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PubMed2004

A transversely isotropic, transversely homogeneous microstructural-statistical model of articular cartilage.

Articular cartilage is a multi-phasic, composite, fibre-reinforced material. Therefore, its mechanical properties are determined by the tissue microstructure. The presence of cells (chondrocytes) and collagen fibres within the proteoglycan matrix influences, at a local and a global level, the material symmetries. The volumetric concentration and shape of chondrocytes, and the volumetric concentration and spatial arrangement of collagen fibres have been observed to change as a function of depth in articular cartilage. In particular, collagen fibres are perpendicular to the bone-cartilage interface in the deep zone, their orientation is almost random in the middle zone, and they are parallel to the surface in the superficial zone. The aim of this work is to develop a model of elastic properties of articular cartilage based on its microstructure. In previous work, we addressed this problem based on Piola's notation for fourth-order tensors. Here, mathematical tools initially developed for transversely isotropic composite materials comprised of a statistical orientation of spheroidal inclusions are extended to articular cartilage, while taking into account the dependence of the elastic properties on cartilage depth. The resulting model is transversely isotropic and transversely homogeneous (TITH), the transverse plane being parallel to the bone-cartilage interface and the articular surface. Our results demonstrate that the axial elastic modulus decreases from the deep zone to the articular surface, a result that is in good agreement with experimental findings. Finite element simulations were carried out, in order to explore the TITH model's behaviour in articular cartilage compression tests. The force response, fluid flow and displacement fields obtained with the TITH model were compared with the classical linear elastic, isotropic, homogeneous (IH) model, showing that the IH model is unable to predict the non-uniform behaviour of the tissue. Based on considerations that the mechanical stability of the tissue depends on its topological and microstructural properties, our long-term goal is to clearly understand the stability conditions in topological terms, and the relationship with the growth and remodelling mechanisms in the healthy and diseased tissue.

Cartilage, Articular↗
PubMed2004

A kinematic model for calculating cup alignment error during total hip arthroplasty.

Reduced range of motion, prosthetic impingement, and joint dislocation can all result from misalignment of the acetabular component (i.e. cup alignment) in patients undergoing total hip arthroplasty. Most methods for acetabular component alignment are designed to provide 45-50 degrees abduction and 15-25 degrees of operative anteversion (also known as flexion) with respect to the anterior pelvic plane coordinate system. Yet in most cases, this coordinate system is not assigned properly, due to differences in patient anatomy and improper positioning in the operating room. This misalignment can result in an error in the cup alignment, which can cause the above-mentioned consequences. This work presents a complete mathematical formulation for the analysis of the inaccuracies related to the anterior pelvic plane axes (APPA) definition and their effect on final cup orientation. We do this by introducing a method taken from Kinematics of Mechanisms, and by representing the errors in the APPA as three concurrent axes of rotation, followed by the version and abduction rotations which are defined relative to the previous rotations. We also present a sensitivity analysis of the results by introducing differential changes between sequential coordinate frames, which simulates the errors in the APPA and their effect on cup orientation. Finally, we demonstrate a computational method which provides corrected version and abduction angles to achieve the desired cup orientation, given that the actual measurement errors are known.

Arthroplasty, Replacement, Hip↗
PubMed2005

Optimal control simulations reveal mechanisms by which arm movement improves standing long jump performance.

Optimal control simulations of the standing long jump were developed to gain insight into the mechanisms of enhanced performance due to arm motion. The activations that maximize standing long jump distance of a joint torque actuated model were determined for jumps with free and restricted arm movement. The simulated jump distance was 40 cm greater when arm movement was free (2.00 m) than when it was restricted (1.60 m). The majority of the performance improvement in the free arm jump was due to the 15% increase (3.30 vs. 2.86 m/s) in the take-off velocity of the center of gravity. Some of the performance improvement in the free arm jump was attributable to the ability of the jumper to swing the arms backwards during the flight phase to alleviate excessive forward rotation and position the body segments properly for landing. In restricted arm jumps, the excessive forward rotation was avoided by "holding back" during the propulsive phase and reducing the activation levels of the ankle, knee, and hip joint torque actuators. In addition, swinging the arm segments allowed the lower body joint torque actuators to perform 26 J more work in the free arm jump. However, the most significant contribution to developing greater take-off velocity came from the additional 80 J work done by the shoulder actuator in the jump with free arm movement.

Arm↗
PubMed2005

Geometric modeling of functional trileaflet aortic valves: development and clinical applications.

The dimensions of the aortic valve components condition its ability to prevent blood from flowing back into the heart. While the theoretical parameters for best trileaflet valve performance have already been established, an effective approach to describe other less optimal, but functional models has been lacking. Our goal was to establish a method to determine by how much the dimensions of the aortic valve components can vary while still maintaining proper function. Measurements were made on silicone rubber casts of human aortic valves to document the range of dimensional variability encountered in normal adult valves. Analytical equations were written to describe a fully three-dimensional geometric model of a trileaflet valve in both the open and closed positions. A complete set of analytical, numerical and graphical tools was developed to explore a range of component dimensions within functional aortic valves. A list of geometric guidelines was established to ensure safe operation of the valve during the cardiac cycle, with practical safety margins. The geometry-based model presented here allows determining quickly if a certain set of valve component dimensions results in a functional valve. This is of great interest to designers of new prosthetic heart valve models, as well as to surgeons involved in valve-sparing surgery.

Algorithms↗
PubMed2006

Influence of glottic aperture on the tracheal flow.

The extra-thoracic mouth-throat area has a major influence on the aerosol delivery to the proximal or peripheral intra-thoracic airways. To characterize the particle deposition in this area, it is important to investigate first the flow structures in this crucial--in relation to the aerosol deposition--region. The glottis, which is delimited by the vocal cords and therefore has the narrowest passage, generates a laryngeal jet and a reverse flow downstream the glottis. It is generally assumed that the glottis has different shapes and cross-sectional areas at different moments during the respiratory cycle and also depends on the average inspiratory flow rate. Therefore, the influence of a circular glottal aperture, with a cross-sectional area of 90 mm2 and an elliptical and triangular shape, both with an area of 45 mm2, on the flow is investigated. However, the area of the circular aperture is twice as big as the area of the elliptical one, it has almost no influence on the flow structures. On the other hand, the triangular glottal aperture shifts the laryngeal jet in the direction of the posterior wall, and generates two pairs of counter rotating secondary vortices downstream the glottis, where the circular and elliptical only aperture generates one pair of vortices. The difference in pressure drop is more dominated by the cross-sectional area than by the shape of the glottis. This suggests the need for rendering geometry of future upper airway models even more realistic as the appropriate three-dimensional (3D) medical imaging techniques are becoming available.

Biomechanical Phenomena↗
PubMed2005

Computational and experimental models of the human torso for non-penetrating ballistic impact.

Both computational finite element and experimental models of the human torso have been developed for ballistic impact testing. The human torso finite element model (HTFEM), including the thoracic skeletal structure and organs, was created in the finite element code LS-DYNA. The skeletal structure was assumed to be linear-elastic while all internal organs were modeled as viscoelastic. A physical human surrogate torso model (HSTM) was developed using biosimulant materials and the same anthropometry as the HTFEM. The HSTM response to impact was recorded with piezoresistive pressure sensors molded into the heart, liver and stomach and an accelerometer attached to the sternum. For experimentation, the HSTM was outfitted with National Institute of Justice (NIJ) Level I, IIa, II and IIIa soft armor vests. Twenty-six ballistic tests targeting the HSTM heart and liver were conducted with 22 caliber ammunition at a velocity of 329 m/s and 9 mm ammunition at velocities of 332, 358 and 430 m/s. The HSTM pressure response repeatability was found to vary by less than 10% for similar impact conditions. A comparison of the HSTM and HTFEM response showed similar pressure profiles and less than 35% peak pressure difference for organs near the ballistic impact point. Furthermore, the peak sternum accelerations of the HSTM and HTFEM varied by less than 10% for impacts over the sternum. These models provide comparative tools for determining the thoracic response to ballistic impact and could be used to evaluate soft body armor design and efficacy, determine thoracic injury mechanisms and assist with injury prevention.

Biomechanical Phenomena↗
PubMed2006

In vivo pons motion within the skull.

Finite element (FE) models are used to identify head injury mechanisms and design new and improved injury prevention schemes. Although brain-skull boundary conditions strongly influence the model mechanical responses, limited experimental data are available to develop an informed representation. We hypothesize that the spinal cord tension and gravity contribute to the pons displacement in vivo. Static high-resolution T1-weighted sagittal MR images of the inferior portion of the head in neutral and flexion positions were acquired in 15 human volunteers in both supine and prone postures. Boundaries of the pons and clivus were extracted with a gradient-based algorithm, and the pontes were fitted into ellipses. Assuming rigid body motion of the skull, image pairs in different postures were co-registered with an autocorrelation technique. By comparing images before and after the motion, we found that while the rotation of the pons is negligible relative to the skull, the pons displaces significantly at the foramen magnum, on the order of approximately 2 mm. When the spinal cord tension and gravity act in concert, the pons moves caudally; when opposed, superiorly, such that the influence of gravity on the pons is six times that of the spinal cord tension. Based on these findings, we recommend that the brainstem-skull interface be treated as a sliding (with or without friction) boundary condition in FE models of the human head.

Adult↗
PubMed2006

Ambulatory measurement of arm orientation.

In order to evaluate the impact of neuromuscular disorders affecting the upper extremities, the functional use of the arm need to be evaluated during daily activities. A system suitable for measuring arm kinematics should be ambulatory and not interfere with activities of daily living. A measurement system based on miniature accelerometers and gyroscopes is adequate because the sensors are small and do not suffer from line of sight problems. A disadvantage of such sensors is the cumulative drift around the vertical and the problems with aligning the sensor with the segment. A method that uses constraints in the elbow to measure the orientation of the lower arm with respect to the upper arm is described. This requires a calibration method to determine the exact orientation of each of the sensors with respect to the segment. Some preliminary measurements were analyzed and they indicated a strong reduction in orientation error around the vertical. It seemed that the accuracy of the method is limited by the accuracy of the sensor to segment calibration.

Acceleration↗
PubMed2006

Biomechanics of vertebral level, geometry, and transcortical tumors in the metastatic spine.

Metastatic involvement can disrupt the mechanical integrity of the spine, rendering vertebrae susceptible to burst fracture and neurologic damage. Fracture risk assessment for patients with spinal metastases is important in considering prophylactic treatment options. Stability of thoracic vertebrae affected by metastatic disease has been shown to be dependent on tumor size and bone density, but additional structural and geometric factors may also play a role in fracture risk assessment. The objective of this study was to use parametric finite element modeling to determine the effects of vertebral level, geometry, and metastatic compromise to the cortical shell on the risk of burst fracture in the thoracic spine. Analysis of vertebral level and geometry was assessed by investigation of seven scenarios ranging in geometry from T2-T4 to T10-T12. The effects of cortical shell compromised were assessed by comparison of four transcortical scenarios to a fully contained central vertebral body tumor scenario. Results demonstrated that upper thoracic vertebrae are at greater risk of burst fracture and that kyphotic motion segments are at decreased risk of burst fracture. Vertebrae with transcortical lesions are up to 30% less likely to lead to burst fracture initiation. The findings of this study are important for improving the understanding of burst fracture mechanics in metastatically involved vertebrae and guiding future modeling efforts.

Biomechanical Phenomena↗
PubMed2006

The use of sparse CT datasets for auto-generating accurate FE models of the femur and pelvis.

The finite element (FE) method when coupled with computed tomography (CT) is a powerful tool in orthopaedic biomechanics. However, substantial data is required for patient-specific modelling. Here we present a new method for generating a FE model with a minimum amount of patient data. Our method uses high order cubic Hermite basis functions for mesh generation and least-square fits the mesh to the dataset. We have tested our method on seven patient data sets obtained from CT assisted osteodensitometry of the proximal femur. Using only 12 CT slices we generated smooth and accurate meshes of the proximal femur with a geometric root mean square (RMS) error of less than 1 mm and peak errors less than 8 mm. To model the complex geometry of the pelvis we developed a hybrid method which supplements sparse patient data with data from the visible human data set. We tested this method on three patient data sets, generating FE meshes of the pelvis using only 10 CT slices with an overall RMS error less than 3 mm. Although we have peak errors about 12 mm in these meshes, they occur relatively far from the region of interest (the acetabulum) and will have minimal effects on the performance of the model. Considering that linear meshes usually require about 70-100 pelvic CT slices (in axial mode) to generate FE models, our method has brought a significant data reduction to the automatic mesh generation step. The method, that is fully automated except for a semi-automatic bone/tissue boundary extraction part, will bring the benefits of FE methods to the clinical environment with much reduced radiation risks and data requirement.

Algorithms↗
PubMed2006

Why fine-wire fixators work: an analysis of pressure distribution at the wire-bone interface.

Tensioned fine-wire external fixator systems have been used successfully for the treatment of fractures, mal-unions and for limb lengthening for many years. When used in metaphyseal bone, this type of fixator has a lower loosening rate than half-pin fixators. The differing mechanical properties of these fixator systems have been investigated extensively; however, most studies have centered on the mechanical properties of the fixator as a whole. Our knowledge of the interactions occurring at the interface between implant and bone remains sparse. In order to investigate this interaction, we devised a simple experimental model to characterise the distribution of pressure in cancellous bone surrounding a tensioned wire under loading conditions. Comparison was then made to a similar model of a half-pin fixator. Pressure was measured using pressure sensitive film at various distances away from the implant-bone interface. Static, single cycle loading of the model was performed with a Universal Testing Machine. Pressure distribution in the fine-wire model was found to occur in three regions: polar, beam loading and uniform. Polar patterns were seen closest to the wire with pressure concentrated at the entry and exit points of the wire. Beam loading was seen at a distance of 1.5 mm from the wire and pressure reached a uniform distribution at 4.0 mm. Most of the pressure measured was less than 2 MPa, which is less than the yield strength of cancellous bone (2-7 MPa). Higher loads produced higher stresses but the distribution pattern was similar. In contrast, the half-pin model showed far higher pressures (20 MPa), which were present deeper in the bone specimen. These results further our understanding of the biomechanics of fine-wire fixators and may explain the lower loosening rate of this type of fixator when compared to half-pin fixators used in metaphyseal bone.

Biomechanical Phenomena↗
PubMed2006

The influence of deceleration forces on ACL strain during single-leg landing: a simulation study.

Anterior cruciate ligament (ACL) injury commonly occurs during single limb landing or stopping from a run, yet the conditions that influence ACL strain are not well understood. The purpose of this study was to develop, test and apply a 3D specimen-specific dynamic simulation model of the knee designed to evaluate the influence of deceleration forces during running to a stop (single-leg landing) on ACL strain. This work tested the conceptual development of the model by simulating a physical experiment that provided direct measurements of ACL strain during vertical impact loading (peak value 1294N) with the leg near full extension. The properties of the soft tissue structures were estimated by simulating previous experiments described in the literature. A key element of the model was obtaining precise anatomy from segmented MR images of the soft tissue structures and articular geometry for the tibiofemoral and patellofemoral joints of the knee used in the cadaver experiment. The model predictions were correlated (Pearson correlation coefficient 0.889) to the temporal and amplitude characteristic of the experimental strains. The simulation model was then used to test the balance between ACL strain produced by quadriceps contraction and the reductions in ACL strain associated with the posterior braking force. When posterior forces that replicated in vivo conditions were applied, the peak ACL strain was reduced. These results suggest that the typical deceleration force that occurs during running to a single limb landing can substantially reduce the strain in the ACL relative to conditions associated with an isolated single limb landing from a vertical jump.

Anterior Cruciate Ligament↗
PubMed2006

Constrained least-squares optimization for robust estimation of center of rotation.

This paper presents a new direct method for estimating the average center of rotation (CoR). An existing least-squares (LS) solution has been shown by previous works to have reduced accuracy for data with small range of motion (RoM). Alternative methods proposed to improve the CoR estimation use iterative algorithms. However, in this paper we show that with a carefully chosen normalization scheme, constrained least-squares solutions can perform as well as iterative approaches, even for challenging problems with significant noise and small RoM. In particular, enforcing the normalization constraint avoids poor fits near plane singularities that can affect the existing LS method. Our formulation has an exact solution, accounts for multiple markers simultaneously, and does not depend on manually-adjusted parameters. Simulation tests compare the method to four published CoR estimation techniques. The results show that the new approach has the accuracy of the iterative methods as well as the short computation time and repeatability of a least-squares solution. In addition, application of the new method to experimental motion capture data of the thumb carpometacarpal (CMC) joint yielded a more plausible CoR location compared to the previously reported LS solution and required less time than all four alternative techniques.

Algorithms↗
PubMed2006

Three-dimensional computer simulation of radiostereometric analysis (RSA) in distal radius fractures.

Physical phantom models have conventionally been used to determine the accuracy and precision of radiostereometric analysis (RSA) in various orthopaedic applications. Using a phantom model of a fracture of the distal radius it has previously been shown that RSA is a highly accurate and precise method for measuring both translation and rotation in three-dimensions (3-D). The main shortcoming of a physical phantom model is its inability to mimic complex 3-D motion. The goal of this study was to create a realistic computer model for preoperative planning of RSA studies and to test the accuracy of RSA in measuring complex movements in fractures of the distal radius using this new model. The 3-D computer model was created from a set of tomographic scans. The simulation of the radiographic imaging was performed using ray-tracing software (POV-Ray). RSA measurements were performed according to standard protocol. Using a two-part fracture model (AO/ASIF type A2), it was found that for simple movements in one axis, translations in the range of 25microm-2mm could be measured with an accuracy of +/-2microm. Rotations ranging from 16 degrees to 2 degrees could be measured with an accuracy of +/-0.015 degrees . Using a three-part fracture model the corresponding values of accuracy were found to be +/-4microm and +/-0.031 degrees for translation and rotation, respectively. For complex 3-D motion in a three-part fracture model (AO/ASIF type C1) the accuracy was +/-6microm for translation and +/-0.120 degrees for rotation. The use of 3-D computer modelling can provide a method for preoperative planning of RSA studies in complex fractures of the distal radius and in other clinical situations in which the RSA method is applicable.

Computer Simulation↗
PubMed2004

Analysis of stray-light effects related to intraocular lens edge design.

PURPOSE: To study the behavior of light rays that impact the frosted, double-square edge of an intraocular lens (IOL). SETTING: Optical Phisiophatological Department, University of Florence, Florence, Italy. METHODS: The interaction of light rays as a function of the edge design of a frosted, sharp-edged IOL was evaluated using an experimental eye model and an advanced ray-tracing program. The model simulates the irregularities of the frosted edge by the random overlap of sinusoidal phase gratings that have a random phase, an orientation, and a fixed period. RESULTS: The reduction in the maximum intensity of the ghost image by frosting the square edge was linked to the period of the microroughness. At a maximum microroughness, when the period is less than 5 microm, the reduction in the value of an unfrosted, square-edged IOL was 17.5%. CONCLUSIONS: The frosted edge had a small impact on reducing the intensity of the ghost image caused by the reflection of light from the double square edge of the IOL. Furthermore, in optics, the stray light from microroughness is generally considered to be a drawback because it can decrease contrast sensitivity.

Humans↗
PubMed2004

Finite element contact stress analysis of the RPD abutment tooth and periodontal ligament.

OBJECTIVES: The purpose of this study was to determine the influence of the occlusal rest position in removable partial dentures on the displacement of the abutment tooth and the stress distribution in the periodontal ligament (PL). METHODS: We constructed three-dimensional finite element models of the mandibular first and second premolars. A layer of the PL and a mesial or distal occlusal rest were produced on the second premolar as an abutment. A zero displacement was prescribed on the outer surface of the PL and the first premolar. In each simulation, the rest was moved 0.05 mm vertically to the apical direction, with or without restriction of horizontal movements. We simulated the contact phenomena on the abutment surfaces, and calculated the movements of the abutment and stress distributions in the PL. RESULTS: We observed a maximum distal displacement of 42 microm at the buccal cusp of the abutment and a principal compressive stress of 0.35 MPa in the PL when the abutment was vertically loaded by a distal rest that was allowed to move horizontally. However, the displacements and stresses were relatively small, and were all within the physiological limitations of the tissues. The restriction of the horizontal movement of the rests was effective in reducing the horizontal displacements of the abutment, regardless of the rest position. CONCLUSIONS: The single vertical load exerted from either the mesial or distal rest on the abutment was unlikely to cause any mechanical damage to its supporting tissues.

Bicuspid↗
PubMed2004

Animal laboratories for procedural education of emergency medicine residents.

Many Emergency Medicine residencies incorporate animal laboratories into their training for procedural education because clinical opportunities to practice some emergency technical procedures are limited. To determine the proportion of Emergency Medicine residency programs utilizing animal laboratories, their characteristics, and the major impediments to providing animal laboratories, a cross-sectional descriptive survey of Emergency Medicine residency directors was conducted. Surveys were returned by 109/123 (89%) program directors. Ninety-four (87%) programs provide live animal laboratories for procedural training, an increase from previous studies. Although only 28% of directors knew the cost of the laboratories, this was the most commonly listed impediment (66%) to providing them. In conclusion, the use of animal laboratories for procedural training in Emergency Medicine residencies has increased in recent years. Cost is reported to be the most significant impediment to providing animal laboratories. The majority of program directors do not know the actual expense of providing animal laboratories.

Animals↗
PubMed2005

Effects of limb mass distribution on the ontogeny of quadrupedalism in infant baboons (Papio cynocephalus) and implications for the evolution of primate quadrupedalism.

Primate quadrupedal kinematics differ from those of other mammals. Several researchers have suggested that primate kinematics are adaptive for safe travel in an arboreal, small-branch niche. This study tests a compatible hypothesis that primate kinematics are related to their limb mass distribution patterns. Primates have more distally concentrated limb mass than most other mammals due to their grasping hands and feet. Experimental studies have shown that increasing distal limb mass by adding weights to the limbs of humans and dogs influences kinematics. Adding weights to distal limb elements increases the natural period of a limb's oscillation, leading to relatively long swing and stride durations. It is therefore possible that primates' distal limb mass is responsible for some of their unique kinematics. This hypothesis was tested using a longitudinal ontogenetic sample of infant baboons (Papio cynocephalus). Because limb mass distribution changes with age in infant primates, this project examined how these changes influence locomotor kinematics within individuals. The baboons in this sample showed a shift in their kinematics as their limb mass distributions changed during ontogeny. When their limb mass was most distally concentrated (at young ages), stride frequencies were relatively low, stride lengths were relatively long, and stance durations were relatively long compared to older ages when limb mass was more proximally concentrated. These results suggest that the evolution of primate quadrupedal kinematics was tied to the evolution of grasping hands and feet.

Age Factors↗