In defense of becoming unhinged.
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Biomedical subjects
Publications and source records attributed to D G Murray.
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A low-cost FM/FM radio telemetry system is detailed, designed for motion analysis of the knee joint during walking in total knee replacement patients.
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Knee prostheses of eight different designs were tested experimentally to determine the axial torque necessary to rotate the tibial component relative to the femoral component with the prosthesis positioned at or near full extension. The results represent transmitted torque as a function of axial rotation. For six designs, the transmitted torque was 11.3 newton-meters (100 inch-pounds) or greater at 6 degrees of rotation, with an axial load of 1556.8 newtons (350 pounds). These prostheses either had close conformation between femoral and tibial components, or were mechanically linked. In these prostheses, the geometry of the articulating surfaces was the primary determinant of torque. For the other two types, under similar loading conditions the transmitted torques were 2.5 newton-meters (twenty-two inch-pounds) at 6 degrees of rotation. These prostheses were designed to allow greater freedom for rotation, and hence for them the primary determinant of torque was friction between the articulating surfaces. The predictive value of this torque characteristic relative to the incidence of loosening will have to be determined by comparison with clinical experience.
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We tested the Herbert knee prosthesis, which was designed to restore intrinsic stability with limited degrees of freedom for rotation to severely damaged or deformed knees, in a knee simulator. These tests indicated a tendency for the prosthesis to fracture through the medial femoral housing after cycling for the equivalent of one to three years of normal use. In a clinical series of thirty-five knees treated with the prosthesis, there were five failures similar to those produced by laboratory testing. On the basis of this combined study, the Herbert prosthesis appears to have design characteristics that seriously limit its usefulness for long-term knee replacement. Testing in a knee simulator in this case appeared to be a valid predictor of clinical failure.
Because of the unique properties for swelling in a fluid medium and variable modulus of elasticity, hydrophilic methacrylates may be of potential usefulness for implanting prosthetic devices in bone. To investigate the biocompatibility, electron micrographic studies were done on specimens of poly(2-hydroxyethyl methacrylate) imbedded in bone for varying periods of time. Ultrastructural examination revealed progressive ossification of surrounding connective tissue up to the tissue polymer junction over a 6 month period. There was no evidence of inflammatory response. Based upon this study, it would appear that bone adjusts to an implant of hydrophilic methacrylate by ossification to the implant junction. This supports continued studies into the usefulness of this material as an implant.
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