Carpal tunnel syndrome is a frequently encountered peripheral nerve disorder caused by mechanical insult to the median nerve, which may in part be a result of impingement by the adjacent digital flexor tendons. Realistic finite element (FE) analysis to determine contact stresses between the flexor tendons and median nerve depends upon the use of physiologically accurate material properties. To assess the transverse compressive properties of the digital flexor tendons and median nerve, these tissues from ten cadaveric forearm specimens were compressed transversely while under axial load. The experimental compression data were used in conjunction with an FE-based optimization routine to determine apparent hyperelastic coefficients (μ and α) for a first-order Ogden material property definition. The mean coefficient pairs were μ=35.3kPa, α =8.5 for the superficial tendons, μ=39.4kPa, α=9.2 for the deep tendons, μ=24.9kPa, α=10.9 for the flexor pollicis longus (FPL) tendon, and μ=12.9kPa, α=6.5 for the median nerve. These mean Ogden coefficients indicate that the FPL tendon was more compliant at low strains than either the deep or superficial flexor tendons, and that there was no significant difference between superficial and deep flexor tendon compressive behavior. The median nerve was significantly more compliant than any of the flexor tendons. The material properties determined in this study can be used to better understand the functional mechanics of the carpal tunnel soft tissues and possible mechanisms of median nerve compressive insult, which may lead to the onset of carpal tunnel syndrome.
Computational simulations of wear of orthopaedic total joint replacement implants have proven to valuably complement laboratory physical simulators, for pre-clinical estimation of abrasive/adhesive wear propensity. This class of numerical formulations has primarily involved implementation of the Archard/Lancaster relationship, with local wear computed as the product of (finite element) contact stress, sliding speed, and a bearing-couple-dependent wear factor. The present study introduces an augmentation, whereby the influence of interface cross-shearing motion transverse to the prevailing molecular orientation of the polyethylene articular surface is taken into account in assigning the instantaneous local wear factor. The formulation augment is implemented within a widely-utilized commercial finite element software environment (ABAQUS). Using a contemporary metal-on-polyethylene total disc replacement (ProDisc-L) as an illustrative implant, physically validated computational results are presented to document the role of cross-shearing effects in alternative laboratory consensus testing protocols. Going forward, this formulation permits systematically accounting for cross-shear effects in parametric computational wear studies of metal-on-polyethylene joint replacements, heretofore a substantial limitation of such analyses.
A common in vitro model for studying acute mechanical damage in cartilage is to impact an isolated osteochondral or cartilage specimen with a metallic impactor. The mechanics of a cartilage-on-cartilage (COC) impact, as encountered in vivo, are likely different than those of a metal-on-cartilage (MOC) impact. The hypothesis of this study was that impacted in vitro COC and MOC specimens would differ in their impact behavior, mechanical properties, chondrocyte viability, cell metabolism, and histologic structural damage. Osteochondral specimens were impacted with either an osteochondral plug or a metallic cylinder at the same delivered impact energy per unit area, and processed after 14 days in culture. The COC impacts resulted in about half of the impact maximum stress and a quarter of the impact maximum stress rate of change, as compared to the MOC impacts. The impacted COC specimens had smaller changes in mechanical properties, smaller decreases in chondrocyte viability, higher total proteoglycan content, and less histologic structural damage, as compared to the impacted MOC specimens. If metal-on-cartilage impact conditions are to be used for modeling of articular injuries and post-traumatic osteoarthritis, the differences between COC and MOC impacts must be kept in mind.
Both instability and residual articular incongruity are implicated in the development of post-traumatic osteoarthritis following intra-articular fracture, but currently no information exists regarding cartilage stresses for unstable residual incongruities. In this study, a transversely isotropic poroelastic cartilage finite element model was implemented and validated within physiologically relevant loading ranges. This material model was then used to simulate the loading of cartilage during stable and unstable motion accompanying a step-off incongruity residual from intra-articular fracture, using load data from previous cadaver tests of ankle instability. Peak solid-phase stresses and fluid pressure were found to increase markedly in the presence of instability. Solid phase transients of normal stress increased from 2.00 to 13.8 MPa/s for stable compared to unstable motion, and tangential stress transients increased from 17.1 to 118.1 MPa/s. Corresponding fluid pressure transients increased from 15.1 to 117.9 MPa/s for unstable motion. In the most rapidly loaded sections of cartilage, the fluid was found to carry nearly all of the normal load, with the pressurization of the fluid resulting in high solid matrix tangential stresses.
Laboratory wear simulations of the dual-bearing surface Charité total disc replacement (TDR) are complicated by the non-specificity of the device's center of rotation (CoR). Previous studies have suggested that articulation of the Charité preferentially occurs at the superior-bearing surface, although it is not clear how sensitive this phenomenon is to lubrication conditions or CoR location. In this study, a computational wear model is used to study the articulation kinematics and wear of the Charité TDR. Implant wear was found to be insensitive to the CoR location, although seemingly non-physiologic endplate motion can result. Articulation and wear were biased significantly to the superior-bearing surface, even in the presence of significant perturbations of loading and friction. The computational wear model provides novel insight into the mechanics and wear of the Charité TDR, allowing for better interpretation of in vivo results, and giving useful insight for designing future laboratory physical tests.
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