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Biomedical subjects

I Hvid

Publications and source records attributed to I Hvid.

At least 19 recordsLinked to original sources
PubMed1992

The effect of specimen geometry on the mechanical behaviour of trabecular bone specimens.

The effect of specimen geometry on the mechanical behaviour of trabecular bone specimens was studied by non-destructive uniaxial compression to 0.4% strain using cylindrical specimens with different sizes and length-to-diameter ratios, and by comparing cubic and cylindrical specimens with the same cross-sectional area. Both the length and the cross-sectional area of the specimen had a highly significant influence on the mechanical behaviour (p less than 0.0001). Within the actual range of length (2.75-11.0 mm) the normalized stiffness (Young's modulus) was related nearly linearly to the specimen length. This dependency on specimen length is suggested to be caused mainly by structural disintegrity of the trabecular specimens near the surface. The normalized stiffness (Young's modulus) was also positively correlated to the cross-sectional area. This dependency on cross-sectional area is probably due to friction-induced stress inhomogeneity at the platen-specimen interface. A cube with side length 6.5 mm or a cylindrical specimen with 7.5 mm diameter and 6.5 mm length are suggested as standard specimens for comparative studies on trabecular bone mechanics.

Adult↗
PubMed1992

The press-fit Kinemax knee arthroplasty. High failure rate of non-cemented implants.

We report the results of 75 consecutive primary press-fit Kinemax arthroplasties with an average follow-up of 14 months (three to 28). We reviewed 26 cemented and 49 non-cemented tibial components implanted into 72 patients (30 men and 42 women, median age 70 years). At the latest follow-up the overall evaluation (Hospital for Special Surgery knee rating scale) for cemented cases was excellent in 54%, good in 42% and poor in 4%. No cemented prosthesis loosened. Of the non-cemented cases 55% were excellent, 23% good, and 2% fair. Ten tibial implants (20%) loosened and required revision. Residual pain marred the result in 24% of the non-cemented prostheses and in 4% of the cemented group. We do not recommend the press-fit, smooth-surfaced Kinemax prosthesis for non-cemented use.

Adult↗
PubMed1992

Long-term results of total condylar knee arthroplasty in rheumatoid arthritis.

We have reviewed at an average period of ten years the results of 71 consecutive primary arthroplasties with the Insall-Burstein total condylar knee prosthesis in patients with rheumatoid arthritis. Their mean age at surgery was 52 years (24 to 72). At follow-up the overall results (Hospital for Special Surgery knee rating score) were excellent or good in 77%, fair in 11% and poor in 11%. There was residual pain in only 5% of patients with prostheses in situ; 58% could walk more than 500 m, and the median range of motion was 108 degrees. Eight knees had been revised. Five underwent arthrodesis because of deep infection and three needed revision arthroplasty for mechanical loosening. The crude survival rate of the arthroplasties was 89%. The presence of radiolucency around the tibial component correlated significantly with the severity of residual pain.

Adult↗
PubMed1991

[Long-term results of total condylar knee alloplasty by the Insall-Burstein method. A follow-up after 9-11 years].

A total of 118 patients (164 knees) participated in this investigation. These consisted of 23 males (31 knees) and 95 females (113 knees). The average age was 63 years (24-80 years) and the average period of observation was 10 years (9-11 years). The patients were examined clinically and radiographically preoperatively and also 8-12 weeks postoperatively and at intervals of one year thereafter. The Hospital for Special Surgery knee rating scale was employed in the clinical assessment and The Knee Society recognized radiolucency index in the radiographic assessment. At the most recent control examination, 82% of the knees assessed showed excellent or good results, 9% had fair results and 9% poor. The median total score was 84 points (quartiles: 76 and 98). Complete freedom from pain or slight pain were found in 91%. The range of motion was increased by an average of 12 degrees. A considerable improvement in the walking ability was found. A significantly positive correlation was found between the varus positioning of the tibial component and the occurrence of translucent zones. Serious complications occurred in 10% but none proved fatal.

Adult↗
PubMed1991

Physical bone changes in carragheenin-induced arthritis evaluated by quantitative computed tomography.

Repeated non-invasive measurements were performed in dogs of trabecular bone density (TBD), low density bone area (LDBA), and high density bone area (HDBA) in chronic arthritis using quantitative computed tomography (QCT). Unilateral chronic arthritis of the knee had been induced by weekly instillation of 2 ml carragheenin into the right knee joint for 12 weeks with the left knee serving as a control. CT scanning of the distal femoral condyles was performed in 12 mature dogs with chronic arthritis. Another 6 dogs underwent a longitudinal CT study starting immediately prior to induction of arthritis. During induction of arthritis TBD decreased (P less than 0.01), LDBA increased (P less than 0.05) and HDBA decreased (P less than 0.01) in the arthritic bone. Opposite changes were found on the control side, i.e. TBD increased (P less than 0.01), LDBA decreased (P less than 0.01) and HDBA increased (P less than 0.01). The chronic arthropathic bone showed 20% lower TBD (P less than 0.0001), greater LDBA (P less than 0.0001) and lower HDBA (P less than 0.0001) as compared with the control bone. Reproducibility tests of TBD showed a coefficient of variation of 0.8%. Indentation tests and histomorphometric analyses confirmed the bone density changes as measured by CT.

Animals↗
PubMed1991

Mechanical properties of trabecular bone. Dependency on strain rate.

The effect of strain rate (epsilon) and apparent density (rho) on stiffness (E), strength (sigma u), and ultimate strain (epsilon u) was studied in 60 human trabecular bone specimens from the proximal tibia. Testing was performed by uniaxial compression to 5% specimen strain. Six different strain rates were used: 0.0001, 0.001, 0.01, 0.1, 1, and 10 s-1. Apparent density ranged between 0.23 and 0.59 g cm-3. Linear and non-linear regression analyses using strength, stiffness and ultimate strain as dependent variables (Y) and strain rate and apparent density as independent variables were performed using the following models: Y = a rho b epsilon c, Y = rho b(a + c epsilon; Y = (a + b rho)epsilon c, Y = a rho 2 epsilon c, E = a rho 3 epsilon c. The variations of strength and stiffness were explained equally well by the linear and the power function relationship to strain rate. The exponent was 0.07 in the power function relationship between strength and strain rate and 0.05 between stiffness and strain rate. The variation of ultimate strain was explained best using a power function relationship to strain rate (exponent = 0.03). The variation of strength and stiffness was explained equally well by the linear, power function and quadratic relationship to apparent density. The cubic relationship between stiffness and apparent density showed a less good fit. Ultimate strain varied independently of apparent density.

Aged↗
PubMed1991

Fixation of titanium and hydroxyapatite-coated implants in arthritic osteopenic bone.

Retrieval studies of porous-coated prostheses have demonstrated deficient bony ingrowth in high percentages. Possible reasons for this are lack of initial mechanical stability and the presence of osteopenia. The authors studied ingrowth of osteopenic bone into titanium alloy (Ti) porous-coated implants with and without hydroxyapatite (HA) coating in an experimental dog model. Unilateral osteopenia of the knee with a 20% reduced bone density as judged by computed tomography (CT) scanning (P less than .001) was induced in 12 mature dogs by weekly intraarticular injections of Carragheenin into the right knee for 12 weeks, with the left knee serving as control. Ti porous-coated cylinders were inserted in press-fit bilaterally in the lateral femoral condyles in six dogs. HA-coated titanium plugs were implanted similarly in another sex-, age-, and weight-matched group of six dogs. Bony ingrowth after 4 weeks was significantly reduced for Ti implants in osteopenic bone compared to control bone, but HA-coated implants were covered by equal amounts of bone tissue. Bone-implant shear strength of Ti implants also was reduced in osteopenic bone compared to control bone. In control bone, the anchorage of Ti implants was stronger than HA-coated implants, whereas the fixation of Ti and HA-coated implants was equal in the osteopenic bone. The results demonstrate that the bony fixation of Ti porous-coated implants is weakened by the presence of experimentally induced osteopenia. However, the fixation of HA-coated implants was not affected by the osteopenic condition in the surrounding bone. The fixation of Ti and HA-coated implants was equal in osteopenic bone, whereas the fixation of Ti porous-coated implants was superior to that of HA-coated implants in control bone.

Animals↗
PubMed1991

Anterolateral instability in the anterior cruciate ligament deficient knee. A cadaver study.

Knee instability was evaluated in 13 normal osteoligamentous knee preparations after transection of the anterior cruciate ligament. Abduction-adduction rotation, coupled tibial translatory movement, and coupled tibial axial rotation were recorded continuously and simultaneously during flexion or extension while applying a well defined valgus directed moment and during extension while applying an anterior tibial force. As a result of the valgus-directed moment, an increase was found in abduction rotation, in coupled anterior tibial translation, and in coupled internal tibial axial rotation. Coupled rotatory and translatory instabilities were larger, and maximum instability was observed at a smaller knee angle during the extension movement than during the flexion movement. The pattern of the instability, excited as a result of the valgus moment, was different from the instability excited as a result of an anterior tibial force.

Aged↗
PubMed1991

Gap healing enhanced by hydroxyapatite coating in dogs.

During prosthetic implantation, gaps between the implant surface and the surrounding bone may occur resulting in reduced implant stability. In these instances bone-conductive materials might augment the formation of hosting bone into the pores of the implant and insure earlier implant stabilization and fixation by bony ingrowth. Titanium-alloy cylinders with a porous-titanium-alloy plasma spray coating were implanted into the medial femoral condyles in six mature dogs. In another group of six dogs, matched in age, weight, and gender, hydroxyapatite (HA) coated implants were used. All implants were surrounded by a 1-mm gap. Unilateral osteopenia of the knee, with a 20% reduction of bone density as judged by computed tomography scanning, was induced by 12 weekly intraarticular injections of carrageenin into the right knee before surgery. Four weeks after implantation, the HA-coated implants were compared to the parent porous-titanium implants by mechanical testing and histomorphometry. A marked positive influence of HA coating on bone mineralization and the strength of the interfacial bone between the bone and implant was found. The increment in interface shear strength and shear stiffness was three- to fivefold in osteopenic bone and two-fold in control bone. Coating of an unloaded porous-titanium-coated implant with HA accelerates the rate of bone ingrowth and thereby provides relatively high, early interfacial shear strengths in the presence of an initial gap between bone and implant even in the presence of osteopenic host bone.

Animals↗
PubMed1990

Three-axial strain controlled testing applied to bone specimens from the proximal tibial epiphysis.

Reproducibility of the determination of Young's modulus and energy absorption along the three axes of trabecular bone cubes was analysed by non-destructive compression to 0.5% strain using different testing protocols. These protocols included testing with and without pre-conditioning to a viscoelastic steady state, and different orders of test directions. Reproducibility of conditioned tests was generally better than that of non-conditioned tests. No major effect of changing the order of the test direction was found. Three-axial conditioned testing of cubes from the proximal tibial epiphysis of five humans revealed a global transverse isotrophy while most cubes showed orthotropy. The ratio between stiffness along the long axis of the tibia and the stiffness in the transverse plane was 3.7 +/- 0.4 (mean +/- 2 SE). The corresponding ratios for elastic energy storage and viscoelastic energy dissipation were 2.5 +/- 0.2. There was no difference between the relative energy loss during a testing cycle (loss tangent) in the three axes.

Adult↗
PubMed1989

Energy absorptive properties of human trabecular bone specimens during axial compression.

Human trabecular bone specimens (n = 121) from the proximal tibial epiphysis of nine macroscopically normal cadaver knees were tested nondestructively to a fixed strain (0.6%) for analysis of unloading energy and hysteresis energy followed by a destructive test for analysis of work to failure. All energy properties showed interindividual variation (p less than 0.005). There was a strong positive correlation between unloading energy and both stress (r = 0.95) and stiffness (r = 0.89) determined at 0.6% strain. A less strong, but statistically significant, correlation was found between hysteresis energy and stress (r = 0.82) and stiffness (r = 0.76) at 0.6% strain. There was a negative correlation between the loss tangent and stiffness at 0.6% strain (r = -0.40, p less than 0.001). Work to failure correlated positively with modulus of elasticity (r = 0.75), ultimate stress (r = 0.92), and ultimate strain (r = 0.51). There was a positive mutual correlation between all energy properties (p less than 0.001).

Aged↗
PubMed1989

Density changes at the proximal tibia after medial meniscectomy.

Trabecular bone density changes at the proximal tibia were studied after total and partial meniscectomy using quantitative computerized tomography. Thirty-seven medially meniscectomized patients (5- and 10-year follow-up) and 10 control persons were included. In the partially and the totally meniscectomized knees, the area of maximal density in the medial tibial condyle was displaced approximately 4 mm in a posteromedial direction relative to the position in the intact knees. In both partially and totally meniscectomized knees, the density in the region of tibiofemoral contact in the medial tibial condyle was higher compared with the density in the same region in the contralateral intact knees. This difference was of the same order in the 5- and 10-year follow-up groups. The density difference between the meniscectomized and the intact knees in the region of tibiofemoral contact in the medial condyle was significantly higher in totally than in partially meniscectomized patients. It is concluded that not only total but also partial medial meniscectomy is followed by density changes, occurring within the first 5 years after meniscectomy. The results emphasize the importance of the utmost conservatism in surgery on the meniscus.

Adult↗
PubMed1989

Compressive axial strain distributions in cancellous bone specimens.

The compressive axial strain distribution in cylindrical trabecular bone specimens was studied using digitized images of the specimen surface. Specimens were tested with strain rate 0.00015 s-1. Images were taken at 0, 1, 2, 3, 4, 6, 8 and 10% strain. Using an optical illusion of movement by rapidly changing succeeding images, failures were classified as transverse (33%) or oblique collapses (67%). The location of failure was not determined by the specimen density gradient. Local axial strain in the distal, intermediate and proximal third was measured throughout the compression in the transversely failing specimens, whereas local strain in the obliquely failing specimens was measured in the pre-failure phase only. Axial strain inhomogeneity was observed in the pre-failure as well as in the post-failure phase. In the pre-failure phase the intermediate third was strained significantly less than the thirds near the ends. In the post-failure phase specimen strain occurred solely in the collapsed part. Ultimate strain of the transversely failing specimens was 2.5% and ultimate strain of the failing third was 3.7%. At failure less than 1% strain was observed in the intermediate third and at 10% specimen strain 1.5% local strain was found in the intermediate third. The results indicate unreliability of conventional stiffness and strain measurements in trabecular bone specimens probably due to lack of trabecular constraint at the end surfaces. Conventional measurements tend to underestimate stiffness and, by giving an average value of strain in spite of considerable strain inhomogeneity, to underestimate failure strain.

Bone Density↗
PubMed1989

X-ray quantitative computed tomography: the relations to physical properties of proximal tibial trabecular bone specimens.

Cylindrical bone specimens from the proximal epiphysis of ten normal human proximal tibiae were randomly assigned to a destructive axial compression test-series (N = 94) or to a protocol of standardized mechanical conditioning followed by non-destructive repeated testing to 0.6% strain and a final destructive test (N = 121). Specimen X-ray quantitative computed tomography (QCT) obtained at different scanning energies (100, 120 and 140 kVp) yielded closely related results (r = 1.00). Accordingly, predictions of physically measured densities or mechanical properties were not improved by using more than one scanning energy. QCT and physically measured densities were intimately related (QCT at 140 kVp to apparent density using linear regression: r = 0.94, and to apparent ash density: r = 0.95) and did not differ significantly in their ability to predict the mechanical properties, thus favouring the more easily implemented QCT for routine work. Evaluation of the relation of apparent density to Young's modulus and ultimate strength suggested that a power law regression model is preferable to a linear model, although linear model prediction of mechanical properties does not have significantly worse accuracy within the narrow density range investigated. The effect of conditioning on the behaviour of bone specimens subjected to destructive compression tests was to increase the stiffness and strength by approximately 50 and 20% respectively.

Absorptiometry, Photon↗
PubMed1989

The effect of constraint on the mechanical behaviour of trabecular bone specimens.

The effect of the boundary conditions between trabecular bone specimens and the test columns of the testing machine was studied together with the effect of side-constraint on the mechanical behaviour of trabecular bone during axial compression. Cylindrical specimens taken from the upper tibial epiphysis of autopsy knees were tested non-destructively by cyclic compression to 0.8% strain under different conditions. Fixation of the specimens to the test columns by a thin layer of bone cement increased the stiffness by 40% and reduced the energy dissipation to 67% of those measured under unconstrained conditions (p less than 0.001). The thin cement layer alone increased the stiffness 19% and reduced energy dissipation to 86% (n.s.). When the machine was equipped with polished steel columns coated by a film of low-viscous oil, both the stiffness and the energy dissipation were reduced to 93% of those measured under standard conditions (p less than 0.005). Trabecular bone specimens tested side-constrained by the surrounding trabecular bone (in situ) showed a 19% larger stiffness than that measured during later testing of the corresponding machined specimens (p less than 0.005) whereas the energy dissipation was not altered significantly. The same specimens showed a 22% increase of stiffness and a 68% increase of energy dissipation when they were side-constrained by a closely fitting steel cylinder (p less than 0.005).

Adult↗
PubMed1989

Total condylar knee arthroplasty in osteoarthritis. A four- to six-year follow-up evaluation of 103 cases.

One hundred and three consecutive total condylar knee prostheses in patients with gonarthrosis inserted from 1979 to 1981 have been prospectively followed for four to six years. According to the New York Hospital for Special Surgery Knee Rating Scale, 58 knees (56%) were rated excellent; 34 (33%), good; seven (7%), fair; and four (4%), poor at the latest follow-up evaluation. The median preoperative score was 57 points and the median postoperative score 87 points. Thirteen knees (13%) had a radiolucency with a width of 2 mm or more beneath one or more of three tibial zones. In only one case did this represent a clinical loosening. Six knees (6%) had complications requiring reoperation. One deep infection was treated with an arthrodesis, one patellar button was revised after a traumatic patellar fracture, and three superficial skin necroses were surgically managed. Moreover, in one mechanically loosened tibial component, a revision has been planned. No complications were fatal. The modified total condylar I prosthesis is an excellent prosthetic design with a low failure rate in gonarthrosis.

Adult↗