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PubMed1983

Isometric muscle strength and endurance after knee arthroplasty with the modular knee in patients with osteoarthrosis and rheumatoid arthritis.

Maximum isometric muscle strength and endurance were used in an investigation of knee extension and knee flexion in patients with rheumatoid arthritis (RA) and osteoarthrosis (OA) with such severe changes of the joint that arthroplasty with the Modular prosthesis was performed. The measurements were done preoperatively and 3, 12, 24 and 36 months postoperatively. Muscle strength preoperatively was very weak compared with that of a group of healthy persons. The muscle strength 3 months postoperatively remained unchanged, which could mean a very slight trauma from the operation, very good pain relief and efficient physiotherapy. During the first 2 years the maximum isometric muscle strength was significantly increased both in patients with RA and in those with OA. Thereafter there was no increase in the RA patients, whereas in women with OA there was an improvement up to 3 years postoperatively. The improvement in the flexion strength was greater than that of the extension strength, thus indicating the importance of postoperative training of extension strength. Isometric muscle strength measurements show that there is an equalization between the non-diseased knee and the one operated with the Modular knee.

Aged↗
PubMed1997

A modular endoprosthetic system for tumor and non-tumor reconstruction: preliminary experience.

Though originally designed to facilitate the management of primary malignant bone tumors, the indications for the Howmedica Oncology modular endoprostheses have expanded to include the reconstruction of metastatic lesions, failed internal fixation of difficult trauma problems, and failed conventional and custom tumor endoprostheses. Between July 1989 and August 1992, 24 patients underwent 25 procedures, either proximal humeral replacement (7), proximal femoral replacement (5), distal femoral replacement (9), or total femoral replacement (4). Diagnoses included primary bone tumor (6), metastases (5), and failed previous orthopedic intervention (14). Two early and four late complications in five patients were all treated successfully with surgical or nonoperative treatment. Preliminary functional results indicate very satisfactory results. Modular endoprostheses appear to be effective in the treatment of a wide range of diagnoses, not limited to the reconstruction following primary malignant bone tumor resections.

Adolescent↗
PubMed2005

Femoral version: definition, diagnosis, and intraoperative correction with modular femoral components.

Normal femoral version contributes to the inherent stability of the hip joint. Abnormal version is found in a variety of hip diseases afflicting children and adults. At the time of reconstruction for end-stage hip disease, maintaining proper femoral version in conjunction with acetabular version allows for hip stability and unimpeded functional range of motion. In those instances where femoral version is significantly abnormal, a means of correction at time of surgery is necessary. Non-modular femoral components allow for minor adjustments in version at time of surgery. To accommodate significant versional abnormalities, the modular S-ROM (DePuy Orthopaedics Inc, Warsaw, Ind) was introduced in 1984. In a series of 156 primary S-ROM total hip arthroplasties, the ability to correct for abnormal version resulted in excellent clinical results with no incidence of hip instability and excellent range of motion.

Adult↗
PubMed2005

Modular junctions.

A concern about modular stems is that the taper will not provide an adequate seal, causing the stem distal to the taper to become part of the effective joint space. In this study, 380 primary patients and 309 revision patients were treated with a proximally modular stem. Follow-up was between 5 and 17 years (mean 9.4 years). Three patients only had distal osteolysis. All three patients had failure of proximal bone ingrowth. It was concluded that a Morse taper provides an adequate seal or gasket.

Arthroplasty, Replacement, Hip↗
PubMedDate not supplied

The canine cemented modular total hip prosthesis.

Total hip replacement (THR) is well established as a treatment modality for dogs with noninfectious, nonneoplastic, disabling conditions of the coxofemoral joint. Since the mid 1970s, a fixed-head prosthesis has been used in this procedure. A modular prosthesis, which is based on many of the technical advances found in human prostheses, now is available for use in veterinary medicine. The prosthesis, surgical instrumentation, surgical technique, and clinical results have been evaluated in a prospective study conducted at The Ohio State University's College of Veterinary Medicine. The modular prosthesis provides results equal to or better than the fixed-head prosthesis.

Animals↗
PubMed2000

Point-of-care glucose testing: effects of critical care variables, influence of reference instruments, and a modular glucose meter design.

OBJECTIVE: To assess the clinical performance of glucose meter systems when used with critically ill patients. DESIGN: Two glucose meter systems (SureStepPro and Precision G) and a modular adaptation (Immediate Response Mobile Analysis-SureStepPro) were assessed clinically using arterial samples from critically ill patients. A biosensor-based analyzer (YSI 2700) and a hospital chemistry analyzer (Synchron CX-7) were the primary and secondary reference instruments, respectively. PATIENTS AND SETTING: Two hundred forty-seven critical care patients at the University of California, Davis, Medical Center participated in this study. OUTCOME MEASURES: Error tolerances of +/-15 mg/dL for glucose levels </=100 mg/dL and +/-15% for glucose levels >100 mg/dL were used to evaluate glucose meter performance; 95% of glucose meter measurements should fall within these tolerances. RESULTS: Compared to the primary reference method, 98% to 100% of SureStepPro and 91% to 95% of Precision G measurements fell within the error tolerances. Paired differences of glucose measurements versus critical care variables (Po(2), pH, Pco(2), and hematocrit) were analyzed to determine the effects of these variables on meter measurements. Po(2) and Pco(2) decreased Precision G and SureStepPro measurements, respectively, but not enough to be clinically significant based on the error tolerance criteria. Hematocrit levels affected glucose measurements on both meter systems. Modular adaptation did not affect test strip performance. CONCLUSIONS: Glucose meter measurements correlated best with primary reference instrument measurements. Overall, both glucose meter systems showed acceptable performance for point-of-care testing. However, the effects of some critical care variables, especially low and high hematocrit values, could cause overestimated or underestimated glucose measurements.

Blood Glucose↗
PubMed1993

Optimum pressfit and proximal stress transfer with an improved modular design in total hip arthroplasty.

Femoral stem pressfit fixation depends on optimal proximal fit and stress transfer for long-term function. Newer modular designs offer improvements that enhance proximal-distal sizing, anatomical canal fill in the proximal metaphysis, and better stress transfer resulting from more intimate cortical contact. The Infinity modular femoral stem has the unique advantage of very proximal loading and gains fixation with a flexible stem that allows matching the variables of anteversion and proximal metaphyseal bow.

Body Constitution↗
PubMed1994

Clinical and laboratory investigations of fretting and corrosion of a three-component modular femoral stem design.

A retrieval analysis of three modular femoral stems in vivo up to 25 months were examined using laboratory-based comparisons of similar devices as controls. The internal taper connection of each retrieved femoral component, and the laboratory controls were evaluated using SEM, EDAX, and epoxy vacuum infiltration. No corrosion of the substrate was detected for any of the retrievals. Fretting was mild on one retrieval and the in vitro-fatigued component, whereas minor fretting was observed for the other retrievals. Particulate debris was not evident as revealed by the epoxy infiltrate of the modular junction.

Adult↗
PubMedDate not supplied

Impact on human resources: Core Laboratory versus laboratory information system versus modular robotics.

Technological advances in laboratory systems have had a great impact on human resources. Surviving the changes requires an in-depth understanding of the technology to implement the appropriate operational model. St. Mary's is a 414-bed, acute care hospital. For 18 months, the laboratories went through the process of moving from a noncomputerized traditional model laboratory (i.e., by discipline) to a fully computerized Core Lab. The Core Lab concept fully integrates biochemistry, hematology, blood bank, and microbiology into two sections (not physically separated): tests processed by automation and tests processed manually. This approach led to a 15% reduction in staff while the volume doubled. The transitions occurred sequentially: from traditional laboratory to Core Lab (noncomputerized), from manual Core Lab to fully computerized Core Lab, and ultimately from a simulation of manual preanalytical phase to automated preanalytical phase (modular robotics). The findings show that Core Lab and computerization have almost the same impact on human resources, 35% and 30% respectively, and modular robotics the least impact with 17%.

Clinical Laboratory Information Systems↗
PubMed1999

Patellofemoral complications after total knee arthroplasty: a comparison of Modular Porous-Coated Anatomic with Duracon prostheses.

Clinical and radiographic analyses were used to compare results obtained in 45 patients who underwent a Modular Porous-Coated Anatomic total knee arthroplasty with results in a similar group of 45 patients who underwent a Duracon total knee arthroplasty. The surgeries were consecutively performed over an 8-month period, and follow-up evaluation averaged 63 months. The two patient groups were similar with regard to the following variables: age, sex, diagnosis, height, weight, and preoperative and postoperative activity levels. Whereas both Duracon and Modular total knee arthroplasty prostheses yielded similar results approximately 5 years after surgery, the data suggest that Duracon appears to minimize patellofemoral complications.

Adult↗
PubMed1999

The efficacy of modular transitional implants placed simultaneously with implant fixtures.

After the placement of implants in areas in which several teeth have been lost, both the clinician and the patient face many difficulties, particularly during healing. If no prosthesis is provided, the patient's quality of life suffers. If a removable prosthesis is provided for optimum mastication and speech, many complicated adjustments of the denture may become necessary during healing, and the possibility of osseointegration failure increases. This case report describes simultaneous placement of implant fixtures and modular transitional implants, providing occlusal function immediately after placement. The use of modular transitional implants is very effective in maintaining good oral function for the patient.

Dental Implantation, Endosseous↗
PubMedDate not supplied

Modularity of object and place memory in children.

The present study investigated modularity of object and place memory in children with the reaction time/accuracy paradigm. The memory task was presented in two spatial arrays, a frame with landmarks and a grid. Modularity was tested using perceptual size judgment (what-interference) and movement direction judgment (where-interference). Latencies of object memory were increased by same-system what-interference in all age groups indicating limited capacity of an object memory system. With respect to accuracy of object and place memory, only young children's performance was susceptible to same-system interference of perceptual judgment.

Age Factors↗
PubMed2000

[Modularization by the open standard. (I)].

We are proceeding with the project called "Open LA21 Project" in the course of the clinical laboratory automation toward the 21st century. With the modular system that realizes integration, downsizing, a reasonable price, and is the future course in the clinical testing automation system as well, we aim to establish common standards among manufacturers as the only way to create user friendly market environments where the proper competition exists among the manufacturers. The common standards which are in preparation by the participating companies as "Open module system standards" are the standards which are going to be made public. They are intended to guarantee connection, compatibility of the products in conformity with the standards. In this project, we intend to realize the modular system that integrates each field, such as chemistry, hematology, coagulation/fibrinolysis, immunology, urinalysis in an early stage, and contribute positively to restructuring and upgrading the "raison d'etre" of the 21st century clinical testing.

Automation↗
PubMedDate not supplied

The use of the carbon-fiber reinforced modular implant for the reconstruction of the anterior column of the spine. A clinical and experimental study conducted on 42 cases.

The conservative treatment of neoplasms of the locomotor apparatus means the production of bone defects that may be filled with prostheses, bone grafts, systems of osteosynthesis. In the vertebral column, reconstruction of the resected elements--in the case of total vertebrectomy--requires the combination of anterior and posterior implants. It is the purpose of this study to analyze a group of 42 patients who, after accurate and uniform oncological (Enneking) and surgical (Weinstein-Boriani-Biagini) staging, were submitted to excision of one or more vertebral bodies for the treatment of neoplastic pathology, with reconstruction by prosthetic carbon fiber modular implant in order to obtain immediate stability, and to stimulate solid intervertebral fusion by bone grafts introduced inside the prosthesis. Thirty of the 42 patients presented with primary malignant tumor, 3 with benign tumor, 6 with solitary metastases, and 3 with plasmacytoma. In 32 cases, en bloc resection of the vertebral body was carried out (vertebrectomy) with combined anterior and posterior access in 29 patients (69.0%), and by posterior approach alone in 3 cases (7.1%). Ten intralesional corporectomies were carried out, 8 by anterior approach, 2 by posterior approach. The carbon prosthesis was filled with cortical and cancellous bone grafts in 38 cases. At a mean clinical and instrumental follow-up obtained 26 months after surgery for all of the patients, the use of a carbon prosthesis did not cause short- or long-term mechanical complications. The results of our study tend to affirm that the use of a carbon fiber modular implant may fill any loss of bone substance of the vertebral column, that it allows for immediate weight-bearing, and that if favors bone fusion. Some particular features of the carbon prosthesis favorably adapt to the surgical method of vertebrectomy: 1. The various components of the prosthesis may adapt to any type of bone resection of the vertebral body, even in unexpected situations; 2. Connection to posterior instrumentation in total vertebrectomies avoids the use of an anterior plate, thus reducing the time required for reconstruction of the anterior column, eliminating necessary surgical procedures in the segmental vascular structures. Finally, the radiolucency of the prosthesis allows for an easy evaluation of the formation of bone within and around the implant up to definitive anterior fusion and, of no less importance, early diagnosis of any local recurrence.

Adolescent↗
PubMed2001

Modular fluorescence sensors for saccharides.

Modular and modular polymer supported fluorescence photoinduced electron transfer (PET) sensors 2 and 3 with two boronic acid receptor units, a pyren-1-yl fluorophore, and hexamethylene linker show selective saccharide binding in aqueous methanolic solution at pH 8.21.

Journal Article↗
PubMed2002

A modular approach to dental implant therapy: the appropriate selection of one- and two-stage surgeries.

Different clinical situations merit careful consideration of the surgical and restorative approaches taken during the process of tooth replacement using dental implants. When clinically feasible, one-stage surgical procedures and subsequent restoration offer practical advantages. Modular implant designs comprised of separate endosseous implants and transmucosal abutments provide important clinical advantages for one-stage surgeries. The biological and mechanical advantages of conus implant-abutment interfaces reinforce the selection of modular implants for the broad application of one-stage dental implant procedures.

Animals↗
PubMed2005

Humeral component modularity may not be an important factor in the outcome of shoulder arthroplasty for glenohumeral osteoarthritis.

We examined the outcomes of using 3 types of humeral prostheses in total shoulder arthroplasty for osteoarthritis: a modular prosthesis with variable head diameters (MV), a nonmodular prosthesis with variable head diameters (NV), and a nonmodular prosthesis with a fixed head diameter (NF). Patients (N=101) completed self-assessments of shoulder function and health status before surgery and at follow-up between 30 and 60 months after surgery. Outcomes for the MV and NV prostheses did not differ statistically. The NF prosthesis trended toward poorer functional scores. Two Short Form-36 dimensions were statistically significantly lower (P<.05) in the NF group than in the MV and NV groups. These results fail to confirm that humeral component modularity is an important factor in the outcome of shoulder arthroplasty.

Aged↗
PubMed2005

Modular expert system for the diagnosis of operating conditions of industrial anaerobic digestion plants.

Anaerobic digestion (AD) plants are highly efficient wastewater treatment processes with possible energetic valorisation. Despite these advantages, many industries are still reluctant to use them because of their instability in the face of changes in operating conditions. To the face this drawback and to enhance the industrial use of anaerobic digestion, one solution is to develop and to implement knowledge base (KB) systems that are able to detect and to assess in real-time the quality of operating conditions of the processes. Case-based techniques and heuristic approaches have been already tested and validated on AD processes but two major properties were lacking: modularity of the system (the knowledge base system should be easily tuned on a new process and should still work if one or more sensors are added or removed) and uncertainty management (the assessment of the KB system should remain relevant even in the case of too poor or conflicting information sources). This paper addresses these two points and presents a modular KB system where an uncertain reasoning formalism is used to combine partial and complementary fuzzy diagnosis modules. Demonstration of the interest of the approach is provided from real-life experiments performed on an industrial 2,000 m3 CSTR anaerobic digester.

Bacteria, Anaerobic↗