Prosthesis

假体
  • 文章类型: Case Reports
    在因以下一种或多种事件而失去眼睛的患者中,比如手术,创伤,肿瘤,或出生时的眼睛缺陷,眼假体在恢复眼睛外观和社交外观中起着非常重要的作用。此病例报告重点介绍了在患有眼睛缺陷的患者中成功安装和制造定制的眼部假体。假体的制造过程涉及仔细评估和制造,涉及一系列步骤以实现成功的假体。定制的假肢保证了出色的美学匹配,更舒适,增加了病人的信心,从而获得更好的生活质量。
    In patients who have lost their eye due to one or many of the following events, such as surgery, trauma, tumors, or birth eye defects, ocular prostheses play a very vital role in the recovery of their eye appearance and social appearance. This case report highlights the successful fitting and fabrication of a custom-made ocular prosthesis in a patient with an eye defect. The manufacturing process of the prostheses involved careful evaluation and fabrication involving a series of steps to achieve a successful prosthesis. A customized prosthesis guarantees excellent esthetic matching, more comfort, and increased patient confidence, thereby a better quality of life.
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  • 文章类型: Case Reports
    人们失去牙齿的最常见原因是外伤,龋齿,发育缺陷,和遗传异常。由于能够通过骨整合恢复功能,牙科植入物已成为传统假牙和牙桥的流行替代品。该病例报告介绍了一名35岁的男性,由于龋齿而有两年的右下磨牙缺失史。没有系统性健康问题或有害习惯,经过全面评估和锥形束计算机断层扫描(CBCT)分析后,患者接受了种植牙.一个平行的侧面,螺纹植入物放置在46区域。术后护理包括抗生素,镇痛药,和后续访问。做了第二阶段的手术,其次是印模制作和愈合基台放置。通过仔细的咬合验证,将最终的牙冠固定。患者表现出良好的愈合,并计划进行定期随访,以确保成功的植入物整合和功能恢复。
    The most frequent reasons why people lose their teeth are trauma, dental caries, developmental defects, and genetic abnormalities. Dental implants have become a popular alternative to traditional dentures and bridges due to their ability to restore function through osseointegration. This case report presents a 35-year-old male with a two-year history of a missing lower right molar due to caries. With no systemic health issues or harmful habits, the patient underwent dental implant placement after a thorough evaluation and cone-beam computed tomography (CBCT) analysis. A parallel-sided, threaded implant was placed in the 46 region. Postoperative care included antibiotics, analgesics, and follow-up visits. Second-stage surgery was done, which was followed by impression-making and healing abutment placement. The final crown was cemented with careful occlusion verification. The patient exhibited excellent healing and was scheduled for regular follow-ups to ensure successful implant integration and function restoration.
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  • 文章类型: Journal Article
    背景:人工关节感染(PJI)是顽固性的,难以治疗的感染和关节置换术的严重并发症。因此,有必要开发新的有效治疗策略,和高临床相关性的动物模型是必需的。这项研究旨在为哥廷根小型猪的髋关节置换术制定详细的手术方案,并制定彻底的验尸采样方案,为创建小型猪PJI模型铺平道路。
    方法:三只成年雌性哥廷根小型猪接受了插入髋关节半髋关节置换术的手术,用髋关节前路.手术后,对小型猪进行每日临床评估和步态评分。进行全面的验尸分析,评估宏观病变,微生物学,滑液分析和组织学。
    结果:该研究导致了第一只哥廷根小型猪进行了髋关节半髋关节置换术,并确定了在小型猪中插入髋关节假体时的几个意识点,尤其是关节脱位的风险很高。一只小型猪发生了自发性PJI,显示免疫细胞到达骨-假体界面处的细菌的能力受损。
    结论:本研究提供了手术技术和死后采样的详细描述,并验证了人工髋关节置换小型猪模型在PJI未来实验建模中的适用性。
    BACKGROUND: Prosthetic joint infections (PJI) are recalcitrant, hard-to-treat infections and severe complications of joint arthroplasty. Therefore, there is a need to develop new effective treatment strategies, and animal models of high clinical relevance are needed. This study aimed to develop a detailed surgical protocol for hip hemiarthroplasty in Göttingen minipigs and a thorough post-mortem sampling protocol to pave the way for creating a minipig PJI model.
    METHODS: Three adult female Göttingen minipigs underwent surgery with insertion of a hip hemiarthroplasty, using the anterior approach to the hip joint. After surgery the minipigs were followed closely with daily clinical evaluation and gait scoring. Comprehensive post-mortem analyses were performed with evaluation of macroscopic lesions, microbiology, synovial fluid analysis and histology.
    RESULTS: The study resulted in the first Göttingen minipig with hip hemiarthroplasty and identified several points of awareness when inserting a hip prosthesis in minipigs, especially the high risk of joint dislocation. A spontaneous PJI occurred in one of the minipigs, revealing an impaired ability of the immune cells to reach the bacteria at the bone-prosthesis interface.
    CONCLUSIONS: The present study provides a detailed description of surgical technique and post-mortem sampling and validates the suitability of the hip hemiarthroplasty minipig model for future experimental modeling of PJI.
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  • 文章类型: Journal Article
    目前盆腔恶性肿瘤的主要治疗方法包括肿瘤切除后的半骨盆假体重建。在EnnekingII+III型骨盆肿瘤的病例中,假体需要固定在剩余的髂骨上。假体固定的常用方法包括鞍座假体,冰淇淋假体,模块化半骨盆假体,和使用三维打印的个性化假肢。为了防止半骨盆假体的失败,设计了一种新颖的固定方法,并进行了有限元分析。在临床病例中,第三个和第四个骶骨螺钉断裂,在有限元分析的结果中也观察到了这种现象。在原有手术模式的基础上,设计是为辅助背髂关节设计的,辅助髂底,辅助骶骨螺钉,和辅助耻骨支固定。然后在步态周期的最大载荷下进行了非线性准静态有限元分析,结果表明,辅助骶骨背侧固定显著降低了骶骨螺钉上的应力和超过28μm的相对微动。耻骨支的固定进一步增加了假体的初始稳定性及其界面骨整合能力。因此,对于半骨盆假体,合并耻骨支支撑和髂背固定是可取的,为半骨盆肿瘤假体的应用提供了新的选择。
    The current primary treatment approach for malignant pelvic tumors involves hemipelvic prosthesis reconstruction following tumor resection. In cases of Enneking type II + III pelvic tumors, the prosthesis necessitates fixation to the remaining iliac bone. Prevailing methods for prosthesis fixation include the saddle prosthesis, ice cream prosthesis, modular hemipelvic prosthesis, and personalized prosthetics using three-dimensional printing. To prevent failure of hemipelvic arthroplasty protheses, a novel fixation method was designed and finite element analysis was conducted. In clinical cases, the third and fourth sacral screws broke, a phenomenon also observed in the results of finite element analysis. Based on the original surgical model, designs were created for auxiliary dorsal iliac, auxiliary iliac bottom, auxiliary sacral screw, and auxiliary pubic ramus fixation. A nonlinear quasi-static finite element analysis was then performed under the maximum load of the gait cycle, and the results indicated that assisted sacral dorsal fixation significantly reduces stress on the sacral screws and relative micromotion exceeding 28 μm. The fixation of the pubic ramus further increased the initial stability of the prosthesis and its interface osseointegration ability. Therefore, for hemipelvic prostheses, incorporating pubic ramus support and iliac back fixation is advisable, as it provides new options for the application of hemipelvic tumor prostheses.
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  • 文章类型: Case Reports
    背景:人工血管吻合导致外渗和假性动脉瘤的创伤性损伤是罕见的。如果没有确定与这种情况相关的并发症可能导致高发病率和死亡率,需要手术治疗。
    方法:我们描述了一名患者,该患者在植入后八年在假体-假体吻合术中出现撕裂,导致假性动脉瘤。患者在无症状性渗漏之前有严重的跌倒。通过在血管和血管内外科进行新的吻合重新衬砌移植物,成功治疗了并发症。丹麦的Kolding医院。
    结论:推测撕裂的原因是由于重建部位的薄弱,织物降解,和/或缝合线材料的降解。
    结论:由创伤事件引起的晚期假体-假体吻合撕裂是罕见的。如果有迟来的眼泪,涉及材料的回忆和组织学分析很重要。
    BACKGROUND: Traumatic injury of a vascular prosthesis-to-prosthesis anastomosis leading to an extravasation and pseudoaneurysm is rare. If not identified the complications associated with this condition can lead to high morbidity and mortality and require surgical treatment.
    METHODS: We describe a patient who presented with a tear in prosthesis-prosthesis anastomosis eight years after implantation resulting in a pseudoaneurysm. The patient had a severe fall prior to the non-symptomatic leakage. The complication was successfully treated by re-lining the graft with a new anastomosis at the Department of Vascular and Endovascular Surgery, Kolding Hospital in Denmark.
    CONCLUSIONS: Cause of tear is speculated to be due to weakness at site of reconstruction, fabric degradation, and/or degradation of suture material.
    CONCLUSIONS: Late prosthesis-prosthesis anastomosis tear caused by a traumatic event is rare. In the event of a late tear, anamnesis and histological analysis of involved material is important.
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  • 文章类型: Journal Article
    背景:骨和关节感染是一个主要的公共卫生问题,因为它们的患病率越来越高,他们的功能预后和社会成本。噬菌体疗法对假体关节感染(PJI)具有有价值的抗生物膜特性。这项研究的目的是确定有资格接受噬菌体治疗的患者比例,并评估针对所有患有PJI的患者判断的临床结果。
    方法:。回顾性纳入了2015年至2019年在法国综合医院因假体周围感染(PJI)入院的患者。根据法国的建议确定噬菌体疗法的资格,多微生物感染作为排除标准。患者分为两组:符合条件的和不适合噬菌体治疗的。我们分析了它们的特点和结果,包括严重不良事件,静脉抗生素治疗的持续时间,住院时间,和复发率。
    结果:。在这项研究中,在多学科医学会议中考虑了96例PJI患者。其中,44%的患者(42/96)有资格接受额外的噬菌体疗法。这组患者的静脉治疗持续时间较长(17天vs.10天,p=0.02),更严重的不良事件(11vs.3,p=0.08),并且住院时间更长(43天vs.18天,p<0.01)。
    结论:。大量患者符合噬菌体疗法和治疗的资格标准,并且随访更加复杂。更大的流行病学研究将更准确地描述合格患者的预后。
    BACKGROUND: Bone and joint infections represent a major public health issue due to their increasing prevalence, their functional prognosis and their cost to society. Phage therapy has valuable anti-biofilm properties against prosthetic joint infections (PJI). The aim of this study was to establish the proportion of patients eligible for phage therapy and to assess their clinical outcome judged against all patients presenting with PJI.
    METHODS: . Patients admitted for periprosthetic joint infection (PJI) at a French general hospital between 2015 and 2019 were retrospectively included. Eligibility for phage therapy was determined based on French recommendations, with polymicrobial infections serving as exclusion criteria. Patients were categorized into two groups: those eligible and those ineligible for phage therapy. We analyzed their characteristics and outcomes, including severe adverse events, duration of intravenous antibiotic therapy, length of hospitalization, and relapse rates.
    RESULTS: . In this study, 96 patients with PJI were considered in multidisciplinary medical meetings. Of these, 44% patients (42/96) were eligible for additional phage therapy. This group of patients had a longer duration of intravenous therapy (17 days vs. 10 days, p = 0.02), more severe adverse events (11 vs. 3, p = 0.08) and had a longer hospital stay (43 days vs. 18 days, p < 0.01).
    CONCLUSIONS: . A large number of patients met eligibility criteria for phage therapy and treatment and follow-up is more complex. A larger epidemiological study would more accurately describe the prognosis of eligible patients.
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  • 文章类型: Journal Article
    具有sEMG的手部运动识别(HMR)对于人造&#xD;手部假体至关重要。HMR性能主要取决于馈送到分类器的特征信息。然而,sEMG通常会捕获诸如电力线&#xD;干扰(PLI)和运动伪影之类的噪声。这可能会提取冗余和无关紧要的特征信息,这会降低HMR性能并增加计算 复杂性。本研究旨在通过提出一种新颖的程序&#xD;来解决这些问题,该程序可自动从实验性sEMG信号中去除PLI和运动伪影。&#xD;这将使从信号中提取更好的特征并改善&#xD;各种手部动作的分类成为可能。利用经验模式分解和 能量熵阈值来选择用于去除伪影 的相关模式分量。然后使用时域特征来训练分类器(kNN,LDA,SVM) 用于手部运动分类,平均准确率达到92.36%,93.63%, 和98.12%,分别,跨主题。此外,肌肉收缩的努力被归类为低,中等,和使用这种技术的高级类别。验证是对来自十个受试者的数据进行的,这些受试者进行了八个手部运动课程和三个表面电极通道的三个肌肉收缩努力。结果表明 所提出的预处理使用SVM 分类器将平均准确率提高了9.55%,显著减少计算时间。
    Hand Movement Recognition (HMR) with sEMG is crucial for artificial hand prostheses. HMR performance mostly depends on the feature information that is fed to the classifiers. However, sEMG often captures noise like power line interference (PLI) and motion artifacts. This may extract redundant and insignificant feature information, which can degrade HMR performance and increase computational complexity. This study aims to address these issues by proposing a novel procedure for automatically removing PLI and motion artifacts from experimental sEMG signals. This will make it possible to extract better features from the signal and improve the categorization of various hand movements. Empirical mode decomposition and energy entropy thresholding are utilized to select relevant mode components for artifact removal. Time domain features are then used to train classifiers (kNN, LDA, SVM) for hand movement categorization, achieving average accuracies of 92.36%, 93.63%, and 98.12%, respectively, across subjects. Additionally, muscle contraction efforts are classified into low, medium, and high categories using this technique. Validation is performed on data from ten subjects performing eight hand movement classes and three muscle contraction efforts with three surface electrode channels. Results indicate that the proposed preprocessing improves average accuracy by 9.55% with the SVM classifier, significantly reducing computational time.
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  • 文章类型: Case Reports
    硅胶填充乳房植入物广泛用于乳房切除术后的隆胸和重建。然而,有一些已知的并发症与有机硅植入物相关:有机硅颗粒从植入物中泄漏和迁移导致肉芽肿反应。肉芽肿在乳腺MRI上可能表现为具有恶性肿瘤特征的肿块。我们介绍了一例巨大的乳房硅质瘤患者,该患者接受了乳房假体的重建,8年前因为破裂而手术切除.教学要点:尽管越来越有效的诊断工具,siliconoma诊断仍然具有挑战性。
    Silicone gel-filled breast implants are widely used for breast augmentation and reconstruction after mastectomy. However, there are some known complications associated with silicone implants: Leakage and migration of silicone particles from the implant cause a granulomatous reaction. Granulomas may present as masses with features of malignancy on breast MRI. We present a case of a giant breast siliconoma in a woman who had undergone reconstruction with breast prostheses, which were surgically removed because of rupture 8 years ago. Teaching point: Despite increasingly efficient diagnostic tools, siliconoma diagnosis remains challenging.
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  • 文章类型: Journal Article
    目的:目前尚不清楚泪液分泌减少是否会导致假眼患者的不适。迄今为止,仅使用Schirmer测试来测量泪液分泌,这可能会受到假体后面泪液汇集的影响。在这项研究中,已对泪腺进行了直接成像,以测量无眼窝的泪液分泌。还评估了睑板腺面积与干眼症状之间的关系。
    方法:纳入12例患者。通过泪腺的直接成像来测量泪液分泌量,同时使用睑板腺造影来确定睑板腺的存在。5项干眼问卷用于评估干眼症状。
    结果:无眼窝和对侧眼的泪液分泌无差异。在假眼一侧的眼睑中,睑板腺的面积显着减少,与对侧眼睛相比。7名患者报告了无眼眼窝干眼的症状,相比之下,对侧眼睛只有两个。
    结论:眼假体对睑板腺的影响可能会导致干眼的常见症状,尽管泪液分泌不受影响。
    OBJECTIVE: It is unclear whether a reduction in tear secretion contributes to the discomfort experienced by those with prosthetic eyes. Tear secretion has hitherto only been measured with the Schirmer test which may be affected by the pooling of tears behind the prosthesis. In this study, direct imaging of the lacrimal gland has been performed to measure tear secretion in anophthalmic sockets. The relation between the area of meibomian glands and dry eye symptoms was also assessed.
    METHODS: 12 patients were included. The amount of tear secretion was measured by direct imaging of the lacrimal gland while the presence of meibomian glands was determined using meibography. The 5-item Dry Eye Questionnaire was used to assess symptoms of dry eye.
    RESULTS: No difference was found in tear secretion between the anophthalmic socket and the contralateral eye. The area of meibomian glands was significantly reduced in eyelids on the side of the prosthetic eye, compared with the contralateral eye. Seven patients reported symptoms indicative of dry eye in the anophthalmic socket, compared with only two in the contralateral eye.
    CONCLUSIONS: The effects of an eye prosthesis on meibomian glands may contribute to the frequently perceived symptoms of dry eye despite unaffected in tear secretion.
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  • 文章类型: Journal Article
    背景:本研究的目的是使用临床相关的体外肘部磨损测试方法,对非机械连接的全肘关节成形术植入物进行聚乙烯磨损测试,该测试方法模拟了在日常生活范围的轻度至中度活动中使用十年的时间。
    方法:测试方案应用了80°的尺肱骨运动弧,从完全伸展的30°开始,并发展到110°的屈曲。以7°施加力以在肘部上重新产生外翻载荷。采用频率为0.5Hz的可变关节载荷曲线。在牛血清润滑剂中测试植入物5百万次循环(Mc)。表征了植入物组件的失效,并通过重量法测定了聚乙烯的磨损。
    结果:在5Mc之后,小聚乙烯衬套的磨损率为0.56mg/Mc。中等尺寸磨损率为0.28mg/Mc。测试了三个大尺寸,平均磨损率为0.39±0.07mg/Mc。未发现植入物失败。
    结论:该测试重新创建了体内加载环境,并在指定的循环计数下测量了聚乙烯的磨损率。该试验表明比其他关节置换件磨损较小。进一步的临床评估是必要的,以确定这是否转化为减少与磨损相关的全肘关节置换的并发症。
    BACKGROUND: The objective of this study was to perform a polyethylene wear test on a non-mechanically linked total elbow arthroplasty implant using a clinically relevant in-vitro elbow wear test methodology that simulated ten years of use in the light to moderate activity of daily living range.
    METHODS: The test protocol applied an 80° arc of ulnohumeral motion beginning at 30° shy of full extension and progressing to 110° of flexion. Force was applied at 7° to recreate a valgus load on the elbow. A variable joint load profile at a frequency of 0.5 Hz was employed. The implants were tested for 5 million cycles (Mc) in a bovine serum lubricant. Implant component failure was characterized and polyethylene wear was determined gravimetrically.
    RESULTS: After 5 Mc the small polyethylene bushing wear rate was 0.56 mg/Mc. The medium size wear rate was 0.28 mg/Mc. Three large sizes were tested and the average wear rate was 0.39 ± 0.07 mg/Mc. No implant failure was identified.
    CONCLUSIONS: The test recreated an in vivo loading environment and measured polyethylene wear rates at specified cycle counts. The test demonstrated less wear than other joint replacements. Further clinical evaluation is necessary to determine if this translates into reduced complications of total elbow replacement associated with wear.
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