Analysis of pelvic strain in different gait configurations in a validated cohort of computed tomography based finite element models

The pelvis functions to transmit upper body loads to the lower limbs and is critical in human locomotion. Semi-automated, landmark-based finite element (FE) morphing and mapping techniques eliminate the need for segmentation and have shown to accelerate the generation of multiple specimen-specific pelvic FE models to enable the study of pelvic mechanical behaviour. The purpose of this research was to produce an experimentally validated cohort of specimen-specific FE models of the human pelvis and to use this cohort to analyze pelvic strain patterns during gait. Using an initially segmented specimen-specific pelvic FE model as a source model, four more specimen-specific pelvic FE models were generated from target clinical CT scans using landmark-based morphing and mapping techniques. FE strains from the five models were compared to the experimental strains obtained from cadaveric testing via linear regression analysis, (R² values ranging from 0.70 to 0.93). Inter-specimen variability in FE strain distributions was seen among the five specimen-specific pelvic FE models. The validated cohort of specimen-specific pelvic FE models was utilized to examine pelvic strains at different phases of the gait cycle. Each validated specimen-specific FE model was reconfigured into gait cycle phases representing heel-strike/heel-off and midstance/midswing. No significant difference was found in the double-leg stance and heel-strike/heel-off models (p = 0.40). A trend was observed between double-leg stance and midstance/midswing models (p = 0.07), and a significant difference was found between heel-strike/heel-off models and midstance/midswing models (p = 0.02). Significant differences were also found in comparing right vs. left models (heel-strike/heel-off p = 0.14, midstance/midswing p = 0.04).     

Density-based load estimation using two-dimensional finite element models: a parametric study

A parametric investigation was conducted to determine the effects on the load estimation method of varying: (1) the thickness of back-plates used in the two-dimensional finite element models of long bones, (2) the number of columns of nodes in the outer medial and lateral sections of the diaphysis to which the back-plate multipoint constraints are applied and (3) the region of bone used in the optimization procedure of the density-based load estimation technique. The study is performed using two-dimensional finite element models of the proximal femora of a chimpanzee, gorilla, lion and grizzly bear. It is shown that the density-based load estimation can be made more efficient and accurate by restricting the stimulus optimization region to the metaphysis/epiphysis. In addition, a simple method, based on the variation of diaphyseal cortical thickness, is developed for assigning the thickness to the back-plate. It is also shown that the number of columns of nodes used as multipoint constraints does not have a significant effect on the method.     

Cervical spine morphology and ligament property variations: A finite element study of their influence on sagittal bending characteristics

Cervical spine finite element models reported in biomechanical literature usually represent a static morphology. Not considering morphology as a model parameter limits the predictive capabilities for applications in personalized medicine, a growing trend in modern clinical practice. The objective of the study was to investigate the influence of variations in spinal morphology on the flexion-extension responses, utilizing mesh-morphing-based parametrization and metamodel-based sensitivity analysis. A C5-C6 segment was used as the baseline model. Variations of intervertebral disc height, facet joint slope, facet joint articular processes height, vertebral body anterior-posterior depth, and segment size were parametrized. In addition, material property variations of ligaments were considered for sensitivity analysis. The influence of these variations on vertebral rotation and forces in the ligaments were analyzed. The disc height, segmental size, and body depth were found to be the most influential (in the cited order) morphology variations; while among the ligament material property variations, capsular ligament and ligamentum flavum influenced vertebral rotation the most. Changes in disc height influenced forces in the posterior ligaments, indicating that changes in the anterior load-bearing column of the spine could have consequences on the posterior column. A method to identify influential morphology variations is presented in this work, which will help automation efforts in modeling to focus on variations that matter. This study underscores the importance of incorporating influential morphology parameters, easily obtained through computed tomography/magnetic resonance images, to better predict subject-specific biomechanical responses for applications in personalized medicine.     

An automated method to morph finite element whole-body human models with a wide range of stature and body shape for both men and women

Field data analyses have shown that small female, obese, and/or older occupants are at increased risks of death and serious injury in motor-vehicle crashes compared with mid-size young men. The current adult finite element (FE) human models represent occupants in the same three body sizes (large male, mid-size male, and small female) as those for the contemporary adult crash dummies. Further, the time needed to develop an FE human model using the traditional method is measured in months or even years. In the current study, an improved regional mesh morphing method based on landmark-based radial basis function (RBF) interpolation was developed to rapidly morph a mid-size male FE human model into different geometry targets. A total of 100 human models with a wide range of human attributes were generated. A pendulum chest impact condition was applied to each model as an initial assessment of the resulting variability in response. The morphed models demonstrated mesh quality similar to the baseline model. The peak impact forces and chest deflections in the chest pendulum impacts varied substantially with different models, supportive of consideration of population variation in evaluating the occupant injury risks. The method developed in this study will enable future safety design optimizations targeting at various vulnerable populations that cannot be considered with the current models.     

Comparison of eight published static finite element models of the intact lumbar spine: Predictive power of models improves when combined together

Finite element (FE) model studies have made important contributions to our understanding of functional biomechanics of the lumbar spine. However, if a model is used to answer clinical and biomechanical questions over a certain population, their inherently large inter-subject variability has to be considered. Current FE model studies, however, generally account only for a single distinct spinal geometry with one set of material properties. This raises questions concerning their predictive power, their range of results and on their agreement with in vitro and in vivo values.     

FEBio finite element models of the human lumbar spine

Finite element analysis has proven to be a viable method for assessing many structure-function relationships in the human lumbar spine. Several validated models of the spine have been published, but they typically rely on commercial packages and are difficult to share between labs. The goal of this study is to present the development of the first open-access models of the human lumbar spine in FEBio. This modeling framework currently targets three deficient areas in the field of lumbar spine modeling: 1) open-access models, 2) accessibility for multiple meshing schemes, and 3) options to include advanced hyperelastic and biphasic constitutive models.     

Using 3D finite element models verified the importance of callus material and microstructure in biomechanics restoration during bone defect repair

Background: There is lack of further observations on the microstructure and material property of callus during bone defect healing and the relationships between callus properties and the mechanical strength. Methods: Femur bone defect model was created in rabbits and harvested CT data to reconstruct finite element models at 1 and 2 months. Three types of assumed finite element models were compared to study the callus properties, which assumed the material elastic property as heterogeneous (R-model), homogenous (H-model) or did not change from 1 to 2 months (U-model). Results: The apparent elastic moduli increased at 2 months (from 355.58 ± 132.67 to 1139.30 ± 967.43 MPa) in R-models. But there was no significant difference in apparent elastic moduli between R-models (355.58 ± 132.67 and 1139.30 ± 967.43 MPa) and H-models (344.79 ± 138.73 and 1001.52 ± 692.12 MPa) in 1 and 2 months. A significant difference of apparent elastic moduli was found between the R-model (1139.30 ± 967.43 MPa) and U-model group (207.15 ± 64.60 MPa) in 2 months. Conclusions: This study showed that the callus structure stability remodeled overtime to achieve a more effective structure, while the material quality of callus tissue is a very important factor for callus strength. At the meantime, this study showed an evidence that the material heterogeneity maybe not as important as it is in bone fracture model.     

Estimation of in vivo inter-vertebral loading during motion using fluoroscopic and magnetic resonance image informed finite element models

Finite element (FE) models driven by medical image data can be used to estimate subject-specific spinal biomechanics. This study aimed to combine magnetic resonance (MR) imaging and quantitative fluoroscopy (QF) in subject-specific FE models of upright standing, flexion and extension. Supine MR images of the lumbar spine were acquired from healthy participants using a 0.5 T MR scanner. Nine 3D quasi-static linear FE models of L3 to L5 were created with an elastic nucleus and orthotropic annulus. QF data was acquired from the same participants who performed trunk flexion to 60° and trunk extension to 20°. The displacements and rotations of the vertebrae were calculated and applied to the FE model. Stresses were averaged across the nucleus region and transformed to the disc co-ordinate system (S1 = mediolateral, S2 = anteroposterior, S3 = axial). In upright standing S3 was predicted to be −0.7 ± 0.6 MPa (L3L4) and −0.6 ± 0.5 MPa (L4L5). S3 increased to −2.0 ± 1.3 MPa (L3L4) and −1.2 ± 0.6 MPa (L4L5) in full flexion and to −1.1 ± 0.8 MPa (L3L4) and −0.7 ± 0.5 MPa (L4L5) in full extension. S1 and S2 followed similar patterns; shear was small apart from S23. Disc stresses correlated to disc orientation and wedging. The results demonstrate that MR and QF data can be combined in a participant-specific FE model to investigate spinal biomechanics in vivo and that predicted stresses are within ranges reported in the literature.     

Simple finite element models for use in the design of therapeutic footwear

Therapeutic footwear is frequently prescribed in cases of rheumatoid arthritis and diabetes to relieve or redistribute high plantar pressures in the region of the metatarsal heads. Few guidelines exist as to how these interventions should be designed and what effect such interventions actually have on the plantar pressure distribution. Finite element analysis has the potential to assist in the design process by refining a given intervention or identifying an optimal intervention without having to actually build and test each condition. However, complete and detailed foot models based on medical image segmentation have proven time consuming to build and computationally expensive to solve, hindering their utility in practice. Therefore, the goal of the current work was to determine if a simplified patient-specific model could be used to assist in the design of foot orthoses to reduce the plantar pressure in the metatarsal head region. The approach is illustrated by a case study of a diabetic patient experiencing high pressures and pain over the fifth metatarsal head. The simple foot model was initially calibrated by adjusting the individual loads on the metatarsals to approximate measured peak plantar pressure distributions in the barefoot condition to within 3%. This loading was used in various shod conditions to identify an effective orthosis. Model results for metatarsal pads were considerably higher than measured values but predictions for uniform surfaces were generally within 16% of measured values. The approach enabled virtual prototyping of the orthoses, identifying the most favorable approach to redistribute the patient’s plantar pressures.     

A novel methodology for generating 3D finite element models of the hip from 2D radiographs

Finite element (FE) modelling has been proposed as a tool for estimating fracture risk and patient-specific FE models are commonly based on computed tomography (CT). Here, we present a novel method to automatically create personalised 3D models from standard 2D hip radiographs. A set of geometrical parameters of the femur were determined from seven a–p hip radiographs and compared to the 3D femoral shape obtained from CT as training material; the error in reconstructing the 3D model from the 2D radiographs was assessed. Using the geometry parameters as the input, the 3D shape of another 21 femora was built and meshed, separating a cortical and trabecular compartment. The material properties were derived from the homogeneity index assessed by texture analysis of the radiographs, with focus on the principal tensile and compressive trabecular systems. The ability of these FE models to predict failure load as determined by experimental biomechanical testing was evaluated and compared to the predictive ability of DXA. The average reconstruction error of the 3D models was 1.77 mm (±1.17 mm), with the error being smallest in the femoral head and neck, and greatest in the trochanter. The correlation of the FE predicted failure load with the experimental failure load was r²=64% for the reconstruction FE model, which was significantly better (p<0.05) than that for DXA (r²=24%). This novel method for automatically constructing a patient-specific 3D finite element model from standard 2D radiographs shows encouraging results in estimating patient-specific failure loads.     

Stress analysis of irradiated human tooth enamel using finite element methods

The objectives of this project were to use finite element methods to determine how changes in the elastic modulus due to oral cancer therapeutic radiation alter the distribution of mechanical stresses in teeth and to determine if observed failures in irradiated teeth correlate with changes in mechanical stresses. A thin slice section finite element (FE) model was constructed from micro CT sections of a molar tooth using MIMICS and 3-Matic software. This model divides the tooth into three enamel regions, the dentin-enamel junction (DEJ) and dentin. The enamel elastic modulus was determined in each region using nano indentation for three experimental groups namely – control (non-radiated), in vitro irradiated (simulated radiotherapy following tooth extraction) and in vivo irradiated (extracted subsequent to oral cancer patient radiotherapy) teeth. Physiological loads were applied to the tooth models at the buccal and lingual cusp regions for all three groups (control, in vitro and in vivo). The principal tensile stress and the maximum shear stress were used to compare the results from different groups since it has been observed in previous studies that delamination of enamel from the underlying dentin was one of the major reasons for the failure of teeth following therapeutic radiation. From the FE data, we observed an increase in the principal tensile stress within the inner enamel region of in vivo irradiated teeth (9.97 ± 1.32 MPa) as compared to control/non-irradiated teeth (8.44 ± 1.57 MPa). Our model predicts that failure occurs at the inner enamel/DEJ interface due to extremely high tensile and maximum shear stresses in in vivo irradiated teeth which could be a cause of enamel delamination due to radiotherapy.     

Mechanics of the right whale mandible: Full scale testing and finite element analysis

In an effort to better understand the mechanics of ship-whale collision and to reduce the associated mortality of the critically endangered North Atlantic right whale, a comprehensive biomechanical study has been conducted by the Woods Hole Oceanographic Institution and the University of New Hampshire. The goal of the study is to develop a numerical modeling tool to predict the forces and stresses during impact and thereby the resulting mortality risk to whales from ship strikes.Based on post-mortem examinations, jaw fracture was chosen as a fatal endpoint for the whales hit by a vessel. In this paper we investigate the overall mechanical behavior of a right whale mandible under transverse loading and develop a finite element analysis model of the bone. The equivalent elastic modulus of the cortical component of right whale mandible is found by comparing full-scale bending tests with the results of numerical modeling. The finite element model of the mandible can be used in conjunction with a vessel-whale collision event model to predict bone fracture for various ship strike scenarios.     

High-resolution finite element models with tissue strength asymmetry accurately predict failure of trabecular bone

The ability to predict trabecular failure using microstructure-based computational models would greatly facilitate study of trabecular structure–function relations, multiaxial strength, and tissue remodeling. We hypothesized that high-resolution finite element models of trabecular bone that include cortical-like strength asymmetry at the tissue level, could predict apparent level failure of trabecular bone for multiple loading modes. A bilinear constitutive model with asymmetric tissue yield strains in tension and compression was applied to simulate failure in high-resolution finite element models of seven bovine tibial specimens. Tissue modulus was reduced by 95% when tissue principal strains exceeded the tissue yield strains. Linear models were first calibrated for effective tissue modulus against specimen-specific experimental measures of apparent modulus, producing effective tissue moduli of (mean±S.D.) 18.7±3.4 GPa. Next, a parameter study was performed on a single specimen to estimate the tissue level tensile and compressive yield strains. These values, 0.60% strain in tension and 1.01% strain in compression, were then used in non-linear analyses of all seven specimens to predict failure for apparent tensile, compressive, and shear loading. When compared to apparent yield properties previously measured for the same type of bone, the model predictions of both the stresses and strains at failure were not statistically different for any loading case (p>0.15). Use of symmetric tissue strengths could not match the experimental data. These findings establish that, once effective tissue modulus is calibrated and uniform but asymmetric tissue failure strains are used, the resulting models can capture the apparent strength behavior to an outstanding level of accuracy. As such, these computational models have reached a level of fidelity that qualifies them as surrogates for destructive mechanical testing of real specimens.     

Long-term study of bone remodelling after femoral stem: a comparison between dexa and finite element simulation

A hip replacement with a cemented or cementless femoral stem produces an effect on the bone called adaptive remodelling, attributable to mechanical and biological factors. The objective of all of cementless prostheses designs has been to achieve a perfect transfer of loads in order to avoid stress-shielding, which produces an osteopenia. In order to quantify this, the long term and mass-produced study with dual energy X-ray absorptiometry (DEXA) is necessary. Finite element (FE) simulation makes possible the explanation of the biomechanical changes which are produced in the femur after stem implantation. The good correlation obtained between the results of the FE simulation and the densitometric study allow, on one hand, to explain from the point of view of biomechanical performance the changes observed in bone density in the long-term, where it is clear that these are due to a different transfer of load in the implanted model compared to the healthy femur; on the other hand, it validates the simulation model, in a way that it can be used in different conditions and at different time periods, to carry out a sufficiently precise prediction of the evolution of the bone density from the biomechanical behaviour in the interaction between the prosthesis and femur.     

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.     

A finite element model of an anthropomorphic test device lower limb to assess risk of injuries during vertical accelerative loading

Improvised explosive devices (IEDs) were used extensively to target occupants of military vehicles during the conflicts in Iraq and Afghanistan (2003–2011). War fighters exposed to an IED attack were highly susceptible to lower limb injuries. To appropriately assess vehicle safety and make informed improvements to vehicle design, a novel Anthropomorphic Test Device (ATD), called the Warrior Injury Assessment Manikin (WIAMan), was designed for vertical loading. The main objective of this study was to develop and validate a Finite Element (FE) model of the WIAMan lower limb (WIAMan-LL). Appropriate materials and contacts were applied to realistically model the physical dummy. Validation of the model was conducted based on experiments performed on two different test rigs designed to simulate the vertical loading experienced during an under-vehicle explosion. Additionally, a preliminary evaluation of the WIAMan and Hybrid-III test devices was performed by comparing force responses to post-mortem human surrogate (PMHS) corridors. The knee axial force recorded by the WIAMan-LL when struck on the plantar surface of the foot (2 m/s) fell mostly within the PMHS corridor, but the corresponding data predicted by the Hybrid-III was almost 60% higher. Overall, good agreements were observed between the WIAMan-LL FE predictions and experiments at various pre-impact speeds ranging from 2 m/s up to 5.8 m/s. Results of the FE model were backed by mean objective rating scores of 0.67–0.76 which support its accuracy relative to the physical lower limb dummy. The observations and objective rating scores show the model is validated within the experimental loading conditions. These results indicate the model can be used in numerical studies related to possible dummy design improvements once additional PMHS data is available. The numerical lower limb is currently incorporated into a whole body model that will be used to evaluate the vehicle design for underbody blast protection.     

On the importance of 3D,geometrically accurate,and subject-specific finite element analysis for evaluation of in-vivo soft tissue loads

Pressure ulcers are a type of local soft tissue injury due to sustained mechanical loading and remain a common issue in patient care. People with spinal cord injury (SCI) are especially at risk of pressure ulcers due to impaired mobility and sensory perception. The development of load improving support structures relies on realistic tissue load evaluation e.g. using finite element analysis (FEA). FEA requires realistic subject-specific mechanical properties and geometries. This study focuses on the effect of geometry. MRI is used for the creation of geometrically accurate models of the human buttock for three able-bodied volunteers and three volunteers with SCI. The effect of geometry on observed internal tissue deformations for each subject is studied by comparing FEA findings for equivalent loading conditions. The large variations found between subjects confirms the importance of subject-specific FEA.     

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 the effect of design parameters and their interactions on the strength of dental restorations with endodontic posts,using finite element models and statistical analysis

Many previous studies, both in vitro and with model simulations, have been conducted in an attempt to reach a full understanding of how the different design parameters of an endodontically restored tooth affect its mechanical strength. However, differences in the experimental set-up or modelling conditions and the limited number of parameters studied in each case prevent us from obtaining clear conclusions about the real significance of each parameter. In this work, a new approach is proposed for this purpose based on the combination of a validated three-dimensional parametric biomechanical model of the restored tooth and statistical analysis using full factorial analysis of variance. A two-step approach with two virtual tests (with, respectively, 128 and 81 finite element models) was used in the present work to study the effect of several design parameters on the strength of a restored incisor, using full factorial designs. Within the limitations of this study, and for cases where the parameters are within the ranges that were tested, the conclusions indicate that the material of the post is the most significant factor as far as its strength is concerned, the use of a low Young's modulus being preferable for this component. Once the post material has been chosen, the geometry of the post is of less importance than the Young's modulus selected for the core or, especially, for the crown.