Anisotropic microsphere-based approach to damage in soft fibered tissue

Risky interpretations across the length scales: continuum vs. discrete models for soft tissue mechanobiology

Modelling and simulation in mechanobiology play an increasingly important role to unravel the complex mechanisms that allow resident cells to sense and respond to mechanical cues. Many of the in vivo mechanical loads occur on the tissue length scale, thus raising the essential question how the resulting macroscopic strains and stresses are transferred across the scales down to the cellular and subcellular levels. Since cells anchor to the collagen fibres within the extracellular matrix, the reliable representation of fibre deformation is a prerequisite for models that aim at linking tissue biomechanics and cell mechanobiology. In this paper, we consider the two-scale mechanical response of an affine structural model as an example of a continuum mechanical approach and compare it with the results of a discrete fibre network model. In particular, we shed light on the crucially different mechanical properties of the 'fibres' in these two approaches. While assessing the capability of the affine structural approach to capture the fibre kinematics in real tissues is beyond the scope of our study, our results clearly show that neither the macroscopic tissue response nor the microscopic fibre orientation statistics can clarify the question of affinity.

A Review on Damage and Rupture Modelling for Soft Tissues

Computational modelling of damage and rupture of non-connective and connective soft tissues due to pathological and supra-physiological mechanisms is vital in the fundamental understanding of failures. Recent advancements in soft tissue damage models play an essential role in developing artificial tissues, medical devices/implants, and surgical intervention practices. The current article reviews the recently developed damage models and rupture models that considered the microstructure of the tissues. Earlier review works presented damage and rupture separately, wherein this work reviews both damage and rupture in soft tissues. Wherein the present article provides a detailed review of various models on the damage evolution and tear in soft tissues focusing on key conceptual ideas, advantages, limitations, and challenges. Some key challenges of damage and rupture models are outlined in the article, which helps extend the present damage and rupture models to various soft tissues.

Prediction of diabetic foot ulcer progression: a computational study

The development of foot ulcers is a common consequence of severe diabetes. Due to vascular disorders and impeded healing caused by the disease, most foot ulcers have been reported to be affected by body weight and progress with time. Also, abnormal distribution of plantar pressures has been observed to cause the formation of additional ulcers, which may collectively lead to traumatic amputations. While a study of such pathophysiology is not possible through experiments, a few computational modelling works have investigated diabetic foot ulcers. To date, ulcers with a few sizes and locations have been studied, and their effect on the plantar stresses has been quantified. In this work, we have attempted to study the effect of all possible ulcer locations on the generated plantar peak stresses and peak stress locations where additional ulcers may form. Also, the effect of ulcer location on the possible ulcer growth was investigated. A full-scale foot model was developed and a total of 52 ulcer locations were simulated separately, with standing and walking loads. The generated stresses were normalised with the foot size and statistically analysed to develop novel formulations for predicting peak plantar stresses and their locations for any known ulcer location. The results from this study are anticipated to provide important guidelines to doctors and medical practitioners for predicting foot ulcer progression in diabetic patients with existing ulcers and allow the administration of timely preventive interventions.

A Chemomechanobiological Model of the Long-Term Healing Response of Arterial Tissue to a Clamping Injury

Vascular clamping often causes injury to arterial tissue, leading to a cascade of cellular and extracellular events. A reliable in silico prediction of these processes following vascular injury could help us to increase our understanding thereof, and eventually optimize surgical techniques or drug delivery to minimize the amount of long-term damage. However, the complexity and interdependency of these events make translation into constitutive laws and their numerical implementation particularly challenging. We introduce a finite element simulation of arterial clamping taking into account acute endothelial denudation, damage to extracellular matrix, and smooth muscle cell loss. The model captures how this causes tissue inflammation and deviation from mechanical homeostasis, both triggering vascular remodeling. A number of cellular processes are modeled, aiming at restoring this homeostasis, i.e., smooth muscle cell phenotype switching, proliferation, migration, and the production of extracellular matrix. We calibrated these damage and remodeling laws by comparing our numerical results to in vivo experimental data of clamping and healing experiments. In these same experiments, the functional integrity of the tissue was assessed through myograph tests, which were also reproduced in the present study through a novel model for vasodilator and -constrictor dependent smooth muscle contraction. The simulation results show a good agreement with the in vivo experiments. The computational model was then also used to simulate healing beyond the duration of the experiments in order to exploit the benefits of computational model predictions. These results showed a significant sensitivity to model parameters related to smooth muscle cell phenotypes, highlighting the pressing need to further elucidate the biological processes of smooth muscle cell phenotypic switching in the future.

Unraveling the multilayer mechanical response of aorta using layer-specific residual stresses and experimental properties

To test the capability of the multilayer model, we used previously published layer-specific experimental data relating to the axial pre-stretch, the opening angle, the fiber distribution obtained by polarized light microscopy measurements, and the uniaxial and biaxial response of the porcine descending and abdominal aorta. We fitted the mechanical behavior of each arterial layer using Gasser, Holzapfel and Ogden strain energy function using the dispersion parameter κ as phenomenological parameter obtained during the fitting procedure or computed from the experimental fiber distribution. A multilayer finite element model of the whole aorta with the dimensions of the circumferential and longitudinal strips were then built using layer-specific material parameters previously fitted. This model was used to capture the whole aorta response under uniaxial and biaxial stress states and to reproduce the response of the whole aorta to internal pressure. Our results show that a model based on a multilayer structure without residual stresses is unable to render the uniaxial and biaxial mechanical response of the aorta (R²=0.6954 and R²=0.8582 for descending thoracic aorta (DTA) and infrarenal abdominal aorta (IAA), respectively). Only an appropriate multilayer model that includes layer-specific residual stresses can reproduce the response of the whole aorta (R²=0.9787 and R²=0.9636 for DTA and IAA respectively). In addition, a multilayer model without residual stresses produces the same stress distribution as a monolayer model without residual stresses where the maximal value of circumferential and longitudinal stresses appears at the inner radius of the intima. Finally, if layer-specific residual stresses are not available, there is less error the stress distribution using a monolayer model with residual stresses that a multilayer model without residual stresses.

Polydispersity controls the strength of semi-flexible polymer networks

The classical theory of polymer elasticity is built upon the assumption of network monodispersity-the premise that polymer networks are comprised of sub-chains of equal length. The crosslinking of biopolymers, however, is a random process and the resultant networks are likely to be polydisperse. The effect of structural polydispersity on the mechanical behavior of biopolymer networks is not well understood. The purpose of this contribution is to show how network polydispersity controls mechanical behavior and the ultimate properties of crosslinked semi-flexible filaments at finite deformations. The proposed micromechanical continuum model is based on the force-elongation relation of individual chains of different lengths. It is shown that the mechanical strength of the network is controlled by the finite-extensibility of filaments and the degradation of shorter filaments at relatively small stretches. The progressive failure of filaments continues and eventually determines the ultimate strength of the network. The predicted stress-stretch behaviors are in reasonable agreement with the experimental data for connective tissues.

Structural modeling reveals microstructure-strength relationship for human ascending thoracic aorta

High lethality of aortic dissection necessitates accurate predictive metrics for dissection risk assessment. The not infrequent incidence of dissection at aortic diameters <5.5 cm, the current threshold guideline for surgical intervention (Nishimura et al., 2014), indicates an unmet need for improved evidence-based risk stratification metrics. Meeting this need requires a fundamental understanding of the structural mechanisms responsible for dissection evolution within the vessel wall. We present a structural model of the repeating lamellar structure of the aortic media comprised of elastic lamellae and collagen fiber networks, the primary load-bearing components of the vessel wall. This model was used to assess the role of these structural features in determining in-plane tissue strength, which governs dissection initiation from an intimal tear. Ascending aortic tissue specimens from three clinically-relevant patient populations were considered: non-aneurysmal aorta from patients with morphologically normal tricuspid aortic valve (CTRL), aneurysmal aorta from patients with tricuspid aortic valve (TAV), and aneurysmal aorta from patients with bicuspid aortic valve (BAV). Multiphoton imaging derived collagen fiber organization for each patient cohort was explicitly incorporated in our model. Model parameters were calibrated using experimentally-measured uniaxial tensile strength data in the circumferential direction for each cohort, while the model was validated by contrasting simulated tissue strength against experimentally-measured strength in the longitudinal direction. Orientation distribution, controlling the fraction of loaded collagen fibers at a given stretch, was identified as a key feature governing anisotropic tissue strength for all patient cohorts.

A novel computational remodelling algorithm for the probabilistic evolution of collagen fibre dispersion in biaxially strained vascular tissue

In this work, we constructed a novel collagen fibre remodelling algorithm that incorporates the complex nature of random evolution acting on single fibres causing macroscopic fibre dispersion. The proposed framework is different from the existing remodelling algorithms, in that the microscopic random force on cellular scales causing a rotational-type Brownian motion alone is considered as an aspect of vascular tissue remodelling. A continuum mechanical framework for the evolution of local dispersion and how it could be used for modeling the evolution of internal radius of biaxially strained artery structures under constant internal blood pressure are presented. A linear evolution form for the statistical fibre dispersion is employed in the model. The random force component of the evolution, which depends on the mechanical stress stimuli, is described by a single parameter. Although the mathematical form of the proposed model is simple, there is a strong link between the microscopic evolution of collagen dispersion on the cellular level and its effects on the macroscopic visible world through mechanical variables. We believe that the proposed algorithm utilizes a better understanding of the relationship between the evolution rates of mean fibre direction and fibre dispersion. The predictive capability of the algorithm is presented using experimental data. The model has been simulated by solving a single-layered axisymmetric artery (adventitia) deformation problem. The algorithm performed well for estimating the quantitative features of experimental anisotropy, the mean fibre direction vector and the dispersion (κ) measurements under strain-dependent evolution assumptions.

Damage Models for Soft Tissues: A Survey

Damage to soft tissues in the human body has been investigated for applications in healthcare, sports, and biomedical engineering. This paper reviews and classifies damage models for soft tissues to summarize achievements, identify new directions, and facilitate finite element analysis. The main ideas of damage modeling methods are illustrated and interpreted. A few key issues related to damage models, such as experimental data curve-fitting, computational effort, connection between damage and fractures/cracks, damage model applications, and fracture/crack extension simulation, are discussed. Several new challenges in the field are identified and outlined. This review can be useful for developing more advanced damage models and extending damage modeling methods to a variety of soft tissues.

A microstructurally inspired damage model for early venous thrombus

Accumulative damage may be an important contributor to many cases of thrombotic disease progression. Thus, a complete understanding of the pathological role of thrombus requires an understanding of its mechanics and in particular mechanical consequences of damage. In the current study, we introduce a novel microstructurally inspired constitutive model for thrombus that considers a non-uniform distribution of microstructural fibers at various crimp levels and employs one of the distribution parameters to incorporate stretch-driven damage on the microscopic level. To demonstrate its ability to represent the mechanical behavior of thrombus, including a recently reported Mullins type damage phenomenon, we fit our model to uniaxial tensile test data of early venous thrombus. Our model shows an agreement with these data comparable to previous models for damage in elastomers with the added advantages of a microstructural basis and fewer model parameters. We submit that our novel approach marks another important step toward modeling the evolving mechanics of intraluminal thrombus, specifically its damage, and hope it will aid in the study of physiological and pathological thrombotic events.

Relaxed incremental variational approach for the modeling of damage-induced stress hysteresis in arterial walls

In this paper, a three-dimensional relaxed incremental variational damage model is proposed, which enables the description of complex softening hysteresis as observed in supra-physiologically loaded arterial tissues, and which thereby avoids a loss of convexity of the underlying formulation. The proposed model extends the relaxed formulation of Balzani and Ortiz [2012. Relaxed incremental variational formulation for damage at large strains with application to fiber-reinforced materials and materials with truss-like microstructures. Int. J. Numer. Methods Eng. 92, 551-570], such that the typical stress-hysteresis observed in arterial tissues under cyclic loading can be described. This is mainly achieved by constructing a modified one-dimensional model accounting for cyclic loading in the individual fiber direction and numerically homogenizing the response taking into account a fiber orientation distribution function. A new solution strategy for the identification of the convexified stress potential is proposed based on an evolutionary algorithm which leads to an improved robustness compared to solely Newton-based optimization schemes. In order to enable an efficient adjustment of the new model to experimentally observed softening hysteresis, an adjustment scheme using a surrogate model is proposed. Therewith, the relaxed formulation is adjusted to experimental data in the supra-physiological domain of the media and adventitia of a human carotid artery. The performance of the model is then demonstrated in a finite element example of an overstretched artery. Although here three-dimensional thick-walled atherosclerotic arteries are considered, it is emphasized that the formulation can also directly be applied to thin-walled simulations of arteries using shell elements or other fiber-reinforced biomembranes.

Selective enzymatic removal of elastin and collagen from human abdominal aortas: uniaxial mechanical response and constitutive modeling

The ability to selectively remove the structurally most relevant components of arterial wall tissues such as collagen and elastin enables ex vivo biomechanical testing of the remaining tissues, with the aim of assessing their individual mechanical contributions. Resulting passive material parameters can be utilized in mathematical models of the cardiovascular system. Using eighteen wall specimens from non-atherosclerotic human abdominal aortas (55 ± 11 years; 9 female, 9 male), we tested enzymatic approaches for the selective digestion of collagen and elastin, focusing on their application to human abdominal aortic wall tissues from different patients with varying sample morphologies. The study resulted in an improved protocol for elastin removal, showing how the enzymatic process is affected by inadequate addition of trypsin inhibitor. We applied the resulting protocol to circumferential and axial specimens from the media and the adventitia, and performed cyclic uniaxial extension tests in the physiological and supra-physiological loading domain. The collagenase-treated samples showed a (linear) response without distinct softening behavior, while the elastase-treated samples exhibited a nonlinear, anisotropic response with pronounced remanent deformations (continuous softening), presumably caused by some sliding of collagen fibers within the damaged regions of the collagen network. In addition, our data showed that the stiffness in the initial linear stress-stretch regime at low loads is lower in elastin-free tissue compared to control samples (i.e. collagen uncrimping requires less force than the stretching of elastin), experimentally confirming that elastin is responsible for the initial stiffness in elastic arteries. Utilizing a continuum mechanical description to mathematically capture the experimental results we concluded that the inclusion of a damage model for the non-collagenous matrix material is, in general, not necessary. To model the softening behavior, continuous damage was included in the fibers by adding a damage variable which led to remanent strains through the consideration of damage.

Computational model of collagen turnover in carotid arteries during hypertension

It is well known that biological tissues adapt their properties because of different mechanical and chemical stimuli. The goal of this work is to study the collagen turnover in the arterial tissue of hypertensive patients through a coupled computational mechano-chemical model. Although it has been widely studied experimentally, computational models dealing with the mechano-chemical approach are not. The present approach can be extended easily to study other aspects of bone remodeling or collagen degradation in heart diseases. The model can be divided into three different stages. First, we study the smooth muscle cell synthesis of different biological substances due to over-stretching during hypertension. Next, we study the mass-transport of these substances along the arterial wall. The last step is to compute the turnover of collagen based on the amount of these substances in the arterial wall which interact with each other to modify the turnover rate of collagen. We simulate this process in a finite element model of a real human carotid artery. The final results show the well-known stiffening of the arterial wall due to the increase in the collagen content.

Elastic-viscoplastic modeling of soft biological tissues using a mixed finite element formulation based on the relative deformation gradient

The characteristic highly nonlinear, time-dependent, and often inelastic material response of soft biological tissues can be expressed in a set of elastic-viscoplastic constitutive equations. The specific elastic-viscoplastic model for soft tissues proposed by Rubin and Bodner (2002) is generalized with respect to the constitutive equations for the scalar quantity of the rate of inelasticity and the hardening parameter in order to represent a general framework for elastic-viscoplastic models. A strongly objective integration scheme and a new mixed finite element formulation were developed based on the introduction of the relative deformation gradient-the deformation mapping between the last converged and current configurations. The numerical implementation of both the generalized framework and the specific Rubin and Bodner model is presented. As an example of a challenging application of the new model equations, the mechanical response of facial skin tissue is characterized through an experimental campaign based on the suction method. The measurement data are used for the identification of a suitable set of model parameters that well represents the experimentally observed tissue behavior. Two different measurement protocols were defined to address specific tissue properties with respect to the instantaneous tissue response, inelasticity, and tissue recovery.

A damage model for the percutaneous triple hemisection technique for tendo-achilles lengthening

A full understanding of the mechanisms of action in the percutaneous triple hemisection technique for tendo-achilles lengthening has yet to be acquired and therefore, an accurate prediction of the amount of lengthening that occurs is difficult to make. The purpose of this research was to develop a phenomenological damage model that utilizes both matrix and fiber damage and replicates the observed behavior of the tendon tissue during the lengthening process. Matrix damage was triggered and evolved relative to shear strain and the fiber damage was triggered and evolved relative to fiber stretch. Three examples are given to show the effectiveness of the model. Implementation of the damage model provides a tool for studying this common procedure, and may allow for numerical investigation of alternative surgical approaches that could reduce the incidence rates of severe over-lengthening.