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Abstract Background Limited studies have reported surgical outcomes that are defined by strict criteria following grade 2 or 3 socket reconstruction using an oral mucosal graft (OMG). We aimed to determine factors influencing surgical outcomes of anophthalmic socket reconstruction using OMG in patients with grade 2 or 3 socket contractures. Methods Thirty-seven patients who underwent socket reconstruction with autologous OMG between January 2007 and December 2017 were retrospectively analyzed. The successful outcome was defined as an eye prosthesis wearing without experiencing displacement and the absence of any re-operations or additional surgeries following socket reconstruction. Factors affecting surgical outcomes were identified using multivariate analysis. Results A total of 15 male and 22 female patients (mean age: 40.2 ± 17.2 years) were included. The median duration of socket contracture was 21.5 years. Grade 2 and 3 socket contractures, based on Tawfik’s classification, were reported in 20 and 17 patients, respectively. Twenty-eight and eight patients underwent socket reconstruction using OMG alone and OMG combined with a hard palate graft, respectively. The success rates of grades 2 and 3 socket contracture reconstruction were 80.0% and 52.9%, respectively. Multivariate analysis demonstrated that only grade 3 contractures were predictive of worse outcomes. At the final visit (mean follow-up: 6.3 years), 34 patients (91.9%) could wear their eye prostheses. Conclusions Socket reconstruction using autologous OMG can provide acceptable results in grade 2 and 3 contractures; however, satisfactory results were more significantly reported in grade 2 than in grade 3 contractures.

Increased pressure and shear stress distributions at the limb–socket interface are hypothesised to result from changes in the residual limb shape and volume, which can cause socket fit difficulties. Accurate residual limb volume measurements may aid clinicians in developing strategies to accommodate volume fluctuations. This review primarily aims to analyse the techniques available for measuring the residual lower limb volume that may be used in clinical settings, as documented in the works published over the previous four decades. A comprehensive search of articles in PubMed, ScienceDirect, Web of Science, and Google Scholar identified 904 articles, and further analysis resulted in only 39 articles being chosen to be analysed. Based on the findings, there are nine techniques available to measure the residual limb volume: water displacement, anthropometric measurement, contact probes, optical scanning, spiral X-ray computed tomography (SXCT), magnetic resonance imaging (MRI), ultrasound, laser scanning, and bioimpedance. Considering the variety of techniques for determining residual limb volume, it is critical to choose the ones that best suit clinicians' objectives, and each technique has potential sources of error that should be avoided by taking precautionary action. A comprehensive study of the measurement techniques is needed since researchers have developed and extensively utilised many new measuring devices, especially handheld 3D laser scanners. [ABSTRACT FROM AUTHOR]

Prosthetic appropriateness plays an important role in the rehabilitation of a lower-limb amputee. Reduced compliance to wearing prosthesis may be due to consequences of the amputation or an ill-fitting prosthesis. Assessment of prosthetic fitment can be tedious, expensive and inaccessible. Here, we discuss a case of transtibial amputee where prosthetic fitment was assessed by the use of plain radiographs, and modifications were made accordingly. The timeline of events is also described in brief. The patient is a 35-year-old woman, who underwent a below-knee amputation after developing necrotising fasciitis, secondary to a snake bite. After being mobilised with a transtibial prosthesis, the patient was noted to have recurrent ulcers at the distal end of the residual limb. On radiological evaluation and comparison with the radiographs taken in the immediate post-operative period, sequestral bone formation was noted at the distal end of the tibia. Fibular end was noted to be unbevelled and at a longer level than of the tibia. Weight-bearing and non-weight-bearing radiographs with the prosthetic limb showed a reduction of distal end clearance due to pistoning action, indicative of improper prosthetic fitting. Through the use of radiographs, we were able to substantiate objectively, the need for surgical revisions as well as prosthetic modification. Plain radiographs may serve as a cost-effective tool to assess quantitatively and qualitatively the fitting of a prosthesis. In the Indian scenario, it becomes relevant in making surgical and prosthetic decisions, especially in a low-resource setting.

Background: It is common for dental technicians to adjust the proximal surface of adjacent teeth on casts when fabricating single crowns. However, whether the accuracy of the proximal contact is affected if this step is eliminated is unclear. Objective: To evaluate the accuracy of the proximal contact of single crowns for mandibular first molars fabricated from four different restorative materials, without adjustment of the proximal surface of the adjacent teeth by the laboratory/dental technician. Methods: This study was in vitro; all the clinical procedures were conducted on a dentoform. The mandibular first molar tooth on the dentoform was prepared using diamond burs and a high speed handpiece. Twenty single crowns were fabricated, five for each group (monolithic zirconia, lithium disilicate, metal ceramic, and cast gold). No proximal surface adjacent to the definitive crowns was adjusted for tight contact in the dental laboratory. Both the qualitative analyses, using dental floss and shimstock, and the quantitative analyses, using a stereo microscope, were performed to evaluate the accuracy of the proximal contact of the restoration with the adjacent teeth. In the quantitative analysis, one-way analysis of variance was used to compare mean values at a significance level of 0.05. Results: In quantitative analysis, the differences between the proximal contact tightness of the four groups was not statistically significant (P = 0.802 for mesial contacts, P = 0.354 for distal contacts). In qualitative analysis, in most crowns, dental floss passed through the contact with tight resistance and only one film of shimstock could be inserted between the adjacent teeth and the restoration. However, one specimen from the cast gold crown had open contact. Conclusions: Even without proximal surface adjustment of the adjacent teeth during the crown fabrication process, adequate proximal contact tightness between the restoration and adjacent teeth could be achieved.

Copyright of Rehabilitation / Rehabilitacija is the property of University Rehabilitation Institute, Republic of Slovenia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Human-in-the-loop optimization algorithms have proven useful in optimizing complex interactive problems, such as the interaction between humans and robotic exoskeletons. Specifically, this methodology has been proven valid for reducing metabolic cost while wearing robotic exoskeletons. However, many prostheses and orthoses still consist of passive elements that require manual adjustments of settings.Methods: In the present study, we investigated if human-in-the-loop algorithms could guide faster manual adjustments in a procedure similar to fitting a prosthesis. Eight healthy participants wore a prosthesis simulator and walked on a treadmill at 0.8 ms−1 under 16 combinations of shoe heel height and pylon height. A human-in-the-loop optimization algorithm was used to find an optimal combination for reducing the loading rate on the limb contralateral to the prosthesis simulator. To evaluate the performance of the optimization algorithm, we used a convergence criterium. We evaluated the accuracy by comparing it against the optimum from a full sweep of all combinations.Results: In five out of the eight participants, the human-in-the-loop optimization reduced the time taken to find an optimal combination; however, in three participants, the human-in-the-loop optimization either converged by the last iteration or did not converge.Discussion: Findings from this study show that the human-in-the-loop methodology could be helpful in tasks that require manually adjusting an assistive device, such as optimizing an unpowered prosthesis. However, further research is needed to achieve robust performance and evaluate applicability in persons with amputation wearing an actual prosthesis.

Introduction: Suspension systems are essential components for a lower-limb prosthesis, as they provide sufficient prosthetic fit. Although various adverse and positive effects have been reported for suspension systems, it is important to determine the effects on the prosthesis users in detail. Objective: The aim of this study was to compare the pin suspension system (PSS) with the vacuum-assisted suspension system (VASS) in terms of parameters including walking capacity, functional mobility, weight bearing on the operated side, prosthesis satisfaction, and body image perception. Study Design: This is an original research report. Methods: Nine individuals with transtibial amputation were evaluated. Both suspension systems were applied consecutively. Initially, participants used the PSS for 3 months after fabrication and adjustment of the prosthesis and a prosthetic training period. They then used the VASS for 3 months after a similar training period. After both prosthetic systems had been adjusted, L.A.S.A.R. Posture was used to determine weight bearing on the prosthetic side. The 6-minute walk test was applied for walking capacity, the timed up-and-go test was used to determine functional mobility, the Prosthetic Satisfaction Index was used for prosthetic satisfaction, and the Amputee Body Image Scale was used for body image perception. Results: Significant differences were observed between PSS and VASS in terms of prosthetic side weight-bearing ratios, walking capacity, functional mobility, and prosthetic satisfaction (P < 0.05), all in favor of VASS. No significant difference was determined in terms of body image scores (P > 0.05). Conclusion: In terms of function and prosthetic satisfaction in individuals with transtibial amputation, VASS was determined to be superior. The available evidence suggests that if there is no contraindication for the use of VASS, it may contribute to the individual with amputation functionally and increase the satisfaction with the prosthesis. Clinical Relevance: Vacuum systems can make a positive contribution to reaching the goals for prosthesis users who are targeted to have high physical activity levels. This positive contribution includes increased weight transfer to the prosthetic side, an increase in mobility determinants, and increased prosthesis satisfaction, which has many dimensions. [ABSTRACT FROM AUTHOR]

Aims The aim of this study is to assess the relationship between the prosthesis length and the outcome of the primary stapes surgery in patients with otosclerosis. Material and Methods This was a retrospective cohort study. We reviewed medical records of 218 patients between January 2015 and August 2020 in two different referral centers. It was conducted in two hospitals by two different well experienced otologic surgeons that one of them believes in fixed length (4.75 mm) of stapes prosthesis (group A) and, the other one believes in measuring the distance between the footplate and incus long process to choose the proper length of prosthesis (group B). The surgery success rates and complications between these two groups were compared 3 months postoperatively. Results Mean age, preoperative bone conduction (BC) audiometric threshold and air-bone gap, postoperative BC and air-bone gap were similar in both groups (All p > 0.05). Vertigo frequency was not significantly different between the two groups (p = 0.303). There were no significant differences regarding the number of favorable postoperative outcomes between group A and B (70 (97.2%) vs. 142(97.3%) respectively) (p = 0.632). Conclusion This study found no significant difference regarding the hearing outcomes between fixed length vs measured length of stapes prosthesis. [ABSTRACT FROM AUTHOR]

Abstract Background To study the biomechanical effects of femoral prostheses at different coronal positions using finite element analysis and provide a clinical reference for unicompartmental knee arthroplasty (UKA). Methods A normal knee joint model was established and verified, establishing 13 working conditions for the femoral prosthesis: the standard position, varus and valgus angles of 3°, 6° and 9° and medial and lateral translations of 1 mm, 3 mm and 5 mm. The stress changes at different positions were analysed, including the polyethylene (PE) insert upper surface, the surface of lateral compartment cartilage and the surface of cancellous bone under tibial prosthesis. Results The stresses on the PE insert upper surface and the cancellous bone surface increased with increasing femoral prosthesis valgus/varus, and the stress increased gradually during medial to lateral translation. The stress change is more significant during valgus and lateral translation. However, the stress on the cartilage surface decreases in the process of varus to valgus and medial translation to lateral translation. Conclusion The fixed-bearing femoral prosthesis of the medial UKA should avoid translation or varus/valgus tilt on the coronal plane as much as possible. The obvious misalignment of the femoral prosthesis will significantly affect the stress on the internal structure of the knee joint, especially the PE insert and cartilage surface. A femoral prosthesis coronal tilt of more than 6° may significantly increase the stress on the PE surface, and varus of more than 6° may significantly increase the stress on the cartilage surface. For the femoral prosthesis position at the distal end of the femoral condyle, it is recommended to be placed in the centre.

In persons with a hip or knee flexion contracture ≥25°, fitting a prosthesis is said to be difficult. This systematic review aims to assess the evidence for fitting of a prosthesis in persons with a severe contracture (≥25°) after a lower limb amputation. PubMed, Embase, Scopus, CINAHL, and Orthotics & Prosthetics Virtual Library databases were searched from inception to December 2019, using database specific search terms related to amputation, prosthesis, and contracture. Reference lists of included studies were checked for relevant studies. Quality of the included studies was assessed using the critical appraisal checklist for case reports (Joanna Briggs Institute). In total, 13 case studies provided evidence for fitting of a prosthesis in more than 63 persons with a transtibial amputation and three with a transfemoral amputation, all of whom had a hip or knee flexion contracture ≥25°. Some studies found a reduction in contractures after prosthesis use. Several techniques for fitting a prosthesis in case of a flexion contracture ≥25° were found. Contracture reduction occurred in some cases and was possibly related to prosthesis use. Fitting a transtibial or transfemoral prosthesis in persons with a lower limb amputation with a severe flexion contracture is possible. This study provides information on prosthesis prescriptions and adaptations for persons with a transfemoral and transtibial amputation with a flexion contracture ≥25°. The fitting of bent prostheses is not limited by prosthetic components and techniques. Parallel to the use of bent prostheses, it is also important to treat the contracture. [ABSTRACT FROM AUTHOR]

BACKGROUND: Most of the revision causes of unicompartmental knee arthroplasty are postoperative complications, such as prosthesis loosening, polyethylene wear and progression of uninvolved compartment arthritis, which are linked to the abnormal intra-articular stress caused by the malposition of the prosthesis. OBJECTIVE: To study the effects of different positions of the femoral prosthesis on the stress magnitude and distribution of polyethylene surface, articular cartilage surface, and cancellous bone surface during unicompartmental knee arthroplasty. METHODS: The digital image of the knee joint and prosthesis was obtained using radiological technologies and three-dimensional scanning techniques. A normal knee model was developed and validated using mimics and Ansys workbench software. Unicompartmental knee arthroplasty was simulated in Ansys Workbench software. The prosthesis was positioned appropriately and the femoral prosthesis was requisitioned. Nine working conditions were established at the 0°, 3°, 6°, 9°, and 12° of femoral prosthesis varus and valgus to observe the changes in stress and distribution of polyethylene surface, articular cartilage surface and cancellous bone surface in each model. RESULTS AND CONCLUSION: (1) The stress on the upper surface of polyethylene increased with the increase of the valgus and varus angle in the prosthesis under static load of knee joint extension, and the increase range was large during valgus. The stress distribution on the upper surface of polyethylene shifts was inward during varus and outward during valgus. (2) The stress on the articular cartilage surface increased during varus and decreased during valgus. (3) The stress on the surface of cancellous bone was concentrated in the grooves, and the stress was increased during valgus and varus, and greater during valgus. (4) As move from varus to valgus, the load shifted to the medial side of the knee. (5) Among all the structures, the stress on the upper surface of polyethylene prosthesis was the highest, and the stress value at ≥6° of valgus and valgus of femoral prosthesis was significantly higher than that at the standard position (0° valgus and valgus). [ABSTRACT FROM AUTHOR]

Background: To study the biomechanical effects of femoral prostheses at different coronal positions using finite element analysis and provide a clinical reference for unicompartmental knee arthroplasty (UKA). Methods: A normal knee joint model was established and verified, establishing 13 working conditions for the femoral prosthesis: the standard position, varus and valgus angles of 3°, 6° and 9° and medial and lateral translations of 1 mm, 3 mm and 5 mm. The stress changes at different positions were analysed, including the polyethylene (PE) insert upper surface, the surface of lateral compartment cartilage and the surface of cancellous bone under tibial prosthesis. Results: The stresses on the PE insert upper surface and the cancellous bone surface increased with increasing femoral prosthesis valgus/varus, and the stress increased gradually during medial to lateral translation. The stress change is more significant during valgus and lateral translation. However, the stress on the cartilage surface decreases in the process of varus to valgus and medial translation to lateral translation. Conclusion: The fixed-bearing femoral prosthesis of the medial UKA should avoid translation or varus/valgus tilt on the coronal plane as much as possible. The obvious misalignment of the femoral prosthesis will significantly affect the stress on the internal structure of the knee joint, especially the PE insert and cartilage surface. A femoral prosthesis coronal tilt of more than 6° may significantly increase the stress on the PE surface, and varus of more than 6° may significantly increase the stress on the cartilage surface. For the femoral prosthesis position at the distal end of the femoral condyle, it is recommended to be placed in the centre. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the marginal adaptation and internal fit of cobalt-chromium copings fabricated by the selective laser melting (SLM) and conventional techniques using a profilometer. Materials and Methods: In this in vitro study sample size was calculated to be a total of 10 in two groups (n = 5). A brass model was used that had a circular cross-section with a round shoulder margin with 0.5 mm thickness and axial walls with 10 mm length and 6° taper. The copings fabricated with both techniques (SLM and casting method) were placed on the model, and vertical marginal gap was measured using a profilometer. The internal fit of copings was assessed by weighing the light-body addition silicone applied inside them, which simulated the cement. Data were analyzed through parametric (Independent t-test) and nonparametric (Mann–Whitney U-test, Bootstrap, Spearman, and Pearson Correlation) analysis. All analyses were performed at a significant level (α = 0.05) using SPSS. Results: The mean marginal gap in the casting group (132.93 ± ) was significantly higher than that in the SLM group (67.14 ± 15.67 μm) (P < 0.05). The mean weight of light-body silicone was 9.60 ± in the SLM and 8.70 ± 1.21 mg in the casting group. No significant difference was noted between the two groups regarding the internal fit (P > 0.05). Conclusion: The copings fabricated by the SLM technique showed a smaller vertical marginal gap compared to the casting group. However, the two groups were not significantly different in terms of internal fit.

Abstract Background To minimize misfit between prosthesis and implant, the welding of the implant fixed partial denture (IFPD) framework is recommended and autopolymerized acrylic resin (AR) is the material of choice for the indexing process. As for any prosthetic device that comes into contact with saliva and blood in the oral cavity, IFPD indexed with AR must be disinfected before sending to the laboratory. However, disinfection procedures are often neglected for fear of shrinkage or distortion caused by a dimensional change of the acrylic resin. Peracetic acid is a high-level disinfectant agent at low concentrations and immersion time, with no reported toxic residues, and it is not inactivated in the presence of organic matter when compared to other disinfectants. This study aimed to evaluate the influence of 0.2% peracetic acid disinfectant solution after different storage media and times on the horizontal dimension of IFPD frameworks indexed with AR. Material and methods IFPD frameworks were indexed with two AR: group 1 Duralay and group 2 Pattern Resin LS. Each group was further divided into five subgroups according to disinfection procedure and storage medium: no disinfection and dry storage, no disinfection and water storage, 0.2% peracetic acid disinfection and water storage, 0.2% peracetic acid disinfection and peracetic acid storage, and 0.2% peracetic acid disinfection and dry storage. The horizontal dimension of the specimens and an average was established for analysis. Measurements were performed at four different storage times (hours): T0, T24, T48, T168. Results No statistical differences were found when T0 was compared to T168 for Pattern resin groups submitted to disinfection and storage in water (group 2b, p = 1.000) or peracetic acid solution (group 2c, p = 0.352). For Duralay groups, the use of peracetic acid solution did not affect the horizontal dimension of the specimens when T0 was compared to T168 only with water as a storage medium (group 1b, p = 1.000). Additionally, T0 did not differ from T24 for groups 1c (p = 0.553), 2b (p = 1.000), 2d (p = 0.234), and 2e (p = 1.000) and from T48 for groups 1d (p = 0.118) and 2b (p = 1.000). Conclusion Within the studied conditions, the use of 0.2% peracetic acid can be safely used as a disinfectant solution regarding dimensional stability of AR-indexed IFPD until 7 days of storage. Horizontal discrepancies are dependent on acrylic resin type, time, and medium of storage.

Objectives: To determine the perspectives of amputees and rehabilitation clinicians on the effect of socket fit and issues caused by ill-fitting sockets throughout lower limb prosthetic rehabilitation. Design: A survey was developed to identify rehabilitation factors and issues for prosthesis wearers and rehabilitation clinicians. Participants opted to participate in a further telephone interview. Setting: Online and across the United Kingdom. Participants: Lower limb prosthetic wearers and clinicians who are part of a lower limb prosthetic rehabilitation team (N=94). Interventions: Not applicable. Main Outcome Measures: A survey and an interview to measure the perceived effect of socket fit on lower limb rehabilitation. Results: Issues related to socket fit were identified as the biggest factor affecting rehabilitation by 48.0% of amputees and 65.7% of clinicians. Amputee interviewees focused on the effect of fit on quality of life and the ability to complete daily tasks, whereas clinicians focused on the lack of widespread ability to adjust the socket and gait re-education. Conclusions: Socket fit has a large effect on and is a large source of frustration to amputees and their clinical teams throughout rehabilitation. From the interviews, it became clear that the interpretation of socket fit is different for each person; thus, “socket fit” does not mean the same for all patients.

Background: This study aimed to assess the marginal adaptation and internal fit of cobalt-chromium copings fabricated by the selective laser melting (SLM) and conventional techniques using a profilometer. Materials and Methods: In this in vitro study sample size was calculated to be a total of 10 in two groups (n = 5). A brass model was used that had a circular cross-section with a round shoulder margin with 0.5 mm thickness and axial walls with 10 mm length and 6° taper. The copings fabricated with both techniques (SLM and casting method) were placed on the model, and vertical marginal gap was measured using a profilometer. The internal fit of copings was assessed by weighing the light-body addition silicone applied inside them, which simulated the cement. Data were analyzed through parametric (Independent t-test) and nonparametric (Mann–Whitney U-test, Bootstrap, Spearman, and Pearson Correlation) analysis. All analyses were performed at a significant level (α = 0.05) using SPSS. Results: The mean marginal gap in the casting group (132.93 ±) was significantly higher than that in the SLM group (67.14 ± 15.67 μm) (P < 0.05). The mean weight of light-body silicone was 9.60 ± in the SLM and 8.70 ± 1.21 mg in the casting group. No significant difference was noted between the two groups regarding the internal fit (P > 0.05). Conclusion: The copings fabricated by the SLM technique showed a smaller vertical marginal gap compared to the casting group. However, the two groups were not significantly different in terms of internal fit. [ABSTRACT FROM AUTHOR]

The purpose of this research project was to compare the fit of a retrievable cement-retained implantsupported framework to that of a traditional wax and cast, screw-retained framework and to test the strength of the cemented restoration. Ten telescopic frameworks were luted to gold cylinders with a bis-GMA resin cement. The control group consisted of 10 frameworks fabricated with traditional wax and casting techniques directly to the gold cylinders. Frameworks were analyzed for distortion in the z-axis using scanning electron microscopy and a single screw test. Results demonstrated that the retrievable cement-retained group had a decreased gap distance and improved angular distortion (statistical significance P < .01) compared to the control group. Retentive strength measurements for the cement-retained group with a direct pull-out test revealed a mean pull-out force of 65.7 kg. Three of the 5 samples surpassed the tensile strength of the gold retaining screws (76 kg). Cement-retained restorations demonstrated superior fit in the z-axis and angular distortion compared to traditional wax and cast screw-retained frameworks. Retentive tests support a simplified technique of clinically luting telescopic implant-supported frameworks with adequate retentive strength. [ABSTRACT FROM AUTHOR]

Background: Vacuum-assisted suspension systems provide better suspension than non-vacuum systems, but data are limited on whether they improve physical activity levels and quality of life for people with amputation.Objectives: To compare the physical activity and quality of life levels of people with transtibial amputation using PIN/LOCK suspension system or vacuum-assisted suspension systems with those of able-bodied controls and to investigate parameters associated with physical activity levels.Study Design: A cross-sectional observational study.Methods: Fifty-one people with amputation and 51 controls participated. The International Physical Activity Questionnaire Short Form and Short Form 36 were used to measure the physical activity and quality of life, respectively.Results: The total physical activity and Short Form 36 scores were significantly lower in the participants with amputation than the controls. There were no significant differences between the two types of suspension systems in terms of physical activity levels and quality of life. The vacuum-assisted suspension system users reported significantly more bodily pain on the Short Form 36 questionnaire than the controls (p = 0.003). The only parameter that correlated significantly with the total physical activity was the Short Form 36 physical functioning subscale (r = 0.302, p = 0.031).Conclusion: Contrary to our expectations, vacuum-assisted suspension system users compared to PIN/LOCK users did not report greater levels of physical activity or improved quality of life or levels closer to comparable controls.Clinical Relevance: A better understanding of the effects of different prosthetic suspension systems on physical activity and quality of life may help clinicians when prescribing prostheses, as well as setting appropriate prosthetic expectations. This study suggests that vacuum-assisted suspension systems and PIN/LOCK suspension systems provide equal benefit to users with regards to physical activity and quality of life. [ABSTRACT FROM AUTHOR]

Background: Patient-prosthesis mismatch after mitral valve replacement has an unfavorable postoperative hemodynamic outcome, which underlines the importance of identifying and preventing prosthesis- and patient-related risk factors. This study was conducted to determine the incidence and identify possible predictors of patient-prosthesis mismatch. Methods: A prospective study was conducted on 715 patients with a mean age of 42 ± 11 years who underwent mechanical mitral valve replacement between 2013 and 2017. The effective orifice area of the prostheses was estimated by the continuity equation, and a mismatch was defined as an effective orifice area index ≤1.2 cm2·m−2. The mean clinical and echocardiographic follow-up was 26.74 ± 11.58 months. Multivariate regression analysis was performed to identify predictors of patient-prosthesis mismatch. Results: Patient-prosthesis mismatch was detected in 382 (53.4%) patients. A small mechanical prosthesis (<27 mm) was inserted in 54.3%. Mortality during follow-up was 9% (65 patients). Patient-prosthesis mismatch was identified in patients with preoperative rheumatic mitral valve pathology, associated tricuspid regurgitation, higher New York Heart Association class, preoperative atrial fibrillation, mitral stenosis, and small preoperative left ventricular dimensions. Multivariate analysis identified mitral stenosis, preoperative atrial fibrillation, and small postoperative left ventricular end-diastolic dimension as risk factors for patient-prosthesis mismatch. Conclusion: Patient-prosthesis mismatch is a common sequela after mechanical mitral valve replacement. Identification of predictors of patient-prosthesis mismatch can help so that a preoperative strategy can be implemented to avoid its occurrence. [ABSTRACT FROM AUTHOR]

Osseointegrated transradial prostheses have the potential to preserve the natural range of wrist rotation, which improves the performance of activities of daily living and reduces compensatory movements that potentially lead to secondary health problems over time. This is possible by enabling the radius and the ulna bone to move with respect to each other, restoring the functionality of the original distal-radioulnar joint. In this paper, we report on psychophysics tests performed on an osseointegrated transradial amputee with the aim to understand the extent of mobility of the implants that is required to preserve the natural forearm rotation. Based on these experiments, we designed and developed an attachment device between the implants and the hand prosthesis that serves as an artificial distal radio-ulnar joint. This device was fitted on an osseointegrated transradial amputee and its functionality assessed by means of the Southampton Hand Assessment Procedure (SHAP) and the Minnesota Manual Dexterity test (MMDT). We found that the axial rotation of the implants is required to preserve forearm rotation, to distribute loads equally over the two implants (60% radius – 40% ulna), and to enable loading of the implants without unpleasant feelings for the patient. Higher function was recorded when our attachment device enabled forearm rotation: SHAP from 61 to 71, MMDT from 258s to 231s. Natural forearm rotation can be successfully restored in transradial amputees by using osseointegration and our novel mechanical attachment to the hand prosthesis. [ABSTRACT FROM AUTHOR]

Determining the optimal length of artificial chordae tendineae and then effectively securing them is a major challenge in mitral valve repair. Our technique for measuring and stabilizing neochordae involves tying a polypropylene suture loop onto the annuloplasty ring. We used this method in 4 patients who had moderate-to-severe mitral regurgitation from degenerative posterior leaflet (P2) prolapse and flail chordae. Results of intraoperative saline tests and postoperative transesophageal echocardiography revealed only mild insufficiency. One month postoperatively, echocardiograms showed trivial regurgitation in all 4 patients. We think that this simple, precise method for adjusting and stabilizing artificial chordae will be advantageous in mitral valve repair. [ABSTRACT FROM AUTHOR]

In the prosthetics field, one of the most important bottlenecks is still the human-machine interface, namely the socket. Indeed, a large number of amputees still rejects prostheses or points out a low satisfaction level, due to a sub-optimal interaction between the socket and the residual limb tissues. The aim of this paper is to describe the main parameters (displacements, stress, volume fluctuations and temperature) affecting the stump-socket interface and reducing the comfort/stability of limb prostheses. In this review, a classification of the different socket types proposed in the literature is reported, together with an analysis of advantages and disadvantages of the different solutions, from multiple viewpoints. The paper then describes the technological solutions available to face an altered distribution of stresses on the residual limb tissues, volume fluctuations affecting the stump overtime and temperature variations affecting the residual tissues within the socket. The open challenges in this research field are highlighted and the possible future routes are discussed, towards the ambitious objective of achieving an advanced socket able to self-adapt in real-time to the complex interplay of factors affecting the stump, during both static and dynamic tasks. [ABSTRACT FROM AUTHOR]

The loss of an upper limb significantly limits the functional activities of daily living. A huge emphasis is placed on the manipulation, shape, weight, and comfort of a prosthesis, to enable its use as an inherent body part. Even with technological advances, customized upper-extremity myoelectric prosthesis remain heavy and expensive. The high cost of upper-extremity prosthesis is an especially steep economic barrier for patients. Three-dimensional (3D) printing is a promising avenue for reducing the cost of prosthesis. We applied 3D-printed pressure-sensored prosthetics to a traumatic transradial amputee, and compared the hand functions with a customized myoelectric prosthesis. The 3D-printed pressure-sensored prosthetics showed low grip strength and decreased dexterity compared to the conventional myoelectric prosthesis. Although there were a few limitations, the fabrication of prosthesis with 3D printing technology can overcome previous problems such as high production cost, long fabrication period and heavy weight. [ABSTRACT FROM AUTHOR]

Objective To investigate the microstructural properties and reliability of zirconia partially stabilized by yttrium oxide (Y-TZP) for use in monolithic form (Vita YZ HT, Vita Zahnfabrik, Germany) after different clinical adjustment protocols simulation. One-hundred and sixty two Y-TZP discs of high translucency were divided into 6 groups (n = 27), according to simulated adjustments: S-Y-TZP as sintered; G-glazed Y-TZP; DbG-Y-TZP with diamond bur adjustment simulation followed by glaze application; GDb-glazed Y-TZP adjusted with diamond bur; DbDrG-Y-TZP with adjustment simulation with diamond bur and polishing kit (diamond rubber), followed by glaze; GDbDr-glazed Y-TZP with adjustment simulation with diamond bur followed by polishing kit. Methods After monotonic testing under biaxial flexure (n = 3), remaining specimens were distributed into 3:2:3 ratio and tested under step-stress accelerated life testing. Specimens were evaluated in a stereomicroscope and SEM. Microstructure was analyzed by X-ray diffraction and mean surface roughness (Ra). Survival data were used to calculate Weibull's beta value (β) and reliability for missions of 300,000 and 600,000 cycles at 200 N. Ra data were statistically analyzed by 1-way ANOVA and Tukey’s test (both, a = 5%). Results The untreated HT zirconia (S) presented a lower probability of survival after 600,000 cycles at 200 N, compared to HT zirconia adjusted with diamond bur and glazed (DbG), and after final polishing with polishing kit (GDbDr). Final polishing with diamond rubber (GDbDr) resulted in a more homogeneous surface compared to glazed samples (G, DbG and DbDrG). Significance HT zirconia is more likely to present increased survival when glazed after diamond adjustments (DbG) or when it is finished with polishing kit (GDbDr). [ABSTRACT FROM AUTHOR]

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Fundamento: la estomatitis subprótesis es una lesión que constituye un factor de riesgo para la aparición de afecciones premalignas y malignas de la cavidad bucal.Objetivo: caracterizar a los pacientes con estomatitis subprótesis atendidos en el policlínico universitario "Julio Antonio Mella", de Camagüey.Métodos: se realizó un estudio observacional descriptivo en pacientes atendidos en el referido policlínico desde enero hasta noviembre de 2014. El universo lo constituyeron 643 pacientes mayores de 20 años de edad, de ambos sexos, que acudieron para ser evaluados por la especialidad de prótesis. La selección de la muestra fue no probabilística y quedó constituida por 296 pacientes que presentaron estomatitis subprótesis.Resultados: entre los 296 pacientes predominó el sexo femenino, con el 70,94 %. Los que usaron la prótesis por más de diez años fueron los más afectados (60,47 %), principalmente por lesiones grado II (59,45 %). El 81,41 % eran portadores de prótesis total y el 18,58 % padecieron la enfermedad con prótesis parcial. La forma continua de usar la prótesis ocupó el lugar de mayor importancia en el estudio, con 195 enfermos para el 65,87 %.Conclusiones: se caracterizaron los pacientes mayores de 20 años de edad con estomatitis subprótesis, objetos de la investigación.

OBJECTIVE: The purpose of this study was to provide information regarding the marginal adaptation of composite resin onlays in primary teeth previously treated with 1% sodium hypochlorite (NaOCl) (pulp irrigant) using two different resin luting agents. MATERIAL AND METHODS: Forty extracted sound primary molars had their crowns prepared in a standardized machine and were randomly divided into 4 groups (n=10): G1 (1% NaOCl irrigation+EnForce); G2 (EnForce); G3 (1% NaOCl irrigation+Rely X); G4 (Rely X). The onlays were made with Z250 composite resin on plaster models. After luting, the tooth/restoration set was stored in 100% relative humidity at 37ºC for 24 h and finished with Soflex discs. Caries Detector solution was applied at the tooth/restoration interface for 5 s. The specimens were washed and four digital photos of each tooth were then taken. The extents of the gaps were measured with Image Tool 3.0 software. The percentage data were submitted to a Kruskal-Wallis test (α=0.05). The Relative Risk test analyzed the chance of a gap presence correlated to each group. RESULTS: There were no statistically significant differences (p>0.05) among the groups. The relative risk test revealed that some groups were more apt to have a presence of gaps than others. CONCLUSION: Neither the 1% NaOCl treatment nor the resin luting agents caused any alterations in the dental substrate that could have influenced the marginal adaptation of composite onlays in primary teeth.

Aim: Success of implant-supported prostheses is related to the frameworks’ passive fit, hence inaccuracies can generate stress, leading to bone resorption and rehabilitation failure. This study evaluated misfit levels of implant-supported frameworks after different coverage treatments. Methods: Twenty commercially pure titanium (CP Ti) frameworks were manufactured with 5 Branemark type multi-unit abutments. Frameworks were distributed in two groups as follows: G1 - porcelain application (n=10); G2 - porcelain firing cycle simulation (n=10). Using a traveling microscope, marginal misfit was measured before and after undertaking the techniques, following the single-screw test protocol. All data were submitted to ANOVA and Tukey’s test (p

Objective:To compare stimulation parameters of peri-modiolar and anti-modiolar electrode arrays using two surgical approaches.Methods:Impedance, stimulation thresholds, comfortably loud current levels, electrically evoked compound action potential thresholds and electrically evoked stapedial reflex thresholds were compared between 2 arrays implanted in the same child at 5 time points: surgery, activation/day 1, week 1, and months 1 and 3. The peri-modiolar array was implanted via cochleostomy in all children (n = 64), while the anti-modiolar array was inserted via a cochleostomy in 43 children and via the round window in 21 children.Results:The anti-modiolar array had significantly lower impedance, but required higher current levels to elicit thresholds, comfort, electrically evoked compound action potential thresholds and electrically evoked stapedial reflex thresholds than the peri-modiolar array across all time points, particularly in basal electrodes (p < 0.05). The prevalence of open electrodes was similar in anti-modiolar (n = 5) and peri-modiolar (n = 3) arrays.Conclusion:Significant but clinically acceptable differences in stimulation parameters between peri-modiolar and anti-modiolar arrays persisted four months after surgery in children using bilateral cochlear implants. The surgical approach used to insert the anti-modiolar array had no overall effect on outcomes. [ABSTRACT FROM PUBLISHER]

The aims of this study were to measure and describe the oral health-related quality of life (OHRQoL) and to identify the complications caused by partial removable dental prosthesis (RDPs) in patients 1-5 years after treatment. Complications were identified in 65 patients who were treated with 83 RDPs (48 upper, 35 lower). OHRQoL was measured using the OHIP-49 before treatment and at the baseline (1-2 months after treatment) and follow-up (1-5 years after treatment) examinations. The types and numbers of oral problems that were experienced were described based on OHIP items with a score of 3 and 4. A significant improvement (P < 0·05) in the total OHIP-49 was registered from pre-treatment (mean 42, SD ± 37) to baseline (mean 29, SD ± 27) and from pre-treatment to 1-5 years after treatment (mean 32, SD ± 30). There was no significant difference between the baseline and 1- to 5-year follow-up examinations. Problems with eating and appearance registered at pre-treatment were improved at baseline and after 1-5 years. Problems with dentures that had been registered pre-treatment were improved at baseline but reoccurred after 1-5 years. The two most frequent complications were ill-fitting RDPs and inflammation of the oral mucosa, followed less frequently by fractures of the clasps. Treatment with RDPs improved OHRQoL, but denture-related problems partly remained, and new problems related to RDPs occurred 1-5 years after treatment. The two most frequent complications were ill-fitting RDPs and inflammation of the oral mucosa. [ABSTRACT FROM AUTHOR]

The aims of this study were to measure and describe the oral health-related quality of life (OHRQoL) and to identify the complications caused by partial removable dental prosthesis (RDPs) in patients 1-5 years after treatment. Complications were identified in 65 patients who were treated with 83 RDPs (48 upper, 35 lower). OHRQoL was measured using the OHIP-49 before treatment and at the baseline (1-2 months after treatment) and follow-up (1-5 years after treatment) examinations. The types and numbers of oral problems that were experienced were described based on OHIP items with a score of 3 and 4. A significant improvement (P < 0·05) in the total OHIP-49 was registered from pre-treatment (mean 42, SD ± 37) to baseline (mean 29, SD ± 27) and from pre-treatment to 1-5 years after treatment (mean 32, SD ± 30). There was no significant difference between the baseline and 1- to 5-year follow-up examinations. Problems with eating and appearance registered at pre-treatment were improved at baseline and after 1-5 years. Problems with dentures that had been registered pre-treatment were improved at baseline but reoccurred after 1-5 years. The two most frequent complications were ill-fitting RDPs and inflammation of the oral mucosa, followed less frequently by fractures of the clasps. Treatment with RDPs improved OHRQoL, but denture-related problems partly remained, and new problems related to RDPs occurred 1-5 years after treatment. The two most frequent complications were ill-fitting RDPs and inflammation of the oral mucosa. [ABSTRACT FROM AUTHOR]

La rehabilitación protésica de un paciente conlleva una serie de cambios, que en un tiempo se traducen en todo un proceso adaptativo. Una vez instalada la prótesis en el paciente se le instruye en lo que debe hacer para su mejor adaptación, se le dan indicaciones sobre el uso y cuidado de la prótesis. El uso nocturno de la prótesis constituyó el motor impulsor para nuestro trabajo, en el cual nos dimos a la tarea de relacionar la adaptación con el uso nocturno en cuanto a tiempo de instalada, experiencia protésica anterior, tipo de prótesis y tiempo de uso nocturno. Para su realización se encuestaron a 50 pacientes pertenecientes al consultorio 25 de la Clínica Estomatológica "Manuel Angulo Farrán", con lo cual se evidenció que existe una relación directa entre el uso nocturno y la adaptación favorable a medida que se prolonga el tiempo de uso y de instalada la prótesis, en el paciente que haya tenido experiencia protésica anterior y en los portadores de prótesis totales superiores e inferiores de acrílico.The prosthetic rehabilitation of a patient leads to a series of changes that are part of an adaptation process. Once the prosthesis is placed, the patient is instructed what to do for a better adaptation and indications are given on the use and care of the prosthesis. The nocturnal use of the prosthesis is the main objective of our paper, in which we related the adaptation to the nocturnal use as regards the time of placement, the previous prosthetic experience, the type of prosthesis and the time of nocturnal use. 50 patients from the physician´s office No. 25 of "Manuel Angulo Farrán" Dental Clinic were surveyed and it was observed that there was a direct relationship between the nocturnal use and the favorable adaptation as the time of placement and use of the prosthesis were longer among those patients with previous prosthetic experience and in those having upper and lower acrylic dental prostheses.

The objective of this study was to perform a systematic review on the use of radiographic methods for the diagnosis of misfit in dental prostheses and restorations. The MEDLINE bibliographic database was searched from 1950 to February 2014 for reports on the radiographic diagnosis of misfits. The search strategy was limited to English-language publications using the following combined Me SH terms in the search strategy: (Dental Restoration OR Dental Prosthesis OR Crown OR Inlays OR Dental Abutments) and (Dental Leakage OR Prosthesis Fitting OR Dental Marginal Adaptation OR Surface Properties) and (Radiography, Dental OR Radiography, Dental, Digital OR Cone-Beam Computed Tomography). Twenty-eight publications were identified and read in full text, and 14 studies fulfilled criteria for inclusion. Information regarding the use of radiographic methods for the diagnosis of misfits in dental prosthesis and restorations, and in which the methodology/results comprised information regarding how the sample was collected/prepared, the method, imaging protocol, presence of a reference test and the outcomes were evaluated. QUADAS criteria was used to rate the studies in high, moderate or low quality. The evidence supporting the use of radiographic methods for the diagnosis of misfits in dental prosthesis and restorations is limited to low-/moderate-quality studies. The well-established intra-oral orthogonal projection is still under investigation and considered the most appropriate method, both when evaluating the relation between dental restoration to tooth and abutment to implant. Studies using digital radiographs have not evaluated the effect of image post-processing, and tomography has not been evaluated. [ABSTRACT FROM AUTHOR]

Objective: The objectives of this study were to describe the authors' experience with the timeline for prosthetic fitting after rotationplasty of the knee and to determine factors that may be associated with earlier prosthetic fitting. Design: The authors conducted a retrospective observational study of 1 2 patients who underwent rotationplasty of the knee and received prosthetic care at this institution. All patients had oncologic causes for surgery. Results: The median age at amputation was 10 yrs. The overall survival rate was 92%. Five patients received a preliminary bypass prosthesis. All 1 2 patients were successfully fitted with a definitive prosthesis. Three patients were fitted within 90 days; two of these three patients did not require chemotherapy. The median time for definitive prosthetic fitting in the ten patients requiring chemotherapy was 230.5 days (range, 85-425 days). Nine patients had documentation supporting a return to sport/premorbid physical recreational activities. Conclusions: In the authors' experience, chemotherapy was associated with delayed definitive prosthetic fitting. Typically, the patients who required rotationplasty for cancer completed fitting with a definitive prosthesis in 6 mos. The findings of this study validate previous reports and confirm that most rotationplasty patients have excellent outcomes with return to premorbid physical activities. [ABSTRACT FROM AUTHOR]

Management of residual limb volume affects decisions regarding timing of fit of the first prosthesis, when a new prosthetic socket is needed, design of a prosthetic socket, and prescription of accommodation strategies for daily volume fluctuations. This systematic review assesses what is known about measurement and management of residual limb volume change in persons with lower-limb amputation. Publications that met inclusion criteria were grouped into three categories: group I: descriptions of residual limb volume measurement techniques; group II: studies investigating the effect of residual limb volume change on clinical care in people with lower-limb amputation; and group III: studies of residual limb volume management techniques or descriptions of techniques for accommodating or controlling residual limb volume. We found that many techniques for the measurement of residual limb volume have been described but clinical use is limited largely because current techniques lack adequate resolution and in-socket measurement capability. Overall, limited evidence exists regarding the management of residual limb volume, and the evidence available focuses primarily on adults with transtibial amputation in the early postoperative phase. While we can draw some insights from the available research about residual limb volume measurement and management, further research is required. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this study was to evaluate the influence of veneer application on the misfit level of implant-supported frameworks. Materials and Methods. Thirty commercially pure titanium (Tritan, Dentaurum, Pforzheim, Germany) frameworks were fabricated from a metallic index containing five Branemark-type multi-unit abutments. Analogs of the abutments were positioned into the framework to manufacture an index for each framework, which permitted the evaluation of the marginal gap caused only by the veneer coverage. The frameworks were grouped ( n == 10) in the following manner: (G1) heat-cured acrylic resin (Cláássico, Cláássico, Sãão Paulo, Brazil); (G2) light-cured resin (Versyo.com, Heraeus Kulzer, Brazil); and (G3) porcelain (Triceram, Dentaurum, Pforzheim, Germany). Marginal refinement with spark erosion was then conducted. The marginal gap was verified before and after the veneer coverage and the spark erosion procedure, following the single screw test protocol (tightening force of 10 Ncm). Data were submitted to an analysis of variance (ANOVA) in a split-plot design for repeated measurements followed by a Tukey test ( p == 0.05). Results. The veneer application was associated with a significant increase in the mean misfit values of all groups. The lowest values were presented by G2. After the spark erosion process, the mean misfit value decreased only on G3. Conclusions. Heat-cured acrylic resin and porcelain produced the highest values of marginal gaps, whereas light-cured acrylic resin produced the lowest. In addition, the spark erosion process was effective only in the marginal gap of the porcelain application group. [ABSTRACT FROM AUTHOR]

The article presents a pilot study which verified the effect of botulinum toxin type B (BTX-B) in the treatment of residual limb hyperhidrosis for lower limb amputees. The study examined nine leg amputees with marked sweating of residual limb, in which the patients received a single administration of 1750 U BTX-B. Results showed that patients' quality of life, artificial limb, steadiness of gait, and work performance have increased, skin problems have decreased, and stump pain was also reduced.

Despite recent advances in left ventricular assist device and total artificial heart technologies, these devices are still so large that they pose a significant problem in small patients with refractory heart failure. Excising the left ventricle while preserving the right ventricle--and then replacing the left ventricle with a mechanical pump--has been proposed as an alternative approach to this problem. We conducted a pilot study to evaluate possible surgical techniques and the hemodynamic effects of right ventricle-sparing left ventricular resection and replacement with a continuous-flow rotary blood pump in a healthy bovine model. [ABSTRACT FROM AUTHOR]

The biocompatibility assessment of the Cleveland Clinic continuous-flow total artificial heart is an important part of the device developmental program. Surgical and postoperative management are key factors in achieving optimal outcomes. However, the presence of vascular anatomical abnormalities in experimental animal models is often unpredictable and may worsen the expected outcomes. We report a technical impediment encountered during total artificial heart implantation complicated by unfavorable bovine anatomy of the ascending aorta and brachiocephalic arterial trunk. [ABSTRACT FROM AUTHOR]

The article presents a study which investigates the roles of predisposing characteristics, established need, and enabling resources in upper-limb prosthesis use and abandonment. According to the author, future research should focus on continued development of more comfortable and functional prostheses, particularly for individuals with high-level or bilateral limb absence. Improved follow-up, repair, and information services, together with active involvement of clients in the selection of prostheses meeting their specific goals and needs, is recommended.

Purpose. To measure consumer satisfaction with upper limb prosthetics and provide an enumerated list of design priorities for future developments. Methods. A self-administered, anonymous survey collected information on participant demographics, history of and goals for prosthesis use, satisfaction, and design priorities. The questionnaire was available online and in paper format and was distributed through healthcare providers, community support groups, and one prosthesis manufacturer; 242 participants of all ages and levels of upper limb absence completed the survey. Results. Rates of rejection for myoelectric hands, passive hands, and body-powered hooks were 39%, 53%, and 50%, respectively. Prosthesis wearers were generally satisfied with their devices while prosthesis rejecters were dissatisfied. Reduced prosthesis weight emerged as the highest priority design concern of consumers. Lower cost ranked within the top five design priorities for adult wearers of all device types. Life-like appearance is a priority for passive/cosmetic prostheses, while improved harness comfort, wrist movement, grip control and strength are required for body-powered devices. Glove durability, lack of sensory feedback, and poor dexterity were also identified as design priorities for electric devices. Conclusions. Design priorities reflect consumer goals for prosthesis use and vary depending on the type of prosthesis used and age. Future design efforts should focus on the development of more light-weight, comfortable prostheses. [ABSTRACT FROM AUTHOR]

Purpose. Prosthesis use and abandonment is a complex function of variables defining the contextualized individual. This review presents a comprehensive panoramic of these factors as related to the management of upper limb deficiency. Method. Anderson's model for health service utilization was used to frame prosthesis use and abandonment as a function of (1) predisposing characteristics of the individual (e.g. gender or level of limb loss); (2) established need, as characterized by lifestyle- and age-related demands; and (3) enabling resources (e.g. clinical and social). English-language articles pertaining to these components were identified in a search of Ovid, PubMed, ISI Web of Science and www.scholar.google.com (1980 - November 2006) for key words upper limb and prosthesis. Approximately 90 articles were included as evidence in this review. Results. Personal and contextual factors are critical determinants of prosthesis acceptance. While the influence of some factors (i.e. lifestyle, level of limb loss), is strongly supported in the literature, the impact of others, (i.e. age of fitting, efficacy of training protocols), remain controversial. Conclusions. Enhanced understanding of these factors is required to optimize clinical practices, guide design efforts, and satiate demand for evidence-based measures of intervention. Future research should comprise of controlled, multifactor studies adopting standardized outcome measures and providing comprehensive descriptions of population characteristics. [ABSTRACT FROM AUTHOR]

Lower-limb amputees often exhibit large fluctuation in residual-limb shape, necessitating careful observation and anthropometric measurement for pros thetists to ensure socket fit. Anthropometric measurement may become more important as an outcome measure indicating success in rehabilitation. This study investigated the accuracy and reliability of seven prosthetic anthropometric measurement devices as used by a group of eight prosthetic-orthotic practitioners and a group of five prosthetic-orthotic students to measure six common anthropometric dimensions on three foam positive models of transtibial amputee residual limbs. Two of the models were identical, enabling assessment of individual repeatability. Some clinically significant errors were noted in the results; however, the general variability in measurements was not clinically significant. Students were slightly more consistent than practitioners; students were more consistent with linear measurements, while practitioners were more cons is- tent with circumferential measures. The results further demonstrated that the VAPC measurement device used in the study was both inaccurate and unreliable. [ABSTRACT FROM AUTHOR]