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Biomedical subjects

D D Anderson

Publications and source records attributed to D D Anderson.

At least 19 recordsLinked to original sources

Quantification of ankle articular cartilage topography and thickness using a high resolution stereophotography system.

OBJECTIVE: To describe the topography and to measure thicknesses, surface areas and volumes in the cartilage layers of the ankle. METHODS: Twelve cadaveric ankle joints were disarticulated and the cartilage surfaces of each bone were imaged with a highly accurate (+/-2 microm) stereophotography system (ATOS). The cartilage was then dissolved and the subchondral bone imaged. The geometric data were then used to measure the quantitative parameters in each cartilage layer. RESULTS: The mean cartilage volume across the 12 specimens ranged from 0.32+/-0.08 ml for the fibula to 2.44+/-0.48 ml for the talus. The mean thickness of both the talar (1.1+/-0.18 mm) and tibial (1.16+/-0.14 mm) cartilage was significantly thicker than the fibula (0.85+/-0.13 mm). The talus had the greatest mean maximum cartilage thickness (2.38+/-0.4 mm). CONCLUSIONS: The reported stereophotographic technique may be used as an independent gold standard for validation of the accuracy of quantitative cartilage measurements made using magnetic resonance imaging. The thickness distribution maps show that the thickest articular cartilage occurs over the talar shoulders where osteochondral lesions commonly occur and not in the centre of the talar dome as commonly believed.

Aged↗

Nonsteroidal selective glucocorticoid modulators: the effect of C-5 alkyl substitution on the transcriptional activation/repression profile of 2,5-dihydro-10-methoxy-2,2,4-trimethyl-1H-[1]benzopyrano[3,4-f]quinolines.

The preparation and characterization of a series of selective glucocorticoid receptor modulators are described. The preliminary structure-activity relationship of nonaromatic C-5 substitution on the tetracyclic quinoline core showed a preference for small lipophilic side chains. Proper substitution at this position maintained the transcriptional repression of proinflammatory transcription factors while diminishing the transcriptional activation activity of the ligand/glucocorticoid receptor complex. The optimal compounds described in this study were the allyl analogue 18 and cyclopentyl analogue 32. These candidates showed slightly less potent, highly efficacious E-selectin repression with significantly reduced levels of glucocorticoid response element activation in reporter gene assays vs prednisolone. Allyl analogue 18 was evaluated in vivo. An oral dose of 18 showed an ED(50) = 1.7 mg/kg as compared to 1.2 mg/kg for prednisolone in the Sephadex-induced pulmonary eosinophilia model and an ED(50) = 15 mg/kg vs 4 mg/kg for prednisolone in the carrageenan-induced paw edema model.

Animals↗

Impact of exercise on bone health and contraindication of oral contraceptive use in young women.

PURPOSE: The effect of quantified resistance and high impact exercise training on bone mass as modified by age and oral contraceptive (OCont) use in young women was studied. METHODS: Women were categorized by age (18-23 vs 24-31 yr) and OCont use, and were then randomized into either three sessions of resistance exercise plus 60 min.wk-1 of jumping rope or a control group for 24 months. Total body, spine, femoral neck, greater trochanter, Ward's area, and radial bone mineral density (BMD) and/or content (BMC), biochemical markers of bone turnover, dietary intake of calcium, lean body mass, maximal oxygen uptake, and strength were determined at baseline and every 6 months. RESULTS: Total body (TB) BMC percent change from baseline was higher in exercisers compared with nonexercisers at 6 and 24 months. OCont users had lower bone turnover at baseline and a decrease in TBBMC from baseline compared with non-OCont users at 24 months. Spine BMC and BMD decreased in the exercise and OCont group at 6 months and remained significantly below nonexercisers who used oral contraceptives at 2 yr. Femoral neck BMD also decreased in the exercise and oral contraceptive group at 6 months. CONCLUSIONS: Exercise prevented a decline in TBBMC seen in the nonexercisers. On the other hand, exercise in oral contraceptive users prevented the increase observed in the spine of the nonexercise plus OCont group.

Adolescent↗

Correlation of wrist ligamentotaxis with carpal distraction: implications for external fixation.

Cadaver forearms were tested to measure carpal bone separation and wrist ligament tension in response to MTS-based incremental wrist distraction. Distraction of 2 mm separated the proximal carpal row from the radius and transmitted an average tension of 8 N. The mid-carpal joint also began to widen at this level of distraction. Distraction of 4 mm resulted in an average tension of 20 N. At this level of distraction, radioscaphoid separation started to exceed radiolunate separation. A transition from low- to high-stiffness response was observed over a range of 4-8 mm distraction for the 12 specimens tested, with an average tension of 80 N associated with 8 mm distraction. Average values of carpal height ratio, revised carpal height ratio, and carpal height index were found to be poor indicators of distraction, owing to their high variability between specimens.

Cadaver↗

Displaced intra-articular fractures of the distal radius: the effect of fracture displacement on contact stresses in a cadaver model.

Contact stresses in the wrist were measured after simulating displaced fractures of the lunate fossa in the distal radius of eight human cadaver arms. Osteotomies created displaced lunate fossa fractures of 0, 1, 2, and 3 mm. Contact stresses were measured with Fuji pressure-sensitive film after loads of 100 N were applied to the wrist through wrist flexor and extensor tendons. Mean contact stresses were significantly increased with step-offs of 1 mm or more. Maximum stresses and overloaded areas were significantly increased with step-offs of 2 mm or more. As the magnitude of the fracture displacement increased, there was a shift in the focus of the maximum stresses toward the fracture line. In this model, simulated displaced die-punch fractures created alterations in both the magnitude and location of contact stresses in the wrist joint.

Biomechanical Phenomena↗

Contact stress distributions in malreduced intraarticular distal radius fractures.

Residual articular incongruity of the distal radius following intraarticular fracture has been correlated with early osteoarthritis (OA) and a poor clinical outcome. We developed a simple in vitro fracture model of the distal radius to investigate the relationship between degree of articular incongruity and the resulting distribution of radiocarpal contact stress. Twelve fresh-frozen cadaver arms were dissected, packets of Fuji Pressensor film were inserted into the wrist, and the wrist was loaded through its flexor and extensor tendons. We created a simple intraarticular fracture that allowed controlled distal radius articular incongruity. Loading trials were performed for the intact distal radius, for a fully reduced case, and for step-offs of 0.4, 1, 2, and 3 mm. Mean contact stress was significantly greater than the anatomically reduced case at only 3 mm of step-off. Contact area was greater than the anatomically reduced case at 0.4, 1, and 2 mm of step-off. The elevations in contact stress that we observed were only modest, suggesting that other factors may be involved in the pathogenesis of radiocarpal OA in the presence of residual articular incongruity.

Adult↗

Physical modelling of hip joint forces in stair climbing.

A test device has been developed and validated to simulate physiologic loading of the hip during stair climbing. Forces about the hip joint were measured in static simulations of stair climbing using simulated extensor, abductor and adductor muscle groups to support the joint. Femoral flexion angle (to model step length and height) and applied hip flexion moment (to model trunk lean) were varied to examine the effects of different loading conditions on the hip. In stair climbing the maximum total joint force was six times body weight at 34 degrees of femoral flexion and 60 N m of hip flexion moment. Joint forces increased with hip flexion moment and varied little with femoral flexion angle, except for the posteriorly directed force. This component, which twists implants about the femoral shaft, increased with femoral flexion angle but changed little with hip flexion moment.

Biomechanical Phenomena↗

Biomechanical evaluation of cervical spine stabilization methods using a porcine model.

STUDY DESIGN: The biomechanical stability of three different methods of cervical spine stabilization was evaluated in a porcine model. Specimens were tested in flexion, extension, and axial rotation. OBJECTIVES: Our goal was to determine if posterior lateral mass plating after anterior reconstruction provided more stability compared with unicortical or bicortical anterior plate fixation after a simulated corpectomy. SUMMARY OF BACKGROUND DATA: Previous implant biomechanical evaluations use ligamentous and intervertebral disc disruption models under constrained and nonrepetitive loading. This study examines implant performance using a corpectomy model loaded for multiple cycles, allowing for unconstrained motion. METHODS: Twenty-one porcine cervical spines were destabilized with a one-level cervical corpectomy and reconstructed with an anterior methacrylate graft. Each construct was stabilized with either an AO Morscher plate system with unicortical, self-locking screws; a Caspar plate with biocortical screws; or two posterior lateral mass plates. Testing with cyclic loads was performed on an MTS machine in flexion, extension, and axial rotation. RESULTS: There was no statistical difference between the two anterior forms of fixation in flexion, extension, or axial rotation. Posterior lateral mass plating was significantly more stable than either anterior construct. Screw loosening was seen more frequently with bicortical Caspar plating. CONCLUSIONS: After a single-level cervical corpectomy and idealized grafting, all three surgical constructs provided stability equal to or greater than the intact condition in flexion, extension, and axial rotation. In unstable cervical spine injury patterns involving anterior disruption, this study supports the use of anterior grafting combined with posterior lateral mass plating to achieve maximum stability.

Animals↗

Radial instability of the metacarpophalangeal joint of the thumb. A biomechanical investigation.

Human cadaver thumbs were tested to evaluate stability of the radial side of the MP joint. The contributions of the dorsal capsule, radial collateral ligament, accessory collateral ligament, and volar plate were examined with the joint in 0 degrees and 30 degrees of flexion. At 0 degrees flexion, the average joint angulation increased 4 degrees following isolated radial collateral ligament transection and 6 degrees following isolated accessory collateral ligament transection. Release of both the accessory and radial collateral ligaments produced marked instability with joint angulation of at least 46 degrees. The accessory collateral ligament helped to stabilize the extended MP joint. There were no significant contributions to stability from the dorsal capsule and volar plate when the collateral ligaments were intact. In the laboratory setting, radial-side instability of the MP joint of the thumb requires transection of both the proper and accessory radial collateral ligament.

Biomechanical Phenomena↗

A contact-coupled finite element analysis of the radiocarpal joint.

A plane-strain finite element contact model of the radiocarpal joint has been developed to investigate the mechanical relationship between initial intra-articular fracture of the distal radius, subsequent imprecise reduction of articular incongruency, and final onset of osteoarthrosis. The model includes the radius, two carpal bones (the lunate and the scaphoid), and the articulations and ligamentous connections between the bones. The model has been validated through comparisons with previous experimental and computational models of the wrist. The relationship between malreduced intra-articular fracture of the distal radius and the subsequent onset of posttraumatic radiocarpal osteoarthrosis is clinically important but poorly understood. The broad objective of the current research is the development of a well-verified computational model of the radiocarpal joint, which in concert with previously developed experimental models, will be capable of providing guidance toward rigorously grounded improvements in distal radius intra-articular fracture management techniques. This model represents a first step toward this objective as well as a new level of computational simulation of wrist mechanics.

Biomechanical Phenomena↗

The influence of basal cartilage calcification on dynamic juxtaarticular stress transmission.

Dynamic finite element analysis is used to elucidate the manner in which juxtaarticular stress distributions depend on the transitional mechanical properties of the calcified cartilage layer. A finite element model is used to study how these stresses change in response to the thinning of the articular cartilage layer associated with tidemark advancement. The finite element results indicate that shear stress levels within the deepest layer of articular cartilage are increased when tidemark advancement with concomitant cartilage-thinning and calcified cartilage/subchondral plate thickening is modeled. The cartilage-thinning associated with tidemark advancement, observed both clinically and experimentally, may be an explanation for what has previously been considered wear-related thinning.

Animals↗

Open hand fractures: prognosis and classification.

Two hundred open fractures distal to the carpus in one hundred twenty-one patients were studied retrospectively. One hundred seventy-three fractures were followed-up to complete bony union, which occurred at a median period of seven weeks. Ninety-seven total complications included nine wound infections in seven patients, eighteen malunions, seventeen delayed or nonunions, twenty-three fixation problems, and two late amputations. Infection rate increased in the presence of wound contamination, delay in treatment greater than twenty-four hours, or systemic illness. It was not increased by presence of internal fixation, immediate wound closure, large wound size, tendon/nerve/vascular injury, or high-energy mechanism. We suggest a classification predictive of infection: type I: Clean wound and no systemic illness; type II: Contaminated wound, delay in treatment greater than twenty-four hours, or significant systemic illness. We recommend choosing fracture stabilization on the basis of the mechanical needs of the fracture, regardless of wound size, injury energy, or contamination. Immediate wound closure is appropriate for type I injuries and delayed closure should be reserved for type II wounds.

Adolescent↗

Stress wave effects in a finite element analysis of an impulsively loaded articular joint.

A dynamic contact finite element formulation was used to study transient stresses in the impulsively loaded rabbit knee, an established experimental model of mechanically induced osteoarthrosis. The computations were used to test the hypothesis that stress wave propagation and reflection, from juxtarticular interfaces of material property discontinuity, could be responsible for markedly increased levels of transient local cartilage stress. The finite element results demonstrated intuitively credible stress wave propagation and interfacial reflection phenomena. However, the magnitude of these waves was not nearly large enough to appreciably alter the quasi-static stress distributions otherwise prevailing. Thus, local stress wave reflection from interfaces of modulus discontinuity (for example the cartilage/subchondral plate) probably does not contribute appreciably to the heightened tissue sensitivity to impulsive loading experimentally observed in this animal model.

Animals↗

A dynamic finite element analysis of impulsive loading of the extension-splinted rabbit knee.

A dynamic nonlinear finite element model was developed to study juxtarticular stresses in the splinted rabbit knee, an established laboratory model for creating osteoarthrosis due to impulsive loading. Plane strain finite element results were validated by comparison with corresponding experimental data. Parametric effects studied included the input tibial displacement speed, the local bone density distribution, and the modulus of cartilage and subchondral bone. While the computed resultant contact force magnitude was sensitive to a number of model parameters, the stress patterns, when normalized to a given resultant force magnitude, were not. Despite comparable force peaks, the finite element results showed approximately six-fold higher effective strain rate levels for a severely impulsive loading protocol known to induce rapid osteoarthrosis, versus those for a mildly impulsive loading protocol not usually associated with cartilage damage. A propensity for elevated shear in the deep cartilage layer near the contact periphery, observed in nearly all computed stress distributions, is consistent with previous experimental findings of fissuring at that level in the impulsively loaded rabbit knee.

Animals↗

Contact stress aberrations following imprecise reduction of simple tibial plateau fractures.

Despite the well-recognized association between poorly reduced intraarticular fractures and late degenerative changes, current guidelines regarding the reduction precision necessary to avoid excessive cartilage pressures are based largely on anecdotal clinical observations. To gain a quantitative appreciation of the relation between local pressure elevations and fracture reduction imprecision, a simplified laboratory cadaver model of minimally displaced tibial plateau fractures was developed. Cartilage contact stress distributions were measured as a function of depressed fragment malreduction in seven knees, using high-resolution (100 pixels/mm2) digital image scans of Fuji-film stain patterns. The contact stress data showed a general trend of increases of peak local pressure with increasing fracture site incongruity, and in a few isolated instances the effect was very pronounced. Across the whole series, however, statistically significant departures from anatomic pressure levels did not occur until the fragment stepoff was greater than 1.5 mm. Even at the 3-mm stepoff level, for which the depressed fragment usually no longer made contact with the femoral condyle, the peak local pressure values on the intact side of the fracture line averaged only approximately 75% greater than those prevailing anatomically. Given the successful clinical outcomes normally achieved for conservatively managed simple tibial plateau fractures having stepoff magnitudes (5-10 mm) clearly sufficient to insure fragment articular noncontact, the present laboratory results suggest that nominally factor-of-two peak local pressure elevations, provided that they occur over only small portions of the cartilage surface, are probably within the long-term overall tolerance range of an articular joint.

Aged↗

Effect of osteochondral defects on articular cartilage. Contact pressures studied in dog knees.

Full thickness osteochondral defects 6 mm in diameter were created in the weight-bearing regions of the femoral condyles in 5 adult mongrel dogs to study the contact pressure changes accompanying healing. A digital imaging technique employing Fuji Prescale film mapped contact pressures following 11 months of healing for comparison with contralateral normal knees, and knees with freshly made defects. Although all defects healed uneventfully with subchondral plate reconstitution and with growth restoration of the articular surface, the repair soft tissue appeared histologically to be primarily fibrous tissue, with varying degrees of a fibrocartilaginous component. The mean and peak stresses about fresh defects were not appreciably different from those about healed defects. Neither were there substantial differences in the total cartilage area making contact, except when very low loads were applied. The results suggest that the repair tissue is of poor mechanical quality, and does not contribute appreciably to weight bearing. The cartilage adjacent to the defect did not experience high stresses; neither gross nor light microscopic evidence of degeneration appeared at 11 months. If degeneration does occur following such defects, our data suggest that it is not because of elevated contact stresses.

Animals↗