Are spontaneous fractures possible? An example of clinical application for personalised, multiscale neuro-musculo-skeletal modelling

Viceconti, Marco; Taddei, Fulvia; Cristofolini, Luca; Martelli, Saulo; Falcinelli, Cristina; Schileo, Enrico

doi:10.1016/j.jbiomech.2011.11.048

Cited by 52 publications

(50 citation statements)

References 44 publications

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“…To reach the goal of replacing the current process (mainly hand made) with a virtual one, several issues have been considered and addressed: capture and formalization of orthopaedic technicians' knowledge of the process, the acquisition of patient information and morphology by means of diagnostic instruments, the development of integrated solutions to design and test standard and custom-fit components and the use of digital human techniques to simulate the way the prosthesis will behave during walking. The adoption of a digital model to represent the patient is in line with the current research trend focused on multi-scale human modelling as a tool for a wide variety of applications, from ergonomics to work safety and health [10][11][12].…”

Section: Introductionmentioning

confidence: 80%

A digital patient for computer-aided prosthesis design

2013

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One contribution of 25 to a Theme Issue 'The virtual physiological human: integrative approaches to computational biomedicine'. This article concerns the design of lower limb prosthesis, both below and above knee. It describes a new computer-based design framework and a digital model of the patient around which the prosthesis is designed and tested in a completely virtual environment. The virtual model of the patient is the backbone of the whole system, and it is based on a biomechanical generalpurpose model customized with the patient's characteristics (e.g. anthropometric measures). The software platform adopts computer-aided and knowledge-guided approaches with the goal of replacing the current development process, mainly hand made, with a virtual one. It provides the prosthetics with a set of tools to design, configure and test the prosthesis and comprehends two main environments: the prosthesis modelling laboratory and the virtual testing laboratory. The first permits the three-dimensional model of the prosthesis to be configured and generated, while the second allows the prosthetics to virtually set up the artificial leg and simulate the patient's postures and movements, validating its functionality and configuration. General architecture and modelling/simulation tools for the platform are described as well as main aspects and results of the experimentation.

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Section: Introductionmentioning

confidence: 80%

A digital patient for computer-aided prosthesis design

2013

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“…But in the elderly, the density of the area was thinner and it is very easier to occur fracture and we can find the right thin density in head-neck junction area when the left femoral neck fractured (Figure 1). Stress fracture of the femoral neck is usually seen in military [8]. And in the elderly, they could be easily overlooked.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Spontaneous Femoral Neck Fracture

Sun¹,

Li²,

Jiang³

2016

Ann Clin Lab Res

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“…For the musculoskeletal system one of the first clinical problems VPH technologies 395 confronted is the risk of bone fracture in osteoporotic patients (36) (37) (38). Today, the Insigneo predictive technology can correctly discriminate in retrospective studies fractured and non-fractured patients with an accuracy of 75%-84%, depending on the age distribution of the patients (39) (40).…”

Section: The Targetsmentioning

confidence: 99%

“…Today, the Insigneo predictive technology can correctly discriminate in retrospective studies fractured and non-fractured patients with an accuracy of 75%-84%, depending on the age distribution of the patients (39) (40). An interesting derivation of this research line is the stochastic modelling of neuromuscular control, which has allowed to consider sub-optimal muscle 400 activation patterns (41; 42), enabling population modelling of the risk of hip fracture (38), but more recently showed to improve the predictive accuracy of musculoskeletal dynamics models even in relation to normal health subjects (43). Whole body musculoskeletal patientspecific models are also used in the treatment planning and functional grading of paediatric cerebral palsy patients (44) A very important feature of all connective tissues is their ability to adapt to altered environmental requirements (62) (63) (64) (65) (66), and to repair damage (67) (68); both topics have been thoroughly investigated using VPH approaches.…”

Section: The Targetsmentioning

confidence: 99%

The Virtual Physiological Human: Ten Years After

Viceconti

Hunter

2016

Annu. Rev. Biomed. Eng.

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Biomedical research and clinical practice are struggling to cope with the growing complexity that the progress of healthcare involves. The most challenging diseases, those with the largest 40 socioeconomic impact (cardiovascular conditions, musculoskeletal conditions, cancer, metabolic, immunity and neurodegenerative conditions) are all characterised by a complex genotype/phenotype interaction, and in general by a ÒsystemicÓ nature that the traditional reductionist approach struggle to cope with. In May 2005 a small group of researchers with different backgrounds met in Barcelona to discuss how the vision of computational 45 physiology promoted by the Physiome Project could be translated into the clinical practice.In that meeting the term Virtual Physiological Human was formally proposed. We know a lot about these diseases, but our knowledge is fragmentary as it is associated with molecular and cellular processes on the one hand, and with tissue and organ phenotype changes (related to clinical symptoms of disease conditions) on the other. The problem could be solved if we 50 could capture all these fragments of knowledge into predictive models and then compose them into hypermodels that help us to tame the complexity that such systemic behaviour involves. In 2005 this was simply not possible -the necessary methods and technologies were not available. Now, ten years later, it seems the right time to reflect on the original vision, the results achieved so far, and what remains to be done. 55 KEYWORDS

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Are spontaneous fractures possible? An example of clinical application for personalised, multiscale neuro-musculo-skeletal modelling

Cited by 52 publications

References 44 publications

A digital patient for computer-aided prosthesis design

A digital patient for computer-aided prosthesis design

Bilateral Spontaneous Femoral Neck Fracture

The Virtual Physiological Human: Ten Years After

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