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Upper extremity prosthetic selection influences loading of transhumeral osseointegrated systems
Percutaneous osseointegrated (OI) implants are increasingly viable as an alternative to socket suspension of prosthetic limbs. Upper extremity prostheses have also become more complex to better replicate hand and arm function and attempt to recreate pre-amputation functional levels. With more functi...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7410272/ https://www.ncbi.nlm.nih.gov/pubmed/32760149 http://dx.doi.org/10.1371/journal.pone.0237179 |
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author | Taylor, Carolyn E. Drew, Alex J. Zhang, Yue Qiu, Yuqing Bachus, Kent N. Foreman, K. Bo Henninger, Heath B. |
author_facet | Taylor, Carolyn E. Drew, Alex J. Zhang, Yue Qiu, Yuqing Bachus, Kent N. Foreman, K. Bo Henninger, Heath B. |
author_sort | Taylor, Carolyn E. |
collection | PubMed |
description | Percutaneous osseointegrated (OI) implants are increasingly viable as an alternative to socket suspension of prosthetic limbs. Upper extremity prostheses have also become more complex to better replicate hand and arm function and attempt to recreate pre-amputation functional levels. With more functionality comes heavier devices that put more stress on the bone-implant interface, which could be an issue for implant stability. This study quantified transhumeral loading at defined amputation levels using four simulated prosthetic limb-types: (1) body powered hook, (2) myoelectric hook, (3) myoelectric hand, and (4) advanced prosthetic limb. Computational models were constructed to replicate the weight distribution of each prosthesis type, then applied to motion capture data collected during Advanced Activities of Daily Living (AADLs). For activities that did not include a handheld weight, the body powered prosthesis bending moments were 13–33% (range of means for each activity across amputation levels) of the intact arm moments (reference 100%), torsional moments were 12–15%, and axial pullout forces were 30–40% of the intact case (p≤0.001). The myoelectric hook and hand bending moments were 60–99%, torsional moments were 44–97%, and axial pullout forces were 62–101% of the intact case. The advanced prosthesis bending moments were 177–201%, torsional moments were 164–326%, and axial pullout forces were 133–185% of the intact case (p≤0.001). The addition of a handheld weight for briefcase carry and jug lift activities reduced the overall impact of the prosthetic model itself, where the body powered forces and moments were much closer to those of the intact model, and more complex prostheses further increased forces and moments beyond the intact arm levels. These results reveal a ranked order in loading magnitude according to complexity of the prosthetic device, and highlight the importance of considering the patient’s desired terminal device when planning post-operative percutaneous OI rehabilitation and training. |
format | Online Article Text |
id | pubmed-7410272 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-74102722020-08-13 Upper extremity prosthetic selection influences loading of transhumeral osseointegrated systems Taylor, Carolyn E. Drew, Alex J. Zhang, Yue Qiu, Yuqing Bachus, Kent N. Foreman, K. Bo Henninger, Heath B. PLoS One Research Article Percutaneous osseointegrated (OI) implants are increasingly viable as an alternative to socket suspension of prosthetic limbs. Upper extremity prostheses have also become more complex to better replicate hand and arm function and attempt to recreate pre-amputation functional levels. With more functionality comes heavier devices that put more stress on the bone-implant interface, which could be an issue for implant stability. This study quantified transhumeral loading at defined amputation levels using four simulated prosthetic limb-types: (1) body powered hook, (2) myoelectric hook, (3) myoelectric hand, and (4) advanced prosthetic limb. Computational models were constructed to replicate the weight distribution of each prosthesis type, then applied to motion capture data collected during Advanced Activities of Daily Living (AADLs). For activities that did not include a handheld weight, the body powered prosthesis bending moments were 13–33% (range of means for each activity across amputation levels) of the intact arm moments (reference 100%), torsional moments were 12–15%, and axial pullout forces were 30–40% of the intact case (p≤0.001). The myoelectric hook and hand bending moments were 60–99%, torsional moments were 44–97%, and axial pullout forces were 62–101% of the intact case. The advanced prosthesis bending moments were 177–201%, torsional moments were 164–326%, and axial pullout forces were 133–185% of the intact case (p≤0.001). The addition of a handheld weight for briefcase carry and jug lift activities reduced the overall impact of the prosthetic model itself, where the body powered forces and moments were much closer to those of the intact model, and more complex prostheses further increased forces and moments beyond the intact arm levels. These results reveal a ranked order in loading magnitude according to complexity of the prosthetic device, and highlight the importance of considering the patient’s desired terminal device when planning post-operative percutaneous OI rehabilitation and training. Public Library of Science 2020-08-06 /pmc/articles/PMC7410272/ /pubmed/32760149 http://dx.doi.org/10.1371/journal.pone.0237179 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication. |
spellingShingle | Research Article Taylor, Carolyn E. Drew, Alex J. Zhang, Yue Qiu, Yuqing Bachus, Kent N. Foreman, K. Bo Henninger, Heath B. Upper extremity prosthetic selection influences loading of transhumeral osseointegrated systems |
title | Upper extremity prosthetic selection influences loading of transhumeral osseointegrated systems |
title_full | Upper extremity prosthetic selection influences loading of transhumeral osseointegrated systems |
title_fullStr | Upper extremity prosthetic selection influences loading of transhumeral osseointegrated systems |
title_full_unstemmed | Upper extremity prosthetic selection influences loading of transhumeral osseointegrated systems |
title_short | Upper extremity prosthetic selection influences loading of transhumeral osseointegrated systems |
title_sort | upper extremity prosthetic selection influences loading of transhumeral osseointegrated systems |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7410272/ https://www.ncbi.nlm.nih.gov/pubmed/32760149 http://dx.doi.org/10.1371/journal.pone.0237179 |
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