Knee swelling is common after injury or surgery, resulting in pain, restricted range of movement and limited mobility. Accurately measuring knee swelling is critical to assess recovery. However, current measurement methods are either unreliable or expensive [1,2]. Therefore, a new measurement method is developed. This wearable (the ‘smart brace’) has shown the ability to distinguish a swollen knee from a not swollen knee using multi-frequency-bio impedance analysis (MF-BIA) [3]. This study aimed to determine the accuracy of this
Introduction. The accuracy of hexapod circular external fixator deformity correction is contingent on the precision of radiographic analysis during the planning stage. The aim of this study was to compare the
Introduction & Aims. In other medical fields,
Traumatic acute or chronic tendon injuries are a wide clinical problem in modern society, resulting in important economic burden to the health system and poor quality of life in patients. Due to the low cellularity and vascularity of tendon tissue the repair process is slow and inefficient, resulting in mechanically, structurally, and functionally inferior tissue. Tissue engineering and regenerative medicine are promising alternatives to the natural healing process for tendon repair, especially in the reconstruction of large damaged tissues. The aim of TRITONE project is to develop a
Introduction. Evaluation of post-operative soft tissue balancing outcomes after Total Knee Arthroplasty (TKA) and other procedures can be measured by stability tests, with Anterior-Posterior (AP) drawer tests and Varus-Valgus (VV) ligamentous laxity tests being particularly important. AP stability can be quantified using a KT1000 device; however there is no standard way of measuring VV stability. The VV test relies on subjective force application and perception of laxity. Therefore we sought to develop and validate a device and method for quantifying knee balancing by analyzing VV stability. Materials and Methods. Our team developed a
The surgical correction of hammer digits offers a variety of surgical treatments ranging from arthroplasty to arthrodesis, with many options for fixation. In the present study, we compared 2 buried implants for arthrodesis of lesser digit deformities: a
Excellent outcomes following total hip arthroplasty require both optimal soft-tissue management and precise planning and placement of prosthetic components. The use of detailed and dynamic three-dimensional surgical plans combined with
Introduction. While component malposition remains a major short and long term problem associated with total hip arthroplasty, enhanced technologies such as navigation and robotics have not yet been widely adopted. Both expense and increased OR time can be obstacles to adoption. The current study assesses the effect of the use of a
Pre-operative knowledge. Knowledge-based total hip arthroplasty is becoming increasingly recognised for improved safety, efficiency, and accuracy. Pre-operative knowledge of native and planned femoral anteversion, the exact size of implants, neck length and offset, and head lengths can serve to safely accelerate surgery and reduce the need for intra-operative imaging. Pre-operative knowledge of the effect on change in leg length and offset effected by specific implant combinations can serve to minimise undesired changes. The use of a
Purpose. To evaluate whether continuous training and education of posture can help children to improve kyphosis. Method. A
Introduction:. In 2009 the
Surgical instrumentation for total knee arthroplasty has improved the accuracy, reproducibility and reliability of the procedure. In recent years, minimally invasive surgery introduced instrumentation that was reduced in size to fit within the smaller operative field; with this move the impact and influence of technology became proportionately larger. The introduction of computer navigation is an attempt to improve the surgeon’s visibility in a limited operative field, improve the position of the resection guides, and ultimately the position of the final components. While it may be appealing to rely on computer navigation to perform a TKA, it is not artificial intelligence and does not make any of the surgical decisions. The procedure still is surgeon directed with navigation serving as a tool of confirmation with the potential for improvements in surgical accuracy and reproducibility. The accuracy of TKA has always been dependent upon the surgeon’s judgment, experience, ability to integrate images, utilize pre-operative radiographs, knowledge of anatomic landmarks, knowledge of knee kinematics, and hand eye co-ordination. Recent advances in medical imaging, computer vision and patient specific instrumentation have provided enabling technologies, which in a synergistic manner optimize the accurate performance of the surgery. The successful use of this technology requires that it not replace the surgeon, but support the surgeon with enhanced intra-operative feedback, integration of pre-operative and intra-operative information, and visual dexterity during the procedure. In developing
Total knees today are performed with the use of standard trials that the surgeon utilises to define appropriate implant rotation, range of motion, and soft tissue balance. This “feel” based approach is very subjective, and lacks a quantifiable approach to interpret our intra-operative knee assessment. Sensor-based trials are embedded into the specific knee designed tibial trial, and wirelessly displays data related to the implant's position and ligament tension. The surgeon can now identify malrotation, soft tissue imbalance, and instability through a full ROM. The surgeon can see dynamic responses to ligament releases, alignment changes, and implant adjustments. As Insall taught us; a TKR is a soft tissue procedure, and a “balanced” knee will demonstrate improved outcomes and greater patient satisfaction.
Introduction. Lesser toe proximal interphalangeal joint arthrodesis is a common forefoot procedure for correction of claw toe deformities. The most common method of fixation is with k-wires. Although this is a very cost-effective method of fixation, well-known disadvantages include pin site infection, non union, wire migration and the inconvenience to the patients of percutaneous wires for up to six weeks. For these reasons, intramedullary devices for joint fixation without crossing the distal IP joint have been developed. Many different designs are currently available. The
Acetabular component malalignment remains the single greatest root cause for revision THA with malposition of at least ½ of all acetabular components placed using conventional methods. The use of local anatomical landmarks has repeatedly proven to be unreliable due to individual variation of these structures. As a result, the use of such landmarks without knowledge of their three-dimensional orientation may actually be a major cause of component malpositioning. Traditional navigation and robotics can potentially lead to improved component placement but these technologies have not gained widespread use due to the increase in time of use, complexity, and cost of these systems. The alternative of placing the cup in the supine position, even with the use of arthroscopy, has been proven to have an incidence of inaccuracy equal or greater than that in the lateral position. A
Major aspects on long-term outcome in Total Knee Arthroplasty are the correct alignment of the implant with the mechanical load axis, the rotational alignment of the components as well as good soft tissue balancing. To reduce the variability of implant alignment and at the same time minimise the invasiveness different computer assisted systems have been introduced. To achieve accuracy as high as those of a robotic system but with a pure mechanically adjustable cutting block, the Exactech GPS system has been developed. The new concept comprises a seamlessly planning and navigation screen with an integrated optical tracking system for fast and accurate acquisition and verification of anatomical landmarks within the sterile field as well as a tiny cutting guide for accurate transfer of the planned bone resections. Using a conventional screwdriver the cutting block could be accurately aligned with the planned resection by controlling the current position of the cutting block on the navigation screen. To save time, to maximise the ease of use and to minimize the surgeon's mental workload during adjustment, a
Symptomatic flexion deformity of proximal interpahalangeal joint (PIPJ) is one of the most common foot deformities and usually treated with arthrodesis. In general, percutaneous K-wires are used to stabilize the joint after excision of cartilage. K-wires projecting out of the toe need special care and can occasionally be dislodged accidentally. Furthermore issues such as cellulitis, pin tract infections, rarely osteomyelitis and need for removal make alternative fixation methods desirable.
Background. Symptomatic flexion deformity of proximal interpahalangeal joint (PIPJ) is one of the most common foot deformities and usually treated with arthrodesis. In general, percutaneous K-wires are used to stabilize the joint after excision of cartilage. K-wires projecting out of the toe need special care and can occasionally be dislodged accidentally. Furthermore issues such as cellulitis, pin tract infections, rarely osteomyelitis and need for removal make alternative fixation methods desirable.
By definition, a