Mesh : Humans Female Prosthesis Implantation Artificial Limbs Amputation, Surgical Leg / surgery Osseointegration Prosthesis Design

来  源:   DOI:10.1097/PXR.0000000000000182

Abstract:
BACKGROUND: Although there have been a number of studies exploring the impact and efficacy of transfemoral prosthetic components such as knee and foot mechanisms, the empirical evidence surrounding transfemoral prosthetic interface considerations is limited. This constitutes a substantial void for practicing clinicians seeking to apply best practices for patients who use transfemoral prostheses. Recent years have seen increased production and availability of clinical practice guidelines germane to prosthetic rehabilitation. In those areas where empirical evidence is lacking, consensus clinical opinions may constitute the highest level of evidence.
OBJECTIVE: A consensus exercise was performed to generate clinical practice recommendations in the areas of transfemoral interface considerations including socket variations and critical design features, suspension and interface considerations, alignment, heat retention and dermatologic considerations, female considerations, surgical considerations, and both regulatory and ethical considerations related to osseointegration.
METHODS: This began with the generation of postulate items through systematic and narrative literature reviews. A Delphi consensus exercise was performed among clinical experts in government hospital and private clinical practice settings, culminating in a series of clinical practice recommendations associated with the prosthesis-limb interface for individuals with transfemoral amputation.
RESULTS: The completed recommendations include guidance statements relative to socket variations and critical design features, female considerations, suspension and interface considerations, surgical variations and prescription considerations, rehabilitation team considerations and both regulatory and ethical considerations related to osseointegration.
CONCLUSIONS: The Delphi process facilitated the development of practice guidelines for transfemoral prosthetic interface considerations based on aggregated subject matter expertise.
摘要:
背景:尽管已经有许多研究探索了诸如膝盖和脚机制之类的经股骨假体组件的影响和功效,围绕经股假体接口考虑的经验证据是有限的。对于寻求为使用经股假体的患者应用最佳实践的执业临床医生而言,这构成了很大的空白。近年来,与假肢康复密切相关的临床实践指南的产量和可用性有所增加。在那些缺乏经验证据的领域,共识的临床意见可能构成最高水平的证据。
目的:进行了一项共识练习,以在经股动脉接口考虑方面产生临床实践建议,包括窝变化和关键设计特征,悬挂和接口注意事项,对齐,保温和皮肤病学的考虑,女性考虑,手术考虑,以及与骨整合相关的监管和伦理考虑。
方法:这始于通过系统和叙述性文献综述生成假设项目。在政府医院和私人临床实践机构的临床专家中进行了德尔菲共识练习,最终提出了一系列与经股截肢患者的假肢-肢体界面相关的临床实践建议。
结果:完成的建议包括有关插座变化和关键设计特征的指导声明,女性考虑,悬挂和接口注意事项,手术变化和处方考虑,康复团队的考虑以及与骨整合相关的监管和道德考虑。
结论:Delphi过程促进了基于综合主题专业知识的经股假体接口注意事项的实践指南的制定。
公众号