Large diameter femoral heads impose significant alterations on the strains developed on femoral component and bone: a finite element analysis.

Total Hip Arthroplasty aims at fully recreating a functional hip joint. Over the past years modular implant systems have become common practice and are widely used, due to the surgical options they provide. In addition Big Femoral Heads have also been implemented in the process, providing more flexibility for the surgeon. The current study aims at investigating the effects that femoral heads of bigger diameter may impose on the mechanical behavior of the bone-implant assembly. Using data acquired by Computed Tomographies and a Coordinate Measurement Machine, a cadaveric femur and a Profemur-E modular stem were fully digitized, leading to a three dimensional finite element model in ANSYS Workbench. Strains and stresses were then calculated, focusing on areas of clinical interest, based on Gruen zones: the calcar and the corresponding below the greater trochanter area in the proximal femur, the stem tip region and a profile line along linea aspera. The performed finite elements analysis revealed that the use of large diameter heads produces significant changes in strain development within the bone volume, especially in the lateral side. The application of Frost's law in bone remodeling, validated the hypothesis that for all diameters normal bone growth occurs. However, in the calcar area lower strain values were recorded, when comparing with the reference model featuring a 28mm femoral head. Along line aspera and for the stem tip area, higher values were recorded. Finally, stresses calculated on the modular neck revealed increased values, but without reaching the yield strength of the titanium alloy used.

A pilot finite element study of an osteoporotic L1-vertebra compared to one with normal T-score.

In this paper, two patient-specific finite element (FE) models of both an L1 vertebra with a normal T-score and a mildly wedging, osteoporotic one were created and analysed under usual action. Utilising commercial software packages for image processing and FE analysis (FEA) along with in house computer codes for a posteriori assignment of material properties, in vivo high-resolution spiral computed tomography of the entire vertebrae and FEA were combined. Using the vertebra with a normal T-score as baseline it was found that the maximum value of the von Mises stress in the osteoporotic vertebra was 60% higher but still far below bone strength, while the maximum value of von Mises strain in the same vertebra was 148% higher than that of the vertebra with normal T-score. In the vertebra with normal T-score, 17% of its volume exhibited values of von Mises strain higher than the threshold of 4500 µstrains, referenced by Homminga et al. as a threshold of fracture risk, while in the osteoporotic one this percentage was raised up to 37%. The results suggested that the osteoporotic vertebra is susceptible to fracture due to raised strains and not stresses.

A finite element analysis of a T12 vertebra in two consecutive examinations to evaluate the progress of osteoporosis.

Osteoporosis is a metabolic disease that causes bones to become fragile and be more likely to break. As basic clinical examinations to detect osteoporosis, dual energy X-ray absorptiometry (DXA) and quantitative computer tomography (QCT) are used. In the framework of a typical clinical examination, QCT scans were obtained from the T12 vertebra of an elderly woman and osteoporosis was diagnosed. One year later, new QCT scans were obtained in order to evaluate her clinical condition. Using both sets as primary information, two patient-specific finite element (FE) models were created and analyzed under compressive load. Vertebral bone was treated as orthotropic material and its elastic modulus was set as an indirect function of Hounsfield Units (HU). Commercial software for medical image processing and FE analysis, along with in house codes, were used for the mechanical analysis of the FE models. Alterations in the geometry/shape of the vertebra as well as in the distributions of several mechanical quantities were detected between the two FE models. As far as the volume of the vertebra is concerned, it augmented by a percentage of 9.7% while the volume of the vertebral body alone increased by 5.6%. In all the maximum values of the mechanical quantities a measurable reduction was observed (axial compressive displacement: 37.9%, von Mises stress: 23.8%, von Mises strains: 15.1%) and all the investigated distributions in the second FE model became smoother. Finally, the percentage of volume with von Mises strains greater than 4500 microstrain dropped from 8.9%, in the first examination, to 4.9% in the second one. Clinically, the prescribed medication seems to have reinforced the structural stability of the vertebra as a whole and through external remodeling the shape of the vertebra changed in a way that the majority of its volume was relieved from stresses and strains of high magnitude.

Evaluation of craniofacial effects during rapid maxillary expansion through combined in vivo/in vitro and finite element studies.

It is well documented in the literature that a contracted maxilla is commonly associated with nasal obstruction. Midpalatal splitting using the rapid maxillary expansion (RME) technique produces separation of the maxillary halves with consequent widening of the nasal cavity. Although clinicians agree about many of the indications for and outcomes of RME, some disagreements persist in relation to the biomechanical effects induced. The present research was based on the parametric analysis of a finite element model (FEM) of a dry human skull with the RME appliance cemented in place in order to evaluate these effects on the overall craniofacial complex with different suture ossification. The behaviour of the FEM was compared with the findings of a clinical study and to an in vitro experiment of the same dry skull. Comparisons refer to the opening pattern and associated displacements of four anatomical points located at the left and right maxilla (MI, UM, EM, CN). It was found that the maxillolacrymal, the frontomaxillary, the nasomaxillary, the transverse midpalatal sutures, and the suture between the maxilla and pterygoid process of the sphenoid bone did not influence the outcome of RME, while the zygomatico-maxillary suture influenced the response of the craniofacial complex to the expansion forces. Moreover, the sagittal suture at the level of the frontal part of the midpalatal suture plays an important role in the degree and manner of maxillary separation. Maximum displacements were observed in the area of maxilla below the hard palate, from the central incisors to second premolars, which dissipated at the frontal and parietal bone and nullified at the occipital bone.

On the FEM modeling of craniofacial changes during rapid maxillary expansion.

This paper discusses several aspects related to the development of a reliable finite element model to simulate the craniofacial changes during rapid maxillary expansion treatment. The mechanical model concerns the entire human skull (bony structure and sutures) as well as the jackscrew device; the latter transforms the manual openings into orthodontic forces usually applied to the two maxillary halves through the first premolars and first permanent molars, which are the support points of the appliance. A sensitivity analysis of an approximate finite element model is performed in order to investigate the influence of the model size, the influence of the degree of sutural ossification by assigning different mechanical properties to the sutures and the influence of bone relaxation concerning the effects of dentofacial orthopaedics. Moreover, a more accurate model including the aforementioned teeth and their periodontal ligament as solid elastic structures was analysed in order to evaluate the orthodontic effects induced. Results refer to the opening pattern and associated stresses/displacements/strains on the cranium, the maxillae and the periodontal ligament.

In vitro validated finite element method model for a human skull and related craniofacial effects during rapid maxillary expansion.

This paper presents the biomechanical effects on the craniofacial complex during rapid maxillary expansions (RME), by using an in vitro experiment compared with a three-dimensional (3D) finite element model of a human skull. For this purpose, a dry human skull with artificially constructed teeth was used. In addition, a 3D finite element model including the craniofacial sutures was developed based on computed tomography (CT) scans. Initially, two types of models were analysed. In the first model, the total activation of the jackscrew device was applied in one step. In the second model, more steps were applied, taking into account the phenomenon of stress relaxation during RME treatment. Afterwards, a parametric analysis of the finite element method model was performed using three more models in order to evaluate the influence of craniofacial sutures. Both in vitro and finite element results refer to the openings of four critical points (MI, UM, EM, and CN) on the left and right maxilla. Results show that the maxillae open in a pyramidal shape and that the degree of sutures ossification influences the displacement distribution on the craniofacial complex much more than the phenomenon of stress relaxation. The areas of the maximum stresses and displacements were also determined.

A comparative FEM-study of tooth mobility using isotropic and anisotropic models of the periodontal ligament. Finite Element Method.

Orthodontic tooth movement is usually characterized by two centres: the centre of resistance and the centre of rotation. A literature survey shows that both centres vary to a significant extent in both clinical and computational experiments. This paper reports on studies upon five different hypothetical mechanical representations of the periodontal ligament (PDL) which plays the most significant role in tooth mobility. The first model considers the PDL as an isotropic and linear-elastic continuum without fibres; it also discusses some preliminary visco-elastic aspects. The next three models assume a nonlinear and anisotropic material composed of fibres only that are arranged in three different orientations, two hypothetical that have appeared previously in the literature and one more consistent with actual morphological data. The fifth model considers the PDL as an orthotropic material consisting of both a continuum and of fibres. Results were obtained by applying the Finite Element Method (FEM) on a maxillary central incisor. It was found that the isotropic linear-elastic PDL leads to occlusal positions of both centres in comparison with those obtained through the well-known Burstone's theoretical formula, while histological anisotropic fibres locate them apically and eccentrically.