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Figure C shows an example of an Walldius hinge total knee prosthesis

arthroplasty, bone, direct skeletal attachment, infection, limb amputation, osseointegration, porous pylon, prosthesis, prosthetic rehabilitation, residuum.

THA Periprosthetic Fracture - Recon - Orthobullets

Abstract — This article presents results on the effectiveness of a new version of the titanium porous composite skin and bone integrated pylon (SBIP). The SBIP is designed for direct skeletal attachment of limb prostheses and was evaluated in a preclinical study with three rabbits. In accordance with the study protocol, a new version of the pylon (SBIP-3) was implanted into the hind leg residuum of three rabbits. The SBIP-3 has side fins that are designed to improve the bond between the bone and pylon. The fins are positioned inside two slots precut in the bone walls; their length can be adjusted to match the thickness of the bone walls. After 13 (animal 1) or 26 (animals 2 and 3) wk, the animals were sacrificed and samples collected for histopathological analysis. The space between the fins and the bone into which they were fit was filled with fibrovascular tissue and woven bone. No substantial inflammation was found. We suggest that if further studies substantiate the present results, the proposed method can become an alternative to the established technique of implanting prostheses into the medullary canal of the hosting bone.

Prosthetic-Joint Infections — NEJM

Fixed-bearing Prosthesis vs. Mobile-bearing Prosthesis
The difference between a Fixed-bearing Prosthesis and a Mobile-bearing Prosthesis is in the bearing surface. In a mobile-bearing prosthesis, the femoral component and tibial plate move across a polyethylene insert to create a dual surface articulation. A mobile-bearing prosthesis allows greater rotation of the knee and helps reduce the amount of wear to the bearing to help prevent loosening where the prosthesis attaches to bone.

In direct skeletal attachment (DSA) of limb prostheses, a pylon is implanted transcutaneously into the bone of a limb's residuum. A specific procedure, called Osseointegrated Prostheses for the Rehabilitation of Amputees (OPRA), and the attendant instrumentation (Integrum AB; M??lndal, Sweden) have been developed and implemented [1]. In this original, two-stage technique, a threaded cylindrical fixture is first screwed into the medullary canal of the hosting bone. A second surgery is performed after several months to screw the transcutaneous abutment into the fixture [2].

Interaction among Microbial, Host, and Prosthetic Factors

Animal 3. X-ray of implanted prosthesis (oblique view) in first week. Side fins of pylon inside bone walls are shown by black arrows. Imaging parameters of radiography were 70 kV and8 mAs (Kodak computed radiography system).

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