Macrodamage Accumulation Model for a Human Femur

The objective of this study was to more fully understand the mechanical behavior of bone tissue that is important to find an alternative material to be used as an implant and to develop an accurate model to predict the fracture of the bone. Predicting and preventing bone failure is an important area in orthopaedics. In this paper, the macrodamage accumulation models in the bone tissue have been investigated. Phenomenological models for bone damage have been discussed in detail. In addition, 3D finite element model of the femur prepared from imaging data with both cortical and trabecular structures is delineated using MIMICS and ANSYS® and simulated as a composite structure. The damage accumulation occurring during cyclic loading was analyzed for fatigue scenario. We found that the damage accumulates sooner in the multiaxial than in the uniaxial loading condition for the same number of cycles, and the failure starts in the cortical bone. The damage accumulation behavior seems to follow a three-stage growth: a primary phase, a secondary phase of damage growth marked by linear damage growth, and a tertiary phase that leads to failure. Finally, the stiffness of the composite bone comprising the cortical and trabecular bone was significantly different as expected

Hierarchical Structure and Properties of the Bone at Nano Level

Bone is a highly hierarchical complex structure that consists of organic and mineral components represented by collagen molecules (CM) and hydroxyapatite crystals (HAC), respectively. The nanostructure of bone can significantly affect its mechanical properties. There is a lack of understanding how collagen fibrils (CF) in different orientations may affect the mechanical properties of the bone. The objective of this study is to investigate the effect of interaction, orientation, and hydration on atomic models of the bone composed of collagen helix (CH) and HAC, using molecular dynamics simulations and therefrom bone-related disease origins. The results demonstrate that the mechanical properties of the bone are affected significantly by the orientation of the CF attributed to contact areas at 0° and 90° models. The molecular dynamics simulation illustrated that there is significant difference (p \u3c 0.005) in the ultimate tensile strength and toughness with respect to the orientation of the hydrated and un-hydrated CF. Additionally, the results indicated that having the force in a longitudinal direction (0°) provides more strength compared with the CF in the perpendicular direction (90°). Furthermore, the results show that substituting glycine (GLY) with any other amino acid affects the mechanical properties and strength of the CH, collagen–hydroxyapatite interface, and eventually affects the HAC. Generally, hydration dramatically influences bone tissue elastic properties, and any change in the orientation or any abnormality in the atomic structure of either the CM or the HAC would be the main reason of the fragility in the bone, affecting bone pathology

Hierarchical Structure, Properties and Bone Mechanics at Macro, Micro, and Nano Levels

This research focuses on the hierarchical structure of bone and associated mechanical properties at different scales to assess damage accumulation leading to premature failure, with or without instrumentation. In this work, an attempt was made to develop a framework of macro, micro, and nano damage accumulation models and implementing them to derive mechanical behavior of the bone. At macrolevel, retrospective evaluation of 313 subjects was conducted, and the damage of bone tissue was investigated with respect to subject demography including age, gender, race, body mass index (BMI), height and weight, and their role in initiating fracture. Experimental data utilized 28 human femoral bones implanted with cephalomedullary nails were used to develop damage prediction models. Investigation of three real life medical device failures identified the mechanical and clinical bases of bone failure. At the micro level, microdamage accumulation of the bone was investigated in 307 subjects and new effective morphological parameters at microscale were proposed. At the nano level, molecular dynamics simulation was performed to investigate the effect of interaction, orientation, and hydration on the atomic models of the bone composed of collagen helix and hydroxyapatite crystal. The results showed that bone density and maximum von Mises stress decreased drastically in elderly patients, implying fixation devices and implants used by the young cannot be used. The results also showed that the two-dimensional representation of the morphological parameters of the bone at microscale does not provide a realistic description of bone structure. Therefore, in this work, three-dimensional representations at microscale indicated that bone interconnectivity is higher in female patients than in male patients. Gender has a significant effect on microdamage distribution in the bone. More precautions should be taken into consideration for older female patients. Race should also be considered during modeling implants or suggesting therapeutic techniques. Caucasian subjects are more susceptible to bone fatigue failure than other races. The mechanical properties of bone are affected significantly by the orientation of the collagen fibril, which varies between ethnicities. Any change in the structure of the collagen-hydroxyapatite composite leads to variable bone diseases. There is significant difference in the ultimate tensile strength and toughness of the bone with respect to the orientation of the hydrated and un-hydrated collagen fibrils. Water content also influences the bone tissues’ elastic properties. The force in longitudinal direction (0°) provides more strength compared with the collagen fibril in the perpendicular direction (90°). Substituting Glycine with other amino acids affects the mechanical properties and strength of the collagen helix, collagen-hydroxyapatite interface, and eventually affecting hydroxyapatite crystal. Appropriate models developed in each category showing experimental and computational relationships and their application in selecting implant materials

Failure Analysis of PHILOS Plate Construct Used for Pantalar Arthrodesis Paper II-Screws and FEM Simulations

A fractured stainless steel 3.5 mm proximal humerus internal locking system (PHILOS) plate and screws were investigated in this paper. This plate was used for ankle arthrodesis of a 68-year-old female with a right ankle deformity. Both the plate and screws were considered in this investigation. Optical and scanning electron microscopes (SEM) were used to document fracture surface characteristics, such as extensive scratching, plastic deformation, rubbed surfaces, discoloration, and pitting, along with cleavage, secondary cracking, deposits of debris, striations, and dimples. Indications of these features show that the plate failed by corrosion fatigue, however, overloading separated the screw(s) in two parts. Radiographic evidence shows that the screws failed ahead of the plate from the proximal end. Three-dimensional models of the plate and the screws: cortical, locking, and cannulated, were constructed using Solidworks and imported in ANSYS Workbench 16.2 to simulate the loading conditions and regions of stress development. Statistical analysis was conducted to understand the impact of different factors on the maximum von Mises stresses of the locking compression plate. These factors were the load, screw design pattern, coefficient of friction between the plate and screws, and cortical screw displacement. In summary, the finite element simulation of the plate validates the fractographic examination results. The following observations were made: (a) as the angle between the screws and the plates increased, the von Mises stresses increased in the cortical screws; and (b) the stress in the locking screws was lower than that of the cortical screws, which may be due to locking the screws with fixed angles onto the plate. Finally, fractographic examination of the cortical and locking screws supports the mechanism of corrosion-fatigue fracture from crack initiation sites, pits, due to the presence of inclusion bodies for this material (ASTM standards F138-03 and F139-03) documented for the plate in Paper I

Retrospective Evaluation and Framework Development of Bone Anisotropic Material Behavior Compared with Elastic, Elastic-Plastic, and Hyper-Elastic Properties

The main motivation for studying damage in bone tissue is to better understand how damage develops in the bone tissue and how it progresses. Such knowledge may help in the surgical aspects of joint replacement, fracture fixation or establishing the fracture tolerance of bones to prevent injury. Currently, there are no standards that create a realistic bone model with anisotropic material properties, although several protocols have been suggested. This study seeks to retrospectively evaluate the damage of bone tissue with respect to patient demography including age, gender, race, body mass index (BMI), height, and weight, and their role in causing fracture. Investigators believe that properties derived from CT imaging data to estimate the material properties of bone tissue provides more realistic models. Quantifying and associating damage with in vivo conditions will provide the required information to develop mathematical equations and procedures to predict the premature failure and potentially mitigate problems before they begin. Creating a realistic model for bone tissue can predict the premature failure(s), provide preliminary results before getting the surgery, and optimize the design of orthopaedic implants. A comparison was performed between the proposed model and previous efforts, where they used elastic, hyper- elastic, or elastic-plastic properties. Results showed that there was a significant difference between the anisotropic material properties of bone when compared with unrealistic previous methods. The results showed that the density is 50% higher in male subjects than female subjects. Additionally, the results showed that the density is 47.91% higher in Black subjects than Mixed subjects, 53.27% higher than Caucasian subjects and 57.41% higher than Asian. In general, race should be considered during modeling implants or suggesting therapeutic techniques

Macrodamage Accumulation Model for a Human Femur

The objective of this study was to more fully understand the mechanical behavior of bone tissue that is important to find an alternative material to be used as an implant and to develop an accurate model to predict the fracture of the bone. Predicting and preventing bone failure is an important area in orthopaedics. In this paper, the macrodamage accumulation models in the bone tissue have been investigated. Phenomenological models for bone damage have been discussed in detail. In addition, 3D finite element model of the femur prepared from imaging data with both cortical and trabecular structures is delineated using MIMICS and ANSYS® and simulated as a composite structure. The damage accumulation occurring during cyclic loading was analyzed for fatigue scenario. We found that the damage accumulates sooner in the multiaxial than in the uniaxial loading condition for the same number of cycles, and the failure starts in the cortical bone. The damage accumulation behavior seems to follow a three-stage growth: a primary phase, a secondary phase of damage growth marked by linear damage growth, and a tertiary phase that leads to failure. Finally, the stiffness of the composite bone comprising the cortical and trabecular bone was significantly different as expected

Biomechanical Behavior of a Variable Angle Locked Tibiotalocalcaneal Construct

This paper examines the mechanics of the tibiotalocalcaneal construct made with a PHILOS plating system. A failed device consisting of the LCP plate and cortical, locking, and cannulated screws was used to perform the analysis. Visual, microstructure, and fractographic examinations were carried out to characterize the fracture surface topology. These examinations revealed the presence of surface scratching, inclusions, discoloration, corrosion pits, beach marks, and cleavage and striations on the fracture surface. Further examination of the material crystallography and texture revealed an interaction of S, Ni, and Mo-based inclusions that may have raised pitting susceptibility of the device made with Stainless Steel 316L. These features suggest that the device underwent damage by pitting the corrosion-fatigue mechanism and overloading towards the end to fail the plate and screws in two or more components. The screws failed via conjoint bending and torsion fatigue mechanisms. Computer simulations of variable angle locking screws were performed in this paper. The material of construction of the device was governed by ASTM F138-8 or its ISO equivalent 5832 and exhibited inconsistencies in chemistry and hardness requirements. The failure conditions were matched in finite element modeling and those boundary conditions discussed in this paper

Cyclic Damage Accumulation in the Femoral Constructs Made With Cephalomedullary Nails

Background: The purpose of this study was to evaluate the risk of peri-prosthetic fracture of constructs made with cephalomedullary (CM) long and short nails. The nails were made with titanium alloy (Ti-6Al-4V) and stainless steel (SS 316L). Methods: Biomechanical evaluation of CM nail constructs was carried out with regard to post-primary healing to determine the risk of peri-implant/peri-prosthetic fractures. Therefore, this research comprised of, non-fractured, twenty-eight pairs of cadaveric femora that were randomized and implanted with four types of fixation CM nails resulting in four groups. These constructs were cyclically tested in bi-axial mode for up to 30,000 cycles. All the samples were then loaded to failure to measure failure loads. Three frameworks were carried out through this investigation, Michaelis–Menten, phenomenological, and probabilistic Monte Carlo simulation to model and predict damage accumulation. Findings: Damage accumulation resulting from bi-axial cyclic loading in terms of construct stiffness was represented by Michaelis–Menten equation, and the statistical analysis demonstrated that one model can explain the damage accumulation during cyclic load for all four groups of constructs (P \u3e 0.05). A two-stage stiffness drop was observed. The short stainless steel had a significantly higher average damage (0.94) than the short titanium nails (0.90, P \u3c 0.05). Long titanium nail group did not differ substantially from the short stainless steel nails (P \u3e 0.05). Results showed gender had a significant effect on load to failure in both torsional and bending tests (P \u3c 0.05 and P \u3c 0.001, respectively). Interpretation: Kaplan–Meier survival analysis supports the use of short titanium CM nail. We recommend that clinical decisions should take age and gender into consideration in the selection of implants

Cyclic Damage Accumulation in the Femoral Constructs Made With Cephalomedullary Nails

Background: The purpose of this study was to evaluate the risk of peri-prosthetic fracture of constructs made with cephalomedullary (CM) long and short nails. The nails were made with titanium alloy (Ti-6Al-4V) and stainless steel (SS 316L). Methods: Biomechanical evaluation of CM nail constructs was carried out with regard to post-primary healing to determine the risk of peri-implant/peri-prosthetic fractures. Therefore, this research comprised of, non-fractured, twenty-eight pairs of cadaveric femora that were randomized and implanted with four types of fixation CM nails resulting in four groups. These constructs were cyclically tested in bi-axial mode for up to 30,000 cycles. All the samples were then loaded to failure to measure failure loads. Three frameworks were carried out through this investigation, Michaelis–Menten, phenomenological, and probabilistic Monte Carlo simulation to model and predict damage accumulation. Findings: Damage accumulation resulting from bi-axial cyclic loading in terms of construct stiffness was represented by Michaelis–Menten equation, and the statistical analysis demonstrated that one model can explain the damage accumulation during cyclic load for all four groups of constructs (P > 0.05). A two-stage stiffness drop was observed. The short stainless steel had a significantly higher average damage (0.94) than the short titanium nails (0.90, P < 0.05). Long titanium nail group did not differ substantially from the short stainless steel nails (P > 0.05). Results showed gender had a significant effect on load to failure in both torsional and bending tests (P < 0.05 and P < 0.001, respectively). Interpretation: Kaplan–Meier survival analysis supports the use of short titanium CM nail. We recommend that clinical decisions should take age and gender into consideration in the selection of implant

Macrodamage Accumulation Model for a Human Femur

The objective of this study was to more fully understand the mechanical behavior of bone tissue that is important to find an alternative material to be used as an implant and to develop an accurate model to predict the fracture of the bone. Predicting and preventing bone failure is an important area in orthopaedics. In this paper, the macrodamage accumulation models in the bone tissue have been investigated. Phenomenological models for bone damage have been discussed in detail. In addition, 3D finite element model of the femur prepared from imaging data with both cortical and trabecular structures is delineated using MIMICS and ANSYS® and simulated as a composite structure. The damage accumulation occurring during cyclic loading was analyzed for fatigue scenario. We found that the damage accumulates sooner in the multiaxial than in the uniaxial loading condition for the same number of cycles, and the failure starts in the cortical bone. The damage accumulation behavior seems to follow a three-stage growth: a primary phase, a secondary phase of damage growth marked by linear damage growth, and a tertiary phase that leads to failure. Finally, the stiffness of the composite bone comprising the cortical and trabecular bone was significantly different as expected