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ObjectiveTo evaluate the kinematics and stability of the temporomandibular joint (TMJ) of cats and dogs with and without a TMJ replacement (TMJR) prosthesis under simulated bite forces and mouth opening.AnimalsSixteen cadaver skulls from domestic cats (n = 8) and medium- to large-breed dogs (n = 8).MethodsIntact TMJs were tested. Following condylectomy and coronoidectomy, the skulls were fitted with a TMJR prosthesis unilaterally and retested. Prosthesis was similarly implanted in the contralateral TMJ in 4 cats and 4 dogs before retesting. Left and right bite motions were evaluated before bite contact to peak bite force (200 N in dogs, 63 N in cats). Mouth opening motion was recorded. Mandibular displacement under load was evaluated in 3 orthogonal planes. Maximal displacement was compared between TMJR groups and native TMJ. Prosthesis-bone motion of the temporal and mandibular components was evaluated during simulated bites and mouth opening.ResultsTMJR resulted in joint motion not demonstrably different from the native TMJ, with the ability to fully open and close the mouth and with minimal laterotrusion. The TMJR prosthesis demonstrated similar stability after unilateral and bilateral replacement during bite force and with an open mouth. Mean implant-bone motion during bite simulations for the temporal and mandibular TMJR components was ≤ 60 µm in cats and ≤ 30 µm in dogs.Clinical relevanceA novel TMJR can be implanted and allows normal jaw motion. Joint stability is maintained after TMJR implantation in the TMJ of dogs and cats TMJ that is devoid of muscular support.

The House of Commons Standing Committee on Health proposed in 2022 to start a national registry for breast implants. Why, and what requirements are needed, will be outlined. Breast implant products are not always in compliance with international norms and standards, and several scandals have occurred because of industry fraud. To trace which patients have defective breast implants, a good registry is an absolute must. Furthermore, some diseases, such as lymphomas, autoimmune diseases, and so-called breast implant illness, are believed to be associated with breast implants. An accurate estimation of how often these diseases occur in patients with breast implants is lacking. A registry in which not only surgical data but also patient-reported outcome measurements are recorded will result in a better understanding of patient outcomes and device performance. The registry should not be a voluntary ('opt-in') registry but a mandatory ('opt-out') registry, in which only the patient (and not the surgeon) has the choice whether to participate., It is estimated that 3%-4% of women in Western countries have silicone breast implants. Of these, 70% are placed for cosmetic reasons, whereas about 30% are placed for reconstruction after [...]

Purpose: Little is known about the outcomes that are most important to prosthesis users and funders. A Prosthetic Interventions Core Outcome Set (PI-COS) will help researchers and practitioners measure outcomes that are the most important to prosthesis users and funders. Materials and methods: Prosthesis users and funders rated the importance of 121 International Classification of Functioning, Disability, and Health (ICF) second-level categories using a two-round Delphi survey. A Consensus Meeting using the nominal group technique resolved rating differences between groups. The ICF second-level categories were ranked according to importance and a K-Means Cluster Analysis helped establish the PI-COS. Results: 65 users and 8 funders completed the Delphi surveys, followed by a Consensus Meeting. 26 ICF second-level categories were considered important to prosthesis users and funders and a PI-COS of 14 ICF second-level categories drawn predominantly from five ICF chapters was established: Sensory Functions and Pain (b2), Neuromusculoskeletal and Movement-related Functions (b7), General Tasks and Demands (d2), Mobility (d4), and Products and Technology (e1). Conclusions: The PI-COS describes the outcomes that are most important to prosthesis users and funders. The PI-COS can help focus on the most important outcome measures in clinical practice and research, including future prosthetic health economic evaluations. [ABSTRACT FROM AUTHOR]

The current primary treatment approach for malignant pelvic tumors involves hemipelvic prosthesis reconstruction following tumor resection. In cases of Enneking type II + III pelvic tumors, the prosthesis necessitates fixation to the remaining iliac bone. Prevailing methods for prosthesis fixation include the saddle prosthesis, ice cream prosthesis, modular hemipelvic prosthesis, and personalized prosthetics using three-dimensional printing. To prevent failure of hemipelvic arthroplasty protheses, a novel fixation method was designed and finite element analysis was conducted. In clinical cases, the third and fourth sacral screws broke, a phenomenon also observed in the results of finite element analysis. Based on the original surgical model, designs were created for auxiliary dorsal iliac, auxiliary iliac bottom, auxiliary sacral screw, and auxiliary pubic ramus fixation. A nonlinear quasi-static finite element analysis was then performed under the maximum load of the gait cycle, and the results indicated that assisted sacral dorsal fixation significantly reduces stress on the sacral screws and relative micromotion exceeding 28 μm. The fixation of the pubic ramus further increased the initial stability of the prosthesis and its interface osseointegration ability. Therefore, for hemipelvic prostheses, incorporating pubic ramus support and iliac back fixation is advisable, as it provides new options for the application of hemipelvic tumor prostheses. [ABSTRACT FROM AUTHOR]

Background: Bone and joint infections represent a major public health issue due to their increasing prevalence, their functional prognosis and their cost to society. Phage therapy has valuable anti-biofilm properties against prosthetic joint infections (PJI). The aim of this study was to establish the proportion of patients eligible for phage therapy and to assess their clinical outcome judged against all patients presenting with PJI. Method:. Patients admitted for periprosthetic joint infection (PJI) at a French general hospital between 2015 and 2019 were retrospectively included. Eligibility for phage therapy was determined based on French recommendations, with polymicrobial infections serving as exclusion criteria. Patients were categorized into two groups: those eligible and those ineligible for phage therapy. We analyzed their characteristics and outcomes, including severe adverse events, duration of intravenous antibiotic therapy, length of hospitalization, and relapse rates. Results:. In this study, 96 patients with PJI were considered in multidisciplinary medical meetings. Of these, 44% patients (42/96) were eligible for additional phage therapy. This group of patients had a longer duration of intravenous therapy (17 days vs. 10 days, p = 0.02), more severe adverse events (11 vs. 3, p = 0.08) and had a longer hospital stay (43 days vs. 18 days, p < 0.01). Conclusion:. A large number of patients met eligibility criteria for phage therapy and treatment and follow-up is more complex. A larger epidemiological study would more accurately describe the prognosis of eligible patients. [ABSTRACT FROM AUTHOR]

Objectives: This study compares hearing outcomes of two prosthesis materials, bone and titanium, used in ossiculoplasty. Design: This retrospective nationwide registry‐based study uses data systematically collected by the Swedish Quality Registry for Ear Surgery (SwedEar). Setting: The data were obtained from clinics in Sweden that perform ossiculoplasty. Participants: Patients who underwent ossiculoplasty using either bone or titanium prostheses were registered in SwedEar between 2013 and 2019. Main Outcome Measures: Hearing outcome expressed as air–bone gap (ABG) gain. Results: The study found no differences between bone and titanium for ABG or air conduction (AC) for either partial ossicular replacement prostheses (PORP) or total ossicular replacement prostheses (TORP). In a comparison between PORP and TORP for ABG and AC outcomes, regardless of the material used, PORP showed a small advantage, with an additional improvement of 3.3 dB (95% CI [confidence interval], 0.1–4.4) in ABG and 2.2 dB (95% CI, 1.7–4.8) in AC. In secondary surgery using TORP, titanium produced slightly better results for high‐frequency pure tone average. The success rate, a postoperative ABG ≤20 dB, was achieved in 62% of the operations for the whole group. Conclusion: Both bone and titanium used to reconstruct the ossicular chain produce similar hearing outcomes for both PORP and TORP procedures. However, titanium may be a preferable option for secondary surgeries involving TORP. The success rate, a postoperative ABG ≤20 dB, is consistent with other studies, but there is room for improvement in patient selection criteria and surgical techniques. [ABSTRACT FROM AUTHOR]

Background: Satisfaction with prosthesis plays a key role in regaining mobility and is important for optimizing prosthetic usage, mobility, and increasing compliance with medical regimen. Despite unchangeable factors like age and comorbidities, other factors, like pain, received rehabilitation, satisfaction with assistive devices, service, and information, can be changed and might contribute to a better usage and acceptance of the prosthesis and amputees' mobility. Objectives: The aim of the study was to analyze mobility, pain, supply of assistive devices, and additional therapies received after major limb amputations. Furthermore, a correlation of those parameters was evaluated. Methods: Retrospective identification of patients with major limb amputation (operation and procedures classification system (OPS)) and relevant related demographics within the clinical documentation system during a four-year observation time. In addition, we undertook prospective assessment of mobility (K-level), pain qualities, additional therapies, self-rated overall quality of life (QoL) and degree of adaptation to the life after amputation, dependency from caregivers, and satisfaction with the provided assistive devices (QUEST). Results: A total of 164 patients (mean age 68, age range: 19 to 97 years) underwent major limb amputation. A total of 27 questionnaires were returned and analyzed. All those traumatic and nontraumatic amputees received assistive devices. Although mobility and QoL decreased significantly after amputation, a high satisfaction with provided prosthetic and assistive devices and care was found. Conclusions: Amputation registries are becoming elementary to allow for nationwide comparisons of clinics, to identify the requirements of amputees, and to design an interdisciplinary care model for a successful comprehensive approach. [ABSTRACT FROM AUTHOR]

This study investigated the impact of early prosthetic intervention on children with upper limb agenesis or amputation. The aim was to assess both how early prosthetics improve a child's movement and coordination skills, as well as how satisfied both the child and their parents are with the prosthesis. Twenty-nine children were evaluated using the Unilateral Below Elbow Test (UBET) and Child Amputee Prosthetics Project—Prothesis Satisfaction Inventory (CAPP-PSI). Results suggest that while children performed tasks faster and more fluidly without a prosthesis, they were satisfied with the prostheses and the service provided. This may be due to ongoing adaptation to the new device. The single child re-evaluated at 12 months showed improvement in prosthesis use, highlighting the potential benefits of early intervention coupled with motor re-education. Further research is needed to optimize prosthetic features and address initial challenges associated with prosthesis use. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONTo evaluate the psychometric properties of the Arabic version of the Activities-Specific Balance Confidence Scale using the 5-option response categories for individuals with lower limb amputation (ABC-5/Ar).This was a methodological study on a convenience sample of individuals with unilateral lower-limb amputation attending outpatient rehabilitation centres in Saudi Arabia and Turkey (N = 155). Rasch analysis (WINSTEPS version 4.6.5) was used to examine the 5-categories rating scale structure, item fit, item difficulty hierarchy, person separation index, unidimensionality, local item dependency, and differential item functioning.The ABC-5/Ar 5-response option demonstrated an appropriate model fit. Most items fit the Rasch model, except for item #12 “walk in a crowded mall,” which showed an overfitting value of 0.63. The person separation indices 2.95 (Cronbach’s α = 0.96). Principal component analysis of residuals confirmed the unidimensionality of the scale; however, local dependency was detected between item #14 “Ride in escalator holding rail,” and item #15 “Ride in escalator not holding rail.”The findings suggest that the ABC-5/Ar shows promise in assessing balance confidence in Arabic-speaking lower-limb prosthesis users. However, further studies with larger sample sizes and in diverse clinical contexts are needed to confirm its effectiveness in various clinical settings.Overall, our Rasch-based study provides additional evidence to support the psychometric appropriateness of using the Activity-specific Balance Confidence scale with the 5-category options (ABC-5) of the Arabic version among lower prosthesis users.Clinicians and researchers should be mindful of cultural and contextual differences that exist among Arabic-speaking population which may influence how participants responded to certain items in the scale.It is essential to conduct a comprehensive psychometric evaluation to guide the implementation and interpretation of scales, particularly in Arabic-speaking countries due to the scarcity of validated and standardised outcome measures to assess prosthesis users’ confidenceOverall, our Rasch-based study provides additional evidence to support the psychometric appropriateness of using the Activity-specific Balance Confidence scale with the 5-category options (ABC-5) of the Arabic version among lower prosthesis users.Clinicians and researchers should be mindful of cultural and contextual differences that exist among Arabic-speaking population which may influence how participants responded to certain items in the scale.It is essential to conduct a comprehensive psychometric evaluation to guide the implementation and interpretation of scales, particularly in Arabic-speaking countries due to the scarcity of validated and standardised outcome measures to assess prosthesis users’ confidence [ABSTRACT FROM AUTHOR]

Background: Patient access to body-powered and myoelectric upper limb prostheses in the United States is often restricted by a healthcare system that prioritizes prosthesis prescription based on cost and perceived value. Although this system operates on an underlying assumption that design differences between these prostheses leads to relative advantages and disadvantages of each device, there is limited empirical evidence to support this view. Main text: This commentary article will review a series of studies conducted by our research team with the goal of differentiating how prosthesis design might impact user performance on a variety of interrelated domains. Our central hypothesis is that the design and actuation method of body-powered and myoelectric prostheses might affect users' ability to access sensory feedback and account for device properties when planning movements. Accordingly, other domains that depend on these abilities may also be affected. While our work demonstrated some differences in availability of sensory feedback based on prosthesis design, this did not result in consistent differences in prosthesis embodiment, movement accuracy, movement quality, and overall kinematic patterns. Conclusion: Collectively, our findings suggest that performance may not necessarily depend on prosthesis design, allowing users to be successful with either device type depending on the circumstances. Prescription practices should rely more on individual needs and preferences than cost or prosthesis design. However, we acknowledge that there remains a dearth of evidence to inform decision-making and that an expanded research focus in this area will be beneficial. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion Multi‐segmental total en bloc spondylectomy (TES) gradually became more commonly used by clinicians. However, the choice of surgical strategy is unclear. This study aims to investigate the biomechanical performance of different prosthesis types and fixation ranges in multisegmental TES.In this study, a validated finite element model of T12–L2 post‐spondylectomy operations were carried out. The prostheses of these models used either 3D‐printed artificial vertebrae or titanium mesh cages. The fixed range was two or three segment levels. Range of motion, stress distribution of the endplate and internal fixation system, intervertebral disc pressure, and facet joint surface force of four postoperative models and intact model in flexion and extension, as well as lateral bending and rotation were analyzed and compared.The type of prosthesis used in the anterior column reconstruction mainly affected the stress of the adjacent endplate and the prosthesis itself. The posterior fixation range had a greater influence on the overall range of motion (ROM), the ROM of the adjacent segment, the stress of the screw‐rod system, and adjacent facet joint surface force. For the model of the same prosthesis, the increase of fixed length resulted in an obvious reduction of ROM. The maximal decrease was 70.23% during extension, and the minimal decrease was 30.19% during rotation.In three‐segment TES, the surgical strategy of using 3D‐printed artificial prosthesis for anterior column support and pedicle screws for posterior fixation at both two upper and lower levels respectively can reduce the stress on internal fixation system, endplates, and adjacent intervertebral discs, resulting in a reduced risk of internal fixation failure, and ASD development. [ABSTRACT FROM AUTHOR]

Purpose: Three‐level hybrid surgery (HS) consisting of cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) has been partly used for the treatment of multi‐level cervical degenerative disc disease (CDDD). The complications related to the implants and the collapse of the surgical vertebral bodies had been reported in multi‐level anterior cervical spine surgery. Thus, this study aimed to explore the biomechanical effects on the prostheses and vertebrae in three‐level HS. Methods: A FE model of cervical spine (C0‐T1) was constructed. Five surgical models were developed. They were FAF model (ACDF‐CDA‐ACDF), AFA model (CDA‐ACDF‐CDA), FFF model (three‐level ACDF), SF model (single‐level ACDF), and SA model (single‐level CDA). A 75‐N follower load and 1.0‐N·m moment was applied to produce flexion, extension, lateral bending, and axial rotation. Results: Compared with the intact model, the range of motion (ROM) of total cervical spine in FAF model decreased by 34.54%, 54.48%, 31.76%, and 27.14%, respectively, in flexion, extension, lateral bending, and axial rotation, which were lower than those in FFF model and higher than those in AFA model. The ROMs of CDA segments in FAF and AFA models were similar to the intact model and SA model. Compared with the intact model, the ROMs at C3/4 segment in FFF model increased from 5.71% to 7.85%, and increased from 5.31% to 6.81% at C7/T1 segment, following by FAF model, then the FAF model. The maximum interface pressures of the Prestige‐LP in FAF model were similar to SA model, however the corresponding values were increased in AFA model. The maximum interface pressures of the Zero‐P were increased in FAF and AFA model compared with those in SF and FFF models. The stress was mainly distributed on the screws. In AFA model, the maximum pressures of the ball and trough articulation in superior and inferior Prestige‐LP were all increased compared with those in SA and FAF model. In FFF model, the maximum pressures of the vertebrae were higher than those in other models. The stress was mainly distributed on the anterior area of the vertebral bodies. Conclusions: HS seemed to be more suitable than ACDF for the surgical treatment of three‐level CDDD in consideration of the biomechanical effects, especially for the two‐level CDA and one‐level ACDF construct. But a more appropriate CDA prosthesis should be explored in the future. [ABSTRACT FROM AUTHOR]

The distal femur is one of the most common sites for primary bone tumors. As the tumor progresses and bone destruction worsens, it can severely affect knee function and even pose a threat to life. In cases where only one condyle is affected and requires resection, preserving the healthy contralateral condyle can substantially enhance the biomechanics of the knee. Furthermore, preserving bone stock may enable future salvage procedures in the event of initial surgery failure, be it from fractures or osteoarthritis. Distal femoral unicondyle resection can offer better functional outcomes in select cases. However, it is essential to prioritize oncological safety with adequate margins over short‐term knee function. Currently, the primary methods for reconstruction after the excision of a unicondylar tumor include allograft transplantation (bi‐ or uni‐condylar) and prosthetic or allograft‐prosthesis composite replacement (APC). However, there is currently some controversy regarding the optimal surgical reconstruction method, and a consensus within the academic community has yet to be reached. Moreover, due to the rarity of bone tumors, extensive clinical data from a single center is limited. Current studies are mainly retrospective and single‐center, lacking sufficient cases and follow‐up duration. This article reviews surgical reconstruction after solitary condylar excision in distal femoral tumors. It summarizes, compares, and analyzes mainstream reconstruction methods, exploring their technical details and clinical outcomes to highlight their potential in bone oncology. [ABSTRACT FROM AUTHOR]

• An improved prosthesis structure was proposed. • The improved prosthesis can reduce the pressure in the intervertebral disc of the adjacent segment, the contact stress of the facet joint and the artificial prosthesi. Artificial lumbar disc replacement is an effective method for the treatment of lumbosacral degenerative diseases. An appropriate artificial intervertebral disc device is of great significance for the maintenance of spinal stability and activity. Two finite element models of ProDisc-L prosthesis replacement and improved prosthesis replacement were constructed by using the finite element model of complete lumbar L1-L5 segment established by CT image data. The mechanical properties of the surgical models before and after improvement were analyzed and evaluated. The ProDisc-L group and the improved group showed similar lumbar's ROM and maintained a similar ROM with the normal lumbar spine. There was no significant change in the intervertebral disc's pressure between the adjacent segments of the two prosthesis groups compared with the normal group, but the stress value of the improved prosthesis group was slightly lower than that of the ProDisc-L group. In addition, the improved prosthesis replacement has more reasonable stress distribution. Compared with the ProDisc-L prosthesis, the improved prosthesis can reduce the pressure in the intervertebral disc of the adjacent segment, the contact stress of the facet joint and the artificial prosthesis, which provides reference for the subsequent design of the prosthesis structure. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate existing staging recommendations for peri-implantitis and its applicability for auricular bone anchoring. In this cross-sectional study, 44 patients treated with 47 ear epitheses and 128 implants were analyzed over 191.6 months (mean). Peri-implant sulcus depth, sulcus fluid flow rate, and peri-implant skin reaction, as well as cleaning habits and patients' quality of life, were analyzed. Mixed effect linear and mixed effect ordered logistic regression models were used. Two of the 128 implants were lost (1.6 %). A total of 14.5 % of all patients presented light erythemas, 19.4 % showed stage 2, 4.8 % stage 3, and 12.9 % an acute infection according to Holgers. A correlation between skin reaction and sulcus fluid flow rate was observed, when grouping patients with acute signs of inflammation. Concerning patient satisfaction, 58.1 % of the patients were highly satisfied with their epitheses, 39.5 % very satisfied, and one patient was just satisfied. Younger age correlated with lower satisfaction rates. Implant-retained auricular epitheses are a safe, highly sufficient and satisfying way of extending ear reconstruction. Sulcus depth and skin reaction are quick and valuable assessment tools in auricular implants, but skin reaction alone was clinically insufficient to predict peri-implant pocket inflammation. [ABSTRACT FROM AUTHOR]

Chin prosthesis implantation, a cosmetic procedure to correct chin asymmetry, depression, or retraction, is generally safe and simple. However, its long-term effects on surrounding tissues are a concern. This study aimed to use three-dimensional (3D) scanning to classify the mentalis muscle shapes and assess the impact of prosthesis implantation on these muscles. This study evaluated 450 eligible female participants. Using three-dimensional imaging, data on the types, thickness, width, and length of the left and right mentalis muscles were collected and summarized. The impact of chin prosthesis on these muscle dimensions was assessed using analysis of variance, and the effect on muscle type was determined using χ 2 test. Chin implant placement affected the mentalis muscles, resulting in increased length, thickness, and width. The subjects' mentalis muscles were categorized into 3 types and divided into 7 subtypes. χ 2 test results indicated that implantation influences the classification of these muscles. Recognizing how implant placement affects the mentalis muscle can guide the development of treatments to mitigate these changes. Additionally, understanding the muscle's morphology enables more precise treatment approaches for patients. [ABSTRACT FROM AUTHOR]

Background: The company Ethnocare has developed the Overlay, a new pneumatic solution for managing volumetric variations (VVs) of the residual limb (RL) in transtibial amputees (TTAs), which improves socket fitting. However, the impact of the Overlay during functional tasks and on the comfort and pain felt in the RL is unknown. Methods: 8 TTAs participated in two evaluations, separated by two weeks. We measured compensatory strategies (CS) using spatio-temporal parameters and three-dimensional lower limb kinematics and kinetics during gait and sit-to-stand (STS) tasks. During each visit, the participant carried out our protocol while wearing the Overlay and prosthetic folds (PFs), the most common solution to VV. Between each task, comfort and pain felt were assessed using visual analog scales. Results: While walking, the cadence with the Overlay was 105 steps/min, while it was 101 steps/min with PFs (p = 0.021). During 35% and 55% of the STS cycle, less hip flexion was observed while wearing the Overlay compared to PFs (p = 0.004). We found asymmetry coefficients of 13.9% with the Overlay and 17% with PFs during the STS (p = 0.016) task. Pain (p = 0.031), comfort (p = 0.017), and satisfaction (p = 0.041) were better with the Overlay during the second visit. Conclusion: The Overlay's impact is similar to PFs' but provides less pain and better comfort. [ABSTRACT FROM AUTHOR]

Background: This case highlights several complications of a late and rare presentation of culture-negative Streptococcus pyogenes endocarditis of a previously repaired mitral valve with an annuloplasty ring including recurrent cardioembolic strokes, which was initially missed on transthoracic echocardiography. Case presentation: A 66-year-old Caucasian female with prior mitral valve prolapse status post mitral valve annuloplasty and left atrial appendage occlusion, followed by two strokes, presented with supraventricular tachycardia that resolved spontaneously. During an inpatient admission, she developed symptoms of another stroke, and imaging studies were suggestive of recurrent cardioembolic phenomenon. Additional workup revealed two small intra-atrial masses adherent to the mitral annuloplasty ring missed on prior evaluation for recurrent stroke. She underwent surgical repair in the setting of a chronic culture-negative infectious endocarditis with Streptococcus pyogenes and recovered well with no further cardioembolic phenomenon. Conclusion: This case serves to highlight the importance of having a higher index of suspicion in any cardiac prosthesis patient for endocarditis when presenting with symptoms such as recurrent stroke, arrhythmias, and abnormal cardiac lab work. It also demonstrates the need for appropriate imaging with transthoracic echocardiography followed by transesophageal echocardiography and reviews surgical indications to diagnose and treat culture-negative endocarditis. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the present study is to analyze the clinical–radiological outcomes of patients undergoing knee prosthesis revision surgery using constrained condylar prosthesis (LCCK; Zimmer-Biomet). Material and methods: Retrospective study of 89 patients operated on between the years 2008 and 2020 with a minimum of 2 years of follow-up. Clinical outcomes were evaluated using the WOMAC Index score and KOOS scales. Radiological results (radiolucent lines, osteolysis, and cortical hypertrophy) were evaluated by two independent observers. Implant survival was analyzed using the Kaplan–Meier method. Results: At the end of follow-up, a mean WOMAC Index score of 78.67 and KOOS score of 68.8 were obtained. Radiolucent lines (both non-progressive and progressive) were detected in 83.3% of the patients in the sample. Areas of osteolysis > 5 mm around the components were present in 6.75%. Cortical hypertrophy was seen around the femoral stem in 20.3% of cases, around the tibial stem in 20.3% and around both components in 6.76%. No statistically significant relationship was found between the presence of radiolucent lines, osteolysis or cortical hypertrophy with functional results. Implant survival was 88.1% at 13 years. Conclusion: The present study shows high survival of LCCK prosthesis in revision surgery. The progressive radiolucencies, were associated with worst clinical outcome. [ABSTRACT FROM AUTHOR]

Introduction: There are numerous ways to transfer the alignment of a lower-limb prosthesis that have been used and adapted over the last several decades. The proposed glass tracing alignment method (GTAM) allows for a convenient and rapid transfer of prosthetic alignment in the coronal and sagittal planes with minimal equipment requirements. Objective: The aim of this article is to share a novel method for coronal and sagittal plane prosthetic alignment transfer, which may be done with minimal time, materials, and expense. Materials and Methods: Prosthetic alignment may be transferred in part or in whole by tracing the prosthesis in both the coronal and sagittal planes. The prosthesis must first be stabilized on a surface that allows for the prosthetic foot to be traced and is adjacent to a wall surface that allows for tracing of the prosthesis proximal to the foot. The line of progression (LOP) of the prosthesis should be parallel to the edge of the table it is traced upon and in a vertical orientation when tracing the entire prosthesis in the sagittal plane. When tracing the coronal plane alignment, the foot should be oriented vertically and placed in the LOP. Sagittal and coronal tracings should include as much of the prosthesis as possible to insure the most accurate alignment transfer of components. The GTAM was developed to be a clinical complement to traditional alignment transfer methods, which may include use a vertical or horizontal prosthetic alignment transfer jig. Results: Use of the described alignment tracing technique allows for the rapid alignment transfer of prosthetic componentry for a variety of applications. Conclusions: The GTAM proposed is an easy way for a busy practitioner to certify that alignment transfers have been performed correctly or to preserve alignment when replacing elements of a prosthesis for clinical and/or research applications. [ABSTRACT FROM AUTHOR]

Introduction: Electronic versions of patient-reported outcome measures (PROMs) seem to have a clear administrative logging advantage to traditional paper versions. However, most of them have not been formally evaluated for their suitability to replace paper outcome measures for assessment of individuals with lower-limb amputations. The aim of this study is to examine the usability and equivalence of electronic to paper versions of PROMs suitable for use in prosthetic clinical care and research for persons with lower-limb loss. Methods: In this cross-sectional study, 10 participants remotely completed the following PROMs online and then on paper: Orthotic and Prosthetic User Survey (OPUS), Modified Falls Efficacy Scale (MFES), Prosthetic Evaluation Questionnaire (PEQ), Patient Health Questionnaire–9 (PHQ-9), and Community Participation Indicators (CPI). Participants also answered open-ended and standardized questions regarding the usability of the electronic surveys. Wilcoxon signed rank tests, comparisons to minimum detectable change, intraclass correlation coefficients, and Bland-Altman plots were used to evaluate differences between the two survey versions, meaningful changes in scores, reliability, and systematic biases, respectively. Results: Electronic surveys had fewer missing or ambiguous responses than paper surveys; however, the PEQ Social Burdens subscale could not be evaluated due to error in the creation of the electronic survey. No significant differences were found between scores of the two versions for any of the measures, but multiple participants had meaningful changes in the Appearance and Sounds PEQ subscales. All measures demonstrated acceptable reliability between versions, except the Appearance, Perceived Response, and Sounds subscales of the PEQ. No systematic biases in scores or usability concerns were found for any measures. Conclusions: This study analysis showed that most of the electronic PROMs studied are easily used and demonstrate equivalence to the paper versions. However, the PEQ Appearance, Perceived Response, Sounds, and Social Burden subscales require further evaluation. [ABSTRACT FROM AUTHOR]

In orthopedic oncology, total scapulectomy is necessary to allow a wide resection of extended malignancies of the scapula and scapular girdle. Scapular reconstruction is challenging even for the most experienced surgeon. This paper reports our experience with total scapular resections, followed by humeral suspension or custom-made prostheses. In this retrospective study, we evaluated all the oncologic patients treated in our institution between 2016 and 2023 with total scapulectomy and consequential reconstruction using humeral suspension or a custom-made prosthesis. Only cases suffering from malignant bone tumors were included. The postoperative functionality of the treated limbs was assessed using the Musculoskeletal Tumor Society (MSTS) scoring scale. Complications and local recurrences were also recorded. Nine patients were enrolled. Five had custom-made implants, and four had humeral suspensions. The mean postoperative MSTS score of patients treated with custom-made prostheses was 24.0 (22–26). Globally, our cohort's mean MSTS score was 19.1 (9–26). Patients with custom-made prostheses had significantly better functional outcomes (MSTS 24 vs 13) and similar complication rates (40% vs 50%) than those who received humeral suspensions. Our outcomes suggest that, when feasible, custom-made scapular prostheses can represent a reliable reconstructive option after total scapulectomy for malignant scapular tumors. [ABSTRACT FROM AUTHOR]

Background: The knee joint must adapt to the changes in walking speed to stabilize the stance phase and provide fluency in the swing phase. Objective: This study aimed to report a comparison of the gait patterns of transfemoral amputees using a novel mechanical prosthetic knee that can adapt automatically to different walking speeds with 3R60 and 3R15 knee prostheses. Material and Methods: In this experimental study, biomechanical data were collected from six unilateral trans-femoral amputees walking with three knee prostheses. Gait data were gathered at slow, normal, and fast walking speeds across a 7-meter walkway using the Vicon motion system. Results: The results revealed a significant difference in knee angular velocity during the swing phase between prosthetic knees across three walking speeds (P-value=0.002). Prosthetic knee flexion decreased significantly by increasing walking speed for the novel mechanical auto-adaptive prosthetic knee (P-value<0.001). A lower value of hip power during early swing was considered when amputees walked with novel knee prosthesis (P-value<0.00). The intact leg ankle plantar flexion angle or vaulting did not significantly change while walking speed increased in the novel knee prostheses compared to walking with the 3R60 and 3R15 knee prostheses (P-value=0.002 and P-value<0.06, respectively). Conclusion: Based on the results, a novel mechanical auto-adaptive knee prosthesis has advantages compared to the other conventional designs for unilateral trans-femoral amputees walking at different speeds. [ABSTRACT FROM AUTHOR]

Application of additive manufacturing (AM)/three-dimensional (3D) printing has been a very hot area of research in recent years. The fast and easy way to get the desired product and additive function, such as anti-bacterial materials, embedded nano detective sensors. This study reviewed 197 articles on application of AM/3D printing in rehabilitation and healthcare. The distribution of these articles was investigated in terms of journal type, year of publication, methodologies, and research contexts, etc. Based on the use of citation network analysis (CNA), the result shows the selected articles (197 articles) can be divided into two directions, healthcare and rehabilitation, and healthcare monitoring and materials for 3D printing purposes. All of them represent possible opportunities for future research. Further investigation was done by conducting a Main Path Analysis of the articles to draw a map of knowledge structure within each research domain. Finally, future research opportunities and directions are proposed for each research domain, rehabilitation and healthcare. In addition, use of 3D printing materials with antimicrobial properties for healthcare and rehabilitation is having more potential in future research. [ABSTRACT FROM AUTHOR]

Abstract Background Bone and joint infections represent a major public health issue due to their increasing prevalence, their functional prognosis and their cost to society. Phage therapy has valuable anti-biofilm properties against prosthetic joint infections (PJI). The aim of this study was to establish the proportion of patients eligible for phage therapy and to assess their clinical outcome judged against all patients presenting with PJI. Method . Patients admitted for periprosthetic joint infection (PJI) at a French general hospital between 2015 and 2019 were retrospectively included. Eligibility for phage therapy was determined based on French recommendations, with polymicrobial infections serving as exclusion criteria. Patients were categorized into two groups: those eligible and those ineligible for phage therapy. We analyzed their characteristics and outcomes, including severe adverse events, duration of intravenous antibiotic therapy, length of hospitalization, and relapse rates. Results . In this study, 96 patients with PJI were considered in multidisciplinary medical meetings. Of these, 44% patients (42/96) were eligible for additional phage therapy. This group of patients had a longer duration of intravenous therapy (17 days vs. 10 days, p = 0.02), more severe adverse events (11 vs. 3, p = 0.08) and had a longer hospital stay (43 days vs. 18 days, p

Abstract The current primary treatment approach for malignant pelvic tumors involves hemipelvic prosthesis reconstruction following tumor resection. In cases of Enneking type II + III pelvic tumors, the prosthesis necessitates fixation to the remaining iliac bone. Prevailing methods for prosthesis fixation include the saddle prosthesis, ice cream prosthesis, modular hemipelvic prosthesis, and personalized prosthetics using three-dimensional printing. To prevent failure of hemipelvic arthroplasty protheses, a novel fixation method was designed and finite element analysis was conducted. In clinical cases, the third and fourth sacral screws broke, a phenomenon also observed in the results of finite element analysis. Based on the original surgical model, designs were created for auxiliary dorsal iliac, auxiliary iliac bottom, auxiliary sacral screw, and auxiliary pubic ramus fixation. A nonlinear quasi-static finite element analysis was then performed under the maximum load of the gait cycle, and the results indicated that assisted sacral dorsal fixation significantly reduces stress on the sacral screws and relative micromotion exceeding 28 μm. The fixation of the pubic ramus further increased the initial stability of the prosthesis and its interface osseointegration ability. Therefore, for hemipelvic prostheses, incorporating pubic ramus support and iliac back fixation is advisable, as it provides new options for the application of hemipelvic tumor prostheses.

Abstract Background Prosthetic joint infections (PJI) are recalcitrant, hard-to-treat infections and severe complications of joint arthroplasty. Therefore, there is a need to develop new effective treatment strategies, and animal models of high clinical relevance are needed. This study aimed to develop a detailed surgical protocol for hip hemiarthroplasty in Göttingen minipigs and a thorough post-mortem sampling protocol to pave the way for creating a minipig PJI model. Methods Three adult female Göttingen minipigs underwent surgery with insertion of a hip hemiarthroplasty, using the anterior approach to the hip joint. After surgery the minipigs were followed closely with daily clinical evaluation and gait scoring. Comprehensive post-mortem analyses were performed with evaluation of macroscopic lesions, microbiology, synovial fluid analysis and histology. Results The study resulted in the first Göttingen minipig with hip hemiarthroplasty and identified several points of awareness when inserting a hip prosthesis in minipigs, especially the high risk of joint dislocation. A spontaneous PJI occurred in one of the minipigs, revealing an impaired ability of the immune cells to reach the bacteria at the bone-prosthesis interface. Conclusion The present study provides a detailed description of surgical technique and post-mortem sampling and validates the suitability of the hip hemiarthroplasty minipig model for future experimental modeling of PJI.

Summary: Background: Augmentation mammoplasty with subpectoral prosthesis implantation is a frequent performed procedure in plastic surgery for reconstructive and aesthetic purposes. Although prosthesis implantation in a pocket under the major pectoralis muscle has been related to volumetric and functional alterations, there is not much information about the associated short- and long-term histological changes. Therefore, the aim of our study was to describe the acute and chronic histological muscle alterations associated with subpectoral prosthesis implantation. Materials and Method: We collected samples from patients with breast tissue expander (1 year after implantation) and from patients without implantation as a control group. The samples were processed for assessing their histological, histochemical and immunohistochemical properties. Results: In the control group, no relevant histological findings were identified. Additionally, in the patients with expander, we observed mild augmentation of the internalised nuclei, normal morphology, significant muscle atrophy and fibrosis, whereas in the patients with prosthesis considerable augmentation of internalised nuclei, significant muscle atrophy, fibrosis and alteration of normal muscle morphology were observed. Conclusion: Prosthesis implantation induces histological changes in the periprosthetic striated muscle. Chronic fibrosis and inflammation play key roles in this process, which should be characterised in more detail from the histological and molecular biological perspective.

Background: The knee joint must adapt to the changes in walking speed to stabilize the stance phase and provide fluency in the swing phase.Objective: This study aimed to report a comparison of the gait patterns of transfemoral amputees using a novel mechanical prosthetic knee that can adapt automatically to different walking speeds with 3R60 and 3R15 knee prostheses.Material and Methods: In this experimental study, biomechanical data were collected from six unilateral trans-femoral amputees walking with three knee prostheses. Gait data were gathered at slow, normal, and fast walking speeds across a 7-meter walkway using the Vicon motion system.Results: The results revealed a significant difference in knee angular velocity during the swing phase between prosthetic knees across three walking speeds (P-value=0.002). Prosthetic knee flexion decreased significantly by increasing walking speed for the novel mechanical auto-adaptive prosthetic knee (P-value

Objective To explore better methods of ceramic crown design and reduce foreign body sensation of prostheses by digitally replicating the lingual morphology of the original teeth in the patient's aesthetic zone. Methods Patients with anterior tooth defects were collected from July 2022 to December 2023 at Department of Second Clinical Division of the Affiliated Stomatological Hospital, Nanjing Medical University. Patients with crown prostheses designed using automatically matched tooth morphology from the tooth shape database served as the control group. Patients with crown prostheses designed using digital technology to replicate the lingual morphology of the original teeth were used as the experimental group. Differences in occlusal evaluation and foreign body sensation evaluation of the prostheses in the two groups were compared. Results Results showed that the minimal interocclusal distance of the experimental group was greater than that of the control group, and the difference was statistically significant. The occlusal evaluation of the prostheses in the experimental group was better than that of the control group, and the difference was statistically significant. The foreign body sensation of the prostheses in the experimental group was also less than that of the control group. Conclusion Prostheses designed using digital technology to replicate the original lingual morphology of the teeth have a better lingual occlusal relationship with less foreign body sensation and better comfort.

Abstract Background Patient access to body-powered and myoelectric upper limb prostheses in the United States is often restricted by a healthcare system that prioritizes prosthesis prescription based on cost and perceived value. Although this system operates on an underlying assumption that design differences between these prostheses leads to relative advantages and disadvantages of each device, there is limited empirical evidence to support this view. Main text This commentary article will review a series of studies conducted by our research team with the goal of differentiating how prosthesis design might impact user performance on a variety of interrelated domains. Our central hypothesis is that the design and actuation method of body-powered and myoelectric prostheses might affect users’ ability to access sensory feedback and account for device properties when planning movements. Accordingly, other domains that depend on these abilities may also be affected. While our work demonstrated some differences in availability of sensory feedback based on prosthesis design, this did not result in consistent differences in prosthesis embodiment, movement accuracy, movement quality, and overall kinematic patterns. Conclusion Collectively, our findings suggest that performance may not necessarily depend on prosthesis design, allowing users to be successful with either device type depending on the circumstances. Prescription practices should rely more on individual needs and preferences than cost or prosthesis design. However, we acknowledge that there remains a dearth of evidence to inform decision-making and that an expanded research focus in this area will be beneficial.

The distal femur is one of the most common sites for primary bone tumors. As the tumor progresses and bone destruction worsens, it can severely affect knee function and even pose a threat to life. In cases where only one condyle is affected and requires resection, preserving the healthy contralateral condyle can substantially enhance the biomechanics of the knee. Furthermore, preserving bone stock may enable future salvage procedures in the event of initial surgery failure, be it from fractures or osteoarthritis. Distal femoral unicondyle resection can offer better functional outcomes in select cases. However, it is essential to prioritize oncological safety with adequate margins over short‐term knee function. Currently, the primary methods for reconstruction after the excision of a unicondylar tumor include allograft transplantation (bi‐ or uni‐condylar) and prosthetic or allograft‐prosthesis composite replacement (APC). However, there is currently some controversy regarding the optimal surgical reconstruction method, and a consensus within the academic community has yet to be reached. Moreover, due to the rarity of bone tumors, extensive clinical data from a single center is limited. Current studies are mainly retrospective and single‐center, lacking sufficient cases and follow‐up duration. This article reviews surgical reconstruction after solitary condylar excision in distal femoral tumors. It summarizes, compares, and analyzes mainstream reconstruction methods, exploring their technical details and clinical outcomes to highlight their potential in bone oncology.

Purpose Three‐level hybrid surgery (HS) consisting of cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) has been partly used for the treatment of multi‐level cervical degenerative disc disease (CDDD). The complications related to the implants and the collapse of the surgical vertebral bodies had been reported in multi‐level anterior cervical spine surgery. Thus, this study aimed to explore the biomechanical effects on the prostheses and vertebrae in three‐level HS. Methods A FE model of cervical spine (C0‐T1) was constructed. Five surgical models were developed. They were FAF model (ACDF‐CDA‐ACDF), AFA model (CDA‐ACDF‐CDA), FFF model (three‐level ACDF), SF model (single‐level ACDF), and SA model (single‐level CDA). A 75‐N follower load and 1.0‐N·m moment was applied to produce flexion, extension, lateral bending, and axial rotation. Results Compared with the intact model, the range of motion (ROM) of total cervical spine in FAF model decreased by 34.54%, 54.48%, 31.76%, and 27.14%, respectively, in flexion, extension, lateral bending, and axial rotation, which were lower than those in FFF model and higher than those in AFA model. The ROMs of CDA segments in FAF and AFA models were similar to the intact model and SA model. Compared with the intact model, the ROMs at C3/4 segment in FFF model increased from 5.71% to 7.85%, and increased from 5.31% to 6.81% at C7/T1 segment, following by FAF model, then the FAF model. The maximum interface pressures of the Prestige‐LP in FAF model were similar to SA model, however the corresponding values were increased in AFA model. The maximum interface pressures of the Zero‐P were increased in FAF and AFA model compared with those in SF and FFF models. The stress was mainly distributed on the screws. In AFA model, the maximum pressures of the ball and trough articulation in superior and inferior Prestige‐LP were all increased compared with those in SA and FAF model. In FFF model, the maximum pressures of the vertebrae were higher than those in other models. The stress was mainly distributed on the anterior area of the vertebral bodies. Conclusions HS seemed to be more suitable than ACDF for the surgical treatment of three‐level CDDD in consideration of the biomechanical effects, especially for the two‐level CDA and one‐level ACDF construct. But a more appropriate CDA prosthesis should be explored in the future.

Abstract Background This case highlights several complications of a late and rare presentation of culture-negative Streptococcus pyogenes endocarditis of a previously repaired mitral valve with an annuloplasty ring including recurrent cardioembolic strokes, which was initially missed on transthoracic echocardiography. Case presentation A 66-year-old Caucasian female with prior mitral valve prolapse status post mitral valve annuloplasty and left atrial appendage occlusion, followed by two strokes, presented with supraventricular tachycardia that resolved spontaneously. During an inpatient admission, she developed symptoms of another stroke, and imaging studies were suggestive of recurrent cardioembolic phenomenon. Additional workup revealed two small intra-atrial masses adherent to the mitral annuloplasty ring missed on prior evaluation for recurrent stroke. She underwent surgical repair in the setting of a chronic culture-negative infectious endocarditis with Streptococcus pyogenes and recovered well with no further cardioembolic phenomenon. Conclusion This case serves to highlight the importance of having a higher index of suspicion in any cardiac prosthesis patient for endocarditis when presenting with symptoms such as recurrent stroke, arrhythmias, and abnormal cardiac lab work. It also demonstrates the need for appropriate imaging with transthoracic echocardiography followed by transesophageal echocardiography and reviews surgical indications to diagnose and treat culture-negative endocarditis.

Background: Large-diameter head (LDH) total hip arthroplasty (THA) with a monobloc acetabular component improves hip stability. However, obtaining initial press-fit stability is quite challenging in atypical acetabula. The purpose of this study was to assess primary and secondary fixation of monobloc cups in atypical acetabula. Methods: In this consecutive case series, the local arthroplasty database was used to retrospectively identify patients with secondary osteoarthritis who underwent primary hip replacement with press-fit only LDH monobloc acetabular components between 2005 and 2018 and who had a minimum of 2 years of follow-up. Radiographic evaluation was performed at last follow-up, and patient-reported outcome measures (PROMs) were assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Forgotten Joint Score (FJS), and the Patient's Joint Perception (PJP) question. Results: One hundred and six LDH THAs and 19 hip resurfacings were included in the study. Preoperative diagnoses included hip dysplasia (36.8%), Legg-Calve-Perthes disease (32.0%), osteoarthritis with acetabular deficiency (17.6%), periacetabular osteotomy (8.0%), arthrodesis (4.0%), and osteopetrosis (1.6%). After a mean follow-up of 9.2 years, no aseptic loosening of the acetabular component was recorded nor observed on radiologic review. There were 13 (10.4%) revisions unrelated to the acetabular component fixation. The mean WOMAC and FJS scores were 9.2 and 80.9, respectively. In response to the PJP question, 49.4% of the patients perceived their hip as natural, 19.1% as an artificial joint with no restriction, 31.5% as an artificial joint with restriction, and none as a non-functional joint. Conclusion: Primary press-fit fixation of monobloc acetabular components with LDH implanted in atypical acetabula led to secondary fixation in all cases with low revision and complication rates and great functional outcomes. With careful surgical technique and experience, systematic use of supplemental screw fixation is not essential in THA with atypical acetabula. Contexte : L'arthroplastie pour prothèse totale de la hanche (PTH) avec tête de grand diamètre (LDH, pour large-diameter head) et composant acétabulaire monobloc améliore la stabilité de la hanche. Par contre, en présence d'un acétabulum atypique, il est assez difficile d'obtenir une stabilité mécanique directe par effet << press-fit >> (cupule impactée en force dans la cavité acétabulaire préalablement préparée). Cette étude avait pour but d'évaluer la fixation primaire et secondaire de cupules acétabulaires monoblocs en présence d'acétabulums atypiques. Méthodes : Pour cette série de cas consécutifs, nous avons utilisé la base de données locale sur les arthroplasties afin d'identifier rétrospectivement les personnes atteintes d'arthrose secondaire ayant subi entre 2005 et 2018 une arthroplastie primaire pour prothèse de hanche avec composants acétabulaires LDH monoblocs et fixation pressfit uniquement, et qui ont pu être suivis pendant une période d'au moins 2 ans. Au moment du dernier suivi, des radiographies ont été effectuées et nous avons évalué les mesures des résultats déclarés par la patientèle (MRDP) au moyen de l'indice WOMAC (indice d'évaluation de l'arthrose des Universités Western Ontario et McMaster), du score de l'articulation oubliée (FJS, pour Forgotten Joint Score), et de la question sur la perception articulaire PJP (Patient's Joint Perception). Résultats : L'étude a regroupé 106 PTH avec LDH et 19 resurfaçages de la hanche. Les diagnostics préopératoires incluaient dysplasie de la hanche (36,8%), maladie de Legg-Calve-Perthes (32,0%), arthrose avec insuffisance acétabulaire (17,6%), ostéotomie périacétabulaire (8,0%), arthrodèse (4,0%), et ostéopétrose (1,6%). Après un suivi moyen de 9,2 ans, aucun descellement aseptique du composant acétabulaire n'a été signalé ou observé à la radiologie. On a dénombré 13 (10,4%) révisions sans lien avec la fixation du composant acétabulaire. Les scores WOMAC et FJS moyens ont été de 9,2 et 80,9, respectivement. En réponse à la question PJP, 49,4% des personnes ont déclaré avoir la perception d'une hanche naturelle, 19,1% d'une hanche artificielle sans restriction, et 31,5% d'une hanche artificielle avec restriction; aucune des personnes interrogées n'a eu la perception d'une hanche non fonctionnelle. Conclusion : La fixation press-fit primaire de composants acétabulaires monoblocs avec LDH implantés dans des acétabulums atypiques a été suivie d'une fixation secondaire dans tous les cas; les taux de complications et de révisions ont été faibles et les résultats au plan du fonctionnement ont été très bons. Avec une technique chirurgicale minutieuse et de l'expérience, l'ajout systématique de vis de fixation n'est pas essentiel pour la PTH dans les cas d'acétabulums atypiques., Patients may have atypical acetabular anatomy secondary to childhood hip diseases such as developmental dysplasia of the hip (DDH), Legg-Calve-Perthes disease, or other conditions such as septic arthritis, pelvic osteotomy, [...]

The article provides readers with a detailed overview of the AutoMedPrint technology, its advantages and opportunities, based on a number of studies and case examples. The AutoMedPrint system represents a significant advancement in the field of orthopedics, offering a comprehensive solution for the automated design and rapid production of personalized orthopedic and prosthetic devices through 3D printing technology. This paper details the system's capabilities and methodologies behind it, which include the design and manufacturing of various devices such as wrist hand orthoses (WHO) and ankle foot orthoses (AFO), among others. These devices are crafted using data obtained from precise anthropometric measurements, allowing for high customization to meet individual patient needs. The AutoMedPrint system enhances the quality of life for patients by providing devices that are not only functional and cost-effective but also rapidly produced, ensuring timely intervention. Case studies demonstrate the system's effectiveness in practical scenarios, highlighting its potential to revolutionize orthopedic care by integrating new materials and technologies that adapt to changing medical and patient requirements. The discussion extends to the lifecycle of the produced devices, emphasizing sustainability and continuous improvement, ensuring the system's relevance and efficacy in modern medical practice.