Celina Pezowicz

Comparative biomechanical study of cervical spine stabilisation by cage alone, cage with plate, or plate-cage: a porcine model

Purpose. To compare stability and subsidence associated with 3 types of cervical spine stabilisation. Methods. The C3 to C4 vertebrae of 28 Polish pigs were used. Pigs with intact vertebrae (group 1) underwent standard anterior cervical discectomy (group 2), followed by stabilisation using a cage alone (group 3), a cage with plate (group 4), or a plate-cage (group 5). Cervical spine stability and subsidence were compared in all 5 groups. Results. Stability was significantly increased after stabilisation by a cage with plate or a plate-cage, but not by a cage alone. The difference between stabilisation by a cage with plate and a plate-cage was not significant. Subsidence was maximal after the cage-alone stabilisation (3.1 mm), being 1.6 mm after the cage-with-plate and plate-cage stabilisations. Conclusion. Additional plating as a supplement to anterior interbody cervical cage stabilisation significantly improves segmental stability and subsidence.

In vitro and in vivo evaluation of sol-gel derived TiO 2 coatings based on a variety of precursors and synthesis conditions

The effect of synthesis way of TiO2 coatings on biocompatibility of transplanted materials using an in vitro and in vivo rat model was investigated. TiO2 layers were synthesized by a nonaqueous sol-gel dip-coating method on stainless steel 316L substrates applying two different precursors and their combination. Morphology and topography of newly formed biomaterials were determined as well as chemical composition and elemental distribution of a surface samples. In vitro tests were conducted by adipose-derived mesenchymal stem cells cultured on TiO2 coatings and stainless steel without coatings to assess the bioreactivity of obtained materials. A positive biological effect of TiO2/316L/1 coatings--based on titanium(IV) ethoxide--was found in both in vitro and in vivo models. The TiO2/316L/1 exhibited the highest roughness and the lowest titanium concentration in TiO2 than TiO2/316L/2-- based on titanium(IV) propoxide and TiO2/316L/3--based on both above-mentioned precursors. The proper fibroblast-like morphology and higher proliferation rate of cells cultured on TiO2/316L/1 were observed when compared to the other biomaterials. No inflammatory response in the bone surrounding implant covered by each of the obtained TiO2 was present. Our results showed that improvement of routinely used stainless steel 316L with TiO2/316L/1 layer can stimulate beneficial biological response.

Kinematic Analysis of a Six-Degrees-of-Freedom Model Based on ISB Recommendation: A Repeatability Analysis and Comparison with Conventional Gait Model

Objective. The purpose of the present work was to assess the validity of a six-degrees-of-freedom gait analysis model based on the ISB recommendation on definitions of joint coordinate systems (ISB 6DOF) through a quantitative comparison with the Helen Hays model (HH) and repeatability assessment. Methods. Four healthy subjects were analysed with both marker sets: an HH marker set and four marker clusters in ISB 6DOF. A navigated pointer was used to indicate the anatomical landmark position in the cluster reference system according to the ISB recommendation. Three gait cycles were selected from the data collected simultaneously for the two marker sets. Results. Two protocols showed good intertrial repeatability, which apart from pelvic rotation did not exceed 2°. The greatest differences between protocols were observed in the transverse plane as well as for knee angles. Knee internal/external rotation revealed the lowest subject-to-subject and interprotocol repeatability and inconsistent patterns for both protocols. Knee range of movement in transverse plane was overestimated for the HH set (the mean is 34°), which could indicate the cross-talk effect. Conclusions. The ISB 6DOF anatomically based protocol enabled full 3D kinematic description of joints according to the current standard with clinically acceptable intertrial repeatability and minimal equipment requirements.

Cytokine induction of sol–gel-derived TiO 2 and SiO 2 coatings on metallic substrates after implantation to rat femur

Material surface is a key determinant of host response on implanted biomaterial. Therefore, modification of the implant surface may optimize implant–tissue reactions. Inflammatory reaction is inevitable after biomaterial implantation, but prolonged inflammation may lead to adverse reactions and subsequent implant failure. Proinflammatory activities of cytokines like interleukin (IL)-1, IL-6, and tumor necrosis factor-alpha (TNF-α) are attractive indicators of these processes and ultimately characterize biocompatibility. The objective of the study was to evaluate local cytokine production after implantation of stainless steel 316L (SS) and titanium alloy (Ti6Al4V) biomaterials coated with titanium dioxide (TiO2) and silica (SiO2) coatings prepared by sol–gel method. Biomaterials were implanted into rat femur and after 12 weeks, bones were harvested. Bone–implant tissue interface was evaluated; immunohistochemical staining was performed to identify IL-6, TNF-α, and Caspase-1. Histomorphometry (AxioVision Rel. 4.6.3 software) of tissue samples was performed in order to quantify the cytokine levels. Both the oxide coatings on SS and Ti6Al4V significantly reduced cytokine production. However, the lowest cytokine levels were observed in TiO2 groups. Cytokine content in uncoated groups was lower in Ti6Al4V than in SS, although coating of either metal reduced cytokine production to similar levels. Sol–gel TiO2 or SiO2 coatings reduced significantly the production of proinflammatory cytokines by local tissues, irrespective of the material used as a substrate, that is, either Ti6Al4V or SS. This suggests lower inflammatory response, which directly points out improvement of materials’ biocompatibility.

The content of collagen type II in human arteries is correlated with the stage of atherosclerosis and calcification foci

OBJECTIVE The signature processes during atherosclerosis development are arterial calcification and accumulation in the arterial walls of proteins that are specific to bone and cartilage, e.g., collagen type II. The purpose of this study was to characterize localization of collagen type II and quantify its content in human arteries. RESULTS The study was conducted on sections of thoracic and abdominal aortas (n=97) subjected to histological evaluation and classified into six grades according to the Stary scale of the atherosclerosis severity. Three types of samples were distinguished from the group of arteries: (1) without macroscopically visible calcifications, (2) with macroscopically visible calcifications dispersed within the arterial wall, and (3) calcium deposits isolated from the walls tested with respect to the segment of the artery from which they had originated. The results demonstrate that both cholesterol and collagen type II content are significantly higher in samples with calcification, whereas collagen type II is localized mainly in the tissue around the calcium deposit. A positive correlation has been shown between the levels of collagen type II and cholesterol (r=0.57, P<.05). A similar trend was observed with respect to the grade of atherosclerosis (r=0.43, P<.05). CONCLUSIONS The amount of collagen type II is higher in the tissue around the calcium deposit. The correlation was observed between the quantityof collagen type II, the grade of atherosclerosis, and cholesterol.

Qualitative and quantitative assessment of collagen and elastin in annulus fibrosus of the physiologic and scoliotic intervertebral discs

The biophysical properties of the annulus fibrosus of the intervertebral disc are determined by collagen and elastin fibres. The progression of scoliosis is accompanied by a number of pathological changes concerning these structural proteins. This is a major cause of dysfunction of the intervertebral disc. The object of the study were annulus fibrosus samples excised from intervertebral discs of healthy subjects and patients treated surgically for scoliosis in the thoracolumbar or lumbar spine. The research material was subjected to structural analysis by light microscopy and quantitative analysis of the content of collagen types I, II, III and IV as well as elastin by immunoenzymatic test (ELISA). A statistical analysis was conducted to assess the impact of the sampling site (Mann-Whitney test, α=0.05) and scoliosis (Wilcoxon matched pairs test, α=0.05) on the obtained results. The microscopic studies conducted on scoliotic annulus fibrosus showed a significant architectural distortion of collagen and elastin fibres. Quantitative biochemical assays demonstrated region-dependent distribution of only collagen types I and II in the case of healthy intervertebral discs whereas in the case of scoliotic discs region-dependent distribution concerned all examined proteins of the extracellular matrix. Comparison of scoliotic and healthy annulus fibrosus revealed a significant decrease in the content of collagen type I and elastin as well as a slight increase in the proportion of collagen types III and IV. The content of collagen type II did not differ significantly between both groups. The observed anomalies are a manifestation of degenerative changes affecting annulus fibrosus of the intervertebral disc in patients suffering from scoliosis.

Hip Joint Centre Localization: Evaluation of Formal Methods and Effects on Joint Kinematics

Accurate methods of hip joint centre (HJC) localization are necessary in gait analysis. It was shown that current methods could involve large mislocation errors, what affect both kinematics and kinetics. The purpose of present study was to compare three different HJC localization methods: predictive methods, functional calibration methods, and medical imaging analysis technique, as well as to assess of its effect on joint kinematic variables during gait on population of three able-bodied subjects. Significant deviations were observed for HJC determined with predictive method compared to ultrasound technique (44 ± 7 mm), resulted in errors propagating into calculated joint angles (mean 2.7°). While lower deviations observed for functional method comparing to ultrasound technique (mean 23 ± 6 mm) results in negligible joint angle differences (mean 0.6°.). Therefore, functional methods are highly recommended in the absence of imaging technique.

Mechanical properties and dynamics of degradation of polylactide matrix composites with calcium and sodium alginate fibers

In the present article, new polylactide/alginate fibers composites were investigated. Composite pre-pregs were made by solution casting method. The aim of the study was to define physico-mechanical properties of developed materials. The scope of the studies included: examining the static mechanical properties, properties of the surface and their changes during degradation. Moreover, intensity of the release of degradation products to the environment and a change of the mass of examined samples were analyzed. Obtained results were evaluated taking into account possibility to use prepared composited as materials for vascular implants.

Feasibility and accuracy of new insertion technique of S1 transpedicular screw. Computed tomography-based morphometric analysis

OBJECTIVE To assess feasibility and accuracy of a new insertion technique of S1 transpedicular screw. SUMMARY OF BACKGROUND DATA Transpedicular stabilization in the first sacral vertebra (S1) is a technically demanding surgical procedure with inherent risk of loosening of the implant. A modification of the technique was recently proposed, along with the analytical verification which was performed based on the available literature. In the study, we performed radiological assessment of screws inserted into the S1 using the classical and modified techniques. METHODS The analysis was performed in two parts. The first part was performed on eight cadaver specimens after implantation of the screws. In the second part, we used computed tomography images of patients with degenerative disk disease with a superimposed representation of screws. The thickness of the posterior cortex adherent to the screws, screw trajectory and their position with regard to the spinal canal was measured. The area of posterior cortex in contact with the screws was also calculated. RESULTS The contact length and area was found to be two times greater for screws introduced with the modified technique. The convergence angle was comparable between the techniques, despite the shift of entry point. There was no canal breach, although with the modified technique the screws passed closer to the spinal canal. CONCLUSIONS The modified technique is considered safe. In this technique, the screws pass through a thicker portion of the posterior cortex compared to the classical technique that aims at improving the stability of the fixation.

The Influence of Uncertainty in Body Segment Mass on Calculated Joint Moments and Muscle Forces

Musculoskeletal models and computer simulations have been extensively developed in recent years. The purpose of present study was to investigate the effect of uncertainty in segment masses on joint torques and muscle forces. Segment mass uncertainties estimated on the basis of Dempster measurement have been introduced to the musculoskeletal model Gait 2392. Inverse dynamics, static optimization and CMC algorithm have been performed using OpenSim software. The segment mass uncertainty has limited effect on the net joint moments. However, the error propagation in proximal direction have been observed and the greatest impact was observed for residual moments and forces acting on pelvis. The greatest effect on muscle forces can be observed for both static optimization and CMC results. Furthermore, considerable differences can be seen between static optimization and CMC results. Therefore, an accurate estimation of muscles forces and load condition in musculoskeletal system is still posing a challenge.