Physiological Loading Conditions Research Articles

Structural simulation of Ti–Ha–CaCO3 biocomposites using finite element analysis (FEA) for biomechanical stability of hip implant

AbstractThe structural integrity of new biocomposite implants is critical in ensuring the success of biomedical implants under physiological loading conditions. Studying the stress distribution, deformation, and potential failure modes under different loading scenarios is complex, expensive, and time-consuming, as it involves repeated surgery on clinical assessment. The present study aims to investigate the biomechanical stability of hip implants made of a Ti–Ha–CaCO3 biocomposite using finite element analysis. The Ti–Ha–CaCO3 biocomposite was modeled and simulated using Solidworks. The model mesh was generated to represent the implant’s geometry accurately, and normal human activities (standing and jumping) were considered the boundary conditions with the lower part of the femur fixed. The model was subjected to static loading following ISO 7206-4 with an equivalent load of 2300 N according to ASTM F2996-13 standard. The Ti–Ha–CaCO3 biocomposite demonstrated outstanding biomechanical stability under loading circumstances. The maximum von Mises stress (354.7 MPa) observed with the GSB-femur model in the implant was below the yield strength of the titanium implant, indicating that the implant can withstand applied loads without experiencing permanent deformation. However, 74.11 MPa was obtained as acceptable von Mises stress using GSB intramedullary rods for bone fixation. The most stable implant is DSB, with the lowest displacement value of 2.68 mm. Low equivalent strains were achieved for all the implants, as the highest strain (0.012) was obtained in the simulation of the stem DSB-femur model. Low-stress signals (SS) were obtained for the implant-femur models, indicating they are suitable for replacing bone for that loading. The DSB (7.19) is the most suitable among the studied stem-femur models, and GSB (0.87) remains the suitable intramedullary rod-femur model with the lowest SS.

Structural simulation of Ti–Ha–CaCO3 biocomposites using finite element analysis (FEA) for biomechanical stability of hip implant

AbstractThe structural integrity of new biocomposite implants is critical in ensuring the success of biomedical implants under physiological loading conditions. Studying the stress distribution, deformation, and potential failure modes under different loading scenarios is complex, expensive, and time-consuming, as it involves repeated surgery on clinical assessment. The present study aims to investigate the biomechanical stability of hip implants made of a Ti–Ha–CaCO3 biocomposite using finite element analysis. The Ti–Ha–CaCO3 biocomposite was modeled and simulated using Solidworks. The model mesh was generated to represent the implant’s geometry accurately, and normal human activities (standing and jumping) were considered the boundary conditions with the lower part of the femur fixed. The model was subjected to static loading following ISO 7206-4 with an equivalent load of 2300 N according to ASTM F2996-13 standard. The Ti–Ha–CaCO3 biocomposite demonstrated outstanding biomechanical stability under loading circumstances. The maximum von Mises stress (354.7 MPa) observed with the GSB-femur model in the implant was below the yield strength of the titanium implant, indicating that the implant can withstand applied loads without experiencing permanent deformation. However, 74.11 MPa was obtained as acceptable von Mises stress using GSB intramedullary rods for bone fixation. The most stable implant is DSB, with the lowest displacement value of 2.68 mm. Low equivalent strains were achieved for all the implants, as the highest strain (0.012) was obtained in the simulation of the stem DSB-femur model. Low-stress signals (SS) were obtained for the implant-femur models, indicating they are suitable for replacing bone for that loading. The DSB (7.19) is the most suitable among the studied stem-femur models, and GSB (0.87) remains the suitable intramedullary rod-femur model with the lowest SS.

The anisotropic and region-dependent mechanical response of wrap-around tendons under tensile, compressive and combined multiaxial loads

The present work reports on the multiaxial region and orientation-dependent mechanical properties of two porcine wrap-around tendons under tensile, compressive and combined loads based on an extensive study with n=175 samples. The results provide a detailed dataset of the anisotropic tensile and compressive longitudinal properties and document a pronounced tension-compression asymmetry. Motivated by the physiological loading conditions of these tendons, which include transversal compression at bony abutments in addition to longitudinal tension, we systematically investigated the change in axial tension when the tendon is compressed transversally along one or both perpendicular directions. The results reveal that the transversal compression can increase axial tension (proximal-distal direction) in both cases to orders of 30%, yet by a larger amount in the first case (transversal compression in anterior-posterior direction), which seems to be more relevant for wrap-around tendons in-vivo. These quantitative measurements are in line with earlier findings on auxetic properties of tendon tissue, but show for the first time the influence of this property on the stress response of the tendon, and may thus reveal an important functional principle within these essential elements of force transmission in the body. Statement of significanceThe work reports for the first time on multiaxial region and orientation-dependent mechanical properties of wrap-around tendons under various loads. The results indicate that differences in the mechanical properties exist between zones that are predominantly in a uniaxial tensile state and those that experience complex load states. The observed counterintuitive increase of the axial tension upon lateral compression points at auxetic properties of the tendon tissue which may be pivotal for the function of the tendon as an element of the musculoskeletal system. It suggests that the tendon’s performance in transmitting forces is not diminished but enhanced when the action line is deflected by a bony pulley around which the tendon wraps, representing an important functional principle of tendon tissue.

A Preclinical Trial Protocol Using an Ovine Model to Assess Scaffold Implant Biomaterials for Repair of Critical-Sized Mandibular Defects.

The present work describes a preclinical trial (in silico, in vivo and in vitro) protocol to assess the biomechanical performance and osteogenic capability of 3D-printed polymeric scaffolds implants used to repair partial defects in a sheep mandible. The protocol spans multiple steps of the medical device development pipeline, including initial concept design of the scaffold implant, digital twin in silico finite element modeling, manufacturing of the device prototype, in vivo device implantation, and in vitro laboratory mechanical testing. First, a patient-specific one-body scaffold implant used for reconstructing a critical-sized defect along the lower border of the sheep mandible ramus was designed using on computed-tomographic (CT) imagery and computer-aided design software. Next, the biomechanical performance of the implant was predicted numerically by simulating physiological load conditions in a digital twin in silico finite element model of the sheep mandible. This allowed for possible redesigning of the implant prior to commencing in vivo experimentation. Then, two types of polymeric biomaterials were used to manufacture the mandibular scaffold implants: poly ether ether ketone (PEEK) and poly ether ketone (PEK) printed with fused deposition modeling (FDM) and selective laser sintering (SLS), respectively. Then, after being implanted for 13 weeks in vivo, the implant and surrounding bone tissue was harvested and microCT scanned to visualize and quantify neo-tissue formation in the porous space of the scaffold. Finally, the implant and local bone tissue was assessed by in vitro laboratory mechanical testing to quantify the osteointegration. The protocol consists of six component procedures: (i) scaffold design and finite element analysis to predict its biomechanical response, (ii) scaffold fabrication with FDM and SLS 3D printing, (iii) surface treatment of the scaffold with plasma immersion ion implantation (PIII) techniques, (iv) ovine mandibular implantation, (v) postoperative sheep recovery, euthanasia, and harvesting of the scaffold and surrounding host bone, microCT scanning, and (vi) in vitro laboratory mechanical tests of the harvested scaffolds. The results of microCT imagery and 3-point mechanical bend testing demonstrate that PIII-SLS-PEK is a promising biomaterial for the manufacturing of scaffold implants to enhance the bone-scaffold contact and bone ingrowth in porous scaffold implants. MicroCT images of the harvested implant and surrounding bone tissue showed encouraging new bone growth at the scaffold-bone interface and inside the porous network of the lattice structure of the SLS-PEK scaffolds.

Biomechanical evaluation of a custom-made mandibular plate

In the field of maxillofacial surgery, mandibular reconstruction with plates is one of the operations that is performed when resection of part of the jaw is unavoidable in patients suffering from pathologies such as, for example, neoplasms and osteonecrosis. Through the use of standard prostheses, which are commercially available in various models, mandibular reconstruction is possible. However, in the presence of particularly serious and complex clinical pictures, in which it is necessary to resect large parts of the mandibular bone, such as in some oncological cases, the use of serial prostheses is not always resolving. In these cases, a customized implant, designed specifically for the patient, is preferable.Aim of this work is the mechanical evaluation of a custom-made mandibular plate with an innovative bone-implant interface geometry through a finite element analysis. Three physiological loading conditions were analysed: RUC (right unilateral canine) bite, RGF (right group functional) bite and maximum opening. Finally, the maximum pull-out force acting on the fixation screws was evaluated through an experimental fatigue test.

Assessment of bone ingrowth around beaded coated tibial implant for total ankle replacement using mechanoregulatory algorithm

The long-term performance of porous coated tibial implants for total ankle replacement (TAR) primarily depends on the extent of bone ingrowth at the bone-implant interface. Although attempts were made for primary fixation for immediate post-operative stability, no investigation was conducted on secondary fixation. The aim of this study is to assess bone ingrowth around the porous beaded coated tibial implant for TAR using a mechanoregulatory algorithm. A realistic macroscale finite element (FE) model of the implanted tibia was developed based on computer tomography (CT) data to assess implant-bone micromotions and coupled with microscale FE models of the implant-bone interface to predict bone ingrowth around tibial implant for TAR. The macroscale FE model was subjected to three near physiological loading conditions to evaluate the site-specific implant-bone micromotion, which were then incorporated into the corresponding microscale model to mimic the near physiological loading conditions. Results of the study demonstrated that the implant experienced tangential micromotion ranged from 0 to 71 μm with a mean of 3.871 μm. Tissue differentiation results revealed that bone ingrowth across the implant ranged from 44 to 96 %, with a mean of around 70 %. The average Young's modulus of the inter-bead tissue layer varied from 1444 to 4180 MPa around the different regions of the implant. The analysis postulates that when peak micromotion touches 30 μm around different regions of the implant, it leads to pronounced fibrous tissues on the implant surface. The highest amount of bone ingrowth was observed in the central regions, and poor bone ingrowth was seen in the anterior parts of the implant, which indicate improper osseointegration around this region. This macro-micro mechanical FE framework can be extended to improve the implant design to enhance the bone ingrowth and in future to develop porous lattice-structured implants to predict and enhance osseointegration around the implant.

A probabilistic approach for assessing the mechanical performance of intertrochanteric fracture stabilized with proximal femoral nail antirotation.

Maintaining post-operative mechanical stability is crucial for successfully healing intertrochanteric fractures treated with the Proximal Femoral Nail Antirotation (PFNA) system. This stability is primarily dependent on the bone mineral density (BMD) and strain on the fracture. Current PFNA failure analyses often overlook the uncertainties related to BMD and body weight (BW). Therefore, this study aimed to develop a probabilistic model using finite element modeling and engineering reliability analysis to assess the post-operative performance of PFNA under various physiological loading conditions. The model predictions were validated through a series of experimental test. The results revealed a negative nonlinear relationship between the BMD and compressive strain. Conversely, the BW was positively and linearly correlated with the compressive strain. Importantly, the compressive strain was more sensitive to BW than to BMD when the BMD exceeded 0.6 g/cm3. Potential trabecular bone compression failure is also indicated if BMD is equal to or below 0.15 g/cm3 and BW increases to approximately 2.5 times the normal or higher. This study emphasizes that variations in the BMD significantly affect the probability of failure of a PFNA system. Thus, careful planning of post-operative physical therapy is essential. For patients aged > 50 years restrictions on high-intensity activities are advised, while limiting strenuous movements is recommended for those aged > 65 years.

1072 SIJ Fusion Device Testing

INTRODUCTION: Screw use for SIJ fixation began in the 1980s with the FDA first classifying SIJ fusion devices in 2002. For 40 years, no standardized test method existed. Various methodologies (for bone screw, intramedullary nail, or spinal fusion implants) were modified to accommodate the design and function of sacroiliac devices including ASTM F543’s torsion, pullout, and insertion tests, ASTM F1264’s three- or four-point bending tests, and ASTM F2193’s cantilever bending tests. For many years, SIJ fusion screw indications were limited to fixation of pelvic bones for sacroiliac joint disruptions and degenerative sacroiliitis. While the FDA typically accepted performance testing according to combinations of the aforementioned tests, the specific test expectations have been relatively undefined with inconsistent testing batteries from submission to submission. METHODS: Collaboration among testing experts, manufacturers, and FDA regulators within ASTM’s Spinal Devices sub-committee resulted in the development and publication of ASTM F3574 (Standard Test Methods for Sacroiliac Joint Fusion Devices) based on physiologic loading conditions in the joint as documented in published studies. These tests included: For SI Screws: • Static/dynamic cantilever bending •Static torsion •Driving torque •Pullout For SI Posterior Spacers: •Static/dynamic shear •Static/dynamic torsion. RESULTS: The medical device industry now has access to standardized test methods for SI devices while the FDA or other regulators now have device specific test methods to recommend for pre-clinical testing. CONCLUSIONS: Many new standards drag through years of development and refinement within sub-committees, but ASTM F3574 developed quickly due to efforts of the Spinal sub-committee task group to meet the needs for SI fusion devices.

Assessment of subchondral bone microdamage quantification using contrast-enhanced imaging techniques.

Bone microdamage is common at subchondral bone (SCB) sites subjected to repeated high rate and magnitude of loading in the limbs of athletic animals and humans. Microdamage can affect the biomechanical behaviour of bone under physiological loading conditions. To understand the effects of microdamage on the mechanical properties of SCB, it is important to be able to quantify it. The extent of SCB microdamage had been previously estimated qualitatively using plain microcomputed tomography (μCT) and a radiocontrast quantification method has been used for trabecular bone but this method may not be directly applicable to SCB due to differences in bone structure. In the current study, SCB microdamage detection using lead uranyl acetate (LUA) and quantification by contrast-enhanced μCT and backscattered scanning electron microscopy (SEM) imaging techniques were assessed to determine the specificity of the labels to microdamage and the accuracy of damaged bone volume metrices. SCB specimens from the metacarpus of racehorses, with the hyaline articular cartilage (HAC) removed, were grouped into two with one group subjected to exvivo uniaxial compression loading to create experimental bone damage. The other group was not loaded to preserve the pre-existing invivo propagated bone microdamage. A subset of each group was stained with LUA using an established or a modified protocol to determine label penetration into SCB. The μCT and SEM images of stained specimens showed that penetration of LUA into the SCB was better using the modified protocol, and this protocol was repeated in SCB specimens with intact hyaline articular cartilage. The percentage of total label localised to bone microdamage was determined on SEM images, and the estimated labelled bone volume determined by μCT in SCB groups was compared. Label was present around diffuse and linear microdamage as well as oblique linear microcracks present at the articular surface, except in microcracks with high-density mineral infills. Bone surfaces lining pores with recent mineralisation were also labelled. Labelled bone volume fraction (LV/BV) estimated by μCT was higher in the absence of HAC. At least 50% of total labels were localised to bone microdamage when the bone area fraction (B.Ar/T.Ar) of the SCB was greater than 0.85 but less than 30% when B.Ar/T.Ar of the SCB was less than 0.85. To adjust for LUA labels on bone surfaces, a measure of the LV/BV corrected for bone surface area (LV/BV BS-1 ) was used to quantify damaged SCB. In conclusion, removal of HAC and using a modified labelling protocol effectively stained damaged SCB of the metacarpus of racehorses and represents a technique useful for quantifying microdamage in SCB. This method can facilitate future investigations of the effects of microdamage on joint physiology.

Mechanical response of local regions of subchondral bone under physiological loading conditions

Most fractures in the third metacarpal bone of equine athletes occur due to repeated cycles of high load magnitudes and are commonly generated during fast-training workouts. These repetitive loads may induce changes in the microstructure and mechanical properties that can develop into subchondral bone (SCB) injuries near the articular surface. In this study, we investigated the fatigue behaviour of local regions in SCB (near the articular surface i.e., 2 mm superficial SCB and the underlying 2 mm deeper SCB) under a simulated fast-training workout of an equine athlete. A fatigue test on SCB specimens was designed to simulate the fast-training workout, which comprised of repeated load cycles with varying load magnitude, representing the varying gait speed during a fast-training workout. The fatigue test was applied three times to each of the five cylindrical SCB specimens harvested from the left and right metacarpal condyles of five thoroughbred racehorses). All specimens completed at least one fatigue test. Three specimens completed all three fatigue tests with no visible cracks identified with Micro-CT scans. The other two specimens failed in the second fatigue test, and cracks were identified with Micro-CT scans in the various local regions. Using Digital Image Correlation (DIC) analysis, we found that in the local regions of all specimens, modulus decreased between load cycles corresponding to 68 and 93 MPa load magnitudes (equivalent to the fastest gallop speed). Wherein specimens that failed exhibited a greater decrease in modulus (in superficial SCB by 45.64 ± 5.66% and in deeper SCB by −36.85 ± 10.47% (n = 2)) than those not failed (in superficial SCB by −7.45 ± 14.62% and in deeper SCB by −5.67 ± 7.32% (n = 3)). This has provided evidence that the loads on SCB at galloping speeds are most likely to produce fatigue damage and that the damage induced is localised. Furthermore, one of the failed specimens exhibited a peak in the tensile strain rather than compressive strain in the superficial region with a rapid decrease in modulus. In addition, the superficial region of all specimens exhibited greater residual tensile strain than that of the deeper region.

Inter-Specimen Analysis of Diverse Finite Element Models of the Lumbar Spine.

Over the past few decades, there has been a growing popularity in utilizing finite element analysis to study the spine. However, most current studies tend to use one specimen for their models. This research aimed to validate multiple finite element models by comparing them with data from in vivo experiments and other existing finite element studies. Additionally, this study sought to analyze the data based on the gender and age of the specimens. For this study, eight lumbar spine (L2-L5) finite element models were developed. These models were then subjected to finite element analysis to simulate the six fundamental motions. CT scans were obtained from a total of eight individuals, four males and four females, ranging in age from forty-four (44) to seventy-three (73) years old. The CT scans were preprocessed and used to construct finite element models that accurately emulated the motions of flexion, extension, lateral bending, and axial rotation. Preloads and moments were applied to the models to replicate physiological loading conditions. This study focused on analyzing various parameters such as vertebral rotation, facet forces, and intradiscal pressure in all loading directions. The obtained data were then compared with the results of other finite element analyses and in vivo experimental measurements found in the existing literature to ensure their validity. This study successfully validated the intervertebral rotation, intradiscal pressure, and facet force results by comparing them with previous research findings. Notably, this study concluded that gender did not have a significant impact on the results. However, the results did highlight the importance of age as a critical variable when modeling the lumbar spine.

Simulation of the Mechanical Behavior of the Degradation L4-L5 Lumbar Spine

Degenerative changes in the lumbar spine significantly reduce the quality of life of people. To fully understand the biomechanics of the affected spine, it is crucial to consider the biomechanical alterations caused by degeneration of the intervertebral disc (IVD). Therefore this study is aimed at the development of a discrete element model of the mechanical behavior of the L4-L5 spinal motion segment, which covers all the degeneration grades from healthy IVD to its severe degeneration, and numerical study of the influence of the IVD degeneration on stress state and biomechanics of the spine. To analyze the effects of IVD degeneration on spine biomechanics we simulated physiological loading conditions using compressive forces. The results of modeling showed that at the initial stages of degenerative changes, an increase in the amplitude and area of maximum compressive stresses in the disc is observed. At the late stages of disc degradation, a decrease in the value of intradiscal pressure and a shift in the maximum compressive stresses in the dorsal direction are observed. Such an influence of the degradation of the geometric and mechanical parameters of the tissues of the disc leads to the effect of bulging, which in turn will lead to the formation of an intervertebral hernia.

Fatigue Analysis of Novel Aortic Valve Stent Using Finite Element Analysis

Aortic stenosis and Regurgitation are the common heart valve diseases that about 20% of the US population get diagnosed with each year. Recent advances in minimally invasive surgical techniques like transcatheter aortic valve replacement (TAVR) have paved the way for high-risk patient treatment with minimal hospital stay and use of anesthetic. While the patient data on prosthetic stent based aortic valve durability from the last decade has instilled confidence, this data is still considered inadequate for large scale adoption of TAVR therapy for low and medium risk patients. As one of the leading failure modes for the Nitinol based prosthetic stents is material fracture due to cycling fatigue, it is critical to identify a method to accurately predict it. While the historic scientific literature available indicates the presence of stress based, strain based and damage-tolerance analysis-based assessments of fatigue behavior of Nitinol material, there still exists a gap specifically for accurate prediction of fatigue life of Nitinol based prosthetic stents using computational methods like finite element analysis. This article presents a case study of estimating the fatigue life of novel aortic valve when subjected to physiological loading conditions using FEA while using minimal computational resources. This FEA and strain-based approach using constant-life diagram method of fatigue estimation will allow for preliminary evaluation of fatigue life and make design and process changes before fabrication and testing of prosthetic aortic.

A Mechanical Approach to the Growth Plate Behaviour and Chondrocytes Columns Organization

This study aims to explore the behaviour of mechanical stimuli and their effect on growth plate shape under different physiological scenarios and loading conditions. A linear elastic, isotropic, and homogeneous model was implemented to model the epiphyseal progressive ossification and the development of the secondary ossification centre. Results shed light on the role of mechanical stimulus, suggesting that maximum shear stress, hydrostatic stress, and von Mises Stress may contribute to the morphological changes of the growth plate. This model is a useful tool to improve orthopaedic therapies focused on pathologies that imply abnormal bone growth under abnormal mechanical conditions.

Stress analysis of the screw of atlantoaxial posterior screw fixation C1LM-C2PS and C1LM-C2PARS with and without rod: A FEM based study

Human cervical spine consists of three vertebrae C0-occiput, C1-atlas, & C3-axial in its upper part. The atlantoaxial complex is the most portable segment of the cervical spine and is accountable for half of the flexion, extension, and axial rotation movements of the neck. Atlantoaxial cervical spine injuries are serious injuries since there is a likely risk of harm to the spinal cord. Sustaining stability of the atlantoaxial joint following a neck injury is a difficult task because both vertebrae have complicated anatomy. Thus, the strength of a bone screw is especially significant in the early post-operative stages. Different stabilization procedures have been accounted for C1-C2 injury fixation, out of which fixation with transarticular screws is considered as the gold standard procedure. But screw malposition and high riding transverse foramen of the C2 vertebra are some limitations of this fixation technique. Current FE-based study provides a comparison of the biomechanical stability of the two different atlantoaxial posterior screw fixation techniques (C1Lateral Mass-C2 Pedicle screws, C1Lateral Mass-C2PARS screws).In this work, a C1-C2 cervical spine model of a male patient is developed using MRI CT scan data using a 3-d slicer software and biomechanical stability comparison is done for C1LM-C2PS & C1LM-C2PARS screws fixed once with a supporting posterior screw fixation rod and once without rod under the physiological loading conditions of flexion, extension, lateral bending, and axial rotation using ANSYS WORKBENCH 16.2. The effects of the engaging supporting rod on the cervical spine were evaluated in the form of von-mises stresses induced in screws. Result shows reduction in screw stress values when implanted with supporting rods. C1LM-C2PS screw fixation with rod might be thought of as the best fixation solution for fractured C1-C2 vertebrae as it showed minimum stress values in the analysis as compared to C1LM-C2PARS with and without rod.

Cervical facet capsular ligament mechanics: Estimations based on subject-specific anatomy and kinematics.

To understand the facet capsular ligament's (FCL) role in cervical spine mechanics, the interactions between the FCL and other spinal components must be examined. One approach is to develop a subject-specific finite element (FE) model of the lower cervical spine, simulating the motion segments and their components' behaviors under physiological loading conditions. This approach can be particularly attractive when a patient's anatomical and kinematic data are available. We developed and demonstrated methodology to create 3D subject-specific models of the lower cervical spine, with a focus on facet capsular ligament biomechanics. Displacement-controlled boundary conditions were applied to the vertebrae using kinematics extracted from biplane videoradiography during planar head motions, including axial rotation, lateral bending, and flexion-extension. The FCL geometries were generated by fitting a surface over the estimated ligament-bone attachment regions. The fiber structure and material characteristics of the ligament tissue were extracted from available human cervical FCL data. The method was demonstrated by application to the cervical geometry and kinematics of a healthy 23-year-old female subject. FCL strain within the resulting subject-specific model were subsequently compared to models with generic: (1) geometry, (2) kinematics, and (3) material properties to assess the effect of model specificity. Asymmetry in both the kinematics and the anatomy led to asymmetry in strain fields, highlighting the importance of patient-specific models. We also found that the calculated strain field was largely independent of constitutive model and driven by vertebrae morphology and motion, but the stress field showed more constitutive-equation-dependence, as would be expected given the highly constrained motion of cervical FCLs. The current study provides a methodology to create a subject-specific model of the cervical spine that can be used to investigate various clinical questions by coupling experimental kinematics with multiscale computational models.

Biomechanical analysis of different internal fixation methods for special Maisonneuve fracture of the ankle joint based on finite element analysis

ObjectiveThe objective of this study was to evaluate the biomechanical properties of different internal fixation methods for Maisonneuve fractures under physiological loading conditions. MethodsFinite element analysis was used to numerically analyze various fixation methods. The study focused on high fibular fractures and included six groups of internal fixation: high fibular fracture without fixation + distal tibiofibular elastic fixation (group A), high fibular fracture without fixation + distal tibiofibular strong fixation (group B), high fibular fracture with 7-hole plate internal fixation + distal tibiofibular elastic fixation (group C), high fibular fracture with 7-hole plate internal fixation + distal tibiofibular strong fixation (group D), high fibular fracture with 5-hole plate internal fixation + distal tibiofibular elastic fixation (group E), and high fibular fracture with 5-hole plate internal fixation + distal tibiofibular strong fixation (group F). The finite element method was employed to simulate and analyze the different internal fixation models for the six groups, generating overall structural displacement and Von Mises stress distribution maps during slow walking and external rotation motions. ResultsGroup A demonstrated the best ankle stability under slow walking and external rotation, with reduced tibial and fibular stress after fibular fracture fixation. Group D had the least displacement and most stability, while group A had the largest displacement and least stability. Overall, high fibular fracture fixation improved ankle stability. In slow walking, groups D and A had the least and greatest interosseous membrane stress. Comparing 5-hole plate (E/F) and 7-hole plate (C/D) fixation, no significant differences were found in ankle strength or displacement under slow walking or external rotation. ConclusionCombining internal fixation for high fibular fractures with elastic fixation of the lower tibia and fibula is optimal for orthopedic treatment. It yields superior outcomes compared to no fibular fracture fixation or strong fixation of the lower tibia and fibula, especially during slow walking and external rotation. To minimize nerve damage, a smaller plate is recommended. This study strongly advocates for the clinical use of 5-hole plate internal fixation for high fibular fractures with elastic fixation of the lower tibia and fibula (group E).

Preparation and biological properties of BCZT/TiO2 electrokinetic conversion coating on titanium surface in vitro for dental implants

Titanium implants have the risk of loosening or even failure, especially the force generated by chewing is not conducive to the use of conventional titanium bioactive coatings in the oral environment. In this work, a BCZT/TiO2 bio-piezoelectric coating was prepared on titanium surface. The force generated by chewing is cleverly converted into the piezoelectric charge on the coating surface, and the formation of the combination of implant and alveolar bone is accelerated by its promoting effect on bone repair. The formation mechanism of the coating was studied. The BCZT/TiO2 bio-piezoelectric coating showed good piezoelectric properties. The calcium deposition results of BCZT/TiO2 coating with static, physiological loading and low-frequency ultrasonic conditions were compared. Interestingly, the effect of polarized BCZT/TiO2 coating applied with low-intensity pulsed ultrasound on promoting calcium deposition was similar to that applied with physiological loading, suggesting that low-intensity pulsed ultrasound has the potential to stimulate piezoelectric effects. In addition, the BCZT/TiO2 coating was non-toxic and has good biocompatibility and bioactivity. The polarized BCZT/TiO2 coating showed the best proliferation results, and the osteoblast adhesion morphology on the coating surface was extended. The results provide data support for the application of titanium bio-piezoelectric coating on dental implants.

Superficial zone chondrocytes can get compacted under physiological loading: A multiscale finite element analysis.

Recent in vivo and in vitro studies have demonstrated that superficial zone (SZ) chondrocytes within articular layers of diarthrodial joints die under normal physiologic loading conditions. In order to further explore the implications of this observation in future investigations, we first needed to understand the mechanical environment of SZ chondrocytes that might cause them to die under physiological sliding contact conditions. In this study we performed a multiscale finite element analysis of articular contact to track the temporal evolution of a SZ chondrocyte's interstitial fluid pressure, hydraulic permeability, and volume under physiologic loading conditions. The effect of the pericellular matrix modulus and permeability was parametrically investigated. Results showed that SZ chondrocytes can lose ninety percent of their intracellular fluid after several hours of intermittent or continuous contact loading, resulting in a reduction of intracellular hydraulic permeability by more than three orders of magnitude. These findings are consistent with loss of cell viability due to the impediment of cellular metabolic pathways induced by the loss of fluid. They suggest that there is a simple mechanical explanation for the vulnerability of SZ chondrocytes to sustained physiological loading conditions. Future studies will focus on validating these specific findings experimentally. STATEMENT OF SIGNIFICANCE: As with any mechanical system, normal 'wear and tear' of cartilage tissue lining joints is expected. Yet incidences of osteoarthritis are uncommon in individuals younger than 45. This counter-intuitive observation suggests there must be an intrinsic repair mechanism compensating for this wear and tear over many decades of life. Recent experimental studies have shown superficial zone chondrocytes die under physiologic loading conditions, suggesting that this repair mechanism may involve cell replenishment. To better understand the mechanical environment of these cells, we performed a multiscale computational analysis of articular contact under loading. Results indicated that normal activities like walking or standing can induce significant loss of intracellular fluid volume, potentially hindering metabolic activity and fluid transport properties, and causing cell death.

Biomechanical analysis of a single-level customized cage screw fixation for anterior cervical discectomy and fusion in the cervical spine: an in-silico study

The usual surgical choice of customized cage fixation is anterior cervical discectomy and fusion (ACDF) for cervical spondylosis with disc herniation. The safe and successful cage fixation for ACDF surgery benefits patients with cervical disc degenerative disease by easing their discomfort and regaining function. The cage prevents mobility between the vertebrae by using cage fixation to anchor the neighbouring vertebrae. The goal of the current study is to develop a customized cage-screw implant for single-level cage fixation at C4–C5 level of the cervical spine (C2–C7). The Finite Element Analysis (FEA) is performed for the intact and implanted cervical spine and analysed the flexibility, stress of the implant and implant adjacent bone during three physiological loading conditions being analysed. Lower surface of the C7 vertebrae is fixed and 50 N compressive force with 1 Nm moment are applied on the C2 vertebrae for simulated lateral bending, axial rotation and flexion-extension. The flexibility is decreased at single level of fixation (C4–C5 level) by 64% to 86%, as compared to natural cervical spine. The flexibility is increased 3% to 17% at the nearest levels of fixation. The maximum Von Mises stress in PEEK cage varies from 24 to 59 MPa and for Ti-6Al-4V screw the stress varies from 84 MPa to 121 MPa which are far below the yield stress of PEEK (95 MPa) and Ti-6Al-4V (750 MPa).