[Feasibility and accuracy of ultrasound-guided methodology in the examination of lumbar spine facet joints].

PubMed

Wen, Chuan-Bing; Li, Yong-Zhong; Tang, Qin-Qin; Sun, Lin; Xiao, Hong; Yang, Bang-Xiang; Song, Li; Liu, Hui

2013-03-01

To investigate the feasibility, accuracy of B ultrasound in the examination of joint space of lumbar spine facet joints compared with CT scan. Ten healthy adult volunteers were enrolled. The joint space of lumbar facet joints was measured by ultrasound. To identify the spinal levels, the posterior parasagittal sonograms were obtained at levels L1 to S1. The lumbar facet joints were delineated with the help of transverse sonograms at each level. Meanwhile, the lumbar facet joints were evaluated by spiral CT on the same plane, reformatted to 1-mm axial slices. A total of 88 lumbar facet joints from L1 to S1 were clearly visualized in the 10 volunteers. Both ultrasound and CT measurements showed the same average depth and lateral distance of lumbar facet joint space (P > 0.05). The lumbar facet joint space can be accurately demonstrated by ultrasound.

Contact characteristics of the subtalar joint after a simulated calcaneus fracture.

PubMed

Sangeorzan, B J; Ananthakrishnan, D; Tencer, A F

1995-06-01

A simple calcaneus fracture consisting of two parts was modeled in nine fresh cadaver hindfoot specimens to assess changes in subtalar joint contact characteristics with increasing plantar depression of the posterolateral fracture component. To perform the experiment, rods were placed in the tibial and fibular shafts of each specimen, which was mounted in a frame in neutral stance. A pneumatic cylinder was used to deliver a vertical compressive load through the rods into the foot while permitting free motion of the foot in the horizontal plane. Sealed packets of pressure-sensitive film were inserted into the anterior-middle and posterior facets of the talocalcaneal articulation, and a 700-N load was applied. After testing of the intact foot, a primary fracture line was created using a microoscillating saw. The osteotomized posterolateral component was anatomically reduced and fixed, the film inserted, and the load reapplied. The test was repeated after the posterolateral fragment was displaced 2, 5, and 10 mm in a plantar direction. The resulting pressure prints were scanned along with pressure/color density calibration strips using a flat-bed scanner, and an image analysis system was used to determine contact areas within specified pressure intervals. The contact area (> 0.5 MPa) of the posterior facet was significantly decreased with 2, 5, and 10 mm displacements of the posterolateral calcaneus fracture component. The ratio of high-pressure area (< 5.0 MPa) to contact area in the posterior facet was significantly increased only with displacements of 5 and 10 mm. There were no significant changes in any contact parameters in the anterior-middle facet.(ABSTRACT TRUNCATED AT 250 WORDS)

Migrating lumbar facet joint cysts.

PubMed

Palmieri, Francesco; Cassar-Pullicino, Victor N; Lalam, Radhesh K; Tins, Bernhard J; Tyrrell, Prudencia N M; McCall, Iain W

2006-04-01

The majority of lumbar facet joint cysts (LFJCs) are located in the spinal canal, on the medial aspect of the facet joint with characteristic diagnostic features. When they migrate away from the joint of origin, they cause diagnostic problems. In a 7-year period we examined by computed tomography (CT) and magnetic resonance (MR) imaging five unusual cases of facet joint cysts which migrated from the facet joint of origin. Three LFJCs were identified in the right S1 foramen, one in the right L5-S1 neural foramen and one in the left erector spinae and multifidus muscles between the levels of L2-L4 spinous process. Awareness that spinal lesions identified at MRI and CT could be due to migrating facet joint cyst requires a high level of suspicion. The identification of the appositional contact of the cyst and the facet joint needs to be actively sought in the presence of degenerative facet joints.

Facet joint laser radiation: tissue effects of a new clinical laser application

NASA Astrophysics Data System (ADS)

Werkmann, Klaus; Thal, Dietmar R.

1996-01-01

Chronic unilateral and bilateral back pain with pseudoradicular symptoms, is a common clinical syndrome, which in many cases can be related to the facet joint syndrome. The pain is caused by mechanical affection of synovial and capsular nerve terminals. Therefore, current therapeutical attempts including physical therapy, intra-articular injection of local anesthetics and steroids and thermocoagulation of the facet joint with a thermocoagulator, are performed. We confirmed laser coagulation of the facet joint. Porcine cadaveric spines were treated immediately after death by intra-articular facet joint laser radiation. With the pulsed Nd:YAG laser (1064 nm) altogether 600 J were applied in three different places 4 mm apart at the top of the facet joint. The results showed that facet joint laser radiation leads to a small (about 1 - 2 mm diameter) lesion restricted to the facet joint cavity and its synovia. Histologically, we found a central carbonization zone and necrosis, including almost the whole cartilage and approximately 0.2 mm of the adjacent bone. These changes are similar to Nd:Yag-laser applications in other skeletal regions. It is suggested that these changes may lead to facet joint denervation by coagulation of the synovial nerve terminals. Cicatration of the laser lesion might cause ankylosis of this joint. In sum, facet joint laser radiation could be an alternative therapeutical tool for lower back pain of the facet joint syndrome type. Therefore, future clinical application of this technique seems to be very promising.

Effect of the transverse ligament rupture on the biomechanics of the cervical spine under a compressive loading.

PubMed

Mesfar, Wissal; Moglo, Kodjo

2013-10-01

In order to diagnosis a transverse ligament rupture in the cervical spine, clinicians normally measure the atlas-dens interval by using CT scan images. However, the impact of this tear on the head and neck complex biomechanics is not widely studied. The transverse ligament plays a very important role in stabilizing the joint and its alteration may have a substantial effect on the whole head and neck complex. A finite element model consisting of bony structures along with cartilage, intervertebral discs and all ligaments was developed based on CT and MRI images. The effect of head weights (compressive load) of 30 N to 57 N was investigated in the cases of intact and ruptured transverse ligament joints. The model was validated based on experimental studies investigating the response of the cervical spine under the extension-flexion moment. The predictions indicate a significant alteration of the kinematics and load distribution at the facet joints of the cervical spine with a transverse ligament tear. The vertebrae flexion, the contact force at the facets joints and the atlas-dens interval increase with the rupture of the transverse ligament and are dependent to the head weight. A transverse ligament tear increases the flexion angle of the head and the vertebrae as well as the atlas-dens interval. The atlas-dens interval reaches a critical value when the compressive loading exceeds 40 N. Supporting the head after an injury should be considered to avoid compression of the spinal cord and permanent neurologic damage. © 2013.

The comparison of measurement between ultrasound and computed tomography for abnormal degenerative facet joints: A STROBE-compliant article.

PubMed

Shi, Wen; Tian, Dan; Liu, Da; Yin, Jing; Huang, Ying

2017-08-01

Besides the study on examining facet joints of lumbar spine by ultrasound in normal population, there has not been any related report about examining normal facet joints of lumbar spine by ultrasound so far. This study was aimed to explore the feasibility of ultrasound assessment of lumber spine facet joints by comparing ultrasound measure values of normal and degenerative lumber spine facet joints, and by comparing measure values of ultrasound and computed tomography (CT) of degenerative lumber spine facet joints.This study included 15 patients who had chronic low back pain because of degenerative change in lumbar vertebrae, and 19 volunteers who did not have low back pain or pain in the lower limb. The ultrasound measure values (height [H] and width [W]) of normal and degenerative lumber spine facet joints were compared. And the differentiation between measure values (H and W) of ultrasound and CT of degenerative lumber spine facet joints was also analyzed.The ultrasound clearly showed abnormal facet joints lesion, which was characterized by hyperostosis on the edge of joints, bone destruction under joints, and thinner or thicker articular cartilage. There were significant differences between the ultrasound measure values of the normal (H: 1.26 ± 0.03 cm, W: 0.18 ± 0.01 cm) and abnormal facet joints (H: 1.43 ± 0.05 cm, W: 0.15 ± 0.02 cm) (all P < .05). However, there were no significant differences between the measure values of the ultrasound (H: 1.43 ± 0.17 cm, W: 0.15 ± 0.03 cm) and CT (H: 1.42 ± 0.16, W: 0.14 ± 0.03) of the degenerative lumber spine facet joints (all P > .05).Ultrasound can clearly show the structure of facet joints of lumbar spine. It is precise and feasible to assess facet joints of lumbar spine by ultrasound. This study has important significance for the diagnosis of lumbar facet joint degeneration.

Facet joint geometry and intervertebral disk degeneration in the L5-S1 region of the vertebral column in German Shepherd dogs.

PubMed

Seiler, Gabriela S; Häni, Hansjürg; Busato, André R; Lang, Johann

2002-01-01

To evaluate the possible association between facet joint geometry and intervertebral disk degeneration in German Shepherd Dogs. 25 German Shepherd Dogs and 11 control dogs of similar body weight and condition. Facet joint angles in the caudal portion of the lumbar region of the vertebral column (L5-S1) were measured by use of computed tomography, and the intervertebral discs were evaluated microscopically. The relationship between facet joint geometry and disk degeneration was evaluated by use of statistical methods. German Shepherd Dogs had significantly more facet joint tropism than control dogs, but an association with disk degeneration was not found. However, German Shepherd Dogs had a different facet joint conformation, with more sagittally oriented facet joints at L5-L6 and L6-L7 and a larger angle difference between the lumbar and lumbosacral facet joints, compared with control dogs. A large difference between facet joint angles at L6-L7 and L7-S1 in German Shepherd Dogs may be associated with the frequent occurrence of lumbosacral disk degeneration in this breed.

Quantitative in vivo MRI evaluation of lumbar facet joints and intervertebral discs using axial T2 mapping.

PubMed

Stelzeneder, David; Messner, Alina; Vlychou, Marianna; Welsch, Goetz H; Scheurecker, Georg; Goed, Sabine; Pieber, Karin; Pflueger, Verena; Friedrich, Klaus M; Trattnig, Siegfried

2011-11-01

To assess the feasibility of T2 mapping of lumbar facet joints and intervertebral discs in a single imaging slab and to compare the findings with morphological grading. Sixty lumbar spine segments from 10 low back pain patients and 5 healthy volunteers were examined by axial T2 mapping and morphological MRI at 3.0 Tesla. Regions of interest were drawn on a single slice for the facet joints and the intervertebral discs (nucleus pulposus, anterior and posterior annulus fibrosus). The Weishaupt grading was used for facet joints and the Pfirrmann score was used for morphological disc grading ("normal" vs. "abnormal" discs). The inter-rater agreement was excellent for the facet joint T2 evaluation (r = 0.85), but poor for the morphological Weishaupt grading (kappa = 0.15). The preliminary results show similar facet joint T2 values in segments with normal and abnormal Pfirrmann scores. There was no difference in mean T2 values between facet joints in different Weishaupt grading groups. Facet joint T2 values showed a weak correlation with T2 values of the posterior annulus (r = 0.32) This study demonstrates the feasibility of a combined T2 mapping approach for the facet joints and intervertebral discs using a single axial slab.

Intra-articular nerve growth factor regulates development, but not maintenance, of injury-induced facet joint pain & spinal neuronal hypersensitivity.

PubMed

Kras, J V; Kartha, S; Winkelstein, B A

2015-11-01

The objective of the current study is to define whether intra-articular nerve growth factor (NGF), an inflammatory mediator that contributes to osteoarthritic pain, is necessary and sufficient for the development or maintenance of injury-induced facet joint pain and its concomitant spinal neuronal hyperexcitability. Male Holtzman rats underwent painful cervical facet joint distraction (FJD) or sham procedures. Mechanical hyperalgesia was assessed in the forepaws, and NGF expression was quantified in the C6/C7 facet joint. An anti-NGF antibody was administered intra-articularly in additional rats immediately or 1 day following facet distraction or sham procedures to block intra-articular NGF and test its contribution to initiation and/or maintenance of facet joint pain and spinal neuronal hyperexcitability. NGF was injected into the bilateral C6/C7 facet joints in separate rats to determine if NGF alone is sufficient to induce these behavioral and neuronal responses. NGF expression increases in the cervical facet joint in association with behavioral sensitivity after that joint's mechanical injury. Intra-articular application of anti-NGF immediately after a joint distraction prevents the development of both injury-induced pain and hyperexcitability of spinal neurons. Yet, intra-articular anti-NGF applied after pain has developed does not attenuate either behavioral or neuronal hyperexcitability. Intra-articular NGF administered to the facet in naïve rats also induces behavioral hypersensitivity and spinal neuronal hyperexcitability. Findings demonstrate that NGF in the facet joint contributes to the development of injury-induced joint pain. Localized blocking of NGF signaling in the joint may provide potential treatment for joint pain. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Biochemical and biomechanical characterisation of equine cervical facet joint cartilage.

PubMed

O'Leary, S A; White, J L; Hu, J C; Athanasiou, K A

2018-04-15

The equine cervical facet joint is a site of significant pathology. Located bilaterally on the dorsal spine, these diarthrodial joints work in conjunction with the intervertebral disc to facilitate appropriate spinal motion. Despite the high prevalence of pathology in this joint, the facet joint is understudied and thus lacking in viable treatment options. The goal of this study was to characterise equine facet joint cartilage and provide a comprehensive database describing the morphological, histological, biochemical and biomechanical properties of this tissue. Descriptive cadaver studies. A total of 132 facet joint surfaces were harvested from the cervical spines of six skeletally mature horses (11 surfaces per animal) for compiling biomechanical and biochemical properties of hyaline cartilage of the equine cervical facet joints. Gross morphometric measurements and histological staining were performed on facet joint cartilage. Creep indentation and uniaxial strain-to-failure testing were used to determine the biomechanical compressive and tensile properties. Biochemical assays included quantification of total collagen, sulfated glycosaminoglycan and DNA content. The facet joint surfaces were ovoid in shape with a flat articular surface. Histological analyses highlighted structures akin to articular cartilage of other synovial joints. In general, biomechanical and biochemical properties did not differ significantly between the inferior and superior joint surfaces as well as among spinal levels. Interestingly, compressive and tensile properties of cervical facet articular cartilage were lower than those of articular cartilage from other previously characterised equine joints. Removal of the superficial zone reduced the tissue's tensile strength, suggesting that this zone is important for the tensile integrity of the tissue. Facet surfaces were sampled at a single, central location and do not capture the potential topographic variation in cartilage properties. This is the first study to report the properties of equine cervical facet joint cartilage and may serve as the foundation for the development of future tissue-engineered replacements as well as other treatment strategies. © 2018 EVJ Ltd.

Topping-off technique prevents aggravation of degeneration of adjacent segment fusion revealed by retrospective and finite element biomechanical analysis.

PubMed

Zhu, Zhenqi; Liu, Chenjun; Wang, Kaifeng; Zhou, Jian; Wang, Jiefu; Zhu, Yi; Liu, Haiying

2015-01-28

The aim of this study was to evaluate the effect of the Topping-off technique in preventing the aggravation of degeneration caused by adjacent segment fusion. Clinical parameters of patients who underwent L5-S1 posterior lumbar interbody fusion + interspinous process at L4-L5 (PLIF + ISP) with the Wallis system (Topping-off group) were compared retrospectively with those of patients who underwent solely PLIF. Pre- and post-operative x-ray measurements, visual analogue scale (VAS) scores, and Japanese Orthopaedic Association (JOA) scores were assessed in all subjects. Normal L1-S1 lumbosacral finite element models were established in accordance with the two types of surgery in our study, respectively. Virtual loading was added to assess the motility, disc pressure, and facet joint stress of L4-L5. There were 22 and 23 valid cases included in the Topping-off and PLIF groups. No degeneration was observed in either group. Both VAS and JOA scores improved significantly post-operatively (P < 0.01). The intervertebral angle and lumbar lordosis of L4-L5 were both significantly increased (t = -2.89 and -2.68, P < 0.05 in the Topping-off group and t = -2.25 and -2.15, P < 0.05 in the PLIF group). In the Topping-off group, x-ray in dynamic position showed no significant difference in the angulation or distance of the anterior movement of the L4-L5 segment. The angle of hyper-extension and distance of the posterior movement of L4 were significantly decreased. In the PLIF group, both hyper-flexion and hyper-extension and posterior movement were increased significantly. In finite element analysis, displacement of the L4 vertebral body, pressure of the annulus fibrosus and nucleus pulposus, and stress of the bilateral facet joint were less in the Topping-off group under loads of anterior flexion and posterior extension. Facet joint stress on the left side of the L4-L5 segment was also less in the Topping-off group under left flexion loads. Short-term efficacy and safety between Topping-off and PLIF were similar, whilst the Topping-off technique could restrict the hyper-extension movement of adjacent segments, prevent back and forth movement of proximal vertebrae, and decrease loads of intervertebral disc and facet joints.

Facet joint disturbance induced by miniscrews in plated cervical laminoplasty

PubMed Central

Chen, Hua; Li, Huibo; Wang, Beiyu; Li, Tao; Gong, Quan; Song, Yueming; Liu, Hao

2016-01-01

Abstract A retrospective cohort study. Plated cervical laminoplasty is an increasingly common technique. A unique facet joint disturbance induced by lateral mass miniscrews penetrating articular surface was noticed. Facet joints are important to maintain cervical spine stability and kinetic balance. Whether this facet joint disturbance could affect clinical and radiologic results is still unknown. The objective of this study is to investigate the clinical and radiologic outcomes of patients with facet joints disturbance induced by miniscrews in plated cervical laminoplasty. A total of 105 patients who underwent cervical laminoplasty with miniplate fixation between May 2010 and February 2014 were comprised. Postoperative CT images were used to identify whether facet joints destroyed by miniscrews. According to facet joints destroyed number, all the patients were divided into: group A (none facet joint destroyed), group B (1–2 facet joints destroyed), and group C (≥3 facet joints destroyed). Clinical data (JOA, VAS, and NDI scores), radiologic data (anteroposterior diameter and Palov ratio), and complications (axial symptoms and C5 palsy) were evaluated and compared among the groups. There were 38, 40, and 27 patients in group A, B, and C, respectively. The overall facet joints destroyed rate was 30.7%. All groups gained significant JOA and NDI scores improvement postoperatively. The preoperative JOA, VAS, NDI scores, and postoperative JOA scores did not differ significantly among the groups. The group C recorded significant higher postoperative VAS scores than group A (P = 0.002) and B (P = 0.014) and had significant higher postoperative NDI scores than group A (P = 0.002). The pre- and postoperative radiologic data were not significant different among the groups. The group C had a significant higher axial symptoms incidence than group A (12/27 vs 8/38, P = 0.041). Facet joints disturbance caused by miniscrews in plated cervical laminoplasty may not influence neurological recovery and spinal canal expansion, but may negatively affect postoperative axial symptoms. PMID:27661016

Bipolar Radiofrequency Facet Ablation of the Lumbar Facet Capsule: An Adjunct to Conventional Radiofrequency Ablation for Pain Management

PubMed Central

Palea, Ovidiu; Granville, Michelle

2017-01-01

Radiofrequency facet ablation (RFA) has been performed using the same technique for over 50 years. Except for variations in electrode size, tip shape, and change in radiofrequency (RF) stimulation parameters, using standard, pulsed, and cooled RF wavelengths, the target points have remained absolutely unchanged from the original work describing RFA for lumbar pain control. Degenerative changes in the facet joint and capsule are the primary location for the majority of lumbar segmental pathology and pain. Multiple studies show that the degenerated facet joint is richly innervated as a result of the inflammatory overgrowth of the synovium. The primary provocative clinical test to justify an RFA is to perform an injection with local anesthetic into the facet joint and the posterior capsule and confirm pain relief. However, after a positive response, the radiofrequency lesion is made not to the facet joint but to the more proximal fine nerve branches that innervate the joint. The accepted target points for the recurrent sensory branch ignore the characteristic rich innervation of the pathologic lumbar facet capsule and assume that lesioning of these recurrent branches is sufficient to denervate the painful pathologic facet joint. This report describes the additional targets and technical steps for further coagulation points along the posterior capsule of the lumbar facet joint and the physiologic studies of the advantage of the bipolar radiofrequency current in this location. Bipolar RF to the facet capsule is a simple, extra step that easily creates a large thermo-coagulated lesion in this capsule region of the pathologic facet joint. Early studies demonstrate bipolar RF to the facet capsule can provide long-term pain relief when used alone for specific localized facet joint pain, to coagulate lumbar facet cysts to prevent recurrence, and to get more extensive pain control by combining it with traditional lumbar RFA, especially when RFA is repeated. PMID:29119066

Bipolar Radiofrequency Facet Ablation of the Lumbar Facet Capsule: An Adjunct to Conventional Radiofrequency Ablation for Pain Management.

PubMed

Jacobson, Robert E; Palea, Ovidiu; Granville, Michelle

2017-09-01

Radiofrequency facet ablation (RFA) has been performed using the same technique for over 50 years. Except for variations in electrode size, tip shape, and change in radiofrequency (RF) stimulation parameters, using standard, pulsed, and cooled RF wavelengths, the target points have remained absolutely unchanged from the original work describing RFA for lumbar pain control. Degenerative changes in the facet joint and capsule are the primary location for the majority of lumbar segmental pathology and pain. Multiple studies show that the degenerated facet joint is richly innervated as a result of the inflammatory overgrowth of the synovium. The primary provocative clinical test to justify an RFA is to perform an injection with local anesthetic into the facet joint and the posterior capsule and confirm pain relief. However, after a positive response, the radiofrequency lesion is made not to the facet joint but to the more proximal fine nerve branches that innervate the joint. The accepted target points for the recurrent sensory branch ignore the characteristic rich innervation of the pathologic lumbar facet capsule and assume that lesioning of these recurrent branches is sufficient to denervate the painful pathologic facet joint. This report describes the additional targets and technical steps for further coagulation points along the posterior capsule of the lumbar facet joint and the physiologic studies of the advantage of the bipolar radiofrequency current in this location. Bipolar RF to the facet capsule is a simple, extra step that easily creates a large thermo-coagulated lesion in this capsule region of the pathologic facet joint. Early studies demonstrate bipolar RF to the facet capsule can provide long-term pain relief when used alone for specific localized facet joint pain, to coagulate lumbar facet cysts to prevent recurrence, and to get more extensive pain control by combining it with traditional lumbar RFA, especially when RFA is repeated.

Surgical Tips to Preserve the Facet Joint during Microdiscectomy

PubMed Central

Park, Man-Kyu; Cho, Dae-Chul; Sung, Joo-Kyung

2013-01-01

Lumbar microdiscectomy (MD) is the gold standard for treatment of lumbar disc herniation. Generally, the surgeon attempts to protect the facet joint in hopes of avoiding postoperative pain/instability and secondary degenerative arthropathy. We believe that preserving the facet joint is especially important in young patients, owing to their life expectancy and activity. However, preserving the facet joint is not easy during lumbar MD. We propose several technical tips (superolateral extension of conventional laminotomy, oblique drilling for laminotomy, and additional foraminotomy) for facet joint preservation during lumbar MD. PMID:24294466

INTRA-ARTICULAR NERVE GROWTH FACTOR REGULATES DEVELOPMENT, BUT NOT MAINTENANCE, OF INJURY-INDUCED FACET JOINT PAIN & SPINAL NEURONAL HYPERSENSITIVITY

PubMed Central

Kras, Jeffrey V.; Kartha, Sonia; Winkelstein, Beth A.

2015-01-01

Objective The objective of the current study is to define whether intra-articular nerve growth factor (NGF), an inflammatory mediator that contributes to osteoarthritic pain, is necessary and sufficient for the development or maintenance of injury-induced facet joint pain and its concomitant spinal neuronal hyperexcitability. Method Male Holtzman rats underwent painful cervical facet joint distraction or sham procedures. Mechanical hyperalgesia was assessed in the forepaws, and NGF expression was quantified in the C6/C7 facet joint. An anti-NGF antibody was administered intra-articularly in additional rats immediately or 1 day following facet distraction or sham procedures to block intra-articular NGF and test its contribution to initiation and/or maintenance of facet joint pain and spinal neuronal hyperexcitability. NGF was injected into the bilateral C6/C7 facet joints in separate rats to determine if NGF alone is sufficient to induce these behavioral and neuronal responses. Results NGF expression increases in the cervical facet joint in association with behavioral sensitivity after that joint’s mechanical injury. Intra-articular application of anti-NGF immediately after a joint distraction prevents the development of both injury-induced pain and hyperexcitability of spinal neurons. Yet, intra-articular anti-NGF applied after pain has developed does not attenuate either behavioral or neuronal hyperexcitability. Intra-articular NGF administered to the facet in naïve rats also induces behavioral hypersensitivity and spinal neuronal hyperexcitability. Conclusion Findings demonstrate that NGF in the facet joint contributes to the development of injury-induced joint pain. Localized blocking of NGF signaling in the joint may provide potential treatment for joint pain. PMID:26521746

Magnetic resonance-guided focused ultrasound treatment of facet joint pain: summary of preclinical phase

PubMed Central

2014-01-01

Study design A phantom experiment, two thermocouple experiments, three in vivo pig experiments, and a simulated treatment on a healthy human volunteer were conducted to test the feasibility, safety, and efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) for treating facet joint pain. Objective The goal of the current study was to develop a novel method for accurate and safe noninvasive facet joint ablation using MRgFUS. Summary of background data Facet joints are a common source of chronic back pain. Direct facet joint interventions include medial branch nerve ablation and intra-articular injections, which are widely used, but limited in the short and long term. MRgFUS is a breakthrough technology that enables accurate delivery of high-intensity focused ultrasound energy to create a localized temperature rise for tissue ablation, using MR guidance for treatment planning and real-time feedback. Methods We validated the feasibility, safety, and efficacy of MRgFUS for facet joint ablation using the ExAblate 2000® System (InSightec Ltd., Tirat Carmel, Israel) and confirmed the system's ability to ablate the edge of the facet joint and all terminal nerves innervating the joint. A phantom experiment, two thermocouple experiments, three in vivo pig experiments, and a simulated treatment on a healthy human volunteer were conducted. Results The experiments showed that targeting the facet joint with energies of 150–450 J provides controlled and accurate heating at the facet joint edge without penetration to the vertebral body, spinal canal, or root foramina. Treating with reduced diameter of the acoustic beam is recommended since a narrower beam improves access to the targeted areas. Conclusions MRgFUS can safely and effectively target and ablate the facet joint. These results are highly significant, given that this is the first study to demonstrate the potential of MRgFUS to treat facet joint pain. PMID:24921048

Superior Recess Access of the Lumbar Facet Joint.

PubMed

Demir-Deviren, Sibel; Singh, Sukhminder; Hanelin, Joshua

2017-04-01

Descriptive approach to accessing the lumbar facet joint by superior recess. This study is aimed to describe an approach to accessing the lumbar facet joint through targeting the superior recess during lumbar facet joint injections. Lumbar facet joint injections are routinely performed for both the diagnosis and treatment of chronic low back pain. Previous studies either did not specify which part of the joint to target, or recommended targeting the inferior aspect of the joint to access the inferior recess. One study did mention the superior recess as an alternative to injecting the inferior recess, but none has focused on description of the technique. This is the first time this technique has been described. The records and fluoroscopic images were reviewed for all patients over a period of 9 months (January-September 2012) using the proposed technique. This resulted in a total of 48 patients; 15 men, 29 women, and a total of 117 facet joint intra-articular injections. Among these 48 patients, injections were repeated in total of 4 cases. The average time of injections among 4 repeat cases was 121 days. The success of the procedure was confirmed with an arthrogram demonstrating contrast flowing from the superior recess inferiorly through the joint space. Successful access of the lumbar facet joint through puncture of the superior recess was seen in 114 cases, with 3 unsuccessful attempts to enter facet joints due to osteophytes at involved levels. There were no complications observed during the procedure. We find this approach to be highly successful, safe, and well tolerated by the patient and recommend it as a technique for access of the lumbar facet joint in those patients in whom direct puncture of the inferior recess is difficult.

Facet joint hypertrophy is a misnomer: A retrospective study.

PubMed

An, Sang Joon; Seo, Mi Sook; Choi, Soo Il; Lim, Tae-Ha; Shin, So Jin; Kang, Keum Nae; Kim, Young Uk

2018-06-01

One of the major causes of lumbar spinal canal stenosis (LSCS) has been considered facet joint hypertrophy (FJH). However, a previous study asserted that "FJH" is a misnomer because common facet joints are no smaller than degenerative facet joints; however, this hypothesis has not been effectively demonstrated. Therefore, in order to verify that FJH is a misnomer in patients with LSCS, we devised new morphological parameters that we called facet joint thickness (FJT) and facet joint cross-sectional area (FJA).We collected FJT and FJA data from 114 patients with LSCS. A total of 86 control subjects underwent lumbar magnetic resonance imaging (MRI) as part of routine medical examinations, and axial T2-weighted MRI images were obtained from all participants. We measured FJT by drawing a line along the facet area and then measuring the narrowest point at L4-L5. We measured FJA as the whole cross-sectional area of the facet joint at the stenotic L4-L5 level.The average FJT was 1.60 ± 0.36 mm in the control group and 1.11 ± 0.32 mm in the LSCS group. The average FJA was 14.46 ± 5.17 mm in the control group and 9.31 ± 3.47 mm in the LSCS group. Patients with LSCS had significantly lower FJTs (P < .001) and FJAs (P < .001).FJH, a misnomer, should be renamed facet joint area narrowing. Using this terminology would eliminate confusion in descriptions of the facet joint.

THE PROSTAGLANDIN E2 RECEPTOR, EP2, IS UPREGULATED IN THE DRG AFTER PAINFUL CERVICAL FACET JOINT INJURY IN THE RAT

PubMed Central

Kras, Jeffrey V.; Dong, Ling; Winkelstein, Beth A.

2012-01-01

Study Design This study implemented immunohistochemistry to assay prostaglandin E2 (PGE2) receptor EP2 expression in the dorsal root ganglion (DRG) of rats after painful cervical facet joint injury. Objective The objective of this study was to identify if inflammatory cascades are induced in association with cervical facet joint distraction-induced pain by investigating the time course of EP2 expression in the DRG. Summary of Background Data The cervical facet joint is a common source of neck pain and non-physiological stretch of the facet capsular ligament can initiate pain from the facet joint via mechanical injury. PGE2 levels are elevated in painful inflamed and arthritic joints, and PGE2 sensitizes joint afferents to mechanical stimulation. Although in vitro studies suggest the EP2 receptor subtype contributes to painful joint disease the EP2 response has not been investigated for any association with painful mechanical joint injury. Methods Separate groups of male Holtzman rats underwent either a painful cervical facet joint distraction injury or sham procedure. Bilateral forepaw mechanical allodynia was assessed, and immunohistochemical techniques were used to quantify EP2 expression in the DRG at days 1 and 7. Results Facet joint distraction induced mechanical allodynia that was significant (p<0.024) at all time points. Painful joint injury also significantly elevated total EP2 expression in the DRG at day 1 (p=0.009), which was maintained also at day 7 (p<0.001). Neuronal expression of EP2 in the DRG was only increased over sham levels at day 1 (p=0.013). Conclusions Painful cervical facet joint distraction induces an immediate and sustained increase of EP2 expression in the DRG, implicating peripheral inflammation in the initiation and maintenance of facet joint pain. The transient increase in neuronal EP2 suggests, as in other painful joint conditions, that after joint injury non-neuronal cells may migrate to the DRG, some of which likely express EP2. PMID:22789984

Isolation and Characterization of Human Mesenchymal Stem Cells From Facet Joints and Interspinous Ligaments.

PubMed

Kristjánsson, Baldur; Limthongkul, Worawat; Yingsakmongkol, Wicharn; Thantiworasit, Pattarawat; Jirathanathornnukul, Napaphat; Honsawek, Sittisak

2016-01-01

A descriptive in vitro study on isolation and differentiation of human mesenchymal stem cells (MSCs) derived from the facet joints and interspinous ligaments. To isolate cells from the facet joints and interspinous ligaments and investigate their surface marker profile and differentiation potentials. Lumbar spinal canal stenosis and ossification of the posterior longitudinal ligament are progressive conditions characterized by the hypertrophy and ossification of ligaments and joints within the spinal canal. MSCs are believed to play a role in the advancement of these diseases and the existence of MSCs has been demonstrated within the ligamentum flavum and posterior longitudinal ligament. The aim of this study was to investigate whether these cells could also be found within facet joints and interspinous ligaments. Samples were harvested from 10 patients undergoing spinal surgery. The MSCs from facet joints and interspinous ligaments were isolated using direct tissue explant technique. Cell surface antigen profilings were performed via flow cytometry. Their lineage differentiation potentials were analyzed. The facet joints and interspinous ligaments-derived MSCs have the tri-lineage potential to be differentiated into osteogenic, adipogenic, and chondrogenic cells under appropriate inductions. Flow cytometry analysis revealed both cell lines expressed MSCs markers. Both facet joints and interspinous ligaments-derived MSCs expressed marker genes for osteoblasts, adipocytes, and chondrocytes. The facet joints and interspinous ligaments may provide alternative sources of MSCs for tissue engineering applications. The facet joints and interspinous ligaments-derived MSCs are part of the microenvironment of the human ligaments of the spinal column and might play a crucial role in the development and progression of degenerative spine conditions.

Does superior-segment facet violation or laminectomy destabilize the adjacent level in lumbar transpedicular fixation? An in vitro human cadaveric assessment.

PubMed

Cardoso, Mario J; Dmitriev, Anton E; Helgeson, Melvin; Lehman, Ronald A; Kuklo, Timothy R; Rosner, Michael K

2008-12-15

This is an in vitro biomechanical study. The current investigation was performed to evaluate adjacent level kinematic change following unilateral and bilateral facet violation and laminectomy following 1-, 2-, and 3-level reconstruction. The incidence of superior-segment facet violation with lumbar transpedicular fixation has been reported as high as 35%; however, its contribution to biomechanical instability at the supradjacent level is unknown. In addition, superior-segment laminectomy has been implicated as a risk factor for the development of adjacent level disease. The authors assess the acute biomechanical effects of proximal facet violation and subsequent laminectomy in an instrumented posterior fusion model in 10 cadaveric specimens. Biomechanical testing was performed on 10 human cadaveric spines under axial rotation (AR), flexion-extension (FE), and lateral bending (LB) loading. After intact analysis, pedicle screws were inserted from L5-S1 and testing repeated with: (1) preserved L4-L5 facets, (2) unilateral facet breach, (3) bilateral breach, and (4) L5 laminectomy. Following biomechanical analysis, instrumentation was extended to L4, then L3 and biomechanical testing repeated. Full range of motion (ROM) at the proximal adjacent levels were recorded and normalized to intact (100%). Supradjacent level ROM was increased for all groups under all loading methods relative to intact (P < 0.05). However, AR testing revealed progressive instability at the adjacent level in groups 3 and 4, relative to group 1, following 1-, 2- and 3-level fixation (P < 0.05). During FE, supradjacent level ROM was significantly increased for group 4 specimens compared with group 1 after L5-S1 fixation (P < 0.05), and was greater than all other groups for L3-S1 constructs (P < 0.05). Interestingly, under lateral bending, facet joint destabilization did not change adjacent segment ROM. There were significant changes in proximal level ROM immediately after posterior stabilization. However, an additional increase in supradjacent segment ROM was recorded during AR after bilateral facet breach.Subsequent complete laminectomy at the uppermostfixation level further destabilized the supradjacent segment in FE and AR. Therefore, meticulous preservation of the cephalad-most segment facet joints-is paramount to ensure stability.

Factors affecting results of fluoroscopy-guided facet joint injection: Probable differences in the outcome of treatment between pure facet joint hypertrophy and concomitant diseases.

PubMed

Albayrak, Akif; Ozkul, Baris; Balioglu, Mehmet Bulent; Atici, Yunus; Gultekin, Muhammet Zeki; Albayrak, Merih Dilan

2016-01-01

Retrospective cohort study. Facet joints are considered a common source of chronic low-back pain. To determine whether pathogens related to the facet joint arthritis have any effect on treatment failure. Facet joint injection was applied to 94 patients treated at our hospital between 2011 and 2012 (mean age 59.5 years; 80 women and 14 men). For the purpose of analysis, the patients were divided into two groups. Patients who only had facet hypertrophy were placed in group A (47 patients, 41 women and 6 men, mean age 55.3 years) and patients who had any additional major pathology to facet hypertrophy were placed in group B (47 patients, 39 women and 8 men, mean age 58.9 years). Injections were applied around the facet joint under surgical conditions utilizing fluoroscopy device guidance. A mixture of methylprednisolone and lidocaine was used as the injection ingredient. In terms of Oswestry Disability Index (ODI) and visual analog scale (VAS) scores, no significant difference was found between preinjection and immediate postinjection values in both groups, and the scores of group A patients were significantly lower (P < 0.005) compared with that of group B patients at the end of the third, sixth, and twelfth month. For low-back pain caused by facet hypertrophy, steroid injection around the facet joint is an effective treatment, but if there is an existing major pathology, it is not as effective.

[CORRELATION OF LUMBAR FACET JOINT DEGENERATION AND SPINE-PELVIC SAGITTAL BALANCE].

PubMed

Lo, Xin; Zhang, Bin; Liu, Yuan; Dai, Min

2015-08-01

To investigate the relationship between lumbar facet joint degeneration of each segment and spine-pelvic sagittal balance parameters. A retrospective analysis was made the clinical data of 120 patients with lumbar degenerative disease, who accorded with the inclusion criteria between June and November 2014. There were 58 males and 62 females with an average age of 53 years (range, 24-77 years). The disease duration ranged from 3 to 96 months (mean, 6.6 months). Affected segments included L3,4 in 32 cases, L4,5 in 47 cases, and L5, S1 in 52 cases. The CT and X-ray films of the lumbar vertebrae were taken. The facet joint degeneration was graded based on the grading system of Pathria. The spine-pelvic sagittal balance parameters were measured, including lumbar lordosis (LL), upper lumbar lordosis (ULL), lower lumbar lordosis (LLL), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). According to normal range of PI, the patients were divided into 3 groups: group A (PI was less than normal range), group B (PI was within normal range), and group C (PI was more than normal range). The facet joint degeneration was compared; according to the facet joint degeneration degree, the patients were divided into group N (mild degeneration group) and group M (serious degeneration group) to observe the relationship of lumbar facet joint degeneration of each segment and spine-pelvic sagittal balance parameters. At L4,5 and L5, S1, facet joint degeneration showed significant difference among groups A, B, and C (P < 0.05), more serious facet joint degeneration was observed in group C; no significant difference was found in facet joint degeneration at L3,4 (P > 0.05). There was no significant difference in the other spine-pelvic sagittal balance parameters between groups N and M at each segment (P > 0.05) except for PT (P < 0.05). PI of more than normal range may lead to or aggravate lumbar facet joint degeneration at L4,5 and L5, Si; PT and PI are significantly associated with facet joint degeneration at the lower lumbar spine.

Biomechanics of the L5-S1 motion segment after total disc replacement - Influence of iatrogenic distraction, implant positioning and preoperative disc height on the range of motion and loading of facet joints.

PubMed

Dreischarf, Marcel; Schmidt, Hendrik; Putzier, Michael; Zander, Thomas

2015-09-18

Total disc replacement has been introduced to overcome negative side effects of spinal fusion. The amount of iatrogenic distraction, preoperative disc height and implant positioning have been considered important for surgical success. However, their effect on the postoperative range of motion (RoM) and loading of the facets merits further discussion. A validated osteoligamentous finite element model of the lumbosacral spine was employed and extended with four additional models to account for different disc heights. An artificial disc with a fixed center of rotation (CoR) was implemented in L5-S1. In 4000 simulations, the influence of distraction and the CoR's location on the RoM, facet joint forces (FJFs) and facet capsule ligament forces (FCLFs) was investigated. Distraction substantially altered segmental kinematics in the sagittal plane by decreasing range of flexion (0.5° per 1mm of distraction), increasing range of extension (0.7°/mm) and slightly affecting complete sagittal RoM (0.2°/mm). The distraction already strongly increased the FCLFs during surgery (up to 230N) and in flexion (~12N/mm), with higher values in models with larger preoperative disc heights, and increased FJFs in extension. A more anterior implant location decreased the RoM in all planes. In most loading cases, a more posterior location of the implant's CoR increased the FJFs and FCLFs, whereas a more caudal location increased the FCLFs but decreased the FJFs. The results of this study may explain the worse clinical results in patients with overdistraction after TDR. The complete RoM in the sagittal plane appears to be insensitive to detecting surgery-related biomechanical changes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Incidence of inadvertent intra-articular lumbar facet joint injection during fluoroscopically guided interlaminar epidural steroid injection.

PubMed

Huang, Ambrose J; Palmer, William E

2012-02-01

To determine the incidence of inadvertent lumbar facet joint injection during an interlaminar epidural steroid injection (ESI). A total of 686 interlaminar lumbar ESIs were performed from January 1, 2009 to December 31, 2009. Archived images from these cases were retrospectively reviewed on the PACS. Positive cases of inadvertent lumbar facet joint injection were identified by the characteristic sigmoid-shaped contrast pattern projecting over the posterior elements on the lateral view and/or ovoid contrast projecting over the facet joints on the anteroposterior (AP) view. Eight positive events were identified (1.2%). There was no statistically significant gender or lumbar level predilection. In 3/8 of the positive cases (37.5%), the inadvertent facet joint injection was recognized by the operator. The needle was repositioned as a result, and contrast within the posterior epidural space was documented by the end of the procedure. In 5/8 of the positive cases (62.5%), the patients reported an immediate decrease in the presenting pain. The incidence of inadvertent lumbar facet joint injection during an interlaminar epidural steroid injection is low. Recognizing the imaging features of this event permits the operator to redirect the needle tip into the epidural space and/or identify the facet joint(s) as a source of the patient's presenting pain.

Evaluation of Lumbar Facet Joint Nerve Blocks in Managing Chronic Low Back Pain: A Randomized, Double-Blind, Controlled Trial with a 2-Year Follow-Up

PubMed Central

Manchikanti, Laxmaiah; Singh, Vijay; Falco, Frank J.E.; Cash, Kimberly A.; Pampati, Vidyasagar

2010-01-01

Study Design: A randomized, double-blind, controlled trial. Objective: To determine the clinical effectiveness of therapeutic lumbar facet joint nerve blocks with or without steroids in managing chronic low back pain of facet joint origin. Summary of Background Data: Lumbar facet joints have been shown as the source of chronic pain in 21% to 41% of low back patients with an average prevalence of 31% utilizing controlled comparative local anesthetic blocks. Intraarticular injections, medial branch blocks, and radiofrequency neurotomy of lumbar facet joint nerves have been described in the alleviation of chronic low back pain of facet joint origin. Methods: The study included 120 patients with 60 patients in each group with local anesthetic alone or local anesthetic and steroids. The inclusion criteria was based upon a positive response to diagnostic controlled, comparative local anesthetic lumbar facet joint blocks. Outcome measures included the numeric rating scale (NRS), Oswestry Disability Index (ODI), opioid intake, and work status, at baseline, 3, 6, 12, 18, and 24 months. Results: Significant improvement with significant pain relief of ≥ 50% and functional improvement of ≥ 40% were observed in 85% in Group 1, and 90% in Group II, at 2-year follow-up. The patients in the study experienced significant pain relief for 82 to 84 weeks of 104 weeks, requiring approximately 5 to 6 treatments with an average relief of 19 weeks per episode of treatment. Conclusions: Therapeutic lumbar facet joint nerve blocks, with or without steroids, may provide a management option for chronic function-limiting low back pain of facet joint origin. PMID:20567613

Correlations between the feature of sagittal spinopelvic alignment and facet joint degeneration: a retrospective study.

PubMed

Lv, Xin; Liu, Yuan; Zhou, Song; Wang, Qiang; Gu, Houyun; Fu, Xiaoxing; Ding, Yi; Zhang, Bin; Dai, Min

2016-08-15

Sagittal spinopelvic alignment changes associated with degenerative facet joint arthritis have been assessed in a few studies. It has been documented that patients with facet joint degeneration have higher pelvic incidence, but the relationship between facet joint degeneration and other sagittal spinopelvic alignment parameters is still disputed. Our purpose was to evaluate the correlation between the features of sagittal spinopelvic alignment and facet joint degeneration. Imaging data of 140 individuals were retrospectively analysed. Lumbar lordosis, pelvic tilt (PT), pelvic incidence (PI), sacral slope, and height of the lumbar intervertebral disc were measured on lumbar X-ray plates. Grades of facet joint degeneration were evaluated from the L2 to S1 on CT scans. Spearman's rank correlation coefficient and Student's t-test were used for statistical analyses, and a P-value <0.05 was considered statistically significant. PI was positively associated with degeneration of the facet joint at lower lumbar levels (p < 0.001 r = 0.50 at L5/S1 and P = 0.002 r = 0.25 at L4/5). A significant increase of PT was found in the severe degeneration group compared with the mild degeneration group: 22.0° vs 15.7°, P = 0.034 at L2/3;21.4°vs 15.1°, P = 0.006 at L3/4; 21.0° vs 13.5°, P = 0.000 at L4/5; 20.8° vs 12.1°, P = 0.000 at L5/S1. Our results indicate that a high PI is a predisposing factor for facet joint degeneration at the lower lumbar spine, and that severe facet joint degeneration may accompany with greater PT at lumbar spine.

Kinematic and fatigue biomechanics of an interpositional facet arthroplasty device.

PubMed

Dahl, Michael C; Freeman, Andrew L

2016-04-01

Although approximately 30% of chronic lumbar pain can be attributed to the facets, limited surgical options exist for patients. Interpositional facet arthroplasty (IFA) is a novel treatment for lumbar facetogenic pain designed to provide patients who gain insufficient relief from medical interventional treatment options with long-term relief, filling a void in the facet pain treatment continuum. This study aimed to quantify the effect of IFA on segmental range of motion (ROM) compared with the intact state, and to observe device position and condition after 10,000 cycles of worst-case loading. In situ biomechanical analysis of the lumbar spine following implantation of a novel IFA device was carried out. Twelve cadaveric functional spinal units (L2-L3 and L5-S1) were tested in 7.5 Nm flexion-extension, lateral bending, and torsion while intact and following device implantation. Additionally, specimens underwent 10,000 cycles of worst-case complex loading and were testing in ROM again. Load-displacement and fluoroscopic data were analyzed to determine ROM and to evaluate device position during cyclic testing. Devices and facets were evaluated post testing. Institutional support for implant evaluation was received by Zyga Technology. Range of motion post implantation decreased versus intact, and then was restored post cyclic-testing. Of the tested devices, 6.5% displayed slight movement (0.5-2 mm), all from tight L2-L3 facet joints with misplaced devices or insufficient cartilage. No damage was observed on the devices, and wear patterns were primarily linear. The results from this in situ cadaveric biomechanics and cyclic fatigue study demonstrate that a low-profile, conformable IFA device can maintain position and facet functionality post implantation and through 10,000 complex loading cycles. In vivo conditions were not accounted for in this model, which may affect implant behavior not predictable via a biomechanical study. However, these data along with published 1-year clinical results suggest that IFA may be a valid treatment option in patients with chronic lumbar zygapophysial pain who have exhausted medical interventional options. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Subdural empyema following lumbar facet joint injection: An exceeding rare complication.

PubMed

Fayeye, Oluwafikayo; Silva, Adikarige Haritha Dulanka; Chavda, Swarupsinh; Furtado, Navin Raoul

2016-01-01

Chronic low back pain is extremely common with a life time prevalence estimated at greater than 70%. Facet joint arthrosis is thought to be the causative aetiological substrate in approximately 25% of chronic low back pain cases. Facet joint injection is a routine intervention in the armamentarium for both the diagnostic and therapeutic management of chronic low back pain. In fact, a study by Carrino et al. reported in excess of 94,000 facet joint injection procedures were carried out in the US in 1999. Although generally considered safe, the procedure is not entirely without risk. Complications including bleeding, infection, exacerbation of pain, dural puncture headache, and pneumothorax have been described. We report a rare case of a 47-year-old female patient who developed a left L4/5 facet septic arthrosis with an associated subdural empyema and meningitis following facet joint injection. This case is unique, as to the best of our knowledge no other case of subdural empyema following facet joint injection has been reported in the literature. Furthermore this case serves to highlight the potential serious adverse sequelae of a routine and apparently innocuous intervention. The need for medical practitioners to be alert to and respond rapidly to the infective complications of facet joint injection cannot be understated. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Influence of Spinal Manipulative Therapy Force Magnitude and Application Site on Spinal Tissue Loading: A Biomechanical Robotic Serial Dissection Study in Porcine Motion Segments.

PubMed

Funabashi, Martha; Nougarou, François; Descarreaux, Martin; Prasad, Narasimha; Kawchuk, Greg

In order to define the relation between spinal manipulative therapy (SMT) input parameters and the distribution of load within spinal tissues, the aim of this study was to determine the influence of force magnitude and application site when SMT is applied to cadaveric spines. In 10 porcine cadavers, a servo-controlled linear actuator motor provided a standardized SMT simulation using 3 different force magnitudes (100N, 300N, and 500N) to 2 different cutaneous locations: L3/L4 facet joint (FJ), and L4 transverse processes (TVP). Vertebral kinematics were tracked optically using indwelling bone pins, the motion segment removed and mounted in a parallel robot equipped with a 6-axis load cell. The kinematics of each SMT application were replicated robotically. Serial dissection of spinal structures was conducted to quantify loading characteristics of discrete spinal tissues. Forces experienced by the L3/L4 segment and spinal structures during SMT replication were recorded and analyzed. Spinal manipulative therapy force magnitude and application site parameters influenced spinal tissues loading. A significant main effect (P < .05) of force magnitude was observed on the loads experienced by the intact specimen and supra- and interspinous ligaments. The main effect of application site was also significant (P < .05), influencing the loading of the intact specimen and facet joints, capsules, and ligamentum flavum (P < .05). Spinal manipulative therapy input parameters of force magnitude and application site significantly influence the distribution of forces within spinal tissues. By controlling these SMT parameters, clinical outcomes may potentially be manipulated. Copyright © 2017. Published by Elsevier Inc.

Validation of lumbar spine loading from a musculoskeletal model including the lower limbs and lumbar spine.

PubMed

Actis, Jason A; Honegger, Jasmin D; Gates, Deanna H; Petrella, Anthony J; Nolasco, Luis A; Silverman, Anne K

2018-02-08

Low back mechanics are important to quantify to study injury, pain and disability. As in vivo forces are difficult to measure directly, modeling approaches are commonly used to estimate these forces. Validation of model estimates is critical to gain confidence in modeling results across populations of interest, such as people with lower-limb amputation. Motion capture, ground reaction force and electromyographic data were collected from ten participants without an amputation (five male/five female) and five participants with a unilateral transtibial amputation (four male/one female) during trunk-pelvis range of motion trials in flexion/extension, lateral bending and axial rotation. A musculoskeletal model with a detailed lumbar spine and the legs including 294 muscles was used to predict L4-L5 loading and muscle activations using static optimization. Model estimates of L4-L5 intervertebral joint loading were compared to measured intradiscal pressures from the literature and muscle activations were compared to electromyographic signals. Model loading estimates were only significantly different from experimental measurements during trunk extension for males without an amputation and for people with an amputation, which may suggest a greater portion of L4-L5 axial load transfer through the facet joints, as facet loads are not captured by intradiscal pressure transducers. Pressure estimates between the model and previous work were not significantly different for flexion, lateral bending or axial rotation. Timing of model-estimated muscle activations compared well with electromyographic activity of the lumbar paraspinals and upper erector spinae. Validated estimates of low back loading can increase the applicability of musculoskeletal models to clinical diagnosis and treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Intraarticular Pulsed Radiofrequency to Treat Refractory Lumbar Facet Joint Pain in Patients with Low Back Pain.

PubMed

Chang, Min Cheol; Cho, Yun-Woo; Ahn, Da Hyun; Do, Kyung Hee

2018-04-01

Many treatment techniques have been used for refractory lumbar facet joint pain; however, their efficacy has been controversial. In this study, we investigated the clinical efficacy and safety of intra-articular pulsed radiofrequency for the treatment of refractory lumbar facet joint pain in patients with low back pain. Twenty patients with refractory lumbar facet joint pain were recruited, and each patient was treated via intra-articular pulsed radiofrequency. The treatment effects were measured with a numerical rating scale, and the technical accuracy of intra-articular pulsed radiofrequency treatment was evaluated independently by 2 radiologists. Any adverse events or complications also were checked. We performed intra-articular pulsed radiofrequency treatment at 48 levels of the lumbar facet joints in 20 patients (5 men and 15 women; mean age, 64.50 ± 10.65 years) with refractory lumbar facet joint pain. Pain scores were significantly reduced at 1 month, 3 months, and 6 months after treatment (P < 0.05). The face validity revealed good intraarticular pulsed radiofrequency results in all 20 patients, without any serious adverse effects. Treatment using intra-articular pulsed radiofrequency is an alternative to other techniques in patients with refractory lumbar facet joint pain. Copyright © 2018 Elsevier Inc. All rights reserved.

Percutaneous Facet Screw Fixation in the Treatment of Symptomatic Recurrent Lumbar Facet Joint Cyst: A New Technique

DOE Office of Scientific and Technical Information (OSTI.GOV)

Amoretti, Nicolas, E-mail: amorettinicolas@yahoo.fr; Gallo, Giacomo, E-mail: giacomo.gallo83@gmail.com; Bertrand, Anne-Sophie, E-mail: asbertrand3@hotmail.com

We present a case of percutaneous treatment of symptomatic recurrent lumbar facet joint cyst resistant to all medical treatments including facet joint steroid injection. Percutaneous transfacet fixation was then performed at L4–L5 level with a cannulated screw using CT and fluoroscopy guidance. The procedure time was 30 min. Using the visual analog scale (VAS), pain decreased from 9.5, preoperatively, to 0 after the procedure. At 6-month follow-up, an asymptomatic cystic recurrence was observed, which further reduced at the 1-year follow-up. Pain remained stable (VAS at 0) during all follow-ups. CT- and fluoroscopy-guided percutaneous cyst rupture associated with facet screw fixation couldmore » be an alternative to surgery in patients suffering from a symptomatic recurrent lumbar facet joint cyst.« less

A novel approach to symptomatic lumbar facet joint synovial cyst injection and rupture using iGuide navigational software: A case report and review.

PubMed

Wang, David J; Lownie, Stephen P; Pelz, David; Pandey, Sachin

2016-10-01

Spinal synovial cysts are benign protrusions of facet joint capsules caused by degenerative spondylosis, most frequently involving the L4-5 level, and commonly lead to symptoms of back pain, radiculopathy and neurogenic claudication. Although percutaneous treatment via facet joint steroid injection with cyst rupture can provide significant symptom relief, cyst rupture is not always achievable via an indirect trans-facet approach due to limited access from severe degenerative changes. In this case, we describe a successful approach to direct cyst access using a laser-guided navigational software in a patient with severe facet joint osteophytosis. We provide a brief review of literature. © The Author(s) 2016.

Mechanical role of the posterior column components in the cervical spine.

PubMed

Hartman, Robert A; Tisherman, Robert E; Wang, Cheng; Bell, Kevin M; Lee, Joon Y; Sowa, Gwendolyn A; Kang, James D

2016-07-01

To quantify the mechanical role of posterior column components in human cervical spine segments. Twelve C6-7 segments were subjected to resection of (1) suprasinous/interspinous ligaments (SSL/ISL), (2) ligamenta flavum (LF), (3) facet capsules, and (4) facets. A robot-based testing system performed repeated flexibility testing of flexion-extension (FE), axial rotation (AR), and lateral bending (LB) to 2.5Nm and replayed kinematics from intact flexibility tests for each state. Range-of-motion, stiffness, moment resistance and resultant forces were calculated. The LF contributes largely to moment resistance, particularly in flexion. Facet joints were primary contributors to AR and LB mechanics. Moment/force responses were more sensitive and precise than kinematic outcomes. The LF is mechanically important in the cervical spine; its injury could negatively impact load distribution. Damage to facets in a flexion injury could lead to AR or LB hypermobility. Quantifying the contribution of spinal structures to moment resistance is a sensitive, precise process for characterizing structural mechanics.

Subtalar joint stress imaging with tomosynthesis.

PubMed

Teramoto, Atsushi; Watanabe, Kota; Takashima, Hiroyuki; Yamashita, Toshihiko

2014-06-01

The purpose of this study was to perform stress imaging of hindfoot inversion and eversion using tomosynthesis and to assess the subtalar joint range of motion (ROM) of healthy subjects. The subjects were 15 healthy volunteers with a mean age of 29.1 years. Coronal tomosynthesis stress imaging of the subtalar joint was performed in a total of 30 left and right ankles. A Telos stress device was used for the stress load, and the load was 150 N for both inversion and eversion. Tomographic images in which the posterior talocalcaneal joint could be confirmed on the neutral position images were used in measurements. The angle of the intersection formed by a line through the lateral articular facet of the posterior talocalcaneal joint and a line through the surface of the trochlea of the talus was measured. The mean change in the angle of the calcaneus with respect to the talus was 10.3 ± 4.8° with inversion stress and 5.0 ± 3.8° with eversion stress from the neutral position. The result was a clearer depiction of the subtalar joint, and inversion and eversion ROM of the subtalar joint was shown to be about 15° in healthy subjects. Diagnostic, Level IV.

Morphological Asymmetry of the Superior Cervical Facets from C3 through C7 due to Degeneration.

PubMed

Van Vlasselaer, Nicolas; Van Roy, Peter; Cattrysse, Erik

2017-01-01

Knowledge about facet morphology has already been discussed extensively in literature but is limited regarding asymmetry and its relation to facet degeneration. Facet dimensions, surface area, curvature, and degeneration of the superior facets were measured in 85 dried human vertebrae from the anatomical collection of the Vrije Universiteit Brussel. The vertebrae were analysed using the Microscribe G2X digitizer (Immersion Co., San Jose, CA) and a grading system for the evaluation of cervical facet degeneration. Coordinates were processed mathematically to evaluate articular tropism. The statistical analysis includes the paired t -test and the Pearson correlation. On average, no systematic differences between the left and right facets were found concerning morphology and degeneration. However, there were significant differences regardless of the side-occurrence. There was a significant correlation between the dimensions of the total facet surface and the degree of degeneration but not for the recognizable joint surface. Facet tropism of the upper joint facets occurred often in the cervical spine but without side preference. A bigger difference in degeneration asymmetry was associated with a bigger difference in facet joint dimension asymmetry.

Skeletal development of hallucal tarsometatarsal joint curvature and angulation in extant apes and modern humans.

PubMed

Gill, Corey M; Bredella, Miriam A; DeSilva, Jeremy M

2015-11-01

The medial cuneiform, namely the curvature and angulation of its distal facet with metatarsal 1, is crucial as a stabilizer in bipedal locomotion and an axis upon which the great toe medially deviates during arboreal locomotion in extant apes. Previous work has shown that facet curvature and angulation in adult dry-bone specimens can distinguish African apes from Homo, and can even distinguish among species of Gorilla. This study provides the first ontogenetic assessment of medial cuneiform curvature and angulation in juvenile (n = 68) and adult specimens (n = 102) using computed tomography in humans and extant ape specimens, including Pongo. Our data find that modern human juveniles initially have a convex and slightly medially oriented osseous surface of the developing medial cuneiform distal facet that flattens and becomes more distally oriented with age. The same pattern (though of a different magnitude) occurs developmentally in the chimpanzee medial cuneiform, but not in Gorilla or Pongo, whose medial cuneiform facet angulation remains unchanged ontogenetically. These data suggest that the medial cuneiform ossifies in a distinguishable pattern between Pongo, Gorilla, Pan, and Homo, which may in part be due to subtle differences in the loading environment at the hallucal tarsometatarsal joint-a finding that has important implications for interpreting fossil medial cuneiforms. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of facet joint injection versus systemic steroids in low back pain: a randomized controlled trial.

PubMed

Ribeiro, Luiza Helena; Furtado, Rita Nely Vilar; Konai, Monique Sayuri; Andreo, Ana Beatriz; Rosenfeld, Andre; Natour, Jamil

2013-11-01

Randomized clinical trial. To compare the effectiveness of facet joint injection versus systemic steroid in patients with a diagnosis of facet joint syndrome. The term facet joint syndrome has been used to define back pain originating from the facet joints. Treatment is mainly conservative, although interventions, including intra-articular injections and medial branch nerve blocks are used to manage facet-mediated pain. Several studies have evaluated the effectiveness of these interventions. Results of facet joint injection, however, are conflicting. Sixty subjects with a diagnosis of facet joint syndrome were enrolled in the study. They were randomized into experimental and control groups. The experimental group was administered with intra-articular injection of 6 lumbar facet joints with triamcinolone hexacetonide; the control group was administered with triamcinolone acetonide intramuscular injection of 6 lumbar paravertebral points. Visits were taken at baseline and at 1, 4, 12, and 24 weeks after interventions. Outcome measures were used: pain visual analogue scale, pain visual analogue scale during extension of the spine, Likert scale, improvement percentage scale, Roland-Morris, 36-Item Short Form Health Survey, and accountability of medications taken.Homogeneity was tested using the Student t, Pearson χ, and Mann-Whitney tests. Analysis of variance was used to analyze differences in the groups over time and the Student t test to analyze differences between groups at each time evaluation. The groups were similar at baseline. Comparisons between the groups showed, in analysis of variance analysis, an improvement in the experimental group regarding diclofenac intake and quality of life, in the "role physical" profile, assessed by 36-Item Short Form Health Survey.In the analysis at each time point, an improvement in the experimental group was also found in the Roland-Morris questionnaire, in the improvement percentage scale and in the response to treatment, assessed by the Likert scale. Both treatments were effective, with a slight superiority of the intra-articular injection of steroids over intramuscular injection.

Uncovertebral joint injury in cervical facet dislocation: the headphones sign.

PubMed

Palmieri, Francesco; Cassar-Pullicino, Victor N; Dell'Atti, Claudia; Lalam, Radhesh K; Tins, Bernhard J; Tyrrell, Prudencia N M; McCall, Iain W

2006-06-01

The purpose of our study is to demonstrate the uncovertebral mal-alignment as a reliable indirect sign of cervical facet joint dislocation. We examined the uncovertebral axial plane alignment of 12 patients with unilateral and bilateral cervical facet joint dislocation (UCFJD and BCFJD, respectively), comparing its frequency to the reverse hamburger bun sign on CT and MR axial images. Of the seven cases with BCFJD, five clearly demonstrated the diagnostic reverse facet joint hamburger bun sign on CT and MR images, but in two cases this sign was not detectable. In the five cases with UCFJD, four demonstrated the reverse hamburger bun sign on both CT and MRI. In one case the reverse hamburger bun sign was not seen adequately with either image modality, but the facet dislocation was identified on sagittal imaging. The uncovertebral mal-alignment was detected in all 12 cases. Normally, the two components of the uncovertebral joint enjoy a concentric relationship that in the axial plane is reminiscent of the relationship of headphones with the wearer's head. We name this appearance the 'headphones' sign. Radiologists should be aware of the headphones sign as a reliable indicator of facet joint dislocation on axial imaging used in the assessment of cervical spine injuries.

PAIN FROM INTRA-ARTICULAR NGF OR JOINT INJURY IN THE RAT REQUIRES CONTRIBUTIONS FROM PEPTIDERGIC JOINT AFFERENTS

PubMed Central

Kras, Jeffrey V.; Weisshaar, Christine L.; Pall, Parul S.; Winkelstein, Beth A.

2015-01-01

Non-physiological stretch of the cervical facet joint’s capsular ligament induces persistent behavioral hypersensitivity and spinal neuronal hyperexcitability via an intra-articular NGF-dependent mechanism. Although that ligament is innervated by nociceptors, it is unknown if a subpopulation is exclusively responsible for the behavioral and spinal neuronal responses to intra-articular NGF and/or facet joint injury. This study ablated joint afferents using the neurotoxin saporin targeted to neurons involved in either peptidergic ([Sar9,Met(O2)11]-substance P-saporin (SSP-Sap)) or non-peptidergic (isolectin B4-saporin (IB4-Sap)) signaling to investigate the contributions of those neuronal populations to facet-mediated pain. SSP-Sap, but not IB4-Sap, injected into the bilateral C6/C7 facet joints 14 days prior to an intra-articular NGF injection prevents NGF-induced mechanical and thermal hypersensitivity in the forepaws. Similarly, only SSP-Sap prevents the increase in mechanical forepaw stimulation-induced firing of spinal neurons after intra-articular NGF. In addition, intra-articular SSP-Sap prevents both behavioral hypersensitivity and upregulation of NGF in the dorsal root ganglion after a facet joint distraction that normally induces pain. These findings collectively suggest that disruption of peptidergic signaling within the joint may be a potential treatment for facet pain, as well as other painful joint conditions associated with elevated NGF, such as osteoarthritis. PMID:26240991

Pain from intra-articular NGF or joint injury in the rat requires contributions from peptidergic joint afferents.

PubMed

Kras, Jeffrey V; Weisshaar, Christine L; Pall, Parul S; Winkelstein, Beth A

2015-09-14

Non-physiological stretch of the cervical facet joint's capsular ligament induces persistent behavioral hypersensitivity and spinal neuronal hyperexcitability via an intra-articular NGF-dependent mechanism. Although that ligament is innervated by nociceptors, it is unknown if a subpopulation is exclusively responsible for the behavioral and spinal neuronal responses to intra-articular NGF and/or facet joint injury. This study ablated joint afferents using the neurotoxin saporin targeted to neurons involved in either peptidergic ([Sar(9),Met (O2)(11)]-substance P-saporin (SSP-Sap)) or non-peptidergic (isolectin B4-saporin (IB4-Sap)) signaling to investigate the contributions of those neuronal populations to facet-mediated pain. SSP-Sap, but not IB4-Sap, injected into the bilateral C6/C7 facet joints 14 days prior to an intra- articular NGF injection prevents NGF-induced mechanical and thermal hypersensitivity in the forepaws. Similarly, only SSP- Sap prevents the increase in mechanical forepaw stimulation- induced firing of spinal neurons after intra-articular NGF. In addition, intra-articular SSP-Sap prevents both behavioral hypersensitivity and upregulation of NGF in the dorsal root ganglion after a facet joint distraction that normally induces pain. These findings collectively suggest that disruption of peptidergic signaling within the joint may be a potential treatment for facet pain, as well as other painful joint conditions associated with elevated NGF, such as osteoarthritis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Percutaneous radiofrequency facet capsule denervation as an alternative target in lumbar facet syndrome.

PubMed

Moussa, Wael Mohamed Mohamed; Khedr, Wael

2016-11-01

Percutaneous radiofrequency denervation of the medial dorsal branch is often used in chronic low back pain of intervertebral facet etiology, which is sometimes difficult to perform and recurrence of pain often ensues. We theorized that shifting the target of RF coagulation to the facet joint capsule would provide an easier target and a longer-lived pain relieving response. A prospective randomized controlled trial where 120 patients diagnosed with CLBP of a confirmed facet origin were randomly divided into three equal groups, the first was submitted to percutaneous radiofrequency coagulation of the facet joint capsule, the second underwent percuataneous denervation of the medial dorsal branch and the third did not receive radiofrequency lesioning. All the three groups received local injection of a mixture of local anesthetic and steroid. Cases were followed for up to 3 years. 87(72.5%) patients were females. By 3 months' post procedure, improvement in VAS was significantly better than pretreatment levels in all groups (p<0.05). The control group lost improvement by 1-year follow-up (p=0.017). At 2 years' follow-up, the joint capsule denervation group maintained significant improvement (p=0.033) whereas the medial branch denervation group lost its significant effect (p=0.479). By the end of follow-up period, only joint capsule denervation group kept significant improvement (p=0.026). In CLBP of facet origin, shifting the target of percutaneous radiofrequency to the facet joint capsule provides an easier technique with an extended period of pain relief compared to the medial dorsal branch of the facet joint. Copyright © 2016 Elsevier B.V. All rights reserved.

Morphological Asymmetry of the Superior Cervical Facets from C3 through C7 due to Degeneration

PubMed Central

Van Roy, Peter

2017-01-01

Introduction Knowledge about facet morphology has already been discussed extensively in literature but is limited regarding asymmetry and its relation to facet degeneration. Method Facet dimensions, surface area, curvature, and degeneration of the superior facets were measured in 85 dried human vertebrae from the anatomical collection of the Vrije Universiteit Brussel. The vertebrae were analysed using the Microscribe G2X digitizer (Immersion Co., San Jose, CA) and a grading system for the evaluation of cervical facet degeneration. Coordinates were processed mathematically to evaluate articular tropism. The statistical analysis includes the paired t-test and the Pearson correlation. Results On average, no systematic differences between the left and right facets were found concerning morphology and degeneration. However, there were significant differences regardless of the side-occurrence. There was a significant correlation between the dimensions of the total facet surface and the degree of degeneration but not for the recognizable joint surface. Conclusions Facet tropism of the upper joint facets occurred often in the cervical spine but without side preference. A bigger difference in degeneration asymmetry was associated with a bigger difference in facet joint dimension asymmetry. PMID:29359153

Augmented Reality-Guided Lumbar Facet Joint Injections.

PubMed

Agten, Christoph A; Dennler, Cyrill; Rosskopf, Andrea B; Jaberg, Laurenz; Pfirrmann, Christian W A; Farshad, Mazda

2018-05-08

The aim of this study was to assess feasibility and accuracy of augmented reality-guided lumbar facet joint injections. A spine phantom completely embedded in hardened opaque agar with 3 ring markers was built. A 3-dimensional model of the phantom was uploaded to an augmented reality headset (Microsoft HoloLens). Two radiologists independently performed 20 augmented reality-guided and 20 computed tomography (CT)-guided facet joint injections each: for each augmented reality-guided injection, the hologram was manually aligned with the phantom container using the ring markers. The radiologists targeted the virtual facet joint and tried to place the needle tip in the holographic joint space. Computed tomography was performed after each needle placement to document final needle tip position. Time needed from grabbing the needle to final needle placement was measured for each simulated injection. An independent radiologist rated images of all needle placements in a randomized order blinded to modality (augmented reality vs CT) and performer as perfect, acceptable, incorrect, or unsafe. Accuracy and time to place needles were compared between augmented reality-guided and CT-guided facet joint injections. In total, 39/40 (97.5%) of augmented reality-guided needle placements were either perfect or acceptable compared with 40/40 (100%) CT-guided needle placements (P = 0.5). One augmented reality-guided injection missed the facet joint space by 2 mm. No unsafe needle placements occurred. Time to final needle placement was substantially faster with augmented reality guidance (mean 14 ± 6 seconds vs 39 ± 15 seconds, P < 0.001 for both readers). Augmented reality-guided facet joint injections are feasible and accurate without potentially harmful needle placement in an experimental setting.

Intraarticular Facet Injections for Low Back Pain: Design Considerations, Consensus Methodology to Develop the Protocol for a Randomized Controlled Trial.

PubMed

Mars, Tom; Ellard, David R; Antrobus, James H L; Cairns, Melinda; Underwood, Martin; Haywood, Kirstie; Keohane, Susie; Sandhu, Harbinder; Griffiths, Frances

2015-01-01

Since the publication of guidelines by the UK National Institute for Health and Care Excellence (NICE) and the American Pain Society guidelines for low back pain in 2009 there have been deep divisions in the pain treatment community about the use of therapeutic intraarticular facet joint injections. While evidence for the effectiveness or not of intraarticular facet joint injections remains sparse, uncertainty will remain. The Warwick feasibility study, along with a concurrent study with a different design led by another group, aims to provide a stable platform from which the effectiveness and cost effectiveness of intraarticular facet joint injections added to normal care could be evaluated in randomized controlled trials (RCTs). To reach consensus on key design considerations for the Warwick facet feasibility study from which the study protocol and working manuals will be developed. A consensus conference involving expert professionals and lay members. Preliminary work identified 5 key design considerations for deliberation at our consensus conference. Three concerned patient assessment and treatment: diagnosis of possible facet joint pain, interaarticular facet joint injection technique, and best usual care. Two concerned trial analysis: a priori sub-groups and minimally important difference and are reported elsewhere. We did systematic evidence reviews of the design considerations and summarized the evidence. Our design questions and evidence summaries were distributed to all delegates. This formed the basis for discussions on the day. Clinical experts in all aspects of facet joint injection from across the UK along with lay people were invited via relevant organizations. Nominal group technique was used in 15 facilitated initial small group discussions. Further discussion and ranking was undertaken in plenary. All small group and plenary results were recorded and checked and verified post conference. Where necessary participants were contacted via email to resolve outstanding issues. Fifty-two delegates attended the conference with lay people and all relevant professions represented. Consensus was reached on the details of how to assess patients for facet joint pain, undertake the injections, and deliver usual care. Where post conference checking of results revealed errors in calculating ranking results on the day, consensus was reached by email consultation. All but 3 delegates agreed to be associated with the outcome. Allocating one day for discussing a wide range of topics imposed time pressure on discussion and calculation of the numerous rankings. Through the use of an evidence-based, systematic, inclusive, and transparent process we have established consensus from expert health professionals in the UK, with lay input, on the clinical assessment of suspected facet joint pain, interaarticular injection for facet joint pain, and best usual care for use in a feasibility study for a proposed pragmatic clinical trial of interaarticular facet joint injections. This provides a strong basis for a clinical trial that will be acceptable to the pain treatment community.

Effect of Retrograde Reaming for Tibiotalocalcaneal Arthrodesis on Subtalar Joint Destruction: A Cadaveric Study.

PubMed

Lowe, Jason A; Routh, Lucas K; Leary, Jeffrey T; Buzhardt, Paul C

2016-01-01

Recent published data have suggested successful union of subtalar and tibiotalar joints without formal debridement during tibiotalocalcaneal (TTC) fusion procedures. Although previous studies have reported on the importance of the proper guidewire starting point and trajectory to obtain appropriate hindfoot alignment for successful fusion, to our knowledge, no studies have quantified the amount of articular damage to the subtalar joint with retrograde reaming. We hypothesized that reaming would destroy >50% of the posterior facet of the subtalar joint. The bilateral lower extremities of 5 cadavers were obtained and the subtalar joints exposed. Retrograde TTC nail guidewires were inserted, and a 12-mm reamer was passed through the subtalar and ankle joints. Pre- and postreaming images of the subtalar joint were obtained to compare the amount of joint destruction after reaming. We found an average of 5.89% articular destruction of the talar posterior facet and an average of 4.01% articular destruction of the posterior facet of the calcaneus. No damage to the middle facets of the subtalar joint was observed. TTC nailing is a successful procedure for ankle and subtalar joint fusion. Published studies have reported successful subtalar union using TTC nailing without formal open debridement of the subtalar joint, preserving the soft tissue envelope. TTC nail insertion using a 12-mm reamer will destroy 5.89% and 4.01% of the respective talar and calcaneal posterior facets of the subtalar joint. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Physiotherapy and lumbar facet joint injections as a combination treatment for chronic low back pain. A narrative review of lumbar facet joint injections, lumbar spinal mobilizations, soft tissue massage and lower back mobility exercises.

PubMed

Chambers, Hannah

2013-06-01

The aim of this study was to summarize the available evidence on lumbar facet joint injections and the physiotherapy treatments, land-based lower back mobility exercise, soft tissue massage and lumbar spinal mobilizations for chronic low back pain (CLBP). The plausibility of physiotherapy and lumbar facet joint injections as a combination treatment is discussed. Using a systematic process, an online electronic search was performed using key words utilizing all available databases and hand searching reference lists. Using a critical appraisal tool from the Critical Appraisal Skills Programme (CASP), the literature was screened to include primary research. The main aspects of the research were summarized. The evidence for lumbar facet joint injections suggests an overall short-term positive effect on CLBP. Land-based lower back mobility exercise and soft tissue massage appear to have a positive effect on CLBP in the short term and possibly in the longer term. There is insufficient evidence to draw conclusions for lumbar spinal mobilizations. The review indicates that lumbar facet joint injections create a short period when pain is reduced. Physiotherapy treatments including land-based lower back mobility exercise and soft tissue massage may be of benefit during this time to improve the longer-term outcomes of patients with CLBP. It is not possible to make generalizations or firm conclusions. The current review highlights the need for further research. A randomized controlled trial is recommended to assess the impact of physiotherapy in combination with lumbar facet joint injections on CLBP. Copyright © 2013 John Wiley & Sons, Ltd.

An International Multicenter Study Assessing the Role of Ethnicity on Variation of Lumbar Facet Joint Orientation and the Occurrence of Degenerative Spondylolisthesis in Asia Pacific: A Study from the AOSpine Asia Pacific Research Collaboration Consortium

PubMed Central

Williams, Richard; Cheung, Jason Pui Yin; Goss, Ben; Rajasekaran, Shanmuganathan; Kawaguchi, Yoshiharu; Acharya, Shankar; Kawakami, Mamoru; Satoh, Shigenobu; Chen, Wen-Jer; Park, Chun-Kun; Lee, Chong-Suh; Foocharoen, Thanit; Nagashima, Hideki; Kuh, Sunguk; Zheng, Zhaomin; Condor, Richard; Ito, Manabu; Iwasaki, Motoki; Jeong, Je Hoon; Luk, Keith D. K.; Prijambodo, Bambang; Rege, Amol; Jahng, Tae-Ahn; Luo, Zhuojing; Tassanawipas, Warat; Acharya, Narayana; Pokharel, Rohit; Shen, Yong; Ito, Takui; Zhang, Zhihai; Aithala P, Janardhana; Kumar, Gomatam Vijay; Jabir, Rahyussalim Ahmad; Basu, Saumyajit; Li, Baojun; Moudgil, Vishal; Sham, Phoebe; Samartzis, Dino

2015-01-01

Study Design A multinational, multiethnic, cross-sectional image-based study was performed in 33 institutions, representing 10 countries, which were part of the AOSpine Asia Pacific Research Collaboration Consortium. Objective Lumbar facet joint orientation has been reported to be associated with the development of degenerative spondylolisthesis (DS). The role of ethnicity regarding facet joint orientation remains uncertain. As such, the following study was performed across a wide-ranging population base to assess the role of ethnicity in facet joint orientation in patients with DS in the Asia Pacific region. Methods Lateral standing X-rays and axial magnetic resonance imaging scans were obtained for patients with lumbar DS. The DS parameters and facet joint angulations were assessed from L3–S1. Sex, age, body mass index (BMI), and ethnicity were also noted. Results The study included 371 patients with known ethnic origin (mean age: 62.0 years; 64% males, 36% females). The mean BMI was 25.6 kg/m2. The level of DS was most prevalent at L4–L5 (74.7%). There were 28.8% Indian, 28.6% Japanese, 18.1% Chinese, 8.6% Korean, 6.5% Thai, 4.9% Caucasian, 2.7% Filipino, and 1.9% Malay patients. Variations in facet joint angulations were noted from L3 to S1 and between patients with and without DS (p < 0.05). No differences were noted with regards to sex and overall BMI to facet joint angulations (p > 0.05); however, increasing age was found to increase the degree of angulation throughout the lumbar spine (p < 0.05). Accounting for age and the presence or absence of DS at each level, no statistically significant differences between ethnicity and degree of facet joint angulations from L3–L5 were noted (p > 0.05). Ethnic variations were noted in non-DS L5–S1 facet joint angulations, predominantly between Caucasian, Chinese, and Indian ethnicities (p < 0.05). Conclusions This study is the first to suggest that ethnicity may not play a role in facet joint orientation in the majority of cases of DS in the Asia-Pacific region. Findings from this study may facilitate future comparative studies in other multiethnic populations. An understanding of ethnic variability may assist in identifying those patients at risk of postsurgical development or progression of DS. This study also serves as a model for large-scale multicenter studies across different ethnic groups and cultural boundaries in Asia. PMID:26835200

Lumbar disc degeneration was not related to spine and hip bone mineral densities in Chinese: facet joint osteoarthritis may confound the association.

PubMed

Pan, Jianjiang; Lu, Xuan; Yang, Ge; Han, Yongmei; Tong, Xiang; Wang, Yue

2017-12-01

A sample of 512 Chinese was studied and we observed that greater disc degeneration on MRI was associated with greater spine DXA BMD. Yet, this association may be confounded by facet joint osteoarthritis. BMD may not be a risk factor for lumbar disc degeneration in Chinese. Evidence suggested that lumbar vertebral bone and intervertebral disc interact with each other in multiple ways. The current paper aims to determine the association between bone mineral density (BMD) and lumbar disc degeneration using a sample of Chinese. We studied 165 patients with back disorders and 347 general subjects from China. All subjects had lumbar spine magnetic resonance (MR) imaging and dual- energy X-ray absorptiometry (DXA) spine BMD studies, and a subset of general subjects had additional hip BMD measurements. On T2-weighted MR images, Pfirrmann score was used to evaluate the degree of lumbar disc degeneration and facet joint osteoarthritis was assessed as none, slight-moderate, and severe. Regression analyses were used to examine the associations between lumbar and hip BMD and disc degeneration, adjusting for age, gender, body mass index (BMI), lumbar region, and facet joint osteoarthritis. Greater facet joint osteoarthritis was associated with greater spine BMD (P < 0.01) in both patients and general subjects. For general subjects, greater spine BMD was associated with severe disc degeneration, controlling for age, gender, BMI, and lumbar region. When facet joint osteoarthritis entered the regression model, however, greater spine BMD was associated with greater facet joint osteoarthritis (P < 0.01) but not greater disc degeneration (P > 0.05). No statistical association was observed between spine BMD and lumbar disc degeneration in patients with back disorders (P > 0.05), and between hip BMD and disc degeneration in general subjects (P > 0.05). BMD may not be a risk factor for lumbar disc degeneration in Chinese. Facet joint osteoarthritis inflates DXA spine BMD measurements and therefore, may confound the association between spine BMD and disc degeneration.

Radiological analysis of minimal safe distance and optimal screw angle to avoid facet violation in open-door laminoplasty using precontoured plate.

PubMed

Min, Woo-Kie; Seo, Il; Na, Sang-Bong; Choi, Young-Seo; Choi, Ji-Yeon

2017-01-01

This study aimed to present radiologic analysis of minimal safe distance (MSD) and optimal screw angle (OSA) that enables to fix screws in a lateral mass safely without facet joint violation in open-door laminoplasty using a plate. A retrospective analysis was made of 22 patients (male: 17; female: 5), average age 62 years. Seventy-nine lateral mass screws were fixed among a total of 158 screws. MSD that doesn't allow 5-mm screws to violate a facet joint was measured for C3-C7 and a comparative analysis was performed. If the MSD is not secured, the OSA to be given to the cephalad direction is calculated to avoid violation of the facet joint. The screws violating inferior facet joints accounted for 34.1% of the screws fixed in inferior lateral mass. Joint surface to distal mini-screw distances were 3.18 ± 1.46 mm and 4.75 ± 1.71 mm in groups of facet joint violation and non-facet violation (FV), respectively ( p = 0.001). When 5-mm screws were inserted into a lateral mass, MSD was 4.39 ± 0.83 mm. The average MSD of C3, C4, and C5 was 4.05 ± 0.78 mm, 4.10 ± 0.70 mm, and 4.26 ± 0.74 mm, respectively. There was no significant differences among levels ( p > 0.05). The average MSD of C6 and C7 was 4.92 ± 0.81 mm and 4.80 ± 0.96 mm, respectively, showing significant differences from those of C3, C4, and C5 ( p < 0.05). If 6 mm of the MSD isn't secured, OSA showed in the cephalad direction of 11.5° for 5 mm and 22° for 4 mm approximately. We suggest that mini-screw on lateral mass can be fixed safely without FV, if they are fixed at MSD of 6 mm from a joint surface. Facet joint violation doesn't occur if an OSA is given in the cephalad direction in case of not enough MSD for mini-screws.

The Relationship Between Osteoarthritis of the Lumbar Facet Joints and Lumbosacropelvic Morphology.

PubMed

Sahin, Mehmet Sukru; Ergün, Adviye; Aslan, Akın

2015-10-01

Cross-sectional study. To investigate the relation between lumbosacropelvic morphology and the presence and degree of facet joint degeneration. Osteoarthritis of the facet joints is one of the most common degenerative changes in the spine. It is considered to be formed secondary to repetitive stress or trauma and spinal deformity with secondary overload. The cause(s) of facet joints osteoarthritis, however, have not been clearly identified. Abdominal computed tomography (CT) images of 723 patients which were taken between the years 2010 and 2014 were evaluated retrospectively. Patients with prior lumbar spinal surgery, serious congenital anomalies on CT, incomplete or complete lumbosacral transition, severe scoliosis, were excluded from the study. To eliminate the age- and sex-related differences in spinopelvic morphology, a study group was formed of the remaining subjects by including patients from a specific age group (30-35 yr) and same sex (females). For each patient the presence and grade of facet joint degeneration was investigated. In addition, pelvic incidence (PI), sacral slope and the angles of L1-L5 lumbar lordosis, sacral table, L5 vertebra posterior, and sacral kyphosis were measured for each patient. Sacral slope, sacral kyphosis, and L1-L5 lumbar lordosis angle were significantly higher in patients with osteoarthritic compared with normal subjects (P = 0.015, P = 0.018, P = 0.016). L5 vertebra posterior and sacral table angle were found to be significantly lower in patients with osteoarthritic than in normal subjects (P = 0.019, P = 0.007). The degree of facet joint degeneration was noticed to increase parallel to the decrease in the sacral table angle and L5 vertebra posterior angle, and to the increase in the L1-L5 lumbar lordosis, PI, and sacral slope. A close relation exists between the presence and degree of degeneration in the facet joint and lumbosacral pelvic morphology. Prevalence and degree of the degeneration in facet joint increases as the angle of sacral slope, L1-L5 lumbar lordosis, and PI increases or the angle of sacral table and L5 vertebra posterior decreases. 4.

A New Technique for the Treatment of Lumbar Facet Joint Syndrome Using Intra-articular Injection with Autologous Platelet Rich Plasma.

PubMed

Wu, Jiuping; Du, Zhenwu; Lv, Yang; Zhang, Jun; Xiong, Wei; Wang, Ruiqiang; Liu, Rui; Zhang, Guizhen; Liu, Qinyi

2016-01-01

Lumbar facet joint syndrome is currently suggested to be a main source of axial low back pain, and a large portion of axial low back pain is caused by disorders in lumbar facet joints. Intra-articular injection is one of the most common treatment methods in the early clinical application. Therefore, we attempt to seek a new injectable material, autologous platelet rich plasma (PRP), to treat lumbar facet syndrome, as well as to assess its therapeutic effectiveness and safety. A prospective clinic evaluation. The outpatient clinic of a single academic medical center. Total 19 patients with lumbar facet joint syndrome (8 men, 11 women; mean ages: 52.53 ± 6.79 years, range: 38 - 62 years) were enrolled to receive lumbar facet joint injection with autologous PRP under x-ray fluoroscopic control. Patients were followed up immediately, at one week, one month, 2 months, and 3 months following treatment, and the elements of this analysis included low back pain visual analogue scale (VAS) at rest and during flexion, Roland-Morris Disability Questionnaire (RMQ), Oswestry Disability Index (ODI), and modified MacNab criteria for the pain relief. All the 19 patients completed the intra-articular injections with autologous PRP successfully. At one week after treatment, low back pain reduced significantly compared with prior to treatment both at rest and during flexion. The outcomes were assessed as "good" or "excellent" for 9 patients (47.37%) immediately after treatment, 14 patients (73.68%) at one week, 15 patients (78.95%) at one month, 15 patients (78.95%) at 2 months, and 15 patients (78.95%) at 3 months. Statistically significant differences were observed based on RMQ and a more than 10% improvement in lumbar functional capacity was observed based on ODI between pre-treatment and post-treatment. In addition, there were no severe relevant complications during the whole process of injection and follow-up period. A control group and the curative effect observations with longer follow-up may lead to a more convincing result for our study. In the short-term period of 3 months, the new technique of lumbar facet joint injection with autologous PRP is effective and safe for patients with lumbar facet joint syndrome. Key words: Low back pain, lumbar facet joint syndrome, autologous platelet rich plasma, intra-articular injection.

Bony ankylosis of the facet joint of the cervical spine in rheumatoid arthritis: Its characteristics and relationship to the clinical findings.

PubMed

Iizuka, Haku; Iizuka, Yoichi; Okamura, Koichi; Yonemoto, Yukio; Mieda, Tokue; Takagishi, Kenji

2017-09-01

The purpose of this study was to clarify the characteristics of bony ankylosis of the facet joint of the cervical spine in rheumatoid arthritis (RA) patients who required cervical spine surgery, and its relationship to the clinical findings. Eighty consecutive RA patients with cervical spine disorder who received initial surgery were reviewed. The occurrence of bony ankylosis of the facet joint of the cervical spine was investigated using computed tomography (CT) before surgery. We also evaluated the severity of neurological symptoms and the plain wrist radiographs taken before surgery; furthermore, we evaluated each patient's medical history for total knee arthroplasty (TKA) or hip arthroplasty (THA). The preoperative CT imaging demonstrated bony ankylosis of the facet joint of the cervical spine in 45 facet levels of 19 cases (BA + group). In all patients, responsible instability or stenosis was demonstrated just caudal or on the cranial side of those bony ankylosis. Before surgery, the BA + group included significantly more patients showing severe cervical myelopathy (p < 0.05), and significantly more cases showing progressed ankylosis in the wrist joint bilaterally (p < 0.01). There were also significantly more patients who received two or more TKA or THA before the cervical spine surgery in the BA + group (p < 0.01). Bony ankylosis of the facet joint of the cervical spine may be a risk factor of instability or stenosis at the adjacent disc level and severe cervical myelopathy. Furthermore, its ankylosis was demonstrated in RA patients with severe destroyed joints.

Management of lumbar zygapophysial (facet) joint pain

PubMed Central

Manchikanti, Laxmaiah; Hirsch, Joshua A; Falco, Frank JE; Boswell, Mark V

2016-01-01

AIM: To investigate the diagnostic validity and therapeutic value of lumbar facet joint interventions in managing chronic low back pain. METHODS: The review process applied systematic evidence-based assessment methodology of controlled trials of diagnostic validity and randomized controlled trials of therapeutic efficacy. Inclusion criteria encompassed all facet joint interventions performed in a controlled fashion. The pain relief of greater than 50% was the outcome measure for diagnostic accuracy assessment of the controlled studies with ability to perform previously painful movements, whereas, for randomized controlled therapeutic efficacy studies, the primary outcome was significant pain relief and the secondary outcome was a positive change in functional status. For the inclusion of the diagnostic controlled studies, all studies must have utilized either placebo controlled facet joint blocks or comparative local anesthetic blocks. In assessing therapeutic interventions, short-term and long-term reliefs were defined as either up to 6 mo or greater than 6 mo of relief. The literature search was extensive utilizing various types of electronic search media including PubMed from 1966 onwards, Cochrane library, National Guideline Clearinghouse, clinicaltrials.gov, along with other sources including previous systematic reviews, non-indexed journals, and abstracts until March 2015. Each manuscript included in the assessment was assessed for methodologic quality or risk of bias assessment utilizing the Quality Appraisal of Reliability Studies checklist for diagnostic interventions, and Cochrane review criteria and the Interventional Pain Management Techniques - Quality Appraisal of Reliability and Risk of Bias Assessment tool for therapeutic interventions. Evidence based on the review of the systematic assessment of controlled studies was graded utilizing a modified schema of qualitative evidence with best evidence synthesis, variable from level I to level V. RESULTS: Across all databases, 16 high quality diagnostic accuracy studies were identified. In addition, multiple studies assessed the influence of multiple factors on diagnostic validity. In contrast to diagnostic validity studies, therapeutic efficacy trials were limited to a total of 14 randomized controlled trials, assessing the efficacy of intraarticular injections, facet or zygapophysial joint nerve blocks, and radiofrequency neurotomy of the innervation of the facet joints. The evidence for the diagnostic validity of lumbar facet joint nerve blocks with at least 75% pain relief with ability to perform previously painful movements was level I, based on a range of level I to V derived from a best evidence synthesis. For therapeutic interventions, the evidence was variable from level II to III, with level II evidence for lumbar facet joint nerve blocks and radiofrequency neurotomy for long-term improvement (greater than 6 mo), and level III evidence for lumbosacral zygapophysial joint injections for short-term improvement only. CONCLUSION: This review provides significant evidence for the diagnostic validity of facet joint nerve blocks, and moderate evidence for therapeutic radiofrequency neurotomy and therapeutic facet joint nerve blocks in managing chronic low back pain. PMID:27190760

A study of cervical spine kinematics and joint capsule strain in rear impacts using a human FE model.

PubMed

Kitagawa, Yuichi; Yasuki, Tsuyoshi; Hasegawa, Junji

2006-11-01

Many efforts have been made to understand the mechanism of whiplash injury. Recently, the cervical facet joint capsules have been focused on as a potential site of injury. An experimental approach has been taken to analyze the vertebral motion and to estimate joint capsule stretch that was thought to be a potential cause of pain. The purpose of this study is to analyze the kinematics of the cervical facet joint using a human FE model in order to better understand the injury mechanism. The Total Human Model for Safety (THUMS) was used to visually analyze the local and global kinematics of the spine. Soft tissues in the neck were newly modeled and introduced into THUMS for estimating the loading level in rear impacts. The model was first validated against human test data in the literature by comparing vertebrae motion as well as head and neck responses. Joint capsule strain was estimated from a maximum principal strain output from the elements representing the capsule tissues. A rear-end collision was then simulated using THUMS and a prototype seat model, assuming a delta-V of 25 km/h. The trajectory of the vertebrae was analyzed in a local coordinate system defined along the joint surface. Strain growth in the joint capsules was explained, as related to contact events between the occupant and the seat. A new seat concept was proposed to help lessen the loading level to the neck soft tissues. The foam material of the seat back was softened, the initial gap behind the head was reduced and the head restraint was stiffened for firm support. The lower seat back frame was also reinforced to withstand the impact severity at the given delta-V. Another rear impact simulation was conducted using the new seat concept model to examine the effectiveness of the new concept. The joint capsule strain was found to be relatively lower with the new seat concept. The study also discusses the influence of seat parameters to the vertebral motion and the resultant strain in the joint capsules. The meaning of the contact timing of the head to the head restraint was examined based on the results in terms of correlation with injury indicators such as NIC and the joint capsule strain.

Analysis of the load on the knee joint and vertebral column with changes in squatting depth and weight load.

PubMed

Hartmann, Hagen; Wirth, Klaus; Klusemann, Markus

2013-10-01

It has been suggested that deep squats could cause an increased injury risk of the lumbar spine and the knee joints. Avoiding deep flexion has been recommended to minimize the magnitude of knee-joint forces. Unfortunately this suggestion has not taken the influence of the wrapping effect, functional adaptations and soft tissue contact between the back of thigh and calf into account. The aim of this literature review is to assess whether squats with less knee flexion (half/quarter squats) are safer on the musculoskeletal system than deep squats. A search of relevant scientific publications was conducted between March 2011 and January 2013 using PubMed. Over 164 articles were included in the review. There are no realistic estimations of knee-joint forces for knee-flexion angles beyond 50° in the deep squat. Based on biomechanical calculations and measurements of cadaver knee joints, the highest retropatellar compressive forces and stresses can be seen at 90°. With increasing flexion, the wrapping effect contributes to an enhanced load distribution and enhanced force transfer with lower retropatellar compressive forces. Additionally, with further flexion of the knee joint a cranial displacement of facet contact areas with continuous enlargement of the retropatellar articulating surface occurs. Both lead to lower retropatellar compressive stresses. Menisci and cartilage, ligaments and bones are susceptible to anabolic metabolic processes and functional structural adaptations in response to increased activity and mechanical influences. Concerns about degenerative changes of the tendofemoral complex and the apparent higher risk for chondromalacia, osteoarthritis, and osteochondritis in deep squats are unfounded. With the same load configuration as in the deep squat, half and quarter squat training with comparatively supra-maximal loads will favour degenerative changes in the knee joints and spinal joints in the long term. Provided that technique is learned accurately under expert supervision and with progressive training loads, the deep squat presents an effective training exercise for protection against injuries and strengthening of the lower extremity. Contrary to commonly voiced concern, deep squats do not contribute increased risk of injury to passive tissues.

Radiological and Radionuclide Imaging of Degenerative Disease of the Facet Joints

PubMed Central

Shur, Natalie; Corrigan, Alexis; Agrawal, Kanhaiyalal; Desai, Amidevi; Gnanasegaran, Gopinath

2015-01-01

The facet joint has been increasingly implicated as a potential source of lower back pain. Diagnosis can be challenging as there is not a direct correlation between facet joint disease and clinical or radiological features. The purpose of this article is to review the diagnosis, treatment, and current imaging modality options in the context of degenerative facet joint disease. We describe each modality in turn with a pictorial review using current evidence. Newer hybrid imaging techniques such as single photon emission computed tomography/computed tomography (SPECT/CT) provide additional information relative to the historic gold standard magnetic resonance imaging. The diagnostic benefits of SPECT/CT include precise localization and characterization of spinal lesions and improved diagnosis for lower back pain. It may have a role in selecting patients for local therapeutic injections, as well as guiding their location with increased precision. PMID:26170560

Three-dimensional evaluation of the facet joints

NASA Astrophysics Data System (ADS)

Folio, Les R.

1990-04-01

Computerized tomography and magnetic resonance imaging nave revolurionalized analysis of vertebral anatomy and pathology. Further advances with 3-dimensional imaging have recently become an important adjunct for diagnosis and treatment in structural abnormalities. Facets are intimately related to their surrounding musculature and malalignment may cause pain directly or indirectly. High resolution 3-dimensional reformations of CT Scans give us new insight on structure and function of facet joints, since their motion and architecture are ever complex. It is well documented in the literature that facet joint biomecnanics is a partial contributor to the myriad at causes of low back The term "facet Joint syndrome" was coined in 1933 by GhorMley.3 The osteopathic lesion complex is well defined by LeRoy and McCole and comparison of roentgenographic findings before and after manipulation has teen described by Long and Lioyd.4,5 since alterations in facet biamechanics are an important aspect of osteopathic manipulative therapy (OT), 3-dimensional hign resolution imaging will prove to be a great asset in osteopathic research. Rotating the spine allows for different viewing perspectives to provide optimal and consistent measurements of the facet joint. Rotations are performed on the X, Y and 7, axis and measurements pre and post-manipulation are performed and compared on matching axis and perspectives. Rotation about the X, Y and Z axis help appreciate the 3-dimensionality of the vertebral column to project to the viewer a feeling that the spine is floating in space before them. This does give the viewer a 3-D understanding of the object however, only at a perspective at a Lime.

Morphological changes in the cervical intervertebral foramen dimensions with unilateral facet joint dislocation.

PubMed

Ebraheim, Nabil A; Liu, Jiayong; Ramineni, Satheesh K; Liu, Xiaochen; Xie, Joe; Hartman, Ryan G; Goel, Vijay K

2009-11-01

Many investigators have conducted studies to determine the biomechanics, causes, complications and treatment of unilateral facet joint dislocation in the cervical spine. However, there is no quantitative data available on morphological changes in the intervertebral foramen of the cervical spine following unilateral facet joint dislocation. These data are important to understand the cause of neurological compromise following unilateral facet joint dislocation. Eight embalmed human cadaver cervical spine specimens ranging from level C1-T1 were used. The nerve roots of these specimens at C5-C6 level were marked by wrapping a 0.12mm diameter wire around them. Unilateral facet dislocation at C5-C6 level was simulated by serially sectioning the corresponding ligamentous structures. A CT scan of the specimens was obtained before and after the dislocation was simulated. A sagittal plane through the centre of the pedicle and facet joint was constructed and used for measurement. The height and area of the intervertebral foramen, the facet joint space, nerve root diameter and area, and vertebral alignment both before and after dislocation were evaluated. The intervertebral foramen area changed from 50.72+/-0.88mm(2) to 67.82+/-4.77mm(2) on the non-dislocated side and from 41.39+/-1.11mm(2) to 113.77+/-5.65mm(2) on the dislocated side. The foraminal heights changed from 9.02+/-0.30mm to 10.52+/-0.50mm on the non-dislocated side and 10.43+/-0.50mm to 17.04+/-0.96mm on the dislocated side. The facet space area in the sagittal plane changed from 6.80+/-0.80mm(2) to 40.02+/-1.40mm(2) on the non-dislocated side. The C-5 anterior displacement showed a great change from 0mm to 5.40+/-0.24mm on the non-dislocated side and from 0mm to 3.42+/-0.20mm on the dislocated side. Neither of the nerve roots on either side showed a significant change in size. The lack of change in nerve root area indicates that the associated nerve injury with unilateral facet joint dislocation is probably due to distraction rather than due to direct nerve root compression.

A prospective, randomized, controlled trial of robot-assisted vs freehand pedicle screw fixation in spine surgery.

PubMed

Kim, Ho-Joong; Jung, Whan-Ik; Chang, Bong-Soon; Lee, Choon-Ki; Kang, Kyoung-Tak; Yeom, Jin S

2017-09-01

The purpose of this study was to compare the accuracy and safety of an instrumented posterior lumbar interbody fusion (PLIF) using a robot-assisted minimally invasive (Robot-PLIF) or a conventional open approach (Freehand-PLIF). Patients undergoing an instrumented PLIF were randomly assigned to be treated using a Robot-PLIF (37 patients) and a Freehand-PLIF (41 patients). For intrapedicular accuracy, there was no significant difference between the groups (P = 0.534). For proximal facet joint accuracy, none of the 74 screws in the Robot-PLIF group violated the proximal facet joint, while 13 of 82 in the Freehand-PLIF group violated the proximal facet joint (P < 0.001). The average distance of the screws from the facets was 5.2 ± 2.1 mm and 2.7 ± 1.6 mm in the Robot-PLIF and Freehand-PLIF groups, respectively (P < 0.001). Robotic-assisted pedicle screw placement was associated with fewer proximal facet joint violations and better convergence orientations. Copyright © 2016 John Wiley & Sons, Ltd.

Rates of Upper Facet Joint Violation in Minimally Invasive Percutaneous and Open Instrumentation: A Comparative Cohort Study of Different Insertion Techniques.

PubMed

Archavlis, Eleftherios; Amr, Nimer; Kantelhardt, Sven Rainer; Giese, Alf

2018-01-01

 Minimally invasive pedicle screw placement may have a higher incidence of violation of the superior cephalad unfused facet joint.  We investigated the incidence and risk factors of upper facet joint violation in percutaneous robot-assisted instrumentation versus percutaneous fluoroscopy-guided and open transpedicular instrumentation.  A retrospective study including all consecutive patients who underwent lumbar instrumentation, fusion, and decompression for spondylolisthetic stenosis and degenerative disk disease was conducted between January 2012 and January 2016. All operations were performed by the same surgeon; the patients were divided into three groups according to the method of instrumentation. Group 1 involved the robot-assisted instrumentation in 58 patients, group 2 consisted of 64 patients treated with a percutaneous transpedicular instrumentation using fluoroscopic guidance, and 72 patients in group 3 received an open midline approach for pedicle screw insertion.  Superior segment facet joint violation occurred in 2 patients in the robot-assisted group 1 (7%), in 22 of the percutaneous fluoroscopy-guided group 2 (34%), and in 6 cases of the open group (8%). The incidence of facet joint violation was present in 5% (3) of the screws in group 1, 22% (28) of the screws in group 2, and 3% (4) of the screws in group 3.  Meticulous surgical planning of the appropriate entry site (Weinstein's method), trajectory planning, and proper robot-assisted instrumentation of pedicle screws reduced the risk of superior segment facet joint violation. Georg Thieme Verlag KG Stuttgart · New York.

Lumbar Facet Joint Motion in Patients with Degenerative Disc Disease at Affected and Adjacent Levels

PubMed Central

Li, Weishi; Wang, Shaobai; Xia, Qun; Passias, Peter; Kozanek, Michal; Wood, Kirkham; Li, Guoan

2013-01-01

Study Design Controlled laboratory study. Objective To evaluate the effect of lumbar degenerative disc diseases (DDDs) on motion of the facet joints during functional weight-bearing activities. Summary of Background Data It has been suggested that DDD adversely affects the biomechanical behavior of the facet joints. Altered facet joint motion, in turn, has been thought to associate with various types of lumbar spine pathology including facet degeneration, neural impingement, and DDD progression. However, to date, no data have been reported on the motion patterns of the lumbar facet joint in DDD patients. Methods Ten symptomatic patients of DDD at L4–S1 were studied. Each participant underwent magnetic resonance images to obtain three-dimensional models of the lumbar vertebrae (L2–S1) and dual fluoroscopic imaging during three characteristic trunk motions: left-right torsion, left-right bending, and flexion-extension. In vivo positions of the vertebrae were reproduced by matching the three-dimensional models of the vertebrae to their outlines on the fluoroscopic images. The kinematics of the facet joints and the ranges of motion (ROMs) were compared with a group of healthy participants reported in a previous study. Results In facet joints of the DDD patients, there was no predominant axis of rotation and no difference in ROMs was found between the different levels. During left-right torsion, the ROMs were similar between the DDD patients and the healthy participants. During left-right bending, the rotation around mediolateral axis at L4–L5, in the DDD patients, was significantly larger than that of the healthy participants. During flexion-extension, the rotations around anterioposterior axis at L4–L5 and around craniocaudal axis at the adjacent level (L3–L4), in the DDD patients, were also significantly larger, whereas the rotation around mediolateral axis at both L2–L3 and L3–L4 levels in the DDD patients were significantly smaller than those of the healthy participants. Conclusion DDD alters the ROMs of the facet joints. The rotations can increase significantly not only at the DDD levels but also at their adjacent levels when compared to those of the healthy participants. The increase in rotations did not occur around the primary rotation axis of the torso motion but around the coupled axes. This hypermobility in coupled rotations might imply a biomechanical mechanism related to DDD. PMID:21270686

A closer look at the lower-order structure of the Personality Inventory for DSM-5: comparison with the Five-Factor Model.

PubMed

Griffin, Sarah A; Samuel, Douglas B

2014-10-01

The Personality Inventory for DSM-5 (PID-5) was developed as a measure of the maladaptive personality trait model included within Section III of the DSM-5. Although preliminary findings have suggested the PID-5 has a five-factor structure that overlaps considerably with the Five-Factor Model (FFM) at the higher order level, there has been much less attention on the specific locations of the 25 lower-order traits. Joint exploratory factor analysis of the PID-5 traits and the 30 facets of the NEO-PI-R were used to determine the lower-order structure of the PID-5. Results indicated the PID-5's domain-level structure closely resembled the FFM. We also explored the placement of several lower-order facets that have not loaded consistently in previous studies. Overall, these results indicate that the PID-5 shares a common structure with the FFM and clarify the placement of some interstitial facets. More research investigating the lower-order facets is needed to determine how they fit into the hierarchical structure and explicate their relationships to existing measures of pathological traits. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Qualitative and quantitative assessment of degeneration of cervical intervertebral discs and facet joints.

PubMed

Walraevens, Joris; Liu, Baoge; Meersschaert, Joke; Demaerel, Philippe; Delye, Hans; Depreitere, Bart; Vander Sloten, Jos; Goffin, Jan

2009-03-01

Degeneration of intervertebral discs and facet joints is one of the most frequently encountered spinal disorders. In order to describe and quantify degeneration and evaluate a possible relationship between degeneration and biomechanical parameters, e.g., the intervertebral range of motion and intradiscal pressure, a scoring system for degeneration is mandatory. However, few scoring systems for the assessment of degeneration of the cervical spine exist. Therefore, two separate objective scoring systems to qualitatively and quantitatively assess the degree of cervical intervertebral disc and facet joint degeneration were developed and validated. The scoring system for cervical disc degeneration consists of three variables which are individually scored on neutral lateral radiographs: "height loss" (0-4 points), "anterior osteophytes" (0-3 points) and "endplate sclerosis" (0-2 points). The scoring system for facet joint degeneration consists of four variables which are individually scored on neutral computed tomography scans: "hypertrophy" (0-2 points), "osteophytes" (0-1 point), "irregularity" on the articular surface (0-1 point) and "joint space narrowing" (0-1 point). Each variable contributes with varying importance to the overall degeneration score (max 9 points for the scoring system of cervical disc degeneration and max 5 points for facet joint degeneration). Degeneration of 20 discs and facet joints of 20 patients was blindly assessed by four raters: two neurosurgeons (one senior and one junior) and two radiologists (one senior and one junior), firstly based on first subjective impression and secondly using the scoring systems. Measurement errors and inter- and intra-rater agreement were determined. The measurement error of the scoring system for cervical disc degeneration was 11.1 versus 17.9% of the subjective impression results. This scoring system showed excellent intra-rater agreement (ICC = 0.86, 0.75-0.93) and excellent inter-rater agreement (ICC = 0.78, 0.64-0.88). Surgeons as well as radiologists and seniors as well as juniors obtained excellent inter- and intra-rater agreement. The measurement error of the scoring system for cervical facet joint degeneration was 20.1 versus 24.2% of the subjective impression results. This scoring system showed good intra-rater agreement (ICC = 0.71, 0.42-0.89) and fair inter-rater agreement (ICC = 0.49, 0.26-0.74). Both scoring systems fulfilled the criteria for recommendation proposed by Kettler and Wilke. Our scoring systems can be reliable and objective tools for assessing cervical disc and facet joint degeneration. Moreover, the scoring system of cervical disc degeneration was shown to be experience- and discipline-independent.

The lumbar facet arthrosis syndrome. Clinical presentation and articular surface changes.

PubMed

Eisenstein, S M; Parry, C R

1987-01-01

We describe a lumbar facet syndrome in which disabling symptoms are associated with normal or near-normal plain radiographs. Local spinal fusion relieved symptoms in 12 patients; the excised facet joint surfaces showed some of the histological changes seen in chondromalacia patellae and in osteoarthritis of other large joints. The most frequent change was focal full-thickness cartilage necrosis or loss of cartilage with exposure of subchondral bone, but osteophyte formation was remarkably absent in all specimens. We suggest that there are both clinical and histological similarities between the facet arthrosis syndrome and chondromalacia patellae. Facet arthrosis may be a relatively important cause of intractable back pain in young and middle-aged adults.

Research study on neck injury lessening with active head restraint using human body FE model.

PubMed

Kitagawa, Yuichi; Yasuki, Tsuyoshi; Hasegawa, Junji

2008-12-01

The objective of this study is to examine the effectiveness of the active head restraint system in reducing neck injury risk of car occupants in low-speed rear impacts. A human body FE model "THUMS" was used to simulate head and neck kinematics of the occupant and to evaluate loading to the neck. Joint capsule strain was calculated to predict neck injury risk as well as NIC. The validity of the model was confirmed comparing its mechanical responses to those in human subjects in the literatures. Seat FE models were also prepared representing one with a fixed head restraint and the other one with an active head restraint system. The active head restraint system was designed to move the head restraint forward and upward when the lower unit was lower unit was loaded by the pelvis. Rear impact simulations were performed assuming a triangular acceleration pulse at a delta-V of 25 km/h. The model reproduced similar head and neck motions to those measured in the human volunteer test, except for active muscular responses. The calculated joint capsule strain also showed a good match with those of PMHS tests in the literature. A rear-impact simulation was conducted using the model with the fixed head restraint. The result revealed that NIC was strongly correlated with the relative acceleration between the head and the torso and that its maximum peak appeared when the head contacted the head restraint. It was also found that joint capsule strain grew in later timing synchronizing with the relative displacement. Another simulation with the active head restraint system showed that both NIC and joint capsule strain were lowered owing to the forward and upward motion of the head restraint. A close investigation of the vertebral motion indicated that the active head restraint reduced the magnitude of shear deformation in the facet joint, which contributed to the strain growth in the fixed head restraint case. Rear-impact simulations were conducted using a human body FE model, THUMS, representing an average-size male occupant. The cervical system including the facet joint capsules was incorporated to the model. The validity of the model was examined comparing its mechanical responses to those in the literature such as the whole body motion of the volunteer subject and the vertebral motion in the PMHS tests. Rear-impact simulations were conducted using the validated THUMS model and two prototype seat models; one had a fixed head restraint and the other one was equipped with an active head restraint system. The active head restraint system works moving the head restraint forward and upward when the lower unit is loaded by the pelvis. The head and neck kinematics and responses were analyzed from the simulation results. The force and acceleration rose at the pelvis first, followed by T1 and the head. The early timing of force rise and its magnitude indicated that the pelvis force was a good trigger for the active head restraint system. The results showed that the head was supported earlier in a case with the active head restraint system, and both NIC and joint capsule strain were lowered. The study also analyzed the mechanism of strain growth in the joint capsules. Relatively greater strain was observed in the direction of the facet joint surface, which was around 45 degrees inclined to the spinal column. The forward and upward motion of the active head restraint were aligned with the direction of the joint deformation and contributed to lower strain in the joint capsules. The results indicated that the active head restraint could help reduce the neck injury risk not only by supporting the head at an early timing but also through its trajectory stopping the joint deformation.

Optimal area of lateral mass mini-screws implanted in plated cervical laminoplasty: a radiography anatomy study.

PubMed

Chen, Hua; Li, Huibo; Deng, Yuxiao; Rong, Xin; Gong, Quan; Li, Tao; Song, Yueming; Liu, Hao

2017-04-01

Lateral mass mini-screws used in plated cervical laminoplasty might penetrate into facet joints. The objective is to observe this complication incidence and to identify the optimal areas for 5- and 7-mm-long mini-screws to implant on lateral mass. 47 patients who underwent plated cervical laminoplasty were included. The optimal area for mini-screws implanting was set according to pre-operative 3D CT reconstruction data. Then, each posterior-lateral mass surface was divided into three regions: 7-mm region, 5-mm region, and dangerous area. The mini-screw implanted region was recorded. Post-operative CT images were used to identify whether the mini-screws penetrated into facet joints. 235 mini-plates and 470 lateral mass mini-screws were used in the study. 117 (24.9%) mini-screws penetrated 88 (37.4%) facet joints. The 5-mm-long mini-screw optimal area occupied the upper 72, 65, 65, 64, and 65 % area of the posterior-lateral mass surface for C3-7, while the 7-mm-long mini-screw optimal area encompassed the upper 54, 39, 40, 33, and 32 %. Only 7-mm-long mini-screws were used to fix the plate to the lateral mass. 4 of 240 mini-screws in 7-mm region, 67 of the 179 mini-screws in 5-mm region, and 46 of the 51 mini-screws in dangerous region penetrated into the facet joint. The differences in the rate of facet joint penetration related to region were statistically significant (P < 0.001). The facet joint destruction by mini-screws was not a rare complication in plated cervical laminoplasty. The optimal areas we proposed may help guide the mini-screw implantation positions.

The maladaptive personality traits of the Personality Inventory for DSM-5 (PID-5) in relation to the HEXACO personality factors and schizotypy/dissociation.

PubMed

Ashton, Michael C; Lee, Kibeom; de Vries, Reinout E; Hendrickse, Joshua; Born, Marise Ph

2012-10-01

The Personality Inventory for DSM-5 (PID-5), a new measure of maladaptive personality traits, has recently been developed by the DSM-5 Personality and Personality Disorders Workgroup. The PID-5 variables were examined within the seven-factor space defined by the six HEXACO factors and the Schizotypy/Dissociation factor (Ashton & Lee, 2012) using participant samples from Canada (N = 378) and the Netherlands (N = 476). Extension analyses showed that several PID-5 facet-level scales represented each of the Honesty-Humility, Emotionality, Extraversion, Conscientiousness, and Schizotypy/Dissociation factors. In contrast, only one PID-5 scale loaded strongly on HEXACO Agreeableness, and no PID-5 scales loaded strongly on Openness to Experience. In addition, a joint factor analysis involving the PID-5 variables and facets of the Five-Factor Model was conducted in the Canadian sample and recovered a set of seven factors corresponding rather closely to the HEXACO factors plus Schizotypy/Dissociation. The authors discuss implications for the assessment and structure of normal and abnormal personality.

Audit of conservative management of chronic low back pain in a secondary care setting--part I: facet joint and sacroiliac joint interventions.

PubMed

Chakraverty, Robin; Dias, Richard

2004-12-01

The work of a chronic back pain service in secondary care in the West Midlands is reported. The service offers acupuncture, spinal injection procedures, osteopathy and a range of other interventions for patients whose back pain has not responded to conservative management. This section of the report focuses on injection procedures for lumbar facet joint and sacroiliac joint pain, which have been shown to be the cause of chronic low back pain in 16-40% and 13-19% of patients respectively. Diagnosis relies on the use of intra-articular or sensory nerve block injections with local anaesthetic. Possible treatments following diagnosis include intra-articular corticosteroid, radiofrequency denervation (for facet joint pain) or ligament prolotherapy injections (for sacroiliac joint pain). The results of several hospital audits are reported. At six month follow up, 50% of 38 patients undergoing radiofrequency denervation following diagnostic blocks for facet joint pain had improved by more than 50%, compared to 29% of 34 patients treated with intra-articular corticosteroid injection. Sixty three per cent of 19 patients undergoing prolotherapy following diagnostic block injection for sacroiliac joint pain had improved at six months, compared to 33% of 33 who had intra-articular corticosteroid. Both radiofrequency denervation and sacroiliac prolotherapy showed good long-term outcomes at one year.

Direct Posterior Bipolar Cervical Facet Radiofrequency Rhizotomy: A Simpler and Safer Approach to Denervate the Facet Capsule.

PubMed

Palea, Ovidiu; Andar, Haroon M; Lugo, Ramon; Granville, Michelle; Jacobson, Robert E

2018-03-14

Radiofrequency cervical rhizotomy has been shown to be effective for the relief of chronic neck pain, whether it be due to soft tissue injury, cervical spondylosis, or post-cervical spine surgery. The target and technique have traditionally been taught using an oblique approach to the anterior lateral capsule of the cervical facet joint. The goal is to position the electrode at the proximal location of the recurrent branch after it leaves the exiting nerve root and loops back to the cervical facet joint. The standard oblique approach to the recurrent nerve requires the testing of both motor and sensory components to verify the correct position and ensure safety so as to not damage the slightly more anterior nerve root. Bilateral lesions require the repositioning of the patient's neck. Poorly positioned electrodes can also pass anteriorly and contact the nerve root or vertebral artery. The direct posterior approach presented allows electrode positioning over a broader expanse of the facet joint without risk to the nerve root or vertebral artery. Over a four-year period, direct posterior radiofrequency ablation was performed under fluoroscopic guidance at multiple levels without neuro-stimulation testing with zero procedural neurologic events even as high as the C2 spinal segment. The direct posterior approach allows either unipolar or bipolar lesioning at multiple levels. Making a radiofrequency lesion along the larger posterior area of the facet capsule is as effective as the traditional target point closer to the nerve root but technically easier, allowing bilateral access and safety. The article will review the anatomy and innervation of the cervical facet joint and capsule, showing the diffuse nerve supply extending into the capsule of the facet joint that is more extensive than the recurrent medial sensory branches that have been the focus of radiofrequency lesioning.

Direct Posterior Bipolar Cervical Facet Radiofrequency Rhizotomy: A Simpler and Safer Approach to Denervate the Facet Capsule

PubMed Central

Palea, Ovidiu; Andar, Haroon M; Lugo, Ramon; Jacobson, Robert E

2018-01-01

Radiofrequency cervical rhizotomy has been shown to be effective for the relief of chronic neck pain, whether it be due to soft tissue injury, cervical spondylosis, or post-cervical spine surgery. The target and technique have traditionally been taught using an oblique approach to the anterior lateral capsule of the cervical facet joint. The goal is to position the electrode at the proximal location of the recurrent branch after it leaves the exiting nerve root and loops back to the cervical facet joint. The standard oblique approach to the recurrent nerve requires the testing of both motor and sensory components to verify the correct position and ensure safety so as to not damage the slightly more anterior nerve root. Bilateral lesions require the repositioning of the patient's neck. Poorly positioned electrodes can also pass anteriorly and contact the nerve root or vertebral artery. The direct posterior approach presented allows electrode positioning over a broader expanse of the facet joint without risk to the nerve root or vertebral artery. Over a four-year period, direct posterior radiofrequency ablation was performed under fluoroscopic guidance at multiple levels without neuro-stimulation testing with zero procedural neurologic events even as high as the C2 spinal segment. The direct posterior approach allows either unipolar or bipolar lesioning at multiple levels. Making a radiofrequency lesion along the larger posterior area of the facet capsule is as effective as the traditional target point closer to the nerve root but technically easier, allowing bilateral access and safety. The article will review the anatomy and innervation of the cervical facet joint and capsule, showing the diffuse nerve supply extending into the capsule of the facet joint that is more extensive than the recurrent medial sensory branches that have been the focus of radiofrequency lesioning. PMID:29765790

“Soft that molds the hard:” Geometric morphometry of lateral atlantoaxial joints focusing on the role of cartilage in changing the contour of bony articular surfaces

PubMed Central

Prasad, Prashant Kumar; Salunke, Pravin; Sahni, Daisy; Kalra, Parveen

2017-01-01

Purpose: The existing literature on lateral atlantoaxial joints is predominantly on bony facets and is unable to explain various C1-2 motions observed. Geometric morphometry of facets would help us in understanding the role of cartilages in C1-2 biomechanics/kinematics. Objective: Anthropometric measurements (bone and cartilage) of the atlantoaxial joint and to assess the role of cartilages in joint biomechanics. Materials and Methods: The authors studied 10 cadaveric atlantoaxial lateral joints with the articular cartilage in situ and after removing it, using three-dimensional laser scanner. The data were compared using geometric morphometry with emphasis on surface contours of articulating surfaces. Results: The bony inferior articular facet of atlas is concave in both sagittal and coronal plane. The bony superior articular facet of axis is convex in sagittal plane and is concave (laterally) and convex medially in the coronal plane. The bony articulating surfaces were nonconcordant. The articular cartilages of both C1 and C2 are biconvex in both planes and are thicker than the concavities of bony articulating surfaces. Conclusion: The biconvex structure of cartilage converts the surface morphology of C1-C2 bony facets from concave on concavo-convex to convex on convex. This reduces the contact point making the six degrees of freedom of motion possible and also makes the joint gyroscopic. PMID:29403249

Indices of Paraspinal Muscles Degeneration: Reliability and Association With Facet Joint Osteoarthritis: Feasibility Study.

PubMed

Kalichman, Leonid; Klindukhov, Alexander; Li, Ling; Linov, Lina

2016-11-01

A reliability and cross-sectional observational study. To introduce a scoring system for visible fat infiltration in paraspinal muscles; to evaluate intertester and intratester reliability of this system and its relationship with indices of muscle density; to evaluate the association between indices of paraspinal muscle degeneration and facet joint osteoarthritis. Current evidence suggests that the paraspinal muscles degeneration is associated with low back pain, facet joint osteoarthritis, spondylolisthesis, and degenerative disc disease. However, the evaluation of paraspinal muscles on computed tomography is not radiological routine, probably because of absence of simple and reliable indices of paraspinal degeneration. One hundred fifty consecutive computed tomography scans of the lower back (N=75) or abdomen (N=75) were evaluated. Mean radiographic density (in Hounsfield units) and SD of the density of multifidus and erector spinae were evaluated at the L4-L5 spinal level. A new index of muscle degeneration, radiographic density ratio=muscle density/SD of density, was calculated. To evaluate the visible fat infiltration in paraspinal muscles, we proposed a 3-graded scoring system. The prevalence of facet joint osteoarthritis was also evaluated. Intraclass correlation and κ statistics were used to evaluate inter-rater and intra-rater reliability. Logistic regression examined the association between paraspinal muscle indices and facet joint osteoarthritis. Intra-rater reliability for fat infiltration score (κ) ranged between 0.87 and 0.92; inter-rater reliability between 0.70 and 0.81. Intra-rater reliability (intraclass correlation) for mean density of paraspinal muscles ranged between 0.96 and 0.99, inter-rater reliability between 0.95 and 0.99; SD intra-rater reliability ranged between 0.82 and 0.91, inter-rater reliability between 0.80 and 0.89. Significant associations (P<0.01) were found between facet joint osteoarthritis, fat infiltration score, and radiographic density ratio. Two suggested indices of paraspinal muscle degeneration showed excellent reliability and were significantly associated with facet joint osteoarthritis. Additional studies are needed to evaluate the associations with other spinal degeneration features and low back pain.

Management of irreducible unilateral facet joint dislocations in subaxial cervical spine: two case reports and a review of the literature.

PubMed

Zhou, Yu; Zhou, Zhenyu; Liu, Lifeng; Cao, Xuecheng

2018-03-21

Skeletal and soft tissue damage are often associated with unilateral facet dislocations, which undoubtedly lead to instability of the spine and further increase difficulties in cervical reduction. This type of irreducible facet dislocation is usually accompanied with potential catastrophic consequences including neurological deficit and severe disability. Therefore, a consistent and evidence-based treatment plan is imperative. The literature regarding the management of traumatic unilateral locked cervical facet dislocations was reviewed. Two patient cases (a 30-year-old Asian man and a 25-year-old Asian woman) who suffered irreducible cervical facet dislocations were presented. These two patients received surgical treatments including posterior reduction by poking facet joints, adjacent spinous process fixation by wire rope banding, anterior plate fixation, and intervertebral fusion after the failure of skull traction and closed reduction. At the postoperative 24-month follow-up, intervertebral fusion was achieved and our patients' neurological status improved based on the American Spinal Injury Association scale, compared with their preoperative status. Unilateral facet joint dislocations of subaxial cervical spine are difficult to reduce when complicated with posterior facet fractures or ligamentous injury. Magnetic resonance imaging can be beneficial for identifying ventral and dorsal compressive lesions, as well as ligamentous or capsule rupture. The combination of posterior reduction and anterior fixation with fusion has advantages in terms of clinical safety, ease of operation, and less iatrogenic damage.

Complications of fluoroscopically directed facet joint nerve blocks: a prospective evaluation of 7,500 episodes with 43,000 nerve blocks.

PubMed

Manchikanti, Laxmaiah; Malla, Yogesh; Wargo, Bradley W; Cash, Kimberly A; Pampati, Vidyasagar; Fellows, Bert

2012-01-01

Chronic spinal pain is common along with numerous modalities of diagnostic and therapeutic interventions utilized, creating a health care crisis. Facet joint injections and epidural injections are the 2 most commonly utilized interventions in managing chronic spinal pain. While the literature addressing the effectiveness of facet joint nerve blocks is variable and emerging, there is paucity of literature on adverse effects of facet joint nerve blocks. A prospective, non-randomized study of patients undergoing interventional techniques from May 2008 to December 2009. A private interventional pain management practice, a specialty referral center in the United States. Investigation of the incidence in characteristics of adverse effects and complications of facet joint nerve blocks. The study was carried out over a period of 20 months including almost 7,500 episodes of 43,000 facet joint nerve blocks with 3,370 episodes in the cervical region, 3,162 in the lumbar region, and 950 in the thoracic region. All facet joint nerve blocks were performed under fluoroscopic guidance in an ambulatory surgery center by 3 physicians. The complications encountered during the procedure and postoperatively were evaluated prospectively. This study was carried out over a period of 20 months and included over 7,500 episodes or 43,000 facet joint nerve blocks. All of the interventions were performed under fluoroscopic guidance in an ambulatory surgery center by one of 3 physicians. The complications encountered during the procedure and postoperatively were prospectively evaluated. Measurable outcomes employed were intravascular entry of the needle, profuse bleeding, local hematoma, dural puncture and headache, nerve root or spinal cord irritation with resultant injury, and infectious complications. There were no major complications. Multiple side effects and complications observed included overall intravascular penetration in 11.4% of episodes with 20% in cervical region, 4% in lumbar region, and 6% in thoracic region; local bleeding in 76.3% of episodes with highest in thoracic region and lowest in cervical region; oozing with 19.6% encounters with highest in cervical region and lowest in lumbar region; with local hematoma seen only in 1.2% of the patients with profuse bleeding, bruising, soreness, nerve root irritation, and all other effects such as vasovagal reactions observed in 1% or less of the episodes. Limitations of this study include lack of contrast injection, use of intermittent fluoroscopy and also an observational nature of the study. This study illustrate that major complications are extremely rare and minor side effects are common.

Talocalcaneal Joint Middle Facet Coalition Resection With Interposition of a Juvenile Hyaline Cartilage Graft.

PubMed

Tower, Dyane E; Wood, Ryan W; Vaardahl, Michael D

2015-01-01

Talocalcaneal joint middle facet coalition is the most common tarsal coalition, occurring in ≤2% of the population. Fewer than 50% of involved feet obtain lasting relief of symptoms after nonoperative treatment, and surgical intervention is commonly used to relieve symptoms, increase the range of motion, improve function, reconstruct concomitant pes planovalgus, and prevent future arthrosis from occurring at the surrounding joints. Several approaches to surgical intervention are available for patients with middle facet coalitions, ranging from resection to hindfoot arthrodesis. We present a series of 4 cases, in 3 adolescent patients, of talocalcaneal joint middle facet coalition resection with interposition of a particulate juvenile hyaline cartilaginous allograft (DeNovo(®) NT Natural Tissue Graft, Zimmer, Inc., Warsaw, IN). With a mean follow-up period of 42.8 ± 2.9 (range 41 to 47) months, the 3 adolescent patients in the present series were doing well with improved subtalar joint motion and decreased pain, and 1 foot showed no bony regrowth on a follow-up computed tomography scan. The use of a particulate juvenile hyaline cartilaginous allograft as interposition material after talocalcaneal middle facet coalition resection combined with adjunct procedures to address concomitant pes planovalgus resulted in good short-term outcomes in 4 feet in 3 adolescent patients. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Lumbar Facet Joint Compressive Injury Induces Lasting Changes in Local Structure, Nociceptive Scores, and Inflammatory Mediators in a Novel Rat Model

PubMed Central

Henry, James L.; Yashpal, Kiran; Vernon, Howard; Kim, Jaesung; Im, Hee-Jeong

2012-01-01

Objective. To develop a novel animal model of persisting lumbar facet joint pain. Methods. Sprague Dawley rats were anaesthetized and the right lumbar (L5/L6) facet joint was exposed and compressed to ~1 mm with modified clamps applied for three minutes; sham-operated and naïve animals were used as control groups. After five days, animals were tested for hind-paw sensitivity using von Frey filaments and axial deep tissue sensitivity by algometer on assigned days up to 28 days. Animals were sacrificed at selected times for histological and biochemical analysis. Results. Histological sections revealed site-specific loss of cartilage in model animals only. Tactile hypersensitivity was observed for the ipsi- and contralateral paws lasting 28 days. The threshold at which deep tissue pressure just elicited vocalization was obtained at three lumbar levels; sensitivity at L1 > L3/4 > L6. Biochemical analyses revealed increases in proinflammatory cytokines, especially TNF-α, IL-1α, and IL-1β. Conclusions. These data suggest that compression of a facet joint induces a novel model of local cartilage loss accompanied by increased sensitivity to mechanical stimuli and by increases in inflammatory mediators. This new model may be useful for studies on mechanisms and treatment of lumbar facet joint pain and osteoarthritis. PMID:22966427

Melorheostosis of the tenth and eleventh thoracic vertebrae crossing the facet joint: a rare cause of back pain.

PubMed

McCarthy, M; Mehdian, H; Fairbairn, K J; Stevens, A

2004-05-01

Melorheostosis affecting the axial skeleton is a rare condition. We present a case affecting a single thoracic zygoapophyseal (facet) joint that proved to be a diagnostic challenge. CT, MRI and radionuclide imaging with surgical and histopathology findings are discussed.

Intra-articular injection of collagenase induced experimental osteoarthritis of the lumbar facet joint in rats.

PubMed

Yeh, Tsu-Te; Wen, Zhi-Hong; Lee, Herng-Sheng; Lee, Chian-Her; Yang, Zhi; Jean, Yen-Hsuan; Wu, Shing-Sheng; Nimni, Marcel E; Han, Bo

2008-05-01

We aimed to establish an animal model to investigate primary osteoarthritis of the lumbar facet joints after collagenase injection in rats and its effects on chondrocyte apoptosis. We hypothesized that osteoarthritic-like changes would be induced by collagenase injection and that apoptosis of chondrocytes would increase. Collagenase (1, 10, or 50 U) or saline (control) was injected into the lumbar facet joints. The histology and histochemistry of cartilage, synovium, and subchondral bone were examined at 1, 3, and 6 weeks after surgery. Apoptotic cells induced by 1 U of collagenase were quantified using the terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling (TUNEL) assay. Degeneration of the cartilage and changes to the synovium and subchondral bone were dependent on both the doses of collagenase and the time after surgery. There were significantly more apoptotic chondrocytes in collagenase-treated joints than in control (P < 0.001 at 1 and 3 weeks and P < 0.05 at 6 weeks). Thus, lumbar facet joints subjected to collagenase developed osteoarthritic-like changes that could be quantified and compared. This model provides a useful tool for further study on the effects of compounds that have the potential to inhibit enzyme-associated damage to cartilage.

Effect of Radiofrequency Denervation on Pain Intensity Among Patients With Chronic Low Back Pain: The Mint Randomized Clinical Trials.

PubMed

Juch, Johan N S; Maas, Esther T; Ostelo, Raymond W J G; Groeneweg, J George; Kallewaard, Jan-Willem; Koes, Bart W; Verhagen, Arianne P; van Dongen, Johanna M; Huygen, Frank J P M; van Tulder, Maurits W

2017-07-04

Radiofrequency denervation is a commonly used treatment for chronic low back pain, but high-quality evidence for its effectiveness is lacking. To evaluate the effectiveness of radiofrequency denervation added to a standardized exercise program for patients with chronic low back pain. Three pragmatic multicenter, nonblinded randomized clinical trials on the effectiveness of minimal interventional treatments for participants with chronic low back pain (Mint study) were conducted in 16 multidisciplinary pain clinics in the Netherlands. Eligible participants were included between January 1, 2013, and October 24, 2014, and had chronic low back pain, a positive diagnostic block at the facet joints (facet joint trial, 251 participants), sacroiliac joints (sacroiliac joint trial, 228 participants), or a combination of facet joints, sacroiliac joints, or intervertebral disks (combination trial, 202 participants) and were unresponsive to conservative care. All participants received a 3-month standardized exercise program and psychological support if needed. Participants in the intervention group received radiofrequency denervation as well. This is usually a 1-time procedure, but the maximum number of treatments in the trial was 3. The primary outcome was pain intensity (numeric rating scale, 0-10; whereby 0 indicated no pain and 10 indicated worst pain imaginable) measured 3 months after the intervention. The prespecified minimal clinically important difference was defined as 2 points or more. Final follow-up was at 12 months, ending October 2015. Among 681 participants who were randomized (mean age, 52.2 years; 421 women [61.8%], mean baseline pain intensity, 7.1), 599 (88%) completed the 3-month follow-up, and 521 (77%) completed the 12-month follow-up. The mean difference in pain intensity between the radiofrequency denervation and control groups at 3 months was -0.18 (95% CI, -0.76 to 0.40) in the facet joint trial; -0.71 (95% CI, -1.35 to -0.06) in the sacroiliac joint trial; and -0.99 (95% CI, -1.73 to -0.25) in the combination trial. In 3 randomized clinical trials of participants with chronic low back pain originating in the facet joints, sacroiliac joints, or a combination of facet joints, sacroiliac joints, or intervertebral disks, radiofrequency denervation combined with a standardized exercise program resulted in either no improvement or no clinically important improvement in chronic low back pain compared with a standardized exercise program alone. The findings do not support the use of radiofrequency denervation to treat chronic low back pain from these sources. trialregister.nl Identifier: NTR3531.

The Role of Thoracic Medial Branch Blocks in Managing Chronic Mid and Upper Back Pain: A Randomized, Double-Blind, Active-Control Trial with a 2-Year Followup

PubMed Central

Manchikanti, Laxmaiah; Singh, Vijay; Falco, Frank J. E.; Cash, Kimberly A.; Pampati, Vidyasagar; Fellows, Bert

2012-01-01

Study Design. A randomized, double-blind, active-control trial. Objective. To determine the clinical effectiveness of therapeutic thoracic facet joint nerve blocks with or without steroids in managing chronic mid back and upper back pain. Summary of Background Data. The prevalence of thoracic facet joint pain has been established as 34% to 42%. Multiple therapeutic techniques utilized in managing chronic thoracic pain of facet joint origin include medial branch blocks, radiofrequency neurotomy, and intraarticular injections. Methods. This randomized double-blind active controlled trial was performed in 100 patients with 50 patients in each group who received medial branch blocks with local anesthetic alone or local anesthetic and steroids. Outcome measures included the numeric rating scale (NRS), Oswestry Disability Index (ODI), opioid intake, and work status, at baseline, 3, 6, 12, 18, and 24 months. Results. Significant improvement with significant pain relief and functional status improvement of 50% or more were observed in 80% of the patients in Group I and 84% of the patients in Group II at 2-year followup. Conclusions. Therapeutic medial branch blocks of thoracic facets with or without steroids may provide a management option for chronic function-limiting thoracic pain of facet joint origin. PMID:22851967

Interspecific scaling patterns of talar articular surfaces within primates and their closest living relatives

PubMed Central

Yapuncich, Gabriel S; Boyer, Doug M

2014-01-01

The articular facets of interosseous joints must transmit forces while maintaining relatively low stresses. To prevent overloading, joints that transmit higher forces should therefore have larger facet areas. The relative contributions of body mass and muscle-induced forces to joint stress are unclear, but generate opposing hypotheses. If mass-induced forces dominate, facet area should scale with positive allometry to body mass. Alternatively, muscle-induced forces should cause facets to scale isometrically with body mass. Within primates, both scaling patterns have been reported for articular surfaces of the femoral and humeral heads, but more distal elements are less well studied. Additionally, examination of complex articular surfaces has largely been limited to linear measurements, so that ‘true area' remains poorly assessed. To re-assess these scaling relationships, we examine the relationship between body size and articular surface areas of the talus. Area measurements were taken from microCT scan-generated surfaces of all talar facets from a comprehensive sample of extant euarchontan taxa (primates, treeshrews, and colugos). Log-transformed data were regressed on literature-derived log-body mass using reduced major axis and phylogenetic least squares regressions. We examine the scaling patterns of muscle mass and physiological cross-sectional area (PCSA) to body mass, as these relationships may complicate each model. Finally, we examine the scaling pattern of hindlimb muscle PCSA to talar articular surface area, a direct test of the effect of mass-induced forces on joint surfaces. Among most groups, there is an overall trend toward positive allometry for articular surfaces. The ectal (= posterior calcaneal) facet scales with positive allometry among all groups except ‘sundatherians', strepsirrhines, galagids, and lorisids. The medial tibial facet scales isometrically among all groups except lemuroids. Scaling coefficients are not correlated with sample size, clade inclusivity or behavioral diversity of the sample. Muscle mass scales with slight positive allometry to body mass, and PCSA scales at isometry to body mass. PCSA generally scales with negative allometry to articular surface area, which indicates joint surfaces increase faster than muscles' ability to generate force. We suggest a synthetic model to explain the complex patterns observed for talar articular surface area scaling: whether ‘muscles or mass' drive articular facet scaling is probably dependent on the body size range of the sample and the biological role of the facet. The relationship between ‘muscle vs. mass' dominance is likely bone-and facet-specific, meaning that some facets should respond primarily to stresses induced by larger body mass, whereas others primarily reflect muscle forces. PMID:24219027

[Study on the effect of vertebrae semi-dislocation on the stress distribution in facet joint and interuertebral disc of patients with cervical syndrome based on the three dimensional finite element model].

PubMed

Zhang, Ming-cai; Lü, Si-zhe; Cheng, Ying-wu; Gu, Li-xu; Zhan, Hong-sheng; Shi, Yin-yu; Wang, Xiang; Huang, Shi-rong

2011-02-01

To study the effect of vertebrae semi-dislocation on the stress distribution in facet joint and interuertebral disc of patients with cervical syndrome using three dimensional finite element model. A patient with cervical spondylosis was randomly chosen, who was male, 28 years old, and diagnosed as cervical vertebra semidislocation by dynamic and static palpation and X-ray, and scanned from C(1) to C(7) by 0.75 mm slice thickness of CT. Based on the CT data, the software was used to construct the three dimensional finite element model of cervical vertebra semidislocation (C(4)-C(6)). Based on the model,virtual manipulation was used to correct the vertebra semidislocation by the software, and the stress distribution was analyzed. The result of finite element analysis showed that the stress distribution of C(5-6) facet joint and intervertebral disc changed after virtual manipulation. The vertebra semidislocation leads to the abnormal stress distribution of facet joint and intervertebral disc.

Symptomatic lumbar facet joint cysts treated by CT-guided intracystic and intra-articular steroid injections.

PubMed

Amoretti, Nicolas; Huwart, Laurent; Foti, Pauline; Boileau, Pascal; Amoretti, Marie-Eve; Pellegrin, Amelie; Marcy, Pierre-Yves; Hauger, Olivier

2012-12-01

To evaluate percutaneous computed tomography (CT)-guided intracystic and intra-articular steroid injections for the treatment of lumbar facet joint cyst causing radicular pain. A single-centre prospective study involving 120 consecutive patients with symptomatic lumbar facet joint cyst-induced radicular pain was done (72 women, 48 men). The average age was 68.2 years (52-84). Patients were treated by percutaneous CT-guided intracystic and intra-articular steroid injections. The clinical course of nerve root pain was evaluated after 1 day, and 1, 3 and 6 months, with long-term follow-up after 12 months. Patient follow-ups in our series show supportive results: within 120 patients, 54% of patients were satisfied with a long-lasting result from the first intra-cystic and intra-articular steroid injections (n = 65), while 20.8% were satisfied with a long-lasting result from a second intervention. Combining these two results shows that 75% of patients were satisfied with a long-lasting result. Our results showed that percutaneous treatment of vertebral lumbar facet joint cysts by double injections is an effective and economic therapeutic technical management among 75% of our patients. Thus we recommend that it should be considered as a first choice of treatment. Lumbar facet joint cysts are a common feature of back and radicular pain. They may be treated effectively by interventional radiologists using CT guidance. Percutaneous treatment using double injections can save surgery in 75% of patients.

Systematic review of patient history and physical examination to diagnose chronic low back pain originating from the facet joints.

PubMed

Maas, E T; Juch, J N S; Ostelo, R W J G; Groeneweg, J G; Kallewaard, J W; Koes, B W; Verhagen, A P; Huygen, F J P M; van Tulder, M W

2017-03-01

Patient history and physical examination are frequently used procedures to diagnose chronic low back pain (CLBP) originating from the facet joints, although the diagnostic accuracy is controversial. The aim of this systematic review is to determine the diagnostic accuracy of patient history and/or physical examination to identify CLBP originating from the facet joints using diagnostic blocks as reference standard. We searched MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Collaboration database from inception until June 2016. Two review authors independently selected studies for inclusion, extracted data and assessed the risk of bias. We calculated sensitivity and specificity values, with 95% confidence intervals (95% CI). Twelve studies were included, in which 129 combinations of index tests and reference standards were presented. Most of these index tests have only been evaluated in single studies with a high risk of bias. Four studies evaluated the diagnostic accuracy of the Revel's criteria combination. Because of the clinical heterogeneity, results were not pooled. The published sensitivities ranged from 0.11 (95% CI 0.02-0.29) to 1.00 (95% CI 0.75-1.00), and the specificities ranged from 0.66 (95% CI 0.46-0.82) to 0.91 (95% CI 0.83-0.96). Due to clinical heterogeneity, the evidence for the diagnostic accuracy of patient history and/or physical examination to identify facet joint pain is inconclusive. Patient history and physical examination cannot be used to limit the need of a diagnostic block. The validity of the diagnostic facet joint block should be studied, and high quality studies are required to confirm the results of single studies. Patient history and physical examination cannot be used to limit the need of a diagnostic block. The validity of the diagnostic facet joint block should be studied, and high quality studies are required to confirm the results of single studies. © 2016 European Pain Federation - EFIC®.

Arthrofibrosis involving the middle facet of the talocalcaneal joint in children and adolescents.

PubMed

El Rassi, George; Riddle, Eric C; Kumar, S Jay

2005-10-01

Pain over the anterolateral aspect of the ankle in a patient with a history of repeated ankle sprains and with restricted subtalar movement may be associated with a tarsal coalition. Nineteen patients presented with such a history, but conventional imaging did not reveal a cartilaginous or osseous coalition. Since symptoms persisted despite nonoperative treatment, the middle facet was explored surgically. The purpose of this study was to discuss the operative findings and to report the results of treatment. Nineteen patients (twenty-three feet) with pain over the anterolateral aspect of the ankle or a history of repeated ankle sprains had restricted subtalar joint motion and inconclusive findings on diagnostic imaging, except for bone-scanning. Their ages ranged from 9.1 to 18.5 years. The middle facet of the subtalar joint was explored surgically through a 3 to 4-cm-long incision centered over the sustentaculum tali. The results at a mean of 5.8 years were classified as good, fair, or poor on the basis of pain, talocalcaneal joint motion, and shoe wear. Routine radiographs, computed tomography, and magnetic resonance imaging revealed no major abnormality, whereas technetium-99m bone scintigraphy consistently showed slightly increased isotope uptake in the middle facet. Surgical removal of a hypervascular and thickened capsule and synovium in the area of the middle facet of the subtalar joint decreased pain and improved subtalar motion. The final result was good in seventeen patients (twenty feet) and fair in two patients (three feet). There were no poor results. A diagnosis of inflammatory arthrofibrosis should be considered when a patient with a painful rigid flatfoot has normal findings on radiographs and hematological studies but increased isotope uptake in the middle facet of the talocalcaneal joint on bone scintigraphy. Excision of the hypervascular capsule and synovium from this area can result in resolution of the symptoms. Therapeutic Level IV.

[Degenerative adult scoliosis].

PubMed

García-Ramos, C L; Obil-Chavarría, C A; Zárate-Kalfópulos, B; Rosales-Olivares, L M; Alpizar-Aguirre, A; Reyes-Sánchez, A A

2015-01-01

Adult scoliosis is a complex three-dimensional rotational deformity of the spine, resulting from the progressive degeneration of the vertebral elements in middle age, in a previously straight spine; a Cobb angle greater than 10° in the coronal plane, which also alters the sagittal and axial planes. It originates an asymmetrical degenerative disc and facet joint, creating asymmetrical loads and subsequently deformity. The main symptom is axial, radicular pain and neurological deficit. Conservative treatment includes drugs and physical therapy. The epidural injections and facet for selectively blocking nerve roots improves short-term pain. Surgical treatment is reserved for patients with intractable pain, radiculopathy and/ or neurological deficits. There is no consensus for surgical indications, however, it must have a clear understanding of the symptoms and clinical signs. The goal of surgery is to decompress neural elements with restoration, modification of the three-dimensional shape deformity and stabilize the coronal and sagittal balance.

A New Sensor for Measurement of Dynamic Contact Stress in the Hip

PubMed Central

Rudert, M. J.; Ellis, B. J.; Henak, C. R.; Stroud, N. J.; Pederson, D. R.; Weiss, J. A.; Brown, T. D.

2014-01-01

Various techniques exist for quantifying articular contact stress distributions, an important class of measurements in the field of orthopaedic biomechanics. In situations where the need for dynamic recording has been paramount, the approach of preference has involved thin-sheet multiplexed grid-array transducers. To date, these sensors have been used to study contact stresses in the knee, shoulder, ankle, wrist, and spinal facet joints. Until now, however, no such sensor had been available for the human hip joint due to difficulties posed by the deep, bi-curvilinear geometry of the acetabulum. We report here the design and development of a novel sensor capable of measuring dynamic contact stress in human cadaveric hip joints (maximum contact stress of 20 MPa and maximum sampling rate 100 readings/s). Particular emphasis is placed on issues concerning calibration, and on the effect of joint curvature on the sensor's performance. The active pressure-sensing regions of the sensors have the shape of a segment of an annulus with a 150-deg circumferential span, and employ a polar/circumferential “ring-and-spoke” sensel grid layout. There are two sensor sizes, having outside radii of 44 and 48 mm, respectively. The new design was evaluated in human cadaver hip joints using two methods. The stress magnitudes and spatial distribution measured by the sensor were compared to contact stresses measured by pressure sensitive film during static loading conditions that simulated heel strike during walking and stair climbing. Additionally, the forces obtained by spatial integration of the sensor contact stresses were compared to the forces measured by load cells during the static simulations and for loading applied by a dynamic hip simulator. Stress magnitudes and spatial distribution patterns obtained from the sensor versus from pressure sensitive film exhibited good agreement. The joint forces obtained during both static and dynamic loading were within ±10% and ±26%, respectively, of the forces measured by the load cells. These results provide confidence in the measurements obtained by the sensor. The new sensor's real-time output and dynamic measurement capabilities hold significant advantages over static measurements from pressure sensitive film. PMID:24763632

A new sensor for measurement of dynamic contact stress in the hip.

PubMed

Rudert, M J; Ellis, B J; Henak, C R; Stroud, N J; Pederson, D R; Weiss, J A; Brown, T D

2014-03-01

Various techniques exist for quantifying articular contact stress distributions, an important class of measurements in the field of orthopaedic biomechanics. In situations where the need for dynamic recording has been paramount, the approach of preference has involved thin-sheet multiplexed grid-array transducers. To date, these sensors have been used to study contact stresses in the knee, shoulder, ankle, wrist, and spinal facet joints. Until now, however, no such sensor had been available for the human hip joint due to difficulties posed by the deep, bi-curvilinear geometry of the acetabulum. We report here the design and development of a novel sensor capable of measuring dynamic contact stress in human cadaveric hip joints (maximum contact stress of 20 MPa and maximum sampling rate 100 readings/s). Particular emphasis is placed on issues concerning calibration, and on the effect of joint curvature on the sensor's performance. The active pressure-sensing regions of the sensors have the shape of a segment of an annulus with a 150-deg circumferential span, and employ a polar/circumferential "ring-and-spoke" sensel grid layout. There are two sensor sizes, having outside radii of 44 and 48 mm, respectively. The new design was evaluated in human cadaver hip joints using two methods. The stress magnitudes and spatial distribution measured by the sensor were compared to contact stresses measured by pressure sensitive film during static loading conditions that simulated heel strike during walking and stair climbing. Additionally, the forces obtained by spatial integration of the sensor contact stresses were compared to the forces measured by load cells during the static simulations and for loading applied by a dynamic hip simulator. Stress magnitudes and spatial distribution patterns obtained from the sensor versus from pressure sensitive film exhibited good agreement. The joint forces obtained during both static and dynamic loading were within ±10% and ±26%, respectively, of the forces measured by the load cells. These results provide confidence in the measurements obtained by the sensor. The new sensor's real-time output and dynamic measurement capabilities hold significant advantages over static measurements from pressure sensitive film.

Intra-articular injection of collagenase induced experimental osteoarthritis of the lumbar facet joint in rats

PubMed Central

Yeh, Tsu-Te; Wen, Zhi-Hong; Lee, Herng-Sheng; Lee, Chian-Her; Yang, Zhi; Jean, Yen-Hsuan; Nimni, Marcel E.; Han, Bo

2008-01-01

We aimed to establish an animal model to investigate primary osteoarthritis of the lumbar facet joints after collagenase injection in rats and its effects on chondrocyte apoptosis. We hypothesized that osteoarthritic-like changes would be induced by collagenase injection and that apoptosis of chondrocytes would increase. Collagenase (1, 10, or 50 U) or saline (control) was injected into the lumbar facet joints. The histology and histochemistry of cartilage, synovium, and subchondral bone were examined at 1, 3, and 6 weeks after surgery. Apoptotic cells induced by 1 U of collagenase were quantified using the terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling (TUNEL) assay. Degeneration of the cartilage and changes to the synovium and subchondral bone were dependent on both the doses of collagenase and the time after surgery. There were significantly more apoptotic chondrocytes in collagenase-treated joints than in control (P < 0.001 at 1 and 3 weeks and P < 0.05 at 6 weeks). Thus, lumbar facet joints subjected to collagenase developed osteoarthritic-like changes that could be quantified and compared. This model provides a useful tool for further study on the effects of compounds that have the potential to inhibit enzyme-associated damage to cartilage. PMID:18224353

Ablating spinal NK1-bearing neurons eliminates the development of pain & reduces spinal neuronal hyperexcitability & inflammation from mechanical joint injury in the rat

PubMed Central

Weisshaar, Christine L.; Winkelstein, Beth A.

2014-01-01

The facet joint is a common source of pain especially from mechanical injury. Although chronic pain is associated with altered spinal glial and neuronal responses, the contribution of specific spinal cells to joint pain are not understood. This study used the neurotoxin [Sar9,Met(O2)11]-substance P-saporin (SSP-SAP) to selectively eliminate spinal cells expressing neurokinin-1 receptor (NK1R) in a rat model of painful facet joint injury to determine the role of those spinal neurons in pain from facet injury. Following spinal administration of SSP-SAP or its control (blank-SAP), a cervical facet injury was imposed and behavioral sensitivity assessed. Spinal extracellular recordings were made on day 7 to classify neurons and quantify evoked firing. Spinal glial activation and IL1α expression also were evaluated. SSP-SAP prevented the development of mechanical hyperalgesia that is induced by joint injury and reduced NK1R expression and mechanically-evoked neuronal firing in the dorsal horn. SSP-SAP also prevented a shift toward wide dynamic range neurons that is seen after injury. Spinal astrocytic activation and IL1α expression were reduced to sham levels with SSP-SAP treatment. These results suggest that spinal NK1R-bearing cells are critical in initiating spinal nociception and inflammation associated with a painful mechanical joint injury. Perspective Results demonstrate that cells expressing NK1R in the spinal cord are critical for the development of joint pain and spinal neuroplasticity and inflammation after trauma to the joint. These findings have utility for understanding mechanisms of joint pain and developing potential targets to treat pain. PMID:24389017

Effect of Radiofrequency Denervation on Pain Intensity Among Patients With Chronic Low Back Pain

PubMed Central

Juch, Johan N. S.; Ostelo, Raymond W. J. G.; Groeneweg, J. George; Kallewaard, Jan-Willem; Koes, Bart W.; Verhagen, Arianne P.; van Dongen, Johanna M.; Huygen, Frank J. P. M.; van Tulder, Maurits W.

2017-01-01

Importance Radiofrequency denervation is a commonly used treatment for chronic low back pain, but high-quality evidence for its effectiveness is lacking. Objective To evaluate the effectiveness of radiofrequency denervation added to a standardized exercise program for patients with chronic low back pain. Design, Setting, and Participants Three pragmatic multicenter, nonblinded randomized clinical trials on the effectiveness of minimal interventional treatments for participants with chronic low back pain (Mint study) were conducted in 16 multidisciplinary pain clinics in the Netherlands. Eligible participants were included between January 1, 2013, and October 24, 2014, and had chronic low back pain, a positive diagnostic block at the facet joints (facet joint trial, 251 participants), sacroiliac joints (sacroiliac joint trial, 228 participants), or a combination of facet joints, sacroiliac joints, or intervertebral disks (combination trial, 202 participants) and were unresponsive to conservative care. Interventions All participants received a 3-month standardized exercise program and psychological support if needed. Participants in the intervention group received radiofrequency denervation as well. This is usually a 1-time procedure, but the maximum number of treatments in the trial was 3. Main Outcomes and Measures The primary outcome was pain intensity (numeric rating scale, 0-10; whereby 0 indicated no pain and 10 indicated worst pain imaginable) measured 3 months after the intervention. The prespecified minimal clinically important difference was defined as 2 points or more. Final follow-up was at 12 months, ending October 2015. Results Among 681 participants who were randomized (mean age, 52.2 years; 421 women [61.8%], mean baseline pain intensity, 7.1), 599 (88%) completed the 3-month follow-up, and 521 (77%) completed the 12-month follow-up. The mean difference in pain intensity between the radiofrequency denervation and control groups at 3 months was −0.18 (95% CI, −0.76 to 0.40) in the facet joint trial; −0.71 (95% CI, −1.35 to −0.06) in the sacroiliac joint trial; and −0.99 (95% CI, −1.73 to −0.25) in the combination trial. Conclusions and Relevance In 3 randomized clinical trials of participants with chronic low back pain originating in the facet joints, sacroiliac joints, or a combination of facet joints, sacroiliac joints, or intervertebral disks, radiofrequency denervation combined with a standardized exercise program resulted in either no improvement or no clinically important improvement in chronic low back pain compared with a standardized exercise program alone. The findings do not support the use of radiofrequency denervation to treat chronic low back pain from these sources. Trial Registration trialregister.nl Identifier: NTR3531 PMID:28672319

The Influence of Artificial Cervical Disc Prosthesis Height on the Cervical Biomechanics: A Finite Element Study.

PubMed

Yuan, Wei; Zhang, Haiping; Zhou, Xiaoshu; Wu, Weidong; Zhu, Yue

2018-05-01

Artificial cervical disc replacement is expected to maintain normal cervical biomechanics. At present, the effect of the Prestige LP prosthesis height on cervical biomechanics has not been thoroughly studied. This finite element study of the cervical biomechanics aims to predict how the parameters, like range of motion (ROM), adjacent intradiscal pressure, facet joint force, and bone-implant interface stress, are affected by different heights of Prestige LP prostheses. The finite element model of intact cervical spine (C3-C7) was obtained from our previous study, and the model was altered to implant Prestige LP prostheses at the C5-C6 level. The effects of the height of 5, 6, and 7 mm prosthesis replacement on ROM, adjacent intradiscal pressure, facet joint force, as well as the distribution of bone-implant interface stress were examined. ROM, adjacent intradiscal pressure, and facet joint force increased with the prosthesis height, whereas ROM and facet joint force decreased at C5-C6. The maximal stress on the inferior surface of the prostheses was greater than that on the superior surface, and the stresses increased with the prosthesis height. The biomechanical changes were slightly affected by the height of 5 and 6 mm prostheses, but were strongly affected by the 7-mm prosthesis. An appropriate height of the Prestige LP prosthesis can preserve normal ROM, adjacent intradiscal pressure, and facet joint force. Prostheses with a height of ≥2 mm than normal can lead to marked changes in the cervical biomechanics and bone-implant interface stress. Copyright © 2018 Elsevier Inc. All rights reserved.

Vertebral rotatory subluxation in degenerative scoliosis: facet joint tropism is related.

PubMed

Bao, Hongda; Zhu, Feng; Liu, Zhen; Bentley, Mark; Mao, Saihu; Zhu, Zezhang; Ding, Yitao; Qiu, Yong

2014-12-15

A cross-sectional study. To identify facet tropism as one of the possible risk factors leading to vertebral rotatory subluxation (VRS). VRS has been considered as one of the prognostic factors for degenerative scoliosis. Although several risk factors of VRS, including age and Cobb angle, have been investigated, few studies exist that have evaluated the correlation between VRS and anatomical structures of the vertebral column. This retrospective study recruited 23 patients diagnosed with degenerative lumbar scoliosis with VRS and 20 patients with degenerative scoliosis without VRS. The lateral translation on coronal radiographs was measured and 5 mm was used as the cutoff value to define rotatory subluxation. Computed tomographic scans for facet joints were made for all lumbar levels. The difference between right and left facet angles was recorded as ΔFA. Facet tropism was defined as a difference between the bilateral facet angles of more than 10°. In this study, VRS was most commonly found at the L3-L4 level (49%) and, with decreasing frequency at L2-L3 (24%), L4-L5 (20%), and L1-L2 (7%). On the convex side of the main curve, face joints at levels with VRS were more coronally oriented compared with those at levels without VRS (41.64° ± 11.65° vs. 36.30° ± 10.99°, P = 0.034). ΔFA was also significantly different between levels with and without VRS (P = 0.005). A strong correlation was found between ΔFA and lateral translation, with a coefficient of 0.33 (P < 0.001). In addition, ΔFA and a larger Cobb angle were found to be significantly associated with VRS based on binary regression analysis, with an odds ratio of 4.68 and 2.14, respectively. Facet tropism was more significantly observed at levels with VRS. On the convex side of the main curve, facet joints at levels with VRS were more coronally oriented. A larger Cobb angle and severe facet tropism in degenerative scoliosis should be considered to be related to VRS.

Facet joint injections as a means of reducing the need for vertebroplasty in insufficiency fractures of the spine.

PubMed

Wilson, David J; Owen, Sara; Corkill, Rufus A

2011-08-01

Recent publications compared treatment of vertebral fractures reporting improvement in the majority but with no significant difference between the local anaesthetic and vertebroplasty groups. Potential explanations include placebo response or therapeutic response to the "control procedure". We investigated whether preliminary facet joint injection can identify those patients whose pain arises from paravertebral structures rather than the vertebral insufficiency fracture itself. Patients referred for treatment by vertebroplasty were first offered local anaesthetic and steroid facet joint injection (FJI) at the most painful level. Those who failed to respond were offered a vertebroplasty. Ninety one patients referred, 16 went straight to vertebroplasty. Sixty one of 75 were initially offered FJI. Twenty one were successful; two relapsed, had further FJIs with good results; three declined treatment; 5 had temporary benefit; 1 died from unrelated causes. Of 29 who failed to respond to FJIs, 24 underwent vertebroplasty and 23 had a successful outcome. A third of patients technically suitable for vertebroplasty responded beneficially to FJI. In this group the pain mediator maybe one of instability and overload on the facet joints produced by adjacent wedge fracture. This protocol allows more selective and more successful vertebroplasty.

Facet orientation and tropism: Associations with asymmetric lumbar paraspinal and psoas muscle parameters in patients with chronic low back pain.

PubMed

Xu, W B; Chen, S; Fan, S W; Zhao, F D; Yu, X J; Hu, Z J

2016-08-10

Many studies have explored the relationship between facet tropism and facet joint osteoarthritis, disc degeneration and degenerative spondylolisthesis. However, the associations between facet orientation and tropism, and paraspinal muscles have not been studied. To analyze the associations between facet orientation and tropism, and parameters of paraspinal muscles in patients with chronic low back pain. Ninety-five patients with chronic low back pain were consecutively enrolled. Their facet joint angles were measured on computed tomography (CT) while gross cross-sectional area (GCSA), functional cross-sectional area (FCSA) and T2 signal intensity of lumbar paraspinal and psoas muscle were evaluated on magnetic resonance imaging (MRI). The GCSA and FCSA were significantly smaller for multifidus muscle (P< 0.001), but significantly larger for erector spinae and psoas muscles (P< 0.001), in coronally-orientated group than those in sagittally-orientated group. The differences of bilateral GCSA and FCSA of multifidus muscle were significantly larger in facet tropism group than those in no facet tropism group (P= 0.009 and P= 0.019). Muscular asymmetries may develop in the lumbar region of the spine, which are associated with facet asymmetry in patients with chronic low back pain. Longitudinal studies are needed to understand the causal relationship between facet orientation and tropism and muscular asymmetry in future.

Buckling behavior of origami unit cell facets under compressive loads

NASA Astrophysics Data System (ADS)

Kshad, Mohamed Ali Emhmed; Naguib, Hani E.

2018-03-01

Origami structures as cores for sandwich structures are designed to withstand the compressive loads and to dissipate compressive energy. The deformation of the origami panels and the unit cell facets are the primary factors behind the compressive energy dissipation in origami structures. During the loading stage, the origami structures deform through the folding and unfolding process of the unit cell facets, and also through the plastic deformation of the facets. This work presents a numerical study of the buckling behavior of different origami unit cell elements under compressive loading. The studied origami configurations were Miura and Ron-Resch-like origami structures. Finite element package was used to model the origami structures. The study investigated the buckling behavior of the unit cell facets of two types of origami structures Miura origami and Ron-Resch-Like origami structures. The simulation was conducted using ANSYS finite element software, in which the model of the unit cell represented by shell elements, and the eigenvalues buckling solver was used to predict the theoretical buckling of the unit cell elements.

Does disc space height of fused segment affect adjacent degeneration in ALIF? A finite element study.

PubMed

Tang, Shujie; Meng, Xueying

2011-01-01

The restoration of disc space height of fused segment is essential in anterior lumbar interbody fusion, while the disc space height in many cases decreased postoperatively, which may adversely aggravate the adjacent segmental degeneration. However, no literature available focused on the issue. A normal healthy finite element model of L3-5 and four anterior lumbar interbody fusion models with different disc space height of fused segment were developed. 800 N compressive loading plus 10 Nm moments simulating flexion, extension, lateral bending and axial rotation were imposed on L3 superior endplate. The intradiscal pressure, the intersegmental rotation, the tresca stress and contact force of facet joints in L3-4 were investigated. Anterior lumbar interbody fusion with severely decreased disc space height presented with the highest values of the four parameters, and the normal healthy model presented with the lowest values except, under extension, the contact force of facet joints in normal healthy model is higher than that in normal anterior lumbar interbody fusion model. With disc space height decrease, the values of parameters in each anterior lumbar interbody fusion model increase gradually. Anterior lumbar interbody fusion with decreased disc space height aggravate the adjacent segmental degeneration more adversely.

Posterior Branches of Lumbar Spinal Nerves - Part I: Anatomy and Functional Importance.

PubMed

Kozera, Katarzyna; Ciszek, Bogdan

2016-01-01

The aim of this paper is to compare anatomic descriptions of posterior branches of the lumbar spinal nerves and, on this basis, present the location of these structures. The majority of anatomy textbooks do not describe these nerves in detail, which may be attributable to the fact that for many years they were regarded as structures of minor clinical importance. The state of knowledge on these nerves has changed within the last 30 years. Attention has been turned to their function and importance for both diagnostic practice and therapy of lower back pain. Summarising the available literature, we may conclude that the medial and lateral branches separate at the junction of the facet joint and the distal upper edge of the transverse process; that the size, course and area supplied differ between the lateral and the medial branch; and that facet joints receive multisegmental innervation. It has been demonstrated that medial branches are smaller than the respective lateral branches and they have a more constant course. Medial branches supply the area from the midline to the facet joint line, while lateral branches innervate tissues lateral to the facet joint. The literature indicates difficulties with determining specific anatomic landmarks relative to which the lateral branch and the distal medial branch can be precisely located. Irritation of sensory fibres within posterior branches of the lumbar spinal nerves may be caused by pathology of facet joints, deformity of the spine or abnormalities due to overloading or injury. The anatomic location and course of posterior branches of spinal nerves should be borne in mind to prevent damaging them during low-invasive analgesic procedures.

Facet Joint Osteoarthritis Affects Spinal Segmental Motion in Degenerative Spondylolisthesis.

PubMed

Kitanaka, Shigeyuki; Takatori, Ryota; Arai, Yuji; Nagae, Masateru; Tonomura, Hitoshi; Mikami, Yasuo; Inoue, Nozomu; Ogura, Taku; Fujiwara, Hiroyoshi; Kubo, Toshikazu

2018-06-15

This is a retrospective clinical case series (case-control study). To clarify the influence of facet joint osteoarthritis (FJOA) on the pathology of degenerative spondylolisthesis (DS) using in vivo 3-dimensional image analysis. There are no radical treatments to prevent progression of DS in patients with lumbar spinal canal stenosis associated with DS. Therefore, an effective treatment method based on the pathology of DS should be developed. In total, 50 patients with lumbar spinal canal stenosis involving L4/5 who underwent dynamic computed tomography were divided into 2 groups: with DS [spondylolisthesis (Sp) group; 12 male, 14 female; mean age, 74 y]; and without DS (non-Sp group; 15 male, 9 female; mean age, 70 y). Degeneration of the intervertebral disk and FJOA at L4/5 were evaluated using magnetic resonance imaging. Disk and intervertebral foramen heights, the distance between the craniocaudal edges of the facet joint, and the interspinous distance were measured on dynamic computed tomographic images. Also, in vivo 3-dimensional segmental motion was evaluated using the volume merge method. There were no significant differences in degenerative findings for the intervertebral disk; however, progressive FJOA was detected in the Sp group. Dynamic changes in the distance between the craniocaudal edges of the facet joints were significantly larger in the Sp group. In this study, progressive FJOA and larger segmental motion in the distance between the craniocaudal edges of the facet joints were found in the Sp group. We clarified for the first time that DS involves ligament laxity due to FJOA that affects spinal segmental motion in vivo. We consider that a treatment method based on FJOA would be useful for treating patients with DS. Level IV.

A novel anchoring system for use in a nonfusion scoliosis correction device.

PubMed

Wessels, Martijn; Homminga, Jasper J; Hekman, Edsko E G; Verkerke, Gijsbertus J

2014-11-01

Insertion of a pedicle screw in the mid- and high thoracic regions has a serious risk of facet joint damage. Because flexible implant systems require intact facet joints, we developed an enhanced fixation that is less destructive to spinal structures. The XSFIX is a posterior fixation system that uses cables that are attached to the transverse processes of a vertebra. To determine whether a fixation to the transverse process using the XSFIX is strong enough to withstand the loads applied by the XSLATOR (a novel, highly flexible nonfusion implant system) and thus, whether it is a suitable alternative for pedicle screw fixation. The strength of a novel fixation system using transverse process cables was determined and compared with the strength of a similar fixation using polyaxial pedicle screws on different vertebral levels. Each of the 58 vertebrae, isolated from four adult human cadavers, was instrumented with either a pedicle screw anchor (PSA) system or a prototype of the XSFIX. The PSA consisted of two polyaxial pedicle screws and a 5 mm diameter rod. The XSFIX prototype consisted of two bodies that were fixed to the transverse processes, interconnected with a similar rod. Each fixation system was subjected to a lateral or an axial torque. The PSA demonstrated fixation strength in lateral loading and torsion higher than required for use in the XSLATOR. The XSFIX demonstrated high enough fixation strength (in both lateral loading and torsion), only in the high and midthoracic regions (T10-T12). This experiment showed that the fixation strength of XSFIX is sufficient for use with the XSLATOR only in mid- and high thoracic regions. For the low thoracic and lumbar region, the PSA is a more rigid fixation. Because the performance of the new fixation system appears to be favorable in the high and midthoracic regions, a clinical study is the next challenge. Copyright © 2014 Elsevier Inc. All rights reserved.

Atlantoaxial manual realignment in a patient with traumatic atlantoaxial joint disruption.

PubMed

Goel, Atul; Figueiredo, Antonio; Maheshwari, Shradha; Shah, Abhidha

2010-05-01

We report a patient with complex traumatic translatory atlantoaxial dislocation, who we treated by joint exposure and reduction of the dislocation by facet manipulation and subsequent plate and screw atlantoaxial fixation. A 28-year-old male had fallen 7.6m (25 feet), and following the fall had severe neck pain but no neurological deficit. Investigations revealed a fracture at the base of the odontoid process and posterior displacement of the entire atlas over the axis, resulting in a translatory atlantoaxial dislocation. Head traction failed as he developed severe vertigo following its application. The patient was operated upon in a prone position. We opened the atlantoaxial joint and realigned the facets using distraction and manipulation techniques and secured the joint using a plate and screw interarticular method. The patient tolerated the treatment well and was symptom-free after 28 months. Postoperative images showed good craniovertebral alignment. Although technically challenging, direct manipulation of the facets of the atlas and axis can result in excellent craniovertebral realignment.

The retrodural space of Okada.

PubMed

Murthy, Naveen S; Maus, Timothy P; Aprill, Charles

2011-06-01

The retrodural space of Okada is a potential space that can act as a conduit for the spread of inflammatory or infectious processes, connecting ipsilateral adjacent facet joints, contralateral adjacent facet joints, adjacent neural foramen, paraspinal musculature, and spinous process adventitial bursa (i.e., Baastrup disease). Awareness of these potential retrodural communications during diagnostic imaging interpretation and interventional spine injection procedures can play an important role in patient care and management.

Joint FACET: the Canada-Netherlands initiative to study multisensor data fusion systems

NASA Astrophysics Data System (ADS)

Bosse, Eloi; Theil, Arne; Roy, Jean; Huizing, Albert G.; van Aartsen, Simon

1998-09-01

This paper presents the progress of a collaborative effort between Canada and The Netherlands in analyzing multi-sensor data fusion systems, e.g. for potential application to their respective frigates. In view of the overlapping interest in studying and comparing applicability and performance and advanced state-of-the-art Multi-Sensor Data FUsion (MSDF) techniques, the two research establishments involved have decided to join their efforts in the development of MSDF testbeds. This resulted in the so-called Joint-FACET, a highly modular and flexible series of applications that is capable of processing both real and synthetic input data. Joint-FACET allows the user to create and edit test scenarios with multiple ships, sensor and targets, generate realistic sensor outputs, and to process these outputs with a variety of MSDF algorithms. These MSDF algorithms can also be tested using typical experimental data collected during live military exercises.

Incidence of the coracoclavicular joint in South African populations.

PubMed Central

Nalla, S; Asvat, R

1995-01-01

The presence of a diarthrotic coracoclavicular joint, as represented by an articular facet on the conoid tubercle of the clavicle and the superior surface of the coracoid process of the scapula, was investigated. The sample consisted of 60 white and 180 black South African (60 Sotho, 60 Xhosa and 60 Zulu) skeletons. Each group consisted of 30 male and 30 female skeletons. The presence of the articular facet was recorded as either bilateral, unilateral left or unilateral right. The effect of clavicular length, scapular size and first rib angle on the presence of the coracoclavicular joint was also investigated. The presence of the articular facet was noted in 23 (9.6%) of the 240 individuals studied. Of these 23 individuals, 6 (26.1%) were white and 17 (73.9%) were black. Males (56.5%) presented a higher incidence of this anomaly than females (43.5%). The articular facet occurred bilaterally in 47.9% (11/23), unilaterally on the left in 30.4% (7/23) and unilaterally on the right in 21.7% (5/23). Sexual, racial and tribal differences were not statistically significant. Individuals possessing the joint showed statistically significantly (P < 0.01) larger scapulae (increased border lengths and superior angles), longer clavicles and longer first ribs. No statistically significant differences in the first rib angles were observed between individuals who possessed the joint and those who did not, thus implying similar thoracic inlet size. It is proposed that the aforementioned morphometry of the scapulae, clavicles and first ribs may restrict associated movements of the scapulae, resulting in the development of the coracoclavicular joint. Images Fig. 4 Fig. 5 PMID:7559137

Bilateral symptomatic synovial cysts of the lumbar spine caused by calcium pyrophosphate deposition disease: a case report.

PubMed

Gadgil, Anirudh A; Eisenstein, Stephan M; Darby, Alan; Cassar Pullicino, Victor

2002-10-01

A case of bilateral symptomatic facet joint synovial cysts arising in association with calcium pyrophosphate deposition disease is reported. To present a previously unreported cause for symptomatic synovial cysts of the lumbar spine. Synovial cysts of the facet joints occur most commonly in association with degenerative disease of the spine in older individuals. The association of these cysts with trauma, rheumatoid arthritis, spondylolysis, and kissing spinous processes also has been reported. These cysts can cause symptoms and signs from direct compression of the dura. Chondrocalcinosis has not been previously reported to cause symptomatic synovial cysts. A 67-year-old woman presented with right lower limb sciatica caused by a right L4-L5 facet joint cyst, which resolved after surgical decompression. A year later, she presented with left lower limb sciatica caused by development of a new L4-L5 facet joint cyst, which also resolved after surgical decompression. Histopathologic examination of each cyst showed a cyst wall of fibrous tissue with synovial lining, inflammation, and granulation tissue. Examination of the tissue under polarized light showed positively birefringent, short blunt crystals of calcium pyrophosphate dihydrate. In patients with a history of gout or pseudogout, a rare possibility of a synovial cyst should be considered in the differential diagnosis during investigation for the cause of neural compression resulting in sciatic syndrome.

Osseous associated cervical spondylomyelopathy at the C2-C3 articular facet joint in 11 dogs.

PubMed

Cooper, C; Gutierrez-Quintana, R; Penderis, J; Gonçalves, R

2015-11-21

In dogs, vertebral canal stenosis at C2-C3 due to articular facet joint degeneration is only sporadically identified. The authors' aims were to review the clinical presentation, MRI characteristics, treatment and outcome of dogs presenting with this condition. Eleven cases were eligible for inclusion. Neurological examination revealed tetraparesis and proprioceptive ataxia in all 4 limbs in 3/11, proprioceptive tetra-ataxia only in 4/11, pelvic limb proprioceptive ataxia in 2/11 and no gait abnormalities in 2/11 dogs. Cervical hyperaesthesia was present in 7/11 dogs. MRI revealed bilateral articular facet joint degeneration in 10/11 cases and unilateral degeneration in one. Surgery was performed in six cases and medical management elected in five. Long-term follow-up information was available for 11 animals. Four of the surgical cases are alive and have no neurological deficits, one was euthanased for an unrelated condition and one lost to follow-up. Of the cases managed medically, three are alive showing no neurological deficits, one is alive still displaying neurological deficits and one euthanased for an unrelated condition whilst still ataxic. This study shows that both medical and surgical management can result in good outcomes in dogs with vertebral canal stenosis resulting from articular facet joint degeneration at the level of C2-C3. British Veterinary Association.

Atlantoaxial joint distraction for treatment of basilar invagination secondary to rheumatoid arthritis.

PubMed

Goel, A; Pareikh, S; Sharma, P

2005-06-01

We present our experience of treating two cases of rheumatoid arthritis involving the craniovertebral junction and having marked basilar invagination by an alternative treatment method. In both the cases, the facets were osteoporotic and were not suitable for screw implantation. The patients were 66 and 72 years of age and both patients were females. Both the patients presented with complaints of progressively increasing spastic quadriparesis. Surgery involved attempts to reduce the basilar invagination and restore the height of the 'collapsed' lateral mass by manual distraction of the facets of the atlas and axis and forced impaction of titanium spacers in the joint in addition to bone graft harvested from the iliac crest. The procedure also provided stabilization of the region. No other fixation procedure involving wires, screws, plate and rods was carried out simultaneously. Following surgery both the patients showed symptomatic improvement and partial restoration of craniovertebral alignments. Follow-up is of 2 and 24 months. Distraction of the facets of atlas and axis and impaction of metal implant and bone graft in the facet joint can assist in reduction of basilar invagination and fixation of the region in selected cases of rheumatoid arthritis involving the craniovertebral junction.

Enhanced visible-light-driven photocatalytic H2-production activity of CdS-loaded TiO2 microspheres with exposed (001) facets

NASA Astrophysics Data System (ADS)

Gao, Bifen; Yuan, Xia; Lu, Penghui; Lin, Bizhou; Chen, Yilin

2015-12-01

CdS-loaded TiO2 microspheres with highly exposed (001) facets were prepared by hydrothermal treatment of a TiF4-HCl-H2O mixed solution followed by a chemical bath deposition of CdS onto TiO2 microspheres. The crystal structure, surficial micro-structure and photo-absorption property of the samples were characterized by XRD, FE-SEM, TEM and UV-vis diffuse reflectance spectroscopy, etc. The as-prepared samples exhibited superior visible-light-driven photocatalytic H2-production activity from lactic acid aqueous solution in comparison with CdS-sensitized TiO2 nanoparticles, whose surface was dominated by (101) facets. Photoelectrochemical measurement confirmed that (001) facet is beneficial for the transfer of photo-generated electron from CdS to TiO2 microsphere, which led to the unexpected high photocatalytic activity of CdS-loaded TiO2 microspheres.

Painful lumbar spondylolysis among pediatric sports players: a pilot MRI study.

PubMed

Sairyo, Koichi; Sakai, Toshinori; Mase, Yasuyoshi; Kon, Tamiyo; Shibuya, Isao; Kanamori, Yasuo; Kosugi, Tatsuo; Dezawa, Akira

2011-11-01

For children and adolescents who are very active athletes, fresh lumbar spondylolysis is the main pathologic cause of lower back pain (LBP). However, regarding the terminal-stage spondylolysis (pars defect), there have been few studies to clarify the pathomechanism of LBP. The purpose of this study is to clarify the cause of LBP associated with pars defects in athletes. This is the first report showing a possible pathomechanism of LBP in active athletes with painful pars defect. Six pediatric athletes (5 boys and 1 girl) below 18 years old with painful bilateral lumbar spondylolysis were evaluated. In all cases, spondylolysis was identified as terminal stage (pseudoarthrosis) on CT scan. To evaluate the inflammation around the pars defects, short time inversion recovery (STIR) MRI was performed along with the sagittal section. Fluid collection, which is an indicator of inflammatory events, was evaluated in 12 pars defects as well as in 12 cranial and caudal adjoining facet joints. Inflammation (i.e., fluid collection) was observed in all 12 pars defects in six subjects at the pseudoarthrotic pars defects. In terms of facet joints, 7 of 12 (58%) pars defects showed fluid collection at the cranial and/or caudal adjoining joints on STIR MRI. The present study showed that inflammation was always present at the pars defects and in some cases at the adjoining facet joints. Thus, it is not difficult to understand how, during sports activity, inflammation may first occur at the pseudoarthrotic site and then spread to the adjoining facet joints. This mechanism could cause LBP associated with terminal-stage (pseudoarthrotics) spondylolysis in athletes.

Real-time ultrasound image classification for spine anesthesia using local directional Hadamard features.

PubMed

Pesteie, Mehran; Abolmaesumi, Purang; Ashab, Hussam Al-Deen; Lessoway, Victoria A; Massey, Simon; Gunka, Vit; Rohling, Robert N

2015-06-01

Injection therapy is a commonly used solution for back pain management. This procedure typically involves percutaneous insertion of a needle between or around the vertebrae, to deliver anesthetics near nerve bundles. Most frequently, spinal injections are performed either blindly using palpation or under the guidance of fluoroscopy or computed tomography. Recently, due to the drawbacks of the ionizing radiation of such imaging modalities, there has been a growing interest in using ultrasound imaging as an alternative. However, the complex spinal anatomy with different wave-like structures, affected by speckle noise, makes the accurate identification of the appropriate injection plane difficult. The aim of this study was to propose an automated system that can identify the optimal plane for epidural steroid injections and facet joint injections. A multi-scale and multi-directional feature extraction system to provide automated identification of the appropriate plane is proposed. Local Hadamard coefficients are obtained using the sequency-ordered Hadamard transform at multiple scales. Directional features are extracted from local coefficients which correspond to different regions in the ultrasound images. An artificial neural network is trained based on the local directional Hadamard features for classification. The proposed method yields distinctive features for classification which successfully classified 1032 images out of 1090 for epidural steroid injection and 990 images out of 1052 for facet joint injection. In order to validate the proposed method, a leave-one-out cross-validation was performed. The average classification accuracy for leave-one-out validation was 94 % for epidural and 90 % for facet joint targets. Also, the feature extraction time for the proposed method was 20 ms for a native 2D ultrasound image. A real-time machine learning system based on the local directional Hadamard features extracted by the sequency-ordered Hadamard transform for detecting the laminae and facet joints in ultrasound images has been proposed. The system has the potential to assist the anesthesiologists in quickly finding the target plane for epidural steroid injections and facet joint injections.

Reduction of radiation dose during facet joint injection using the new image guidance system SabreSource™: a prospective study in 60 patients

PubMed Central

Proschek, Dirk; Kafchitsas, K.; Rauschmann, M. A.; Kurth, A. A.; Vogl, T. J.

2008-01-01

Interventional procedures are associated with high radiation doses for both patients and surgeons. To reduce the risk from ionizing radiation, it is essential to minimize radiation dose. This prospective study was performed to evaluate the effectiveness in reducing radiation dose during facet joint injection in the lumbar spine and to evaluate the feasibility and possibilities of the new real time image guidance system SabreSource™. A total of 60 patients, treated with a standardized injection therapy of the facet joints L4–L5 or L5–S1, were included in this study. A total of 30 patients were treated by fluoroscopy guidance alone, the following 30 patients were treated using the new SabreSource™ system. Thus a total of 120 injections to the facet joints were performed. Pain, according to the visual analogue scale (VAS), was documented before and 6 h after the intervention. Radiation dose, time of radiation and the number of exposures needed to place the needle were recorded. No significant differences concerning age (mean age 60.5 years, range 51–69), body mass index (mean BMI 26.2, range 22.2–29.9) and preoperative pain (VAS 7.9, range 6–10) were found between the two groups. There was no difference in pain reduction between the two groups (60 vs. 61.5%; P = 0.001) but the radiation dose was significantly smaller with the new SabreSource™ system (reduction of radiation dose 32.7%, P = 0.01; reduction of mean entrance surface dose 32.3%, P = 0.01). The SabreSource™ System significantly reduced the radiation dose received during the injection therapy of the lumbar facet joints. With minimal effort for the setup at the beginning of a session, the system is easy to handle and can be helpful for other injection therapies (e.g. nerve root block therapies). PMID:19082641

Ketorolac reduces spinal astrocytic activation and PAR1 expression associated with attenuation of pain after facet joint injury.

PubMed

Dong, Ling; Smith, Jenell R; Winkelstein, Beth A

2013-05-15

Chronic neck pain affects up to 70% of persons, with the facet joint being the most common source. Intra-articular injection of the non-steroidal anti-inflammatory drug ketorolac reduces post-operative joint-mediated pain; however, the mechanism of its attenuation of facet-mediated pain has not been evaluated. Protease-activated receptor-1 (PAR1) has differential roles in pain maintenance depending on the type and location of painful injury. This study investigated if the timing of intra-articular ketorolac injection after painful cervical facet injury affects behavioral hypersensitivity by modulating spinal astrocyte activation and/or PAR1 expression. Rats underwent a painful joint distraction and received an injection of ketorolac either immediately or 1 day later. Separate control groups included injured rats with a vehicle injection at day 1 and sham operated rats. Forepaw mechanical allodynia was measured for 7 days, and spinal cord tissue was immunolabeled for glial fibrillary acidic protein (GFAP) and PAR1 expression in the dorsal horn on day 7. Ketorolac administered on day 1 after injury significantly reduced allodynia (p=0.0006) to sham levels, whereas injection immediately after the injury had no effect compared with vehicle. Spinal astrocytic activation followed behavioral responses and was significantly decreased (p=0.009) only for ketorolac given at day 1. Spinal PAR1 (p=0.0025) and astrocytic PAR1 (p=0.012) were significantly increased after injury. Paralleling behavioral data, astrocytic PAR1 was returned to levels in sham only when ketorolac was administered on day 1. Yet, spinal PAR1 was significantly reduced (p<0.0001) by ketorolac independent of timing. Spinal astrocyte expression of PAR1 appears to be associated with the maintenance of facet-mediated pain.

Ketorolac Reduces Spinal Astrocytic Activation and PAR1 Expression Associated with Attenuation of Pain after Facet Joint Injury

PubMed Central

Dong, Ling; Smith, Jenell R.

2013-01-01

Abstract Chronic neck pain affects up to 70% of persons, with the facet joint being the most common source. Intra-articular injection of the non-steroidal anti-inflammatory drug ketorolac reduces post-operative joint-mediated pain; however, the mechanism of its attenuation of facet-mediated pain has not been evaluated. Protease-activated receptor-1 (PAR1) has differential roles in pain maintenance depending on the type and location of painful injury. This study investigated if the timing of intra-articular ketorolac injection after painful cervical facet injury affects behavioral hypersensitivity by modulating spinal astrocyte activation and/or PAR1 expression. Rats underwent a painful joint distraction and received an injection of ketorolac either immediately or 1 day later. Separate control groups included injured rats with a vehicle injection at day 1 and sham operated rats. Forepaw mechanical allodynia was measured for 7 days, and spinal cord tissue was immunolabeled for glial fibrillary acidic protein (GFAP) and PAR1 expression in the dorsal horn on day 7. Ketorolac administered on day 1 after injury significantly reduced allodynia (p=0.0006) to sham levels, whereas injection immediately after the injury had no effect compared with vehicle. Spinal astrocytic activation followed behavioral responses and was significantly decreased (p=0.009) only for ketorolac given at day 1. Spinal PAR1 (p=0.0025) and astrocytic PAR1 (p=0.012) were significantly increased after injury. Paralleling behavioral data, astrocytic PAR1 was returned to levels in sham only when ketorolac was administered on day 1. Yet, spinal PAR1 was significantly reduced (p<0.0001) by ketorolac independent of timing. Spinal astrocyte expression of PAR1 appears to be associated with the maintenance of facet-mediated pain. PMID:23126437

[Lumbosacral facet joint stabilization: Mc Bride technique].

PubMed

Martínez, Ernesto De León; García, J Antonio Vázquez; Castillo, Pablo Atlitec

2008-01-01

We carried out a retrospective study of the clinical results of lumbosacral decompression with Mc Bride technique, in treatment of degenerative unstable lumbar stenosis. Three hundred and forty patients (180 male) were treated during May 1996 to May 2003. Mean age at surgery was 47 years old (22-85) with 3 to 8 years of follow up. All patients fulfilled clinical and image criteria for chronic lumbar pain due to degenerative lumbar stenosis and segmental instability that did not improve with conservative treatment. We found very good results in 114 patients (33.5%), good in 203 patients (59.7%), regular in 16 patients (4.7%), and poor in 6 patients (2%). The Mc Bride technique is based in interlaminar distraction and permits managing lumbar stenosis and arthrodesis of an unstable segment simultaneously. It diminishes compression in the foramen, maintains a position in extension, reduces facet joints subluxation and eliminates the strategic point of intervertebral mobility in facet joints. It allows immediate stabilization and later fusion by placing a bone block.

Modified Goel’s Methods for Basilar Impression: A Case Report with Literature

PubMed Central

Asamoto, Shunji; Fukui, Yasuyuki; Nishiyama, Makoto; Ishikawa, Masayuki; Nakamura, Satoshi; Nagashima, Masaki; Muto, Jun; Jimbo, Hiroyuki

2016-01-01

We report the case of a 57-year-old woman who had basilar impression manifesting as severe myelopathy and occipital neuralgia and was treated by distraction and fixation performed using a modification of Goel’s method. Magnetic resonance imaging (MRI) and computed tomography (CT) scans showed severe myelocompression by the dens of the axis from the ventral side and occipitalization of the atlas. After traction using a Halo vest, C1–2 facet distraction and fixation was performed in one stage using a modified Goel’s method. Although Goel et al. used a custom-made spacer to distract the facet joints, we used a threaded titanium cylindrical cage that was inserted into the joint to fix the C1–2 facet joint with posterior fixation from occipital bone to C5. Postoperatively, gradual symptomatic and neurological amelioration were observed. The atlantoaxial joints were bone-fused at 3 years post-operation. Distraction and fixation performed using this modified version of Goel’s method was effective for treating basilar invagination. The threaded titanium cylindrical cage provided adequate C1–2 space and strong initial fixation. PMID:28663991

The efficacy of conventional radiofrequency denervation in patients with chronic low back pain originating from the facet joints: a meta-analysis of randomized controlled trials.

PubMed

Lee, Chang-Hyun; Chung, Chun Kee; Kim, Chi Heon

2017-11-01

Radiofrequency denervation is commonly used for the treatment of chronic facet joint pain that has been refractory to more conservative treatments, although the evidence supporting this treatment has been controversial. We aimed to elucidate the precise effects of radiofrequency denervation in patients with low back pain originating from the facet joints relative to those obtained using control treatments, with particular attention to consistency in the denervation protocol. A meta-analysis of randomized controlled trials was carried out. Adult patients undergoing radiofrequency denervation or control treatments (sham or epidural block) for facet joint disease of the lumbar spine comprised the patient sample. Visual analog scale (VAS) pain scores were measured and stratified by response of diagnostic block procedures. We searched PubMed, Embase, Web of Science, and the Cochrane Database for randomized controlled trials regarding radiofrequency denervation and control treatments for back pain. Changes in VAS pain scores of the radiofrequency group were compared with those of the control group as well as the minimal clinically important difference (MCID) for back pain VAS. Meta-regression model was developed to evaluate the effect of radiofrequency treatment according to responses of diagnostic block while controlling for other variables. We then calculated mean differences and 95% confidence intervals (CIs) using random-effects models. We included data from seven trials involving 454 patients who had undergone radiofrequency denervation (231 patients) and control treatments such as sham or epidural block procedures (223 patients). The radiofrequency group exhibited significantly greater improvements in back pain score when compared with the control group for 1-year follow-up. Although the average improvement in VAS scores exceeded the MCID, the lower limit of the 95% CI encompassed the MCID. A subgroup of patients who responded very well to diagnostic block procedures demonstrated significant improvements in back pain relative to the control group at all times. When placed into our meta-regression model, the response to diagnostic block procedure was responsible for a statistically significant portion of treatment effect. Studies published over the last two decades revealed that radiofrequency denervation reduced back pain significantly in patients with facet joint disease compared with the MCID and control treatments. Conventional radiofrequency denervation resulted in significant reductions in low back pain originating from the facet joints in patients showing the best response to diagnostic block over the first 12 months when compared with sham procedures or epidural nerve blocks. Copyright © 2017 Elsevier Inc. All rights reserved.

Clinical diagnosis scale for pain lumbar of facet origin: systematic review of literature and pilot study.

PubMed

Gómez Vega, Juan Carlos; Acevedo-González, Juan Carlos

2018-06-14

Lumbar pain affects between 60-90% of people. It is a frequent cause of disability in adults. Pain may be generated by different anatomical structures such as the facet joint. However, nowadays pain produced by the facet joint has no clinical diagnosis. Therefore, the purpose of this article is to propose a clinical diagnostic scale for lumbar facet syndrome. The study was conducted by means of 6 phases as follows, Phase 1, a systematic review of the literature was performed regarding the clinical diagnosis of facet-based lumbar pain based on the PRISMA checklist; Phase 2, a list of signs and symptoms proposed for diagnosis lumbar pain of facet origin was made. Phase 3, the list of signs and symptoms found was submitted to a committee of experts to discriminate the most significant signs and symptoms, these were linked to general sociodemographic variables to develop an evaluation questionnaire; Phase 4, the evaluation questionnaire was applied, including those selected signs and symptoms to a group of patients with clinical diagnosis of facet disease lumbar pain and who underwent a selective facet block. Phase 5, under standard technique selective facet block and subsequent postoperative clinical control at 1 month. Phase 6, given pre and postsurgical results associated with signs present in the patients we propose a clinical scale of diagnosis scale. Descriptive statistics and Stata 12.0 were used as statistical software. A total of 36 signs and symptoms were found for the diagnosis of lumbar facet syndrome that were submitted to the group of experts, where a total of 12 (8 symptoms and 4 signs) were included for the final survey. 31 patients underwent selective lumbar facet blockade, mostly women, with an average of 60±11.5 years, analogous visual scale of preoperative pain of 8/10, postoperative of 1.7/10, the signs and symptoms most frequently found included in a diagnostic scale were: 3 symptoms 1) axial or bilateral axial lumbar pain, 2) improvement with rest, 3) absence of root pattern, may have pseudoradicular pattern, however, the pain is greater lumbar than pain in the leg and 3 clinical signs 1) Kemp sign, 2) pain induced in joint or transverse process, 3) facet stress sign or Acevedo sign. The clinical diagnosis of lumbar facet pain is still debated. Few diagnostic scales have been postulated, with little or no external validity, so the present study proposes a diagnostic scale consisting of 3 symptoms and 3 clinical signs. Copyright © 2018 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

CT-Guided Transfacet Pedicle Screw Fixation in Facet Joint Syndrome: A Novel Approach

PubMed Central

Manfré, Luigi

2014-01-01

Summary Axial microinstability secondary to disc degeneration and consequent chronic facet joint syndrome (CFJS) is a well-known pathological entity, usually responsible for low back pain (LBP). Although posterior lumbar fixation (PIF) has been widely used for lumbar spine instability and LBP, complications related to wrong screw introduction, perineural scars and extensive muscle dissection leading to muscle dysfunction have been described. Radiofrequency ablation (RFA) of facet joints zygapophyseal nerves conventionally used for pain treatment fails in approximately 21% of patients. We investigated a “covert-surgery” minimal invasive technique to treat local spinal instability and LBP, using a novel fully CT-guided approach in patients with axial instability complicated by CFJS resistant to radioablation, by introducing direct fully or partially threaded transfacet screws (transfacet fixation - TFF), to acquire solid arthrodesis, reducing instability and LBP. The CT-guided procedure was well tolerated by all patients in simple analogue sedation, and mean operative time was approximately 45 minutes. All eight patients treated underwent clinical and CT study follow-up at two months, revealing LBP disappearance in six patients, and a significant reduction of lumbar pain in two. In conclusion, CT-guided TFF is a fast and safe technique when facet posterior fixation is needed. PMID:25363265

Biomechanical changes of the lumbar segment after total disc replacement : charite(r), prodisc(r) and maverick(r) using finite element model study.

PubMed

Kim, Ki-Tack; Lee, Sang-Hun; Suk, Kyung-Soo; Lee, Jung-Hee; Jeong, Bi-O

2010-06-01

The purpose of this study was to analyze the biomechanical effects of three different constrained types of an artificial disc on the implanted and adjacent segments in the lumbar spine using a finite element model (FEM). The created intact model was validated by comparing the flexion-extension response without pre-load with the corresponding results obtained from the published experimental studies. The validated intact lumbar model was tested after implantation of three artificial discs at L4-5. Each implanted model was subjected to a combination of 400 N follower load and 5 Nm of flexion/extension moments. ABAQUS version 6.5 (ABAQUS Inc., Providence, RI, USA) and FEMAP version 8.20 (Electronic Data Systems Corp., Plano, TX, USA) were used for meshing and analysis of geometry of the intact and implanted models. Under the flexion load, the intersegmental rotation angles of all the implanted models were similar to that of the intact model, but under the extension load, the values were greater than that of the intact model. The facet contact loads of three implanted models were greater than the loads observed with the intact model. Under the flexion load, three types of the implanted model at the L4-5 level showed the intersegmental rotation angle similar to the one measured with the intact model. Under the extension load, all of the artificial disc implanted models demonstrated an increased extension rotational angle at the operated level (L4-5), resulting in an increase under the facet contact load when compared with the adjacent segments. The increased facet load may lead to facet degeneration.

Biomechanical analysis of a new lumbar interspinous device with optimized topology.

PubMed

Chen, Chen-Sheng; Shih, Shih-Liang

2018-01-06

Interspinous spacers used stand-alone preserve joint movement but provide little protection for diseased segments of the spine. Used as adjuncts with fusion, interspinous spacers offer rigid stability but may accelerate degeneration on adjacent levels. Our new device is intended to balance the stability and preserves motion provided by the implant. A new interspinous spacer was devised according to the results of topology optimization studies. Four finite element (FE) spine models were created that consisted of an intact spine without an implant, implantation of the novel, the device for intervertebral assisted motion (DIAM system), and the Dynesys system. All models were loaded with moments, and their range of motions (ROMs), peak disc stresses, and facet contact forces were analyzed. The limited motion segment ROMs, shielded disc stresses, and unloaded facet contact forces of the new devices were greater than those of the DIAM and Dynesys system at L3-L4 in almost all directions of movements. The ROMs, disc stresses, and facet contact forces of the new devices at L2-L3 were slightly greater than those in the DIAM system, but much lower than those in the Dynesys system in most directions. This study demonstrated that the new device provided more stability at the instrumented level than the DIAM system did, especially in lateral rotation and the bending direction. The device caused fewer adjacent ROMs, lower disc stresses, and lower facet contact forces than the Dynesys system did. Additionally, this study conducted topology optimization to design the new device and created a smaller implant for minimal invasive surgery.

Partial lumbosacral transitional vertebra resection for contralateral facetogenic pain.

PubMed

Brault, J S; Smith, J; Currier, B L

2001-01-15

Case report of surgically treated mechanical low back pain from the facet joint contralateral to a unilateral anomalous lumbosacral articulation (Bertolotti's syndrome). To describe the clinical presentation, diagnostic evaluation, and management of facet-related low back pain in a 17-year-old cheerleader and its successful surgical treatment with resection of a contralateral anomalous articulation. Lumbosacral transitional vertebrae are common in the general population. Bertolotti's syndrome is mechanical low back pain associated with these transitional segments. Little is known about the pathophysiology and mechanics of these vertebral segments and their propensity to be pain generators. Treatment of this syndrome is controversial, and surgical intervention has been infrequently reported. A retrospective chart analysis and radiographic review were performed. Repeated fluoroscopically guided injections implicated a symptomatic L6-S1 facet joint contralateral to an anomalous lumbosacral articulation. Eventually, a successful surgical outcome was achieved with resection of the anomalous articulation. Clinicians should consider the possibility that mechanical low back pain may occur from a facet contralateral to a unilateral anomalous lumbosacral articulation, even in a young patient. Although reports of surgical treatment of Bertolotti's syndrome are infrequent, resection of the anomalous articulation provided excellent results in this patient, presumably because of reduced stresses on the symptomatic facet.

Does increased femoral antetorsion predispose to cartilage lesions of the patellofemoral joint?

PubMed

Oppermann, Johannes; Bredow, Jan; Wissusek, Boris; Spies, Christian Karl; Boese, Christoph Kolja; Chang, Shi-Min; Eysel, Peer; Dargel, Jens

2017-09-01

The purpose of this study was to investigate whether there was a relationship between femoral neck antetorsion and the presence and pattern of osteoarthritis of the patellofemoral joint. It was hypothesized that an increased femoral neck antetorsion (1) correlates with osteoarthritic changes of the lateral facet of the patellofemoral joint and (2) correlates with an increased lateral trochlear height and a decreased sulcus angle. Seventy-eight formalin-embedded cadaveric lower extremities from thirty-nine subjects with a median age of 74 years (range 60-88) were used. Surrounding soft tissues of the lower limb were removed. The femoral neck antetorsion was measured and referenced to the transepicondylar axis and the posterior condylar line. The height of the medial and lateral facet of the trochlea and the sulcus angle was measured. The location and the degree of patellofemoral cartilage degeneration were recorded. A Pearson's correlation analysis was performed to correlate the femoral neck antetorsion with the measured knee parameters. No significant correlation could be found between the femoral antetorsion and cartilage degeneration of the lateral patellofemoral joint (n.s.), the height of the lateral trochlea (n.s.) and the sulcus angle (n.s.). This study could not document that the femoral neck antetorsion and subsequent internal rotation of the distal femur correlated with the degree of degeneration of the lateral facet of the patellofemoral joint. Clinically, femoral internal rotation may play a minor role in the development of lateral patellofemoral joint degeneration.

A Novel Technique for Cervical Facet Joint Hyperplasia-Spondylotic Radiculopathy by Laminar and Lateral Mass Screw Cofixations.

PubMed

Sheng, Sun-Ren; Wang, Ke; Nisar, Majid; Chen, Jiao-Xiang; Wu, Ai-Min; Wang, Xiang-Yang

2018-02-01

We sought to describe the novel technique and report the outcomes of cervical spondylotic radiculopathy caused by facet joint hyperplasia treated with minimally invasive surgery by laminar and lateral mass screw cofixations. In this retrospective study, patients with spondylotic radiculopathy caused by facet joint hyperplasia underwent this technique in our unit between January 2010 and June 2015. Hospital charts, magnetic resonance imaging studies, and follow-up records for all the patients were reviewed. Outcomes were assessed on the basis of neurologic status, magnetic resonance imaging, and visual analog scale for neck and radicular pain and by the short form-36 health survey questionnaire. Thirteen men and 5 women, aged 47-73 years (mean, 61.8 years), were included in this study. The follow-up time ranged from 19-50 months (mean, 32.4 months). The mean visual analog scale scores for radicular pain and neck pain, as well as the scores for all 8 domains of the short form-36 health survey questionnaire, showed significant improvements (P < 0.05). Cervical lordosis showed bending, whereas the height of the targeted disk segment showed no change (P > 0.05). Complications included 2 cases of neck pain that lasted for 3 months. Minimally invasive surgery by lamina and lateral mass screw cofixation is safe and effective for the treatment of cervical spondylotic radiculopathy caused by facet joint hyperplasia. In addition to sufficient decompression, this technique provides relative stability to the cervical spine. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Risk factors for degenerative spondylolisthesis: a systematic review

PubMed Central

DeVine, John G.; Schenk-Kisser, Jeannette M.; Skelly, Andrea C.

2012-01-01

Study design: Systematic literature review. Rationale: Many authors have postulated on various risk factors associated with the pathogenesis of degenerative spondylolisthesis (DS), yet controversies regarding those risk factors still exist. Objective: To critically appraise and summarize evidence on risk factors for DS. Methods: Articles published before October 15, 2011, were systematically reviewed using PubMed and bibliographies of key articles. Each article was subject to quality rating and was analyzed by two independent reviewers. Results: From 382 citations, 30 underwent full-text review. Fourteen studies met inclusion criteria. All but two were considered poor quality. Female gender and higher facet joint angle were consistently associated with an increased risk of DS across multiple studies. Multiple studies also consistently reported no association between back pain and prolonged occupational sitting. Associations between age, parity, lumbosacral angle, lumbar lordosis, facet joint tropism, and pelvic inclination angles were inconsistent. Conclusions: There appears to be consistent evidence to suggest that the risk of DS increases with increasing age and is greater for females and people with a greater facet joint angle. PMID:23230415

Quantitative morphometric analysis of the lumbar vertebral facets and evaluation of feasibility of lumbar spinal nerve root and spinal canal decompression using the Goel intraarticular facetal spacer distraction technique: A lumbar/cervical facet comparison

PubMed Central

Satoskar, Savni R.; Goel, Aimee A.; Mehta, Pooja H.; Goel, Atul

2014-01-01

Objective: The authors evaluate the anatomic subtleties of lumbar facets and assess the feasibility and effectiveness of use of ‘Goel facet spacer’ in the treatment of degenerative spinal canal stenosis. Materials and Methods: Twenty-five lumbar vertebral cadaveric dried bones were used for the purpose. A number of morphometric parameters were evaluated both before and after the introduction of Goel facet spacers within the confines of the facet joint. Results: The spacers achieved distraction of facets that was more pronounced in the vertical perspective. Introduction of spacers on both sides resulted in an increase in the intervertebral foraminal height and a circumferential increase in the spinal canal dimensions. Additionally, there was an increase in the disc space or intervertebral body height. The lumbar facets are more vertically and anteroposteriorly oriented when compared to cervical facets that are obliquely and transversely oriented. Conclusions: Understanding the anatomical peculiarities of the lumbar and cervical facets can lead to an optimum utilization of the potential of Goel facet distraction arthrodesis technique in the treatment of spinal degenerative canal stenosis. PMID:25558146

A new technique to treat facet joint pain with pulsed radiofrequency.

PubMed

Schianchi, Pietro Martino

2015-02-01

Facet joint pain affects 5% to 15% of the population with low back pain and the prevalence increases with age due to progression of arthritis. While conservative treatments are often unsuccessful, the scientific evidence on minimally invasive therapies such as intra-articular steroid infiltration and continuous and pulsed radiofrequency (PRF) of the medial branches is contradictory. Since PRF has recently been reported to successfully treat joint pain, a new application of this method is proposed for facetogenic lumbar pain via an intra-articular subcapsular approach. Here we reported two cases with successful treatment. A 71-year-old patient presented because of persisting pain in the left gluteal region radiating to the lateral thigh and calf when standing. Anti-inflammatory drugs produced only short-lasting insufficient relief. A 52-year-old employee was admitted in June 2012 because of axial lower lumbar pain with intermittent diffuse radiation to the right lower extremity that worsened during walking and lying down despite receiving analgesics and physiotherapy. A new approach to treat lumbar facet joint pain with PRF is simple to perform and without serious complications. In view of the good long-lasting results obtained with the two reported cases, randomized control trials are necessary to validate this new approach.

FacetGist: Collective Extraction of Document Facets in Large Technical Corpora.

PubMed

Siddiqui, Tarique; Ren, Xiang; Parameswaran, Aditya; Han, Jiawei

2016-10-01

Given the large volume of technical documents available, it is crucial to automatically organize and categorize these documents to be able to understand and extract value from them. Towards this end, we introduce a new research problem called Facet Extraction. Given a collection of technical documents, the goal of Facet Extraction is to automatically label each document with a set of concepts for the key facets ( e.g. , application, technique, evaluation metrics, and dataset) that people may be interested in. Facet Extraction has numerous applications, including document summarization, literature search, patent search and business intelligence. The major challenge in performing Facet Extraction arises from multiple sources: concept extraction, concept to facet matching, and facet disambiguation. To tackle these challenges, we develop FacetGist, a framework for facet extraction. Facet Extraction involves constructing a graph-based heterogeneous network to capture information available across multiple local sentence-level features, as well as global context features. We then formulate a joint optimization problem, and propose an efficient algorithm for graph-based label propagation to estimate the facet of each concept mention. Experimental results on technical corpora from two domains demonstrate that Facet Extraction can lead to an improvement of over 25% in both precision and recall over competing schemes.

FacetGist: Collective Extraction of Document Facets in Large Technical Corpora

PubMed Central

Siddiqui, Tarique; Ren, Xiang; Parameswaran, Aditya; Han, Jiawei

2017-01-01

Given the large volume of technical documents available, it is crucial to automatically organize and categorize these documents to be able to understand and extract value from them. Towards this end, we introduce a new research problem called Facet Extraction. Given a collection of technical documents, the goal of Facet Extraction is to automatically label each document with a set of concepts for the key facets (e.g., application, technique, evaluation metrics, and dataset) that people may be interested in. Facet Extraction has numerous applications, including document summarization, literature search, patent search and business intelligence. The major challenge in performing Facet Extraction arises from multiple sources: concept extraction, concept to facet matching, and facet disambiguation. To tackle these challenges, we develop FacetGist, a framework for facet extraction. Facet Extraction involves constructing a graph-based heterogeneous network to capture information available across multiple local sentence-level features, as well as global context features. We then formulate a joint optimization problem, and propose an efficient algorithm for graph-based label propagation to estimate the facet of each concept mention. Experimental results on technical corpora from two domains demonstrate that Facet Extraction can lead to an improvement of over 25% in both precision and recall over competing schemes. PMID:28210517

Femoral articular geometry and patellofemoral stability.

PubMed

Iranpour, Farhad; Merican, Azhar M; Teo, Seow Hui; Cobb, Justin P; Amis, Andrew A

2017-06-01

Patellofemoral instability is a major cause of anterior knee pain. The aim of this study was to examine how the medial and lateral stability of the patellofemoral joint in the normal knee changes with knee flexion and measure its relationship to differences in femoral trochlear geometry. Twelve fresh-frozen cadaveric knees were used. Five components of the quadriceps and the iliotibial band were loaded physiologically with 175N and 30N, respectively. The force required to displace the patella 10mm laterally and medially at 0°, 20°, 30°, 60° and 90° knee flexion was measured. Patellofemoral contact points at these knee flexion angles were marked. The trochlea cartilage geometry at these flexion angles was visualized by Computed Tomography imaging of the femora in air with no overlying tissue. The sulcus, medial and lateral facet angles were measured. The facet angles were measured relative to the posterior condylar datum. The lateral facet slope decreased progressively with flexion from 23°±3° (mean±S.D.) at 0° to 17±5° at 90°. While the medial facet angle increased progressively from 8°±8° to 36°±9° between 0° and 90°. Patellar lateral stability varied from 96±22N at 0°, to 77±23N at 20°, then to 101±27N at 90° knee flexion. Medial stability varied from 74±20N at 0° to 170±21N at 90°. There were significant correlations between the sulcus angle and the medial facet angle with medial stability (r=0.78, p<0.0001). These results provide objective evidence relating the changes of femoral profile geometry with knee flexion to patellofemoral stability. Copyright © 2017 Elsevier B.V. All rights reserved.

Percutaneous adhesiolysis procedures in the medicare population: analysis of utilization and growth patterns from 2000 to 2011.

PubMed

Manchikanti, Laxmaiah; Helm Ii, Standiford; Pampati, Vidyasagar; Racz, Gabor B

2014-01-01

Multiple reviews have shown that interventional techniques for chronic pain have increased dramatically over the years. Of these interventional techniques, both sacroiliac joint injections and facet joint interventions showed explosive growth, followed by epidural procedures. Percutaneous adhesiolysis procedures have not been assessed for their utilization patterns separately from epidural injections. An analysis of the utilization patterns of percutaneous adhesiolysis procedures in managing chronic low back pain in the Medicare population from 2000 to 2011. To assess the utilization and growth patterns of percutaneous adhesiolysis in managing chronic low back pain. The study was performed utilizing the Centers for Medicare and Medicaid Services (CMS) Physician Supplier Procedure Summary Master of Fee-For-Service (FFS) Data from 2000 to 2011. Percutaneous adhesiolysis procedures increased 47% with an annual growth rate of 3.6% in the FFS Medicare population from 2000 to 2011. These growth rates are significantly lower than the growth rates for sacroiliac joint injections (331%), facet joint interventions (308%), and epidural injections (130%), but substantially lower than lumbar transforaminal injections (665%) and lumbar facet joint neurolysis (544%). Study limitations include lack of inclusion of Medicare Advantage patients. In addition, the statewide data is based on claims which may include the contiguous or other states. Percutaneous adhesiolysis utilization increased moderately in Medicare beneficiaries from 2000 to 2011. Overall, there was an increase of 47% in the utilization of adhesiolysis procedures per 100,000 Medicare beneficiaries, with an annual geometric average increase of 3.6%.

A Prospective Study Comparing Platelet-Rich Plasma and Local Anesthetic (LA)/Corticosteroid in Intra-Articular Injection for the Treatment of Lumbar Facet Joint Syndrome.

PubMed

Wu, Jiuping; Zhou, Jingjing; Liu, Chibing; Zhang, Jun; Xiong, Wei; Lv, Yang; Liu, Rui; Wang, Ruiqiang; Du, Zhenwu; Zhang, Guizhen; Liu, Qinyi

2017-09-01

To compare the effectiveness and safety between autologous platelet-rich plasma (PRP) and Local Anesthetic (LA)/corticosteroid in intra-articular injection for the treatment of lumbar facet joint syndrome. Forty-six eligible patients with lumbar facet joint syndrome were randomized into group A (intra-articular injection with PRP) and group B (intra-articular injection with LA/corticosteroid). The following contents were evaluated: pain visual analog scale (VAS) at rest and during flexion, and the Roland-Morris Disability Questionnaire (RMQ), Oswestry Disability Index (ODI), and modified MacNab criteria for pain relief and applications of post-treatment drugs. All outcome assessments were performed immediately after and at 1 week, 1, 2, 3, and 6 months after treatment. No significant difference between groups was observed at baseline. Compared with pretreatment, both group A and group B demonstrated statistical improvements in the pain VAS score at rest or during flexion, the RMQ, and the ODI (P < 0.01). And there were significant differences between the 2 groups on the above-mentioned items (P < 0.05). For group B, subjective satisfaction based on the modified MacNab criteria and objective success rate were highest (80% and 85%) after 1 month, but only 50% and 20% after 6 months. However, for group A, they increased over time. In addition, there were no treatment-related complications in either group during follow-up. Both autologous PRP and LA/corticosteroid for intra-articular injection are effective, easy, and safe enough in the treatment of lumbar facet joint syndrome. However, autologous PRP is a superior treatment option for longer duration efficacy. © 2016 World Institute of Pain.

Randomised sham-controlled double-blind multicentre clinical trial to ascertain the effect of percutaneous radiofrequency treatment for lumbar facet joint pain.

PubMed

van Tilburg, C W J; Stronks, D L; Groeneweg, J G; Huygen, F J P M

2016-11-01

The aim of this study was to compare the effect of a percutaneous radiofrequency heat lesion at the medial branch of the primary dorsal ramus with a sham procedure, for the treatment of lumbar facet joint pain. A randomised sham-controlled double blind multicentre trial was carried out at the multidisciplinary pain centres of two hospitals. A total of 60 patients aged > 18 years with a history and physical examination suggestive of facet joint pain and a decrease of ≥ 2 on a numerical rating scale (NRS 0 to 10) after a diagnostic facet joint test block were included. In the treatment group, a percutaneous radiofrequency heat lesion (80 o C during 60 seconds per level) was applied to the medial branch of the primary dorsal ramus. In the sham group, the same procedure was undertaken without for the radiofrequency lesion. Both groups also received a graded activity physiotherapy programme. The primary outcome measure was decrease in pain. A secondary outcome measure was the Global Perceived Effect scale (GPE). There was a statistically significant effect on the level of pain in the factor Period (T0-T1). However, there was no statistically significant difference with the passage of time between the groups (Group × Period) or in the factor Group. In the crossover group, 11 of 19 patients had a decrease in NRS of ≥ 2 at one month crossover (p = 0.65). There was no statistically significant difference in satisfaction with the passage of time between the groups (Group × Period). The independent factors Group and Period also showed no statistically significant difference. There was no statistically significant Group × Period effect for recovery, neither an effect of Group or of Period. The null hypothesis of no difference in the decrease in pain and in GPE between the treatment and sham groups cannot be rejected. Post hoc analysis revealed that the age of the patients and the severity of the initial pain significantly predicted a positive outcome. Cite this article: Bone Joint J 2016;98-B:1526-33. ©2016 The British Editorial Society of Bone & Joint Surgery.

Cervical Spine Stiffness and Geometry of the Young Human Male

DTIC Science & Technology

1982-11-01

angle of zero degrees, i.e., the well-known vertical apposition of facets in the thoracic and lumbar area; d) The cervical articular facet areas are...were used by Rolander (1966) and White (1969) to study the motion segments of the lumbar and thoracic spines, respectively. When forces and moments are...unaer axial tension and compression as well as bending with axial load, Evans and Lissner (1959) gave load-deflection curves for the lumbar spine in

Development of iFab (Instant Foundry Adaptive Through Bits) Manufacturing Process and Machine Library

DTIC Science & Technology

2012-08-01

loaded joints including bearing -type shear loaded joints and friction type shear loaded joints . Appendix Figure 2f.A-3 shows an illustration of each... Loaded Joint Bearing Type Shear Loaded Joint Friction Type Shear Loaded Joint Tension Loaded Joint 62 Approved for public release...Joining of materials and structures: from pragmatic process to enabling technology.

Distraction of facets with intraarticular spacers as treatment for lumbar canal stenosis: report on a preliminary experience with 21 cases.

PubMed

Goel, Atul; Shah, Abhidha; Jadhav, Madan; Nama, Santhosh

2013-12-01

The authors report their experience in treating 21 patients by using a novel form of treatment of lumbar degenerative disease that leads to canal stenosis. The surgery involved distraction of the facets using specially designed Goel intraarticular spacers and was aimed at arthrodesis of the spinal segment in a distracted position. The operation is based on the premise that subtle and longstanding facet instability, joint space reduction, and subsequent facet override had a profound and primary influence in the pathogenesis of degenerative lumbar canal stenosis. The surgical technique and the rationale for treatment are discussed. Between April 2006 and January 2011, 21 cases of lumbar degenerative disease resulting in characteristic lumbar canal stenosis were treated in the authors' department with the proposed technique. The patients were prospectively analyzed. There were 15 men and 6 women who ranged in age from 48 to 71 years (mean 58 years). Nine patients underwent 1-level and 12 patients underwent 2-level treatment. Surgery involved wide opening of the articular joint, denuding of the articular capsule/endplate cartilage, distraction of the facets, and forced impaction of Goel intraarticular spacers. Bone graft pieces obtained by sectioning the spinous processes were placed within and over the joint and in the midline over the adequately prepared host area of laminae. The Oswestry Disability Index and visual analog scale were used to clinically assess the patients before and after surgery and at follow-up. The alterations in the physical architecture of spinal canal and intervertebral foramen dimensions were evaluated before and after placement of the intrafacet implant and after at least 6 months of follow-up. All patients had varying degrees of relief from symptoms of local back pain and radiculopathy. Impaction of spacers within the facet joints resulted in an increase in the spinal canal and intervertebral root canal dimensions (mean 2.33 mm), reduction of buckling of the ligamentum flavum, and reduction of the extent of bulge of the disc into the spinal canal. The procedure resulted in firm stabilization and fixation of the spinal segment and provided a ground for arthrodesis. No patient worsened neurologically after treatment. During the follow-up period, all patients had evidence of segmental bone fusion. No patient underwent reexploration or further surgery of the lumbar spine. Impaction of the spacers within the articular cavity after facet distraction resulted in reversal of several effects of spine degeneration that had caused spinal and root canal stenosis. The safe, firm, and secure stabilization at the fulcrum of lumbar spinal movements provided a ground for segmental spinal arthrodesis. The immediate postoperative and lasting recovery from symptoms suggests the validity of the procedure.

On the relative importance of bending and compression in cervical spine bilateral facet dislocation.

PubMed

Nightingale, Roger W; Bass, Cameron R; Myers, Barry S

2018-03-08

Cervical bilateral facet dislocations are among the most devastating spine injuries in terms of likelihood of severe neurological sequelae. More than half of patients with tetraparesis had sustained some form of bilateral facet fracture dislocation. They can occur at any level of the sub-axial cervical spine, but predominate between C5 and C7. The mechanism of these injuries has long been thought to be forceful flexion of the chin towards the chest. This "hyperflexion" hypothesis comports well with intuition and it has become dogma in the clinical literature. However, biomechanical studies of the human cervical spine have had little success in producing this clinically common and devastating injury in a flexion mode of loading. The purpose of this manuscript is to review the clinical and engineering literature on the biomechanics of bilateral facet dislocations and to describe the mechanical reasons for the causal role of compression, and the limited role of head flexion, in producing bilateral facet dislocations. Bilateral facet dislocations have only been produced in experiments where compression is the primary loading mode. To date, no biomechanical study has produced bilateral facet dislocations in a whole spine by bending. Yet the notion that it is primarily a hyper-flexion injury persists in the clinical literature. Compression and compressive buckling are the primary causes of bilateral facet dislocations. It is important to stop using the hyper-flexion nomenclature to describe this class of cervical spines injuries because it may have a detrimental effect on designs for injury prevention. Copyright © 2018 Elsevier Ltd. All rights reserved.

Crack Front Segmentation and Facet Coarsening in Mixed-Mode Fracture

NASA Astrophysics Data System (ADS)

Chen, Chih-Hung; Cambonie, Tristan; Lazarus, Veronique; Nicoli, Matteo; Pons, Antonio J.; Karma, Alain

2015-12-01

A planar crack generically segments into an array of "daughter cracks" shaped as tilted facets when loaded with both a tensile stress normal to the crack plane (mode I) and a shear stress parallel to the crack front (mode III). We investigate facet propagation and coarsening using in situ microscopy observations of fracture surfaces at different stages of quasistatic mixed-mode crack propagation and phase-field simulations. The results demonstrate that the bifurcation from propagating a planar to segmented crack front is strongly subcritical, reconciling previous theoretical predictions of linear stability analysis with experimental observations. They further show that facet coarsening is a self-similar process driven by a spatial period-doubling instability of facet arrays.

Development and Validation of the Faceted Inventory of the Five-Factor Model (FI-FFM).

PubMed

Watson, David; Nus, Ericka; Wu, Kevin D

2017-06-01

The Faceted Inventory of the Five-Factor Model (FI-FFM) is a comprehensive hierarchical measure of personality. The FI-FFM was created across five phases of scale development. It includes five facets apiece for neuroticism, extraversion, and conscientiousness; four facets within agreeableness; and three facets for openness. We present reliability and validity data obtained from three samples. The FI-FFM scales are internally consistent and highly stable over 2 weeks (retest rs ranged from .64 to .82, median r = .77). They show strong convergent and discriminant validity vis-à-vis the NEO, the Big Five Inventory, and the Personality Inventory for DSM-5. Moreover, self-ratings on the scales show moderate to strong agreement with corresponding ratings made by informants ( rs ranged from .26 to .66, median r = .42). Finally, in joint analyses with the NEO Personality Inventory-3, the FI-FFM neuroticism facet scales display significant incremental validity in predicting indicators of internalizing psychopathology.

Stress Corrosion Cracking Facet Crystallography of Ti-8Al-1Mo-1V (Preprint)

DTIC Science & Technology

2011-05-01

fractography and electron backscatter diffraction. The results indicate that most facets are formed nearly perpendicular to the loading direction on...of Ti-8Al- 1Mo-1V have been characterized using quantitative fractography and electron backscatter diffraction. The results indicate that most facets...EBSD and quantitative tilt fractography [27;29] allow for determination of the crystallographic fracture plane to an accuracy between 1o [29] and

Interrater reliability of identifying indicators of posterior ligamentous complex disruption when plain films are indeterminate in thoracolumbar injuries.

PubMed

Schweitzer, Karl M; Vaccaro, Alexander R; Harrop, James S; Hurlbert, John; Carrino, John A; Rechtine, Glenn R; Schwartz, David G; Alanay, Ahmet; Sharma, Dinesh K; Anderson, D Greg; Lee, Joon Y; Arnold, Paul M

2007-09-01

The Spine Trauma Study Group (STSG) has proposed a novel thoracolumbar injury classification system and score (TLICS) in an attempt to define traumatic spinal injuries and direct appropriate management schemes objectively. The TLICS assigns specific point values based on three variables to generate a final severity score that guides potential treatment options. Within this algorithm, significant emphasis has been placed on posterior ligamentous complex (PLC) integrity. The purpose of this study was to determine the interrater reliability of indicators surgeons use when assessing PLC disruption on imaging studies, including computed tomography (CT) and magnetic resonance imaging (MRI). Orthopedic surgeons and neurosurgeons retrospectively reviewed a series of thoracolumbar injury case studies. Thirteen case studies, including images, were distributed to STSG members for individual, independent evaluation of the following three criteria: (1) diastasis of the facet joints on CT; (2) posterior edema-like signal in the region of PLC components on sagittal T2-weighted fat saturation (FAT SAT) MRI; and (3) disrupted PLC components on sagittal T1-weighted MRI. Interrater agreement on the presence or absence of each of the three criteria in each of the 13 cases was assessed. Absolute interrater percent agreement on diastasis of the facet joints on CT and posterior edema-like signal in the region of PLC components on sagittal T2-weighted FAT SAT MRI was similar (agreement 70.5%). Interrater agreement on disrupted PLC components on sagittal T1-weighted MRI was 48.9%. Facet joint diastasis on CT was the most reliable indicator of PLC disruption as assessed by both Cohen's kappa (kappa = 0.395) and intraclass correlation coefficient (ICC 0.430). The interrater reliability of assessing diastasis of the facet joints on CT had fair to moderate agreement. The reliability of assessing the posterior edema-like signal in the region of PLC components was lower but also fair, whereas the reliability of identifying disrupted PLC components was poor.

Fluoroscopically guided infiltration of the cervical nerve root: an indirect approach through the ipsilateral facet joint.

PubMed

Kelekis, Alexios; Filippiadis, Dimitrios K; Velonakis, Georgios; Martin, Jean-Baptist; Oikonomopoulos, Nikolaos; Brountzos, Elias; Kelekis, Nikolaos

2014-01-01

Transforaminal infiltrations in the cervical spine are governed by a higher rate of vascular puncture than in the lumbar spine. The purpose of our study is to assess the safety and efficacy of percutaneous, fluoroscopically guided nerve root infiltrations in cases of cervical radiculopathy. An indirect postero-lateral approach was performed through the ipsilateral facet joint. During the last 2 years, 25 patients experiencing cervical radiculopathy underwent percutaneous, fluoroscopically guided nerve root infiltrations by means of an indirect postero-lateral approach through the ipsilateral facet joint. The intra-articular position of the needle (22-gauge spinal needle) was fluoroscopically verified after injection of a small amount of contrast medium which also verified dispersion of the contrast medium periradicularly and in the epidural space. Then a mixture of long-acting glucocorticosteroid diluted in normal saline (1.5/1 mL) was injected intra-articularly. A questionnaire with a Numeric Visual Scale (NVS) scale helped assess pain relief, life quality, and mobility improvement. A mean of 2.3 sessions was performed in the patients of our study. In the vast majority of our patients 19/25 (76%), the second infiltration was performed within 7-10 days of the first one. Comparing the pain scores prior (mean value 8.80 ± 1.080 NVS units) and after (mean value 1.84 ± 1.405 NVS units), there was a mean decrease of 6.96 ± 1.695 NVS units [median value 7 NVS units (P < 0.001) in terms of pain reduction, effect upon mobility, and life quality. There were no clinically significant complications noted in our study. Fluoroscopically guided transforaminal infiltrations through the ipsilateral facet joint seem to be a feasible, efficacious, and safe approach for the treatment of patients with cervical radiculopathy. This approach facilitates needle placement and minimizes risk of complications.

Prevention of Child Sexual Abuse. Final Report of the Joint Commission of the Chancellor and the Special Commissioner.

ERIC Educational Resources Information Center

New York City Office of the Special Commissioner of Investigation, NY.

In recent years, sex abuse scandals have struck schools around the country. This report contends that the way to address sexual abuse is to face it head on and to develop a comprehensive program to attack every facet of the problem. It is the multi-faceted nature of child sexual abuse that dictates this comprehensive approach. It is recommended…

Computed tomography of calcaneal fractures: anatomy, pathology, dosimetry, and clinical relevance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Guyer, B.H.; Levinsohn, E.M.; Fredrickson, B.E.

1985-11-01

Eighteen CT examinations were performed in 10 patients for the evaluation of acute intraarticular fractures and their follow-up. Fractures comparable to those in the patients were created in cadavers. The normal anatomy and the traumatically altered anatomy of the calcaneus in the axial, coronal, and sagittal planes are demonstrated by CT and corresponding anatomic sections. Scanning was performed in the axial plane, with subsequent reconstruction in the coronal and sagittal planes. The axial scans show disruption of the inferior part of the posterior facet, calcaneocuboid joint involvement, and widening of the calcaneus. The coronal scans show disruption of the superiormore » part of the posterior facet, sustentaculum tali depression (involvement of middle and anterior facets), peroneal and flexor hallucis longus tendon impingement, and widening and height loss of the calcaneus. The sagittal scans show disruption of the posterior facet, calcaneocuboid joint involvement, and height loss of the calcaneus and allow the evaluation of Boehler's and Gissane's angles. All three planes show the position of major fracture fragments. Radiation dose to the foot was measured to be 0.1 rad (0.001 Gy) for plain film radiography (five exposures), 18 rad (0.18 Gy) for conventional tomography (20 cuts), and 2.6 rad (0.026 Gy) for axial CT examination.« less

Vertebral pneumatocysts.

PubMed

Arslan, G; Ceken, K; Cubuk, M; Ozkaynak, C; Lüleci, E

2001-01-01

To review the prevalence and location of vertebral pneumatocysts and evaluate the CT findings of these benign lesions. Retrospectively we reviewed CT images of 89 patients with suspected disc disease during a 6-month period. Distinctive CT pattern of intraosseous pneumatocysts involving the cervical, thoracic and lumbar spine was found. In 8 patients (9%), 10 vertebral pneumatocysts were detected. Five were located in the vertebral body and 4 of these were associated with vacuum phenomenon in adjacent intervertebral discs. Five were located near the facet joint and all were associated with vacuum phenomenon in adjacent facet joint. Intraosseous pneumatocyst is a benign lesion, therefore biopsy and follow-up are unnecessary. Although vertebral pneumatocysts seem to be uncommon with a few reported cases, this study shows them to be more frequent than previously thought.

[Mathematical simulation of biomechanical background of osteophyte formation in cervical vertebra].

PubMed

Barsa, P; Novák, J; Souček, T; Maršík, F; Suchomel, P

2011-01-01

The aim of this study was to simulate different types of cervical vertebra loading and to find out whether mechanical stress would concentrate in regions known in clinical practice as predilection sites for osteophyte formation. The objective was to develop a theoretical model that would elucidate clinical observations concerning the predilection site of bone remodelling in view of the physiological changes inside the cervical vertebral body. A real 3D-geometry of the fourth cervical vertebra had been made by the commercially available system ATOS II. This is a high-resolution measuring system using principles of optical triangulation. This flexible optical measuring machine projects fringe patterns on the surface of a selected object and the pattern is observed with two cameras. 3D coordinates for each camera pixel were calculated with high precision and a polygon mesh of the object's surface was further generated. In the next step an ANSYS programme was used to calculate strains and stresses in each finite element of the virtual vertebra. The applied forces used in the experiment corresponded in both magnitude and direction to physiological stress. Mechanical loading in neutral position was characterized by a distribution of 80% mechanical stress to the vertebral body and 10% to each of the zygoapophyseal joints. Hyperlordotic loading was simulated by 60% force transfer to the vertebral body end-plate and 20% to each of the small joint while kyphotic loading involved a 90% load on the vertebral body endplate and 5% on each facet. Mechanical stress distribution calculated in a neutral position of the model correlated well with bone mineral distribution of a healthy vertebra, and verified the model itself. The virtual mechanical loading of a vertebra in kyphotic position concentrated deformation stress into the uncinate processes and the dorsal apophyseal rim of the vertebral body. The simulation of mechanical loading in hyperlordosis, on the other hand, shifted the region of maximum deformation into the articulation process of the Z-joint. All locations are known as areas of osteophyte formation in degenerated cervical vertebrae. The theoretical model developed during this study corresponded well with human spine behaviour in terms of predilection sites for osteodegenerative changes, as observed in clinical practice. A mathematical simulation of mechanical stress distribution in pre-operative planning may lead to the optimisation of post-operative anatomical relationship between adjacent vertebrae. Such improvement in our surgical practice may further reduce the incidence of degenerative changes in adjacent motion segments of the cervical spine and possibly also lead to better subjective and clinical results after cervical spine reconstruction.

Antero-medial approach to the wrist: anatomic basis and new application in cases of fracture of the lunate facet.

PubMed

Uzel, A-P; Bulla, A; Laurent-Joye, M; Caix, P

2011-08-01

The Henry approach is the classical anterolateral surgical exposure of the volar aspect of the distal radius. This approach does not allow good access to the medial side of the volar distal radius (lunate facet) and the distal radio-ulnar joint, unless it is extended proximally, retracting the tendons and the median nerve medially, which can cause some trauma. The purpose of our study was to investigate the anatomic basis and to outline the advantages of the unusual anteromedial approach, reporting our experience in the treatment of 4 distal radius fractures, with a 90° or 180° twist of the lunate facet, and 10 wrist dissections on cadavers. The average follow-up was 68.8 months (range 18 to 115 months). In our series, this approach did not cause any nerve injuries or any sensory loss of the distal forearm and the palm. All the fractures of the lunate facet and of the radial styloid process healed. One patient with an ulnar styloid process fracture associated showed pseudarthrosis, but with no instability of the distal radio-ulnar joint or pain on the ulnar side. Using the criteria of Green and O'Brien, modified by Cooney, the results were: excellent in two cases, good in one case, and average in another. The evaluation of arthritis according to Knirk and Jupiter's classification showed grade 0 in three cases and grade 3 in one case with osteochondral sclerosis. We showed that the anteromedial approach is reliable and convenient in the case of fractures situated in the antero-medial portion of the radius, for the double objective of reducing the fracture under direct control and checking the congruence of the distal radio-ulnar joint.

Morphometric Study of Clavicular Facet of Coracoclavicular Joint in Adult Indian Population

PubMed Central

Mahajan, Anita; Vasudeva, Neelam

2016-01-01

Introduction Anthropologists have used Coracoclavicular Joint (CCJ), a non-metric anatomical variant in population, as a marker for population migration from prehistoric times to present. Aim The aim of this osteological study was to determine the incidence and morphometry of articular facet of CCJ on conoid tubercle of clavicle in Indian population, as Indian studies are scanty and incomplete. Materials and Methods The study was done on 144 adult human clavicles (76 right and 68 left; 93 males and 51 females) collected from osteology museum in Department of Anatomy, Maulana Azad Medical College, New Delhi, India. The presence of articular facet on the conoid tubercle was determined and Maximum Antero-Posterior (MAPD) and maximum transverse diameter (MTD) was measured by digital vernier calliper. The incidence was compared on the basis of sex, side and with other osteological studies in the world. Statistical analysis was done using the Chi-Square test for nominal categorical data and student’s t-test for normally distributed continuous variables in Microsoft Excel 2007 to assess the relationship between the examined variables. Results Articular facet on conoid tubercle was found in 8 cases (5.6%). Seven (9.2%) were present on the right side and one (1.5%) on the left side. Seven cases (7.5%) were present in males and one case (2%) was found in females. The facets were generally oval, with MAPD and MTD of 12.28 and 17.17 mm respectively. A significant side variation was present with right sided facet being more common. The left sided facet was more transversely elongated than right. In males, the facets were more elongated antero-posteriorly than in females. Conclusion The Indian population showed an incidence of 5.6%, which was comparable to other ethnic groups in world population. The morphometric and side differences could be attributed to the occupational factors and range of movements associated with the CCJ. The CCJ should be borne in mind as a differential diagnosis for thoracic outlet syndrome and in general for shoulder pain. PMID:27190785

Biomechanical stability of intramedullary technique for fixation of joint depressed calcaneus fracture.

PubMed

Nelson, Joshua D; McIff, Terence E; Moodie, Patrick G; Iverson, Jamey L; Horton, Greg A

2010-03-01

Internal fixation of the os calcis is often complicated by prolonged soft tissue management and posterior facet disruption. An ideal calcaneal construct would include minimal hardware prominence, sturdy posterior facet fixation and nominal soft tissue disruption. The purpose of this study was to develop such a construct and provide a biomechanical analysis comparing our technique to a standard internal fixation technique. Twenty fresh-frozen cadaver calcanei were used to create a reproducible Sanders type-IIB calcaneal fracture pattern. One calcaneus of each pair was randomly selected to be fixed using our compressive headless screw technique. The contralateral matched calcaneus was fixed with a nonlocking calcaneal plate in a traditional fashion. Each calcaneus was cyclically loaded at a frequency of 1 Hz for 4000 cycles using an increasing force from 250 N to 1000 N. An Optotrak motion capturing system was used to detect relative motion of the three fracture fragments at eight different points along the fracture lines. Horizontal separation and vertical displacement at the fracture lines was recorded, as well as relative rotation at the primary fracture line. When the data were averaged, there was more horizontal displacement at the primary fracture line of the plate and screw construct compared to the headless screw construct. The headless screw construct also had less vertical displacement at the primary fracture line at every load. On average those fractures fixed with the headless screw technique had less rotation than those fixed with the side plate technique. A new headless screw technique for calcaneus fracture fixation was shown to provide stability as good as, or better than, a standard side plating technique under the axial loading conditions of our model. Although further testing is needed, the stability of the proposed technique is similar to that typically provided by intramedullary fixation. This fixation technique provides a biomechanically stable construct with the potential for a minimally invasive approach and improved post-operative soft tissue healing.

Clinical trial involving sufferers and non-sufferers of cervicogenic headache (CGH): potential mechanisms of action of photobiomodulation (Conference Presentation)

NASA Astrophysics Data System (ADS)

Liebert, Ann D.; Bicknell, Brian

2017-02-01

Photobiomodulation (PBM) is an effective tool for the management of spinal pain including inflammation of facet joints. Apart from cervical and lumbar joint pain the upper cervical spine facet joint inflammation can result in the CGH (traumatic or atraumatic in origin). This condition affects children, adults and elders and is responsible for 19% of chronic headache and up to 33% of patients in pain clinics. The condition responds well to physiotherapy, facet joint injection, radiofrequency neurotomy and surgery at a rate of 75%. The other 25% being unresponsive to treatment with no identified features of unresponsiveness. In other conditions of chronic unresponsive cervical pain have responded to photobiomodulation at a level of 80% in the short and medium term. A clinical trial was therefore conducted on a cohort of atraumatic patients from the ages of 5-93 (predominantly Neurologist referred / familial sufferers 2/3 generations vertically and laterally) who had responded to a course of PBM and physiotherapy. The CGH sufferers and their non CGH suffering relatives over these generations were then compared for features that distinguish the two groups. Fifty parameters were tested (anthropmetric, movement and neural tension tests included) and there was a noted difference in tandem stance between the groups (.04 significance with repeated measures). As this impairment is common to benign ataxia and migrainous vertigo and in these conditions there is an ion channelopathy (especially potassium channelopathy). A postulated mechanism of action of PBM would involve modulation of ion channels and this is discussed in this presentation.

Posterior Epidural Migration of an Extruded Lumbar Disc Mimicking a Facet Cyst: A Case Report

PubMed Central

Yoo, Young Sun; Ju, Chang Il; Kim, Dong Min

2015-01-01

Dorsal extradural migration of extruded disc material is clinically uncommon. We report a rare case of posterior epidural migration of an extruded lumbar disc mimicking a facet cyst. A 32-year-old man was admitted to our institute with a 2-week history of severe low back pain and radiating pain in the left leg. The magnetic resonance (MR) images revealed a dorsally located, left-sided extradural cystic mass at the L2-3 level. The initial diagnosis was an epidural facet cyst because of the high signal intensity on MR images and its location adjacent to the facet joint. Intraoperatively, an encapsulated mass of soft tissue adherent to the dural sac was observed and excised. The pathological diagnosis was degenerated disc material. After surgery, the patient experienced complete relief from leg pain. PMID:25883662

Facet orientation in the thoracolumbar spine: three-dimensional anatomic and biomechanical analysis.

PubMed

Masharawi, Youssef; Rothschild, Bruce; Dar, Gali; Peleg, Smadar; Robinson, Dror; Been, Ella; Hershkovitz, Israel

2004-08-15

Thoracolumbar facet orientations were measured and analyzed. To establish a comprehensive database for facet orientation in the thoracolumbar vertebrae and to determine the normal human condition. Most studies on facet orientation have based their conclusions on two-dimensional measurements, in small samples or isolated vertebrae. The amount of normal asymmetry in facet orientation is poorly addressed. Transverse and longitudinal facet angles were measured directly from 240 human vertebral columns (males/females, blacks/whites). The specimens' osteologic material is part of the Hamann-Todd Osteological Collection housed at the Cleveland Museum of Natural History (Cleveland, OH). A total of 4,080 vertebrae (T1-L5) from the vertebral columns of individuals 20 to 80 years of age were measured, using a Microscribe three-dimensional apparatus (Immersion Co., San Jose, CA). Data were recorded directly on computer software. Statistical analysis included paired t tests and analysis of variance. RESULTS.: Facet orientation is independent of gender, age, and ethnic group. Asymmetry in facet orientation is found in the thorax. All thoracolumbar facets are positioned in an oblique plane. In the transverse plane, all facets from T1 to T11 are positioned with an anterior inclination of approximately 25 degrees to 30 degrees from the frontal plane. The facets of T12-L2 are oriented closer to the midsagittal plane of the vertebral body (mean range, 25.89 degrees-33.87 degrees), while the facets of L3-L5 are oriented away from that plane (mean range, 40.40 degrees-56.30 degrees). Facet transverse orientation at the thoracolumbar junction is highly variable (approximately 80% with approximately 101 degrees and approximately 20% with 35 degrees). All facets are oriented more vertically from T1 (approximately 150 degrees) to L5 (approximately 170 degrees). The facet sagittal orientations of the lumbar zygoapophyseal joints are not equivalent. CONCLUSIONS.: Asymmetry in facet orientation is a normal characteristic in the thorax.

Computed tomography of calcaneal fractures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Heger, L.; Wulff, K.; Seddiqi, M.S.A.

1985-07-01

Computed tomography (CT) of 25 fractured calcanei was performed to investigate the potential of CT in evaluating the pattern and biomechanics of these fractures. The characteristic findings of typical fractures are presented, including the number and type of principal fragments, size and dislocation of the sustentacular fragment, and involvement of the anterior and posterior facets of the subtalar joint. In 17 cases, the calcaneus consisted of four or more fragments. Furthermore, in 17 cases the sustentacular fragment included all or part of the posterior facet joint. In 18 of the 25 cases, the sustentacular fragment was displaced. It is concludedmore » that well performed CT is an invaluable adjunct in understanding the fracture mechanism and in detecting pain-provoking impingement between the fibular malleolus and the tuberosity fragment.« less

Taming a Beast of Burden--On Some Issues with the Conceptualisation and Operationalisation of Cognitive Load

ERIC Educational Resources Information Center

Beckmann, Jens F.

2010-01-01

Research on cognitive load theory (CLT) has not yet provided facet-specific measures of cognitive load. The lack of valid methods to measure intrinsic, extraneous and germane cognitive load makes it difficult to empirically test theoretical explanations of effects caused by manipulations of instructional designs. This situation also imposes…

Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain

PubMed Central

Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D.; Hirsch, Joshua A.

2017-01-01

Background:Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design:Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives:To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results:The results showed direct procedural costs per one-year improvement in quality adjusted life year (QALY) of United States Dollar (USD) of $2,552, and overall costs of USD $4,261. Overall, each patient on average received 5.7 ± 2.2 procedures over a period of 2 years. Average significant improvement per procedure was 15.6 ± 12.3 weeks and average significant improvement in 2 years per patient was 86.0 ± 24.6 weeks. Limitations:The limitations of this cost utility analysis are that data are based on a single center evaluation. Only costs of therapeutic interventional procedures and physician visits were included, with extrapolation of indirect costs. Conclusion:The cost utility analysis of therapeutic cervical medial branch blocks in the treatment of chronic neck pain non-responsive to conservative management demonstrated clinical effectiveness and cost utility at USD $4,261 per one year of QALY. PMID:29200944

Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain.

PubMed

Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D; Hirsch, Joshua A

2017-01-01

Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design: Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives: To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results: The results showed direct procedural costs per one-year improvement in quality adjusted life year (QALY) of United States Dollar (USD) of $2,552, and overall costs of USD $4,261. Overall, each patient on average received 5.7 ± 2.2 procedures over a period of 2 years. Average significant improvement per procedure was 15.6 ± 12.3 weeks and average significant improvement in 2 years per patient was 86.0 ± 24.6 weeks. Limitations: The limitations of this cost utility analysis are that data are based on a single center evaluation. Only costs of therapeutic interventional procedures and physician visits were included, with extrapolation of indirect costs. Conclusion: The cost utility analysis of therapeutic cervical medial branch blocks in the treatment of chronic neck pain non-responsive to conservative management demonstrated clinical effectiveness and cost utility at USD $4,261 per one year of QALY.

Effects of inter-individual lumbar spine geometry variation on load-sharing: Geometrically personalized Finite Element study.

PubMed

Naserkhaki, Sadegh; Jaremko, Jacob L; El-Rich, Marwan

2016-09-06

There is a large, at times contradictory, body of research relating spinal curvature to Low Back Pain (LBP). Mechanical load is considered as important factor in LBP etiology. Geometry of the spinal structures and sagittal curvature of the lumbar spine govern its mechanical behavior. Thus, understanding how inter-individual geometry particularly sagittal curvature variation affects the spinal load-sharing becomes of high importance in LBP assessment. This study calculated and compared kinematics and load-sharing in three ligamentous lumbosacral spines: one hypo-lordotic (Hypo-L) with low lordosis, one normal-lordotic (Norm-L) with normal lordosis, and one hyper-lordotic (Hyper-L) with high lordosis in flexed and extended postures using 3D nonlinear Finite Element (FE) modeling. These postures were simulated by applying Follower Load (FL) combined with flexion or extension moment. The Hypo-L spine demonstrated stiffer behavior in flexion but more flexible response to extension compared to the Norm-L spine. The excessive lordosis stiffened response of the Hyper-L spine to extension but did not affect its resistance to flexion compared to the Norm-L spine. Despite the different resisting actions of the posterior ligaments to flexion moment, the increase of disc compression was similar in all the spines leading to similar load-sharing. However, resistance of the facet joints to extension was more important in the Norm- and Hyper-L spines which reduced the disc compression. The spinal curvature strongly influenced the magnitude and location of load on the spinal components and also altered the kinematics and load-sharing particularly in extension. Consideration of the subject-specific geometry and sagittal curvature should be an integral part of mechanical analysis of the lumbar spine. Copyright © 2016 Elsevier Ltd. All rights reserved.

Anatomy of the Spine

MedlinePlus

... is called the conus medullaris. There is a thread that continues from the conus called the filum ... bodies, the facet joint created by their articular processes, the intervertebral disc between them and the associated ...

Two-year follow-up results of fluoroscopic cervical epidural injections in chronic axial or discogenic neck pain: a randomized, double-blind, controlled trial.

PubMed

Manchikanti, Laxmaiah; Cash, Kimberly A; Pampati, Vidyasagar; Malla, Yogesh

2014-01-01

A randomized, double-blind, active-controlled trial. To assess the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids for the management of axial or discogenic pain in patients without disc herniation, radiculitis, or facet joint pain. Cervical discogenic pain without disc herniation is a common cause of suffering and disability in the adult population. Once conservative management has failed and facet joint pain has been excluded, cervical epidural injections may be considered as a management tool. Despite a paucity of evidence, cervical epidural injections are one of the most commonly performed nonsurgical interventions in the management of chronic axial or disc-related neck pain. One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain as determined by means of controlled diagnostic medial branch blocks were randomly assigned to one of the 2 treatment groups. Group I patients received cervical interlaminar epidural injections of local anesthetic (lidocaine 0.5%, 5 mL), whereas Group II patients received 0.5% lidocaine, 4 mL, mixed with 1 mL or 6 mg of nonparticulate betamethasone. The primary outcome measure was ≥ 50% improvement in pain and function. Outcome assessments included numeric rating scale (NRS), Neck Disability Index (NDI), opioid intake, employment, and changes in weight. Significant pain relief and functional improvement (≥ 50%) was present at the end of 2 years in 73% of patients receiving local anesthetic only and 70% receiving local anesthetic with steroids. In the successful group of patients, however, defined as consistent relief with 2 initial injections of at least 3 weeks, significant improvement was illustrated in 78% in the local anesthetic group and 75% in the local anesthetic with steroid group at the end of 2 years. The results reported at the one-year follow-up were sustained at the 2-year follow-up. Cervical interlaminar epidural injections with or without steroids may provide significant improvement in pain and functioning in patients with chronic discogenic or axial pain that is function-limiting and not related to facet joint pain.

Fluoroscopic caudal epidural injections in managing chronic axial low back pain without disc herniation, radiculitis, or facet joint pain

PubMed Central

Manchikanti, Laxmaiah; Cash, Kimberly A; McManus, Carla D; Pampati, Vidyasagar

2012-01-01

Background Chronic low back pain without disc herniation is common. Various modalities of treatments are utilized in managing this condition, including epidural injections. However, there is continued debate on the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections. Methods A randomized, double-blind, actively controlled trial was conducted. The objective was to evaluate the ability to assess the effectiveness of caudal epidural injections of local anesthetic with or without steroids for managing chronic low back pain not caused by disc herniation, radiculitis, facet joints, or sacroiliac joints. A total of 120 patients were randomized to two groups; one group did not receive steroids (group 1) and the other group did (group 2). There were 60 patients in each group. The primary outcome measure was at least 50% improvement in Numeric Rating Scale and Oswestry Disability Index. Secondary outcome measures were employment status and opioid intake. These measures were assessed at 3, 6, 12, 18, and 24 months after treatment. Results Significant pain relief and functional status improvement (primary outcome) defined as a 50% or more reduction in scores from baseline, were observed in 54% of patients in group 1 and 60% of patients in group 2 at 24 months. In contrast, 84% of patients in group 1 and 73% in group 2 saw significant pain relief and functional status improvement in the successful groups at 24 months. Conclusion Caudal epidural injections of local anesthetic with or without steroids are effective in patients with chronic axial low back pain of discogenic origin without facet joint pain, disc herniation, and/or radiculitis. PMID:23091395

Composite Overwrapped Pressure Vessels: Database Extension Task 3.0 and Impact Damage Effects Control Task 8.0

NASA Technical Reports Server (NTRS)

Beeson, Harold D.; Davis, Dennis D.; Ross, William L., Sr.; Tapphorn, Ralph M.

2002-01-01

This document represents efforts accomplished at the NASA Johnson Space Center White Sands Test Facility (WSTF) in support of the Enhanced Technology for Composite Overwrapped Pressure Vessels (COPV) Program, a joint research and technology effort among the U.S. Air Force, NASA, and the Aerospace Corporation. WSTF performed testing for several facets of the program. Testing that contributed to the Task 3.0 COPV database extension objective included baseline structural strength, failure mode and safe-life, impact damage tolerance, sustained load/impact effect, and materials compatibility. WSTF was also responsible for establishing impact protection and control requirements under Task 8.0 of the program. This included developing a methodology for establishing an impact control plan. Seven test reports detail the work done at WSTF. As such, this document contributes to the database of information regarding COPV behavior that will ensure performance benefits and safety are maintained throughout vessel service life.

Biomechanical Analysis of Lateral Lumbar Interbody Fusion Constructs with Various Fixation Options: Based on a Validated Finite Element Model.

PubMed

Zhang, Zhenjun; Fogel, Guy R; Liao, Zhenhua; Sun, Yitao; Liu, Weiqiang

2018-06-01

Lateral lumbar interbody fusion using cage supplemented with fixation has been used widely in the treatment of lumbar disease. A combined fixation (CF) of lateral plate and spinous process plate may provide multiplanar stability similar to that of bilateral pedicle screws (BPS) and may reduce morbidity. The biomechanical influence of the CF on cage subsidence and facet joint stress has not been well described. The aim of this study was to compare biomechanics of various fixation options and to verify biomechanical effects of the CF. The surgical finite element models with various fixation options were constructed based on computed tomography images. The lateral plate and posterior spinous process plate were applied (CF). The 6 motion modes were simulated. Range of motion (ROM), cage stress, endplate stress, and facet joint stress were compared. For the CF model, ROM, cage stress, and endplate stress were the minimum in almost all motion modes. Compared with BPS, the CF reduced ROM, cage stress, and endplate stress in all motion modes. The ROM was reduced by more than 10% in all motion modes except for flexion; cage stress and endplate stress were reduced more than 10% in all motion modes except for rotation-left. After interbody fusion, facet joint stress was reduced substantially compared with the intact conditions in all motion modes except for flexion. The combined plate fixation may offer an alternative to BPS fixation in lateral lumbar interbody fusion. Copyright © 2018 Elsevier Inc. All rights reserved.

Relative Intensity Influences the Degree of Correspondence of Jump Squats and Push Jerks to Countermovement Jumps.

PubMed

Cushion, Emily J; Goodwin, Jon E; Cleather, Daniel J

2016-05-01

The aim of this study was to determine the mechanical similarity between push jerk (PJ) and jump squat (JS) to countermovement jump (CMJ) and further understand the effect increasing external load may have on this relationship. Eight physically trained men (age 22 ± 3; height 176 ± 7 kg; weight 83 ± 8 kg) performed an unloaded CMJ followed by JS under a range of loads (10, 25, 35, and 50% 1RM back squat) and PJ (30, 50, 65, and 75% 1RM push jerk). A portable force platform and high-speed camera both collecting at 250 Hz were used to establish joint moments and impulse during the propulsive phase of the movements. A standard inverse dynamics model was used to determine joint moment and impulse at the hip, knee, and ankle. Significant correlations (p ≤ 0.05) were shown between CMJ knee joint moment and JS knee joint moment at 25% load and PJ knee joint moment at 30 and 50% load. Significant correlations were also observed between CMJ knee joint impulse and JS knee joint impulse at 10% load and PJ knee joint moment at 30 and 65% load. Significant correlation was also observed between CMJ hip joint impulse and PJ hip joint impulse at 30% load. No significant joint × load interaction was shown as load increased for either PJ or JS. Results from the study suggest partial correspondence between PJ and JS to CMJ, where a greater mechanical similarity was observed between the PJ and CMJ. This interaction is load and joint dependent where lower relative loads showed greatest mechanical similarity. Therefore using lower relative loads when programming may provide a greater transfer of training effect.

Zeroing In on Mindfulness Facets: Similarities, Validity, and Dimensionality across Three Independent Measures.

PubMed

Siegling, Alex B; Petrides, K V

2016-01-01

The field of mindfulness has seen a proliferation of psychometric measures, characterised by differences in operationalisation and conceptualisation. To illuminate the scope of, and offer insights into, the diversity apparent in the burgeoning literature, two distinct samples were used to examine the similarities, validity, and dimensionality of mindfulness facets and subscales across three independent measures: the Five Facet Mindfulness Questionnaire (FFMQ), Philadelphia Mindfulness Scale (PHLMS), and Toronto Mindfulness Scale (TMS). Results revealed problematic associations of FFMQ Observe with the other FFMQ facets and supported a four-factor structure (omitting this facet), while disputing the originally envisaged five-factor model; thus, solidifying a pattern in the literature. Results also confirmed the bidimensional nature of the PHLMS and TMS subscales, respectively. A joint Confirmatory Factor Analysis showed that PHLMS Acceptance could be assimilated within the FFMQ's four-factor model (as a distinct factor). The study offers a way of understanding interrelationships between the available mindfulness scales, so as to help practitioners and researchers make a more informed choice when conceptualising and operationalising mindfulness.

Zeroing In on Mindfulness Facets: Similarities, Validity, and Dimensionality across Three Independent Measures

PubMed Central

Siegling, Alex B.; Petrides, K. V.

2016-01-01

The field of mindfulness has seen a proliferation of psychometric measures, characterised by differences in operationalisation and conceptualisation. To illuminate the scope of, and offer insights into, the diversity apparent in the burgeoning literature, two distinct samples were used to examine the similarities, validity, and dimensionality of mindfulness facets and subscales across three independent measures: the Five Facet Mindfulness Questionnaire (FFMQ), Philadelphia Mindfulness Scale (PHLMS), and Toronto Mindfulness Scale (TMS). Results revealed problematic associations of FFMQ Observe with the other FFMQ facets and supported a four-factor structure (omitting this facet), while disputing the originally envisaged five-factor model; thus, solidifying a pattern in the literature. Results also confirmed the bidimensional nature of the PHLMS and TMS subscales, respectively. A joint Confirmatory Factor Analysis showed that PHLMS Acceptance could be assimilated within the FFMQ’s four-factor model (as a distinct factor). The study offers a way of understanding interrelationships between the available mindfulness scales, so as to help practitioners and researchers make a more informed choice when conceptualising and operationalising mindfulness. PMID:27055017

In situ three-dimensional reciprocal-space mapping during mechanical deformation.

PubMed

Cornelius, T W; Davydok, A; Jacques, V L R; Grifone, R; Schülli, T; Richard, M I; Beutier, G; Verdier, M; Metzger, T H; Pietsch, U; Thomas, O

2012-09-01

Mechanical deformation of a SiGe island epitaxically grown on Si(001) was studied by a specially adapted atomic force microscope and nanofocused X-ray diffraction. The deformation was monitored during in situ mechanical loading by recording three-dimensional reciprocal-space maps around a selected Bragg peak. Scanning the energy of the incident beam instead of rocking the sample allowed the safe and reliable measurement of the reciprocal-space maps without removal of the mechanical load. The crystal truncation rods originating from the island side facets rotate to steeper angles with increasing mechanical load. Simulations of the displacement field and the intensity distribution, based on the finite-element method, reveal that the change in orientation of the side facets of about 25° corresponds to an applied pressure of 2-3 GPa on the island top plane.

Biomechanics of a Fixed–Center of Rotation Cervical Intervertebral Disc Prosthesis

PubMed Central

Crawford, Neil R.; Baek, Seungwon; Sawa, Anna G.U.; Safavi-Abbasi, Sam; Sonntag, Volker K.H.; Duggal, Neil

2012-01-01

Background Past in vitro experiments studying artificial discs have focused on range of motion. It is also important to understand how artificial discs affect other biomechanical parameters, especially alterations to kinematics. The purpose of this in vitro investigation was to quantify how disc replacement with a ball-and-socket disc arthroplasty device (ProDisc-C; Synthes, West Chester, Pennsylvania) alters biomechanics of the spine relative to the normal condition (positive control) and simulated fusion (negative control). Methods Specimens were tested in multiple planes by use of pure moments under load control and again in displacement control during flexion-extension with a constant 70-N compressive follower load. Optical markers measured 3-dimensional vertebral motion, and a strain gauge array measured C4-5 facet loads. Results Range of motion and lax zone after disc replacement were not significantly different from normal values except during lateral bending, whereas plating significantly reduced motion in all loading modes (P < .002). Plating but not disc replacement shifted the location of the axis of rotation anteriorly relative to the intact condition (P < 0.01). Coupled axial rotation per degree of lateral bending was 25% ± 48% greater than normal after artificial disc replacement (P = .05) but 37% ± 38% less than normal after plating (P = .002). Coupled lateral bending per degree of axial rotation was 37% ± 21% less than normal after disc replacement (P < .001) and 41% ± 36% less than normal after plating (P = .001). Facet loads did not change significantly relative to normal after anterior plating or arthroplasty, except that facet loads were decreased during flexion in both conditions (P < .03). Conclusions In all parameters studied, deviations from normal biomechanics were less substantial after artificial disc placement than after anterior plating. PMID:25694869

EPA EMERGENCY PLANNING TOOLBOX

EPA Science Inventory

EPA's Office of Research and Development and Office of Water/Water Security Division have jointly developed a Response Protocol Toolbox (RPTB) to address the complex, multi-faceted challenges of a water utility's planning and response to intentional contamination of drinking wate...

Giant, Completely Calcified Lumbar Juxtafacet Cyst: Report of an Unusual Case

PubMed Central

Huang, Kevin T.; Owens, Timothy R.; Wang, Teresa S.; Moreno, Jessica R.; Bagley, Jacob H.; Bagley, Carlos A.

2013-01-01

Study Design Case report. Objective To report the case of one patient who developed a giant, completely calcified, juxtafacet cyst. Methods A 57-year-old woman presented with a 2-year history of progressively worsening lower back pain, left leg pain, weakness, and paresthesias. Imaging showed a giant, completely calcified mass arising from the left L5–S1 facet joint, with coexisting grade I L5 on S1 anterolisthesis. The patient was treated with laminectomy, excision of the mass, and L5–S1 fixation and fusion. Results The patient had an uncomplicated postoperative course and had complete resolution of her symptoms as of 1-year follow-up. Conclusions When presented with a solid-appearing, calcified mass arising from the facet joint, a completely calcified juxtafacet cyst should be considered as part of the differential diagnosis. PMID:25083359

Relationship between disc injury and manual lifting: a poroelastic finite element model study.

PubMed

Natarajan, R N; Williams, J R; Lavender, S A; An, H S; Anderson, G B

2008-02-01

Understanding how failure originates in a lumbar motion segment subjected to loading conditions that are representative of manual lifting is important because it will pave the way for a better formulation of the exposure-injury relationship. The aim of the current investigation was to use a poroelastic finite element model of a human lumbar disc to determine its biomechanical characteristics under loading conditions that corresponded to three different, commonly occurring lifting activities and to identify the most hazardous type of loading with regard to damage to the disc. The current study showed that asymmetric lifting may increase the risk of back injury and pain. Lifting that involved lateral bending (asymmetric lifting) of the trunk was found to produce stresses at a localized area in the annulus, annuluar fibres, end plates, and facet joints that were higher than their respective tissue failure strength. Thus asymmetric lifting, if performed over a large number of cycles, might help to propagate this localized failure of the disc tissue to a larger area, owing to fatigue. The analyses also showed that largest fluid exchange between the nucleus and the end plates occurred during asymmetric lifting. If the fluid exchange is restricted owing to end plate calcification or sclerosis of the subchondral bone, high intradiscal pressure might develop, leading to higher disc bulge causing back pain.

Testing the feasibility of using a conveyor belt to load weanling and nursery pigs for transportation

USDA-ARS?s Scientific Manuscript database

Transportation is known to be a multi-faceted stressor, with the process of loading being one of the most significant factors impacting the stress to which animals are exposed. This project was designed to determine if using a conveyor to load pigs into the top deck of a simulated straight deck trai...

Within-trait heterogeneity in age group differences in personality domains and facets: implications for the development and coherence of personality traits.

PubMed

Mõttus, René; Realo, Anu; Allik, Jüri; Esko, Tõnu; Metspalu, Andres; Johnson, Wendy

2015-01-01

The study investigated differences in the Five-Factor Model (FFM) domains and facets across adulthood. The main questions were whether personality scales reflected coherent units of trait development and thereby coherent personality traits more generally. These questions were addressed by testing if the components of the trait scales (items for facet scales and facets for domain scales) showed consistent age group differences. For this, measurement invariance (MI) framework was used. In a sample of 2,711 Estonians who had completed the NEO Personality Inventory 3 (NEO PI-3), more than half of the facet scales and one domain scale did not meet the criterion for weak MI (factor loading equality) across 12 age groups spanning ages from 18 to 91 years. Furthermore, none of the facet and domain scales met the criterion for strong MI (intercept equality), suggesting that items of the same facets and facets of the same domains varied in age group differences. When items were residualized for their respective facets, 46% of them had significant (p < 0.0002) residual age-correlations. When facets were residualized for their domain scores, a majority had significant (p < 0.002) residual age-correlations. For each domain, a series of latent factors were specified using random quarters of their items: scores of such latent factors varied notably (within domains) in correlations with age. We argue that manifestations of aetiologically coherent traits should show similar age group differences. Given this, the FFM domains and facets as embodied in the NEO PI-3 do not reflect aetiologically coherent traits.

Within-Trait Heterogeneity in Age Group Differences in Personality Domains and Facets: Implications for the Development and Coherence of Personality Traits

PubMed Central

Mõttus, René; Realo, Anu; Allik, Jüri; Esko, Tõnu; Metspalu, Andres; Johnson, Wendy

2015-01-01

The study investigated differences in the Five-Factor Model (FFM) domains and facets across adulthood. The main questions were whether personality scales reflected coherent units of trait development and thereby coherent personality traits more generally. These questions were addressed by testing if the components of the trait scales (items for facet scales and facets for domain scales) showed consistent age group differences. For this, measurement invariance (MI) framework was used. In a sample of 2,711 Estonians who had completed the NEO Personality Inventory 3 (NEO PI-3), more than half of the facet scales and one domain scale did not meet the criterion for weak MI (factor loading equality) across 12 age groups spanning ages from 18 to 91 years. Furthermore, none of the facet and domain scales met the criterion for strong MI (intercept equality), suggesting that items of the same facets and facets of the same domains varied in age group differences. When items were residualized for their respective facets, 46% of them had significant (p < 0.0002) residual age-correlations. When facets were residualized for their domain scores, a majority had significant (p < 0.002) residual age-correlations. For each domain, a series of latent factors were specified using random quarters of their items: scores of such latent factors varied notably (within domains) in correlations with age. We argue that manifestations of aetiologically coherent traits should show similar age group differences. Given this, the FFM domains and facets as embodied in the NEO PI-3 do not reflect aetiologically coherent traits. PMID:25751273

The anterior borders of the clavicle and the acromion are not always aligned in the intact acromioclavicular joint: a cadaveric study.

PubMed

Barth, Johannes; Boutsiadis, Achilleas; Narbona, Pablo; Lädermann, Alexandre; Arrigoni, Paolo; Adams, Christopher R; Burkhart, Stephen S; Denard, Patrick J

2017-07-01

The aim of this study was to find reliable anatomic landmarks of the normal acromioclavicular joint (ACJ) that could enable the precise evaluation of the horizontal displacement of the clavicle after dislocation. The hypothesis was that the anterior borders of the acromion and the clavicle are always aligned in intact ACJs. In 30 cadaveric specimens, the anterior and posterior borders of the ACJ's articular facets and the most prominent anterior and posterior bony landmarks of the acromion and the clavicle were identified. The anterior and posterior overhang of the acromion and the clavicle was measured in relation to the borders of the articular facets. Therefore, the possible anterior and posterior alignment of the ACJ was evaluated. Anteriorly, only 18 ACJs (60%) were aligned whereas 7 (24%) had major overhang of the acromion and 3 (10%) had major overhang of the clavicle. Similarly, 18 cases (60%) were posteriorly aligned, whereas 6 (20%) had major clavicular overhang and 4 (14%) had major overhang of the acromion. In 78% of these cases, the ACJ was aligned as well anteriorly as posteriorly (P < .001). Finally, the larger the width of the acromion (P = .032) or the clavicle (P = .049), the better the posterior joint alignment. Our hypothesis was not verified. The acromion and clavicle are not perfectly aligned in a significant number of specimens with intact ACJs (40% of cases). The most reliable landmarks remain their articular facets. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Fluoroscopic cervical epidural injections in chronic axial or disc-related neck pain without disc herniation, facet joint pain, or radiculitis

PubMed Central

Manchikanti, Laxmaiah; Cash, Kimberly A; Pampati, Vidyasagar; Malla, Yogesh

2012-01-01

Background While chronic neck pain is a common problem in the adult population, with a typical 12-month prevalence of 30%–50%, there is a lack of consensus regarding its causes and treatment. Despite limited evidence, cervical epidural injections are one of the commonly performed nonsurgical interventions in the management of chronic neck pain. Methods A randomized, double-blind, active, controlled trial was conducted to evaluate the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids for the management of chronic neck pain with or without upper extremity pain in patients without disc herniation, radiculitis, or facet joint pain. Results One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain by means of controlled diagnostic medial branch blocks were randomly assigned to one of two treatment groups, ie, injection of local anesthetic only (group 1) or local anesthetic mixed with nonparticulate betamethasone (group 2). The primary outcome of significant pain relief and improvement in functional status (≥50%) was demonstrated in 72% of group 1 and 68% of group 2. The overall average number of procedures per year was 3.6 in both groups with an average total relief per year of 37–39 weeks in the successful group over a period of 52 weeks. Conclusion Cervical interlaminar epidural injections of local anesthetic with or without steroids may be effective in patients with chronic function-limiting discogenic or axial pain. PMID:22826642

Modified fenestration with restorative spinoplasty for lumbar spinal stenosis.

PubMed

Matsudaira, Ko; Yamazaki, Takashi; Seichi, Atsushi; Hoshi, Kazuto; Hara, Nobuhiro; Ogiwara, Satoshi; Terayama, Sei; Chikuda, Hirotaka; Takeshita, Katsushi; Nakamura, Kozo

2009-06-01

The authors developed an original procedure, modified fenestration with restorative spinoplasty (MFRS) for the treatment of lumbar spinal stenosis. The first step is to cut the spinous process in an L-shape, which is caudally reflected. This procedure allows easy access to the spinal canal, including lateral recesses, and makes it easy to perform a trumpet-style decompression of the nerve roots without violating the facet joints. After the decompression of neural tissues, the spinous process is anatomically restored (spinoplasty). The clinical outcomes at 2 years were evaluated using the Japanese Orthopaedic Association (JOA) scale and patients' satisfaction. Radiological follow-up included radiographs and CT. Between January 2000 and December 2002, 109 patients with neurogenic intermittent claudication with or without mild spondylolisthesis underwent MFRS. Of these, 101 were followed up for at least 2 years (follow-up rate 93%). The average score on the self-administered JOA scale in 89 patients without comorbidity causing gait disturbance improved from 13.3 preoperatively to 22.9 at 2 years' follow-up. Neurogenic intermittent claudication disappeared in all cases. The patients' assessment of treatment satisfaction was "satisfied" in 74 cases, "slightly satisfied" in 12, "slightly dissatisfied" in 2, and "dissatisfied" in 1 case. In 16 cases (18%), a minimum progression of slippage occurred, but no symptomatic instability or recurrent stenosis was observed. Computed tomography showed that the lateral part of the facet joints was well preserved, and the mean residual ratio was 80%. The MFRS technique produces an adequate and safe decompression of the spinal canal, even in patients with narrow and steep facet joints in whom conventional fenestration is technically demanding.

Study on the Strength of GFRP/Stainless Steel Adhesive Joints Reinforced with Glass Mat

NASA Astrophysics Data System (ADS)

Iwasa, Masaaki

The adhesive strengths of glass fiber reinforced plastics/metal adhesive joints reinforced with glass mat under tensile shear loads and tensile loads were investigated analytically and experimentally. First, the stress singularity parameters of the bonding edges were analyzed by FEM for various types of adhesive joints reinforced with glass mat. The shear stress and normal stress distributions near the bonding edge can be expressed by two stress singularity parameters. Second, tensile shear tests were performed on taper lap joint and taper lap joint reinforced with glass mat and tensile tests were performed on T-type adhesive joint and T-type adhesive joint reinforced with glass mat. The relationships between the loads and the crosshead displacements were measured. We concluded that reinforcing adhesive joints has a greater effect on strength under tensile load than under tensile shear load. The adhesive joints strength reinforced with glass mat can be evaluated by using stress singularity parameters.

Sensate Scaffolds Can Reliably Detect Joint Loading

PubMed Central

Bliss, C. L.; Szivek, J. A.; Tellis, B. C.; Margolis, D. S.; Schnepp, A. B.; Ruth, J. T.

2008-01-01

Treatment of cartilage defects is essential to the prevention of osteoarthritis. Scaffold-based cartilage tissue engineering shows promise as a viable technique to treat focal defects. Added functionality can be achieved by incorporating strain gauges into scaffolds, thereby providing a real-time diagnostic measurement of joint loading. Strain-gauged scaffolds were placed into the medial femoral condyles of 14 adult canine knees and benchtop tested. Loads between 75 and 130 N were applied to the stifle joints at 30°, 50°, and 70° of flexion. Strain-gauged scaffolds were able to reliably assess joint loading at all applied flexion angles and loads. Pressure sensitive films were used to determine joint surface pressures during loading and to assess the effect of scaffold placement on joint pressures. A comparison of peak pressures in control knees and joints with implanted scaffolds, as well as a comparison of pressures before and after scaffold placement, showed that strain-gauged scaffold implantation did not significantly alter joint pressures. Future studies could possibly use strain-gauged scaffolds to clinically establish normal joint loads and to determine loads that are damaging to both healthy and tissue-engineered cartilage. Strain-gauged scaffolds may significantly aid the development of a functional engineered cartilage tissue substitute as well as provide insight into the native environment of cartilage. PMID:16941586

Kinetic magnetic resonance imaging analysis of abnormal segmental motion of the functional spine unit.

PubMed

Kong, Min Ho; Hymanson, Henry J; Song, Kwan Young; Chin, Dong Kyu; Cho, Yong Eun; Yoon, Do Heum; Wang, Jeffrey C

2009-04-01

The authors conducted a retrospective observational study using kinetic MR imaging to investigate the relationship between instability, abnormal sagittal segmental motion, and radiographic variables consisting of intervertebral disc degeneration, facet joint osteoarthritis (FJO), degeneration of the interspinous ligaments, ligamentum flavum hypertrophy (LFH), and the status of the paraspinal muscles. Abnormal segmental motion, defined as > 10 degrees angulation and > 3 mm of translation in the sagittal plane, was investigated in 1575 functional spine units (315 patients) in flexion, neutral, and extension postures using kinetic MR imaging. Each segment was assessed based on the extent of disc degeneration (Grades I-V), FJO (Grades 1-4), interspinous ligament degeneration (Grades 1-4), presence of LFH, and paraspinal muscle fatty infiltration observed on kinetic MR imaging. These factors are often noted in patients with degenerative disease, and there are grading systems to describe these changes. For the first time, the authors attempted to address the relationship between these radiographic observations and the effects on the motion and instability of the functional spine unit. The prevalence of abnormal translational motion was significantly higher in patients with Grade IV degenerative discs and Grade 3 arthritic facet joints (p < 0.05). In patients with advanced disc degeneration and FJO, there was a lesser amount of motion in both segmental translation and angulation when compared with lower grades of degeneration, and this difference was statistically significant for angular motion (p < 0.05). Patients with advanced degenerative Grade 4 facet joint arthritis had a significantly lower percentage of abnormal angular motion compared to patients with normal facet joints (p < 0.001). The presence of LFH was strongly associated with abnormal translational and angular motion. Grade 4 interspinous ligament degeneration and the presence of paraspinal muscle fatty infiltration were both significantly associated with excessive abnormal angular motion (p < 0.05). This kinetic MR imaging analysis showed that the lumbar functional unit with more disc degeneration, FJO, and LFH had abnormal sagittal plane translation and angulation. These findings suggest that abnormal segmental motion noted on kinetic MR images is closely associated with disc degeneration, FJO, and the pathological characteristics of interspinous ligaments, ligamentum flavum, and paraspinal muscles. Kinetic MR imaging in patients with mechanical back pain may prove a valuable source of information about the stability of the functional spine unit by measuring abnormal segmental motion and grading of radiographic parameters simultaneously.

Two-Year Follow-Up Results of Fluoroscopic Cervical Epidural Injections in Chronic Axial or Discogenic Neck Pain: A Randomized, Double-Blind, Controlled Trial

PubMed Central

Manchikanti, Laxmaiah; Cash, Kimberly A.; Pampati, Vidyasagar; Malla, Yogesh

2014-01-01

Study Design: A randomized, double-blind, active-controlled trial. Objective: To assess the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids for the management of axial or discogenic pain in patients without disc herniation, radiculitis, or facet joint pain. Summary of Background Data: Cervical discogenic pain without disc herniation is a common cause of suffering and disability in the adult population. Once conservative management has failed and facet joint pain has been excluded, cervical epidural injections may be considered as a management tool. Despite a paucity of evidence, cervical epidural injections are one of the most commonly performed nonsurgical interventions in the management of chronic axial or disc-related neck pain. Methods: One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain as determined by means of controlled diagnostic medial branch blocks were randomly assigned to one of the 2 treatment groups. Group I patients received cervical interlaminar epidural injections of local anesthetic (lidocaine 0.5%, 5 mL), whereas Group II patients received 0.5% lidocaine, 4 mL, mixed with 1 mL or 6 mg of nonparticulate betamethasone. The primary outcome measure was ≥ 50% improvement in pain and function. Outcome assessments included numeric rating scale (NRS), Neck Disability Index (NDI), opioid intake, employment, and changes in weight. Results: Significant pain relief and functional improvement (≥ 50%) was present at the end of 2 years in 73% of patients receiving local anesthetic only and 70% receiving local anesthetic with steroids. In the successful group of patients, however, defined as consistent relief with 2 initial injections of at least 3 weeks, significant improvement was illustrated in 78% in the local anesthetic group and 75% in the local anesthetic with steroid group at the end of 2 years. The results reported at the one-year follow-up were sustained at the 2-year follow-up. Conclusions: Cervical interlaminar epidural injections with or without steroids may provide significant improvement in pain and functioning in patients with chronic discogenic or axial pain that is function-limiting and not related to facet joint pain. PMID:24578607

PLIF with a titanium cage and excised facet joint bone for degenerative spondylolisthesis--in augmentation with a pedicle screw.

PubMed

Okuyama, Koichiro; Kido, Tadato; Unoki, Eiki; Chiba, Mitsuho

2007-02-01

To determine the validity of posterior lumbar interbody fusion (PLIF) using a titanium cage filled with excised facet joint bone and a pedicle screw for degenerative spondylolisthesis. PLIF using a titanium cage filled with excised facet joint bone and a pedicle screw was performed in 28 consecutive patients (men 10, women 18). The mean age of the patients was 60 years (range, 52 to 75 y) at the time of surgery. The mean follow-up period was 2.3 years (range, 2.0 to 4.5 y). The operation was done at L3/4 in 5, L4/5 in 20, and L3/4/5 in 3 patients. The mean operative bleeding was 318+/-151 g (mean+/-standard deviation), and the mean operative time was 3.34+/-0.57 hours per fixed segment. Clinical outcome was assessed by Denis' Pain and Work scale. Radiologic assessment was done using Boxell's method. Fusion outcome was assessed using an established criteria. On Pain scale, 20 and 8 patients were rated P4 and P5 before surgery, and 11, 12, 2, 2, and 1 patients were rated P1, P2, P3, P4, and P5 at final follow-up, respectively. On Work scale (for only physical labors), 12 and 9 patients were rated W4 and W5, before surgery, and 12, 5, 1, and 3 patients were rated W1, W2, W3 and W5 at final follow-up, respectively. There was significant difference in clinical outcome (P<0.01, Wilcoxon singled-rank test) The mean %Slip and Slip Angle was 17.9+/-8.1% and 3.9+/-5.8 degrees before surgery. The mean % Slip and Slip Angle was 5.4+/-4.4% and -2.0+/-4.8 degrees at final follow-up. There was a significant difference between the values (P<0.01, paired t test). "Union" and "probable union" was determined in 29 (93.5%) and 2 (6.5%) of 31 operated segments at 2.3 years (range, 2.0 to 4.5 y), postoperatively. PLIF using a titanium cage filled with excised facet joint bone and a pedicle screw provided a satisfactory clinical outcome and an excellent union rate without harvesting and grafting the autologous iliac bone.

Experimental Investigation on the Fatigue Mechanical Properties of Intermittently Jointed Rock Models Under Cyclic Uniaxial Compression with Different Loading Parameters

NASA Astrophysics Data System (ADS)

Liu, Yi; Dai, Feng; Dong, Lu; Xu, Nuwen; Feng, Peng

2018-01-01

Intermittently jointed rocks, widely existing in many mining and civil engineering structures, are quite susceptible to cyclic loading. Understanding the fatigue mechanism of jointed rocks is vital to the rational design and the long-term stability analysis of rock structures. In this study, the fatigue mechanical properties of synthetic jointed rock models under different cyclic conditions are systematically investigated in the laboratory, including four loading frequencies, four maximum stresses, and four amplitudes. Our experimental results reveal the influence of the three cyclic loading parameters on the mechanical properties of jointed rock models, regarding the fatigue deformation characteristics, the fatigue energy and damage evolution, and the fatigue failure and progressive failure behavior. Under lower loading frequency or higher maximum stress and amplitude, the jointed specimen is characterized by higher fatigue deformation moduli and higher dissipated hysteresis energy, resulting in higher cumulative damage and lower fatigue life. However, the fatigue failure modes of jointed specimens are independent of cyclic loading parameters; all tested jointed specimens exhibit a prominent tensile splitting failure mode. Three different crack coalescence patterns are classified between two adjacent joints. Furthermore, different from the progressive failure under static monotonic loading, the jointed rock specimens under cyclic compression fail more abruptly without evident preceding signs. The tensile cracks on the front surface of jointed specimens always initiate from the joint tips and then propagate at a certain angle with the joints toward the direction of maximum compression.

Effects of load proportioning on the capacity of multiple-hole composite joints

NASA Technical Reports Server (NTRS)

Hyer, M. W.; Chastain, P. A.

1985-01-01

This study addresses the issue of adjusting the proportion of load transmitted by each hole in a multiple-hole joint so that the joint capacity is a maximum. Specifically two-hole-in-series joints are examined. The results indicate that when each hole reacts 50% of the total load, the joint capacity is not a maximum. One hole generally is understressed at joint failure. The algorithm developed to determine the load proportion at each hole which results in maximum capacity is discussed. The algorithm includes two-dimensional finite-element stress analysis and failure criteria. The algorithm is used to study the effects of joint width, hole spacing, and hole to joint-end distance on load proportioning and capacity. To study hole size effects, two hole diameters are considered. Three laminates are considered: a quasi-isotropic laminate; a cross-ply laminate; and a 45 degree angle-ply laminate. By proportioning the load, capacity can be increased generally from 5 to 10%. In some cases a greater increase is possible.

[A feasibility research of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using hybrid internal fixation for recurrent lumbar disc herniation].

PubMed

Mao, Ke-ya; Wang, Yan; Xiao, Song-hua; Zhang, Yong-gang; Liu, Bao-wei; Wang, Zheng; Zhang, Xi-Feng; Cui, Geng; Zhang, Xue-song; Li, Peng; Mao, Ke-zheng

2013-08-01

To investigate the feasibility of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using hybrid internal fixation of pedicle screws and a translaminar facet screw for recurrent lumbar disc herniation. From January 2010 to December 2011, 16 recurrent lumbar disc herniation patients, 10 male and 6 female patients with an average age of 45 years (35-68 years) were treated with unilateral incision MIS-TLIF through working channel. After decompression, interbody fusion and fixation using unilateral pedicle screws, a translaminar facet screw was inserted from the same incision through spinous process and laminar to the other side facet joint. The results of perioperative parameters, radiographic images and clinical outcomes were assessed. The repeated measure analysis of variance was applied in the scores of visual analogue scale (VAS) and Oswestry disablity index (ODI). All patients MIS-TLIF were accomplished under working channel including decompression, interbody fusion and hybrid fixation without any neural complication. The average operative time was (148 ± 75) minutes, the average operative blood loss was (186 ± 226) ml, the average postoperative ambulation time was (32 ± 15) hours, and the average hospitalization time was (6 ± 4) days. The average length of incision was (29 ± 4) mm, and the average length of translaminar facets screw was (52 ± 6) mm. The mean follow-up was 16.5 months with a range of 12-24 months. The postoperative X-ray and CT images showed good position of the hybrid internal fixation, and all facets screws penetrate through facets joint. The significant improvement could be found in back pain VAS, leg pain VAS and ODI scores between preoperative 1 day and postoperative follow-up at all time-points (back pain VAS:F = 52.845, P = 0.000;leg pain VAS:F = 113.480, P = 0.000;ODI:F = 36.665, P = 0.000). Recurrent lumbar disc herniation could be treated with MIS-TLIF using hybrid fixation through unilateral incision, and the advantage including less invasion and quickly recovery.

Simplified Design Method for Tension Fasteners

NASA Astrophysics Data System (ADS)

Olmstead, Jim; Barker, Paul; Vandersluis, Jonathan

2012-07-01

Tension fastened joints design has traditionally been an iterative tradeoff between separation and strength requirements. This paper presents equations for the maximum external load that a fastened joint can support and the optimal preload to achieve this load. The equations, based on linear joint theory, account for separation and strength safety factors and variations in joint geometry, materials, preload, load-plane factor and thermal loading. The strength-normalized versions of the equations are applicable to any fastener and can be plotted to create a "Fastener Design Space", FDS. Any combination of preload and tension that falls within the FDS represents a safe joint design. The equation for the FDS apex represents the optimal preload and load capacity of a set of joints. The method can be used for preliminary design or to evaluate multiple pre-existing joints.

Facetal distraction as treatment for single- and multilevel cervical spondylotic radiculopathy and myelopathy: a preliminary report.

PubMed

Goel, Atul; Shah, Abhidha

2011-06-01

The authors discuss their successful preliminary experience with 36 cases of cervical spondylotic disease by performing facetal distraction using specially designed Goel cervical facet spacers. The clinical and radiological results of treatment are analyzed. The mechanism of action of the proposed spacers and the rationale for their use are evaluated. Between 2006 and February 2010, 36 patients were treated using the proposed technique. Of these patients, 18 had multilevel and 18 had single-level cervical spondylotic radiculopathy and/or myelopathy. The average follow-up period was 17 months with a minimum of 6 months. The Japanese Orthopaedic Association classification system, visual analog scale (neck pain and radiculopathy), and Odom criteria were used to monitor the clinical status of the patient. The patients were prospectively analyzed. The technique of surgery involved wide opening of the facet joints, denuding of articular cartilage, distraction of facets, and forced impaction of Goel cervical facet spacers into the articular cavity. Additionally, the interspinous process ligaments were resected, and corticocancellous bone graft from the iliac crest was placed and was stabilized over the adjoining laminae and facets after adequately preparing the host bone. Eighteen patients underwent single-level, 6 patients underwent 2-level, and 12 patients underwent 3-level treatment. The alterations in the physical architecture of spine and canal dimensions were evaluated before and after the placement of intrafacet joint spacers and after at least 6 months of follow-up. All patients had varying degrees of relief from symptoms of pain, radiculopathy, and myelopathy. Analysis of radiological features suggested that the distraction of facets with the spacers resulted in an increase in the intervertebral foraminal dimension (mean 2.2 mm), an increase in the height of the intervertebral disc space (range 0.4-1.2 mm), and an increase in the interspinous distance (mean 2.2 mm). The circumferential distraction resulted in reduction in the buckling of the posterior longitudinal ligament and ligamentum flavum. The procedure ultimately resulted in segmental bone fusion. No patient worsened after treatment. There was no noticeable implant malfunction. During the follow-up period, all patients had evidence of segmental bone fusion. No patient underwent reexploration or further surgery of the neck. Distraction of the facets of the cervical vertebra can lead to remarkable and immediate stabilization-fixation of the spinal segment and increase in space for the spinal cord and roots. The procedure results in reversal of several pathological events related to spondylotic disease. The safe, firm, and secure stabilization at the fulcrum of cervical spinal movements provided a ground for segmental spinal arthrodesis. The immediate postoperative improvement and lasting recovery from symptoms suggest the validity of the procedure.

Numerical Investigation of the Dynamic Properties of Intermittent Jointed Rock Models Subjected to Cyclic Uniaxial Compression

NASA Astrophysics Data System (ADS)

Liu, Yi; Dai, Feng; Zhao, Tao; Xu, Nu-wen

2017-01-01

Intermittent jointed rocks, which exist in a myriad of engineering projects, are extraordinarily susceptible to cyclic loadings. Understanding the dynamic fatigue properties of jointed rocks is necessary for evaluating the stability of rock engineering structures. This study numerically investigated the influences of cyclic loading conditions (i.e., frequency, maximum stress and amplitude) and joint geometric configurations (i.e., dip angle, persistency and interspace) on the dynamic fatigue mechanisms of jointed rock models. A reduction model of stiffness and strength was first proposed, and then, sixteen cyclic uniaxial loading tests with distinct loading parameters and joint geometries were simulated. Our results indicate that the reduction model can effectively reproduce the hysteresis loops and the accumulative plastic deformation of jointed rocks in the cyclic process. Both the loading parameters and the joint geometries significantly affect the dynamic properties, including the irreversible strain, damage evolution, dynamic residual strength and fatigue life. Three failure modes of jointed rocks, which are principally controlled by joint geometries, occur in the simulations: splitting failure through the entire rock sample, sliding failure along joint planes and mixed failure, which are principally controlled by joint geometries. Furthermore, the progressive failure processes of the jointed rock samples are numerically observed, and the different loading stages can be distinguished by the relationship between the number of broken bonds and the axial stress.

Cyclic loading increases friction and changes cartilage surface integrity in lubricin-mutant mouse knees

PubMed Central

Drewniak, Elizabeth I; Jay, Gregory D; Fleming, Braden C; Zhang, Ling; Warman, Matthew L; Crisco, Joseph J

2012-01-01

Objective To investigate the effects of lubricin gene dosage and cyclic loading on whole joint coefficient of friction and articular cartilage surface integrity in mouse knee joints. Methods Joints from mice with 2 (Prg4+/+), 1 (Prg4+/−), or no (Prg4−/−) functioning lubricin alleles were subjected to 26 hours of cyclic loading using a custom-built pendulum. Coefficient of friction values were measured at multiple time points. Contralateral control joints were left unloaded. Following testing, joints were examined for histologic evidence of damage and cell viability. Results At baseline, the coefficient of friction values in Prg4−/− mice were significantly higher than those in Prg4+/+ and Prg4+/− mice (P < 0.001). Cyclic loading continuously increased the coefficient of friction in Prg4−/− mouse joints. In contrast, Prg4+/− and Prg4+/+ mouse joints had no coefficient of friction increases during the first 4 hours of loading. After 26 hours of loading, joints from all genotypes had increased coefficient of friction values compared to baseline and unloaded controls. Significantly greater increases occurred in Prg4−/− and Prg4+/− mouse joints compared to Prg4+/+ mouse joints. The coefficient of friction values were not significantly associated with histologic evidence of damage or loss of cell viability. Conclusion Our findings indicate that mice lacking lubricin have increased baseline coefficient of friction values and are not protected against further increases caused by loading. Prg4+/− mice are indistinguishable from Prg4+/+ mice at baseline, but have significantly greater coefficient of friction values following 26 hours of loading. Lubricin dosage affects joint properties during loading, and may have clinical implications in patients for whom injury or illness alters lubricin abundance. PMID:21905020

Load environment of rail joint bars - phase I, effects of track parameters on rail joint stresses and crack growth.

DOT National Transportation Integrated Search

2013-04-01

The load environment of joint bars was assessed under a variety of loading and track conditions. Bending stresses, thermal stresses, and residual stresses were measured on commonly used joint bars. Crack growth rates from artificially induced cracks ...

Effect of dowel bar looseness on measured load transfer efficiency using FWD load

NASA Astrophysics Data System (ADS)

Shoukry, Samir N.; William, Gergis W.; Riad, Mourad Y.

2001-07-01

The effect of dowel bar looseness on the joint load transfer efficiency using Falling Weight Deflectometer is the subject of this paper. The mechanism of dynamic load transfer at transverse joints of Jointed Plain Concrete Pavement is examined using nonlinear 3D finite element analysis.

Anterior facetal realignment and distraction for atlanto-axial subluxation with basilar invagination …. a technical note.

PubMed

Patkar, Sushil

2016-08-01

Unilateral anterior retropharyngeal approach was used in a case of basilar invagination with atlanto-axial instability. This approach provided easy access to both atlanto-axial joints. Wedge-shaped titanium cages were used to distract the joints and reduce the basilar invagination. Titanium plates with screws were used to fix the lateral mass of atlas with the body of axis, bilaterally. The anterior atlanto-axial joint distraction procedure has not been described in literature before seems to be an easy option in selected cases of craniovertebral anomalies and needs to be investigated by more surgeons.

Subchondral bone density distribution of the talus in clinically normal Labrador Retrievers.

PubMed

Dingemanse, W; Müller-Gerbl, M; Jonkers, I; Vander Sloten, J; van Bree, H; Gielen, I

2016-03-15

Bones continually adapt their morphology to their load bearing function. At the level of the subchondral bone, the density distribution is highly correlated with the loading distribution of the joint. Therefore, subchondral bone density distribution can be used to study joint biomechanics non-invasively. In addition physiological and pathological joint loading is an important aspect of orthopaedic disease, and research focusing on joint biomechanics will benefit veterinary orthopaedics. This study was conducted to evaluate density distribution in the subchondral bone of the canine talus, as a parameter reflecting the long-term joint loading in the tarsocrural joint. Two main density maxima were found, one proximally on the medial trochlear ridge and one distally on the lateral trochlear ridge. All joints showed very similar density distribution patterns and no significant differences were found in the localisation of the density maxima between left and right limbs and between dogs. Based on the density distribution the lateral trochlear ridge is most likely subjected to highest loads within the tarsocrural joint. The joint loading distribution is very similar between dogs of the same breed. In addition, the joint loading distribution supports previous suggestions of the important role of biomechanics in the development of OC lesions in the tarsus. Important benefits of computed tomographic osteoabsorptiometry (CTOAM), i.e. the possibility of in vivo imaging and temporal evaluation, make this technique a valuable addition to the field of veterinary orthopaedic research.

Characterisation of the correlation between standing lordosis and degenerative joint disease in the lower lumbar spine in women and men: a radiographic study.

PubMed

Murray, Kelvin J; Le Grande, Michael R; Ortega de Mues, Arantxa; Azari, Michael F

2017-08-01

Degenerative joint disease (DJD) in the lumbar spine is a common condition that is associated with chronic low back pain. Excessive loading of lumbar joints is a risk factor for DJD. Changes in lumbar lordosis significantly redistribute the forces of weight-bearing on the facet joints and the intervertebral discs. However, the relationship between lumbar lordosis and DJD has not been characterized in men and women. We characterised the correlation between standing lumbar lordosis and DJD in standing radiographic images from 301 adult female and male chiropractic patients. DJD was rated using the Kellgren-Lawrence scale, and lordosis was measured using the Cobb angle. Linear and curvilinear correlations were investigated while controlling for age and sex. We found a highly significant curvilinear correlation between lordosis and DJD of the lower lumbar spine in both sexes, but especially in women, irrespective of the effects of age. We found the effect size of lordosis on lower lumbar DJD to be between 17.4 and 18.1% in women and 12.9% in older men. In addition, lordosis of 65 (95% CI 55.3-77.7) and 68 (98% CI 58.7-73.3) degrees were associated with minimal DJD in the lower lumbar spine of women and men respectively, and were therefore considered 'optimal'. This optimal lordotic angle was 73 (95% CI 58.8-87.2) degrees in older men. Both hypo- and hyper-lordosis correlate with DJD in the lumbar spine, particularly in women and in older men. These findings may well be of relevance to spinal pain management and spinal rehabilitation.

Human Lumbar Spine Creep during Cyclic and Static Flexion: Creep Rate, Biomechanics, and Facet Joint Capsule Strain

PubMed Central

Little, Jesse S.; Khalsa, Partap S.

2005-01-01

There is a high incidence of low back pain (LBP) associated with occupations requiring sustained and/or repetitive lumbar flexion (SLF and RLF, respectively), which cause creep of the viscoelastic tissues. The purpose of this study was to determine the effect of creep on lumbar biomechanics and facet joint capsule (FJC) strain. Specimens were flexed for 10 cycles, to a maximum 10 Nm moment at L5-S1, before, immediately after, and 20 min after a 20-min sustained flexion at the same moment magnitude. The creep rates of SLF and RLF were also measured during each phase and compared to the creep rate predicted by the moment relaxation rate function of the lumbar spine. Both SLF and RLF resulted in significantly increased intervertebral motion, as well as significantly increased FJC strains at the L3-4 to L5-S1 joint levels. These parameters remained increased after the 20-min recovery. Creep during SLF occurred significantly faster than creep during RLF. The moment relaxation rate function was able to accurately predict the creep rate of the lumbar spine at the single moment tested. The data suggest that SLF and RLF result in immediate and residual laxity of the joint and stretch of the FJC, which could increase the potential for LBP. PMID:15868730

Are cross-cultural comparisons of personality profiles meaningful? Differential item and facet functioning in the Revised NEO Personality Inventory.

PubMed

Church, A Timothy; Alvarez, Juan M; Mai, Nhu T Q; French, Brian F; Katigbak, Marcia S; Ortiz, Fernando A

2011-11-01

Measurement invariance is a prerequisite for confident cross-cultural comparisons of personality profiles. Multigroup confirmatory factor analysis was used to detect differential item functioning (DIF) in factor loadings and intercepts for the Revised NEO Personality Inventory (P. T. Costa, Jr., & R. R. McCrae, 1992) in comparisons of college students in the United States (N = 261), Philippines (N = 268), and Mexico (N = 775). About 40%-50% of the items exhibited some form of DIF and item-level noninvariance often carried forward to the facet level at which scores are compared. After excluding DIF items, some facet scales were too short or unreliable for cross-cultural comparisons, and for some other facets, cultural mean differences were reduced or eliminated. The results indicate that considerable caution is warranted in cross-cultural comparisons of personality profiles.

Minimum distraction gap: how much ankle joint space is enough in ankle distraction arthroplasty?

PubMed

Fragomen, Austin T; McCoy, Thomas H; Meyers, Kathleen N; Rozbruch, S Robert

2014-02-01

The success of ankle distraction arthroplasty relies on the separation of the tibiotalar articular surfaces. The purpose of this study was to find the minimum distraction gap needed to ensure that the tibiotalar joint surfaces would not contact each other with full weight-bearing while under distraction. Circular external fixators were mounted to nine cadaver ankle specimens. Each specimen was then placed into a custom-designed load chamber. Loads of 0, 350, and 700N were applied to the specimen. Radiographic joint space was measured and joint contact pressure was monitored under each load. The external fixator was then sequentially distracted, and the radiographic joint space was measured under the three different loads. The experiment was stopped when there was no joint contact under 700N of load. The radiographic joint space was measured and the initial (undistracted) radiographic joint space was subtracted from it yielding the distraction gap. The minimum distraction gap (mDG) that would provide total unloading was calculated. The average mDG was 2.4 mm (range, 1.6 to 4.0 mm) at 700N of load, 4.4 mm (range, 3.7 to 5.8 mm) at 350N of load, and 4.9 mm (range, 3.7 to 7.0 mm) at 0N of load. These results suggest that if the radiographic joint space of on a standing X-ray of an ankle undergoing distraction arthroplasty shows a minimum of 5.8 mm of DG, then there will be no contact between joint surfaces during full weight-bearing. Therefore, 5 mm of radiographic joint space, as recommended historically, may not be adequate to prevent contact of the articular surfaces during weight-bearing.

Room Temperature and Elevated Temperature Composite Sandwich Joint Testing

NASA Technical Reports Server (NTRS)

Walker, Sandra P.

1998-01-01

Testing of composite sandwich joint elements has been completed to verify the strength capacity of joints designed to carry specified running loads representative of a high speed civil transport wing. Static tension testing at both room and an elevated temperature of 350 F and fatigue testing at room temperature were conducted to determine strength capacity, fatigue life, and failure modes. Static tension test results yielded failure loads above the design loads for the room temperature tests, confirming the ability of the joint concepts tested to carry their design loads. However, strength reductions as large as 30% were observed at the elevated test temperature, where all failure loads were below the room temperature design loads for the specific joint designs tested. Fatigue testing resulted in lower than predicted fatigue lives.

The effects of load carriage and muscle fatigue on lower-extremity joint mechanics.

PubMed

Wang, He; Frame, Jeff; Ozimek, Elicia; Leib, Daniel; Dugan, Eric L

2013-09-01

Military personnel are commonly afflicted by lower-extremity overuse injuries. Load carriage and muscular fatigue are major stressors during military basic training. To examine effects of load carriage and muscular fatigue on lower-extremity joint mechanics during walking. Eighteen men performed the following tasks: unloaded walking, walking with a 32-kg load, fatigued walking with a 32-kg load, and fatigued walking. After the second walking task, muscle fatigue was elicited through a fatiguing protocol consisting of metered step-ups and heel raises with a 16-kg load. Each walking task was performed at 1.67 m x s(-1) for 5 min. Walking movement was tracked by a VICON motion capture system at 120 Hz. Ground reaction forces were collected by a tandem force instrumented treadmill (AMTI) at 2,400 Hz. Lower-extremity joint mechanics were calculated in Visual 3D. There was no interaction between load carriage and fatigue on lower-extremity joint mechanics (p > .05). Both load carriage and fatigue led to pronounced alterations of lower-extremity joint mechanics (p < .05). Load carriage resulted in increases of pelvis anterior tilt, hip and knee flexion at heel contact, and increases of hip, knee, and ankle joint moments and powers during weight acceptance. Muscle fatigue led to decreases of ankle dorsiflexion at heel contact, dorsiflexor moment, and joint power at weight acceptance. In addition, muscle fatigue increased demand for hip extensor moment and power at weight acceptance. Statistically significant changes in lower-extremity joint mechanics during loaded and fatigued walking may expose military personnel to increased risk for overuse injuries.

Sacroiliac joint dysfunction.

PubMed

Ilaslan, Hakan; Arslan, Ahmet; Koç, Omer Nadir; Dalkiliç, Turker; Naderi, Sait

2010-07-01

Sacroiliac joint dysfunction is a disorder presenting with low back and groin pain. It should be taken into consideration during the preoperative differential diagnosis of lumbar disc herniation, lumbar spinal stenosis and facet syndrome. Four cases with sacroiliac dysfunction are presented. The clinical and radiological signs supported the evidence of sacroiliac dysfunction, and exact diagnosis was made after positive response to sacroiliac joint block. A percutaneous sacroiliac fixation provided pain relief in all cases. The mean VAS scores reduced from 8.2 to 2.2. It is concluded that sacroiliac joint dysfunction diagnosis requires a careful physical examination of the sacroiliac joints in all cases with low back and groin pain. The diagnosis is made based on positive response to the sacroiliac block. Sacroiliac fixation was found to be effective in carefully selected cases.

Muscle-Specific Effective Mechanical Advantage and Joint Impulse in Weightlifting.

PubMed

Kipp, Kristof; Harris, Chad

2017-07-01

Kipp, K, and Harris, C. Muscle-specific effective mechanical advantage and joint impulse in weightlifting. J Strength Cond Res 31(7): 1905-1910, 2017-Lifting greater loads during weightlifting exercises may theoretically be achieved through increasing the magnitudes of net joint impulses or manipulating the joints' effective mechanical advantage (EMA). The purpose of this study was to investigate muscle-specific EMA and joint impulse as well as impulse-momentum characteristics of the lifter-barbell system across a range of external loads during the execution of the clean. Collegiate-level weightlifters performed submaximal cleans at 65, 75, and 85% of their 1-repetition maximum (1-RM), whereas data from a motion analysis system and a force plate were used to calculate lifter-barbell system impulse and velocity, as well as net extensor impulse generated at the hip, knee, and ankle joints and the EMA of the gluteus maximus, hamstrings, quadriceps, and triceps surae muscles. The results indicated that the lifter-barbell system impulse did not change as load increased, whereas the velocity of the lifter-barbell system decreased with greater load. In addition, the net extensor impulse at all joints increased as load increased. The EMA of all muscles did not, however, change as load increased. The load-dependent effects on the impulse-velocity characteristics of the lifter-barbell system may reflect musculoskeletal force-velocity behaviors, and may further indicate that the weightlifting performance is limited by the magnitude of ground reaction force impulse. In turn, the load-dependent effects observed at the joint level indicated that lifting greater loads were due to greater net extensor impulses generated at the joints of the lower extremity and not greater EMAs of the respective extensor muscles. In combination, these results suggest that lifting greater external loads during the clean is due to the ability to generate large extensor joint impulses, rather than manipulate EMA.

Does aquatic exercise reduce hip and knee joint loading? In vivo load measurements with instrumented implants

PubMed Central

Kutzner, Ines; Dymke, Jörn; Damm, Philipp; Duda, Georg N.; Günzl, Reiner; Bergmann, Georg

2017-01-01

Aquatic exercises are widely used for rehabilitation or preventive therapies in order to enable mobilization and muscle strengthening while minimizing joint loading of the lower limb. The load reducing effect of water due to buoyancy is a main advantage compared to exercises on land. However, also drag forces have to be considered that act opposite to the relative motion of the body segments and require higher muscle activity. Due to these opposing effects on joint loading, the load-reducing effect during aquatic exercises remains unknown. The aim of this study was to quantify the joint loads during various aquatic exercises and to determine the load reducing effect of water. Instrumented knee and hip implants with telemetric data transfer were used to measure the resultant joint contact forces in 12 elderly subjects (6x hip, 6x knee) in vivo. Different dynamic, weight-bearing and non-weight-bearing activities were performed by the subjects on land and in chest-high water. Non-weight-bearing hip and knee flexion/extension was performed at different velocities and with additional Aquafins. Joint forces during aquatic exercises ranged between 32 and 396% body weight (BW). Highest forces occurred during dynamic activities, followed by weight-bearing and slow non-weight-bearing activities. Compared to the same activities on land, joint forces were reduced by 36–55% in water with absolute reductions being greater than 100%BW during weight-bearing and dynamic activities. During non-weight-bearing activities, high movement velocities and additional Aquafins increased the joint forces by up to 59% and resulted in joint forces of up to 301%BW. This study confirms the load reducing effect of water during weight-bearing and dynamic exercises. Nevertheless, high drag forces result in increased joint contact forces and indicate greater muscle activity. By the choice of activity, movement velocity and additional resistive devices joint forces can be modulated individually in the course of rehabilitation or preventive therapies. PMID:28319145

Does aquatic exercise reduce hip and knee joint loading? In vivo load measurements with instrumented implants.

PubMed

Kutzner, Ines; Richter, Anja; Gordt, Katharina; Dymke, Jörn; Damm, Philipp; Duda, Georg N; Günzl, Reiner; Bergmann, Georg

2017-01-01

Aquatic exercises are widely used for rehabilitation or preventive therapies in order to enable mobilization and muscle strengthening while minimizing joint loading of the lower limb. The load reducing effect of water due to buoyancy is a main advantage compared to exercises on land. However, also drag forces have to be considered that act opposite to the relative motion of the body segments and require higher muscle activity. Due to these opposing effects on joint loading, the load-reducing effect during aquatic exercises remains unknown. The aim of this study was to quantify the joint loads during various aquatic exercises and to determine the load reducing effect of water. Instrumented knee and hip implants with telemetric data transfer were used to measure the resultant joint contact forces in 12 elderly subjects (6x hip, 6x knee) in vivo. Different dynamic, weight-bearing and non-weight-bearing activities were performed by the subjects on land and in chest-high water. Non-weight-bearing hip and knee flexion/extension was performed at different velocities and with additional Aquafins. Joint forces during aquatic exercises ranged between 32 and 396% body weight (BW). Highest forces occurred during dynamic activities, followed by weight-bearing and slow non-weight-bearing activities. Compared to the same activities on land, joint forces were reduced by 36-55% in water with absolute reductions being greater than 100%BW during weight-bearing and dynamic activities. During non-weight-bearing activities, high movement velocities and additional Aquafins increased the joint forces by up to 59% and resulted in joint forces of up to 301%BW. This study confirms the load reducing effect of water during weight-bearing and dynamic exercises. Nevertheless, high drag forces result in increased joint contact forces and indicate greater muscle activity. By the choice of activity, movement velocity and additional resistive devices joint forces can be modulated individually in the course of rehabilitation or preventive therapies.

Canine stifle joint biomechanics associated with tibial plateau leveling osteotomy predicted by use of a computer model.

PubMed

Brown, Nathan P; Bertocci, Gina E; Marcellin-Little, Denis J

2014-07-01

To evaluate effects of tibial plateau leveling osteotomy (TPLO) on canine stifle joint biomechanics in a cranial cruciate ligament (CrCL)-deficient stifle joint by use of a 3-D computer model simulating the stance phase of gait and to compare biomechanics in TPLO-managed, CrCL-intact, and CrCL-deficient stifle joints. Computer simulations of the pelvic limb of a Golden Retriever. A previously developed computer model of the canine pelvic limb was used to simulate TPLO stabilization to achieve a tibial plateau angle (TPA) of 5° (baseline value) in a CrCL-deficient stifle joint. Sensitivity analysis was conducted for tibial fragment rotation of 13° to -3°. Ligament loads, relative tibial translation, and relative tibial rotation were determined and compared with values for CrCL-intact and CrCL-deficient stifle joints. TPLO with a 5° TPA converted cranial tibial translation to caudal tibial translation and increased loads placed on the remaining stifle joint ligaments, compared with results for a CrCL-intact stifle joint. Lateral collateral ligament load was similar, medial collateral ligament load increased, and caudal cruciate ligament load decreased after TPLO, compared with loads for a CrCL-deficient stifle joint. Relative tibial rotation after TPLO was similar to that of a CrCL-deficient stifle joint. Stifle joint biomechanics were affected by TPLO fragment rotation. In the model, stifle joint biomechanics were partially improved after TPLO, compared with CrCL-deficient stifle joint biomechanics, but TPLO did not fully restore CrCL-intact stifle joint biomechanics. Overrotation of the tibial fragment negatively influenced stifle joint biomechanics by increasing caudal tibial translation.

[Biomechanical analysis of different ProDisc-C arthroplasty design parameters after implanted: a numerical sensitivity study based on finite element method].

PubMed

Tang, Qiaohong; Mo, Zhongjun; Yao, Jie; Li, Qi; Du, Chenfei; Wang, Lizhen; Fan, Yubo

2014-12-01

This study was aimed to estimate the effect of different ProDisc-C arthroplasty designs after it was implanted to C5-C6 cervicalspine. Finite element (FE) model of intact C5-C6 segments including the vertebrae and disc was developed and validated. Ball-and-socket artificial disc prosthesis model (ProDisc-C, Synthes) was implanted into the validated FE model and the curvature of the ProDisc-C prosthesis was varied. All models were loaded with compressed force 74 N and the pure moment of 1.8 Nm along flexion-extension and bilateral bending and axial torsion separately. The results indicated that the variation in the curvature of ball and socket configuration would influence the range of motion in flexion/extension, while there were not apparently differences under other conditions of loads. The method increasing the curvature will solve the stress concentration of the polyethylene, but it will also bring adverse outcomes, such as facet joint force increasing and ligament tension increasing. Therefore, the design of artificial discs should be considered comprehensively to reserve the range of motion as well as to avoid the adverse problems, so as not to affect the long-term clinical results.

Distal radius fractures and the volar lunate facet fragment: Kirschner wire fixation in addition to volar-locked plating.

PubMed

Moore, Amy M; Dennison, David G

2014-06-01

The volar lunate facet fragment of a distal radius fracture may not be stabilized with volar-locked plating alone due to the small size and distal location of the fragment. Identification and stabilization of this small fragment is critical as unstable fixation may result in radiocarpal and radioulnar joint subluxation. The addition of spring wire fixation with volar plating can provide stable internal fixation of this critical fracture fragment. A retrospective review (2006-2011) identified nine patients with distal radius fractures with an associated volar lunate facet fragment that were treated with volar-locked plating and spring wire fixation of the volar lunate facet fragment. Radiographic indices, range of motion, grip strength, and postoperative Patient-related wrist evaluation (PRWE) scores were obtained to assess pain and function. All distal radius fractures healed, and the volar lunate facet fragment reduction was maintained. The mean follow-up was 54 weeks. Mean active range of motion was 46° wrist flexion, 51° wrist extension, 80° pronation, and 68° supination. The mean grip strength was 21 Kg, achieving 66 % of the uninjured limb. The average PRWE score was 17. No patient required removal of hardware or had evidence of tendon irritation. The addition of spring wire fixation to volar-locked plating provided stable fixation of the volar lunate facet fragment of distal radius fractures without complication. This technique addresses a limitation of volar-locked plating to control the small volar lunate facet fragment in distal radius fractures otherwise amenable to volar plating. A retrospective case series, Level IV.

Kinematic and kinetic synergies of the lower extremities during the pull in olympic weightlifting.

PubMed

Kipp, Kristof; Redden, Josh; Sabick, Michelle; Harris, Chad

2012-07-01

The purpose of this study was to identify multijoint lower extremity kinematic and kinetic synergies in weightlifting and compare these synergies between joints and across different external loads. Subjects completed sets of the clean exercise at loads equal to 65, 75, and 85% of their estimated 1-RM. Functional data analysis was used to extract principal component functions (PCF's) for hip, knee, and ankle joint angles and moments of force during the pull phase of the clean at all loads. The PCF scores were then compared between joints and across loads to determine how much of each PCF was present at each joint and how it differed across loads. The analyses extracted two kinematic and four kinetic PCF's. The statistical comparisons indicated that all kinematic and two of the four kinetic PCF's did not differ across load, but scaled according to joint function. The PCF's captured a set of joint- and load-specific synergies that quantified biomechanical function of the lower extremity during Olympic weightlifting and revealed important technical characteristics that should be considered in sports training and future research.

Estimation of joint stiffness with a compliant load.

PubMed

Ludvig, Daniel; Kearney, Robert E

2009-01-01

Joint stiffness defines the dynamic relationship between the position of the joint and the torque acting about it. It consists of two components: intrinsic and reflex stiffness. Many previous studies have investigated joint stiffness in an open-loop environment, because the current algorithm in use is an open-loop algorithm. This paper explores issues related to the estimation of joint stiffness when subjects interact with compliant loads. First, we show analytically how the bias in closed-loop estimates of joint stiffness depends on the properties of the load, the noise power, and length of the estimated impulse response functions (IRF). We then demonstrate with simulations that the open-loop analysis will fail completely for an elastic load but may succeed for an inertial load. We further show that the open-loop analysis can yield unbiased results with an inertial load and document IRF length, signal-to-noise ratio needed, and minimum inertia needed for the analysis to succeed. Thus, by using a load with a properly selected inertia, open-loop analysis can be used under closed-loop conditions.

A practical guide for performing arthrography under fluoroscopic or ultrasound guidance.

PubMed

Lungu, Eugen; Moser, Thomas P

2015-12-01

We propose a practical approach for performing arthrography with fluoroscopic or ultrasound guidance. Different approaches to the principal joints of the upper limb (shoulder, elbow, wrist and fingers), lower limb (hip, knee, ankle and foot) as well as the facet joints of the spine are discussed and illustrated with numerous drawings. Whenever possible, we emphasise the concept of targeting articular recesses, which offers many advantages over traditional techniques aiming at the joint space. • Arthrography remains a foremost technique in musculoskeletal radiology • Most joints can be successfully accessed by targeting the articular recess • Targeting the recess offers several advantages over traditional approaches • Ultrasound-guidance is now favoured over fluoroscopy and targeting the recess is equally applicable.

NASA Simulation Capabilities

NASA Technical Reports Server (NTRS)

Grabbe, Shon R.

2017-01-01

This presentation provides a high-level overview of NASA's Future ATM Concepts Evaluation Tool (FACET) with a high-level description of the system's inputs and outputs. This presentation is designed to support the joint simulations that NASA and the Chinese Aeronautical Establishment (CAE) will conduct under an existing Memorandum of Understanding.

RESPONSE PROTOCOL TOOLBOX: PLANNING FOR AND RESPONDING TO CONTAMINATION THREATS TO DRINKING WATER SYSTEMS

EPA Science Inventory

EPA's Office of Research and Development and Office of Water/Water Security Division have jointly developed a Response Protocol Toolbox (RPTB) to address the complex, multi-faceted challenges of a water utility's planning and response to intentional contamination of drinking wate...

A preliminary study on effects of increment of loads to lower extremity joints during kettlebell swing activity

NASA Astrophysics Data System (ADS)

Zin, Muhammad Athif Mat; Rambely, Azmin Sham; Ariff, Noratiqah Mohd

2018-04-01

The purpose of the study was to determine the effects of increment of loads to lower extremity joints during the two-hand kettlebell swing (KS) activity with loads of 4 kg, 6 kg and 8 kg. Three male adults participated in this study. Subjects were required to perform a two-hand KS with three different loads which were 4 kg, 6 kg and 8 kg. A Vicon Nexus system (v1.5.2) with three infrared cameras adjusted with 100 Hz speed were used to capture KS motion to produce kinematics data for lower extremity joints which were ankle, knee and hip joints. The results showed that mean maximum flexion angle (MFA) of ankle, knee and hip joints decreased as load increased. Mean MFA of knee joint was the highest while mean MFA of ankle joint was the smallest recorded. Mean MFA of ipsilateral leg was higher than that of contralateral leg for a right-dominant subject.

Robot-assisted and conventional freehand pedicle screw placement: a systematic review and meta-analysis of randomized controlled trials.

PubMed

Gao, Shutao; Lv, Zhengtao; Fang, Huang

2018-04-01

Several studies have revealed that robot-assisted technique might improve the pedicle screw insertion accuracy, but owing to the limited sample sizes in the individual study reported up to now, whether or not robot-assisted technique is superior to conventional freehand technique is indefinite. Thus, we performed this systematic review and meta-analysis based on randomized controlled trials to assess which approach is better. Electronic databases including PubMed, EMBASE, CENTRAL, ISI Web of Science, CNKI and WanFang were systematically searched to identify potentially eligible articles. Main endpoints containing the accuracy of pedicle screw implantation and proximal facet joint violation were evaluated as risk ratio (RR) and the associated 95% confidence intervals (95% CIs), while radiation exposure and surgical duration were presented as mean difference (MD) or standard mean difference (SMD). Meta-analyses were performed using RevMan 5.3 software. Six studies involving 158 patients (688 pedicle screws) in robot-assisted group and 148 patients (672 pedicle screws) in freehand group were identified matching our study. The Grade A accuracy rate in robot-assisted group was superior to freehand group (RR 1.03, 95% CI 1.00, 1.06; P = 0.04), but the Grade A + B accuracy rate did not differ between the two groups (RR 1.01, 95% CI 0.99, 1.02; P = 0.29). With regard to proximal facet joint violation, the combined results suggested that robot-assisted group was associated with significantly fewer proximal facet joint violation than freehand group (RR 0.07, 95% CI 0.01, 0.55; P = 0.01). As was the radiation exposure, our findings suggested that robot-assisted technique could significantly reduce the intraoperative radiation time (MD - 12.38, 95% CI - 17.95, - 6.80; P < 0.0001) and radiation dosage (SMD - 0.64, 95% CI - 0.85, - 0.43; P < 0.00001). But the overall surgical duration was longer in robot-assisted group than conventional freehand group (MD 20.53, 95% CI 5.17, 35.90; P = 0.009). The robot-assisted technique was associated with equivalent accuracy rate of pedicle screw implantation, fewer proximal facet joint violation, less intraoperative radiation exposure but longer surgical duration than freehand technique. Powerful evidence relies on more randomized controlled trials with high quality and larger sample size in the future.

Effect of walking speed on lower extremity joint loading in graded ramp walking.

PubMed

Schwameder, Hermann; Lindenhofer, Elke; Müller, Erich

2005-07-01

Lower extremity joint loading during walking is strongly affected by the steepness of the slope and might cause pain and injuries in lower extremity joint structures. One feasible measure to reduce joint loading is the reduction of walking speed. Positive effects have been shown for level walking, but not for graded walking or hiking conditions. The aim of the study was to quantify the effect of walking speed (separated into the two components, step length and cadence) on the joint power of the hip, knee and ankle and to determine the knee joint forces in uphill and downhill walking. Ten participants walked up and down a ramp with step lengths of 0.46, 0.575 and 0.69 m and cadences of 80, 100 and 120 steps per minute. The ramp was equipped with a force platform and the locomotion was filmed with a 60 Hz video camera. Loading of the lower extremity joints was determined using inverse dynamics. A two-dimensional knee model was used to calculate forces in the knee structures during the stance phase. Walking speed affected lower extremity joint loading substantially and significantly. Change of step length caused much greater loading changes for all joints compared with change of cadence; the effects were more distinct in downhill than in uphill walking. The results indicate that lower extremity joint loading can be effectively controlled by varying step length and cadence during graded uphill and downhill walking. Hikers can avoid or reduce pain and injuries by reducing walking speed, particularly in downhill walking.

Ultrasonic measurement and monitoring of loads in bolts used in structural joints

NASA Astrophysics Data System (ADS)

Koshti, Ajay M.

2015-04-01

The paper is an overview of work by the author in measuring and monitoring loads in bolts using an ultrasonic extensometer. A number of cases of bolted joints are covered. These include, a clamped joint with clearance fit between the bolt and hole, a clamped joint with bolt in an interference fit with the hole, a flanged joint which allows the flange and bolt to bend; and a shear joint in a clevis and tang configuration. These applications were initially developed for measuring and monitoring preload in National Aeronautics and Space Administration (NASA) Space Shuttle Orbiter critical joints but are also applicable for monitoring loads in other critical bolted joints of structures such as transportation bridges and other aerospace structures. The papers cited here explain how to set-up a model to estimate the ultrasonic load factor and accuracy for the ultrasonic preload application in a clamped joint with clearance fit. The ultrasonic preload application for clamped joint with bolt in an interference fit can also be used to measure diametrical interference between the bolt shank and hole, as well as interference pressure on the bolt shank. Results of simulation and experimental data are given to demonstrate use of ultrasonic measurements in a shear joint. A bolt in a flanged joint experiences both tensile and bending loads. This application involves measurement of bending and tensile preload in a bolt. The ultrasonic beam bends due to bending load on the bolt. Results of a numerical technique to compute the trace of ultrasonic ray are presented.

Cartilage degeneration in the human patellae and its relationship to the mineralisation of the underlying bone: a key to the understanding of chondromalacia patellae and femoropatellar arthrosis?

PubMed

Eckstein, F; Putz, R; Müller-Gerbl, M; Steinlechner, M; Benedetto, K P

1993-01-01

According to the literature subchondral bone plays a significant role in the transmission of load through joints and in the pathogenesis of osteoarthrosis. Therefore the degeneration of the articular cartilage was investigated in the patellae from 30 dissecting-room specimens and of 20 patients, previously submitted to arthroscopy, and subchondral mineralisation of their underlying bone was at the same time assessed by means of CT osteoabsorptiometry. Lateral cartilage lesions were localised over highly mineralised subchondral bone; these appear to be due to long-term stress. They were mainly found in the older specimens and showed a high rate of progression with increasing age. Medially localised cartilage lesions, on the other hand, were situated in a transitional region between moderate and slight subchondral mineralisation; they may be caused by infrequent stress peaks and by shear stress in the articular cartilage, the very medial part of the joint being deprived of mechanical stimulation for much of the time. These lesions were to be found predominantly in the younger specimens and showed little progress with advancing age. Patients with lateral cartilage degeneration exhibited higher, patients with medial chondromalacia patellae lower mineralisation than normals. Their density patterns therefore indicate a different mechanical pathogenesis of the cartilage lesions in the lateral and medial facet. It could be shown that CT osteoabsorptiometry allows an assessment of the mechanical situation, present in individual femoro-patellar joints, and that this situation is highly relevant for the pathogenesis of patellar cartilage degeneration.

Method and apparatus for calibrating multi-axis load cells in a dexterous robot

NASA Technical Reports Server (NTRS)

Wampler, II, Charles W. (Inventor); Platt, Jr., Robert J. (Inventor)

2012-01-01

A robotic system includes a dexterous robot having robotic joints, angle sensors adapted for measuring joint angles at a corresponding one of the joints, load cells for measuring a set of strain values imparted to a corresponding one of the load cells during a predetermined pose of the robot, and a host machine. The host machine is electrically connected to the load cells and angle sensors, and receives the joint angle values and strain values during the predetermined pose. The robot presses together mating pairs of load cells to form the poses. The host machine executes an algorithm to process the joint angles and strain values, and from the set of all calibration matrices that minimize error in force balance equations, selects the set of calibration matrices that is closest in a value to a pre-specified value. A method for calibrating the load cells via the algorithm is also provided.

Low-Friction, High-Stiffness Joint for Uniaxial Load Cell

NASA Technical Reports Server (NTRS)

Lewis, James L.; Le, Thang; Carroll, Monty B.

2007-01-01

A universal-joint assembly has been devised for transferring axial tension or compression to a load cell. To maximize measurement accuracy, the assembly is required to minimize any moments and non-axial forces on the load cell and to exhibit little or no hysteresis. The requirement to minimize hysteresis translates to a requirement to maximize axial stiffness (including minimizing backlash) and a simultaneous requirement to minimize friction. In practice, these are competing requirements, encountered repeatedly in efforts to design universal joints. Often, universal-joint designs represent compromises between these requirements. The improved universal-joint assembly contains two universal joints, each containing two adjustable pairs of angular-contact ball bearings. One might be tempted to ask why one could not use simple ball-and-socket joints rather than something as complex as universal joints containing adjustable pairs of angularcontact ball bearings. The answer is that ball-and-socket joints do not offer sufficient latitude to trade stiffness versus friction: the inevitable result of an attempt to make such a trade in a ball-and-socket joint is either too much backlash or too much friction. The universal joints are located at opposite ends of an axial subassembly that contains the load cell. The axial subassembly includes an axial shaft, an axial housing, and a fifth adjustable pair of angular-contact ball bearings that allows rotation of the axial housing relative to the shaft. The preload on each pair of angular-contact ball bearings can be adjusted to obtain the required stiffness with minimal friction, tailored for a specific application. The universal joint at each end affords two degrees of freedom, allowing only axial force to reach the load cell regardless of application of moments and non-axial forces. The rotational joint on the axial subassembly affords a fifth degree of freedom, preventing application of a torsion load to the load cell.

Analysis of Contraction Joint Width Influence on Load Stress of Pavement Panels

NASA Astrophysics Data System (ADS)

Gao, Wei; Cui, Wei; Sun, Wei

2018-05-01

The width of transverse contraction joint of the cement road varies with temperatures, which leads to changes in load transmission among plates of the road surface and affects load stress of the road plates. Three-dimensional element analysis software EverFE is used to address the relation between the contraction joint width and road surface load stress, revealing the impact of reducing contraction joint width. The results could be of critical value in maintaining road functions and extending the service life of cement road surfaces.

Contribution of tibiofemoral joint contact to net loads at the knee in gait.

PubMed

Walter, Jonathan P; Korkmaz, Nuray; Fregly, Benjamin J; Pandy, Marcus G

2015-07-01

Inverse dynamics analysis is commonly used to estimate the net loads at a joint during human motion. Most lower-limb models of movement represent the knee as a simple hinge joint when calculating muscle forces. This approach is limited because it neglects the contributions from tibiofemoral joint contact forces and may therefore lead to errors in estimated muscle forces. The aim of this study was to quantify the contributions of tibiofemoral joint contact loads to the net knee loads calculated from inverse dynamics for multiple subjects and multiple gait patterns. Tibiofemoral joint contact loads were measured in four subjects with instrumented implants as each subject walked at their preferred speed (normal gait) and performed prescribed gait modifications designed to treat medial knee osteoarthritis. Tibiofemoral contact loads contributed substantially to the net knee extension and knee adduction moments in normal gait with mean values of 16% and 54%, respectively. These findings suggest that knee-contact kinematics and loads should be included in lower-limb models of movement for more accurate determination of muscle forces. The results of this study may be used to guide the development of more realistic lower-limb models that account for the effects of tibiofemoral joint contact at the knee. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

The relationship between knee joint loading rate during walking and degenerative changes on magnetic resonance imaging.

PubMed

Morgenroth, David C; Medverd, Jonathan R; Seyedali, Mahyo; Czerniecki, Joseph M

2014-06-01

While animal study and cadaveric study have demonstrated an association between knee joint loading rate and joint degeneration, the relationship between knee joint loading rate during walking and osteoarthritis has not yet been sufficiently studied in humans. Twenty-eight participants (14 transfemoral amputees and 14 age and body mass matched controls) underwent knee MRI with subsequent assessment using the semiquantitative Whole-Organ Magnetic Resonance Image Score. Each subject also underwent gait analysis in order to determine knee adduction moment loading rate, peak, and impulse and an exploratory measure, knee adduction moment rate∗magnitude. Significant correlations were found between medial tibiofemoral joint degeneration and knee adduction moment peak (slope=0.42 [SE 0.20]; P=.037), loading rate (slope=12.3 [SE 3.2]; P=.0004), and rate∗magnitude (slope=437 [SE 100]; P<.0001). These relationships continued to be significant after adjusting for body mass or subject type. The relationship between medial knee semiquantitative MRI score and knee adduction moment loading rate and rate∗magnitude continued to be significant even after adjusting for peak moment (P<.0001), however, the relationship between medial knee semiquantitative MRI score and peak moment was no longer significant after adjusting for either loading rate or rate∗magnitude (P>.2 in both cases). This study suggests an independent relationship between knee adduction moment loading rate and medial tibiofemoral joint degeneration. Our results support the hypothesis that rate of loading, represented by the knee adduction moment loading rate, is strongly associated with medial tibiofemoral joint degeneration independent of knee adduction moment peak and impulse. Published by Elsevier Ltd.

The effects of load carriage on joint work at different running velocities.

PubMed

Liew, Bernard X W; Morris, Susan; Netto, Kevin

2016-10-03

Running with load carriage has become increasingly prevalent in sport, as well as many field-based occupations. However, the "sources" of mechanical work during load carriage running are not yet completely understood. The purpose of this study was to determine the influence of load magnitudes on the mechanical joint work during running, across different velocities. Thirty-one participants performed overground running at three load magnitudes (0%, 10%, 20% body weight), and at three velocities (3, 4, 5m/s). Three dimensional motion capture was performed, with synchronised force plate data captured. Inverse dynamics was used to quantify joint work in the stance phase of running. Joint work was normalized to a unit proportion of body weight and leg length (one dimensionless work unit=532.45J). Load significantly increased total joint work and total positive work and this effect was greater at faster velocities. Load carriage increased ankle positive work (β coefficient=rate of 6.95×10 -4 unit work per 1% BW carried), and knee positive (β=1.12×10 -3 unit) and negative work (β=-2.47×10 -4 unit), and hip negative work (β=-7.79×10 -4 unit). Load carriage reduced hip positive work and this effect was smaller at faster velocities. Inter-joint redistribution did not contribute significantly to altered mechanical work within the spectrum of load and velocity investigated. Hence, the ankle joint contributed to the greatest extent in work production, whilst that of the knee contributed to the greatest extent to work absorption when running with load. Copyright © 2016 Elsevier Ltd. All rights reserved.

Plausibility and parameter sensitivity of micro-finite element-based joint load prediction at the proximal femur.

PubMed

Synek, Alexander; Pahr, Dieter H

2018-06-01

A micro-finite element-based method to estimate the bone loading history based on bone architecture was recently presented in the literature. However, a thorough investigation of the parameter sensitivity and plausibility of this method to predict joint loads is still missing. The goals of this study were (1) to analyse the parameter sensitivity of the joint load predictions at one proximal femur and (2) to assess the plausibility of the results by comparing load predictions of ten proximal femora to in vivo hip joint forces measured with instrumented prostheses (available from www.orthoload.com ). Joint loads were predicted by optimally scaling the magnitude of four unit loads (inclined [Formula: see text] to [Formula: see text] with respect to the vertical axis) applied to micro-finite element models created from high-resolution computed tomography scans ([Formula: see text]m voxel size). Parameter sensitivity analysis was performed by varying a total of nine parameters and showed that predictions of the peak load directions (range 10[Formula: see text]-[Formula: see text]) are more robust than the predicted peak load magnitudes (range 2344.8-4689.5 N). Comparing the results of all ten femora with the in vivo loading data of ten subjects showed that peak loads are plausible both in terms of the load direction (in vivo: [Formula: see text], predicted: [Formula: see text]) and magnitude (in vivo: [Formula: see text], predicted: [Formula: see text]). Overall, this study suggests that micro-finite element-based joint load predictions are both plausible and robust in terms of the predicted peak load direction, but predicted load magnitudes should be interpreted with caution.

The mechanism of bolt loading

NASA Technical Reports Server (NTRS)

Lee, H. M.

1992-01-01

It is shown that the mechanism of bolt loading for preloaded fasteners can be effectively portrayed through simple spring models and some algebraic manipulations. Understanding schematically what is involved in such joints provides insight into the distribution of loads. The developed equations confirm that for both symmetric and nonsymmetric joints the loading plane factor and the stiffness factor directly affect the load seen in preloaded fasteners. The manner in which an external loading is transferred through the joint can be explained as energy dissipated in the various springs of both the abutment and the bolt itself.

Behavior of single lap composite bolted joint under traction loading: Experimental investigation

NASA Astrophysics Data System (ADS)

Awadhani, L. V.; Bewoor, Anand

2018-04-01

Composite bolted joints are preferred connection in the composite structures to facilitate the dismantling for the replacements/ maintenance work. The joint behavior under tractive forces has been studied in order to understand the safety of the structure designed. The main objective of this paper is to investigate the behavior of single-lap joints in carbon fiber reinforced epoxy composites under traction loading conditions. The experiments were designed to identify the effect of bolt diameter, stacking sequence and loading rate on the properties of the joint. The experimental results show that the parameters influence the joint performance significantly.

The effects of load on system and lower-body joint kinetics during jump squats.

PubMed

Moir, Gavin L; Gollie, Jared M; Davis, Shala E; Guers, John J; Witmer, Chad A

2012-11-01

To investigate the effects of different loads on system and lower-body kinetics during jump squats, 12 resistance-trained men performed jumps under different loading conditions: 0%, 12%, 27%, 42%, 56%, 71%, and 85% of 1-repetition maximum (1-RM). System power output was calculated as the product of the vertical component of the ground reaction force and the vertical velocity of the bar during its ascent. Joint power output was calculated during bar ascent for the hip, knee, and ankle joints, and was also summed across the joints. System power output and joint power at knee and ankle joints were maximized at 0% 1-RM (p < 0.001) and followed the linear trends (p < 0.001) caused by power output decreasing as the load increased. Power output at the hip was maximized at 42% 1-RM (p = 0.016) and followed a quadratic trend (p = 0.030). Summed joint power could be predicted from system power (p < 0.05), while system power could predict power at the knee and ankle joints under some of the loading conditions. Power at the hip could not be predicted from system power. System power during loaded jumps reflects the power at the knee and ankle, while power at the hip does not correspond to system power.

Joint power and kinematics coordination in load carriage running: Implications for performance and injury.

PubMed

Liew, Bernard X W; Morris, Susan; Netto, Kevin

2016-06-01

Investigating the impact of incremental load magnitude on running joint power and kinematics is important for understanding the energy cost burden and potential injury-causative mechanisms associated with load carriage. It was hypothesized that incremental load magnitude would result in phase-specific, joint power and kinematic changes within the stance phase of running, and that these relationships would vary at different running velocities. Thirty-one participants performed running while carrying three load magnitudes (0%, 10%, 20% body weight), at three velocities (3, 4, 5m/s). Lower limb trajectories and ground reaction forces were captured, and global optimization was used to derive the variables. The relationships between load magnitude and joint power and angle vectors, at each running velocity, were analyzed using Statistical Parametric Mapping Canonical Correlation Analysis. Incremental load magnitude was positively correlated to joint power in the second half of stance. Increasing load magnitude was also positively correlated with alterations in three dimensional ankle angles during mid-stance (4.0 and 5.0m/s), knee angles at mid-stance (at 5.0m/s), and hip angles during toe-off (at all velocities). Post hoc analyses indicated that at faster running velocities (4.0 and 5.0m/s), increasing load magnitude appeared to alter power contribution in a distal-to-proximal (ankle→hip) joint sequence from mid-stance to toe-off. In addition, kinematic changes due to increasing load influenced both sagittal and non-sagittal plane lower limb joint angles. This study provides a list of plausible factors that may influence running energy cost and injury risk during load carriage running. Copyright © 2016 Elsevier B.V. All rights reserved.

LAB ANALYSIS OF EMERGENCY WATER SAMPLES CONTAINING UNKNOWN CONTAMINANTS: CONSIDERATIONS FROM THE USEPA RESPONSE PROTOCOL TOOLBOX

EPA Science Inventory

EPA's Office of Research and Development and Office of Water/Water Security Division have jointly developed a Response Protocol Toolbox (RPTB) to address the complex, multi-faceted challenges of a water utility's planning and response to intentional contamination of drinking wate...

Developmental Planning: An Introduction for Parents

ERIC Educational Resources Information Center

Noland, Jim

2009-01-01

"Developmental Planning" is the thinking process of using developmental milestones as a general basis for planning and predicting needs for the child within the early years. It considers the time frames associated with normal development across all facets of the child's development. The areas include bone and joint development, movement, sensory…

Influence of weak hip abductor muscles on joint contact forces during normal walking: probabilistic modeling analysis.

PubMed

Valente, Giordano; Taddei, Fulvia; Jonkers, Ilse

2013-09-03

The weakness of hip abductor muscles is related to lower-limb joint osteoarthritis, and joint overloading may increase the risk for disease progression. The relationship between muscle strength, structural joint deterioration and joint loading makes the latter an important parameter in the study of onset and follow-up of the disease. Since the relationship between hip abductor weakness and joint loading still remains an open question, the purpose of this study was to adopt a probabilistic modeling approach to give insights into how the weakness of hip abductor muscles, in the extent to which normal gait could be unaltered, affects ipsilateral joint contact forces. A generic musculoskeletal model was scaled to each healthy subject included in the study, and the maximum force-generating capacity of each hip abductor muscle in the model was perturbed to evaluate how all physiologically possible configurations of hip abductor weakness affected the joint contact forces during walking. In general, the muscular system was able to compensate for abductor weakness. The reduced force-generating capacity of the abductor muscles affected joint contact forces to a mild extent, with 50th percentile mean differences up to 0.5 BW (maximum 1.7 BW). There were greater increases in the peak knee joint loads than in loads at the hip or ankle. Gluteus medius, particularly the anterior compartment, was the abductor muscle with the most influence on hip and knee loads. Further studies should assess if these increases in joint loading may affect initiation and progression of osteoarthritis. Copyright © 2013 Elsevier Ltd. All rights reserved.

Agreement between diagnoses reached by clinical examination and available reference standards: a prospective study of 216 patients with lumbopelvic pain

PubMed Central

Laslett, Mark; McDonald, Barry; Tropp, Hans; Aprill, Charles N; Öberg, Birgitta

2005-01-01

Background The tissue origin of low back pain (LBP) or referred lower extremity symptoms (LES) may be identified in about 70% of cases using advanced imaging, discography and facet or sacroiliac joint blocks. These techniques are invasive and availability varies. A clinical examination is non-invasive and widely available but its validity is questioned. Diagnostic studies usually examine single tests in relation to single reference standards, yet in clinical practice, clinicians use multiple tests and select from a range of possible diagnoses. There is a need for studies that evaluate the diagnostic performance of clinical diagnoses against available reference standards. Methods We compared blinded clinical diagnoses with diagnoses based on available reference standards for known causes of LBP or LES such as discography, facet, sacroiliac or hip joint blocks, epidurals injections, advanced imaging studies or any combination of these tests. A prospective, blinded validity design was employed. Physiotherapists examined consecutive patients with chronic lumbopelvic pain and/or referred LES scheduled to receive the reference standard examinations. When diagnoses were in complete agreement regardless of complexity, "exact" agreement was recorded. When the clinical diagnosis was included within the reference standard diagnoses, "clinical agreement" was recorded. The proportional chance criterion (PCC) statistic was used to estimate agreement on multiple diagnostic possibilities because it accounts for the prevalence of individual categories in the sample. The kappa statistic was used to estimate agreement on six pathoanatomic diagnoses. Results In a sample of chronic LBP patients (n = 216) with high levels of disability and distress, 67% received a patho-anatomic diagnosis based on available reference standards, and 10% had more than one tissue origin of pain identified. For 27 diagnostic categories and combinations, chance clinical agreement (PCC) was estimated at 13%. "Exact" agreement between clinical and reference standard diagnoses was 32% and "clinical agreement" 51%. For six pathoanatomic categories (disc, facet joint, sacroiliac joint, hip joint, nerve root and spinal stenosis), PCC was 33% with actual agreement 56%. There was no overlap of 95% confidence intervals on any comparison. Diagnostic agreement on the six most common patho-anatomic categories produced a kappa of 0.31. Conclusion Clinical diagnoses agree with reference standards diagnoses more often than chance. Using available reference standards, most patients can have a tissue source of pain identified. PMID:15943873

Creation of an Aeronautical Capstone Design Project Program at Ohio State University

DTIC Science & Technology

2014-12-08

Equation 12 below. As Figure 35 shows, a single adhesively bonded lap joint is considered. The epoxy only sees a load in the axial direction. In...lap joint [1] = = ( ) 12 =stress distribution factor = applied load in the axial direction ...Figure 11. The joints are designed to handle the bending loads of horizontal, vertical and angled deployment and are designed to directly load the carbon

Biomechanics of an orthosis-managed cranial cruciate ligament-deficient canine stifle joint predicted by use of a computer model.

PubMed

Bertocci, Gina E; Brown, Nathan P; Mich, Patrice M

2017-01-01

OBJECTIVE To evaluate effects of an orthosis on biomechanics of a cranial cruciate ligament (CrCL)-deficient canine stifle joint by use of a 3-D quasistatic rigid-body pelvic limb computer model simulating the stance phase of gait and to investigate influences of orthosis hinge stiffness (durometer). SAMPLE A previously developed computer simulation model for a healthy 33-kg 5-year-old neutered Golden Retriever. PROCEDURES A custom stifle joint orthosis was implemented in the CrCL-deficient pelvic limb computer simulation model. Ligament loads, relative tibial translation, and relative tibial rotation in the orthosis-stabilized stifle joint (baseline scenario; high-durometer hinge]) were determined and compared with values for CrCL-intact and CrCL-deficient stifle joints. Sensitivity analysis was conducted to evaluate the influence of orthosis hinge stiffness on model outcome measures. RESULTS The orthosis decreased loads placed on the caudal cruciate and lateral collateral ligaments and increased load placed on the medial collateral ligament, compared with loads for the CrCL-intact stifle joint. Ligament loads were decreased in the orthosis-managed CrCL-deficient stifle joint, compared with loads for the CrCL-deficient stifle joint. Relative tibial translation and rotation decreased but were not eliminated after orthosis management. Increased orthosis hinge stiffness reduced tibial translation and rotation, whereas decreased hinge stiffness increased internal tibial rotation, compared with values for the baseline scenario. CONCLUSIONS AND CLINICAL RELEVANCE Stifle joint biomechanics were improved following orthosis implementation, compared with biomechanics of the CrCL-deficient stifle joint. Orthosis hinge stiffness influenced stifle joint biomechanics. An orthosis may be a viable option to stabilize a CrCL-deficient canine stifle joint.

Analytical and Experimental Assessment of Seismic Vulnerability of Beam-Column Joints without Transverse Reinforcement in Concrete Buildings

NASA Astrophysics Data System (ADS)

Hassan, Wael Mohammed

Beam-column joints in concrete buildings are key components to ensure structural integrity of building performance under seismic loading. Earthquake reconnaissance has reported the substantial damage that can result from inadequate beam-column joints. In some cases, failure of older-type corner joints appears to have led to building collapse. Since the 1960s, many advances have been made to improve seismic performance of building components, including beam-column joints. New design and detailing approaches are expected to produce new construction that will perform satisfactorily during strong earthquake shaking. Much less attention has been focused on beam-column joints of older construction that may be seismically vulnerable. Concrete buildings constructed prior to developing details for ductility in the 1970s normally lack joint transverse reinforcement. The available literature concerning the performance of such joints is relatively limited, but concerns about performance exist. The current study aimed to improve understanding and assessment of seismic performance of unconfined exterior and corner beam-column joints in existing buildings. An extensive literature survey was performed, leading to development of a database of about a hundred tests. Study of the data enabled identification of the most important parameters and the effect of each parameter on the seismic performance. The available analytical models and guidelines for strength and deformability assessment of unconfined joints were surveyed and evaluated. In particular, The ASCE 41 existing building document proved to be substantially conservative in joint shear strength estimation. Upon identifying deficiencies in these models, two new joint shear strength models, a bond capacity model, and two axial capacity models designed and tailored specifically for unconfined beam-column joints were developed. The proposed models strongly correlated with previous test results. In the laboratory testing phase of the current study, four full-scale corner beam-column joint subassemblies, with slab included, were designed, built, instrumented, tested, and analyzed. The specimens were tested under unidirectional and bidirectional displacement-controlled quasi-static loading that incorporated varying axial loads that simulated overturning seismic moment effects. The axial loads varied between tension and high compression loads reaching about 50% of the column axial capacity. The test parameters were axial load level, loading history, joint aspect ratio, and beam reinforcement ratio. The test results proved that high axial load increases joint shear strength and decreases the deformability of joints failing in pure shear failure mode without beam yielding. On the contrary, high axial load did not affect the strength of joints failing in shear after significant beam yielding; however, it substantially increased their displacement ductility. Joint aspect ratio proved to be instrumental in deciding joint shear strength; that is the deeper the joint the lower the shear strength. Bidirectional loading reduced the apparent strength of the joint in the uniaxial principal axes. However, circular shear strength interaction is an appropriate approximation to predict the biaxial strength. The developed shear strength models predicted successfully the strength of test specimens. Based on the literature database investigation, the shear and axial capacity models developed and the test results of the current study, an analytical finite element component model based on a proposed joint shear stress-rotation backbone constitutive curve was developed to represent the behavior of unconfined beam-column joints in computer numerical simulations of concrete frame buildings. The proposed finite element model included the effect of axial load, mode of joint failure, joint aspect ratio and axial capacity of joint. The proposed backbone curve along with the developed joint element exhibited high accuracy in simulating the test response of the current test specimens as well as previous test joints. Finally, a parametric study was conducted to assess the axial failure vulnerability of unconfined beam-column joints based on the developed shear and axial capacity models. This parametric study compared the axial failure potential of unconfined beam-column joint with that of shear critical columns to provide a preliminary insight into the axial collapse vulnerability of older-type buildings during intense ground shaking.

Soldier-relevant body borne loads increase knee joint contact force during a run-to-stop maneuver.

PubMed

Ramsay, John W; Hancock, Clifford L; O'Donovan, Meghan P; Brown, Tyler N

2016-12-08

The purpose of this study was to understand the effects of load carriage on human performance, specifically during a run-to-stop (RTS) task. Using OpenSim analysis tools, knee joint contact force, grounds reaction force, leg stiffness and lower extremity joint angles and moments were determined for nine male military personnel performing a RTS under three load configurations (light, ~6kg, medium, ~20kg, and heavy, ~40kg). Subject-based means for each biomechanical variable were submitted to repeated measures ANOVA to test the effects of load. During the RTS, body borne load significantly increased peak knee joint contact force by 1.2 BW (p<0.001) and peak vertical (p<0.001) and anterior-posterior (p=0.002) ground reaction forces by 0.6 BW and 0.3 BW, respectively. Body borne load also had a significant effect on hip (p=0.026) posture with the medium load and knee (p=0.046) posture with the heavy load. With the heavy load, participants exhibited a substantial, albeit non-significant increase in leg stiffness (p=0.073 and d=0.615). Increases in joint contact force exhibited during the RTS were primarily due to greater GRFs that impact the soldier with each incremental addition of body borne load. The stiff leg, extended knee and large braking force the soldiers exhibited with the heavy load suggests their injury risk may be greatest with that specific load configuration. Further work is needed to determine if the biomechanical profile exhibited with the heavy load configuration translates to unsafe shear forces at the knee joint and consequently, a higher likelihood of injury. Published by Elsevier Ltd.

Biomechanical testing simulation of a cadaver spine specimen: development and evaluation study.

PubMed

Ahn, Hyung Soo; DiAngelo, Denis J

2007-05-15

This article describes a computer model of the cadaver cervical spine specimen and virtual biomechanical testing. To develop a graphics-oriented, multibody model of a cadaver cervical spine and to build a virtual laboratory simulator for the biomechanical testing using physics-based dynamic simulation techniques. Physics-based computer simulations apply the laws of physics to solid bodies with defined material properties. This technique can be used to create a virtual simulator for the biomechanical testing of a human cadaver spine. An accurate virtual model and simulation would complement tissue-based in vitro studies by providing a consistent test bed with minimal variability and by reducing cost. The geometry of cervical vertebrae was created from computed tomography images. Joints linking adjacent vertebrae were modeled as a triple-joint complex, comprised of intervertebral disc joints in the anterior region, 2 facet joints in the posterior region, and the surrounding ligament structure. A virtual laboratory simulation of an in vitro testing protocol was performed to evaluate the model responses during flexion, extension, and lateral bending. For kinematic evaluation, the rotation of motion segment unit, coupling behaviors, and 3-dimensional helical axes of motion were analyzed. The simulation results were in correlation with the findings of in vitro tests and published data. For kinetic evaluation, the forces of the intervertebral discs and facet joints of each segment were determined and visually animated. This methodology produced a realistic visualization of in vitro experiment, and allowed for the analyses of the kinematics and kinetics of the cadaver cervical spine. With graphical illustrations and animation features, this modeling technique has provided vivid and intuitive information.

Joint contact loading in forefoot and rearfoot strike patterns during running.

PubMed

Rooney, Brandon D; Derrick, Timothy R

2013-09-03

Research concerning forefoot strike pattern (FFS) versus rearfoot strike pattern (RFS) running has focused on the ground reaction force even though internal joint contact forces are a more direct measure of the loads responsible for injury. The main purpose of this study was to determine the internal loading of the joints for each strike pattern. A secondary purpose was to determine if converted FFS and RFS runners can adequately represent habitual runners with regards to the internal joint loading. Using inverse dynamics to calculate the net joint moments and reaction forces and optimization techniques to estimate muscle forces, we determined the axial compressive loading at the ankle, knee, and hip. Subjects consisted of 15 habitual FFS and 15 habitual RFS competitive runners. Each subject ran at a preferred running velocity with their habitual strike pattern and then converted to the opposite strike pattern. Plantar flexor muscle forces and net ankle joint moments were greater in the FFS running compared to the RFS running during the first half of the stance phase. The average contact forces during this period increased by 41.7% at the ankle and 14.4% at the knee joint during FFS running. Peak ankle joint contact force was 1.5 body weights greater during FFS running (p<0.05). There was no evidence to support a difference between habitual and converted running for joint contact forces. The increased loading at the ankle joint for FFS is an area of concern for individuals considering altering their foot strike pattern. Copyright © 2013 Elsevier Ltd. All rights reserved.

Assessing adolescents' personality with the NEO PI-R.

PubMed

De Fruyt, F; Mervielde, I; Hoekstra, H A; Rolland, J P

2000-12-01

The suitability of the Revised NEO Personality Inventory (NEO PI-R) to assess adolescents' personality traits was investigated in an unselected heterogeneous sample of 469 adolescents aged 12 to 17 years. They were further administered the Hierarchical Personality Inventory for Children (HiPIC) to allow an examination of convergent and discriminant validity. The adult NEO PI-R factor structure proved to be highly replicable in the sample of adolescents, with all facet scales primarily loading on the expected factors, independent of the age group. Domain and facet internal consistency coefficients were comparable to those obtained in adult samples, with less than 12% of the items showing corrected item-facet correlations below absolute value .20. Although, in general, adolescents reported few difficulties with the comprehensibility of the items, they tend to report more problems with the Openness to Ideas (05) and Openness to Values (06) items. Correlations between NEO PI-R and HiPIC scales underscored the convergent and discriminant validity of the NEO facets and HiPIC scales. It was concluded that the NEO PI-R in its present form is useful for assessing adolescents' traits at the primary level, but additional research is necessary to infer the most appropriate facet level structure.

EPA RESPONSE PROTOCOL TOOLBOX TO HELP EVALUATION OF CONTAMINATION THREATS & RESPONDING TO THREATS: MODULE 1-WATER UTILITY PLANNING GUIDE

EPA Science Inventory

EPA's Office of Research and Development and Office of Water/Water Security Division have jointly developed a Response Protocol Toolbox (RPTB) to address the complex, multi-faceted challenges of a water utility's planning and response to intentional contamination of drinking wate...

Do cervical epidural injections provide long-term relief in neck and upper extremity pain? A systematic review.

PubMed

Manchikanti, Laxmaiah; Nampiaparampil, Devi E; Candido, Kenneth D; Bakshi, Sanjay; Grider, Jay S; Falco, Frank J E; Sehgal, Nalini; Hirsch, Joshua A

2015-01-01

The high prevalence of chronic persistent neck pain not only leads to disability but also has a significant economic, societal, and health impact. Among multiple modalities of treatments prescribed in the management of neck and upper extremity pain, surgical, interventional and conservative modalities have been described. Cervical epidural injections are also common modalities of treatments provided in managing neck and upper extremity pain. They are administered by either an interlaminar approach or transforaminal approach. To determine the long-term efficacy of cervical interlaminar and transforaminal epidural injections in the treatment of cervical disc herniation, spinal stenosis, discogenic pain without facet joint pain, and post surgery syndrome. The literature search was performed from 1966 to October 2014 utilizing data from PubMed, Cochrane Library, US National Guideline Clearinghouse, previous systematic reviews, and cross-references. The evidence was assessed based on best evidence synthesis with Level I to Level V. There were 7 manuscripts meeting inclusion criteria. Of these, 4 assessed the role of interlaminar epidural injections for managing disc herniation or radiculitis, and 3 assessed these injections for managing central spinal stenosis, discogenic pain without facet joint pain, and post surgery syndrome. There were 4 high quality manuscripts. A qualitative synthesis of evidence showed there is Level II evidence for each etiology category. The evidence is based on one relevant, high quality trial supporting the efficacy of cervical interlaminar epidural injections for each particular etiology. There were no randomized trials available assessing the efficacy of cervical transforaminal epidural injections. Paucity of available literature, specifically conditions other than disc herniation. This systematic review with qualitative best evidence synthesis shows Level II evidence for the efficacy of cervical interlaminar epidural injections with local anesthetic with or without steroids, based on at least one high-quality relevant randomized control trial in each category for disc herniation, discogenic pain without facet joint pain, central spinal stenosis, and post surgery syndrome.

The morphological characteristics of the antebrachiocarpal joint of the cheetah (Acinonyx jubatus).

PubMed

Ohale, L O C; Groenewald, H B

2003-03-01

A morphological study of the structures of the antebrachiocarpal (AC) joint of the cheetah was carded out by dissection of eight forelimbs obtained from four adult cheetahs culled from the Kruger National Park, Republic of South Africa. The aim was to evaluate the deviations of this joint from the normal feline pattern and to consider their possible relationship to the cheetah's adaptation to speed. Although published data on the AC joint of the other felids show general resemblance to that of the cheetah, there are nevertheless slight, but significant variations and modifications which tend to suggest adaptation to speed. The shafts of the radius and ulna of the cheetah are relatively straight and slender, with poorly developed distal ends. The ulnar notch is reduced to a very shallow concavity while the corresponding ulnar facet is a barely noticeable convexity, separated from the distal ulnar articular facet by an ill-defined groove. The movement of the distal radio-ulnar joint is highly restricted by the presence of a fibro-cartilaginous structure and a strong interrosseous membrane, limiting pronation and supination normally achieved by the rotation of the radius around the ulna. The extensor grooves at the distal extremity of the radius are deep and narrow and are guarded by prominent ridges. A thick extensor retinaculum anchors the strong extensor tendons in these grooves. The distal articular surface of the radius is concave in all directions except at the point where it moves into its stylold process. At this point it is convex in the dorsopalmar direction, with a surface that is rather deep and narrow. The proximal row of carpal bones presents a strongly convex surface, which is more pronounced in the dorsopalmar direction with the greatest convexity on the lateral aspect. Medially, there is a ridge-like concavity across the base of the tubercle, which rocks on the flexor surface of the radius, limiting excessive flexion as well as restricting lateral deviation of the AC joint.

Dutch Multidisciplinary Guideline for Invasive Treatment of Pain Syndromes of the Lumbosacral Spine.

PubMed

Itz, Coen J; Willems, Paul C; Zeilstra, Dick J; Huygen, Frank J

2016-01-01

When conservative therapies such as pain medication or exercise therapy fail, invasive treatment may be indicated for patients with lumbosacral spinal pain. The Dutch Society of Anesthesiologists, in collaboration with the Dutch Orthopedic Association and the Dutch Neurosurgical Society, has taken the initiative to develop the guideline "Spinal low back pain," which describes the evidence regarding diagnostics and invasive treatment of the most common spinal low back pain syndromes, that is, facet joint pain, sacroiliac joint pain, coccygodynia, pain originating from the intervertebral disk, and failed back surgery syndrome. The aim of the guideline is to determine which invasive treatment intervention is preferred for each included pain syndrome when conservative treatment has failed. Diagnostic studies were evaluated using the EBRO criteria, and studies on therapies were evaluated with the Grading of Recommendations Assessment, Development and Evaluation system. For the evaluation of invasive treatment options, the guideline committee decided that the outcome measures of pain, function, and quality of life were most important. The definition, epidemiology, pathophysiological mechanism, diagnostics, and recommendations for invasive therapy for each of the spinal back pain syndromes are reported. The guideline committee concluded that the categorization of low back pain into merely specific or nonspecific gives insufficient insight into the low back pain problem and does not adequately reflect which therapy is effective for the underlying disorder of a pain syndrome. Based on the guideline "Spinal low back pain," facet joint pain, pain of the sacroiliac joint, and disk pain will be part of a planned nationwide cost-effectiveness study. © 2015 World Institute of Pain.

Time- and temperature-dependent failures of a bonded joint

NASA Astrophysics Data System (ADS)

Sihn, Sangwook

This dissertation summarizes my study of time- and temperature-dependent behavior of a tubular lap bonded joint to provide a design methodology for windmill blade structures. The bonded joint is between a cast-iron rod and a GFRP composite pipe. The adhesive material is an epoxy containing chopped glass fibers. We proposed a new fabrication method to make concentric and void-less specimens of the tubular joint with a thick adhesive bondline to stimulate the root bond of a blade. The thick bondline facilitates the joint assembly of actual blades. For a better understanding of the behavior of the bonded joint, we studied viscoelastic behavior of the adhesive materials by measuring creep compliance at several temperatures during loading period. We observed that the creep compliance depends highly on the period of loading and the temperature. We applied time-temperature equivalence to the creep compliance of the adhesive material to obtain time-temperature shift factors. We also performed constant-rate of monotonically increased uniaxial tensile tests to measure static strength of the tubular lap joint at several temperatures and different strain-rates. We observed two failure modes from load-deflection curves and failed specimens. One is the brittle mode, which was caused by weakness of the interfacial strength occurring at low temperature and short period of loading. The other is the ductile mode, which was caused by weakness of the adhesive material at high temperature and long period of loading. Transition from the brittle to the ductile mode appeared as the temperature or the loading period increased. We also performed tests under uniaxial tensile-tensile cyclic loadings to measure fatigue strength of the bonded joint at several temperatures, frequencies and stress ratios. The fatigue data are analyzed statistically by applying the residual strength degradation model to calculate statistical distribution of the fatigue life. Combining the time-temperature equivalence and the residual strength degradation model enables us to estimate the fatigue life of the bonded joint at different load levels, frequencies and temperatures with a certain probability. A numerical example shows how to apply the life estimation method to a structure subjected to a random load history by rainflow cycle counting.

From Cylindrical to Stretching Ridges and Wrinkles in Twisted Ribbons

NASA Astrophysics Data System (ADS)

Pham Dinh, Huy; Démery, Vincent; Davidovitch, Benny; Brau, Fabian; Damman, Pascal

2016-09-01

Twisted ribbons under tension exhibit a remarkably rich morphology, from smooth and wrinkled helicoids, to cylindrical or faceted patterns. This complexity emanates from the instability of the natural, helicoidal symmetry of the system, which generates both longitudinal and transverse stresses, thereby leading to buckling of the ribbon. Here, we focus on the tessellation patterns made of triangular facets. Our experimental observations are described within an "asymptotic isometry" approach that brings together geometry and elasticity. The geometry consists of parametrized families of surfaces, isometric to the undeformed ribbon in the singular limit of vanishing thickness and tensile load. The energy, whose minimization selects the favored structure among those families, is governed by the tensile work and bending cost of the pattern. This framework describes the coexistence lines in a morphological phase diagram, and determines the domain of existence of faceted structures.

Indian Hedgehog signaling pathway members are associated with magnetic resonance imaging manifestations and pathological scores in lumbar facet joint osteoarthritis.

PubMed

Shuang, Feng; Zhou, Ying; Hou, Shu-Xun; Zhu, Jia-Liang; Liu, Yan; Zhang, Chun-Li; Tang, Jia-Guang

2015-05-20

Indian Hedgehog (HH) has been shown to be involved in osteoarthritis (OA) in articular joints, where there is evidence that Indian HH blockade could ameliorate OA. It seems to play a prominent role in development of the intervertebral disc (IVD) and in postnatal maintenance. There is little work on IHH in the IVD. Hence the aim of the current study was to investigate the role of Indian Hedgehog in the pathology of facet joint (FJ) OA. 24 patients diagnosed with lumbar intervertebral disk herniation or degenerative spinal stenosis were included. Preoperative magnetic resonance imaging (MRI) and Osteoarthritis Research Society International (OARSI) histopathology grading system was correlated to the mRNA levels of GLI1, PTCH1, and HHIP in the FJs. The Weishaupt grading and OARSI scores showed high positive correlation (r = 0.894) (P < 0.01). MRI Weishaupt grades showed positive correlation with GLI1 (r = 0.491), PTCH1 (r = 0.444), and HHIP (r = 0.654) mRNA levels (P < 0.05 in each case). OARSI scores were also positively correlated with GLI1 (r = 0. 646), PTCH1 (r = 0. 518), and HHIP (r = 0.762) mRNA levels (P < 0.01 in each case). Cumulatively our findings indicate that Indian HH signaling is increased in OA and is perhaps a key component in OA pathogenesis and progression.

Structure-Specific Movement Patterns in Patients With Chronic Low Back Dysfunction Using Lumbar Combined Movement Examination.

PubMed

Monie, Aubrey P; Price, Roger I; Lind, Christopher R P; Singer, Kevin P

2017-06-01

A test-retest cohort study was conducted to assess the use of a novel computer-aided, combined movement examination (CME) to measure change in low back movement after pain management intervention in 17 cases of lumbar spondylosis. Additionally we desired to use a CME normal reference range (NRR) to compare and contrast movement patterns identified from 3 specific structural pathologic conditions: intervertebral disc, facet joint, and nerve root compression. Computer-aided CME was used before and after intervention, in a cohort study design, to record lumbar range of movement along with pain, disability, and health self-report questionnaires in 17 participants who received image-guided facet, epidural, and/or rhizotomy intervention. In the majority of cases, CME was reassessed after injection together with 2 serial self-reports after an average of 2 and 14 weeks. A minimal clinically important difference of 30% was used to interpret meaningful change in self-reports. A CME NRR (n = 159) was used for comparison with the 17 cases. Post hoc observation included subgrouping cases into 3 discrete pathologic conditions, intervertebral disc, facet dysfunction, and nerve root compression, in order to report intergroup differences in CME movement. Seven of the 17 participants stated that a "combined" movement was their most painful CME direction. Self-report outcome data indicated that 4 participants experienced significant improvement in health survey, 5 improved by ≥30% on low back function, and 8 reported that low back pain was more bothersome than stiffness, 6 of whom achieved the minimal clinically important difference for self-reported pain. Subgrouping of cases into structure-specific groups provided insight to different CME movement patterns. The use of CME assists in identifying atypical lumbar movement relative to an age and sex NRR. Data from this study, exemplified by representative case studies, provide preliminary evidence for distinct intervertebral disc, facet joint, and nerve root compression CME movement patterns in cases of chronic lumbar spondylosis. Copyright © 2017. Published by Elsevier Inc.

Identifying interactive effects of task demands in lifting on estimates of in vivo low back joint loads.

PubMed

Gooyers, Chad E; Beach, Tyson A C; Frost, David M; Howarth, Samuel J; Callaghan, Jack P

2018-02-01

This investigation examined interactions between the magnitude of external load, movement speed and (a)symmetry of load placement on estimates of in vivo joint loading in the lumbar spine during simulated occupational lifting. Thirty-two participants with manual materials handling experience were included in the study. Three-dimensional motion data, ground reaction forces, and activation of six bilateral trunk muscle groups were captured while participants performed lifts with two loads at two movement speeds and using two load locations. L4-L5 joint compression and shear force-time histories were estimated using an EMG-assisted musculoskeletal model of the lumbar spine. Results from this investigation provide strong evidence that known mechanical low back injury risk factors should not be viewed in isolation. Rather, injury prevention efforts need to consider the complex interactions that exist between external task demands and their combined influence on internal joint loading. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cumulative loads increase at the knee joint with slow-speed running compared to faster running: a biomechanical study.

PubMed

Petersen, Jesper; Sørensen, Henrik; Nielsen, Rasmus Østergaard

2015-04-01

Biomechanical cross-sectional study. To investigate the hypothesis that the cumulative load at the knee during running increases as running speed decreases. The knee joint load per stride decreases as running speed decreases. However, by decreasing running speed, the number of strides per given distance is increased. Running a given distance at a slower speed may increase the cumulative load at the knee joint compared with running the same distance at a higher speed, hence increasing the risk of running-related injuries in the knee. Kinematic and ground reaction force data were collected from 16 recreational runners, during steady-state running with a rearfoot strike pattern at 3 different speeds (mean ± SD): 8.02 ± 0.17 km/h, 11.79 ± 0.21 km/h, and 15.78 ± 0.22 km/h. The cumulative load (cumulative impulse) over a 1000-m distance was calculated at the knee joint on the basis of a standard 3-D inverse-dynamics approach. Based on a 1000-m running distance, the cumulative load at the knee was significantly higher at a slow running speed than at a high running speed (relative difference, 80%). The mean load per stride at the knee increased significantly across all biomechanical parameters, except impulse, following an increase in running speed. Slow-speed running decreases knee joint loads per stride and increases the cumulative load at the knee joint for a given running distance compared to faster running. The primary reason for the increase in cumulative load at slower speeds is an increase in number of strides needed to cover the same distance.

Stress analysis method for clearance-fit joints with bearing-bypass loads

NASA Technical Reports Server (NTRS)

Naik, R. A.; Crews, J. H., Jr.

1989-01-01

Within a multi-fastener joint, fastener holes may be subjected to the combined effects of bearing loads and loads that bypass the hole to be reacted elsewhere in the joint. The analysis of a joint subjected to search combined bearing and bypass loads is complicated by the usual clearance between the hole and the fastener. A simple analysis method for such clearance-fit joints subjected to bearing-bypass loading has been developed in the present study. It uses an inverse formulation with a linear elastic finite-element analysis. Conditions along the bolt-hole contact arc are specified by displacement constraint equations. The present method is simple to apply and can be implemented with most general purpose finite-element programs since it does not use complicated iterative-incremental procedures. The method was used to study the effects of bearing-bypass loading on bolt-hole contact angles and local stresses. In this study, a rigid, frictionless bolt was used with a plate having the properties of a quasi-isotropic graphite/epoxy laminate. Results showed that the contact angle as well as the peak stresses around the hole and their locations were strongly influenced by the ratio of bearing and bypass loads. For single contact, tension and compression bearing-bypass loading had opposite effects on the contact angle. For some compressive bearing-bypass loads, the hole tended to close on the fastener leading to dual contact. It was shown that dual contact reduces the stress concentration at the fastener and would, therefore, increase joint strength in compression. The results illustrate the general importance of accounting for bolt-hole clearance and contact to accurately compute local bolt-hole stresses for combined bearings and bypass loading.

The effect of glenosphere diameter in reverse shoulder arthroplasty on muscle force, joint load, and range of motion.

PubMed

Langohr, G Daniel G; Giles, Joshua W; Athwal, George S; Johnson, James A

2015-06-01

Little is known about the effects of glenosphere diameter on shoulder joint loads. The purpose of this biomechanical study was to investigate the effects of glenosphere diameter on joint load, load angle, and total deltoid force required for active abduction and range of motion in internal/external rotation and abduction. A custom, instrumented reverse shoulder arthroplasty implant system capable of measuring joint load and varying glenosphere diameter (38 and 42 mm) and glenoid offset (neutral and lateral) was implanted in 6 cadaveric shoulders to provide at least 80% power for all variables. A shoulder motion simulator was used to produce active glenohumeral and scapulothoracic motion. All implant configurations were tested with active and passive motion with joint kinematics, loads, and moments recorded. At neutral and lateralized glenosphere positions, increasing diameter significantly increased joint load (+12 ± 21 N and +6 ± 9 N; P < .01) and deltoid load required for active abduction (+9 ± 22 N and +11 ± 15 N; P < .02), whereas joint load angle was unaffected (P > .8). Passive internal rotation was reduced with increased diameter at both neutral and lateralized glenosphere positions (-6° ± 6° and -12° ± 6°; P < .002); however, external rotation was not affected (P > .05). At neutral glenosphere position, increasing diameter increased the maximum angles of both adduction (+1° ± 1°; P = .03) and abduction (+8° ± 9°; P < .05). Lateralization also increased abduction range of motion compared with neutral (P < .01). Although increasing glenosphere diameter significantly increased joint load and deltoid force, the clinical impact of these changes is presently unclear. Internal rotation, however, was reduced, which contradicts previous bone modeling studies, which we postulate is due to increased posterior capsular tension as it is forced to wrap around a larger 42 mm implant assembly. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Analysis of the Constraint Joint Loading in the Thumb During Pipetting.

PubMed

Wu, John Z; Sinsel, Erik W; Zhao, Kristin D; An, Kai-Nan; Buczek, Frank L

2015-08-01

Dynamic loading on articular joints is essential for the evaluation of the risk of the articulation degeneration associated with occupational activities. In the current study, we analyzed the dynamic constraint loading for the thumb during pipetting. The constraint loading is considered as the loading that has to be carried by the connective tissues of the joints (i.e., the cartilage layer and the ligaments) to maintain the kinematic constraints of the system. The joint loadings are solved using a classic free-body approach, using the external loading and muscle forces, which were obtained in an inverse dynamic approach combined with an optimization procedure in anybody. The constraint forces in the thumb joint obtained in the current study are compared with those obtained in the pinch and grasp tests in a previous study (Cooney and Chao, 1977, "Biomechanical Analysis of Static Forces in the Thumb During Hand Function," J. Bone Joint Surg. Am., 59(1), pp. 27-36). The maximal compression force during pipetting is approximately 83% and 60% greater than those obtained in the tip pinch and key pinch, respectively, while substantially smaller than that obtained during grasping. The maximal lateral shear force is approximately six times, 32 times, and 90% greater than those obtained in the tip pinch, key pinch, and grasp, respectively. The maximal dorsal shear force during pipetting is approximately 3.2 and 1.4 times greater than those obtained in the tip pinch and key pinch, respectively, while substantially smaller than that obtained during grasping. Our analysis indicated that the thumb joints are subjected to repetitive, intensive loading during pipetting, compared to other daily activities.

Joint Manipulation: Toward a General Theory of High-Velocity, Low-Amplitude Thrust Techniques.

PubMed

Harwich, Andrew S

2017-12-01

The objective of this study was to describe the initial stage of a generalized theory of high-velocity, low-amplitude thrust (HVLAT) techniques for joint manipulation. This study examined the movements described by authors from the fields of osteopathy, chiropractic, and physical therapy to produce joint cavitation in both the metacarpophalangeal (MCP) joint and the cervical spine apophysial joint. This study qualitatively compared the kinetics, the similarities, and the differences between MCP cavitation and cervical facet joint cavitation. A qualitative vector analysis of forces and movements was undertaken by constructing computer-generated, simplified graphical models of the MCP joint and a typical cervical apophysial joint and imposing the motions dictated by the clinical technique. Comparing the path to cavitation of 2 modes of HVLAT for the MCP joint, namely, distraction and hyperflexion, it was found that the hyperflexion method requires an axis of rotation, the hinge axis, which is also required for cervical HVLAT. These results show that there is an analogue of cervical HVLAT in one of the MCP joint HVLATs. The study demonstrated that in a theoretical model, the path to joint cavitation is the same for asymmetric separation of the joint surfaces in the cervical spine and the MCP joints.

Postero-Lateral Disc Prosthesis Combined With a Unilateral Facet Replacement Device Maintains Quantity and Quality of Motion at a Single Lumbar Level

PubMed Central

Nayak, Aniruddh N.; Doarn, Michael C.; Gaskins, Roger B.; James, Chris R.; Cabezas, Andres F.; Castellvi, Antonio E.

2014-01-01

Background Mechanically replacing one or more pain generating articulations in the functional spinal unit (FSU) may be a motion preservation alternative to arthrodesis at the affected level. Baseline biomechanical data elucidating the quantity and quality of motion in such arthroplasty constructs is non-existent. Purpose The purpose of the study was to quantify the motion-preserving effect of a posterior total disc replacement (PDR) combined with a unilateral facet replacement (FR) system at a single lumbar level (L4-L5). We hypothesized that reinforcement of the FSU with unilateral FR to replace the resected, native facet joint following PDR implantation would restore quality and quantity of motion and additionally not change biomechanics at the adjacent levels. Study Design In-vitro study using human cadaveric lumbar spines. Methods Six (n = 6) cadaveric lumbar spines (L1-S1) were evaluated using a pure-moment stability testing protocol (±7.5 Nm) in flexion-extension (F/E), lateral bending (LB) and axial rotation (AR). Each specimen was tested in: (1) intact; (2) unilateral FR; and (3) unilateral FR + PDR conditions. Index and adjacent level ROM (using hybrid protocol) were determined opto-electronically. Interpedicular travel (IPT) and instantaneous center of rotation (ICR) at the index level were radiographically determined for each condition. ROM, ICR, and IPT measurements were compared (repeated measures ANOVA) between the three conditions. Results Compared to the intact spine, no significant changes in F/E, LB or AR ROM were identified as a result of unilateral FR or unilateral FR + PDR. No significant changes in adjacent L3-L4 or L5-S1 ROM were identified in any loading mode. No significant differences in IPT were identified between the three test conditions in F/E, LB or AR at the L4-L5 level. The ICRs qualitatively were similar for the intact and unilateral FR conditions and appeared to follow placement (along the anterior-posterior (AP) direction) of the PDR in the disc space Conclusion Biomechanically, quantity and quality of motion are maintained with combined unilateral FR + PDR at a single lumbar spinal level. PMID:25694929

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prodan, V.D.

The working load on the fastening parts of a permanent tight joint, which determines the strength, and on the gasket, which determines the hermeticity of the joint, depends on the stress of preliminary tightening. This stress must be determined when calculating the force distribution of the joint, since it depends on the magnitude of the stress whether the joint is capable of withstanding the internal pressure of the medium in the vessel without disturbing the tightness of the joint and strength of its parts. The seal will be hermetic when the specific load on the sealing surfaces of the lenticularmore » gasket becomes equal to or higher than the specific load established for given conditions of pressure and properties of the sealing medium. The recommended specific load was calculated for nitrogen as the working medium. The required tightening stress was calculated for standard flange joints with a lenticular gasket of nominal diameter 25-200mm at a working pressure of 32 MPa. The equations given can also be used to calculate the stress of preliminary tightening of the fastening parts and of other types of permanent tight joints with partial radial self-sealing.« less

Medial Elbow Joint Space Increases With Valgus Stress and Decreases When Cued to Perform A Maximal Grip Contraction.

PubMed

Pexa, Brett S; Ryan, Eric D; Myers, Joseph B

2018-04-01

Previous research indicates that the amount of valgus torque placed on the elbow joint during overhead throwing is higher than the medial ulnar collateral ligament (UCL) can tolerate. Wrist and finger flexor muscle activity is hypothesized to make up for this difference, and in vitro studies that simulated activity of upper extremity musculature, specifically the flexor digitorum superficialis and flexor carpi ulnaris, support this hypothesis. To assess the medial elbow joint space at rest, under valgus stress, and under valgus stress with finger and forearm flexor contraction by use of ultrasonography in vivo. Controlled laboratory study. Participants were 22 healthy males with no history of elbow dislocation or UCL injury (age, 21.25 ± 1.58 years; height, 1.80 ± 0.08 m; weight, 79.43 ± 18.50 kg). Medial elbow joint space was measured by use of ultrasonography during 3 separate conditions: at rest (unloaded), under valgus load (loaded), and with a maximal grip contraction under a valgus load (loaded-contracted) in both limbs. Participants lay supine with their arm abducted 90° and elbow flexed 30° with the forearm in full supination. A handgrip dynamometer was placed in the participants' hand to grip against during the contracted condition. Images were reduced in ImageJ to assess medial elbow joint space. A 2-way (condition × limb) repeated-measures analysis of variance and Cohen's d effect sizes were used to assess changes in medial elbow joint space. Post hoc testing was performed with a Bonferroni adjustment to assess changes within limb and condition. The medial elbow joint space was significantly larger in the loaded condition (4.91 ± 1.16 mm) compared with the unloaded condition (4.26 ± 1.23 mm, P < .001, d = 0.712) and the loaded-contracted condition (3.88 ± 0.94 mm, P < .001, d = 1.149). No significant change was found between the unloaded and loaded-contracted conditions ( P = .137). Medial elbow joint space increases under a valgus load and then decreases when a maximal grip contraction is performed. This indicates that wrist and finger flexor muscle contraction may assist in limiting medial elbow joint space, a result similar to findings of previous research in vitro. Muscle activation of the upper extremity limits the medial elbow joint space, suggesting that injury prevention programs for throwing athletes should incorporate exercises for the elbow, wrist, and hand to limit excessive medial elbow joint space gapping during activities that create high valgus load.

Adaptive plasticity in mammalian masticatory joints

NASA Astrophysics Data System (ADS)

Ravosa, Matthew J.; Kunwar, Ravinder; Nicholson, Elisabeth K.; Klopp, Emily B.; Pinchoff, Jessie; Stock, Stuart R.; Stack, M. Sharon; Hamrick, Mark W.

2006-08-01

Genetically similar white rabbits raised on diets of different mechanical properties, as well as wild-type and myostatin-deficient mice raised on similar diets, were compared to assess the postweaning effects of elevated masticatory loads due to increased jaw-adductor muscle and bite forces on the proportions and properties of the mandibular symphysis and temporomandibular joint (TMJ). Microcomputed tomography (microCT) was used to quantify bone structure at a series of equidistant external and internal sites in coronal sections for a series of joint locations. Discriminant function analyses and non-parametric ANOVAs were used to characterize variation in biomineralization within and between loading cohorts. In both species, long-term excessive loading results in larger joint proportions, thicker articular and cortical bone, and increased biomineralization of hard tissues. Such adaptive plasticity appears designed to maintain the postnatal integrity of masticatory joint systems for a primary loading environment(s). This behavioral signal may be increasingly mitigated in older organisms by the interplay between adaptive and degradative joint tissue responses.

Some new evidence on human joint lubrication.

PubMed Central

Unsworth, A; Dowson, D; Wright, V

1975-01-01

Theoretical consideration has been given to the use of pendulum machines which are used to examine the frictional properties of human joints by incorporating them as fulcra. As a result, a new type of pendulum machine has been built which incorporates the facility to apply sudden loads to the joint on starting the swinging motion, and also the ability to measure directly the frictional torque experienced by the joint. The results obtained from natural hip joints indicate the presence of squeeze film lubrication under conditions of sudden loading of a joint. In addition, a self-generated fluid film process was observed at low loads while at higher loads boundary lubrication appeared to be important. These results have been used to describe the lubrication regimens occurring in a normal activity such as walking. A single experiment carried out on a hip from a patient suffering from severe rheumatoid arthritis has also been reported and the frictional resistance was seen to be increased fifteenfold compared to a normal hip. Images PMID:1190847

A Systems Biology Approach to Synovial Joint Lubrication in Health, Injury, and Disease

PubMed Central

Hui, Alexander Y.; McCarty, William J.; Masuda, Koichi; Firestein, Gary S.; Sah, Robert L.

2013-01-01

The synovial joint contains synovial fluid (SF) within a cavity bounded by articular cartilage and synovium. SF is a viscous fluid that has lubrication, metabolic, and regulatory functions within synovial joints. SF contains lubricant molecules, including proteoglycan-4 and hyaluronan. SF is an ultrafiltrate of plasma with secreted contributions from cell populations lining and within the synovial joint space, including chondrocytes and synoviocytes. Maintenance of normal SF lubricant composition and function are important for joint homeostasis. In osteoarthritis, rheumatoid arthritis, and joint injury, changes in lubricant composition and function accompany alterations in the cytokine and growth factor environment and increased fluid and molecular transport through joint tissues. Thus, understanding the synovial joint lubrication system requires a multi-faceted study of the various parts of the synovial joint and their interactions. Systems biology approaches at multiple scales are being used to describe the molecular, cellular, and tissue components and their interactions that comprise the functioning synovial joint. Analyses of the transcriptome and proteome of SF, cartilage, and synovium suggest that particular molecules and pathways play important roles in joint homeostasis and disease. Such information may be integrated with physicochemical tissue descriptions to construct integrative models of the synovial joint that ultimately may explain maintenance of health, recovery from injury, or development and progression of arthritis. PMID:21826801

A Revolute Joint With Linear Load-Displacement Response for Precision Deployable Structures

NASA Technical Reports Server (NTRS)

Lake, Mark S.; Warren, Peter A.; Peterson, Lee D.

1996-01-01

NASA Langley Research center is developing key structures and mechanisms technologies for micron-accuracy, in-space deployment of future space instruments. Achieving micron-accuracy deployment requires significant advancements in deployment mechanism design such as the revolute joint presented herein. The joint presented herein exhibits a load-cycling response that is essentially linear with less than two percent hysteresis, and the joint rotates with less than one in.-oz. of resistance. A prototype reflector metering truss incorporating the joint exhibits only a few microns of kinematic error under repeated deployment and impulse loading. No other mechanically deployable structure found in literature has been demonstrated to be this kinematically accurate.

Are the Kinematics of the Knee Joint Altered during the Loading Response Phase of Gait in Individuals with Concurrent Knee Osteoarthritis and Complaints of Joint Instability? A Dynamic Stereo X-ray Study

PubMed Central

Farrokhi, Shawn; Tashman, Scott; Gil, Alexandra B.; Klatt, Brian A.; Fitzgerald, G. Kelley

2011-01-01

Background Joint instability has been suggested as a risk factor for knee osteoarthritis and a cause of significant functional declines in those with symptomatic disease. However, the relationship between altered knee joint mechanics and self-reports of instability in individuals with knee osteoarthritis remains unclear. Methods Fourteen subjects with knee osteoarthritis and complaints of joint instability and 12 control volunteers with no history of knee disease were recruited for this study. Dynamic stereo X-ray technology was used to assess the three-dimensional kinematics of the knee joint during the loading response phase of gait. Findings Individuals with concurrent knee osteoarthritis and joint instability demonstrated significantly reduced flexion and internal/external rotation knee motion excursions during the loading response phase of gait (P < 0.01), while the total abduction/adduction range of motion was increased (P < 0.05). In addition, the coronal and transverse plane alignment of the knee joint at initial contact was significantly different (P < 0.05) for individuals with concurrent knee osteoarthritis and joint instability. However, the anteroposterior and mediolateral tibiofemoral joint positions at initial contact and the corresponding total joint translations were similar between groups during the loading phase of gait. Interpretations The rotational patterns of tibiofemoral joint motion and joint alignments reported for individuals with concurrent knee osteoarthritis and joint instability are consistent with those previously established for individuals with knee osteoarthritis. Furthermore, the findings of similar translatory tibiofemoral motion between groups suggest that self-reports of episodic joint instability in individuals with knee osteoarthritis may not necessarily be associated with adaptive alterations in joint arthrokinematics. PMID:22071429

Are the kinematics of the knee joint altered during the loading response phase of gait in individuals with concurrent knee osteoarthritis and complaints of joint instability? A dynamic stereo X-ray study.

PubMed

Farrokhi, Shawn; Tashman, Scott; Gil, Alexandra B; Klatt, Brian A; Fitzgerald, G Kelley

2012-05-01

Joint instability has been suggested as a risk factor for knee osteoarthritis and a cause of significant functional decline in those with symptomatic disease. However, the relationship between altered knee joint mechanics and self-reports of instability in individuals with knee osteoarthritis remains unclear. Fourteen subjects with knee osteoarthritis and complaints of joint instability and 12 control volunteers with no history of knee disease were recruited for this study. Dynamic stereo X-ray technology was used to assess the three-dimensional kinematics of the knee joint during the loading response phase of gait. Individuals with concurrent knee osteoarthritis and joint instability demonstrated significantly reduced flexion and internal/external rotation knee motion excursions during the loading response phase of gait (P<0.01), while the total abduction/adduction range of motion was increased (P<0.05). In addition, the coronal and transverse plane alignment of the knee joint at initial contact was significantly different (P<0.05) for individuals with concurrent knee osteoarthritis and joint instability. However, the anteroposterior and mediolateral tibiofemoral joint positions at initial contact and the corresponding total joint translations were similar between groups during the loading phase of gait. The rotational patterns of tibiofemoral joint motion and joint alignments reported for individuals with concurrent knee osteoarthritis and joint instability are consistent with those previously established for individuals with knee osteoarthritis. Furthermore, the findings of similar translatory tibiofemoral motion between groups suggest that self-reports of episodic joint instability in individuals with knee osteoarthritis may not necessarily be associated with adaptive alterations in joint arthrokinematics. Copyright © 2011 Elsevier Ltd. All rights reserved.

Relationship between leg extensor muscle strength and knee joint loading during gait before and after total knee arthroplasty.

PubMed

Vahtrik, Doris; Gapeyeva, Helena; Ereline, Jaan; Pääsuke, Mati

2014-01-01

The aim of the present study was to evaluate an isometric maximal voluntary contraction (MVC) force of the leg extensor muscles and its relationship with knee joint loading during gait prior and after total knee arthroplasty (TKA). Custom-made dynamometer was used to assess an isometric MVC force of the leg extensor muscles and 3-D motion analysis system was used to evaluate the knee joint loading during gait in 13 female patients (aged 49-68 years) with knee osteoarthritis. Patients were evaluated one day before, and three and six months following TKA in the operated and non-operated leg. Six months after TKA, MVC force of the leg extensor muscles for the operated leg did not differ significantly as compared to the preoperative level, whereas it remained significantly lower for the non-operated leg and controls. The knee flexion moment and the knee joint power during mid stance of gait was improved six months after TKA, remaining significantly lowered compared with controls. Negative moderate correlation between leg extensor muscles strength and knee joint loading for the operated leg during mid stance was noted three months after TKA. The correlation analysis indicates that due to weak leg extensor muscles, an excessive load is applied to knee joint during mid stance of gait in patients, whereas in healthy subjects stronger knee-surrounding muscles provide stronger knee joint loading during gait. III (correlational study). Copyright © 2013 Elsevier B.V. All rights reserved.

Hex ball torque test

NASA Technical Reports Server (NTRS)

Robinson, B. A.; Foster, C. L.

1986-01-01

A series of torque tests were performed on four flight-type hex ball universal joints in order to characterize and determine the actual load-carrying capability of this device. The universal joint is a part of manual actuation rods for scientific instruments within the Hubble Space Telescope. It was found that the hex ball will bind slightly during the initial load application. This binding did not affect the function of the universal joint, and the units would wear-in after a few additional loading cycles. The torsional yield load was approximately 50 ft-lb, and was consistent among the four test specimens. Also, the torque required to cause complete failure exceeded 80 ft-lb. It is concluded that the hex ball universal joint is suitable for its intended applications.

Reliability aspects of a composite bolted scarf joint. [in wing skin splice

NASA Technical Reports Server (NTRS)

Reed, D. L.; Eisenmann, J. R.

1975-01-01

The design, fabrication, static test, and fatigue test of both tension and compression graphite-epoxy candidates for a wing splice representative of a next-generation transport aircraft was the objective of the reported research program. A single-scarf bolted joint was selected as the design concept. Test specimens were designed and fabricated to represent an upper-surface and a lower-surface panel containing the splice. The load spectrum was a flight-by-flight random-load history including ground-air-ground loads. The results of the fatigue testing indicate that, for this type of joint, the inherent fatigue resistance of the laminate is reflected in the joint behavior and, consequently, the rate of damage accumulation is very slow under realistic fatigue loadings.

Early Response of Mouse Joint Tissues to Noninvasive Knee Injury Suggests Treatment Targets

PubMed Central

Wu, P.; Holguin, N.; Silva, M. J.; Fu, M.; Liao, W.; Sandell, L. J.

2015-01-01

Objective Joint trauma can lead to a spectrum of acute lesions, including cartilage degradation, ligament or meniscus tears, and synovitis, all potentially associated with osteoarthritis. The goal of this study was to generate and validate a murine model of knee joint trauma following non-invasive controlled injurious compression in vivo and to investigate early molecular events. Methods The right knees of 8-week old mice were placed in a hyperflexed position and subjected to compressive joint loading at one of three peak forces (3, 6, 9 N) for 60 cycles in a single loading period and harvested at 5, 9 and 14 days post loading (n=3–5 mice for each time point and for each loading). The left knees were not loaded and served as the contralateral controls. Histological, immunohistochemical and ELISA analyses were performed to evaluate acute pathologic features in chondrocyte viability, cartilage matrix metabolism, synovial reaction, and serum COMP levels. Results Acute joint pathology was associated with increased injurious loads. All loading regimens induced chondrocyte apoptosis, cartilage matrix degradation, disruption of cartilage collagen fibril arrangement, and increased levels of serum COMP. We also observed that 6N loading induced mild synovitis by day 5 whereas at 9 N, with tearing of the anterior cruciate ligament, severe posttraumatic synovitis and ectopic cartilage formation were observed. Conclusion We have established and analyzed some early events in a murine model of knee joint trauma with different degrees of over-loading in vivo. These results suggest that immediate therapies particularly targeted to apoptosis and synovial cell proliferation could affect the acute posttraumatic reaction to potentially limit chronic consequences and osteoarthritis. PMID:24470303

Gender dimorphic ACL strain in response to combined dynamic 3D knee joint loading: implications for ACL injury risk.

PubMed

Mizuno, Kiyonori; Andrish, Jack T; van den Bogert, Antonie J; McLean, Scott G

2009-12-01

While gender-based differences in knee joint anatomies/laxities are well documented, the potential for them to precipitate gender-dimorphic ACL loading and resultant injury risk has not been considered. To this end, we generated gender-specific models of ACL strain as a function of any six degrees of freedom (6DOF) knee joint load state via a combined cadaveric and analytical approach. Continuously varying joint forces and torques were applied to five male and five female cadaveric specimens and recorded along with synchronous knee flexion and ACL strain data. All data (approximately 10,000 samples) were submitted to specimen-specific regression analyses, affording ACL strain predictions as a function of the combined 6 DOF knee loads. Following individual model verifications, generalized gender-specific models were generated and subjected to 6 DOF external load scenarios consistent with both a clinical examination and a dynamic sports maneuver. The ensuing model-based strain predictions were subsequently examined for gender-based discrepancies. Male and female specimen-specific models predicted ACL strain within 0.51%+/-0.10% and 0.52%+/-0.07% of the measured data respectively, and explained more than 75% of the associated variance in each case. Predicted female ACL strains were also significantly larger than respective male values for both simulated 6 DOF load scenarios. Outcomes suggest that the female ACL will rupture in response to comparatively smaller external load applications. Future work must address the underlying anatomical/laxity contributions to knee joint mechanical and resultant ACL loading, ultimately affording prevention strategies that may cater to individual joint vulnerabilities.

Adaptive torque estimation of robot joint with harmonic drive transmission

NASA Astrophysics Data System (ADS)

Shi, Zhiguo; Li, Yuankai; Liu, Guangjun

2017-11-01

Robot joint torque estimation using input and output position measurements is a promising technique, but the result may be affected by the load variation of the joint. In this paper, a torque estimation method with adaptive robustness and optimality adjustment according to load variation is proposed for robot joint with harmonic drive transmission. Based on a harmonic drive model and a redundant adaptive robust Kalman filter (RARKF), the proposed approach can adapt torque estimation filtering optimality and robustness to the load variation by self-tuning the filtering gain and self-switching the filtering mode between optimal and robust. The redundant factor of RARKF is designed as a function of the motor current for tolerating the modeling error and load-dependent filtering mode switching. The proposed joint torque estimation method has been experimentally studied in comparison with a commercial torque sensor and two representative filtering methods. The results have demonstrated the effectiveness of the proposed torque estimation technique.

Knee Joint Loads and Surrounding Muscle Forces during Stair Ascent in Patients with Total Knee Replacement

PubMed Central

Rasnick, Robert; Standifird, Tyler; Reinbolt, Jeffrey A.; Cates, Harold E.

2016-01-01

Total knee replacement (TKR) is commonly used to correct end-stage knee osteoarthritis. Unfortunately, difficulty with stair climbing often persists and prolongs the challenges of TKR patents. Complete understanding of loading at the knee is of great interest in order to aid patient populations, implant manufacturers, rehabilitation, and future healthcare research. Musculoskeletal modeling and simulation approximates joint loading and corresponding muscle forces during a movement. The purpose of this study was to determine if knee joint loadings following TKR are recovered to the level of healthy individuals, and determine the differences in muscle forces causing those loadings. Data from five healthy and five TKR patients were selected for musculoskeletal simulation. Variables of interest included knee joint reaction forces (JRF) and the corresponding muscle forces. A paired samples t-test was used to detect differences between groups for each variable of interest (p<0.05). No differences were observed for peak joint compressive forces between groups. Some muscle force compensatory strategies appear to be present in both the loading and push-off phases. Evidence from knee extension moment and muscle forces during the loading response phase indicates the presence of deficits in TKR in quadriceps muscle force production during stair ascent. This result combined with greater flexor muscle forces resulted in similar compressive JRF during loading response between groups. PMID:27258086

Comparison of structural performance of one- and two-bay rotary joints for truss applications

NASA Technical Reports Server (NTRS)

Vail, J. Douglas; Lake, Mark S.

1991-01-01

The structural performance of one- and two-bay large-diameter discrete-bearing rotary joints was addressed for application to truss-beam structures such as the Space Station Freedom. Finite element analyses are performed to determine values for rotary joint parameters that give the same bending vibration frequency as the parent truss beam. The structural masses and maximum internal loads of these joints are compared to determine their relative structural efficiency. Results indicate that no significant difference exists in the masse of one- and two-bay rotary joints. This conclusion is reinforced with closed-form calculations of rotary joint structural efficiency in extension. Also, transition truss-member loads are higher in the one-bay rotary joint. However, because of the increased buckling strength of these members, the external load-carrying capability of the one-bay concept is higher than that of the two-bay concept.

Development of a Portable Knee Rehabilitation Device That Uses Mechanical Loading.

PubMed

Fitzwater, Daric; Dodge, Todd; Chien, Stanley; Yokota, Hiroki; Anwar, Sohel

2013-12-01

Joint loading is a recently developed mechanical modality, which potentially provides a therapeutic regimen to activate bone formation and prevent degradation of joint tissues. To our knowledge, however, few joint loading devices are available for clinical or point-of-care applications. Using a voice-coil actuator, we developed an electromechanical loading system appropriate for human studies and preclinical trials that should prove both safe and effective. Two specific tasks for this loading system were development of loading conditions (magnitude and frequency) suitable for humans, and provision of a convenient and portable joint loading apparatus. Desktop devices have been previously designed to evaluate the effects of various loading conditions using small and large animals. However, a portable knee loading device is more desirable from a usability point of view. In this paper, we present such a device that is designed to be portable, providing a compact, user-friendly loader. The portable device was employed to evaluate its capabilities using a human knee model. The portable device was characterized for force-pulse width modulation duty cycle and loading frequency properties. The results demonstrate that the device is capable of producing the necessary magnitude of forces at appropriate frequencies to promote the stimulation of bone growth and which can be used in clinical studies for further evaluations.

Experimental Investigation of the Influence of Joint Geometric Configurations on the Mechanical Properties of Intermittent Jointed Rock Models Under Cyclic Uniaxial Compression

NASA Astrophysics Data System (ADS)

Liu, Yi; Dai, Feng; Fan, Pengxian; Xu, Nuwen; Dong, Lu

2017-06-01

Intermittent joints in rock mass are quite sensitive to cyclic loading conditions. Understanding the fatigue mechanical properties of jointed rocks is beneficial for rational design and stability analysis of rock engineering projects. This study experimentally investigated the influences of joint geometry (i.e., dip angle, persistency, density and spacing) on the fatigue mechanism of synthetic jointed rock models. Our results revealed that the stress-strain curve of jointed rock under cyclic loadings is dominated by its curve under monotonic uniaxial loadings; the terminal strain in fatigue curve is equal to the post-peak strain corresponding to the maximum cyclic stress in the monotonic stress-strain curve. The four joint geometrical parameters studied significantly affect the fatigue properties of jointed rocks, including the irreversible strains, the fatigue deformation modulus, the energy evolution, the damage variable and the crack coalescence patterns. The higher the values of the geometrical parameters, the lower the elastic energy stores in this jointed rock, the higher the fatigue damage accumulates in the first few cycles, and the lower the fatigue life. The elastic energy has certain storage limitation, at which the fatigue failure occurs. Two basic micro-cracks, i.e., tensile wing crack and shear crack, are observed in cyclic loading and unloading tests, which are controlled principally by joint dip angle and persistency. In general, shear cracks only occur in the jointed rock with higher dip angle or higher persistency, and the jointed rock is characterized by lower fatigue strength, larger damage variable and lower fatigue life.

Heat Shield Employing Cured Thermal Protection Material Blocks Bonded in a Large-Cell Honeycomb Matrix

NASA Technical Reports Server (NTRS)

Zell, Peter

2012-01-01

A document describes a new way to integrate thermal protection materials on external surfaces of vehicles that experience the severe heating environments of atmospheric entry from space. Cured blocks of thermal protection materials are bonded into a compatible, large-cell honeycomb matrix that can be applied on the external surfaces of the vehicles. The honeycomb matrix cell size, and corresponding thermal protection material block size, is envisioned to be between 1 and 4 in. (.2.5 and 10 cm) on a side, with a depth required to protect the vehicle. The cell wall thickness is thin, between 0.01 and 0.10 in. (.0.025 and 0.25 cm). A key feature is that the honeycomb matrix is attached to the vehicle fs unprotected external surface prior to insertion of the thermal protection material blocks. The attachment integrity of the honeycomb can then be confirmed over the full range of temperature and loads that the vehicle will experience. Another key feature of the innovation is the use of uniform-sized thermal protection material blocks. This feature allows for the mass production of these blocks at a size that is convenient for quality control inspection. The honeycomb that receives the blocks must have cells with a compatible set of internal dimensions. The innovation involves the use of a faceted subsurface under the honeycomb. This provides a predictable surface with perpendicular cell walls for the majority of the blocks. Some cells will have positive tapers to accommodate mitered joints between honeycomb panels on each facet of the subsurface. These tapered cells have dimensions that may fall within the boundaries of the uniform-sized blocks.

The latent structure of personality functioning: Investigating criterion a from the alternative model for personality disorders in DSM-5.

PubMed

Zimmermann, Johannes; Böhnke, Jan R; Eschstruth, Rhea; Mathews, Alessa; Wenzel, Kristin; Leising, Daniel

2015-08-01

The alternative model for the classification of personality disorders (PD) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Section III comprises 2 major components: impairments in personality functioning (Criterion A) and maladaptive personality traits (Criterion B). In this study, we investigated the latent structure of Criterion A (a) within subdomains, (b) across subdomains, and (c) in conjunction with the Criterion B trait facets. Data were gathered as part of an online study that collected other-ratings by 515 laypersons and 145 therapists. Laypersons were asked to assess 1 of their personal acquaintances, whereas therapists were asked to assess 1 of their patients, using 135 items that captured features of Criteria A and B. We were able to show that (a) the structure within the Criterion A subdomains can be appropriately modeled using generalized graded unfolding models, with results suggesting that the items are indeed related to common underlying constructs but often deviate from their theoretically expected severity level; (b) the structure across subdomains is broadly in line with a model comprising 2 strongly correlated factors of self- and interpersonal functioning, with some notable deviations from the theoretical model; and (c) the joint structure of the Criterion A subdomains and the Criterion B facets broadly resembles the expected model of 2 plus 5 factors, albeit the loading pattern suggests that the distinction between Criteria A and B is somewhat blurry. Our findings provide support for several major assumptions of the alternative DSM-5 model for PD but also highlight aspects of the model that need to be further refined. (c) 2015 APA, all rights reserved).

Image-based multiscale mechanical modeling shows the importance of structural heterogeneity in the human lumbar facet capsular ligament.

PubMed

Zarei, Vahhab; Liu, Chao J; Claeson, Amy A; Akkin, Taner; Barocas, Victor H

2017-08-01

The lumbar facet capsular ligament (FCL) primarily consists of aligned type I collagen fibers that are mainly oriented across the joint. The aim of this study was to characterize and incorporate in-plane local fiber structure into a multiscale finite element model to predict the mechanical response of the FCL during in vitro mechanical tests, accounting for the heterogeneity in different scales. Characterization was accomplished by using entire-domain polarization-sensitive optical coherence tomography to measure the fiber structure of cadaveric lumbar FCLs ([Formula: see text]). Our imaging results showed that fibers in the lumbar FCL have a highly heterogeneous distribution and are neither isotropic nor completely aligned. The averaged fiber orientation was [Formula: see text] ([Formula: see text] in the inferior region and [Formula: see text] in the middle and superior regions), with respect to lateral-medial direction (superior-medial to inferior-lateral). These imaging data were used to construct heterogeneous structural models, which were then used to predict experimental gross force-strain behavior and the strain distribution during equibiaxial and strip biaxial tests. For equibiaxial loading, the structural model fit the experimental data well but underestimated the lateral-medial forces by [Formula: see text]16% on average. We also observed pronounced heterogeneity in the strain field, with stretch ratios for different elements along the lateral-medial axis of sample typically ranging from about 0.95 to 1.25 during a 12% strip biaxial stretch in the lateral-medial direction. This work highlights the multiscale structural and mechanical heterogeneity of the lumbar FCL, which is significant both in terms of injury prediction and microstructural constituents' (e.g., neurons) behavior.

Load Variation Influences on Joint Work During Squat Exercise in Reduced Gravity

NASA Technical Reports Server (NTRS)

DeWitt, John K.; Fincke, Renita S.; Logan, Rachel L.; Guilliams, Mark E.; Ploutz-Snyder, Lori L.

2011-01-01

Resistance exercises that load the axial skeleton, such as the parallel squat, are incorporated as a critical component of a space exercise program designed to maximize the stimuli for bone remodeling and muscle loading. Astronauts on the International Space Station perform regular resistance exercise using the Advanced Resistive Exercise Device (ARED). Squat exercises on Earth entail moving a portion of the body weight plus the added bar load, whereas in microgravity the body weight is 0, so all load must be applied via the bar. Crewmembers exercising in microgravity currently add approx.70% of their body weight to the bar load as compensation for the absence of the body weight. This level of body weight replacement (BWR) was determined by crewmember feedback and personal experience without any quantitative data. The purpose of this evaluation was to utilize computational simulation to determine the appropriate level of BWR in microgravity necessary to replicate lower extremity joint work during squat exercise in normal gravity based on joint work. We hypothesized that joint work would be positively related to BWR load.

Understanding how axial loads on the spine influence segmental biomechanics for idiopathic scoliosis patients: A magnetic resonance imaging study.

PubMed

Little, J P; Pearcy, M J; Izatt, M T; Boom, K; Labrom, R D; Askin, G N; Adam, C J

2016-02-01

Segmental biomechanics of the scoliotic spine are important since the overall spinal deformity is comprised of the cumulative coronal and axial rotations of individual joints. This study investigates the coronal plane segmental biomechanics for adolescent idiopathic scoliosis patients in response to physiologically relevant axial compression. Individual spinal joint compliance in the coronal plane was measured for a series of 15 idiopathic scoliosis patients using axially loaded magnetic resonance imaging. Each patient was first imaged in the supine position with no axial load, and then again following application of an axial compressive load. Coronal plane disc wedge angles in the unloaded and loaded configurations were measured. Joint moments exerted by the axial compressive load were used to derive estimates of individual joint compliance. The mean standing major Cobb angle for this patient series was 46°. Mean intra-observer measurement error for endplate inclination was 1.6°. Following loading, initially highly wedged discs demonstrated a smaller change in wedge angle, than less wedged discs for certain spinal levels (+2,+1,-2 relative to the apex, (p<0.05)). Highly wedged discs were observed near the apex of the curve, which corresponded to lower joint compliance in the apical region. While individual patients exhibit substantial variability in disc wedge angles and joint compliance, overall there is a pattern of increased disc wedging near the curve apex, and reduced joint compliance in this region. Approaches such as this can provide valuable biomechanical data on in vivo spinal biomechanics of the scoliotic spine, for analysis of deformity progression and surgical planning. Copyright © 2015 Elsevier Ltd. All rights reserved.

Is increased joint loading detrimental to obese patients with knee osteoarthritis? A secondary data analysis from a randomized trial.

PubMed

Henriksen, M; Hunter, D J; Dam, E B; Messier, S P; Andriacchi, T P; Lohmander, L S; Aaboe, J; Boesen, M; Gudbergsen, H; Bliddal, H; Christensen, R

2013-12-01

To investigate whether increased knee joint loading due to improved ambulatory function and walking speed following weight loss achieved over 16 weeks accelerates symptomatic and structural disease progression over a subsequent 1 year weight maintenance period in an obese population with knee osteoarthritis (OA). Data from a prospective study of weight loss in obese patients with knee OA (the CARtilage in obese knee OsteoarThritis (CAROT) study) were used to determine changes in knee joint compressive loadings (model estimated) during walking after a successful 16 week weight loss intervention. The participants were divided into 'Unloaders' (participants that reduced joint loads) and 'Loaders' (participants that increased joint loads). The primary symptomatic outcome was changes in knee symptoms, measured with the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire, during a subsequent 52 weeks weight maintenance period. The primary structural outcome was changes in tibiofemoral cartilage loss assessed semi-quantitatively (Boston Leeds Knee Osteoarthritis Score (BLOKS) from MRI after the 52 weight maintenance period. 157 participants (82% of the CAROT cohort) with medial and/or lateral knee OA were classified as Unloaders (n = 100) or Loaders (n = 57). The groups showed similar significant changes in symptoms (group difference: -2.4 KOOS points [95% CI -6.8:1.9]) and cartilage loss (group difference: -0.06 BLOKS points [95% CI -0.22:0.11) after 1 year, with no statistically significant differences between Loaders and Unloaders. For obese patients undergoing a significant weight loss, increased knee joint loading for 1 year was not associated with accelerated symptomatic and structural disease progression compared to a similar weight loss group that had reduced ambulatory compressive knee joint loads. NCT00655941. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Increasing Running Step Rate Reduces Patellofemoral Joint Forces

PubMed Central

Lenhart, Rachel L.; Thelen, Darryl G.; Wille, Christa M.; Chumanov, Elizabeth S.; Heiderscheit, Bryan C.

2013-01-01

Purpose Increasing step rate has been shown to elicit changes in joint kinematics and kinetics during running, and has been suggested as a possible rehabilitation strategy for runners with patellofemoral pain. The purpose of this study was to determine how altering step rate affects internal muscle forces and patellofemoral joint loads, and then to determine what kinematic and kinetic factors best predict changes in joint loading. Methods We recorded whole body kinematics of 30 healthy adults running on an instrumented treadmill at three step rate conditions (90%, 100%, and 110% of preferred step rate). We then used a 3D lower extremity musculoskeletal model to estimate muscle, patellar tendon, and patellofemoral joint forces throughout the running gait cycles. Additionally, linear regression analysis allowed us to ascertain the relative influence of limb posture and external loads on patellofemoral joint force. Results Increasing step rate to 110% of preferred reduced peak patellofemoral joint force by 14%. Peak muscle forces were also altered as a result of the increased step rate with hip, knee and ankle extensor forces, and hip abductor forces all reduced in mid-stance. Compared to the 90% step rate condition, there was a concomitant increase in peak rectus femoris and hamstring loads during early and late swing, respectively, at higher step rates. Peak stance phase knee flexion decreased with increasing step rate, and was found to be the most important predictor of the reduction in patellofemoral joint loading. Conclusion Increasing step rate is an effective strategy to reduce patellofemoral joint forces and could be effective in modulating biomechanical factors that can contribute to patellofemoral pain. PMID:23917470

Strain measurements in composite bolted-joint specimens

NASA Technical Reports Server (NTRS)

Hyer, M. W.; Lightfoot, M. C.; Perry, J. C.

1979-01-01

Strain data from a series of bolted joint tests is presented. Double lap, double hole, double lap, single hole, and open hole tensile specimens were tested and the strain gage locations, load strain responses, and load axial displacement responses are presented. The open hole specimens were gaged to determine strain concentration factors. The double lap, double hole specimens were gaged to determine the uniformity of the strain in the joint and the amount of load transferred past the first bolt. The measurements indicated roughly half the load passed the first bolt to be reacted by the second bolt.

Lamb Wave-Based Structural Health Monitoring on Composite Bolted Joints under Tensile Load

PubMed Central

Yang, Bin; Xuan, Fu-Zhen; Xiang, Yanxun; Li, Dan; Zhu, Wujun; Tang, Xiaojun; Xu, Jichao; Yang, Kang; Luo, Chengqiang

2017-01-01

Online and offline monitoring of composite bolted joints under tensile load were investigated using piezoelectric transducers. The relationships between Lamb wave signals, pre-tightening force, the applied tensile load, as well as the failure modes were investigated. Results indicated that S0/A0 wave amplitudes decrease with the increasing of load. Relationships between damage features and S0/A0 mode were built based on the finite element (FE) simulation and experimental results. The possibility of application of Lamb wave-based structure health monitoring in bolted joint-like composite structures was thus achieved. PMID:28773014

A chemical bath deposition route to facet-controlled Ag{sub 3}PO{sub 4} thin films with improved visible light photocatalytic activity

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gunjakar, Jayavant L.; Jo, Yun Kyung; Kim, In Young

A facile, economic, and reproducible chemical bath deposition (CBD) method is developed for the fabrication of facet-controlled Ag{sub 3}PO{sub 4} thin films with enhanced visible light photocatalytic activity. The fine-control of bath temperature, precursor, complexing agent, substrate, and solution pH is fairly crucial in preparing the facet-selective thin film of Ag{sub 3}PO{sub 4} nanocrystal. The change of precursor from silver nitrate to silver acetate makes possible the tailoring of the crystal shape of Ag{sub 3}PO{sub 4} from cube to rhombic dodecahedron and also the bandgap tuning of the deposited films. The control of [Ag{sup +}]/[phosphate] ratio enables to maximize themore » loading amount of Ag{sub 3}PO{sub 4} crystals per the unit area of the deposited film. All the fabricated Ag{sub 3}PO{sub 4} thin films show high photocatalytic activity for visible light-induced degradation of organic molecules, which can be optimized by tailoring the crystal shape of the deposited crystals. This CBD method is also useful in preparing the facet-controlled hybrid film of Ag{sub 3}PO{sub 4}–ZnO photocatalyst. The present study clearly demonstrates the usefulness of the present CBD method for fabricating facet-controlled thin films of metal oxosalt and its nanohybrid. - Highlights: • The crystal facet of Ag{sub 3}PO{sub 4} films can be tuned by chemical bath deposition. • The crystal shape of Ag{sub 3}PO{sub 4} is tailorable from cube to rhombic dodecahedron. • Facet-tuned Ag{sub 3}PO{sub 4} film shows enhanced visible light photocatalyst activity.« less

Biomechanics of unilateral and bilateral sacroiliac joint stabilization: laboratory investigation.

PubMed

Lindsey, Derek P; Parrish, Robin; Gundanna, Mukund; Leasure, Jeremi; Yerby, Scott A; Kondrashov, Dimitriy

2018-03-01

OBJECTIVE Bilateral symptoms have been reported in 8%-35% of patients with sacroiliac (SI) joint dysfunction. Stabilization of a single SI joint may significantly alter the stresses on the contralateral SI joint. If the contralateral SI joint stresses are significantly increased, degeneration may occur; alternatively, if the stresses are significantly reduced, bilateral stabilization may be unnecessary for patients with bilateral symptoms. The biomechanical effects of 1) unilateral stabilization on the contralateral SI joint and 2) bilateral stabilization on both SI joints are currently unknown. The objectives of this study were to characterize bilateral SI joint range of motion (ROM) and evaluate and compare the biomechanical effects of unilateral and bilateral implant placement for SI joint fusion. METHODS A lumbopelvic model (L5-pelvis) was used to test the ROM of both SI joints in 8 cadavers. A single-leg stance setup was used to load the lumbar spine and measure the ROM of each SI joint in flexion-extension, lateral bending, and axial rotation. Both joints were tested 1) while intact, 2) after unilateral stabilization, and 3) after bilateral stabilization. Stabilization consisted of lateral transiliac placement of 3 triangular titanium plasma-sprayed (TPS) implants. RESULTS Intact testing showed that during single-leg stance the contralateral SI joint had less ROM in flexion-extension (27%), lateral bending (32%), and axial rotation (69%) than the loaded joint. Unilateral stabilization resulted in significant reduction of flexion-extension ROM (46%) on the treated side; no significant ROM changes were observed for the nontreated side. Bilateral stabilization resulted in significant reduction of flexion-extension ROM of the primary (45%) and secondary (75%) SI joints. CONCLUSIONS This study demonstrated that during single-leg loading the ROMs for the stance (loaded) and swing (unloaded) SI joints are significantly different. Unilateral stabilization for SI joint dysfunction significantly reduces the ROM of the treated side, but does not significantly reduce the ROM of the nontreated contralateral SI joint. Bilateral stabilization is necessary to significantly reduce the ROM for both SI joints.

Facet joint injections for people with persistent non-specific low back pain (Facet Injection Study): a feasibility study for a randomised controlled trial.

PubMed

Ellard, David R; Underwood, Martin; Achana, Felix; Antrobus, James Hl; Balasubramanian, Shyam; Brown, Sally; Cairns, Melinda; Griffin, James; Griffiths, Frances; Haywood, Kirstie; Hutchinson, Charles; Lall, Ranjit; Petrou, Stavros; Stallard, Nigel; Tysall, Colin; Walsh, David A; Sandhu, Harbinder

2017-05-01

The National Institute for Health and Care Excellence (NICE) 2009 guidelines for persistent low back pain (LBP) do not recommend the injection of therapeutic substances into the back as a treatment for LBP because of the absence of evidence for their effectiveness. This feasibility study aimed to provide a stable platform that could be used to evaluate a randomised controlled trial (RCT) on the clinical effectiveness and cost-effectiveness of intra-articular facet joint injections (FJIs) when added to normal care. To explore the feasibility of running a RCT to test the hypothesis that, for people with suspected facet joint back pain, adding the option of intra-articular FJIs (local anaesthetic and corticosteroids) to best usual non-invasive care is clinically effective and cost-effective. The trial was a mixed design. The RCT pilot protocol development involved literature reviews and a consensus conference followed by a randomised pilot study with an embedded mixed-methods process evaluation. Five NHS acute trusts in England. Participants were patients aged ≥ 18 years with moderately troublesome LBP present (> 6 months), who had failed previous conservative treatment and who had suspected facet joint pain. The study aimed to recruit 150 participants (approximately 30 per site). Participants were randomised sequentially by a remote service to FJIs combined with 'best usual care' (BUC) or BUC alone. All participants were to receive six sessions of a bespoke BUC rehabilitation package. Those randomised into the intervention arm were, in addition, given FJIs with local anaesthetic and steroids (at up to six injection sites). Randomisation occurred at the end of the first BUC session. Process and clinical outcomes. Clinical outcomes included a measurement of level of pain on a scale from 0 to 10, which was collected daily and then weekly via text messaging (or through a written diary). Questionnaire follow-up was at 3 months. Fifty-two stakeholders attended the consensus meeting. Agreement informed several statistical questions and three design considerations: diagnosis, the process of FJI and the BUC package and informing the design for the randomised pilot study. Recruitment started on 26 June 2015 and was terminated by the funder (as a result of poor recruitment) on 11 December 2015. In total, 26 participants were randomised. Process data illuminate some of the reasons for recruitment problems but also show that trial processes after enrolment ran smoothly. No between-group analysis was carried out. All pain-related outcomes show the expected improvement between baseline and follow-up. The mean total cost of the overall treatment package (injection £419.22 and BUC £264.00) was estimated at £683.22 per participant. This is similar to a NHS tariff cost for a course of FJIs of £686.84. Poor recruitment was a limiting factor. This feasibility study achieved consensus on the main challenges in a trial of FJIs for people with persistent non-specific low back pain. Further work is needed to test recruitment from alternative clinical situations. EudraCT 2014-000682-50 and Current Controlled Trials ISRCTN93184143. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 21, No. 30. See the NIHR Journals Library website for further project information.

Successful NEES Grand Challenge Tests on Non-Ductile Beam-Column Joints

Science.gov Websites

potential of existing gravity load designed RC buildings is a great concern during intense seismic events evaluate unreinforced corner joints shear strength and axial residual capacity under high axial load axial load is 0.20f ’c Ag , while the overturning axial loads vary with displacement reversals to range

Putting the shoulder to the wheel: a new biomechanical model for the shoulder girdle.

PubMed

Levin, S M

1997-01-01

The least successfully modeled joint complex has been the shoulder. In multi-segmented mathematical shoulder models rigid beams (the bones) act as a series of columns or levers to transmit forces or loads to the axial skeleton. Forces passing through the almost frictionless joints must, somehow, always be directed perfectly perpendicular to the joints as only loads directed at right angles to the surfaces could transfer across frictionless joints. Loads transmitted to the axial skeleton would have to pass through the moving ribs or the weak jointed clavicle and then through the ribs. A new model of the shoulder girdle, based on the tension icosahedron described by Buckminster Fuller, is proposed that permits the compression loads passing through the arm and shoulder to be transferred to the axial skeleton through its soft tissues. In this model the scapula 'floats' in the tension network of shoulder girdle muscles just as the hub of the wire wheel is suspended in its tension network of spokes. With this construct inefficient beams and levers are eliminated. A more energy efficient, load distributing, integrated, hierarchical system is created.

Shear joint capability versus bolt clearance

NASA Technical Reports Server (NTRS)

Lee, H. M.

1992-01-01

The results of a conservative analysis approach into the determination of shear joint strength capability for typical space-flight hardware as a function of the bolt-hole clearance specified in the design are presented. These joints are comprised of high-strength steel fasteners and abutments constructed of aluminum alloys familiar to the aerospace industry. A general analytical expression was first arrived at which relates bolt-hole clearance to the bolt shear load required to place all joint fasteners into a shear transferring position. Extension of this work allowed the analytical development of joint load capability as a function of the number of fasteners, shear strength of the bolt, bolt-hole clearance, and the desired factor of safety. Analysis results clearly indicate that a typical space-flight hardware joint can withstand significant loading when less than ideal bolt hole clearances are used in the design.

A revolute joint with linear load-displacement response for a deployable lidar telescope

NASA Technical Reports Server (NTRS)

Lake, Mark S.; Warren, Peter A.; Peterson, Lee D.

1996-01-01

NASA Langley Research Center is developing concepts for an advanced spacecraft, called LidarTechSat, to demonstrate key structures and mechanisms technologies necessary to deploy a segmented telescope reflector. Achieving micron-accuracy deployment requires significant advancements in deployment mechanism design, such as the revolute joint presented herein. The joint exhibits load-cycling response that is essentially linear with less than 2% hysteresis, and the joint rotates with less than 7 mN-m (1 in-oz) of resistance. A prototype reflector metering truss incorporating the joint exhibits only a few microns of kinematic error under repected deployment and impulse loading. No other mechanically deployment structure found in the literature has been demonstrated to be this kinematically accurate.

An in vitro assessment of the effect of load and pH on wear between opposing enamel and dentine surfaces.

PubMed

Ranjitkar, Sarbin; Kaidonis, John A; Townsend, Grant C; Vu, Anh M; Richards, Lindsay C

2008-11-01

Previous in vitro studies have described the wear characteristics of specimens in which enamel has been opposed to enamel and dentine opposed to dentine. The aim of this study was to assess the characteristics of wear between specimens in which enamel was opposed to dentine at loads simulating attrition and at pH values simulating different erosive environments. It was hypothesized that enamel would wear more slowly than dentine under all conditions. Opposing enamel and dentine specimens from 57 human third molar teeth were worn in electromechanical machines with various loads (32, 62 and 100 N) and lubricants (pH 1.2, 3.0 and 6.1). Tooth wear was quantified by measuring reduction in dentine volume over time using a 3D profilometer. Qualitative assessment was also carried out using scanning electron microscopy. Dentine wear increased with increasing load, and dentine wear was faster at pH 1.2 than at pH 3.0 or 6.1 for all loads tested. Interestingly, enamel wore more rapidly than dentine at pH 1.2 under all loads. At pH values of 3.0 and 6.1, enamel wear rates were not measurably different from zero and they were less than wear rates for opposing dentine specimens at all loads. Micrographic assessment showed extensive surface destruction of dentine wear facets due to erosion at pH 1.2. Dentine wear facets were smoother at pH 3.0 that at pH 6.1. When enamel wears against dentine in an acidic environment enamel will wear more rapidly at very low pH, while under less acid conditions dentine will wear faster than enamel.

Tips, techniques and suggestions for improving learning from escaped prescribed fire reviews

Treesearch

Anne Black; Dave Thomas; Jennifer Ziegler; Jim Saveland

2012-01-01

In 2011, we held five 2-day workshops at various locations around the US as part of a Joint Fire Science Program project to understand 'learning from escaped prescribed fire reviews'. Each workshop drew an interagency audience with representation from all facets of fire management, from ground personnel to local line officers, regional, and national positions...

Tips, techniques, and suggestions for improving learning from escaped prescribed fire reviews (Poster Abstract)

Treesearch

Anne Black; Dave Thomas; Jennifer Ziegler; Jim Saveland

2012-01-01

In 2011, we held five 2-day workshops at various locations around the US as part of a Joint Fire Science Program project to understand 'learning from escaped prescribed fire reviews'. Each workshop drew an interagency audience with representation from all facets of fire management, from ground personnel to local line officers, regional, and national positions...

Facets of Spirituality as Predictors of Adjustment to Cancer: Relative Contributions of Having Faith and Finding Meaning

ERIC Educational Resources Information Center

Yanez, Betina; Edmondson, Donald; Stanton, Annette L.; Park, Crystal L.; Kwan, Lorna; Ganz, Patricia A.; Blank, Thomas O.

2009-01-01

Spirituality is a multidimensional construct, and little is known about how its distinct dimensions jointly affect well-being. In longitudinal studies (Study 1, n = 418 breast cancer patients; Study 2, n = 165 cancer survivors), the authors examined 2 components of spiritual well-being (i.e., meaning/peace and faith) and their interaction, as well…

[Quality of life of people living with HIV/AIDS and its relationship with CD4+ lymphocytes, viral load and time of diagnosis].

PubMed

Ferreira, Brunno Elias; Oliveira, Isabele Mendes; Paniago, Anamaria Mello Miranda

2012-03-01

Quality of life (QOL) has accompanied the treatment of AIDS patients, along with pharmacological innovations that have allowed patients to live longer and maintain their well-being. The present study aimed at evaluating the QOL of these patients and correlate it with clinical and laboratory data. The study included 205 patients with HIV/AIDS, who answered the WHOQOL-120-HIV; and whose socio-demographic data, clinical and laboratory findings were collected. The average age was 40.59 ± 11.81 years; CD4+ lymphocyte count, 397.9 ± 232.84 mm³; and years of diagnosis of HIV, 5.23 ± 3.94. Viral load was <50 copies/ml in 115 patients; 50 to 10.000 in 61; and above 10.000 copies in 29 patients. Domains achieved satisfactory average scores, and the best were the psychological (14.5 ± 2.7), followed by social relationships (13.7 ± 2.2), physical (12.7 ± 3.5), independence (12.6 ± 2.5), personal beliefs (12.4 ± 2.4), and environment (12.4 ± 1.8). The best scores on pain, pleasure, social support, physical environment, and personal belief facets were observed for those with higher CD4 levels (p < 0.05). The best scores for the finance, leisure, concerns about the future, overall QOL, and perceived health facets were observed for patients with viral load <50 (p < 0.05). The highest rates for energy, fatigue, sexual activity, information, transportation, symptoms, care, and concerns about the future facets were seen in patients with less time of diagnosis (p < 0.05). HIV/AIDS patients in the study had an intermediate QOL correlating to CD4 levels, VL, and time of diagnosis.

Adjacent level effects of bi level disc replacement, bi level fusion and disc replacement plus fusion in cervical spine--a finite element based study.

PubMed

Faizan, Ahmad; Goel, Vijay K; Biyani, Ashok; Garfin, Steven R; Bono, Christopher M

2012-03-01

Studies delineating the adjacent level effect of single level disc replacement systems have been reported in literature. The aim of this study was to compare the adjacent level biomechanics of bi-level disc replacement, bi-level fusion and a construct having adjoining level disc replacement and fusion system. In total, biomechanics of four models- intact, bi level disc replacement, bi level fusion and fusion plus disc replacement at adjoining levels- was studied to gain insight into the effects of various instrumentation systems on cranial and caudal adjacent levels using finite element analysis (73.6N+varying moment). The bi-level fusion models are more than twice as stiff as compared to the intact model during flexion-extension, lateral bending and axial rotation. Bi-level disc replacement model required moments lower than intact model (1.5Nm). Fusion plus disc replacement model required moment 10-25% more than intact model, except in extension. Adjacent level motions, facet loads and endplate stresses increased substantially in the bi-level fusion model. On the other hand, adjacent level motions, facet loads and endplate stresses were similar to intact for the bi-level disc replacement model. For the fusion plus disc replacement model, adjacent level motions, facet loads and endplate stresses were closer to intact model rather than the bi-level fusion model, except in extension. Based on our finite element analysis, fusion plus disc replacement procedure has less severe biomechanical effects on adjacent levels when compared to bi-level fusion procedure. Bi-level disc replacement procedure did not have any adverse mechanical effects on adjacent levels. Copyright © 2011 Elsevier Ltd. All rights reserved.

The influence of minimalist footwear and stride length reduction on lower-extremity running mechanics and cumulative loading.

PubMed

Firminger, Colin R; Edwards, W Brent

2016-12-01

To examine the effects of shoe type and stride length reduction on lower-extremity running mechanics and cumulative loading. Within-subject with four conditions: (1) control shoe at preferred stride length; (2) control shoe at 90% preferred stride length; (3) minimalist shoe at preferred stride length; (4) minimalist shoe at 90% preferred stride length. Fourteen young healthy males ran overground at their preferred speed while motion capture, force platform, and plantar pressure data were collected. Peak moments, impulse, mechanical work, and cumulative impulse were calculated at the metatarsophalangeal, ankle, and knee joint, and compared between conditions using a 2×2 factor repeated measures ANOVA. In general, running in minimalist footwear increased measures of loading at the metatarsophalangeal joint and ankle joint (mean increases of 7.3% and 5.9%, respectively), but decreased measures of loading at the knee (mean decrease of 7.3%). Conversely, running with reduced stride length decreased single-stance measures of loading at the ankle and knee joint (ranging from -0.9% to -20.5%), though cumulative impulse was higher at the ankle and lower at the knee. Running in minimalist shoes increased loads at the metatarsophalangeal and ankle joint, which may explain some of the incidence of overuse injuries observed in minimalist shoe users. Decreased ankle loads at 90% preferred stride length were not necessarily sufficient to reduce cumulative loads when impulse and loading cycles were weighted equally. Knee loads decreased more when running at 90% preferred stride length (16.2% mean reduction) versus running in a minimalist shoe (7.3% mean reduction), but both load reduction mechanisms appeared to have an additive effect (22.2% mean reduction). Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Load Dependency of Postural Control--Kinematic and Neuromuscular Changes in Response to over and under Load Conditions.

PubMed

Ritzmann, Ramona; Freyler, Kathrin; Weltin, Elmar; Krause, Anne; Gollhofer, Albert

2015-01-01

Load variation is associated with changes in joint torque and compensatory reflex activation and thus, has a considerable impact on balance control. Previous studies dealing with over (OL) and under loading (UL) used water buoyancy or additional weight with the side effects of increased friction and inertia, resulting in substantially modified test paradigms. The purpose of this study was to identify gravity-induced load dependency of postural control in comparable experimental conditions and to determine the underlying neuromuscular mechanisms. Balance performance was recorded under normal loading (NL, 1 g), UL (0.16 g 0.38 g) and OL (1.8 g) in monopedal stance. Center of pressure (COP) displacement and frequency distribution (low 0.15-0.5 Hz (LF), medium 0.5-2 Hz (MF), high 2-6 Hz (HF)) as well as ankle, knee and hip joint kinematics were assessed. Soleus spinal excitability was determined by H/M-recruitment curves (H/M-ratios). Compared to NL, OL caused an increase in ankle joint excursion, COP HF domain and H/M-ratio. Concomitantly, hip joint excursion and COP LF decreased. Compared to NL, UL caused modulations in the opposite direction: UL decreased ankle joint excursions, COP HF and H/M-ratio. Collaterally, hip joint excursion and COP LF increased. COP was augmented both in UL and in OL compared to NL. Subjects achieved postural stability in OL and UL with greater difficulty compared to NL. Reduced postural control was accompanied by modified balance strategies and compensatory reflex activation. With increasing load, a shift from hip to ankle strategy was observed. Accompanying, COP frequency distribution shifted from LF to HF and spinal excitability was enhanced. It is suggested that in OL, augmented ankle joint torques are compensated by quick reflex-induced postural reactions in distal muscles. Contrarily, UL is associated with diminished joint torques and thus, postural equilibrium may be controlled by the proximal segments to adjust the center of gravity above the base of support.

Medial knee joint contact force in the intact limb during walking in recently ambulatory service members with unilateral limb loss: a cross-sectional study

PubMed Central

Krupenevich, Rebecca L.; Pruziner, Alison L.; Wolf, Erik J.; Schnall, Barri L.

2017-01-01

Background Individuals with unilateral lower limb amputation have a high risk of developing knee osteoarthritis (OA) in their intact limb as they age. This risk may be related to joint loading experienced earlier in life. We hypothesized that loading during walking would be greater in the intact limb of young US military service members with limb loss than in controls with no limb loss. Methods Cross-sectional instrumented gait analysis at self-selected walking speeds with a limb loss group (N = 10, age 27 ± 5 years, 170 ± 36 days since last surgery) including five service members with transtibial limb loss and five with transfemoral limb loss, all walking independently with their first prosthesis for approximately two months. Controls (N = 10, age 30 ± 4 years) were service members with no overt demographical risk factors for knee OA. 3D inverse dynamics modeling was performed to calculate joint moments and medial knee joint contact forces (JCF) were calculated using a reduction-based musculoskeletal modeling method and expressed relative to body weight (BW). Results Peak JCF and maximum JCF loading rate were significantly greater in limb loss (184% BW, 2,469% BW/s) vs. controls (157% BW, 1,985% BW/s), with large effect sizes. Results were robust to probabilistic perturbations to the knee model parameters. Discussion Assuming these data are reflective of joint loading experienced in daily life, they support a “mechanical overloading” hypothesis for the risk of developing knee OA in the intact limb of limb loss subjects. Examination of the evolution of gait mechanics, joint loading, and joint health over time, as well as interventions to reduce load or strengthen the ability of the joint to withstand loads, is warranted. PMID:28168120

Program Evaluation of Outcomes Based Orthotic and Prosthetic Education

DTIC Science & Technology

2006-12-01

Rheumatoid Arthritis; synovial joints ; tendon sheaths. b. Osteoarthritis; weight bearing joints ; loading areas. c. Osteoporosis; cancellous bone...flexion. 32. The desirable length of a thumb post is: a. to the thumb IP joint . b. proximal to the IP joint . c. to the nail bed. d. just...assist hyperextension of the thoracic spine. b. eliminate motion. c. prevent lumbar flexion. d. reduce axial load on lumbar vertebrae. 44

Hydrostatic self-aligning axial/torsional mechanism

DOEpatents

O'Connor, Daniel G.; Gerth, Howard L.

1990-01-01

The present invention is directed to a self-aligning axial/torsional loading mechanism for testing the strength of brittle materials which are sensitive to bending moments. Disposed inside said self-aligning loading mechanism is a frictionless hydrostatic ball joint with a flexure ring to accommodate torsional loads through said ball joint.

Therapeutic efficacy of intra-articular hyaluronan derivative and platelet-rich plasma in mice following axial tibial loading

PubMed Central

Duan, Xin; Sandell, Linda J.; Chinzei, Nobuaki; Holguin, Nilsson; Silva, Matthew J.; Schiavinato, Antonella

2017-01-01

Objective To investigate the therapeutic potential of intra-articular hyaluronan-derivative HYADD® 4-G and/or platelet-rich plasma (PRP) in a mouse model of non-invasive joint injury. Methods Non-invasive axial tibial loading was used to induce joint injury in 10-week-old C57BL/6J mice (n = 86). Mice underwent a single loading of either 6 Newton (N) or 9N axial tibial compression. HYADD® 4-G was injected intra-articularly at 8 mg/mL or 15 mg/mL either before or after loading with or without PRP. Phosphate-buffered-saline was injected as control. Knee joints were harvested at 5 or 56 days post-loading and prepared for micro-computed tomography scanning and subsequently processed for histology. Immunostaining was performed for aggrecan to monitor its distribution, for CD44 to monitor chondrocyte reactive changes and for COMP (cartilage oligomeric matrix protein) as an index for cartilage matrix changes related to loading and cartilage injury. TUNEL assay was performed to identify chondrocyte apoptosis. Results Loading initiated cartilage proteoglycan loss and chondrocyte apoptosis within 5 days with slowly progressive post-traumatic osteoarthritis (no cartilage degeneration, but increased synovitis and ectopic calcification after 9N loading) at 56 days. Mice treated with repeated HYADD® 4-G (15 mg/mL) or HYADD® 4-G (8 mg/mL) ± PRP or PRP alone exhibited no significant improvement in the short-term (5 days) and long-term (56 days) consequences of joint loading except for a trend for improved bone changes compared to non-loaded joints. Conclusion While we failed to show an overall effect of intra-articular delivery of hyaluronan-derivative and/or PRP in reversing/protecting the pathological events in cartilage and synovium following joint injury, some bone alterations were relatively less severe with hyaluronan-derivative at higher concentration or in association with PRP. PMID:28406954

Force measurements in the medial meniscus posterior horn attachment: effects of anterior cruciate ligament removal.

PubMed

Markolf, Keith L; Jackson, Steven R; McAllister, David R

2012-02-01

Tears of the medial meniscus posterior horn attachment (PHA) occur clinically, and an anterior cruciate ligament (ACL)-deficient knee may be more vulnerable to this injury. The PHA forces from applied knee loadings will increase after removal of the ACL. Controlled laboratory study. A cap of bone containing the medial meniscus PHA was attached to a load cell that measured PHA tensile force. Posterior horn attachment forces were recorded before and after ACL removal during anteroposterior (AP) laxity testing at ±200 N and during passive knee extension tests with 5 N·m tibial torque and varus-valgus moment. Selected tests were also performed with 500 N joint load. For AP tests with no joint load, ACL removal increased laxity between 0° and 90° and increased PHA force generated by applied anterior tibial force between 30° and 90°. For AP tests with an intact ACL, application of joint load approximately doubled PHA forces. Anteroposterior testing of ACL-deficient knees was not possible with joint load because of bone cap failures from high PHA forces. Removal of the ACL during knee extension tests under joint load significantly increased PHA forces between 20° and 90° of flexion. For unloaded tests with applied tibial torque and varus-valgus moment, ACL removal had no significant effect on PHA forces. Applied anterior tibial force and external tibial torque were loading modes that produced relatively high PHA forces, presumably by impingement of the medial femoral condyle against the medial meniscus posterior horn rim. Under joint load, an ACL-deficient knee was particularly susceptible to PHA injury from applied anterior tibial force. Because tensile forces developed in the PHA are also borne by meniscus tissue near the attachment site, loading mechanisms that produce high PHA forces could also produce complete or partial radial tears near the posterior horn, a relatively common clinical observation.

Loading Analysis of Composite Wind Turbine Blade for Fatigue Life Prediction of Adhesively Bonded Root Joint

NASA Astrophysics Data System (ADS)

Salimi-Majd, Davood; Azimzadeh, Vahid; Mohammadi, Bijan

2015-06-01

Nowadays wind energy is widely used as a non-polluting cost-effective renewable energy resource. During the lifetime of a composite wind turbine which is about 20 years, the rotor blades are subjected to different cyclic loads such as aerodynamics, centrifugal and gravitational forces. These loading conditions, cause to fatigue failure of the blade at the adhesively bonded root joint, where the highest bending moments will occur and consequently, is the most critical zone of the blade. So it is important to estimate the fatigue life of the root joint. The cohesive zone model is one of the best methods for prediction of initiation and propagation of debonding at the root joint. The advantage of this method is the possibility of modeling the debonding without any requirement to the remeshing. However in order to use this approach, it is necessary to analyze the cyclic loading condition at the root joint. For this purpose after implementing a cohesive interface element in the Ansys finite element software, one blade of a horizontal axis wind turbine with 46 m rotor diameter was modelled in full scale. Then after applying loads on the blade under different condition of the blade in a full rotation, the critical condition of the blade is obtained based on the delamination index and also the load ratio on the root joint in fatigue cycles is calculated. These data are the inputs for fatigue damage growth analysis of the root joint by using CZM approach that will be investigated in future work.

Gender Dimorphic ACL Strain In Response to Combined Dynamic 3D Knee Joint Loading: Implications for ACL Injury Risk

PubMed Central

Mizuno, Kiyonori; Andrish, Jack T.; van den Bogert, Antonie J.; McLean, Scott G.

2009-01-01

While gender-based differences in knee joint anatomies/laxities are well documented, the potential for them to precipitate gender-dimorphic ACL loading and resultant injury risk has not been considered. To this end, we generated gender-specific models of ACL strain as a function of any six degrees of freedom (6DOF) knee joint load state via a combined cadaveric and analytical approach. Continuously varying joint forces and torques were applied to five male and five female cadaveric specimens and recorded along with synchronous knee flexion and ACL strain data. All data (~10,000 samples) were submitted to specimen-specific regression analyses, affording ACL strain predictions as a function of the combined 6 DOF knee loads. Following individual model verifications, generalized gender-specific models were generated and subjected to 6 DOF external load scenarios consistent with both a clinical examination and a dynamic sports maneuver. The ensuing model-based strain predictions were subsequently examined for gender-based discrepancies. Male and female specimen specific models predicted ACL strain within 0.51% ± 0.10% and 0.52% ± 0.07% of the measured data respectively, and explained more than 75% of the associated variance in each case. Predicted female ACL strains were also significantly larger than respective male values for both of simulated 6 DOF load scenarios. Outcomes suggest that the female ACL will rupture in response to comparatively smaller external load applications. Future work must address the underlying anatomical/laxity contributions to knee joint mechanical and resultant ACL loading, ultimately affording prevention strategies that may cater to individual joint vulnerabilities. PMID:19464897

Strength and failure analysis of composite-to-composite adhesive bonds with different surface treatments

NASA Astrophysics Data System (ADS)

Paranjpe, Nikhil; Alamir, Mohammed; Alonayni, Abdullah; Asmatulu, Eylem; Rahman, Muhammad M.; Asmatulu, Ramazan

2018-03-01

Adhesives are widely utilized materials in aviation, automotive, energy, defense, and marine industries. Adhesive joints are gradually supplanting mechanical fasteners because they are lightweight structures, thus making the assembly lighter and easier. They also act as a sealant to prevent a structural joint from galvanic corrosion and leakages. Adhesive bonds provide high joint strength because of the fact that the load is distributed uniformly on the joint surface, while in mechanical joints, the load is concentrated at one point, thus leading to stress at that point and in turn causing joint failures. This research concentrated on the analysis of bond strength and failure loads in adhesive joint of composite-to-composite surfaces. Different durations of plasma along with the detergent cleaning were conducted on the composite surfaces prior to the adhesive applications and curing processes. The joint strength of the composites increased about 34% when the surface was plasma treated for 12 minutes. It is concluded that the combination of different surface preparations, rather than only one type of surface treatment, provides an ideal joint quality for the composites.

Bolted joints in graphite-epoxy composites

NASA Technical Reports Server (NTRS)

Hart-Smith, L. J.

1976-01-01

All-graphite/epoxy laminates and hybrid graphite-glass/epoxy laminates were tested. The tests encompassed a range of geometries for each laminate pattern to cover the three basic failure modes - net section tension failure through the bolt hole, bearing and shearout. Static tensile and compressive loads were applied. A constant bolt diameter of 6.35 mm (0.25 in.) was used in the tests. The interaction of stress concentrations associated with multi-row bolted joints was investigated by testing single- and double-row bolted joints and open-hole specimens in tension. For tension loading, linear interaction was found to exist between the bearing stress reacted at a given bolt hole and the remaining tension stress running by that hole to be reacted elsewhere. The interaction under compressive loading was found to be non-linear. Comparative tests were run using single-lap bolted joints and double-lap joints with pin connection. Both of these joint types exhibited lower strengths than were demonstrated by the corresponding double-lap joints. The analysis methods developed here for single bolt joints are shown to be capable of predicting the behavior of multi-row joints.

Indian Hedgehog signaling pathway members are associated with magnetic resonance imaging manifestations and pathological scores in lumbar facet joint osteoarthritis

NASA Astrophysics Data System (ADS)

Shuang, Feng; Zhou, Ying; Hou, Shu-Xun; Zhu, Jia-Liang; Liu, Yan; Zhang, Chun-Li; Tang, Jia-Guang

2015-05-01

Indian Hedgehog (HH) has been shown to be involved in osteoarthritis (OA) in articular joints, where there is evidence that Indian HH blockade could ameliorate OA. It seems to play a prominent role in development of the intervertebral disc (IVD) and in postnatal maintenance. There is little work on IHH in the IVD. Hence the aim of the current study was to investigate the role of Indian Hedgehog in the pathology of facet joint (FJ) OA. 24 patients diagnosed with lumbar intervertebral disk herniation or degenerative spinal stenosis were included. Preoperative magnetic resonance imaging (MRI) and Osteoarthritis Research Society International (OARSI) histopathology grading system was correlated to the mRNA levels of GLI1, PTCH1, and HHIP in the FJs. The Weishaupt grading and OARSI scores showed high positive correlation (r = 0.894) (P < 0.01). MRI Weishaupt grades showed positive correlation with GLI1 (r = 0.491), PTCH1 (r = 0.444), and HHIP (r = 0.654) mRNA levels (P < 0.05 in each case). OARSI scores were also positively correlated with GLI1 (r = 0. 646), PTCH1 (r = 0. 518), and HHIP (r = 0.762) mRNA levels (P < 0.01 in each case). Cumulatively our findings indicate that Indian HH signaling is increased in OA and is perhaps a key component in OA pathogenesis and progression.

Structural characterization of a first-generation articulated-truss joint for space crane application

NASA Technical Reports Server (NTRS)

Sutter, Thomas R.; Wu, K. Chauncey; Riutort, Kevin T.; Laufer, Joseph B.; Phelps, James E.

1992-01-01

A first-generation space crane articulated-truss joint was statically and dynamically characterized in a configuration that approximated an operational environment. The articulated-truss joint was integrated into a test-bed for structural characterization. Static characterization was performed by applying known loads and measuring the corresponding deflections to obtain load-deflection curves. Dynamic characterization was performed using modal testing to experimentally determine the first six mode shapes, frequencies, and modal damping values. Static and dynamic characteristics were also determined for a reference truss that served as a characterization baseline. Load-deflection curves and experimental frequency response functions are presented for the reference truss and the articulated-truss joint mounted in the test-bed. The static and dynamic experimental results are compared with analytical predictions obtained from finite element analyses. Load-deflection response is also presented for one of the linear actuators used in the articulated-truss joint. Finally, an assessment is presented for the predictability of the truss hardware used in the reference truss and articulated-truss joint based upon hardware stiffness properties that were previously obtained during the Precision Segmented Reflector (PSR) Technology Development Program.

Development of a versatile intra-articular pressure sensing array.

PubMed

Welcher, J B; Popovich, J M; Hedman, T P

2011-10-01

A new sensor array intended to accurately and directly measure spatial and time-dependent pressures within a highly curved biological intra-articular joint was developed and tested. To evaluate performance of the new sensor array for application within intra-articular joints generally, and specifically to fit within the relatively restrictive space of the lumbar spine facet joint, geometric constraints of length, width, thickness and sensor spatial resolution were evaluated. Additionally, the effects of sensor array curvature, frequency response, linearity, drift, hysteresis, repeatability, and total system cost were assessed. The new sensor array was approximately 0.6mm in thickness, scalable to below the nominal 12 mm wide by 15 high lumbar spine facet joint size, offered no inherent limitations on the number or spacing of the sensors with less than 1.7% cross talk with sensor immediately adjacent to one another. No difference was observed in sensor performance down to a radius of curvature of 7 mm and a 0.66±0.97% change in sensor sensitivity was observed at a radius of 5.5mm. The sensor array had less than 0.07 dB signal loss up to 5.5 Hz, linearity was 0.58±0.13% full scale (FS), drift was less than 0.2% FS at 250 s and less than 0.6% FS at 700 s, hysteresis was 0.78±0.18%. Repeatability was excellent with a coefficient of variation less than 2% at pressures between 0 and 1.000 MPa. Total system cost was relatively small as standard commercially available data acquisition systems could be utilized, with no specialized software, and individual sensors within an array can be replaced as needed. The new sensor array had small and scalable geometry and very acceptable intrinsic performance including minimal to no alteration in performance at physiologically relevant ranges of joint curvature. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

Cervical myelopathy associated with extradural synovial cysts in 4 dogs.

PubMed

Levitski, R E; Chauvet, A E; Lipsitz, D

1999-01-01

Three Mastiffs and 1 Great Dane were presented to the University of Wisconsin Veterinary Medical Teaching Hospital for cervical myelopathy based on history and neurologic examination. All dogs were males and had progressive ataxia and tetraparesis. Degenerative arthritis of the articular facet joints was noted on survey spinal radiographs. Myelography disclosed lateral axial compression of the cervical spinal cord medial to the articular facets. Extradural compressive cystic structures adjacent to articular facets were identified on magnetic resonance imaging (1 dog). High protein concentration was the most important finding on cerebrospinal fluid analysis. Dorsal laminectomies were performed in all dogs for spinal cord decompression and cyst removal. Findings on cytologic examination of the cystic fluid were consistent with synovial fluid, and histopathologic results supported the diagnosis of synovial cysts. All dogs are ambulatory and 3 are asymptomatic after surgery with a follow-up time ranging from 1 to 8 months. This is the 1st report of extradural synovial cysts in dogs, and synovial cysts should be a differential diagnosis for young giant breed dogs with cervical myelopathy.

Increase in Leg Stiffness Reduces Joint Work During Backpack Carriage Running at Slow Velocities.

PubMed

Liew, Bernard; Netto, Kevin; Morris, Susan

2017-10-01

Optimal tuning of leg stiffness has been associated with better running economy. Running with a load is energetically expensive, which could have a significant impact on athletic performance where backpack carriage is involved. The purpose of this study was to investigate the impact of load magnitude and velocity on leg stiffness. We also explored the relationship between leg stiffness and running joint work. Thirty-one healthy participants ran overground at 3 velocities (3.0, 4.0, 5.0 m·s -1 ), whilst carrying 3 load magnitudes (0%, 10%, 20% weight). Leg stiffness was derived using the direct kinetic-kinematic method. Joint work data was previously reported in a separate study. Linear models were used to establish relationships between leg stiffness and load magnitude, velocity, and joint work. Our results found that leg stiffness did not increase with load magnitude. Increased leg stiffness was associated with reduced total joint work at 3.0 m·s -1 , but not at faster velocities. The association between leg stiffness and joint work at slower velocities could be due to an optimal covariation between skeletal and muscular components of leg stiffness, and limb attack angle. When running at a relatively comfortable velocity, greater leg stiffness may reflect a more energy efficient running pattern.

Effects of Imbalanced Muscle Loading on Hip Joint Development and Maturation

PubMed Central

Ford, Caleb A.; Nowlan, Niamh C.; Thomopoulos, Stavros; Killian, Megan L.

2017-01-01

The mechanical loading environment influences the development and maturation of joints. In this study, the influence of imbalanced muscular loading on joint development was studied using localized chemical denervation of hip stabilizing muscle groups in neonatal mice. It was hypothesized that imbalanced muscle loading, targeting either gluteal muscles or quadriceps muscles, would lead to bilateral hip joint asymmetry, as measured by acetabular coverage, femoral head volume and bone morphometry, and femoral-acetabular shape. The contralateral hip joints as well as age-matched, uninjected mice were used as controls. Altered bone development was analyzed using micro-computed tomography, histology, and image registration techniques at postnatal days (P) 28, 56, and 120. This study found that unilateral muscle unloading led to reduced acetabular coverage of the femoral head, lower total volume, lower bone volume ratio, and lower mineral density, at all three time points. Histologically, the femoral head was smaller in unloaded hips, with thinner triradiate cartilage at P28 and thinner cortical bone at P120 compared to contralateral hips. Morphological shape changes were evident in unloaded hips at P56. Unloaded hips had lower trabecular thickness and increased trabecular spacing of the femoral head compared to contralateral hips. The present study suggests that decreased muscle loading of the hip leads to altered bone and joint shape and growth during postnatal maturation. Statement of Clinical Significance: Adaptations from altered muscle loading during postnatal growth investigated in this study have implications on developmental hip disorders that result from asymmetric loading, such as patients with limb-length inequality or dysplasia. PMID:27391299

A finite element evaluation of the moment arm hypothesis for altered vertebral shear failure force.

PubMed

Howarth, Samuel J; Karakolis, Thomas; Callaghan, Jack P

2015-01-01

The mechanism of vertebral shear failure is likely a bending moment generated about the pars interarticularis by facet contact, and the moment arm length (MAL) between the centroid of facet contact and the location of pars interarticularis failure has been hypothesised to be an influential modulator of shear failure force. To quantitatively evaluate this hypothesis, anterior shear of C3 over C4 was simulated in a finite element model of the porcine C3-C4 vertebral joint with each combination of five compressive force magnitudes (0-60% of estimated compressive failure force) and three postures (flexed, neutral and extended). Bilateral locations of peak stress within C3's pars interarticularis were identified along with the centroids of contact force on the inferior facets. These measurements were used to calculate the MAL of facet contact force. Changes in MAL were also related to shear failure forces measured from similar in vitro tests. Flexed and extended vertebral postures respectively increased and decreased the MAL by 6.6% and 4.8%. The MAL decreased by only 2.6% from the smallest to the largest compressive force. Furthermore, altered MAL explained 70% of the variance in measured shear failure force from comparable in vitro testing with larger MALs being associated with lower shear failure forces. Our results confirmed that the MAL is indeed a significant modulator of vertebral shear failure force. Considering spine flexion is necessary when assessing low-back shear injury potential because of the association between altered facet articulation and lower vertebral shear failure tolerance.

Neandertal talus bones from El Sidrón site (Asturias, Spain): A 3D geometric morphometrics analysis.

PubMed

Rosas, Antonio; Ferrando, Anabel; Bastir, Markus; García-Tabernero, Antonio; Estalrrich, Almudena; Huguet, Rosa; García-Martínez, Daniel; Pastor, Juan Francisco; de la Rasilla, Marco

2017-10-01

The El Sidrón tali sample is assessed in an evolutionary framework. We aim to explore the relationship between Neandertal talus morphology and body size/shape. We test the hypothesis 1: talar Neandertal traits are influenced by body size, and the hypothesis 2: shape variables independent of body size correspond to inherited primitive features. We quantify 35 landmarks through 3D geometric morphometrics techniques to describe H. neanderthalensis-H. sapiens shape variation, by Mean Shape Comparisons, Principal Component, Phenetic Clusters, Minimum spanning tree analyses and partial least square and regression of talus shape on body variables. Shape variation correlated to body size is compared to Neandertals-Modern Humans (MH) evolutionary shape variation. The Neandertal sample is compared to early hominins. Neandertal talus presents trochlear hypertrophy, a larger equality of trochlear rims, a shorter neck, a more expanded head, curvature and an anterior location of the medial malleolar facet, an expanded and projected lateral malleolar facet and laterally expanded posterior calcaneal facet compared to MH. The Neandertal talocrural joint morphology is influenced by body size. The other Neandertal talus traits do not co-vary with it or not follow the same co-variation pattern as MH. Besides, the trochlear hypertrophy, the trochlear rims equality and the short neck could be inherited primitive features; the medial malleolar facet morphology could be an inherited primitive feature or a secondarily primitive trait; and the calcaneal posterior facet would be an autapomorphic feature of the Neandertal lineage. © 2017 Wiley Periodicals, Inc.

Effects of load carriage and footwear on lower extremity kinetics and kinematics during overground walking.

PubMed

Dames, Kevin D; Smith, Jeremy D

2016-10-01

Kinetic and kinematic responses during walking vary by footwear condition. Load carriage also influences gait patterns, but it is unclear how an external load influences barefoot walking. Twelve healthy adults (5 women, 7 men) with no known gait abnormalities participated in this study (age=23±3years, height=1.73±0.11m, and mass=70.90±12.67kg). Ground reaction forces and 3D motion were simultaneously collected during overground walking at 1.5ms -1 in four conditions: Barefoot Unloaded, Shod Unloaded, Barefoot Loaded, and Shod Loaded. Barefoot walking reduced knee and hip joint ranges of motion, as well as stride length, stance time, swing time, and double support time. Load carriage increased stance and double support times. The 15% body weight load increased GRFs ∼15%. Walking barefoot reduced peak anteroposterior GRFs but not peak vertical GRFs. Load carriage increased hip, knee, and ankle joint moments and powers, while walking barefoot increased knee and hip moments and powers. Thus, spatiotemporal and kinematic adjustments to walking barefoot decrease GRFs but increase knee and hip kinetic measures during overground walking. The ankle seems to be less affected by these footwear conditions. Regardless of footwear, loading requires larger GRFs, joint loads, and joint powers. Copyright © 2016 Elsevier B.V. All rights reserved.

Periodontal Ligament Entheses and their Adaptive Role in the Context of Dentoalveolar Joint Function

PubMed Central

Lin, Jeremy D.; Jang, Andrew T.; Kurylo, Michael P.; Hurng, Jonathan; Yang, Feifei; Yang, Lynn; Pal, Arvin; Chen, Ling; Ho, Sunita P.

2017-01-01

Objectives The dynamic bone-periodontal ligament (PDL)-tooth fibrous joint consists of two adaptive functionally graded interfaces (FGI), the PDL-bone and PDL-cementum that respond to mechanical strain transmitted during mastication. In general, from a materials and mechanics perspective, FGI prevent catastrophic failure during prolonged cyclic loading. This review is a discourse of results gathered from literature to illustrate the dynamic adaptive nature of the fibrous joint in response to physiologic and pathologic simulated functions, and experimental tooth movement. Methods Historically, studies have investigated soft to hard tissue transitions through analytical techniques that provided insights into structural, biochemical, and mechanical characterization methods. Experimental approaches included two dimensional to three dimensional advanced in situ imaging and analytical techniques. These techniques allowed mapping and correlation of deformations to physicochemical and mechanobiological changes within volumes of the complex subjected to concentric and eccentric loading regimes respectively. Results Tooth movement is facilitated by mechanobiological activity at the interfaces of the fibrous joint and generates elastic discontinuities at these interfaces in response to eccentric loading. Both concentric and eccentric loads mediated cellular responses to strains, and prompted self-regulating mineral forming and resorbing zones that in turn altered the functional space of the joint. Significance A multiscale biomechanics and mechanobiology approach is important for correlating joint function to tissue-level strain-adaptive properties with overall effects on joint form as related to physiologic and pathologic functions. Elucidating the shift in localization of biomolecules specifically at interfaces during development, function, and therapeutic loading of the joint is critical for developing “functional regeneration and adaptation” strategies with an emphasis on restoring physiologic joint function. PMID:28476202

Correlation between hindfoot joint three-dimensional kinematics and the changes of the medial arch angle in stage II posterior tibial tendon dysfunction flatfoot.

PubMed

Zhang, Yi-Jun; Xu, Jian; Wang, Yue; Lin, Xiang-Jin; Ma, Xin

2015-02-01

The aim of this study was to explore the correlation between the kinematics of the hindfoot joint and the medial arch angle change in stage II posterior tibial tendon dysfunction flatfoot three-dimensionally under loading. Computed tomography (CT) scans of 12 healthy feet and 12 feet with stage II posterior tibial tendon dysfunction flatfoot were taken both in non- and full-body-weight-bearing condition. The CT images of the hindfoot bones were reconstructed into three-dimensional models with Mimics and Geomagic reverse engineering software. The three-dimensional changes of the hindfoot joint were calculated to determine their correlation to the medial longitudinal arch angle. The medial arch angle change was larger in stage II posterior tibial tendon dysfunction flatfoot compared to that in healthy foot under loading. The rotation and translation of the talocalcaneal joint, the talonavicular joint and the calcanocuboid joint had little influence on the change of the medial arch angle in healthy foot. However, the eversion of the talocalcaneal joint, the proximal translation of the calcaneus relative to the talus and the dorsiflexion of talonavicular joint could increase the medial arch angle in stage II posterior tibial tendon dysfunction flatfoot under loading. Joint instability occurred in patients with stage II posterior tibial tendon dysfunction flatfoot under loading. Limitation of over movement of the talocalcaneal joint and the talonavicular joint may help correct the medial longitudinal arch in stage II posterior tibial tendon dysfunction flatfoot. Copyright © 2014 Elsevier Ltd. All rights reserved.

Joint Procrustes Analysis for Simultaneous Nonsingular Transformation of Component Score and Loading Matrices

ERIC Educational Resources Information Center

Adachi, Kohei

2009-01-01

In component analysis solutions, post-multiplying a component score matrix by a nonsingular matrix can be compensated by applying its inverse to the corresponding loading matrix. To eliminate this indeterminacy on nonsingular transformation, we propose Joint Procrustes Analysis (JPA) in which component score and loading matrices are simultaneously…

The Effects of Load Carriage and Muscle Fatigue on Lower-Extremity Joint Mechanics

ERIC Educational Resources Information Center

Wang, He; Frame, Jeff; Ozimek, Elicia; Leib, Daniel; Dugan, Eric L.

2013-01-01

Military personnel are commonly afflicted by lower-extremity overuse injuries. Load carriage and muscular fatigue are major stressors during military basic training. Purpose: To examine effects of load carriage and muscular fatigue on lower-extremity joint mechanics during walking. Method: Eighteen men performed the following tasks: unloaded…

Experimental Characterization of Hysteresis in a Revolute Joint for Precision Deployable Structures

NASA Technical Reports Server (NTRS)

Lake, Mark S.; Fung, Jimmy; Gloss, Kevin; Liechty, Derek S.

1997-01-01

Recent studies of the micro-dynamic behavior of a deployable telescope metering truss have identified instabilities in the equilibrium shape of the truss in response to low-energy dynamic loading. Analyses indicate that these micro-dynamic instabilities arise from stick-slip friction within the truss joints (e.g., hinges and latches). The present study characterizes the low-magnitude quasi-static load cycle response of the precision revolute joints incorporated in the deployable telescope metering truss, and specifically, the hysteretic response of these joints caused by stick-slip friction within the joint. Detailed descriptions are presented of the test setup and data reduction algorithms, including discussions of data-error sources and data-filtering techniques. Test results are presented from thirteen specimens, and the effects of joint preload and manufacturing tolerances are investigated. Using a simplified model of stick-slip friction, a relationship is made between joint load-cycle behavior and micro-dynamic dimensional instabilities in the deployable telescope metering truss.

The effects of the sagittal plane malpositioning of the patella and concomitant quadriceps hypotrophy on the patellofemoral joint: a finite element analysis.

PubMed

Aksahin, Ertugrul; Kocadal, Onur; Aktekin, Cem N; Kaya, Defne; Pepe, Murad; Yılmaz, Serdar; Yuksel, H Yalcin; Bicimoglu, Ali

2016-03-01

Anterior knee pain is a common symptom after intramedullary nailing in tibia shaft fracture. Moreover, patellofemoral malalignment is also known to be a major reason for anterior knee pain. Patellofemoral malalignment predisposes to increased loading in patellar cartilage. In the previous study, we have demonstrated the quadriceps atrophy and patellofemoral malalignment after intramedullary nailing due to tibia shaft fracture. In this study, our aim was to clarify the effects of quadriceps atrophy and patellofemoral malalignment with the pathologic loading on the joint cartilage. Mesh models of patellofemoral joint were constructed with CT images and integrated with soft tissue components such as menisci and ligaments. Physiological and sagittal tilt models during extension and flexion at 15°, 30° and 60° were created generating eight models. All the models were applied with 137 N force to present the effects of normal loading and 115.7 N force for the simulation of quadriceps atrophy. Different degrees of loading were applied to evaluate the joint contact area and pressure value with the finite element analysis. There was increased patellofemoral contact area in patellar tilt models with respect to normal models. The similar loading patterns were diagnosed in all models at 0° and 15° knee flexion when 137 N force was applied. Higher loading values were obtained at 30° and 60° knee flexions in sagittal tilt models. Furthermore, in the sagittal tilt models, in which the quadriceps atrophy was simulated, the loadings at 30° and 60° knee flexion were higher than in the physiological ones. Sagittal malalignment of the patellofemoral joint is a new concept that results in different loading patterns in the patellofemoral joint biomechanics. This malalignment in sagittal plane leads to increased loading values on the patellofemoral joint at 30° and 60° of the knee flexions. This new concept should be kept in mind during the course of diagnosis and treatment in patients with anterior knee pain. Definition of the exact biomechanical effects of the sagittal tilting will lead to the development of new treatment modalities.

Early effects of embryonic movement: ‘a shot out of the dark’

PubMed Central

Pitsillides, Andrew A

2006-01-01

It has long been appreciated that studying the embryonic chick in ovo provides a variety of advantages, including the potential to control the embryo's environment and its movement independently of maternal influences. This allowed early workers to identify movement as a pivotal factor in the development of the locomotor apparatus. With an increasing focus on the earliest detectable movements, we have exploited this system by developing novel models and schemes to examine the influence of defined periods of movement during musculoskeletal development. Utilizing drugs with known neuromuscular actions to provoke hyperactivity (4-aminopyridine, AP) and either rigid (decamethonium bromide, DMB) or flaccid (pancuronium bromide, PB) paralysis, we have examined the role of movement in joint, osteochondral and muscle development. Our initial studies focusing on the joint showed that AP-induced hyperactivity had little, if any, effect on the timing or scope of joint cavity elaboration, suggesting that endogenous activity levels provide sufficient stimulus, and additional mobilization is without effect. By contrast, imposition of either rigid or flaccid paralysis prior to cavity formation completely blocked this process and, with time, produced fusion of cartilaginous elements and formation of continuous single cartilaginous rods across locations where joints would ordinarily form. The effect of these distinct forms of paralysis differed, however, when treatment was initiated after formation of an overt cavity; rigid, but not flaccid, paralysis partly conserved precavitated joints. This observation suggests that ‘static’ loading derived from ‘spastic’ rigidity can act to preserve joint cavities. Another facet of these studies was the observation that DMB-induced rigid paralysis produces a uniform and specific pattern of limb deformity whereas PB generated a diverse range of fixed positional deformities. Both also reduced limb growth, with different developmental periods preferentially modifying specific osteochondral components. Changes in cartilage and bone growth induced by 3-day periods of flaccid immobilization, imposed at distinct developmental phases, provides support for a diminution in cartilage elaboration at an early phase and for a relatively delayed influence of movement on osteogenesis, invoking critical periods during which the developing skeleton becomes receptive to the impact of movement. Immobilization also exerts differential impact along the proximo-distal axis of the limb. Finally, our preliminary results support the possibility that embryonic hyperactivity influences the potential for postnatal muscle growth. PMID:16637868

Improving the Photo-Oxidative Performance of Bi2MoO6 by Harnessing the Synergy between Spatial Charge Separation and Rational Co-Catalyst Deposition.

PubMed

Wu, Xuelian; Hart, Judy N; Wen, Xiaoming; Wang, Liang; Du, Yi; Dou, Shi Xue; Ng, Yun Hau; Amal, Rose; Scott, Jason

2018-03-21

It has been reported that photogenerated electrons and holes can be directed toward specific crystal facets of a semiconductor particle, which is believed to arise from the differences in their surface electronic structures, suggesting that different facets can act as either photoreduction or photo-oxidation sites. This study examines the propensity for this effect to occur in faceted, plate-like bismuth molybdate (Bi 2 MoO 6 ), which is a useful photocatalyst for water oxidation. Photoexcited electrons and holes are shown to be spatially separated toward the {100} and {001}/{010} facets of Bi 2 MoO 6 , respectively, by facet-dependent photodeposition of noble metals (Pt, Au, and Ag) and metal oxides (PbO 2 , MnO x , and CoO x ). Theoretical calculations revealed that differences in energy levels between the conduction bands and valence bands of the {100} and {001}/{010} facets can contribute to electrons and holes being drawn to different surfaces of the plate-like Bi 2 MoO 6 . Utilizing this knowledge, the photo-oxidative capability of Bi 2 MoO 6 was improved by adding an efficient water oxidation co-catalyst, CoO x , to the system, whereby the extent of enhancement was shown to be governed by the co-catalyst location. A greater oxygen evolution occurred when CoO x was selectively deposited on the hole-rich {001}/{010} facets of Bi 2 MoO 6 compared to when CoO x was randomly located across all of the facets. The elevated performance exhibited for the selectively loaded CoO x /Bi 2 MoO 6 was ascribed to the greater opportunity for hole trapping by the co-catalyst being accentuated over other potentially detrimental effects, such as the co-catalyst acting as a recombination medium and/or covering reactive sites. The results indicate that harnessing the synergy between the spatial charge separation and the co-catalyst location on the appropriate facets of plate-like Bi 2 MoO 6 can promote its photocatalytic activity.

Design and clinical outcome of a novel 3D-printed prosthetic joint replacement for the human temporomandibular joint.

PubMed

Ackland, David; Robinson, Dale; Lee, Peter Vee Sin; Dimitroulis, George

2018-05-11

Stock prosthetic temporomandibular joint replacements come in limited sizes, and do not always encompass the joint anatomy that presents clinically. The aims of this study were twofold. Firstly, to design a personalized prosthetic total joint replacement for the treatment of a patient's end-stage temporomandibular joint osteoarthritis, to implant the prosthesis into the patient, and assess clinical outcome 12-months post-operatively; and secondly, to evaluate the influence of changes in prosthetic condyle geometry on implant load response during mastication. A 48-year-old female patient with Grade-5 osteoarthritis to the left temporomandibular joint was recruited, and a prosthesis developed to match the native temporomandibular joint anatomy. The prosthesis was 3D printed, sterilized and implanted into the patient, and pain and function measured 12-months post-operatively. The prosthesis load response during a chewing-bite and maximum-force bite was evaluated using a personalized multi-body musculoskeletal model. Simulations were performed after perturbing condyle thickness, neck length and head sphericity. Increases in prosthetic condyle neck length malaligned the mandible and perturbed temporomandibular joint force. Changes in condylar component thickness greatly influenced fixation screw stress response, while a more eccentric condylar head increased prosthetic joint-contact loading. Post-operatively, the prosthetic temporomandibular joint surgery reduced patient pain from 7/10 to 1/10 on a visual analog scale, and increased intercisal opening distance from 22 mm to 38 mm. This study demonstrates effectiveness of a personalized prosthesis that may ultimately be adapted to treat a wide-range of end-stage temporomandibular joint conditions, and highlights sensitivity of prosthesis load response to changes in condylar geometry. Copyright © 2018 Elsevier Ltd. All rights reserved.

Preliminary 2-D shell analysis of the space shuttle solid rocket boosters

NASA Technical Reports Server (NTRS)

Knight, Norman F., Jr.; Gillian, Ronnie E.; Nemeth, Michael P.

1987-01-01

A two-dimensional shell model of an entire solid rocket booster (SRB) has been developed using the STAGSC-1 computer code and executed on the Ames CRAY computer. The purpose of these analyses is to calculate the overall deflection and stress distributions for the SRB when subjected to mechanical loads corresponding to critical times during the launch sequence. The mechanical loading conditions for the full SRB arise from the external tank (ET) attachment points, the solid rocket motor (SRM) pressure load, and the SRB hold down posts. The ET strut loads vary with time after the Space Shuttle main engine (SSME) ignition. The SRM internal pressure varies axially by approximately 100 psi. Static analyses of the full SRB are performed using a snapshot picture of the loads. The field and factory joints are modeled by using equivalent stiffness joints instead of detailed models of the joint. As such, local joint behavior cannot be obtained from this global model.

3-D Analysis of Flanged Joints Through Various Preload Methods Using ANSYS

NASA Astrophysics Data System (ADS)

Murugan, Jeyaraj Paul; Kurian, Thomas; Jayaprakash, Janardhan; Sreedharapanickar, Somanath

2015-10-01

Flanged joints are being employed in aerospace solid rocket motor hardware for the integration of various systems or subsystems. Hence, the design of flanged joints is very important in ensuring the integrity of motor while functioning. As these joints are subjected to higher loads due to internal pressure acting inside the motor chamber, an appropriate preload is required to be applied in this joint before subjecting it to the external load. Preload, also known as clamp load, is applied on the fastener and helps to hold the mating flanges together. Generally preload is simulated as a thermal load and the exact preload is obtained through number of iterations. Infact, more iterations are required when considering the material nonlinearity of the bolt. This way of simulation will take more computational time for generating the required preload. Now a days most commercial software packages use pretension elements for simulating the preload. This element does not require iterations for inducing the preload and it can be solved with single iteration. This approach takes less computational time and thus one can study the characteristics of the joint easily by varying the preload. When the structure contains more number of joints with different sizes of fasteners, pretension elements can be used compared to thermal load approach for simulating each size of fastener. This paper covers the details of analyses carried out simulating the preload through various options viz., preload through thermal, initial state command and pretension element etc. using ANSYS finite element package.

Economic Development in Indonesia

DTIC Science & Technology

1960-11-21

Deficit Spending and Economic Development..,.. 1 What Follows Rupiah Rehabilitation 9 Private Capital and the Cooperative Movement 14 Some Facets of...the American dollar. 13 PRIVATE CAPITAL AND THE COOPERATIVE MOVEMENT J^he following is a full translation of an article-Wägten by R. P. Suroso...bent themselves energetically to the realization of the ideals and principles enunciated in the Joint Declaration, then the cooperative movement can

Distraction Arthrodesis of the C1-C2 Facet Joint with Preservation of the C2 Root for the Management of Intractable Occipital Neuralgia Caused by C2 Root Compression.

PubMed

Yeom, Jin S; Riew, K Daniel; Kang, Sung Shik; Yi, Jemin; Lee, Gun Woo; Yeom, Arim; Chang, Bong-Soon; Lee, Choon-Ki; Kim, Ho-Joong

2015-10-15

Prospective observational cohort study. To compare the outcomes of our new technique, distraction arthrodesis of C1-C2 facet joint with C2 root preservation (Study group), to those of conventional C1-C2 fusion with C2 root transection (Control group) for the management of intractable occipital neuralgia caused by C2 root compression. We are not aware of any report concerning C2 root decompression during C1-C2 fusion. Inclusion criteria were visual analogue scale (VAS) score for occipital neuralgia 7 or more; C2 root compression at the collapsed C1-C2 neural foramen; and follow-up 12 months or more. The Study group underwent surgery with our new technique including (1) C1-C2 facet joint distraction and bone block insertion while preserving the C2 root; and (2) use of C1 posterior arch screws instead of conventional lateral mass screws during C1-C2 segmental screw fixation. The Control group underwent C2 root transection with C1-C2 segmental screw fixation and fusion. We compared the prospectively collected outcomes data. There were 15 patients in the Study group and 8 in the Control group. Although there was no significant difference in the VAS score for the occipital neuralgia between the 2 groups preoperatively (8.2 ± 0.9 vs. 7.9 ± 0.6, P = 0.39), it was significantly lower in the Study group at 1, 3, and 6 months postoperatively (P < 0.01, respectively). At 12 months, it was 0.4 ± 0.6 versus 2.5 ± 2.6 (P = 0.01). There was no significant difference in improvement in the VAS score for neck pain and neck disability index and Japanese Orthopedic Association recovery rate, which are minimally influenced by occipital neuralgia. Our novel technique of distraction arthrodesis with C2 root preservation can be an effective option for the management of intractable occipital neuralgia caused by C2 root compression.

Dynamic Analyses Including Joints Of Truss Structures

NASA Technical Reports Server (NTRS)

Belvin, W. Keith

1991-01-01

Method for mathematically modeling joints to assess influences of joints on dynamic response of truss structures developed in study. Only structures with low-frequency oscillations considered; only Coulomb friction and viscous damping included in analysis. Focus of effort to obtain finite-element mathematical models of joints exhibiting load-vs.-deflection behavior similar to measured load-vs.-deflection behavior of real joints. Experiments performed to determine stiffness and damping nonlinearities typical of joint hardware. Algorithm for computing coefficients of analytical joint models based on test data developed to enable study of linear and nonlinear effects of joints on global structural response. Besides intended application to large space structures, applications in nonaerospace community include ground-based antennas and earthquake-resistant steel-framed buildings.

Predicting the Functional Roles of Knee Joint Muscles from Internal Joint Moments.

PubMed

Flaxman, Teresa E; Alkjær, Tine; Simonsen, Erik B; Krogsgaard, Michael R; Benoit, Daniel L

2017-03-01

Knee muscles are commonly labeled as flexors or extensors and aptly stabilize the knee against sagittal plane loads. However, how these muscles stabilize the knee against adduction-abduction and rotational loads remains unclear. Our study sought 1) to classify muscle roles as they relate to joint stability by quantifying the relationship between individual muscle activation patterns and internal net joint moments in all three loading planes and 2) to determine whether these roles change with increasing force levels. A standing isometric force matching protocol required subjects to modulate ground reaction forces to elicit various combinations and magnitudes of sagittal, frontal, and transverse internal joint moments. Surface EMG measured activities of 10 lower limb muscles. Partial least squares regressions determined which internal moment(s) were significantly related to the activation of individual muscles. Rectus femoris and tensor fasciae latae were classified as moment actuators for knee extension and hip flexion. Hamstrings were classified as moment actuators for hip extension and knee flexion. Gastrocnemius and hamstring muscles were classified as specific joint stabilizers for knee rotation. Vastii were classified as general joint stabilizers because activation was independent of moment generation. Muscle roles did not change with increasing effort levels. Our findings indicate muscle activation is not dependent on anatomical orientation but perhaps on its role in maintaining knee joint stability in the frontal and transverse loading planes. This is useful for delineating the roles of biarticular knee joint muscles and could have implications in robotics, musculoskeletal modeling, sports sciences, and rehabilitation.

Effects of imbalanced muscle loading on hip joint development and maturation.

PubMed

Ford, Caleb A; Nowlan, Niamh C; Thomopoulos, Stavros; Killian, Megan L

2017-05-01

The mechanical loading environment influences the development and maturation of joints. In this study, the influence of imbalanced muscular loading on joint development was studied using localized chemical denervation of hip stabilizing muscle groups in neonatal mice. It was hypothesized that imbalanced muscle loading, targeting either gluteal muscles or quadriceps muscles, would lead to bilateral hip joint asymmetry, as measured by acetabular coverage, femoral head volume and bone morphometry, and femoral-acetabular shape. The contralateral hip joints as well as age-matched, uninjected mice were used as controls. Altered bone development was analyzed using micro-computed tomography, histology, and image registration techniques at postnatal days (P) 28, 56, and 120. This study found that unilateral muscle unloading led to reduced acetabular coverage of the femoral head, lower total volume, lower bone volume ratio, and lower mineral density, at all three time points. Histologically, the femoral head was smaller in unloaded hips, with thinner triradiate cartilage at P28 and thinner cortical bone at P120 compared to contralateral hips. Morphological shape changes were evident in unloaded hips at P56. Unloaded hips had lower trabecular thickness and increased trabecular spacing of the femoral head compared to contralateral hips. The present study suggests that decreased muscle loading of the hip leads to altered bone and joint shape and growth during postnatal maturation. Statement of Clinical Significance: Adaptations from altered muscle loading during postnatal growth investigated in this study have implications on developmental hip disorders that result from asymmetric loading, such as patients with limb-length inequality or dysplasia. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1128-1136, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Program Calculates Forces in Bolted Structural Joints

NASA Technical Reports Server (NTRS)

Buder, Daniel A.

2005-01-01

FORTRAN 77 computer program calculates forces in bolts in the joints of structures. This program is used in conjunction with the NASTRAN finite-element structural-analysis program. A mathematical model of a structure is first created by approximating its load-bearing members with representative finite elements, then NASTRAN calculates the forces and moments that each finite element contributes to grid points located throughout the structure. The user selects the finite elements that correspond to structural members that contribute loads to the joints of interest, and identifies the grid point nearest to each such joint. This program reads the pertinent NASTRAN output, combines the forces and moments from the contributing elements to determine the resultant force and moment acting at each proximate grid point, then transforms the forces and moments from these grid points to the centroids of the affected joints. Then the program uses these joint loads to obtain the axial and shear forces in the individual bolts. The program identifies which bolts bear the greatest axial and/or shear loads. The program also performs a fail-safe analysis in which the foregoing calculations are repeated for a sequence of cases in which each fastener, in turn, is assumed not to transmit an axial force.

A Wolff in sheep's clothing: trabecular bone adaptation in response to changes in joint loading orientation.

PubMed

Barak, Meir M; Lieberman, Daniel E; Hublin, Jean-Jacques

2011-12-01

This study tests Wolff's law of trabecular bone adaptation by examining if induced changes in joint loading orientation cause corresponding adjustments in trabecular orientation. Two groups of sheep were exercised at a trot, 15 min/day for 34 days on an inclined (7°) or level (0°) treadmills. Incline trotting caused the sheep to extend their tarsal joints by 3-4.5° during peak loading (P<0.01) but has no effect on carpal joint angle (P=0.984). Additionally, tarsal joint angle in the incline group sheep were maintained more extended throughout the day using elevated platform shoes on their forelimbs. A third "sedentary group" group did not run but wore platform shoes throughout the day. As predicted by Wolff's law, trabecular orientation in the distal tibia (tarsal joint) were more obtuse by 2.7 to 4.3° in the incline group compared to the level group; trabecular orientation was not significantly different in the sedentary and level groups. In addition, trabecular orientations in the distal radius (carpal joint) of the sedentary, level and incline groups did not differ between groups, and were aligned almost parallel to the radius long axis, corresponding to the almost straight carpal joint angle at peak loading. Measurements of other trabecular bone parameters revealed additional responses to loading, including significantly higher bone volume fraction (BV/TV), Trabecular number (Tb.N) and trabecular thickness (Tb.Th), lower trabecular spacing (Tb.Sp), and less rod-shaped trabeculae (higher structure model index, SMI) in the exercised than sedentary sheep. Overall, these results demonstrate that trabecular bone dynamically adjusts and realigns itself in very precise relation to changes in peak loading direction, indicating that Wolff's law is not only accurate but also highly sensitive. Copyright © 2011 Elsevier Inc. All rights reserved.

Implementation of a gait cycle loading into healthy and meniscectomised knee joint models with fibril-reinforced articular cartilage.

PubMed

Mononen, Mika E; Jurvelin, Jukka S; Korhonen, Rami K

2015-01-01

Computational models can be used to evaluate the functional properties of knee joints and possible risk locations within joints. Current models with fibril-reinforced cartilage layers do not provide information about realistic human movement during walking. This study aimed to evaluate stresses and strains within a knee joint by implementing load data from a gait cycle in healthy and meniscectomised knee joint models with fibril-reinforced cartilages. A 3D finite element model of a knee joint with cartilages and menisci was created from magnetic resonance images. The gait cycle data from varying joint rotations, translations and axial forces were taken from experimental studies and implemented into the model. Cartilage layers were modelled as a fibril-reinforced poroviscoelastic material with the menisci considered as a transversely isotropic elastic material. In the normal knee joint model, relatively high maximum principal stresses were specifically predicted to occur in the medial condyle of the knee joint during the loading response. Bilateral meniscectomy increased stresses, strains and fluid pressures in cartilage on the lateral side, especially during the first 50% of the stance phase of the gait cycle. During the entire stance phase, the superficial collagen fibrils modulated stresses of cartilage, especially in the medial tibial cartilage. The present computational model with a gait cycle and fibril-reinforced biphasic cartilage revealed time- and location-dependent differences in stresses, strains and fluid pressures occurring in cartilage during walking. The lateral meniscus was observed to have a more significant role in distributing loads across the knee joint than the medial meniscus, suggesting that meniscectomy might initiate a post-traumatic process leading to osteoarthritis at the lateral compartment of the knee joint.

Load Dependency of Postural Control - Kinematic and Neuromuscular Changes in Response to over and under Load Conditions

PubMed Central

Ritzmann, Ramona; Freyler, Kathrin; Weltin, Elmar; Krause, Anne; Gollhofer, Albert

2015-01-01

Introduction Load variation is associated with changes in joint torque and compensatory reflex activation and thus, has a considerable impact on balance control. Previous studies dealing with over (OL) and under loading (UL) used water buoyancy or additional weight with the side effects of increased friction and inertia, resulting in substantially modified test paradigms. The purpose of this study was to identify gravity-induced load dependency of postural control in comparable experimental conditions and to determine the underlying neuromuscular mechanisms. Methods Balance performance was recorded under normal loading (NL, 1g), UL (0.16g; 0.38g) and OL (1.8g) in monopedal stance. Center of pressure (COP) displacement and frequency distribution (low 0.15-0.5Hz (LF), medium 0.5-2Hz (MF), high 2-6Hz (HF)) as well as ankle, knee and hip joint kinematics were assessed. Soleus spinal excitability was determined by H/M-recruitment curves (H/M-ratios). Results Compared to NL, OL caused an increase in ankle joint excursion, COP HF domain and H/M-ratio. Concomitantly, hip joint excursion and COP LF decreased. Compared to NL, UL caused modulations in the opposite direction: UL decreased ankle joint excursions, COP HF and H/M-ratio. Collaterally, hip joint excursion and COP LF increased. COP was augmented both in UL and in OL compared to NL. Conclusion Subjects achieved postural stability in OL and UL with greater difficulty compared to NL. Reduced postural control was accompanied by modified balance strategies and compensatory reflex activation. With increasing load, a shift from hip to ankle strategy was observed. Accompanying, COP frequency distribution shifted from LF to HF and spinal excitability was enhanced. It is suggested that in OL, augmented ankle joint torques are compensated by quick reflex-induced postural reactions in distal muscles. Contrarily, UL is associated with diminished joint torques and thus, postural equilibrium may be controlled by the proximal segments to adjust the center of gravity above the base of support. PMID:26053055

Model test study on propagation law of plane stress wave in jointed rock mass under different in-situ stresses

NASA Astrophysics Data System (ADS)

Dong, Qian

2017-12-01

The study of propagation law of plane stress wave in jointed rock mass under in-situ stress has important significance for safety excavation of underground rock mass engineering. A model test of the blasting stress waves propagating in the intact rock and jointed rock mass under different in-situ stresses was carried out, and the influencing factors on the propagation law, such as the scale of static loads and the number of joints were studied respectively. The results show that the transmission coefficient of intact rock is larger than that of jointed rock mass under the same loading condition. With the increase of confining pressure, the transmission coefficients of intact rock and jointed rock mass both show an trend of increasing first and then decreasing, and the variation of transmission coefficients in intact rock is smaller than that of jointed rock mass. Transmission coefficient of jointed rock mass decreases with the increase of the number of joints under the same loading condition, when the confining pressure is relatively small, the reduction of transmission coefficients decreases with the increasing of the number of joints, and the variation law of the reduction of transmission coefficients is contrary when the confining pressure is large.

The effect on knee-joint load of instruction in analgesic use compared with neuromuscular exercise in patients with knee osteoarthritis: study protocol for a randomized, single-blind, controlled trial (the EXERPHARMA trial).

PubMed

Clausen, Brian; Holsgaard-Larsen, Anders; Søndergaard, Jens; Christensen, Robin; Andriacchi, Thomas P; Roos, Ewa M

2014-11-15

Knee osteoarthritis (OA) is a mechanically driven disease, and it is suggested that medial tibiofemoral knee-joint load increases with pharmacologic pain relief, indicating that pharmacologic pain relief may be positively associated with disease progression. Treatment modalities that can both relieve pain and reduce knee-joint load would be preferable. The knee-joint load is influenced by functional alignment of the trunk, pelvis, and lower-limb segments with respect to the knee, as well as the ground-reaction force generated during movement. Neuromuscular exercise can influence knee load and decrease knee pain. It includes exercises to improve balance, muscle activation, functional alignment, and functional knee stability. The primary objective of this randomized controlled trial (RCT) is to investigate the efficacy of a NEuroMuscular EXercise (NEMEX) therapy program, compared with optimized analgesics and antiinflammatory drug use, on the measures of knee-joint load in people with mild to moderate medial tibiofemoral knee osteoarthritis. One hundred men and women with mild to moderate medial knee osteoarthritis will be recruited from general medical practices and randomly allocated (1:1) to one of two 8-week treatments, either (a) NEMEX therapy twice a week or (b) information on the recommended use of analgesics and antiinflammatory drugs (acetaminophen and oral NSAIDs) via a pamphlet and video materials. The primary outcome is change in knee load during walking (the Knee Index, a composite score of the first external peak total reaction moment on the knee joint from all three planes based on 3D movement analysis) after 8 weeks of intervention. Secondary outcomes include changes in the external peak knee-adduction moment and impulse and functional performance measures, in addition to changes in self-reported pain, function, health status, and quality of life. These findings will help determine whether 8 weeks of neuromuscular exercise is superior to optimized use of analgesics and antiinflammatory drugs regarding knee-joint load, pain and physical function in people with mild to moderate knee osteoarthritis. ClinicalTrials.gov Identifier: NCT01638962 (July 3, 2012).

In vivo cyclic compression causes cartilage degeneration and subchondral bone changes in mouse tibiae.

PubMed

Ko, Frank C; Dragomir, Cecilia; Plumb, Darren A; Goldring, Steven R; Wright, Timothy M; Goldring, Mary B; van der Meulen, Marjolein C H

2013-06-01

Alterations in the mechanical loading environment in joints may have both beneficial and detrimental effects on articular cartilage and subchondral bone, and may subsequently influence the development of osteoarthritis (OA). Using an in vivo tibial loading model, the aim of this study was to investigate the adaptive responses of cartilage and bone to mechanical loading and to assess the influence of load level and duration. Cyclic compression at peak loads of 4.5N and 9.0N was applied to the left tibial knee joint of adult (26-week-old) C57BL/6 male mice for 1, 2, and 6 weeks. Only 9.0N loading was utilized in young (10-week-old) mice. Changes in articular cartilage and subchondral bone were analyzed by histology and micro-computed tomography. Mechanical loading promoted cartilage damage in both age groups of mice, and the severity of joint damage increased with longer duration of loading. Metaphyseal bone mass increased with loading in young mice, but not in adult mice, whereas epiphyseal cancellous bone mass decreased with loading in both young and adult mice. In both age groups, articular cartilage thickness decreased, and subchondral cortical bone thickness increased in the posterior tibial plateau. Mice in both age groups developed periarticular osteophytes at the tibial plateau in response to the 9.0N load, but no osteophyte formation occurred in adult mice subjected to 4.5N peak loading. This noninvasive loading model permits dissection of temporal and topographic changes in cartilage and bone and will enable investigation of the efficacy of treatment interventions targeting joint biomechanics or biologic events that promote OA onset and progression. Copyright © 2013 by the American College of Rheumatology.

Effects of high-heeled shoes and asymmetrical load carrying on lower-extremity kinematics during walking in young women.

PubMed

Lee, Soul; Li, Jing Xian

2014-01-01

Asymmetrical load carrying and wearing high-heeled shoes are very common. Biomechanics studies on the combined effects of high-heeled shoe wearing and asymmetrical load carrying are lacking. We sought to identify changes in lower-extremity joint kinematics associated with the effect of shoes and asymmetrical load carrying during walking. Fifteen healthy young women (mean ± SD: age, 24.67 ± 3.54 years; body weight, 54.96 ± 6.67 kg; and height, 162.2 ± 3.91 cm) who habitually wore high-heeled shoes participated in the study. They were asked to walk under nine combined conditions of three heights of shoe heels (0, 3, and 9 cm) and three carried loads (0%, 5%, and 10% of body weight). Temporospatial parameters and maximal joint angles in the sagittal and frontal planes of the hip, knee, and ankle on both limbs were studied. It was found that high-heeled shoe wearing and asymmetrical load carrying altered temporospatial parameters and joint kinematics. With increased heel height and load weight, cadence decreased and stride length increased. The knee flexion angle increased with an increase in heel height, and the load served only to exacerbate the changes. Changes in the hip angle were mostly caused by asymmetrical load carrying, whereas angle changes in the ankle were mostly caused by an increase in heel height. This study demonstrated that when high-heeled shoe wearing and asymmetrical load carrying are combined, changes at each joint are much greater than with high-heeled shoe wearing or load carrying alone.

Quantifying in vivo laxity in the anterior cruciate ligament and individual knee joint structures.

PubMed

Westover, L M; Sinaei, N; Küpper, J C; Ronsky, J L

2016-11-01

A custom knee loading apparatus (KLA), when used in conjunction with magnetic resonance imaging, enables in vivo measurement of the gross anterior laxity of the knee joint. A numerical model was applied to the KLA to understand the contribution of the individual joint structures and to estimate the stiffness of the anterior-cruciate ligament (ACL). The model was evaluated with a cadaveric study using an in situ knee loading apparatus and an ElectroForce test system. A constrained optimization solution technique was able to predict the restraining forces within the soft-tissue structures and joint contact. The numerical model presented here allowed in vivo prediction of the material stiffness parameters of the ACL in response to applied anterior loading. Promising results were obtained for in vivo load sharing within the structures. The numerical model overestimated the ACL forces by 27.61-92.71%. This study presents a novel approach to estimate ligament stiffness and provides the basis to develop a robust and accurate measure of in vivo knee joint laxity.

Design and evaluation of a bolted joint for a discrete carbon-epoxy rod-reinforced hat section

NASA Technical Reports Server (NTRS)

Rousseau, Carl Q.; Baker, Donald J.

1996-01-01

The use of prefabricated pultruded carbon-epoxy rods has reduced the manufacturing complexity and costs of stiffened composite panels while increasing the damage tolerance of the panels. However, repairability of these highly efficient discrete stiffeners has been a concern. Design, analysis, and test results are presented in this paper for a bolted-joint repair for the pultruded rod concept that is capable of efficiently transferring axial loads in a hat-section stiffener on the upper skin segment of a heavily loaded aircraft wing component. A tension and a compression joint design were evaluated. The tension joint design achieved approximately 1.0% strain in the carbon-epoxy rod-reinforced hat-section and failed in a metal fitting at 166% of the design ultimate load. The compression joint design failed in the carbon-epoxy rod-reinforced hat-section test specimen area at approximately 0.7% strain and at 110% of the design ultimate load. This strain level of 0.7% in compression is similar to the failure strain observed in previously reported carbon-epoxy rod-reinforced hat-section column tests.

Joint angles of the ankle, knee, and hip and loading conditions during split squats.

PubMed

Schütz, Pascal; List, Renate; Zemp, Roland; Schellenberg, Florian; Taylor, William R; Lorenzetti, Silvio

2014-06-01

The aim of this study was to quantify how step length and the front tibia angle influence joint angles and loading conditions during the split squat exercise. Eleven subjects performed split squats with an additional load of 25% body weight applied using a barbell. Each subject's movements were recorded using a motion capture system, and the ground reaction force was measured under each foot. The joint angles and loading conditions were calculated using a cluster-based kinematic approach and inverse dynamics modeling respectively. Increases in the tibia angle resulted in a smaller range of motion (ROM) of the front knee and a larger ROM of the rear knee and hip. The external flexion moment in the front knee/hip and the external extension moment in the rear hip decreased as the tibia angle increased. The flexion moment in the rear knee increased as the tibia angle increased. The load distribution between the legs changed < 25% when split squat execution was varied. Our results describing the changes in joint angles and the resulting differences in the moments of the knee and hip will allow coaches and therapists to adapt the split squat exercise to the individual motion and load demands of athletes.

Biomechanical loading on the upper extremity increases from single key tapping to directional tapping.

PubMed

Qin, Jin; Trudeau, Matthieu; Katz, Jeffrey N; Buchholz, Bryan; Dennerlein, Jack T

2011-08-01

Musculoskeletal disorders associated with computer use span the joints of the upper extremity. Computing typically involves tapping in multiple directions. Thus, we sought to describe the loading on the finger, wrist, elbow and shoulder joints in terms of kinematic and kinetic difference across single key switch tapping to directional tapping on multiple keys. An experiment with repeated measures design was conducted. Six subjects tapped with their right index finger on a stand-alone number keypad placed horizontally in three conditions: (1) on single key switch (the number key 5); (2) left and right on number key 4 and 6; (3) top and bottom on number key 8 and 2. A force-torque transducer underneath the keypad measured the fingertip force. An active-marker infrared motion analysis system measured the kinematics of the fingertip, hand, forearm, upper arm and torso. Joint moments for the metacarpophalangeal, wrist, elbow, and shoulder joints were estimated using inverse dynamics. Tapping in the top-bottom orientation introduced the largest biomechanical loading on the upper extremity especially for the proximal joint, followed by tapping in the left-right orientation, and the lowest loading was observed during single key switch tapping. Directional tapping on average increased the fingertip force, joint excursion, and peak-to-peak joint torque by 45%, 190% and 55%, respectively. Identifying the biomechanical loading patterns associated with these fundamental movements of keying improves the understanding of the risks of upper extremity musculoskeletal disorders for computer keyboard users. Copyright © 2010 Elsevier Ltd. All rights reserved.

The in situ force in the calcaneofibular ligament and the contribution of this ligament to ankle joint stability.

PubMed

Kobayashi, Takuma; Yamakawa, Satoshi; Watanabe, Kota; Kimura, Kei; Suzuki, Daisuke; Otsubo, Hidenori; Teramoto, Atsushi; Fujimiya, Mineko; Fujie, Hiromichi; Yamashita, Toshihiko

2016-12-01

Numerous biomechanical studies of the lateral ankle ligaments have been reported; however, the isolated function of the calcaneofibular ligament has not been clarified. We hypothesize that the calcaneofibular ligament would stabilize the ankle joint complex under multidirectional loading, and that the in situ force in the calcaneofibular ligament would change in each flexed position. Using seven fresh frozen cadaveric lower extremities, the motions and forces of the intact ankle under multidirectional loading were recorded using a 6-degree-of-freedom robotic system. On repeating these intact ankle joint complex motions after the calcaneofibular ligament transection, the in situ force in the calcaneofibular ligament and the contribution of the calcaneofibular ligament to ankle joint complex stability were calculated. Finally, the motions of the calcaneofibular ligament-transected ankle joint complex were recorded. Under an inversion load, significant increases of inversion angle were observed in all the flexed positions following calcaneofibular ligament transection, and the calcaneofibular ligament accounted for 50%-70% of ankle joint complex stability during inversion. The in situ forces in the calcaneofibular ligament under an anterior force, inversion moment, and external rotation moment were larger in the dorsiflexed position than in the plantarflexed position. The calcaneofibular ligament plays a role in stabilizing the ankle joint complex to multidirectional loads and the role differs with load directions. The in situ force of the calcaneofibular ligament is larger at the dorsiflexed position. This ligament provides the primary restraint to the inversion ankle stability. Copyright © 2016 Elsevier Ltd. All rights reserved.

Strength evaluation of socket joints

NASA Technical Reports Server (NTRS)

Rash, Larry C.

1994-01-01

This report documents the development of a set of equations that can be used to provide a relatively simple solution for identifying the strength of socket joints and for most cases avoid the need of more lengthy analyses. The analytical approach was verified by comparison of the contact load distributions to results obtained from a finite element analysis. The contacting surfaces for the specific joint in this analysis are in the shape of frustrums of a cone and are representative of the tapered surfaces in the socket-type joints used to join segments of model support systems for wind tunnels. The results are in the form of equations that can be used to determine the contact loads and stresses in the joint from the given geometry and externally applied loads. Equations were determined to define the bending moments and stresses along the length of the joints based on strength and materials principles. The results have also been programmed for a personal computer and a copy of the program is included.

Experimental Study of the Compression Response of Fluted-Core Composite Panels with Joints

NASA Technical Reports Server (NTRS)

Schultz, Marc R.; Rose, Cheryl A.; Guzman, J. Carlos; McCarville, Douglas; Hilburger, Mark W.

2012-01-01

Fluted-core sandwich composites consist of integral angled web members spaced between laminate face sheets, and may have the potential to provide benefits over traditional sandwich composites for certain aerospace applications. However, fabrication of large autoclave-cured fluted-core cylindrical shells with existing autoclaves will require that the shells be fabricated in segments, and joined longitudinally to form a complete barrel. Two different longitudinal fluted-core joint designs were considered experimentally in this study. In particular, jointed fluted-core-composite panels were tested in longitudinal compression because longitudinal compression is the primary loading condition in dry launch-vehicle barrel sections. One of the joint designs performed well in comparison with unjointed test articles, and the other joint design failed at loads approximately 14% lower than unjointed test articles. The compression-after-impact (CAI) performance of jointed fluted-core composites was also investigated by testing test articles that had been subjected to 6 ft-lb impacts. It was found that such impacts reduced the load-carrying capability by 9% to 40%. This reduction is dependent on the joint concept, component flute size, and facesheet thickness.

Correlation between varus knee malalignment and patellofemoral osteoarthritis.

PubMed

Otsuki, Shuhei; Nakajima, Mikio; Okamoto, Yoshinori; Oda, Shuhei; Hoshiyama, Yoshiaki; Iida, Go; Neo, Masashi

2016-01-01

To evaluate the relationship between patellofemoral osteoarthritis (OA) and varus OA of the knee with a focus on the location of joint space narrowing. Eighty-five patients scheduled to undergo total knee arthroplasty caused by varus OA were enrolled in this study. The relationship between patellofemoral OA and varus knee malalignment was elucidated. To determine the alignment of the patellofemoral joint in varus knees, patellar tilt, and the tibial tuberosity-trochlear groove (TT-TG) distance were measured, and patellofemoral OA was classified using computed tomography. The femorotibial angles in patients with stage II-IV patellofemoral OA were significantly larger than those in patients with stage I patellofemoral OA, and the patellar tilt in patients with stage II-IV patellofemoral OA and the TT-TG distance in patients with stage IV patellofemoral OA were significantly larger than those in patients with stage I patellofemoral OA. The TT-TG distance was strongly correlated with patellar tilt (R(2) = 0.41, P < 0.001). Patellofemoral joint space narrowing was mainly noted at the lateral facet, and it was found on both sides as patellofemoral OA worsened. Varus knee malalignment was induced by patellofemoral OA, especially at the lateral facet. Patellar tilt and the TT-TG distance are considered critical factors for the severity of patellofemoral OA. Understanding the critical factors for patellofemoral OA in varus knees such as the TT-TG distance and patellar will facilitate the prevention of patellofemoral OA using procedures such as high tibial osteotomy and total knee arthroplasty to correct knee malalignment. Retrospective cohort study, Level III.

Effects of changing speed on knee and ankle joint load during walking and running.

PubMed

de David, Ana Cristina; Carpes, Felipe Pivetta; Stefanyshyn, Darren

2015-01-01

Joint moments can be used as an indicator of joint loading and have potential application for sports performance and injury prevention. The effects of changing walking and running speeds on joint moments for the different planes of motion still are debatable. Here, we compared knee and ankle moments during walking and running at different speeds. Data were collected from 11 recreational male runners to determine knee and ankle joint moments during different conditions. Conditions include walking at a comfortable speed (self-selected pacing), fast walking (fastest speed possible), slow running (speed corresponding to 30% slower than running) and running (at 4 m · s(-1) ± 10%). A different joint moment pattern was observed between walking and running. We observed a general increase in joint load for sagittal and frontal planes as speed increased, while the effects of speed were not clear in the transverse plane moments. Although differences tend to be more pronounced when gait changed from walking to running, the peak moments, in general, increased when speed increased from comfortable walking to fast walking and from slow running to running mainly in the sagittal and frontal planes. Knee flexion moment was higher in walking than in running due to larger knee extension. Results suggest caution when recommending walking over running in an attempt to reduce knee joint loading. The different effects of speed increments during walking and running should be considered with regard to the prevention of injuries and for rehabilitation purposes.

Biomechanical evaluation of native acromioclavicular joint ligaments and two reconstruction techniques in the presence of the sternoclavicular joint: A cadaver study.

PubMed

Masionis, Povilas; Šatkauskas, Igoris; Mikelevičius, Vytautas; Ryliškis, Sigitas; Bučinskas, Vytautas; Griškevičius, Julius; Martin Oliva, Xavier; Monzó Planella, Mariano; Porvaneckas, Narūnas; Uvarovas, Valentinas

2017-01-01

Where is over 100 reconstruction techniques described for acromioclavicular (AC) joint reconstruction. Although, it is not clear whether the presence of the sternoclavicular (SC) joint influences the biomechanical properties of native AC ligaments and reconstruction techniques. The purpose of the present study was to investigate the biomechanical properties of native AC joint ligaments and two reconstruction techniques in cadavers with the SC joint still present. We tested eight fresh-frozen cadaver hemithoraces for superior translation (70 N load) and translation increment after 1000 cycles (loading from 20 to 70 N) in a controlled laboratory study. There were three testing groups created: native ligaments, the single coracoclavicular loop (SCL) technique, and the two coracoclavicular loops (TCL) technique. Superior translation was measured after static loading. Translation increment was calculated as the difference between superior translation after cyclic and static loading. Native AC ligaments showed significantly lower translation than the SCL ( p = 0.023) and TCL ( p = 0.046) groups. The SCL had a significantly lower translation increment than native AC ligaments ( p = 0.028). There was no significant difference between reconstruction techniques in terms of translation ( p = 0.865) and translation increment ( p = 0.113). Native AC joint ligaments had better static properties than both reconstruction techniques and worse dynamic biomechanical properties than the SCL technique. The SCL technique appeared to be more secure than the TCL technique. The presence of the SC joint did not have an observable influence on test results.

Patellofemoral Joint Loads During Running at the Time of Return to Sport in Elite Athletes With ACL Reconstruction.

PubMed

Herrington, Lee; Alarifi, Saud; Jones, Richard

2017-10-01

Patellofemoral joint pain and degeneration are common in patients who undergo anterior cruciate ligament reconstruction (ACLR). The presence of patellofemoral joint pain significantly affects the patient's ability to continue sport participation and may even affect participation in activities of daily living. The mechanisms behind patellofemoral joint pain and degeneration are unclear, but previous research has identified altered patellofemoral joint loading in individuals with patellofemoral joint pain when running. It is unclear whether this process occurs after ACLR. To assess the patellofemoral joint stresses during running in ACLR knees and compare the findings to the noninjured knee and matched control knees. Controlled laboratory study. Thirty-four elite sports practitioners who had undergone ACLR and 34 age- and sex-matched controls participated in the study. The participants' running gait was assessed via 3D motion capture, and knee loads and forces were calculated by use of inverse dynamics. A significance difference was found in knee extensor moment, knee flexion angles, patellofemoral contact force (about 23% greater), and patellofemoral contact pressure (about 27% greater) between the ACLR and the noninjured limb ( P ≤ .04) and between the ACLR and the control limb ( P ≤ .04); no significant differences were found between the noninjured and control limbs ( P ≥ .44). Significantly greater levels of patellofemoral joint stress and load were found in the ACLR knee compared with the noninjured and control knees. Altered levels of patellofemoral stress in the ACLR knee during running may predispose individuals to patellofemoral joint pain.

Hip and knee joint loading during vertical jumping and push jerking

PubMed Central

Cleather, Daniel J; Goodwin, Jon E; Bull, Anthony MJ

2014-01-01

Background The internal joint contact forces experienced at the lower limb have been frequently studied in activities of daily living and rehabilitation activities. In contrast, the forces experienced during more dynamic activities are not well understood, and those studies that do exist suggest very high degrees of joint loading. Methods In this study a biomechanical model of the right lower limb was used to calculate the internal joint forces experienced by the lower limb during vertical jumping, landing and push jerking (an explosive exercise derived from the sport of Olympic weightlifting), with a particular emphasis on the forces experienced by the knee. Findings The knee experienced mean peak loadings of 2.4-4.6 × body weight at the patellofemoral joint, 6.9-9.0 × body weight at the tibiofemoral joint, 0.3-1.4 × body weight anterior tibial shear and 1.0-3.1 × body weight posterior tibial shear. The hip experienced a mean peak loading of 5.5-8.4 × body weight and the ankle 8.9-10.0 × body weight. Interpretation The magnitudes of the total (resultant) joint contact forces at the patellofemoral joint, tibiofemoral joint and hip are greater than those reported in activities of daily living and less dynamic rehabilitation exercises. The information in this study is of importance for medical professionals, coaches and biomedical researchers in improving the understanding of acute and chronic injuries, understanding the performance of prosthetic implants and materials, evaluating the appropriateness of jumping and weightlifting for patient populations and informing the training programmes of healthy populations. PMID:23146164

Hip and knee joint loading during vertical jumping and push jerking.

PubMed

Cleather, Daniel J; Goodwin, Jon E; Bull, Anthony M J

2013-01-01

The internal joint contact forces experienced at the lower limb have been frequently studied in activities of daily living and rehabilitation activities. In contrast, the forces experienced during more dynamic activities are not well understood, and those studies that do exist suggest very high degrees of joint loading. In this study a biomechanical model of the right lower limb was used to calculate the internal joint forces experienced by the lower limb during vertical jumping, landing and push jerking (an explosive exercise derived from the sport of Olympic weightlifting), with a particular emphasis on the forces experienced by the knee. The knee experienced mean peak loadings of 2.4-4.6×body weight at the patellofemoral joint, 6.9-9.0×body weight at the tibiofemoral joint, 0.3-1.4×body weight anterior tibial shear and 1.0-3.1×body weight posterior tibial shear. The hip experienced a mean peak loading of 5.5-8.4×body weight and the ankle 8.9-10.0×body weight. The magnitudes of the total (resultant) joint contact forces at the patellofemoral joint, tibiofemoral joint and hip are greater than those reported in activities of daily living and less dynamic rehabilitation exercises. The information in this study is of importance for medical professionals, coaches and biomedical researchers in improving the understanding of acute and chronic injuries, understanding the performance of prosthetic implants and materials, evaluating the appropriateness of jumping and weightlifting for patient populations and informing the training programmes of healthy populations. Copyright © 2012 Elsevier Ltd. All rights reserved.

Review, Analysis and Evaluation of Certain Areas and Facets of Policies, Systems, Processes and Management of the U.S. Government Printing Office.

ERIC Educational Resources Information Center

Coopers & Lybrand, New York, NY.

Covered in this report of the 1978 project of the Joint Committee on Printing are aspects of three selected areas. Part one, Management Review and Assessment, contains a summary of management and user interviews, a review of GPO's goals and organizational structure, and an assessment of management systems and procedures. The accounting system is…

The effect of augmented reality training on percutaneous needle placement in spinal facet joint injections.

PubMed

Yeo, Caitlin T; Ungi, Tamas; U-Thainual, Paweena; Lasso, Andras; McGraw, Robert C; Fichtinger, Gabor

2011-07-01

The purpose of this study was to determine if augmented reality image overlay and laser guidance systems can assist medical trainees in learning the correct placement of a needle for percutaneous facet joint injection. The Perk Station training suite was used to conduct and record the needle insertion procedures. A total of 40 volunteers were randomized into two groups of 20. 1) The Overlay group received a training session that consisted of four insertions with image and laser guidance, followed by two insertions with laser overlay only. 2) The Control group received a training session of six classical freehand insertions. Both groups then conducted two freehand insertions. The movement of the needle was tracked during the series of insertions. The final insertion procedure was assessed to determine if there was a benefit to the overlay method compared to the freehand insertions. The Overlay group had a better success rate (83.3% versus 68.4%, p=0.002), and potential for less tissue damage as measured by the amount of needle movement inside the phantom (3077.6 mm(2) versus 5607.9 mm(2) , p =0.01). These results suggest that an augmented reality overlay guidance system can assist medical trainees in acquiring technical competence in a percutaneous needle insertion procedure. © 2011 IEEE

Effects of cervical arthrodesis and arthroplasty on neck response during a simulated frontal automobile collision.

PubMed

White, Nicholas A; Moreno, Daniel P; Brown, Philip J; Gayzik, F Scott; Hsu, Wesley; Powers, Alexander K; Stitzel, Joel D

2014-09-01

Whereas arthrodesis is the most common surgical intervention for the treatment of symptomatic cervical degenerative disc disease, arthroplasty has become increasingly more popular over the past decade. Although literature exists comparing the effects of anterior cervical discectomy and fusion and cervical total disc replacement (CTDR) on neck kinematics and loading, the vast majority of these studies apply only quasi-static, noninjurious loading conditions to a segment of the cervical spine. The objective of this study was to investigate the effects of arthrodesis and arthroplasty on biomechanical neck response during a simulated frontal automobile collision with air bag deployment. This study used a full-body, 50th percentile seated male finite element (FE) model to evaluate neck response during a dynamic impact event. The cervical spine was modified to simulate either an arthrodesis or arthroplasty procedure at C5-C6. Five simulations of a belted driver, subjected to a 13.3 m/s ΔV frontal impact with air bag deployment, were run in LS-DYNA with the Global Human Body Models Consortium full-body FE model. The first simulation used the original model, with no modifications to the neck, whereas the remaining four were modified to represent either interbody arthrodesis or arthroplasty of C5-C6. Cross-sectional forces and moments at the C5 and C6 cervical levels of the neck, along with interbody and facet forces between C5 and C6, were reported. Adjacent-level, cross-sectional neck loading was maintained in all simulations without exceeding any established injury thresholds. Interbody compression was greatest for the CTDRs, and interbody tension occurred only in the fused and nonmodified spines. Some interbody separation occurred between the superior and inferior components of the CTDRs during flexion-induced tension of the cervical spine, increasing the facet loads. This study evaluated the effects of C5-C6 cervical arthrodesis and arthroplasty on neck response during a simulated frontal automobile impact. Although cervical arthrodesis and arthroplasty at C5-C6 did not appear to significantly alter the adjacent-level, cross-sectional neck responses during a simulated frontal automobile impact, key differences were noted in the interbody and facet loading. Copyright © 2014 Elsevier Inc. All rights reserved.

Adaptive velocity-based six degree of freedom load control for real-time unconstrained biomechanical testing.

PubMed

Lawless, I M; Ding, B; Cazzolato, B S; Costi, J J

2014-09-22

Robotic biomechanics is a powerful tool for further developing our understanding of biological joints, tissues and their repair. Both velocity-based and hybrid force control methods have been applied to biomechanics but the complex and non-linear properties of joints have limited these to slow or stepwise loading, which may not capture the real-time behaviour of joints. This paper presents a novel force control scheme combining stiffness and velocity based methods aimed at achieving six degree of freedom unconstrained force control at physiological loading rates. Copyright © 2014 Elsevier Ltd. All rights reserved.

Shoulder joint loading and posture during medicine cart pushing task.

PubMed

Xu, Xu; Lin, Jia-Hua; Boyer, Jon

2013-01-01

Excessive physical loads and awkward shoulder postures during pushing and pulling are risk factors for shoulder pain. Pushing a medicine cart is a major component of a work shift for nurses and medical assistants in hospitals and other health care facilities. A laboratory experiment was conducted to examine the effects of common factors (e.g., lane congestion, cart load stability, floor surface friction) on shoulder joint moment and shoulder elevation angle of participants during cart pushing. Participants pushed a medicine cart on straight tracks and turning around right-angle corners. Peak shoulder joint moments reached 25.1 Nm, 20.3 Nm, and 26.8 Nm for initial, transition, and turning phases of the pushing tasks, indicating that shoulder joint loading while pushing a medical cart is comparable to levels previously reported from heavy manual activities encountered in industry (e.g., garbage collection). Also, except for user experience, all other main study factors, including congestion level, cart load stability, location of transition strip, shoulder tendency, surface friction, and handedness, significantly influenced shoulder joint moment and shoulder elevation angle. The findings provide a better understanding of shoulder exposures associated with medicine cart operations and may be helpful in designing and optimizing the physical environment where medicine carts are used.

Subject-Specific Modeling of Muscle Force and Knee Contact in Total Knee Arthroplasty

PubMed Central

Navacchia, Alessandro; Rullkoetter, Paul J.; Schütz, Pascal; List, Renate B.; Fitzpatrick, Clare K.; Shelburne, Kevin B.

2017-01-01

Understanding the mechanical loading environment and resulting joint mechanics for activities of daily living in total knee arthroplasty is essential to continuous improvement in implant design. Although survivorship of these devices is good, a substantial number of patients report dissatisfaction with the outcome of their procedure. Knowledge of in vivo kinematics and joint loading will enable improvement in preclinical assessment and refinement of implant geometry. The purpose of this investigation was to describe the mechanics of total knee arthroplasty during a variety of activities of daily living (gait, walking down stairs, and chair rise/sit). Estimates of muscle forces, tibial contact load, location, and pressure distribution was performed through a combination of mobile fluoroscopy data collection, musculoskeletal modeling, and finite element simulation. For the activities evaluated, joint compressive load was greatest during walking down stairs; however, the highest contact pressure occurred during chair rise/sit. The joint contact moment in the frontal plane was mainly varus for gait and walking down stairs, while it was valgus during chair rise/sit. Excursion of the center of pressure on the tibial component was similar during each activity and between the medial and lateral sides. The main determinants of center of pressure location were internal–external rotation, joint load, and tibial insert conformity. PMID:26792665

Buckling of a Longitudinally Jointed Curved Composite Panel Arc Segment for Next Generation of Composite Heavy Lift Launch Vehicles: Verification Testing Analysis

NASA Technical Reports Server (NTRS)

Farrokh, Babak; Segal, Kenneth N.; Akkerman, Michael; Glenn, Ronald L.; Rodini, Benjamin T.; Fan, Wei-Ming; Kellas, Sortiris; Pineda, Evan J.

2014-01-01

In this work, an all-bonded out-of-autoclave (OoA) curved longitudinal composite joint concept, intended for use in the next generation of composite heavy lift launch vehicles, was evaluated and verified through finite element (FE) analysis, fabrication, testing, and post-test inspection. The joint was used to connect two curved, segmented, honeycomb sandwich panels representative of a Space Launch System (SLS) fairing design. The overall size of the resultant panel was 1.37 m by 0.74 m (54 in by 29 in), of which the joint comprised a 10.2 cm (4 in) wide longitudinal strip at the center. NASTRAN and ABAQUS were used to perform linear and non-linear analyses of the buckling and strength performance of the jointed panel. Geometric non-uniformities (i.e., surface contour imperfections) were measured and incorporated into the FE model and analysis. In addition, a sensitivity study of the specimens end condition showed that bonding face-sheet doublers to the panel's end, coupled with some stress relief features at corner-edges, can significantly reduce the stress concentrations near the load application points. Ultimately, the jointed panel was subjected to a compressive load. Load application was interrupted at the onset of buckling (at 356 kN 80 kips). A post-test non-destructive evaluation (NDE) showed that, as designed, buckling occurred without introducing any damage into the panel or the joint. The jointed panel was further capable of tolerating an impact damage to the same buckling load with no evidence of damage propagation. The OoA cured all-composite joint shows promise as a low mass factory joint for segmented barrels.

Design and fabrication of graphite-epoxy bolted wing skin splice specimens

NASA Technical Reports Server (NTRS)

Johnson, R. W.; Mccarty, J. E.

1977-01-01

Graphite-epoxy bolted joint specimens were designed and fabricated. These specimens were to be representative of a side-of-body wing skin splice with a 20-year life expectancy in a commercial transport environment. Preliminary tests were performed to determine design values of bearing and net tension stresses. Based upon the information developed, a three-fastener-wide representative wing skin splice was designed for a load of 2627 KN/m (15,000 lbf/in.). One joint specimen was fabricated and tested at NASA. The wing skin splice failed at 106 percent of design ultimate load. This joint design achieved all static load objectives. Fabrication of six specimens, together with their loading fixtures, was completed, and the specimens were delivered to NASA-LRC.

Symphyseal fixation in open book injuries cannot fully compensate anterior SI joint injury-A biomechanical study in a two-leg alternating load model.

PubMed

Stuby, Fabian M; Lenz, Mark; Doebele, Stefan; Agarwal, Yash; Skulev, Hristo; Ochs, Björn G; Zwingmann, Jörn; Gueorguiev, Boyko

2017-01-01

In open book injuries type Tile B1.1 or B1.2 also classified as APC II (anteroposterior compression), it remains controversial, if a fixation of the anterior ring provides sufficient stability or a fixation of the posterior ring should be included. Therefore the relative motion at the sacroiliac joint was quantified in a two-leg alternating load biomechanical pelvis model in the intact, the injured and the restored pelvis. Fresh-frozen intact (I) pelvises (n = 6) were subjected to a non-destructive cyclic test under sinosuidal axial two-leg alternating load with progressively increasing amplitude. Afterwards an open book injury (J) including the anterior ligament complex of the left sacroiliac joint, the sacrospinal and sacrotuberal ligaments (Tile B1.1) was created and the specimens were retested. Finally, the symphysis was stabilized with a modular fixation system (1-, 2- or 4-rod configuration) (R) and specimens were cyclically retested. Relative motion at the sacroiliac joint was captured at both sacroiliac joints by motion tracking system at two load levels of 170 N and 340 N during all tests. Relative sacroiliac joint movements at both load levels were significantly higher in the J-state compared to the I-state, excluding superoinferior translational movement. With exception of the anteroposterior translational movement at 340N, the relative sacroiliac joint movements after each of the three reconstructions (1-, 2-, 4-rod fixation) were significantly smaller compared to the J-state and did not differ significantly to the I-state, but stayed above the values of the latter. Relative movements did not differ significantly in a direct comparison between the 1-rod, 2-rod and 4-rod fixations. Symphyseal locked plating significantly reduces relative movement of the sacroiliac joint in open book injuries type Tile B1.1 or B1.2 (APC II) but cannot fully restore the situation of the intact sacroiliac joint.

Effects of different overlap lengths and composite adherend thicknesses on the performance of adhesively-bonded joints under tensile and bending loadings

NASA Astrophysics Data System (ADS)

Kadioglu, F.; Avil, E.; Ercan, M. E.; Aydogan, T.

2018-05-01

Fiber-reinforced polymer composites are being used in an increasingly wide range of products. They are particularly popular in automotive and aerospace sectors because they offer an attractive combination of stiffness, strength and low mass. Adhesively-bonded joints of such materials are preferred by many designers due to their assembling advantages over other traditional mechanical joining systems, such as bolted and riveted joints. In this study, some experimental works have been carried out on adhesively-bonded adherends manufactured from a woven carbon fiber-reinforced polymer matrix composite (Hexply 8552S/A280-5H, produced by Hexcel), by using a film adhesive (AF163-2K produced by 3 M). The bonded specimens were prepared in the Single Lap Joint (SLJ) configuration, and tested in tensile and also in four-point bending loading. In order to assess the joint performance, three different overlap lengths, 15 mm, 25 mm and 40 mm, and two different thicknesses of the composite adherends, 2 mm and 3 mm, were used. The results shown that the parameters are controlled by the loading modes; while the overlap length increases the joint performance significantly in tensile loading, the opposite was the case for those in bending loading, which was affected mainly by the adherend thicknesses. The results were related to the mechanisms of joint failures; while the joints in the tensile failed in the adhesive layer with some exceptions, those in the bending mainly failed in the plies adjacent to the layer. The current study indicates that one of the important factors affecting the joint strength of the adherends manufactured from the laminated composites is the local failure of the plies. It is thought more focused-studies would be needed to lessen such problems, which would be possible via in-depth numerical analysis.

Symphyseal fixation in open book injuries cannot fully compensate anterior SI joint injury—A biomechanical study in a two-leg alternating load model

PubMed Central

Stuby, Fabian M.; Lenz, Mark; Agarwal, Yash; Skulev, Hristo; Ochs, Björn G.; Zwingmann, Jörn; Gueorguiev, Boyko

2017-01-01

Introduction In open book injuries type Tile B1.1 or B1.2 also classified as APC II (anteroposterior compression), it remains controversial, if a fixation of the anterior ring provides sufficient stability or a fixation of the posterior ring should be included. Therefore the relative motion at the sacroiliac joint was quantified in a two-leg alternating load biomechanical pelvis model in the intact, the injured and the restored pelvis. Methods Fresh-frozen intact (I) pelvises (n = 6) were subjected to a non-destructive cyclic test under sinosuidal axial two-leg alternating load with progressively increasing amplitude. Afterwards an open book injury (J) including the anterior ligament complex of the left sacroiliac joint, the sacrospinal and sacrotuberal ligaments (Tile B1.1) was created and the specimens were retested. Finally, the symphysis was stabilized with a modular fixation system (1-, 2- or 4-rod configuration) (R) and specimens were cyclically retested. Relative motion at the sacroiliac joint was captured at both sacroiliac joints by motion tracking system at two load levels of 170 N and 340 N during all tests. Results Relative sacroiliac joint movements at both load levels were significantly higher in the J-state compared to the I-state, excluding superoinferior translational movement. With exception of the anteroposterior translational movement at 340N, the relative sacroiliac joint movements after each of the three reconstructions (1-, 2-, 4-rod fixation) were significantly smaller compared to the J-state and did not differ significantly to the I-state, but stayed above the values of the latter. Relative movements did not differ significantly in a direct comparison between the 1-rod, 2-rod and 4-rod fixations. Conclusion Symphyseal locked plating significantly reduces relative movement of the sacroiliac joint in open book injuries type Tile B1.1 or B1.2 (APC II) but cannot fully restore the situation of the intact sacroiliac joint. PMID:29176772

[Spondylarthrosis of the cervical spine. Therapy].

PubMed

Radl, R; Leixner, G; Stihsen, C; Windhager, R

2013-09-01

Chronic neck pain is often associated with spondylarthrosis, whereby segments C4/C5 (C: cervical) are most frequently affected. Spondylarthrosis can be the sole complaint, but it is associated with a degenerative cascade of the spine. The umbrella term for neck pain is the so-called cervical syndrome, which can be differentiated into segmental dysfunction and/or morphological changes of the intervertebral discs and small joints of the vertebral column. Conservative therapy modalities include physical therapy, subcutaneous application of local anesthetics, muscle, nerve and facet joint injections in addition to adequate analgesic and muscle relaxant therapy. If surgery is required, various techniques via dorsal and ventral approaches, depending on the clinic and morphologic changes, can be applied.

Knee Joint Loading during Single-Leg Forward Hopping.

PubMed

Krupenevich, Rebecca L; Pruziner, Alison L; Miller, Ross H

2017-02-01

Increased or abnormal loading on the intact limb is thought to contribute to the relatively high risk of knee osteoarthritis in this limb for individuals with unilateral lower limb loss. This theory has been assessed previously by studying walking, but knee joint loading during walking is often similar between individuals with and without limb loss, prompting assessment of other movements that may place unusual loads on the knee. One such movement, hopping, is a form of locomotion that individuals with unilateral lower limb loss may situationally use instead of walking, but the mechanical effects of hopping on the intact limb are unknown. Compare knee joint kinetics of healthy adults during single-leg forward hopping compared to walking, a more traditional form of locomotion. Twenty-four healthy adults walked and hopped at self-selected speeds of 1.5 and 2.3 m·s, respectively. Joint moments were calculated using inverse dynamics. A paired Student's t-test was utilized to compare peak, impulse, and loading rate (LR) of knee adduction moment (KAM), and peak knee flexion moment (KFM) between walking and hopping. Peak KFM and KAM LR were greater during hopping compared to walking (peak KFM: 20.73% vs 5.51% body weight (BW) × height (Ht), P < 0.001; KAM LR: 0.47 vs. 0.33 BW·Ht·s, P = 0.01). Kinetic measures affecting knee joint loading are greater in hopping compared to walking. It may be advisable to limit single-leg forward hopping in the limb loss population until it is known if these loads increase knee osteoarthritis risk.

Anterior cruciate ligament (ACL) loading in a collegiate athlete during sidestep cutting after ACL reconstruction: A case study.

PubMed

Samaan, Michael A; Ringleb, Stacie I; Bawab, Sebastian Y; Greska, Eric K; Weinhandl, Joshua T

2016-08-01

Athletes with anterior cruciate ligament (ACL) injuries usually undergo ACL-reconstruction (ACLR) in order to restore joint stability, so that dynamic maneuvers such as the sidestep cut can be performed. Despite restoration of joint stability after ACLR, many athletes do not return to pre-injury levels and may be at a high risk of a second ACL injury. The purpose of this study was to determine whether or not ACL loading, would increase after ACLR. One female Division I collegiate athlete performed bilateral unanticipated sidestep cuts both before ACL injury and 27months after ACLR. Musculoskeletal simulations were used to calculate ACL loading during the deceleration phase of the sidestep cuts. Twenty-seven months after ACLR, the athlete demonstrated higher total ACL loading in the ipsilateral limb as well as altered joint kinematics, moments, and quadriceps muscle force production. In the contralateral limb, there were no increases in total ACL loading or muscle force production yet altered lower extremity joint kinematics and moments were present after ACLR. Higher total ACL loading in the ipsilateral limb of this athlete may suggest an increased risk of second ACL injury. The results of this study provide an initial step in understanding the effects of ACLR on the risk of second ACL injury in an elite athlete and suggest that it is important to develop a better understanding of this surgical intervention on knee joint loading, in order to reduce the risk of second ACL injury while performing dynamic maneuvers. Copyright © 2016 Elsevier B.V. All rights reserved.

Early Osteoarthritis of the Trapeziometacarpal Joint Is Not Associated With Joint Instability during Typical Isometric Loading

PubMed Central

Halilaj, Eni; Moore, Douglas C.; Patel, Tarpit K.; Ladd, Amy L.; Weiss, Arnold-Peter C.; Crisco, Joseph J.

2015-01-01

The saddle-shaped trapeziometacarpal (TMC) joint contributes importantly to the function of the human thumb. A balance between mobility and stability is essential in this joint, which experiences high loads and is prone to osteoarthritis (OA). Since instability is considered a risk factor for TMC OA, we assessed TMC joint instability during the execution of three isometric functional tasks (key pinch, jar grasp, and jar twist) in 76 patients with early TMC OA and 44 asymptomatic controls. Computed tomography images were acquired while subjects held their hands relaxed and while they applied 80% of their maximum effort for each task. Six degree-of-freedom rigid body kinematics of the metacarpal with respect to the trapezium from the unloaded to the loaded task positions were computed in terms of a TMC joint coordinate system. Joint instability was expressed as a function of the metacarpal translation and the applied force. We found that the TMC joint was more unstable during a key pinch task than during a jar grasp or a jar twist task. Sex, age, and early OA did not have an effect on TMC joint instability, suggesting that instability during these three tasks is not a predisposing factor in TMC OA. PMID:25941135

In vitro method for assessing the biomechanics of the patellofemoral joint following total knee arthroplasty.

PubMed

Coles, L G; Gheduzzi, S; Miles, A W

2014-12-01

The patellofemoral joint is a common site of pain and failure following total knee arthroplasty. A contributory factor may be adverse patellofemoral biomechanics. Cadaveric investigations are commonly used to assess the biomechanics of the joint, but are associated with high inter-specimen variability and often cannot be carried out at physiological levels of loading. This study aimed to evaluate the suitability of a novel knee simulator for investigating patellofemoral joint biomechanics. This simulator specifically facilitated the extended assessment of patellofemoral joint biomechanics under physiological levels of loading. The simulator allowed the knee to move in 6 degrees of freedom under quadriceps actuation and included a simulation of the action of the hamstrings. Prostheses were implanted on synthetic bones and key soft tissues were modelled with a synthetic analogue. In order to evaluate the physiological relevance and repeatability of the simulator, measurements were made of the quadriceps force and the force, contact area and pressure within the patellofemoral joint using load cells, pressure-sensitive film, and a flexible pressure sensor. The results were in agreement with those previously reported in the literature, confirming that the simulator is able to provide a realistic physiological loading situation. Under physiological loading, average standard deviations of force and area measurements were substantially lower and comparable to those reported in previous cadaveric studies, respectively. The simulator replicates the physiological environment and has been demonstrated to allow the initial investigation of factors affecting patellofemoral biomechanics following total knee arthroplasty. © IMechE 2014.

Transient Pressure Test Article (TPTA) 1.1 and 1.1A, volume 1

NASA Technical Reports Server (NTRS)

Rebells, Clarence A.

1988-01-01

This final test report presents the results obtained during the static hot firing and cold-gas high Q tests of the first Transient Pressure Test Article (TPTA) 1.1. The TPTA consisted of field test joints A and B, which were the original RSRM J-insulation configuration, with a metal capture feature. It also consisted of a flight configuration nozzle-to-case test joint (Joint D) with shorter vent slots. Fluorocarbon O-rings were used in all the test joints. The purpose of the TPTA tests is to evaluate and characterize the RSMR field and nozzle-to-case joints under the influence of ignition and strut loads during liftoff anf high Q. All objectives of the cold-gas high Q (TPTA 1.1A) test were met and all measurements were close to predicted values. During the static hot-firing test (TPTA 1.1), the motor was inadvertently plugged by the quench injector plug, making it a more severe test, although no strut loads were applied. The motor was depressurized after approximately 11 min using an auxiliary system, and no anomalies were noted. In the static hot-firing test, pressure was incident on the insulation and the test joint gaps were within the predicted range. During the static hot-firing test, no strut loads were applied because the loading system malfunctioned. For this test, all measurements were within range of similar tests performed without strut loads.

Biomechanical analysis of disc pressure and facet contact force after simulated two-level cervical surgeries (fusion and arthroplasty) and hybrid surgery.

PubMed

Park, Jon; Shin, Jun Jae; Lim, Jesse

2014-12-01

The objective of this study was designed to compare 2-level cervical disc surgery (2-level anterior cervical discectomy and fusion [ACDF] or disc arthroplasty) and hybrid surgery (ACDF/arthroplasty) in terms of postoperative adjacent-level intradiscal pressure (IDP) and facet contact force (FCF). Twenty-four cadaveric cervical spines (C3-T2) were tested in various modes, including extension, flexion, and bilateral axial rotation, to compare adjacent-level IDP and FCF after specified treatments as follows: 1) C5-C6 arthroplasty using ProDisc-C (Synthes Spine, West Chester, Pennsylvania, USA) and C6-C7 ACDF, 2) C5-C6 ACDF and C6-C7 arthroplasty using ProDisc-C, 3) 2-level C5-C6/C6-C7 disc arthroplasties, and 4) 2-level C5-C6/C6-C7 ACDF. IDPs were recorded at anterior, central, and posterior disc portions. After 2-level cervical arthrodesis (ACDF), IDP increased significantly at the anterior annulus of distal adjacent-level disc during flexion and axial rotation and at the center of proximal adjacent-level disc during flexion. In contrast, after cervical specified treatments, including disc arthroplasty (2-level disc arthroplasties and hybrid surgery), IDP decreased significantly at the anterior annulus of distal adjacent-level disc during flexion and extension and was unchanged at the center of proximal adjacent-level disc during flexion. Two-level cervical arthrodesis also tended to adversely impact facet loads, increasing distal rather than proximal adjacent-level FCF. Both hybrid surgery and 2-level arthroplasties seem to offer significant advantages over 2-level arthrodesis by reducing IDP at adjacent levels and approximating FCF of an intact spine. These findings suggest that cervical arthroplasties and hybrid surgery are an alternative to reduce IDP and facet loads at adjacent levels. Copyright © 2014 Elsevier Inc. All rights reserved.

Ability of finger-jointed lumber to maintain load at elevated temperatures

Treesearch

Douglas R. Rammer; Samuel L. Zelinka; Laura E Hasburgh; Steven T. Craft

2018-01-01

This article presents a test method that was developed to screen adhesive formulations for finger-jointed lumber. The goal was to develop a small-scale test that could be used to predict whether an adhesive would pass a full-scale ASTM E119 wall assembly test. The method involved loading a 38-mm square finger-jointed sample in a four-point bending test inside of an...

Three-Dimensional Lower Extremity Joint Loading in a Carved Ski and Snowboard Turn: A Pilot Study

PubMed Central

Müller, Erich

2014-01-01

A large number of injuries to the lower extremity occur in skiing and snowboarding. Due to the difficulty of collecting 3D kinematic and kinetic data with high accuracy, a possible relationship between injury statistic and joint loading has not been studied. Therefore, the purpose of the current study was to compare ankle and knee joint loading at the steering leg between carved ski and snowboard turns. Kinetic data were collected using mobile force plates mounted under the toe and heel part of the binding on skies or snowboard (KISTLER). Kinematic data were collected with five synchronized, panning, tilting, and zooming cameras. An extended version of the Yeadon model was applied to calculate inertial properties of the segments. Ankle and knee joint forces and moments were calculated using inverse dynamic analysis. Results showed higher forces along the longitudinal axis in skiing and similar forces for skiing and snowboarding in anterior-posterior and mediolateral direction. Joint moments were consistently greater during a snowboard turn, but more fluctuations were observed in skiing. Hence, when comparing joint loading between carved ski and snowboard turns, one should differentiate between forces and moments, including the direction of forces and moments and the turn phase. PMID:25317202

A microscale three-dimensional urban energy balance model for studying surface temperatures

NASA Astrophysics Data System (ADS)

Krayenhoff, E. Scott; Voogt, James A.

2007-06-01

A microscale three-dimensional (3-D) urban energy balance model, Temperatures of Urban Facets in 3-D (TUF-3D), is developed to predict urban surface temperatures for a variety of surface geometries and properties, weather conditions, and solar angles. The surface is composed of plane-parallel facets: roofs, walls, and streets, which are further sub-divided into identical square patches, resulting in a 3-D raster-type model geometry. The model code is structured into radiation, conduction and convection sub-models. The radiation sub-model uses the radiosity approach and accounts for multiple reflections and shading of direct solar radiation. Conduction is solved by finite differencing of the heat conduction equation, and convection is modelled by empirically relating patch heat transfer coefficients to the momentum forcing and the building morphology. The radiation and conduction sub-models are tested individually against measurements, and the complete model is tested against full-scale urban surface temperature and energy balance observations. Modelled surface temperatures perform well at both the facet-average and the sub-facet scales given the precision of the observations and the uncertainties in the model inputs. The model has several potential applications, such as the calculation of radiative loads, and the investigation of effective thermal anisotropy (when combined with a sensor-view model).

Strength analysis and design of adhesive joints between circular elements made of metal and reinforced polymer materials

NASA Astrophysics Data System (ADS)

Pelekh, B. L.; Marchuk, M. V.; Kogut, I. S.

1992-06-01

The stress-strain state of an adhesive joint between cylindrical components made of a metal (steel) and a cross-reinforced filament-wound composite (glass/polymer or basalt/polymer) was investigated under static axial loading using newly proposed experimental techniques and a refined mathematical model. Analytical expressions are obtained for contact stresses in the adhesive joint. The maximum permissible load and the ultimate shear strength of the joint are determined. The experimental results are found to be in satisfactory agreement with model predictions.

Joint Strength Control at the Fiber/Matrix Interface during the Production of Polymer Composite Materials Reinforced with High Performance Fibers

NASA Astrophysics Data System (ADS)

Kudinov, Vladimir V.; Korneeva, Natalia V.

2010-06-01

The paper presents the results obtained in the study of the joint strength between polymer matrix and high performance polyethylene fiber. The fiber/matrix joints simulate the unit cell of the fiber-reinforced composite materials. Effect of heat treatment on the composite properties at the interface was estimated by a multifilament wet-pull-out method. It was found that the joint strength may be increased with the help of extra heart treatment. Both the energy to peak load and the energy to failure for CM joints at various stages of loading were determined.

BSA nanoparticle loaded atorvastatin calcium--a new facet for an old drug.

PubMed

Sripriyalakshmi, S; Anjali, C H; George, Priya Doss C; Rajith, B; Ravindran, Aswathy

2014-01-01

Currently, the discovery of effective chemotherapeutic agents poses a major challenge to the field of cancer biology. The present study focuses on enhancing the therapeutic and anti cancer properties of atorvastatin calcium loaded BSA (ATV-BSA) nanoparticles in vitro. BSA-ATV nanoparticles were prepared using desolvation technique. The process parameters were optimized based on the amount of desolvating agent, stabilization conditions as well as the concentration of the cross linker. The anti cancer properties of the protein coated ATV nanoparticles were tested on MiaPaCa-2 cell lines. In vitro release behavior of the drug from the carrier suggests that about 85% of the drug gets released after 72 hrs. Our studies show that ATV-BSA nanoparticles showed specific targeting and enhanced cytotoxicity to MiaPaCa-2 cells when compared to the bare ATV. We hereby propose that the possible mechanism of cellular uptake of albumin bound ATV could be through caveolin mediated endocytosis. Hence our studies open up new facet for an existing cholesterol drug as a potent anti-cancer agent.

Focal cartilage defect compromises fluid-pressure dependent load support in the knee joint.

PubMed

Dabiri, Yaghoub; Li, LePing

2015-06-01

A focal cartilage defect involves tissue loss or rupture. Altered mechanics in the affected joint may play an essential role in the onset and progression of osteoarthritis. The objective of the present study was to determine the compromised load support in the human knee joint during defect progression from the cartilage surface to the cartilage-bone interface. Ten normal and defect cases were simulated with a previously tested 3D finite element model of the knee. The focal defects were considered in both condyles within high load-bearing regions. Fluid pressurization, anisotropic fibril-reinforcement, and depth-dependent mechanical properties were considered for the articular cartilages and menisci. The results showed that a small cartilage defect could cause 25% reduction in the load support of the knee joint due to a reduced capacity of fluid pressurization in the defect cartilage. A partial-thickness defect could cause a fluid pressure decrease or increase in the remaining underlying cartilage depending on the defect depth. A cartilage defect also increased the shear strain at the cartilage-bone interface, which was more significant with a full-thickness defect. The effect of cartilage defect on the fluid pressurization also depended on the defect sites and contact conditions. In conclusion, a focal cartilage defect causes a fluid-pressure dependent load reallocation and a compromised load support in the joint, which depend on the defect depth, site, and contact condition. Copyright © 2015 John Wiley & Sons, Ltd.

[Relevance of nerve blocks in treating and diagnosing low back pain--is the quality decisive?].

PubMed

Hildebrandt, J

2001-12-01

Diagnostic nerve blocks: The popularity of neural blockade as a diagnostic tool in painful conditions, especially in the spine, is due to features like the unspecific character of spinal pain, the irrelevance of radiological findings and the purely subjective character of pain. It is said that apart from specific causes of pain and clear radicular involvement with obvious neurological deficits and corresponding findings of a prolapsed disc in MRI or CT pictures, a diagnosis of the anatomical cause of the pain can only be established if invasive tests are used [5]. These include zygapophyseal joint blocks, sacroiliacal joint blocks, disc stimulation and nerve root blocks. Under controlled conditions, it has been shown that among patients with chronic nonradicular low back pain, some 10-15% have zygapophyseal joint pain [58], some 15-20% have sacroiliacal joint pain [36, 59] and 40% have pain from internal disc disruption [60]. The diagnostic use of neural blockade rests on three premises. First, pathology causing pain is located in an exact peripheral location, and impulses from this site travel via a unique and consistent neural root. Second, injection of local aneasthetic totally abolishes sensory function of intended nerves and does not affect other nerves. Third, relief of pain after local anaesthetic block is attributable solely to block of the target afferent neural pathway. The validity of these assumptions is limited by complexities of anatomy, physiology, and psychology of pain perception and the effect of local anaesthetics on impulse conduction [28]. Facet joints: The prevalence of zygapophyseal joint pain among patients with low back pain seems to be between 15% and 40% [62], but apparently only 7% of patients have pure facet pain [8, 29]. Facet blockade is achieved either by injection of local anaesthetic into the joint space or around the medial branches of the posterior medial rami of the spinal nerves that innervate the joint. There are several problems with intraarticular facet injections, mainly failure to enter the joint capsule and rupture of the capsule during the injection [11]. There is no physiological means to test the adaequacy of medial nerve block, because the lower branches have no cutaneous innervation. Medial ramus blocks (for one joint two nerves have to be infiltrated) are as effective as intraarticular joint blocks [37]. Reproducibility of the test is not high, the specifity is only 65% [61]. For diagnosis of facet pain fluoroscopic control is always necessary as in the other diagnostic blocks. Sacroiliacal joint: Definitely the sacroiliacal joint can be the source of low back pain. Stimulation of the joint by injection in subjects without pain produces pain in the buttock, in the posterior thigh and the knee. There are many clinical tests which confirm the diagnosis, but the interrater reliability is moderate [53]. Intraarticular injection can be achieved in the lower part of the joint with fluoroscopic guidance only, but an accurate intraarticular injection, which is confirmed by contrast medium, even at this place is often difficult. It is not clear whether intraarticular spread is necessary to achieve efficacy. Discography: Two primary syndromes concerning the ventral compartment have been described: anular fissures of the disc and instability of the motion segment. In the syndrome of anular tear, leakage of nucleus pulposus material into the anulus fibrosus is considered to be the source of pain. The studies of Vaharanta [71] and Moneta [41] show a clear and significant correlation between disc pain and grade 3 fissures of the anulus fibrosus. intervertebral discs are difficult to anaesthetize. Intradiskal injections of local anaesthetics may succeed in relieving the patient's pain, but such injections are liable to yield false negative results if the injected agent fails to adequately infiltrate the nerve endings in the outer anulus fibrosus that mediate the patient's pain. In the majority of cases MRI provide adaequate information, but discography may be superior in early stages of anular tear and in clarifying the relation between imaging data and pain [71]. Selective spinal nerve injection: In patients with complicated radiculopathy, the contribution of root inflammation to pain may not be certain, or the level of pathology may be unclear. Diagnostic root blocks are indicated in the following situations: atypical topography of radicular pain, disc prolapses or central spinal stenosis at more than one level and monoradicular pain, lateral spinal stenosis, postnucleotomysyndrome. Injection of individual spinal nerves by paravertebral approach has to be used to elucidate the mechanism and source of pain in this unclear situations. The premise is that needle contact will identify the nerve that produces the patient's characteristic pain and that local anaesthetic delivered to the pathogenic nerve will be uniquely analgesic. Often, this method is used for surgical planning, such as determining the site of foraminotomy. All diagnostic nerve root blocks have to be done under fluoroscopic guidance. Pain relief with blockade of a spinal nerve cannot distinguish between pathology of the proximal nerve in the intervertebral foramen or pain transmitted from distal sites by that nerve. Besides, the tissue injury in the nerve's distribution and neuropathic pain (for instance as a result of root injury) likewise would be relieved by a proximal block of the nerve. Satisfactory needle placement could not be achieved in 10% of patient's at L4, 15% at L5 and 30% at S1 [28]. The positive predictive value of indicated radiculopathy confirmed by surgery ranged between 87-100% [14, 22]. The negative predictive value is poorly studied, because few patients in the negative test group had surgery. Negative predictive values were 27% and 38% of the small number of patients operated on despite a negative test. Only one prospective study was published, which showed a positive predictive value of 95% and an untested negative predictive value [66]. Some studies repeatedly demonstrated that pain relief by nerve root block does not predict success by neuroablative procedures, neither by dorsal rhyzotomy nor by dorsal gangliectomy [46]. Therapeutic nerve blocks - facet joints: Intraarticular injection of steroids offer no greater benefit than injections of normal saline [8, 15] and long lasting success is lacking. In this case, a denervation of the medial branches can be considered. To date three randomized controlled studies of radiofrequency facet denervation have been published. One study [20] reported only modest outcomes and its results remained inconclusive, another study [72] with a double blind controlled design showed some effects in a small selected group of patients (adjusted odds ratio 4.8) 3, 6 and 12 months after treatment, concerning not only reduction of pain but alleviating functional disability also. The third study (34a) showed no effect 3 months after treatment. Discogenic pain: Intradiscal radiofrequency lesions, intradiscal injections of steroids and phenol have been advocated, but there are no well controlled studies. Just recently, intradiscal lesion and denervation of the anulus has been described with promising results, but a randomized controlled study is lacking up to now [31, 55]. Epidural Steroids: Steroids relieve pain by reducing inflammation and by blocking transmission of nociceptive C-fiber input. Koes et al. [33] reviewed the randomized trials of epidural steroids: To date, 15 trials have been performed to evaluate the efficacy, 11 of which showed method scores of 50 points (from 100) ore more. The trials showed inconsistent results of epidural injections. Of the 15 trials, 8 reported positive results and 7 others reported negative results. Consequently the efficacy of epidural steroid injections has not yet been established. The benefits of epidural steroid injections seem to be of short duration only. Future efficacy studies, which are clearly needed, should take into account the apparent methological shortcomings. Furthermore, it is unclear which patients benefit from these injections. In our hands the injection technique can be much improved by fluoroscopic guidance of the needle, with a prone position of the patient, and lateral injection at the relevant level and with a small volume (1-2 ml) and low dose of corticosteroid (20 mg triamcinolone in the case of a monoradicular pain, for example). In the case of epidural adhesions in postoperative radicular pain [50], the study of Heafner showed that the additional effect of hyaloronidase and hypertonic saline to steroids was minimal. In our hands there was no effect in chronic radicular pain 3 months after the injection.

Discriminating Schizophrenia and Bipolar Disorder by Fusing FMRI and DTI in A Multimodal CCA+ Joint ICA Model

PubMed Central

Sui, Jing; Pearlson, Godfrey; Adali, Tülay; Kiehl, Kent A.; Caprihan, Arvind; Liu, Jingyu; Yamamoto, Jeremy; Calhoun, Vince D.

2011-01-01

Diverse structural and functional brain alterations have been identified in both schizophrenia and bipolar disorder, but with variable replicability, significant overlap and often in limited number of subjects. In this paper, we aimed to clarify differences between bipolar disorder and schizophrenia by combining fMRI (collected during an auditory oddball task) and diffusion tensor imaging (DTI) data. We proposed a fusion method, “multimodal CCA+ joint ICA’, which increases flexibility in statistical assumptions beyond existing approaches and can achieve higher estimation accuracy. The data collected from 164 participants (62 healthy controls, 54 schizophrenia and 48 bipolar) were extracted into “features” (contrast maps for fMRI and fractional anisotropy (FA) for DTI) and analyzed in multiple facets to investigate the group differences for each pair-wised groups and each modality. Specifically, both patient groups shared significant dysfunction in dorsolateral prefrontal cortex and thalamus, as well as reduced white matter (WM) integrity in anterior thalamic radiation and uncinate fasciculus. Schizophrenia and bipolar subjects were separated by functional differences in medial frontal and visual cortex, as well as WM tracts associated with occipital and frontal lobes. Both patients and controls showed similar spatial distributions in motor and parietal regions, but exhibited significant variations in temporal lobe. Furthermore, there were different group trends for age effects on loading parameters in motor cortex and multiple WM regions, suggesting brain dysfunction and WM disruptions occurred in identified regions for both disorders. Most importantly, we can visualize an underlying function-structure network by evaluating the joint components with strong links between DTI and fMRI. Our findings suggest that although the two patient groups showed several distinct brain patterns from each other and healthy controls, they also shared common abnormalities in prefrontal thalamic WM integrity and in frontal brain mechanisms. PMID:21640835

14 CFR 296.4 - Joint loading.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS INDIRECT AIR TRANSPORTATION OF PROPERTY General § 296.4 Joint loading. Nothing in this part shall... transportation as one shipment, under an agreement between two or more indirect air carriers or foreign indirect...

Evaluation of an intact, an ACL-deficient, and a reconstructed human knee joint finite element model.

PubMed

Vairis, Achilles; Stefanoudakis, George; Petousis, Markos; Vidakis, Nectarios; Tsainis, Andreas-Marios; Kandyla, Betina

2016-02-01

The human knee joint has a three-dimensional geometry with multiple body articulations that produce complex mechanical responses under loads that occur in everyday life and sports activities. Understanding the complex mechanical interactions of these load-bearing structures is of use when the treatment of relevant diseases is evaluated and assisting devices are designed. The anterior cruciate ligament (ACL) in the knee is one of four main ligaments that connects the femur to the tibia and is often torn during sudden twisting motions, resulting in knee instability. The objective of this work is to study the mechanical behavior of the human knee joint and evaluate the differences in its response for three different states, i.e., intact, ACL-deficient, and surgically treated (reconstructed) knee. The finite element models corresponding to these states were developed. For the reconstructed model, a novel repair device was developed and patented by the author in previous work. Static load cases were applied, as have already been presented in a previous work, in order to compare the calculated results produced by the two models the ACL-deficient and the surgically reconstructed knee joint, under the exact same loading conditions. Displacements were calculated in different directions for the load cases studied and were found to be very close to those from previous modeling work and were in good agreement with experimental data presented in literature. The developed finite element model for both the intact and the ACL-deficient human knee joint is a reliable tool to study the kinematics of the human knee, as results of this study show. In addition, the reconstructed human knee joint model had kinematic behavior similar to the intact knee joint, showing that such reconstruction devices can restore human knee stability to an adequate extent.

High-temperature properties of joint interface of VPS-tungsten coated CFC

NASA Astrophysics Data System (ADS)

Tamura, S.; Liu, X.; Tokunaga, K.; Tsunekawa, Y.; Okumiya, M.; Noda, N.; Yoshida, N.

2004-08-01

Tungsten coated carbon fiber composite (CFC) is a candidate material for the high heat flux components in fusion reactors. In order to investigate the high-temperature properties at the joint interface of coating, heat load experiments by using electron beam were performed on VPS-tungsten coated CX-2002U samples. After the heat load test for 3.6 ks at 1400 °C, tungsten-rhenium multilayer (diffusion barrier for carbon) at the joint interface of coating was observed clearly. But, at the temperatures above 1600 °C, the multilayer was disappeared and a tungsten carbide layer was formed in the VPS-tungsten coating. At the temperatures below 1800 °C, the thickness of this layer logarithmically increased with increasing its loading time. At 2000 °C, the growth of the tungsten carbide layer was proportional to the square root of loading time. These results indicate that the diffusion barrier for carbon is not expected to suppress the carbide formation at the joint interface of the VPS-tungsten coating above 1600 °C.

Constitutive Modeling of a Glass Fiber-Reinforced PTFE Gasketed-Joint Under a Re-torque

NASA Astrophysics Data System (ADS)

Williams, James; Gordon, Ali P.

Joints gasketed with viscoelastic seals often receive an application of a secondary torque, i.e., retorque, in order to ensure joint tightness and proper sealing. The motivation of this study is to characterize and analytically model the load and deflection re-torque response of a single 25% glass-fiber reinforced polytetrafluorethylene (PTFE) gasket-bolted joint with serrated flange detail. The Burger-type viscoelastic modeling constants of the material are obtained through isolating the gasket from the bolt by performing a gasket creep test via a MTS electromechanical test frame. The re-load creep response is also investigated by re-loading the gasket after a period of initial creep to observe the response. The modeling constants obtained from the creep tests are used with a Burger-type viscoelastic model to predict the re-torque response of a single bolt-gasket test fixture in order to validate the ability of the model to simulate the re-torque response under various loading conditions and flange detail.

In situ Compressive Loading and Correlative Noninvasive Imaging of the Bone-periodontal Ligament-tooth Fibrous Joint

PubMed Central

Jang, Andrew T.; Lin, Jeremy D.; Seo, Youngho; Etchin, Sergey; Merkle, Arno; Fahey, Kevin; Ho, Sunita P.

2014-01-01

This study demonstrates a novel biomechanics testing protocol. The advantage of this protocol includes the use of an in situ loading device coupled to a high resolution X-ray microscope, thus enabling visualization of internal structural elements under simulated physiological loads and wet conditions. Experimental specimens will include intact bone-periodontal ligament (PDL)-tooth fibrous joints. Results will illustrate three important features of the protocol as they can be applied to organ level biomechanics: 1) reactionary force vs. displacement: tooth displacement within the alveolar socket and its reactionary response to loading, 2) three-dimensional (3D) spatial configuration and morphometrics: geometric relationship of the tooth with the alveolar socket, and 3) changes in readouts 1 and 2 due to a change in loading axis, i.e. from concentric to eccentric loads. Efficacy of the proposed protocol will be evaluated by coupling mechanical testing readouts to 3D morphometrics and overall biomechanics of the joint. In addition, this technique will emphasize on the need to equilibrate experimental conditions, specifically reactionary loads prior to acquiring tomograms of fibrous joints. It should be noted that the proposed protocol is limited to testing specimens under ex vivo conditions, and that use of contrast agents to visualize soft tissue mechanical response could lead to erroneous conclusions about tissue and organ-level biomechanics. PMID:24638035

Changes in collagen fibril network organization and proteoglycan distribution in equine articular cartilage during maturation and growth

PubMed Central

Hyttinen, Mika M; Holopainen, Jaakko; René van Weeren, P; Firth, Elwyn C; Helminen, Heikki J; Brama, Pieter A J

2009-01-01

The aim of this study was to record growth-related changes in collagen network organization and proteoglycan distribution in intermittently peak-loaded and continuously lower-level-loaded articular cartilage. Cartilage from the proximal phalangeal bone of the equine metacarpophalangeal joint at birth, at 5, 11 and 18 months, and at 6–10 years of age was collected from two sites. Site 1, at the joint margin, is unloaded at slow gaits but is subjected to high-intensity loading during athletic activity; site 2 is a continuously but less intensively loaded site in the centre of the joint. The degree of collagen parallelism was determined with quantitative polarized light microscopy and the parallelism index for collagen fibrils was computed from the cartilage surface to the osteochondral junction. Concurrent changes in the proteoglycan distribution were quantified with digital densitometry. We found that the parallelism index increased significantly with age (up to 90%). At birth, site 2 exhibited a more organized collagen network than site 1. In adult horses this situation was reversed. The superficial and intermediate zones exhibited the greatest reorganization of collagen. Site 1 had a higher proteoglycan content than site 2 at birth but here too the situation was reversed in adult horses. We conclude that large changes in joint loading during growth and maturation in the period from birth to adulthood profoundly affect the architecture of the collagen network in equine cartilage. In addition, the distribution and content of proteoglycans are modified significantly by altered joint use. Intermittent peak-loading with shear seems to induce higher collagen parallelism and a lower proteoglycan content in cartilage than more constant weight-bearing. Therefore, we hypothesize that the formation of mature articular cartilage with a highly parallel collagen network and relatively low proteoglycan content in the peak-loaded area of a joint is needed to withstand intermittent stress and shear, whereas a constantly weight-bearing joint area benefits from lower collagen parallelism and a higher proteoglycan content. PMID:19732210

Conformational Changes in the Carpus During Finger Traps Distraction

PubMed Central

Leventhal, Evan L.; Moore, Douglas C.; Akelman, Edward; Wolfe, Scott W.; Crisco, Joseph J.

2010-01-01

Introduction Wrist distraction is a common treatment maneuver used clinically for the reduction of distal radial fractures and mid-carpal dislocations. Wrist distraction is also required during wrist arthroscopy to access the radiocarpal joint and has been used as a test for scapholunate ligament injury. However, the effect of a distraction load on the normal wrist has not been well studied. The purpose of this study was to measure the 3-D conformational changes of the carpal bones in the normal wrist as a result of a static distractive load. Methods The dominant wrists of 14 healthy volunteers were scanned using computed tomography at rest and during application of 98N of distraction. Load was applied using finger traps and volunteers were encouraged to relax their forearm muscles and to allow distraction of the wrist. The motions of the bones in the wrist were tracked between the unloaded and loaded trial using markerless bone registration. The average displacement vector of each bone was calculated relative to the radius as well as the interbone distances for 20 bone-bone interactions. Joint separation was estimated at the radiocarpal, midcarpal and carpal-metacarpal joints in the direction of loading using the radius, lunate, capitate and 3rd metacarpal. Results With loading, the distance between the radius and 3rd metacarpal increased an average of 3.3±3.1mm in the direction of loading. This separation was primarily located in the axial direction at the radiocarpal (1.0±1.0mm) and midcarpal (2.0±1.7mm) joints. There were minimal changes in the transverse direction within the distal row, although the proximal row narrowed by 0.98±0.7mm. Distraction between the radius and scaphoid (2.5±2.2mm) was 2.4 times greater than between the radius and lunate (1.0±1.0mm). Conclusions Carpal distraction has a significant effect on the conformation of the carpus, especially at the radiocarpal and midcarpal joints. In the normal wrist, external traction causes twice as much distraction at the lunocapitate joint than at the radiolunate joint. PMID:20141894

Conformational changes in the carpus during finger trap distraction.

PubMed

Leventhal, Evan L; Moore, Douglas C; Akelman, Edward; Wolfe, Scott W; Crisco, Joseph J

2010-02-01

Wrist distraction is a common treatment maneuver used clinically for the reduction of distal radial fractures and midcarpal dislocations. Wrist distraction is also required during wrist arthroscopy to access the radiocarpal joint and has been used as a test for scapholunate ligament injury. However, the effect of a distraction load on the normal wrist has not been well studied. The purpose of this study was to measure the three-dimensional conformational changes of the carpal bones in the normal wrist as a result of a static distractive load. Using computed tomography, the dominant wrists of 14 healthy volunteers were scanned at rest and during application of 98 N of distraction. Load was applied using finger traps, and volunteers were encouraged to relax their forearm muscles and to allow distraction of the wrist. The motions of the bones in the wrist were tracked between the unloaded and loaded trial using markerless bone registration. The average displacement vector of each bone relative to the radius was calculated, as were the interbone distances for 20 bone-bone interactions. Joint separation was estimated at the radiocarpal, midcarpal, and carpometacarpal joints in the direction of loading using the radius, lunate, capitate, and third metacarpal. With loading, the distance between the radius and third metacarpal increased an average of 3.3 mm +/- 3.1 in the direction of loading. This separation was primarily in the axial direction at the radiocarpal (1.0 mm +/- 1.0) and midcarpal (2.0 mm +/- 1.7) joints. There were minimal changes in the transverse direction within the distal row, although the proximal row narrowed by 0.98 mm +/- 0.7. Distraction between the radius and scaphoid (2.5 mm +/- 2.2) was 2.4 times greater than that between the radius and lunate (1.0 mm +/- 1.0). Carpal distraction has a significant (p < .01) effect on the conformation of the carpus, especially at the radiocarpal and midcarpal joints. In the normal wrist, external traction causes twice as much distraction at the lunocapitate joint than at the radiolunate joint. Copyright 2010. Published by Elsevier Inc.

Running stability is enhanced by a proximo-distal gradient in joint neuromechanical control.

PubMed

Daley, M A; Felix, G; Biewener, A A

2007-02-01

We currently know little about how animals achieve dynamic stability when running over uneven and unpredictable terrain, often characteristic of their natural environment. Here we investigate how limb and joint mechanics of an avian biped, the helmeted guinea fowl Numida meleagris, respond to an unexpected drop in terrain during running. In particular, we address how joint mechanics are coordinated to achieve whole limb dynamics. Based on muscle-tendon architecture and previous studies of steady and incline locomotion, we hypothesize a proximo-distal gradient in joint neuromechanical control. In this motor control strategy, (1) proximal muscles at the hip and knee joints are controlled primarily in a feedforward manner and exhibit load-insensitive mechanical performance, and (2) distal muscles at the ankle and tarsometatarso-phalangeal (TMP) joints are highly load-sensitive, due to intrinsic mechanical effects and rapid, higher gain proprioceptive feedback. Limb kinematics and kinetics during the unexpected perturbation reveal that limb retraction, controlled largely by the hip, remains similar to level running throughout the perturbed step, despite altered limb loading. Individual joints produce or absorb energy during both level and perturbed running steps, such that the net limb work depends on the balance of energy among the joints. The hip maintains the same mechanical role regardless of limb loading, whereas the ankle and TMP switch between spring-like or damping function depending on limb posture at ground contact. Initial knee angle sets limb posture and alters the balance of work among the joints, although the knee contributes little work itself. This distribution of joint function results in posture-dependent changes in work performance of the limb, which allow guinea fowl to rapidly produce or absorb energy in response to the perturbation. The results support the hypothesis that a proximo-distal gradient exists in limb neuromuscular performance and motor control. This control strategy allows limb cycling to remain constant, whereas limb posture, loading and energy performance are interdependent. We propose that this control strategy provides simple, rapid mechanisms for managing energy and controlling velocity when running over rough terrain.

Running stability is enhanced by a proximo-distal gradient in joint neuromechanical control

PubMed Central

Daley, M. A.; Felix, G.; Biewener, A. A.

2008-01-01

Summary We currently know little about how animals achieve dynamic stability when running over uneven and unpredictable terrain, often characteristic of their natural environment. Here we investigate how limb and joint mechanics of an avian biped, the helmeted guinea fowl Numida meleagris, respond to an unexpected drop in terrain during running. In particular, we address how joint mechanics are coordinated to achieve whole limb dynamics. Based on muscle–tendon architecture and previous studies of steady and incline locomotion, we hypothesize a proximo-distal gradient in joint neuromechanical control. In this motor control strategy, (1) proximal muscles at the hip and knee joints are controlled primarily in a feedforward manner and exhibit load-insensitive mechanical performance, and (2) distal muscles at the ankle and tarsometatarso-phalangeal (TMP) joints are highly load-sensitive, due to intrinsic mechanical effects and rapid, higher gain proprioceptive feedback. Limb kinematics and kinetics during the unexpected perturbation reveal that limb retraction, controlled largely by the hip, remains similar to level running throughout the perturbed step, despite altered limb loading. Individual joints produce or absorb energy during both level and perturbed running steps, such that the net limb work depends on the balance of energy among the joints. The hip maintains the same mechanical role regardless of limb loading, whereas the ankle and TMP switch between spring-like or damping function depending on limb posture at ground contact. Initial knee angle sets limb posture and alters the balance of work among the joints, although the knee contributes little work itself. This distribution of joint function results in posture-dependent changes in work performance of the limb, which allow guinea fowl to rapidly produce or absorb energy in response to the perturbation. The results support the hypothesis that a proximo-distal gradient exists in limb neuromuscular performance and motor control. This control strategy allows limb cycling to remain constant, whereas limb posture, loading and energy performance are interdependent. We propose that this control strategy provides simple, rapid mechanisms for managing energy and controlling velocity when running over rough terrain. PMID:17234607

Joint loads resulting in ACL rupture: Effects of age, sex, and body mass on injury load and mode of failure in a mouse model.

PubMed

Blaker, Carina L; Little, Christopher B; Clarke, Elizabeth C

2017-08-01

Anterior cruciate ligament (ACL) tears are a common knee injury with a known but poorly understood association with secondary joint injuries and post-traumatic osteoarthritis (OA). Female sex and age are known risk factors for ACL injury but these variables are rarely explored in mouse models of injury. This study aimed to further characterize a non-surgical ACL injury model to determine its clinical relevance across a wider range of mouse specifications. Cadaveric and anesthetized C57BL/6 mice (9-52 weeks of age) underwent joint loading to investigate the effects of age, sex, and body mass on ACL injury mechanisms. The ACL injury load (whole joint load required to rupture the ACL) was measured from force-displacement data, and mode of failure was assessed using micro-dissection and histology. ACL injury load was found to increase with body mass and age (p < 0.001) but age was not significant when controlling for mass. Sex had no effect. In contrast, the mode of ACL failure varied with both age and sex groups. Avulsion fractures (complete or mixed with mid-substance tears) were common in all age groups but the proportion of mixed and mid-substance failures increased with age. Females were more likely than males to have a major avulsion relative to a mid-substance tear (p < 0.01). This data compliments studies in human cadaveric knees, and provides a basis for determining the severity of joint injury relative to a major ACL tear in mice, and for selecting joint loading conditions in future experiments using this model. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1754-1763, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Assessment of Embedded Conjugated Polymer Sensor Arrays for Potential Load Transmission Measurement in Orthopaedic Implants

PubMed Central

Micolini, Carolina; Holness, Frederick Benjamin; Johnson, James A.

2017-01-01

Load transfer through orthopaedic joint implants is poorly understood. The longer-term outcomes of these implants are just starting to be studied, making it imperative to monitor contact loads across the entire joint implant interface to elucidate the force transmission and distribution mechanisms exhibited by these implants in service. This study proposes and demonstrates the design, implementation, and characterization of a 3D-printed smart polymer sensor array using conductive polyaniline (PANI) structures embedded within a polymeric parent phase. The piezoresistive characteristics of PANI were investigated to characterize the sensing behaviour inherent to these embedded pressure sensor arrays, including the experimental determination of the stable response of PANI to continuous loading, stability throughout the course of loading and unloading cycles, and finally sensor repeatability and linearity in response to incremental loading cycles. This specially developed multi-material additive manufacturing process for PANI is shown be an attractive approach for the fabrication of implant components having embedded smart-polymer sensors, which could ultimately be employed for the measurement and analysis of joint loads in orthopaedic implants for in vitro testing. PMID:29186079

Is there a causal link between knee loading and knee osteoarthritis progression? A systematic review and meta-analysis of cohort studies and randomised trials

PubMed Central

Henriksen, Marius; Creaby, Mark W; Lund, Hans; Juhl, Carsten; Christensen, Robin

2014-01-01

Objective We performed a systematic review, meta-analysis and assessed the evidence supporting a causal link between knee joint loading during walking and structural knee osteoarthritis (OA) progression. Design Systematic review, meta-analysis and application of Bradford Hill's considerations on causation. Data sources We searched MEDLINE, Scopus, AMED, CINAHL and SportsDiscus for prospective cohort studies and randomised controlled trials (RCTs) from 1950 through October 2013. Study eligibility criteria We selected cohort studies and RCTs in which estimates of knee joint loading during walking were used to predict structural knee OA progression assessed by X-ray or MRI. Data analyses Meta-analysis was performed to estimate the combined OR for structural disease progression with higher baseline loading. The likelihood of a causal link between knee joint loading and OA progression was assessed from cohort studies using the Bradford Hill guidelines to derive a 0–4 causation score based on four criteria and examined for confirmation in RCTs. Results Of the 1078 potentially eligible articles, 5 prospective cohort studies were included. The studies included a total of 452 patients relating joint loading to disease progression over 12–72 months. There were very serious limitations associated with the methodological quality of the included studies. The combined OR for disease progression was 1.90 (95% CI 0.85 to 4.25; I2=77%) for each one-unit increment in baseline knee loading. The combined causation score was 0, indicating no causal association between knee loading and knee OA progression. No RCTs were found to confirm or refute the findings from the cohort studies. Conclusions There is very limited and low-quality evidence to support for a causal link between knee joint loading during walking and structural progression of knee OA. Trial registration number CRD42012003253 PMID:25031196

Is there a causal link between knee loading and knee osteoarthritis progression? A systematic review and meta-analysis of cohort studies and randomised trials.

PubMed

Henriksen, Marius; Creaby, Mark W; Lund, Hans; Juhl, Carsten; Christensen, Robin

2014-07-15

We performed a systematic review, meta-analysis and assessed the evidence supporting a causal link between knee joint loading during walking and structural knee osteoarthritis (OA) progression. Systematic review, meta-analysis and application of Bradford Hill's considerations on causation. We searched MEDLINE, Scopus, AMED, CINAHL and SportsDiscus for prospective cohort studies and randomised controlled trials (RCTs) from 1950 through October 2013. We selected cohort studies and RCTs in which estimates of knee joint loading during walking were used to predict structural knee OA progression assessed by X-ray or MRI. Meta-analysis was performed to estimate the combined OR for structural disease progression with higher baseline loading. The likelihood of a causal link between knee joint loading and OA progression was assessed from cohort studies using the Bradford Hill guidelines to derive a 0-4 causation score based on four criteria and examined for confirmation in RCTs. Of the 1078 potentially eligible articles, 5 prospective cohort studies were included. The studies included a total of 452 patients relating joint loading to disease progression over 12-72 months. There were very serious limitations associated with the methodological quality of the included studies. The combined OR for disease progression was 1.90 (95% CI 0.85 to 4.25; I(2)=77%) for each one-unit increment in baseline knee loading. The combined causation score was 0, indicating no causal association between knee loading and knee OA progression. No RCTs were found to confirm or refute the findings from the cohort studies. There is very limited and low-quality evidence to support for a causal link between knee joint loading during walking and structural progression of knee OA. CRD42012003253. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Preventive lateral ligament tester (PLLT): a novel method to evaluate mechanical properties of lateral ankle joint ligaments in the intact ankle.

PubMed

Best, Raymond; Böhle, Caroline; Mauch, Frieder; Brüggemann, Peter G

2016-04-01

To construct and evaluate an ankle arthrometer that registers inversion joint deflection at standardized inversion loads and that, moreover, allows conclusions about the mechanical strain of intact ankle joint ligaments at these loads. Twelve healthy ankles and 12 lower limb cadaver specimens were tested in a self-developed measuring device monitoring passive ankle inversion movement (Inv-ROM) at standardized application of inversion loads of 5, 10 and 15 N. To adjust in vivo and in vitro conditions, the muscular inactivity of the evertor muscles was assured by EMG in vivo. Preliminary, test-retest and trial-to-trial reliabilities were tested in vivo. To detect lateral ligament strain, the cadaveric calcaneofibular ligament was instrumented with a buckle transducer. After post-test harvesting of the ligament with its bony attachments, previously obtained resistance strain gauge results were then transferred to tensile loads, mounting the specimens with their buckle transducers into a hydraulic material testing machine. ICC reliability considering the Inv-ROM and torsional stiffness varied between 0.80 and 0.90. Inv-ROM ranged from 15.3° (±7.3°) at 5 N to 28.3° (±7.6) at 15 N. The different tests revealed a CFL tensile load of 31.9 (±14.0) N at 5 N, 51.0 (±15.8) at 10 N and 75.4 (±21.3) N at 15 N inversion load. A highly reliable arthrometer was constructed allowing not only the accurate detection of passive joint deflections at standardized inversion loads but also reveals some objective conclusions of the intact CFL properties in correlation with the individual inversion deflections. The detection of individual joint deflections at predefined loads in correlation with the knowledge of tensile ligament loads in the future could enable more individual preventive measures, e.g., in high-level athletes.

Rate dependent strengths of some solder joints

NASA Astrophysics Data System (ADS)

Williamson, D. M.; Field, J. E.; Palmer, S. J. P.; Siviour, C. R.

2007-08-01

The shear strengths of three lead-free solder joints have been measured over the range of loading rates 10-3 to ~105 mm min-1. Binary (SnAg), ternary (SnAgCu) and quaternary (Castin: SnAgCuSb) alloys have been compared to a conventional binary SnPb solder alloy. Results show that at loading rates from 10-3 to 102 mm min-1, all four materials exhibit a linear relationship between the shear strength and the loading rate when the data are plotted on a log-log plot. At the highest loading rate of 105 mm min-1, the strengths of the binary alloys were in agreement with extrapolations made from the lower loading rate data. In contrast, the strengths of the higher order alloys were found to be significantly lower than those predicted by extrapolation. This is explained by a change in failure mechanism on the part of the higher order alloys. Similar behaviour was found in measurements of the tensile strengths of solder joints using a novel high-rate loading tensile test. Optical and electron microscopy were used to examine the microstructures of interest in conjunction with energy dispersive x-ray analysis for elemental identification. The effect of artificial aging and reflow of the solder joints is also reported.

Influence of Grid Reinforcement Placed In Masonry Bed Joints on Its Flexural Strength

NASA Astrophysics Data System (ADS)

Piekarczyk, Adam

2017-10-01

The paper presents the test results of the flexural strength of masonry when plane of failure is perpendicular to the bed joints. Comparison tests of unreinforced specimens and specimens reinforced with steel wire, glass and basalt fibre grids applied in masonry bed joints showed the higher flexural strength and crack resistance of masonry reinforced in this manner and so loaded. Reinforced masonry exposed plastic character after cracking allow for large horizontal displacements and transfer the considerable loads perpendicular to their surface. The strengthening of masonry was observed in most tests of reinforced specimens leading to occurrence of the maximum load in after cracking phase.

Fatigue Rated Fastener Systems

DTIC Science & Technology

1985-11-01

programme part also .how. that the »tatement "the higher th«. load traust.,, the shorter the tallgu. lite could not b. confirmed for all Joints. It might...realistic fatigue loading: the lite improvement mechanisms are more marked in these Joints than in .-.-* luad transfer/low secondary bending Joints...7050-T76 PRIMER REAM HI-LOK TEST SERIES NOT CLEARANCE 10-30 34432 11832 GH3 JRFS-A") COLD WORK VRFS -B) INTERFERENCE 15-35 >16773 >16044

The effect of intervertebral cartilage on neutral posture and range of motion in the necks of sauropod dinosaurs.

PubMed

Taylor, Michael P; Wedel, Mathew J

2013-01-01

The necks of sauropod dinosaurs were a key factor in their evolution. The habitual posture and range of motion of these necks has been controversial, and computer-aided studies have argued for an obligatory sub-horizontal pose. However, such studies are compromised by their failure to take into account the important role of intervertebral cartilage. This cartilage takes very different forms in different animals. Mammals and crocodilians have intervertebral discs, while birds have synovial joints in their necks. The form and thickness of cartilage varies significantly even among closely related taxa. We cannot yet tell whether the neck joints of sauropods more closely resembled those of birds or mammals. Inspection of CT scans showed cartilage:bone ratios of 4.5% for Sauroposeidon and about 20% and 15% for two juvenile Apatosaurus individuals. In extant animals, this ratio varied from 2.59% for the rhea to 24% for a juvenile giraffe. It is not yet possible to disentangle ontogenetic and taxonomic signals, but mammal cartilage is generally three times as thick as that of birds. Our most detailed work, on a turkey, yielded a cartilage:bone ratio of 4.56%. Articular cartilage also added 11% to the length of the turkey's zygapophyseal facets. Simple image manipulation suggests that incorporating 4.56% of neck cartilage into an intervertebral joint of a turkey raises neutral posture by 15°. If this were also true of sauropods, the true neutral pose of the neck would be much higher than has been depicted. An additional 11% of zygapophyseal facet length translates to 11% more range of motion at each joint. More precise quantitative results must await detailed modelling. In summary, including cartilage in our models of sauropod necks shows that they were longer, more elevated and more flexible than previously recognised.

The Effect of Intervertebral Cartilage on Neutral Posture and Range of Motion in the Necks of Sauropod Dinosaurs

PubMed Central

Taylor, Michael P.; Wedel, Mathew J.

2013-01-01

The necks of sauropod dinosaurs were a key factor in their evolution. The habitual posture and range of motion of these necks has been controversial, and computer-aided studies have argued for an obligatory sub-horizontal pose. However, such studies are compromised by their failure to take into account the important role of intervertebral cartilage. This cartilage takes very different forms in different animals. Mammals and crocodilians have intervertebral discs, while birds have synovial joints in their necks. The form and thickness of cartilage varies significantly even among closely related taxa. We cannot yet tell whether the neck joints of sauropods more closely resembled those of birds or mammals. Inspection of CT scans showed cartilage:bone ratios of 4.5% for Sauroposeidon and about 20% and 15% for two juvenile Apatosaurus individuals. In extant animals, this ratio varied from 2.59% for the rhea to 24% for a juvenile giraffe. It is not yet possible to disentangle ontogenetic and taxonomic signals, but mammal cartilage is generally three times as thick as that of birds. Our most detailed work, on a turkey, yielded a cartilage:bone ratio of 4.56%. Articular cartilage also added 11% to the length of the turkey's zygapophyseal facets. Simple image manipulation suggests that incorporating 4.56% of neck cartilage into an intervertebral joint of a turkey raises neutral posture by 15°. If this were also true of sauropods, the true neutral pose of the neck would be much higher than has been depicted. An additional 11% of zygapophyseal facet length translates to 11% more range of motion at each joint. More precise quantitative results must await detailed modelling. In summary, including cartilage in our models of sauropod necks shows that they were longer, more elevated and more flexible than previously recognised. PMID:24205163

Fluoroscopic lumbar interlaminar epidural injections in managing chronic lumbar axial or discogenic pain

PubMed Central

Manchikanti, Laxmaiah; Cash, Kimberly A; McManus, Carla D; Pampati, Vidyasagar; Benyamin, Ramsin

2012-01-01

Among the multiple causes of chronic low back pain, axial and discogenic pain are common. Various modalities of treatments are utilized in managing discogenic and axial low back pain including epidural injections. However, there is a paucity of evidence regarding the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections. In an interventional pain management practice in the US, a randomized, double-blind, active control trial was conducted. The objective was to assess the effectiveness of lumbar interlaminar epidural injections of local anesthetic with or without steroids for managing chronic low back pain of discogenic origin. However, disc herniation, radiculitis, facet joint pain, or sacroiliac joint pain were excluded. Two groups of patients were studied, with 60 patients in each group receiving either local anesthetic only or local anesthetic mixed with non-particulate betamethasone. Primary outcome measures included the pain relief-assessed by numeric rating scale of pain and functional status assessed by the, Oswestry Disability Index, Secondary outcome measurements included employment status, and opioid intake. Significant improvement or success was defined as at least a 50% decrease in pain and disability. Significant improvement was seen in 77% of the patients in Group I and 67% of the patients in Group II. In the successful groups (those with at least 3 weeks of relief with the first two procedures), the improvement was 84% in Group I and 71% in Group II. For those with chronic function-limiting low back pain refractory to conservative management, it is concluded that lumbar interlaminar epidural injections of local anesthetic with or without steroids may be an effective modality for managing chronic axial or discogenic pain. This treatment appears to be effective for those who have had facet joints as well as sacroiliac joints eliminated as the pain source. PMID:23055773

Evaluation of Margins of Safety in Brazed Joints

NASA Technical Reports Server (NTRS)

Flom, Yury; Wang, Len; Powell, Mollie M.; Soffa, Matthew A.; Rommel, Monica L.

2009-01-01

One of the essential steps in assuring reliable performance of high cost critical brazed structures is the assessment of the Margin of Safety (MS) of the brazed joints. In many cases the experimental determination of the failure loads by destructive testing of the brazed assembly is not practical and cost prohibitive. In such cases the evaluation of the MS is performed analytically by comparing the maximum design loads with the allowable ones and incorporating various safety or knock down factors imposed by the customer. Unfortunately, an industry standard methodology for the design and analysis of brazed joints has not been developed. This paper provides an example of an approach that was used to analyze an AlBeMet 162 (38%Be-62%Al) structure brazed with the AWS BAlSi-4 (Al-12%Si) filler metal. A practical and conservative interaction equation combining shear and tensile allowables was developed and validated to evaluate an acceptable (safe) combination of tensile and shear stresses acting in the brazed joint. These allowables are obtained from testing of standard tensile and lap shear brazed specimens. The proposed equation enables the assessment of the load carrying capability of complex brazed joints subjected to multi-axial loading.

Design and Evaluation of a Bolted Joint for a Discrete Carbon-Epoxy Rod-Reinforced Hat Section

NASA Technical Reports Server (NTRS)

Baker, Donald J.; Rousseau, Carl Q.

1996-01-01

The use of pre-fabricated pultruded carbon-epoxy rods has reduced the manufacturing complexity and costs of stiffened composite panels while increasing the damage tolerance of the panels. However, repairability of these highly efficient discrete stiffeners has been a concern. Design, analysis, and test results are presented in this paper for a bolted-joint repair for the pultruded rod concept that is capable of efficiently transferring axial loads in a hat-section stiffener on the upper skin segment of a heavily loaded aircraft wing component. A tension and a compression joint design were evaluated. The tension joint design achieved approximately 1.0 percent strain in the carbon-epoxy rod-reinforced hat-section and failed in a metal fitting at 166 percent of the design ultimate load. The compression joint design failed in the carbon-epoxy rod-reinforced hat-section test specimen area at approximately 0.7 percent strain and at 110 percent of the design ultimate load. This strain level of 0.7 percent in compression is similar to the failure strain observed in previously reported carbon-epoxy rod-reinforced hat-section column tests.

Experimental investigation of the dynamic installation of a slip joint connection between the monopile and tower of an offshore wind turbine

NASA Astrophysics Data System (ADS)

Segeren, M. L. A.; Hermans, K. W.

2014-06-01

The failure of the traditional grouted connections of offshore wind turbines has led to the investigation of alternatives that provide a connection between the foundation pile and the turbine tower. An alternative to the traditional joint is a steel-to-steel connection also called a slip joint. To ensure a proper fit of the slip joint a dynamic installation of the joint is proposed. In this contribution, the effectiveness of harmonic excitation as an installation procedure is experimentally investigated using a 1:10 scaled model of the joint. During the dynamic installation test the applied static load, settlements and dynamic response of the joint are monitored using respectively load cells, taut wires and strain gauges placed both inside and outside the conical surfaces. The results show that settlement occurs only when applying a harmonic load at specific forcing frequencies. The settlement stabilizes to a certain level for each of the specific frequencies, indicating that a controlled way of installation is possible. The results show that it is essential to vibrate at specific frequencies and that a larger amplitude of the harmonic force does not automatically lead to additional settlement.

Musculoskeletal multibody dynamics simulation of the contact mechanics and kinematics of a natural knee joint during a walking cycle.

PubMed

Hu, Jiayu; Chen, Zhenxian; Xin, Hua; Zhang, Qida; Jin, Zhongmin

2018-05-01

Detailed knowledge of the in vivo loading and kinematics in the knee joint is essential to understand its normal functions and the aetiology of osteoarthritis. Computer models provide a viable non-invasive solution for estimating joint loading and kinematics during different physiological activities. However, the joint loading and kinematics of the tibiofemoral and patellofemoral joints during a gait cycle were not typically investigated concurrently in previous computational simulations. In this study, a natural knee architecture was incorporated into a lower extremity musculoskeletal multibody dynamics model based on a force-dependent kinematics approach to investigate the contact mechanics and kinematics of a natural knee joint during a walking cycle. Specifically, the contact forces between the femoral/tibial articular cartilages and menisci and between the femoral and tibial/patellar articular cartilages were quantified. The contact forces and kinematics of the tibiofemoral and patellofemoral joints and the muscle activations and ligament forces were predicted simultaneously with a reasonable level of accuracy. The developed musculoskeletal multibody dynamics model with a natural knee architecture can serve as a potential platform for assisting clinical decision-making and postoperative rehabilitation planning.

Evaluation of traction stirrup distraction technique to increase the joint space of the shoulder joint in the dog: A cadaveric study.

PubMed

Devesa, V; Rovesti, G L; Urrutia, P G; Sanroman, F; Rodriguez-Quiros, J

2015-06-01

The objective of this study was to evaluate technical feasibility and efficacy of a joint distraction technique by traction stirrup to facilitate shoulder arthroscopy and assess potential soft tissue damage. Twenty shoulders were evaluated radiographically before distraction. Distraction was applied with loads from 40 N up to 200 N, in 40 N increments, and the joint space was recorded at each step by radiographic images. The effects of joint flexion and intra-articular air injection at maximum load were evaluated. Radiographic evaluation was performed after distraction to evaluate ensuing joint laxity. Joint distraction by traction stirrup technique produces a significant increase in the joint space; an increase in joint laxity could not be inferred by standard and stress radiographs. However, further clinical studies are required to evaluate potential neurovascular complications. A wider joint space may be useful to facilitate arthroscopy, reducing the likelihood for iatrogenic damage to intra-articular structures. Copyright © 2015 Elsevier Ltd. All rights reserved.

Vehicle design considerations for active control application to subsonic transport aircraft

NASA Technical Reports Server (NTRS)

Hofmann, L. G.; Clement, W. F.

1974-01-01

The state of the art in active control technology is summarized. How current design criteria and airworthiness regulations might restrict application of this emerging technology to subsonic CTOL transports of the 1980's are discussed. Facets of active control technology considered are: (1) augmentation of relaxed inherent stability; (2) center-of-gravity control; (3) ride quality control; (4) load control; (5) flutter control; (6) envelope limiting, and (7) pilot interface with the control system. A summary and appraisal of the current state of the art, design criteria, and recommended practices, as well as a projection of the risk in applying each of these facets of active control technology is given. A summary of pertinent literature and technical expansions is included.

Mathematical modelling as a tool to assessment of loads in volleyball player's shoulder joint during spike.

PubMed

Jurkojć, Jacek; Michnik, Robert; Czapla, Krzysztof

2017-06-01

This article deals with kinematic and kinetic conditions in volleyball attack and identifies loads in the shoulder joint. Joint angles and velocities of individual segments of upper limb were measured with the use of the motion capture system XSENS. Muscle forces and loads in skeletal system were calculated by means of mathematical model elaborated in AnyBody system. Spikes performed by players in the best and worst way were compared with each other. The relationships were found between reactions in shoulder joint and flexion/extension, abduction/adduction and rotation angles in the same joint and flexion/extension in the elbow joint. Reactions in shoulder joint varied from 591 N to 2001 N (in relation to body weight [BW] 83-328%). The analysis proved that hand velocity at the moment of the ball hit (which varied between 6.8 and 13.3 m s -1 ) influences on the value of reaction in joints, but positions of individual segments relative to each other are also crucial. It was also proved in objective way, that position of the upper limb during spike can be more or less harmful assuming that bigger reaction increases possibility of injury, what can be an indication for trainers and physiotherapists how to improve injury prevention.

Does distal tibiofibular joint mobilization decrease limitation of ankle dorsiflexion?

PubMed

Fujii, Misaki; Suzuki, Daisuke; Uchiyama, Eiichi; Muraki, Takayuki; Teramoto, Atsushi; Aoki, Mitsuhiro; Miyamoto, Shigenori

2010-02-01

Limitation of ankle motion is in many cases treated by joint mobilization (JM), a kind of manual physical therapy technique. Until now, the JM approach has mainly focused on the talocrural joint, with less attention to the distal tibiofibular joint. We applied cyclic loading to the lateral malleolus as in JM in order to clarify the relationship between the dorsiflexion angle and the excursion of the lateral malleolus. Seven normal, fresh-frozen cadaver legs were used. To each specimen, cyclic loading with a 30N force was applied 1000 times to the lateral malleolus at a speed of 15N/s. The displacement of the lateral malleolus was measured with a magnetic tracking system. The maximum dorsiflexion angle was measured before and after cyclic loading. After the first 100 and 1000 times of cyclic loading, the tibia was displaced 0.44+/-0.30mm and 0.75+/-0.36mm, respectively, and the fibula was displaced 0.44+/-0.28mm and 0.92+/-0.39mm, respectively. The average dorsiflexion angle increased from 14.36+/-7.51 degrees to 16.74+/-7.21 degrees after cyclic loading (P<0.05). Movement of the distal tibiofibular joint led to a significant increase in the range of ankle dorsiflexion. These results suggest that tibiofibular JM would be effective for limitation of ankle dorsiflexion.

Cervical spondylosis anatomy: pathophysiology and biomechanics.

PubMed

Shedid, Daniel; Benzel, Edward C

2007-01-01

Cervical spondylosis is the most common progressive disorder in the aging cervical spine. It results from the process of degeneration of the intervertebral discs and facet joints of the cervical spine. Biomechanically, the disc and the facets are the connecting structures between the vertebrae for the transmission of external forces. They also facilitate cervical spine mobility. Symptoms related to myelopathy and radiculopathy are caused by the formation of osteophytes, which compromise the diameter of the spinal canal. This compromise may also be partially developmental. The developmental process, together with the degenerative process, may cause mechanical pressure on the spinal cord at one or multiple levels. This pressure may produce direct neurological damage or ischemic changes and, thus, lead to spinal cord disturbances. A thorough understanding of the biomechanics, the pathology, the clinical presentation, the radiological evaluation, as well as the surgical indications of cervical spondylosis, is essential for the management of patients with cervical spondylosis.

Utilization and growth patterns of sacroiliac joint injections from 2000 to 2011 in the medicare population.

PubMed

Manchikanti, Laxmaiah; Hansen, Hans; Pampati, Vidyasagar; Falco, Frank J E

2013-01-01

  The high prevalence of persistent low back pain and growing number of diagnostic and therapeutic modalities employed to manage chronic low back pain and the subsequent impact on society and the economy continue to hold sway over health care policy. Among the multiple causes responsible for chronic low back pain, the contributions of the sacroiliac joint have been a subject of debate albeit a paucity of research. At present, there are no definitive conservative, interventional or surgical management options for managing sacroiliac joint pain. It has been shown that the increases were highest for facet joint interventions and sacroiliac joint blocks with an increase of 310% per 100,000 Medicare beneficiaries from 2000 to 2011. There has not been a systematic assessment of the utilization and growth patterns of sacroiliac joint injections. Analysis of the growth patterns of sacroiliac joint injections in Medicare beneficiaries from 2000 to 2011. To evaluate the utilization and growth patterns of sacroiliac joint injections. This assessment was performed utilizing Centers for Medicare and Medicaid Services (CMS) Physician/Supplier Procedure Summary (PSPS) Master data from 2000 to 2011. The findings of this assessment in Medicare beneficiaries from 2000 to 2011 showed a 331% increase per 100,000 Medicare beneficiaries with an annual increase of 14.2%, compared to an increase in the Medicare population of 23% or annual increase of 1.9%. The number of procedures increased from 49,554 in 2000 to 252,654 in 2011, or a rate of 125 to 539 per 100,000 Medicare beneficiaries. Among the various specialists performing sacroiliac joint injections, physicians specializing in physical medicine and rehabilitation have shown the most increase, followed by neurology with 1,568% and 698%, even though many physicians from both specialties have been enrolling in interventional pain management and pain management. Even though the numbers were small for nonphysician providers including certified registered nurse anesthetists, nurse practitioners, and physician assistants, these numbers increased substantially at a rate of 4,526% per 100,000 Medicare beneficiaries with 21 procedures performed in 2000 increasing to 4,953 procedures in 2011. The, majority of sacroiliac joint injections were performed in an office setting. The utilization of sacroiliac joint injections by state from 2008 to 2010 showed increases of more than 20% in New Hampshire, Alabama, Minnesota, Vermont, Oregon, Utah, Massachusetts, Kansas, and Maine. Similarly, some states showed significant decreases of 20% or more, including Oklahoma, Louisiana, Maryland, Arkansas, New York, and Hawaii. Overall, there was a 1% increase per 100,000 Medicare population from 2008 to 2010. However, 2011 showed significant increases from 2010. The limitations of this study included a lack of inclusion of Medicare participants in Medicare Advantage plans, the availability of an identifiable code for only sacroiliac joint injections, and the possibility that state claims data may include claims from other states. . This study illustrates the explosive growth of sacroiliac joint injections even more than facet joint interventions. Furthermore, certain groups of providers showed substantial increases. Overall, increases from 2008 to 2010 were nominal with 1%, but some states showed over 20% increases whereas some others showed over 20% decreases.

Device for measuring hole elongation in a bolted joint

NASA Technical Reports Server (NTRS)

Wichorek, Gregory R. (Inventor)

1987-01-01

A device to determine the operable failure mode of mechanically fastened lightweight composite joints by measuring the hole elongation of a bolted joint is disclosed. The double-lap joint test apparatus comprises a stud, a test specimen having a hole, two load transfer plates, and linear displacement measuring instruments. The test specimen is sandwiched between the two load transfer plates and clamped together with the stud. Spacer washers are placed between the test specimen and each load transfer plate to provide a known, controllable area for the determination of clamping forces around the hole of the specimen attributable to bolt torque. The spacer washers also provide a gap for the mounting of reference angles on each side of the test specimen. Under tensile loading, elongation of the hole of the test specimen causes the stud to move away from the reference angles. This displacement is measured by the voltage output of two linear displacement measuring instruments that are attached to the stud and remain in contact with the reference angles throughout the tensile loading. The present invention obviates previous problems in obtaining specimen deformation measurements by monitoring the reference angles to the test specimen and the linear displacement measuring instruments to the stud.

Debonding of Stitched Composite Joints: Testing and Analysis

NASA Technical Reports Server (NTRS)

Glaessgen, E. H.; Raju, I. S.; Poe, C. C., Jr.

1999-01-01

The effect of stitches on the failure of a single lap joint configuration was determined in a combined experimental and analytical study. The experimental study was conducted to determine debond growth under static monotonic loading. The stitches were shown to delay the initiation ofthe debond and provide load transfer beyond the load necessary to completely debond the stitched lap joint. The strain energy release rates at the debond front were calculated using a finite element-based technique. Models of the unstitched configuration showed significant values of modes I and II across the width of the joint and showed that mode III is zero at the centerline but increases near the free edge. Models of the stitched configuration showed that the stitches effectively reduced mode I to zero, but had less of an effect on modes II and III.

Whiplash causes increased laxity of cervical capsular ligament

PubMed Central

Ivancic, Paul C.; Ito, Shigeki; Tominaga, Yasuhiro; Rubin, Wolfgang; Coe, Marcus P.; Ndu, Anthony B.; Carlson, Erik J.; Panjabi, Manohar M.

2009-01-01

Background Previous clinical studies have identified the cervical facet joint, including the capsular ligaments, as sources of pain in whiplash patients. The goal of this study was to determine whether whiplash caused increased capsular ligament laxity by applying quasi-static loading to whiplash-exposed and control capsular ligaments. Methods A total of 66 capsular ligament specimens (C2/3 to C7/T1) were prepared from 12 cervical spines (6 whiplash-exposed and 6 control). The whiplash-exposed spines had been previously rear impacted at a maximum peak T1 horizontal acceleration of 8 g. Capsular ligaments were elongated at 1 mm/s in increments of 0.05 mm until a tensile force of 5 N was achieved and subsequently returned to neutral position. Four pre-conditioning cycles were performed and data from the load phase of the fifth cycle were used for subsequent analyses. Ligament elongation was computed at tensile forces of 0, 0.25, 0.5, 0.75, 1.0, 2.5, and 5.0 N. Two factor, non-repeated measures ANOVA (P<0.05) was performed to determine significant differences in the average ligament elongation at tensile forces of 0 and 5 N between the whiplash-exposed and control groups and between spinal levels. Findings Average elongation of the whiplash-exposed capsular ligaments was significantly greater than that of the control ligaments at tensile forces of 0 and 5 N. No significant differences between spinal levels were observed. Interpretation Capsular ligament injuries, in the form of increased laxity, may be one component perpetuating chronic pain and clinical instability in whiplash patients. PMID:17959284

Electrical resistance determination of actual contact area of cold welded metal joints

NASA Technical Reports Server (NTRS)

Hordon, M. J.

1970-01-01

Method measures the area of the bonded zone of a compression weld by observing the electrical resistance of the weld zone while the load changes from full compression until the joint ruptures under tension. The ratio of bonding force to maximum tensile load varies considerably.

Joint Loads and Cartilage Stress in Intact Joints of Military Transtibial Amputees: Enhancing Quality of Life

DTIC Science & Technology

2017-04-01

crosstalk); analysis of tested subjects underway. 4) Developed analytical methods to obtain knee joint loads using EMG-driven inverse dynamics; analysis of...13/2018. Completion %: 40. Task 1.3: EMG-driven inverse dynamic (ID) analyses with OpenSim for amputee and control group subjects. Target date: 1...predicted by EMG-driven inverse dynamics. Two-three conference papers are being prepared for submission in February 2017. Other achievements. None

The influence of hand positions on biomechanical injury risk factors at the wrist joint during the round-off skills in female gymnastics.

PubMed

Farana, Roman; Jandacka, Daniel; Uchytil, Jaroslav; Zahradnik, David; Irwin, Gareth

2017-01-01

The aim of this study was to examine the biomechanical injury risk factors at the wrist, including joint kinetics, kinematics and stiffness in the first and second contact limb for parallel and T-shape round-off (RO) techniques. Seven international-level female gymnasts performed 10 trials of the RO to back handspring with parallel and T-shape hand positions. Synchronised kinematic (3D motion analysis system; 247 Hz) and kinetic (two force plates; 1235 Hz) data were collected for each trial. A two-way repeated measure analysis of variance (ANOVA) assessed differences in the kinematic and kinetic parameters between the techniques for each contact limb. The main findings highlighted that in both the RO techniques, the second contact limb wrist joint is exposed to higher mechanical loads than the first contact limb demonstrated by increased axial compression force and loading rate. In the parallel technique, the second contact limb wrist joint is exposed to higher axial compression load. Differences between wrist joint kinetics highlight that the T-shape technique may potentially lead to reducing these bio-physical loads and consequently protect the second contact limb wrist joint from overload and biological failure. Highlighting the biomechanical risk factors facilitates the process of technique selection making more objective and safe.

Nonsurgical interventional therapies for low back pain: a review of the evidence for an American Pain Society clinical practice guideline.

PubMed

Chou, Roger; Atlas, Steven J; Stanos, Steven P; Rosenquist, Richard W

2009-05-01

Systematic review. To systematically assess benefits and harms of nonsurgical interventional therapies for low back and radicular pain. Although use of certain interventional therapies is common or increasing, there is also uncertainty or controversy about their efficacy. Electronic database searches on Ovid MEDLINE and the Cochrane databases were conducted through July 2008 to identify randomized controlled trials and systematic reviews of local injections, botulinum toxin injection, prolotherapy, epidural steroid injection, facet joint injection, therapeutic medial branch block, sacroiliac joint injection, intradiscal steroid injection, chemonucleolysis, radiofrequency denervation, intradiscal electrothermal therapy, percutaneous intradiscal radiofrequency thermocoagulation, Coblation nucleoplasty, and spinal cord stimulation. All relevant studies were methodologically assessed by 2 independent reviewers using criteria developed by the Cochrane Back Review Group (for trials) and by Oxman (for systematic reviews). A qualitative synthesis of results was performed using methods adapted from the US Preventive Services Task Force. For sciatica or prolapsed lumbar disc with radiculopathy, we found good evidence that chemonucleolysis is moderately superior to placebo injection but inferior to surgery, and fair evidence that epidural steroid injection is moderately effective for short-term (but not long-term) symptom relief. We found fair evidence that spinal cord stimulation is moderately effective for failed back surgery syndrome with persistent radiculopathy, though device-related complications are common. We found good or fair evidence that prolotherapy, facet joint injection, intradiscal steroid injection, and percutaneous intradiscal radiofrequency thermocoagulation are not effective. Insufficient evidence exists to reliably evaluate other interventional therapies. Few nonsurgical interventional therapies for low back pain have been shown to be effective in randomized, placebo-controlled trials.

Deformations and strains in adhesive joints by moire interferometry

NASA Technical Reports Server (NTRS)

Post, D.; Czarnek, R.; Wood, J.; John, D.; Lubowinski, S.

1984-01-01

Displacement fields in a thick adherend lap joint and a cracked lap shear specimen were measured by high sensitivity moire interferometry. Contour maps of in-plane U and V displacements were obtained across adhesive and adherent surfaces. Loading sequences ranged from modest loads to near-failure loads. Quantitative results are given for displacements and certain strains in the adhesive and along the adhesive/adherend boundary lines. The results show nonlinear displacements and strains as a function of loads or stresses and they show viscoelastic or time-dependent response. Moire interferometry is an excellent method for experimental studies of adhesive joint performance. Subwavelength displacement resolution of a few micro-inches, and spatial resolution corresponding to 1600 fringes/inch (64 fringes/mm), were obtained in these studies. The whole-field contour maps offer insights not available from local measurements made by high sensitivity gages.

New hand bones of Hadropithecus stenognathus: implications for the paleobiology of the Archaeolemuridae.

PubMed

Lemelin, Pierre; Hamrick, Mark W; Richmond, Brian G; Godfrey, Laurie R; Jungers, William L; Burney, David A

2008-03-01

A partial, associated skeleton of Hadropithecus stenognathus (AHA-I) was discovered in 2003 at Andrahomana Cave in southeastern Madagascar. Among the postcranial elements found were the first hand bones (right scaphoid, right hamate, left first metacarpal, and right and left fifth metacarpals) attributed to this rare subfossil lemur. These hand bones were compared to those of extant strepsirrhines and catarrhines in order to infer the positional adaptations of Hadropithecus, and they were compared to those of Archaeolemur in order to assess variation in hand morphology among archaeolemurids. The scaphoid tubercle does not project palmarly as in suspensory and climbing taxa, and the hamate has no hook at all (just a small tubercle), which also points to a poorly developed carpal tunnel. There is a distinctive, radioulnarly directed "spiral" facet for articulation with the triquetrum that is most similar in orientation to that of more terrestrial primates (i.e., Lemur catta, Papio, and Gorilla). The first metacarpal is very reduced and represents only 48% of the length of metacarpal V, as in Archaeolemur, which suggests that pollical grasping of arboreal supports was not important. Compared to Archaeolemur, the shaft of metacarpal V is gracile, and the head has no dorsal ridge and lacks characteristics functionally associated with digitigrade, extended metacarpophalangeal joint postures. Proximally, the articular facet for the hamate is oriented more dorsally. Thus, the carpometacarpal joint V appears to have a distinctive hyperextended set, which has no analog among living or extinct primates. The carpals of Hadropithecus are diagnostic of a pronograde, arboreal and terrestrial (although not digitigrade) locomotor repertoire that typifies Lemur catta and some Old World monkeys. No clinging, suspensory, or climbing specializations that characterize indriids or lorises can be found in the hand of this subfossil lemur. The hand of Hadropithecus likely had similar ranges of movement at the radiocarpal and midcarpal joints as of those of pronograde primates, such as lemurids, for which the hand is held in a more extended, pronated, and neutral (i.e., showing less ulnar deviation) position during locomotion in comparison to that of vertical clingers or slow climbers. Although highly autapomorphic, the hand of Hadropithecus resembles that of its sister taxon, Archaeolemur, in having a very reduced pollex and an articular facet on the scaphoid for a sizeable prepollex. These unusual hand features reinforce the monophyly of the Archaeolemuridae.

Dynamic analysis of clamp band joint system subjected to axial vibration

NASA Astrophysics Data System (ADS)

Qin, Z. Y.; Yan, S. Z.; Chu, F. L.

2010-10-01

Clamp band joints are commonly used for connecting circular components together in industry. Some of the systems jointed by clamp band are subjected to dynamic load. However, very little research on the dynamic characteristics for this kind of joint can be found in the literature. In this paper, a dynamic model for clamp band joint system is developed. Contact and frictional slip between the components are accommodated in this model. Nonlinear finite element analysis is conducted to identify the model parameters. Then static experiments are carried out on a scaled model of the clamp band joint to validate the joint model. Finally, the model is adopted to study the dynamic characteristics of the clamp band joint system subjected to axial harmonic excitation and the effects of the wedge angle of the clamp band joint and the preload on the response. The model proposed in this paper can represent the nonlinearity of the clamp band joint and be used conveniently to investigate the effects of the structural and loading parameters on the dynamic characteristics of this type of joint system.

Torque Limit for Bolted Joint For Composites. Part B; Experimentation

NASA Technical Reports Server (NTRS)

Kostreva, Kristian M.

2003-01-01

Today, aerospace quality composite parts are generally made from either a unidirectional tape or a fabric prepreg form depending on the application. The matrix material, typically epoxy because of it dimensional stability, is pre-impregnated onto the fibers to ensure uniform distribution. Both of these composite forms are finding themselves used in applications where a joint is required. Two widely used joint methods are the classic mechanically fastened joint, and the contemporary bonded joint; however, the mechanically fastened joint is most commonly used by design engineers. A major portion of the research up-to-date about bolted composite joints has dealt with the inplane static load capacity. This work has helped to spawn standards dealing with filled-hole static joint strength. Other research has clearly shown that the clamp-up load in the mechanical fastener significantly affects the joint strength in a beneficial manner by reducing the bearing strength dependence of the composite laminate. One author reported a maximum increase in joint strength of 28%. This finding has helped to improve the reliability and efficiency of the joint in a composite structure.

Acromioclavicular joint dislocations: coracoclavicular reconstruction with and without additional direct acromioclavicular repair.

PubMed

Weiser, Lukas; Nüchtern, Jakob V; Sellenschloh, Kay; Püschel, Klaus; Morlock, Michael M; Rueger, Johannes M; Hoffmann, Michael; Lehmann, Wolfgang; Großterlinden, Lars G

2017-07-01

To evaluate different stabilisation techniques for acromioclavicular (AC) joint separations, including direct AC repair, and to compare the properties of the stabilised and native joints. An established in vitro testing model for the AC joint was used to analyse joint stability after surgical reconstruction [double TightRope (DTR), DTR with AC repair (DTR + AC), single TR with AC repair (TR + AC), and PDS sling with AC repair (PDS + AC)]. Twenty-four human cadaveric shoulders were randomised by age into four testing groups. Joint stiffness was measured by applying an axial load during defined physiological ranges of motion. Similar tests were performed for the native joints, after dissecting the coracoclavicular and AC ligaments, and after surgical reconstruction. Cyclic loading was performed for 1000 cycles with 20-70 N and vertical load to failure determined after cyclic testing. Axial stiffness for all TR groups was significantly higher than for the native joint (DTR 38.94 N/mm, p = 0.005; DTR + AC 37.79 N/mm, p = 0.015; TR + AC 45.61 N/mm, p < 0.001 vs. native 26.05 N/mm). The axial stiffness of the PDS + AC group was similar to that of the native joint group (21.4 N/mm, n.s.). AC repair did not significantly influence rotational stiffness. Load to failure was similar and >600 N in all groups (n.s.). Reconstruction of AC dislocations with one or two TRs leads to stable results with a higher stiffness than the native joints. For the PDS + AC group, axial stiffness was similar to the native situation, although there might be a risk of elongation. Direct AC repair showed no significantly increased stability in comparison with reconstructions without direct AC repair. Thus, a direct AC repair seems to be dispensable in clinical practice, while TRs or PDS cerclages appear to provide sufficiently stable results.

Lower limb muscle co-contraction and joint loading of flip-flops walking in male wearers

PubMed Central

Chen, Tony Lin-Wei; Wong, Duo Wai-Chi; Xu, Zhi; Tan, Qitao; Wang, Yan; Luximon, Ameersing

2018-01-01

Flip-flops may change walking gait pattern, increase muscle activity and joint loading, and predispose wearers to foot problems, despite that quantitative evidence is scarce. The purpose of this study was to examine the lower limb muscle co-contraction and joint contact force in flip-flops gait, and compare with those of barefoot and sports shoes walking. Ten healthy males were instructed to perform over-ground walking at self-selected speed under three footwear conditions: 1) barefoot, 2) sports shoes, and 3) thong-type flip-flops. Kinematic, kinetic and EMG data were collected and input to a musculoskeletal model to estimate muscle force and joint force. One-way repeated measures ANOVA was conducted to compare footwear conditions. It was hypothesized that flip-flops would induce muscle co-contraction and produce different gait kinematics and kinetics. Our results demonstrated that the musculoskeletal model estimation had a good temporal consistency with the measured EMG. Flip-flops produced significantly lower walking speed, higher ankle and subtalar joint range of motion, and higher shear ankle joint contact force than sports shoes (p < 0.05). There were no significant differences between flip-flops and barefoot conditions in terms of muscle co-contraction index, joint kinematics, and joint loading of the knee and ankle complex (p > 0.05). The variance in walking speed and footwear design may be the two major factors that resulted in the comparable joint biomechanics in flip-flops and barefoot walking. From this point of view, whether flip-flops gait is potentially harmful to foot health remains unclear. Given that shod walking is more common than barefoot walking on a daily basis, sports shoes with close-toe design may be a better footwear option than flip-flops for injury prevention due to its constraint on joint motion and loading. PMID:29561862

Lower limb muscle co-contraction and joint loading of flip-flops walking in male wearers.

PubMed

Chen, Tony Lin-Wei; Wong, Duo Wai-Chi; Xu, Zhi; Tan, Qitao; Wang, Yan; Luximon, Ameersing; Zhang, Ming

2018-01-01

Flip-flops may change walking gait pattern, increase muscle activity and joint loading, and predispose wearers to foot problems, despite that quantitative evidence is scarce. The purpose of this study was to examine the lower limb muscle co-contraction and joint contact force in flip-flops gait, and compare with those of barefoot and sports shoes walking. Ten healthy males were instructed to perform over-ground walking at self-selected speed under three footwear conditions: 1) barefoot, 2) sports shoes, and 3) thong-type flip-flops. Kinematic, kinetic and EMG data were collected and input to a musculoskeletal model to estimate muscle force and joint force. One-way repeated measures ANOVA was conducted to compare footwear conditions. It was hypothesized that flip-flops would induce muscle co-contraction and produce different gait kinematics and kinetics. Our results demonstrated that the musculoskeletal model estimation had a good temporal consistency with the measured EMG. Flip-flops produced significantly lower walking speed, higher ankle and subtalar joint range of motion, and higher shear ankle joint contact force than sports shoes (p < 0.05). There were no significant differences between flip-flops and barefoot conditions in terms of muscle co-contraction index, joint kinematics, and joint loading of the knee and ankle complex (p > 0.05). The variance in walking speed and footwear design may be the two major factors that resulted in the comparable joint biomechanics in flip-flops and barefoot walking. From this point of view, whether flip-flops gait is potentially harmful to foot health remains unclear. Given that shod walking is more common than barefoot walking on a daily basis, sports shoes with close-toe design may be a better footwear option than flip-flops for injury prevention due to its constraint on joint motion and loading.

Biomechanical Comparison of an Intramedullary and Extramedullary Free-Tissue Graft Reconstruction of the Acromioclavicular Joint Complex

PubMed Central

Garg, Rishi; Javidan, Pooya; Lee, Thay Q.

2013-01-01

Background Several different surgical techniques have been described to address the coracoclavicular (CC) ligaments in acromioclavicular (AC) joint injuries. However, very few techniques focus on reconstructing the AC ligaments, despite its importance in providing stability. The purpose of our study was to compare the biomechanical properties of two free-tissue graft techniques that reconstruct both the AC and CC ligaments in cadaveric shoulders, one with an extramedullary AC reconstruction and the other with an intramedullary AC reconstruction. We hypothesized intramedullary AC reconstruction will provide greater anteroposterior translational stability and improved load to failure characteristics than an extramedullary technique. Methods Six matched cadaveric shoulders underwent translational testing at 10 N and 15 N in the anteroposterior and superoinferior directions, under AC joint compression loads of 10 N, 20 N, and 30 N. After the AC and CC ligaments were transected, one of the specimens was randomly assigned the intramedullary free-tissue graft reconstruction while its matched pair received the extramedullary graft reconstruction. Both reconstructed specimens then underwent repeat translational testing, followed by load to failure testing, via superior clavicle distraction, at a rate of 50 mm/min. Results Intramedullary reconstruction provided significantly greater translational stability in the anteroposterior direction than the extramedullary technique for four of six loading conditions (p < 0.05). There were no significant differences in translational stability in the superoinferior direction for any loading condition. The intramedullary reconstructed specimens demonstrated improved load to failure characteristics with the intramedullary reconstruction having a lower deformation at yield and a higher ultimate load than the extramedullary reconstruction (p < 0.05). Conclusions Intramedullary reconstruction of the AC joint provides greater stability in the anteroposterior direction and improved load to failure characteristics than an extramedullary technique. Reconstruction of the injured AC joint with an intramedullary free tissue graft may provide greater strength and stability than other currently used techniques, allowing patients to have improved clinical outcomes. PMID:24340150

Immediate effects of manipulation of the talocrural joint on stabilometry and baropodometry in patients with ankle sprain.

PubMed

López-Rodríguez, Sandra; Fernández de-Las-Peñas, César; Alburquerque-Sendín, Francisco; Rodríguez-Blanco, Cleofás; Palomeque-del-Cerro, Luis

2007-01-01

This study assessed the immediate effects of talocrural joint manipulation on stabilometric and baropodometric outcomes in patients with grade II ankle sprain. Fifty-two field hockey players (35 men and 17 women) between 18 and 40 years old (mean = 22.5 years, SD = 3.6 years) were included in this study. A simple blind, intrapatient, placebo-controlled, and repeated-measures study was carried out. All the patients underwent a baropodometric study performed with a Foot Work force platform (4 times; pre-post placebo group and pre-post intervention group). The sample was subjected to two techniques of manipulative treatment: (a) talocrural joint manipulation and (b) posterior gliding manipulation over the talus. In a second instance, placebo manipulation was applied. Unilateral analysis of variance and multivariate analysis of variance were used for statistical analysis. The results in the intervention group revealed significant differences in the percentage of posterior load on the foot (P = .015) and the percentage of bilateral anterior load (P = .02) before and after the manipulation. The placebo group did not show any change in any of the variables except for area (P = .045). Intergroup comparison revealed statistically significant differences in the increase in percentage of posterior load on the manipulated foot, percentage of bilateral posterior load, percentage of anterior load on the manipulated foot, and percentage of bilateral anterior load (with the exception of the total load on the foot). The application of caudal talocrural joint manipulation, as compared with placebo manipulation, in athletic patients with grade II ankle sprain redistributed the load supports at the level of the foot.

Effect of tibial plateau leveling on stability of the canine cranial cruciate-deficient stifle joint: an in vitro study.

PubMed

Reif, Ullrich; Hulse, Donald A; Hauptman, Joe G

2002-01-01

To evaluate the effect of tibial plateau leveling on joint motion in canine stifle joints in which the cranial cruciate ligament (CCL) had been severed. In vitro cadaver study. Six canine cadaver hind legs. Radiographs of the stifle joints were made to evaluate the tibial plateau angle with respect to the long axis of the tibia. The specimens were mounted in a custom-made testing device to measure cranio-caudal translation of the tibia with respect to the femur. An axial load was applied to the tibia, and its position was recorded in the normal stifle, after transection of the CCL, and after tibial plateau leveling. Further, the amount of caudal tibial thrust was measured in the tibial plateau leveled specimen while series of eight linearly increasing axial tibial loads were applied. Transection of the CCL resulted in cranial tibial translation when axial tibial load was applied. After tibial plateau leveling, axial loading resulted in caudal translation of the tibia. Increasing axial tibial load caused a linear increase in caudal tibial thrust in all tibial plateau-leveled specimens. After tibial plateau leveling, axial tibial load generates caudal tibial thrust, which increases if additional axial load is applied. Tibial plateau leveling osteotomy may prevent cranial translation during weight bearing in dogs with CCL rupture by converting axial load into caudal tibial thrust. The amount of caudal tibial thrust seems to be proportional to the amount of weight bearing. Copyright 2002 by The American College of Veterinary Surgeons

Intradiscal and intra-articular facet infiltrations with plasma rich in growth factors reduce pain in patients with chronic low back pain.

PubMed

Kirchner, Fernando; Anitua, Eduardo

2016-01-01

Low back pain (LBP) is a complex and disabling condition, and its treatment becomes a challenge. The aim of our study was to assess the clinical outcome of plasma rich in growth factors (PRGF-Endoret) infiltrations (one intradiscal, one intra-articular facet, and one transforaminal epidural injection) under fluoroscopic guidance-control in patients with chronic LBP. PRGF-Endoret which has been shown to be an efficient treatment to reduce joint pain. The study was designed as an observational retrospective pilot study. Eighty-six patients with a history of chronic LBP and degenerative disease of the lumbar spine who met inclusion and exclusion criteria were recruited between December 2010 and January 2012. One intradiscal, one intra-articular facet, and one transforaminal epidural injection of PRGF-Endoret under fluoroscopic guidance-control were carried out in 86 patients with chronic LBP in the operating theater setting. Descriptive statistics were performed using absolute and relative frequency distributions for qualitative variables and mean values and standard deviations for quantitative variables. The nonparametric Friedman statistical test was used to determine the possible differences between baseline and different follow-up time points on pain reduction after treatment. Pain assessment was determined using a visual analog scale (VAS) at the first visit before (baseline) and after the procedure at 1, 3, and 6 months. The pain reduction after the PRGF-Endoret injections showed a statistically significant drop from 8.4 ± 1.1 before the treatment to 4 ± 2.6, 1.7 ± 2.3, and 0.8 ± 1.7 at 1, 3, and 6 months after the treatment, respectively, with respect to all the time evaluations ( P < 0.0001) except for the pain reduction between the 3 rd and 6 th month whose signification was lower ( P < 0.05). The analysis of the VAS over time showed that at the end point of the study (6 months), 91% of patients showed an excellent score, 8.1% showed a moderate improvement, and 1.2% were in the inefficient score. Fluoroscopy-guided infiltrations of intervertebral discs and facet joints with PRGF in patients with chronic LBP resulted in significant pain reduction assessed by VAS.

Intradiscal and intra-articular facet infiltrations with plasma rich in growth factors reduce pain in patients with chronic low back pain

PubMed Central

Kirchner, Fernando; Anitua, Eduardo

2016-01-01

Context: Low back pain (LBP) is a complex and disabling condition, and its treatment becomes a challenge. Aims: The aim of our study was to assess the clinical outcome of plasma rich in growth factors (PRGF-Endoret) infiltrations (one intradiscal, one intra-articular facet, and one transforaminal epidural injection) under fluoroscopic guidance-control in patients with chronic LBP. PRGF-Endoret which has been shown to be an efficient treatment to reduce joint pain. Settings and Design: The study was designed as an observational retrospective pilot study. Eighty-six patients with a history of chronic LBP and degenerative disease of the lumbar spine who met inclusion and exclusion criteria were recruited between December 2010 and January 2012. Subjects and Methods: One intradiscal, one intra-articular facet, and one transforaminal epidural injection of PRGF-Endoret under fluoroscopic guidance-control were carried out in 86 patients with chronic LBP in the operating theater setting. Statistical Analysis Used: Descriptive statistics were performed using absolute and relative frequency distributions for qualitative variables and mean values and standard deviations for quantitative variables. The nonparametric Friedman statistical test was used to determine the possible differences between baseline and different follow-up time points on pain reduction after treatment. Results: Pain assessment was determined using a visual analog scale (VAS) at the first visit before (baseline) and after the procedure at 1, 3, and 6 months. The pain reduction after the PRGF-Endoret injections showed a statistically significant drop from 8.4 ± 1.1 before the treatment to 4 ± 2.6, 1.7 ± 2.3, and 0.8 ± 1.7 at 1, 3, and 6 months after the treatment, respectively, with respect to all the time evaluations (P < 0.0001) except for the pain reduction between the 3rd and 6th month whose signification was lower (P < 0.05). The analysis of the VAS over time showed that at the end point of the study (6 months), 91% of patients showed an excellent score, 8.1% showed a moderate improvement, and 1.2% were in the inefficient score. Conclusions: Fluoroscopy-guided infiltrations of intervertebral discs and facet joints with PRGF in patients with chronic LBP resulted in significant pain reduction assessed by VAS. PMID:27891035

Multiple linear regression approach for the analysis of the relationships between joints mobility and regional pressure-based parameters in the normal-arched foot.

PubMed

Caravaggi, Paolo; Leardini, Alberto; Giacomozzi, Claudia

2016-10-03

Plantar load can be considered as a measure of the foot ability to transmit forces at the foot/ground, or foot/footwear interface during ambulatory activities via the lower limb kinematic chain. While morphological and functional measures have been shown to be correlated with plantar load, no exhaustive data are currently available on the possible relationships between range of motion of foot joints and plantar load regional parameters. Joints' kinematics from a validated multi-segmental foot model were recorded together with plantar pressure parameters in 21 normal-arched healthy subjects during three barefoot walking trials. Plantar pressure maps were divided into six anatomically-based regions of interest associated to corresponding foot segments. A stepwise multiple regression analysis was performed to determine the relationships between pressure-based parameters, joints range of motion and normalized walking speed (speed/subject height). Sagittal- and frontal-plane joint motion were those most correlated to plantar load. Foot joints' range of motion and normalized walking speed explained between 6% and 43% of the model variance (adjusted R 2 ) for pressure-based parameters. In general, those joints' presenting lower mobility during stance were associated to lower vertical force at forefoot and to larger mean and peak pressure at hindfoot and forefoot. Normalized walking speed was always positively correlated to mean and peak pressure at hindfoot and forefoot. While a large variance in plantar pressure data is still not accounted for by the present models, this study provides statistical corroboration of the close relationship between joint mobility and plantar pressure during stance in the normal healthy foot. Copyright © 2016 Elsevier Ltd. All rights reserved.

A neural network approach for determining gait modifications to reduce the contact force in knee joint implant.

PubMed

Ardestani, Marzieh Mostafavizadeh; Chen, Zhenxian; Wang, Ling; Lian, Qin; Liu, Yaxiong; He, Jiankang; Li, Dichen; Jin, Zhongmin

2014-10-01

There is a growing interest in non-surgical gait rehabilitation treatments to reduce the loading in the knee joint. In particular, synergetic kinematic changes required for joint offloading should be determined individually for each subject. Previous studies for gait rehabilitation designs are typically relied on a "trial-and-error" approach, using multi-body dynamic (MBD) analysis. However MBD is fairly time demanding which prevents it to be used iteratively for each subject. This study employed an artificial neural network to develop a cost-effective computational framework for designing gait rehabilitation patterns. A feed forward artificial neural network (FFANN) was trained based on a number of experimental gait trials obtained from literature. The trained network was then hired to calculate the appropriate kinematic waveforms (output) needed to achieve desired knee joint loading patterns (input). An auxiliary neural network was also developed to update the ground reaction force and moment profiles with respect to the predicted kinematic waveforms. The feasibility and efficiency of the predicted kinematic patterns were then evaluated through MBD analysis. Results showed that FFANN-based predicted kinematics could effectively decrease the total knee joint reaction forces. Peak values of the resultant knee joint forces, with respect to the bodyweight (BW), were reduced by 20% BW and 25% BW in the midstance and the terminal stance phases. Impulse values of the knee joint loading patterns were also decreased by 17% BW*s and 24%BW*s in the corresponding phases. The FFANN-based framework suggested a cost-effective forward solution which directly calculated the kinematic variations needed to implement a given desired knee joint loading pattern. It is therefore expected that this approach provides potential advantages and further insights into knee rehabilitation designs. Copyright © 2014 IPEM. Published by Elsevier Ltd. All rights reserved.

Development and Prevention of Running-Related Osteoarthritis.

PubMed

Ni, Guo-Xin

2016-01-01

Studies investigating the effect of running on risk for developing osteoarthritis at weight-bearing joints have reported with conflicting results. Generally, moderate-level running is not likely detrimental to joint health. However, many factors may be associated with the increased risk of developing osteoarthritis in runners. Factors often implicated in the development of osteoarthritis comprise those that increase joint vulnerability and those which increase joint loading. It is therefore suggested that running has different effects on different people. Efforts should be made to identify those with joint vulnerability and joint loading, and measures should be taken to have those factors and/or their running programs modified to run safely. Further investigations are needed to examine the effect of running on joint health under different conditions to confirm the association between exposure to risk factors and development of osteoarthritis, as well as to validate the effectiveness of measures for preventing running-related osteoarthritis.

On the organizing role of nonmuscular forces during performance of a giant circle in gymnastics.

PubMed

Sevrez, Violaine; Rao, Guillaume; Berton, Eric; Bootsma, Reinoud J

2012-02-01

Five elite gymnasts performed giant circles on the high bar under different conditions of loading (without and with 6-kg loads attached to the shoulders, waist or ankles). Comparing the gymnasts' kinematic pattern of movement with that of a triple-pendulum moving under the sole influence of nonmuscular forces revealed qualitative similarities, including the adoption of an arched position during the downswing and a piked position during the upswing. The structuring role of nonmuscular forces in the organization of movement was further reinforced by the results of an inverse dynamics analysis, assessing the contributions of gravitational, inertial and muscular components to the net joint torques. Adding loads at the level of the shoulders, waist or ankles systematically influenced movement kinematics and net joint torques. However, with the loads attached at the level of the shoulders or waist, the load-induced changes in gravitational and inertial torques provided the required increase in net joint torque, thereby allowing the muscular torques to remain unchanged. With the loads attached at the level of the ankles, this was no longer the case and the gymnasts increased the muscular torques at the shoulder and hip joints. Together, these results demonstrate that expert gymnasts skillfully exploit the operative nonmuscular forces, employing muscle force only in the capacity of complementary forces needed to perform the task.

An Orthopedic Perspective. Does Running Cause Osteoarthritis?

ERIC Educational Resources Information Center

Pascale, Mark; Grana, William A.

1989-01-01

Discusses the development of osteoarthritis and whether running and other impact loading sports promote it. Although these sports do not cause arthritis in normal weight bearing limbs, they can accelerate it in damaged joints. It is important to identify people with preeexisting joint disease so they can choose nonimpact-loading aerobic exercise.…

Delamination and Stitched Failure in Stitched Composite Joints

NASA Technical Reports Server (NTRS)

Glaessgen, E. H.; Raju, I. S.; Poe, C. C., Jr.

1999-01-01

The effect of stitches on the failure of a single lap joint configuration was determined in a combined experimental and finite element study. The experimental program was conducted to determine debond growth under static monotonic loading. The stitches were shown to delay the initiation of the debond and provide load transfer beyond the load necessary to completely debond the stitched lap joint. The experimentally determined debond length vs. applied load was used as an input parameter in the finite element analysis of both configurations. The strain energy release rates at the debond from were calculated using plate finite elements. Nonlinear fastener elements were used to model the stitches and multipoint constraints were used to model the contact problem. Models of the unstitched configuration showed significant values of modes I and II across the width of the joint and showed that mode III is zero at the centerline but increases near the free edge. Models of the stitched configuration showed that the stitches were effective in reducing mode I to zero, but had less of an effect on modes II and III.

The Load Distribution in Bolted or Riveted Joints in Light-Alloy Structures

NASA Technical Reports Server (NTRS)

Vogt, F.

1947-01-01

This report contains a theoretical discussion of the load distribution in bolted or riveted joints in light-alloy structures which is applicable not only for loads below the limit of proportionality but also for loads above this limit. The theory is developed for double and single shear joints. The methods given are illustrated by numerical examples and the values assumed for the bolt (or rivet) stiffnesses are based partly on theory and partly on known experimental values. It is shown that the load distribution does not vary greatly with the bolt (or rivet) stiffnesses and that for design purposes it is usually sufficient to know their order of magnitude. The theory may also be directly used for spot-welded structures and, with small modifications, for seam-welded structures, The computational work involved in the methods described is simple and may be completed in a reasonable time for most practical problems. A summary of earlier theoretical and experimental investigations on the subject is included in the report.

Critical Joints in Large Composite Primary Aircraft Structures. Volume 3: Ancillary Test Results

NASA Technical Reports Server (NTRS)

Bunin, Bruce L.; Sagui, R. L.

1985-01-01

A program was conducted to develop the technology for critical structural joints for composite wing structure that meets all the design requirements of a 1990 commercial transport aircraft. The results of a comprehensive ancillary test program are summarized, consisting of single-bolt composite joint specimens tested in a variety of configurations. These tests were conducted to characterize the strength and load deflection properties that are required for multirow joint analysis. The composite material was Toray 300 fiber and Ciba-Geigy 914 resin, in the form of 0.005 and 0.01 inch thick unidirectional tape. Tests were conducted in single and double shear for loaded and unloaded hole configurations under both tensile and compressive loading. Two different layup patterns were examined. All tests were conducted at room temperature. In addition, the results of NASA Standard Toughness Test (NASA RP 1092) are reported, which were conducted for several material systems.

Modeling the Influence of Stitching on Delamination Growth in Stitched Warp-Knit Composite Lap Joints

NASA Technical Reports Server (NTRS)

Glaessgen, E. H.; Raju, I. S.; Poe, C. C., Jr.

1999-01-01

The effect of stitches on the failure of a single lap joint configuration was determined in a combined experimental and analytical study. The experimental study was conducted to determine debond growth under static monotonic loading. The stitches were shown to delay the initiation of the debond and provide load transfer beyond the load necessary to completely debond the stitched lap joint. The strain energy release rates at the debond front were calculated using a finite element-based technique. Models of the unstitched configuration showed significant values of modes I and II across the width of the joint and showed that mode III is zero at the centerline but increases near the free edge. Models of the stitched configuration showed that the stitches effectively reduced mode I to zero, but had less of an effect on modes II and III.

Bonded composite to metal scarf joint performance in an aircraft landing gear drag strut. [for Boeing 747 aircraft

NASA Technical Reports Server (NTRS)

Howell, W. E.

1974-01-01

The structural performance of a boron-epoxy reinforced titanium drag strut, which contains a bonded scarf joint and was designed to the criteria of the Boeing 747 transport, was evaluated. An experimental and analytical investigation was conducted. The strut was exposed to two lifetimes of spectrum loading and was statically loaded to the tensile and compressive design ultimate loads. Throughout the test program no evidence of any damage in the drag strut was detected by strain gage measurements, ultrasonic inspection, or visual observation. An analytical study of the bonded joint was made using the NASA structural analysis computer program NASTRAN. A comparison of the strains predicted by the NASTRAN computer program with the experimentally determined values shows excellent agreement. The NASTRAN computer program is a viable tool for studying, in detail, the stresses and strains induced in a bonded joint.

Coracoclavicular joint: osteologic study of 1020 human clavicles

PubMed Central

Gumina, S; Salvatore, M; De Santis, P; Orsina, L; Postacchini, F

2002-01-01

We examined 1020 dry clavicles from cadavers of Italian origin to determine the prevalence of the coracoclavicular joint (ccj), a diarthrotic synovial joint occasionally present between the conoid tubercle of the clavicle and the superior surface of the horizontal part of the coracoid process. Five hundred and nine clavicles from individuals of different ages were submitted to X-ray examination. Using radiography, we measured the entire length and the index of sinuosity of the anterior lateral curve, on which the distance between the conoid tubercle and the coracoid process depends. We also used radiography to record the differences in prevalence of arthritis in two neighbouring joints, the acromioclavicular and sternoclavicular joints. Of the 1020 clavicles, eight (0.8%) displayed the articular facet of the ccj. No statistical correlation was found between clavicular length and the index of sinuosity of the anterior lateral curve. The prevalence of arthritis in clavicles with ccj was higher than that revealed in clavicles without ccj. The prevalence of ccj in the studied clavicles is lower than that observed in Asian cohorts. Furthermore, ccj is not conditioned by either length or sinuosity of the anterior lateral curve of the clavicle. Finally, the assumption that ccj is a predisposing factor for degenerative changes of neighbouring joints is statistically justified. PMID:12489763

Microstructure and Mechanical Properties of Fiber-Laser-Welded and Diode-Laser-Welded AZ31 Magnesium Alloy

NASA Astrophysics Data System (ADS)

Chowdhury, S. M.; Chen, D. L.; Bhole, S. D.; Powidajko, E.; Weckman, D. C.; Zhou, Y.

2011-07-01

The microstructures, tensile properties, strain hardening, and fatigue strength of fiber-laser-welded (FLW) and diode-laser-welded (DLW) AZ31B-H24 magnesium alloys were studied. Columnar dendrites near the fusion zone (FZ) boundary and equiaxed dendrites at the center of FZ, with divorced eutectic β-Mg17Al12 particles, were observed. The FLW joints had smaller dendrite cell sizes with a narrower FZ than the DLW joints. The heat-affected zone consisted of recrystallized grains. Although the DLW joints fractured at the center of FZ and exhibited lower yield strength (YS), ultimate tensile strength (UTS), and fatigue strength, the FLW joints failed at the fusion boundary and displayed only moderate reduction in the YS, UTS, and fatigue strength with a joint efficiency of ~91 pct. After welding, the strain rate sensitivity basically vanished, and the DLW joints exhibited higher strain-hardening capacity. Stage III hardening occurred after yielding in both base metal (BM) and welded samples. Dimple-like ductile fracture characteristics appeared in the BM, whereas some cleavage-like flat facets together with dimples and river marking were observed in the welded samples. Fatigue crack initiated from the specimen surface or near-surface defects, and crack propagation was characterized by the formation of fatigue striations along with secondary cracks.

Tibiofemoral loss of contact area but no changes in peak pressures after meniscectomy in a Lapine in vivo quadriceps force transfer model.

PubMed

Leumann, Andre; Fortuna, Rafael; Leonard, Tim; Valderrabano, Victor; Herzog, Walter

2015-01-01

The menisci are thought to modulate load transfer and to absorb shocks in the knee joint. No study has experimentally measured the meniscal functions in the intact, in vivo joint loaded by physiologically relevant muscular contractions. Right knee joints of seven New Zealand white rabbits were loaded using isometric contractions of the quadriceps femoris muscles controlled by femoral nerve stimulation. Isometric knee extensor torques at the maximal and two submaximal force levels were performed at knee angles of 70°, 90°, 110°, and 130°. Patellofemoral and tibiofemoral contact areas and pressure distributions were measured using Fuji Presensor film inserted above and below the menisci and also with the menisci removed. Meniscectomy was associated with a decrease in tibiofemoral contact area ranging from 30 to 70% and a corresponding increase in average contact pressures. Contact areas measured below the menisci were consistently larger than those measured on top of the menisci. Contact areas in the patellofemoral joint (PFJ), and peak pressures in tibiofemoral and PFJs, were not affected by meniscectomy. Contact areas and peak pressures in all joints depended crucially on knee joint angle and quadriceps force: The more flexed the knee joint was, the larger were the contact areas and the higher were the peak pressures. In agreement with the literature, removal of the menisci was associated with significant decreases in tibiofemoral contact area and corresponding increases in average contact pressures, but surprisingly, peak pressures remained unaffected, indicating that the function of the menisci is to distribute loads across a greater contact area.

Normal axial alignment of the lower extremity and load-bearing distribution at the knee.

PubMed

Hsu, R W; Himeno, S; Coventry, M B; Chao, E Y

1990-06-01

Based on a series of 120 normal subjects of different gender and age, the geometry of the knee joint was analyzed using a full-length weight-bearing roentgenogram of the lower extremity. A special computer program based on the theory of a rigid body spring model was applied to calculate the important anatomic and biomechanical factors of the knee joint. The tibiofemoral mechanical angle was 1.2 degrees varus. Hence, it is difficult to rationalize the 3 degree varus placement of the tibial component in total knee arthroplasty suggested by some authors. The distal femoral anatomic valgus (measured from the lower one-half of the femur) was 4.2 degrees in reference to its mechanical axis. This angle became 4.9 degrees when the full-length femoral anatomic axis was used. When simulating a one-legged weight-bearing stance by shifting the upper-body gravity closer to the knee joint, 75% of the knee joint load passed through the medial tibial plateau. The knee joint-line obliquity was more varus in male subjects. The female subjects had a higher peak joint pressure and a greater patello-tibial Q angle. Age had little effect on the factors relating to axial alignment of the lower extremity and load transmission through the knee joint.

Experimental investigation on the failure of T-joints at elevated temperature under unaxial loading

NASA Astrophysics Data System (ADS)

Bahri, N. F.; Afendi, M.; Razlan, Z. M.; Nor, A.; Baharuddin, S. A.

2017-09-01

In this study, the mechanical properties and maximum failure load of a bulk and T-joints subjected to tensile loading were investigated experimentally. A bulk and the T-joint specimens were fabricated and tested in order to investigate the effects of temperature conditions on the failure of the joints. The adherent and adhesive used for T-joint are 304 L stainless steel and Hysol E 214 HP with the adhesive thickness of 1.0 mm. The tensile test of the bulk specimen and adhesively T-joint were conducted by using a universal testing machine (UTM) at room temperature (RT), 55 °C, 75 °C, 100 °C and 120 °C, respectively. It was found that as the temperature increases, the failure force strength decreases for bulk and T-joint specimen. Data obtained from the tests at 120 °C showed the failure force of the bulk adhesive decreased by approximately 44 % compared to the specimen tested at RT. Next, the bulk of Hysol failure force result was compared with Araldite at RT and 100 °C. Araldite data was taken from the previous study [1]. It has also been found that the bulk for Hysol has higher failure force compared to Araldite at RT and 100 °C.

The Movement- and Load-Dependent Differences in the EMG Patterns of the Human Arm Muscles during Two-Joint Movements (A Preliminary Study)

PubMed Central

Tomiak, Tomasz; Abramovych, Tetiana I.; Gorkovenko, Andriy V.; Vereshchaka, Inna V.; Mishchenko, Viktor S.; Dornowski, Marcin; Kostyukov, Alexander I.

2016-01-01

Slow circular movements of the hand with a fixed wrist joint that were produced in a horizontal plane under visual guidance during conditions of action of the elastic load directed tangentially to the movement trajectory were studied. The positional dependencies of the averaged surface EMGs in the muscles of the elbow and shoulder joints were compared for four possible combinations in the directions of load and movements. The EMG intensities were largely correlated with the waves of the force moment computed for a corresponding joint in the framework of a simple geometrical model of the system: arm - experimental setup. At the same time, in some cases the averaged EMGs exit from the segments of the trajectory restricted by the force moment singular points (FMSPs), in which the moments exhibited altered signs. The EMG activities display clear differences for the eccentric and concentric zones of contraction that are separated by the joint angle singular points (JASPs), which present extreme at the joint angle traces. We assumed that the modeled patterns of FMSPs and JASPs may be applied for an analysis of the synergic interaction between the motor commands arriving at different muscles in arbitrary two-joint movements. PMID:27375496

Stress analysis of bolted joints under centrifugal force

NASA Astrophysics Data System (ADS)

Imura, Makoto; Iizuka, Motonobu; Nakae, Shigeki; Mori, Takeshi; Koyama, Takayuki

2014-06-01

Our objective is to develop a long-life rotary machine for synchronous generators and motors. To do this, it is necessary to design a high-strength bolted joint, which is responsible for fixing a salient pole on a rotor shaft. While the rotary machine is in operation, not only centrifugal force but also moment are loaded on a bolted joint, because a point of load is eccentric to a centre of a bolt. We tried to apply the theory proposed in VDI2230-Blatt1 to evaluate the bolted joint under eccentric force, estimate limited centrifugal force, which is the cause of partial separation between the pole and the rotor shaft, and then evaluate additional tension of a bolt after the partial separation has occurred. We analyzed the bolted joint by FEM, and defined load introduction factor in that case. Additionally, we investigated the effect of the variation of bolt preload on the partial separation. We did a full scale experiment with a prototype rotor to reveal the variation of bolt preload against tightening torque. After that, we verified limited centrifugal force and the strength of the bolted joint by the VDI2230-Blatt1 theory and FEM considering the variation of bolt preload. Finally, we could design a high-strength bolted joint verified by the theoretical study and FEM analysis.

Post-Traumatic Osteoarthritis in Mice Following Mechanical Injury to the Synovial Joint

PubMed Central

Rai, Muhammad Farooq; Duan, Xin; Quirk, James D.; Holguin, Nilsson; Schmidt, Eric J.; Chinzei, Nobuaki; Silva, Matthew J.; Sandell, Linda J.

2017-01-01

We investigated the spectrum of lesions characteristic of post-traumatic osteoarthritis (PTOA) across the knee joint in response to mechanical injury. We hypothesized that alteration in knee joint stability in mice reproduces molecular and structural features of PTOA that would suggest potential therapeutic targets in humans. The right knees of eight-week old male mice from two recombinant inbred lines (LGXSM-6 and LGXSM-33) were subjected to axial tibial compression. Three separate loading magnitudes were applied: 6N, 9N, and 12N. Left knees served as non-loaded controls. Mice were sacrificed at 5, 9, 14, 28, and 56 days post-loading and whole knee joint changes were assessed by histology, immunostaining, micro-CT, and magnetic resonance imaging. We observed that tibial compression disrupted joint stability by rupturing the anterior cruciate ligament (except for 6N) and instigated a cascade of temporal and topographical features of PTOA. These features included cartilage extracellular matrix loss without proteoglycan replacement, chondrocyte apoptosis at day 5, synovitis present at day 14, osteophytes, ectopic calcification, and meniscus pathology. These findings provide a plausible model and a whole-joint approach for how joint injury in humans leads to PTOA. Chondrocyte apoptosis, synovitis, and ectopic calcification appear to be targets for potential therapeutic intervention. PMID:28345597

Dynamic simulation of knee-joint loading during gait using force-feedback control and surrogate contact modelling.

PubMed

Walter, Jonathan P; Pandy, Marcus G

2017-10-01

The aim of this study was to perform multi-body, muscle-driven, forward-dynamics simulations of human gait using a 6-degree-of-freedom (6-DOF) model of the knee in tandem with a surrogate model of articular contact and force control. A forward-dynamics simulation incorporating position, velocity and contact force-feedback control (FFC) was used to track full-body motion capture data recorded for multiple trials of level walking and stair descent performed by two individuals with instrumented knee implants. Tibiofemoral contact force errors for FFC were compared against those obtained from a standard computed muscle control algorithm (CMC) with a 6-DOF knee contact model (CMC6); CMC with a 1-DOF translating hinge-knee model (CMC1); and static optimization with a 1-DOF translating hinge-knee model (SO). Tibiofemoral joint loads predicted by FFC and CMC6 were comparable for level walking, however FFC produced more accurate results for stair descent. SO yielded reasonable predictions of joint contact loading for level walking but significant differences between model and experiment were observed for stair descent. CMC1 produced the least accurate predictions of tibiofemoral contact loads for both tasks. Our findings suggest that reliable estimates of knee-joint loading may be obtained by incorporating position, velocity and force-feedback control with a multi-DOF model of joint contact in a forward-dynamics simulation of gait. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

Subject-specific modeling of muscle force and knee contact in total knee arthroplasty.

PubMed

Navacchia, Alessandro; Rullkoetter, Paul J; Schütz, Pascal; List, Renate B; Fitzpatrick, Clare K; Shelburne, Kevin B

2016-09-01

Understanding the mechanical loading environment and resulting joint mechanics for activities of daily living in total knee arthroplasty is essential to continuous improvement in implant design. Although survivorship of these devices is good, a substantial number of patients report dissatisfaction with the outcome of their procedure. Knowledge of in vivo kinematics and joint loading will enable improvement in preclinical assessment and refinement of implant geometry. The purpose of this investigation was to describe the mechanics of total knee arthroplasty during a variety of activities of daily living (gait, walking down stairs, and chair rise/sit). Estimates of muscle forces, tibial contact load, location, and pressure distribution was performed through a combination of mobile fluoroscopy data collection, musculoskeletal modeling, and finite element simulation. For the activities evaluated, joint compressive load was greatest during walking down stairs; however, the highest contact pressure occurred during chair rise/sit. The joint contact moment in the frontal plane was mainly varus for gait and walking down stairs, while it was valgus during chair rise/sit. Excursion of the center of pressure on the tibial component was similar during each activity and between the medial and lateral sides. The main determinants of center of pressure location were internal-external rotation, joint load, and tibial insert conformity. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1576-1587, 2016. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Monitoring of fatigue damage in composite lap-joints using guided waves and FBG sensors

NASA Astrophysics Data System (ADS)

Karpenko, Oleksii; Khomenko, Anton; Koricho, Ermias; Haq, Mahmoodul; Udpa, Lalita

2016-02-01

Adhesive bonding is being increasingly employed in many applications as it offers possibility of light-weighting and efficient multi-material joining along with reduction in time and cost of manufacturing. However, failure initiation and progression in critical components like joints, specifically in fatigue loading is not well understood, which necessitates reliable NDE and SHM techniques to ensure structural integrity. In this work, concurrent guided wave (GW) and fiber Bragg grating (FBG) sensor measurements were used to monitor fatigue damage in adhesively bonded composite lap-joints. In the present set-up, one FBG sensor was strategically embedded in the adhesive bond-line of a lap-joint, while two other FBGs were bonded on the surface of the adherends. Full spectral responses of FBG sensors were collected and compared at specific intervals of fatigue loading. In parallel, guided waves were actuated and sensed using PZT wafers mounted on the composite adherends. Experimental results demonstrated that time-of-flight (ToF) of the fundamental modes transmitted through the bond-line and spectral response of FBG sensors were sensitive to fatigue loading and damage. Combination of guided wave and FBG measurements provided the desired redundancy and synergy in the data to evaluate the degradation in bond-line properties. Measurements taken in the presence of continuously applied load replicated the in-situ/service conditions. The approach shows promise in understanding the behavior of bonded joints subjected to complex loading.

Failure Predictions of Out-of-Autoclave Sandwich Joints with Delaminations under Flexure Loads

NASA Technical Reports Server (NTRS)

Nordendale, Nikolas; Goyal, Vinay; Lundgren, Eric; Patel, Dhruv; Farrokh, Babak; Jones, Justin; Fischetti, Grace; Segal, Kenneth

2015-01-01

An analysis and a test program was conducted to investigate the damage tolerance of composite sandwich joints. The joints contained a single circular delamination between the face-sheet and the doubler. The coupons were fabricated through out-of-autoclave (OOA) processes, a technology NASA is investigating for joining large composite sections. The four-point bend flexure test was used to induce compression loading into the side of the joint where the delamination was placed. The compression side was chosen since it tends to be one of the most critical loads in launch vehicles. Autoclave cure was used to manufacture the composite sandwich sections, while the doubler was co-bonded onto the sandwich face-sheet using an OOA process after sandwich panels were cured. A building block approach was adopted to characterize the mechanical properties of the joint material, including the fracture toughness between the doubler and facesheet. Twelve four-point-bend samples were tested, six in the sandwich core ribbon orientation and six in sandwich core cross-ribbon direction. Analysis predicted failure initiation and propagation at the pre-delaminated location, consistent with experimental observations. A building block approach using fracture analyses methods predicted failure loads in close agreement with tests. This investigation demonstrated a small strength reduction due to a flaw of significant size compared to the width of the sample. Therefore, concerns of bonding an OOA material to an in-autoclave material was mitigated for the geometries, materials, and load configurations considered.

Failure Predictions of Out-of-Autoclave Sandwich Joints with Delaminations Under Flexure Loads

NASA Technical Reports Server (NTRS)

Nordendale, Nikolas A.; Goyal, Vinay K.; Lundgren, Eric C.; Patel, Dhruv N.; Farrokh, Babak; Jones, Justin; Fischetti, Grace; Segal, Kenneth N.

2015-01-01

An analysis and a test program was conducted to investigate the damage tolerance of composite sandwich joints. The joints contained a single circular delamination between the face-sheet and the doubler. The coupons were fabricated through out-of-autoclave (OOA) processes, a technology NASA is investigating for joining large composite sections. The four-point bend flexure test was used to induce compression loading into the side of the joint where the delamination was placed. The compression side was chosen since it tends to be one of the most critical loads in launch vehicles. Autoclave cure was used to manufacture the composite sandwich sections, while the doubler was co-bonded onto the sandwich face-sheet using an OOA process after sandwich panels were cured. A building block approach was adopted to characterize the mechanical properties of the joint material, including the fracture toughness between the doubler and face-sheet. Twelve four-point-bend samples were tested, six in the sandwich core ribbon orientation and six in sandwich core cross-ribbon direction. Analysis predicted failure initiation and propagation at the pre-delaminated location, consistent with experimental observations. A building block approach using fracture analyses methods predicted failure loads in close agreement with tests. This investigation demonstrated a small strength reduction due to a flaw of significant size compared to the width of the sample. Therefore, concerns of bonding an OOA material to an in-autoclave material was mitigated for the geometries, materials, and load configurations considered.

Failure Predictions of Out-of-Autoclave Sandwich Joints with Delaminations Under Flexure Loads

NASA Technical Reports Server (NTRS)

Nordendale, Nikolas; Goyal, Vinay; Lundgren, Eric; Patel, Dhruv; Farrokh, Babak; Jones, Justin; Fischetti, Grace; Segal, Kenneth

2015-01-01

An analysis and a test program was conducted to investigate the damage tolerance of composite sandwich joints. The joints contained a single circular delamination between the face-sheet and the doubler. The coupons were fabricated through out-of-autoclave (OOA) processes, a technology NASA is investigating for joining large composite sections. The four-point bend flexure test was used to induce compression loading into the side of the joint where the delamination was placed. The compression side was chosen since it tends to be one of the most critical loads in launch vehicles. Autoclave cure was used to manufacture the composite sandwich sections, while the doubler was co-bonded onto the sandwich face-sheet using an OOA process after sandwich panels were cured. A building block approach was adopted to characterize the mechanical properties of the joint material, including the fracture toughness between the doubler and face-sheet. Twelve four-point-bend samples were tested, six in the sandwich core ribbon orientation and six in sandwich core cross-ribbon direction. Analysis predicted failure initiation and propagation at the pre-delaminated location, consistent with experimental observations. Fracture analyses methods predicted failure loads in close agreement with tests. This investigation demonstrated a strength reduction of 10 percent due to a flaw of significant size compared to the width of the sample. Therefore, concerns of bonding an OOA material to an in-autoclave material was mitigated for the geometries, materials, and load configurations considered.

Cyclic Behavior of Mortarless Brick Joints with Different Interlocking Shapes

PubMed Central

Liu, Hongjun; Liu, Peng; Lin, Kun; Zhao, Sai

2016-01-01

The framed structure infilled with a mortarless brick (MB) panel exhibits considerable in-plane energy dissipation because of the relative sliding between bricks and good out-of-plane stability resulting from the use of interlocking mechanisms. The cyclic behaviors of MB are investigated experimentally in this study. Two different types of bricks, namely non-interlocking mortarless brick (N-IMB) and interlocking mortarless brick (IMB), are examined experimentally. The cyclic behavior of all of the joints (N-IMB and IMB) are investigated in consideration of the effects of interlocking shapes, loading compression stress levels and loading cycles. The hysteretic loops of N-IMB and IMB joints are obtained, according to which a mechanical model is developed. The Mohr–Coulomb failure criterion is employed to describe the shear failure modes of all of the investigated joints. A typical frictional behavior is observed for the N-IMB joints, and a significant stiffening effect is observed for the IMB joints during their sliding stage. The friction coefficients of all of the researched joints increase with the augmentation of the compression stress level and improvement of the smoothness of the interlocking surfaces. An increase in the loading cycle results in a decrease in the friction coefficients of all of the joints. The degradation rate (DR) of the friction coefficients increases with the reduction in the smoothness of the interlocking surface. PMID:28773291

On the convergence between PSY-5 domains and PID-5 domains and facets: implications for assessment of DSM-5 personality traits.

PubMed

Anderson, Jaime L; Sellbom, Martin; Bagby, R Michael; Quilty, Lena C; Veltri, Carlo O C; Markon, Kristian E; Krueger, Robert F

2013-06-01

The DSM-5 Personality and Personality Disorders workgroup and their consultants have developed the 220-item, self-report Personality Inventory for the DSM-5 (PID-5) for direct assessment of the proposed personality trait system for DSM-5; however, most practicing clinical psychologists will likely continue to rely on separate omnibus measures to index symptoms and traits associated with psychopathology. The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) is one such measure and assesses the Personality Psychopathology Five (PSY-5) domains, which are conceptual cognates of the DSM-5 trait domains. The current study examined the associations between the MMPI-2-RF PSY-5 scales and the DSM-5 trait domains and facets indexed by the PID-5. A clear pattern of convergence was found indicating that each of the PSY-5 scales was most highly correlated with its conceptually expected PID-5 counterpart (rs = .44-.67; Mdn r = .53) and facet correlations generally showed the same pattern. Similarly, when each of the PSY-5 scales was regressed onto the PID-5 domains, the conceptually expected pattern of associations emerged even more clearly. Finally, a joint exploratory factor analysis with the PSY-5 and PID-5 trait facet scales indicated a five-factor solution that clearly resembled both of the PSY-5/DSM-5 trait domains. These results show clear evidence that the MMPI-2-RF has utility in the assessment of dimensional personality traits proposed for the upcoming DSM-5.

Chondrocyte Deformations as a Function of Tibiofemoral Joint Loading Predicted by a Generalized High-Throughput Pipeline of Multi-Scale Simulations

PubMed Central

Sibole, Scott C.; Erdemir, Ahmet

2012-01-01

Cells of the musculoskeletal system are known to respond to mechanical loading and chondrocytes within the cartilage are not an exception. However, understanding how joint level loads relate to cell level deformations, e.g. in the cartilage, is not a straightforward task. In this study, a multi-scale analysis pipeline was implemented to post-process the results of a macro-scale finite element (FE) tibiofemoral joint model to provide joint mechanics based displacement boundary conditions to micro-scale cellular FE models of the cartilage, for the purpose of characterizing chondrocyte deformations in relation to tibiofemoral joint loading. It was possible to identify the load distribution within the knee among its tissue structures and ultimately within the cartilage among its extracellular matrix, pericellular environment and resident chondrocytes. Various cellular deformation metrics (aspect ratio change, volumetric strain, cellular effective strain and maximum shear strain) were calculated. To illustrate further utility of this multi-scale modeling pipeline, two micro-scale cartilage constructs were considered: an idealized single cell at the centroid of a 100×100×100 μm block commonly used in past research studies, and an anatomically based (11 cell model of the same volume) representation of the middle zone of tibiofemoral cartilage. In both cases, chondrocytes experienced amplified deformations compared to those at the macro-scale, predicted by simulating one body weight compressive loading on the tibiofemoral joint. In the 11 cell case, all cells experienced less deformation than the single cell case, and also exhibited a larger variance in deformation compared to other cells residing in the same block. The coupling method proved to be highly scalable due to micro-scale model independence that allowed for exploitation of distributed memory computing architecture. The method’s generalized nature also allows for substitution of any macro-scale and/or micro-scale model providing application for other multi-scale continuum mechanics problems. PMID:22649535

Study of mechanical joint strength of aluminum alloy 7075-T6 and dual phase steel 980 welded by friction bit joining and weld-bonding under corrosion medium

DOE PAGES

Lim, Yong Chae; Squires, Lile; Pan, Tsung-Yu; ...

2014-12-30

We have employed a unique solid-sate joining process, called friction bit joining (FBJ), to spot weld aluminum alloy (AA) 7075-T6 and dual phase (DP) 980 steel. Static joint strength was studied in the lap shear tension configuration. In addition, weld-bonding (adhesive + FBJ) joints were studied in order to evaluate the ability of adhesive to mitigate the impact of corrosion on joint properties. Accelerated laboratory cyclic corrosion tests were carried out for both FBJ only and weld-bonding joints. Furthermore, the FBJ only joints that emerged from corrosion testing had lap shear failure loads that were significantly lower than freshly preparedmore » joints. However, weld-bonding specimens retained more than 80% of the lap shear failure load of the freshly prepared weld-bonding specimens. Moreover, examination of joint cross sections confirmed that the presence of adhesive in the weld-bonding joints mitigated the effect of the corrosion environment, compared to FBJ only joints.« less

Experimental and numerical study of Bondura® 6.6 PIN joints

NASA Astrophysics Data System (ADS)

Berkani, I.; Karlsen, Ø.; Lemu, H. G.

2017-12-01

Pin joints are widely used in heavy-duty machinery such as aircrafts, cranes and offshore drilling equipment to transfer multi-dimensional shear forces. Their strength and service life depend on the clamping force in the contact region that is provided by interference fits. Though the interference fits provide full contact at the pin-hole interface under pretension loads, the contact interface reduces when the pin is subjected to an external load and hence a smaller contact surface leads to dramatic increase of the contact stress. The PIN joint of Bondura® Technology, investigated in this study, is an innovative solution intended to reduce the slack at the contact surface of the pin joint of heavy-duty machinery by using tapered sleeves on each end of the PIN. The study is aimed to better understand the contact pressure build-up and stress distribution in the supporting contact surface under pre-loading of the joint and the influence of temperature difference between part assembly and operation conditions. Numerical simulation using finite element method and diverse experimental tests were conducted. The numerical simulation and the test results, particularly the tests conducted with lubricated joints, show good conformance.

A Numerical Study on Toppling Failure of a Jointed Rock Slope by Using the Distinct Lattice Spring Model

NASA Astrophysics Data System (ADS)

Lian, Ji-Jian; Li, Qin; Deng, Xi-Fei; Zhao, Gao-Feng; Chen, Zu-Yu

2018-02-01

In this work, toppling failure of a jointed rock slope is studied by using the distinct lattice spring model (DLSM). The gravity increase method (GIM) with a sub-step loading scheme is implemented in the DLSM to mimic the loading conditions of a centrifuge test. A classical centrifuge test for a jointed rock slope, previously simulated by the finite element method and the discrete element model, is simulated by using the GIM-DLSM. Reasonable boundary conditions are obtained through detailed comparisons among existing numerical solutions with experimental records. With calibrated boundary conditions, the influences of the tensional strength of the rock block, cohesion and friction angles of the joints, as well as the spacing and inclination angles of the joints, on the flexural toppling failure of the jointed rock slope are investigated by using the GIM-DLSM, leading to some insight into evaluating the state of flexural toppling failure for a jointed slope and effectively preventing the flexural toppling failure of jointed rock slopes.

Techniques of Force and Pressure Measurement in the Small Joints of the Wrist.

PubMed

Schreck, Michael J; Kelly, Meghan; Canham, Colin D; Elfar, John C

2018-01-01

The alteration of forces across joints can result in instability and subsequent disability. Previous methods of force measurements such as pressure-sensitive films, load cells, and pressure-sensing transducers have been utilized to estimate biomechanical forces across joints and more recent studies have utilized a nondestructive method that allows for assessment of joint forces under ligamentous restraints. A comprehensive review of the literature was performed to explore the numerous biomechanical methods utilized to estimate intra-articular forces. Methods of biomechanical force measurements in joints are reviewed. Methods such as pressure-sensitive films, load cells, and pressure-sensing transducers require significant intra-articular disruption and thus may result in inaccurate measurements, especially in small joints such as those within the wrist and hand. Non-destructive methods of joint force measurements either utilizing distraction-based joint reaction force methods or finite element analysis may offer a more accurate assessment; however, given their recent inception, further studies are needed to improve and validate their use.

Hip and knee net joint moments that correlate with success in lateral load transfers over a low friction surface.

PubMed

Catena, Robert D; Xu, Xu

2016-12-01

We previously described two different preferred strategies used to perform a lateral load transfer. The wide stance strategy was not used successfully on a low-friction surface, while the narrow stance strategy was successful. Here, we retrospectively examined lower extremity net joint moments between successful and unsuccessful strategies to determine if there is a kinetic benefit consideration that may go into choosing the preferred strategy. Success vs. failure over a novel slippery surface was used to dichotomise 35 healthy working-age individuals into the two groups (successful and unsuccessful). Participants performed lateral load transfers over three sequential surface conditions: high friction, novel low friction and practised low friction. The unsuccessful strategy required larger start torques, but lower dynamic moments during transfer compared to the successful strategy. These results indicate that the periodically unsuccessful strategy may be preferred because it requires less muscle recruitment and lower stresses on lower extremity soft tissues. Practitioner Summary: The reason for this paper is to retrospectively examine the joint moment in two different load transfer strategies that are used in a lateral load transfer. We found that periodically unsuccessful strategies that we previously reported may be a beneficial toward reduced lower extremity joint stresses.

Biomechanics of the incudo-malleolar-joint - Experimental investigations for quasi-static loads.

PubMed

Ihrle, S; Gerig, R; Dobrev, I; Röösli, C; Sim, J H; Huber, A M; Eiber, A

2016-10-01

Under large quasi-static loads, the incudo-malleolar joint (IMJ), connecting the malleus and the incus, is highly mobile. It can be classified as a mechanical filter decoupling large quasi-static motions while transferring small dynamic excitations. This is presumed to be due to the complex geometry of the joint inducing a spatial decoupling between the malleus and incus under large quasi-static loads. Spatial Laser Doppler Vibrometer (LDV) displacement measurements on isolated malleus-incus-complexes (MICs) were performed. With the malleus firmly attached to a probe holder, the incus was excited by applying quasi-static forces at different points. For each force application point the resulting displacement was measured subsequently at different points on the incus. The location of the force application point and the LDV measurement points were calculated in a post-processing step combining the position of the LDV points with geometric data of the MIC. The rigid body motion of the incus was then calculated from the multiple displacement measurements for each force application point. The contact regions of the articular surfaces for different load configurations were calculated by applying the reconstructed motion to the geometry model of the MIC and calculate the minimal distance of the articular surfaces. The reconstructed motion has a complex spatial characteristic and varies for different force application points. The motion changed with increasing load caused by the kinematic guidance of the articular surfaces of the joint. The IMJ permits a relative large rotation around the anterior-posterior axis through the joint when a force is applied at the lenticularis in lateral direction before impeding the motion. This is part of the decoupling of the malleus motion from the incus motion in case of large quasi-static loads. Copyright © 2015 Elsevier B.V. All rights reserved.

The short-term effects of running on the deformation of knee articular cartilage and its relationship to biomechanical loads at the knee.

PubMed

Boocock, M; McNair, P; Cicuttini, F; Stuart, A; Sinclair, T

2009-07-01

To investigate the short-term effects of recreational running on the deformation of knee articular cartilage and to examine the relationship between changes in knee cartilage volume and biomechanical modulators of knee joint load. Twenty healthy volunteers participated in a two phase cross-sectional study. Session 1 involved Magnetic Resonance Imaging (MRI) of femoral and tibial cartilage volumes prior to and following a 30 min period of relaxed sitting, which was directly followed by a recreational run of 5000 steps. Subsequently, all participants undertook a laboratory study of their running gait to compare biomechanical derived measures of knee joint loading with changes in cartilage volume. Estimates of knee joint load were determined using a rigid-link segment, dynamic biomechanical model of the lower limbs and a simplified muscle model. Running resulted in significant deformation of the medial (5.3%, P<0.01) and lateral femoral cartilage (4.0%, P<0.05) and lateral aspect of the tibial cartilage (5.7%, P<0.01), with no significant differences between genders. Maximum compression stress was significantly correlated with percentage changes in lateral femoral cartilage volume (r(2)=0.456, P<0.05). No other biomechanical variables correlated with volume changes. Limited evidence was found linking biomechanical measures of knee joint loading and observed short-term deformation of knee articular cartilage volume following running. Further enhancement of knee muscle modelling and analysis of stress distribution across cartilage are needed if we are to fully understand the contribution of biomechanical factors to knee joint loading and the pathogenesis of knee osteoarthritis (OA).

Radiographic Analysis of Simulated First Dorsal Interosseous and Opponens Pollicis Loading Upon Thumb CMC Joint Subluxation: A Cadaver Study.

PubMed

Adams, Julie E; O'Brien, Virginia; Magnusson, Erik; Rosenstein, Benjamin; Nuckley, David J

2018-01-01

Therapy programs to treat thumb carpometacarpal (CMC) arthritis may engage selective activation and reeducation of thenar muscles, particularly the first dorsal interosseous (FDI) and opponens pollicis (OP) to reduce subluxation of the joint. We describe the effect of simulated selective activation of the FDI and OP muscles upon radiographic subluxation of the thumb CMC joint. In a cadaver model of CMC subluxation, loads were applied to the FDI, the OP, and then concomitantly at 0%, 25%, 50%, 75%, and 100% maximal loads and radial subluxation of the joint and reduction in subluxation was measured. Selective activation of the OP, alone, improved the subluxation ratio (SR) in a dose-dependent manner. Selective activation of FDI, alone, demonstrated minimal effects on SR. Concomitant activation of OP and FDI improved the SR across all loading states, and activation of 75% and greater, when compared with FDI activation alone, resulted in a statistically significant improvement in SR to within 10% of the presubluxed joint. Concomitant activation of the FDI and OP acts to reduce subluxation of the thumb CMC joint in a dose-dependent fashion. The OP is likely the predominant reducing force. Hand therapy programs that focus on selective strengthening programs likely function in part to encourage patients to activate the easily palpable and easily understood FDI. Concomitant coactivation of the OP may be the major reducing force to elicit clinical and radiographic reduction of subluxation, improved thumb positioning, and reduction of pain and arthritic symptoms.

The friction coefficient of shoulder joints remains remarkably low over 24 h of loading.

PubMed

Jones, Brian K; Durney, Krista M; Hung, Clark T; Ateshian, Gerard A

2015-11-05

The frictional response of whole human joints over durations spanning activities of daily living has not been reported previously. This study measured the friction of human glenohumeral joints during 24 h of reciprocal loading in a pendulum testing device, at moderate (0.2 mm/s, 4320 cycles) and low (0.02 mm/s, 432 cycles) sliding speeds, under a 200 N load. The effect of joint congruence was also investigated by testing human humeral heads against significantly larger mature bovine glenoids. Eight human joints and six bovine joints were tested in four combinations: human joints tested at moderate (hHCMS, n=6) and low speed (hHCLS, n=3), human humeral heads tested against bovine glenoids at moderate speed (LCMS, n=3), and bovine joints tested at moderate speed (bHCMS, n=3). In the first half hour the mean±standard deviation of the friction coefficient was hHCMS: 0.0016±0.0011, hHCLS: 0.0012±0.0002, LCMS: 0.0008±0.0002 and bHCMS: 0.0024±0.0008; in the last four hours it was hHCMS: 0.0057±0.0025, hHCLS: 0.0047±0.0017, LCMS: 0.0012±0.0003 and bHCMS: 0.0056±0.0016. The initial value was lower than the final value (p<0.0001). The value in LCMS was significantly lower than in hHCMS and bHCMS (p<0.01). No visual damage was observed in any of the specimens. These are the first results to demonstrate that the friction coefficient of natural human shoulders remains remarkably low (averaging as little as 0.0015 and no greater than 0.006) for up to 24 h of continuous loading. The sustained low friction coefficients observed in incongruent joints (~0.001) likely represent rolling rather than sliding friction. Copyright © 2015. Published by Elsevier Ltd.

Village microgrids: The Chile project

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baring-Gould, E.I.

1997-12-01

This paper describes a village application in Chile. The objective was to demonstrate the technical, economic and institutional viability of renewable energy for rural electrification, as well as to allow local partners to gain experience with hybrid/renewable technology, resource assessment, system siting and operation. A micro-grid system is viewed as a small village system, up to 1200 kWh/day load with a 50 kW peak load. It can consist of components of wind, photovoltaic, batteries, and conventional generators. It is usually associated with a single generator source, and uses batteries to cover light day time loads. This paper looks at themore » experiences learned from this project with regard to all of the facets of planning and installing this project.« less

Thermal Fatigue Study of W/cu Joint

NASA Astrophysics Data System (ADS)

Zhang, Fu; Wu, Jihong; Xu, Zengyu; Xu, Ying

2003-06-01

HHFC mock-ups with a structure of W/Cu/SS were developed by hot isostatic pressing (HIP). The performance of the W/Cu joint under high heat loads was tested using an electron beam. The size of specimens for heat load tests was 25×25 mm and the size of beam spot on the specimen surface was 22 mm in diameter. During heat load test, the specimens were water-cooled. Thermal fatigue test were conducted at power density of 8.7 MW/m2 with pulse duration of 20 seconds and interval of 20 seconds. After 1000 cycles of tests, no cracks and failure were found in the W/Cu joint. The thermal performance was also investigated in the range of 1 ~ 9 MW/m2.

Cervical spine injuries in pediatric athletes: mechanisms and management.

PubMed

Jagannathan, Jay; Dumont, Aaron S; Prevedello, Daniel M; Shaffrey, Christopher I; Jane, John A

2006-10-15

Sports-related injuries to the spine, although relatively rare compared with head injuries, contribute to significant morbidity and mortality in children. The reported incidence of traumatic cervical spine injury in pediatric athletes varies, and most studies are limited because of the low prevalence of injury. The anatomical and biomechanical differences between the immature spine of pediatric patients and the mature spine of adults that make pediatric patients more susceptible to injury include a greater mobility of the spine due to ligamentous laxity, shallow angulations of facet joints, immature development of neck musculature, and incomplete ossification of the vertebrae. As a result of these differences, 60 to 80% of all pediatric vertebral injuries occur in the cervical region. Understanding pediatric injury biomechanics in the cervical spine is important to the neurosurgeon, because coaches, parents, and athletes who place themselves in positions known to be associated with spinal cord injury (SCI) run a higher risk of such injury and paralysis. The mechanisms of SCI can be broadly subclassified into five types: axial loading, dislocation, lateral bending, rotation, and hyperflexion/hyperextension, although severe injuries often result from a combination of more than one of these subtypes. The aim of this review was to detail the characteristics and management of pediatric cervical spine injury.

Fatigue damage behavior of a surface-mount electronic package under different cyclic applied loads

NASA Astrophysics Data System (ADS)

Ren, Huai-Hui; Wang, Xi-Shu

2014-04-01

This paper studies and compares the effects of pull-pull and 3-point bending cyclic loadings on the mechanical fatigue damage behaviors of a solder joint in a surface-mount electronic package. The comparisons are based on experimental investigations using scanning electron microscopy (SEM) in-situ technology and nonlinear finite element modeling, respectively. The compared results indicate that there are different threshold levels of plastic strain for the initial damage of solder joints under two cyclic applied loads; meanwhile, fatigue crack initiation occurs at different locations, and the accumulation of equivalent plastic strain determines the trend and direction of fatigue crack propagation. In addition, simulation results of the fatigue damage process of solder joints considering a constitutive model of damage initiation criteria for ductile materials and damage evolution based on accumulating inelastic hysteresis energy are identical to the experimental results. The actual fatigue life of the solder joint is almost the same and demonstrates that the FE modeling used in this study can provide an accurate prediction of solder joint fatigue failure.

[Development of polyaxial locking plate screw system of sacroiliac joint].

PubMed

Fan, Weijie; Xie, Xuesong; Zhou, Shuping; Zhang, Yonghu

2014-09-01

To develop an instrument for sacroiliac joint fixation with less injury and less complications. Firstly, 18 adult pelvic specimens (8 males and 10 females) were used to measure the anatomical data related to the locking plates and locking screws on the sacrum and ilium, and the polyaxial locking plate screw system of the sacroiliac joint was designed according to the anatomic data. This system was made of medical titanium alloy. Then 4 adult male plevic specimens were harvested and the experiment was divided into 3 groups: group A (normal pelvic), group B (the dislocated sacroiliac joint fixed with sacroiliac screws), and group C (the dislocated sacroiliac joint fixed with polyaxial locking plate screw system). The vertical displacement of sacroiliac joint under the condition of 0-700 N vertical load and the horizontal displacement on angle under the condition of 0-12 N·m torsional load were compared among the 3 groups by using the biological material test system. Finally, the simulated application test was performed on 1 adult male cadaveric specimen to observe soft tissue injury and the position of the locking plate and screw by X-ray films. According to the anatomic data of the sacrum and ilium, the polyaxial locking plate screw system of the sacroiliac joint was designed. The biomechanical results showed that the vertical displacement of the sacroiliac joint under the condition of 0-700 N vertical load in group A was significantly bigger than that in group B and group C (P < 0.05), but there was no significant difference between group B and group C (P > 0.05). The horizontal displacement on angle under the condition of 0-12 N·m torsional load in group A was significantly less than that in group B and group C (P < 0.05). The horizontal displacement on angle under the condition of 0-6 N·m torsional load in group B was bigger than that in group C, and the horizontal displacement on angle under the condition of 6-12 N·m torsional load in group B was less than that in group C, but there was no significant difference between group B and group C (P > 0.05). The test of simulating application showed that the specimen suffered less soft tissue injury, and this instrument could be implanted precisely and safely. The polyaxial locking plate screw system of the sacroiliac joint has the advantages of smaller volume and less injury; polyaxial fixation enables flexible adjustment screw direction. The simulated application test shows satisfactory fixing effect.

Modulation of shoulder muscle and joint function using a powered upper-limb exoskeleton.

PubMed

Wu, Wen; Fong, Justin; Crocher, Vincent; Lee, Peter V S; Oetomo, Denny; Tan, Ying; Ackland, David C

2018-04-27

Robotic-assistive exoskeletons can enable frequent repetitive movements without the presence of a full-time therapist; however, human-machine interaction and the capacity of powered exoskeletons to attenuate shoulder muscle and joint loading is poorly understood. This study aimed to quantify shoulder muscle and joint force during assisted activities of daily living using a powered robotic upper limb exoskeleton (ArmeoPower, Hocoma). Six healthy male subjects performed abduction, flexion, horizontal flexion, reaching and nose touching activities. These tasks were repeated under two conditions: (i) the exoskeleton compensating only for its own weight, and (ii) the exoskeleton providing full upper limb gravity compensation (i.e., weightlessness). Muscle EMG, joint kinematics and joint torques were simultaneously recorded, and shoulder muscle and joint forces calculated using personalized musculoskeletal models of each subject's upper limb. The exoskeleton reduced peak joint torques, muscle forces and joint loading by up to 74.8% (0.113 Nm/kg), 88.8% (5.8%BW) and 68.4% (75.6%BW), respectively, with the degree of load attenuation strongly task dependent. The peak compressive, anterior and superior glenohumeral joint force during assisted nose touching was 36.4% (24.6%BW), 72.4% (13.1%BW) and 85.0% (17.2%BW) lower than that during unassisted nose touching, respectively. The present study showed that upper limb weight compensation using an assistive exoskeleton may increase glenohumeral joint stability, since deltoid muscle force, which is the primary contributor to superior glenohumeral joint shear, is attenuated; however, prominent exoskeleton interaction moments are required to position and control the upper limb in space, even under full gravity compensation conditions. The modeling framework and results may be useful in planning targeted upper limb robotic rehabilitation tasks. Copyright © 2018 Elsevier Ltd. All rights reserved.

A finite element investigation of upper cervical instrumentation.

PubMed

Puttlitz, C M; Goel, V K; Traynelis, V C; Clark, C R

2001-11-15

The finite element technique was used to predict changes in biomechanics that accompany the application of a novel instrumentation system designed for use in the upper cervical spine. To determine alterations in joint loading, kinematics, and instrumentation stresses in the craniovertebral junction after application of a novel instrumentation system. Specifically, this design was used to assess the changes in these parameters brought about by two different cervical anchor types: C2 pedicle versus C2-C1 transarticular screws, and unilateral versus bilateral instrumentation. Arthrodesis procedures can be difficult to obtain in the highly mobile craniovertebral junction. Solid fusion is most likely achieved when motion is eliminated. Biomechanical studies have shown that C1-C2 transarticular screws provide good stability in craniovertebral constructs; however, implantation of these screws is accompanied by risk of vertebral artery injury. A novel instrumentation system that can be used with transarticular screws or with C2 pedicle screws has been developed. This design also allows for unilateral or bilateral implantation. However, the authors are unaware of any reports to date on the changes in joint loading or instrumentation stresses that are associated with the choice of C2 anchor or unilateral/bilateral use. A ligamentous, nonlinear, sliding contact, three-dimensional finite element model of the C0-C1-C2 complex and a novel instrumentation system was developed. Validation of the model has been previously reported. Finite element models representing combinations of cervical anchor type (C1-C2 transarticular screws vs. C2 pedicle screws) and unilateral versus bilateral instrumentation were evaluated. All models were subjected to compression with pure moments in either flexion, extension, or lateral bending. Kinematic reductions with respect to the intact (uninjured and without instrumentation) case caused by instrumentation use were reported. Changes in loading profiles through the right and left C0-C1 and C1-C2 facets, transverse ligament-dens, and dens-anterior ring of C1 articulations were calculated by the finite element model. Maximum von Mises stresses within the instrumentation were predicted for each model variant and loading scenario. Bilateral instrumentation provided greater motion reductions than the unilateral instrumentation. When used bilaterally, C2 pedicle screws approximate the kinematic reductions and instrumentation stresses (except in lateral bending) that are seen with C1-C2 transarticular screws. The finite element model predicted that the maximum stress was always in the region in which the plate transformed into the rod. To the best of the authors' knowledge, this is the first report of predicting changes in loading in the upper cervical spine caused by instrumentation. The most significant conclusion that can be drawn from the finite element model predictions is that C2 pedicle screw fixation provides the same relative stability and instrumentation stresses as C1-C2 transarticular screw use. C2 pedicle screws can be a good alternative to C2-C1 transarticular screws when bilateral instrumentation is applied.

A parametric shell analysis of the shuttle 51-L SRB AFT field joint

NASA Technical Reports Server (NTRS)

Davis, Randall C.; Bowman, Lynn M.; Hughes, Robert M., IV; Jackson, Brian J.

1990-01-01

Following the Shuttle 51-L accident, an investigation was conducted to determine the cause of the failure. Investigators at the Langley Research Center focused attention on the structural behavior of the field joints with O-ring seals in the steel solid rocket booster (SRB) cases. The shell-of-revolution computer program BOSOR4 was used to model the aft field joint of the solid rocket booster case. The shell model consisted of the SRB wall and joint geometry present during the Shuttle 51-L flight. A parametric study of the joint was performed on the geometry, including joint clearances, contact between the joint components, and on the loads, induced and applied. In addition combinations of geometry and loads were evaluated. The analytical results from the parametric study showed that contact between the joint components was a primary contributor to allowing hot gases to blow by the O-rings. Based upon understanding the original joint behavior, various proposed joint modifications are shown and analyzed in order to provide additional insight and information. Finally, experimental results from a hydro-static pressurization of a test rocket booster case to study joint motion are presented and verified analytically.

Mechanical loading, damping, and load-driven bone formation in mouse tibiae.

PubMed

Dodge, Todd; Wanis, Mina; Ayoub, Ramez; Zhao, Liming; Watts, Nelson B; Bhattacharya, Amit; Akkus, Ozan; Robling, Alexander; Yokota, Hiroki

2012-10-01

Mechanical loads play a pivotal role in the growth and maintenance of bone and joints. Although loading can activate anabolic genes and induce bone remodeling, damping is essential for preventing traumatic bone injury and fracture. In this study we investigated the damping capacity of bone, joint tissue, muscle, and skin using a mouse hindlimb model of enhanced loading in conjunction with finite element modeling to model bone curvature. Our hypothesis was that loads were primarily absorbed by the joints and muscle tissue, but that bone also contributed to damping through its compression and natural bending. To test this hypothesis, fresh mouse distal lower limb segments were cyclically loaded in axial compression in sequential bouts, with each subsequent bout having less surrounding tissue. A finite element model was generated to model effects of bone curvature in silico. Two damping-related parameters (phase shift angle and energy loss) were determined from the output of the loading experiments. Interestingly, the experimental results revealed that the knee joint contributed to the largest portion of the damping capacity of the limb, and bone itself accounted for approximately 38% of the total phase shift angle. Computational results showed that normal bone curvature enhanced the damping capacity of the bone by approximately 40%, and the damping effect grew at an accelerated pace as curvature was increased. Although structural curvature reduces critical loads for buckling in beam theory, evolution apparently favors maintaining curvature in the tibia. Histomorphometric analysis of the tibia revealed that in response to axial loading, bone formation was significantly enhanced in the regions that were predicted to receive a curvature-induced bending moment. These results suggest that in addition to bone's compressive damping capacity, surrounding tissues, as well as naturally-occurring bone curvature, also contribute to mechanical damping, which may ultimately affect bone remodeling and bone quality. Copyright © 2012 Elsevier Inc. All rights reserved.

The Degenerative Spine.

PubMed

Clarençon, Frédéric; Law-Ye, Bruno; Bienvenot, Peggy; Cormier, Évelyne; Chiras, Jacques

2016-08-01

Degenerative disease of the spine is a leading cause of back pain and radiculopathy, and is a frequent indication for spine MR imaging. Disc degeneration, disc protrusion/herniation, discarhtrosis, spinal canal stenosis, and facet joint arthrosis, as well as interspinous processes arthrosis, may require an MR imaging workup. This review presents the MR imaging patterns of these diseases and describes the benefit of the MR imaging in these indications compared with the other imaging modalities like plain radiographs or computed tomography scan. Copyright © 2016 Elsevier Inc. All rights reserved.

Use of two-dimensional transmission photoelastic models to study stresses in double-lap bolted joints

NASA Technical Reports Server (NTRS)

Hyer, M. W.; Liu, D. H.

1981-01-01

The stress distribution in two hole connectors in a double lap joint configuration was studied. The following steps are described: (1) fabrication of photoelastic models of double lap double hole joints designed to determine the stresses in the inner lap; (2) assessment of the effects of joint geometry on the stresses in the inner lap; and (3) quantification of differences in the stresses near the two holes. The two holes were on the centerline of the joint and the joints were loaded in tension, parallel to the centerline. Acrylic slip fit pins through the holes served as fasteners. Two dimensional transmission photoelastic models were fabricated by using transparent acrylic outer laps and a photoelastic model material for the inner laps. It is concluded that the photoelastic fringe patterns which are visible when the models are loaded are due almost entirely to stresses in the inner lap.

An analytical investigation of a conceptual design for the station transverse boom rotary joint structure

NASA Technical Reports Server (NTRS)

Lake, M. S.; Bush, H. G.

1986-01-01

A study was conducted to define an annular ring, discrete roller assembly concept for the space station transverse boom rotary joint. The concept was analyzed using closed-form and finite element techniques, to size structural members for a range of joint diameters and to determine necessary equivalent stiffnesses for the roller assemblies. Also, a mass study of the system was conducted to determine its practicality, and maximum loads in the joint were identified. To obtain the optimum balance between high stiffness and low structural mass in the design of the rotary joint, it is necessary to maximize the diameter of the annular ring within operational constraints (i.e., shuttle cargo bay size). Further, a rotary joint designed with the largest possible ring diameter will result in minimum operational loads in both the roller assemblies and the transition truss members while also allowing minimum design stiffnesses for the roller assemblies.

Walking velocity and step length adjustments affect knee joint contact forces in healthy weight and obese adults.

PubMed

Milner, Clare E; Meardon, Stacey A; Hawkins, Jillian L; Willson, John D

2018-04-28

Knee osteoarthritis is a major public health problem and adults with obesity are particularly at risk. One approach to alleviating this problem is to reduce the mechanical load at the joint during daily activity. Adjusting temporospatial parameters of walking could mitigate cumulative knee joint mechanical loads. The purpose of this study was to determine how adjustments to velocity and step length affects knee joint loading in healthy weight adults and adults with obesity. We collected three-dimensional gait analysis data on 10 adults with a normal body mass index and 10 adults with obesity during over ground walking in nine different conditions. In addition to preferred velocity and step length, we also conducted combinations of 15% increased and decreased velocity and step length. Peak tibiofemoral joint impulse and knee adduction angular impulse were reduced in the decreased step length conditions in both healthy weight adults (main effect) and those with obesity (interaction effect). Peak knee joint adduction moment was also reduced with decreased step length, and with decreased velocity in both groups. We conclude from these results that adopting shorter step lengths during daily activity and when walking for exercise can reduce mechanical stimuli associated with articular cartilage degenerative processes in adults with and without obesity. Thus, walking with reduced step length may benefit adults at risk for disability due to knee osteoarthritis. Adopting a shorter step length during daily walking activity may reduce knee joint loading and thus benefit those at risk for knee cartilage degeneration. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:XX-XX, 2018. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Lower extremity joint loads in habitual rearfoot and mid/forefoot strike runners with normal and shortened stride lengths.

PubMed

Boyer, Elizabeth R; Derrick, Timothy R

2018-03-01

Our purpose was to compare joint loads between habitual rearfoot (hRF) and habitual mid/forefoot strikers (hFF), rearfoot (RFS) and mid/forefoot strike (FFS) patterns, and shorter stride lengths (SLs). Thirty-eight hRF and hFF ran at their normal SL, 5% and 10% shorter, as well as with the opposite foot strike. Three-dimensional ankle, knee, patellofemoral (PF) and hip contact forces were calculated. Nearly all contact forces decreased with a shorter SL (1.2-14.9% relative to preferred SL). In general, hRF had higher PF (hRF-RFS: 10.8 ± 1.4, hFF-FFS: 9.9 ± 2.0 BWs) and hip loads (axial hRF-RFS: -9.9 ± 0.9, hFF-FFS: -9.6 ± 1.0 BWs) than hFF. Many loads were similar between foot strike styles for the two groups, including axial and lateral hip, PF, posterior knee and shear ankle contact forces. Lateral knee and posterior hip contact forces were greater for RFS, and axial ankle and knee contact forces were greater for FFS. The tibia may be under greater loading with a FFS because of these greater axial forces. Summarising, a particular foot strike style does not universally decrease joint contact forces. However, shortening one's SL 10% decreased nearly all lower extremity contact forces, so it may hold potential to decrease overuse injuries associated with excessive joint loads.

Using "Mighty Mouse" to understand masticatory plasticity: myostatin-deficient mice and musculoskeletal function.

PubMed

Ravosa, Matthew J; López, Elisabeth K; Menegaz, Rachel A; Stock, Stuart R; Stack, M Sharon; Hamrick, Mark W

2008-09-01

Knockout mice lacking myostatin (Mstn), a negative regulator of the growth of skeletal muscle, develop significant increases in the relative mass of masticatory muscles as well as the ability to generate higher maximal muscle forces. Wild-type and Mstn-deficient mice were compared to investigate the postnatal influence of elevated masticatory loads due to increased jaw-adductor and bite forces on the biomineralization of mandibular articular and cortical bone, the internal structure of the jaw joints, and the composition of temporomandibular joint (TMJ) articular cartilage. To provide an interspecific perspective on the long-term responses of mammalian jaw joints to altered loading conditions, the findings on mice were compared to similar data for growing rabbits subjected to long-term dietary manipulation. Statistically significant differences in joint proportions and bone mineral density between normal and Mstn-deficient mice, which are similar to those observed between rabbit loading cohorts, underscore the need for a comprehensive analysis of masticatory tissue plasticity vis-à-vis altered mechanical loads, one in which variation in external and internal structure are considered. Differences in the expression of proteoglycans and type-II collagen in TMJ articular cartilage between the mouse and rabbit comparisons suggest that the duration and magnitude of the loading stimulus will significantly affect patterns of adaptive and degradative responses. These data on mammals subjected to long-term loading conditions offer novel insights regarding variation in ontogeny, life history, and the ecomorphology of the feeding apparatus.

Design and evaluation of a slave manipulator with roll-pitch-roll wrist and automatic tool loading mechanism in telerobotic surgery.

PubMed

Kim, Ki-Young; Lee, Jung-Ju

2012-12-01

As there is a shortage of scrub nurses in many hospitals, automatic surgical tool exchanging mechanism without human labour has been studied. Minimally invasive robotic surgeries (MIRS) also require scrub nurses. A surgical tool loading mechanism without a scrub nurse's assistance for MIRS is proposed. Many researchers have developed minimally invasive surgical instruments with a wrist joint that can be movable inside the abdomen. However, implementation of a distal rolling joint on a gripper is rare. To implement surgical tool exchanging without a scrub nurse's assistance, a slave manipulator and a tool loader were developed to load and unload a surgical tool unit. A surgical tool unit with a roll-pitch-roll wrist was developed. Several experiments were performed to validate the effectiveness of the slave manipulator and the surgical tool unit. The slave manipulator and the tool loader were able to successfully unload and load the surgical tool unit without human assistance. The total duration of unloading and loading the surgical tool unit was 97 s. Motion tracking experiments of the distal rolling joint were performed. The maximum positioning error of the step input response was 2°. The advantage of the proposed slave manipulator and tool loader is that other robotic systems or human labour are not needed for surgical tool loading. The feasibility of the distal rolling joint in MIS is verified. Copyright © 2012 John Wiley & Sons, Ltd.