This study investigates head-neck taper corrosion with varying head size in a novel hip simulator instrumented to measure corrosion related electrical activity under torsional loads. In all, six 28 mm and six 36 mm titanium stem-cobalt chrome head pairs with polyethylene sockets were tested in a novel instrumented hip simulator. Samples were tested using simulated gait data with incremental increasing loads to determine corrosion onset load and electrochemical activity. Half of each head size group were then cycled with simulated gait and the other half with gait compression only. Damage was measured by area and maximum linear wear depth.Aims
Methods
Maintenance of vertebral mechanical stability is of paramount importance to prevent pathologic fractures and resultant neurologic compromise in individuals with spinal metastases. Current non-surgical treatments for vertebral metastases (i.e. chemotherapy, bisphophonates (BP) and radiation) yield variable responses in the tumour and surrounding bone. Photodynamic therapy (PDT) is a novel, minimally-invasive technology that utilizes a drug activated by light at a specific non-thermal wavelength to locally destroy tumour cells. Previously, we observed that PDT can ablate cancer cells within bone and yield short-term (1-week) improvements in vertebral architecture and biomechanical strength, particularly when combined with BP therapy. This study aims to evaluate the effects of PDT in vertebral bone over a longer (6-week) time period, alone and combined with previous BP treatment, to determine if improvements in skeletal architecture and strength are maintained. Fourty healthy rnu/rnu rats were randomly assigned to four treatment groups: (i) untreated control, (ii) BP only, (iii) PDT only and (iv) PDT following BP. BP treatments were administered on day 0 via subcutaneous injection of zoledronic acid. PDT was administered on day 7 via an intravenous injection of BPD-MA photosensitizer. A flat-cut optical fiber was inserted percutaneously adjacent to lumbar vertebra L2. After a 15-minute drug-light interval, 75J of light energy was delivered from a 690nm laser. Six weeks later, animals were euthanized. Structural properties of excised L2 vertebral bodies were quantified through semi-automated analysis of micro-CT images. In of the specimens, mechanical properties were evaluated by loading the L2 vertebral body to failure in axial compression. The remaining L2 vertebrae were analyzed for morphology, osteoid formation and osteoclast activity using histological methods.Purpose
Method
Nucleus pulposus (NP) replacements represent a less invasive alternative for treatment of early stage degenerative disc disease (DDD). Hydrogel based NP replacements are of particular interest as they can be injected/implanted using minimally invasive surgical (MIS) techniques to re-establish mechanical integrity and as a scaffold for regeneration. A thiol-modified hyaluronan elastin-like polypeptide (TMHA/EP) hydrogel crosslinked using polyethylene diacrylate has shown promise as a potential NP replacement for DDD in vitro. This study aims to assess the mechanical properties of this hydrogel when injected into an induced early stage DDD porcine model and to determine the optimal injection method for delivery. It is hypothesized that minimally invasive injection of the TMHA/EP material can restore mechanical behaviour of spinal motion segments in early stage DDD. Intervertebral disc (IVD) degeneration was enzymatically induced in L2-L3 and L4-L5 lumbar levels in 10 Yorkshire boars using chondroitinase ABC (n=20 discs). An additional three animals served as healthy controls (n=6 discs). Following a four-week degradation period, the TMHA/EP solution (250microL in a 3:1 weight ratio) was injected into the degenerate NP of 16 discs by one of two MIS techniques: A direct 18G needle injection or a modified kyphoplasty technique (MKT) in which a balloon angiocatheter was inserted through an 11G trocar into the IVD and inflated to create a cavitary defect that was then filled with the hydrogel. Excised motion segments were tested in axial compression under a load of 400N and in axial rotation (AR), lateral bending (LB) and flexion/extension (FE) at 5Nm. Range of motion (ROM), neutral zone (NZ) length, NZ stiffness (NZStiff) and axial compressive stiffness (ACStiff) were quantified.Purpose
Method
To develop a low complexity highly-automated multimodal approach to segment vertebral structure and quantify mixed osteolytic/osteoblastic metastases in the rat spine using a combination of CT and MR imaging. We hypothesize that semi-automated multimodal analysis applied to 3D CT and MRI reconstructions will yield accurate and repeatable quantification of whole vertebrae affected by mixed metastases. Mixed spinal metastases were developed via intra-cardiac injection of canine Ace-1 luciferase transfected prostate cancer cells in a 3 week old rnu/rnu rat. Two sequential MR images of the L1-L3 vertebral motion segments were acquired using a 1H quadrature customized birdcage coil at 60 m isotropic voxel size followed by CT imaging at a 14m isotropic voxel size. The first MR image was T1 weighted to highlight the trabecular structure to ensure accurate registration with the CT image. The second MR image was T2 weighted to optimize differentiation between bone marrow and osteolytic tumour tissue. Samples were then processed for undecalcified histology and stained with Goldners Trichrome to identify mineralized bone and unmineralized new bone formation. All images were resampled to 34.9 m and manually aligned to a global axis. This was followed by an affine registration using a Quasi Newton optimizer and a Normalized Mutual Information metric to ensure accurate registration. The whole individual vertebrae and their trabecular centrums were then segmented from the CT images using an extended version of a previously developed atlas based registration algorithm. An intensity-based thresholding method was used to segment the regions corresponding to osteoblastic tumor predominantly attached to the outside of the cortical shell. The whole vertebral segmentation from the CT was warped around the T2 weighted MR to define the bone boundaries. An intensity-based thresholding approach was then applied to the T2 weighted MR segment the osteolytic tumor.Purpose
Method
Femoral shaft fractures are routinely treated using antegrade intramedullary nailing under fluoroscopic guidance. Malreduction is common and can be due to multiple factors. Correct entry point identification can help minimize malreduction and the risk of iatrogenic fracture. This study aims to compare landmark identification used to guide nail entry, the piriformis fossa (PF) and the trochanteric tip (T), via computer navigation and conventional fluoroscopy. The location of the PF and T were digitized under direct visualization with a three-dimensional scribe on ten, fresh-frozen cadaveric right femora (two male, eight female) by three fellowship trained orthopaedic surgeons. To estimate inter- and intraobserver reliability of the direct measurements, an intraclass correlation coefficient was calculated with a minimum of two weeks between measurements. Under navigation, each specimen was draped and antero-posterior (AP) and lateral radiographs of the proximal femur were taken with a c-arm and image intensifier. The c-arm was positioned in a neutral position (0 for AP, 90 for lateral) and rotated in 5 increments, yielding a range of acceptable images. Images, in increments of 5, within the AP range (with a neutral lateral) were loaded into a navigation system (Stryker, MI). A single surgeon digitized the T and PF directly based on conventional fluoroscopy, and again directed by navigation, yielding two measurements per entry point per specimen. This was repeated for the lateral range. Hierarchical linear modelling and a Wilcox rank test were used to determine differences in accuracy and precision, respectively, in the identification of PF and T using computer navigation vs. conventional fluoroscopy.Purpose
Method
Based on a structure function relationship, bone density distribution has been described as being representative of skeletal loading. As such, computed tomography (CT) may be used to visualize the structure of femoral head subchondral bone to allow in vivo quantification of joint mechanics without the need for implanted hardware. This study aims to characterize the distribution of subchondral bone density in the femoral head. We hypothesize that a non-uniform distribution of bone density will be observed, with correlation between left and right sides for a given patient. Femoral head surfaces were created bilaterally for thirty patients through semi-automatic segmentation of reconstructed CT data and used to map bone density, by shrinking them into the subchondral bone and averaging the grey values (linearly related to bone density) within five millimeters of the articular surface. Density maps were then oriented with the center of the head at the origin, the femoral mechanical axis (FMA) aligned with the vertical, and the posterior condylar axis (PCA) aligned with the horizontal. Twelve regions were created by dividing the density maps into three concentric rings at increments of thirty degrees from the horizontal, then splitting into four quadrants along the anterior-posterior and medial-lateral axes. Average bone density within each region was then calculated using histogram analysis. All analysis was performed with AmriaDEV 5.2.2 image analysis software (Visage Imaging, Carlsbad USA).Purpose
Method
control, no treatment; BP only; PDT only; BP and PDT combined. Seven days after MT-1 injection 60 μg/kg of zoledronic acid was injected. PDT treatment was administered on day 14 using the photosensitizer BPD-MA (1.0 mg/kg; Visudyne). Fifteen minutes later, laser-light (690nm; 75J) was administered to the lumbar vertebrae. The rats were euthanized 7 days after PDT treatment. A total of 45 vertebrae were evaluated using a histomorphometric program (GENIE™, Aperio) to assess tumour burden. Statistical analyses were performed using a one-way ANOVA with a Tukey post hoc test. A p-value p<
.05 was considered to be statistically significant..
Rodents are often used as preclinical models for investigating the biomechanical consequences of spinal pathologies and interventions. Growth plates are present within rat vertebrae throughout life and may alter the vertebral biomechanics. This study investigates the biomechanical response of rat-tail vertebrae to axial compressive loading using μCT imaging and image registration to spatially resolve strain fields. The sixth caudal vertebrae of eight immunocompromised (rnu/rnu) rats were μCT scanned (17.5 ×17.5×17.5μm/pixel) in both loaded (27N-32N axial compression) and unloaded configurations. Image registration was used to calculate strain and displacement fields in the bone due to the applied load by finding a spatial mapping between the two scans. Strain was resolved to varying spatial resolutions; high strain gradient regions, such as the growth plates, were analyzed to higher spatial resolutions. Axial strains calculated by image registration ranged from 2% in tension to 16% in compression with an average axial strain of 1.6% in compression. In seven rats the majority of the strain measured within the vertebrae was concentrated in the growth plate. Very soft growth plates in three specimens resulted in maximum axial strains from 10–16% in compression. The remaining four rats with strain concentrations in the growth plate had maximum axial strains ranging from 2.2%–3.2%. Centrally located strain concentrations of lower magnitudes and more limited spatial extent were observed in the trabecular bone. The majority of the strain within the rat vertebrae was absorbed by the growth plates. The amount of strain within the growth plate is important to consider when interpreting biomechanical data on rat vertebrae. Load application to rodent vertebrae will first compress the growth plate and only following compression of this structure cause significant development of displacement and strains within the trabecular and cortical bone. This insight into the biomechanical response of rat vertebrae is apparent through the application of image registration to analyse vertebral body behaviour; such information would not be evident in analysing preclinical whole vertebral body response using finite element modeling or experimental testing protocols.
To compare strains measured in a whole rat-tail vertebra by image registration (IM) with those predicted by solid finite element analysis (FEA). Quantification of bone strain allows better understand fracture risk, bone healing and turnover. The sixth caudal vertebra of an rnu/rnu rat was μCT scanned (17.5×17.5×17.5μm/voxel) while loaded (27N axial compression) and unloaded. IM was used to calculate strain and displacement fields in the bone due to the applied load by finding a spatial mapping between the two scans. Strain was resolved to varying spatial resolution; high strain gradient regions (ie growth plates) were analyzed to higher spatial resolutions. A FE model was created of the unloaded vertebra, consisting of tetrahedral elements with transversely isotropic material properties. Elements were assigned elastic moduli based upon μCT image intensities. Growth plate moduli ranged from 0–150kPa and the bone moduli ranged from 0.2–15000MPa. Vertebral geometry was created through segmentation of μCT images. Displacement boundary conditions were obtained by matching cranial and caudal surfaces in the unloaded and loaded scans. The displacement fields of the two methods were compared by using the fields calculated to deform the unloaded scan to match the loaded scan. The strains were compared by plotting FEA measured axial strain against IM calculated axial strain. The displacement fields calculated by both methods were able to spatially align the unloaded scan to the loaded scan (Mean Voxel Intensity Difference: FEA=441HU, IM=328HU, Unregistered=969HU). IM and FEA show very limited agreement in axial strain measurement (R2=0.388, Slope=0.75, X-Intercept=0.0037) although both calculated high axial strains in the growth plates and low axial strains in the trabecular and cortical bone. Good agreement was found in the mean axial strain measured by both methods (IM= −0.044, FEA=−0.037). IM was better able to deal with difficulties in quantifying bone strain due to the growth plate than FEA. IM presents advantages over FEA in measuring strain in complex whole bone trabecular structures, however has lower spatial resolution than is possible with FEA.
