BIOMECHANICAL ASPECTS OF ENDO-EXO-PROSTHETICS OF THE LOWER LIMBS

Authors

  • Oleksandr Sitenko Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
  • Taras Sitenko Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine

DOI:

https://doi.org/10.15674/0030-59872024269-75

Keywords:

Endo-exo-prosthetics, requirements for the functions of endo-exo-prostheses, biomechanical patterns of movements

Abstract

The prospects of creating new opportunities in the rehabilitation of patients with limb amputations are generally associated with the method of osseointegration and endo-exo-prosthetics (EEP). The results of the practical application of the method indicate attention to the analytical consideration of all its components, all stages. Objective. To substantiate the expediency and directions of research and development of the theoretical and practical principles of EEP from the standpoint of the full cycle, including both the problems of osseointegration and functional qualities, constructive and technological principles regarding the prostheses themselves, the methodology of the process of mastering and using them. Results. Considered biomechanical and other arguments, which substantiate the objects of research and development of medicaltechnical and medical-technological means, including the constructions of endo-exo-prostheses, methods of learning to use them, evaluation of the quality of locomotion, increasing the reliability of the «implant-bone» c ontact. The d esign principle of a hip prosthesis with a removable unloading module is proposed, which is installed at the stage of mastering the prosthesis, and in necessary cases, during constant use. The possibilities of the method of recognizing biomechanical patterns of movements for teaching patients to walk on prostheses, for adjusting functional nodes and assessing the quality of prosthetics are shown. Conclusions. The problem
of endo-exo-prosthetics is considered for the first time  from the standpoint of the requirements for the functions and qualities of the prostheses themselves. Reasoned directions of application and significance of clinical, experimental and mathematical biomechanics methods for analysis and development of the functional structure of endo-exo prostheses, to reduce risks when using them.

Author Biographies

Oleksandr Sitenko, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

PhD

Vashkivtsi Rehabilitation Hospital, Vashkivtsi. Ukraine

Taras Sitenko, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD

References

  1. Li, Y., & Brånemark, R. (2017). Osseointegrated prostheses for rehabilitation following amputation. Der Unfallchirurg, 120(4), 285-292. doi:10.1007/s00113-017-0331-4
  2. Hoellwarth, J. S., Tetsworth, K., Akhtar, M. A., & Al Muderis, M. (2022). The clinical history and basic science origins of transcutaneous Osseointegration for amputees. Advances in Orthopedics, 2022, 1-14. doi:10.1155/2022/7960559
  3. Al Muderis, M., Khemka, A., Lord, S. J., Van de Meent, H., & Frоlke, J. P. (2016). Safety of Osseointegrated implants for Transfemoral amputees. Journal of Bone and Joint Surgery, 98(11), 900-909. doi:10.2106/jbjs.15.00808
  4. Jeyapalina, S., Beck, J. P., Bachus, K. N., Chalayon, O., & Bloebaum, R. D. (2014). Radiographic evaluation of bone adaptation adjacent to percutaneous Osseointegrated prostheses in a sheep model. Clinical Orthopaedics & Related Research, 472(10), 2966-2977. doi:10.1007/s11999-014-3523-z
  5. Hoellwarth, J. S., Tetsworth, K., Rozbruch, S. R., Handal, M. B., Coughlan, A., & Al Muderis, M. (2020). Osseointegration for amputees. JBJS Reviews, 8(3), e0043-e0043. doi:10.2106/jbjs.rvw.19.00043
  6. Zaid, M. B., O'Donnell, R. J., Potter, B. K., & Forsberg, J. A. (2019). Orthopaedic Osseointegration: State of the art. Journal of the American Academy of Orthopaedic Surgeons, 27(22), e977-e985. doi:10.5435/jaaos-d-19-00016
  7. Li, Y., & Felländer-Tsai, L. (2021). The bone anchored prostheses for amputees — Historical development, current status, and future aspects. Biomaterials, 273, 120836. doi:10.1016/j.biomaterials.2021.120836
  8. Juhnke, D., Beck, J. P., Jeyapalina, S., & Aschoff, H. H. (2015). Fifteen years of experience with integral-leg-Prosthesis: Cohort study of artificial limb attachment system. Journal of Rehabilitation Research and Development, 52(4), 407-420. doi:10.1682/jrrd.2014.11.0280
  9. Al Muderis, M., Khemka, A., Lord, S. J., Van de Meent, H., &Frоlke, J. P. (2016). Safety of Osseointegrated implants for Transfemoral amputees. Journal of Bone and Joint Surgery, 98(11), 900-909. doi:10.2106/jbjs.15.00808
  10. Yanson, H. A. (1975). Biomechanics of the human lower limb. Riga : Publishing house «Zinatne». (in russian)
  11. Pitkin, M., Cassidy, C., Muppavarapu, R., Raymond, J., Shevtsov, M., Galibin, O., & Rousselle, S. D. (2013). New method of fixation of in-bone implanted prosthesis. The Journal of Rehabilitation Research and Development, 50(5), 709. doi:10.1682/jrrd.2012.11.0202
  12. Rosenbaum Chou, T. G., Child, J. R., Naughtin, R. J., Rigdon, R. R., Schumann, C., & Bloebaum, R. D. (2007). The relationship between femoral periprosthetic cortical bone geometry and porosity after total hip arthroplasty. Journal of Biomedical Materials Research Part A, 87A(1), 107-115. doi:10.1002/jbm.a.31702
  13. Tomaszewski, P., Van Diest, M., Bulstra, S., Verdonschot, N., & Verkerke, G. (2012). Numerical analysis of an osseointegrated prosthesis fixation with reduced bone failure risk and periprosthetic bone loss. Journal of Biomechanics, 45(11), 1875-1880. doi:10.1016/j.jbiomech.2012.05.032
  14. Nebergall, A., Bragdon, C., Antonellis, A., Kärrholm, J., Brånemark, R., & Malchau, H. (2012). Stable fixation of an osseointegated implant system for above-the-knee amputees. Acta Orthopaedica, 83(2), 121-128. doi:10.3109/17453674.2012.678799
  15. Frossard, L., Stevenson, N., Sullivan, J., Uden, M., & Pearcy, M. (2011). Categorization of activities of daily living of lower limb amputees during short-term use of a portable kinetic recording system: A preliminary study. JPO Journal of Prosthetics and Orthotics, 23(1), 2-11. doi:10.1097/jpo.0b013e318207914c
  16. Lee, W. C., Frossard, L. A., Hagberg, K., Haggstrom, E., Gow, D. L., Gray, S., & Brånemark, R. (2008). Magnitude and variability of loading on the osseointegrated implant of transfemoral amputees during walking. Medical Engineering & Physics, 30(7), 825-833. doi:10.1016/j.medengphy.2007.09.003
  17. Sitenko, O. M., &Yaremenko, D. O. (1981). The method of graphic registration of biomechanical images of human walking. Patent 933075 (in Ukrainian)
  18. Bernstein, N. A. (1947). About the construction of movements. Medgiz. (in russian)
  19. Latash, M. L. (1993). Control of Human Movement. Human Kinetics Publishers

How to Cite

Sitenko, O. ., & Sitenko, T. . (2024). BIOMECHANICAL ASPECTS OF ENDO-EXO-PROSTHETICS OF THE LOWER LIMBS. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (2), 69–75. https://doi.org/10.15674/0030-59872024269-75

Issue

Section

REHABILITATION