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Although proximal row carpectomy, wrist arthrodesis and even total wrist arthroplasty were developed to treat wrist disease using bone and cartilage of the wrist, severe and complicated bone defects caused by ferocious trauma and bone tumors remain a stubborn problem for surgeons. Development and application of the three-dimensional (3D) printing technology may provide possible solutions.

Computed tomography (CT) data of three cases with severe bone defects caused by either trauma or bone tumor were collected and converted into three-dimensional models. Prostheses were designed individually according to the residual anatomical structure of the wrist based on the models. Both the models and prostheses were produced using 3D printing technology. A preoperative design was prepared according to the models and prostheses. Then arthroplasty was performed after preoperative simulation with printed models and prostheses.

The diameter of the stem and radial medullary cavity, the direction and location of the prosthesis, and other components were checked during the preoperative design and simulation process phases. The three cases with 3D printed wrist all regained reconstruction of normal anatomy and part of the function after surgery. The average increasing Cooney score rate of Cases 2 and 3 was 133.34 ± 23.57 per cent, and that of Case 1 reached 85 per cent. The average declining rate of the Gartland and Werley Score in Cases 2 and 3 was 65.21 ± 18.89 per cent, and that of Case 1 dropped to 5 per cent in the last follow-up. The scores indicated that patients experienced pain relief and function regain. In addition, the degree of patient satisfaction improved.

3D printed wrist arthroplasty may provide an effective method for severe and complicated cases without sacrificing other bones. Personal customization can offer better anatomy and function than arthrodesis or other traditional surgical techniques.

This paper aims to review the latest applications in terms of three-dimensional printed (3DP) metal implants in orthopedics, and, importantly, the design of 3DP metal implants through a series of cases operated at The Second Hospital of Jilin University were presented.

This paper is available to practitioners who are use 3DP implants in orthopedics. This review began with the deficiency of traditional prostheses and basic concepts of 3DP implants. Then, representative 3DP clinical cases were summarized and compared, and the experiences using customized prostheses and directions for future potential development are also shown.

The results obtained from the follow-up of clinical applications of 3DP implants show that the 3D designed and printed metal implants could exhibit good bone defect matching, quick and safe joint functional rehabilitation as well as saving time in surgery, which achieved high patient satisfaction collectively.

Single center experiences of 3DP metal implants design were shared and the detailed technical points between various regions were compared and analyzed. In conclusion, the 3DP technology is infusive and will present huge potential to reform future orthopedic practice.

This paper aims to fill a research gap by presenting design and 3D printing guidelines and considerations which apply to the development process of patient-specific osteotomy guides for orthopaedic surgery.

Analysis of specific constraints related to patient-specific surgical guides design and 3D printing, lessons learned during the development process of osteotomy guides for orthopaedic surgery, literature review of recent studies in the field and data gathered from questioning a group of surgeons for capturing their preferences in terms of surgical guides design corresponding to precise functionality (materializing cutting trajectories, ensuring unique positioning and stable fixation during surgery), were all used to extract design recommendations.

General design rules for patient-specific osteotomy guides were inferred from examining each step of the design process applied in several case studies in relation to how these guides should be designed to fulfill medical and manufacturing (fused deposition modelling process) constraints. Literature was also investigated for finding other information than the simple reference that the surgical guide is modelled as negative of the bone. It was noticed that literature is focussed more on presenting and discussing medical issues and on assessing surgical outcomes, but hardly at all on guides’ design and design for additive manufacturing aspects. Moreover, surgeons’ opinion was investigated to collect data on different design aspects, as well as interest and willingness to use such 3D-printed surgical guides in training and surgery.

The study contains useful rules and recommendations for engineers involved in designing and 3D printing patient-specific osteotomy guides.

A synergetic approach to identify general rules and recommendations for the patient-specific surgical guides design is presented. Specific constraints are identified and analysed using three case studies of wrist, femur and foot osteotomies. Recent literature is reviewed and surgeons’ opinion is investigated.

The purpose of this paper is to design and analyze four proximal interphalangeal joint (PIP) prosthesis thorough finite element analysis (FEA) and fabricate them using rapid prototyping (RP) technique. Arthritis of the finger joints is an important pathology of the hand. Major complaints in arthritis are stiffness, deformity and severe pain. The pain is due to the inflammatory process that occurs due to pathology, which involves joint degeneration, synovial swelling and ligament and muscle stiffness. Among the surgical treatment of arthritis is Arthroplasty which involves replacing the diseased joint with an artificial joint.

In this paper, four proximal interphalangeal joint (PIP) prostheses are designed, analyzed using FEA and fabricated using rapid prototyping technique. Four different prostheses “BM”, “IMP”, “IMP2” and “FINS” are designed using CATIA software and tested by normal daily functions such as grasp, key pinch and tip pinch tests using FEA to analyze the results based on their stress and deformation. Finally, the prostheses are fabricated using electron beam melting technology.

This paper examined and analyzed the relative motion of PIP designs using FEA by applying varying loads to check the stability and range of motion of the PIP implant. The ANSYS summary results were analyzed depending on the minimal results of equivalent stress and deformation from the taken tests that have happened on the designed prosthesis. The results conclude that, in the grasp test, the minimal equivalent stress and deformation have happened on the “BM” and “IMP2” implants. Furthermore, in the key pinch test, minimal equivalent stress and deformation occurred on the “FINS” implant, and finally, in the tip pinch, minimal equivalent stress occurred on the “FINS” and minimal deformation has happened on the “IMP2” implant.

These results conclude that both “IMP2” and “FINS” share the minimum results in the taken tests, and this shows that these implants may be further studied brainstormed upon to aid innovation of a better implant design that shares both of these implants’ features and shape. Nevertheless, testing in an in vivo or in vitro model to prove more of the effectiveness of these implants should be taken into consideration, and to test how the prostheses will function in an actual environment, a simulated hand can be designed and made to discover the true forces and mechanics of the fingers and the hands with the prosthesis that is implanted, as well as to know if the hand works properly.

This paper examined and analyzed the relative motion of PIP designs using FEA by applying varying loads to check the stability and range of motion of the PIP implant.

The purpose of this paper is to propose a gait analysis technique that aims to identify differences and similarities in gait performance between three different assistive devices (ADs).

Two feature reduction techniques, linear principal component analysis (PCA) and nonlinear kernel-PCA (KPCA), are expanded to provide a comparison of the spatio-temporal, symmetrical indexes and postural control parameters among the three different ADs. Then, a multiclass support vector machine (MSVM) with different approaches is designed to evaluate the potential of PCA and KPCA to extract relevant gait features that can differentiate between ADs.

Results demonstrated that symmetrical indexes and postural control parameters are better suited to provide useful information about the different gait patterns that total knee arthroplasty (TKA) patients present when walking with different ADs. The combination of KPCA and MSVM with discriminant functions (MSVM DF) resulted in a noticeably improved performance. Such combination demonstrated that, with symmetric indexes and postural control parameters, it is possible to extract with high-accuracy nonlinear gait features for automatic classification of gait patterns with ADs.

The information obtained with the proposed technique could be used to identify benefits and limitations of ADs on the rehabilitation process and to evaluate the benefit of their use in TKA patients.

The purpose of this paper is to present a robotic motion compensation system, using ultrasound images, to assist orthopedic surgery. The robotic system can compensate for femur movements during bone drilling procedures. Although it may have other applications, the system was thought to be used in hip resurfacing (HR) prosthesis surgery to implant the initial guide tool. The system requires no fiducial markers implanted in the patient, by using only non-invasive ultrasound images.

The femur location in the operating room is obtained by processing ultrasound (USA) and computer tomography (CT) images, obtained, respectively, in the intra-operative and pre-operative scenarios. During surgery, the bone position and orientation is obtained by registration of USA and CT three-dimensional (3D) point clouds, using an optical measurement system and also passive markers attached to the USA probe and to the drill. The system description, image processing, calibration procedures and results with simulated and real experiments are presented and described to illustrate the system in operation.

The robotic system can compensate for femur movements, during bone drilling procedures. In most experiments, the update was always validated, with errors of 2 mm/4°.

The navigation system is based entirely on the information extracted from images obtained from CT pre-operatively and USA intra-operatively. Contrary to current surgical systems, it does not use any type of implant in the bone to track the femur movements.

Rapid prototype models are directly integrated into non‐engineering applications such as medicine. Medical models are used to plan complex procedures prior to surgery with potential to optimise patient treatment in the operating theatre. This paper presents results following a 12 month National Health Service Executive research project to assess the feasibility of using rapid prototype medical models. A total of 16 medical models were created. Nine anatomical sites were reconstructed from patient data acquired from five London hospitals. The purpose of the models is described and the commissioning surgeons as part of a questionnaire assessed their usefulness. Future developments are discussed and conclusions about the use of medical models are made.

The purpose of this paper is to implement a new process aimed at the design and production of orthopaedic devices fully manufacturable by additive manufacturing (AM). In this context, the use of generative algorithms for parametric modelling of additively manufactured textiles (AMTs) also has been investigated, and new modelling solutions have been proposed.

A new method for the design of customised elbow orthoses has been implemented. In particular, to better customise the elbow orthosis, a generative algorithm for parametric modelling and creation of a flexible structure, typical of an AMT, has been developed.

To test the developed modelling algorithm, a case study based on the design and production of an elbow orthosis made by selective laser sintering was investigated. The obtained results have demonstrated that the implemented algorithm overcomes many drawbacks typical of the traditional computer aided design (CAD) modelling approaches. The parametric CAD model of the orthosis obtained through the new approach is characterised by a flexible structure with no deformations or mismatches and has been effectively used to produce the prototype through AM technologies.

The obtained results present innovative elements of originality in the CAD modelling sector, which can contribute to solving problems related to modelling for AM in different application fields.

This study aims to examine the existing literature on sleep-related interventions and confirm the intervention methods and their effectiveness led by occupational therapists.

All the relevant literature published from 2010 to June 31, 2022, in five prominent databases were searched using the five-stage review framework proposed by Arksey and O’Malley.

In this review, four types of sleep-related interventions were led by occupational therapists (tool use, exercise program, sleep education and occupational-based program). When the intervention was analyzed based on its content, occupational therapists demonstrated excellent ability in interventions based on sensory intervention and lifestyle redesign.

Various factors cause sleep problems; hence, the development of individualized and extensive occupational therapy intervention methods is required.

This paper aims to provide an insight into recent advancements and developments of robotics for Natural Orifice Transluminal Surgery (NOTES) procedures.

Following an introduction that highlights the evolution from Minimally Invasive Surgery (MIS) to NOTES in the medical field, this paper reviews the main robotics systems that have been designed and implemented for MIS and NOTES, summarising their advantages and limitations and remarking the technological challenges and the requirements that still should be addressed and fulfilled.

The state-of-the-art presented in this paper shows that the majority of the platforms created for NOTES are laboratory prototypes, and their performances are still far from being optimal. New solutions are required to solve the problems confronted by the proposed systems such as the limited number of DOFs, the limited resolution, the optimal fixation and stiffening of the instruments for enabling stable and precise operation, the effective transmission of forces to the tip tools, the improvement of the force feedback feeling and the proper visualization and spatial orientation of the surgical field. Advances in robotics can contribute significantly to the development and future implementation of the NOTES procedure.

This paper highlights the current trends and challenges ahead in robotics applied to NOTES procedure.