ADDRESSING PARTIAL VOLUME ARTIFACTS WITH QUANTITATIVE COMPUTED TOMOGRAPHY-BASED FINITE ELEMENT MODELING OF THE HUMAN PROXIMAL TIBIA

Quantitative computed tomography (QCT) based finite element modeling (FE) has potential to clarify the role of subchondral bone stiffness in osteoarthritis. The limited spatial resolution of clinical CT systems, however, results in partial volume (PV) artifacts and low contrast between the cortical and trabecular bone, which adversely affect the accuracy of QCT-FE models. Using different cortical modeling and partial volume correction algorithms, the overall aim of this research was to improve the accuracy of QCT-FE predictions of stiffness at the proximal tibial subchondral surface. For Study #1, QCT-FE models of the human proximal tibia were developed by (1) separate modeling of cortical and trabecular bone (SM), and (2) continuum models (CM). QCT-FE models with SM and CM explained 76%-81% of the experimental stiffness variance with error ranging between 11.2% and 20.2%. SM did not offer any improvement relative to CM. The segmented cortical region indicated densities below the range reported for cortical bone, suggesting that cortical voxels were corrupted by PV artifacts. For Study #2, we corrected PV layers at the cortical bone using four different methods including: (1) Image Deblurring of all of the proximal tibia (IDA); (2) Image Deblurring of the cortical region (IDC); (3) Image Remapping (IR); and (4) Voxel Exclusion (VE). IDA resulted in low predictive accuracy with R2=50% and error of 76.4%. IDC explained 70% of the measured stiffness variance with 23.3% error. The IR approach resulted in an R2 of 81% with 10.6% error. VE resulted in the highest predictive accuracy with R2=84%, and 9.8% error. For Study #3, we investigated whether PV effects could be addressed by mapping bone’s elastic modulus (E) to mesh Gaussian points. Corresponding FE models using the Gauss-point method converged with larger elements when compared to the conventional method which assigned a single elastic modulus to each element (constant-E). The error at the converged mesh was similar for constant-E and Gauss-point; though, the Gauss-point method indicated this error with larger elements and less computation time (30 min vs 180 min). This research indicated that separate modeling of cortical and trabecular bone did not improve predictions of stiffness at the subchondral surface. However, this research did indicate that PV correction has potential to improve QCT-FE models of subchondral bone. These models may help to clarify the role of subchondral bone stiffness in knee OA pathogenesis with living people

Micro Finite Element models of the vertebral body: Validation of local displacement predictions

The estimation of local and structural mechanical properties of bones with micro Finite Element (microFE) models based on Micro Computed Tomography images depends on the quality bone geometry is captured, reconstructed and modelled. The aim of this study was to validate microFE models predictions of local displacements for vertebral bodies and to evaluate the effect of the elastic tissue modulus on model’s predictions of axial forces. Four porcine thoracic vertebrae were axially compressed in situ, in a step-wise fashion and scanned at approximately 39μm resolution in preloaded and loaded conditions. A global digital volume correlation (DVC) approach was used to compute the full-field displacements. Homogeneous, isotropic and linear elastic microFE models were generated with boundary conditions assigned from the interpolated displacement field measured from the DVC. Measured and predicted local displacements were compared for the cortical and trabecular compartments in the middle of the specimens. Models were run with two different tissue moduli defined from microindentation data (12.0GPa) and a back-calculation procedure (4.6GPa). The predicted sum of axial reaction forces was compared to the experimental values for each specimen. MicroFE models predicted more than 87% of the variation in the displacement measurements (R2 = 0.87–0.99). However, model predictions of axial forces were largely overestimated (80–369%) for a tissue modulus of 12.0GPa, whereas differences in the range 10–80% were found for a back-calculated tissue modulus. The specimen with the lowest density showed a large number of elements strained beyond yield and the highest predictive errors. This study shows that the simplest microFE models can accurately predict quantitatively the local displacements and qualitatively the strain distribution within the vertebral body, independently from the considered bone types

Micro-Computed Tomography-Based Finite Element Analysis Of The Mechanical Integrity Of In Vivo Biodegradable Magnesium-Alloy Screw And Surrounding Bone

The anterior cruciate ligament (ACL) tear, the most common knee injury, affects 100,000 to 200,000 persons in the US annually. Surgical repair is employed to restore the knee to its full range of motion. In the surgery, an interference screw is used to a secure a soft tissue graft that is used to replace the torn ACL. In 2012, orthopedic devices for knees accounted for the largest share of the $29.2 billion overall revenue for orthopedic devices. Biodegradable implants are expected to lead growth in the orthopedic sector by increasing the quality of life and decreasing recovery time after orthopedic injury for athletes and non-athletes and aging, osteoporotic, osteoarthritic and obese populations. Magnesium-based orthopedic devices, including interference screws, are being investigated because of their ability to provide high strength as a metal, but degrade like a polymer. One objective of this study was to compare the pull-out forces of an unnamed magnesium-alloy against a commercially available copolymer, 82:18 PLLA:PLGA, in woven bone using finite element analysis. The reaction forces in bone and displacement of the screws were used to assess the overall performance of each material in a pull-out test. The second objective of this work was to develop and evaluate micro-computed tomography-based finite element models of in vivo biodegradable screws of the unnamed magnesium-alloy over time in rabbit femurs. Several foundational observations were made about modeling in vivo degrading magnesium devices with a micro-CT to FEA protocol. The results of this work have shown that an unnamed biodegradable magnesium-alloy and a biodegradable 82:18 PLLA:PLGA copolymer performed equally in nodal displacement and that the Mg-based device only outperformed the copolymer in Emin woven bone

Mechanics of the right whale mandible : full scale testing and finite element analysis

Author Posting. © Elsevier B.V., 2009. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in Journal of Experimental Marine Biology and Ecology 374 (2009): 93-103, doi:10.1016/j.jembe.2009.03.012.In an effort to better understand the mechanics of ship-whale collision and to reduce the associated mortality of the critically endangered North Atlantic right whale, a comprehensive biomechanical study has been conducted by the Woods Hole Oceanographic Institution and the University of New Hampshire. The goal of the study is to develop a numerical modeling tool to predict the forces and stresses during impact and thereby the resulting mortality risk to whales from ship strikes. Based on post-mortem examinations, jaw fracture was chosen as a fatal endpoint for the whales hit by a vessel. In this paper we investigate the overall mechanical behavior of a right whale mandible under transverse loading and develop a finite element analysis model of the bone. The equivalent elastic modulus of the cortical component of right whale mandible is found by comparing full-scale bending tests with the results of numerical modeling. The finite element model of the mandible can be used in conjunction with a vessel-whale collision event model to predict bone fracture for various ship strike scenarios.Funding for this work was provided by the National Science Foundation (Graduate Research Fellowship Program, Campbell-Malone), the National Oceanic and Atmospheric Administration (Right Whale Grants Program, award number NA04NMF4720402), and the Woods Hole Oceanographic Institution Ocean Life Institute

Mechanical and morphometric characterization of cancellous bone

[EN] Bone fracture is a social health problem of increasing magnitude because of its prevalence in aged population due to osteoporosis. Bone quality is often characterized by bone mineral density (BMD) measured at cancellous bone regions using dual-energy X-ray absorptiometry (DXA). However, BMD alone cannot predict several cases because not only density is important, but also microstructure plays an important role in cancellous bone strength. The mechanical properties can be used as indicators of bone integrity as a function of age, disease or treatment. Therefore, cancellous bone fracture characterization and its relationship to microstructure has not been completely solved in the literature and is relevant to improve fracture prediction. In this thesis, we aim at characterizing cancellous bone morphometry and mechanical behavior. Morphometry is estimated through the analysis of micro-computed tomography (micro-CT) images of vertebral cancellous bone specimens. With regards to the mechanical behavior, we calculate elastic, yield and failure properties at the apparent and tissue levels. To determine them, we followed different approaches: compression tests, finite element models and micro-CT phantoms. We have developed finite element models that reproduce the elastic and failure response of cancellous bone under compression conditions. We modeled failure as a combination of continuum damage mechanics and the element deletion technique. The numerical models permitted to estimate elastic and failure properties. Failure properties were consistent with results reported in the literature. Specifically, our results revealed that yield strain is relatively constant (0.7 %) over a range of apparent densities, while failure strain presents a wider range of variation. A single strain parameter (equivalent strain) was found as an accurate descriptor of cancellous bone compression failure. Image-based numerical models usually need for the action of a technician to segment the images. Therefore, we studied the sensitivity to variations of the segmentation threshold on the morphometry and the elastic properties of vertebral cancellous bone specimens of different bone volume fractions. The apparent modulus is highly sensitive to the segmentation threshold. We report variations between 45 and 120 % for a ± 15 % threshold variation. Other parameters, such as BS/BV, BS/TV, Tb.Sp, Tb.N, Conn.D and fractal dimension were influenced significantly. Digital image correlation (DIC) was applied to images taken during compression testing to analyze displacement fields at failure and characterize them. Some variables were explored to describe failure and a study is done about how DIC parameters influence the strain field obtained. Facet and step sizes have a relevant effect on the failure strain estimation, and an increment of both parameters reduces the strain estimation up to 40 %. Besides, several parameters combination led to correct failure pattern detection, so values reported in the literature should be referred to the parameters used. Furthermore, we explored if cancellous bone microstructure acts (non-speckle/texture approach) as a proper pattern to calculate displacements using DIC technique. As regards relationships between microstructure and mechanics, single and multiple parameter analysis were performed to assess the morphometric variables that control the explanation of mechanical properties variation. Bone volume fraction (BV/TV), bone surface to volume ratio (BS/BV), mean trabecular thickness (Tb.Th) and fractal dimension (D) presented the best linear correlations to the elastic properties, while both the yield and failure strains did not show correlation to any morphometric parameter. The regressions obtained permit to estimate those mechanical properties that describe the state of a specimen.[ES] Las fracturas óseas constituyen un problema social de salud con magnitud creciente por su prevalencia en la población de edad avanzada debido a la osteoporosis. La calidad del hueso suele caracterizarse mediante la estimación de la densidad mineral ósea (DMO) en regiones de hueso trabecular, utilizando absorciometría de rayos X de energía dual (DXA). No obstante, la DMO por si sola no es capaz de predecir numerosos casos de fractura porque no solo importa la pérdida de densidad, sino que la microestructura también tiene un papel principal en la resistencia del hueso. Las propiedades mecánicas del hueso pueden usarse como indicadores de su integridad en función de la edad, enfermedad o tratamiento. Por lo tanto, la caracterización de la fractura de hueso trabecular y su relación con la microestructura no se ha resuelto de forma completa en la literatura y es relevante para mejorar las predicciones de fractura. En esta tesis, nuestro principal objetivo es caracterizar la morfometría y el comportamiento mecánico del hueso trabecular. Estimamos la morfometría a través del análisis de imágenes obtenidas por micro tomografía computerizada (micro-CT) de muestras de hueso trabecular vertebral de cerdo. Respecto al comportamiento mecánico, calculamos propiedades elásticas, de plasticidad y fractura a escala aparente y de tejido. Para determinar esas propiedades, hemos seguido diferentes procedimientos: ensayos a compresión, modelos de elementos finitos y fantomas de calibración micro-CT. Los modelos de elementos finitos desarrollados reproducen la respuesta elástica y de fallo bajo condiciones de compresión en hueso trabecular, modelando el fallo como combinación de mecánica del daño contínuo y la técnica de eliminación de elementos. Los modelos numéricos desarrollados han permitido estimar propiedades elásticas y de fallo. En concreto, las deformaciones de inicio de fallo estimadas son relativamente constantes para las muestras analizadas (0.7 %), mientras que las deformaciones últimas de fallo presentan un rango de variación mayor. Por otro lado, encontramos que la deformación equivalente es el descriptor más preciso del fallo a compresión del hueso trabecular. Normalmente, los modelos numéricos basados en imágenes suelen necesitar la acción de un técnico para segmentar las imágenes. En este sentido, estudiamos la sensibilidad de la morfometría y la estimación de propiedades elásticas ante variaciones en el umbral de segmentación en muestras con distinta fracción en volumen. Hemos obtenido que la rigidez aparente es muy sensible a cambios en el umbral de segmentación, con variaciones entre 45 y 120 % para una variación de ± 15 % del umbral de segmentación. Otros parámetros, como BS/BV, BS/TV, Tb.Sp, Tb.N, Conn.D y la dimensión fractal se ven afectados significativamente. Por otro lado, hemos aplicado la técnica correlación digital por imagen (DIC) para caracterizar campos de desplazamientos en el fallo a compresión del hueso trabecular, a partir del análisis de imágenes tomadas durante el ensayo de las muestras. Además, estudiamos la influencia de algunos parámetros de la técnica DIC en el campo de deformaciones obtenido. También, hemos explorado la aplicación DIC sin el uso de moteado, utilizando como patrón de reconocimiento la propia microestructura trabecular. En relación al estudio de la influencia de la microestructura en la respuesta mecánica, hemos calculado correlaciones de uno y varios parámetros para analizar qué variables morfométricas explican la variación de las propiedades mecánicas. La fracción en volumen de hueso (BV/TV), la relación entre el área y el volumen de hueso (BS/BV), el espesor trabecular medio (Tb.Th) y la dimensión fractal (D) presentan las mejores correlaciones lineales respecto a las propiedades elásticas, mientras que las deformaciones de inicio de plasticidad y fractura no mostraron correlación con ningún parámetro morfométrico.[CA] Les fractures òssies constitueixen un problema social de salut amb magnitud creixent per la seua prevalença en la població d'edat avançada a causa de l'osteoporosi. La qualitat de l'os sol caracteritzar-se mitjançant l'estimació de la densitat mineral òssia (DMO) en regions d'os trabecular, utilitzant absorciometria de raigs X d'energia dual (DXA). No obstant això, la DMO per si sola no és capaç de predir nombrosos casos de fractura perquè no sols importa la pèrdua de densitat, sinó que la microestructura també té un paper principal en la resistència de l'os. Les propietats mecàniques de l'os poden usar-se com a indicadors de la seua integritat en funció de l'edat, malaltia o tractament. Per tant, la caracterització de la fractura d'os trabecular i la seua relació amb la microestructura no s'ha resolt de manera completa en la literatura i és rellevant per a millorar les prediccions de fractura. En aquesta tesi, el nostre principal objectiu és caracteritzar la morfometria i el comportament mecànic de l'os trabecular. Estimem la morfometria a través de l'anàlisi d'imatges obtingudes per micro tomografia automatitzada (micro-CT) de mostres d'os trabecular vertebral de porc. Respecte al comportament mecànic, calculem propietats elàstiques, de plasticitat i fractura a escala aparent i de teixit. Per a determinar aqueixes propietats, hem seguit diferents procediments: assajos a compressió, models d'elements finits i fantomas de calibratge micro-CT. Hem desenvolupat models d'elements finits que reprodueixen la resposta elàstica i de fallada sota condicions de compressió en os trabecular, modelant la fallada com a combinació de mecànica del dany continu i la tècnica d'eliminació d'elements. Els models numèrics desenvolupats han permés estimar propietats elàstiques i de fallada. Les nostres estimacions respecte a propietats de fallada són consistents amb valors reportats en la literatura. En concret, les deformacions d'inici de fallada estimades són relativament constants per a les mostres analitzades (0.7 %), mentre que les deformacions últimes de fallada presenten un rang de variació major. D'altra banda, trobem que la deformació equivalent és el descriptor més precís de la fallada a compressió de l'os trabecular. Els models numèrics basats en imatges solen necessitar l'acció d'un tècnic per a segmentar les imatges. En aquest sentit, estudiem la sensibilitat de la morfometria i l'estimació de propietats elàstiques davant variacions en el llindar de segmentació en mostres amb diferent fracció en volum. Hem obtingut que la rigidesa aparent és molt sensible a canvis en el llindar de segmentació, amb variacions entre 45 i 120 % per a una variació de ± 15 % del llindar de segmentació. Altres paràmetres, com BS/BV, BS/TV, Tb.Sp, Tb.N, Conn.D i la dimensió fractal es veuen afectats significativament. D'altra banda, hem aplicat la tècnica correlació digital per imatge (DIC) per a caracteritzar camps de desplaçaments en la fallada a compressió de l'os trabecular, a partir de l'anàlisi d'imatges preses durant l'assaig de les mostres. A més, estudiem la influència d'alguns paràmetres de la tècnica DIC en el camp de deformacions obtingut. També, hem explorat l'aplicació DIC sense l'ús de clapejat, utilitzant com a patró de reconeixement la pròpia microestructura trabecular. En relació a l'estudi de la influència de la microestructura en la resposta mecànica, hem calculat correlacions d'un i diversos paràmetres per a analitzar quines variables morfomètriques expliquen la variació de les propietats mecàniques. La fracció en volum d'os (BV/TV), la relació entre l'àrea i el volum d'os (BS/BV), la espessor trabecular mitjà (Tb.th) i la dimensió fractal (D) presenten les millors correlacions lineals respecte a les propietats elàstiques, mentre que les deformacions d'inici de plasticitat i fractura no van mostrar correlació amb cap paràmetre morfomètric.Belda González, R. (2020). Mechanical and morphometric characterization of cancellous bone [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/149376TESI

Predicting Distal Radius Failure Load during a Fall using Mechanical Testing and Peripheral Quantitative Computed Tomography

Distal radius fractures are the most common form of osteoporotic fracture in women and play an important role in predicting other osteoporotic fractures. Colles’ fracture, a type of DRF, result from a fall from standing height or less. Peripheral quantitative computed tomography (pQCT) imaging is commonly used to estimate distal radius strength (resistance to failure) via bone strength indices such as BSIc (related to compressive axial loading resistance). BSIc has been validated in experimental compressive testing. However, during a fall, the distal radius is subjected to a combination of dorsal-directed forces (which result in bending) and axial compression. The primary objective of this study was to validate new pQCT-based bone strength indices combining resistance to bending and compression using optimized and clinically-applied image resolutions. The secondary objective was to validate these new indices against reported bone strength indices and bone properties for predicting the failure load in a mechanical testing scenario representing a fall on the extended hand. Fourteen cadaveric forearms, with the hand intact, were scanned using pQCT at 4% of the length of the radius away from the distal end. Bone was defined as pixels with density > 100 mg/cm3 and cortical bone as pixels with density > 480 mg/cm3 using BoneJ, a tool designed to be used with ImageJ, an open source image analysis tool. This thresholding provided the basis for various measures which have been used in existing literature to predict failure load. Novel bone strength indices were calculated using composite beam theory based on the density of each pixel using total bone area, total volumetric bone mineral density and a density weighted modulus. Each of the novel measures examined the point of maximum stress in a single direction; this combined the uniform axial load applied over the cross-section and the bending resulting from an off-axis load, like that experienced during a fall. After scanning, potted samples were placed in a material testing system (MTS Bionix) with 15° of dorsal inclination and 3-6° of radial inclination, corresponding with the hand positon during a fall. Testing was performed at 3mm/s (180 mm/min) until fracture occurred and ultimate failure load was recorded. Linear regression models were used to assess imaged-based bone strength indices and bone properties predicting variance (coefficient of determination, R2) in the experimentally derived failure load. A new bone strength index BSIM , bone strength index in medial direction - which considered axial loading and bending stresses at the farther medial point on the radius, explained up to 90% of variance in the experimental failure load. The highest coefficient of determination from metrics used previously in the literature was total bone mineral content (R2 = 0.88). Two other novel bone strength indices, BSIV (farthest point in the volar direction) and BSID (farthest point in the dorsal direction) predicted 88% of variance. Additionally, BSIL (farthest point in the lateral direction) explained 86% of variance. This validates the use of these new measures as predictors of failure load in the distal radius during a fall. This work also found the existing measure of bone strength index in compression, BSIc, predicted up to 83% of variance in the experimental failure load, which validates its use on the radius instead of remaining as a tibia specific tool