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Brenac C, Pithioux M, Tomczak S, Lallemand M, Jaloux C, de Villeneuve Bargemon JB. Biomechanical evaluation of the ST-knot: A new suture for flexor tendon repair. Hand Surg Rehabil 2024; 43:101650. [PMID: 38301768 DOI: 10.1016/j.hansur.2024.101650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/03/2024]
Abstract
PURPOSE Although tendon lacerations are common, there is currently no consensus on choice of suture. Easy and fast sutures that impart enough strength to allow mobilization are needed. This study compared the ex vivo biomechanical strength (force required to create a 2 mm tendon gap) of a novel suture (ST-knot) with that of a conventional suture (double Kessler). MATERIALS AND METHODS Forty fresh deep flexor tendons from porcine forelimbs were used. Both repaired tendon ends were mounted on standard traction jaws of an axial traction machine at an initial distance of 40 mm for all tendons. A high-definition camera was used to determine the force forming a 2 mm gap. Ten tendons in group 1 (ST-knot) and 10 in group 2 (double Kessler) were prepared with PDS 4.0 (single thread for Kessler, double thread for ST-knot). Tendons in groups 3 (ST-knot) and 4 (double Kessler) were repaired with PDS 1.0 using the same principle. RESULTS There was no significant difference in the force required to form a 2 mm tendon gap between groups 1 and 2, and this trend was identical when using a stronger thread in groups 3 and 4. The maximum force before rupture, mode of repair failure, stress and stiffness were also comparable, with no significant differences between groups 1 and 2, or between groups 3 and 4. CONCLUSIONS The ST-knot showed comparable results to the double-Kessler knot, whichever the thread used. Because it involves fewer steps than conventional techniques and is easy to perform, the ST-knot may offer a therapeutic solution, particularly in complex trauma with multiple tendon injury.
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Affiliation(s)
- Camille Brenac
- Hospices Civils de Lyon, Hôpital Croix Rousse, Service de Chirurgie Plastique, Esthétique et Réparatrice, Lyon F-69003, France.
| | - Martine Pithioux
- Aix Marseille Univ, CNRS, ISM, 13009 Marseille, France; Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Department of Orthopaedics and Traumatology, 13009 Marseille, France; Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, 13009 Marseille, France
| | - Sacha Tomczak
- Plastic and Reconstructive Surgery Department, Hôpital Conception, AP-HM, Marseille, France
| | - Marylène Lallemand
- Ecole Centrale Marseille, 13013 Marseille, France; Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Department of Orthopaedics and Traumatology, 13009 Marseille, France
| | - Charlotte Jaloux
- Hand Surgery and Limb Reconstructive Surgery, CHU de Timone, Aix-Marseille University, 264 Rue Saint Pierre, 13005 Marseille, France
| | - Jean Baptiste de Villeneuve Bargemon
- Hand Surgery and Limb Reconstructive Surgery, CHU de Timone, Aix-Marseille University, 264 Rue Saint Pierre, 13005 Marseille, France; Hand, Wrist and Elbow Surgery, Saint Roch Private Hospital, Toulon, 99 Avenue Saint Roch, 83100 Toulon, France
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Camy C, Grünewald T, Lamy E, Roseren F, Caumes M, Fovet T, Brioche T, Genovesio C, Chopard A, Pithioux M, Roffino S. Characterization of the mechanical properties of the mouse Achilles tendon enthesis by microindentation. Effects of unloading and subsequent reloading. Bone Rep 2024; 20:101734. [PMID: 38292933 PMCID: PMC10825371 DOI: 10.1016/j.bonr.2024.101734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 12/14/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024] Open
Abstract
The fibrocartilaginous tendon enthesis, i.e. the site where a tendon is attached to bone through a fibrocartilaginous tissue, is considered as a functionally graded interface. However, at local scale, a very limited number of studies have characterized micromechanical properties of this transitional tissue. The first goal of this work was to characterize the micromechanical properties of the mineralized part of the healthy Achilles tendon enthesis (ATE) through microindentation testing and to assess the degree of mineralization and of carbonation of mineral crystals by Raman spectroscopy. Since little is known about enthesis biological plasticity, our second objective was to examine the effects of unloading and reloading, using a mouse hindlimb-unloading model, on both the micromechanical properties and the mineral phase of the ATE. Elastic modulus, hardness, degree of mineralization, and degree of carbonation were assessed after 14 days of hindlimb suspension and again after a subsequent 6 days of reloading. The elastic modulus gradually increased along the mineralized part of the ATE from the tidemark to the subchondral bone, with the same trend being found for hardness. Whereas the degree of carbonation did not differ according to zone of measurement, the degree of mineralization increased by >70 % from tidemark to subchondral bone. Thus, the gradient in micromechanical properties is in part explained by a mineralization gradient. A 14-day unloading period did not appear to affect the gradient of micromechanical properties of the ATE, nor the degree of mineralization or carbonation. However, contrary to a short period of unloading, early return to normal mechanical load reduced the micromechanical properties gradient, regardless of carbonate-to-phosphate ratios, likely due to the more homogeneous degree of mineralization. These findings provide valuable data not only for tissue bioengineering, but also for musculoskeletal clinical studies and microgravity studies focusing on long-term space travel by astronauts.
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Affiliation(s)
- Claire Camy
- Aix Marseille Univ, CNRS, ISM, 13009 Marseille, France
| | - Tilman Grünewald
- Aix Marseille Univ, CNRS, Centrale Marseille, Institut Fresnel, Marseille, France
| | - Edouard Lamy
- Aix Marseille Univ, CNRS, ISM, 13009 Marseille, France
| | - Flavy Roseren
- Aix Marseille Univ, CNRS, ISM, 13009 Marseille, France
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Department of Orthopaedics and Traumatology, 13009 Marseille, France
| | | | - Théo Fovet
- DMEM, Montpellier University, INRAE, UMR 866, Montpellier, France
| | - Thomas Brioche
- DMEM, Montpellier University, INRAE, UMR 866, Montpellier, France
| | | | - Angèle Chopard
- DMEM, Montpellier University, INRAE, UMR 866, Montpellier, France
| | - Martine Pithioux
- Aix Marseille Univ, CNRS, ISM, 13009 Marseille, France
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Department of Orthopaedics and Traumatology, 13009 Marseille, France
- Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, 13009 Marseille, France
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Avellan S, Mabrouk A, Taillebot V, Pithioux M, Ollivier M. Using a patient-specific cutting guide enables identical knee osteotomies: An evaluation of accuracy on sawbones. Orthop Traumatol Surg Res 2024:103813. [PMID: 38218221 DOI: 10.1016/j.otsr.2024.103813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 12/22/2023] [Accepted: 01/08/2024] [Indexed: 01/15/2024]
Abstract
PURPOSE It was hypothesized that using a Patient-Specific Cutting Guide (PSCG) would allow the creation of sawbones model osteotomies, identical in the 3 planes and the hinge parameters, that can be used for biomechanical studies. The aim of the study was to evaluate the accuracy of the PSCG system and to introduce and assess the new hinge parameter; the hinge area. METHODS Six identical sawbones tibia models were identically set up for identical osteotomy cuts by the same surgeon in the same session and with identical instruments. A medical scanner was used to evaluate the 3D configuration of all the specimens. The analyzed parameters included the cutting angles in both the coronal and sagittal planes (degrees) and the hinge and the slicing areas (cm2), and the hinge thickness (mm). The values were statistically evaluated for average, standard deviation, 95% confidence index, and delta to the expected values were calculated. RESULTS The mean values for the coronal and sagittal angles were 110.5̊±1̊ and 89.8̊±0.8̊, respectively. The 95% confidence index level ranged between 0.1̊, and 0.8̊ in both the coronal & the sagittal planes. The mean values for the hinge thickness, the hinge area, and the slicing area were 12.7±1.5mm, 4.2±0.9 cm2, and 18.3±1.2 cm2, respectively. CONCLUSION In the presented study, it can be demonstrated that mechanically identical osteotomy specimens, with regard to the cutting planes and hinge parameters, can be reliably created using the PSCG. The identical specimens can be used for biomechanical research purposes to further expand our knowledge of the factors affecting osteotomy outcomes. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Sébastien Avellan
- Aix Marseille Univ, CNRS, ISM, 13009 Marseille, France; Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, 13009 Marseille, France; BIOBank®, Tissue Bank, Lieusaint, France
| | - Ahmed Mabrouk
- Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, 13009 Marseille, France; Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Virginie Taillebot
- Aix Marseille Univ, CNRS, ISM, 13009 Marseille, France; Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, 13009 Marseille, France.
| | - Martine Pithioux
- Aix Marseille Univ, CNRS, ISM, 13009 Marseille, France; Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, 13009 Marseille, France
| | - Matthieu Ollivier
- Aix Marseille Univ, CNRS, ISM, 13009 Marseille, France; Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, 13009 Marseille, France
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Caubère A, Roseren F, Aullo-Rasser G, Pithioux M, Ollivier M, Chabrand P. Osteochondral autograft transplantation (mosaicplasty): What is the impact of plug diameter in cartilage repair? Int Orthop 2023; 47:623-630. [PMID: 36637461 DOI: 10.1007/s00264-022-05686-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 12/29/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE To compare the mechanical stress applied to our grafted defect area according to the diameter of the plugs used in the treatment of osteochondral lesion with osteochondral autograft transplantation (OAT) procedure. METHODS A biomechanical study was conducted on eight cadaveric knees. A 20-mm defect was created in the weight-bearing zone on the medial femoral condyle then filled either with three plugs of 8 mm, or with four plugs of 6 mm, or with 6 plugs of 4 mm diameter. After the preparation of the specimens, each knee was installed on a mechanical test bench (Instron 5566A). A continuous axial compression of 700 N at 10 mm.min-1 was exerted on the joint. A K-scan 4000-type pressure sheet was used to record the contact area (mm2), the mean pressure (MPa), and the maximum pressure (MPa) on the area of interest. RESULTS The differences found between the conditions were not statistically significant but showed tendencies. Filling the defect with six plugs of 4 mm restores a larger contact surface compared with the other plugs. The use of 8- and 6-mm grafts lead to a respective increase of 12% and 52% of the mean pressure compared with the 4 mm grafts. This difference was also found for the maximum pressure (36% and 129%). Regardless of the diameter of the plugs used, filling the lesion reduces the mean pressure exerted on the healthy cartilage by 19%. DISCUSSION A trend emerged towards a better restoration of the cartilage surface and a more harmonious distribution of the pressures exerted in favour of the grafts of smaller diameter. A larger study is needed to obtain a statistically significant result.
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Affiliation(s)
- Alexandre Caubère
- Department of Orthopaedic Surgery and Traumatology, Military Hospital Sainte-Anne, 2, Bd Sainte Anne, BP600 83800, Toulon, France.
| | - Flavy Roseren
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Anatomy laboratory, Marseille, France
- Mecabio Platform, ISM, Aix Marseille University, 13009, Marseille, France
- Department of Orthopaedic Surgery and Traumatology, Institute of Locomotion, Sainte-Marguerite Hospital, Hospitalo-University Center of Marseille, APHM, Aix-Marseille University, 270, Boulevard de Sainte-Marguerite, 13009, Marseille, France
| | - Gaëtan Aullo-Rasser
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Anatomy laboratory, Marseille, France
- RLC Systems & Research, 13008, Marseille, France
- Department of Orthopaedic Surgery and Traumatology, Institute of Locomotion, Sainte-Marguerite Hospital, Hospitalo-University Center of Marseille, APHM, Aix-Marseille University, 270, Boulevard de Sainte-Marguerite, 13009, Marseille, France
| | - Martine Pithioux
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Anatomy laboratory, Marseille, France
- Department of Orthopaedic Surgery and Traumatology, Institute of Locomotion, Sainte-Marguerite Hospital, Hospitalo-University Center of Marseille, APHM, Aix-Marseille University, 270, Boulevard de Sainte-Marguerite, 13009, Marseille, France
| | - Matthieu Ollivier
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Anatomy laboratory, Marseille, France
- RLC Systems & Research, 13008, Marseille, France
| | - Patrick Chabrand
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Anatomy laboratory, Marseille, France
- Department of Orthopaedic Surgery and Traumatology, Institute of Locomotion, Sainte-Marguerite Hospital, Hospitalo-University Center of Marseille, APHM, Aix-Marseille University, 270, Boulevard de Sainte-Marguerite, 13009, Marseille, France
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5
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Milan JL, Manifacier I, Rousseau N, Pithioux M. In silico modelling of long bone healing involving osteoconduction and mechanical stimulation. Comput Methods Biomech Biomed Engin 2023; 26:174-186. [PMID: 35312400 DOI: 10.1080/10255842.2022.2052051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A lot of evidence has shown the importance of stimulating cell mechanically during bone repair. In this study, we modeled the challenging fracture healing of a large bone defect in tibial diaphysis. To fill the fracture gap, we considered the implantation of a porous osteoconductive biomaterial made of poly-lactic acid wrapped by a hydrogel membrane mimicking osteogenic properties of the periosteum. We identified the optimal loading case that best promotes the formation and differentiation into bone tissue. Our results support the idea that a patient's rehabilitation program should be adapted to reproduce optimal mechanical stimulations.
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Affiliation(s)
- Jean-Louis Milan
- Aix Marseille University, CNRS, ISM, Marseille, France.,Aix Marseille University, Marseille Public University Hospital System (APHM), French National Center for Scientific Research (CNRS), Institute of Movement Science (ISM), Sainte Marguerite Hospital, IML, Department of Orthopedics and Traumatology, Marseille, France.,Aix Marseille University, Marseille Public University Hospital System (APHM), French National Center for Scientific Research (CNRS), Anatomic laboratory, Timone, Marseille, France.,Aix Marseille University, Mecabio Platform, French National Center for Scientific Research (CNRS), Marseille, France
| | - Ian Manifacier
- Aix Marseille University, CNRS, ISM, Marseille, France.,Aix Marseille University, Marseille Public University Hospital System (APHM), French National Center for Scientific Research (CNRS), Institute of Movement Science (ISM), Sainte Marguerite Hospital, IML, Department of Orthopedics and Traumatology, Marseille, France.,Aix Marseille University, Marseille Public University Hospital System (APHM), French National Center for Scientific Research (CNRS), Anatomic laboratory, Timone, Marseille, France.,Aix Marseille University, Mecabio Platform, French National Center for Scientific Research (CNRS), Marseille, France
| | - Nicolas Rousseau
- Aix Marseille University, CNRS, ISM, Marseille, France.,Aix Marseille University, Marseille Public University Hospital System (APHM), French National Center for Scientific Research (CNRS), Institute of Movement Science (ISM), Sainte Marguerite Hospital, IML, Department of Orthopedics and Traumatology, Marseille, France.,Aix Marseille University, Marseille Public University Hospital System (APHM), French National Center for Scientific Research (CNRS), Anatomic laboratory, Timone, Marseille, France.,Aix Marseille University, Mecabio Platform, French National Center for Scientific Research (CNRS), Marseille, France.,Selenium Medical, La Rochelle, France
| | - Martine Pithioux
- Aix Marseille University, CNRS, ISM, Marseille, France.,Aix Marseille University, Marseille Public University Hospital System (APHM), French National Center for Scientific Research (CNRS), Institute of Movement Science (ISM), Sainte Marguerite Hospital, IML, Department of Orthopedics and Traumatology, Marseille, France.,Aix Marseille University, Marseille Public University Hospital System (APHM), French National Center for Scientific Research (CNRS), Anatomic laboratory, Timone, Marseille, France.,Aix Marseille University, Mecabio Platform, French National Center for Scientific Research (CNRS), Marseille, France
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Castoldi M, Solla F, Camuzard O, Pithioux M, Rampal V, Rosello O. A 3-Dimensional Suture Technique for Flexor Tendon Repair: A Biomechanical Study. J Hand Surg Am 2023; 48:194.e1-194.e9. [PMID: 34848101 DOI: 10.1016/j.jhsa.2021.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 07/21/2021] [Accepted: 09/22/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE Flexor tendon injury continues to pose a number of challenges for hand surgeons. Improving mechanical properties of repairs should allow for earlier and unprotected rehabilitation. A 3-dimensional (3D) 4-strand suture technique has been proposed to combine high tensile strength and low gliding resistance without causing suture pullout due to tendon delamination. Our hypothesis is that the 3D technique can result in better mechanical properties than the Adelaide technique. METHODS Four groups of 10 porcine flexor tendons were sutured using the 3D or Adelaide technique with a 3-0 polypropylene or ultrahigh molecular weight polyethylene (UHMWPE) suture. The axial traction test to failure was performed on each tendon to measure 2-mm gap force and ultimate tensile strength. RESULTS The mean 2-mm gap force was 49 N for group A (3D + polypropylene), 145 N for group B (3D + UHMWPE), 47 N for group C (Adelaide + polypropylene), and 80 N for group D (Adelaide + UHMWPE). Failure mode was caused by suture breakage for group A (10/10) and mainly by suture pullout for the other groups (8/10 up to 10/10). With the UHMWPE suture, the mean ultimate tensile strength was 145 N for the 3D technique and 80 N for the Adelaide technique. CONCLUSIONS Porcine flexor tendons repaired using the 3D technique and UHMWPE suture exceeded a 2-mm gap force and tensile strength of 140 N. The ultimate tensile strength was superior to that of the Adelaide technique, regardless of the suture material. CLINICAL RELEVANCE This in vitro study on porcine flexor tendon suture highlights that the mechanical properties of 3D repair are better than those of 3D repair using the Adelaide technique when a UHMWPE suture is used.
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Affiliation(s)
- Marie Castoldi
- Orthopaedic Surgery, Lenval University Children's Hospital, Nice, France; Medical School, Institute of Musculoskeletal Surgery, University of Nice, Nice, France; Aix-Marseille University, CNRS, ISM, Marseille, France
| | - Federico Solla
- Orthopaedic Surgery, Lenval University Children's Hospital, Nice, France.
| | - Olivier Camuzard
- Medical School, Institute of Musculoskeletal Surgery, University of Nice, Nice, France
| | - Martine Pithioux
- Aix-Marseille University, CNRS, ISM, Marseille, France; Aix-Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Virginie Rampal
- Orthopaedic Surgery, Lenval University Children's Hospital, Nice, France; LAMHESS, UPR 6312, Université Nice - Côte d'Azur, Nice, France
| | - Olivier Rosello
- Orthopaedic Surgery, Lenval University Children's Hospital, Nice, France
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Soudé G, De Villeneuve Bargemon JB, Khakha R, Pithioux M, Argenson JN, Ollivier M, Jacquet C. Pivot shift intraoperative quantitative assessment using a smartphone accelerometer in ACL deficient knees. J Exp Orthop 2023; 10:6. [PMID: 36695976 PMCID: PMC9877253 DOI: 10.1186/s40634-023-00570-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/06/2023] [Indexed: 01/26/2023] Open
Abstract
PURPOSE The Pivot Shift (PS) test is a complex clinical sign that assesses the internal rotation and anterior tibial translation, which occurs abnormally in ACL deficient-knees. Because of the high inter-observer variability, different devices have been designed to characterize this complex movement in quantitative variables. The objective of this pilot study is to validate the reproducibility of intraoperative quantitative assessment of the PS with a smartphone accelerometer. METHODS Twelve ACL-injured knees were included and compared with the contralateral uninjured side. The PS was measured by two independent observers utilizing a smartphone accelerometer and graded according to the IKDC classification. Measurements were taken preoperatively, intraoperatively and postoperatively. Intraoperative readings were taken during each stage of reconstruction or repair of meniscoligamentous lesions including meniscal lesions, ramp lesions, ACL reconstruction and lateral tenodesis. Reproducibility of the measurements were evaluated according to an intraclass correlation coefficient (ICC). RESULTS The intra-observer reliability was good for the first examiner and excellent for the second examiner, with the ICC 0.89 [0.67, 0.98] p < 0,001 and ICC 0.97 [0.91, 1.0] p < 0,001 respectively. The inter-observer reliability was excellent between the two observers with the ICC 0.99 [0.97, 1.0] p < 0,001. The mean tibial acceleration measured 3.45 m.s2 (SD = 1.71) preoperatively on the injured knees and 1.03 m.s2 (SD = 0.36) on the healthy knees, demonstrating a significant difference following univariate analysis p < 0.001. Postoperatively, no significant difference was observed between healthy and reconstructed knees The magnitudes of tibial acceleration values were correlated with the PS IKDC grade. CONCLUSION The smartphone accelerometer is a reproducible device to quantitatively assess the internal rotation and anterior tibial translation during ACL reconstruction surgery. The measurements are influenced by the different surgical steps. Other larger cohort studies are needed to evaluate the specific impact of each step of the ACL reconstruction and meniscal repair on this measurement. An external validation using other technologies are needed to validate the reliability of this device to assess the PS test. LEVEL OF EVIDENCE Level IV, case series, pilot study.
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Affiliation(s)
- Guillaume Soudé
- grid.5399.60000 0001 2176 4817Aix-Marseille University, CNRS, ISM UMR 7287, 13288, cedex 09 Marseille, France ,Department of Orthopedic surgery and Traumatology St. Marguerite Hospital, Institute of movement and locomotion, 270 Boulevard Sainte Marguerite, 29 13274 Marseille, BP France
| | - Jean-Baptiste De Villeneuve Bargemon
- Department of Orthopedic surgery and Traumatology St. Marguerite Hospital, Institute of movement and locomotion, 270 Boulevard Sainte Marguerite, 29 13274 Marseille, BP France ,International Wrist Center, Bizet Clinic, Paris, France
| | - Raghbir Khakha
- grid.420545.20000 0004 0489 3985Guys and St Thomas Hospitals, London, UK
| | - Martine Pithioux
- grid.5399.60000 0001 2176 4817Aix-Marseille University, CNRS, ISM UMR 7287, 13288, cedex 09 Marseille, France ,Department of Orthopedic surgery and Traumatology St. Marguerite Hospital, Institute of movement and locomotion, 270 Boulevard Sainte Marguerite, 29 13274 Marseille, BP France
| | - Jean-Noël Argenson
- grid.5399.60000 0001 2176 4817Aix-Marseille University, CNRS, ISM UMR 7287, 13288, cedex 09 Marseille, France ,Department of Orthopedic surgery and Traumatology St. Marguerite Hospital, Institute of movement and locomotion, 270 Boulevard Sainte Marguerite, 29 13274 Marseille, BP France
| | - Matthieu Ollivier
- grid.5399.60000 0001 2176 4817Aix-Marseille University, CNRS, ISM UMR 7287, 13288, cedex 09 Marseille, France ,Department of Orthopedic surgery and Traumatology St. Marguerite Hospital, Institute of movement and locomotion, 270 Boulevard Sainte Marguerite, 29 13274 Marseille, BP France
| | - Christophe Jacquet
- grid.5399.60000 0001 2176 4817Aix-Marseille University, CNRS, ISM UMR 7287, 13288, cedex 09 Marseille, France ,Department of Orthopedic surgery and Traumatology St. Marguerite Hospital, Institute of movement and locomotion, 270 Boulevard Sainte Marguerite, 29 13274 Marseille, BP France
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Roumani S, Jeanneau C, Giraud T, Cotten A, Laucournet M, Sohier J, Pithioux M, About I. Osteogenic Potential of a Polyethylene Glycol Hydrogel Functionalized with Poly-Lysine Dendrigrafts (DGL) for Bone Regeneration. Materials (Basel) 2023; 16:ma16020862. [PMID: 36676600 PMCID: PMC9863473 DOI: 10.3390/ma16020862] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/28/2022] [Accepted: 01/12/2023] [Indexed: 05/27/2023]
Abstract
Resorbable hydrogels are widely used as scaffolds for tissue engineering. These hydrogels can be modified by grafting dendrimer-linked functionalized molecules (dendrigrafts). Our aim was to develop a tunable poly(L-lysine) dendrigrafts (DGL)/PEG-based hydrogel with an inverse porosity and to investigate its osteogenic potential. DGL/PEG hydrogels were emulsified in a surfactant-containing oil solution to form microspheres. The toxicity was evaluated on Human Vascular Endothelial Cells (HUVECs) and Bone Marrow Mesenchymal Stem Cells (hMSCs) with Live/Dead and MTT assays. The effects on HUVECs were investigated through C5 Complement expression by RT-PCR and C5a/TGF-β1 secretion by ELISA. Recruitment of hMSCs was investigated using Boyden chambers and their osteogenic differentiation was studied by measuring Alkaline Phosphatase activity (ALP) and BMP-2 secretion by ELISA. Adjusting the stirring speed during the emulsification allowed to obtain spherical microspheres with tunable diameters (10-1600 µm). The cell viability rate with the hydrogel was 95 and 100% with HUVECs and hMSCs, respectively. Incubating HUVECs with the biomaterial induced a 5-fold increase in TGF-β1 and a 3-fold increase in Complement C5a release. Furthermore, HUVEC supernatants obtained after incubation with the hydrogel induced a 2.5-fold increase in hMSC recruitment. The hydrogel induced a 3-fold increase both in hMSC ALP activity and BMP-2 secretion. Overall, the functionalized hydrogel enhanced the osteogenic potential by interacting with endothelial cells and hMSCs and represents a promising tool for bone tissue engineering.
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Affiliation(s)
- Sandra Roumani
- Aix-Marseille University, CNRS, ISM, 13009 Marseille, France
| | | | - Thomas Giraud
- Aix-Marseille University, CNRS, ISM, 13009 Marseille, France
- APHM, Hôpital Timone, Pôle Odontologie, 13005 Marseille, France
| | - Aurélie Cotten
- Aix-Marseille University, CNRS, ISM, 13009 Marseille, France
| | - Marc Laucournet
- Laboratory for Tissue Biology and Therapeutic Engineering (LBTI), UMR 5305, CNRS, Lyon University, 69367 Lyon, France
| | - Jérôme Sohier
- Laboratory for Tissue Biology and Therapeutic Engineering (LBTI), UMR 5305, CNRS, Lyon University, 69367 Lyon, France
| | - Martine Pithioux
- Aix-Marseille University, CNRS, ISM, 13009 Marseille, France
- Aix-Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, 13009 Marseille, France
| | - Imad About
- Aix-Marseille University, CNRS, ISM, 13009 Marseille, France
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9
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Soldati E, Roseren F, Guenoun D, Mancini L, Catelli E, Prati S, Sciutto G, Vicente J, Iotti S, Bendahan D, Malucelli E, Pithioux M. Multiscale Femoral Neck Imaging and Multimodal Trabeculae Quality Characterization in an Osteoporotic Bone Sample. Materials (Basel) 2022; 15:8048. [PMID: 36431532 PMCID: PMC9694313 DOI: 10.3390/ma15228048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/05/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
Although multiple structural, mechanical, and molecular factors are definitely involved in osteoporosis, the assessment of subregional bone mineral density remains the most commonly used diagnostic index. In this study, we characterized bone quality in the femoral neck of one osteoporotic patients as compared to an age-matched control subject, and so used a multiscale and multimodal approach including X-ray computed microtomography at different spatial resolutions (pixel size: 51.0, 4.95 and 0.9 µm), microindentation and Fourier transform infrared spectroscopy. Our results showed abnormalities in the osteocytes lacunae volume (358.08 ± 165.00 for the osteoporotic sample vs. 287.10 ± 160.00 for the control), whereas a statistical difference was found neither for shape nor for density. The osteoporotic femoral head and great trochanter reported reduced elastic modulus (Es) and hardness (H) compared to the control reference (−48% (p < 0.0001) and −34% (p < 0.0001), respectively for Es and H in the femoral head and −29% (p < 0.01) and −22% (p < 0.05), respectively for Es and H in the great trochanter), whereas the corresponding values in the femoral neck were in the same range. The spectral analysis could distinguish neither subregional differences in the osteoporotic sample nor between the osteoporotic and healthy samples. Although, infrared spectroscopic measurements were comparable among subregions, and so regardless of the bone osteoporotic status, the trabecular mechanical properties were comparable only in the femoral neck. These results illustrate that bone remodeling in osteoporosis is a non-uniform process with different rates in different bone anatomical regions, hence showing the interest of a clear analysis of the bone microarchitecture in the case of patients’ osteoporotic evaluation.
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Affiliation(s)
- Enrico Soldati
- Aix Marseille University, CNRS, IUSTI, 13453 Marseille, France
- Aix Marseille University, CNRS, CRMBM, 13385 Marseille, France
- Aix Marseille University, CNRS, ISM, 13288 Marseille, France
| | - Flavy Roseren
- Aix Marseille University, CNRS, ISM, 13288 Marseille, France
| | - Daphne Guenoun
- Aix Marseille University, CNRS, ISM, 13288 Marseille, France
- Aix Marseille University, APHM, CNRS, ISM, Sainte Marguerite Hospital, Institute for Locomotion, Department of Radiology, 13274 Marseille, France
| | - Lucia Mancini
- Elettra-Sincrotrone Trieste S.C.p.A, SS 14–km 1535 in Area Science Park, Basovizza, 34149 Trieste, Italy
- Slovenian National Building and Civil Engineering Institute, Dimičeva ulica 12, 1000 Ljubljana, Slovenia
| | - Emilio Catelli
- University of Bologna, Department of Chemistry “G. Ciamician”, Ravenna Campus, Via Guaccimanni, 42, 48121 Ravenna, Italy
| | - Silvia Prati
- University of Bologna, Department of Chemistry “G. Ciamician”, Ravenna Campus, Via Guaccimanni, 42, 48121 Ravenna, Italy
| | - Giorgia Sciutto
- University of Bologna, Department of Chemistry “G. Ciamician”, Ravenna Campus, Via Guaccimanni, 42, 48121 Ravenna, Italy
| | - Jerome Vicente
- Aix Marseille University, CNRS, IUSTI, 13453 Marseille, France
| | - Stefano Iotti
- Università di Bologna, Department of Pharmacy and Biotechnology (FaBit), Via Zamboni 33, 40126 Bologna, Italy
- National Institute of Biostructures and Biosystems, Viale delle Medaglie d’Oro 305, 00136 Roma, Italy
| | - David Bendahan
- Aix Marseille University, CNRS, CRMBM, 13385 Marseille, France
| | - Emil Malucelli
- Università di Bologna, Department of Pharmacy and Biotechnology (FaBit), Via Zamboni 33, 40126 Bologna, Italy
| | - Martine Pithioux
- Aix Marseille University, CNRS, ISM, 13288 Marseille, France
- Aix Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, 13274 Marseille, France
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10
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Camy C, Brioche T, Senni K, Bertaud A, Genovesio C, Lamy E, Fovet T, Chopard A, Pithioux M, Roffino S. Effects of hindlimb unloading and subsequent reloading on the structure and mechanical properties of Achilles tendon-to-bone attachment. FASEB J 2022; 36:e22548. [PMID: 36121701 DOI: 10.1096/fj.202200713r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/10/2022] [Accepted: 09/02/2022] [Indexed: 11/11/2022]
Abstract
While muscle and bone adaptations to deconditioning have been widely described, few studies have focused on the tendon enthesis. Our study examined the effects of mechanical loading on the structure and mechanical properties of the Achilles tendon enthesis. We assessed the fibrocartilage surface area, the organization of collagen, the expression of collagen II, the presence of osteoclasts, and the tensile properties of the mouse enthesis both after 14 days of hindlimb suspension (HU) and after a subsequent 6 days of reloading. Although soleus atrophy was severe after HU, calcified fibrocartilage (CFc) was a little affected. In contrast, we observed a decrease in non-calcified fibrocartilage (UFc) surface area, collagen fiber disorganization, modification of morphological characteristics of the fibrocartilage cells, and altered collagen II distribution. Compared to the control group, restoring normal loads increased both UFc surface area and expression of collagen II, and led to a crimp pattern in collagen. Reloading induced an increase in CFc surface area, probably due to the mineralization front advancing toward the tendon. Functionally, unloading resulted in decreased enthesis stiffness and a shift in site of failure from the osteochondral interface to the bone, whereas 6 days of reloading restored the original elastic properties and site of failure. In the context of spaceflight, our results suggest that care must be taken when performing countermeasure exercises both during missions and during the return to Earth.
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Affiliation(s)
- Claire Camy
- Aix Marseille University, CNRS, ISM, Institute of Movement Sciences, Marseille, France
| | - Thomas Brioche
- DMEM, Montpellier University, INRAE, UMR 866, Montpellier, France
| | - Karim Senni
- Laboratoire EBInnov, Ecole de Biologie Industrielle-EBI, Cergy, France
| | - Alexandrine Bertaud
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France.,Laboratoire de Biochimie, Faculté de Pharmacie, Marseille, France
| | - Cécile Genovesio
- Laboratoire de Biochimie, Faculté de Pharmacie, Marseille, France
| | - Edouard Lamy
- Aix Marseille University, CNRS, ISM, Institute of Movement Sciences, Marseille, France.,Laboratoire de Biochimie, Faculté de Pharmacie, Marseille, France
| | - Théo Fovet
- DMEM, Montpellier University, INRAE, UMR 866, Montpellier, France
| | - Angèle Chopard
- DMEM, Montpellier University, INRAE, UMR 866, Montpellier, France
| | - Martine Pithioux
- Aix Marseille University, CNRS, ISM, Institute of Movement Sciences, Marseille, France.,Department of Orthopaedics and Traumatology, Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Marseille, France.,Aix Marseille Univ, APHM, CNRS, Centrale Marseille, ISM, Mecabio Platform, Anatomy Laboratory, Timone, Marseille, France
| | - Sandrine Roffino
- Aix Marseille University, CNRS, ISM, Institute of Movement Sciences, Marseille, France.,Aix Marseille Univ, APHM, CNRS, Centrale Marseille, ISM, Mecabio Platform, Anatomy Laboratory, Timone, Marseille, France
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11
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Roseren F, Roffino S, Pithioux M. Mechanical Characterization at the Microscale of Mineralized Bone Callus after Bone Lengthening. Materials (Basel) 2022; 15:6207. [PMID: 36143518 PMCID: PMC9501547 DOI: 10.3390/ma15186207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Abstract
Distraction osteogenesis (DO) involves several processes to form an organized distracted callus. While bone regeneration during DO has been widely described, no study has yet focused on the evolution profile of mechanical properties of mineralized tissues in the distracted callus. The aim of this study was therefore to measure the elastic modulus and hardness of calcified cartilage and trabecular and cortical bone within the distracted callus during the consolidation phase. We used a microindentation assay to measure the mechanical properties of periosteal and endosteal calluses; each was subdivided into two regions. Histological sections were used to localize the tissues. The results revealed that the mechanical properties of calcified cartilage did not evolve over time. However, trabecular bone showed temporal variation. For elastic modulus, in three out of four regions, a similar evolution profile was observed with an increase and decrease over time. Concerning hardness, this evolves differently depending on the location in the distracted callus. We also observed spatial changes in between regions. A first duality was apparent between regions close to the native cortices and the central area, while latter differences were seen between periosteal and endosteal calluses. Data showed a heterogeneity of mechanical properties in the distracted callus with a specific mineralization profile.
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Affiliation(s)
- Flavy Roseren
- Aix Marseille Univ, CNRS, ISM, 13009 Marseille, France
- Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, 13009 Marseille, France
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Anatomy Laboratory, 13009 Marseille, France
| | - Sandrine Roffino
- Aix Marseille Univ, CNRS, ISM, 13009 Marseille, France
- Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, 13009 Marseille, France
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Anatomy Laboratory, 13009 Marseille, France
| | - Martine Pithioux
- Aix Marseille Univ, CNRS, ISM, 13009 Marseille, France
- Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, 13009 Marseille, France
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Anatomy Laboratory, 13009 Marseille, France
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12
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Soldati E, Pithioux M, Guenoun D, Bendahan D, Vicente J. Assessment of Bone Microarchitecture in Fresh Cadaveric Human Femurs: What Could Be the Clinical Relevance of Ultra-High Field MRI. Diagnostics (Basel) 2022; 12:diagnostics12020439. [PMID: 35204529 PMCID: PMC8870786 DOI: 10.3390/diagnostics12020439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/27/2022] [Accepted: 02/03/2022] [Indexed: 11/16/2022] Open
Abstract
MRI could be applied for bone microarchitecture assessment; however, this technique is still suffering from low resolution compared to the trabecular dimension. A clear comparative analysis between MRI and X-ray microcomputed tomography (μCT) regarding microarchitecture metrics is still lacking. In this study, we performed a comparative analysis between μCT and 7T MRI with the aim of assessing the image resolution effect on the accuracy of microarchitecture metrics. We also addressed the issue of air bubble artifacts in cadaveric bones. Three fresh cadaveric femur heads were scanned using 7T MRI and µCT at high resolution (0.051 mm). Samples were submitted to a vacuum procedure combined with vibration to reduce the volume of air bubbles. Trabecular interconnectivity, a new metric, and conventional histomorphometric parameters were quantified using MR images and compared to those derived from µCT at full resolution and downsized resolutions (0.102 and 0.153 mm). Correlations between bone morphology and mineral density (BMD) were evaluated. Air bubbles were reduced by 99.8% in 30 min, leaving partial volume effects as the only source of bias. Morphological parameters quantified with 7T MRI were not statistically different (p > 0.01) to those computed from μCT images, with error up to 8% for both bone volume fraction and trabecular spacing. No linear correlation was found between BMD and all morphological parameters except trabecular interconnectivity (R2 = 0.69 for 7T MRI-BMD). These results strongly suggest that 7T MRI could be of interest for in vivo bone microarchitecture assessment, providing additional information about bone health and quality.
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Affiliation(s)
- Enrico Soldati
- Aix Marseille Univ, CNRS, IUSTI, 13453 Marseille, France;
- Aix Marseille Univ, CNRS, CRMBM, 13385 Marseille, France;
- Aix Marseille Univ, CNRS, ISM, 13288 Marseille, France; (M.P.); (D.G.)
- Correspondence:
| | - Martine Pithioux
- Aix Marseille Univ, CNRS, ISM, 13288 Marseille, France; (M.P.); (D.G.)
- Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, 13274 Marseille, France
| | - Daphne Guenoun
- Aix Marseille Univ, CNRS, ISM, 13288 Marseille, France; (M.P.); (D.G.)
- Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Radiology, 13274 Marseille, France
| | - David Bendahan
- Aix Marseille Univ, CNRS, CRMBM, 13385 Marseille, France;
| | - Jerome Vicente
- Aix Marseille Univ, CNRS, IUSTI, 13453 Marseille, France;
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13
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Baron C, Follet H, Pithioux M, Payan C, Lasaygues P. Assessing the Elasticity of Child Cortical Bone. Advances in Experimental Medicine and Biology 2022; 1364:297-318. [DOI: 10.1007/978-3-030-91979-5_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Soldati E, Vicente J, Guenoun D, Bendahan D, Pithioux M. Validation and Optimization of Proximal Femurs Microstructure Analysis Using High Field and Ultra-High Field MRI. Diagnostics (Basel) 2021; 11:1603. [PMID: 34573945 PMCID: PMC8466948 DOI: 10.3390/diagnostics11091603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 11/18/2022] Open
Abstract
Trabecular bone could be assessed non-invasively using MRI. However, MRI does not yet provide resolutions lower than trabecular thickness and a comparative analysis between different MRI sequences at different field strengths and X-ray microtomography (μCT) is still missing. In this study, we compared bone microstructure parameters and bone mineral density (BMD) computed using various MRI approaches, i.e., turbo spin echo (TSE) and gradient recalled echo (GRE) images used at different magnetic fields, i.e., 7T and 3T. The corresponding parameters computed from μCT images and BMD derived from dual-energy X-ray absorptiometry (DXA) were used as the ground truth. The correlation between morphological parameters, BMD and fracture load assessed by mechanical compression tests was evaluated. Histomorphometric parameters showed a good agreement between 7T TSE and μCT, with 8% error for trabecular thickness with no significative statistical difference and a good intraclass correlation coefficient (ICC > 0.5) for all the extrapolated parameters. No correlation was found between DXA-BMD and all morphological parameters, except for trabecular interconnectivity (R2 > 0.69). Good correlation (p-value < 0.05) was found between failure load and trabecular interconnectivity (R2 > 0.79). These results suggest that MRI could be of interest for bone microstructure assessment. Moreover, the combination of morphological parameters and BMD could provide a more comprehensive view of bone quality.
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Affiliation(s)
- Enrico Soldati
- Aix Marseille Univ, CNRS, IUSTI, 13453 Marseille, France;
- Aix Marseille Univ, CNRS, CRMBM, 13385 Marseille, France;
- Aix Marseille Univ, CNRS, ISM, 13288 Marseille, France; (D.G.); (M.P.)
| | - Jerome Vicente
- Aix Marseille Univ, CNRS, IUSTI, 13453 Marseille, France;
| | - Daphne Guenoun
- Aix Marseille Univ, CNRS, ISM, 13288 Marseille, France; (D.G.); (M.P.)
- Department of Radiology, Institute for Locomotion, Sainte-Marguerite Hospital, Aix Marseille Univ, APHM, CNRS, ISM, 13274 Marseille, France
| | - David Bendahan
- Aix Marseille Univ, CNRS, CRMBM, 13385 Marseille, France;
| | - Martine Pithioux
- Aix Marseille Univ, CNRS, ISM, 13288 Marseille, France; (D.G.); (M.P.)
- Department of Orthopaedics and Traumatology, Institute for Locomotion, Sainte-Marguerite Hospital, Aix Marseille Univ, APHM, CNRS, ISM, 13274 Marseille, France
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15
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Roffino S, Camy C, Foucault-Bertaud A, Lamy E, Pithioux M, Chopard A. Negative impact of disuse and unloading on tendon enthesis structure and function. Life Sci Space Res (Amst) 2021; 29:46-52. [PMID: 33888287 DOI: 10.1016/j.lssr.2021.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/19/2021] [Accepted: 03/05/2021] [Indexed: 06/12/2023]
Abstract
Exposure to chronic skeletal muscle disuse and unloading that astronauts experience results in muscle deconditioning and bone remodeling. Tendons involved in the transmission of force from muscles to skeleton are also affected. Understanding the changes that occur in muscle, tendon, and bone is an essential step toward limiting or preventing the deleterious effects of chronic reduction in mechanical load. Numerous reviews have reported the effects of this reduction on both muscle and bone, and to a lesser extent on the tendon. However, none focused on the tendon enthesis, the tendon-to-bone attachment site. While the enthesis structure appears to be determined by mechanical stress, little is known about enthesis plasticity. Our review first looks at the relationship between entheses and mechanical stress, exploring how tensile and compressive loads determine and influence enthesis structure and composition. The second part of this review addresses the deleterious effects of skeletal muscle disuse and unloading on enthesis structure, composition, and function. We discuss the possibility that spaceflight-induced enthesis remodeling could impact both the capacity of the enthesis to withstand compressive stress and its potential weakness. Finally, we point out how altered compressive strength at entheses could expose astronauts to the risk of developing enthesopathies.
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Affiliation(s)
- S Roffino
- ISM Inst Movement Sci, Aix-Marseille University, CNRS, Marseille, France.
| | - C Camy
- ISM Inst Movement Sci, Aix-Marseille University, CNRS, Marseille, France
| | - A Foucault-Bertaud
- INSERM 1263, INRA 1260, C2VN, Aix-Marseille University, Marseille, France
| | - E Lamy
- ISM Inst Movement Sci, Aix-Marseille University, CNRS, Marseille, France
| | - M Pithioux
- ISM Inst Movement Sci, Aix-Marseille University, CNRS, Marseille, France
| | - A Chopard
- DMEM, Montpellier University, INRAE, Montpellier, France
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16
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Soldati E, Rossi F, Vicente J, Guenoun D, Pithioux M, Iotti S, Malucelli E, Bendahan D. Survey of MRI Usefulness for the Clinical Assessment of Bone Microstructure. Int J Mol Sci 2021; 22:ijms22052509. [PMID: 33801539 PMCID: PMC7958958 DOI: 10.3390/ijms22052509] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/21/2021] [Accepted: 02/25/2021] [Indexed: 12/12/2022] Open
Abstract
Bone microarchitecture has been shown to provide useful information regarding the evaluation of skeleton quality with an added value to areal bone mineral density, which can be used for the diagnosis of several bone diseases. Bone mineral density estimated from dual-energy X-ray absorptiometry (DXA) has shown to be a limited tool to identify patients’ risk stratification and therapy delivery. Magnetic resonance imaging (MRI) has been proposed as another technique to assess bone quality and fracture risk by evaluating the bone structure and microarchitecture. To date, MRI is the only completely non-invasive and non-ionizing imaging modality that can assess both cortical and trabecular bone in vivo. In this review article, we reported a survey regarding the clinically relevant information MRI could provide for the assessment of the inner trabecular morphology of different bone segments. The last section will be devoted to the upcoming MRI applications (MR spectroscopy and chemical shift encoding MRI, solid state MRI and quantitative susceptibility mapping), which could provide additional biomarkers for the assessment of bone microarchitecture.
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Affiliation(s)
- Enrico Soldati
- CRMBM, CNRS, Aix Marseille University, 13385 Marseille, France;
- IUSTI, CNRS, Aix Marseille University, 13013 Marseille, France;
- ISM, CNRS, Aix Marseille University, 13288 Marseille, France; (D.G.); (M.P.)
- Correspondence:
| | - Francesca Rossi
- Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy; (F.R.); (S.I.); (E.M.)
| | - Jerome Vicente
- IUSTI, CNRS, Aix Marseille University, 13013 Marseille, France;
| | - Daphne Guenoun
- ISM, CNRS, Aix Marseille University, 13288 Marseille, France; (D.G.); (M.P.)
- Department of Radiology, Institute for Locomotion, Saint-Marguerite Hospital, ISM, CNRS, APHM, Aix Marseille University, 13274 Marseille, France
| | - Martine Pithioux
- ISM, CNRS, Aix Marseille University, 13288 Marseille, France; (D.G.); (M.P.)
- Department of Orthopedics and Traumatology, Institute for Locomotion, Saint-Marguerite Hospital, ISM, CNRS, APHM, Aix Marseille University, 13274 Marseille, France
| | - Stefano Iotti
- Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy; (F.R.); (S.I.); (E.M.)
- National Institute of Biostructures and Biosystems, 00136 Rome, Italy
| | - Emil Malucelli
- Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy; (F.R.); (S.I.); (E.M.)
| | - David Bendahan
- CRMBM, CNRS, Aix Marseille University, 13385 Marseille, France;
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17
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Lefevre E, Baron C, Gineyts E, Bala Y, Gharbi H, Allain JM, Lasaygues P, Pithioux M, Follet H. Ultrasounds could be considered as a future tool for probing growing bone properties. Sci Rep 2020; 10:15698. [PMID: 32973276 PMCID: PMC7518273 DOI: 10.1038/s41598-020-72776-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 08/26/2020] [Indexed: 11/30/2022] Open
Abstract
Juvenile bone growth is well described (physiological and anatomical) but there are still lacks of knowledge on intrinsic material properties. Our group has already published, on different samples, several studies on the assessment of intrinsic material properties of juvenile bone compared to material properties of adult bone. The purpose of this study was finally to combine different experimental modalities available (ultrasonic measurement, micro-Computed Tomography analysis, mechanical compression tests and biochemical measurements) applied on small cubic bone samples in order to gain insight into the multiparametric evaluation of bone quality. Differences were found between juvenile and adult groups in term of architectural parameters (Porosity Separation), Tissue Mineral Density (TMD), diagonal stiffness coefficients (C33, C44, C55, C66) and ratio between immature and mature cross-links (CX). Diagonal stiffness coefficients are more representative of the microstructural and biochemical parameters of child bone than of adult bone. We also found that compression modulus E was highly correlated with several microstructure parameters and CX in children group while it was not at all correlated in the adult group. Similar results were found for the CX which was linked to several microstructure parameters (TMD and E) only in the juvenile group. To our knowledge, this is the first time that, on a same sample, ultrasonic measurements have been combined with the assessment of mechanical and biochemical properties. It appears that ultrasonic measurements can provide relevant indicators of child bone quality (microstructural and biochemical parameters) which is promising for clinical application since, B-mode ultrasound is the preferred first-line modality over other more constraining imaging modalities (radiation, parent–child accessibility and access to the patient's bed) for pediatric patients.
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Affiliation(s)
- Emmanuelle Lefevre
- Aix Marseille Univ, CNRS,ISM, Marseille, France.,Aix Marseille Univ, APHM,CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Cécile Baron
- Aix Marseille Univ, CNRS,ISM, Marseille, France.,Aix Marseille Univ, APHM,CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Evelyne Gineyts
- Univ Lyon, Univ Claude Bernard Lyon 1, INSERM, LYOS UMR1033, F69008, Lyon, France
| | - Yohann Bala
- Univ Lyon, Univ Claude Bernard Lyon 1, INSERM, LYOS UMR1033, F69008, Lyon, France.,Laboratoire Vibrations Acoustique, INSA Lyon, Campus LyonTech la Doua, Villeurbanne, France
| | - Hakim Gharbi
- LMS, Ecole Polytechnique,CNRS, Institut Polytechnique de Paris, Palaiseau, France
| | - Jean-Marc Allain
- LMS, Ecole Polytechnique,CNRS, Institut Polytechnique de Paris, Palaiseau, France.,Inria, Palaiseau, France
| | | | - Martine Pithioux
- Aix Marseille Univ, CNRS,ISM, Marseille, France.,Aix Marseille Univ, APHM,CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Hélène Follet
- Univ Lyon, Univ Claude Bernard Lyon 1, INSERM, LYOS UMR1033, F69008, Lyon, France.
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18
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Jacquet C, Jaubert M, Pioger C, Sbihi A, Pithioux M, Le Baron M, Sharma A, Ollivier M. Presoaking of Semitendinosus Graft With Vancomycin Does Not Alter Its Biomechanical Properties: A Biomechanical In Vitro-Controlled Study Using Graft From Living Donors. Arthroscopy 2020; 36:2231-2236. [PMID: 32304710 DOI: 10.1016/j.arthro.2020.03.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the biomechanical properties of human semitendinosus graft presoaked with or without vancomycin under a load to failure tensile test. METHODS Thirty semitendinosus grafts harvested during anterior cruciate ligament reconstruction were included. These were dissected equally into 2 halves and subsequently randomly allocated to a vancomycin group and to a control group. A digital caliper was used to precisely measure each samples thickness, length, and width. For the vancomycin group, samples were presoaked in a solution of 5 mg/mL vancomycin for a duration of 10 minutes and the control group samples were presoaked in a physiological serum equally for 10 minutes. Mechanical testing was performed on a universal testing machine (Instron 5566-A) after a preconditioning of 10 cycles of 1 mm extension and a progression of 10 mm/min to failure for each sample. The stress-strain curve was obtained to determine the elastic modulus (Young's modulus), the ultimate tensile stress, the ultimate tensile elongation (UTE) before failure and the elasticity limit. RESULTS For the control group, the average Young's modulus value was 4.8 ± 0.8, the average UTS was 25.2 ± 5.2 MPa, the average percentage of UTE was 78 ± 17%, and the average elasticity limit value was 17.3 ± 5.3 MPa. For the vancomycin group, the average Young's modulus value was 4.7 ± 0.9, the average ultimate tensile stress was 24.1 ± 6.1 MPa, the average percentage of UTE was 82 ± 14%, and the average elasticity limit value was 18.5 ± 5.9 MPa. No significant difference was observed between the 2 groups for all investigated parameters. CONCLUSIONS Presoaking of human semitendinosus graft with vancomycin does not alter its biomechanical properties. CLINICAL RELEVANCE This study demonstrates that vancomycin presoaking used to prevent post-anterior cruciate ligament reconstruction septic arthritis does not affect immediate biomechanical properties of semitendinosus tendons.
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Affiliation(s)
- Christophe Jacquet
- Institute of Movement and Locomotion, Department of Orthopedics and Traumatology, St. Marguerite Hospital, Marseille, France
| | - Maxime Jaubert
- Institute of Movement and Locomotion, Department of Orthopedics and Traumatology, St. Marguerite Hospital, Marseille, France
| | - Charles Pioger
- Institute of Movement and Locomotion, Department of Orthopedics and Traumatology, St. Marguerite Hospital, Marseille, France
| | - Abderahmane Sbihi
- Institute of Movement and Locomotion, Department of Orthopedics and Traumatology, St. Marguerite Hospital, Marseille, France
| | - Martine Pithioux
- Institute of Movement and Locomotion, Department of Orthopedics and Traumatology, St. Marguerite Hospital, Marseille, France
| | - Marie Le Baron
- Institute of Movement and Locomotion, Department of Orthopedics and Traumatology, St. Marguerite Hospital, Marseille, France
| | - Akash Sharma
- Institute of Movement and Locomotion, Department of Orthopedics and Traumatology, St. Marguerite Hospital, Marseille, France; Institut de Chirurgie Orthopédique et Sportive, Marseille, France
| | - Matthieu Ollivier
- Institute of Movement and Locomotion, Department of Orthopedics and Traumatology, St. Marguerite Hospital, Marseille, France.
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19
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Lefèvre E, Farlay D, Bala Y, Subtil F, Wolfram U, Rizzo S, Baron C, Zysset P, Pithioux M, Follet H. Compositional and mechanical properties of growing cortical bone tissue: a study of the human fibula. Sci Rep 2019; 9:17629. [PMID: 31772277 PMCID: PMC6879611 DOI: 10.1038/s41598-019-54016-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/08/2019] [Indexed: 01/28/2023] Open
Abstract
Human cortical bone contains two types of tissue: osteonal and interstitial tissue. Growing bone is not well-known in terms of its intrinsic material properties. To date, distinctions between the mechanical properties of osteonal and interstitial regions have not been investigated in juvenile bone and compared to adult bone in a combined dataset. In this work, cortical bone samples obtained from fibulae of 13 juveniles patients (4 to 18 years old) during corrective surgery and from 17 adult donors (50 to 95 years old) were analyzed. Microindentation was used to assess the mechanical properties of the extracellular matrix, quantitative microradiography was used to measure the degree of bone mineralization (DMB), and Fourier transform infrared microspectroscopy was used to evaluate the physicochemical modifications of bone composition (organic versus mineral matrix). Juvenile and adult osteonal and interstitial regions were analyzed for DMB, crystallinity, mineral to organic matrix ratio, mineral maturity, collagen maturity, carbonation, indentation modulus, indicators of yield strain and tissue ductility using a mixed model. We found that the intrinsic properties of the juvenile bone were not all inferior to those of the adult bone. Mechanical properties were also differently explained in juvenile and adult groups. The study shows that different intrinsic properties should be used in case of juvenile bone investigation.
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Affiliation(s)
- Emmanuelle Lefèvre
- Aix-Marseille Univ., CNRS, ISM Inst Movement Sci, Marseille, France.,Department of Orthopaedics and Traumatology, Institute for Locomotion, APHM, Sainte-Marguerite Hospital, Marseille, France
| | - Delphine Farlay
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM, Lyos UMR1033, F69622, Lyon, France
| | - Yohann Bala
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM, Lyos UMR1033, F69622, Lyon, France.,Laboratoire Vibrations Acoustique, INSA Lyon, Campus LyonTech la Doua, F69621, Villeurbanne Cedex, France
| | - Fabien Subtil
- Univ Lyon, Université Claude Bernard Lyon 1, Equipe Biostatistique Santé - LBBE, F69003, Lyon, France
| | - Uwe Wolfram
- School of Engineering and Physical Science, Heriot-Watt University, Edinburgh, United Kingdom
| | - Sébastien Rizzo
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM, Lyos UMR1033, F69622, Lyon, France
| | - Cécile Baron
- Aix-Marseille Univ., CNRS, ISM Inst Movement Sci, Marseille, France.,Department of Orthopaedics and Traumatology, Institute for Locomotion, APHM, Sainte-Marguerite Hospital, Marseille, France
| | - Philippe Zysset
- ARTORG Center for biomedical engineering research, University of Bern, Bern, Switzerland
| | - Martine Pithioux
- Aix-Marseille Univ., CNRS, ISM Inst Movement Sci, Marseille, France.,Department of Orthopaedics and Traumatology, Institute for Locomotion, APHM, Sainte-Marguerite Hospital, Marseille, France
| | - Hélène Follet
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM, Lyos UMR1033, F69622, Lyon, France.
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20
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Remache D, Semaan M, Rossi JM, Pithioux M, Milan JL. Application of the Johnson-Cook plasticity model in the finite element simulations of the nanoindentation of the cortical bone. J Mech Behav Biomed Mater 2019; 101:103426. [PMID: 31557661 DOI: 10.1016/j.jmbbm.2019.103426] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/28/2018] [Accepted: 09/09/2019] [Indexed: 11/28/2022]
Abstract
The mechanical behavior of the cortical bone in nanoindentation is a complicated mechanical problem. The finite element analysis has commonly been assumed to be the most appropriate approach to this issue. One significant problem in nanoindentation modeling of the elastic-plastic materials is pile-up deformation, which is not observed in cortical bone nanoindentation testing. This phenomenon depends on the work-hardening of materials; it doesn't occur for work-hardening materials, which suggests that the cortical bone could be considered as a work-hardening material. Furthermore, in a recent study [59], a plastic hardening until failure was observed on the micro-scale of a dry ovine osteonal bone samples subjected to micropillar compression. The purpose of the current study was to apply an isotropic hardening model in the finite element simulations of the nanoindentation of the cortical bone to predict its mechanical behavior. The Johnson-Cook (JC) model was chosen as the constitutive model. The finite element modeling in combination with numerical optimization was used to identify the unknown material constants and then the finite element solutions were compared to the experimental results. A good agreement of the numerical curves with the target loading curves was found and no pile-up was predicted. A Design Of Experiments (DOE) approach was performed to evaluate the linear effects of the material constants on the mechanical response of the material. The strain hardening modulus and the strain hardening exponent were the most influential parameters. While a positive effect was noticed with the Young's modulus, the initial yield stress and the strain hardening modulus, an opposite effect was found with the Poisson's ratio and the strain hardening exponent. Finally, the JC model showed a good capability to describe the elastoplastic behavior of the cortical bone.
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Affiliation(s)
- D Remache
- Aix Marseille Univ, CNRS, ISM, Marseille, France; Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France.
| | - M Semaan
- Aix Marseille Univ, CNRS, ISM, Marseille, France; Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France; University of Balamand, Faculty of Engineering, Al Kurah, Lebanon.
| | - J M Rossi
- Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France; Aix Marseille Univ, CNRS, Centrale Marseille, ISM, Marseille, France.
| | - M Pithioux
- Aix Marseille Univ, CNRS, ISM, Marseille, France; Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France.
| | - J L Milan
- Aix Marseille Univ, CNRS, ISM, Marseille, France; Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France.
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21
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Guenoun D, Pithioux M, Souplet JC, Guis S, Le Corroller T, Fouré A, Pauly V, Mattei JP, Bernard M, Guye M, Chabrand P, Champsaur P, Bendahan D. Assessment of proximal femur microarchitecture using ultra-high field MRI at 7 Tesla. Diagn Interv Imaging 2019; 101:45-53. [PMID: 31331831 DOI: 10.1016/j.diii.2019.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/07/2019] [Accepted: 06/28/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The purpose of this study was to investigate bone microarchitecture of cadaveric proximal femurs using ultra-high field (UHF) 7-Tesla magnetic resonance imaging (MRI) and to compare the corresponding metrics with failure load assessed during mechanical compression test and areal bone mineral density (ABMD) measured using dual-energy X-ray absorptiometry. MATERIALS AND METHODS ABMD of ten proximal femurs from five cadavers (5 women; mean age=86.2±3.8 (SD) years; range: 82.5-90 years) were investigated using dual-energy X-ray absorptiometry and the bone volume fraction, trabecular thickness, trabecular spacing, fractal dimension, Euler characteristics, connectivity density and degree of anisotropy of each femur was quantified using UHF MRI. The whole set of specimens underwent mechanical compression tests to failure. The inter-rater reliability of microarchitecture characterization was assessed with the intraclass correlation coefficient (ICC). Associations were searched using correlation tests and multiple regression analysis. RESULTS The inter-rater reliability for bone microarchitecture parameters measurement was good with ICC ranging from 0.80 and 0.91. ABMD and the whole set of microarchitecture metrics but connectivity density significantly correlated with failure load. Microarchitecture metrics correlated to each other but did not correlate with ABMD. Multiple regression analysis disclosed that the combination of microarchitecture metrics and ABMD improved the association with failure load. CONCLUSION Femur bone microarchitecture metrics quantified using UHF MRI significantly correlated with biomechanical parameters. The multimodal assessment of ABMD and trabecular bone microarchitecture using UHF MRI provides more information about fracture risk of femoral bone and might be of interest for future investigations of patients with undetected osteoporosis.
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Affiliation(s)
- D Guenoun
- Department of Radiology, Institute for Locomotion, Sainte-Marguerite Hospital, APHM, 13009 Marseille, France; CNRS, ISM, Institute Movement Sci, Aix-Marseille Université, 13000 Marseille, France.
| | - M Pithioux
- CNRS, ISM, Institute Movement Sci, Aix-Marseille Université, 13000 Marseille, France
| | - J-C Souplet
- CNRS, CRMBM UMR 7339, Aix-Marseille Université, 13385 Marseille, France
| | - S Guis
- CNRS, CRMBM UMR 7339, Department of Rheumatology, Aix-Marseille Université, AP-HM, 13000 Marseille, France
| | - T Le Corroller
- Department of Radiology, Institute for Locomotion, Sainte-Marguerite Hospital, APHM, 13009 Marseille, France; CNRS, ISM, Institute Movement Sci, Aix-Marseille Université, 13000 Marseille, France
| | - A Fouré
- CNRS, CRMBM UMR 7339, Aix-Marseille Université, 13385 Marseille, France
| | - V Pauly
- Unité de recherche EA3279, santé publique et maladies chroniques: qualité de vie concepts, usages et limites, déterminants, Aix-Marseille Université, 13005 Marseille, France; Service de santé publique et d'information médicale, Hôpital de la Conception, APHM, 13000 Marseille, France
| | - J-P Mattei
- CNRS, CRMBM UMR 7339, Department of Rheumatology, Aix-Marseille Université, AP-HM, 13000 Marseille, France
| | - M Bernard
- CNRS, CRMBM UMR 7339, Aix-Marseille Université, 13385 Marseille, France
| | - M Guye
- CNRS, CRMBM UMR 7339, Aix-Marseille Université, 13385 Marseille, France
| | - P Chabrand
- CNRS, ISM, Institute Movement Sci, Aix-Marseille Université, 13000 Marseille, France
| | - P Champsaur
- Department of Radiology, Institute for Locomotion, Sainte-Marguerite Hospital, APHM, 13009 Marseille, France; CNRS, ISM, Institute Movement Sci, Aix-Marseille Université, 13000 Marseille, France
| | - D Bendahan
- CNRS, CRMBM UMR 7339, Aix-Marseille Université, 13385 Marseille, France
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22
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Abstract
Purpose: Non-pathological child cortical bone (NPCCB) studies can provide clinicians with vital information and insights. However, assessing the anisotropic elastic properties of NPCCB remains a challenge for the biomechanical engineering community. For the first time, this paper provides elastic moduli values for NPCCB specimens in two perpendicular directions (longitudinal and transverse) and for two different structural components of bone tissue (osteon and interstitial lamellae). Materials and Methods: Microindentation is one of the reference methods used to measure bone stiffness. Here, 8 adult femurs (mean age 82 ± 8.9 years), 3 child femurs (mean age 13.3 ± 2.1 years), and 16 child fibulae (mean age 10.2 ± 3.9 years) were used to assess the elastic moduli of adult and child bones by microindentation. Results: For adult specimens, the mean moduli measured in this study are 18.1 (2.6) GPa for osteons, 21.3 (2.3) GPa for interstitial lamellae, and 13.8 (1.7) GPa in the transverse direction. For child femur specimens, the mean modulus is 14.1 (0.8) GPa for osteons, lower than that for interstitial lamellae: 15.5 (1.5) GPa. The mean modulus is 11.8 (0.7) GPa in the transverse direction. Child fibula specimens show a higher elastic modulus for interstitial lamellae 15.8 (1.5) than for osteons 13.5 (1.6), with 10.2 (1) GPa in the transverse direction. Conclusion: For the first time, NPCCB elastic modulus values are provided in longitudinal and transverse directions at the microscale level.
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Affiliation(s)
- Marie Semaan
- a Aix Marseille Univ, CNRS, ISM, Inst Movement Sci , Marseille , France.,b Faculty of Engineering , University of Balamand , Al Kurah , Lebanon.,c APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology , , Marseille , France
| | - Elie Karam
- b Faculty of Engineering , University of Balamand , Al Kurah , Lebanon
| | - Cécile Baron
- a Aix Marseille Univ, CNRS, ISM, Inst Movement Sci , Marseille , France.,c APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology , , Marseille , France
| | - Martine Pithioux
- a Aix Marseille Univ, CNRS, ISM, Inst Movement Sci , Marseille , France.,c APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology , , Marseille , France
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23
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Jacquet C, Erivan R, Sharma A, Pithioux M, Parratte S, Argenson JN, Ollivier M. Preservation Methods Influence the Biomechanical Properties of Human Lateral Menisci: An Ex Vivo Comparative Study of 3 Methods. Orthop J Sports Med 2019; 7:2325967119841622. [PMID: 31065555 PMCID: PMC6488788 DOI: 10.1177/2325967119841622] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Three main meniscal preservation methods have been used over the past decade: cryopreservation, freezing, and freezing with gamma irradiation. Hypothesis: All 3 preservation methods will result in similar biomechanical properties as defined by tensile and compression testing. Study Design: Controlled laboratory study. Methods: A total of 24 human lateral menisci were collected from patients who underwent total knee arthroplasty. Inclusion criteria were patients younger than 70 years with primary unilateral (medial) femorotibial knee osteoarthritis. Each meniscus was divided into 2 specimens cross-sectionally. One specimen was systematically cryopreserved and constituted the control (Cy; –140°C), and the other specimen was used for either the simple frozen group (Fr; –80°C) or the frozen+irradiated group (FrI; –80°C + 25-kGy irradiation). Compression and tensile tests were performed to analyze the elasticity modulus (Young modulus) in compression, the elasticity modulus in tension, the tensile force at failure, and the rupture profile of the tensile stress-strain curve. Results: A significant difference in the mean compression elasticity modulus was observed between the Cy and Fr groups (28.86 ± 0.77 vs 37.26 ± 1.08 MPa, respectively; P < .001) and between the Cy and FrI groups (28.86 ± 0.77 vs 45.92 ± 1.09 MPa, respectively; P < .001). A significant difference in the mean tensile elasticity modulus was also observed between the Cy and Fr groups (11.66 ± 0.97 vs 19.97 ± 1.37 MPa, respectively; P = .008) and between the Cy and FrI groups (11.66 ± 0.97 vs 45.25 ± 1.39 MPa, respectively; P < .001). There were no significant differences between the control and study groups in tensile force at failure. The analysis of the stress-strain curve revealed a slow-slope curve with a nonabrupt rupture (ductile material) for the Cy samples versus a clear rupture of the curve for the Fr and FrI samples (more fragile material). Conclusion: Cryopreservation allows for more elastic and less fragile tissue compared with simple freezing or freezing plus irradiation. Clinical Relevance: The study results exhibit the detrimental effect of simple freezing and freezing plus irradiation on human meniscal mechanical properties. If these effects occur in menisci prepared for allograft procedures, important differences could appear in the graft’s mechanical behavior and thus patient outcomes.
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Affiliation(s)
- Christophe Jacquet
- Aix-Marseille University, Marseille, France.,Department of Orthopedics and Traumatology, Institute of Movement and Locomotion, St Marguerite Hospital, Marseille, France
| | - Roger Erivan
- University of Clermont Auvergne, Clermont-Ferrand, France
| | - Akash Sharma
- Aix-Marseille University, Marseille, France.,Department of Orthopedics and Traumatology, Institute of Movement and Locomotion, St Marguerite Hospital, Marseille, France
| | - Martine Pithioux
- Aix-Marseille University, Marseille, France.,Department of Orthopedics and Traumatology, Institute of Movement and Locomotion, St Marguerite Hospital, Marseille, France
| | - Sebastien Parratte
- Aix-Marseille University, Marseille, France.,Department of Orthopedics and Traumatology, Institute of Movement and Locomotion, St Marguerite Hospital, Marseille, France
| | - Jean-Nöel Argenson
- Aix-Marseille University, Marseille, France.,Department of Orthopedics and Traumatology, Institute of Movement and Locomotion, St Marguerite Hospital, Marseille, France
| | - Matthieu Ollivier
- Aix-Marseille University, Marseille, France.,Department of Orthopedics and Traumatology, Institute of Movement and Locomotion, St Marguerite Hospital, Marseille, France.,Etablissement Français du Sang, Marseille, France
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24
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Nakhli Z, Hatira FB, Pithioux M, Chabrand P, Saanouni K. On prediction of the compressive strength and failure patterns of human vertebrae using a quasi-brittle continuum damage finite element model. Acta Bioeng Biomech 2019; 21:143-151. [PMID: 31741469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE Damage of bone structures is mainly conditioned by bone quality related to the bone strength. The purpose of this work was to present a simple and reliable numerical treatment of a quasi-brittle damage constitutive model coupled with two different elastic modulus and to compare the numerical results with the experimental ones. METHODS To achieve this goal, a QCT based finite element model was developed within the framework of CDM (Continuum Damage Mechanics) and implemented in the FE code (ABAQUS). It described the propagation of brittle cracks which will help to predict the ultimate load fracture of a human vertebra by reproducing the experimental failure under quasi-static compressive loading paths of nineteen cadaveric lumbar vertebral bodies. RESULTS The numerical computations delivered by the proposed method showed a better agreement with the available experimental results when bone volume fraction related Young's modulus (E(BV/TV)) is used instead of density related Young's modulus (E(ρ)). Also, the study showed that the maximum relative error (%) in failure was 8.47% when E(BV/TV) is used, whereas the highest relative error (%) was 68.56% when E(ρ) is adopted. Finally, a mesh sensitivity analysis revealed that the element size has a weak incidence on the computed load magnitude. CONCLUSIONS The numerical results provided by the proposed quasi-brittle damage model combined with E(BV/TV) are a reliable tool for the vertebrae fracture prediction.
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Affiliation(s)
- Zahira Nakhli
- Laboratoire de Recherche Matériaux Mesures et Application (MMA), University of Carthage, National Institute of Sciences and Technology (INSAT), Tunis, Tunisia
| | - Fafa Ben Hatira
- Laboratoire de Recherche Matériaux Mesures et Application (MMA), University of Carthage, National Institute of Sciences and Technology (INSAT), Tunis, Tunisia
| | - Martine Pithioux
- Aix Marseille University, (ISM) Institute of Movement Sciences, Marseille, France
| | - Patrick Chabrand
- Aix Marseille University, (ISM) Institute of Movement Sciences, Marseille, France
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25
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Semaan M, Mora P, Bernard S, Launay F, Payan C, Lasaygues P, Pithioux M, Baron C. Assessment of elastic coefficients of child cortical bone using resonant ultrasound spectroscopy. J Mech Behav Biomed Mater 2018; 90:40-44. [PMID: 30343169 DOI: 10.1016/j.jmbbm.2018.09.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/30/2018] [Accepted: 09/26/2018] [Indexed: 10/28/2022]
Abstract
The assessment of the anisotropic elastic properties of non-pathological child cortical bone remains a challenge for the biomechanical engineering community and an important clinical issue. Resonant ultrasound spectroscopy (RUS) can be used to determine bone stiffness coefficients from the mechanical resonances of bone specimens. Here, a RUS protocol was used on 7 fibula specimens from children (mean age 14 ± 3 years) to estimate the whole elastic stiffness tensor of non-pathological child cortical bone considered as orthotropic. Despite a small number of sample, results are consistent with this hypothesis, even if a trend towards transverse isotropy is discussed. Indeed, the average values of the 9 independent stiffness coefficients obtained in this study for child bone are: C11 = 16.73 ± 0.19 GPa, C22 = 16.19 ± 0.12 GPa, C33 = 24.47 ± 0.30 GPa, C44 = 4.14 ± 0.08 GPa, C55 = 4.16 ± 0.07 GPa, C66 = 3.13 ± 0.05 GPa, C12 = 10.14 ± 0.20 GPa, C13 = 10.67 ± 0.27 GPa, C23 = 10.25 ± 0.14 GPa.
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Affiliation(s)
- Marie Semaan
- Aix-Marseille Univ, CNRS, ISM, Marseille, France; Aix-Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Pierric Mora
- Aix-Marseille Univ., CNRS, IUSTI, Marseille, France
| | - Simon Bernard
- Aix-Marseille Univ, CNRS, Centrale Marseille, LMA, Marseille, France
| | - Franck Launay
- Aix-Marseille Univ, CNRS, ISM, Marseille, France; Department of Pediatric Orthopaedic Surgery APHM Timone Hospital, Marseille, France
| | - Cédric Payan
- Aix-Marseille Univ, CNRS, Centrale Marseille, LMA, Marseille, France
| | | | - Martine Pithioux
- Aix-Marseille Univ, CNRS, ISM, Marseille, France; Aix-Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France.
| | - Cécile Baron
- Aix-Marseille Univ, CNRS, ISM, Marseille, France; Aix-Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
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26
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Dagneaux L, Allal R, Pithioux M, Chabrand P, Ollivier M, Argenson JN. Femoral malrotation from diaphyseal fractures results in changes in patellofemoral alignment and higher patellofemoral stress from a finite element model study. Knee 2018; 25:807-813. [PMID: 30060996 DOI: 10.1016/j.knee.2018.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 05/11/2018] [Accepted: 06/06/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Malrotation of the femur is a frequent complication in the management of a diaphyseal fracture. It is often responsible for pain and adverse functional results. Among these complications, contact stress effects on the patellofemoral joint are recognized as predictive factors of impaired results. The purpose of this study was to analyze the effect of malrotation on stress distribution on the patellofemoral joint, using radiological measurement and three-dimensional finite element models. METHODS Functional analysis of the patellofemoral joint was evaluated in eight knee pairs from patients with unilateral femoral fractures and subsequent femoral malrotation. A computed tomography-based protocol allowed patellofemoral joint analysis. A finite element model of the healthy (contralateral) knee was then created from 3D reconstruction at 30° flexion. In a finite element model, incremental rotational malalignment was simulated to observe changes in stress distribution on the patellar surface. RESULTS Femoral malrotation was associated with anomalies of patellofemoral joint rotational alignment. Internal rotation resulted in increased stress on the lateral side of the patella, and external rotation increased inferior medial side stress. CONCLUSIONS Rotational disorders of the distal femur resulted in increased stress on the patellofemoral joint and alignment changes. Malrotation in internal and external rotation might cause patellofemoral pain syndrome from rotations <10°. Care should be taken especially for internal malrotation in the management of femoral shaft fracture.
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Affiliation(s)
- Louis Dagneaux
- Aix Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France; Department of Orthopaedic Surgery, Lower Limb Surgery Unit, Lapeyronie University Hospital, Montpellier Cedex 05, France; Aix Marseille University, CNRS, ISM, Inst Movement Sci, France.
| | - Raphael Allal
- Aix Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Martine Pithioux
- Aix Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Patrick Chabrand
- Aix Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Matthieu Ollivier
- Aix Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Jean-Noël Argenson
- Aix Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
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Ollivier M, Falguières J, Pithioux M, Boisrenoult P, Beaufils P, Pujol N. Sectioning of the Anterior Intermeniscal Ligament Changes Knee Loading Mechanics. Arthroscopy 2018; 34:2837-2843. [PMID: 29789250 DOI: 10.1016/j.arthro.2018.03.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 02/24/2018] [Accepted: 03/01/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this cadaver research project was to describe the biomechanical consequences of anterior intermeniscal ligament (AIML) resection on menisci function under load conditions in full extension and 60° of flexion. METHODS Ten unpaired fresh frozen cadaveric knees were dissected leaving the knee joint intact with its capsular and ligamentous attachments. The femur and tibia were sectioned 15 cm from the joint line and mounted onto the loading platform. A linear motion x-y table allows the tibial part of the joint to freely translate in the anterior-posterior direction. K-scan sensors were used to define contact area, contact pressure, and position of pressure center of application (PCOA). Two series of analysis were planned: before and after AIML resection, mechanical testing was performed with specimens in full extension (1,400 N load) and in 60° of flexion (700 N load) to approximate heel strike and foot impulsion during the gait. RESULTS Sectioning of the AIML produced mechanical variations below the 2 menisci when specimens were at full extension and loaded to 1,400 N: increasing the mean contact pressure (delta 0.4 ± 0.2 MPa, +15% variation P = .008) and maximum contact pressure (delta 1.50 ± 0.8 MPa, 15% variation P < .0001) and decreasing of tibiofemoral contact area (delta 71 ± 51 mm2, -15% variation P < .0001) and PCOA (delta 2.1 ± 0.8 mm). At 60° flexion, significant differences regarding lateral meniscus mechanical parameters were observed before and after AIML resection: mean contact pressure increasing (delta 0.06 ± 0.1 MPa, +21% variation P = .001), maximal contact-pressure increasing (delta 0.17 ± 0.9 MPa, +28% variation P = .001), mean contact area decreasing (delta 1.84 ± 8 mm2, 4% variation P = .3), and PCOA displacement to the joint center (mean displacement 0.6 ± 0.5 mm). CONCLUSIONS The section of the intermeniscal ligament leads to substantial changes in knee biomechanics, increasing femorotibial contact pressures, decreasing contact areas, and finally moving force center of application, which becomes more central inside the joint. CLINICAL RELEVANCE AIML resection performed ex vivo in this study, might potentially be deleterious in vivo. Clinical studies focusing on preserving or even repairing the AIML are needed to evaluate those ex vivo elements.
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Affiliation(s)
- Matthieu Ollivier
- Aix-Marseille University, France; Institut du mouvement et de l'appareil locomoteur, Hopital sainte-marguerite, France.
| | - Julie Falguières
- Aix-Marseille University, France; Institut du mouvement et de l'appareil locomoteur, Hopital sainte-marguerite, France
| | | | - Philippe Boisrenoult
- Service d'orthopédie et de traumatologie, centre hospitalier de Versailles, Le Chesnay, France
| | - Phillippe Beaufils
- Service d'orthopédie et de traumatologie, centre hospitalier de Versailles, Le Chesnay, France
| | - Nicolas Pujol
- Service d'orthopédie et de traumatologie, centre hospitalier de Versailles, Le Chesnay, France
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Moukoko D, Pourquier D, Genovesio C, Thezenas S, Chabrand P, Roffino S, Pithioux M. Granulocyte-colony stimulating factor enhances bone fracture healing. Clin Biomech (Bristol, Avon) 2018; 58:62-68. [PMID: 30036852 DOI: 10.1016/j.clinbiomech.2018.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 04/27/2018] [Accepted: 07/11/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Circulating mesenchymal stem cells contribute to bone repair. Their incorporation in fracture callus is correlated to their bioavailability. In addition, Granulocyte-colony stimulating factor induces the release of vascular and mesenchymal progenitors. We hypothesized that this glycoprotein stimulates fracture healing, and analyzed the effects of its administration at low doses on bone healing. METHODS 27 adult male Sprague-Dawley rats underwent mid-femur osteotomy stabilized by centromedullar pinning. In a post (pre) operative group, rats were subcutaneously injected with 5 μg/kg per day of Granulocyte-colony stimulating factor for 5 days after (before) surgery. In a control group, rats were injected with saline solution for 5 days immediately after surgery. A radiographic consolidation score was calculated. At day 35, femurs were studied histologically and underwent biomechanical tests. FINDINGS 5 weeks after surgery, mean radiographic scores were significantly higher in the Preop group 7.75 (SD 0.42) and in the Postop group 7.67 (SD 0.52) than in the control group 6.75 (SD 0.69). Biomechanical tests showed femur stiffness to be more than three times higher in both the Preop 109.24 N/mm (SD 51.86) and Postop groups 100.05 N/mm (SD 60.24) than in control 32.01 N/mm (SD 15.78). Mean maximal failure force was twice as high in the Preop group 68.66 N (SD 27.78) as in the control group 34.21 N (SD 11.79). Histological results indicated a later consolidation process in control than in treated groups. INTERPRETATION Granulocyte-colony stimulating factor injections strongly stimulated early femur fracture healing, indicating its potential utility in human clinical situations such as programmed osteotomy and fracture.
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Affiliation(s)
- Didier Moukoko
- Département de Chirurgie Orthopédique Pédiatrique, CHU Angers, 4 rue Larrey, 49100 Angers, France
| | - Didier Pourquier
- Institut régional du Cancer de Montpellier (ICM)- Val d'Aurelle, Montpellier, France
| | - Cécile Genovesio
- Laboratoire de Biochimie, Faculté de Pharmacie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Simon Thezenas
- Institut régional du Cancer de Montpellier (ICM)- Val d'Aurelle, Montpellier, France
| | - Patrick Chabrand
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; APHM, Hôpital Sainte Marguerite, IML, Marseille, France
| | - Sandrine Roffino
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; Université Côte d'Azur, Univ Nice Sophia Antipolis, France
| | - Martine Pithioux
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; APHM, Hôpital Sainte Marguerite, IML, Marseille, France.
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Chivot M, Harrosch S, Kelberine F, Pithioux M, Argenson JN, Ollivier M. Pull-out strength of four tibial fixation devices used in anterior cruciate ligament reconstruction. Orthop Traumatol Surg Res 2018; 104:203-207. [PMID: 29408566 DOI: 10.1016/j.otsr.2017.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/20/2017] [Accepted: 12/28/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION In reconstructions of the anterior cruciate ligament (ACL), tibial fixation can be the weak point in the assembly during the early postoperative period. The present study sought to compare pull-out strength between four tibial fixation systems used in ACL reconstruction. HYPOTHESIS The study hypothesis was that all four devices show ≥450N pull-out strength with comparable biomechanical breakage characteristics. MATERIAL AND METHODS An experimental study used a mechanical model to perform axial traction on a synthetic ligament (polypropylene cord folded in four) implanted in an artificial tibia (Sawbones Proximal Tibia # 1116-2: model: normal anatomy; solid foam; size: medium) using four tibial fixation systems: Ligafix® interference screw (SBM™); Bio-Intrafix® (Mitek™); Translig® (SBM™); RIGIDfix® (SBM™). For each system, four models were tested using an Instron 5566® traction machine, allowing 100mm/min stretching up to breakage. Study parameters comprised: pull-out strength, maximal whole assembly slippage, stiffness at breaking point, and type of break. RESULTS Mean pull-out strength was 450±24N (range, 421-488N) for Ligafix®, 415±60N (327-454N) for Bio-Intrafix®, 539±66N (449-636N) for RigidFix and 1067±211N (736-1301N) for Translig®, and was significantly greater for Translig® than for the other devices (p=0.02), which did not significantly differ from one another. The expected maximal load of 450N was reached in 100% of cases with Translig® and RIGIDfix® and in 50% of cases with Bio-Intrafix® and Ligafix®. There were no significant differences regarding stiffness. Ligafix® showed significantly less slippage than the others (p=0.006), with breakage caused by the ligament sliding between bone and implant. DISCUSSION In this in-vitro study, the Translig® fixation device showed better pull-out strength than the other three devices tested. TYPE OF STUDY AND LEVEL OF EVIDENCE Comparative laboratory study. Level II.
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Affiliation(s)
- M Chivot
- Aix-Marseille université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France; Service de chirurgie orthopédique et traumatologique, institut du mouvement et de la locomotion, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, BP 29, 13274 Marseille, France
| | - S Harrosch
- Aix-Marseille université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France; Service de chirurgie orthopédique et traumatologique, institut du mouvement et de la locomotion, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, BP 29, 13274 Marseille, France
| | - F Kelberine
- Clinique La-Provençale, 67, Cours-Gambetta, 13100 Aix-en-Provence, France
| | - M Pithioux
- Aix-Marseille université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France; Service de chirurgie orthopédique et traumatologique, institut du mouvement et de la locomotion, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, BP 29, 13274 Marseille, France
| | - J-N Argenson
- Aix-Marseille université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France; Service de chirurgie orthopédique et traumatologique, institut du mouvement et de la locomotion, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, BP 29, 13274 Marseille, France
| | - M Ollivier
- Aix-Marseille université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France; Service de chirurgie orthopédique et traumatologique, institut du mouvement et de la locomotion, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, BP 29, 13274 Marseille, France.
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Ollivier M, Sbihi J, Sbihi A, Pithioux M, Parratte S, Argenson JN. Ropivacaine alters the mechanical properties of hamstring tendons: In vitro controlled mechanical testing of tendons from living donors. Orthop Traumatol Surg Res 2017; 103:1027-1030. [PMID: 28760374 DOI: 10.1016/j.otsr.2017.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/17/2017] [Accepted: 05/02/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Intraarticular or periarticular injection of ropivacaine (RI) is an element of current knee surgery practices. The goal of this study was to determine the effects of RI on the mechanical properties of hamstring tendons. We hypothesized that RI would have a detrimental effect on the mechanical properties of periarticular soft tissues METHODS: A tensile test to failure was performed on 120 hamstring tendon segments harvested during ACL reconstruction surgery in 120 patients. Two sets of tensile tests were done. The first evaluated the effect of RI itself on the mechanical properties of tendons: 30 samples were soaked for 1hour in a 2% RI solution and compared to 30 samples soaked in a saline solution (control group). The second evaluated the effect of RI concentration on the mechanical properties of hamstring tendons: 30 samples were soaked for 1hour in a 2% RI solution and 30 samples were soaked in a 7.5% RI solution. RESULTS In the first test, 29 samples from each group were analyzed as two samples (one in each group) failed at the grip interface. The specimens exposed to 2% RI had lower ultimate tensile strength (Δ=4.4MPa, P=0.001), strain energy (Δ=13MPa, P=0.001) and Young's modulus (Δ=1.6MPa, P=0.02) than the specimens in the control group. There was no significant difference in the strain at failure between groups (Δ=5%, P=0.3). In the second test, one specimen from the 7.5% RI group failed during the preloading and was excluded. There was no significant difference in terms of the load at failure and ultimate tensile stress (Δ=0.45MPa, P=0.6) and strain energy (Δ=0.49MPa, P=0.49) between the two groups. There were significant differences in terms of elongation at failure (Δ=28%, P=0.0003) and Young's modulus (Δ=2.6MPa, P=0.005), with the specimens exposed to 7.5% RI undergoing greater deformation and having a lower Young's modulus. DISCUSSION While local RI injections are widely performed in clinical practice, the results of this in vitro study point to short-term alterations of the mechanical properties of hamstring tendons. If these results hold in vivo, this could lead to weakness of the soft tissues exposed to this product, particularly the tendons and ligaments around the injection area. LEVEL OF EVIDENCE Experimental study. Level 1.
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Affiliation(s)
- M Ollivier
- Institute for movement and locomotion, orthopedic surgery, boulevard Sainte-Marguerite, 13009 Marseille, France.
| | - J Sbihi
- ICOS13, institut de chirurgie orthopédique et sportive de Marseille, 13008 Marseille, France
| | - A Sbihi
- ICOS13, institut de chirurgie orthopédique et sportive de Marseille, 13008 Marseille, France
| | - M Pithioux
- Institut des sciences du mouvement UMR 7287, Aix-Marseille université, CNRS, 13288 Marseille, France
| | - S Parratte
- Institute for movement and locomotion, orthopedic surgery, boulevard Sainte-Marguerite, 13009 Marseille, France
| | - J-N Argenson
- Institute for movement and locomotion, orthopedic surgery, boulevard Sainte-Marguerite, 13009 Marseille, France
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Pithioux M, Roseren F, Jalain C, Launay F, Charpiot P, Chabrand P, Roffino S, Lamy E. An Efficient and Reproducible Protocol for Distraction Osteogenesis in a Rat Model Leading to a Functional Regenerated Femur. J Vis Exp 2017. [PMID: 29155725 DOI: 10.3791/56433] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
This protocol describes the use of a newly developed external fixator for distraction osteogenesis in a rat femoral model. Distraction osteogenesis (DO) is a surgical technique leading to bone regeneration after an osteotomy. The osteotomized extremities are moved away from each other by gradual distraction to reach the desired elongation. This procedure is widely used in humans for lower and upper limb lengthening, treatment after a bone nonunion, or the regeneration of a bone defect following surgery for bone tumor excision, as well as in maxillofacial reconstruction. Only a few studies clearly demonstrate the efficiency of their protocol in obtaining a functional regenerated bone, i.e., bone that will support physiological weight-bearing without fracture after removal of the external fixator. Moreover, protocols for DO vary and reproducibility is limited by lack of information, making comparison between studies difficult. The aim of this study was to develop a reproducible protocol comprising an appropriate external fixator design for rat limb lengthening, with a detailed surgical technique that permits physiological weight-bearing by the animal after removal of the external fixator.
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Affiliation(s)
- Martine Pithioux
- CNRS, ISM, Inst Movement Sci, Aix Marseille Univ; Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, APHM;
| | - Flavy Roseren
- CNRS, ISM, Inst Movement Sci, Aix Marseille Univ; Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, APHM
| | | | - Franck Launay
- CNRS, ISM, Inst Movement Sci, Aix Marseille Univ; Sainte-Marguerite Hospital, Institute for Locomotion, Department of Peadiatric Orthopaedics, APHM
| | | | - Patrick Chabrand
- CNRS, ISM, Inst Movement Sci, Aix Marseille Univ; Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, APHM
| | | | - Edouard Lamy
- CNRS, ISM, Inst Movement Sci, Aix Marseille Univ; Service Central de la Qualité et de l'Information Pharmaceutiques, APHM
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Metwally K, Lefevre E, Baron C, Zheng R, Pithioux M, Lasaygues P. Measuring mass density and ultrasonic wave velocity: A wavelet-based method applied in ultrasonic reflection mode. Ultrasonics 2016; 65:10-17. [PMID: 26403278 DOI: 10.1016/j.ultras.2015.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 08/24/2015] [Accepted: 09/08/2015] [Indexed: 06/05/2023]
Abstract
When assessing ultrasonic measurements of material parameters, the signal processing is an important part of the inverse problem. Measurements of thickness, ultrasonic wave velocity and mass density are required for such assessments. This study investigates the feasibility and the robustness of a wavelet-based processing (WBP) method based on a Jaffard-Meyer algorithm for calculating these parameters simultaneously and independently, using one single ultrasonic signal in the reflection mode. The appropriate transmitted incident wave, correlated with the mathematical properties of the wavelet decomposition, was determined using a adapted identification procedure to build a mathematically equivalent model for the electro-acoustic system. The method was tested on three groups of samples (polyurethane resin, bone and wood) using one 1-MHz transducer. For thickness and velocity measurements, the WBP method gave a relative error lower than 1.5%. The relative errors in the mass density measurements ranged between 0.70% and 2.59%. Despite discrepancies between manufactured and biological samples, the results obtained on the three groups of samples using the WBP method in the reflection mode were remarkably consistent, indicating that it is a reliable and efficient means of simultaneously assessing the thickness and the velocity of the ultrasonic wave propagating in the medium, and the apparent mass density of material.
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Affiliation(s)
- Khaled Metwally
- Laboratory of Mechanics and Acoustics, UPR CNRS 7051, Aix-Marseille University, Centrale Marseille, 13009 Marseille, France
| | - Emmanuelle Lefevre
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France; APHM, Institute for Locomotion, Sainte-Marguerite Hospital, 13009 Marseille, France
| | - Cécile Baron
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France; APHM, Institute for Locomotion, Sainte-Marguerite Hospital, 13009 Marseille, France
| | - Rui Zheng
- Dept. of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Martine Pithioux
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France; APHM, Institute for Locomotion, Sainte-Marguerite Hospital, 13009 Marseille, France
| | - Philippe Lasaygues
- Laboratory of Mechanics and Acoustics, UPR CNRS 7051, Aix-Marseille University, Centrale Marseille, 13009 Marseille, France.
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Lefèvre E, Lasaygues P, Baron C, Payan C, Follet H, Pithioux M. Ultrasonic assessment of diagonal stiffness coefficients in children cortical bone. Comput Methods Biomech Biomed Engin 2015; 18 Suppl 1:1978-9. [DOI: 10.1080/10255842.2015.1070587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- E. Lefèvre
- Aix-Marseille Université, CNRS, ISM UMR 7287, Marseille, France
- APHM, Institute for Locomotion, Sainte-Marguerite Hospital, Marseille, France
| | - P. Lasaygues
- Laboratory of Mechanics and Acoustics, UPR CNRS 7051, Aix-Marseille University, Marseille, France
| | - C. Baron
- Aix-Marseille Université, CNRS, ISM UMR 7287, Marseille, France
- APHM, Institute for Locomotion, Sainte-Marguerite Hospital, Marseille, France
| | - C. Payan
- Laboratory of Mechanics and Acoustics, UPR CNRS 7051, Aix-Marseille University, Marseille, France
| | - H. Follet
- INSERM, UMR 1033, University of Lyon, Lyon, France
| | - M. Pithioux
- Aix-Marseille Université, CNRS, ISM UMR 7287, Marseille, France
- APHM, Institute for Locomotion, Sainte-Marguerite Hospital, Marseille, France
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Berteau JP, Gineyts E, Pithioux M, Baron C, Boivin G, Lasaygues P, Chabrand P, Follet H. Ratio between mature and immature enzymatic cross-links correlates with post-yield cortical bone behavior: An insight into greenstick fractures of the child fibula. Bone 2015; 79:190-5. [PMID: 26079997 DOI: 10.1016/j.bone.2015.05.045] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 05/28/2015] [Accepted: 05/29/2015] [Indexed: 01/22/2023]
Abstract
As a determinant of skeletal fragility, the organic matrix is responsible for the post-yield and creep behavior of bone and for its toughness, while the mineral apatite acts on stiffness. Specific to the fibula and ulna in children, greenstick fractures show a plastic in vivo mechanical behavior before bone fracture. During growth, the immature form of collagen enzymatic cross-links gradually decreases, to be replaced by the mature form until adolescence, subsequently remaining constant throughout adult life. However, the link between the cortical bone organic matrix and greenstick fractures in children remains to be explored. Here, we sought to determine: 1) whether plastic bending fractures can occur in vitro, by testing cortical bone samples from children's fibula and 2) whether the post-yield behavior (ωp plastic energy) of cortical bone before fracture is related to total quantity of the collagen matrix, or to the quantity of mature and immature enzymatic cross-links and the quantity of non-enzymatic cross-links. We used a two-step approach; first, a 3-point microbending device tested 22 fibula machined bone samples from 7 children and 3 elderly adults until fracture. Second, biochemical analysis by HPLC was performed on the sample fragments. When pooling two groups of donors, children and elderly adults, results show a rank correlation between total energy dissipated before fracture and age and a linear correlation between plastic energy dissipated before fracture and ratio of immature/mature cross-links. A collagen matrix with more immature cross-links (i.e. a higher immature/mature cross-link ratio) is more likely to plastically deform before fracture. We conclude that this ratio in the sub-nanostructure of the organic matrix in cortical bone from the fibula may go some way towards explaining the variance in post-yield behavior. From a clinical point of view, therefore, our results provide a potential explanation of the presence of greenstick fractures in children.
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Affiliation(s)
- Jean-Philippe Berteau
- Institute of Movement Science (ISM), CNRS, UMR 7287, Aix-Marseille University, av. de, Luminy, F-13288 Marseille France; Laboratory of Mechanics and Acoustics (LMA), CNRS, UPR 7051, Aix-Marseille University, Centrale Marseille, 31 chemin Joseph-Aiguier, F-13402 Marseille cedex 20, France; Department of Physical Therapy, College of Staten Island, City University of New York, NY 10314, United States.
| | - Evelyne Gineyts
- INSERM, UMR 1033, F-69008 Lyon, France; Université de Lyon, F-69008 Lyon, France
| | - Martine Pithioux
- Institute of Movement Science (ISM), CNRS, UMR 7287, Aix-Marseille University, av. de, Luminy, F-13288 Marseille France
| | - Cécile Baron
- Institute of Movement Science (ISM), CNRS, UMR 7287, Aix-Marseille University, av. de, Luminy, F-13288 Marseille France
| | - Georges Boivin
- Department of Physical Therapy, College of Staten Island, City University of New York, NY 10314, United States; INSERM, UMR 1033, F-69008 Lyon, France
| | - Philippe Lasaygues
- Laboratory of Mechanics and Acoustics (LMA), CNRS, UPR 7051, Aix-Marseille University, Centrale Marseille, 31 chemin Joseph-Aiguier, F-13402 Marseille cedex 20, France
| | - Patrick Chabrand
- Institute of Movement Science (ISM), CNRS, UMR 7287, Aix-Marseille University, av. de, Luminy, F-13288 Marseille France
| | - Hélène Follet
- INSERM, UMR 1033, F-69008 Lyon, France; Université de Lyon, F-69008 Lyon, France
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Lefèvre E, Lasaygues P, Baron C, Payan C, Launay F, Follet H, Pithioux M. Analyzing the anisotropic Hooke׳s law for children׳s cortical bone. J Mech Behav Biomed Mater 2015; 49:370-7. [DOI: 10.1016/j.jmbbm.2015.05.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/13/2015] [Accepted: 05/17/2015] [Indexed: 11/25/2022]
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Lefèvre E, Duboeuf F, Rizzo S, Baron C, Follet H, Pithioux M. Structural and behavioural analysis of children's cortical bones. Comput Methods Biomech Biomed Engin 2014; 17 Suppl 1:60-1. [PMID: 25074164 DOI: 10.1080/10255842.2014.931116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- E Lefèvre
- a Aix-Marseille Université, CNRS, ISM UMR 7287 , 13288 , Marseille , France
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Le Cann S, Galland A, Rosa B, Le Corroller T, Pithioux M, Argenson JN, Chabrand P, Parratte S. Does surface roughness influence the primary stability of acetabular cups? A numerical and experimental biomechanical evaluation. Med Eng Phys 2014; 36:1185-90. [PMID: 25080896 DOI: 10.1016/j.medengphy.2014.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 07/03/2014] [Accepted: 07/04/2014] [Indexed: 01/01/2023]
Abstract
Most acetabular cups implanted today are press-fit impacted cementless. Anchorage begins with the primary stability given by insertion of a slightly oversized cup. This primary stability is key to obtaining bone ingrowth and secondary stability. We tested the hypothesis that primary stability of the cup is related to surface roughness of the implant, using both an experimental and a numerical models to analyze how three levels of surface roughness (micro, macro and combined) affect the primary stability of the cup. We also investigated the effect of differences in diameter between the cup and its substrate, and of insertion force, on the cups' primary stability. The results of our study show that primary stability depends on the surface roughness of the cup. The presence of macro-roughness on the peripheral ring is found to decrease primary stability; there was excessive abrasion of the substrate, damaging it and leading to poor primary stability. Numerical modeling indicates that oversizing the cup compared to its substrate has an impact on primary stability, as has insertion force.
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Affiliation(s)
- Sophie Le Cann
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France; APHM, Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte Marguerite, 249 et 270, bd Sainte-Marguerite, 13274 Marseille, France.
| | - Alexandre Galland
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France; APHM, Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte Marguerite, 249 et 270, bd Sainte-Marguerite, 13274 Marseille, France
| | - Benoît Rosa
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France
| | - Thomas Le Corroller
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France; APHM, Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte Marguerite, 249 et 270, bd Sainte-Marguerite, 13274 Marseille, France
| | - Martine Pithioux
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France; APHM, Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte Marguerite, 249 et 270, bd Sainte-Marguerite, 13274 Marseille, France
| | - Jean-Noël Argenson
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France; APHM, Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte Marguerite, 249 et 270, bd Sainte-Marguerite, 13274 Marseille, France
| | - Patrick Chabrand
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France; APHM, Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte Marguerite, 249 et 270, bd Sainte-Marguerite, 13274 Marseille, France
| | - Sébastien Parratte
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France; APHM, Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte Marguerite, 249 et 270, bd Sainte-Marguerite, 13274 Marseille, France
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Berteau JP, Baron C, Pithioux M, Launay F, Chabrand P, Lasaygues P. In vitro ultrasonic and mechanic characterization of the modulus of elasticity of children cortical bone. Ultrasonics 2014; 54:1270-1276. [PMID: 24112598 DOI: 10.1016/j.ultras.2013.09.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 08/30/2013] [Accepted: 09/10/2013] [Indexed: 06/02/2023]
Abstract
The assessment of elastic properties in children's cortical bone is a major challenge for biomechanical engineering community, more widely for health care professionals. Even with classical clinical modalities such as X-ray tomography, MRI, and/or echography, inappropriate diagnosis can result from the lack of reference values for children bone. This study provides values for elastic properties of cortical bone in children using ultrasonic and mechanical measurements, and compares them with adult values. 18 fibula samples from 8 children (5-16 years old, mean age 10.6 years old ±4.4) were compared to 16 fibula samples from 3 elderly adults (more than 65 years old). First, the dynamic modulus of elasticity (Edyn) and Poisson's ratio (ν) are evaluated via an ultrasonic method. Second, the static modulus of elasticity (Esta) is estimated from a 3-point microbending test. The mean values of longitudinal and transverse wave velocities measured at 10 MHz for the children's samples are respectively 3.2mm/μs (±0.5) and 1.8mm/μs (±0.1); for the elderly adults' samples, velocities are respectively 3.5mm/μs (±0.2) and 1.9 mm/μs (±0.09). The mean Edyn and the mean Esta for the children's samples are respectively 15.5 GPa (±3.4) and 9.1 GPa (±3.5); for the elderly adults' samples, they are respectively 16.7 GPa (±1.9) and 5.8 GPa (±2.1). Edyn, ν and Esta are in the same range for children's and elderly adults' bone without any parametric statistical difference; a ranking correlation between Edyn and Esta is shown for the first time.
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Affiliation(s)
- Jean-Philippe Berteau
- Laboratory of Mechanics and Acoustics (LMA), CNRS UPR 7051, Aix-Marseille University, Centrale Marseille, 31 Chemin Joseph-Aiguier, F-13402 Marseille cedex 20, France; Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France.
| | - Cécile Baron
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France
| | - Martine Pithioux
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France
| | - Franck Launay
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France
| | - Patrick Chabrand
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France
| | - Philippe Lasaygues
- Laboratory of Mechanics and Acoustics (LMA), CNRS UPR 7051, Aix-Marseille University, Centrale Marseille, 31 Chemin Joseph-Aiguier, F-13402 Marseille cedex 20, France
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Lefèvre E, Guivier-Curien C, Pithioux M, Charrier A. Determination of mechanical properties of cortical bone using AFM under dry and immersed conditions. Comput Methods Biomech Biomed Engin 2013; 16 Suppl 1:337-9. [DOI: 10.1080/10255842.2013.815974] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lefèvre E, Baron C, Pithioux M. Evaluation of the elastic modulus of cortical bone: adaptation of experimental protocols to small samples. Comput Methods Biomech Biomed Engin 2013; 16 Suppl 1:328-9. [DOI: 10.1080/10255842.2013.815945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Launay F, Younsi R, Pithioux M, Chabrand P, Bollini G, Jouve JL. Fracture following lower limb lengthening in children: a series of 58 patients. Orthop Traumatol Surg Res 2013; 99:72-9. [PMID: 23246008 DOI: 10.1016/j.otsr.2012.08.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 07/17/2012] [Accepted: 08/21/2012] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Fracture is one of the main complications following external fixator removal used in cases of progressive lower limb lengthening; rates as high as 50% are found in the literature. The aim of this study was to determine the factors influencing this complication. MATERIALS AND METHODS One hundred and eleven cases of lower limb lengthening were performed in 58 patients (40 femurs and 71 tibias). The mean age at surgery was 10.1years old. Lengthening was performed in all cases with an external fixator alone, associated in 39.6% of cases with intramedullary nailing. The patients were divided into three groups according to disease etiology (congenital, achondroplasia and other). The fractures were classified according to the Simpson classification. RESULTS Twenty fractures were recorded (18%). Sixteen fractures were found in patients with congenital disease, four with achondroplasia and none in the group of other etiologies. The fracture was more often in the femur (27.5%) than in the tibia (12.7%). DISCUSSION The rate of fracture is influenced by different factors depending on the etiology of disease. In congenital diseases, the fracture rate is higher when there is lengthening of more than 15% of the initial length and a delay between surgery and the beginning of lengthening of less than 7days. In patients with achondroplasia, the influence of a relative percentage of lengthening is less important than in those with congenital disease. However, to avoid fractures, lengthening should not be started in children under the age of nine. Moreover, lengthening should begin at least 7days after the fixator has been placed. TYPE OF STUDY Retrospective. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- F Launay
- Timone Children Hospital, Department of Pediatric and Orthopaedic Surgery, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
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Le Corroller T, Pithioux M, Chaari F, Rosa B, Parratte S, Maurel B, Argenson JN, Champsaur P, Chabrand P. Bone texture analysis is correlated with three-dimensional microarchitecture and mechanical properties of trabecular bone in osteoporotic femurs. J Bone Miner Metab 2013; 31:82-8. [PMID: 22886379 DOI: 10.1007/s00774-012-0375-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 06/26/2012] [Indexed: 01/23/2023]
Abstract
Fracture of the proximal femur is a major public health problem in elderly persons. It has recently been suggested that combining texture analysis and bone mineral density measurement improves the failure load prediction in human femurs. In this study, we aimed to compare bone texture analysis with three-dimensional (3D) microarchitecture and mechanical properties of trabecular bone in osteoporotic femurs. Eight femoral heads from osteoporotic patients who fractured their femoral neck provided 31 bone cores. Bone samples were studied using a new high-resolution digital X-ray device (BMA™, D3A Medical Systems) allowing for texture analysis with fractal parameter H (mean), and were examined using micro-computed tomography (microCT) for 3D microarchitecture. Finally, uniaxial compression tests to failure were performed to estimate failure load and apparent modulus of bone samples. The fractal parameter H (mean) was strongly correlated with bone volume fraction (BV/TV) (r = 0.84) and trabecular thickness (Tb.Th) (r = 0.91) (p < 0.01). H (mean) was also markedly correlated with failure load (r = 0.84) and apparent modulus (r = 0.71) of core samples (p < 0.01). Bone volume fraction (BV/TV) and trabecular thickness (Tb.Th) demonstrated significant correlations with failure load (r = 0.85 and 0.72, respectively) and apparent modulus (r = 0.72 and 0.64, respectively) (p < 0.01). Overall, the best predictors of failure load were H (mean), bone volume fraction, and trabecular thickness, with r (2) coefficients of 0.83, 0.76, and 0.80 respectively. This study shows that the fractal parameter H (mean) is correlated with 3D microCT parameters and mechanical properties of femoral head bone samples, which suggests that radiographic texture analysis is a suitable approach for trabecular bone microarchitecture assessment in osteoporotic femurs.
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Affiliation(s)
- Thomas Le Corroller
- Radiology Department, Hôpital Sainte-Marguerite, 270 Boulevard de Sainte-Marguerite, 13009, Marseille, France.
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Berteau JP, Pithioux M, Baron C, Gineyts E, Follet H, Lasaygues P, Chabrand P. Characterisation of the difference in fracture mechanics between children and adult cortical bone. Comput Methods Biomech Biomed Engin 2012; 15 Suppl 1:281-2. [DOI: 10.1080/10255842.2012.713687] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Le Corroller T, Halgrin J, Pithioux M, Guenoun D, Chabrand P, Champsaur P. Combination of texture analysis and bone mineral density improves the prediction of fracture load in human femurs. Osteoporos Int 2012; 23:163-9. [PMID: 21739104 DOI: 10.1007/s00198-011-1703-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 06/16/2011] [Indexed: 01/23/2023]
Abstract
UNLABELLED Twenty-one excised femurs were studied using (1) a high-resolution digital X-ray device to estimate three textural parameters, (2) dual-energy X-ray absorptiometry (DXA) to measure bone mineral density (BMD), and (3) mechanical tests to failure. Textural parameters significantly correlated with BMD (p < 0.05) and bone strength (p < 0.05). Combining texture parameters and BMD significantly improved the fracture load prediction from adjusted r(2) = 0.74 to adjusted r(2) =0.82 (p < 0.05). INTRODUCTION The purpose of this study is to determine if the combination of bone texture parameters using a new high-resolution X-ray device and BMD measurement by DXA provided a better prediction of femoral failure load than BMD evaluation alone. METHODS The proximal ends of 21 excised femurs were studied using (1) a high-resolution digital X-ray device (BMA, D3A Medical Systems) to estimate three textural parameters: fractal parameter Hmean, co-occurrence, and run-length matrices, (2) DXA to measure BMD, and (3) mechanical tests to failure in a side-impact configuration. Regions of interest in the femoral neck, intertrochanteric region, and greater trochanter were selected for DXA and bone texture analysis. Every specimen was scanned twice with repositioning before mechanical testing to assess reproducibility using intraclass correlation coefficient (ICC) with 95% confidence interval. The prediction of femoral failure load was evaluated using multiple regression analysis. RESULTS Thirteen femoral neck and 8 intertrochanteric fractures were observed with a mean failure load of 2,612 N (SD, 1,382 N). Fractal parameter Hmean, co-occurrence, and run-length matrices each significantly correlated with site-matched BMD (p < 0.05) and bone strength (p < 0.05). The ICC of the textural parameters varied between 0.65 and 0.90. Combining bone texture parameters and BMD significantly improved the fracture load prediction from adjusted r(2) =0.74 to adjusted r(2) = 0.82 (p < 0.05). CONCLUSION In these excised femurs, the combination of bone texture parameters with BMD demonstrated a better performance in the failure load prediction than that of BMD alone.
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Affiliation(s)
- T Le Corroller
- Department of Radiology, Hôpital Sainte Marguerite, 270 Boulevard de Sainte Marguerite, 13009 Marseille, France.
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Berteau JP, Lasaygues P, Pithioux M, Chabrand P. Adolescent idiopathic scoliosis young female rib hump: normative biomechanical data study. Comput Methods Biomech Biomed Engin 2011. [DOI: 10.1080/10255842.2011.591633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Berteau JP, Pithioux M, Mesure S, Bollini G, Chabrand P. Beyond the classic correction system: a numerical nonrigid approach to the scoliosis brace. Spine J 2011; 11:424-31. [PMID: 21402500 DOI: 10.1016/j.spinee.2011.01.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Revised: 12/13/2010] [Accepted: 01/26/2011] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Adolescent idiopathic scoliosis (AIS) causes a spine and rib cage three-dimensional (3D) deformity previously treated by bracing. Whatever the manufacturing process, this rigid system acts biomechanically on the patient through the "three-point bending" mechanical principle. It applies corrective forces to a limited area and acts especially in the frontal plane. It seemed to us that a nonrigid system, called "Cbrace," with 3D action allowing distribution of forces could increase compliance and provide better long-term correction prospects. PURPOSE The aim of this study was to design a nonrigid brace by numerically testing in a finite-element model developed here. STUDY DESIGN A finite-element model has been developed to simulate brace effect on AIS right thoracic deformation of a 10-year-old patient. METHODS A two-step method was needed; first, the reliability of our model is evaluated, and then, the ability to use distributed forces to correct scoliosis deformation is tested. To obtain a 3D correction, several treatments are experimented, leading to a comparison test between the best combination to the "three-point bending" principle. RESULTS The numerical model developed here shows good qualitative answers for the treatment of brace forces. The first results demonstrate numerically that distributed forces may be of interest in brace treatment design. Overall force of 40 N above cartilage of the last nonfloating ribs associated to two posterior asymmetrical areas appears to be the best way to correct scoliosis deformation with nonrigid action. CONCLUSION The results show numerical efficacy of distributed forces to correct spinal deformities and raises the prospect that a new numerical brace, called "Cbrace," could be a starting point in the search for a nonrigid system.
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Affiliation(s)
- Jean-Philippe Berteau
- Institute of Movement Science, University of the Mediterranean, Ave. de Luminy, Marseille Cedex 09, France
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Moukoko D, Pourquier D, Pithioux M, Chabrand P. Influence of cyclic bending loading on in vivo skeletal tissue regeneration from periosteal origin. Orthop Traumatol Surg Res 2010; 96:833-9. [PMID: 21036687 DOI: 10.1016/j.otsr.2010.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 07/12/2010] [Accepted: 07/26/2010] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Periosteum osteogenic and chondrogenic properties stimulate the proliferation then differentiation of mesenchymal precursor cells originating from its deeper layers and from neighboring host tissues. The local mechanical environment plays a role in regulating this differentiation of cells into lineages involved in the skeletal regeneration process. HYPOTHESIS The aim of this experimental animal study is to explore the influence of cyclic high amplitude bending-loading on skeletal tissue regeneration. The hypothesis is that this mechanical loading modality can orient the skeletogenesis process towards the development of anatomical and histological articular structures. MATERIAL AND METHODS A vascularised periosteal flap was transferred in close proximity to each knee joint line in 17 rabbits. On one side, the tibiofemoral joint space was bridged and loading occurred when the animal bent its knee during spontaneous locomotion. On the other side, the flap was placed 12 mm distal to the joint line producing no loading during bending. Tissue regeneration was chronologically analyzed on histologic samples taken from the 4th day to the 6th month. RESULTS The structure and mechanical behavior of regenerating tissue evolved over time. As a result of the cyclic bending-loading regimen, cartilage tissue was maintained in specific areas of the regenerating tissue. When loading was discontinued, final osteogenic and fibrogenic differentiation occurred in the neoformed cartilage. Fissures developed in the cartilage aggregates resulting in pseudo-gaps suggesting similar processes to embryonic articular development. Ongoing mesenchymal stem cells stimulation was identified in the host tissues contiguous to the periosteal transfer. DISCUSSION These results suggest that the pseudarthrosis concept should be reconsidered within the context of motion induced articular histogenesis.
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Affiliation(s)
- D Moukoko
- Experimental Surgery Research Laboratory, School of Medicine, Montpellier I University, 4, boulevard Henri IV, 34000 Montpellier, France
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Casanova R, Moukoko D, Pithioux M, Pailler-Mattéi C, Zahouani H, Chabrand P. Temporal evolution of skeletal regenerated tissue: what can mechanical investigation add to biological? Med Biol Eng Comput 2010; 48:811-9. [DOI: 10.1007/s11517-010-0637-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Accepted: 05/14/2010] [Indexed: 11/30/2022]
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Casanova R, Moukoko D, Pithioux M, Marchat D, Chabrand P. Experimental study of biomaterials for application in bone regeneration. Comput Methods Biomech Biomed Engin 2009. [DOI: 10.1080/10255840903077162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Berteau JP, Lasaygues P, Pithioux M, Chabrand P. Ultrasonic method to characterise children bone elastic properties. Comput Methods Biomech Biomed Engin 2009. [DOI: 10.1080/10255840903065373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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