Mechanical loading may be required for proper tendon formation. However, it is not well understood how tendon formation is impacted by the development of weight-bearing locomotor activity in the neonate. This study assessed tendon mechanical properties, and concomitant changes in weight-bearing locomotion, in neonatal rats subjected to a low thoracic spinal cord transection or a sham surgery at postnatal day (P)1. On P10, spontaneous locomotion was evaluated in spinal cord transected and sham controls to determine impacts on weight-bearing hindlimb movement. The mechanical properties of P10 Achilles tendons (ATs), as representative energy-storing, weight-bearing tendons, and tail tendons (TTs), as representative positional, non-weight-bearing tendons were evaluated. Non- and partial weight-bearing hindlimb activity decreased in spinal cord transected rats compared to sham controls. No spinal cord transected rats showed full weight-bearing locomotion. ATs from spinal cord transected rats had increased elastic modulus, while cross-sectional area trended lower compared to sham rats. TTs from spinal cord transected rats had higher stiffness and cross-sectional area. Collagen structure of ATs and TTs did not appear impacted by surgery condition, and no significant differences were detected in the collagen crimp pattern. Our findings suggest that mechanical loading from weight-bearing locomotor activity during development regulates neonatal AT lateral expansion and maintains tendon compliance, and that TTs may be differentially regulated. The onset and gradual increase of weight-bearing movement in the neonate may provide the mechanical loading needed to direct functional postnatal tendon formation.

Although wear is known as the primary cause of long-time failure of total knee arthroplasty (TKA), it can be vital in short- and midterm TKA failure due to laxity. One of the reasons leading to joint laxity and instability is ligamentous insufficiency. This study, therefore, aims to investigate the effects of insufficient ligaments-related knee laxity on both nonlinear dynamics and wear of TKA. The study hypothesizes (a) ligamentous insufficiency can increase TKA damage; (b) stiffness reduction of each of the posterior cruciate ligament (PCL) and medial–lateral collateral ligaments (MCL-LCL) can differently contribute to TKA damage. A forward dynamics methodology is developed and the ligament behavior is simulated employing an asymmetric nonlinear elastic model. External loads and moment, due to the presence of all soft tissues, e.g., muscles and hip joint reaction forces, applied to the femoral bone are determined using a musculoskeletal approach linked to the developed model. A mesh density analysis is performed and comparing outcomes with that available in the literature allows for the assessment of our approach. From the results acquired, reduced PCL stiffness leads to an increase in linear wear rates and results in the maximum damage in TKAs. However, the maximum linear wear rates on both condyles occur once the stiffness of all ligaments is reduced. Moreover, the worn area of the tibia surface increases with the reduction in MCL-LCL stiffness on the medial condyle. The joint with insufficient PCL also shows a considerable increase in ligament forces right after toe-off.

The primary aim of this study was to validate predictions of human knee-joint contact mechanics (specifically, contact pressure, contact area, and contact force) derived from finite-element models of the tibiofemoral and patellofemoral joints against corresponding measurements obtained in vitro during simulated weight-bearing activity. A secondary aim was to perform sensitivity analyses of the model calculations to identify those parameters that most significantly affect model predictions of joint contact pressure, area, and force. Joint pressures in the medial and lateral compartments of the tibiofemoral and patellofemoral joints were measured in vitro during two simulated weight-bearing activities: stair descent and squatting. Model-predicted joint contact pressure distribution maps were consistent with those obtained from experiment. Normalized root-mean-square errors between the measured and calculated contact variables were on the order of 15%. Pearson correlations between the time histories of model-predicted and measured contact variables were generally above 0.8. Mean errors in the calculated center-of-pressure locations were 3.1 mm for the tibiofemoral joint and 2.1 mm for the patellofemoral joint. Model predictions of joint contact mechanics were most sensitive to changes in the material properties and geometry of the meniscus and cartilage, particularly estimates of peak contact pressure. The validated finite element modeling framework offers a useful tool for noninvasive determination of knee-joint contact mechanics during dynamic activity under physiological loading conditions.

Total disk arthroplasty (TDA) using an artificial disk (AD) is an attractive surgical technique for the treatment of spinal disorders, since it can maintain or restore spinal motion (unlike interbody fusion). However, adverse surgical outcomes of contemporary lumbar TDAs have been reported. We previously proposed a new mobile-bearing AD design concept featuring a biconcave ultrahigh-molecular-weight polyethylene (UHMWPE) mobile core. The objective of this study was to develop an artificial neural network (NN) based multiobjective optimization framework to refine the biconcave-core AD design considering multiple TDA performance metrics, simultaneously. We hypothesized that there is a tradeoff relationship between the performance metrics in terms of range of motion (ROM), facet joint force (FJF), and polyethylene contact pressure (PCP). By searching the resulting three-dimensional (3D) Pareto frontier after multiobjective optimization, it was found that there was a “best-tradeoff” AD design, which could balance all the three metrics, without excessively sacrificing each metric. However, for each single-objective optimum AD design, only one metric was optimal, and distinct sacrifices were observed in the other two metrics. For a commercially available biconvex-core AD design, the metrics were even worse than the poorest outcomes of the single-objective optimum AD designs. Therefore, multiobjective design optimization could be useful for achieving native lumbar segment biomechanics and minimal PCPs, as well as for improving the existing lumbar motion-preserving surgical treatments.

Prolonged static weight bearing (WBR) is thought to aggravate plantar heel pain and is common in the workplace, which may put employees at greater risk of developing plantar heel pain. However, objective measures of physical activity and sedentary behaviors in the workplace are lacking, making it difficult to establish or refute the connection between work exposure and plantar heel pain. Characterizing loading patterns during common workplace postures will enhance the understanding of foot function and inform the development of new measurement tools. Plantar pressure data during periods of sitting, standing, and walking were measured in ten healthy participants using the F-Scan in-shoe measurement system (Tekscan Inc, Boston, MA). Peak and average pressure, peak and average contact area, and average pressure differential were analyzed in ten different regions of the foot. A two-way repeated measures analysis of variance (ANOVA) assessed the posture by foot region interaction for each measurement parameter; significant effects of posture by foot region were identified for all five measurement parameters. Ten foot region by measurement parameter combinations were found to significantly differentiate all three postures simultaneously; seven used pressure measures to differentiate while three used area measures. The heel, lateral midfoot (LM), and medial and central forefoot (CFF) encompassed nine of ten areas capable of differentiating all postures simultaneously. This work demonstrates that plantar pressure is a viable means to characterize and differentiate three common workplace postures. The results of this study can inform the development of measurement tools for quantifying posture duration at work.

Early weight bearing appears to enhance bone fracture healing under Ilizarov circular fixators (ICFs). However, the role of early weight bearing in the healing process remains unclear. This study aims to provide insights into the effects of early weight bearing on healing of bone fractures stabilized with ICFs, with the aid of mathematical modeling. A computational model of fracture site was developed using poro-elastic formulation to simulate the transport of mesenchymal stem cells (MSCs), fibroblasts, chondrocytes, osteoblasts, osteogenic growth factor (OGF), and chondrogenic growth factor (CGF) and MSC differentiation during the early stage of healing, under various combinations of fracture gap sizes (GS), ICF wire pretension forces, and axial loads. 1 h of physiologically relevant cyclic axial loading followed by 23 h of rest in the post-inflammation phase (i.e., callus with granulation tissue) was simulated. The results show that physiologically relevant dynamic loading could significantly enhance cell and growth factor concentrations in the fracture site in a time and spatially dependent manner. 1 h cyclic loading (axial load with amplitude, P A , of 200 N at 1 Hz) increased the content of chondrocytes up to 37% (in all zones of callus), CGF up to 28% (in endosteal and periosteal callus) and OGF up to 50% (in endosteal and cortical callus) by the end of the 24 h period simulated. This suggests that the synergistic effect of dynamic loading-induced advective transport and mechanical stimuli due to early weight bearing is likely to enhance secondary healing. Furthermore, the study suggests that relatively higher P A values or lower ICF wire pretension forces or smaller GS could result in increased chondrocyte and GF content within the callus.

The normal knee joint maintains stable motion during activities of daily living. After total knee arthroplasty (TKA), stability is achieved by the conformity of the bearing surfaces of the implant components, ligaments, and constraint structures incorporated in the implant design. The large, rectangular tibial post in constrained condylar knee (CCK) arthroplasty, often used in revision surgery, provides added stability, but increases susceptibility to polyethylene wear as it contacts the intercondylar box on the femoral component. We examined coronal plane stability to understand the relative contributions of the mechanisms that act to stabilize the CCK knee under varus–valgus loading, namely, load distribution between the medial and lateral condyles, contact of the tibial post with the femoral intercondylar box, and elongation of the collateral ligaments. A robot testing system was used to determine the joint stability in human cadaveric knees as described by the moment versus angular rotation behavior under varus–valgus moments at 0 deg, 30 deg, and 90 deg of flexion. The angular rotation of the CCK knee in response to the physiological moments was limited to ≤1.5 deg. The primary stabilizing mechanism was the redistribution of the contact force on the bearing surfaces. Contact between the tibial post and the femoral box provided a secondary stabilizing mechanism after lift-off of a condyle had occurred. Collateral ligaments provide limited stability because little ligament elongation occurred under such small angular rotations. Compressive loads applied across the knee joint, such as would occur with the application of muscle forces, enhanced the ability of the bearing surfaces to provide resisting internal varus–valgus moment and, thus, reduced the exposure of the tibial post to the external varus–valgus loads. Our results suggest that the CCK stability can be refined by considering both the geometry of the bearing surfaces and the contacting geometry between the tibial post and femoral box.

Knee joint stability is important in maintaining normal joint motion during activities of daily living. Joint instability not only disrupts normal motion but also plays a crucial role in the initiation and progression of osteoarthritis. Our goal was to examine knee joint coronal plane stability under varus or valgus loading and to understand the relative contributions of the mechanisms that act to stabilize the knee in response to varus–valgus moments, namely, load distribution between the medial and lateral condyles and the ligaments. A robot testing system was used to determine joint stability in human cadaveric knees as described by the moment versus angular rotation behavior under varus and valgus loads at extension and at 30 deg and 90 deg of flexion. The anatomic knee joint was more stable in response to valgus than varus moments, and stability decreased with flexion angle. The primary mechanism for providing varus–valgus stability was the redistribution of the contact force on the articular surfaces from both condyles to a single condyle. Stretching of the collateral ligaments provided a secondary stabilizing mechanism after the lift-off of a condyle occurred. Compressive loads applied across the knee joint, such as would occur with the application of muscle forces, enhanced the ability of the articular surface to provide varus–valgus moment, and thus, helped stabilize the joint in the coronal plane. Coupled internal/external rotations and anteroposterior and medial–lateral translations were variable and in the case of the rotations were often as large as the varus–valgus rotations created by the applied moment.

There are several ways to represent a given object's motion in a 3D space having 6DOF i.e., three translations and three rotations. Some of the methods that are used are mathematical and do not provide any geometrical insight into the nature of the motion. Screw theory is a mathematical, while at the same time, geometrical method in which the 6DOF motion of an object can be represented. We describe the 6DOF motion of a weight-bearing knee by its screw parameters, that are extracted from 3D Optical Reflective motion capture data. The screw parameters which describe the transformation of the shank with respect to the thigh in each two successive frames, is represented as the instantaneous screw axis of the motion given in its Plücker line coordinate, along with its corresponding pitch and intensity values. Moreover, the Striction curve associated with the motion provides geometrical insight into the nature of the motion and its repeatability. We describe the theoretical background and demonstrate what the screw can tell us about the motion of healthy subjects' knee.

Robotic locomotor training devices have gained popularity in recent years, yet little has been reported regarding contact forces experienced by the subject performing automated locomotor training, particularly in animal models of neurological injury. The purpose of this study was to develop a means for acquiring contact forces between a robotic device and a rodent model of spinal cord injury through instrumentation of a robotic gait training device (the rat stepper) with miniature force/torque sensors. Sensors were placed at each interface between the robot arm and animal’s hindlimb and underneath the stepping surface of both hindpaws (four sensors total). Twenty four female, Sprague-Dawley rats received mid-thoracic spinal cord transections as neonates and were included in the study. Of these 24 animals, training began for 18 animals at 21 days of age and continued for four weeks at five min/day, five days/week. The remaining six animals were untrained. Animal-robot contact forces were acquired for trained animals weekly and untrained animals every two weeks while stepping in the robotic device with both 60 and 90% of their body weight supported (BWS). Animals that received training significantly increased the number of weight supported steps over the four week training period. Analysis of raw contact forces revealed significant increases in forward swing and ground reaction forces during this time, and multiple aspects of animal-robot contact forces were significantly correlated with weight bearing stepping. However, when contact forces were normalized to animal body weight, these increasing trends were no longer present. Comparison of trained and untrained animals revealed significant differences in normalized ground reaction forces (both horizontal and vertical) and normalized forward swing force. Finally, both forward swing and ground reaction forces were significantly reduced at 90% BWS when compared to the 60% condition. These results suggest that measurement of animal-robot contact forces using the instrumented rat stepper can provide a sensitive and reliable measure of hindlimb locomotor strength and control of flexor and extensor muscle activity in neurologically impaired animals. Additionally, these measures may be useful as a means to quantify training intensity or dose-related functional outcomes of automated training.

It is widely recognized that the tracking of patella is strongly influenced by the geometry of the trochlear groove. Nonetheless, quantitative baseline data regarding correlation between the three-dimensional geometry of the trochlear groove and patellar tracking under in vivo weight-bearing conditions are not available. A combined magnetic resonance and dual fluoroscopic imaging technique, coupled with multivariate regression analysis, was used to quantify the relationship between trochlear groove geometry (sulcus location, bisector angle, and coronal plane angle) and in vivo patellar tracking (shift, tilt, and rotation) during weight-bearing knee flexion. The results showed that in the transverse plane, patellar shift was strongly correlated (correlation coefficient R = 0.86 , p < 0.001 ) to mediolateral location of the trochlear sulcus (raw regression coefficient β raw = 0.62 ) and the trochlear bisector angle ( β raw = 0.31 ) . Similarly, patellar tilt showed a significant association with the trochlear bisector angle ( R = 0.45 , p < 0.001 , and β raw = 0.60 ). However, in the coronal plane patellar rotation was poorly correlated with its matching geometric parameter, namely, the coronal plane angle of the trochlea ( R = 0.26 , p = 0.01 , β raw = 0.08 ). The geometry of the trochlear groove in the transverse plane of the femur had significant effect on the transverse plane motion of the patella (patellar shift and tilt) under in vivo weight-bearing conditions. However, patellar rotation in the coronal plane was weakly correlated with the trochlear geometry.

Accurately determining in vivo knee kinematics is still a challenge in biomedical engineering. This paper presents an imaging technique using two orthogonal images to measure 6 degree-of-freedom (DOF) knee kinematics during weight-bearing flexion. Using this technique, orthogonal images of the knee were captured using a 3-D fluoroscope at different flexion angles during weight-bearing flexion. The two orthogonal images uniquely characterized the knee position at the specific flexion angle. A virtual fluoroscope was then created in solid modeling software and was used to reproduce the relative positions of the orthogonal images and X-ray sources of the 3-D fluoroscope during the actual imaging procedure. Two virtual cameras in the software were used to represent the X-ray sources. The 3-D computer model of the knee was then introduced into the virtual fluoroscope and was projected onto the orthogonal images by the two virtual cameras. By matching the projections of the knee model to the orthogonal images of the knee obtained during weight-bearing flexion, the knee kinematics in 6 DOF were determined. Using regularly shaped objects with known positions and orientations, this technique was shown to have an accuracy of 0.1 mm and 0.1 deg in determining the positions and orientations of the objects, respectively.

This paper presents a theoretical investigation of a geometrically idealized artificial joint with micro-pocket-covered component and biphasic cartilage on the opposite articulating surface. The fluid that exudes from the biphasic cartilage fills and pressurizes the micro-pockets. In this way, a poro-elasto-hydrodynamic regime of lubrication is developed. Assuming that lower friction would result in lower adhesive wear, and neglecting the fatigue as well as the abrasive wear, the proposed bearing system hypothetically could reduce the amount of wear debris. Equations of the linear biphasic theory are applied for the confined and unconfined compression of the cartilage. The fluid pressure and the elastic deformation of the biphasic cartilage are explicitly presented. The effective and equilibrium friction coefficients are obtained for the particular configuration of this bearing system. The micro-pockets geometrical parameters (depth, radius, surface distribution and edge radius) must be established to reduce the local contact stresses, to assure low friction forces and to minimize the biphasic cartilage damage. The influence of the applied pressure, porosity of the micro-pocket-covered component, filling time, cartilage elasticity, permeability and porosity upon the micro-pockets depth is illustrated. Our results are based upon the previously published data for a biphasic cartilage.

In this study, a finite element model of a vertebral body was used to study the load-bearing role of the two components (shell and core) under compression. The model of the vertebral body has the characteristic kidney shape transverse cross section with concave lateral surfaces and flat superior and inferior surfaces. A nonlinear unit cell based foam model was used for the trabecular core, where nonlinearity was introduced as coupled elastoplastic beam behavior of individual trabeculae. The advantage of the foam model is that architecture and material properties are separated, thus facilitating studies of the effects of architecture on the apparent behavior. Age-related changes in the trabecular architecture were considered in order to address the effects of osteoporosis on the load-sharing behavior. Stiffness changes with age (architecture and porosity changes) for the trabecular bone model were shown to follow trends in published experimental results. Elastic analyses showed that the relative contribution of the shell to the load-bearing ability of the vertebra decreases with increasing age and lateral wall curvature. Elasto-plastic (nonlinear) analyses showed that failure regions were concentrated in the upper posterior region of the vertebra in both the shell and core components. The ultimate load of the vertebral body model varied from 2800 N to 5600 N, depending on age (architecture and porosity of the trabecular core) and shell thickness. The model predictions lie within the range of experimental results. The results provide an understanding of the relative role of the core and shell in vertebral body mechanics and shed light on the yield and post-yield behavior of the vertebral body.

A hydrogel with potential applications in the role of a cushion form replacement joint bearing surface material has been investigated. The material properties are required for further development and design studies and have not previously been quantified. Creep indentation experiments were therefore performed on samples of the hydrogel. The biphasic model developed by Mow and co-workers (Mak et al., 1987; Mow et al., 1989a) was used to curve-fit the experimental data to theoretical solutions in order to extract the three intrinsic biphasic material properties of the hydrogel (aggregate modulus, H A , Poisson’s ratio, ν s , and permeability, k). Ranges of material properties were determined: aggregate modulus was calculated to be between 18.4 and 27.5 MPa, Poisson’s ratio 0.0–0.307, and permeability 0.012–7.27 × 10 −17 m 4 /Ns. The hydrogel thus had a higher aggregate modulus than values published for natural normal articular cartilage, the Poisson’s ratios were similar to articular cartilage, and finally the hydrogel was found to be less permeable than articular cartilage. The determination of these values will facilitate further numerical analysis of the stress distribution in a cushion form replacement joint.

This paper describes the design and accuracy evaluation of a dynamometric pedal, which measures the two pedal force components in the plane of the bicycle. To realize a design that could be used during actual off-road cycling, a popular clipless pedal available commercially was modified so that both the form and the function of the original design were maintained. To measure the load components of interest, the pedal spindle was replaced with a spindle fixed to the pedal body and instrumented with eight strain gages connected into two Wheatstone bridge circuits. The new spindle is supported by bearings in the crank arm. Static calibration and a subsequent accuracy check revealed root mean square errors of less than 1 percent full scale (FS) when only the force components of interest were applied. Application of unmeasured load components created an error less than 2 percent FS. The natural frequency with half the weight of a 75 kgf person standing on the pedal was greater than 135 Hz. These performance capabilities make the dynamometer suitable for measuring either pedaling loads due to the rider’s muscular action or inertial loads due to surface-induced acceleration. To demonstrate this suitability, sample pedal load data are presented both for steady-state ergometer cycling and coasting over a rough surface while standing.

This study was conducted to validate a new in vitro method to expose the medial compartment of the knee to be used in subsequent studies aimed at examining the load bearing capabilities of medial meniscal allografts. The new method involves an osteotomy and reattachment of the medial femoral condyle. The primary hypothesis was that the new method does not alter tibio-femoral contact pressure and area. To validate this method, the baseline contact pressure of the intact medial compartment was measured using a new nondestructive procedure for inserting pressure measurement film into the intact medial hemijoint. A secondary and related hypothesis was that incising the coronary ligament, a destructive method used by previous investigators to position pressure measurement film, alters the normal tibio-femoral contact pressure. To test these hypotheses, Fuji Prescale pressure-sensitive film was used to measure both tibio-femoral contact pressure and area within the medial compartment of the (1) intact knee, (2) the knee after osteotomizing and reattaching the medial femoral condyle, and (3) the osteotomized knee with an incised coronary ligament, using seven cadaver specimens. Measurements were taken at a compressive load of approximately two times body weight with the knee in 0, 15, 30, 45 deg of flexion. No significant differences between the intact and osteotomized knee were detected. Likewise, no significant differences were observed between the osteotomized knee and the osteotomized knee with an incised coronary ligament. These results confirm the utility of the new method in exposing the medial compartment for manipulation and placement of medial meniscal allografts in future studies examining the load-bearing characteristics of meniscal allografts.

Clinical follow-up studies of joint replacements indicate that debonding of the implant from the bone-cement is the first mechanical event of loosening. Debonding can occur due to unsustainable interface stresses, usually initiated from defects along the interface. Such defects, or flaws, are inevitably introduced during the surgical procedure and from polymerisation shrinkage. Debonding leads to increased stresses within the cement mantle. This study is concerned with modelling the propagation of a crack from the debonded region on the cement/implant interface under physiological loading conditions for different implant materials and prosthesis designs. Using the theory of linear fracture mechanics for bimaterial interfaces, the behaviour of a crack along an interface between implant materials, under various states of stress, is studied. Specifically, a model is developed to determine the conditions under which a debonded region, along an otherwise bonded interface, will either propagate along the interface or will “kink” into the cement mantle. The relationship between the stress state and the crack propagation direction at the interface is then predicted for different interface materials, and it is shown that different crack directions exist for different materials, even when the stress state is the same. Furthermore, the crack behavior is shown to be dependent on the ratio of normal stress to shear stress at the interface and this may be important for the design optimisation of load-bearing cemented prostheses. Finally, the likelihood that an interface crack will propagate into the cement mantle is explored using a suitable fracture criterion.