One main disadvantage of commercially available allogenic bone substitute materials is the altered mechanical behavior due to applied material processing, including sterilization methods like thermal processing or gamma irradiation. The use of high hydrostatic pressure (HHP) might be a gentle alternative to avoid mechanical alteration. Therefore, we compressed ground trabecular human bone to granules and, afterwards, treated them with 250 and 300 MPa for 20 and 30 min respectively. We characterized the formed bone granule cylinders (BGC) with respect to their biomechanical properties by evaluating stiffness and stress at 15% strain. Furthermore, the stiffness and yield strength of HHP-treated and native human trabecular bone cylinders (TBC) as control were evaluated. The mechanical properties of native vs. HHP-treated TBCs as well as HHP-treated vs. untreated BGCs did not differ, independent of the applied HHP magnitude and duration. Our study suggests HHP treatment as a suitable alternative to current processing techniques for allogenic bone substitutes since no negative effects on mechanical properties occurred.

For the treatment of severe symptomatic aortic valve stenosis, minimally invasive heart valve prostheses are increasingly used, especially for elderly patients. The current generation of devices is based on xenogenic leaflet material, involving limitations with regard to calcification and durability. Artificial polymeric leaflet-structures represent a promising approach for improvement of valve performance. Within the current work, finite-element analysis (FEA) design studies of polymeric leaflet structures were conducted. Design of an unpressurized and axiallysymmetric trileaflet heart valve was developed based on nine parameters. Physiological pressurization in FEA was specified, based on in vitro hydrodynamic testing of a commercially available heart valve prosthesis. Hyperelastic constitutive law for polymeric leaflet material was implemented based on experimental stress strain curves resulting from uniaxial tensile and planar shear testing. As a result of FEA, time dependent leaflet deformation of the leaflet structure was calculated. Obtained leaflet dynamics were comparable to in vitro performance of the analyzed prosthesis. As a major design parameter, the lunula angle has demonstrated crucial influence on the performance of the polymeric leaflet structures. FEA represented a useful tool for design of improved polymeric leaflet structures for minimally invasive implantable heart valve prostheses.

Hydrogels have become an increasingly interesting topic in numerous fields of application. In addition to their use as immobilization matrixes in (bio)catalysis, they are widely used in the medical sector, e.g., in drug delivery systems, contact lenses, biosensors, electrodes, and tissue engineering. Cartilage tissue engineering hydrogels from natural origins, such as collagen, hyaluronic acid, and gelatin, are widely known for their good biocompatibility. However, they often lack stability, reproducibility, and mechanical strength. Synthetic hydrogels, on the other hand, can have the advantage of tunable swelling and mechanical properties, as well as good reproducibility and lower costs. In this study, we investigated the swelling and mechanical properties of synthetic polyelectrolyte hydrogels. The resulting characteristics such as swelling degree, stiffness, stress, as well as stress-relaxation and cyclic loading behavior, were compared to a commercially available biomaterial, the ChondroFiller® liquid, which is already used to treat articular cartilage lesions. Worth mentioning are the observed good reproducibility and high mechanical strength of the synthetic hydrogels. We managed to synthesize hydrogels with a wide range of compressive moduli from 2.5 ± 0.1 to 1708.7 ± 67.7 kPa, which addresses the span of human articular cartilage.

In total hip arthroplasty, excessive acetabular cup deformations and altered strain distribution in the adjacent bone are potential risk factors for implant loosening. Materials with reduced stiffness might alter the strain distribution less, whereas shell and liner deformations might increase. The purpose of our current computational study was to evaluate whether carbon fiber-reinforced poly-ether-ether-ketones with a Young´s modulus of 15 GPa (CFR-PEEK-15) and 23 GPa (CFR-PEEK-23) might be an alternative shell material compared to titanium in terms of shell and liner deformation, as well as strain distribution in the adjacent bone. Using a finite element analysis, the press-fit implantation of modular acetabular cups with shells made of titanium, CFR-PEEK-15 and CFR-PEEK-23 in a human hemi-pelvis model was simulated. Liners made of ceramic and polyethylene were simulated. Radial shell and liner deformations as well as strain distributions were analyzed. The shells made of CFR-PEEK-15 were deformed most (266.7 µm), followed by CFR-PEEK-23 (136.5 µm) and titanium (54.0 µm). Subsequently, the ceramic liners were radially deformed by up to 4.4 µm and the polyethylene liners up to 184.7 µm. The shell materials slightly influenced the strain distribution in the adjacent bone with CFR-PEEK, resulting in less strain in critical regions (<400 µm/m or >3000 µm/m) and more strain in bone building or sustaining regions (400 to 3000 µm/m), while the liner material only had a minor impact. The superior biomechanical properties of the acetabular shells made of CFR-PEEK could not be determined in our present study.Materials 2020, 13, 1372 2 of 16 ceramic and UHMWPE liners combined with structurally identical metallic shells were compared [6]. Therefore, the shell material of modular acetabular cups might have a stronger influence on the strain distribution than the liner material and shells made of polymers might have a lower influence on strain distribution.Besides UHMWPE, poly-ether-ether-ketone (PEEK), often applied with carbon fibers for reinforcement (CFR-PEEK), is a biocompatible polymer that has been introduced as a material for monolithic cups and liners, but not as a material for acetabular shells [7][8][9][10][11].However, PEEK and CFR-PEEK might be suitable alternatives to metal shells in modular acetabular cups as well, in order to avoid adverse effects on stress and strain distribution within the bone stock. However, it was shown that the reduced stiffness of shells made of PEEK and CFR-PEEK leads to increased shell deformations in the case of press-fit fixation in a finite element analysis (FEA) [12]. In particular, shells made of pure PEEK without reinforcement were deformed excessively, resulting in strong deformations of the liners, which might cause further problems in vivo. Excessive liner deformations can lead to a reduced clearance between the liner and femoral ball head and subsequently to increased frictional torques and increased wear rates [13][14][15][16]. Moreover, the seating of the liner might be j...

An established therapy for aortic valve stenosis and insufficiency is the transcatheter aortic valve replacement. By means of numerical simulation the valve dynamics can be investigated to improve the valve prostheses performance. This study examines the influence of the hemodynamic properties on the valve dynamics utilizing fluidstructure interaction (FSI) compared with results of finiteelement analysis (FEA). FEA and FSI were conducted using a previously published aortic valve model combined with a new developed model of the aortic root. Boundary conditions for a physiological pressurization were based on measurements of ventricular and aortic pressure from in vitro hydrodynamic studies of a commercially available heart valve prosthesis using a pulse duplicator system. A linear elastic behavior was assumed for leaflet material properties and blood was specified as a homogeneous, Newtonian incompressible fluid. The type of fluid domain discretization can be described with an arbitrary Lagrangian-Eulerian formulation. Comparison of significant points of time and the leaflet opening area were used to investigate the valve opening behavior of both analyses. Numerical results show that total valve opening modelled by FEA is faster compared to FSI by a factor of 5. In conclusion the inertia of the fluid, which surrounds the valve leaflets, has an important influence on leaflet deformation. Therefore, fluid dynamics should not be neglected in numerical analysis of heart valve prostheses.