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Mechanics of biomaterials : fundamental principles for implant design
\"Teaching mechanical and structural biomaterials concepts for successful medical implant design, this self-contained text provides a complete grounding for students and newcomers to the field. Split into three sections: Materials, Mechanics and Case Studies, it begins with a review of sterilization, biocompatibility and foreign body response before presenting the fundamental structures of synthetic biomaterials and natural tissues. Mechanical behavior of materials is then discussed in depth, covering elastic deformation, viscoelasticity and time-dependent behavior, multiaxial loading and complex stress states, yielding and failure theories, and fracture mechanics. The final section on clinical aspects of medical devices provides crucial information on FDA regulatory issues and presents case studies in four key clinical areas: orthopedics, cardiovascular devices, dentistry and soft tissue implants. Each chapter ends with a list of topical questions, making this an ideal course textbook for senior undergraduate and graduate students, and also a self-study tool for engineers, scientists and clinicians\"-- Provided by publisher.
Book
Antibiotic Therapy for 6 or 12 Weeks for Prosthetic Joint Infection
The appropriate duration of antimicrobial therapy for bacterial prosthetic joint infection is debated. In this open-label, randomized, controlled, noninferiority trial involving 410 patients with prosthetic joint infection at 28 centers across France, antimicrobial therapy for 6 weeks was compared with therapy for 12 weeks and was not found to be noninferior.
Journal Article
Limbo
In the aftermath of an atomic war, a new international movement of pacifism has arisen. Multitudes of young men have chosen to curb their aggressive instincts through voluntary amputation - disarmament in its most literal sense. Those who have undergone this procedure are highly esteemed in the new society. But they have a problem - their prosthetics require a rare metal to function, and international tensions are rising over which countries get the right to mine it ...
Book
Transcatheter Valve Replacement in Severe Tricuspid Regurgitation
Severe tricuspid regurgitation is associated with disabling symptoms and an increased risk of death. Data regarding outcomes after percutaneous transcatheter tricuspid-valve replacement are needed.
In this international, multicenter trial, we randomly assigned 400 patients with severe symptomatic tricuspid regurgitation in a 2:1 ratio to undergo either transcatheter tricuspid-valve replacement and medical therapy (valve-replacement group) or medical therapy alone (control group). The hierarchical composite primary outcome was death from any cause, implantation of a right ventricular assist device or heart transplantation, postindex tricuspid-valve intervention, hospitalization for heart failure, an improvement of at least 10 points in the score on the Kansas City Cardiomyopathy Questionnaire overall summary (KCCQ-OS), an improvement of at least one New York Heart Association (NYHA) functional class, and an improvement of at least 30 m on the 6-minute walk distance. A win ratio was calculated for the primary outcome by comparing all possible patient pairs, starting with the first event in the hierarchy.
A total of 267 patients were assigned to the valve-replacement group and 133 to the control group. At 1 year, the win ratio favoring valve replacement was 2.02 (95% confidence interval [CI], 1.56 to 2.62; P<0.001). In comparisons of patient pairs, those in the valve-replacement group had more wins than the control group with respect to death from any cause (14.8% vs. 12.5%), postindex tricuspid-valve intervention (3.2% vs. 0.6%), and improvement in the KCCQ-OS score (23.1% vs. 6.0%), NYHA class (10.2% vs. 0.8%), and 6-minute walk distance (1.1% vs. 0.9%). The valve-replacement group had fewer wins than the control group with respect to the annualized rate of hospitalization for heart failure (9.7% vs. 10.0%). Severe bleeding occurred in 15.4% of the valve-replacement group and in 5.3% of the control group (P = 0.003); new permanent pacemakers were implanted in 17.4% and 2.3%, respectively (P<0.001).
For patients with severe tricuspid regurgitation, transcatheter tricuspid-valve replacement was superior to medical therapy alone for the primary composite outcome, driven primarily by improvements in symptoms and quality of life. (Funded by Edwards Lifesciences; TRISCEND II ClinicalTrials.gov number, NCT04482062.).
Journal Article
Unstoppable : true stories of amazing bionic animals
\"In this title, readers learn the stories of animals that are both benefitting from and helping out the world of prosthetic science - covering all species, situations, and science backgrounds. From the high-tech science of 3D printing, to inflatables, to toy wheels, this title has it all, including visits with subjects who are accessible for interviews and photography. INSPIRING is a perfect fit for animal lovers and science enthusiasts alike.\"-- Provided by publisher.
Book
Efficacy of the preformulated irrigation solution Bactisure® in acute periprosthetic joint infection debridement surgery: study protocol for a randomized controlled trial
Background
Despite significant progress in orthopaedic surgery, the prevalence of periprosthetic joint infections (PJIs) remains persistent, and future increases are expected due to the increasing number of joint arthroplasties. PJIs are intricately connected to biofilm-producing bacteria, which encase infected prostheses, impairing the effectiveness of antibiotics and the immune system. Acute PJIs with immature biofilms are traditionally managed with debridement, antibiotics, and implant retention (DAIR). However, to date, there has not been a conclusive direct clinical comparison (in vivo) demonstrating the superiority of one irrigation solution over others. Recently, there has been a growing interest in irrigation solutions with antibiofilm properties demonstrated in in vitro studies, exemplified by the preformulated Bactisure® irrigation solution, which contains ethanol, acetic acid, sodium acetate, benzalkonium chloride, and sterile water. The main objective of this study was to evaluate the effectiveness (infection cure rate) of preformulated Bactisure® irrigation solution in vivo compared with saline solution in a control group of patients with acute knee and/or hip periprosthetic infections treated with DAIR.
Methods
Prospective single-centre randomized controlled trial involving patients with acute or haematogenous PJI who received standard DAIR surgery from December 2022 to December 2024. The type of irrigation solution used during surgery will include two groups allocated at a 1:1 ratio: a control group (
n
= 25) with saline solution and an experimental group (
n
= 25) receiving the Bactisure® preformulated solution. The sample size was calculated based on an expected reduction in reinfection rates from 45% in the control group to 10% in the experimental group. Data on baseline patient characteristics, clinical and radiological information, and healthcare questionnaires will be recorded. All patients will be followed for minimum of 12 months. The infection cure rate at 1 year will be the primary outcome.
Discussion
This study is the first to compare the effectiveness of preformulated Bactisure® irrigation solution with that of saline solution in real clinical practice (in vivo) in patients with acute knee and/or hip periprosthetic infections treated with DAIR. Our main hypothesis is that, compared with saline solution, Bactisure® provides a better infection cure rate at 1 year post-DAIR.
Trial registration
International Standard Randomized Controlled Trial Number (ISRCTN):
https://doi.org/10.1186/ISRCTN10873696
. Registered on December 19, 2023.
Journal Article
Phantom limb : amputation, embodiment, and prosthetic technology /
\"Phantom limb pain is one of the most intractable and merciless pains ever known--a pain that haunts appendages that do not physically exist, often persisting with uncanny realness long after fleshy limbs have been traumatically, surgically, or congenitally lost. The very existence and \"naturalness\" of this pain has been instrumental in modern science's ability to create prosthetic technologies that many feel have transformative, self-actualizing, and even transcendent power. In Phantom Limb, Cassandra S. Crawford critically examines phantom limb pain and its relationship to prosthetic innovation, tracing the major shifts in knowledge of the causes and characteristics of the phenomenon. Crawford exposes how the meanings of phantom limb pain have been influenced by developments in prosthetic science and ideas about the extraordinary power of these technologies to liberate and fundamentally alter the human body, mind, and spirit. Through intensive observation at a prosthetic clinic, interviews with key researchers and clinicians, and an analysis of historical and contemporary psychological and medical literature, she examines the modernization of amputation and exposes how medical understanding about phantom limbs has changed from the late-19th to the early-21st century. Crawford interrogates the impact of advances in technology, medicine, psychology and neuroscience, as well as changes in the meaning of limb loss, popular representations of amputees, and corporeal ideology. Phantom Limb questions our most deeply held ideas of what is normal, natural, and even moral about the physical human body. Cassandra S. Crawford is Assistant Professor of Sociology at Northern Illinois University and a faculty associate in Women's Studies and in Lesbian, Gay, Bisexual, Transgender Studies. \"-- Provided by publisher.
Book
Phantom limbs and body integrity identity disorder : literary and psychoanalytic reflections
\"Phantom Limbs and Body Integrity Identity Disorder discusses the conditions of Phantom Limb Syndrome and Body Integrity Identity Disorder together for the first time, exploring examples from literature, film, and psychoanalysis to re-ground theories of the body in material experience\"-- Provided by publisher.
Book
Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients
In a randomized trial, 1468 patients with severe aortic stenosis who were at low risk for death with surgery were assigned to either transcatheter aortic-valve replacement with a self-expanding valve or surgical aortic-valve replacement. At 2 years, TAVR was noninferior to surgery with respect to death or disabling stroke.
Journal Article