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Biomedical subjects

W C Hayes

Publications and source records attributed to W C Hayes.

At least 37 records · Page 2Linked to original sources
PubMed1998

Fluorescence-aided detection of microdamage in compact bone.

En bloc staining with basic fuchsin is an established method for demonstrating microdamage in bone. Using transmitted light microscopy, variations in light intensity, depth of focus and magnification are necessary to distinguish fully-stained microcracks generated in vivo, from partially-stained or unstained artefactual cracks due to cutting and machining. This process is both difficult and time-consuming. In this study, 2 methods were used to examine fuchsin-stained microcracks in human rib sections, transmitted light and epifluorescence microscopy. No differences were found in crack number, density or length between the 2 methods indicating comparable accuracy. Using green epifluorescence, only microcracks containing fuchsin fluoresced orange against the darkfield background, enabling unstained, artefactual cracks to be screened out. Under UV epifluorescence, microcracks stained through the full 100 microm depth of the section fluoresced purple. Partially-stained artefactual cracks failed to fluoresce and were screened out. Epifluorescence is a simple, rapid and accurate screening method for differentiating fully-stained from artefactual microcracks in bone.

Aged↗
PubMed1998

Creep contributes to the fatigue behavior of bovine trabecular bone.

Repetitive, low-intensity loading from normal daily activities can generate fatigue damage in trabecular bone, a potential cause of spontaneous fractures of the hip and spine. Finite element models of trabecular bone (Guo et al., 1994) suggest that both creep and slow crack growth contribute to fatigue failure. In an effort to characterize these damage mechanisms experimentally, we conducted fatigue and creep tests on 85 waisted specimens of trabecular bone obtained from 76 bovine proximal tibiae. All applied stresses were normalized by the previously measured specimen modulus. Fatigue tests were conducted at room temperature; creep tests were conducted at 4, 15, 25, 37, 45, and 53 degrees C in a custom-designed apparatus. The fatigue behavior was characterized by decreasing modulus and increasing hysteresis prior to failure. The hysteresis loops progressively displaced along the strain axis, indicating that creep was also involved in the fatigue process. The creep behavior was characterized by the three classical stages of decreasing, constant, and increasing creep rates. Strong and highly significant power-law relationships were found between cycles-to-failure, time-to-failure, steady-state creep rate, and the applied loads. Creep analyses of the fatigue hysteresis loops also generated strong and highly significant power law relationships for time-to-failure and steady-state creep rate. Lastly, the products of creep rate and time-to-failure were constant for both the fatigue and creep tests and were equal to the measured failure strains, suggesting that creep plays a fundamental role in the fatigue behavior of trabecular bone. Additional analysis of the fatigue strain data suggests that creep and slow crack growth are not separate processes that dominate at high and low loads, respectively, but are present throughout all stages of fatigue.

Animals↗
PubMed1998

Micro-compression: a novel technique for the nondestructive assessment of local bone failure.

Many bones within the axial and appendicular skeleton are subjected to repetitive, cyclic loading during the course of ordinary daily activities. If this repetitive loading is of sufficient magnitude or duration, fatigue failure of the bone tissue may result. In clinical orthopedics, trabecular fatigue fractures are observed as compressive stress fractures in the proximal femur, vertebrae, calcaneus and tibia, and are often preceded by buckling and bending of microstructural elements. However, the relative importance of bone density and architecture in the etiology of these fractures is poorly understood. The aim of the study was to investigate failure mechanisms of 3D trabecular bone using micro-computed tomography (microCT). Because of its nondestructive nature, microCT represents an ideal approach for performing not only static measurements of bone architecture but also dynamic measurements of failure initiation and propagation as well as damage accumulation. For the purpose of the study, a novel micro-compression device was devised to measure loaded trabecular bone specimens directly in a micro-tomographic system. The measurement window in the device was made of a radiolucent, highly stiff plastic to enable X-rays to penetrate the material. The micro-compressor has an outer diameter of 19 mm and a total length of 65 mm. The internal load chamber fits wet or dry bone specimens with maximal diameters of 9 mm and maximal lengths of 22 mm. For the actual measurement, first, the unloaded bone is measured in the microCT. Second, a load-displacement curve is recorded where the load is measured with an integrated mini-button load cell and the displacement is computed directly from the microCT scout-view. For each load case, a 3D snap-shot of the structure under load is taken providing 34 microm nominal resolution. Initial measurements included specimens from bovine tibiae and whale spine to investigate the influence of the structure type on the failure mechanism. In a rod-like type of architecture as seen in the whale spine, structural failure was described by an initial buckling and bending of structural elements followed by a collapse of the overloaded trabeculae. In the more plate-like bovine tibial architecture, buckling and bending could not be observed. Failure rather seemed to occur instantaneously. In conclusion, micro-compression in combination with 3D microCT allows visualization of failure initiation and propagation and monitoring of damage accumulation in a nondestructive way. We expect these findings to improve our understanding of the relative importance of density, architecture and load in the etiology of spontaneous fractures of the hip and the spine. Eventually, this improved understanding may lead to more successful approaches to the prevention of age-related fractures.

Animals↗
PubMed1998

Tibiofemoral contact pressures in degenerative joint disease.

Using tibiofemoral joints from older (age, 53-80 years) human cadavers with articular cartilage degeneration, contact pressures and contact areas were measured in the extended knee in four conditions: (1) neutral alignment; (2) 5 degrees varus (simulating single limb stance of gait); (3) 5 degrees valgus; and (4) after a 5 degrees proximal tibial closing wedge valgus osteotomy. In degenerated cartilage, contact pressures were reduced at the lesion sites and were high on the borders of the lesions. No statistically significant changes occurred in contact pressures and areas when values from neutral loading were compared with values during loading in each of the other three conditions. Lateral average and maximum contact pressures were less in varus loading than in valgus loading. Equal medial and lateral contact pressures during varus loading, in contrast to lower medial than lateral contact pressures in the other three loading, supports the theory that the varus moment imposed on the knee in single limb stance could be a mechanism causing medial tibiofemoral osteoarthritis. The 5 degrees valgus osteotomy resulted in contact pressures similar to those in neutral loading. These experiments do not support the value of the 5 degrees valgus osteotomy in reducing contact pressures on the medial tibial plateau.

Aged↗
PubMed1997

Ex vivo degradation of a poly(propylene glycol-fumarate) biodegradable particulate composite bone cement.

We have developed a biodegradable particulate composite bone cement consisting of a poly(propylene glycolfumarate)-(methylmethacrylate) matrix mixed with calcium carbonate and tricalcium phosphate particulates. Previous ex vivo studies suggest that this system provides sufficient strength for a number of potential clinical applications including structural reinforcement of osseous defects, internal fixation devices for age-related fractures, and delivery of antibiotics to treat osteomyelitis. As a first step toward investigating in vivo responses to this material, we studied the influence of varied concentrations of crosslinker, accelerator, and free radical on the mechanical properties of the cement. We then developed an ex vivo degradation assay and correlated the mechanical properties of degrading cement with the temporal changes in chemical properties of both the cement and the bathing medium. The optimal cement formulation was composed of one-third poly(propylene glycolfumarate)-(methylmethacrylate), one-third calcium carbonate, and one-third tricalcium phosphate, and provided initial compressive strengths of up to 30 MPa and compressive moduli of up to 300 MPa. Degradation rates, measured by a decline in mechanical properties, dissolution of calcium from the cement, and change in pH of the bathing medium, could be controlled by changing the concentration of reactants in the matrix. Specifically, an increase in methylmeth-acrylate or increase in both methylmethacrylate and benzoyl peroxide was inversely proportional to the rate of degradation and directly proportional to the initial mechanical properties. The degradation products and environmental changes appear to be compatible with physiologic remodeling and therefore justify examination of the in vivo response to implantation of this material.

Analysis of Variance↗
PubMed1997

Load sharing between the shell and centrum in the lumbar vertebral body.

STUDY DESIGN: A finite element parametric analysis to investigate the relative load carrying roles of the shell and centrum in the lumbar vertebral body. OBJECTIVE: To address the issue of the structural role of the vertebral shell and clarify some of the contradictions raised by previous studies. SUMMARY OF BACKGROUND DATA: A number of experimental and finite element studies have attempted to quantify the relative structural roles of the shell and centrum, but these studies support no consensus on the relative contribution of the shell to vertebral body strength. METHODS: The authors developed finite element models to predict the fraction of the total compressive force acting on the lumbar vertebral body that is carried by the shell. Parametric variations were investigated to determine how the fraction of shell force was affected by changes in shell thickness, shell and centrum modulus, centrum anistropy, and loading conditions. RESULTS: The fraction of compressive force carried by the shell increased from approximately 0 at the endplate to approximately 0.2 at the mid-transverse plane for a typical case. The shell force was highly sensitive to the degree of anisotropy of the trabecular centrum but was relatively insensitive to changes in shell thickness and the ratio of shell-to-centrum elastic modulus. CONCLUSIONS: The conflicting conclusions of previous studies about the structural roles of the vertebral shell and centrum can be explained by differences in their methods. Our findings support the claims that the shell accounts for only approximately 10% of vertebral strength in vivo and that the trabecular centrum is the dominant structural component of the vertebral body.

Biomechanical Phenomena↗
PubMed1997

Biomechanical effects of operative nerve mobilization and transposition in a canine ulnar nerve model.

The purpose of this study was to evaluate the effects that operative mobilization and transposition of the ulnar nerve have on both neural excursion and mechanical properties. Twelve dogs underwent ulnar nerve transposition and postoperative casting. Four animals were killed at 3 weeks and four animals were killed at 6 weeks. Four animals had their casts removed at 3 weeks, were allowed to ambulate, and were killed at 6 weeks. Operated and contralateral control nerves were compared. Neural excursion was measured near the elbow and 12 cm proximally. The nerves were harvested and their mechanical properties determined. Repeated measures analysis of variance revealed significant differences in longitudinal excursion between control and experimental groups at both sites. Ultimate strain, ultimate strength, and modulus were significantly reduced in the experimental groups. No differences were seen in cross-sectional area or stiffness between control and experimental groups. Analysis revealed no independent effect of the rehabilitation method. Results of this study indicate that significant changes in neural excursion, ultimate strain, ultimate strength, and modulus occur following ulnar nerve mobilization and transposition and that these changes persist throughout the early postoperative period.

Analysis of Variance↗
PubMed1997

Self-paced resistance training and walking exercise in community-dwelling older adults: effects on neuromotor performance.

BACKGROUND: Resistance-training intervention studies have demonstrated meaningful health benefits in older adults; however, most have used exercises performed at specific intensities on expensive equipment, which limit their widespread applicability. We tested whether two self-paced, less expensive exercise protocols could be effective and safe for modifying neuromotor performance and functional capacity in community-dwelling adults 65-95 years of age. METHODS: One hundred and thirty-one subjects were randomized to a novel resistance training, walking, or control group. Subjects determined their level of resistance or walking intensity (self-paced) on a session-by-session basis. Muscle strength, balance, reaction time, stair climbing speed, and a timed pen pickup task were measured before and after the intervention period. Exercisers met three times per week for 10 months. RESULTS: Significant improvements in tandem stance and single-legged stance with eyes open times and stair climbing speed were seen in both exercise groups. In addition, resistance trainers improved their muscle strength and ability to pick up an object from the floor and reduced the number of missteps taken during tandem walking, and walkers reduced tandem walking time. Controls showed no significant improvement in any variable. CONCLUSIONS: The two self-paced exercise protocols were effective at improving neuromotor performance and functional capacity in the study sample and show promise as a safe, effective, cost-efficient, acceptable exercise model for primary and secondary prevention in the general population of community-dwelling older adults.

Aged↗
PubMed1997

Predicting the impact response of a nonlinear single-degree-of-freedom shock-absorbing system from the measured step response.

We measured the step response of a surrogate human pelvis/impact pendulum system at force levels between 50 and 350 N. We then fit measured response curves with four different single-degree-of-freedom models, each possessing a single mass, and supports of the following types: standard linear solid, Voigt, Maxwell, and spring. We then compared model predictions of impact force during high-energy collisions (pendulum impact velocity ranging from 1.16 to 2.58 m/s) to force traces from actual impacts to the surrogate pelvis. We found that measured peak impact forces, which ranged from 1700 to 5600 N, were best predicted by the mass-spring, Maxwell, and standard linear solid models, each of which had average errors less than 3 percent. Reduced accuracy was observed for the commonly used Voigt model, which exhibited an average error of 10 percent. Considering that the surrogate pelvis system used in this study exhibited nonlinear stiffness and damping similar to that observed in simulated fall impact experiments with human volunteers, our results suggest that these simple models allow-impact forces in potentially traumatic falls to be predicted to within reasonable accuracy from the measured response of the body in safe, simulated collisions.

Accidental Falls↗
PubMed1997

Characterization of partially saturated poly(propylene fumarate) for orthopaedic application.

A partially saturated linear polyester based on poly(propylene fumarate) (PPF) was synthesized for potential application in filling skeletal defects. The synthesis was carried out according to a two-step reaction scheme. Propylene glycol and fumaryl chloride were first combined to form an intermediate fumaric diester. The intermediate was then subjected to a transesterification to form the PPF-based polymer. This method allowed for production of a polymer with a number average molecular weight up to 1500 and a polydispersity index of 2.8 and below. The polymeric backbone structure was investigated through the use of FTIR and NMR. Kinetic studies of the transesterification allowed mapping of the molecular weight increase with reaction time. The final product was also characterized by thermal and solubility analysis.

Bone Cements↗
PubMed1997

Biomechanical considerations of hip and spine fractures in osteoporotic bone.

Falls and fall-related hip fractures are among the most serious, common, and costly medical problems facing the elderly. Recently, we and others have shown that falls to the side, particularly those that end with impact on the hip, raise the risk of hip fracture from six- to thirty-fold, compared to about threefold increases in risk associated with one SD reduction in BMD at the hip. And yet, despite the apparently crucial importance of sideways falls, little is known about the mechanics of falling to the side. In addition, while previous studies have helped identify those factors that place the elderly at high risk for falling and provided assessment procedures that can be used to identify those at risk for falls, as far as we are aware no previous work has successfully identified subjects at increased risk of falling to the side. Moreover, while rigorous, multifactorial fall prevention efforts have demonstrated moderate reductions in fall incidence, such programs are expensive and potentially inefficient in that they have not consistently demonstrated reductions in the numbers of injurious falls. While trochanteric padding systems show considerable promise for hip fracture prevention by reducing impact force, they involve difficult acceptance and compliance issues and will require large and rigorous clinical trials to demonstrate effectiveness. Finally, while it also appears that osteodynamic agents can be used to increase BMD at the hip and spine, little is known about the local structural consequences of these changes and, in particular, if they are sufficient to prevent hip fracture from a severe fall. The findings reviewed here thus emphasize the continuing need for combined intervention strategies that focus on fall prevention, on reductions in fall severity, and on maintaining or increasing bone mass and strength, either through targeted exercise programs or the use of osteodynamic agents. By developing and refining the factor of risk phi, a property that captures both the contributions of bone density and the confounding influences of body habitus and fall severity, we believe these intervention strategies can be targeted more appropriately. Based on such approaches and an improved understanding of the complex interplay between fall biomechanics and bone fragility in the etiology of hip fracture, there is hope that the growing worldwide epidemic of hip fractures among the elderly can be substantially abated.

Accidental Falls↗
PubMed1997

Predicting failure of thoracic vertebrae with simulated and actual metastatic defects.

Indications for operative treatment in spinal metastatic disease depend on estimates of vertebral loadbearing capacity. There are no noninvasive diagnostic tools for estimating vertebral loadbearing capacity in the presence of a metastatic lesion. Thus, relationships between vertebral failure load and measurements from computed tomography data were investigated to determine if measurements that account for defect size and bone density can predict loadbearing capacity better than can defect size alone. Cylindrical defects were created in thoracic vertebrae of 20 anatomic specimen spinal segments, with 10 other segments serving as controls. Five vertebrae with actual metastatic defects also were tested. Vertebrae were scanned using quantitative computed tomography, and the defect size and the axial rigidity of the midvertebral cross section were calculated using an image analysis program. The spinal segments were tested to failure using a combination of axial compression and anterior flexion. Linear regressions between axial rigidity and absolute failure load showed a high positive correlation, but there was no correlation between defect size and failure load. Axial rigidity may prove useful as a noninvasive assessment of vertebral loadbearing capacity in patients with spinal metastatic disease.

Aged↗
PubMed1996

The effect of impact direction on the structural capacity of the proximal femur during falls.

As with any structure, the structural capacity of the proximal femur depends on the applied loads and these can vary as a function of impact direction during a fall. However, despite its potential importance in hip fracture risk assessment, the relative importance of impact direction is unknown. To investigate the role of impact direction in hip fracture, we developed a detailed finite element model of the proximal femur. We analyzed four loading configurations that represent a range of possible falls on the greater trochanter. Our results indicate that a change in the angle between the line of action of the applied force and the axis of the femoral neck from 0 degrees (representing a direct lateral impact) to 45 degrees (representing a posterolateral impact) reduced structural capacity by 26%. This weakening of the femur with changes in impact direction is comparable to the weakening associated with 2-3 decades of age-related bone loss. Our result elucidates the independent contribution of fall mechanics to hip fracture risk by identifying an aspect of the fall (the direction of impact) that is an important determinant of fall severity. The results can also be incorporated into a refined clinical method for assessment of hip fracture risk that accounts for the complex interactions between fall severity and bone fragility.

Absorptiometry, Photon↗
PubMed1996

Impact direction from a fall influences the failure load of the proximal femur as much as age-related bone loss.

Recent studies have shown that factors related to fall biomechanics may play as important a role in the etiology of hip fracture as age-related bone loss. Motivated by finite element analyses that showed failure of the proximal femur to be sensitive to loading direction, our objective with the current investigation was to determine experimentally if changes in impact direction affect the failure load of the elderly proximal femur. Thirty-three cadaveric femurs were assigned randomly to three groups of 11 and tested at one of three loading angles, 0 degree, 15 degrees, or 30 degrees, representing a fall on the hip rolled slightly forward, to the side, or rolled slightly backwards, respectively. Femurs were scanned using dual-energy X-ray absorptiometry (DXA) to assess bone mineral density (BMD) and tested to failure in a fall loading configuration at a displacement rate of 100 mm/second. Using an analysis of covariance to adjust for total hip BMD, we found that failure load decreased by 24% as the loading angle changed from 0 degree to 30 degrees. This reduction in failure load is comparable to that associated with about 25 years of age-related bone loss after the age of 65. Therefore, the impact direction associated primarily with a fall is a critical determinant of hip fracture risk that is both independent of bone density and associated with fall biomechanics.

Accidental Falls↗
PubMed1996

Hip impact velocities and body configurations for voluntary falls from standing height.

Fall dynamics have largely been ignored in the study of hip fracture etiology and in the development of hip fracture prevention strategies. In this study, we asked the following questions: (1) What are the ranges of hip impact velocities associated with a sideways fall from standing height? (2) What are the ranges of body configurations at impact? and (3) How do protective reflexes such as muscle activation or using an outstretched hand influence fall kinematics? To answer these questions, we recruited six young healthy athletes who performed voluntary sideways falls on a thick foam mattress. Several categories of falls were investigated: (a) muscle-active vs muscle-relaxed falls; (b) falls from a standing position or from walking; and (c) falls in which an outstretched arm was used to break the fall. Each fall was videotaped at 60 frames s(-1). Fall kinematics parameters were obtained by digitizing markers placed on anatomical points of interest. The mean value for vertical hip impact velocity was 2.75 ms(-1) (+ or - 0.42 ms(-1) [S.D.]). The mean value for trunk angle (the angle between the trunk and the vertical) was 17.3 degrees (+ or - 11.5 degrees [S.D.]). We found a 38 percent reduction in the trunk angle at impact, and a 7 percent reduction in hip impact velocity for relaxed vs muscle-active falls. Finally, regarding the. falls in which an outstretched arm was used, only two out of the six subjects were able to break the fall with their arm or hand. For the remaining subjects hip impact occurred first, followed by contact of the arm or hand.

Accidental Falls↗
PubMed1996

Age-related differences in post-yield damage in human cortical bone. Experiment and model.

Very few quantitative comparisons between mechanical test behavior of cortical bone and microscopic evidence of damage have been reported. In this study, the hypothesis that age-related degradation of mechanical properties in human cortical bone is associated with increases in damage in the form of microcracks was investigated. The initial modulus and yield stress were 6% (not significant) and 10% (p = 0.05) lower, respectively, in specimens from elderly femora than in specimens from young adult femora. However, both groups showed a 34% decrease in modulus after being loaded to 1% strain. Microcracks were observed in cement lines and between lamellae and were parallel to the loading direction. There were 50% more cracks in longitudinal sections of tested specimens than in controls from elderly femora; however, there were no more cracks in tested specimens than in controls from young adult femora. In addition, there were twice as many cracks in controls and three times as many cracks in tested specimens from elderly femora than in those from young adult femora (p < 0.01). A microstructurally based model was developed which supported the mechanical test results and indicated that damage began to develop at about 1500 mu epsilon. The results suggest that older bone may have reduced mechanical properties due to the presence of more microcracks, and that older bone is more susceptible to developing microcracks at a given strain level. However, the mechanical test data indicate that specimens from young adult femora also sustained some king of damage as a result of mechanical loading, which requires further investigation.

Adult↗
PubMed1996

The tensile behavior of demineralized bovine cortical bone.

Bone is frequently modeled as a two-phase composite of hydroxyapatite mineral crystals dispersed throughout an organic collagen matrix. However, because of the numerous limitations (e.g. small sample size, poor strain measuring techniques, rapid demineralization with acids) of previous mechanical tests of bone with its hydroxyapatite chemically removed, we have determined new, accurate data on the material properties of the demineralized bone matrix for use in these composite models. We performed tensile tests on waisted specimens of demineralized bovine cortical bone from six humeral diaphyses. Specimens were demineralized over 14 days with a 0.5 M disodium EDTA solution that was replaced daily. Atomic absorption spectrophotometry was used to track the demineralization process and to determine the effectiveness of our demineralization protocol. Mechanical tests were performed at room temperature under displacement control at an approximate strain rate of 0.5% per s. We imposed nine preconditioning cycles before a final ramp to failure, and measured gauge length displacements using a non-invasive optical technique. The resulting stress-strain curves were similar to the tensile behavior observed in mechanical tests of other collagenous tissues, exhibiting an initial non-linear 'toe' region, followed by a linear region and subsequent failure without evidence of yielding. We found an average modulus, ultimate stress, and ultimate strain of 613 MPa (S.D. = 113 MPa), 61.5 MPa (S.D. = 13.1 MPa), and 12.3% (S.D. = 0.5%), respectively. Our average modulus is approximately half the value frequently used in current composite bone analyses. These data should also have clinical relevance because the early strength of healing fractured bone depends largely on the material properties of the collagen matrix.

Analysis of Variance↗