Age-related Differences in Volumetric Bone Mineral Density, Structure, and Bone Strength of Surgical Neck of Humerus in Postmenopausal Women.

OBJECTIVE: Postmenopausal changes in bone mass and structure compromise the mechanical properties of proximal humerus, predisposing it to low-energy fractures with complex morphology. The aim of the study is to investigate associations of bone quality and estimated bone strength of the surgical neck with age after menopause. METHODS: A total of 122 healthy postmenopausal women were recruited from December 2016 to December 2022 and assigned to three groups: the 50-59 years group, the 60-69 years group, and the older than 70 years group. Bone properties of the surgical neck, including volumetric bone mineral density (vBMD), cortical thickness (CTh), the periosteal and medullary size, and estimated indices of bone strength were evaluated by quantitative computed tomography. RESULTS: Compared to the 50-59 years group, postmenopausal women aged over 70 years were characterized by lower cortical thickness (13.9%) and vBMD (6.65%), as well as reduced strength indices including the minimum and maximum section modulus (Zmin 18.11%, Zmax 21.71%), polar section modulus (Zpol 20.21%), and the minimum and maximum second moments of area (Imax 21.01%, Imin 21.43%). Meanwhile, the difference in periosteal diameter and perimeter, total area in three groups did not reach statistical significance. Both cortical thickness and vBMD value were inversely associated with age, showing 10.56% and 23.92% decline. Imax showed the greatest age-related decrease between age of 54 and 86 years (39.08%), followed by Zmax (-35.77%), Imin (-35.73%), Zpol (-34.90%) and Imin (-23.92%).The strength indices had stronger correlations with cortical thickness than with bone size or density. CONCLUSION: In postmenopausal women, aging is associated with a significant decline in cortical bone thickness and mechanical strength of the proximal humerus, especially over the age of 70 years.

[Design and performance study of bone trabecular scaffolds based on triply periodic minimal surface method].

Triply periodic minimal surface (TPMS) is widely used because it can be used to control the shape of porous scaffolds precisely by formula. In this paper, an I-wrapped package (I-WP) type porous scaffolds were constructed. The finite element method was used to study the relationship between the wall thickness and period, the morphology and mechanical properties of the scaffolds, as well as to study the compression and fluid properties. It was found that the porosity of I-WP type scaffolds with different wall thicknesses (0.1 ~ 0.2 mm) and periods (I-WP 1 ~ I-WP 5) ranged from 68.01% ~ 96.48%, and the equivalent elastic modulus ranged from 0.655 ~ 18.602 GPa; the stress distribution of the scaffolds tended to be uniform with the increase of periods and wall thicknesses; the equivalent elastic modulus of the I-WP type scaffolds was basically unchanged after the topology optimization, and the permeability was improved by 52.3%. In conclusion, for the I-WP type scaffolds, the period parameter can be adjusted first, then the wall thickness parameter can be controlled. Topology optimization can be combined to meet the design requirements. The I-WP scaffolds constructed in this paper have good mechanical properties and meet the requirements of repairing human bone tissue, which may provide a new choice for the design of artificial bone trabecular scaffolds.

Changes in bone density and structure of proximal humerus with aging in Chinese women.

AIMS: This study aimed to investigate age- and menopause-related differences in bone mineral density (BMD), bone structure and estimated bone strength at surgical neck of humerus in Chinese female sample. METHODS: We conducted a cross-sectional cohort study of 171 Chinese women. Bone mass, indices of geometric properties and estimated mechanical strength of the surgical neck were evaluated by quantitative computed tomography (QCT). Comparisons were performed across menstrual status categories. Age-related changes in QCT-derived bone parameters were calculated. RESULTS: The age-related difference of BMD and cortical thickness was 40.25 % and 32.86 % between the age of 20 and 86 years. Progressive periosteal and endosteal expansion was associated linearly with age. Estimated mechanical strength indexes showed significant quadratic associations with age, with their peak occurred at the age of 46-55 years. The quartile of women with the greatest medullary diameter also had the lowest valve of BMD and cortical thickness and the greatest in skeletal width. Compared to premenopausal individuals, perimenopausal women were distinguished by lower cortical thickness (18.63 %) and BMD (20.05 %). The continued decrease in cortical thickness and BMD was noted after menopause. The medullary and periosteal diameter increased by 17.98 % and 9.34 % respectively in perimenopausal period, but not after menopause. The accelerated loss of the maximum and polar section modulus was observed in late postmenopausal women. CONCLUSIONS: The increase in bone size only occurred during the menopause transition. Obvious loss of resistance to bending was in late postmenopausal period.

Research on workflow recognition for liver rupture repair surgery.

Liver rupture repair surgery serves as one tool to treat liver rupture, especially beneficial for cases of mild liver rupture hemorrhage. Liver rupture can catalyze critical conditions such as hemorrhage and shock. Surgical workflow recognition in liver rupture repair surgery videos presents a significant task aimed at reducing surgical mistakes and enhancing the quality of surgeries conducted by surgeons. A liver rupture repair simulation surgical dataset is proposed in this paper which consists of 45 videos collaboratively completed by nine surgeons. Furthermore, an end-to-end SA-RLNet, a self attention-based recurrent convolutional neural network, is introduced in this paper. The self-attention mechanism is used to automatically identify the importance of input features in various instances and associate the relationships between input features. The accuracy of the surgical phase classification of the SA-RLNet approach is 90.6%. The present study demonstrates that the SA-RLNet approach shows strong generalization capabilities on the dataset. SA-RLNet has proved to be advantageous in capturing subtle variations between surgical phases. The application of surgical workflow recognition has promising feasibility in liver rupture repair surgery.

Numerical analysis of streaming potential induced by loads in micro-pores of articular cartilage.

In order to understand the distribution of streaming potentials in cartilage pores, this paper established finite element model to analyze. The results showed that the streaming potential in cartilage micro-pores increased along the axis. The electric potential in 5 µm straight micro-pore was about 50 µV, and the electric potential of curved bifurcation model was about 30 µV. The pressure and Zeta potential had a linear growth relationship with the streaming potential. The streaming potential decreased with the increase of ion concentration until ion concentration was saturated. These results could provide a theoretical basis for cartilage research.

Intrinsic Cortical Property Analysis of the Medial Column of Proximal Humerus.

OBJECTIVE: Adequate mechanical support of the medial column is paramount to maintain fracture reduction in locking plating of proximal humerus fractures. However, intrinsic cortical properties of the medial column are rarely discussed. The purpose of the study is to describe regional variation of cortex in the medial column. METHODS: A total of 147 healthy participants were eligible for enrollment between December 2016 and December 2018. Subjects were divided into three groups: group A (20-39 years), group B (40-59 years), and group C (>60 years). For each individual, a color 3D thickness map for proximal humerus was created by cortical bone mapping (CBM) technique after bilateral shoulders were imaged by computed tomography. Measurement Indices including the cortical thickness (CTh), cortical mass surface density (CM) and the endocortical trabecular density (ECTD) were determined, after six regions of interest (ROI) were defined in metaphyseal region. Regional parameter variations were analyzed by one-way ANOVA. RESULTS: The CTh, CM and ECTD values were approximately equivalent between genders in the proximal part of the medial column across all ages (P > 0.05).The greatest difference between sexes was found in CTh and CM values of middle and distal part (P < 0.05). The CTh and CM within medial column were negatively associated with age (P < 0.05). The proximal cortical bone of the medial column was thicker and more dense, compared to the lateral column (P < 0.05). Significant regional variation was found in all measured parameters in group A, but not in groups B and C. CONCLUSION: Our finding proved that regional differences in the distribution of cortical bone in the medial column The attenuation of cortical bone heterogeneity in the medial column was found after the age of 40 years.

Material parameters identification of 3D printed titanium alloy prosthesis stem based on response surface method.

3D printed Titanium alloy is widely used as a material of artificial joints and its mechanical properties is a key factor for improving operation results. Because the elastic modulus of the 3 D printed titanium alloy specimen was related to the size of the metal blank. It is very difficult to identify mechanical parameters by traditional mechanics experiments. In this paper, according to the inverse analysis principle of the parameter estimation, a response surface methodology (RSM) was proposed to identify the mechanical parameters, based on finite element inverse analysis. The finite element models of femoral prosthesis stem were established in line with compression experiments. The material parameters were combined by central composite design (CCD), and the response surface (RS) models were constructed using a quadratic polynomial with cross terms and optimized using a genetic algorithm (GA). Finally, the best mechanical parameter combination of the femoral prosthesis was calculated. The calculated elastic modulus and Poisson's ratio of a 3 D printed titanium alloy femoral prosthesis stem were 109.07 GPa and 0.29, respectively, with the elastic modulus error being very small. The proposed method is effective and can be extended for the identification of mechanical parameters in other 3 D printed models.

Menopause-related cortical loss of the humeral head region mainly occurred in the greater tuberosity.

Aims: Proximal humerus fractures are commonly observed in postmenopausal women. The goal of this study was to investigate menopause-related changes in cortical structure of the humeral head. Materials and methods: Clinical computed tomography (CT) scans of 75 healthy women spanning a wide range of ages (20-72 years) were analyzed. For each subject, cortical bone mapping (CBM) was applied to create a color three-dimensional (3D) thickness map for the proximal humerus. Nine regions of interest (ROIs) were defined in three walls of the humeral head. Cortical parameters, including the cortical thickness (CTh), cortical mass surface density (CM), and the endocortical trabecular density (ECTD), were measured. Results: Compared to premenopausal women, postmenopausal women were characterized by a significantly lower CTh and CM value in the lateral part of the greater tuberosity. Similar changes were only found in ROI 4, but not in ROIs 5-6 in the lesser tuberosity. Linear regression analysis revealed that the CTh and CM value of ROIs 1, 3, and 4 were negatively associated with age. These results showed that menopause-related loss in CTh and CM was mainly in the greater tuberosity besides the proximal part of the lesser tuberosity. Trabecular bone variable measured as ECTD showed a notably lower value in ROIs 1-9 in postmenopausal vs. premenopausal group. Inverse linear associations for ECTD and age were found in ROIs 2, 3, 5, 6, 7, and 9, indicating no site-specific differences of endocortical trabecular bone loss between the greater and lesser tuberosity. Conclusions: Menopause-related cortical loss of the humeral head mainly occurred in the lateral part of the greater tuberosity. The increased rate of humeral bone loss in the greater tuberosity may contribute materially to complex proximal humerus fractures.

[Experimental study of the response of articular cartilage surface roughness to load].

Cartilage surface fibrosis is an early sign of osteoarthritis and cartilage surface damage is closely related to load. The purpose of this study was to study the relationship between cartilage surface roughness and load. By applying impact, compression and fatigue loads on fresh porcine articular cartilage, the rough value of cartilage surface was measured at an interval of 10 min each time and the change rule of roughness before and after loading was obtained. It was found that the load increased the roughness of cartilage surface and the increased value was related to the load size. The time of roughness returning to the initial condition was related to the load type and the load size. The impact load had the greatest influence on the roughness of cartilage surface, followed by the severe fatigue load, compression load and mild fatigue load. This article provides reference data for revealing the pathogenesis of early osteoarthritis and preventing and treating articular cartilage diseases.

Gait Recognition for Lower Limb Exoskeletons Based on Interactive Information Fusion.

In recent decades, although the research on gait recognition of lower limb exoskeleton robot has been widely developed, there are still limitations in rehabilitation training and clinical practice. The emergence of interactive information fusion technology provides a new research idea for the solution of this problem, and it is also the development trend in the future. In order to better explore the issue, this paper summarizes gait recognition based on interactive information fusion of lower limb exoskeleton robots. This review introduces the current research status, methods, and directions for information acquisition, interaction, fusion, and gait recognition of exoskeleton robots. The content involves the research progress of information acquisition methods, sensor placements, target groups, lower limb sports biomechanics, interactive information fusion, and gait recognition model. Finally, the current challenges, possible solutions, and promising prospects are analysed and discussed, which provides a useful reference resource for the study of interactive information fusion and gait recognition of rehabilitation exoskeleton robots.

Mechanical Roles in Formation of Oriented Collagen Fibers.

Collagen is a structural protein that is widely present in vertebrates, being usually distributed in tissues in the form of fibers. In living organisms, fibers are organized in different orientations in various tissues. As the structural base in connective tissue and load-bearing tissue, the orientation of collagen fibers plays an extremely important role in the mechanical properties and physiological and biochemical functions. The study on mechanics role in formation of oriented collagen fibers enables us to understand how discrete cells use limited molecular materials to create tissues with different structures, thereby promoting our understanding of the mechanism of tissue formation from scratch, from invisible to tangible. However, the current understanding of the mechanism of fiber orientation is still insufficient. In addition, existing fabrication methods of oriented fibers are varied and involve interdisciplinary study, and the achievements of each experiment are favorable to the construction and improvement of the fiber orientation theory. To this end, this review focuses on the preparation methods of oriented fibers and proposes a model explaining the formation process of oriented fibers in tendons based on the existing fiber theory. Impact statement As the structural base in connective tissue and load-bearing tissue, the orientation of collagen fibers plays an extremely important role in the mechanical properties and physiological and biochemical functions. However, the current understanding of the mechanism of fiber orientation is still insufficient, which is greatly responsible for the challenge of functional tissue repair and regeneration. Understanding the mechanism of fiber orientation can promote the successful application of fiber orientation scaffolds in tissue repair and regeneration, as well as providing an insight for the mechanism of tissue histomorphology.

Experimental Study on Creep Characteristics of Microdefect Articular Cartilages in the Damaged Early Stage.

Traumatic joint injury is known to cause cartilage deterioration and osteoarthritis. In order to study the mechanical mechanism of damage evolution on articular cartilage, taking the fresh porcine articular cartilage as the experimental samples, the creep experiments of the intact cartilages and the cartilages with different depth defect were carried out by using the noncontact digital image correlation technology. And then, the creep constitutive equations of cartilages were established. The results showed that the creep curves of different layers changed exponentially and were not coincident for the cartilage sample. The defect affected the strain values of the creep curves. The creep behavior of cartilage was dependent on defect depth. The deeper the defect was, the larger the strain value was. The built three-parameter viscoelastic constitutive equation had a good correlation with the experimental results and could predict the creep performance of the articular cartilage. The creep values of the microdefective cartilage in the damaged early stage were different from the diseased articular cartilage. These findings pointed out that defect could accelerate the damage of cartilage. It was helpful to study the mechanical mechanism of damage evolution.

Analysis of the mechanical effects of defect shape on damage evolution of articular cartilage under rolling load.

To study the mechanical effects of defect shape on the damage evolution of knee cartilage and find the causes of fragments, so as to obtain damage evolution rules and determine the most appropriate shape used in a clinical repair. A porous viscoelasticity fiber-reinforced 2D numerical model with different micro-defect shapes was established which considered the depth-dependent Young's modulus, fiber distribution, porosity and permeability. The stress-strain relationship, interstitial hydraulic and interstitial flow velocity was obtained under rolling load. The results showed that damage developed at the bottom corner of the defect, preferentially deep within the cartilage tangential to the fibers direction, and then extended to the surface along adjacent fibers, finally forming fragments. In the early stages of damage, the shear stress and interstitial flow velocity within cartilage with a rectangular cross-sectional defect were the lowest, while interstitial hydraulic pressure was the highest, followed by 100° trapezoid and semicircle, and finally 80° trapezoid defects. In the later stage of damage, the results were very similar. The shear strain, interstitial flow velocity and interstitial hydraulic pressure decreased with increasing defect depth. Therefore, defect shape only affected damage evolution in the early stages. The fragments in cartilage were the result of the damage evolution which sizes were correlated with the initial defect depth. The damage velocity of cartilage with a rectangular section-incision was the slowest. Finally, we concluded that cylindrical incisions are optimal in clinical surgery. These results provide a theoretical basis for the clinical interpretation of pathological degeneration and repair therapy.

Experimental Study on the Mechanical Properties of Porcine Cartilage with Microdefect under Rolling Load.

OBJECTIVES: To investigate the mechanical responses of microdefect articular cartilage under rolling load and find out the failure rule. METHODS: Rolling load was applied to the porcine articular cartilage samples with rectangular notches of different depths. The displacement and strain near the notches were obtained by the noncontact digital image correlation technique. RESULTS: The strain value and peak frequency around the notch increased; the maximum equivalent strain value could be observed at both bottom corners of the notch; the equivalent strain value first increased and then decreased at the points in the superficial and middle layers with the increase of rolling velocity; the points in the deep layer were less affected by rolling velocity; the equivalent strain value of the points in the superficial layer declined after rising with the increase of defect depth, while a decreased trend could be found for the points in the middle and deep layers. CONCLUSIONS: The shear strain, which rose with the increase in defect depth, was the main factor in cartilage destruction. The cartilage tended to be destructed firstly at the bottom corner of the defect. Rolling velocity showed significant effects on superficial and middle layers. Cartilage had the ability to resist destruction.

Experimental Study on the Mechanical Properties of Porcine Cartilage with Microdefect under Rolling Load

Objectives: To investigate the mechanical responses of microdefect articular cartilage under rolling load and find out the failure rule. Methods: Rolling load was applied to the porcine articular cartilage samples with rectangular notches of different depths. The displacement and strain near the notches were obtained by the noncontact digital image correlation technique. Results: The strain value and peak frequency around the notch increased; the maximum equivalent strain value could be observed at both bottom corners of the notch; the equivalent strain value first increased and then decreased at the points in the superficial and middle layers with the increase of rolling velocity; the points in the deep layer were less affected by rolling velocity; the equivalent strain value of the points in the superficial layer declined after rising with the increase of defect depth, while a decreased trend could be found for the points in the middle and deep layers. Conclusions: The shear strain, which rose with the increase in defect depth, was the main factor in cartilage destruction. The cartilage tended to be destructed firstly at the bottom corner of the defect. Rolling velocity showed significant effects on superficial and middle layers. Cartilage had the ability to resist destruction.

On mechanical mechanism of damage evolution in articular cartilage.

Superficial lesions of cartilage are the direct indication of osteoarthritis. To investigate the mechanical mechanism of cartilage with micro-defect under external loading, a new plain strain numerical model with micro-defect was proposed and damage evolution progression in cartilage over time has been simulated, the parameter were studied including load style, velocity of load and degree of damage. The new model consists of the hierarchical structure of cartilage and depth-dependent arched fibers. The numerical results have shown that not only damage of the cartilage altered the distribution of the stress but also matrix and fiber had distinct roles in affecting cartilage damage, and damage in either matrix or fiber could promote each other. It has been found that the superficial cracks in cartilage spread preferentially along the tangent direction of the fibers. It is the arched distribution form of fibers that affects the crack spread of cartilage, which has been verified by experiment. During the process of damage evolution, its extension direction and velocity varied constantly with the damage degree. The rolling load could cause larger stress and strain than sliding load. Strain values of the matrix initially increased and then decreased gradually with the increase of velocity, and velocity had a greater effect on matrix than fibers. Damage increased steadily before reaching 50%, sharply within 50 to 85%, and smoothly and slowly after 85%. The finding of the paper may help to understand the mechanical mechanism why the cracks in cartilage spread preferentially along the tangent direction of the fibers.