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Biomedical subjects

S Tepic

Publications and source records attributed to S Tepic.

At least 19 recordsLinked to original sources
PubMed2001

Direction-dependent resistance to flow in the endplate of the intervertebral disc: an ex vivo study.

A comparison of the higher hydrostatic pressure in the nucleus of the healthy intervertebral disc during daily loading with the relatively lower osmotic swelling pressure in the disc during rest suggests the existence of direction-dependent flow resistance such that all of the fluid exuded from the disc during loading is recovered during rest. In this study, this direction-dependent resistance was demonstrated for flows through the cartilage endplates and the underlying marrow contact channels in the bony endplates. Using an ex vivo sheep endplate model, the resistance ratio (Rout/Rin) for flow through the endplate was 39.0+/-3.8 (mean +/- S.E.). In addition, a path of fluid flow through the marrow contact holes was revealed using fluorescent staining.

Animals↗
PubMed2001

Treating forearm fractures using an internal fixator: a prospective study.

Some major complications of internal fixation with plates, such as infections and disturbance of healing, have been shown to be related to necrosis of bone and to the soft tissues immediately deep to the plate. This is attributable to plate contact. To deal with this phenomenon, an internal fixator, the Point Contact Fixator, was developed according to a new concept. The Point Contact Fixator resembles a plate but functions like a fixator, that is, the fracture is stabilized using a splint fixed to the bone by monocortical, angularly locked screws that are designed not to exert pressure between the splint and the bone, thereby minimizing implant-to-bone contact. Vascular damage to the osseous blood supply consequently is avoided. The new internal fixator is the first of a new family of implants in addition to nails, plates, and external fixators. To study the potential of the Point Contact Fixator in a prospective study, 79 forearm fractures in 55 patients were treated in a consecutive series by one surgeon using the same technique throughout. Followup to union is reported for 100% of the patients. Handling the fixator was simple; healing was uneventful; and the rate of complication was low.

Adult↗
PubMed2000

Direction-dependent constriction flow in a poroelastic solid: the intervertebral disc valve.

We hypothesize that a direction-dependent flow resistance exists in the intervertebral disc due to constriction flow in the cartilage endplates. A comparison of the hydrostatic pressure in the nucleus of the healthy intervertebral disc during daily loading with the relatively low osmotic swelling pressure during rest, suggests the necessity of such direction-dependent flow resistance to ensure that all the fluid exuded from the disc during loading is recovered during rest. A physical model demonstrating the direction-dependent resistance of constriction flow in a poroelastic solid is presented. A finite element model was developed and validated against this physical model. The finite element model showed that decrease of the constriction hole area not only increases the resistance to fluid flow, but also causes the direction-dependency of flow resistance to decrease. Through this mechanism, endplate sclerosis could affect normal daily fluid exchange in the intervertebral disc, resulting in decreased mass transport and/or dehydration of the disc.

Biological Transport↗
PubMed1999

Biomechanical analysis of dynamic external fixation devices for the treatment of distal radial fractures.

BACKGROUND: Several dynamic external fixation devices have been introduced to permit early functional treatment of unstable distal radial fractures. METHODS: An intact cadaver wrist was spanned by a dynamic external fixator. Forces between the fixator and the radius were recorded during passive motion using a single, strain-gauged pin. A device with a double ball joint was compared with a new, experimental fixator with 3 degrees of freedom and its center of rotation coincident with that of the wrist. RESULTS: During flexion and extension, the pin load was approximately the same for both fixators. Radioulnar deviation resulted in high pin loads for the fixator with ball joints; the new device showed no considerable pin load. CONCLUSION: The new device has a high degree of kinematic compatibility with the natural wrist joint. When used for the treatment of distal radial fractures, it should provide favorable conditions for the maintenance of fracture reduction compared with a device with an offset ball joint.

Biomechanical Phenomena↗
PubMed1998

Fatigue of bone cement with simulated stem interface porosity.

Cracks in bone cement have been observed in carefully examined post-mortem preparations of cemented stems. These cracks were probably caused by fatigue, and frequently appeared to initiate at pores. Ubiquitous porosity, occurring preferentially at, or near, the stem, is most likely caused by polymerization shrinkage. Preparation of air-free cement has only a marginal influence on the interface porosity, but pre-heating the stem in order to reverse the direction of polymerization can reduce or eliminate it. To estimate the impact of interface porosity on the fatigue strength of bone cement, test plates for this study were cast in a steel mold without release foils, and with one side of the mold warmer. Sample plates so prepared from chilled, partial vacuum-mixed PALACOS, have one face essentially pore-free and the other porous, the extent and morphology of the porosity being very similar to that observed on the stem-cement interface. Four-point bending fatigue strength, determined after 60 d conditioning in Ringer's solution at 37 degrees C, was only 20 MPa (at 10(6) cycles, with the porous side under tension) compared to 30 MPa for conventionally prepared, pore-free material. This corresponds to a 10-100 fold reduction in cycles to failure in the range of stresses predicted to occur in vivo.

Journal Article↗
PubMed1997

Strength recovery in fractured sheep tibia treated with a plate or an internal fixator: an experimental study with a two-year follow-up.

OBJECTIVES: Comparison of fracture healing with two different implants: a conventional Dynamic Compression Plate (DCP) and a new internal Point Contact Fixator (PC-Fix). DESIGN: Randomized, prospective study in experimental animals. Observation times: 12, 24, 48 and 96 weeks, with six sheep per group. SETTING: Following surgery, animals were kept with unrestricted weight-bearing in individual stalls for 12 weeks, thereafter in groups. ANIMALS: 56 adult Swiss mountain sheep. INTERVENTION: A standardized oblique fracture of the sheep tibia was reduced and compressed by a lag screw and "neutralized" with one of the implants. MAIN OUTCOME MEASUREMENTS: Standard radiographs were used for callus size measurements. After sacrifice the implant was removed and both the treated bone and the contralateral bone were tested for static strength in bending with the plate side under tension. Broken bones were processed for histological evaluation. RESULTS: In the DCP group all six bones failed through the original fracture at 12 weeks. At 24 and 48 weeks two out of six, at 96 weeks one out of six bones failed through the original fracture, others through one of the screw holes. In the PC-Fix group there were no failures through the original fracture with a single exception at 96 weeks. The strength values in the PC-Fix groups of 12 and 96 weeks were significantly higher then in the corresponding DCP groups. CONCLUSIONS: Healing of simple diaphysial fractures treated by PC-Fix was superior to that achieved by conventional plating. The histological evaluation suggested that the observed differences can be accounted for by the absence of implant-related cortical necrosis and by the circumferentially uninterrupted (if smaller) callus in the PC-Fix group.

Animals↗
PubMed1996

Porosity reduction in bone cement at the cement-stem interface.

The fatigue failure of bone cement, leading to loosening of the stem, is likely to be one mode of failure of cemented total hip replacements. There is strong evidence that cracks in the cement are initiated at voids which act as stress risers, particularly at the cement-stem interface. The preferential formation of voids at this site results from shrinkage during polymerisation and the initiation of this process at the warmer cement-bone interface, which causes bone cement to shrink away from the stem. A reversal of the direction of polymerisation would shrink the cement on to the stem and reduce or eliminate the formation of voids at this interface. We have investigated this by implanting hip prostheses, at room temperature or preheated to 44 degrees C, into human cadaver femora kept at 37 degrees C. Two types of bone cement were either hand-mixed or vacuum-mixed before implantation. We found that the area of porosity at the cement-stem interface was dramatically reduced by preheating the stem and that the preheating temperature of 44 degrees C determined by computer analysis of transient heat transfer was the minimum required to induce initial polymerisation at the cement-stem interface. Temperature measurements taken during these experiments in vitro showed that preheating of the stem caused a negligible increase in the temperature of the bone. Reduction of porosity at the cement-stem interface could significantly increase the life of hip arthroplasties.

Bone Cements↗
PubMed1995

A mechanical comparison of the dynamic compression plate, limited contact-dynamic compression plate, and point contact fixator.

Cortical bone porosis associated with the dynamic compression plate (DCP) prompted the development of the limited-contact dynamic compression plate (LC-DCP) and the point-contact fixator (PC-Fix) to increase bone vascularity. However, the comparative fixation characteristics of the three designs are unknown. Transverse fractures were physiologically created in paired cadaveric sheep tibiae, which were plated before torsion testing and four-point bending to failure. The tibiae were grouped randomly and compared as follows: DCP versus LC-DCP, DCP versus PC-Fix, and LC-DCP versus PC-Fix. Mean torque to failure demonstrated no significant difference between the three plates (p < 0.33). Mean bending stiffness, gap opening, and moment to failure also demonstrated no significant difference between the three designs with p < 0.29, < 0.13, and < 0.16, respectively. The LC-DCP and PC-Fix have torsion and bending properties comparable with the DCP in the fixation of simple transverse diaphyseal fractures.

Animals↗
PubMed1994

Three-dimensional dynamic AO external fixation of distal radial fractures--a preliminary report.

External fixation of unstable and intra-articular distal radial fractures has become increasingly popular. Dynamic external fixation, allowing movement of the wrist during the fixation period, is a relatively new approach which may further improve functional end results. To permit early functional treatment, the small AO external fixator was supplemented by a joint allowing all three degrees of rotational freedom. The centre of rotation is located at a point outside the device and lies approximately in the head of the capitate. With the natural centre of wrist rotation coincident with that of the fixator, admissable movements of the wrist include both flexion-extension and radio-ulnar deviation, without threatening fracture reduction. In vitro testing and initial clinical experience with a prototype are encouraging. Several improvements of the original design have been made and a multicentric clinical study is scheduled for further evaluation of the new dynamic external fixator.

Adult↗
PubMed1994

Cartilage stresses in the human hip joint.

The total surface stress measured in vitro on acetabular cartilage when step-loaded by an instrumented hemiprosthesis are partitioned into fluid and cartilage network stresses using a finite element model of the cartilage layer and measurements of the layer consolidation. The finite element model is based on in situ measurements of cartilage geometry and constitutive properties. Unique instrumentation was employed to collect the geometry and constitutive properties and pressure and consolidation data. When loaded, cartilage consolidates and exudes its interstitial fluid through and from its solid network into the inter-articular gap. The finite element solutions include the spatial distributions of fluid and network stresses, the normal flow velocities into the gap, and the contact network stresses at the cartilage surface, all versus time. Even after long-duration application of physiological-level force, fluid pressure supports 90 percent of the load with the cartilage network stresses remaining well below the drained modulus of cartilage. The results support the "weeping" mechanism of joint lubrication proposed by McCutchen.

Anthropometry↗
PubMed1993

The effect of fracture on femoral head blood flow. Osteonecrosis and revascularization studied in miniature swine.

Miniature swine were used to study the effect of cervical fracture on femoral head blood flow. Laser Doppler flowmetry was used to evaluate femoral head blood flow before and after the fracture, after internal fixation with or without compression, and 8 weeks post-fracture. Fluorescent bone-labeling was performed at 2, 4 and 6 weeks post-fracture. Femoral head blood flow decreased to 40 percent of baseline following fracture, partly from the disruption of venous drainage. Histologically, all femoral heads showed some degree of trabecular thinning, microfracture, and neovascularization when compared with controls. Analyses of the laser Doppler flowmetry data, fluorescent label histology, microradiography and bone densitometry indicated that late (4-6 weeks) revascularization produces severe trabecular mechanical weakening and resultant femoral head collapse. Femoral head ischemia following fracture probably falls along a continuum, with only the more severe cases proceeding to mechanical collapse. Femoral neck fractures in the minipig produce femoral head necrosis of a severity and incidence which closely parallels that of the human population; thus, the minipig is a useful model for further study of complications following femoral neck fracture in humans.

Animals↗
PubMed1992

Effect of animal species and age on plate-induced vascular damage in cortical bone.

Plates used for fracture fixation produce vascular injury to the underlying cortical bone. During the recovery of the blood supply, temporary osteoporosis is observed as a result of Haversian remodeling of the necrotic bone. This process temporarily reduces the strength of the bone. We tackled the postulate that quantitative differences exist between animal species, and in different bones within the same species, due to variations in the relative importance of the endosteal and periosteal blood supplies. Using implants scaled to the size of the bone, we found comparable cortical vascular damage in the sheep and in the dog, and in the tibia and femur of each animal. We observed a significant reduction in cortical vascular damage using plates that had a smaller contact area with the underlying bone. No significant difference in cortical vascular damage was noted in animals of different ages.

Age Factors↗
PubMed1991

Induction and prevention of pin loosening in external fixation: an in vivo study on sheep tibiae.

In external fixation of fractures, pin loosening is a major concern. Preloading the pins is generally done to ensure their stability within the bone cortex. The effect of radial preload and bending preload in reducing resorption at the pin/bone interface was tested. Schanz screws were fixed to live sheep tibiae using a pneumatically operated external fixator frame. Evaluation was based on radiological observation and fluorochrome histology using sequential labels. Though not completely absent, bone resorption was minimal in the radial preload group, compared with the two other groups. More important, the bone-to-pin contact surface in the radial preload group was found to be almost intact after 5 weeks. In this study, radial preload appears to be superior to bending preload in terms of minimizing the problems of pin loosening.

Animals↗
PubMed1990

Limb lengthening and three-dimensional deformity corrections. A retrospective clinical study.

Different methods of limb lengthening as used at the Orthopedic Surgery Clinic of the Medical School, University of Zagreb, are compared. The results of operations performed between 1979 and 1989 on 111 patients are presented. These patients were subjected to surgery aimed at length equalization of limbs and/or correction of three-dimensional deformities. Lengthening was performed in 104 patients at one level, and in 7 patients at two levels of the same limb for a total of 118 procedures. In order to compare limb lengthening techniques the patients were divided into four groups: group I, original Wagner technique (45 patients); group II, Wagner technique using corticotomy (33 patients); group III, original Ilizarov technique (35 patients); group IV, continuous lengthening (2 patients). The evaluation covered radiological aspects of regenerated bone, complications and basic lengthening parameters. The results indicate that corticotomy has considerable advantages over osteotomy, provided bone circulation is maintained. These advantages manifest themselves in a reduced number of operations, lower incidence of infection and improved bone regeneration. It is preferable to perform corticotomy at the metaphysis site because of its optimum blood supply and its higher potential for osteogenesis. With corticotomy performed at the diaphysis site, satisfactory results were observed in only one-third of the cases.

Adolescent↗
PubMed1989

[High-speed motion picture analysis of bone fractures].

Torsional fractures of plastic and cadaver tibiae were investigated using high speed cinematography. The bones were fractured while immersed in water. With greater than 9000 frames/sec the fracture was displayed in about 5 frames showing the progression of the fracture lines. The immersion in water made a strong implosion visible which may result in considerable tissue damage in vivo.

Biomechanical Phenomena↗
PubMed1986

Laser Doppler flowmetry for bone blood flow measurement: correlation with microsphere estimates and evaluation of the effect of intracapsular pressure on femoral head blood flow.

Laser Doppler flowmetry (LDF) was used to measure bone blood flow in the rabbit femoral head and femoral condyles. To correlate the LDF output signal blood cell flux to in vivo blood flow, simultaneous measurements using LDF and 85Sr-labeled microspheres were made in an adult rabbit model. There was no correlation between the two methods for blood flow in the femoral condyles and the correlation between the two methods for blood flow in the femoral head does not achieve statistical significance. An LDF signal of 0.4 V was approximately equal to a microsphere measured flow rate of 0.4 ml blood/g bone/min. The strength of the correlation in the latter case may have been affected by (a) large arteriovenous shunts, (b) inadequate mixing of the microspheres with a left ventricular injection, and (c) insufficient numbers of microspheres present in the bone samples with which to satisfy the mathematical requirements of the microsphere method. When LDF was used to evaluate the effect of elevated intracapsular pressure on femoral head blood flow in skeletally mature rabbits, femoral head subchondral bone blood flow declined with increasing intracapsular pressure from a baseline value of 0.343 +/- 0.036 to a value of 0.127 +/- 0.27 at 120 cm of water pressure. The decline in femoral head blood flow was statistically significant at pressures of 40 cm of water or higher (p less than 0.001), and evaluation of sections of the proximal femora made from preterminal disulphine blue injections confirmed these findings. Intracapsular tamponade has an adverse effect on femoral head blood flow beginning well below central venous pressure and should be considered in the pathophysiology of posttraumatic and nontraumatic necrosis of the femoral head. Laser Doppler flowmetry was easy to use and appears to be a reproducible technique for evaluating femoral head blood flow, offering distinct advantages over the microsphere technique for measuring bone blood flow. Further studies of the in vivo calibration of the LDF method for bone blood flow are necessary for the method to have potential for clinical application.

Animals↗
PubMed1985

Experimental temperature rise in human hip joint in vitro in simulated walking.

Although reported frictional coefficients in synovial joints are very low, a computer model of the human hip joint in simulated walking predicted a temperature rise of several degrees Celsius. To confirm this prediction, physical experiments were conducted in vitro on intact human hip joints dynamically loaded and articulated as in walking. Thermisters were placed in subchondral bone in both the acetabulum and femoral head, just below the cartilage layers. The surrounding saline bath was maintained at 37 degrees C. Measured temperatures as high as 2.5 degrees C above the 37 degrees C were recorded in the subchondral bone. Loading that simulated the stance/swing phases of gait but without articulation produced no significant increase in temperature; thus fluid flow per se is not significantly energy dissipative; the prime source is friction at the articulating surfaces.

Hip Joint↗