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Go to Editorial ManagerRecently, three-dimensional models 3DM in the prosthetics field gained popularity, especially in the context of residual limb shape creation resulting from collecting medical images in Digital Imaging and Communications in Medicine DICOM format from a magnetic resonance imaging MRI after image processing accurately. In this study, a three-dimensional model of the residual limb for a patient with transtibial amputation was realized with the integration of artificial intelligence and a computer vision approach demonstrating the benefits of AI segmentation tools and artificial algorithms to generate higher accuracy three-dimensional model before prosthetic socket design or in case of comparison the 3D model generated from MRI with another 3D model generated from another technique, where a residual limb of a 23 years old male patient with amputation in the left leg wearing a prosthetic socket liner, and having 62 kg weight, 168 cm height, with high activity level. The patient was scanned using GE Medical Systems, 1,5 Tesla Signa Excite. MRI images in DICOM format were read to retrieve essential metadata such as pixel spacing and slice thickness. These images were processed to obtain a model that reflects the real shape of the residual limb using a specific algorithm, and the 3D model was extracted using AI segmentation tools. The obtained 3D model result with high resolution proves the potential of the artificial intelligence approach with deep learning to reconstruct 3D models concluding that AI has an instrumental role in medical image analysis, particularly in the areas of organ and tissue classification and segmentation., thus generating automatic and repetitive a 3D model.
Additionally, it has been demonstrated that osseointegrated implantation offers superior proprioception and control over the prosthesis, enabling more natural movement and improved functional results. Additionally, it lowers the chance of falling and increases energy transfer efficiency, making it simpler for amputees to engage in physical activity. Furthermore, as compared to conventional socket prosthesis attachment, osseointegrated implantation has been linked to higher patient satisfaction and quality of life._x000D_ It is crucial to remember that osseointegration is a surgical operation with risks including infection and implant failure. Additionally, for effective implantation, it needs a specific amount and quality of bone, which may restrict its usage in some individuals. Furthermore, osseointegrated implantation could be more expensive than conventional socket prosthetics._x000D_ Understanding the efficacy and safety of this method requires research on complication rates and outcome metrics in patients having osseointegrated prosthesis implantation. You may acquire information on things like infection rates, implant failure, patient satisfaction, and functional results by studying original research papers. Clinical decision-making can then be improved with the use of this information._x000D_ In transfemoral amputees, osseointegration has showed promise as a powerful substitute for socket prostheses. A growing corpus of research has shown that osseointegrated implantation provides advantages in terms of increasing mobility, decreasing discomfort, and improving general quality of life. The efficiency of osseointegration for transtibial and upper extremity implants has received little attention._x000D_ Minor soft tissue infections are the most frequent consequences, although they are manageable with the right treatment and monitoring. To further reduce the risk of problems and improve the overall success of osseointegrated implantation, research and development are ongoingly focused on enhancing surgical methods and implant design._x000D_ Although osseointegration has a lot of potential, not all amputees may be good candidates for it. Considerations for osseointegrated implantation must take into consideration elements including the degree and nature of the amputation, the quality and density of the bone, and the desires of the patient.
ESAR feet are prosthetic feet with carbon fiber parts that store mechanical energy while standing and release it during propulsion. It is believed to reduce the metabolic energy needed for walking, and to promote the economy of walking. However, there is little scientific evidence to support this claim. This study aimed to compare the energy storage properties of two prosthetic feet made of carbon fiber using the P-Walk, G-Walk, and Podium devices developed for gait analysis, which is a systematic examination of human movement, enabling phasing, estimation of musculoskeletal performance, and determination of kinematic and motor parameters. The amount of energy was calculated for each of the feet using the load deflection test, and the results showed that the new artificial foot with an energy of 6.186 joules showed a great improvement in the results of the tests compared to the old artificial foot with an energy of 3.403 joules. The Podium device tests showed a significant improvement in walking patterns and pressure distribution after using a new foot. The pressure distribution became almost equal on both sides, and the angular deviation of COP decreased from -7 to 1.3 degrees. Ground reaction force vector tilt results also improved, with a body angle of 0 degrees and inclination varying slightly depending on the tibiofemoral angle for males. P-Walk results reveal left-sided static test pressure distribution, exposing amputees to osteoarthritis risk and revealing lack of confidence in prosthetic foot. After use the new prosthetic foot, amputees press more on right foot, indicating balance restoration. The G-Walk device shows the effectiveness of both healthy left and prosthetic foot when walking on an amputated right leg when use the new prosthetic foot. The amputated side's performance is similar to a healthy limb, with minimal difference and within normal limits. Walking cadence and speed values are within normal ranges, while stride length and step length are outside normal ranges for both sides. Obliquity results show a small difference in pelvic angles due to weak pelvic muscles, but these are close to standard values for prosthetic foot use. The amputee's opinions about the evaluation of the new prosthetic foot were good when using the T-score by 61.0 with a rate of 86.4%. It was a significant improvement compared to the old foot with an evaluation of 53.6 by 63.9%.
The mixing technique was applied in this study to enhance the strength performance of the cement. The addition of 3% by weight of hydroxyapatite (HA) nanoparticles were mixed with 97% polymethyl methacrylate (PMMA) acrylic polymer, which has a nano size to serve as the matrix material. The surface roughness and continuous porosity of the bone cement were found to be slightly increased by the incorporation of nanoparticles, which enhanced bone-implant osseointegration and ingrowth. Atomic force microscopy (AFM) analysis revealed that the addition of hydroxyapatite (HAp) nanoparticles resulted in a surface roughness value (Sa) of 16.25 nm, which is similar to that of natural bone. The energy-dispersive X-ray spectroscopy (EDS) mapping results discover precentor material and uniform distribution. The Sample exhibited promising results in the antibacterial test, showing efficacy against bacteria both with and without sterilization, confirming its antibacterial properties. The mechanical tests conducted on the sample, including tensile, compression, bending and Vickers hardness tests, yielded favorable results and indicated that the sample is suitable for its intended application. In the theoretical works the design of the bone, screw, and bone plate was conducted using SolidWorks, followed by an analysis using ANSYS under both axial and bending load conditions. The theoretical analysis revealed that the safety factor was less than 1 when an axial load of 13 N was applied and a bending load of 2 N was applied, indicating that the structure may not be able to withstand these loads safely. Under both ambient and physiologically relevant conditions in the human body, HA and PMMA have demonstrated to be excellent choices for enhancing the clinical performance of bone cement. This, in turn, can lead to increased longevity of implants, decreased patient risk, and lower healthcare costs
With the occurrence of pathological disorders in some people or aging, metabolic energy consumption begins significantly due to the weakness of the peripheral muscles and the increase in body fat with time, which aggravates the issues for this type of people, causing the rest hours extremely lengthy and consequently may produce heart or arterial diseases and elevate the mortality rate. Regarding the significance of the matter, this study examines a number of previous researches that featured several approaches to energy calculation and strategies for lowering energy consumption through the use of various external assistance devices, such as exosuits or exoskeletons, to assist people in carrying out their everyday tasks. And additionally discussed musculoskeletal simulation employs a variety of programs, especially OpenSim, which enables users to build models of musculoskeletal structures and produce dynamic movement simulations. According to the research findings, exoskeletons and other assistive technology can successfully lower the cost of metabolic energy to varying extents, depending on the device's weight, placement within the body, and whether it is active, semi-active, or inactive. In the future, the work to design and simulate a semi-active torsional ankle-foot exoskeleton with a specialized mechanism aimed to minimize metabolic energy.
Nowadays, robotic exoskeletons demonstrated great abilities to replace traditional rehabilitation processes for activating neural abilities performed by physiotherapists. The main aim of this review study is to determine a state-of-the-art robotic exoskeleton that can be used for the rehabilitation of the lower limb of people who have mobile disabilities as a result of stroke and musculoskeletal conditions. The study presented the anatomy of the lower limb and the biomechanics of human gait to explain the mechanism of the limb, which helps in constructing a robotic exoskeleton. A state-of-the-art review of more than 100 articles related to robotic exoskeletons and their constructions, functionality, and rehabilitation capabilities are accurately implemented. Moreover, the study included a review of upper limb rehabilitation that has been studied locally and successfully applied to patients who exhibited significant improvements. Results of recent studies herald an abundant future for robotic exoskeletons used in the rehabilitation of the lower extremity. Significant improvement in the mechanism and design, as well as the quality, were observed. Also, impressive results were obtained from the performance when used by patients. This study concludes that working and improving the robotic devices continuously in accordance with the cases are necessary to be treated with the best results and the lowest cost.
This study compares two different sockets, traditional and smart. It includes designs, manufacturing, and testing to evaluate the influence of the socket designs on gait symmetry. The proposed materials are locally available in the prosthetics center where traditional sockets are manufactured. and smart socket designs with the same materials as traditional additions. A simple electronic system programmed to control the movement of the stump by pneumatic pads and prevent slipping during movement is considered an advanced suspension system. A gait cycle test was carried out to evaluate the sockets. it was performed on a patient with AK amputation in two cases: the first when the patient was wearing the traditional and the second when wearing the smart. Where the difference in (gait cycle time, step velocity, heel contact, and mid-stance) between the left and right leg is equal to (0.54, 4.3, 0.19, and 0.34) respectively, when the patient uses the traditional, while these values reduce to (0.09, 0.7, 0.07, and 0.27) respectively when the patient used the smart, it improves comfort by modifying pressure distribution, relieving pressure points, and enhancing functionality through gait analysis. They adjust to the volume of the residual limb, ensuring an effective fit. Real-time monitoring and remote modifications decrease the need for in-person meetings and enhance user confidence. The smart socket, designed to fit user requirements, provides enhanced comfort, functionality, and independence. The studies will explore its long-term benefits and broader applications, focusing on its originality, practical implications, and outcome measurement.
This article is about studying the placing direction effect of a piezoelectric sensor on the shoe insole in the GRF results. Where the sensors used in this research are in two directions, along and perpendicular to the foot midline. In the both cases the sensors were fixed on the shoe insole to sense the foot pressure. For the first set of sensors which are perpendicular to the foot midline the collected data has similar trend to the GRF collected from the force plate, as the small lateral strain in the shoe insole due to the patient weight and GRF is close to the GRF data collected from other measurement system. On the other hand, the collected data from the second set of sensors which are in a longitudinal direction with the foot midline will have different trend and values from the collected data from the force plate or any other GRF measurement system. This different in the results is due to the large longitudinal strain in the shoe insole due to the patient weight which produce dissimilar results from the force plate result data.
The purpose of this research is to manufacture and test adjustable sockets for below-knee amputation. This article studies using the pnuematic–pads for adjustable sockets. The manufacturing of an adjustable socket with pneumatic pads goes through several stages: In the theoretical design of the adjustable socket, the suggested materials were studied for the pneumatic pads, tubes, and pneumatic pump which should be suitable for the suggested application. In the experimental work, using composite materials for manufacturing the socket consisting of perlon and resin to achieve the rigid shape and required flexibility for the prosthetic user with the pneumatic pads. After assembling the adjustable socket parts, the pneumatic pads, the pump and the tubes, the socket were tested for several times on the patient. In the last stage, the pressure between the socket and the residual limb was measured using F-socket, and it was found that the results were: anterior (160kPa), lateral (167kPa), posterior (153kPa) and medial (348kPa). By comparing these results with what was previously studied, the pressure between the socket and the residual limb is within the acceptable range. The design provides good suspension and more adaptability to the change in stump volume. A posative feedback was given by the patient who used the prosthetic patient for several days as a trial to measure its safety and comfortablty.
In this research, polymer polymethyl methacrylate PMMA composite with nano ceramic Zr and HAp material were used to manufacture one part of the implant system (femoral ball head of hip implant). Three set of hybrid materials were fabricated and tested for this study; the first mixtures which contains 100% (PMMA), the second mixtures which contains (90% (PMMA) + 8% (Zr) + 2% (HAp)), and the third mixtures which contains (80% (PMMA) + 18% (Zr) + 2% (HAp)) were investigated. The mechanical properties for these mixtures increased with the increasing of nano ceramic concentration (Zr and HAp) composite material in the polymer compared to pure polymer PMMA sample. However, an increase in the concentration of Zr from 8% to 18% content cause a considerable decrease of the hardness where a drop of homogeneity in Zr- matrix PMMA contact occurred, V Hardness value are (68 ,80 and 70) Kg.mm for three mixture respectively. The wear test was in agreement with results of the hardness test. The weight loss of the above samples of the wear test were (0.041, 0.035 and 0.037) respectively. According to mechanical properties, the best sample contains (90% (PMMA) + 8% (Zr) + 2% (HAp)). The Scanning electron microscopy resolute showed the particles forming semi-continuous network along grain boundaries polymer for second sample mixtures containing (90% (PMMA) + 8% (Zr) + 2% (HAp)), provides a low atomic packing and high energy. This will make the grain boundaries more reactive and strengthen mechanical performance. The Optical microscopy, Scanning electron microscopy and Xray spectroscopy analysis for In vitro test using SBF shows the growth of HAp layer with an increase in concentration of Ca and P elements formed on the surface of the second sample. This display of good results is a proof of the biocompatibility of the polymer sample.
Gait analysis can be described as a field of biomechanical engineering dealing with the subject of human locomotion. This study aimed to identify the effect of Ilizarov on gait when the presence the above-knee prosthesis. The study was made on a 50-year-old male patient was underwent correction right tibia with Ilizarov fixation due to war accident in July 2012. Also, this accident led to trans-femoral amputation. Two-dimensional gait system of a synchronized 25 Hz camera with an AMTI force platform was use for measuring gait kinematics and kinetics data while walking at a self-selected speed. These data can be used as standard measures in pathology studies, as input to theoretical joint models, and as input to mechanical joint simulators treated with Ilizarov and prosthetics.