Danè Dabirrahmani

Mechanical variables affecting balloon kyphoplasty outcome – a finite element study

It is still unclear how a vertebral fracture should be stabilised and strengthened without endangering the remaining intact bone of the augmented vertebra or the adjacent vertebrae. Numerical modelling may provide insight. To date, however, few finite element (FE) spine models have been developed which are both multi-segmental and capture a more complete anatomy of the vertebrae. A 3-D, two-functional unit, CT-based, lumbar spine, FE model was developed and used to predict load transfer and likelihood of fracture following balloon kyphoplasty. The fractured anterior wall and injected cement were modelled in a two-functional spinal unit model with osteoporotic bone properties. Parameters investigated included: cement stiffness, cement volume and height restoration. Models were assessed based on stresses and a user-defined fracture-predicting field. Augmentation altered the stress distribution; shielding was dependent on positioning of the cement; and fracture algorithm found incomplete height restoration to increase the likelihood of fracture, particularly in adjacent vertebrae.

Primary and long-term stability of a short-stem hip implant

Abstract The new generation short-stem hip implants are designed to encourage physiological-like loading, to minimize stress—strain shielding and therefore implant loosening in the long term. As yet there are no long-term clinical studies available to prove the benefits of these short-stem implants. Owing to this lack of clinical data, numerical simulation may be used as a predictor of longer term behaviour. This finite element study predicted both the primary stability and long-term stability of a short-stem implant. The primary implant stability was evaluated in terms of interface micromotion. This study found primary stability to fall within the critical threshold for osseointegration to occur. Longer term stability was evaluated using a strain-adaptive bone remodelling algorithm to predict the long-term behaviour of the bone in terms of bone mineral density (BMD) changes. No BMD loss was observed in the classical Gruen zones 1 and 7 and bone remodelling patterns were comparable with hip resurfacing results in the literature.

Dual-energy computed tomography - How accurate is gemstone spectrum imaging metal artefact reduction: its application to orthopedic metal implants

Objective To assess the accuracy and suitability of dual-energy computed tomography (DECT) in scanning metals used in orthopedic implants. Materials and Methods Four metal phantoms (Cobalt Chrome, Titanium Grade 5, Stainless Steel 316, and Stainless Steel 630), commonly used materials in orthopedic implants, were scanned by conventional, polychromatic CT as well as Gemstone Spectrum Imaging (GSI) DECT, with and without metal artefact reduction software (MARS). Scans were assessed for artefact based on Hounsfield unit values; and surfaces generated, based on a Canny edge detection algorithm. Two separate metal implants were also scanned and assessed for dimensional accuracy. Results Conventional, polychromatic CT, and GSI DECT (without MARS) scans displayed major beam hardening in the presence of all four metals. The GSI DECT with MARS showed very clear and reproducible boundaries with minimal noise surrounding the metal phantoms. However, geometric analysis found overestimation of the dimensions, volume, and surface area for most of the metal phantoms. Titanium displayed the least artefact, compared to the other metals, in all scan scenarios. Conclusions Although metal artefact reduction using GSI DECT looks superior to conventional CT, when measured objectively, it was shown to overestimate geometries and skew dimensions. The GSI DECT with MARS should be used with caution, especially when assessing questions of implant shape or wear.

A Computational Analysis of Squeaking Hip Prostheses

A ceramic-on-ceramic (CoC) hip prosthesis with clearance is modeled as a multibody dynamics system for the purpose of studying hip squeaking. A continuous contact force model provides the intrajoint forces developed at the hip joint. Friction effects due to the relative motion are also considered. A FFT analysis of the audible sounds from CoC hip acceleration is carried out to analyze hip squeaking. The effects of friction, hip implant size, and the head initial position on hip squeaking and the trajectory of femoral head are analyzed and discussed. It was shown that the causes of hip squeaking are stick/slip, friction-induced vibration, and the femoral head angular speed and force changes. [DOI: 10.1115/1.4028109]

Lunate trabecular structure: a radiographic cadaveric study of risk factors for Kienböcks disease

The aetiology of Kienböcks disease is unknown. Ulnar variance and lunate shape are possible mechanical risk factors. This study assessed the trabecular structure in 29 cadaveric lunates using microCT and correlated this with ulnar variance and lunate shape on plain radiographs and with bone density assessed using conventional CT. The bony trabeculae within the lunate were shown to run almost perpendicular to the proximal and distal joint surfaces in the coronal plane; these trabeculae met the subchondral bone at an angle between 72–102°. In lunates whose proximal and distal articular surfaces are not parallel, the trabecular orientation may be less able to resist compressive forces and more susceptible to fracture.

Lunate trabecular structure: a cadaveric radiograph study of risk factors for Kienböck's disease

The aetiology of Kienböcks disease is unknown. Ulnar variance and lunate shape are possible mechanical risk factors. This study assessed the trabecular structure in 29 cadaveric lunates using microCT and correlated this with ulnar variance and lunate shape on plain radiographs and with bone density assessed using conventional CT. The bony trabeculae within the lunate were shown to run almost perpendicular to the proximal and distal joint surfaces in the coronal plane; these trabeculae met the subchondral bone at an angle between 72–102°. In lunates whose proximal and distal articular surfaces are not parallel, the trabecular orientation may be less able to resist compressive forces and more susceptible to fracture.

Biomechanical Comparison of Metatarsal Head Designs in First Metatarsophalangeal Joint Arthroplasty

Background: Arthritis of the metatarsophalangeal (MTP) joint is characterized by loss of MTP joint range of motion (ROM) and pain. Joint arthroplasty is one treatment option, and while results can be satisfactory, there is still room for improvement. The aim was to use cadaveric model to compare the sagittal kinematics and articulating contact properties of 4 different first metatarsal head designs of an MTP joint implant. Methods: Six cadaveric feet were each prepared with a single modular first MTP joint total arthroplasty. A standard cyclic load, which induced hallux dorsiflexion, was applied and motion measured from high resolution images. Contact behavior was collected simultaneously using a pressure transducer. Data collected compared the native joint with 4 different reconstructed cases. Each reconstructed joint used a different metatarsal-head-component while reusing the same phalangeal component to compare the 4 alternative metatarsal head designs. Results: All reconstructed joints displayed greater ROM compared with the intact joint. Of the 4 metatarsal head components, the grooved, anatomical design demonstrated the greatest dorsiflexion when compared to the standard design, 31.6 degrees (SD ± 8.6 degrees), P < .05. All reconstructed joints displayed contact areas lower than the intact (~50%, P < .001). The grooved metatarsal-head-component experienced the least contact force (P < .015), and the eccentric component underwent the greatest contact pressure (P < .05) when compared to the intact case. Conclusions: In this study of a first metatarsophalangeal joint replacement design, ROM was shown to be better for the more anatomically designed metatarsal head, while contact properties did not vary across different designs. Clinical Relevance: This information may be useful in the development of new metatarsal components.

Wear Prediction of Ceramic-on-Ceramic Artificial Hip Joints

Wear can influence the lifetime and performance of implants and has been found to be a key factor in primary failure of artificial hip joints. The present study aims to present a spatial multibody dynamic model to predict wear in ceramic-on-ceramic hip implants. The problem was formulated by developing a spatial multibody dynamic model of a hip prosthesis taking three-dimensional physiological loading and motion of the human body into account. Then, the Archard wear model was integrated into the dynamic calculation of the hip implant to predict wear. Additionally, geometries of the cup and head were updated throughout the simulation to generate a more realistic wear simulation. The results were validated against current literature. Finally it was illustrated that friction-induced vibration caused excessive wear of hip implant components.

A Novel Dynamic Mechanical Testing Technique for Reverse Shoulder Replacements

In vitro mechanical testing of orthopedic implants provides information regarding their mechanical performance under simulated biomechanical conditions. Current in vitro component stability testing methods for reverse shoulder implants are based on anatomical shoulder designs, which do not capture the dynamic nature of these loads. With glenoid component loosening as one of the most prevalent modes of failure in reverse shoulder replacements, it is important to establish a testing protocol with a more realistic loading regime. This paper introduces a novel method of mechanically testing reverse shoulder implants, using more realistic load magnitudes and vectors, than is currently practiced. Using a custom made jig setup within an Instron mechanical testing system, it is possible to simulate the change in magnitude and direction of the joint load during arm abduction. This method is a step towards a more realistic testing protocol for measuring reverse shoulder implant stability.

Modification of the Grood and Suntay Joint Coordinate System equations for knee joint flexion

Since its introduction, the Grood and Suntay Joint Coordinate System (JCS) has been embraced by the International Society of Biomechanics (ISB) and been widely used for biomechanical reporting. There is, however, a limitation in its ability to provide correct flexion values over a wide range of clinically relevant flexion angles. This technical note addresses the limitation of the JCS equations and introduces a new set of equations to overcome this problem.