501 research outputs found
Biomechanical analysis of reversed shoulder prosthesis: benefit of the inferior position of the glenoid base plate
Mobile Bearing Plate Dislocation in Total Knee Arthroplasty Due to Muscle Spasm: A Case Report
A flow sensing model for mesenchymal stromal cells using morphogen dynamics
The differentiation of mesenchymal stromal cells has been shown to be af- fected by many parameters such as morphogens, flow rate, medium viscosity, and shear stress when exposed to fluid flow. The mechanism by which these cells sense their environment is still under intense discussion. In particular, during flow chamber experiments, it is difficult to interpret the interplay of the above-mentioned parameters in the process of cell differentiation. In this work, we tested the hypothesis that the competition between diffusion and advection of paracrine morphogens could explain the dependency of the cell differentiation to the above-mentioned parameters. To evaluate this hy- pothesis, we developed a numerical model simulating a simplified version of the advection-diffusion-reaction of morphogens secreted by the cells within a flow chamber. The model predicted a sharp transition in the fraction of receptors bound to the morphogen. This transition was characterized by a new dimensionless number depending on flow rate, flow viscosity, flow chamber dimensions, and morphogen decay rate. We concluded that the competition between diffusion and advection of paracrine morphogens can act as a probe for the cells to sense their peri-cellular environment.LB
Micromotion-induced peri-prosthetic fluid flow around a cementless femoral stem
Micromotion-induced interstitial fluid flow at the bone-implant interface has been proposed to play an important role in aseptic loosening of cementless implants. High fluid velocities are thought to promote aseptic loosening through activation of osteoclasts, shear stress induced control of mesenchymal stem cells differentiation, or transport of molecules. In this study, our objectives were to characterize and quantify micromotion-induced fluid flow around a cementless femoral stem using finite element modeling. With a 2D model of the bone-implant interface and full-factorial design, we first evaluated the relative influence of material properties, and bone-implant micromotion and gap on fluid velocity. Transverse sections around a femoral stem were built from computed tomography images, while boundary conditions were obtained from experimental measurements on the same femur. In a second step, a 3D model was built from the same dataset to estimate the shear stress experienced by cells hosted in the peri-implant tissues. The full-factorial design analysis showed that local micromotion had the most influence on peak fluid velocity at the interface. Remarkable variations in fluid velocity were observed in the macrostructures at the surface of the implant in the 2D transverse sections of the stem. The 3D model predicted peak fluid velocities extending up to 2.2 mm/s in the granulation tissue and to 3.9 mm/s in the trabecular bone. Peak shear stresses on the cells hosted in these tissues ranged from 0.1 Pa to 12.5 Pa. These results offer insight into mechanical stimuli encountered at the bone-implant interface
Osteoclastogenesis can be mechanically-induced in the peri-implant bone
Total joint replacements are highly successful in relieving pain and restoring movement of damaged joints. However, the lifespan of the implants is limited. The implant’s long-term stability depends largely on the preservation of periprosthetic bone. Debris-wear particulates were first identified as the factor inducing periprosthetic bone loss. However, it was later shown that the resorption process starts before the particulates reach the periprosthetic bone. Thus a mechanical factor, interface micromotions, has been suspected to be the initiator of the early bone loss. In this work, we then investigated the response of bone cells to micromotions. Using an ex vivo setup, we applied micromotions on fresh human bone cores and showed that micromotions could indirectly activate osteoclasts after only 1 hour of stimulation. Thus micromotion-related osteoclastic activity could be the initiator of periprosthetic bone loss
Time course of bone screw fixation following a local delivery of zoledronate in a rat femoral model – a micro-finite element analysis
A good fixation of osteosynthesis implants is crucial for a successful bone healing but often difficult to achieve in osteoporotic patients. One possible solution to this issue is the local delivery of bisphosphonates in direct proximity to the implants, A critical aspect of this method, that has not yet been well investigated, is the time course of the implant fixation following the drug release. Usual destructive mechanical tests require large numbers of animals to produce meaningful results. Therefore, a micro-finite element (microFE) approach was chosen to analyze implant fixation. In vivo micro computed tomography (microCT) scans were obtained, first weekly and later bi-weekly, after implantation of polymeric screws in the femoral condyles of ovariectomized rats. In one half of the animals, Zoledronate was released from a hydrogel matrix directly in the peri-implant bone stock, the other animals were implanted only with screws as control. The time course of the implant fixation was investigated with linear elastic microFE models that were created based on in vivo microCT scans. The numerical models were validated against experimental pullout-tests measurements in an additional cadaver study. The microFE analysis revealed a significant increase in force at yield of the Zoledronate treated group compared to the control group. The force of the treated group was 28% higher after 17 days of screw implantation, 42% higher after 31 days. The significant difference persisted until the end of the in vivo study at day 58 (p<0.01). The early onset and prolonged duration of the implant anchorage improvement that was found in this study indicates the great potential of Zoledronate-loaded hydrogel for an enhancement of osteosynthesis implant fixation in impaired bone
Development and experimental validation of a finite element model of total ankle replacement
Total ankle replacement remains a less satisfactory solution compared to other joint replacements. The goal of this study was to develop and validate a finite element model of total ankle replacement, for future testing of hypotheses related to clinical issues. To validate the finite element model, an experimental setup was specifically developed and applied on 8 cadaveric tibias. A non-cemented press fit tibial component of a mobile bearing prosthesis was inserted into the tibias. Two extreme anterior and posterior positions of the mobile bearing insert were considered, as well as a centered one. An axial force of 2 kN was applied for each insert position. Strains were measured on the bone surface using digital image correlation. Tibias were CT scanned before implantation, after implantation, and after mechanical tests and removal of the prosthesis. The finite element model replicated the experimental setup. The first CT was used to build the geometry and evaluate the mechanical properties of the tibias. The second CT was used to set the implant position. The third CT was used to assess the bone-implant interface conditions. The coefficient of determination (R-squared) between the measured and predicted strains was 0.91. Predicted bone strains were maximal around the implant keel, especially at the anterior and posterior ends. The finite element model presented here is validated for future tests using more physiological loading conditions
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