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Shariyate MJ, Kheir N, Caro D, Abbasian M, Rodriguez EK, Snyder BD, Nazarian A. Assessment of Bone Healing: Opportunities to Improve the Standard of Care. J Bone Joint Surg Am 2023; 105:1193-1202. [PMID: 37339171 DOI: 10.2106/jbjs.22.01224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
➤ Bone healing is commonly evaluated by clinical examination and serial radiographic evaluation. Physicians should be mindful that personal and cultural differences in pain perception may affect the clinical examination. Radiographic assessment, even with the Radiographic Union Score, is qualitative, with limited interobserver agreement.➤ Physicians may use serial clinical and radiographical examinations to assess bone healing in most patients, but in ambiguous and complicated cases, they may require other methods to provide assistance in decision-making.➤ In complicated instances, clinically available biomarkers, ultrasound, and magnetic resonance imaging may determine initial callus development. Quantitative computed tomography and finite element analysis can estimate bone strength in later callus consolidation phases.➤ As a future direction, quantitative rigidity assessments for bone healing may help patients to return to function earlier by increasing a clinician's confidence in successful progressive healing.
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Affiliation(s)
- Mohammad Javad Shariyate
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Nadim Kheir
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Daniela Caro
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Mohammadreza Abbasian
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Edward K Rodriguez
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
- Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Brian D Snyder
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
- Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ara Nazarian
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
- Department of Orthopaedic Surgery, Yerevan State Medical University Yerevan, Armenia
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Catelani F, Costa-Júnior JFS, de Andrade MC, Von Krüger MA, Pereira WCDA. Recycled windshield glass as new material for producing ultrasonic phantoms of cortical bone-healing stages. Biomed Phys Eng Express 2021; 7. [PMID: 34340223 DOI: 10.1088/2057-1976/ac19ce] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 08/02/2021] [Indexed: 11/11/2022]
Abstract
The quantitative ultrasound technique was used to evaluate bone-mimicking phantoms; however, these phantoms do not mimic the intermediate stages of cortical bone healing. We propose using windshield glass as an original material to produce phantoms that mimic the characteristics of three different stages of cortical bone healing. This material was processed via a route that included breaking, grinding, compacting, drying, and sintering in four temperature groups: 625 °C, 645 °C, 657 °C, and 663 °C. The parameters evaluated were the ultrasonic longitudinal phase velocity (cL), corrected (αc) ultrasonic attenuation coefficient, and bulk density (ρs). The results showed that the mean values ofcL,αc,andρsvaried from 2, 398 to 4, 406 m·s-1, 3 to 10 dB·cm-1, and 1, 563 to 2, 089 kg·m-3, respectively. The phantoms exhibited properties comparable with the three stages of cortical bone healing and can be employed in diagnostic and therapeutic studies using ultrasound.
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Affiliation(s)
- Fernanda Catelani
- Brazilian Navy, Rio de Janeiro, RJ, Brazil.,Raul Sertã Municipal Hospital, Nova Friburgo, RJ, Brazil.,Biomedical Engineering Program - COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - José Francisco Silva Costa-Júnior
- Biomedical Engineering Program - COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Brazilian Air Force Academy, Pirassununga, SP, Brazil
| | | | - Marco Antônio Von Krüger
- Biomedical Engineering Program - COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Long Cortical Bone Fracture Evaluation Using Ultrasonic Guided Waves: A Tubular Phantom Study. 6TH INTERNATIONAL CONFERENCE ON THE DEVELOPMENT OF BIOMEDICAL ENGINEERING IN VIETNAM (BME6) 2018. [DOI: 10.1007/978-981-10-4361-1_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Transverse and Oblique Long Bone Fracture Evaluation by Low Order Ultrasonic Guided Waves: A Simulation Study. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3083141. [PMID: 28182135 PMCID: PMC5274688 DOI: 10.1155/2017/3083141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 11/28/2016] [Indexed: 11/17/2022]
Abstract
Ultrasonic guided waves have recently been used in fracture evaluation and fracture healing monitoring. An axial transmission technique has been used to quantify the impact of the gap breakage width and fracture angle on the amplitudes of low order guided wave modes S0 and A0 under a 100 kHz narrowband excitation. In our two dimensional finite-difference time-domain (2D-FDTD) simulation, the long bones are modeled as three layers with a soft tissue overlay and marrow underlay. The simulations of the transversely and obliquely fractured long bones show that the amplitudes of both S0 and A0 decrease as the gap breakage widens. Fixing the crack width, the increase of the fracture angle relative to the cross section perpendicular to the long axis enhances the amplitude of A0, while the amplitude of S0 shows a nonmonotonic trend with the decrease of the fracture angle. The amplitude ratio between the S0 and A0 modes is used to quantitatively evaluate the fracture width and angles. The study suggests that the low order guided wave modes S0 and A0 have potentials for transverse and oblique bone fracture evaluation and fracture healing monitoring.
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Hata T, Nagatani Y, Takano K, Matsukawa M. Simulation study of axial ultrasonic wave propagation in heterogeneous bovine cortical bone. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2016; 140:3710. [PMID: 27908063 DOI: 10.1121/1.4967234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The effect of the heterogeneity of the long cortical bone is an important factor when applying the axial transmission technique. In this study, the axial longitudinal wave velocity distributions in specimens from the mid-shaft of a bovine femur were measured, in the MHz range. Bilinear interpolation and the piecewise cubic Hermite interpolating polynomial method were used to construct three-dimensional (3D) axial velocity models with a resolution of 40 μm. By assuming the uniaxial anisotropy of the bone and using the results of previous experimental studies [Yamato, Matsukawa, Yanagitani, Yamazaki, Mizukawa, and Nagano (2008b). Calcified Tissue Int. 82, 162-169; Nakatsuji, Yamamoto, Suga, Yanagitani, Matsukawa, Yamazaki, and Matsuyama (2011). Jpn. J. Appl. Phys. 50, 07HF18], the distributions of all elastic moduli were estimated to obtain a 3D heterogeneous bone model and a uniform model. In the heterogeneous model, moduli at the surface were smaller than those inside the model. The elastic finite-difference time-domain method was used to simulate axial ultrasonic wave propagation in these models. In the heterogeneous model, the wavefront of the first arriving signal (FAS) was dependent on the heterogeneity, and the FAS velocity depended on the measured position. These phenomena were not observed in the uniform model.
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Affiliation(s)
- Toshiho Hata
- Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe 610-0321, Japan
| | - Yoshiki Nagatani
- Department of Electronics, Kobe City College of Technology, Kobe 651-2194, Japan
| | - Koki Takano
- Faculty of Science and Engineering, Doshisha University, Kyotanabe 610-0321, Japan
| | - Mami Matsukawa
- Faculty of Science and Engineering, Doshisha University, Kyotanabe 610-0321, Japan
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de Mesquita AQ, Barbieri G, Barbieri CH. Correlation between ultrasound velocity and densitometry in fresh and demineralized cortical bone. Clinics (Sao Paulo) 2016; 71:657-663. [PMID: 27982167 PMCID: PMC5108171 DOI: 10.6061/clinics/2016(11)07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 08/05/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE: To compare ultrasound propagation velocity with densitometry in the diaphyseal compact cortical bone of whole sheep metatarsals. METHODS: The transverse ultrasound velocity and bone mineral density of 5-cm-long diaphyseal bone segments were first measured. The bone segments were then divided into four groups of 15 segments each and demineralized in an aqueous 0.5 N hydrochloric acid solution for 6, 12, 24 or 36 hours. All measurements were repeated after demineralization for each time duration and the values measured before and after demineralization were compared. RESULTS: Ultrasound velocity and bone mineral density decreased with demineralization time, and most differences in the pre- and post-demineralization values within each group and between groups were significant: A moderate correlation coefficient (r=0.75956) together with a moderate agreement was determined between both post-demineralization parameters, detected by the Bland-Altman method. CONCLUSION: We conclude that both ultrasound velocity and bone mineral density decrease as a result of demineralization, thus indicating that bone mineral content is of great importance for maintaining the acoustic parameters of cortical bone, as observed for cancellous bone. Ultrasound velocity can be used to evaluate both compact cortical bone quality and bone mineral density.
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Affiliation(s)
- Alessandro Queiroz de Mesquita
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Ribeirão Preto/SP, Brazil
| | - Giuliano Barbieri
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Ribeirão Preto/SP, Brazil
| | - Claudio Henrique Barbieri
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Ribeirão Preto/SP, Brazil
- E-mail:
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Potsika VT, Grivas KN, Gortsas T, Protopappas VC, Polyzos DK, Fotiadis DI. Boundary element simulation of ultrasonic backscattering during the fracture healing process. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2016:2913-2916. [PMID: 28268923 DOI: 10.1109/embc.2016.7591339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Competent fracture healing monitoring and treatment requires an extensive knowledge of bone biology and microstructure. The use of non-invasive and non-radiating means for the monitoring of the bone healing process has gained significant interest in recent years. Ultrasound is considered as a modality which can contribute to the assessment of bone status during the healing process, as well as, enhance the rate of the tissues' ossification. This work presents boundary element simulations of ultrasound propagation in healing long bones to investigate the monitoring potential of backscattering parameters. The interaction of a plane wave at 100 kHz with the bone and the callus is examined by calculating the acoustic pressure and scattering amplitude in the backward direction. Callus is considered as a two-dimensional, non-homogeneous medium consisted of multiple layers with evolving material properties. It was shown that the backscattering parameters could potentially reflect the fracture healing progress.
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Quantitative ultrasound measurement of bone density based on dynamic time window: suitable for the measurement of speed of sound in radius. J Med Ultrason (2001) 2016; 43:347-54. [DOI: 10.1007/s10396-016-0710-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 03/14/2016] [Indexed: 10/21/2022]
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Mandarano-Filho LG, Bezuti MT, Barbieri CH. In vivo standardization of bone ultrasonometry of the clavicle. Clinics (Sao Paulo) 2016; 71:140-4. [PMID: 27074174 PMCID: PMC4785852 DOI: 10.6061/clinics/2016(03)04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 01/21/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The assessment of fracture union includes physical examination and radiographic imaging, which depend on the examiner's experience. The development of ancillary methods may avoid prolonged treatments and the improper removal of implants. Quantitative bone ultrasonometry has been studied for this purpose and will soon be included in clinical practice. The aims of the present study were to assess the feasibility of using this technique on the clavicle and to standardize its in vivo application. METHODS Twenty adult volunteers, including 10 men and 10 women without medical conditions or a previous history of clavicle fracture, underwent axial quantitative ultrasonometric assessment using transducers in various positions (different distances between the transducers and different angulations relative to the clavicle). RESULTS Similar values of wave propagation velocity were obtained in the different tested set-ups, which included distinct distances between the transducers and angular positions relative to the clavicle. There were significant differences only in the transducers positioned at 0° and at 5 or 7 cm apart. CONCLUSIONS The use of bone ultrasonometry on the clavicle is feasible and the standardization of the technique proposed in this study (transducers placed at 45° and at 7 cm apart) will allow its future application in clinical trials to evaluate the healing process of diaphyseal fractures of the clavicle.
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Bezuti MT, Mandarano-Filho LG, Barbieri G, Mazzer N, Barbieri CH. Influence of the osteosynthesis plate on ultrasound propagation in the bone. ACTA ORTOPEDICA BRASILEIRA 2014; 22:269-74. [PMID: 25328436 PMCID: PMC4199645 DOI: 10.1590/1413-78522014220500733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 06/25/2013] [Indexed: 11/23/2022]
Abstract
Objective: To analyze the influence of steel plates for osteosynthesis on the velocity of ultrasound propagation (VU) through the bone. Methods: The transverse coronal and sagittal velocity of ultrasound propagation underwater were measured on the intact bone and then on assemblies of the same bone with two types of osteosynthesis plates (DCP and semi tubular), fixed onto the dorsal side of the bones. The first arriving signal (FAS) was the ultrasound parameter used, taking the coronal and sagittal diameters as the distances to calculate velocity. Intergroup statistical comparisons were made at significance level of 1% (p<0.01). Results: Velocity was higher on the intact bones than on the bone-plate assemblies and higher for the semitubular than for the compression plates, although differences were not statistically significant for most comparisons (p=0.0132 to 0.9884), indicating that the steel plates do not interfere significantly with ultrasound wave propagation through the bone-plate assemblies. Conclusion: The velocity reduction effect was attributed to the greater reflection coefficient of the steel as compared to that of bone and water. Ultrasonometry can, thus, be used in the evaluation of healing of fractures fixed with steel plates. Experimental Study.
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Barbieri G, Barbieri CH. A comparative in vivo ultrasonometric evaluation of normal and delayed fracture healing in sheep tibiae. Clinics (Sao Paulo) 2014; 69:634-40. [PMID: 25318096 PMCID: PMC4192429 DOI: 10.6061/clinics/2014(09)10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 04/28/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To compare normal and delayed bone healing by measuring ultrasound conduction velocity across the bone callus. METHODS A model of transverse linear and 5 mm resection osteotomies of sheep tibiae was used. Fourteen sheep were operated on and were divided into two groups of seven according to osteotomy type. The procedure was performed on the right tibiae and the intact left tibiae were used as controls. The transverse and axial ultrasound velocities were measured at 30-day intervals for 90 days, after which the animals were killed and both the right and left tibiae were resected for in vitro biomechanical analysis. RESULTS Both the transverse and axial ultrasound velocities progressively increased, but the increase was smaller for the delayed union that resulted from the resection osteotomy. The mechanical resistance was higher for the normally healed tibiae that resulted from a linear osteotomy; this result closely correlated with the ultrasound velocity results. Significant differences were found for the comparisons between the intact and operated tibiae in both groups and between the groups for both the transverse and axial ultrasound velocities, but the differences were greater for the latter. CONCLUSION We conclude that in vivo transverse and axial ultrasound velocities provide highly precise information about the healing state of both linear and resection diaphyseal osteotomies, but the axial ultrasound velocity most likely has greater discriminatory power. This method has the potential for clinical application in humans.
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Affiliation(s)
- Giuliano Barbieri
- Medicine and Rehabilitation of the Locomotor Apparatus, Department of Biomechanics, Ribeirão Preto School of Medicine, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Cláudio Henrique Barbieri
- Medicine and Rehabilitation of the Locomotor Apparatus, Department of Biomechanics, Ribeirão Preto School of Medicine, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Xu K, Liu D, Ta D, Hu B, Wang W. Quantification of guided mode propagation in fractured long bones. ULTRASONICS 2014; 54:1210-1218. [PMID: 24139020 DOI: 10.1016/j.ultras.2013.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Revised: 09/03/2013] [Accepted: 09/03/2013] [Indexed: 06/02/2023]
Abstract
Guided modes propagation in intact, fractured and healing long bone has drawn significant research interests. However, mode quantifications for the direct comparison are still necessary to address. The aim of the study is to analyze the mode interaction with a notch-fracture in the long bone and find quantitative ultrasound parameters sensitive to depth and width variation of the fracture. We analyzed the impacts of the partially and completely diaphyseal osteotomy on fundamental guided modes propagation using the two-dimension finite-difference time-domain (2D-FDTD) simulations. The long bones were built as three layer models by a cortical plate embedded between overlying soft tissue and inner-coated marrow. Narrowband low-frequency sinusoids (100 kHz) were employed to only excite two fundamental guided modes. The mode amplitude variations were investigated as functions of the gap-breakage width and depth. It is found that the transverse fractures have strong influences on the anti-symmetric mode A0 transmission and reflection, whereas amplitudes of the symmetric mode S0 are not sensitive to the fracture degree. The quantitative results consistently indicate that reflection energy and transmission coefficients of the S0 and A0 modes can be used to quantify the mode interaction in the fractured long bone and further to evaluate long bone fracture status. Future study is needed to investigate the physical experiments on realistic fractured long bone and to insure that the proposed ultrasound parameters can be used to quantitatively evaluate the long bone fracture in clinical application.
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Affiliation(s)
- Kailiang Xu
- Department of Electronic Engineering, Fudan University, 200433 Shanghai, China
| | - Dan Liu
- Department of Electronic Engineering, Fudan University, 200433 Shanghai, China
| | - Dean Ta
- Department of Electronic Engineering, Fudan University, 200433 Shanghai, China.
| | - Bo Hu
- Department of Electronic Engineering, Fudan University, 200433 Shanghai, China
| | - Weiqi Wang
- Department of Electronic Engineering, Fudan University, 200433 Shanghai, China
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Xu K, Ta D, He R, Qin YX, Wang W. Axial transmission method for long bone fracture evaluation by ultrasonic guided waves: simulation, phantom and in vitro experiments. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:817-27. [PMID: 24433749 PMCID: PMC4973576 DOI: 10.1016/j.ultrasmedbio.2013.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 10/15/2013] [Accepted: 10/21/2013] [Indexed: 05/25/2023]
Abstract
Mode conversion occurs when the ultrasonic guided waves encounter fractures. The aim of this study was to investigate the feasibility of fracture assessment in long cortical bone using guided-mode conversion. Mode conversion behavior between the fundamental modes S0 and A0 was analyzed. The expressions proposed for modal velocity were used to identify the original and converted modes. Simulations and phantom experiments were performed using 1.0-mm-thick steel plates with a notch width of 0.5 mm and notch depths of 0.2, 0.4, 0.6 and 0.8 mm. Furthermore, in vitro experiments were carried out on nine ovine tibias with 1.0-mm-wide partial transverse gap break and cortical thickness varying from 2.10 to 3.88 mm. The study confirmed that mode conversion gradually becomes observable as fracture depth increases. Energy percentages of the converted modes correlated strongly with fracture depth, as illustrated by the frequency-sweeping experiments on steel phantoms (100-1100 kHz, r(2) = 0.97, p < 0.0069) and the fixed-frequency experiments on nine ovine tibias (250 kHz, r(2) = 0.97, p < 0.0056). The approaches described, including mode excitation, velocity expressions and energy percentage criteria, may also contribute to ultrasonic monitoring of long bone fracture healing.
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Affiliation(s)
- Kailiang Xu
- Department of Electronic Engineering, Fudan University, Shanghai, China
| | - Dean Ta
- Department of Electronic Engineering, Fudan University, Shanghai, China.
| | - Runxin He
- Department of Electronic Engineering, Fudan University, Shanghai, China
| | - Yi-Xian Qin
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA
| | - Weiqi Wang
- Department of Electronic Engineering, Fudan University, Shanghai, China
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Rohrbach D, Preininger B, Hesse B, Gerigk H, Perka C, Raum K. The early phases of bone healing can be differentiated in a rat osteotomy model by focused transverse-transmission ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:1642-1653. [PMID: 23830097 DOI: 10.1016/j.ultrasmedbio.2013.03.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 03/25/2013] [Accepted: 03/26/2013] [Indexed: 06/02/2023]
Abstract
Here we describe the use of a 5-MHz focused transmission system to image the bone repair region and to distinguish the early healing phases in a rat osteotomy (OT) model. Twelve-month-old female rats underwent a 2-mm OT. After 6 wk of consolidation, 2-D projection images of time-of-flight, speed of sound, and ultrasound attenuation were measured in vitro. The tissue types in the OT gap region were assessed by site-matched histology sections and micro-computed tomography (μCT). In the cases investigated, OT gap regions containing fibrous tissue (group A) were found to have similar properties compared with adjacent muscle tissue, whereas regions filled with cartilage and mineralized callus tissues (group B) differed significantly. Analysis of variance revealed that the healing group had a stronger effect on acoustic parameters (F < 35) than on μCT-based parameters (F < 22). This pilot study reports the feasibility of transverse transmission quantitative ultrasound in assessment of the onset of cartilage formation during callus formation.
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Affiliation(s)
- Daniel Rohrbach
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Germany
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Xu K, Liu C, Ta D. Ultrasonic guided waves dispersion reversal for long bone thickness evaluation: a simulation study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2013:1930-1933. [PMID: 24110091 DOI: 10.1109/embc.2013.6609904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
It has been shown that ultrasonic guided waves have great potentials for long cortical bone evaluation. However, due to the multimodal dispersion, the received signals usually contain several mixed guided modes, which highly complicates the mode separation and signal processing. In the study, we showed that the use of dispersion reversal excitation allows the self-compensation of the dispersive modes in the long cortical bone. Two-dimension finite-difference time-domain (2D-FDTD) method was employed to simulate the propagation of two fundamental guided modes, symmetrical S0 and anti-symmetrical A0, in the long cortical bones. It was demonstrated that the pulse-like modes of S0 and A0 can be detected under the dispersion reversal excitations. The simulations also illustrated that the proposed dispersion reversal method can be used to evaluate the cortical thickness. Results are promising for the application of dispersion reversal method in ultrasonic assessment of the long cortical bone.
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16
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Bezuti MT, Mandarano Filho LG, Barbieri G, Mazzer N, Barbieri CH. Ultrasonometry evaluation of axial compression osteosinthesis. An experimental study. ACTA ORTOPEDICA BRASILEIRA 2013; 21:46-51. [PMID: 24453644 PMCID: PMC3862021 DOI: 10.1590/s1413-78522013000100010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 08/12/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: To measure the ultrasound propagation velocity (UV) through a tibial transverse osteotomy in sheep, before and after the fixation with a DCP plate. MATERIAL AND METHODS: Ten assemblies of a DCP plate with the diaphyseal segment of tibiae, in which a transverse osteotomy was made, were used. Both coronal and sagittal transverse and the axial UV were measured, first with the intact bone assembled with the plate and then with the uncompressed and compressed osteotomy; statistical comparisons were made at the 1% (p<0.01) level of significance. RESULTS: Compared with the intact bone assembly, axial UV significantly decreased with the addition of the osteotomy and significantly increased with compression, presenting the same behavior for the other modalities, although not significantly. DISCUSSION AND CONCLUSION: In accordance with the literature data on the ultrasonometric evaluation of fracture healing, underwater UV measurement was able to demonstrate the efficiency of DCP plate fixation. The authors conclude that the method has a potential for clinical application in the postoperative follow-up of DCP plate osteosinthesis, with a capability to demonstrate when it becomes ineffective. Laboratory investigation.
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Barbieri G, Mazzer N, Ribeiro EA, Nogueira-Barbosa MH, Barbieri CH. A comparative analysis between ultrasonometry and computer-aided tomography to evaluate bone healing. J Orthop Res 2012; 30:1076-82. [PMID: 22161915 DOI: 10.1002/jor.22039] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 11/18/2011] [Indexed: 02/04/2023]
Abstract
An ultrasonometric and computed-tomographic study of bone healing was undertaken using a model of a transverse mid-shaft osteotomy of sheep tibiae fixed with a semi-flexible external fixator. Fourteen sheep were operated and divided into two groups of seven according to osteotomy type, either regular or by segmental resection. The animals were killed on the 90th postoperative day and the tibiae resected for the in vitro direct contact transverse and axial measurement of ultrasound propagation velocity (UV) followed by quantitative computer-aided tomography (callus density and volume) through the osteotomy site. The intact left tibiae were used for control, being examined in a symmetrical diaphyseal segment. Regular osteotomies healed with a smaller and more mature callus than resection osteotomies. Axial UV was consistently and significantly higher (p ≤ 0.01) than transverse UV and both transverse and axial UV were significantly higher for the regular than for the segmental resection osteotomy. Transverse UV did not differ significantly between the intact and operated tibiae (p=0.20 for regular osteotomy; p=0.02 for resection osteotomy), but axial UV was significantly higher for the intact tibiae. Tomographic callus density was significantly higher for the regular than for the resection osteotomy and higher than both for the intact tibiae, presenting a strong positive correlation with UV. Callus volume presented an opposite behavior, with a negative correlation with UV. We conclude that UV is at least as precise as quantitative tomography for providing information about the healing state of both regular and resection osteotomy.
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Affiliation(s)
- Giuliano Barbieri
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine, São Paulo University. Campus Universitário, 14049-900 Ribeirão Preto, SP, Brazil
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Kumar VV, Sagheb K, Klein MO, Al-Nawas B, Kann PH, Kämmerer PW. Relation between bone quality values from ultrasound transmission velocity and implant stability parameters - an ex vivo study. Clin Oral Implants Res 2011; 23:975-80. [DOI: 10.1111/j.1600-0501.2011.02250.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2011] [Indexed: 11/29/2022]
Affiliation(s)
- Vinay V. Kumar
- Department of Oral and Maxillofacial Surgery; University Medical Centre of the Johannes Gutenberg University; Mainz; Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery; University Medical Centre of the Johannes Gutenberg University; Mainz; Germany
| | - Marcus O. Klein
- Department of Oral and Maxillofacial Surgery; University Medical Centre of the Johannes Gutenberg University; Mainz; Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery; University Medical Centre of the Johannes Gutenberg University; Mainz; Germany
| | - Peter H. Kann
- Department of Internal Medicine (Endocrinology); University Hospital Marburg; Germany
| | - Peer W. Kämmerer
- Resident, Department of Oral and Maxillofacial Surgery; University Medical Centre of the Johannes Gutenberg University; Mainz; Germany
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