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European Review For Medical and... Oct 2023We reviewed the potential benefits of conchal cartilage or Polydioxanone (PDS) foil-empowered nasal cartilage as caudal septal extension grafts (CSEGs). Research methods... (Review)
Review
We reviewed the potential benefits of conchal cartilage or Polydioxanone (PDS) foil-empowered nasal cartilage as caudal septal extension grafts (CSEGs). Research methods included searching online databases such as Google, Google Scholar, PubMed, and Proquest Central at Kırıkkale University. Use terms like "caudal septal extension grafts," "septal extension grafts," "conchal cartilage," and "PDS foil-empowered nasal cartilage" to find related articles. Due to the anchoring of the lower alar cartilage to the nasal septum, the results of a CSEG rhinoplasty are relatively stable over the long term. They can be adjusted independently by the rhinoplasty surgeon. Over time, the skin and soft tissue envelope contract and a downward force for these grafts develops. It allows for independent regulation of projection and rotation, unlike conventional columellar strut procedures and lateral crural steal techniques. Inadequate cartilage may need conchal or costal cartilage, depending on the application and the need for projection and counter rotation. Costal cartilage transplant outperformed conchal cartilage graft in a rabbit model regarding tip projection and angle relapse rate. Three-patient case series show that PDS foil-enhanced nasal cartilage led to septal cartilage loss. However, other research draws a different result, finding that PDS foil-enhanced nasal cartilage prevented growth inhibition in the developing nasal septum following septoplasty, and reduced late problems in animals. The caudal septal extension grafts should prioritize septum cartilage if it is readily available, of adequate size, and with sufficient strength. If this is not possible, PDS foil-enhanced nasal cartilage fragments or conchal cartilage could be used as a backup. PDS foil will maintain the integrity and stability of the implanted cartilage. Due to its strength, stability, and convenient location, conchal cartilage will serve as the second donor site.
Topics: Humans; Animals; Rabbits; Nasal Cartilages; Nasal Septum; Rhinoplasty; Prostheses and Implants; Skin; Retrospective Studies
PubMed: 37869954
DOI: 10.26355/eurrev_202310_34077 -
Computer Methods and Programs in... Dec 2023Bioresorbable braided stents, typically made of bioresorbable polymers such as poly-l-lactide (PLLA), have great potential in the treatment of critical limb ischemia,...
BACKGROUND AND OBJECTIVES
Bioresorbable braided stents, typically made of bioresorbable polymers such as poly-l-lactide (PLLA), have great potential in the treatment of critical limb ischemia, particularly in cases of long-segment occlusions and lesions with high angulation. However, the successful adoption of these devices is limited by their low radial stiffness and reduced elastic modulus of bioresorbable polymers. This study proposes a computational optimization procedure to enhance the mechanical performance of bioresorbable braided stents and consequently improve the treatment of critical limb ischemia.
METHODS
Finite element analyses were performed to replicate the radial crimping test and investigate the implantation procedure of PLLA braided stents. The stent geometry was characterized by four design parameters: number of wires, wire diameter, initial stent diameter, and braiding angle. Manufacturing constraints were considered to establish the design space. The mechanical performance of the stent was evaluated by defining the radial force, foreshortening, and peak maximum principal stress of the stent as objectives and constraint functions in the optimization problem. An approximate relationship between the objectives, constraint, and the design parameters was defined using design of experiment coupled with surrogate modelling. Surrogate models were then interrogated within the design space, and a multi-objective design optimization was conducted.
RESULTS
The simulation of radial crimping was successfully validated against experimental data. The radial force was found to be primarily influenced by the number of wires, wire diameter, and braiding angle, with the wire diameter having the most significant impact. Foreshortening was predominantly affected by the braiding angle. The peak maximum principal stress exhibited contrasting behaviour compared to the radial force for all parameters, with the exception of the number of wires. Among the Pareto-optimal design candidates, feasible peak maximum principal stress values were observed, with the braiding angle identified as the differentiating factor among these candidates.
CONCLUSIONS
The exploration of the design space enabled both the understanding of the impact of design parameters on the mechanical performance of bioresorbable braided stents and the successful identification of optimal design candidates. The optimization framework contributes to the advancement of innovative bioresorbable braided stents for the effective treatment of critical limb ischemia.
Topics: Humans; Absorbable Implants; Chronic Limb-Threatening Ischemia; Stress, Mechanical; Stents; Polymers; Prosthesis Design
PubMed: 37683458
DOI: 10.1016/j.cmpb.2023.107781 -
Journal of Indian Prosthodontic Society 2023
Topics: Dental Research; Dental Implants; Dental Prosthesis, Implant-Supported
PubMed: 37861607
DOI: 10.4103/jips.jips_453_23 -
BMC Musculoskeletal Disorders Apr 2024Total joint arthroplasty as a surgical treatment option for trapeziometacarpal joint arthritis is recently revived. The aim of this study is to report on mid- and...
BACKGROUND
Total joint arthroplasty as a surgical treatment option for trapeziometacarpal joint arthritis is recently revived. The aim of this study is to report on mid- and long-term results of the Elektra (single-mobility) and Moovis (dual-mobility) prosthesis for treatment of primary thumb carpometacarpal joint arthritis.
METHODS
In this retrospective, monocentric, descriptive cohort study, 31 prostheses were evaluated that were implanted by a single surgeon in 26 patients between 2009 and 2019. Indication for surgery was trapeziometacarpal joint osteoarthritis (Eaton/Littler Stage II and III). Clinical and radiological follow-up was performed at a minimum of 24 months. The postoperative assessment included range of motion, pain, strength as well as functional scores (DASH, MHQ). Implant survival and complications were the primary endpoints.
RESULTS
10 Elektra and 21 Moovis prostheses were implanted between 2009 and 2019 with a mean follow-up of 74.2 months in the Elektra and 41.4 months in the Moovis group. The average patients' age at surgery was 64 years. Postoperative pain levels (VAS 0-10) were below 2 at rest and under stress in both groups. Grip/pinch strength and range of motion showed results comparable to the contralateral hand. Opposition was excellent with an average Kapandji index of 9.6 in both groups. Elektra achieved slightly better functional scores in the DASH and MHQ score. Satisfaction was high in both groups, and 96% of the patients would recommend the procedure. Metacarpophalangeal hyperextension > 15° was seen in 3 patients per group preoperatively and was corrected to < 5° post-surgery. 3 Elektra prostheses were revised due to cup loosening and dislocation for cup and/or neck replacement or secondary trapeziectomy. 1 Moovis prosthesis was revised with an exchange of the neck to a larger size due to restricted movement. After the mean follow-up of 7.9 years in Elektra and 3.5 years in MOOVIS, cumulative survival was 68.6% vs. 95.2%, respectively.
CONCLUSIONS
In this mid- to long-term retrospective analysis, total joint arthroplasty in primary trapeziometacarpal joint arthritis results in low pain levels, excellent mobility and clinical function. Patient satisfaction is overall high. While revision due to cup loosening occurred more often in patients with single-mobility implants, no cases of dislocation or loosening of components were observed in the dual-mobility group.
TRIAL REGISTRATION
The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of the Medical Faculty of Heidelberg University, reference number S-150/2020.
Topics: Humans; Male; Retrospective Studies; Female; Middle Aged; Carpometacarpal Joints; Aged; Joint Prosthesis; Osteoarthritis; Range of Motion, Articular; Treatment Outcome; Prosthesis Design; Follow-Up Studies; Trapezium Bone; Arthroplasty, Replacement; Thumb
PubMed: 38664698
DOI: 10.1186/s12891-024-07439-5 -
Annals of Biomedical Engineering Nov 2023Additive Manufacturing is noted for ease of product customization and short production run cost-effectiveness. As our global population approaches 8 billion, additive... (Review)
Review
Additive Manufacturing is noted for ease of product customization and short production run cost-effectiveness. As our global population approaches 8 billion, additive manufacturing has a future in maintaining and improving average human life expectancy for the same reasons that it has advantaged general manufacturing. In recent years, additive manufacturing has been applied to tissue engineering, regenerative medicine, and drug delivery. Additive Manufacturing combined with tissue engineering and biocompatibility studies offers future opportunities for various complex cardiovascular implants and surgeries. This paper is a comprehensive overview of current technological advancements in additive manufacturing with potential for cardiovascular application. The current limitations and prospects of the technology for cardiovascular applications are explored and evaluated.
Topics: Humans; Models, Cardiovascular; Bioengineering; Tissue Engineering; Prostheses and Implants; Biomedical Engineering
PubMed: 37466879
DOI: 10.1007/s10439-023-03322-x -
Orthopadie (Heidelberg, Germany) Sep 2023More than almost any other implant, fully implantable intramedullary distraction nails have changed corrective and reconstructive bone surgery. Based on the fundamentals... (Review)
Review
More than almost any other implant, fully implantable intramedullary distraction nails have changed corrective and reconstructive bone surgery. Based on the fundamentals of callus distraction, these new apparatus developments with their novel planning strategies and minimally invasive surgical techniques have opened up a wide range of indications and made the treatment reproducible and safe. The prerequisite, however, is that standardized procedures are adhered to, which concern both the preparation for the surgery, the surgery itself and the subsequent distraction treatment. Treatment with fully implantable intramedullary distraction nails should be performed at specialized centers, so that the paradigm shift in corrective and reconstructive limb surgery, which is already recognizable, will open the door for further developments.
Topics: Nails; Internal Fixators; Fracture Fixation, Intramedullary; Prostheses and Implants; Bone Lengthening; Dioctyl Sulfosuccinic Acid; Phenolphthalein
PubMed: 37620678
DOI: 10.1007/s00132-023-04418-x -
Nature Jun 2024Implanted biomaterials and devices face compromised functionality and efficacy in the long term owing to foreign body reactions and subsequent formation of fibrous...
Implanted biomaterials and devices face compromised functionality and efficacy in the long term owing to foreign body reactions and subsequent formation of fibrous capsules at the implant-tissue interfaces. Here we demonstrate that an adhesive implant-tissue interface can mitigate fibrous capsule formation in diverse animal models, including rats, mice, humanized mice and pigs, by reducing the level of infiltration of inflammatory cells into the adhesive implant-tissue interface compared to the non-adhesive implant-tissue interface. Histological analysis shows that the adhesive implant-tissue interface does not form observable fibrous capsules on diverse organs, including the abdominal wall, colon, stomach, lung and heart, over 12 weeks in vivo. In vitro protein adsorption, multiplex Luminex assays, quantitative PCR, immunofluorescence analysis and RNA sequencing are additionally carried out to validate the hypothesis. We further demonstrate long-term bidirectional electrical communication enabled by implantable electrodes with an adhesive interface over 12 weeks in a rat model in vivo. These findings may offer a promising strategy for long-term anti-fibrotic implant-tissue interfaces.
Topics: Animals; Female; Humans; Male; Mice; Rats; Abdominal Wall; Adsorption; Biocompatible Materials; Colon; Electrodes, Implanted; Fibrosis; Foreign-Body Reaction; Heart; Lung; Mice, Inbred C57BL; Organ Specificity; Polymerase Chain Reaction; Prostheses and Implants; Rats, Sprague-Dawley; Stomach; Swine; Time Factors; Tissue Adhesives; Fluorescent Antibody Technique; Reproducibility of Results; Sequence Analysis, RNA
PubMed: 38778109
DOI: 10.1038/s41586-024-07426-9 -
Nature Biomedical Engineering Nov 2023Small animals do not replicate the severity of the human foreign-body response (FBR) to implants. Here we show that the FBR can be driven by forces generated at the...
Small animals do not replicate the severity of the human foreign-body response (FBR) to implants. Here we show that the FBR can be driven by forces generated at the implant surface that, owing to allometric scaling, increase exponentially with body size. We found that the human FBR is mediated by immune-cell-specific RAC2 mechanotransduction signalling, independently of the chemistry and mechanical properties of the implant, and that a pathological FBR that is human-like at the molecular, cellular and tissue levels can be induced in mice via the application of human-tissue-scale forces through a vibrating silicone implant. FBRs to such elevated extrinsic forces in the mice were also mediated by the activation of Rac2 signalling in a subpopulation of mechanoresponsive myeloid cells, which could be substantially reduced via the pharmacological or genetic inhibition of Rac2. Our findings provide an explanation for the stark differences in FBRs observed in small animals and humans, and have implications for the design and safety of implantable devices.
Topics: Mice; Humans; Animals; Foreign-Body Reaction; Mechanotransduction, Cellular; Prostheses and Implants; Myeloid Cells; Signal Transduction
PubMed: 37749310
DOI: 10.1038/s41551-023-01091-5 -
International Journal of Molecular... Mar 2024Poly(propylene carbonate) (PPC) is an emerging "carbon fixation" polymer that holds the potential to become a "biomaterial of choice" in healthcare owing to its good... (Review)
Review
Poly(propylene carbonate) (PPC) is an emerging "carbon fixation" polymer that holds the potential to become a "biomaterial of choice" in healthcare owing to its good biocompatibility, tunable biodegradability and safe degradation products. However, the commercialization and wide application of PPC as a biomedical material are still hindered by its narrow processing temperature range, poor mechanical properties and hydrophobic nature. Over recent decades, several physical, chemical and biological modifications of PPC have been achieved by introducing biocompatible polymers, inorganic ions or small molecules, which can endow PPC with better cytocompatibility and desirable biodegradability, and thus enable various applications. Indeed, a variety of PPC-based degradable materials have been used in medical applications including medical masks, surgical gowns, drug carriers, wound dressings, implants and scaffolds. In this review, the molecular structure, catalysts for synthesis, properties and modifications of PPC are discussed. Recent biomedical applications of PPC-based biomaterials are highlighted and summarized.
Topics: Biocompatible Materials; Polymers; Prostheses and Implants; Propane
PubMed: 38474185
DOI: 10.3390/ijms25052938 -
Clinical Rehabilitation Dec 2023This study presents the walking abilities of participants fitted with transfemoral bone-anchored prostheses using a total of 14 gait parameters.
OBJECTIVE
This study presents the walking abilities of participants fitted with transfemoral bone-anchored prostheses using a total of 14 gait parameters.
DESIGN
Two-centre retrospective cross-sectional comparative study.
SETTING
Research facilities equipped with tridimensional motion capture systems.
PARTICIPANTS
Two control arms included eight able-bodied participants arm (54 ± 9 years, 1.75 ± 0.07 m, 76 ± 7 kg) and nine participants fitted with transfemoral socket-suspended prostheses arm (59 ± 9 years, 1.73 ± 0.07 m, 80 ± 16 kg). The intervention arm included nine participants fitted with transfemoral bone-anchored prostheses arm (51 ± 13 years, 1.78 ± 0.09 m, 87.3 ± 16.1 kg).
INTERVENTION
Fitting of transfemoral bone-anchored prostheses.
MAIN MEASURES
Comparisons were performed for two spatio-temporal, three spatial and nine temporal gait parameters.
RESULTS
The cadence and speed of walking were 107 ± 6 steps/min and 1.23 ± 0.19 m/s for the able-bodied participants arm, 88 ± 7 steps/min and 0.87 ± 0.17 m/s for the socket-suspended prosthesis arm, and 96 ± 6 steps/min and 1.03 ± 0.17 m/s for bone-anchored prosthesis arm, respectively. Able-bodied participants and bone-anchored prosthesis arms were comparable in age, height, and body mass index as well as cadence and speed of walking, but the able-bodied participant arm showed a swing phase 31% shorter. Bone-anchored and socket-suspended prostheses arms were comparable for age, height, mass, and body mass index as well as cadence and speed of walking, but the bone-anchored prosthesis arm showed a step width and duration of double support in seconds 65% and 41% shorter, respectively.
CONCLUSIONS
Bone-anchored and socket-suspended prostheses restored equally well the gait parameters at a self-selected speed. This benchmark data provides new insights into the walking ability of individuals using transfemoral bionics bone-anchored prostheses.
Topics: Humans; Bone-Anchored Prosthesis; Amputation, Surgical; Retrospective Studies; Amputees; Cross-Sectional Studies; Gait; Walking; Artificial Limbs; Biomechanical Phenomena; Prosthesis Design
PubMed: 37350084
DOI: 10.1177/02692155231183779