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Zou Z, Tian K, Hooblal AP, Wagner T, Zhang W. Bibliometric analysis of the acetabular labrum. Medicine (Baltimore) 2024; 103:e38730. [PMID: 38941388 DOI: 10.1097/md.0000000000038730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
The acetabular labrum (AL) plays a crucial role in the normal physiological functioning of the hip joint. This study aims to present an overview of the current status and research hotspots concerning the AL and to explore the field from a bibliometric perspective. A total of 1918 AL-related records published between January 1, 2000 and November 8, 2023 were gathered from the Web of Science Core Collection database. By utilizing tools such as HisCite, CiteSpace, VOSviewer, and the R package "bibliometrix," the regions, institutions, journals, authors, and keywords were analyzed to predict the latest trends in AL research. Global research interest and publication output related to this topic continues to escalate. The United States leads in international collaborations, number of publications, and citation frequency, underscoring its preeminent position in this field. The American Hip Institute emerged as the most prolific institution, making the greatest contribution to publications. Notably, Arthroscopy and the American Journal of Sports Medicine are the 2 most popular journals in this domain, accounting for 13.29% and 10.1% of publications, respectively, and were also found to be the most co-cited journals. Amongst authors, Benjamin G. Domb leads with 160 articles (8.35%), while Marc J. Philippon is the most frequently cited author. The keyword co-occurrence network showed 3 hot clusters, including "AL," "femoral acetabular impingement (FAI)," and "osteoarthritis." In addition, "survivorship," "FAI," and "patient-reported outcomes" were identified as trending topics for future exploration. This study represents the first comprehensive bibliometric analysis, summarizing the present state and future trends in AL research. The findings serve as a valuable resource for scholars, offering practical insights into key information within the field and identifying potential research frontiers and emerging directions in the near future.
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Affiliation(s)
- Zaijun Zou
- Department of Joint and Sports Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
- School of Graduates, Dalian Medical University, Dalian, Liaoning, China
| | - Kang Tian
- Department of Joint and Sports Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Liaoning Province, Dalian, Liaoning, China
| | - Atiya Prajna Hooblal
- Department of Joint and Sports Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Timoné Wagner
- Department of Joint and Sports Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Weiguo Zhang
- Department of Joint and Sports Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Liaoning Province, Dalian, Liaoning, China
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Li J, Xu J, Chen Z, Lu Y, Hua X, Jin Z. Computational modelling of articular joints with biphasic cartilage: recent advances, challenges and opportunities. Med Eng Phys 2024; 126:104130. [PMID: 38621832 DOI: 10.1016/j.medengphy.2024.104130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/16/2024] [Accepted: 02/25/2024] [Indexed: 04/17/2024]
Abstract
Biphasic models have been widely used to simulate the time-dependent biomechanical response of soft tissues. Modelling techniques of joints with biphasic weight-bearing soft tissues have been markedly improved over the last decade, enhancing our understanding of the function, degenerative mechanism and outcomes of interventions of joints. This paper reviews the recent advances, challenges and opportunities in computational models of joints with biphasic weight-bearing soft tissues. The review begins with an introduction of the function and degeneration of joints from a biomechanical aspect. Different constitutive models of articular cartilage, in particular biphasic materials, are illustrated in the context of the study of contact mechanics in joints. Approaches, advances and major findings of biphasic models of the hip and knee are presented, followed by a discussion of the challenges awaiting to be addressed, including the convergence issue, high computational cost and inadequate validation. Finally, opportunities and clinical insights in the areas of subject-specific modeling and tissue engineering are provided and discussed.
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Affiliation(s)
- Junyan Li
- Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, PR China.
| | - Jinghao Xu
- Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, PR China
| | - Zhenxian Chen
- Key Laboratory of Road Construction Technology and Equipment (Ministry of Education), Chang'an University, Xi'an, PR China
| | - Yongtao Lu
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, PR China
| | - Xijin Hua
- Faculty of Environment, Science and Economy, University of Exeter, Exeter, United Kingdom
| | - Zhongmin Jin
- Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, PR China; Sate Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, PR China; Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, United Kingdom
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3
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Raju V, Koorata PK. Computational assessment on the impact of collagen fiber orientation in cartilages on healthy and arthritic knee kinetics/kinematics. Med Eng Phys 2023; 117:103997. [PMID: 37331751 DOI: 10.1016/j.medengphy.2023.103997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND The inhomogeneous distribution of collagen fiber in cartilage can substantially influence the knee kinematics. This becomes vital for understanding the mechanical response of soft tissues, and cartilage deterioration including osteoarthritis (OA). Though the conventional computational models consider geometrical heterogeneity along with fiber reinforcements in the cartilage model as material heterogeneity, the influence of fiber orientation on knee kinetics and kinematics is not fully explored. This work examines how the collagen fiber orientation in the cartilage affects the healthy (intact knee) and arthritic knee response over multiple gait activities like running and walking. METHODS A 3D finite element knee joint model is used to compute the articular cartilage response during the gait cycle. A fiber-reinforced porous hyper elastic (FRPHE) material is used to model the soft tissue. A split-line pattern is used to implement the fiber orientation in femoral and tibial cartilage. Four distinct intact cartilage models and three OA models are simulated to assess the impact of the orientation of collagen fibers in a depth wise direction. The cartilage models with fibers oriented in parallel, perpendicular, and inclined to the articular surface are investigated for multiple knee kinematics and kinetics. FINDINGS The comparison of models with fiber orientation parallel to articulating surface for walking and running gait has the highest elastic stress and fluid pressure compared with inclined and perpendicular fiber-oriented models. Also, the maximum contact pressure is observed to be higher in the case of intact models during the walking cycle than for OA models. In contrast, the maximum contact pressure is higher during running in OA models than in intact models. Additionally, parallel-oriented models produce higher maximum stresses and fluid pressure for walking and running gait than proximal-distal-oriented models. Interestingly, during the walking cycle, the maximum contact pressure with intact models is approximately three times higher than on OA models. In contrast, the OA models exhibit higher contact pressure during the running cycle. INTERPRETATION Overall, the study indicates that collagen orientation is crucial for tissue responsiveness. This investigation provides insights into the development of tailored implants.
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Affiliation(s)
- Vaishakh Raju
- Applied Solid Mechanics Laboratory, Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, 575025, India
| | - Poornesh Kumar Koorata
- Applied Solid Mechanics Laboratory, Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, 575025, India.
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Goetz JE, Thomas-Aitken HD, Sitton SE, Westermann RW, Willey MC. Joint contact stress improves in dysplastic hips after periacetabular osteotomy but remains higher than in normal hips. Hip Int 2023; 33:298-305. [PMID: 34348517 PMCID: PMC9744023 DOI: 10.1177/11207000211036414] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIM The purpose of this study was to use computational modeling to determine if surgical correction of hip dysplasia restores hip contact mechanics to those of asymptomatic, radiographically normal hips. METHODS Discrete element analysis (DEA) was used to compute joint contact stresses during the stance phase of normal walking gait for 10 individuals with radiographically normal, asymptomatic hips and 10 age- and weight-matched patients with acetabular dysplasia who underwent periacetabular osteotomy (PAO). RESULTS Mean and peak contact stresses were higher (p < 0.001 and p = 0.036, respectively) in the dysplastic hips than in the matched normal hips. PAO normalised standard radiographic measurements and medialised the location of computed contact stress within the joint. Mean contact stress computed in dysplastic hips throughout the stance phase of gait (median 5.5 MPa, [IQR 3.9-6.1 MPa]) did not significantly decrease after PAO (3.7 MPa, [IQR 3.2-4.8]; p = 0.109) and remained significantly (p < 0.001) elevated compared to radiographically normal hips (2.4 MPa, [IQR 2.2-2.8 MPa]). Peak contact stress demonstrated a similar trend. Joint contact area during the stance phase of gait in the dysplastic hips increased significantly (p = 0.036) after PAO from 395 mm2 (IQR 378-496 mm2) to 595 mm2 (IQR 474-660 mm2), but remained significantly smaller (p = 0.001) than that for radiographically normal hips (median 1120 mm2, IQR 853-1444 mm2). CONCLUSIONS While contact mechanics in dysplastic hips more closely resembled those of normal hips after PAO, the elevated contact stresses and smaller contact areas remaining after PAO indicate ongoing mechanical abnormalities should be expected even after radiographically successful surgical correction.
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Affiliation(s)
- Jessica E. Goetz
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, 52242, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, 52242, USA
| | - Holly D. Thomas-Aitken
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, 52242, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, 52242, USA
| | - Sean E. Sitton
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, 52242, USA
| | - Robert W. Westermann
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, 52242, USA
| | - Michael C. Willey
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, 52242, USA
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Schuring LL, Mozingo JD, Lenz AL, Uemura K, Atkins PR, Fiorentino NM, Aoki SK, Peters CL, Anderson AE. Acetabular labrum and cartilage contact mechanics during pivoting and walking tasks in individuals with cam femoroacetabular impingement syndrome. J Biomech 2023; 146:111424. [PMID: 36603366 PMCID: PMC9869780 DOI: 10.1016/j.jbiomech.2022.111424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 12/01/2022] [Accepted: 12/23/2022] [Indexed: 12/25/2022]
Abstract
Femoroacetabular impingement syndrome (FAIS) is a motion-related pathology of the hip characterized by pain, morphological abnormalities of the proximal femur, and an elevated risk of joint deterioration and hip osteoarthritis. Activities that require deep flexion are understood to induce impingement in cam FAIS patients, however, less demanding activities such as walking and pivoting may induce pain as well as alterations in kinematics and joint stability. Still, the paucity of quantitative descriptions of cam FAIS has hindered understanding underlying hip joint mechanics during such activities. Previous in silico studies have employed generalized model geometry or kinematics to simulate impingement between the femur and acetabulum, which may not accurately capture the interplay between morphology and motion. In this study, we utilized models with participant-specific bone and articular soft tissue anatomy and kinematics measured by dual-fluoroscopy to compare hip contact mechanics of cam FAIS patients to controls during four activities of daily living (internal/external pivoting and level/incline walking). Averaged across the gait cycle during incline walking, patients displayed increased strain in the anterior joint (labrum strain: p-value = 0.038, patients: 11.7 ± 6.7 %, controls: 5.0 ± 3.6 %; cartilage strain: p-value = 0.029, patients: 9.1 ± 3.3 %, controls: 4.2 ± 2.3). Patients also exhibited increased average anterior cartilage strains during external pivoting (p-value = 0.039; patients: 13.0 ± 9.2 %, controls: 3.9 ± 3.2 %]). No significant differences between patient and control contact area and strain were found for level walking and internal pivoting. Our study provides new insights into the biomechanics of cam FAIS, including spatiotemporal hip joint contact mechanics during activities of daily living.
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Affiliation(s)
- Lindsay L Schuring
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA; Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA
| | - Joseph D Mozingo
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA
| | - Amy L Lenz
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA; Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; Department of Mechanical Engineering, University of Utah, Salt Lake City, UT 84112, USA
| | - Keisuke Uemura
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA
| | - Penny R Atkins
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; Scientific Computing and Imaging Institute, Salt Lake City, UT 84112, USA
| | - Niccolo M Fiorentino
- Mechanical Engineering Department, University of Vermont, Burlington, VT 05405, USA
| | - Stephen K Aoki
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA
| | | | - Andrew E Anderson
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA; Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; Scientific Computing and Imaging Institute, Salt Lake City, UT 84112, USA; Department of Physical Therapy, University of Utah, Salt Lake City, UT 84108, USA.
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Gaffney BMM, Williams ST, Todd JN, Weiss JA, Harris MD. A Musculoskeletal Model for Estimating Hip Contact Pressure During Walking. Ann Biomed Eng 2022; 50:1954-1963. [PMID: 35864367 PMCID: PMC9797423 DOI: 10.1007/s10439-022-03016-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 07/07/2022] [Indexed: 12/31/2022]
Abstract
Cartilage contact pressures are major factors in osteoarthritis etiology and are commonly estimated using finite element analysis (FEA). FEA models often include subject-specific joint geometry, but lack subject-specific joint kinematics and muscle forces. Musculoskeletal models use subject-specific kinematics and muscle forces but often lack methods for estimating cartilage contact pressures. Our objective was to adapt an elastic foundation (EF) contact model within OpenSim software to predict hip cartilage contact pressures and compare results to validated FEA models. EF and FEA models were built for five subjects. In the EF models, kinematics and muscle forces were applied and pressure was calculated as a function of cartilage overlap depth. Cartilage material properties were perturbed to find the best match to pressures from FEA. EF models with elastic modulus = 15 MPa and Poisson's ratio = 0.475 yielded results most comparable to FEA, with peak pressure differences of 4.34 ± 1.98 MPa (% difference = 39.96 ± 24.64) and contact area differences of 3.73 ± 2.92% (% difference = 13.4 ± 11.3). Peak pressure location matched between FEA and EF for 3 of 5 subjects, thus we do not recommend this model if the location of peak contact pressure is critically important to the research question. Contact area magnitudes and patterns matched reasonably between FEA and EF, suggesting that this model may be useful for questions related to those variables, especially if researchers desire inclusion of subject-specific geometry, kinematics, muscle forces, and dynamic motion in a computationally efficient framework.
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Affiliation(s)
- Brecca M M Gaffney
- Department of Mechanical Engineering, University of Colorado Denver, Denver, CO, USA
- Center of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Spencer T Williams
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Jocelyn N Todd
- Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
| | - Jeffrey A Weiss
- Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
| | - Michael D Harris
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, 4444 Forest Park Ave., Suite 1101, St. Louis, MO, 63108, USA.
- Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, St. Louis, MO, USA.
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A computational approach to determine key anatomic landmarks on pelvis and its application to acetabular orientation assessment and hip computational biomechanics. Med Eng Phys 2022; 105:103824. [DOI: 10.1016/j.medengphy.2022.103824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/07/2022] [Accepted: 05/25/2022] [Indexed: 11/23/2022]
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Multiscale modelling for investigating the long-term time-dependent biphasic behaviour of the articular cartilage in the natural hip joint. Biomech Model Mechanobiol 2022; 21:1145-1155. [PMID: 35482145 DOI: 10.1007/s10237-022-01581-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 03/25/2022] [Indexed: 11/02/2022]
Abstract
A better understanding of the time-dependent biomechanical behaviour of the biphasic hip articular cartilage (AC) under physiological loadings is important to understand the onset of joint pathology and guide the clinical treatment. Current computational studies for the biphasic hip AC were usually limited to short-term duration or using elaborate loading. The present study aimed to develop a multiscale computational modelling to investigate the long-term biphasic behaviour of the hip AC under physiological loadings over multiple gait cycles. Two-scale computational modelling including a musculoskeletal model and a finite element model of the natural hip was created. These two models were then combined and used to investigate the biphasic behaviour of hip AC over 80 gait cycles. The results showed that the interstitial fluid pressure in the AC supported over 89% of the loading during gait. When the contact area was located at the AC centre, the contact pressure and fluid pressure increased over time from the first cycle to the 80th cycle, while when the contact area approached the edge, these pressures decreased first dramatically and then slowly over time. The peak stresses and strains in the solid matrix of the AC remained at a low level and increased over time from the first cycle to the 80th cycle. This study demonstrated that the long-term temporal variations of the biphasic behaviour of hip AC under physiological loadings are significant. The methodology has potentially important implications in the biomechanical studies of human cartilage and supporting the development of cartilage substitution.
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Todd JN, Maak TG, Anderson AE, Ateshian GA, Weiss JA. How Does Chondrolabral Damage and Labral Repair Influence the Mechanics of the Hip in the Setting of Cam Morphology? A Finite-Element Modeling Study. Clin Orthop Relat Res 2022; 480:602-615. [PMID: 34766936 PMCID: PMC8846280 DOI: 10.1097/corr.0000000000002000] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 09/13/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Individuals with cam morphology are prone to chondrolabral injuries that may progress to osteoarthritis. The mechanical factors responsible for the initiation and progression of chondrolabral injuries in these individuals are not well understood. Additionally, although labral repair is commonly performed during surgical correction of cam morphology, the isolated mechanical effect of labral repair on the labrum and surrounding cartilage is unknown. QUESTION/PURPOSES Using a volunteer-specific finite-element analysis, we asked: (1) How does cam morphology create a deleterious mechanical environment for articular cartilage (as evaluated by shear stress, tensile strain, contact pressure, and fluid pressure) that could increase the risk of cartilage damage compared with a radiographically normal hip? (2) How does chondrolabral damage, specifically delamination, delamination with rupture of the chondrolabral junction, and the presence of a chondral defect, alter the mechanical environment around the damage? (3) How does labral repair affect the mechanical environment in the context of the aforementioned chondrolabral damage scenarios? METHODS The mechanical conditions of a representative hip with normal bony morphology (characterized by an alpha angle of 37°) and one with cam morphology (characterized by an alpha angle of 78°) were evaluated using finite-element models that included volunteer-specific anatomy and kinematics. The bone, cartilage, and labrum geometry for the hip models were collected from two volunteers matched by age (25 years with cam morphology and 23 years with normal morphology), BMI (both 24 kg/m2), and sex (both male). Volunteer-specific kinematics for gait were used to drive the finite-element models in combination with joint reaction forces. Constitutive material models were assigned to the cartilage and labrum, which simulate a physiologically realistic material response, including the time-dependent response from fluid flow through the cartilage, and spatially varied response from collagen fibril reinforcement. For the cam hip, three models were created to represent chondrolabral damage conditions: (1) "delamination," with the acetabular cartilage separated from the bone in one region; (2) "delamination with chondrolabral junction (CLJ) rupture," which includes separation of the cartilage from the labrum tissue; and (3) a full-thickness chondral defect, referred to throughout as "defect," where the acetabular cartilage has degraded so there is a void. Each of the three conditions was modeled with a labral tear and with the labrum repaired. The size and location of the damage conditions simulated in the cartilage and labrum were attained from reported clinical prevalence of the location of these injuries. For each damage condition, the contact area, contact pressure, tensile strain, shear stress, and fluid pressure were predicted during gait and compared. RESULTS The cartilage in the hip with cam morphology experienced higher stresses and strains than the normal hip. The peak level of tensile strain (25%) and shear stress (11 MPa) experienced by the cam hip may exceed stable conditions and initiate damage or degradation. The cam hip with simulated damage experienced more evenly distributed contact pressure than the intact cam hip, as well as decreased tensile strain, shear stress, and fluid pressure. The peak levels of tensile strain (15% to 16%) and shear stress (2.5 to 2.7 MPa) for cam hips with simulated damage may be at stable magnitudes. Labral repair only marginally affected the overall stress and strain within the cartilage, but it increased local tensile strain in the cartilage near the chondrolabral junction in the hip with delamination and increased the peak tensile strain and shear stress on the labrum. CONCLUSION This finite-element modeling pilot study suggests that cam morphology may predispose hip articular cartilage to injury because of high shear stress; however, the presence of simulated damage distributed the loading more evenly and the magnitude of stress and strain decreased throughout the cartilage. The locations of the peak values also shifted posteriorly. Additionally, in hips with cam morphology, isolated labral repair in the hip with a delamination injury increased localized strain in the cartilage near the chondrolabral junction. CLINICAL RELEVANCE In a hip with cam morphology, labral repair alone may not protect the cartilage from damage because of mechanical overload during the low-flexion, weightbearing positions experienced during gait. The predicted findings of redistribution of stress and strain from damage in the cam hip may, in some cases, relieve disposition to damage progression. Additional studies should include volunteers with varied acetabular morphology, such as borderline dysplasia with cam morphology or pincer deformity, to analyze the effect on the conclusions presented in the current study. Further, future studies should evaluate the combined effects of osteochondroplasty and chondrolabral treatment.
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Affiliation(s)
- Jocelyn N. Todd
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
| | - Travis G. Maak
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - Andrew E. Anderson
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
- School of Computing, University of Utah, Salt Lake City, UT, USA
- Department of Physical Therapy, University of Utah, Salt Lake City, UT, USA
| | - Gerard A. Ateshian
- Department of Mechanical Engineering, Columbia University, New York, NY, USA
| | - Jeffrey A. Weiss
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
- School of Computing, University of Utah, Salt Lake City, UT, USA
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Hua X, Li J, De Pieri E, Ferguson SJ. Multiscale biomechanics of the biphasic articular cartilage in the natural hip joint during routine activities. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 215:106606. [PMID: 35016083 DOI: 10.1016/j.cmpb.2021.106606] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 11/04/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE The investigation of the biomechanical behaviour of the articular cartilage (AC) under physiological loading is important to understand the joint function and onset of pathologies. This study aimed to develop a multiscale computational modelling approach and apply the approach to investigate the time-dependant biphasic behaviour of the AC in the natural hip joint under repetitive physiological loading over 80 cycles amongst six routine activities. METHODS A subject-specific musculoskeletal multibody dynamics (MBD) model was developed based on the anthropometry and motion capture data collected for a male subject. A corresponding FE model of the natural hip joint with biphasic AC was created based on the bone geometries exported from the MBD model. A multiscale computational modelling was then developed to couple the MBD model and the FE model and used to investigate the time-dependant biphasic behaviour of the AC under subject-specific physiological loading over 80 cycles amongst six routine activities. RESULTS The results showed that for all the activities considered, the interstitial fluid pressure in the AC supported over 80% of the loading. The maximum values of the peak contact pressure and peak fluid pressure for the whole cycle increased firstly and then remained stable over time from the 1st cycle to the 80th cycle. At these instants, the contact areas were located at the centre region of the AC. By contrast, when the contact area was located at the edge of the AC, these peak pressures were found to increase over time for some of the activities (squat, ascending stairs, descending stairs) but decrease for the other activities (normal walking, standing up, sitting down). CONCLUSION This study for the first time developed a multiscale computational modelling approach to couple a musculoskeletal MBD model of the body and a detailed FE model of the natural hip joint with biphasic AC, which enabled the evaluation of time-dependant biphasic behaviour of the AC under realistic physiological loading conditions. The study may have important implications in biomechanical studies of human cartilage to understand the joint function and biomechanical factors related to joint disease, and to support the development of cartilage substitution.
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Affiliation(s)
- Xijin Hua
- Institute for Manufacturing, Department of Engineering, University of Cambridge, Cambridge, United Kingdom; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland.
| | - Junyan Li
- Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
| | - Enrico De Pieri
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; University of Basel Children's Hospital, Laboratory for Movement Analysis, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland
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Morgan O, Hillstrom H, Bitar R, Sturnick D, Koff MF, Ellis S, Deland J, Hillstrom R. Finite Element Modelling of Planus and Rectus Foot Types for the Study of First Metatarsophalangeal and First Metatarsocuneiform Joint Contact Mechanics. J Biomech Eng 2022; 144:1135615. [PMID: 35147162 DOI: 10.1115/1.4053791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Indexed: 11/08/2022]
Abstract
Evaluating the contact mechanics of human joints is an important element in understanding the pathomechanics of orthopaedic diseases. Although physical testing is essential in the evaluation process, reliable computational models can augment these experiments by non-invasive predictions of biomechanical or surgical variables. The objective of this study was to perform verification of a framework for developing a medial forefoot finite element. Verification was conducted by comparing computational predictions to experimental measurements of first metatarsophalangeal and first metatarsocuneiform joint contact mechanics. A custom-built force-controlled cadaveric test-rig was used to derive measurements of contact pressure, force, and area. A quasi-static finite element was developed and driven under the same boundary and loading conditions. Calibration of cartilage moduli and mesh sensitivity analyses were performed. Mean errors in contact pressures, forces, and areas were 24%, 4%, and 40% at the first metatarsophalangeal joint and 23%, 12%, and 19% at the first Metatarsocuneiform joint, respectively. Verification of a medial forefoot finite element model development framework was presented and found to be within 30% for contact pressure and contact force of both joints. This study presents a method to verify and simulate realistic physiological loading to investigate orthopaedic diseases of the medial forefoot.
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Affiliation(s)
- Oliver Morgan
- Faculty of Science and Engineering, Anglia Ruskin University, Chelmsford, Essex, UK
| | - Howard Hillstrom
- Leon Root, MD Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - Rogerio Bitar
- Department of Biomechanics, Hospital for Special Surgery, New York, NY, USA
| | - Daniel Sturnick
- Department of Biomechanics, Hospital for Special Surgery, New York, NY, USA
| | - Matthew F Koff
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York, USA
| | - Scott Ellis
- Department of Orthopedics, Foot and Ankle Division, Hospital for Special Surgery, New York, NY, USA
| | - Jonathan Deland
- Department of Orthopedics, Foot and Ankle Division, Hospital for Special Surgery, New York, NY, USA
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Todd JN, Allan AN, Maak TG, Weiss JA. Characterization and finite element validation of transchondral strain in the human hip during static and dynamic loading. J Biomech 2021; 114:110143. [PMID: 33307354 PMCID: PMC10714355 DOI: 10.1016/j.jbiomech.2020.110143] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/04/2020] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
Abstract
Distribution of strain through the thickness of articular cartilage, or transchondral strain, is highly dependent on the geometry of the joint involved. Excessive transchondral strain can damage the solid matrix and ultimately lead to osteoarthritis. Currently, high-resolution transchondral strain distribution is unknown in the human hip. Thus, knowledge of transchondral strain patterns is of fundamental importance to interpreting the patterns of injury that occur in prearthritic hip joints. This study had three main objectives. We sought to 1) quantify high-resolution transchondral strain in the native human hip, 2) determine differences in transchondral strain between static and dynamic loading conditions to better understand recovery and repressurization of cartilage in the hip, and 3) create finite element (FE) models of the experimental testing to validate a modeling framework for future analysis. The transchondral strain patterns found in this study provide insight on the localization of strain within cartilage of the hip. Most notably, the chondrolabral junction experienced high tensile and shear strain across all samples, which explains clinical data reporting it as the most common region of damage in cartilage of the hip. Further, the representative FE framework was able to match the experimental static results and predict the dynamic results with very good agreement. This agreement provides confidence for both experimental and computational measurement methods and demonstrates that the specific anisotropic biphasic FE framework used in this study can both describe and predict the experimental results.
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Affiliation(s)
- Jocelyn N Todd
- Department of Biomedical Engineering, and Scientific Computing and Imaging Institute University of Utah, Salt Lake City, UT 84112, United States.
| | - Alexandra N Allan
- Department of Biomedical Engineering, and Scientific Computing and Imaging Institute University of Utah, Salt Lake City, UT 84112, United States
| | - Travis G Maak
- Department of Orthopedics, University of Utah, Salt Lake City, UT 84108, United States.
| | - Jeffrey A Weiss
- Department of Biomedical Engineering, and Scientific Computing and Imaging Institute University of Utah, Salt Lake City, UT 84112, United States; Department of Orthopedics, University of Utah, Salt Lake City, UT 84108, United States.
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Development and validation of a finite-element musculoskeletal model incorporating a deformable contact model of the hip joint during gait. J Mech Behav Biomed Mater 2020; 113:104136. [PMID: 33053499 DOI: 10.1016/j.jmbbm.2020.104136] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 09/22/2020] [Accepted: 10/07/2020] [Indexed: 01/01/2023]
Abstract
Musculoskeletal models provide non-invasive and subject-specific biomechanical investigations of the musculoskeletal system. In a musculoskeletal model, muscle forces contribute to the deformation and kinematics of the joint which in turn would alter moment arms of muscles and ground reaction forces and thus affect the prediction of muscle forces and contact forces and contact mechanics of the joint. By far, deformable contact models of the hip have not been considered in musculoskeletal models, and the role of kinematics and deformation within the hip in muscle forces and hip contact mechanics is unknown. In this study, an FE musculoskeletal model including bones, joints and muscles of the lower extremity was developed. A deformable contact model of the hip joint was incorporated and coupled into the musculoskeletal model. Joint angles and ground reaction forces during gait were used as inputs. Optimization minimizing the sum of muscle stresses squared was performed directly to the FE musculoskeletal model in order to simultaneously solve muscle forces and contact forces and contact stresses of the hip joint within a single framework. The calculated hip contact forces corresponded well to the in vivo measurement data. The maximum hip contact stress was 6.5 MPa and occurred at weight-acceptance. The influence of kinematics and deformation in the hip on muscles forces and hip contact forces was minimal and not sensitive to variations in the thickness and properties of the joint cartilage during gait. This suggests that the uncoupled approach in which the hip contact forces and contact mechanics are simulated in separate frameworks would serve as an effective and efficient alternative for subject-specific modelling of the hip. This study provides guidance for the level of complexity needed for future hip models and can be used to evaluate biomechanical changes of the musculoskeletal system following interventions.
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Maas SA, LaBelle SA, Ateshian GA, Weiss JA. A Plugin Framework for Extending the Simulation Capabilities of FEBio. Biophys J 2018; 115:1630-1637. [PMID: 30297132 DOI: 10.1016/j.bpj.2018.09.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 09/05/2018] [Accepted: 09/12/2018] [Indexed: 10/28/2022] Open
Abstract
The FEBio software suite is a set of software tools for nonlinear finite element analysis in biomechanics and biophysics. FEBio employs mixture theory to account for the multiconstituent nature of biological materials, integrating the field equations for irreversible thermodynamics, solid mechanics, fluid mechanics, mass transport with reactive species, and electrokinetics. This communication describes the development and application of a new "plugin" framework for FEBio. Plugins are dynamically linked libraries that allow users to add new features and to couple FEBio with other domain-specific software applications without modifying the source code directly. The governing equations and simulation capabilities of FEBio are reviewed. The implementation, structure, use, and application of the plugin framework are detailed. Several example plugins are described in detail to illustrate how plugins enrich, extend, and leverage existing capabilities in FEBio, including applications to deformable image registration, constitutive modeling of biological tissues, coupling to an external software package that simulates angiogenesis using a discrete computational model, and a nonlinear reaction-diffusion solver. The plugin feature facilitates dissemination of new simulation methods, reproduction of published results, and coupling of FEBio with other domain-specific simulation approaches such as compartmental modeling, agent-based modeling, and rigid-body dynamics. We anticipate that the new plugin framework will greatly expand the range of applications for the FEBio software suite and thus its impact.
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Affiliation(s)
- Steve A Maas
- Department of Biomedical Engineering, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah
| | - Steven A LaBelle
- Department of Biomedical Engineering, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah
| | - Gerard A Ateshian
- Department of Mechanical Engineering, Columbia University, New York, New York
| | - Jeffrey A Weiss
- Department of Biomedical Engineering, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah.
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