scholarly journals A Critical Analysis of TKR In Vitro Wear Tests Considering Predicted Knee Joint Loads

Materials ◽  
2019 ◽  
Vol 12 (10) ◽  
pp. 1597 ◽  
Author(s):  
Saverio Affatato ◽  
Alessandro Ruggiero
Keyword(s):  
Knee Joint ◽  
Detailed Knowledge ◽  
Musculoskeletal Modelling ◽  
Assessment Protocol ◽  
Joint Forces ◽  
Joint Reaction Forces ◽  
Reaction Forces ◽  
Wear Tests

Detailed knowledge about loading of the knee joint is essential for preclinical testing of total knee replacement. Direct measurement of joint reaction forces is generally not feasible in a clinical setting; non-invasive methods based on musculoskeletal modelling should therefore be considered as a valid alternative to the standards guidelines. The aim of this paper is to investigate the possibility of using knee joint forces calculated through musculoskeletal modelling software for developing an in vitro wear assessment protocol by using a knee wear simulator. In particular, in this work we preliminarily show a comparison of the predicted knee joint forces (in silico) during the gait with those obtained from the ISO 14243-1/3 and with those measured in vivo by other authors. Subsequently, we compare the wear results obtained from a knee wear joint simulator loaded by calculated forces in correspondence to the “normal gait” kinematics with those obtained in correspondence to the loads imposed by the ISO. The obtained results show that even if the predicted load profiles are not totally in good agreement with the loads deriving from ISO standards and from in vivo measurements, they can be useful for in vitro wear tests, since the results obtained from the simulator in terms of wear are in agreement with the literature data.

Estimation of In-Vivo Quadriceps Forces of the Knee: A Combined In-Vivo Patellofemoral Joint Kinematics Measurement and Finite Element Prediction

2011 ◽  
Author(s):  
Koichi Kobayashi ◽  
Guoan Li
Keyword(s):  
Knee Joint ◽  
Load Transfer ◽  
Weight Bearing ◽  
Knee Oa ◽  
Moment Arms ◽  
Joint Reaction Forces ◽  
Joint Contact ◽  
Reaction Forces ◽  
Knee Pathology

The load transfer mechanics across the patellofemoral (PF) joint during weight-bearing conditions is important for treatment of the knee pathology, such as knee OA, ACL deficiency as well as TKA. Many studies have characterized the PF joint reaction forces using equilibriums of the quadriceps and ground reaction forces at the knee joint [1,2,3]. However, this simplification does not consider other muscle function as well as 3D knee joint contact location when calculate moment arms of the involved forces.

scholarly journals Biomechanics of hip joint: a systematic review

2018 ◽  
Vol 7 (3) ◽  
pp. 1672 ◽  
Author(s):  
Chethan KN ◽  
Shyamasunder Bhat N ◽  
Satish Shenoy B
Keyword(s):  
Hip Joint ◽  
Living Organism ◽  
Upper Body ◽  
Joint Prosthesis ◽  
Load Carrying ◽  
Different Types ◽  
Joint Reaction Forces ◽  
Reaction Forces

Hip joint is the second largest joint in human after knee joint. It is associated with different types of motion which helps in the movement of human body and provide stability. Biomechanics involves the study of movement of living organism. It is important to know and understand the basics of biomechanics of hip joint to define the movement of hip joint along with its load carrying capacity in different day to day activities. Many researchers are worked to know the basics biomechanics of hip joint both in in-vitro and in- vivo conditions. In this paper, it has been reported in detail to know the different biomechanical aspects involved in the hip joint during different movement and also different biomaterials used in the hip joint prosthesis. It is majorly focused on load transmitting by hip joint by upper body to lower body in different activities such as walking, running, stumbling etc. So, these basic understanding helps to understand effectively the joint reaction forces which is acting on hip joint while designing new hip joint prosthesis.  

scholarly journals An Evidence-Based Systematic Review of Human Knee Post-Traumatic Osteoarthritis (PTOA): Timeline of Clinical Presentation and Disease Markers, Comparison of Knee Joint PTOA Models and Early Disease Implications

2021 ◽  
Vol 22 (4) ◽  
pp. 1996 ◽  
Author(s):  
Christine M. Khella ◽  
Rojiar Asgarian ◽  
Judith M. Horvath ◽  
Bernd Rolauffs ◽  
Melanie L. Hart
Keyword(s):  
Synovial Fluid ◽  
Knee Joint ◽  
Ex Vivo ◽  
Disease Process ◽  
Early Disease ◽  
Knee Trauma ◽  
Post Traumatic ◽  
Acute Knee

Understanding the causality of the post-traumatic osteoarthritis (PTOA) disease process of the knee joint is important for diagnosing early disease and developing new and effective preventions or treatments. The aim of this review was to provide detailed clinical data on inflammatory and other biomarkers obtained from patients after acute knee trauma in order to (i) present a timeline of events that occur in the acute, subacute, and chronic post-traumatic phases and in PTOA, and (ii) to identify key factors present in the synovial fluid, serum/plasma and urine, leading to PTOA of the knee in 23–50% of individuals who had acute knee trauma. In this context, we additionally discuss methods of simulating knee trauma and inflammation in in vivo, ex vivo articular cartilage explant and in vitro chondrocyte models, and answer whether these models are representative of the clinical inflammatory stages following knee trauma. Moreover, we compare the pro-inflammatory cytokine concentrations used in such models and demonstrate that, compared to concentrations in the synovial fluid after knee trauma, they are exceedingly high. We then used the Bradford Hill Framework to present evidence that TNF-α and IL-6 cytokines are causal factors, while IL-1β and IL-17 are credible factors in inducing knee PTOA disease progresssion. Lastly, we discuss beneficial infrastructure for future studies to dissect the role of local vs. systemic inflammation in PTOA progression with an emphasis on early disease.

A Robotic Cadaveric Flatfoot Analysis of Stance Phase

2011 ◽  
Vol 133 (5) ◽  
Author(s):  
Lyle T. Jackson ◽  
Patrick M. Aubin ◽  
Matthew S. Cowley ◽  
Bruce J. Sangeorzan ◽  
William R. Ledoux
Keyword(s):  
Surgical Treatment ◽  
Degrees Of Freedom ◽  
Stance Phase ◽  
Gait Cycle ◽  
Ground Reaction Forces ◽  
Pes Planus ◽  
Reaction Forces ◽  
Vertical Ground

The symptomatic flatfoot deformity (pes planus with peri-talar subluxation) can be a debilitating condition. Cadaveric flatfoot models have been employed to study the etiology of the deformity, as well as invasive and noninvasive surgical treatment strategies, by evaluating bone positions. Prior cadaveric flatfoot simulators, however, have not leveraged industrial robotic technologies, which provide several advantages as compared with the previously developed custom fabricated devices. Utilizing a robotic device allows the researcher to experimentally evaluate the flatfoot model at many static instants in the gait cycle, compared with most studies, which model only one to a maximum of three instances. Furthermore, the cadaveric tibia can be statically positioned with more degrees of freedom and with a greater accuracy, and then a custom device typically allows. We created a six degree of freedom robotic cadaveric simulator and used it with a flatfoot model to quantify static bone positions at ten discrete instants over the stance phase of gait. In vivo tibial gait kinematics and ground reaction forces were averaged from ten flatfoot subjects. A fresh frozen cadaveric lower limb was dissected and mounted in the robotic gait simulator (RGS). Biomechanically realistic extrinsic tendon forces, tibial kinematics, and vertical ground reaction forces were applied to the limb. In vitro bone angular position of the tibia, calcaneus, talus, navicular, medial cuneiform, and first metatarsal were recorded between 0% and 90% of stance phase at discrete 10% increments using a retroreflective six-camera motion analysis system. The foot was conditioned flat through ligament attenuation and axial cyclic loading. Post-flat testing was repeated to study the pes planus deformity. Comparison was then made between the pre-flat and post-flat conditions. The RGS was able to recreate ten gait positions of the in vivo pes planus subjects in static increments. The in vitro vertical ground reaction force was within ±1 standard deviation (SD) of the in vivo data. The in vitro sagittal, coronal, and transverse plane tibial kinematics were almost entirely within ±1 SD of the in vivo data. The model showed changes consistent with the flexible flatfoot pathology including the collapse of the medial arch and abduction of the forefoot, despite unexpected hindfoot inversion. Unlike previous static flatfoot models that use simplified tibial degrees of freedom to characterize only the midpoint of the stance phase or at most three gait positions, our simulator represented the stance phase of gait with ten discrete positions and with six tibial degrees of freedom. This system has the potential to replicate foot function to permit both noninvasive and surgical treatment evaluations throughout the stance phase of gait, perhaps eliciting unknown advantages or disadvantages of these treatments at other points in the gait cycle.

Influence of the Musculotendon Dynamics on the Muscle Force-Sharing Problem of the Shoulder—A Fully Inverse Dynamics Approach

2018 ◽  
Vol 140 (7) ◽  
Author(s):  
Quental Carlos ◽  
Azevedo Margarida ◽  
Ambrósio Jorge ◽  
Gonçalves S. B. ◽  
Folgado João
Keyword(s):  
Muscle Activation ◽  
Inverse Dynamics ◽  
Glenohumeral Joint ◽  
Inverse Dynamic ◽  
Force Sharing ◽  
Joint Reaction Forces ◽  
Reaction Forces ◽  
Muscle Activations ◽  
Joint Reaction

Abstract Most dynamic simulations are based on inverse dynamics, being the time-dependent physiological nature of the muscle properties rarely considered due to numerical challenges. Since the influence of muscle physiology on the consistency of inverse dynamics simulations remains unclear, the purpose of the present study is to evaluate the computational efficiency and biological validity of four musculotendon models that differ in the simulation of the muscle activation and contraction dynamics. Inverse dynamic analyses are performed using a spatial musculoskeletal model of the upper limb. The muscle force-sharing problem is solved for five repetitions of unloaded and loaded motions of shoulder abduction and shoulder flexion. The performance of the musculotendon models is evaluated by comparing muscle activation predictions with electromyography (EMG) signals, measured synchronously with motion for 11 muscles, and the glenohumeral joint reaction forces estimated numerically with those measured in vivo. The results show similar muscle activations for all muscle models. Overall, high cross-correlations are computed between muscle activations and the EMG signals measured for all movements analyzed, which provides confidence in the results. The glenohumeral joint reaction forces estimated compare well with those measured in vivo, but the influence of the muscle dynamics is found to be negligible. In conclusion, for slow-speed, standard movements of the upper limb, as those studied here, the activation and musculotendon contraction dynamics can be neglected in inverse dynamic analyses without compromising the prediction of muscle and joint reaction forces.

scholarly journals OC 8510 BIOTRANSFORMATION OF PRAZIQUANTEL FOR THE PHARMACOKINETIC OPTIMISATION OF PRAZIQUANTEL USE IN MASS DRUG ADMINISTRATION AND DEVELOPMENT OF NEW PAEDIATRIC FORMULATIONS

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A11.1-A11
Author(s):  
Roslyn S Thelingwani ◽  
Nyasha Kapungu ◽  
Xueqing Li ◽  
Comfort Kanji ◽  
Chenai Mutiti ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Liver Microsomes ◽  
Individual Variability ◽  
Clinical Samples ◽  
Pharmacokinetic Data ◽  
Detailed Knowledge ◽  
Pbpk Modelling

BackgroundPraziquantel (PZQ) is the only drug available for the treatment of all forms of schistosomiasis. New paediatric formulations for the active enantiomer R-PZQ and the racemate PZQ are currently under development. There is however limited drug metabolism and pharmacokinetic data on PZQ available to support these initiatives. Detailed knowledge of PZQ metabolism will enable the use of PBPK modelling to determine appropriate doses for the new formulations in paediatric patients and to predict risks for drug-drug interactions in mass drug administration.MethodsBiotransformation studies on PZQ were conducted in human liver microsomes and recombinant Cytochrome P450s (CYPs). Structure elucidation was inferred from mass spectra. Enzyme kinetic studies to determine the Michaelis-Menten kinetics, Km and Vmax, of the formation of the main metabolites and analysis of clinical samples were determined by LC-MS/MS.ResultsCYP reaction phenotyping studies with HLM and r-CYPs indicate major involvement of CYP1A2, 2 C19, 2D6 and 3A4/5 in the metabolism of R- and S-PZQ. Biotransformation studies showed that PZQ is metabolised to cis-4-OH-PZQ mainly by CYP1A2 and CYP2C19. CYP3A4/5 metabolises PZQ to a mono-hydroxyl metabolite (X-OH-PZQ) whilst CYP2D6 metabolises PZQ to minor novel mono-hydroxyl metabolite (Y-OH-PZQ) both pending structural elucidation by nuclear magnetic resonance. R-PZQ was more rapidly cleared than S–PZQ with variable interindividual AUC and Cmax.Discussion and conclusionThe differential role of CYP1A2 and CYP2C19 and of CYP3A4 and CYP3A5 in the formation the 4-OH-PZQ and the novel X-OH-PZQ respectively are intriguing findings as this has not been reported before in humans. In vitro, cis and not trans 4-OH-PZQ formation has been observed contrary in vivo reports in humans which indicate trans 4-OH-PZQ as the main metabolite. The data will enable us to understand the rapid clearance of PZQ and predict potential drug-drug-gene interactions which may’explain the inter-individual variability of PZQ pharmacokinetics.

scholarly journals Injectable mechanical pillows for attenuation of load-induced post-traumatic osteoarthritis

2019 ◽  
Vol 6 (4) ◽  
pp. 211-219
Author(s):  
Derek T Holyoak ◽  
Tibra A Wheeler ◽  
Marjolein C H van der Meulen ◽  
Ankur Singh
Keyword(s):  
Knee Joint ◽  
Joint Damage ◽  
Mechanical Trauma ◽  
Protective Effects ◽  
Post Injury ◽  
On Demand ◽  
Post Traumatic ◽  
Anti Inflammatory

Abstract Osteoarthritis (OA) of the knee joint is a degenerative disease initiated by mechanical stress that affects millions of individuals. The disease manifests as joint damage and synovial inflammation. Post-traumatic osteoarthritis (PTOA) is a specific form of OA caused by mechanical trauma to the joint. The progression of PTOA is prevented by immediate post-injury therapeutic intervention. Intra-articular injection of anti-inflammatory therapeutics (e.g. corticosteroids) is a common treatment option for OA before end-stage surgical intervention. However, the efficacy of intra-articular injection is limited due to poor drug retention time in the joint space and the variable efficacy of corticosteroids. Here, we endeavored to characterize a four-arm maleimide-functionalized polyethylene glycol (PEG-4MAL) hydrogel system as a ‘mechanical pillow’ to cushion the load-bearing joint, withstand repetitive loading and improve the efficacy of intra-articular injections of nanoparticles containing dexamethasone, an anti-inflammatory agent. PEG-4MAL hydrogels maintained their mechanical properties after physiologically relevant cyclic compression and released therapeutic payload in an on-demand manner under in vitro inflammatory conditions. Importantly, the on-demand hydrogels did not release nanoparticles under repetitive mechanical loading as experienced by daily walking. Although dexamethasone had minimal protective effects on OA-like pathology in our studies, the PEG-4MAL hydrogel functioned as a mechanical pillow to protect the knee joint from cartilage degradation and inhibit osteophyte formation in an in vivo load-induced OA mouse model.

A Cadaverically Evaluated Dynamic FEM Model of Closed-Chain TKR Mechanics

2009 ◽  
Vol 131 (5) ◽  
Author(s):  
Joel L. Lanovaz ◽  
Randy E. Ellis
Keyword(s):  
Model Performance ◽  
Element Model ◽  
Joint Kinematics ◽  
Contact Friction ◽  
Model Parameters ◽  
Factors Affecting ◽  
Reaction Forces ◽  
Total Knee

Knowledge of the behavior and mechanics of a total knee replacement (TKR) in an in vivo environment is key to optimizing the functional outcomes of the implant procedure. Computational modeling has shown to be an important tool for investigating biomechanical variables that are difficult to address experimentally. To assist in examining TKR mechanics, a dynamic finite-element model of a TKR is presented. The objective of the study was to develop and evaluate a model that could simulate full knee motion using a physiologically consistent quadriceps action, without prescribed joint kinematics. The model included tibiofemoral (TFJs) and patellofemoral joints (PFJs), six major ligament bundles and was driven by a uni-axial representation of a quadricep muscle. An initial parameter screening analysis was performed to assess the relative importance of 31 different model parameters. This analysis showed that ligament insertion location and initial ligament strain were significant factors affecting simulated joint kinematics and loading, with the contact friction coefficient playing a lesser role and ligament stiffness having little effect. The model was then used to simulate in vitro experiments utilizing a flexed-knee-stance testing rig. General model performance was assessed by comparing simulation results with experimentally measured kinematics and tibial reaction forces collected from two implanted specimens. The simulations were able to reproduce experimental differences observed between the test specimens and were able to accurately predict trends seen in the tibial reaction loads. The simulated kinematics of the TFJ and PFJ were less consistent when compared with experimental data but still reproduced many trends.

scholarly journals Adverse biological effects of Milan urban PM looking for suitable molecular markers of exposure

2012 ◽  
Vol 18 (4-2) ◽  
pp. 635-641 ◽  
Author(s):  
Paride Mantecca ◽  
Maurizio Gualtieri ◽  
Eleonora Longhin ◽  
Giuseppina Bestetti ◽  
Paola Palestini ◽  
...  
Keyword(s):  
Molecular Markers ◽  
Chemical Composition ◽  
Biological Effects ◽  
Detailed Knowledge ◽  
Biological Responses ◽  
Physico Chemical ◽  
Biological Hazard ◽  
The Impact

The results presented summarise the ones obtained in the coordinated research project Tosca, which extensively analysed the impact of Milan urban PM on human health. The molecular markers of exposure and effects of seasonally and size-fractionated PMs (summer and winter PM10, PM2.5) were investigated in in vitro (human lung cell lines) and in vivo (mice) systems. The results obtained by the analyses of cytotoxic, pro-inflammatory and genotoxic parameters demonstrate that the biological responses are strongly dependent upon the PM samples seasonal and dimensional variability, that ultimately reflect their chemical composition and source. In fact summer PM10, enriched in crustal elements and endotoxins, was the most cytotoxic and pro-inflammatory fraction, while fine winter PMs induced genotoxic effects and xenobiotic metabolizing enzymes (like CYP1B1) production, likely as a consequence of the higher content in combustion derived particles reach in PAHs and heavy toxic metals. These outcomes outline the need of a detailed knowledge of the PMs physico-chemical composition on a local scale, coupled with the biological hazard directly associated to PM exposure. Apparently this is the only way allowing scientists and police-makers to establish the proper relationships between the respirable PM quantity/quality and the health outcomes described by clinicians and epidemiologists.

The Effect of the Tibiofemoral Contact Path Centroid Location on TKR Contact Forces

2010 ◽  
Author(s):  
Hannah J. Lundberg ◽  
Markus A. Wimmer
Keyword(s):  
Knee Joint ◽  
Tibial Plateau ◽  
Soft Tissues ◽  
Three Dimensional ◽  
Solution Space ◽  
Contact Forces ◽  
Detailed Knowledge ◽  
Joint Contact ◽  
Total Knee

Detailed knowledge of in vivo knee contact forces and the contribution from muscles, ligaments, and other soft-tissues to knee joint function are essential for evaluating total knee replacement (TKR) designs. We have recently developed a mathematical model for calculating knee joint contact forces using parametric methodology (Lundberg et al., 2009). The numerical model calculates a “solution space” of three-dimensional contact forces for both the medial and lateral compartments of the tibial plateau. The solution spaces are physiologically meaningful, and represent the result of balancing the external moments and forces by different strategies.

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