The Experts below are selected from a list of 3000 Experts worldwide ranked by ideXlab platform
C F Minoli - One of the best experts on this subject based on the ideXlab platform.
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distal Leg septic critical size bone defects proposal of an original distal Leg Prosthesis
Orthopaedic Proceedings, 2018Co-Authors: M Colombo, G M Calori, E Mazza, S Mazzola, C F MinoliAbstract:IntroductionIn orthopaedics one of the most common complications is infection. The occurrence of a postoperative infection significantly increases the failure rate; both in the case of prosthetic and trauma surgery. Some patients despite a meticulous antiseptic procedures, a close monitoring of controls peri- and post-operative undergo the development of infection of the fixation devices with the risk of developing osteomyelitis. This risk is highly increased in the distal Leg because of the known problems with blood supply and poor muscle coverage. The functionality of the affected segment is impaired, quoad fuctionem, with increased risk of amputation and sometimes with poor prognosis, quoad vitam. The therapeutic strategy proposed by our group is to treat an osteomyelitic site as a pseudo-tumor with a megaimplant following a ladder strategy driven by the NUSS classification. This work shows our experience with a developing system by Waldemar-LINK highlighting critical issues and preliminary results.Obj...
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distal Leg septic critical size bone defects proposal of an original distal Leg Prosthesis
Journal of Bone and Joint Surgery-british Volume, 2016Co-Authors: M Colombo, G M Calori, E Mazza, S Mazzola, C F MinoliAbstract:Introduction In orthopaedics one of the most common complications is infection. The occurrence of a postoperative infection significantly increases the failure rate; both in the case of prosthetic and trauma surgery. Some patients despite a meticulous antiseptic procedures, a close monitoring of controls peri- and post-operative undergo the development of infection of the fixation devices with the risk of developing osteomyelitis. This risk is highly increased in the distal Leg because of the known problems with blood supply and poor muscle coverage. The functionality of the affected segment is impaired, quoad fuctionem, with increased risk of amputation and sometimes with poor prognosis, quoad vitam. The therapeutic strategy proposed by our group is to treat an osteomyelitic site as a pseudo-tumor with a megaimplant following a ladder strategy driven by the NUSS classification. This work shows our experience with a developing system by Waldemar-LINK highlighting critical issues and preliminary results. Objectives The purpose of this study is to evaluate retrospectively the early outcome after the implantation of this megaProsthesis of the lower Leg in infected post-traumatic bone defects and septic peri-device bone loss. We registered all the complications and infection recurrence. Methods Between January 2013 today we have developed this system following the chamber induction technique (C.I.T.). We perform a 2 steps procedure: 1° step: resection, debridement, devices removal and bi-antibiotic spacer implantation; 2° step: spacer removal and megaProsthesis implantation. Results Our first 10 patients with lower Leg septic critical size bone defect were post-traumatic, 3 have ended the C.I.T. procedure with good clinical result and return to function. Conclusions The background experience in orthopaedic oncology, has allowed to develop megaimplants to break the vicious cycle of osteomyelitis and restore an optimal performance of the affected segment. We can perform a one step procedure only when all the infected segment is entirely removed, in other partial resections is better to follow a two steps procedure. In the development of this project will be possible to connect to a Megasystem C; this system will then be able to replace from the hip to the foot in the most complex cases. We also concluded that this type of complex surgery must be performed in specialized centers where knowledge and technologies are present.
Levi J. Hargrove - One of the best experts on this subject based on the ideXlab platform.
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design and characterization of an open source robotic Leg Prosthesis
IEEE International Conference on Biomedical Robotics and Biomechatronics, 2018Co-Authors: Alejandro F Azocar, Levi J. Hargrove, Luke M Mooney, Elliott J RouseAbstract:Challenges associated with current prosthetic technologies limit the quality of life of lower-limb amputees. Passive prostheses lead amputees to walk slower, use more energy, fall more often, and modify their gait patterns to compensate for the Prosthesis' lack of net-positive mechanical energy. Robotic prostheses can provide mechanical energy, but may also introduce challenges through controller design. Fortunately, talented researchers are studying how to best control robotic Leg prostheses, but the time and resources required to develop prosthetic hardware has limited their potential impact. Even after research is completed, comparison of results is confounded by the use of different, researcher-specific hardware. To address these issues, we have developed the Open-source Leg (OSL): a scalable robotic knee/ankle Prosthesis intended to foster investigations of control strategies. This paper introduces the design goals, transmission selection, hardware implementation, and initial control benchmarks for the OSL. The OSL provides a common hardware platform for comparison of control strategies, lowers the barrier to entry for Prosthesis research, and enables testing within the lab, community, and at home.
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Online adaptive neural control of a robotic lower limb Prosthesis.
Journal of neural engineering, 2018Co-Authors: John A. Spanias, Ann M. Simon, Suzanne B. Finucane, Eric J. Perreault, Levi J. HargroveAbstract:Objective The purpose of this study was to develop and evaluate an adaptive intent recognition algorithm that continuously learns to incorporate a lower limb amputee's neural information (acquired via electromyography (EMG)) as they ambulate with a robotic Leg Prosthesis. Approach We present a powered lower limb Prosthesis that was configured to acquire the user's neural information and kinetic/kinematic information from embedded mechanical sensors, and identify and respond to the user's intent. We conducted an experiment with eight transfemoral amputees over multiple days. EMG and mechanical sensor data were collected while subjects using a powered knee/ankle Prosthesis completed various ambulation activities such as walking on level ground, stairs, and ramps. Our adaptive intent recognition algorithm automatically transitioned the Prosthesis into the different locomotion modes and continuously updated the user's model of neural data during ambulation. Main results Our proposed algorithm accurately and consistently identified the user's intent over multiple days, despite changing neural signals. The algorithm incorporated 96.31% [0.91%] (mean, [standard error]) of neural information across multiple experimental sessions, and outperformed non-adaptive versions of our algorithm-with a 6.66% [3.16%] relative decrease in error rate. Significance This study demonstrates that our adaptive intent recognition algorithm enables incorporation of neural information over long periods of use, allowing assistive robotic devices to accurately respond to the user's intent with low error rates.
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Effect of additional mechanical sensor data on an EMG-based pattern recognition system for a powered Leg Prosthesis
2015 7th International IEEE EMBS Conference on Neural Engineering (NER), 2015Co-Authors: John A. Spanias, Ann M. Simon, Kimberly A. Ingraham, Levi J. HargroveAbstract:Powered lower limb prostheses can improve amputees' ability to traverse stairs and ramps by providing positive mechanical work at the knee and ankle joint. EMG signals have been proposed as one way of providing seamless mode transitions by using them in combination with embedded mechanical sensors as inputs to a pattern recognition system that predicts the user's desired locomotion mode. In this study, we have expanded the amount of mechanical sensor information to include data from an additional five degrees of freedom in the load cell, as well as calculated thigh and shank angles. The purpose of this study was to determine the impact of this additional information on the performance of an EMG-based pattern recognition system designed to predict the desired locomotion mode. Our results indicate that including the additional mechanical sensor signals decreased the error rates of the system for both steady-state and transitional steps when compared to the reduced sensor set. We also found that EMG still decreased the error rate of the system, but to a lesser extent when using the additional mechanical sensors.
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robotic Leg control with emg decoding in an amputee with nerve transfers
The New England Journal of Medicine, 2013Co-Authors: Levi J. Hargrove, Ann M. Simon, Suzanne B. Finucane, Aaron Young, Robert D Lipschutz, Douglas G Smith, Todd A KuikenAbstract:The clinical application of robotic technology to powered prosthetic knees and ankles is limited by the lack of a robust control strategy. We found that the use of electromyographic (EMG) signals from natively innervated and surgically reinnervated residual thigh muscles in a patient who had undergone knee amputation improved control of a robotic Leg Prosthesis. EMG signals were decoded with a patternrecognition algorithm and combined with data from sensors on the Prosthesis to interpret the patient’s intended movements. This provided robust and intuitive control of ambulation — with seamless transitions between walking on level ground, stairs, and ramps — and of the ability to reposition the Leg while the patient was seated.
M Colombo - One of the best experts on this subject based on the ideXlab platform.
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distal Leg septic critical size bone defects proposal of an original distal Leg Prosthesis
Orthopaedic Proceedings, 2018Co-Authors: M Colombo, G M Calori, E Mazza, S Mazzola, C F MinoliAbstract:IntroductionIn orthopaedics one of the most common complications is infection. The occurrence of a postoperative infection significantly increases the failure rate; both in the case of prosthetic and trauma surgery. Some patients despite a meticulous antiseptic procedures, a close monitoring of controls peri- and post-operative undergo the development of infection of the fixation devices with the risk of developing osteomyelitis. This risk is highly increased in the distal Leg because of the known problems with blood supply and poor muscle coverage. The functionality of the affected segment is impaired, quoad fuctionem, with increased risk of amputation and sometimes with poor prognosis, quoad vitam. The therapeutic strategy proposed by our group is to treat an osteomyelitic site as a pseudo-tumor with a megaimplant following a ladder strategy driven by the NUSS classification. This work shows our experience with a developing system by Waldemar-LINK highlighting critical issues and preliminary results.Obj...
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distal Leg septic critical size bone defects proposal of an original distal Leg Prosthesis
Journal of Bone and Joint Surgery-british Volume, 2016Co-Authors: M Colombo, G M Calori, E Mazza, S Mazzola, C F MinoliAbstract:Introduction In orthopaedics one of the most common complications is infection. The occurrence of a postoperative infection significantly increases the failure rate; both in the case of prosthetic and trauma surgery. Some patients despite a meticulous antiseptic procedures, a close monitoring of controls peri- and post-operative undergo the development of infection of the fixation devices with the risk of developing osteomyelitis. This risk is highly increased in the distal Leg because of the known problems with blood supply and poor muscle coverage. The functionality of the affected segment is impaired, quoad fuctionem, with increased risk of amputation and sometimes with poor prognosis, quoad vitam. The therapeutic strategy proposed by our group is to treat an osteomyelitic site as a pseudo-tumor with a megaimplant following a ladder strategy driven by the NUSS classification. This work shows our experience with a developing system by Waldemar-LINK highlighting critical issues and preliminary results. Objectives The purpose of this study is to evaluate retrospectively the early outcome after the implantation of this megaProsthesis of the lower Leg in infected post-traumatic bone defects and septic peri-device bone loss. We registered all the complications and infection recurrence. Methods Between January 2013 today we have developed this system following the chamber induction technique (C.I.T.). We perform a 2 steps procedure: 1° step: resection, debridement, devices removal and bi-antibiotic spacer implantation; 2° step: spacer removal and megaProsthesis implantation. Results Our first 10 patients with lower Leg septic critical size bone defect were post-traumatic, 3 have ended the C.I.T. procedure with good clinical result and return to function. Conclusions The background experience in orthopaedic oncology, has allowed to develop megaimplants to break the vicious cycle of osteomyelitis and restore an optimal performance of the affected segment. We can perform a one step procedure only when all the infected segment is entirely removed, in other partial resections is better to follow a two steps procedure. In the development of this project will be possible to connect to a Megasystem C; this system will then be able to replace from the hip to the foot in the most complex cases. We also concluded that this type of complex surgery must be performed in specialized centers where knowledge and technologies are present.
G M Calori - One of the best experts on this subject based on the ideXlab platform.
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distal Leg septic critical size bone defects proposal of an original distal Leg Prosthesis
Orthopaedic Proceedings, 2018Co-Authors: M Colombo, G M Calori, E Mazza, S Mazzola, C F MinoliAbstract:IntroductionIn orthopaedics one of the most common complications is infection. The occurrence of a postoperative infection significantly increases the failure rate; both in the case of prosthetic and trauma surgery. Some patients despite a meticulous antiseptic procedures, a close monitoring of controls peri- and post-operative undergo the development of infection of the fixation devices with the risk of developing osteomyelitis. This risk is highly increased in the distal Leg because of the known problems with blood supply and poor muscle coverage. The functionality of the affected segment is impaired, quoad fuctionem, with increased risk of amputation and sometimes with poor prognosis, quoad vitam. The therapeutic strategy proposed by our group is to treat an osteomyelitic site as a pseudo-tumor with a megaimplant following a ladder strategy driven by the NUSS classification. This work shows our experience with a developing system by Waldemar-LINK highlighting critical issues and preliminary results.Obj...
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distal Leg septic critical size bone defects proposal of an original distal Leg Prosthesis
Journal of Bone and Joint Surgery-british Volume, 2016Co-Authors: M Colombo, G M Calori, E Mazza, S Mazzola, C F MinoliAbstract:Introduction In orthopaedics one of the most common complications is infection. The occurrence of a postoperative infection significantly increases the failure rate; both in the case of prosthetic and trauma surgery. Some patients despite a meticulous antiseptic procedures, a close monitoring of controls peri- and post-operative undergo the development of infection of the fixation devices with the risk of developing osteomyelitis. This risk is highly increased in the distal Leg because of the known problems with blood supply and poor muscle coverage. The functionality of the affected segment is impaired, quoad fuctionem, with increased risk of amputation and sometimes with poor prognosis, quoad vitam. The therapeutic strategy proposed by our group is to treat an osteomyelitic site as a pseudo-tumor with a megaimplant following a ladder strategy driven by the NUSS classification. This work shows our experience with a developing system by Waldemar-LINK highlighting critical issues and preliminary results. Objectives The purpose of this study is to evaluate retrospectively the early outcome after the implantation of this megaProsthesis of the lower Leg in infected post-traumatic bone defects and septic peri-device bone loss. We registered all the complications and infection recurrence. Methods Between January 2013 today we have developed this system following the chamber induction technique (C.I.T.). We perform a 2 steps procedure: 1° step: resection, debridement, devices removal and bi-antibiotic spacer implantation; 2° step: spacer removal and megaProsthesis implantation. Results Our first 10 patients with lower Leg septic critical size bone defect were post-traumatic, 3 have ended the C.I.T. procedure with good clinical result and return to function. Conclusions The background experience in orthopaedic oncology, has allowed to develop megaimplants to break the vicious cycle of osteomyelitis and restore an optimal performance of the affected segment. We can perform a one step procedure only when all the infected segment is entirely removed, in other partial resections is better to follow a two steps procedure. In the development of this project will be possible to connect to a Megasystem C; this system will then be able to replace from the hip to the foot in the most complex cases. We also concluded that this type of complex surgery must be performed in specialized centers where knowledge and technologies are present.
E Mazza - One of the best experts on this subject based on the ideXlab platform.
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distal Leg septic critical size bone defects proposal of an original distal Leg Prosthesis
Orthopaedic Proceedings, 2018Co-Authors: M Colombo, G M Calori, E Mazza, S Mazzola, C F MinoliAbstract:IntroductionIn orthopaedics one of the most common complications is infection. The occurrence of a postoperative infection significantly increases the failure rate; both in the case of prosthetic and trauma surgery. Some patients despite a meticulous antiseptic procedures, a close monitoring of controls peri- and post-operative undergo the development of infection of the fixation devices with the risk of developing osteomyelitis. This risk is highly increased in the distal Leg because of the known problems with blood supply and poor muscle coverage. The functionality of the affected segment is impaired, quoad fuctionem, with increased risk of amputation and sometimes with poor prognosis, quoad vitam. The therapeutic strategy proposed by our group is to treat an osteomyelitic site as a pseudo-tumor with a megaimplant following a ladder strategy driven by the NUSS classification. This work shows our experience with a developing system by Waldemar-LINK highlighting critical issues and preliminary results.Obj...
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distal Leg septic critical size bone defects proposal of an original distal Leg Prosthesis
Journal of Bone and Joint Surgery-british Volume, 2016Co-Authors: M Colombo, G M Calori, E Mazza, S Mazzola, C F MinoliAbstract:Introduction In orthopaedics one of the most common complications is infection. The occurrence of a postoperative infection significantly increases the failure rate; both in the case of prosthetic and trauma surgery. Some patients despite a meticulous antiseptic procedures, a close monitoring of controls peri- and post-operative undergo the development of infection of the fixation devices with the risk of developing osteomyelitis. This risk is highly increased in the distal Leg because of the known problems with blood supply and poor muscle coverage. The functionality of the affected segment is impaired, quoad fuctionem, with increased risk of amputation and sometimes with poor prognosis, quoad vitam. The therapeutic strategy proposed by our group is to treat an osteomyelitic site as a pseudo-tumor with a megaimplant following a ladder strategy driven by the NUSS classification. This work shows our experience with a developing system by Waldemar-LINK highlighting critical issues and preliminary results. Objectives The purpose of this study is to evaluate retrospectively the early outcome after the implantation of this megaProsthesis of the lower Leg in infected post-traumatic bone defects and septic peri-device bone loss. We registered all the complications and infection recurrence. Methods Between January 2013 today we have developed this system following the chamber induction technique (C.I.T.). We perform a 2 steps procedure: 1° step: resection, debridement, devices removal and bi-antibiotic spacer implantation; 2° step: spacer removal and megaProsthesis implantation. Results Our first 10 patients with lower Leg septic critical size bone defect were post-traumatic, 3 have ended the C.I.T. procedure with good clinical result and return to function. Conclusions The background experience in orthopaedic oncology, has allowed to develop megaimplants to break the vicious cycle of osteomyelitis and restore an optimal performance of the affected segment. We can perform a one step procedure only when all the infected segment is entirely removed, in other partial resections is better to follow a two steps procedure. In the development of this project will be possible to connect to a Megasystem C; this system will then be able to replace from the hip to the foot in the most complex cases. We also concluded that this type of complex surgery must be performed in specialized centers where knowledge and technologies are present.