Metallic implants have been used widely in a lot of orthopaedic applications. Titanium, Ceramics,medical grade titanium and other metal alloys are inserted in large bones designed as artificialjoints. Plates and bars are also attached to bones in order to facilitate healing of fracturedbones. The disadvantages of metal implants however are corrosion and the release of ions, sothere is need for finding new orthopaedic materials like composites, which have a closer densityto the natural bone too.This project is part of European project NEWBONE and it is based on the manufacturing andprocessing of glass fiber reinforced composite and the assessment of its properties.The goal of the project is to manufacture composite parts in the lab in different designs and dimensionswhich are suitable for mechanical and chemical tests.The theoretical work deals with the processing methods and the medical composites, medical devices,plastics, reinforcement of medical composites, PEEK and carbon fibers and other materials.The glass fibers are impregnated with dental curing resin. The residual void content, glass fibercontent and chemical and mechanical properties are estimated by ASTM standard methods.Results are resented according to evaluation of composite performance mechanically and chemicallyand show the best choice of composite parts in order to improve future use of orthopaedicapplications.

No description available.

Orientador: Fausto Orsi Medola / Banca: Sergio Tosi Rodrigues / Banca: Milton José Cinelli / Resumo: As lesões nos membros superiores causam impacto direto na vida de um indivíduo. As órteses são dispositivos utilizados para a reabilitação desses membros e, assim como as demais Tecnologias Assistivas, necessitam da adaptação e aceitação do usuário. O aumento de incentivo às pesquisas em Tecnologia Assistiva é um fator favorável ao desenvolvimento de órteses uma vez que traz a tona questões referentes à ergonomia e ao desempenho destes dispositivos; aspectos importantes a serem considerados para garantir a eficiência fisiológica e funcional do equipamento e a adaptação do usuário. Todas essas informações podem auxiliar no design de órteses mais ergonômicas e, portanto, mais apropriadas às necessidades e expectativas dos consumidores. O presente estudo teve como objetivo avaliar e comparar o desempenho, desconforto e transmissão de força de torque em tarefas manuais em quatro condições: três órteses pré-fabricadas de punho e mão, feitas de neoprene e lona, e mão livre, através de tarefas simuladas e da avaliação de torque manual. A avaliação de desconforto mostrou diferenças na percepção de desconforto entre todas as órtese e revelou regiões que devem receber maior atenção no projeto desses dispositivos a fim de garantir o conforto do usuário. Com relação ao desempenho na realização das tarefas de digitação e escrita manual, foram observadas diferenças estatísticas significativas entre condições avaliadas, sendo que a órtese Lona apresentou os maiores valores de dificuldade e ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Upper limb injuries have a direct impact on an individual's life. Orthoses are devices used in the rehabilitation of these members and, like the other Assistive Technologies, they need the adaptation and acceptance of the user. The increased incentive to research in Assistive Technology is a beneficial factor for the development of orthotics since they raise questions regarding the ergonomics and performance of these devices; important aspects to be considered to guarantee the physiological and functional efficiency of the equipment and user's adaptation. All this information can support the design of orthoses more ergonomic and, therefore, better suitable for consumer's needs and expectations. The present study aimed to compare performance, discomfort and torsion transmission in manual tasks under various conditions: Three pre-fabricated wrist and hand orthosis, made of neoprene and canvas, and free hand, through simulated tasks and manual torque evaluation. The discomfort evaluation showed differences in the perception of discomfort among all orthoses and revealed regions that should receive attention during the design of these devices in order to guarantee user's comfort. Regarding the performance in the tasks of typing and hand writing, significant statistical differences were observed between the evaluated conditions and Canvas orthosis showed the highest values of difficulty and time in the accomplishment of the tasks. Significant statistical differences in torque trans... (Complete abstract click electronic access below) / Mestre

Lumbar degenerative disc disease is a remarkably common condition among patients presenting with chronic low back pain and physical disability. When a surgical treatment option is warranted, patients now have the option of undergoing lumbar total disc replacement (TDR), a relatively new procedure that is designed to replace lumbar fusion, the traditional surgical intervention for degenerative disc disease. The lumbar TDR procedure has demonstrated clinical efficacy equivalent to that of lumbar fusion, although concern remains about the longevity, safety, and costs related to the procedure. These issues were addressed in three separate observational studies using administrative claims data. The first study estimated the revision burden and economic revision burden of lumbar TDR. The second study examined the lumbar TDR hybrid procedure, where both a lumbar TDR and lumbar fusion are performed simultaneously. No observational data have been reported on the frequency, cost, and diagnostic indications related to the TDR hybrid procedure. The third study mapped the geographic variation of procedural rates of lumbar TDR. Previous research has found substantial geographic variation in lumbar spine surgery rates and a similar analysis of lumbar TDR variation has yet to be reported. The present series of studies found the revision burden and economic revision burden of lumbar TDR to be similar to data reported for this procedure from the mid-2000s, though the overall occurrence of the procedure appears to have declined. The economic revision burden made this a lower-cost procedure than lumbar fusion, with a tradeoff in terms of revision burden being higher for lumbar TDR. The lumbar TDR hybrid procedure was found to make up approximately 16% of the total number of TDR procedures, involving much higher costs than a single-level TDR procedure. Finally, geographic variation of the procedural rate of lumbar TDR varied dramatically across the U.S., surpassing the variation observed in lumbar fusion surgery. Limitations of the observational data used in these studies are described. Recommendations for future observational research are offered as well. Finally, implications for these studies on practice guidelines and reimbursement policies are provided.

No description available.

The aim of this thesis is to evaluate the short and long term effectiveness of foot orthoses in the treatment of plantar fasciitis.Three studies were undertaken, the first two informing the third. The aim of the first study was to establish prescription habits of Australian and New Zealand podiatrists in order to ascertain the most commonly prescribed foot orthoses. The second study was conducted to establish the most appropriate outcome measure to assess the effectiveness of foot orthoses in the treatment of plantar faciitis. The main study, a pragmatic single-blind randomised control trial, was conducted to evaluate the effectiveness of three types of foot orthoses in the treatment of plantar fasciitis. The research concluded that provision of appropriate foot orthoses produces small short-term benefits in function for people with plantar fasciitis, but no effect is apparent at twelve months. / Doctor of Philosophy (PhD)

<p>Akut förvirring hos höftfrakturpatienter är vanlig. Den akuta förvirringen kan förebyggas eller kortas och rehabiliteringstiden kan då också kortas. Ett förvirringstillstånd innebär stora påfrestningar på kroppen. Syftet med denna litteraturstudie är att se hur litteraturen beskriver hur man kan ge en god postoperativ omvårdnad och ett gott bemötande till de patienter som drabbas eller riskerar att drabbas av postoperativ förvirring. Till grund för arbetet ligger ett antal vetenskapliga artiklar samt facklitteratur. Trots att den postoperativa förvirringen är mycket vanlig, att den orsakar stort lidande och stora vårdkostnader, saknas tillfredsställande studier som kan ligga till grund för farmakologiska behandlingsrekommendationer. Oaktat detta ges ofta farmaka till dessa patienter. Enligt litteraturen har sjuksköterskans möte med den deliriösa patienten stor betydelse för att förebygga och lindra ett förvirringsbeteende. Eftersom det saknas riktlinjer för omvårdnad av akut förvirrade patienter beror det på den enskilda sjuksköterskans bemötande hur mötet med patienten blir. Den postoperativa förvirringen måste lyftas fram eftersom antalet patienter med höftfrakturer ständigt ökar. Rutiner och vårdprogram måste tas fram eller ses över. Vi måste lära oss att bemöta dessa patienter på ett professionellt sätt. Att möta den förvirrade höftledspatienten på ett etiskt och förberett sätt är en förutsättning för en bra vård.</p>

Ankle injuries comprise more than 15% of all sports injuries worldwide. The efficacy of the ankle taping for injury prevention has long been under scrutiny as numerous studies have shown that tape rapidly loses its ability to constrain ankle motion with exercise. Consequently, ankle braces (orthoses) are being used with increasing frequency for the prevention and functional management of ankle injuries. However, the motion restraining qualities of ankle orthoses have not been widely evaluated in closed kinetic chain environments under physiologic loads. The primary purpose of this study was to compare the abilities of four ankle orthoses (ankle taping, lace-up brace, semirigid orthosis and hybrid brace) against a control condition (no brace or tape) to control subtalar and talocrural motion during running on a laterally-tilted treadmill at 16.2 km/h before and after exercise. It has been hypothesized that ankle orthoses make a secondary contribution to injury prevention through enhanced proprioception. The secondary purpose of this study was to quantify the effects of the aforementioned ankle orthoses on postural stability during single-limb stance following a bout of exercise. Fifteen healthy university students (8 men and 7 women) with no history of significant ankle injuries (age, mean �� SD: 22.9 �� 3.9 years) volunteered to participate in this study. Three-dimensional kinematic data were captured with an active infrared digital camera system sampling at 120 Hz. To address the first question, data analyses were performed using 2way univariate (Ankle Orthoses x Pre/Post-Exercise x Subjects) (5 x 2 x 15) repeated measures analysis of variance (ANOVA) to determine the existence of differences among three closed and four open kinematic chain dependent measures before and after exercise. Maximum inversion angles (MAXINV) were similar for all ankle orthoses, with no orthosis limiting inversion during tilted treadmill running significantly more than another, or compared to the control condition, either before or after exercise (p>.05). Pre-exercise MAXINV group means and standard deviations during treadmill running ranged from 6.8 �� 3.4 deg with the Royce Medical Speed Brace to 9.5 �� 4.1 deg in the tape condition; post-exercise MAXINV mean values ranged from 7.6 �� 3.2 deg for the Aircast Sport Stirrup to 9.1 �� 4.6 deg with closed basketweave tape. While not statistically significant (p=0.10), ankle taping provided the least amount of inversion restraint, both before and after the exercise bout. The MAXINV angles measured during treadmill running (8.2 �� 4.0 deg) and open chain inversion AROM measured with a goniometer (34.5 �� 6.2 deg) were not related (r=-0.0003). The compressive forces present during closed kinetic chain activity are known to increase joint stability and thus may explain why MAXINV under dynamic varus loads was so much less in magnitude than inversion AROM measured under open kinetic chain conditions. The nonlinear relationship of these two variables supports our contention that reports of the motion controlling properties of ankle orthoses measured in open kinetic chain environments should not be used to infer the response characteristics of these same orthoses under dynamic, physiologic loads. To address the second question, data were analyzed using 3-way univariate (Ankle Orthoses x Pre/Post-Exercise x Eyes Open/Closed x Subjects) (5 x 2 x 2 x 15) repeated measures ANOVAs. Subjects' postural stability was assessed using a Biodex Balance System with eyes open and eyes closed conditions, before and after an exercise bout. The ankle orthoses evaluated did not influence postural stability as measured by mediolateral sway index, anteroposterior sway index, and overall sway index. Removal of visual perception via blindfolding resulted in significant decreases in all three measures of postural stability (p=.001). There was poor association among the closed chain postural stability parameters and the open chain AROM measures. These correlations ranged from r=.04 to .17, indicating minimal relationship between the amount of AROM permitted by the orthoses and postural stability as quantified by this method. / Graduation date: 2000

While there is continuing interest in bioresorbable materials for orthopedic fixation devices, the major challenge in utilizing these materials in load-bearing applications is creating materials sufficiently stiff and strong to sustain loads throughout healing while maintaining fracture stability. The primary aim of this study is to quantify the degradation rate of a bioresorbable material system, then use this degradation rate to determine the material response of an orthopedic device made of the same material as healing progresses. The present research focuses on the development and characterization of a material system consisting of carbon foam infiltrated with hydroxyapatite (HA) reinforced poly(D,L-lactide)-co-poly(glycolide) (PDLGA). A processing technique is developed to infiltrate carbon foam with HA/PDLGA and material morphology is investigated. Additionally, short-term rat osteoblast cell studies are undertaken to establish a starting point for material biocompatibility. Degradation experiments are conducted to elicit the time-dependent properties of the material system at the material scale. These properties are then incorporated into computational models of an internal plate attached to a fractured human femur to design and predict the material response to applied physiological loads. Results from this work demonstrate the importance of material dissolution rate as well as material strength when designing internal fixation plates.

Akut förvirring hos höftfrakturpatienter är vanlig. Den akuta förvirringen kan förebyggas eller kortas och rehabiliteringstiden kan då också kortas. Ett förvirringstillstånd innebär stora påfrestningar på kroppen. Syftet med denna litteraturstudie är att se hur litteraturen beskriver hur man kan ge en god postoperativ omvårdnad och ett gott bemötande till de patienter som drabbas eller riskerar att drabbas av postoperativ förvirring. Till grund för arbetet ligger ett antal vetenskapliga artiklar samt facklitteratur. Trots att den postoperativa förvirringen är mycket vanlig, att den orsakar stort lidande och stora vårdkostnader, saknas tillfredsställande studier som kan ligga till grund för farmakologiska behandlingsrekommendationer. Oaktat detta ges ofta farmaka till dessa patienter. Enligt litteraturen har sjuksköterskans möte med den deliriösa patienten stor betydelse för att förebygga och lindra ett förvirringsbeteende. Eftersom det saknas riktlinjer för omvårdnad av akut förvirrade patienter beror det på den enskilda sjuksköterskans bemötande hur mötet med patienten blir. Den postoperativa förvirringen måste lyftas fram eftersom antalet patienter med höftfrakturer ständigt ökar. Rutiner och vårdprogram måste tas fram eller ses över. Vi måste lära oss att bemöta dessa patienter på ett professionellt sätt. Att möta den förvirrade höftledspatienten på ett etiskt och förberett sätt är en förutsättning för en bra vård.