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A finite element analysis of the load transfer between an above-knee residual limb and its prosthetic socket--roles of interface friction and distal-end boundary conditions.

A nonlinear finite element model was developed to investigate the manner of the load transfer between the above-knee residual limb and its prosthetic socket. The model was two-dimensional (2-D) with consideration of nonlinear boundary conditions and large deformation. Interface elements were used to simulate the friction/slip conditions between skin and the socket. Different distal-end conditions, including air cushion distal-end loading, were simulated to explore their influences on the load transfer.

Amputation Stumps↗

Three-dimensional finite element analysis of human temporomandibular joint with and without disc displacement during jaw opening.

The aim of this study was to evaluate the differences of stress distribution in the temporomandibular joint (TMJ) disc during jaw opening between the subjects with and without internal derangement of TMJ (TMJ-ID). Three symptom-free volunteers and three symptomatic patients with anterior disc displacement were selected as normal and TMJ-ID subjects, respectively. For each subject, magnetic resonance images (MRI) were taken in the axial, sagittal and coronal directions. Using MRI taken, six three-dimensional finite element models of TMJ were developed. For each subject, the condylar movements during jaw opening were recorded and used as the loading condition for stress analysis. By comparing the calculated disc displacement to the measured one from MRI, the frictional coefficients were mu = 0.001 for the normal subjects, but mu = 0.01-0.001 for the TMJ-ID subjects. For the normal subjects, relatively high stresses were found at the anterior and lateral portions of the disc throughout jaw opening. In the connective tissues, the stress level was higher in the TMJ-ID than in the normal subjects. It is suggested that the disc displacement induces the change of stress distribution in the disc and the increase of frictional coefficients between articular surfaces, resulting in the secondary tissue damage.

Adult↗

Real-time patient-specific finite element analysis of internal stresses in the soft tissues of a residual limb: a new tool for prosthetic fitting.

Fitting of a prosthetic socket is a critical stage in the process of rehabilitation of a trans-tibial amputation (TTA) patient, since a misfit may cause pressure ulcers or a deep tissue injury (DTI: necrosis of the muscle flap under intact skin) in the residual limb. To date, prosthetic fitting typically depends on the subjective skills of the prosthetist, and is not supported by biomedical instrumentation that allows evaluation of the quality of fitting. Specifically, no technology is presently available to provide real-time continuous information on the internal distribution of mechanical stresses in the residual limb during fitting of the prosthesis, or while using it and this severely limits patient evaluations. In this study, a simplified yet clinically oriented patient-specific finite element (FE) model of the residual limb was developed for real-time stress analysis. For this purpose we employed a custom-made FE code that continuously calculates internal stresses in the residual limb, based on boundary conditions acquired in real-time from force sensors, located at the limb-prosthesis interface. Validation of the modeling system was accomplished by means of a synthetic phantom of the residual limb, which allowed simultaneous measurements of interface pressures and internal stresses. Human studies were conducted subsequently in five TTA patients. The dimensions of bones and soft tissues were obtained from X-rays of the residual limb of each patient. An indentation test was performed in order to obtain the effective elastic modulus of the soft tissues of the residual limb. Seven force sensors were placed between the residual limb and the prosthetic liner, and subjects walked on a treadmill during analysis. Generally, stresses under the shinbones were approximately threefold higher than stresses at the soft tissues behind the bones. Usage of a thigh corset decreased the stresses in the residual limb during gait by approximately 80%. Also, the stresses calculated during the trial of a subject who complained about pain and discomfort were the highest, confirming that his socket was not adequately fitted. We conclude that real-time patient-specific FE analysis of internal stresses in deep soft tissues of the residual limb in TTA patients is feasible. This method is promising for improving the fitting of prostheses in the clinical setting and for protecting the residual limb from pressure ulcers and DTI.

Amputees↗

Influence of geometrical factors on the behavior of lumbar spine segments: a finite element analysis.

The main objective of this study was the assessment of the influence of geometrical factors on the behavior of lumbar segments. To this end, a three-dimensional, parameterized, finite element model of the lumbar spine was used, and the results were compared with inhouse experimental results and with the few published experimental results available concerning either the geometry of the tested samples or the differences observed at different vertebral levels. Furthermore, in order to appreciate the relative importance of the geometry, the influence of the variation of some other parameters was studied, such as the orientation of the facet joints, the gap between the articular processes, and the Young's modulus of the disk fibers. As a first approach, a series of computations was carried out in order to evaluate the role of geometry in the mechanical behavior differences observed at different levels. It has been found that geometrical factors do exert a noticeable influence on the behavior of the spine, especially those which interfere with the dimensions of the intervertebral disk.

Biomechanical Phenomena↗

Effects of cervical cages on load distribution of cancellous core: a finite element analysis.

METHODS: The study was designed to analyze the load distribution of the cancellous core after implantation of vertical ring cages made of titanium, cortical bone, and tantalum using the finite element (FE) method. The intact FE model of C5-C6 motion segment was validated with experimental results. RESULTS: The percentage of load distribution in cancellous core dropped by about one-third of the level for the intact model after the cage implantation. The difference among cages made of different materials (or different stiffnesses) was not very obvious. CONCLUSIONS: These results implied that the influence of the cage on the load transfer in the cancellous core is greatly related to the cage's dimensions and position within the intervertebral space. The dimension and position of the cage that least disturb the load distribution in cancellous core could be criteria in cage development.

Cadaver↗

A finite element analysis of the natural frequencies of vibration of the human tympanic membrane. Part I.

The present work examines the natural frequencies of vibration of the decoupled human tympanic membrane using the finite element method. A model comprising 49 isoparametric semi-loof thin shell elements was built, based on shape measurements of Kirikae (1960) and our own measurements on several local cadaver ears. A range of material data input was used similar to that assessed earlier by Funnell and Laszlo (1978). The present results indicate the natural vibration mode shapes are simple at low frequencies, but become more complex at higher values as found earlier (Tonndorf and Khanna, 1972; Funnell and Laszlo, 1978), but at reduced frequencies. Data input of the real drum thickenesses and dimensions considerably increases the natural frequencies by about 50% above those for a uniformly thick membrane. It is suggested that realistic eardrum natural frequencies may result from the use of a membrane internal stress parameter in the data file in order to simulate the interplay between radial and circular fibres resulting in the observed drum curvature.

Ear, Middle↗

Evaluation of mechanical loading of a trileaflet polyurethane blood pump valve by finite element analysis.

The mechanical loading of the leaflets of a polyurethane blood pump valve at closing pressure (max 300 mmHg) and during the opening phase can be numerically calculated by the finite element method. Geometrical and physical non-linearities, supporting forces by neighbouring leaflets and manufacturing-related thickness distribution are taken into account. The valve housing is assumed to be rigid. Volume forces are neglected. The calculations showed that the critical strain limit of 4.5% (long-term failure limit) was exceeded at closing pressure and during valve opening. During valve operation the connection between leaflet and valve housing and the central leaflet region seem to be the critical areas.

Biocompatible Materials↗

Risk of fracture in elderly patients: a new predictive index based on bone mineral density and finite element analysis.

Hip fracture is more and more frequent in elderly population. For this reason, an increasing attention has been focused on the development of a non-invasive method to predict femoral neck fracture. A conventional approach to fracture diagnosis is the measurement of bone mass by dual-energy X-ray absorptiometry in some regions of interest. The aim of this work is to assess a method that accounts for the structural details of the bone providing a more direct determination of strength properties, and improving the diagnostic power of the current densitometric systems. A 2D finite element model of the proximal femur is derived from dual-energy X-ray absorptiometry data. Initially, the method is validated in vitro using a replica of the human femur. The predicted results are compared to strain-gauge measurements and to a 3D finite element model, with good agreement being observed. Then, an in vivo preliminary study on a limited group of patients is carried out. The loading condition that simulates a fall to the side onto the greater trochanter from standing height is employed. All simulations show a peak strain at the femoral neck region with a strain distribution typical of a fall on the side. The proposed method seems to supply a useful tool for the in vivo analysis of the risk of hip fracture.

Aged↗

Finite element analysis of cervical facetectomy.

STUDY DESIGN: Moment-rotation responses and disc anulus stresses of intact and facetectomized C4-C6 cervical spinal units were analyzed using detailed, three-dimensional, finite element models. OBJECTIVES: To evaluate biomechanical effects of progressive unilateral and bilateral facet resections on cervical spine segmental mobility (external response) and disc anulus stress (internal response). SUMMARY OF BACKGROUND DATA: Experimental studies have demonstrated that facetectomy significantly increases segmental mobility of the cervical spine. The biomechanical effects of facetectomy on the internal response, however, have not been investigated. METHODS: Moment-rotation responses of C4 with respect to C6 and von Mises stress in the disc anulus were examined using finite element models of a 0% (intact), 25%, 50%, 75%, and 100% unilaterally and bilaterally facetectomized cervical spinal unit. The model simulations were conducted under the pure-moment loading of 1.8 Nm in flexion, extension, lateral bending, and axial torsion. The intact model also was validated experimentally under the same conditions. RESULTS: The moment-rotation responses of the intact unit were within the ranges of experimental data. Cervical rotations increased with the increased degree of facet resection. The greatest change occurred between 50% and 75% facet resections in bilateral facetectomy. Similar patterns were found for disc anulus stresses, but to a greater extent. The maximum increase in rotation (11%) and in anulus stress (30%) occurred in lateral bending. Torsion was the least affected loading mode. The effects of unilateral facetectomy were considerably less than those of 75% bilateral facetectomy. CONCLUSIONS: Facetectomy has a greater effect on anulus stress than on intervertebral joint stiffness. Significant increase in anulus stresses and segmental mobility may occur when bilateral facet resection exceeds 50%.

Adult↗

Large-scale finite element analysis of the beating heart.

The regional mechanics of the beating heart are directly related to factors such as ventricular pumping performance, coronary blood flow, myocardial energetics and oxygen consumption, vulnerability to ischemia and injury, hypertrophy and remodeling, and arrhythmogenesis. Important characteristics include: the complex three-dimensional geometry and fibrous architecture; the nonlinear, nonhomogeneous, anisotropic material properties of the myocardium; the hierarchical collagen connective tissue matrix; the time- and history-dependent active tension development of the cardiac muscle cells; and the three-dimensional anisotropic patterns of cardiac impulse propagation. To model these features realistically requires large-scale computational analysis with sophisticated numerical methods. As described in the chapter by Dr. Hunter and colleagues, an accurate three-dimensional finite element model has been developed to describe the geometry, fiber architecture, and extracellular matrix structure of the heart. The model is based on extensive anatomical measurements in the left and right ventricles (LV and RV) of the canine heart. In this chapter, we illustrate some new approaches to the special problems of large-scale finite element modeling in biomechanics using examples from the analysis of stress and electrical activation in the heart. Prospects for further progress--particularly in coupled problems such as cardiac electromechanics--are examined in light of new developments in high-performance computing.

Animals↗

Three-dimensional finite element analysis for stress in the periodontal tissue by orthodontic forces.

This study was designed to investigate the stress levels induced in the periodontal tissue by orthodontic forces using the three-dimensional finite element method. The three-dimensional finite element model of the lower first premolar was constructed on the basis of average anatomic morphology and consisted of 240 isoparametric elements. Principal stresses were determined at the root, alveolar bone, and periodontal ligament (PDL). In all loading cases for the buccolingually directed forces, three principal stresses in the PDL were very similar. At the surface of the root and the alveolar bone, large bending stresses acting almost in parallel to the root were generally observed. During tipping movement, stresses nonuniformly varied with a large difference from the cervix to the apex of the root. On the other hand, in case of movement approaching translation, the stresses induced were either tensile or compressive at all occlusogingival levels with some difference of the stress from the cervix to the apex. The pattern and magnitude of stresses in the periodontium from a given magnitude of force were markedly different, depending on the center of rotation of the tooth.

Alveolar Process↗

The effect of ventricular volume reduction surgery in the dilated, poorly contractile left ventricle: a simple finite element analysis.

OBJECTIVES: Ventricular volume reduction surgery has been proposed by Batista to improve cardiac function in patients with dilated cardiomyopathy. However, limited clinical data exist to determine the efficacy of this operation. A finite element simulation is therefore used to determine the effect of volume reduction surgery on left ventricular end-systolic elastance, diastolic compliance, stroke work/end-diastolic volume (preload recruitable stroke work), and stroke work/end-diastolic pressure (Starling) relationships. METHODS: End-diastole and end-systole were represented by elastic finite element models with different unloaded shapes and nonlinear material properties. End-systolic elastance, diastolic compliance, preload recruitable stroke work, and Starling relationships, as well as energy expenditure per gram of unresected myocardium, were calculated. Two different types of volume reduction surgery (apical and lateral) were simulated at 10% and 20% left ventricular mass reduction. RESULTS: Ventricular volume reduction surgery causes diastolic compliance to shift further to the left on the pressure-volume diagram than end-systolic elastance. Volume reduction surgery increases the slope of the preload recruitable stroke work relationship (dilated cardiomyopathy 0.006 J/mL; 20% lateral volume reduction surgery 0.009 J/mL) but decreases the slope of the Starling relationship (dilated cardiomyopathy 0.028 J/mm Hg; 20% lateral volume reduction 0.023 J/mm Hg). For a given amount of resection, lateral volume reduction has a greater effect than apical volume reduction. Ten-percent and 20% lateral volume reduction reduces energy expenditure by 7% and 17%, respectively. CONCLUSION: Ventricular volume reduction surgery shifts end-systolic elastance and diastolic compliance to the left on the pressure-volume diagram. The net effect on ventricular function is mixed. Volume reduction surgery increases the slope of preload recruitable stroke work, but increased diastolic compliance causes a small decrease in the Starling relationship (3 mm Hg difference between dilated cardiomyopathy and volume reduction surgery at stroke work = 0.5 J).

Adult↗

Finite element analysis of poor distal contact of the femoral component of a cementless hip endoprosthesis.

The difficulty of achieving good distal contact between a cementless hip endoprosthesis and the femur is well established. This finite element study investigates the effect on the stress distribution within the femur due to varying lengths of distal gap. Three-dimensional anatomical models of two different sized femurs were generated, based upon computer tomograph scans of two cadaveric specimens. A further six models were derived from each original model, with distal gaps varying from 10 to 60 mm in length. The resulting stress distributions within these were compared to the uniform contact models. The extent to which femoral geometry was an influencing factor on the stress distribution within the bone was also studied. Lack of distal contact with the prosthesis was found not to affect the proximal stress distribution within the femur, for distal gap lengths of up to 60 mm. In the region of no distal contact, the stress within the femur was at normal physiological levels associated with the applied loading and boundary conditions. The femoral geometry was found to have little influence on the stress distribution within the cortical bone. Although localized variations were noted, both femurs exhibited the same general stress distribution pattern.

Biomechanical Phenomena↗

Initial stress differences between tipping and torque movements. A three-dimensional finite element analysis.

The aim of this study was to analyse the distribution of the stress on dental and periodontal structures when a simple tipping dental movement or torque movement is produced. A tridimensional computer model based on finite element techniques was used for this purpose. The model of the lower canine was constructed on the average anatomical morphology and 396 isoparametric elements were considered. The three principal stresses (maximum, minimum and intermediate) and Von Mises stress were determined at the root, alveolar bone and periodontal ligament (PDL). It was observed how the distribution of stress is not the same for the three structures studied. In all loading cases for bucco-lingually directed forces, the three principal stresses were very similar in the PDL. The dental apex and bony alveolar crest zones are the areas that suffer the greatest stress when these kind of movements are produced.

Alveolar Process↗

Finite element analysis of the implanted proximal tibia: a relationship between the initial cancellous bone stresses and implant migration.

The cancellous bone stresses within the implanted proximal tibia were examined using a three-dimensional anatomical finite element model. Three versions of a proximal tibial prosthesis were examined: an all polyethylene press-fit design; a metal backed, stemmed press-fit design and a (horizontally) cemented metal backed, stemmed design. All three designs had published migration and survivorship data. The objectives of the study were (i) to compare the stresses generated by each of the tibial components, (ii) examine the influence of the resected surface morphology and (iii) compare the initial cancellous bone stresses with the published migration and survivorship data. The all polyethylene prosthesis generated the highest cancellous bone stresses. Addition of a metal backing and a stem reduced the stresses, but the cemented device produced the lowest cancellous bone stresses. The surface morphology had a significant effect on the cancellous bone stresses generated by press-fit prostheses. As the bone-prosthesis contact area decreased, the peak cancellous bone stresses increased by as much as 243%. The surface morphology had no effect on the cancellous bone stresses generated by the cemented implant. Good correlation was found between the predicted cancellous bone stresses and the migration and survivorship data, with the implant generating the highest cancellous bone stresses migrating the most and having the poorest survival rates at 5 year. The results support the hypothesis that the progressive failure of cancellous bone is a mechanism of implant migration regardless of the method of fixation and the implantation site.

Biomechanical Phenomena↗

Adaptive Finite Element Analysis of the Anisotropic Biphasic Theory of Tissue-Equivalent Mechanics.

The nonlinear partial differential equations of the anisotropic biphasic theory of tissue-equivalent mechanics are solved with axial symmetry by an adaptive finite element system. The adaptive procedure operates within a method-of-lines framework using finite elements in space and backward difference software in time. Spatial meshes are automatically refined, coarsened, and relocated in response to error indications and material deformation. Problems with arbitrarily complex two-dimensional regions may be addressed. With meshes graded in high-error regions, the adaptive solutions have fewer degrees of freedom than solutions with comparable accuracy obtained on fixed quasi-uniform meshes. The adaptive software is used to address problems involving an isometric cell traction assay, where a cylindrical tissue equivalent is adhered at its end to fixed circular platens; a prototypical bioartificial artery; and a novel configuration that is intended as an initial step in a study to determine bioartificial arteries having optimal collagen and cell concentrations.

Journal Article↗

Interlaminar shear stresses and laminae separation in a disc. Finite element analysis of the L3-L4 motion segment subjected to axial compressive loads.

STUDY DESIGN: This study analyzed interlaminar shear stresses across the laminae of a ligamentous L3-L4 motion segment. A three-dimensional finite element model of the motion segment was developed and its response in axial compression mode was predicted. OBJECTIVES: The contributions of "mechanical" factors in producing laminae separation in a disc are not well understood, especially when the nucleus is still gel-like in appearance (stage 1 of disc degeneration). All types of stresses are likely to contribute to laminae separation. The authors believe it is partially due to the interlaminar shear stresses at the laminae interfaces in specific regions of an intact disc because the disc is a composite structure. The effects of anular tears on the interlaminar shear stresses were also investigated. These tears can be circumferential or radial in nature, and commonly occur in the aged, degenerated disc. SUMMARY OF BACKGROUND DATA: A large number of biomechanical studies dealing with the role of the disc vis-a-vis other spinal components have been reported in the literature. The role of mechanical factors, however, in producing laminae separation, especially when the nucleus is still gel-like in appearance (stage 1 of disc degeneration), is not entirely clear. METHODS: A three-dimensional nonlinear finite element model of an intact L3-L4 lumbar motion segment, based on the use of a special type of element for the disc anulus, was created to investigate the interlaminar shear stresses in the anulus. The effects of radial "out-in," radial "in-out," and "circumferential" injuries were analyzed. Injury was modeled as element removal in the posterolateral portion of the disc. Models subjected to axial compressive loads, ranging from 200 N to 2000 N, were analyzed. In addition to the interlaminar shear stresses, disc bulge, and displacements including coupled motions were predicted. RESULTS: The theoretical disc bulge predictions for the radial in-out injury case were in agreement with the disc bulge data obtained experimentally. Displacements, disc bulge, and coupled motions increased with injury, as expected. The interlaminar shear stresses were highest in the posterolateral portions of the intact disc model. Interlaminar shear stresses, in general, increased with injury. Also, a slight increase in circumferential injury was sufficient to see a substantial increase in interlaminar shear stresses. CONCLUSIONS: The interlaminar shear stresses being higher in the posterolateral regions of the intact disc reinforces that, from clinical studies, tears originate in the posterolateral portion of the disc. The large interlaminar shear stresses, caused by asymmetry in the disc structure due to injury, along with chemical and structural changes in the disc with age, may be an important cause of further degeneration through laminae separation. This is the case for traditional composite laminates. This study points out the importance of interlaminar shear stresses to gain further understanding of the role of mechanical factors in producing disc degeneration, especially delamination of the anulus. Clinical relevance of the findings and possible relationship to the aging process are explored.

Adolescent↗