It is known that structural integrity of articular cartilage is compromised at impact loads exceeding 25 MPa, and chondrocyte apoptosis can occur at sustained loads of as little as 4.5 MPa in immature bovine cartilage. The results of this study indicate that although the patellofemoral contact pressures are higher with SP nail insertion, they remain below the values reported to be detrimental to articular cartilage. Based on these data, we do not believe that the SP entry portal poses a significant risk to the viability or structural integrity of the articular cartilage of the patellofemoral joint. Clinical correlation is needed.

The purpose of this study was to seek broad verification and validation of human lumbar spine finite element models created using a previously published automated algorithm. The automated algorithm takes segmented CT scans of lumbar vertebrae, automatically identifies important landmarks and contact surfaces, and creates a finite element model. Mesh convergence was evaluated by examining changes in key output variables in response to mesh density. Semi-direct validation was performed by comparing experimental results for a single specimen to the automated finite element model results for that specimen with calibrated material properties from a prior study. Indirect validation was based on a comparison of results from automated finite element models of 18 individual specimens, all using one set of generalized material properties, to a range of data from the literature. A total of 216 simulations were run and compared to 186 experimental data ranges in all six primary bending modes up to 7.8Nm with follower loads up to 1000N. Mesh convergence results showed less than a 5% difference in key variables when the original mesh density was doubled. The semi-direct validation results showed that the automated method produced results comparable to manual finite element modeling methods. The indirect validation results showed a wide range of outcomes due to variations in the geometry alone. The studies showed that the automated models can be used to reliably evaluate lumbar spine biomechanics, specifically within our intended context of use: in pure bending modes, under relatively low non-injurious simulated in vivo loads, to predict torque rotation response, disc pressures, and facet forces.

Understanding the kinematics of the lumbosacral spine and the individual functional spinal units (FSU) is essential in assessing spine mechanics and implant performance. The lumbosacral spine and the FSU are comprised of bones and complex soft tissues such as intervertebral discs (IVD) and ligaments. Prior studies have focused on the behavior of isolated structures, but the contribution of each structure to the overall kinematics of the spine needs to be further understood. In this study, the behavior of various structural conditions was determined by experimentally dissecting each ligament in a stepwise fasion until only the IVD remained, and applying loading conditions to the FSU. The FE model was validated through optimization to match the in vitro load-deflection characteristics and contact mechanics for the various structural configurations.

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Soft tissue structures of the L4-L5 level of the human lumbar spine are represented in finite-element (FE) models, which are used to evaluate spine biomechanics and implant performance. These models typically use average properties; however, experimental testing reports variation up to 40% in ligament stiffness and even greater variability for annulus fibrosis (AF) properties. Probabilistic approaches enable consideration of the impact of intersubject variability on model outputs. However, there are challenges in directly applying the variability in measured load–displacement response of structures to a finite-element model. Accordingly, the objectives of this study were to perform a comprehensive review of the properties of the L4-L5 structures and to develop a probabilistic representation to characterize variability in the stiffness of spinal ligaments and parameters of a Holzapfel–Gasser–Ogden constitutive material model of the disk. The probabilistic representation was determined based on direct mechanical test data as found in the literature. Monte Carlo simulations were used to determine the uncertainty of the Holzapfel–Gasser–Ogden constitutive model. A single stiffness parameter was defined to characterize each ligament, with the anterior longitudinal ligament (ALL) being the stiffest, while the posterior longitudinal ligament and interspinous ligament (ISL) had the greatest variation. The posterior portion of the annulus fibrosis had the greatest stiffness and greatest variation up to 300% in circumferential loading. The resulting probabilistic representation can be utilized to include intersubject variability in biomechanics evaluations.