Biomechanical factors associated with the development of tibiofemoral knee osteoarthritis: protocol for a systematic review and meta-analysis

INTRODUCTION: Altered biomechanics, increased joint loading and tissue damage, might be related in a vicious cycle within the development of knee osteoarthritis (KOA). We have defined biomechanical factors as joint-related factors that interact with the forces, moments and kinematics in and around a synovial joint. Although a number of studies and systematic reviews have been performed to assess the association of various factors with the development of KOA, a comprehensive overview focusing on biomechanical factors that are associated with the development of KOA is not available. The aim of this review is (1) to identify biomechanical factors that are associated with (the development of) KOA and (2) to identify the impact of other relevant risk factors on this association. METHODS AND ANALYSIS: Cohort, cross-sectional and case–control studies investigating the association of a biomechanical factor with (the development of) KOA will be included. MEDLINE, EMBASE, CINAHL and SPORTDiscus will be searched from their inception until August 2015. 2 reviewers will independently screen articles obtained by the search for eligibility, extract data and score risk of bias. Quality of evidence will be evaluated. Meta-analysis using random effects model will be applied in each of the biomechanical factors, if possible. ETHICS AND DISSEMINATION: This systematic review and meta-analysis does not require ethical approval. The results of this systematic review and meta-analysis will be disseminated through publications in peer-reviewed journals and presentations at (inter)national conferences. TRIAL REGISTRATION NUMBER: CRD42015025092

Cockpit design and evaluation using interactive graphics

A general overview of the characteristics of an interactive graphics system which was developed to assist cockpit engineers design and evaluate work stations was presented. The manikin used in this COMputerized BIomechanical MAN-model (COMBIMAN) was described, as are provisions for generating work stations and assessing interactions between man and environment. The applications of the present system are explained, and critiques of COMBIMAN are presented. The limitations of the existing programs and the requirements of the designers necessitate future revisions and additions to the biomechanical and erogonomic properties of COMBIMAN. Some of these enhancements are discussed

ISSLS PRIZE IN BIOENGINEERING SCIENCE 2019: biomechanical changes in dynamic sagittal balance and lower limb compensatory strategies following realignment surgery in adult spinal deformity patients.

Study designA longitudinal cohort study.ObjectiveTo define a set of objective biomechanical metrics that are representative of adult spinal deformity (ASD) post-surgical outcomes and that may forecast post-surgical mechanical complications. Current outcomes for ASD surgical planning and post-surgical assessment are limited to static radiographic alignment and patient-reported questionnaires. Little is known about the compensatory biomechanical strategies for stabilizing sagittal balance during functional movements in ASD patients.MethodsWe collected in-clinic motion data from 15 ASD patients and 10 controls during an unassisted sit-to-stand (STS) functional maneuver. Joint motions were measured using noninvasive 3D depth mapping sensor technology. Mathematical methods were used to attain high-fidelity joint-position tracking for biomechanical modeling. This approach provided reliable measurements for biomechanical behaviors at the spine, hip, and knee. These included peak sagittal vertical axis (SVA) over the course of the STS, as well as forces and muscular moments at various joints. We compared changes in dynamic sagittal balance (DSB) metrics between pre- and post-surgery and then separately compared pre- and post-surgical data to controls.ResultsStandard radiographic and patient-reported outcomes significantly improved following realignment surgery. From the DSB biomechanical metrics, peak SVA and biomechanical loads and muscular forces on the lower lumbar spine significantly reduced following surgery (- 19 to - 30%, all p < 0.05). In addition, as SVA improved, hip moments decreased (- 28 to - 65%, all p < 0.05) and knee moments increased (+ 7 to + 28%, p < 0.05), indicating changes in lower limb compensatory strategies. After surgery, DSB data approached values from the controls, with some post-surgical metrics becoming statistically equivalent to controls.ConclusionsLongitudinal changes in DSB following successful multi-level spinal realignment indicate reduced forces on the lower lumbar spine along with altered lower limb dynamics matching that of controls. Inadequate improvement in DSB may indicate increased risk of post-surgical mechanical failure. These slides can be retrieved under Electronic Supplementary Material

Laparoscopic Assisted Fusion of the Lumbosacral Spine: A Biomechanical and Histologic Analysis of the Open Versus Laparoscopic Technique in an Animal Model

Study Design. An animal model for laparoscopic lumbosacral fusion. Objectives. To compare the biomechanical and histologic results of open to laparoscopic lumbosacral discectomy and fusion in an animal model. Background Data. Early clinical reports of laparoscopic lumbosacral fusions are encouraging, but animal experiments have not been reported. Methods. Ten pigs (50-80 kg) were divided into two groups. Group 1 underwent an open anterior lumbosacral discectomy and fusion at L7-S1 using autologous bone graft and a titanium MOSS (DePuy Motech) cage. Group 2 was identical to Group 1 except that a laparoscopic technique was used. The animals were killed at 3 months, and the lumbosacral spines were harvested for biomechanical and histologic testing. Results. Estimated blood loss and average length of operation, respectively, for the two groups were: Group 1, 50 mL, 2 hours 50 minutes; and Group 2, 40 mL, 3 hours 40 minutes. There were no perioperative or postoperative complications in either group. Motion analysis results showed less motion in lateral bending, flexion, and extension than in the intact specimen in both groups. Tensile testing showed that the stiffness was significantly greater in the open group than in the laparoscopic group (P \u3c 0.004). Histologic examination showed a less extensive discectomy and less bone growth in the implant in the laparoscopic group. Inadequate decortication of end-plates occurred in two animals who underwent laparoscopy. Conclusions. Although lumbosacral discectomy and implant insertion can be performed using the laparoscopic technique, the construct may not have the same biomechanical strength as that attained with the open procedure. Laparoscopic-assisted lumbosacral fusion surgery requires additional investigation before it is widely used in clinical situations

Incremental embodied chaotic exploration of self-organized motor behaviors with proprioceptor adaptation

This paper presents a general and fully dynamic embodied artificial neural system, which incrementally explores and learns motor behaviors through an integrated combination of chaotic search and reflex learning. The former uses adaptive bifurcation to exploit the intrinsic chaotic dynamics arising from neuro-body-environment interactions, while the latter is based around proprioceptor adaptation. The overall iterative search process formed from this combination is shown to have a close relationship to evolutionary methods. The architecture developed here allows realtime goal-directed exploration and learning of the possible motor patterns (e.g., for locomotion) of embodied systems of arbitrary morphology. Examples of its successful application to a simple biomechanical model, a simulated swimming robot, and a simulated quadruped robot are given. The tractability of the biomechanical systems allows detailed analysis of the overall dynamics of the search process. This analysis sheds light on the strong parallels with evolutionary search