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首页> 美国卫生研究院文献>Journal of Visualized Experiments : JoVE >Bioelectric Analyses of an Osseointegrated Intelligent Implant Design System for Amputees
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Bioelectric Analyses of an Osseointegrated Intelligent Implant Design System for Amputees

机译：用于被截肢者的骨集成智能植入物设计系统的生物电分析

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The projected number of American amputees is expected to rise to 3.6 million by 2050. Many of these individuals depend on artificial limbs to perform routine activities, but prosthetic suspensions using traditional socket technology can prove to be cumbersome and uncomfortable for a person with limb loss. Moreover, for those with high proximal amputations, limited residual limb length may prevent exoprosthesis attachment all together. Osseointegrated implant technology is a novel operative procedure which allows firm skeletal attachment between the host bone and an implant. Preliminary results in European amputees with osseointegrated implants have shown improved clinical outcomes by allowing direct transfer of loads to the bone-implant interface. Despite the apparent advantages of osseointegration over socket technology, the current rehabilitation procedures require long periods of restrictive load bearing prior which may be reduced with expedited skeletal attachment via electrical stimulation. The goal of the osseointegrated intelligent implant design (OIID) system is to make the implant part of an electrical system to accelerate skeletal attachment and help prevent periprosthetic infection. To determine optimal electrode size and placement, we initiated proof of concept with computational modeling of the electric fields and current densities that arise during electrical stimulation of amputee residual limbs. In order to provide insure patient safety, subjects with retrospective computed tomography scans were selected and three dimensional reconstructions were created using customized software programs to ensure anatomical accuracy (Seg3D and SCIRun) in an IRB and HIPAA approved study. These software packages supported the development of patient specific models and allowed for interactive manipulation of electrode position and size. Preliminary results indicate that electric fields and current densities can be generated at the implant interface to achieve the homogenous electric field distributions required to induce osteoblast migration, enhance skeletal fixation and may help prevent periprosthetic infections. Based on the electrode configurations experimented with in the model, an external two band configuration will be advocated in the future.
机译：预计到2050年，美国截肢者的数量将增加到360万。其中许多人依靠假肢来进行例行活动，但是使用传统承窝技术的假肢悬吊对于肢体残缺的人可能会很麻烦且不舒服。此外，对于那些截肢率高的患者，有限的残肢长度可能会阻止假肢附着在一起。骨整合植入物技术是一种新颖的手术程序，可以使宿主骨与植入物之间牢固地固定骨骼。在欧洲截肢者中使用骨整合植入物的初步结果显示，通过将载荷直接转移到骨-植入物界面，临床效果得到了改善。尽管骨整合比承窝技术有明显的优势，但目前的康复程序需要长时间的限制性负荷承受，而这可以通过电刺激加速骨骼附着而减少。骨集成智能植入物设计（OIID）系统的目标是使植入物成为电气系统的一部分，以加速骨骼附着并帮助预防假体周围感染。为了确定最佳的电极尺寸和位置，我们通过对截肢残肢电刺激过程中产生的电场和电流密度的计算模型进行了概念验证。为了确保患者安全，在IRB和HIPAA批准的研究中，选择具有回顾性计算机断层扫描的受试者，并使用定制的软件程序创建三维重建物，以确保解剖学准确性（Seg3D和SCIRun）。这些软件包支持患者特定模型的开发，并允许交互式操作电极位置和大小。初步结果表明，可以在植入物界面产生电场和电流密度，以实现诱导成骨细胞迁移，增强骨骼固定并有助于预防假体周围感染所需的均匀电场分布。根据模型中实验的电极配置，将来将提倡外部两波段配置。

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