Abstract
In direct skeletal attachment (DSA) of limb prostheses, the main problems are the bone–implant and skin–implant interfaces. As we have demonstrated in this book, the design of prosthetic joints influences the forces applied to the residuum through the prosthetic socket. The same influence exists if the socket-type attachment is replaced by a direct-type attachment. By carefully selecting the prosthetic components, it is possible to reduce excessive forces and moments on the implant and prolong the safe bond of the implant with the residuum.
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Notes
- 1.
International Society for Prosthetics and Orthotics.
- 2.
The thin layer of cells lining the medullary cavity of a bone. 3Surgical replacement of arthritic or destructive joint with prosthesis.
References
Aaron RK, Morgan JR (2007) Biohybrid limbs: new materials and new properties. Med Health R I 90(1):4–6
Bateni H, Olney S (2002) Kinematic and kinetic variations of below-knee amputee gait. JPO 14(1):2–12
Bowlby AA (1895) Surgical pathology and morbid anatomy, page 329. London, J. and A. Churchill, 640 p
Branemark R, Branemark PI, Rydevik B, Myers RR (2001) Osseointegration in skeletal reconstruction and rehabilitation: a review. J Rehabil Res Dev 38(2):175–181
Drygas KA, Taylor R, Sidebotham CG, Hugate RR, McAlexander H (2008) Transcutaneous tibial implants: a surgical procedure for restoring ambulation after amputation of the distal aspect of the tibia in a dog. Vet Surg 37(4):322–327
Edell DJ (1986) A peripheral nerve information transducer for amputees: long-term multichannel recordings from rabbit peripheral nerves. IEEE Trans Biomed Eng 33(2):203–214
Eriksson E, Branemark PI (1994) Osseointegration from the perspective of the plastic surgeon. Plast Reconstr Surg 93(3):626–637
Frei H, O’Connell J, Masri BA, Duncan CP, Oxland TR (2005) Biological and mechanical changes of the bone graft-cement interface after impaction allografting. J Orthop Res 23(6): 1271–1279
Frossard L, Stevenson N, Smeathers J, Haggstrom E, Hagberg K, Sullivan J, Ewins D, Gow DL, Gray S, Branemark R (2008) Monitoring of the load regime applied on the osseointegrated fixation of a trans-femoral amputee: a tool for evidence-based practice. Prosthet Orthot Int 32(1):68–78
Handbook (1977). Handbook of steel construction. Canadian Institute of Steel Construction
Hasan Z, Thomas JS (1999) Kinematic redundancy. Prog Brain Res 123:379–387
Ilizarov GA (1989) The tension-stress effect on the genesis and growth of tissues: Part II. The influence of the rate and frequency of distraction. Clin Orthop (239):263–285
Lundborg G, Branemark PI, Rosen B (1996) Osseointegrated thumb prostheses: a concept for fixation of digit prosthetic devices. J Hand Surg 21(2):216–221
O’Shaughnessy KD, Dumanian GA, Lipschutz RD, Miller LA, Stubblefield K, Kuiken TA (2008) Targeted reinnervation to improve prosthesis control in transhumeral amputees. A report of three cases. J Bone Joint Surg 90(2):393–400
Palmquist A, Jarmar T, Emanuelsson L, Branemark R, Engqvist H, Thomsen P (2008) Forearm bone-anchored amputation prosthesis: a case study on the osseointegration. Acta Orthop 79 (1):78–85
Perry J, Boyd LA, Rao SS, Mulroy SJ (1997) Prosthetic weight acceptance mechanics in transtibial amputees wearing the single axis, seattle lite, and flex foot. IEEE Trans Rehabil Eng 5 (4):283–289
Pitkin M (1995) Prosthetic foot and direct skeletal attachment. Proceedings of the 8th World Congress of ISPO. Melbourne, Australia, 42
Pitkin M (2007) In-bone implantable shaft for prosthetic joints or for direct skeletal attachment of external limb prostheses and method of its installation. US Patent Application No. 11/899068
Pitkin M (2008) One lesson from arthroplasty to osseointegration in a search for better fixation of in-bone implanted prosthesis. J Rehabil Res Dev 45(4):vii–xiv
Pitkin M (2009) On the way to total integration of the prosthetic pylon with residuum. J Rehabil Res Dev 46(3): 345-360
Pitkin M, Blinova MI, Yudintseva NV, Potokin IL, Raykhtsaum G, Pinaev GP.(2004) Skin and bone integrated prosthetic technology. I. Characterization and morphology of human cells cultivated on titanium implants of different structures. 9th Russian National Congress “People and Health”. St. Petersburg, November 22–26, p 117
Pitkin M, Raykhtsaum G (2005) Skin integrated device. US Patent Application No.11/233,233
Pitkin M, Raykhtsaum G, Galibin OV, Protasov MV, Chihovskaya JV, Belyaeva IG (2006) Skin and bone integrated prosthetic pylon: a pilot animal study. J Rehabil Res Dev 43(4):573–580 http://www.rehab.research.va.gov/jour/06/43/4/pdf/pitkin.pdf
Pitkin M, Raykhtsaum G, Pilling J, Galibin O, Protasov M, Chihovskaya J, Belyaeva I, Blinova M, Yudintseva M, Potokin I, Pinaev G, Moxson V, Duz V (2007) Porous composite prosthetic pylon for integration with skin and bone. J Rehabil Res Dev 44(5):723–738 http://www.rehab.research.va.gov/jour/07/44/5/pdf/pitkin.pdf
Robinson D, Hendel D, Halperin N (1994) Changes in femur dimensions in asymptomatic non-cemented hip arthroplasties. 20 cases followed for 5–8 years. Acta Orthop Scand 65(4): 415–417
Robinson K, Brånemark R, Ward D (2004) Future developments: osseointegration in transfemoral amputees. In: Smith D, Michael J, Bowker J (eds) Atlas of amputations and limb deficiencies: surgical, prosthetic and rehabilitation principles 3rd edn. pp 673–681
Smidt GL (1990) Gait in rehabilitation. Churchill Livingstone, New York
Stevens A, Lowe JS (2005) Human histology. Elsevier/Mosby, Amsterdam, Philadelphia
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Pitkin, M.R. (2010). Biomechanical Aspects of Direct Skeletal Attachment of Lower Limb Prostheses. In: Biomechanics of Lower Limb Prosthetics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-03016-1_7
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