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Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured.
The following types of contributions and areas are considered:
1. Original articles:
Technology development in medicine: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine.
Significance of medical technology and informatics for healthcare: The appropriateness, efficacy and usefulness deriving from the application of engineering methods, devices and informatics in medicine and with respect to public health are discussed.
2. Technical notes:
Short communications on novel technical developments with relevance for clinical medicine.
3. Reviews and tutorials (upon invitation only):
Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented.
4. Minisymposia (upon invitation only):
Under the leadership of a Special Editor, controversial issues relating to healthcare are highlighted and discussed by various authors.
Abstract: BACKGROUND: The number of patients requiring a total knee arthroplasty (TKA) is increasing and postoperative care is an important factor for the recovery of knee function. It is discussed controversially, if the benefits of controlled active motion (CAM) therapies are comparable to continuous passive motion (CPM) therapies. OBJECTIVE: Comparison of postoperative outcomes using a device in CAM and CPM settings, in addition to standard physiotherapeutical exercises immediately after TKA. METHODS: TKA patients were randomized to either CAM or CPM therapy performed with an identical device (ARTROMOT ® ACTIVE-K, Ormed…GmbH). All patients received an additional physiotherapeutic program. Pain, knee associated problems (KOOS), active range of motion (ROM), and adverse events were documented before surgery, during the stationary stay and after an outpatient period. RESULTS: We included 50 patients (70 ± 8 years). During the postoperative period, KOOS scales improved significantly in both groups, but the CAM group showed a significantly better improvement of pain and quality of life scale. Furthermore, postoperative course of pain intensity and knee flexion was significantly better in the CAM group. CONCLUSIONS: CAM and CPM lead to significant improvements after TKA, but CAM shows better results in terms of flexion, pain and quality of life.
Keywords: CAM, CPM, TKA, continuous passive motion, controlled active motion
Abstract: BACKGROUND: Incongruity in the evaluation of outcomes between patients and surgeons has led to an increasing utilization of patient-reported outcome measures (PROMs) as an evaluation method of outcome. OBJECTIVE: The aim of this study was to compare Oxford Knee Score (OKS), KOOS-PS and Kujala Score results in patients who received either PFA or TKA with and without patella resurfacing in the tretament of knee osteoarthritis. METHODS: A total of 50 patients (PFA = 19 patients; TKA with patelloplasty = 15 patients; TKA with patellar resurfacing =…16 patients) undergone surgery between 2011 and 2014 and were included for final analysis. RESULTS: No statistical significance was found for OKS, KOOS-PS and Kujala scores between the three groups. However, although patients with PFA experienced higher levels of pain. CONCLUSIONS: According to our results, it is essential to discuss the treatment options and quality of life expectations with the patient prior joint replacement surgery in order to reduce patient dissatisfaction. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
Keywords: PROMS, patellofemoral, total knee arthroplasty, outcome, failure, patella resurfacing
Abstract: BACKGROUND: Exact positioning of implants and accuracy of alignment are important parameters to provide an long survivorship of endoprostheses after total knee arthroplasty. It was suggested that an alignment within 3 ∘ from centerline provides the best long-term survivorship of TKA. Therefore, computer-assisted navigation became more important in TKAs. Another tool to improve the accuracy in TKA is the preoperative planning software. OBJECTIVE: Main goal was to determine if advantages of an intraoperative navigation system during TKA can be reached by an exact implementation of a preoperative computer-aided planning. METHODS:…Based on all patients (n = 100) underwent primarily TKA in 2015 and 2016 two groups were declared: (1) conventionally operated TKA without navigation system and (2) operation with an optical navigation system. Data on age, sex, date, operative time, severe complications and preoperative vs. postoperative alignment were collected retrospectively. RESULTS: The two groups do not differ in postoperative alignment and frequency of outliers. Furthermore, there was no difference referring to complications and the length of stay in hospital, but operative time was prolonged in the navigation-assisted group. CONCLUSIONS: It can be stated that conventional surgical techniques in TKA are as accurate as navigated ones if an exact preoperative computer aided planning is implemented during surgery.
Keywords: Computer-aided planning, total knee arthroplasty, TKA, intraoperative navigation
Abstract: BACKGROUND: An increasing demand for total knee arthroplasty (TKA) has pushed innovations in the industry and created a promising new technique called patient specific instruments (PSI). Early reports had promising results such as reducing operative time, cost, and improved alignment. More recent reports are conflicting. OBJECTIVE: We aimed to evaluate bleeding, operative time, complication rates, and in-hospital stay. METHODS: A monocentric retrospective analysis was performed on a total of 961 patients that met inclusion criteria. Four different TKA Systems, two of which were performed using conventional instrumentation (CI) (n =…768) and two with PSI (n = 193) were trialed under the same conditions by three senior surgeons. Operative time, complications, bleeding, range of motion, and length of stay were analyzed. RESULTS: There was no difference in operative time (p = 0.991) and length of hospital stay (p = 0.371) between PSI and CI approaches. Complication rates were lower in the PSI group. CI patients showed less non-compensated blood loss (p < 0.001) but required more transfusions (5.8% vs. 1.5%, p = 0.014). CONCLUSIONS: There was no difference in duration of surgery, length of stay, and total blood loss when performing TKA with PSI or CI. There were fewer complications in the PSI group. It remains debatable whether these findings justify routine use of PSI in TKA.
Abstract: BACKGROUND: Out-of-hospital cardiac arrest is common in public locations, including public transportation sites. Feedback devices are increasingly being used to improve chest-compression quality. However, their performance during public transportation has not been studied yet. OBJECTIVE: To test two CPR feedback devices representative of the current technologies (accelerometer and electromag- netic-field) in a long-distance train. METHODS: Volunteers applied compressions on a manikin during the train route using both feedback devices. Depth and rate measurements computed by the devices were compared to the gold-standard values. RESULTS: Sixty-four 4-min records were acquired. The…accelerometer-based device provided visual help in all experiments. Median absolute errors in depth and rate were 2.4 mm and 1.3 compressions per minute (cpm) during conventional speed, and 2.5 mm and 1.2 cpm during high speed. The electromagnetic-field-based device never provided CPR feedback; alert messages were shown instead. However, measurements were stored in its internal memory. Absolute errors for depth and rate were 2.6 mm and 0.7 cpm during conventional speed, and 2.6 mm and 0.7 cpm during high speed. CONCLUSIONS: Both devices were accurate despite the accelerations and the electromagnetic interferences induced by the train. However, the electromagnetic-field-based device would require modifications to avoid excessive alerts impeding feedback.
Abstract: BACKGROUND: Measuring body weight (BW) for bedridden patients often presents difficulty and challenge. OBJECTIVES: The present study aimed at providing a self-designed indirect method to predict BW by measuring weight underneath the buttock (WUB) of an individual in supine position, thereby providing an easy, safe and effective way of BW measurement for bedridden patients. METHODS: A total of 180 subjects participated in the present study and agreed to have their BW and WUB to be measured. BW was measured normally at the standing position through an electronic weighing machine without any special requirement.…By placing the electronic weighing machine under the subject’s buttock along with an additional hard board set under the electronic weighing machine, WUB was measured in subjects who were asked to assume a supine position in beds to simulate conditions of bedridden individuals. Measurement was repeated thrice to minimise the test error. RESULTS: Average BW (62.7 ± 11.7 kg) was 2.0 ± 0.1 (≈ 2) folds of WUB (31.4 ± 6.0 kg). Significant linear correlation was identified between BW and WUB in all subjects with a linear equation yielded (y = 1.8 x + 6.0). Further multiple regression analysis resulted in an equation of BW (kg) = - 36.8 + 1.66*WUB (kg) + 29.0*height (m). Predicted BW (PBW) was calculated out based on the results described above: the multiple relationship (2 folds), the linear equation, and the multiple regression equation, and differed from the measured BW by 3.6 ± 2.8, 3.5 ± 2.7 and 4.2 ± 3.1 kg respectively. CONCLUSIONS: Predicting BW through WUB in supine position is effective and reliable because the latter can be easily measured and features a strong linear relationship with BW. This method provides clinical staff with remarkable benefits in BW determination for bedridden patients.
Abstract: Knee pain is one of the main health issues faced by different people in different parts of the world. Over one fourth of the people above the age of fifty suffer from knee pain. Though there are several physiotherapy treatments for treating knee pain they are not self-applicable and those which are self-applicable by the patient are not highly efficient. This paper deals with an approach towards the use of combining two effective physiotherapy treatments which include vibrations at acupressure points on knee and alternate heating and cooling treatments. These treatments are controlled by a smart phone in which the…user can choose their setting depending on intensity and places of pain. The knee pad controlled using the smart phone serves as a self-applicable and effective knee pain treatment especially for the elderly. Heating and cooling combination therapy will be a suitable alternative for treatment of musculoskeletal diseases, decreases muscle spasms, muscular pain/tension and also increases the speed of nerve conduction, thus improving range of motion. This methodology also helps to relieve the sinusitis pain, chronic low back pain and muscular sprain in athletes.
Keywords: Knee, self-applicable, physiotherapy, alternate heating and cooling, vibration, pressure points, smart phone, knee pad
Abstract: BACKGROUND: This experiment was designed to study the respective effects of the closed-state human palm and dynamic arm bending on intra-body communication channel attenuation. METHODS: We selected the right upper arm of a healthy adult male as the experimental object to measure channel attenuation variation in a closed or open palm, and when the arm was bent, so as to analyze channel characteristics. CONCLUSIONS: The experiment showed that, in a quasi-static stable system, the effects of a closed palm on channel attenuation were negligibly minimal. In contrast, the physiological signal of the living…body significantly interfered with the channel in the low-frequency mode. In the dynamic arm-bending experiment, we found that the attenuation variation range corresponds to the intersection angle (90 ∘ ⩽ θ ⩽ 180 ∘ ) of the upper arm and forearm; these results provide the basis for the establishment of a theoretical model.
Abstract: BACKGROUND: Thermography is a safe, painless, and efficient method for checking the temperature of the skin. OBJECTIVE: Was to assess the pattern of skin temperature of healthy men, as well as to verify the reproducibility of the method. METHODS: This cross-sectional observational study was conducted with 30 men evaluated by thermography in two moments by using an infrared camera (FLIR +T650SC ® ). The skin temperature of 24 regions of interest (ROI) was measured. RESULTS: The mean difference in temperature of 10 ROIs in the two…evaluations was not statistically significant. The comparisons of the Δ Tsk between the right and left sides by the two evaluations showed no differences. The intra-class correlation coefficient (ICC) between the two moments of evaluation were statistically significant, where the dorsal measurements (Left forearm and Right dorsal arm) showed poor correlations and the others ranged from moderate to strong. Greater reproducibility was confirmed for ventral and dorsal hand ROIs; however, they presented the highest coefficient of variation (9% and 8%).Conclusion: There is a similarity between the temperatures of the ROIs and the reproducibility in 22 of the 24 ROIs varies from moderate to strong, showing that thermography is a reproducible method in healthy men.
Abstract: This technical note describes an effective method for monitoring temperature based on the minimum curvature surface fitting (MCSF) referenceless proton resonance frequency shift (PRFs) at 0.35 T. Experimental tests on phantom, ex vivo porcine livers and human brain were conducted. A comparison study between the proposed method and a fiber optic temperature probe was conducted for microwave (MW) ablation. Experimental results showed that temperature root mean square error (RMSE) calculated by MCSF model were lower than those computed by high-order polynomial fitting. For ablation experiments, the temperature errors between temperature probe and MCSF method were all less than 2 ∘…C.