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1.
Int J Mol Sci ; 24(7)2023 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-37047494

RESUMO

A better understanding of molecular events following cartilage injury is required to develop treatments that prevent or delay the onset of trauma-induced osteoarthritis. In this study, alterations to SIRT1 activity in bovine articular cartilage explants were evaluated in the 24 h following a mechanical overload, and the effect of pharmacological SIRT1 activator SRT1720 on acute chondrocyte injury was assessed. SIRT1 enzymatic activity decreased as early as 5 min following the mechanical overload, and remained suppressed for at least 24 h. The chondrocyte injury response, including apoptosis, oxidative stress, secretion of inflammatory mediators, and alterations in cartilage matrix expression, was prevented with pharmacological activation of SIRT1 in a dose-dependent manner. Overall, the results implicate SIRT1 deactivation as a key molecular event in chondrocyte injury following a mechanical impact overload. As decreased SIRT1 signaling is associated with advanced age, these findings suggest that downregulated SIRT1 activity may be common to both age-related and injury-induced osteoarthritis.


Assuntos
Cartilagem Articular , Doenças Musculoesqueléticas , Osteoartrite , Animais , Bovinos , Condrócitos/metabolismo , Sirtuína 1/genética , Sirtuína 1/metabolismo , Cartilagem Articular/metabolismo , Apoptose , Osteoartrite/etiologia , Osteoartrite/metabolismo , Doenças Musculoesqueléticas/metabolismo
2.
J Mech Behav Biomed Mater ; 142: 105827, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37060715

RESUMO

Healthy articular cartilage exhibits remarkable resistance to wear, sustaining mechanical loads and relative motion for decades. However, tissues that replace or repair cartilage defects are much less long lasting. Better information on the compositional and material characteristics that contribute to the wear resistance of healthy cartilage could help guide strategies to replace and repair degenerated tissue. The main objective of this study was to assess the relationship between wear of healthy articular cartilage, its biochemical composition, and its viscoelastic material properties. The correlation of these factors with the coefficient of friction during the wear test was also evaluated. Viscoelastic properties of healthy bovine cartilage were determined via stress relaxation indentation. The same specimens underwent an accelerated, in vitro wear test, and the amount of glycosaminoglycans (GAGs) and collagen released during the wear test were considered measures of wear. The frictional response during the wear test was also recorded. The GAG, collagen and water content and the concentration of the enzymatic collagen crosslink pyridinoline were quantified in tissue that was adjacent to each wear test specimen. Finally, correlation analysis was performed to identify potential relationships between wear characteristics of healthy articular cartilage with its composition, viscoelastic material properties and friction. The findings suggest that stiffer cartilage with higher GAG, collagen and water content has a higher wear resistance. Enzymatic collagen crosslinks also enhance the wear resistance of the collagen network. The parameters of wear, composition, and mechanical stiffness of cartilage were all correlated with one another, suggesting that they are interrelated. However, friction was largely independent of these in this study. The results identify characteristics of healthy articular cartilage that contribute to its remarkable wear resistance. These data may be useful for guiding techniques to restore, regenerate, and stabilize cartilage tissue.


Assuntos
Cartilagem Articular , Animais , Bovinos , Fricção , Cartilagem Articular/fisiologia , Glicosaminoglicanos/análise , Colágeno/análise , Água , Estresse Mecânico
3.
Global Spine J ; 13(8): 2336-2344, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35225035

RESUMO

STUDY DESIGN: Finite element (FE) study. OBJECTIVE: Pedicle subtraction osteotomy (PSO) is a surgical method to correct sagittal plane deformities. In this study, we aimed to investigate the biomechanical effects of lumbar disc degeneration on the instrumentation following PSO and assess the effects of using interbody spacers adjacent to the PSO level in a long instrumented spinal construct. METHODS: A spinopelvic model (T10-pelvis) with PSO at the L3 level was used to generate 3 different simplified grades of degenerated lumbar discs (mild (Pfirrmann grade III), moderate (Pfirrmann grade IV), and severe (Pfirrmann grade V)). Instrumentation included eighteen pedicle screws and bilateral primary rods. To investigate the effect of interbody spacers, the model with normal disc height was modified to accommodate 2 interbody spacers adjacent to the PSO level through a lateral approach. For the models, the rods' stress distribution, PSO site force values, and the spine range of motion (ROM) were recorded. RESULTS: The mildly, moderately, and severely degenerated models indicated approximately 10%, 26%, and 40% decrease in flexion/extension motion, respectively. Supplementing the instrumented spinopelvic PSO model using interbody spacers reduced the ROM by 22%, 21%, 4%, and 11% in flexion, extension, lateral bending, and axial rotation, respectively. The FE results illustrated lower von Mises stress on the rods and higher forces at the PSO site at higher degeneration grades and while using the interbody spacers. CONCLUSIONS: Larger and less degenerated discs adjacent to the PSO site may warrant consideration for interbody cage instrumentation to decrease the risk of rod fracture and PSO site non-union.

4.
Cartilage ; 13(3): 19476035221093064, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35819016

RESUMO

OBJECTIVE: The objective of this study was to evaluate photochemical crosslinking using Al(III) phthalocyanine chloride tetrasulfonic acid (CASPc) and light with a wavelength of 670 nm as a potential therapy to strengthen articular cartilage and prevent tissue degradation. DESIGN: Changes in viscoelastic properties with indentation were used to identify 2 crosslinking protocols for further testing. Crosslinked cartilage was subjected to an in vitro, accelerated wear test. The ability of the crosslinked tissue to resist biochemical degradation via collagenase was also measured. To better understand how photochemical crosslinking with CASPc varies through the depth of the tissue, the distribution of photo-initiator and penetration of light through the tissue depth was characterized. Finally, the effect of CASPc on chondrocyte viability and of co-treatment with an antioxidant was evaluated. RESULTS: The equilibrium modulus was the most sensitive viscoelastic measure of crosslinking. Crosslinking decreased both mechanical wear and collagenase digestion compared with control cartilage. These beneficial effects were realized despite the fact that crosslinking appeared to be localized to a region near the articular surface. In addition, chondrocyte viability was maintained in crosslinked tissue treated with antioxidants. CONCLUSION: These results suggest that photochemical crosslinking with CASPc and 670 nm light holds promise as a potential therapy to prevent cartilage degeneration by protecting cartilage from mechanical wear and biochemical degradation. Limitations were also evident, however, as an antioxidant treatment was necessary to maintain chondrocyte viability in crosslinked tissue.


Assuntos
Cartilagem Articular , Antioxidantes , Cartilagem Articular/metabolismo , Condrócitos/metabolismo , Colagenases/metabolismo , Colagenases/farmacologia
5.
Hip Int ; 32(3): 298-303, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-32865039

RESUMO

BACKGROUND: The use of total hip arthroplasty (THA) femoral stems that transmit force in a favourable manner to the femur may minimise periprosthetic fractures. Finite element analysis (FEA) is a computerised method that analyses the effect of forces applied to a structure with complex shape. Our aim was to apply FEA to compare primary THA cementless stem designs and their association with periprosthetic fracture risk. METHODS: 3-dimensional (3D) models of a Dorr Type A femur and 5 commonly used primary THA cementless stem designs (short single wedge, standard-length single wedge, modular, double-wedge metaphyseal filling, and cylindrical fully coated) were developed using computed tomography (CT) imaging. Implant insertion, single-leg stance, and twisting with a planted foot were simulated. FEA was performed, and maximum femoral strain along the implant-bone interface recorded. RESULTS: Femoral strain was highest with short single-wedge stem design (0.3850) and lowest with standard-length single-wedge design (0.0520). Location of maximum femoral strain varied by stem design, but not with implant insertion, single-leg stance, or twisting with a planted foot. Strain was as high during implant insertion as with single-leg stance or twisting with a planted foot. CONCLUSIONS: Our results suggest the risk of intraoperative and postoperative periprosthetic fracture with THA in a Dorr A femur is highest with short single-wedge stems and lowest with standard-length single-wedge stems. Consideration may be given to minimising the use of short single-wedge stems in THA. Implant-specific sites of highest strain should be carefully inspected for fracture.


Assuntos
Artroplastia de Quadril , Fraturas do Fêmur , Prótese de Quadril , Fraturas Periprotéticas , Artroplastia de Quadril/efeitos adversos , Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/etiologia , Fraturas do Fêmur/cirurgia , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Análise de Elementos Finitos , Humanos , Fraturas Periprotéticas/diagnóstico por imagem , Fraturas Periprotéticas/etiologia , Fraturas Periprotéticas/cirurgia , Desenho de Prótese , Estudos Retrospectivos
6.
Global Spine J ; 12(7): 1495-1502, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33517788

RESUMO

STUDY DESIGN: To evaluate the mechanical effectiveness of "tuning fork" plate fixation system by comparing with dual iliac screw fixation under different spinal motion through finite element analysis (FEA). OBJECTIVE: Lumbosacral deficiencies occur from birth defects or following destruction by tumors. The objective of this study was to evaluate the mechanical effectiveness of the tuning fork plate compared to dual iliac screw system which is the gold standard fixation in treating lumbosacral deficiencies. This is an innovative fixation device for treating lumbosacral deficiencies. METHODS: The deficiency model was prepared using a previously developed and validated finite element T10-pelvis model. To create the lumbo-sacral deficiency the segments between L3 and sacrum were removed from the model. The model was then instrumented from T10 to L2 segments and the ilium using either the tuning fork plate or a dual iliac screw construct. With the ilium fixed, the T10 vertebrae was subjected to 10 Nm moment and 400 N follower load to simulate spinal motions. Range of motion (ROM) of spine and stresses on the instrumentation were calculated for 2 fixation devices and compared with each other. RESULTS: The 2 fixation systems demonstrate a comparable motion reduction in all loading modes. Stress values were higher in the dual iliac screw constructs compared with the tuning fork plate fixation system. The factor of safety of the tuning fork plate device was higher than the dual iliac screw fixation by 50%. CONCLUSIONS: Both fixation devices had similar performance in motion reduction at spine levels. However, based on predicted implant stresses there were less chances of implant failure in the fork plate fixation, compared to the dual iliac screw system.

7.
J Neurosurg Spine ; 36(6): 928-936, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34952510

RESUMO

OBJECTIVE: Low fusion rates and cage subsidence are limitations of lumbar fixation with stand-alone interbody cages. Various approaches to interbody cage placement exist, yet the need for supplemental posterior fixation is not clear from clinical studies. Therefore, as prospective clinical studies are lacking, a comparison of segmental kinematics, cage properties, and load sharing on vertebral endplates is needed. This laboratory investigation evaluates the mechanical stability and biomechanical properties of various interbody fixation techniques by performing cadaveric and finite element (FE) modeling studies. METHODS: An in vitro experiment using 7 fresh-frozen human cadavers was designed to test intact spines with 1) stand-alone lateral interbody cage constructs (lateral interbody fusion, LIF) and 2) LIF supplemented with posterior pedicle screw-rod fixation (360° constructs). FE and kinematic data were used to validate a ligamentous FE model of the lumbopelvic spine. The validated model was then used to evaluate the stability of stand-alone LIF, transforaminal lumbar interbody fusion (TLIF), and anterior lumbar interbody fusion (ALIF) cages with and without supplemental posterior fixation at the L4-5 level. The FE models of intact and instrumented cases were subjected to a 400-N compressive preload followed by an 8-Nm bending moment to simulate physiological flexion, extension, bending, and axial rotation. Segmental kinematics and load sharing at the inferior endplate were compared. RESULTS: The FE kinematic predictions were consistent with cadaveric data. The range of motion (ROM) in LIF was significantly lower than intact spines for both stand-alone and 360° constructs. The calculated reduction in motion with respect to intact spines for stand-alone constructs ranged from 43% to 66% for TLIF, 67%-82% for LIF, and 69%-86% for ALIF in flexion, extension, lateral bending, and axial rotation. In flexion and extension, the maximum reduction in motion was 70% for ALIF versus 81% in LIF for stand-alone cases. When supplemented with posterior fixation, the corresponding reduction in ROM was 76%-87% for TLIF, 86%-91% for LIF, and 90%-92% for ALIF. The addition of posterior instrumentation resulted in a significant reduction in peak stress at the superior endplate of the inferior segment in all scenarios. CONCLUSIONS: Stand-alone ALIF and LIF cages are most effective in providing stability in lateral bending and axial rotation and less so in flexion and extension. Supplemental posterior instrumentation improves stability for all interbody techniques. Comparative clinical data are needed to further define the indications for stand-alone cages in lumbar fusion surgery.

8.
Eur Spine J ; 30(8): 2351-2359, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34023965

RESUMO

PURPOSE: This study's objective was to assess biomechanical parameters across fused and contralateral sacroiliac joints (SIJs) and implants during all spinal motions for both sexes. Various SIJ implant devices on the market are used in minimally invasive surgeries. These implants are placed across the joint using different surgical approaches. The biomechanical effects of fusion surgical techniques in males and females have not been studied. METHODS: The validated finite element models of a male, and a female spine-pelvis-femur were unilaterally instrumented across the SIJ using three screws for two SIJ implants, half threaded and fully threaded screws placed laterally and posteriorly to the joint, respectively. RESULTS: Motion and peak stress data at the SIJs showed that the female model exhibited lower stresses and higher reduction in motion at the contralateral SIJ in all motions than the male model predictions with 84% and 71% reductions in motion and stresses across the SIJ. CONCLUSION: Implants exhibited higher stresses in the female model compared to the male model. However, chances of SIJ implant failure in the female patients are still minimal, based on the calculated factor of safety which is still very high. Both lateral and posterior surgical approaches were effective in both sexes; however, the lateral approach may provide a better biomechanical response, especially for females. Moreover, implant design characteristics did not make a difference in the implants' biomechanical performance. SIJ stabilization was primarily provided by the implants which were the farthest from the sacrum rotation center.


Assuntos
Dor Lombar , Articulação Sacroilíaca , Fenômenos Biomecânicos , Feminino , Análise de Elementos Finitos , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos , Próteses e Implantes , Articulação Sacroilíaca/cirurgia
9.
Int J Spine Surg ; 14(3): 355-367, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32699758

RESUMO

BACKGROUND: Fixation is one of the most common surgical techniques for the treatment of chronic pain originating from the sacroiliac joint (SIJ). Many studies have investigated the clinical outcomes and biomechanics of various SIJ surgical procedures. However, the biomechanical literature points to several issues that need to be further explored, especially for the devices used in minimally invasive surgery of the SIJ. This study (part II) aims to assess biomechanical literature to understand the existing information as it relates to efficacies of the surgical techniques and the gaps in the knowledge base. Part I reviewed basic anatomy and mechanics of the SIJ joint, including difference between males and females, and causes of pain emanating from these joints. METHODS: A thorough literature review was performed pertaining to studies related to SIJ fixation techniques and the biomechanical outcomes of the surgical procedures. RESULTS: Fifty-five studies matched the search criteria and were considered for the review. These articles predominantly pertained to the biomechanical outcomes of the minimally invasive surgery with different instrumentation systems and surgical settings. CONCLUSIONS: The SIJ is one of the most overlooked sources of lower back pain. The joint is responsible for the pain in 15% to 30% of people suffering from lower back pain. Various studies have investigated the clinical outcomes of different surgical procedures intended to improve the pain and quality of life following surgery. The data show that these techniques are indeed effective. However, clinical studies have raised several issues, like optimal number and positioning of implants, unilateral versus bilateral placements, adjacent segment disease, implant designs, and optimal location of implants with respect to variations in bone density across the SIJ. Biomechanical studies using in vitro and in silico techniques have addressed some of these issues. Studies also point out the need for additional investigations for a better understanding of the underlying mechanics for the improved long-term surgical outcomes. Further long-term clinical follow-ups are essential as well. This review presents pertinent findings.

10.
J Mech Behav Biomed Mater ; 109: 103834, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32543401

RESUMO

Many material properties of articular cartilage are anisotropic, particularly in the superficial zone where collagen fibers have a preferential direction. However, the anisotropy of cartilage wear had not been previously investigated. The objective of this study was to evaluate the anisotropy of cartilage material behavior in an in vitro wear test. The wear and coefficient of friction of bovine condylar cartilage were measured with loading in directions parallel (longitudinal) and orthogonal (transverse) to the collagen fiber orientation at the articular surface. An accelerated cartilage wear test was performed against a T316 stainless-steel plate in a solution of phosphate buffered saline with protease inhibitors. A constant load of 160 N was maintained for 14000 cycles of reciprocal sliding motion at 4 mm/s velocity and a travel distance of 18 mm in each direction. The contact pressure during the wear test was approximately 2 MPa, which is in the range of that reported in the human knee and hip joint. Wear was measured by biochemically quantifying the glycosaminoglycans (GAGs) and collagen that was released from the tissue during the wear test. Collagen damage was evaluated with collagen hybridizing peptide (CHP), while visualization of the tissue composition after the wear test was provided with histologic analysis. Results demonstrated that wear in the transverse direction released about twice as many GAGs than in the longitudinal direction, but that no significant differences were seen in the amount of collagen released from the specimens. Specimens worn in the transverse direction had a higher intensity of CHP stain than those worn in the longitudinal direction, suggesting more collagen damage from wear in the transverse direction. No anisotropy in friction was detected at any point in the wear test. Histologic and CHP images demonstrate that the GAG loss and collagen damage extended through much of the depth of the cartilage tissue, particularly for wear in the transverse direction. These results highlight distinct differences between cartilage wear and the wear of traditional engineering materials, and suggest that further study on cartilage wear is warranted. A potential clinical implication of these results is that orienting osteochondral grafts such that the direction of wear is aligned with the primary fiber direction at the articular surface may optimize the life of the graft.


Assuntos
Cartilagem Articular , Animais , Anisotropia , Bovinos , Fricção , Humanos , Técnicas In Vitro , Articulação do Joelho
11.
Int J Spine Surg ; 14(Suppl 1): 3-13, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32123652

RESUMO

BACKGROUND: The sacroiliac joints (SIJs), the largest axial joints in the body, sit in between the sacrum and pelvic bones on either side. They connect the spine to the pelvis and thus facilitate load transfer from the lumbar spine to the lower extremities. The majority of low back pain (LBP) is perceived to originate from the lumbar spine; however, another likely source of LBP that is mostly overlooked is the SIJ. This study (Parts I and II) aims to evaluate the clinical and biomechanical literature to understand the anatomy, biomechanics, sexual dimorphism, and causes and mechanics of pain of the SIJ leading to conservative and surgical treatment options using instrumentation. Part II concludes with the mechanics of the devices used in minimal surgical procedures for the SIJ. METHODS: A thorough review of the literature was performed to analyze studies related to normal SIJ mechanics, as well as the effects of sex and pain on SIJ mechanics. RESULTS: A total of 65 studies were selected related to anatomy, biomechanical function of the SIJ, and structures that surround the joints. These studies discussed the effects of various parameters, gender, and existence of common physiological disorders on the biomechanics of the SIJ. CONCLUSIONS: The SIJ lies between the sacrum and the ilium and connects the spine to the pelvic bones. The SIJ transfers large bending moments and compression loads to lower extremities. However, the joint does not have as much stability of its own against the shear loads but resists shear due the tight wedging of the sacrum between hip bones on either side and the band of ligaments spanning the sacrum and the hip bones. Due to these, sacrum does not exhibit much motion with respect to the ilium. The SIJ range of motion in flexion-extension is about 3°, followed by axial rotation (about 1.5°), and lateral bending (about 0.8°). The sacrum of the female pelvis is wider, more uneven, less curved, and more backward tilted, compared to the male sacrum. Moreover, women exhibit higher mobility, stresses/loads, and pelvis ligament strains compared to male SIJs. Sacroiliac pain can be due to, but not limited to, hypo- or hypermobility, extraneous compression or shearing forces, micro- or macro-fractures, soft tissue injury, inflammation, pregnancy, adjacent segment disease, leg length discrepancy, and prior lumbar fusion. These effects are well discussed in this review. This review leads to Part II, in which the literature on mechanics of the treatment options is reviewed and synthesized.

12.
JOR Spine ; 2(4): e1067, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31891117

RESUMO

For those patients who suffer from low back pain generated by the sacroiliac (SI) joint, fusion of the SI joint has proven to be an effective means of stabilizing it and reducing pain. Though it has shown promise, SI joint fusion raises clinical questions regarding its effect on neighboring joints such as the hip. As such, the purpose of this study was to determine the effects of SI joint fixation on the hip. A finite element spine-sacroiliac-hip (SSIH) model was developed and its functionality was verified against SI joint range of motion (ROM) and hip contact stress, respectively. The intact model was fixed in double leg stance at the distal femora, and loading was applied at the lumbar spine to simulate stance, flexion, extension, right and left lateral bending, and right and left axial rotation. Functionality was confirmed by measuring and comparing SI joint ROM and contact stress and area at the hip with data from the literature. Following verification of the intact SSIH model, both unilateral and bilateral SI joint fixation were modeled; hip contact stress and area were compared to the intact state. Average hip contact stress was ~2 MPa, with most motions resulting in changes less than 5% relative to intact; contact area changed less than 10% for any motion. Clinical significance: these results demonstrated that SI joint fixation with triangular titanium implants imparted little change in stress at the hip, which suggests that the risk of developing adjacent segment disease is likely low. Future clinical studies may be executed to confirm the results of this computational study.

13.
Spine J ; 19(5): 931-941, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30414992

RESUMO

BACKGROUND CONTEXT: Pedicle subtraction osteotomy (PSO) is a challenging restoration technique for sagittal imbalance and is associated with significant complications. One of the major complications is rod fracture and there exists a need for a biomechanical assessment of this complication for various instrumentation configurations. PURPOSE: To evaluate and compare the global range of motion (ROM), rod stress distribution, and the forces on the pedicle subtraction site in various instrumentation configurations using finite element analysis. STUDY DESIGN/SETTING: A computational biomechanical analysis. METHODS: A previously validated osseoligamentous three-dimensional spinopelvic finite element model (T10-pelvis) was used to develop a 30° PSO at the L3 level. In addition to the standard bilateral cobalt chromium primary rod instrumentation of the PSO model, various multirod configurations including constructs with medially, laterally, and posteriorly affixed satellite rods and the short-rod technique were assessed in spinal physiological motions. T10-S1 global ROM, maximum von Mises stress on the rods and at the PSO level, factor of safety (yield stress of the rod material/maximum actual stress in the rod) and the load acting across the PSO site were compared between various instrumentation configurations. The higher the factor of safety the lesser the chances of rod failure. RESULTS: Among all multirod constructs, posteriorly affixed satellite rod construct showed the greatest motion reduction compared to the standard bilateral rod configuration followed by medially and laterally affixed satellite rod constructs. Compared to the standard bilateral rod configuration, recessed short-rod technique resulted in 4% to 49% reduction in T10-S1 ROM recorded in extension and lateral bending motions, respectively, while the axial rotation motion increased by approximately 31%. Considering the maximum stress values on the rods, the recessed short-rod technique showed the greatest factor of safety (FOS = 4.1) followed by posteriorly (FOS = 3.9), medially (FOS = 3), laterally affixed satellite rod constructs (FOS = 2.8), and finally the standard bilateral rod construct (FOS = 2.7). By adding satellite rods, the maximum von Mises stress at the PSO level of the rods also reduced significantly and at this level resulted in the greatest FOS in the posteriorly affixed satellite rod construct. Compared to the standard bilateral rod construct, the load magnitude acting on the osteotomy site decreased by 11%, 16%, and 37% in the laterally, medially, and posteriorly affixed satellite rod constructs, respectively, and did not change with the short-rod technique. CONCLUSIONS: Adding satellite rods increases the rigidity of the construct, which results in an increase in the stability and the reduction of the global ROM. Additionally, having satellite rods reduces the stress on the primary rods at the PSO level and shifts the stresses from this PSO region to areas adjacent to the side-by-side connectors. The data suggest a significant benefit in supplementing medial over lateral satellite rods at the PSO by reducing stress on the primary rods. Except the recessed short-rod technique, all other multirod constructs decrease the magnitude of the load acting across the osteotomy region, which could cause a delayed or non-union at the PSO site. CLINICAL SIGNIFICANCE: The study evaluates the mechanical performance of various satellite rod instrumentation configurations following PSO to predict the risk factors for rod fracture and thereby mitigate the rate of clinically relevant failures.


Assuntos
Simulação por Computador , Osteotomia/métodos , Parafusos Pediculares/efeitos adversos , Complicações Pós-Operatórias/prevenção & controle , Fusão Vertebral/métodos , Fenômenos Biomecânicos , Análise de Elementos Finitos , Humanos , Vértebras Lombares/cirurgia , Osteotomia/efeitos adversos , Parafusos Pediculares/normas , Complicações Pós-Operatórias/etiologia , Falha de Prótese , Rotação , Fusão Vertebral/efeitos adversos
14.
Spine (Phila Pa 1976) ; 43(18): E1053-E1060, 2018 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-29509655

RESUMO

STUDY DESIGN: The comparison of sacroiliac joint (SIJ) angular motions, pelvis ligaments strain, load sharing, and stress distribution across the joint for male and female spine-pelvis-femur models using finite element analysis. OBJECTIVE: To quantify biomechanical parameters at SIJ for all motions for both male and female models. SUMMARY OF BACKGROUND DATA: SIJ has been recognized as a main source of pain in 13% to 30% of patients with low back pain. It is shown that the SIJ rotation and translation in different planes are not exceeding 2° to 3° and 2 mm, respectively. Due to limitation of in vivo and in vitro studies, it is difficult to quantify certain biomechanical parameters such as load-sharing and stress distribution across the joint. Finite element analysis is a useful tool which can be utilized to understand the biomechanics of the SIJ. METHODS: The validated finite element models of a male and a female lumbar spine-pelvis-femur were developed from computer tomography (CT) scans. The models were used to simulate spine physiological motions. The range of motion, ligament strains, load sharing, and stress distribution across the left and right SIJs were compared between male and female models. RESULTS: Motions data at SIJs demonstrated that female model experienced 86% higher mobility in flexion, 264% in extension, 143% in left bending, and 228% in right bending compared with the male model. The stresses and loads on SIJs were higher on the female model compared with the male model. Female model ligaments underwent larger strains compared with the male model ligaments. CONCLUSION: Female SIJ had higher mobility, stresses, loads, and pelvis ligament strains compared with the male SIJ which led to higher stress across the joint, especially on the sacrum under identical loading conditions. This could be a possible reason for higher incidence of SIJ pain and pelvic stress fracture in females. LEVEL OF EVIDENCE: N/A.


Assuntos
Análise de Elementos Finitos , Modelos Anatômicos , Postura/fisiologia , Articulação Sacroilíaca/diagnóstico por imagem , Caracteres Sexuais , Fenômenos Biomecânicos/fisiologia , Feminino , Humanos , Dor Lombar/diagnóstico por imagem , Dor Lombar/fisiopatologia , Vértebras Lombares/anatomia & histologia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/fisiologia , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologia , Articulação Sacroilíaca/anatomia & histologia , Articulação Sacroilíaca/fisiologia
15.
Comput Methods Programs Biomed ; 133: 133-141, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27393805

RESUMO

The osteocyte cell is a bone cell that also functions as a bone mechanosensor. In this work, a three-dimensional (3D) fluid-structure interaction (FSI) model of an osteocyte cell under different mechanical loading conditions was used to obtain a better understanding of osteocyte cell behavior under different physiological conditions. In the current study, both fluid and solid parts of osteocyte cell were considered in order to allow for more accurate results. Five different loading conditions have been applied to the osteocyte cell, and consequently the different interstitial fluid flow velocities and shear stresses have been investigated. Furthermore, using a mathematical model, the change in the stimulus function value with shear stress and NO enzyme was revealed. This work suggests that changes in osteocyte morphology and direction of loadings affect cell stimulation. It was found that cell is mostly stimulated and expanded in the direction experiencing the most shear stress. Finally, the amount of cell stimulation was shown quantitatively and there was strong dependency between stimulus function, shear stress, calcium, and NO concentration.


Assuntos
Mecanotransdução Celular , Osteócitos/citologia , Humanos , Estresse Mecânico
16.
J Therm Biol ; 49-50: 74-81, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25774029

RESUMO

The application of laser in ophthalmology and eye surgery is so widespread that hardly can anyone deny its importance. On the other hand, since the human eye is an organ susceptible to external factors such as heat waves, laser radiation rapidly increases the temperature of the eye and therefore the study of temperature distribution inside the eye under laser irradiation is crucial; but the use of experimental and invasive methods for measuring the temperature inside the eye is typically high-risk and hazardous. In this paper, using the three-dimensional finite element method, the distribution of heat transfer inside the eye under transient condition was studied through three different lasers named Nd:Yag, Nd:Yap and ArF. Considering the metabolic heat and blood perfusion rate in various regions of the eye, numerical solution of space-time dependant Pennes bioheat transfer equation has been applied in this study. Lambert-Beer's law has been used to model the absorption of laser energy inside the eye tissues. It should also be mentioned that the effect of the ambient temperature, tear evaporation rate, laser power and the pupil diameter on the temperature distribution have been studied. Also, temperature distribution inside the eye after applying each laser and temperature variations of six optional regions as functions of time have been investigated. The results show that these radiations cause temperature rise in various regions, which will in turn causes serious damages to the eye tissues. Investigating the temperature distribution inside the eye under the laser irradiation can be a useful tool to study and predict the thermal effects of laser radiation on the human eye and evaluate the risk involved in performing laser surgery.


Assuntos
Temperatura Corporal , Lasers , Modelos Biológicos , Fenômenos Fisiológicos Oculares , Simulação por Computador , Análise de Elementos Finitos , Temperatura Alta , Humanos , Imageamento Tridimensional
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