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E S Grood

Publications and source records attributed to E S Grood.

At least 55 records · Page 3Linked to original sources

Effects of structure and strain measurement technique on the material properties of young human tendons and fascia.

It is generally recognized that the organization of collagen bundles in soft tissues strongly influences their material properties. To study this, sixty failure tests were conducted on double-layered fascia lata, 'isolated' parallel-bundled tendons (gracilis and semitendinosus) and parallel-bundled bone-patellar tendon-bone units taken from about the knees of eighteen young human donors (mean age of 26 yr). Surprisingly, most material parameters for the two-layered fascia lata did not differ significantly from corresponding values for the isolated tendons and tendon-bone preparations, suggesting their longitudinal fibers predominated during loading. Differences were present however between the gracilis tendon and all other tissues for both modulus and maximum stress. The large variations in reported maximum and failure strains for tendons, fascia and other collagenous tissues prompted the other phase of the study. During 15 of the 60 failure tests, surface markers were simultaneously filmed to determine; differences between local surface strains and grip to grip values; the amount of tissue slippage and/or failure occurring in the grips; and the effect of strain measurement technique on tissue moduli and failure energy densities. Maximum local strains were found to be 25-30% of grip strains for all tissues tested. Some slippage and/or failure could be seen in all isolated tissues which were gripped directly although their maximum grip strains were similar to values for tendon-bone units. For all tissues, two to three fold differences were also found in moduli and failure energy densities between grip and midregion measurements.

Adult↗

Strain topography of human tendon and fascia.

Discretized surface strains for human tendon and fascia were photogrammetrically determined with high-speed cinematography and were displayed topographically using three-dimensional computer graphics. Substantial differences were found between estimates of tissue strain measured from grip motion versus discretized strain estimates from high-speed films. The computer-generated contour maps also provide a useful technique for analyzing the nonhomogeneity of tendon and fascial strains during high rate tests.

Adult↗

Advances in the understanding of knee ligament injury, repair, and rehabilitation.

Knee injuries continue to present a complex set of clinical problems. The answers to these problems have recently been redefined by the application of sophisticated biomechanical research methods to the study of knee ligaments and joint function. This manuscript reviews contributions which our laboratory has made to the understanding of knee injury, highlighting those research findings which form the basis for our clinical treatment of knee ligament injuries. High strain-rate techniques for studying knee ligament failure have replaced the previous low strain-rate methods and distinguish the failure mechanism of ligaments from that of bone. Ligament function is now further defined by measuring the restraining force provided by specific ligaments, adding to the information provided by cutting studies. The development of the 6-degrees-of-freedom concept and the instrumented kinematic chain now permit precise analysis of joint position, motion, and laxity. Biomechanical evaluation of intra-articular anterior cruciate ligament substitution has emphasized the importance of selection of a high-strength graft material, meticulous surgical technique with attention to graft vascularity, precise location of graft fixation sites, judicious adjustment of graft tension, post-operative protection during tissue remodelling, and a carefully conceived rehabilitation program. Newer biomechanical research methods have provided a sound scientific foundation on which to base clinical decisions concerning the care of knee ligament injuries.

Adrenal Cortex Hormones↗

Biomechanical analysis of human ligament grafts used in knee-ligament repairs and reconstructions.

Virtually all types of collagenous tissues have been transferred in and around the knee joint for intra-articular and extra-articular ligament reconstructions. However, the mechanical properties (in particular, strength) of such grafts have not been determined in tissues from young adult donors, where age and disuse-related effects have been excluded. To provide this information, we subjected ligament graft tissues to high-strain-rate failure tests to determine their strength and elongation properties. The results were compared with the mechanical properties of anterior cruciate ligaments from a similar young-adult donor population. The study indicated that some graft tissues used in ligament reconstructions are markedly weak and therefore are at risk for elongation and failure at low forces. Grafts utilizing prepatellar retinacular tissues (as in certain anterior-cruciate reconstructions) and others in which a somewhat narrow width of fascia lata or distal iliotibial tract is utilized are included in this at-risk group. Wider grafts from the iliotibial tract or fascia lata would of course proportionally increase ultimate strength. The semitendinosus and gracilis tendons are stronger, having 70 and 49 per cent, respectively, of the initial strength of anterior cruciate ligaments. The bone-patellar tendon-bone graft (fourteen to fifteen millimeters wide, medial or central portion) was the strongest, with a mean strength of 159 to 168 per cent of that of anterior cruciate ligaments. Patellar tendon-bone units, based on grip-to-grip motions, were found to be three to four times stiffer than similarly gripped anterior cruciate ligaments, while gracilis and semitendinosus tendon preparations had values that were nearly identical to those of anterior cruciate ligaments.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Biomechanics of the knee-extension exercise. Effect of cutting the anterior cruciate ligament.

UNLABELLED: We conducted this study to determine the effective moment arm of the knee extensor mechanism and the conditions under which the anterior cruciate ligament is loaded during knee-extension exercises. The moment arm was calculated from measurement of the quadriceps force required to extend the knee with and without resistive weights placed at the foot, the leg weight, and the location of its center of gravity. Changes in three-dimensional joint motion after the anterior cruciate ligament was removed were considered to be an indication that the ligament was loaded. The quadriceps force rose during the initial phase of knee extension and remained nearly constant at an average value of 177 newtons between 50 and 15 degrees. With extension past 15 degrees it rose rapidly, reaching an average of 350 newtons at zero degrees of extension, and continued to increase with hyperextension. The addition of thirty-one newtons (seven pounds) at the foot approximately doubled the quadriceps force that was required to extend the knee. The effective moment arm of the extensor mechanism increased with knee extension, peaked at approximately 20 degrees, and rapidly decreased with further extension. No change was found in the quadriceps force or its effective moment arm when the anterior cruciate ligament was sectioned except in hyperextension, where the quadriceps force decreased in two of five specimens. There was, however, an increased anterior tibial displacement in the range of 30 degrees to full extension, suggesting that the anterior cruciate ligament is loaded in that flexion arc. CLINICAL RELEVANCE: This study demonstrates that very large quadriceps forces are required to accomplish the last 15 degrees of extension during leg-raising exercises, typically twice those required to reach 30 degrees of flexion. The large forces that are required to obtain full extension explain why an extensor lag occurs with quadriceps weakness even though a full passive range of motion is possible. Since thirty-one newtons (seven pounds) of resistive weight added at the foot approximately doubles the quadriceps forces required to extend the leg alone, using such weights can produce very large quadriceps forces and concurrent patellofemoral and tibiofemoral contact forces. Because the quadriceps force increases little as the leg is extended from 50 to 15 degrees, in patients with patellofemoral chondroses for whom a full range of joint motion is not desired, quadriceps exercises can be limited to the amount of extension without decreasing quadriceps force.(ABSTRACT TRUNCATED AT 400 WORDS)

Biomechanical Phenomena↗

Error analysis of a system for measuring three-dimensional joint motion.

In the past ten years there has been increased use of six-degree-of-freedom instrumented spatial linkages for the measurement of biological joint motions. In spite of the increased popularity, little information has been reported on the accuracy of these devices. In this paper, we present a two-part investigation of the accuracy of the instrumented spatial linkage when used to measure knee joint kinematics. In the first part, we present the results of a theoretical analysis and an experimental determination of the errors associated with spatial linkage systems. In the second part, we describe the errors associated with a bi-planar X-ray system used to obtain the coordinate transformation between the linkage ends and coordinate systems located in the bones comprising the joint. We found that the theoretical error analysis consistently overestimated the actual measurement error, thus providing an unreliable estimate of errors. The experimental study of both the linkage system and the bi-planar X-ray system demonstrated that the accuracy of displacement measurement is insensitive to large systematic errors in position measurement.

Biomechanical Phenomena↗

A joint coordinate system for the clinical description of three-dimensional motions: application to the knee.

The experimental study of joint kinematics in three dimensions requires the description and measurement of six motion components. An important aspect of any method of description is the ease with which it is communicated to those who use the data. This paper presents a joint coordinate system that provides a simple geometric description of the three-dimensional rotational and translational motion between two rigid bodies. The coordinate system is applied to the knee and related to the commonly used clinical terms for knee joint motion. A convenient characteristic of the coordinate system shared by spatial linkages is that large joint displacements are independent of the order in which the component translations and rotations occur.

Biomechanical Phenomena↗

An analytical technique for modeling knee joint stiffness--Part II: Ligamentous geometric nonlinearities.

An analytical technique previously developed to evaluate the contribution of the ligaments to the nonlinear, coupled stiffness characteristics of the human knee joint [1] is extended here to include geometric nonlinearities. In [1], we assumed that the ligaments act as tensile bands running in a straight line between tibial and femoral insertion sites. Here, two forms of geometric nonlinearities are introduced and analyzed: ligaments wrapping around bone surfaces, such as occurs with the medial collateral ligament, the posterior capsule, and the anterior cruciate in hyperextension, and wrapping of ligaments around each other, such as occurs with the cruciate ligaments as the knee is flexed and internally rotated.

Biomechanical Phenomena↗

Analysis of retrieved implants: crystallinity changes in ultrahigh molecular weight polyethylene.

The extent of in vivo induced structural alterations were evaluated in 13 retrieved implants ranging from two weeks' to seven years' implantation. A statistically significant difference in crystallinity was seen between weight-bearing and non-weight-bearing regions of the implants. Further, in the weight-bearing region, crystallinity was higher in components implanted for two or more years than in those implanted for less than one-half year. These results were consistent with our prior in vitro study on the effects of sterilization and aging. Taken together, the data indicate that UHMW polyethylene is not a static material but is continually dynamic changes in vivo.

Biocompatible Materials↗

Left ventricular work and power: circumferential, radial and longitudinal components. Mathematical derivation and characteristic variation with left ventricular dysfunction.

Cardiac work and power, defined as the wall stress-velocity product per unit volume, have been derived with respect to a circumferential, radial and longitudinal component for the human left ventricle during a complete cardiac cycle. Thirty-nine patients, comprising five clinical groups, were evaluated using pressure and volume data acquired from single-plane cineangiography. The results indicate that work and power are divided into approximately 60% circumferential, 23% radial and 17% longitudinal components for normals. Characteristic variations from normal are presented for selected pathological case studies. With a compensated volume overload patient, diastolic work and power are uniformly reduced in all three directions and systolic radial power approximately equals longitudinal power. With a decompensated volume overload patient, systolic radial power is greater than longitudinal power. With a compensated pressure overload patient, systolic radial work and power are greatly elevated as compared to the normals and represent about 30% of the total work and power, while longitudinal work and power represent only about 8% of the total. With a congestive cardiomyopathy patient, systolic work and power are greatly reduced in all three directions as compared to normals.

Adult↗

Effect of radiation sterilization and aging on ultrahigh molecular weight polyethylene.

The mechanical properties of polyethylene components used in prosthesis are altered after fabrication by the sterilization procedure and by the environmental and mechanical aging which occurs after implantation. To assess the importance and extent of these alterations, ultrahigh molecular weight polyethylenes from two sources, Hercules 1900 and RCH 1000C, were subjected to gamma-ray irradiation and aging in serum and argon environments. Changes induced by these treatments in the structural and mechanical parameters have been determined by a variety of experimental techniques. The effect of irradiation is to introduce crosslinks and to increase the degree of crystallinity resulting in changes in the tensile properties in the direction of higher stiffness and reduced ductility. Aging for six months produced similar changes with subtle differences. The results suggest that the initially low degree of crystallinity which results from the sluggish mobility of the very long chain molecules offers the opportunity for significant changes in the properties during use in the long run.

Crystallization↗

Knee ligament tests: what do they really mean?

In summary, newer biomechanical concepts clarify human function, the clinical laxity tests, and functional stability of the joint. Biomechanical studies show that one or two ligaments provide the primary passive restraint for each plane of knee stability, with the remaining ligaments having a secondary, helping role. Correct interpretation of clinical laxity tests and surgical treatment of instability require understanding of this differentiation. Knowledge of the interaction between the primary and secondary restraints during the clinical laxity tests allows for more accurate interpretation of the extent of ligament injury. Weak secondary restraints may initially allow little laxity to be demonstrated in the clinical laxity tests. However, the secondary restraints will eventually stretch out and cause a greater laxity. In an acute knee injury, "a little laxity is a lot" and should be considered as serious. In knee injuries, an exact diagnosis of injury is required. This often requires examination under anesthesia and arthroscopy to define the extent of ligament damage. Functional stability of the knee is a primary treatment goal after ligament injury but the stability may be short term if it relies on muscle control alone without the finetuning action of the ligamentous system. Abnormal laxity on clinical examination means increased risk for joint wear, cartilage deterioration, and arthritis on a long-term basis. Close follow-up after ligament injuries, adequate rehabilitation, and correct advice on allowable activities are important treatment concepts after any serious ligament injury.

Biomechanical Phenomena↗

Arthroscopy in acute traumatic hemarthrosis of the knee. Incidence of anterior cruciate tears and other injuries.

In a prospective study, all injured knees that had traumatic hemarthrosis and absent or negligible instability on clinical examination underwent arthroscopy and examination under anesthesia. Eighty-five knees (eighty-three patients) were examined over a 125-week period. Some degree of disruption of the anterior cruciate ligament was found in sixty-one (72 per cent) of the knees (a partial tear in 28 per cent and a complete tear in 44 per cent), frequently associated with an injury of varying severity to other joint structures. These included minor ligament sprains without laxity in 41 per cent, a major associated ligament injury in 21 per cent, meniscal tears in 62 per cent (partial in 30 per cent and complete in 70 per cent), and a femoral chondral fracture or surface defect in 20 per cent. A popping sensation at injury occurred in 33 per cent of knees with a normal anterior cruciate ligament and in 36 per cent of those with a disruption. One-third of the knees had no to slight pain at the time of injury. The anterior drawer test without anesthesia was positive in only 24 per cent of the knees with a torn anterior cruciate ligament. We concluded that: (1) a traumatic hemarthrosis indicates a significant knee injury; (2) examination under anesthesia plus arthroscopy allows a more accurate diagnosis of injury to joint structures; and (3) such data are required for a rational treatment program to be outlined.

Adolescent↗