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Druel J, Gelin N, Ollivier M, Roseren F, Chabrand P, Jacquet C, Argenson JNA. Outcomes of Short and Long Tibial Stems for Primary Total Knee Arthroplasty in a Population of Obese Patients at Two-Year Follow-Up: A Clinical and Biomechanical Study. J Arthroplasty 2024:S0883-5403(24)00146-3. [PMID: 38401608 DOI: 10.1016/j.arth.2024.02.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Obesity can be a source of higher failure rates and inferior clinical outcomes after total knee arthroplasty (TKA). The aim of this study was to compare outcomes, failure rates, and stress distributions of TKA in obese patients using a short, long, or no tibial stem. METHODS A matching process based on the type of stem used and the age allowed included 180 patients who had a body mass index (BMI) > 30 and underwent a TKA between January 2010 and December 2019, with a minimum follow-up of 2 years. They were classified as moderately obese (MO: 30 < BMI < 35, N = 90) and severely obese (SO: BMI > 35, N = 90). For each, 3 subgroups were defined: thirty patients received a 30 mm short stem (SS), thirty received a 100 mm long stem (LS), and thirty received no stem (NS). Patients were assessed preoperatively and postoperatively using the Knee Society Score (KSS). A finite element model was developed to evaluate the biomechanical effects of the tibial stem on stress distribution in the subchondral bone based on BMI. RESULTS The SS patients had significantly higher postoperative KSS knee score [MO: 88.9 (SS) versus 79 (LS) versus 80.6 (NS); SO: 84.5 versus 72.4 versus 78.2] (P < .0001) and function score [MO: 90.4 (SS) versus 78.4 (LS) versus 68.5 (NS); SO: 85.5 versus 73 versus 61.8] (P < .0001) compared to LS and NS patients. The biomechanical study demonstrated a BMI-dependent increase in stress in the subchondral bone in contact with the tibial components. These stresses were mainly distributed at the tibial cut for NS and along the stem for SS and LS. CONCLUSIONS A short, cemented tibial stem offers better functional outcomes without increasing failure rates compared to a longer stem during primary TKA in a population of obese patients at two-year follow-up. A short tibial stem does not lead to increased stress compared to an LS, at least for certain BMI categories.
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Affiliation(s)
- Julien Druel
- Department of Orthopedic Surgery, Institute for Locomotion, Aix-Marseille University, Marseille, France; Department of Biomechanics, Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Marseille, France
| | - Nolwenn Gelin
- Department of Biomechanics, Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Marseille, France
| | - Matthieu Ollivier
- Department of Orthopedic Surgery, Institute for Locomotion, Aix-Marseille University, Marseille, France; Department of Biomechanics, Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Marseille, France
| | - Flavy Roseren
- Department of Biomechanics, Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Marseille, France
| | - Patrick Chabrand
- Department of Biomechanics, Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Marseille, France
| | - Christophe Jacquet
- Department of Orthopedic Surgery, Institute for Locomotion, Aix-Marseille University, Marseille, France; Department of Biomechanics, Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Marseille, France
| | - Jean-Noel A Argenson
- Department of Orthopedic Surgery, Institute for Locomotion, Aix-Marseille University, Marseille, France; Department of Biomechanics, Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Marseille, France
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Winter R, Citarel A, Chabrand P, Chenel A, Bronsard N, Poujade T, Gauci MO. An Evaluation of the Reliability of Manual Landmark Identification on 3D Segmented Wrists. J Bone Joint Surg Am 2024; 106:315-322. [PMID: 37995208 DOI: 10.2106/jbjs.23.00173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND Three-dimensional (3D) preoperative planning is increasingly used in orthopaedic surgery. Two-dimensional (2D) characterization of distal radial deformities remains inaccurate, and 3D planning requires a reliable reference frame at the wrist. We aim to evaluate the reliability of the determination of anatomical points placed manually on 3D models of the radius to determine which of those points allow reliable morphometric measurements. METHODS Twenty-three radial scans were reconstructed in 3D. Five operators specialized in the upper limb manually positioned 8 anatomical points on each model. One of the operators repeated the operation 6 times. The anatomical points were based on previously published 3D models used for radial inclination and dorsopalmar tilt measurements. The repeatability and reproducibility of the measurements derived using this manual landmarking were calculated using different measurement methods based on the identified points. An error of ≤2° was considered clinically acceptable. RESULTS This study of intraobserver and interobserver variability of the anatomic points allowed us to determine the least variable and most accurately defined points. The middle of the ulnar border of the radius, the radial styloid, and the midpoint of the ulnar incisura of the radius were the least variable. The palmar and dorsal ends of the ridge delineating the scaphoid and lunate facets were the most variable. Only 1 of the radial inclination measurement methods was clinically acceptable; the others had a repeatability and reproducibility limit of >2°, making those measurements clinically unacceptable. CONCLUSIONS The use of isolated points seems insufficient for the development of a wrist reference frame, especially for the purpose of measuring dorsopalmar tilt. If one concurs that an error of 2° is unacceptable for all distal radial measurements, then clinicians should avoid using 3D landmarked points, due to their unreliability, except for radial inclination measured using the radial styloid and the midpoint of the ulnar edge of the radius. A characterization of the wrist using 3D shapes that fit the articular surface of the radius should be considered. LEVEL OF EVIDENCE Diagnostic Level III . See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Rémy Winter
- Unité de Recherche Clinique Côte d'Azur (UR2CA), Université Côte d'Azur, Nice, France
- Hôpital Pasteur 2, Centre Hospitalier Universitaire de Nice, Nice, France
- Newclip Technics, Haute-Goulaine, France
| | | | - Patrick Chabrand
- Institut des Sciences Mouvement, Aix-Marseille University, French National Centre for Scientific Research, Marseille, France
| | | | - Nicolas Bronsard
- Unité de Recherche Clinique Côte d'Azur (UR2CA), Université Côte d'Azur, Nice, France
- Hôpital Pasteur 2, Centre Hospitalier Universitaire de Nice, Nice, France
| | | | - Marc-Olivier Gauci
- Unité de Recherche Clinique Côte d'Azur (UR2CA), Université Côte d'Azur, Nice, France
- Hôpital Pasteur 2, Centre Hospitalier Universitaire de Nice, Nice, France
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Micicoi L, Gonzalez JF, Gauci MO, Chabrand P, Machado A, Bronsard N, Micicoi G. Acute compartment syndrome of the lower limbs: Fasciotomy or dermofasciotomy? A cadaver study of compartment pressures. Orthop Traumatol Surg Res 2024; 110:103736. [PMID: 37890523 DOI: 10.1016/j.otsr.2023.103736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 03/06/2023] [Accepted: 03/15/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Acute compartment syndrome (ACS) of the lower limbs is a function-threatening event usually managed by extended dermofasciotomy. Closure of the skin may be delayed, creating a risk of complications when there is an underlying fracture. Early treatment at the pre-ACS stage might allow isolated fasciotomy with no skin incision. The primary objective of this study was to compare intracompartmental pressure (ICP) changes after fasciotomy and after dermofasciotomy. The secondary objectives were to evaluate potential associations linking the starting ICP to achievement of an ICP below the physiological cut-off of 10mm Hg and to determine whether the ICP changes after fasciotomy and dermofasciotomy varied across muscle compartments. HYPOTHESIS Fasciotomy with no skin incision may not provide a sufficient ICP decrease, depending on the initial ICP value. MATERIAL AND METHODS A previously validated model of cadaver ACS of the lower limbs was used. Saline was injected gradually to raise the ICP to>15mmHg (ICP15), >30mmHg (ICP30), and >50mmHg (ICP50). We studied 70 leg compartments (anterior, lateral, and superficial posterior) in 13 cadavers (mean age, 89.1±4.6years). ICP was monitored continuously. Percutaneous, minimally invasive fasciotomy consisting in one to three 1-cm incisions was performed in each compartment. ICP was measured before and after fasciotomy then after subsequent skin incision. The objective was to decrease the ICP below 10mmHg after fasciotomy or dermofasciotomy. RESULTS Overall, mean ICP was 37.8±19.1mmHg after the injection of 184.0±133.01mL of saline. In the ICP15 group, the mean ICP of 16.1mmHg fell to 1.4mmHg after fasciotomy (ΔF=14.7) and 0.3mmHg after dermofasciotomy (ΔDF=1.1). Corresponding values in the ICP30 group were 33.9mmHg, 4.7mmHg (ΔF=29.2), and 1.2mmHg (ΔDF=3.5); and in the ICP50 group, 63.7mmHg, 17.0mmHg (ΔF=46.7), and 1.2mmHg (ΔDF=15.8). Thus, in the group with initial pressures >50mmHg, the ICP decrease was greater after both procedures, but fasciotomy alone nonetheless failed to achieve physiological values (<10mmHg). The pressure changes were not significantly associated with the compartment involved (anterior, lateral, or superficial posterior) (p<0.05). CONCLUSION Under the conditions of this study, higher baseline ICPs were associated with larger ICP drops after fasciotomy and dermofasciotomy. Nevertheless, when the baseline ICP exceeded 50mmHg, fasciotomy alone failed to decrease the ICP below 10mmHg. Adding a skin incision achieved this goal. LEVEL OF EVIDENCE IV, experimental study.
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Affiliation(s)
- Lolita Micicoi
- IULS-University Institute for Locomotion and Sports, Pasteur 2 Hospital, 06000 Nice, France; Unité de Recherche Clinique Côte d'Azur (UR2CA), CHU de Nice, Université Côte d'Azur (UCA), Nice, France
| | - Jean-François Gonzalez
- IULS-University Institute for Locomotion and Sports, Pasteur 2 Hospital, 06000 Nice, France; Unité de Recherche Clinique Côte d'Azur (UR2CA), CHU de Nice, Université Côte d'Azur (UCA), Nice, France
| | - Marc-Olivier Gauci
- IULS-University Institute for Locomotion and Sports, Pasteur 2 Hospital, 06000 Nice, France; Unité de Recherche Clinique Côte d'Azur (UR2CA), CHU de Nice, Université Côte d'Azur (UCA), Nice, France
| | | | - Axel Machado
- IULS-University Institute for Locomotion and Sports, Pasteur 2 Hospital, 06000 Nice, France; Unité de Recherche Clinique Côte d'Azur (UR2CA), CHU de Nice, Université Côte d'Azur (UCA), Nice, France
| | - Nicolas Bronsard
- IULS-University Institute for Locomotion and Sports, Pasteur 2 Hospital, 06000 Nice, France; Unité de Recherche Clinique Côte d'Azur (UR2CA), CHU de Nice, Université Côte d'Azur (UCA), Nice, France
| | - Grégoire Micicoi
- IULS-University Institute for Locomotion and Sports, Pasteur 2 Hospital, 06000 Nice, France; Unité de Recherche Clinique Côte d'Azur (UR2CA), CHU de Nice, Université Côte d'Azur (UCA), Nice, France.
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Ait Oumghar I, Barkaoui A, Merzouki T, Guenoun D, Chabrand P. Chemotherapy and adjuvant therapies' impact on the internal remodeling process of bone and its mechanical behavior for breast cancer patients. Int J Numer Method Biomed Eng 2024; 40:e3788. [PMID: 37960964 DOI: 10.1002/cnm.3788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/17/2023] [Accepted: 10/01/2023] [Indexed: 11/15/2023]
Abstract
Breast cancer is a significant public health issue affecting women worldwide. While advancements in treatment options have led to improved survival rates, the impact of breast cancer and its treatments on bone health cannot be overlooked. Bone remodeling is a complex process regulated by the delicate balance between bone formation and resorption. Any disruption to this balance can lead to decreased bone density, increased fracture risk, and compromised physical function. To investigate the effects of breast cancer and its treatments on bone remodeling, a finite element model was developed in this study. This model incorporated bone remodeling equations to simulate the mechanical behavior of bone under different conditions. The ABAQUS/UMAT software was used to simulate the behavior of bone tissue under the influence of breast cancer and treatments. Our findings suggest that bone loss is more pronounced after secondary breast cancer and treatment, leading to bone loss (6%-19% decrease in BV/TV), reduced bone stimulation, and decreased effectiveness of physical activity on recovery. These results highlight the importance of early intervention and management of bone health in breast cancer patients to mitigate the negative impact of cancer and treatment on bone remodeling.
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Affiliation(s)
- Imane Ait Oumghar
- Laboratoire des Energies Renouvelables et Matériaux Avancés (LERMA), Université Internationale de Rabat, Rabat, Morocco
- Institut des Sciences du Mouvement (ISM), Université Aix-Marseille, Marseille, France
| | - Abdelwahed Barkaoui
- Laboratoire des Energies Renouvelables et Matériaux Avancés (LERMA), Université Internationale de Rabat, Rabat, Morocco
| | - Tarek Merzouki
- Laboratoire d' Ingénierie des Systèmes de Versailles LISV, IUT de Mantes en Yvelines Université de Versailles Saint-Quentin, Mantes-La-Jolie, France
| | - Daphne Guenoun
- Institut des Sciences du Mouvement (ISM), Université Aix-Marseille, Marseille, France
| | - Patrick Chabrand
- Institut des Sciences du Mouvement (ISM), Université Aix-Marseille, Marseille, France
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Dufrénot M, Dagneaux L, Fernando C, Chabrand P, Ollivier M, Lintz F. Three-dimensional biometrics using weight-bearing imaging shows relationship between knee and hindfoot axial alignment. Orthop Traumatol Surg Res 2023; 109:103482. [PMID: 36435375 DOI: 10.1016/j.otsr.2022.103482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/15/2022] [Accepted: 08/25/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Existence of a relationship between knee and hindfoot alignments is commonly accepted, but not clearly proven. While studied in the coronal plane using 2D imaging, axial alignment has not been studied yet, likely requiring 3D measurements. We aimed to investigate how knee and hindfoot rotational alignments are related using 3D biometrics and modern 3D weight-bearing technologies. HYPOTHESIS Hindfoot alignment is correlated with femoral and tibial torsions. PATIENTS AND METHODS All patients who underwent both weight-bearing CT (WBCT) and low dose biplanar radiographs (LDBR) were selected in this retrospective observational study, resulting in a cohort of 157 lower limbs from 99 patients. Patients' pathologies were stratified in subgroups and those with a history of trauma or surgery affecting lower limb alignment were excluded. Foot Ankle Offset was calculated from WBCT; femoral and tibial torsions and coronal alignment were calculated from LDBR, respectively. RESULTS Overall, mean Foot Ankle Offset was 1.56% (SD 7.4), mean femoral anteversion was 15.6° (SD 9.5), and mean external tibial torsion was 32.6° (SD 7.6). Moderate negative correlation between Tibial Torsion and Foot Ankle Offset was found in the whole series (rho=-0.23, p=0.003) and for non-pathologic patients (rho=-0.27, p=0.01). Linear models to estimate Tibial Torsion with Foot Ankle Offset and conversely were found, with a low adjusted R2 (3% DISCUSSION External tibial rotation was associated with varus hindfoot configuration in the group without pathologies, suggesting that compensatory mechanisms may occur between knee and hindfoot alignments. In pathological cases, however, the same relationship wasn't found, raising concerns about compensatory failure in spite of the numbers available. We didn't find similar correlations with the femur possibly because the hip has a degree of liberty in the axial plane. LEVEL OF EVIDENCE III, retrospective comparative study.
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Affiliation(s)
- Maryama Dufrénot
- CNRS, institut des sciences du mouvement Étienne-Jules Marey, UMR 7287, Aix-Marseille université, 163, avenue de Luminy, 13009 Marseille, France; Institut du membre inférieur et de l'appareil locomoteur, APHM, hôpital Sainte-Marguerite, 270, boulevard de Sainte-Marguerite, 13009 Marseille, France; Newclip Technics, PA de la Lande Saint-Martin, 45, rue des Garottières, 44115 Haute-Goulaine, France.
| | - Louis Dagneaux
- Département de chirurgie orthopédique du membre inférieur, CHU de Montpellier, hôpital Lapeyronie, 371 avenue du Doyen Gaston-Giraud, 39295 Montpellier cedex 05, France; Laboratoire de mécanique et génie civil (LMGC), université de Montpellier, 860, rue de Saint-Priest, 34090 Montpellier, France
| | - Celine Fernando
- Service de chirurgie du pied et de la cheville, Ramsay Santé - clinique de l'Union, boulevard de Ratalens, 31240 Saint-Jean, France
| | - Patrick Chabrand
- CNRS, institut des sciences du mouvement Étienne-Jules Marey, UMR 7287, Aix-Marseille université, 163, avenue de Luminy, 13009 Marseille, France; Institut du membre inférieur et de l'appareil locomoteur, APHM, hôpital Sainte-Marguerite, 270, boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - Matthieu Ollivier
- CNRS, institut des sciences du mouvement Étienne-Jules Marey, UMR 7287, Aix-Marseille université, 163, avenue de Luminy, 13009 Marseille, France; Institut du membre inférieur et de l'appareil locomoteur, APHM, hôpital Sainte-Marguerite, 270, boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - François Lintz
- Service de chirurgie du pied et de la cheville, Ramsay Santé - clinique de l'Union, boulevard de Ratalens, 31240 Saint-Jean, France
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Ait Oumghar I, Barkaoui A, Ghazi AE, Chabrand P. Modeling and simulation of bone cells dynamic behavior under the late effect of breast cancer treatments. Med Eng Phys 2023; 115:103982. [PMID: 37120177 DOI: 10.1016/j.medengphy.2023.103982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 04/14/2023] [Accepted: 04/19/2023] [Indexed: 05/01/2023]
Abstract
Breast Cancer (BC) treatments have been proven to interfere with the health of bones. Chemotherapy and endocrinal treatment regimens such as tamoxifen and aromatase inhibitors are frequently prescribed for women with BC. However, these drugs increase bone resorption and reduce the Bone Mineral Density (BMD), thus increasing the risk of bone fracture. In the current study, a mechanobiological bone remodeling model has been developed by coupling cellular activities, mechanical stimuli, and the effect of breast cancer treatments (chemotherapy, tamoxifen, and aromatase inhibitors). This model algorithm has been programmed and implemented on MATLAB software to simulate different treatment scenarios and their effects on bone remodeling and also predict the evolution of Bone Volume fraction (BV/TV) and the associated Bone Density Loss (BDL) over a period of time. The simulation results, achieved from different combinations of Breast Cancer treatments, allow the researchers to predict the intensity of each combination treatment on BV/TV and BMD. The combination of chemotherapy, tamoxifen, and aromatase inhibitors, followed by the combination of chemotherapy and tamoxifen remain the most harmful regimen. This is because they have a strong ability to induce the bone degradation which is represented by a decrease of 13.55% and 11.55% of the BV/TV value, respectively. These results were compared with the experimental studies and clinical observations which showed good agreement. The proposed model can be used by clinicians and physicians to choose the most appropriate combination of treatments, according to the patient's case.
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Affiliation(s)
- Imane Ait Oumghar
- Université Internationale de Rabat, LERMA Lab, Rocade Rabat Salé 11100, Rabat-Sala El Jadida, Morocco; Université Aix-Marseille, ISM, 163 av. de Luminy F-13288, Marseille cedex 09, France
| | - Abdelwahed Barkaoui
- Université Internationale de Rabat, LERMA Lab, Rocade Rabat Salé 11100, Rabat-Sala El Jadida, Morocco.
| | - Abdellatif El Ghazi
- Université Internationale de Rabat, TIC Lab, Rocade Rabat Salé 11100, Rabat-Sala El Jadida, Morocco
| | - Patrick Chabrand
- Université Aix-Marseille, ISM, 163 av. de Luminy F-13288, Marseille cedex 09, France
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Caubère A, Roseren F, Aullo-Rasser G, Pithioux M, Ollivier M, Chabrand P. Osteochondral autograft transplantation (mosaicplasty): What is the impact of plug diameter in cartilage repair? Int Orthop 2023; 47:623-630. [PMID: 36637461 DOI: 10.1007/s00264-022-05686-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 12/29/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE To compare the mechanical stress applied to our grafted defect area according to the diameter of the plugs used in the treatment of osteochondral lesion with osteochondral autograft transplantation (OAT) procedure. METHODS A biomechanical study was conducted on eight cadaveric knees. A 20-mm defect was created in the weight-bearing zone on the medial femoral condyle then filled either with three plugs of 8 mm, or with four plugs of 6 mm, or with 6 plugs of 4 mm diameter. After the preparation of the specimens, each knee was installed on a mechanical test bench (Instron 5566A). A continuous axial compression of 700 N at 10 mm.min-1 was exerted on the joint. A K-scan 4000-type pressure sheet was used to record the contact area (mm2), the mean pressure (MPa), and the maximum pressure (MPa) on the area of interest. RESULTS The differences found between the conditions were not statistically significant but showed tendencies. Filling the defect with six plugs of 4 mm restores a larger contact surface compared with the other plugs. The use of 8- and 6-mm grafts lead to a respective increase of 12% and 52% of the mean pressure compared with the 4 mm grafts. This difference was also found for the maximum pressure (36% and 129%). Regardless of the diameter of the plugs used, filling the lesion reduces the mean pressure exerted on the healthy cartilage by 19%. DISCUSSION A trend emerged towards a better restoration of the cartilage surface and a more harmonious distribution of the pressures exerted in favour of the grafts of smaller diameter. A larger study is needed to obtain a statistically significant result.
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Affiliation(s)
- Alexandre Caubère
- Department of Orthopaedic Surgery and Traumatology, Military Hospital Sainte-Anne, 2, Bd Sainte Anne, BP600 83800, Toulon, France.
| | - Flavy Roseren
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Anatomy laboratory, Marseille, France
- Mecabio Platform, ISM, Aix Marseille University, 13009, Marseille, France
- Department of Orthopaedic Surgery and Traumatology, Institute of Locomotion, Sainte-Marguerite Hospital, Hospitalo-University Center of Marseille, APHM, Aix-Marseille University, 270, Boulevard de Sainte-Marguerite, 13009, Marseille, France
| | - Gaëtan Aullo-Rasser
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Anatomy laboratory, Marseille, France
- RLC Systems & Research, 13008, Marseille, France
- Department of Orthopaedic Surgery and Traumatology, Institute of Locomotion, Sainte-Marguerite Hospital, Hospitalo-University Center of Marseille, APHM, Aix-Marseille University, 270, Boulevard de Sainte-Marguerite, 13009, Marseille, France
| | - Martine Pithioux
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Anatomy laboratory, Marseille, France
- Department of Orthopaedic Surgery and Traumatology, Institute of Locomotion, Sainte-Marguerite Hospital, Hospitalo-University Center of Marseille, APHM, Aix-Marseille University, 270, Boulevard de Sainte-Marguerite, 13009, Marseille, France
| | - Matthieu Ollivier
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Anatomy laboratory, Marseille, France
- RLC Systems & Research, 13008, Marseille, France
| | - Patrick Chabrand
- Aix Marseille Univ, APHM, CNRS, ISM, Mecabio Platform, Anatomy laboratory, Marseille, France
- Department of Orthopaedic Surgery and Traumatology, Institute of Locomotion, Sainte-Marguerite Hospital, Hospitalo-University Center of Marseille, APHM, Aix-Marseille University, 270, Boulevard de Sainte-Marguerite, 13009, Marseille, France
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Winter R, Citarel A, Chabrand P, Chenel A, Poujade T, Gauci MO. Évaluation de la fiabilité du placement manuel de point anatomiques sur des poignets segmentés en 3D: Vers une nouvelle façon de caractériser l’articulation? Hand Surgery and Rehabilitation 2022. [DOI: 10.1016/j.hansur.2022.09.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ait Oumghar I, Barkaoui A, Chabrand P. ABSTRACTS 47th congress of the Society of Biomechanics. Comput Methods Biomech Biomed Engin 2022. [DOI: 10.1080/10255842.2022.2116885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- I. Ait Oumghar
- LERMA Lab, Université Internationale de Rabat, Rabat-Sala El Jadida, Morocco
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France
| | - A. Barkaoui
- LERMA Lab, Université Internationale de Rabat, Rabat-Sala El Jadida, Morocco
| | - P. Chabrand
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France
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Ait Oumghar I, Barkaoui A, Chabrand P, Ghazi AE, Jeanneau C, Guenoun D, Pivonka P. Experimental-based mechanobiological modeling of the anabolic and catabolic effects of breast cancer on bone remodeling. Biomech Model Mechanobiol 2022; 21:1841-1856. [PMID: 36001274 DOI: 10.1007/s10237-022-01623-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/02/2022] [Indexed: 11/02/2022]
Abstract
Bone is a biological tissue characterized by its hierarchical organization. This material has the ability to be continually renewed, which makes it highly adaptative to external loadings. Bone renewing is managed by a dynamic biological process called bone remodeling (BR), where continuous resorption of old bone and formation of new bone permits to change the bone composition and microstructure. Unfortunately, because of several factors, such as age, hormonal imbalance, and a variety of pathologies including cancer metastases, this process can be disturbed leading to various bone diseases. In this study, we have investigated the effect of breast cancer (BC) metastases causing osteolytic bone loss. BC has the ability to affect bone quantity in different ways in each of its primary and secondary stages. Based on a BR mathematical model, we modeled the BC cells' interaction with bone cells to assess their effect on bone volume fraction (BV/TV) evolution during the remodeling process. Some of the parameters used in our model have been determined experimentally using the enzyme-linked immune-sorbent assay (ELISA) and the MTT assay. Our numerical simulations show that primary BC plays a significant role in enhancing bone-forming cells' activity leading to a 6.22% increase in BV/TV over 1 year. On the other hand, secondary BC causes a noticeable decrease in BV/TV reaching 15.74% over 2 years.
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Affiliation(s)
- Imane Ait Oumghar
- LERMA Lab, Université Internationale de Rabat, Rocade Rabat Salé 11100, Rabat-Sala El Jadida, Morocco.,Université Aix-Marseille, ISM, 163 av. de Luminy, 13288, Marseille Cedex 09, France
| | - Abdelwahed Barkaoui
- LERMA Lab, Université Internationale de Rabat, Rocade Rabat Salé 11100, Rabat-Sala El Jadida, Morocco.
| | - Patrick Chabrand
- Université Aix-Marseille, ISM, 163 av. de Luminy, 13288, Marseille Cedex 09, France
| | - Abdellatif El Ghazi
- TIC Lab, Université Internationale de Rabat, Rocade Rabat Salé 11100, Rabat-Sala El Jadida, Morocco
| | - Charlotte Jeanneau
- Université Aix-Marseille, ISM, 163 av. de Luminy, 13288, Marseille Cedex 09, France
| | - Daphne Guenoun
- Université Aix-Marseille, ISM, 163 av. de Luminy, 13288, Marseille Cedex 09, France
| | - Peter Pivonka
- Biomechanics and Spine Research Group, Queensland University of Technology at the Centre for Children's Health Research, South Brisbane, 4101, QLD, Australia
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11
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Rousseau N, Chabrand P, Destainville A, Richart O, Milan JL. Mechanobiological model to study the influence of screw design and surface treatment on osseointegration. Comput Methods Biomech Biomed Engin 2021; 25:273-289. [PMID: 34854783 DOI: 10.1080/10255842.2021.1950144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aims at suggesting a new approach to peri-implant healing models, providing a set of taxis-diffusion-reaction equations under the combined influence of mechanical and biochemical factors. Early events of osseointegration were simulated for titanium screw implants inserted into a pre-drilled trabecular bone environment, up to 12 weeks of peri-implant bone healing. Simulations showed the ability of the model to reproduce biological events occurring at the implant interface through osteogenesis. Implants with shallow healing chamber showed higher proportions of lamellar bone, enhanced by the increase of mechanical stimulation. Osteoconduction was observed through the surface treatment model and similar bone healing patterns compared to in vivo studies.
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Affiliation(s)
- Nicolas Rousseau
- CNRS, ISM, Aix Marseille University, Marseille, France.,Selenium Medical, La Rochelle, France
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12
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Rousseau N, Msolli I, Chabrand P, Destainville A, Richart O, Milan JL. Local tissue effects and peri-implant bone healing induced by implant surface treatment: an in vivo study in the sheep. J Periodontal Res 2021; 56:789-803. [PMID: 33788298 DOI: 10.1111/jre.12878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/16/2021] [Accepted: 03/03/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to assess, through biological analysis, the local effects and osseointegration of dental implants incorporating surface micro/nanofeatures compared with implants of identical design without surface treatment. BACKGROUND Known to impact bone cell behavior, surface chemical and topography modifications target improved osseointegration and long-term success of dental implants. Very few studies assess the performance of implants presenting both micro- and nanofeatures in vivo on the animal models used in preclinical studies for medical device certification. METHODS Implant surfaces were characterized in terms of topography and surface chemical composition. After 4 weeks and 13 weeks of implantation in sheep femoral condyles, forty implants were evaluated through micro-computed tomography, histopathologic, and histomorphometric analyses. RESULTS No local adverse effects were observed around implants. Histomorphometric analyses showed significantly higher bone-to-implant contact in the coronal region of the surface-treated implant at week 4 and week 13, respectively, was 79.3 ± 11.2% and 86.4 ± 6.7%, compared with the untreated implants (68.3 ± 8.8% and 74.8 ± 13%). Micro-computed tomography analyses revealed that healing patterns differed between coronal and apical regions, with higher coronal bone-to-implant contact at week 13. Histopathologic results showed, at week 13, bone healing around the surface-treated implant with undistinguishable defect margins, while the untreated implant still presented bone condensation and traces of the initial drill defect. CONCLUSION Our results suggest that the surface-treated implant not only shows no deleterious effects on local tissues but also promotes faster bone healing around the implant.
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Affiliation(s)
- Nicolas Rousseau
- CNRS, ISM, Aix Marseille Univ, Marseille, France.,Selenium Medical, La Rochelle, France
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13
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Ait Oumghar I, Barkaoui A, Chabrand P. Toward a Mathematical Modeling of Diseases' Impact on Bone Remodeling: Technical Review. Front Bioeng Biotechnol 2020; 8:584198. [PMID: 33224935 PMCID: PMC7667152 DOI: 10.3389/fbioe.2020.584198] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/30/2020] [Indexed: 12/18/2022] Open
Abstract
A wide variety of bone diseases have hitherto been discovered, such as osteoporosis, Paget’s disease, osteopetrosis, and metastatic bone disease, which are not well defined in terms of changes in biochemical and mechanobiological regulatory factors. Some of these diseases are secondary to other pathologies, including cancer, or to some clinical treatments. To better understand bone behavior and prevent its deterioration, bone biomechanics have been the subject of mathematical modeling that exponentially increased over the last years. These models are becoming increasingly complex. The current paper provides a timely and critical analysis of previously developed bone remodeling mathematical models, particularly those addressing bone diseases. Besides, mechanistic pharmacokinetic/pharmacodynamic (PK/PD) models, which englobe bone disease and its treatment’s effect on bone health. Therefore, the review starts by presenting bone remodeling cycle and mathematical models describing this process, followed by introducing some bone diseases and discussing models of pathological mechanisms affecting bone, and concludes with exhibiting the available bone treatment procedures considered in the PK/PD models.
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Affiliation(s)
- Imane Ait Oumghar
- Laboratoire des Energies Renouvelables et Matériaux Avancés (LERMA), Université Internationale de Rabat, Rabat-Sala El Jadida, Morocco.,Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France
| | - Abdelwahed Barkaoui
- Laboratoire des Energies Renouvelables et Matériaux Avancés (LERMA), Université Internationale de Rabat, Rabat-Sala El Jadida, Morocco
| | - Patrick Chabrand
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France
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14
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Goin B, Renault JB, Thibes L, Chabrand P. Influence of material properties and boundary conditions on patient-specific models. Comput Methods Biomech Biomed Engin 2020; 24:429-439. [PMID: 33063536 DOI: 10.1080/10255842.2020.1833326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Patient-specific finite element models (PSFEM) are becoming more and more used. Different methods for assigning their material properties were studied on PSFEMs of 9 tibias along with the minimal required length of the CT acquisition window. Material properties are generally attributed to the PSFEM using relationships linking the grayscale of CT scans to the elasticity moduli. Using cortical-specific and trabecular-specific relationships or a generic one, did not result in significant differences. However, the use of homogeneous elastic moduli in the cortical and trabecular regions led to considerable differences. The result highlight that the PSFEM must comprise at least 40% of the tibia to ensure consistent results in the proximal 20%.
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Affiliation(s)
- Bastien Goin
- CNRS, ISM, Aix-Marseille Universite, Marseille, France
| | - Jean-Baptiste Renault
- CNRS, ISM, Aix-Marseille Universite, Marseille, France.,Department of orthopaedics and Traumatology, APHM, Institute for Locomotion, Sainte-Marguerite Hospital, Marseille, France
| | - Lisa Thibes
- CNRS, ISM, Aix-Marseille Universite, Marseille, France
| | - Patrick Chabrand
- CNRS, ISM, Aix-Marseille Universite, Marseille, France.,Department of orthopaedics and Traumatology, APHM, Institute for Locomotion, Sainte-Marguerite Hospital, Marseille, France
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15
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Rousseau N, Msolli I, Chabrand P, Destainville A, Richart O, Milan J. Local tissue effects and peri‐implant bone original architecture recovery induced by implants micro‐ and nanotopography: an in vivo study in the sheep. Clin Oral Implants Res 2020. [DOI: 10.1111/clr.130_13644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Aüllo-Rasser G, Dousset E, Roffino S, Zahouani H, Lecurieux-Clerville R, Argenson JN, Chabrand P. Early-stage knee OA induced by MIA and MMT compared in the murine model via histological and topographical approaches. Sci Rep 2020; 10:15430. [PMID: 32963278 PMCID: PMC7508866 DOI: 10.1038/s41598-020-72350-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/24/2020] [Indexed: 01/07/2023] Open
Abstract
Osteoarthritis (OA) is a common degenerative disease whose early management includes promising mechanical treatments. New treatments are initially validated using an animal model in which OA is induced. The MMT (mechanical induction) and MIA (chemical induction) models of OA induction are widespread, but their use to generate early OA is poorly documented. We analyzed and compared early-stage knee OA-induction via these two methods in 16 rats divided into two groups. After 4 weeks of induction, the knees were sampled and studied using both histology (Toluidine Blue and Sirius Red) and surface topology, an innovative technique for characterizing osteoarthritic cartilage. The Mankin-modified score confirms that the two OA-induction models evolved at the same speed. At this early stage, the two models can be differentiated morphologically, although no significant differences were revealed by either cellularity or birefringence analysis. However, the topological analysis generated two forms of quantitative data, the deformation ratio and the cohesion index, that differentiated between the two groups. Thus, the early-stage OA induced by these two models is revealed to differ. The patterns of cartilage damage induced point to MMT as the better choice to assess mechanical approaches to clinical OA treatment.
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Affiliation(s)
- Gaetan Aüllo-Rasser
- CNRS, ISM UMR 7287, Aix-Marseille University, 13009, Marseille, France. .,Department of Orthopaedics and Traumatology, APHM, Institute for Locomotion, Sainte-Marguerite Hospital, 13009, Marseille, France. .,RLC Systems & Research, 13008, Marseille, France.
| | - Erick Dousset
- CNRS, ISM UMR 7287, Aix-Marseille University, 13009, Marseille, France
| | - Sandrine Roffino
- CNRS, ISM UMR 7287, Aix-Marseille University, 13009, Marseille, France.,Department of Orthopaedics and Traumatology, APHM, Institute for Locomotion, Sainte-Marguerite Hospital, 13009, Marseille, France
| | - Hassan Zahouani
- Laboratoire de Tribologie et de Dynamique des Systèmes, 69134, Ecully, France
| | | | - Jean-Noël Argenson
- CNRS, ISM UMR 7287, Aix-Marseille University, 13009, Marseille, France.,Department of Orthopaedics and Traumatology, APHM, Institute for Locomotion, Sainte-Marguerite Hospital, 13009, Marseille, France
| | - Patrick Chabrand
- CNRS, ISM UMR 7287, Aix-Marseille University, 13009, Marseille, France.,Department of Orthopaedics and Traumatology, APHM, Institute for Locomotion, Sainte-Marguerite Hospital, 13009, Marseille, France
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17
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Guenoun D, Pithioux M, Souplet JC, Guis S, Le Corroller T, Fouré A, Pauly V, Mattei JP, Bernard M, Guye M, Chabrand P, Champsaur P, Bendahan D. Assessment of proximal femur microarchitecture using ultra-high field MRI at 7 Tesla. Diagn Interv Imaging 2019; 101:45-53. [PMID: 31331831 DOI: 10.1016/j.diii.2019.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/07/2019] [Accepted: 06/28/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The purpose of this study was to investigate bone microarchitecture of cadaveric proximal femurs using ultra-high field (UHF) 7-Tesla magnetic resonance imaging (MRI) and to compare the corresponding metrics with failure load assessed during mechanical compression test and areal bone mineral density (ABMD) measured using dual-energy X-ray absorptiometry. MATERIALS AND METHODS ABMD of ten proximal femurs from five cadavers (5 women; mean age=86.2±3.8 (SD) years; range: 82.5-90 years) were investigated using dual-energy X-ray absorptiometry and the bone volume fraction, trabecular thickness, trabecular spacing, fractal dimension, Euler characteristics, connectivity density and degree of anisotropy of each femur was quantified using UHF MRI. The whole set of specimens underwent mechanical compression tests to failure. The inter-rater reliability of microarchitecture characterization was assessed with the intraclass correlation coefficient (ICC). Associations were searched using correlation tests and multiple regression analysis. RESULTS The inter-rater reliability for bone microarchitecture parameters measurement was good with ICC ranging from 0.80 and 0.91. ABMD and the whole set of microarchitecture metrics but connectivity density significantly correlated with failure load. Microarchitecture metrics correlated to each other but did not correlate with ABMD. Multiple regression analysis disclosed that the combination of microarchitecture metrics and ABMD improved the association with failure load. CONCLUSION Femur bone microarchitecture metrics quantified using UHF MRI significantly correlated with biomechanical parameters. The multimodal assessment of ABMD and trabecular bone microarchitecture using UHF MRI provides more information about fracture risk of femoral bone and might be of interest for future investigations of patients with undetected osteoporosis.
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Affiliation(s)
- D Guenoun
- Department of Radiology, Institute for Locomotion, Sainte-Marguerite Hospital, APHM, 13009 Marseille, France; CNRS, ISM, Institute Movement Sci, Aix-Marseille Université, 13000 Marseille, France.
| | - M Pithioux
- CNRS, ISM, Institute Movement Sci, Aix-Marseille Université, 13000 Marseille, France
| | - J-C Souplet
- CNRS, CRMBM UMR 7339, Aix-Marseille Université, 13385 Marseille, France
| | - S Guis
- CNRS, CRMBM UMR 7339, Department of Rheumatology, Aix-Marseille Université, AP-HM, 13000 Marseille, France
| | - T Le Corroller
- Department of Radiology, Institute for Locomotion, Sainte-Marguerite Hospital, APHM, 13009 Marseille, France; CNRS, ISM, Institute Movement Sci, Aix-Marseille Université, 13000 Marseille, France
| | - A Fouré
- CNRS, CRMBM UMR 7339, Aix-Marseille Université, 13385 Marseille, France
| | - V Pauly
- Unité de recherche EA3279, santé publique et maladies chroniques: qualité de vie concepts, usages et limites, déterminants, Aix-Marseille Université, 13005 Marseille, France; Service de santé publique et d'information médicale, Hôpital de la Conception, APHM, 13000 Marseille, France
| | - J-P Mattei
- CNRS, CRMBM UMR 7339, Department of Rheumatology, Aix-Marseille Université, AP-HM, 13000 Marseille, France
| | - M Bernard
- CNRS, CRMBM UMR 7339, Aix-Marseille Université, 13385 Marseille, France
| | - M Guye
- CNRS, CRMBM UMR 7339, Aix-Marseille Université, 13385 Marseille, France
| | - P Chabrand
- CNRS, ISM, Institute Movement Sci, Aix-Marseille Université, 13000 Marseille, France
| | - P Champsaur
- Department of Radiology, Institute for Locomotion, Sainte-Marguerite Hospital, APHM, 13009 Marseille, France; CNRS, ISM, Institute Movement Sci, Aix-Marseille Université, 13000 Marseille, France
| | - D Bendahan
- CNRS, CRMBM UMR 7339, Aix-Marseille Université, 13385 Marseille, France
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18
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Goin B, Rafael P, Blanc Q, Cachon T, Buttin P, Carozzo C, Chabrand P, Viguier E. Biomechanical analysis of a ligament fixation system for CCL reconstruction in a canine cadaver model. Comput Methods Biomech Biomed Engin 2019. [DOI: 10.1080/10255842.2020.1713499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- B. Goin
- Aix-Marseille Université, CNRS, ISM, Marseille, France
- Université de Lyon, VetAgro Sup, ICE, Marcy l’Etoile, France
| | - P. Rafael
- Université de Lyon, VetAgro Sup, ICE, Marcy l’Etoile, France
| | - Q. Blanc
- Université de Lyon, VetAgro Sup, ICE, Marcy l’Etoile, France
| | - T. Cachon
- Université de Lyon, VetAgro Sup, ICE, Marcy l’Etoile, France
| | - P. Buttin
- Université de Lyon, VetAgro Sup, ICE, Marcy l’Etoile, France
| | - C. Carozzo
- Université de Lyon, VetAgro Sup, ICE, Marcy l’Etoile, France
| | - P. Chabrand
- Aix-Marseille Université, CNRS, ISM, Marseille, France
| | - E. Viguier
- Université de Lyon, VetAgro Sup, ICE, Marcy l’Etoile, France
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19
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Sautet P, Giorgi H, Chabrand P, Tropiano P, Argenson JN, Parratte S, Blondel B. Corrigendum to "Is anatomic acetabular orientation related to pelvic morphology? CT analysis of 150 healthy pelvises" [Orthop. Traumatol. Surg. Res. 104 (2018) 347-351]. Orthop Traumatol Surg Res 2019; 105:195. [PMID: 30630739 DOI: 10.1016/j.otsr.2018.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- P Sautet
- Institut du mouvement et de l'appareil locomoteur, groupe interdisciplinaire en biomécanique, hôpital Sainte-Marguerite, Aix-Marseille université, 270, boulevard Sainte-Marguerite, 13009 Marseille, France.
| | - H Giorgi
- Unité chirurgie vertébrale et orthopédique, Aix-Marseille université, CHU de Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - P Chabrand
- Institut du mouvement et de l'appareil locomoteur, groupe interdisciplinaire en biomécanique, hôpital Sainte-Marguerite, Aix-Marseille université, 270, boulevard Sainte-Marguerite, 13009 Marseille, France
| | - P Tropiano
- Unité chirurgie vertébrale et orthopédique, Aix-Marseille université, CHU de Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - J-N Argenson
- Institut du mouvement et de l'appareil locomoteur, groupe interdisciplinaire en biomécanique, hôpital Sainte-Marguerite, Aix-Marseille université, 270, boulevard Sainte-Marguerite, 13009 Marseille, France
| | - S Parratte
- Institut du mouvement et de l'appareil locomoteur, groupe interdisciplinaire en biomécanique, hôpital Sainte-Marguerite, Aix-Marseille université, 270, boulevard Sainte-Marguerite, 13009 Marseille, France
| | - B Blondel
- Unité chirurgie vertébrale et orthopédique, Aix-Marseille université, CHU de Timone, 264, rue Saint-Pierre, 13005 Marseille, France
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20
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Nakhli Z, Hatira FB, Pithioux M, Chabrand P, Saanouni K. On prediction of the compressive strength and failure patterns of human vertebrae using a quasi-brittle continuum damage finite element model. Acta Bioeng Biomech 2019; 21:143-151. [PMID: 31741469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE Damage of bone structures is mainly conditioned by bone quality related to the bone strength. The purpose of this work was to present a simple and reliable numerical treatment of a quasi-brittle damage constitutive model coupled with two different elastic modulus and to compare the numerical results with the experimental ones. METHODS To achieve this goal, a QCT based finite element model was developed within the framework of CDM (Continuum Damage Mechanics) and implemented in the FE code (ABAQUS). It described the propagation of brittle cracks which will help to predict the ultimate load fracture of a human vertebra by reproducing the experimental failure under quasi-static compressive loading paths of nineteen cadaveric lumbar vertebral bodies. RESULTS The numerical computations delivered by the proposed method showed a better agreement with the available experimental results when bone volume fraction related Young's modulus (E(BV/TV)) is used instead of density related Young's modulus (E(ρ)). Also, the study showed that the maximum relative error (%) in failure was 8.47% when E(BV/TV) is used, whereas the highest relative error (%) was 68.56% when E(ρ) is adopted. Finally, a mesh sensitivity analysis revealed that the element size has a weak incidence on the computed load magnitude. CONCLUSIONS The numerical results provided by the proposed quasi-brittle damage model combined with E(BV/TV) are a reliable tool for the vertebrae fracture prediction.
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Affiliation(s)
- Zahira Nakhli
- Laboratoire de Recherche Matériaux Mesures et Application (MMA), University of Carthage, National Institute of Sciences and Technology (INSAT), Tunis, Tunisia
| | - Fafa Ben Hatira
- Laboratoire de Recherche Matériaux Mesures et Application (MMA), University of Carthage, National Institute of Sciences and Technology (INSAT), Tunis, Tunisia
| | - Martine Pithioux
- Aix Marseille University, (ISM) Institute of Movement Sciences, Marseille, France
| | - Patrick Chabrand
- Aix Marseille University, (ISM) Institute of Movement Sciences, Marseille, France
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21
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Dagneaux L, Allal R, Pithioux M, Chabrand P, Ollivier M, Argenson JN. Femoral malrotation from diaphyseal fractures results in changes in patellofemoral alignment and higher patellofemoral stress from a finite element model study. Knee 2018; 25:807-813. [PMID: 30060996 DOI: 10.1016/j.knee.2018.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 05/11/2018] [Accepted: 06/06/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Malrotation of the femur is a frequent complication in the management of a diaphyseal fracture. It is often responsible for pain and adverse functional results. Among these complications, contact stress effects on the patellofemoral joint are recognized as predictive factors of impaired results. The purpose of this study was to analyze the effect of malrotation on stress distribution on the patellofemoral joint, using radiological measurement and three-dimensional finite element models. METHODS Functional analysis of the patellofemoral joint was evaluated in eight knee pairs from patients with unilateral femoral fractures and subsequent femoral malrotation. A computed tomography-based protocol allowed patellofemoral joint analysis. A finite element model of the healthy (contralateral) knee was then created from 3D reconstruction at 30° flexion. In a finite element model, incremental rotational malalignment was simulated to observe changes in stress distribution on the patellar surface. RESULTS Femoral malrotation was associated with anomalies of patellofemoral joint rotational alignment. Internal rotation resulted in increased stress on the lateral side of the patella, and external rotation increased inferior medial side stress. CONCLUSIONS Rotational disorders of the distal femur resulted in increased stress on the patellofemoral joint and alignment changes. Malrotation in internal and external rotation might cause patellofemoral pain syndrome from rotations <10°. Care should be taken especially for internal malrotation in the management of femoral shaft fracture.
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Affiliation(s)
- Louis Dagneaux
- Aix Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France; Department of Orthopaedic Surgery, Lower Limb Surgery Unit, Lapeyronie University Hospital, Montpellier Cedex 05, France; Aix Marseille University, CNRS, ISM, Inst Movement Sci, France.
| | - Raphael Allal
- Aix Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Martine Pithioux
- Aix Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Patrick Chabrand
- Aix Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Matthieu Ollivier
- Aix Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Jean-Noël Argenson
- Aix Marseille University, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
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Moukoko D, Pourquier D, Genovesio C, Thezenas S, Chabrand P, Roffino S, Pithioux M. Granulocyte-colony stimulating factor enhances bone fracture healing. Clin Biomech (Bristol, Avon) 2018; 58:62-68. [PMID: 30036852 DOI: 10.1016/j.clinbiomech.2018.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 04/27/2018] [Accepted: 07/11/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Circulating mesenchymal stem cells contribute to bone repair. Their incorporation in fracture callus is correlated to their bioavailability. In addition, Granulocyte-colony stimulating factor induces the release of vascular and mesenchymal progenitors. We hypothesized that this glycoprotein stimulates fracture healing, and analyzed the effects of its administration at low doses on bone healing. METHODS 27 adult male Sprague-Dawley rats underwent mid-femur osteotomy stabilized by centromedullar pinning. In a post (pre) operative group, rats were subcutaneously injected with 5 μg/kg per day of Granulocyte-colony stimulating factor for 5 days after (before) surgery. In a control group, rats were injected with saline solution for 5 days immediately after surgery. A radiographic consolidation score was calculated. At day 35, femurs were studied histologically and underwent biomechanical tests. FINDINGS 5 weeks after surgery, mean radiographic scores were significantly higher in the Preop group 7.75 (SD 0.42) and in the Postop group 7.67 (SD 0.52) than in the control group 6.75 (SD 0.69). Biomechanical tests showed femur stiffness to be more than three times higher in both the Preop 109.24 N/mm (SD 51.86) and Postop groups 100.05 N/mm (SD 60.24) than in control 32.01 N/mm (SD 15.78). Mean maximal failure force was twice as high in the Preop group 68.66 N (SD 27.78) as in the control group 34.21 N (SD 11.79). Histological results indicated a later consolidation process in control than in treated groups. INTERPRETATION Granulocyte-colony stimulating factor injections strongly stimulated early femur fracture healing, indicating its potential utility in human clinical situations such as programmed osteotomy and fracture.
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Affiliation(s)
- Didier Moukoko
- Département de Chirurgie Orthopédique Pédiatrique, CHU Angers, 4 rue Larrey, 49100 Angers, France
| | - Didier Pourquier
- Institut régional du Cancer de Montpellier (ICM)- Val d'Aurelle, Montpellier, France
| | - Cécile Genovesio
- Laboratoire de Biochimie, Faculté de Pharmacie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Simon Thezenas
- Institut régional du Cancer de Montpellier (ICM)- Val d'Aurelle, Montpellier, France
| | - Patrick Chabrand
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; APHM, Hôpital Sainte Marguerite, IML, Marseille, France
| | - Sandrine Roffino
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; Université Côte d'Azur, Univ Nice Sophia Antipolis, France
| | - Martine Pithioux
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; APHM, Hôpital Sainte Marguerite, IML, Marseille, France.
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Donnez M, Ollivier M, Munier M, Berton P, Podgorski JP, Chabrand P, Parratte S. Are three-dimensional patient-specific cutting guides for open wedge high tibial osteotomy accurate? An in vitro study. J Orthop Surg Res 2018; 13:171. [PMID: 29986731 PMCID: PMC6038309 DOI: 10.1186/s13018-018-0872-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 06/25/2018] [Indexed: 11/23/2022] Open
Abstract
Background The aim of this in vitro study was to assess the accuracy of three-dimensional patient-specific cutting guides for open wedge high tibial osteotomy (OWHTO) to provide the planned correction in both frontal and sagittal planes. Methods Ten cadaveric tibias underwent OWHTO performed using a patient-specific cutting guide based on 3D preoperative planning. An initial CT scan of the tibias was performed, and after segmentation, 3D geometrical models of the pre-OWHTO tibias were obtained. Reference planes were defined, and OWHTO virtually planned to then design patient-specific cutting guides. OWHTO were performed using the patient-specific cutting guides. The patient-specific cutting guide controls the cut and the correction of the OWHTO in both planes. 3D models of post-OWHTO tibias were created after a postoperative CT scan. Geometrical post-OWHTO 3D models were superimposed on pre-OWHTO 3D models. Mechanical medial proximal tibial angle (mMPTA) in the frontal plane and posterior tibial slope (PTS) in the sagittal plane were compared between planned-OWHTO and post-OWHTO 3D reconstructions relative to the pre-OWHTO reference planes and axis. Pearson’s and Lin’s correlation tests were performed to assess precision and accuracy of patient-specific cutting guides. Results The mean difference between post-OWHTO and planned-OWHTO was 0.2° (max 0.5°, SD 0.3°) in the frontal plane and − 0.1° (max 0.8°, SD 0.5°) in the sagittal plane. Statistically significant correlations were found between the planned-OWHTO and post-OWHTO configurations for the mMPTA (p < 0.0001) and PTS (p < 0.0001) measurements, and the bias correction factor was 0.99 in both planes. Conclusions 3D patient-specific cutting guides for OWHTO-based 3D virtual planning is a reliable and accurate method of achieving multiplanar correction in both frontal and sagittal planes.
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Affiliation(s)
- Mathias Donnez
- Aix Marseille Univ, CNRS, ISM, Marseille, France. .,Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France. .,Newclip Technics, Haute-Goulaine, France.
| | - Matthieu Ollivier
- Aix Marseille Univ, CNRS, ISM, Marseille, France.,Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Maxime Munier
- Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | | | | | - Patrick Chabrand
- Aix Marseille Univ, CNRS, ISM, Marseille, France.,Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
| | - Sébastien Parratte
- Aix Marseille Univ, CNRS, ISM, Marseille, France.,Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
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Spartacus V, Mayoly A, Gay A, Le Corroller T, Némoz-Gaillard M, Roffino S, Chabrand P. Biomechanical analysis of the trapeziometacarpal arthroplasty failures. Comput Methods Biomech Biomed Engin 2017; 20:193-194. [PMID: 29088595 DOI: 10.1080/10255842.2017.1382928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- V Spartacus
- a Aix Marseille University, CNRS , ISM, Inst Movement Sci , France.,b Department of orthopaedics and Traumatology , APHM, Sainte Marguerite Hospital, Institute for Locomotion , 13009 , Marseille , France.,d Orthopaedic and Spine Development , 84911 , Avignon , France
| | - A Mayoly
- a Aix Marseille University, CNRS , ISM, Inst Movement Sci , France.,e Department of hand and reconstruction surgery , Aix Marseille University , La Timone Teaching Hospital, 13005 , Marseille , France
| | - A Gay
- a Aix Marseille University, CNRS , ISM, Inst Movement Sci , France.,b Department of orthopaedics and Traumatology , APHM, Sainte Marguerite Hospital, Institute for Locomotion , 13009 , Marseille , France.,e Department of hand and reconstruction surgery , Aix Marseille University , La Timone Teaching Hospital, 13005 , Marseille , France
| | - T Le Corroller
- a Aix Marseille University, CNRS , ISM, Inst Movement Sci , France.,c Department of radiology , APHM, Sainte Marguerite Hospital, Institute for Locomotion , 13009 , Marseille
| | | | - S Roffino
- a Aix Marseille University, CNRS , ISM, Inst Movement Sci , France.,b Department of orthopaedics and Traumatology , APHM, Sainte Marguerite Hospital, Institute for Locomotion , 13009 , Marseille , France.,f University of Nice Sophia Antipolis, CNRS , ISM, Inst Movement Sci , France
| | - P Chabrand
- a Aix Marseille University, CNRS , ISM, Inst Movement Sci , France.,b Department of orthopaedics and Traumatology , APHM, Sainte Marguerite Hospital, Institute for Locomotion , 13009 , Marseille , France
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Rivière C, Iranpour F, Harris S, Auvinet E, Aframian A, Chabrand P, Cobb J. The kinematic alignment technique for TKA reliably aligns the femoral component with the cylindrical axis. Orthop Traumatol Surg Res 2017; 103:1069-1073. [PMID: 28870873 DOI: 10.1016/j.otsr.2017.06.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 06/15/2017] [Accepted: 06/23/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Kinematic alignment (KA) technique is an alternative technique for positioning a TKA, which aims a patient-specific implant positioning in order to reproduce the pre-arthritic knee anatomy. Because reliability in implant positioning is of interest to obtain reproducible good functional results, our study tests the hypothesis that the medial and lateral distal and posterior positions of the planned and surgically implanted kinematically aligned femoral component are similar. METHODS Preoperative knee magnetic resonance imaging (MRI) and postoperative knee computed tomography (CT) of 13 patients implanted with a KA Persona® TKA (Zimmer, Warsaw, USA) using manual instrumentation (kinematically-aligned TKA procedure pack®, Zimmer Biomet, Warsaw, USA) were segmented to create 3D femoral models. The kinematic alignment position of the femoral component was planned on the 3D model created from the preoperative MRI. Differences in the positions of the planned and surgically implanted kinematically-aligned femoral component were determined with in-house analysis software. RESULTS The average differences between the medial and lateral distal and posterior positions of the planned and surgically implanted kinematically-aligned femoral component were inferior to 1mm and no statistically significant. In terms of variability, 62% (8/13) of performed implants matched all four positions within 1.5mm, and the maximum difference was 3mm. CONCLUSION In this small series, intraoperative kinematic positioning of the femoral component with the specific manual instrumentation closely matched the planned position, which suggests that this technique reliably aligned the flexion-extension axis of the femoral component to the cylindrical axis. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- C Rivière
- Department of joint replacement, the MSK Lab, Charing Cross Campus, Laboratory Block, Fulham Palace Rd, W6 8RP London, UK.
| | - F Iranpour
- Department of joint replacement, the MSK Lab, Charing Cross Campus, Laboratory Block, Fulham Palace Rd, W6 8RP London, UK
| | - S Harris
- Department of joint replacement, the MSK Lab, Charing Cross Campus, Laboratory Block, Fulham Palace Rd, W6 8RP London, UK
| | - E Auvinet
- Department of joint replacement, the MSK Lab, Charing Cross Campus, Laboratory Block, Fulham Palace Rd, W6 8RP London, UK
| | - A Aframian
- Department of joint replacement, the MSK Lab, Charing Cross Campus, Laboratory Block, Fulham Palace Rd, W6 8RP London, UK
| | - P Chabrand
- Institut des sciences du mouvement, université Aix-Marseille, 171, avenue de Luminy, 13009 Marseille, France
| | - J Cobb
- Department of joint replacement, the MSK Lab, Charing Cross Campus, Laboratory Block, Fulham Palace Rd, W6 8RP London, UK
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Pithioux M, Roseren F, Jalain C, Launay F, Charpiot P, Chabrand P, Roffino S, Lamy E. An Efficient and Reproducible Protocol for Distraction Osteogenesis in a Rat Model Leading to a Functional Regenerated Femur. J Vis Exp 2017. [PMID: 29155725 DOI: 10.3791/56433] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
This protocol describes the use of a newly developed external fixator for distraction osteogenesis in a rat femoral model. Distraction osteogenesis (DO) is a surgical technique leading to bone regeneration after an osteotomy. The osteotomized extremities are moved away from each other by gradual distraction to reach the desired elongation. This procedure is widely used in humans for lower and upper limb lengthening, treatment after a bone nonunion, or the regeneration of a bone defect following surgery for bone tumor excision, as well as in maxillofacial reconstruction. Only a few studies clearly demonstrate the efficiency of their protocol in obtaining a functional regenerated bone, i.e., bone that will support physiological weight-bearing without fracture after removal of the external fixator. Moreover, protocols for DO vary and reproducibility is limited by lack of information, making comparison between studies difficult. The aim of this study was to develop a reproducible protocol comprising an appropriate external fixator design for rat limb lengthening, with a detailed surgical technique that permits physiological weight-bearing by the animal after removal of the external fixator.
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Affiliation(s)
- Martine Pithioux
- CNRS, ISM, Inst Movement Sci, Aix Marseille Univ; Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, APHM;
| | - Flavy Roseren
- CNRS, ISM, Inst Movement Sci, Aix Marseille Univ; Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, APHM
| | | | - Franck Launay
- CNRS, ISM, Inst Movement Sci, Aix Marseille Univ; Sainte-Marguerite Hospital, Institute for Locomotion, Department of Peadiatric Orthopaedics, APHM
| | | | - Patrick Chabrand
- CNRS, ISM, Inst Movement Sci, Aix Marseille Univ; Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, APHM
| | | | - Edouard Lamy
- CNRS, ISM, Inst Movement Sci, Aix Marseille Univ; Service Central de la Qualité et de l'Information Pharmaceutiques, APHM
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Spartacus V, Mayoly A, Gay A, Le Corroller T, Némoz-Gaillard M, Roffino S, Chabrand P. Biomechanical causes of trapeziometacarpal arthroplasty failure. Comput Methods Biomech Biomed Engin 2017; 20:1233-1235. [DOI: 10.1080/10255842.2017.1348502] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- V. Spartacus
- CNRS, ISM, Inst Movement Sci, Aix Marseille University, Marseille, France
- Department of Orthopaedics and Traumatology, APHM, Institute for Locomotion, Sainte-Marguerite Hospital, , Marseille, France
- Orthopaedic and Spine Development, Avignon, France
| | - A. Mayoly
- CNRS, ISM, Inst Movement Sci, Aix Marseille University, Marseille, France
- Department of hand and reconstruction surgery, La Timone Teaching Hospital, Aix Marseille University, Marseille, France
| | - A. Gay
- CNRS, ISM, Inst Movement Sci, Aix Marseille University, Marseille, France
- Department of Orthopaedics and Traumatology, APHM, Institute for Locomotion, Sainte-Marguerite Hospital, , Marseille, France
- Department of hand and reconstruction surgery, La Timone Teaching Hospital, Aix Marseille University, Marseille, France
| | - T. Le Corroller
- CNRS, ISM, Inst Movement Sci, Aix Marseille University, Marseille, France
- Department of Radiology, APHM, Institute for Locomotion, Sainte-Marguerite Hospital, Marseille, France
| | | | - S. Roffino
- CNRS, ISM, Inst Movement Sci, Aix Marseille University, Marseille, France
- Department of Orthopaedics and Traumatology, APHM, Institute for Locomotion, Sainte-Marguerite Hospital, , Marseille, France
- CNRS, ISM, Inst Movement Sci, University of Nice Sophia Antipolis, Nice, France
| | - P. Chabrand
- CNRS, ISM, Inst Movement Sci, Aix Marseille University, Marseille, France
- Department of Orthopaedics and Traumatology, APHM, Institute for Locomotion, Sainte-Marguerite Hospital, , Marseille, France
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Spartacus V, Vargiolu R, Zahouani H, Nemoz-Gaillard M, Chabrand P. Multi-scale analysis of cartilage surface for trapeziometacarpal hemi-arthroplasty. Biosurface and Biotribology 2017. [DOI: 10.1016/j.bsbt.2017.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Munier M, Donnez M, Ollivier M, Flecher X, Chabrand P, Argenson JN, Parratte S. Can three-dimensional patient-specific cutting guides be used to achieve optimal correction for high tibial osteotomy? Pilot study. Orthop Traumatol Surg Res 2017; 103:245-250. [PMID: 28137553 DOI: 10.1016/j.otsr.2016.11.020] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 11/23/2016] [Accepted: 11/30/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Treatment of medial tibiofemoral osteoarthritis with a high-tibial osteotomy (HTO) is most effective when the optimal angular correction is achieved. However, conventional instrumentation is limited when multiplanar correction is needed. HYPOTHESIS Use of patient-specific cutting guides (PSCGs) for HTO provides an accurate correction (difference<2°) relative to the preoperative planning. MATERIALS AND METHODS Between February 2014 and February 2015, 10 patients (mean age: 46 years [range: 31-59]; grade 1 or 2 osteoarthritis in Ahlbäck's classification) were included prospectively in this reliability and safety study. All patients were operated using the same medial opening-wedge osteotomy technique. Preoperative planning was based on long-leg radiographs and CT scans with 3D reconstruction. The PSGCs were used to align the osteotomy cut and position the screw holes for the plate. The desired correction was achieved in the three planes when the holes on the plate were aligned with the holes drilled based on the PSCG. Preoperatively, the mean HKA angle was 171.9° (range: 166-179°), the mean proximal tibial angle was 87° (86-88°) and the mean tibial slope was 7.8° (1-22°). The postoperative correction was compared to the planned correction using 3D CT scan transformations. Intraoperative and postoperative complications were assessed at a minimum follow-up of 1 year. RESULTS The procedure was successfully carried out in all patients with the PSCGs. On postoperative long-leg radiographs, the mean HKA was 182.3° (180-185°); on the CT scan, the mean tibial mechanical angle was 94° (90-98°) and the mean tibial slope was 7.1° (4-11°). In 19 out of 20 postoperative HKA and slope measurements, the difference between the planned and achieved correction was <2° based on the 3D analysis of the three planes in space; in the other case, the slope was 13° instead of the planned 10°. The intra-class correlation coefficients between the postoperative and planned parameters were 0.98 [0.92-0.99] for the HKA and 0.96 [0.79-0.99] for the tibial slope. There were no surgical site infections; one patient had a postoperative hematoma that resolved spontaneously. DISCUSSION The results of this study showed that use of PSCGs in HTO procedures helps to achieve optimal correction in a safe and reliable manner. LEVEL OF EVIDENCE IV - Prospective cohort study.
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Affiliation(s)
- M Munier
- UMR CNRS 787/AMU, institut du mouvement et de l'appareil locomoteur, groupe interdisciplinaire en biomécanique, hôpital Sainte-Marguerite, centre hospitalo-universitaire Sud, boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - M Donnez
- UMR CNRS 787/AMU, institut du mouvement et de l'appareil locomoteur, groupe interdisciplinaire en biomécanique, hôpital Sainte-Marguerite, centre hospitalo-universitaire Sud, boulevard de Sainte-Marguerite, 13009 Marseille, France; Newclip Technics, 44115 Haute-Goulaine, France
| | - M Ollivier
- UMR CNRS 787/AMU, institut du mouvement et de l'appareil locomoteur, groupe interdisciplinaire en biomécanique, hôpital Sainte-Marguerite, centre hospitalo-universitaire Sud, boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - X Flecher
- UMR CNRS 787/AMU, institut du mouvement et de l'appareil locomoteur, groupe interdisciplinaire en biomécanique, hôpital Sainte-Marguerite, centre hospitalo-universitaire Sud, boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - P Chabrand
- UMR CNRS 787/AMU, institut du mouvement et de l'appareil locomoteur, groupe interdisciplinaire en biomécanique, hôpital Sainte-Marguerite, centre hospitalo-universitaire Sud, boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - J-N Argenson
- UMR CNRS 787/AMU, institut du mouvement et de l'appareil locomoteur, groupe interdisciplinaire en biomécanique, hôpital Sainte-Marguerite, centre hospitalo-universitaire Sud, boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - S Parratte
- UMR CNRS 787/AMU, institut du mouvement et de l'appareil locomoteur, groupe interdisciplinaire en biomécanique, hôpital Sainte-Marguerite, centre hospitalo-universitaire Sud, boulevard de Sainte-Marguerite, 13009 Marseille, France.
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Le Cann S, Chaves-Jacob J, Rossi JM, Linares JM, Chabrand P. Tribology of flexible and sliding spinal implants: Development of experimental and numerical models. J Biomed Mater Res B Appl Biomater 2016; 106:104-111. [PMID: 27875027 DOI: 10.1002/jbm.b.33819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 10/05/2016] [Accepted: 11/08/2016] [Indexed: 11/08/2022]
Abstract
New fusionless devices are being developed to get over the limits of actual spinal surgical treatment, based on arthrodesis. However, due to their recentness, no standards exist to test and validate those devices, especially concerning the wear. A new tribological first approach to the definition of an in vitro wear protocol to study wear of flexible and sliding spinal devices is presented in this article, and was applied to a new concept. A simplified synthetic spine portion (polyethylene) was developed to reproduce a simple supra-physiological spinal flexion (10° between two vertebrae). The device studied with this protocol was tested in wet environment until 1 million cycles (Mc). We obtained an encouraging estimated wear volume of same order of magnitude compared to similar devices. An associated finite element (FE) numerical model has permitted to access contact information and study the effect of misalignment of one screw. First results could point out how to improve the design and suggest that a vertical misalignment of a screw (under or over-screwing) has more impact than a horizontal one. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 104-111, 2018.
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Affiliation(s)
- Sophie Le Cann
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France.,APHM, Hôpital Sainte-Marguerite, Institute for Locomotion, 13009, Marseille, France
| | - Julien Chaves-Jacob
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France
| | - Jean-Marie Rossi
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France.,APHM, Hôpital Sainte-Marguerite, Institute for Locomotion, 13009, Marseille, France
| | - Jean-Marc Linares
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France
| | - Patrick Chabrand
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France.,APHM, Hôpital Sainte-Marguerite, Institute for Locomotion, 13009, Marseille, France
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Manifacier I, Milan JL, Jeanneau C, Chmilewsky F, Chabrand P, About I. Computational Tension Mapping of Adherent Cells Based on Actin Imaging. PLoS One 2016; 11:e0146863. [PMID: 26812601 PMCID: PMC4728200 DOI: 10.1371/journal.pone.0146863] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 12/21/2015] [Indexed: 01/14/2023] Open
Abstract
Forces transiting through the cytoskeleton are known to play a role in adherent cell activity. Up to now few approaches haves been able to determine theses intracellular forces. We thus developed a computational mechanical model based on a reconstruction of the cytoskeleton of an adherent cell from fluorescence staining of the actin network and focal adhesions (FA). Our custom made algorithm converted the 2D image of an actin network into a map of contractile interactions inside a 2D node grid, each node representing a group of pixels. We assumed that actin filaments observed under fluorescence microscopy, appear brighter when thicker, we thus presumed that nodes corresponding to pixels with higher actin density were linked by stiffer interactions. This enabled us to create a system of heterogeneous interactions which represent the spatial organization of the contractile actin network. The contractility of this interaction system was then adapted to match the level of force the cell truly exerted on focal adhesions; forces on focal adhesions were estimated from their vinculin expressed size. This enabled the model to compute consistent mechanical forces transiting throughout the cell. After computation, we applied a graphical approach on the original actin image, which enabled us to calculate tension forces throughout the cell, or in a particular region or even in single stress fibers. It also enabled us to study different scenarios which may indicate the mechanical role of other cytoskeletal components such as microtubules. For instance, our results stated that the ratio between intra and extra cellular compression is inversely proportional to intracellular tension.
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Affiliation(s)
- Ian Manifacier
- Aix-Marseille Université, ISM, CNRS, UMR 7287, Marseille, France
- APHM, Institute for Locomotion, Sainte-Marguerite Hospital, 13009, Marseille, France
- * E-mail:
| | - Jean-Louis Milan
- Aix-Marseille Université, ISM, CNRS, UMR 7287, Marseille, France
- APHM, Institute for Locomotion, Sainte-Marguerite Hospital, 13009, Marseille, France
| | | | - Fanny Chmilewsky
- Aix-Marseille Université, ISM, CNRS, UMR 7287, Marseille, France
| | - Patrick Chabrand
- Aix-Marseille Université, ISM, CNRS, UMR 7287, Marseille, France
- APHM, Institute for Locomotion, Sainte-Marguerite Hospital, 13009, Marseille, France
| | - Imad About
- Aix-Marseille Université, ISM, CNRS, UMR 7287, Marseille, France
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Le Cann S, Cachon T, Viguier E, Miladi L, Odent T, Rossi JM, Chabrand P. Pedicle Screw Fixation Study in Immature Porcine Spines to Improve Pullout Resistance during Animal Testing. PLoS One 2015; 10:e0127463. [PMID: 26451947 PMCID: PMC4599826 DOI: 10.1371/journal.pone.0127463] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 04/15/2015] [Indexed: 11/18/2022] Open
Abstract
The porcine model is frequently used during development and validation of new spinal devices, because of its likeness to the human spine. These spinal devices are frequently composed of pedicle screws with a reputation for stable fixation but which can suffer pullouts during preclinical implantation on young animals, leading to high morbidity. With a view to identifying the best choices to optimize pedicle screw fixation in the porcine model, this study evaluates ex vivo the impact of weight (age) of the animal, the level of the vertebrae (lumbar or thoracic) and the type of screw anchorage (mono- or bi-cortical) on pedicle screw pullouts. Among the 80 pig vertebrae (90- and 140-day-old) tested in this study, the average screw pullout forces ranged between 419.9N and 1341.2N. In addition, statistical differences were found between test groups, pointing out the influence of the three parameters stated above. We found that the the more caudally the screws are positioned (lumbar level), the greater their pullout resistance is, moreover, screw stability increases with the age, and finally, the screws implanted with a mono-cortical anchorage sustained lower pullout forces than those implanted with a bi-cortical anchorage. We conclude that the best anchorage can be obtained with older animals, using a lumbar fixation and long screws traversing the vertebra and inducing bi-cortical anchorage. In very young animals, pedicle screw fixations need to be bi-cortical and more numerous to prevent pullout.
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Affiliation(s)
- Sophie Le Cann
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288, Marseille cedex 09, France
- EUROS, Z.E. Athélia III, 824 Voie Antiope, 13600, La Ciotat, France
- APHM, Hôpital Sainte-Marguerite, Institute for Locomotion, 13009, Marseille, France
- * E-mail:
| | - Thibaut Cachon
- ICE UPSP, VetAgro Sup, Campus vétérinaire de Lyon, University of Lyon, F-69280, Marcy l'Étoile, France
| | - Eric Viguier
- ICE UPSP, VetAgro Sup, Campus vétérinaire de Lyon, University of Lyon, F-69280, Marcy l'Étoile, France
| | - Lotfi Miladi
- Hôpital Universitaire Necker Enfants malades, Assistance Publique Hôpitaux de Paris, Faculté de médecine Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - Thierry Odent
- Hôpital Universitaire Necker Enfants malades, Assistance Publique Hôpitaux de Paris, Faculté de médecine Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - Jean-Marie Rossi
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288, Marseille cedex 09, France
- APHM, Hôpital Sainte-Marguerite, Institute for Locomotion, 13009, Marseille, France
| | - Patrick Chabrand
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288, Marseille cedex 09, France
- APHM, Hôpital Sainte-Marguerite, Institute for Locomotion, 13009, Marseille, France
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Berteau JP, Gineyts E, Pithioux M, Baron C, Boivin G, Lasaygues P, Chabrand P, Follet H. Ratio between mature and immature enzymatic cross-links correlates with post-yield cortical bone behavior: An insight into greenstick fractures of the child fibula. Bone 2015; 79:190-5. [PMID: 26079997 DOI: 10.1016/j.bone.2015.05.045] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 05/28/2015] [Accepted: 05/29/2015] [Indexed: 01/22/2023]
Abstract
As a determinant of skeletal fragility, the organic matrix is responsible for the post-yield and creep behavior of bone and for its toughness, while the mineral apatite acts on stiffness. Specific to the fibula and ulna in children, greenstick fractures show a plastic in vivo mechanical behavior before bone fracture. During growth, the immature form of collagen enzymatic cross-links gradually decreases, to be replaced by the mature form until adolescence, subsequently remaining constant throughout adult life. However, the link between the cortical bone organic matrix and greenstick fractures in children remains to be explored. Here, we sought to determine: 1) whether plastic bending fractures can occur in vitro, by testing cortical bone samples from children's fibula and 2) whether the post-yield behavior (ωp plastic energy) of cortical bone before fracture is related to total quantity of the collagen matrix, or to the quantity of mature and immature enzymatic cross-links and the quantity of non-enzymatic cross-links. We used a two-step approach; first, a 3-point microbending device tested 22 fibula machined bone samples from 7 children and 3 elderly adults until fracture. Second, biochemical analysis by HPLC was performed on the sample fragments. When pooling two groups of donors, children and elderly adults, results show a rank correlation between total energy dissipated before fracture and age and a linear correlation between plastic energy dissipated before fracture and ratio of immature/mature cross-links. A collagen matrix with more immature cross-links (i.e. a higher immature/mature cross-link ratio) is more likely to plastically deform before fracture. We conclude that this ratio in the sub-nanostructure of the organic matrix in cortical bone from the fibula may go some way towards explaining the variance in post-yield behavior. From a clinical point of view, therefore, our results provide a potential explanation of the presence of greenstick fractures in children.
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Affiliation(s)
- Jean-Philippe Berteau
- Institute of Movement Science (ISM), CNRS, UMR 7287, Aix-Marseille University, av. de, Luminy, F-13288 Marseille France; Laboratory of Mechanics and Acoustics (LMA), CNRS, UPR 7051, Aix-Marseille University, Centrale Marseille, 31 chemin Joseph-Aiguier, F-13402 Marseille cedex 20, France; Department of Physical Therapy, College of Staten Island, City University of New York, NY 10314, United States.
| | - Evelyne Gineyts
- INSERM, UMR 1033, F-69008 Lyon, France; Université de Lyon, F-69008 Lyon, France
| | - Martine Pithioux
- Institute of Movement Science (ISM), CNRS, UMR 7287, Aix-Marseille University, av. de, Luminy, F-13288 Marseille France
| | - Cécile Baron
- Institute of Movement Science (ISM), CNRS, UMR 7287, Aix-Marseille University, av. de, Luminy, F-13288 Marseille France
| | - Georges Boivin
- Department of Physical Therapy, College of Staten Island, City University of New York, NY 10314, United States; INSERM, UMR 1033, F-69008 Lyon, France
| | - Philippe Lasaygues
- Laboratory of Mechanics and Acoustics (LMA), CNRS, UPR 7051, Aix-Marseille University, Centrale Marseille, 31 chemin Joseph-Aiguier, F-13402 Marseille cedex 20, France
| | - Patrick Chabrand
- Institute of Movement Science (ISM), CNRS, UMR 7287, Aix-Marseille University, av. de, Luminy, F-13288 Marseille France
| | - Hélène Follet
- INSERM, UMR 1033, F-69008 Lyon, France; Université de Lyon, F-69008 Lyon, France
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Le Cann S, Cachon T, Viguier E, Baron C, Miladi L, Odent T, Rossi JM, Chabrand P. Influence of age and localisation on pedicle fixation in immature porcine spines. Comput Methods Biomech Biomed Engin 2014; 17 Suppl 1:66-7. [PMID: 25074167 DOI: 10.1080/10255842.2014.931128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- S Le Cann
- a Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 , Marseille Cedex 09, France
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Le Cann S, Galland A, Rosa B, Le Corroller T, Pithioux M, Argenson JN, Chabrand P, Parratte S. Does surface roughness influence the primary stability of acetabular cups? A numerical and experimental biomechanical evaluation. Med Eng Phys 2014; 36:1185-90. [PMID: 25080896 DOI: 10.1016/j.medengphy.2014.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 07/03/2014] [Accepted: 07/04/2014] [Indexed: 01/01/2023]
Abstract
Most acetabular cups implanted today are press-fit impacted cementless. Anchorage begins with the primary stability given by insertion of a slightly oversized cup. This primary stability is key to obtaining bone ingrowth and secondary stability. We tested the hypothesis that primary stability of the cup is related to surface roughness of the implant, using both an experimental and a numerical models to analyze how three levels of surface roughness (micro, macro and combined) affect the primary stability of the cup. We also investigated the effect of differences in diameter between the cup and its substrate, and of insertion force, on the cups' primary stability. The results of our study show that primary stability depends on the surface roughness of the cup. The presence of macro-roughness on the peripheral ring is found to decrease primary stability; there was excessive abrasion of the substrate, damaging it and leading to poor primary stability. Numerical modeling indicates that oversizing the cup compared to its substrate has an impact on primary stability, as has insertion force.
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Affiliation(s)
- Sophie Le Cann
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France; APHM, Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte Marguerite, 249 et 270, bd Sainte-Marguerite, 13274 Marseille, France.
| | - Alexandre Galland
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France; APHM, Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte Marguerite, 249 et 270, bd Sainte-Marguerite, 13274 Marseille, France
| | - Benoît Rosa
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France
| | - Thomas Le Corroller
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France; APHM, Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte Marguerite, 249 et 270, bd Sainte-Marguerite, 13274 Marseille, France
| | - Martine Pithioux
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France; APHM, Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte Marguerite, 249 et 270, bd Sainte-Marguerite, 13274 Marseille, France
| | - Jean-Noël Argenson
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France; APHM, Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte Marguerite, 249 et 270, bd Sainte-Marguerite, 13274 Marseille, France
| | - Patrick Chabrand
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France; APHM, Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte Marguerite, 249 et 270, bd Sainte-Marguerite, 13274 Marseille, France
| | - Sébastien Parratte
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France; APHM, Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte Marguerite, 249 et 270, bd Sainte-Marguerite, 13274 Marseille, France
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Berteau JP, Baron C, Pithioux M, Launay F, Chabrand P, Lasaygues P. In vitro ultrasonic and mechanic characterization of the modulus of elasticity of children cortical bone. Ultrasonics 2014; 54:1270-1276. [PMID: 24112598 DOI: 10.1016/j.ultras.2013.09.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 08/30/2013] [Accepted: 09/10/2013] [Indexed: 06/02/2023]
Abstract
The assessment of elastic properties in children's cortical bone is a major challenge for biomechanical engineering community, more widely for health care professionals. Even with classical clinical modalities such as X-ray tomography, MRI, and/or echography, inappropriate diagnosis can result from the lack of reference values for children bone. This study provides values for elastic properties of cortical bone in children using ultrasonic and mechanical measurements, and compares them with adult values. 18 fibula samples from 8 children (5-16 years old, mean age 10.6 years old ±4.4) were compared to 16 fibula samples from 3 elderly adults (more than 65 years old). First, the dynamic modulus of elasticity (Edyn) and Poisson's ratio (ν) are evaluated via an ultrasonic method. Second, the static modulus of elasticity (Esta) is estimated from a 3-point microbending test. The mean values of longitudinal and transverse wave velocities measured at 10 MHz for the children's samples are respectively 3.2mm/μs (±0.5) and 1.8mm/μs (±0.1); for the elderly adults' samples, velocities are respectively 3.5mm/μs (±0.2) and 1.9 mm/μs (±0.09). The mean Edyn and the mean Esta for the children's samples are respectively 15.5 GPa (±3.4) and 9.1 GPa (±3.5); for the elderly adults' samples, they are respectively 16.7 GPa (±1.9) and 5.8 GPa (±2.1). Edyn, ν and Esta are in the same range for children's and elderly adults' bone without any parametric statistical difference; a ranking correlation between Edyn and Esta is shown for the first time.
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Affiliation(s)
- Jean-Philippe Berteau
- Laboratory of Mechanics and Acoustics (LMA), CNRS UPR 7051, Aix-Marseille University, Centrale Marseille, 31 Chemin Joseph-Aiguier, F-13402 Marseille cedex 20, France; Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France.
| | - Cécile Baron
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France
| | - Martine Pithioux
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France
| | - Franck Launay
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France
| | - Patrick Chabrand
- Aix-Marseille University, CNRS, ISM UMR 7287, 13288 Marseille cedex 9, France
| | - Philippe Lasaygues
- Laboratory of Mechanics and Acoustics (LMA), CNRS UPR 7051, Aix-Marseille University, Centrale Marseille, 31 Chemin Joseph-Aiguier, F-13402 Marseille cedex 20, France
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Schlatterer B, Linares JM, Chabrand P, Sprauel JM, Argenson JN. Influence of the optical system and anatomic points on computer-assisted total knee arthroplasty. Orthop Traumatol Surg Res 2014; 100:395-402. [PMID: 24835533 DOI: 10.1016/j.otsr.2013.12.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 11/23/2013] [Accepted: 12/12/2013] [Indexed: 02/02/2023]
Abstract
BACKGROUND For over a decade, computer-assisted orthopaedic surgery for total knee arthroplasty has been accepted as ensuring accurate implant alignment in the coronal plane. HYPOTHESIS We hypothesised that lack of accuracy in skeletal landmark identification during the acquisition phase and/or measurement variability of the infrared optical system may limit the validity of the numerical information used to guide the surgical procedure. METHODS We built a geometric model of a navigation system, with no preoperative image acquisition, to simulate the stages of the acquisition process. Random positions of each optical reflector center and anatomic acquisition point were generated within a sphere of predefined diameter. Based on the virtual geometric model and navigation process, we obtained 30,000 simulations using the Monte Carlo statistical method then computed the variability of the anatomic reference frames used to guide the bone cuts. Rotational variability (α, β, γ) of the femoral and tibial landmarks reflected implant positioning errors in flexion-extension, valgus-varus, and rotation, respectively. RESULTS Taking into account the uncertainties pertaining to the 3D infrared optical measurement system and to anatomic point acquisition, the femoral and tibial landmarks exhibited maximal alpha (flexion-extension), beta (valgus-varus), and gamma (axial rotation) errors of 1.65° (0.9°); 1.51° (0,98°), and 2.37° (3.84°), respectively. Variability of the infrared optical measurement system had no significant influence on femoro-tibial alignment angles. CONCLUSION The results of a Monte Carlo simulation indicate a certain level of vulnerability of navigation systems for guiding position in rotation, contrasting with robustness for guiding sagittal and coronal alignments. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- B Schlatterer
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France; Institut Monégasque de Médecine et Chirurgie du Sport, 98000 Monaco, Monaco.
| | - J-M Linares
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France
| | - P Chabrand
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France
| | - J-M Sprauel
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France
| | - J-N Argenson
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France; Institut du Mouvement et de l'Appareil Locomoteur, Hôpital Sainte-Marguerite, CHU Marseille, 13274 Marseille, France
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Liotier P, Rossi J, Wendling-Mansuy S, Chabrand P. Trabecular bone remodelling under pathological conditions based on biochemical and mechanical processes involved in BMU activity. Comput Methods Biomech Biomed Engin 2013; 16:1150-62. [DOI: 10.1080/10255842.2012.654781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Le Cann S, Rossi JM, Mesure S, Miladi L, Waquet T, Chabrand P. Numerical modelling of a new flexible spinal implant to control scoliosis aggravation. First set-up of a parametric study. Comput Methods Biomech Biomed Engin 2013; 16 Suppl 1:239-41. [PMID: 23923924 DOI: 10.1080/10255842.2013.815973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- S Le Cann
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France.
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Galland A, Airaudi S, Gravier R, Le Cann S, Chabrand P, Argenson JN. Pullout strength of all suture anchors in the repair of rotator cuff tears: a biomechanical study. Int Orthop 2013; 37:2017-23. [PMID: 23835556 DOI: 10.1007/s00264-013-1984-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 06/13/2013] [Indexed: 01/08/2023]
Abstract
PURPOSE We evaluated the biomechanical strength of two all suture anchors (ASA) of reduced diameter (1.4 mm) and compared them with the standard screw anchor (SA) with larger diameter (5.5 mm) used in rotator cuff tears. METHODS We conducted 30 uniaxial vertical pullout tests using Material Testing System Instron 5566A until failure of the anchorage defined as rupture of the threads or anchor or detachment of the anchor. Anchor fixation was on tuberosities of fresh bovine humerus bone. ASAs were spaced four millimetres apart and were compared with a control SA implanted on the same greater tubercle at two centimetres. The tests were all performed at room temperature in a dry environment. Tensile loads (10 mm/min) were applied parallel to the axis of insertion. A preloading of 10 N was used to overcome loading artifacts of the test sample at the beginning of the test. RESULTS Student's t test showed no statistically significant difference between anchors in terms of load to failure (ASA: force 265.06 ± 87.25 N versus SA : 325.35 ± 113.46 N; p = 0.09) and mean elongation at rupture (ASA : 23 ± 7 mm versus SA : 21 ± 6 mm; p = 0.46). CONCLUSIONS In vitro, this experimental study showed no statistically significant difference in pullout strength and displacement between ASA and SA at a chosen level of significance (p < 0.05).
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Affiliation(s)
- Alexandre Galland
- Institut du Mouvement et de l'appareil Locomoteur, 270 Bd Sainte Marguerite, 13009, Marseille, France,
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Chabrand P. Editorial. Comput Methods Biomech Biomed Engin 2013; 16 Suppl 1:1. [DOI: 10.1080/10255842.2013.817723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Launay F, Younsi R, Pithioux M, Chabrand P, Bollini G, Jouve JL. Fracture following lower limb lengthening in children: a series of 58 patients. Orthop Traumatol Surg Res 2013; 99:72-9. [PMID: 23246008 DOI: 10.1016/j.otsr.2012.08.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 07/17/2012] [Accepted: 08/21/2012] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Fracture is one of the main complications following external fixator removal used in cases of progressive lower limb lengthening; rates as high as 50% are found in the literature. The aim of this study was to determine the factors influencing this complication. MATERIALS AND METHODS One hundred and eleven cases of lower limb lengthening were performed in 58 patients (40 femurs and 71 tibias). The mean age at surgery was 10.1years old. Lengthening was performed in all cases with an external fixator alone, associated in 39.6% of cases with intramedullary nailing. The patients were divided into three groups according to disease etiology (congenital, achondroplasia and other). The fractures were classified according to the Simpson classification. RESULTS Twenty fractures were recorded (18%). Sixteen fractures were found in patients with congenital disease, four with achondroplasia and none in the group of other etiologies. The fracture was more often in the femur (27.5%) than in the tibia (12.7%). DISCUSSION The rate of fracture is influenced by different factors depending on the etiology of disease. In congenital diseases, the fracture rate is higher when there is lengthening of more than 15% of the initial length and a delay between surgery and the beginning of lengthening of less than 7days. In patients with achondroplasia, the influence of a relative percentage of lengthening is less important than in those with congenital disease. However, to avoid fractures, lengthening should not be started in children under the age of nine. Moreover, lengthening should begin at least 7days after the fixator has been placed. TYPE OF STUDY Retrospective. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- F Launay
- Timone Children Hospital, Department of Pediatric and Orthopaedic Surgery, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
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Milan JL, Lavenus S, Pilet P, Louarn G, Wendling S, Heymann D, Layrolle P, Chabrand P. Computational model combined with in vitro experiments to analyse mechanotransduction during mesenchymal stem cell adhesion. Eur Cell Mater 2013; 25:97-113. [PMID: 23325541 DOI: 10.22203/ecm.v025a07] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The shape that stem cells reach at the end of adhesion process influences their differentiation. Rearrangement of cytoskeleton and modification of intracellular tension may activate mechanotransduction pathways controlling cell commitment. In the present study, the mechanical signals involved in cell adhesion were computed in in vitro stem cells of different shapes using a single cell model, the so-called Cytoskeleton Divided Medium (CDM) model. In the CDM model, the filamentous cytoskeleton and nucleoskeleton networks were represented as a mechanical system of multiple tensile and compressive interactions between the nodes of a divided medium. The results showed that intracellular tonus, focal adhesion forces as well as nuclear deformation increased with cell spreading. The cell model was also implemented to simulate the adhesion process of a cell that spreads on protein-coated substrate by emitting filopodia and creating new distant focal adhesion points. As a result, the cell model predicted cytoskeleton reorganisation and reinforcement during cell spreading. The present model quantitatively computed the evolution of certain elements of mechanotransduction and may be a powerful tool for understanding cell mechanobiology and designing biomaterials with specific surface properties to control cell adhesion and differentiation.
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Affiliation(s)
- Jean-Louis Milan
- Institute of Movement Sciences, Aix-Marseille Univ, CNRS UMR 7287, F-13288 Marseille, France
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Le Corroller T, Pithioux M, Chaari F, Rosa B, Parratte S, Maurel B, Argenson JN, Champsaur P, Chabrand P. Bone texture analysis is correlated with three-dimensional microarchitecture and mechanical properties of trabecular bone in osteoporotic femurs. J Bone Miner Metab 2013; 31:82-8. [PMID: 22886379 DOI: 10.1007/s00774-012-0375-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 06/26/2012] [Indexed: 01/23/2023]
Abstract
Fracture of the proximal femur is a major public health problem in elderly persons. It has recently been suggested that combining texture analysis and bone mineral density measurement improves the failure load prediction in human femurs. In this study, we aimed to compare bone texture analysis with three-dimensional (3D) microarchitecture and mechanical properties of trabecular bone in osteoporotic femurs. Eight femoral heads from osteoporotic patients who fractured their femoral neck provided 31 bone cores. Bone samples were studied using a new high-resolution digital X-ray device (BMA™, D3A Medical Systems) allowing for texture analysis with fractal parameter H (mean), and were examined using micro-computed tomography (microCT) for 3D microarchitecture. Finally, uniaxial compression tests to failure were performed to estimate failure load and apparent modulus of bone samples. The fractal parameter H (mean) was strongly correlated with bone volume fraction (BV/TV) (r = 0.84) and trabecular thickness (Tb.Th) (r = 0.91) (p < 0.01). H (mean) was also markedly correlated with failure load (r = 0.84) and apparent modulus (r = 0.71) of core samples (p < 0.01). Bone volume fraction (BV/TV) and trabecular thickness (Tb.Th) demonstrated significant correlations with failure load (r = 0.85 and 0.72, respectively) and apparent modulus (r = 0.72 and 0.64, respectively) (p < 0.01). Overall, the best predictors of failure load were H (mean), bone volume fraction, and trabecular thickness, with r (2) coefficients of 0.83, 0.76, and 0.80 respectively. This study shows that the fractal parameter H (mean) is correlated with 3D microCT parameters and mechanical properties of femoral head bone samples, which suggests that radiographic texture analysis is a suitable approach for trabecular bone microarchitecture assessment in osteoporotic femurs.
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Affiliation(s)
- Thomas Le Corroller
- Radiology Department, Hôpital Sainte-Marguerite, 270 Boulevard de Sainte-Marguerite, 13009, Marseille, France.
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Le Cann S, Galland A, Parratte S, Rosa B, Argenson JN, Chabrand P. Biomechanical testing of the primary stability of macro and micro-roughnesses acetabular cups: a numerical and an experimental study. Comput Methods Biomech Biomed Engin 2012; 15 Suppl 1:350-2. [PMID: 23009537 DOI: 10.1080/10255842.2012.713720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- S Le Cann
- Aix-Marseille University, ISM, CNRS, UMR 7287, 13288, Marseille, France.
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Berteau JP, Pithioux M, Baron C, Gineyts E, Follet H, Lasaygues P, Chabrand P. Characterisation of the difference in fracture mechanics between children and adult cortical bone. Comput Methods Biomech Biomed Engin 2012; 15 Suppl 1:281-2. [DOI: 10.1080/10255842.2012.713687] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Yone CC, Milan JL, Rossi JM, Witz JF, Brieu M, Chabrand P. Model of cancellous bone adaptation considering hypermineralised bone tissue. Comput Methods Biomech Biomed Engin 2012; 15 Suppl 1:353-4. [DOI: 10.1080/10255842.2012.713724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Yone CC, Milan JL, Rossi JM, Witz JF, Brieu M, Chabrand P. HOMOGENIZATION AND μCT ANALYSIS FOR THE TRABECULAR BONE REMODELLING. J Biomech 2012. [DOI: 10.1016/s0021-9290(12)70533-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Le Corroller T, Halgrin J, Pithioux M, Guenoun D, Chabrand P, Champsaur P. Combination of texture analysis and bone mineral density improves the prediction of fracture load in human femurs. Osteoporos Int 2012; 23:163-9. [PMID: 21739104 DOI: 10.1007/s00198-011-1703-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 06/16/2011] [Indexed: 01/23/2023]
Abstract
UNLABELLED Twenty-one excised femurs were studied using (1) a high-resolution digital X-ray device to estimate three textural parameters, (2) dual-energy X-ray absorptiometry (DXA) to measure bone mineral density (BMD), and (3) mechanical tests to failure. Textural parameters significantly correlated with BMD (p < 0.05) and bone strength (p < 0.05). Combining texture parameters and BMD significantly improved the fracture load prediction from adjusted r(2) = 0.74 to adjusted r(2) =0.82 (p < 0.05). INTRODUCTION The purpose of this study is to determine if the combination of bone texture parameters using a new high-resolution X-ray device and BMD measurement by DXA provided a better prediction of femoral failure load than BMD evaluation alone. METHODS The proximal ends of 21 excised femurs were studied using (1) a high-resolution digital X-ray device (BMA, D3A Medical Systems) to estimate three textural parameters: fractal parameter Hmean, co-occurrence, and run-length matrices, (2) DXA to measure BMD, and (3) mechanical tests to failure in a side-impact configuration. Regions of interest in the femoral neck, intertrochanteric region, and greater trochanter were selected for DXA and bone texture analysis. Every specimen was scanned twice with repositioning before mechanical testing to assess reproducibility using intraclass correlation coefficient (ICC) with 95% confidence interval. The prediction of femoral failure load was evaluated using multiple regression analysis. RESULTS Thirteen femoral neck and 8 intertrochanteric fractures were observed with a mean failure load of 2,612 N (SD, 1,382 N). Fractal parameter Hmean, co-occurrence, and run-length matrices each significantly correlated with site-matched BMD (p < 0.05) and bone strength (p < 0.05). The ICC of the textural parameters varied between 0.65 and 0.90. Combining bone texture parameters and BMD significantly improved the fracture load prediction from adjusted r(2) =0.74 to adjusted r(2) = 0.82 (p < 0.05). CONCLUSION In these excised femurs, the combination of bone texture parameters with BMD demonstrated a better performance in the failure load prediction than that of BMD alone.
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Affiliation(s)
- T Le Corroller
- Department of Radiology, Hôpital Sainte Marguerite, 270 Boulevard de Sainte Marguerite, 13009 Marseille, France.
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