1
|
Colbrunn RW, Loss JG, Gillespie CM, Pace EB, Nagle TF. Methodology for Robotic In Vitro Testing of the Knee. J Knee Surg 2024. [PMID: 38513696 DOI: 10.1055/a-2292-1157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
The knee joint plays a pivotal role in mobility and stability during ambulatory and standing activities of daily living (ADL). Increased incidence of knee joint pathologies and resulting surgeries has led to a growing need to understand the kinematics and kinetics of the knee. In vivo, in silico, and in vitro testing domains provide researchers different avenues to explore the effects of surgical interactions on the knee. Recent hardware and software advancements have increased the flexibility of in vitro testing, opening further opportunities to answer clinical questions. This paper describes best practices for conducting in vitro knee biomechanical testing by providing guidelines for future research. Prior to beginning an in vitro knee study, the clinical question must be identified by the research and clinical teams to determine if in vitro testing is necessary to answer the question and serve as the gold standard for problem resolution. After determining the clinical question, a series of questions (What surgical or experimental conditions should be varied to answer the clinical question, what measurements are needed for each surgical or experimental condition, what loading conditions will generate the desired measurements, and do the loading conditions require muscle actuation?) must be discussed to help dictate the type of hardware and software necessary to adequately answer the clinical question. Hardware (type of robot, load cell, actuators, fixtures, motion capture, ancillary sensors) and software (type of coordinate systems used for kinematics and kinetics, type of control) can then be acquired to create a testing system tailored to the desired testing conditions. Study design and verification steps should be decided upon prior to testing to maintain the accuracy of the collected data. Collected data should be reported with any supplementary metrics (RMS error, dynamic statistics) that help illuminate the reported results. An example study comparing two different anterior cruciate ligament reconstruction techniques is provided to demonstrate the application of these guidelines. Adoption of these guidelines may allow for better interlaboratory result comparison to improve clinical outcomes.
Collapse
|
2
|
Chen W, Zhou Q, Tang J. Material Properties of Fiber Bundles of the Superficial Medial Collateral Ligament of the Knee Joint. J Biomech Eng 2024; 146:031003. [PMID: 38217110 DOI: 10.1115/1.4064476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 12/27/2023] [Indexed: 01/15/2024]
Abstract
The superficial medial collateral ligament (sMCL) of the human knee joint has functionally separate anterior and posterior fiber bundles. The two bundles are alternatively loaded as the knee flexion angle changes during walking. To date, the two bundles are usually not distinguished in knee ligament simulations because there has been little information about their material properties. In this study, we conducted quasi-static tensile tests on the sMCL of matured porcine stifle joints and obtained the material properties of the anterior bundle (AB), posterior bundle (PB), and whole ligament (WL). AB and PB have similar failure stress but different threshold strain, modulus, and failure strain. As a result, we recommend assigning different material properties (i.e., modulus and failure strain) to the two fiber bundles to realize biofidelic ligament responses in human body models. However, it is often inconvenient to perform tensile tests on AB and PB. Hence, we proposed a microstructural model-based approach to predict the material properties of AB and PB from the test results of WL. Such obtained modulus values of AB and PB had an error of 2% and 0.3%, respectively, compared with those measured from the tests. This approach can reduce the experimental cost for acquiring the needed mechanical property data for simulations.
Collapse
Affiliation(s)
- Wentao Chen
- State Key Laboratory of Automotive Safety and Energy, School of Vehicle and Mobility, Tsinghua University, Beijing 100084, China
| | - Qing Zhou
- State Key Laboratory of Automotive Safety and Energy, School of Vehicle and Mobility, Tsinghua University, Beijing 100084, China
| | - Jisi Tang
- State Key Laboratory of Automotive Safety and Energy, School of Vehicle and Mobility, Tsinghua University, Beijing 100084, China
| |
Collapse
|
3
|
Orozco GA, Ristaniemi A, Haghighatnejad M, Mohammadi A, Finnilä MAJ, Saarakkala S, Herzog W, Isaksson H, Korhonen RK. Adaptation of Fibril-Reinforced Poroviscoelastic Properties in Rabbit Collateral Ligaments 8 Weeks After Anterior Cruciate Ligament Transection. Ann Biomed Eng 2023; 51:726-740. [PMID: 36129552 PMCID: PMC10023629 DOI: 10.1007/s10439-022-03081-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/07/2022] [Indexed: 11/30/2022]
Abstract
Ligaments of the knee provide stability and prevent excessive motions of the joint. Rupture of the anterior cruciate ligament (ACL), a common sports injury, results in an altered loading environment for other tissues in the joint, likely leading to their mechanical adaptation. In the collateral ligaments, the patterns and mechanisms of biomechanical adaptation following ACL transection (ACLT) remain unknown. We aimed to characterize the adaptation of elastic and viscoelastic properties of the lateral and medial collateral ligaments eight weeks after ACLT. Unilateral ACLT was performed in six rabbits, and collateral ligaments were harvested from transected and contralateral knee joints after eight weeks, and from an intact control group (eight knees from four animals). The cross-sectional areas were measured with micro-computed tomography. Stepwise tensile stress-relaxation testing was conducted up to 6% final strain, and the elastic and viscoelastic properties were characterized with a fibril-reinforced poroviscoelastic material model. We found that the cross-sectional area of the collateral ligaments in the ACL transected knees increased, the nonlinear elastic collagen network modulus of the LCL decreased, and the amount of fast relaxation in the MCL decreased. Our results indicate that rupture of the ACL leads to an early adaptation of the elastic and viscoelastic properties of the collagen fibrillar network in the collateral ligaments. These adaptations may be important to consider when evaluating whole knee joint mechanics after ACL rupture, and the results aid in understanding the consequences of ACL rupture on other tissues.
Collapse
Affiliation(s)
- Gustavo A Orozco
- Department of Applied Physics, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland.
- Department of Biomedical Engineering, Lund University, Box 188, 221 00, Lund, Sweden.
| | - Aapo Ristaniemi
- Department of Applied Physics, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland
- AO Research Institute Davos, Davos, Switzerland
| | - Mehrnoush Haghighatnejad
- Department of Applied Physics, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland
| | - Ali Mohammadi
- Department of Applied Physics, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland
| | - Mikko A J Finnilä
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Walter Herzog
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Hanna Isaksson
- Department of Biomedical Engineering, Lund University, Box 188, 221 00, Lund, Sweden
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland
| |
Collapse
|
4
|
He S, Azar DA, Esfahani FN, Azar GA, Shazly T, Saeidi N. Mechanoscopy: A Novel Device and Procedure for in vivo Detection of Chronic Colitis in Mice. Inflamm Bowel Dis 2022; 28:1143-1150. [PMID: 35325126 PMCID: PMC9340527 DOI: 10.1093/ibd/izac046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND Gut stiffening caused by fibrosis plays a critical role in the progression of inflammatory bowel disease (IBD) and colon cancer. Previous studies have characterized the biomechanical response of healthy and pathological gut, with most measurements obtained ex vivo. METHODS Here, we developed a device and accompanying procedure for in vivo quantification of gut stiffness, termed mechanoscopy. Mechanoscopy includes a flexible balloon catheter, pressure sensor, syringe pump, and control system. The control system activates the balloon catheter and performs automated measurements of the gut stress-strain biomechanical response. RESULTS A gut stiffness index (GSI) is identified based on the slope of the obtained stress-strain response. Using a colitis mouse model, we demonstrated that GSI positively correlates with the extent of gut fibrosis, the severity of mucosal damage, and the infiltration of immune cells. Furthermore, a critical strain value is suggested, and GSI efficiently detects pathological gut fibrotic stiffening when the strain exceeds this value. CONCLUSIONS Based on these results, we envision that mechanoscopy and GSI will facilitate the clinical diagnosis of IBD.
Collapse
Affiliation(s)
| | | | - Farid Nasr Esfahani
- Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
- Shriners Hospital for Children, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Golara A Azar
- Department of Electrical Engineering and Computer Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Tarek Shazly
- Department of Mechanical Engineering, University of South Carolina, Columbia, SC, USA
| | - Nima Saeidi
- Address correspondence to: Nima Saeidi, 51 Blossom St., Room 207, Boston, MA, 02114, USA ()
| |
Collapse
|
5
|
A regeneration process-matching scaffold with appropriate dynamic mechanical properties and spatial adaptability for ligament reconstruction. Bioact Mater 2022; 13:82-95. [PMID: 35224293 PMCID: PMC8844703 DOI: 10.1016/j.bioactmat.2021.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 12/12/2022] Open
Abstract
Ligament regeneration is a complicated process that requires dynamic mechanical properties and allowable space to regulate collagen remodeling. Poor strength and limited space of currently available grafts hinder tissue regeneration, yielding a disappointing success rate in ligament reconstruction. Matching the scaffold retreat rate with the mechanical and spatial properties of the regeneration process remains challenging. Herein, a scaffold matching the regeneration process was designed via regulating the trajectories of fibers with different degradation rates to provide dynamic mechanical properties and spatial adaptability for collagen infiltration. This core-shell structured scaffold exhibited biomimetic fiber orientation, having tri-phasic mechanical behavior and excellent strength. Besides, by the sequential material degradation, the available space of the scaffold increased from day 6 and remained stable on day 24, consistent with the proliferation and deposition phase of the native ligament regeneration process. Furthermore, mature collagen infiltration and increased bone integration in vivo confirmed the promotion of tissue regeneration by the adaptive space, maintaining an excellent failure load of 67.65% of the native ligament at 16 weeks. This study proved the synergistic effects of dynamic strength and adaptive space. The scaffold matching the regeneration process is expected to open new approaches in ligament reconstruction. Regeneration process-matching scaffold was made via regulating fiber trajectory. The scaffold showed tri-phasic mechanical behavior and fatigue properties. Matching repair process with dynamic mechanical property and spatial adaptability. A feasible substitute for the T/L reconstruction by spatial adaptability.
Collapse
|
6
|
Chen W, Zhou Q. Opposite Effect of Cyclic Loading on the Material Properties of Medial Collateral Ligament at Different Temperatures: An Animal Study. Front Bioeng Biotechnol 2022; 10:925033. [PMID: 35774057 PMCID: PMC9237215 DOI: 10.3389/fbioe.2022.925033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
In traffic accidents, the medial collateral ligament (MCL) injury of the knee joint of pedestrians is common. Biofidelic material is important to realize MCL's native biomechanics in simulations to clarify the injury mechanisms of pedestrians. Pedestrians' MCLs usually experience cyclic loading at the intra-articular temperature of the knee joint before accidents. Temperature influences the material behaviors of ligaments. However, the mechanical properties of ligaments under cyclic loading have been widely evaluated only at room temperature rather than physiological temperature. Therefore, this study aimed to determine whether the difference between room and intra-articular temperatures influences the effect of cyclic loading on the mechanical properties of MCL. We measured the tensile properties of 34 porcine MCLs at room temperature (21-23°C) and intra-articular temperature (35-37°C), with either 10 cycles or 240 cycles of cyclic loading, a total of four different conditions. The structural responses and geometric data were recorded. After 240 cycles of cyclic loading, stiffness increased by 29.0% (p < 0.01) at room temperature and decreased by 11.5% (p = 0.106) at intra-articular temperature. Material properties were further compared because the geometric differences between samples were inevitable. At room temperature, after 240 cycles of cyclic loading, elastic modulus increased by 29.6% (p < 0.001), and failure strain decreased by 20.4% (p < 0.05). By contrast, at intra-articular temperature, after 240 cycles of cyclic loading, modulus decreased by 27.4% (p < 0.001), and failure strain increased by 17.5% (p = 0.193), insignificant though. In addition, there were no significant differences between the four groups in other structural or material properties. The results showed that temperature reversed the effect of cyclic loading on the mechanical properties of MCL, which may be caused by the high strength and thermally stable crosslinks of MCL. Therefore, for improving the fidelity of knee joint simulations and elucidating the injury mechanism of pedestrians, it is better to measure the mechanical properties of MCL at intra-articular temperature rather than room temperature.
Collapse
Affiliation(s)
| | - Qing Zhou
- State Key Laboratory of Automotive Safety and Energy, School of Vehicle and Mobility, Tsinghua University, Beijing, China
| |
Collapse
|
7
|
Mayr R, Sigloch M, Coppola C, Hoermann R, Iltchev A, Schmoelz W. Modified Lemaire tenodesis reduces anterior cruciate ligament graft forces during internal tibial torque loading. J Exp Orthop 2022; 9:45. [PMID: 35583714 PMCID: PMC9117580 DOI: 10.1186/s40634-022-00484-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The aim of the study was to directly measure graft forces of an anterior cruciate ligament reconstruction (ACLR) and a lateral extra-articular tenodesis (LET) using the modified Lemaire technique in combined anterior cruciate ligament (ACL) deficient and anterolateral rotatory instable knees and to analyse the changes in knee joint motion resulting from combined ACLR + LET. METHODS On a knee joint test bench, six fresh-frozen cadaveric specimens were tested at 0°, 30°, 60°, and 90° of knee flexion in the following states: 1) intact; 2) with resected ACL; 3) with resected ACL combined with anterolateral rotatory instability; 4) with an isolated ACLR; and 5) with combined ACLR + LET. The specimens were examined under various external loads: 1) unloaded; 2) with an anterior tibial translation force (ATF) of 98 N; 3) with an internal tibial torque (IT) of 5 Nm; and 4) with a combined internal tibial torque of 5 Nm and an anterior tibial translation force of 98 N (IT + ATF). The graft forces of the ACLR and LET were recorded by load cells incorporated into custom devices, which were screwed into the femoral tunnels. Motion of the knee joint was analysed using a 3D camera system. RESULTS During IT and IT + ATF, the addition of a LET reduced the ACLR graft forces up to 61% between 0° and 60° of flexion (P = 0.028). During IT + ATF, the LET graft forces reached 112 N. ACLR alone did not restore native internal tibial rotation after combined ACL deficiency and anterolateral rotatory instability. Combined ACLR + LET was able to restore native internal tibial rotation values for 0°, 60° and 90° of knee flexion with decreased internal tibial rotation at 30° of flexion. CONCLUSION The study demonstrates that the addition of a LET decreases the forces seen by the ACLR graft and reduces residual rotational laxity after isolated ACLR during internal tibial torque loading. Due to load sharing, a LET could support the ACLR graft and perhaps be the reason for reduced repeat rupture rates seen in clinical studies. Care must be taken not to limit the internal tibial rotation when performing a LET.
Collapse
Affiliation(s)
- Raul Mayr
- Department for Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Maximilian Sigloch
- Department for Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Christian Coppola
- Department for Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Romed Hoermann
- Institute for Clinical and Functional Anatomy, Medical University of Innsbruck, Innsbruck, Austria
| | - Alessandra Iltchev
- Department for Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Werner Schmoelz
- Department for Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
| |
Collapse
|
8
|
Ristaniemi A, Torniainen J, Paakkonen T, Stenroth L, Finnilä MA, Tanska P, Töyräs J, Korhonen RK. Biomechanical, biochemical, and near infrared spectral data of bovine knee ligaments and patellar tendon. Data Brief 2021; 36:106976. [PMID: 33869696 PMCID: PMC8042288 DOI: 10.1016/j.dib.2021.106976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/03/2021] [Accepted: 03/15/2021] [Indexed: 11/24/2022] Open
Abstract
Knee joint ligaments and patellar tendon are rope-like tissues that enable the proper function of the knee by connecting the bones that form the joint. A better understanding of ligament structure-function relationships is needed to develop objective and reliable diagnostic methods for ligaments. Recently, arthroscopic near infrared spectroscopy (NIR) has shown the potential to quantitatively evaluate the health of the cartilages and menisci of the knee. In this dataset, we present a unique combination of NIR spectral data, biomechanical properties, and biochemical composition of bovine primary knee ligaments and patellar tendon (10 knees, 50 tissue samples). NIR spectral data were measured at 5 locations in each sample, biomechanical properties were obtained with tensile testing, and biochemical composition was quantified using colorimetric biochemical methods. The data can be reused for investigations of structure-function relationships of knee ligaments and patellar tendon, for the development of NIR spectroscopic methods to quantify the health of these tissues, and to develop new computational models to describe ligament and tendon biomechanics.
Collapse
Affiliation(s)
- Aapo Ristaniemi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Jari Torniainen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Tommi Paakkonen
- School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Lauri Stenroth
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Mikko A.J. Finnilä
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Petri Tanska
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
| | - Rami K. Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| |
Collapse
|
9
|
Ristaniemi A, Regmi D, Mondal D, Torniainen J, Tanska P, Stenroth L, Finnilä MAJ, Töyräs J, Korhonen RK. Structure, composition and fibril-reinforced poroviscoelastic properties of bovine knee ligaments and patellar tendon. J R Soc Interface 2021; 18:20200737. [PMID: 33499766 DOI: 10.1098/rsif.2020.0737] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Tissue-level stress-relaxation of ligaments and tendons in the toe region is characterized by fast and long-term relaxations and an increase in relaxation magnitude with strain. Characterizing the compositional and structural origins of these phenomena helps in the understanding of mechanisms of ligament and tendon function and adaptation in health and disease. A three-step tensile stress-relaxation test was conducted on dumbbell-shaped pieces of bovine knee ligaments and patellar tendon (PT) (n = 10 knees). Their mechanical behaviour was characterized by a fibril-reinforced poroviscoelastic material model, able to describe characteristic times and magnitudes of fast and long-term relaxations. The crimp angle and length of tissues were measured with polarized light microscopy, while biochemical contents were determined by colorimetric biochemical methods. The long-term relaxation time was longer in the anterior cruciate ligament (ACL) and PT compared with collateral ligaments (p < 0.05). High hydroxyproline content predicted greater magnitude and shorter time of both fast and long-term relaxation. High uronic acid content predicted longer time of long-term relaxation, whereas high crimp angle predicted higher magnitude of long-term relaxation. ACL and PT are better long-term stabilizers than collateral ligaments. The long-term relaxation behaviour is affected or implied by proteoglycans and crimp angle, possibly relating to slow structural reorganization of the tissue.
Collapse
Affiliation(s)
- Aapo Ristaniemi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Dristi Regmi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Diponkor Mondal
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Jari Torniainen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Petri Tanska
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Lauri Stenroth
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Mikko A J Finnilä
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.,School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| |
Collapse
|
10
|
Readioff R, Geraghty B, Elsheikh A, Comerford E. Viscoelastic characteristics of the canine cranial cruciate ligament complex at slow strain rates. PeerJ 2020; 8:e10635. [PMID: 33391887 PMCID: PMC7761198 DOI: 10.7717/peerj.10635] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/02/2020] [Indexed: 11/20/2022] Open
Abstract
Ligaments including the cruciate ligaments support and transfer loads between bones applied to the knee joint organ. The functions of these ligaments can get compromised due to changes to their viscoelastic material properties. Currently there are discrepancies in the literature on the viscoelastic characteristics of knee ligaments which are thought to be due to tissue variability and different testing protocols. The aim of this study was to characterise the viscoelastic properties of healthy cranial cruciate ligaments (CCLs), from the canine knee (stifle) joint, with a focus on the toe region of the stress-strain properties where any alterations in the extracellular matrix which would affect viscoelastic properties would be seen. Six paired CCLs, from skeletally mature and disease-free Staffordshire bull terrier stifle joints were retrieved as a femur-CCL-tibia complex and mechanically tested under uniaxial cyclic loading up to 10 N at three strain rates, namely 0.1%, 1% and 10%/min, to assess the viscoelastic property of strain rate dependency. The effect of strain history was also investigated by subjecting contralateral CCLs to an ascending (0.1%, 1% and 10%/min) or descending (10%, 1% and 0.1%/min) strain rate protocol. The differences between strain rates were not statistically significant. However, hysteresis and recovery of ligament lengths showed some dependency on strain rate. Only hysteresis was affected by the test protocol and lower strain rates resulted in higher hysteresis and lower recovery. These findings could be explained by the slow process of uncrimping of collagen fibres and the contribution of proteoglycans in the ligament extracellular matrix to intra-fibrillar gliding, which results in more tissue elongations and higher energy dissipation. This study further expands our understanding of canine CCL behaviour, providing data for material models of femur-CCL-tibia complexes, and demonstrating the challenges for engineering complex biomaterials such as knee joint ligaments.
Collapse
Affiliation(s)
- Rosti Readioff
- School of Engineering, University of Liverpool, Liverpool, UK
| | - Brendan Geraghty
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Ahmed Elsheikh
- School of Engineering, University of Liverpool, Liverpool, UK.,Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China.,UCL Institute of Ophthalmology, NIHR Moorfields BRC, London, UK
| | - Eithne Comerford
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.,School of Veterinary Science, University of Liverpool, Neston, UK
| |
Collapse
|
11
|
Ristaniemi A, Tanska P, Stenroth L, Finnilä MAJ, Korhonen RK. Comparison of material models for anterior cruciate ligament in tension: from poroelastic to a novel fibril-reinforced nonlinear composite model. J Biomech 2020; 114:110141. [PMID: 33302181 DOI: 10.1016/j.jbiomech.2020.110141] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 11/05/2020] [Accepted: 11/12/2020] [Indexed: 12/15/2022]
Abstract
Computational models of the knee joint are useful for evaluating stresses and strains within the joint tissues. However, the outcome of those models is sensitive to the material model and material properties chosen for ligaments, the collagen reinforced tissues connecting bone to bone. The purpose of this study was to investigate different compositionally motivated material models and further to develop a model that can accurately reproduce experimentally measured stress-relaxation data of bovine anterior cruciate ligament (ACL). Tensile testing samples were extracted from ACLs of bovine knee joints (N = 10) and subjected to a three-step stress-relaxation test at the toe region. Data from the experiments was averaged and one average finite element model was generated to replicate the experiment. Poroelastic and different fibril-reinforced poro(visco)elastic material models were applied, and their material parameters were optimized to reproduce the experimental force-time response. Material models with only fluid flow mediated relaxation were not able to capture the stress-relaxation behavior (R2 = 0.806, 0.803 and 0.938). The inclusion of the viscoelasticity of the fibrillar network improved the model prediction (R2 = 0.978 and 0.976), but the complex stress-relaxation behavior was best captured by a poroelastic model with a nonlinear two-relaxation-time strain-recruited viscoelastic fibrillar network (R2 = 0.997). The results suggest that in order to replicate the multi-step stress-relaxation behavior of ACL in tension, the fibrillar network formulation should include the complex nonlinear viscoelastic phenomena.
Collapse
Affiliation(s)
- A Ristaniemi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
| | - P Tanska
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - L Stenroth
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - M A J Finnilä
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - R K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| |
Collapse
|
12
|
Kafian-Attari I, Nippolainen E, Semenov D, Hauta-Kasari M, Töyräs J, Afara IO. Tissue optical properties combined with machine learning enables estimation of articular cartilage composition and functional integrity. BIOMEDICAL OPTICS EXPRESS 2020; 11:6480-6494. [PMID: 33282503 PMCID: PMC7687936 DOI: 10.1364/boe.402929] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 05/06/2023]
Abstract
Absorption and reduced scattering coefficients ( μ a , μ s ' ) of biological tissues have shown significant potential in biomedical applications. Thus, they are effective parameters for the characterization of tissue integrity and provide vital information on the health of biological tissues. This study investigates the potential of optical properties ( μ a , μ s ' ) for estimating articular cartilage composition and biomechanical properties using multivariate and machine learning techniques. The results suggest that μa could optimally estimate cartilage proteoglycan content in the superficial zone, in addition to its equilibrium modulus. While μ s ' could effectively estimate the proteoglycan content of the middle and deep zones in addition to the instantaneous and dynamic moduli of articular cartilage.
Collapse
Affiliation(s)
- Iman Kafian-Attari
- University of Eastern Finland, Department of Applied Physics, Yliopistonranta 1, Kuopio 70120, Finland
| | - Ervin Nippolainen
- University of Eastern Finland, Department of Applied Physics, Yliopistonranta 1, Kuopio 70120, Finland
| | - Dmitry Semenov
- University of Eastern Finland, School of Computing, Lämsikatu 15, Joensuu 80110, Finland
| | - Markku Hauta-Kasari
- University of Eastern Finland, School of Computing, Lämsikatu 15, Joensuu 80110, Finland
| | - Juha Töyräs
- University of Eastern Finland, Department of Applied Physics, Yliopistonranta 1, Kuopio 70120, Finland
- The University of Queensland, School of Information Technology, and Electrical Engineering, Brisbane, QLD 4067, Australia
| | - Isaac O. Afara
- University of Eastern Finland, Department of Applied Physics, Yliopistonranta 1, Kuopio 70120, Finland
| |
Collapse
|
13
|
Liu T, Shen M, Li H, Zhang Y, Mu B, Zhao X, Wang Y. Changes and quantitative characterization of hyper-viscoelastic biomechanical properties for young corneal stroma after standard corneal cross-linking treatment with different ultraviolet-A energies. Acta Biomater 2020; 113:438-451. [PMID: 32525050 DOI: 10.1016/j.actbio.2020.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/30/2020] [Accepted: 06/02/2020] [Indexed: 12/27/2022]
Abstract
Corneal collagen cross-linking (CXL) treatment can restore vision in patients suffering from keratoconus and corneal injury, by improving the mechanical properties of the cornea. The correlation between ultraviolet-A (UVA) irradiant energies of standard CXL (SCXL) and corneal visco-hyperelastic mechanical behavior remains unknown. In this study, SCXL with four different UVA irradiant energy doses (0-5.4 J/cm2) were administered as part of quantitative treatments of corneal stromal lenticules extracted from young myopic patients via small incision lenticule extraction (SMILE) corneal refractive surgery. Double-strip samples with symmetric geometries were cut simultaneously for SCXL treatment and non-treated control. First, 40 pairs of strips were loaded to failure to assess the mechanical parameters of the material. Then, another 40 pairs were tested using a special uniaxial tensile test including quasi-static loading-unloading, instantaneous loading, and stress relaxation, to determine the visco-hyperelastic mechanical behavior. Upon combining the collagen fibril crimping constitutive model with the quasi-linear viscoelastic model, it was observed that with increasing UVA energy dose, the corneal strength and hyperelastic stiffness were significantly enhanced, while the maximum stretch and viscosity of the cornea were significantly reduced. Considering the quantitative analysis of SCXL and the rehabilitation prediction of keratoconus treatment, the results clarify the biomechanical behavior of human corneal stroma in SCXL clinical surgery. STATEMENT OF SIGNIFICANCE: This study quantitatively analyzes the improvement in the biomechanical properties of young central corneal stroma, due to SCXL treatment with different energies. Furthermore, the correlation between the hyper-viscoelastic mechanical parameters and UVA irradiant energy doses of SCXL are clarified. The contribution of this study fills the knowledge gap of the CXL on corneal biomechanics. It can not only clarify this mechanism better but also assist with guiding SCXL surgery for individualized patient corneas.
Collapse
Affiliation(s)
- Taiwei Liu
- Department of Mechanics, School of Mechanical Engineering, Tianjin University, Tianjin 300350 China; Department of Engineering Mechanics, School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Min Shen
- Department of Mechanics, School of Mechanical Engineering, Tianjin University, Tianjin 300350 China.
| | - Hongxun Li
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020 China; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300070 China
| | - Yan Zhang
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020 China; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300070 China
| | - Bokun Mu
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020 China; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300070 China
| | - Xinheng Zhao
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020 China; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300070 China
| | - Yan Wang
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020 China; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300070 China
| |
Collapse
|
14
|
A comprehensive testing protocol for macro-scale mechanical characterization of knee articular cartilage with documented experimental repeatability. J Mech Behav Biomed Mater 2020; 112:104025. [PMID: 32841833 DOI: 10.1016/j.jmbbm.2020.104025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 06/14/2020] [Accepted: 08/01/2020] [Indexed: 01/10/2023]
Abstract
Articular cartilage mechanics has been extensively studied with various approaches and mechanical characterization strategies. However testing protocols can be highly varying and difficult to reproduce, particularly for specimen-specific analyses. Detailed knowledge of testing protocols is important for reliable use in concordant finite element analyses. This study presents a detailed, robust procedure for cartilage testing-with multiple regions and per sample repeatability data. Samples were taken from femur, tibia and patella of a human cadaver knee and tested in unconfined compression, confined compression and uniaxial tension. Each test was repeated three times. The testing protocols provide elastic and time dependent characterization data. Results, for example equilibrium modulus of 0.28 (0.0024) MPa for patella under unconfined compression indicate that variability is well controlled and that protocol(s) presented here can generate repeatable specimen-specific data. As per the authors' knowledge this is the first study to report in-depth uncertainty assessment of the experimental procedures for multi-region knee cartilage characterization.
Collapse
|
15
|
Ristaniemi A, Torniainen J, Stenroth L, Finnilä M, Paakkonen T, Töyräs J, Korhonen R. Comparison of water, hydroxyproline, uronic acid and elastin contents of bovine knee ligaments and patellar tendon and their relationships with biomechanical properties. J Mech Behav Biomed Mater 2020; 104:103639. [DOI: 10.1016/j.jmbbm.2020.103639] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 01/13/2020] [Accepted: 01/13/2020] [Indexed: 12/13/2022]
|
16
|
Characterization of hyperelastic mechanical properties for youth corneal anterior central stroma based on collagen fibril crimping constitutive model. J Mech Behav Biomed Mater 2020; 103:103575. [DOI: 10.1016/j.jmbbm.2019.103575] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 11/03/2019] [Accepted: 11/29/2019] [Indexed: 11/19/2022]
|