Viscoelastic properties of a spinal posterior dynamic stabilisation device

A genetic algorithm optimization framework for the characterization of hyper-viscoelastic materials: application to human articular cartilage

This study aims to develop an automated framework for the characterization of materials which are both hyper-elastic and viscoelastic. This has been evaluated using human articular cartilage (AC). AC (26 tissue samples from 5 femoral heads) underwent dynamic mechanical analysis with a frequency sweep from 1 to 90 Hz. The conversion from a frequency- to time-domain hyper-viscoelastic material model was approximated using a modular framework design where finite element analysis was automated, and a genetic algorithm and interior point technique were employed to solve and optimize the material approximations. Three orders of approximation for the Prony series were evaluated at N = 1, 3 and 5 for 20 and 50 iterations of a genetic cycle. This was repeated for 30 simulations of six combinations of the above all with randomly generated initialization points. There was a difference between N = 1 and N = 3/5 of approximately ~5% in terms of the error estimated. During unloading the opposite was seen with a 10% error difference between N = 5 and 1. A reduction of ~1% parameter error was found when the number of generations increased from 20 to 50. In conclusion, the framework has proved effective in characterizing human AC.

Surgical tips for the implantation of BDYNTM dynamic stabilization system: combining spinal navigation with motion preservation for low-grade lumbar degenerative spondylolisthesis

BACKGROUND

As required in every dynamic stabilization system, the implantation of the BDYNTM device implies a perfect positioning of the screws and rods to benefit from its biomechanical properties. To achieve this goal, intra-operative imaging seems mandatory.

METHOD

Through a case report of a patient with symptomatic grade I lumbar degenerative spondylolisthesis, we present the surgical tips for the implantation of BDYNTM dynamic stabilization system under the assistance of spinal navigation Surgivisio® 2D/3D.

CONCLUSION

The pedicular screw convergence, their placement in the pedicles, and the proper alignment of the BDYNTM system placed in neutral position are important steps of the surgery. Intra-operative spinal navigation helps achieving precise and safe positioning of the dynamic stabilization BDYNTM device taking optimal advantages of its biomechanical characteristics.

Dynamic viscoelastic properties of porcine gastric tissue: Effects of loading frequency, region and direction

The gastric biomechanics influences digestive function as well as a range of topics of medical and scientific interests such as interaction between the stomach and gastric devices. Hence, the mechanical properties are essential for understanding gastric tissue and function in health and disease, and for the development of diagnostic or therapeutic devices. A key characteristic to be characterized is the time dependent mechanical tissue properties. The aim of this study was to characterize viscoelastic properties of the stomach across a frequency range. Longitudinal and circumferential stomach samples from the porcine fundus, corpus and antrum were pre-stretched 10 % and sinusoidally loaded with 10 % dynamic strain. The viscoelastic properties were assessed from 0.01 - 15 Hz using dynamic mechanical analysis. The storage moduli, loss moduli and tan δ had a significant second-order polynomial trend with increasing frequency. For the loss moduli, significant differences were observed between 0.01 and 15 Hz and between 0.05 and 15 Hz (p = 0.023 to 0.041). Significant differences were not found for storage moduli. Tan δ was frequency-independent, indicating that the two moduli varied proportionally. Fundus had significantly smaller storage moduli for longitudinal samples compared to corpus (p = 0.034) and antrum (p = 0.014) but was not significantly different for circumferential samples. Analysis of direction-dependency showed significant differences between longitudinal and circumferential samples (p = 0.002 to 0.042). The presented work provides insight into tensile viscoelastic properties of gastric tissue, which is useful for developing biomaterials, devices and computational models for device development specification calibrations.

The dynamic viscoelastic characterisation and magnetic resonance imaging of poly(vinyl alcohol) cryogel: Identifying new attributes and opportunities

Poly(vinyl alcohol) (PVA) cryogel is a biocompatible, synthetic hydrogel, compatible with magnetic resonance (MR) imaging. It is widely used as a biomaterial in tissue scaffolds and mimics to test various diagnostic techniques. The aim of this study is to characterise the effect of varying PVA concentration, molecular weight (MW) and manufacturing protocol on the viscoelastic mechanical properties and MR T₂ relaxation time. Further to this MR imaging (MRI) was investigated as a method to quantify material homogeneity. Cylindrical samples of PVA, of varying MW, concentration and number of freeze thaw cycles (FTCs), were manufactured. Dynamic mechanical analysis was performed to evaluate the storage and loss moduli between frequencies of 0.5 and 10 Hz. MR T₂ relaxation maps were imaged using a 7 T MRI instrument. Storage and loss moduli were shown to increase with MW, concentration, or the number of FTCs; with storage modulus ranging from 55 kPa to 912 kPa and loss modulus ranging from 6 kPa to 103 kPa. MR T₂ relaxation time was shown to increase linearly with PVA concentration. The qualitative and quantitative heterogeneity of the PVA sample were identified through MR T₂ relaxation time maps. Excitingly, PVA demonstrated a composition-dependent casual correlation between the viscoelastic mechanical properties and MR T₂ relaxation time. In conclusion, this research thoroughly characterised the viscoelastic mechanical properties of PVA to support its extensive use as a biomaterial, and demonstrated the use of MRI to non-invasively identify sample heterogeneity and to predict the composition-dependent viscoelastic properties of PVA.

The orthotropic viscoelastic characterisation of sub-zero 3D-printed poly(vinyl alcohol) cryogel

Abstract

Poly(vinyl alcohol) cryogel (PVA) is a versatile biomaterial used to replicate the biomechanics of tissues. Additive manufacture (AM) at sub-zero (°C) temperatures enables the manufacture of PVA with complex geometry; however, the effect of processing parameters on the mechanical properties of PVA has not been evaluated. The aim of this study is to understand the impact of print nozzle diameter and orientation on the viscoelastic mechanical properties of PVA. Samples of sub-zero AM PVA, with different filament thicknesses, were tested under tension relative to the print direction, to calculate the storage and loss moduli. As the nozzle size was decreased, AM PVA exhibited more pronounced orthotropic properties; the smallest size showed a 33% decrease in storage moduli when tested perpendicular to the print direction, as opposed to parallel. This study has demonstrated the ability of sub-zero AM to tailor the orthotropic properties of PVA.

Graphic abstract

Mechanical testing of glutaraldehyde cross-linked mitral valves. Part two: Elastic and viscoelastic properties of chordae tendineae

The aim of this study was to assess whether the mechanical properties of mitral valve chordae tendineae are sensitive to being cross-linked under load. A total 64 chordae were extracted from eight porcine hearts. Two chordae (posterior basal) from each heart were subjected to uniaxial ramp testing and six chordae (two strut, two anterior basal and two posterior basal) were subjected to dynamic mechanical analysis over frequencies between 0.5 and 10 Hz. Chordae were either cross-linked in tension or cross-linked in the absence of loading. Chordae cross-linked under load transitioned from high to low extension at a lower strain than cross-linked unloaded chordae (0.07 cf. 0.22), with greater pre-transitional (30.8 MPa cf. 5.78 MPa) and post-transitional (139 MPa cf. 74.1 MPa) moduli. The mean storage modulus of anterior strut chordae ranged from 48 to 54 MPa for cross-linked unloaded chordae, as compared to 53-61 MPa cross-linked loaded chordae. The mean loss modulus of anterior strut chordae ranged from 2.3 to 2.9 MPa for cross-linked unloaded chordae, as compared to 3.8-4.8 MPa cross-linked loaded chordae. The elastic and viscoelastic properties of chordae following glutaraldehyde cross-linking are dependent on the inclusion/exclusion of loading during the cross-linking process; with loading increasing the magnitude of the material properties measured.

Dynamic viscoelastic characterisation of human osteochondral tissue: understanding the effect of the cartilage-bone interface

BACKGROUND

Despite it being known that subchondral bone affects the viscoelasticity of cartilage, there has been little research into the mechanical properties of osteochondral tissue as a whole system. This study aims to unearth new knowledge concerning the dynamic behaviour of human subchondral bone and how energy is transferred through the cartilage-bone interface.

METHODS

Dynamic mechanical analysis was used to determine the frequency-dependent (1-90 Hz) viscoelastic properties of the osteochondral unit (cartilage-bone system) as well as isolated cartilage and bone specimens extracted from human femoral heads obtained from patients undergoing total hip replacement surgery, with a mean age of 78 years (N = 5, n = 22). Bone mineral density (BMD) was also determined for samples using micro-computed tomography as a marker of tissue health.

RESULTS

Cartilage storage and loss moduli along with bone storage modulus were found to increase logarithmically (p < 0.05) with frequency. The mean cartilage storage modulus was 34.4 ± 3.35 MPa and loss modulus was 6.17 ± 0.48 MPa (mean ± standard deviation). In contrast, bone loss modulus decreased logarithmically between 1 and 90 Hz (p < 0.05). The storage stiffness of the cartilage-bone-core was found to be frequency-dependent with a mean value of 1016 ± 54.0 N.mm^- 1, while the loss stiffness was determined to be frequency-independent at 78.84 ± 2.48 N.mm^- 1. Notably, a statistically significant (p < 0.05) linear correlation was found between the total energy dissipated from the isolated cartilage specimens, and the BMD of the isolated bone specimens at all frequencies except at 90 Hz (p = 0.09).

CONCLUSIONS

The viscoelastic properties of the cartilage-bone core were significantly different to the tissues in isolation (p < 0.05). Results from this study demonstrate that the functionality of these tissues arises because they operate as a unit. This is evidenced through the link between cartilage energy dissipated and bone BMD. The results may provide insights into the functionality of the osteochondral unit, which may offer further understanding of disease progression, such as osteoarthritis (OA). Furthermore, the results emphasise the importance of studying human tissue, as bovine models do not always display the same trends.

Lumbar model generator: a tool for the automated generation of a parametric scalable model of the lumbar spine

Low back pain is a major cause of disability and requires the development of new devices to treat pathologies and improve prognosis following surgery. Understanding the effects of new devices on the biomechanics of the spine is crucial in the development of new effective and functional devices. The aim of this study was to develop a preliminary parametric, scalable and anatomically accurate finite-element model of the lumbar spine allowing for the evaluation of the performance of spinal devices. The principal anatomical surfaces of the lumbar spine were first identified, and then accurately fitted from a previous model supplied by S14 Implants (Bordeaux, France). Finally, the reconstructed model was defined according to 17 parameters which are used to scale the model according to patient dimensions. The developed model, available as a toolbox named the lumbar model generator, enables generating a population of models using subject-specific dimensions obtained from data scans or averaged dimensions evaluated from the correlation analysis. This toolbox allows patient-specific assessment, taking into account individual morphological variation. The models have applications in the design process of new devices, evaluating the biomechanics of the spine and helping clinicians when deciding on treatment strategies.

The role of subchondral bone, and its histomorphology, on the dynamic viscoelasticity of cartilage, bone and osteochondral cores

OBJECTIVE

Viscoelastic properties of articular cartilage have been characterised at physiological frequencies. However, studies investigating the interaction between cartilage and subchondral bone and the influence of underlying bone histomorphometry on the viscoelasticity of cartilage are lacking.

METHOD

Dynamic Mechanical Analysis (DMA) has been used to quantify the dynamic viscoelasticity of bovine tibial plateau osteochondral cores, over a frequency sweep from 1 to 88 Hz. Specimens (approximately aged between 18 and 30 months) were neither osteoarthritic nor otherwise compromised. A maximum nominal stress of 1.7 MPa was induced. Viscoelastic properties of cores have been compared with that of its components (cartilage and bone) in terms of the elastic and viscous components of both structural stiffness and material modulus. Micro-computed tomography scans were used to quantify the histomorphological properties of the subchondral bone.

RESULTS

Opposing frequency-dependent loss stiffness, and modulus, trends were witnessed for osteochondral tissues: for cartilage it increased logarithmically (P < 0.05); for bone it decreased logarithmically (P < 0.05). The storage stiffness of osteochondral cores was logarithmically frequency-dependent (P < 0.05), however, the loss stiffness was typically frequency-independent (P > 0.05). A linear relationship between the subchondral bone plate (SBP) thickness and cartilage thickness (P < 0.001) was identified. Cartilage loss modulus was linearly correlated to bone mineral density (BMD) (P < 0.05) and bone volume (P < 0.05).

CONCLUSION

The relationship between the subchondral bone histomorphometry and cartilage viscoelasticity (namely loss modulus) and thickness, have implications for the initiation and progression of osteoarthritis (OA) through an altered ability of cartilage to dissipate energy.

Design and material evaluation for a novel lumbar disc replacement implanted via unilateral transforaminal approach

The degeneration of the intervertebral disc is one of the principal causes of low back pain. Total disc replacement is a surgical treatment that aims to replace the degenerated disc with a dynamic implant to restore spine biomechanics. This paper proposes the first design of an elastomeric lumbar disc replacement that is implanted as a pair of devices via unilateral transforaminal surgical approach. Furthermore, several biomaterials (Polyurethanes (PU) and Polycarbonate Urethanes (PCU)) are evaluated for the purpose of the implant to mimic the axial compliance of the spine. Bionate II 80A (a pure PCU), Elast Eon 82A E5-325 (a PU with polydimethylsiloxane and polyhexamethylene oxide), Chronosil (a PCU based silicone elastomer) 80A with 5% and 10% of silicone were obtained and injection moulded according to the shape of the implant core, which was defined after a stress distribution analysis with the finite element method. The dimensions for each specimen were: 14.6 × 5.6 × 6.1 mm (length, width and height). Quasistatic compression tests were performed at a displacement rate of 0.02 mm/s. The obtained stiffness for each material at 1 mm displacement was: Bionate II 80A, 448.48 N/mm; Elast Eon 82A E5-325, 216.55 N/mm; Chronosil 80A 5%, 127.73 N/mm; and Chronosil 80A 10%, 126.48 N/mm. Dimensional changes were quantified after two quasi-static compression tests. Plastic deformation was perceived in all cases with a total percentage of height loss of: 4.1 ± 0.5% for Elast Eon 82A E5-325; 3.2 ± 0.5% for Chronosil 80A 10%; 2.7 ± 0.3% for Chronosil 80A 5% and 1.1 ± 0.2% for Bionate II 80A. The mechanical behaviour of these biomaterials is discussed to assess their suitability for the novel disc replacement device proposed.

Matrix degradation in osteoarthritis primes the superficial region of cartilage for mechanical damage

Osteoarthritis (OA) is a degenerative disease that affects 25% of the world's population over fifty years of age. It is a chronic disease of the synovial joints, primarily the hip and knee. The main pathologies are degradation of the articular cartilage and changes to the subchondral bone, as a result of both mechanical wear and a locally elevated inflammatory state. This study compares the viscoelastic properties of cartilage that represents the biochemical changes in OA and age-matched healthy tissue. Further, the mechanical damage induced by this compressive loading cycle was characterised and the mechanism for it was investigated. The storage modulus of OA cartilage was shown to be significantly lower than that of healthy cartilage whilst having a higher capacity to hold water. Following mechanical testing, there was a significant increase in the surface roughness of OA cartilage. This change in surface structure occurred following a reduction in sulphated glycosaminoglycan content of the superficial region in OA, as seen by alcian blue staining and quantified by micro X-ray fluorescence. These findings are important in understanding how the chemical changes to cartilage matrix in OA influence its dynamic mechanical properties and structural integrity.

STATEMENT OF SIGNIFICANCE

Cartilage has a very specialised tissue structure which acts to resist compressive loading. In osteoarthritis (OA), there is both mechanically- and chemically-induced damage to cartilage, resulting in severe degradation of the tissue. In this study we have undertaken a detailed mechanical and chemical analysis of macroscopically undamaged OA and healthy cartilage tissue. We have demonstrated, for the first time in human tissue, that the mechanical degradation of the tissue is attributed to a chemical change across the structure. In macroscopically undamaged OA tissue, there is a reduction in the elastic response of cartilage tissue and an associated destabilisation of the matrix that leaves it susceptible to damage. Understanding this allows us to better understand the progression of OA to design better therapeutic interventions.

Effect of glutaraldehyde based cross-linking on the viscoelasticity of mitral valve basal chordae tendineae

BACKGROUND

Mitral valve failure can require repair or replacement. Replacement bioprosthetic valves are treated with glutaraldehyde prior to implantation. The aim of this study was to determine the changes in mechanical properties following glutaraldehyde fixation of mitral valve chordae.

METHODS

To investigate the impact of glutaraldehyde on mitral valve chordae, 24 basal chordae were dissected from four porcine hearts. Anterior and posterior basal (including strut) chordae were used. All 24 chordae were subjected to a sinusoidally varying load (mean level 2N, dynamic amplitude 2N) over a frequency range of 0.5-10 Hz before and after glutaraldehyde treatment.

RESULTS

The storage and loss modulus of all chordal types decreased following glutaraldehyde fixation. The storage modulus ranged from: 108 to 119 MPa before fixation and 67.3-87.4 MPa following fixation for basal chordae; 52.3-58.4 MPa before fixation and 47.9-53.5 MPa following fixation for strut chordae. Similarly, the loss modulus ranged from: 5.47 to 6.25 MPa before fixation and 3.63-4.94 MPa following fixation for basal chordae; 2.60-2.97 MPa before fixation and 2.31-2.93 MPa following fixation for strut chordae.

CONCLUSION

The viscoelastic properties of mitral valve chordae are affected by glutaraldehyde fixation; in particular, the reduction in storage moduli decreased with an increase in chordal diameter.

Hyperspectral chemical imaging reveals spatially varied degradation of polycarbonate urethane (PCU) biomaterials

Hyperspectral chemical imaging (HCI) is an emerging technique which combines spectroscopy with imaging. Unlike traditional point spectroscopy, which is used in the majority of polymer biomaterial degradation studies, HCI enables the acquisition of spatially localised spectra across the surface of a material in an objective manner. Here, we demonstrate that attenuated total reflectance Fourier transform infra-red (ATR-FTIR) HCI reveals spatial variation in the degradation of implantable polycarbonate urethane (PCU) biomaterials. It is also shown that HCI can detect possible defects in biomaterial formulation or specimen production; these spatially resolved images reveal regional or scattered spatial heterogeneity. Further, we demonstrate a map sampling method, which can be used in time-sensitive scenarios, allowing for the investigation of degradation across a larger component or component area. Unlike imaging, mapping does not produce a contiguous image, yet grants an insight into the spatial heterogeneity of the biomaterial across a larger area. These novel applications of HCI demonstrate its ability to assist in the detection of defective manufacturing components and lead to a deeper understanding of how a biomaterial's chemical structure changes due to implantation.

STATEMENT OF SIGNIFICANCE

The human body is an aggressive environment for implantable devices and their biomaterial components. Polycarbonate urethane (PCU) biomaterials in particular were investigated in this study. Traditionally one or a few points on the PCU surface are analysed using ATR-FTIR spectroscopy. However the selection of acquisition points is susceptible to operator bias and critical information can be lost. This study utilises hyperspectral chemical imaging (HCI) to demonstrate that the degradation of a biomaterial varies spatially. Further, HCI revealed spatial variations of biomaterials that were not subjected to oxidative degradation leading to the possibility of HCI being used in the assessment of biomaterial formulation and/or component production.

Formulation and viscoelasticity of mineralised hydrogels for use in bone-cartilage interfacial reconstruction

Articular cartilage is a viscoelastic tissue whose structural integrity is important in maintaining joint health. To restore the functionality of osteoarthritic joints it is vital that regenerative strategies mimic the dynamic loading response of cartilage and bone. Here, a rotating simplex model was employed to optimise the composition of agarose and gellan hydrogel constructs structured with hydroxyapatite (HA) with the aim of obtaining composites mechanically comparable to human cartilage in terms of their ability to dissipate energy. Addition of ceramic particles was found to reinforce both matrices up to a critical concentration (< 3w/v%). Beyond this, larger agglomerates were formed, as evidenced by micro computed tomography data, which acted as stress risers and reduced the ability of composites to dissipate energy demonstrated by a reduction in tan δ values. A maximum compressive modulus of 450.7±24.9 kPa was achieved with a composition of 5.8w/v% agarose and 0.5w/v% HA. Interestingly, when loaded dynamically (1-20Hz) this optimised formulation did not exhibit the highest complex modulus instead a sample with a higher concentration of mineral was identified (5.8w/v% agarose and 25w/v% HA). Thus, demonstrating the importance of examining the mechanical behaviour of biomaterials under conditions representative of physiological environments. While the complex moduli of the optimised gellan (1.0 ± 0.2MPa at 1Hz) and agarose (1.7 ± 0.2MPa at 1Hz) constructs did not match the complex moduli of healthy human cartilage samples (26.3 ± 6.5MPa at 1Hz), similar tan δ values were observed between 1 and 5Hz. This is promising since these frequencies represent the typical heel strike time of the general population. In summary, this study demonstrates the importance of considering more than just the strength of biomaterials since tissues like cartilage play a more complex role.

Viscoelasticity of articular cartilage: Analysing the effect of induced stress and the restraint of bone in a dynamic environment

The aim of this study was to determine the effect of the induced stress and restraint provided by the underlying bone on the frequency-dependent storage and loss stiffness (for bone restraint) or modulus (for induced stress) of articular cartilage, which characterise its viscoelasticity. Dynamic mechanical analysis has been used to determine the frequency-dependent viscoelastic properties of bovine femoral and humeral head articular cartilage. A sinusoidal load was applied to the specimens and out-of-phase displacement response was measured to determine the phase angle, the storage and loss stiffness or modulus. As induced stress increased, the storage modulus significantly increased (p < 0.05). The phase angle decreased significantly (p < 0.05) as the induced stress increased; reducing from 13.1° to 3.5°. The median storage stiffness ranged from 548N/mm to 707N/mm for cartilage tested on-bone and 544N/mm to 732N/mm for cartilage tested off-bone. On-bone articular cartilage loss stiffness was frequency independent (p > 0.05); however, off-bone, articular cartilage loss stiffness demonstrated a logarithmic frequency-dependency (p < 0.05). In conclusion, the frequency-dependent trends of storage and loss moduli of articular cartilage are dependent on the induced stress, while the restraint provided by the underlying bone removes the frequency-dependency of the loss stiffness.

In vitro oxidative degradation of a spinal posterior dynamic stabilization device

This study quantified the changes of the frequency-dependant viscoelastic properties of the BDyn (S14 Implants, Pessac, France) spinal posterior dynamic stabilization (PDS) device due to in vitro oxidation. Six polycarbonate urethane (PCU) rings and six silicone cushions were degraded using a 20% hydrogen peroxide/0.1 M cobalt (II) chloride hexahydrate, at 37°C, for 24 days. The viscoelastic properties of the individual components and the components assembled into the BDyn PDS device were determined using Dynamic Mechanical Analysis at frequencies from 0.01 to 30 Hz. Attenuated Total Reflectance Fourier Transform Infra-Red spectra demonstrated chemical structure changes, of the PCU, associated with oxidation while Scanning Electron Microscope images revealed surface pitting. No chemical structure or surface morphology changes were observed for the silicone cushion. The BDyn device storage and loss stiffness ranged between 84.46 N/mm to 99.36 N/mm and 8.13 N/mm to 21.99 N/mm, respectively. The storage and loss stiffness for the components and BDyn device increased logarithmically with respect to frequency. Viscoelastic properties, between normal and degraded components, were significantly different for specific frequencies only. This study demonstrates the importance of analyzing changes of viscoelastic properties of degraded biomaterials and medical devices into which they are incorporated, using a frequency sweep. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1237-1244, 2018.

Dynamic Viscoelasticity and Surface Properties of Porcine Left Anterior Descending Coronary Arteries

The aim of this study was, for the first time, to measure and compare quantitatively the viscoelastic properties and surface roughness of coronary arteries. Porcine left anterior descending coronary arteries were dissected ex vivo. Viscoelastic properties were measured longitudinally using dynamic mechanical analysis, for a range of frequencies from 0.5 to 10 Hz. Surface roughness was calculated following three-dimensional reconstructed of surface images obtained using an optical microscope. Storage modulus ranged from 14.47 to 25.82 MPa, and was found to be frequency-dependent, decreasing as the frequency increased. Storage was greater than the loss modulus, with the latter found to be frequency-independent with a mean value of 2.10 ± 0.33 MPa. The circumferential surface roughness was significantly greater (p < 0.05) than the longitudinal surface roughness, ranging from 0.73 to 2.83 and 0.35 to 0.92 µm, respectively. However, if surface roughness values were corrected for shrinkage during processing, circumferential and longitudinal surface roughness were not significantly different (1.04 ± 0.47, 0.89 ± 0.27 µm, respectively; p > 0.05). No correlation was found between the viscoelastic properties and surface roughness. It is feasible to quantitatively measure the viscoelastic properties of coronary arteries and the roughness of their endothelial surface.