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C Hurschler

Publications and source records attributed to C Hurschler.

At least 19 recordsLinked to original sources

Experimental measurement of tibiofemoral contact area in a meniscectomized ovine model using a resistive pressure measuring sensor.

Animal models are necessary for the development and analysis of surgical techniques in meniscal surgery because they are the only means of preclinically determining the influence of biological factors such as healing processes and joint remodeling. Furthermore, little is known about the biomechanical effect of meniscectomy in sheep. The aim of the study was thus to investigate the efficacy of using a resistive pressure measuring sensor to quantify the effect of chronic meniscectomy in an ovine model. Twelve sheep were divided into two groups (n = 6): a sham operated control group (A), and a medially meniscectomized group (B). After six months, lower limb specimens were loaded with a joint-compressive force of 500 N during which the pressure measuring sensor was positioned underneath the meniscus to determine contact area, mean and peak contact pressure. A significant reduction in contact area of about 55% was observed in the meniscectomized knees compared to the controls. Peak contact pressure of the meniscectomized knees significantly increased an average of 260.4% compared to the control knees. Based on the results of this study, we conclude that the resistive pressure measuring sensors provide a means to experimentally measure tibiofemoral contact mechanics even in this relatively small (compared to human) animal model.

Animals↗

Tibial press-fit fixation of the hamstring tendons for ACL-reconstruction.

Press-fit fixation of patellar tendon bone anterior cruciate ligament autografts is an interesting technique because no hardware is necessary to achieve fixation. Up till the present point, there is no biomechanical data available for the tibial press-fit fixation of the hamstring tendons. Hamstring tendons of 21 human cadavers (age: 41.9 +/- 13.1 years) were used. A press-fit fixation with looped semitendinosus and gracilis tendons secured by a tape (T) over a bone bridge, or by a baseball-stitched suture (S), was compared with degradable interference screw fixation (I) in 21 porcine tibiae. The constructs were cyclically strained and subsequently loaded to failure. The maximum load to failure, stiffness, and elongation during cyclical loading were measured. The maximum load to failure was highest for the T-fixation at 970 +/- 83 N, followed by the I-fixation with 544 +/- 109 N, and the S-fixation with 402 +/- 78 N (P < 0.03). Stiffness of the constructs averaged 78 +/- 13 N/mm for T, 108 +/- 18 N/mm for S, and 162 +/- 27 N/mm for I (P < 0.03). Elongation during initial cyclical loading was 2.0 +/- 0.6 mm for T, 3.3 +/- 1.1 mm for S, and 1.4 +/- 0.5 mm for I (S inferior to I and T, P<0.05). Elongation between the 20th and 1,500th loading cycle was lower for T (2.2 +/- 0.7 mm) compared with I (4.1 +/- 2.7 mm) and S (4.8 +/- 0.7 mm; P < 0.001). The T-fixation technique exhibited a significantly higher failure load than the S-, and I- techniques. All techniques exhibited larger elongation during initial cyclical loading than is reported in the literature for grafts with bone blocks. Only one technique (T) showed satisfactory elongation behavior during long-term cyclic loading. Interference screw fixation demonstrated significantly higher stiffness. Only one of the investigated techniques (T) seemed to exhibit adequate mechanical properties necessary for early aggressive rehabilitation programs.

Adolescent↗

Comparison of capacitive versus resistive joint contact stress sensors.

Cartilage contact stress elevations might be associated with pain or other symptoms after malunited, incongruous intraarticular fractures. Studies identifying fractures with patterns of elevated contact stresses would help to ensure more appropriate choices of treatment. However, appropriate instrumentation for such studies is crucial. We tested two such systems, one capacitive and one resistive, under identical loading conditions presumed to occur in the ankle. We used a materials testing machine and customized-loading fixtures to measure force detection error, contact area error, repeatability, homogeneity, creep, and one-axis and two-axis bending artifacts. The loading regimen caused pressures up to 2.5 MPa. An error in force detection between -3% and +5% was observed with the capacitive sensor whereas an error between -12% and +20% was observed with the resistive sensor. Repeatability and homogeneity were greater for the capacitive sensor. Errors in contact area measurement were less than 2% for the resistive sensor and less than 6% for the capacitive sensor. The resistive sensor could not conform to spherical surfaces without crinkling. Creep artifact was observed with both sensors. We concluded that the capacitive sensor had superior performance even though its thickness and high compliance may be disadvantageous in intraarticular measurements. The resistive sensor is required for use where higher pressures are expected despite its inferior accuracy.

Ankle Joint↗

The influence of pre-tensioning of meniscal transplants on the tibiofemoral contact area.

The purpose of the present study was to determine the effect of biological in-growth and pre-tensioning on the load transmission function of meniscal transplants. The ability of meniscal transplants to transfer load to the tibial plateau was measured in an animal model. Thirty-six sheep were divided into six groups: group A was the sham group, in group B a medial meniscectomy was performed, and in groups C-F a medial meniscal transplantation with an autograft was carried out. In groups C-F, different levels of pre-tensioning force were applied via bone tunnel sutures (C=0, D=20, E=40, and F=60 N, respectively). The animals were killed after 6 months. The excised knees were mounted in a materials testing machine at 30, 60, and 90 degrees of flexion, and loaded through the femoral axis to 500 N. A thin film pressure measuring transducer (K-scan, Tekscan) was positioned underneath the meniscus in the medial compartment in order to determine contact area and pressure. The mean contact pressure (MCP) of the sham group (A) and the groups with the transplanted meniscus (C-F) was significantly lower in relation to the meniscectomized knees (B). Significant increases in contact area and reductions in peak contact pressure were also observed. Only the meniscal transplantation group with 40 N (E) pre-tension consistently showed a significant or strong trend toward increased contact area, compared to the meniscectomized knees (B) at all flexion angles tested. All meniscal transplanted groups with the exception of the 0 N group (C) showed a significant reduction in peak contact pressure in comparison to the meniscectomized group (B). The results indicate that meniscal transplantation reduces the MCP on the tibial plateau independent of the level of intraoperative pre-tensioning. Furthermore, the menisci pre-tensioned to 40 N showed significantly increased contact area and reduced peak contact pressure in comparison to the meniscectomized knees at all flexion angles tested, and revealed results similar to those reported in the literature for meniscal allografts fixated with bone plugs.

Animals↗

Primary stability of four different implants for opening wedge high tibial osteotomy.

Since a significant number of implant failures have been reported in association with the procedure of open wedge valgus high tibial osteotomy, the initial biomechanical stability of different fixation devices was investigated in this study. Fifteen third generation Sawbones composite tibiae were used as a model. Four different plates were tested: a short spacer plate (OWO) (n = 4), a short spacer plate with multi-directional locking bolts (MSO) (n = 5), a prototype version of a long spacer plate with multi-directional locking bolts (MSOnew) (n = 2), and a long medial tibia plate fixator with locking bolts (MPF) (n = 4). All opening wedge osteotomies were performed by the same surgeon (PL) in a standardized fashion. Axial compression of the tibiae was performed using a materials testing machine under standardized alignment of the loading axis. Single load to failure tests as well as load-controlled cyclical failure tests were performed. The required force and cycles to failure were recorded. Osteotomy gap motion was measured using linear displacement transducers. Residual stability after failure of the opposite lateral cortex was analysed. Failure occurred at the lateral cortex bone-bride in all tested implants. The rigid long plate fixator (MPF) resisted the greatest amount of force (2,881 N) in the single load to failure tests. In the cyclical load-to-failure tests, the constructs with MPF resisted more than twice the amount of loading cycles when compared to the short spacer plates. The osteotomy gap motion was smallest in the MPF, with a reduction of the displacements of up to 65, 66 and 88%, when compared to OWO, MSO and MSOnew, respectively. The highest residual stability after failure of the lateral cortex was observed in MPF as well. The results suggest that the implant design strongly influences the primary stability of medial opening wedge tibial osteotomy. A rigid long plate fixator with angle-stable locking bolts yields the best results.

Bone Plates↗

[The development and biomechanical testing of a femoral press fit fixation for hamstring tendons].

PURPOSE: The purpose of this study was to investigate press fit femoral fixation of hamstring tendons and to compare the mechanical properties with press fit patellar tendon bone (PTB) fixation. METHODS: The PTB and hamstring tendons of 30 human cadavers (age: 55.8+/-18.0 years) were used as grafts. An outside-in press fit fixation with a knot in the semitendinosus and gracilis graft (SG-K) and an inside-out (SG-BI) and an outside-in fixation (SG-BO) with the tendons looped over a bone block were compared with a bone-patellar tendon (PT) press fit fixation in 30 bovine femora. The angle between the direction of force and bone tunnel was 60 degrees. The constructs underwent 20 cycles of loading between 60 and 260 N. Constructs were loaded until failure at a speed of 1 mm/sec. Graft fixation was analyzed in terms of maximum load to failure, stiffness and elongation during cyclic stretching. A video analysis of length changes was investigated. RESULTS: There was a significant difference in the maximum load to failure. The SG-BI fixation was inferior to the other three techniques (Mann-WhitneyU-test, P<0.01). There was no difference in stiffness between the techniques. Length changes of PT-fixation from the first to the fifth loading cycle were significantly smaller compared with all other groups (0.73+/-0.58 mm). There was no significant difference between the groups from the 15th to the 20th cycle of cyclic loading. CONCLUSIONS: Press fit fixation of hamstring grafts is technically challenging. However, pull-out forces for SG-O and SG-K were equivalent to BPT-graft fixation. Adequate preconditioning for all hamstring tendon press fit techniques is crucial.

Anterior Cruciate Ligament↗

Comparison of various types of stiffness as predictors of the load-bearing capacity of callus tissue.

The ability to predict load-bearing capacity during the consolidation phase in distraction osteogenesis by non-invasive means would represent a significant advance in the management of patients undergoing such treatment. Measurements of stiffness have been suggested as a promising tool for this purpose. Although the multidimensional characteristics of bone loading in compression, bending and torsion are apparent, most previous experiments have analysed only the relationship between maximum load-bearing capacity and a single type of stiffness. We have studied how compressive, bending and torsional stiffness are related to the torsional load-bearing capacity of healing callus using a common set of samples of bone regenerate from 26 sheep treated by tibial distraction osteogenesis. Our findings showed that measurements of torsional, bending and compressive stiffness were all suitable as predictors of the load-bearing capacity of healing callus. Measurements of torsional stiffness performed slightly better than those of compressive and bending stiffness.

Animals↗

Effect of high tibial flexion osteotomy on cartilage pressure and joint kinematics: a biomechanical study in human cadaveric knees. Winner of the AGA-DonJoy Award 2004.

INTRODUCTION: Valgus high tibial osteotomy is an established treatment for unicompartmental varus osteoarthritis. However, only little is known about the effect of osteotomy in the sagittal plane on biomechanical parameters such as cartilage pressure and joint kinematics. This study investigated the effects of high tibial flexion osteotomy in a human cadaver model. MATERIALS AND METHODS: Seven fresh human cadaveric knees underwent an opening wedge osteotomy of the proximal tibia in the sagittal plane. The osteotomy was opened anteriorly, and the tibial slope of the specimen was increased gradually. An isokinetic flexion-extension motion was simulated in a kinematic knee simulator. The contact pressure and topographic pressure distribution in the medial joint space was recorded using an electronic pressure-sensitive film. Simultaneously the motion of the tibial plateau was analyzed three-dimensionally by an ultrasonic tracking system. The traction force to the quadriceps tendon which was applied by the simulator for extension of the joint was continuously measured. The experiments were carried out with intact ligaments and then after successively cutting the posterior and anterior cruciate ligaments. RESULTS: The results demonstrate that tibial flexion osteotomy leads to a significant alteration in pressure distribution on the tibial plateau. The tibiofemoral contact area and contact pressure was shifted anteriorly, which led to decompression of the posterior half of the plateau. Moreover, the increase in the slope resulted in a significant anterior and superior translation of the tibial plateau with respect to the femoral condyles. Posterior subluxation of the tibial head after cutting the posterior cruciate ligament was completely neutralized by the osteotomy. The increase in slope resulted in a significant higher quadriceps strength which was necessary for full knee extension. CONCLUSIONS: We conclude from these results that changes in tibial slope have a strong effect on cartilage pressure and kinematics of the knee. Therapeutically a flexion osteotomy may be used for decompression of the degenerated cartilage in the posterior part of the plateau, for example, after arthroscopic partial posterior meniscectomy. If a valgus osteotomy is combined with a flexion component of the proximal tibia, complex knee pathologies consisting of posteromedial cartilage damage and posterior and posterolateral instability can be addressed in one procedure, which facilitates a quicker rehabilitation of these patients.

Aged↗

[Injectable carrier system for growth factor application in minimally invasive stimulation of bone healing].

The characterization and cloning of growth factors for bone healing provide an enormous potential for minimally invasive treatment procedures for bone defects or fractures. However, the clinical application of injection vehicles for these growth factors must be made user-friendlier. In this study, two different injection vehicles were tested for their practicability and efficacy to enhance callus maturation during distraction osteogenesis. Calcium phosphate carriers showed a rather low user-friendliness and were less efficient in the animal model of distraction osteogenesis in sheep. Collagen carriers provided both a higher practicability for injection procedures and a higher efficacy.

Animals↗

Quadriceps function after TKA--an in vitro study in a knee kinematic simulator.

OBJECTIVE: The purpose of this in vitro study was to investigate the amount of quadriceps force required to extend the knee during an isokinetic extension cycle before and after total knee arthroplasty. DESIGN: The magnitude of the extension torque used in simulating a constant moment extension exercise was derived from tests made using a dynamometer on patients who had received a total knee arthroplasty. Quadriceps force needed to extend the knee was measured. METHODS: Human knee specimens (n=8, mean age=65 SD 7 years, all male) were tested in a kinematic knee simulating machine untreated and after implantation of two different knee prosthesis. During simulation, a hydraulic cylinder applied sufficient force to the quadriceps tendon to produce an extension moment of 31 Nm about the knee. RESULTS: The quadriceps forces needed to extend the knee during the physiologic simulation reached levels as high as 1238.9 N (SD 46.6). After implantation the Interax-prosthesis, quadriceps force increased up to 13.9% (P=0.003), in conjunction with resurfacing of the patella 11.9% (P=0.01). With the LCS-prosthesis implanted, quadriceps force showed a somewhat smaller increase of up to 6.6% (P=0.007). RELEVANCE: The following study helps to clarify postoperative problems related to the extensor mechanisms of the knee after implantation of total knee arthroplasty.

Arthroplasty, Replacement, Knee↗

[Influence of the posterior tibial tendon on the medial arch of the foot: an in vitro kinetic and kinematic study].

INTRODUCTION: The respective contributions of the active and passive structures of the foot to the stability of the medical arch were investigated using an in vitro kinetic and kinematic model. The effect of the tibialis posterior tendon on foot and ankle movements, and plantar pressure distribution of the foot were tested in a cadaveric human foot. METHOD: The stance phase from heel-contact to toe-off of normal walking gait and after tibialis posterior tendon rupture was simulated in eight roentenographically normal human feet (age 66 +/- 19 years, males). Ground reaction force and tibial inclination was simulated by means of a tilting angle and force-controlled translation stage. Plantar pressure was measured using a pressure-measuring platform. The force developed by the flexors and extensor muscles of the foot were simulated via cables attached to 7 force-controlled hydraulic cylinders. Tibial rotation was produced by an electric servo-motor, and foot movements measured with an ultrasonic analysis system. RESULTS: The model was verified against the plantar distribution and kinematics of healthy subjects measured during normal gait. Tibialis posterior deficit did not result in any detectable changes in pressure or force-time integral in the medial regions of the foot--a common sign of flat foot (pressure: midfoot 0.2 < or = 0.9; medial forefoot 0.5 < or = p < or = 0.9; hallux 0.5 < or = p < or = 0.9; force-time integral: midfoot p = 0-871; medial forefoot p = 0.632; hallux p = 0.068). Only small tendential changes in the kinematics of the talus and calcaneus were observed in dorsiflexion (0-58 sec; talus 0.1 < or = p < or = 0.6; calcaneus 0.4 < or = p < or = 0.06) and eversion (talus: 0-60 sec. 0.1 < or = p < or = 0.6; calcaneus: 37-60 sec. 0.2 < or = p < or = 0.7). CONCLUSION: The results of this in vitro study show that defective tibialis posterior alone does not produce significant changes in the kinetics or kinematics of the stance phase of normal gait. This suggests that the development of flat foot observed in degeneration of the tibialis posterior tendon occurs only after fatigue of the passive structures of the foot.

Adult↗

Bone turnover during distraction osteogenesis in an experimental sheep model.

Biochemical serum markers of osteoblastic activity and collagen turnover were measured in a sheep model of distraction osteogenesis. Significant increases of the bone formation marker osteocalcin were found during the first part of the consolidation phase and peaked at a time point equalling the distraction phase. Collagen turnover parameters pyridinoline and the specific type I collagen marker desoxypyridinoline consistently increased during the distraction and consolidation phases. While pyridinoline peaked at a time point similar to osteocalcin, desoxypyridinoline increased to a later stage in consolidation, indicating continuous turnover of bone-specific type I collagen. The results indicate a characteristic pattern of osteoblast cellular activation during distraction osteogenesis with possible consequences for the timing of treatment.

Amino Acids↗

[Muscle efficiency in total shoulder prosthesis implantation: dependence on position of the humeral head and rotator cuff function].

Modern shoulder prostheses permit an anatomic reconstruction of the joint, although the biomechanical advantages are not proven. The goal of this study was to investigate the relationship between position of the humeral head and function of the shoulder prosthesis (muscle efficiency). Shoulder elevation-motion and rotator cuff defects were simulated in vitro in a robot-assisted shoulder simulator. The EPOCA Custom Offset shoulder prosthesis (Argomedical AG, Cham, CH) was implanted in seven normal shoulders (77 +/- 20 kg, 55 +/- 14 years). Active elevation was simulated by hydraulic cylinders, and scapulothoratic motion by a specially programmed industrial robot. Muscle efficiency (elevation-angle/muscle-force of the deltoid muscle) was measured in anatomic (ANA), medialised (MED) and lateralised (LAT) positions of the humeral head, with or without rotator cuff muscle deficiency. Medialisation increased efficiency by 0.03 +/- 0.04 deg/N (p = 0.022), lateralisation decreased it by 0.04 +/- 0.06 deg/N (p = 0.009). Supraspinatus muscle deficiency increased the deltoid force required to elevate the arm, and thus decreased efficiency (ANA p = 0.091, MED p = 0.018, LAT p = 0.028). The data confirm that the position of the humeral head affects the mechanics of total shoulder arthroplasty. Medialisation increases efficiency of the deltoid muscle and may prove useful in compensating isolated supraspinatus muscle deficiency. Lateralisation, in contrast, leads to an unfavorable situation.

Adult↗

Microstructural morphology in the transition region between scar and intact residual segments of a healing rat medial collateral ligament.

This study used a rat model to investigate the microstructural organization of collagen through the transition from scar to intact residual segments of a healing medial collateral ligament (MCL). Twenty-two male retired breeder Sprague-Dawley rats were randomly separated into two groups. Eleven underwent surgical transections of both MCLs and were allowed unrestricted cage activity until euthanized two weeks post surgery. The remaining eleven rats were used as normal controls. All 44 MCLs were harvested including intact femoral and tibial insertions and prepared for scanning electron microscopy (SEM) imaging. At harvest the scar region in the healing ligaments was more translucent than the normal tissue. Ligaments were viewed from femoral to tibial insertions at magnifications of 100X through 20,000X. Tissue away from the scar region in the transected MCLs was indistinguishable from normal tissue in uninjured ligaments. Collagen fibers and fibrils in these tissues were more aligned along the longitudinal axis of the ligament than in the scar tissue. Continuity of collagen fibers and fibrils were consistently observed from the residual portions of the transected ligament through the scar region. Bifurcations/fusions, but no anastomoses, in fibers and fibrils were observed in both normal and scar tissues of ligaments. Qualitatively, bifurcations were encountered more frequently in scar tissue. In the transition region, larger diameter fibers from the residual tissue bifurcated into smaller diameter fibrils in the scar. This connection between larger diameter and smaller diameter fibers and fibrils indicates that bifurcations/fusions are likely to be the dominant way in which force is transmitted from a region with larger fibrils (residual ligament) into and through a region with smaller fibrils (scar).

Animals↗

[Knee endoprosthesis: biomechanical requirements and consequences].

The experiments described herein permitted the dynamic in vitro measurement of the mechanical efficiency of the quadriceps muscle, both before and after total knee arthroplasty (TKA). The measurement of tibiofemoral pressure on fixed and mobile polyethylene inlays, as well as the movement of mobile inlays, is described. The Interax TKA system was implanted in 8 fresh frozen knee cadavers which were then mounted onto a knee-simulating machine. An isokinetic extension motion was simulated by extending the knee specimens under a constant extension torque of 31 Nm. The quadriceps muscle force required for this motion was not found to increase after implantation of the prostheses. Pressure on the mobile inlay was 60% lower than that measured on the fixed inlay. A 4-mm posterior migration of the mobile inlay on the tibial base plate was observed, with no motion of the inlay femoral component contact surface, which migrated posteriorly in the fixed bearing prosthesis. Thus, instead of moving posteriorly, the mobile inlay femoral component contact area remained at the center of the inlay during the entire extension motion.

Aged↗

The effect of negative intraarticular pressure and rotator cuff force on glenohumeral translation during simulated active elevation.

OBJECTIVE: The objective of this study was to determine the effect of negative pressure in the intraarticular space and subacromial bursa, as well as rotator cuff force, on glenohumeral translation during active elevation. DESIGN: Glenohumeral translation during elevation in the scapular plane was measured under greater than, less than, and equal to physiologic rotator cuff muscle force, as well as with and without the subacromial bursa and intraarticular space vented. BACKGROUND: Negative intraarticular pressure has been shown to help stabilize the glenohumeral joint in passive motion, although the effect on translation during active motion has not been investigated. METHODS: Eight cadaverous human shoulder specimens were tested in a dynamic shoulder simulator. Forces in the muscles of the rotator as well as the middle deltoid muscle were simulated using servohydraulic cylinders. Joint motion was measured using an ultrasonic motion analysis system. RESULTS: Superior translation of the humerus increased 1.2 mm (SD, 0.4) upon venting of the bursa, and 2.1 mm (SD, 1.7) upon venting of the joint capsule at 25 degrees of glenohumeral elevation in the scapular plane. At 90 degrees elevation, venting the bursa did not change superior translation but increased anterior translation 1.04 mm (SD, 1.0). Venting of the joint capsule increased superior translation by 2.8 mm (SD, 2.5). Decreasing rotator cuff force increased superior translation, while reducing it did not. CONCLUSION: The muscles of the rotator cuff and the negative pressure of the intraarticular space and the subacromial bursa stabilize the glenohumeral joint since they restrict translation in the superior and anterior directions. RelevanceIncreased glenohumeral translation and the resulting asymmetric loading may lead to arthrosis and ultimately rotator cuff arthropathy.

Adult↗

Primary stability of different implants used in conjunction with high tibial osteotomy.

High tibial osteotomy in the varus knee has been successfully performed for a long time. Several newer operation techniques have been established in recent years. We tested the primary stability of several of these techniques in vitro. Ten human cadaveric fresh-frozen specimens were used that had a mean age of 54 years (range 29-72 years) and a weight of 55-85 kg. All specimens were harvested, frozen, and subsequently thawed under the same conditions before testing. The following implants were tested: one-third tubular plate with a cortical screw (AO, Synthes), blade plate with screws (Giebel's plate, Link), bone staples (osteotomy staples, Krackow staples, Smith & Nephew) and an external fixator (Orthofix). The specimens were mounted in metal cylinders and then loaded in two different setups: transverse forces were applied to the osteotomy site by hanging weights parallel to the osteotomy plane in a static-loading frame, and axial forces were applied by a materials testing machine (Zwick). Displacement was recorded using a linear variable displacement transducer (LVDT). The highest stability was achieved by the external fixator and the bone staples. Giebel's blade plate and the one-third tubular plate were less stable. Retention of an intact medial cortex was a decisive factor in obtaining primary stability. We found that the primary stability of the tested devices was generally comparable as long as they were correctly implanted. It was also noted that lateral spacing of the osteotomized bone should not exceed 3 mm. If the medial cortex is transected intraoperatively in lateral osteosynthesis, an additional medial implant is necessary to ensure sufficient primary stability. For practical reasons it was necessary to neglect the contribution of the soft tissues around the knee, although all implants were tested under the same conditions. Care should thus be taken when interpreting the results of this study in a clinical setting.

Adult↗

A structurally based stress-stretch relationship for tendon and ligament.

We propose a mechanical model for tendon or ligament stress-stretch behavior that includes both microstructural and tissue level aspects of the structural hierarchy in its formulation. At the microstructural scale, a constitutive law for collagen fibers is derived based on a strain-energy formulation. The three-dimensional orientation and deformation of the collagen fibrils that aggregate to form fibers are taken into consideration. Fibril orientation is represented by a probability distribution function that is axisymmetric with respect to the fiber. Fiber deformation is assumed to be incompressible and axisymmetric. The matrix is assumed to contribute to stress only through a constant hydrostatic pressure term. At the tissue level, an average stress versus stretch relation is computed by assuming a statistical distribution for fiber straightening during tissue loading. Fiber straightening stretch is assumed to be distributed according to a Weibull probability distribution function. The resulting comprehensive stress-stretch law includes seven parameters, which represent structural and microstructural organization, fibril elasticity, as well as a failure criterion. The failure criterion is stretch based. It is applied at the fibril level for disorganized tissues but can be applied more simply at a fiber level for well-organized tissues with effectively parallel fibrils. The influence of these seven parameters on tissue stress-stretch response is discussed and a simplified form of the model is shown to characterize the nonlinear experimentally determined response of healing medial collateral ligaments. In addition, microstructural fibril organizational data (Frank et al., 1991, 1992) are used to demonstrate how fibril organization affects material stiffness according to the formulation. A simplified form, assuming a linearly elastic fiber stress versus stretch relationship, is shown to be useful for quantifying experimentally determined nonlinear toe-in and failure behavior of tendons and ligaments. We believe this ligament and tendon stress-stretch law can be useful in the elucidation of the complex relationships between collagen structure, fibril elasticity, and mechanical response.

Animals↗