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Biomedical subjects

M Viceconti

Publications and source records attributed to M Viceconti.

At least 55 records · Page 3Linked to original sources
PubMed1999

CT data sets surface extraction for biomechanical modeling of long bones.

In modelling applications such as custom-made implants design is useful to have a surface representation of the anatomy of bones rather than the voxel-based representation generated by tomography systems. A voxel-to-surface conversion process is usually done by a 2D segmentation of the images stack. However, other methods allow a direct 3D segmentation of the CT or MRI data set. In the present work, two of these methods, namely the Standard Marching Cube (SMC) and the Discretized Marching Cube (DMC) algorithms, were compared in terms of local accuracy when used to reconstruct the geometry of a human femur. The SMC method was found to be more accurate than the DMC method. The SMC method was capable of reconstructing the inner and outer geometry of a human femur with a peak error lower than 0.9 mm and an average error comparable to the pixel size (0.3 mm). However, the large number of triangles generated by the algorithm may limit its adoption in many modelling applications. The peak error of the DMC algorithm was 1.6 mm but it produced approximately 70% less triangles than the SMC method. From the results of this study, it may be concluded that three dimensional segmentation algorithms are useful not only in visualisation applications but also in the creation of geometry models.

Algorithms↗
PubMed1999

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↗
PubMed1999

Endurance testing of hip prostheses: a comparison between the load fixed in ISO 7206 standard and the physiological loads.

BACKGROUND: Pre-clinical endurance validation of innovative hip prostheses femoral components are carried out following the ISO 7206 standard. The in vitro fatigue test must simulate accurately the physiological load to correctly define the section of the stem. OBJECTIVE: This study investigates if the loads defined in the ISO 7206 standard simulate correctly the physiological load that occur in vivo. DESIGN: Simulation of the damage induced by in vitro test and in vivo loads is performed. Different designs of the stem are examined. Materials with different fatigue limit are considered. For the in vivo loads, different body weights are modelled. METHODS: The minimal stem dimensions required to stand 20years of patient use and to pass the fatigue test are calculated based on linear damage accumulation. RESULTS: The results show that the ISO load simulates reasonably well the physiological load that is likely to occur in active patients with a low or normal body weight. Conversely, the ISO test underestimates the physiological load that heavy and active patients are likely to apply to the implant. CONCLUSIONS: Different minimum requirements for endurance strength should be fixed for hip prostheses designed for patients of different weight. This solution would reduce the risk of undersizing or oversizing the stem. RELEVANCE: The introduction of a classification of the hip prostheses, fixing different minimum requirements for endurance strength, will lead to correctly size stems made of new materials or coated using new surface treatments, reducing the risk of implant failure of innovative prostheses.

Hip Prosthesis↗
PubMed1999

In vitro stress shielding measurements can be affected by large errors.

Hip prostheses and other implantable devices for the proximal femur are tested experimentally to study their effects on load transfer. We report on some experimental errors (related to the load simulation) that can undermine the reliability of strain measurements. A first source of error is that of overconstraining the setup. This situation makes it impossible to control or even determine the force values. The second source of error is related to geometric alterations induced by surgery, which modify the lever arms and thus the loading system. Two options are available to compensate for a geometric alteration: either applying the same system of forces or the same resultant bending moment to the implanted femur. The errors that arise if these parameters are not controlled can make it impossible to determine if one device performs better or worse than another.

Biomechanical Phenomena↗
PubMed1999

Methods for quantitative analysis of the primary stability in uncemented hip prostheses.

Torsional loads of daily activities contribute to the failure of the primary fixation of hip prostheses. Implant torsional stability must be evaluated prior to in vivo clinical trials. Whereas previous work has investigated this phenomenon, descriptions of physiologically accurate and reproducible in vitro methodologies are rare. The present study aimed to detect and control the sources of error and variability that influence in vitro methods. A typical set-up for the analysis of primary stability of hip stems was studied. Load cycles included proximal-to-distal axial force, torque, and bending moment. The effects of loading frequency and strain distribution across the cortical bone were investigated in order to optimize testing conditions and measurement set-up. The relative shear motion at the bone-stem interface was measured transcortically using linear variable displacement transducers. The procedures developed for mounting specimens on the testing machine and for positioning sensors on the specimen were standardized and tested for reproducibility. The protocol was finally tested for repeatability and accuracy. Measurement errors were 2.3 microm between load cycles and 4.9 microm for repeated set-ups, comparing favorably with the literature.

Activities of Daily Living↗
PubMed1998

Global asymptotic stability of bone remodeling theories: a new approach based on non-linear dynamical systems analysis.

Mathematical tools for the analysis of nonlinear dynamical systems are applied to the study of stability of bone remodeling theories. As a practical application, the same problem studied by Harrigan and Hamilton (1992) and Cowin et al. (1994b) is analysed using these tools, and their findings on the necessary and sufficient conditions to ensure local asymptotic stability are easily confirmed. Using a general approach based on Lyapunov's method the same condition has been found to be necessary and sufficient also for the global asymptotic stability, thus confirming a result obtained by Harrigan and Hamilton (1994) by variational methods applied to finite-element models. The proof is based on the discretization of the spatial domain but the results for the continuum can be easily extrapolated.

Animals↗
PubMed1998

TRI2SOLID: an application of reverse engineering methods to the creation of CAD models of bone segments.

For many biomechanical engineering activities it would be useful to have the three dimensional (3D) geometry of bone segments available in form of vectorial models within computer aided design (CAD) environments. In this paper a new method for the semi-automatic conversion of a stack of CT images of a femur into a CAD solid model is described. This method is relatively simple, accurate, and requires only a 3D CAD plus a few additional programs available in the public domain. The proposed method was used to convert the CT scan data set of a human femur into a valid CAD model; the resulting solid was two times more accurate than that obtained using the commonly used procedure based on 2D segmentation.

Algorithms↗
PubMed1998

A comparative study on different methods of automatic mesh generation of human femurs.

The aim of this study was to evaluate comparatively five methods for automating mesh generation (AMG) when used to mesh a human femur. The five AMG methods considered were: mapped mesh, which provides hexahedral elements through a direct mapping of the element onto the geometry; tetra mesh, which generates tetrahedral elements from a solid model of the object geometry; voxel mesh which builds cubic 8-node elements directly from CT images; and hexa mesh that automatically generated hexahedral elements from a surface definition of the femur geometry. The various methods were tested against two reference models: a simplified geometric model and a proximal femur model. The first model was useful to assess the inherent accuracy of the meshes created by the AMG methods, since an analytical solution was available for the elastic problem of the simplified geometric model. The femur model was used to test the AMG methods in a more realistic condition. The femoral geometry was derived from a reference model (the "standardized femur") and the finite element analyses predictions were compared to experimental measurements. All methods were evaluated in terms of human and computer effort needed to carry out the complete analysis, and in terms of accuracy. The comparison demonstrated that each tested method deserves attention and may be the best for specific situations. The mapped AMG method requires a significant human effort but is very accurate and it allows a tight control of the mesh structure. The tetra AMG method requires a solid model of the object to be analysed but is widely available and accurate. The hexa AMG method requires a significant computer effort but can also be used on polygonal models and is very accurate. The voxel AMG method requires a huge number of elements to reach an accuracy comparable to that of the other methods, but it does not require any pre-processing of the CT dataset to extract the geometry and in some cases may be the only viable solution.

Algorithms↗
PubMed1998

Material properties assignment to finite element models of bone structures: a new method.

Finite element analysis (FEA) is widely adopted to investigate the mechanical behaviour of bone structures. Computed tomography (CT) data are frequently used to generate FE models of bone. If properly calibrated, CT images are capable of providing accurate information about the bone morphology and tissue density. The aim of this work was to develop a special program able to read a CT data set as well as the FEA mesh generated from it, and to assign to each element of the mesh the material properties derived from the bone tissue density at the element location. The program was tested on phantom data sets and was adopted to evaluate the effects of the discrete description of the bone material properties. A three-dimensional FE model was generated automatically from a 16 bit CT data set of a distal femur acquired in vivo. The strain energy density (SED) was evaluated for each model element for increasing model complexity (number of different material cards assigned to the model). The computed SED were strongly dependent on the material mapping strategy.

Algorithms↗
PubMed1998

Optimal CT scanning plan for long-bone 3-D reconstruction.

Digital computed tomographic (CT) data are widely used in three-dimensional (3-D) reconstruction of bone geometry and density features for 3-D) modeling purposes. During in vivo CT data acquisition the number of scans must be limited in order to protect patients from the risks related to X-ray absorption. Aim of this work is to automatically define, given a finite number of CT slices, the scanning plan which returns the optimal 3-D) reconstruction of a bone segment from in vivo acquired CT images. An optimization algorithm based on a Discard-Insert-Exchange technique has been developed. In the proposed method the optimal scanning sequence is searched by minimizing the overall reconstruction error of a two-dimensional (2-D) prescanning image: an anterior-posterior (AP) X-ray projection of the bone segment. This approach has been validated in vitro on three different femurs. The 3-D reconstruction errors obtained through the optimization of the scanning plan on the 2-D) prescanning images and on the corresponding 3-D data sets have been compared. Two-dimensional and 3-D data sets have been reconstructed by linear interpolation along the longitudinal axis. Results show that direct 3-D optimization yields root mean square reconstruction errors which are only 4%-7% lower than the 2-D-optimized plan, thus proving that 2-D-optimization provides a good suboptimal scanning plan for 3-D reconstruction. Further on, 3-D reconstruction errors given by the optimized scanning plan and a standard radiological protocol for long bones have been compared. Results show that the optimized plan yields 20%-50% lower 3-D reconstruction errors.

Algorithms↗
PubMed1997

Fretting wear in a modular neck hip prosthesis.

In vitro cyclic load fretting tests were conducted on a prototype of a cementless, modular neck, hip prosthesis. The study had three major objectives: to determine the amount of fretted material in the tapered-neck joint under various load cycle amplitudes, to determine the fretting damage evolution, and to determine the effect of different-sized stem bodies on the production of debris. All the tests produced some fretting microdamage on the tapered surface although the extent was quite different among test groups. The amount of abraded material increased almost linearly with the applied load magnitude but not with the number of load cycles. The amount of weight loss was higher in the large stem bodies than in the small ones. Weight loss ranged from 0.28 +/- 0.10 mg for small stem bodies loaded 5.5 million times up to 2300N to 2.54 +/- 0.53 mg for large stem bodies located 20 million times up to 3300N. Considering the large-size stem results, and assuming one million load cycles between 300N and 3300N to be the average yearly load history, the modular neck tapered joint would produce 0.6 mg/year of metal debris. The clinical impact of this observation is unknown; however, some of the literature on the presence of metal in patient tissues and fluids supports the hypothesis that a normal and stable prosthesis is likely to produce less than 10 mg/year of metal debris. Thus, a further production of 0.6 mg/year due to the modular neck should not have any significant effect.

Alloys↗
PubMed1997

Biomechanical validation of a new nail-plate for the repair of stable proximal femoral fractures.

The mechanical performance and the stress shielding effects of the Howmedica Spherolock MKII implant were evaluated. Three types of stable proximal femoral fractures were created in composite femurs and fixed with the nail-plate. The femurs were loaded to failure, and the yield strength, stiffness, and failure modes were noted. Additional intact composite femurs were fitted proximally with strain gauges, and the strain was examined under load. The femurs then underwent intertrochanteric fracture, plating, and re-testing. Comparative analysis showed that while the Spherolock system is less strong and stiff than other commonly used implants, it provides excellent and uniform load transfer across the fracture site. Varus rotation of the femoral head under load tended to open the fracture gap and localize the resultant load medially. Stress shielding of the calcar was less than 25% of the applied load even in the worst case. This very low stress shielding behavior was attributed mainly to the implant's low stiffness.

Biomechanical Phenomena↗
PubMed1996

Design-related fretting wear in modular neck hip prosthesis.

An accelerated cyclic loading corrosion test was used to determine the corrosion behavior of a commercial (GSP) and a prototype titanium hip prosthesis each with a modular neck. Four GSP and four prototype stems were subjected to a 2-Hz cyclic load ranging between 200 and 2,100 N for 1,000,000 cycles. Three stems were tested in an environment of FeCl3 solution, three stems were tested in Ringer's solution, and two stems were tested in air. After cyclic loading, the specimens were carefully examined with optical and scanning electron microscopy (SEM). None of them showed macroscopic or microscopic signs of corrosion, regardless of the environment to which the specimens were subjected. However, macroscopic evidence of mechanical fretting was present at the neck-stem modular junction, primarily concentrated at the medial contact point between stem and neck, especially for the prototype stems. SEM analysis confirmed these observations. The appreciable differences observed between the two designs suggest that the problem can be minimized or eliminated with an accurately designed taper fitting.

Chlorides↗
PubMed1996

Mechanical validation of whole bone composite femur models.

Composite synthetic models of the human femur have recently become commercially available as substitutes for cadaveric specimens. Their quick diffusion was justified by the advantages they offer as a substitute for real femurs. The present investigation concentrated on an extensive experimental validation of the mechanical behaviour of the whole bone composite model, compared to human fresh-frozen and dried-rehydrated specimens for different loading conditions. First, the viscoelastic behaviour of the models was investigated under simulated single leg stance loading, showing that the little time dependent phenomena observed tend to extinguish within a few minutes of the load application. The behaviour under axial loading was then studied by comparing the vertical displacement of the head as well as the axial strains, by application of a parametric descriptive model of the strain distribution. Finally, a four point bending test and a torsional test were performed to characterize the whole bone stiffness of the femur. In all these tests, the composite femurs were shown to fall well within the range for cadaveric specimens, with no significant differences being detected between the synthetic femurs and the two groups of cadaveric femurs. Moreover, the interfemur variability for the composite femurs was 20-200 times lower than that for the cadaveric specimens, thus allowing smaller differences to be characterized as significant using the same simple size, if the composite femurs are employed.

Biomechanical Phenomena↗
PubMed1996

Bone remodelling adjacent to intramedullary stems: an optimal structures approach.

The internal parameters in bone remodelling theories often are not clearly related to the bony structure which results from the simulations in which they are implemented. For a restricted class of bone remodelling theories, we have previously found a connection between overall structural optimization and the parameters within a continuum-level remodelling rule. In this study, we assess whether a simplified analytical formula based on structural optimization can predict the behaviour of a large-scale finite element bone remodelling simulation. The analytical formula predicts when bone will remain around an intramedullary implant. The predictions of the formula are borne out in the numerical results. This leads to a physical interpretation of one of the two parameters in the remodelling rule used. The results also show some characteristics which are clinically relevant. This study extends earlier results due to Huiskes for internal remodelling around intramedullary implants by using a different, numerically stable remodelling algorithm based on optimization. The study also shows a direct practical application of the optimizing remodelling theory the authors have developed previously.

Biomechanical Phenomena↗
PubMed1996

Discussion on the design of a hip joint simulator.

Hip joint simulators were developed for predicting, by attempting to duplicate in vitro physiological loads and motion, the wear rate that total hip replacements are likely to show in vivo. From a theoretical point of view, loading and motion cycles of hip joints could be closely reproduced by three rotation actuators and three force actuators. However existing devices have been designed assuming that some of these degrees of freedom are negligible, in order to reduce the complexity of the equipment. The present study singles out some preliminary indications on the design choices regarding the spatial configuration of loading and motion actuators. The aim is to define theoretically a simplified simulator but still able to apply the most physiologically realistic loading cycle to the specimen.

Biomechanical Phenomena↗
PubMed1996

A minimal parametric model of the femur to describe axial elastic strain in response to loads.

Evaluating the state of stress/strain for a given geometry and load in femurs can be done both experimentally, measuring strain at a limited number of locations, and theoretically with finite element models. Another approach is to describe the state of strain with a few synthetic indices. For this purpose the reverse elastic problem (i.e. bone parameters are estimated given the strain distribution and loads) needs to be solved as opposed to the finite element direct problem. Such reverse models can be then used: (1) to describe simply the strain distribution by means of few synthetic indices; (2) to explain the state of strain; and (3) to predict the strain distribution under different loading conditions. Various linear models, characterized by two to five bone related parameters, were tested on (1) 12 femurs, (2) a finite element model, and (3) data taken from the literature, for a total of 43 loading cases. Three and four-parameter models were able to fit the experimental strain distributions with mean squared residuals smaller than 5% of the strain range. The consistency of the model was proved by the repeatability of the parameters estimate for identical femurs. Furthermore, the bone-related coefficients were able to detect the stiffening effect of the implantation of an uncemented stem. Finally, the model can be used for predictive purposes if the parameter estimates are used with different loading conditions.

Biomechanical Phenomena↗