Karakteristik Mekanik Komposit Lamina Serat Rami Epoksi Sebagai Bahan Alternatif Soket Prostesis

Mechanical properties of ramie fiber reinforced epoxy lamina composite for socket prosthesis. This paper presentsan investigation into the application of natural fiber composite especially ramie fiber reinforced epoxy laminacomposite for socket prosthesis. The research focuses on the tensile and shear strength from ramie fiber reinforcedepoxy lamina composite which will be applied as alternative material for socket prosthesis. The research based onAmerican Society for Testing Material (ASTM) standard D 3039/D 3039M for tensile strength and ASTM D 4255/D4255M-83 for shear strength. The ramie fiber applied is a fiber continue 100 % Ne14\u27S with Epoxy Resin Bakelite EPR174 as matrix and Epoxy Hardener V-140 as hardener. The sample composite test made by hand lay up method.Multiaxial characteristic from ramie fiber reinforced epoxy composite will be compared with ISO standard forplastic/polymer for health application and refers strength of material application at Prosthetics and Orthotics. Theanalysis was completed with the mode of the failure and the failure criterion observation by using Scanning ElectronMicroscope (SEM). Based on results of the research could be concluded that ramie fiber reinforced epoxy compositecould be developed further as the alternative material for socket prosthesis on Vf 40-50%. Results of the research willbe discussed in more detail in this paper

Stable fixation of an osseointegated implant system for above-the-knee amputees: titel RSA and radiographic evaluation of migration and bone remodeling in 55 cases.

Background and purposeRehabilitation of patients with transfemoral amputations is particularly difficult due to problems in using standard socket prostheses. We wanted to assess long-term fixation of the osseointegrated implant system (OPRA) using radiostereometric analysis (RSA) and periprosthetic bone remodeling.Methods51 patients with transfemoral amputations (55 implants) were enrolled in an RSA study. RSA and plain radiographs were scheduled at 6 months and at 1, 2, 5, 7, and 10 years after surgery. RSA films were analyzed using UmRSA software. Plain radiographs were graded for bone resorption, cancellization, cortical thinning, and trabecular streaming or buttressing in specifically defined zones around the implant.ResultsAt 5 years, the median (SE) migration of the implant was -0.02 (0.06) mm distally. The rotational movement was 0.42 (0.32) degrees around the longitudinal axis. There was no statistically significant difference in median rotation or migration at any follow-up time. Cancellization of the cortex (plain radiographic grading) appeared in at least 1 zone in over half of the patients at 2 years. However, the prevalence of cancellization had decreased by the 5-year follow-up.InterpretationThe RSA analysis for the OPRA system indicated stable fixation of the implant. The periprosthetic bone remodeling showed similarities with changes seen around uncemented hip stems. The OPRA system is a new and promising approach for addressing the challenges faced by patients with transfemoral amputations

Komposit Laminate Rami Epoksi Sebagai Bahan Alternatif Socket Prosthesis

Pure plant oil, biofuel, coconut oil, palm oil, jatropha oilSocket is the most important component in a prosthesis making. Performance criteria for prosthetic socket material include strength, durability, minimal weight, comfort, and minimal fabrication cost. This research attempts to analyze the strength of ramie fiber reinforced epoxy laminate composite as an alternative of socket prosthesis. The research based on ASTM D 3039/D 3039M for tensile strength and ASTM D 695 for compressive strength. The ramie fiber used was a continuous fiber 100 % Ne14'S, with Epoxy Resin Bakelite EPR 174 and Epoxy Hardener V-140. The sample test was created using a hand lay-up method. The result of this research is presented in a correlation of finsile strength (st), compression strength (sc), elasticity modulus (E) versus fraction volume of fiber (Vf). The result is then being compared with some of the prosthesis material's strength produced by Otto Bock. The analysis was completed with the mode of the failure observation by using Scanning Electron Microscope (SEM). The result concludes that the ramie fiber reinforced epoxy laminate composite is potentially developed further as a socket prosthesis material on Vf 40 – 50 %. Tensile strength and specific strength that has been generated was higher than that of several materias for socket prosthesis, including fiberglass. The mode of the failure found were a brittle failure on Vf: 10-30%, debonding and delamination on Vf: 40-50%

Hands-off and hands-on casting consistency of amputee below knee sockets using magnetic resonance imaging

Residual limb shape capturing (Casting) consistency has a great influence on the quality of socket fit. Magnetic Resonance Imaging was used to establish a reliable reference grid for inter cast and intra cast shape and volume consistency of two common casting methods, Hands-off and Hands-on. Design: Residual limbs were cast for twelve people with a unilateral below knee amputation and scanned twice for each casting concept. Subsequently, all four volume images of each amputee were semi-automatically segmented and registered to a common coordinate system using the tibia and then the shape and volume differences were calculated. Results: The results show that both casting methods have intra cast volume consistency and there is no significant volume difference between the two methods. Inter and intra cast mean volume differences were not clinically significant based on the volume of one sock criteria. Neither the Hands-off nor the Hands-on method resulted in a consistent residual limb shape as the coefficient of variation of shape differences was high. Conclusion: The resultant shape of the residual limb in the Hands-off casting was variable but the differences were not clinically significant. For the Hands-on casting, shape differences were equal to the maximum acceptable limit for a poor socket fit

Osseointegrated total hip replacement connected to a lower limb prosthesis: a proof-of-concept study with three cases

Background Osseointegrated implants are a suitable alternative for prosthetic attachment in individuals with a transfemoral amputation, who are unable to wear a socket. However, the small bone-implant contact area, reduced muscular leverage, and osteoporosis contraindicate osseointegrated implant use in transfemoral amputees with osteoporosis and a short residuum. We report on the feasibility of combining total hip replacement (THR) with an osseointegrated implant for prosthetic attachment. Methods We retrospectively reviewed the cases of three transfemoral amputees who underwent osseointegration with THR between 2013 and 2014. In a two-stage procedure, a custom-made femoral prosthesis was connected to a THR with a modular revision stem and a stoma was created. Clinical outcomes were assessed at baseline and 1.5–2.5-year follow-up using standard measures of health-related quality of life, ambulation, and activity levels including the Short Form-36 (SF-36), Questionnaire for Transfemoral Amputees (Q-TFA), Timed Up and Go test, and 6-min walk test. Results Patient age ranged from 35 to 65 years. There were no major adverse events, but there was one case of superficial infection. All patients showed improved Q-TFA and SF-36 scores. Two patients who were wheelchair-bound at baseline became community ambulators, and the third patient exhibited improved ambulation. Conclusions This study demonstrated the feasibility of combining a THR with an osseointegrated implant in transfemoral amputees

Pseudo-Kaposi's Sarcoma Because of Suction-Socket Lower Limb Prosthesis

Pseudo-Kaposi sarcoma is a benign reactive vascular proliferation mainly involving the lower legs, which can be related to acquired chronic venous insufficiency or congenital arteriovenous malformations. In its most common presentation, acroangiodermatitis is seen in patients with chronic venous insufficiency of the lower limbs as an exaggeration of the stasis dermatitis. However, rare reports of acroangiodermatitis include descriptions in amputees (especially in those with poorly fitting suction-type devices), in patients undergoing hemodialysis (with lesions developing distally to arteriovenous shunts) and in patients with paralyzed legs. We report on a 28 year-old-male who presented pseudo-Kaposi's sarcoma in an amputation stump because of suction-socket lower limb prosthesis

Examination of anticipated chemical shift and shape distortion effect on materials commonly used in prosthetic socket fabrication when measured using MRI: a validation study

The quality of lower-limb prosthetic socket fit is influenced by shape and volume consistency during the residual limb shape-capturing process (i.e., casting). Casting can be quantified with magnetic resonance imaging (MRI) technology. However, chemical shift artifact and image distortion may influence the accuracy of MRI when common socket/casting materials are used. We used a purpose-designed rig to examine seven different materials commonly used in socket fabrication during exposure to MRI. The rig incorporated glass marker tubes filled with water doped with 1 g/L copper sulfate (CS) and 9 plastic sample vials (film containers) to hold the specific material specimens. The specimens were scanned 9 times in different configurations. The absolute mean difference of the glass marker tube length was 1.39 mm (2.98%) (minimum = 0.13 mm [0.30%], maximum = 5.47 mm [14.03%], standard deviation = 0.89 mm). The absolute shift for all materials was <1.7 mm. This was less than the measurement tolerance of +/–2.18 mm based on voxel (three-dimensional pixel) dimensions. The results show that MRI is an accurate and repeatable method for dimensional measurement when using matter containing water. Additionally, silicone and plaster of paris plus 1 g/L CS do not show a significant shape distortion nor do they interfere with the MRI image of the residual limb

Osseointegrated prostheses for rehabilitation following amputation : The pioneering Swedish model.

The direct attachment of osseointegrated (OI) prostheses to the skeleton avoids the inherent problems of socket suspension. It also provides physiological weight bearing, improved range of motion in the proximal joint, as well as osseoperceptive sensory feedback, enabling better control of the artificial limbs by amputees. The present article briefly reviews the pioneering efforts on extremity osseointegration surgeries in Sweden and the development of the OPRA (Osseointegrated Prostheses for the Rehabilitation of Amputees) program. The standard implant design of the OPRA system and surgical techniques are described as well as the special rehabilitation protocols based on surgical sites. The results of long-term follow-up for transradial, transhumeral, and thumb amputee operations are briefly reported including the prospective study of transfemoral amputees according to OPRA protocol. The importance of refinement on implant designs and surgical techniques based on the biomechanical analysis and early clinical trials is emphasized. Future aspects on osseointegration surgery are briefly described, including novel treatment options using implanted electrodes