Jose L. Zavaleta-Ruiz, Stefania Fatone, Matthew J. Major, Pankaj Pankaj
Individuals with transfemoral amputation (TFA) experience bone loss in their residual femur at levels seen in bedridden and post-menopausal individuals. It has been suggested that the time until first prosthesis fitting, gait deviations, and muscle atrophy may be contributing factors, but evidence is inconsistent. Prosthetic sockets are typically designed to off-load the distal end of the residual limb, yet the effect of the load transmission pathways of the prosthetic socket on a residual femur has not been examined. Using existing datasets, we recreated the prosthetic socket environment within finite element (FE) models by extracting the skeletal geometries of 10 able-bodied individuals from computer tomography scans, and anthropometrically pairing them with gait data acquired from individuals with unilateral TFA. Normal skeletal geometries were modified to resemble a TFA and fit with an ischial containment socket (ICS). The modified skeleton was positioned with respect to the socket using motion analysis marker locations and tested using the ground reaction forces corresponding to three gait instances from at least four steps. Additional mirror models without the ICS were created for comparison. We validated our study by comparing hip forces from the original gait data to acetabular contact forces estimated using the FE models. We found that the residual femur wearing an ICS experienced mean compressive strain of −105 ± 42 μE and −722 ± 155 μE without the ICS. Simulations show that this is because the ICS redirects load through the pelvis, diminishing force transmission from the femoral head to the acetabulum.
{"title":"Mechanical Stimulation in the Residual Femur During Gait in Transfemoral Prosthesis Users Provides a Potential Reason for Bone Mineral Density Loss","authors":"Jose L. Zavaleta-Ruiz, Stefania Fatone, Matthew J. Major, Pankaj Pankaj","doi":"10.1002/cnm.70103","DOIUrl":"10.1002/cnm.70103","url":null,"abstract":"<p>Individuals with transfemoral amputation (TFA) experience bone loss in their residual femur at levels seen in bedridden and post-menopausal individuals. It has been suggested that the time until first prosthesis fitting, gait deviations, and muscle atrophy may be contributing factors, but evidence is inconsistent. Prosthetic sockets are typically designed to off-load the distal end of the residual limb, yet the effect of the load transmission pathways of the prosthetic socket on a residual femur has not been examined. Using existing datasets, we recreated the prosthetic socket environment within finite element (FE) models by extracting the skeletal geometries of 10 able-bodied individuals from computer tomography scans, and anthropometrically pairing them with gait data acquired from individuals with unilateral TFA. Normal skeletal geometries were modified to resemble a TFA and fit with an ischial containment socket (ICS). The modified skeleton was positioned with respect to the socket using motion analysis marker locations and tested using the ground reaction forces corresponding to three gait instances from at least four steps. Additional mirror models without the ICS were created for comparison. We validated our study by comparing hip forces from the original gait data to acetabular contact forces estimated using the FE models. We found that the residual femur wearing an ICS experienced mean compressive strain of −105 ± 42 μE and −722 ± 155 μE without the ICS. Simulations show that this is because the ICS redirects load through the pelvis, diminishing force transmission from the femoral head to the acetabulum.</p>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"41 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cnm.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mikael Karlsson, Mina Nashed, Tamer Elnady, Mats Åbom
Reduced order hemodynamic models are an increasingly important complementary tool to in vivo measurements. They enable effective creation of large datasets with well-defined parameter variations, which can be used, for example, for training machine learning models, conducting virtual studies of intervention strategies, or for the development of pulse wave analysis algorithms. Here, a 1D frequency domain formalism for pulse wave propagation in the cardiovascular system is presented. Using the scattering matrix formulation, a computationally efficient and causal solution is obtained, including possible source terms and nonideal coupling conditions. Local nonlinear effects, as those seen in stenoses or aneurysms, are introduced via an iterative procedure, achieving as good accuracy as state-of-the-art time-domain solvers while being significantly more computationally efficient. The new formalism has been successfully validated against well-documented reference cases from the literature.
{"title":"A Computationally Efficient and Causal Frequency Domain Formalism for Hemodynamics Allowing for Nonlinearities and Generalized Coupling Conditions","authors":"Mikael Karlsson, Mina Nashed, Tamer Elnady, Mats Åbom","doi":"10.1002/cnm.70104","DOIUrl":"10.1002/cnm.70104","url":null,"abstract":"<p>Reduced order hemodynamic models are an increasingly important complementary tool to in vivo measurements. They enable effective creation of large datasets with well-defined parameter variations, which can be used, for example, for training machine learning models, conducting virtual studies of intervention strategies, or for the development of pulse wave analysis algorithms. Here, a 1D frequency domain formalism for pulse wave propagation in the cardiovascular system is presented. Using the scattering matrix formulation, a computationally efficient and causal solution is obtained, including possible source terms and nonideal coupling conditions. Local nonlinear effects, as those seen in stenoses or aneurysms, are introduced via an iterative procedure, achieving as good accuracy as state-of-the-art time-domain solvers while being significantly more computationally efficient. The new formalism has been successfully validated against well-documented reference cases from the literature.</p>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"41 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jose L. Monclova, Scott D. Simon, Keefe B. Manning, Francesco Costanzo
Ischemic stroke, caused by a blood clot lodging in cerebral vasculature, is a leading cause of death worldwide. The mechanics of vessel occlusion and the influence of residual stress on thrombectomy outcomes remain poorly understood. Most computational studies neglect arterial residual stress and the deformation a clot undergoes as it lodges, both of which elevate system stresses. Here, we introduce a method to simulate the initial state of a clot lodged in an idealized artery with residual stress. In this study, the artery is formulated as two concentric right cylinders with fibers embedded in an isotropic mesh, with a pre-deformation used to incorporate residual stress. A base equilibrium state of an elastic clot is simulated in continuous contact with the arterial wall. The opening angle of the artery, un-lodged-to-lodged dimensional ratios, and stiffness of the clot are varied in parametric sweeps to characterize the traction forces of the clot into the arterial wall. An aspiration pressure is applied to the proximal end of the clot to determine the pressures necessary to begin tensile detachment of the clot. As the artery opening angle increased, removal aspiration pressures increased, while the pressures decreased with increasing artery fiber orientation. The stress-free-to-lodged length ratio of the clot influenced the removal aspiration pressure, with pressures increasing nearly a thousand-fold with increased ratio. By incorporating different factors that contribute to the stress state of the system, this study provides a library of realistic initial conditions for simulating aspiration thrombectomy and validating new surgical techniques.
{"title":"Characterization of the In Situ Stress State of Blood Clots in Ischemic Stroke: The Effect of Initial Conditions and Arterial Interaction","authors":"Jose L. Monclova, Scott D. Simon, Keefe B. Manning, Francesco Costanzo","doi":"10.1002/cnm.70094","DOIUrl":"10.1002/cnm.70094","url":null,"abstract":"<p>Ischemic stroke, caused by a blood clot lodging in cerebral vasculature, is a leading cause of death worldwide. The mechanics of vessel occlusion and the influence of residual stress on thrombectomy outcomes remain poorly understood. Most computational studies neglect arterial residual stress and the deformation a clot undergoes as it lodges, both of which elevate system stresses. Here, we introduce a method to simulate the initial state of a clot lodged in an idealized artery with residual stress. In this study, the artery is formulated as two concentric right cylinders with fibers embedded in an isotropic mesh, with a pre-deformation used to incorporate residual stress. A base equilibrium state of an elastic clot is simulated in continuous contact with the arterial wall. The opening angle of the artery, un-lodged-to-lodged dimensional ratios, and stiffness of the clot are varied in parametric sweeps to characterize the traction forces of the clot into the arterial wall. An aspiration pressure is applied to the proximal end of the clot to determine the pressures necessary to begin tensile detachment of the clot. As the artery opening angle increased, removal aspiration pressures increased, while the pressures decreased with increasing artery fiber orientation. The stress-free-to-lodged length ratio of the clot influenced the removal aspiration pressure, with pressures increasing nearly a thousand-fold with increased ratio. By incorporating different factors that contribute to the stress state of the system, this study provides a library of realistic initial conditions for simulating aspiration thrombectomy and validating new surgical techniques.</p>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"41 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cnm.70094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}