1
|
Kislov MA, Krupin KN, Pigolkin YI. [Mathematical modeling of the fracture along the length of the femur diaphysis]. Sud Med Ekspert 2023; 66:19-24. [PMID: 37496477 DOI: 10.17116/sudmed20236604119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
THE AIM OF THE STUDY Was to establish a pattern of femur diaphysis fracture with impact force over the entire front surface in an increments of 25 mm. Transverse, oblique and comminuted femur fractures were studied as a result of mathematical modeling. The application of mathematical modeling using the finite element analysis made it possible to visualize and predict the tension arising in the transient material during the impact force of blunt object, as well as the features of fractures' morphology in different sections of femur diaphysis. Modelled data about the mechanism and morphology of femur fracture were confirmed by the results of original full-scale experiments.
Collapse
Affiliation(s)
- M A Kislov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - K N Krupin
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Research-and-development Laboratory of Human Morphology, Samara, Russia
| | - Yu I Pigolkin
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| |
Collapse
|
2
|
Hug L, Dahan G, Kollmannsberger S, Rank E, Yosibash Z. Predicting fracture in the proximal humerus using phase field models. J Mech Behav Biomed Mater 2022; 134:105415. [PMID: 36049369 DOI: 10.1016/j.jmbbm.2022.105415] [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: 06/07/2022] [Revised: 07/20/2022] [Accepted: 08/08/2022] [Indexed: 11/29/2022]
Abstract
Proximal humerus impacted fractures are of clinical concern in the elderly population. Prediction of such fractures by CT-based finite element methods encounters several major obstacles such as heterogeneous mechanical properties and fracture due to compressive strains. We herein propose to investigate a variation of the phase field method (PFM) embedded into the finite cell method (FCM) to simulate impacted humeral fractures in fresh frozen human humeri. The force-strain response, failure loads and the fracture path are compared to experimental observations for validation purposes. The PFM (by means of the regularization parameter ℓ0) is first calibrated by one experiment and thereafter used for the prediction of the mechanical response of two other human fresh frozen humeri. All humeri are fractured at the surgical neck and strains are monitored by Digital Image Correlation (DIC). Experimental strains in the elastic regime are reproduced with good agreement (R2=0.726), similarly to the validated finite element method (Dahan et al., 2022). The failure pattern and fracture evolution at the surgical neck predicted by the PFM mimic extremely well the experimental observations for all three humeri. The maximum relative error in the computed failure loads is 3.8%. To the best of our knowledge this is the first method that can predict well the experimental compressive failure pattern as well as the force-strain relationship in proximal humerus fractures.
Collapse
Affiliation(s)
- L Hug
- Chair for Computational Modeling and Simulation, Technical University of Munich, Arcisstr. 21, 80333 Munich, Germany.
| | - G Dahan
- School of Mechanical Engineering, The Iby and Aladar Fleischman Faculty of Engineering, Tel-Aviv University, 69978 Ramat-Aviv, Israel
| | - S Kollmannsberger
- Chair for Computational Modeling and Simulation, Technical University of Munich, Arcisstr. 21, 80333 Munich, Germany
| | - E Rank
- Chair for Computational Modeling and Simulation, Technical University of Munich, Arcisstr. 21, 80333 Munich, Germany
| | - Z Yosibash
- School of Mechanical Engineering, The Iby and Aladar Fleischman Faculty of Engineering, Tel-Aviv University, 69978 Ramat-Aviv, Israel
| |
Collapse
|
3
|
Dahan G, Safran O, Yosibash Z. Can neck fractures in proximal humeri be predicted by CT-based FEA? J Biomech 2022; 136:111039. [PMID: 35381504 DOI: 10.1016/j.jbiomech.2022.111039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Proximal humeri fractures at anatomical and surgical neck (∼5% and ∼50% incidence respectively) are frequent in elderly population. Yet, neither in-vitro experiments nor CT-based finite element analyses (CTFEA) have investigated these in depth. Herein we enhance (Dahan et al., 2019) (addressing anatomical neck fractures) by more experiments and specimens, accounting for surgical neck fractures and explore CTFEA's prediction of humeri mechanical response and yield force. METHODS Four fresh frozen human humeri were tested in a new experimental configuration inducing surgical neck fractures. Digital image correlation (DIC) provided strains and displacements on humeri surfaces and used to validate CTFEA predictions. CTFEA were enhanced herein to improve the accuracy at the proximal neck: A cortical bone mapping (CBM) algorithm was implemented to overcome insufficient scanning resolution, and a new trabecular material mapping was investigated. RESULTS The new experimental setting induced impacted surgical neck fractures in all humeri. Excellent DIC to CTFEA correlation in strains was obtained at the shaft (slope 0.984, R2=0.99) and a fair agreement (slope 0.807, R2=0.73) at the neck. CBM algorithm had worsened the correlation, whereas the new material mapping had a negligible influence. Yield loads predictions improved considerably when trabecular yielding (maximum principal strain criterion) was considered instead of surface cortical yielding. DISCUSSION CTFEA well predicts strains on the shaft and reasonably well on the neck. This enhances former conclusions by past studies conducted using SGs, now also evident by DIC. Yield load prediction for surgical neck fractures (involving crushing of trabecular bone) is predicted better by trabecular failure laws rather than cortex ones. Further FEA studies using trabecular orthotropic constitutive models and failure laws are warrant.
Collapse
|
4
|
Kislov MA, Bakhmetiev VI, Kildyushov EM, Krupin KN. [Mathematical modeling of femoral diaphyseal fracture at an acute angle]. Sud Med Ekspert 2022; 65:37-41. [PMID: 36472178 DOI: 10.17116/sudmed20226506137] [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] [Indexed: 06/17/2023]
Abstract
The aim of the work is to establish the regularity of the formation femoral diaphysis fracture under an impact action on the anterior surface of the femur at an acute angle. As a result of mathematical modeling, transverse and short oblique, comminuted fractures of the femoral diaphysis were studied. Application of mathematical modeling with final element analysis made it possible to visualize and predict the stresses arising in the trace-perceiving material under the impact action of a blunt solid object. The data obtained in modeling of the mechanism and morphology of the femoral diaphysis fracture are confirmed by the results of the original full-scale experiments. Absence of experiments and practical observations of femoral fractures with the above described conditions does not enable us to fully validate the mathematical model of femoral fracture and indicates the need for scientific research on biomannequins.
Collapse
Affiliation(s)
- M A Kislov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - V I Bakhmetiev
- Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia
| | - E M Kildyushov
- Pirogov Russian Research Medical University, Moscow, Russia
| | - K N Krupin
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| |
Collapse
|
5
|
Miller CV, Pittman M. The diet of early birds based on modern and fossil evidence and a new framework for its reconstruction. Biol Rev Camb Philos Soc 2021; 96:2058-2112. [PMID: 34240530 PMCID: PMC8519158 DOI: 10.1111/brv.12743] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 12/14/2022]
Abstract
Birds are some of the most diverse organisms on Earth, with species inhabiting a wide variety of niches across every major biome. As such, birds are vital to our understanding of modern ecosystems. Unfortunately, our understanding of the evolutionary history of modern ecosystems is hampered by knowledge gaps in the origin of modern bird diversity and ecosystem ecology. A crucial part of addressing these shortcomings is improving our understanding of the earliest birds, the non-avian avialans (i.e. non-crown birds), particularly of their diet. The diet of non-avian avialans has been a matter of debate, in large part because of the ambiguous qualitative approaches that have been used to reconstruct it. Here we review methods for determining diet in modern and fossil avians (i.e. crown birds) as well as non-avian theropods, and comment on their usefulness when applied to non-avian avialans. We use this to propose a set of comparable, quantitative approaches to ascertain fossil bird diet and on this basis provide a consensus of what we currently know about fossil bird diet. While no single approach can precisely predict diet in birds, each can exclude some diets and narrow the dietary possibilities. We recommend combining (i) dental microwear, (ii) landmark-based muscular reconstruction, (iii) stable isotope geochemistry, (iv) body mass estimations, (v) traditional and/or geometric morphometric analysis, (vi) lever modelling, and (vii) finite element analysis to reconstruct fossil bird diet accurately. Our review provides specific methodologies to implement each approach and discusses complications future researchers should keep in mind. We note that current forms of assessment of dental mesowear, skull traditional morphometrics, geometric morphometrics, and certain stable isotope systems have yet to be proven effective at discerning fossil bird diet. On this basis we report the current state of knowledge of non-avian avialan diet which remains very incomplete. The ancestral dietary condition in non-avian avialans remains unclear due to scarce data and contradictory evidence in Archaeopteryx. Among early non-avian pygostylians, Confuciusornis has finite element analysis and mechanical advantage evidence pointing to herbivory, whilst Sapeornis only has mechanical advantage evidence indicating granivory, agreeing with fossilised ingested material known for this taxon. The enantiornithine ornithothoracine Shenqiornis has mechanical advantage and pedal morphometric evidence pointing to carnivory. In the hongshanornithid ornithuromorph Hongshanornis only mechanical advantage evidence indicates granivory, but this agrees with evidence of gastrolith ingestion in this taxon. Mechanical advantage and ingested fish support carnivory in the songlingornithid ornithuromorph Yanornis. Due to the sparsity of robust dietary assignments, no clear trends in non-avian avialan dietary evolution have yet emerged. Dietary diversity seems to increase through time, but this is a preservational bias associated with a predominance of data from the Early Cretaceous Jehol Lagerstätte. With this new framework and our synthesis of the current knowledge of non-avian avialan diet, we expect dietary knowledge and evolutionary trends to become much clearer in the coming years, especially as fossils from other locations and climates are found. This will allow for a deeper and more robust understanding of the role birds played in Mesozoic ecosystems and how this developed into their pivotal role in modern ecosystems.
Collapse
Affiliation(s)
- Case Vincent Miller
- Vertebrate Palaeontology Laboratory, Research Division for Earth and Planetary ScienceThe University of Hong KongPokfulamHong Kong SARChina
| | - Michael Pittman
- Vertebrate Palaeontology Laboratory, Research Division for Earth and Planetary ScienceThe University of Hong KongPokfulamHong Kong SARChina
| |
Collapse
|
6
|
Lewandowski K, Kaczmarczyk Ł, Athanasiadis I, Marshall JF, Pearce CJ. A computational framework for crack propagation in spatially heterogeneous materials. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2021; 379:20200291. [PMID: 34148414 DOI: 10.1098/rsta.2020.0291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
This paper presents a mathematical formulation and numerical modelling framework for brittle crack propagation in heterogeneous elastic solids. Such materials are present in both natural and engineered scenarios. The formulation is developed in the framework of configurational mechanics and solved numerically using the finite-element method. We show the methodology previously established for homogeneous materials without the need for any further assumptions. The proposed model is based on the assumption of maximal dissipation of energy and uses the Griffith criterion; we show that this is sufficient to predict crack propagation in brittle heterogeneous materials, with spatially varying Young's modulus and fracture energy. Furthermore, we show that the crack path trajectory orientates itself such that it is always subject to Mode-I. The configurational forces and fracture energy release rate are both expressed exclusively in terms of nodal quantities, avoiding the need for post-processing and enabling a fully implicit formulation for modelling the evolving crack front and creation of new crack surfaces. The proposed formulation is verified and validated by comparing numerical results with both analytical solutions and experimental results. Both the predicted crack path and load-displacement response show very good agreement with experiments where the crack path was independent of material heterogeneity for those cases. Finally, the model is successfully used to consider the real and challenging scenario of fracture of an equine bone, with spatially varying material properties obtained from CT scanning. This article is part of a discussion meeting issue 'A cracking approach to inventing new tough materials: fracture stranger than friction'.
Collapse
Affiliation(s)
- Karol Lewandowski
- Glasgow Computational Engineering Centre, The James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK
| | - Łukasz Kaczmarczyk
- Glasgow Computational Engineering Centre, The James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK
| | - Ignatios Athanasiadis
- Glasgow Computational Engineering Centre, The James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK
| | - John F Marshall
- Weipers Centre Equine Hospital, School of Veterinary Medicine, University of Glasgow, Glasgow G61 1QH, UK
| | - Chris J Pearce
- Glasgow Computational Engineering Centre, The James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK
| |
Collapse
|
7
|
Dutel H, Gröning F, Sharp AC, Watson PJ, Herrel A, Ross CF, Jones MEH, Evans SE, Fagan MJ. Comparative cranial biomechanics in two lizard species: impact of variation in cranial design. J Exp Biol 2021; 224:jeb.234831. [PMID: 33504585 PMCID: PMC7970069 DOI: 10.1242/jeb.234831] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/18/2021] [Indexed: 12/19/2022]
Abstract
Cranial morphology in lepidosaurs is highly disparate and characterised by the frequent loss or reduction of bony elements. In varanids and geckos, the loss of the postorbital bar is associated with changes in skull shape, but the mechanical principles underlying this variation remain poorly understood. Here, we sought to determine how the overall cranial architecture and the presence of the postorbital bar relate to the loading and deformation of the cranial bones during biting in lepidosaurs. Using computer-based simulation techniques, we compared cranial biomechanics in the varanid Varanus niloticus and the teiid Salvator merianae, two large, active foragers. The overall strain magnitude and distribution across the cranium were similar in the two species, despite lower strain gradients in V. niloticus. In S. merianae, the postorbital bar is important for resistance of the cranium to feeding loads. The postorbital ligament, which in varanids partially replaces the postorbital bar, does not affect bone strain. Our results suggest that the reduction of the postorbital bar impaired neither biting performance nor the structural resistance of the cranium to feeding loads in V. niloticus. Differences in bone strain between the two species might reflect demands imposed by feeding and non-feeding functions on cranial shape. Beyond variation in cranial bone strain related to species-specific morphological differences, our results reveal that similar mechanical behaviour is shared by lizards with distinct cranial shapes. Contrary to the situation in mammals, the morphology of the circumorbital region, calvaria and palate appears to be important for withstanding high feeding loads in these lizards. Summary:In vivo measurements and computer-based simulations of the cranial mechanics of two large lizards indicate that similar mechanical behaviour is shared by lizards with distinct cranial architecture, and show the importance of the postorbital bar in resisting the feeding loads.
Collapse
Affiliation(s)
- Hugo Dutel
- School of Earth Sciences, University of Bristol, Bristol, BS8 1TQ, UK .,Department of Engineering, Medical and Biological Engineering Research Group, University of Hull, Hull, HU6 7RX, UK
| | - Flora Gröning
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Alana C Sharp
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK.,Centre for Integrative Anatomy, Research Department of Cell and Developmental Biology, University College London, Anatomy Building, Gower Street, London, WCIE 6BT, UK
| | - Peter J Watson
- Department of Engineering, Medical and Biological Engineering Research Group, University of Hull, Hull, HU6 7RX, UK
| | - Anthony Herrel
- UMR 7179 MECADEV, MNHN - CNRS, Département Adaptations du Vivant, Muséum national d'Histoire naturelle, 75005 Paris, France
| | - Callum F Ross
- Organismal Biology and Anatomy, University of Chicago, 1027 East 57th Street, Chicago, IL 60637, USA
| | - Marc E H Jones
- Centre for Integrative Anatomy, Research Department of Cell and Developmental Biology, University College London, Anatomy Building, Gower Street, London, WCIE 6BT, UK
| | - Susan E Evans
- Centre for Integrative Anatomy, Research Department of Cell and Developmental Biology, University College London, Anatomy Building, Gower Street, London, WCIE 6BT, UK
| | - Michael J Fagan
- Department of Engineering, Medical and Biological Engineering Research Group, University of Hull, Hull, HU6 7RX, UK
| |
Collapse
|
8
|
Patient-specific computed tomography-based finite element analysis: a new tool to assess fracture risk in benign bone lesions of the femur. Clin Biomech (Bristol, Avon) 2020; 80:105155. [PMID: 32916567 DOI: 10.1016/j.clinbiomech.2020.105155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 08/16/2020] [Accepted: 08/19/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Most benign active and latent lesions of proximal femur do not predispose a patient to a pathologic fracture. Nonetheless, there is a tendency to perform internal fixation due to the lack of accurate clinical tools that may reliably confirm low risk of pathologic fracture. As many as 30% of these surgeries may be unnecessary. A patient-specific CT-based finite element analysis may quantify bone strength and risk of fracture under normal weight-bearing conditions. METHODS The clinical relevance of such finite element analysis was investigated in a retrospective study on a cohort of 17 patients. Finite element analysis results (high risk = indication for surgery, low or moderate risk = follow-up) were compared to actual clinical decisions (surgery vs follow-up). All patients predicted by the finite element analysis as high risk underwent internal fixation and had good outcomes (n = 6). FINDINGS Four of the 11 low- and moderate-risk finite element analysis patients (36%) were operated immediately, and seven (64%) were either operated after a delay of at least 6 months or were never operated. None sustained a pathologic fracture. Patients who were predicted as low fracture risk by finite element analysis remained fracture-free for a minimal period of 6 months. Prediction of high risk of pathologic fracture by finite element analysis was in complete agreement with the conventional clinical evaluation. INTERPRETATION We consider finite element analysis a promising decision support system for the management of patients with benign tumors of femur, and that it may reliably endorse the decision to withhold surgery for patients at low fracture-risk.
Collapse
|
9
|
Falcinelli C, Whyne C. Image-based finite-element modeling of the human femur. Comput Methods Biomech Biomed Engin 2020; 23:1138-1161. [PMID: 32657148 DOI: 10.1080/10255842.2020.1789863] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Fracture is considered a critical clinical endpoint in skeletal pathologies including osteoporosis and bone metastases. However, current clinical guidelines are limited with respect to identifying cases at high risk of fracture, as they do not account for many mechanical determinants that contribute to bone fracture. Improving fracture risk assessment is an important area of research with clear clinical relevance. Patient-specific numerical musculoskeletal models generated from diagnostic images are widely used in biomechanics research and may provide the foundation for clinical tools used to quantify fracture risk. However, prior to clinical translation, in vitro validation of predictions generated from such numerical models is necessary. Despite adopting radically different models, in vitro validation of image-based finite element (FE) models of the proximal femur (predicting strains and failure loads) have shown very similar, encouraging levels of accuracy. The accuracy of such in vitro models has motivated their application to clinical studies of osteoporotic and metastatic fractures. Such models have demonstrated promising but heterogeneous results, which may be explained by the lack of a uniform strategy with respect to FE modeling of the human femur. This review aims to critically discuss the state of the art of image-based femoral FE modeling strategies, highlighting principal features and differences among current approaches. Quantitative results are also reported with respect to the level of accuracy achieved from in vitro evaluations and clinical applications and are used to motivate the adoption of a standardized approach/workflow for image-based FE modeling of the femur.
Collapse
Affiliation(s)
- Cristina Falcinelli
- Orthopaedic Biomechanics Laboratory, Sunnybrook Research Institute, Toronto, Canada
| | - Cari Whyne
- Orthopaedic Biomechanics Laboratory, Sunnybrook Research Institute, Toronto, Canada
| |
Collapse
|
10
|
Strain shielding for cemented hip implants. Clin Biomech (Bristol, Avon) 2020; 77:105027. [PMID: 32447179 DOI: 10.1016/j.clinbiomech.2020.105027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Long-term survival of hip implants is of increasing relevance due to the rising life expectancy. The biomechanical effect of strain shielding as a result of implant insertion may lead to bone resorption, thus increasing risk for implant loosening and periprosthetic fractures. Patient-specific quantification of strain shielding could assist orthopedic surgeons in choosing the biomechanically most appropriate prosthesis. METHODS Validated quantitative CT-based finite element models of five femurs in intact and implanted states were considered to propose a systematic algorithm for strain shielding quantification. Three different strain measures were investigated and the most appropriate measure for strain shielding quantification is recommended. It is used to demonstrate a practical femur-specific implant selection among three common designs. FINDINGS Strain shielding measures demonstrated similar trends in all Gruen zones except zone 1, where the volumetric strain measure differed from von-Mises and maximum principal strains. The volumetric strain measure is in better agreement with clinical bone resorption records. It is also consistent with the biological mechanism of bone remodeling so it is recommended for strain shielding quantification. Applying the strain shielding algorithm on three different implants for a specific femur suggests that the collared design is preferable. Such quantitative biomechanical input is valuable for practical patient specific implant selection. INTERPRETATION Volumetric strain should be considered for strain shielding examination. The presented methodology may potentially enable patient-specific pre-operative strain shielding evaluation so to minimize strain shielding. It should be further used in a longitudinal study so to correlate between strain shielding predictions and clinical bone resorption.
Collapse
|
11
|
Katz Y, Yosibash Z. New insights on the proximal femur biomechanics using Digital Image Correlation. J Biomech 2020; 101:109599. [DOI: 10.1016/j.jbiomech.2020.109599] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 12/27/2019] [Accepted: 12/31/2019] [Indexed: 01/22/2023]
|
12
|
Alcântara ACS, Assis I, Prada D, Mehle K, Schwan S, Costa-Paiva L, Skaf MS, Wrobel LC, Sollero P. Patient-Specific Bone Multiscale Modelling, Fracture Simulation and Risk Analysis-A Survey. MATERIALS (BASEL, SWITZERLAND) 2019; 13:E106. [PMID: 31878356 PMCID: PMC6981613 DOI: 10.3390/ma13010106] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/26/2022]
Abstract
This paper provides a starting point for researchers and practitioners from biology, medicine, physics and engineering who can benefit from an up-to-date literature survey on patient-specific bone fracture modelling, simulation and risk analysis. This survey hints at a framework for devising realistic patient-specific bone fracture simulations. This paper has 18 sections: Section 1 presents the main interested parties; Section 2 explains the organzation of the text; Section 3 motivates further work on patient-specific bone fracture simulation; Section 4 motivates this survey; Section 5 concerns the collection of bibliographical references; Section 6 motivates the physico-mathematical approach to bone fracture; Section 7 presents the modelling of bone as a continuum; Section 8 categorizes the surveyed literature into a continuum mechanics framework; Section 9 concerns the computational modelling of bone geometry; Section 10 concerns the estimation of bone mechanical properties; Section 11 concerns the selection of boundary conditions representative of bone trauma; Section 12 concerns bone fracture simulation; Section 13 presents the multiscale structure of bone; Section 14 concerns the multiscale mathematical modelling of bone; Section 15 concerns the experimental validation of bone fracture simulations; Section 16 concerns bone fracture risk assessment. Lastly, glossaries for symbols, acronyms, and physico-mathematical terms are provided.
Collapse
Affiliation(s)
- Amadeus C. S. Alcântara
- Department of Computational Mechanics, School of Mechanical Engineering, University of Campinas—UNICAMP, Campinas, Sao Paulo 13083-860, Brazil; (A.C.S.A.); (D.P.)
| | - Israel Assis
- Department of Integrated Systems, School of Mechanical Engineering, University of Campinas—UNICAMP, Campinas, Sao Paulo 13083-860, Brazil;
| | - Daniel Prada
- Department of Computational Mechanics, School of Mechanical Engineering, University of Campinas—UNICAMP, Campinas, Sao Paulo 13083-860, Brazil; (A.C.S.A.); (D.P.)
| | - Konrad Mehle
- Department of Engineering and Natural Sciences, University of Applied Sciences Merseburg, 06217 Merseburg, Germany;
| | - Stefan Schwan
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, 06120 Halle/Saale, Germany;
| | - Lúcia Costa-Paiva
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas—UNICAMP, Campinas, Sao Paulo 13083-887, Brazil;
| | - Munir S. Skaf
- Institute of Chemistry and Center for Computing in Engineering and Sciences, University of Campinas—UNICAMP, Campinas, Sao Paulo 13083-860, Brazil;
| | - Luiz C. Wrobel
- Institute of Materials and Manufacturing, Brunel University London, Uxbridge UB8 3PH, UK;
- Department of Civil and Environmental Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro 22451-900, Brazil
| | - Paulo Sollero
- Department of Computational Mechanics, School of Mechanical Engineering, University of Campinas—UNICAMP, Campinas, Sao Paulo 13083-860, Brazil; (A.C.S.A.); (D.P.)
| |
Collapse
|
13
|
Laurent CP, Böhme B, Verwaerde J, Papeleux L, Ponthot JP, Balligand M. Effect of orthopedic implants on canine long bone compression stiffness: a combined experimental and computational approach. Proc Inst Mech Eng H 2019; 234:255-264. [PMID: 31608817 DOI: 10.1177/0954411919882603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Osteosynthesis for canine long bones is a complex process requiring knowledge of biology, surgical techniques and (bio)mechanical principles. Subject-specific finite element analysis constitutes a promising tool to evaluate the effect of surgical intervention on the global properties of a bone-implant construct, but suffers from a lack of validation. In this study, the biomechanical behavior of 10 canine humeri was compared before and after creation of a 10 mm bone defect stabilized with an eight-hole locking compression plate (Synthes®) and two locking screws on each fragment. The response under compression of both intact and plated samples was measured experimentally and reproduced with a finite element model. The experimental stiffness ratio between plated and intact bone was equal to 0.39 ± 0.06. A subject-specific finite element analysis including density-dependent elasto-plastic material properties for canine bone and automatic generation of orthopedic implants was then conducted to recover these experimental results. The stiffness of intact and plated samples could be predicted, with no significant differences with experimental data. The simulated stiffness ratio between plated and intact canine bone was equal to 0.43 ± 0.03. This study constitutes a first step toward the building of a virtual database of pre-computed cases, aiming at helping the veterinary surgeons to make decisions regarding the most suited orthopedic solution for a given dog and a given fracture.
Collapse
Affiliation(s)
| | - Béatrice Böhme
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Jolanthe Verwaerde
- CNRS, LEMTA, UMR 7563, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Luc Papeleux
- Department of Aerospace & Mechanical Engineering, University of Liège, Liège, Belgium
| | - Jean-Philippe Ponthot
- Department of Aerospace & Mechanical Engineering, University of Liège, Liège, Belgium
| | - Marc Balligand
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| |
Collapse
|
14
|
Finite element analyses for predicting anatomical neck fractures in the proximal humerus. Clin Biomech (Bristol, Avon) 2019; 68:114-121. [PMID: 31200295 DOI: 10.1016/j.clinbiomech.2019.05.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 05/14/2019] [Accepted: 05/17/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Proximal humerus fractures which occur as a result of a fall on an outstretched arm are frequent among the elderly population. The necessity of stabilizing such fractures by surgical procedures is a controversial matter among surgeons. Validating a personalized FE analysis by ex-vivo experiments of humeri and mimicking such fractures by experiments is the first step along the path to determine the necessity of such surgeries. METHODS Four fresh frozen human humeri were loaded using a new simple experimental setting, so to fracture the humeri at the anatomical neck. Strains on humeri's surfaces predicted by the high order FE analyses (as in Dahan et al., 2016) were compared to the experimental observations to further enhance the validity of the FE analyses. A simplified yield criterion based on a linear elastic analysis and principal strains was used to predict the anatomical neck fracture as observed in the experiment. FINDINGS An excellent correlation between experimental measured and FE predicted strains was obtained (slope of 0.99 and R2=0.98). All humeri were fractured at the anatomical neck. The predicted yield load was within 10%-20% accuracy. INTERPRETATION High-order FE analyses reliably predict strains and yield loads in the humeri. Fractures induced by the experimental setting correspond to anatomical neck fractures noticed in practice and classified as AO C1.1-C1.3. Surgical neck fractures, which are most common in clinical practice, could not be realized in the proposed experiments, and a different experimental setting should be sought to obtain them ex-vivo.
Collapse
|
15
|
Lee Y, Ogihara N, Lee T. Assessment of finite element models for prediction of osteoporotic fracture. J Mech Behav Biomed Mater 2019; 97:312-320. [PMID: 31151004 DOI: 10.1016/j.jmbbm.2019.05.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/05/2019] [Accepted: 05/09/2019] [Indexed: 12/16/2022]
Abstract
With increasing life expectancy and mortality rates, the burden of osteoporotic hip fractures is continually on an upward trend. In terms of prevention, there are several osteoporosis treatment strategies such as anti-resorptive drug treatments, which attempt to retard the rate of bone resorption, while promoting the rate of formation. With respect to prediction, several studies have provided insights into obtaining bone strength by non-invasive means through the application of FE analysis. However, what valuable information can we obtain from FE studies that have focused on osteoporosis research, with respect to the prediction of osteoporotic fractures? This paper aims to fine studies that have used FE analysis to predict fractures in the proximal femur through a systematic search of literature using PUBMED, with the main objective of supporting the diagnosis of osteoporosis. The focus of these FE studies is first discussed, and the methodological aspects are summarized, by mainly comparing and contrasting their meshing properties, material properties, and boundary conditions. The implications of these methodological differences in FE modelling processes and propositions with the aim of consolidating or minimalizing these differences are further discussed. We proved that studies need to start converging in terms of their input parameters to make the FE method applicable to clinical settings. This, in turn, will decrease the time needed for in vitro tests. Current advancements in FE analysis need to be consolidated before any further steps can be taken to implement engineering analysis into the clinical scenario.
Collapse
Affiliation(s)
- Yeokyeong Lee
- Department of Architectural Engineering, Ewha Womans University, Republic of Korea
| | | | - Taeyong Lee
- Division of Mechanical and Biomedical Engineering, Ewha Womans University, Republic of Korea.
| |
Collapse
|
16
|
Accuracy Quantification of the Reverse Engineering and High-Order Finite Element Analysis of Equine MC3 Forelimb. J Equine Vet Sci 2019; 78:94-106. [PMID: 31203991 DOI: 10.1016/j.jevs.2019.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/08/2019] [Accepted: 04/08/2019] [Indexed: 02/08/2023]
Abstract
Shape is a key factor in influencing mechanical responses of bones. Considered to be smart viscoelastic and inhomogeneous materials, bones are stimulated to change shape (model and remodel) when they experience changes in the compressive strain distribution. Using reverse engineering techniques via computer-aided design (CAD) is crucial to create a virtual environment to investigate the significance of shape in biomechanical engineering. Nonetheless, data are lacking to quantify the accuracy of generated models and to address errors in finite element analysis (FEA). In the present study, reverse engineering through extrapolating cross-sectional slices was used to reconstruct the diaphysis of 15 equine third metacarpal bones (MC3). The reconstructed geometry was aligned with, and compared against, computed tomography-based models (reference models) of these bones and then the error map of the generated surfaces was plotted. The minimum error of reconstructed geometry was found to be +0.135 mm and -0.185 mm (0.407 mm ± 0.235, P > .05 and -0.563 mm ± 0.369, P > .05 for outside [convex] and inside [concave] surface position, respectively). Minor reconstructed surface error was observed on the dorsal cortex (0.216 mm ± 0.07, P > .05) for the outside surface and -0.185 mm ± 0.13, P > .05 for the inside surface. In addition, a displacement-based error estimation was used on 10 MC3 to identify poorly shaped elements in FEA, and the relations of finite element convergence analysis were used to present a framework for minimizing stress and strain errors in FEA. Finite element analysis errors of 3%-5% provided in the literature are unfortunate. Our proposed model, which presents an accurate FEA (error of 0.12%) in the smallest number of iterations possible, will assist future investigators to maximize FEA accuracy without the current runtime penalty.
Collapse
|
17
|
Katz Y, Dahan G, Sosna J, Shelef I, Cherniavsky E, Yosibash Z. Scanner influence on the mechanical response of QCT-based finite element analysis of long bones. J Biomech 2019; 86:149-159. [DOI: 10.1016/j.jbiomech.2019.01.049] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 01/03/2019] [Accepted: 01/30/2019] [Indexed: 01/30/2023]
|
18
|
Falcinelli C, Di Martino A, Gizzi A, Vairo G, Denaro V. Mechanical behavior of metastatic femurs through patient-specific computational models accounting for bone-metastasis interaction. J Mech Behav Biomed Mater 2019; 93:9-22. [PMID: 30738327 DOI: 10.1016/j.jmbbm.2019.01.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 01/23/2019] [Accepted: 01/27/2019] [Indexed: 12/21/2022]
Abstract
This paper proposes a computational model based on a finite-element formulation for describing the mechanical behavior of femurs affected by metastatic lesions. A novel geometric/constitutive description is introduced by modelling healthy bone and metastases via a linearly poroelastic constitutive approach. A Gaussian-shaped graded transition of material properties between healthy and metastatic tissues is prescribed, in order to account for the bone-metastasis interaction. Loading-induced failure processes are simulated by implementing a progressive damage procedure, formulated via a quasi-static displacement-driven incremental approach, and considering both a stress- and a strain-based failure criterion. By addressing a real clinical case, left and right patient-specific femur models are geometrically reconstructed via an ad-hoc imaging procedure and embedding multiple distributions of metastatic lesions along femurs. Significant differences in fracture loads, fracture mechanisms, and damage patterns, are highlighted by comparing the proposed constitutive description with a purely elastic formulation, where the metastasis is treated as a pseudo-healthy tissue or as a void region. Proposed constitutive description allows to capture stress/strain localization mechanisms within the metastatic tissue, revealing the model capability in describing possible strain-induced mechano-biological stimuli driving onset and evolution of the lesion. The proposed approach opens towards the definition of effective computational strategies for supporting clinical decision and treatments regarding metastatic femurs, contributing also to overcome some limitations of actual standards and procedures.
Collapse
Affiliation(s)
- Cristina Falcinelli
- Department of Engineering, Campus Bio-Medico University of Rome, Italy; Department of Civil Engineering & Computer Science, University of Rome "Tor Vergata", Italy
| | - Alberto Di Martino
- Department of Orthopaedics and Trauma Surgery, Campus Bio-Medico University of Rome, Italy; Sideny Kimmel Medical College, Thomas Jefferson University (SKMC), Philadelphia, USA
| | - Alessio Gizzi
- Department of Engineering, Campus Bio-Medico University of Rome, Italy
| | - Giuseppe Vairo
- Department of Civil Engineering & Computer Science, University of Rome "Tor Vergata", Italy.
| | - Vincenzo Denaro
- Department of Orthopaedics and Trauma Surgery, Campus Bio-Medico University of Rome, Italy
| |
Collapse
|
19
|
Katz Y, Lubovsky O, Yosibash Z. Patient-specific finite element analysis of femurs with cemented hip implants. Clin Biomech (Bristol, Avon) 2018; 58:74-89. [PMID: 30053643 DOI: 10.1016/j.clinbiomech.2018.06.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 06/19/2018] [Accepted: 06/22/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Over 1.6 million hip replacements are performed annually in Organisation for Economic Cooperation and Development countries, half of which involve cemented implants. Quantitative computer tomography based finite element methods may be used to assess the change in strain field in a femur following such a hip replacement, and thus determine a patient-specific optimal implant. A combined experimental-computational study on fresh frozen human femurs with different cemented implants is documented, aimed at verifying and validating the methods. METHODS Ex-vivo experiments on four fresh-frozen human femurs were conducted. Femurs were scanned, fractured in a stance position loading, and thereafter implanted with four different prostheses. All femurs were reloaded in stance positions at three different inclination angles while recording strains on bones' and prosthesis' surfaces. High-order FE models of the intact and implanted femurs were generated based on the computer tomography scans and X-ray radiographs. The models were virtually loaded mimicking the experimental conditions and FE results were compared to experimental observations. FINDINGS Strains predicted by finite element analyses in all four femurs were in excellent correlation with experimental observations FE = 1.01 × EXP - 0.07,R2 = 0.976, independent of implant's type, loading angle and fracture location. INTERPRETATION Computer tomography based finite element models can reliably determine strains on femur surface and on inserted implants at the contact with the cement. This allows to investigate suitable norms to rank implants for a patient-specific femur so to minimize changes in strain patterns in the operated femur.
Collapse
Affiliation(s)
- Yekutiel Katz
- School of Mechanical Engineering, Faculty of Engineering, Tel-Aviv University, Ramat-Aviv, Israel
| | - Omri Lubovsky
- Department of Orthopedic Surgery, Barzilai Medical Center, Ashqelon, Israel
| | - Zohar Yosibash
- School of Mechanical Engineering, Faculty of Engineering, Tel-Aviv University, Ramat-Aviv, Israel.
| |
Collapse
|
20
|
Marcián P, Wolff J, Horáčková L, Kaiser J, Zikmund T, Borák L. Micro finite element analysis of dental implants under different loading conditions. Comput Biol Med 2018; 96:157-165. [PMID: 29587150 DOI: 10.1016/j.compbiomed.2018.03.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/16/2018] [Accepted: 03/16/2018] [Indexed: 11/29/2022]
Abstract
Osseointegration is paramount for the longevity of dental implants and is significantly influenced by biomechanical stimuli. The aim of the present study was to assess the micro-strain and displacement induced by loaded dental implants at different stages of osseointegration using finite element analysis (FEA). Computational models of two mandible segments with different trabecular densities were constructed using microCT data. Three different implant loading directions and two osseointegration stages were considered in the stress-strain analysis of the bone-implant assembly. The bony segments were analyzed using two approaches. The first approach was based on Mechanostat strain intervals and the second approach was based on tensile/compression yield strains. The results of this study revealed that bone surrounding dental implants is critically strained in cases when only a partial osseointegration is present and when an implant is loaded by buccolingual forces. In such cases, implants also encounter high stresses. Displacements of partially-osseointegrated implant are significantly larger than those of fully-osseointegrated implants. It can be concluded that the partial osseointegration is a potential risk in terms of implant longevity.
Collapse
Affiliation(s)
- Petr Marcián
- Institute of Solid Mechanics, Mechatronics and Biomechanics, Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic.
| | - Jan Wolff
- Department of Oral and Maxillofacial Surgery/Oral Pathology and 3D Innovation Lab, VU University Medical Center, Amsterdam, The Netherlands
| | - Ladislava Horáčková
- Department of Anatomy, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jozef Kaiser
- X-ray Micro CT and Nano CT Research Group, CEITEC - Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic
| | - Tomáš Zikmund
- X-ray Micro CT and Nano CT Research Group, CEITEC - Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic
| | - Libor Borák
- Institute of Solid Mechanics, Mechatronics and Biomechanics, Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic
| |
Collapse
|
21
|
Ramos-Infante SJ, Pérez MA. In vitro and in silico characterization of open-cell structures of trabecular bone. Comput Methods Biomech Biomed Engin 2017; 20:1562-1570. [DOI: 10.1080/10255842.2017.1390086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S. J. Ramos-Infante
- M2BE-Multiscale in Mechanical and Biological Engineering, Instituto de Investigación en Ingeniería de Aragón (I3A), Universidad de Zaragoza Campus Río Ebro, Zaragoza, Spain
| | - M. A. Pérez
- M2BE-Multiscale in Mechanical and Biological Engineering, Instituto de Investigación en Ingeniería de Aragón (I3A), Universidad de Zaragoza Campus Río Ebro, Zaragoza, Spain
| |
Collapse
|
22
|
Faisal TR, Luo Y. Study of the variations of fall induced hip fracture risk between right and left femurs using CT-based FEA. Biomed Eng Online 2017; 16:116. [PMID: 28974207 PMCID: PMC5627442 DOI: 10.1186/s12938-017-0407-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 09/22/2017] [Indexed: 01/23/2023] Open
Abstract
Background Hip fracture of elderly people—suffering from osteoporosis—is a severe public health concern, which can be reduced by providing a prior assessment of hip fracture risk. Image-based finite element analysis (FEA) has been considered an effective computational tool to assess the hip fracture risk. Considering the femoral neck region is the weakest, fracture risk indicators (FRI) are evaluated for both single-legged stance and sideways fall configurations and are compared between left and right femurs of each subject. Quantitative Computed Tomography (QCT) scan datasets of thirty anonymous patients’ left and right femora have been considered for the FE models, which have been simulated with an equal magnitude of load applied to the aforementioned configurations. The requirement of bilateral hip assessment in predicting the fracture risk has been explored in this study. Results Comparing the sideways fall and single-legged stance, the FRI varies by 64 to 74% at the superior aspects and by 14 to 19% at the inferior surfaces of both the femora. The results of this in vivo analysis clearly substantiate that the fracture is expected to initiate at the superior surface of femoral neck region if a patient falls from his/her standing height. The distributions of FRI between the femurs vary considerably, and the variability is significant at the superior aspects. The p value (= 0.02) obtained from paired sample t-Test yields p value ≤ 0.05, which shows the evidence of variability of the FRI distribution between left and right femurs. Moreover, the comparison of FRIs between the left and right femur of men and women shows that women are more susceptible to hip fracture than men. Conclusions The results and statistical variation clearly signify a need for bilateral hip scanning in predicting hip fracture risk, which is clinically conducted, at present, based on one hip chosen randomly and may lead to inaccurate fracture prediction. This study, although preliminary, may play a crucial role in assessing the hip fractures of the geriatric population and thereby, reducing the cost of treatment by taking predictive measure.
Collapse
Affiliation(s)
- Tanvir R Faisal
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.,Legs + Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, 60610, USA
| | - Yunhua Luo
- Department of Mechanical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
| |
Collapse
|
23
|
Understanding Hip Fracture by QCT-Based Finite Element Modeling. J Med Biol Eng 2017. [DOI: 10.1007/s40846-017-0266-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
24
|
Lee CH, Landham PR, Eastell R, Adams MA, Dolan P, Yang L. Development and validation of a subject-specific finite element model of the functional spinal unit to predict vertebral strength. Proc Inst Mech Eng H 2017; 231:821-830. [DOI: 10.1177/0954411917708806] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Chu-Hee Lee
- The Mellanby Centre for Bone Research, The University of Sheffield, Sheffield, UK
| | | | - Richard Eastell
- The Mellanby Centre for Bone Research, The University of Sheffield, Sheffield, UK
- INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK
| | - Michael A Adams
- Centre for Applied Anatomy, University of Bristol, Bristol, UK
| | - Patricia Dolan
- Centre for Applied Anatomy, University of Bristol, Bristol, UK
| | - Lang Yang
- The Mellanby Centre for Bone Research, The University of Sheffield, Sheffield, UK
- INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK
| |
Collapse
|
25
|
Abstract
Beyond bone mineral density (BMD), bone quality designates the mechanical integrity of bone tissue. In vivo images based on X-ray attenuation, such as CT reconstructions, provide size, shape, and local BMD distribution and may be exploited as input for finite element analysis (FEA) to assess bone fragility. Further key input parameters of FEA are the material properties of bone tissue. This review discusses the main determinants of bone mechanical properties and emphasizes the added value, as well as the important assumptions underlying finite element analysis. Bone tissue is a sophisticated, multiscale composite material that undergoes remodeling but exhibits a rather narrow band of tissue mineralization. Mechanically, bone tissue behaves elastically under physiologic loads and yields by cracking beyond critical strain levels. Through adequate cell-orchestrated modeling, trabecular bone tunes its mechanical properties by volume fraction and fabric. With proper calibration, these mechanical properties may be incorporated in quantitative CT-based finite element analysis that has been validated extensively with ex vivo experiments and has been applied increasingly in clinical trials to assess treatment efficacy against osteoporosis.
Collapse
Affiliation(s)
- Dieter H Pahr
- Institute of Lightweight Design and Structural Biomechanics, Vienna University of Technology, Vienna, Austria
| | - Philippe K Zysset
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland.
| |
Collapse
|
26
|
Faisal TR, Luo Y. Study of stress variations in single-stance and sideways fall using image-based finite element analysis. Biomed Mater Eng 2016; 27:1-14. [PMID: 27175463 DOI: 10.3233/bme-161563] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Image-based finite element analysis (FEA) has been considered an effective computational tool to predict hip fracture risk. The patient specific FEA gives an insight into the inclusive effect of three-dimensional (3D) complex bone geometry, and the distribution of inhomogeneous isotropic material properties in conjunction with loading conditions. The neck region of a femur is primarily the weakest in which fracture is likely to happen, when someone falls. A sideways fall results in the development of greater tensile and compressive stresses, respectively, in the inferior and superior aspects of the femoral neck, whereas the state of stress is reversed in usual gait or stance configuration. Herein, the variations of stresses have been investigated at the femoral neck region considering both single-stance and sideways fall. Finite element models of ten human femora have been generated using Quantitative Computed Tomography (QCT) scan datasets and have been simulated with an equal magnitude of load applied to the aforementioned configurations. Fracture risk indicator, defined as the ratio of the maximum compressive or tensile stress computed at the superior and inferior surfaces to the corresponding yield stress, has been used in this work to measure the variations of fracture risk between single-stance and sideways fall. The average variations of the fracture risk indicators between the fall and stance are at least 24.3% and 8% at the superior and inferior surfaces, respectively. The differences may interpret why sideways fall is more dangerous for the elderly people, causing hip fracture.
Collapse
Affiliation(s)
- Tanvir R Faisal
- Department of Mechanical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB R3T 2N2, Canada. E-mails: ,
| | - Yunhua Luo
- Department of Mechanical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB R3T 2N2, Canada. E-mails: ,
| |
Collapse
|
27
|
Zysset P, Pahr D, Engelke K, Genant HK, McClung MR, Kendler DL, Recknor C, Kinzl M, Schwiedrzik J, Museyko O, Wang A, Libanati C. Comparison of proximal femur and vertebral body strength improvements in the FREEDOM trial using an alternative finite element methodology. Bone 2015; 81:122-130. [PMID: 26141837 DOI: 10.1016/j.bone.2015.06.025] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 06/23/2015] [Accepted: 06/29/2015] [Indexed: 01/15/2023]
Abstract
Denosumab reduced the incidence of new fractures in postmenopausal women with osteoporosis by 68% at the spine and 40% at the hip over 36 months compared with placebo in the FREEDOM study. This efficacy was supported by improvements from baseline in vertebral (18.2%) strength in axial compression and femoral (8.6%) strength in sideways fall configuration at 36 months, estimated in Newtons by an established voxel-based finite element (FE) methodology. Since FE analyses rely on the choice of meshes, material properties, and boundary conditions, the aim of this study was to independently confirm and compare the effects of denosumab on vertebral and femoral strength during the FREEDOM trial using an alternative smooth FE methodology. Unlike the previous FE study, effects on femoral strength in physiological stance configuration were also examined. QCT data for the proximal femur and two lumbar vertebrae were analyzed by smooth FE methodology at baseline, 12, 24, and 36 months for 51 treated (denosumab) and 47 control (placebo) subjects. QCT images were segmented and converted into smooth FE models to compute bone strength. L1 and L2 vertebral bodies were virtually loaded in axial compression and the proximal femora in both fall and stance configurations. Denosumab increased vertebral body strength by 10.8%, 14.0%, and 17.4% from baseline at 12, 24, and 36 months, respectively (p<0.0001). Denosumab also increased femoral strength in the fall configuration by 4.3%, 5.1%, and 7.2% from baseline at 12, 24, and 36 months, respectively (p<0.0001). Similar improvements were observed in the stance configuration with increases of 4.2%, 5.2%, and 5.2% from baseline (p≤0.0007). Differences between the increasing strengths with denosumab and the decreasing strengths with placebo were significant starting at 12 months (vertebral and femoral fall) or 24 months (femoral stance). Using an alternative smooth FE methodology, we confirmed the significant improvements in vertebral body and proximal femur strength previously observed with denosumab. Estimated increases in strength with denosumab and decreases with placebo were highly consistent between both FE techniques.
Collapse
Affiliation(s)
| | - Dieter Pahr
- Vienna University of Technology, Vienna, Austria
| | - Klaus Engelke
- University of Erlangen, Erlangen, Germany and Synarc Germany, Hamburg, Germany
| | | | | | | | | | | | | | - Oleg Museyko
- University of Erlangen-Nuremberg, Erlangen-Nuremberg, Germany
| | | | | |
Collapse
|
28
|
Bettamer A, Hambli R, Allaoui S, Almhdie-Imjabber A. Using visual image measurements to validate a novel finite element model of crack propagation and fracture patterns of proximal femur. COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING-IMAGING AND VISUALIZATION 2015. [DOI: 10.1080/21681163.2015.1079505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
29
|
VAN DEN MUNCKHOF SVEN, NIKOOYAN ALIASADI, ZADPOOR AMIRABBAS. ASSESSMENT OF OSTEOPOROTIC FEMORAL FRACTURE RISK: FINITE ELEMENT METHOD AS A POTENTIAL REPLACEMENT FOR CURRENT CLINICAL TECHNIQUES. J MECH MED BIOL 2015. [DOI: 10.1142/s0219519415300033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Femoral fracture risk prediction is a necessary step preceding effective pharmacological intervention or pre-operative planning. Current clinical methods for fracture risk prediction rely on 2D imaging methods and have limited predictive value. Researchers are therefore trying to find improved methods for fracture prediction. During last few decades, many studies have focused on integration of 3D imaging techniques and the finite element (FE) method to improve the accuracy of fracture assessment techniques. In this paper, we review the recent advances in FE and other techniques for predicting the risk of femoral fractures. Based on a number of selected studies, the different steps that are involved in generation of patient-specific FE models are reviewed with particular emphasis on the fracture criteria. The inaccuracies that might arise due to the imperfections of the involved steps are also discussed. It is concluded that compared to image- and geometry-based techniques, FE is a more promising approach for prediction of fracture loads. However, certain technological advancements in FE modeling protocols are required before FE modeling can be recruited in clinical settings.
Collapse
Affiliation(s)
- SVEN VAN DEN MUNCKHOF
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft 2628 CD, The Netherlands
| | - ALI ASADI NIKOOYAN
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft 2628 CD, The Netherlands
- Department of Integrative Physiology, University of Colorado, Boulder, CO 80309, USA
| | - AMIR ABBAS ZADPOOR
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft 2628 CD, The Netherlands
| |
Collapse
|
30
|
Liebl H, Garcia EG, Holzner F, Noel PB, Burgkart R, Rummeny EJ, Baum T, Bauer JS. In-vivo assessment of femoral bone strength using Finite Element Analysis (FEA) based on routine MDCT imaging: a preliminary study on patients with vertebral fractures. PLoS One 2015; 10:e0116907. [PMID: 25723187 PMCID: PMC4344329 DOI: 10.1371/journal.pone.0116907] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 12/16/2014] [Indexed: 01/26/2023] Open
Abstract
Purpose To experimentally validate a non-linear finite element analysis (FEA) modeling approach assessing in-vitro fracture risk at the proximal femur and to transfer the method to standard in-vivo multi-detector computed tomography (MDCT) data of the hip aiming to predict additional hip fracture risk in subjects with and without osteoporosis associated vertebral fractures using bone mineral density (BMD) measurements as gold standard. Methods One fresh-frozen human femur specimen was mechanically tested and fractured simulating stance and clinically relevant fall loading configurations to the hip. After experimental in-vitro validation, the FEA simulation protocol was transferred to standard contrast-enhanced in-vivo MDCT images to calculate individual hip fracture risk each for 4 subjects with and without a history of osteoporotic vertebral fractures matched by age and gender. In addition, FEA based risk factor calculations were compared to manual femoral BMD measurements of all subjects. Results In-vitro simulations showed good correlation with the experimentally measured strains both in stance (R2 = 0.963) and fall configuration (R2 = 0.976). The simulated maximum stress overestimated the experimental failure load (4743 N) by 14.7% (5440 N) while the simulated maximum strain overestimated by 4.7% (4968 N). The simulated failed elements coincided precisely with the experimentally determined fracture locations. BMD measurements in subjects with a history of osteoporotic vertebral fractures did not differ significantly from subjects without fragility fractures (femoral head: p = 0.989; femoral neck: p = 0.366), but showed higher FEA based risk factors for additional incident hip fractures (p = 0.028). Conclusion FEA simulations were successfully validated by elastic and destructive in-vitro experiments. In the subsequent in-vivo analyses, MDCT based FEA based risk factor differences for additional hip fractures were not mirrored by according BMD measurements. Our data suggests, that MDCT derived FEA models may assess bone strength more accurately than BMD measurements alone, providing a valuable in-vivo fracture risk assessment tool.
Collapse
Affiliation(s)
- Hans Liebl
- Department of Radiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany
| | - Eduardo Grande Garcia
- Department of Radiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany; Department of Orthopaedic Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany
| | - Fabian Holzner
- Department of Orthopaedic Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany
| | - Peter B Noel
- Department of Radiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany
| | - Rainer Burgkart
- Department of Orthopaedic Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany
| | - Ernst J Rummeny
- Department of Radiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany
| | - Thomas Baum
- Department of Radiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany
| | - Jan S Bauer
- Section of Neuroradiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany
| |
Collapse
|
31
|
Granke M, Grimal Q, Parnell WJ, Raum K, Gerisch A, Peyrin F, Saïed A, Laugier P. To what extent can cortical bone millimeter-scale elasticity be predicted by a two-phase composite model with variable porosity? Acta Biomater 2015; 12:207-215. [PMID: 25462527 DOI: 10.1016/j.actbio.2014.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 09/01/2014] [Accepted: 10/09/2014] [Indexed: 10/24/2022]
Abstract
An evidence gap exists in fully understanding and reliably modeling the variations in elastic anisotropy that are observed at the millimeter scale in human cortical bone. The porosity (pore volume fraction) is known to account for a large part, but not all, of the elasticity variations. This effect may be modeled by a two-phase micromechanical model consisting of a homogeneous matrix pervaded by cylindrical pores. Although this model has been widely used, it lacks experimental validation. The aim of the present work is to revisit experimental data (elastic coefficients, porosity) previously obtained from 21 cortical bone specimens from the femoral mid-diaphysis of 10 donors and test the validity of the model by proposing a detailed discussion of its hypotheses. This includes investigating to what extent the experimental uncertainties, pore network modeling, and matrix elastic properties influence the model's predictions. The results support the validity of the two-phase model of cortical bone which assumes that the essential source of variations of elastic properties at the millimeter-scale is the volume fraction of vascular porosity. We propose that the bulk of the remaining discrepancies between predicted stiffness coefficients and experimental data (RMSE between 6% and 9%) is in part due to experimental errors and part due to small variations of the extravascular matrix properties. More significantly, although most of the models that have been proposed for cortical bone were based on several homogenization steps and a large number of variable parameters, we show that a model with a single parameter, namely the volume fraction of vascular porosity, is a suitable representation for cortical bone. The results could provide a guide to build specimen-specific cortical bone models. This will be of interest to analyze the structure-function relationship in bone and to design bone-mimicking materials.
Collapse
|
32
|
Yosibash Z, Plitman Mayo R, Dahan G, Trabelsi N, Amir G, Milgrom C. Predicting the stiffness and strength of human femurs with real metastatic tumors. Bone 2014; 69:180-90. [PMID: 25284156 DOI: 10.1016/j.bone.2014.09.022] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/25/2014] [Accepted: 09/26/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Predicting patient specific risk of fracture in femurs with metastatic tumors and the need for surgical intervention are of major clinical importance. Recent patient-specific high-order finite element methods (p-FEMs) based on CT-scans demonstrated accurate results for healthy femurs, so that their application to metastatic affected femurs is considered herein. METHODS Radiographs of fresh frozen proximal femur specimens from donors that died of cancer were examined, and seven pairs with metastatic tumor were identified. These were CT-scanned, instrumented by strain-gauges and loaded in stance position at three inclination angles. Finally the femurs were loaded until fracture that usually occurred at the neck. Histopathology was performed to determine whether metastatic tumors are present at fractured surfaces. Following each experiment p-FE models were created based on the CT-scans mimicking the mechanical experiments. The predicted displacements, strains and yield loads were compared to experimental observations. RESULTS The predicted strains and displacements showed an excellent agreement with the experimental observations with a linear regression slope of 0.95 and a coefficient of regression R(2)=0.967. A good correlation was obtained between the predicted yield load and the experimental observed yield, with a linear regression slope of 0.80 and a coefficient of regression R(2)=0.78. DISCUSSION CT-based patient-specific p-FE models of femurs with real metastatic tumors were demonstrated to predict the mechanical response very well. A simplified yield criterion based on the computation of principal strains was also demonstrated to predict the yield force in most of the cases, especially for femurs that failed at small loads. In view of the limited capabilities to predict risk of fracture in femurs with metastatic tumors used nowadays, the p-FE methodology validated herein may be very valuable in making clinical decisions.
Collapse
Affiliation(s)
- Zohar Yosibash
- Department of Mechanical Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Romina Plitman Mayo
- Department of Mechanical Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gal Dahan
- Department of Mechanical Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nir Trabelsi
- Department of Mechanical Engineering, Shamoon College of Engineering, Beer-Sheva, Israel
| | - Gail Amir
- Department of Pathology, Hadassah University Hospital, Jerusalem, Israel
| | - Charles Milgrom
- Department of Orthopaedics, Hadassah University Hospital, Jerusalem, Israel
| |
Collapse
|
33
|
Mootanah R, Imhauser CW, Reisse F, Carpanen D, Walker RW, Koff MF, Lenhoff MW, Rozbruch SR, Fragomen AT, Dewan Z, Kirane YM, Cheah K, Dowell JK, Hillstrom HJ. Development and validation of a computational model of the knee joint for the evaluation of surgical treatments for osteoarthritis. Comput Methods Biomech Biomed Engin 2014; 17:1502-17. [PMID: 24786914 PMCID: PMC4047624 DOI: 10.1080/10255842.2014.899588] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A three-dimensional (3D) knee joint computational model was developed and validated to predict knee joint contact forces and pressures for different degrees of malalignment. A 3D computational knee model was created from high-resolution radiological images to emulate passive sagittal rotation (full-extension to 65°-flexion) and weight acceptance. A cadaveric knee mounted on a six-degree-of-freedom robot was subjected to matching boundary and loading conditions. A ligament-tuning process minimised kinematic differences between the robotically loaded cadaver specimen and the finite element (FE) model. The model was validated by measured intra-articular force and pressure measurements. Percent full scale error between EE-predicted and in vitro-measured values in the medial and lateral compartments were 6.67% and 5.94%, respectively, for normalised peak pressure values, and 7.56% and 4.48%, respectively, for normalised force values. The knee model can accurately predict normalised intra-articular pressure and forces for different loading conditions and could be further developed for subject-specific surgical planning.
Collapse
Affiliation(s)
- R Mootanah
- a Medical Engineering Research Group, Faculty of Science and Technology, Anglia Ruskin University , Chelmsford, Essex , UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
How accurately can we predict the fracture load of the proximal femur using finite element models? Clin Biomech (Bristol, Avon) 2014; 29:373-80. [PMID: 24485865 DOI: 10.1016/j.clinbiomech.2013.12.018] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 12/30/2013] [Accepted: 12/31/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Current clinical methods for fracture prediction rely on two-dimensional imaging methods such as dual-energy X-ray absorptiometry and have limited predictive value. Several researchers have tried to integrate three-dimensional imaging techniques with the finite element (FE) method to improve the accuracy of fracture predictions. Before FE models could be used in clinical settings, a thorough validation of their accuracy is required. In this paper, we try to evaluate the current state of accuracy of subject-specific FE models that are used for prediction of the fracture load of proximal femora. METHODS All the studies that have used FE for prediction of fracture load and have compared the predicted fracture load with experimentally measured fracture loads in vitro are identified through a systematic search of the literature. A quantitative analysis of the results of those studies has been carried out to determine the absolute prediction error, percentage error, and linear correlations between predicted and measured fracture loads. FINDINGS The reported coefficients of determination (R(2)) vary between 0.773 and 0.96 while the percentage error in prediction of fracture load varies between 5 and 46% with most studies reporting percentage errors between 10 and 20%. INTERPRETATION We conclude that FE models, which are currently used only experimentally, are in general more accurate than clinically used fracture risk assessment techniques. However, the accuracy of FE models depends on the details of their modeling methodologies. Therefore, modeling procedures need to be optimized and standardized before FE could be used in clinical settings.
Collapse
|
35
|
Luisier B, Dall'Ara E, Pahr D. Orthotropic HR-pQCT-based FE models improve strength predictions for stance but not for side-way fall loading compared to isotropic QCT-based FE models of human femurs. J Mech Behav Biomed Mater 2014; 32:287-299. [DOI: 10.1016/j.jmbbm.2014.01.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 01/09/2014] [Accepted: 01/13/2014] [Indexed: 11/25/2022]
|
36
|
Hambli R. 3D finite element simulation of human proximal femoral fracture under quasi-static load. ACTA ACUST UNITED AC 2014. [DOI: 10.12989/aba.2013.1.1.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
37
|
Trabelsi N, Milgrom C, Yosibash Z. Patient-specific FE analyses of metatarsal bones with inhomogeneous isotropic material properties. J Mech Behav Biomed Mater 2014; 29:177-89. [DOI: 10.1016/j.jmbbm.2013.08.030] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 08/18/2013] [Accepted: 08/31/2013] [Indexed: 11/24/2022]
|
38
|
A Robust 3D Finite Element Simulation of Human Proximal Femur Progressive Fracture Under Stance Load with Experimental Validation. Ann Biomed Eng 2013; 41:2515-27. [DOI: 10.1007/s10439-013-0864-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 07/06/2013] [Indexed: 01/22/2023]
|
39
|
Yosibash Z, Katz A, Milgrom C. Toward verified and validated FE simulations of a femur with a cemented hip prosthesis. Med Eng Phys 2013; 35:978-87. [DOI: 10.1016/j.medengphy.2012.09.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 08/24/2012] [Accepted: 09/13/2012] [Indexed: 11/28/2022]
|
40
|
Affiliation(s)
- M. Gföhler
- Faculty of Mechanical and Industrial Engineering; University of Technology; Vienna; Austria
| | - C. Peham
- Companion Animals and Horses; University of Veterinary Medicine; Vienna; Austria
| |
Collapse
|
41
|
Basafa E, Armiger RS, Kutzer MD, Belkoff SM, Mears SC, Armand M. Patient-specific finite element modeling for femoral bone augmentation. Med Eng Phys 2013; 35:860-5. [PMID: 23375663 DOI: 10.1016/j.medengphy.2013.01.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 12/22/2012] [Accepted: 01/05/2013] [Indexed: 11/15/2022]
Abstract
The aim of this study was to provide a fast and accurate finite element (FE) modeling scheme for predicting bone stiffness and strength suitable for use within the framework of a computer-assisted osteoporotic femoral bone augmentation surgery system. The key parts of the system, i.e. preoperative planning and intraoperative assessment of the augmentation, demand the finite element model to be solved and analyzed rapidly. Available CT scans and mechanical testing results from nine pairs of osteoporotic femur bones, with one specimen from each pair augmented by polymethylmethacrylate (PMMA) bone cement, were used to create FE models and compare the results with experiments. Correlation values of R(2)=0.72-0.95 were observed between the experiments and FEA results which, combined with the fast model convergence (~3 min for ~250,000 degrees of freedom), makes the presented modeling approach a promising candidate for the intended application of preoperative planning and intraoperative assessment of bone augmentation surgery.
Collapse
Affiliation(s)
- Ehsan Basafa
- Laboratory for Computational Sensing & Robotics, Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA.
| | | | | | | | | | | |
Collapse
|
42
|
Juszczyk MM, Cristofolini L, Salvà M, Zani L, Schileo E, Viceconti M. Accurate in vitro identification of fracture onset in bones: failure mechanism of the proximal human femur. J Biomech 2012; 46:158-64. [PMID: 23218142 DOI: 10.1016/j.jbiomech.2012.11.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Revised: 10/05/2012] [Accepted: 11/03/2012] [Indexed: 11/27/2022]
Abstract
Bone fractures have extensively been investigated, especially for the proximal femur. While failure load can easily be recorded, and the fracture surface is readily accessible, identification of the point of fracture initiation is difficult. Accurate location of fracture initiation is extremely important to understand the multi-scale determinants of bone fracture. In this study, a recently developed technique based on electro-conductive lines was applied to the proximal femoral metaphysis to elucidate the fracture mechanism. Eight cadaveric femurs were prepared with 15-20 electro-conductive lines (crack-grid) covering the proximal region. The crack-grid was connected to a dedicated data-logger that monitored electrical continuity of each line at 700 kHz. High-speed videos (12,000 frames/s, 0.1-0.2 mm pixel size) of the destructive tests were acquired. Most crack-grid-lines failed in a time-span of 0.08-0.50 ms, which was comparable to that identified in the high-speed videos, and consistent with previous video recordings. However, on all specimens 1-3 crack-grid-lines failed significantly earlier (2-200 ms) than the majority of the crack-grid-lines. The first crack-grid-line to fail was always the closest one to the point of fracture initiation identified in the high-speed videos (superior-lateral neck region). Then the crack propagated simultaneously, at comparable velocity on the anterior and posterior sides of the neck. Such a failure pattern has never been observed before, as spatial resolution of the high-speed videos prevented from observing the initial opening of a crack. This mechanism (fracture onset, time-lag, followed by catastrophic failure) can be explained with a transfer of load to the internal trabecular structure caused by the initial fracture of the thin cortical shell. This study proves the suitability of the crack-grid method to investigate bone fractures associated to tensile stress. The crack-grid method enables significantly faster sampling than high-speed cameras. The present findings elucidate some aspects of the failure mechanism of the proximal human femoral metaphysis.
Collapse
|
43
|
A quasi-brittle continuum damage finite element model of the human proximal femur based on element deletion. Med Biol Eng Comput 2012. [DOI: 10.1007/s11517-012-0986-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
44
|
San Antonio T, Ciaccia M, Müller-Karger C, Casanova E. Orientation of orthotropic material properties in a femur FE model: A method based on the principal stresses directions. Med Eng Phys 2012; 34:914-9. [DOI: 10.1016/j.medengphy.2011.10.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 10/20/2011] [Accepted: 10/22/2011] [Indexed: 10/15/2022]
|
45
|
Wille H, Rank E, Yosibash Z. Prediction of the mechanical response of the femur with uncertain elastic properties. J Biomech 2012; 45:1140-8. [DOI: 10.1016/j.jbiomech.2012.02.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Revised: 01/31/2012] [Accepted: 02/02/2012] [Indexed: 10/28/2022]
|
46
|
Relationships Between Femoral Strength Evaluated by Nonlinear Finite Element Analysis and BMD, Material Distribution and Geometric Morphology. Ann Biomed Eng 2012; 40:1575-85. [DOI: 10.1007/s10439-012-0514-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 01/10/2012] [Indexed: 12/29/2022]
|
47
|
Accuracy of finite element predictions in sideways load configurations for the proximal human femur. J Biomech 2012; 45:394-9. [DOI: 10.1016/j.jbiomech.2011.10.019] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 10/11/2011] [Accepted: 10/13/2011] [Indexed: 11/24/2022]
|
48
|
Juszczyk MM, Cristofolini L, Viceconti M. The human proximal femur behaves linearly elastic up to failure under physiological loading conditions. J Biomech 2011; 44:2259-66. [DOI: 10.1016/j.jbiomech.2011.05.038] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 05/26/2011] [Accepted: 05/27/2011] [Indexed: 11/26/2022]
|
49
|
Trabelsi N, Yosibash Z. Patient-Specific Finite-Element Analyses of the Proximal Femur with Orthotropic Material Properties Validated by Experiments. J Biomech Eng 2011; 133:061001. [DOI: 10.1115/1.4004180] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Abstract
Patient-specific high order finite-element (FE) models of human femurs based on quantitative computer tomography (QCT) with inhomogeneous orthotropic and isotropic material properties are addressed. The point-wise orthotropic properties are determined by a micromechanics (MM) based approach in conjunction with experimental observations at the osteon level, and two methods for determining the material trajectories are proposed (along organs outer surface, or along principal strains). QCT scans on four fresh-frozen human femurs were performed and high-order FE models were generated with either inhomogeneous MM-based orthotropic or empirically determined isotropic properties. In vitro experiments were conducted on the femurs by applying a simple stance position load on their head, recording strains on femurs’ surface and head’s displacements. After verifying the FE linear elastic analyses that mimic the experimental setting for numerical accuracy, we compared the FE results to the experimental observations to identify the influence of material properties on models’ predictions. The strains and displacements computed by FE models having MM-based inhomogeneous orthotropic properties match the FE-results having empirically based isotropic properties well, and both are in close agreement with the experimental results. When only the strains in the femoral neck are being compared a more pronounced difference is noticed between the isotropic and orthotropic FE result. These results lay the foundation for applying more realistic inhomogeneous orthotropic material properties in FEA of femurs.
Collapse
Affiliation(s)
- Nir Trabelsi
- Department of Mechanical Engineering, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel
| | - Zohar Yosibash
- Department of Mechanical Engineering, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel
| |
Collapse
|
50
|
Viceconti M, Kohl P. The virtual physiological human: computer simulation for integrative biomedicine I. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2010; 368:2591-2594. [PMID: 20439263 DOI: 10.1098/rsta.2010.0096] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Marco Viceconti
- Laboratorio di Tecnologia Medica, Istituto Ortopedico Rizzoli, Bologna, Italy.
| | | |
Collapse
|