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S J Piazza

Publications and source records attributed to S J Piazza.

9 recordsLinked to original sources
PubMed2001

In vitro modeling of human tibial strains during exercise in micro-gravity.

Prolonged exposure to micro-gravity causes substantial bone loss (Leblanc et al., Journal of Bone Mineral Research 11 (1996) S323) and treadmill exercise under gravity replacement loads (GRLs) has been advocated as a countermeasure. To date, the magnitudes of GRLs employed for locomotion in space have been substantially less than the loads imposed in the earthbound 1G environment, which may account for the poor performance of locomotion as an intervention. The success of future treadmill interventions will likely require GRLs of greater magnitude. It is widely held that mechanical tissue strain is an important intermediary signal in the transduction pathway linking the external loading environment to bone maintenance and functional adaptation; yet, to our knowledge, no data exist linking alterations in external skeletal loading to alterations in bone strain. In this preliminary study, we used unique cadaver simulations of micro-gravity locomotion to determine relationships between localized tibial bone strains and external loading as a means to better predict the efficacy of future exercise interventions proposed for bone maintenance on orbit. Bone strain magnitudes in the distal tibia were found to be linearly related to ground reaction force magnitude (R(2)>0.7). Strain distributions indicated that the primary mode of tibial loading was in bending, with little variation in the neutral axis over the stance phase of gait. The greatest strains, as well as the greatest strain sensitivity to altered external loading, occurred within the anterior crest and posterior aspect of the tibia, the sites furthest removed from the neutral axis of bending. We established a technique for estimating local strain magnitudes from external loads, and equations for predicting strain during simulated micro-gravity walking are presented.

Aged↗
PubMed2001

Accuracy of the functional method of hip joint center location: effects of limited motion and varied implementation.

Accurate location of the hip joint center is essential for computation of hip kinematics and kinetics as well as for determination of the moment arms of muscles crossing the hip. The functional method of hip joint center location involves fitting a pelvis-fixed sphere to the path traced by a thigh-fixed point while a subject performs hip motions; the center of this sphere is the hip joint center. The aim of the present study was to evaluate the potential accuracy of the functional method and the dependence of its accuracy on variations in its implementation and the amount of available hip motion. The motions of a mechanical linkage were studied to isolate the factors of interest, removing errors due to skin movement and the palpation of bony landmarks that are always present in human studies. It was found that reducing the range of hip motion from 30 degrees to 15 degrees did significantly increase hip joint center location errors, but that restricting motion to a single plane did not. The magnitudes of these errors, however, even in the least accurate cases, were smaller than those previously reported for either the functional method or other methods based on pelvis measurements of living subjects and cadaver specimens. Neither increasing the number of motion data observations nor analyzing the motion of a single thigh marker (rather than the centroid of multiple markers) was found to significantly increase error. The results of this study (1) imply that the limited range of motion that is often evident in subjects with hip pathology does not preclude accurate determination of the hip joint center when the functional method is used; and (2) provide guidelines for the use of the functional method in human subjects.

Biomechanical Phenomena↗
PubMed2001

Changes in muscle moment arms following split tendon transfer of tibialis anterior and tibialis posterior.

Moment arms of tibialis anterior (TA) and tibialis posterior (TP) about the subtalar and talocrural joint axes were measured in anatomic specimens both before and after split tendon transfers. These procedures are commonly performed to correct hindfoot varus, a gait deformity that is often seen in patients with cerebral palsy, stroke, and brain injury. Split tendon transfer significantly reduced the inversion moment arms of tibialis anterior and tibialis posterior at all subtalar joint angles except for the most everted position in the case of TA. Changes in subtalar joint moment arms produced by split tendon transfer, especially those seen in TA, were variable, suggesting that the procedure may be susceptible to technical errors, especially related to balancing tensions in the medial and lateral tendon halves. Talocrural joint moment arms of both muscles were preserved following split tendon transfer. This study presents the first measurements of the moment arms of split transferred muscles. These characterizations of the mechanics of split tendon transfer will aid in the planning and assessment of these procedures.

Adult↗
PubMed2001

Three-dimensional dynamic simulation of total knee replacement motion during a step-up task.

A three-dimensional dynamic model of the tibiofemoral and patellofemoral articulations was developed to predict the motions of knee implants during a step-up activity. Patterns of muscle activity, initial joint angles and velocities, and kinematics of the hip and tinkle were measured experimentally and used as inputs to the simulation. Prosthetic knee kinematics were determined by integration of dynamic equations of motion subject to forces generated by muscles, ligaments, and contact at both the tibiofemoral and patellofemoral articulations. The modeling of contacts between implants did not rely upon explicit constraint equations; thus, changes in the number of contact points were allowed without modification to the model formulation. The simulation reproduced experimentally measured flexion-extension angle of the knee (within one standard deviation), but translations at the tibiofemoral articulations were larger during the simulated step-up task than those reported for patients with total knee replacements.

Adult↗
PubMed2000

Measurement of the screw-home motion of the knee is sensitive to errors in axis alignment.

Measurements of joint angles during motion analysis are subject to error caused by kinematic crosstalk, that is, one joint rotation (e. g., flexion) being interpreted as another (e.g., abduction). Kinematic crosstalk results from the chosen joint coordinate system being misaligned with the axes about which rotations are assumed to occur. The aim of this paper is to demonstrate that measurement of the so-called "screw-home" motion of the human knee, in which axial rotation and extension are coupled, is especially prone to errors due to crosstalk. The motions of two different two-segment mechanical linkages were examined to study the effects of crosstalk. The segments of the first linkage (NSH) were connected by a revolute joint, but the second linkage (SH) incorporated gearing that caused 15 degrees of screw-home rotation to occur with 90 degrees knee flexion. It was found that rotating the flexion axis (inducing crosstalk) could make linkage NSH appear to exhibit a screw-home motion and that a different rotation of the flexion axis could make linkage SH apparently exhibit pure flexion. These findings suggest that the measurement of screw-home rotation may be strongly influenced by errors in the location of the flexion axis. The magnitudes of these displacements of the flexion axis were consistent with the inter-observer variability seen when five experienced observers defined the flexion axis by palpating the medial and lateral femoral epicondyles. Care should be taken when interpreting small internal-external rotations and abduction-adduction angles to ensure that they are not the products of kinematic crosstalk.

Adult↗
PubMed1998

Posterior tilting of the tibial component decreases femoral rollback in posterior-substituting knee replacement: a computer simulation study.

Posterior tilting of the tibial component is thought to increase the range of motion in posterior cruciate-retaining total knee replacement, but its effect on implant motion in posterior cruciate-substituting total knee replacement is unknown. This issue has become of interest recently because manufacturers have introduced instrumentation that produces a posteriorly tilted tibial cut for both implant types. The purpose of this study was to investigate how motion of posterior cruciate-substituting total knee replacement is affected when the tibial component is installed with posterior tilt. Sagittal plane implant motions were predicted from prosthesis geometry with use of a computer simulation in which the femoral condyles were assumed to sit in the bottoms of the tibial condylar wells when the knee was in extension. Rollback of the femoral component was produced by a cam-spine mechanism at higher angles of flexion. The simulations revealed that even small degrees of posterior tilt reduced rollback by limiting the interaction between the cam and spine. Tilting the component posteriorly by 5 degrees caused the cam to contact the spine at a knee flexion angle that was 18 degrees higher than with the untilted component. The results suggest that posterior tilting of the tibial component in posterior cruciate-substituting knee replacement may not produce the same beneficial effects that have been reported for the tilting of tibial components in posterior cruciate-retaining knee replacement.

Arthroplasty, Replacement, Knee↗
PubMed1996

The influence of muscles on knee flexion during the swing phase of gait.

Although the movement of the leg during swing phase is often compared to the unforced motion of a compound pendulum, the muscles of the leg are active during swing and presumably influence its motion. To examine the roles of muscles in determining swing phase knee flexion, we developed a muscle-actuated forward dynamic simulation of the swing phase of normal gait. Joint angles and angular velocities at toe-off were derived from experimental measurements, as were pelvis motions and muscle excitations. Joint angles and joint moments resulting from the simulation corresponded to experimental measurements made during normal gait. Muscular joint moments and initial joint angular velocities were altered to determine the effects of each upon peak knee flexion in swing phase. As expected, the simulation demonstrated that either increasing knee extension moment or decreasing toe-off knee flexion velocity decreased peak knee flexion. Decreasing hip flexion moment or increasing toe-off hip flexion velocity also caused substantial decreases in peak knee flexion. The rectus femoris muscle played an important role in regulating knee flexion; removal of the rectus femoris actuator from the model resulted in hyperflexion of the knee, whereas an increase in the excitation input to the rectus femoris actuator reduced knee flexion. These findings confirm that reduced knee flexion during the swing phase (stiff-knee gait) may be caused by overactivity of the rectus femoris. The simulations also suggest that weakened hip flexors and stance phase factors that determine the angular velocities of the knee and hip at toe-off may be responsible for decreased knee flexion during swing phase.

Acceleration↗
PubMed1991

Biomechanics of fracture risk prediction of the hip and spine by quantitative computed tomography.

In this review, we have made use of some simple engineering concepts to summarize current efforts relating QCT measures to bone density and strength. From a variety of in vitro experiments on cadaveric vertebrae and femora, it is evident that both apparent and ash densities are strong linear functions of QCT measures, with coefficients of determination ranging from 0.49 to 0.90 and relative errors from 44.9% to 7.1%. QCT data also can be used (with somewhat less confidence) to determine the compressive modulus (R2s from 0.36 to 0.68, relative errors from 45.0% to 35.5%) and compressive strength (R2s from 0.58 to 0.70, relative errors from 56.5% to 39.9%) of trabecular bone from the proximal femur and vertebral body. In cortical bone, material properties are only correlated weakly with QCT measures. Experiments designed to relate QCT data to failure loads for the proximal femur and vertebral body have been remarkably successful. Coefficients of determination have ranged from 0.32 to 0.93, with relative errors from 31.1% to 13.9%. However, when the in vitro failure loads determined in these experiments are compared against available estimates of in vivo loads on the spine and hip, it is apparent, at least in the elderly, that in vivo loads are relatively close to those that cause fracture in vitro. To assess the possibility of developing QCT-based clinical predictors of fracture risk for individual patients, we have introduced the concept factor of risk often used in engineering design to account for uncertainties in estimates of service loads and component strength. The factor of risk for a particular loading condition is defined as the ratio of expected service loads to the known failure loads. To extend this concept to densitometric fracture risk prediction in vivo, it is important to recognize that densitometric data must not only be used to predict the ultimate load carrying capacity of the region of interest, but that this ultimate load must then be compared to the forces expected in vivo under comparable loading conditions. One difficulty with this approach is that little is known about the in vivo forces that are associated with atraumatic age-related fractures of the hip and vertebrae and even less about the forces applied to the hip and spine during traumatic events such as falls. However, from available estimates of in vivo loads during bending and lifting, it is apparent that in the elderly, factors of risk for the spine can easily approach 1.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗