With the goal of increasing the survivorship of the prosthesis and anticipating primary stability problems of new prosthetic implants, finite element evaluation of the micromotion, at an early stage of the development, is mandatory. This allows assessing and optimizing different designs without manufacturing prostheses. This study aimed at investigating, using finite element analysis (FEA), the difference in the prediction of the primary stability of cementless hip prostheses implanted into a $Sawbones^{(R)}$ 4th generation, using the manufacturer's mechanical properties and using mechanical properties close to that of human bone provided by the literature (39 papers). FEA was carried out on the composite $Sawbones^{(R)}$ implanted with a straight taper femoral stem subjected to a loading condition simulating normal walking. Our results show that micromotion increases with a reduction of the bone material properties and decreases with the augmentation of the bone material properties at the stem-bone interface. Indeed, a decrease of the cancellous Young modulus from 155MPa to 50MPa increased the average micromotion from $29{\mu}m$ up to $41{\mu}m$ (+42%), whereas an increase of the cancellous Young modulus from 155MPa to 1000MPa decreased the average micromotion from $29{\mu}m$ to $5{\mu}m$ (-83%). A decrease of cortical Young modulus from 16.7GPa to 9GPa increase the average global micromotion from $29{\mu}m$ to $35{\mu}m$ (+33%), whereas an increase of the cortical Young modulus from 16.7GPa to 21GPa decreased the average global micromotion from $29{\mu}m$ to $27{\mu}m$ (-7%). It can also be seen that the material properties of the cancellous structure had a greater influence on the micromotion than the material properties of the cortical structure. The present study shows that micromotion predicted at the stem-bone interface with material properties of the $Sawbones^{(R)}$ 4th generation is close to that predicted with mechanical properties of human femur.
Control of bone cement volume (PMMA) may be critical for preventing complications in vertebroplasty, the percutaneous injection of PMMA into vertebra. The purpose of this study was to predict the optimal volume of PMMA injection based on CT images. For this, correlation between PMMA volume and textural features of CT images was examined before and after surgery to evaluate the appropriate PMMA amount. The gray level run length analysis was used to determine the textural features of the trabecular bone. Extimation of PMMA volume was done using 3D visualization with semi-automatic segmentation on postoperative CT images. Then, finite element (FE) models were constructed based on the CT image data of patients and PMMA volume. Appropriate material properties for the trabecular bone were assigned by converting BMD to elastic modulus. Structural reinforcement due to the changes in PMMA volume and BMD was assessed in terms of axial displacement of the superior endplate. A strong correlation was found between the injected PMMA volume and the area of the intertrabecular space and that of trabecular bone calculated from the CT images (r=0.90 and -0.90, respectively). FE results suggested that vertebroplasty could effectively reinforce the osteoporotic vertebra regardless of BMD or PMMA volume. Effectiveness of additional PMMA injection tended to decrease. For patients with BMD well lower than 50mg/ml, injection of up to 30% volume of the vertebral body is recommended. However, less than 30% is recommended otherwise to avoid any complications from excessive PMMA because the strength has already reached the normal level.
Kim, Hwan;Shin, YiRang;Kim, Sung-Hwan;Lee, Young Han
Investigative Magnetic Resonance Imaging
/
v.25
no.2
/
pp.93-100
/
2021
Purpose: (1) To evaluate the trabecular pattern at the femoral attachment of the posterior cruciate ligament (PCL) in patients with a PCL injury; (2) to analyze bone microarchitecture by applying gray level co-occurrence matrix (GLCM)-based texture analysis; and (3) to determine if there is a significant relationship between bone microarchitecture and posterior instability. Materials and Methods: The study included 96 patients with PCL tears. Trabecular patterns were evaluated on T2-weighted MRI qualitatively, and were evaluated by GLCM texture analysis quantitatively. The grades of posterior drawer test (PDT) and the degrees of posterior displacement on stress radiographs were recorded. The 96 patients were classified into two groups: acute and chronic injury. And 27 patients with no PCL injury were enrolled for control. Pearson's correlation coefficient and one-way ANOVA with Bonferroni test were conducted for statistical analyses. This protocol was approved by the Institutional Review Board. Results: A thick and anisotropic trabecular bone pattern was apparent in normal or acute injury (n = 57/61;93.4%), but was not prominent in chronic injury and posterior instability (n = 31/35;88.6%). Grades of PDT and degrees of posterior displacement on stress radiograph were not correlated with texture parameters. However, the texture analysis parameters of chronic injury were significantly different from those of acute injury and control groups (P < 0.05). Conclusion: The trabecular pattern and texture analysis parameters are useful in predicting posterior instability in patients with PCL injury. Evaluation of the bone microarchitecture resulting from altered biomechanics could advance the understanding of PCL function and improve the detection of PCL injury.
Purpose: This pilot study was conducted to develop a novel test setup for the in vitro assessment of the primary stability of dental implants. This was achieved by characterising their long-term behaviour based on the continuous recording of micromotions resulting from dynamic and cyclic loading. Methods: Twenty screw implants, each 11 mm in length and either 3.8 mm (for premolars) or 4.3 mm (for molars) in diameter, were inserted into the posterior region of 5 synthetic mandibular models. Physiological masticatory loads were simulated by superimposing cyclic buccal-lingual movement of the mandible with a vertically applied masticatory force. Using an optical 3-dimensional (3D) measuring system, the micromotions of the dental crowns relative to the alveolar bone resulting from alternating off-centre loads were concurrently determined over 10,000 test cycles. Results: The buccal-lingual deflections of the dental crowns significantly increased from cycle 10 to cycle 10,000 (P<0.05). The deflections increased sharply during the first 500 cycles before approaching a plateau. Premolars exhibited greater maximum deflections than molars. The bone regions located mesially and distally adjacent to the loaded implants demonstrated deflections that occurred synchronously and in the same direction as the applied loads. The overall spatial movement of the implants over time followed an hourglass-shaped loosening pattern with a characteristic pivot point 5.5±1.1 mm from the apical end. Conclusions: In synthetic mandibular models, the cyclic reciprocal loading of dental implants with an average masticatory force produces significant loosening. The evasive movements observed in the alveolar bone suggest that its anatomy and yielding could significantly influence the force distribution and, consequently, the mechanical behaviour of dental implants. The 3D visualisation of the overall implant movement under functional cyclic loading complements known methods and can contribute to the development of implant designs and surgical techniques by providing a more profound understanding of dynamic bone-implant interactions.
Mohamed, Cherfi;Smail, Benbarek;Bouiadjra, Bachir;Serier, B.
Structural Engineering and Mechanics
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v.57
no.4
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pp.717-731
/
2016
In orthopedic surgery and more especially in total arthroplastie of hip, the fixing of the implants generally takes place essentially by means of constituted surgical polymer cement. The damage of this materiel led to the fatal rupture and thus loosening of the prosthesis in total hip, the effect of over loading as the case of tripping of the patient during walking is one of the parameters that led to the damage of this binder. From this phenomenon we supposed that a remain of bone is included in the cement implantation. The object of this work is to study the effect of this bony inclusion in the zones where the outside conditions (loads and geometric shapes) can provoke the fracture of the cement and therefore the aseptic lousing of the prosthesis. In this study it was assumed the presence of two bones -type inclusions in this material, one after we analyzed the effect of interaction between these two inclusions damage of damage to this material. One have modeled the damage in the cement around this bone inclusion and estimate the crack length from the damaged cement zone in the acetabulum using the finite element method, for every position of the implant under the extreme effort undergone by the prosthesis. We noted that the most intense stress position is around the sharp corner of the bone fragment and the higher level of damage leads directly the fracture of the total prosthesis of the hip.
bin Kamisan, Mohammad Aimaduddin Atiq;Yokota, Kenichiro;Ueno, Takayuki;Kinoshita, Hideaki;Homma, Shinya;Yajima, Yasutomo;Abe, Shinichi;Takano, Naoki
Biomaterials and Biomechanics in Bioengineering
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v.3
no.1
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pp.15-26
/
2016
Based on a survey done recently in Japan, 30 percent of the serious accidents occurred in oral implant surgery were concerned with the mandibular canal and 3/4 of them were related to drilling. One of the reasons lies in the lack of the education system. To overcome this problem, a new educational system focusing on drilling the mandibular trabecular bone has been developed mainly for dental college students in the form of an oral implant surgery training simulator that enables student to sense the reaction force during drilling. On the other hand, the conventional system uses polymeric model. Based on these systems, two approaches were proposed; the evaluation by experienced clinicians using the simulator, and experimental works on the polymeric model. Focusing on the combination of the drilling force sensed and drilling speed obtained through both approaches, the results were compared. It was found that the polymeric models were much softer especially near the mandibular canal. In addition, the study gave us an insight of the understanding in bone quality through tactile sensation of the drilling force and speed. Furthermore, the clinicians positively reviewed the simulator as a valid tool.
dos Santos, Pamela Leticia;de Molon, Rafael Scaf;Queiroz, Thallita Pereira;Okamoto, Roberta;de Souza Faloni, Ana Paula;Gulinelli, Jessica Lemos;Luvizuto, Eloa Rodrigues;Garcia, Idelmo Rangel Junior
Journal of Periodontal and Implant Science
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v.46
no.3
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pp.176-196
/
2016
Purpose: We sought to evaluate the effectiveness of bone substitutes in circumferential periimplant defects created in the rabbit tibia. Methods: Thirty rabbits received 45 implants in their left and right tibia. A circumferential bone defect (6.1 mm in diameter/4 mm depth) was created in each rabbit tibia using a trephine bur. A dental implant ($4.1mm{\times}8.5mm$) was installed after the creation of the defect, providing a 2-mm gap. The bone defect gaps between the implant and the bone were randomly filled according to the following groups: blood clot (CO), particulate Bio-Oss$^{(R)}$ (BI), and Bio-Oss$^{(R)}$ Collagen (BC). Ten animals were euthanized after periods of 15, 30, and 60 days. Biomechanical analysis by means of the removal torque of the implants, as well as histologic and immunohistochemical analyses for protein expression of osteocalcin (OC), Runx2, OPG, RANKL, and TRAP were evaluated. Results: For biomechanics, BC showed a better biological response ($61.00{\pm}15.28Ncm$) than CO ($31.60{\pm}14.38Ncm$) at 30 days. Immunohistochemical analysis showed significantly different OC expression in CO and BC at 15 days, and also between the CO and BI groups, and between the CO and BC groups at 60 days. After 15 days, Runx2 expression was significantly different in the BI group compared to the CO and BC groups. RANKL expression was significantly different in the BI and CO groups and between the BI and BC groups at 15 days, and also between the BI and CO groups at 60 days. OPG expression was significantly higher at 60 days postoperatively in the BI group than the CO group. Conclusions: Collectively, our data indicate that, compared to CO and BI, BC offered better bone healing, which was characterized by greater RUNX2, OC, and OPG immunolabeling, and required greater reversal torque for implant removal. Indeed, along with BI, BC presents promising biomechanical and biological properties supporting its possible use in osteoconductive grafts for filling peri-implant gaps.
Objective : To mitigate the risk of iatrogenic instability, new posterior decompression techniques able to preserve musculoskeletal structures have been introduced but never extensively investigated from a biomechanical point of view. This study was aimed to investigate the impact on spinal flexibility caused by a unilateral laminotomy for bilateral decompression, in comparison to the intact condition and a laminectomy with preservation of a bony bridge at the vertebral arch. Secondary aims were to investigate the biomechanical effects of two-level decompression and the quantification of the restoration of stability after posterior fixation. Methods : A universal spine tester was used to measure the flexibility of six L2-L5 human spine specimens in intact conditions and after decompression and fixation surgeries. An incremental damage protocol was applied : 1) unilateral laminotomy for bilateral decompression at L3-L4; 2) on three specimens, the unilateral laminotomy was extended to L4-L5; 3) laminectomy with preservation of a bony bridge at the vertebral arch (at L3-L4 in the first three specimens and at L4-L5 in the rest); and 4) pedicle screw fixation at the involved levels. Results : Unilateral laminotomy for bilateral decompression had a minor influence on the lumbar flexibility. In flexion-extension, the median range of motion increased by 8%. The bone-preserving laminectomy did not cause major changes in spinal flexibility. Two-level decompression approximately induced a twofold destabilization compared to the single-level treatment, with greater effect on the lower level. Posterior fixation reduced the flexibility to values lower than in the intact conditions in all cases. Conclusion : In vitro testing of human lumbar specimens revealed that unilateral laminotomy for bilateral decompression and bone-preserving laminectomy induced a minor destabilization at the operated level. In absence of other pathological factors (e.g., clinical instability, spondylolisthesis), both techniques appear to be safe from a biomechanical point of view.
El Sallah, Zagane Mohammed;Ali, Benouis;Abderahmen, Sahli
Biomaterials and Biomechanics in Bioengineering
/
v.5
no.1
/
pp.11-23
/
2020
Total hip prosthesis is used for the patients who have hip fracture and are unable to recover naturally. To de-sign highly durable prostheses one has to take into account the natural processes occurring in the bone. Finite element analysis is a computer based numerical analysis method which can be used to calculate the response of a model to a set of well-defined boundary conditions. In this paper, the static load analysis is based, by se-lecting the peak load during the stumbling activity. Two different implant materials have been selected to study appropriate material. The results showed the difference of maximum von Misses stress and detected the frac-ture of the femur shaft for different model (Charnley and Osteal) implant with the extended finite element method (XFEM), and after the results of the numerical simulation of XFEM for different was used in deter-mining the stress intensity factors (SIF) to identify the crack behavior implant materials for different crack length. It has been shown that the maximum stress intensity factors were observed in the model of Charnley.
Park, Sang-Kyoon;Koo, Seungbum;Yoon, Suk-Hoon;Park, Sangheon;Kim, Yongcheol;Ryu, Ji-Seon
Korean Journal of Applied Biomechanics
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v.28
no.2
/
pp.101-108
/
2018
Objective: The aim of this study was to investigate gender differences in ground reaction force (GRF) components among different speeds of running. Method: Twenty men ($age=22.4{\pm}1.6years$, $mass=73.4{\pm}8.4kg$, $height=176.2{\pm}5.6cm$) and twenty women ($age=20.7{\pm}1.2years$, $mass=55.0{\pm}8.2kg$, $height=163.9{\pm}5.3cm$) participated in this study. All participants were asked to run on an instrumented dual belt treadmill (Bertec, USA) at 8, 12, and 16 km/h for 3 min, after warming up. GRF data were collected from 30 strides while they were running. Hypotheses were tested using one-way ANOVA, and level of significance was set at p-value <.05. Results: The time to passive peaks was significantly earlier in women than in men at three different running speeds (p<.05). Further, the impact loading rates were significantly greater in women than in men at three different running speeds (p<.05). Moreover, the propulsive peak at 8 km/h, which is the slowest running speed, was significantly greater in women than in men (p<.05), and the vertical impulse at 16 km/h, which is the fastest running speed, was significantly greater in men than in women (p<.05). The absolute anteroposterior impulse at 8 km/h was significantly greater in women than in men (p<.05). In addition, as the running speed increased, impact peak, active peak, impact loading rate, breaking peak, propulsive peak, and anteroposterior impulse were significantly increased, but vertical impulse was significantly decreased (p<.05). Conclusion: The impact loading rate is greater in women than in men regardless of different running speeds. Therefore, female runners might be exposed to the risk of potential injuries related to the bone and ligament. Moreover, increased running speeds could lead to higher possibility of running injuries.
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