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Biomedical subjects

G Bergmann

Publications and source records attributed to G Bergmann.

At least 37 records · Page 2Linked to original sources
PubMed2001

Magnetic behavior of na films with Fe, Co, and Ni impurities.

Thin films of Na with Fe, Co, and Ni impurities are investigated. The magnetization of the impurities is measured by means of the anomalous Hall resistance. Fe and Co show a moment of about 6mu(B), while for Ni no moment is detected. Furthermore, the magnetic dephasing of the conduction electrons is measured by means of weak localization. The dephasing rate 1/tau(phi) of the 3d impurities differ qualitatively. For Fe impurities, 1/tau(phi) is so large that it cannot be measured. For Co, 1/tau(phi) has a moderate value while Ni shows hardly a dephasing effect at all.

Journal Article↗
PubMed2001

[The biomechanics of kyphosis].

Kyphosis is a dorsally convex curvature of the spine in the sagittal plane. A pathological kyphosis of the thoracic spine has a Cobb angle greater than 50 degrees. It occurs when the anterior and/or posterior load-transferring elements of the spine are overloaded or damaged. Wedge-shaped vertebral bodies may be found at one or several levels. A wedge-shaped vertebral body increases the curvature of the spine and moves the centre of gravity of the body parts above of the corresponding vertebral body in a ventral direction. This increases the flexion-bending moment acting on the spine. In the case of a wedge-shaped deformation of a vertebral body, the relative increase of the flexion moment is a function of the wedge angle and of the original position of the centre of gravity of the upper body.

Biomechanical Phenomena↗
PubMed2001

Effect of an internal fixator and a bone graft on intersegmental spinal motion and intradiscal pressure in the adjacent regions.

Stabilizing a lumbar spine with an implant alters the mechanical properties of the bridged region. In order to determine whether this procedure is associated with higher loads in the adjacent segments, seven lumbar cadaver spines were mounted in a spine tester and loaded with pure moments of flexion/extension, left and right lateral bending, and left and right axial rotation. The material studied comprised intact lumbar spines, intact spines with bisegmental internal spinal fixators, and postcorpectomy spines both with a graft and fixators and with fixators alone. Intradiscal pressures and intersegmental motion were measured at all levels. In the bridged region, these parameters were strongly affected by an internal fixator. In most cases, the effect was small in the regions above and below the fixators. Highly significant differences in these regions (P<0.01) were far below the interspecimen range. We did not find any case where both intradiscal pressure changes and intersegmental motion showed highly significantly differences in the regions adjacent to the bridged one. Our results suggest that disc degeneration, which is sometimes found at the level directly above and below the fixators, is not caused by mechanical factors.

Adult↗
PubMed2001

Frictional heating of total hip implants. Part 1: measurements in patients.

Hip implants heat up due to friction during long lasting, high loading activities like walking. Thermal damage in the surrounding soft and hard tissues and deteriorated lubrication of synovial fluid could contribute to implant loosening. The goal of this study was to determine the implant temperatures in vivo under varying conditions. Temperatures and contact forces in the joints were measured in seven joints of five patients using instrumented prostheses with alumina ceramic heads and telemetry data transmission. The peak temperature in implants with polyethylene cups rose up to 43.1 degrees C after an hour of walking but varied considerably individually. Even higher temperatures at the joints are probable for patients with higher body weight or while jogging. The peak temperature was lower with a ceramic cup, showing the influence of friction in the joint. During cycling the peak temperatures were lower than during walking, proving the effect of force magnitudes on the produced heat. However, no positive correlation was found between force magnitude and maximum temperature during walking. Other individual parameters than just the joint force influence the implant temperatures. Based on the obtained data and the available literature about thermal damage of biological tissues a detrimental effect of friction induced heat on the stability of hip implants cannot be excluded. Because the potential risk for an individual patient cannot be foreseen, the use and improvement of low friction implant materials is important.

Aged↗
PubMed2001

Frictional heating of total hip implants. Part 2: finite element study.

Due to higher friction artificial hip joints warm up more than natural joints during walking and other continuous activities. This could lead to thermal damage in the surrounding tissues and be a reason for long-term implant loosening, an effect which has not yet been investigated. In vivo measurements with instrumented implants showed temperatures inside the prosthetic head up to 43.1 degrees C (Part 1 of this work). Based on the experimental data a finite element model was developed to calculate the temperatures in the tissues surrounding the hip implant to determine whether these tissues can heat up to critical levels. Various parameters were investigated which could account for the variations in the measured temperatures in the patients, including the perfusion rate in tissues, the volume of synovial fluid, and different implant materials. We found that the synovial fluid is most endangered by thermal damage and consequent deterioration of lubricating properties. Implants with a cobalt-chromium head and a polyethylene cup are unfavourable as they can elevate the temperature in the synovia to more than 46 degrees C. With regard to thermal properties stems made from cobalt-chromium alloys are superior to titanium stems, by better conducting heat to the femur and minimizing the synovial fluid temperature. Factors determining the temperatures during walking are insufficiently known or cannot be determined in the individual patient. Therefore, the risk of a thermally induced implant loosening cannot currently be estimated. Under unfavourable conditions such a risk exists, however. General improvements of implant materials and clinical studies on the possibility of implant loosening due to high temperatures are therefore required.

Alloys↗
PubMed2001

Duration and frequency of every day activities in total hip patients.

Little knowledge about frequency and duration of daily activities in patients after total hip arthroplasty is available. Such information is required for the definition of realistic load collectives for pre-clinical testing of prostheses. It could also be helpful for the quantitative evaluation of surgery outcome with different prosthesis types. The purpose of this study was to develop and apply a system for the determination of frequency and duration of patient activities in their habitual environment and to compare the results to a clinical outcome score (Harris hip score).A portable activity monitoring system (weight 1.6 kg including batteries) was designed using a Palm top computer, 2 inclination sensors for the thigh and calf and one goniometer positioned at the knee joint. An algorithm was developed to identify frequency and duration of the activities lying, sitting, standing, walking and stair climbing from the signals of the 3 sensors. 42 patients participated in the study and were equipped with the system in the morning at their home. Datasets of 31 patients (age 62.5+/-11.5 y) covered more than 6h (9.8 +/- 1.6 h) and were included in the analysis. Prosthesis specific data as well as the Harris hip score were collected. The most frequent patient activity was sitting (44.3% of the time), followed by standing (24.5%), walking (10.2%), lying (5.8%) and stair climbing (0.4%). The median number of steps/stairs was 6048/164. The number of step cycles representing one year in vivo use should, consequently, be increased to 1.1 million. The Harris hip score (91.4 +/- 9.8) correlated significantly with the number of stairs (r(2) = 0.26, p = 0.003) and showed a positive tendency with the number of steps per day. No differences in activity levels between prosthesis specific factors were found.

Activities of Daily Living↗
PubMed2001

Musculo-skeletal loading conditions at the hip during walking and stair climbing.

Musculo-skeletal loading plays an important role in the primary stability of joint replacements and in the biological processes involved in fracture healing. However, current knowledge of musculo-skeletal loading is still limited. In the past, a number of musculo-skeletal models have been developed to estimate loading conditions at the hip. So far, a cycle-to-cycle validation of predicted musculo-skeletal loading by in vivo measurements has not been possible. The aim of this study was to determine the musculo-skeletal loading conditions during walking and climbing stairs for a number of patients and compare these findings to in vivo data. Following total hip arthroplasty, four patients underwent gait analysis during walking and stair climbing. An instrumented femoral prosthesis enabled simultaneous measurement of in vivo hip contact forces. On the basis of CT and X-ray data, individual musculo-skeletal models of the lower extremity were developed for each patient. Muscle and joint contact forces were calculated using an optimization algorithm. The calculated peak hip contact forces both over- and under-estimated the measured forces. They differed by a mean of 12% during walking and 14% during stair climbing. For the first time, a cycle-to-cycle validation of predicted musculo-skeletal loading was possible for walking and climbing stairs in several patients. In all cases, the comparison of in vivo measured and calculated hip contact forces showed good agreement.Thus, the authors consider the presented approach as a useful means to determine valid conditions for the analysis of prosthesis loading, bone modeling or remodeling processes around implants and fracture stability following internal fixation.

Aged↗
PubMed2001

Hip contact forces and gait patterns from routine activities.

In vivo loads acting at the hip joint have so far only been measured in few patients and without detailed documentation of gait data. Such information is required to test and improve wear, strength and fixation stability of hip implants. Measurements of hip contact forces with instrumented implants and synchronous analyses of gait patterns and ground reaction forces were performed in four patients during the most frequent activities of daily living. From the individual data sets an average was calculated. The paper focuses on the loading of the femoral implant component but complete data are additionally stored on an associated compact disc. It contains complete gait and hip contact force data as well as calculated muscle activities during walking and stair climbing and the frequencies of daily activities observed in hip patients. The mechanical loading and function of the hip joint and proximal femur is thereby completely documented. The average patient loaded his hip joint with 238% BW (percent of body weight) when walking at about 4 km/h and with slightly less when standing on one leg. This is below the levels previously reported for two other patients (Bergmann et al., Clinical Biomechanics 26 (1993) 969-990). When climbing upstairs the joint contact force is 251% BW which is less than 260% BW when going downstairs. Inwards torsion of the implant is probably critical for the stem fixation. On average it is 23% larger when going upstairs than during normal level walking. The inter- and intra-individual variations during stair climbing are large and the highest torque values are 83% larger than during normal walking. Because the hip joint loading during all other common activities of most hip patients are comparably small (except during stumbling), implants should mainly be tested with loading conditions that mimic walking and stair climbing.

Activities of Daily Living↗
PubMed2001

Loads on an internal spinal fixation device during sitting.

Sitting is often assumed to involve high loads on the spine as well as on implants for stabilising the spine. Loads on internal spinal fixation devices were therefore measured in ten patients sitting on several types of seats, including a stool, a stool with a padded wedge, a chair, a physiotherapy ball, a knee-stool, and a bench. The patients also successively sat relaxed and erect on a stool. In addition, six of them sat on a special chair allowing different inclinations of the backrest. Implant loads were also measured for standing up and sitting down. There were only minor differences in fixator loads for sitting on the different types of seats. Sitting erect caused an average of 11% higher implant loads than sitting relaxed. Implant loads decreased with increasing inclination of the upper body while sitting on a chair with an adjustable backrest. Implant loads were about 27% higher for standing up and sitting down than for sitting.

Adult↗
PubMed2001

Estimation of muscle forces in the lumbar spine during upper-body inclination.

OBJECTIVE: To estimate the muscle forces during upper-body inclination and to determine their influence on stress distribution in the annulus fibrosus of the lumbar spine discs. DESIGN: The muscle forces and stresses were calculated using a non-linear finite element model of the lumbar spine. BACKGROUND: Little is known about the influence of muscle forces on the deformation of, and stresses in, the lumbar spine. In most studies, muscle forces are neglected. METHODS: Three-dimensional non-linear finite element models of the ligamentous lumbar spine, with and without internal spinal fixators, were created. They were validated by use of experimental data from in vitro measurements on cadaver specimens. In a second step, the influence of muscle forces on stresses in the annulus fibrosus of the lumbar spine discs was investigated in a parameter study. This was done for different inclination angles of the upper-body. RESULTS: Good agreement between analytical and experimental results proved achievable when loading with pure moments in the three main planes of the lumbar spine. For inclination of the upper-body, the flexion angle clearly has a strong influence on the stresses in the lumbar spine while the influence of local muscles was small. The stress distribution in the discs differed considerably when the muscle forces are neglected and only a pure moment is applied. CONCLUSIONS: This study confirmed earlier ones that have shown that muscle forces should not be neglected when studying the stresses in the lumbar spine. The local dorsal muscles, however, have only a small influence on the stresses in the discs. RELEVANCE: For investigations of the biomechanical effects of spinal implants and surgical procedures, experimental or analytical methods are used. Due to the complexity involved, as well as to a lack of information, muscle forces are often neglected. Our study showed that muscles do in fact have a major influence on the mechanical behaviour of the spine and should always be taken into account.

Biomechanical Phenomena↗
PubMed2001

Influence of femoral anteversion on proximal femoral loading: measurement and simulation in four patients.

OBJECTIVE: The aim of this study was to determine the loading of the proximal femur during daily activities and to quantify the influence of femoral anteversion. DESIGN: This study combined experimental and analytical approaches to determine the in vivo loading at the hip joint. A numerical musculo-skeletal model was validated against measured in vivo hip contact forces and then used to analyse the influence of anteversion on the loading conditions in the femur. BACKGROUND: Musculo-skeletal loading of long bones is essential for joint replacement and fracture healing. Although joint contact forces have previously been measured in selected patients, the interaction between femoral anteversion and the associated musculo-skeletal loading environment remains unknown. METHODS: The gait of four patients with force measuring hip prostheses was analysed during walking and stair-climbing. Musculo-skeletal loading was determined using individual numerical models by minimising the sum of the muscle forces. RESULTS: Experimentally and numerically determined hip contact forces agreed both qualitatively and quantitatively. Muscle activity resulted in compression of the femur and small shear forces in the meta- and epi-physeal regions. Increasing the anteversion to an angle of 30 degrees increased hip contact forces and bending moments up to 28%. CONCLUSIONS: This study has shown that femoral anteversion has a strong influence on the musculo-skeletal loading environment in the proximal femur. RELEVANCE: Detailed musculo-skeletal modelling may allow pre-surgical, patient specific optimisation of loading on implant, bone and soft tissues.

Biomechanical Phenomena↗
PubMed2001

Averaging of strongly varying signals.

Forces acting at the hip joint during a given activity often vary much between trials and subjects. Large variations are also encountered in many other biomechanical signals. Arithmetic mean curves then lead to falsified results, especially if extreme values occur at very different times. A method was developed for calculating a typical curve from such varying, time dependent signals. All cycle times are first averaged and the signals are then more and more smoothed using Fourier series with decreasing numbers of harmonics. The remaining extrema are analysed to decide whether they are typical for all curves or not. This is done by systematically cutting off a varying number of extrema at the beginning or end of all curves. After this an equal number of extrema remains in all curves. These extrema are then shifted to average positions in time, i.e. the times between consecutive extrema are compressed or expanded, and the standard deviation of all curves is calculated. The combination of cut off extrema which results in the smallest standard deviation is then used further on. The same time distortions are applied to the original curves and their arithmetic mean finally results in the typical signal. This procedure is well suited for averaging hip contact forces and other varying signals as long as their complexity and variation is not extremely large.

Arthroplasty, Replacement, Hip↗
PubMed2000

2000 Volvo Award winner in biomechanical studies: Monitoring in vivo implant loads with a telemeterized internal spinal fixation device.

STUDY DESIGN: Implant loads were measured in 10 patients using telemeterized internal spinal fixation devices. OBJECTIVE: To determine the postoperative temporal course of implant loads. SUMMARY OF BACKGROUND DATA: Little information exists regarding the temporal course of loads on internal spinal fixation devices. METHODS: The telemeterized internal spinal fixator allows the measurement of three force components and three moments acting in the fixator. Implant loads were determined in up to 20 measuring sessions for different activities, including walking, standing, sitting, lying in the supine position, and lifting an extended leg while in the supine position. RESULTS: Implant loads often increased shortly after anterior interbody fusion was performed. Several patients retained the same high level even after fusion had taken place. This explains the reason why screw breakage sometimes occurs more than half a year after implantation. The time of fusion could not be pinpointed from the loading curves. CONCLUSIONS: The results show that fixators may be highly loaded even after fusion has occurred. A flexion bending moment acts on the implant even with the body in a relaxed lying position. This means that already shortly after the anterior procedure, the shape of the spine is not neutral and unloaded, but slightly deformed, which loads the fixators. Pedicle screw breakage more than half a year after insertion does not prove that anterior interbody fusion has not occurred.

Adult↗
PubMed2000

Influence of load carrying on loads in internal spinal fixators.

After spinal stabilization with an implant, patients want to know whether carrying loads will endanger their spine and their implant. Therefore, the effect of carrying a weight on the loading of internal spinal fixation devices was determined in 10 patients using instrumented, telemeterized internal fixators. Patients carried a 5kg dumbbell in one hand as well as up to 20kg in both hands. Compared to normal standing carrying a weight caused only a slight increase of the fixator loads in all patients. The maximum flexion bending moment in the fixators was then lower than during walking. Carrying a weight even decreased the axial compression force in the fixators of the patients with the T11 or T12 vertebra bridged. Patients also raised their arms in anteversion while holding weights of up to 5kg with both hands. This increased the flexion bending moment in the fixators. Only a small part of a carried weight is taken over by internal fixators. Carrying a shopping bag only slightly increases the risk of pedicle screw breakage, however, since the spine has to support most of the additional weight, it represents a risk with regard to correction loss and bone sintering.

Adult↗
PubMed2000

Interfacial conditions between a press-fit acetabular cup and bone during daily activities: implications for achieving bone in-growth.

Interfacial gaps and relative micromotions during activities are widely believed to restrict the boney in-growth process of non-cemented acetabular cups. Using finite element modeling of the cup-bone system, relative micromotions and interfacial gaps are calculated for walking slow, normal and fast and for climbing upstairs, downstairs and standing up from a chair. A 2mm press-fit is simulated and interfacial conditions in the immediate postoperative period (i.e. prior to boney in-growth) calculated between paired nodes covering the whole of the interface. In regions of 'safe' micromotions and 'allowable' gaps, boney in-growth is simulated by specifying zero relative displacement between nodal pairs. The modified model is then resubjected to the loads associated with climbing upstairs, which was shown to be the worst activity. Interfacial conditions are recalculated for subsequent iterations. The procedure is repeated until no further in-growth is predicted. The final pattern of in-growth calculated with the model compares reasonably well with histological evidence from explanted canine cups (Cha et al., 1998. Transactions of the Orthopaedic Research Society, 23, p. 373). Bridging between adjacent regions of in-growth is observed. Notably, in-growth occurs at most of the periphery but not in the polar region. The lack of polar in-growth is caused by the interfacial gap assumed to exist after cup implantation. It is suggested that increasing/decreasing hip-joint loads would have little effect on this lack of polar in-growth. However, excessive micromotions as a result of high hip-joint loads cause a lack of in-growth in the anterior region of the periphery in the model. Although such results were not found in the canine study, if relevant to the general human population, the avoidance of harsh weight-bearing activities may encourage complete peripheral in-growth but is speculated to do little for polar in-growth.

Acetabulum↗
PubMed2000

Family perception of interpersonal behavior as a predictor in eating disorders: a prospective, six-year followup study.

This study assessed family perception patterns of interpersonal behavior in families with a daughter diagnosed with an eating disorder 6 years after treatment that used a prospective design. Family perception patterns of patients found to have a poor outcome at followup (n = 15) were compared with patients with a good outcome (n = 23), as well as a control group (n = 36). Using the system of multiple level observation of groups (SYMLOG), all 238 family members evaluated themselves and each other. The index patients with a poor outcome perceived themselves as friendlier and more positive than they were perceived by their families. In comparison to parents of daughters with a good outcome and the control group, parents of daughters in the poor outcome group perceived themselves to be less friendly than their partners perceived them to be. A rigid polarization of the perception of the index patient by family members and a discrepancy in this perception between the index patient and the rest of the family were found to be indicative of a poor prognosis. Implications for treatment based on family perception patterns of interpersonal behavior are discussed.

Adolescent↗