A pintura de íris protética é uma das fases mais delicadas durante o processo de confecção de uma prótese ocular e requer, do Cirurgião-Dentista especialista em Prótese Bucomaxilofacial, qualidades técnico-artísticas para uma dissimulação satisfatória. A reprodução fiel da íris do paciente é de fundamental importância para sua reabilitação estética e consequente reintegração social. Em função disso, o presente estudo desenvolveu uma escala de cores para pintura de íris em prótese ocular, a fim de ser utilizada como ferramenta auxiliar durante esta fase. Foram desenvolvidas sete matizes (castanho-avermelhado, castanho, ocre, verde, verde-azulado, azul e cinza) a partir de mistura de tintas acrílicas Acrilex®, levando como base os conceitos de formação da cor da íris para o proporcionamento das tintas, no intúito de mapear os tons presentes nas íris humanas. A escala foi testada em 145 indivíduos com íris saudáveis, por três observadores calibrados, verificando se algum tom da escala se aproximava à cor base dessas íris. A opinião de cada obeservador foi anotada em ficha de avaliação da íris e os dados seguiram para análise estatística. Foram avaliadas a associação entre matiz de escolha e observadores, a coerência inter-observador em relação ao matiz e a coerência inter-observador em relação ao tom. Os resultados apontaram alta concordância entre os obeservadores, o que garantiu a validação da escala proposta. / Artificial eye iris painting is one of the most delicate stages in the process of making an ocular prosthesis. The Oral and Maxillofacial Prosthodontics Specialist Dentist is required to have technical and artistic abilities for a satisfactory simulation. The accurate reproduction of the patient\'s iris is thoroughly important for his or her aesthetic rehabilitation and social reintegration. On that basis, the present study aimed to develop an iris painting color scale, which can be used as an auxiliary tool for this stage of production. In order to map out the present shades in human irides, seven hues have been developed (reddish-brown, brown, ochre, green, bluishgreen, blue and gray) by mixing Acrilex® acrylic paint, which were based on the concepts of iris color formation for the establishment of the paint mixtures. The scale has been tested by three calibrated observers in 145 individuals presenting healthy irides. The observers would verify if any of the shades in the color scale matched the subject\'s iris color base. Each observer\'s opinion was registered in an iris evaluation sheet and the data was then submitted to statistical analysis. Evaluated factors included the association of the selected hue by the observer; the consistency of the choice of hue among all observers; the consistency of the choice of shade among all observers. Results revealed substantial consensus among observers, ensuring the legitimacy of the proposed color scale.

Nesta pesquisa, foi avaliado o hábito alimentar de pacientes senescentes totalmente desdentados, antes e após a reabilitação por próteses totais bimaxilares convencionais. A avaliação foi realizada por meio de exame clínico, entrevista e a aplicação de questionários pela própria pesquisadora. O trabalho foi conduzido em três fases distintas: a primeira, desenvolvida antes do início de qualquer procedimento relacionado com a confecção das próteses e consistiu no preenchimento de ficha clínica, avaliação protética e da realização de uma anamnese alimentar, sendo essa última elaborada com a orientação de uma nutricionista. Já a segunda e a terceira fases foram executadas em períodos compreendidos entre aproximadamente dois a três meses e cinco a seis meses após a reabilitação protética respectivamente, quando novos exames clínicos eram realizados. Os dados coletados nesses três períodos distintos foram processados por um computador utilizando-se do software BioEstat 3.0,sendo o nível de significância estabelecido para p< 0,05, em uma prova bilateral. Os resultados demonstraram que após a instalação de uma nova prótese total convencional confeccionada no rigor da técnica tivemos, não só melhora funcional do aparelho protético, como alteração positiva na habilidade mastigatória dos indivíduos, além de alteração da consistência da dieta acompanhada da introdução de novos alimentos. Os resultados demonstraram ainda, que quando o aparelho protético apresentava retenção e estabilidade consideradas satisfatórias, aquele acabava influenciando positivamente o hábito intestinal do paciente.Contudo, através desse estudo, não foi possível identificar se houve uma real modificação da dieta dos pacientes com inserção de nutrientes, uma vez que para obtermos esses dados seriam necessários exames complementares. / In this research, the alimentary attitude of senescent edentulous patients was evaluated, before and after the rehabilitation by new complete dentures. A clinical exam, an interview and a survey were performed. The work was accomplished in three different phases: the first was developed before the beginning of any procedure related to the construction of the new dentures and consisted of a clinical record, a prosthetic evaluation and an alimentary anamnesis. The second and the third phases took place after the prosthetic rehabilitation and were done in periods between two to three months and five to six months respectively, together with new clinical exams. The data collected during those three different periods were processed using software BioEstat 3.0 ; the level of significant was p <0,05, in a bilateral proof. The results demonstrated that after the installation of new complete dentures made according to the technique there was a functional improvement of the dentures noticed as a better performance in the individuals' masticatory ability. It was reported also changes in the consistence of the diet associated to the increasing of different nutrients to the diet. It was also possible to verify that when the prostheses presented satisfactory retention and stability, intestinal habit was influenced positively. However, through this study only, it was not possible to identify if there was a real modification in patients’ alimentary habit or if different nutrients were inserted to it. To make sure those modifications had happened complementary exams should have been performed as well.

Abstract Prosthetic joint infection (PJI) is one of the most devastating complications of hip or knee arthroplasty. Treatment options for PJI include prosthesis retention, prosthesis exchange and salvage procedures (e.g., arthrodesis or amputation). The purpose of this retrospective study is to assess the impact of shortening antibiotic treatment durations in PJIs treated with debridement, antibiotics and implant retention (DAIR) and to evaluate the predictors of DAIR treatment failure for PJIs. A second aim is to evaluate the outcomes and reimplantation microbiologies of PJIs treated with two-stage revision. The main data consist of 197 patients with PJI treated in Oulu University Hospital, Finland, between February 2001 and August 2009. Patients were identified retrospectively using the hospital’s patient databases. The study shows that, if antibiotic treatments for PJI are completed as planned, then DAIR treatment success rates (88%) are excellent. Prolonging antibiotic treatment over three months in total knee arthroplasty PJIs or over two months in total hip arthroplasty PJIs does not seem to offer any additional benefits. The failure of DAIR in the treatment of PJI is independently associated with high leucocyte counts at admission and with ineffective empirical antibiotics. Rifampin combination therapy, especially the combination of rifampin and ciprofloxacin, is significantly associated with successful DAIR treatments of staphylococcal PJIs. Our study also shows that a six-week course of antibiotics between stages is sufficient for treating PJIs with two-stage revision. Positive reimplantation cultures do not seem to be associated with significantly worse outcomes. / Tiivistelmä Tekonivelinfektio on yksi vakavimmista lonkan ja polven tekonivelleikkauksen komplikaatioista. Tekonivelinfektion hoitovaihtoehtoja ovat tekonivelen säästävä hoito, tekonivelen vaihto ja ns. salvage-toimenpiteet (esimerkiksi jäykistys tai amputaatio). Tämän retrospektiivisen tutkimuksen tavoitteena oli selvittää lyhennetyn mikrobilääkehoidon toimivuutta tekonivelinfektion säästävässä hoidossa. Lisäksi pyrittiin löytämään tekonivelinfektion hoidon epäonnistumiselle altistavia tekijöitä. Tavoitteena oli myös selvittää hoidon tuloksia silloin, kun hoidetaan tekonivelinfektiota kaksivaiheisella revisiolla, sekä tutkia revision toisessa vaiheessa otettavien mikrobinäytteiden merkitystä hoidon onnistumiselle. Tutkimusaineisto koostui 197 potilaasta, joilta hoidettiin tekonivelinfektiota Oulun yliopistollisessa sairaalassa helmikuun 2001 ja huhtikuun 2009 välisenä aikana. Potilastiedot saatiin sairaalan hoitotietojärjestelmästä. Tutkimuksessa todettiin, että lyhyemmällä hoitoajalla voidaan saavuttaa erinomaiset hoitotulokset (88 %) tekonivelinfektion säästävässä hoidossa, jos suunniteltu antibioottihoitoaika voidaan toteuttaa. Yli kahden kuukauden (lonkan tekonivelinfektio) ja kolmen kuukauden (polven tekonivelinfektio) hoitoajasta ei näytä olevan hyötyä säästävässä hoidossa. Lisäksi todettiin, että sairaalaantulovaiheessa mitattu veren leukosyyttiarvo > 10×109/l ja tehoton empiirinen antibiootti ovat itsenäisesti hoidon epäonnistumiselle altistavia tekijöitä. Rifampisiini-yhdistelmähoidon, erityisesti rifampisiini yhdistettynä siprofloksasiiniin, todettiin olevan merkittävästi yhteydessä hoidon onnistumiseen silloin, kun hoidetaan stafylokokki-infektiota tekonivelen säästävällä hoidolla. Tutkimuksemme osoitti myös, että kuuden viikon antibioottihoito on riittävä hoidettaessa tekonivelinfektiota kaksivaiheisella revisiolla. Positiivinen mikrobiviljelynäyte toisen vaiheen leikkauksessa ei näytä olevan yhteydessä huonompaan hoitotulokseen.

No description available.

La Prothèse Totale de Hanche Double Mobilité (PTH-DM) a été inventée pour conjuguer l’usure faible du concept de low friction tout en proposant une solution au problème de la luxation. La Double Mobilité présente différentes composantes et ses indications sont diverses.Une étude clinique à long terme a permis de définir les avantages et échecs de ce concept. Une complication spécifique est la Luxation Intra Prothétique (LIP) ou usure de la collerette de rétention de l’insert en polyéthylène. Différentes formes peuvent être rencontrées.L’objectif principal de notre travail était de comprendre le fonctionnement de la Double Mobilité, c’est-à-dire le rôle respectif des 2 mobilités et de la collerette ainsi que leurs profils d’usure.Les objectifs secondaires étaient de comprendre les échecs, le descellement de cupule et la luxation intra-prothétique et de définir des pistes d’optimisation de l’usure.Plusieurs techniques d’analyse d’usure, à différentes échelles ont été élaborées. La profilométrie mécanique permet d’étudier la rugosité de surface, la microscopie électronique à balayage recherche les mécanismes d’usure. La cartographie CMM permet d’appréhender les paramètres de forme et d’ondulation. Nous proposons une nouvelle technique pour augmenter l’analyse qualitative de l’usure. L’analyse FE complète ces moyens, qui ont été appliquées sur des explants. 3 groupes d’explants, constitués par les inserts ayant fonctionnés plus de 15 ans sans LIP, les inserts issus de LIP et les inserts récents, le dessin et le matériau de l’insert ayant été modifiés.Les trois groupes ont été comparés. La LIP a pu être identifiée comme liée à l’usure de la collerette. Cette usure est majoritairement composée par l’usure externe de la collerette, elle-même liée aux propriétés du col de la tige fémorale.Les explants de plus de 15 ans ont présenté une usure d’environ 45 mm3/an, comparable aux implants métal-polyéthylène. Les méthodes standard d’analyse d’usure radiographique ne peuvent pas être appliquées à l’analyse des PTH-DM. Les dimensions de la cupule métallique et les caractéristiques du col fémoral prothétique étaient les seuls facteurs influant sur l’incidence de LIP. Une ébauche de modélisation de fonctionnement de la PTH-DM a pu être proposée en se basant sur les données des explants. La deuxième mobilité, par son rôle de réserve de mobilité, permet de diminuer l’usure globale et doit être encouragée. La collerette de rétention constitue également un point clé du concept et possède un rôle dans la survie. / Dual Mobility Total Hip Arthroplasty (DM-THA) was invented to combine the low wear of low friction while providing the solution to the problem of dislocation. Dual Mobility has different components and indications are diverse. A clinical long-term study of a PTH-DM first line has identified the benefits and failures of this concept. A specific complication is Intra Prosthetic Dislocation (IPD. Different types of IPD can be encountered. The main objective of our work was to understand the functioning of the Dual Mobility, the respective roles of the two mobilities and retention and their wear profiles. Secondary objectives were to understand the failures, loosening of the cup and intra-prosthetic dislocation and define an optimization of wear. Material and Methods: Several wear analysis techniques at different scales have been developed. Mechanical profilometry was used to study the surface roughness, the scanning electron microscopy researched the mechanisms of wear. CMM allowed us to understand the shape and waviness parameters. We suggested a new technique to increase the qualitative analysis of wear. The FE analysis would complete these means, which were applied to the explants. 3 groups of explants, formed by the liners having functioned for over 15 years without IPD, IPD and more recent liners, the design and material of the insert having been changed. Results: The three groups were compared. IPD has been identified as related to wear of the rim. This wear was mainly composed by the wear of the outer side of the rim, which was itself related to the properties of the neck of the femoral stem. Explants over 15 years showed wear about 45 mm3/year, which was at least comparable to standard metal on polyethylene implants. Standard wear analytical methods could not be applied to the analysis of DM-THA. The dimensions of the metal back and characteristics of the prosthetic femoral neck were the only factors affecting the incidence of IPD. Discussion: A schematic model of the functioning of DM-THA has been given based on the data of the explants. The second mobility, through its role as a reserve of mobility, reduces the overall wear and should be encouraged. The retentive rim is also a key point in the design and has a role in the implant survival. The wear data were still incomplete and there will be further work to improve our work at the statistical level.

Ces travaux s'inscrivent dans le cadre plus général de la réalisation d'une prothèse visuelle, destinée aux personnes atteintes de cécité tardive due à une maladie dégénérative des cellules photo réceptrices de la rétine. Par la stimulation adéquate de certaines parties des voies optiques encore fonctionnelles, il est possible de transmettre à nouveau des perceptions visuelles, appelées phosphènes, dans le champ visuel du patient. Les études actuelles portant sur le contenu informationnel de cette vision prothétique proposent simplement de réduire la résolution de l'image d'une caméra embarquée. Notre étude propose une nouvelle approche basée sur le principe de la vision fonctionnelle, développée en collaboration avec les spécialistes de la rééducation fonctionnelle de l'institut ARAMAV. Par le biais de cette approche innovante, nous avons défini des méthodes d'extraction et de représentation des informations de la scène. L'objectif est d'améliorer l'autonomie en mobilité et de rendre possible la perception des expressions faciales. Pour évaluer la pertinence de ces propositions, nous avons développé un simulateur de vision prothétique, dont les paramètres sont basés sur les résultats d'essais cliniques. Pour la mobilité, nous mettons notamment en évidence l'intérêt de fournir un accès aux informations 3D, en substitution ou en complément de l'information de luminosité, ainsi que l'intérêt d'utiliser un oculomètre pour améliorer et faciliter la prise d'informations. Des expériences spécifiques à la mobilité, ainsi que certains résultats initiaux sont présentés. Pour la reconnaissance des expressions faciales, notre étude apporte la preuve que ces expressions sont correctement perçues si nous combinons des techniques de sélection de l'information et l'utilisation de certains prétraitements. / This work falls within the broader framework of visual prostheses conception, designed for people suffering from late blindness due to degenerative diseases of retina photoreceptor cells. By stimulating certain part of the optical pathway that is still functional, it is possible to elicit visual perceptions, called phosphenes, in the subject's visual field. Recent studies on the problematic of informational content of prosthetic vision propose, in majority, a simple reduction in the resolution of grayscale images acquired from a single head worn camera. Our study proposes a new approach based on the principle of functional vision, developed in collaboration with specialists in functional rehabilitation of the ARAMAV institute. Through this innovative approach, we have defined methods for extraction and representation of scene informational content, which aim to improve autonomy in mobility and to make possible the perception of facial expressio ns. In order to evaluate these propositions, we have developed a prosthetic vision simulator, whose parameters are based on clinical trials results. For mobility, we present the usefulness of providing access to 3D information, in substitution or in addition with brightness information and the usefulness of an eye tracking device to improve and facilitate spatial knowledge acquisition. Experiments dedicated to mobility as well as some preliminary results are presented. For the recognition of facial expressions, our study provides evidence that these expressions are correctly perceived if we combined information selection and specific image processing techniques.

Subject of this diploma thesis is a design of a prosthetic foot for an additive manufacturing. It is a dynamic foot made of plastic, designed for an 80 kg patient with a second level of a movement aktivity. From a few concepts is chosen one, which is then optimalized and printed with a MJF method. Functional sample is then undergoing static and cyclic tests according to ISO 10328.

La survenue d’une infection péri prothétique (IPP) est la principale complication de la chirurgie prothétique articulaire, depuis son invention par Robert et Jean Judet en 1947. Comme le nombre de prothèses articulaires posées chaque année augmente de façon importante, ces infections sont de plus en plus fréquentes et l’optimisation de leur prise en charge est un enjeu important sur le plan médical et économique.Les modèles animaux d’IPP permettent de comprendre les mécanismes éthio-pathogéniques et tester de nouvelles thérapeutiques. Une analyse critique de la littérature a été effectuée en évaluant chaque modèle selon son type d’inoculation qui influence les taux et la sévérité de l’infection expérimentale obtenue.Un modèle expérimental d’IPP chez le lapin obtenu par remplacement partiel du genou et inoculation locale a été utilisé pour tester l’efficacité de nouvelles thérapeutiques au cours d’infections à deux bactéries multi résistantes qui posent des problèmes en thérapeutique humaine.Dans un 1er temps nous avons évalué l’efficacité de la ceftaroline (CPT) céphalosporine bactéricide in vivo contre le Staphylococcus aureus résistant à la méticilline (SARM) en la comparant à la vancomycine en association ou non à la rifampicine. 5.107UFC (Unités Formant Colonies) de SARM (Concentration Minimale Inhibitrice (CMI) de 0,38, 0,006, et 1 mg/l pour CPT, RIF, et VAN, respectivement) était injecté dans le genou. Les animaux infectés ont été randomisés et recevaient : aucun traitement (contrôles), CPT (60 mg/kg im), VAN (60 mg/kg im), CPT plus RIF (10 mg/kg im), ou VAN plus RIF débutant 7 jours après l'inoculation et durant 7 jours. L’efficacité des traitements a été évaluée sur la quantité de bactéries persistantes dans l’os (tibia proximal) après traitement. Ce travail a montré que la CPT et la VAN étaient efficace en monothérapie mais que seule l’association avec la rifampicine permettait de stériliser la quasi totalité des animaux. La CPT apparaît donc comme un traitement potentiellement efficace dans cette infection.Dans un 2ème temps nous avons étudié l'efficacité de la colistine (COL) dans le ciment, seule ou en combinaison avec des injections intramusculaires (im) de COL et/ou de méropénème (MRP) dans des infections à Klebsiella pneumoniae résistantes aux carbapénèmes (KPC). Un modèle proche de celui décrit pour le SARM a été utilisé. La souche KPC99YC est une souche clinique, résistante à la gentamicine (CMI 8mg/l) intermédiaire à l'imipénème (CMI 4mg/l), et sensible à la COL (CMI 0,25mg/l). L’inoculum était de 1.109UFC. Sept jours après l'infection, les prothèses étaient remplacées par espaceur sans antibiotique (contrôle), ou par espaceur imprégné de COL (3 MUI de COL/40g de ciment), ou par espaceur sans antibiotique et injections de COL (12 mg/kg im), ou l’association des deux, ou injections de COL avec espaceur en ciment imprégné de COL associé ou non à des injections de MRP (80 mg/kg im). Le traitement durait 7 jours. Tous les lapins témoins étaient infectés à J15, avec une moyenne de densité bactérienne de 6,17 [5,69, 7,04] CFU/g d'os. Contrairement à la COL locale, la COL systémique seule ou combinée avec le MRP était plus efficace que le contrôle sur le nombre de bactéries dans l'os à la fin du traitement. L’association COL locale + systémique était significativement plus efficace que le groupe témoin sur le dénombrement bactérien. D’ailleurs, c'était le seul schéma efficace sur le nombre de lapins avec un os stérile et à la limite de significativité par rapport au traitement systémique seul. Une souche résistante à la COL a été détectée dans le traitement local seul mais pas avec l’association de COL locale et systémique.Les modes d’inoculation directs sont les plus efficaces pour reproduire une IPP aigue. Les études expérimentales permettent de tester des traitements innovants en particulier pour les infections à bactéries multi résistantes. / The occurrence of prosthetic joint infection (PJI) is the main complication of joint prosthetic surgery since its invention by Robert and Jean Judet in 1947. Since the number of articular prostheses placed each year increases significantly, these infections are more and more frequent and the optimization of their management is an important medical and economic stake.The animal models of PJI make it possible to understand the ethiopathogenic mechanisms and to test new therapeutics. A critical analysis of the literature was carried out by evaluating each model according to its type of inoculation which influences the rates and the severity of the experimental infection obtained.An experimental model of PJI in rabbits obtained by partial replacement of the knee and local inoculation was used to test the efficacy of new therapeutics during infections with two multi-resistant bacteria which pose problems in human therapeutics.In a first step we evaluated the efficacy of ceftaroline (CPT) cephalosporin bactericidal in vivo against methicillin-resistant Staphylococcus aureus (MRSA) by comparing it with vancomycin (VAN) in combination with or without rifampin (RIF). 5.107UFC MRSA (Minimum Inhibitory Concentration (MIC) of 0.38, 0.006, and 1 mg/l for CPT, RIF, and VAN, respectively) was injected into the knee. Infected animals were randomized to receive no treatment (control), CPT (60 mg/kg im), VAN (60 mg/kg im), CPT plus RIF (10 mg/kg im) or VAN plus RIF, 7 days after inoculation and for 7 days. The efficacy of treatments was evaluated on the amount of persistent bacteria in the bone (proximal tibia) after treatment. This work has shown that CPT and VAN were effective as monotherapy, but only the combination with RIF allowed the sterilization of almost all animals. CPT appears to be a potentially effective treatment in this infection.In a second step we studied the efficacy of colistin (COL) in cement, alone or in combination with intramuscular (im) injections of COL and/or meropenem (MRP) in carbapenem-resistant Klebsiella pneumoniae infections (KPC). A model close to that used for MRSA was used. The strain KPC99YC is a clinical strain, resistant to gentamicin (MIC 8mg/L) intermediate to imipenem (MIC 4mg/l), and sensitive to COL (MIC 0,25mg/l). The inoculum was 1,109UFC. Seven days after the infection, the prosthesis were replaced by antibiotic-free spacer (control), or by COL-impregnated spacer (3 MIU of COL/40g of cement), or by antibiotic-free spacer and COL injections (12 mg/kg im), or the combination of the two, or COL injections with COL-impregnated cement spacer associated or not with MRP injections (80 mg/kg im). The treatment lasted 7 days. All control rabbits were infected at D15, with median and interquartile range (IQR) bone bacterial count of 6.17 [5.69, 7.04] CFU/g of bones. In contrast to local COL, systemic COL alone or combined with MRP was more effective than control on bacterial counts in bone at the end of treatment. The combination of COL local + systemic was significantly more effective than control group on bacterial counts. Interestingly it was the only effective regimen on the number of rabbits with sterile bone and at the limit of significance vs systemic treatment alone. One COL-resistant strain was detected in the COL local treatment alone but not with the combination of local and systemic COL.Direct inoculation modes are most effective in reproducing an acute PJI. The experimental studies allow testing innovative treatments in particular for the infections with multi-resistant bacteria.

Transfemoral amputees around the world experience increased difficulty in climbing stairs due to lack of muscle, balance, and other factors. The loss of a lower limb greatly diminishes the amount of natural force generation provided that is necessary to propel oneself up stairs. This study investigated possible solutions to the problem of stair ascension for transfemoral amputees by the means of designing and developing an externally attachable device to a prosthesis. The number of amputations from military service has greatly increased since 2008, which shows there is a clear need for assistive devices (Wenke, Krueger, & Ficke, 2012). With the number of amputations rising and no current externally attachable products on the market to aid in stair ascension for transfemoral amputees, the need for this specific device has become more prominent. Research, previous work, and preliminary testing provided a basis for design and development of a new prototype. Bench top testing was conducted to review concepts in the prototype and provide data for further modifications. Results from testing of previous work, as well as testing of new concepts and modifications, provided a framework for designing a new externally attachable device for assistance in stair ascension. A new prototype was then designed, manufactured, and tested with bench models as well as real-time testing with amputees. Success of the device’s performance was based on bench top results and feedback from amputees, noting both the advantages and shortcomings of the new prototype. Testing provided results and feedback that the device was well built and functioned properly, but did not perform satisfactorily, particularly in the categories of force generation and balance.

Yes / Introduction: Clinicians typically use findings from cohort studies to objectively inform judgements regarding the potential (dis)advantages of prescribing a new prosthetic device. However, before finalising prescription a clinician will typically ask a patient to ‘try out’ a change of prosthetic device while the patient is at the clinic. Observed differences in gait when using the new device should be the result of the device’s mechanical function, but could also conceivably be due to patient related factors which can change from day-to-day and can thus make device comparisons unreliable. To determine whether a device’s mechanical function consistently has a more meaningful impact on gait than patient-related factors, the present study undertook quantitative gait analyses of a trans-tibial amputee walking using two different foot-ankle devices on two occasions over a year apart. If the observed differences present between devices, established using quantitative gait analysis, were in the same direction and of similar magnitude on each of the two occasions, this would indicate that device-related factors were more important than patient-related factors. Methods: One adult male with a unilateral trans-tibial amputation completed repeated walking trials using two different prosthetic foot devices on two separate occasions, 14 months apart. Walking speed and sagittal plane joint kinematics and kinetics for both limbs were assessed on each occasion. Clinically meaningful differences in these biomechanical outcome variables were defined as those with an effect size difference (d) between prosthetic conditions of at least 0.4 (i.e. ‘medium’ effect size). Results: Eight variables namely, walking speed, prosthetic ‘ankle’ peak plantar- and dorsi- flexion and peak positive power, and residual knee loading response flexion, peak stance-phase extension and flexion moments and peak negative power, displayed clinically meaningful differences (d > 0.4) between foot devices during the first session. All eight of these showed similar effect size differences during the second session despite the participant being heavier and older. Conclusions: Findings suggest that a prosthetic device’s mechanical function consistently has a more meaningful impact on gait than patient-related factors. These findings support the current clinical practice of making decisions regarding prosthetic prescription for an individual, based on a single session evaluation of their gait using two different devices. However, to confirm this conclusion, a case series using the same approach as the present study could be undertaken.