Identification of the critical level of implantation of an osseointegrated prosthesis for above-knee amputees.

The aim of our study was to identify potential critical levels of implantation of an osseointegrated prosthesis for above-knee amputees. The implant used was the OPRA system. It was inserted in the femur at four different amputation heights, characterized by their residual limb ratios (0.299, 0.44, 0.58 and 0.73). The stress and strain distribution was evaluated in the bone-implant system during walking, considering a body mass of 100 kg. Considerably high stimulus (11,489 µÎµ) in the tissue near the tip was found at the highest implantation level. All models presented small non-physiologic stress values in the tissue around the implant. The results revealed that the implantation level has a decisive effect on bone-implant performance. Mainly, the analysis indicates adverse biomechanical conditions for implantations in very short residual limbs.

Age-related distribution of longitudinal pre-strain in abdominal aorta with emphasis on forensic application.

It is a well-known fact that the length of an artery in situ and the length of an excised artery differs. Retraction of blood vessels is usually observed. This pre-tension plays crucial role in arterial biomechanics. It augments an artery wall load-bearing capacity. This paper presents the longitudinal pre-strain of the human aorta as an index of human age. The length of abdominal aortas was measured during autopsies before and after segment resection. The longitudinal pre-strain was calculated in 130 donors; 100 male and 30 female bodies. The pre-strain was defined as the ratio between in situ length and the length after the excision. The mean pre-strain was found to be 1.18±0.10 for male and 1.14±0.10 for female sample (mean±standard deviation). The age in the male group was 41.6±15.9 years; and 47.7±17.7 years in the female group. Statistical analysis revealed the correlation coefficient between age and pre-strain r=-0.821 and r=-0.839 in male and female group, respectively. The analysis also confirmed close correlation between aortic circumference and age; and between circumference and pre-strain. Linear and power law regression equations were employed and prediction intervals were computed. The power law estimates the age more accurately than linear one model. Nevertheless, especially for small values of the pre-strain (aged individuals) the linear model can be advantageous.

Correlations between age, prestrain, diameter and atherosclerosis in the male abdominal aorta.

The longitudinal prestrain of arteries facilitates their physiological function. Remodeling, adaptation and aging result in an age-dependent magnitude of the pretension. Although the phenomenon is known, detailed statistics, especially for human arteries, are lacking. This study was designed to propose the regression model capable of estimating the prestrain of the human abdominal aorta. The length of the abdominal aorta before, l, and after excision from the body, L, the diameter, heart weight, thickness of left ventricle and degree of atherosclerosis were collected in autopsies of 156 male cadavers of known age. Longitudinal prestrain was quantified by means of the stretch ratio λ=l/L. Statistical analysis revealed significant dependence between age, prestrain, diameter and atherosclerosis, which were best fitted to the power law equation. Longitudinal prestretch reduced with age significantly; λmean=1.30±0.07 for age<30 (n=29), whereas λmean=1.06±0.03 for age>59 (n=31) with p-value<0.0001. Raw data gave linear correlation coefficients as follows: λ-age (R=-0.842); l-age (R=0.023); L-age (R=0.476); (l-L)-age (R=-0.811). It was concluded that longitudinal prestrain decreases nonlinearly with age and both age and diameter are suitable predictors of the prestrain. Data suggests that unloaded length elongates with age in contrast to the elastic retraction.

Knee joint endoprosthesis loading in full extension.

This paper deals with a knee joint endoprosthesis finite element analysis. Based on a three dimensional geometric model of a lower extremity, a mechanical axis of the limb was designed. This axis is important for several reasons. Firstly, the endoprosthesis was positioned due to its direction, secondly, boundary conditions was defined on its proximal and distal end and finally, the axis enabled reasonable simplification of the model which led to the time saving analysis while preserving principal features of the model like the natural boundary conditions or knee joint's degrees of freedom . Having this, one leg stance was simulated. Results of the analysis were encouraging for future models. Especially the choice of the mechanical axis was suitable and enabled a better distribution of contact pressures and stress on both femoral and tibial component compared to our former models. Also their magnitudes correspond better the manufacturer's experience and our findings. The stresses did not exceeded 30MPa for the UHMWPE tibial plateau and 100MPa for the femoral component. The contact pressures were lower than 40MPa.

Time analysis of hard and soft bolus processing.

OBJECTIVE: Clinical observations and mathematical models show that dental implants are influenced by the magnitude of loading. Therefore, the knowledge of mandible movement during mastication is important to assess occlusal and masticatory force vectors. The purpose of this study was to detect the path of movement of the lower jaw and to distinguish stages of mastication, duration of bolus processing and peak amplitude of mastication. METHOD: Motion analysis was used to record three-dimensional mandible movements. Individualized sensors were rigidly attached to the mandible of 51 study participants. At the beginning of the measurement, all subjects were asked to move the mandible in extreme positions (maximal opening and maximal lateral movements). Then, each subject masticated a bite of hard and soft food. Duration of bolus mastication and peak amplitude of mastication movement in mesio-distal, cranio-caudal and vestibulo-oral axes related to peak amplitude of marginal movements were evaluated for each subject. The chewing record of each subject was divided into three phases (chopping, grinding and swallowing), and the duration of mastication and number of closing movements were evaluated. RESULTS: The findings of this pilot study suggest that masticatory movements vary in individuals. Bolus character influences the process duration, but not the frequency of closing movements. Neither gender nor age had any influence on either the time or frequency of bolus processing. CONCLUSION: Relationships to directions and magnitudes of acting chewing force should be more precisely examined since transversally acted forces during grinding are important factors in tooth/implant overloading.

Computer system for definition of the quantitative geometry of musculature from CT images.

The computer system for quantitative determination of musculoskeletal geometry from computer tomography (CT) images has been developed. The computer system processes series of CT images to obtain three-dimensional (3D) model of bony structures where the effective muscle fibres can be interactively defined. Presented computer system has flexible modular structure and is suitable also for educational purposes.

Influence of implant length and diameter on stress distribution: a finite element analysis.

STATEMENT OF PROBLEM: Masticatory forces acting on dental implants can result in undesirable stress in adjacent bone, which in turn can cause bone defects and the eventual failure of implants. PURPOSE: A mathematical simulation of stress distribution around implants was used to determine which length and diameter of implants would be best to dissipate stress. MATERIAL AND METHODS: Computations of stress arising in the implant bed were made with finite element analysis, using 3-dimensional computer models. The models simulated implants placed in vertical positions in the molar region of the mandible. A model simulating an implant with a diameter of 3.6 mm and lengths of 8 mm, 10 mm, 12 mm, 14 mm, 16 mm, 17 mm, and 18 mm was developed to investigate the influence of the length factor. The influence of different diameters was modeled using implants with a length of 12 mm and diameters of 2.9 mm, 3.6 mm, 4.2 mm, 5.0 mm, 5.5 mm, 6.0 mm, and 6.5 mm. The masticatory load was simulated using an average masticatory force in a natural direction, oblique to the occlusal plane. Values of von Mises equivalent stress at the implant-bone interface were computed using the finite element analysis for all variations. Values for the 3 most stressed elements of each variation were averaged and expressed in percent of values computed for reference (100%), which was the stress magnitude for the implant with a length of 12 mm and diameter of 3.6 mm. RESULTS: Maximum stress areas were located around the implant neck. The decrease in stress was the greatest (31.5%) for implants with a diameter ranging from of 3.6 mm to 4.2 mm. Further stress reduction for the 5.0-mm implant was only 16.4%. An increase in the implant length also led to a decrease in the maximum von Mises equivalent stress values; the influence of implant length, however, was not as pronounced as that of implant diameter. CONCLUSIONS: Within the limitations of this study, an increase in the implant diameter decreased the maximum von Mises equivalent stress around the implant neck more than an increase in the implant length, as a result of a more favorable distribution of the simulated masticatory forces applied in this study.

Age related constitutive laws and stress distribution in human main coronary arteries with reference to residual strain.

An analytical model has been used to simulate the effects of tissue aging on residual strain, constitutive relations and stiffness parameter in the main right and left (ramus circumflexus) human coronary arteries, based on experimental data. The experimental opening angle theta scatters considerably with age. The optimum angle theta(op) approximately equals 70 degrees, which makes the circumferential stress uniform in the arterial wall at a normal blood pressure, is approximately constant throughout aging. Above age of the 15 years the estimated and experimental values of theta are greater than theta(op) and therefore the mechanical load of the inner layers of the media and the intima decreases and the adventitia is overloaded. On the basis of nonlinear regression analysis, age-related constitutive laws of arterial wall circumferential stiffness have been determined. Above the age of 30, arterial wall hardening increases rapidly. The left coronary artery is stiffer than the right artery for groups from 35 to 45 years of age. Hyperelasticity theory has been used to identify age-related multiaxial stress through wall thickness. A theoretical model based on the reduced Green strain provides a very good representation of the coronary artery circumferential mechanical response and predicts its nearly isotropic behavior. Bio-composite material forms non-homogeneous stresses and, in the course of aging, it increases the adventitia loading. In groups aged from 10 to 15 years, whose coronary artery residual strains are low, the circumferential stress distribution has a classic form. Stiffness parameter beta gradually increases with age and this increase is significant above the age of 60. Parameter beta tends to decrease when the opening angle theta increases.