The reversible adjustable coupling: A lightweight and low-cost alignment component for the lower limb prosthesis

Sasaki, Kazuhiko; Pinitlertsakun, Jutamat; Nualnim, Pakwan; Guerra, Gary; Sansook, Yuttapichai; Kaewdoung, Supachai; Chotirossukon, Suttinun; Lanlongsa, Parichat; Tangpornprasert, Pairat; Virulsri, Chanyaphan; Nattavut, Wit; Buttonkum, Danupong

doi:10.1177/2055668317706427

Cited by 4 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When the prostheses is inserted, proper alignment of the lower limb must be restored. Correct reconstruction of lower limb alignment is a critical step for long-term prostheses stability and patient limb function recovery [ 22 , 39 ]. The deviation of the anatomical axis and the lower limb alignment were significant at the tip of the intramedullary stem, as was the resulting bending moment.…”

Section: Discussionmentioning

confidence: 99%

Aseptic loosening of tumor prostheses in distal femur after revision surgery: a retrospective study

et al. 2023

World J Surg Onc

View full text Add to dashboard Cite

Background Tumor prostheses of the distal femur after revision surgery is associated with high rates of aseptic loosening, which has introduced great challenges to the survival of patients, but only a few studies have evaluated their X-ray imaging. The purpose of this study was to analyze the risk factors for recurrence of aseptic loosening and make recommendations to reduce the incidence of aseptic loosening after revision surgery of tumor prostheses in the distal femur. Method A retrospective analysis was performed on 23 patients who had revision surgery for distal femur prostheses due to aseptic loosening between June 2002 and June 2021. They were divided into two groups based on the condition of the prostheses after revision surgery: loosening group (9 patients) and control group (14 patients). Following the initial replacement, the length and diameter of the prosthetic intramedullary stem were measured through the standard full-length anteroposterior X-ray imaging of both lower limbs. The osteotomy length, femoral length and diameter, femoral intramedullary stem diameter, hip-knee-ankle angle (HKAA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), and so on were measured as well. Following that, statistical analysis was performed. Results Patients in the loosening group had statistically significant differences in the ratio of prostheses length to femur length (71.89 ± 6.62) and the ratio of intramedullary stem diameter to femoral diameter (25.50 ± 6.90) (P < 0.05), when compared to the control group. The HKAA (175.58 ± 2.78), mLDFA (94.42 ± 2.57), and the deviation angle between the lower limb alignment and the tibial prostheses force line (2.23 ± 1.09) in the loosening group were significantly different from those in the control group (P < 0.05) on postoperative radiographs of the entire length of the lower limbs. The lowest score in intramedullary manubrium I indicated less osteolysis, while the highest score in intramedullary manubrium III indicated the most serious osteolysis, and the difference was statistically significant (P < 0.05). Conclusions Our study suggests that the use of longer and thicker intramedullary stems can effectively decrease the occurrence of aseptic loosening. Additionally, it is important to avoid using the original prostheses and reconstruct the standard line of lower limb force to further reduce the incidence of aseptic loosening. It is crucial to closely monitor the distal segment of the intramedullary stem for osteolysis after surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Aseptic loosening of tumor prostheses in distal femur after revision surgery: a retrospective study

et al. 2023

World J Surg Onc

View full text Add to dashboard Cite

show abstract

“…It became the most popular design among prosthetists for its simplicity. A few other temporary adapters, such as 4R101 49 (Otto Bock), enable sliding adjustment in A/P and M/L planes, 4R1alignment jig 50 (Otto Bock) offers both tilting and sliding adjustment in all plans, and a Reversible Adjustable Coupling 51 allows int/external rotation and sliding in A/P, M/L planes for exoskeletal/endoskeletal prostheses; thus, once dynamic alignment is completed, these adaptors are removed and alignment is transferred using a duplication jig.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of methods used to assist transtibial prosthetic alignment decision-making

Malaheem,

Abd Razak,

Abu Osman

2023

Prosthetics &Amp; Orthotics International

View full text Add to dashboard Cite

Prosthetic alignment is a highly subjective process that is still based on clinical judgments. Thus, researchers have aimed their effort to quantify prosthetic alignment by providing an objective method that can assist and guide prosthetists in achieving transtibial (TT) prosthetic alignment. This systematic review aimed to examine the current literature on TT prosthetic alignment to scope the qualitative and quantitative methods designed to guide prosthetists throughout the TT prosthetic alignment process as well as evaluate the reported instruments and devices that are used to align TT prostheses and their clinical feasibility. A literature search, completed in June 2022, was performed using the following databases: Web of Science (Clarivate), SCOPUS (Elsevier), and Pub Med (Medline) with searching terms focusing on TT, prosthesis, prosthetist, prosthetic alignment, and questionnaires, resulting in 2790 studies being screened. Twenty-four studies have used quantitative methodologies, where sensor technologies were found to be the most frequently proposed technology combined with gait analysis tools and/or subjective assessments. A qualitative method that assists prosthetists throughout the alignment process was not found. In this systematic review, we presented diverse methods for guiding and assisting clinical decision-making regarding TT prosthetic alignment. However, most of these methods considered varied parameters, and there is a need for elaboration toward standardized methods, which would improve the prosthetic alignment clinical outcome.

show abstract

“…When the prosthesis is inserted, proper alignment of the lower limb must be restored. Correct reconstruction of lower limb alignment is a critical step for long-term prosthesis stability and patient limb function recovery [29,30]. The deviation of the anatomical axis and force line was signi cant at the tip of the intramedullary stem, as was the resulting bending moment.…”

Section: How To Reduce the Failure Rate Of Prosthesis Revisionmentioning

confidence: 99%

Aseptic loosening of tumor endprostheses in distal femur after revision surgery: a retrospective study

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: More patients are having revision surgery because of aseptic loosening of tumor prostheses in distal femur, but the revision failure rate is also increasing, which is mainly due to the recurrence of aseptic loosening. The purpose of this study was to analyze the risk factors for recurrence of aseptic loosening after revision surgery of tumor prosthesis in the distal femur. Method: A retrospective analysis was performed on 23 patients who had revision surgery for distal femur prosthesis due to aseptic loosening between June 2002 and June 2021. They were divided into two groups based on the condition of the prostheses after revision surgery: loosening group and control group. After the initial replacement, length and diameter of the prosthetic intramedullary stem were measured. The osteotomy length, femoral length and diameter, femoral intramedullary stem diameter, hip–knee–ankle angle (HKAA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA) and so on were measured as well. Following that, statistical analysis was performed. Results: Patients in the loosening group had statistically significant differences in the ratio of prosthesis length to femur length (71.89±6.62) and the ratio of intramedullary stem diameter to medullary cavity diameter (25.50±6.90) (P < 0.05) when compared to the control group. The HKAA (175.58°±2.78°), mLDFA (94.42°±2.57°), and the deviation angle between the force line of the lower limb and the longitudinal axis of the tibial prosthesis (2.23°±1.09°) in the loosening group were significantly different from those in the control group (P < 0.05) on postoperative radiographs of the entire length of the lower limbs. The lowest score in intramedullary manubrium I indicated less osteolysis, while the highest score in intramedullary manubrium Ⅲ indicated the most serious osteolysis, and the difference was statistically significant (P < 0.05). Conclusions: We conclude that using longer and thicker intramedullary stems can effectively reduce the incidence of aseptic loosening, and that using the original prosthesis carefully can reconstruct the standard line of lower limb force. The distal segment of the intramedullary stem is more prone to osteolysis and should be closely follow-up after surgery.

show abstract

The reversible adjustable coupling: A lightweight and low-cost alignment component for the lower limb prosthesis

Cited by 4 publications

References 11 publications

Aseptic loosening of tumor prostheses in distal femur after revision surgery: a retrospective study

Aseptic loosening of tumor prostheses in distal femur after revision surgery: a retrospective study

A systematic review of methods used to assist transtibial prosthetic alignment decision-making

Aseptic loosening of tumor endprostheses in distal femur after revision surgery: a retrospective study

Contact Info

Product

Resources

About