Design features of implants for direct skeletal attachment of limb prostheses

Pitkin, Mark R.

doi:10.1002/jbm.a.34606

Cited by 56 publications

(63 citation statements)

References 87 publications

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“…Some of the issues associated with the interface between the residuum and the socket can be resolved with a boneanchored prosthesis [1]. In this case, the prosthesis is attached to the residuum using an implant inserted into the bone [1][2][3]. To date, approximately 300 individuals through the prosthesis" [25, p. 206].…”

Section: Introductionmentioning

confidence: 99%

Load applied on bone-anchored transfemoral prosthesis: Characterization of a prosthesis� A pilot study

Frossard¹,

Häggström²,

Hagberg³

et al. 2013

JRRD

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Abstract-The objectives of this study were to (1) record the inner-prosthesis loading during activities of daily living (ADLs), (2) present a set of variables comparing loading data, and (3) provide an example of characterization of two prostheses. The load was measured at 200 Hz using a multi-axial transducer mounted between the residuum and the knee of an individual with unilateral transfemoral amputation fitted with a bone-anchored prosthesis. The load was measured while using two different prosthetic knees, mechanical (PRO1) and microprocessor-controlled (PRO2), during six ADLs. The characterization of the prostheses was achieved using a set of variables split into four categories, including temporal characteristics, maximum loading, loading slopes, and impulse. Approximately 360 gait cycles were analyzed for each prosthesis. PRO1 showed a cadence improved by 19% and 7%, a maximum force on the long axis reduced by 11% and 19%, and an impulse reduced by 32% and 15% during descent of incline and stairs compared with PRO2, respectively. This work confirmed that the proposed apparatus and characterization can reveal how changes of prosthetic components are translated into inner-prosthetic loading.

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Section: Introductionmentioning

confidence: 99%

Load applied on bone-anchored transfemoral prosthesis: Characterization of a prosthesis� A pilot study

Frossard¹,

Häggström²,

Hagberg³

et al. 2013

JRRD

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“…Specification for all modifications of the SBIP pylons, defining the four critical parameters of particle size, pore size, porosity and volume fraction, is uniquely selected and protected by US Patent # 8257435. Durability, resistance to fatigue, safety and efficiency of the SBIP specification has been confirmed in mechanical and animal studies [19, 21, 22, 27, 35 41]. …”

Section: Methodsmentioning

confidence: 95%

“…There are eight known implant systems for DSA, including the SBIP system, all of whose features are summarized in [27]. The first DSA system was applied at the Rancho Los Amigos Hospital (RLAH) to three amputees in 1977 [28].…”

Section: Methodsmentioning

confidence: 99%

Application of the skin and bone integrated pylon with titanium oxide nanotubes and seeded with dermal fibroblasts

Shevtsov

Yudintceva

Блинова

et al. 2015

Prosthetics &Amp; Orthotics International

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Study Design The feasibility and safety of in bone implantation of the skin and bone integrated pylons (SBIP) with nanotubes was investigated in vitro and in vivo in the animal model. Background Direct Direct skeletal attachment of limb prostheses is associated with high rate of transcutaneous infection and loosening of the fixture in the medullary canal prompting for careful assessment of various means for enhancing the skin-device and bone-device interface. The SBIP system constitutes a technological platform for different modifications being evaluated previously. Objectives The current study assessed the combination of nano treatment SBIP with its pre seeding with dermal fibroblasts. We hypothesized that this combination will enhance cell interaction with SBIP compared to nano treatment and the fibroblast seeding when done separately. Methods TiO2 nanotubes were fabricated on the SBIP, and the fibroblasts taken from rabbit's skin were cultured on the pylons before implantation. Results The in vitro experiments demonstrated higher cellular density in the samples with a nanotubular surface than in the non modified pylons used as control. There were no postoperative complications in any of the animals during the 6 month observation period. Subsequent SEM of the pylon extracted from the rabbit's femur showed the stable contact between the pylon and soft tissues in comparison to control samples where the patchy fibrovascular ingrowth was detected. Conclusions The promising results prompt further investigation of the integrative properties of the nanotextured SBIP system seeded with dermal fibroblasts and its optimization for clinical application.

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“…Implants had a tapered design similar to the tibial marrow cavity, which was reamed to a press fit. The distinction of the SBIP from existing systems for direct skeletal attachment of limb prostheses (Pitkin, 2013) is its total permeability achieved in a structure consisting of porous cladding and perforated inserts (Pitkin et al, 2012). The SBIP material specification has a uniquely selected combination of four critical parameters: particle size, pore size, porosity and volume fraction (Pitkin and Raykhtsaum, 2012).…”

Section: Methodsmentioning

confidence: 99%

Kinetics of individual limbs during level and slope walking with a unilateral transtibial bone-anchored prosthesis in the cat

Jarrell

Farrell

Kistenberg

et al. 2018

Journal of Biomechanics

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Ongoing animal preclinical studies on transcutaneous bone-anchored prostheses have aimed to improve biomechanics of prosthetic locomotion in people with limb loss. It is much less common to translate successful developments in human biomechanics and prosthetic research to veterinary medicine to treat animals with limb loss. Current standard of care in veterinary medicine is amputation of the whole limb if a distal segment cannot be salvaged. Bone-anchored transcutaneous prostheses, developed for people with limb loss, could be beneficial for veterinary practice. The aim of this study was to examined if and how cats utilize the limb with a bone-anchored passive transtibial prosthesis during level and slope walking. Four cats were implanted with a porous titanium implant into the right distal tibia. Ground reaction forces and full-body kinematics were recorded during level and slope (±50%) walking before and 4–6 months after implantation and prosthesis attachment. The duty factor of the prosthetic limb exceeded zero in all cats and slope conditions (p < 0.05) and was in the range of 45.0–60.6%. Thus, cats utilized the prosthetic leg for locomotion instead of walking on three legs. Ground reaction forces, power and work of the prosthetic limb were reduced compared to intact locomotion, whereas those of the contralateral hind- and forelimbs increased (p < 0.05). This asymmetry was likely caused by insufficient energy generation for propulsion by the prosthetic leg, as no signs of pain or discomfort were observed in the animals. We concluded that cats could utilize a unilateral bone-anchored transtibial prosthesis for quadrupedal level and slope locomotion.

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Design features of implants for direct skeletal attachment of limb prostheses

Cited by 56 publications

References 87 publications

Load applied on bone-anchored transfemoral prosthesis: Characterization of a prosthesis� A pilot study

Load applied on bone-anchored transfemoral prosthesis: Characterization of a prosthesis� A pilot study

Application of the skin and bone integrated pylon with titanium oxide nanotubes and seeded with dermal fibroblasts

Kinetics of individual limbs during level and slope walking with a unilateral transtibial bone-anchored prosthesis in the cat

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