing directly with, or maybe even exceeding, the performance of permanent implants. The initial implantation of biodegradable materials, as with permanent materials, mounts an acute host inflammatory response. Over time, the implant degradation profile and possible degradation product toxicity mediate long-term biodegradable implant-induced inflammation. However, unlike permanent implants, this inflammation is likely to cease once the material disappears. Implant-mediated inflammation is a critical determinant for implant success. Thus, for the development of a proactive biodegradable implant that has the ability to promote optimal bone regeneration and minimal detrimental inflammation, a thorough understanding of short- and long-term inflammatory events is required. Here, we discuss an array of biodegradable orthopedic implants, their associated short- and long- term inflammatory effects, and methods to mediate these inflammatory events. PMID:22043969

  12. Porous poly(para-phenylene) scaffolds for load-bearing orthopedic applications.

    PubMed

    DiRienzo, Amy L; Yakacki, Christopher M; Frensemeier, Mareike; Schneider, Andreas S; Safranski, David L; Hoyt, Anthony J; Frick, Carl P

    2014-02-01

    The focus of this study was to fabricate and investigate the mechanical behavior of porous poly(para-phenylene) (PPP) for potential use as a load-bearing orthopedic biomaterial. PPPs are known to have exceptional mechanical properties due to their aromatic backbone; however, the manufacturing and properties of PPP porous structures have not been previously investigated. Tailored porous structures with either small (150-250µm) or large (420-500µm) pore sizes were manufactured using a powder-sintering/salt-leaching technique. Porosities were systematically varied using 50 to 90vol%. Micro-computed tomography (µCT) and scanning electron microscopy (SEM) were used to verify an open-cell structure and investigate pore morphology of the scaffolds. Uniaxial mechanical behavior of solid and porous PPP samples was characterized through tensile and compressive testing. Both modulus and strength decreased with increasing porosity and matched well with foam theory. Porous scaffolds showed a significant decrease in strain-to-failure (<4%) under tensile loading and experienced linear elasticity, plastic deformation, and densification under compressive loading. Over the size ranges tested, pore size did not significantly influence the mechanical behavior of the scaffolds on a consistent basis. These results are discussed in regards to use of porous PPP for orthopedic applications and a prototype porous interbody fusion cage is presented. PMID:24374261

  13. HOW DOES THE BRAZILIAN ORTHOPEDIC SURGEONS TREAT ACUTE LATERAL ANKLE SPRAIN?

    PubMed Central

    Belangero, Paulo Santoro; Tamaoki, Marcel Jun Sugawara; Nakama, Gilberto Yoshinobu; Shoiti, Marcus Vinicius; Gomes, Rodrigo Vick Fernandes; Belloti, João Carlos

    2015-01-01

    Acute lateral ankle sprain (ALAS) is a common injury, but its treatment has yet to be firmly established. The purpose of this study was to investigate how Brazilian Orthopedists (including residents) manage the diagnosis, classification, treatment and complications of ALAS. Methods: A multiple-choice questionnaire was developed with the aim of addressing the main aspects of the treatment of ALAS. The questionnaire was made available on the official website of the Brazilian Society of Orthopedics and Traumatology between June 15 and August 1, 2004. Results: 444 questionnaires were included in the analysis. The results showed agreement among most of the interviewees in the following regards: 90.8% used a classification method to guide treatment of the sprain; 59% classified the ankle sprain with certainty; 63.7% used rigid immobilization in cases of totally torn ligaments; 60.6% used anti-inflammatory medication in cases of partial ligament tears; and 75.9% reported that residual pain was the most frequent complication. There was no consensus regarding the immobilization method for partial ALAS, given that immobilization and functional treatment were chosen with the same frequency (47%). There was no significant difference between the responses from residents and from orthopedists (p = 0.81). Conclusions: Orthopedists and orthopedic residents in Brazil have difficulty classifying ALAS and there is no consensus about the best therapeutic option for partial ALAS. PMID:27022596

  14. Influence of preoperative emotional state on postoperative pain following orthopedic and trauma surgery

    PubMed Central

    Robleda, Gemma; Sillero-Sillero, Amalia; Puig, Teresa; Gich, Ignasi; Baños, Josep-E

    2014-01-01

    OBJECTIVES: to analyze the relationship between preoperative emotional state and the prevalence and intensity of postoperative pain and to explore predictors of postoperative pain. METHOD: observational retrospective study undertaken among 127 adult patients of orthopedic and trauma surgery. Postoperative pain was assessed with the verbal numeric scale and with five variables of emotional state: anxiety, sweating, stress, fear, and crying. The Chi-squared test, Student's t test or ANOVA and a multivariate logistic regression analysis were used for the statistical analysis. RESULTS: the prevalence of immediate postoperative pain was 28%. Anxiety was the most common emotional factor (72%) and a predictive risk factor for moderate to severe postoperative pain (OR: 4.60, 95% CI 1.38 to 15.3, p<0.05, AUC: 0.72, 95% CI: 0.62 to 0.83). Age exerted a protective effect (OR 0.96, 95% CI: 0.94-0.99, p<0.01). CONCLUSION: preoperative anxiety and age are predictors of postoperative pain in patients undergoing orthopedic and trauma surgery. PMID:25493674

  15. Biologic response to orthopedic sutures: a histologic study in a rabbit model.

    PubMed

    Carr, Brian J; Ochoa, Leah; Rankin, David; Owens, Brett D

    2009-11-01

    Biologic reactivity to suture materials can have an effect on patient outcomes. The goal of this study was to determine the histologic response to 8 commonly used orthopedic sutures--Ethibond (Ethicon, Somerville, New Jersey), Ticron (Tyco, Waltham, Massachusetts), HiFi (Linvatec, Largo, Florida), Ultrabraid (Smith & Nephew, Memphis, Tennessee), MaxBraid (Biomet, Warsaw, Indiana), Orthocord (Mitek, Raynham, Massachusetts), MagnumWire (Opus Medical, San Juan Capistrano, California), and FiberWire (Arthrex, Naples, Florida)--using a rabbit model. The suture granuloms were evaluated at 30, 60, and 120 days with measurement of the fibrous capsule, the number of giant cells in and near the capsule, and the overall inflammatory grade: 1 (mild), 2 (moderate), and 3 (severe). MagnumWire and Ticron sutures initiated a more intense inflammatory reaction when compared to the other sutures. By 120 days, MagnumWire (P=.0297) and Ticron (P=.1855) had fewer giant cells at the soft tissue-suture interface, fewer giant cells within the capsule (P=.0074 and P=.0377, respectively), and the greatest capsular thickness of all suture types (P<.0001 and P=.1378, respectively). Differences exist between the biologic reactivity of commonly used orthopedic sutures that may be attributable to their material composition and/or braid characteristics. In comparison to other high-strength sutures, MagnumWire and Ticron stimulated a more intense foreign body inflammatory response. PMID:19902886

  16. Evaluating the reliability of surgical assessment methods in an orthopedic residency program

    PubMed Central

    Smith, Nicholas; Harnett, John; Furey, Andrew

    2015-01-01

    Background Orthopedic surgical education in Canada has seen major change in the last 15 years. Work hour restrictions and external influence have led to new approaches for surgical training. With a change toward competency-based educational models under the CanMEDS headings there is a need to ensure the validity of modern assessment methods. Our objective was to evaluate the reliability of a currently used surgical skill assessment tool within an orthopedic residency program, as measured by the Surgical Encounters Form. Methods A surgical assessment tool has previously been created at our institution that comprises 15 items spanning 4 of the CanMEDS competencies. Results were blinded to the primary investigator and coded by a third party. The assessments were collected, and we measured percent agreement using Cronbach’s α and Fleiss κ. Results Over a 5-month period 11 staff members assessed 10 residents. Eighty-eight assessments were completed in total. Weighted percent agreement was 90.9%. Cronbach’s α averaged 0.865 for the medical expert role, 0.920 for technical skills, 0.934 for the communicator role, 1.00 for the collaborator role and 1.00 for the health advocate role. The mean Fleiss κ score was 0.147 (95% confidence interval &0.071 to 0.364), demonstrating low interrater reliability. Conclusion Despite the development of a validated assessment tool to evaluate surgical skills acquisition, interrater reliability results suggest low levels of agreement among assessors. PMID:26204142

  17. Predicting postoperative vomiting among orthopedic patients receiving patient-controlled epidural analgesia using SVM and LR

    PubMed Central

    Wu, Hsin-Yun; Gong, Cihun-Siyong Alex; Lin, Shih-Pin; Chang, Kuang-Yi; Tsou, Mei-Yung; Ting, Chien-Kun

    2016-01-01

    Patient-controlled epidural analgesia (PCEA) has been applied to reduce postoperative pain in orthopedic surgical patients. Unfortunately, PCEA is occasionally accompanied by nausea and vomiting. The logistic regression (LR) model is widely used to predict vomiting, and recently support vector machines (SVM), a supervised machine learning method, has been used for classification and prediction. Unlike our previous work which compared Artificial Neural Networks (ANNs) with LR, this study uses a SVM-based predictive model to identify patients with high risk of vomiting during PCEA and comparing results with those derived from the LR-based model. From January to March 2007, data from 195 patients undergoing PCEA following orthopedic surgery were applied to develop two predictive models. 75% of the data were randomly selected for training, while the remainder was used for testing to validate predictive performance. The area under curve (AUC) was measured using the Receiver Operating Characteristic curve (ROC). The area under ROC curves of LR and SVM models were 0.734 and 0.929, respectively. A computer-based predictive model can be used to identify those who are at high risk for vomiting after PCEA, allowing for patient-specific therapeutic intervention or the use of alternative analgesic methods. PMID:27247165

  18. Predicting postoperative vomiting among orthopedic patients receiving patient-controlled epidural analgesia using SVM and LR.

    PubMed

    Wu, Hsin-Yun; Gong, Cihun-Siyong Alex; Lin, Shih-Pin; Chang, Kuang-Yi; Tsou, Mei-Yung; Ting, Chien-Kun

    2016-01-01

    Patient-controlled epidural analgesia (PCEA) has been applied to reduce postoperative pain in orthopedic surgical patients. Unfortunately, PCEA is occasionally accompanied by nausea and vomiting. The logistic regression (LR) model is widely used to predict vomiting, and recently support vector machines (SVM), a supervised machine learning method, has been used for classification and prediction. Unlike our previous work which compared Artificial Neural Networks (ANNs) with LR, this study uses a SVM-based predictive model to identify patients with high risk of vomiting during PCEA and comparing results with those derived from the LR-based model. From January to March 2007, data from 195 patients undergoing PCEA following orthopedic surgery were applied to develop two predictive models. 75% of the data were randomly selected for training, while the remainder was used for testing to validate predictive performance. The area under curve (AUC) was measured using the Receiver Operating Characteristic curve (ROC). The area under ROC curves of LR and SVM models were 0.734 and 0.929, respectively. A computer-based predictive model can be used to identify those who are at high risk for vomiting after PCEA, allowing for patient-specific therapeutic intervention or the use of alternative analgesic methods. PMID:27247165

  19. [Principles of the EOS™ X-ray machine and its use in daily orthopedic practice].

    PubMed

    Illés, Tamás; Somoskeöy, Szabolcs

    2012-02-26

    The EOS™ X-ray machine, based on a Nobel prize-winning invention in Physics in the field of particle detection, is capable of simultaneously capturing biplanar X-ray images by slot scanning of the whole body in an upright, physiological load-bearing position, using ultra low radiation doses. The simultaneous capture of spatially calibrated anterioposterior and lateral images allows the performance of a three-dimensional (3D) surface reconstruction of the skeletal system by a special software. Parts of the skeletal system in X-ray images and 3D-reconstructed models appear in true 1:1 scale for size and volume, thus spinal and vertebral parameters, lower limb axis lengths and angles, as well as any relevant clinical parameters in orthopedic practice could be very precisely measured and calculated. Visualization of 3D reconstructed models in various views by the sterEOS 3D software enables the presentation of top view images, through which one can analyze the rotational conditions of lower limbs, joints and spine deformities in horizontal plane and this provides revolutionary novel possibilities in orthopedic surgery, especially in spine surgery. PMID:22330840

  20. Polysaccharide-coated thermosets for orthopedic applications: from material characterization to in vivo tests.

    PubMed

    Travan, Andrea; Marsich, Eleonora; Donati, Ivan; Foulc, Marie-Pierre; Moritz, Niko; Aro, Hannu T; Paoletti, Sergio

    2012-05-14

    The long-term stability and success of orthopedic implants depend on the osseointegration process, which is strongly influenced by the biomaterial surface. A promising approach to enhance implant integration involves the modification of the surface of the implant by means of polymers that mimic the natural components of the extracellular matrix, for example, polysaccharides. In this study, methacrylate thermosets (bisphenol A glycidylmethacrylate/triethyleneglycol dimethacrylate), a widely used composition for orthopedic and dental applications, have been coated by electrostatic deposition of a bioactive chitosan-derivative. This polysaccharide was shown to induce osteoblasts aggregation in vitro, to stimulate cell proliferation and to enhance alkaline phosphatase activity. The coating deposition was studied by analyzing the effect of pH and ionic strength on the grafting of the polysaccharide. Contact angle studies show that the functionalized material displays a higher hydrophilic character owing to the increase of surface polar groups. The mechanical properties of the coating were evaluated by nanoindentation studies which point to higher values of indentation hardness and modulus (E) of the polysaccharide surface layer, while the influence of cyclic stress on the construct was assessed by fatigue tests. Finally, in vivo tests in minipigs showed that the polysaccharide-based implant showed a good biocompatibility and an ability for osseointegration at least similar to that of the titanium Ti6Al4V alloy with roughened surface. PMID:22509800

  1. Cell-Derived Extracellular Matrix: Basic Characteristics and Current Applications in Orthopedic Tissue Engineering.

    PubMed

    Zhang, Weixiang; Zhu, Yun; Li, Jia; Guo, Quanyi; Peng, Jiang; Liu, Shichen; Yang, Jianhua; Wang, Yu

    2016-06-01

    The extracellular matrix (ECM) is a dynamic and intricate microenvironment with excellent biophysical, biomechanical, and biochemical properties, which can directly or indirectly regulate cell proliferation, adhesion, migration, and differentiation, as well as plays key roles in homeostasis and regeneration of tissues and organs. The ECM has attracted a great deal of attention with the rapid development of tissue engineering in the field of regenerative medicine. Tissue-derived ECM scaffolds (also referred to as decellularized tissues and whole organs) are considered a promising therapy for the repair of musculoskeletal defects, including those that are widely used in orthopedics, although there are a few shortcomings. Similar to tissue-derived ECM scaffolds, cell-derived ECM scaffolds also have highly advantageous biophysical and biochemical properties, in particular their ability to be produced in vitro from a number of different cell types. Furthermore, cell-derived ECM scaffolds more closely resemble native ECM microenvironments. The products of cell-derived ECM have a wide range of biomedical applications; these include reagents for cell culture substrates and biomaterials for scaffolds, hybrid scaffolds, and living cell sheet coculture systems. Although cell-derived ECM has only just begun to be investigated, it has great potential as a novel approach for cell-based tissue repair in orthopedic tissue engineering. This review summarizes and analyzes the various types of cell-derived ECM products applied in cartilage, bone, and nerve tissue engineering in vitro or in vivo and discusses future directions for investigation of cell-derived ECM. PMID:26671674

  2. Innate immune evasion of Escherichia coli clinical strains from orthopedic implant infections.

    PubMed

    Crémet, L; Broquet, A; Jacqueline, C; Chaillou, C; Asehnoune, K; Corvec, S; Caroff, N

    2016-06-01

    Escherichia coli is one of the first causes of Gram-negative orthopedic implant infections (OII). Those infections, usually hematogenous, mostly originate from the urinary tract. We investigated the strategies developed by E. coli in this context to evade host innate immune responses, i.e. complement and polymorphonuclear neutrophils (PMN). Twenty strains from OII were compared with 20 strains from bacteremia in patients with non-infected orthopedic implant. In both groups, 6/20 (30 %) strains lysed PMNs, due to the production of the pore-forming toxin α-hemolysin (HlyA). For the others, resistance to phagocytic killing by PMN was not significantly different between both groups. In contrast, resistance to complement-mediated serum killing was significantly higher in OII strains than in the others (65 % vs 10 %; P <0.001). In E. coli, different mechanisms have been involved in complement resistance. Here, serum resistance was not linked to a group 2 capsule, or a loss of outer membrane permeability, or the recruitment of the complement inhibitor C4bp, but was significantly associated with the synthesis of long-chain LPS, regardless of the O-antigen. Thus, serum resistance could promote seeding of peri-implant tissues by helping E. coli to either persist in blood and reach the site of infection or overcome localized complement activation. PMID:27039343

  3. Use of commercial manipulator to handle a nuclear weapon component

    SciTech Connect

    Baker, C.P.

    1994-08-01

    Pacific Northwest Laboratory (PNL) has developed a manipulator workcell to load and unload nuclear weapon pit assemblies from a cart. To develop this workcell, PNL procured a commercially available manipulator, equipped it with force-sensing and vision equipment, and developed manipulator control software. Manipulator workcell development demonstrated that commercially available manipulator systems can successfully perform this task if the appropriate manipulator is selected and the manipulator workcell tooling and software are carefully designed.

  4. On stiffening cables of a long reach manipulator

    SciTech Connect

    Wang, S.L.; Santiago, P.

    1996-02-01

    A long reach manipulator will be used for waste remediation in large underground storage tanks. The manipulator`s slenderness makes it flexible and difficult to control. A low-cost and effective method to enhance the manipulator`s stiffness is proposed in this research by using suspension cables. These cables can also be used to accurately measure the position of the manipulator`s wrist.

  5. Manipulating duckweed through genome duplication.

    PubMed

    Vunsh, R; Heinig, U; Malitsky, S; Aharoni, A; Avidov, A; Lerner, A; Edelman, M

    2015-01-01

    Significant inter- and intraspecific genetic variation exists in duckweed, thus the potential for genome plasticity and manipulation is high. Polyploidy is recognised as a major mechanism of adaptation and speciation in plants. We produced several genome-duplicated lines of Landoltia punctata (Spirodela oligorrhiza) from both whole plants and regenerating explants using a colchicine-based cocktail. These lines stably maintained an enlarged frond and root morphology. DNA ploidy levels determined by florescence-activated cell sorting indicated genome duplication. Line A4 was analysed after 75 biomass doublings. Frond area, fresh and dry weights, rhizoid number and length were significantly increased versus wild type, while the growth rate was unchanged. This resulted in accumulation of biomass 17-20% faster in the A4 plants. We sought to determine if specific differences in gene products are found in the genome duplicated lines. Non-targeted ultra performance LC-quadrupole time of flight mass spectrometry was employed to compare some of the lines and the wild type to seek identification of up-regulated metabolites. We putatively identified differential metabolites in Line A65 as caffeoyl hexoses. The combination of directed genome duplication and metabolic profiling might offer a path for producing stable gene expression, leading to altered production of secondary metabolites. PMID:25040392

  6. Manipulating resource allocation in plants.

    PubMed

    Bennett, Emma; Roberts, Jeremy A; Wagstaff, Carol

    2012-05-01

    The distribution of nutrients and assimilates in different organs and tissues is in a constant state of flux throughout the growth and development of a plant. At key stages during the life cycle profound changes occur, and perhaps one of the most critical of these is during seed filling. By restricting the competition for reserves in Arabidopsis plants, the ability to manipulate seed size, seed weight, or seed content has been explored. Removal of secondary inflorescences and lateral branches resulted in a stimulation of elongation of the primary inflorescence and an increase in the distance between siliques. The pruning treatment also led to the development of longer and larger siliques that contained fewer, bigger seeds. This seems to be a consequence of a reduction in the number of ovules that develop and an increase in the fatty acid content of the seeds that mature. The data show that shoot architecture could have a substantial impact on the partitioning of reserves between vegetative and reproductive tissues and could be an important trait for selection in rapid phenotyping screens to optimize crop performance. PMID:22291133

  7. Coanda-assisted Spray Manipulation

    NASA Astrophysics Data System (ADS)

    Mabey, Katie; Smith, Barton; Archibald, Reid; West, Brian

    2009-11-01

    An overview of research on a flow control technique called Coanda-assisted Spray Manipulation (CSM) is presented. CSM uses a high-momentum control jet under the influence of the Coanda effect to vector a high volume-flow jet or spray. Actuators provide the capability of moving the location of applied control flow making rotary or arbitrary motion of the vectored flow possible. The presented work includes a fundamental isothermal study on the effects of rotation speed and Reynolds number on a vectored jet using a belt-driven CSM actuator. Three-component velocity data were acquired for three Reynolds numbers and three rotation speeds using timed resolved high-speed stereo Particle Image Velocimetry. A second CSM system with 16 pneumatically-driven control ports has been retrofitted to a flame spray gun. This combination provides the capability to rapidly alter the direction of applied metal powders. High speed video of this process will also be presented. Finally, a fundamental study on the pneumatic system's response to minor losses and connection lines of varying lengths is presented.

  8. Interactive digital image manipulation system

    NASA Technical Reports Server (NTRS)

    Henze, J.; Dezur, R.

    1975-01-01

    The system is designed for manipulation, analysis, interpretation, and processing of a wide variety of image data. LANDSAT (ERTS) and other data in digital form can be input directly into the system. Photographic prints and transparencies are first converted to digital form with an on-line high-resolution microdensitometer. The system is implemented on a Hewlett-Packard 3000 computer with 128 K bytes of core memory and a 47.5 megabyte disk. It includes a true color display monitor, with processing memories, graphics overlays, and a movable cursor. Image data formats are flexible so that there is no restriction to a given set of remote sensors. Conversion between data types is available to provide a basis for comparison of the various data. Multispectral data is fully supported, and there is no restriction on the number of dimensions. In this way multispectral data collected at more than one point in time may simply be treated as a data collected with twice (three times, etc.) the number of sensors. There are various libraries of functions available to the user: processing functions, display functions, system functions, and earth resources applications functions.

  9. Fuzzy logic control of telerobot manipulators

    NASA Technical Reports Server (NTRS)

    Franke, Ernest A.; Nedungadi, Ashok

    1992-01-01

    Telerobot systems for advanced applications will require manipulators with redundant 'degrees of freedom' (DOF) that are capable of adapting manipulator configurations to avoid obstacles while achieving the user specified goal. Conventional methods for control of manipulators (based on solution of the inverse kinematics) cannot be easily extended to these situations. Fuzzy logic control offers a possible solution to these needs. A current research program at SRI developed a fuzzy logic controller for a redundant, 4 DOF, planar manipulator. The manipulator end point trajectory can be specified by either a computer program (robot mode) or by manual input (teleoperator). The approach used expresses end-point error and the location of manipulator joints as fuzzy variables. Joint motions are determined by a fuzzy rule set without requiring solution of the inverse kinematics. Additional rules for sensor data, obstacle avoidance and preferred manipulator configuration, e.g., 'righty' or 'lefty', are easily accommodated. The procedure used to generate the fuzzy rules can be extended to higher DOF systems.

  10. Task based synthesis of serial manipulators

    PubMed Central

    Patel, Sarosh; Sobh, Tarek

    2015-01-01

    Computing the optimal geometric structure of manipulators is one of the most intricate problems in contemporary robot kinematics. Robotic manipulators are designed and built to perform certain predetermined tasks. There is a very close relationship between the structure of the manipulator and its kinematic performance. It is therefore important to incorporate such task requirements during the design and synthesis of the robotic manipulators. Such task requirements and performance constraints can be specified in terms of the required end-effector positions, orientations and velocities along the task trajectory. In this work, we present a comprehensive method to develop the optimal geometric structure (DH parameters) of a non-redundant six degree of freedom serial manipulator from task descriptions. In this work we define, develop and test a methodology to design optimal manipulator configurations based on task descriptions. This methodology is devised to investigate all possible manipulator configurations that can satisfy the task performance requirements under imposed joint constraints. Out of all the possible structures, the structures that can reach all the task points with the required orientations are selected. Next, these candidate structures are tested to see whether they can attain end-effector velocities in arbitrary directions within the user defined joint constraints, so that they can deliver the best kinematic performance. Additionally least power consuming configurations are also identified. PMID:26257946

  11. Large planar maneuvers for articulated flexible manipulators

    NASA Technical Reports Server (NTRS)

    Huang, Jen-Kuang; Yang, Li-Farn

    1988-01-01

    An articulated flexible manipulator carried on a translational cart is maneuvered by an active controller to perform certain position control tasks. The nonlinear dynamics of the articulated flexible manipulator are derived and a transformation matrix is formulated to localize the nonlinearities within the inertia matrix. Then a feedback linearization scheme is introduced to linearize the dynamic equations for controller design. Through a pole placement technique, a robust controller design is obtained by properly assigning a set of closed-loop desired eigenvalues to meet performance requirements. Numerical simulations for the articulated flexible manipulators are given to demonstrate the feasibility and effectiveness of the proposed position control algorithms.

  12. W-026, acceptance test report manipulator system

    SciTech Connect

    Watson, T.L.

    1997-04-15

    The purpose of the WRAP Manipulator System Acceptance Test Plan (ATP) is to verify that the 4 glovebox sets of WRAP manipulator components, including rail/carriage, slave arm, master controller and auxiliary equipment, meets the requirements of the functional segments of 14590 specification. The demonstration of performance elements of the ATP are performed as a part of the Assembly specifications. Manipulator integration is integrated in the performance testing of the gloveboxes. Each requirement of the Assembly specification will be carried out in conjunction with glovebox performance tests.

  13. Dynamically consistent Jacobian inverse for mobile manipulators

    NASA Astrophysics Data System (ADS)

    Ratajczak, Joanna; Tchoń, Krzysztof

    2016-06-01

    By analogy to the definition of the dynamically consistent Jacobian inverse for robotic manipulators, we have designed a dynamically consistent Jacobian inverse for mobile manipulators built of a non-holonomic mobile platform and a holonomic on-board manipulator. The endogenous configuration space approach has been exploited as a source of conceptual guidelines. The new inverse guarantees a decoupling of the motion in the operational space from the forces exerted in the endogenous configuration space and annihilated by the dual Jacobian inverse. A performance study of the new Jacobian inverse as a tool for motion planning is presented.

  14. Issues in advanced automation for manipulator control

    NASA Technical Reports Server (NTRS)

    Bejczy, A. K.

    1976-01-01

    This paper provides a brief description and analysis of the main issues in advanced autonomous control of manipulators as seen from a system point of view. The nature of manipulation is analyzed at some depth. A general multilevel structure is outlined for manipulator control organization which includes the human operator at the top level of the control structure. Different approaches to the development of advanced automation of mechanical arms are summarized. Recent work in the JPL teleoperator project is described, including control system, force/torque sensor, and control software development. Some results from control experiments are summarized.

  15. A cohort study on the incidence and outcome of pulmonary embolism in trauma and orthopedic patients

    PubMed Central

    2014-01-01

    Background This study aims to determine the incidence of pulmonary embolism (PE) in trauma and orthopedic patients within a regional tertiary referral center and its association with the pattern of injury, type of treatment, co-morbidities, thromboprophylaxis and mortality. Methods All patients admitted to our institution between January 2010 and December 2011, for acute trauma or elective orthopedic procedures, were eligible to participate in this study. Our cohort was formed by identifying all patients with clinical features of PE who underwent Computed Tomography-Pulmonary Angiogram (CT-PA) to confirm or exclude the clinical suspicion of PE, within six months after the injury or the surgical procedure. Case notes and electronic databases were reviewed retrospectively to identify each patient’s venous thromboembolism (VTE) risk factors, type of treatment, thromboprophylaxis and mortality. Results Out of 18,151 patients admitted during the study period only 85 (0.47%) patients developed PE (positive CT-PA) (24 underwent elective surgery and 61 sustained acute trauma). Of these, only 76% of the patients received thromboprophylaxis. Hypertension, obesity and cardiovascular disease were the most commonly identifiable risk factors. In 39% of the cases, PE was diagnosed during the in-hospital stay. The median time of PE diagnosis, from the date of injury or the surgical intervention was 23 days (range 1 to 312). The overall mortality rate was 0.07% (13/18,151), but for those who developed PE it was 15.29% (13/85). Concomitant deep venous thrombosis (DVT) was identified in 33.3% of patients. The presence of two or more co-morbidities was significantly associated with the incidence of mortality (unadjusted odds ratio (OR) = 3.52, 95% confidence interval (CI) (1.34, 18.99), P = 0.034). Although there was also a similar clinical effect size for polytrauma injury on mortality (unadjusted OR = 1.90 (0.38, 9.54), P = 0.218), evidence was not statistically

  16. Seasonal variation in orthopedic health services utilization in Switzerland: The impact of winter sport tourism

    PubMed Central

    Matter-Walstra, Klazien; Widmer, Marcel; Busato, André

    2006-01-01

    Background Climate- or holiday-related seasonality in hospital admission rates is well known for many diseases. However, little research has addressed the impact of tourism on seasonality in admission rates. We therefore investigated the influence of tourism on emergency admission rates in Switzerland, where winter and summer leisure sport activities in large mountain regions can generate orthopedic injuries. Methods Using small area analysis, orthopedic hospital service areas (HSAo) were evaluated for seasonality in emergency admission rates. Winter sport areas were defined using guest bed accommodation rate patterns of guest houses and hotels located above 1000 meters altitude that show clear winter and summer peak seasons. Emergency admissions (years 2000–2002, n = 135'460) of local and nonlocal HSAo residents were evaluated. HSAo were grouped according to their area type (regular or winter sport area) and monthly analyses of admission rates were performed. Results Of HSAo within the defined winter sport areas 70.8% show a seasonal, summer-winter peak hospital admission rate pattern and only 1 HSAo outside the defined winter sport areas shows such a pattern. Seasonal hospital admission rates in HSAo in winter sport areas can be up to 4 times higher in winter than the intermediate seasons, and they are almost entirely due to admissions of nonlocal residents. These nonlocal residents are in general -and especially in winter- younger than local residents, and nonlocal residents have a shorter length of stay in winter sport than in regular areas. The overall geographic distribution of nonlocal residents admitted for emergencies shows highest rates during the winter as well as the summer in the winter sport areas. Conclusion Small area analysis using orthopedic hospital service areas is a reliable method for the evaluation of seasonality in hospital admission rates. In Switzerland, HSAo defined as winter sport areas show a clear seasonal fluctuation in admission

  17. Influence of Ketamine on Early Postoperative Cognitive Function After Orthopedic Surgery in Elderly Patients

    PubMed Central

    Lee, Ki Hwa; Kim, Ji Yeon; Kim, Jeong Won; Park, Jang Su; Lee, Kyu Won; Jeon, Sang Yoon

    2015-01-01

    Background: Postoperative cognitive dysfunction (POCD) is a serious and frequent complication after surgery, especially in elderly patients. Ketamine is an N-methyl D-aspartic acid receptor antagonist with demonstrated neuroprotective effects. An intravenous bolus of a sub-anesthetic dose (0.5 mg/kg) of ketamine can reduce postoperative delirium (POD) and POCD after cardiac surgery. But, the influence of ketamine on early POCD after non-cardiac surgery is unclear. Objectives: The current study aimed to evaluate the influence of ketamine on early postoperative cognitive function after orthopedic surgery in elderly patients. Patients and Methods: Fifty six elderly patients (> 60-years-old), scheduled for elective orthopedic surgery during general anesthesia (duration of anesthesia > two hours) were enrolled. Patients received intravenous bolus, a total of 3 mL mixed with 0.9% normal saline and 0.5 mg/kg ketamine (K group) or 3 mL of 0.9% normal saline (N group). Three neurocognitive function tests (mini-mental status examination, trail-making test, digit substitution test), and c-reactive protein (CRP) concentration were determined before surgery and on postoperative day one (POD 1) and postoperative day six (POD 6). Results: The two groups had similar demographic characteristics except for the gender. Surgical and anesthetic data were not significantly different. A statistically significant difference was observed in comparison of trail-making test score. Trail-making test score increased more in the N group (52.5 points) than the K group (13 points) at POD 1 (P = 0.047) compared with baseline scores. There were no significant differences in the mini-mental status examination, digit substitution test and CRP concentration at POD 1 and POD 6 between the two groups. POCD (the two Z-scores in more than two tests or the combined Z-score was 1.96 or more) was present in one patient (4%) in the K group at POD 6 (P = 0.98). Conclusions: The incidence of POCD was not

  18. Single high dose gentamicin for perioperative prophylaxis in orthopedic surgery: Evaluation of nephrotoxicity

    PubMed Central

    Dubrovskaya, Yanina; Tejada, Rainer; Bosco, Joseph; Stachel, Anna; Chen, Donald; Feng, Melinda; Rosenberg, Andrew; Phillips, Michael

    2015-01-01

    Background: Recent studies described an increase in acute kidney injury when high dose gentamicin was included in perioperative prophylaxis for orthopedic surgeries. To this effect, we compared the rate of nephrotoxicity for selected orthopedic surgeries where gentamicin was included (Gentamicin Group) to those where it was not included (Control Group) for perioperative prophylaxis and evaluated risk factors for nephrotoxicity. Methods: Spine, hip and knee surgeries performed between April 2011 and December 2013 were reviewed retrospectively. Gentamicin was given to eligible patients based on age, weight and Creatinine Clearance. Nephrotoxicity was assessed using Risk, Injury, Failure, Loss, End-stage kidney disease (RIFLE) criteria. Results: Among selected surgeries (N = 1590 in Gentamicin Group: hip = 926, spine = 600, knee = 64; N = 2587 in Control Group: hip = 980, spine = 902, knee = 705), patients’ body weight, serum creatinine, comorbidities and surgery duration were similar in Gentamicin Group and Control Group. Gentamicin median dose was 4.5 mg/kg of dosing weight. Nephrotoxicity rate was 2.5% in Gentamicin Group and 1.8% in Control Group, p = 0.17. Most cases of nephrotoxicity were Risk category by RIFLE criteria (67% in Gentamicin Group and 72% in Control Group, p = 0.49). In logistic regression, risk factors for nephrotoxicity were hospital stay >1 day prior to surgery (odds ratio = 8.1; 95% confidence interval = 2.25–28.97, p = 0.001), knee or hip surgery (odds ratio = 4.7; 95% confidence interval = 2.9–9.48, p = 0.0005) and diabetes (odds ratio = 1.95; 95% confidence interval = 1.13–3.35, p = 0.016). Receipt of gentamicin was not an independent predictor of nephrotoxicity (odds ratio = 1.5; 95% confidence interval = 0.97–2.35, p = 0.07). Conclusion: In this cohort, rate of nephrotoxicity was similar between Gentamicin Group and Control Group. Single

  19. The Living Stage Improvisational Theatre Demonstration Project for Orthopedically Handicapped Children, Ages 4-8. Overview, 1978-1981.

    ERIC Educational Resources Information Center

    Alexander, Robert; Haynes, Wendy

    The Living Stage Improvisational Theatre Demonstration Project (Washington, D.C.) conducts weekly workshops to enhance the creative expression and self esteem of orthopedically handicapped children, aged 4 to 8 years. The Living Stage program is designed to demonstrate that methods of improvisational theatre can have a positive impact on parental…

  20. Using the Integration of Discrete Event and Agent-Based Simulation to Enhance Outpatient Service Quality in an Orthopedic Department.

    PubMed

    Kittipittayakorn, Cholada; Ying, Kuo-Ching

    2016-01-01

    Many hospitals are currently paying more attention to patient satisfaction since it is an important service quality index. Many Asian countries' healthcare systems have a mixed-type registration, accepting both walk-in patients and scheduled patients. This complex registration system causes a long patient waiting time in outpatient clinics. Different approaches have been proposed to reduce the waiting time. This study uses the integration of discrete event simulation (DES) and agent-based simulation (ABS) to improve patient waiting time and is the first attempt to apply this approach to solve this key problem faced by orthopedic departments. From the data collected, patient behaviors are modeled and incorporated into a massive agent-based simulation. The proposed approach is an aid for analyzing and modifying orthopedic department processes, allows us to consider far more details, and provides more reliable results. After applying the proposed approach, the total waiting time of the orthopedic department fell from 1246.39 minutes to 847.21 minutes. Thus, using the correct simulation model significantly reduces patient waiting time in an orthopedic department. PMID:27195606

  1. An Intelligibility Assessment of Toddlers with Cleft Lip and Palate Who Received and Did Not Receive Presurgical Infant Orthopedic Treatment.

    ERIC Educational Resources Information Center

    Konst, Emmy M.; Weersink-Braks, Hanny; Rietveld, Toni; Peters, Herman

    2000-01-01

    The influence of presurgical infant orthopedic treatment (PIO) on speech intelligibility was evaluated with 10 toddlers who used PIO during the first year of life and 10 who did not. Treated children were rated as exhibiting greater intelligibility, however, transcription data indicated there were not group differences in actual intelligibility.…

  2. Laser speckle technology in stomatology. diagnostics of stresses and strains of hard biotissues and orthodontic and orthopedic structures

    NASA Astrophysics Data System (ADS)

    Denisova, Yu. L.; Bazylev, N. B.; Rubnikovich, S. P.; Fomin, N. A.

    2013-07-01

    We have investigated the formation and dynamics of speckle biofi elds formed by hard biotissues of the oral cavity irradiated with low-intensity radiation. We present experimental methods for diagnosing the stressed-strained state of the maxillodental system and orthodontic and orthopedic structures based on speckle technologies and crosscorrelation analysis of speckle biofi elds.

  3. Patient refusal for regional anesthesia in elderly orthopedic population: A cross-sectional survey at a tertiary care hospital

    PubMed Central

    Salam, Asma Abdus; Afshan, Gauhar

    2016-01-01

    Background and Aims: Improvements in pain management techniques in the last decade have had a major impact on the practice of orthopedic surgeries, for example, total hip arthroplasty and total knee arthroplasty. Although there are a number of treatment options for postoperative pain, a gold standard has not been established. In our institution, both general anesthesia and regional anesthesia (RA), are being offered to the elderly orthopedic population but RA is not frequently accepted by elderly population. The objective of this study was to determine the frequency of various reasons for refusal of RA in elderly patients undergoing orthopedic surgeries. Material and Methods: A prospective study conducted over a period of 1 year, had 549 patients with ages above 60 years who underwent different types of elective orthopedic procedures 182 patients who refused RA were interviewed according to a structured questionnaire designed to assess the reasons of refusal. Results: Most common reason for the refusal of RA was surgeon's choice (38.5%), whereas 20.3% of the patients were unaware about the RA. There was a significant association between female gender and refusing RA due to backache (17.2%) and fear of being awake during the operation (24.1%) respectively. Conclusion: This survey showed that the main reasons among elderly female population were the fear of remaining awake and backache. However, overall it was the surgeon's choice which made patients refuse RA, and the anesthesiologists were the main source of information. PMID:27006550

  4. Fibrin-related markers for diagnosing acute-, subclinical-, and pre-venous thromboembolism in patients with major orthopedic surgery.

    PubMed

    Yamaguchi, Toshio; Wada, Hideo; Miyazaki, Shinichi; Hasegawa, Masahiro; Wakabayashi, Hiroki; Asanuma, Kunihiro; Fujimoto, Naoki; Matsumoto, Takeshi; Ohishi, Kohshi; Sakaguchi, Akane; Yamada, Norikazu; Ito, Masaaki; Yamashita, Yoshiki; Katayama, Naoyuki; Sudo, Akihiro

    2016-05-01

    Venous thromboembolism (VTE) is a common complication in patients who have undergone major orthopedic surgery, but there are few predictors of VTE after major orthopedic surgery treated with an anticoagulant. We measured levels of fibrin-related markers (FRMs), such as D-dimer, soluble fibrin (SF), and fibrinogen and fibrin degradation products (FDPs) in 66 patients with acute-phase VTE, and 367 patients undergoing major orthopedic surgery. Plasma FDP, D-dimer, and SF levels were significantly higher in patients with acute VTE, but only FDP and D-dimer levels were significantly higher in subclinical VTE. Adequate cut-off levels of D-dimer were 2.2 μg/ml for diagnosing acute VTE and 1.5 μg/ml for diagnosing subclinical VTE. D-dimer of less than 1.9 or 0.7 μg/ml ruled out acute VTE or subclinical VTE. D-dimer of more than 1.3 μg/ml preoperatively showed a moderate risk for postoperative VTE. Measurement of FRMs is useful for evaluating the risk of subclinical or postoperative VTE in patients with major orthopedic surgery. In particular, FDP is the most valuable marker for diagnosing acute VTE, whereas D-dimer is the most valuable for diagnosing subclinical VTE or predicting VTE. PMID:26872909

  5. Orthopedic application of spikenard herbal rhizome decorated microstructured polymer biocomposites and their in vitro cytotoxicity.

    PubMed

    Priya, Sahariya; Jeya Jothi, Gabriel

    2016-09-01

    The present study explores the synthesis of highly potential polymer biocomposite from Nardostachys jatamansi rhizome extract. The polymer biocomposites were synthesized from methyl methacrylate by free radical polymerization. ATR-IR enunciate the functional groups attributed at 956 cm(-1) (aromatic), a peak appeared at 1685 cm(-1) (-C 000000000000 000000000000 000000000000 111111111111 000000000000 111111111111 000000000000 000000000000 000000000000 O), 1186 cm(-1) (-O-CH3), 1149 cm(-1) (-C-O-C) framework and 1279 cm(-1) (-C-O), which are good agreement for the formation composites. The quantitative evaluations of antimicrobial studies were analyzed by serial dilution method and also improved activity in orthopedic infection pathogens. Cytocompatibility was analyzed by keratinocyte cell lines and it may be used for various biomedical applications. PMID:27408493

  6. Dominance of foreign citations in Brazilian orthopedics journals☆☆☆

    PubMed Central

    Teixeira, Renan Kleber Costa; Yamaki, Vitor Nagai; Rosa, Rita de Cássia Rodrigues; de Barros, Rui Sergio Monteiro; Botelho, Nara Macedo

    2014-01-01

    Objective To evaluate whether there is any preference for citing journals from other countries to the detriment of Brazilian journals, in three Brazilian orthopedics journals. Methods All the references of articles published in 2011 by the journals Acta Ortopédica Brasileira, Coluna/Columna and Revista Brasileira de Ortopedia were evaluated to as certain how many of these came from Brazilian journals and how many from foreign journals. Results 3813 references distributed among 187 articles were analyzed. Out of this total, 306 (8.02%) were from Brazilian journals. There was no difference between the three journals analyzed. There were 76 articles (40.64%) without any citations of articles in Brazilian journals and only two articles (1%) cited more Brazilian articles than articles published elsewhere. Conclusion There is a need for Brazilian researchers to cite articles from Brazilian journals more often. PMID:26229879

  7. Treatment of Pseudomonas aeruginosa-infected orthopedic prostheses with ceftazidime-ciprofloxacin antibiotic combination.

    PubMed

    Brouqui, P; Rousseau, M C; Stein, A; Drancourt, M; Raoult, D

    1995-11-01

    Indwelling device infections are associated with considerable morbidity and extremely high cost. Pseudomonas aeruginosa is the most frequent gram-negative etiologic agent associated with infections of indwelling catheters and foreign body implants. It is generally agreed that eradication of infection in the presence of a foreign body requires removal of the foreign body. Using a combination of ceftazidime and ciprofloxacin, we cured nine of nine patients with P. aeruginosa-infected osteosynthetic material and four of five patients with hip and knee prostheses without removing the foreign material. Follow-up was for a mean of 21 months (range, 6 to 60 months). Some patients experienced minor side effects (arthralgia in one patient and rash in another patient). We conclude that this combination is effective and safe and should be useful in the treatment of P. aeruginosa-infected orthopedic implants. PMID:8585720

  8. Prosthesis Infections after Orthopedic Joint Replacement: The Possible Role of Bacterial Biofilms

    PubMed Central

    Song, Zhijun; Borgwardt, Lotte; Høiby, Niels; Wu, Hong; Sørensen, Torben Sandberg; Borgwardt, Arne

    2013-01-01

    Prosthesis-related infection is a serious complication for patients after orthopedic joint replacement, which is currently difficult to treat with antibiotic therapy. Consequently, in most cases, removal of the infected prosthesis is the only solution to cure the infection. It is, therefore, important to understand the comprehensive interaction between the microbiological situation and the host immune responses that lead to prosthesis infections. Evidence indicates that prosthesis infections are actually biofilm-correlated infections that are highly resistant to antibiotic treatment and the host immune responses. The authors reviewed the related literature in the context of their clinical experience, and discussed the possible etiology and mechanism leading to the infections, especially problems related to bacterial biofilm, and prophylaxis and treatment of infection, including both microbiological and surgical measures. Recent progress in research into bacterial biofilm and possible future treatment options of prosthesis-related infections are discussed. PMID:23888204

  9. Transforaminal sacral approach for spinal anesthesia in orthopedic surgery: A novel approach.

    PubMed

    Sujay, Mysore; Madhavi, Santpur; Aravind, G; Hasan, Adil; Venugopalan, V M

    2014-01-01

    Regional anesthesia is preferred world-wide for its distinct advantages. The benefits of regional anesthesia in patients with comorbid conditions are well-established. The administration of regional anesthesia can sometimes pose a challenge to the anesthesiologist due to the structural abnormalities of the spine. The most common difficulty encountered for spinal anesthesia in our hospital (Nalgonda District) is skeletal fluorosis. Apart from the midline approach, paramedian, and Taylor's approaches are advocated for difficult scenarios. This article reports two orthopedic cases, conducted under a novel spinal anesthesia technique, i.e., transforaminal sacral approach under C-arm guidance with a successful outcome. The sacral foraminal subarachnoid block is a method to access the subarachnoid space through the upper posterior sacral foramina. PMID:25886238

  10. Transforaminal sacral approach for spinal anesthesia in orthopedic surgery: A novel approach

    PubMed Central

    Sujay, Mysore; Madhavi, Santpur; Aravind, G.; Hasan, Adil; Venugopalan, V. M.

    2014-01-01

    Regional anesthesia is preferred world-wide for its distinct advantages. The benefits of regional anesthesia in patients with comorbid conditions are well-established. The administration of regional anesthesia can sometimes pose a challenge to the anesthesiologist due to the structural abnormalities of the spine. The most common difficulty encountered for spinal anesthesia in our hospital (Nalgonda District) is skeletal fluorosis. Apart from the midline approach, paramedian, and Taylor's approaches are advocated for difficult scenarios. This article reports two orthopedic cases, conducted under a novel spinal anesthesia technique, i.e., transforaminal sacral approach under C-arm guidance with a successful outcome. The sacral foraminal subarachnoid block is a method to access the subarachnoid space through the upper posterior sacral foramina. PMID:25886238

  11. 3D Bioprinting of Cartilage for Orthopedic Surgeons: Reading between the Lines

    PubMed Central

    Di Bella, Claudia; Fosang, Amanda; Donati, Davide M.; Wallace, Gordon G.; Choong, Peter F. M.

    2015-01-01

    Chondral and osteochondral lesions represent one of the most challenging and frustrating scenarios for the orthopedic surgeon and for the patient. The lack of therapeutic strategies capable to reconstitute the function and structure of hyaline cartilage and to halt the progression toward osteoarthritis has brought clinicians and scientists together, to investigate the potential role of tissue engineering as a viable alternative to current treatment modalities. In particular, the role of bioprinting is emerging as an innovative technology that allows for the creation of organized 3D tissue constructs via a “layer-by-layer” deposition process. This process also has the capability to combine cells and biomaterials in an ordered and predetermined way. Here, we review the recent advances in cartilage bioprinting and we identify the current challenges and the directions for future developments in cartilage regeneration. PMID:26322314

  12. The distribution of mental illness found by DIS (Diagnostic Interview Schedule) among internal and orthopedic patients.

    PubMed

    Nishioka, Y; Nishizono, M; Yamamoto, J

    1990-03-01

    In order to understand how psychiatric problems are distributed in general medical departments, we used DIS (Diagnostic Interview Schedule). The subjects are 307 inpatients and outpatients in the Departments in Internal Medicine and Orthopedics of Fukuoka University Hospital, M Hospital and N Hospital. As a result, 53.4% of all the subjects showed some psychiatric problems. These are, in a descending order, tobacco dependence (30.0%), psychosexual dysfunction (14.3%), alcohol abuse/dependence (14.0%), major depressive episode (6.5%), organic brain syndrome (4.9%), obsessive-compulsive disorder (3.9%), dysthymic disorder (2.3%), panic disorder (2.0%) and others. Also, we discussed comparison between internal patients and neurotic patients who visited psychiatrists complaining of physical symptoms, and the incidence of DIS diagnoses in individual physical diseases. PMID:2362392

  13. Biomarkers of Brain Damage and Postoperative Cognitive Disorders in Orthopedic Patients: An Update

    PubMed Central

    Tomaszewski, Dariusz

    2015-01-01

    The incidence of postoperative cognitive dysfunction (POCD) in orthopedic patients varies from 16% to 45%, although it can be as high as 72%. As a consequence, the hospitalization time of patients who developed POCD was longer, the outcome and quality of life were worsened, and prolonged medical and social assistance were necessary. In this review the short description of such biomarkers of brain damage as the S100B protein, NSE, GFAP, Tau protein, metalloproteinases, ubiquitin C terminal hydrolase, microtubule-associated protein, myelin basic protein, α-II spectrin breakdown products, and microRNA was made. The role of thromboembolic material in the development of cognitive decline was also discussed. Special attention was paid to optimization of surgical and anesthetic procedures in the prevention of postoperative cognitive decline. PMID:26417595

  14. Use of direct oral anticoagulants with regional anesthesia in orthopedic patients.

    PubMed

    Cappelleri, Gianluca; Fanelli, Andrea

    2016-08-01

    The use of direct oral anticoagulants including apixaban, rivaroxaban, and dabigatran, which are approved for several therapeutic indications, can simplify perioperative and postoperative management of anticoagulation. Utilization of regional neuraxial anesthesia in patients receiving anticoagulants carries a relatively small risk of hematoma, the serious complications of which must be acknowledged. Given the extensive use of regional anesthesia in surgery and the increasing number of patients receiving direct oral anticoagulants, it is crucial to understand the current clinical data on the risk of hemorrhagic complications in this setting, particularly for anesthesiologists. We discuss current data, guideline recommendations, and best practice advice on effective management of the direct oral anticoagulants and regional anesthesia, including in specific clinical situations, such as patients undergoing major orthopedic surgery at high risk of a thromboembolic event, or patients with renal impairment at an increased risk of bleeding. PMID:27290980

  15. A controlled antibiotic release system to prevent orthopedic-implant associated infections: An in vitro study

    PubMed Central

    Gimeno, Marina; Pinczowski, Pedro; Pérez, Marta; Giorello, Antonella; Martínez, Miguel Ángel; Santamaría, Jesús; Arruebo, Manuel; Luján, Lluís

    2015-01-01

    A new device for local delivery of antibiotics is presented, with potential use as a drug-eluting fixation pin for orthopedic applications. The implant consists of a stainless steel hollow tubular reservoir packed with the desired antibiotic. Release takes place through several orifices previously drilled in the reservoir wall, a process that does not compromise the mechanical properties required for the implant. Depending on the antibiotic chosen and the number of orifices, the release profile can be tailored from a rapid release of the load (ca. 20 h) to a combination of rapid initial release and slower, sustained release for a longer period of time (ca. 200 h). An excellent bactericidal action is obtained, with 4-log reductions achieved in as little as 2 h, and total bacterial eradication in 8 h using 6-pinholed implants filled with cefazolin. PMID:26297104

  16. Preparation Methods for Improving PEEK's Bioactivity for Orthopedic and Dental Application: A Review

    PubMed Central

    Almasi, Davood; Iqbal, Nida; Sadeghi, Maliheh; Sudin, Izman; Abdul Kadir, Mohammed Rafiq; Kamarul, Tunku

    2016-01-01

    There is an increased interest in the use of polyether ether ketone (PEEK) for orthopedic and dental implant applications due to its elastic modulus close to that of bone, biocompatibility, and its radiolucent properties. However, PEEK is still categorized as bioinert due to its low integration with surrounding tissues. Many studies have reported on methods to increase the bioactivity of PEEK, but there is still one-preparation method for preparing bioactive PEEK implant where the produced implant with desirable mechanical and bioactivity properties is required. The aim of this review is to present the progress of the preparation methods for improvement of the bioactivity of PEEK and to discuss the strengths and weaknesses of the existing methods. PMID:27127513

  17. The Choice Between Total Hip Arthroplasty and Arthrodesis in Adolescent Patients: A Survey of Orthopedic Surgeons.

    PubMed

    Kelman, Mark G; Studdert, David M; Callaghan, John J; Farid, Monica S; Titan, Ashley L; Dietz, Frederick R

    2016-01-01

    For adolescent patients with end-stage hip disease, the choice between total hip arthroplasty (THA) and arthrodesis is complex; the clinical evidence is not definitive, and there are difficult trade-offs between clear short-term benefits from THA and uncertain long-term risks. We surveyed nearly 700 members of the Pediatric Orthopedic Society of North America and the American Association of Hip and Knee Surgeons. Respondents chose between a recommendation of THA or arthrodesis in four clinical vignettes. A clear majority of surgeons recommended THA in two of the vignettes, however opinion was somewhat divided in one vignette (overweight adolescent) and deeply divided in another (adolescent destined for manual labor job). Across all vignettes, recommendations varied systematically according to surgeons' age and their attitudes regarding tradeoffs between life stages. PMID:26298281

  18. 3D Bioprinting of Cartilage for Orthopedic Surgeons: Reading between the Lines.

    PubMed

    Di Bella, Claudia; Fosang, Amanda; Donati, Davide M; Wallace, Gordon G; Choong, Peter F M

    2015-01-01

    Chondral and osteochondral lesions represent one of the most challenging and frustrating scenarios for the orthopedic surgeon and for the patient. The lack of therapeutic strategies capable to reconstitute the function and structure of hyaline cartilage and to halt the progression toward osteoarthritis has brought clinicians and scientists together, to investigate the potential role of tissue engineering as a viable alternative to current treatment modalities. In particular, the role of bioprinting is emerging as an innovative technology that allows for the creation of organized 3D tissue constructs via a "layer-by-layer" deposition process. This process also has the capability to combine cells and biomaterials in an ordered and predetermined way. Here, we review the recent advances in cartilage bioprinting and we identify the current challenges and the directions for future developments in cartilage regeneration. PMID:26322314

  19. Micro/nanoscale mechanical and tribological characterization of SiC for orthopedic applications.

    PubMed

    Li, Xiaodong; Wang, Xinnan; Bondokov, Robert; Morris, Julie; An, Yuehuei H; Sudarshan, Tangali S

    2005-02-15

    Micro/nanomechanical and tribological characterization of SiC has been carried out. For comparison, measurements on SiC, CoCrMo, Ti-6Al-4V, and stainless steel have also been made. Hardness and elastic modulus of these materials were measured by nanoindentation using a nanoindenter. The nanoindentation impressions were imaged using an atomic force microscope (AFM). Scratch, friction, and wear properties were measured using an accelerated microtribometer. Scratch and wear damages were studied using a scanning electron microscope (SEM). It is found that SiC exhibits higher hardness, elastic modulus, scratch resistance as well as lower friction with fewer and smaller debris particles compared to other materials. These results show that SiC possesses superior mechanical and tribological properties that make it an ideal material for use in orthopedic and other biomedical applications. PMID:15538716

  20. In-111-labeled leukocyte scintigraphy in suspected orthopedic prosthesis infection: comparison with other imaging modalities

    SciTech Connect

    Magnuson, J.E.; Brown, M.L.; Hauser, M.F.; Berquist, T.H.; Fitzgerald, R.H. Jr.; Klee, G.G.

    1988-07-01

    When infection of prosthetic orthopedic implants is suspected, optimal management requires accurate confirmation or exclusion of infection. The authors retrospectively studied 98 patients with possible infection who underwent scanning with indium-111-labeled white blood cells (WBCs) and subsequently underwent surgery within 14 days. At surgery, 50 patients had infections, as determined by means of culture or histologic results. The diagnostic accuracy of In-111 scanning was compared with that of plain radiography, arthrography, three-phase bone scanning, and various clinical and laboratory findings classically associated with infection. Positive findings on In-111 WBC scans and elevated erythrocyte sedimentation rates were found to be the most predictive variables in the diagnosis of septic prostheses (P less than or equal to .001 and P less than or equal to .002, respectively). Likelihood ratio analysis more clearly demonstrated the superiority of In-111 WBC scanning, with positive and negative scans yielding likelihood ratios of 5.0 and 0.16, respectively.

  1. Quaternized Chitosan as an Antimicrobial Agent: Antimicrobial Activity, Mechanism of Action and Biomedical Applications in Orthopedics

    PubMed Central

    Tan, Honglue; Ma, Rui; Lin, Chucheng; Liu, Ziwei; Tang, Tingting

    2013-01-01

    Chitosan (CS) is a linear polysaccharide with good biodegradability, biocompatibility and antimicrobial activity, which makes it potentially useful for biomedical applications, including an antimicrobial agent either alone or blended with other polymers. However, the poor solubility of CS in most solvents at neutral or high pH substantially limits its use. Quaternary ammonium CS, which was prepared by introducing a quaternary ammonium group on a dissociative hydroxyl group or amino group of the CS, exhibited improved water solubility and stronger antibacterial activity relative to CS over an entire range of pH values; thus, this quaternary modification increases the potential biomedical applications of CS in the field of anti-infection. This review discusses the current findings on the antimicrobial properties of quaternized CS synthesized using different methods and the mechanisms of its antimicrobial actions. The potential antimicrobial applications in the orthopedic field and perspectives regarding future studies in this field are also considered. PMID:23325051

  2. Wear Properties of Porous NiTi Orthopedic Shape Memory Alloy

    NASA Astrophysics Data System (ADS)

    Wu, Shuilin; Liu, Xiangmei; Yeung, K. W. K.; Xu, Z. S.; Chung, C. Y.; Chu, Paul K.

    2012-12-01

    Porous NiTi shape memory alloy (SMA) scaffolds have great potential to be used as orthopedic implants because of their porous structure and superior physical properties. Its metallic nature provides it with better mechanical properties and Young's modulus close to that of natural bones. Besides allowing tissue ingrowth and transfer of nutrients, porous SMA possesses unique pseudoelastic properties compatible to natural hard tissues like bones and tendons, thus expediting in vivo osseointegration. However, the nickel release from debris and the metal surface may cause osteocytic osteolysis at the interface between the artificial implants and bone tissues. Subsequent mobilization may finally lead to implant failure. In this study, the wear properties of porous NiTi with different porosities processed at different treatment temperatures are determined. The results of the study show that the porosity, phase transformation temperature, and annealing temperature are major factors influencing the wear characteristics of porous NiTi SMA.

  3. [Orthopedic hippotherapy--new methods in treatment of segmental instabilities of the lumbar spine].

    PubMed

    Rothhaupt, D; Ziegler, H; Laser, T

    1997-01-01

    The orthopedic hippotherapy represents a new form of therapeutic exercise in the conservative treatment of segmental instabilities in the lumbar spine region. This kind of therapy works on the principle of conveying to the patient the three-dimensional swinging motion of the horse's back. The patient reacts to these movement impulses by moving up and down (vertical movement of the spine), back and forth (sagittal movement) and to the right and the left (horizontal movement). The small movements of the spine thus produced bring about a mobilization of the segments involved in movement and therefore eliminate articular hypomobilities. Moreover, the short monosegmental muscles of the back are subjected to an excentric training which leads to a muscular stabilization of segmental hypermobilities. Due to the varying pressure load during the riding exercise the trophic conditions of the active and passive structures of the spine are improved. PMID:9487617

  4. Fabrication aspects of PLA-CaP/PLGA-CaP composites for orthopedic applications: a review.

    PubMed

    Zhou, Huan; Lawrence, Joseph G; Bhaduri, Sarit B

    2012-07-01

    For several decades, composites made of polylactic acid-calcium phosphates (PLA-CaP) and polylactic acid-co-glycolic acid-calcium phosphates (PLGA-CaP) have seen widespread uses in orthopedic applications. This paper reviews the fabrication aspects of these composites, following the ubiquitous materials science approach by studying "processing-structure-property" correlations. Various fabrication processes such as microencapsulation, phase separation, electrospinning, supercritical gas foaming, etc., are reviewed, with specific examples of their applications in fabricating these composites. The effect of the incorporation of CaP materials on the mechanical and biological performance of PLA/PLGA is addressed. In addition, this paper describes the state of the art on challenges and innovations concerning CaP dispersion, incorporation of biomolecules/stem cells and long-term degradation of the composites. PMID:22342596

  5. Role of Sonication in the Microbiological Diagnosis of Implant-Associated Infections: Beyond the Orthopedic Prosthesis.

    PubMed

    Oliva, Alessandra; Pavone, Paola; D'Abramo, Alessandra; Iannetta, Marco; Mastroianni, Claudio Maria; Vullo, Vincenzo

    2016-01-01

    Implant-associated infections are difficult-to-treat conditions associated with high morbidity, mortality and length of hospitalization. They are characterized by biofilm formation on implant surface, which makes the microbiological diagnosis difficult and requires a complete device removal for the correct management. The sonication method, which is based on the application of long-wave ultrasounds radiating in a liquid medium, has been recently validated for the diagnosis of prosthetic joint infections. Additionally, this technique has been considered a potential tool in order to improve the microbiological diagnosis of infections associated with other foreign bodies, such as breast, urinary, endovascular and cerebral implants. In the present study, the application of sonication in the setting of implant-associated infections other than orthopedics will be reviewed. PMID:26566645

  6. Ion beam sputter etching of orthopedic implanted alloy MP35N and resulting effects on fatigue

    NASA Technical Reports Server (NTRS)

    Wintucky, E. G.; Christopher, M.; Bahnuik, E.; Wang, S.

    1981-01-01

    The effects of two types of argon ion sputter etched surface structures on the tensile stress fatigue properties of orthopedic implant alloy MP35N were investigated. One surface structure was a natural texture resulting from direct bombardment by 1 keV argon ions. The other structure was a pattern of square holes milled into the surface by a 1 keV argon ion beam through a Ni screen mask. The etched surfaces were subjected to tensile stress only in fatigue tests designed to simulate the cyclic load conditions experienced by the stems of artificial hip joint implants. Both types of sputter etched surface structures were found to reduce the fatigue strength below that of smooth surface MP35N.

  7. X-rays as evidence in German orthopedic surgery, 1895-1900.

    PubMed

    Warwick, Andrew

    2005-03-01

    Historians have found it difficult to give a general account of the early medical use of X-rays in medicine. While the rays were hailed by some as a miracle technology, their early medical application was patchy, often remaining subsidiary to traditional methods of diagnosis and treatment, and was of disputed value. In this essay, I argue that the selective appropriation of the new technology needs to be understood within the wider medical practice of the period. The argument is developed around the case of orthopedic surgery in Germany, probably the first example in which doctors quickly made X-rays indispensable as a medical tool. I show that value of X-rays in this case was contingent upon an ongoing dispute, the theory and practice of surgical intervention, and the sociology of new surgical knowledge. PMID:16114797

  8. Therapeutic approach to Class II, Division 1 malocclusion with maxillary functional orthopedics

    PubMed Central

    de Bittencourt, Aristeu Corrêa; Saga, Armando Yukio; Pacheco, Ariel Adriano Reyes; Tanaka, Orlando

    2015-01-01

    INTRODUCTION: Interceptive treatment of Class II, Division 1 malocclusion is a challenge orthodontists commonly face due to the different growth patterns they come across and the different treatment strategies they have available. OBJECTIVE: To report five cases of interceptive orthodontics performed with the aid of Klammt's elastic open activator (KEOA) to treat Class II, Division 1 malocclusion. METHODS: Treatment comprehends one or two phases; and the use of functional orthopedic appliances, whenever properly recommended, is able to minimize dentoskeletal discrepancies with consequent improvement in facial esthetics during the first stage of mixed dentition. The triad of diagnosis, correct appliance manufacture and patient's compliance is imperative to allow KEOA to contribute to Class II malocclusion treatment. RESULTS: Cases reported herein showed significant improvement in skeletal, dental and profile aspects, as evinced by cephalometric analysis and clinical photographs taken before, during and after interceptive orthodontics. PMID:26352852

  9. Reconfigurable mobile manipulation for accident response

    SciTech Connect

    ANDERSON,ROBERT J.; MORSE,WILLIAM D.; SHIREY,DAVID L.; CDEBACA,DANIEL M.; HOFFMAN JR.,JOHN P.; LUCY,WILLIAM E.

    2000-06-06

    The need for a telerobotic vehicle with hazard sensing and integral manipulation capabilities has been identified for use in transportation accidents where nuclear weapons are involved. The Accident Response Mobile Manipulation System (ARMMS) platform has been developed to provide remote dexterous manipulation and hazard sensing for the Accident Response Group (ARG) at Sandia National Laboratories. The ARMMS' mobility platform is a military HMMWV [High Mobility Multipurpose Wheeled Vehicle] that is teleoperated over RF or Fiber Optic communication channels. ARMMS is equipped with two high strength Schilling Titan II manipulators and a suite of hazardous gas and radiation sensors. Recently, a modular telerobotic control architecture call SMART (Sandia Modular Architecture for Robotic and Teleoperation) has been applied to ARMMS. SMART enables input devices and many system behaviors to be rapidly configured in the field for specific mission needs. This paper summarizes current SMART developments applied to ARMMS.

  10. 75 FR 67657 - Prohibition of Market Manipulation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-03

    ... Manipulation, 71 FR 4244, 4253 (Jan. 26, 2006) (`` inal rule prohibits the use or employment of any device... indeed is easier to follow than a standard that requires the exercise of judgment in the light of all...

  11. Optoelectronic Tweezers for Microparticle and Cell Manipulation

    NASA Technical Reports Server (NTRS)

    Wu, Ming Chiang (Inventor); Chiou, Pei-Yu (Inventor); Ohta, Aaron T. (Inventor)

    2014-01-01

    An optical image-driven light induced dielectrophoresis (DEP) apparatus and method are described which provide for the manipulation of particles or cells with a diameter on the order of 100 micromillimeters or less. The apparatus is referred to as optoelectric tweezers (OET) and provides a number of advantages over conventional optical tweezers, in particular the ability to perform operations in parallel and over a large area without damage to living cells. The OET device generally comprises a planar liquid-filled structure having one or more portions which are photoconductive to convert incoming light to a change in the electric field pattern. The light patterns are dynamically generated to provide a number of manipulation structures that can manipulate single particles and cells or group of particles/cells. The OET preferably includes a microscopic imaging means to provide feedback for the optical manipulation, such as detecting position and characteristics wherein the light patterns are modulated accordingly.

  12. Optoelectronic tweezers for microparticle and cell manipulation

    NASA Technical Reports Server (NTRS)

    Wu, Ming Chiang (Inventor); Chiou, Pei Yu (Inventor); Ohta, Aaron T. (Inventor)

    2009-01-01

    An optical image-driven light induced dielectrophoresis (DEP) apparatus and method are described which provide for the manipulation of particles or cells with a diameter on the order of 100 .mu.m or less. The apparatus is referred to as optoelectric tweezers (OET) and provides a number of advantages over conventional optical tweezers, in particular the ability to perform operations in parallel and over a large area without damage to living cells. The OET device generally comprises a planar liquid-filled structure having one or more portions which are photoconductive to convert incoming light to a change in the electric field pattern. The light patterns are dynamically generated to provide a number of manipulation structures that can manipulate single particles and cells or groups of particles/cells. The OET preferably includes a microscopic imaging means to provide feedback for the optical manipulation, such as detecting position and characteristics wherein the light patterns are modulated accordingly.

  13. Tension Stiffened and Tendon Actuated Manipulator

    NASA Technical Reports Server (NTRS)

    Doggett, William R. (Inventor); Dorsey, John T. (Inventor); Ganoe, George G. (Inventor); King, Bruce D. (Inventor); Jones, Thomas C. (Inventor); Mercer, Charles D. (Inventor); Corbin, Cole K. (Inventor)

    2015-01-01

    A tension stiffened and tendon actuated manipulator is provided performing robotic-like movements when acquiring a payload. The manipulator design can be adapted for use in-space, lunar or other planetary installations as it is readily configurable for acquiring and precisely manipulating a payload in both a zero-g environment and in an environment with a gravity field. The manipulator includes a plurality of link arms, a hinge connecting adjacent link arms together to allow the adjacent link arms to rotate relative to each other and a cable actuation and tensioning system provided between adjacent link arms. The cable actuation and tensioning system includes a spreader arm and a plurality of driven and non-driven elements attached to the link arms and the spreader arm. At least one cable is routed around the driven and non-driven elements for actuating the hinge.

  14. Simulator for training remote-manipulator operators

    NASA Technical Reports Server (NTRS)

    Orr, D. H.; Ward, L. C.

    1979-01-01

    Six-degree-of-freedom simulator uses economical components. Reduction in complexity makes this or similar system cost-effective for training manipulator operators, such as those in industries handling nuclear wastes and hazardous chemicals.

  15. The Frankfurt School's Theory of Manipulation

    ERIC Educational Resources Information Center

    Petryszak, Nicholas

    1977-01-01

    Discusses the critical sociology of communication of the Frankfurt School suggesting that theorists such as Lowenthal, Adorno, and Habermas have outlined both the political economics of manipulation and the social psychological interaction between the audience and the media. (MH)

  16. Manipulator path planning in 3-dimensional space

    NASA Astrophysics Data System (ADS)

    Pavlov, Dmitry A.

    2006-04-01

    Present paper is aimed to work out efficient algorithm of multi-chain manipulator path planning in 3D space with static polygonal obstacles. The resulting solution is based on navigational maps approach. Using this approach, manipulator features are considered as intellectual agent, and reachability information is stored in compact form. This enables fast adaptation to arbitrary parameters of manipulator and workspace. The paper describes two algorithms: (i) a local walkthrough with obstacle avoidance, and (ii) incremental navigational map building, performed at running stage. Both algorithms take an extensive use of the specific features of the task. Working simultaneously, they allow real-time manipulator path planning, as well as self-learning in idle mode. Algorithms are implemented as a demonstration program.

  17. Clinical and Cost Implications of Inpatient Versus Outpatient Orthopedic Surgeries: A Systematic Review of the Published Literature

    PubMed Central

    Crawford, Dennis C.; Sprague, Sheila; Bhandari, Mohit

    2015-01-01

    The number of outpatient orthopedic surgeries performed within North America continues to increase. The impact of this change in services on patient outcomes is largely unknown. The objective of this review is to compare patient outcomes and associated costs for outpatient orthopedic surgeries traditionally performed in hospital to inpatient surgeries, as well as to summarize the eligibility and preoperative education requirements for outpatient orthopedic surgery in North America. We performed a systematic review of Medline, Pubmed and Embase databases for articles comparing the clinical and economic impact of outpatient orthopedic surgical procedures versus inpatient procedures in North America. We reported on requirements for inpatient versus outpatient care, preoperative education requirements, complications and patient outcomes, patient satisfaction, and when available total mean costs. Nine studies met the inclusion criteria for this review. Eligibility requirements for outpatient orthopedic surgery within the included studies varied, but generally included: patient consent, a caregiver at home following surgery, close proximity to an outpatient center, and no history of serious medical problems. Preoperative education programs were not always compulsory and practices varied between outpatient centers. All of the reviewed studies reported that outpatient surgeries had similar or improved level of pain and rates of nausea. Outpatients reported increased satisfaction with the care they received. As expected, outpatient procedures were less expensive than inpatient procedures. This review found that outpatient procedures in North America appear to be less expensive and safe alternatives to inpatient care for patients who are at lower risk for complications and procedures that do not necessarily require close hospital level care monitoring following same day surgery. PMID:26793295

  18. Hybrid Image-Plane/Stereo Manipulation

    NASA Technical Reports Server (NTRS)

    Baumgartner, Eric; Robinson, Matthew

    2004-01-01

    Hybrid Image-Plane/Stereo (HIPS) manipulation is a method of processing image data, and of controlling a robotic manipulator arm in response to the data, that enables the manipulator arm to place an end-effector (an instrument or tool) precisely with respect to a target (see figure). Unlike other stereoscopic machine-vision-based methods of controlling robots, this method is robust in the face of calibration errors and changes in calibration during operation. In this method, a stereoscopic pair of cameras on the robot first acquires images of the manipulator at a set of predefined poses. The image data are processed to obtain image-plane coordinates of known visible features of the end-effector. Next, there is computed an initial calibration in the form of a mapping between (1) the image-plane coordinates and (2) the nominal three-dimensional coordinates of the noted end-effector features in a reference frame fixed to the main robot body at the base of the manipulator. The nominal three-dimensional coordinates are obtained by use of the nominal forward kinematics of the manipulator arm that is, calculated by use of the currently measured manipulator joint angles and previously measured lengths of manipulator arm segments under the assumption that the arm segments are rigid, that the arm lengths are constant, and that there is no backlash. It is understood from the outset that these nominal three-dimensional coordinates are likely to contain possibly significant calibration errors, but the effects of the errors are progressively reduced, as described next. As the end-effector is moved toward the target, the calibration is updated repeatedly by use of data from newly acquired images of the end-effector and of the corresponding nominal coordinates in the manipulator reference frame. By use of the updated calibration, the coordinates of the target are computed in manipulator-reference-frame coordinates and then used to the necessary manipulator joint angles to position

  19. High-strength, surface-porous polyether-ether-ketone for load-bearing orthopedic implants.

    PubMed

    Evans, Nathan T; Torstrick, F Brennan; Lee, Christopher S D; Dupont, Kenneth M; Safranski, David L; Chang, W Allen; Macedo, Annie E; Lin, Angela S P; Boothby, Jennifer M; Whittingslow, Daniel C; Carson, Robert A; Guldberg, Robert E; Gall, Ken

    2015-02-01

    Despite its widespread clinical use in load-bearing orthopedic implants, polyether-ether-ketone (PEEK) is often associated with poor osseointegration. In this study, a surface-porous PEEK material (PEEK-SP) was created using a melt extrusion technique. The porous layer was 399.6±63.3 μm thick and possessed a mean pore size of 279.9±31.6 μm, strut spacing of 186.8±55.5 μm, porosity of 67.3±3.1% and interconnectivity of 99.9±0.1%. Monotonic tensile tests showed that PEEK-SP preserved 73.9% of the strength (71.06±2.17 MPa) and 73.4% of the elastic modulus (2.45±0.31 GPa) of as-received, injection-molded PEEK. PEEK-SP further demonstrated a fatigue strength of 60.0 MPa at one million cycles, preserving 73.4% of the fatigue resistance of injection-molded PEEK. Interfacial shear testing showed the pore layer shear strength to be 23.96±2.26 MPa. An osseointegration model in the rat revealed substantial bone formation within the pore layer at 6 and 12 weeks via microcomputed tomography and histological evaluation. Ingrown bone was more closely apposed to the pore wall and fibrous tissue growth was reduced in PEEK-SP when compared to non-porous PEEK controls. These results indicate that PEEK-SP could provide improved osseointegration while maintaining the structural integrity necessary for load-bearing orthopedic applications. PMID:25463499

  20. High-strength poly(para-phenylene) as an orthopedic biomaterial.

    PubMed

    Frick, Carl P; DiRienzo, Amy L; Hoyt, Anthony J; Safranski, David L; Saed, Mohand; Losty, Eric J; Yakacki, Christopher M

    2014-09-01

    Poly(para-phenylene) (PPP) exhibits exceptional mechanical strength, stiffness, toughness, and chemical inertness, although it is not currently used in any biomedical applications. The purpose of this study is to serve as a preliminary investigation into the potential of PPP as a biomaterial in orthopedic load-bearing applications. Nuclear magnetic resonance (NMR) analysis confirmed a polymer structure composed of an aromatic backbone and side groups. Tensile PPP specimens along with samples from several other polymers often used for orthopedic applications were elongated to failure after being soaked in phosphate buffered saline (PBS) for 1 h, 1 day, 1 week, 2 weeks, 1 month, and more than 1 year. Results showed that PBS absorption of the PPP plateaued at 1 week at values of ∼0.7 wt % and remained within one standard deviation when soaked for over 1 year. PBS absorption did not affect elastic modulus (5.0 GPa), yield strength (141 MPa), fracture strength (120 MPa) and strain-to-failure (17%) more than one standard deviation. Zero-to-tension fatigue testing established an endurance limit of approximately 35 MPa, which was relatively insensitive to frequency (1-10 Hz). Eagle's minimum essential medium (MEM) elution assay with fibroblasts confirmed that the PPP was noncytotoxic. Relative to other polymers used for load-bearing biomedical applications, PPP displays promising mechanical properties that remain stable in aqueous solution. Lastly, prototype PPP and polyetheretherketone (PEEK) bone plates were manufactured and tested, with the PPP plate showing a 38% higher maximum tensile load before failure. PMID:24123879