Caractérisation et modélisation des actions mécaniques des orthèses du genou

L articulation du genou est sujette à de nombreuses pathologies pouvant entraîner des instabilités. Les démarches thérapeutiques incluent communément le port d orthèses, dans le but de stabiliser ou limiter les mouvements articulaires. Malgré une forte prescription, l évaluation de ces dispositifs manque encore de standardisation.En lien avec des médecins et des industriels, différents outils ont été développés pour évaluer leur efficacité biomécanique. Un modèle éléments finis d un membre inférieur appareillé a notamment permis d étudier l effet de divers paramètres de conception d une genouillère sur les pressions exercées et sur sa capacité à limiter un mouvement pathologique. Ce modèle a servi à valider un banc de test pouvant contribuer à l innovation et la certification. Afin d appréhender les problèmes de confort, le glissement des orthèses sur la peau a été caractérisé par des mesures de champ. Enfin, leurs actions in vivo ont été mesurées à l aide d un arthromètre sur des patients présentant une laxité.Les résultats mettent en évidence l importance des caractéristiques techniques des orthèses et la spécificité du patient sur leurs niveaux d action. Ainsi, il est possible de cibler des pathologies en jouant sur certains facteurs. Cependant, comparé aux structures de stabilisation passive (ligaments), le rôle des orthèses s avère limité aux conditions de faibles sollicitations mécaniques. Néanmoins, leurs effets actifs et proprioceptifs (contrôle neuro-musculaire) seraient également à considérer.Ces outils s avèrent complémentaires ; ils ouvrent la voie à des démarches d évaluation standardisées et pourront également aider au développement de nouveaux produits.The knee joint is vulnerable to various injuries and degenerative conditions, potentially leading to instabilities. Usual treatments involve orthoses, which are medical devices aimed at supporting, aligning or immobilizing the joint. However, the evaluation of these devices lacks standardisation despite high prescription and demand.In relation with clinicians and manufacturers, different tools were developed to assess their biomechanical efficiency. Firstly, a finite element analysis (FEA) of a braced lower limb was used to investigate the effects of brace design on its ability to prevent a pathological motion and understand the force transfer mechanisms. This model provided a basis to validate an experimental surrogate limb with the aim of providing an innovation and certification tool for manufacturers. In an attempt to apprehend comfort issues, full-field measurements of brace migration and FEA of contact pressures were performed. Finally, their in vivo actions were measured on ACL-deficient patients using a laxity testing device.Results highlight the importance of brace technical characteristics and patient-specificity on characterized levels of action and comfort. Furthermore, some key design factors allowed to target devices to particular pathologies. However, when compared to in vivo passive stabilizing structures (ligaments), the efficiency of knee braces was restrained to low load conditions. Nevertheless, these devices may also have a substantial effect on active stabilizing mechanisms such as neuro-muscular control.These tools were found to be complementary and may hopefully pave the way to a standardised procedure for evaluating and developing new designs.ST ETIENNE-ENS des Mines (422182304) / SudocSudocFranceF

Efficiency and comfort of knee braces: A parametric study based on computational modelling

International audienceKnee orthotic devices are widely proposed by physicians and medical practitioners for preventive or therapeutic objectives in relation with their effects, usually known as to stabilize joint or restrict ranges of motion. This study focuses on the understanding of force transfer mechanisms from the brace to the joint thanks to a Finite Element Model. A Design Of Experiments approach was used to characterize the stiffness and comfort of various braces in order to identify their mechanically influent characteristics. Results show conflicting behavior: influent parameters such as the brace size or textile stiffness improve performance in detriment of comfort. Thanks to this computational tool, novel brace designs can be tested and evaluated for an optimal mechanical efficiency of the devices and a better compliance of the patient to the treatment

Efficiency of knee braces: A biomechanical approach based on computational modeling.

International audienceThe knee is the largest joint in the body and is vulnerable to injury during athletic activities or to musculoskeletal conditions such as arthrosis. Knee orthotic devices are widely used by physicians as preventive and therapeutic adjuncts for both musculoskeletal conditions and sport injuries. Their goal is to stabilize or restrict non-physiological knee ranges of motion. The efficiency of these devices has been studied both from clinical and biomechanical perspectives, leading to controversial results from questionable methods. As for now, the mechanisms of force transfer from the device to the joint bones have never been characterized and both device manufacturers and clinicians still expect a standard procedure to compare and grade the efficiency of different knee braces. The objectives of this work are: 1. to quantify the mechanical reactions of knee braces against non-physiological movements; 2. to relate these mechanical reactions to the pressure applied by the braces onto the skin. The latter is particularly important because it refers to comfort issues, which play a key role in a patient's compliance to the orthopedic treatment. A Finite Element Model of a braced human leg is developed. The model is first applied for characterizing the behavior of different kinds of knee braces, focusing on the mechanical reactions against non-physiological movements. In the model, a special attention is paid to the interfaces between knee-braces and the skin and between the skin and the muscles. The interface properties of the model are calibrated against experimental data measured by full-field measurements of 3D displacement over the surface of a patient's leg. The results show that the mechanical action of knee braces is essentially limited by skin/fabric and skin/muscles sliding. Finally, the model leads to a better understanding of the knee/brace interaction, and of the role of the brace components on the stability of the injured knee. Thanks to this computational tool, novel brace designs can be tested and evaluated for an optimal mechanical efficiency of the devices. Future work consists in considering the patient's comfort in the approach

Machine learning and reduced order modelling for the simulation of braided stent deployment

Endoluminal reconstruction using flow diverters represents a novel paradigm for the minimally invasive treatment of intracranial aneurysms. The configuration assumed by these very dense braided stents once deployed within the parent vessel is not easily predictable and medical volumetric images alone may be insufficient to plan the treatment satisfactorily. Therefore, here we propose a fast and accurate machine learning and reduced order modelling framework, based on finite element simulations, to assist practitioners in the planning and interventional stages. It consists of a first classification step to determine a priori whether a simulation will be successful (good conformity between stent and vessel) or not from a clinical perspective, followed by a regression step that provides an approximated solution of the deployed stent configuration. The latter is achieved using a non-intrusive reduced order modelling scheme that combines the proper orthogonal decomposition algorithm and Gaussian process regression. The workflow was validated on an idealised intracranial artery with a saccular aneurysm and the effect of six geometrical and surgical parameters on the outcome of stent deployment was studied. The two-step workflow allows the classification of deployment conditions with up to 95% accuracy and real-time prediction of the stent deployed configuration with an average prediction error never greater than the spatial resolution of 3D rotational angiography (0.15 mm). These results are promising as they demonstrate the ability of these techniques to achieve simulations within a few milliseconds while retaining the mechanical realism and predictability of the stent deployed configuration

Machine learning and reduced order modelling for the simulation of braided stent deployment

Endoluminal reconstruction using flow diverters represents a novel paradigm for the minimally invasive treatment of intracranial aneurysms. The configuration assumed by these very dense braided stents once deployed within the parent vessel is not easily predictable and medical volumetric images alone may be insufficient to plan the treatment satisfactorily. Therefore, here we propose a fast and accurate machine learning and reduced order modelling framework, based on finite element simulations, to assist practitioners in the planning and interventional stages. It consists of a first classification step to determine a priori whether a simulation will be successful (good conformity between stent and vessel) or not from a clinical perspective, followed by a regression step that provides an approximated solution of the deployed stent configuration. The latter is achieved using a non-intrusive reduced order modelling scheme that combines the proper orthogonal decomposition algorithm and Gaussian process regression. The workflow was validated on an idealized intracranial artery with a saccular aneurysm and the effect of six geometrical and surgical parameters on the outcome of stent deployment was studied. We trained six machine learning models on a dataset of varying size and obtained classifiers with up to 95% accuracy in predicting the deployment outcome. The support vector machine model outperformed the others when considering a small dataset of 50 training cases, with an accuracy of 93% and a specificity of 97%. On the other hand, real-time predictions of the stent deployed configuration were achieved with an average validation error between predicted and high-fidelity results never greater than the spatial resolution of 3D rotational angiography, the imaging technique with the best spatial resolution (0.15 mm). Such accurate predictions can be reached even with a small database of 47 simulations: by increasing the training simulations to 147, the average prediction error is reduced to 0.07 mm. These results are promising as they demonstrate the ability of these techniques to achieve simulations within a few milliseconds while retaining the mechanical realism and predictability of the stent deployed configuration

Caractérisation et modélisation des actions mécaniques des orthèses du genou

The knee joint is vulnerable to various injuries and degenerative conditions, potentially leading to instabilities. Usual treatments involve orthoses, which are medical devices aimed at supporting, aligning or immobilizing the joint. However, the evaluation of these devices lacks standardisation despite high prescription and demand.In relation with clinicians and manufacturers, different tools were developed to assess their biomechanical efficiency. Firstly, a finite element analysis (FEA) of a braced lower limb was used to investigate the effects of brace design on its ability to prevent a pathological motion and understand the force transfer mechanisms. This model provided a basis to validate an experimental surrogate limb with the aim of providing an innovation and certification tool for manufacturers. In an attempt to apprehend comfort issues, full-field measurements of brace migration and FEA of contact pressures were performed. Finally, their in vivo actions were measured on ACL-deficient patients using a laxity testing device.Results highlight the importance of brace technical characteristics and patient-specificity on characterized levels of action and comfort. Furthermore, some key design factors allowed to target devices to particular pathologies. However, when compared to in vivo passive stabilizing structures (ligaments), the efficiency of knee braces was restrained to low load conditions. Nevertheless, these devices may also have a substantial effect on active stabilizing mechanisms such as neuro-muscular control.These tools were found to be complementary and may hopefully pave the way to a standardised procedure for evaluating and developing new designs.L’articulation du genou est sujette à de nombreuses pathologies pouvant entraîner des instabilités. Les démarches thérapeutiques incluent communément le port d’orthèses, dans le but de stabiliser ou limiter les mouvements articulaires. Malgré une forte prescription, l’évaluation de ces dispositifs manque encore de standardisation.En lien avec des médecins et des industriels, différents outils ont été développés pour évaluer leur efficacité biomécanique. Un modèle éléments finis d’un membre inférieur appareillé a notamment permis d’étudier l’effet de divers paramètres de conception d’une genouillère sur les pressions exercées et sur sa capacité à limiter un mouvement pathologique. Ce modèle a servi à valider un banc de test pouvant contribuer à l’innovation et la certification. Afin d’appréhender les problèmes de confort, le glissement des orthèses sur la peau a été caractérisé par des mesures de champ. Enfin, leurs actions in vivo ont été mesurées à l’aide d’un arthromètre sur des patients présentant une laxité.Les résultats mettent en évidence l’importance des caractéristiques techniques des orthèses et la spécificité du patient sur leurs niveaux d’action. Ainsi, il est possible de cibler des pathologies en jouant sur certains facteurs. Cependant, comparé aux structures de stabilisation passive (ligaments), le rôle des orthèses s’avère limité aux conditions de faibles sollicitations mécaniques. Néanmoins, leurs effets actifs et proprioceptifs (contrôle neuro-musculaire) seraient également à considérer.Ces outils s’avèrent complémentaires ; ils ouvrent la voie à des démarches d’évaluation standardisées et pourront également aider au développement de nouveaux produits

Oxidation of an ultra high temperature ceramic : zirconium carbide

This project reports on the study of the oxidation of ZrC – 20vol% MoSi2 in the temperature range 1800 – 2400 K in two oxidizing atmospheres. One is air in order to partially reproduce the operating conditions of a high-temperature receiver for concentrated solar radiation. Such receivers are used in solar tower power plants, this technology being likely to grow in scale in the future due to environmental concerns. The other is helium with a low oxygen partial pressure in order to study incidental and accidental conditions of a Gas-Cooled Fast Reactor (GFR), a Generation IV nuclear reactor. A thermodynamical calculation showed the existence of a limit temperature above which the solid oxide turns into gaseous species. This temperature was influenced by the oxygen partial pressure and the kind of oxidizing atmosphere. During oxidation experiments carried out in a 6 kW solar furnace in PROMES laboratory, France, reliable results were obtained in air. From 2000 K, bubbles emerged from the surface of the samples, grew and burst more and more rapidly with increasing temperature. The formation of these bubbles was accompanied by an increase in oxidation damage for the material. It was assumed that these bubbles formed because of the surface melting of the samples in addition to an increased release of CO. However ZrC was found to undergo less oxidation damage than SiC under the same conditions, as demonstrated in this study. Two different ZrC surface states were studied, but no major differences were observed in term of oxidation behavior. In impure helium, the experiments were not sufficiently reliable to draw conclusions about the possibility of using this material for a GFR. Nevertheless, the observation of a very thin, perhaps protective, glassy layer at 1800K might lead to interesting results in the future. Results of thermodynamical calculation and characterization of the oxide layer suggest that the addition of such a high amount of MoSi2 was detrimental to the oxidation behavior above 1800 K because of its dissociation and its role in melting of the surface in air. A numerical analysis of the reactor was performed with Ansys-Fluent® in order to model the solar furnace in operation. This analysis gave interesting results about temperature, flows and chemical species showing that the reactor is well designed for this kind of experiments, and the development of a flame-like flow as reported by the analysis was observed in reality.Validerat; 20101217 (root

Biomechanical effects of knee orthoses : experimental characterization and modelling.

L’articulation du genou est sujette à de nombreuses pathologies pouvant entraîner des instabilités. Les démarches thérapeutiques incluent communément le port d’orthèses, dans le but de stabiliser ou limiter les mouvements articulaires. Malgré une forte prescription, l’évaluation de ces dispositifs manque encore de standardisation.En lien avec des médecins et des industriels, différents outils ont été développés pour évaluer leur efficacité biomécanique. Un modèle éléments finis d’un membre inférieur appareillé a notamment permis d’étudier l’effet de divers paramètres de conception d’une genouillère sur les pressions exercées et sur sa capacité à limiter un mouvement pathologique. Ce modèle a servi à valider un banc de test pouvant contribuer à l’innovation et la certification. Afin d’appréhender les problèmes de confort, le glissement des orthèses sur la peau a été caractérisé par des mesures de champ. Enfin, leurs actions in vivo ont été mesurées à l’aide d’un arthromètre sur des patients présentant une laxité.Les résultats mettent en évidence l’importance des caractéristiques techniques des orthèses et la spécificité du patient sur leurs niveaux d’action. Ainsi, il est possible de cibler des pathologies en jouant sur certains facteurs. Cependant, comparé aux structures de stabilisation passive (ligaments), le rôle des orthèses s’avère limité aux conditions de faibles sollicitations mécaniques. Néanmoins, leurs effets actifs et proprioceptifs (contrôle neuro-musculaire) seraient également à considérer.Ces outils s’avèrent complémentaires ; ils ouvrent la voie à des démarches d’évaluation standardisées et pourront également aider au développement de nouveaux produits.The knee joint is vulnerable to various injuries and degenerative conditions, potentially leading to instabilities. Usual treatments involve orthoses, which are medical devices aimed at supporting, aligning or immobilizing the joint. However, the evaluation of these devices lacks standardisation despite high prescription and demand.In relation with clinicians and manufacturers, different tools were developed to assess their biomechanical efficiency. Firstly, a finite element analysis (FEA) of a braced lower limb was used to investigate the effects of brace design on its ability to prevent a pathological motion and understand the force transfer mechanisms. This model provided a basis to validate an experimental surrogate limb with the aim of providing an innovation and certification tool for manufacturers. In an attempt to apprehend comfort issues, full-field measurements of brace migration and FEA of contact pressures were performed. Finally, their in vivo actions were measured on ACL-deficient patients using a laxity testing device.Results highlight the importance of brace technical characteristics and patient-specificity on characterized levels of action and comfort. Furthermore, some key design factors allowed to target devices to particular pathologies. However, when compared to in vivo passive stabilizing structures (ligaments), the efficiency of knee braces was restrained to low load conditions. Nevertheless, these devices may also have a substantial effect on active stabilizing mechanisms such as neuro-muscular control.These tools were found to be complementary and may hopefully pave the way to a standardised procedure for evaluating and developing new designs

A computational model for understanding the micro-mechanics of collagen fiber network in the tunica adventitia

International audienc