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At least 19 recordsLinked to original sources
PubMed1993

Transcutaneous oxygen pressure. An effective measure for prosthesis fitting on below-knee amputations.

After amputation for arterial occlusive disease of the lower limbs, healing and local adaptation to a prosthesis depend on the oxygen ratio in the tissue. Transcutaneous oxygen tension (TcPO2) is a noninvasive microcirculatory exploration. Forty six below-knee stumps were selected without any prosthetic problem excepting vascular, with a follow-up mean duration of 23 months. They were classified into different prosthetic categories. The first was the worst because it required further amputation on the thigh and the fourth the best, which displayed complete adaptation to a socket contact. These groups were related to their TcPO2 values on the anterior and exterior face of the stumps in both reclined and seated positions. It seems that it is impossible to achieve healing when the TcPO2 value is lower than 15 mm Hg in lying position. However, healing is possible above 20 mm Hg but socket contact is not possible when TcPO2 values are under 40 mm Hg. When TcPO2 values are above 40 mm Hg, a good prosthesis fitting is possible when no problems are encountered other than vascular ones.

Aged↗
PubMed1994

[Possibilities for quantitative gait analysis in evaluation of prosthesis fit].

Nowadays, the fitting of a lower-limb prosthesis is done mainly on an empirical basis. The main aim of the present study was to provide objective data and presentations to support the subjective data. With the aid of a cybernetic statement, the process of fitting a prosthesis to a human subject was developed as a self-optimizing control cycle. Using this systematic scheme, the walking trial was identified as the process element of this control cycle in which the fitting proper took place. Starting with this systematic scheme, the characteristics of defined changes to the system human-prosthesis during walking were measured with the aid of a specially configured gait analysis system. For the estimation of the characteristics of the measured walking trial, a three stage parameter system based initially only on the angle, velocity and acceleration curves at the knee joint was developed. On the basis of pattern recognition routines, the parameter system permits a very high level of identification of the measurements. The identification of poor fittings not covered by the pattern recognition system is not yet satisfactory. However, with the incorporation of additional gait parameters, it will be possible to further improve the description of the gait, enabling better recognition of disturbances in the human-prosthesis system.

Artificial Limbs↗
PubMed1994

[Evaluation of patients with below knee amputation with respect to postoperative prosthesis fitting].

A follow-up of 78 patients who underwent amputations just below the knee at Herlev University Hospital in the county of Copenhagen during the period 1985-88 is reported. The examination was carried out at an average of 39 months later. There was a high early mortality postoperatively as well as in the subsequent years. Of the survivors, about 87% were found to be candidates for prosthetic fitting. Nearly all of these patients became functional ambulators. The long-term survival rate was primarily correlated to a reduced occurrence of concurrent medical diseases, especially of cardiovascular nature. All women with diabetes mellitus were deceased at the time of examination. This is a well-known phenomenon, relating diabetes with a six times higher mortality risk. The study indicates that the effort and expense of fitting and training patients with prostheses may be well worthwhile.

Adolescent↗
PubMed1982

[Disarticulation of the knee. Surgical technic--prosthesis fitting].

The authors describe a modified technique for knee joint disarticulation surgery. Their approach provides two flaps, one medial and one lateral, which result in a posterior, longitudinal scar that remains outside the contact areas of the prosthesis. They abrade the lateral and posterior aspect of each condyle, peeling out the articular cartilage and re-covering the condyles with the joint capsule. This technique allows a satisfactory stability in prosthetic rotation, and improves the appearance of the artificial limb. For post-operative rehabilitation the authors use a tridimensional alignment jig and a prosthetic ankle with three degrees of freedom: flexion-extension, lateral-medial motion and rotation, making easier the swing phase while maintaining the obvious advantages of a pilon-type prosthesis.

Amputation, Surgical↗
PubMed1988

Loosening of the socket in a 35-mm snap-fit prosthesis and the Charnley hip prosthesis. A roentgenographic evaluation of 321 cases operated upon because of osteoarthritis.

Migration and lucencies around the acetabular component were evaluated in serial roentgenograms of patients with osteoarthritis treated with total hip arthroplasty (THA); 207 were Charnley and 114 were Brunswik THAs. In this consecutive series of THAs followed for nine to ten years, the loosening rate (corrected for deaths and revisions) was significantly higher (35%-45%) in the Brunswik snap-fit sockets (bearing surface 35 mm in diameter) than in the Charnley sockets (5%-12%). Presumably, mechanical factors, i.e., friction torque and impingement, are responsible for the difference in durability between the two designs.

Aged↗
PubMedDate not supplied

[Exercise test before prosthesis fitting in amputees with vascular insufficiency].

93 subjects (age = 65 +/- 10 years) with lower limb amputation ensuing from peripheral vascular disease performed a graded exercise test on arm cranking ergometer with an electromagnetic braking to assess their physical fitness and cardiac condition before starting a prosthetic training programme. The protocol was continuous with a workload increment of 10 watts every two minutes. Heart rate, blood pressure and ECG were recorded at each stage. Reasons to stop the test were 1) arm muscle fatigue, 2) reaching of target heart rate, 3) cardiovascular abnormalities. At the end of the test, the mean percentage of maximum heart rate was 53%, 92%, and 66% for each of these reasons, respectively (p less than .0001). Results showed that subjects who received a prosthesis had a higher exercise capacity than those who did not get a prosthesis (39.0 watts vs 18.5 watts, p less than 0.001). Furthermore, maximal oxygen uptake (4.4 METs vs 3.0 METs, p less than 0.001) and reached maximal heart rate (131 vs 110 bpm, p less than .005) were both higher in subjects of prosthesis group. Results suggest that a graded exercise test at the beginning of prosthetic training allows a rehabilitation team 1) to predict the success of the prosthetic process and 2) to identify subjects for which this process could increase the risks of health problems.

Aged↗