Purpose: Osteoarthritis occurs in many different joints of the body, causing pain, stiffness, and decreased function. The knee is the most frequently affected joint of the lower limb. The aim of this study was to investigate the differences of biomechanics between independent gait and anterior walker dependent gait of patients with osteoarthritis of the knee. Methods: Lower limb joint kinematics and kinetics were evaluated in 15 patients with knee osteoarthritis when walking independently and when walking with an anterior walker. Participants were evaluated in a gait laboratory, with self-selected gait speed and natural arm swing. Results: When walking with a dependent anterior walker, participants walked significantly faster (p<0.01), using a longer stride length (p<0.01), compared to independent gait. When walking with a dependent anterior walker, participants exhibited significantly greater knee flexion/extension motion (p<0.01) and lower knee flexion moment (p<0.05) compared to independent gait. When walking with a dependent anterior walker, participants showed significantly greater peak ankle motion (p<0.01), ankle dorsiflexion/plantarflexion moments (p<0.01), and ankle power generation (p<0.05) compared to independent gait. Conclusion: These biomechanical properties of gait, observed when participants walked with a dependent anterior walker, may be a compensatory response to impaired knee function to allow sufficient power generation for propulsion. Therefore, rehabilitative strategies for patients with osteoarthritis of the knee are needed in order to improve not only knee function but also hip and ankle function.
We investigated the biomechanical properties of a newly designed self-expansion type anterior cruciate ligament (ACL) anchor. The ACL anchor consists of the ring section giving the elastic force, the wedge for maintaining in contact with the femur tunnel wall and the link suspending hamstring graft or artificial ligament. The main design parameters that determine the performance of this device were the expansion angle (${\theta}$) and the thickness ($t_R$). The Ti6Al4V anchors were heated after inserting in a jig for 1 hour at $800^{\circ}C$ in a protective argon gas atmosphere and allowed to cool to room temperature in the furnace. In order to investigate the influence of the expansion angle and the thickness of the ring on the biomechanical properties of the anchor, the maximum pull-out load, stiffness and slippage of the ACL anchor were measured using the pull-out tester, and statistical analyses were also executed. The present results showed that the design parameters gave a significant effect on the performance of the self- expansion type of anchor. The pull-out load of the ACL anchors significantly increased as the thickness of the ring section was increased, having a similar trend for both expansion angles. The ACL anchor showed about 2.5 times higher values of the pull-out load than that of the minimum load (500N)required for the "accelerated rehabilitation". The optimum ${\theta}$ and $t_R$ values of this ACL anchor were suggested to have sufficient resistance against the pull-out force, high stiffness and relatively low slippage after ACL reconstruction.
Many recent studies suggest that the posterior dynamic stabilization(PDS) can be a more physiologically-relevant alternative to the rigid fixation for the patients suffering from low back pain. However, its biomechanical effects or clinically proven efficacies still remain unknown. In this study, we evaluated kinematic behaviors of the lower lumbar spine with the PDS system and then compared to those of the rigid fixation system using finite element (FE) analysis. A validated FE model of intact lumbar spine(L2-L5) was developed. The implanted model was then constructed after modification from the intact to simulate two kinds of pedicle screw systems (PDS and the rigid fixation). Hybrid protocol was used to flex, extend, laterally bend and axially rotate the FE model. Results showed that the PDS systems are more flexible than rigid fixation systems, yet not flexible enough to preserve motion. PDS system allowed $16.2{\sim}42.2%$ more intersegmental rotation than the rigid fixation at the implanted level. One the other hand, at the adjacent level it allowed more range of motion ($2.0%{\sim}8.3%$) than the rigid fixation. The center of rotation of the PDS model remained closer to that of the intact spine. These results suggest that the PDS system could be able to prevent excessive motion at the adjacent levels and restore the spinal kinematics.
Considerable controversy surrounds the choice of the best abutment type for implant prosthetics. The two most common structures are hex and non-hex abutments. The non-hex abutment typically furnishes a larger contact area between itself and the implant than that provided by a hex structure. However, when a hex abutment is loaded, the position of its contact area may be deeper than that of a non-hex abutment. Hence, the purpose of this study is to determine the different biomechanical behaviors of an internal bone-level implant based on the abutment type-hex or non-hex-and clinical crown length under static and cyclic loadings using finite element analysis (FEA). The hex structure was found to increase the implant and abutment stability more than the nonhex structure among several criteria. The use of the hex structure resulted in a smaller volume of bone tissues being at risk of hypertrophy and fatigue failure. It also reduced micromovement (separation) between the implant components, which is significantly related to the pumping effect and possible inflammation. Both static and fatigue analyses, used to examine short- and long-term stability, demonstrated the advantages of the hex abutment over the non-hex type for the stability of the implant components. Moreover, although its impact was not as significant as that of the abutment type, a large crown-implant ratio (CIR) increased bone strain and stress in the implant components, particularly under oblique loading.
Objective : To investigate the effects of posterior implant rigidity on spinal kinematics at adjacent levels by utilizing a cadaveric spine model with simulated physiological loading. Methods : Five human lumbar spinal specimens (L3 to S1) were obtained and checked for abnormalities. The fresh specimens were stripped of muscle tissue, with care taken to preserve the spinal ligaments and facet joints. Pedicle screws were implanted in the L4 and L5 vertebrae of each specimen. Specimens were tested under 0 N and 400 N axial loading. Five different posterior rods of various elastic moduli (intact, rubber, low-density polyethylene, aluminum, and titanium) were tested. Segmental range of motion (ROM), center of rotation (COR) and intervertebral disc pressure were investigated. Results : As the rigidity of the posterior rods increased, both the segmental ROM and disc pressure at L4-5 decreased, while those values increased at adjacent levels. Implant stiffness saturation was evident, as the ROM and disc pressure were only marginally increased beyond an implant stiffness of aluminum. Since the disc pressures of adjacent levels were increased by the axial loading, it was shown that the rigidity of the implants influenced the load sharing between the implant and the spinal column. The segmental CORs at the adjacent disc levels translated anteriorly and inferiorly as rigidity of the device increased. Conclusion : These biomechanical findings indicate that the rigidity of the dynamic stabilization implant and physiological loading play significant roles on spinal kinematics at adjacent disc levels, and will aid in further device development.
Various methods for fixation of graft have been widely used for reconstruction of anterior cruciate ligament. However, the biomechanical strength of each fixation techniques are not fully understood. The purpose of this study is to compare the pull out strength of different fixation techniques which is probably the most important factor for the success at the initial stage of healing. Biomechanical test was carried out to measure and compare the pull out tensile strength of five different fixation techniques in 35 pig(Yorkshire) knees. ANOVA and Duncan multiple comparison test was applied for statistical analysis. In the two fixation techniques with bone patellar tendon bone graft, the mean maximum tensile strength was $1333.4{\pm}148.5N$ with titanium interference screw, while it was $1310.1{\pm}168.9N$ with biodegradable interference screw. The failure mode were pulled out of bone plugs from the femoral tunnel in majority cases. In the fixations with hamstring tendon, the mean maximum tensile strength were $1405.9{\pm}135.1N$ with SemiFix screw, $820.3{\pm}104.5N$ with biodegradable interference screw, and $682.1{\pm}54.2N$ with Endobutton. The mode of failure was variable in each technique. The tendon was pulled out from the tunnel in biodegradable interference screw fixation, the screw was bent in the SemiFix system, and the polyester tape were ruptured or the buttons were pulled into tunnel in Endobutton fixation. The mean maximum tensile strength of two interference screws with bone patellar tendon bone was statistically comparable to that of SemiFix with hamstring tendon. However biodegradable interference screw and Endobutton with hamstring tendon showed weaker maximum tensile strength than above three fixation techniques (P<0.05).
Ha, Sung-Kon;Kim, Se-Hoon;Kim, Daniel H.;Park, Jung-Yul;Lim, Dong-Jun;Lee, Sang-Kook
Journal of Korean Neurosurgical Society
/
제45권3호
/
pp.169-175
/
2009
Objective : The goal of this study was to evaluate the biomechanical features of human cadaveric spines implanted with the Activ L prosthesis. Methods : Five cadaveric human lumbosacral spines (L2-S2) were tested for different motion modes, i.e. extension and flexion, right and left lateral bending and rotation. Baseline measurements of the range of motion (ROM), disc pressure (DP), and facet strain (FS) were performed in six modes of motion by applying loads up to 8 Nm, with a loading rate of 0.3 Nm/second. A constant 400 N axial follower preload was applied throughout the loading. After the Activ L was implanted at the L4-L5 disc space, measurements were repeated in the same manner. Results : The Activ L arthroplasty showed statistically significant decrease of ROM during rotation, increase of ROM during flexion and lateral bending at the operative segment and increase of ROM at the inferior segment during flexion. The DP of the superior disc of the operative site was comparable to those of intact spine and the DP of the inferior disc decreased in all motion modes, but these were not statistically significant. For FS, statistically significant decrease was detected at the operative facet during flexion and at the inferior facet during rotation. Conclusion : In vitro physiologic preload setting, the Activ L arthroplasty showed less restoration of ROM at the operative and adjacent levels as compared with intact spine. However, results of this study revealed that there are several possible theoretical useful results to reduce the incidence of adjacent segment disease.
The general objective of this study was to investigate biomechanical characteristics of bowling swing using three-dimensional cinematography. This study focused specifically on movements of the upper body segments during a bowling swing. Eight elite female bowling players participated in this study. Subjects performed bowling swing and their performance was sampled at 60 frame/sec using two high-speed video cameras with a synchronizer. After digitizing images from two cameras, the two-dimensional coordinates were used to produce three-dimensional coordinates of the 12 body segments (20 joint reference makers). The obtained three-dimensional coordinates were fed to a custom-written kinematic and kinetic analyses program (LabView 6.1, National Instrument, Austin, TX, USA). The analyses determined the linear and angular kinematic variables of the body segments with which joint force and torque of the lower and upper trunks and the shoulder were estimated based on the Newton-Euler equations. It was found that during the bowling swing the peak linear velocities of the body segments were reached in sequence the trunk, the shoulder, the elbow, the wrist, and the bowl. This result indicates that linear momentum of the lower body and the trunk transmits to the arm segment during the bowling swing. The joint torques of the torso and the arm occurred almost simultaneously, indicating that bowling swing seem to be a push-like motion, rather than a proximal-distal sequence motion in which many of throwing motions are categorized. The ultimate objective of the bowling swing is to release a heavy-weight bowl with power and consistency. Therefore, the bowling swing observed in this study well agrees with that bowlers use the stepping to increase the linear velocity of the bowl, the simple pendulum system and the push-like segmental motion in the torso and the arm segment to enhance the power at the release of the bowl.
The purpose of this study was to find the relationship between Achilles tendon angle, angular velocity from 2D cinematography utilized to easily analyze the functions of shoes, ankle joint moment, knee joint moment, and hip joint moment from 3D cinematography utilized to predict the injury. Also, this study was to provide the optimal standard to analyze the injury related to the shoes. Subjects in this study were 30 university male students and 18 conditions (2 types of running speed, 3 of midsole hardness, 3 of midsole height) were measured using cinematography and force platform. The results were as following. 1) Hip joint abduction moment was effected by many variables such as running speed, midsole height, maximum achilles tendon angle, ground reaction force. 2) Knee joint rotational moment in running was approximately 1/10 - 1/4 times of the injury critical value and eversion moment was approximately 1/4 - 1/2 times of the injury critical value. 3) Ankle joint pronation moment in running was 1/3 - 1/2 times of the injury critical value. 4) Knee joint rotational moment was found to be irrelevant with maximum achilles tendon angle or angular velocity. 5) Pronation from running was thought to be relevant to rather eversion moment activity than rotational moment activity of knee joint. 6) Plantar flexion abductor of ankle showed significant relationship with the ground reaction force variable. 7) When the loading rate for ground reaction force in passive region increased, extensor tended to be exposed to the injury. Main variables in biomechanical analysis of shoes were impact absorption and pronation. Among these variables, pronation factor was reported to be relevant with knee injury from long duration exercise. Achilles tendon angle factor was utilized frequently to evaluate this. However, as the results of this study showed, the relationship between these variables and injury relating variable of knee moment was so important. Studies without consideration on this finding should be reconsidered and reconfirmed.
The purpose of this study was to analyze the Biomechanical elements by looking at the differences on the motions of the right and left spikes of right-handed offense volleyball players, using 3D image analysis and force platform. For that purpose, spike motions of six male university volleyball players were recorded three times each using two 16mm high speed cameras and the speed of recording was set at 60 frames/sec. The coordinated raw data was leveled as 6Hz using low pass filtering method and the calculation of 3D coordinates was done by using a DLT (Direct Linear Transformation) method. Also KWON 3D program was used to analyze the variables. Through the experiments and research, the following results were found: That is, in case of the right spike, the required time from the toss to the impact, which affected the success rate of offense showed as longer and on the take-off, the exact timing to touch the ball was longer because the pace between right and left feet was wider, and also after the jump, the distance between the feet indicated shorter, than the left. In addition, the degree of somersault and horizontal adduction of shoulder joint was smaller and the degree of medial rotation of shoulder joint showed bigger than the left, so it indicated that it was not centered on the body, but by the arm with an axis of shoulder using a swing motion. After the impact, the speed of the ball indicated slower compared to the left spike.
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