Exploiting light-based 3D-printing for the fabrication of mechanically enhanced, patient-specific aortic grafts

Despite polyester vascular grafts being routinely used in life-saving aortic aneurysm surgeries, they are less compliant than the healthy, native human aorta. This mismatch in mechanical behaviour has been associated with disruption of haemodynamics contributing to several long-term cardiovascular complications. Moreover, current fabrication approaches mean that opportunities to personalise grafts to the individual anatomical features are limited. Various modifications to graft design have been investigated to overcome such limitations; yet optimal graft functionality remains to be achieved. This study reports on the development and characterisation of an alternative vascular graft material. An alginate:PEGDA (AL:PE) interpenetrating polymer network (IPN) hydrogel has been produced with uniaxial tensile tests revealing similar strength and stiffness (0.39 ± 0.05 MPa and 1.61 ± 0.19 MPa, respectively) to the human aorta. Moreover, AL:PE tubular conduits of similar geometrical dimensions to segments of the aorta were produced, either via conventional moulding methods or stereolithography (SLA) 3D-printing. While both fabrication methods successfully demonstrated AL:PE hydrogel production, SLA 3D-printing was more easily adaptable to the fabrication of complex structures without the need of specific moulds or further post-processing. Additionally, most 3D-printed AL:PE hydrogel tubular conduits sustained, without failure, compression up to 50% their outer diameter and returned to their original shape upon load removal, thereby exhibiting promising behaviour that could withstand pulsatile pressure in vivo. Overall, these results suggest that this AL:PE IPN hydrogel formulation in combination with 3D-printing, has great potential for accelerating progress towards personalised and mechanically-matched aortic grafts.

Deficits in muscle strength are not seen following recovery from augmented primary repair of anterior cruciate ligament tears

OBJECTIVES

Anterior cruciate ligament (ACL) repair for proximal tears, where the ligament is re-attached and augmented with suture tape, can negate the need for graft harvest, thereby maintaining native anatomy. Autograft harvest has been associated with persistent deficits in lower limb muscle strength after recovery from ACL reconstruction. The aim of this study is to compare lower limb muscle strength following ACL repair and reconstruction.

METHODS

Nineteen ACL repair patients augmented with suture tape and nineteen ipsilateral semitendinosus-gracilis autograft ACL reconstruction patients (both mean 4 years postoperatively) were recruited, along with twenty healthy volunteers. Patient-reported outcome measures (PROMs) were obtained using the Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm, and Tegner scores. Maximal isometric quadriceps and hamstring strength at 90° knee flexion were measured using a fixed Myometer after a warm-up and three maximal-effort contractions.

RESULTS

Mean hamstring strength of the reconstructed legs was lower than that of healthy volunteers by 0.29 Nm/kg. The hamstring strength ratio of the operated side to the uninjured side was greater in the repair (95% ​± ​13) than in the reconstruction (81% ​± ​18) group. There were no statistically significant differences between sides for quadriceps peak torque or for hamstrings in the volunteer or repair group. PROMs scores for the reconstruction group were significantly lower than volunteers across all domains and lower than repair for KOOS activities of daily living and Lysholm scores.

CONCLUSION

Hamstring weakness seen following ACL reconstruction is not evident following ACL repair with suture tape augmentation. Strength asymmetry could contribute to re-injury risk and influence functional performance, while altered loads affect knee biomechanics and may lead to osteoarthritis progression. The absence of these deficits in the repair group demonstrates a potential benefit of this technique when used in appropriate patients.

LEVEL OF EVIDENCE

II.

Anterior cruciate ligament repair with internal brace augmentation: A systematic review

BACKGROUND

Primary repair of anterior cruciate ligament (ACL) ruptures has re-emerged as a treatment option for proximal tears, with internal brace augmentation often utilised. The aim of this study is to provide an overview of the current evidence presenting outcomes of ACL repair with internal bracing to assess the safety and efficacy of this technique.

METHODS

All studies reporting outcomes of arthroscopic primary repair of proximal ACL tears, augmented with internal bracing from 2014-2021 were included. Primary outcome was failure rate and secondary outcomes were subjective patient reported outcome measures (PROMs) and objective assessment of anteroposterior knee laxity.

RESULTS

Nine studies were included, consisting of 347 patients, mean age 32.5 years, mean minimum follow up 2 years. There were 36 failures (10.4%, CI 7.4% - 14.1%). PROMs reporting was variable across studies. KOOS, Lysholm and IKDC scores were most frequently used with mean scores > 87%. The mean Tegner and Marx scores at follow-up were 6.1 and 7.8 respectively. The mean side to side difference measured for anteroposterior knee laxity was 1.2mm.

CONCLUSIONS

This systematic review with meta-analysis shows that ACL repair with internal bracing is a safe technique for treatment of proximal ruptures, with a failure rate of 10.4%. Subjective scores and clinical laxity testing also revealed satisfactory results. This suggests that ACL repair with internal bracing should be considered as an alternative to ACL reconstruction for acute proximal tears, with the potential benefits of retained native tissue and proprioception, as well as negating the need for graft harvest.

Computer assisted orthopaedic surgery: Past, present and future

Computer technology is ubiquitous and relied upon in virtually all professional activities including neurosurgery, which is why it is surprising that it is not the case for orthopaedic surgery with fewer than 5% of surgeons using available computer technology in their procedures. In this review, we explore the evolution and background of Computer Assisted Orthopaedic Surgery (CAOS), delving into the basic principles behind the technology and the changes in the discussion on the subject throughout the years and the impact these discussions had on the field. We found evidence that industry had an important role in driving the discussion at least in knee arthroplasty-a leading field of CAOS-with the ratio between patents and publications increased from approximately 1:10 in 2004 to almost 1:3 in 2014. The adoption of CAOS is largely restrained by economics and ergonomics with sceptics challenging the accuracy and precision of navigation during the early years of CAOS moving to patient functional improvements and long term survivorship. Nevertheless, the future of CAOS remains positive with the prospect of new technologies such as improvements in image-guided surgery, enhanced navigation systems, robotics and artificial intelligence.

The assessment of instability in the osteoarthritic knee

Patient-reported instability is a common complaint amongst those with knee arthritis.

Much research has examined the assessment of self-reported instability in the knee; however, no definitive quantitative measure of instability has been developed.

This review focuses on the current literature investigating the nature of self-reported instability in the arthritic knee and discusses the possibilities of further investigation.

Cite this article: EFORT Open Rev 2019;4:70-76. DOI: 10.1302/2058-5241.4.170079

Lower limb alignment becomes more varus and hyperextended from supine to bipedal stance in asymptomatic, osteoarthritic and prosthetic neutral or varus knees

PURPOSE

Knee alignment is a fundamental measurement in the assessment, monitoring and surgical management of patients with osteoarthritis. There is a lack of data regarding how static tibiofemoral alignment varies between supine and standing conditions. This study aimed to quantify the relationship between supine and standing lower limb alignment in asymptomatic, osteoarthritic (OA) and prosthetic (TKA) knees.

METHODS

A non-invasive position capture system was used to assess knee alignment for 30 asymptomatic controls and 31 patients with OA both before and after TKA. Coronal and sagittal mechanical femorotibial angles were measured supine with the lower limb in extension and in bipedal stance. Changes between conditions were analysed using paired ttests. Vector plots of ankle centre displacement relative to the knee centre from supine to standing were produced to allow three-dimensional visualisation.

RESULTS

All groups showed a trend towards varus and extension when going from supine to standing. Mean change for asymptomatic knees was 1.2° more varus (p = 0.001) and 3.8° more extended (p < 0.001). For OA knees this was 1.1° more varus (p = 0.009) and 5.9° more extended (p < 0.001) and TKA knees 1.9° more varus (p < 0.001) and 5.6° more extended (p < 0.001).

CONCLUSION

The observed consistent changes in lower limb alignment between supine and standing positions across knee types suggests the soft tissue envelope restraining the knee may have a greater influence on dynamic alignment changes than the underlying bony deformity. This highlights the importance of quantifying soft tissue behaviour when planning, performing and evaluating alignment dependent surgical interventions of the knee. When routinely assessing any type of knee, clinicians should be aware that subtle consistent alignment changes occur under weightbearing conditions and tailor their treatments accordingly.

LEVEL OF EVIDENCE

II.

Inertial properties of the German Shepherd Dog

One of the most popular dog breeds deployed by both the police and military has been the German Shepherd yet little is known about the morphology or body segment parameters of this breed. Such measures are essential for developing biomechanical models which, in turn, may guide clinicians in developing surgical interventions, injury treatment and prevention procedures. This paper provides a complete set of body segment parameters and inertial properties for the German Shepherd. Morphometric measures and 3-dimensional inertial properties, including mass, centre of mass, moment of inertia and volume, were measured from 17 segments from 6 German Shepherd police service dog cadavers. Using whole body mass and geometric modelling, 11 regression equations were developed for predicting segment masses, and 33 equations were developed for predicting moments of inertia. Using these data, inverse dynamic analyses may be applied in future investigations of canine mechanics, guiding surgical procedures, rehabilitation and training especially for the German Shepherd breed but potentially for other breeds too.

A numerical investigation and experimental verification of size effects in loaded bovine cortical bone

In this paper, we present 2- and 3-dimensional finite element-based numerical models of loaded bovine cortical bone that explicitly incorporate the dominant microstructural feature: the vascular channel or Haversian canal system. The finite element models along with the representation of the microstructure within them are relatively simple: 2-dimensional models, consisting of a structured mesh of linear elastic planar elements punctuated by a periodic distribution of circular voids, are used to represent beam samples of cortical bone in which the channels are orientated perpendicular to the sample major axis, while 3-dimensional models, using a corresponding mesh of equivalent solid elements, represent those samples in which the canals are aligned with the axis. However, these models are exploited in an entirely novel approach involving the representation of material samples of different sizes and surface morphology. The numerical results obtained for the virtual material samples when loaded in bending indicate that they exhibit size effects not forecast by either classical (Cauchy) or more generalized elasticity theories. However, these effects are qualitatively consistent with those that we observed in a series of carefully conducted experiments involving the flexural testing of bone samples of different sizes. Encouraged by this qualitative agreement, we have identified appropriate model parameters, primarily void volume fraction but also void separation and matrix modulus by matching the computed size effects to those we observed experimentally. Interestingly, the parameter choices that provide the most suitable match of these effects broadly concur with those we actually observed in cortical bone.

Development and mechanical characterisation of self-compressed collagen gels

Collagen gels are considered a promising biomaterial for the manufacturing of tissue engineering scaffolds, however, their mechanical properties often need to be improved to enable them to provide enough mechanical support during the course of tissue regeneration process. In this paper, we present a simple self-compression technique for the improvement of the mechanical properties of collagen gels, identified by the fitting of bespoke biphasic finite element models. Radially-confined highly hydrated gels were allowed to self-compress for 18h, expelling fluid, and which were subsequently subjected to unconfined ramp-hold compression. Gels, initially of 0.2%, 0.3% and 0.4% (w/v) collagen and 13mm thickness, transformed to 2.9±0.2%, 3.2±0.3% and 3.6±0.1% (w/w) collagen and 0.45±0.06mm, 0.69±0.04mm and 0.99±0.07mm thickness. Young's moduli of the compressed gels did not increase with increasing collagen fibril density, whilst zero-strain hydraulic permeability significantly decreased from 51 to 21mm⁴/Ns. The work demonstrates that biphasic theory, applied to unconfined compression, is a highly appropriate paradigm to mechanically characterise concentrated collagen gels and that confined compression of highly hydrated gels should be further investigated to enhance gel mechanical performance.

Lower limb alignment and laxity measures before, during and after total knee arthroplasty: A prospective cohort study

BACKGROUND

This study compared knee alignment and laxity in patients before, during and after total knee arthroplasty, using methodologically similar procedures, with an aim to help inform pre-operative planning.

METHODS

Eighteen male and 13 female patients were recruited, mean age 66years (51-82) and mean body mass index of 33 (23-43). All were assessed pre- and postoperatively using a non-invasive infrared position capture system and all underwent total knee arthroplasty using a navigation system. Knee kinematic data were collected and comparisons made between preoperative clinical and intraoperative measurements for osteoarthritic knees, and between postoperative clinical and intraoperative measurements for prosthetic knees.

FINDINGS

There was no difference in unstressed coronal mechanical femoral-tibial angles for either osteoarthritic or prosthetic knees. However, for sagittal alignment the knees were in greater extension intraoperatively (osteoarthritic 5.2° p<0.001, prosthetic 7.2° p<0.001). For osteoarthritic knees, both varus and valgus stress manoeuvres had greater angular displacements intraoperatively by a mean value of 1.5° for varus (p=0.002) and 1.6° for valgus (p<0.001). For prosthetic knees, only valgus angular displacement was greater intraoperatively (0.9°, p=0.002).

INTERPRETATION

Surgeons performing total knee arthroplasties should be aware of potential differences in alignment and laxity measured under different conditions to facilitate more accurate operative planning and follow-up.

Thermal Damage Done to Bone by Burring and Sawing With and Without Irrigation in Knee Arthroplasty

BACKGROUND

Heat from bone resecting tools used in knee surgery can induce thermal osteonecrosis, potentially causing aseptic implant loosening. This study compared oscillating saws to burrs in terms of temperature generation and histologic damage. Use of irrigation to reduce bone temperature was also investigated.

METHODS

Temperatures were recorded during sawing and burring with or without irrigation (uncooled or cooled). Histologic analyses were then carried out. Differences between groups were tested statistically (α = 0.05).

RESULTS

On average, burring produced higher temperatures than sawing (P < .001). When uncooled irrigation was used, bone temperatures were significantly lower in sawed bone than in burred bone (P < .001). Irrigation lowered temperatures and thermal damage depths and increased osteocyte viability (P < .001).

CONCLUSION

These results suggest that irrigating bone during resection could prevent osteonecrosis onset.

Tensile properties of the transverse carpal ligament and carpal tunnel complex

BACKGROUND

A new sophisticated method that uses video analysis techniques together with a Maillon Rapide Delta to determine the tensile properties of the transverse carpal ligament-carpal tunnel complex has been developed.

METHODS

Six embalmed cadaveric specimens amputated at the mid-forearm and aged (mean (SD)): 82 (6.29) years were tested. The six hands were from three males (four hands) and one female (two hands). Using trigonometry and geometry the elongation and strain of the transverse carpal ligament and carpal arch were calculated. The cross-sectional area of the transverse carpal ligament was determined. Tensile properties of the transverse carpal ligament-carpal tunnel complex and Load-Displacement data were also obtained. Descriptive statistics, one-way ANOVA together with a post-hoc analysis (Tukey) and t-tests were incorporated.

FINDINGS

A transverse carpal ligament-carpal tunnel complex novel testing method has been developed. The results suggest that there were no significant differences between the original transverse carpal ligament width and transverse carpal ligament at peak elongation (P=0.108). There were significant differences between the original carpal arch width and carpal arch width at peak elongation (P=0.002). The transverse carpal ligament failed either at the mid-substance or at their bony attachments. At maximum deformation the peak load and maximum transverse carpal ligament displacements ranged from 285.74N to 1369.66N and 7.09mm to 18.55mm respectively. The transverse carpal ligament cross-sectional area mean (SD) was 27.21 (3.41)mm(2).

INTERPRETATION

Using this method the results provide useful biomechanical information and data about the tensile properties of the transverse carpal ligament-carpal tunnel complex.

On the Poisson’s ratio of the nucleus pulposus

Existing experimental data on the Poisson’s ratio of nucleus pulposus (NP) tissue is limited. This study aims to determine whether the Poisson’s ratio of NP tissue is strain-dependent, strain-rate-dependent, or varies with axial location in the disk. Thirty-two cylindrical plugs of bovine tail NP tissue were subjected to ramphold unconfined compression to 20% axial strain in 5% increments, at either 30 lm/s or 0.3 lm/s ramp speeds and the radial displacement determined using biaxial video extensometry. Following radial recoil, the true Poisson’s ratio of the solid phase of NP tissue increased linearly with increasing strain and demonstrated strain-rate dependency. The latter finding suggests that the solid matrix undergoes stress relaxation during the test. For small strains, we suggest a Poisson’s ratio of 0.125 to be used in biphasic models of the intervertebral disk

Research synthesis of recommended acetabular cup orientations for total hip arthroplasty

Total hip arthroplasty (THA) is regarded as one of the most successful surgical procedures of modern times yet continues to be associated with a small but significant complication rate. Many early failures may be associated with poor component positioning with, in particular, acetabular component orientation dependent on the subjective judgement of the surgeon. In this paper, we compare the manufacturers' instructions on acetabular cup orientation with the literature-based recommended safety zones and surgical technique, by transforming them onto a single, clinically-relevant framework in which the different reference systems, safety guidelines and current instrumentation surgical techniques can be evaluated. The observed limited consensus between results reflects ongoing uncertainty regarding the optimum acetabular component positioning. As malpositioning of the acetabular cup increases the risk of revision surgery, any ambiguity over the correct position can have a causal effect. Our analysis highlights the need for a surgical reference system which can be used to describe the position of the acetabular cup intra-operatively.

Accuracy of a freehand sculpting tool for unicondylar knee replacement

BACKGROUND

Unicondylar knee replacement is technically challenging and malalignment of the implant components is one of the factors that results in high failure rates. Surgical robotics with navigation is emerging as a potential solution to improve the accuracy of implant placement.

METHODS

The accuracy of performing unicondylar knee replacement using a freehand sculpting, semi-active robotic tool was investigated using 20 synthetic femurs and tibia. Resultant femoral and tibial implant placement was compared to the planned implant position.

RESULTS

The maximum rotational error was 3.2(o) and RMS angular error was 1.46(o) across all orientations, for both the tibia and femoral implants. The maximum translational error was 1.18 mm and the RMS translational error across all directions was 0.61 mm.

CONCLUSIONS

The freehand sculpting tool produced accurate implant placement with small errors comparable to those reported by other robotic-assistive devices on the market for unicondylar knee replacement.

Comparison of power and EMG during 6-s all-out cycling between young and older women

To investigate the effects of ageing on the neural control strategies governing sprint cycling on a friction-loaded cycle-ergometer, 10 older (aged 70-83 yr) and 8 young (aged 19-35 yr) healthy women completed seven 6-s all-out cycling trials against varying loads. Root mean square (RMS), median frequency and muscle fibre conduction velocity were determined from the vastus lateralis of the dominant limb during each pedal stroke. Peak power was 43% lower in the older group compared to the younger (p < 0.001) and was accompanied by a significantly lower RMS (p < 0.05). No differences were observed in the other electromyography (EMG) parameters between the groups (p > 0.05). ΔRMS from the first to the sixth second during each trial was found to increase significantly with the development of power output in both groups (p < 0.05). For the first time during an all-out 6-s cycle trial, it has been demonstrated that older women's lower mechanical power output was accompanied by a significantly lower RMS, which indicates a decline in either the number of active of motor units or a reduced discharge rate. Hence, changes in motor units can be regarded as a contributory factor to the decline of muscle power with advancing age. Overall, though, similar neural strategies are adopted in both younger and older populations.

Standardising the clinical assessment of coronal knee laxity

Clinical laxity tests are used for assessing knee ligament injuries and for soft tissue balancing in total knee arthroplasty. This study reports the development and validation of a quantitative technique of assessing collateral knee laxity through accurate measurement of potential variables during routine clinical examination. The hypothesis was that standardisation of a clinical stress test would result in a repeatable range of laxity measurements.

Non-invasive infrared tracking technology with kinematic registration of joint centres gave real-time measurement of both coronal and sagittal mechanical tibiofemoral alignment. Knee flexion, moment arm and magnitude of the applied force were all measured and standardised. Three clinicians then performed six knee laxity examinations on a single volunteer using a target moment of 18 Nm.

Standardised laxity measurements had small standard deviations (within 1.1°) for each clinician and similar mean values between clinicians, with the valgus laxity assessment (mean of 3°) being slightly more consistent than varus (means of 4° or 5°).

The manual technique of coronal knee laxity assessment was successfully quantified and standardised, leading to a narrow range of measurements (within the accuracy of the measurement system). Minimising the subjective variables of clinical examination could improve current knowledge of soft tissue knee behaviour.

Biomechanical analysis of locked and non-locked plate fixation of the clavicle

INTRODUCTION

During plate fixation of clavicular fractures the brachial plexus and subclavian vessels are vulnerable to injury beneath the clavicle. Locking plate fixation allows for mono-cortical fixation, theoretically reducing the risk of injury to these structures. Biomechanical analysis of the performance of such fixation is limited, and this study was designed to explore this further as a treatment option in clavicle fractures.

MATERIALS AND METHODS

Fixation of fifteen simulated mid-shaft fractures was undertaken using a combination of mono-cortical locked, bicortical locked and bicortical non-locked plating methods in cadaveric clavicles. Samples were then tested via three-point bending to destruction, and the performance of each with respect to failure load, bending stress, bending stiffness and Young's modulus was then analysed. The influence of the number of cortices engaged and locking was also assessed.

RESULTS

Clavicles fixed with monocortical locking plates displayed a significantly lower bending stress (12±1 MPa) than both the bicortical locking (28±3 MPa, p=0.015) and non-locking specimens (24±3 MPa, p=0.002). Engaging two cortices with the fixation produced a significant increase in failure load (291±28 N vs 138±48 N, p=0.018) and bending stress (26±2 MPa vs 9.9±3.5 MPa, p=0.002) compared to single cortex fixation.

DISCUSSION

The greatest influence upon the performance of the fixation was the number of cortices engaged, with bicortical fixation performing significantly better than mono-cortical. Whether or not the fixation device was a locking one did not have a significant bearing upon the performance.

CONCLUSION

This in vitro biomechanical analysis demonstrates that mono-cortical locked plating fails at significantly lower levels of load and stress than bicortical locked and non-locked plating in mid-shaft fractures of the clavicle, and caution would therefore be advised in its use as a fixation modality for these injuries.

Under-arm partial body weight unloading causes spinal elongation and vibration attenuation during treadmill walking

Whilst exercise is beneficial to those suffering from low back pain (LBP), spinal shrinkage and vibration during walking may aggravate the condition. This study investigates the effects of spinal unloading, by means of body-weight unloading (BWU), on spinal length and vibration response. Under-arm partial BWU (40% of bodyweight) was performed on 8 healthy males whilst walking on a treadmill for 1h, and compared to a control condition in the same participants. Motion analysis was used to track four reflective markers attached to the spine between C7 and the lumbar concavity at 100Hz, in 7s samples at regular intervals during the walk. A quintic polynomial was fitted to the coordinates in the sagittal plane, and sub-sectioned into three regions: the upper thoracic (UT), lower thoracic (LT) and upper lumbar (UL). The lengths of the curves were analysed in the time and frequency domains. The length of the spine increased by 4+/-2% (18mm) during the unloading condition with all regions showing an increase in length. The UL and LT regions lost length in the control condition, thereby exhibiting a significant interaction between unloading and time on region length (both P<0.05). In addition, compared to the control condition, the frequencies of the length changes were attenuated between 3 and 6Hz with unloading. Therefore, under-arm BWU facilitates spinal elongation, attenuates the frequency response of the spine in its resonant frequency regime and thus has potential benefits to the LBP population.

The strain-dependent osmotic pressure and stiffness of the bovine nucleus pulposus apportioned into ionic and non-ionic contributors

Elucidation of the load-bearing mechanism of the nucleus pulposus (NP) facilitates understanding of the mechanical and metabolic functioning of the intervertebral disc and provides key data for mathematical models. Negatively charged proteoglycans in the NP generate an ionic osmotic pressure, pi(i), which contributes to the tissue's resistance to load and, moreover, is the main mechanism by which the unloaded disc rehydrates. Functionally important, pi(i) has seldom been investigated in situ and, crucially, its variation with strain has not been reported. In a confined compression apparatus, we aimed to apportion the strain-dependent load-bearing mechanism of the NP at equilibrium to the tissue matrix and ionic osmotic pressure; and to determine whether any proteoglycan loss occurs during confined compression testing. Forty-eight confined compression experiments were conducted in isotonic (0.15M NaCl) and hypertonic (3.0 and 6.1M NaCl) external solutions in single and multiple step-strain protocols. The 6.1M NaCl external solution was needed to eliminate as much of the ionic effects as possible. The ionic osmotic pressure was well described by pi(i)=19.1lambda(-1.58) (R(2)=0.992), and was approximately 70% of the applied load at equilibrium, independent of lambda. The effective aggregate modulus, H(A)(eff), also increased with strain: H(A)(eff)=59.0lambda(-2.18). Concentrations of sulphated glycosaminoglycans were obtained for the samples tested in isotonic NaCl with no proteoglycan loss detected from the confined compression tests. These results highlight the non-linearity of the stress-strain response of NP tissue and the necessity to include a non-linear function for osmotic pressure in mathematical models of this tissue.

A comparison of sprinting kinematics on two types of treadmill and over-ground

Conventionally motorized treadmills elicit different sprinting kinematics to the over-ground condition. Treadmills powered by a torque motor have been used to assess sprinting power; yet, the kinematics of sprinting on the torque treadmill are unknown. This study compares the sprinting kinematics, during the constant velocity phase, between a conventional treadmill, a torque treadmill and the over-ground condition to assess the suitability of each treadmill for sprinting studies and training. After familiarization, 13 recreationally active males performed multiple sprints at various experimental settings on each surface. Ninety sprints, which attained mean velocities over 7.0 m/s, had their lower-body sagittal plane joint angles during ground contact captured at 250 Hz. These data were low-pass filtered at 10 Hz, and compared with respect to surface, subject and velocity using an ANCOVA statistical model. Sprinting on the conventional treadmill elicited a longer ground contact time, a longer braking phase, a more extended knee at foot strike and a faster extending hip than the torque treadmill and over-ground (all P<0.05). The torque treadmill obtained an equivalent sprinting technique to the over-ground condition, with the exception of a less extended hip at toe-off, suggesting that it is more appropriate for laboratory sprinting analyses and training than the conventional treadmill.

Moderate alterations in lower limbs muscle temperature do not affect postural stability during quiet standing in both young and older women

Older adults demonstrate increased amounts of postural sway, which may ultimately lead to falls. Temperature is known to have a profound effect on the performance of the neuromuscular system which could have important implications on motor control. It is, therefore, of interest to investigate if the age-related decline in postural stability could be affected by changes in local limbs temperature. The present study investigated the effects of localized warming and cooling on postural sway in nine young (22+/-3 years) and nine older (73+/-3 years) women. Postural sway was assessed, using a single force platform, during quiet standing at three muscle temperature conditions: control (34.2+/-0.2 degrees C), cold (31.3+/-0.3 degrees C) and warm (37.0+/-0.1 degrees C). Two stances were evaluated, the Romberg (large support base) and modified Tandem (narrow support base), under both eyes-open and eyes-closed conditions. Root mean square (RMS), mean velocity (MV), sway area (SA) and mean power frequency (MPF) were calculated from the centre of pressure (COP) displacement. Neither warming nor cooling significantly affected any of the postural parameters which were, however, all higher (P<0.05) in the older group than the young group in all conditions. This study demonstrated that, in quiet standing conditions, a moderate variation (+/-3 degrees C) in lower limbs temperature does not affect postural steadiness in either young or older women.

A one-dimensional theoretical prediction of the effect of reduced end-plate permeability on the mechanics of the intervertebral disc

The permeability of the cartilage end-plate (CEP) may play an important role in intervertebral disc (IVD) degeneration by controlling the convective and diffusive transport of metabolites into the nucleus pulposus. A one-dimensional poroelastic model was used to predict the effect of a CEP of lower permeability than the disc tissue on the convective transfer into and out of the IVD. With decreasing CEP permeability, associated with degeneration, the model predicted that the change in disc height with time became more linear; the disc could not rehydrate as quickly; and internal fluid movement was slowed. This study has shown that CEP permeability will only markedly have an effect on fluid movement, and hence convective nutrition, if the permeability of the CEP is reduced to less than that of the disc tissue.

Temperature dependence of soleus H-reflex and M wave in young and older women

The purpose of this study was to investigate the effect of altered local temperature on soleus H-reflex and compound muscle action potential (M wave) in young and older women. H-reflex and M wave responses were elicited in 10 young (22.3 +/- 3.3 years) and 10 older (72.5 +/- 3.2 years) women at three muscle temperatures: control (34.2 +/- 0.3 degrees C), cold (31.3+/-0.5 degrees C) and warm (37.1 +/- 0.2 degrees C). H-reflex output, expressed as the ratio between maximal H-reflex and maximal M wave (H(max)/M(max)), was lower in the older, compared with the younger, group, regardless of temperature. In control temperature conditions, for example, the H(max)/M(max) ratio was 36.8 +/- 24% in the young and 25.4 +/- 20% in the older (P<0.05). Warming had no effect on the H-reflex output in either group, whilst cooling increased H-reflex output only in the younger group (+28%). In both groups, cooling increased (+5.3%), and warming decreased (-5.5%) the H-reflex latency. This study confirms that older individuals experience a reduced ability to modulate the reflex output in response to a perturbation. In a cold environment, for example, the lack of facilitation in the reflex output, along with a delayed reflex response could be critical to an older individual in responding to postural perturbations thus potentially compromising both static and dynamic balance.

Is the coactivation of biceps femoris during isometric knee extension affected by adiposity in healthy young humans?

This study aimed to verify if the level of biceps femoris antagonist activity measured during isometric knee extension was affected by the individual degree of adiposity in 14 young healthy subjects of both genders aged between 18 and 24. Surface EMG signals were recorded from the biceps femoris muscle of the dominant leg during isometric knee extension at three levels of voluntary contraction: maximum (MVC), 80% MVC and 200 N, respectively. In addition, whole-body percentage of fat, volume of the thigh and skinfold thickness below the electrodes were achieved. Biceps femoris coactivation values were: 28.5 +/- 17.9%, 30.9 +/- 17.7% and 25.3 +/- 17.5% for MVC, 80% MVC and 200 N trials, respectively (NS). Neither the whole-body percentage of fat nor the skinfold thickness influenced percentage coactivation, irrespective of the intensity of contraction. However, an increase in the whole-body percentage of fat showed a tendency to augment the biceps femoris coactivation (P(I)=0.079; P(II)=0.575). No differences in coactivation were observed between genders. In addition, the duration of contraction did not affect the level of coactivation.

The internal mechanics of the intervertebral disc under cyclic loading

The mechanics of the intervertebral disc (IVD) under cyclic loading are investigated via a one-dimensional poroelastic model and experiment. The poroelastic model, based on that of Biot (J. Appl. Phys. 12 (1941) 155; J. Appl. Mech. 23 (1956) 91), includes a power-law relation between porosity and permeability, and a linear relation between the osmotic potential and solidity. The model was fitted to experimental data of the unconfined IVD undergoing 5 cyclic loads of 20 min compression by an applied stress of 1MPa, followed by 40 min expansion. To obtain a good agreement between experiment and theory, the initial elastic deformation of the IVD, possibly associated with the bulging of the IVD into the vertebral bodies or laterally, was removed from the experimental data. Many combinations of the permeability-porosity relationship with the initial osmotic potential (pi(i)) were investigated, and the best-fit parameters for the aggregate modulus (H(A)) and initial permeability (k(i)) were determined. The values of H(A) and k(i) were compared to literature values, and agreed well especially in the context of the adopted high-stress testing regime, and the strain related permeability in the model.

Knoop microhardness anisotropy of the ovine radius

The Knoop indenter has been used to characterise fully the Knoop microhardness (H(K)) anisotropy of compact bone. 2120 indentations were performed on mature ovine radii and a linear relationship was found between H(K) and the angle between the major diagonal of the indenter and the lamella boundaries (p<<0.001). H(K) increased significantly with ash fraction (p<0.001), but decreased with atmospheric vapour pressure (p<0.05). A significant interaction was found between ash fraction and atmospheric vapour pressure (p<0.01). H(K) significantly varied with indentation position along the diaphysis and around the cortex (both p<<0.001), however radial variation in H(K) was not statistically significant. The variation of ash fraction showed similar trends. These data show that H(K) varies similarly to Vickers microhardness, but in addition, can provide clear information on the anisotropy of Haversian bone without the need for excising many different indentation planes. A large number of indentations are required to obtain low type I and type II errors in the statistical analysis.

Microhardness anisotropy of lamellar bone

The Knoop microhardness test has been utilised to observe in-plane microhardness anisotropy of rat tibiae. The elongated rhombohedral geometry of the Knoop indenter enables the Knoop microhardness (HK) to be calculated for a given indenter orientation. Two indenter orientations were used: the major axis of the indenter was aligned along the length of, and across the mid-sagittal section. The statistical analysis demonstrated that the variation in HK was primarily due to the orientation of the Knoop indenter (p < 0.001). HK was consistently greater when the indenter was aligned with the major diagonal radial on the mid-sagittal section.