Transcranial Low-Intensity Focused Ultrasound Stimulation of the Visual Thalamus Produces Long-Term Depression of Thalamocortical Synapses in the Adult Visual Cortex

Transcranial focused ultrasound stimulation (tFUS) is a noninvasive neuromodulation technique, which can penetrate deeper and modulate neural activity with a greater spatial resolution (on the order of millimeters) than currently available noninvasive brain stimulation methods, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). While there are several studies demonstrating the ability of tFUS to modulate neuronal activity, it is unclear whether it can be used for producing long-term plasticity as needed to modify circuit function, especially in adult brain circuits with limited plasticity such as the thalamocortical synapses. Here we demonstrate that transcranial low-intensity focused ultrasound (LIFU) stimulation of the visual thalamus (dorsal lateral geniculate nucleus, dLGN), a deep brain structure, leads to NMDA receptor (NMDAR)-dependent long-term depression of its synaptic transmission onto layer 4 neurons in the primary visual cortex (V1) of adult mice of both sexes. This change is not accompanied by large increases in neuronal activity, as visualized using the cFos Targeted Recombination in Active Populations (cFosTRAP2) mouse line, or activation of microglia, which was assessed with IBA-1 staining. Using a model (SONIC) based on the neuronal intramembrane cavitation excitation (NICE) theory of ultrasound neuromodulation, we find that the predicted activity pattern of dLGN neurons upon sonication is state-dependent with a range of activity that falls within the parameter space conducive for inducing long-term synaptic depression. Our results suggest that noninvasive transcranial LIFU stimulation has a potential for recovering long-term plasticity of thalamocortical synapses in the postcritical period adult brain.

Dataset of quantitative structured office measurements of movements in the extremities

A low-cost quantitative structured office measurement of movements in the extremities of people with Parkinson's disease [1,2] was performed on people with Parkinson's disease, multiple system atrophy, and age-matched healthy volunteers. Participants underwent twelve videotaped procedures rated by a trained examiner while connected to four accelerometers [1,2] generating a trace of the three location dimensions expressed as spreadsheets [3,4]. The signals of the five repetitive motion items [1,2] underwent processing to fast Fourier [5] and continuous wavelet transforms [6]. The dataset [7] includes the coding form with scores of the live ratings [1,2], the raw files [3], the converted spreadsheets [4], and the fast Fourier [5] and continuous wavelet transforms [6]. All files are unfiltered. The data also provide findings suitable to compare and contrast with data obtained by investigators applying the same procedure to other populations. Since this is an inexpensive procedure to quantitatively measure motions in Parkinson's disease and other movement disorders, this will be a valuable resource to colleagues, particularly in underdeveloped regions with limited budgets. The dataset will serve as a template for other investigations to develop novel techniques to facilitate the diagnosis, monitoring, and treatment of Parkinson's disease, other movement disorders, and other nervous and mental conditions. The procedure will provide the basis to obtain objective quantitative measurements of participants in clinical trials of new agents.

A low-cost quantitative continuous measurement of movements in the extremities of people with Parkinson's disease

The assessment of Parkinson's disease currently relies on the history of the present illness, the clinical interview, the physical examination, and structured instruments. Drawbacks to the use of clinical ratings include the reliance on real-time human vision to quantify small differences in motion and significant inter-rater variability due to inherent subjectivity in scoring the procedures. Rating tools are semi-quantitative by design, however, in addition to significant inter-rater variability, there is inherent subjectivity in administering these tools, which are not blinded in clinical settings. Sophisticated systems to quantify movements are too costly to be used by some providers with limited resources. A simple procedure is described to obtain continuous quantitative measurements of movements of people with Parkinson's disease for objective analysis and correlation with visual observation of the movements. •Inexpensive accelerometers are attached to the upper and lower extremities of patients with Parkinson's disease and related conditions to generate a continuous, three-dimensional recorded representation of movements occurring while performing tasks to characterize the deficits of Parkinson's disease.•Movements of the procedure are rated by trained examiners live in real-time and later by videotapes.•The output of the instrumentation can be conveyed to experts for interpretation for diagnostic and therapeutic purposes.

Mechanical assessment of the effects of metastatic lytic defect on the structural response of human thoracolumbar spine

To investigate the effects of a clinical lytic defect on the structural response of human thoracolumbar functional spinal unit. A novel CT-compatible mechanical test system was used to image the deformation of a T12-L1 motion segment and measure the change in strain response under compressive loads ranging from 50 to 750 N. A lytic lesion (LM) with cortex involvement (33% by volume) was introduced to the upper vertebral body and the CT experiments were repeated. Finite element models, established from the CT volumes, were used to investigate the defect's effects on the structural response and the state of principal and shear stresses within the affected and adjacent vertebrae. The lytic lesion resulted in severe loss of the vertebral structural competence, resulting in significant, non-linear, and asymmetric increase in the experimentally measured strains and computed stresses within both vertebrae (p < 0.01). At the cortex, the tensile strains were significantly increased, while compressive strains significantly decreased, (p < 0.05). Both the vertebral bone and cortex regions adjacent to the defect showed significant increase in computed compressive, tensile, and shear stresses (p < 0.01). Changes in stress and strain distribution within the affected and adjacent vertebral bone and the experimentally observed bulging and buckling of the vertebral cortices suggested that initiation of catastrophic vertebral failure may occur under load magnitudes encountered in daily living. Although the effect of LM on the global deformation of the spine was well-predicted, our results show that FE predictions of local strain changes must be carefully assessed for clinical relevance. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1808-1819, 2016.

Effect of skull flexural properties on brain response during dynamic head loading - biomed 2013

The skull-brain complex is typically modeled as an integrated structure, similar to a fluid-filled shell. Under dynamic loads, the interaction of the skull and the underlying brain, cerebrospinal fluid, and other tissue produces the pressure and strain histories that are the basis for many theories meant to describe the genesis of traumatic brain injury. In addition, local bone strains are of interest for predicting skull fracture in blunt trauma. However, the role of skull flexure in the intracranial pressure response to blunt trauma is complex. Since the relative time scales for pressure and flexural wave transmission across the skull are not easily separated, it is difficult to separate out the relative roles of the mechanical components in this system. This study uses a finite element model of the head, which is validated for pressure transmission to the brain, to assess the influence of skull table flexural stiffness on pressure in the brain and on strain within the skull. In a Human Head Finite Element Model, the skull component was modified by attaching shell elements to the inner and outer surfaces of the existing solid elements that modeled the skull. The shell elements were given the properties of bone, and the existing solid elements were decreased so that the overall stiffness along the surface of the skull was unchanged, but the skull table bending stiffness increased by a factor of 2.4. Blunt impact loads were applied to the frontal bone centrally, using LS-Dyna. The intracranial pressure predictions and the strain predictions in the skull were compared for models with and without surface shell elements, showing that the pressures in the mid-anterior and mid-posterior of the brain were very similar, but the strains in the skull under the loads and adjacent to the loads were decreased 15% with stiffer flexural properties. Pressure equilibration to nearly hydrostatic distributions occurred, indicating that the important frequency components for typical impact loading are lower than frequencies based on pressure wave propagation across the skull. This indicates that skull flexure has a local effect on intracranial pressures but that the integrated effect of a dome-like structure under load is a significant part of load transfer in the skull in blunt trauma.

Poly(α-Hydroxy Ester)/Short Fiber Hydroxyapatite Composite Foams for Orthopedic Application

A process has been developed to manufacture biodegradable composite foams of poly(DL-lactic- co-glycolic acid) (PLGA) and hydroxyapatite short fibers for use in bone regeneration. The processing technique allows the manufacture of three-dimensional foam scaffolds and involves the formation of a composite material consisting of a porogen material (either gelatin microspheres or salt particles) and hydroxyapatite short fibers embedded in a PLGA matrix. After the porogen is leached out, an open-cell composite foam remains which has a pore size and morphology defined by the porogen. The foam porosity can be controlled by altering the volume fraction of porogen used to make the composite material. Foams made using NaCl particles as a porogen were manufactured with porosities as high as 0.84±0.01 (n=3). The short hydroxyapatite fibers served to reinforce the PLGA. The compressive yield strength of foams manufactured using gelatin microspheres as a porogen was found to increase with fiber content. Foams with compressive yield strengths up to 2.82±0.63 MPa (n=3) with porosities of 0.47±0.01 (n=3) were manufactured using 30% by weight hydroxyapatite fibers in the initial composite prior to leaching. These composite foams with improved mechanical properties may also be expected to have enhanced osteoconductivity and hence provide a novel material which may prove useful in the field of bone regeneration.

An in vitro model for fluid pressurization of screw holes in metal-backed total joint components

Fluid pressure may stimulate osteolysis near screw holes in joint arthroplasty components. We developed a generalized in vitro model of a polyethylene liner and metal backing with a screw hole to investigate whether implant design factors influence local fluid pressure. We observed an order of magnitude of variation in the peak screw hole pressure (from 16.0 and 163 kPa) under clinically relevant loading conditions. Of the implant factors investigated, the surface finish of the metallic base plate had the greatest effect on peak screw hole fluid pressures; the thickness of the polyethylene liner, as well as the gap between the liner and the base plate, were also significant design variables. Our data suggest that unpolished metal base plates, thick polyethylene liners, and tight conformity between the liner and the metal base plate will all contribute to significantly reduced peak screw hole fluid pressures in joint arthroplasty.

The biomechanical effects of kyphoplasty on treated and adjacent nontreated vertebral bodies

It remains unclear whether adjacent vertebral body fractures are related to the natural progression of osteoporosis or if adjacent fractures are a consequence of augmentation with bone cement. Experimental or computational studies have not completely addressed the biomechanical effects of kyphoplasty on adjacent levels immediately following augmentation. This study presents a validated two-functional spinal unit (FSU) T12-L2 finite element model with a simulated kyphoplasty augmentation in L1 to predict stresses and strains within the bone cement and bone of the treated and adjacent nontreated vertebral bodies. The findings from this multiple-FSU study and a recent retrospective clinical study suggest that changes in stresses and strains in levels adjacent to a kyphoplasty-treated level are minimal. Furthermore, the stress and strain levels found in the treated levels are less than injury tolerance limits of cancellous and cortical bone. Therefore, subsequent adjacent level fractures may be related to the underlying etiology (weakening of the bone) rather than the surgical intervention.

Estimation of material elastic moduli in elastography: a local method, and an investigation of Poisson's ratio sensitivity

The local material stiffness of tissues is a well-known indicator of pathology, with locally stiffer tissue related to the possible presence of an abnormal growth in otherwise compliant tissue. Elastography is a non-invasive technique for measuring displacement distributions in loaded tissues within a medical imaging context. From these measured displacement fields, estimated for local strain have been made using well-studied techniques, but the calculation of elastic modulus has been difficult. In this study we show a method for estimating local tissue elastic modulus that gives numerically stable and robust results in test cases, and that is numerically efficient. The method assumes the tissue is isotropic and it requires an independent estimate of tissue Poisson's ratio, but the method reaches a stable result when the estimated Poisson's ratio is in error, and the resulting estimates are not very sensitive to the assumed value.

Poroelastography: imaging the poroelastic properties of tissues

In the field of elastography, biological tissues are conveniently assumed to be purely elastic solids. However, several tissues, including brain, cartilage and edematous soft tissues, have long been known to be poroelastic. The objective of this study is to show the feasibility of imaging the poroelastic properties of tissue-like materials. A poroelastic material is a material saturated with fluid that flows relative to a deforming solid matrix. In this paper, we describe a method for estimating the poroelastic attributes of tissues. It has been analytically shown that during stress relaxation of a poroelastic material (i.e., sustained application of a constant applied strain over time), the lateral-to-axial strain ratio decreases exponentially with time toward the Poisson's ratio of the solid matrix. The time constant of this variation depends on the elastic modulus of the solid matrix, its permeability and its dimension along the direction of fluid flow. Recently, we described an elastographic method that can be used to map axial and lateral tissue strains. In this study, we use the same method in a stress relaxation case to measure the time-dependent lateral-to-axial strain ratio in poroelastic materials. The resulting time-sequenced images (poroelastograms) depict the spatial distribution of the fluid within the solid at each time instant, and help to differentiate poroelastic materials of distinct Poisson's ratios and permeabilities of the solid matrix. Results are shown from finite-element simulations.

Limiting models for calcification in fibrous tissues adjacent to orthopedic implants: variational indicator functions and influences of implant stiffness

Calcification and eventual integration of orthopedic implants into bone is important to many load-bearing devices, and the influence of load and implant stiffness on this process are assessed in this mathematical modelling study. Three research questions are posed in this study. First, can limiting material models provide useful information on the overall behavior of the tissue adjacent to a loaded orthopedic implant? Second, can the limiting models lead to optimization criteria? Third, can an optimization approach be used to differentiate between the four prospective remodeling rate equations which are proposed? The answers are yes, yes, and no, respectively. A two degree of freedom lumped parameter model for axial loading of an intramedullary implant is considered. Two limiting composite material models are used, and the strain energy density in the calcified and non-calcified phases are assessed as stimuli for calcification. The rate equations posed here assume that the calcified material volume fraction decreases at high strain-energy densities, and increases at small strain-energy densities. In all four cases (both models, both phases) the steady states for these rate equations find equilibrium points of indicator functions which are a weighted sum of total strain energy and the mass of calcified tissue in the layer considered. The weights on strain-energy density and mass differ in each case. This shows that for appropriate choices of parameters, all four models can yield the same results, and it also shows that an optimization approach does not uniquely determine the appropriate rate equation in these cases. The rate equations showed complicated dynamic behavior and a phase-plane analysis was used which led to upper bounds on load, which depended on implant stiffness and distal support. The predictions of the four cases studied are compared.

Regulatory interaction between myogenic and shear-sensitive arterial segments: conditions for stable steady states

Myogenic and shear stress-sensitive mechanisms control the caliber of a small blood vessel in this modeling study. This blood vessel in our model was composed of a pressure-sensitive (myogenic) component and a series-connected shear-sensitive component. The response of this model to imposed pressure and the conditions that result in a stable steady-state vessel diameter were investigated. The requirement that the model parameters need to satisfy for a stable steady state to exist are expressed by the numerical solution of simultaneous nonlinear equations. Also, if a vessel is put into an initial state that is not an equilibrium state, then the system must occupy a range of initial conditions to arrive at a stable equilibrium. These are described graphically for three cases. In general, the initial shear stress should be higher than the equilibrium value of shear stress, and/or the initial transmural pressure should be low, compared with the imposed feed pressure. Increasing the imposed pressure on the vessel can lead to elimination of the equilibrium state and vasospasm, according to this model. When a stable steady state is not reached, the model predicts elimination of the vessel or vasospasm. The model is in qualitative agreement with experimental observations that, during angiogenesis, vessels with low flow are often eliminated.

Mechanical model for critical strain in mineralizing biological tissues: application to bone formation in biomaterials

A simple theoretical model for the role of strain energy density in the initial mineralization of soft tissues is presented and used to derive a limit of the allowable strain in tissue engineered biomaterials. The model incorporates the mechanical energy in calcified tissue due to time-varying loads into the more commonly used energetic arguments for mineralization. By using the Voight (equal-strain) and Reuss (equal-stress) composite material models to relate the volumetric density of calcified tissue to overall material modules, two models were developed to assess the effect of an imposed overall material strain on mineralization. A rate equation based on strain energy was used to model the kinetics of mineralization, and the stability of the rate equation was assessed, leading to a limit on overall material strain based on the specific energy for mineralization of soft tissues. The result depended on the stiffness of the material in series with the mineralizing tissue. Taking the stiffness of the material in series with the tissue as infinite lead to a prediction of critical strain for mineralization in the calcifying biological tissue which was the same on the Reuss and Voight models. The interaction of this theoretical model with biological factors and some clinical implications of the model are discussed.

A nonlinear model for myogenic regulation of blood flow to bone: equilibrium states and stability characteristics

A simple compartmental model for myogenic regulation of interstitial pressure in bone is developed, and the interaction between changes in interstitial pressure and changes in arterial and venous resistance is studied. The arterial resistance is modeled by a myogenic model that depends on transmural pressure, and the venous resistance is modeled by using a vascular waterfall. Two series capacitances model blood storage in the vascular system and interstitial fluid storage in the extravascular space. The static results mimic the observed effect that vasodilators work less well in bone than do vasoconstrictors. The static results also show that the model gives constant flow rates over a limited range of arterial pressure. The dynamic model shows unstable behavior at small values of bony capacitance and at high enough myogenic gain. At low myogenic gain, only a single equilibrium state is present, but a high enough myogenic gain, two new equilibrium states appear. At additional increases in gain, one of the two new states merges with and then separates from the original state, and the original state becomes a saddle point. The appearance of the new states and the transition of the original state to a saddle point do not depend on the bony capacitance, and these results are relevant to general fluid compartments. Numerical integration of the rate equations confirms the stability calculations and shows limit cycling behavior in several situations. The relevance of this model to circulation in bone and to other compartments is discussed.

Bone remodelling adjacent to intramedullary stems: an optimal structures approach

The internal parameters in bone remodelling theories often are not clearly related to the bony structure which results from the simulations in which they are implemented. For a restricted class of bone remodelling theories, we have previously found a connection between overall structural optimization and the parameters within a continuum-level remodelling rule. In this study, we assess whether a simplified analytical formula based on structural optimization can predict the behaviour of a large-scale finite element bone remodelling simulation. The analytical formula predicts when bone will remain around an intramedullary implant. The predictions of the formula are borne out in the numerical results. This leads to a physical interpretation of one of the two parameters in the remodelling rule used. The results also show some characteristics which are clinically relevant. This study extends earlier results due to Huiskes for internal remodelling around intramedullary implants by using a different, numerically stable remodelling algorithm based on optimization. The study also shows a direct practical application of the optimizing remodelling theory the authors have developed previously.

Effect of porous coating and loading conditions on total hip femoral stem stability

An examination of femoral bone-prosthesis interface behavior under different load types is undertaken using finite-element analysis. Three-dimensional finite-element models are made of two designs of hip prostheses after implantation in a femur. Femoral geometry was determined by computed tomography scans. The models were loaded in one-legged stance and stairclimbing configurations. The implants were modeled as both smooth surfaced and porous coated. The amount of contact and the relative motion between bone and implant were calculated. It is shown that torsional loads such as occur during stairclimbing contribute to larger amounts of implant micromotion than does stance loading. Contact at the bone-prosthesis interface is more dependent on load type than on implant geometry or surface coating type.

Fit of the uncemented femoral component and the use of cement influence the strain transfer the femoral cortex

To determine whether the strain patterns produced in the femoral cortex after uncemented femoral arthroplasty are influenced by the fit of the component and whether these patterns are different from those of cemented components, cortical surface strains of cadaveric femurs subjected to loads simulating single-limb stance were measured before and after the insertion of uncemented, collared, straight-stemmed femoral components. The effects of press fit, loose fit, and precise fit of the components were evaluated and were contrasted to the strain patterns occurring after insertion of cemented femoral components. Strains varied markedly, depending on the fit of the stem of the uncemented femoral component within the isthmus. Nearly normal patterns of femoral strain were produced when the femoral stem was fit precisely at the isthmus, and the proximal femoral strains were similar to those of the intact state. In contrast, press fit and loose fit at the isthmus altered the strain patterns. The proximal medial axial strains were significantly reduced with press fit, to a mean of 39% of normal (p < 0.05), and increased with loose fit, to a mean of 141% of normal (p < 0.05). The prostheses fixed with cement showed a mean reduction in proximal medial axial strains to 33% of normal, which was comparable with press fit uncemented components even though the collar was well seated. Thus, our findings indicated that, in the immediate postoperative period, femoral strain patterns can be influenced by the fit of an uncemented component within the isthmus and by the use of cement.

Bone remodeling and structural optimization

Bone remodeling has been viewed both as a process which adapts bone tissue to the mechanical environment at each point in the structure, and as a process which optimally adjusts the tissue distribution within bones to bear the loads placed on them. We have developed a connection between these two views of bone remodeling, in a restricted sense. We start with a remodeling rate equation based on strain energy density. We then define an indicator function which is a weighted sum of total strain energy and a measure of bone mass, and we show that finding bone density distributions in which the remodeling rate equation predicts no changes with time is the same as finding density distributions in which the indicator function is insensitive to small changes in density. The set point in the remodeling rate equation corresponds to a parameter in the indicator function which determines the relative importance of bone mass and strain energy in the optimization indicator function. We have not assessed whether the density distributions which make the density rate of change zero are actually local or global minima for the indicator function in this study, but a related study shows that there is a single unique minimum for the indicator function developed here, implying that a unique solution exists for the bone remodeling rate equations considered in this study.

On the sufficiency conditions for the stability of bone remodeling equilibrium

In this technical note a sufficiency condition is established for the stability of a strain-energy-based bone remodeling theory in the special case of a beam loaded by an axial force and a bending moment. In a previous report the same condition was shown to be a necessary condition for stability in the same situation. The remodeling scheme is one characterized by a remodeling stimulus equal to the strain energy density divided by the bulk or apparent density raised to an exponent m as well an elastic modulus proportional to bulk or apparent density raised to an exponent n. In order for a remodeling scheme to be stable for an elastic beam loaded by an axial force and a bending moment, it is established that the condition that m must be greater than n is not only necessary, but also sufficient.

Determination of loading parameters in the canine hip in vivo

The loading parameters in the canine hip were determined from multiple studies, involving the collection of kinematic and force plate data in vivo joint reaction force from an instrumented hip replacement prosthesis, and in vivo femoral cortical bone strain gauge data in different dogs. In the middle of the stance phase of gait the canine femur was flexed 110 degrees with respect to the pelvis and formed a 20 degree angle relative to the floor. At this point in the gait cycle, a line passing from the superior to the inferior aspect of the pubic symphysis was parallel to the floor. The joint reaction force measurements showed that the net force vector during midstance was directed inferiorly, posteriorly, and laterally, with a peak magnitude of up to 1.65 times the body weight. A torsional moment of 1.6 N m is exerted about the femoral shaft. In vivo strain data showed that during gait peak compressive strains of -300 to -502 microstrain were produced on the medial aspect of the femoral cortex and peak tensile strains of +250 to +458 midstrain were produced on the femoral cortex. At the midstance phase of gait, principal cortical bone strains were rotated up to 29 degrees relative to the long axis of the femur, suggesting torsional loads on the femur. These data in combination provide valuable insights on the loading parameters of the canine hip which can be used in future applications of the canine as a model for evaluating mechanically based phenomena such as bone ingrowth and remodeling or hip prostheses.

Bone strain sensation via transmembrane potential changes in surface osteoblasts: loading rate and microstructural implications

A model is developed in which osteoblasts can sense the strains applied to a small region of bone through electrical coupling between adjacent cells. The stress-generated potentials within bone are assumed to occur through streaming potentials, and the coupled network of osteocytes is assumed to act in a manner similar to the classical cable model for nerve cells. In a one-dimensional model, the linear poroelastic equations for motion of the fluid are solved analytically for sinusoidally varying imposed strains, and the streaming potentials are predicted from the fluid flow. The changes in the osteocyte and osteoblast transmembrane potential are given by an analytical solution to the governing equations, and the dependence of the transmembrane potential changes (TPC) on position, loading rate, manner of loading (compression versus bending), and on the degree of cellular coupling is discussed. The model correctly predicts the rate dependence of remodelling established by other investigators. The influence of the electrical parameters within the model indicate that further study of the cellular coupling in bone can yield important new information on bone remodelling.

An analytical and numerical study of the stability of bone remodelling theories: dependence on microstructural stimulus

The origin of unstable bone remodelling simulations using strain-energy-based remodelling rules was studied mathematically in order to assess whether the unstable behavior was due to the mathematical rules proposed to characterize the processes, or to the numerical approximations used to exercise the mathematical predictions. A condition which is necessary for the stability of a strain-energy-based remodelling theory was derived analytically using the calculus of variation. The analytical result was derived using a simple elastic model which consists of a long beam loaded by an axial force and a bending moment. This loading situation mimics the coupling between local density and global density distributions seen in vivo. A condition necessary for a stable remodelling scheme is arrived at, but the conditions necessary to guarantee a stable remodelling scheme are not. In this remodelling scheme, the elastic modulus is proportional to volumetric density raised to an exponent n, and the microstructural stimulus is taken as the strain energy density divided by volumetric density raised to an exponent m. In order for a remodelling scheme to be stable in this loading situation, m must be greater than n. Finite-difference time-stepping is used to verify the predictions of the analytical study. These numerical studies appear to confirm the analytical studies. Physiologic interpretation of the behavior found with n greater than m indicates that this type of unstable behavior is unlikely to be observed in vivo. Since numerical approximations are not made in deriving this stability condition, we conclude that the mathematical rules proposed to characterize bone remodelling based on strain energy density should meet this condition to be relevant to physiologic bone remodelling.

A finite element study of the initiation of failure of fixation in cemented femoral total hip components

In order to study initial mechanisms of failure in cemented femoral total hip components, an anatomically accurate three-dimensional linear finite element model was constructed and verified against experimental strain measurements in the cement mantle. Good agreement was found between predicted and measured strains. The likelihood of failure initiation due to cement-prosthesis debonding and crack initiation at voids was studied for loading conditions simulating both one-legged stance and stair climbing. The "out of plane" forces involved in stair climbing appear to be the greatest threat to the fixation of total hip replacements. In stair climbing, cement-prosthesis debonding and pore crack initiation were probable in the proximal anteromedial region of the cement mantle, and near the distal tip of the implant. The proximal stresses in stair climbing were higher than the distal stresses in either stair climbing or one-legged stance.

A finite element study of the effect of diametral interface gaps on the contact areas and pressures in uncemented cylindrical femoral total hip components

Uncemented femoral total hip components rely entirely on contact with the prepared femur for their initial fixation. The contact areas and stresses between a straight tubular bone and a metal cylindrical prosthesis 12.5 cm long and 13 mm in diameter were calculated in a finite element model which includes uniform diametral gaps varying from 20 to 500 microns, using transverse loads from 100 to 2000 N. Frictionless three-dimensional contact elements were used between the bone and the prosthesis. Contact stresses were high and irregular in all cases, and the contact areas were small. Two regions of contact were apparent for lower loads and larger gaps. A third region of contact occurred near the distal tip of the implant at higher loads. This region of contact markedly increased the contact stresses at the distal tip of the prosthesis. A 20 microns overlap between bone and implant was modelled to assess a slight interference fit. The contact stress distribution in this case was markedly different from the stress distribution with a 20 microns diametral gap. The data collectively indicates that gaps of less than 20 microns between bone and implant can substantially change contact stress distributions.

A three-dimensional non-linear finite element study of the effect of cement-prosthesis debonding in cemented femoral total hip components

A three-dimensional non-linear finite element analysis of a cemented femoral component in which the component was partially debonded from the cement mantle was used to assess the effects of debonding on stresses in the cement. Three cases of partial cement-metal debonding were modelled with debonding of the proximal portion of the implant down to a horizontal plane which was 35, 62.5, or 82.5 mm below the prosthesis collar. Each situation was studied under loads simulating both gait and stairclimbing. Also, complete debonding between the implant and the surrounding cement mantle was modeled for loads simulating gait. Under stair climbing loads with partial cement-mental debonding, hoop stresses of 13-18 MPa were observed in the cement at the cement-metal interface at the proximal postero-medial corner of the implant. Similarly, in stair climbing, the maximum principal stresses in the cement were also adjacent to the proximal postero-medial region of the implant. These stresses were compressive and increased from 15 MPa with fully bonded interfaces to 48 MPa with debonding down to 82.5 mm below the prosthesis collar. Under gait loads, complete debonding caused high compressive stresses up to 34.9 MPa in the cement distal to the prosthesis tip. Thus, cement failure subsequent to prosthesis debonding is likely in the proximal region in a partially debonded implant due to stair climbing loads and is likely below the prosthesis tip in a fully debonded implant due to gait loading.

A double-blind study on the effects of a capacitively coupled electrical field on bone ingrowth into porous-surfaced canine total hip prostheses

The effect of a capacitively coupled electrical field on bone ingrowth into titanium fiber mesh porous-surfaced canine total hip arthroplasties (THAs) was investigated in a double-blind experiment. The electrical field was induced by an external source delivering a 60-kHz 5-6-V peak-to-peak sinusoid voltage through skin electrodes. No significant increase in the ingrowth of bone into the porous coating occurred at the end of six weeks of electrical stimulation. The amount of bone that grew into the porous surface, the areal density of bone within the available pore space, and the extent of the prosthesis surface area with bone ingrowth or apposition were not significantly different in the control and stimulated groups. This particular form of electrical stimulation does not improve bone ingrowth into porous-surfaced canine THAs by six weeks.

Porosity of various preparations of acrylic bone cements

The total porosity and mean pore sizes of various bone cement preparations were measured using image analysis. The porosity in different commercial bone cements varied from 5% to 16% when these cements were prepared in the usual fashion. Centrifugation for 30 seconds resulted in a substantial reduction in the overall porosity of Simplex P, AKZ, Zimmer Regular, and CMW bone cements by reducing both the mean pore size and the number of pores per unit area. In contrast, the porosity of LVC, Palacos R, and Palacos R with gentamicin bone cements was not significantly decreased by centrifugation. Chilling the monomer before mixing resulted in higher porosity of both the centrifuged and uncentrifuged Simplex P, Zimmer Regular, and CMW bone cements. Simplex P mixed with chilled monomer and centrifuged for 120 seconds has one of the lowest porosities of the various cements, while retaining good handling characteristics and excellent fatigue strength.

The influence of support conditions in the loading fixture on failure mechanisms in the push-out test: a finite element study

The usefulness of the push-out test as an indicator of interface strength was evaluated using finite element models of intact and partially failed cylindrical push-out specimens loaded against a rigid annular support. The irregular stress distributions that were found in intact specimens depended more on interface conditions at the loading fixture than on a 35% increase in interface area. The maximum stress at the interface was a tensile stress. Critical energy release rates for interface failure were calculated for flawed specimens in which flaw size was either 10 or 100 microns, and for boundary conditions at the loading fixture that were either fixed or slipping in the radial direction. The critical energy release rates depended heavily on the support boundary conditions. Thus, the results of parametric push-out tests can be reasonably compared only for specimens that are very similar in geometry and that are loaded in very carefully controlled fixtures.

The effect of centrifuging bone cement

We have tested the porosity and fatigue life of five commonly used bone cements: Simplex P, LVC, Zimmer regular, CMW and Palacos R. Tests were conducted with and without centrifugation and with the monomer at room temperature and, except for LVC, at 0 degrees C. We found that the fatigue life of different specimens varied by a factor of nearly 100. It did not depend on porosity alone, but was more influenced by the basic composition of the cement. Simplex P when mixed with monomer at 0 degrees C and centrifuged for 60 seconds had the highest fatigue life and was still sufficiently liquid to use easily.

Limitations of the continuum assumption in cancellous bone

Most existing stress analyses of the skeleton which consider cancellous bone assume that it can be modelled as a continuum. In this paper we develop a criterion for the validity of this assumption. The limitations of the continuum assumption appear in two areas: near biologic interfaces, and in areas of large stress gradients. These limitations are explored using a probabilistic line scanning model for density measurement, resulting in an estimate of density accuracy as a function of line length which is experimentally verified. Within three to five trabeculae of an interface, a continuum model is suspect. When results as predicted using continuum analyses vary by more than 20-30% over a distance spanning three to five trabeculae, the results are suspect.

A study of intrusion characteristics of low viscosity cement Simplex-P and Palacos cements in a bovine cancellous bone model

Aseptic loosening is the most common long-term complication of cemented total hip arthroplasties (THA). The functional longevity of these implants depends on the bone-cement interface. The influence of cement injection pressure, type of cement, ambient temperature, chilling of the monomer, and centrifugation of cement-on-cement intrusion depth was investigated in specimens of bovine cancellous bone. In order to validate the bovine model for comparative purposes relative to use in man, a linear relationship between human and bovine cancellous bone was first demonstrated for various porosities and cement intrusion depth. Three cements (Low Viscosity Cement [LVC], Simplex-P, and Palacos) were intruded at three different pressures (20, 40, and 60 PSI) at the same ambient temperature and relative humidity into commercially prepared plugs of bovine cancellous bone. Cement intrusion depth was proportional to injection pressure for all three cements, but was significantly different for each cement at a given pressure. At 20, 40, and 60 PSI, Palacos had a cement intrusion depth of 1.4, 2.4, and 2.8 mm respectively, while the figures for Simplex-P were 2.2, 4.2, and 5.0 mm, and for LVC were 8.0, 12.0, and 14.6 mm. Ambient temperature had an inverse relationship with cement intrusion depth for all three cements given the same experimental conditions. Chilling the monomer increased the intrusion of Simplex-P to 5.8, 8.2, and 12.7 mm at 20, 40, and 60 PSI injection pressure respectively. Simplex-P intrusion depth was not modified by cement centrifugation at any of the three injection pressures tested.(ABSTRACT TRUNCATED AT 250 WORDS)

Determination of muscle orientations and moment arms

In muscle force analysis, orientations and moment arms of the muscles about a joint provide essential coefficients in the equilibrium equations. For the determination of these parameters, several experimental techniques, including geometric measurement, tendon-joint displacement measurement and direct load measurement, are available. Advantages and disadvantages associated with each of the techniques are reviewed and compared based on our extensive experience.