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Biomedical subjects

R Huiskes

Publications and source records attributed to R Huiskes.

At least 91 records · Page 5Linked to original sources
PubMed1997

The predictive value of stress shielding for quantification of adaptive bone resorption around hip replacements.

The presence of a femoral hip stem changes local mechanical signals inside the surrounding bone. In this study we examined the hypothesis that the eventual loss of bone can be estimated from the initial patterns of elastic energy deviation, as determined in FE models of the intact bone and the operated femur. For that purpose two hypothetical relations between elastic energy reduction and resorption were investigated. Their estimates of bone loss were compared to the results of iterative computer simulations. Two kinds of FE model were used, and in each stem stiffness and remodeling threshold (a measure of "biological reactivity") were varied. Provided that reasonable values of the remodeling threshold are assumed and that the stem is firmly bonded to the bone, we found that the difference between direct estimates and simulation models was 4 percent of bone loss. It is therefore concluded that initial patterns of elastic energy deviation give a reasonable indication of expected bone loss.

Adaptation, Physiological↗
PubMed1997

Stress shielding after total knee replacement may cause bone resorption in the distal femur.

Inadequate bone stock is often found in revision surgery of femoral components of total knee replacements. Our aim was to test the hypothesis that these remodelling patterns can be explained by stress shielding, and that prosthetic bonding characteristics affect maintenance of bone mass. We made a three-dimensional finite-element model of an average male femur with a cemented femoral knee component. This model was integrated with iterative remodelling procedures. Two extreme prosthetic bonding conditions were analysed and gradual changes in bone density were calculated. The long-term bone loss under the femoral knee component resembled clinical findings which confirms the hypothesis that stress shielding can cause distal femoral bone loss. Our study predicts, contrary to clinical findings, that an equilibrium situation is not reached after two years, but that bone resorption may continue. This hidden bone loss may be so drastic that large reconstructions are needed at the time of revision.

Biomechanical Phenomena↗
PubMed1997

Acrylic cement creeps but does not allow much subsidence of femoral stems.

It has been suggested that the endurance of cemented femoral reconstructions in total hip arthroplasty is affected by the creep of acrylic cement, but it is not known to what extent cement creeps under loading conditions in vivo, or how this affects load transfer. We have simulated the long-term creep properties of acrylic cement in finite-element models of femoral stem constructs and analysed their effects. We investigated whether subsidence rates measured in vivo could be explained by creep of acrylic cement, and if polished, unbonded, stems accommodated creep better than bonded stems. Our findings showed that polished prostheses subsided only about 50 microm as a result of cement creep. The long-term prosthetic subsidence rates caused by creep of acrylic cement are therefore very small and do not explain the excessive migration rates which have sometimes been reported. Cement creep did, however, relax cement stresses and create a more favourable stress distribution at the interfaces. These trends were found around both the bonded and unbonded stems. Our results did not confirm that polished, unbonded, stems accommodated creep better than bonded stems in terms of cement and interface stress patterns.

Acrylic Resins↗
PubMed1997

Prospects of computer models for the prediction of osteoporotic bone fracture risk.

Bone fractures are major problems for osteoporosis patients. To avoid such fractures, more information is needed about the factors that determine the bone fracture risk. In this chapter, it is discussed how recently developed finite element computer models that can represent the trabecular architecture in full detail can provide such information. It is concluded that a computer modeling approach to this problem is feasible, required and promising. It is expected that, eventually, such models can be used as a basis for an accurate diagnosis of the bone fracture risk.

Biomechanical Phenomena↗
PubMed1997

Validation of adaptive bone-remodeling simulation models.

Using computer models based on Finite Element Analysis (FEA), Wolff's paradigm of mechanically-controlled adaptive bone remodeling can be simulated. These simulation models use empirical mathematical rules that describe the assumed relationships between local bone loads and bone mass. These models are particularly valuable for preclinical testing of orthopaedic implants, relative to their bone-maintaining capacities. In this Chapter the question of validity of these models for these purposes is considered. Furthermore, an overview is presented of validation studies that were performed by the research group of the author.

Animals↗
PubMed1996

Friction and stem stiffness affect dynamic interface motion in total hip replacement.

Large cyclic movements between the femoral stem and bone during the first weeks after total hip arthroplasty may hamper bone ingrowth and adversely affect the eventual success of the arthroplasty. Little is known, however, about the magnitude of the motions and its relationship to design and surgical factors. A two-dimensional finite element model of a cementless prosthesis inserted into the proximal femur was constructed to study the effects of two mechanical variables--the stiffness of the implant and the coefficient of friction between bone and implant--on the magnitude of the motions. We investigated the influences of these variables on the subsidence of the prosthesis, the magnitudes of the cyclic motions, and the level of the interface stresses. The presence of friction reduced cyclic motions by about 85% compared with a frictionless interface. Once friction was assumed, varying the coefficient of friction had little effect. The effect of friction on the interface stress state and gross subsidence of the prosthesis was not as great as on cyclic motion. Implant stiffness also affected the magnitudes and distributions of the cyclic motions along the interface. A flexible stem generated motions about three to four times larger proximally than those of a stiff stem, which generated larger motions distally. The influence of stem stiffness on interface stresses and prosthetic subsidence was less than on cyclic motion. The location of the peak shear stresses at the interface around a bonded prosthesis corresponded to the location where cyclic interface motion was maximal for an unbonded prosthesis. However, no direct relationship was found between the magnitudes of peak stresses and the amplitudes of cyclic motions.

Elasticity↗
PubMed1996

A mechanism for rotation restraints in the knee joint.

Ligament function in restraining axial rotation of the tibia relative to the femur cannot be revealed by analysis of ligament forces alone. The action of the articular surfaces should be taken into account as well. In this study, three-dimensional mathematical models of four human knee joints were used to determine the limits of axial rotation between 0 and 90 degrees of flexion, whereby the forces in the ligaments and articular contact were calculated, together with their contribution to the restraint moment that was required to counterbalance the applied axial moment of 3 Nm. In external rotation, the direct axial restraint was provided by the collateral ligaments. In internal rotation, when the cruciate ligaments and medial collateral ligament were predominantly loaded, the direct restraint moment resulting from the ligament forces was not sufficient to counterbalance the applied moment. The articular contact forces, which resulted from balancing the axial components of the ligament forces, contributed considerably to the restraint of internal rotation. Depending on the flexion angle, the contact forces provided approximately 50-85% of the internal restraint, whereas 95-100% of the external rotation restraint was accounted for by the ligament forces.

Humans↗
PubMed1996

Osteocyte density and histomorphometric parameters in cancellous bone of the proximal femur in five mammalian species.

The species-specific relationships between trabecular morphology and osteocyte density were investigated in the femoral heads of 30 adult animals of five mammalian species (rat, rabbit, Rhesus monkey, pig, and cow). Our hypothesis is that osteocytes are mechanosensory cells and are involved in the regulation of bone remodeling. According to the predictions from a simulation model, this hypothesis implies that the influencing distance of osteocytes, together with the magnitude of the mechanical loads, determines the thickness of trabeculae and that the number of osteocytes primarily affects the rate of bone remodeling. The number of osteocytes per bone volume ranged from 93,200 mm-3 in rat to 31,900 mm-3 in bovine cancellous bone. Osteocyte density was inversely related to the size of the species. Since basal metabolic output is related to body mass, we speculate that osteocyte density may be related to metabolic rates. Trabecular thickness was larger in the cow than in the other species, but the range of variation between species was relatively small. This agrees with the hypothesis that trabecular thickness is limited by the domain that can be regulated by an osteocyte and that this domain is of similar size regardless of the species. Only in the rat was trabecular thickness considerably smaller than in the other species. This is probably due to the presence of the cartilaginous growth plate in the femoral head of the rat. The relationships with species are different for osteocyte density than for morphometric parameters. Hence, our data support our hypothesis that osteocyte density is not directly associated with the macroscopic trabecular architecture.

Animals↗
PubMed1996

Characterization of the mechanical behavior of human knee ligaments: a numerical-experimental approach.

During knee-joint motions, the fiber bundles of the knee ligaments are nonuniformly loaded in a recruitment pattern, which depends on successive relative orientations of the insertion sites. These fiber bundles vary with respect to length, orientation and mechanical properties. As a result, the stiffness characteristics of the ligaments as a whole are variable during knee-joint motion. The purpose of the present study is to characterize this variable mechanical behavior. It is hypothesized that for this purpose it is essential to consider the ligaments mechanically as multi-bundle structures in which the variability in fiber bundle characteristics is accounted for, rather than as one-dimensional structures. To verify this hypothesis, bone-ligament-bone preparations of the ligaments were subjected to series of unidirectional subfailure tensile tests in which the relative insertion orientations were varied. For each individual test specimen, this series of tensile tests was simulated with a mathematical ligament model. Geometrically, this model consists of multiple line elements, of which the insertions and orientations are anatomically based. In a mathematical optimization process, the unknown stiffness and recruitment parameters of the line elements are identified by fitting the variable stiffness characteristics of the model to those of the test series. Thus, lumped parameters are obtained which describe the mechanical behavior of the ligament as a function of the relative insertion orientation. This method of identification was applied to all four knee ligaments. In all cases, a satisfactory fit between experimental results and computer simulation was obtained, although the residual errors were lower for the cruciate ligaments (1.0-2.4%) than for the collateral ligaments (3.7-8.1%). It was found that models with three or less line elements were very sensitive to geometrical parameters, whereas models with more than 7 line elements suffered from mathematical redundancy. Between 4 and 7 line elements little difference was found. It is concluded that the present ligament models can realistically simulate the variable tensile behavior of human knee ligaments. Hereby the hypothesis is verified that it is essential to consider the ligaments of the knee as multi-bundle structures in order to characterize fully their mechanical behavior.

Aged↗
PubMed1996

Validation of a three-dimensional model of the knee.

Three-dimensional mathematical models of the tibio-femoral joint require input of the geometry of articulating surfaces and ligament insertions, and the mechanical properties of cartilage and ligaments. This paper describes a validation of a knee model through a direct specimen-related comparison between the knee model and the kinematics of four knee joint specimens from which the geometry data were used as input of the model. The knee model is quasi-static and is based on equilibrium of forces and moments. The stiffness properties of the ligaments and articular cartilage were estimated on the basis of data reported in the literature. The so-called reference strains in the ligament bundles for the joint in extension, were determined by using an optimization procedure, minimizing the difference between the kinematics of the model and the kinematics of experimentally obtained flexion motions with an internally or an externally rotated tibia (+/- 3 Nm load). A reasonable to good agreement between the model and the experimental kinematics could be obtained for internal-external rotation laxity and the coupled translations and varus-valgus rotation. The disparity between model and experiment varied from knee to knee, average deviations ranging from close to zero to 8 degrees internal rotation deviation and from 5 mm posterior to 3 mm anterior position deviation. The average anterior-posterior laxities at both 20 degrees and 90 degrees flexion were within the variations reported in the literature, although for each individual joint with some underestimation or overestimation. It was concluded that the optimization procedure compensated for the lack of menisci and capsular structures by higher prestrains, thereby overestimating the ligament forces. Despite the gross simplifications relative to the complex anatomy of the knee, the present knee model can realistically simulate the passive motion characteristics of the human knee joint.

Elasticity↗
PubMed1996

Direct mechanics assessment of elastic symmetries and properties of trabecular bone architecture.

A method is presented to find orthotropic elastic symmetries and constants directly from the elastic coefficients in the overall stiffness matrix of trabecular bone test specimens. Contrary to earlier developed techniques, this method does not require pure orthotropic behavior or additional fabric measurements. The method uses high-resolution computer reconstructions of trabecular bone specimens as input for large-scale FE-analyses to determine all the 21 elastic coefficients in the overall stiffness matrix of the specimen, using a direct mechanics approach. An optimization procedure is then used to find the coordinate transformation that yields the best orthotropic representation of this matrix. The method is illustrated here relative to two trabecular bone specimens. The techniques developed here can be used to obtain a complete characterization of the mechanical properties of trabecular architecture. With the development of in vivo reconstruction techniques, even in vivo measurements will be possible.

Algorithms↗
PubMed1996

Biomechanical and histological evaluation of a hydroxyapatite-coated titanium femoral stem fixed with an intramedullary morsellized bone grafting technique: an animal experiment on goats.

To reconstruct femoral intramedullary bone-stock loss in revision surgery of failed total hip arthro-plasties, morsellized trabecular bone grafts can be used. In 14 goats a noncemented hydroxyapatite-coated titanium stem was fixed within a circumferential construction of bone allografts. After 6 or 12 wk, four goats were used for mechanical tests and three for histology. The stability of the stems relative to the bone was determined in a loading experiment with Roentgenstereo-Photogrammatic Analysis (RSA). Owing to two loosenings and two fractures, only one 6-wk specimen and three 12-wk specimens were available for mechanical testing. The prostheses were very stable at 12 wk. The most important movements were axial rotation (maximal 0.17 degrees at 800 N) and subsidence (maximal 0.036 mm at 800 N). After unloading, there was 40-60% elastic recovery. Histological examination showed revascularization and remodelling of the graft in all the specimens investigated. At the graft site, bone apposition and bone resorption had resulted in a mixture of graft and new bone. Bone incorporation was mainly seen in the proximal areas. Graft lysis was evident in the midshaft region and at distal levels around the prostheses.

Animals↗
PubMed1996

Osteocyte density changes in aging and osteoporosis.

Recently, it was suggested that osteocytes are involved in the regulation of bone remodeling. We have examined human trabecular bone of the iliac crest of fracture patients and control subjects to determine if osteoporosis is associated with changes in osteocyte density or osteocyte death. The relationships of these parameters with age was also investigated. It was found that osteocyte death was not related to age, nor was it increased in osteoporosis compared with the controls. In healthy adults ranging from 30 to 91 years, lacunar number per bone area decreases with advancing age, from about 210/mm(2) to 150/mm(2). Significantly higher lacunar and osteocyte numbers per bone tissue volume were found in osteoporotics than in controls (17,100 lacunae/mm(3) and 13,300 osteocytes/mm(3) vs. 12,900 lacunae/mm(3) and 10,500 osteocytes/mm(3), respectively), whereas lacunar area was significantly reduced in osteoporotics (from 44.1 mu m(3) to 39.1 mu m(2)). These findings are compatible with the hypothesis that, in osteoporosis, osteoblasts produce less bone per cell. This can in turn explain the reduced wall thickness, which has previously been described as characteristic for osteoporosis.

Adult↗
PubMed1996

Acetabular and femoral reconstruction with impacted graft and cement.

Loosening of primary cemented and noncemented components of total hip arthroplasties always is accompanied by a loss of bone stock. There are several options for reconstruction of the acetabular and femoral defects. The authors' treatment of choice is a standardized cemented revision procedure with tight impaction of morsellized cancellous autograft or allograft chips in acetabular and femoral reconstructions. In this study, the clinical and radiographic evaluation of acetabular defects reconstructed with impacted morsellized allograft femoral heads was described. A cemented cup supplemented with morsellized cancellous grafts and wire meshes in cases of segmental defects was sufficiently stable to allow for complete graft consolidation. After a mean followup of 70 months of 88 hips, 4 cases of clinical failures (including 1 infection) and 6 cases of radiologic failure of the reconstructions were observed, resulting in a failure percentage of 11.4% after 5 years. Autografts and allografts were equally effective. Because the clinical success of the technique also was supported by the results of histologic and biomechanic studies in animals, the authors were encouraged to continue this technique, not only in the acetabulum, but also in the femur.

Acetabulum↗
PubMed1996

Mechanical effects of stem cement interface characteristics in total hip replacement.

Stem cement debonding is 1 of the most common forms of fixation failure and is thought to be a prelude to gross loosening of a total hip reconstruction. However, the immediate consequences of debonding remains a matter of controversy. The dynamic effects of stem cement debonding in total hip reconstruction were analyzed using 3-dimensional finite element techniques. Stem cement interface conditions were assumed as completely bonded or unbonded, with or without friction. The dynamic effects were accounted for, as presented by the stance and swing phases of the gait cycle. It was found that both cyclic micromotions at the stem cement interface and stresses in the cement mantle were effectively reduced by friction. The friction cases produced failure probabilities of the cement mantle that were relatively close to the one generated by the bonded stem. The probability of mechanical failure of the cement bone interface decreased after debonding and decreased more with reduced stem cement friction. These results show that, although a firm and lasting bond between stem and cement may be desirable for preventing cement failure, the mechanical effects of a debonded stem are less detrimental than were assumed earlier. For straight tapered stem shapes subjected to the loading conditions described, a polished stem may be desirable for the cement bone interface mechanics.

Bone Cements↗
PubMed1996

Microdamage and osteocyte-lacuna strain in bone: a microstructural finite element analysis.

Damage accumulation in living tissues occurs when the rate of damage formation is greater than the rate of damage repair. For very large increases in the loading rate of bones, this can result in "stress fractures" due to the growth and coalescence of fatigue related microdamage. At lower increases of loading rates, the damage accumulation process is halted because there is time for adaptive bone-remodeling to occur in response to the new load. However, it is not known if there is a relationship between microdamage and bone remodeling per se. One hypothesis for the control of bone remodeling is that osteocytes sense strains and mediate osteoblastic and osteoclastic activity. The purpose of this study was to investigate whether damage generates strains which may trigger bone remodeling. If this were true, then accumulative damage would cause adaptive bone remodeling. This study applies the methods of finite element analysis to determine the effect of observed damage mechanisms on the proposed sensors of remodeling in Haversian bone. Individual lamellae are modeled and osteocyte-lacunae are included in a generalized plane strain geometric representation. It is predicted that microdamage alters the local deformation behavior around lacunae, and that the changes increase as microdamage accumulates. Hence, if damage accumulates in a bone, it could be sensed as a change in strain at a microstructural level. The results give theoretical support to the experimental studies that have shown a correlation between microdamage and the initiation of resorption as a first step in bone remodeling.

Bone Remodeling↗