Gaussian random field-based characterization and reconstruction of cancellous bone microstructure considering the constraint of correlation structure.

The macro scale physical properties of cancellous bone materials are governed by the microstructural features, which is of great significance for the multi-scale research of cancellous bone and the inverse design of bone-mimicking materials. Therefore, it is essential to characterize the natural cancellous bone samples, and reconstruct the microstructures with the biomimetic osteointegration and mechanical properties. In this research, a novel approach for the characterization and reconstruction of cancellous bone was proposed, based on the medical image analysis and anisotropic three-dimensional Gaussian random field (GRF). The geometric similarity, i.e. the interface curvature distribution (ISD), was meticulously studied, which is important to the osteointegration ability. And the mechanical properties were validated by the stress-strain curves under the large compressive strain simulated by the smoothed particle hydrodynamic (SPH) method. In addition, the effects of the generation parameters of GRF-based biomimetic microstructures on the apparent properties were analyzed. The ISD results demonstrated that both GRF and micro-CT groups had the similar columnar morphological properties, while the latter had more hyperbolic features. And it was found that the GRF-based biomimetic microstructures and the natural bone samples based on micro-CT (MCT) had the similar failure mode. The concordance correlation coefficient between MCT and GRF pairs was 0.8685, with a Pearson ρ value of 0.8804, and significance level p<0.0001. The Bland-Altman LoA was 0.1647 MPa with 95 % (1.96SD) lower and upper bound value between -0.2892 and 0.6185 MPa. The two groups had almost the same elastic modulus with the mean absolute percentage error (MAPE) of 7.84 %. While the yield stress and total conversion energy of the GRF-based samples were lower than those of the natural bone samples, and the MAPE were 16.99 % and 16.27 %, respectively. Although it meant the lower structural efficiency, the huge design space of this approach and advanced 3D printing technology can provide great potential for the design of orthopedic implants.

A Review on Nonlocal Theories in Fatigue Assessment of Solids.

A review of nonlocal theories utilized in the fatigue and fracture modeling of solid structures is addressed in this paper. Numerous papers have been studied for this purpose, and various nonlocal theories such as the nonlocal continuum damage model, stress field intensity model, peridynamics model, elastic-plastic models, energy-based model, nonlocal multiscale model, microstructural sensitive model, nonlocal lattice particle model, nonlocal high cycle fatigue model, low cycle fatigue model, nonlocal and gradient fracture criteria, nonlocal coupled damage plasticity model and nonlocal fracture criterion have been reviewed and summarized in the case of fatigue and fracture of solid structures and materials.

Static Compressive Behavior and Material Failure Mechanism of Trabecular Tantalum Scaffolds Fabricated by Laser Powder Bed Fusion-based Additive Manufacturing.

Additively manufactured trabecular tantalum (Ta) scaffolds are promising bone repair materials for load-bearing applications due to their good pore interconnectivity. However, a thorough mechanical behavior evaluation is required before conducting animal studies and clinical research using these scaffolds. In this study, we revealed the compressive mechanical behavior and material failure mechanism of trabecular tantalum scaffolds by compression testing, finite element analysis (FEA), and scanning electron microscopy (SEM). Trabecular tantalum scaffolds with porosities of 65%, 75%, and 85% were fabricated by laser powder bed fusion-based additive manufacturing. Porosity has a significant effect on their compressive mechanical properties. As the porosity decreased from 85% to 65%, the compressive yield strength and elastic modulus increased from 11.9 MPa to 35.7 MPa and 1.1 GPa to 3.0 GPa, respectively. Compression testing results indicate that trabecular tantalum scaffolds demonstrate ductile deformation and excellent mechanical reliability. No macroscopic cracks were found when they were subjected to strain up to 50%. SEM observations showed that material failure results from tantalum strut deformation and fracture. Most microcracks occurred at conjunctions, whereas few of them appear on the struts. FEA-generated compressive stress distribution and material deformation were consistent with experimental results. Stress concentrates at strut conjunctions and vertical struts, where fractures occur during compression testing, indicating that the load-bearing capability of trabecular tantalum scaffolds can be enhanced by strengthening strut conjunctions and vertical struts. Therefore, additively manufactured trabecular tantalum scaffolds can be used in bone tissue reconstruction applications.

A unified approach for topology optimization with local stress constraints considering various failure criteria: von Mises, Drucker-Prager, Tresca, Mohr-Coulomb, Bresler- Pister and Willam-Warnke.

An interesting, yet challenging problem in topology optimization consists of finding the lightest structure that is able to withstand a given set of applied loads without experiencing local material failure. Most studies consider material failure via the von Mises criterion, which is designed for ductile materials. To extend the range of applications to structures made of a variety of different materials, we introduce a unified yield function that is able to represent several classical failure criteria including von Mises, Drucker-Prager, Tresca, Mohr-Coulomb, Bresler-Pister and Willam-Warnke, and use it to solve topology optimization problems with local stress constraints. The unified yield function not only represents the classical criteria, but also provides a smooth representation of the Tresca and the Mohr-Coulomb criteria-an attribute that is desired when using gradient-based optimization algorithms. The present framework has been built so that it can be extended to failure criteria other than the ones addressed in this investigation. We present numerical examples to illustrate how the unified yield function can be used to obtain different designs, under prescribed loading or design-dependent loading (e.g. self-weight), depending on the chosen failure criterion.

Plate-and-bone-strut fixation of distal third humeral shaft aseptic non-unions: A consecutive case series.

INTRODUCTION: Non-union after humeral shaft fractures are seen frequently in clinical practice. The incidence is 2-10% after conservative management and up to 30% after surgical treatment. The purpose of this study is to evaluate the outcomes of plate-and-bone-strut-allograft technique with bone chip augmentation for aseptic non-unions of the distal third of the humerus. MATERIALS AND METHODS: 26 consecutive cases were treated using a trans-triceps approach. The non-union was fixed with a 4.5 mm Locking Compression Plate combined with a strut bone allograft at the anterior part of the humerus and bone chips. All patients underwent the same rehabilitation protocol of 12 weeks. Clinical evaluation took place 12 months after surgery with the Mayo elbow score and Oxford elbow score. RESULTS: Complete bone healing without complications was achieved in all 26 patients. The average period of radiographic union was 106 days. The average range of flexion-extension was 108° (94°-180°) and pro-supination was 159° (102°-180°). Twelve months after surgery, average Mayo elbow score was 86 (68-100) and the Oxford elbow score was 83 (52-100). CONCLUSION: The plate-and-bone-strut-allograft technique with bone chip augmentation in distal humeral shaft for aseptic non-unions resulted in union of all cases. No adverse events related to the surgery or the materials used were documented.

Material failure in dynamic spine implants: are the standardized implant tests before market launch sufficient?

PURPOSE: International Standards Organization (ISO) 12189 and American Society for Testing and Materials F2624 are two standard material specification and test methods for spinal implant devices. The aim of this study was to assess whether the existing and required tests before market launch are sufficient. METHODS: In three prospective studies, patients were treated due to degenerative disease of the lumbar spine or spondylolisthesis with lumbar interbody fusion and dynamic stabilization of the cranial adjacent level. The CD HORIZON BalanC rod and S4 Dynamic rod were implanted in 45 and 11 patients, respectively. RESULTS: A fatigue fracture of the material of the topping off system has been found in five cases (11%) for the group fitted with the CD HORIZON BalanC rod. In the group using the S4 Dynamic rod group, a material failure of the dynamic part was demonstrated in seven patients (64%). All three studies were interrupted due to these results, and a report to the Federal Institute for Drugs and Medical Devices was generated. CONCLUSION: Spinal implants have to be checked by a notified body before market launch. The notified body verifies whether the implants fulfil the requirements of the current standards. These declared studies suggest that the current standards for the testing of load bearing capacity and stand ability of dynamic spine implants might be insufficient. Revised standards depicting sufficient deformation and load pattern have to be developed and counted as a requirement for the market launch of an implant. These slides can be retrieved under Electronic Supplementary Material.

Clinical experiences with a PEEK-based dynamic instrumentation device in lumbar spinal surgery: 2 years and no more.

BACKGROUND: Dynamic spine implants were developed to prevent adjacent segment degeneration (ASD) and adjacent segment disease (ASDi). Purpose of this study was to investigate the clinical and radiological outcomes of "topping off" devices following lumbar spinal fusion procedure using a PEEK-based dynamic rod system. Moreover, this study focused on the hypothesis that "topping off" devices can prevent ASD. METHODS: This prospective nonrandomized study included patients with indication for single-level lumbar fusion and radiological signs of ASD without instability. The exclusion criteria were previous lumbar spine surgery and no sign of disc degeneration in the adjacent segment according to magnetic resonance imaging. All patients were treated with single-level lumbar interbody fusion and dynamic stabilization of the cranial adjacent segment. Patients underwent a clinical examination and radiographs preoperatively and at 1 and 2 years after surgery. Analyses were performed on clinical data collected with the German Spine Registry using the core outcome measure index (COMI) and visual analogue scale (VAS) scores for back and leg pain. RESULTS: A total of 22 patients (6 male and 16 female) with an average age of 57.6 years were included in the study; 20 patients completed the follow-up (FU). The average COMI score was 9.0 preoperatively, 4.2 at the 1-year FU, and 4.7 at the 2-year FU. The average preoperative VAS scores for back and leg pain were 7.7 and 7.1, respectively. At the 1-year FU, the scores were 4.25 for back pain and 2.2 for leg pain, and at the 2-year FU, the scores were 4.7 for back pain and 2.3 for leg pain. At FU, failure of the dynamic topping off implant material was verified in four cases, and ASD of the segment cranial to the topping off was confirmed in three cases. CONCLUSIONS: These results demonstrate significant improvements in clinical outcomes and pain reduction after lumbar spinal fusion with topping off at 2 years after surgery. However, the implant failed due to the high rate of implant failure and the development of ASD in the segment cranial to the dynamic stabilized segment.

Mechanical failure modes of chronically implanted planar silicon-based neural probes for laminar recording.

Penetrating intracortical electrode arrays that record brain activity longitudinally are powerful tools for basic neuroscience research and emerging clinical applications. However, regardless of the technology used, signals recorded by these electrodes degrade over time. The failure mechanisms of these electrodes are understood to be a complex combination of the biological reactive tissue response and material failure of the device over time. While mechanical mismatch between the brain tissue and implanted neural electrodes have been studied as a source of chronic inflammation and performance degradation, the electrode failure caused by mechanical mismatch between different material properties and different structural components within a device have remained poorly characterized. Using Finite Element Model (FEM) we simulate the mechanical strain on a planar silicon electrode. The results presented here demonstrate that mechanical mismatch between iridium and silicon leads to concentrated strain along the border of the two materials. This strain is further focused on small protrusions such as the electrical traces in planar silicon electrodes. These findings are confirmed with chronic in vivo data (133-189 days) in mice by correlating a combination of single-unit electrophysiology, evoked multi-unit recordings, electrochemical impedance spectroscopy, and scanning electron microscopy from traces and electrode sites with our modeling data. Several modes of mechanical failure of chronically implanted planar silicon electrodes are found that result in degradation and/or loss of recording. These findings highlight the importance of strains and material properties of various subcomponents within an electrode array.

Simple and accurate methods for quantifying deformation, disruption, and development in biological tissues.

When mechanical factors underlie growth, development, disease or healing, they often function through local regions of tissue where deformation is highly concentrated. Current optical techniques to estimate deformation can lack precision and accuracy in such regions due to challenges in distinguishing a region of concentrated deformation from an error in displacement tracking. Here, we present a simple and general technique for improving the accuracy and precision of strain estimation and an associated technique for distinguishing a concentrated deformation from a tracking error. The strain estimation technique improves accuracy relative to other state-of-the-art algorithms by directly estimating strain fields without first estimating displacements, resulting in a very simple method and low computational cost. The technique for identifying local elevation of strain enables for the first time the successful identification of the onset and consequences of local strain concentrating features such as cracks and tears in a highly strained tissue. We apply these new techniques to demonstrate a novel hypothesis in prenatal wound healing. More generally, the analytical methods we have developed provide a simple tool for quantifying the appearance and magnitude of localized deformation from a series of digital images across a broad range of disciplines.