ABSTRACT
Regardless of the type of prosthetic lower limb, successful ambulation requires proper prosthetic attachment. To help alleviate many of the problems associated with prosthetic attachment, direct skeletal attachment (DSA) has been proposed as an alternative to conventional sockets. The purpose of the current study was to evaluate the feasibility of lower limb DSA in a micropig model and to develop a systematic approach to the development and analysis of DSA systems. The DSA device consisted of two stages. The load-carrying stage embedded in the bone canal was designed using bone remodeling theory in conjunction with finite element analysis to approximate implant-induced remodeling and stabilization out to 36 months postimplantation. The skin-interfacing stage was designed to maintain an immutable infection barrier where the prosthesis exited the body. Following successful design, fabrication, and benchtop evaluation, the device was surgically implanted in a Yucatan micropig. The animal trial was successful out to 10 weeks and revealed potential flaws in the surgical protocol related to thermal necrosis. However, no signs of infection were present at the time of implant retrieval. While results of this pilot study support the feasibility of a DSA approach to prosthetic limb attachment, additional animal trials are necessary to prove long-term viability.
Subject(s)
Artificial Limbs , Lower Extremity/surgery , Models, Animal , Prosthesis Implantation/instrumentation , Prosthesis Implantation/methods , Animals , Bone Remodeling/physiology , Feasibility Studies , Female , Finite Element Analysis , Lower Extremity/physiology , Models, Biological , Pilot Projects , Prosthesis Design , Swine , Swine, Miniature , Weight-BearingABSTRACT
In this study, we developed an approach for prosthetic foot design incorporating motion analysis, mechanical testing and computer analysis. Using computer modeling and finite element analysis, a three-dimensional (3D), numerical foot model of the solid ankle cushioned heel (SACH) foot was constructed and analyzed based upon loading conditions obtained from the gait analysis of an amputee and validated experimentally using mechanical testing. The model was then used to address effects of viscoelastic heel performance numerically. This is just one example of the type of parametric analysis and design enabled by this approach. More importantly, by incorporating the unique gait characteristics of the amputee, these parametric analyses may lead to prosthetic feet more appropriately representing a particular user's needs, comfort and activity level.
Subject(s)
Amputation, Surgical/rehabilitation , Artificial Limbs , Foot/physiopathology , Gait , Models, Biological , Computer Simulation , Elasticity , Equipment Failure Analysis/methods , Finite Element Analysis , Foot/surgery , Heel/physiopathology , Heel/surgery , Humans , Male , Materials Testing/methods , Middle Aged , Prosthesis Design/methods , Quality Control , Stress, Mechanical , Viscosity , Weight-BearingABSTRACT
The purpose of this study was to investigate the coordination of the head relative to the trunk within a gait cycle during gaze fixation. Nine normal subjects walked on a motorized treadmill driven at 1.79 m/s (20 s trials) while fixing their gaze on a centrally located earth-fixed target positioned at a distance of 2 m from their eyes. The net and relative angular motions of the head about the three axes of rotations, as well as the corresponding values for the moments acting on it relative to the trunk during the gait cycle were quantified and used as measures of coordination. The average net moment, as well as the average moments about the different axes were significantly different (P<0.01) between the high impact and low/no impact phases of the gait cycle. However, the average net angular displacement as well as the average angular displacement about the axial rotation axis of the head relative to the trunk was maintained uniform (P>0.01) throughout the gait cycle. The average angular displacement about the lateral bending axis was significantly increased (P<0.01) during the high impact phase while that about the flexion-extension axis was significantly decreased (P<0.01) throughout the gait cycle. Thus, the coordination of the motion of the head relative to the trunk during walking is dynamically modulated depending on the behavioral events occurring in the gait cycle. This modulation may serve to aid stabilization of the head by counteracting the force variations acting on the upper body that may aid in the visual fixation of targets during walking.
