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Biomedical subjects

G N Duda

Publications and source records attributed to G N Duda.

31 records · Page 2Linked to original sources

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↗

Chondrocyte death precedes structural damage in blunt impact trauma.

Joint impact trauma has been shown to cause fissures, fibrillation, and other structural damage of the cartilage or subchondral bone. Previous studies used impact energies sufficient to fracture the underlying bone. Under these circumstances, the initial influence of impact trauma on cellular components and cartilage structure is unknown. The goal of this study was to determine whether an impact trauma first causes cellular or structural damage to a cartilage layer. Such damage might be the starting point of degenerative changes found in osteoarthrosis. Porcine patellas (n = 12) were subjected to standardized low-impact loading of three magnitudes with a spherical impactor attached to a drop tower device (0.06, 0.1, and 0.2 J). India ink staining and scanning electron microscopic analysis were used for analysis and showed no evidence of gross structural disruption. Chondrocyte viability assessed with thiazole blue staining and propidium iodide counterstaining was reduced significantly in the tangential and middle zones with increasing impact energy. These results indicate that chondrocyte death may precede excessive structural damage reported in earlier studies and might be a crucial factor in posttraumatic osteoarthrosis.

Animals↗

[Evaluating the stability of fracture fixation systems: mechanical device for evaluation of 3-D stiffness in vitro].

Different fixation systems are used for fracture and defect treatment. A prerequisite for complication free healing is sufficient mechanical stability of the osteosynthesis. In vitro investigations offer the possibility of both analysing and assessing the pre-clinical fixation stability. Due to the complex loading environment in vivo, stiffness analysis should include a complete determination of the stiffness under standardised conditions. Based on a mathematical procedure to calculate the 3-D stiffness, a mechanical testing device for the 3-D loading of fixation systems was designed and integrated in the existing test set-up. The set-up consisted of a material testing machine to produce the necessary loads and an optical measurement device to detect the resulting inter-fragmentary movements. To validate the testing device, the 3-D stiffness matrices of different Ilizarov fixator configurations were determined and compared. The good reproducibility of the test was reflected in the small intra-individual variability of the stiffness components. A distinct direction dependence of the fixator stiffness was observed. Increasing the number of rings led to a stiffness increase of up to 50%, especially in bending. The presented testing device allows a complete standardised determination of the stiffness of different fixation systems. It considers the direction dependence of the stiffness and creates a prerequisite for a more direct implant comparison.

Biomechanical Phenomena↗

Mechanical quality of tissue engineered cartilage: results after 6 and 12 weeks in vivo.

Traumatic events are a primary cause for local lesions of articular cartilage. If treated early, restoration of the initial joint geometry and integrity may be achieved. In large defects, sufficient material is not available to bridge the affected area. Heterologeous transplantation is not well accepted due to the risk of infection and immune response. Alternatives are cartilage-like structures, which may be cultured in vitro and transplanted into the defect site. Critical to the success of these new tissues are their mechanical properties. Goals of this study were to generate a hyaline-like cartilage structure, to evaluate its performance in vivo and to verify that its cellular and material properties meet those of native cartilage. Hyaline-like cartilage specimens were generated in vitro and implanted in the backs of nude mice. Specimens were explanted after 6 and 12 weeks, mechanically tested using an indentation test and histologically examined. In mechanical testing, stiffness and failure load significantly increased between weeks 6 and 12. At 12 weeks, mechanical properties of the hyaline-like cartilage were comparable to those of native nasal septal cartilage. Compared to native articular cartilage, the engineered tissue achieved up to 30-50% in strength and mechanical stiffness. In histological examination, specimens showed neocartilage formation. The mechanical testing procedure proved to be sufficiently sensitive to identify differences in properties between cartilage specimens of different origin and at different stages of healing. As an adjunct to histological analysis, mechanical testing may be a valuable tool for judging the utility of engineered cartilage prior to a broad clinical usage.

Adult↗

[Mechanical behavior of Ilizarov ring fixators. Effect of frame parameters on stiffness and consequences for clinical use].

Using a mechanical testing procedure, various fixator constructs were tested in vitro. In addition, the influence of the passive soft tissue structures on the fixation stiffness was determined. An increased number of Schanz' screws or Kirschner wires led to a comparable increase in stiffness than that observed with an increasing screw or wire diameter. In consequence, larger diameters should be preferred over an additional screw or wire where clinically applicable. With diaphyseal telescoping rods only the axial stiffness decreased. As expected, large ring diameters as well as titanium wires reduced stiffness components. Bracing the outer rings caused a reduction of the overall stiffness. Asymmetric pre-tensioning of the K-wires resulted in a significant reduction of tension in the neighboring wire. Removal of the soft tissues reduced stiffness to a similar extend as experienced in a fibula defect situation. The study demonstrates the correlation between design parameters, passive soft tissues and fixation stiffness and presents guidelines for an optimized fixator design.

Biomechanical Phenomena↗

Stress and micromotion in the taper lock joint of a modular segmental bone replacement prosthesis.

The stress distribution within the components and the micromotion of the interface significantly influence the long-term function of the taper lock joint in a modular segmental bone replacement prosthesis. Bending-induced gap opening between the cone and the sleeve can lead to an inflow of biological fluids, and thus accelerate implant corrosion. Local areas of high stress can also accelerate the corrosive processes and initiate local yielding, which may lead to a fracture in one of the components. In this study, a 3-D finite element (FE) model of a modular segmental bone replacement prosthesis was developed to study the interface micromotion and component stress distribution under the maximum loads applied during gait for a taper lock joint with multiple material combinations. Bending was the main cause of the local high stresses and interface separation within the taper joint. For Ti6A14V components, cortical bone bridging and ingrowth across the taper lock gap reduced the peak stress by 45% and reduced the contact interface separation by 55%. Such tissue formation around the taper lock joint could also form a closed capsule to restrict the migration of potential wear particles and thus prevent the biologic process of bone resorption induced by metal debris.

Bone and Bones↗

Initial stability of fully and partially cemented femoral stems.

OBJECTIVE: To test the initial stability of a newly designed partially cemented femoral stem in comparison with a fully cemented conventional stem. DESIGN: An in vitro study to determine the interface motion between femoral stem and bone as a response to loading. BACKGROUND: The aim of the new prosthesis design is a proximal load transfer by a defined partial cement fixation in the proximal femur region and a slim prosthesis stem in the distal region. Before a clinical study can be started, the new stem has to show an initial stability comparable to that of fully cemented prostheses. METHOD: Six paired fresh cadaveric femora were used for the testing of the new partially cemented stem (Option 3000, Mathys Orthopaedics, Bettlach, Switzerland) and a fully cemented stem (Weber Shaft, AlloPro, Baar, Swizerland). Under cyclic loading up to 1600 N hip joint forces, the interface motion between implants and bone was measured at six locations. RESULTS: Both stems showed uncritical interface motions below 43 microm. However, the Option 3000 stem exhibited significantly smaller motions in the proximal region and slightly larger movements in the distal regions than the Weber prosthesis. CONCLUSIONS: The new type of partially cemented stem provided a comparable initial stability to the fully cemented Weber prosthesis. Relevance The high initial stability of the Option 3000 stem justified the clinical use of the new implant. More than 100 implantations in the last three years, with very good preliminary clinical results, support the preclinical findings.

Aged↗

A method to determine the 3-D stiffness of fracture fixation devices and its application to predict inter-fragmentary movement.

Inter-fragmentary movement considerably influences the fracture healing process. Large shear movement delays while moderate axial movement stimulates the healing process. To be able to control the mechanical situation at a fracture site and to achieve optimal bony healing it is essential to understand the relationship between inter-fragmentary movement, bony loading and fixation stiffness. A 6 x 6 stiffness matrix is introduced which completely describes the linear relationship between the 6 inter-fragmentary movements and the resulting bony loading (3 forces and 3 moments). Further, it is illustrated that even in relatively stiff external fixateur constructs simple axial loading of the bony fragments leads to complex inter-fragmentary movement. When the 3-D stiffness description is multiplied by the load state in sheep tibiae, movements similar to those measured in vivo are calculated. The relationship between axial compression and medio-lateral or dorso-ventral shear varies depending on the mounting plane of the external fixateur. The authors conclude that a single value is not sufficient to describe the mechanical relationship between inter-fragmentary movement and bony loading. Only a complete description of fixation stiffness allows prediction of inter-fragmentary movement and differentiation between various configurations of fixation devices and their potential for mechanically promoting bony healing.

Animals↗

Analysis of inter-fragmentary movement as a function of musculoskeletal loading conditions in sheep.

It is well accepted that inter-fragmentary movement influences the fracture healing process. Small axial movement can stimulate callus formation whereas larger shear movement delays the healing process. It is, therefore, essential for optimal fracture healing to minimize shear and to control axial movement. Unfortunately, the complex gap movements are mostly unknown under the large variety of clinical as well as experimental conditions of fracture fixation. To further understand the complex interactions of musculoskeletal loading and inter-fragmentary movements in bones and to reduce the need for animal experiments, a three-dimensional (3D) musculoskeletal model of the left hind limb of a sheep was developed. From 3D ground reaction forces and inverse dynamics, resultant joint loading was determined over a gait cycle. Muscle and joint contact forces were derived from an optimization routine and internal loads in the tibia and metatarsus from beam theory. Finally, inter-fragmentary movements were calculated from the bony loading condition and experimentally determined stiffness matrices of monolateral AISF external fixator constructs. Both the joint contact forces at the hip and gap movement of a mid-shaft tibial fracture agree with in vivo data reported in the literature. The bones proved to be mainly axially loaded with slightly increasing shear forces toward their ends. The results suggest that inter-fragmentary movement of metatarsal fractures is fairly independent of the fracture location whereas the movement increases in proximal tibial fractures compared to those in the distal and diaphyseal tibia. Considerable shear movement was found for all locations and external fixator mountings. However, shear movement could be minimized with a cranio-lateral rather than a cranio-medial shift from the cranial fixator plane.

Animals↗

Influence of muscle forces on femoral strain distribution.

Musculoskeletal loading influences the stresses and strains within the human femur and thereby affects the processes of bone modeling and remodeling. It is essential for implant design and simulations of bone modeling processes to identify locally high or low strain values which may lead to bone resorption and thereby affect the clinical outcome. Using a finite element model the stresses and strains of a femur with all thigh muscle and joint contact forces were calculated for four phases of a gait cycle. Reduced load sets with only a few major muscles were analyzed alternatively. In a completely balanced femur with all thigh muscles the stress and strain patterns are characterized by combined bending and torsion throughout the bone. Similar to in vivo recordings, the model with all thigh muscles showed peak surface strains below 2000 mu epsilon (45% gait cycle). Under simplified load regimes surface strains reached values close to 3000 mu epsilon. Within the proximal femur, the simplified load regimes produced differences in strain as high as 26% in comparison to those with all thigh muscles included. This difference is reduced to 5% if the adductors are added to a loading consisting of hip contact, abductors and ilio-tibial band. This study demonstrates the importance of an ensemble of muscle forces to reproduce a physiological strain distribution in the femur. Analytical attempts to simulate bone modeling, remodeling or bone density distributions should therefore rely on fully balanced external load regimes which account for the role of the various soft tissue forces.

Biomechanical Phenomena↗

Internal forces and moments in the femur during walking.

The forces exerted by the soft and hard tissues of the thigh together represent a system in equilibrium. This balance of loads must be considered when the system components are examined independently. However, in many biomechanical analyses of the thigh, the femur is studied without considering soft tissue loading. To improve the understanding of femoral loading a three-dimensional model was developed. Taking into account all thigh muscles, body weight and contact forces at the hip, patello-femoral and knee joints, the internal loads of the bone were calculated. Internal loads of the femur decreased as a result of muscle activity from proximal to distal at the hip and from distal to proximal at the knee. The load reduction could be up to 50% of the internal forces at the hip, depending on gait phase. Maximal forces were found between 40 and 60% of the stance phase, whereas maximal torsional moments occurred shortly after heel strike. This model demonstrated that muscles play a substantial role in balancing the loads within the femur. In general, the bone is loaded axially, rather than in bending, with maximum shear forces at the proximal and distal ends. Bending moments are relatively small compared to models which do not consider muscle activity. From one gait phase to another, the femur experiences alternating, rather than one-sided bending load.

Biomechanical Phenomena↗

Locking strength of Morse tapers used for modular segmental bone defect replacement prostheses.

Mechanical testing has been performed to characterize the locking strength of Morse taper locks used for reconstruction of large bone defects. Taper joint pairs were locked with a series of compressive loads increasing from 500 to 3500 N. Following each load application the taper locks were distracted with either an axial load or a torsional load. Additional tapers were loaded with 2 million cycles of axial compression or 2 million cycles of cantilever bending combined with axial compression, followed by axial distraction. The torsional and axial distraction loads increased linearly with the compressive load. Compared to a single compressive load application, cyclic axial loading had little influence on the joint strength, while a combination of axial loading and bending increased the joint strength. Based on these results, in vivo loading should increase the locking strength of Morse taper locks used for bone defect reconstruction.

Biomechanical Phenomena↗

Variability of femoral muscle attachments.

Analytical and experimental models of the musculoskeletal system often assume single values rather than ranges for anatomical input parameters. The hypothesis of the present study was that anatomical variability significantly influences the results of biomechanical analyses, specifically regarding the moment arms of the various thigh muscles. Insertions and origins of muscles crossing or attaching to the femur were digitized in six specimens. Muscle volumes were measured; muscle attachment area and centroid location were computed. To demonstrate the influence of inter-individual anatomic variability on a mechanical modeling parameter, the corresponding range of muscle moment arms were calculated. Standard deviations, as a percentage of the mean, were about 70% for attachment area and 80% for muscle volume and attachment centroid location. The resulting moment arms of the m. gluteus maximus and m. rectus femoris were especially sensitive to anatomical variations (SD 65%). The results indicate that sensitivity to anatomical variations should be analyzed in any investigation simulating musculoskeletal interactions. To avoid misinterpretations, investigators should consider using several anatomical configurations rather than relying on a mean data set.

Aged↗