An article published in The Journal of Bone and Joint Surgery, British Volume demonstrates that in cases where resources are limited and there is a delay from injury to treatment, femoral fractures can heal successfully without stabilisation by external or internal fixation.
The research was based on treatment of patients at a Red Cross Hospital in Kenya where injuries consisted of bullet wounds caused during the current conflict in neighbouring Sudan and therefore there was over 24 hours between injury and treatment owing to the long distances involved and lack of available transport. In current practice it is believed that these wounds must be treated without delay, despite the fact that recent reports have shown that delays up to 24 hours do not affect the outcome.
While the authors do not advocate delaying treatment, of the 52 patients treated for ballistic fractures of the femur three required amputation for persisting infection. 48 of the fractures healed, with 15 patients mobilised early requiring only plaster protection acting as a simple form of functional brace.
With the advances in fractures techniques, methods such as traction and plaster have come to be seen as inadequate, however, the study shows that femoral fractures can heal in times when resources are limited, such as in less developed countries.
Click here to Read the full text article.
Notes
- The Journal of Bone and Joint Surgery - British Volume is a world leading orthopaedics journal with an Impact Factor of 1.868
- JBJS-Br publishes twelve issues a year of high-quality, peer-reviewed research, overseen by an international editorial board led by Editor James Scott
- The Journal was first published in 1948 by The British Editorial Society of Bone and Joint Surgery, a registered charity (No. 209299), with the object of the advancement and improvement of education in orthopaedic surgery and allied branches of surgery and the diffusion of knowledge of new and improved methods of teaching and practicing orthopaedic surgery in all its branches
- You can find out more about The Journal at jbjs.uk
Source
Becky Hall
The Journal of Bone and Joint Surgery - British Volume
среда, 24 августа 2011 г.
воскресенье, 21 августа 2011 г.
Perceptions Of Risk Aggravating Stress Epidemic
Britain is facing a stress epidemic as more than 77% of people surveyed by the British College of Osteopathic Medicine (BCOM) claim that the current risk of economic uncertainty has increased theirs or their partner's stress levels.
A staggering 79% of those same respondents claimed to have lost their job or become aware that they are at risk of losing it within the past 3-6 months, even though, when pushed, only 29% of those respondents could say with any certainty that they or their partner had already lost their job or that they were liable to lose it, highlighting the gap between actual reality and anticipation of what could happen. Asked whether the media portrayal of the economic situation was creating more stress for them almost 79% claimed that it was.
In addition, 72% said that the stress experienced by themselves or their partner was also manifesting itself physically. Asked for the way in which their stress was presenting itself the majority (45%) said they felt depressed, followed by 20% citing insomnia and 9% with 'chronic pain' such as back pain and RSI. Stress-induced headaches and migraine were cited by 8%, and 6% with psoriasis or eczema.
Asked how significant an impact the stress was having on close relationships with family friends 14% said it was 'very significant', followed by 44% claiming it was 'fairly significant'. However, when asked what steps they were taking in order to combat the stress 55% claimed to be focussed more on exercise and healthy diet, followed by 34% who simply said they were 'doing nothing'; 13% said they were using prescribed medication, compared with almost 7% on alternative medication. In terms of physical therapies, massage fared well with almost 13% claiming to use it to manage, and 2% using osteopathy specifically.
When asked what would encourage them to take up a physical therapy to treat their stress 57% said the cost, 44% said better information, 33% said easier access to facilities and 22% said more widely publicised scientific results.
Dr. Ian Drysdale, College Principal, said, "This survey shows not only how the obvious factors of economic uncertainty affect our stress levels, but that the cost of then taking up activities or treatments that could combat the stress is an equally important factor. We hear of so many different treatments out there that all claim to alleviate stress but many of them are still inaccessible to far too many. It also highlights the importance of clearer communication of the benefits of alternative and physical therapies as well as more evidence-based benefits of such therapies"
About BCOM
The British College of Osteopathic Medicine (BCOM) was founded in 1936 by Stanley Lief, the eminent naturopathic osteopath. It is a statutory regulated and accredited training facility, educational charity and centre of excellence in Osteopathic education, regulated by the Osteopaths act of 1993 and accredited by the General Osteopathic Council.
BCOM clinics provide high quality, low-cost treatment based on holistic, or naturopathic, osteopathy. This is a uniquely integrated approach, centring on the treatment and education of our patients not only in terms of their particular problem, but also in the wider context of their lifestyle and its effect on them.
Men, women and children of all ages come to BCOM Clinics for treatment of a wide variety of conditions. Patients are assured of the highest standards of care, with all treatments carried out by clinical students under strict supervision of qualified and experienced osteopaths.
Since its formation in 1936, the British College of Osteopathic Medicine has achieved an international reputation for the professional excellence of its teaching and qualifications. In 2008, BCOM launched its undergraduate Masters in Osteopathy, providing public funding to eligible students.
Source
British College of Osteopathic Medicine
A staggering 79% of those same respondents claimed to have lost their job or become aware that they are at risk of losing it within the past 3-6 months, even though, when pushed, only 29% of those respondents could say with any certainty that they or their partner had already lost their job or that they were liable to lose it, highlighting the gap between actual reality and anticipation of what could happen. Asked whether the media portrayal of the economic situation was creating more stress for them almost 79% claimed that it was.
In addition, 72% said that the stress experienced by themselves or their partner was also manifesting itself physically. Asked for the way in which their stress was presenting itself the majority (45%) said they felt depressed, followed by 20% citing insomnia and 9% with 'chronic pain' such as back pain and RSI. Stress-induced headaches and migraine were cited by 8%, and 6% with psoriasis or eczema.
Asked how significant an impact the stress was having on close relationships with family friends 14% said it was 'very significant', followed by 44% claiming it was 'fairly significant'. However, when asked what steps they were taking in order to combat the stress 55% claimed to be focussed more on exercise and healthy diet, followed by 34% who simply said they were 'doing nothing'; 13% said they were using prescribed medication, compared with almost 7% on alternative medication. In terms of physical therapies, massage fared well with almost 13% claiming to use it to manage, and 2% using osteopathy specifically.
When asked what would encourage them to take up a physical therapy to treat their stress 57% said the cost, 44% said better information, 33% said easier access to facilities and 22% said more widely publicised scientific results.
Dr. Ian Drysdale, College Principal, said, "This survey shows not only how the obvious factors of economic uncertainty affect our stress levels, but that the cost of then taking up activities or treatments that could combat the stress is an equally important factor. We hear of so many different treatments out there that all claim to alleviate stress but many of them are still inaccessible to far too many. It also highlights the importance of clearer communication of the benefits of alternative and physical therapies as well as more evidence-based benefits of such therapies"
About BCOM
The British College of Osteopathic Medicine (BCOM) was founded in 1936 by Stanley Lief, the eminent naturopathic osteopath. It is a statutory regulated and accredited training facility, educational charity and centre of excellence in Osteopathic education, regulated by the Osteopaths act of 1993 and accredited by the General Osteopathic Council.
BCOM clinics provide high quality, low-cost treatment based on holistic, or naturopathic, osteopathy. This is a uniquely integrated approach, centring on the treatment and education of our patients not only in terms of their particular problem, but also in the wider context of their lifestyle and its effect on them.
Men, women and children of all ages come to BCOM Clinics for treatment of a wide variety of conditions. Patients are assured of the highest standards of care, with all treatments carried out by clinical students under strict supervision of qualified and experienced osteopaths.
Since its formation in 1936, the British College of Osteopathic Medicine has achieved an international reputation for the professional excellence of its teaching and qualifications. In 2008, BCOM launched its undergraduate Masters in Osteopathy, providing public funding to eligible students.
Source
British College of Osteopathic Medicine
четверг, 18 августа 2011 г.
Value Of Calcium And Vitamin D Supplements For Older Women
What benefits are there for older women if they take Calcium and Vitamin D supplements? A new study found that a woman's risk of having a hip fracture goes down, but her risk of other types of fractures remain the same. Researchers also found that the supplements did not alter a post-menopausal woman's risk of developing colorectal cancer.
The research was carried out by the Women's Health Initiative, USA.
The study, of 36,000 menopausal women, found a 1% improvement in bone density as a result of taking Calcium and Vitamin D supplements for 7 years. Hip fractures went down 29% (for women over 60 it was 29%).
The study found the benefits were only there for women who took their supplements regularly, at least four days out of every five.
Written by:
The research was carried out by the Women's Health Initiative, USA.
The study, of 36,000 menopausal women, found a 1% improvement in bone density as a result of taking Calcium and Vitamin D supplements for 7 years. Hip fractures went down 29% (for women over 60 it was 29%).
The study found the benefits were only there for women who took their supplements regularly, at least four days out of every five.
Written by:
понедельник, 15 августа 2011 г.
Blue Cross And Blue Shield Companies To Reimburse SBi's Star™ Total Ankle Replacement
Small Bone Innovations, Inc. (SBi) announced today that 38 of the 39 independent member companies of the BlueCross and BlueShield Association will cover SBi's STAR™ Total Ankle Replacement system to benefit an estimated 98.5 million insured in 49 states.
SBi is an orthopedics company focused exclusively on serving patients and their physicians with technologies and treatments for joint replacement (arthroplasty) and post-traumatic reconstruction of the small bones & joints of the thumb, fingers, hand, wrist, elbow, toes, foot and ankle.
According to SBi, more than 90 percent of the approximately 175 million members of commercial insurance plans in the U.S. now have access to the STAR ankle replacement surgery, when deemed clinically appropriate by experienced surgeons.
"The STAR ankle is the first and only total ankle replacement system to have performed successfully in the FDA's rigorous pre-market approval (PMA) process," said James A. Nunley II, MD1, Chief of Orthopaedic Surgery at Duke University Medical Center in Durham, NC. "The compelling clinical data from the prospective, multi-center U.S. Investigational Device Exemption (IDE) STAR Ankle clinical trial, initiated in 2000, has been instrumental in the current stream of favorable coverage decisions by insurers as well as independent non-profit health care institutions." Dr. Nunley is a clinical investigator in the STAR clinical trials who has assisted in SBi's effort to benefit patients by changes in reimbursement policies.
"The STAR ankle is the only total ankle replacement indicated for use as a 'non-cemented' implant to replace painful ankle joints affected by osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis. In the IDE clinical trials, the STAR ankle was deemed superior in efficacy and comparable in safety when compared to fusion, for treating ankle arthritis." Dr. Nunley added.
1 Dr. Nunley is paid consultant to SBi - providing education services.
Source:
Small Bone Innovations, Inc.
SBi is an orthopedics company focused exclusively on serving patients and their physicians with technologies and treatments for joint replacement (arthroplasty) and post-traumatic reconstruction of the small bones & joints of the thumb, fingers, hand, wrist, elbow, toes, foot and ankle.
According to SBi, more than 90 percent of the approximately 175 million members of commercial insurance plans in the U.S. now have access to the STAR ankle replacement surgery, when deemed clinically appropriate by experienced surgeons.
"The STAR ankle is the first and only total ankle replacement system to have performed successfully in the FDA's rigorous pre-market approval (PMA) process," said James A. Nunley II, MD1, Chief of Orthopaedic Surgery at Duke University Medical Center in Durham, NC. "The compelling clinical data from the prospective, multi-center U.S. Investigational Device Exemption (IDE) STAR Ankle clinical trial, initiated in 2000, has been instrumental in the current stream of favorable coverage decisions by insurers as well as independent non-profit health care institutions." Dr. Nunley is a clinical investigator in the STAR clinical trials who has assisted in SBi's effort to benefit patients by changes in reimbursement policies.
"The STAR ankle is the only total ankle replacement indicated for use as a 'non-cemented' implant to replace painful ankle joints affected by osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis. In the IDE clinical trials, the STAR ankle was deemed superior in efficacy and comparable in safety when compared to fusion, for treating ankle arthritis." Dr. Nunley added.
1 Dr. Nunley is paid consultant to SBi - providing education services.
Source:
Small Bone Innovations, Inc.
пятница, 12 августа 2011 г.
Kiadis Pharma Announces Positive Clinical Results For ATIR(TM) In Mismatched Bone Marrow Transplantations
Biopharmaceutical company Kiadis Pharma announces that it has successfully completed treatment of the last patient on its ATIR(TM) phase I/II clinical trial. ATIR(TM), a donor lymphocyte cell based product, is under development to prevent acute Graft versus Host Disease (GvHD) and allow early immune reconstitution following a mismatched bone marrow transplantation. Nineteen end stage blood cancer patients were treated with no cases of grade III/IV acute GvHD occurring within the first 100 days after ATIR(TM) infusion, showing the feasibility and tolerability of the addition of ATIR(TM) in combination with a mismatched transplant procedure.
Following scientific advice from the EMEA Kiadis Pharma is preparing to initiate a multi center multinational pivotal study starting recruitment early 2009. In this study the efficacy of ATIR(TM) will be investigated in patients diagnosed with AML, ALL or MDS eligible for an allogeneic bone marrow transplantation but for whom no matching donor is available.
"Bone marrow transplantations are often the only treatment option left for end-stage blood cancer patients. But too many patients simply do not find a suitable matched donor in time" says Dr. Denis-Claude Roy of the Maisonneuve-Rosemont Hospital in Montreal, the principal investigator on the study. "Our study shows a rapid immune reconstitution in transplanted patients provided with ATIR(TM) treated immune cells from mismatched donors. Without ATIR(TM) treatment this would not be possible because of the high risk of acute Graft versus Host Disease with mismatched donor immune cells. This is obviously a very hopeful development for a large patient group."
Dr. Manja Bouman, CEO of Kiadis Pharma, says "The results of this clinical trial are very encouraging and it is another important milestone in the development of ATIR(TM) as a novel approach which may enable a safe and potentially life-saving mismatched bone marrow transplantation as a treatment option for end-stage blood cancer patients."
For the complete press release please go to: kiadis/news
English release is provided by Kiadis Pharma. Equivalent translations are from a third party.
Kiadis Pharma
kiadis
Following scientific advice from the EMEA Kiadis Pharma is preparing to initiate a multi center multinational pivotal study starting recruitment early 2009. In this study the efficacy of ATIR(TM) will be investigated in patients diagnosed with AML, ALL or MDS eligible for an allogeneic bone marrow transplantation but for whom no matching donor is available.
"Bone marrow transplantations are often the only treatment option left for end-stage blood cancer patients. But too many patients simply do not find a suitable matched donor in time" says Dr. Denis-Claude Roy of the Maisonneuve-Rosemont Hospital in Montreal, the principal investigator on the study. "Our study shows a rapid immune reconstitution in transplanted patients provided with ATIR(TM) treated immune cells from mismatched donors. Without ATIR(TM) treatment this would not be possible because of the high risk of acute Graft versus Host Disease with mismatched donor immune cells. This is obviously a very hopeful development for a large patient group."
Dr. Manja Bouman, CEO of Kiadis Pharma, says "The results of this clinical trial are very encouraging and it is another important milestone in the development of ATIR(TM) as a novel approach which may enable a safe and potentially life-saving mismatched bone marrow transplantation as a treatment option for end-stage blood cancer patients."
For the complete press release please go to: kiadis/news
English release is provided by Kiadis Pharma. Equivalent translations are from a third party.
Kiadis Pharma
kiadis
вторник, 9 августа 2011 г.
Camping Injuries Can Be A Bear
Camping, hiking, and other similar activities are great ways to get fresh air, exercise and recreation all at the same time; however, they also offer the potential for serious injuries if campers do not take care. If you plan to head back to nature before summer's end or as the leaves change colors in the fall, the American Academy of Orthopaedic Surgeons (AAOS) has recommendations to help you stay safe while camping in the great outdoors.
According to the U.S. Consumer Products Safety Commission:
-- In 2007, more than 11,000 people were treated in hospital emergency rooms, doctors' offices, clinics and other medical settings for injuries sustained while camping.
-- These numbers do not include those injured while using cots, trailers, stoves, and other camping equipment.
Musculoskeletal injuries can include:
-- Sprains
-- Fractures of the ankle and wrist
-- Shoulder strains and lacerations
"You should always try to camp with at least one partner, so if someone gets hurt, the other person can help," says John D. Kelly, IV, MD, spokesperson for the AAOS and an orthopaedic surgeon in Philadelphia. "Also, before you leave for the camping trip, be sure to notify someone at home where you are going and when you expect to return."
The Academy offers the following strategies to prevent injuries while camping:
-- Bring a first aid kit and understand how to use its contents.
Suggested items for a first kit include: clean dressings and adhesives, antibiotic ointment, sterile gauze, simple splinting materials two wooden sticks with an sports elastic bandage should be suffice, a smoke flare, a chemical ice pack, a small-utility knife, a charged cell phone or other communication device.
Camping and hiking often involve rough terrain, making slips and falls common.
o Be sure to wear the right footwear, especially hiking boots, which offer support and traction.
If a camper or hiker twists an ankle:
-- Apply compression in the form of a wrap
-- If available, apply ice and elevate the limb
-- Try to walk sparingly.
Should a severe cut or laceration occur:
-- Apply direct pressure to control bleeding and use tap water to rinse the wound thoroughly.
-- If dressings are available, apply to the wound otherwise a clean cloth will suffice.
If a camper or hiker sprains a muscle, it should be wrapped and iced.
Should a sprain to the wrist or a fracture occur, you should apply an ice pack and immobilize the area with a splint.
Other important camping tips:
-- Be aware of potentially harmful animals or plants in the area and know what to do if injured by one.
-- Stay well hydrated.
-- Drink plenty of water, even if the weather is not hot.
-- Learn to recognize the signs of dehydration.
-- Wear sunscreen and insect repellent.
-- Use tools only for their intended purpose, for example:
-- Using a knife to open a can or cut wood can result in a serious laceration.
Mountain biking, rafting and kayaking can be dangerous. Do not attempt activities or stunts that are beyond your ability. Be sure protective gear, such as helmets, gloves and shoes fit properly and are appropriate to the activity.
o Bring appropriate clothing for the climate, keeping in mind that weather can change drastically between day and night. Check weather forecasts before you go.
Finally, please keep in mind that these tips are especially important when camping with children, who are more likely to get lost and are more susceptible to dehydration and other common camping injuries.
Tips to prepare for an emergency or disaster (orthoinfo.aaos/topic.cfm?topic=A00059)
Orthoinfo (orthoinfo)
American Academy of Orthopaedic Surgeons (AAOS)
6300 N River Rd.
Rosemont, IL 60018
United States
aaos
According to the U.S. Consumer Products Safety Commission:
-- In 2007, more than 11,000 people were treated in hospital emergency rooms, doctors' offices, clinics and other medical settings for injuries sustained while camping.
-- These numbers do not include those injured while using cots, trailers, stoves, and other camping equipment.
Musculoskeletal injuries can include:
-- Sprains
-- Fractures of the ankle and wrist
-- Shoulder strains and lacerations
"You should always try to camp with at least one partner, so if someone gets hurt, the other person can help," says John D. Kelly, IV, MD, spokesperson for the AAOS and an orthopaedic surgeon in Philadelphia. "Also, before you leave for the camping trip, be sure to notify someone at home where you are going and when you expect to return."
The Academy offers the following strategies to prevent injuries while camping:
-- Bring a first aid kit and understand how to use its contents.
Suggested items for a first kit include: clean dressings and adhesives, antibiotic ointment, sterile gauze, simple splinting materials two wooden sticks with an sports elastic bandage should be suffice, a smoke flare, a chemical ice pack, a small-utility knife, a charged cell phone or other communication device.
Camping and hiking often involve rough terrain, making slips and falls common.
o Be sure to wear the right footwear, especially hiking boots, which offer support and traction.
If a camper or hiker twists an ankle:
-- Apply compression in the form of a wrap
-- If available, apply ice and elevate the limb
-- Try to walk sparingly.
Should a severe cut or laceration occur:
-- Apply direct pressure to control bleeding and use tap water to rinse the wound thoroughly.
-- If dressings are available, apply to the wound otherwise a clean cloth will suffice.
If a camper or hiker sprains a muscle, it should be wrapped and iced.
Should a sprain to the wrist or a fracture occur, you should apply an ice pack and immobilize the area with a splint.
Other important camping tips:
-- Be aware of potentially harmful animals or plants in the area and know what to do if injured by one.
-- Stay well hydrated.
-- Drink plenty of water, even if the weather is not hot.
-- Learn to recognize the signs of dehydration.
-- Wear sunscreen and insect repellent.
-- Use tools only for their intended purpose, for example:
-- Using a knife to open a can or cut wood can result in a serious laceration.
Mountain biking, rafting and kayaking can be dangerous. Do not attempt activities or stunts that are beyond your ability. Be sure protective gear, such as helmets, gloves and shoes fit properly and are appropriate to the activity.
o Bring appropriate clothing for the climate, keeping in mind that weather can change drastically between day and night. Check weather forecasts before you go.
Finally, please keep in mind that these tips are especially important when camping with children, who are more likely to get lost and are more susceptible to dehydration and other common camping injuries.
Tips to prepare for an emergency or disaster (orthoinfo.aaos/topic.cfm?topic=A00059)
Orthoinfo (orthoinfo)
American Academy of Orthopaedic Surgeons (AAOS)
6300 N River Rd.
Rosemont, IL 60018
United States
aaos
суббота, 6 августа 2011 г.
For Orthopedic Injuries, A Robot That Follows Patients As They Move
The MRI and CT scan may one day have a robotic cousin capable of following and peering into patients as they move around.
A University of Florida engineer has designed a robot to shadow and shoot X-ray video of sufferers of orthopedic injuries as they walk, climb stairs, stand up from a seated position or pursue other normal activities - and maybe even athletic ones like swinging a bat.
UF mechanical and aerospace engineer Scott Banks' goal is to augment static images of patients' bones, muscles and joints with an interior view of these and other parts in action during normal physical activity. By merging such full-motion X-rays with computerized representations, orthopedic surgeons will make better diagnoses, suggest more appropriate treatments and get a clearer idea of post-operative successes and failures, he said.
"Our goal is come up with a way to observe and measure how joints are moving when people are actually using them," Banks said. "We think this will be tremendously powerful, not only for research but also in the clinical setting as well."
Complaints about orthopedic injuries are among the most common reasons people visit the doctor, according to the American Academy of Orthopedic Surgeons. More than 8 million people were hospitalized in 2003 for musculoskeletal conditions or injuries, which are estimated to cost the United States at least $215 billion annually.
Orthopedic surgeons have long diagnosed patients by touch or with static X-rays, MRI and CT scans. They also may use X-ray video, but current technologies provide only a tight view of a very limited range of motion in a controlled laboratory setting.
While all of these techniques can be effective, they do not work well with injuries that manifest themselves when a joint is in motion, Banks said. These include, for example, injuries to the patella, or kneecap, and injuries of the shoulder. Surgeons sometimes have to operate to diagnose these and other injuries, which can lead to unnecessary surgeries.
After operations, surgeons have few tools beyond the patient's experience to tell them whether a procedure worked as intended and whether it will forestall additional joint damage.
Banks hopes his robot - actually, a system that uses two robots because one robot will be necessary to shoot the X-ray video and another to hold the image sensor -- will lead to a radical improvement.
He has one working robot currently. The robot, which has a one-meter mechanical arm, is a commercial product normally used in robotically assisted surgeries and silicon chip manufacturing that Banks and his graduate students have re-engineered. The robot can shadow a person's knee, shoulder or other joint with its hand as he or she moves.
In its completed form, the hand will hold lightweight equipment capable of shooting X-rays, while another robot will hold the sensor that captures images of the body as moving videos. Although the robots will be attached to a fixed base, there is room for a person to move around normally within their reach. And in the future, said Banks, "we could put these robots on wheels and they could follow you around."
For now, the single robot holds a standard video camera.
To use it, a patient wears an LED-lit patch on the body part that is intended for targeting. The patch, several cameras placed around the room and a networked computer command the robots to hone in on and track the joint.
In a slightly spooky demonstration, using a graduate student instead of a patient, the camera-tipped hand followed the student's thigh as he walked and otherwise moved normally. While the hand appeared accurate to the untrained eye, Banks said the video image, which included shots of the student's jeans, showed that it couldn't yet track the small LED patch with the accuracy needed for video X-ray.
Improving the accuracy is one of several challenges that remain in the project, Banks said. He has applied for a $275,000 grant from the National Institutes of Health to continue the work. UF has also applied for a patent on the new imaging technique, and Banks said it's possible that it could become standard equipment in hospitals.
Mike Moser, a UF orthopedic surgeon working with Banks on the project, said he thinks the robot system would be very useful to surgeons.
"The biggest thing that this technology could offer in treating orthopedic injuries is that it has the ability to visualize joint motion dynamically, as it changes," he said. "I think this would be good for many different conditions of the shoulder, knee, elbow and ankle. And I think it could be extrapolated to pretty much any orthopedic injury or condition."
Scott Banks
banksufl
University of Florida
ufl
A University of Florida engineer has designed a robot to shadow and shoot X-ray video of sufferers of orthopedic injuries as they walk, climb stairs, stand up from a seated position or pursue other normal activities - and maybe even athletic ones like swinging a bat.
UF mechanical and aerospace engineer Scott Banks' goal is to augment static images of patients' bones, muscles and joints with an interior view of these and other parts in action during normal physical activity. By merging such full-motion X-rays with computerized representations, orthopedic surgeons will make better diagnoses, suggest more appropriate treatments and get a clearer idea of post-operative successes and failures, he said.
"Our goal is come up with a way to observe and measure how joints are moving when people are actually using them," Banks said. "We think this will be tremendously powerful, not only for research but also in the clinical setting as well."
Complaints about orthopedic injuries are among the most common reasons people visit the doctor, according to the American Academy of Orthopedic Surgeons. More than 8 million people were hospitalized in 2003 for musculoskeletal conditions or injuries, which are estimated to cost the United States at least $215 billion annually.
Orthopedic surgeons have long diagnosed patients by touch or with static X-rays, MRI and CT scans. They also may use X-ray video, but current technologies provide only a tight view of a very limited range of motion in a controlled laboratory setting.
While all of these techniques can be effective, they do not work well with injuries that manifest themselves when a joint is in motion, Banks said. These include, for example, injuries to the patella, or kneecap, and injuries of the shoulder. Surgeons sometimes have to operate to diagnose these and other injuries, which can lead to unnecessary surgeries.
After operations, surgeons have few tools beyond the patient's experience to tell them whether a procedure worked as intended and whether it will forestall additional joint damage.
Banks hopes his robot - actually, a system that uses two robots because one robot will be necessary to shoot the X-ray video and another to hold the image sensor -- will lead to a radical improvement.
He has one working robot currently. The robot, which has a one-meter mechanical arm, is a commercial product normally used in robotically assisted surgeries and silicon chip manufacturing that Banks and his graduate students have re-engineered. The robot can shadow a person's knee, shoulder or other joint with its hand as he or she moves.
In its completed form, the hand will hold lightweight equipment capable of shooting X-rays, while another robot will hold the sensor that captures images of the body as moving videos. Although the robots will be attached to a fixed base, there is room for a person to move around normally within their reach. And in the future, said Banks, "we could put these robots on wheels and they could follow you around."
For now, the single robot holds a standard video camera.
To use it, a patient wears an LED-lit patch on the body part that is intended for targeting. The patch, several cameras placed around the room and a networked computer command the robots to hone in on and track the joint.
In a slightly spooky demonstration, using a graduate student instead of a patient, the camera-tipped hand followed the student's thigh as he walked and otherwise moved normally. While the hand appeared accurate to the untrained eye, Banks said the video image, which included shots of the student's jeans, showed that it couldn't yet track the small LED patch with the accuracy needed for video X-ray.
Improving the accuracy is one of several challenges that remain in the project, Banks said. He has applied for a $275,000 grant from the National Institutes of Health to continue the work. UF has also applied for a patent on the new imaging technique, and Banks said it's possible that it could become standard equipment in hospitals.
Mike Moser, a UF orthopedic surgeon working with Banks on the project, said he thinks the robot system would be very useful to surgeons.
"The biggest thing that this technology could offer in treating orthopedic injuries is that it has the ability to visualize joint motion dynamically, as it changes," he said. "I think this would be good for many different conditions of the shoulder, knee, elbow and ankle. And I think it could be extrapolated to pretty much any orthopedic injury or condition."
Scott Banks
banksufl
University of Florida
ufl
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