Biomedical subjects

D L Bartel

Publications and source records attributed to D L Bartel.

At least 19 recordsLinked to original sources

PubMed2002

Periprosthetic modelling of femoral component fit using computed tomography data for total hip arthroplasty: a feasibility study.

The aim of the work was to create a new three-dimensional periprosthetic multi-criteria optimisation technique to identify the best six degrees of freedom transform to position a porous-coated anatomic cementless femoral component for three factors, including: first, maximisation of the degree of contact achieved between designated bone ingrowth surfaces and the periprosthetic bone; secondly, minimisation of the bone mass to be removed to accommodate the component and thirdly, the extreme constraint of the component to be positioned so that it does not project beyond the periosteum. Discrete integrals were computed over regions of interest derived from the polyhedral component mesh in transaxial CT scan planes, using a polygon scan-conversion algorithm. A new biomedical imaging volume rendering technique utilising dynamic virtual textures was developed to visualise the design trade-offs. Pareto-optima were identified for four femora that matched an average-sized component. The non-linear, multi-modal fit metric was quadratic near minima, with a narrow trough of equivalent fit values within 3mm of translation and 3 degrees of rotation with respect to the canal axis, and possessed a dependence most pronounced for distal-directed insertion against varus/valgus rotation. The study gives previously unavailable data on the three-dimensional femoral component fit and is the first report that demonstrates that fitting the implant using several design criteria in a multi-criteria optimisation scheme is feasible.

Arthroplasty, Replacement, Hip↗

PubMed2001

Design and analysis of robust total joint replacements: finite element model experiments with environmental variables.

Computer simulation of orthopaedic devices can be prohibitively time consuming, particularly when assessing multiple design and environmental factors. Chang et al. (1999) address these computational challenges using an efficient statistical predictor to optimize a flexible hip implant, defined by a midstem reduction, subjected to multiple environmental conditions. Here, we extend this methodology by: (1) explicitly considering constraint equations in the optimization formulation, (2) showing that the optimal design for one environmental distribution is robust to alternate distributions, and (3) illustrating a sensitivity analysis technique to determine influential design and environmental factors. A thin midstem diameter with a short stabilizing distal tip minimized the bone remodeling signal while maintaining satisfactory stability. Hip joint force orientation was more influential than the effect of the controllable design variables on bone remodeling and the cancellous bone elastic modulus had the most influence on relative motion, both results indicating the importance of including uncontrollable environmental factors. The optimal search indicated that only 16 to 22 computer simulations were necessary to predict the optimal design, a significant savings over traditional search techniques.

Arthroplasty, Replacement, Hip↗

PubMed2000

A reconciliation of local and global models for bone remodeling through optimization theory.

Remodeling rules with either a global or a local mathematical form have been proposed for load-bearing bones in the literature. In the local models, the bone architecture (shape, density) is related to the strains/energies sensed at any point in the bone, while in the global models, a criterion believed to be applicable to the whole bone is used. In the present paper, a local remodeling rule with a strain "error" form is derived as the necessary condition for the optimum of a global remodeling criterion, suggesting that many of the local error-driven remodeling rules may have corresponding global optimization-based criteria. The global criterion proposed in the present study is a trade-off between the cost of metabolic growth and use, mathematically represented by the mass, and the cost of failure, mathematically represented by the total strain energy. The proposed global criterion is shown to be related to the optimality criteria methods of structural optimization by the equivalence of the model solution and the fully stressed solution for statically determinate structures. In related work, the global criterion is applied to simulate the strength recovery in bones with screw holes left behind after removal of fracture fixation plates. The results predicted by the model are shown to be in good agreement with experimental results, leading to the conclusion that load-bearing bones are structures with optimal shape and property for their function.

Bias↗

PubMed1999

Preclinical cost analysis of orthopaedic implants: a custom versus standard cementless femoral component for revision total hip arthroplasty.

A preclinical cost analysis method was introduced to assess the cost effectiveness of using a custom implant instead of standard "off-the-shelf" implants for revision total hip arthroplasty. Finite element models of proximal femur-implant systems were constructed and an array of environmental factors, including loads and bone properties, was incorporated into a computer experiment to evaluate relative motion between implant and bone. Implant performance related cost was then determined from relative motion measures using a quality loss function. Unit manufacturing cost was added to implant performance cost to determine the cost difference between the two implants. The reduction in relative motion achieved by the custom implant with respect to an equivalent-lengthed standard implant justified its additional unit manufacturing costs. In response to these results and suggestions by surgeons, we increased the length of the standard implant by 50 mm and performed an identical series of analyses. We found that increasing the stem length to 120 mm substantially decreased the relative motion of the standard implant to values less than for the custom implant. This case study provides preliminary evidence that a surgical inventory consisting of longer-stemmed standard implants or modular distal stems is more cost effective than designing custom devices on a case-by-case basis. Additional design studies are warranted before generalizing such a claim.

Aged↗

PubMed1999

Robust optimization of total joint replacements incorporating environmental variables.

Direct search techniques for the optimal design of biomechanical devices are computationally intensive requiring many iterations before converging to a global solution. This, along with the incorporation of environmental variables such as multiple loading conditions and bone properties, makes direct search techniques infeasible. In this study, we introduced new methods that are based on the statistical design and analysis of computer experiments to account efficiently for environmental variables. Using data collected at a relatively small set of training sites, the method employs a computationally inexpensive predictor of the structural response that is statistically motivated. By using this predictor in place of the simulator (e.g., finite element model), a sufficient number of iterations can be performed to facilitate the optimization of the complex system. The applicability of these methods was demonstrated through the design of a femoral component for total hip arthroplasty incorporating variations in joint force orientation and cancellous bone properties. Beams on elastic foundation (BOEF) finite element models were developed to simulate the structural response. These simple models were chosen for their short computation time. This allowed us to represent the actual structural response surface by an exhaustive enumeration of the design and environmental variable space, and provided a means by which to validate the statistical predictor. We were able to predict the structural response and the optimal design accurately using only 16 runs of the computer code. The general trends predicted by the BOEF models were in agreement with previous three-dimensional finite element computer simulations, and experimental and clinical results, which demonstrated that the important features of intramedullary fixation systems were captured. These results indicate that the statistically based optimization methods are appropriate for optimization studies using computationally demanding models.

Algorithms↗

PubMed1998

Predictive model for tensile true stress-strain behavior of chemically and mechanically degraded ultrahigh molecular weight polyethylene.

The gamma radiation sterilization of ultrahigh molecular weight polyethylene (UHMWPE) components in air generates long-lived free radicals that oxidize slowly over time during shelf storage and after implantation. To investigate the combined effects of chemical and mechanical degradation on the mechanical behavior of UHMWPE, sterilized tensile specimens were immersed in 0.5% hydrogen peroxide solution at 37 degrees C for up to 9 months and concurrently subjected to cyclic stress levels of 0 (control), 0 to 5, and 0 to 10 MPa. After chemical and mechanical preconditioning, specimen density was measured using the density gradient column technique. The true stress-strain behavior was measured up to 0.12 true strain and characterized using a multilinear material model, the parameters of which were found to vary linearly with density and cyclic stress history. The mechanical behavior of as-irradiated and degraded UHMWPE was accurately predicted by an analytical composite beam model of the tensile specimens. The results of this study support the hypothesis that chemical and mechanical degradation affect the true stress-strain behavior of UHMWPE. In the future, the material model data presented in this study will enable more accurate prediction of the stresses and strains in UHMWPE components following gamma sterilization in air and subsequent in vivo degradation.

Biocompatible Materials↗

PubMed1998

Residual stresses in ultra-high molecular weight polyethylene loaded cyclically by a rigid moving indenter in nonconforming geometries.

The characterization of stress and deformation fields that incorporate moving cyclic loads and nonlinear material response in ultra-high molecular weight polyethylene components for total knee replacements is required to quantify mechanisms of surface damage. A simulation of stresses in polyethylene components for total knee replacement subjected to cyclic moving loads was performed with use of nonlinear finite element analysis. Convergence to a steady-state cycle of stress and deformation was observed within five cycles of loading. Differential plastic deformation under the surface of the polyethylene led to horizontal residual stresses that were tensile at the surface and compressive in the subsurface. The magnitudes of the residual stresses indicate their importance in surface failure mechanisms. Horizontal residual tensile stresses at the surface are consistent with the initiation and propagation of surface cracks that could cause pitting in polyethylene. Horizontal residual compressive stresses under the surface could cause such cracks to arrest or turn and thus limit damage to a region just beneath the surface. The results emphasize the importance of incorporating nonlinear effects to simulate long-term stress fields associated with surface damage in polyethylene.

Arthroplasty, Replacement, Knee↗

PubMed1998

Postirradiation aging affects stress and strain in polyethylene components.

Ultrahigh molecular weight polyethylene components oxidatively degrade because of gamma radiation sterilization and subsequent shelf aging in air. The effects of shelf aging on the stresses and strains associated with surface damage in tibial and acetabular components were examined. A material model was developed to predict the stress and strain relationship of oxidatively degraded polyethylene as a function of density using samples of polyethylene that were gamma radiation sterilized and evaluated immediately after irradiation and after 42 months of shelf aging. The finite element method was used to determine the stresses and strains before and after shelf aging for two tibial components with different conformities between the articulating surfaces and for an acetabular component. The stresses increased by 10% to 14% in the conforming tibial model after 42 months of aging, whereas the stresses in the nonconforming tibial model and in the acetabular model increased by only 4% to 8%. Aging decreased the principal strains by 5% to 10% in both tibial models and by 15% to 17% in the acetabular model. Postirradiation aging during shelf storage of polyethylene joint components is likely to worsen long term wear, based on the increased stresses and decreased strains predicted to occur as a result of aging.

Gamma Rays↗

PubMed1998

Cemented femoral stem performance. Effects of proximal bonding, geometry, and neck length.

The effects of proximal bonding, distal stem geometry, and femoral neck length on cement and interface stresses were determined to understand better their role in clinical performance. The effects of stem design were compared with the effects of environmental variables, patient weight, and patient activity. Finite element models were used to determine peak cement and interface stresses, and an experimental layout was used to separate design and environmental effects. Bonding reduced cement mantle stresses by 35% to 60%, to levels below the cement fatigue strength. A flat sided implant provided more torsional resistance, reducing shear stresses at the proximal cement-prosthesis interface by 22% to 73% with respect to a distal round implant. Neck length had minimal effects on stresses compared with bonding or implant geometry. Cement-bone interface stresses were more sensitive to patient activity than to the design variables. Therefore, claims that a strong cement and prosthesis bond may be harmful to the bone-cement interface are unjustified based on these results. The best combination of design variables was a proximally bonded, flat sided implant with neck length left to the surgeon's discretion. This combination was most effective at protecting the cement mantle and prosthesis interface and perhaps the cement-bone interface by minimizing stresses associated with cement debris generation.

Activities of Daily Living↗

PubMed1997

Degradation rate of ultra-high molecular weight polyethylene.

Ultra-high molecular weight polyethylene components for total joint replacement chemically degrade before and after implantation, and the degradation is associated with an increase in density. The goal of this study was to determine the average rate of density change in these components following sterilization by gamma radiation in air as a function of shelf age and implantation time. Using the density gradient column method, density profiles were obtained through the thickness from loaded and unloaded regions of 10 retrieved Insall-Burstein/Posterior-Stabilized II tibial components and one operating-room inventory component for which the initial density profile and patient history (if applicable) were known. The average density of the components increased at a constant rate of 0.000186 g/cc/month during the first 50 months after sterilization (r2 = 0.54) but was not significantly affected by loading (p > 0.05). The quantitative degradation rates may be useful to help verify kinetic models to predict bulk degradative changes on the basis of micro-structural and chemical processes. This research also suggests the hypothesis that degradation of ultra-high molecular weight polyethylene can be modeled in terms of changes in bulk or average properties.

Gamma Rays↗

PubMed1997

Influence of stem geometry on mechanics of cemented femoral hip components with a proximal bond.

Nonlinear, three-dimensional, finite element models of cemented femoral hip components with a proximal stem-cement bond were developed with use of a Charnley stem geometry and a modified Charnley stem geometry that had a cylindrical cross section over the distal two-thirds of the stem (Distal-Round). Peak tensile stresses in the proximal cement mantle increased 63 and 74% for the Charnley and Distal-Round stems, respectively, when the proximal stem-cement interface was debonded. The shear stresses over the stem-cement interface with a proximal bond were 29% larger for the Distal-Round stem than for the Charnley stem. After the proximal stem-cement interface was debonded, the peak tensile stresses in the cement mantle were 15% larger for the Distal-Round stem than for the Charnley stem. The results illustrate that stresses within the proximal cement mantle could be substantially reduced for both Charnley and Distal-Round stems through use of a proximal stem-cement bond. However, the risk of debonding may be higher for the Distal-Round stem because of increased shear stresses, and once debonded the risk of further loosening due to failure of the cement mantle would also be higher for the Distal-Round stem.

Bone Cements↗

PubMed1997

The role of backside polishing, cup angle, and polyethylene thickness on the contact stresses in metal-backed acetabular components.

Mechanical interactions between the polyethylene liner and the metal-backing play an important role in the load transfer and debris-generation mechanisms of an acetabular component. Insert thickness, cup orientation, and insert-shell interface conditions affect the resulting contact stresses at the articulating and backside surfaces of the polyethylene component. The objective of this study was to determine the variation in contact stresses on a hemispherical acetabular component as a function of the friction coefficient of the line-shell interface, the thickness of the insert, and the load application angle. Three-dimensional finite element models of a metal-backed acetabular component with liner thicknesses of 3-12 mm were developed. The insert-shell interface was modeled as either matte or highly polished, and the load angle of the joint reaction force was changed from 36 to 63 degrees with respect to the dome. We found that the contact stresses at the articulating and backside surfaces of the insert were relatively insensitive to changes in the coefficient of friction at the insert-shell interface (resulting in approximately 1-10% variation in contact stress), when compared to the effect of changing the insert's thickness (approximately 80% variation in contact stress) or changing the direction of the joint reaction force (approximately 20% variation in contact stress). The results of this study suggest that polishing the metal at the insert-shell interface does not substantially change the contact stresses at either surface of the component. Of the design variables available for selective modification by either the surgeon or the engineer, insert thickness and shell orientation play a greater role in determining the magnitude of the resulting contact stresses.

Acetabulum↗

PubMed1996

Exponential model for the tensile true stress-strain behavior of as-irradiated and oxidatively degraded ultra high molecular weight polyethylene.

Following sterilization by gamma radiation, ultra high molecular weight polyethylene components for total joint replacement undergo oxidative degradation upon exposure to air and the in vivo environment. Oxidative degradation is accompanied by an increase in density. The primary objective of this study was to develop a mathematical model to predict the monotonic tensile mechanical behavior of these sterilized components as a function of changes in density arising from oxidative degradation. Tensile specimens of ultra high molecular weight polyethylene were sterilized with gamma radiation and then oxidatively degraded in an air furnace. The average density of each specimen was measured using a density gradient column. Differential scanning calorimetry and Fourier transform infrared spectroscopy were conducted on selected specimens to characterize the physical and chemical changes due to accelerated aging as opposed to ambient shelf aging. Mechanical testing was conducted in monotonic uniaxial tension. An exponential model was fitted to the true stress-strain data (up to a true strain of 0.12). The observed fitted stress had a correlation coefficient of 0.996. The model permits a quantitative prediction of the association between the true stress-strain curve and density for the ultra high molecular weight polyethylene components. The proposed exponential model effectively describes changes in the large-strain monotonic tensile behavior of as-irradiated and oxidatively degraded ultra high molecular weight polyethylene components.

Air↗

PubMed1996

Surface geometry of retrieved McKee-Farrar total hip replacements.

A coordinate measurement machine was used to determine the surface geometry of 22 retrieved McKee-Farrar total hip replacements. The radial clearance of each acetabular cup-femoral head pair was computed to see whether there was potential for hydrodynamic lubrication. The surface geometry was used to estimate the volumetric wear for the acetabular cup and the femoral head, and to assess whether those prostheses that had the potential for fluid film lubrication also displayed lower wear. The volumetric wear rate for each prosthesis was estimated by dividing the volumetric wear by the corresponding service life. Two distinct wear patterns were seen on the femoral head. Prostheses displaying polar wear on the femoral head showed significantly greater service lives than those displaying non-polar wear. Although several prostheses had clearances that provided for the possibility of hydrodynamic lubrication, no correlation could be found between clearance and the measured wear.

Biomechanical Phenomena↗

PubMed1995

Coulomb frictional interfaces in modeling cemented total hip replacements: a more realistic model.

Loosening of cemented femoral hip stems could be initiated by failure of the cement mantle due to high cement stresses. The goals of this study were to determine if realistic stem-cement interface characteristics could result in high cement stresses when compared to a bonded stem-cement interface and to determine if stem design parameters could be chosen to reduce peak cement stresses. Three-dimensional finite-element models of cemented femoral hip components were studied with bonded or realistic Coulomb friction stem-cement interfaces. The results showed that the use of a non-bonded, non-linear Coulomb friction interface resulted in substantially different stress fields in the cement when compared to a bonded stem-cement interface. Tensile stresses in the proximal cement mantel for the Coulomb friction interface case (10.8 MPa) were greater than the fatigue strength of the cement. In contrast, the tensile stresses in the cement mantle were not greater than the fatigue strength for the bonded case (7.5 MPa). Failure of the cement mantle in the proximal femur could therefore be initiated by a lack of a bond at the stem-cement interface. The effect of different cross-sectional stem geometries (medial radii of 3.0, 4.9 and 5.5 mm and antero-posterior widths of 9.8 and 13.7 mm) and different elastic moduli (cobalt chromium alloy and titanium alloy) for the stem material were also evaluated for models with a Coulomb friction interface. Changes in the stem cross-section and elastic modulus had only limited effects on the stress distributions in the cement. Of the parameters evaluated in this study, the characteristics of the stem-cement interface had the largest effect on cement mantle stresses.

Alloys↗

PubMed1995

Mechanical consequences of bone ingrowth in a hip prosthesis inserted without cement.

Long-term biomechanical problems associated with the use of sintered porous coating on prosthetic femoral stems inserted without cement include proximal loss of bone and a risk of fatigue fracture of the prosthesis. We sought to identify groups of patients in whom these problems are accentuated and in whom the use of porous coating may thus jeopardize the success of the arthroplasty. We attempted to develop clinical guidelines for the use of sintered porous coating by investigating the long-term biomechanical effects of bone growth into partially (two-thirds) porous-coated anatomic medullary locking hip prostheses that fit well. More specifically, we used a detailed finite element analysis and a composite beam theory to determine the dependence of proximal loading of the bone and maximum stresses on the stem on the development of clinically observed patterns of bone ingrowth and the dependence of the risk of fatigue fracture of the stem on the diameter of the stem, the diameter of the periosteal bone, and the material from which the prosthesis was made. We found that bone ingrowth per se substantially reduced proximal loading of the bone. With typical bone ingrowth, axial and torsional loads acting on the proximal end of the bone were reduced aa much as twofold compared with when there was no ingrowth; bending loads on the proximal end of the bone were also reduced. The risk of fatigue fracture of the stem was insensitive to the development of bone ingrowth. However, the risk of fatigue fracture of the stem increased with decreased diameters of the stem and the periosteal bone and with increased modulus of the stem. The maximum risk of fracture was found in active patients in whom a cobalt-chromium-alloy stem with a small diameter had been implanted in a bone with a small diameter.

Biomechanical Phenomena↗

PubMed1995

Stresses in polyethylene components of contemporary total knee replacements.

Contemporary knee designs differ considerably in the conformity that exists between the articulating surfaces of the femoral and tibial components. The thickness of the polyethylene components also varies from design to design. Conformity and thickness affect the stresses associated with surface damage and the subsequent generation of harmful polyethylene debris. In this study, the stresses and strains caused by contact were calculated for 8 contemporary knee prostheses. Finite element analysis using large-strain theory was used to determine the stresses and strains for the minimum available polyethylene thickness and for the knee in flexion. The greatest differences among designs was for the von Mises strain, which reached its maximum beneath the surface. The differences in stresses were less notable because of the nonlinear material behavior of the polyethylene. This study also confirmed the advantages of designs that have more conforming articulating surfaces and thicker polyethylene components.

Humans↗

PubMed1994

Fatigue crack propagation behavior of ultra high molecular weight polyethylene under mixed mode conditions.

Analytical studies of the stresses on and within ultra high molecular weight polyethylene joint components suggest that damage modes associated with polyethylene fatigue failure are caused by a combination of surface and subsurface crack propagation. Fatigue crack propagation tests under mixed mode loading conditions were conducted on center-cracked tension specimens machined from extruded blocks of sterilized polyethylene in an attempt to determine how fatigue cracks change direction in this material. Cyclic testing was performed using a sinusoidal wave form at a frequency of 5 Hz and an R-ratio (minimum load/maximum load) of 0.15. Specimens had the notch oriented perpendicular to the direction of applied load and at angles of 60 degrees and 45 degrees to the loading direction. Numerical analyses were used to interpret the experimental test and to predict the fatigue behavior of polyethylene under mixed mode conditions. It was found that all cracks eventually propagated horizontally, regardless of the initial angle of inclination of the notch to the direction of applied cyclic load. In fact, the extent of the curvilinear crack growth was quite limited. An effective range of cyclic stress intensity factor was calculated for correlation with the rate of crack growth. The results followed a Paris relation, with crack growth rate linearly related to a power of the range of stress intensity, for all three crack orientations. The numerical analyses adequately modeled the experimental fatigue crack growth results.

Materials Testing↗