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Biomedical subjects

D L Bartel

Publications and source records attributed to D L Bartel.

At least 37 records · Page 2Linked to original sources
PubMed1994

Fundamental load transfer patterns for press-fit, surface-treated intramedullary fixation stems.

To extend our understanding of the concentric cylinder idealization of a cementless hip stem, we used finite element analysis to study the effects of various types and amounts of surface treatments on the mechanical environment of the bone-stem interface for different load cases in the early post-operative situation. All analyses used no-tension interface conditions with various values of the frictional coefficient. We found that the shear stresses along the medial bone-stem interface were most sensitive to the type and amount of surface treatment, while the contact regions were relatively insensitive to the surface treatment. Consequently, the surface treatment had a negligible effect on the transfer of bending loads. By contrast, the axial load (when combined with a bending load) was transferred by shear stresses at the lateral stem tip for fully coated stems, but by shear stresses at the medial coating junction for partially coated stems. These findings therefore indicate that transfer of bending loads from the stem to the diaphysis cannot be controlled in the early post-operative situation by surface treatments, while transfer of axial loads can be controlled with the appropriate choice and distribution of a coating. In addition, the correspondence between the predicted shear stress distributions at the porous coating junction of partially coated devices and observed bone hypertrophy patterns that are apparently biased towards the medial aspect of the junction suggest that bone remodeling at the interface around porous coated hip implants may be initially stimulated by the development of small shear stresses.

Bone Cements↗
PubMed1993

Load transfer with the Austin Moore cementless hip prosthesis.

More than 1,300 Austin Moore hemiarthroplasties have been reviewed in the literature, with no reports of fracture of the stem. Many patients with these hip implants had good function. The lack of stem fractures in patients with good functions has not been explained and contrasts with stem fractures that have occurred in patients with cemented prostheses of other designs during the same time. We used three-dimensional finite-element analysis and free-body diagrams to explain the lack of fractures for this device by a description of the probable load-transfer mechanisms between the prosthesis and the bone. Results from our finite-element analysis indicate that, with good calcar-collar support, the stresses in the stem are small because the stem portion of the prosthesis and the bone are uncoupled and, consequently, do not share the resultant bending moment of the head and abductor forces. If the stem is coupled to the bone so that the resultant bending moment is shared, high stresses in the stem are predicted; such stresses are inconsistent with the complete absence of fractures of these prostheses. The results of the finite-element analysis further showed that loss of calcar-collar support with proximal fixation through the fenestrations resulted in high stresses in the stem and stress shielding of the proximal medial cortex. The uncoupled prosthesis also may be modeled with a free-body diagram as a three-force member loaded at the head, stem tip, and in the proximal region. With this model, it can be shown that the reaction force of the stem tip, and thus the peak bending stress in the stem, increases as calcar-collar support is decreased. If there is no calcar-collar support, proximal support must be provided by some combination of integration of bone in the fenestrations and wedging due to the lateral-medial taper of the device. Stresses in the stem are largest when there is no wedging, but high stresses develop in the cancellous bone in the fenestrations. When there is wedging, stresses in the stem can be low, but stresses in the supporting cancellous bone can be high; additional proximal support through the fenestrations substantially reduces these bone stresses. If reduced stresses in the cancellous bone are indicative of a stable device, these mechanisms indicate that fractures of the Austin Moore prosthesis have not occurred in normally loaded hips because load was transferred primarily either through the collar or by wedging, with additional support at the fenestrations.

Aged↗
PubMed1993

Effects of porous coating and collar support on early load transfer for a cementless hip prosthesis.

We used a new postprocessing method with the results from a three-dimensional finite element analysis to describe the general load transfer patterns for a cementless hip arthroplasty in the early postoperative situation, and to determine the effects of porous coating [full, partial (2/3), and none] and calcar-collar support (ideal initial contact with separation allowed upon loading, no collar) on this early load transfer. No-tension interfaces were modeled over the entire bone-prosthesis interface, with an upper bound on the Coulomb-friction over coated surfaces, and zero friction over smooth surfaces to accentuate the frictional effects of the coating. The results indicate that the anteroposterior, mediolateral, and axial forces acting on each cross section of the bone were substantially different from the corresponding homeostatic (no prosthesis) forces for the fully coated device with collar support. The frontal bending moments acting on the bone were substantially less than the homeostatic values all along the prosthesis, while the sagittal bending and torsional loads were relatively similar to the homeostatic values. By far, the largest change in these loading patterns occurred with the loss of collar support, where axial loads acting on the bone were so low that over half the bone was in net tension because appreciable transfer of the compressive head force did not occur until well below the lesser trochanter. Both axial and torsional loads were transferred more distally for devices with more coating, and torsional loading of the bone was also sensitive to the degree of collar support. The frontal bending moments acting over most of the bone were insensitive to the coating or collar support. The strain energy density in the endosteal bone was most sensitive to these design variables in the proximal region, and the largest values occurred without a collar and without coating. These findings indicate that all load components acting on the proximal bone in the early postoperative situation (no bone-ingrowth or fibrous tissue at the interface) are altered by the frictional coefficient of the bone-prosthesis interface (i.e. the presence of porous coating or some other surface treatment) and the degree of collar support, while only the axial and torsional loads are altered in the distal bone. From a prosthesis design perspective this implies that surface treatments and collar support can be used to control the axial forces and the torsional moments acting all along the bone. By contrast, the distal frontal bending moment, which dominates stresses in the diaphysis, cannot be altered by these design variables.

Bone Remodeling↗
PubMed1993

Effects of porous coating, with and without collar support, on early relative motion for a cementless hip prosthesis.

In theory, porous or rough coatings could be used to reduce early post-operative relative motion about cementless hip prostheses. To investigate this theory, we used detailed, non-linear finite element analysis to compare early relative motion about a well-fit Anatomical Medullary Locking (AML) prosthesis for different amounts of porous coating (full, proximal 2/3, and no coating), both with and without collar support. Details of the model included quantitative computed tomography-derived (QCT-derived) geometric and material properties for the bone, and a no-tension interface condition at all bone-prosthesis interfaces, with Coulomb friction (mu = 1.73) over coated surfaces and zero friction elsewhere. Predicted values of relative motion for this well-fit device were in the range of approximately 1-550 microns. The distribution of relative motion was relatively insensitive to the amount of porous coating but was sensitive to collar support, while the magnitude of relative motion was sensitive to the porous coating and collar support. In addition, a reduction in the porous coating caused larger increases in relative motion when there was no collar support, indicating an interaction between the effects of porous coating and collar support. For example, distal twist increased (full vs 2/3 partial coating) by 38% with collar support and by 58% without collar support. These data suggest that porous coating, or other surface treatments which result in a high coefficient of friction at the bone-prosthesis interface, may well be used to control the magnitude of early relative motion, particularly when there is no collar support.

Biomechanical Phenomena↗
PubMed1992

Consequences of an interference fit on the fixation of porous-coated tibial components in total knee replacement.

A linearly elastic, axisymmetrical finite-element model was developed in an attempt to explain observed long-term patterns of growth of bone into tibial components. This model, which represents a portion of the tibial tray, one peg, and the surrounding cancellous bone, was used to examine two conditions of fixation in the immediate postoperative period. The first was characterized by the use of an interference fit for initial fixation of the component and the second, by the use of an interference fit with the hole in the bone deeper than the length of the peg. Two conditions of long-term fixation were also examined. In one, the bone was assumed to have grown into all of the porous coating. In the other, the bone was assumed to have grown only into the peg, and a layer of fibrous tissue was assumed to have developed between the tray and the bone. An interference fit between the peg and the cancellous bone produced considerable residual radial stresses in the bone. These stresses provide conditions that are favorable for ingrowth of bone into the pegs because the bone at the interface is stressed, and these stresses inhibit relative motion at the bone-peg interface. However, the interference fit of the peg relieved the stresses in the cancellous bone under the tray of the implant. Lack of stress at this interface is consistent with relative motion and subsequent formation of a layer of fibrous tissue. Deepening of the hole for the peg in the cancellous bone did not diminish the effects of the interference fit. Stresses in the bone under the metal tray were relieved when a layer of fibrous tissue under the tibial tray was represented in the model.

Biomechanical Phenomena↗
PubMed1991

Mechanical characteristics of the stem-cement interface.

The mechanical characteristics of the interface between a metallic stem and the surrounding poly(methyl methacrylate) bone cement were determined from experimental tests and finite element analyses. Push-through-stem tests of straight and tapered titanium alloy stems, surrounded by cement columns, were performed and the resulting load-displacement behavior and strain distribution on the surface of the cement column were measured for loading, unloading, and reloading. Test geometries were modelled using nonlinear, axisymmetric, finite element analyses, which incorporated Coulomb friction elements at the titanium alloy-cement interface. Initial residual stresses, due to curing of the cement column, were modeled by thermal contraction of the cement. Good agreement was obtained between load-displacement curves and surface strains predicted from the nonlinear analysis and those obtained from experiments, when a coefficient of friction of 0.3 was assumed for the stem-cement interface. These results show that, in the absence of chemical adhesion, the load-displacement behavior of a stem-cement composite can be described completely in terms of the friction at the interface and the residual stresses normal to the interface.

Animals↗
PubMed1991

Effects of sodium hyaluronate on tendon healing and adhesion formation in horses.

Sodium hyaluronate reduces adhesions after tendon repair in rodents and dogs, and has been used in limited clinical trials in people. To evaluate its effect on tendon healing and adhesion formation in horses and to compare these effects with those of a compound of similar visco-elastic properties, a study was performed in horses, using a model of collagenase injection in the flexor tendons within the digital sheath. Eight clinically normal horses were randomly allotted to 2 groups. Adhesion formation between the deep digital flexor tendon and the tendon sheath at the pastern region was induced in the forelimbs of all horses. Using tenoscopic control, a 20-gauge needle was inserted into the deep digital flexor tendon of horses under general anesthesia and 0.2 ml of collagenase (2.5 mg/ml) was injected. The procedure was repeated proximally at 2 other sites, spaced 1.5 cm apart. A biopsy forceps was introduced, and a 5-mm tendon defect was created at each injection site. Group-A horses had 120 mg of sodium hyaluronate (NaHA) gel injected into the tendon sheath of one limb. Group-B horses had methylcellulose gel injected at the same sites. The contralateral limbs of horses in both groups served as surgical, but noninjected, controls. Horses were euthanatized after 8 weeks of stall rest. Ultrasonographic evaluation revealed improved tendon healing after NaHa injection, but no difference in peritendinous adhesion formation. Tendon sheath fluid volume and hyaluronic acid (HA) content were greater in NaHA-treated limbs. Gross pathologic examination revealed considerably fewer and smaller adhesions when limbs were treated with NaHA. However, significant difference in pull-out strengths was not evident between NaHA-treated and control limbs. Histologically, the deep digital flexor tendon from the NaHA-treated limbs had reduced inflammatory cell infiltration, improved tendon structure, and less intratendinous hemorrhage. Treatment with methylcullulose had no significant effect on tendon healing, adhesion size, quantity, or strength or on the volume and composition of the tendon sheath fluid. Sodium hyaluronate, administered intrathecally, appears to have a pharmaceutically beneficial action in this collagenase-induced tendinitis and adhesion model in horses.

Animals↗
PubMed1986

The problem of surface damage in polyethylene total knee components.

Observations of surface damage on retrieved total knee polyethylene components have been combined with experimental and analytical studies of the contact problem to identify important clinical and design factors. The amount and severity of damage occurring on the articulating surfaces of knee components increases significantly with patient weight and with the length of time the component is implanted. The design variables that affect the amount of damage are component thickness, the conformity of the articulating surfaces, and the type of polyethylene material used. Surface damage will be more severe in thin (less than 4-6 mm) components and in components with relatively flat tibial articulating surfaces. Surface damage is also expected to be more extreme for carbon-reinforced polyethylene components than for components made from plain polyethylene.

Body Weight↗
PubMed1986

The effect of conformity, thickness, and material on stresses in ultra-high molecular weight components for total joint replacement.

Debris resulting from damage to the surface of polyethylene components of total joint replacements has previously been shown to contribute to long-term problems such as loosening and infection. Surface damage has been associated with fatigue processes due to stresses arising from contact between the metal and polyethylene components in these prostheses. In the present study, we used elasticity and finite-element solutions to determine these stresses for total hip replacements with head diameters of twenty-two and twenty-eight millimeters and for a condylar total knee replacement. We also examined the effect on these stresses of using carbon-fiber-reinforced polyethylene instead of plain polyethylene. Stresses associated with surface damage in the tibial component of the total knee replacement were much larger than those in the hip replacements. The analysis of contact stress as a function of thickness of the polyethylene insert for tibial components showed that a thickness of more than eight to ten millimeters should be maintained when possible. The contact stress in the tibial components was reduced most when the articulating surfaces were more conforming in the medial-lateral direction. Contact stresses were much less sensitive to changes in geometry in the anterior-posterior direction. For the hip components, the stresses were lower in the acetabular component of the twenty-eight-millimeter hip replacement than in the twenty-two-millimeter replacement. The use of carbon-fiber-reinforced polyethylene resulted in stresses that were higher by as much as 40 per cent. Because the contact area between articulating surfaces moves during flexion, portions of the surface will be subjected to cyclic stresses. The contact area for the knee replacements in flexion was smaller than for the hip replacements, and the range of the maximum principal stress was larger. Consequently, the combination of the higher stress and the moving contact area is more likely to cause surface damage due to fatigue in tibial components than in acetabular components, which is consistent with clinical observations.

Biomechanical Phenomena↗
PubMed1985

The effect of conformity and plastic thickness on contact stresses in metal-backed plastic implants.

Surface damage in polyethylene components for total joint replacement is associated with large contact stresses. An elasticity solution and finite element analyses were used to determine the influence of design parameters on the stresses due to contact in metal-backed components. For nearly conforming contact surfaces, it was found that the stresses in the plastic are very sensitive to clearance, that minimum plastic thickness of 4-6 mm should be maintained for metal-backed components, and that bonding the plastic to the metal backing reduces tensile stresses in the plastic at the edge of the contact zone.

Elasticity↗
PubMed1985

Elastic constitutive laws for cow teat tissue undergoing finite deformations.

Five constitutive laws are investigated to model the effect of machine milking. A nonlinear least squares procedure is employed to estimate material constants from in vivo teat inflation data. An exponential form is found to be statistically adequate as a constitutive law, and is used to determine the mechanical stresses in teat tissue during finite deformations.

Animals↗
PubMed1982

Performance of the tibial component in total knee replacement.

UNLABELLED: In patients with deficient bone in the proximal end of the tibia, the mechanical support of a conventional total knee replacement may be inadequate. We have developed a custom design for use in situations in which there is extensive deficiency of tibial cancellous bone. To do this, we examined conventional and custom prosthetic tibial components using finite-element analysis. Several loading configurations were tested, and the worst loading conditions were found to be those in which eccentric loads were placed on the margin of the tibial component. The results showed that the stresses on the cancellous bone beneath a conventional-design prosthesis may be lowered if a metal tray and metal peg are employed. A salvage-design concept for revision in the presence of deficient cancellous bone was tested analytically and used successfully. This concept requires that some portion of the applied load be transferred directly to the tibial cortical shell. Stresses in the remaining cancellous bone were lowered by the combination of a thickened metal tray and a metal support buttress. CLINICAL RELEVANCE: This study demonstrates the advantage of metal trays for the tibial plateau and suggests that they should be used whenever the supporting tibial bone is insufficient. In knees in which there are large defects in the bone, direct transfer of the load to the cortical shell through the prosthesis, made possible by a custom design, appears to be necessary.

Aged↗