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Fracture stabilization plates are an essential aspect of orthopedic surgery as they offer support and stability to fractured bones during the healing process. However, traditional manufacturing methods often produce standard designs that may not fully accommodate the unique anatomy of individual patients. This research endeavors to explore the application of additive manufacturing (AM) techniques in the customized design of fracture fixation plates. This includes the use of various materials suitable for medical-surgical purposes, such as polymer-based and biocompatible metal materials. The objective of this approach is to overcome the limitations of conventional manufacturing methods and elucidate the entire workflow for fabricating virtual models of metal-plastic fixation plates for femur fractures. A customized fixation plate is designed based on digital models of a patient's broken bone, which can be generated through advanced imaging techniques like computed tomography (CT) using additive manufacturing, particularly 3D printing. The implementation of this approach is supported by an experimental study on medical cases, specifically focusing on custom-designed fracture fixation plates using additive manufacturing for femur fractures. Both plastic and metal prototypes are produced, with UrukTech's facilities in Baghdad, Iraq being utilized for the plastic prototype. The results demonstrate that precise fitting of the plate to the patient's anatomy not only improves biomechanical performance but also mitigates potential problems associated with generic, off-the-shelf plates. The ability to design fixation plates according to each patient's unique anatomy has the potential to revolutionize the field, leading to enhanced patient outcomes and a more personalized approach to fracture management. [ABSTRACT FROM AUTHOR]

3D printing has been trending now-a-days and developing really fast, as it might play a very important role in our life in the next few years and even be more efficient in the medical field. Distinct geometries of bones generate complexity in orthopedic surgery which is now being simplified using 3D printing that revolutionized medical sector. This advanced technology helps doctors in terms of accuracy, visualization and efficient surgery which is also beneficial for patient. In this report we are going to review the applications of 3D printing in the orthopedic surgeries and how the technological advancement and futuristic benefits can help people to develop the healthcare sector and be more reliable in complicated surgeries. [ABSTRACT FROM AUTHOR]

Identifying potentially fraudulent or wasteful medical insurance claims can be difficult due to the large amounts of data and human effort involved. We applied unsupervised machine learning to construct interpretable models which rank variations in medical provider claiming behaviour in the domain of unilateral joint replacement surgery, using data from the Australian Medicare Benefits Schedule. For each of three surgical procedures reference models of claims for each procedure were constructed and compared analytically to models of individual provider claims. Providers were ranked using a score based on fees for typical claims made in addition to those in the reference model. Evaluation of the results indicated that the top-ranked providers were likely to be unusual in their claiming patterns, with typical claims from outlying providers adding up to 192% to the cost of a procedure. The method is efficient, generalizable to other procedures and, being interpretable, integrates well into existing workflows. [ABSTRACT FROM AUTHOR]

The objective of this study was to summarize the evidence in relation to telemedicine systems as regards their effectiveness, costs and satisfaction in the last decade. A summary of main findings is presented. According to results telemedicine proved to be a feasible and effective tool to provide health care as a replacement or complement to usual care, especially when applied to chronic diseases. [ABSTRACT FROM AUTHOR]

Computer Aided Design (CAD) and 3D printing are increasingly bringing innovation to orthopedic surgery by allowing customization of surgical procedures. This study proposes the design and 3D printing of patient-specific surgical cutting guides (PSCG) that can be implemented in orthopedic surgery. Cutting guides are surgical tools that allow surgeons to perform cutting operations more accurately, achieving the desired result with high accuracy. During an osteotomy, for example, the surgeon will be able to better determine the position of the cutting line and its direction. This study aims to propose an advanced method of designing cutting guides for an orthopedic surgery procedure. Proposed tools are obtained by an additive manufacturing process that starts with a 3D model of the patient's bone obtained from CT scan images and ends by designing the patient-specific cutting guide model in a CAD environment. Virtual surgical planning (VSP) allows for increasing the surgeon's awareness for developing an orthopedic surgical strategy and allows for the design of cutting guides designed around the patient's specific anatomy. [ABSTRACT FROM AUTHOR]

This work aims to present the application of mechanical modeling software in three dimensions in the medical field, analyzing the procedures used by the engineer to support the orthopedic surgeon in preoperative planning. The first step of the procedure involves CT examinations in patients selected for surgery: DICOM images are managed in post-processing to obtain multiplanar reconstructions of the bone lesion to be treated. The files are then optimized, made shareable and imported into CREO's work platform; this is part of a family of CAD software products for mechanical design, developed by PTC, and is the fundamental application dedicated to parametric modeling. The result will be a faithful representation of the anatomical part both before and after surgical procedure, screening all the intermediate phases. The doctor will assess different lines of action according to the results, than he will communicate them to the engineer who, consequently, will correct and regenerate the model. The method finds its power in the dialogue between engineer and doctor: in complex cases closer collaboration is needed while, for the evaluation of less demanding injuries, the exam could be assigned as a remote project which, once completed, is returned to the medical facility of competence. [ABSTRACT FROM AUTHOR]

This work is the outcome of a partnership between the Department of Industrial Engineering of the University of Bologna and the Rizzoli Orthopedic Institute of Bologna. The aim of this collaboration is using medical engineering tools during orthopedic surgeries. This article focuses on the design and construction of a custom-made surgical guide for cubitus varus. The guides are special aids that allow surgeons to perform operations smoothly, to achieve the planned result and to reduce the risk of inaccuracy. They are obtained with an additive manufacturing process that starts from a 3D digital model of the patient's bone obtained from CT scans and allow designing patient-specific templates using specific software as the Creo Parametric CAD. For the proper functioning of the guide the internal shape must correspond to the external profile of the patient's bone. In this way, the tool obtained fits exactly to the bone and it is possible to direct the cutting during surgery in a very specific direction as identified in the preoperative planning phase. [ABSTRACT FROM AUTHOR]

The recreation of bone structures from the human body has very complex geometry and a lack of symmetry. A small series of vertebrae replications, digitized by computed tomography, could serve in exercises for medical students to help them perform operational planning for inserting implant structures, cage type implants, or screws and rods implants. Additionally, these replications could be used in the planning of extraordinary clinical cases, for example complex vertebrae deformities. The replicated structure could be fulfilled in a 1:1 ratio or scaled. For the selection of an appropriate production technology a block diagram is followed which considers suitable technologies for the production of polymer parts, compared to the series size and the complexity of the geometry. Both criteria must be taken into account when considering which technology should be used in the production of polymer parts. Comparing the advantages and disadvantages of additive technologies and replication in silicone mold, the best choice for technology is set to be replication in silicone mold. The initial preparation for the manufacture of the silicone mold includes a detailed analysis of the geometry of the model for replication. The first step includes defining the runner place as well as mounting the runner to the model. To ensure the mold is completely filled while casting, positive-shaped vents in the mold are defined. Because of the complex shapes of the spinal vertebrae and the need to take out elements in many directions, the mold is divided into multiple parts. A block-diagram that summarizes the entire manufacturing cycle for replication in a silicone mold is developed. [ABSTRACT FROM AUTHOR]

Total hip replacement is a successful procedure in orthopedic surgery for the long term. However, implants from biocompatible aspects of materials remain an emerging problem. Implants from metal materials generally produce predictable and successful processes, while ceramic materials can cause several problems. One of the fractures, total hip replacement implants is low tensile strength and wearability. Many studies have concluded that the manufacturing process is difficult and can affect production costs. In addition, the heterogeneity of the material caused not optimized mechanical properties. The purpose of this paper is to find out the characteristic of Dental Stone Grade IV material see from a mechanical aspect. The measurement used in the experimental method included tensile, hardness, and wear tests. The results of the tensile test are 10,69 MPa, the average value of hardness is 1092.20 HVN, and the wear rate of Dental Stone Grade IV Material is 1,17 × 10-7 mm³/mm. [ABSTRACT FROM AUTHOR]

Knee arthroplasty is one of most frequent orthopedic surgery perfomed in Indonesia. Unfortunately, most of implant products for knee arthroplasty are imported and designed not specifically for Indonesian. This might negatively affects patients due to improper fitting and non-ideal stress distribution between the implant and the surrounding bone tissue. Here, we design and numerically test knee joint implants based on Indonesian anthropometry. The anthropometry of Indonesian male and female adults are obtained from literatures. In addition, we optimize the design by examining the stress distribution of current commercial knee implant products and looking for geometrical modification to obtain the most ideal stress distribution. The results are designs of knee joint implant which have been designed based on adult Indonesian’s anthropometry. Stress distribution can be optimized by providing geometrical features which differ from current commercial product. In addition, our knee implant designs consume less material than current commercial product while providing better fitting and stress distribution. We also consider the design to be able to be fabricated using CNC machining to obtain rapid and customizable fabrication process. [ABSTRACT FROM AUTHOR]

Many operations within the UK do not require general anaesthesia, and are instead carried out under sedation. A doctor normally provides this, and as the patient is not in control, they may be either under or over-sedated due to a misjudgement of patient anxiety. One solution would be to allow the patients to directly control their own sedation level. This paper presents an invention for innovation (i4i) project developing such a Patient Maintained Propofol Sedation Device (PMPSD). Due to the health risks associated with under and over-sedation, the anaesthetists' interface takes on an added importance to ensure they can oversee the process and intervene when needed. Through the project, a unique opportunity has arisen where anaesthetists have been involved throughout the interface design process, contributing to the development and testing of a prototype. We present this prototype, highlight its key features and how it differs from existing sedation pump interface systems. As the project continues, the interface will be used as part of a clinical trial at Nottingham University Hospitals NHS Trust involving 80 orthopaedic patients throughout the rest of 2018 and into 2019. [ABSTRACT FROM AUTHOR]

Practical surgery, traumatology, orthopedics, and oncology require bioengineered constructs suitable for replacement of large-area bone defects. Only rigid/elastic matrix containing recipient's bone cells capable of mitosis, differentiation, and synthesizing extracellular matrix that supports cell viability can comply with these requirements. Therefore, the development of the techniques to produce structural and functional substitutes, whose three-dimensional structure corresponds to the recipient's damaged tissues, is the main objective of tissue engineering. This is achieved by developing tissue-engineering constructs represented by cells placed on the matrices. Low effectiveness of carrier matrix colonization with cells and their uneven distribution is one of the major problems in cell culture on various matrixes. In vitro studies of the interactions between cells and material, as well as the development of new techniques for scaffold colonization by cellular components are required to solve this problem. [ABSTRACT FROM AUTHOR]

This paper presents a novel approach in training for orthopaedic surgeons, developed within the ERASMUS + research project 2015-1-RO01-KA202-015230, ERASMUS+ VET "Collaborative learning for enhancing practical skills for patient-focused interventions in gait rehabilitation after orthopaedic surgery". Considering that classical education of orthopaedic surgeons, which is based on lectures, self-study, workshops and cadaver dissections, followed by supervised practical training within daily practice, quite often results in limited ability of the trainees to practically apply the knowledge, this project is directed to vocational training for enhancing the practical skills of the orthopaedic trainees and prepare them for future practice. The project has some particular features features apart from the standard educational frames: the type of information delivered to the trainees, consists not of classical courses, but of surgical guidelines (including explanatory videos) and case presentations, and the method for delivery is an e-learning platform, also giving the possibility of interactive internetdelivered questionnaires, based on case scenarios. Based on a thorough trans-national needs analysis, this educational scaffold resulting from collaboration between hospitals and Higher Education Institutes from different European countries, is an attempt illustrate the "trainee-focused learning" principle; the platform works as a virtual medical environment in which the trainee will have to adapt to the individual situation of each patient, choosing the proper diagnosis and treatment (patient focused interventions). The innovative aspects of this project will enhance the diagnostic and therapeutic skills of the orthopaedic trainees in the direction of individualised medical interventions, which will increase the quality of health care services, the patient's level of satisfaction and quality of life. [ABSTRACT FROM AUTHOR]

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Patients’ hospital length of stay (LOS) as a surgical outcome is important indicator of quality of care. We used EMR data to build artificial neural network models to better understand the impact of cold weather on outcome of first surgeries in a day in comparison to a matched cohort receiving surgical treatment in warm days. We found that LOS for first-in-a-day cardiac and orthopedic surgical cases are longer in very cold days. [ABSTRACT FROM AUTHOR]

Calcium phosphate cements (CPC) are used in orthopaedic surgery as bone substitution and fixation of metallic implants, showing advantages with respect to other materials like polymeric cements or ceramic blocks also used for bone repair. For example, they are easy to shape and fill bone defects, react at low temperature and their setting product is hydroxyapatite, mineral from it’s composed the inorganic part of the bone, resulting a bioabsorbable material that can be replaced by new bone. Nevertheless there are still some complications like their low absorption rate, inyectability, setting times and their low strength that limits their use to only non load bearing applications. In this work we present a brief resume of some investigations that has been proposed to solve some of these problems, like the addition of phosphates solutions or seeds to increase the reaction rate, or fibers and hard particles to produce a composite material. © 2006 American Institute of Physics [ABSTRACT FROM AUTHOR]

The article offers information on the dynamical contact problems associated in computational medicine and orthopaedic surgery. It states that a research group has identified a time dependent contact problem in Newmark method that generate an unsatisfactory result in artificial oscillation. The research team also suggests new modification research to sustain classical consistency of numerical integration and create new theoretical characters and energy.