The role of high-resolution cartilage thickness distribution for contact mechanics predictions in the tibiofemoral joint.

Subject-specific finite element models of knee joint contact mechanics are used in assessment of interventions and disease states. Cartilage thickness distribution is one factor influencing the distribution of pressure. Precision of cartilage geometry capture varies between imaging protocols.

Injectable peptide-glycosaminoglycan hydrogels for soft tissue repair: assessment for nucleus augmentation.

We report the development of peptide-glycosaminoglycan hydrogels as injectable biomaterials for load-bearing soft tissue repair. The hydrogels are injectable as a liquid for clinical delivery, rapidly form a gel , and mimic the osmotic swelling behaviour of natural tissue. We used a new model to demonstrate their application as a nucleus augmentation material for the treatment of intervertebral disc degeneration.

A Finite Element Model to Investigate the Stability of Osteochondral Grafts Within a Human Tibiofemoral Joint.

Osteochondral grafting has demonstrated positive outcomes for treating articular cartilage defects by replacing the damaged region with a cylindrical graft consisting of bone with a layer of cartilage. However, factors that cause graft subsidence are not well understood. The aim of this study was to develop finite element (FE) models of osteochondral grafts within a tibiofemoral joint, suitable for an investigation of parameters affecting graft stability.

Dynamic Acetabular Cup Orientation during Gait: A Study of Fast- and Slow-Walking Total Hip Replacement Patients.

The dynamic orientation of total hip replacement acetabular cups during walking may vary substantially from their assumed position at surgical implantation and may vary between individuals. The scale of this effect is of interest for both pre-clinical device testing and for pre-operative surgical planning. This work aimed to evaluate (1) patient variation in dynamic cup orientation; (2) whether walking speed was a candidate proxy measure for the dynamic cup orientation; and (3) the relationships between dynamic cup orientation angles and planar pelvic angles.

Cost-effectiveness of decellularised bone allograft compared with fresh-frozen bone allograft for acetabular impaction bone grafting during a revision hip arthroplasty in the UK.

Objectives: Fresh-frozen allograft is the gold-standard bone graft material used during revision hip arthroplasty. However, new technology has been developed to manufacture decellularised bone with potentially better graft incorporation. As these grafts cost more to manufacture, the aim of this cost-effectiveness study was to estimate whether the potential health benefit of decellularised bone allograft outweighs their increased cost.

Controlling the Self-Assembly and Material Properties of β-Sheet Peptide Hydrogels by Modulating Intermolecular Interactions.

Self-assembling peptides are a promising biomaterial with potential applications in medical devices and drug delivery. In the right combination of conditions, self-assembling peptides can form self-supporting hydrogels. Here, we describe how balancing attractive and repulsive intermolecular forces is critical for successful hydrogel formation.

A geometric assessment method for estimating dimensional change of retrieved dual mobility liners for total hip arthroplasty.

Despite their emerging use, the current understanding of the in-vivo functional mechanisms of Dual Mobility (DM) Total Hip Replacements (THRs) is poor, and current characterisation methodologies are not suitable for the unique function and design of these types of devices. Therefore, the aim of this study was to develop a geometric characterisation methodology to estimate dimensional change across the articulating surfaces of retrieved DM polyethylene liners so that their invivo function may be better understood. The method involves the acquisition of three-dimensional coordinate data from the internal and external surfaces of DM liners.

Dynamic finite element analysis of hip replacement edge loading: Balancing precision and run time in a challenging model.

An important aspect in evaluating the resilience of hip replacement designs is testing their performance under adverse conditions that cause edge loading of the acetabular liner. The representation of edge loading conditions in finite element models is computationally challenging due to the changing contact locations, need for fine meshes, and dynamic nature of the system. In this study, a combined mesh and mass-scaling sensitivity study was performed to identify an appropriate compromise between convergence and solution time of explicit finite element analysis in investigating edge loading in hip replacement devices.

Contribution of Shape Features to Intradiscal Pressure and Facets Contact Pressure in L4/L5 FSUs: An In-Silico Study.

Finite element models (FEMs) of the spine commonly use a limited number of simplified geometries. Nevertheless, the geometric features of the spine are important in determining its FEM outcomes. The link between a spinal segment's shape and its biomechanical response has been studied, but the co-variances of the shape features have been omitted.

Development of robust finite element models to investigate the stability of osteochondral grafts within porcine femoral condyles.

Osteoarthritis (OA) is the most prevalent chronic rheumatic disease worldwide with knee OA having an estimated lifetime risk of approximately 14%. Autologous osteochondral grafting has demonstrated positive outcomes in some patients, however, understanding of the biomechanical function and how treatments can be optimised remains limited. Increased short-term stability of the grafts allows cartilage surfaces to remain congruent prior to graft integration.

Impingement in total hip arthroplasty: A geometric model.

Total Hip Arthroplasty (THA) is one of the most common and successful surgical interventions. The survivorship at 10 years for the most commonly used systems is over 95%. However, the incidence of revision is usually much higher in the 0-1 year time period following the intervention.

Evaluation of injectable nucleus augmentation materials for the treatment of intervertebral disc degeneration.

Back pain affects a person's health and mobility as well as being associated with large health and social costs. Lower back pain is frequently caused by degeneration of the intervertebral disc. Current operative and non-operative treatments are often ineffective and expensive.

Importance of dynamics in the finite element prediction of plastic damage of polyethylene acetabular liners under edge loading conditions.

After hip replacement, in cases where there is instability at the joint, contact between the femoral head and the acetabular liner can move from the bearing surface to the liner rim, generating edge loading conditions. This has been linked to polyethylene liner fracture and led to the development of a regulatory testing standard (ISO 14242:4) to replicate these conditions. Performing computational modelling alongside simulator testing can provide insight into the complex damage mechanisms present in hard-on-soft bearings under edge loading.

Experimental and Computational Comparison of Intervertebral Disc Bulge for Specimen-Specific Model Evaluation Based on Imaging.

Finite element modelling of the spinal unit is a promising preclinical tool to assess the biomechanical outcome of emerging interventions. Currently, most models are calibrated and validated against range of motion and rarely directly against soft-tissue deformation. The aim of this contribution was to develop an methodology to measure disc bulge and assess the ability of different specimen-specific modelling approaches to predict disc bulge.

Hydrodynamic Mixing Tunes the Stiffness of Proteoglycan-Mimicking Physical Hydrogels.

Self-assembling hydrogels are promising materials for regenerative medicine and tissue engineering. However, designing hydrogels that replicate the 3-4 order of magnitude variation in soft tissue mechanics remains a major challenge. Here hybrid hydrogels are investigated formed from short self-assembling β-fibril peptides, and the glycosaminoglycan chondroitin sulfate (CS), chosen to replicate physical aspects of proteoglycans, specifically natural aggrecan, which provides structural mechanics to soft tissues.

Decellularized Intervertebral Discs: A Potential Replacement for Degenerate Human Discs.

Intervertebral disc (IVD) degeneration is a major cause of back pain. Current surgical interventions have limitations. An alternative approach is to replace degenerated IVDs with a natural biological scaffold.

Development of robust finite element models of porcine tibiofemoral joints loaded under varied flexion angles and tibial freedoms.

The successful development of cartilage repair treatments for the knee requires understanding of the biomechanical environment within the joint. Computational finite element models play an important role in non-invasively understanding knee mechanics, but it is important to compare model findings to experimental data. The purpose of this study was to develop a methodology for generating subject-specific finite element models of porcine tibiofemoral joints that was robust and valid over multiple different constraint scenarios.

Optimizing computational methods of modeling vertebroplasty in experimentally augmented human lumbar vertebrae.

Vertebroplasty has been widely used for the treatment of osteoporotic compression fractures but the efficacy of the technique has been questioned by the outcomes of randomized clinical trials. Finite-element (FE) models allow an investigation into the structural and geometric variation that affect the response to augmentation. However, current specimen-specific FE models are limited due to their poor reproduction of cement augmentation behavior.

Initiating factors for the onset of OA: A systematic review of animal bone and cartilage pathology in OA.

There is controversy over whether bone or cartilage is primarily involved in osteoarthritis (OA) pathogenesis; this is important for targeting early interventions. We explored evidence from animal models of knee OA by preforming a systematic review of PubMed, Scopus, and Web of Science for original articles reporting subchondral bone and cartilage pathology in animal models with epiphyseal closure. Extracted data included: method of induction; animal model; cartilage and bone assessment and method; meniscal assessment; skeletal maturity; controls; and time points assessed.

Finite element models of the tibiofemoral joint: A review of validation approaches and modelling challenges.

The knee joint is a complex mechanical system, and computational modelling can provide vital information for the prediction of disease progression and of the potential for therapeutic interventions. This review provides an overview of the challenges involved in developing finite element models of the tibiofemoral joint, including the representation of appropriate geometry and material properties, loads and motions, and establishing pertinent outputs. The importance of validation for computational models in biomechanics has been highlighted by a number of papers, and finite element models of the tibiofemoral joint are a particular area in which validation can be challenging, due to the complex nature of the knee joint, its geometry and its constituent tissue properties.

Finite element analysis of polyethylene wear in total hip replacement: A literature review.

Evaluation and prediction of wear play a key role in product design and material selection of total hip replacements, because wear debris is one of the main causes of loosening and failure. Multifactorial clinical or laboratory studies are high cost and require unfeasible timeframes for implant development. Simulation using finite element methods is an efficient and inexpensive alternative to predict wear and pre-screen various parameters.

Computationally efficient modelling of hip replacement separation due to small mismatches in component centres of rotation.

Patient imaging and explant analysis has shown evidence of edge loading of hard-on-hard hip replacements in vivo. Experimental hip simulator testing under edge loading conditions has produced increased, clinically-relevant, wear rates for hard-on-hard bearings when compared to concentric conditions. Such testing, however, is time consuming and costly.

An In Vitro Study of the Intervertebral Disc Structure Using 3 T Magnetic Resonance Imaging.

Study Design: An in vitro magnetic resonance imaging (MRI) study.

Objective: Investigate the potential of high-field MRI for producing higher quality images of the intervertebral disc (IVD) to better distinguish structural details.

Summary Of Background Data: Higher spatial and contrast resolution are important advantages when imaging the complex tissue structures in the spine such as the IVDs.