Effects of Aging on Patellofemoral Joint Stress during Stair Negotiation on Challenging Surfaces.

This study examined the effect of age and surface on patellofemoral joint (PFJ) stress magnitude and waveform during stair ascent and descent tasks. A total of 12 young and 12 older adults had knee biomechanics quantified while they ascended and descended stairs on normal, slick, and uneven surfaces. The peak of stance (0-100%) PFJ stress and associated components were submitted to a two-way repeated measures ANOVA, while the PFJ stress waveform was submitted to statistical parametric mapping two-way ANOVA.

Computational Lower Limb Simulator Boundary Conditions to Reproduce Measured TKA Loading in a Cohort of Telemetric Implant Patients.

Recent advancements in computational modeling offer opportunities to refine total knee arthroplasty (TKA) design and treatment strategies. This study developed patient-specific simulator external boundary conditions (EBCs) using a PID-controlled lower limb finite element (FE) model. Calibration of the external actuation required to achieve measured patient-specific joint loading and motion was completed for nine patients with telemetric implants during gait, stair descent, and deep knee bend.

Effect of age on ankle biomechanics and tibial compression during stair descent.

Background: Stress fracture is a concern among older adults, as age-related decrements in ankle neuromuscular function may impair their ability to attenuate tibial compressive forces experienced during daily locomotor tasks, such as stair descent. Yet, it is unknown if older adults exhibit greater tibial compression than their younger counterparts when descending stairs.

Research Question: Do older adults exhibit differences in ankle biomechanics that alter their tibial compression during stair descent compared to young adults, and is there a relation between tibial compression and specific changes in ankle biomechanics?

Methods: Thirteen young (18-25 years) and 13 older (> 65 years) adults had ankle joint biomechanics and tibial compression quantified during a stair descent.

Porcine computational modeling to investigate developmental dysplasia of the hip.

While it is well-established that early detection and initiation of treatment of developmental dysplasia of the hip (DDH) is crucial to successful clinical outcomes, research on the mechanics of the hip joint during healthy and pathological hip development in infants is limited. Quantification of mechanical behavior in both the healthy and dysplastic developing joints may provide insight into the causes of DDH and facilitate innovation in treatment options. In this study, subject-specific three-dimensional finite element models of two pigs were developed: one healthy pig and one pig with induced dysplasia in the right hindlimb.

Instantaneous Generation of Subject-Specific Finite Element Models of the Hip Capsule.

Subject-specific hip capsule models could offer insights into impingement and dislocation risk when coupled with computer-aided surgery, but model calibration is time-consuming using traditional techniques. This study developed a framework for instantaneously generating subject-specific finite element (FE) capsule representations from regression models trained with a probabilistic approach. A validated FE model of the implanted hip capsule was evaluated probabilistically to generate a training dataset relating capsule geometry and material properties to hip laxity.

Neural-driven activation of 3D muscle within a finite element framework: exploring applications in healthy and neurodegenerative simulations.

This paper presents a novel computational framework for neural-driven finite element muscle models, with an application to amyotrophic lateral sclerosis (ALS). The multiscale neuromusculoskeletal (NMS) model incorporates physiologically accurate motor neurons, 3D muscle geometry, and muscle fiber recruitment. It successfully predicts healthy muscle force and tendon elongation and demonstrates a progressive decline in muscle force due to ALS, dropping from 203 N (healthy) to 155 N (120 days after ALS onset).

Increased deformations are dispensable for cell mechanoresponse in engineered bone analogs mimicking aging bone marrow.

Aged individuals and astronauts experience bone loss despite rigorous physical activity. Bone mechanoresponse is in-part regulated by mesenchymal stem cells (MSCs) that respond to mechanical stimuli. Direct delivery of low intensity vibration (LIV) recovers MSC proliferation in senescence and simulated microgravity models, indicating that age-related reductions in mechanical signal delivery within bone marrow may contribute to declining bone mechanoresponse.

Surface, but Not Age, Impacts Lower Limb Joint Work during Walking and Stair Ascent.

Older adults often suffer an accidental fall when navigating challenging surfaces during common locomotor tasks, such as walking and ascending stairs. This study examined the effect of slick and uneven surfaces on lower limb joint work in older and younger adults while walking and ascending stairs. Fifteen young (18-25 years) and 12 older (>65 years) adults had stance phase positive limb and joint work quantified during walking and stair ascent tasks on a normal, slick, and uneven surface, which was then submitted to a two-way mixed model ANOVA for analysis.

Pedicle Screw Placement Accuracy in Robot-Assisted Spinal Fusion in a Multicenter Study.

Pedicle screw fixation is a spinal fusion technique that involves the implantation of screws into vertebral pedicles to restrict movement between those vertebrae. The objective of this research is to measure pedicle screw placement accuracy using a novel automated measurement system that directly compares the implanted screw location to the planned target in all three anatomical views. Preoperative CT scans were used to plan the screw trajectories in 122 patients across four surgical centers.

Computational comparison of medializing tibial tubercle osteotomy and trochleoplasty in patients with trochlear dysplasia.

Medial patellofemoral ligament reconstruction (MPFLR) has emerged as the procedure of choice for recurrent patellar dislocation. This addresses soft tissue injury but does not address underlying anatomic factors, including trochlear dysplasia, that are commonly present and increase risk of dislocation. Quantification of the stability offered by other surgical interventions, namely, medializing tibial tubercle osteotomy (mTTO) and trochleoplasty, with and without MPFLR, may provide insight for surgical choices in patients with trochlear dysplasia.

Robust automatic hexahedral cartilage meshing framework enables population-based computational studies of the knee.

Osteoarthritis of the knee is increasingly prevalent as our population ages, representing an increasing financial burden, and severely impacting quality of life. The invasiveness of procedures and the high cost of cadaveric studies has left computational tools uniquely suited to study knee biomechanics. Developments in deep learning have great potential for efficiently generating large-scale datasets to enable researchers to perform investigations, but the time and effort associated with producing robust hexahedral meshes has been a limiting factor in expanding finite element studies to encompass a population.

Musculoskeletal adaptation of young and older adults in response to challenging surface conditions.

Over 36 million adults over 65 years of age experience accidental falls each year. The underlying neuromechanics (whole-body function) and driving forces behind accidental falls, as well as the effects of aging on the ability of the musculoskeletal system to adapt, are poorly understood. We evaluated differences in kinematics (lower extremity joint angles and range of motion), kinetics (ground reaction force), and electromyography (muscle co-contraction), due to changes in surface conditions during gait in 14 older adults with a history of falling and 14 young adults.

Integration of neural architecture within a finite element framework for improved neuromusculoskeletal modeling.

Neuromusculoskeletal (NMS) models can aid in studying the impacts of the nervous and musculoskeletal systems on one another. These computational models facilitate studies investigating mechanisms and treatment of musculoskeletal and neurodegenerative conditions. In this study, we present a predictive NMS model that uses an embedded neural architecture within a finite element (FE) framework to simulate muscle activation.

Modeling stem cell nucleus mechanics using confocal microscopy.

Nuclear mechanics is emerging as a key component of stem cell function and differentiation. While changes in nuclear structure can be visually imaged with confocal microscopy, mechanical characterization of the nucleus and its sub-cellular components require specialized testing equipment. A computational model permitting cell-specific mechanical information directly from confocal and atomic force microscopy of cell nuclei would be of great value.

Applying ASTM Standards to Tensile Tests of Musculoskeletal Soft Tissue: Methods to Reduce Grip Failures and Promote Reproducibility.

Tensile testing is an essential experiment to assess the mechanical integrity of musculoskeletal soft tissues, yet standard test methods have not been developed to ensure the quality and reproducibility of these experiments. The ASTM International standards organization has created tensile test standards for common industry materials that specify geometric dimensions of test specimens (coupons) that promote valid failures within the gage section (midsubstance), away from the grips. This study examined whether ASTM test standards for plastics, elastomers, and fiber-reinforced composites are suitable for tensile testing of bovine meniscus along the circumferential fiber direction.

Emerging Gene-Editing Modalities for Osteoarthritis.

Osteoarthritis (OA) is a pathological degenerative condition of the joints that is widely prevalent worldwide, resulting in significant pain, disability, and impaired quality of life. The diverse etiology and pathogenesis of OA can explain the paucity of viable preventive and disease-modifying strategies to counter it. Advances in genome-editing techniques may improve disease-modifying solutions by addressing inherited predisposing risk factors and the activity of inflammatory modulators.

Development and calibration of a probabilistic finite element hip capsule representation.

The objective of this study was to develop a probabilistic representation of the hip capsule, which is calibrated to experimental capsular torque-rotation behavior and captures the observed variability for use in population-based studies. A finite element model of the hip capsule was developed with structures composed of a fiber-reinforced membrane, represented by 2D quadrilateral elements embedded with tension-only non-linear spring. An average capsule representation was developed by calibrating ligament properties (linear stiffness, reference strain) so that torque-rotation behavior matched mean cadaveric data.

Center of Biomedical Research Excellence in Matrix Biology: Building Research Infrastructure, Supporting Young Researchers, and Fostering Collaboration.

The Center of Biomedical Research Excellence in Matrix Biology strives to improve our understanding of extracellular matrix at molecular, cellular, tissue, and organismal levels to generate new knowledge about pathophysiology, normal development, and regenerative medicine. The primary goals of the Center are to i) support junior investigators, ii) enhance the productivity of established scientists, iii) facilitate collaboration between both junior and established researchers, and iv) build biomedical research infrastructure that will support research relevant to cell-matrix interactions in disease progression, tissue repair and regeneration, and v) provide access to instrumentation and technical support. A Pilot Project program provides funding to investigators who propose applying their expertise to matrix biology questions.

Computational framework for population-based evaluation of TKR-implanted patellofemoral joint mechanics.

Differences in patient anatomy are known to influence joint mechanics. Accordingly, intersubject anatomical variation is an important consideration when assessing the design of joint replacement implants. The objective of this study was to develop a computational workflow to perform population-based evaluations of total knee replacement implant mechanics considering variation in patient anatomy and to assess the potential for an efficient sampling strategy to support design phase screening analyses.

Computational approach to correcting joint instability in patients with recurrent patellar dislocation.

Patellar dislocation is a debilitating injury common in active adolescents and young adults. Conservative treatment after initial dislocation is often recommended, but almost half of these patients continue to suffer from recurrent dislocation. The objective of this study was to compare preoperative patellofemoral joint stability with stability after a series of simulated procedures, including restorative surgery to correct to pre-injury state, generic tibial tubercle osteotomy, patient-specific reconstructive surgery to correct anatomic abnormality, less invasive patient-specific surgery, and equivalent healthy controls.

Development of a statistical shape-function model of the implanted knee for real-time prediction of joint mechanics.

Outcomes of total knee arthroplasty (TKA) are dependent on surgical technique, patient variability, and implant design. Non-optimal design or alignment choices may result in undesirable contact mechanics and joint kinematics, including poor joint alignment, instability, and reduced range of motion. Implant design and surgical alignment are modifiable factors with potential to improve patient outcomes, and there is a need for robust implant designs that can accommodate patient variability.

Electrode Placement Accuracy in Robot-Assisted Asleep Deep Brain Stimulation.

Deep brain stimulation (DBS) involves the implantation of electrodes into specific central brain structures for the treatment of Parkinson's disease. Image guidance and robot-assisted techniques have been developed to assist in the accuracy of electrode placement. Traditional DBS is performed with the patient awake and utilizes microelectrode recording for feedback, which yields lengthy operating room times.