Modified Bilston nonlinear viscoelastic model for finite element head injury studies

This paper proposes a modified nonlinear viscoelastic Bilston model (Bilston et al., 2001, Biorheol., 38, pp. 335-345). for the modeling of brain tissue constitutive properties. The modified model can be readily implemented in a commercial explicit finite element (FE) code, PamCrash. Critical parameters of the model have been determined through a series of rheological tests on porcine brain tissue samples and the time-temperature superposition (TTS) principle has been used to extend the frequency to a high region. Simulations by using PamCrash are compared with the test results. Through the use of the TTS principle, the mechanical and rheological behavior at high frequencies up to 10(4) rads may be obtained. This is important because the properties of the brain tissue at high frequencies and impact rates are especially relevant to studies of traumatic head injury. The averaged dynamic modulus ranges from 130 Pa to 1500 Pa and loss modulus ranges from 35 Pa to 800 Pa in the frequency regime studied (0.01 rads to 3700 rads). The errors between theoretical predictions and averaged relaxation test results are within 20% for strains up to 20%. The FEM simulation results are in good agreement with experimental results. The proposed model will be especially useful for application to FE analysis of the head under impact loads. More realistic analysis of head injury can be carried out by incorporating the nonlinear viscoelastic constitutive law for brain tissue into a commercial FE code.     

Fracture risk in the femoral hip region: A finite element analysis supported experimental approach

The decrease of bone mineral density (BMD) is a multifactorial bone pathology, commonly referred to as osteoporosis. The subsequent decline of the bone's micro-structural characteristics renders the human skeletal system, and especially the hip, susceptible to fragility fractures. This study represents a systematic attempt to correlate BMD spectrums to the mechanical strength characteristics of the femoral neck and determine a fracture risk indicator based on non-invasive imaging techniques. The BMD of 30 patients' femurs was measured in vivo by Dual-energy X-ray absorptiometry (DXA). As these patients were subjected to total hip replacement, the mechanical strength properties of their femurs' were determined ex-vivo using uniaxial compression experiments. FEA simulations facilitated the correlation of the DXA measurements to the apparent fracture risk, indicating critical strain values during complex loading scenarios.     

股骨头缺血坏死介入治疗的临床应用研究

目的:探讨介入治疗股骨头缺血坏死的临床应用价值。方法:采用Seldinger技术对28例患者行超选择股骨头供血动脉插管,动脉造影、溶通治疗。结果:28例患者治疗后髋部疼痛及关节功能障碍均有不同程度的减轻及改善,有效率96.4%;治疗后病变区血管分支增多、增粗;影像随访显示股骨头骨质不同程度修复。结论:介入治疗具有创伤小、并发症低、血管再通率高、临床症状改善明显的优势,能有效的改善股骨头的局部血液循环和髋关节的疼痛、活动功能,应大力推广。     

Influence of femur size and morphology on load transfer in the resurfaced femoral head: A large scale, multi-subject finite element study

Femoral resurfacing has become an increasingly popular procedure, especially for young, active patients. The procedure is known to alter load transfer through the proximal femur and this has been linked with the most commonly observed complication, neck fracture. An intriguing observation noted by registry data and clinical studies is an inverse relationship between implant size and revision rate. While computational analysis has become an established part of biomedical engineering, the majority of work uses a single or small set of bone models, with a single implant size, due to the constraints of time and data availability. Therefore, it has been infeasible to run a study incorporating natural inter-patient variability or the performance of smaller implants could not be meaningfully studied. In previous work a statistical model of the whole femur was used to generate large numbers of unique, realistic, FE-ready femur models describing both geometry and material properties. The current study demonstrates a methodology for virtually implanting and performing stress analysis of cemented femoral resurfacing components, with model specific sizing and orientation. Automated analysis of 400 generated femurs, in both implanted and intact configurations showed the strain changes induced by resurfacing. This produced a statistically meaningful number of results and allowed the examination of outliers. Results showed increased femoral neck strain changes potentially increasing the risk of neck fracture, associated with smaller, less dense femurs and smaller implant sizes; agreeing with clinical observations. The study demonstrates a methodology for more comprehensive analyses, based on populations rather than individuals.     

Creating a human head finite element model using a multi-block approach for predicting skull response and brain pressure

To better understand head injuries, human head finite element (FE) models have been reported in the literature. In scenarios where the head is directly impacted and measurements of head accelerations are not available, a high-quality skull model, as well as a high-quality brain model, is needed to predict the effect of impact on the brain through the skull. Furthermore, predicting cranial bone fractures requires comprehensively validated skull models. Lastly, high-quality meshes for both the skull and brain are needed for accurate strain/stress predictions across the entire head. Hence, we adopted a multi-block approach to develop hexahedral meshes for the brain, skull, and scalp simultaneously, a first approach in its kind. We then validated our model against experimental data of brain pressures (Nahum et al., 1977 Nahum AM, Smith R, Ward CC. 1977. Intracranial pressure dynamics during head impact. Proceedings of the 21st Stapp Car Crash Conference, SAE Paper No. 770922; Warrendale, PA: Society of Automotive Engineers.[Crossref] , [Google Scholar]) and comprehensive skull responses (Yoganandan et al., 1995 Yoganandan N, Pintar FA, Sances A, Jr., Walsh PR, Ewing CL, Thomas DJ, Snyder RG. 1995. Biomechanics of skull fracture. J Neurotrauma. 12(4):659–668.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar], Yoganandan et al., 2004 Yoganandan N, Zhang J, Pintar FA. 2004. Force and acceleration corridors from lateral head impact. Traffic Injury Prevention. 5(4):368–373.[Taylor &; Francis Online] , [Google Scholar], and Raymond et al., 2009 Raymond D, Van Ee C, Crawford G, Bir C. 2009. Tolerance of the skull to blunt ballistic temporo-parietal impact. J Biomech. 42(15):2479–2485.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). We concluded that a human head FE model was developed with capabilities to predict blunt- and ballistic-impact-induced skull fractures and pressure-related brain injuries.     

Mechanical significance of femoral head trabecular bone structure in Loris and Galago evaluated using micromechanical finite element models

Work on the interspecific and intraspecific variation of trabecular bone in the proximal femur of primates demonstrates important architectural variation between animals with different locomotor behaviors. This variation is thought to be related to the processes of bone adaptation whereby bone structure is optimized to the mechanical environment. Micromechanical finite element models were created for the proximal femur of the leaping Galago senegalensis and the climbing and quadrupedal Loris tardigradus by converting bone voxels from high-resolution X-ray computed tomography scans of the femoral head to eight-noded brick elements. The resulting models had approximately 1.8 million elements each. Loading conditions representing takeoff phase of a leap and more generalized load orientations were applied to the models, and the models were solved using the iterative "row-by-row" matrix-vector multiplication algorithm. The principal strain and Von Mises stress results for the leaping model were similar for both species at each load orientation. Similar hip joint reaction forces in the range of 4.9 x to 12 x body weight were calculated for both species under each loading condition, but the hip reaction values estimated for Loris were higher than predicted based on locomotor behavior. These results suggest that functional adaptation to hip joint loading may not fully explain the differences in femoral head trabecular bone structure in Galago and Loris. The finite element method represents a unique and useful tool for analyzing the functional adaptation of trabecular bone in a diversity of animals and for reconstructing locomotor behavior in extinct taxa.     

Self-healing and injectable hybrid hydrogel for bone regeneration of femoral head necrosis and defect

Background

HA modified by bisphosphonate (BP) (HA-BP) was synthesized by chemical reaction and possessed promising properties such as self-healing, injection ability, and strong adhesion. The main aim of this study was to confirm its role in promoting osteogenic differentiation in vitro and bone regeneration in vivo.

Cortical bone viscoelasticity and fixation strength of press-fit femoral stems: finite element model

Many cementless implant designs rely upon a diaphyseal press-fit in conjunction with a porous coated implant surface to achieve primary or short term fixation, thereby constraining interface micromotion to such a level that bone ingrowth and consequent secondary or long-term fixation, i.e., osseointegration, can occur. Bone viscoelasticity, however, has been found to affect stem primary stability by reducing push-out load. In this investigation, an axisymmetric finite element model of a cylindrical stem and diaphyseal cortical bone section was created in order to parametrically evaluate the effect of bone viscoelasticity on stem push-out while controlling coefficient of friction (mu = 0.15, 0.40, and 1.00) and stem-bone diametral interference (delta = 0.01, 0.05, 0.10, and 0.50 mm). Based on results from a previous study, it was hypothesized that stem-bone interference (i.e., press-fit) would elicit a bone viscoelastic response which would reduce the initial fixation of the stem as measured by push-out load. Results indicate that for all examined combinations of mu and delta, bone viscoelastic behavior reduced the push-out load by a range of 2.6-82.6% due to stress relaxation of the bone. It was found that the push-out load increased with mu for each value of delta, but minimal increases in the push-out load (2.9-4.9%) were observed as delta was increased beyond 0.10 mm. Within the range of variables reported for this study, it was concluded that bone viscoelastic behavior, namely stress relaxation, has an asymptotic affect on stem contact pressure, which reduces stem push-out load. It was also found that higher levels of coefficient of friction are beneficial to primary fixation, and that an interference "threshold" exists beyond which no additional gains in push-out load are achieved.     

A three-dimensional human head finite element model and power flow in a human head subject to impact loading

A three-dimensional finite element model of the human head is presented. The model has been validated against two sets of experimental results. To assess injury likelihood of the head subjected to impact loading, the structural intensity (SI) methodology is introduced in accordance with the prevailing practice in experimental biomechanics. SI is a vector quantity indicating the direction and magnitude of power flow inside a dynamically loaded structure. In this paper, the SI field inside the head model is computed for three cases, namely frontal, rear and side impacts. The results for the three cases have revealed that there exist power flow paths. The skull is, in general, a good energy flow channel. The study has also revealed the high possibility of spinal cord injury due to wave motion inside the head.     

A new approach for assigning bone material properties from CT images into finite element models

Generation of subject-specific finite element (FE) models from computed tomography (CT) datasets is of significance for application of the FE analysis to bone structures. A great challenge that remains is the automatic assignment of bone material properties from CT Hounsfield Units into finite element models. This paper proposes a new assignment approach, in which material properties are directly assigned to each integration point. Instead of modifying the dataset of FE models, the proposed approach divides the assignment procedure into two steps: generating the data file of the image intensity of a bone in a MATLAB program and reading the file into ABAQUS via user subroutines. Its accuracy has been validated by assigning the density of a bone phantom into a FE model. The proposed approach has been applied to the FE model of a sheep tibia and its applicability tested on a variety of element types. The proposed assignment approach is simple and illustrative. It can be easily modified to fit users’ situations.     

The influence of uncemented femoral stem length and design on its primary stability: a finite element analysis

One of the crucial factors for short- and long-term clinical success of total hip arthroplasty cementless implants is primary stability. Indeed, motion at the bone–implant interface above 40 μm leads to partial bone ingrowth, while motion exceeding 150 μm completely inhibits bone ingrowth. The aim of this study was to investigate the effect of two cementless femoral stem designs with different lengths on the primary stability. A finite element model of a composite Sawbones^® fourth generation, implanted with five lengths of the straight prosthesis design and four lengths of the curved prosthesis design, was loaded with hip joint and abductor forces representing two physiological activities: fast walking and stair climbing. We found that reducing the straight stem length from 146 to 54 mm increased the average micromotion from 17 to 52 μm during fast walking, while the peak value increased from 42 to 104 μm. With the curved stem, reducing length from 105 to 54 mm increased the average micromotion from 10 to 29 μm, while the peak value increased from 37 to 101 μm. Similar findings are obtained for stair climbing for both stems. Although the present study showed that femoral stem length as well as stem design directly influences its primary stability, for the two femoral stems tested, length could be reduced substantially without compromising the primary stability. With the aim of minimising surgical invasiveness, newer femoral stem design and currently well performing stems might be used with a reduced length without compromising primary stability and hence, long-term survivorship.     

Bone regeneration: stem cell therapies and clinical studies in orthopaedics and traumatology

Regenerative medicine seeks to repair or replace damaged tissues or organs, with the goal to fully restore structure and function without the formation of scar tissue. Cell based therapies are promising new therapeutic approaches in regenerative medicine. By using mesenchymal stem cells, good results have been reported for bone engineering in a number of clinical studies, most of them investigator initiated trials with limited scope with respect to controls and outcome. With the implementation of a new regulatory framework for advanced therapeutic medicinal products, the stage is set to improve both the characterization of the cells and combination products, and pave the way for improved controlled and well-designed clinical trials. The incorporation of more personalized medicine approaches, including the use of biomarkers to identify the proper patients and the responders to treatment, will be contributing to progress in the field. Both translational and clinical research will move the boundaries in the field of regenerative medicine, and a coordinated effort will provide the clinical breakthroughs, particularly in the many applications of bone engineering.     

A penetration-based finite element method for hyperelastic 3D biphasic tissues in contact. Part II: finite element simulations

The penetration method allows for the efficient finite element simulation of contact between soft hydrated biphasic tissues in diarthrodial joints. Efficiency of the method is achieved by separating the intrinsically nonlinear contact problem into a pair of linked biphasic finite element analyses, in which an approximate, spatially and temporally varying contact traction is applied to each of the contacting tissues. In Part I of this study, we extended the penetration method to contact involving nonlinear biphasic tissue layers, and demonstrated how to derive the approximate contact traction boundary conditions. The traction derivation involves time and space dependent natural boundary conditions, and requires special numerical treatment. This paper (Part II) describes how we obtain an efficient nonlinear finite element procedure to solve for the biphasic response of the individual contacting layers. In particular, alternate linearization of the nonlinear weak form, as well as both velocity-pressure, v-p, and displacement-pressure, u-p, mixed formulations are considered. We conclude that the u-p approach, with linearization of both the material law and the deformation gradients, performs best for the problem at hand. The nonlinear biphasic contact solution will be demonstrated for the motion of the glenohumeral joint of the human shoulder joint.     

3D finite element model of the diabetic neuropathic foot: A gait analysis driven approach

Diabetic foot is an invalidating complication of diabetes that can lead to foot ulcers. Three-dimensional (3D) finite element analysis (FEA) allows characterizing the loads developed in the different anatomical structures of the foot in dynamic conditions. The aim of this study was to develop a subject specific 3D foot FE model (FEM) of a diabetic neuropathic (DNS) and a healthy (HS) subject, whose subject specificity can be found in term of foot geometry and boundary conditions. Kinematics, kinetics and plantar pressure (PP) data were extracted from the gait analysis trials of the two subjects with this purpose. The FEM were developed segmenting bones, cartilage and skin from MRI and drawing a horizontal plate as ground support. Materials properties were adopted from previous literature. FE simulations were run with the kinematics and kinetics data of four different phases of the stance phase of gait (heel strike, loading response, midstance and push off). FEMs were then driven by group gait data of 10 neuropathic and 10 healthy subjects. Model validation focused on agreement between FEM-simulated and experimental PP.     

Analysis of tantalum implants used for avascular necrosis of the femoral head: a review of five retrieved specimens

Aim: The effective results shown in the porous systems of tantalum employed for the use of osseointegrates has been demonstrated by means of animal experimentation. However, there is a total lack of any research studies on the osseointegration of tantalum implants from retrieval of the same after a period of time whereby the material had been implanted within the human body. Materials and Methods: For this study, five rod implants used for the treatment of avascular necrosis of the femoral head were retrieved following collapse of the femoral head and conversion to total hip arthroplasty. The time of implantation ranged between six weeks and twenty months. Results: Observation during this study has confirmed the effectiveness of osseointegration within this period of time. New bone was observed around and within the porous system of the on rod devices at retrieval date. The bone ingrowth, however, proved to be slower and less intense than that resulting within animal species during the first few months after implantation. Conclusions: Nevertheless, the results obtained in the quantitative assessment of this process proved to be similar to those results achieved by other authors in previous experimental work studies.     

A convenient scheme for coupling a finite element curvilinear mesh to a finite element voxel mesh: application to the heart

Background  

In some cases, it may be necessary to combine distinct finite element meshes into a single system. The present work describes a scheme for coupling a finite element mesh, which may have curvilinear elements, to a voxel based finite element mesh.