Wear analysis in anatomical and reversed shoulder prostheses

This paper describes the development of a computational model to calculate wear rates in total shoulder prostheses, for a 5–150 degrees arm abduction. Anatomical keeled and pegged prosthesis as well as reversed prosthesis were the studied implants. The bone models were built based on computed tomography (CT) images and using a computer aided design-based modelling pipeline. The finite element method was used to solve the contact problem between the surface of the polyethylene (PE) components and the corresponding articular component. The aim of this work was to determine linear and volumetric PE wear, for several radial mismatches, in conditions of pathological (rheumatoid arthritis) and non-pathological bone. Results showed that contact pressures and linear wear developed in anatomical prosthesis were higher than those visualised in reversed prosthesis. However, anatomical prosthesis exhibited a better volumetric wear performance. Moreover, our findings indicated higher values of volumetric wear in higher congruent models and on pathological bone conditions.     

Investigation of the Molecular Nature of Low-molecular-mass Cobalt(II) Ions in Isolated Osteoarthritic Knee-joint Synovial Fluid

High field ¹H NMR spectroscopy demonstrated that addition of Co(II) ions to osteoarthritic knee-joint synovial fluid (SF) resulted in its complexation by a range of biomolecules, the relative efficacies of these complexants/chelators being citrate ? histidine ～ threonine?glycine ～ glutamate ～ glutamine ～ phenylalanine ～ tyrosine > formate > lactate?alanine > valine > acetate > pyruvate > creatinine, this order reflecting the ability of these ligands to compete for the available Co(II) in terms of (1) thermodynamic equilibrium constants for the formation of their complexes and (2) their SF concentrations. Since many of these SF Co(II) complexants (e.g. histidinate) serve as powerful ^?OH scavengers, the results acquired indicate that any of this radical generated from the Co(II) source in such complexes via Fenton or pseudo-Fenton reaction systems will be “site-specifically” scavenged. The significance of these observations with regard to cobalt toxicity and the in vivo corrosion of cobalt-containing metal alloy joint prostheses (e.g. CoCr alloys) is discussed.     

Influence of different combinations of bacteria and yeasts in voice prosthesis biofilms on air flow resistance

Laryngectomized patients use silicone rubber voice prostheses to rehabilitate their voice. However, biofilm formation limits the lifetime of voice prostheses. The presence of particular combinations of bacterial and yeast strains in voice prosthesis biofilms has been suggested to be crucial for causing valve failure. In order to identify combinations of bacterial and yeast strains causative to failure of voice prostheses, the effects of various combinations of bacterial and yeast strains on air flow resistances of Groningen button voice prostheses were determined. Biofilms were grown on Groningen button voice prostheses by inoculating so-called artificial throats with various combinations of clinically relevant bacterial and yeast strains. After 3 days, all throats were perfused three times daily with 250 ml phosphate buffered saline and at the end of each day the artificial throats were filled with growth medium for half an hour. After 7 days, the air flow resistances of the prostheses were measured. These air flow resistances were expressed relative to the air flow resistances of the same prostheses prior to biofilm formation. This study shows that biofilms causing strong increases in air flow resistance (26 to 28 cm water.s/l) comprised combinations of microorganisms, involving Candida tropicalis, Staphylococcus aureus and Rothia dentocariosa. This revised version was published online in June 2006 with corrections to the Cover Date.     

Moving minds: Ethical aspects of neural motor prostheses

Modern brain technology is a highly dynamic and innovative field of research with great potential for medical applications. Recent advances in recording neural signals from the brain by brain-machine interfacing presage new therapeutic options for paralyzed people by means of neural motor prostheses. This paper examines foreseeable ethical questions related to the research on brainmachine interfaces and their possible future applications. It identifies four major topics that need to be considered: first, the questions of personality and its possible alterations; second, responsibility and its possible constraints; third, therapeutic applications and their possible exceedance; and fourth, questions of research ethics that arise when progressing from animal experimentation to application to human subjects. This paper, in identifying and addressing the ethical questions raised by brain-machine interfaces, presents concerns that need to be considered if possible prosthetics based on modern brain technology are to be used cautiously and responsibly.     

纺织基人造血管几何特征表征的实验研究

人造血管的壁厚和松弛内径是其主要的几何特征参数。本文中首先依据国际标准ISO 7198的要求设计了测试人造血管松弛内径的测试定规,并对人造血管样品进行了测试。然后对人造血管壁厚的测试方法进行了初步探讨。     

Implant overdentures for edentulous elders: study of patient preference

Background: Studies show that elders wearing implant overdentures have improved nutrition and quality of life. However, upfront costs of this therapy are high, and the income of elderly edentulous populations is low. Objectives: This study was designed (i) to measure the preferences of edentulous patients for mandibular two‐implant overdentures using Willingness‐To‐Pay (WTP) and Willingness‐To‐Accept (WTA), (ii) to assess the effect of long‐term financing on WTP and (iii) to assess the desired role of health care plans in financing dental prostheses. Methods: Edentulous elders (68–79 years; n = 36) wearing maxillary dentures and either a mandibular conventional denture (CD, n = 13) or a two‐implant overdenture with ball attachments (IOD, n = 23) participated in this study. All had received their prostheses 2 years previously, as part of a randomised clinical trial. A three‐part questionnaire was completed during a 20‐min interview with a trained researcher. Results: Forty‐six per cent (6/13) of the CD wearers and 70% (16/23) of the IOD wearers were willing to pay three times more than the current cost of conventional dentures for implant prostheses. These percentages were increased to 77% (CD) and 96% (IOD) if participants could pay for implant overdentures in monthly instalments. Eighty‐six per cent (31/36) of all participants in both groups (21/23 IOD; 10/13 CD) thought that the government should cover at least some of the cost of implant overdentures. Conclusions: This study shows that, the majority of elderly edentate individuals who have not experienced mandibular two‐implant overdenture therapy are willing to pay the cost, particularly when payment can be made in monthly instalments.     

The cytocompatibility of compound polyester-protein surfaces using an in vitro technique

Summary To avoid the need to preclot porous polyester (Dacron) vascular prostheses, we have proposed the use of a protein coating that will promote the growth and adhesion of endothelial cells. This study assessed the relative advantages of coating woven, knitted, and velour polyester fabrics with albumin, collagen, and a albumin-collagen mixture after preservation in saline or drying by a commercial dehydration process. Preclotted fabrics were used as controls. The cytocompatibility of these biopolymers was measured by an organotypic culture technique which relies on the migration of chick embryonic endothelial cells. After 7 d of culture the cytocompatibility was quantified by counting the cells in the area of migration and the morphology of the endothelial cells was observed by scanning electron microscopy. In general, the knitted and velour fabrics showed superior compatibility than the woven one. The results confirmed that collagen, either alone or combined with albumin, provides in most cases a more cytocompatible surface than albumin alone. A cell morphology most closely resembling that of natural arterial endothelial cells was observed on the albumin-collagen substrate. This study was supported by INSERM Grant C. R. L. 82 30 16, the Medical Research Council of Canada, and the Canadian Heart Foundation.     

Masticatory performance in 80-year-old individuals

Objective: To evaluate the masticatory performance of elderly people at the age of 80 years. Subjects: A total of 283 individuals of 80 years of age took part in a general and dental health survey. Main outcome measures: A dental examination including the number of remaining teeth, occlusion, prostheses, bite force recording, and a questionnaire regarding masticatory performance were recorded. Setting: Five municipalities (Okazaki city, Tokoname city, Tahara town, Atsumi town and Minami‐chita town) in Aichi prefecture, Japan. Results: There were 20 or more teeth in 7.4% subjects, and 44.5% were edentulous. Subjects with no occlusion accounted for 77.4% of the total. Subjects with prostheses accounted for 90.8%. Maximum bite force and masticatory ability score for patients with 20 or more teeth or not wearing prostheses were higher than other groups. The non‐wearing prostheses group had a low masticatory ability score. Conclusion: Most of the 80‐year‐old individuals recovered their masticatory ability with the assistance of prostheses. Several individuals with 20 or more remaining teeth or without removable dentures present in both jaws had a high score for bite forces and masticatory abilities.     

经编人造血管顺应性的实验研究

对EP系列经编人造血管的径向顺应性和纵向顺应性进行了体外测试和研究,并分析了不同制备工艺对经编人造血管的径向顺应性的影响。实验结果表明,紧密化处理和波纹化热定性对人造血管的径向顺应性影响较大。测试压力段的选择对人造血管成品的纵向顺应性有较大的关系。     

Multi-channel surface EMG classification using support vector machines and signal-based wavelet optimization

The study proposes a method for supervised classification of multi-channel surface electromyographic signals with the aim of controlling myoelectric prostheses. The representation space is based on the discrete wavelet transform (DWT) of each recorded EMG signal using unconstrained parameterization of the mother wavelet. The classification is performed with a support vector machine (SVM) approach in a multi-channel representation space. The mother wavelet is optimized with the criterion of minimum classification error, as estimated from the learning signal set. The method was applied to the classification of six hand movements with recording of the surface EMG from eight locations over the forearm. Misclassification rate in six subjects using the eight channels was (mean ± S.D.) 4.7 ± 3.7% with the proposed approach while it was 11.1 ± 10.0% without wavelet optimization (Daubechies wavelet). The DWT and SVM can be implemented with fast algorithms, thus, the method is suitable for real-time implementation.