Biomedical subjects

Todd O McKinley

Publications and source records attributed to Todd O McKinley.

11 recordsLinked to original sources

PubMed2006

In vivo measurement of translational stiffness of rabbit knees.

This paper describes the design, evaluation, and preliminary results of a specialized testing device and surgical protocol to determine translational stiffness of a rabbit knee, replicating the clinical anterior drawer test. Coronal-plane transverse pins are inserted through the rabbit leg, two in the tibia and one in the distal femur, to hold and reproducibly position the leg in the device for tests at multiple time points. A linear stepper motor draws the tibia upward then returns to the home position, and a load cell measures the resisting force; force-displacement knee stiffness is then calculated. Initial evaluation of this testing device determined the effects of preconditioning, intra-operator repeatability, rabbit-to-rabbit variability, knee flexion angle (90 degrees vs. 135 degrees ), and anterior cruciate ligament (ACL) sectioning (0%, 25%, 50%, 75%, 100%). Knee stiffness generally decreased as ACL sectioning increased. This testing device and surgical protocol provide an objective and efficient method of determining translational rabbit knee stiffness in vivo, and are being used in an ongoing study to evaluate the effect of knee instability (via partial to complete ACL sectioning) on the development of post-traumatic osteoarthritis.

Animals↗

PubMed2005

Contact stress transients during functional loading of ankle stepoff incongruities.

Cartilage deformation demonstrates viscoelastic behavior due to its unique structure. However, nearly all contact studies investigating incongruity-associated changes in cartilage surface stresses have been static tests. These tests have consistently measured only modest increases in contact stresses, even with large incongruities. In this study, an experimental approach measuring real-time contact stresses in human cadaveric ankles during quasi-physiologic motion and loading was used to determine how stepoff incongruities of the distal tibia affected contact stresses and contact stress gradients. Peak instantaneous contact stresses, in ankles with stepoffs between 1.0 and 4.0mm of the anterolateral articular surface, increased by between 2.3 x and 3.0 x compared to the corresponding intact ankle values. Peak instantaneous contact stress gradients in stepoff configurations increased by between 1.9 x and 2.6 x the corresponding intact configuration values. Anatomic reduction of the displaced fragment restored intact contact stresses and contact stress gradients. Intact and anatomic configurations demonstrated a heterogeneous population of low-magnitude, randomly oriented contact stress gradient vectors in contrast to high-magnitude, preferentially oriented gradients in stepoff configurations. Peak instantaneous contact stresses may be important pathomechanical determinants of post-traumatic arthritis. Abnormal contact stress gradients could cause regional pathological disturbances in cartilage stress and interstitial fluid distribution. Measuring contact stresses and contact stress gradients during motion allowed potential incongruity-associated pathologic changes in loading that occur over the complete motion cycle to be investigated.

Ankle Joint↗

PubMed2004

Incongruity versus instability in the etiology of posttraumatic arthritis.

The etiology of posttraumatic arthritis is understood poorly but it clearly has a pathomechanical component. Posttraumatic arthritis likely results from irreversible cartilage damage sustained at the time of injury and chronic cartilage overloading resulting from articular incongruity and instability. However, the relative importance of instability and incongruity is unknown. Clinical studies show that the hip, knee, and ankle tolerate incongruity differently. However, all three joints poorly tolerate instability. Basic mechanical studies have shown that static loading of articular surface incongruities have caused relatively modest increases in contact pressure. However, static testing poorly replicates normal viscoelastic properties of cartilage, which may mask important transient stress elevations that occur during motion. Static tests also ignore potential abnormal loads that may accumulate throughout a motion cycle. We review the clinical and basic scientific evidence linking incongruity and instability to posttraumatic arthritis. Preliminary data from a newly developed dynamic ankle testing device are presented. Dynamic testing allows measurement of transient contact loads and loading rates that occur through the entire motion cycle and it opens the door to measure mechanical abnormalities associated with instability.

Ankle Injuries↗

PubMed2004

Pathomechanic determinants of posttraumatic arthritis.

The etiology of posttraumatic arthritis is poorly understood. One possible mechanism involves a mechanical insult to the cartilage matrix that affects chondrocyte function. To better understand the etiology of posttraumatic arthritis, pathomechanic changes in articular contact mechanics resulting from injury during physiologic motion and loading need to be determined. Previous studies of injury-associated changes in articular contact mechanics, using static testing methods, have measured relatively modest increases in contact stresses. Static testing cannot measure transient loads associated with motion or loading rates. This testing method poorly simulates normal viscoelastic cartilage properties, and accounts for contact stress changes in a single or limited number of joint positions. In this study, time-variant contact stresses in two ankles with an anterolateral stepoff were measured during quasiphysiologic motion and loading. Contact stresses were integrated over the entire range of motion to estimate pathomechanic loads that accumulate over the entire motion cycle. Numerical techniques were applied to time-variant contact stress data to calculate contact stress directional gradients and contact stress rates of change. Contact stress directional gradients and rates of change were integrated over the complete motion cycle to estimate whole-cycle accumulation of these potential pathomechanic parameters.

Ankle Injuries↗

PubMed2003

Trabecular bone strain changes associated with subchondral stiffening of the proximal tibia.

Subchondral stiffening is a hallmark pathologic feature of osteoarthritis but its mechanical and temporal relationship to the initiation or the progression of osteoarthritis is not established. The mechanical effect of subchondral stiffening on the surrounding trabecular bone is poorly understood. This study employs a relatively new application of digital image correlation to measure strain in the trabecular region of the proximal medial tibia in normal specimens and in specimens with simulated subchondral bone stiffening. Coronal sections from eight normal human cadaveric proximal tibiae were loaded in static compression and high resolution contact radiographs were made. Repeat contact radiographs were collected after the subchondral bone near the jointline was stiffened using polymethylmethacrylate. Digital images, made from loaded and unloaded contact radiographs, were compared using in-house software to measure trabecular displacement and calculate trabecular bone strain. Overall strain was higher in the stiffened specimens suggesting experimental artifiact significantly affected our results. Consistent increases in median maximum shear strain, median maximum principal strain, median minimum principal strain, and peak shear strain were measured near the inner and outer edges of the stiffened segment. Our experiment provides direct experimental measurement of increases in trabecular bone strain caused by subchondral stiffening, however, the clinical and biologic importance of strain increases is unknown.

Aged↗

PubMed2003

Trabecular bone strain changes resulting from partial and complete meniscectomy.

Previous studies have documented how partial and complete meniscectomy affect articular contact pressure, but changes in load transfer through the complete osteochondral structure of the proximal tibia after partial and complete meniscectomy are not well known. The current study measured trabecular bone strain changes in the medial tibial plateau resulting from partial and complete medial meniscectomy. Midcoronal sections were prepared from knees from cadavers. High quality digital images, made from contact radiographs of loaded samples, were compared with digital images of unloaded samples using in-house software to measure trabecular bone strain. Measurements were made on specimens with an intact medial meniscus, after removal of the inner (2/3) of the meniscus, and after complete meniscectomy. Partial meniscectomy caused minimal increases in trabecular bone strain throughout the proximal tibia. However specimens with complete meniscectomy had significant trabecular bone strain increases. Many patients sustaining meniscus tears are young, therefore, it is important to understand mechanical changes associated with partial meniscectomy. The data suggest partial meniscectomy causes little change in load transfer through the proximal tibia, supporting partial meniscectomy as a good surgical option for patients with meniscus tears.

Aged↗

PubMed2003

The Bernese Periacetabular Osteotomy: review of reported outcomes and the early experience at the University of Iowa.

The Bernese Periacetabular Osteotomy (PAO) is an operation designed to relieve hip pain and improve function in patients with symptomatic dysplastic hips. The short-term results of the Bernese PAO indicate that there is a learning curve but most patients with dysplasia and mild arthritis have excellent pain relief. Outcomes and complications are the primary focus of discussion. Operative data and complications from the first 36 patients undergoing the Bernese PAO at the University of Iowa have been comparable to those reported in the literature.

Adolescent↗

PubMed2002

Trabecular bone strain changes associated with subchondral bone defects of the tibial plateau.

OBJECTIVE: To measure trabecular bone strain changes resulting from three increasing subchondral bone defects in the medial tibial plateau. DESIGN: Cadaveric biomechanical model. SETTING: Contact radiographs were made from coronal sections of human cadaveric proximal tibia under no load and loaded to 400 newtons (N). Digital images made from contact radiographs of unloaded specimens were compared to corresponding digital images of loaded specimens using in-house software that detects trabecular deformation and measure trabecular bone strain. INTERVENTION: Ten specimens were loaded intact and with three increasing circular subchondral bone defects and centered under the subchondral plates in the medial tibial plateau that were 10%, 20%, and 30% of the coronal width of the medial plateau. MAIN OUTCOME MEASURE: Maximum shear strain and minimum principal strain were measured at approximately 2,600 discrete points in the trabecular bone in the medial tibial plateau. RESULTS: Trabecular strain increased most dramatically as defects increased from the medium (20%) to the large (30%) defect. The regions of greatest strain elevation were between the physeal scar and joint line near the medial cortex. Small (10%) and medium (20%) defects resulted in modest strain elevations. CONCLUSIONS: Subchondral defects cause size-dependent elevations in trabecular bone strain in the medial tibial plateau. A size threshold may exist, above which the trabecular bone is subjected to rapidly increasing deformation under load.

Aged↗

PubMedDate not supplied

Trabecular bone strain changes associated with subchondral comminution of the distal tibia.

OBJECTIVE: To measure trabecular bone strain changes resulting from three increasing subchondral bone defects in the distal tibia. DESIGN: Cadaveric biomechanical model. SETTING: Contact radiographs were made from sagittal sections of human cadaveric distal tibia under no load and loaded to 400 N. Digital images, made from contact radiographs of unloaded specimens, were compared to corresponding digital images of loaded specimens using custom software that measures trabecular deformation and calculates trabecular bone strain. INTERVENTION: Twelve specimens were initially loaded intact in compression. Testing was repeated after creating three increasing circular subchondral bone defects in the center of a sagittal cross-section of the distal tibia. Defects were 10%, 20%, and 30% of the sagittal diameter of the distal tibia. MAIN OUTCOME MEASURES: Maximum shear strain, maximum principal strain, and minimum principal strain were measured in six discrete regions in the trabecular bone in the distal tibia. RESULTS: Small defects (10%) caused minimal strain elevations. Significant increases in trabecular bone strain were measured with medium (20%) and large (30%) defects. Compressive strain increases as high as 1400 microstrain (10 strain) were measured adjacent to and proximal to the defects with medium and large defects. CONCLUSIONS: Subchondral defects cause size-dependent elevations in trabecular bone strain in the distal tibia. Medium and large defects caused rapidly increasing trabecular bone deformation under load.

Adult↗

PubMedDate not supplied

Kinematic and contact stress analysis of posterior malleolus fractures of the ankle.

OBJECTIVE: To determine if there are measurable dynamic contact stress aberrations and kinematic abnormalities (instability) that have not been observed in conventional static loading studies of posterior malleolar ankle fractures. DESIGN: Cadaveric fracture model. SETTING: Biomechanics laboratory. INTERVENTION: Seven fresh cadaveric specimens were fixed in an unconstrained testing apparatus and loaded to one body weight. The ankle was moved from 25 degrees of plantarflexion to 15 degrees of dorsiflexion. The model included the intact ankle and four fracture simulations (50% fracture without internal fixation, 2 mm gap and step malreductions, and anatomically fixed). MAIN OUTCOME MEASURE: Motion at the ankle was monitored with an electromagnetic tracking device, and intra-articular contact stresses were measured using a real-time stress sensor. RESULTS: There were no kinematic abnormalities suggestive of tibiotalar subluxation in any of the fracture simulations. There was no increase in peak contact stress in any of the fracture models compared with the unfractured model. However, there was a shift in the location of the contact stresses to a more anterior and medial location following the fracture. When summed over the range of motion, these areas of cartilage bore significantly higher cumulative contact stresses relative to the nonfracture situation. CONCLUSIONS: We found no talar subluxation and no increase in contact stresses near the articular incongruity, making it unlikely that these factors explain the increased incidence of arthrosis after trimalleolar fractures (OTA/AO classification 44 B3 fractures). Rather, we found that the joint remaining bears increased stress and that the center of stress shifts anteriorly, loading cartilage that normally sees little load.

Ankle Joint↗

PubMedDate not supplied

Incongruity-dependent changes of contact stress rates in human cadaveric ankles.

Cartilage biosynthetic transduction and injury characteristics have been shown to be particularly sensitive to changes in contact stress rates. This study investigated incongruity-associated changes in contact stress rates that resulted from an articular surface stepoff of the distal tibia in human cadaveric ankles. Ten human cadaveric ankles were subjected to quasi-physiologic stance-phase motion and loading and instantaneous contact stresses were captured at 132 Hz over the entire articular surface using a custom-fabricated stress transducer. An osteoarticular fragment consisting of the anterolateral 25% of the distal tibia was osteotomized. Testing was repeated after displacing the fragment proximally between 0.0 mm to 4.0 mm in 1.0 mm increments. Transient contact stress measurements were used to calculate contact stress rates. Compared to intact ankles, the anatomic configuration had modest increases in global and peak postitive and negative contact stress rates throughout the motion cycle. In contrast, stepoff specimens had significant increases in global and complete motion cycle peak positive and negative contact stress rates, as high as 3.1X intact values in specimens with a 4.0 mm stepoff. Contour plots of contact stress rates also demonstrated an instability event during motion. An anterolateral stepoff of the distal tibia caused significant changes in positive and negative contact stress rates in cadaveric ankles. Incongruity-associated changes in contact stress rates and incongruity-associated instability events may be important pathomechanical determinants of post-traumatic arthritis.

Ankle Injuries↗