Biomedical subjects

D R Pedersen

Publications and source records attributed to D R Pedersen.

At least 37 records · Page 2Linked to original sources

PubMed1997

Assessing the accuracy of a prototype drill guide for fibular graft placement in femoral head necrosis.

A prototype drill guide was developed to improve the accuracy of surgical placement of fibular grafts for the treatment of femoral head necrosis. To document performance, two tantalum beads, one placed on the lateral femoral shaft and the other embedded in the superior portion of the head, were used to define the desired graft tract in a series of seven surrogate femurs. Two orthogonal x-rays of the drill guide mounted on each surrogate femur were taken both before and after drilling. After stylus digitization of each x-ray pair, a computer program calculated the achieved accuracy of the drill. The mean of the absolute error between the desired versus obtained position of the drill tip was 3.68 mm (s.d. 1.24 mm), and the random component of the error was 1.98 mm (s.d. 0.89 mm).

Anthropometry↗

PubMed1997

Retropatellar contact stress in simulated patella infera.

Six fresh-frozen cadaver knee joints were used to study changes in retropatellar contact mechanics accompanying patella infera. The knees were tested on a servohydraulic testing machine under conditions simulating stair descent at 10 degrees, 30 degrees, 60 degrees, and 90 degrees of knee flexion. A slotted metallic block mechanism embedded in the region of the tibial tubercle allowed selective distal offset of the patellar tendon insertion so as to model conditions of 0, 6, 13, 19, and 25 mm of patella infera. Patellofemoral and quadriceps tendofemoral contact areas and contact stresses were recorded using Pressensor contact film and quantitated using digital image analysis. Patella infera significantly altered retropatellar contact mechanics. Contact areas migrated proximally on the patella and decreased in size with progressive severity of patella infera. However, the peak and spatial mean retropatellar contact stresses were not elevated correspondingly. Apparently, quadriceps tendofemoral contact was initiated at progressively lower angles of knee flexion as the patella infera progressed. Under conditions of extreme infera at high flexion angles, the magnitude of tendofemoral contact force approached that of retropatellar contact force. These data indicate that in patella infera, patellofemoral contact stresses are not elevated appreciably. Therefore, the disabling symptoms associated with patella infera may be due to factors other than local mechanical overload.

Humans↗

PubMed1997

The Frank Stinchfield Award. Contribution of cable debris generation to accelerated polyethylene wear.

The decision of the senior author of a large total hip replacement practice to switch from wire to braided cable for reattachment of the greater trochanter provided the opportunity to evaluate the long term effects (on acetabular component wear, osteolysis, and component loosening) caused by the introduction of metallic debris (generated by cable fretting and breakage) into the total hip arthroplasty construct. Seven hundred and nine consecutive primary total hip arthroplasties were performed during a 5-year period and followed up for a minimum of 10 years. Wire and cable reattachment of the greater trochanter was used sequentially. At minimum 10-year followup the cable group had significantly more wear, osteolysis, and acetabular radiographic evidence of loosening. Those involved in the design and use of total hip arthroplasty devices must minimize potential sources of metallic debris and other potential sources for third body wear in the total hip arthroplasty construct to help ensure longevity of the arthroplasty.

Adolescent↗

PubMed1997

Finite element analysis of acetabular wear. Validation, and backing and fixation effects.

A two-phase investigation was undertaken to study computational performance aspects of a recently developed finite element formulation that has shown promise in the study of design related influences on total hip arthroplasty wear. In the first phase, computational model predictions were evaluated against directly corresponding physical wear measurements performed in a biaxial rocking hip simulator. The discrepancy between the predictions and the measurements was approximately 4.1%. In the second phase, a bony support bed was introduced to supersede the model's previous simplifying assumption of rigid support at the cup backing. Other factors being equal, computed wear rates differed negligibly for three very different cup backing and fixation modalities studied with the new bony bed support condition, and for two individual cups studied with bony bed support versus the rigid backing support simplification.

Acetabulum↗

PubMed1996

Adaptive finite element modeling of long-term polyethylene wear in total hip arthroplasty.

Adaptive remeshing capability was added to an existing sliding-distance-coupled finite element model of polyethylene wear in total hip arthroplasty. This augmentation allowed earlier postoperative wear simulation to be extended to the clinically more significant long-term regimen (as long as 20 years). Loads and femoral head excursions were taken from a physically validated gait analysis model of a patient with an instrumented total hip replacement. For otherwise identical 22, 28, and 32 mm components, the least volumetric wear but the most linear wear occurred for the 22 mm head. When the polyethylene thickness in a 22 mm component was reduced to the same as that in a 32 mm component, the volumetric wear rate for the 22 mm component was still much less than that for the larger component, indicating that sliding distance (head size), rather than polyethylene liner thickness, was primarily responsible for the difference in rates. A "28 mm" series, for which head sizes were varied across the range of currently accepted industrial tolerances, showed that although initial wear rates were greatest for the least congruent articulations, the long-term volumetric wear was nearly the same, regardless of initial clearance.

Arthroplasty↗

PubMed1996

Effects of anisotropy and material axis registration on computed stress and strain distributions in the turkey ulna.

Finite element stress and strain distributions were studied parametrically for a curved long bone using several common material simplifications. A new technique is presented whereby local material axes conforming to local surface topology were automatically computed. Linearly elastic stress/strain solutions were evaluated as a function of the manner in which principal material directions are defined. The simplifications inherent in assumptions of local isotropy or globally registered transverse isotropy led to appreciably different solutions, particularly for some of the lesser-magnitude components of the strain tensor.

Algorithms↗

PubMed1996

A sliding-distance-coupled finite element formulation for polyethylene wear in total hip arthroplasty.

A three-dimensional, nonlinear contact finite element (FE) model of total hip replacement, linked to a sliding-distance-coupled wear algorithm, was used to study polyethylene wear rates for three different femoral head sizes. Hip resultant loads from a validated gait analysis model were used in the FE model to determine contact stress distributions on the polyethylene bearing surface, for 16 discrete instants of stance phase. Sliding distances of points on the femoral head surface were obtained from the corresponding flexion/extension kinematics. Wear rates were determined by a custom-written computer program that used a relationship that coupled contact stress, sliding distance, and a pin-on-disk determined wear coefficient. The wear rates computed by this formulation were well within clinically observed ranges for each component size.

Algorithms↗

PubMed1996

The Frank Stinchfield Award. 3-Dimensional sliding/contact computational simulation of total hip wear.

Polyethylene wear in total hip replacements is a complex, multifactorial process. A tribologically grounded finite element formulation was developed to make quantitative estimates of polyethylene wear in total hip arthroplasty, incorporating the combined influences of contact stress, sliding distance, and a surface specific wear coefficient. For loading and sliding distance inputs taken directly from human gait data, the computational model showed a strong direct proportionality between femoral head size and volumetric wear rate. Other factors being equal, reducing the thickness of the polyethylene liner led to increases in the computed wear rates, but the effect was far less pronounced than the strong increases in wear rate that accompanied head size increases. Compared with human gait inputs, the load and sliding distance inputs for a 23 degrees biaxial rocking hip simulator led to computed wear rates that were 1.7 times as large, and in which the direction of wear was near the cup apex rather than within the posterosuperolateral quadrant. In general, the finite element model's results emphasize the importance of articulation kinematics, especially sliding distance, in the complex process of polyethylene wear in total hip arthroplasty.

Computer Simulation↗

PubMed1995

Three-dimensional geometric and structural symmetry of the turkey ulna.

Structural models of long-bone preparations usually assume left-right symmetry of contralateral bones under normal (baseline) conditions. To obtain insight on how this assumption affects the detection of subtle changes (as from functional adaptation), we formally examined the three-dimensional geometric and structural symmetry of paired long bones, using contemporary image reconstruction and stress analysis techniques. Nine pairs of ulnae from normal male turkeys were reconstructed computationally from serial transverse images obtained by either (a) mechanical sectioning and digital photographic imaging or (b) computed tomography. Computed tomography scans allowed greater precision in reconstruction than did digitally imaged photographs. Left-right comparisons of parameters of geometric symmetry (from computed tomography reconstructions) revealed average differences in whole bone volume and whole bone principal moments of inertia of 3.6 and 3.0%, respectively. Differences in bone curvature were indexed as noncolinearity of left compared with (mirrored) right centroidal axes, giving a disparity of 0.7 +/- 0.3 mm. Within the longitudinal central 20% of the diaphysis (the customary region for histomorphometry), average left-right differences in cross-sectional area and area principal moments of inertia for computed tomography images were 4.7 and 5.0%, respectively. The overlap of longitudinally paired cross sections of the mid-diaphysis, aligned at common centroids and oriented in the respective principal inertial directions, was greatest (as much as 95%) in the central 20% of the diaphysis. Paired three-dimensional finite element models demonstrated nearly identical left and right stress/strain fields throughout the ulnar diaphyses for both compressive and torsional loading. Our data suggest that the assumption of contralateral geometric symmetry in long bones should be judged in the context of the specific attribute of symmetry under consideration; however, we conclude that for purposes of finite element modeling the assumption of symmetry is reasonable.

Adaptation, Physiological↗

PubMed1995

In vivo quantification of the cat patellofemoral joint contact stresses and areas.

A new method for in vivo measurement of patellofemoral joint contact areas, stresses, and patellar displacements, with joint loading approximating physiologic conditions was developed. Joint contact measurements were obtained using pressure sensitive film inserted directly between articular joint surfaces. Two-dimensional joint kinematics were measured using a high-speed video based motion analysis system. Joint loading, provided by quadriceps muscle stimulation, was measured with an implantable force transducer (IFT). Variations in joint mechanics as a function of joint flexion angle, joint loading and joint stability (anterior cruciate ligament intact or transected) were determined for four adult male cats. The contact measurements obtained with the pressure sensitive film displayed high repeatability with a standard error of +/- 6.8% of the mean value of the median pressure and +/- 4.4% of the mean contact area value. Substantial differences in joint mechanics were reliably detected with the new technique. The influence of experimental procedures, such as incisions in the joint capsule and insertion of pressure sensitive film between the articular surfaces, produced minimal changes in the joint kinematics during muscular contraction.

Animals↗

PubMed1995

Reamed surface topography and component seating in press-fit cementless acetabular fixation.

Thirty-eight paired, size-matched, fresh-frozen cadaver acetabulae were used to study reamed surface topography and the seating of on-line versus oversized noncemented components. Four commonly used constructs were considered: on-line reamed and 2-mm oversized hemispherical cups, and on-line reamed and 1-mm oversized dual-radius cups. Reamed surface topography was indexed by three-dimensional surfaces mathematically fitted to digitized castings. Component seating was indexed by the distribution of bone-cup contact and the thickness of the gap between the component backing and the bone. The reamed surfaces were better approximated by slightly blunt ellipsoids than by spheres, especially for the smaller acetabulae. Seating of the on-line hemispherical cups was best near the pole and poorest near the equator, whereas the converse was true for the 1-mm oversized dual-radius cups. The on-line dual-radius cups offered better overall compromise between polar and equatorial contact than did the 2-mm oversized hemispherical components.

Acetabulum↗

PubMed1995

An articulated ankle external fixation system that can be aligned with the ankle axis.

Aligning an articulated ankle external fixator with the ankle axis located using a mechanical axis finder has been shown to preserve normal ankle joint kinematics while the fixed hinge device is attached. However, several problems exist preventing the clinical application of this finding for fractures of the tibial plafond. We initiated a series of studies to resolve these issues. First, the accuracy of the mechanical axis finder in biological systems was quantified by comparing it to that of a computationally derived helical axis. Second, a prototype fixator design was developed in the biomechanics lab to increase the versatility of intraoperative fixator placement. Finally, a radiographic method of locating the ankle axis was developed which is based on talar morphology independent of the fractured tibia. The prototype fixator has been accurately aligned along the ankle axis in cadaveric specimens using this method. Open reduction and internal fixation (ORIF) is the accepted method of treatment for tibial plafond fractures. It holds the advantage of sufficient fracture fixation to permit early joint motion. Good results have been reported using this method, but some authors have reported complication rates up to 50%. The wide surgical approaches required, in conjunction with preexisting soft tissue injury, are thought to significantly increase the risk of soft tissue complications. In response to these problems, many investigators are beginning to utilize external fixation as an alternate treatment modality. One external fixation system which has shown particularly good results is a monolateral cross-ankle articulated fixator (Orthofix SRL., Verona, Italy) which allows motion at the ankle joint as the plafond fracture is healing (Figure 1).(ABSTRACT TRUNCATED AT 250 WORDS)

Ankle Joint↗

PubMed1995

Concerns and improvements with cementless metal-backed acetabular components.

The relatively high incidence of acetabular component failure shown in long-term followup studies of cemented total hip replacement has led to the use of noncemented fixation on the acetabular side of the total hip arthroplasty. In the first generation of noncemented acetabular devices, large-size femoral heads requiring thinner polyethylene were used with many of the popular designs. These components were also modular, but the design considerations involved in minimizing polyethylene debris were not fully appreciated. The newer designs of noncemented acetabular components are addressing the need to minimize wear and the production of particulate debris at the bearing surface and metal-polyethylene interface. Newer techniques also have been developed to provide initial component stability and bone-prosthesis contact. With these improvements, the results of noncemented acetabular fixation may outperform the results with cemented fixation. This may be especially true when considering the ease of insertion and versatility of noncemented acetabular components.

Acetabulum↗

PubMed1995

Radiographic measurement of wear in 5 cohorts of patients observed for 5 to 22 years.

Standardized wear measurements using a tablet digitizer were made on long-term serial radiographs for 5 cohorts of total hip replacements to determine any differences in acetabular component polyethylene wear rates. The 5 groups included 4 cemented acetabular component series and 1 cementless acetabular component series. Comparing the rates of linear wear for the 5 groups, 22-mm-head components had similar wear when compared with the 28-mm-head components, both cemented and uncemented, and volumetric wear rates were greater for the cemented 28-mm-head components than for the 22-mm-head components. Although molded 22-mm-head components had less wear than the machined 22-mm-head components, there was no statistically significant difference between the 2. The uncemented metal-backed component with 28-mm-head articulation showed no accelerated wear when compared with the cemented metal-backed components at a shorter 5-year followup. The constant variable in all series was a cemented femoral component.

Adult↗

PubMed1994

Comparison of hip force calculations and measurements in the same patient.

Many investigations report hip-contact-force estimates based either on mathematical models or on the output of instrumented implants. Data from instrumented implants have been consistently lower than mathematical predictions. The authors compared mathematical estimates derived from gait laboratory observations made in a patient with an instrumented hip implant. Appropriate modifications to past models resulted in force predictions that were reasonably similar to the output of the instrumented implant. Peak resultant forces were in the range of 2.5-3.5 body weight during level walking at a freely selected speed, while peak out-of-plane forces ranged from 0.6 to 0.9 body weight. Previous parametric hip-force predictions resulting from mathematically modeled surgical alterations may be high insofar as absolute peak values, but trends are likely correct.

Aged↗

PubMed1994

Areas of contact and extent of gaps with implantation of oversized acetabular components in total hip arthroplasty.

Contact between porous surfaces and bone and initial stable fixation of the implant to bone are required to achieve bone ingrowth into prosthetic devices. To avoid the potential problems associated with screws that are often used to obtain initial stability of uncemented acetabular components, oversizing of the component has been recommended. This study investigated the shape of the reamed surface compared with the acetabular reamers used, the areas of bone implant contact obtained with oversizing, and the extent of polar area gaps created by this surgical technique. In embalmed hemipelvises, using surface fitting algorithms, the average departure from sphericity, of the reamed acetabular surface, was 0.56 mm. Using Pressensor film, extensive peripheral cup contact but minimal polar area contact was demonstrated when oversizing the components. In addition, large polar area gaps were demonstrated using polyvinylsiloxane epoxy molds. This study confirms the potential concerns associated with oversizing the acetabular component in relation to the reamed acetabular surface. Although excellent peripheral contact was obtained using this technique, polar area contact was demonstrated to be minimal or nonexistent, and large polar area gaps were observed. In addition, this study demonstrates that a precisely reamed surface can be obtained in the acetabulum when accurately sized reamers are used.

Acetabulum↗

PubMed1993

Mechanical consequences of core drilling and bone-grafting on osteonecrosis of the femoral head.

We employed an anatomically realistic three-dimensional finite-element model to explore several biomechanical variables involved in coring or bone-grafting of a segmentally necrotic femoral head. The mechanical efficacy of several variants of these procedures was indexed in terms of their alteration of the stress:strength ratio in at-risk necrotic cancellous bone. For coring alone, the associated structural compromise was generally modest, provided that the tract did not extend near the subchondral plate. Cortical bone-grafting was potentially of great structural benefit for femoral heads in which the graft penetrated deeply into the superocentral or lateral aspect of the lesion, ideally with abutment against the subchondral plate. By contrast, central or lateral grafts that stopped well short of the subchondral plate were contraindicated biomechanically because they caused marked elevations in stress on the necrotic cancellous bone. Calculated levels of stress were relatively insensitive to variations in the diameter of the graft.

Bone Transplantation↗

PubMed1991

Are leg electromyogram profiles symmetrical?

Electromyographic (EMG) patterns reflect function of the neuromuscular system. Abnormality of a given pattern may be established by comparison with that of the contralateral (presumably normal) limb if one ensures a difference beyond normal degrees of symmetry. We studied EMG patterns in six homologous knee muscles during freely selected, slow, and fast gaits in normal subjects. EMG signals were electronically conditioned to produce linear envelopes; envelopes from at least eight cycles from each subject at each speed were ensemble averaged. Grand ensemble averages for each muscle and speed were assembled from all subjects for right and left muscles. Transformed correlation coefficients (r') and variance ratios established the degree of similarity. All muscles exhibited a fair degree of symmetry (mean r' = 0.797-0.953), but we saw exceptions. On rare occasion, muscles repeatedly exhibited monophasic signals on one side and biphasic on the other. With increasing speed, signals generally became more repeatable, but we occasionally saw monophasic patterns becoming biphasic or vice versa. Considerable caution is essential before presuming any given pattern is abnormal. To ensure that a given pattern is abnormal one could establish that the pattern lies outside some statistical limits for normal population patterns controlled for speed and outside statistical limits for normal symmetry. Alternatively, one could determine the level of statistical differences in EMG patterns associated with distinct differences in level of functional performance between normal subjects and patients.

Adult↗