PubMed HealthSearch

Biomedical subjects

W Plitz

Publications and source records attributed to W Plitz.

At least 19 recordsLinked to original sources

Changes in cadaveric cancellous vertebral bone strength in relation to time. A biomechanical investigation.

STUDY DESIGN: A biomechanical study was conducted during a 3.5-day period to test for changes occurring in pullout strengths of cancellous screws inserted into human cadaveric vertebral bodies. OBJECTIVES: To quantify, within the testing time of 3.5 days, the possible changes to the mechanical properties of cadaveric vertebral bodies, resulting from structural degradation caused by postmortem, time-dependent, autolytic processes during mechanical testing of implant-bone biomechanics. SUMMARY OF BACKGROUND DATA: Biomechanical testing of whole spinal implants and analysis of the screw-bone interface of spinal implants is an area of clinical interest that frequently requires the use of cadaveric spine specimens. Changes in vertebral bone properties during the testing period may invalidate experimental results, but no data are available on degradation of bone during the testing period. METHODS: Anterior oblique cancellous screws were inserted into human vertebral bodies from which the ventral cortex had been removed. The pullout strength was measured at 0, 24, 60, and 84 hours after insertion. The tests were performed on 48 human vertebral bodies, which were stored by freezing to -23 C, thawed for testing, and kept at room temperature during the testing time for as long as 84 hours. RESULTS: The axial pullout strength showed no statistically significant change during 84 hours (P = 0.15). There were no significant differences attributable to vertebral level from T4 to L4, probably because the ventral cortices had been removed (P = 0.7). CONCLUSIONS: During 3.5 days, there were no changes in pullout strength of vertebral cancellous bone. In biomechanical studies during a maximum period of 3 days with a small number of cadaveric spines (e.g., four spine specimen) the time-dependent changes in pullout strength play a less significant role than do the interspine differences. Interspine differences should be regarded as an important factor to be considered in the design of biomechanical tests.

Autolysis

Autologous perichondral tissue for meniscal replacement.

Our aim was to examine the potential of autologous perichondral tissue to form a meniscal replacement. In 18 mature sheep we performed a complete medial meniscectomy. The animals were then divided into two groups: 12 had a meniscal replacement using strips of autologous perichondral tissue explanted from the lower rib (group G) and six (group C) served as a control group without a meniscal replacement. In all animals restriction from weight-bearing was achieved by means of transection and partial resection of tendo Achillis. Six animals (four from group G and two from group C) were each killed at 3, 6 and 12 months. The grafts and the underlying articular cartilage were removed and studied by gross macroscopic examination, light microscopy, SEM, polarised light examination, and by biomechanical tests. In all the transplanted animals a new perichondral meniscus developed. After three months the transplants resembled normal menisci in size and thickness, while in the control animals only small rims of spontaneously grown tissue were seen. Microscopically, the perichondral menisci showed a normal orientation of collagen fibres and normal cellular characteristics, but in the central region, areas of calcification disturbed the regular tissue differentiation. Healing tissue in control animals lacked the normal fibre orientation and cellularity. SEM of perichondral menisci showed surface characteristics similar to those of normal sheep menisci without fissures and lacerations; the control specimens had these defects. The femoral and tibial cartilage in contact with the new menisci had normal surface characteristics apart from one animal with slight surface irregularities. Control animals showed superficial lesions after three months which increased at six to 12 months postoperatively. Microangiography of the newly grown tissue demonstrated a less intense vascularisation after three months when compared with normal menisci. The failure stress and tensile modulus of perichondral menisci were significantly lower than those of normal contralateral menisci, and spontaneously regenerated tissue in meniscectomised animals had even lower values. There were no significant differences in values between newly grown perichondral menisci and spontaneously grown tissue.

Animals

[Comparative tribological studies of Chirulen, Hylamer and Enduron combined with A1203].

The creep and wear behaviour of Chirulen, Hylamer and Enduron, materials which differ only in their manufacturing procedures, was examined and compared. Chirulen is manufactured by being pressed into form by plates, whereas Hylamer and Enduron are shaped by tubes. Hylamer differs from Enduron in that intermediate material processing is undertaken with the goal of improving the initial material. The wear and deformation rate was determined by means of the ring-on-disc testing device after 360,000 cycles and after 1.0 x 10(6) cycles, respectively. The static tests for the determination of wear were carried out at a contact stress of 5.62 MPa and a testing time of 100 h in analogy to the ring-on-disc tests. Chirulen and Hylamer demonstrated comparable wear with a tendency toward a lower wear rate in Hylamer, while Enduron presented a clearly higher wear rate.

Biocompatible Materials

[Experimental studies of metal-metal slide combinations and their value in relation to expected in-vivo behavior].

A simulator test was carried out in the hip joint simulator on a metal-on-metal coupling of a modified CoCrMo alloy. The test was run up to 1.9 million cycles and the tribological behaviour of the coupling was documented by means of roundness measurements and scanning electron microscopy. It is seen that the tribological system metal on metal is characterized by mixed friction in the artificial hip joint, thus generating material contacts that are documented by the roundness variation and by the SEM contact zone analysis, showing "three-body" wear of this system. The roundness variations indicate that running-in wear is to be noticed at first with a decreasing tendency over the 1.9 million cycles. Nevertheless, this observation does not allow any prognosis as to the wear rates in the case of a higher number of cycles. It must be taken into consideration that aqua destillata had to be used as a lubricant for technical reasons; the use of serum/Ringer solution might have produced different results. Further investigations in the hip joint simulator and on revised metal-on-metal couplings will be carried out in this respect.

Biomechanical Phenomena

[Changes in shape of the McKee-Farrar hip endoprosthesis].

The still unsolved problem of aseptic loosening in total hip arthroplasties with identification of polyethylene wear particles as one of its major causes, has led to reintroduction of metal-to-metal articulations, as indicated by a few good clinical long-term results with all-metal McKee-Farrar arthroplasties. In this paper, data on 145 patients from a population of more than 1400, all with implanted McKee-Farrars, who underwent revision surgery for aseptic loosening, are collected and analysed for dependence of duration to brands of the implants and position of the cups. The surface of each of 55 revised implants was measured using a 3-D device. The results showed no interdependence between time of loosening, brand inclination of the cup and deviation in shape of ball and cup. Additionally, the deviations in shape were slight.

Acetabulum

Medial meniscus replacement by a fat pad autograft. An experimental study in sheep.

The medial meniscus in 15 sheep was replaced by a pediculated infrapatellar fat pad graft and resulted in the development of a macroscopically meniscus-like structure within 6 months. Five additional sheep with a meniscectomy were controls. Degenerative changes in the fat pad autograft were visible after one year. Osteoarthritis of the weightbearing medial compartment was detected after 6 months. A temporary protective effect on the cartilage could be attributed to the autograft, but the long term results indicated that this was not permanent. Fat is not suitable as a meniscal substitute.

Adipose Tissue

[A dynamic shoulder model for biomechanical measurements of shoulder specimen].

The article discusses a dynamic shoulder model capable of simulating the forces generated by the rotator cuff and the deltoid muscle, and elevation movements of the glenohumeral joint using, a computer-aided servohydraulic unit. In 10 cadaver shoulder specimen, the effects of the loss of function of the supraspinatus muscle on maximum elevation was determined with an ultrasound system. Changes in the so-called impingement pressure below the coracoacromial arch were determined with the aid of capacitive pressure sensors. With the supraspinatus muscle inactive/ absent, the maximum elevation of the humerus showed a decrease of 6% (p < 0.05), which, however, was overcome by an increase in deltoid power of only one-third of the supraspinatus muscle power loss. For a simulated isolated supraspinatus defect, the subacromial pressure below the coracoacromial arch decreased by 8% (p > 0.05). These results confirm clinical investigations showing that isolated lesions affecting the supraspinatus tendon often fail to produce symptoms and thus require no surgical reconstruction.

Adult

A dynamic shoulder model: reliability testing and muscle force study.

This study introduces a dynamic shoulder model, where forces were applied to individual muscles in ten cadaveric specimens. The model provided reproducible glenohumeral joint motion and thereby allowed the investigation of active, glenohumeral joint mechanics. Forces were created by servo-actuated hydrodynamic cylinders and applied to the deltoid muscle and to the rotator cuff through wire cables. Computerized regulation initiated precise, time controlled cycles of glenohumeral joint motion. The position of the glenohumeral joint in all spatial orientations was measured and recorded using an ultrasonic sensor device. Reproducibility of glenohumeral joint motion was demonstrated on the basis of five cycles of glenohumeral joint elevation. Repeatability variance of position measurements for five cycles of elevation averaged 0.80 degrees for abduction, 0.75 degrees for anteflexion and 1.36 degrees for internal rotation. Arm weight and force distribution at the shoulder musculature were estimated according to the literature. In comparison to estimated physiologic conditions, a one third increase of arm weight led to a significant (p < 0.05) decrease of elevation of 20%, a one third decrease of arm weight to an average increase of elevation of 18% (p < 0.05). Exclusion of the supraspinatus muscle caused a significant (p < 0.05) 6% decrease of elevation of the glenohumeral joint. Without force applied to the subscapularis and infraspinatus/teres minor muscles, elevation decreased 16% (p < 0.05). A decrease of glenohumeral joint elevation of 25% resulted when force was applied to the deltoid muscle alone (p < 0.05).

Adult

[Effect of the manufacturing process on creep and wear properties of UHMWPE (ultra-high molecular weight polyethylene)].

The creep and wear behaviour of pressed UHMWPE and extruded UHMWPE was compared, taking Chirulen and extruded UHMWPE of the Lennite type as examples. Using the ring-on-disc test, the wear and deformation volumes per 360,000 cycles were determined. The static tests were performed at surface pressures of 5.62 MPa and 9.37 MPa, while the test duration was 41.86 and 100 hours, respectively. The surface pressures result from the axial forces of 900 N and 1500 N, respectively, and a ring surface analogous to the DIN 58,835 and ISO 6474 standards. Between conventionally pressed and the extruded UHMWPE material differences of up to 350% in the sums of wear and deformation were found. It was noted that already at low surface pressures the extruded UHMWPE is more susceptible to creep deformation than is the conventionally pressed material, and that this effect dramatically increases at high surface pressures.

Biomechanical Phenomena

[Endoprosthesis and bone reaction].

Prosthetic implants cause a reaction on the part of the surrounding bone. Bone reaction can be interpreted as a dynamic response of the internal bone architecture to stress and strain. On the other hand, instability at the bone-implant interface or biological reactions to wear particles may lead to bone resorption. Standard X-ray examination has remained the most important tool for evaluation of the bone-implant relationship. Knowledge of the radiological features of bone remodelling and bone reaction is therefore a prerequisite for the orthopaedic surgeon. Based on eight case reports after prosthetic replacement of the hip, important radiological signs of bone reaction are presented. If possible a biomechanical or biological explanation is attempted. The information drawn from these cases, as well as from the current literature, suggests that after prosthetic joint replacement routine X-ray follow-up is required, even in asymptomatic patients, and that progressive osteolysis requires early operative revision, even if there are no acute clinical problems.

Aged

Retropatellar forces after rupture of the PCL and patello-tibial transfixation: an in vitro study.

Compared to injuries of the other knee ligaments, a rupture of the posterior cruciate ligament (PCL) is relatively rare. Treatment may be conservative or operative. A rupture that has been operated on temporarily can be stabilised using a Grammont patello-tibial transfixation (olecranisation). Flexion and extension between 30 degrees and 60 degrees are allowed. The advantage of this method is that it avoids complete immobilisation of the joint and also the reduction of pull on the PCL. However, patients treated with this method show long-term osteoarthritis of the retropatellar joint area. Our study aimed to show the distribution of forces at the dorsal patellar surface in the following: (1) knee with intact ligaments; (2) knee with PCL rupture; (3) knee with PCL rupture plus olecranisation. Fourteen fresh knee specimens were investigated in a Plitz/Wirth knee kinemator. The femur was fixed while the tibia was flexed between 5 degrees and 120 degrees. Pull was placed on the patella and on the dorsal side of the tibia with weights over the tendons of the quadriceps and the roots of the ischio-crural muscles. With the aid of a special measurement device in the patella, the medially laterally, proximally and distally acting forces in a movement cycle could be measured as well as the total retropatellar force in the above experimental setups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Function of the supraspinatus muscle. Abduction of the humerus studied in cadavers.

We evaluated the function of the supraspinatus tendon with a dynamic shoulder model. Active glenohumeral joint motion was simulated in 10 cadaveric shoulder specimens with hydrodynamic cylinder forces at the deltoid muscle and at the rotator cuff. Computerized regulation initiated standardized cycles of glenohumeral joint motion, where the isolated effect of the supraspinatus muscle could be studied. The efficacy of the supraspinatus muscle on elevation of the glenohumeral joint was measured with an ultrasonic sensor system. Pressures underneath the coracoacromial vault were recorded with capacitive sensors, as an indicator of the impingement at the shoulder. Elimination of force of the supraspinatus muscle led to a 6 percent decrease in elevation of the glenohumeral joint. The deltoid muscle was able to reverse this loss of elevation by a force increase of one third of the lost supraspinatus force. If no force was applied to the supraspinatus muscle, average pressures underneath the coracoacromial vault decreased 8 percent. It was concluded that the supraspinatus produces less torque and more glenohumeral joint compression than the deltoid. However, the supraspinatus has no effect on depression of the humeral head during elevation. The clinical consequence of our observations is that operative closure of supraspinatus tendon defects is not mandatory.

Adult

[Biomechanical prerequisites for examining the stability of osteosynthesis procedures of the spine].

Basic reflections on biomechanical tests of spinal implants are reviewed. Four different pedicle screw systems are compared during loading in extension, flexion, side-bending, and rotation. The thoracolumbar and the lumbar spine were tested. Stability against rotation forces was lowest in all systems. Because of this, a cross-connector is recommended in highly unstable situations. All tests were done in cadaver spines with normal bone mineral density (measured before the tests). The first series of tests was done without destroying the cadavers. A second series was done with maximal load until the implants or the bony bed of the screws failed. The results show that rigid implants more often led to pedicle fractures. An unstable screw rod interface led to implant failure. Cadaver tests can provide answers about the primary stability characteristic only. Fatigue tests are not possible in cadaver spines because they become autolytic before enough cycles can be applied.

Adult

[Function of the supraspinatus muscle in a dynamic shoulder model].

Active glenohumeral joint motion was simulated in ten cadaveric shoulder specimens with hydrodynamic cylinder forces at the deltoid muscle and at the rotator cuff. Computerized regulation initiated standardized cycles of glenohumeral joint motion in which the isolated effect of the supraspinatus muscle could be studied. The effect of the supraspinatus muscle on the elevation of the glenohumeral joint was measured with an ultrasonic sensor system. Pressures underneath the coracoacromial arch as an indicator of the 'impingement' at the shoulder were recorded with capacitive sensors. Elimination of force of the supraspinatus muscle led to a significant 6% decrease in elevation (p < 0.05). The deltoid muscle was able to reverse this loss of elevation by an increase in force equal to only one third the force lost at the supraspinatus muscle. When no force was applied to the supraspinatus muscle average pressures under the coracoacromial vault decreased by 8% (p > 0.05). In conclusion, the supraspinatus muscle produces less torque and more glenohumeral joint compression than the deltoid muscle. However, the supraspinatus muscle has no significant effect on the centering of the humeral head on the glenoid during elevation.

Acromioclavicular Joint

Biomechanical data concerning the shoulder impingement syndrome.

This study evaluates forces underneath the coracoacromial vault during elevation of the arm, using a dynamic shoulder model. Muscle forces at the glenohumeral joint were simulated with hydrodynamic cylinders and applied to the deltoid muscle and to the rotator cuff through wire cables in ten anatomic specimens. Computerized regulation initiated precise, time-controlled cycles of glenohumeral joint motion. The position of the arm in all spatial orientations was measured with an ultrasonic device. Forces underneath the coracoacromial vault were recorded with capacitive sensors. The mean force during one cycle of elevation averaged 13.9 N +/- 12.5 N underneath the acromion, 0.43 N +/- 0.51 N underneath the coracoacromial ligament, and 3.44 N +/- 4.37 N underneath the coracoid process. The peak force averaged 37.8 N +/- 33.2 N underneath the acromion, 3.03 N +/- 2.62 N underneath the coracoacromial ligament, and 6.93 N +/- 7.38 N underneath the coracoid process. Forces under the coracoid process exceeded forces under the acromion in some specimens. A marked increase in forces was observed at the final stage of arm elevation and during early reverse-elevation in most specimens. The authors believe that these force values represent the pathomechanics of the shoulder impingement syndrome.

Acromioclavicular Joint

Investigations on mechanism of Salter-1-fractures of the greater trochanter.

This study aims at clarifying why the apophysis of the greater trochanter very rarely separates, in contrast to other apophyses of the hip region. The inclination and area measurement of the greater trochanteric growth plate and the mode of insertion of the muscles on the apophysis were analyzed on the basis of 16 anatomic femoral specimens from newborn to children of 14 years of age. The physiological muscle cross section Q of the muscles inserting at the greater trochanter was determined on 6 specimens. In a cross-sectional radiological study, carried out on 1350 hip joints of healthy children, the inclination of the greater trochanter growth plate was measured. The anatomical and radiological findings show that the nearly plane-shaped greater trochanter growth plate remains inclined at a 50 degree angle to the horizontal body line and is loaded from a diagonally craniolateral direction throughout the total growth period. The lateral surface of the apophysis is covered by a fibrous connection which joins the insertion areas of the gluteus medius, minimus and vastus lateralis muscles. The vastus lateralis muscle is intimately bound to the vastus intermedius muscle by fibrous tissue. According to the results of the physiological muscle cross sections these four muscle groups can form a counteracting muscle sling, which transforms the traction forces at the surface of the greater trochanter into pressure forces in line with a tension band effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Characterization of the different prosthesis models.

Polyethylene is always exposed to wear. The more punctual and asymmetric the force on the surfaces, the stronger the wear. Thus, fatigue wear is more often found in unconstrained prostheses. In regard to wear problems, a prosthesis should have an axis that avoids fatigue wear and two polyethylene parts on the tibial plateau.

Biomechanical Phenomena

Medial meniscus replacement by a tendon autograft. Experiments in sheep.

In 20 skeletally mature female merino sheep, divided into four groups, we performed total medial meniscectomy, removal of the middle third of the patellar tendon, and tenotomy of the calcaneal tendon of the right hind leg. Group I (control) had no additional procedures. In the other three groups the medial meniscus was replaced by the middle third of the patellar tendon from the ipsilateral knee. The animals were killed at three (group II), six (group III), or 12 months (group IV) and the tendon-meniscus examined macroscopically, by light and scanning electron microscopy, and biomechanically. Remodelling of the tissue had taken place by 12 months but the failure stress and tensile modulus for the tendon-meniscus were lower than for the normal meniscus. Our evidence suggests that, in sheep, replacement of a meniscus by a tendon autograft may decrease the severity of the degenerative changes that occur after meniscectomy.

Animals