José A. Simões

Review of fiber-optic pressure sensors for biomedical and biomechanical applications

Abstract. As optical fibers revolutionize the way data is carried in telecommunications, the same is happening in the world of sensing. Fiber-optic sensors (FOS) rely on the principle of changing the properties of light that propagate in the fiber due to the effect of a specific physical or chemical parameter. We demonstrate the potentialities of this sensing concept to assess pressure in biomedical and biomechanical applications. FOSs are introduced after an overview of conventional sensors that are being used in the field. Pointing out their limitations, particularly as minimally invasive sensors, is also the starting point to argue FOSs are an alternative or a substitution technology. Even so, this technology will be more or less effective depending on the efforts to present more affordable turnkey solutions and peer-reviewed papers reporting in vivo experiments and clinical trials.

From conventional sensors to fibre optic sensors for strain and force measurements in biomechanics applications: A review

In vivo measurement, not only in animals but also in humans, is a demanding task and is the ultimate goal in experimental biomechanics. For that purpose, measurements in vivo must be performed, under physiological conditions, to obtain a database and contribute for the development of analytical models, used to describe human biomechanics. The knowledge and control of the mechanisms involved in biomechanics will allow the optimization of the performance in different topics like in clinical procedures and rehabilitation, medical devices and sports, among others. Strain gages were first applied to bone in a live animal in 40s and in 80s for the first time were applied fibre optic sensors to perform in vivo measurements of Achilles tendon forces in man. Fibre optic sensors proven to have advantages compare to conventional sensors and a great potential for biomechanical and biomedical applications. Compared to them, they are smaller, easier to implement, minimally invasive, with lower risk of infection, highly accurate, well correlated, inexpensive and multiplexable. The aim of this review article is to give an overview about the evolution of the experimental techniques applied in biomechanics, from conventional to fibre optic sensors. In the next sections the most relevant contributions of these sensors, for strain and force in biomechanical applications, will be presented. Emphasis was given to report of in vivo experiments and clinical applications.

Straight, semi-anatomic and anatomic TMJ implants: The influence of condylar geometry and bone fixation screws

A 3D finite element model of in vitro intact and implanted mandibles with different temporomandibular joints (TMJ) was analyzed. Three TMJ implant geometries were assessed. The displacements, stress and strain fields on the condyle were obtained for both simulated cases. Strains were also assessed near the screws that fixate the implant to the mandible. The geometry of the mandible was obtained through 3D digitalization of a synthetic model. The TMJ implants studied were modelled considering a commercial implant which was also used to create semi-anatomic and anatomic implants that were analyzed and to assess the influence of the geometry. Numerical finite element models were built and the implants were positioned by an experienced orofacial surgeon. All implants were fixed by four screws which were placed in the same position on the mandible. The boundary conditions were simulated considering the support on the incisive tooth, the loads of the five most important muscular forces and a 5mm mouth aperture. This study indicates that the deformation on the intact mandible was similar when an anatomic implant was considered in the implanted mandible. However, the anatomic geometry presented some problems concerning the implant integrity due to geometric variations. The geometry of TMJ implant also played a role relatively to the screws structural integration and bone fixation. The geometry of TMJ implant defines the necessary number of screws and position in the mandible fixation.

The influence of finishing milling strategies on texture, roughness and dimensional deviations on the machining of complex surfaces

Abstract The objective of the study hereby presented consisted on the analysis of different finishing milling strategies of a complex geometry part containing concave and convex surfaces. The machining quality was assessed through the comparison of surface roughness, surface texture and dimensional control parameters. Three typical milling strategies were studied: radial, raster and 3D offset. The tool-cutting parameters were maintained constant for all strategies tested. The 3D offset machining strategy evidenced to be the suitable one for the geometry model used within the study.

Design of a controlled-stiffness composite proximal femoral prosthesis

The design and prototype manufacture of a controlled-stiffness composite femoral prosthesis is described. The prosthesis is composed of a cobalt-chrome core surrounded by a flexible composite outer layer. By varying the composite layer thickness it was possible to control the prosthesis stiffness. The new design was critically assessed by means of finite-element method and its predicted performance compared with those of conventional, single-modulus prostheses. A simple model based on composite beam theory was used to determine the optimum thickness of the composite material. The composite was made of an epoxy resin reinforced with braided hybrid carbon-glass pre-forms. A prototype incorporating the novel concept design was manufactured by using the compression moulding technique.

In vitro studies of multiwalled carbon nanotube/ultrahigh molecular weight polyethylene nanocomposites with osteoblast-like MG63 cells

Carbon nanotubes are highly versatile materials; new applications using them are continuously being developed. Special attention is being dedicated to the possible use of multiwalled carbon nanotubes in biomaterials contacting with bone. However, carbon nanotubes are also controversial in regards to effects exerted on living organisms. Carbon nanotubes can be used to improve the tribological properties of polymer/composite materials. Ultrahigh molecular weight polyethylene (UHMWPE) is a polymer widely used in orthopedic applications that imply wear and particle generation. We describe here the response of human osteoblast-like MG63 cells after 6 days of culture in contact with artificially generated particles from both UHMWPE polymer and multiwalled carbon nanotubes (MWCNT)/UHMWPE nanocomposites. This novel composite has superior wear behavior, having thus the potential to reduce the number of revision hip arthroplasty surgeries required by wear failure of acetabular cups and diminish particle-induced osteolysis. The results of an in vitro study of viability and proliferation and interleukin-6 (IL-6) production suggest good cytocompatibility, similar to that of conventional UHMWPE (WST-1 assay results are reported as percentage of control +/- SD: UHMWPE = 96.19 +/- 7.92, MWCNT/UHMWPE = 97.92 +/- 8.29%; total protein: control = 139.73 +/- 10.78, UHMWPE = 137.07 +/- 6.17, MWCNT/UHMWPE = 163.29 +/- 11.81 microg/mL; IL-6: control = 90.93 +/- 10.30, UHMWPE = 92.52 +/- 11.02, MWCNT/UHMWPE = 108.99 +/- 9.90 pg/mL). Standard cell culture conditions were considered as control. These results, especially the absence of significant elevation in the osteolysis inductor IL-6 values, reinforce the potential of this superior wear-resistant composite for future orthopedic applications, when compared to traditional UHMWPE.

Polymeric piezoelectric actuator substrate for osteoblast mechanical stimulation

Bone mass distribution and structure are dependent on mechanical stress and adaptive response at cellular and tissue levels. Mechanical stimulation of bone induces new bone formation in vivo and increases the metabolic activity and gene expression of osteoblasts in culture. A wide variety of devices have been tested for mechanical stimulation of cells and tissues in vitro. The aim of this work was to experimentally validate the possibility to use piezoelectric materials as a mean of mechanical stimulation of bone cells, by converse piezoelectric effect. To estimate the magnitude and the distribution of strain, finite numerical models were applied and the results were complemented with the optical tests (Electronic Speckle Pattern Interferometric Process). In this work, osteoblasts were grown on the surface of a piezoelectric material, both in static and dynamic conditions at low frequencies, and total protein, cell viability and nitric oxide measurement comparisons are presented.

Strain shielding in distal femur after patellofemoral arthroplasty under different activity conditions.

Strain shielding, a mechanical effect occurring in structures combining stiff with more flexible materials, is considered to lead to a reduction of density in bone surrounding the implant. This effect can be related to the weakness of the implant fixation, which can promote implant loosening. Several studies describe a significant decrease in postoperative bone mineral density adjacent to joint implants, which can compromise their long-term fixation. The aim of the present study was to quantify the strain shielding effect on the distal femur after patellofemoral arthroplasty. For this purpose three activities of daily living were considered: level walking, stair climbing and deep bending at different angles of knee flexion. To determine the strain shielding effect, cortical bone strains were measured experimentally with triaxial strain gauges in synthetic femurs before and after patellofemoral arthroplasty for each of the different daily activities. The results showed that the patellofemoral arthroplasty in general reduced the strains in the medial and distal regions of the femur when deep bending activity occurred, consequently, strain shielding in these regions, with strain decreases of -72.0% and -67.5% were measured. On the other side, higher values of strain were found in the anterior region after patellofemoral replacement for this activity with an increase of +182.0%. The occurrence of strain shielding seems to be more significant when the angle of knee flexion and applied load increases. Strain shielding and over-loading may have relevant effects on bone remodeling surrounding the patellofemoral implant, suggesting a potential effect of later bone resorption in the medial and distal femur regions in case of regular deep bending activity.

A new piezoelectric actuator induces bone formation in vivo: A preliminary study

This in vivo study presents the preliminary results of the use of a novel piezoelectric actuator for orthopedic application. The innovative use of the converse piezoelectric effect to mechanically stimulate bone was achieved with polyvinylidene fluoride actuators implanted in osteotomy cuts in sheep femur and tibia. The biological response around the osteotomies was assessed through histology and histomorphometry in nondecalcified sections and histochemistry and immunohistochemistry in decalcified sections, namely, through Massons trichrome, and labeling of osteopontin, proliferating cell nuclear antigen, and tartrate-resistant acid phosphatase. After one-month implantation, total bone area and new bone area were significantly higher around actuators when compared to static controls. Bone deposition rate was also significantly higher in the mechanically stimulated areas. In these areas, osteopontin increased expression was observed. The present in vivo study suggests that piezoelectric materials and the converse piezoelectric effect may be used to effectively stimulate bone growth.

Biomechanical evaluation of proximal tibia behaviour with the use of femoral stems in revision TKA: An in vitro and finite element analysis

BACKGROUND Recognized failure mechanisms after revision total knee arthroplasty include failure of fixation, instability and loosening. Thus, extended stems have been used to improve fixation and stability. In clinical cases where the stem is only applied in the femur, a question concerning the structural aspect of tibia may arise: Does a stemmed femur changes the structural behaviour of proximal tibia? It seems, that question has not yet been fully answered and the use of stems in the opposite bone structure requires further analysis. METHODS Proximal cortex strains were measured with tri-axial strain gauges in synthetic tibias for three different types of implanted femurs, with two constrained implants. To assess the strains at the cancellous bone under the tibial tray, it was considered a closest physiological load condition with the use of finite element models. FINDINGS No significant differences of the mean of the tibial cortex strains for the stemmed femur relatively to the stemless femur were observed. The R(2) and slopes values of the linear regressions between experimental and finite element strains were close to one indicating good correlations. The strain behaviour of cancellous bone under the tibial tray is not completely immune to the use of femoral stem extensions. However, the level of this alteration is relatively small when compared with the strain magnitudes. INTERPRETATION The main insight given by the present study could probably lie in the fact that the use of femoral stems does not contribute to an increase of the risk of failure of the tibia.