The predictive ability of a QCT-FE model of the proximal femoral stiffness under multiple load cases is strongly influenced by experimental uncertainties

Amini, Morteza; Reisinger, Andreas; Synek, Alexander; Hirtler, Lena; Pahr, Dieter H.

doi:10.1016/j.jmbbm.2023.105664

Cited by 2 publications

(1 citation statement)

References 38 publications

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“…As FE models may be sensitive to operator-dependant variables and uncertainties in their experimental validation (Taddei et al 2006;Amini et al 2023), this study aims to explore the inter-institutional reproducibility of a FE model previously validated for prediction of femoral fracture under torsional load (Johnson et al 2020).…”

Section: Discussionmentioning

confidence: 99%

Simulated Increase in Monoarticular Hip Muscle Strength Reduces the First Peak of Knee Compression Forces During Walking

Jolas,

Simonsen,

Andersen

2023

Journal of Biomechanical Engineering

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Reducing compressive knee contact forces (KCF) during walking could slow the progression of knee osteoarthritis. A previous study has shown that compensating for the hip flexion/extension moment could reduce the KCF peak occurring during early-stance (KCFp1). Therefore, this study aimed to identify if monoarticular hip muscle could allow this compensation while considering different walking strategies. Gait trials from 24 healthy participants were used to make musculoskeletal models. Five load-cases were examined: (I) Normal, (II) with an applied external moment compensating for the hip flexion/extension moment, (III-V) three conditions with isolated/combined 30% increase of isometric strength of gluteus medius and maximus. KCF, hip muscle forces, and joint moments were computed. A cluster analysis of the Normal condition was performed with hip and knee flexion/extension moment during KCFp1 as input to examine the influence of walking strategies. The cluster analysis revealed two groups having different hip and knee moments in early-stance [p<0.01]. The reduction in KCFp1 from the normal condition, although present in both groups, was greater for the group with the highest hip and lowest knee flexion/extension moments for all conditions (II: -6.03% versus -21.82% [p<0.001], III: -3.21% versus -1.59%, IV: -3.00% versus -1.76%, V: -6.12 versus -3.09%). This reduction in KCFp1 occurred through a shift in force developed by the hamstrings to the gluteus medius and maximus. Differences between groups suggest that this reduction depends on the walking strategy.

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Section: Discussionmentioning

confidence: 99%

Simulated Increase in Monoarticular Hip Muscle Strength Reduces the First Peak of Knee Compression Forces During Walking

Jolas,

Simonsen,

Andersen

2023

Journal of Biomechanical Engineering

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Significance of Choosing Fixators for Osteosynthesis in the Treatment of Patients With Fractures of Proximal Femoral Part

Kozin

2023

Act. Probl. of the Modern Med.

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Introduction. Fracture of the proximal part of the femur is one of the most common and most life-threatening injuries in the elderly patients. At the current stage, the surgical method has taken the leading place in the treatment of these patients. The growing number of surgical interventions, along with the increase in the elderly population globally, has led to a corresponding increase in the number of complications related to both the biological and mechanical properties of the fixator used. The optimal location of the fixing elements in relation to the center and edge of the femoral head, the value of the cervical-diaphyseal angle, and the technical characteristics of the implants remains a relevant issue today. The purpose of this study was to analyze the cause of complications after surgical treatment in patients with fractures of the femoral proximal part taking into account the biomechanical properties of the fixators. Material and methods. Staged results of surgical treatment of 60 patients with fractures of the proximal part of the thigh, who were hospitalized due to complications related to imperfect mechanical fixation of bone fractures, were studied. Patients were divided into 2 groups depending on the type of fixator used. Results. Migration of fixators with a low level of stability occurs even with the initial correct placement of the implant. Notably, a relatively higher frequency of migration occurred when the fixator was applied to the left limb (23:37). Analysis of immediate post-implantation frontal and axial radiographs revealed that, in all instances of medial migration (cutout effect) and lateral migration (outout effect), the Tip-Apex Distance exceeded 25 mm. The positioning of the cervical component of the fixator did not align with its optimal placement as per the Cleveland zones in 84.6% of cases. A notable incidence of complications in extramedullary osteosynthesis was diagnosed during the early postoperative period. This observation may be attributed to an imperfect plan of the staged rehabilitation functional regime. Conclusions. The use of fixators with a low level of stability does not provide high-quality prediction of the course of the postoperative period in patients with femoral proximal fractures. Placing implants for osteosynthesis of the femoral proximal part should ensure reliable fixation of fragments for successful postoperative rehabilitation by taking into account the number of fixators and the features of their location in the proximal fragment of the fracture.

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The predictive ability of a QCT-FE model of the proximal femoral stiffness under multiple load cases is strongly influenced by experimental uncertainties

Cited by 2 publications

References 38 publications

Simulated Increase in Monoarticular Hip Muscle Strength Reduces the First Peak of Knee Compression Forces During Walking

Simulated Increase in Monoarticular Hip Muscle Strength Reduces the First Peak of Knee Compression Forces During Walking

Significance of Choosing Fixators for Osteosynthesis in the Treatment of Patients With Fractures of Proximal Femoral Part

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