Viscoelasticity of articular cartilage: Analysing the effect of induced stress and the restraint of bone in a dynamic environment.

The aim of this study was to determine the effect of the induced stress and restraint provided by the underlying bone on the frequency-dependent storage and loss stiffness (for bone restraint) or modulus (for induced stress) of articular cartilage, which characterise its viscoelasticity. Dynamic mechanical analysis has been used to determine the frequency-dependent viscoelastic properties of bovine femoral and humeral head articular cartilage. A sinusoidal load was applied to the specimens and out-of-phase displacement response was measured to determine the phase angle, the storage and loss stiffness or modulus. As induced stress increased, the storage modulus significantly increased (p < 0.05). The phase angle decreased significantly (p < 0.05) as the induced stress increased; reducing from 13.1° to 3.5°. The median storage stiffness ranged from 548N/mm to 707N/mm for cartilage tested on-bone and 544N/mm to 732N/mm for cartilage tested off-bone. On-bone articular cartilage loss stiffness was frequency independent (p > 0.05); however, off-bone, articular cartilage loss stiffness demonstrated a logarithmic frequency-dependency (p < 0.05). In conclusion, the frequency-dependent trends of storage and loss moduli of articular cartilage are dependent on the induced stress, while the restraint provided by the underlying bone removes the frequency-dependency of the loss stiffness.

Biotransformation of Silver Released from Nanoparticle Coated Titanium Implants Revealed in Regenerating Bone.

Antimicrobial silver nanoparticle coatings have attracted interest for reducing prosthetic joint infection. However, few studies report in vivo investigations of the biotransformation of silver nanoparticles within the regenerating tissue and its impact on bone formation. We present a longitudinal investigation of the osseointegration of silver nanoparticle-coated additive manufactured titanium implants in rat tibial defects. Correlative imaging at different time points using nanoscale secondary ion mass spectrometry, transmission electron microscopy (TEM), histomorphometry, and 3D X-ray microcomputed tomography provided quantitative insight from the nano- to macroscales. The quality and quantity of newly formed bone is comparable between the uncoated and silver coated implants. The newly formed bone demonstrates a trabecular morphology with bone being located at the implant surface, and at a distance, at two weeks. Nanoscale elemental mapping of the bone-implant interface showed that silver was present primarily in the osseous tissue and colocalized with sulfur. TEM revealed silver sulfide nanoparticles in the newly regenerated bone, presenting strong evidence that the previously in vitro observed biotransformation of silver to silver sulfide occurs in vivo.

Effect of accelerated aging on the viscoelastic properties of a medical grade silicone.

The viscoelastic properties of cylinders (diameter 5 mm, height 2.2 ± 0.2 mm) of Nagor silicone elastomer of medium hardness, were investigated before and after the specimens had undergone accelerated aging in saline solution at 70°C for 38, 76 and 114 days (to simulate aging at 37°C, for 1, 2 and 3 years, respectively). All sets of specimens were immersed in physiological saline solution at 37°C during testing and the properties were measured using dynamic mechanical analysis (DMA). A sinusoidal cyclic compression of 40 N ± 5 N was applied over a frequency range, f, of 0.02-25 Hz. Values of the storage, E', and loss, E″, moduli were found to depend on f; the dependence of E' or E″ on the logarithm (base 10) of f was represented by a second-order polynomial. After accelerated aging, the E' and E″ values did not increase significantly (p<0.05). Furthermore, scanning electron microscopy (SEM) showed that accelerated aging did not affect the surface morphology of silicone. Attenuated total reflectance Fourier transform infra-red spectroscopy (ATR-FTIR) showed that accelerated aging had a negligible effect on the surface chemical structures of the material. Differential scanning calorimetry (DSC) showed no changes to the bulk properties of silicone, following accelerated aging.

Assessment of non-contacting optical methods to measure wear and surface roughness in ceramic total disc replacements.

This study presents a method for measuring the low volumetric wear expected in ceramic total disc replacements, which can be used to replace intervertebral discs in the spine, using non-contacting optical methods. Alumina-on-alumina ball-on-disc tests were conducted with test conditions approximating those of cervical (neck region of the spine) total disc replacement wear tests. The samples were then scanned using a three-dimensional non-contacting optical profilometer and the data used to measure surface roughness and develop a method for measuring the wear volume. The results showed that the magnification of the optical lens affected the accuracy of both the surface roughness and wear volume measurements. The method was able to successfully measure wear volumes of 0.0001 mm(3), which corresponds to a mass of 0.0001 mg, which would have been undetectable using the gravimetric method. A further advantage of this method is that with one scan the user can measure changes in surface topography, volumetric wear and the location of the wear on the implant surface. This method could also be applied to more severe wear, other types of orthopaedic implants and different materials.

Wear of the Charité® lumbar intervertebral disc replacement investigated using an electro-mechanical spine simulator.

The Charité(®) lumbar intervertebral disc replacement was subjected to wear testing in an electro-mechanical spine simulator. Sinusoidally varying compression (0.6-2 kN, frequency 2 Hz), rotation (±2°, frequency 1 Hz), flexion-extension (6° to -3°, frequency 1 Hz) and lateral bending (±2°, frequency 1 Hz) were applied out of phase to specimens immersed in diluted calf serum at 37 °C. The mass of the ultra-high-molecular weight polyethylene component of the device was measured at intervals of 0.5, 1, 2, 3, 4 and 5 million cycles; its volume was also measured by micro-computed tomography. Total mass and volume losses were 60.3 ± 4.6 mg (mean ± standard deviation) and 64.6 ± 6.0 mm(3). Corresponding wear rates were 12.0 ± 1.4 mg per million cycles and 12.8 ± 1.2 mm(3) per million cycles; the rate of loss of volume corresponds to a mass loss of 11.9 ± 1.1 mg per million cycles, that is, the two sets of measurements of wear agree closely. Wear rates also agree closely with measurements made in another laboratory using the same protocol but using a conventional mechanical spine simulator.

Feasibility of using mixtures of silicone elastomers and silicone oils to model the mechanical behaviour of biological tissues.

Mixtures of silicone elastomer and silicone oil were prepared and the values of their Young's moduli, E, determined in compression. The mixtures had volume fractions, [Formula: see text], of silicone oil in the range of 0-0.73. Measurements were made, under displacement control, for strain rates, [Formula: see text], in the range of 0.04-3.85 s(-1). The behaviour of [Formula: see text] as a function of [Formula: see text] and [Formula: see text] was investigated using a response surface model. The effects of the two variables were independent for the silicones used in this investigation. As a result, the dependence of E values (measured in MPa) on [Formula: see text] and [Formula: see text] (s(-1)) could be represented by [Formula: see text]. This means that these silicones can be mixed to give materials with E values in the range of about 0.02-0.57 MPa, which includes E values for many biological tissues. Thus, the mixtures can be used for making models for training health-care professionals and may be useful in some research applications as model tissues that do not exhibit biological variability.

Viscoelastic properties of bovine knee joint articular cartilage: dependency on thickness and loading frequency.

BACKGROUND: The knee is an incongruent joint predisposed to developing osteoarthritis, with certain regions being more at risk of cartilage degeneration even in non-osteoarthrosed joints.At present it is unknown if knee regions prone to cartilage degeneration have similar storage and/or loss stiffness, and frequency-dependent trends, to other knee joint cartilage. The aim of this study was to determine the range of frequency-dependent, viscoelastic stiffness of articular cartilage across the bovine knee joint. Such changes were determined at frequencies associated with normal and rapid heel-strike rise times. METHODS: Cartilage on bone, obtained from bovine knee joints, was tested using dynamic mechanical analysis (DMA). DMA was performed at a range of frequencies between 1 and 88 Hz (i.e. relevant to normal and rapid heel-strike rise times). Viscoelastic stiffness of cartilage from the tibial plateau, femoral condyles and patellar groove were compared. RESULTS: For all samples the storage stiffness increased, but the loss stiffness remained constant, with frequency. They were also dependent on cartilage thickness. Both the loss stiffness and the storage stiffness decreased with cartilage thickness. Femoral condyles had the thinnest cartilage but had the highest storage and loss stiffness. Tibial plateau cartilage not covered by the meniscus had the thickest cartilage and lowest storage and loss stiffness. CONCLUSION: Differences in regional thickness of knee joint cartilage correspond to altered frequency-dependent, viscoelastic stiffness.

Evaluation of a transient, simultaneous, arbitrary Lagrange-Euler based multi-physics method for simulating the mitral heart valve.

A transient multi-physics model of the mitral heart valve has been developed, which allows simultaneous calculation of fluid flow and structural deformation. A recently developed contact method has been applied to enable simulation of systole (the stage when blood pressure is elevated within the heart to pump blood to the body). The geometry was simplified to represent the mitral valve within the heart walls in two dimensions. Only the mitral valve undergoes deformation. A moving arbitrary Lagrange-Euler mesh is used to allow true fluid-structure interaction (FSI). The FSI model requires blood flow to induce valve closure by inducing strains in the region of 10-20%. Model predictions were found to be consistent with existing literature and will undergo further development.

Effect of lubricants on friction in laboratory tests of a total disc replacement device.

Some designs of total disc replacement devices have articulating bearing surfaces, and these devices are tested in vitro with a lubricant of diluted calf serum. It is believed that the lubricant found in total disc replacement devices in vivo is interstitial fluid that may have properties between that in Ringer's solution and diluted calf serum. To investigate the effect of lubricants, a set of friction tests were performed on a generic model of a metal against metal ball-and-socket total disc replacement device. Two devices were tested: one with a ball radius of 10 mm and other with a ball radius of 16 mm; each device had a radial clearance of 0.015 mm. A spine simulator was used to measure frictional torque for each device in axial rotation, flexion-extension and lateral bending at frequencies of 0.25-2 Hz, under 1200 N axial load. Each device was tested with two different lubricants: a solution of new born calf serum diluted with deionised water and Ringer's solution. The results showed that the frictional torque generated between the bearing surfaces was significantly higher in Ringer's solution than in diluted calf serum. The use of Ringer's solution as a lubricant provides a stringent test condition to detect possible problems. Diluted calf serum is more likely to provide an environment closer to that in vivo. However, the precise properties of the fluid lubricating a total disc replacement device are not known; hence, tests using diluted calf serum may not necessarily give the same results as those obtained in vivo.

In vitro investigation of friction at the interface between bone and a surgical instrument.

This study investigated the friction between surgical instruments and bone to aid improvements to instrument design. The bases of orthopaedic surgical instruments are usually made of metal, especially stainless steel. Silicone elastomer was chosen as an alternate biocompatible material, which would be compliant on the bone surface when used as the base of an instrument. The coefficient of static friction was calculated at the bone/material interface in the presence of a synthetic solution that had a comparable viscosity to that of blood, to assess the friction provided by each base material. Three types of silicone elastomers with different hardnesses (Shore A hardness 23, 50 and 77) and three distinct stainless steel surfaces (obtained by spark erosion, sand blasting and surface grinding) were used to assess the friction provided by the materials on slippery bone. The bone specimens were taken from the flattest region of the femoral shaft of a bovine femur; the outer surfaces of the specimens were kept intact. In general, the stainless steel surfaces exhibited higher values of coefficient of static friction, compared to the silicone elastomer samples. The stainless steel surface finished by spark erosion (surface roughness Ra = 8.9 ± 1.6 µm) had the highest coefficient value of 0.74 ± 0.04. The coefficient values for the silicone elastomer sample with the highest hardness (Dow Corning Silastic Q7-4780, Shore A hardness 77) was not significantly different to values provided by the stainless steel surface finished by sand blasting (surface roughness Ra = 2.2 ± 0.1 µm) or surface grinding (surface roughness Ra = 0.1 ± 0.0 µm). Based on the results of this study, it is concluded that silicone could be a potentially useful material for the design of bases of orthopaedic instruments that interface with bone.

Wear in metal-on-metal total disc arthroplasty.

The wear of a model metal-on-metal ball-and-socket total disc arthroplasty was measured in a simulator. The ball had a radius of 10 mm, and there was a radial clearance between ball and socket of 0.015 mm. The model was subjected to simultaneous flexion-extension, lateral bending, axial rotation (frequency: 1 Hz) and compression (frequency: 2 Hz, maximum load: 2 kN). Throughout the tests, the models were immersed in calf serum diluted to a concentration of 15 g protein per litre, at a controlled temperature of 37 °C. Tests were performed on three models. At regular intervals (0, 0.5, 1, 2, 3, 4 and 5 million cycles), mass and surface roughness were determined; mass measurements were converted into the volume lost as a result of wear. All measurements were repeated six times. Wear occurred in two stages. In the first stage (duration about 1 million cycles), there was a linear wear rate of 2.01 ± 0.04 mm(3) per million cycles; in the second stage, there was a linear wear rate of 0.76 ± 0.02 mm(3) per million cycles. Surface roughness increased linearly in the first million cycles and then continued to increase linearly but more slowly.

Applicability of sheep and pig models for cancellous bone in human vertebral bodies.

The mineral content of cancellous bone from sheep and pig vertebral bodies was determined by ashing at 800 degrees C. The results were compared with published results for human vertebral cancellous bone. The results for sheep (0.37 +/- 0.06 gcm(-3), mean +/- standard deviation) were not significantly different (p = 0.127) to those from pigs (0.33 +/- 0.03 gcm(-3)). The results from both species were significantly higher (p < 0.001) than those from human bones (0.15 +/- 0.02 gcm(-3)). This means that cancellous bone from sheep and pig vertebral bodies is not a good model for corresponding human bone. However, sheep and pig bone are useful, for example, for providing stringent tests of cutting instruments to be used in human spinal surgery.

Biomechanical assessment of surgical repair of the mitral valve.

Repair of the mitral valve is defined (loosely) as a procedure that alters the valve structure, without replacement, enabling the natural valve itself to continue to perform under the physical conditions to which it is exposed. As the mitral valve is driven by flow and pressure, it should be feasible to analyse and assess its function, failure and repair as a mechanical system. This article reviews the current state of mechanical evaluation of surgical repairs of the failed mitral valve of the heart. This review describes the anatomy and physiology of the mitral valve, followed by the failure of the mitral valve from a mechanical point of view. The surgical methods used to repair failed valves are introduced, while the use of engineering analysis to aid understanding of mitral valve repair is also reviewed. Finally, a section on recommendations for development and future uses of engineering techniques to surgical repair are presented.

Polymer-on-metal or metal-on-polymer total disc arthroplasty: does it make a difference?

STUDY DESIGN: Mechanical testing of total disc arthroplasty (TDA). OBJECTIVE: To compare the friction between a polymer socket-on-metal ball and metal socket-on-polymer ball TDA. SUMMARY OF BACKGROUND DATA: A degenerate intervertebral disc can be replaced by TDA. The most common designs have a ball and socket articulation; the contact between the surfaces leads to friction. Friction needs to be minimized to prevent loosening and wear. One of the common material combinations in disc arthroplasty devices is the articulation of a metal socket on polymer ball. However, the combination of a polymer socket on metal ball (which is used in hip arthroplasty) has not been investigated for TDA. METHODS: TDA models with either a polymer socket/metal ball or a metal socket/polymer ball were manufactured with ball radii of 10 and 14 mm, each with a radial clearance of 0.35 mm. Samples were tested using a spine simulator with a lubricant of diluted newborn calf serum. Each sample was subjected to an axial load of 1200 N; motions of flexion-extension, lateral bending, and axial rotation were then applied at frequencies of 0.25 to 2 Hz. Frictional torque was measured to compare the performance of the TDAs. RESULTS: The frictional torque was found to be significantly higher for a disc with a metal socket/polymer ball than for a disc with a polymer socket/metal ball for both 10 and 14 mm radii in axial rotation, lateral bend, and extension. The frictional torque in flexion (0°-6°) was not found to be significantly different between the 2 different material combinations. However, when the flexion motion was reduced to 0° to 2°, frictional torque in the metal socket/polymer ball was found to be significantly higher than the polymer socket/metal ball. CONCLUSION: TDA with a combination of a polymer socket/metal ball has lower friction than the conventional TDA with metal socket/polymer ball. This conclusion has implications in the design of TDA.

Effect of axial load on the flexural properties of an elastomeric total disc replacement.

STUDY DESIGN: Twelve Cadisc-L devices were subjected to flexion (0°-6°) and extension (0° to -3°) motions at compressive loads between 500 N and 2000 N at a flexural rate between 0.25°/s and 3.0°/s. OBJECTIVE: To quantify the change in flexural properties of the Cadisc-L (elastomeric device), when subjected to increasing magnitudes of axial load and at different flexural rates. SUMMARY OF BACKGROUND DATA: The design of motion preservation devices, used to replace degenerated intervertebral discs, is commonly based on a low-friction, ball-and-socket-articulating joint. Recently, elastomeric implants have been developed that attempt to provide mechanical and motion properties that resemble those of the natural disc more closely. METHODS: Twelve Cadisc-L devices (MC-10 mm-9° and MC-10 mm-12° size) were supplied by Ranier Technology Ltd (Cambridge, United Kingdom). The devices were hydrated and tested using a Bose spinal disc-testing machine (Bose Corporation, ElectroForce Systems Group, Eden Prairie, MN) in Ringer's solution at 37°C. A static load of 500 N was applied to a device and it was then subjected to motions of 0° to 6° to 0° (flexion) and 0° to -3° to 0° (extension) at a flexural rate of 0.25°/s, 0.5°/s, 1.0°/s, 1.5°/s, 2.0°/s, and 3.0°/s. Tests were repeated at 1000 N, 1500 N, and 2000 N. RESULTS: Regression analyses showed a significant (R > 0.99, P < 0.05) linear increase in bending moment and flexural stiffness with flexion and extension angles (at 1000 N and higher loads)-a significant (R > 0.994, P < 0.05) linear decrease in flexural stiffness in flexion and extension as flexural rate increased. CONCLUSION: The bending moment of the Cadisc-L increased linearly with flexion and extension angles at 1000 N and higher loads. Flexural stiffness increased with compressive load but decreased with flexural rate.

Friction in metal-on-metal total disc arthroplasty: effect of ball radius.

Total disc arthroplasty (TDA) can be used to replace a degenerated intervertebral disc in the spine. There are different designs of prosthetic discs, but one of the most common is a ball-and-socket combination. Contact between the bearing surfaces can result in high frictional torque, which can then result in wear and implant loosening. This study was designed to determine the effects of ball radius on friction. Generic models of metal-on-metal TDA were manufactured with ball radii of 10, 12, 14 and 16 mm, with a radial clearance of 0.015 mm. A simulator was used to test each sample in flexion-extension, lateral bending and axial rotation at frequencies of 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75 and 2 Hz under loads of 50, 600, 1200 and 2000 N, in new born calf serum. Frictional torque was measured and Stribeck curves were plotted to illustrate the lubrication regime in each case. It was observed that implants with a smaller ball radius showed lower friction and showed boundary and mixed lubrication regimes, whereas implants with larger ball radius showed boundary lubrication only. This study suggests designing metal-on-metal TDAs with ball radius of 10 or 12 mm, in order to reduce wear and implant loosening.

Effect of calcium alginate concentration on viability and proliferation of encapsulated fibroblasts.

Alginate hydrogels have been used widely in tissue engineering for cell encapsulation for several reasons: low toxicity, the ability to gel under gentle condition and compatibility with cells. In this study, we determined the effect of different concentrations of alginate on encapsulation of 3T3 fibroblast cells at two different cell seeding densities. Live/dead staining and MTT assay were performed at regular intervals up to 4 weeks. A Hoechst 33258 assay was done to validate the MTT results. There were more dead cells on day 1 for the higher concentrations of alginate while at, the lower concentration of alginate, cell proliferation and spheroid formation occurred more quickly. Furthermore, at low cell seeding density, cell proliferation was prolonged compared to the intermediate seeding density. In conclusion, by altering both alginate concentration and cell seeding density, proliferation and spheroid formation can be controlled.

The effect of screw insertion angle and thread type on the pullout strength of bone screws in normal and osteoporotic cancellous bone models.

Screw fixation can be extremely difficult to achieve in osteoporotic (OP) bone because of its low strength. This study determined how pullout strength is affected by placing different bone screws at varying angles in normal and OP bone models. Pullout tests of screws placed axially, and at angles to the pullout axis (ranging from 10° to 40°), were performed in 0.09 g cm(-3), 0.16 g cm(-3) and 0.32 g cm(-3) polyurethane (PU) foam. Two different titanium alloy bone screws were used to test for any effect of thread type (i.e. cancellous or cortical) on the screw pullout strength. The cancellous screw required a significantly higher pullout force than the cortical screw (p<0.05). For both screws, pullout strength significantly increased with increasing PU foam density (p<0.05). For screws placed axially, and sometimes at 10°, the observed mechanism of failure was stripping of the internal screw threads generated within the PU foam by screw insertion. For screws inserted at 10°, 20°, 30° and 40°, the resistance to pullout force was observed to be by compression of the PU foam material above the angled screw; clinically, this suggests that compressed OP bone is stronger than unloaded OP bone.

Swelling of medical grade silicones in liquids and calculation of their cross-link densities.

Four medical grade silicones were swollen, until they reached equilibrium (i.e. constant mass) in eight liquids at 25 degrees C. The greatest swelling was obtained with n-heptane but the volume fraction, varphi, of the silicones in their swollen state was not significantly different (p<0.05) in this liquid than in cyclohexane. For each grade of silicone, varphi was plotted against delta(l), the liquid solubility parameter, for each liquid in which it was swollen. A second-order polynomial was plotted through the results; the minimum in this polynomial provided a value for the polymer solubility parameter, delta(p). The Flory polymer-liquid interaction parameter, chi, was calculated for the four best liquids, using Hildebrand's solubility parameter theory. An alternative method for calculating chi, directly from swelling measurements, was shown to produce physically unreasonable results. The cross-link density, upsilon, was calculated, from varphi and chi, for each grade of silicone, using the Flory-Rehner equation. Since the values of two parameters involved in Hildebrand's theory cannot be determined reliably and because the Flory-Rehner equation is an approximation, absolute values of upsilon cannot be obtained. However, the relative values of upsilon obtained were higher for the harder grades then for the softer grades and similarly, the grades with the higher Young's modulus had higher upsilon values.

Viscoelastic properties of bovine articular cartilage attached to subchondral bone at high frequencies.

BACKGROUND: Articular cartilage is a viscoelastic material, but its exact behaviour under the full range of physiological loading frequencies is unknown. The objective of this study was to measure the viscoelastic properties of bovine articular cartilage at loading frequencies of up to 92 Hz. METHODS: Intact tibial plateau cartilage, attached to subchondral bone, was investigated by dynamic mechanical analysis (DMA). A sinusoidally varying compressive force of between 16 N and 36 N, at frequencies from 1 Hz to 92 Hz, was applied to the cartilage surface by a flat indenter. The storage modulus, loss modulus and phase angle (between the applied force and the deformation induced) were determined. RESULTS: The storage modulus, E', increased with increasing frequency, but at higher frequencies it tended towards a constant value. Its dependence on frequency, f, could be represented by, E' = Alog(e) (f) + B where A = 2.5 +/- 0.6 MPa and B = 50.1 +/- 12.5 MPa (mean +/- standard error). The values of the loss modulus (4.8 +/- 1.0 MPa mean +/- standard deviation) were much less than the values of storage modulus and showed no dependence on frequency. The phase angle was found to be non-zero for all frequencies tested (4.9 +/- 0.6 degrees ). CONCLUSION: Articular cartilage is viscoelastic throughout the full range of frequencies investigated. The behaviour has implications for mechanical damage to articular cartilage and the onset of osteoarthritis. Storage modulus increases with frequency, until the plateau region is reached, and has a higher value than loss modulus. Furthermore, loss modulus does not increase with loading frequency. This means that more energy is stored by the tissue than is dissipated and that this effect is greater at higher frequencies. The main mechanism for this excess energy to be dissipated is by the formation of cracks.