Bone Strain Research Articles

Comparative analysis of the biomechanical behavior of two different design metaphyseal-fitting short stems using digital image correlation

BackgroundThe progressive evolution in hip replacement research is directed to follow the principles of bone and soft tissue sparing surgery. Regarding hip implants, a renewed interest has been raised towards short uncemented femoral implants. A heterogeneous group of short stems have been designed with the aim to approximate initial, post-implantation bone strain to the preoperative levels in order to minimize the effects of stress shielding. This study aims to investigate the biomechanical properties of two distinctly designed femoral implants, the TRI-LOCK Bone Preservation Stem, a shortened conventional stem and the Minima S Femoral Stem, an even shorter and anatomically shaped stem, based on experiments and numerical simulations. Furthermore, finite element models of implant–bone constructs should be evaluated for their validity against mechanical tests wherever it is possible. In this work, the validation was performed via a direct comparison of the FE calculated strain fields with their experimental equivalents obtained using the digital image correlation technique.ResultsDesign differences between Trilock BPS and Minima S femoral stems conditioned different strain pattern distributions. A distally shifting load distribution pattern as a result of implant insertion and also an obvious decrease of strain in the medial proximal aspect of the femur was noted for both stems. Strain changes induced after the implantation of the Trilock BPS stem at the lateral surface were greater compared to the non-implanted femur response, as opposed to those exhibited by the Minima S stem. Linear correlation analyses revealed a reasonable agreement between the numerical and experimental data in the majority of cases.ConclusionThe study findings support the use of DIC technique as a preclinical evaluation tool of the biomechanical behavior induced by different implants and also identify its potential for experimental FE model validation. Furthermore, a proximal stress-shielding effect was noted after the implantation of both short-stem designs. Design-specific variations in short stems were sufficient to produce dissimilar biomechanical behaviors, although their clinical implication must be investigated through comparative clinical studies.

Comparison of femur strain under different loading scenarios: Experimental testing.

Bone fracture, formation and adaptation are related to mechanical strains in bone. Assessing bone stiffness and strain distribution under different loading conditions may help predict diseases and improve surgical results by determining the best conditions for long-term functioning of bone-implant systems. In this study, an experimentally wide range of loading conditions (56) was used to cover the directional range spanned by the hip joint force. Loads for different stance configurations were applied to composite femurs and assessed in a material testing machine. The experimental analysis provides a better understanding of the influence of the bone inclination angle in the frontal and sagittal planes on strain distribution and stiffness. The results show that the surface strain magnitude and stiffness vary significantly under different loading conditions. For the axial compression, maximal bending is observed at the mid-shaft, and bone stiffness is also maximal. The increased inclination leads to decreased stiffness and increased magnitude of maximum strain at the distal end of the femur. For comparative analysis of results, a three-dimensional, finite element model of the femur was used. To validate the finite element model, strain gauges and digital image correlation system were employed. During validation of the model, regression analysis indicated robust agreement between the measured and predicted strains, with high correlation coefficient and low root-mean-square error of the estimate. The results of stiffnesses obtained from multi-loading conditions experiments were qualitatively compared with results obtained from a finite element analysis of the validated model of femur with the same multi-loading conditions. When the obtained numerical results are qualitatively compared with experimental ones, similarities can be noted. The developed finite element model of femur may be used as a promising tool to estimate proximal femur strength and identify the best conditions for long-term functioning of the bone-implant system in future study.

Ratcheting-fatigue behavior of trabecular bone under cyclic tensile-compressive loading

This study aims to investigate the ratcheting-fatigue behaviors of trabecular bone under cyclic tension-compression, which are produced due to the accumulations of residual strain in trabecular bone. Simultaneously, the effects of different loading conditions on ratcheting behaviors of trabecular bone were probed. It is found that the gap between ratcheting strains under three stress amplitudes will gradually widen. As the stress amplitude increases, the ratcheting strain also increases. Mean stress has a significant effect on the ratcheting strain. When the mean stress is 0 MPa and 0.155 MPa, the ratcheting strain increases with the number of cycles. However, when the mean stress is -0.155 MPa, the ratcheting strain decreases as the cycle goes on. The existence of double stress peak holding time causes the creep deformation of trabecular bone, which leads to the increase of ratcheting strain. It is also noted that the ratcheting strain is greatly increased with prolongation of stress peak holding time. The digital image correlation (DIC) technique was applied to analyze the fatigue failure of trabecular bone under cyclic tension-compression. It is found that the increase of stress amplitude accelerates the damage of sample and further reduces its fatigue life. Cracks are observed in trabecular bone sample, and it is noted that the crack propagation is rapid during cyclic loading.

Impaction technique influences implant stability in low-density bone model.

AimsCementless acetabular components rely on press-fit fixation for initial stability. In certain cases, initial stability is more difficult to obtain (such as during revision). No current study evaluates how a surgeon’s impaction technique (mallet mass, mallet velocity, and number of strikes) may affect component fixation. This study seeks to answer the following research questions: 1) how does impaction technique affect a) bone strain generation and deterioration (and hence implant stability) and b) seating in different density bones?; and 2) can an impaction technique be recommended to minimize risk of implant loosening while ensuring seating of the acetabular component?MethodsA custom drop tower was used to simulate surgical strikes seating acetabular components into synthetic bone. Strike velocity and drop mass were varied. Synthetic bone strain was measured using strain gauges and stability was assessed via push-out tests. Polar gap was measured using optical trackers.ResultsA phenomenon of strain deterioration was identified if an excessive number of strikes was used to seat a component. This effect was most pronounced in low-density bone at high strike velocities. Polar gap was reduced with increasing strike mass and velocity.ConclusionA high mallet mass with low strike velocity resulted in satisfactory implant stability and polar gap, while minimizing the risk of losing stability due to over-striking. Extreme caution not to over-strike must be exercised when using high velocity strikes in low-density bone for any mallet mass.Cite this article: Bone Joint Res 2020;9(7):386–393.

Comparison of optimal screw configurations in two locking plate systems for proximal humerus fixation - a finite element analysis study

BackgroundManagement of proximal humerus fractures is challenging, especially in elderly. Locking plating is a common surgical treatment option. The Proximal Humerus Internal Locking System (plate-A) has shown to lower complication rates compared to conventional plates, but is associated with impingement risk, which could be avoided using Peri-articular Proximal Humerus Plate (plate-B). Nevertheless, biomechanical performance and optimal screw configuration of plate-B is unknown. The aim of this study was to evaluate different screw configurations of plate-B and compare with plate-A using finite element analyses. MethodsTwenty-six proximal humerus models were osteotomised to create unstable three-part fractures, fixed with either of the two plates, and tested under three anatomical loading conditions using a previous established and validated finite element simulation framework. Various clinically relevant screw configurations were investigated for both plates and compared based on the predicted peri-implant bone strain, being a validated surrogate of cyclic cut-out failure. FindingsBesides increasing the number of screws, the placement of the posterior screws in combination with the calcar screw in the plate-B significantly decreased the predicted failure risk. Generally, plate-A had a lower predicted failure risk than plate-B. InterpretationThe posterior and calcar screws may be prioritized in plate-B. Compared to plate-A, the more distal positioning, less purchase in the posterior aspect and a smaller screw spread due to not fitting of the most distal calcar screw in most investigated subjects led to a significantly higher predicted failure risk for most plate-B configurations. The findings of the simulations study require clinical corroboration.

The Influence of Custom-Milled Framework Design for an Implant-Supported Full-Arch Fixed Dental Prosthesis: 3D-FEA Sudy.

The current study aimed to evaluate the mechanical behavior of two different maxillary prosthetic rehabilitations according to the framework design using the Finite Element Analysis. An implant-supported full-arch fixed dental prosthesis was developed using a modeling software. Two conditions were modeled: a conventional casted framework and an experimental prosthesis with customized milled framework. The geometries of bone, prostheses, implants and abutments were modeled. The mechanical properties and friction coefficient for each isotropic and homogeneous material were simulated. A load of 100 N load was applied on the external surface of the prosthesis at 30° and the results were analyzed in terms of von Mises stress, microstrains and displacements. In the experimental design, a decrease of prosthesis displacement, bone strain and stresses in the metallic structures was observed, except for the abutment screw that showed a stress increase of 19.01%. The conventional design exhibited the highest stress values located on the prosthesis framework (29.65 MPa) between the anterior implants, in comparison with the experimental design (13.27 MPa in the same region). An alternative design of a stronger framework with lower stress concentration was reported. The current study represents an important step in the design and analysis of implant-supported full-arch fixed dental prosthesis with limited occlusal vertical dimension.

3D full-field strain in bone-implant and bone-tooth constructs and their morphological influential factors

The biomechanics of bone-tooth and bone-implant interfaces affects the outcomes of several dental treatments, such as implant placement, because bone, tooth and periodontal ligament are living tissues that adapt to the changes in mechanical stimulations. In this work, mechanical testing coupled with micro-CT was performed on human cadaveric mandibular bone-tooth and bone-implant constructs. Using digital volume correlation, the 3D full-field strain in bone under implant loading and tooth loading was measured. Concurrently, bone morphology and bone-implant and bone-tooth contact were also measured through the analysis of micro-CT images. The results show that strain in bone increased when a tooth was replaced by a dental implant. Strain concentration was observed in peri-implant bone, as well as in the buccal bone plate, which is also the clinically-observed bone resorption area after implant placement. Decreasing implant stability measurements (resonance frequency analysis and torque test) indicated increased peri-implant strain, but their relationships may not be linear. Peri-implant bone strain linearly increased with decreasing bone-implant contact (BIC) ratio. It also linearly decreased with increasing bone-tooth/bone-implant contact ratio. The high strain in the buccal bone plate linearly increased with decreasing buccal bone plate thickness. The results of this study revealed 3D full-field strain in bone-tooth and bone-implant constructs, as well as their several morphological influential factors.

Biomechanical Evaluation of the Effects of Implant Neck Wall Thickness and Abutment Screw Size: A 3D Nonlinear Finite Element Analysis

In this study, we evaluate the influence of implant neck wall thickness and abutment screw size on alveolar bone and implant component biomechanical responses using nonlinear finite element (FE) analysis. Twelve internal hexagon Morse taper implant–abutment connection FE models with three different implant sizes (diameters 4, 5, and 6 mm), secured with 1.4, 1.6, and 1.8 mm abutment screws to fit with three unilateral implant neck wall thicknesses of 0.45, 0.50, and 1.00 mm, were constructed to perform simulations. Nonlinear contact elements were used to simulate realistic interface fixation within the implant system. A 200 N concentrated force was applied toward the center of a hemispherical load cap and inclined 30° relative to the implant axis as the loading condition. The simulation results indicated that increasing the unilateral implant neck wall thickness from 0.45 to 1.00 mm can significantly decrease implant, abutment, and abutment screw stresses and bone strain, decreased to 58%, 48%, 54%, and 70%, respectively. Variations in abutment screw size only significantly influenced abutment screw stress, and the maximum stress dissipation rates were 10% and 29% when the diameter was increased from 1.4 to 1.6 and 1.8 mm, respectively. We conclude that the unilateral implant neck wall thickness is the major design factor for the implant system and implant neck wall thickness in effectively decreasing implant, abutment, and abutment screw stresses and bone strain.

Distribution of mechanical strain in equine distal metacarpal subchondral bone: A microCT-based finite element model

Microdamage accumulation and adaptation of subchondral bone subjected to intensive cyclic loading are important processes associated with catastrophic bone failure, and joint degeneration in athletic humans and racehorses. At the tissue-level, they lead to a spatial variation in bone tissue mineral density (TMD) which affects the response of the bone to mechanical load. Quantifying the spatial distribution of mechanical load within the subchondral bone is critical for understanding the mechanism of the joint failure. Previously, a gradient of TMD and mechanical properties has been reported under unconfined compression in osteochondral plugs. In the present study, we used micro computed tomography (μCT)-based finite element (FE) models of cartilage-bone to investigate the gradient of strain in the subchondral bone (SCB) from the third metacarpal (MC3) condyle of racehorses under simulated in situ compression. Non-destructive mechanical testing of specimens under high-rate compression provided the apparent-level modulus of SCB. FE models were analysed using unconfined and confined boundary conditions. Unconfined FE-predicted apparent-level gradient of modulus across the SCB thickness correlated well with the experimental results (R2 ​= ​0.72, p ​< ​0.05). The highest strain occurred in the most superficial SCB (0.5–2.5 ​mm deep to the cartilage-bone interface) under the simulated in-situ compression through articular cartilage. The findings of this study provide an estimation for the spatial distribution of mechanical strain within SCB in-situ in the presence of heterogeneous bone tissue which is commonly observed in joints subjected to intensive cyclic loading.

Hinge location and apical drill holes in opening wedge high tibial osteotomy: A finite element analysis.

At the time of medial opening wedge high tibial osteotomy (HTO) to realign the lower limb and offload medial compartment knee osteoarthritis, unwanted fractures can propagate from the osteotomy apex. The aim of this study was to use finite element (FE) analysis to determine the effect of hinge location and apical drill holes on cortical stresses and strains in HTO. A monoplanar medial opening wedge HTO was created above the tibial tuberosity in a composite tibia. Using the FE method, intact lateral hinges of different widths were considered (5, 7.5, and 10 mm). Additional apical drill holes (2, 4, and 6 mm diameters) were then incorporated into the 10 mm hinge model. The primary outcome measure was the maximum principal strain in the cortical bone surrounding the hinge axis. Secondary outcomes included the force required for osteotomy opening, minimum principal strain, and mean cortical bone stresses (maximum principal/minimum principal/von Mises). Larger intact hinges (10 mm) were associated with higher cortical bone maximum principal strain and stress, lower minimum principal strain/stress, and required greater force to open. Lateral cortex strain concentrations were present in all scenarios, but extended to the joint surface with the 10 mm hinge. Apical drill holes reduced the mean cortical bone maximum principal strain adjacent to the hinge axis: 2 mm hole 6% reduction; 4 mm 35% reduction; and 6 mm 55% reduction. Incorporating a 4-mm apical drill hole centered 10 mm from the intact lateral cortex maintains a cortical bone hinge, minimizes cortical bone strains and reduces the force required to open the HTO; thus improving control.

Post-yield mechanical properties of bovine trabecular bone – Relationships with bone volume fraction and strain rate

Bone finite element models, which are increasingly used to assess fracture risk in patients with degenerative bone diseases, require extensive experimental data to adequately model the material properties being assigned. Previous studies have demonstrated that bone elastic mechanical properties are dependent on density as well as strain rate, however, the effect these same variables on the post-yield behaviour of trabecular bone has not been thoroughly studied. For this study, bovine femoral samples were tested at several strain rates using three different tests devices: a conventional constant strain rate apparatus for low strain rates, a Drop Weight Impact Test device for the intermediate regime and a Split Hopkinson Pressure Bar System with magnesium bar and a PVCA pulse shaper for high strain rates. Ultimate and plateau stress, as well as absorbed energy were recorded. The results of this experimentation show that post-yield mechanical properties of trabecular bone are strain rate and volume fraction dependant. Two constitutive material models describing the Ultimate strength, Plateau stress and absorbed energy are proposed based on published models valid for elastic properties of trabecular bone.

Mobile bearing leads to less proximal medial tibial strain following UKA in comparison with fixed bearing in a cadaver setup

Aims and Objectives:Inexplicable pain to the medial proximal tibia is a frequent finding leading to revision after unicondylar knee arthroplasty (UKA). This study is an effort to find out, if there are any differences between mobile (MB) and fixed bearing (FB) UKA designs in terms of resulting strain in the medial proximal tibia as measured in an in vitro cadaver setup. It was hypothesized that MB UKA would result in lower bone strain.Materials and Methods:Five pairs of fresh-frozen full leg cadaver specimens were mounted in a kinematic rig that applied a dynamic squatting motion knee flexion after prior 3D CT. The rig allowed for 6 degrees-of-freedom at the knee while forces were applied to the quadriceps and hamstrings. During testing, an infrared camera system tracked the location of reflective markers attached to the tibia and femur with bicortical bone pins. Tibial cortical bone strain was measured with stacked strain gauge rosettes attached at predefined anterior and posterior positions on the medial cortex. Sensor outputs were recorded at 2000 Hz and synchronized with kinematic data prior and after pairwise implantation of MB and FB UKA directly comparing those between left and right knees from the same donor.Results:Bone strain values consistently increased with increasing flexion angle. FB UKA significantly increased strain in the anterior region of the medial tibial bone, while MB closely replicated strain values of the native knee.Conclusion:Proximal tibial bone strain seems to be lesser following MB UKA in comparison with FB UKA. Clinical studies will have to show, if this translates into a higher rate of pain problems with FB UKA.

A finite element analysis of tibial tritanium cones without stems in varying bone defects

BackgroundIn the UK around 10% of hip and knee arthroplasties are revision operations. At revision total knee arthroplasty (rTKA), bone loss management is critical to achieving a stable bone-implant construct. Though tritanium cones have been used to manage bone defects in rTKA, their biomechanical performance with varying defects remains unknown. MethodsUncontained tibial bone defects at four anatomic locations, with varying depths and widths (Type T2A and T2B) were investigated computationally in a composite tibia which was subjected to four loading scenarios. The ability of the tritanium cone to replace the tibial bone defect was examined using the outcome measures of bone strain distribution and interface micromotions. ResultsIt was found that anterior and lateral defects do not significantly alter the strain distribution compared with intact bone. For medial defects, strain distribution is sensitive to defect width; while strain distributions for posterior defects are associated with defect width and depth. In general, micromotions at the bone-implant interface are small and are primarily influenced by defect depth. ConclusionsOur models show that the cone is an acceptable choice for bone defect management in rTKA. Since all observed micromotions were small, successful osteointegration would be expected in all types of uncontained defects considered in this study. Tritanium cones safely accommodate uncontained tibial defects up to 10 mm deep and extending up to 9 mm from the centre of the cone. Medial and posteriorly based defects managed with symmetric cones display the greatest bone strains and asymmetric cones may be useful in this context.

Femoral revision knee Arthroplasty with Metaphyseal sleeves: the use of a stem is not mandatory of a structural point of view

PurposeAlthough metaphyseal sleeves are usually used with stems, little is known about the exact contribution/need of the stem for the initial sleeve-bone interface stability, particularly in the femur, if the intramedullary canal is deformed or bowed. The aim of the present study is (1) to determine the contribution of the diaphyseal-stem on sleeve-femur interface stability and (2) to determine experimentally the strain shielding effect on the metaphyseal femur with and without diaphyseal-stem. It is hypothesised that diaphyseal-stem addition increases the sleeve-femur interface stability and the strain-shielding effect on the metaphyseal femur relatively to the stemless condition.Material and methodsThe study was developed through a combined experimental and finite-element analysis approach. Five synthetic femurs were used to measure cortex strain (triaxial-rosette-gages) behaviour and implant cortex micromotions (Digital Image Correlation) for three techniques: only femoral-component, stemless-sleeve and stemmed-sleeve. Paired t-tests were performed to evaluate the statistical significance of the difference of cortex strains and micromotions. Finite-element models were developed to assess the cancellous bone strain behaviour and sleeve-bone interface micromotions; these models were validated against the measurements.ResultsCortex strains are significantly reduced (p < 0.05) on the stemmed-sleeve with a 150 μstrain mean reduction at the medial and lateral distal sides which compares with a 60 μstrain mean reduction (p > 0.05) on the stemless condition. Both techniques presented a mean cancellous bone strain reduction of 700 μstrain (50%) at the distal region and a mean increase of 2500 μstrain (4x) at the sleeve proximal region relative to the model only with the femoral component. Both techniques presented sleeve-bone micromotions amplitude below 50-150 μm, suitable for bone ingrowth.ConclusionsThe use of a supplemental diaphyseal-stem potentiates the risk of cortex bone resorption as compared to the stemless-sleeve condition; however, the stem is not essential for the enhancement of the initial sleeve-bone stability and has minor effect on the cancellous bone strain behaviour. Based on a purely structural point view, it appears that the use of a diaphyseal-femoral-stem with the metaphyseal sleeve is not mandatory in the revision TKA, which is particularly relevant in cases where the use of stems is impracticable.

In Vitro Study Regarding the Biomechanical Behaviour of Bone, Fibre Reinforced Polymer and Wire Composite Perio-dontal Splints. Model Analysis

This paper is the second part of a study regarding the biomechanical behaviour of mandibular bone in the context of different periodontal splinting systems, occlusal forces and load distributions. Electric resistive tensometry method was used to measure the strains developed in mandibular bone replica. The tests were carried out on six mandibular acrylic models, each with 8 natural teeth. The experimental groups were defined corresponding to the bone condition and splint type: normal height bone; bone resorption without splint; bone resorption and wire-composite splint; bone resorption and polyethylene fiber-reinforced composite splint. Each sample was subjected to three similar loading cycles, the force being applied successively on four incisors, two central incisors and canines, and the specific deformation values were read for four loading forces: 30 N, 50 N, 100 N and 150 N. In case of bone loss, the bone deformations are up to 110%. Periodontal splinting redistribute forces, reducing incisors bone strains associated with a slight increase in canine bone strains.

Bone strain index in the prediction of vertebral fragility refracture

Dual-energy x-ray absorptiometry (DXA) can provide quantitative (bone mineral density, BMD) and qualitative (trabecular bone score, TBS) indexes of bone status, able to predict fragility fractures in most osteoporotic patients. A new qualitative index of bone strength, based on finite element analysis and named bone strain index (BSI), has been recently developed from lumbar DXA scan. We present the preliminary results about the BSI ability to predict a refracture in patients with fragility fractures. A total of 143 consecutive fractured patients with primary osteoporosis (121 females) performed a spine x-ray examination for the calculation of spine deformity index (SDI) and a DXA densitometry for BMD, TBS, and BSI at basal time and in the follow-up. A refracture was considered as a one-unit increase in SDI. For each unit increase of the investigated indexes, the hazard ratio of refracture, 95% confidence interval, p value, and proportionality test p value were for BSI 1.201, 0.982−1.468, 0.074, and 0.218; for lumbar BMD 0.231, 0.028−1.877, 0.170, and 0.305; and for TBS 0.034, 0.001−2.579, 0.126, and 0.518, respectively. BSI was the index predictive of refracture nearest to statistical significance. If confirmed, it may be used for a better risk assessment of osteoporotic patients.

Immunohistochemical expression of β‐Catenin associated to bone strain changes in the subchondral bone of mandibular condyle – study in Wistar rats with dental premature contact

From the biomechanical concepts regarding the masticatory load distribution, the mandible has a load flow pattern from the teeth to the temporomandibular joint (TMJ). Studies have presented morphological changes in the temporomandibular joint after dental occlusal alterations, such as the premature contacts. Thus, it is important to figure out the bone mechanobiology of the mandibular condyle, involving the relation mechanical stimuli x biological response. The aim of this work was to perform an immunohistochemical analysis of β‐catenin expression associated to a computational simulation by finite element analysis (FEA) to evaluate the relation between the osteocyte mechanosensation and the bone strain. This relation was evaluated in rats with occlusal changes by premature contact. Thirty male rats (Rattus norvegicus albinus), Wistar lineage and 2 months old were used in this study. The animals were divided into two groups: control group (N = 10) and experimental group (N = 20). In the experimental group, premature contact was created by a stainless‐steel fragment, with 0.7 mm thickness, cemented on the first upper molar of all animals. Then, these animals were subdivided into two groups, according to the period with premature contact of 7 days (7D) and 14 days (14D). After euthanasia, the immunohistochemical analysis was performed by indirect immunoperoxidase method for β‐catenin expression, using diaminobenzidine for staining and hematoxylin for counter stain. From the head microCT scans of control and experimental groups, finite element models were created and the FEA was performed for both groups, considering the presence of premature contact in experimental group. In all analyses, the subchondral bone of condyle was analyzed in three regions (medial, central and lateral). The immunohistochemical analysis presented higher expression of β‐catenin in the lateral region in all groups as well as the bone strain in FEA. The experimental group presented higher β‐catenin expression 7D compared to control group. At 14D the β‐catenin expression the bone strain was similar to the control group. Thus, in conclusion, the β‐catenin expression can be associated to the strain sensitivity in the subchondral bone of the mandibular condyle. The premature contact increased the bone strain and the expression of β‐catenin in the subchondral bone.Support or Funding InformationBrazilian Coordination for the Improvement of Higher Education Personnel (PNPD/CAPES).

Cortical bone mapping improves finite element strain prediction accuracy at the proximal femur.

Despite evidence of the biomechanical role of cortical bone, current state of the art finite element models of the proximal femur built from clinical CT data lack a subject-specific representation of the bone cortex. Our main research hypothesis is that the subject-specific modelling of cortical bone layer from CT images, through a deconvolution procedure known as Cortical Bone Mapping (CBM, validated for cortical thickness and density estimates) can improve the accuracy of CT-based FE models of the proximal femur, currently limited by partial volume artefacts. Our secondary hypothesis is that a careful choice of cortical-specific density-elasticity relationship may improve model accuracy. We therefore: (i) implemented a procedure to include subject-specific CBM estimates of both cortical thickness and density in CT-based FE models. (ii) defined alternative models that included CBM estimates and featured a cortical-specific or an independently optimised density-elasticity relationship. (iii) tested our hypotheses in terms of elastic strain estimates and failure load and location prediction, by comparing with a published cohort of 14 femurs, where strain and strength in stance and fall loading configuration were experimentally measured, and estimated through reference FE models that did not explicitly model the cortical compartment. Our findings support the main hypothesis: an explicit modelling of the proximal femur cortical bone layer including CBM estimates of cortical bone thickness and density increased the FE strains prediction, mostly by reducing peak errors (average error reduced by 30%, maximum error and 95th percentile of error distribution halved) and especially when focusing on the femoral neck locations (all error metrics at least halved). We instead rejected the secondary hypothesis: changes in cortical density-elasticity relationship could not improve validation performances. From these improved baseline strain estimates, further work is needed to achieve accurate strength predictions, as models incorporating cortical thickness and density produced worse estimates of failure load and equivalent estimates of failure location when compared to reference models. In summary, we recommend including local estimates of cortical thickness and density in FE models to estimate bone strains in physiological conditions, and especially when designing exercise studies to promote bone strength.

CORR Insights®: Does Unicondylar Knee Arthroplasty Affect Tibial Bone Strain? A Paired Cadaveric Comparison of Fixed- and Mobile-bearing Designs.

CORR Insights®: Does Unicondylar Knee Arthroplasty Affect Tibial Bone Strain? A Paired Cadaveric Comparison of Fixed- and Mobile-bearing Designs.

Применение комплекса упражнений «Пилатес» для оптимизации функционального состояния организма студентов

The article deals with the study of the possibility of applying Pilates exercises for optimization of the functional state of students’ bodies by performing the basic principles of technology and its implementation in students’ educational process. The characteristic of basic Pilates exercises is given. Among those exercises are: twisting, body-rocking, and strain of the spine bone. Methods of research. During the study the methods that allow us to assess the dynamics of the functional state of the body (determination of heart rate, blood pressure (systolic and diastolic), hypoxic samples «Stange and Genchi», the Rufier tese, the Kerdo index, Spielberger State-Trait Anxiety Inventory, assessment of general state, activity and mood) were applied. The results presented indicate the effectiveness of the Pilates exercises implementation in the program on the subject «Physical Culture» for optimization the functional state and improvement of bodies of female students at the age of 17-20 years. It is concluded that this set of exercises increases the efficiency and effectiveness of the cardiovascular and respiratory systems, physical performance, as well as reduce the level of state and trait anxiety, and the activity of the sympathetic division of the autonomic nervous system.