Search PubMed⌕ Search

Biomedical subjects

W C Hayes

Publications and source records attributed to W C Hayes.

At least 127 records · Page 7Linked to original sources

The use of quantitative computed tomography to estimate risk of fracture of the hip from falls.

We conducted an in vitro investigation of the loads and energies needed to fracture the proximal part of the femur in twelve fresh cadavera under loading conditions simulating one particular type of fall. The fracture loads ranged from 778 to 4,040 newtons and the work to fracture, from five to fifty-one joules. We also investigated the relationship between the fracture loads and several potential indices of bone strength, which were measured non-invasively at the subcapital, basic-cervical, and intertrochanteric regions with quantitative computed tomography. A very high positive correlation with the fracture load resulted from use of an intertrochanteric index--the product of the average trabecular computed-tomography number and the total cross-sectional area of the bone (R2 = 0.93, standard error of estimate = 295 newtons, and p less than 0.00001). We expect the use of this parameter to result in improved assessments of the degree of osteoporosis and of the component of risk of fracture of the hip that is associated with bone strength. However, the measured work to fracture for the isolated femur was an order of magnitude smaller than estimates of the energy available during a typical fall (about 450 joules), suggesting that energy absorbed during falling and impact, rather than bone strength, may be the dominant factors in the biomechanics of fracture of the hip.

Accidental Falls↗

In vivo histologic and biomechanical characterization of a biodegradable particulate composite bone cement.

A biodegradable particulate composite bone cement consisting of a crosslinked gelatin matrix and tricalcium phosphate particles was implanted intraosseously in rabbits for up to 12 weeks. Cured cylindrical implants were inserted in holes drilled in the proximal tibial metaphysis. Sequential fluorochrome labeling and radiographs were done, and specimens were processed for decalcified and nondecalcified histology. At 4 weeks, the cross-sectional diameter of the implant was slightly greater than at implantation. There was considerable dissolution of the matrix and some new bone ingrowth. At 12 weeks, the diameter was reduced to half the original diameter and bone had grown throughout the matrix. In the distal femur, freshly mixed cement was used to stabilize an osteochondral fracture. Mechanical testing of the cement-stabilized fracture revealed a decrease in compressive strength and modulus at 4 weeks followed by an increase to greater than initial values at 12 weeks. Over time, the osteochondral fragment subsided into the underlying cement, but the subsidence did not correlate with mechanical strength. This osteochondral fracture model permits measurement of the overall material properties of a cement simultaneously weakened by resorption and reinforced by ingrowing bone.

Animals↗

Biomechanical properties of the proximal femur determined in vitro by single-energy quantitative computed tomography.

To assess the use of quantitative computed tomography as an in vivo predictor of fracture in the osteoporotic hip, we examined the in vitro relationship between single-energy quantitative computed tomography data, calibrated for scanner drift, and the mechanical properties of trabecular bone from the proximal femur. For 49 samples, the apparent density and ultimate strength were measured and their functional relationship to the computed tomography data determined. Apparent density demonstrated a moderate linear correlation to the computed tomography numbers (R2 = 0.60), and the ultimate strength was related through a power law (R2 = 0.83). In addition, for 8 intact femora, average computed tomographic data from the sub-capital region were moderately correlated to the ultimate fracture load applied under controlled in vitro conditions (R2 = 0.64). The average fracture energy for these femora was 43 J, a value more than an order of magnitude less than the energy available in a fall from standing height, suggesting that fall mechanics are a more important determinant of fracture risk than has been previously thought. The relationship between the energy absorbed to failure and the computed tomography data was best described by a power law (R2 = 0.90). Based on these results, it appears that quantitative computed tomography provides a potentially useful approach for the direct estimate of that component of fracture risk that can be attributed to a reduction in bone strength.

Aged↗

Structural consequences of endosteal metastatic lesions in long bones.

Lytic metastatic lesions from breast, prostate, and other cancers often develop on the endosteal surface of a long bone without penetrating the cortical wall. Current clinical guidelines for determining the fracture risk associated with these endosteal defects do not account for the structural consequences of the lesion. We undertook a combined experimental and analytical study of the structural consequences of the lesions with the ultimate goal of providing improved fracture risk guidelines. Endosteal defects of variable length and involving a variable amount of the cortical wall were created with an expanding reamer in canine femurs. The contralateral femur served as a control. The femurs were tested to failure in four point bending. The geometry of the experimental defects was determined from radiographs and CT. Finite element models of the canine femurs were then used to examine geometric and material parameters in both four point bending and in torsion. The experimental data demonstrate a linear relation between bone strength and amount of cortical wall remaining: % intact strength = 99.6 x remaining wall thickness - 2.0, R2 = 0.769, standard deviation of regression = 11.57. Four of five data points from the linear finite element models were within the 95% confidence intervals for the experimental data. Experimental and finite element data suggest that the minimum wall thickness is the most critical geometric parameter for predicting the structural consequences of endosteal defects. The length of the defect along the bones' long axis has little effect on bone strength. The anelastic behavior of bone does not need to be represented in finite element models of simple endosteal defects because the defects do not cause significant stress concentrations. However, reduction in the modulus of bone along the border of a defect (due to osteolytic changes) can significantly reduce bone strength. These results indicate that the minimum wall thickness should be determined when clinically evaluating an endosteal defect. The results also suggest that information on bone porosity around metastatic lesions should be considered when making estimates of bone strength.

Animals↗

In vitro characterization and biomechanical optimization of a biodegradable particulate composite bone cement.

We have developed a biodegradable particulate composite bone cement and used in vitro and in vivo methods for studying its suitability for orthopaedic applications. The composite matrix consists of gelatin, water, and sodium salicylate. The particulate phase is made up of powdered and particulate (355-600 microns diameter) tricalcium phosphate. Paraformaldehyde (0.1% to 0.5% by weight) is used as a matrix cross-linking agent. The effects of incubation time, particulate volume fraction, density of the individual particles, water content, concentration of crosslinking agent, and freeze-drying on the unconfined compressive strength and modulus of the particulate composite were measured. Compressive strengths of 7 MPa and moduli of 65 MPa could be achieved. Mechanical properties depended critically upon the water content of the particulate composite, with values of strength and modulus decreasing rapidly outside a range of 10-14% of specimen dry weight. High-density tricalcium phosphate particulate produced cement with twice the strength found with porous particulate. In a companion study we document in vivo performance of this particulate composite in an animal model system.

Biocompatible Materials↗

Strength reductions from metastatic cortical defects in long bones.

The purpose of this investigation was to measure the reduction in bone strength resulting from drill holes in diaphyseal bone and to compare this with finite element and theoretical predictions for stresses in a tubular structure. Fifty-two pairs of canine femora were tested to failure in four-point bending. One bone of each pair was used as the control; the other femora had holes of variable size drilled in the lateral cortex. At a ratio of drill hole diameter to bone diameter of 0.2, the bone retained only 62% of its expected strength. A linear regression between the area fraction (the ratio of the cross-sectional area of the drilled specimen to the control specimen) and the percentage of expected strength yielded a strong positive correlation (R2 = 0.79). The average cross-sectional properties were used as the basis for linear orthotropic and nonlinear elastic-plastic finite element models of idealized geometry. The linear models proved insufficient for prediction of failure loads. The nonlinear models, which accounted for both material plasticity and the stress concentration effects of the defect, yielded good correspondence with the experimental data. While the influence of irregular borders and adaptive remodeling of the bone adjacent to the defect requires further investigation, our results suggest the possibility of prediction of fracture risk based on geometric properties of metastatic lesions. Prophylactic fixation remains a matter of clinical judgement based on the functional demands and expected strength of the affected bones.

Animals↗

Contact pressures in chondromalacia patellae and the effects of capsular reconstructive procedures.

We measured patellofemoral contact areas and pressures using pressure sensitive film in ten human cadaver knees exhibiting degenerative lesions of patellar cartilage. We studied a flexion range from 20 degrees to 90 degrees and compared contact pressures before and after capsular reconstructive procedures. With an intact, normal capsule, localized lesions of grade I-II exhibited a 50% reduction in pressure (from 3.4 +/- 0.7 MPa to 1.6 +/- 0.9 MPa) directly over the lesion. Grade III-IV lesions exhibited a loss of contact pressure greater than 90%. This reduction in pressure appears to result from a loss of stiffness in the low-grade cartilage lesions and from a loss of cartilage thickness in higher grade lesions. Highly localized peak pressures were also observed on the normal cartilage bordering the lesions. Capsular reconstructive procedures (medial plication, lateral plication, lateral release, and bilateral release) did not result in consistent pressure reductions or in the creation of more uniform pressure distributions. In particular, lateral capsular release, a popular surgical procedure, resulted in no change in three knees and four different pressure patterns in the other seven knees.

Aged↗

Antibiotic release from an experimental biodegradable bone cement.

An experimental biodegradable bone cement [poly(propylene fumarate)-methylmethacrylate] (PPF-MMA) has been compared in vivo with polymethylmethacrylate (PMMA) as a carrier agent for local release of antibiotics. This approach is potentially applicable to the treatment of chronic osteomyelitis where the clinical goal is to achieve sustained high concentrations of antibiotics locally in the infected bone. In our experiments, gentamicin- and vancomycin-impregnated cylindrical PMMA and PPF-MMA cement specimens were implanted subcutaneously in rats, and blood and wound fluid samples were obtained over a 2-week period. Antibiotic levels were determined using immunoassays, and microbiologic activity was confirmed with agar diffusion techniques. The biodegradable PPF-MMA cement achieved and maintained considerably higher wound antibiotic levels than did PMMA cement. Vancomycin levels for the PPF-MMA cement were greater than 20 times those for the PMMA cement at all sampling times from 24 h to 14 days. For both cements, the serum antibiotic concentrations remained safely below maximum levels recommended for parenteral therapy. Mechanical testing of the PPF-MMA cement showed that admixture of 3% by weight of antibiotic did not adversely affect material properties. We conclude that this experimental biodegradable bone cement (PPF-MMA) can be used as a carrier to achieve high sustained local levels and low serum levels of antibiotics. Because it is biodegradable and thus does not require a secondary procedure for removal, it has special potential for use in treatment of chronic osteomyelitis.

Administration, Topical↗

Sex differences in age-related remodeling of the femur and tibia.

Changes with age in cross-sectional geometry of the lower limb bones were investigated in a large sample of cadaveric skeletal material from U.S. white adults. Section properties (areas and second moments of area) were determined at 11 locations by sectioning and direct measurement of 103 femora and 99 tibiae. All properties were standardized for body size differences by dividing by powers of bone length, and age trends were determined through linear regression analysis. Results indicate that while both men and women undergo endosteal resorption of bone and medullary expansion with aging, only men exhibit concurrent subperiosteal bone apposition and expansion. As a consequence, men show little change in cortical area and some increase in second moments of area with age, while women show decreases in both cortical area and second moments of area. Thus, only men appear to remodel bone in a way that would tend to compensate for loss of bone material strength with aging. In a previous study of a preindustrial sample with high activity levels, both men and women exhibited bone subperiosteal expansion and increase in second moments of area with aging. Together with observed differences in fracture incidence among living populations, these findings suggest that relatively low activity levels may not stimulate optimal bone remodeling throughout life and thus may contribute to higher risk of fracture in old age.

Adult↗

A nonlinear finite element analysis of interface conditions in porous coated hip endoprostheses.

We used a geometrically simplified finite element model to investigate load transfer between a porous coated hip endoprosthesis and a femur. Assuming both rigidly bonded and nonlinear interfaces, we analyzed fully and partially coated stems that had coatings of different elastic moduli. Our results indicate that maximum values for relative motion in the interface between bone and implant occur for implants with the same elastic modulus as compact bone. By comparison, interface motion is reduced by about half for Co-Cr-Mo alloy stems. We also showed that the elastic modulus of the porous coating had only a small influence on bone stresses.

Biomechanical Phenomena↗

Effect of inhaled propylene oxide on reproductive parameters in Fischer 344 rats.

Reproductive parameters in Fischer 344 rats were evaluated following inhalation of propylene oxide (PO) for two successive generations. Thirty male and 30 female rats were exposed to 0, 30, 100, or 300 ppm PO for 6 hr/day, 5 days/week for 14 weeks and then mated to produce the f1 litters. After weaning, 30 randomly selected f1 pups/sex/group were exposed to PO for 17 weeks and subsequently mated to produce the f2 litters. Reproductive parameters examined included fertility, litter size and neonatal growth, and survival. All adults and selected weanlings were examined for gross and histologic lesions. Toxicity due to PO was demonstrated by decreased body weights of parental f0 and f1 rats at 300 ppm. No treatment-related effects on fertility (mating or conception) were observed in either f0 or f1 matings. Neonatal survival indices for f1 or f2 litters revealed no treatment-related effects. Litter size was decreased in the f1 rats exposed to 100 ppm PO. However, the litter size in the 300 ppm group was comparable to the control group, and no effect on litter size was shown in PO-exposed f2 litters. Pup weights were unaffected by parental exposure to PO in either generation. Pathologic examination of adults and weanlings revealed no changes considered due to PO. Based on these results, it is concluded that inhalation exposure to PO at levels up to 300 ppm over two generations did not produce any adverse effects on reproductive function.

Animals↗

Trabecular bone remodeling around smooth and porous implants in an equine patellar model.

The objective of this investigation was to examine the stress-morphology relationships for trabecular bone around implants with different surface characteristics. Stainless steel spheres with either a polished surface or a sintered-bead porous coating were implanted unilaterally into equine patellae and maintained for a 6 month period. Stereological methods were used to quantify the trabecular bone morphology and finite element analyses were performed to predict the trabecular bone stresses. In general, the remodeling response around the smooth implants was greater than that around those porous implants that exhibited bone ingrowth. In accordance with these differences, the finite element models predicted greater changes in the stresses adjacent to the smooth implants due to the nonlinear boundary conditions. However, it did not appear that the trajectorial theory, in its simplest form, was applicable to the remodeling induced by the implants. A linear relationship between the change in bone areal density and the change in von Mises effective stress provides support for the hypothesis that the architecture of trabecular bone corresponds to an optimal structure. The results also demonstrated that, under certain circumstances, small changes in the stress state may result in large changes in the principal material orientation.

Animals↗

Embryotoxicity and fetotoxicity of orally administered tridiphane in mice and rats.

Tridiphane [2-(3,5-dichlorophenyl)-2-(2,2,2-trichloroethyl)oxirane], a broad-leaf herbicide, was evaluated for its potential effects on mouse and rat embryonal and fetal development. Pregnant CF-1 mice were given 0, 25, 75, or 250 mg tridiphane/kg/day on Days 6 through 15 of gestation. Significant maternal toxicity was observed in both the 75- and 250-mg/kg/day dose groups. An increased percentage of females given 250 mg/kg/day showed implantation sites only after staining of the uterus, suggesting a toxic effect on the embryo during the early stages of development, possibly secondary to maternal toxicity. Increases in some skeletal variants were noted at the 75-mg/kg dose level; however, a teratogenic effect was not observed. An additional group of mice was given 250 mg/kg/day on Days 8 through 15 of gestation. Maternal toxicity was also observed among these mice as manifested by significantly elevated (+50%) liver weight; however, there was a substantial increase in the number of females with full-term litters following this shorter dosing period. An increase in the occurrence of cleft palate in these offspring associated with low fetal body weights was also observed. Pregnant Sprague-Dawley rats were given 0, 30, 100, or 200 mg/kg/day of tridiphane on Days 6 through 15 of gestation. Maternal toxicity was observed among rats given 200 mg/kg. Increased incidences of two minor skeletal variants, lumbar spurs and extra ribs, were observed in the 200-mg/kg/day dose group, and an increase in lumbar spurs was observed at 100 mg/kg/day. Thus, tridiphane was embryotoxic and induced cleft palate in mice only at the maternally toxic dose level of 250 mg/kg/day.(ABSTRACT TRUNCATED AT 250 WORDS)

Abnormalities, Drug-Induced↗

Variation of lumbar spine stiffness with load.

Mechanical studies of the Functional Spinal Unit (FSU) in-vitro have shown that the slopes of the load-displacement curves increase with load. This nonlinearity implies that the stiffness of the FSU is not constant over the range of physiologic loads, and that measurements obtained for FSU specimens through the application of individual loads cannot be summed to predict the response of the specimens to combined loads. Both experimental and analytical methods were developed in the present study to better quantify the nonlinear FSU load-displacement response and to calculate the coupled stiffness of FSU specimens at combined states of load reflecting in-vivo conditions. Results referenced to the center of the vertebral body indicate that lumbar FSU specimens are stiffer in flexion than in extension, and that FSU specimens loaded in flexion are stiffer at high loads than at low loads. The importance of combined load testing and a nonlinear interpretation of load-displacement data is demonstrated.

Biomechanical Phenomena↗

Biomechanical optimization of a model particulate composite for orthopaedic applications.

Particulate composites are a potential solution to the need for an injectable, biocompatible, resorbable material that could be used to reinforce fractures and defects in bone and temporarily to stabilize porous ingrowth prostheses. We have developed a model system for producing and testing particulate composites to determine if mechanical properties suitable for orthopaedic applications can be achieved. The experiments used bovine cortical bone and various forms of hydroxyapatite for the particulate phase and a collagen and particulate reinforce gelatin-resorcinol-formaldehyde (G-R-F) adhesive for the matrix phase. Using unconfined compression testing, we measured the effects of variation in particulate type, size, shape, and volume fraction on the material properties of the particulate composites. We found that compressive strengths greater than 10 MPa and compressive moduli greater than 100 MPa could be achieved in this model system. Rough and irregular particulates exhibited higher compressive strengths and moduli than smooth and spherical particulates. Mechanical properties were largely independent of particulate size in the range of 125-850 microns diameter. This model system suggests that, with the development of new biocompatible matrix materials, particulate composites with mechanical properties suitable for orthopaedic applications can be achieved.

Animals↗

Three-dimensional strain fields in a uniform osteotomy gap.

Stable internal fixation usually results in a unique histological healing pattern which involves direct cortical reconstruction and an absence of periosteal bridging callus. While it has been suggested that longitudinal interfragmentary strain levels control this healing pattern, the complex, multiaxial strain fields in the interfragmentary region are not well understood. Based on an in-vivo study of gap healing in the sheep tibia by Mansmann et al., we used several finite element models of simplified geometry to: explore modeling assumptions on material linearity and deformation kinematics, and examine the strain distribution in a healing fracture gap subjected to known levels of interfragmentary strain. We found that a general nonlinear material, nonlinear geometric analysis is necessary to model an osteotomy gap subjected to a maximum longitudinal strain of 100 percent. The large displacement, large strain conditions which were used in the in-vivo study result in complex, multiaxial strain fields in the gap. Restricting the maximum longitudinal strain to 10 percent allows use of a linear geometric formulation without compromising the numerical results. At this reduced strain level a linear material model can be used to examine the extent of material yielding within a homogeneous osteotomy gap. Severe local strain variations occurred both through the thickness of the gap and radially from the endosteal to periosteal gap surfaces. The bone/gap interface represented a critical plane of high distortional and volumetric change and principal strain magnitudes exceeded the maximum longitudinal strains.

Biomechanical Phenomena↗

Monitoring the healing of a tibial osteotomy in the rabbit treated with external fixation.

Fracture site axial rigidity was monitored non-destructively at weekly intervals during healing of tibial osteotomies in adult rabbits. Two groups of 20 rabbits each were treated with external fixators of two different rigidities. Four animals from each group were killed at 3, 5, 6, 7, and 8 weeks to determine the bending moments at failure of the healing fractures. Normal fracture healing was accompanied by characteristic phases in the development of fracture site axial rigidity. From 0 to 3 weeks there was a period of low and approximately constant rigidity, followed by a linear increase during 3 to 5 weeks to an approximately three to four times greater rigidity. The maximum average normalized axial rigidities were reached at 6 weeks and were 57% (high rigidity group) and 77% (low rigidity group) of the untreated contralateral controls. The maximum average normalized failure moments occurred at 8 weeks and were 48% (high rigidity) and 44% (low rigidity) of controls. The differences due to fixator rigidity were not statistically significant except for a large increase in failure moments at 3 weeks for the low rigidity group. Axial rigidities were correlated (r2 = 0.74 and 0.53, respectively) with failure moments, but only during the first 6 weeks. The monitoring technique provides a nondestructive means for following the biomechanical progress of fracture healing in an animal model. The occurrence of the characteristic increase in fracture site axial rigidity at 3 to 5 weeks can also be used to distinguish between normal and abnormal healing.

Animals↗

Stress analysis of a condylar knee tibial component: influence of metaphyseal shell properties and cement injection depth.

We generated three-dimensional finite element models of the proximal tibia with an implanted tibial component. The component features a cobalt-chromium tray with four short vertical posts and a porous-coated surface for improved fixation to polymethylmethacrylate (PMMA). We examined the stresses after varying: the structural rigidity of the metaphyseal cortical shell; the surface area of the cobalt-chromium tray; and the depth of pressure-injected PMMA bone cement. Our results indicate that previous finite element models of prosthetic tibial components have overestimated the structural contribution of the metaphyseal cortical shell by a factor of approximately 6. A standard size tray, in contrast to a tray that extends to the cortical shell, does not significantly alter the axial load distribution but could result in bone resorption beyond the tray periphery. An important consequence of the component peg locations is that they direct the compressive stresses into dense regions of trabeculae that run from the subchondral articular surface to the metaphyseal-diaphyseal junction. The use of a modified von Mises failure criterion suggests that at excessive load levels the most likely location of material failure is at the bone cement-trabecular bone interface immediately distal to the fixation posts. Due to its added rigidity, injection of cement beyond the fixation posts results in slightly increased stresses in this region, but these stress increases are compensated for by an increased strength of the cement-bone composite.

Bone Cements↗