Publications by authors named "Maeruan Kebbach"

Subject-specific finite element (FE) modeling of the mandible bone has recently gained attention for its higher accuracy. A critical modeling factor is including personalized material properties from medical images especially when bone quality has to be respected. However, there is no consensus on the material model for the mandible that realistically estimates the Young's modulus of the bone.

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The central nervous system momentarily activates a set of specific muscle synergies to maintain balance when external mechanical perturbations induce walking instability, which is critically involved in preventing falls. The activation patterns and composition of the muscle synergies recruited in the perturbed leg have not been fully characterized, and even less so for the recovery step. Here, we addressed this research gap by measuring the surface electromyographic data of the relevant muscles during a backward-pitched perturbed walk, and then extracting muscle synergy-related parameters using a non-negative matrix factorization algorithm.

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Background: Despite advances in total knee arthroplasty, many patients are still unsatisfied with the functional outcome. Multibody simulations enable a more efficient exploration of independent variables compared to experimental studies. However, to what extent numerical models can fully reproduce knee joint kinematics is still unclear.

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Multifunctional materials have been described to meet the diverse requirements of implant materials for femoral components of uncemented total knee replacements. These materials aim to combine the high wear and corrosion resistance of oxide ceramics at the joint surfaces with the osteogenic potential of titanium alloys at the bone-implant interface. Our objective was to evaluate the biomechanical performance of hybrid material-based femoral components regarding mechanical stress within the implant during cementless implantation and stress shielding (evaluated by strain energy density) of the periprosthetic bone during two-legged squat motion using finite element modeling.

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Proximal femur fracture risk depends on subject-specific factors such as bone mineral density and morphological parameters. Here, we aim to analyze the dependency of the femoral strength on sixteen morphological parameters. Therefore, finite-element analyses of 20 human femurs during stumbling and lateral falls on the hip were conducted.

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A three-dimensional (3D) understanding of muscle attachment footprints became increasingly relevant for musculoskeletal modeling. The established method to project attachments as points ignores patient-specific individuality. Research focuses on investigating certain muscle groups rather than comprehensively studying all muscles spanning a joint.

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Background: Computational research methods, such as finite element analysis (FEA) and musculoskeletal multi-body simulation (MBS), are important in musculoskeletal biomechanics because they enable a better understanding of the mechanics of the musculoskeletal system, as well as the development and evaluation of orthopaedic implants. These methods are used to analyze clinically relevant issues in various anatomical regions, such as the hip, knee, shoulder joints and spine. Preoperative simulation can improve surgical planning in orthopaedics and predict individual results.

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The AMTI VIVO™ six degree of freedom joint simulator allows reproducible preclinical testing of joint endoprostheses under specific kinematic and loading conditions. When testing total knee endoprosthesis, the articulating femoral and tibial components are each mounted on an actuator with two and four degrees of freedom, respectively. To approximate realistic physiological conditions with respect to soft tissues, the joint simulator features an integrated virtual ligament model that calculates the restoring forces of the ligament apparatus to be applied by the actuators.

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Article Synopsis
  • * It finds that the PCL's tension significantly influences tibiofemoral joint dynamics and increases maximum contact stress at higher flexion angles, particularly showing higher stresses with tighter PCL configurations.
  • * The research employs advanced musculoskeletal multibody and finite-element simulations to effectively analyze knee joint dynamics and stresses, indicating that PCL tension plays a crucial role in the performance of knee implants after surgery.
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In biomechanical research, advanced joint simulators such as VIVO offer the ability to test artificial joints under realistic kinematics and load conditions. Furthermore, it promises to simplify testing with advanced control approaches and the ability to include virtual ligaments. However, the overall functionality concerning specific test setup conditions, such as the joint lubrication or control algorithm, has not been investigated in-depth so far.

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  • Total hip joint replacement (THR) helps patients move better, and how much they can move (range of motion) is important for their happiness.
  • A study used 3D computer models to check the movement range of three different implant types for hip replacement: conventional hip stem, short hip stem, and hip resurfacing.
  • The results showed that hip resurfacing allowed less movement compared to the other two options, and it also caused a different type of bone impingement during movement.
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Background: Positioning of the implant components and tibial insert thickness constitute critical aspects of total knee replacement (TKR) that influence the postoperative knee joint dynamics. This study aimed to investigate the impact of implant component positioning (anterior-posterior and medio-lateral shift) and varying tibial insert thickness on the tibio-femoral (TF) and patello-femoral (PF) joint kinematics and contact forces after cruciate-retaining (CR)-TKR.

Method: A validated musculoskeletal multibody simulation (MMBS) model with a fixed-bearing CR-TKR during a squat motion up to 90° knee flexion was deployed to calculate PF and TF joint dynamics for varied implant component positions and tibial insert thicknesses.

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  • Researchers studied if older adults should walk with shoes or barefoot to better improve their balance on a treadmill.
  • They tested fourteen healthy older adults, looking at how their walking changed while wearing shoes and while barefoot.
  • The results showed that walking barefoot might be better for helping older people regain their balance after losing it.
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The role of patella height is discussed controversially in total knee arthroplasty (TKA). Therefore, this computational study aims to systematically analyze the biomechanical effect of different patella heights on patellofemoral (PF) forces and kinematics after cruciate-retaining (CR) TKA. We implemented a CR bicondylar TKA with a dome patellar button in a validated dynamic musculoskeletal multibody model of a male human knee joint.

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Article Synopsis
  • The study looked at how younger and older people walk differently when they slip or stumble and how their legs help them recover from these falls.
  • They tested 15 young and 15 older people, recording their movements and forces to see how their walking changes after slipping or stumbling.
  • Results showed that both age groups widened their steps after a slip or stumble, and older folks mainly needed more strength in their hips to recover, suggesting that slipping is tougher to recover from than stumbling.
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  • People with knee osteoarthritis (KOA) have a higher chance of falling because their knees and muscles aren't working properly.
  • A study tested how KOA patients reacted to losing their balance compared to healthy older adults using a special program that created backward slips.
  • The findings showed that KOA patients walked slower and not as steadily, meaning they need to do exercises that strengthen their knees and hips to help prevent falls.
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Background: Patellofemoral problems after total knee arthroplast (TKA) are frequent and often associated with a change in the geometry of the trochlear groove.

Objective: The present study aimed to analyze the feasibility of intraoperative examination of the patellofemoral joint geometry before and after the implantation of bicondylar total knee replacements without exposing the patient to radiation.

Material And Methods: The patellofemoral joint morphology geometries of 33 patients before and after implantation of a bicondylar total knee replacement was intraoperatively analyzed using a digital scanning method.

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Nowadays, several configurations of total knee arthroplasty (TKA) implants are commercially available whose designs resulted from clinical and biomechanical considerations. Previous research activities led to the development of the so-called medial-pivot (MP) design. However, the actual benefits of the MP, with respect to other prosthesis designs, are still not well understood.

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A correlation between patellar kinematics and anterior knee pain is widely accepted. However, there is no consensus on how they are connected or what profile of patellar kinematics would minimize anterior knee pain. Nevertheless, answering this question by merging existing studies is further complicated by the variety of ways to describe patellar kinematics.

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The piezoelectricity of bone is known to play a crucial role in bone adaptation and remodeling. The application of an external stimulus such as mechanical strain or electric field has the potential to enhance bone formation and implant osseointegration. Therefore, in the present study, the objective is to investigate bone remodeling under electromechanical stimulation as a step towards establishing therapeutic strategies.

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Finite element analysis (FEA) has become a fundamental tool for biomechanical investigations in the last decades. Despite several existing initiatives and guidelines for reporting on research methods and results, there are still numerous issues that arise when using computational models in biomechanical investigations. According to our knowledge, these problems and controversies lie mainly in the verification and validation (V&V) process as well as in the set-up and evaluation of FEA.

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Bone tissue exhibits piezoelectric properties and thus is capable of transforming mechanical stress into electrical potential. Piezoelectricity has been shown to play a vital role in bone adaptation and remodelling processes. Therefore, to better understand the interplay between mechanical and electrical stimulation during these processes, strain-adaptive bone remodelling models without and with considering the piezoelectric effect were simulated using the Python-based open-source software framework.

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Femoral bone loss due to stress and strain shielding is a common problem in hip resurfacing arthroplasty (HRA), which arises from the different stiffness of implant materials and the adjacent bone. Usually, the implants used in HRA are made of cobalt-chromium alloy (CoCr). As a novel concept, implants may also be made of ceramics, whose stiffness exceeds that of the adjacent bone by a multiple.

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Patellofemoral (PF) disorders are considered a major clinical complication after total knee replacement (TKR). Malpositioning and design of the patellar component impacts knee joint dynamics, implant fixation and wear propagation. However, only a limited number of studies have addressed the biomechanical impact of the patellar component on PF dynamics and their results have been discussed controversially.

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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.

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