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Yang XG, Peng Z, Liu X, Liu XL, Lu S. A narrative review of the measurement methods for biomechanical properties of plantar soft tissue in patients with diabetic foot. Front Endocrinol (Lausanne) 2024; 15:1332032. [PMID: 39135623 PMCID: PMC11317276 DOI: 10.3389/fendo.2024.1332032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 07/08/2024] [Indexed: 08/15/2024] Open
Abstract
This article provides an overview of the development history and advantages and disadvantages of measurement methods for soft tissue properties of the plantar foot. The measurement of soft tissue properties is essential for understanding the biomechanical characteristics and function of the foot, as well as for designing and evaluating orthotic devices and footwear. Various methods have been developed to measure the properties of plantar soft tissues, including ultrasound imaging, indentation testing, magnetic resonance elastography, and shear wave elastography. Each method has its own strengths and limitations, and choosing the most appropriate method depends on the specific research or clinical objectives. This review aims to assist researchers and clinicians in selecting the most suitable measurement method for their specific needs.
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Affiliation(s)
- Xiong-gang Yang
- Department of Orthopedics, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
- The Key Laboratory of Digital Orthopedics of Yunnan Province, Kunming, Yunnan, China
| | - Zhi Peng
- Department of Orthopedics, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Xiang Liu
- Department of Orthopedics, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Xiao-liang Liu
- Department of Orthopedics, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Sheng Lu
- Department of Orthopedics, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
- The Key Laboratory of Digital Orthopedics of Yunnan Province, Kunming, Yunnan, China
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Bose S, Akbarzadeh Khorshidi M, Johnston RD, Watschke B, Mareena E, Lally C. Experimental testing combined with inverse-FE for mechanical characterisation of penile tissues. Acta Biomater 2024; 179:180-191. [PMID: 38494081 DOI: 10.1016/j.actbio.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/29/2024] [Accepted: 03/11/2024] [Indexed: 03/19/2024]
Abstract
Erectile dysfunction (ED) predominantly affects men in their 40-70s and can lead to poor quality of life. One option for ED treatment is surgical implantation of an inflatable penile prosthesis (IPP). However, they can be associated with negative outcomes including infection, migration or fibrosis. To improve outcomes, the interaction between the IPP device and surrounding tissues needs further investigation and this could be achieved using pre-clinical testbeds, but they need to be informed by extensive tissue testing. In this study, an experimental approach is adopted to characterise the mechanics of horse penile tissue and establish a testing protocol for penile tissue. The whole penis segments were tested in plate compression tests to obtain whole penis behaviour which is necessary for validation of a pre-clinical testbed, whilst tensile and compression tests were performed on individual penile tissues, namely corpus cavernosa and tunica albuginea. The second part of the paper deals with the development of a computational model employing an inverse finite element approach to estimate the material parameters of each tissue layer. These material parameters are in good agreement with the experimental results obtained from the individual tissue layers and whole organ tissue tests. This paper presents the first study proposing realistic nonlinear elastic material parameters for penile tissues and offers a validated testbed for IPPs. STATEMENT OF SIGNIFICANCE: Erectile Dysfunction (ED) affects over half the male population aged 40-70 potentially leading to poor quality of life. Patients not responding to conventional treatments of ED, are advised to use penile prostheses which can create an erection using implanted inflatable cylinders. A significant drawback of such prostheses, however, is the substantial tissue damage they can induce during their usage. Preclinical testbeds, including computational and bench-top models, could offer an efficient means of improving device designs to mitigate this damage but such testbeds require extensive knowledge of penile tissue properties. In this study, the authors determine penile tissue mechanics and apply an inverse FE approach to characterise the penile material properties required to validate preclinical models of the penis.
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Affiliation(s)
- Shirsha Bose
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland; Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin 2, Ireland; Advanced Materials and BioEngineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin 2, Ireland
| | - Majid Akbarzadeh Khorshidi
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland; Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin 2, Ireland; Advanced Materials and BioEngineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin 2, Ireland
| | - Robert D Johnston
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland; Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin 2, Ireland; Advanced Materials and BioEngineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin 2, Ireland
| | - Brian Watschke
- Urology, Boston Scientific Corp, Inc, Minnetonka, MN, USA
| | - Evania Mareena
- Urology, Boston Scientific Corp, Inc, Clonmel Co, Tipperary, Ireland
| | - Caitríona Lally
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland; Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin 2, Ireland; Advanced Materials and BioEngineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin 2, Ireland.
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Biomechanics of Hollow Organs: Experimental Testing and Computational Modeling. Bioengineering (Basel) 2023; 10:bioengineering10020175. [PMID: 36829669 PMCID: PMC9952441 DOI: 10.3390/bioengineering10020175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
Hollow organs are visceral organs that are hollow tubes or pouches (such as the intestine or the stomach, respectively) or that include a cavity (such as the heart) and which subserve a vital function [...].
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Yang Y, Yung KL, Hung TWR, Yu KM. Analyzing Liver Surface Indentation for In Vivo Refinement of Tumor Location in Minimally Invasive Surgery. Ann Biomed Eng 2021; 49:1402-1415. [PMID: 33258091 PMCID: PMC8058013 DOI: 10.1007/s10439-020-02698-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 11/18/2020] [Indexed: 10/27/2022]
Abstract
Manual palpation to update the position of subsurface tumor(s) is a normal practice in open surgery, but is not possible through the small incisions of minimally invasive surgery (MIS). This paper proposes a method that has the potential to use a simple constant-force indenter and the existing laparoscopic camera for tumor location refinement in MIS. The indenter floats with organ movement to generate a static surface deformation on the soft tissue, resolving problems of previous studies that require complicated measurement of force and displacement during indentation. By analyzing the deformation profile, we can intraoperatively update the tumor's location in real-time. Indentation experiments were conducted on healthy and "diseased" porcine liver specimens to obtain the deformation surrounding the indenter site. An inverse finite element (FE) algorithm was developed to determine the optimal material parameters of the healthy liver tissue. With these parameters, a computational model of tumorous tissue was constructed to quantitatively evaluate the effects of the tumor location on the induced deformation. By relating the experimental data from the "diseased" liver specimen to the computational results, we estimated the radial distance between the tumor and the indenter, as well as the angular position of the tumor relative to the indenter.
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Affiliation(s)
- Yingqiao Yang
- Department of Industrial and Systems Engineering, The Hong Kong Polytechnic University, R606, 1 Yuk Road, Hung Hom, Kowloon, Hong Kong.
| | - Kai-Leung Yung
- Department of Industrial and Systems Engineering, The Hong Kong Polytechnic University, R606, 1 Yuk Road, Hung Hom, Kowloon, Hong Kong
| | - Tin Wai Robert Hung
- Department of Industrial and Systems Engineering, The Hong Kong Polytechnic University, R606, 1 Yuk Road, Hung Hom, Kowloon, Hong Kong
| | - Kai-Ming Yu
- Department of Industrial and Systems Engineering, The Hong Kong Polytechnic University, R606, 1 Yuk Road, Hung Hom, Kowloon, Hong Kong
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Malečková A, Kochová P, Pálek R, Liška V, Mik P, Bońkowski T, Horák M, Tonar Z. Blunt injury of liver: mechanical response of porcine liver in experimental impact test. Physiol Meas 2021; 42:025008. [PMID: 33482651 DOI: 10.1088/1361-6579/abdf3c] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The liver is frequently injured in blunt abdominal trauma caused by road traffic accidents. The testing of safety performance of vehicles, e.g. belt usage, head support, seat shape, or air bag shape, material, pressure and reaction, could lead to reduction of the injury seriousness. Current trends in safety testing include development of accurate computational human body models (HBMs) based on the anatomical, morphological, and mechanical behavior of tissues under high strain. APPROACH The aim of this study was to describe the internal pressure changes within porcine liver, the severity of liver injury and the relation between the porcine liver microstructure and rupture propagation in an experimental impact test. Porcine liver specimens (n = 24) were uniformly compressed using a drop tower technique and four impact heights (200, 300, 400 and 500 mm; corresponding velocities: 1.72, 2.17, 2.54 and 2.88 m s-1). The changes in intravascular pressure were measured via catheters placed in portal vein and caudate vena cava. The induced injuries were analyzed on the macroscopic level according to AAST grade and AIS severity. Rupture propagation with respect to liver microstructure was analyzed using stereological methods. MAIN RESULTS Macroscopic ruptures affected mostly the interface between connective tissue surrounding big vessels and liver parenchyma. Histological analysis revealed that the ruptures avoided reticular fibers and interlobular septa made of connective tissue on the microscopic level. SIGNIFICANCE The present findings can be used for evaluation of HBMs of liver behavior in impact situations.
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Affiliation(s)
- Anna Malečková
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Petra Kochová
- European Centre of Excellence NTIS, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic
| | - Richard Pálek
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Department of Surgery, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic
| | - Václav Liška
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Department of Surgery, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic
| | - Patrik Mik
- Department of Anatomy, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Tomasz Bońkowski
- New Technologies-Research Centre, University of West Bohemia, Pilsen, Czech Republic
| | - Miroslav Horák
- Department of Mechanics, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic
| | - Zbyněk Tonar
- European Centre of Excellence NTIS, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic
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Huan Y, Tamadon I, Scatena C, Cela V, Naccarato AG, Menciassi A, Sinibaldi E. Soft Graspers for Safe and Effective Tissue Clutching in Minimally Invasive Surgery. IEEE Trans Biomed Eng 2021; 68:56-67. [DOI: 10.1109/tbme.2020.2996965] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Yang Y, Li K, Sommer G, Yung KL, Holzapfel GA. Mechanical characterization of porcine liver properties for computational simulation of indentation on cancerous tissue. MATHEMATICAL MEDICINE AND BIOLOGY-A JOURNAL OF THE IMA 2020; 37:469-490. [PMID: 32424396 DOI: 10.1093/imammb/dqaa006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 11/13/2022]
Abstract
An accurate characterization of soft biological tissue properties is essential for a realistic simulation of surgical procedures. Unconfined uniaxial compression tests with specimens affixed to the fixtures are often performed to characterize the stress-stretch curves of soft biological tissues, with which the material parameters can be obtained. However, the constrained boundary condition causes non-uniform deformation during the uniaxial test, posing challenges for accurate measurement of tissue deformation. In this study, we measured the deformation locally at the middle of liver specimens and obtained the corresponding stress-stretch curves. Since the effect of the constrained boundary condition on the local deformation of specimen is minimized, the stress-stretch curves are thus more realistic. Subsequently, we fitted the experimental stress-stretch curves with several constitutive models and found that the first-order Ogden hyperelastic material model was most suitable for characterizing the mechanical properties of porcine liver tissues. To further verify the characterized material properties, we carried out indentation tests on porcine liver specimens and compared the experimental data with computational results by using finite element simulations. A good agreement was achieved. Finally, we constructed computational models of liver tissue with a tumor and investigated the effect of the tumor on the mechanical response of the tissue under indentation. The computational results revealed that the liver specimen with tumor shows a stiffer response if the distance between the tumor and the indenter is small.
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Affiliation(s)
- Yingqiao Yang
- Department of Industrial and Systems Engineering, The Hong Kong Polytechnic University, 1 Yuk Road, Hung Hom, Kowloon, Hong Kong
| | - Kewei Li
- Institute of Biomechanics, Graz University of Technology, Stremayrgasse 16-II, 8010 Graz, Austria
| | - Gerhard Sommer
- Institute of Biomechanics, Graz University of Technology, Stremayrgasse 16-II, 8010 Graz, Austria
| | - Kai-Leung Yung
- Department of Industrial and Systems Engineering, The Hong Kong Polytechnic University, 1 Yuk Road, Hung Hom, Kowloon, Hong Kong
| | - Gerhard A Holzapfel
- Institute of Biomechanics, Graz University of Technology, Stremayrgasse 16-II, 8010 Graz, Austria and Department of Structural Engineering, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
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Liver Bioreactor Design Issues of Fluid Flow and Zonation, Fibrosis, and Mechanics: A Computational Perspective. J Funct Biomater 2020; 11:jfb11010013. [PMID: 32121053 PMCID: PMC7151609 DOI: 10.3390/jfb11010013] [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: 12/02/2019] [Revised: 01/27/2020] [Accepted: 02/18/2020] [Indexed: 02/06/2023] Open
Abstract
Tissue engineering, with the goal of repairing or replacing damaged tissue and organs, has continued to make dramatic science-based advances since its origins in the late 1980’s and early 1990’s. Such advances are always multi-disciplinary in nature, from basic biology and chemistry through physics and mathematics to various engineering and computer fields. This review will focus its attention on two topics critical for tissue engineering liver development: (a) fluid flow, zonation, and drug screening, and (b) biomechanics, tissue stiffness, and fibrosis, all within the context of 3D structures. First, a general overview of various bioreactor designs developed to investigate fluid transport and tissue biomechanics is given. This includes a mention of computational fluid dynamic methods used to optimize and validate these designs. Thereafter, the perspective provided by computer simulations of flow, reactive transport, and biomechanics responses at the scale of the liver lobule and liver tissue is outlined, in addition to how bioreactor-measured properties can be utilized in these models. Here, the fundamental issues of tortuosity and upscaling are highlighted, as well as the role of disease and fibrosis in these issues. Some idealized simulations of the effects of fibrosis on lobule drug transport and mechanics responses are provided to further illustrate these concepts. This review concludes with an outline of some practical applications of tissue engineering advances and how efficient computational upscaling techniques, such as dual continuum modeling, might be used to quantify the transition of bioreactor results to the full liver scale.
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Mechanical Response of Porcine Liver Tissue under High Strain Rate Compression. Bioengineering (Basel) 2019; 6:bioengineering6020049. [PMID: 31151177 PMCID: PMC6630843 DOI: 10.3390/bioengineering6020049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/20/2019] [Accepted: 05/22/2019] [Indexed: 12/02/2022] Open
Abstract
In automobile accidents, abdominal injuries are often life-threatening yet not apparent at the time of initial injury. The liver is the most commonly injured abdominal organ from this type of trauma. In contrast to current safety tests involving crash dummies, a more detailed, efficient approach to predict the risk of human injuries is computational modelling and simulations. Further, the development of accurate computational human models requires knowledge of the mechanical properties of tissues in various stress states, especially in high-impact scenarios. In this study, a polymeric split-Hopkinson pressure bar (PSHPB) was utilized to apply various high strain rates to porcine liver tissue to investigate its material behavior during high strain rate compression. Liver tissues were subjected to high strain rate impacts at 350, 550, 1000, and 1550 s−1. Tissue directional dependency was also explored by PSHPB testing along three orthogonal directions of liver at a strain rate of 350 s−1. Histology of samples from each of the three directions was performed to examine the structural properties of porcine liver. Porcine liver tissue showed an inelastic and strain rate-sensitive response at high strain rates. The liver tissue was found lacking directional dependency, which could be explained by the isotropic microstructure observed after staining and imaging. Furthermore, finite element analysis (FEA) of the PSHPB tests revealed the stress profile inside liver tissue and served as a validation of PSHPB methodology. The present findings can assist in the development of more accurate computational models of liver tissue at high-rate impact conditions allowing for understanding of subfailure and failure mechanisms.
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