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Biomedical subjects

D L Bader

Publications and source records attributed to D L Bader.

At least 55 records · Page 3Linked to original sources

The effects of design and configuration on the biomechanical response of an internal spinal fixator.

This study examines the biomechanical performance of an internal spinal fixator and the effects of specific design features under a range of loading modes. The commercial device was mounted on plastic vertebrae in a corpectomy injury model and attached by a series of experimental jigs to an appropriate material testing machine and tested under axial compression, torsion and flexion and extension moments. Results from the torsional tests indicated that increasing the clamp tightening torque from 5 to 15 N m significantly increased the rigidity of the fixation system. The inclusion of the transverse elements resulted in a significant increase in the torsional stiffness, with the increase largely overriding the effect of clamp tightening torque. By contrast, under compressive and both flexion and extension loads, neither of the design features of the fixator had a marked effect on the overall measured stiffness of the system. However, under extension loads, there were specific interactions between the two design parameters. The present study clearly indicates the need for the optimization of the design of the clamps and for alternative configurations of the transverse elements to enhance their performance under sagittal loads.

Elasticity↗

The influence of elaborated pericellular matrix on the deformation of isolated articular chondrocytes cultured in agarose.

This study investigates the mechanical influence of pericellular matrix on the deformation of isolated articular chondrocytes compressed within 3% agarose specimens. After 1 day in culture, the cells were associated with minimal amounts of sulphated glycosaminoglycan (GAG) and hydroxyproline and exhibited substantial deformation from a spherical to an oblate ellipsoid morphology when subjected to 20% gross compressive strain. However, over the 6 day culture period, there was a reduction in cell deformation associated with an increase in matrix content. Treatment with testicular hyaluronidase at days 3 and 6 reduced sulphated GAG content to levels observed in untreated specimens at day 1. At day 3, the resulting cell deformation during 20% compression was equivalent to that in specimens compressed at day 1. However, at day 6 cell deformation was only partially restored, suggesting the presence of additional structural matrix components, other than sulphated GAG, which were not present at day 3. Dual scanning confocal microscopy indicated that the elaborated matrix formed a pericellular shell which did not deform during compression and was therefore stiffer than the 3% agarose substrate. Therefore, the elaboration of a mechanically functional pericellular matrix within 6 days, effectively limits the potential involvement of cell deformation in mechanotransduction within cell seeded systems such as those employed for cartilage repair.

Animals↗

Dynamic mechanical compression influences nitric oxide production by articular chondrocytes seeded in agarose.

Nitric oxide (NO) has been implicated in the inhibition of cell proliferation in cytokine and lipopolysaccharide (LPS)-stimulated chondrocytes and is known to be influenced by physical forces in several tissues. In this study, a well-characterized model system utilizing bovine chondrocytes embedded in 3% agarose constructs has been used to investigate the effect of dynamic strain at 0.3, 1, or 3 Hz on NO production. LPS induced a significant increase in nitrite levels, which was reversed by both L-NAME and dexamethasone. Dynamic compressive strain produced a significant reduction in nitrite production. The effect was partially blocked by L-NAME but unaffected by dexamethasone. L-NAME also reversed dynamic compression-induced stimulation of [3H]-thymidine incorporation. NO appears to be a constituent of mechanotransduction pathways which influence proliferation of bovine chondrocytes seeded within agarose constructs. The inhibitor experiments also infer that alterations in cNOS activity primarily determine the response.

Animals↗

Response of chondrocyte subpopulations cultured within unloaded and loaded agarose.

Although it is well known that the metabolism of chondrocytes can be altered by the application of mechanical strain, it is unclear whether chondrocytes from the superficial and deep zones of cartilage respond in a similar manner. In this study, chondrocytes from the uppermost 15-20% (superficial cells) and the remaining tissue (deep cells) from bovine articular cartilage were isolated separately and cultured in agarose constructs. Cell deformation on application of a 15% static compressive strain was identical for both subpopulations after 24 and 72 hours in culture. The constructs were incubated under static and dynamic (0.3, 1, and 3 Hz) strains of 15% amplitude. Glycosaminoglycan synthesis by deep cells was unaffected by static strain or 3 Hz dynamic strain, whereas 0.3 Hz produced a significant reduction and 1 Hz induced a highly significant 50% stimulation of glycosaminoglycan synthesis (p < 0.001). Superficial cells exhibited a general inhibition of glycosaminoglycan synthesis. By contrast, proliferation of superficial cells was stimulated by dynamic strain whereas deep cells were not influenced. It has been suggested previously that mechanotransduction-induced controls of glycosaminoglycan synthesis and proliferation in chondrocytes embedded in agarose are uncoupled. Data presented in this study demonstrate that the two processes do, in fact, occur in different subpopulations of chondrocytes within the full-depth cell isolate.

Animals↗

The viability of soft tissues in elderly subjects undergoing hip surgery.

AIMS: To assess the viability of soft tissues in elderly patients subjected to prolonged support pressures. DESIGN: measurements were performed on the soft tissues of patients undergoing surgery for fracture of the proximal femur. METHODS: 10 subjects, mean age 84 years, participated. Transcutaneous gas tensions were continuously monitored in an area adjacent to the contralateral greater trochanter, which was loaded with an external applicator. Subcutaneous interstitial pressures using a slit catheter were also measured. RESULTS: Transcutaneous oxygen partial pressure fell in some patients to critically low levels, defined as below 2.7 kPa (20 mmHg), whilst they were subjected to normal interface pressures on the operating table. Transcutaneous partial carbon dioxide pressures rarely rose above 8.0 kPa (60 mmHg). The measured interstitial pressures could lead to local occlusion of skin microvessels. CONCLUSIONS: This study confirms that tissue viability could be compromised in elderly patients undergoing surgical procedures. The methods employed may be of value in assessing support surfaces in the operating theatre to reduce the incidence of pressure sores in this high-risk patient group.

Aged↗

Compressive strains at physiological frequencies influence the metabolism of chondrocytes seeded in agarose.

Articular cartilage is subjected to dynamic compressive loading that is known to influence chondrocyte metabolism. While the exact signalling mechanisms are unclear, it has been proposed that cell deformation plays a role and may stimulate a metabolic response through distinctive pathways. In this study, a well characterized model system in which chondrocytes are embedded in agarose was used to study the effect of dynamic cellular strain on three key metabolic processes, namely the synthesis of glycosaminoglycan, of DNA, and of total protein. Using a specially designed apparatus, 15% compressive strain amplitude was applied to agarose-chondrocyte cylinders statically or dynamically over a range of frequencies (0.3-3 Hz). Static and low-frequency strain (0.3 Hz) inhibited the synthesis of glycosaminoglycan, while a frequency of 1 Hz stimulated synthesis. Static strain reduced the level of thymidine uptake, whereas dynamic strain at all frequencies induced an increase in chondrocyte proliferation. Incorporation of tritiated proline was suppressed by all strain regimens tested. The three parameters investigated were each influenced by the dynamic strain regimens in a distinct manner, implying that the signalling mechanisms involved are uncoupled.

Animals↗

In vitro fatigue of human tendons.

The purpose of this study was to determine the fatigue behaviour of human tendons in vitro. The testing was accomplished with the use of specially designed grips and the local measurement of tendon cross-sectional area. Ninety specimens prepared from Extensor digitorum longus (EDL) tendons of the foot were subjected to a cyclic square tension-tension stress waveform at physiological frequencies. The maximum tensile stress was normalised to values corresponding to prescribed levels between 10% and 90% of the calculated ultimate tensile strength (UTS) of 100 MPa. The minimum stress was set at 1% of the UTS. A replication of 10 specimens per stress level allowed the use of statistical models for the distribution of fatigue life. Results followed a linear model, of form S = 101.3 - 14.8 log(N), relating the normalised stress to the median number of cycles to failure, therefore suggesting the absence of an endurance limit. The Weibull distribution was found to describe adequately the probability of failure at each stress level. A model which takes into account in vivo healing was proposed. This model was able to explain the presence of intact tendons throughout the lifetime of an individual.

Aged↗

The development and characterization of an in vitro system to study strain-induced cell deformation in isolated chondrocytes.

A model system has been developed to investigate cell deformation of chondrocytes in vitro. Chondrocytes were isolated from bovine articular cartilage by enzymatic digestion and seeded in agarose (type VII) at a final concentration of 2 x 10(6) cells.ml-1 in 3% agarose. Mechanical evaluation of the system showed no change in the tangent modulus of agarose/chondrocyte cultures over a 6-d culture period. The resulting agarose/chondrocyte cultures were subjected to compressive strains ranging from 5-20%. Cell shape was assessed by measuring the dimensions of the cell both perpendicular (x) and parallel (y) to the axis of compression and deformation indices (I = y/x) calculated. Cell deformation increased with the level of strain applied for freshly isolated chondrocytes. The cultures were maintained in medium that inhibits or stimulates matrix production (DMEM and DMEM + 20% FCS, respectively) in order to assess the effect of cartilaginous matrix on chondrocyte deformation. Matrix elaborated by the cells markedly influenced levels of cell deformation, an increase in matrix leading to a decrease in cell deformation. Freshly isolated deep zone chondrocytes were found to deform significantly more than surface zone chondrocytes, although this effect was lost after 6 d in culture. The elaborated matrix also altered the recovery characteristics of the chondrocytes following constant compressive strain of 15% for 24 h. Cells that had elaborated matrix took several hours to return to unloaded shape, while cells without matrix returned to the unloaded shape instantly.

Animals↗

Early progressive changes in tissue viability in the seated spinal cord injured subject.

The patient with spinal cord injury is at high risk of tissue breakdown at all times due to a number of adverse factors, such as reduced mobility and anaesthesia. It is therefore essential that each patient is prescribed appropriate support media during initial rehabilitation. In this study, the effectiveness of prescribed wheelchair cushions has been assessed in terms of tissue response at the ischial tuberosities. A total of 42 subjects who had sustained traumatic spinal cord injury within 1 year were monitored on at least two occasions during initial rehabilitation. Changes in transcutaneous gas response (TcPO2 and TcPCO2) were monitored concurrently with regional interface pressures. A series of six transcutaneous gas variables were established, as markers of tissue viability. Non-parametric statistical analyses revealed some significant correlations between these variables. The results of this study also indicate that (1) spinal cord injury subjects with lesions below T6 show a progressive decrease in ability to maintain blood flow in sitting on prescribed support cushions and (2) SCI subjects with lesions above T6 show a progressive improvement in tissue viability status at the seating support interface. Therefore results imply that paraplegics are at a potentially higher risk of tissue breakdown than tetraplegics and thus require effective support cushions with strict adherence to a pressure relief regime.

Adolescent↗

The analysis of metabolites in human sweat: analytical methods and potential application to investigation of pressure ischaemia of soft tissues.

A straightforward technique was developed for sweat collection applicable to tissues subjected to external load without introducing distortion of underlying tissues, and for analysis of six metabolites in the collected sweat. Chloride was measured colorimetrically and lactate, urea and urate by enzymatic methods on a centrifugal analyser. Sodium and potassium were measured by flame photometry. The methods showed good precision, recovery and linearity. To assess the technique sweat was collected: (i) from the sacrum, ischium, forearm and calf in healthy individuals at 32 degrees C for 1 h; (ii) from the sacrum of healthy subjects at ambient temperature for 9 h; (iii) at ambient temperature from the sacrum of a patient with a history of pressure sores. Sweat rates were greater at the sacrum and ischium than the calf or forearm. There were differences in the concentrations of lactate and urea between sites but these were smaller when expressed as amount secreted. Sweat rates were significantly lower in groups (ii) and (iii), but sweat could be collected reliably. This technique has potential clinical application to the investigation of susceptibility to pressure sores.

Adult↗

The short-term compressive properties of adult human articular cartilage.

An apparatus and test method were developed to determine the elastic stiffness and damping coefficient of human cartilage in compression. An underdamped, counterbalanced beam applied a sudden compressive force to a full-thickness cylindrical specimen of articular cartilage. The initial oscillatory response decayed to steady state creep after approximately 10 cycles of oscillation. The results were consistent with a Voigt phenomenological model with linear stiffness and damping terms. Standard dynamics analysis of the transient oscillatory response enabled the elastic stiffness to be determined from the frequency and the damping coefficient to be derived from the logarithmic decrement of the decay of the oscillations. The relationship between the mechanical properties and structure of cartilage was determined by treating specimens with two specific proteolytic enzymes. Digestion and removal of proteoglycans alone with cathepsin D caused the damping coefficient to decrease with no change in elastic stiffness. The action of leukocyte elastase on collagen caused a decrease in both damping coefficient and elastic stiffness. It was concluded that the collagen fibrils in cartilage largely control the elastic response while the viscous response is controlled largely by the hydrated proteoglycans. The effects of cartilage thickness was also examined and found to be inversely proportional to the elastic stiffness. It is suggested that this method could be used to uncouple elastic and viscous properties of other viscoelastic materials.

Adult↗

A biomechanical analysis of the plantar surface of soccer shoes.

The incidence of severe injuries for soccer players may lead to long-term inactivity or, at worst, retirement from the game. Many of these injuries, particularly those involving the lower leg, can be attributed to adverse physical conditions at the interface between the soccer shoe and the playing support surface. This study investigated the biomechanical characteristics at this interface for a range of proprietary soccer shoes. An experimental system was designed and developed which, via a weighted pendulum arm making contact with a vertical column, provided controlled rotation of the forefoot of the soccer shoe on samples of playing surfaces. The overall rotation was found to depend on several physical and material factors. For example, the size 7 soccer shoes produced a statistically significant increase in axial rotation for the same impact energy compared to the larger sized shoes under test. In addition, flat soled shoes, designed for synthetic playing surfaces, produced consistently smaller rotations than shoes with either moulded or screw-in studs, although this finding depended on the moisture content of the playing surface. The pressure distribution within several soccer shoes was also measured using the F-Scan Gait Analysis System, for a subject walking across a grass surface. Results indicated differences in pressure distribution over the first metatarsal area of the foot, in existing shoe designs.

Biomechanical Phenomena↗

The effects of selective matrix degradation on the short-term compressive properties of adult human articular cartilage.

The effects of proteoglycan and collagen digestion on the transient response of human articular cartilage when tested in unconfined compression were determined. Small cylindrical specimens of cartilage, isolated from the femoral head of the hip joint and from the femoral condyles of the knee joint, were subjected to a suddenly applied compressive load using a test apparatus designed to yield a transient oscillatory response. From this response values of the elastic stiffness and the viscous damping coefficient were determined. Cathepsin D and cathepsin B1 were used to digest the proteoglycan in some specimens, while in other specimens leukocyte elastase was used to attack the non-helical terminal regions of the Type II tropocollagen molecules and possibly the Type IX collagen molecule and thereby disturb the integrity of the collagen mesh. The results showed that proteoglycan digestion alone reduced the viscous damping coefficient but it did not significantly alter the elastic stiffness as determined from the oscillatory response. In contrast, the action of elastase reduced both the damping coefficient and the elastic stiffness of the cartilage. The results demonstrated the role of proteoglycans in regulating fluid transport in cartilage and hence controlling the time-dependent viscous properties. The elastic stiffness was shown to be dependent on the integrity of the collagen fibre network and not on the proteoglycans.

Aged↗

Transcutaneous gas tensions in the sacrum during the acute phase of spinal cord injury.

The first few months following injury to the spinal cord requires constant care of the subject if tissue breakdown is to be avoided. The management of acute traumatic cases involves complete bedrest in a supine position with appropriately positioned pillows to minimize trauma to the bone prominences. This study assesses the effectiveness of the management procedure in terms of the tissue response at the sacrum of 15 acute spinal cord injured subjects. The measurement of mean interface pressures during a representative period of recumbency was performed and these were related to changes in transcutaneous gas tensions (TcPO2 and TcPCO2), which are reliable indices of tissue viability. A series of six variables was established which were compared to each other using non-parametric statistical analyses. It was shown that this group of subjects demonstrated a normal mechanism whereby the level of carbon dioxide was able to control the local vascular tone. The results also suggested that the practice of gapping at the sacrum should be revised to reduce mean sacral pressures and minimize the possibility of tissue breakdown, the risk of which is constant throughout the first three months following injury.

Adolescent↗

The recovery characteristics of soft tissues following repeated loading.

Pressure relief at the patient support interface is important to avoid tissue breakdown by ischemia, particularly with debilitated subjects. However, there are still few guidelines to indicate the level of relief required for specific tissue areas. This paper examines the nature of the tissue recovery to repeated loading in compression. Loading was produced by (1) external application using an experimental system attached to the sacrum and (2) ischial support on a dynamic cushion. In both cases, the interface pressures applied for a prescribed time were related to changes in transcutaneous gas tension, the latter being an index of tissue viability. Results indicate two distinct responses to repeated loading. The normal response provides rapid and complete tissue recovery to unloaded values of transcutaneous oxygen tension. This was observed with all normal subjects and some of the debilitated subjects. There was also a group of debilitated subjects who demonstrated impaired and delayed tissue recovery. It is proposed that they are at most risk of developing tissue breakdown.

Adult↗

The biomechanical effectiveness of the Boston brace in the management of adolescent idiopathic scoliosis.

The present study assesses the biomechanical effectiveness of the Boston brace on a group of 14 patients with adolescent scoliosis. Interface pressure measurements were performed at the appropriate compression pads within the brace when it was first applied and on two further sessions within the 6-month period of brace treatment. A corresponding series of Cobb angle measurements also were performed. Mean values of total force exerted through the brace of 58 +/- 18 N were associated with an initial curve correction of 37 +/- 21%. This mean force level was maintained throughout the study, although the mean curve correction at 6 months had reduced to 15 +/- 14%. In addition to biomechanical parameters, factors relating to the nature of the individual curve were important in determining the overall effectiveness of the Boston brace system.

Adolescent↗