14 resultados para KNEE PROSTHESIS

em Universidade do Minho


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Vascular grafts are used to bypass damaged or diseased blood vessels. Bacterial cellulose (BC) has been studied for use as an off-the-shelf graft. Herein, we present a novel, cost-effective, method for the production of small caliber BC grafts with minimal processing or requirements. The morphology of the graft wall produced a tensile strength above that of native vessels, performing similarly to the current commercial alternatives. As a result of the production method, the luminal surface of the graft presents similar topography to that of native vessels. We have also studied the in vivo behavior of these BC graft in order to further demonstrate their viability. In these preliminary studies, 1 month patency was achieved, with the presence of neo-vessels and endothelial cells on the luminal surface of the graft.

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PhD in Sciences Specialty in Physics

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 In orthopaedics, the management and treatment of osteochondral (OC) defects remains an ongoing clinical challenge. Autologous osteochondral mosaicplasty has been used as a valid option for OC treatments although donor site morbidity remains a source of concern [1]. Engineering a whole structure capable of mimicking different tissues (cartilage and subchondral bone) in an integrated manner could be a possible approach to regenerate OC defects. In our group we have been proposing the use of bilayered structures to regenerate osteochondral defects [2,3]. The present study aims to investigate the pre-clinical performance of bilayered hydrogels and spongy-like hydrogels in in vivo  models (mice and rabbit, respectively), in both subcutaneous and orthotopic models. The bilayered structures were produced from Low Acyl Gellan Gum (LAGG) from Sigma-Aldrich, USA. Cartilage-like layers were obtained from a 2wt% LAGG solution. The bone-like layers were made of 2wt% LAGG with incorporation of hydroxyapatite at 20% and 30% (w/v). Hydrogels and spongy-like were subcutaneouly implanted in mice to evaluate the inflammatory response. Then, OC defects were induced in rabbit knee to create a critical size defect (4 mm diameter and 5 mm depth), and then hydrogels and sponges implanted. Both structures followed different processing methods. The hydrogels were injected allowing in situ  crosslinking. Unlike, the spongy-like were pre-formed by freeze-drying. The studies concerning subcutaneous implantation and critical size OC defect were performed for 2 and 4 weeks time, respectively. Cellular behavior and inflammatory responses were assessed by means of histology staining and biochemical function and matrix deposition by immunohistochemistry. Additionally, both OC structures stability and new cartilage and bone formation were evaluated by using vivo- computed tomography (Scanco 80). The results showed no acute inflammatory response for both approaches. New tissue formation and integration in the adjacent tissues were also observed, which present different characteristic behaviors when comparing hydrogels and sponges response. As future insights, a novel strategy for regeneration of OC defects can be designed encompassing both, hydrogels and spongy-like structures and cellular approaches. References: 1. Espregueira-Mendes J. et al. Osteochondral transplantation using autografts from the upper tibio-fibular joint for the treatment of knee cartilage lesions. Knee Surgery, Sports Traumatology, Arthroscopy 20,1136, 2012. 2. Oliveira JM. et al, Novel hydroxyapatite/chitosan bilayered scaffold for osteochondral tissue-engineering applications: Scaffold design and its performance when seeded with goat bone marrow stromal cells. Biomaterials 27, 6123, 2006. 3. Pereira D R. et al. Gellan Gum-Based Hydrogel Bilayered Scaffolds for Osteochondral Tissue Engineering. Key Engineering Materials 587, 255, 2013.

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This study aimed to develop appropriate changes in a pair of shoes in order to improve the gait of an individual selected for this case study. This analysis took into account ergonomic aspects, namely those relating to the individual’s anthropometrics. Gait analysis was done with the adapted footwear both before and after intervention.A conventional X-ray was performed, which revealed a 29-mm left lower limb shortening and possible foot adduction. The anthropometric assessment confirmed a 27-mm asymmetry between the left knee and foot.Corrective changes were implemented in the left boot, with a 20-mm increase in the plantar aspect and approximately 30-mm in the calcaneus area.The pressure-mapping system WalkinSense was used for the kinetic gait analysis. Results showed some improvement in plantar pressure distribution after corrective changes in footwear. Peak pressure in the left foot decreased from 2.8kg/cm2 to 1.6kg/cm2. The second peak also showed a marked decrease. The right foot presented with a reduction in peak plantar pressure from 2.7kg/cm2 to 2.3kg/cm2.After identifying asymmetries, the associated pathologies and modifyingthe footwear, a kinetic analysis of gait before and after altering the footwear was undertaken, which showed improvements in the gait. According to the obtained results, it was possible to demonstrate that the initially proposed objectives were achieved, i.e., the changes in footwear resulted in an improvement of the analyzed individual.

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Electroactive polymers are one of the most interesting class of polymers used as smart materials in various applications, such as the development of sensors and actuators for biomedical applications in areas such as smart prosthesis, implantable biosensors and biomechanical signal monitoring, among others. For acquiring or applying the electrical signal from/to the piezoelectric material, suitable electrodes can be produced from Ti based coatings with tailored multifunctional properties, conductivity and antibacterial characteristics, through Ag inclusions. This work reports on Ag-TiNx electrodes, deposited by d. c. and pulsed magnetron sputtering at room temperature on poly(vinylidene fluoride), PVDF, the all-round best piezoelectric polymer.. Composition of the electrodes was assessed by microanalysis X-ray system (EDS - energy dispersive spectrometer). The XRD results revealed that the deposition conditions preserve the polymer structure and suggested the presence of crystalline fcc-TiN phase and fcc-Ag phase in samples with N2 flow above 3 sccm. According to the results obtained from SEM analysis, the coatings are homogeneous and Ag clusters were found for samples with nitrogen flow above 3 sccm. With increasing nitrogen flow, the sheet resistivity tend to be lower than the samples without nitrogen, leading also to a decrease of the piezoelectric response. It is concluded that the deposition conditions do significantly affect the piezoelectric polymer, which maintain its characteristics for sensor/actuator applications.

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Objectives: This research work intends to clarify the role of artificial saliva, in particularly the role of mucin, a salivary protein, on the surface properties and adhesion ability of Candida spp. oral clinical isolates to abiotic surfaces. Methods: Four oral clinical isolates of Candida spp. were used: two Candida albicans strains (AC; AM) and two Candida parapsilosis strains (AD; AM2). The strains were isolated from patients using oral prosthesis. The microorganisms were cultured in the absence or presence of mucin and artificial saliva, and their adhesion to an abiotic surface (coated with mucin and artificial saliva) was evaluated. Results: The presence of mucin per se onto the abiotic surface decreased the adhesion of all strains, although the combination of mucin with artificial saliva had reduced this effect. No direct correlation between adhesion and the surface free energies of adhesion of the microorganisms was found. Significance: Candida spp. were human commensal microorganisms that became pathogenic when the host immune defenses were compromised. Medical devices were colonized by Candida spp. particularly, oral prostheses, which might lead to the degradation of the prostheses and systemic infections. The salivary secretions that constantly cover the oral cavity influenced Candida spp. adhesion process. Therefore, it was important to understand the interactions between Candida spp., salivary proteins and the characteristic of oral prosthesis when developing materials for oral prostheses.

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Background Several studies link the seamless fit of implant-supported prosthesis with the accuracy of the dental impression technique obtained during acquisition. In addition, factors such as implant angulation and coping shape contribute to implant misfit. Purpose To identify the most accurate impression technique and factors affecting the impression accuracy. Material and Methods A systematic review of peer-reviewed literature was conducted analyzing articles published between 2009 and 2013. The following search terms were used: implant impression, impression accuracy, and implant misfit. A total of 417 articles was identified, 32 were selected for review. Results All 32 selected studies refer to in vitro studies. Fourteen articles compare open and closed impression technique, 8 advocate the open technique and 6 report similar results. Other 14 articles evaluate splinted and non-splinted techniques; all advocating the splinted technique. Polyether material usage was reported in 9; 6 studies tested vinyl polysiloane and 1 study used irreversible hydrocolloid. Eight studies evaluated different copings designs. Intra-oral optical devices were compared in 4 studies. Conclusions The most accurate results were achieved with two configurations: (1) the optical intra-oral system with powder; and (2) the open technique with splinted squared transfer copings, using polyether as impression material.

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Identification of pre-participation risk factors for noncontact anterior cruciate ligament (ACL) injuries has been attracting a great deal of interest in the sports medicine and traumatology communities. Appropriate methods that enable predicting which patients could benefit from pre- ventive strategies are most welcome. This would enable athlete-specific training and conditioning or tailored equipment in order to develop appropriate strategies to reduce incidence of injury. In order to accomplish these goals, the ideal system should be able to assess both anatomic and functional features. Complementarily, the screening method must be cost-effective and suited for widespread application. Anatomic study protocol requiring only standard X rays could answer some of such demands. Dynamic MRI/CT evaluation and electronically assisted pivot-shift evaluation can be powerful tools providing complementary information. These upcoming insights, when validated and properly combined, envision changing pre-participation knee examination in the near future. Herein different methods (validated or under research) aiming to improve the capacity to identify persons/athletes with higher risk for ACL injury are overviewed. 

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In the last few years, many reports have been describing promising biocompatible and biodegradable materials that can mimic in a certain extent the multidimensional hierarchical structure of bone, while are also capable of releasing bioactive agents or drugs in a controlled manner. Despite these great advances, new developments in the design and fabrication technologies are required to address the need to engineer suitable biomimetic materials in order tune cells functions, i.e. enhance cell-biomaterial interactions, and promote cell adhesion, proliferation, and differentiation ability. Scaffolds, hydrogels, fibres and composite materials are the most commonly used as biomimetics for bone tissue engineering. Dynamic systems such as bioreactors have also been attracting great deal of attention as it allows developing a wide range of novel in vitro strategies for the homogeneous coating of scaffolds and prosthesis with ceramics, and production of biomimetic constructs, prior its implantation in the body. Herein, it is overviewed the biomimetic strategies for bone tissue engineering, recent developments and future trends. Conventional and more recent processing methodologies are also described.

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Dissertação de mestrado integrado em Engenharia Biomédica

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Tese de Doutoramento em Ciências (Especialidade de Física)

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Tese de Doutoramento (Programa Doutoral em Engenharia de Materiais)

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"Series: Solid mechanics and its applications, vol. 226"

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"Series: Solid mechanics and its applications, vol. 226"