Finite-Element Analysis of Bone Stresses on Primary Impact in a Large-Animal Model: The Distal End of the Equine Third Metacarpal

Contrast enhanced computed tomography of small ruminants: Caprine and ovine

The use of small ruminants, mainly sheep and goats, is increasing in biomedical research. Small ruminants are a desirable animal model due to their human-like anatomy and physiology. However, the large variability between studies and lack of baseline data on these animals creates a barrier to further research. This knowledge gap includes a lack of computed tomography (CT) scans for healthy subjects. Full body, contrast enhanced CT scans of caprine and ovine subjects were acquired for subsequent modeling studies. Scans were acquired from an ovine specimen (male, Khatadin, 30-35 kg) and caprine specimen (female, Nubian 30-35 kg). Scans were acquired with and without contrast. Contrast enhanced scans utilized 1.7 mL/kg of contrast administered at 2 mL/s and scans were acquired 20 seconds, 80 seconds, and 5 minutes post-contrast. Scans were taken at 100 kV and 400 mA. Each scan was reconstructed using a bone window and a soft tissue window. Sixteen full body image data sets are presented (2 specimens by 4 contrast levels by 2 reconstruction windows) and are available for download through the form located at: https://redcap.link/COScanData. Scans showed that the post-contrast timing and scan reconstruction method affected structural visualization. The data are intended for further biomedical research on ruminants related to computational model development, device prototyping, comparative diagnostics, intervention planning, and other forms of translational research.

Clinical Assessments of Fracture Healing and Basic Science Correlates: Is There Room for Convergence?

PURPOSE OF REVIEW

The purpose of this review is to summarize the clinical and basic science methods used to assess fracture healing and propose a framework to improve the translational possibilities.

RECENT FINDINGS

Mainstays of fracture healing assessment include clinical examination, various imaging modalities, and assessment of function. Pre-clinical studies have yielded insight into biomechanical progression as well as the genetic, molecular, and cellular processes of fracture healing. Efforts are emerging to identify early markers to predict impaired healing and possibly early intervention to alter these processes. Despite of the differences in clinical and preclinical research, opportunities exist to unify and improve the translational efforts between these arenas to develop and optimize our ability to assess and predict fracture healing, thereby improving the clinical care of these patients.

Variations in Strain Distribution at Distal Radius under Different Loading Conditions

Distal radial fractures exhibit various fracture patterns. By assuming that the strain distribution at the distal radius affects the diversification of the fracture pattern, a parameter study using the finite element model of a wrist developed from computed tomography (CT) images was performed under different loading conditions. The finite element model of the wrist consisted of the radius, ulna, scaphoid, lunate, triquetrum, and major carpal ligaments. The material properties of the bone models were assigned on the basis of the Hounsfield Unit (HU) values of the CT images. An impact load was applied to the scaphoid, lunate, and triquetrum to simulate boundary conditions during fall accidents. This study considered nine different loading conditions that combine three different loading directions and three different load distribution ratios. According to the analysis results, the strain distribution at the distal radius changed with respect to the change in the loading condition. High strain concentration occurred in regions where distal radius fractures are commonly developed. The direction and distribution of the load acting on the radius were considered to be factors that may cause variations in the fracture pattern of distal radius fractures.

A Coupled Biomechanical-Smoothed Particle Hydrodynamics Model for Horse Racing Tracks

Distal limb injuries are common in racing horses and track surface properties have been associated with injury risk. To better understand how track surfaces may contribute to equine limb injury, we developed the first 3D computational model of the equine hoof interacting with a racetrack and simulated interactions with model representations of 1) a dirt surface and 2) an all-weather synthetic track. First, a computational track model using the Smoothed Particle Hydrodynamics (SPH) method with a Drucker-Prager (D-P) elastoplastic material model was developed. It was validated against analytical models and published data and then calibrated using results of a custom track testing device applied to the two racetrack types. Second, a sensitivity analysis was performed to determine which model parameters contribute most significantly to the mechanical response of the track under impact-type loading. Third, the SPH track model was coupled to a biomechanical model of the horse forelimb and applied to hoof-track impact for a horse galloping on each track surface. We found that 1) the SPH track model was well validated and it could be calibrated to accurately represent impact loading of racetrack surfaces at two angles of impact; 2) the amount of harrowing applied to the track had the largest effect on impact loading, followed by elastic modulus and cohesion; 3) the model is able to accurately simulate hoof-ground interaction and enables study of the relationship between track surface parameters and the loading on horses’ distal forelimbs.

Imaging and Gross Pathological Appearance of Changes in the Parasagittal Grooves of Thoroughbred Racehorses

Simple Summary

Early detection of racehorses at risk of stress fracture is key to reducing the number of horses with catastrophic fractures while racing. Bone changes are often visible in the limbs of Thoroughbred racehorses in work, particularly in the fetlock region. However, it is currently unknown whether some of these changes indicate an impending fracture or are a healthy adaptation to high-speed exercise. This study looks at imaging and gross changes in a specific area (parasagittal grooves (PSGs) of the cannon bone) and the utility of X-ray, computed tomography (CT) and magnetic resonance imaging (MRI) to detect the changes. All fetlock joints were assessed from twenty horses that died during racing or training, including horses with and without fetlock fracture. Overall, X-ray was poor for detecting PSG changes. Some PSG changes on CT and MRI were common in Thoroughbred racehorses and possibly represent normal bone adaptation when seen in clinical cases. However, certain CT and MRI findings were more prevalent in horses with a fracture, possibly indicating microdamage accumulation and increased risk of fracture. Bilateral advanced imaging is recommended in clinical cases of suspected fetlock pathology.

Abstract

(1) Background: Parasagittal groove (PSG) changes are often present on advanced imaging of racing Thoroughbred fetlocks and have been suggested to indicate increased fracture risk. Currently, there is limited evidence differentiating the imaging appearance of prodromal changes in horses at risk of fracture from horses with normal adaptive modelling in response to galloping. This study aims to investigate imaging and gross PSG findings in racing Thoroughbreds and the comparative utility of different imaging modalities to detect PSG changes. (2) Methods: Cadaver limbs were collected from twenty deceased racing/training Thoroughbreds. All fetlocks of each horse were examined with radiography, low-field magnetic resonance imaging (MRI), computed tomography (CT), contrast arthrography and gross pathology. (3) Results: Horses with fetlock fracture were more likely to have lateromedial PSG sclerosis asymmetry and/or lateral PSG lysis. PSG lysis was not readily detected using MRI. PSG subchondral bone defects were difficult to differentiate from cartilage defects on MRI and were not associated with fractures. The clinical relevance of PSG STIR hyperintensity remains unclear. Overall, radiography was poor for detecting PSG changes. (4) Conclusions: Some PSG changes in Thoroughbred racehorses are common; however, certain findings are more prevalent in horses with fractures, possibly indicating microdamage accumulation. Bilateral advanced imaging is recommended in racehorses with suspected fetlock pathology.

Design of patient specific bone stiffness mimicking scaffold

The difference in stiffness of a patient's bone and bone implant causes stress shielding. Thus, implants which match the stiffness of bone of the patient result in better bone growth and osseointegration. Variation in porosity is one of the methods to obtain implants with different stiffness values. This study proposes a novel method to design biomimetic bone graft implant based on computed tomography (CT) scan data, that creates similar pre- and post-implant mechanical environment on peri-implant bone. The design methodology is demonstrated by taking three different sections of human femur bone, greater trochanter, diaphysis and epicondyle, with two different implant materials, Ti-6Al-4V and Ti-Mg. Bones from these three sections were replaced with porous implants of effective stiffness of replaced bone, as would have been required after a resection surgery. Models were simulated with physiological loading condition using finite element (FE) method. Variation of maximum von Mises stress and average strain on peri-prosthetic bone were found to be in the range of -6% to 10.7% and -7% to -17.9% for porous implants and 26% to 50% and -36% to -59% for solid implant respectively compared to natural bone. The results revealed that the porous implants, which have been designed based on CT scan data, can effectively produce mechanical response at peri-implant bone, which is very close to pre-implanted condition. Following this methodology, more osseointegration friendly mechanical environment can be achieved at peri-implant bone for any anatomical location independent of implant materials.

Three-dimensional topology optimization model to simulate the external shapes of bone

Elucidation of the mechanism by which the shape of bones is formed is essential for understanding vertebrate development. Bones support the body of vertebrates by withstanding external loads, such as those imposed by gravity and muscle tension. Many studies have reported that bone formation varies in response to external loads. An increased external load induces bone synthesis, whereas a decreased external load induces bone resorption. This relationship led to the hypothesis that bone shape adapts to external load. In fact, by simulating this relationship through topology optimization, the internal trabecular structure of bones can be successfully reproduced, thereby facilitating the study of bone diseases. In contrast, there have been few attempts to simulate the external structure of bones, which determines vertebrate morphology. However, the external shape of bones may be reproduced through topology optimization because cells of the same type form both the internal and external structures of bones. Here, we constructed a three-dimensional topology optimization model to attempt the reproduction of the external shape of teleost vertebrae. In teleosts, the internal structure of the vertebral bodies is invariable, exhibiting an hourglass shape, whereas the lateral structure supporting the internal structure differs among species. Based on the anatomical observations, we applied different external loads to the hourglass-shaped part. The simulations produced a variety of three-dimensional structures, some of which exhibited several structural features similar to those of actual teleost vertebrae. In addition, by adjusting the geometric parameters, such as the width of the hourglass shape, we reproduced the variation in the teleost vertebrae shapes. These results suggest that a simulation using topology optimization can successfully reproduce the external shapes of teleost vertebrae. By applying our topology optimization model to various bones of vertebrates, we can understand how the external shape of bones adapts to external loads.

In this paper, we developed a computational method to investigate the relationship between three-dimensional bone shape and external loads imposed on bones. Many studies report that bone formation varies in response to external loads. An increased external load induces bone synthesis, whereas a decreased external load induces bone resorption. This relationship led to the hypothesis that the shape of bones adapts to external load. However, it remains unclear whether this hypothesis can explain the shape of bones. Here, we constructed a three-dimensional mathematical model that imitates the cellular activities of bone formation to attempt the reproduction of the shape of teleost vertebrae. In teleosts, the shape of the vertebrae differs among the species. We set the multiple types of external load conditions in the simulations and compared the simulation results with different teleost vertebrae. The produced structures that can resist the deformation of the surrounding tissues exhibited multiple structural features similar to the vertebrae of several teleost species. This result shows that the formation of bone shape can be explained by the adaptation to external load.

The biomechanical characteristics of a feline distal forelimb: A finite element analysis study

As a typical digitigrade mammal, the uniquely designed small distal limbs of the feline support two to three times of its body weight during daily movements. To understand how force transmission occurs in relation to the distal joint in a feline limb, which transfers bodyweight to the ground, it is necessary to examine the internal stress distribution of the distal joint limb in detail. Therefore, finite element models (FEM) of a healthy feline were established to predict the internal stress distribution of the distal limb. The FEM model included 23 bony components, various cartilaginous ligaments, as well as the encapsulated soft tissue of the paw. The FEM model was validated by comparison of paw pressure distribution, obtained from an experiment for balance standing. The results demonstrated a good agreement between the experimentally measured and numerically predicted pressure distribution in the feline paw. Additionally, higher stress levels were noted in the metacarpal segment, with smaller stresses observed in the phalanges portion including the proximal, middle, and distal segments. The raised metacarpal segment plays an important role in creating a stiff junction between the metacarpophalangeal (MCP) and wrist joint, stabilizing the distal limb. The paw pads help to optimize stress distribution in phalanx region. Findings from this study contribute to our understanding of feline distal forelimb biomechanical behavior. This information can be applied to bionic design of footwear since an optimal stiff junction and pressure distribution can be adapted to enhance injury relief and sports activities. Further developments may include progress, evaluation, and treatment of metatarsophalangeal joint injuries in human populations.

Temporal and spatial changes in bone accrual, density, and strain energy density in growing foals

Bone adaptation is in part driven by mechanical loading, and exercise during youth has been shown to have life-long benefits for bone health. However, the development of early exercise-based interventions that reduce the incidence of fractures in racing horses is limited by the lack of characterization of normal development in growing bone. Previous efforts to quantify bone development in the horse have relied on repeated radiographs or peripheral quantitative computed tomography scans, which are limited in their assessment of the entire bone. In this study, we acquired computed tomography scans of three Standardbred trotting colts longitudinally between 2 and 12 months of age. Finite-element models were constructed of the left forelimb proximal phalanx and used to assess strain energy density during quiet standing. Growth related changes in mineral density and bone area fraction in the distal epiphysis, mid-diaphysis, and proximal epiphysis were evaluated. Mineral density and bone area fraction uniformly increased in the diaphysis and strain energy density was constant during growth, indicating adaptation to quiet standing. Bone mineral density and bone area fraction increased in the medial quadrant of the proximal epiphysis but not in the fracture-prone lateral quadrant. The data presented provides a benchmark of normal growth trajectories that can be used to evaluate the effect of training regimens during growth.

Prediction of load in a long bone using an artificial neural network prediction algorithm

The hierarchical nature of bone makes it a difficult material to fully comprehend. The equine third metacarpal (MC3) bone experiences nonuniform surface strains, which are a measure of displacement induced by loads. This paper investigates the use of an artificial neural network expert system to quantify MC3 bone loading. Previous studies focused on determining the response of bone using load, bone geometry, mechanical properties, and constraints as input parameters. This is referred to as a forward problem and is generally solved using numerical techniques such as finite element analysis (FEA). Conversely, an inverse problem has to be solved to quantify load from the measurements of strain and displacement. Commercially available FEA packages, without manipulating their underlying algebraic formulae, are incapable of completing a solution to the inverse problem. In this study, an artificial neural network (ANN) was employed to quantify the load required to produce the MC3 displacement and surface strains determined experimentally. Nine hydrated MC3 bones from thoroughbred horses were loaded in compression in an MTS machine. Ex-vivo experiments measured strain readings from one three-gauge rosette and three distinct single-element gauges at different locations on the MC3 midshaft, associated displacement, and load exposure time. Horse age and bone side (left or right limb) were also recorded for each MC3 bone. This information was used to construct input variables for the ANN model. The ability of this expert system to predict the MC3 loading was investigated. The ANN prediction offered excellent reliability for the prediction of load in the MC3 bones investigated, i.e. R² ≥ 0.98.

Accuracy Quantification of the Reverse Engineering and High-Order Finite Element Analysis of Equine MC3 Forelimb

Shape is a key factor in influencing mechanical responses of bones. Considered to be smart viscoelastic and inhomogeneous materials, bones are stimulated to change shape (model and remodel) when they experience changes in the compressive strain distribution. Using reverse engineering techniques via computer-aided design (CAD) is crucial to create a virtual environment to investigate the significance of shape in biomechanical engineering. Nonetheless, data are lacking to quantify the accuracy of generated models and to address errors in finite element analysis (FEA). In the present study, reverse engineering through extrapolating cross-sectional slices was used to reconstruct the diaphysis of 15 equine third metacarpal bones (MC3). The reconstructed geometry was aligned with, and compared against, computed tomography-based models (reference models) of these bones and then the error map of the generated surfaces was plotted. The minimum error of reconstructed geometry was found to be +0.135 mm and -0.185 mm (0.407 mm ± 0.235, P > .05 and -0.563 mm ± 0.369, P > .05 for outside [convex] and inside [concave] surface position, respectively). Minor reconstructed surface error was observed on the dorsal cortex (0.216 mm ± 0.07, P > .05) for the outside surface and -0.185 mm ± 0.13, P > .05 for the inside surface. In addition, a displacement-based error estimation was used on 10 MC3 to identify poorly shaped elements in FEA, and the relations of finite element convergence analysis were used to present a framework for minimizing stress and strain errors in FEA. Finite element analysis errors of 3%-5% provided in the literature are unfortunate. Our proposed model, which presents an accurate FEA (error of 0.12%) in the smallest number of iterations possible, will assist future investigators to maximize FEA accuracy without the current runtime penalty.

Numerical time-domain modelling of hoof-ground interaction during the stance phase

BACKGROUND

Hoof-ground interaction impacts on the health and performance characteristics of horses. Due to complex interactions between hoof and ground during the stance phase, previous experimentally dominated studies concentrated on subproblems of the phenomena observed. A multidisciplinary methodology with mathematical modelling, material testing and in vivo experimental measurements seems promising.

OBJECTIVES

With the help of a mathematical approach, this contribution aims to explain from a biomechanical point of view the phenomena observed during experimental investigations (hoof acceleration, interacting forces) and aims to contribute to an overall experimental-mathematical multidisciplinary approach.

STUDY DESIGN

In silico modelling of hoof-ground interaction (limb, hoof and horizontally unbounded ground).

METHODS

Hoof-ground interaction is represented by a time-domain finite element model including the limb, the hoof and the unbounded representation of the ground via the scaled boundary finite element method to capture radiation damping during the stance phase. Motoric forces (driving forces) of the horse during locomotion are included.

RESULTS

Numerical model results for acceleration-time relations (hoof) at different trotting velocities are compared with previously published acceleration-time relations and show qualitative agreement. From the model approach, power loss due to different ground properties and ground damping is computed in combination with the maximum limb force during the stance phase.

MAIN LIMITATIONS

Intentionally, a simplified model approach for the material and structural representation of the limb, the hoof and the ground in terms of material features and spatial resolution has been used for this study, which might be the basis for a model refinement in terms of contact properties as well as the integration of bone and joint structures.

CONCLUSIONS

The comparison to experimentally obtained results demonstrates the applicability of the model, which, in turn, enables an insight into the processes taking place during hoof-ground interaction.

The effect of the sagittal ridge angle on cartilage stress in the equine metacarpo-phalangeal (fetlock) joint

Fatigue failure of bones of the metacarpo-phalangeal (fetlock, MCP) joint is common in thoroughbred racehorses. Stresses within the fetlock joint cartilages are affected by the morphology of the third metacarpal bone (MC3) and proximal phalangeal bone, and the steepness of the median sagittal ridge of MC3 is believed to be associated with fracture. This study investigated the influence of the steepness of the sagittal ridge on cartilage stress distribution using a finite element model of the joint. Changes to the steepness of the sagittal ridge were made by applying a parabolic function to the mesh, creating four different models with sagittal ridge angles ranging from 95° to 105°. In the fetlock joint of Thoroughbred racehorses, sagittal ridge angles of >100° were associated with higher Von Mises stresses in cartilage at the palmar aspect of the condylar groove than such stresses in joints with sagittal ridge angles of <100°. Stresses were high in the specific region where fractures are known to originate in MC3. This aspect of morphology of the fetlock joint thus appears to play an important role in the magnitude and distribution of cartilage stresses, which, when acting on the underlying hard tissues of the articular calcified cartilage and subchondral bone may play a role in the initiation of fatigue fracture in the third metacarpal bone.