Experimental validation of intact and implanted distal femur finite element models

Four finite element (FE) models of intact and distal femur of knee replacements were validated relative to measured bone strains. FE models of linear tetrahedrons were used. Femoral replacements with cemented stemless, cemented and noncemented femoral stems of the PFC Sigma Modular Knee System were analyzed. Bone strains were recorded at ten locations on the cortex. The magnitude of the FE bone strains corresponded to the mean measured strains, with an overall agreement of 10%. Linear regression between the FE and mean experimental strains produced slopes between 0.94 and 1.06 and R(2) values between 0.92 and 0.99. RSME values were less than 12%. The FE models were able to adequately replicate the mechanical behavior of distal femur reconstructions.     

Fracture prediction for the proximal femur using finite element models: Part II--Nonlinear analysis.

In Part I we reported the results of linear finite element models of the proximal femur generated using geometric and constitutive data collected with quantitative computed tomography. These models demonstrated excellent agreement with in vitro studies when used to predict ultimate failure loads. In Part II, we report our extension of those finite element models to include nonlinear behavior of the trabecular and cortical bone. A highly nonlinear material law, originally designed for representing concrete, was used for trabecular bone, while a bilinear material law was used for cortical bone. We found excellent agreement between the model predictions and in vitro fracture data for both the onset of bone yielding and bone fracture. For bone yielding, the model predictions were within 2 percent for a load which simulated one-legged stance and 1 percent for a load which simulated a fall. For bone fracture, the model predictions were within 1 percent and 17 percent, respectively. The models also demonstrated different fracture mechanisms for the two different loading configurations. For one-legged stance, failure within the primary compressive trabeculae at the subcapital region occurred first, leading to load transfer and, ultimately, failure of the surrounding cortical shell. However, for a fall, failure of the cortical and trabecular bone occurred simultaneously within the intertrochanteric region. These results support our previous findings that the strength of the subcapital region is primarily due to trabecular bone whereas the strength of the intertrochanteric region is primarily due to cortical bone.     

Fracture prediction for the proximal femur using finite element models: Part I--Linear analysis.

Over 90 percent of the more than 250,000 hip fractures that occur annually in the United States are the result of falls from standing height. Despite this, the stresses associated with femoral fracture from a fall have not been investigated previously. Our objectives were to use three-dimensional finite element models of the proximal femur (with geometries and material properties based directly on quantitative computed tomography) to compare predicted stress distributions for one-legged stance and for a fall to the lateral greater trochanter. We also wished to test the correspondence between model predictions and in vitro strain gage data and failure loads for cadaveric femora subjected to these loading conditions. An additional goal was to use the model predictions to compare the sensitivity of several imaging sites in the proximal femur which are used for the in vivo prediction of hip fracture risk. In this first of two parts, linear finite element models of two unpaired human cadaveric femora were generated. In Part II, the models were extended to include nonlinear material properties for the cortical and trabecular bone. While there was poor correspondence between strain gage data and model predictions, there was excellent agreement between the in vitro failure data and the linear model, especially using a von Mises effective strain failure criterion. Both the onset of structural yielding (within 22 and 4 percent) and the load at fracture (within 8 and 5 percent) were predicted accurately for the two femora tested. For the simulation of one-legged stance, the peak stresses occurred in the primary compressive trabeculae of the subcapital region.(ABSTRACT TRUNCATED AT 250 WORDS)     

Tissue-fluid interface analysis using biphasic finite element method

Numerical studies on fluid-structure interaction have primarily relied on decoupling the solid and fluid sub-domains with the interactions treated as external boundary conditions on the individual sub-domains. The finite element applications for the fluid-structure interactions can be divided into iterative algorithms and sequential algorithms. In this paper, a new computational methodology for the analysis of tissue-fluid interaction problems is presented. The whole computational domain is treated as a single biphasic continuum, and the same space and time discretisation is carried out for the sub-domains using a penalty-based finite element model. This procedure does not require the explicit modelling of additional boundary conditions or interface elements. The developed biphasic interface finite element model is used in analysing blood flow through normal and stenotic arteries. The increase in fluid flow velocity when passing through a stenosed artery and the drop in pressure at the region are captured using this method.     

A comparative computational study of blood flow through prosthetic heart valves using the finite element method

The steady flow of blood through three common types of prosthetic heart valves was simulated numerically using the finite element method. The velocity, pressure and stress fields were obtained for the disk-type, tilting-disk and ball-type prosthetic heart valves in aortic position, for increasing Reynolds numbers up to 900, 1500 and 2000 respectively. Computer graphics of calculated velocities are presented, showing in detail the accelerated flow, recirculation and stagnation areas developed in the prosthesis. Maximum wall shear stresses were found at 0.5, 1.4, and 1.2 diameters from the sewing ring downstream for the disk, tilting-disk and ball valves being the values of 55, 18 and 33 dyn cm-2 respectively. In the vicinity of the occluder, maximum shear stresses of 38, 30 and 47 dyn cm-2 respectively were computed. The flow characteristics and performance for each valve are compared, the results are presented in terms of energy loss and maximum shear stress. The velocity and stress fields are compared with in vitro evaluations found in the literature.     

Mapping anisotropy of the proximal femur for enhanced image based finite element analysis

Finite element (FE) models of bone derived from quantitative computed tomography (QCT) rely on realistic material properties to accurately predict bone strength. QCT cannot resolve bone microarchitecture, therefore QCT-based FE models lack the anisotropy apparent within the underlying bone tissue. This study proposes a method for mapping femoral anisotropy using high-resolution peripheral quantitative computed tomography (HR-pQCT) scans of human cadaver specimens. Femur HR-pQCT images were sub-divided into numerous overlapping cubic sub-volumes and the local anisotropy was quantified using a ‘direct-mechanics’ method. The resulting directionality reflected all the major stress lines visible within the trabecular lattice, and provided a realistic estimate of the alignment of Harvesian systems within the cortical compartment. QCT-based FE models of the proximal femur were constructed with isotropic and anisotropic material properties, with directionality interpolated from the map of anisotropy. Models were loaded in a sideways fall configuration and the resulting whole bone stiffness was compared to experimental stiffness and ultimate strength. Anisotropic models were consistently less stiff, but no statistically significant differences in correlation were observed between material models against experimental data. The mean difference in whole bone stiffness between model types was approximately 26%, suggesting that anisotropy can still effect considerable change in the mechanics of proximal femur models. The under prediction of whole bone stiffness in anisotropic models suggests that the orthotropic elastic constants require further investigation. The ability to map mechanical anisotropy from high-resolution images and interpolate information into clinical-resolution models will allow testing of new anisotropic material mapping strategies.     

A CT-based high-order finite element analysis of the human proximal femur compared to in-vitro experiments

The prediction of patient-specific proximal femur mechanical response to various load conditions is of major clinical importance in orthopaedics. This paper presents a novel, empirically validated high-order finite element method (FEM) for simulating the bone response to loads. A model of the bone geometry was constructed from a quantitative computerized tomography (QCT) scan using smooth surfaces for both the cortical and trabecular regions. Inhomogeneous isotropic elastic properties were assigned to the finite element model using distinct continuous spatial fields for each region. The Young's modulus was represented as a continuous function computed by a least mean squares method. p-FEMs were used to bound the simulation numerical error and to quantify the modeling assumptions. We validated the FE results with in-vitro experiments on a fresh-frozen femur loaded by a quasi-static force of up to 1500 N at four different angles. We measured the vertical displacement and strains at various locations and investigated the sensitivity of the simulation. Good agreement was found for the displacements, and a fair agreement found in the measured strain in some of the locations. The presented study is a first step toward a reliable p-FEM simulation of human femurs based on QCT data for clinical computer aided decision making.     

Failure analysis of a new post-and-core restoration system using the finite element method

Human teeth with substantial coronal defects are subject to reconstruction by means of post-and-core restorations. Typically, such a restoration comprises a slightly cylindrical post onto which an abutment of varying shape, depending on the designated restoration, is attached. As clinical results are not satisfactory to date, a new post-and-core design which makes use of positive locking (rather than relying on chemical bonding agents for retention in the residual root) was proposed. Using proprietary burs, an inversely conical hole is machined into the root, into which the prefabricated post-and-core restoration is inserted. This part can be spread at the bottom to match the cavity's undercut form, resulting in a positive lock which can only be separated by destruction of root, restoration or both. Another key feature of this system is a ring/groove geometry which is able to absorb the wedging forces created by said spreading and the stress of loading of the restoration which arises from mascatory forces. To assess the properties, especially in terms of the stress imposed on the remaining tooth at highest possible loading, both finite element simulations and in vitro failure tests were performed and the findings compared. The results suggest that the parameters of the finite element simulations are in good agreement with reality. As calculated and measured force levels immediately before failure of the restoration are high, the introduced new geometry has significant advantages over the classical restoration.     

Personalized loading conditions for homogenized finite element analysis of the distal sections of the radius

The microstructure of trabecular bone is known to adapt its morphology in response to mechanical loads for achieving a biomechanical homeostasis. Based on this form–function relationship, previous investigators either simulated the remodeling of bone to predict the resulting density and architecture for a specific loading or retraced physiological loading conditions from local density and architecture. The latter inverse approach includes quantifying bone morphology using computed tomography and calculating the relative importance of selected load cases by minimizing the fluctuation of a tissue loading level metric. Along this concept, the present study aims at identifying an optimal, personalized, multiaxial load case at the distal section of the human radius using in vivo HR-pQCT-based isotropic, homogenized finite element (hFE) analysis. The dataset consisted of HR-pQCT reconstructions of the 20 mm most distal section of 21 human fresh-frozen radii. We simulated six different unit canonical load cases (FX palmar–dorsal force, FY ulnar–radial force, FZ distal–proximal force, MX moment about palmar–dorsal, MY moment about ulnar–radial, MZ moment about distal–proximal) using a simplified and efficient hFE method based on a single isotropic bone phase. Once we used a homogeneous mean density (shape model) and once the original heterogeneous density distribution (shape + density model). Using an analytical formulation, we minimized the deviation of the resulting strain tensors ε(x) to a hydrostatic compressive reference strain ε₀, once for the 6 degrees of freedom (DOF) optimal (OPT) load case and for all individual 1 DOF load cases (FX, FY, FZ, MX, MY, MZ). All seven load cases were then extended in the nonlinear regime using the scaled displacements of the linear load cases as loading boundary conditions (MAX). We then compared the load cases and models for their objective function (OF) values, the stored energies and their ultimate strength using a specific torsor norm. Both shape and shape + density linear-optimized OPT models were dominated by a positive force in the z-direction (FZ). Transversal force DOFs were close to zero and mean moment DOFs were different depending on the model type. The inclusion of density distribution increased the influence and changed direction of MX and MY, while MZ was small in both models. The OPT load case had 12–15% lower objective function (OF) values than the FZ load case, depending on the model. Stored energies at the optimum were consistently 142–178% higher for the OPT load case than for the FZ load case. Differences in the nonlinear response maximum torsor norm ‖t‖ were heterogeneous, but consistently higher for OPT_MAX than FZ_MAX. We presented the proof of concept of an optimization procedure to estimate patient-specific loading conditions for hFE methods. In contrast to similar models, we included canonical load cases in all six DOFs and used a strain metric that favors hydrostatic compression. Based on a biomechanical analysis of the distal joint surfaces at the radius, the estimated load directions are plausible. For our dataset, the resulting OPT load case is close to the standard axial compression boundary conditions, usually used in HR-pQCT-based FE analysis today. But even using the present simplified hFE model, the optimized linear six DOF load case achieves a more homogeneous tissue loading and can absorb more than twice the energy than the standard uniaxial load case. The ultimate strength calculated with a torsor norm was consistently higher for the 6-DOF nonlinear model (OPT_MAX) than for the 1-DOF nonlinear uniaxial model (FZ_MAX). Defining patient-specific boundary conditions may decrease angulation errors during CT measurements and improve repeatability as well as reproducibility of bone stiffness and strength estimated by HR-pQCT-based hFE analysis. These results encourage the extension of the present method to anisotropic hFE models and their application to repeatability data sets to test the hypothesis of reduced angulation errors during measurement.

     

Characterization of craniofacial sutures using the finite element method

Characterizing the biomechanical behavior of sutures in the human craniofacial skeleton (CFS) is essential to understand the global impact of these articulations on load transmission, but is challenging due to the complexity of their interdigitated morphology, the multidirectional loading they are exposed to and the lack of well-defined suture material properties. This study aimed to quantify the impact of morphological features, direction of loading and suture material properties on the mechanical behavior of sutures and surrounding bone in the CFS. Thirty-six idealized finite element (FE) models were developed. One additional specimen-specific FE model was developed based on the morphology obtained from a µCT scan to represent the morphological complexity inherent in CFS sutures. Outcome variables of strain energy (SE) and von Mises stress (σ_vm) were evaluated to characterize the sutures’ biomechanical behavior. Loading direction was found to impact the relationship between SE and interdigitation index and yielded varied patterns of σ_vm in both the suture and surrounding bone. Adding bone connectivity reduced suture strain energy and altered the σ_vm distribution. Incorporating transversely isotropic material properties was found to reduce SE, but had little impact on stress patterns. High-resolution µCT scanning of the suture revealed a complex morphology with areas of high and low interdigitations. The specimen specific suture model results were reflective of SE absorption and σ_vm distribution patterns consistent with the simplified FE results. Suture mechanical behavior is impacted by morphologic factors (interdigitation and connectivity), which may be optimized for regional loading within the CFS.     

Mechanics of cranial sutures using the finite element method

To investigate how cranial suture morphology and the arrangement of sutural collagen fibres respond to compressive and tensile loads, an idealised bone–suture–bone complex was analysed using a two-dimensional finite element model. Three suture morphologies were simulated with an increasing interdigitation index (I.I.): butt-ended, moderate interdigitated, and complex interdigitated. The collagen matrix within all sutures was modelled as an isotropic material, and as an orthotropic material in the interdigitated sutures with fibre alignment as reported in studies of miniature pigs. Static uniform compressive or tensile loading was applied to the complex. In interdigitated sutures with isotropic material properties, the orientation of the maximum (tensile) principal stresses within the suture matched the collagen fibre orientation observed in compressed and tensed sutures of miniature pigs. This suggests that randomly arranged sutural collagen fibres could optimise to an orientation most appropriate to withstand the predominant type of loading. A compression-resistant fibre arrangement imparted the highest suture strain energy relative to the isotropic and tension-resistant arrangements, indicating that this configuration maximises energy storage. A comparison across the different suture morphologies indicated that bone strain energy generally decreased with a decrease in I.I., irrespective of the sutural fibre arrangement. However, high bone stress at the interdigitation apices shifted to the limbs of the suture with an increase in I.I. These combined findings highlight the importance of suture morphology and anisotropy as properties having a significant influence on sutural mechanics.     

Statistical finite element method for real-time tissue mechanics analysis

The finite element (FE) method can accurately calculate tissue deformation. However, its low speed renders it ineffective for many biomedical applications involving real-time data processing. To accelerate FE analysis, we introduce a novel tissue mechanics simulation technique. This technique is suitable for real-time estimation of tissue deformation of specific organs, which is required in computer-aided diagnostic or therapeutic procedures. In this method, principal component analysis is used to describe each organ shape and its corresponding FE field for a pool of patients by a small number of weight factors. A mapping function is developed to relate the parameters of organ shape to their FE field counterpart. We show that irrespective of the complexity of the tissue's constitutive law or its loading conditions, the proposed technique is highly accurate and fast in estimating the FE field. Average deformation errors of less than 2% demonstrate the accuracy of the proposed technique.     

Prediction of strength and strain of the proximal femur by a CT-based finite element method

Hip fractures are the most serious complication of osteoporosis and have been recognized as a major public health problem. In elderly persons, hip fractures occur as a result of increased fragility of the proximal femur due to osteoporosis. It is essential to precisely quantify the strength of the proximal femur in order to estimate the fracture risk and plan preventive interventions. CT-based finite element analysis could possibly achieve precise assessment of the strength of the proximal femur. The purpose of this study was to create a simulation model that could accurately predict the strength and surface strains of the proximal femur using a CT-based finite element method and to verify the accuracy of our model by load testing using fresh frozen cadaver specimens. Eleven right femora were collected. The axial CT scans of the proximal femora were obtained with a calibration phantom, from which the 3D finite element models were constructed. Materially nonlinear finite element analyses were performed. The yield and fracture loads were calculated, while the sites where elements failed and the distributions of the principal strains were determined. The strain gauges were attached to the proximal femoral surfaces. A quasi-static compression test of each femur was conducted. The yield loads, fracture loads and principal strains of the prediction significantly correlated with those measured (r=0.941, 0.979, 0.963). Finite element analysis showed that the solid elements and shell elements in undergoing compressive failure were at the same subcapital region as the experimental fracture site.     

A round-robin finite element analysis of human femur mechanics between seven participating laboratories with experimental validation

Finite element analysis is a common tool that has been used for the past few decades to predict the mechanical behavior of bone. However, to our knowledge, there are no round-robin finite element analyses of long human bones with more than two participating biomechanics laboratories published yet, where the results of the experimental tests were not known in advance. We prepared a fresh-frozen human femur for a compression test in a universal testing machine measuring the strains at 10 bone locations as well as the deformation of the bone in terms of the displacement of the loading point at a load of 2?kN. The computed tomography data of the bone with a calibration phantom as well as the orientation of the bone in the testing machine with the according boundary conditions were delivered to seven participating laboratories. These were asked to perform a finite element analysis simulating the experimental setup and deliver their results to the coordinator without knowing the experimental results. Resultantly, four laboratories had deviations from the experimentally measured strains of less than 40%, and three laboratories had deviations of their numerically determined values compared to the experimental data of more than 120%. These deviations are thought to be based on different material laws and material data, as well as different material mapping methods. Investigations will be conducted to clarify and assess the reasons for the large deviations in the numerical data. It was shown that the precision of finite element models of the human femur is not yet as developed as desired by the biomechanics community.     

A voxel-based formulation for contact finite element analysis

To date, voxel-based finite element models have not been feasible for contact problems, owing to the inherent stair-step boundary discontinuities. New preprocessing techniques are reported herein to mesh these boundaries smoothly, for purposes of contact stress analysis. Further, new techniques are reported to concentrate the mesh resolution automatically near the articular surface, thus reducing the problem size to levels compatible with executing nonlinear problems on contemporary engineering workstations. Close approximations to Hertzian analytical solutions were obtained for spherical and cylindrical geometries meshed in this manner, and an illustrative anatomical contact problem of the human hip joint is presented.     

Deriving indicators for breast conserving surgery using finite element analysis

Breast conserving therapy (BCT), comprising a complete surgical excision of the tumour (partial mastectomy) with post-operative radiotherapy to the remaining breast tissue, is feasible for most women undergoing treatment for breast cancer. The goal of BCT is to achieve local control of the cancer, as well as to preserve a breast that satisfies a woman's cosmetic concerns. Although most women undergo partial mastectomy with satisfactory cosmetic results, in many patients the remaining breast is left with major cosmetic defects including concave deformities, distortion of the nipple–areolar complex, asymmetry and changes in tissue density characterised by excessive density associated with parenchymal scarring, as well as breast pain. There are currently no tools, other than surgical experience and judgement, which can predict the impact of partial mastectomy on the contour, the deformity of the treated breast and the mechanical stress that it induces. In this study, we use a finite element model to execute virtual surgery and carry out a sensitivity analysis on the resection location, the resection size, the breast tissue mechanical property and the different post-surgery recovery stage. We output the result in two different built-in indicators labelled as the cosmetic and the functional indicators. This study used the breast model for three women with breast cancer who have been elected to undergo BCT and are being treated at the Methodist Hospital in Houston, TX. The goal of this study was to propose a first glimpse of the key parameter leading to satisfactory post-BCT cosmetic results.     

Calculation of protein form birefringence using the finite element method.

An approach based on the finite element method (FEM) is employed to calculate the optical properties of macromolecules, specifically form birefringence. Macromolecules are treated as arbitrarily shaped particles suspended in a solvent of refraction index n1. The form birefringence of the solution is calculated as the difference in its refractive index when all the particles of refractive index n2 are either parallel to or normal to the direction of the polarization of light. Since the particles of interest are small compared to the wavelength of light, a quasi-static approximation for the refractive index is used, i.e., that it is equal to the square root of the dielectric constant of the suspension. The average dielectric constant of the mixture is calculated using the finite element method. This approach has been tested for ellipsoidal particles and a good agreement with theoretical results has been obtained. Also, numerical results for the motor domains of ncd and kinesin, small arbitrarily shaped proteins with known x-ray structures, show reasonable agreement with the experimental data obtained from transient electric birefringence experiments.     

Simplified boundary conditions alter cortical-trabecular load sharing at the distal radius; A multiscale finite element analysis

High-resolution peripheral quantitative computed tomography (HR-pQCT) derived micro-finite element (FE) modeling is used to evaluate mechanical behavior at the distal radius microstructure. However, these analyses typically simulate non-physiologic simplified platen-compression boundary conditions on a small section of the distal radius. Cortical and trabecular regions contribute uniquely to distal radius mechanical behavior, and various factors affect these regions distinctly. Generalized strength predictions from standardized platen-compression analyses may not adequately capture region specific responses in bone. Our goal was to compare load sharing within the cortical-trabecular compartments between the standardized platen-compression BC simulations, and physiologic BC simulations using a validated multiscale approach. Clinical- and high-resolution images were acquired from nine cadaveric forearm specimens using an HR-pQCT scanner. Multiscale FE models simulating physiologic BCs, and micro-FE only models simulating platen-compression BCs were created for each specimen. Cortical and trabecular loads (N) along the length of the distal radius micro-FE section were compared between BCs using correlations. Principal strain distributions were also compared quantitatively. Cortical and trabecular loads from the platen-compression BC simulations were strongly correlated to the physiologic BC simulations. However, a 30% difference in cortical loads distally, and a 53% difference in trabecular loads proximally was observed under platen BC simulations. Also, distribution of principal strains was clearly different. Our data indicated that platen-compression BC simulations alter cortical-trabecular load sharing. Therefore, results from these analyses should be interpreted in the appropriate mechanical context for clinical evaluations of normal and pathologic mechanical behavior at the distal radius.