Comparison of extramedullary versus intramedullary referencing for tibial component alignment in total ankle arthroplasty.

BACKGROUND: The majority of total ankle arthroplasty (TAA) systems use extramedullary alignment guides for tibial component placement. However, at least 1 system offers intramedullary referencing. In total knee arthroplasty, studies suggest that tibial component placement is more accurate with intramedullary referencing. The purpose of this study was to compare the accuracy of extramedullary referencing with intramedullary referencing for tibial component placement in total ankle arthroplasty. METHODS: The coronal and sagittal tibial component alignment was evaluated on the postoperative weight-bearing anteroposterior (AP) and lateral radiographs of 236 consecutive fixed-bearing TAAs. Radiographs were measured blindly by 2 investigators. The postoperative alignment of the prosthesis was compared with the surgeon's intended alignment in both planes. The accuracy of tibial component alignment was compared between the extramedullary and intramedullary referencing techniques using unpaired t tests. Interrater and intrarater reliabilities were assessed with intraclass correlation coefficients (ICCs). RESULTS: Eighty-three tibial components placed with an extramedullary referencing technique were compared with 153 implants placed with an intramedullary referencing technique. The accuracy of the extramedullary referencing was within a mean of 1.5 ± 1.4 degrees and 4.1 ± 2.9 degrees in the coronal and sagittal planes, respectively. The accuracy of intramedullary referencing was within a mean of 1.4 ± 1.1 degrees and 2.5 ± 1.8 degrees in the coronal and sagittal planes, respectively. There was a significant difference (P < .001) between the 2 techniques with respect to the sagittal plane alignment. Interrater ICCs for coronal and sagittal alignment were high (0.81 and 0.94, respectively). Intrarater ICCs for coronal and sagittal alignment were high for both investigators. CONCLUSIONS: Initial sagittal plane tibial component alignment was notably more accurate when intramedullary referencing was used. Further studies are needed to determine the effect of this difference on clinical outcomes and long-term survivability of the implants. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Self-referencing and consumer evaluations of larger-sized female models : a weight locus of control perspective

In two experiments, we show that the beliefs women have about the controllability of their weight (i.e., weight locus of control) influences their responses to advertisements featuring a larger-sized female model or a slim female model. Further, we examine self-referencing as a mechanism for these effects. Specifically, people who believe they can control their weight (“internals”), respond most favorably to slim models in advertising, and this favorable response is mediated by self-referencing. In contrast, people who feel powerless about their weight (“externals”), self-reference larger-sized models, but only prefer larger-sized models when the advertisement is for a non-fattening product. For fattening products, they exhibit a similar preference for larger-sized models and slim models. Together, these experiments shed light on the effect of model body size and the role of weight locus of control in influencing consumer attitudes.

The influence of ad model ethnicity and self-referencing on attitudes evidence from New Zealand

This paper examines consumers self-referencing as a mechanism for explaining ethnicity effects in advertising. Data was collected from a 2 (model ethnicity: Asian, white) x 2 (product stereotypicality: stereotypical, non-stereotypical) experiment. Measured independent variables included participant ethnicity and self-referencing. Results shows that (1) Asian exhibit greater self-referencing of Asian models than whites do; (2) self-referencing mediates ethnicity effects on attitude ( ie, attitude towards the model, attitude toward the add, brand attitude, and purchase intentions); (3) high self-referencing Asian have more favourable attitude towards the add and purchase intentions than low self referencing Asians; and (4) Asian models advertising atypical products generate more self-referencing and more favourable attitudes toward the model, A, and purchase intentions for both Asians and whites.

Using self-referencing to explain the effectiveness of ethnic minority models in advertising

Advertising research has generally not gone beyond offering support for a positive effect where ethnic models in advertising are viewed by consumers of the same ethnicity. This study offers an explanation behind this phenomenon that can be useful to marketers using self-reference theory. Our experiment reveals a strong self-referencing effect for ethnic minority individuals. Specifically, Asian subjects (the ethnic minority group) self-referenced ads with Asian models more than white subjects (the ethnic majority group). However, this result was not evident for white subjects. Implications for academics and advertisers are discussed.

How to stop binge drinking and speeding motorists : effects of relational-interdependent self-construal and self-referencing on attitudes toward social marketing

How can marketers stop speeding motorists and binge drinking? Two experiments show that the beliefs consumers have about the degree to which they define themselves in terms of their close relationships (i.e., relational-interdependent self-construal (RISC)) offer useful insights into the effectiveness of communications for two key social marketing issues—road safety (Study 1, New Zealand sample) and alcohol consumption (Study 2, English sample). Further, self-referencing is a mechanism for these effects. Specifically, people who define themselves in terms of their close relationships (high-RISCs) respond most favorably to advertisements featuring a dyadic relationship (two people), and this favorable response is mediated by self-referencing. In contrast, people who do not include close relationships in their sense of self (low-RISCs) respond most favorably to self-reference advertisements featuring solitary models.

Automated fit assessment of intramedullary nail designs during insertion

Modern intramedullary nails, which are utilised for the treatment of bone fractures, need to be designed to fit the anatomy of the patient population. Traditional and recent semi-automated approaches for quantifying the anatomical fit between bones and nail designs suffer from various drawbacks. This thesis proposed an automated comprehensive nail design validation method. The developed software tool was utilised to quantify the anatomical fit of four commercial nail designs. Furthermore, the thesis demonstrated the existence of a bone-nail specific nail entry point. The developed method is of great benefit for the implant manufacturing industry as a nail design validation tool.

A Self-Referencing Intensity Based Polymer Optical Fiber Sensor for Liquid Detection

A novel self-referencing fiber optic intensity sensor based on bending losses of a partially polished polymer optical fiber (POF) coupler is presented. The coupling ratio (K) depends on the external liquid in which the sensor is immersed. It is possible to distinguish between different liquids and to detect their presence. Experimental results for the most usual liquids found in industry, like water and oil, are given. K value increases up to 10% from the nominal value depending on the liquid. Sensor temperature dependence has also been studied for a range from 25 degrees C (environmental condition) to 50 degrees C. Any sector requiring liquid level measurements in flammable atmospheres can benefit from this intrinsically safe technology.

Computer simulating a trial of a load-bearing implant: example of an intramedullary prosthesis

Computational modelling is becoming ever more important for obtaining regulatory approval for new medical devices. An accepted approach is to infer performance in a population from an analysis conducted for an idealised or ‘average’ patient; we present here a method for predicting the performance of an orthopaedic implant when released into a population—effectively simulating a clinical trial. Specifically we hypothesise that an analysis based on a method for predicting the performance in a population will lead to different conclusions than an analysis based on an idealised or ‘average’ patient. To test this hypothesis we use a finite element model of an intramedullary implant in a bone whose size and remodelling activity is different for each individual in the population. We compare the performance of a low Young’s modulus implant (View the MathML source) to one with a higher Young’s modulus (200 GPa). Cyclic loading is applied and failure is assumed when the migration of the implant relative to the bone exceeds a threshold magnitude. The analysis for an idealised of ‘average’ patient predicts that the lower modulus device survives longer whereas the analysis simulating a clinical trial predicts no statistically-significant tendency (p=0.77) for the low modulus device to perform better. It is concluded that population-based simulations of implant performance–simulating a clinical trial–present a very valuable opportunity for more realistic computational pre-clinical testing of medical devices.