Abstract: A constituent based nonlinear viscoelastic (VE) model was modified from a previous study (Vena, et al., 2006, "A Constituent-Based Model for the Nonlinear Viscoelastic Behavior of Ligaments," J. Biomech. Eng., 128, pp. 449-457) to incorporate a glycosaminoglycan (GAG)-collagen (COL) stress balance using compressible elastic stress constitutive equations specific to articular cartilage (AC). For uniaxial loading of a mixture of quasilinear VE constituents, time constant and relaxation ratio equations are derived to highlight how a mixture of constituents with distinct quasilinear VE properties is one mechanism that produces a nonlinear VE tissue. Uniaxial tension experiments were performed with newborn bovine AC specimens before and after approximately 55% and approximately 85% GAG depletion treatment with guanidine. Experimental tissue VE parameters were calculated directly from stress relaxation data, while intrinsic COL VE parameters were calculated by curve fitting the data with the nonlinear VE model with intrinsic GAG viscoelasticity neglected. Select tissue and intrinsic COL VE parameters were significantly different from control and experimental groups and correlated with GAG content, suggesting that GAG-COL interactions exist to modulate tissue and COL mechanical properties. Comparison of the results from this and other studies that subjected more mature AC tissue to GAG depletion treatment suggests that the GAGs interact with the COL network in a manner that may be beneficial for rapid volumetric expansion during developmental growth while protecting cells from excessive matrix strains. Furthermore, the underlying GAG-COL interactions appear to diminish as the tissue matures, indicating a distinctive remodeling response during developmental growth.
Abstract: The aim of this work is to assess the fracture risk prediction of the cancellous bone in the body of a lumbar vertebra when the mechanical parameters of the bone, i.e. stiffness, porosity, and strength anisotropy, of elderly and osteoporotic subjects are considered. For this purpose, a non-linear three-dimensional continuum-based finite element model of the lumbar functional spinal unit L4-L5 was created and strength analyses of the spongy tissue of the vertebral body were carried out. A fabric-dependent strength criterion, which accounts for the micro-architecture of the cancellous bone, based on histomorphometric analyses was used. The strength analyses have shown that the cancellous bone of none of the subject types undergoes failure under loading applied during normal daily life like axial compression; however, bone failure occurs for the osteoporotic segment, subjected to a combination of the compression preloading and moments in the sagittal or in the frontal plane, which are conditions that may not be considered to occur 'daily'. In particular, critical stress conditions are met because of the high porosity values in the horizontal direction within the cancellous bone. The computational approach presented in the paper can potentially predict the material fracture risk of the cancellous bone in the vertebral body and it may be usefully employed to draw failure maps representing, for a given micro-architecture of the spongy tissue, the critical loading conditions (forces and moments) that may lead to such a risk. This approach could be further developed in order to assess the effectiveness of biomedical devices within an engineering approach to the clinical problem of the spinal diseases.
Abstract: The question addressed in this study was whether high-flexion total knee arthroplasty (TKA) designs improve the mechanical behaviour of TKAs in high flexion and whether they maintain the mechanical performance of conventional TKAs at normal flexion angles. A finite element study was performed in which the mechanical behaviour of the conventional Sigma RP and the new high-flexion Sigma RP-F were compared, during a dynamic simulation of a high-flexion squatting activity. Forces, stresses, and contact positions were calculated during different stages of the simulations. In general, higher stresses were found with larger flexion angles for both designs. Mechanical parameters were similar in normal flexion. In high flexion, lower stress and deformation values were found for the high-flexion Sigma RP-F, except for the contact stress at the post of the insert. This study confirms that a high-flexion design can improve mechanical behaviour at high-flexion without changing the performance in normal flexion. Hence, although a high-flexion TKA may show a similar or better performance in comparison with a conventional TKA, high-flexion activities still cause an increase in the implant stress levels. Therefore, the patient's demand for large flexion angles may reduce the longevity of TKA implants.
Abstract: Skin expansion is the principal technique used in plastic surgery to repair large cutaneous defects, typically after tumour removal, burn care, craniofacial surgery and post-mastectomy breast reconstruction. It allows a gain of new tissue by means of gradual expansion of a prosthesis, surgically implanted beneath the patient's skin. Nevertheless, wide clinical use is not supported by a deep quantitative knowledge of the phenomena occurring during the expansion. A finite element model of the skin expansion was developed to evaluate the stresses and the strains of the skin due to the expander inflation and validated by proper in vitro experiments; furthermore, a growth model based on the mechanical stimulus was implemented to estimate the skin area gain. The developed computational approach, composed of the skin expansion model interaction and the growth law, proved its validity to investigate skin expansion phenomena: its use suggests a new predictive tool to optimize clinical procedures and the expander devices' design.
Abstract: This paper presents a constitutive model for predicting the nonlinear viscoelastic behavior of soft biological tissues and in particular of ligaments. The constitutive law is a generalization of the well-known quasi-linear viscoelastic theory (QLV) in which the elastic response of the tissue and the time-dependent properties are independently modeled and combined into a convolution time integral. The elastic behavior, based on the definition of anisotropic strain energy function, is extended to the time-dependent regime by means of a suitably developed time discretization scheme. The time-dependent constitutive law is based on the postulate that a constituent-based relaxation behavior may be defined through two different stress relaxation functions: one for the isotropic matrix and one for the reinforcing (collagen) fibers. The constitutive parameters of the viscoelastic model have been estimated by curve fitting the stress relaxation experiments conducted on medial collateral ligaments (MCLs) taken from the literature, whereas the predictive capability of the model was assessed by simulating experimental tests different from those used for the parameter estimation. In particular, creep tests at different maximum stresses have been successfully simulated. The proposed nonlinear viscoelastic model is able to predict the time-dependent response of ligaments described in experimental works (Bonifasi-Lista et al., 2005, J. Orthopaed. Res., 23, pp. 67-76; Hingorani et al., 2004, Ann. Biomed. Eng., 32, pp. 306-312; Provenzano et al., 2001, Ann. Biomed. Eng., 29, pp. 908-214; Weiss et al., 2002, J. Biomech., 35, pp. 943-950). In particular, the nonlinear viscoelastic response which implies different relaxation rates for different applied strains, as well as different creep rates for different applied stresses and direction-dependent relaxation behavior, can be described.
Abstract: The mechanisms underlying the ability of articular cartilage to withstand and distribute the loads applied across diarthrodial joints have been widely studied. Experimental tests have been done under several configurations to reveal the tissue response to mechanical stimuli, and theoretical models have been developed for the interpretation of the experimental results. The experiments demonstrated that the tissue is non-linear with strain, both in tension and in compression, non-linear with direction of stimulus, anisotropic in tension and compression, non-homogeneous with depth, resulting in depth dependent mechanical properties, and presents fluid dependent and fluid independent viscoelasticity. None of the models up to now developed is able to describe the whole set of responses of such a complex tissue. The purpose of this study was to develop a combined experimental-numerical approach for the proper description of the cartilage response under confined and unconfined compression. We defined a series of experimental tests to be performed on disks of natural and engineered cartilage and we developed a numerical model for cartilage, based on the biphasic theory, which potentially includes the tension-compression non-linearity, the strain non-linearity and the fluid independent viscoelasticity. The model successfully simulated the confined and unconfined compression experiments performed on disks of natural and engineered cartilage, and was also used to identify parameters of difficult experimental evaluation, such as the collagen stiffness and the permeability. In conclusion, the use of our model in combination with biomechanical experimental testing seems a valuable tool to analyze the mechanical properties of natural cartilage and the biofunctionality of tissue engineered cartilage.
Abstract: The biomechanical compatibility of an interspinous device, used for the "dynamic stabilization" of a diseased spinal motion segment, was investigated. The behaviour of an implant made of titanium based alloy (Ti6Al4V) and that of an implant made of a super-elastic alloy (Ni-Ti) have been compared. The assessment of the biomechanical compatibility was achieved by means of the finite element method, in which suitable constitutive laws have been adopted for the annulus fibrosus and for the metal alloys. The model was aimed at simulating the healthy, the nucleotomized and the treated L4-L5 lumbar segment, subjected to compressive force and flexion-extension as well as lateral flexion moments. The computational model has shown that both the implants were able to achieve their main design purpose, which is to diminish the forces acting on the apophyseal joints. Nevertheless, the Ni-Ti implant has shown a more physiological flexural stiffness with respect to the Ti6Al4V implant, which exhibited an excessive stiffness and permanent strains (plastic strains), even under physiological loads. The computational models presented in this paper seems to be a promising tool able to predict the effectiveness of a biomedical device and to select the materials to be used for the implant manufacturing, within an engineering approach to the clinical problem of the spinal diseases.
Abstract: This paper presents a novel approach to constitutive modeling of viscoelastic soft tissues. This formulation combines an anisotropic strain energy function, accounting for preferred material directions, to define the elastic stress-strain relationship, and a discrete time black-box dynamic model, borrowed from the theory of system identification, to describe the time-dependent behavior. This discrete time formulation is straightforwardly oriented to the development of a recursive time integration scheme that calculates the current stress state by using strain and stress values stored at a limited number of previous time instants. The viscoelastic model and the numerical procedure are assessed by implementing two numerical examples, the simulation of a uniaxial tensile test and the inflation of a thin tube. Both simulations are performed using parameter values based on previous experiments on preserved bovine pericardium. Parameters are then adjusted to investigate the sensitivity of the model. The hypotheses the model relies upon are discussed and the main limitations are stated.
Abstract: Experimental studies on immature tendons have shown that the collagen fibril net is discontinuous. Manifold evidences, despite not being conclusive, indicate that mature tissue is discontinuous as well. According to composite theory, there is no requirement that the fibrils should extend from one end of the tissue to the other; indeed, an interfibrillar matrix with a low elastic modulus would be sufficient to guarantee the mechanical properties of the tendon. Possible mechanisms for the stress-transfer involve the interfibrillar proteoglycans and can be related to the matrix shear stress and to electrostatic non-covalent forces. Recent studies have shown that the glycosaminoglycans (GAGs) bound to decorin act like bridges between contiguous fibrils connecting adjacent fibril every 64-68 nm; this architecture would suggest their possible role in providing the mechanical integrity of the tendon structure. The present paper investigates the ability of decorin GAGs to transfer forces between adjacent fibrils. In order to test this hypothesis the stiffness of chondroitin-6-sulphate, a typical GAG associated to decorin, has been evaluated through the molecular mechanics approach. The obtained GAG stiffness is piecewise linear with an initial plateau at low strains (<800%) and a high stiffness region (3.1 x 10(-11)N/nm) afterwards. By introducing the calculated GAG stiffness in a multi-fibril model, miming the relative mature tendon architecture, the stress-strain behaviour of the collagen fibre was determined. The fibre incremental elastic modulus obtained ranges between 100 and 475 MPa for strains between 2% and 6%. The elastic modulus value depends directly on the fibril length, diameter and inversely on the interfibrillar distance. In particular, according to the obtained results, the length of the fibril is likely to play the major role in determining stiffness in mature tendons.
Abstract: A way to prevent polyethylene wear in total hip replacements is to use metal-on-metal bearings. The cup design of these bearings may be a metal inlay in a polyethylene cup. However, these metal inlays are relatively thin and may deform on loading. The purpose of the current study was to determine whether these potential problems become actual for a realistic range of metal-inlay components having a thickness greater than 1 mm. For this purpose, the effects of thickness variation of a metal inlay in an ultrahigh molecular weight polyethylene cup were determined using three-dimensional finite element techniques. The results showed no indications for jamming of the bearing assuming a realistic inlay thickness (3-5 mm), even with a small clearance (25 microm). The metal inlay acted rigidly beyond a thickness of approximately 5 mm. Metal inlays thinner than 1.5 mm led to a considerable increase in contact area and a reduction in contact peak stress, which may be beneficial for the bearing performance. Currently, these thin liners have too many unknown characteristics and therefore the current authors recommend using rigid metal liners that have a thickness greater than 5 mm.
Abstract: The increase of the femoral head roughness in artificial hip joints is strongly influenced by the presence of abrasive particulate entrapped between the articulating surfaces. The aim of the present study is to evaluate the dependence of such damage on the geometry of the particles entrapped in the joint, with reference to the UHMWPE/chrome-cobalt coupling. Five chrome-cobalt femoral heads and their coupled UHMWPE acetabular cups, retrieved at revision surgery after a short period of in situ functioning, have been investigated for the occurrence of third-body damage. This was found on all the prosthetic heads, where the peak-to-valley height of the scratches, as derived from profilometry evaluations, ranged from 0.3-1.3 microm. The observed damage has been divided into four classes, related to the particle motion while being embedded into the polymer. Two kinds of particle morphology have been studied, spherical and prismatic, with size ranging from 5-50 microm. In order to provide an estimation of the damage induced by such particles, a finite element model of the third-body interaction was set up. The peak-to-valley height of the impression due to the particle indentation on the chrome-cobalt surface is assumed as an index of the induced damage. The calculated values range from 0.1-0.5 microm for spherical particles of size ranging from 10-40 microm. In the case of prismatic particles, the peak-to-valley height can reach 1.3 microm and depends both on the size and width of the particle's free corner, indenting the chrome-cobalt. As an example, a sharp-edged particle of size 30 microm can induce on the chrome-cobalt an impression with peak-to-valley height of 0.75 microm, when embedded into the polyethylene with a free edge of 5 microm facing the metallic surface. Negligible damage is induced, if a free edge of 7.5 microm is indenting the counterface. Our findings offer new support to the hypothesis that microscopic third-body particles are capable of causing increased roughening of the femoral head and provide a quantitative evaluation of the phenomenon.
Abstract: A numerical optimization procedure has been applied for the shape optimal design of a femoral head surface replacement. The failure modes of the prosthesis that were considered in the formulation of the objective functions concerned the interface stress magnitude and the bone remodelling activity beneath the implant. In order to find a compromising solution between different requirements demanded by the two objective functions, a two step optimization procedure has been developed. Through step 1 the minimization of interface stress was achieved, through step 2 the minimization of bone remodelling was achieved with constraints on interface stresses. The results obtained provided an optimal design that generates limited bone remodelling activity with controlled interface stress distribution. The computational procedure was based on the application of the finite element method, linked to a mathematical programming package and a design sensitivity analysis package.
