Establishing a New Patient-Specific Implantation Technique for Total Ankle Replacement: An In Vitro Study

Background Revision rates after total ankle replacements (TARs) are higher compared with other total joint replacements. The present study aimed to establish a new patient-specific implantation (PSI) technique for TAR. Material and methods A total of 10 complete Caucasian cadaver legs had whole leg computed tomography scans. The individual geometrical ankle joint axis was determined, and based on this axis, the position of the prosthesis was planned. We assessed prosthesis placement, guiding block position, and preoperative and postoperative ankle rotational axes. Results The guiding block position interobserver reliability was 0.37 mm 0.45 (mean ± SD) for the tibial guiding block. The value for the first talar guiding block was 1.72 ± 1.3 mm and for the second talar guiding block, 0.61 ± 0.39 mm. The tibial slope as well as the frontal angles of the anatomical tibial axis compared to the tibial and talar articular surfaces showed no statistically relevant differences with numbers available. The deviation of the assessed preoperative joint axis to the postoperative joint axis was 14.6° ± 7.8. Conclusion The present study describes the results of an establishing process of a new PSI technique for TAR. The reliability of guiding block positioning and, thereby, prosthesis placement is sufficient. Level of Evidence: Biomechanical study

Innovation Design Roughness on Slope to Reduce Storms at Curved Seawall in Canggu Beach Bali

Seawall or revetment has been designed to preserve coastline erosion from waves. The seawall system or revetment could protect againstpowerful wave, reduce hydraulic power in underring material and constribute to wave reflection. The result of survey show that seawall system have to be repeatedly observed to maximize seawall action to produce a modification of seawall design.In this research, hydrodinamic seawall action is conducted by employing its curve, slope and roughness. It is investigated by using physical modeling in 2D Laboratory of Coastal Dynamics Institute Yogyakarta, Indonesia. Type of wave used in this study is Regularwave within one period of time. Wave experiment is examined in 30° of its slope, constant water depth is0.4 m and roughness on its slope using two types of sequential block position and zig zags. This research results in the significant Reflection Coefficient (Kr) which is 0.141 produced by design 1 compared to the previous research is 0.16923. Therefore, it can be concluded that design 1 is more reliable in reducing reflection wave

Development of a Quantitative Assessment System for Upper Limb Motor Disorder in Occupational Therapy

Many stroke patients nowadays prefer home rehabilitation, which limits their access to proper rehabilitation equipment, treatment, or assessment by therapists. Currently, the rehabilitation programs neglect to maintain a patient’s motivation in doing rehabilitation exercises. The programs also lack a monitoring system to evaluate the patients’ performance quantitatively although this is the most crucial element in rehabilitation. In order to solve these problems, we have developed a novel measurement system for upper limb motor disorder rehabilitation using an optical sensor. This system consists of an optical sensor device, a personal computer and a computerized calculated program for upper limb locus position. The optical sensor detects the user’s motions and calculates position and velocity. The sanding block position, velocity and the motion length of the block during the sanding task of five subjects with motor function disorder were measured. The accuracy of the trajectories was similar in all the actual measured subjects. These outcomes have a potential for the development of rehabilitation training programs and evaluation methods.

The Impact of Pinless Navigation in Conventionally Aligned Total Knee Arthroplasty

Background. Restoration of the mechanical axis is a main objective in total knee replacement (TKR). Aim of this study was to analyse the verification tool of a pinless navigation system in conventional TKR (cTKR). Methods. In a prospective study, 147 TKR were performed by conventional technique. Using the “pinless verification” mode of a smartphone based navigation system, the cutting block position and final resection plane for distal femur and proximal tibial resection were measured. If necessary, the block position or resection level were optimized, corrections were protocolled. Postoperatively, standardized radiographs were performed. Results. In 65.3%, intraoperative measurements changed the surgical procedure (corrections: 20.4% femoral, 25.9% tibial, 19% both). The additional time for surgery compared to cTKR averaged 6 minutes (79 ± 15 versus 73 ± 17 minutes). Using navigation data, the final femoral and tibial axes were in 93% within a range of ±2°. A mean difference of 1.4° and 1.6° could be shown between the final measurement of the navigation system and the postoperative mLDFA and mMPTA. Conclusion. Intraoperative pinless navigation has impact on the surgical procedure in the majority of cTKR. It represents a less time-consuming tool to improve implant position while maintaining the routine of conventional technique.