Early Radiographic and Clinical Outcomes of an Additive-Manufactured Acetabular Component
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ABSTRACT:
SUBMITTER: Radtke L
PROVIDER: S-EPMC10995801 | biostudies-literature | 2024 Mar
REPOSITORIES: biostudies-literature
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Project description:Study Design Retrospective study. Objective Cervical scoliosis is a rare condition that can arise from various etiologies. Few reports on the surgical management of cervical scoliosis exist. Our objective was to evaluate clinical and radiographic outcomes following surgical management of cervical scoliosis. Methods We evaluated our cervical spine surgical database for patients with cervical scoliosis (Cobb angle > 10 degrees) from 2005 to 2010. Demographic data including age, gender, diagnoses, and primary versus revision surgery was collected. Surgical data including procedure (anterior versus posterior), estimated blood loss (EBL), length of surgery, length of hospitalization, and complications was recorded. Preoperative and postoperative Cobb angle measurements and Neck Disability Index (NDI) scores were recorded. Results Cervical scoliosis was identified in 18 patients. We excluded 5, leaving 5 men and 8 women with an average age of 50.7 (median 52, range 25 to 65). The average follow-up was 40 months (median 36.5, range 5 to 87). An anterior-only approach was used in 6 cases (average 4 levels fused), 5 cases were posterior-only approach (average 8.7 levels fused), and 2 cases were combined anterior-posterior approach. The EBL was an average of 286 mL (median 150, range 50 to 900), the average surgical time was 266 minutes (median 239, range 136 to 508), and the average hospital stay was 2.7 days (median 2, range 1 to 7). Complications occurred in 7 patients, and 2 developed adjacent segment pathology. The average coronal Cobb angle preoperatively was 35.1 degrees (median 31, range 13 to 63) and corrected was 15.7 degrees (median 10.5, range 2 to 59) postoperatively (p < 0.005). The average NDI preoperatively was 24.9 (median 26, range 6 to 37) and was reduced to 17.8 (median 18, range 7 to 30) postoperatively (p < 0.02). Conclusion Surgical management of cervical scoliosis can result in deformity correction and improvement in patient outcomes. Higher rates of complications may be encountered.
| S-EPMC4733367 | biostudies-other
Project description:In several cases, it is desirable to have prototypes of low-cost fabrication and adequate performance. In academic laboratories and industries, miniature and microgrippers can be very useful for observations and the analysis of small objects. Piezoelectrically actuated microgrippers, commonly fabricated with aluminum, and with micrometer stroke or displacement, have been considered as Microelectromechanical Systems (MEMS). Recently, additive manufacture using several polymers has also been used for the fabrication of miniature grippers. This work focuses on the design of a piezoelectric-driven miniature gripper, additive manufactured with polylactic acid (PLA), which was modeled using a pseudo rigid body model (PRBM). It was also numerically and experimentally characterized with an acceptable level of approximation. The piezoelectric stack is composed of widely available buzzers. The aperture between the jaws allows it to hold objects with diameters lower than 500 μm, and weights lower than 1.4 g, such as the strands of some plants, salt grains, metal wires, etc. The novelty of this work is given by the miniature gripper's simple design, as well as the low-cost of the materials and the fabrication process used. In addition, the initial aperture of the jaws can be adjusted, by adhering the metal tips in the required position.
| S-EPMC10141374 | biostudies-literature
Project description:BackgroundInappropriate acetabular component angular position is believed to increase the risk of hip dislocation after total hip arthroplasty. However, manual measurement of these angles is time consuming and prone to interobserver variability. The purpose of this study was to develop a deep learning tool to automate the measurement of acetabular component angles on postoperative radiographs.MethodsTwo cohorts of 600 anteroposterior (AP) pelvis and 600 cross-table lateral hip postoperative radiographs were used to develop deep learning models to segment the acetabular component and the ischial tuberosities. Cohorts were manually annotated, augmented, and randomly split to train-validation-test data sets on an 8:1:1 basis. Two U-Net convolutional neural network models (one for AP and one for cross-table lateral radiographs) were trained for 50 epochs. Image processing was then deployed to measure the acetabular component angles on the predicted masks for anatomical landmarks. Performance of the tool was tested on 80 AP and 80 cross-table lateral radiographs.ResultsThe convolutional neural network models achieved a mean Dice similarity coefficient of 0.878 and 0.903 on AP and cross-table lateral test data sets, respectively. The mean difference between human-level and machine-level measurements was 1.35° (σ = 1.07°) and 1.39° (σ = 1.27°) for the inclination and anteversion angles, respectively. Differences of 5⁰ or more between human-level and machine-level measurements were observed in less than 2.5% of cases.ConclusionWe developed a highly accurate deep learning tool to automate the measurement of angular position of acetabular components for use in both clinical and research settings.Level of evidenceIII.
| S-EPMC8197739 | biostudies-literature
Project description:Ultraporous acetabular components were developed to improve osseointegration and fit for increased longevity and better outcomes after total hip arthroplasty. There is a paucity of literature detailing this acetabular component's clinical performance, with even less detailing those with screw fixation. We identify 5 patients at our institution who underwent revision total hip arthroplasty for early aseptic acetabular cup loosening of an ultraporous acetabular component known as the Tritanium primary cup with secondary screw fixation. They all presented with groin and hip pain after index surgery and underwent follow-up radiographic examination consistent with component loosening requiring revision surgery. This case series reports on the risk of early acetabular cup loosening and its associated clinical presentation, workup, and surgical management in patients with the Tritanium primary cup augmented with screws.
| S-EPMC5994600 | biostudies-literature
Project description:BackgroundThe Assessment of SpondyloArthritis international Society-European Alliance of Associations for Rheumatology recommendations for axial spondyloarthritis (axSpA) management include patient assessment for biological disease-modifying antirheumatic drug (bDMARD) treatment response after at least 12 weeks of treatment. The current treat-to-target strategy for axSpA is to achieve inactive disease (ID; Axial Spondyloarthritis Disease Activity Score (ASDAS) <1.3) or at least low disease activity (LDA; 1.3≤ASDAS<2.1).To investigate the association between treatment response at week 12 and/or week 24 and attainment of the ASDAS<2.1 treat-to-target recommendation at week 52 in bDMARD-naïve patients with radiographic (r-)axSpA treated with ixekizumab (IXE).MethodsThis post hoc analysis included patients randomly assigned to IXE 80 mg every 4 weeks from COAST-V (NCT02696785), a phase 3 trial in bDMARD-naïve patients with r-axSpA. The proportion of patients who achieved ASDAS<2.1 at week 52 was measured among those who attained or not clinically important improvement (CII, ∆ASDAS≥1.1) response, and among those with ID, LDA and high or very high disease activity at week 12 and/or week 24. Non-response was assumed for missing data.ResultsAmongst 81 patients, 47 (58.0%) achieved ASDAS CII at week 12, with 70.2% (n=33) achieving ASDAS<2.1 at week 52. At week 24, 52 (64.2%) patients achieved ASDAS CII, with 71.2% (n=37) achieving ASDAS<2.1 at week 52. Of the 24 patients who did not achieve ASDAS CII at either week 12 or week 24, 5 (20.8%) achieved ASDAS<2.1 at week 52.ConclusionThis analysis reinforces the current recommendation that continuing treatment in those achieving ASDAS CII at week 12 and/or week 24 increases the likelihood of obtaining ID/LDA at week 52.Trial registration numberNCT02696785.
| S-EPMC11253752 | biostudies-literature
Project description:Acetabular retroversion is a relatively common condition affecting the hip that can result in symptoms in some patients. Diagnosis of acetabular retroversion relies on obtaining a proper anteroposterior radiograph of the pelvis. Cross-over, posterior wall, and ischial spine signs are usually present in patients on the radiographs of patients with acetabular retroversion. In this illustrative case report, we describe an additional radiographic sign, elephant's ear sign, associated with acetabular retroversion that we have seen to be present in patients with acetabular retroversion. A review of 26 acetabular retroversion case series by 2 independent reviewers showed 100% consensus on the presence of elephant's ear sign in patients with evidence of all other radiographic signs of this hip abnormality. This simple and previously unreported radiographic Elephant's ear sign, in which flared iliac wings appear as elephant's ears, highlights the presence of acetabular retroversion.
| S-EPMC7083708 | biostudies-literature
Project description:A solid epoxy resin formulation containing 2.5 wt % carbon nanotubes is 3D printed into self-standing parts, which after thermal curing result in CNTs/epoxy nanocomposites with mechanical properties attractive for heavy-duty applications.
| S-EPMC7804968 | biostudies-literature
Project description:Additively manufactured metallic materials typically exhibit preferential <001> or <110> crystallographic orientations along the build direction. Nowadays, the challenge is to program crystallographic orientation along arbitrary 3D direction in additive-manufactured materials. In this work, it is established a technique of multitrack coupled directional solidification (MTCDS) to program the <001> crystallographic orientation along an arbitrary 3D direction in biomedical beta-type Ti-Nb-Zr-Ta alloys via laser powder bed fusion (LPBF). MTCDS can be achieved via directional solidification of coupled multi-track melt pools with a specific temperature gradient direction. This results in continuous epitaxial growth of the β-Ti phase and consequently sets the <001> crystallographic orientation along an arbitrary 3D direction. This way, relatively low elastic modulus values of approximately 60 ± 1.2 GPa are customized along an arbitrary 3D direction. It is expected that MTCDS can be generalized to a wide range of applications for programming specific crystallographic orientations and, respectively, tailoring desired properties of different metallic materials.
| S-EPMC10558665 | biostudies-literature
Project description:Background and Objectives: The uncemented threaded DELTA ST-C cup was introduced in last few years. It has a hemispheric shell, consisting of Ti6Al4V titanium alloy. The MINIMA S stem was developed according to the principles of proximal-loading and extended metaphyseal geometry applied to a short stem. The purpose of the study was to assess the clinical and radiographic outcomes and the short- and mid-term survivorship of the DELTA ST-C cup and MINIMA S stem in patients undergoing total hip arthroplasty (THA). The present is the first study to report outcomes and implant survivorship of the DELTA ST-C cup coupled with the MINIMA S femoral stem. Materials and Methods: The present study is a retrospective observational cohort study of a prospectively maintained database, evaluating clinical outcomes and implant survivorship in 95 patients undergoing THA with the MINIMA stem coupled with the DELTA ST-C cup with at least a 3-year follow-up. The clinical evaluation was assessed with a change in the Harris hip score (HHS), while the radiographic evaluation included anteroposterior views of the pelvis and lateral views of the affected hip. Results: The enrolled population's mean age was 69.3 years and most patients were female (64%). The MINIMA S standard stem was implanted in 68 patients (72%), the lateralized stem was implanted in 27 (28%), and the mean acetabular inclination was 48.2°. The HHS improved significantly from the preoperative value (median 46, IQR: 38-55), already at 1 month after surgery (median 76, IQR: 66-77), reaching excellent results at 1 year and 3 years postoperatively (median 96, IQR: 91-100). X-rays demonstrated good implant stability and biomechanics parameter restorations revealed no sign of subsidence, and the presence of radiolucent lines greater than 2 mm in the short stem area in five cases and in the acetabulum in one were not clinically significant. No revisions have been performed so far. Conclusions: The MINIMA S stem coupled with the DELTA ST-C cup demonstrated very good clinical and radiological results with a significant increase of the Harris hip score at short- and mid-term follow-up. This is the first study evaluating the DELTA ST-C cup, showing promising outcomes during the study's follow-up. The MINIMA S stem has been evaluated in a very few studies. However, the combination with this particular cup had not yet been studied. The design of the stem and the cup ensures primary stability and excellent early term outcomes, moreover the study demonstrates extraordinary implant survivorship, equal to 100%.
| S-EPMC10058963 | biostudies-literature
Project description:Additive manufacturing offers exciting new possibilities for improving long-term metallic implant fixation in bone through enabling open porous structures for bony ingrowth. The aim of this research was to investigate how the technology could also improve initial fixation, a precursor to successful long-term fixation. A new barbed fixation mechanism, relying on flexible struts was proposed and manufactured as a push-fit peg. The technology was optimized using a synthetic bone model and compared with conventional press-fit peg controls tested over a range of interference fits. Optimum designs, achieving maximum pull-out force, were subsequently tested in a cadaveric femoral condyle model. The barbed fixation surface provided more than double the pull-out force for less than a third of the insertion force compared to the best performing conventional press-fit peg (p < 0.001). Indeed, it provided screw-strength pull out from a push-fit device (1,124 ± 146 N). This step change in implant fixation potential offers new capabilities for low profile, minimally invasive implant design, while providing new options to simplify surgery, allowing for one-piece push-fit components with high levels of initial stability. © 2017 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society. J Orthop Res 36:1508-1518, 2018.
| S-EPMC6175131 | biostudies-literature