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- J Biomech 42(12):IFC (2009)
- Growth plate mechanics and mechanobiology. A survey of present understanding
Villemure I Stokes IA - J Biomech 42(12):1793-1803 (2009)
The longitudinal growth of long bones occurs in growth plates where chondrocytes synthesize cartilage that is subsequently ossified. Altered growth and subsequent deformity resulting from abnormal mechanical loading is often referred to as mechanical modulation of bone growth. This phenomenon has key implications in the progression of infant and juvenile musculoskeletal deformities, such as adolescent idiopathic scoliosis, hyperkyphosis, genu varus/valgus and tibia vara/valga, as well as neuromuscular diseases. Clinical management of these deformities is often directed at modifying the mechanical environment of affected bones. However, there is limited quantitative and physiological understanding of how bone growth is regulated in response to mechanical loading. This review of published work addresses the state of knowledge concerning key questions about mechanisms underlying biomechanical modulation of bone growth. The longitudinal growth of bones is apparently contro! lled by modifying the numbers of growth plate chondrocytes in the proliferative zone, their rate of proliferation, the amount of chondrocytic hypertrophy and the controlled synthesis and degradation of matrix throughout the growth plate. These variables may be modulated to produce a change in growth rate in the presence of sustained or cyclic mechanical load. Tissue and cellular deformations involved in the transduction of mechanical stimuli depend on the growth plate tissue material properties that are highly anisotropic, time-dependent, and that differ in different zones of the growth plate and with developmental stages. There is little information about the effects of time-varying changes in volume, water content, osmolarity of matrix, etc. on differentiation, maturation and metabolic activity of chondrocytes. Also, the effects of shear forces and torsion on the growth plate are incompletely characterized. Future work on growth plate mechanobiology should distinguish bet! ween changes in the regulation of bone growth resulting from d! ifferent processes, such as direct stimulation of the cell nuclei, physico-chemical stimuli, mechanical degradation of matrix or cellular components and possible alterations of local blood supply. - On the biomechanics of heart valve function
Sacks MS David Merryman W Schmidt DE - J Biomech 42(12):1804-1824 (2009)
Heart valves (HVs) are fluidic control components of the heart that ensure unidirectional blood flow during the cardiac cycle. However, this description does not adequately describe the biomechanical ramifications of their function in that their mechanics are multi-modal. Moreover, they must replicate their cyclic function over an entire lifetime, with an estimated total functional demand of least 3×109 cycles. The focus of the present review is on the functional biomechanics of heart valves. Thus, the focus of the present review is on functional biomechanics, referring primarily to biosolid as well as several key biofluid mechanical aspects underlying heart valve physiological function. Specifically, we refer to the mechanical behaviors of the extracellular matrix structural proteins, underlying cellular function, and their integrated relation to the major aspects of valvular hemodynamic function. While we focus on the work from the author's laboratories, relevant wo! rks of other investigators have been included whenever appropriate. We conclude with a summary of important future trends. - ACL/MCL transection affects knee ligament insertion distance of healing and intact ligaments during gait in the Ovine model
Tapper JE Funakoshi Y Hariu M Marchuk L Thornton GM Ronsky JL Zernicke R Shrive NG Frank CB - J Biomech 42(12):1825-1833 (2009)
The objective of this study was to assess the impact of combined transection of the anterior cruciate and medial collateral ligaments on the intact and healing ligaments in the ovine stifle joint. In vivo 3D stifle joint kinematics were measured in eight sheep during treadmill walking (accuracy: 0.4±0.4 mm, 0.4±0.4°). Kinematics were measured with the joint intact and at 2, 4, 8, 12, 16 and 20 weeks after either surgical ligament transection (n=5) or sham surgery without transection (n=3). After sacrifice at 20 weeks, the 3D subject-specific bone and ligament geometry were digitized, and the 3D distances between insertions (DBI) of ligaments during the dynamic in vivo motion were calculated. Anterior cruciate ligament/medial collateral ligament (ACL/MCL) transection resulted in changes in the DBI of not only the transected ACL, but also the intact lateral collateral ligament (LCL) and posterior cruciate ligament (PCL), while the DBI of the transected MCL was not sig! nificantly changed. Increases in the maximal ACL DBI (2 week: +4.2 mm, 20 week: +5.7 mm) caused increases in the range of ACL DBI (2 week: 3.6 mm, 20 week: +3.8 mm) and the ACL apparent strain (2 week: +18.9%, 20 week: +24.0%). Decreases in the minimal PCL DBI (2 week: −3.2 mm, 20 week: −4.3 mm) resulted in increases in the range of PCL DBI (2 week: +2.7 mm, 20 week: +3.2 mm). Decreases in the maximal LCL DBI (2 week: −1.0 mm, 20 week: −2.0 mm) caused decreased LCL apparent strain (2 week: −3.4%, 20 week: −6.9%). Changes in the mechanical environment of these ligaments may play a significant role in the biological changes observed in these ligaments. - Age-related mechanical work expenditure during normal walking: The Baltimore Longitudinal Study of Aging
uk Ko S Ling SM Winters J Ferrucci L - J Biomech 42(12):1834-1839 (2009)
The aim of this cross-sectional study was to delineate age-associated kinematic and kinetic gait patterns of normal walking, and to test the hypothesis that older adults exhibit gait patterns that reduce generative mechanical work expenditures (MWEs). We studied 52 adult Baltimore Longitudinal Study of Aging participants (means age 72±9, from 60 to 92 years) who could walk 4 m unaided. Three-dimensional kinematic and kinetic parameters assessed during rotation-defined gait periods were used to estimate MWEs for the rotation of lower extremities about the medial–lateral (ML) and anterior–posterior (AP) axes of proximal joints, which represent MWEs in the AP and ML sides, respectively. Relationships between gait parameters and age were examined using regression analysis with adjustments for walking speed, sex, height, and weight. Older age was associated with slower self-selected walking speed (p<0.001), shorter stride length (p<0.001), and greater propensity of lan! ding flat-footed (p=0.003). With older age, hip generative MWE for thigh rotation was lower about the AP axis (hip abduction and adduction) during stance (p=0.010) and higher about the ML axis (hip extension and flexion) during late stance (p<0.001). Knee absorptive MWE for shank rotation about the AP axis (knee abduction and adduction) during early stance was also lower with older age (p<0.003). These age-related gait patterns may represent a compensatory effort to maintain balance and may also reflect mobility limitations. - In vivo measurement of shoulder joint loads during activities of daily living
Westerhoff P Graichen F Bender A Halder A Beier A Rohlmann A Bergmann G - J Biomech 42(12):1840-1849 (2009)
Until recently the contact loads acting in the glenohumeral joint have been calculated using musculoskeletal models or measured in vitro. Now, contact forces and moments are measured in vivo using telemeterized shoulder implants. Mean total contact forces from four patients during eight activities of daily living are reported here. Lifting a coffee pot (1.5 kg) with straight arm caused an average force of 105.0%BW (%body weight) (range: 90–124.6%BW), while setting down the coffee pot in the same position led to higher forces of 122.9%BW on the average (105.3–153.4%BW). The highest joint contact forces were measured when the straight arm was abducted or elevated by 90° or more, with a weight in the hand. Lifting up 2 kg from a board up to head height caused a contact force of 98.3%BW (93–103.6%BW); again, setting it down on the board led to higher forces of 131.5%BW (118.8–144.1%BW). In contrast to previously calculated high loads, the contact force during passive holding of a 10 kg weight laterally was only 12.3%BW (9.2–17.9%BW), but when lifting it up to belt height it increased to 91.5%BW (87–95%BW). The moments transferred inside the joint at our patients varied much more than did the forces both inter and intra-individually. Our data suggest that patients with shoulder problems or during the first post-operative weeks after shoulder fractures or joint replacements should avoid certain activities encountered during daily living e.g. lifting or holding a weight with an outstretched arm. Some energy-related optimization criteria used in the literature for analytical musculoskeletal shoulder models must now be reconsidered. - Evaluation of the roles of passive and active control of balance using a balance control model
Qu X Nussbaum MA - J Biomech 42(12):1850-1855 (2009)
At present there is a lack of consensus regarding the relative roles of passive and active control of quiet upright stance. In the current work, this issue was investigated using two simulation models based on contemporary theories. Specifically, the two models, both of which assumed active control torques to be generated from an optimal neural controller, differed with respect to whether or not passive control torques (stiffness and damping) were included. Model parameters were specified using experimental center-of-pressure (COP) time series obtained during upright stance, and comparisons then made between simulated and actual COP-based measures. Including both active and passive joint torques in the control model did not appear to lead to any improvement in the ability to simulate COP compared with only including active joint torque. Further, simulated passive control torques were typically less than 10% of the active control torques, though some exceptions were fou! nd. These results, along with existing empirical evidence, suggest that active control torque is dominant in maintaining balance during upright stance. - Static and dynamic human flexor tendon–pulley interaction
Schweizer A Moor BK Nagy L Snedecker JG - J Biomech 42(12):1856-1861 (2009)
The aim of the study was to investigate the influence of a preceding flexion or extension movement on the static interaction of human finger flexor tendons and pulleys concerning flexion torque being generated. Six human fresh frozen cadaver long fingers were mounted in an isokinetic movement device for the proximal interphalangeal (PIP) joint. During flexion and extension movement both flexor tendons were equally loaded with 40 N while the generated moment was depicted simultaneously at the fingertip. The movement was stopped at various positions of the proximal interphalangeal joint to record dynamic and static torque. The static torque was always greater after a preceding extension movement compared to a preceding flexion movement in the corresponding same position of the joint. This applied for the whole arc of movement of 0–105°. The difference between static extension and flexion torque was maximal 11% in average at about 83° of flexion. Static torque was alw! ays smaller than dynamic torque during extension movement and always greater than dynamic torque during flexion movement. The kind of preceding movement therefore showed an influence to the torque being generated in the proximal interphalangeal joint. The effect could be simulated on a mechanical finger device. - Finite element simulation of interactions between pelvic organs: Predictive model of the prostate motion in the context of radiotherapy
Boubaker MB Haboussi M Ganghoffer JF Aletti P - J Biomech 42(12):1862-1868 (2009)
The setting up of predictive models of the pelvic organ motion and deformation may prove an efficient tool in the framework of prostate cancer radiotherapy, in order to deliver doses more accurately and efficiently to the clinical target volume (CTV). A finite element (FE) model of the prostate, rectum and bladder motion has been developed, investigating more specifically the influence of the rectum and bladder repletions on the gland motion. The required organ geometries are obtained after processing the computed tomography (CT) images, using specific softwares. Due to their structural characteristics, a 3D shell discretization is adopted for the rectum and the bladder, whereas a volume discretization is adopted for the prostate. As for the mechanical behavior modelling, first order Ogden hyperelastic constitutive laws for both the rectum and bladder are identified. The prostate is comparatively considered as more rigid and is accordingly modelled as an elastic tissue! undergoing small strains. A FE model is then created, accounting for boundary and contact conditions, internal and applied loadings being selected as close as possible to available anatomic data. The order of magnitude of the prostate motion predicted by the FE simulations is similar to the measurements done on a deceased person, accounting for the delineation errors, with a relative error around 8%. Differences are essentially due to uncertainties in the constitutive parameters, pointing towards the need for the setting up of direct measurement of the organs mechanical behavior. - Particle deposition in a CT-scanned human lung airway
Luo HY Liu Y - J Biomech 42(12):1869-1876 (2009)
The particle deposition in a computerized tomography (CT)-scanned human lung was numerically investigated. The five-generation airway is extracted from the trachea to segmental bronchi of a 60-year-old Chinese male patient. Computations were carried out in the flow rate range of 210–630 ml/s (Reynolds number range of 1000–3000) and particle size of 2–10 μm (Stokes number range of 0.0007–0.049). To count the effect of laryngeal jet on trachea inlet, the trachea was extended and modified to simulate the larynx, consequently the inlet velocity profile is biased towards the rear wall. The laryngeal jet-induced turbulence was simulated using low Reynolds number (LRN) κ–ω turbulent model. Particle deposition patterns, deposition efficiency and deposition factor were studied in detail. The turbulent flow has significant effect on the particle deposition, and the present deposition factor is compared well with the available data. - Tibiofemoral kinematics and condylar motion during the stance phase of gait
Kozanek M Hosseini A Liu F Van de Velde SK Gill TJ Rubash HE Li G - J Biomech 42(12):1877-1884 (2009)
Accurate knowledge of the dynamic knee motion in-vivo is instrumental for understanding normal and pathological function of the knee joint. However, interpreting motion of the knee joint during gait in other than the sagittal plane remains controversial. In this study, we utilized the dual fluoroscopic imaging technique to investigate the six-degree-of-freedom kinematics and condylar motion of the knee during the stance phase of treadmill gait in eight healthy volunteers at a speed of 0.67 m/s. We hypothesized that the 6DOF knee kinematics measured during gait will be different from those reported for non-weightbearing activities, especially with regards to the phenomenon of femoral rollback. In addition, we hypothesized that motion of the medial femoral condyle in the transverse plane is greater than that of the lateral femoral condyle during the stance phase of treadmill gait. The rotational motion and the anterior–posterior translation of the femur with respect to! the tibia showed a clear relationship with the flexion–extension path of the knee during the stance phase. Additionally, we observed that the phenomenon of femoral rollback was reversed, with the femur noted to move posteriorly with extension and anteriorly with flexion. Furthermore, we noted that motion of the medial femoral condyle in the transverse plane was greater than that of the lateral femoral condyle during the stance phase of gait (17.4±2.0 mm vs. 7.4±6.1 mm, respectively; p<0.01). The trend was opposite to what has been observed during non-weightbearing flexion or single-leg lunge in previous studies. These data provide baseline knowledge for the understanding of normal physiology and for the analysis of pathological function of the knee joint during walking. These findings further demonstrate that knee kinematics is activity-dependent and motion patterns of one activity (non-weightbearing flexion or lunge) cannot be generalized to interpret a different one ! (gait). - Design of bio-mimetic particles with enhanced vascular interaction
Lee SY Ferrari M Decuzzi P - J Biomech 42(12):1885-1890 (2009)
The majority of particle-based delivery systems for the 'smart' administration of therapeutic and imaging agents have a spherical shape, are made by polymeric or lipid materials, have a size in the order of few hundreds of nanometers and a negligibly small relative density to aqueous solutions. In the microcirculation and deep airways of the lungs, where the creeping flow assumption holds, such small spheres move by following the flow stream lines and are not affected by external volume force fields. A delivery system should be designed to drift across the stream lines and interact repeatedly with the vessel walls, so that vascular interaction could be enhanced. The numerical approach presented in [Gavze, E., Shapiro, M., 1997. Particles in a shear flow near a solid wall: effect of nonsphericity on forces and velocities. International Journal of Multiphase Flow 23, 155–182.] is, here, proposed as a tool to analyze the dynamics of arbitrarily shaped particles in a! creeping flow, and has been extended to include the contribution of external force fields. As an example, ellipsoidal particles with aspect ratio 0.5 are considered. In the absence of external volume forces, a net lateral drift (margination) of the particles has been observed for Stokes number larger than unity (St>1); whereas, for smaller St, the particles oscillate with no net lateral motion. Under these conditions, margination is governed solely by particle inertia (geometry and particle-to-fluid density ratio). In the presence of volume forces, even for fairly small St, margination is observed but in a direction dictated by the external force field. It is concluded that a fine balance between size, shape and density can lead to EVI particles (particles with enhanced vascular interaction) that are able to sense endothelial cells for biological and biophysical abnormalities, mimicking circulating platelets and leukocytes. - Dynamic in vivo 3-dimensional moment arms of the individual quadriceps components
Wilson NA Sheehan FT - J Biomech 42(12):1891-1897 (2009)
The purpose of this study was to provide the first in vivo 3-dimensional (3D) measures of knee extensor moment arms, measured during dynamic volitional activity. The hypothesis was that the vastus lateralis (VL) and vastus medialis (VM) have significant off-axis moment arms compared to the central quadriceps components. After obtaining informed consent, three 3D dynamic cine phase contrast (PC) MRI sets (x,y,z velocity and anatomic images) were acquired from 22 subjects during active knee flexion and extension. Using a sagittal-oblique and two coronal-oblique imaging planes, the origins and insertions of each quadriceps muscle were identified and tracked through each time frame by integrating the cine-PC velocity data. The moment arm (MA) and relative moment (RM, defined as the cross product of the tendon line-of-action and a line connecting the line-of-action with the patellar center of mass) were calculated for each quadriceps component. The tendencies of the VM and ! VL to produce patellar tilt were evenly balanced. Interestingly, the magnitude of RM-PSpin for the VM and VL is approximately four times greater than the magnitude of RM-PTilt for the same muscles suggesting that patellar spin may play a more important role in patellofemoral kinematics than previously thought. Thus, a force imbalance that leads to excessive lateral tilt, such as VM weakness in patellofemoral pain syndrome, would produce excessive negative spin (positive spin: superior patellar pole rotates laterally) and to a much greater degree. This would explain the increased negative spin found in recent studies of patellar maltracking. Assessing the contribution of each quadriceps component in three dimensions provides a more complete understanding of muscle functionality. - Effect of conformity and contact stress on wear in fixed-bearing total knee prostheses
Galvin AL Kang L Udofia I Jennings LM McEwen HM Jin Z Fisher J - J Biomech 42(12):1898-1902 (2009)
Ultra high molecular weight polyethylene (PE) remains the primary bearing surface of choice in total knee replacements (TKR). Wear is controlled by levels of cross-shear motion and contact stress. The aim of this study was to compare the wear of fixed-bearing total knee replacements with curved and flat inserts and to test the hypothesis that the flat inserts which give higher contact stresses and smaller contact areas would lead to lower levels of surface wear. A low-conforming, high contact stress knee with a low-medium level of cross shear resulted in significantly lower wear rates in comparison to a standard cruciate sacrificing fixed-bearing knee. The low wear solution found in the knee simulator was supported by fundamental studies of wear as a function of pressure and cross shear in the pin on plate system. Current designs of fixed-bearing knees do not offer this low wear solution due to their medium cross shear, moderate conformity and medium contact stress. - Role of stability and limb support in recovery against a fall following a novel slip induced in different daily activities
Yang F Bhatt T Pai YC - J Biomech 42(12):1903-1908 (2009)
The purpose of this study was to determine whether stability and limb support play a similar role in governing slip outcome in gait-slip as in sit-to-stand-slip, and whether such prediction could also be derived based on measures of these variables during regular, unperturbed movements. Fifty-three and forty-one young subjects all took one recovery step following an unannounced, novel, forward slip induced in gait and in sit-to-stand, respectively. Logistic regression was used to predict recovery outcome based on preslip and reactive measures of stability and limb support across tasks. Following slip onset, all subjects in both tasks experienced rapid decay in stability and limb support (indicated by a hip descent), leading to some actual falls that could not have been predicted from regular, preslip walking. Immediately before recovery step touchdown, stability and limb support could together best predict 88.9% and 100% falls, respectively, for gait-slip and sit-to-st! and-slip. Because of differences in the execution of the recovery step, stability became a better predictor of fallers in sit-to-stand-slip than in gait-slip after recovery limb touchdown. Recovery steps were highly effective in restoring stability, regardless of outcome and task. The predictive strength of stability diminished in gait-slip or reduced in sit-to-stand-slip after recovery touchdown, while limb support remained able to differentiate fallers from those who recovered in both tasks. When slip-induced instability was combined with inadequate limb support, falls were nearly inevitable in both tasks. - Stress–strain behavior of mitral valve leaflets in the beating ovine heart
Krishnamurthy G Itoh A Bothe W Swanson JC Kuhl E Karlsson M Craig Miller D Ingels NB - J Biomech 42(12):1909-1916 (2009)
Excised anterior mitral leaflets exhibit anisotropic, non-linear material behavior with pre-transitional stiffness ranging from 0.06 to 0.09 N/mm2 and post-transitional stiffness from 2 to 9 N/mm2. We used inverse finite element (FE) analysis to test, for the first time, whether the anterior mitral leaflet (AML), in vivo, exhibits similar non-linear behavior during isovolumic relaxation (IVR). Miniature radiopaque markers were sewn to the mitral annulus, AML, and papillary muscles in 8 sheep. Four-dimensional marker coordinates were obtained using biplane videofluoroscopic imaging during three consecutive cardiac cycles. A FE model of the AML was developed using marker coordinates at the end of isovolumic relaxation (when pressure difference across the valve is approximately zero), as the reference state. AML displacements were simulated during IVR using measured left ventricular and atrial pressures. AML elastic moduli in the radial and circumferential directions were! obtained for each heartbeat by inverse FEA, minimizing the difference between simulated and measured displacements. Stress–strain curves for each beat were obtained from the FE model at incrementally increasing transmitral pressure intervals during IVR. Linear regression of 24 individual stress–strain curves (8 hearts, 3 beats each) yielded a mean (±SD) linear correlation coefficient (r2) of 0.994±0.003 for the circumferential direction and 0.995±0.003 for the radial direction. Thus, unlike isolated leaflets, the AML, in vivo, operates linearly over a physiologic range of pressures in the closed mitral valve. - During sideways falls proximal femur fractures initiate in the superolateral cortex: Evidence from high-speed video of simulated fractures
de Bakker PM Manske SL Ebacher V Oxland TR Cripton PA Guy P - J Biomech 42(12):1917-1925 (2009)
Results of recent imaging studies and theoretical models suggest that the superior femoral neck is a location of local weakness due to an age-related thinning of the cortex, and thus the site of hip fracture initiation. The purpose of this study was to experimentally determine the spatial and temporal characteristics of the macroscopic failure process during a simulated hip fracture that would occur as a result of a sideways fall. Twelve fresh frozen human cadaveric femora were used in this study. The femora were fractured in an apparatus designed to simulate a fall on the greater trochanter. Image sequences of the surface events related to the fractures were captured using two high-speed video cameras at 9111 Hz. The videos were analyzed with respect to time and load to determine the location and sequence of these events occurring in the proximal femur. The mean failure load was 4032 N (SD 370 N). The first surface events were identified in the superior femoral neck i! n eleven of the twelve specimens. Nine of these specimens fractured in a clear two-step process that initiated with a failure in the superior femoral neck, followed by a failure in the inferior femoral neck. This cadaveric model of hip fracture empirically confirms hypotheses that suggested that hip fractures initiate with a failure in the superior femoral neck where stresses are primarily compressive during a sideways fall impact, followed by a failure in the inferior neck where stresses are primarily tensile. Our results confirm the superolateral neck of the femur as an important region of interest for future hip fracture screening, prevention and treatment research. - Discretization error when using finite element models: Analysis and evaluation of an underestimated problem
Schmidt H Alber T Wehner T Blakytny R Wilke HJ - J Biomech 42(12):1926-1934 (2009)
Mesh convergence tests are often insufficiently performed in finite element analyses. There are many parameters which may have an effect on the mesh convergence behavior. The aim of this study was to identify the influence of different parameters on the mesh convergence behavior. For this purpose we used a simplified axis-symmetrical model of a single pedicle screw flank with surrounding bone to simulate a pull-out test. In parameter studies, the flank radii and the contact conditions at the bone–screw interface were varied. These parameter studies were carried out using an implicit and explicit solver. Thereby, the convergence criteria and the number of the substeps for the implicit nonlinear iteration process as well as the velocity and the material density for the explicit approach were considered. The mesh convergence behavior was influenced by varying the flank radii and the contact conditions. The implicit calculations led to a reaction force, which converged rapidly to a certain value with increasing mesh density, whereas the maximum von-Mises stress showed substantial convergence problems. The number of substeps and the convergence criteria of the iteration process strongly influenced the implicit solutions. In contrast, the maximum von-Mises stresses resulting from explicit calculations converged to a certain value after only a few refinement steps. Different pull-out velocities substantially affected the mesh convergence behavior, while the material density showed only a negligible influence. The results indicated the need to perform an appropriate mesh convergence test when using finite element methods. We were able to show that different parameters strongly influence the mesh convergence behavior and we demonstrated that convergence tests do not always lead to a satisfactory or acceptable solution. - A method for the measurement of left ventricular overload for aortic valve insufficiency
Travis BR Fowler BL Robicsek F - J Biomech 42(12):1935-1940 (2009)
Background The degree of left ventricular overload in patients with aortic valve insufficiency (AI) plays an important role in determining the need and timing of surgical intervention. Because hemodynamic evaluation of AI may potentially predict the effects of an insufficient valve on the ventricle before they occur, it would be useful to guide valve surgery with such a diagnostic tool. The purpose of this study was to test the performance of a new hemodynamic index based on mechanical energy loss for the measurement of the effects of insufficiency on ventricular workload. Methods and results An intact and subsequently perforated aortic bioprosthesis was tested within an in vitro model of the left heart, varying cardiac output, diastolic aortic pressure, and the size of perforation. Regurgitant orifice area (ROA), regurgitant volume (RV), regurgitant fraction (RF), and energy loss index (ELI) were measured for each experimental condition and plotted against the increase in workload per unit volume net forward flow (ΔWPV) due to perforation. ROA, RV, and RF showed good correlations with ΔWPV, but the relationship between these variables and ΔWPV became ambiguous as their magnitudes increased. ELI had a near perfect linear relationship with ΔWPV (slope=1.00, r2=0.98) independent of the experimental condition. Conclusions RV, RF, and ROA do not by themselves fully describe the increase in difficulty the ventricle has in moving the blood across an insufficient valve. ELI, in contrast, was found to be a very good measure of the decrease in pump efficiency due to aortic valve insufficiency. - Reduced nucleus pulposus glycosaminoglycan content alters intervertebral disc dynamic viscoelastic mechanics
Boxberger JI Orlansky AS Sen S Elliott DM - J Biomech 42(12):1941-1946 (2009)
The intervertebral disc functions over a range of dynamic loading regimes including axial loads applied across a spectrum of frequencies at varying compressive loads. Biochemical changes occurring in early degeneration, including reduced nucleus pulposus glycosaminoglycan content, may alter disc mechanical behavior and thus may contribute to the progression of degeneration. The objective of this study was to determine disc dynamic viscoelastic properties under several equilibrium loads and loading frequencies, and further, to determine how reduced nucleus glycosaminoglycan content alters dynamic mechanics. We hypothesized that (1) dynamic stiffness would be elevated with increasing equilibrium load and increasing frequency, (2) the disc would behave more elastically at higher frequencies, and finally, (3) dynamic stiffness would be reduced at low equilibrium loads under all frequencies due to nucleus glycosaminoglycan loss. We mechanically tested control and chondroiti! nase ABC injected rat lumbar motion segments at several equilibrium loads using oscillatory loading at frequencies ranging from 0.05 to 5 Hz. The rat lumbar disc behaved non-linearly with higher dynamic stiffness at elevated compressive loads irrespective of frequency. Phase angle was not affected by equilibrium load, although it decreased as frequency was increased. Reduced glycosaminoglycan decreased dynamic stiffness at low loads but not at high equilibrium loads and led to increased phase angle at all loads and frequencies. The findings of this study demonstrate the effect of equilibrium load and loading frequencies on dynamic disc mechanics and indicate possible mechanical mechanisms through which disc degeneration can progress. - Morphology and fracture of enamel
Myoung S Lee J Constantino P Lucas P Chai H Lawn B - J Biomech 42(12):1947-1951 (2009)
This study examines the inter-relation between enamel morphology and crack resistance by sectioning extracted human molars after loading to fracture. Cracks appear to initiate from tufts, hypocalcified defects at the enamel–dentin junction, and grow longitudinally around the enamel coat to produce failure. Microindentation corner cracks placed next to the tufts in the sections deflect along the tuft interfaces and occasionally penetrate into the adjacent enamel. Although they constitute weak interfaces, the tufts are nevertheless filled with organic matter, and appear to be stabilized against easy extension by self-healing, as well as by mutual stress-shielding and decussation, accounting at least in part for the capacity of tooth enamel to survive high functional forces. - Blood damage safety of prosthetic heart valves. Shear-induced platelet activation and local flow dynamics: A fluid–structure interaction approach
Morbiducci U Ponzini R Nobili M Massai D Montevecchi FM Bluestein D Redaelli A - J Biomech 42(12):1952-1960 (2009)
Thromboembolism and the attendant risk of cardioembolic stroke remains an impediment to the development of prosthetic cardiovascular devices. In particular, altered haemodynamics are implicated in the acute blood cell damage that leads to thromboembolic complications, with platelet activation being the underlying mechanism for cardioemboli formation in blood flow past mechanical heart valves (MHVs) and other blood re-circulating devices. In this work, a new modeling paradigm for evaluating the cardioembolic risk of MHVs is described. In silico fluid–structure interaction (FSI) approach is used for providing a realistic representation of the flow through a bileaflet MHV model, and a Lagrangian analysis is adopted for characterizing the mechanism of mechanically induced activation of platelets by means of a mathematical model for platelet activation state prediction. Additionally, the relationship between the thromboembolic potency of the device and the local flow dyna! mics is quantified by giving a measure of the role played by the local streamwise and spanwise vorticity components. Our methodology indicates that (i) mechanically induced activation of platelets when passing through the valve is dependent on the phase of the cardiac cycle, where the platelet rate of activation is lower at early systole than late systole; (ii) local spanwise vorticity has greater influence on the activation of platelets (R≥0.94) than streamwise vorticity (R≥0.78). In conclusion, an integrated Lagrangian description of key flow characteristics could provide a more complete and quantitative picture of blood flow through MHVs and its potential to activate platelets: the proposed "comprehensive scale" approach could represent an efficient and novel assessment tool for MHV performance and may possibly lead to improved valve designs. - Functional cues in the development of osseous tooth support in the pig, Sus scrofa
Popowics T Yeh K Rafferty K Herring S - J Biomech 42(12):1961-1966 (2009)
Alveolar bone supports teeth during chewing through a ligamentous interface with tooth roots. Although tooth loads are presumed to direct the development and adaptation of these tissues, strain distribution in the alveolar bone at different stages of tooth eruption and periodontal development is unknown. This study investigates the biomechanical effects of tooth loading on developing alveolar bone as a tooth erupts into occlusion. Mandibular segments from miniature pigs, Sus scrofa, containing M1 either erupting or in functional occlusion, were loaded in compression. Simultaneous recordings were made from rosette strain gages affixed to the lingual alveolar bone and the M2 crypt. Overall, specimens with erupting M1s were more deformable than specimens with occluding M1s (mean stiffness of 246 vs. 944 MPa, respectively, p=0.004). The major difference in alveolar strain between the two stages was in orientation. The vertically applied compressive loads were more directly! reflected in the alveolar bone strains of erupting M1s, than those of occluding M1s, presumably because of the mediation of a more mature periodontal ligament (PDL) in the latter. The PDL interface between occluding teeth and alveolar bone is likely to stiffen the system, allowing transmission of occlusal loads. Alveolar strains may provide a stimulus for bone growth in the alveolar process and crest. - Effect of landing height on frontal plane kinematics, kinetics and energy dissipation at lower extremity joints
Yeow CH Lee PV Goh JC - J Biomech 42(12):1967-1973 (2009)
Lack of the necessary magnitude of energy dissipation by lower extremity joint muscles may be implicated in elevated impact stresses present during landing from greater heights. These increased stresses are experienced by supporting tissues like cartilage, ligaments and bones, thus aggravating injury risk. This study sought to investigate frontal plane kinematics, kinetics and energetics of lower extremity joints during landing from different heights. Eighteen male recreational athletes were instructed to perform drop-landing tasks from 0.3- to 0.6-m heights. Force plates and motion-capture system were used to capture ground reaction force and kinematics data, respectively. Joint moment was calculated using inverse dynamics. Joint power was computed as a product of joint moment and angular velocity. Work was defined as joint power integrated over time. Hip and knee joints delivered significantly greater joint power and eccentric work (p<0.05) than the ankle joint at bo! th landing heights. Substantial increase (p<0.05) in eccentric work was noted at the hip joint in response to increasing landing height. Knee and hip joints acted as key contributors to total energy dissipation in the frontal plane with increase in peak ground reaction force (GRF). The hip joint was the top contributor to energy absorption, which indicated a hip-dominant strategy in the frontal plane in response to peak GRF during landing. Future studies should investigate joint motions that can maximize energy dissipation or reduce the need for energy dissipation in the frontal plane at the various joints, and to evaluate their effects on the attenuation of lower extremity injury risk during landing. - Kinematic adjustability of unilateral external fixators for fracture reduction and alignment of axial dynamization
Ou YJ - J Biomech 42(12):1974-1980 (2009)
Bone fracture reduction and bone axial dynamization are important operations which effectiveness can be further enhanced by the use of a unilateral external fixator. By design, axial dynamization can be performed through reciprocating one of its translational joints. However, non-axial dynamization may occur after correcting residual fracture deformity. To explore and to maximize its full potential, the joint adjustment constraint equations for fracture reduction and alignment of axial dynamization under unilateral external fixation are derived. Their physical implications and criteria on the kinematic structure of a fixator are then established. In order to correctly make the alignment of axial dynamization with the proper fracture reduction, this study shows that the linkage of a bone–fixator system should have a minimum of eight degrees-of-freedom (DOFs) with at least two nonparallel rotational DOFs adjacent to both ends of the designated single translational DOF ! for axial dynamization. Thus, the adjustment of the connection between bone pin/pin clamp of Othofix® fixator is required, while the alignment of one of the translational joints of Dynafix® fixator with its bone segment axis during fracture stabilization procedure is a crucial step. A conceptual fixator that requires neither an adjustment of the pin/pin clamp connection nor special pre-alignment is demonstrated. Based on the constraint equations and criteria developed throughout this study, the creation of an effective frame design of external fixation device becomes feasible. - A B-spline based heterogeneous modeling and analysis of proximal femur with graded element
Pise UV Bhatt AD Srivastava RK Warkedkar R - J Biomech 42(12):1981-1988 (2009)
Bone is a complex biological tissue and natural heterogeneous object. The main objective of this study is to simulate quasi-static loading of bio-objects like human femur with B-spline based modeling and its 3D finite element analysis with graded element. B-spline surface representation method is extended to represent material composition to develop heterogeneous solid model of proximal femur. Lagrangian graded element is used to assign inhomogeneous isotropic elastic properties in finite element model to improve the performance. Convergence study is carried out with finite element model in single leg stance load condition. To test the feasibility of the model, sensitivity of simulation is investigated. To validate the model, numerical results are compared with those of an experimental work for the same specimen in simple stance load condition obtained from one of the reference paper. Good agreement is achieved for vertical displacement and strains in most of the locat! ions. - Calcium response in single osteocytes to locally applied mechanical stimulus: Differences in cell process and cell body
Adachi T Aonuma Y Tanaka M Hojo M Takano-Yamamoto T Kamioka H - J Biomech 42(12):1989-1995 (2009)
It is proposed that osteocytes embedded in the bone matrix have the ability to sense deformation and/or damage to the matrix and to feed these mechanical signals back to the adaptive bone remodeling process. When osteoblasts differentiate into osteocytes during the bone formation process, they change their morphology to a stellate form with many slender processes. This characteristic cell shape may underlie the differences in mechanosensitivity between the cell processes and cell body. To elucidate the mechanism of cellular response to mechanical stimulus in osteocytes, we investigated the site-dependent response to quantitatively controlled local mechanical stimulus in single osteocytes isolated from chick embryos, using the technique of calcium imaging. A mechanical stimulus was applied to a single osteocyte using a glass microneedle targeting a microparticle adhered to the cell membrane by modification with a monoclonal antibody OB7.3. Application of the local defor! mation induced calcium transients in the vicinity of the stimulated point and caused diffusive wave propagation of the calcium transient to the entire intracellular region. The rate of cell response to the stimulus was higher when applied to the cell processes than when applied to the cell body. In addition, a large deformation was necessary at the cell body to induce calcium transients, whereas a relatively small deformation was sufficient at the cell processes, suggesting that the mechanosensitivity of the cell processes was higher than that of the cell body. These results suggest that the cell shape with slender processes contributes to the site-dependent mechanosensitivity in osteocytes. - Comparison of two methods for calculating the frictional properties of articular cartilage using a simple pendulum and intact mouse knee joints
Drewniak EI Jay GD Fleming BC Crisco JJ - J Biomech 42(12):1996-1999 (2009)
In attempts to better understand the etiology of osteoarthritis, a debilitating joint disease that results in the degeneration of articular cartilage (AC) in synovial joints, researchers have focused on joint tribology, the study of joint friction, lubrication, and wear. Several different approaches have been used to investigate the frictional properties of articular cartilage. In this study, we examined two analysis methods for calculating the coefficient of friction (μ) using a simple pendulum system and BL6 murine knee joints (n=10) as the fulcrum. A Stanton linear decay model (Lin μ) and an exponential model that accounts for viscous damping (Exp μ) were fit to the decaying pendulum oscillations. Root mean square error (RMSE), asymptotic standard error (ASE), and coefficient of variation (CV) were calculated to evaluate the fit and measurement precision of each model. This investigation demonstrated that while Lin μ was more repeatable, based on CV (5.0% for Li! n μ; 18% for Exp μ), Exp μ provided a better fitting model, based on RMSE (0.165° for Exp μ; 0.391° for Lin μ) and ASE (0.033 for Exp μ; 0.185 for Lin μ), and had a significantly lower coefficient of friction value (0.022±0.007 for Exp μ; 0.042±0.016 for Lin μ) (p=0.001). This study details the use of a simple pendulum for examining cartilage properties in situ that will have applications investigating cartilage mechanics in a variety of species. The Exp μ model provided a more accurate fit to the experimental data for predicting the frictional properties of intact joints in pendulum systems. - Using two palpable measurements improves the subject-specific femoral modeling
Luo W Stanhope SJ Sheehan FT - J Biomech 42(12):2000-2005 (2009)
Subject-specific musculoskeletal models are essential to biomedical research and clinical applications, such as customized joint replacement, computer-aided surgical planning, gait analysis and automated segmentation. Generating these models from CT or magnetic resonance imaging (MRI) is time and resource intensive, requiring special skills. Therefore, in many studies individual bone models are approximated by scaling a generic template. Thus, the primary goal of this study was to determine a set of clinically available parameters (palpable measures and demographic data) that could improve the prediction of femoral dimensions, as compared to predicting these variables using uniform scaling based on palpable length. Similar to previous non-homogenous anthropometric scaling methods, the non-homogenous scaling method proposed in this study improved the prediction over uniform scaling of five key femoral measures. Homogenous scaling forces all dimensions of an object to be! scaled equally, whereas non-homogenous scaling allows the dimensions to be scaled independently. The largest improvement was in femoral depth, where the coefficient of determination (r2) improved from 0.22 (homogenous) to 0.60 (non-homogeneous). In general, the major advantage of this non-homogenous scaling method is its ability to support the accurate and rapid generation of subject-specific femoral models since all parameters can be collected clinically, without imaging or invasive methods. - Alternative solution of virtual biomodeling based on CT-scans
Groesel M Gfoehler M Peham C - J Biomech 42(12):2006-2009 (2009)
In this paper, an alternative method is presented to convert computed tomography (CT)-scans into 3D biomodels. The CT-data of an equine spine was converted into TIF format to work with it in a 2D CAD program. Then the bony structure has been marked manually with closed splines and saved as IGS files for the next procedure with 3D CAD software to create virtual biomodels of every single bone. Therefore, the different layers of the CT-scans were positioned in correct distance and then a closed surface was created to cover all spline-curves. Finally, the cover was filled up with material to create a solid part. This method can be recommended as an alternative way, if CAD software is available only. Especially, if it is necessary to add extra artificial spline-curves to split two or more bones which were unnaturally grown together, working with 3D CAD software is the right solution.
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