Role of microRNAs in improved osteogenicity of topographically modified titanium implant surfaces

This project aimed at understanding the molecular mechanisms involved in the superior integration of micro-roughened titanium implant surfaces with the surrounding bone, when compared with their smooth surfaces. It involved studying the role of microRNAs and cell signaling pathways in the molecular regulation of bone cells on topographically modified titanium dental implants. The findings suggest a highly regulated microRNA-mediated control of molecular mechanisms during the process of bone formation that may be responsible for the superior osseointegration properties on micro-roughened titanium implant surfaces and indicate the possibility of using microRNA modulators to enhance osseointegration in clinically demanding circumstances.

Clinically-based automatic implant fitting for shape optimization of fracture fixation plates

Complex bone contour and anatomical variations between individual bones complicate the process of deriving an implant shape that fits majority of the population. This thesis proposes an automatic fitting method for anatomically-precontoured plates based on clinical requirements, and investigated if 100% anatomical fit for a group of bone is achievable through manual bending of one plate shape. It was found that, for the plate used, 100% fit is impossible to achieve through manual bending alone. Rather, newly-developed shapes are also required to obtain anatomical fit in areas with more complex bone contour.

Load bearing exercises and functional outcome of individuals with transfemoral amputation fitted with OPRA fixation

Individuals with lower limb amputation fitted with an OPRA osseointegrated fixation are facing an extensive rehabilitation program including static load bearing exercises (LBE). The application of a suitable amount of stress stimulates osseointegration and prepares the bone to tolerate the forces and moments that will be incurred during activities of daily living (ADL. At present, the monitoring is typically carried out using a normal bathroom weighing scale. This scale provides information only on the magnitude of the vertical component of the applied force. The moment around the long axis of the fixation when the femur is perpendicular to the ground is not assessed and neither are the components of force and moment generated on the other two axes.

Spatio-temporal characteristics of locomotion and functional outcomes of individuals with transfemoral amputation fitted with OPRA fixation

The conventional method of attachment of prosthesis involves a socket. A new method relying on osseointegrated fixation has emerged in the last decades. It has significant prosthetic benefits. Only a few studies demonstrated the biomechanical benefits. The ultimate aim of this study was to characterise the functional outcome of individuals with lower limb amputation fitted with osseointegrated fixation, which can be assess through temporal and spatial gait characteristics. The specific objective of this study was to present the key temporal and spatial gait characteristics of individuals with transfemoral amputation (TFA).

Biomechanics of transfemoral amputees fitted with osseointegrated fixation: Loading data for evidence-based practice

This presentation will provide an overview of the load applied on the residuum of transfemoral amputees fitted with an osseointegrated fixation during (A) rehabilitation, including static and dynamic load bearing exercises (e.g., rowing, adduction, abduction, squat, cycling, walking with aids), and (B) activities of daily living including standardized activities (e.g., level walking in straight line and around a circle, ascending and descending slopes and stairs) and activities in real world environments.

Spatio-temporal characteristics of locomotion of transfemoral amputees fitted with bone-anchored prosthesis

The conventional method of attachment of prosthesis involves on a socket. A new method relying on osseointegrated fixation is emerging. It has significant prosthetic benefits. Only a few studies demonstrated the biomechanical benefits. The specific objective of this study was to present the key temporal and spatial gait characteristics for unilateral amputation. The ultimate aim of this study was to characterise the functional outcome of the individual with transfemoral lower limb amputation fitted with osseointegrated fixation, which can be assess through temporal and spatial gait characteristics.

Safety of OPRA procedure for individuals with upper limb amputation

Surgical implantations of osseointegrated fixations for bone-anchored prosthesis are developing at an unprecedented pace worldwide while initial skepticism in the orthopedic community is slowly fading away. Clearly, this option is becoming accessible to a wide range of individuals with limb loss. [1-18] The team led by Dr Rickard Branemark has previously published a number of landmark articles focusing on the benefits and safety of the OPRA fixation mainly for individual with lower limb loss, particularly those with transfemoral amputation. [1-3, 19-32] However, similar information is lacking for those with upper limb amputation. This team is once again taking a leading role by sharing a retrospective study focusing on the implant survival, adverse events, implant stability, and bone remodelling for 18 individuals with transhumeral amputation over a 5-year post-operative period. Therefore, a comprehensive analysis of the safety of the procedure is accessible for the first time. In essence, the results showed an implant survival rate of 83% and 80% at 2 and 5 year follow ups, respectively. The most frequent adverse events were superficial skin infections that occurred for 28% (5) participants while the least frequent was deep bone infection that happened only once. More importantly, 38% of complications due to infections were effectively managed with nonoperative treatments (e.g., revision of skin penetration site, local cleaning, antibiotics, restriction of soft tissue mobility). Implant stability and bone remodelling were satisfactory. Clearly, this study provided better understanding of the safety of the OPRA surgical and rehabilitation procedure for individuals with upper limb amputation while establishing standards and benchmark data for future studies. However, strong evidences of the benefits are yet to be demonstrated. However, increase in health related quality of life and functional outcomes (e.g., range of movement) are likely. Altogether, the team of authors are providing further evidence that bone-anchored attachment is definitely a promising alternative to socket prostheses.

Bone-anchored prosthesis: Update in international developments

This symposium will provide hand-on update on the current development of the load sensors measuring the inner prosthetic loading that can strongly contribute the ever increasing demand for evidence-based clinical practice. Surgical implantations of osseointegrated fixations for bone-anchored prosthesis are developing at an unprecedented pace worldwide (e.g., Australia, UK, Sweden, US). This option is becoming accessible to a wide range of individuals with limb loss. With these new developments come new potential challenges and opportunities for all the stakeholders involved in the prosthetic care of these patients. Clearly, there is a need for those stakeholders, particularly those attending the ISPO, to be informed of the current and upcoming international developments in bone-anchored prostheses. The objectives of this symposium will be: • To present an overview of the current growth of the procedures worldwide (e.g., identification of key players, centers of activities, growth trend) with a strong focus on the introduction of the framework to evaluate the availability of the procedure at national level (e.g., number of patients treated, range of the levels of implantation, number of commercial fixations accessible), • To provide first-hand updates on the latest cutting-edge scientific and clinical developments of fixations and rehabilitations programs (e.g., Innovative design of implant, cost-effectiveness, long-terms rehabilitation outcomes for screw-type fixation, current developments in US, comparative analysis for press-fit type of implant, potential moves toward single-stage surgeries).

Exploring Technology Evolution Using Patent Classification: A Case of Cochlear Implant Technology Patents

Understanding technology evolution through periodic landscaping is an important stage of strategic planning in R&D Management. In fields like that of healthcare, where the initial R&D investment is huge and good medical product serve patients better, these activities become crucial. Approximately five percentage of the world population has hearing disabilities. Current hearing aid products meet less than ten percent of the global needs. Patent data and classifications on cochlear implants from 1977-2010, show the landscapes and evolution in the area of such implant. We attempt to highlight emergence and disappearance of patent classes over period of time showing variations in cochlear implant technologies. A network analysis technique is used to explore and capture technology evolution in patent classes showing what emerged or disappeared over time. Dominant classes are identified. The sporadic influence of university research in cochlear implants is also discussed.

Wireless parylene-based retinal implant

The degeneration of the outer retina usually causes blindness by affecting the photoreceptor cells. However, the ganglion cells, which consist of optic nerves, on the middle and inner retina layers are often intact. The retinal implant, which can partially restore vision by electrical stimulation, soon becomes a focus for research. Although many groups worldwide have spent a lot of effort on building devices for retinal implant, current state-of-the-art technologies still lack a reliable packaging scheme for devices with desirable high-density multi-channel features. Wireless flexible retinal implants have always been the ultimate goal for retinal prosthesis. In this dissertation, the reliable packaging scheme for a wireless flexible parylene-based retinal implants has been well developed. It can not only provide stable electrical and mechanical connections to the high-density multi-channel (1000+ channels on 5 mm × 5 mm chip area) IC chips, but also survive for more than 10 years in the human body with corrosive fluids.

The device is based on a parylene-metal-parylene sandwich structure. In which, the adhesion between the parylene layers and the metals embedded in the parylene layers have been studied. Integration technology for high-density multi-channel IC chips has also been addressed and tested with dummy and real 268-channel and 1024-channel retinal IC chips. In addition, different protection schemes have been tried in application to IC chips and discrete components to gain the longest lifetime. The effectiveness has been confirmed by the accelerated and active lifetime soaking test in saline solution. Surgical mockups have also been designed and successfully implanted inside dog's and pig's eyes. Additionally, the electrodes used to stimulate the ganglion cells have been modified to lower the interface impedance and shaped to better fit the retina. Finally, all the developed technologies have been applied on the final device with a dual-metal-layer structure.

A preliminary investigation of Elastomer Visible Implant (EVI)tag retention rates and the effect of tagging on the growth and survival of barbel (Barbus barbus L.).

The Elastomer Visible Implant system (EVI) is a relatively new technique for batch marking fish. The aim of this study was to assess retention rates and the possible effects of tagging on the growth and mortality of barbel, Barbus barbus, (81-197mm, fork length) over approximately 2 months using a syringe injection system.