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Wang J, Chu J, Song J, Li Z. The application of impantable sensors in the musculoskeletal system: a review. Front Bioeng Biotechnol 2024; 12:1270237. [PMID: 38328442 PMCID: PMC10847584 DOI: 10.3389/fbioe.2024.1270237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
As the population ages and the incidence of traumatic events rises, there is a growing trend toward the implantation of devices to replace damaged or degenerated tissues in the body. In orthopedic applications, some implants are equipped with sensors to measure internal data and monitor the status of the implant. In recent years, several multi-functional implants have been developed that the clinician can externally control using a smart device. Experts anticipate that these versatile implants could pave the way for the next-generation of technological advancements. This paper provides an introduction to implantable sensors and is structured into three parts. The first section categorizes existing implantable sensors based on their working principles and provides detailed illustrations with examples. The second section introduces the most common materials used in implantable sensors, divided into rigid and flexible materials according to their properties. The third section is the focal point of this article, with implantable orthopedic sensors being classified as joint, spine, or fracture, based on different practical scenarios. The aim of this review is to introduce various implantable orthopedic sensors, compare their different characteristics, and outline the future direction of their development and application.
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Affiliation(s)
- Jinzuo Wang
- Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Dalian, Liaoning, China
| | - Jian Chu
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
| | - Jinhui Song
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
| | - Zhonghai Li
- Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Dalian, Liaoning, China
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Förstl N, Süß F, Englert C, Dendorfer S. Design of a reverse shoulder implant to measure shoulder stiffness during implant component positioning. Med Eng Phys 2023; 121:104059. [PMID: 37985021 DOI: 10.1016/j.medengphy.2023.104059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/11/2023] [Accepted: 10/02/2023] [Indexed: 11/22/2023]
Abstract
To avoid dislocation of the shoulder joint after reverse total shoulder arthroplasty, it is important to achieve sufficient shoulder stability when placing the implant components during surgery. One parameter for assessing shoulder stability can be shoulder stiffness. The aim of this research was to develop a temporary reverse shoulder implant prototype that would allow intraoperative measurement of shoulder stiffness while varying the position of the implant components. Joint angle and torque measurement techniques were developed to determine shoulder stiffness. Hall sensors were used to measure the joint angles by converting the magnetic flux densities into angles. The accuracy of the joint angle measurements was tested using a test bench. Torques were determined by using thin-film pressure sensors. Various mechanical mechanisms for variable positioning of the implant components were integrated into the prototype. The results of the joint angle measurements showed measurement errors of less than 5° in a deflection range of ±15° adduction/abduction combined with ±45° flexion/extension. The proposed design provides a first approach for intra-operative assessment of shoulder stiffness. The findings can be used as a technological basis for further developments.
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Affiliation(s)
- Nikolas Förstl
- Laboratory for Biomechanics, Ostbayerische Technische Hochschule Regensburg, Galgenbergstraße 30, 93053 Regensburg, Germany.
| | - Franz Süß
- Laboratory for Biomechanics, Ostbayerische Technische Hochschule Regensburg, Galgenbergstraße 30, 93053 Regensburg, Germany; Regensburg Center for Biomedical Engineering, RCBE. University and Ostbayerische Technische Hochschule Regensburg, Germany
| | - Carsten Englert
- Orthopaedics and trauma surgery, Hospital zum Heiligen Geist Fritzlar, Am Hospital 6, 34560 Fritzlar, Germany
| | - Sebastian Dendorfer
- Laboratory for Biomechanics, Ostbayerische Technische Hochschule Regensburg, Galgenbergstraße 30, 93053 Regensburg, Germany; Regensburg Center for Biomedical Engineering, RCBE. University and Ostbayerische Technische Hochschule Regensburg, Germany
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Georgoulas P, Fiska A, Ververidis A, Drosos GI, Perikleous E, Tilkeridis K. Reverse Shoulder Arthroplasty, Deltopectoral Approach vs. Anterosuperior Approach: An Overview of the Literature. Front Surg 2021; 8:721054. [PMID: 34869550 PMCID: PMC8636448 DOI: 10.3389/fsurg.2021.721054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
Reverse shoulder arthroplasty (RSA) has become an optimal treatment for numerous orthopedic entities, such as rotator cuff tear arthropathies, pseudoparalysis, fracture sequelae, acute fractures, failed arthroplasties, osteoarthritis, and rheumatoid arthritis, and is linked with relief of topical pain and regaining of functionality. Presently, RSA has been conducted through anterosuperior (AS) or deltopectoral (DP) approach. The aim of the study was to discuss both approaches and to examine broadly their features to render a comparison in terms of clinical effectiveness. An electronic search in PubMed, EMBASE, and Google Scholar databases was performed, using combinations of the following keywords: RSA, DP approach, AS approach, notching, and cuff tear arthropathy. A total of 61 studies were found, and 16 relevant articles were eventually included. Currently published literature has not shown significant diversities in the clinical course due to approach preference; risk of instability seems to be greater in DP approach, while regarding scapular notching and fracture rates the findings were conflicted. In addition, the AS approach has been associated with decreased risk of acromial and scapular spine fractures. In conclusion, both surgical approaches have shown similar clinical outcomes and effectiveness concerning pain and restoring range of motion (ROM) in rotator cuff tear arthropathies. In the future, further investigations based on large-scale well-designed studies are required to address clinical gaps allowing in-depth comparison of both approaches.
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Affiliation(s)
- Paraskevas Georgoulas
- Department of Orthopedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Aliki Fiska
- Department of Anatomy, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.,Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Athanasios Ververidis
- Department of Orthopedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.,Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Georgios I Drosos
- Department of Orthopedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.,Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Konstantinos Tilkeridis
- Department of Orthopedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.,Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Leinauer EC, Kim HM, Kwon JW. Micromachined Tactile Sensor Array for RTSA. MICROMACHINES 2021; 12:1430. [PMID: 34832841 PMCID: PMC8620456 DOI: 10.3390/mi12111430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022]
Abstract
This work presents a polymer-based tactile capacitive sensor capable of measuring joint reaction forces of reverse total shoulder arthroplasty (RTSA). The capacitive sensor contains a polydimethylsiloxane (PDMS) dielectric layer with an array of electrodes. The sensor was designed in such a way that four components of glenohumeral contact forces can be quantified to help ensure proper soft tissue tensioning during the procedure. Fabricated using soft lithography, the sensor has a loading time of approximately 400 ms when a 14.13 kPa load is applied and has a sensitivity of 1.24 × 10-3 pF/kPa at a load of 1649 kPa. A replica RTSA prothesis was 3D printed, and the sensor was mounted inside the humeral cap. Four static right shoulder positions were tested, and the results provided an intuitive graphical description of the pressure distribution across four quadrants of the glenohumeral joint contact surface. It may help clinicians choose a right implant size and offset that best fit a patient's anatomy and reduce postoperative biomechanical complications such as dislocation and stress fracture of the scapula.
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Affiliation(s)
- Elliott C. Leinauer
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO 65201, USA;
| | - H. Mike Kim
- Department of Orthopedic Surgery, University of Missouri, Columbia, MO 65201, USA;
| | - Jae W. Kwon
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO 65201, USA;
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