Zusammenfassung In der Medizin wird eine Vielzahl funktioneller Textilien eingesetzt, da sie ein Höchstmaß an geometrischer und mechanischer Flexibilität bieten und die im Bereich der Prävention geforderte gute Patientencompliance gewährleisten. Die Integration von Sensoren und Aktuatoren in die Bekleidung selbst bietet dabei innovative Lösungen für die Prävention und Rehabilitation. Im Ergebnis zeigt sich, dass vor allem textilbasierte Präventions- und Rehabilitationssysteme dem Patienten bestmögliche Mobilität und Lebensqualität kombiniert mit höchstem Komfort bieten.
The proper reconstruction of midfacial defects is an ongoing challenge in the field of reconstructive surgery. One of the principal aims of adequate therapeutic and anatomical reconstruction was to guarantee good functional and aesthetical results. In this context, one of the most challenging areas as regards reconstruction of the facial skeleton is the orbit, which refers to the cavity or socket of the skull in which the eye and its appendages are situated. Today, computerassisted surgery, particularly in combination with patient-specific implants, allows for the reconstruction of complex orbital defects with high precision. In this regard, in commercially available titanium implants, the final shape of the implant has to be determined before insertion; otherwise, not determining the final implant shape can sometimes result in considerable soft-tissue sequelae after implant placement. This problem can be addressed with the use of new material characteristics such as superelasticity in shape-memory alloys. This special type of nickel-titanium-alloy has already found utility in various medical disciplines. In this context, here, we propose to use shape-memory alloys for orbital reconstruction and combine their unique characteristics with the possibility of patient-specific shape-memory alloy implants. We experimented on a broad spectrum of implant geometries and finally achieved a shape that combines sufficient stiffness with superelastic properties. The combination of patient-specific shape and the special physical properties of shape-memory alloy implants can find utility in orbital reconstruction as well as various other surgical reconstructions.
No abstract
In tumor endoprosthetics, implants are applied to reconstruct the proximal femur. The main problems of these implants are often the high weight and the biomechanically not optimal attachment of soft tissue. The aim of this work is the development of a long-term stable biomechanically correct implant of a proximal femoral replacement. Based on lightweight construction concepts from vehicle construction, a topology optimization was performed with an existing modular implant basic body. The additive manufacturing process laser beam melting was applied to produce the implant with the material TiAl6V4. The individual modules were coupled by a specially designed polygon interface. To disconnect the interface, a joining instrument was used which applies a force at two defined points and thus elastically deforms the internal contour of the interface. This allows the reversible joining of the modular components. In order to fix the muscles anatomically correctly, textile attachment points made of multifilament polyester were produced by embroidery. A functional model of a modular implant was produced. On the basis of a topology optimization, the new implant has a mass reduction of 400 g compared to a proximal femoral set, which was assembled from the MML system. The greatest savings potential was found in the trochanter module (weight reduction by 55%). The loadbearing structures consisted of TiAl6V4, whereas the shell of the neck module was made of polyethylene. The reversible coupling was implemented by a polygonal interface. The force closure took place by switching off the external force effect and thus the deformation of the round bore hole into an elliptical geometry, which resulted in a "jamming" of the spigot. According to ISO 7206 the fatigue strength of the implant was determined. The test implantation at a body donor showed that the implant can be placed under realistic conditions.
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