Biomedical subjects

R Huiskes

Publications and source records attributed to R Huiskes.

At least 109 records · Page 6Linked to original sources

PubMed1996

Relation of ligament damage with site specific cartilage loss and osteophyte formation in collagenase induced osteoarthritis in mice.

OBJECTIVE: To investigate the correlation between initial ligament damage and development of subsequent osteoarthritic changes. METHODS: Collagenase was injected intraarticularly into the knee joint of mice of strain C57B16 or C57B110. After 3 days, ligament damage was evaluated by measurements of knee laxity in the anterior-posterior direction as a measure of cruciate ligament function, and in the varus-valgus direction as a measure of collateral ligament function. The amount and location of cartilage loss and osteophyte formation were determined at Day 42. RESULTS: Significant correlations between the amount of laxity changes and the severity of cartilage loss (r = 0.78), the amount of laxity changes and the size of osteophytes (r = 0.87), and between the severity of cartilage loss and osteophyte size (r = 0.94) were demonstrated. The amount of cartilage loss and the degree of osteophyte formation at the medial side of the joint depended mainly on the severity of cruciate ligament damage. This is contrast to changes at the lateral side of the joint, which appeared not to be associated with the severity of ligament damage. CONCLUSION: A strong relationship exists between the severity of cruciate ligament damage and the severity of osteoarthritic changes on the medial side of the joint. In the lateral joint compartment, prone to spontaneous osteoarthritis in the mouse strain studied, this relation is absent.

Animals↗

PubMed1996

Subsidence of THA stems due to acrylic cement creep is extremely sensitive to interface friction.

Acrylic cement, used to fixate total hip arthroplasty (THA), creeps under dynamic and static loading conditions. As a result, THA stems which are debonded from the cement, may gradually subside, depending on their shape and surface roughness. The purpose of this study was to evaluate the relationship among dynamic load, creep characteristics, interface friction, and subsidence patterns. A laboratory model consisting of a metal tapered cone, surrounded by a cement mantle, was developed. The cone was gradually compressed in the cement by a dynamic, sinusoidal axial force, cycling between 0 and 7 kN for 1.7 million cycles at a frequency of 1 Hz. Subsidence and cement strain were monitored. Two tapers were tested in this way. The relationships among subsidence, creep properties and interface friction were evaluated from a finite element (FE) model, used to simulate the experiments. In this model, the creep properties obtained in dynamic and static, tension and compression experiments measured earlier, were used. The subsidence patterns of both tapers were similar, but one subsided more than the other (380 vs 630 microns). Both subsided stepwise instead of continuous, with a frequency much smaller than that of the applied load. The characteristics of the subsidence and cement-strain patterns could be reproduced by the FE model, but not with great numerical precision. The stepwise subsidence could be explained by slip-stick mechanisms at the interface starting distally and gradually working towards proximal. Variations in friction from 0.25 to 0.50 reduced the total subsidence and the step frequency by about 50%. It was concluded that FE-models used to simulate the mechanical endurance characteristics of THA reconstructions, extended to incorporate cement creep, produce realistic results. These results showed that prosthetic subsidence under dynamic loads occurs due to cement creep. The extent of the subsidence is extremely sensitive to interface friction, hence to small variations in surface roughness and cement constitution. This may explain the relatively large variation of in vivo prosthetic subsidence rates reported in the literature.

Acrylic Resins↗

PubMed1996

A global verification study of a quasi-static knee model with multi-bundle ligaments.

The ligaments of the knee consist of fiber bundles with variable orientations, lengths and mechanical properties. In concept, however, these structures were too often seen as homogeneous structures, which are either stretched or slack during knee motions. In previous studies, we proposed a new structural concept of the ligaments of the knee. In this concept, the ligaments were considered as multi-bundle structures, with nonuniform mechanical properties and zero force lengths. The purpose of the present study was to verify this new concept. For this purpose, laxity characteristics of a human knee joint were compared as measured in an experiment and predicted in a model simulation study. In the experiment, the varus-valgus and anterior-posterior laxities of a knee-joint specimen containing the ligaments and the articular surfaces only, were determined. From this knee-joint, geometric and mechanical parameters were derived to supply the parameters for a three-dimensional quasi-static knee-joint model. These parameters included (i) the three-dimensional insertion points of bundles, defined in the four major knee ligaments, (ii) the mechanical properties of these ligament, as functions of their relative insertion orientations and (iii) three-dimensional representations of the articular surfaces. With this model the experiments were simulated. If knee-model predictions and experimental results agree, then the multi-bundle ligament models are validated, at least with respect to their functional role in anterior-posterior and varus-valgus loading of the joint. The model described the laxity characteristics in AP-translation and VV-rotation of the cadaveric knee-joint specimen reasonably well. Both display the same patterns of laxity changes during knee flexion. Only if a varus moment of 8 N m was applied and if the tibia was posteriorly loaded, did the model predict a slightly higher laxity than that measured experimentally. From the model-experiment comparisons it was concluded that the proposed structural representations of the ligaments and their mechanical property distributions seem to be valid for studying the anterior-posterior and varus-valgus laxity characteristics of the human knee-joint.

Biomechanical Phenomena↗

PubMed1995

Dynamic creep behavior of acrylic bone cement.

Recent studies concerning the fixation of cemented total hip arthroplasty (THA) have led to new hypotheses about the dynamic, long-term failure mechanisms leading to prosthetic loosening. As a result, the long-term mechanical behavior of acrylic bone cement has gained more interest since little is known about these properties. In this study, the dynamic, compressive creep deformation of acrylic bone cement was examined. An amount of creep was found, with creep strains exceeding the elastic strain during 14 x 10(6) loading cycles. There was a linear relationship between the logarithmic values of the number of loading cycles and the creep strain. The effect of stress level on the amount of creep was different from that in results of static experiments reported in the literature. Comparing the results with tensile creep experiments revealed that bone cement under a tensile load creeps much quicker than under a compressive one. Young's modulus was significantly higher when the material was loaded at higher strain rates. The bone cement became stiffer with an increasing number of loading cycles. The creep behavior of bone cement is important for the long-term behavior of cemented THA. It enables subsidence of the stem and attenuation of stress peaks in the cement mantle.

Acrylates↗

PubMed1995

Proposal for the regulatory mechanism of Wolff's law.

It is currently believed that the trabecular structure in bone is the result of a dynamic remodeling process controlled by mechanical loads. We propose a regulatory mechanism based on the hypothesis that osteocytes located within the bone sense mechanical signals and that these cells mediate osteoclasts and osteoblasts in their vicinity to adapt bone mass. A computer-simulation model based on these assumptions was used to investigate if the adaptation of bone, in the sense of Wolff's law, and remodeling phenomena, as observed in reality, can be explained by such a local control process. The model produced structures resembling actual trabecular architectures. The architecture transformed after the external loads were changed, aligning the trabeculae with the actual principal stress orientation, in accordance with Wolff's trajectorial hypothesis. As in reality, the relative apparent density of the structure depended on the magnitude of the applied stresses. Osteocyte density influenced the remodeling rate, which also is consistent with experimental findings. Furthermore, the results indicated that the domain of influence of the osteocytes affects the refinement of the structure as represented by separation and thickness of the struts. We concluded that the trabecular adaptation to mechanical load, as described by Wolff, can be explained by a relatively simple regulatory model. The model is useful for investigating the effects of physiological parameters on the development, maintenance, and adaptation of bone.

Adaptation, Physiological↗

PubMed1995

Laxity characteristics of normal and pathological murine knee joints in vitro.

The aim of this study was to validate a device developed previously to measure laxity of murine knee joints and to investigate whether experimentally induced pathological conditions result in measurable laxity. The laxity characteristics of normal murine knee joints were derived from measurements of 25 left knees of normal mice. Reproducible, nonlinear s-shaped load-displacement curves were determined, and parameters of anterior-posterior translation, varus-valgus rotation, and compliance were calculated from the curves. No differences were found between the left and right knee joints of eight mice. The average displacement between 0.8 N of anterior force and 0.8 N of posterior force was 0.47 +/- 0.10 mm. The endpoint compliances for anterior and posterior displacements were 0.16 +/- 0.03 and 0.16 +/- 0.04 mm/N, respectively. The average rotation between a 4 Nmm valgus moment and a 4 Nmm varus moment was 17.4 +/- 3.3 degrees. The endpoint compliances for varus and valgus rotations were 1.1 +/- 0.7 and 1.0 +/- 0.3 degrees/Nmm, respectively. Storage of the joints at -70 degrees C had no effect on laxity. We also studied the parameters of laxity after pathology of the knee joint was induced. Zymosan-induced or antigen-induced arthritis did not increase laxity of the joint. In an osteoarthritis model induced by injection of collagenase, laxity was markedly increased. In conclusion, laxity in the knees of mice can be measured reproducibly and changes in the characteristics of laxity due to pathological conditions can be quantified.

Animals↗

PubMed1995

The effect of variable relative insertion orientation of human knee bone-ligament-bone complexes on the tensile stiffness.

In order to evaluate the contribution of the knee ligaments to restrain joint motions, knowledge about their structural properties is required. Due to the variable relative insertion orientation of the ligaments during knee motion, however, different fiber bundles are recruited, each with their specific mechanical properties. Hence, the structural properties vary as a function of knee motion. For this reason, a relationship between the structural tensile properties and the relative insertion orientation is required in order to define the role of the ligaments in knee mechanics. In the present study, this relationship is determined by performing a series of tensile tests in which the relative orientations of the insertion sites of human knee bone-ligament-bone preparations were varied systematically. The experimentally obtained stiffness was significantly affected by the relative orientation of the insertion sites, but more profoundly for the anterior and posterior cruciate ligaments (ACL and PCL) as compared to the medial and lateral collateral ligaments (MCL and LCL). The average decreases in stiffness per 5 degrees tilt of the insertion sites were estimated at -11.6 +/- 3.5 N mm-1 (ACL), -20.9 +/- 2.7 N mm-1 (PCL), -2.6 +/- 0.9 N mm-1 (MCL) and -3.7 +/- 0.3 N mm-1 (LCL). For the PCL and the MCL these changes in stiffness with tilt were rather insensitive to the side of the femoral insertion site which was lifted. The ACL and the LCL, conversely, displayed significant differences in stiffness changes between the different tilt directions.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1995

Load transfer across the pelvic bone.

Earlier experimental and finite element studies notwithstanding, the load transfer and stress distribution in the pelvic bone and the acetabulum in normal conditions are not well understood. This hampers the development of orthopaedic reconstruction methods. The present study deals with more precise finite element analyses of the pelvic bone, which are used to investigate its basic load transfer and stress distributions under physiological loading conditions. The analyses show that the major part of the load is transferred through the cortical shell. Although the magnitude of the hip joint force varies considerably, its direction during normal walking remains pointed into the anterior/superior quadrant of the acetabulum. Combined with the fact that the principal areas of support for the pelvic bone are the sacro-iliac joint and the pubic symphysis, this caused the primary areas of load transfer to be found in the superior acetabular rim, the incisura ischiadaca region and, to a lesser extent, the pubic bone. Due to the 'sandwich' behavior of the pelvic bone, stresses in the cortical shell are about 50 times higher than in the underlying trabecular bone (15 to 20 MPa vs 0.3-0.4 MPa at one-legged stance). Highest intraarticular pressures are found to occur during one-legged stance and measured about 9 MPa. During the swing phase, these pressures decrease less than linearly with the magnitude of the hip joint force. Muscle forces have a stabilizing effect on the pelvic load transfer. Analysis without muscle forces show that at some locations stresses are actually higher than when muscle forces are included.

Acetabulum↗

PubMed1995

The biomechanics of the human patella during passive knee flexion.

The fundamental objectives of patello-femoral joint biomechanics include the determination of its kinematics and of its dynamics, as a function of given control parameters like knee flexion or applied muscle forces. On the one hand, patellar tracking provides quantitative information about the joint's stability under given loading conditions, whereas patellar force analyses can typically indicate pathological stress distributions associated for instance with abnormal tracking. The determination of this information becomes especially relevant when facing the problem of evaluating surgical procedures in terms of standard (i.e. non-pathological) knee functionality. Classical examples of such procedures include total knee replacement (TKR) and elevation of the tibial tubercle (Maquet's procedure). Following this perspective, the current study was oriented toward an accurate and reliable determination of the human patella biomechanics during passive knee flexion. To this end, a comprehensive three-dimensional computer model, based on the finite element method, was developed for analyzing articular biomechanics. Unlike previously published studies on patello-femoral biomechanics, this model simultaneously computed the joint's kinematics, associated tendinous and ligamentous forces, articular contact pressures and stresses occurring in the joint during its motion. The components constituting the joint (i.e. bone, cartilage, tendons) were modeled using objective forms of non-linear elastic materials laws. A unilateral contact law allowing for large slip between the patella and the femur was implemented using an augmented Lagrangian formulation. Patellar kinematics computed for two knee specimens were close to equivalent experimental ones (average deviations below 0.5 degrees for the rotations and below 0.5 mm for the translations) and provided validation of the model on a specimen by specimen basis. The ratio between the quadriceps pulling force and the patellar tendon force was less than unity throughout the considered knee flexion range (30-150 degrees), with a minimum near 90 degrees of flexion for both specimens. The contact patterns evolved from the distal part of the retropatellar articular surface to the proximal pole during progressive flexion. The lateral facet bore more pressure than the medial one, with corresponding higher stresses (hydrostatic) in the lateral compartment of the patella. The forces acting on the patella were part of the problem unknowns, thus leading to more realistic loadings for the stress analysis, which was especially important when considering the wide range of variations of the contact pressure acting on the patella during knee flexion.

Algorithms↗

PubMed1995

A new method to determine trabecular bone elastic properties and loading using micromechanical finite-element models.

The apparent mechanical behavior of trabecular bone depends on properties at the tissue or trabecular level. Many investigators have attempted to determine trabecular tissue properties and loading. However, accuracy and applicability of all methods reported are limited. The small size of the trabeculae and a possible size effect are complicating factors when using traditional testing methods on single trabeculae. Other methods reported, using models that describe the trabecular structure, are of limited value because they consider bone as a repetitive structure in order to describe a reasonably large region of bone. The present study introduces a new finite-element method strategy that enables analysis of reasonably large regions of trabecular bone in full detail. The method uses three-dimensional serial reconstruction techniques to construct a large-scale FE model, by directly converting voxels to elements. A 5 mm cube of trabecular bone was modeled in this way, resulting in a FE model that consists of 296,679 elements. Special strategies were developed to solve the set of equations that results from the FE approach. Using this model in combination with experimental apparent data taken from the literature, the upper and lower boundaries for the tissue modulus were calculated to be 10.1 and 2.23 GPa, respectively. From the local stress and strain distributions it was concluded that the deformation mode of the trabeculae in the present cube was predominantly in bending. It was concluded that the method developed offers new perspectives for the study of trabecular bone.

Algorithms↗

PubMed1995

Development and validation of a three-dimensional finite element model of the pelvic bone.

Due to both its shape and its structural architecture, the mechanics of the pelvic bone are complex. In Finite Element (FE) models, these aspects have often been (over)simplified, sometimes leading to conclusions which did not bear out in reality. The purpose of this study was to develop a more realistic FE model of the pelvic bone. This not only implies that the model has to be three-dimensional, but also that the thickness of the cortical shell and the density distribution of the trabecular bone throughout the pelvic bone have to be incorporated in the model in a realistic way. For this purpose, quantitative measurements were performed on computer tomography scans of several pelvic bones, after which the measured quantities were allocated to each element of the mesh individually. To validate this FE model, two fresh pelvic bones were fitted with strain gages and loaded in a testing machine. Stresses calculated from the strain data of this experiment were compared to the results of a simulation with the developed pelvic FE model.

Aged↗

PubMed1995

Preclinical testing of total hip stems. The effects of coating placement.

The long-term fixation endurance of noncemented hip stems in total hip arthroplasty is subject to incompatible design goals. To reduce stress shielding and periprosthetic bone loss, proximal fixation and load transfer are indicated. However, to prevent interface motion and promote interface-bonding security, fixation preferably should be maximized over the entire stem surface. In this study, the authors questioned whether hydroxyapatite coatings could be applied in patterns that reduce bone resorption, while maintaining safe interface stress levels. For that purpose, strain-adaptive bone-remodeling theory was applied in 3-dimensional finite element models, to simulate the long-term postoperative bone resorption process. During the process, the adaptation of interface stresses was monitored, and its effects on interface failure probability evaluated. This analysis was done for a fully coated stem, a 1/3 proximally coated stem, a smooth uncoated, press-fitted stem, and a stem with 5 proximal patches of circumferential stripes. The uncoated stem reduced bone loss dramatically, but promoted interface motions and distal pedestal formation. In all cases, the gradual bone-remodeling process increased the interface security of the coated stems. Bone loss and interface failure probability were not very different for the fully and 1/3-coated stems. Stripe coating reduced bone resorption considerably, while increasing long-term interface failure probability only slightly. The investigators concluded that the initial stability and the ingrowth potential of such a stem design are likely to be inadequate.

Bone Density↗

PubMed1995

The fibre bundle anatomy of human cruciate ligaments.

The cruciate ligaments of the knee consist of numerous fascicles, groups of which comprise fibre bundles. The stabilising function of these ligaments is established by changes in the lengths and orientations of the fascicles. Understanding the function of knee ligaments thus requires an understanding of their 3-dimensional fascicle architecture. Hitherto, the cruciate ligaments have been considered functionally as single-dimensional 'ropes' or, at the most, as consisting of anterior and posterior parts. It is evident from the appearance of these ligamentous structures, however, that fascicles in more than 2 directions are present. This study investigated how many and which fibre bundles are minimally needed to preserve the main fascicle directions in the ligaments. An anatomical analysis of the cruciate ligaments was performed using a 3-dimensional measuring device. Three anterior and 3 posterior cruciate ligaments were isolated and their fascicles measures. Based on the courses of the fascicles, fibre bundles were defined, dissected bluntly, and their corresponding insertion sites measured. Finally, the insertion sites of the bundles were connected into straight-line representations by a computer and transformed to the anatomical position of the knee, so as to be useful for functional analyses of the ligaments. It was found that 6-10 bundles are sufficient to represent the main fascicle directions of the ligaments. Although the number of fibre bundles is not identical for all ligaments, the femur and the tibia are connected in a consistent way by these bundles. Even the ways in which the fibre bundles change their interrelationship from the femoral to the tibial insertion sites are comparable. The results serve as a detailed anatomical basis for functional analyses of the cruciate ligaments.

Anterior Cruciate Ligament↗

PubMed1994

Creep behavior of hand-mixed Simplex P bone cement under cyclic tensile loading.

Acrylic cement, used for the fixation of total hip replacements and other orthopedic implants, is a subject of renewed scientific interest as a result of recent hypotheses about dynamic, long-term mechanical failure mechanisms suspected to play a role in prosthetic loosening. Little is known, however, about the long-term mechanical behavior of cement. In this study, the dynamic creep deformation of hand mixed acrylic cement was examined in laboratory tests. Strain patterns found represented the familiar creep process consisting of a primary, a secondary, and a tertiary creep phase. Specimens dynamically loaded with a maximum stress of 3 MPa from 0 were subject to creep of about 50% of the elastic strain after 250 000 loading cycles. A linear relationship between the logarithmic values of the creep-strain and the number of loading cycles was found. Specimens exposed to higher loads showed significantly higher creep-strains. No relationship could be established between the strain levels and the porosity of the specimens. Specimens dynamically loaded with a maximal stress of 7 or 11 MPa from 0 failed during the tests. The number of loading cycles to failure was similar to fatigue strength data reported in earlier literature.

Acrylic Resins↗

PubMed1994

Nonuniform distribution of collagen density in human knee ligaments.

It is generally recognized that the mechanical properties of soft connective tissues are affected by their structural components. We documented collagen density distributions in human knee ligaments to quantify differences in density within and between these ligaments. In order to explain the variations in mechanical properties within and between different knee ligaments as described in the literature, the distributions of collagen density were correlated with these biomechanical findings. Human knee ligaments were shown to be nonhomogeneous structures with regard to collagen density. The anterior bundles of all ligaments contained significantly more collagen mass per unit of volume than the posterior bundles did. The percentage differences between the anterior and posterior bundles, in relation to the posterior bundles, were about 25% for the anterior cruciate ligament (ACL) and the collateral ligaments and about 10% for the posterior cruciate ligament (PCL). Along the cruciate ligaments, the central segments had higher collagen densities than did segments adjacent to the ligament insertions (ACL 9%, PCL 24%). The collagen density in the ACL was significantly lower than that in the other ligaments. These variations within and between the ligaments correlate well with the variations in mechanical properties described in the literature; however, other structural differences have to be taken into account to fully explain the variations in mechanical properties from the structural components.

Aged↗

PubMed1994

A physiological approach to the simulation of bone remodeling as a self-organizational control process.

Although the capacity of bone to adapt to functional mechanical requirements has been known for more than a century, it is still unclear how the bone adaptation processes are regulated. We hypothesize that osteocytes are sensitive to mechanical loading and control the regulation of bone mass in their environment. Recently, simulation models of such a process were developed, using the finite element method. It was discovered that these models produce discontinuous structures, not unlike trabecular bone. However, it was also found that severe discontinuities violate the continuum assumption underlying the finite element method and that the solutions were element mesh dependent. We have developed a simulation model (which is physiologically and mechanically more consistent) which maintains the self-organizational characteristics but does not produce these discontinuities. This was accomplished by separating the sensor density and range of action from the mesh. The results clearly show that predicted trabecular morphology, i.e. sizes and branching of struts, depend on the actual relationship between local load, sensor density and range of influence. We believe that the model is suitable to study the relationship between trabecular morphology and load and can also explain adaptation of morphology, in the sense of 'Wolff's law'.

Adaptation, Physiological↗

PubMed1994

Prestresses around the acetabulum generated by screwed cups.

Screwed acetabular cups, applied in total hip replacements, generate stresses in the surrounding bone during implantation (prestresses). The effect of these prestresses on the endurance of the hip replacement are unknown. The prestresses in the acetabulum were examined both experimentally, using strain gauge techniques, and numerically, using the finite element method. It was found that the prestresses were of the same order of magnitude, if not larger, than the stresses due to the hip reaction force during one-legged stance. In some cases, the prestresses even approximated the ultimate tensile strength of cortical bone. The prestresses seemed to have a strong dependence on the outer shape of the cup, rather than on the flexibility of the cup or whether the cup had a self-cutting thread or not. Furthermore, it was found that the prestresses are not very susceptible to stress relaxation due to the visco-elastic behaviour of bone. This means that prestresses will remain present over long periods of time. So even when a patient has resumed normal daily activities, the prestresses will still play an important role in the overall stress distributions around the acetabulum. Due to the interaction of prestresses and stresses due to normal loading, the primary stability of a metal-backed screwed cup is better guaranteed than the primary stability of an all-polyethylene screwed cup.

Acetabulum↗

PubMed1994

The in-vivo effects of an intramedullary implant evoking a constant radial stress to bone. An animal study in the tibia of the goat.

Initial stability is essential for successful bone ingrowth into non-cemented prostheses. An entire new concept to increase the initial stability directly after implantation of intramedullary stems was developed (the tension rod prosthesis). The concept is based on a tension rod made out of memory metal that pulls a proximal stem of a prosthesis towards a distal anchor with a constant force. The stress generated along the long axis of the bone produces a radial stress around the prosthesis in the proximal femur. The main goal of this design is to increase the primary stability of the prosthesis during the ingrowth phase and to prevent stress shielding and bone resorption, as realized by the radial force applied to the proximal endosteum of the bone. To assess the efficacy of this concept and to collect data for the anchor design, an implant was developed for implantation into the tibia of the goat. Analyses of push-out strength and bone reactions were performed postoperatively. After 48 weeks the push-out strength of this implant was increased and the histological evaluation showed almost complete osseousintegration. Histomorphometrical analysis showed pronounced, permanent periosteal reactions, located around the anchor of the implant, which generates the radial stress. These first results showed that the bone can withstand the radial stress provoked by the anchor of the tension rod. It is concluded that the concept of a tension rod prosthesis is viable.

Animals↗