An improved method for measuring tibiofemoral contact areas in total knee arthroplasty: a comparison of K-scan sensor and Fuji film.

A computerised, real time, thin-film pressure transducer method is used to measure tibiofemoral contact area in total knee arthroplasty (TKA) devices that is easier and more reliable and reproducible as compared to the Fuji pressure-sensitive film technique. Many authors have suggested that contact areas and pressures within TKA devices can be a predictor of wear and failure of the ultra-high molecular weight polyethylene (UHMWPE) tibial insert. In this study, two contact area measurement techniques (Fuji pressure-sensitive Film and K-scan sensor system) were compared using a custom TKA testing jig designed for freedom of movement so that in any loading configuration the component found and seated in its own "home" position. The K-scan system was used to measure contact areas of one TKA design at several angles from 0 to 110 degrees flexion with loads equating to 4, 4.5, and 5 times body weight. For comparison, four ranges of Fuji film were used to measure areas at the same flexion angles but at 5 times body weight only. Contact areas measured with the Fuji films were 11-36% (p < 0.05) lower than those measured by the K-scan sensor.     

Regulation of the patellofemoral contact area: An essential mechanism in patellofemoral joint mechanics?

Although the relationship between contact area and pressure under physiological loading has been described in the feline patellofemoral joint, this interaction has only been examined under simplified loading conditions and/or considerably lower forces than those occurring during demanding activities in humans. We hypothesized that patellofemoral contact area increases non-linearly under an increasing joint reaction force to regulate patellofemoral pressure. Eight human cadaveric knees were ramp loaded with muscle forces representative of the stance phase of stair climbing at 30° knee flexion. Continuous pressure data were acquired with a pressure sensitive film that was positioned within the patellofemoral joint. While pressure was linearly dependent upon the resulting joint reaction force, contact area asymptotically approached a maximum value and reached 95% of this maximum at patellofemoral forces of 349–723 N (95% CI). Our findings indicate that the regulatory influence of increasing contact area to protect against high patellofemoral pressure is exhausted at relatively low loads.     

Peak dynamic force in human gait

Studies were made of the forces generated at heel stroke in human gait using both force plates having a high resonant frequencies (capable of picking up high frequency components in the contact force) as well as a force transducer inserted into the heel of the shoe of the subjects. The output traces were analyzed for the existence of high frequency impulsive loads during a normal walking cycle. The effect of the complicance of the foot and floor was studied with the force transducers. The results showed that during normal human gait the lower limb is subjected to a high frequency impulsive load at heel strike. The severity of this impulse varied with the individual, the velocity and angle with which the limb aproached the ground and the compliance of the two materials coming in contact at heel strike. The magnitude of this peak force varied from 0.5 to 1.25 times body weight and its frequency components from 10 to 75 Hz.     

Predicting lower body power from vertical jump prediction equations for loaded jump squats at different intensities in men and women

The purpose of this study was to determine the efficacy of estimating peak lower body power from a maximal jump squat using 3 different vertical jump prediction equations. Sixty physically active college students (30 men, 30 women) performed jump squats with a weighted bar's applied load of 20, 40, and 60% of body mass across the shoulders. Each jump squat was simultaneously monitored using a force plate and a contact mat. Peak power (PP) was calculated using vertical ground reaction force from the force plate data. Commonly used equations requiring body mass and vertical jump height to estimate PP were applied such that the system mass (mass of body + applied load) was substituted for body mass. Jump height was determined from flight time as measured with a contact mat during a maximal jump squat. Estimations of PP (PP(est)) for each load and for each prediction equation were compared with criterion PP values from a force plate (PP(FP)). The PP(est) values had high test-retest reliability and were strongly correlated to PP(FP) in both men and women at all relative loads. However, only the Harman equation accurately predicted PP(FP) at all relative loads. It can therefore be concluded that the Harman equation may be used to estimate PP of a loaded jump squat knowing the system mass and peak jump height when more precise (and expensive) measurement equipment is unavailable. Further, high reliability and correlation with criterion values suggest that serial assessment of power production across training periods could be used for relative assessment of change by either of the prediction equations used in this study.     

Fiberoptic measurement of tendon forces is influenced by skin movement artifact

Fiberoptic cables have previously been used for tendon force measurements in vivo. To measure forces in the Achilles tendon, a cable is passed mediolaterally through the skin and tendon, transverse to the loading axis. As the tendon is loaded, its fibers compress the cable and modulate the intensity of transmitted light, which can be related to tendon force by an in situ calibration. The relative movement between skin and tendon at the cable entry and exit sites may cause error by bending the cable and thus altering transducer output. Cadaver simulations of walking were conducted to compare fiberoptic measurements of Achilles tendon forces to known loads applied to the tendon by actuators attached in series. Force measurement errors, which were high when the skin was intact (RMS errors 24-81% peak forces), decreased considerably after skin removal (RMS errors 10-33% peak forces). The fiberoptic transducer is a useful tool for measurement of tendon forces in situ under natural loading conditions when skin can be removed, but caution should be exercised during in vivo use of this technique or under circumstances where skin is in contact with the fiberoptic cable at the insertion and exit sites.     

Accuracy and repeatability of a new method for measuring facet loads in the lumbar spine

We assessed the repeatability and accuracy of a relatively new, resistance-based sensor (Tekscan 6900) for measuring lumbar spine facet loads, pressures, and contact areas in cadaver specimens. Repeatability of measurements in the natural facet joint was determined for five trials of four specimens loaded in pure moment (+/- 7.5 N m) flexibility tests in axial rotation and flexion-extension. Accuracy of load measurements in four joints was assessed by applying known compressive loads of 25, 50, and 100 N to the natural facet joint in a materials testing machine and comparing the known applied load to the measured load. Measurements of load were obtained using two different calibration approaches: linear and two-point calibrations. Repeatability for force, pressure, and area (average of standard deviation as a percentage of the mean for all trials over all specimens) was 4-6% for axial rotation and 7-10% for extension. Peak resultant force in axial rotation was 30% smaller when calculated using the linear calibration method. The Tekscan sensor overestimated the applied force by 18 +/- 9% (mean+/-standard deviation), 35 +/- 7% and 50 +/- 9% for compressive loads of 100, 50, and 25 N, respectively. The two-point method overestimated the loads by 35 +/- 16%, 45 +/- 7%, and 56 +/- 10% for the same three loads. Our results show that the Tekscan sensor is repeatable. However, the sensor measurement range is not optimal for the small loads transmitted by the facets and measurement accuracy is highly dependent on calibration protocol.     

The use of surface strain data and a neural networks solution method to determine lumbar facet joint loads during in vitro spine testing

A new method for determining facet loads during in vitro spine loading using strain gauges and a neural networks solution method was investigated. A test showed that the new solution method was more robust than and as accurate as a previously presented graphical solution method for computing facet loads using surface strain. The technique was subsequently utilized to assess facet loads at L1-L2 during flexibility testing [7.5Nm pure moments in flexion (FL), extension (EX), right and left axial rotation (AR), and right and left lateral bending (LB)], and stiffness testing (FL-EX with 400N compressive follower load) of six human lumbar spine segments (T12-L2). In contrast to other techniques, such as thin film sensors or pressure-sensitive film, the strain-gauge method leaves the facet joint capsule intact during data collection, presumably allowing more natural load transmission. During flexibility tests, the mean (+/-standard deviation) calculated facet loads (in N) were 46.1+/-41.3 (FL), 51.5+/-39.0 (EX), 70.3+/-43.2 (AR-contralateral side), 31.3+/-33.4 (AR-ipsilateral side), 30.6+/-29.1 (LB-contralateral side), and 32.0+/-44.4 (LB-ipsilateral side). During stiffness tests, the calculated facet loads were 45.5+/-40.4 (upright), 46.6+/-41.9 (full FL), and 75.4+/-39.0 (full EX), corresponding to an equivalent of 11.4%, 11.6%, and 18.8% of the compressive follower load (upright, full FL and EX, respectively). The error associated with this technique, which was below 11N for loads up to 125N, is comparable to that reported with other techniques. The new method shows promise for assessing facet load during in vitro spine testing, an important parameter when evaluating new implant systems and surgical techniques.     

Factors influencing the output of an implantable force transducer

The objective of this study was to evaluate the performance of the Arthroscopically Implantable Force Probe (AIFP; MicroStrain, Burlington VT) for measuring force in a patellar tendon graft. Transducer drift, reproducibility of output due to the number of loading cycles and device location, and sensitivity to the tendon cross-sectional area were investigated. The AIFP was initialized, and then implanted into five human patellar tendon grafts three times; twice within the same location and once in a different location. The tendons were cyclically loaded in uniaxial tension for 500 cycles in each insertion site. The AIFP was then removed from the tendon and the baseline output was remeasured. It was determined that transducer drift was negligible. The relationship between the tensile load applied to the graft and AIFP output was quadratic and specimen dependent. The cyclic load response of the tendon-AIFP interface demonstrated a 24.9% decrease over the first 20 loading cycles, and subsequent cycling yielded relatively reproducible output. The output of the transducer varied when it was removed from the tendon and then reimplanted in the same location (range 3.7-109. 4% error), as well as in the second location (range 1.5-202.8% error). No correlation was observed between the cross-sectional area of the tendon and transducer output. This study concludes that implantable force probes should be used with caution and calibrated without removing the transducer from the graft.     

Sensitivity of medial and lateral knee contact force predictions to frontal plane alignment and contact locations

Musculoskeletal models are increasingly used to estimate medial and lateral knee contact forces, which are difficult to measure in vivo. The sensitivity of contact force predictions to modeling parameters is important to the interpretation and implication of results generated by the model. The purpose of this study was to quantify the sensitivity of knee contact force predictions to simultaneous errors in frontal plane knee alignment and contact locations under different dynamic conditions. We scaled a generic musculoskeletal model for N = 23 subjects’ stature and radiographic knee alignment, then perturbed frontal plane alignment and mediolateral contact locations within experimentally-possible ranges of 10° to −10° and 10 to −10 mm, respectively. The sensitivity of first peak, second peak, and mean medial and lateral knee contact forces to knee adduction angle and contact locations was modeled using linear regression. Medial loads increased, and lateral loads decreased, by between 3% and 6% bodyweight for each degree of varus perturbation. Shifting the medial contact point medially increased medial loads and decreased lateral loads by between 1% and 4% bodyweight per millimeter. This study demonstrates that realistic measurement errors of 5 mm (contact distance) or 5° (frontal plane alignment) could result in a combined 50% BW error in subject specific contact force estimates. We also show that model sensitivity varies between subjects as a result of differences in gait dynamics. These results demonstrate that predicted knee joint contact forces should be considered as a range of possible values determined by model uncertainty.     

Inertia Coupling Analysis of a Self-Decoupled Wheel Force Transducer under Multi-Axis Acceleration Fields

Wheel force transducer (WFT), which measures the three-axis forces and three-axis torques applied to the wheel, is an important instrument in the vehicle testing field and has been extremely promoted by researchers with great interests. The transducer, however, is typically mounted on the wheel of a moving vehicle, especially on a high speed car, when abruptly accelerating or braking, the mass/inertia of the transducer/wheel itself will have an extra effect on the sensor response so that the inertia/mass loads will also be detected and coupled into the signal outputs. The effect which is considered to be inertia coupling problem will decrease the sensor accuracy. In this paper, the inertia coupling of a universal WFT under multi-axis accelerations is investigated. According to the self-decoupling approach of the WFT, inertia load distribution is solved based on the principle of equivalent mass and rotary inertia, thus then inertia impact can be identified with the theoretical derivation. The verification is achieved by FEM simulation and experimental tests. Results show that strains in simulation agree well with the theoretical derivation. The relationship between the applied acceleration and inertia load for both wheel force and moment is the approximate linear, respectively. All the relative errors are less than 5% which are within acceptable and the inertia loads have the maximum impact on the signal output about 1.5% in the measurement range.     

Loaded shortening and power output in cardiac myocytes are dependent on myosin heavy chain isoform expression

The purpose of this study was to examine the role of myosin heavy chain (MHC) in determining loaded shortening velocities and power output in cardiac myocytes. Cardiac myocytes were obtained from euthyroid rats that expressed alpha-MHC or from thyroidectomized rats that expressed beta-MHC. Skinned myocytes were attached to a force transducer and a position motor, and isotonic shortening velocities were measured at several loads during steady-state maximal Ca(2+) activation (P(pCa4.5)). MHC expression was determined after mechanical measurements using SDS-PAGE. Both alpha-MHC and beta-MHC myocytes generated similar maximal Ca(2+)-activated force, but alpha-MHC myocytes shortened faster at all loads and generated approximately 170% greater peak normalized power output. Additionally, the curvature of force-velocity relationships was less, and therefore the relative load optimal for power output (F(opt)) was greater in alpha-MHC myocytes. F(opt) was 0.31 +/- 0.03 P(pCa4.5) and 0.20 +/- 0.06 P(pCa4.5) for alpha-MHC and beta-MHC myocytes, respectively. These results indicate that MHC expression is a primary determinant of the shape of force-velocity relationships, velocity of loaded shortening, and overall power output-generating capacity of individual cardiac myocytes.     

Regulation of catch bonds by rate of force application

The current paradigm for receptor-ligand dissociation kinetics assumes off-rates as functions of instantaneous force without impact from its prior history. This a priori assumption is the foundation for predicting dissociation from a given initial state using kinetic equations. Here we have invalidated this assumption by demonstrating the impact of force history with single-bond kinetic experiments involving selectins and their ligands that mediate leukocyte tethering and rolling on vascular surfaces during inflammation. Dissociation of bonds between L-selectin and P-selectin glycoprotein ligand-1 (PSGL-1) loaded at a constant ramp rate to a constant hold force behaved as catch-slip bonds at low ramp rates that transformed to slip-only bonds at high ramp rates. Strikingly, bonds between L-selectin and 6-sulfo-sialyl Lewis X were impervious to ramp rate changes. This ligand-specific force history effect resembled the effect of a point mutation at the L-selectin surface (L-selectinA108H) predicted to contact the former but not the latter ligand, suggesting that the high ramp rate induced similar structural changes as the mutation. Although the A108H substitution in L-selectin eliminated the ramp rate responsiveness of its dissociation from PSGL-1, the inverse mutation H108A in P-selectin acquired the ramp rate responsiveness. Our data are well explained by the sliding-rebinding model for catch-slip bonds extended to incorporate the additional force history dependence, with Ala-108 playing a pivotal role in this structural mechanism. These results call for a paradigm shift in modeling the mechanical regulation of receptor-ligand bond dissociation, which includes conformational coupling between binding pocket and remote regions of the interacting molecules.     

Ultimate strength of the lumbar spine in flexion--an in vitro study

The ultimate strength in flexion of 16 lumbar functional spinal units (FSU) was determined. The specimens were exposed to a combined static load of bending and shearing in the sagittal plane until overt rupture occurred (simulated flexion-distraction injuries). The biomechanical response of the FSU was measured with a force and moment platform. Mechanical displacement gauges were used to measure vertical displacements (flexion angulation) of the specimens. Photographs were taken after each loading step for determination of horizontal displacements and the centre of rotation. The lumbar FSU could resist a combination of bending moment and shear force of 156 Nm and 620 N respectively, before complete disruption occurred. The tension force acting on the posterior structures was 2.8 kN. The flexion angulation just before failure was 20 degrees and the anterior horizontal displacement between the upper and lower vertebrae was 9 mm. The centre of rotation was located in the posterior part of the lower vertebral body. The bone mineral content in the vertebrae appeared to be a good predictor of ultimate strength of the lumbar FSU. Knowledge of the biomechanical response of the lumbar spine under different static traumatic loads is a first step to better understand the injury mechanisms of the spine in traffic accidents.     

Device for measuring soft tissue interface pressures

This paper describes the construction and performance of a simple pressure sensing device with a continuous electrical output. It was constructed utilizing a commercially available transducer, an electropneumatic sensor capsule and a 1 m long tube. The transducer used was a piezo-resistive pressure-sensitive device producing an output voltage proportional to the applied pressure. This low cost, high accuracy device is temperature compensated and shows good linearity and negligible hysteresis. The sensor cell has a good thickness-to-diameter ratio and is sufficiently flexible to conform to most contours of the body. The tubing that conveys the pressure transmitting fluid also serves as a means of keeping the transducer distant from the measuring site. The device showed a highly satisfactory performance under laboratory conditions and has proven to be robust and reliable when used for clinical studies.     

A miniature piezoelectric polymer transducer for in vitro measurement of the dynamic contact stress distribution.

Previous studies of contact pressure measurement between articular surfaces have been mostly limited to static techniques. The purpose of our study was to develop a new dynamic technique for a direct measurement of the local contact stresses, and to apply the new method to an in vitro cadaver study of the patellofemoral joint pressures. The miniature transducer consists of a 2 mm diameter and 28 microns thick piece of piezoelectric polymer film sandwiched between two stainless steel electrodes of similar diameter. A water-resistant capsule consisting of Teflon film and Hysol epoxy was applied around the transducer. The transducer was 3 mm in diameter and 0.7 mm in thickness. A 3 mm well was made at six locations in the patella, corresponding to superior, middle, and inferior regions of both facets. Six transducers were cemented within each well, flush with the articular cartilage. The transducers were calibrated in situ before and after the experiment. The femur was rigidly fixed to the loading apparatus and the tibia was allowed to flex and extend through a 90 degrees range of motion using an Instron and a pulley system connected to the quadriceps tendon. Q angles of 0, 5, 10 and 15 degrees were established by adjusting the direction of the quadriceps tendon. Stresses ranging from 0.1-1.3 MPa were recorded at various locations. These values varied in flexion and extension. An overall decrease in these stresses was noted after tuberosity elevation up to 1.5 cm, following which increased values up to 1.8 MPa were recorded mostly in the superior section.(ABSTRACT TRUNCATED AT 250 WORDS)     

A method for measuring contact pressures instantaneously in articular joints

A method whereby instrumented pipes are inserted part of the way into articular cartilage from the underlying subchondral bone has been developed for measuring instantaneous contact pressures acting within articular joints. Contact pressures developed between two specimens cut from fresh cadaveric knee joints were measured with this technique and then subsequently with pressure-sensitive paper. Average contact pressures (load/contact area) were also calculated. Comparisons of the three sets of data show that contact pressures measured with the pressure pipe system are linearly related (p less than 0.001) to both the contact pressures measured with the pressure-sensitive paper and the calculated average contact pressures.     

Incisal bite force direction in humans and the functional significance of mammalian mandibular translation

Incisal bite force direction was recorded and analyzed in ten human subjects using a specially designed force transducer. In all ten subjects the maxillary incisal bite force was vertically and anteriorly directed both during static biting and during biting associated with simultaneous mandibular translation and rotation. Since the resultant muscle force could not have been equal and opposite to the mandibular bite force, the mandibular condyles must have been loaded. These data demonstrate that the mandible acts as a lever during incisal biting and that there is no consistent relationship between incisal bite force direction and object size. In some individuals the bite force direction was more vertical during biting on a large transducer (30 mm high), while in other subjects it was more vertical during biting on a small transducer (10 mm high).     

Experimental verification of facet load transmission by direct measurement of facet lamina contact pressure

This paper presents results of a new measuring technique by means of which facet tip contact pressure data were obtained. The aim of the paper is to demonstrate by direct measurement the existence of a load transmission mechanism through the facet joint. Six lumbar spine motion segments were used in 21 tests. Simulated extensor muscle action was provided to overcome moments due to eccentric loads which represented body weight and an external hand-held load acting 340 mm anterior to the center of the disc. Facet pressure was measured in all cases when muscle load was applied to counteract body weight. This pressure increased when more muscle force was applied to balance the externally applied flexion moment. When the anterior load was released suddenly, there was a large increase in facet pressure with a concomitant decrease in disc pressure.     

Root elongation against a constant force: experiment with a computerized feedback-controlled device

Axial force was applied to the root tip of corn (Zea mays L. cv. Merit) seedlings using a computerized, feedback-controlled mechanical device. The system's feedback capability allowed continuous control of a constant tip load, and the attached displacement transducer provided the time course of root elongation. Loads up to 7.5 g decreased the root elongation rate by 0.13 mm h-1 g-1, but loads 7.5 to 17.5 g decreased the growth rate by only 0.04 mm h-1 g-1. Loads higher than 18 g stopped root elongation completely. Measurement of the cross-sectional areas of the root tips indicated that the 18 g load had applied about 0.98 MPa of axial pressure to the root, thereby exceeding the root's ability to respond with increased turgor pressure. Recorded time-lapse images of loaded roots showed that radial thickening (swelling) occurred behind the root cap, whose cross-sectional area increased with tip load.