Application of an effective medium theory for modeling ultrasound wave propagation in healing long bones

Potsika, Vassiliki T.; Grivas, Konstantinos; Protopappas, Vasilios C.; Vavva, Maria G.; Raum, Kay; Rohrbach, Daniel; Polyzos, D.; Fotiadis, Dimitrios I.

doi:10.1016/j.ultras.2013.09.002

Cited by 27 publications

(25 citation statements)

References 29 publications

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“…The dispersion of velocity and guided wave features were strongly influenced by the irregular geometry and anisotropy of the osseous, callus and surrounding soft tissues. Then, in (Potsika et al 2014), we presented more realistic numerical models of healing long bones which account for callus porosity and inhomogeneous nature based on SAM images. Wave dispersion and attenuation predictions were performed for the callus at different healing stages.…”

Section: Discussionmentioning

confidence: 99%

“…This could be explained by the consolidation of the callus tissue at the final healing stages, followed by a gradual decrease of the scatterers' volume concentration and diameter. Thus, it was concluded that the effect of scattering, material dispersion and absorption phenomena is more significant during the early healing stages enhancing wave dispersion and attenuation predictions (Potsika et al 2014). Guided wave analysis was also performed and revealed the gradual restoration of Lamb modes in week 9.…”

Section: Fracture Healingmentioning

confidence: 96%

“…. Theoretical group velocity dispersion curves of the symmetric and antisymmetric Lamb modes are also superimposed on each t-f representation More recently in (Potsika et al 2014), we presented a theoretical and computational study based on an iterative effective medium approximation (IEMA) to investigate the evolution of the complex scattering propagation phenomena during fracture healing (Fig. 5).…”

Section: Fracture Healingmentioning

confidence: 99%

“…Nowadays, the rapid technological evolution has enhanced the exploitation of numerical means as powerful computational tools have been developed making efficient use of computation time, power and available memory. Simultaneously, imaging modalities have also evolved, and especially μ-CT and scanning acoustic microscopy (SAM) which illustrate bone microstructure with an analysis down to the μm range leading to more realistic 2D and 3D numerical models , Potsika et al 2014, Moilanen et al 2007). …”

Section: Introductionmentioning

confidence: 99%

“…Emphasis is given on the experimental and numerical studies of our research group over the last decade which investigate bone healing and osteoporosis evolution using QUS , Protopappas et al 2007, Vavva et al 2008a, Potsika et al 2014, Vavva et al 2015, Potsika et al 2016a.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Ultrasonic evaluation of intact, healing and osteoporotic long bones

Potsika¹,

Protopappas²,

Grivas³

et al. 2016

J Serb Soc Comp Mech

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Quantitative ultrasound (QUS) has been introduced in recent years for the comprehensive noninvasive and non-ionizing evaluation of bones. This paper presents a review of our research work of the last decade including experimental and computational studies for the ultrasonic assessment of fracture healing and osteoporosis. The axial transmission and the backscattering methods have been applied to investigate the variation of ultrasound velocity, the propagation of guided waves and the interaction of the complex scattering phenomena with bones. In the macrostructure level, computational models have been established mimicking healthy and pathologic bones, while the use of imaging modalities has opened new perspectives for the evaluation of the bone microstructure using QUS. In the nanostructure level, a deterministic hybrid model for bone healing and angiogenesis predictions under the presence of QUS has been established incorporating the spatiotemporal development of soft tissues, bone and the evolution of blood vessel network. The results reveal the promising monitoring potential of QUS and its positive impact on the acceleration of the bone healing process.

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Section: Discussionmentioning

confidence: 99%

Section: Fracture Healingmentioning

confidence: 96%

Section: Fracture Healingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ultrasonic evaluation of intact, healing and osteoporotic long bones

Potsika¹,

Protopappas²,

Grivas³

et al. 2016

J Serb Soc Comp Mech

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Integrating sensing elements on external fixators for healing assessment of fractured femur

Ong

Chiu

Russ

et al. 2016

Struct. Control Health Monit.

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SUMMARYThis paper highlights the potential of integrating SHM concepts into an external fixator with the aim of using it to assess the healing of a fractured femur. A finite element analysis was first performed on the fixated femur to understand the response of the fixated femur in its fractured and healed state. The underlying mechanics will be used to establish a suitable monitoring strategy for assessment of healing. The results will be supported by a series of experiments using a fixated saw-bone femur, which has been cut to simulate fracture. The cut was filled with epoxy, and the curing of this epoxy was used to simulate healing of the fractured region. The findings lead to an actuation and sensing protocol able to determine the state of union of a fixated long bone. This methodology was tested further by using modelling clay to approximate the mass added by soft tissue surrounding the bone. These results illustrate that the integration of SHM and orthopaedic concepts can provide a quantitative measure that can be used in conjunction with existing techniques for the monitoring of the state of healing of the fracture. This represents a significant potential of reducing or eliminating the qualitative healing assessment.

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Stimulation of Bone Repair with Ultrasound

Padilla

Puts

Vico

et al. 2016

Advances in Experimental Medicine and Biology

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This chapter reviews the different options available for the use of ultrasound in the enhancement of fracture healing or in the reactivation of a failed healing process: LIPUS, shock waves and ultrasound-mediated delivery of bioactive molecules, such as growth factors or plasmids. The main emphasis is on LIPUS, or Low Intensity Pulsed Ultrasound, the most widespread and studied technique. LIPUS has pronounced bioeffects on tissue regeneration, while employing intensities within a diagnostic range. The biological response to LIPUS is complex as the response of numerous cell types to this stimulus involves several pathways. Known to-date mechanotransduction pathways involved in cell responses include MAPK and other kinases signaling pathways, gap-junctional intercellular communication, up-regulation and clustering of integrins, involvement of the COX-2/PGE2 and iNOS/NO pathways, and activation of the ATI mechanoreceptor. Mechanisms at the origin of LIPUS biological effects remain intriguing, and analysis is hampered by the diversity of experimental systems used in-vitro. Data point to clear evidence that bioeffects can be modulated by direct and indirect mechanical effects, like acoustic radiation force, acoustic streaming, propagation of surface waves, heat, fluid-flow induced circulation and redistribution of nutrients, oxygen and signaling molecules. One of the future engineering challenge is therefore the design of dedicated experimental set-ups allowing control of these different mechanical phenomena, and to relate them to biological responses. Then, the derivation of an 'acoustic dose' and the cross-calibration of the different experimental systems will be possible. Despite this imperfect knowledge of LIPUS biophysics, the clinical evidence, although most often of low quality, speaks in favor of the clinical use of LIPUS, when the economics of nonunion and the absence of toxicity of this ultrasound technology are taken into account.

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Application of an effective medium theory for modeling ultrasound wave propagation in healing long bones

Cited by 27 publications

References 29 publications

Ultrasonic evaluation of intact, healing and osteoporotic long bones

Ultrasonic evaluation of intact, healing and osteoporotic long bones

Integrating sensing elements on external fixators for healing assessment of fractured femur

Stimulation of Bone Repair with Ultrasound

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