Personalised prosthetic sockets are fabricated by expert clinicians in a skill- and experience-based process, with research providing tools to support evidence-based practice. We propose that digital volume correlation (DVC) may offer a deeper understanding of load transfer from prosthetic sockets into the residual limb, and tissue injury risk. This study’s aim was to develop a transtibial amputated limb analogue for volumetric strain estimation using DVC, evaluating its ability to distinguish between socket designs. A soft tissue analogue material was developed, comprising silicone elastomer and sand particles as fiducial markers for image correlation. The material was cast to form an analogue residual limb informed by an MRI scan of a person with transtibial amputation, for whom two polymer check sockets were produced by an expert prosthetist. The model was micro-CT scanned according to (i) an unloaded noise study protocol and (ii) a case study comparison between the two socket designs, loaded to represent two-legged stance. The scans were reconstructed to give 108 µm voxels. The DVC noise study indicated a 64 vx subvolume and 50% overlap, giving better than 0.32% strain sensitivity, and ~3.5 mm spatial resolution of strain. Strain fields induced by the loaded sockets indicated tensile, compressive and shear strain magnitudes in the order of 10%, with a high signal:noise ratio enabling distinction between the two socket designs. DVC may not be applicable for socket design in the clinical setting, but does offer critical 3D strain information from which existing in vitro and in silico tools can be compared and validated to support the design and manufacture of prosthetic sockets, and enhance the biomechanical understanding of the load transfer between the limb and the prosthesis.
The survivorship of cementless orthopaedic implants may be related to their initial stability; insufficient press-fit can lead to excessive micromotion between the implant and bone, joint pain, and surgical revision. However, too much interference between implant and bone can produce excessive strains and damage the bone, which also compromises stability. An understanding of the nature and mechanisms of strain generation during implantation would therefore be valuable. Previous measurements of implantation strain have been limited to local discrete or surface measurements. In this work, we devise a Digital Volume Correlation (DVC) methodology to measure the implantation strain throughout the volume. A simplified implant model was implanted into analogue bone media using a customised loading rig, and a micro-CT protocol optimised to minimise artefacts due to the presence of the implant. The measured strains were interpreted by FE modelling of the displacement-controlled implantation, using a bilinear elastoplastic constitutive model for the analogue bone. The coefficient of friction between the implant and bone was determined using the experimental measurements of the reaction force. Large strains at the interface between the analogue bone and implant produced localised deterioration of the correlation coefficient, compromising the ability to measure strains in this region. Following correlation coefficient thresholding (removing strains with a coefficient less than 0.9), the observed strain patterns were similar between the DVC and FE. However, the magnitude of FE strains was approximately double those measured experimentally. This difference suggests the need for improvements in the interface failure model, for example, to account for localised buckling of the cellular analogue bone structure. A further recommendation from this work is that future DVC experiments involving similar geometries and structures should employ a subvolume size of 0.97 mm as a starting point.
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