Biomedical subjects

D P Pioletti

Publications and source records attributed to D P Pioletti.

At least 19 recordsLinked to original sources

PubMed2007

Polylactic acid-phosphate glass composite foams as scaffolds for bone tissue engineering.

Phosphate glass (PG) of the composition 0.46(CaO)-0.04(Na(2)O)-0.5(P(2)O(5)) was used as filler in poly-L-lactic acid (PLA) foams developed as degradable scaffolds for bone tissue engineering. The effect of PG on PLA was assessed both in bulk and porous composite foams. Composites with various PG content (0, 5, 10, and 20 wt %) were melt-extruded, and either compression-molded or foamed through supercritical CO(2). Dynamic mechanical analysis on the bulk composites showed that incorporating 20 wt % PG resulted in a significant increase in storage modulus. Aging studies in deionized water in terms of weight loss, pH change, and ion release inferred that the degradation was due to PG dissolution, and dependent on the amount of glass in the composites. Foaming was only possible for composites containing 5 and 10 wt % PG, as an increase in PG increased the foam densities; however, the level of porosity was maintained above 75%. PLA-T(g) in the foams was higher than those obtained for the bulk. Compressive moduli showed no significant reinforcement with glass incorporation in either expansion direction, indicating no anisotropy. Biocompatibility showed that proliferation of human fetal bone cells was more rapid for PLA compared to PLA-PG foams. However, the proliferation rate of PLA-PG foams were similar to those obtained for foams of PLA with either hydroxyapatite or beta-tricalcium phosphate.

Biocompatible Materials↗

PubMed2006

Biomechanical evaluation of intra-articular and extra-articular procedures in anterior cruciate ligament reconstruction: a finite element analysis.

BACKGROUND: Intra-articular techniques (single and double bundles) are the most widely used procedures for the anterior cruciate ligament reconstruction. Lemaire introduced in 1967 the extra-articular techniques, and combined intra-articular and extra-articular reconstruction, to better restore the stability of the knee. However, the effectiveness of these procedures (intra-articular, extra-articular combined or not with intra-articular) seems to be controversial. METHODS: In the present study, we developed numerical models of a knee joint to evaluate the effects of these different procedures on the kinematics and biomechanics of the knee during an internal rotation test. Six cases were simulated: intact anterior cruciate ligament, intra-articular reconstructed anterior cruciate ligament (single and double bundles), extra-articular reconstructed anterior cruciate ligament alone, and combination of extra- and intra-articular reconstructions. The loading condition was an internal tibial torque of 2 N m at 0 degrees, 15 degrees, 30 degrees and 45 degrees of knee flexion. Internal rotation of the tibia and forces within the grafts and the ligaments were calculated. FINDINGS: This study showed that both single and double bundles intra-articular reconstructions restore similar internal rotation control and biomechanics of the soft structures as the intact anterior cruciate ligament situation. On the other hand, our results indicate that extra-articular reconstruction reduces appreciably the internal rotation and modifies the charges distribution in the soft structures when compared to the intact anterior cruciate ligament. INTERPRETATION: The extra-articular procedure alters the kinematics of the knee, which might overconstraint the ligaments and the femorotibial joints, leading to the failure of the anterior cruciate ligament reconstruction.

Anterior Cruciate Ligament↗

PubMed2005

Bioresorbable composites prepared by supercritical fluid foaming.

Bone is a natural composite construct, with a gradient structure going from a loose interconnected cellular core to an outer dense wall, thus minimizing bone weight while keeping a high mechanical resistance. Due to this unique and complex structure, bone defects are difficult to replace or repair. Tissue engineering aims at providing artificial bone grafts. Several techniques have been proposed to produce porous structures or scaffolds, but, as yet, with no optimal solutions. This article focuses on bioresorbable ceramic-polymer composite foams obtained by supercritical fluid foaming. This flexible technique enables an adequate morphology and suitable properties for bone tissue engineering to be obtained. Composite scaffolds are biocompatible, allowing cell proliferation and differentiation.

Absorbable Implants↗

PubMed2005

How plate positioning impacts the biomechanics of the open wedge tibial osteotomy; a finite element analysis.

A numerical model of the medial open wedge tibial osteotomy based on the finite element method was developed. Two plate positions were tested numerically. In a configuration, (a), the plate was fixed in a medial position and (b) in an anteromedial position. The simulation took into account soft tissues preload, muscular tonus and maximal gait load.The maximal stresses observed in the four structural elements (bone, plate, wedge, screws) of an osteotomy with plate in medial position were substantially higher (1.13-2.8 times more) than those observed in osteotomy with an anteromedial plate configuration. An important increase (1.71 times more) of the relative micromotions between the wedge and the bone was also observed. In order to avoid formation of fibrous tissue at the bone wedge interface, the osteotomy should be loaded under 18.8% (approximately 50 kg) of the normal gait load until the osteotomy interfaces union is achieved.

Arthroplasty, Replacement, Knee↗

PubMed2005

The effect of bisphosphonates and titanium particles on osteoblasts: an in vitro study.

In an attempt to increase the life of cementless prostheses, an hydroxyapatite-coated implant which releases a bisphosphonate has been suggested as a drug-delivery system. Our in vitro study was designed to determine the maximum dose to which osteoblasts could be safely exposed. Our findings demonstrated that zoledronate did not impair the proliferation of human osteoblasts when used at concentrations below 1 microm. Murine cells can be exposed to concentrations as high as 10 microm.A concentration of 0.01% of titanium particles did not impair the proliferation of either cell line. Zoledronate affected the alkaline phosphatase activity of murine osteoblasts through a chelation phenomenon. The presence of titanium particles strongly decreased the alkaline phosphatase activity of murine osteoblasts. We did not detect any synergic effect of zoledronate and titanium particles on the behaviour of both human and murine osteoblasts.

Alkaline Phosphatase↗

PubMed2004

Calcium phosphate drug delivery system: influence of local zoledronate release on bone implant osteointegration.

Despite total hip replacement (THR) gives generally satisfactory results, the quality of outcome in young patients is markedly decreased compared to the average THR outcome. For this population, pharmacological treatment with bisphosphonate would be beneficial to decrease the peri-implant osteolysis. However, as this population does not necessarily suffer from osteoporosis, a nonsystemic treatment would be preferable. Zoledronate was then grafted to hydroxyapatite (HA) coating of titanium implants. The implants were inserted in rat condyles with various zoledronate concentrations. A positive concentration-dependent effect was observed on the peri-implant bone density and on different histomorphometric parameters. Importantly for the outcome of the implants, the mechanical fixation was increased by the local presence of zoledronate. The obtained results open the way of an easy transformation of currently existing HA-coated implants by grafting bisphosphonate onto the coating in order to increase their service life in the patients.

Animals↗

PubMed2004

Peri-implant bone remodeling after total hip replacement combined with systemic alendronate treatment: a finite element analysis.

In order to decrease the peri-implant bone loss during the life-time of the implant, oral use of anti-osteoporosis drugs (like bisphosphonates) has been suggested. In this study, bone remodeling parameters identified from clinical trials of alendronate were used to simulate the effect of those drugs used after total hip arthroplasty on the peri-implant bone density. Results of the simulation show that the oral administrated drugs increase bone density around the implant and decreases, at the same time, the micromovements between the implant and the surrounding bone tissue. Incorporation of drug effect in numerical studies of bone remodeling is a promising tool especially to predetermine safe bisphosphonate doses that could be used with orthopedic implants.

Administration, Oral↗

PubMed2003

Biphasic constitutive laws for biological interface evolution.

A model of tissue differentiation at the bone-implant interface is proposed. The basic hypothesis of the model is that the mechanical environment determines the tissue differentiation. The stimulus chosen is related to the bone-implant micromotions. Equations governing the evolution of the interfacial tissue are proposed and combined with a finite element code to determine the evolution of the fibrous tissue around prostheses. The model is applied to the case of an idealized hip prosthesis.

Algorithms↗

PubMed2000

Combined effect of titanium particles and TNF-alpha on the production of IL-6 by osteoblast-like cells.

To clarify the role of tumor necrosis factor (TNF)-alpha on osteoblast functions in the presence of metal particles, two human osteoblast-like cell lines (MG-63 and SaOS-2) were cultured with TNF-alpha in the presence or absence of titanium particles in vitro. A combination of TNF-alpha and titanium particles showed additive effects on inhibition of cell proliferation and alkaline phosphatase production. On the other hand, production of interleukin-6, which is well known to induce osteoclastogenesis and to directly stimulate bone resorption, was additively stimulated by the combination of TNF-alpha and titanium particles. These results suggest that the association of TNF-alpha and titanium particles may play an important role in the pathogenesis of periprosthetic osteolysis through two different pathways: a reduced periprosthetic bone formation due to inhibition of osteoblast proliferation and alkaline phosphatase production, and osteoblast-mediated activation of osteoclastic bone resorption as suggested by the enhancement of interleukin-6 production.

Biocompatible Materials↗

PubMed2000

Titanium particles inhibit osteoblast adhesion to fibronectin-coated substrates.

To illuminate the effect of titanium particles on osteoblast function, we compared the adhesion force of neonatal rat calvarial osteoblasts on fibronectin-coated glass after incubation with titanium particles (80% had diameters of less than 5 microm). The cells were incubated with the particles for 1.5-72 hours. Using a micropipette single-cell manipulation system, we showed that the adhesion force of the osteoblasts to fibronectin-coated glass (1.0 microg/ml) was significantly affected by the presence of particulate debris. The adhesion force of the cells incubated with titanium particles for less than 4 hours was not significantly affected by exposure to the particles; after 4 hours, however, it was significantly reduced relative to that of controls. Aspiration of particle-challenged osteoblasts into the micropipette demonstrated that the particles were not stripped from the cell surface and therefore confirmed that the osteoblasts had ingested them. During aspiration, the particles traveled through the cytoplasm rather than on the cell surface. When the osteoblasts were exposed to the particles and cytochalasin D, they exhibited much lower adhesion forces than did the controls or the cells exposed to titanium particles only; this indicates an important role of actin filaments in the osteoblastic response to particles. Staining for F-actin also indicated an influence of internalized titanium particulate on cytoskeletal arrangement and cell spreading. Furthermore, with standard Northern blotting techniques, levels of mRNA for collagen type I and fibronectin were significantly reduced as early as 4 hours after exposure to particles compared with levels in controls, and this effect continued to 72 hours. These data indicate that direct exposure of osteoblasts to titanium particles, which we propose to be ingested by the osteoblasts, can significantly decrease osteoblast adhesion force; this may lead to decreased cellular activity and gene expression of fibronectin and collagen type I in the presence of titanium wear debris.

Actins↗

PubMed2000

On the independence of time and strain effects in the stress relaxation of ligaments and tendons.

The hypothesis of variables separation, namely the time and the strain separation in the relaxation function, is widely used in soft tissue biomechanics. Although this hypothesis is central to several biomechanical models, only few experimental works have tried to verify it. From these studies, contradictory results have been found. Moreover, it has recently been noted that no such experimental verification has been performed for ligament tissues. In this paper, an experimental method is developed to test the hypothesis of variables separation. This method is then used with human cruciate ligaments and patellar tendons. It is shown that the use of the variables separation hypothesis is justified at least for strain values lower than 16% for anterior cruciate ligament, lower than 12% for posterior cruciate ligament and lower than 6% for patellar tendon. The method presented in this paper could be used to verify the validity of variables separation for other tissues.

Anterior Cruciate Ligament↗

PubMed2000

The effects of calcium phosphate cement particles on osteoblast functions.

Calcium phosphate cements (CPC) are increasingly used in the orthopedic field. This kind of cement has potential applications in bone defect replacements, osteosynthetic screw reinforcements or drug delivery. In vivo studies have demonstrated a good osteointegration of CPC. However, it was also observed that the resorption of CPC could create particles. It is known from orthopedic implant studies that particles can be responsible for the peri-implant osteolysis. Biocompatibility assessment of CPC should then be performed with particles. In this study, we quantified the functions of osteoblasts in the presence of beta-TCP, brushite and cement particles. Two particle sizes were prepared. The first one corresponded to the critical diameter range 1-10 microm and the second one had a diameter larger than 10 microm. We found that CPC particles could adversely affect the osteoblast functions. A decrease in viability, proliferation and production of extracellular matrix was measured. A dose effect was also observed. A ratio of 50 CPC particles per osteoblast could be considered as the maximum number of particles supported by an osteoblast. The smaller particles had stronger negative effects on osteoblast functions than the larger ones. Future CPC development should minimize the generation of particles smaller than 10 microm.

Animals↗

PubMed1999

The cytotoxic effect of titanium particles phagocytosed by osteoblasts.

The cytotoxic effect of different concentrations of titanium particles on osteoblasts was studied in vitro. It was found that the viability of the osteoblasts was inversely proportional to the particle concentration. Phagocytosis of particles by the osteoblasts was evident and was demonstrated to be responsible for cell necrosis. Moreover, during and after phagocytosis, the osteoblasts released products that were cytotoxic for other osteoblasts, as established with a conditioned medium assay. The titanium particles thus had both a direct and an indirect effect on osteoblast viability. It also was observed that the titanium particles induced a process of programmed cell death (apoptosis) when co-cultured with osteoblasts. The results of this study suggest that not only is the amount of wear debris generated important, but the local accumulation of the debris also may have a significant impact on bone cell function.

Analysis of Variance↗

PubMed1999

Strain rate effect on the mechanical behavior of the anterior cruciate ligament-bone complex.

Traction tests were performed on the bovine anterior cruciate ligament-bone complex at seven strain rates (0.1, 1, 5, 10, 20, 30, 40%/s). Corresponding stress-strain curves showed that, for a given strain level, the stress increased with the augmentation of the strain rate. This phenomenon was important since the stress increased by a factor of three between the tests performed at the lowest and highest strain rates. The influence of the strain rate was quantified with a new variable called the "supplemental stress". This variable represented the percentage of total stress due to the effect of strain rate. It was observed that at a strain rate of 40%/s, more than 70% of the stress in the ligament was due to the strain rate effect. In fact, the strain rate strongly affected the toe region, but did not influence the linear part of the stress-strain curves. The use of the linear tangent moduli was then not adequate to describe the strain rate effect in the anterior cruciate ligament-bone complex. This study showed that the "supplemental stress" was a synthetic and convenient variable to quantify the effect of the strain rate on the entire stress-strain curves. This quantification is especially important when comparing the mechanical behavior between anterior cruciate ligament and tissues used as ligament graft.

Animals↗

PubMed1998

Viscoelastic constitutive law in large deformations: application to human knee ligaments and tendons.

Traction tests on soft tissues show that the shape of the stress strain curves depends on the strain rate at which the tests are performed. Many of the constitutive models that have been proposed fail to properly consider the effect of the strain rate when large deformations are encountered. In the present study, a framework based on elastic and viscous potentials is developed. The resulting constitutive law is valid for large deformations and satisfies the principles of thermodynamics. Three parameters -- two for the elasticity and one for the viscosity -- were enough to precisely fit the non-linear stress strain curves obtained at different strain rates with human cruciate ligaments and patellar tendons. The identification results then in a realistic, three-dimensional viscoelastic constitutive law. The developed constitutive law can be used regardless of the strain or rotation values. It can be incorporated into a finite element program to model the viscoelastic behavior of ligaments and tendons under dynamic situations.

Algorithms↗

PubMed1997

Tibial component positioning in total knee arthroplasty: bone coverage and extensor apparatus alignment.

Correct positioning of the tibial component in total knee arthroplasty (TKA) must take into account both an optimal bone coverage (defined by a maximal cortical bearing with posteromedial and anterolateral support) and satisfactory patellofemoral tracking. Consequently, a compromise position must be found by the surgeon during the operation to simultaneously meet these two requirements. Moreover, tibial tray positioning depends upon the tibial torsion, which has been shown to act mainly in the proximal quarter of the tibia. Therefore, the correct application of the tibial tray is also theoretically related to the level of bone resection. In this study, we first quantified the torsional profile given by an optimal bone coverage for a symmetrical tibial tray design and for an asymmetrical one. Then, for the two types of tibial trays, we measured the angle difference between optimal bone coverage and an alignment on the middle of the tibial tubercule. Results showed that the values of the torsional profile given by the symmetrical tray were more scattered than those from the asymmetrical one. However, determination of the mean differential angle between the position providing optimal bone coverage and the one providing the best patellofemoral tracking indicated that the symmetrical prosthetic tray offered the best compromise between these two requirements. Although the tibiofemoral joint is known to be asymmetric in both shape and dimension, the asymmetrical tray chosen in this study was found to fulfill this compromise with more difficulty.

Aged↗

PubMed1997

Displacements of the tibial tuberosity. Effects of the surgical parameters.

A three-dimensional computer model is used, based on the finite element method, to investigate the effects of 1-, 1.5-, and 2-cm tibial tubercle elevations and of 0.5- and 1-cm medial displacements of the tuberosity, performed with different bone shingles. Patellar kinematics and patellofemoral interface peak pressure, between 45 degrees and 135 degrees of passive knee flexion, are compared for these different surgical parameters with those of a normal knee not surgically treated. The shingle lengths of 3, 5, 7, and 10 cm have little influence on the results. Augmenting tubercle medializations decrease the lateral peak pressure but result in an overpressure of the medial facet that is 154% of the normal peak value. With knee flexion between 45 degrees and 60 degrees, increasing tubercle elevations decreases later and medial peak pressures. With flexion of more than 60 degrees, increasing elevations decrease the lateral peak pressure, but they augment and even cause overpressure on the medial facet. An overpressure on the lateral facet also is seen in midrange knee flexion (75 degrees-90 degrees) for all tubercle elevation values. Increasing tubercle elevations and medializations appear to be the predominant parameters from a biomechanical point of view.

Computer Simulation↗

PubMed1995

Experimental and mathematical methods for representing relative surface elongation of the ACL.

The common approach to assess the stabilizing role of the ACL in the knee has been to measure the elongation of a few marked fibers in the ligament. A comparison of the relative elongation (RE) of these marked fibers between different specimens and studies is delicate due to the difficulty of marking the same fibers. More consistent comparisons would be achieved if the RE of the whole ligament surface was presented. Hence, we developed a mathematical method leading to a continuous description of the relative elongation of the ligament's surface based on experimental measurements of the RE of five fibers. The ligament fibers of two knee specimens were marked by radiopaque markers and a Roentgen Stereophotogrammetric Analysis system was used to reconstruct the three-dimensional positions of these artificial landmarks. The mathematical procedure used isoparametric cubic splines to interpolate the contours of the insertion sites. The results showed that the general pattern of the RE for both specimens was similar, characterized by an undulation near full flexion. In fact, close to full flexion all the RE of the fibers increased. Such a representation describes the changes in the RE for a given fiber during knee flexion and at the same time characterizes the RE distribution at a given flexion angle.

Aged↗