Findings from these techniques yielding data on stress shielding, bone mineral density, extent of bone—prosthesis apposition and osseointegration, and histologic activity are ultimately of considerable clinical significance.
After removal of infected endoprostheses and radical necrosectomy bony defects always will be present. Filling of dead space has been considered mandatory since the old days of septic surgery. It may be presumed that whatever filler is used it needs some kind of protection against colonisation with remaining bacteria. Dead space management after infected THR may be performed with antibiotic loaded cement, spacers or bead chains. It should be kept in mind, that those devices beside their mechanical function cannot be considered as an antimicrobial tool; their antibiotic content provides short lived prophylactic aid against planktonic bacteria but is not capable of sterilizing sites contaminated with sessile bacteria and provide no protection against biofilm colonisation -. Reconstruction of defects seems to be favourable with regard to possible further revisions. Allograft bone is widely used for reconstruction of bony defects and performs favourably in two stage revisions of THR . However, unvascularized bone grafts are at risk to become contaminated and need protection as well. When loading bone grafts with antibiotics it turned out, that their storage capability for antibiotics exceeds those of PMMA by far -. Especially when using highly purified cancellous bone as a carrier local concentrations of up to 20.000mg/l can be released with Vancomycin and up to 13.000mg/l with Tobramycin . With this kind of impregnation the whole amount of loaded antibiotic is available for antimicrobial activity and the activity remains far beyond the susceptibility of relevant pathogens for several weeks. These capacities make them more attractive for local therapy and allow using uncemented implants. If cortical bone should become preferable out of whatever circumstances it can be loaded with antibiotics as well. Using adequate impregnation technique antibiotics may elute similarly effective as is the case with cancellous bone . Kinetics are different but still capable of eliminating surrounding pathogens.
US4775381A - Hip prosthesis - Google Patents
Another neural prosthetic is Johns Hopkins University Applied Physics Laboratory Proto 1. Besides the Proto 1, the university also finished the Proto 2 in 2010.
couples for human hip prosthesis .
Advancements in the processors used in myoelectric arms has allowed for artificial limbs to make gains in fine tuned control of the prosthetic. The Boston Digital Arm is a recent artificial limb that has taken advantage of these more advanced processors. The arm allows movement in five axes and allows the arm to be programmed for a more customized feel. Recently the i-Limb hand, invented in Edinburgh, Scotland, by David Gow has become the first commercially available hand prosthesis with five individually powered digits. The hand also possesses a manually rotatable thumb which is operated passively by the user and allows the hand to grip in precision, power and key grip modes. Raymond Edwards, Limbless Association Acting CEO, was the first amputee to be fitted with the i-LIMB by the National Health Service in the UK. The hand, manufactured by “Touch Bionics” of Scotland (a Livingston company), went on sale on 18 July 2007 in Britain. It was named alongside the Super Hadron Collider in Time magazine’s top fifty innovations. Another robotic hand is the RSLSteeper bebionic
Implantable prosthesis for replacing a human hip or …
Within science fiction, and, more recently, within the scientific community, there has been consideration given to using advanced prostheses to replace healthy body parts with artificial mechanisms and systems to improve function. The morality and desirability of such technologies are being debated. Body parts such as legs, arms, hands, feet, and others can be replaced.
The first experiment with a healthy individual appears to have been that by the British scientist Kevin Warwick. In 2002, an implant was interfaced directly into Warwick’s nervous system. The electrode array, which contained around a hundred electrodes, was placed in the median nerve. The signals produced were detailed enough that a robot arm was able to mimic the actions of Warwick’s own arm and provide a form of touch feedback again via the implant.
Prosthetic enhancement - Artificial Limb Prosthesis
Images and text include the incision site, exposure with excision of the diseased femoral head, preparation of the femoral canal with a rasp for placement of a prosthesis (femoral prosthesis not shown to allow for discussion of different types of components).