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Kumaran Y, Bonsu JM, Tripathi S, Soehnlen SM, Quatman CE. Phase-specific changes in hip joint loading during gait following sacroiliac joint fusion: Findings from a finite element analysis. Clin Biomech (Bristol, Avon) 2025; 122:106429. [PMID: 39798258 DOI: 10.1016/j.clinbiomech.2025.106429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2024] [Revised: 12/12/2024] [Accepted: 01/06/2025] [Indexed: 01/15/2025]
Abstract
BACKGROUND Low back pain affects over 80 % of adults, with sacroiliac joint dysfunction accounting for 15-30 % of these cases. Sacroiliac fusion is a surgical procedure for refractory joint pain. While the biomechanics of the joint and its fusion relative to the spinal column are well-known, the hip-spine relationship post-fusion remains unclear. Understanding the biomechanical state following fusion can enhance patient recovery and optimize surgical outcomes. This study uses finite element analysis to assess hip joint biomechanics following sacroiliac joint fusion. METHODS CTs of a 55-year-old male were used to create a biomechanical model, validated against a cadaveric study. Three triangular titanium alloy implants were placed across the sacroiliac joint in a unilateral and bilateral configuration. The model, loaded with pelvis and hip joint kinematics during a gait cycle, calculated joint reaction forces, contact stress and area on the hip joint across various gait phases. FINDINGS Hip joint contact stresses varied with fixation configurations and gait phases. Unilateral right fusion reduced joint reaction forces by 2 % but increased contact stress by 3.7 %. Bilateral fusion increased joint reaction forces by 6.7 % and contact stress by 3.25 %, with higher stress during foot flat and heel off phases compared to unilateral fixation. INTERPRETATION Fusion alters hip loading patterns during specific gait phases, with bilateral fusion producing the highest stresses during foot flat and heel off. These findings may suggest the need for fusion-specific rehabilitation protocols and warrants further investigation of long-term joint health outcomes.
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Affiliation(s)
- Yogesh Kumaran
- Engineering Center for Orthopaedic Research Excellence (E-CORE), University of Toledo, Departments of Bioengineering and Orthopaedic Surgery, Toledo, OH, USA; Ohio State University Wexner Medical Center, Department of Orthopaedics, Columbus, OH, USA
| | - Janice M Bonsu
- Emory University School of Medicine, Department of Orthopaedics, Atlanta, GA, USA
| | - Sudharshan Tripathi
- Engineering Center for Orthopaedic Research Excellence (E-CORE), University of Toledo, Departments of Bioengineering and Orthopaedic Surgery, Toledo, OH, USA
| | - Sophia M Soehnlen
- Ohio State University Wexner Medical Center, Department of Orthopaedics, Columbus, OH, USA
| | - Carmen E Quatman
- Ohio State University Wexner Medical Center, Department of Orthopaedics, Columbus, OH, USA.
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Prasetya AIP, Ammarullah MI, Winarni TI, Pramono A, Jamari J, Kamarul T, Syahrom A. Understanding Hip Contact Stress Based on Types of Physical Activity: A Systematic Review. Health Sci Rep 2025; 8:e70305. [PMID: 39846047 PMCID: PMC11751712 DOI: 10.1002/hsr2.70305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 11/25/2024] [Accepted: 12/08/2024] [Indexed: 01/24/2025] Open
Abstract
Background and Aims High contact stresses involving the hip have been shown to increase the risk of developing hip osteoarthritis (OA). Although several risk factors have been identified for OA, a holistic approach to predicting contributed factors toward increased hip contact stresses have not been explored. This study was conducted to comprehensively understand the effects of physical activity on high hip contact stress as predisposing factors of OA. Methods The protocol of this systematic review was registered in PROSPERO with registration number CRD42022296638 and conducted based on PRISMA guidelines. Full articles that matched our inclusion criteria were selected using PubMed, Web of Science, and Scopus search engines and keywords such as "hip contact stress," "hip contact force," and/or "hip contact pressure." Category of factors, experimental design, results of the study, and evidence from each article were analyzed. Results In total 7972 papers were screened, identified, and reviewed. Two independent authors read the collected fulltext of eligible articles resulting in 21 papers that fulfilled the inclusion criteria of this systematic review. Conclusion Types of physical activity (n = 21) have correlation with high hip joint contact stress in various manner. Based on the research findings obtained from various inclusion papers, it can be broadly concluded that the more intense the physical activity, such as running and stair climbing, the greater the impact on the increase in hip contact stress values. However, the reviewed studies vary in their methods. This finding suggested that this area is not well investigated and warrants future research.
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Affiliation(s)
- Arief Indra Perdana Prasetya
- Department of Surgery Sub Orthopaedic and TraumatologyFaculty of MedicineUniversitas Islam Sultan AgungSemarangCentral JavaIndonesia
- Postgraduate Program, Faculty of MedicineUniversitas DiponegoroSemarangCentral JavaIndonesia
| | - Muhammad Imam Ammarullah
- Department of Mechanical EngineeringFaculty of EngineeringUniversitas DiponegoroSemarangCentral JavaIndonesia
- Undip Biomechanics Engineering & Research Centre (UBM‐ERC)Universitas DiponegoroSemarangCentral JavaIndonesia
| | - Tri Indah Winarni
- Undip Biomechanics Engineering & Research Centre (UBM‐ERC)Universitas DiponegoroSemarangCentral JavaIndonesia
- Department of AnatomyFaculty of MedicineUniversitas DiponegoroSemarangCentral JavaIndonesia
- Center for Biomedical Research (CEBIOR), Faculty of MedicineUniversitas DiponegoroSemarangCentral JavaIndonesia
| | - Adriyan Pramono
- Department of Nutrition ScienceFaculty of MedicineUniversitas DiponegoroSemarangCentral JavaIndonesia
| | - Jamari Jamari
- Department of Mechanical EngineeringFaculty of EngineeringUniversitas DiponegoroSemarangCentral JavaIndonesia
- Undip Biomechanics Engineering & Research Centre (UBM‐ERC)Universitas DiponegoroSemarangCentral JavaIndonesia
| | - Tunku Kamarul
- Department of Orthopaedic Surgery (NOCERAL)Faculty of MedicineUniversiti MalayaKuala LumpurFederal Territory of Kuala LumpurMalaysia
| | - Ardiyansyah Syahrom
- Department of Applied Mechanics and DesignSchool of Mechanical EngineeringUniversiti Teknologi MalaysiaSkudaiJohorMalaysia
- Mechanical Engineering and Medical Device and Technology Centre (MEDITEC)Universiti Teknologi MalaysiaSkudaiJohorMalaysia
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Cooper RJ, Day GA, Wijayathunga VN, Yao J, Mengoni M, Wilcox RK, Jones AC. The role of high-resolution cartilage thickness distribution for contact mechanics predictions in the tibiofemoral joint. Proc Inst Mech Eng H 2025; 239:18-28. [PMID: 39785359 PMCID: PMC11894913 DOI: 10.1177/09544119241307793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 11/29/2024] [Indexed: 01/12/2025]
Abstract
Subject-specific finite element models of knee joint contact mechanics are used in assessment of interventions and disease states. Cartilage thickness distribution is one factor influencing the distribution of pressure. Precision of cartilage geometry capture varies between imaging protocols. This work evaluated the cartilage thickness distribution precision needed for contact mechanics prediction in models of the tibiofemoral joint by comparing model outputs to experimental measurements for three cadaveric specimens. Models with location-specific cartilage thickness were compared to those with a uniform thickness, for a fixed relative orientation of the femur and tibia and with tibial freedom of movement. Under constrained conditions, the advantage of including location-specific cartilage thickness was clear. Models with location-specific thickness predicted the proportion of force through each condyle with an average error of 5% (compared to 27% with uniform thickness) and predicted the experimental contact area with an error of 21 mm2 (compared to 98 mm2 with uniform thickness). With tibial freedom, the advantage of location-specific cartilage thickness not clear. The attempt to allow three degrees of relative freedom at the tibiofemoral joint resulted in a high degree of experimental and computational uncertainty. It is therefore recommended that researchers avoid this level of freedom. This work provides some evidence that highly constrained conditions make tibiofemoral contact mechanics predictions more sensitive to cartilage thickness and should perhaps be avoided in studies where the means to generate subject-specific cartilage thickness are not available.
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Affiliation(s)
- Robert J Cooper
- Institute of Medical and Biological Engineering, University of Leeds, Leeds, UK
| | - Gavin A Day
- Institute of Medical and Biological Engineering, University of Leeds, Leeds, UK
| | | | - Jiacheng Yao
- Institute of Medical and Biological Engineering, University of Leeds, Leeds, UK
| | - Marlène Mengoni
- Institute of Medical and Biological Engineering, University of Leeds, Leeds, UK
| | - Ruth K Wilcox
- Institute of Medical and Biological Engineering, University of Leeds, Leeds, UK
| | - Alison C Jones
- Institute of Medical and Biological Engineering, University of Leeds, Leeds, UK
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Aitken HD, Goetz JE, Glass NA, Miller A, Rivas DJL, Westermann RW, McKinley TO, Willey MC. Persistently elevated joint contact stress after periacetabular osteotomy is associated with joint failure at minimum 10-year follow-up. J Orthop Res 2024; 42:2773-2783. [PMID: 39030968 PMCID: PMC11654831 DOI: 10.1002/jor.25935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 06/21/2024] [Accepted: 06/27/2024] [Indexed: 07/22/2024]
Abstract
Periacetabular osteotomy (PAO) is a common treatment for prearthritic hip dysplasia. The goal of this investigation was to determine if computationally assessed hip contact mechanics are associated with joint failure at minimum 10-year follow-up. One hundred patients with hip dysplasia (125 hips) completed patient-reported outcomes an average of 13.8 years (range 10.0-18.0 years) after PAO. 63/125 hips were classified as having failed: 26 converted to total hip arthroplasty (THA) and 37 with significant disability indicated by modified Harris Hip Score (mHHS) ≤ 70. Differences in discrete element analysis-computed contact mechanics were compared between (1) preserved and failed hips, (2) preserved hips and hips that failed by THA, and (3) preserved hips and hips that failed by mHHS ≤ 70. Failed hips had significantly higher preoperative contact stress and exposure metrics (p < 0.001-0.009) than preserved hips. Failed hips also had significantly higher postoperative peak contact stress (p = 0.018), higher mean contact stress (p < 0.001), and smaller contact area (p = 0.044). When assessed based on type of failure, hips that failed by THA had significantly higher postoperative contact stress and exposure metrics than preserved hips (p < 0.001-0.020). In hips that failed by mHHS ≤ 70, mean postoperative contact stress exposure was significantly higher compared to preserved hips (p = 0.043). Despite improved radiographic measures of dysplasia after PAO, pathologic joint contact mechanics can persist and predict treatment failure at minimum 10 years after surgery. Operative and nonoperative techniques specifically intended to reduce harmful contact mechanics in dysplastic hips may have the potential to further improve clinical outcomes after PAO.
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Affiliation(s)
- Holly D. Aitken
- Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
| | - Jessica E. Goetz
- Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
| | - Natalie A. Glass
- Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Aspen Miller
- Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Dominic J. L. Rivas
- Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
| | - Robert W. Westermann
- Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Todd O. McKinley
- Indiana University Health, Methodist Hospital, Indianapolis, IN, USA
| | - Michael C. Willey
- Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Hidayat T, Ammarullah MI, Ismail R, Saputra E, Lamura MDP, K N C, Bayuseno AP, Jamari J. Investigation of contact behavior on a model of the dual-mobility artificial hip joint for Asians in different inner liner thicknesses. World J Orthop 2024; 15:321-336. [PMID: 38680676 PMCID: PMC11045469 DOI: 10.5312/wjo.v15.i4.321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/28/2024] [Accepted: 03/25/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND The four components that make up the current dual-mobility artificial hip joint design are the femoral head, the inner liner, the outer liner as a metal cover to prevent wear, and the acetabular cup. The acetabular cup and the outer liner were constructed of 316L stainless steel. At the same time, the inner liner was made of ultra-high-molecular-weight polyethylene (UHMWPE). As this new dual-mobility artificial hip joint has not been researched extensively, more tribological research is needed to predict wear. The thickness of the inner liner is a significant component to consider when calculating the contact pressure. AIM To make use of finite element analysis to gain a better understanding of the contact behavior in various inner liner thicknesses on a new model of a dual-mobility artificial hip joint, with the ultimate objective of determining the inner liner thickness that was most suitable for this particular type of dual-mobility artificial hip joint. METHODS In this study, the size of the femoral head was compared between two diameters (28 mm and 36 mm) and eight inner liner thicknesses ranging from 5 mm to 12 mm. Using the finite element method, the contact parameters, including the maximum contact pressure and contact area, have been evaluated in light of the Hertzian contact theory. The simulation was performed statically with dissipated energy and asymmetric behavior. The types of interaction were surface-to-surface contact and normal contact behavior. RESULTS The maximum contact pressures in the inner liner (UHMWPE) at a head diameter of 28 mm and 36 mm are between 3.7-13.5 MPa and 2.7-10.4 MPa, respectively. The maximum von Mises of the inner liner, outer liner, and acetabular cup are 2.4-11.4 MPa, 15.7-44.3 MPa, and 3.7-12.6 MPa, respectively, for 28 mm head. Then the maximum von Mises stresses of the 36 mm head are 1.9-8.9 MPa for the inner liner, 9.9-32.8 MPa for the outer liner, and 2.6-9.9 MPa for the acetabular cup. A head with a diameter of 28 mm should have an inner liner with a thickness of 12 mm. Whereas the head diameter was 36 mm, an inner liner thickness of 8 mm was suitable. CONCLUSION The contact pressures and von Mises stresses generated during this research can potentially be exploited in estimating the wear of dual-mobility artificial hip joints in general. Contact pressure and von Mises stress reduce with an increasing head diameter and inner liner's thickness. Present findings would become one of the references for orthopedic surgery for choosing suitable bearing geometric parameter of hip implant.
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Affiliation(s)
- Taufiq Hidayat
- Department of Mechanical Engineering, Universitas Muria Kudus, Kudus 59352, Central Java, Indonesia
- Department of Mechanical Engineering, Universitas Diponegoro, Semarang 50275, Central Java, Indonesia
| | - Muhammad Imam Ammarullah
- Department of Mechanical Engineering, Universitas Diponegoro, Semarang 50275, Central Java, Indonesia
- Undip Biomechanics Engineering & Research Centre, Universitas Diponegoro, Semarang 50275, Central Java, Indonesia
| | - Rifky Ismail
- Department of Mechanical Engineering, Universitas Diponegoro, Semarang 50275, Central Java, Indonesia
- Center for Biomechanics Biomaterials Biomechatronics and Biosignal Processing, Universitas Diponegoro, Semarang 50275, Central Java, Indonesia
| | - Eko Saputra
- Department of Mechanical Engineering, Politeknik Negeri Semarang, Semarang 50275, Central Java, Indonesia
| | - M Danny Pratama Lamura
- Department of Mechanical Engineering, Universitas Diponegoro, Semarang 50275, Central Java, Indonesia
- Undip Biomechanics Engineering & Research Centre, Universitas Diponegoro, Semarang 50275, Central Java, Indonesia
| | - Chethan K N
- Department of Aeronautical and Automobile Engineering, Manipal Institute of Technology, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | | | - J Jamari
- Department of Mechanical Engineering, Universitas Diponegoro, Semarang 50275, Central Java, Indonesia
- Undip Biomechanics Engineering & Research Centre, Universitas Diponegoro, Semarang 50275, Central Java, Indonesia
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Valerio T, Milan JL, Goislard de Monsabert B, Vigouroux L. The effect of trapeziometacarpal joint passive stiffness on mechanical loadings of cartilages. J Biomech 2024; 166:112042. [PMID: 38498967 DOI: 10.1016/j.jbiomech.2024.112042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/28/2024] [Accepted: 03/05/2024] [Indexed: 03/20/2024]
Abstract
Hypermobility of the trapeziometacarpal joint is commonly considered to be a potential risk factor for osteoarthritis. Nevertheless, the results remain controversial due to a lack of quantitative validation. The objective of this study was to evaluate the effect of joint laxity on the mechanical loadings of cartilage. A patient-specific finite element model of trapeziometacarpal joint passive stiffness was developed. The joint passive stiffness was modeled by creating linear springs all around the joint. The linear spring stiffness was determined by using an optimization process to fit force-displacement data measured during laxity tests performed on eight healthy volunteers. The estimated passive stiffness parameters were then included in a full thumb finite element simulation of a pinch grip task driven by muscle forces to evaluate the effect on trapeziometacarpal loading. The correlation between stiffness and the loading of cartilage in terms of joint contact pressure and maximum shear strain was analyzed. A significant negative correlation was found between the trapeziometacarpal joint passive stiffness and the contact pressure on trapezium cartilage during the simulated pinch grip task. These results therefore suggest that the hypermobility of the trapeziometacarpal joint could affect the contact pressure on trapezium cartilage and support the existence of an increased risk associated with hypermobility.
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Affiliation(s)
- Thomas Valerio
- Aix-Marseille University, CNRS, ISM, Marseille, France; Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France.
| | - Jean-Louis Milan
- Aix-Marseille University, CNRS, ISM, Marseille, France; Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
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Incze-Bartha Z, Incze-Bartha S, Simon Szabó Z, Feier AM, Vunvulea V, Nechifor-Boilă IA, Pastorello Y, Szasz D, Dénes L. Finite Element Analysis of Normal and Dysplastic Hip Joints in Children. J Pers Med 2023; 13:1593. [PMID: 38003908 PMCID: PMC10672490 DOI: 10.3390/jpm13111593] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
From a surgical point of view, quantification cannot always be achieved in the developmental deformity in hip joints, but finite element analysis can be a helpful tool to compare normal joint architecture with a dysplastic counterpart. CT scans from the normal right hip of an 8-year-old boy and the dysplastic left hip of a 12-year-old girl were used to construct our geometric models. In a three-dimensional model construction, distinctions were made between the cortical bone, trabecular bone, cartilage, and contact nonlinearities of the hip joint. The mathematical model incorporated the consideration of the linear elastic and isotropic properties of bony tissue in children, separately for the cortical bone, trabecular bone, and articular cartilage. Hexahedral elements were used in Autodesk Inventor software version 2022 ("Ren") for finite element analysis of the two hips in the boundary conditions of the single-leg stance. In the normal hip joint on the cartilaginous surfaces of the acetabulum, we found a kidney-shaped stress distribution in a 471,672 mm2 area. The measured contact pressure values were between 3.0 and 4.3 MPa. In the dysplastic pediatric hip joint on a patch of 205,272 mm2 contact area, the contact pressure values reached 8.5 MPa. Furthermore, the acetabulum/femur head volume ratio was 20% higher in the dysplastic hip joint. We believe that the knowledge gained from the normal and dysplastic pediatric hip joints can be used to develop surgical treatment methods and quantify and compare the efficiency of different surgical treatments used in children with hip dysplasia.
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Affiliation(s)
- Zsuzsánna Incze-Bartha
- Department of Anatomy, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania; (Z.I.-B.)
| | - Sandor Incze-Bartha
- Department of Orthopedics and Traumatology, “Fogolyan Kristof” County Hospital Sfantu Gheorghe, 520064 Covasna, Romania
| | - Zsuzsánna Simon Szabó
- Department of Anatomy, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania; (Z.I.-B.)
| | - Andrei Marian Feier
- Department of Orthopaedics and Traumatology, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Vlad Vunvulea
- Department of Anatomy, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania; (Z.I.-B.)
| | - Ioan Alin Nechifor-Boilă
- Department of Anatomy, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania; (Z.I.-B.)
| | - Ylenia Pastorello
- Department of Anatomy, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania; (Z.I.-B.)
| | - Dezso Szasz
- Department of Orthopedics and Traumatology, “Fogolyan Kristof” County Hospital Sfantu Gheorghe, 520064 Covasna, Romania
| | - Lóránd Dénes
- Department of Anatomy, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania; (Z.I.-B.)
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Atkins PR, Morris A, Elhabian SY, Anderson AE. A Correspondence-Based Network Approach for Groupwise Analysis of Patient-Specific Spatiotemporal Data. Ann Biomed Eng 2023; 51:2289-2300. [PMID: 37357248 PMCID: PMC11047278 DOI: 10.1007/s10439-023-03270-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/01/2023] [Indexed: 06/27/2023]
Abstract
Methods for statistically analyzing patient-specific data that vary both spatially and over time are currently either limited to summary statistics or require elaborate surface registration. We propose a new method, called correspondence-based network analysis, which leverages particle-based shape modeling to establish correspondence across a population and preserve patient-specific measurements and predictions through statistical analysis. Herein, we evaluated this method using three published datasets of the hip describing cortical bone thickness of the proximal femur, cartilage contact stress, and dynamic joint space between control and patient cohorts to evaluate activity- and group-based differences, as applicable, using traditional statistical parametric mapping (SPM) and our proposed spatially considerate correspondence-based network analysis approach. The network approach was insensitive to correspondence density, while the traditional application of SPM showed decreasing area of the region of significance with increasing correspondence density. In comparison to SPM, the network approach identified broader and more connected regions of significance for all three datasets. The correspondence-based network analysis approach identified differences between groups and activities without loss of subject and spatial specificity which could improve clinical interpretation of results.
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Affiliation(s)
- Penny R Atkins
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - Alan Morris
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
| | - Shireen Y Elhabian
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
- School of Computing, University of Utah, Salt Lake City, UT, USA
| | - Andrew E Anderson
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA.
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA.
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA.
- Department of Physical Therapy, University of Utah, Salt Lake City, UT, USA.
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Kou W, Liang Y, Wang Z, Liang Q, Sun L, Kuang S. An Integrated Method of Biomechanics Modeling for Pelvic Bone and Surrounding Soft Tissues. Bioengineering (Basel) 2023; 10:736. [PMID: 37370667 DOI: 10.3390/bioengineering10060736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
The pelvis and its surrounding soft tissues create a complicated mechanical environment that greatly affects the success of fixing broken pelvic bones with surgical navigation systems and/or surgical robots. However, the modeling of the pelvic structure with the more complex surrounding soft tissues has not been considered in the current literature. The study developed an integrated finite element model of the pelvis, which includes bone and surrounding soft tissues, and verified it through experiments. Results from the experiments showed that including soft tissue in the model reduced stress and strain on the pelvis compared to when it was not included. The stress and strain distribution during pelvic loading was similar to what is typically seen in research studies and more accurate in modeling the pelvis. Additionally, the correlation with the experimental results from the predecessor's study was strong (R2 = 0.9627). The results suggest that the integrated model established in this study, which includes surrounding soft tissues, can enhance the comprehension of the complex biomechanics of the pelvis and potentially advance clinical interventions and treatments for pelvic injuries.
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Affiliation(s)
- Wei Kou
- Department of Mechanical and Electrical Engineering, Soochow University, Suzhou 215137, China
| | - Yefeng Liang
- Department of Mechanical and Electrical Engineering, Soochow University, Suzhou 215137, China
| | - Zhixing Wang
- Department of Mechanical and Electrical Engineering, Soochow University, Suzhou 215137, China
| | - Qingxi Liang
- Department of Mechanical and Electrical Engineering, Soochow University, Suzhou 215137, China
| | - Lining Sun
- Department of Mechanical and Electrical Engineering, Soochow University, Suzhou 215137, China
| | - Shaolong Kuang
- Department of Mechanical and Electrical Engineering, Soochow University, Suzhou 215137, China
- College of Health Science and Environment Engineering, Shenzhen Technology University, Shenzhen 518118, China
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Ma Y, Chen S, Chen D. Mechanical influence of periacetabular osteotomy on late total hip arthroplasty. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2023; 39:e3690. [PMID: 36846879 DOI: 10.1002/cnm.3690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 01/19/2023] [Accepted: 02/07/2023] [Indexed: 05/13/2023]
Abstract
Periacetabular osteotomy (PAO) is an effective technique to treat symptomatic hip dysplasia. However, following PAO, some patients still experience persistent pain or development of hip arthritis, requiring total hip arthroplasty (THA). Issues such as whether patients with PAO are necessarily at increased risk of post-THA complications and revision of the prosthesis remain debatable. The purpose of this study was to evaluate the biomechanical influence of PAO on the acetabulum after THA by finite element analysis. Eight patients with developmental dysplasia of the hip (DDH) diagnosed in the Fourth Medical Center of the PLA General Hospital were enrolled in this research. Patient-specific hip joint models were reconstructed from computed tomography scans, and the hip prosthesises, were established via computer-aided design (CAD) modeling technology. The finite element analysis was conducted to compare the surface and internal stress through the process mapping of the model due to the THA. Compared with the THA after PAO, the position of the high-stress area of the acetabular fossa of patients without PAO decreased, and the high-stress area developed toward the lower edge of the acetabulum. Although the high-stress area of the suprapubic branch did not change significantly, the peak stress was higher (t = .00237). The analysis of the section plane showed that the high-stress area of cancellous bone had a large distribution. The acetabular size and vertical distance of rotation center (VDRC) were significantly correlated with the maximum postoperative acetabular equivalent stress (p = .011, p = .001). In the Post group, both the horizontal distance of rotation center (HDRC) and A-ASA were significantly correlated with postoperative maximal acetabular equivalent stress, with a significance of 0.014 and 0.035, respectively. The risk of postoperative prosthetic revision following THA is not increased by PAO, although the risk of postoperative suprapubic branch fracture is increased.
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Affiliation(s)
- Yunqing Ma
- Department of Orthopaedics, The Fourth Medical Center of PLA General Hospital, Beijing, China
| | - Songhao Chen
- School of Life Science, Beijing Institute of Technology, China
| | - Duanduan Chen
- School of Life Science, Beijing Institute of Technology, China
- Key Laboratory of Convergence Medical Engineering System and Healthcare Technology, The Ministry of Industry and Information Technology, Beijing Institute of Technology, China
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11
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Goetz JE, Thomas-Aitken HD, Sitton SE, Westermann RW, Willey MC. Joint contact stress improves in dysplastic hips after periacetabular osteotomy but remains higher than in normal hips. Hip Int 2023; 33:298-305. [PMID: 34348517 PMCID: PMC9744023 DOI: 10.1177/11207000211036414] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIM The purpose of this study was to use computational modeling to determine if surgical correction of hip dysplasia restores hip contact mechanics to those of asymptomatic, radiographically normal hips. METHODS Discrete element analysis (DEA) was used to compute joint contact stresses during the stance phase of normal walking gait for 10 individuals with radiographically normal, asymptomatic hips and 10 age- and weight-matched patients with acetabular dysplasia who underwent periacetabular osteotomy (PAO). RESULTS Mean and peak contact stresses were higher (p < 0.001 and p = 0.036, respectively) in the dysplastic hips than in the matched normal hips. PAO normalised standard radiographic measurements and medialised the location of computed contact stress within the joint. Mean contact stress computed in dysplastic hips throughout the stance phase of gait (median 5.5 MPa, [IQR 3.9-6.1 MPa]) did not significantly decrease after PAO (3.7 MPa, [IQR 3.2-4.8]; p = 0.109) and remained significantly (p < 0.001) elevated compared to radiographically normal hips (2.4 MPa, [IQR 2.2-2.8 MPa]). Peak contact stress demonstrated a similar trend. Joint contact area during the stance phase of gait in the dysplastic hips increased significantly (p = 0.036) after PAO from 395 mm2 (IQR 378-496 mm2) to 595 mm2 (IQR 474-660 mm2), but remained significantly smaller (p = 0.001) than that for radiographically normal hips (median 1120 mm2, IQR 853-1444 mm2). CONCLUSIONS While contact mechanics in dysplastic hips more closely resembled those of normal hips after PAO, the elevated contact stresses and smaller contact areas remaining after PAO indicate ongoing mechanical abnormalities should be expected even after radiographically successful surgical correction.
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Affiliation(s)
- Jessica E. Goetz
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, 52242, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, 52242, USA
| | - Holly D. Thomas-Aitken
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, 52242, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, 52242, USA
| | - Sean E. Sitton
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, 52242, USA
| | - Robert W. Westermann
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, 52242, USA
| | - Michael C. Willey
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, 52242, USA
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12
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Gaffney BMM, Williams ST, Todd JN, Weiss JA, Harris MD. A Musculoskeletal Model for Estimating Hip Contact Pressure During Walking. Ann Biomed Eng 2022; 50:1954-1963. [PMID: 35864367 PMCID: PMC9797423 DOI: 10.1007/s10439-022-03016-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 07/07/2022] [Indexed: 12/31/2022]
Abstract
Cartilage contact pressures are major factors in osteoarthritis etiology and are commonly estimated using finite element analysis (FEA). FEA models often include subject-specific joint geometry, but lack subject-specific joint kinematics and muscle forces. Musculoskeletal models use subject-specific kinematics and muscle forces but often lack methods for estimating cartilage contact pressures. Our objective was to adapt an elastic foundation (EF) contact model within OpenSim software to predict hip cartilage contact pressures and compare results to validated FEA models. EF and FEA models were built for five subjects. In the EF models, kinematics and muscle forces were applied and pressure was calculated as a function of cartilage overlap depth. Cartilage material properties were perturbed to find the best match to pressures from FEA. EF models with elastic modulus = 15 MPa and Poisson's ratio = 0.475 yielded results most comparable to FEA, with peak pressure differences of 4.34 ± 1.98 MPa (% difference = 39.96 ± 24.64) and contact area differences of 3.73 ± 2.92% (% difference = 13.4 ± 11.3). Peak pressure location matched between FEA and EF for 3 of 5 subjects, thus we do not recommend this model if the location of peak contact pressure is critically important to the research question. Contact area magnitudes and patterns matched reasonably between FEA and EF, suggesting that this model may be useful for questions related to those variables, especially if researchers desire inclusion of subject-specific geometry, kinematics, muscle forces, and dynamic motion in a computationally efficient framework.
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Affiliation(s)
- Brecca M M Gaffney
- Department of Mechanical Engineering, University of Colorado Denver, Denver, CO, USA
- Center of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Spencer T Williams
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Jocelyn N Todd
- Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
| | - Jeffrey A Weiss
- Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
| | - Michael D Harris
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, 4444 Forest Park Ave., Suite 1101, St. Louis, MO, 63108, USA.
- Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, St. Louis, MO, USA.
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13
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Moshfeghifar F, Gholamalizadeh T, Ferguson Z, Schneider T, Nielsen MB, Panozzo D, Darkner S, Erleben K. LibHip: An open-access hip joint model repository suitable for finite element method simulation. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 226:107140. [PMID: 36162245 DOI: 10.1016/j.cmpb.2022.107140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE population-based finite element analysis of hip joints allows us to understand the effect of inter-subject variability on simulation results. Developing large subject-specific population models is challenging and requires extensive manual effort. Thus, the anatomical representations are often subjected to simplification. The discretized geometries do not guarantee conformity in shared interfaces, leading to complications in setting up simulations. Additionally, these models are not openly accessible, challenging reproducibility. Our work provides multiple subject-specific hip joint finite element models and a novel semi-automated modeling workflow. METHODS we reconstruct 11 healthy subject-specific models, including the sacrum, the paired pelvic bones, the paired proximal femurs, the paired hip joints, the paired sacroiliac joints, and the pubic symphysis. The bones are derived from CT scans, and the cartilages are generated from the bone geometries. We generate the whole complex's volume mesh with conforming interfaces. Our models are evaluated using both mesh quality metrics and simulation experiments. RESULTS the geometry of all the models are inspected by our clinical expert and show high-quality discretization with accurate geometries. The simulations produce smooth stress patterns, and the variance among the subjects highlights the effect of inter-subject variability and asymmetry in the predicted results. CONCLUSIONS our work is one of the largest model repositories with respect to the number of subjects and regions of interest in the hip joint area. Our detailed research data, including the clinical images, the segmentation label maps, the finite element models, and software tools, are openly accessible on GitHub and the link is provided in Moshfeghifar et al.(2022)[1]. Our aim is to empower clinical researchers to have free access to verified and reproducible models. In future work, we aim to add additional structures to our models.
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Affiliation(s)
- Faezeh Moshfeghifar
- Department of Computer Science, University of Copenhagen, Copenhagen 2100, Denmark.
| | - Torkan Gholamalizadeh
- Department of Computer Science, University of Copenhagen, Copenhagen 2100, Denmark; 3Shape A/S, Copenhagen 1060, Denmark
| | - Zachary Ferguson
- Courant Institute of Mathematical Sciences, New York University, 60 5th Ave, New York, NY 10011, United States
| | - Teseo Schneider
- Department of Computer Science, University of Victoria, Victoria, BC V8P 5C2, Canada
| | - Michael Bachmann Nielsen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Radiology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Daniele Panozzo
- Courant Institute of Mathematical Sciences, New York University, 60 5th Ave, New York, NY 10011, United States
| | - Sune Darkner
- Department of Computer Science, University of Copenhagen, Copenhagen 2100, Denmark
| | - Kenny Erleben
- Department of Computer Science, University of Copenhagen, Copenhagen 2100, Denmark
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14
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Aitken HD, Westermann RW, Bartschat NI, Clohisy JC, Willey MC, Goetz JE. Effect of modeling femoral version and head-neck offset correction on computed contact mechanics in dysplastic hips treated with periacetabular osteotomy. J Biomech 2022; 141:111207. [PMID: 35764011 PMCID: PMC9747059 DOI: 10.1016/j.jbiomech.2022.111207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 12/15/2022]
Abstract
While correction of dysplastic acetabular deformity has been a focus of both clinical treatment and research, concurrent femoral deformities have only more recently received serious attention. The purpose of this study was to determine how including abnormalities in femoral head-neck offset and femoral version alter computationally derived contact stresses in patients with combined dysplasia and femoroacetabular impingement (FAI). Hip models with patient-specific bony anatomy were created from preoperative and postoperative CT scans of 20 hips treated with periacetabular osteotomy and femoral osteochondroplasty. To simulate performing only a PAO, a third model was created combining each patient's postoperative pelvis and preoperative femur geometry. These three models were initialized with the femur in two starting orientations: (1) standardized template orientation, and (2) using patient-specific anatomic landmarks. Hip contact stresses were computed in all 6 model sets during an average dysplastic gait cycle, an average FAI gait cycle, and an average stand-to-sit activity using discrete element analysis. No significant differences in peak contact stress (p = 0.190 to 1), mean contact stress (p = 0.273 to 1), or mean contact area (p = 0.050 to 1) were identified during any loading activity based on femoral alignment technique or inclusion of femoral osteochondroplasty. These findings suggest that presence of abnormal femoral version and/or head-neck offset deformities are not themselves predominant factors in intra-articular contact mechanics during gait and stand-to-sit activities. Inclusion of modified movement patterns caused by these femoral deformities may be necessary for models to adequately capture the mechanical effects of these clinically recognized risk factors for negative outcomes.
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Affiliation(s)
- Holly D Aitken
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA 52242, USA
| | - Robert W Westermann
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA 52242, USA
| | - Nicholas I Bartschat
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA 52242, USA
| | - John C Clohisy
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Michael C Willey
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA 52242, USA
| | - Jessica E Goetz
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA 52242, USA; Department of Biomedical Engineering, University of Iowa, Iowa City, IA 52242, USA.
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15
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Cartilage thickness and bone shape variations as a function of sex, height, body mass, and age in young adult knees. Sci Rep 2022; 12:11707. [PMID: 35810204 PMCID: PMC9271066 DOI: 10.1038/s41598-022-15585-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 06/27/2022] [Indexed: 11/22/2022] Open
Abstract
The functional relationship between bone and cartilage is modulated by mechanical factors. Scarce data exist on the relationship between bone shape and the spatial distribution of cartilage thickness. The aim of the study was to characterise the coupled variation in knee bone morphology and cartilage thickness distributions in knees with healthy cartilage and investigate this relationship as a function of sex, height, body mass, and age. MR images of 51 knees from young adults (28.4 ± 4.1 years) were obtained from a previous study and used to train a statistical shape model of the femur, tibia, and patella and their cartilages. Five multiple linear regression models were fitted to characterise morphology as a function of sex, height, body mass, and age. A logistic regression classifier was fitted to characterise morphological differences between males and females, and tenfold cross-validation was performed to evaluate the models’ performance. Our results showed that cartilage thickness and its distribution were coupled to bone morphology. The first five shape modes captured over 90% of the variance and described coupled changes to the bone and spatial distribution of cartilage thickness. Mode 1 (size) was correlated to sex (p < 0.001) and height (p < 0.0001). Mode 2 (aspect ratio) was also correlated to sex (p = 0.006) and height (p = 0.017). Mode 4 (condylar depth) was correlated to sex only (p = 0.024). A logistic regression model trained on modes 1, 2, and 4 could classify sex with an accuracy of 92.2% (95% CI [81.1%, 97.8%]). No other modes were influenced by sex, height, body mass, or age. This study demonstrated the coupled relationship between bone and cartilage, showing that cartilage is thicker with increased bone size, diaphysis size, and decreased femoral skew. Our results show that sex and height influence bone shape and the spatial distribution of cartilage thickness in a healthy young adult population, but body mass and age do not.
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16
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A computational approach to determine key anatomic landmarks on pelvis and its application to acetabular orientation assessment and hip computational biomechanics. Med Eng Phys 2022; 105:103824. [DOI: 10.1016/j.medengphy.2022.103824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/07/2022] [Accepted: 05/25/2022] [Indexed: 11/23/2022]
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17
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Xiong B, Yang P, Lin T, Xu J, Xie Y, Guo Y, Liu C, Zhou QI, Lai Q, He W, Wei Q, Zhang Q. Changes in hip joint contact stress during a gait cycle based on the individualized modeling method of "gait-musculoskeletal system-finite element". J Orthop Surg Res 2022; 17:267. [PMID: 35568957 PMCID: PMC9107226 DOI: 10.1186/s13018-022-03094-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 03/20/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To construct a comprehensive simulation method of "gait-musculoskeletal system (MS)-finite element (FE)" for analysis of hip joint dynamics characteristics and the changes in the contact stress in the hip throughout a gait cycle. METHODS Two healthy volunteers (male and female) were recruited. The 3D gait trajectories during normal walking and the CT images including the hip and femur of the volunteers were obtained. CT imaging data in the DICOM format were extracted for subjected 3D hip joint reconstruction. The reconstructed 3D model files were used to realize the subject-specific registration of the pelvis and thigh segment of general musculoskeletal model. The captured marker trajectory data were used to drive subject-specific musculoskeletal model to complete inverse dynamic analysis. Results of inverse dynamic analysis were exported and applied as boundary and load settings of the hip joint finite element in ABAQUS. Finally, the finite element analysis (FEA) was performed to analyze contact stress of hip joint during a gait cycle of left foot. RESULTS In the inverse dynamic analysis, the dynamic changes of the main hip-femoral muscle force with respect to each phase of a single gait cycle were plotted. The hip joint reaction force reached a maximum value of 2.9%BW (body weight) and appeared at the end of the terminal stance phase. Twin peaks appeared at the initial contact phase and the end of the terminal stance phase, respectively. FEA showed the temporal changes in contact stress in the acetabulum. In the visual stress cloud chart, the acetabular contact stress was mainly distributed in the dome of the acetabulum and in the anterolateral area at the top of the femoral head during a single gait cycle. The acetabular contact area was between 293.8 and 998.4 mm2, and the maximum contact area appear at the mid-stance phase or the loading response phase of gait. The maximum contact stress of the acetabulum reached 6.91 MPa for the model 1 and 6.92 MPa for the model 2 at the terminal stance phase. CONCLUSIONS The "Gait-MS-FE" technology is integrated to construct a comprehensive simulation framework. Based on human gait trajectories and their CT images, individualized simulation modeling can be achieved. Subject-specific gait in combination with an inverse dynamic analysis of the MS provides pre-processing parameters for FE simulation for more accurate biomechanical analysis of hip joint.
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Affiliation(s)
- Binglang Xiong
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,The Lab of Orthopaedics of Chinese Medicine of Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,Department of Joint Orthopaedic, the First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China
| | - Peng Yang
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,The Lab of Orthopaedics of Chinese Medicine of Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,Department of Joint Orthopaedic, the First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,Second People's Hospital of Shenzhen, Shenzhen, 518000, Guangdong, China
| | - Tianye Lin
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,The Lab of Orthopaedics of Chinese Medicine of Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,Department of Joint Orthopaedic, the First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China
| | - Jingli Xu
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,The Lab of Orthopaedics of Chinese Medicine of Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,Department of Joint Orthopaedic, the First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China
| | - Yong Xie
- Guangzhou University, Guangzhou, 510006, Guangdong, China
| | - Yongliang Guo
- Brain Hospital Affiliated to Jinan University, Guangzhou, 510510, Guangdong, China
| | - Churong Liu
- Brain Hospital Affiliated to Jinan University, Guangzhou, 510510, Guangdong, China
| | - QIzhao Zhou
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,The Lab of Orthopaedics of Chinese Medicine of Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,Department of Joint Orthopaedic, the First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China
| | - Qizhong Lai
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,The Lab of Orthopaedics of Chinese Medicine of Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,Department of Joint Orthopaedic, the First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China
| | - Wei He
- The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510240, Guangdong, China.
| | - Qiushi Wei
- The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510240, Guangdong, China.
| | - Qingwen Zhang
- The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510240, Guangdong, China.
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18
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Peiffer M, Burssens A, Duquesne K, Last M, De Mits S, Victor J, Audenaert EA. Personalised statistical modelling of soft tissue structures in the ankle. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 218:106701. [PMID: 35259673 DOI: 10.1016/j.cmpb.2022.106701] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 01/20/2022] [Accepted: 02/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Revealing the complexity behind subject-specific ankle joint mechanics requires simultaneous analysis of three-dimensional bony and soft-tissue structures. 3D musculoskeletal models have become pivotal in orthopedic treatment planning and biomechanical research. Since manual segmentation of these models is time-consuming and subject to manual errors, (semi-) automatic methods could improve the accuracy and enlarge the sample size of personalised 'in silico' biomechanical experiments and computer-assisted treatment planning. Therefore, our aim was to automatically predict ligament paths, cartilage topography and thickness in the ankle joint based on statistical shape modelling. METHODS A personalised cartilage and ligamentous prediction algorithm was established using geometric morphometrics, based on an 'in-house' generated lower limb skeletal model (N = 542), tibiotalar cartilage (N = 60) and ankle ligament segmentations (N = 10). For cartilage, a population-averaged thickness map was determined by use of partial least-squares regression. Ligaments were wrapped around bony contours based on iterative shortest path calculation. Accuracy of ligament path and cartilage thickness prediction was quantified using leave-one-out experiments. The novel personalised thickness prediction was compared with a constant cartilage thickness of 1.50 mm by use of a paired sample T-test. RESULTS Mean distance error of cartilage and ligament prediction was 0.12 mm (SD 0.04 mm) and 0.54 mm (SD 0.05 mm), respectively. No significant differences were found between the personalised thickness cartilage and segmented cartilage of the tibia (p = 0.73, CI [-1.60 .10-17, 1.13 .10-17]) and talus (p = 0.95, CI[ -1.35 .10-17, 1.28 .10-17]). For the constant thickness cartilage, a statistically significant difference was found in 89% and 92% of the tibial (p < 0.001, CI [0.51, 0.58]) and talar (p < 0.001, CI [0.33, 0.40]) cartilage area. CONCLUSIONS In this study, we described a personalised prediction algorithm of cartilage and ligaments in the ankle joint. We were able to predict cartilage and main ankle ligaments with submillimeter accuracy. The proposed method has a high potential for generating large (virtual) sample sizes in biomechanical research and mitigates technological advances in computer-assisted orthopaedic surgery.
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Affiliation(s)
- M Peiffer
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent 9000, Belgium.
| | - A Burssens
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent 9000, Belgium
| | - K Duquesne
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent 9000, Belgium
| | - M Last
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium
| | - S De Mits
- Department of Reumatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium; Department of Podiatry, Artevelde University of Applied Sciences, Voetweg 66, Ghent 9000, Belgium
| | - J Victor
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent 9000, Belgium
| | - E A Audenaert
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent 9000, Belgium; Department of Trauma and Orthopedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK; Department of Electromechanics, Op3Mech research group, University of Antwerp, Groenenborgerlaan 171, 2020, Antwerp, Belgium
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19
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Multiscale modelling for investigating the long-term time-dependent biphasic behaviour of the articular cartilage in the natural hip joint. Biomech Model Mechanobiol 2022; 21:1145-1155. [PMID: 35482145 DOI: 10.1007/s10237-022-01581-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 03/25/2022] [Indexed: 11/02/2022]
Abstract
A better understanding of the time-dependent biomechanical behaviour of the biphasic hip articular cartilage (AC) under physiological loadings is important to understand the onset of joint pathology and guide the clinical treatment. Current computational studies for the biphasic hip AC were usually limited to short-term duration or using elaborate loading. The present study aimed to develop a multiscale computational modelling to investigate the long-term biphasic behaviour of the hip AC under physiological loadings over multiple gait cycles. Two-scale computational modelling including a musculoskeletal model and a finite element model of the natural hip was created. These two models were then combined and used to investigate the biphasic behaviour of hip AC over 80 gait cycles. The results showed that the interstitial fluid pressure in the AC supported over 89% of the loading during gait. When the contact area was located at the AC centre, the contact pressure and fluid pressure increased over time from the first cycle to the 80th cycle, while when the contact area approached the edge, these pressures decreased first dramatically and then slowly over time. The peak stresses and strains in the solid matrix of the AC remained at a low level and increased over time from the first cycle to the 80th cycle. This study demonstrated that the long-term temporal variations of the biphasic behaviour of hip AC under physiological loadings are significant. The methodology has potentially important implications in the biomechanical studies of human cartilage and supporting the development of cartilage substitution.
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Todd JN, Maak TG, Anderson AE, Ateshian GA, Weiss JA. How Does Chondrolabral Damage and Labral Repair Influence the Mechanics of the Hip in the Setting of Cam Morphology? A Finite-Element Modeling Study. Clin Orthop Relat Res 2022; 480:602-615. [PMID: 34766936 PMCID: PMC8846280 DOI: 10.1097/corr.0000000000002000] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 09/13/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Individuals with cam morphology are prone to chondrolabral injuries that may progress to osteoarthritis. The mechanical factors responsible for the initiation and progression of chondrolabral injuries in these individuals are not well understood. Additionally, although labral repair is commonly performed during surgical correction of cam morphology, the isolated mechanical effect of labral repair on the labrum and surrounding cartilage is unknown. QUESTION/PURPOSES Using a volunteer-specific finite-element analysis, we asked: (1) How does cam morphology create a deleterious mechanical environment for articular cartilage (as evaluated by shear stress, tensile strain, contact pressure, and fluid pressure) that could increase the risk of cartilage damage compared with a radiographically normal hip? (2) How does chondrolabral damage, specifically delamination, delamination with rupture of the chondrolabral junction, and the presence of a chondral defect, alter the mechanical environment around the damage? (3) How does labral repair affect the mechanical environment in the context of the aforementioned chondrolabral damage scenarios? METHODS The mechanical conditions of a representative hip with normal bony morphology (characterized by an alpha angle of 37°) and one with cam morphology (characterized by an alpha angle of 78°) were evaluated using finite-element models that included volunteer-specific anatomy and kinematics. The bone, cartilage, and labrum geometry for the hip models were collected from two volunteers matched by age (25 years with cam morphology and 23 years with normal morphology), BMI (both 24 kg/m2), and sex (both male). Volunteer-specific kinematics for gait were used to drive the finite-element models in combination with joint reaction forces. Constitutive material models were assigned to the cartilage and labrum, which simulate a physiologically realistic material response, including the time-dependent response from fluid flow through the cartilage, and spatially varied response from collagen fibril reinforcement. For the cam hip, three models were created to represent chondrolabral damage conditions: (1) "delamination," with the acetabular cartilage separated from the bone in one region; (2) "delamination with chondrolabral junction (CLJ) rupture," which includes separation of the cartilage from the labrum tissue; and (3) a full-thickness chondral defect, referred to throughout as "defect," where the acetabular cartilage has degraded so there is a void. Each of the three conditions was modeled with a labral tear and with the labrum repaired. The size and location of the damage conditions simulated in the cartilage and labrum were attained from reported clinical prevalence of the location of these injuries. For each damage condition, the contact area, contact pressure, tensile strain, shear stress, and fluid pressure were predicted during gait and compared. RESULTS The cartilage in the hip with cam morphology experienced higher stresses and strains than the normal hip. The peak level of tensile strain (25%) and shear stress (11 MPa) experienced by the cam hip may exceed stable conditions and initiate damage or degradation. The cam hip with simulated damage experienced more evenly distributed contact pressure than the intact cam hip, as well as decreased tensile strain, shear stress, and fluid pressure. The peak levels of tensile strain (15% to 16%) and shear stress (2.5 to 2.7 MPa) for cam hips with simulated damage may be at stable magnitudes. Labral repair only marginally affected the overall stress and strain within the cartilage, but it increased local tensile strain in the cartilage near the chondrolabral junction in the hip with delamination and increased the peak tensile strain and shear stress on the labrum. CONCLUSION This finite-element modeling pilot study suggests that cam morphology may predispose hip articular cartilage to injury because of high shear stress; however, the presence of simulated damage distributed the loading more evenly and the magnitude of stress and strain decreased throughout the cartilage. The locations of the peak values also shifted posteriorly. Additionally, in hips with cam morphology, isolated labral repair in the hip with a delamination injury increased localized strain in the cartilage near the chondrolabral junction. CLINICAL RELEVANCE In a hip with cam morphology, labral repair alone may not protect the cartilage from damage because of mechanical overload during the low-flexion, weightbearing positions experienced during gait. The predicted findings of redistribution of stress and strain from damage in the cam hip may, in some cases, relieve disposition to damage progression. Additional studies should include volunteers with varied acetabular morphology, such as borderline dysplasia with cam morphology or pincer deformity, to analyze the effect on the conclusions presented in the current study. Further, future studies should evaluate the combined effects of osteochondroplasty and chondrolabral treatment.
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Affiliation(s)
- Jocelyn N. Todd
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
| | - Travis G. Maak
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - Andrew E. Anderson
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
- School of Computing, University of Utah, Salt Lake City, UT, USA
- Department of Physical Therapy, University of Utah, Salt Lake City, UT, USA
| | - Gerard A. Ateshian
- Department of Mechanical Engineering, Columbia University, New York, NY, USA
| | - Jeffrey A. Weiss
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
- School of Computing, University of Utah, Salt Lake City, UT, USA
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Hua X, Li J, De Pieri E, Ferguson SJ. Multiscale biomechanics of the biphasic articular cartilage in the natural hip joint during routine activities. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 215:106606. [PMID: 35016083 DOI: 10.1016/j.cmpb.2021.106606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 11/04/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE The investigation of the biomechanical behaviour of the articular cartilage (AC) under physiological loading is important to understand the joint function and onset of pathologies. This study aimed to develop a multiscale computational modelling approach and apply the approach to investigate the time-dependant biphasic behaviour of the AC in the natural hip joint under repetitive physiological loading over 80 cycles amongst six routine activities. METHODS A subject-specific musculoskeletal multibody dynamics (MBD) model was developed based on the anthropometry and motion capture data collected for a male subject. A corresponding FE model of the natural hip joint with biphasic AC was created based on the bone geometries exported from the MBD model. A multiscale computational modelling was then developed to couple the MBD model and the FE model and used to investigate the time-dependant biphasic behaviour of the AC under subject-specific physiological loading over 80 cycles amongst six routine activities. RESULTS The results showed that for all the activities considered, the interstitial fluid pressure in the AC supported over 80% of the loading. The maximum values of the peak contact pressure and peak fluid pressure for the whole cycle increased firstly and then remained stable over time from the 1st cycle to the 80th cycle. At these instants, the contact areas were located at the centre region of the AC. By contrast, when the contact area was located at the edge of the AC, these peak pressures were found to increase over time for some of the activities (squat, ascending stairs, descending stairs) but decrease for the other activities (normal walking, standing up, sitting down). CONCLUSION This study for the first time developed a multiscale computational modelling approach to couple a musculoskeletal MBD model of the body and a detailed FE model of the natural hip joint with biphasic AC, which enabled the evaluation of time-dependant biphasic behaviour of the AC under realistic physiological loading conditions. The study may have important implications in biomechanical studies of human cartilage to understand the joint function and biomechanical factors related to joint disease, and to support the development of cartilage substitution.
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Affiliation(s)
- Xijin Hua
- Institute for Manufacturing, Department of Engineering, University of Cambridge, Cambridge, United Kingdom; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland.
| | - Junyan Li
- Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
| | - Enrico De Pieri
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; University of Basel Children's Hospital, Laboratory for Movement Analysis, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland
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Chen S, Zhang L, Mei Y, Zhang H, Hu Y, Chen D. Role of the Anterior Center-Edge Angle on Acetabular Stress Distribution in Borderline Development Dysplastic of Hip Determined by Finite Element Analysis. Front Bioeng Biotechnol 2022; 10:823557. [PMID: 35299631 PMCID: PMC8921530 DOI: 10.3389/fbioe.2022.823557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 01/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background: The joint with hip dysplasia is more likely to develop osteoarthritis because of the higher contact pressure, especially in the socket. The lateral center-edge angle (LCEA) is the major indicator for hip dysplasia via radiography. However, the pathological conditions of LCEA angles in the range of 18°–25° are still controversial, which challenges precise diagnosis and treatment decision-making. Objective: The purpose of this study is to investigate the influence of anterior center-edge angle (ACEA) on the mechanical stress distribution of the hip joint, via finite element analysis, to provide insights into the severity of the borderline development dysplasia. Methods: From 2017 to 2019, there were 116 patients with borderline developmental dysplasia of the hip (BDDH) enrolled in this research. Based on the inclusion criteria, nine patients were involved and categorized into three LCEA groups with the maximal ACEA differences. Patient-specific hip joint models were reconstructed from computed tomography scans, and the cartilages, including the labrum, were established via a modified numerical method. The finite element analysis was conducted to compare the stress distributions due to the different ACEA. Results: As ACEA decreased, the maximum stress of the acetabulum increased, and the high stress area developed toward the edge. Quantitative analysis showed that in the cases with lower ACEA, the area ratio of high stress increased, and the contact facies lunata area significantly affected the stress distribution. Conclusion: For patients with BDDH, both the ACEA and the area of facies lunata played essential roles in determining the severity of hip dysplasia and the mechanical mechanism preceding osteoarthritis.
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Affiliation(s)
- Songhao Chen
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Liqiang Zhang
- Tianjin Medical University, Tianjin, China
- Department of Orthopaedics, Shanxi Children’s Hospital, Taiyuan, China
| | - Yuqian Mei
- School of Life Science, Beijing Institute of Technology, Beijing, China
- School of Medical Imaging, North Sichuan Medical College, Sichuan, China
| | - Hong Zhang
- Department of Orthopaedics, The Fourth Medical Centre of PLA General Hospital, Beijing, China
| | - Yongcheng Hu
- Department of Bone and Soft Tissue Oncology, Tianjin Hospital, Tianjin, China
- *Correspondence: Yongcheng Hu, ; Duanduan Chen,
| | - Duanduan Chen
- School of Life Science, Beijing Institute of Technology, Beijing, China
- *Correspondence: Yongcheng Hu, ; Duanduan Chen,
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Shah H, Singh KA, Swarup I, Morris W, Kim HKW, Joseph B. Does the Deformity Index Reliably Predict the Shape of the Femoral Head at Healing of Legg-Calvé-Perthes Disease? J Pediatr Orthop 2022; 42:e163-e167. [PMID: 34995259 DOI: 10.1097/bpo.0000000000002012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Treatment of Legg-Calvé-Perthes disease (LCPD) aims to preserve the spherical shape of the femoral head. The deformity index (DI) <0.3, measured 2 years from disease onset, is a surrogate measure that predicts that the femoral head will be Stulberg class I or II at skeletal maturity. There is no study that compares the predictive value of DI against a quantitative measure of the shape of the femoral head when the disease heals. We undertook this study to assess the reproducibility of a new method of measurement of DI and see if DI could predict the shape of the femoral head when the disease healed. METHODS DI was measured 2 years after disease onset and the Sphericity Deviation Score (SDS) was measured at healing of LCPD on radiographs of 43 children. Reproducibility of measurement was tested. Each healed femoral head was classified as spherical or aspherical based on subjective visual assessment. The DI values were compared with SDS values. RESULTS The reproducibility of measurement of SDS was excellent and superior to that of DI. The mean duration of disease was 3.97±0.96 years. Only 17 of 32 hips with DI values <0.3 at 2 years had spherical femoral heads at healing (SDS <10). Three hips with SDS values <10 had DI values >0.3. The positive and negative predictive values of a DI <0.3 in predicting if the femoral head will be spherical (SDS <10) when the disease healed were 53% and 73%, respectively. CONCLUSION Though DI can be reproducibly measured the predictive value of a DI <0.3, to accurately identify hips that are likely to heal with spherical femoral heads, is not sufficiently high to justify its use as an outcome measure.
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Affiliation(s)
- Hitesh Shah
- Department of Paediatric Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education
| | - Kumar A Singh
- Department of Paediatric Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education
| | - Ishaan Swarup
- University of California San Francisco, UCSF Benioff Children's Hospital Oakland, Oakland, CA
| | | | | | - Benjamin Joseph
- Former Head of Paediatric Orthopaedic Service, Kasturba Medical College, Manipal, Karnataka, India
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Anderson AE. CORR Insights®: Is Anterior Rotation of the Acetabulum Necessary to Normalize Joint Contact Pressure in Periacetabular Osteotomy? A Finite-element Analysis Study. Clin Orthop Relat Res 2022; 480:79-81. [PMID: 34543252 PMCID: PMC8673982 DOI: 10.1097/corr.0000000000001975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 08/25/2021] [Indexed: 01/31/2023]
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Rooks NB, Schneider MTY, Erdemir A, Halloran JP, Laz PJ, Shelburne KB, Hume DR, Imhauser CW, Zaylor W, Elmasry S, Schwartz A, Chokhandre SK, Abdollahi Nohouji N, Besier TF. A Method to Compare Heterogeneous Types of Bone and Cartilage Meshes. J Biomech Eng 2021; 143:111002. [PMID: 34041519 PMCID: PMC8299816 DOI: 10.1115/1.4051281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/16/2021] [Indexed: 01/29/2023]
Abstract
Accurately capturing the bone and cartilage morphology and generating a mesh remains a critical step in the workflow of computational knee joint modeling. Currently, there is no standardized method to compare meshes of different element types and nodal densities, making comparisons across research teams a significant challenge. The aim of this paper is to describe a method to quantify differences in knee joint bone and cartilages meshes, independent of bone and cartilage mesh topology. Bone mesh-to-mesh distances, subchondral bone boundaries, and cartilage thicknesses from meshes of any type of mesh are obtained using a series of steps involving registration, resampling, and radial basis function fitting after which the comparisons are performed. Subchondral bone boundaries and cartilage thicknesses are calculated and visualized in a common frame of reference for comparison. The established method is applied to models developed by five modeling teams. Our approach to obtain bone mesh-to-mesh distances decreased the divergence seen in selecting a reference mesh (i.e., comparing mesh A-to-B versus mesh B-to-A). In general, the bone morphology was similar across teams. The cartilage thicknesses for all models were calculated and the mean absolute cartilage thickness difference was presented, the articulating areas had the best agreement across teams. The teams showed disagreement on the subchondral bone boundaries. The method presented in this paper allows for objective comparisons of bone and cartilage geometry that is agnostic to mesh type and nodal density.
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Affiliation(s)
- Nynke B. Rooks
- Auckland Bioengineering Institute, University of Auckland, Level 6/70 Symonds Street, Auckland, Grafton 1010, New Zealand
| | - Marco T. Y. Schneider
- Auckland Bioengineering Institute, University of Auckland, Level 6/70 Symonds Street, Auckland, Grafton 1010, New Zealand
| | - Ahmet Erdemir
- Department of Biomedical Engineering & Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue (ND20), Cleveland, OH 44195
| | - Jason P. Halloran
- Applied Sciences Laboratory, Institute for Shock Physics, Washington State University, 1455 East College Avenue, Spokane, Pullman, WA 99164
| | - Peter J. Laz
- Department of Mechanical and Materials Engineering, University of Denver, 2155 East Wesley Avenue, Denver, CO 80210; Center for Orthopaedic Biomechanics, University of Denver, 2155 East Wesley Avenue, Denver, CO 80210
| | - Kevin B. Shelburne
- Department of Mechanical and Materials Engineering, University of Denver, 2155 East Wesley Avenue, Denver, CO 80210; Center for Orthopaedic Biomechanics, University of Denver, 2155 East Wesley Avenue, Denver, CO 80210
| | - Donald R. Hume
- Department of Mechanical and Materials Engineering, University of Denver, 2155 East Wesley Avenue, Denver, CO 80210; Center for Orthopaedic Biomechanics, University of Denver, 2155 East Wesley Avenue, Denver, CO 80210
| | - Carl W. Imhauser
- Department of Biomechanics, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021
| | - William Zaylor
- Department of Mechanical Engineering, Cleveland State University, 1960 East 24th Street, Cleveland, OH 44115; Center for Human Machine Systems, Cleveland State University, 1960 East 24th Street, Cleveland, OH 44115
| | - Shady Elmasry
- Department of Biomechanics, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021
| | - Ariel Schwartz
- Department of Biomedical Engineering & Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue (ND20), Cleveland, OH 44195
| | - Snehal K. Chokhandre
- Department of Biomedical Engineering & Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue (ND20), Cleveland, OH 44195
| | - Neda Abdollahi Nohouji
- Department of Mechanical Engineering, Cleveland State University, 1960 East 24th Street, Cleveland, OH 44115; Center for Human Machine Systems, Cleveland State University, 1960 East 24th Street, Cleveland, OH 44115; Department of Biomedical Engineering & Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue (ND20), Cleveland, OH 44195
| | - Thor F. Besier
- Auckland Bioengineering Institute, University of Auckland, Level 6/70 Symonds Street, Grafton, Auckland 1010, New Zealand; Department of Engineering Science, Faculty of Engineering, University of Auckland, Level 6/70 Symonds Street, Grafton, Auckland 1010, New Zealand
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Sahandifar P, Kleiven S. Influence of nonlinear soft tissue modeling on the external and internal forces during lateral hip impacts. J Mech Behav Biomed Mater 2021; 124:104743. [PMID: 34474319 DOI: 10.1016/j.jmbbm.2021.104743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 11/16/2022]
Abstract
Soft tissues in the hip region, which are typically considered the natural shock-absorbers during falls, attenuate the applied forces to the underlying hard tissue. The soft tissue thickness is, therefore, a significant parameter in the force attenuation. Another factor that could affect the assessment of the force attenuation in numerical simulations is the choice of constitutive model and material parameters for the soft tissue. Several constitutive models and parameters for muscle and adipose tissue were suggested in the published literature; however, the biofidelity of the proposed models for the lateral impacts has not been assessed yet. To achieve this purpose, we used a previously developed human body model named THUMS v4.02 and modified the mechanical properties and geometry of the soft tissues in the hip region. The simulations consisted of regional hip models and whole-body models. The biofidelity of the constitutive models of muscle and adipose tissue was determined objectively using the CORrelation and Analysis (CORA) rating. Moreover, the potential force attenuating effect of the adipose tissue thickness was investigated in the regional models. We collected and fitted several available nonlinear material models for muscle and adipose tissue and implemented them. The CORA ratings for several constitutive models for adipose tissue in the regional model were above 0.8. Among the muscle constitutive models, three Ogden models consistently rated above 0.58 for the whole-body model. Moreover, the impact forces in the selected adipose tissue model attenuated 47 N for every 1 mm increase in thickness. Overall, the choice of the nonlinear material model for the adipose and muscle tissue influences the external and internal force, and the difference between the material models is more pronounced when the thickness of the soft tissue increases.
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Affiliation(s)
- Pooya Sahandifar
- Neuronic Engineering, KTH Royal Institute of Technology, Stockholm, Sweden.
| | - Svein Kleiven
- Neuronic Engineering, KTH Royal Institute of Technology, Stockholm, Sweden
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27
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Ortún-Terrazas J, Cegoñino J, Pérez Del Palomar A. Biomechanical impact of the porous-fibrous tissue behaviour in the temporomandibular joint movements. An in silico approach. J Mech Behav Biomed Mater 2021; 120:104542. [PMID: 33962235 DOI: 10.1016/j.jmbbm.2021.104542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 11/28/2022]
Abstract
The movement of the temporomandibular joint (TMJ) is a function of its complex geometry and its interaction with the surrounding soft tissues. Owing to an increase in the prevalence of temporomandibular joint disorders (TMDs), many computational studies have attempted to characterize its biomechanical behaviour in the last 2 decades. However, most such studies are based on a single computational model that markedly simplifies the complex geometry and mechanical properties of the TMJ's soft tissues. The present study aims to computationally evaluate in a wider sample the importance of considering their complex anatomy and behaviour for simulating both damping and motion responses of this joint. Hence, 6 finite element models of healthy volunteers' TMJ were developed and subjected to both conditions in two different behavioural scenarios. In one, the soft tissues' behaviour was modelled by considering the porous-fibrous properties, whereas in the other case they were simplified assuming isotropic-hyperelastic response, as had been traditionally considered. The damping analysis, which mimic the conditions of an experimental test of the literature, consisted of applying two different compressive loads to the jaw. The motion analysis evaluated the condylar path during the mandible centric depression by the action of muscular forces. From the results of both analyses, the contact pressures, intra-articular fluid pressure, path features, and stress/strain values were compared using the porous-fibrous and isotropic-hyperelastic models. Besides the great differences observed between patients due patient-specific morphology, the porous-fibrous approach yielded results closer to the reference experimental values and to the outcomes of other computational studies of the literature. Our findings underscore, therefore, the importance of considering realistic joint geometries and porous-fibrous contribution in the computational modelling of the TMJ, but also in the design of further joint replacements or in the development of new biomaterials for this joint.
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Affiliation(s)
- Javier Ortún-Terrazas
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain.
| | - José Cegoñino
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
| | - Amaya Pérez Del Palomar
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
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28
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Todd JN, Allan AN, Maak TG, Weiss JA. Characterization and finite element validation of transchondral strain in the human hip during static and dynamic loading. J Biomech 2021; 114:110143. [PMID: 33307354 PMCID: PMC10714355 DOI: 10.1016/j.jbiomech.2020.110143] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/04/2020] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
Abstract
Distribution of strain through the thickness of articular cartilage, or transchondral strain, is highly dependent on the geometry of the joint involved. Excessive transchondral strain can damage the solid matrix and ultimately lead to osteoarthritis. Currently, high-resolution transchondral strain distribution is unknown in the human hip. Thus, knowledge of transchondral strain patterns is of fundamental importance to interpreting the patterns of injury that occur in prearthritic hip joints. This study had three main objectives. We sought to 1) quantify high-resolution transchondral strain in the native human hip, 2) determine differences in transchondral strain between static and dynamic loading conditions to better understand recovery and repressurization of cartilage in the hip, and 3) create finite element (FE) models of the experimental testing to validate a modeling framework for future analysis. The transchondral strain patterns found in this study provide insight on the localization of strain within cartilage of the hip. Most notably, the chondrolabral junction experienced high tensile and shear strain across all samples, which explains clinical data reporting it as the most common region of damage in cartilage of the hip. Further, the representative FE framework was able to match the experimental static results and predict the dynamic results with very good agreement. This agreement provides confidence for both experimental and computational measurement methods and demonstrates that the specific anisotropic biphasic FE framework used in this study can both describe and predict the experimental results.
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Affiliation(s)
- Jocelyn N Todd
- Department of Biomedical Engineering, and Scientific Computing and Imaging Institute University of Utah, Salt Lake City, UT 84112, United States.
| | - Alexandra N Allan
- Department of Biomedical Engineering, and Scientific Computing and Imaging Institute University of Utah, Salt Lake City, UT 84112, United States
| | - Travis G Maak
- Department of Orthopedics, University of Utah, Salt Lake City, UT 84108, United States.
| | - Jeffrey A Weiss
- Department of Biomedical Engineering, and Scientific Computing and Imaging Institute University of Utah, Salt Lake City, UT 84112, United States; Department of Orthopedics, University of Utah, Salt Lake City, UT 84108, United States.
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Mohammadi A, Myller KAH, Tanska P, Hirvasniemi J, Saarakkala S, Töyräs J, Korhonen RK, Mononen ME. Rapid CT-based Estimation of Articular Cartilage Biomechanics in the Knee Joint Without Cartilage Segmentation. Ann Biomed Eng 2020; 48:2965-2975. [PMID: 33179182 PMCID: PMC7723937 DOI: 10.1007/s10439-020-02666-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 10/17/2020] [Indexed: 12/30/2022]
Abstract
Knee osteoarthritis (OA) is a painful joint disease, causing disabilities in daily activities. However, there is no known cure for OA, and the best treatment strategy might be prevention. Finite element (FE) modeling has demonstrated potential for evaluating personalized risks for the progression of OA. Current FE modeling approaches use primarily magnetic resonance imaging (MRI) to construct personalized knee joint models. However, MRI is expensive and has lower resolution than computed tomography (CT). In this study, we extend a previously presented atlas-based FE modeling framework for automatic model generation and simulation of knee joint tissue responses using contrast agent-free CT. In this method, based on certain anatomical dimensions measured from bone surfaces, an optimal template is selected and scaled to generate a personalized FE model. We compared the simulated tissue responses of the CT-based models with those of the MRI-based models. We show that the CT-based models are capable of producing similar tensile stresses, fibril strains, and fluid pressures of knee joint cartilage compared to those of the MRI-based models. This study provides a new methodology for the analysis of knee joint and cartilage mechanics based on measurement of bone dimensions from native CT scans.
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Affiliation(s)
- Ali Mohammadi
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland.
| | - Katariina A H Myller
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.,Department of Medical Physics, Turku University Central Hospital, 20500, Turku, Finland
| | - Petri Tanska
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
| | - Jukka Hirvasniemi
- Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.,School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
| | - Mika E Mononen
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
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Clockwise Torque of Sliding Hip Screws: Is There a Right Side? J Orthop Trauma 2020; 34 Suppl 3:S76-S80. [PMID: 33027170 DOI: 10.1097/bot.0000000000001934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES This study evaluated whether patients with a left-sided femoral neck fracture (FNF) treated with a sliding hip screw (SHS) had a higher implant failure rate than patients treated for a right-sided FNF. This was performed to determine the clinical relevance of the clockwise rotational torque of the femoral neck lag screw in a SHS, in relation to the rotational stability of left and right-sided FNFs after fixation. METHODS Data were derived from the FAITH trial and Dutch Hip Fracture Audit (DHFA). Patients with a FNF, aged ≥50, treated with a SHS, with at least 3-month follow-up data available, were included. Implant failure was analyzed in a multivariable logistic regression model adjusted for age, sex, fracture displacement, prefracture living setting and functional mobility, and American Society for Anesthesiologists Class. RESULTS One thousand seven hundred fifty patients were included, of which 944 (53.9%) had a left-sided and 806 (46.1%) a right-sided FNF. Implant failure occurred in 60 cases (3.4%), of which 31 were left-sided and 29 right-sided. No association between fracture side and implant failure was found [odds ratio (OR) for left vs. right 0.89, 95% confidence interval (CI) 0.52-1.52]. Female sex (OR 3.02, CI: 1.62-6.10), using a mobility aid (OR 2.02, CI 1.01-3.96) and a displaced fracture (OR 2.51, CI: 1.44-4.42), were associated with implant failure. CONCLUSIONS This study could not substantiate the hypothesis that the biomechanics of the clockwise screw rotation of the SHS contributes to an increased risk of implant failure in left-sided FNFs compared with right-sided fractures. LEVEL OF EVIDENCE Therapeutic Level II.See Instructions for Authors for a complete description of levels of evidence.
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Faudot B, Milan JL, Goislard de Monsabert B, Le Corroller T, Vigouroux L. Estimation of joint contact pressure in the index finger using a hybrid finite element musculoskeletal approach. Comput Methods Biomech Biomed Engin 2020; 23:1225-1235. [PMID: 32678683 DOI: 10.1080/10255842.2020.1793965] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The knowledge of local stress distribution in hand joints is crucial to understand injuries and osteoarthritis occurrence. However, determining cartilage contact stresses remains a challenge, requiring numerical models including both accurate anatomical components and realistic tendon force actuation. Contact forces in finger joints have frequently been calculated but little data is available on joint contact pressures. This study aimed to develop and assess a hybrid biomechanical model of the index finger to estimate in-vivo joint contact pressure during a static maximal strength pinch grip task. A finite element model including bones, cartilage, tendons, and ligaments was developed, with tendon force transmission based on a tendon-pulley system. This model was driven by realistic tendon forces estimated from a musculoskeletal model and motion capture data for six subjects. The hybrid model outputs agreed well with the experimental measurement of fingertip forces and literature data on the physiological distribution of tendon forces through the index finger. Mean contact pressures were 6.9 ± 2.7 MPa, 6.2 ± 1.0 MPa and 7.2 ± 1.3 MPa for distal, proximal interphalangeal and metacarpophalangeal joints, respectively. Two subjects had higher mean contact pressure in the distal joint than in the other two joints, suggesting a mechanical cause for the prevalence of osteoarthritis in the index distal joint. The inter-subject variability in joint contact pressure could be explained by different neuromuscular strategies employed for the task. This first application of an effective hybrid model to the index finger is promising for estimating hand joint stresses under daily grip tasks and simulating surgical procedures.
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Affiliation(s)
- Barthélémy Faudot
- Aix Marseille University, CNRS, ISM, Marseille, France.,APHM, Institute for Locomotion, Department of Orthopaedics and Traumatology, St Marguerite Hospital, Marseille, France
| | - Jean-Louis Milan
- Aix Marseille University, CNRS, ISM, Marseille, France.,APHM, Institute for Locomotion, Department of Orthopaedics and Traumatology, St Marguerite Hospital, Marseille, France
| | | | - Thomas Le Corroller
- Aix Marseille University, CNRS, ISM, Marseille, France.,APHM, Institute for Locomotion, Department of Radiology, St Marguerite Hospital, Marseille, France
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Muralidharan L, Cardiff P, Fitzgerald K, Flavin R, Ivanković A. A patient-specific numerical model of the ankle joint for the analysis of contact pressure distribution. Proc Inst Mech Eng H 2020; 234:909-920. [PMID: 32580651 DOI: 10.1177/0954411920932687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A patient-specific numerical model of the ankle joint has been developed using open-source software with realistic material properties that mimics the physiological movement of the foot during the stance phase of the gait cycle. The patient-specific ankle geometry has been segmented as a castellated surface using 3DSlicer from the computed tomography image scans of a subject with no congenital or acquired pathology; subsequently, the bones are smoothed, and cartilage is included as a uniform thickness extruded layer. A high-resolution Cartesian mesh has been generated using cfMesh. The material properties are assigned in the model based on the CT image Hounsfield intensities and compared to a sandwich-based material model. Gait data of the same subject was obtained and used to relatively position the tibia, talus, and calcaneus bones in the model. The stance phase of the gait cycle is simulated using a cell-centred finite-volume method implemented in open-source software OpenFOAM. The predicted peak contact pressures occur in the range of 4.85-5.53 MPa with average pressures in the range of 1.56-1.95 MPa, and the contact area ranges between 429 and 707.8 mm2 for the entire stance phase with the mid-stance phase predicting the maximum contact area. These predictions are in agreement with results from the literature. The effect of arthritis on the contact characteristics of the ankle joint has also been examined. A concentrated increase in pressure was predicted that could be manifested as pain, thereby leading to reduced motion in the ankle. The model, with continued development, has the capability to understand the effect of joint degradation and furthermore, could help provide a tool to predict the efficiency of therapeutic surgical procedures as well as guide the development of next generation ankle prostheses. The work would be made available in the University College Dublin depository (https://github.com/laxmimurali/anklejoint) as well as research gate once the article has been published.
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Affiliation(s)
- Laxmi Muralidharan
- School of Mechanical and Materials Engineering, University College Dublin, Dublin, Ireland
| | - Philip Cardiff
- School of Mechanical and Materials Engineering, University College Dublin, Dublin, Ireland
| | - Karen Fitzgerald
- School of Mechanical and Materials Engineering, University College Dublin, Dublin, Ireland
| | - Robert Flavin
- School of Mechanical and Materials Engineering, University College Dublin, Dublin, Ireland.,St. Vincent's University Hospital, Dublin, Ireland
| | - Alojz Ivanković
- School of Mechanical and Materials Engineering, University College Dublin, Dublin, Ireland
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Van Houcke J, Audenaert EA, Atkins PR, Anderson AE. A Combined Geometric Morphometric and Discrete Element Modeling Approach for Hip Cartilage Contact Mechanics. Front Bioeng Biotechnol 2020; 8:318. [PMID: 32373602 PMCID: PMC7186355 DOI: 10.3389/fbioe.2020.00318] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 03/24/2020] [Indexed: 11/17/2022] Open
Abstract
Finite element analysis (FEA) provides the current reference standard for numerical simulation of hip cartilage contact mechanics. Unfortunately, the development of subject-specific FEA models is a laborious process. Owed to its simplicity, Discrete Element Analysis (DEA) provides an attractive alternative to FEA. Advancements in computational morphometrics, specifically statistical shape modeling (SSM), provide the opportunity to predict cartilage anatomy without image segmentation, which could be integrated with DEA to provide an efficient platform to predict cartilage contact stresses in large populations. The objective of this study was, first, to validate linear and non-linear DEA against a previously validated FEA model and, second, to present and evaluate the applicability of a novel population-averaged cartilage geometry prediction method against previously used methods to estimate cartilage anatomy. The population-averaged method is based on average cartilage thickness maps and therefore allows for a more accurate and individualized cartilage geometry estimation when combined with SSM. The root mean squared error of the population-averaged cartilage geometry predicted by SSM as compared to the manually segmented cartilage geometry was 0.31 ± 0.08 mm. Identical boundary and loading conditions were applied to the DEA and FEA models. Predicted DEA stress distribution patterns and magnitude of peak stresses were in better agreement with FEA for the novel cartilage anatomy prediction method as compared to commonly used parametric methods based on the estimation of acetabular and femoral head radius. Still, contact stress was overestimated and contact area was underestimated for all cartilage anatomy prediction methods. Linear and non-linear DEA methods differed mainly in peak stress results with the non-linear definition being more sensitive to detection of high peak stresses. In conclusion, DEA in combination with the novel population-averaged cartilage anatomy prediction method provided accurate predictions while offering an efficient platform to conduct population-wide analyses of hip contact mechanics.
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Affiliation(s)
- Jan Van Houcke
- Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium.,Department of Orthopaedics, University of Utah, Salt Lake City, UT, United States.,Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Emmanuel A Audenaert
- Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium.,Department of Human Structure and Repair, Ghent University, Ghent, Belgium.,Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.,Department of Electromechanics, Op3Mech Research Group, University of Antwerp, Antwerp, Belgium
| | - Penny R Atkins
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, United States.,Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States
| | - Andrew E Anderson
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, United States.,Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States.,Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States.,Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, United States
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Benemerito I, Modenese L, Montefiori E, Mazzà C, Viceconti M, Lacroix D, Guo L. An extended discrete element method for the estimation of contact pressure at the ankle joint during stance phase. Proc Inst Mech Eng H 2020; 234:507-516. [PMID: 32036769 PMCID: PMC7469707 DOI: 10.1177/0954411920905434] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Abnormalities in the ankle contact pressure are related to the onset of osteoarthritis. In vivo measurements are not possible with currently available techniques, so computational methods such as the finite element analysis (FEA) are often used instead. The discrete element method (DEM), a computationally efficient alternative to time-consuming FEA, has also been used to predict the joint contact pressure. It describes the articular cartilage as a bed of independent springs, assuming a linearly elastic behaviour and absence of relative motion between the bones. In this study, we present the extended DEM (EDEM) which is able to track the motion of talus over time. The method was used, with input data from a subject-specific musculoskeletal model, to predict the contact pressure in the ankle joint during gait. Results from EDEM were also compared with outputs from conventional DEM. Predicted values of contact area were larger in EDEM than they were in DEM (4.67 and 4.18 cm2, respectively). Peak values of contact pressure, attained at the toe-off, were 7.3 MPa for EDEM and 6.92 MPa for DEM. Values predicted from EDEM fell well within the ranges reported in the literature. Overall, the motion of the talus had more effect on the extension and shape of the pressure distribution than it had on the magnitude of the pressure. The results indicated that EDEM is a valid methodology for the prediction of ankle contact pressure during daily activities.
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Affiliation(s)
- Ivan Benemerito
- INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK.,Department of Automatic Control and Systems Engineering, The University of Sheffield, Sheffield, UK
| | - Luca Modenese
- INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK.,Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Erica Montefiori
- INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK.,Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK
| | - Claudia Mazzà
- INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK.,Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK
| | - Marco Viceconti
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy.,Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Damien Lacroix
- INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK.,Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK
| | - Lingzhong Guo
- INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK.,Department of Automatic Control and Systems Engineering, The University of Sheffield, Sheffield, UK
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Cooper RJ, Wilcox RK, Jones AC. Finite element models of the tibiofemoral joint: A review of validation approaches and modelling challenges. Med Eng Phys 2019; 74:1-12. [DOI: 10.1016/j.medengphy.2019.08.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 08/05/2019] [Accepted: 08/21/2019] [Indexed: 12/20/2022]
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Wesseling M, Van Rossom S, Jonkers I, Henak CR. Subject-specific geometry affects acetabular contact pressure during gait more than subject-specific loading patterns. Comput Methods Biomech Biomed Engin 2019; 22:1323-1333. [PMID: 31497996 DOI: 10.1080/10255842.2019.1661393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Finite element modeling (FEM) can predict hip cartilage contact mechanics. This study investigated how subject-specific boundary conditions and joint geometry affect acetabular cartilage contact mechanics using a multi-scale workflow. For two healthy subjects, musculoskeletal models calculated subject-specific hip kinematics and loading, which were used as boundary conditions for FEM. Cartilage contact mechanics were predicted using either generic or subject-specific FEM and boundary conditions. A subject-specific mesh resulted in a more lateral contact. Effects of subject-specific boundary conditions varied between both subjects. Results highlight the complex interplay between loading and kinematics and their effect on cartilage contact mechanics.
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Affiliation(s)
- Mariska Wesseling
- Department of Movement Sciences, Human Movement Biomechanics Research Group, KU Leuven , Leuven , Belgium
| | - Sam Van Rossom
- Department of Movement Sciences, Human Movement Biomechanics Research Group, KU Leuven , Leuven , Belgium
| | - Ilse Jonkers
- Department of Movement Sciences, Human Movement Biomechanics Research Group, KU Leuven , Leuven , Belgium
| | - Corinne R Henak
- Department of Mechanical Engineering, University of Wisconsin , Madison , USA
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Patients With Medial Knee Osteoarthritis Reduce Medial Knee Contact Forces by Altering Trunk Kinematics, Progression Speed, and Stepping Strategy During Stair Ascent and Descent: A Pilot Study. J Appl Biomech 2019; 35:280-289. [PMID: 31141436 DOI: 10.1123/jab.2017-0159] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Medial knee loading during stair negotiation in individuals with medial knee osteoarthritis, has only been reported in terms of joint moments, which may underestimate the knee loading. This study assessed knee contact forces (KCF) and contact pressures during different stair negotiation strategies. Motion analysis was performed in five individuals with medial knee osteoarthritis (52.8±11.0 years) and eight healthy subjects (51.0±13.4 years) while ascending and descending a staircase. KCF and contact pressures were calculated using a multi-body knee model while performing step-over-step at controlled and self-selected speed, and step-by-step strategies. At controlled speed, individuals with osteoarthritis showed decreased peak KCF during stair ascent but not during stair descent. Osteoarthritis patients showed higher trunk rotations in frontal and sagittal planes than controls. At lower self-selected speed, patients also presented reduced medial KCF during stair descent. While performing step-by-step, medial contact pressures decreased in osteoarthritis patients during stair descent. Osteoarthritis patients reduced their speed and increased trunk flexion and lean angles to reduce KCF during stair ascent. These trunk changes were less safe during stair descent where a reduced speed was more effective. Individuals should be recommended to use step-over-step during stair ascent and step-by-step during stair descent to reduce medial KCF.
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Poncery B, Arroyave-Tobón S, Picault E, Linares JM. Effects of realistic sheep elbow kinematics in inverse dynamic simulation. PLoS One 2019; 14:e0213100. [PMID: 30835751 PMCID: PMC6400409 DOI: 10.1371/journal.pone.0213100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 02/14/2019] [Indexed: 12/04/2022] Open
Abstract
Looking for new opportunities in mechanical design, we are interested in studying the kinematic behaviour of biological joints. The real kinematic behaviour of the elbow of quadruped animals (which is submitted to high mechanical stresses in comparison with bipeds) remains unexplored. The sheep elbow joint was chosen because of its similarity with a revolute joint. The main objective of this study is to estimate the effects of elbow simplifications on the prediction of joint reaction forces in inverse dynamic simulations. Rigid motions between humerus and radius-ulna were registered during full flexion-extension gestures on five cadaveric specimens. The experiments were initially conducted with fresh specimens with ligaments and repeated after removal of all soft tissue, including cartilage. A digital image correlation system was used for tracking optical markers fixed on the bones. The geometry of the specimens was digitized using a 3D optical scanner. Then, the instantaneous helical axis of the joint was computed for each acquisition time. Finally, an OpenSim musculoskeletal model of the sheep forelimb was used to quantify effects of elbow joint approximations on the prediction of joint reaction forces. The motion analysis showed that only the medial-lateral translation is sufficiently large regarding the measuring uncertainty of the experiments. This translation assimilates the sheep elbow to a screw joint instead of a revolute joint. In comparison with fresh specimens, the experiments conducted with dry bone specimens (bones without soft tissue) provided different kinematic behaviour. From the results of our inverse dynamic simulations, it was noticed that the inclusion of the medial-lateral translation to the model made up with the mean flexion axis does not affect the predicted joint reaction forces. A geometrical difference between the axis of the best fitting cylinder and the mean flexion axis (derived from the motion analysis) of fresh specimens was highlighted. This geometrical difference impacts slightly the prediction of joint reactions.
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Affiliation(s)
| | | | - Elia Picault
- Aix Marseille Univ, CNRS, ISM, Marseille, France
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Thomas-Aitken HD, Willey MC, Goetz JE. Joint contact stresses calculated for acetabular dysplasia patients using discrete element analysis are significantly influenced by the applied gait pattern. J Biomech 2018; 79:45-53. [PMID: 30104055 PMCID: PMC6237088 DOI: 10.1016/j.jbiomech.2018.07.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 11/26/2022]
Abstract
Gait modifications in acetabular dysplasia patients may influence cartilage contact stress patterns within the hip joint, with serious implications for clinical outcomes and the risk of developing osteoarthritis. The objective of this study was to understand how the gait pattern used to load computational models of dysplastic hips influences computed joint mechanics. Three-dimensional pre- and post-operative hip models of thirty patients previously treated for hip dysplasia with periacetabular osteotomy (PAO) were developed for performing discrete element analysis (DEA). Using DEA, contact stress patterns were calculated for each pre- and post-operative hip model when loaded with an instrumented total hip, a dysplastic, a matched control, and a normal gait pattern. DEA models loaded with the dysplastic and matched control gait patterns had significantly higher (p = 0.012 and p < 0.001) average pre-operative maximum contact stress than models loaded with the normal gait. Models loaded with the dysplastic and matched control gait patterns had nearly significantly higher (p = 0.051) and significantly higher (p = 0.008) average pre-operative contact stress, respectively, than models loaded with the instrumented hip gait. Following PAO, the average maximum contact stress for DEA models loaded with the dysplastic and matched control patterns decreased, which was significantly different (p < 0.001) from observed increases in maximum contact stress calculated when utilizing the instrumented hip and normal gait patterns. The correlation between change in DEA-computed maximum contact stress and the change in radiographic measurements of lateral center-edge angle were greatest (R2 = 0.330) when utilizing the dysplastic gait pattern. These results indicate that utilizing a dysplastic gait pattern to load DEA models may be a crucial element to capturing contact stress patterns most representative of this patient population.
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Affiliation(s)
- Holly D Thomas-Aitken
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA; Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
| | - Michael C Willey
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
| | - Jessica E Goetz
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA; Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA.
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Ravera EP, Crespo MJ, Catalfamo Formento PA. A subject-specific integrative biomechanical framework of the pelvis for gait analysis. Proc Inst Mech Eng H 2018; 232:1083-1097. [PMID: 30280643 DOI: 10.1177/0954411918803125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Analysis of the human locomotor system using rigid-body musculoskeletal models has increased in the biomechanical community with the objective of studying muscle activations of different movements. Simultaneously, the finite element method has emerged as a complementary approach for analyzing the mechanical behavior of tissues. This study presents an integrative biomechanical framework for gait analysis by linking a musculoskeletal model and a subject-specific finite element model of the pelvis. To investigate its performance, a convergence study was performed and its sensitivity to the use of non-subject-specific material properties was studied. The total hip joint force estimated by the rigid musculoskeletal model and by the finite element model showed good agreement, suggesting that the integrative approach estimates adequately (in shape and magnitude) the hip total contact force. Previous studies found movements of up to 1.4 mm in the anterior-posterior direction, for single leg stance. These results are comparable with the displacement values found in this study: 0-0.5 mm in the sagittal axis. Maximum von Mises stress values of approximately 17 MPa were found in the pelvic bone. Comparing this results with a previous study of our group, the new findings show that the introduction of muscular boundary conditions and the flexion-extension movement of the hip reduce the regions of high stress and distributes more uniformly the stress across the pelvic bone. Thus, it is thought that muscle force has a relevant impact in reducing stresses in pelvic bone during walking of the finite element model proposed in this study. Future work will focus on including other deformable structures, such as the femur and the tibia, and subject-specific material properties.
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Affiliation(s)
- Emiliano P Ravera
- 1 Group of Analysis, Modeling, Processing and Clinician Implementation of Biomechanical Signals and Systems, Bioengineering and Bioinformatics Institute, CONICET-UNER, Oro Verde, Argentina.,2 Human Movement Research Laboratory, School of Engineering, National University of Entre Ríos (UNER), Oro Verde, Argentina
| | - Marcos J Crespo
- 3 Gait and Motion Analysis Laboratory, FLENI Institute for Neurological Research, Escobar, Argentina
| | - Paola A Catalfamo Formento
- 1 Group of Analysis, Modeling, Processing and Clinician Implementation of Biomechanical Signals and Systems, Bioengineering and Bioinformatics Institute, CONICET-UNER, Oro Verde, Argentina.,2 Human Movement Research Laboratory, School of Engineering, National University of Entre Ríos (UNER), Oro Verde, Argentina
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Escudier JC, Ollivier M, Donnez M, Parratte S, Lafforgue P, Argenson JN. Superimposition of maximal stress and necrosis areas at the top of the femoral head in hip aseptic osteonecrosis. Orthop Traumatol Surg Res 2018; 104:353-358. [PMID: 29462725 DOI: 10.1016/j.otsr.2018.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 01/05/2018] [Accepted: 01/10/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Recent reports described possible mechanical factors in the development and aggravation of osteonecrosis of the femoral head (OFH), but these have yet to be confirmed on dedicated mechanical study. We therefore developed a 3D finite element model based on in-vivo data from patients with incipient OFH, with a view to determining whether the necrosis area was superimposed on the maximal stress area on the femoral head. HYPOTHESIS The location of the necrosis area is determined by stress on the femoral head. MATERIAL AND METHOD All patients from the rheumatology department with early stage OFH in our center were investigated. Analysis of CT scans showed stress distribution on the head by 3D finite elements models, enabling determination of necrosis volume within the maximal stress area and of the percentage intersection of necrosis within the stress area (%I n/s: necrosis volume in stress area divided by total stress area volume and multiplied by 100) and of stress within the necrosis area (%I s/n: stress volume in necrosis area divided by total necrosis area volume and multiplied by 100). RESULTS Nineteen of the 161 patients assessed retrospectively for the period between 2006 and 2015 had incipient unilateral OFH, 10 of whom (4 right, 6 left) had CT scans of sufficient quality for inclusion. Mean age was 52 years (range, 37-81 years). Mean maximal stress was 1.63MPa, mean maximal exported stress volume was 2,236.9 mm3 and mean necrosis volume 6,291.1 mm3. Mean %I n/s was 83% and mean %I s/n 35%, with no significant differences according to gender, age, side or stress volume. There was a strong inverse correlation between necrosis volume and %I s/n (R2=-0.92) and a strong direct correlation between exported stress volume and %I s/n (R2=0.55). %I s/n was greater in small necrosis (<7,000mm3). CONCLUSION OFH seems to develop within the maximal stress area on the femoral head. The present results need confirmation by larger-scale studies. We consider it essential to take account of these mechanical parameters to reduce failure rates in conservative treatment of OFH. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- J-C Escudier
- ISM UMR 7287, CNRS, Aix-Marseille University, 13288 Marseille cedex 09, France; Department of Orthopedic Surgery and Traumatology, Institute of Movement and Locomotion, Saint-Marguerite Hospital, 270, boulevard Sainte-Marguerite BP 29, 13274 Marseille, France
| | - M Ollivier
- ISM UMR 7287, CNRS, Aix-Marseille University, 13288 Marseille cedex 09, France; Department of Orthopedic Surgery and Traumatology, Institute of Movement and Locomotion, Saint-Marguerite Hospital, 270, boulevard Sainte-Marguerite BP 29, 13274 Marseille, France.
| | - M Donnez
- ISM UMR 7287, CNRS, Aix-Marseille University, 13288 Marseille cedex 09, France
| | - S Parratte
- ISM UMR 7287, CNRS, Aix-Marseille University, 13288 Marseille cedex 09, France; Department of Orthopedic Surgery and Traumatology, Institute of Movement and Locomotion, Saint-Marguerite Hospital, 270, boulevard Sainte-Marguerite BP 29, 13274 Marseille, France
| | - P Lafforgue
- ISM UMR 7287, CNRS, Aix-Marseille University, 13288 Marseille cedex 09, France; Department of Rheumatology, Institute of Movement and Locomotion, Saint-Marguerite Hospital, 270, boulevard Sainte-Marguerite BP 29, 13274 Marseille, France
| | - J-N Argenson
- ISM UMR 7287, CNRS, Aix-Marseille University, 13288 Marseille cedex 09, France; Department of Orthopedic Surgery and Traumatology, Institute of Movement and Locomotion, Saint-Marguerite Hospital, 270, boulevard Sainte-Marguerite BP 29, 13274 Marseille, France
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Cooper RJ, Williams S, Mengoni M, Jones AC. Patient-specific parameterised cam geometry in finite element models of femoroacetabular impingement of the hip. Clin Biomech (Bristol, Avon) 2018; 54:62-70. [PMID: 29554551 DOI: 10.1016/j.clinbiomech.2018.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/02/2018] [Accepted: 03/13/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Impingement resulting in soft tissue damage has been observed in hips with abnormal morphologies. Geometric parameterisation can be used to automatically generate a range of bone geometries for use in computational models, including femurs with cam deformity on the femoral neck. METHODS This study verified patient-specific parametric finite element models of 20 patients with cam deformity (10 female, 10 male) through comparison to their patient-specific segmentation-based equivalents. The parameterisation system was then used to generate further models with parametrically defined geometry to investigate morphological changes in both the femur and acetabulum and their effects on impingement. FINDINGS Similar findings were observed between segmentation-based and parametric models when assessing soft tissue strains under impingement conditions, resulting from high flexion and internal rotations. Parametric models with cam morphology demonstrated that clinically used alpha angles should not be relied on for estimating impingement severity since planar views do not capture the full three-dimensional geometry of the joint. Furthermore, the parametric approach allowed study of labral shape changes, indicating higher strains can result from bony overcoverage. INTERPRETATION The position of cams, as well as their size, can affect the level of soft tissue strain occurring in the hip. This highlights the importance of reporting the full details of three-dimensional geometry used when developing computational models of the hip joint and suggests that it could be beneficial to stratify the patient population when considering treatment options, since certain morphologies may be at greater risk of elevated soft tissue strain.
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Affiliation(s)
- Robert J Cooper
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK.
| | - Sophie Williams
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK
| | - Marlène Mengoni
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK
| | - Alison C Jones
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK
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LI FEI, CHEN HEJUAN, MAWATARI TARO, IWAMOTO YUKIHIDE, JIANG FEI, CHEN XIAN. INFLUENCE OF MODELING METHODS FOR CARTILAGE LAYER ON SIMULATION OF PERIACETABULAR OSTEOTOMY USING FINITE ELEMENT CONTACT ANALYSIS. J MECH MED BIOL 2018. [DOI: 10.1142/s0219519418500185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Finite element (FE) analysis has been used in the simulation of periacetabular osteotomy (PAO) to predict the improvement of contact pressure concentration in dysplastic hip joint. Since the cartilage layer is difficult to be segmented from CT or MRI images, most hip joint models were assumed to be a simple perfect ball and socket joint. However, the influence of different cartilage modeling methods on the reliability of the simulation has not been assessed. The objective of this study is to elucidate the influence of different cartilage modeling methods on predictions of cartilage layers’ contact pressure by FE contact analysis. In this study, the cartilage layer was generated by applying three typical kinds of modeling methods (spherical, uniform thickness, and midline-based). After comparisons with these cartilage modeling methods, the computational results demonstrate that the cartilage modeling methods have a dramatic influence on predictions of contact pressure in the PAO. The relatively continuous contact pressure distribution and lower peak contact pressure are observed in spherical cartilage modeling method. The discontinuous contact pressure distribution and higher peak contact pressure are obtained in uniform thickness and midline-based cartilage modeling methods. And the degree of discontinuous pressure distribution is even worse in the midline-based cartilage modeling method.
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Affiliation(s)
- FEI LI
- School of Mechanical Engineering, Nanjing University of Science and Technology, 200 Xiaolingwei, Nanjing, Jiangsu 210094, P. R. China
| | - HEJUAN CHEN
- School of Mechanical Engineering, Nanjing University of Science and Technology, 200 Xiaolingwei, Nanjing, Jiangsu 210094, P. R. China
| | - TARO MAWATARI
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - YUKIHIDE IWAMOTO
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - FEI JIANG
- Department of Mechanical Engineering, Graduate School of Sciences and Technology for Innovation, Yamaguchi University, 2-16-1 Tokiwadai, Ube, Yamaguchi 755-8611, Japan
| | - XIAN CHEN
- Department of Mechanical Engineering, Graduate School of Sciences and Technology for Innovation, Yamaguchi University, 2-16-1 Tokiwadai, Ube, Yamaguchi 755-8611, Japan
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Hip chondrolabral mechanics during activities of daily living: Role of the labrum and interstitial fluid pressurization. J Biomech 2018; 69:113-120. [PMID: 29366559 DOI: 10.1016/j.jbiomech.2018.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/29/2017] [Accepted: 01/08/2018] [Indexed: 11/21/2022]
Abstract
Osteoarthritis of the hip can result from mechanical factors, which can be studied using finite element (FE) analysis. FE studies of the hip often assume there is no significant loss of fluid pressurization in the articular cartilage during simulated activities and approximate the material as incompressible and elastic. This study examined the conditions under which interstitial fluid load support remains sustained during physiological motions, as well as the role of the labrum in maintaining fluid load support and the effect of its presence on the solid phase of the surrounding cartilage. We found that dynamic motions of gait and squatting maintained consistent fluid load support between cycles, while static single-leg stance experienced slight fluid depressurization with significant reduction of solid phase stress and strain. Presence of the labrum did not significantly influence fluid load support within the articular cartilage, but prevented deformation at the cartilage edge, leading to lower stress and strain conditions in the cartilage. A morphologically accurate representation of collagen fibril orientation through the thickness of the articular cartilage was not necessary to predict fluid load support. However, comparison with simplified fibril reinforcement underscored the physiological importance. The results of this study demonstrate that an elastic incompressible material approximation is reasonable for modeling a limited number of cyclic motions of gait and squatting without significant loss of accuracy, but is not appropriate for static motions or numerous repeated motions. Additionally, effects seen from removal of the labrum motivate evaluation of labral reattachment strategies in the context of labral repair.
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Discrete element analysis is a valid method for computing joint contact stress in the hip before and after acetabular fracture. J Biomech 2017; 67:9-17. [PMID: 29221903 DOI: 10.1016/j.jbiomech.2017.11.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/30/2017] [Accepted: 11/13/2017] [Indexed: 11/20/2022]
Abstract
Evaluation of abnormalities in joint contact stress that develop after inaccurate reduction of an acetabular fracture may provide a potential means for predicting the risk of developing post-traumatic osteoarthritis. Discrete element analysis (DEA) is a computational technique for calculating intra-articular contact stress distributions in a fraction of the time required to obtain the same information using the more commonly employed finite element analysis technique. The goal of this work was to validate the accuracy of DEA-computed contact stress against physical measurements of contact stress made in cadaveric hips using Tekscan sensors. Four static loading tests in a variety of poses from heel-strike to toe-off were performed in two different cadaveric hip specimens with the acetabulum intact and again with an intentionally malreduced posterior wall acetabular fracture. DEA-computed contact stress was compared on a point-by-point basis to stress measured from the physical experiments. There was good agreement between computed and measured contact stress over the entire contact area (correlation coefficients ranged from 0.88 to 0.99). DEA-computed peak contact stress was within an average of 0.5 MPa (range 0.2-0.8 MPa) of the Tekscan peak stress for intact hips, and within an average of 0.6 MPa (range 0-1.6 MPa) for fractured cases. DEA-computed contact areas were within an average of 33% of the Tekscan-measured areas (range: 1.4-60%). These results indicate that the DEA methodology is a valid method for accurately estimating contact stress in both intact and fractured hips.
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Schneider MTY, Zhang J, Crisco JJ, Weiss APC, Ladd AL, Mithraratne K, Nielsen P, Besier T. Trapeziometacarpal joint contact varies between men and women during three isometric functional tasks. Med Eng Phys 2017; 50:43-49. [PMID: 29107572 DOI: 10.1016/j.medengphy.2017.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/05/2017] [Accepted: 09/28/2017] [Indexed: 11/16/2022]
Abstract
Trapeziometacarpal (TMC) joint osteoarthritis (OA) affects women two to six times more than men, and is influenced by stresses and strains in the cartilage. The purpose of this study was to characterise sex and age differences in contact area and peak stress location of the healthy TMC joint during three isometric tasks including pinch, grasp and jar twist. CT images of the hand from 50 healthy adult men and women were used to create a statistical shape model that was used to create finite element models for each subject and task. Force-driven simulations were performed to evaluate cartilage contact area and peak stress location. We tested for sex and age differences using Principal Component Analysis, linear regression, and Linear Discriminant Analysis. We observed sex differences in peak stress location during pinch (p = .0206), grasp (p = .0264), and jar twist (p = .0484). The greatest sex differences were observed during jar twist, where 94% of peak stresses in men were located in the centre compared with 50% in the central-volar region in women. These findings show that peak stress locations are more variable in women during grasp and jar twist than men, and suggest that women may employ different strategies to perform these tasks.
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Affiliation(s)
- Marco T Y Schneider
- Auckland Bioengineering Institute, The University of Auckland, Level 6, 70 Symonds Street, Auckland 1010, New Zealand
| | - Ju Zhang
- Auckland Bioengineering Institute, The University of Auckland, Level 6, 70 Symonds Street, Auckland 1010, New Zealand
| | - Joseph J Crisco
- Department of Orthopedics, Warren Alpert Medical School of Brown University, Rhode Island Hospital, RI, USA
| | - Arnold-Peter C Weiss
- Department of Orthopedics, Warren Alpert Medical School of Brown University, Rhode Island Hospital, RI, USA
| | - Amy L Ladd
- Department of Orthopedic Surgery, Stanford, Stanford University, CA, USA
| | - Kumar Mithraratne
- Auckland Bioengineering Institute, The University of Auckland, Level 6, 70 Symonds Street, Auckland 1010, New Zealand
| | - Poul Nielsen
- Auckland Bioengineering Institute, The University of Auckland, Level 6, 70 Symonds Street, Auckland 1010, New Zealand ; Department of Engineering Science, The University of Auckland, Auckland, New Zealand
| | - Thor Besier
- Auckland Bioengineering Institute, The University of Auckland, Level 6, 70 Symonds Street, Auckland 1010, New Zealand ; Department of Engineering Science, The University of Auckland, Auckland, New Zealand.
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Knight SJ, Abraham CL, Peters CL, Weiss JA, Anderson AE. Changes in chondrolabral mechanics, coverage, and congruency following peri-acetabular osteotomy for treatment of acetabular retroversion: A patient-specific finite element study. J Orthop Res 2017; 35:2567-2576. [PMID: 28370312 PMCID: PMC5623608 DOI: 10.1002/jor.23566] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 03/28/2017] [Indexed: 02/04/2023]
Abstract
UNLABELLED Using a validated finite element (FE) protocol, we quantified cartilage and labrum mechanics, congruency, and femoral coverage in five male patients before and after they were treated for acetabular retroversion with peri-acetabular osteotomy (PAO). Three-dimensional models of bone, cartilage, and labrum were generated from computed tomography (CT) arthrography images, acquired before and after PAO. Walking, stair-ascent, stair-descent, and rising from a chair were simulated. Cartilage and labrum contact stress, contact area, and femoral coverage were calculated overall and regionally. Mean congruency (average of local congruency values for FE nodes in contact) and peak congruency (most incongruent node in contact) were calculated overall and regionally. Load supported by the labrum was represented as a raw change in the ratio of the applied force transferred through the labrum and percent change following surgery (calculated overall only). Considering all activities, following PAO, mean acetabular cartilage contact stress increased medially, superiorly, and posteriorly; peak stress increased medially and posteriorly. Peak labrum stresses decreased overall and superiorly. Acetabular contact area decreased overall and laterally, and increased medially. Labral contact area decreased overall, but not regionally. Load to the labrum decreased. Femoral head coverage increased overall, anterolaterally, and posterolaterally, but decreased anteromedially. Mean congruency indicated the hip became less congruent overall, anteriorly, and posteriorly; peak congruency indicated a less congruent joint posteriorly. CLINICAL RELEVANCE Medialization of contact and reductions in labral loading following PAO may prevent osteoarthritis, but this procedure increases cartilage stresses, decreases contact area, and makes the hip less congruent, which may overload cartilage. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2567-2576, 2017.
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Affiliation(s)
- Spencer J. Knight
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA
| | - Christine L. Abraham
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA,Department of Bioengineering, University of Utah, Salt Lake City, UT 84112, USA
| | - Christopher L. Peters
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA,Department of Bioengineering, University of Utah, Salt Lake City, UT 84112, USA
| | - Jeffrey A. Weiss
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA,Department of Bioengineering, University of Utah, Salt Lake City, UT 84112, USA,Scientific Computing and Imaging Institute, Salt Lake City, UT 84112, USA
| | - Andrew E. Anderson
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA,Department of Bioengineering, University of Utah, Salt Lake City, UT 84112, USA,Scientific Computing and Imaging Institute, Salt Lake City, UT 84112, USA,Department of Physical Therapy, University of Utah, Salt Lake City, UT 84108, USA
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Wang G, Huang W, Song Q, Liang J. Three-dimensional finite analysis of acetabular contact pressure and contact area during normal walking. Asian J Surg 2017; 40:463-469. [DOI: 10.1016/j.asjsur.2016.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 03/28/2016] [Accepted: 03/30/2016] [Indexed: 11/25/2022] Open
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Cooper RJ, Mengoni M, Groves D, Williams S, Bankes MJ, Robinson P, Jones AC. Three-dimensional assessment of impingement risk in geometrically parameterised hips compared with clinical measures. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2017; 33:e2867. [PMID: 28112875 PMCID: PMC5724697 DOI: 10.1002/cnm.2867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 06/06/2023]
Abstract
Abnormal bony morphology is a factor implicated in hip joint soft tissue damage and an increased lifetime risk of osteoarthritis. Standard 2-dimensional radiographic measurements for diagnosis of hip deformities, such as cam deformities on the femoral neck, do not capture the full joint geometry and are not indicative of symptomatic damage. In this study, a 3-dimensional geometric parameterisation system was developed to capture key variations in the femur and acetabulum of subjects with clinically diagnosed cam deformity. The parameterisation was performed for computed tomography scans of 20 patients (10 female and 10 male). Novel quantitative measures of cam deformity were taken and used to assess differences in morphological deformities between males and females. The parametric surfaces matched the more detailed, segmented hip bone geometry with low fitting error. The quantitative severity measures captured both the size and the position of cams and distinguished between cam and control femurs. The precision of the measures was sufficient to identify differences between subjects that could not be seen with the sole use of 2-dimensional imaging. In particular, cams were found to be more superiorly located in males than in females. As well as providing a means to distinguish between subjects more clearly, the new geometric hip parameterisation facilitates the flexible and rapid generation of a range of realistic hip geometries including cams. When combined with material property models, these stratified cam shapes can be used for further assessment of the effect of the geometric variation under impingement conditions.
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Affiliation(s)
- Robert J. Cooper
- Institute of Medical and Biological Engineering, School of Mechanical EngineeringUniversity of LeedsLeedsLS2 9JTUK
| | - Marlène Mengoni
- Institute of Medical and Biological Engineering, School of Mechanical EngineeringUniversity of LeedsLeedsLS2 9JTUK
| | - Dawn Groves
- Institute of Medical and Biological Engineering, School of Mechanical EngineeringUniversity of LeedsLeedsLS2 9JTUK
| | - Sophie Williams
- Institute of Medical and Biological Engineering, School of Mechanical EngineeringUniversity of LeedsLeedsLS2 9JTUK
| | | | - Philip Robinson
- Leeds Musculoskeletal Biomedical Research UnitChapel Allerton HospitalLeedsLS7 4SAUK
| | - Alison C. Jones
- Institute of Medical and Biological Engineering, School of Mechanical EngineeringUniversity of LeedsLeedsLS2 9JTUK
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50
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Chitsazan A, Herzog W, Rouhi G, Abbasi M. Alteration of Strain Distribution in Distal Tibia After Triple Arthrodesis: Experimental and Finite Element Investigations. J Med Biol Eng 2017. [DOI: 10.1007/s40846-017-0330-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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