OrthoAdjust - Shoulder Balancer

**未满足的需求**：与膝关节和髋关节成形术相比，肩关节置换术(SA)在优化植入物就位和软组织平衡方面是一项具有挑战性的程序。种植体部件在关节臼中的位置不佳容易使种植体变形，微运动增加了松动的风险。因此，在肩部肌肉中预先设定正确的被动张力与实现关节突部件的最佳定位和固定同样重要。目前，关节镜试验期间的软组织张力和被动活动范围(ROM)是使用可互换垫片手动评估的，这是劳动密集型的，并且取决于外科医生的经验。**我们的解决方案：**OrthoAdust使用微型螺线管棘轮螺钉可调机构(高4 mm)，该机构可自动调节关节窝试验表面的高度、节距和滚动，证明了比手动垫片更精细地控制植入位置。OrthoAdjust使用安装在外盖中的悬臂上的传感器同时测量关节-肩部的力量，这有助于患者实现不受限制的无痛活动。**方法：**OrthoAdjust基于微型“皮带扳手”的原理，使用一对带电的微型螺线管，使轮子在来回振荡的动作中旋转，以拧紧或松开螺纹螺钉。反过来，轮子驱动一个丝杠“腿”通过一个孔，将旋转转换为直线驱动。三对致动器构成了一个稳定的三脚架，用于调整表面的俯仰和滚动。**项目组：**将一家大公司(Smith+Nephew)和一家小公司(Marturion-Electronics)结合在一起，在医疗设备、低功率电路和微型致动器方面拥有专业知识。**主要目标/重点**：OrthoAdust的开发从有线实验室演示器(TRL-4)到在肩部身体上测试的无线设备(TRL-6/7)，它既可以作为独立的术中软组织平衡器销售，也可以作为更复杂的机器人辅助程序的附件销售。**有针对性的改进：*微型电磁阀(绕组/直径/电流)*棘轮(直径)*主螺杆(尺寸/螺距)*最佳摩擦力；“拉”和“重置”模式，*试用大小/可扩展性；超小型、小型、中型、大型、*板载电源/数据管理。

**Unmet Need**:Shoulder arthroplasty (SA) is a challenging procedure to perform, compared to knee and hip arthroplasties, in terms of optimizing implant seating and soft tissue balancing. Poor implant component seating in the glenoid predisposes the implant to deformation, and micromotion increasing the risk of loosening. Consequently, pre-setting the correct passive tension in the shoulder muscles is as important as achieving optimum orientation and fixation of the glenoid components. Currently, soft tissue tension and passive range-of-motion (ROM) during glenoid trialing are assessed manually using interchangeable shims to adjust the height of the trial, which is labour-intensive, and dependent upon surgeon experience.**Our Solution:**OrthoAdjust uses a micro-solenoid ratcheting screw adjustable mechanism (<4mm high) that automatically adjusts the height, pitch and roll of the glenoid trial surface proving finer control of implant position than manual shims. OrthoAdjust simultaneously measures glenohumeral forces using sensors attached to cantilevers embedded in the outer cap, which help patient achieve unrestricted pain-free mobility.**Approach:**OrthoAdjust is based upon the principle of a miniature "strap-wrench" using a pair of energized micro-solenoids that ratchet a wheel to rotate in a back-and-forth oscillatory action to either tighten or loosen a threaded screw. In turn, the wheel drives a leadscrew "leg" through a hole converting rotary into linear actuation. Three pairs of actuators create a stable tripod for adjusting the pitch and roll of the surface.**Project team:**brings together a large (Smith+Nephew) and a small company (Marturion-Electronics) with combined expertise in medical devices, low-powered circuits and micro-actuators.**Key Objectives/Focus**:Development of OrthoAdjust from a wired lab-demonstrator(TRL-4) to a wireless device tested on shoulder cadavers(TRL-6/7), which can be marketed as either a standalone intra-operative soft-tissue balancer or an adjunct for more complex robot-assisted procedures.**Targeted Improvements:*** Micro-solenoid (windings/diameter/current)* Ratchet wheel (diameter)* Lead screw (size/pitch)* Optimum frictional forces;"pull" and "reset" mode,* Trial size/scalability;extra-small,small,medium,large,* On-board power/data management.