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

Frossard, Laurent; Häggström, Eva; Hagberg, Kerstin; Brånemark, Rickard

doi:10.1682/jrrd.2012.04.0062

Cited by 44 publications

(74 citation statements)

References 48 publications

(81 reference statements)

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“…The magnitudes of the site‐specific load varied between the different patients evaluated in this study, most probably due to their individual anatomy, mass, amputation height, and walking pattern. The load magnitudes and variability agree well with previously published data on the loads applied to the femur or to the implant system during straight‐line level walking . It has further been shown that the walking pattern, pelvic tilt and hip extension change towards normal gait, as compared to gait using a socket prosthesis, when evaluating the same patients pre‐operatively and at a 2‐year follow‐up after treatment with an osseointegrated amputation prosthesis .…”

Section: Discussionsupporting

confidence: 86%

Effect of load on the bone around bone-anchored amputation prostheses

et al. 2016

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Osseointegrated transfemoral amputation prostheses have proven successful as an alternative method to the conventional socket-type prostheses. The method improves prosthetic use and thus increases the demands imposed on the bone-implant system. The hypothesis of the present study was that the loads applied to the bone-anchored implant system of amputees would result in locations of high stress and strain transfer to the bone tissue and thus contribute to complications such as unfavourable bone remodeling and/or elevated inflammatory response and/or compromised sealing function at the tissue-abutment interface. In the study, site-specific loading measurements were made on amputees and used as input data in finite element analyses to predict the stress and strain distribution in the bone tissue. Furthermore, a tissue sample retrieved from a patient undergoing implant revision was characterized in order to evaluate the long-term tissue response around the abutment. Within the limit of the evaluated bone properties in the present experiments, it is concluded that the loads applied to the implant system may compromise the sealing function between the bone and the abutment, contributing to resorption of the bone in direct contact with the abutment at the most distal end. This was supported by observations in the retrieved clinical sample of bone resorption and the formation of a soft tissue lining along the abutment interface. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1113-1122, 2017.

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Section: Discussionsupporting

confidence: 86%

Effect of load on the bone around bone-anchored amputation prostheses

et al. 2016

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“…For the Ext/Flex moment during swing, the RSME% of 16 (14-24) for Total Knee were significantly lower compared to 35 (32)(33)(34)(35)(36)(37)(38) for Mauch Knee (p = 0.0356) and 41 (37-46) for C-Leg (p = 0.0330). Similarly, for the Add/Abd moment during swing, the RSME% of 16 (15)(16)(17)(18)(19)(20)(21)(22) for Total Knee were significantly lower compared to 29 (28)(29)(30) for Mauch Knee (p = 0.0318) and 19 (18)(19)(20) for C-Leg (p = 0.0344). For the Int/Ext moment during swing, the RSME% of 25 (20)(21)(22)(23)(24)(25)(26)(27) for Total Knee were lower than 39 (29-48) for C-Leg but not significantly (p = 0.0874).…”

Section: Resultsmentioning

confidence: 90%

“…Typically, quantitative assessments of prostheses performances rely on spatio-temporal, kinematic and kinetic gait characteristics [1][2][3][4][5][6]. In particular, the analysis of lower limb joints kinetics (i.e., forces, moments, power) has become critical to compare mechanical performances between adaptive dissipation prosthetic knee units [7][8][9][10][11][12][13][14][15][16][17][18][19] and an anatomical knee joint [2,3,20]. Furthermore, the development of osseointegrated fixations for bone-anchored prostheses requires a better understanding and monitoring of implant and prosthetic loading during locomotion to increase walking abilities (e.g., speed of walking) while assuring safety (e.g., limitation of high loading, fall prevention, breakage of fixation parts) [6,[21][22][23][24][25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Gait Analysis of Transfemoral Amputees: Errors in Inverse Dynamics Are Substantial and Depend on Prosthetic Design

Dumas

Brånemark

Frossard

2017

IEEE Trans. Neural Syst. Rehabil. Eng.

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To cite this version:Raphaël Dumas, Rickard Brånemark, Laurent Frossard. Gait analysis of transfemoral amputees: errors in inverse dynamics are substantial and depend on prosthetic design. IEEE Transactions on Neural Systems and Rehabilitation Engineering, Institute of Electrical and Electronics Engineers, 2017, 25 (6), pp.679-685. <10.1109/TNSRE.2016.2601378>. 1  Abstract-Quantitative assessments of prostheses performances rely more and more frequently on gait analysis focusing on prosthetic knee joint forces and moments computed by inverse dynamics. However, this method is prone to errors, as demonstrated in comparison with direct measurements of these forces and moments. The magnitude of errors reported in the literature seems to vary depending on prosthetic components. Therefore, the purposes of this study were (A) to quantify and compare the magnitude of errors in knee joint forces and moments obtained with inverse dynamics and direct measurements on ten participants with transfemoral amputation during walking and (B) to investigate if these errors can be characterised for different prosthetic knees.Knee joint forces and moments computed by inverse dynamics presented substantial errors, especially during the swing phase of gait. Indeed, the median errors in percentage of the moment magnitude were 4% and 26% in extension/flexion, 6% and 19% in adduction/abduction as well as 14% and 27% in internal/external rotation during stance and swing phase, respectively. Moreover, errors varied depending on the prosthetic limb fitted with mechanical or microprocessorcontrolled knees.This study confirmed that inverse dynamics should be used cautiously while performing gait analysis of amputees. Alternatively, direct measurements of joint forces and moments could be relevant for mechanical characterising of components and alignments of prosthetic limbs.

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“…Bone-anchored prostheses improve comfort and confidence of the users (Hagberg et al, 2008; Lundberg et al, 2011; Witso et al, 2006) and permit easier donning and doffing of the prosthesis (Jonsson et al, 2011). In addition, bone-anchored prostheses improve perception of prosthesis loading, defined as osseoperception (Haggstrom et al, 2013a; Jacobs et al, 2000; Lundborg et al, 2006), lead to fewer clinical visits to the prosthetist (Haggstrom et al, 2013b), and result in improvement of walking mechanics (Frossard et al, 2013; Hagberg et al, 2005; Tranberg et al, 2011). …”

Section: Introductionmentioning

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

Cited by 44 publications

References 48 publications

Effect of load on the bone around bone-anchored amputation prostheses

Effect of load on the bone around bone-anchored amputation prostheses

Gait Analysis of Transfemoral Amputees: Errors in Inverse Dynamics Are Substantial and Depend on Prosthetic Design

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

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