The cost and time effectiveness of osseointegration compared to the traditional socket prosthesis

Individuals with limb amputation fitted with conventional socket-suspended prostheses often experience socket related discomfort leading to a significant decrease in quality of life.[1-14] Most of these concerns can be overcome with osseointegration, a direct skeletal fixation method where the prosthetic componentry are directly attached to the fixation, resulting in the redundancy of the traditional socket system. There are two stages of osseointegration; Stage one, a titanium implant is inserted into the marrow space of residual limb bone and Stage two, a titanium extension is attached to the fixture. This surgical procedure is currently blooming worldwide, particularly within Queensland. Whilst providing improvements in quality of life, this new method also has potential to minimise the cost required for an amputee to ambulate during daily living. Thus, the aim of this project was to compare the differences in mean cost of services, cost of componentry and labour hours when using osseointegration compared to traditional socket-based prostheses. Data were extracted from Queensland Artificial Limb Services (QALS) database to determine cost of services, type of services and labour hours required to maintain a prosthetic limb. Five trans-femoral amputee male participants (age 46.4±10.1 yrs; height 175.4±16.3 cm; mass 83.8±14.0 kg; time since second stage 22.0± 8.1 mths) met inclusion criteria which was patient had to be more than 12 months post stage two osseointegration procedure. The socket and osseointegration prosthesis variables examined were the mean hours of labour, mean cost of services and mean cost of prosthetic componentry. Statistical analyses were conducted using an ANOVA. The results identified that there were only significant differences in the number of labour hours (p = 0.005) and cost of services (p = 0.021) when comparing the socket and osseointegration prosthetic type. These results identified that the cost of componentry were comparable between the two methods.

Dislocation after total hip replacement: there is no such thing as a safe zone for socket placement with the posterior approach

Introduction Malorientation of the socket contributes to instability after hip arthroplasty but the optimal orientation of the cup in relation to the pelvis has not been unequivocally described. Large radiological studies are few and problems occur with film standardisation, measurement methodology used and alternative definitions of describing acetabular orientation. Methods A cohort of 1,578 patients from a single institution is studied where all patient data was collected prospectively. Risk factors for patients undergoing surgery are analysed. Radiological data was compared between a series of non-dislocating hips and dislocating cases matched 2:1 by operation type, age and diagnosis. Results The overall dislocation rate for all 1,578 cases was 3.23% but the rate varied according to the type of surgery performed. The rate in uncomplicated primary cases was 2.4% which increased to 9.3% for second stage implantation for a two stage procedure for infection. There was no significant difference in the variability of the dislocating and non-dislocating groups for either inclination (p = 0.393) or anteversion (p = 0.661). Conclusions A “safe zone” for socket orientation to avoid dislocation could not be defined. The cause of dislocation is multifactorial, re-establishing the anatomic centre of rotation, balancing soft tissues and avoidance of impingement around the hip are important considerations.

Experimental and numerical study on power consumptions in a double-tube-socket pneumatic conveying system

A new methodology is proposed in this paper to predict the lowest power consumption for a double-tube-socket (DTS) pneumatic conveying system. This methodology is established on both experimental work and numerical simulation. After parametric studies by numerical simulation, the desired conveying cases which have the lowest power consumption were obtained. Finally those cases were carried out in our experimental system. The measured power consumption was close to that predicted. In this paper the experimental work is discussed and the numerical simulation introduced. (c) 2010 Elsevier B.V. All rights reserved.

CFD analysis of pneumatic conveying in a double-tube-socket (DTS (R)) pipe

A pipeline with a bypass is widely used for the pneumatic conveying of material. The double-tube-socket (DTS (R)) technology, which uses a special inner bypass, represents the current state of the art. Here, a new methodology is proposed based on the use of computational fluid dynamics (CFD) to predict the energy consumption of DTS conveying. The predicted results are in good agreement with those from pilot-scale experiments. (C) 2010 Elsevier Inc. All rights reserved.

NEW METHODOLOGY FOR THE ESTIMATION OF ENERGY CONSUMPTION IN A DOUBLE-TUBE-SOCKET (DTS (R)) PNEUMATIC CONVEYING

A new methodology based on the use of CFD is proposed to estimate the energy consumptions in a DTS (DOUBLE-TUBE-SOCKET) pneumatic conveying. A simple computational program based on this methodology is developed. It can directly give the lowest energy consumption and the compatible gas consumption by only input the distance of conveying and the conveying tonnage. This computational program has been validated through our experimental work.

Brown Bess Socket Mount Bayonet

This original Brown Bess socket mount bayonet is vintage War of 1812. It was purchased in the Niagara area and likely has a long local provenance.

Comparison of white metal and resin socket terminations for wire ropes

Previously the authors have presented both theoretical and experimental work discussing the operating mechanism of a wire rope held in a tapered socket by means of a cast resin cone. The work reported here extends the investigation to address the question of whether the same socket fabricated with white metal operates in the same manner. To date, previous investigations have compared the operational efficiency of resin and white metal in terms of both strength and/or fatigue endurance. Some other work has analysed the operation of resin sockets or specific cast metal terminations. This paper seeks to draw the results from this work together, and, in addition to a theoretical analysis, presents experimental data obtained from a direct comparison of the operation mechanism for the same sockets filled with resin or white metal. Results show that white metal terminations have a very different distribution of stresses along the length of the socket basket from resin terminations, and a smaller but still significant amount of socket draw. For both types of termination the socket draw develops high frictional gripping forces which can transfer the load from the rope to the socket. The different stress distributions mean that the consequences of termination fabrication defects may not be the same for resin and white metal terminations.

Evaluation of alveolar socket response to Angelus MTA and experimental light-cure MTA

Objective. The aim of this study was to evaluate the rat alveolar socket response to implanted polyethylene tubes filled with a light-cured MTA or Angelus MTA.Study design. Fifty-seven Wistar rats received an implant filled with one of the materials in the dental socket of the right central incisor. After 30, 60, and 90 days, animals were killed, and the right hemimaxillas were removed and processed to be analyzed on light microscopy. After embedding in paraffin, 6-mu m-thick sections were obtained and stained with hematoxylin and eosin. Qualitative and quantitative analyses of the reaction were performed.Results. It was observed that the light-cured MTA presented a similar response compared with Angelus MTA, characterized by the reduction of the chronic inflammatory response and organization of the alveolar bone close to the materials, especially at the 90th day of observation.Conclusions. It was concluded that both materials were well accepted by the alveolar tissue of rats, with the formation of mineralized tissue close to the materials. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:e93-e97)

Comparison of Biomaterial Implants in the Dental Socket: Histological Analysis in Dogs

Background:Bone graft procedures have been used commonly in buco-maxillo-facial surgery. For this reason, many researchers have evaluated the bone substitutes.Purpose:The present study evaluated soft and hard tissue reactions to two different hydroxyapatites HAs (synthetic HA and natural HA) and bioactive glass implanted into the sockets immediately after extraction.Materials and Methods:First and third upper and lower premolars, on both sides, were extracted from six female dogs. The alveolar sockets were randomly assigned to four groups: Group 1 - control (unfilled), Group 2 - filled with synthetic hydroxyapatite, Group 3 - filled with bovine bone mineral (natural HA), and Group 4 - filled with bioactive glass. The animals were euthanized at 4 weeks (n = 2), 8 weeks (n = 2), and 28 weeks (n = 2) after extraction. The mandible and maxilla of each animal were removed for histological analysis to determine soft tissue reactions, newly formed bone, bone characteristics, and presence or absence of implanted materials.Results:Most particles of synthetic hydroxyapatite had bone formation on their surface, although some particles showed a layer of fibrous connective tissue. The bovine bone mineral group exhibited particles partially replaced with bone formation. The bioactive glass group showed particles with a thin layer of calcified tissue, but was absent in some specimens, suggesting complete resorption.Conclusion:All biomaterials had similar behavior. Bovine bone mineral, compared to synthetic hydroxyapatite and bioactive glass, showed a larger number of particles covered with osseous tissue. All biomaterials interfered with the socket repair process.