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Biomedical subjects

B K Bay

Publications and source records attributed to B K Bay.

At least 19 recordsLinked to original sources
PubMed2006

The influence of pedicle screw placement on thoracic trabecular strain.

STUDY DESIGN: Experimental study. INTRODUCTION: Although pedicle screw loosening and fracture are not uncommon, there is little understanding of the loading relationship between the pedicle screw and surrounding bone. There is even less understanding of the trabecular bone mechanics one a pedicle screw has been removed. OBJECTIVES: To investigate and understand the influence of the presence of pedicle screw placement and subsequent removal on vertebral trabecular strain under axial loading. SETTING: Orthopaedic Research Laboratories, University of California, Davis, USA. METHODS: Six cadaver spines were biomechanically loaded and the minimum principal and maximum shear strains were measured using texture correlation. The treatments were divided into three conditions as follows: (1) before screw placement, (2) during screw placement, and (3) after screw removal. The obtained data were statistically analyzed. RESULTS: Trabecular strain adjacent to the pedicle screw was increased following pedicle screw placement and remained high following pedicle screw removal. CONCLUSIONS: The current study demonstrates that pedicle screw placement greatly influences the trabecular bone and introduces weakness in the area following screw removal.

Aged↗
PubMed2006

Comparison of the linear finite element prediction of deformation and strain of human cancellous bone to 3D digital volume correlation measurements.

The mechanical properties of cancellous bone and the biological response of the tissue to mechanical loading are related to deformation and strain in the trabeculae during function. Due to the small size of trabeculae, their motion is difficult to measure. To avoid the need to measure trabecular motions during loading the finite element method has been used to estimate trabecular level mechanical deformation. This analytical approach has been empirically successful in that the analytical models are solvable and their results correlate with the macroscopically measured stiffness and strength of bones. The present work is a direct comparison of finite element predictions to measurements of the deformation and strain at near trabecular level. Using the method of digital volume correlation, we measured the deformation and calculated the strain at a resolution approaching the trabecular level for cancellous bone specimens loaded in uniaxial compression. Smoothed results from linearly elastic finite element models of the same mechanical tests were correlated to the empirical three-dimensional (3D) deformation in the direction of loading with a coefficient of determination as high as 97% and a slope of the prediction near one. However, real deformations in the directions perpendicular to the loading direction were not as well predicted by the analytical models. Our results show, that the finite element modeling of the internal deformation and strain in cancellous bone can be accurate in one direction but that this does not ensure accuracy for all deformations and strains.

Anisotropy↗
PubMed2001

S1 screw bending moment with posterior spinal instrumentation across the lumbosacral junction after unilateral iliac crest harvest.

STUDY DESIGN: A biomechanical study comparing fixation across the lumbosacral junction. OBJECTIVES: To determine which long posterior construct across the lumbosacral junction produces the least bending moment on the S1 screw when only one ilium is available for fixation. SUMMARY OF BACKGROUND DATA: Recent in vitro studies have demonstrated the benefit of anterior support and fixation into the ilium when instrumenting a long posterior construct across the lumbosacral junction. METHODS: Four L2-sacrum constructs were tested on six synthetic models of the lumbar spine and pelvis simulating that the right ilium had been harvested. Construct 1: L2-S1 bilateral screws. Construct 2: L2-S1 + left iliac bolt. Construct 3: L2-S1 + left iliac bolt + right S2 screw. Construct 4: L2-S1 + bilateral S2 screws. The four constructs were then retested with an anterior L5-S1 strut. A flexion-extension moment was applied across each construct, and the moment at the left and right S1 pedicle screw was measured with internal strain gauges. RESULTS: Iliac bolt fixation was found to significantly decrease the flexion-extension moment on the ipsilateral S1 screw by 70% and the contralateral screw by 26%. An anterior L5-S1 strut significantly decreased the S1 screw flexion-extension moment by 33%. Anterior support at L5-S1 provided no statistical decrease in the flexion-extension moment when bilateral posterior fixation beyond S1 was present with either a unilateral iliac bolt and contralateral S2 screw, or bilateral S2 screws. CONCLUSIONS: There is a significant decrease in the flexion-extension moment on the S1 screw when extending long posterior constructs to either the ilium or S2 sacral screw. There is no biomechanical advantage of the iliac bolt over the S2 screw in decreasing the moment on the S1 screw in flexion and extension. Adding anterior support to long posterior constructs significantly decreases the moment on the S1 screw. Adding distal posterior fixation to either the ilium or S2 decreases the moment on S1 screws more than adding anterior support. Further, adding anterior support when bilateral distal fixation past S1 is already present does not significantly decrease the moment on the S1 screws in flexion and extension.

Bone Screws↗
PubMed2001

The effect of anterior osteophytes and flexural position on thoracic trabecular strain.

STUDY DESIGN: Compressive and shear trabecular strains were evaluated using six cadaveric thoracic spines that included anterior osteophytes. The treatments were divided into three groups: 1) osteophytes intact and the specimen in the neutral position, 2) osteophytes removed and the specimen in the neutral position, and 3) osteophytes removed and the specimen with 5 degrees of additional flexion. OBJECTIVES: To investigate the influence of osteophytes and flexural position on vertebral trabecular strain during axial compression. SUMMARY OF BACKGROUND DATA: In the thoracic spine, the incidence of anterior wedge fractures increases with the severity of kyphosis. It is unclear whether the role of anterior osteophytes in the thoracic spine is to restrict progressive kyphosis, conduct axial load anteriorly, or both. METHODS: Thoracic motion segments, T10-T12, were axially loaded in compression, and the minimum principal and maximum shear strains were measured using texture correlation. RESULTS: No dramatic changes were found in the spatial distribution of the strains following removal of the anterior osteophytes. Conversely, after removal of the osteophytes and orienting the specimen in 5 degrees of additional flexion, the strain distribution shifted anteriorly and the magnitude increased. CONCLUSIONS: This study demonstrated that osteophytes seem to restrict progressive kyphosis rather than conduct axial load anteriorly.

Aged↗
PubMed2001

Trabecular bone strain changes associated with cartilage defects in the proximal and distal tibia.

Intraarticular fractures with cartilage defects can lead to post-traumatic arthritis (PTA). The purpose of this study was to determine how cartilage defects affect load transmission through subchondral trabecular bone in human cadaveric knees and ankles to further understand the pathomechanics of PTA. We created full-thickness cartilage defects in the meniscectomized proximal tibia and distal tibia and measured changes in trabecular bone strain using Texture Correlation. Texture Correlation compares high quality digital images made from contact radiographs of unloaded samples to images of the same sample under load to measure trabecular bone strain. Cartilage defects caused trabecular bone strain to decrease in the proximal tibia and increase in the distal tibia. The column of bone directly beneath the defect in the tibial plateau had the most significant reduction in strain. In the distal tibia, strain near the jointline and in the anterior third had the most significant increases in strain. The distal tibia had greater strain changes with small defects. The clinical course of intraarticular fractures of the proximal and distal tibia are markedly different. We postulate that disturbances in load transmission through the subchondral bone caused by cartilage defects may be important mechanical determinants of PTA.

Aged↗
PubMed2001

Overload arthrosis: strain patterns in the equine metacarpal condyle.

An overload arthrosis occurs consistently in the palmar region of the metacarpal condyle of the equine fetlock (metacarpophalangeal) joint characterized by subchondral bone sclerosis, devitalization and mechanical failure leading to collapse of the overlying articular cartilage. Samples were selected of joints with mild, moderate, and severe subchondral sclerosis, in which cartilage collapse had not yet occurred. An additional group that had severe sclerosis with focal rarefaction suggesting impending collapse was also studied (n=5/group). Parasagittal slices were milled to 2.0 mm thickness and subjected to palmar forces 50 to 200% of those applied by the sesamoid bone at angles corresponding to early, mid and late stance support phases of the gait cycle. From contact radiographs in the loaded and unloaded samples, strains were determined by recognizing displacements in the trabecular patterns using texture correlation analysis. Failure did not occur in any of the samples. Strains were generally proportional to the forces applied and greatest at midstance. Strain patterns varied between samples and with the different loading positions. With increased subchondral bone sclerosis there was greater shear strain in overlying trabeculae. Strain patterns were not consistently different within the sclerotic bone at the site of failure. Focally higher strains at the surface were sometimes related to the edge of the platen which was molded to mimic the sesamoid bone in vivo. These results indicate that sclerotic thickening of subchondral bone transmits stresses to overlying trabeculae. No consistent strain pattern was recognized where devitalization and mechanical failure occurs. Focally higher strains related to the edge of the opposing sesamoid bone may play a role.

Journal Article↗
PubMed1999

Measurement of strain distributions within vertebral body sections by texture correlation.

STUDY DESIGN: A high-resolution strain measurement technique was applied to axially loaded parasagittal sections from thoracic spinal segments. OBJECTIVES: To establish a new experimental technique, develop data analysis procedures, characterize intrasample shear strain distributions, and measure intersample variability within a group of morphologically diverse samples. SUMMARY OF BACKGROUND DATA: Compression of intact vertebral bodies yields structural stiffness and strength, but not strain patterns within the trabecular bone. Finite element models yield trabecular strains but require uncertain boundary conditions and material properties. METHODS: Six spinal segments (T8-T10) were sliced in parasagittal sections 6-mm thick. Axial compression was applied in 25-N increments up to sample failure, then the load was removed. Contact radiographs of the samples were made at each loading level. Strain distributions within the central vertebral body were measured from the contact radiographs by an image correlation procedure. RESULTS: Intrasample shear strain probability distributions were log-normal at all load levels. Shear strains were concentrated directly inferior to the superior end-plate and adjacent to the anterior cortex, in regions where fractures are commonly seen clinically. Load removal restored overall sample shape, but measurable residual strains remained. CONCLUSIONS: This experimental model is a suitable means of studying low-energy vertebral fractures. The methods of data interpretation are consistent and reliable, and strain patterns correlate with clinical fracture patterns. Quantification of intersample variability provides guidelines for the design of future experiments, and the strain patterns form a basis for validation of finite element models. The results imply that strain uniformity is an important criterion in assessing risk of vertebral failure.

Aged↗
PubMed1999

Dorsal intercarpal ligament capsulodesis for scapholunate dissociation: biomechanical analysis in a cadaver model.

The purpose of this study was to evaluate in cadavers a new method for treating scapholunate dissociations, dorsal intercarpal ligament capsulodesis (DILC), and to compare its performance with that of a previously described soft tissue reconstruction, Blatt capsulodesis (BC). A cadaver model was used to simulate normal and abnormal wrist motions. The positions of the scaphoid and lunate and their changes with wrist motion and ligament condition were recorded using biplanar radiographs taken posteroanteriorly and laterally. The scapholunate gap was measured on the posteroanterior radiographs and the scapholunate angle was measured on the lateral view radiographs. Following scapholunate interosseous ligament sectioning, a diastasis developed between the scaphoid and lunate that was maximum in the clenched fist position 2.1 +/- 0.33 mm (mean +/- SEM) with the ligament intact versus 8.0 +/- 1.74 mm after the ligament was sectioned. Dorsal intercarpal ligament capsulodesis reduced gap formation more than BC, including when the specimens were in the clenched fist position: increased gap versus intact specimens equals 1.0 mm for DILC versus 3.7 mm for BC. The differences in diastasis were statistically significant between BC and DILC when the wrist was in extension, radial deviation, and clenched fist positions. After the scapholunate interosseous ligament was divided, the scaphoid flexed relative to the lunate. Both capsulodeses improved scapholunate alignment and there was a trend for DILC to correct the scapholunate angle more than BC. The results demonstrate that DILC is an attractive alternative to BC ex vivo. Because DILC does not tether the scaphoid to the distal radius, as BC does, improved wrist motion, especially flexion, might be possible in vivo. The use of DILC in the treatment of scapholunate dissociation warrants further investigation and clinical trials.

Adult↗
PubMed1998

The effect of boundary conditions on experimentally measured trabecular strain in the thoracic spine.

Vertebral bodies are the primary structural entities of the spine, and trabecular bone is the dominant material from which vertebral bodies are composed. Understanding the mechanical characteristics of vertebral trabecular bone, therefore, is of critical importance in the many clinical conditions that affect the spine. Numerous studies have loaded vertebral bodies to investigate the influence of trabecular bone characteristics on deformation and failure patterns, but the methods of load application have been inconsistent. These differences in the method of load application are a potential confounding factor in the interpretation of the experimental results. We investigated this problem by measuring the distribution of minimum principal strain and maximum shear strain magnitude within 6.35 mm thick samples cut from thoracic spine segments (T8-T10) and loaded to simulate three common experimental configurations. Measurements were made using the texture correlation technique, which extracts deformation patterns from digitized contact radiographs of samples under load. The three loading configurations examined were a three-body construct, a single vertebral body loaded through sectioned intervertebral discs, and polymethylmethacrylate molded directly to the endplates. Results indicate that from both probability and spatial distribution standpoints the best simulation of in vivo loading generates the least uniform strains. Loading through disc remnants or through plastic molded to the endplates causes increasing degrees of strain homogenization. This result has implications not only for the design of experiments involving spinal loading, but also for theories concerning the adaptation of trabecular bone to functional loads.

Adult↗
PubMed1998

Consequences of transverse acetabular fracture malreduction on load transmission across the hip joint.

OBJECTIVE: To evaluate the biomechanical behavior of gap and step malreductions in a model of transverse acetabular fracture. DESIGN: Cadaver pelvis loading in simulated single-leg stance with intact acetabulum, after transverse acetabular fracture anatomically reduced, and after step and gap malreduction. Five transtectal transverse fractures; five juxtatectal transverse fractures. SETTING: Quasi-static loading of the hip with simulated abductor mechanism to physiologic loads with pressure-sensitive film interposed in the joint to determine contact area and contact pressure within the hip joint. MAIN OUTCOME MEASUREMENT: Hip joint contact parameters: contact area, peak and mean contact pressure, and load distribution. RESULTS: Step malreduction of the transtectal transverse fracture resulted in significantly increased peak contact pressures (20.5 megapascals) in the superior acetabular articular surface as opposed to the intact acetabulum (9.1 megapascals). Gap malreduction of transtectal transverse fracture and step and gap malreduction of juxtatectal fracture did not result in significantly increased contact pressures in the hip. CONCLUSION: Step malreduction of a transverse acetabular fracture in the superior articular surface results in abnormally high contact forces and may predispose to the development of posttraumatic arthritis.

Acetabulum↗
PubMed1997

Surface remodeling of trabecular bone using a tissue level model.

We propose a two-dimensional mathematical model of trabecular bone remodeling that simulates the surface-based addition and removal of material in the actual physiological process. The model is based on a finite element representation of individual trabecular struts in which the material properties of the subtrabecular elements are constant. The remodeling stimulus is strain energy density, sensed and communicated through the osteocytic network as proposed by Mullender et al. We propose a modified osteocyte communication scheme that incorporates bone-lining cells and examines the implications of set point locations in one or the other of these two cell types. This model produces trabecular struts that align with its general loading direction. Placing the set point in the bone-lining cells rather than in the osteocytes makes the model more sensitive to changes in the other biological parameters. Introduction of a dead zone causes the model to reach a less oscillatory equilibrium in fewer iterations and produces better in-filling of trabecular strut intersections. The model gravitates to equilibrium states in which the average strain energy density is inversely proportional to the bone volume fraction to the 3.2 power.

Bone Remodeling↗
PubMed1997

Patellar strain and patellofemoral contact after bone-patellar tendon-bone harvest for anterior cruciate ligament reconstruction.

OBJECTIVE: To characterize the morbific consequences of harvesting a patellar tendon graft for use in reconstructing the anterior cruciate ligament (ACL) of the knee, specifically, (1) to measure changes in patellar strain and patellofemoral contact due to graft harvest, (2) to evaluate the ability of bone-grafting the patellar defect to mitigate these effects, and (3) to characterize failure of the extensor mechanism after harvest of a patellar tendon graft. DESIGN: Twenty-two cadaver knee joints were tested before and after harvest of a patellar tendon graft and after filling the patellar defect with polymethylmethacrylate to simulate a healed bone graft, Knees were positioned in 30 degrees, 60 degrees, and 90 degrees flexion and loaded while measuring axial strain in the anterior patella and patellofemoral contact. Knees were then loaded to failure. RESULTS: Harvest of the graft produced increases in axial strain at all flexion angles. Filling the defect restored axial strain to normal values. Patellofemoral contact in the presence of a defect, either filled or empty, was not different from contact for intact patellae. Most knees failed by transpatellar fracture; mean extension moment at failure was 112.8Nm. The best predictors of failure were age and gender. CONCLUSION: Patients undergoing ACL reconstruction with a patellar tendon graft are at increased risk of anterior knee pain and disruption of the extensor mechanism. Bone-grafting the patellar defect created by graft harvest can reduce these risks. Our findings underscore the importance of carefully controlled rehabilitation and suggest that if an accelerated program of rehabilitation is anticipated, the patellar defect should be bone-grafted. Older patients, particularly women, are at increased risk of catastrophic failure of the knee extensor mechanism after ACL reconstruction using patellar tendon graft.

Adult↗
PubMed1997

Statically equivalent load and support conditions produce different hip joint contact pressures and periacetabular strains.

The hip is a common site of orthopaedic trauma and disease, and considerable research has been directed toward understanding the development of contact pressures within the joint. Virtually all experimental studies to date have employed proximal femurs compressed along the joint reaction force vector into acetabulae explanted from cadaver pelves. This approach presumes that deformations of the acetabulum are highly localized, and that the pelvis is functionally a rigid body. We have developed a methodology that uses intact pelves loaded through simulation of the abductor mechanism. A direct comparison of the two techniques revealed significantly different joint contact characteristics and periacetabular strains. Fuji film measurements of contact area and pressure were more widely distributed across the acetabulum for the intact pelvis, with significant pressure development in anterior and posterior regions. Contact patterns in the explanted acetabulae were concentrated in the superior portion of the joint. Principal strains from three rosette gages placed near the acetabular rim were also significantly different for the two testing techniques, but were not substantially altered by the presence of Fuji film within the joint. The results indicate that deformation of the entire pelvis and the manner in which loads are applied significantly affect development of contact pressures within the hip joint, and that Fuji film is a suitable technique for recording those patterns.

Acetabulum↗
PubMed1997

Displacement and strain of the median nerve at the wrist.

Median nerve displacement and strain in the carpal tunnel region were measured as functions of wrist position and carpal tunnel pressure in 5 cadaver forearms during simulated active finger flexion. The positions of spherical stainless-steel markers embedded within the median nerve and flexor digitorum superficialis of the long finger were measured in 3 dimensions by a radiographic direct linear transformation technique. Each limb was tested in 3 wrist positions (60 degrees extension, neutral, and 60 degrees flexion) and 4 carpal tunnel pressures (0, 30, 60, and 90 mmHg). Carpal tunnel pressure was controlled with a balloon angiocatheter inserted deep to the flexor digitorum profundus. The ratio of median nerve to flexor tendon excursion was linear and was affected by wrist position but not carpal tunnel pressure. Patterns of strain in the median nerve proximal to the flexor retinaculum were different from those of strain within the carpal tunnel. Nerve strains were affected by wrist position, but carpal tunnel pressure had no effect. The hydrostatic pressure effect associated with carpal tunnel syndrome does not appear to influence median nerve kinetics or kinematics for the wrist positions studied.

Biomechanical Phenomena↗
PubMed1997

Biomechanics of the hip joint and the effects of fracture of the acetabulum.

The biomechanical analysis of the normal and arthritic hip joint have been the subject of numerous publications in orthopaedics. Biomechanical investigations focusing on the effect of fractures of the acetabulum on the alteration of hip joint mechanics have been a recent development. This paper outlines currently available methodologies for simulating load across the hip, and as measuring articular contact and contact stresses. Results of investigations of posterior wall fractures and transverse fractures of the acetabulum are presented. Directions for future research in the area of mechanical investigations of acetabular fractures are discussed.

Acetabulum↗
PubMed1996

The effect of variable size posterior wall acetabular fractures on contact characteristics of the hip joint.

The indications for open reduction and internal fixation of posterior wall acetabular fractures associated with a clinically stable hip joint are unclear. In previous work a large posterior wall defect (27% articular surface area) resulted in significant alteration of load transmission across the hip; specifically, there was a transition from evenly distributed loading along the acetabular articular surface to loading concentrated mainly in the superior portion of the articular surface during simulated single leg stance. However, the majority of posterior wall fractures involve a smaller amount of the articular surface. Posterior wall acetabular fractures not associated with instability of the hip are commonly treated nonoperatively. This practice does not account for the size of the posterior wall fracture. To study the biomechanical consequences of variably sized articular defects, a laboratory experiment was conducted evaluating three progressively larger posterior wall defects of the acetabulum during simulated single leg stance using superlow Fuji prescale film (Itochu International, New York): (a) 1/3 articular surface width through a 50 degrees arc along the posterior wall of the acetabulum, (b) 2/3, and (c) 3/3 articular width defects through the same 50 degrees arc along the posterior wall of the acetabulum. In the intact acetabulum, 48% of the total articular contact was located in the superior acetabulum. Twenty-eight percent of articular contact was in the anterior wall region of the acetabulum and 24% in the posterior wall region. After the 1/3 width posterior wall defect, 64% of the articular contact was located in the superior acetabulum (p = 0.0011). The 2/3 width posterior wall defect resulted in 71% of articular contact area being located in the superior acetabulum (p = 0.0006). After the 3/3 width posterior wall defect, 77% of articular contact was located in the superior acetabulum, significantly greater than the intact condition (p < 0.0001) and 1/3 width defect (p = 0.0222). The total absolute contact areas for all defect conditions were significantly less than the intact conditions. The results of this study reconfirm the observation that posterior wall fractures of the acetabulum significantly alter the articular contact characteristics in the hip during single leg stance. The relationship between defect size and changes in joint contact showed that the smallest defect resulted in the greatest alteration in joint contact areas, whereas larger defects resulted in minor increments of change in contact area. This finding is of concern because the clinical practice of managing acetabular fractures nonoperatively if the hip joint is stable is based on the supposition that the joint retains enough integrity to function without undue risk of late posttraumatic osteoarthritis. A better understanding of the natural history of stable posterior wall acetabular fractures is needed to ascertain whether some of these fractures merit operative repair.

Acetabulum↗
PubMed1995

Texture correlation: a method for the measurement of detailed strain distributions within trabecular bone.

A new technique, termed texture correlation, is described for the measurement of displacement and strain patterns within samples of trabecular bone. Texture correlation is a modification of digital image correlation, a method for analysis of deformation in objects marked with random surface speckle. Instead of surface speckle, the trabecular pattern itself is used as a basis for correlation. Digitized contact radiographs of samples in unloaded and loaded states are compared by computer to determine displacements of a grid of points. Displacements are filtered with Savitsky-Golay polynomial-convolution filters to reduce noise, and then strain is calculated with finite element techniques. The method is conceptually similar to the manual measurement of surface markers but has numerous advantages: no marking of the sample is required, displacements are measured automatically by computer, measurement of thousands of displacements is practical, and filtering allows calculation of strain over small regions of the sample. The validity of the technique is demonstrated by comparison of strain patterns measured by texture correlation at low resolution with the same patterns measured by a surface marker technique in six samples of trabecular bone from a human femoral head. The results of texture correlation at full resolution then are presented to demonstrate the capabilities of the method.

Femur Head↗