Tendon Failure Research Articles

Biomechanical Evaluation of the Flexor Digitorum Longus and Flexor Hallucis Longus Transfer Used for the Treatment of Adult Acquired Flatfoot Deformity: A Finite Element Study

Introduction: Management strategies for stage II tibialis posterior tendon dysfunction are centered on tendon transfers and osteotomies. One of the most commonly used tendon transfers is flexor digitorum longus (FDL) tendon to navicular, but its superiority over transfers to other locations or transfers of other tendons, along with the role of spring ligament and tibialis posterior tendons, have not been objectively evaluated. Aims: We aimed to quantify both the location and magnitude of secondary stresses that develop as a consequence of the initial pathology. Methods: In this study, we used a computational model to study flat foot development and evaluate the effects of various tendon transfers and failures of passive structural elements, as well as their effect on the biomechanics of the foot. Results: We found that both FDL and FHL transfers have biomechanical advantages and disadvantages. Neither of these transfers decrease the stress on the tibialis posterior tendon if the underlying pathologies such as spring ligament failure are not addressed. Conclusions: Of the tendon transfers evaluated, FDL transfer to the navicular had the most profound effect on reducing the stresses on the spring ligament.

Developing a three-dimensional convolutional neural network for full volume auto-segmentation of shoulder Dixon MRI with comparison to Goutallier classification and two-dimensional muscle quality assessment.

Preoperative intramuscular fat (IMF) is a strong predictor of tendon failure after a rotator cuff repair. Due to the contemporary labor intensive and time-dependent manual segmentation required for quantitative assessment of IMF, clinical implementation remains a challenge. The emergence of accurate three-dimensional evaluation of the rotator cuff may permit implementation with greater inter-rater reliability than common subjective scales (e.g., Goutallier classification (GC)). Here, we developed and validated convolutional neural network (CNN) model for auto-segmentation of the shoulder on Dixon MRI. Also, we aimed to assess the agreement between GC, two-dimensional (2D) and 3D IMF including their discriminatory ability for the identification of muscles above an IMF threshold shown to negatively impact surgical outcomes (i.e., GC ≥ 3). This study retrospectively obtained fat-water Dixon shoulder MRIs between March 2023 and March 2024 to develop and validate a CNN model for the segmentation of individual rotator cuff muscles and surrounding tissues. The CNN model was trained using a modified U-Net architecture (n = 80) and tested on an external dataset (n = 25). Accuracy was primarily evaluated using the Dice Similarity Coefficient (DSC) compared to manual segmentation. Reliability was evaluated by the intraclass correlation coefficient (ICC2,1) and discriminatory ability was evaluated by the area under the receiver operating characteristic curve (AUC). The model after training (37 male and 43 female, mean age = 55.8 ± 15.6 years) and testing (15 male and 10 female, mean age = 56.6 ± 19.7 years) produced DSCs of ≥ 0.89 except for teres minor (DSC = 0.86 ± 0.03). The model demonstrated excellent reliability for volume (ICC2,1 ≥ 0.93) and good to excellent reliability for IMF (ICC2,1 ≥ 0.80), with the exceptions of teres major volume (ICC2,1 = 0.82, 95% CI: 0.63 - 0.92, p < 0.001) and subscapularis IMF (ICC2,1 = 0.55, 95% CI: 0.22 - 0.77, p < 0.001). 3D IMF but not 2D IMF was associated with GC for the supraspinatus, subscapularis and infraspinatus (U ≥ 4.02, p < 0.045). The proposed CNN model's IMF outputs produced excellent discriminatory capability of muscles above the IMF threshold shown to negatively impact outcomes (AUC ≥ 0.93). The development of a CNN model allows for efficient, accurate segmentation of muscle and bone, enabling reliable evaluation of muscle quality. The model demonstrates that 2D evaluation of IMF is insufficient for differentiating between rotator cuff muscles either side of a clinically meaningful IMF threshold on the GC scheme, whereas 3D IMF shows excellent discriminant validity across all rotator cuff muscles.

Detection of tendon breaks in prestressed concrete structures using coda wave interferometry

AbstractTendon breaks significantly threaten the safety of prestressed concrete structures. Failure of embedded tendons does not necessarily indicate as surface cracks, demonstrating the need for early detection methods. This paper presents a novel ultrasound‐based approach for detecting and localizing tendon breaks using coda wave interferometry. Already few embedded ultrasonic transducers form a robust monitoring network able to detect subtle changes in the structure. To demonstrate the feasibility of detecting tendon breaks, a post‐tensioned concrete beam was fabricated at Ruhr University Bochum, Germany. A break of a centric and eccentric tendon was artificially created by drilling from the outside. Both were successfully detected and localized through characteristic changes in the ultrasound results without any evidence of damage on the concrete surface. Measurements with fiber optic sensors validate the ultrasonic findings and provide insights into the re‐anchoring behavior after tendon failure.

Transmission length of multiwire tendon in existing post-tensioned concrete structures

Transmission length of multiwire tendon in existing post-tensioned concrete structures

Redundancy and reliability levels of post-tensioned and grouted concrete cross-section in case of tendon failure

Since the 1960 s and 1970 s, the prestressing steel used on post-tensioned concrete (PTC) bridges has been known to be susceptible to stress corrosion cracking (SCC). This can result in brittle rupture of the prestressing steel. Objective of this study is to evaluate the reliability levels achieved with assessment method developed for verifying crack behaviour before failure in cross-section of PTC bridges with cross-section loss of prestressing steel. Additionally, the study aims to investigate of tendon loss on crack before failure behaviour. This paper applies a reliability analysis for methodology based on robustness analysis on crack before failure behaviour in PTC with deteriorating prestressing steel. The analysis involves examining cross-sections with various design criteria. The effects of choices made in designing the PTC structure are analysed and noted to have a significant impact on the safety margin of the structure, while the deterioration of prestressing steel does not significantly decrease the ductility of the cross-section if certain conditions are met. The use of stricter serviceability limit-state (SLS) criteria used in past design results the greater safety margin for the structure in the event of tendon loss, which therefore makes it beneficial for structural redundancy in the ultimate limit state (ULS).

Monitoring tendon breaks in concrete structures at different depths using distributed fiber optical sensors

Unannounced tendon breaks are a dreaded failure mechanism in concrete bridges. The failure of single wires or tendons does not necessarily cause cracking of the concrete. Thus, the damage cannot be detected by visual inspection. But, in the case of tendons bonded in concrete, re-anchoring causes characteristic local strain fields: tensile strains occur between the crack edges while three-dimensional compressive strains develop in the area around. On the surface, these strains are small and depend, e.g., on the concrete stiffness, the depth of the tendon inside the member and the anchorage length. Such strain fields can be measured by fiber optical sensors on the surface in two dimensional grids. By evaluating the backscatter of emitted light beams, minimal strain changes (uncertainty: ±1 µm/m) can be detected in quasi-continuous resolution (0.65 mm pitch). An experimental investigation on a prestressed concrete beam with bonded tendons is presented. Gradually, three tendons of 10.5 mm diameter were mechanically cut to simulate failure, while longitudinal strains were measured on a 2D grid at the surface. With a prestressing force of 64.5 kN and up to a depth of 25 cm breaks of the tendons could be detected. They caused strains about 10-15 µm/m at the surface at maximum. For varying tendon positions, the effect of depth on the strain is investigated by two sided measurements. As the distance between the break and the concrete surface increases, the strain significantly decreases but remains detectable. In the future, the results enable deeper analyses of the most influential parameters. The final aim remains to precisely detect the position and number of failed wires or tendons just from the strain signal at the surface.

Indirect Head of the Rectus Femoris Tendon as a Graft for Segmental Hip Labral Reconstruction: An Anatomic, Radiographical, and Biomechanical Study in Comparison With Iliotibial Labral Reconstruction

Background: The indirect head of the rectus femoris (IHRF) tendon has been used as an autograft for segmental labral reconstruction. However, the biomechanical properties and anatomic characteristics of the IHRF, as they relate to surgical applications, have yet to be investigated. Purpose: To (1) quantitatively and qualitatively describe the anatomy of IHRF and its relationship with surrounding arthroscopically relevant landmarks; (2) detail radiographic findings pertinent to IHRF; (3) biomechanically assess segmental labral reconstruction with IHRF, including restoration of the suction seal and contact pressures in comparison with iliotibial band (ITB) reconstruction; and (4) assess potential donor-site morbidity caused by graft harvesting. Study Design: Descriptive laboratory study. Methods: A cadaveric study was performed using 8 fresh-frozen human cadaveric full pelvises and 7 hemipelvises. Three-dimensional anatomic measurements were collected using a 3-dimensional coordinate digitizer. Radiographic analysis was accomplished by securing radiopaque markers of different sizes to the evaluated anatomic structures of the assigned hip.Suction seal and contact pressure testing were performed over 3 trials on 6 pelvises under 4 different testing conditions for each specimen: intact, labral tear, segmental labral reconstruction with ITB, and segmental labral reconstruction with IHRF. After IHRF tendon harvest, each full pelvis had both the intact and contralateral hip tested under tension along its anatomic direction to assess potential site morbidity, such as tendon failure or bony avulsion. Results: The centroid and posterior apex of the indirect rectus femoris attachment are respectively located 10.3 ± 2.6 mm and 21.0 ± 6.5 mm posteriorly, 2.5 ± 7.8 mm and 0.7 ± 8.0 mm superiorly, and 5.0 ± 2.8 mm and 22.2 ± 4.4 mm laterally to the 12:30 labral position. Radiographically, the mean distance of the IHRF to the following landmarks was determined as follows: anterior inferior iliac spine (8.8 ± 2.5 mm), direct head of the rectus femoris (8.0 ± 3.9 mm), 12-o’clock labral position (14.1 ± 2.8 mm), and 3-o’clock labral position (36.5 ± 4.4 mm). During suction seal testing, both the ITB and the IHRF reconstruction groups had significantly lower peak loads and lower energy to peak loads compared with both intact and tear groups (P = .01 to .02 for all comparisons). There were no significant differences between the reconstruction groups for peak loads, energy, and displacement at peak load. In 60° of flexion, there were no differences in normalized contact pressure and contact area between ITB or IHRF reconstruction groups (P > .99). There were no significant differences between intact and harvested specimen groups in donor-site morbidity testing. Conclusion: The IHRF tendon is within close anatomic proximity to arthroscopic acetabular landmarks. In the cadaveric model, harvesting of the IHRF tendon as an autograft does not lead to significant donor-site morbidity in the remaining tendon. Segmental labral reconstruction performed with the IHRF tendon exhibits similar biomechanical outcomes compared with that performed with ITB. Clinical Relevance: This study demonstrates the viability of segmental labral reconstruction with an IHRF tendon and provides a detailed anatomic description of the tendon in the context of an arthroscopic labral reconstruction. Clinicians can use this information during the selection of a graft and as a guide during an arthroscopic graft harvest.

Use of a Krackow suture technique with PEEK barrel augmentation for subscapularis repair is stronger than use of a Mason-Allen suture technique

Use of a Krackow suture technique with PEEK barrel augmentation for subscapularis repair is stronger than use of a Mason-Allen suture technique

Degradation of structural safety levels in prototype balanced beam systems

Degradation of structural safety levels in prototype balanced beam systems

Comparison of Suture Types and Techniques in Achilles Tendon Repair: An Ex Vivo Biomechanical Animal Experiment.

The ideal suture technique and type in tendon repair remain unclear. This biomechanical study aimed to assess the biomechanical characteristics of three techniques-modified Kessler (mKE), modified Krackow (mKR), and modified tension Bunnell (mtBU)-in sheep Achilles tendon tear repair using three suture types-polypropylene, polyester, and ultra-high-molecular-weight polyethylene (UHMWPE)-which are also compared. Sixty-three Achilles tendons harvested from sheep were transversely hacked as a replacement for rupture in a standardized measure and repaired using mKE, mKR, and mtBU techniques with No. 2 polypropylene, polyester, and UHMWPE sutures. Biomechanical parameters, such as Young's modulus, ultimate strength, and strength to the 5-mm gap, were recorded for statistical analysis. The mtBU technique with UHMWPE use resulted in increased ultimate strength, strength to 5-mm gap, Young's modulus, and quantity of specimens with low clinical failure modes compared with the other techniques with other suture materials. Furthermore, mtBU has the lowest thickness at the repair side of the tendons. This approach showed tendon failure during maximal traction testing, whereas the mKE and mKR techniques had polyethylene and polyester suture failures. The UHMWPE suture was significantly superior to the other sutures in each technique in terms of strength and durability. The mtBU technique using UHMWPE suture showed better biomechanical results, implying that this repair might be more appropriate to obtain early mobilization after tendon ruptures.

Experimental study of tendon failure analysis for a TLP floating offshore wind turbine

Experimental study of tendon failure analysis for a TLP floating offshore wind turbine

Damage Detection combining Modal Analysis and Acoustic Emission in Concrete Structures

Damage Detection combining Modal Analysis and Acoustic Emission in Concrete Structures

Detection of internal tendon breaks by fiber-optical measurements – influence of the re-anchoring behavior

Detection of internal tendon breaks by fiber-optical measurements – influence of the re-anchoring behavior

Inspection for Voids in the Grout below the Protective Duct of an External Post-Tensioning Bridge Tendon Using a THz A-Scanner

Grout voids in the tendons of a post-tensioning bridge reduce their strength. Grout voids are also severe flaws causing corrosion of the steel strands in the tendons. Detecting voids during construction and operation of the tendons is essential to prevent tendon failure, which is critical to bridge safety. This study presents a method for inspecting external tendons for voids in the grout below the protective duct pipe using terahertz electromagnetic waves. Due to low attenuation in the high-density polyethylene duct and the large reflectivity difference between the duct/grout and the duct/void interfaces, terahertz waves are suitable for detecting voids in the grout inside tendons. For this study, we developed a mobile frequency-domain terahertz A-scanner that can be used to measure terahertz A-scan data in real time. It is shown that the mobile terahertz A-scanner can be used to assess the area of the grout void in external bridge tendons.

An Experimental Study on the Deterioration Behaviour of External Tendons Due to Corrosion

An Experimental Study on the Deterioration Behaviour of External Tendons Due to Corrosion

Experimental investigation on the fatigue performance of multi-tendon basalt fiber reinforced polymer cable

Experimental investigation on the fatigue performance of multi-tendon basalt fiber reinforced polymer cable

Recent failures of external prestressing grouted tendons: when the ducts take on water…

AbstractThe article describes recent cases of tendon ruptures by corrosion and investigations carried out on some bridges in France. Several causes related to HDPE ducts have been identified such as damages during handling, threading and tensioning of strands, defective connection of the duct to the anchorage, damage during construction or operation, low quality of HDPE material, etc. These cases of tendon rupture exclusively concern ducts injected with cement grout. To our knowledge, no structure built after the application of the 2001 circular [1] (prohibiting cement grout for the injection of external prestressing) is currently exhibiting major disorders.A warning note on existing structures with external prestressing has been updated by Cerema in November 2018 [2]. It describes the diagnosis methodology based on analysis of documentation, thorough visual inspection, destructive and nondestructive investigations. New non‐destructive techniques such as guided‐wave ultrasonic technique and magnetic leakage field test using permanent magnets and induction coils are presented. Innovative methods of local repair of the ducts are also described. Finally, different protective devices are analysed in terms of worker safety in the event of a sudden failure of tendon.

Partial ruptures of the distal triceps tendons show only slightly lower ultimate load to failure: a biomechanical study

ObjectivePartial ruptures of the distal triceps tendon are usually treated surgically from a size of > 50% tendon involvement. The aim of this study was to compare the ultimate load to failure of intact triceps tendons with partially ruptured tendons and describe the rupture mechanism.MethodsEighteen human fresh-frozen cadaveric elbow specimens were randomly assigned to two groups with either an intact distal triceps tendon or with a simulated partial rupture of 50% of the tendon. A continuous traction on the distal triceps tendon was applied to provoke a complete tendon rupture. The maximum required ultimate load to failure of the tendon in N was measured. In addition, video recordings of the ruptures of the intact tendons were performed and analysed by two independent investigators.ResultsA median ultimate load to failure of 1,390 N (range Q0.25—Q0.75, 954 – 2,360) was measured in intact distal triceps tendons. The median ultimate load to failure of the partially ruptured tendons was 1,330 N (range Q0.25—Q0.75, 1,130 – 1.470 N). The differences were not significant. All recorded ruptures began in the superficial tendon portion, and seven out of nine tendons in the lateral tendon portion.DiscussionPartial ruptures of the distal triceps tendon demonstrate a not statistically significant lower ultimate load to failure than intact tendons and typically occur in the superficial, lateral portion of the tendon. This finding can be helpful when deciding between surgical and conservative therapy for partial ruptures of the distal triceps tendon.

The application of mechanical load onto mouse tendons by magnetic restraining represses Mmp-3 expression

ObjectivesMechanical loading is crucial for tendon matrix homeostasis. Under-stimulation of tendon tissue promotes matrix degradation and ultimately tendon failure. In this study, we examined the expression of tendon matrix molecules and matrix-degrading enzymes (matrix metalloproteinases) in stress-deprived tail tendons and compared to tendons that were mechanically loaded by a simple restraining method.Data descriptionIsolated mouse tail fascicles were either floated or restrained by magnets in cell culture media for 24 h. The gene expression of tendon matrix molecules and matrix metalloproteinases in the tendon fascicles of mouse tails were examined by real-time RT-PCR. Stress deprivation of tail tendons increase Mmp3 mRNA levels. Restraining tendons represses these increases in Mmp3. The gene expression response to restraining was specific to Mmp3 at 24 h as we did not observe mRNA level changes in other matrix related genes that we examined (Col1, Col3, Tnc, Acan, and Mmp13). To elucidate, the mechanisms that may regulate load transmission in tendon tissue, we examined filamentous (F-)actin staining and nuclear morphology. As compared to stress deprived tendons, restrained tendons had greater staining for F-actin. The nuclei of restrained tendons are smaller and more elongated. These results indicate that mechanical loading regulates specific gene expression potentially through F-actin regulation of nuclear morphology. A further understanding on the mechanisms involved in regulating Mmp3 gene expression may lead to new strategies to prevent tendon degeneration.

The Effect of Pulling Angle on Rotator Cuff Mechanical Properties in a Canine In Vitro Model.

The objective of this study was to examine the effect of pulling angle on time-zero mechanical properties of intact infraspinatus tendon or infraspinatus tendon repaired with the modified Mason-Allen technique in a canine model in vitro. Thirty-six canine shoulder samples were used. Twenty intact samples were randomly allocated into functional pull (135°) and anatomic pull (70°) groups (n = 10 per group). The remaining sixteen infraspinatus tendons were transected from the insertion and repaired using the modified Mason-Allen technique before being randomly allocated into functional pull or anatomic pull groups (n = 8 per group). Load to failure testing was performed on all specimens. The ultimate failure load and ultimate stress of the functional pulled intact tendons were significantly lower compared with anatomic pulled tendons (1310.2 ± 167.6 N vs. 1687.4 ± 228.2 N, p = 0.0005: 55.6 ± 8.4 MPa vs. 67.1 ± 13.3 MPa, p = 0.0334). For the tendons repaired with the modified Mason-Allen technique, no significant differences were observed in ultimate failure load, ultimate stress or stiffness between functional pull and anatomic pull groups. The variance of pulling angle had a significant influence on the biomechanical properties of the rotator cuff tendon in a canine shoulder model in vitro. Load to failure of the intact infraspinatus tendon was lower at the functional pulling position compared to the anatomic pulling position. This result indicates that uneven load distribution across tendon fibers under functional pull may predispose the tendon to tear. However, this mechanical character is not presented after rotator cuff repair using the modified Mason-Allen technique.