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Aharonov A, Sofer S, Bruck H, Sarig U, Sharabi M. Unveiling the mechanical role of radial fibers in meniscal tissue: Toward structural biomimetics. Acta Biomater 2024; 187:199-211. [PMID: 39181178 DOI: 10.1016/j.actbio.2024.08.024] [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: 05/22/2024] [Revised: 08/01/2024] [Accepted: 08/16/2024] [Indexed: 08/27/2024]
Abstract
The meniscus tissue is crucial for knee joint biomechanics and is frequently susceptible to injuries resulting in early-onset osteoarthritis. Consequently, the need for meniscal substitutes spurs ongoing development. The meniscus is a composite tissue reinforced with circumferential and radial collagenous fibers; the mechanical role of the latter has yet to be fully unveiled. Here, we investigated the role of radial fibers using a synergistic methodology combining meniscal tissue structure imaging, a computational knee joint model, and the fabrication of simple biomimetic composite laminates. These laminates mimic the basic structural units of the meniscus, utilizing longitudinal and transverse fibers equivalent to the circumferential and radial fibers in meniscal tissue. In the computational model, the absence of radial fibers resulted in stress concentration within the meniscus matrix and up to 800 % greater area at the same stress level. Furthermore, the contact pressure on the tibial cartilage increased drastically, affecting up to 322 % larger areas. Conversely, in models with radial fibers, we observed up to 25 % lower peak contact pressures and width changes of less than 0.1 %. Correspondingly, biomimetic composite laminates containing transverse fibers exhibited minor transverse deformations and smaller Poisson's ratios. They demonstrated structural shielding ability, maintaining their mechanical performance with the reduced amount of fibers in the loading direction, similar to the ability of the torn meniscus to carry and transfer loads to some extent. These results indicate that radial fibers are essential to distribute contact pressure and tensile stresses and prevent excessive deformations, suggesting the importance of incorporating them in novel designs of meniscal substitutes. STATEMENT OF SIGNIFICANCE: The organization of the collagen fibers in the meniscus tissue is crucial to its biomechanical function. Radially oriented fibers are an important structural element of the meniscus and greatly affect its mechanical behavior. However, despite their importance to the meniscus mechanical function, radially oriented fibers receive minor attention in meniscal substitute designs. Here, we used a synergistic methodology that combines imaging of the meniscal tissue structure, a structural computational model of the knee joint, and the fabrication of simplistic biomimetic composite laminates that mimic the basic structural units of the meniscus. Our findings highlight the importance of the radially oriented fibers, their mechanical role in the meniscus tissue, and their importance as a crucial element in engineering novel meniscal substitutes.
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Affiliation(s)
- Adi Aharonov
- Department of Mechanical Engineering and Mechatronics, Ariel University, Ariel 407000, Israel
| | - Shachar Sofer
- Dr. Miriam and Sheldon Adelson School of Medicine, Department of Morphological Sciences and Teratology, Ariel University, Ariel 407000, Israel
| | - Hod Bruck
- Dr. Miriam and Sheldon Adelson School of Medicine, Department of Morphological Sciences and Teratology, Ariel University, Ariel 407000, Israel
| | - Udi Sarig
- Dr. Miriam and Sheldon Adelson School of Medicine, Department of Morphological Sciences and Teratology, Ariel University, Ariel 407000, Israel; Department of Chemical Engineering, School of Engineering, Ariel University, Ariel 407000, Israel
| | - Mirit Sharabi
- Department of Mechanical Engineering and Mechatronics, Ariel University, Ariel 407000, Israel.
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Li K, Tian C, Wei Q, Gou X, Chu F, Xu M, Qiang L, Xu S. Design and study of additively manufactured Three periodic minimal surface (TPMS) structured porous titanium interbody cage. Heliyon 2024; 10:e38209. [PMID: 39364254 PMCID: PMC11447334 DOI: 10.1016/j.heliyon.2024.e38209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 09/02/2024] [Accepted: 09/19/2024] [Indexed: 10/05/2024] Open
Abstract
Objective TPMS porous structures have adjustable stiffness, a smooth surface, and highly connected pores, which help avoid stress concentration within the dot-matrix structure and promote cell adhesion and proliferation. A cervical interbody cage based on this type of porous structure was designed and fabricated, and its mechanical properties and biocompatibility were evaluated. Methods TPMS porous structures have adjustable stiffness, a smooth surface, and highly connected pores, which help avoid stress concentration within the dot-matrix structure and promote cell adhesion and proliferation. A cervical interbody cage based on this type of porous structure was designed and fabricated, and its mechanical properties and biocompatibility were evaluated. Results The volume fraction of the 3D-printed TC4-based Tubular-G structure was linearly related to compressive strength. Adjusting the volume fraction resulted in a Tubular-G structure with a modulus and yield strength similar to human bone, without stress concentration within the structure. The designed and fabricated TC4-based Tubular-G porous cervical interbody cage demonstrated excellent anti-sagging properties and biocompatibility. Conclusions The volume fraction of the 3D-printed TC4-based Tubular-G structure was linearly related to compressive strength. Adjusting the volume fraction resulted in a Tubular-G structure with a modulus and yield strength similar to human bone, without stress concentration within the structure. The designed and fabricated TC4-based Tubular-G porous cervical interbody cage demonstrated excellent anti-sagging properties and biocompatibility.
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Affiliation(s)
- Kun Li
- Department of Biomedical Engineering, Chengde Medical University, HeBei Province, China
| | - ChunYan Tian
- Department of Biomedical Engineering, Chengde Medical University, HeBei Province, China
| | - QiuJiang Wei
- Department of Biomedical Engineering, Chengde Medical University, HeBei Province, China
| | - XinRui Gou
- Department of Biomedical Engineering, Chengde Medical University, HeBei Province, China
| | - FuHuan Chu
- Department of Biomedical Engineering, Chengde Medical University, HeBei Province, China
| | - MengJie Xu
- Department of Biomedical Engineering, Chengde Medical University, HeBei Province, China
| | - LinHui Qiang
- Department of Biomedical Engineering, Chengde Medical University, HeBei Province, China
- Hebei International Joint Research Center for Biomedical Engineering, Chengde Medical University, Hebei Province, China
- Chengde Medical Additive Manufacturing Technology Innovation Center, Chengde Medical University, Hebei Province, China
| | - ShiQi Xu
- Department of Biomedical Engineering, Chengde Medical University, HeBei Province, China
- Hebei International Joint Research Center for Biomedical Engineering, Chengde Medical University, Hebei Province, China
- Chengde Medical Additive Manufacturing Technology Innovation Center, Chengde Medical University, Hebei Province, China
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Kumar Shetty S, Sundar Santhanakrishnan S, Padurao S, Mirazkar Dasharatharao P. Prioritizing Biomaterial Driven Clinical Bioactivity Over Designing Intricacy during Bioprinting of Trabecular Microarchitecture: A Clinician's Perspective. ACS OMEGA 2024; 9:12426-12435. [PMID: 38524444 PMCID: PMC10956407 DOI: 10.1021/acsomega.3c08112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/12/2024] [Accepted: 02/21/2024] [Indexed: 03/26/2024]
Abstract
Bone tissue engineering has witnessed a historical shift from three perspectives. From a biomaterial perspective, materials have now become smarter and dynamic; from a bioengineering perspective the bioprinting techniques have now advanced to 4D bioprinting; and from a clinical perspective scaffold bioactivity has progressed toward enhanced osteoinductive scaffolds driven by intricate biomechanical, biophysical, biochemical, and biological cues. Though all of these advancements are indicative of improvised scaffold engineering, a pivotal question regarding the critical role and need of designing and replicating the intricacies of trabecular microarchitecture for enhanced, clinically appreciable osteoangiogenicity needs to be answered. This review hence critically evaluates the rationale and the need of investing substantial effort into designing complex microarchitectures amidst the era of "smart biomaterials" and dynamic 4D bioprinting aimed toward enhancing clinically appreciable bioactivity. The article explores the concept of integrating intricate designs into a scaffold microarchitecture to bolster bioactivity and the practical challenges encountered in 3D bioprinting of complex designs and meticulously examines the pivotal role of biomaterials in scaffold bioactivity, proposing a comprehensive approach to bioprinting geared toward achieving clinical bioactivity and striking a judicious balance between design intricacy and functional outcomes in bone bioprinting.
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Affiliation(s)
- Sahith Kumar Shetty
- Department
of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore 570015, India
| | - Shyam Sundar Santhanakrishnan
- Department
of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore 570015, India
| | - Shubha Padurao
- Department
of Material Science, Mangalagangothri Mangalore
University, Konaja 571449, India
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Yan M, Liang T, Zhao H, Bi Y, Wang T, Yu T, Zhang Y. Model Properties and Clinical Application in the Finite Element Analysis of Knee Joint: A Review. Orthop Surg 2024; 16:289-302. [PMID: 38174410 PMCID: PMC10834231 DOI: 10.1111/os.13980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/21/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
The knee is the most complex joint in the human body, including bony structures like the femur, tibia, fibula, and patella, and soft tissues like menisci, ligaments, muscles, and tendons. Complex anatomical structures of the knee joint make it difficult to conduct precise biomechanical research and explore the mechanism of movement and injury. The finite element model (FEM), as an important engineering analysis technique, has been widely used in many fields of bioengineering research. The FEM has advantages in the biomechanical analysis of objects with complex structures. Researchers can use this technology to construct a human knee joint model and perform biomechanical analysis on it. At the same time, finite element analysis can effectively evaluate variables such as stress, strain, displacement, and rotation, helping to predict injury mechanisms and optimize surgical techniques, which make up for the shortcomings of traditional biomechanics experimental research. However, few papers introduce what material properties should be selected for each anatomic structure of knee FEM to meet different research purposes. Based on previous finite element studies of the knee joint, this paper summarizes various modeling strategies and applications, serving as a reference for constructing knee joint models and research design.
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Affiliation(s)
- Mingyue Yan
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Sports Medicine and Health, Qingdao University, Qingdao, China
| | - Ting Liang
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Sports Medicine and Health, Qingdao University, Qingdao, China
| | - Haibo Zhao
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Sports Medicine and Health, Qingdao University, Qingdao, China
| | - Yanchi Bi
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Sports Medicine and Health, Qingdao University, Qingdao, China
| | - Tianrui Wang
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tengbo Yu
- Institute of Sports Medicine and Health, Qingdao University, Qingdao, China
- Department of Orthopedic Surgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China
| | - Yingze Zhang
- Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China
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Li L, Wang P, Liang H, Jin J, Zhang Y, Shi J, Zhang Y, He S, Mao H, Xue B, Lai J, Zhu L, Jiang Q. Design of a Haversian system-like gradient porous scaffold based on triply periodic minimal surfaces for promoting bone regeneration. J Adv Res 2023; 54:89-104. [PMID: 36632888 DOI: 10.1016/j.jare.2023.01.004] [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: 02/21/2022] [Revised: 09/14/2022] [Accepted: 01/06/2023] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION The bone ingrowth depth in the porous scaffolds is greatly affected by the structural design, notably the pore size, pore geometry, and the pore distribution. To enhance the bone regeneration capability of scaffolds, the bionic design can be regarded as a potential solution. OBJECTIVES We proposed a Haversian system-like gradient structure based on the triply periodic minimal surface architectures with pore size varying from the edge to the center. And its effects in promoting bone regeneration were evaluated in the study. METHODS The gradient scaffold was designed using the triply periodic minimal surface architectures. The mechanical properties were analyzed by the finite element simulation and confirmed using the universal machine. The fluid characteristics were calculated by the computational fluid dynamics analysis. The bone regeneration process was simulated using a in silico computational model containing the main biological, physical, and chemical variation during the bone growth process. Finally, the in vitro and in vivo studies were carried out to verify the actual osteogenic effect. RESULTS Compared to the uniform scaffold, the biomimetic gradient scaffold demonstrated better performance in stress conduction and reduced stress shielding effects. The fluid features were appropriate for cell migration and flow diffusion, and the permeability was in the same order of magnitude with the natural bone. The bone ingrowth simulation exhibited improved angiogenesis and bone regeneration. Higher expression of the osteogenesis-related genes, higher alkaline phosphatase activity, and increased mineralization could be observed on the gradient scaffold in the in vitro study. The 12-week in vivo study proved that the gradient scaffold had deeper bone inserting depth and a more stable bone-scaffold interface. CONCLUSION The Haversian system-like gradient structure can effectively promote the bone regeneration. This structural design can be used as a new solution for the clinical application of prosthesis design.
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Affiliation(s)
- Lan Li
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Branch of National Clinical Research Center for Orthopedics, Drum Tower Hospital Affiliated to Medical School of Nanjing University, No. 321 Zhongshan Road, Nanjing 210000, China; Jiangsu Engineering Research Center for 3D Bioprinting, No. 321 Zhongshan Road, Nanjing 210000, China
| | - Peng Wang
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Branch of National Clinical Research Center for Orthopedics, Drum Tower Hospital Affiliated to Medical School of Nanjing University, No. 321 Zhongshan Road, Nanjing 210000, China; Jiangsu Engineering Research Center for 3D Bioprinting, No. 321 Zhongshan Road, Nanjing 210000, China
| | - Huixin Liang
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Branch of National Clinical Research Center for Orthopedics, Drum Tower Hospital Affiliated to Medical School of Nanjing University, No. 321 Zhongshan Road, Nanjing 210000, China; Jiangsu Engineering Research Center for 3D Bioprinting, No. 321 Zhongshan Road, Nanjing 210000, China
| | - Jing Jin
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Branch of National Clinical Research Center for Orthopedics, Drum Tower Hospital Affiliated to Medical School of Nanjing University, No. 321 Zhongshan Road, Nanjing 210000, China
| | - Yibo Zhang
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Branch of National Clinical Research Center for Orthopedics, Drum Tower Hospital Affiliated to Medical School of Nanjing University, No. 321 Zhongshan Road, Nanjing 210000, China
| | - Jianping Shi
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Branch of National Clinical Research Center for Orthopedics, Drum Tower Hospital Affiliated to Medical School of Nanjing University, No. 321 Zhongshan Road, Nanjing 210000, China
| | - Yun Zhang
- State Key Laboratory of Bioelectronics, School of Biological Science & Medical Engineering, Southeast University, No. 2 Sipailou, Nanjing 210096, China
| | - Siyuan He
- State Key Laboratory of Bioelectronics, School of Biological Science & Medical Engineering, Southeast University, No. 2 Sipailou, Nanjing 210096, China
| | - Hongli Mao
- College of Materials Science and Engineering, Nanjing Tech University, No. 30 South Puzhu Road, Nanjing 211816, China
| | - Bin Xue
- National Laboratory of Solid State Microstructures, Department of Physics, Nanjing University, No. 2 Hankou Road, Nanjing 210093, China
| | - Jiancheng Lai
- Department of Chemical Engineering, Stanford University, Stanford, CA 94305-6104, USA
| | - Liya Zhu
- School of Electrical and Automation Engineering, Nanjing Normal University, No.2 Xuelin Road, Nanjing 210023, China.
| | - Qing Jiang
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Branch of National Clinical Research Center for Orthopedics, Drum Tower Hospital Affiliated to Medical School of Nanjing University, No. 321 Zhongshan Road, Nanjing 210000, China; Jiangsu Engineering Research Center for 3D Bioprinting, No. 321 Zhongshan Road, Nanjing 210000, China.
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Obara K, Silva P, Silva M, Mendes F, Santiago G, Oliveira I, Cardoso J. Isokinetic Training Program to Improve the Physical Function and Muscular Performance of an Individual with Partial Injury of the Medial Meniscus: A Case Report. Int J Sports Phys Ther 2023; 18:758-768. [PMID: 37636894 PMCID: PMC10449488 DOI: 10.26603/001c.74945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 03/08/2023] [Indexed: 08/29/2023] Open
Abstract
Background and Purpose One of the best alternatives for the treatment of meniscal injuries in relation to surgical procedures, is exercise. This case report aimed to describe the effects of isokinetic training and a neuromuscular/proprioceptive exercise program on muscle performance and physical function in an individual after a rupture of the posterior horn of the medial meniscus. Study Design Case report. Case Description A 40-year-old man injured his right knee during a soccer match, with a partial lesion of the medial meniscus confirmed by magnetic resonance imaging. He completed an isokinetic training program in addition to exercises that targeted proprioception (22 sessions, 11 weeks) to improve physical function and performance, which were assessed before and after treatment and at a six-month follow-up. An individual with similar anthropometric characteristics was chosen to be used as a control for understanding the patient's assessment values. Outcomes Muscular performance of the knee flexors and extensors was evaluated isokinetically using the Biodex System-4 in a concentric mode at angular velocities of 60, 120, and 300 °/s . The main results indicated that after 11 weeks, the peak torque normalized to body mass (PT/BM), at 60 °/s of the knee extensors remained unchanged (2.54 N.m/kg) (below the control value - 3.06 N.m/kg), and at the six-month follow-up, increased by approximately 20% (3.08 N.m/kg). For the hamstrings, at 60 °/s, an increase of 18 % occurred after intervention (1.98 N.m/kg) and by approximately 30 % at the six-month follow-up (2.12 N.m/kg) - values much higher than the control 1.55 N.m/kg). This increase in the PT/BM was also reflected in the Hamstrings:Quadriceps ratio (78 %) after treatment which improved at follow-up (68 %). Discussion The results showed that the isokinetic training and neuromuscular/proprioceptive exercises improved the muscle performance of the knee flexors and extensors, after eleven weeks of intervention, and remained (or continued to improve) at the six-month follow-up. Level of evidence 5, single case report.
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Affiliation(s)
- Karen Obara
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group Universidade Estadual de Londrina
| | - Pedro Silva
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group Universidade Estadual de Londrina
| | - Mariana Silva
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group Universidade Estadual de Londrina
| | - Fagner Mendes
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group Universidade Estadual de Londrina
| | - Gabriel Santiago
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group Universidade Estadual de Londrina
| | - Ihan Oliveira
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group Universidade Estadual de Londrina
| | - Jefferson Cardoso
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group Universidade Estadual de Londrina
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Pugliese R, Graziosi S. Biomimetic scaffolds using triply periodic minimal surface-based porous structures for biomedical applications. SLAS Technol 2023; 28:165-182. [PMID: 37127136 DOI: 10.1016/j.slast.2023.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/31/2023] [Accepted: 04/27/2023] [Indexed: 05/03/2023]
Abstract
The design of biomimetic porous scaffolds has been gaining attention in the biomedical sector lately. Shells, marine sponges, shark teeth, cancellous bone, sea urchin spine, and the armadillo armor structure are examples of biological systems that have already been studied to drive the design of innovative, porous, and multifunctional structures. Among these, triply periodic minimal surfaces (TPMSs) have attracted the attention of scientists for the fabrication of biomimetic porous scaffolds. The interest stems from their outstanding properties, which include mathematical controllable geometry features, highly interconnected porous architectures, high surface area to volume ratio, less stress concentration, tunable mechanical properties, and increased permeability. All these distinguishing features enable better cell adhesion, optimal integration to the surrounding tissue avoiding stress shieldings, a good permeability of fluid media and oxygen, and the possibility of vascularization. However, the sophisticated geometry of these TPMS-based structures has proven challenging to fabricate by conventional methods. The emergence of additive manufacturing (AM) and the enhanced manufacturing freedoms and flexibility it guarantees could solve some of the bottlenecks, thus leading to a surge of interest in designing and fabricating such structures in this field. Also, the feasibility of using AM technologies allows for obtaining size programmable TPMS printable in various materials, from polymers to metal alloys. Here, a comprehensive overview of 3D-printed TPMS porous structures is provided from a design for additive manufacturing (DfAM) and application perspective. First, design strategies, geometry design algorithms, and related topological optimization are introduced according to diverse requirements. Based on that, the performance control of TPMS and the pros and cons of the different AM processes for fabricating TPMS scaffolds are summarized. Lastly, practical applications of 3D-printed biomimetic TPMS porous structures for the biomedical field are presented to clarify the advantages and potential of such structures.
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Affiliation(s)
| | - Serena Graziosi
- Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy
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Liu X, Yan P, Cui R, Wu Y, Xu B, Zhou W, Li F, Wu X. Controllable Damping Magnetorheological Elastomer Meniscus. ACS Biomater Sci Eng 2023; 9:869-876. [PMID: 36580436 DOI: 10.1021/acsbiomaterials.2c01083] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The human healthy meniscus fulfills key biomechanical functions in the tibiofemoral (knee) joint. Meniscal injury leads to an increased risk for symptomatic osteoarthritis. In order to prevent osteoarthritis, many researchers have put efforts into developing new-type meniscal substitute materials. In this study, MRI data of the human knee joint is obtained by CT scanning, and a three-dimensional finite element model of the meniscus is established. Compressive forces of 400 N, 600 N, 800 N, and 1000 N are selected to complete the meniscus modeling and finite element simulation analysis of the meniscus by ANSYS; at the same time, the compressive force and compressive displacement of the magnetorheological elastomer are controlled by changing the current size. The results show that the compressive force and compressive displacement of the magnetorheological elastomer can be controlled by an electric current, so as to adapt to the required mechanical properties of the meniscus under external complex loads and provide a theoretical and experimental basis for clinical meniscus replacement.
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Affiliation(s)
- Xuhui Liu
- School of Mechanical Engineering, Shanghai Institute of Technology, Shanghai 201418, China
| | - PianPian Yan
- School of Mechanical Engineering, Shanghai Institute of Technology, Shanghai 201418, China
| | - Ran Cui
- Department of Rheumatology and Immunology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yan Wu
- School of Mechanical Engineering, Shanghai Institute of Technology, Shanghai 201418, China
| | - Bin Xu
- School of Mechanical Engineering, Shanghai Institute of Technology, Shanghai 201418, China
| | - Wentong Zhou
- School of Mechanical Engineering, Shanghai Institute of Technology, Shanghai 201418, China
| | - Fang Li
- School of Mechanical Engineering, Shanghai Institute of Technology, Shanghai 201418, China
| | - Xiaoxue Wu
- Shanghai Minhang Vocational and Technical College, 4080 Yuanjiang Road, Minhang District, Shanghai 201109, China
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Pan CS, Wang X, Ding LZ, Zhu XP, Xu WF, Huang LX. The best position of bone grafts in the medial open-wedge high tibial osteotomy: A finite element analysis. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 228:107253. [PMID: 36434962 DOI: 10.1016/j.cmpb.2022.107253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/13/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE The application of wedge-shaped bone grafts can increase the biomechanical stability of knee during the medial open-wedge high tibial osteotomy (MOWHTO) by reducing the von Mises stress of the medial plate and lateral cortical hinge area. However, the optimal position of bone grafts it remains unclear, so we aimed to determine search for the optimal position of the bone grafts in MOWHTO by using finite element analysis. METHODS In the finite element analysis, MOWHTO models were established with three different osteotomy distraction heights and assembled into four groups according to different conditions, including the no bone grafts (NBG) group, the anterior bone grafts (ABG) group, the middle bone grafts (MBG) group, and the posterior bone grafts (PBG) group. Based on previous studies, 600 N and 1800 N loads were applied to the knee joint to simulate the static forces during a double and single leg stance to measure the von Mises stress of the medial implant area and lateral hinge area, the maximum displacement of different models, the relative displacement of the osteotomy area and the stress distribution in the bone grafts. RESULTS Compared to the NBG and ABG groups, the stress of the lateral cortical hinge area and the medial implate area was significantly lower in the PBG group. For example, under the 600N force load, when the height of the osteotomy area was 10 mm, 15 mm, and 20 mm, the maximum von Mises stress of the medial implate area and lateral cortical hinge area in the NBG group were 140, 141, 172, and 53, 57, 60 MPa, respectively. Compared with the NBG group, the maximum von Mises stress of the medial implate area and lateral cortical hinge area in the PBG group were reduced by 45%, 56%, 63% and 14%, 39%, 68% at distraction height of 10 mm, 15 mm, and 20 mm, respectively. The bone grafts in the posterior parts provide the best stability,with the stress of the middle and posterior bone grafts are mainly concentrated in the edge. CONCLUSIONS The posterior part of the osteotomy area is the best position for bone graft placement since it provides optimal stability and reduces von Mises stress in the medial plate and lateral cortex hinge area, with the stress of the posterior bone grafts mainly concentrated in the edge. These findings guide bone graft placement sites in clinical surgery and are a basis for future research on bone graft materials and structures in MOWHTO.
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Affiliation(s)
- Chen-Shuai Pan
- Department of Orthopedic, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, Jiangsu Province 215006, PR China; Department of Orthopedic, Taizhou Central Hospital (Taizhou University Hospital), No.999, Donghai Avenue, Jiaojiang District, Taizhou City, Zhejiang Province 318000, PR China
| | - Xiao Wang
- Department of Ophthalmology,Taizhou Central Hospital (Taizhou University Hospital), No.999, Donghai Avenue, Jiaojiang District, Taizhou City, Zhejiang Province 318000, PR China
| | - Ling-Zhi Ding
- Department of Orthopedic, Taizhou Central Hospital (Taizhou University Hospital), No.999, Donghai Avenue, Jiaojiang District, Taizhou City, Zhejiang Province 318000, PR China
| | - Xian-Ping Zhu
- Department of Orthopedic, Taizhou Central Hospital (Taizhou University Hospital), No.999, Donghai Avenue, Jiaojiang District, Taizhou City, Zhejiang Province 318000, PR China
| | - Wei-Fang Xu
- Department of Orthopedic, Taizhou Central Hospital (Taizhou University Hospital), No.999, Donghai Avenue, Jiaojiang District, Taizhou City, Zhejiang Province 318000, PR China
| | - Li-Xin Huang
- Department of Orthopedic, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, Jiangsu Province 215006, PR China.
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Li L, Wang P, Jin J, Xie C, Xue B, Lai J, Zhu L, Jiang Q. The triply periodic minimal surface-based 3D printed engineering scaffold for meniscus function reconstruction. Biomater Res 2022; 26:45. [PMID: 36115984 PMCID: PMC9482755 DOI: 10.1186/s40824-022-00293-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/30/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The meniscus injury is a common disease in the area of sports medicine. The main treatment for this disease is the pain relief, rather than the meniscal function recovery. It may lead to a poor prognosis and accelerate the progression of osteoarthritis. In this study, we designed a meniscal scaffold to achieve the purposes of meniscal function recovery and cartilage protection.
Methods
The meniscal scaffold was designed using the triply periodic minimal surface (TPMS) method. The scaffold was simulated as a three-dimensional (3D) intact knee model using a finite element analysis software to obtain the results of different mechanical tests. The mechanical properties were gained through the universal machine. Finally, an in vivo model was established to evaluate the effects of the TPMS-based meniscal scaffold on the cartilage protection. The radiography and histological examinations were performed to assess the cartilage and bony structures. Different regions of the regenerated meniscus were tested using the universal machine to assess the biomechanical functions.
Results
The TPMS-based meniscal scaffold with a larger volume fraction and a longer functional periodicity demonstrated a better mechanical performance, and the load transmission and stress distribution were closer to the native biomechanical environment. The radiographic images and histological results of the TPMS group exhibited a better performance in terms of cartilage protection than the grid group. The regenerated meniscus in the TPMS group also had similar mechanical properties to the native meniscus.
Conclusion
The TPMS method can affect the mechanical properties by adjusting the volume fraction and functional periodicity. The TPMS-based meniscal scaffold showed appropriate features for meniscal regeneration and cartilage protection.
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Li N, Zhang Y, Tang Q, Wang H, He D, Yao Y, Fan Y. Porous interbody fusion cage design via topology optimization and biomechanical performance analysis. Comput Methods Biomech Biomed Engin 2022; 26:650-659. [PMID: 35652627 DOI: 10.1080/10255842.2022.2081505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The porous interbody fusion cage could provide space and stable mechanical conditions for postoperative intervertebral bone ingrowth. It is considered to be an important implant in anterior cervical discectomy and internal fixation. In this study, two types of unit cells were designed using topology optimization method and introduced to the interbody fusion cage to improve the biomechanical performances of the cage. Topology optimization under two typically loading conditions was first conducted to obtain two unit cells (O-unit cell and D-unit cell) with the same volume fraction. Porous structures were developed by stacking the obtained unit cells in space, respectively. Then, porous interbody fusion cages were obtained by the Boolean intersection between the global structural layout and the porous structures. Finite element models of cervical spine were created that C5-C6 segment was fused by the designed porous cages. The range of motion (ROM) of the cervical spine, the maximum stress on the cage and the bone graft, and the stress and displacement distributions of the cage were analyzed. The results showed the ROMs of C5-C6 segment in D-unit cell and O-unit cell models were range from 0.14° to 0.25° under different loading conditions; the cage composed of the D-unit cells had a more uniform stress distribution, smaller displacement on cage, a more reasonable internal stress transfer mode (transmission along struts of the unit cell), and higher stress on the internal bone graft (0.617 MPa). In conclusion, the optimized porous cage is a promising candidate for fusion surgery, which would avoid the cage subsidence, and promote the fusion of adjacent endplates.
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Affiliation(s)
- Nan Li
- Department of Spine Surgery, Beijing Jishuitan Hospital, The Fourth Clinical Medical College of Peking University, Beijing, China
| | - Yang Zhang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Qiaohong Tang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Hongkun Wang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Da He
- Department of Spine Surgery, Beijing Jishuitan Hospital, The Fourth Clinical Medical College of Peking University, Beijing, China
| | - Yan Yao
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Engineering Medicine, Beihang University, Beijing, China
| | - Yubo Fan
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.,Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Engineering Medicine, Beihang University, Beijing, China
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Stocco E, Porzionato A, De Rose E, Barbon S, Caro RD, Macchi V. Meniscus regeneration by 3D printing technologies: Current advances and future perspectives. J Tissue Eng 2022; 13:20417314211065860. [PMID: 35096363 PMCID: PMC8793124 DOI: 10.1177/20417314211065860] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/24/2021] [Indexed: 01/10/2023] Open
Abstract
Meniscal tears are a frequent orthopedic injury commonly managed by conservative
strategies to avoid osteoarthritis development descending from altered
biomechanics. Among cutting-edge approaches in tissue engineering, 3D printing
technologies are extremely promising guaranteeing for complex biomimetic
architectures mimicking native tissues. Considering the anisotropic
characteristics of the menisci, and the ability of printing over structural
control, it descends the intriguing potential of such vanguard techniques to
meet individual joints’ requirements within personalized medicine. This
literature review provides a state-of-the-art on 3D printing for meniscus
reconstruction. Experiences in printing materials/technologies, scaffold types,
augmentation strategies, cellular conditioning have been compared/discussed;
outcomes of pre-clinical studies allowed for further considerations. To date,
translation to clinic of 3D printed meniscal devices is still a challenge:
meniscus reconstruction is once again clear expression of how the integration of
different expertise (e.g., anatomy, engineering, biomaterials science, cell
biology, and medicine) is required to successfully address native tissues
complexities.
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Affiliation(s)
- Elena Stocco
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, Padova, Italy
| | - Andrea Porzionato
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, Padova, Italy
| | - Enrico De Rose
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Padova, Italy
| | - Silvia Barbon
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, Padova, Italy
| | - Raffaele De Caro
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, Padova, Italy
| | - Veronica Macchi
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, Padova, Italy
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