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

Analysis of a Clinically Failed, Mechanically Intact, Hemi-Toe Implant

In this case study a clinically failed, mechanically intact, hemi-toe device was investigated. The clinical indication of the failure constitutes radiolucent line indicating loosening of the implant and possible interactions among the bone-implant initiated by osteolysis may become a factor, producing pain, inflammatory reactions, deformity and discomfort. The patient file was not available to determine these parameters. The device was titanium coated, Cobalt Chromium alloy used for making hemi-toe. Degeneration of hemi implant was due to spalling of the coating from the surface, causing loosening of stem from bone. However, pre-removal X-ray films were not available to confirm. Mechanism by which the clinical failure occurred likely due to lack of bony adhesion or other clinical reasons. Surface topographical features were documented using optical microscope. A method to classify various area of the articulating surface was proposed in this study that shows the anterior contacts were more damaging than the other areas where deeper scratches, pits and some debris were present. There is a need to converge mechanical and clinical failures together for these types of medical devices

Dietary Patterns and Cognitive Function among Older Community-Dwelling Adults.

Diet may be an important modifiable risk factor for maintenance of cognitive health in later life. This study aimed at examining associations between common dietary indices and dietary patterns defined by factor analysis and cognitive function in older community-dwelling adults. Dietary information for 1499 participants from the Rancho Bernardo Study was collected in 1988⁻1992 and used to calculate the alternate Mediterranean diet score, Alternate Healthy Eating Index (AHEI)-2010 score and factor scores derived from factor analysis of nutrients. Global cognitive function, executive function, verbal fluency and episodic memory were assessed at approximate four-year intervals from 1988⁻2016. Linear mixed models were used to examine associations between dietary patterns and cognitive trajectories. Estimates for the highest vs. lowest tertile in models adjusting for age, sex, education, energy intake, lifestyle variables and retest effect showed greater adherence to the Mediterranean score was associated with better baseline global cognitive function (β (95% CI) = 0.33 (0.11, 0.55)). The AHEI-2010 score was not significantly associated with cognitive performance. Higher loading on a plant polyunsaturated fatty acid (PUFA)/vitamin E factor was associated with better baseline global cognitive function and executive function (β = 0.22 (0.02, 0.42) and β = -7.85 (-13.20, -2.47)). A sugar/low protein factor was associated with poorer baseline cognitive function across multiple domains. Dietary patterns were not associated with cognitive decline over time. Adherence to a healthy diet with foods high in PUFA and vitamin E and a low sugar to protein ratio, as typified by a Mediterranean diet, may be beneficial for cognitive health in late life

Methods to determine the volume of infrapatellar fat pad as an indicator of anterior cruciate ligament tear

Introduction: Anterior knee pain is a common problem which affects adolescents and young adults. The most common mechanism for anterior knee pain arises from combination of compression and shear forces across the patellofemoral joint. The structures that commonly cause anterior knee pain include medial and lateral retinaculum, the patellar subchondral bone, the anterior synovium, joint capsule, patellar tendon, and infrapatellar fat pad. It is important to develop methods to measure volume of infrapatellar fat pad without invasive means. The volume of the fat pad was determined based on 3D image reconstruction using Mimics (a software developed by Materialise), by ellipsoidal methods a mathematical method, and program developed using MATLAB. All three methods had used MRI images to determine its volume. The objective of this study is to determine the accuracy of these new methods. The following hypotheses were tested: (1) increased volume of infrapatellar fat pad among torn ACL, (2) increased body mass index would have larger infrapatellar fat pad, and (3) volumes determined from Mimics, MATLAB, and ellipsoidal model would be accurate. Methods: Our institutional review board approved this retrospective study, which involved a search of patient medical records, and waived the requirement for informed consent because there was no change in patient diagnosis or treatment. The study was an evaluation of all consecutive patients who complained of knee problems undergoing MRI examinations at our institution from 2007 to 2013. Two patient groups were evaluated after a search of surgery records for knee procedures: group 1 consisted of patients who had either a partial tear or complete tear of the ACL based on radiologists’ reading on MRI. Group 2 consisted of patients with an intact ACL on MRI. MRI scans were performed using a 1.5 Tesla General Electric (Milwaukee, Wisconsin) signal MRI Scanner. T1 weighted images in 4-mm thick cuts were evaluated based on the integrity of the image. 3D reconstruction was performed using Mimics (Materialise) software. Results: There is a strong correlation between the volumes determined by ellipsoidal model and MRI. It was determined that the coefficient of determination to be 0.9936. The volume estimated by MATLAB was found to be within a band of ±2 MRI values (27.29 mm3; R2 = 0.4186) and may be considered with high statistical confidence. No significant difference was observed between the two groups (p of 0.99 and 0.26) for ellipsoidal and MATLAB, respectively. Conclusions: Volume determinations using ellipsoidal approximation model had been shown to be comparable to that determined by MRI and MATLAB code within a statistical band of ±2. No statistical significance was observed among methods, with p values of 0.99 and 0.26 for ellipsoidal and MATLAB, respectively. The volume and surface of fat pad in patients with torn ACL are significantly larger than those with intact ACL, p values of 0.01 and 0.04, respectively

Analysis of a Clinically Failed, Mechanically Intact, Reconstructive Compression Plate

A reconstructive orthopedic bone plate was submitted for analysis. Traditional failure analysis methods were used to assess the mode of the plate failure. Metallographic investigation of the plate was carried out in this report. Since limited data was available in the literature and clinical data related to subject demography, date of removal as well as reasons for removal unknown, in depth analysis was not possible. However, the plate was received in in-tact condition with minor biological deposits and scratches, it is speculated that the failure of the plate may have been due to biological/clinical reasons, likely infection, rejecting the device due to lack of union at the fracture site

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

The Administration of a Republican Form of Government (enforcement)

Panel on enforcement

Citizen science as a new tool in dog cognition research

The work of Á.M. was supported by the Hungarian Academy of Sciences (MTA 01 031).Family dogs and dog owners offer a potentially powerful way to conduct citizen science to answer questions about animal behavior that are difficult to answer with more conventional approaches. Here we evaluate the quality of the first data on dog cognition collected by citizen scientists using the Dognition. com website. We conducted analyses to understand if data generated by over 500 citizen scientists replicates internally and in comparison to previously published findings. Half of participants participated for free while the other half paid for access. The website provided each participant a temperament questionnaire and instructions on how to conduct a series of ten cognitive tests. Participation required internet access, a dog and some common household items. Participants could record their responses on any PC, tablet or smartphone from anywhere in the world and data were retained on servers. Results from citizen scientists and their dogs replicated a number of previously described phenomena from conventional lab-based research. There was little evidence that citizen scientists manipulated their results. To illustrate the potential uses of relatively large samples of citizen science data, we then used factor analysis to examine individual differences across the cognitive tasks. The data were best explained by multiple factors in support of the hypothesis that nonhumans, including dogs, can evolve multiple cognitive domains that vary independently. This analysis suggests that in the future, citizen scientists will generate useful datasets that test hypotheses and answer questions as a complement to conventional laboratory techniques used to study dog psychology.Publisher PDFPeer reviewe

Forests and The Texas Economy.

68 p