Clinical Biomechanics最新文献_第10页

Acute effects of ankle exosuit on biomechanics, muscle activity, and energy cost of walking in adolescents with unilateral cerebral palsy 踝关节外装对单侧脑瘫青少年行走的生物力学、肌肉活动和能量消耗的急性影响。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-09-06 DOI: 10.1016/j.clinbiomech.2025.106665

Maxwell Thurston , Harri Piitulainen , Ivan Vujaklija , Janne Avela , Juha-Pekka Kulmala

Background

This study aimed to investigate the potential of an assistive ankle exosuit to acutely augment clinically relevant walking parameters in adolescents with Cerebral Palsy (CP).

Methods

Ten exosuit-naïve adolescents with unilateral CP (11–16 years old) walked on a treadmill without the exosuit (baseline), and with the exosuit (ReWalk ReStore®) providing unilateral dorsiflexion and plantarflexion assistance to their more-affected ankle. Five participants also walked with their regular orthosis. Energy cost of transport, kinematics and kinetics, and electromyography of Tibialis Anterior and Gastrocnemius Medialis muscles were assessed.

Findings

The exosuit increased ankle dorsiflexion during swing-phase, alleviating drop-foot on the more-affected side observed during baseline walking. Peak ankle moment was increased with the exosuit. While participants' orthoses restricted plantarflexion during push-off, the exosuit enabled more-typical push-off plantarflexion motion. There were no significant changes in energy cost or muscle activity with the exosuit.

Interpretation

The exosuit facilitated heel-toe ankle kinematics of the more-affected leg during gait, preventing drop-foot, while preserving plantarflexion during push-off. The exosuit slightly increased plantarflexor torque, however this did not translate to increased positive power from the more-affected ankle during gait. Lack of changes in muscle activity or energy cost indicate an inability of exosuit assistance to acutely alter these parameters on initial use of the device. These results display potential of an assistive exosuit to immediately augment ankle kinematics, but also underline limitations of the exosuit to acutely alter other clinical outcomes important for lasting gait changes, namely muscle activity and energy consumption.

背景：本研究旨在探讨一种辅助踝外服在急性增加脑瘫（CP）青少年临床相关行走参数方面的潜力。方法：10名患有单侧CP的exosuit-naïve青少年（11-16岁）在跑步机上行走，不穿外骨骼服（基线），穿着外骨骼服（ReWalk ReStore®），为他们受影响更严重的脚踝提供单侧背屈和跖屈辅助。五名参与者也使用常规矫形器行走。评估胫骨前肌和腓肠肌内侧肌的能量运输成本、运动学和动力学以及肌电图。研究结果：在摇摆阶段，外套增加了踝关节的背屈，减轻了基线行走时观察到的受影响更大的一侧的落脚。踝部峰值力矩随外骨骼的增加而增加。虽然参与者的矫形器在推离时限制了植物屈曲，但外穿服可以实现更典型的推离植物屈曲运动。穿上外套后，能量消耗和肌肉活动没有显著变化。解释：在步态过程中，外衣促进了受影响更大的腿的脚跟-脚趾踝关节的运动学，防止了落脚，同时在推蹬时保持了足底屈曲。外伤服略微增加了跖屈肌扭矩，但这并没有转化为步态中受影响更大的脚踝所增加的正能量。缺乏肌肉活动或能量消耗的变化表明，在最初使用该设备时，外骨骼辅助无法急剧改变这些参数。这些结果显示了辅助外服的潜力，可以立即增强踝关节的运动学，但也强调了外服在剧烈改变其他对持久步态变化重要的临床结果（即肌肉活动和能量消耗）方面的局限性。

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引用次数: 0

External torque application during assessment of syndesmotic ankle lesions: A systematic review 评估关节联合病变时的外扭矩应用：系统回顾

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-09-05 DOI: 10.1016/j.clinbiomech.2025.106662

Axel Degrande , Louise Wittouck , Pieter D'Hooghe , Matthias Peiffer , Thomas Tampere , Sam Van der Jeught , Arne Burssens , Amélie Chevalier

Background

Syndesmotic ankle injuries, particularly those involving the distal tibiofibular joint, are challenging to diagnose due to subtle clinical presentation and complex ankle biomechanics. Both clinical and biomechanical studies struggle with accurately assessing the severity and extent of these injuries. External torque has recently shown promise in enhancing the detection and assessment of syndesmotic injuries, especially in weight-bearing computed tomography (WBCT). This study explores the impact of external torque on the assessment of syndesmotic ankle lesions in clinical versus biomechanical studies.

Methods

A systematic search was conducted using PubMed, Scopus, EMBASE, The Cochrane Library, and Web of Science. The review protocol was registered on PROSPERO (CRD42024535265). Inclusion criteria were biomechanical studies on lower limbs with intact and sectioned syndesmosis; clinical studies comparing injured ankles to healthy contralateral ones; and studies applying torque or weight-bearing to injured ankles. Exclusion criteria consisted of reviews, meta-analyses, studies on syndesmosis repair, acute injuries involving fractures, and studies lacking measurements.

Findings

Eleven studies met the inclusion criteria, including eight biomechanical and three clinical studies.

Interpretation

While biomechanical evidence provides a solid foundation, its translation into clinical practice requires further validation. The importance of assessment of the ankle syndesmosis under torque has been demonstrated, and the application of external torque shows promising results. Multiple studies indicate that applying an external torque between 4.5 and 7.5 [Nm] is sufficient to distinguish between intact and sectioned syndesmotic injuries. However, the need for a standardized diagnostic tool has yet to be established.

踝关节联合损伤，特别是涉及胫腓骨远端关节的损伤，由于其微妙的临床表现和复杂的踝关节生物力学，诊断具有挑战性。临床和生物力学研究都在努力准确评估这些损伤的严重程度和范围。外扭矩最近在增强韧带联合损伤的检测和评估方面显示出前景，特别是在负重计算机断层扫描（WBCT）中。本研究在临床与生物力学研究中探讨了外部扭矩对踝关节联合病变评估的影响。方法系统检索PubMed、Scopus、EMBASE、The Cochrane Library、Web of Science。审查方案已在PROSPERO注册（CRD42024535265）。纳入标准为完整和切片的下肢联合的生物力学研究；损伤踝关节与对侧健康踝关节的临床比较研究研究对受伤的脚踝施加扭矩或负重。排除标准包括综述、荟萃分析、关于韧带联合修复的研究、涉及骨折的急性损伤和缺乏测量的研究。11项研究符合纳入标准，包括8项生物力学研究和3项临床研究。虽然生物力学证据提供了坚实的基础，但其转化为临床实践需要进一步验证。评估踝关节联合在扭矩作用下的重要性已被证明，外扭矩的应用显示出良好的结果。多项研究表明，施加4.5 - 7.5 [Nm]的外扭矩足以区分完整型和节裂型联合损伤。然而，对标准化诊断工具的需求尚未确定。

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引用次数: 0

Wearable monitoring for rehabilitation: Deep learning-driven vertical ground reaction force estimation for anterior cruciate ligament reconstruction 康复可穿戴监测：深度学习驱动的前交叉韧带重建垂直地面反作用力估计

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-09-04 DOI: 10.1016/j.clinbiomech.2025.106663

Tianxiao Chen , Datao Xu , Meizi Wang , Zhifeng Zhou , Tianle Jie , Huiyu Zhou , Yi Yuan , Julien S. Baker , Zixiang Gao , Yaodong Gu

Background

Anterior cruciate ligament reconstruction (ACLR) can restore knee stability, yet many patients fail to regain pre-injury function or develop secondary injuries. Vertical ground reaction force (vGRF) reflects joint loading and recovery but is typically measured via lab-based force plates, limiting real-world use. Wearable sensors and deep learning could enable portable monitoring, but current studies lack accuracy in complex movements and patient-specific adaptations.

Methods

Lower-limb kinematics and vGRF data from 25 ACLR patients during three daily activities (walking, running, descending stairs) was collected by wearable sensors and Vicon system. Three deep learning models were developed and optimized for the prediction tasks. The collected data was used to train the three developed models and the performance of each model was evaluated.

Findings

Among the three deep learning models, CNN-BiGRU-Attention model demonstrated the best predictive performance across all three movement tasks (R²_walking = 0.953 ± 0.006, R²_running = 0.971 ± 0.005, R²_{descending stairs} = 0.979 ± 0.003). Additionally, for the three selected daily activities, all models showed superior vGRF prediction performance in running and stair descending tasks compared to walking.

Interpretation

By integrating data from wearable sensors with a hybrid deep learning framework, the proposed CNN-BiGRU-Attention model successfully achieved accurate estimation of vGRFs of ACLR patients in various movements. This provides a key technical reference for optimizing personalized rehabilitation strategies and improving patient outcomes, demonstrating significant clinical application value and social benefits.

背景：前交叉韧带重建（ACLR）可以恢复膝关节的稳定性，但许多患者不能恢复损伤前的功能或发生继发性损伤。垂直地面反作用力（vGRF）反映了关节的载荷和恢复，但通常通过实验室测力板测量，限制了实际应用。可穿戴传感器和深度学习可以实现便携式监测，但目前的研究在复杂运动和患者特定适应方面缺乏准确性。方法采用可穿戴传感器和Vicon系统采集25例ACLR患者行走、跑步、下楼梯时的下肢运动学和vGRF数据。针对预测任务，开发并优化了三个深度学习模型。将收集到的数据用于训练开发的三个模型，并对每个模型的性能进行评估。结果3种深度学习模型中，CNN-BiGRU-Attention模型对3种运动任务的预测效果最好（r2行走= 0.953±0.006，r2跑步= 0.971±0.005，r2下楼梯= 0.979±0.003）。此外，对于所选的三种日常活动，所有模型在跑步和下楼梯任务中的vGRF预测性能都优于步行。通过将来自可穿戴传感器的数据与混合深度学习框架相结合，所提出的CNN-BiGRU-Attention模型成功地实现了对ACLR患者各种运动状态下vgrf的准确估计。这为优化个性化康复策略、改善患者预后提供了关键的技术参考，具有显著的临床应用价值和社会效益。

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引用次数: 0

Physeal-sparing anterior cruciate ligament reconstruction in an early adolescent porcine model provides better anterior stability but similar tissue function compared to a juvenile porcine model 与幼年猪模型相比，早期青春期猪模型的前交叉韧带重建具有更好的前稳定性，但组织功能相似

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-09-04 DOI: 10.1016/j.clinbiomech.2025.106667

Kaan Gurbuz , Yukun Zhang , Logan Opperman , Jeffrey T. Spang , Matthew B. Fisher

Background

Pediatric anterior cruciate ligament injuries have increased over the past two decades. Surgical reconstruction is often necessary to restore joint stability and prevent secondary injuries. Physeal-sparing anterior cruciate ligament reconstruction is commonly used in prepubertal patients to minimize the risk of growth disturbances. However, this technique has also been used for adolescents. The effect of age on joint stability and tissue function following physeal-sparing reconstruction remains unclear. This study aimed to compare initial biomechanical outcomes of physeal-sparing reconstruction within juvenile and early adolescent porcine joints.

Methods

Twelve porcine hindlimbs (n = 6 per age group) were tested using a robotic testing system. Anterior-posterior loading, compression loading, and varus-valgus torque were applied to the tibia in the intact, anterior cruciate ligament transected, and anterior cruciate ligament reconstructed states at 40° and 60° of flexion. Soft tissue forces were calculated by the principle of superposition.

Findings

Physeal-sparing reconstruction in early adolescent joints resulted in superior anterior stability under anterior tibial loading and compression compared to juvenile joints, especially when normalized for joint size. Medial collateral ligament distraction and medial meniscus compression contributions showed smaller changes following reconstruction in the early adolescent group at 60° of flexion. Other joint kinematics and tissue forces were similar between groups.

Interpretation

These findings suggest that skeletal maturity influences joint stability following physeal-sparing anterior cruciate ligament reconstruction, supporting its viability for both younger and early adolescent patients. This study provides biomechanical insights into surgical treatments for young patients and underscores the importance of using age-specific models to evaluate pediatric surgical techniques.

背景：儿童前交叉韧带损伤在过去二十年中有所增加。手术重建通常是必要的，以恢复关节稳定性和防止继发性损伤。保留身体的前交叉韧带重建通常用于青春期前患者，以尽量减少生长障碍的风险。然而，这种技术也被用于青少年。年龄对保骨重建后关节稳定性和组织功能的影响尚不清楚。本研究旨在比较幼年期和青春期早期猪关节保留重建的初始生物力学结果。方法采用机器人检测系统对12头猪后肢进行检测，每年龄组6头。在完整的胫骨上施加前后负荷、压缩负荷和内翻扭矩，切断前交叉韧带，并在屈曲40°和60°时重建前交叉韧带。采用叠加原理计算软组织受力。研究发现，与青少年关节相比，青少年早期关节保留骨关节重建在胫骨前负荷和压迫下具有更好的前路稳定性，尤其是在关节尺寸标准化时。内侧副韧带撑开和内侧半月板压迫的贡献在早期青少年组60°屈曲重建后显示较小的变化。其他关节运动学和组织力在两组之间相似。这些研究结果表明，骨骼成熟度影响保留前交叉韧带重建后的关节稳定性，支持其对年轻和早期青少年患者的可行性。这项研究为年轻患者的外科治疗提供了生物力学的见解，并强调了使用年龄特异性模型来评估儿科外科技术的重要性。

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引用次数: 0

Knee joint kinematics during the swing phase of patients who experienced a stroke: Comparison of high-speed and low-speed walkers 中风患者摇摆阶段的膝关节运动学：高速和低速步行者的比较

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-08-22 DOI: 10.1016/j.clinbiomech.2025.106654

Hiroo Koshisaki , Shigeo Tanabe , Shota Nagai , Kenji Kawakami , Hiroaki Sakurai

Background

Most studies of knee joint motion during gait in patients who experienced a stroke have focused on comparisons with healthy individuals. However, comparisons of patients with varying gait abilities have not been adequately performed. This study compared the kinematic parameters of the bilateral knee joints of patients who experienced a stroke. These patients were divided into those with fast gait speed and those with slow gait speed to determine any differences in motion.

Methods

Twenty patients who experienced a stroke were included in this study. The fast and slow gait speed groups both comprised 10 patients. Knee joint-related parameters were the timing and flexion angle at the start of the swing phase on both sides and timing and flexion angle at the peak knee joint flexion angle. The difference between timing during both phases and the difference between the knee joint flexion angle during both phases were calculated.

Findings

Significant differences in the timing and angle at the start of the swing phase, peak timing, and peak angle of the fast and slow groups were observed on the affected side (p < 0.05). Significant differences in the timing of the start of the swing phase, peak timing and difference between timing of the fast and slow groups were observed on the unaffected side (p < 0.05).

Interpretation

Clear differences in the kinematic characteristics of the knee joints on the affected and unaffected sides were observed in both groups. These valuable insights regarding knee joint motion may improve the gait speed of such patients.

背景：大多数关于中风患者步态中膝关节运动的研究都集中在与健康个体的比较上。然而，对不同步态能力的患者的比较尚未充分进行。本研究比较了中风患者双侧膝关节的运动学参数。这些患者被分为快步速组和慢步速组，以确定运动是否有差异。方法选取20例中风患者作为研究对象。快步速组和慢步速组各10名患者。膝关节相关参数为两侧摆动阶段开始时的时机和屈曲角度以及膝关节屈曲角度峰值时的时机和屈曲角度。计算了两阶段的时间差值和膝关节屈曲角度差值。结果：患侧快、慢两组摇摆期开始时间、角度、峰值时间、峰值角度差异有统计学意义（p < 0.05）。在未受影响的一侧，快、慢两组在摇摆相开始时间、峰值时间和时间上的差异有统计学意义（p < 0.05）。在两组中，观察到受影响侧和未受影响侧膝关节的运动学特征有明显差异。这些关于膝关节运动的有价值的见解可能会提高这类患者的步态速度。

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引用次数: 0

Porcine tendons as surrogates for human semitendinosus tendons – A biomechanical study 猪肌腱替代人半腱肌腱的生物力学研究

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-08-21 DOI: 10.1016/j.clinbiomech.2025.106655

Salim Youssef , Benjamin Fischer , Garen-Ohan Gregorian , Toni Wendler , Philipp Rolzhäuser , Ahmad Hamedy , Pierre Hepp , Stefan Schleifenbaum , Peter Melcher , Yasmin Youssef , Jan Theopold

Background

Porcine tendons are frequently used as surrogates for human semitendinosus tendons in biomechanical studies, yet their comparability remains unexplored.

Methods

This study evaluates and compares the morphological and biomechanical properties of different porcine tendons (foreleg-extensors (n = 10), foreleg-flexors (n = 10), hindleg-extensors (n = 10) and hindleg-flexors (n = 10)) with those of human semitendinosus tendons (n = 13). Tendon length and cross-sectional area were measured, and maximum load, tensile strength, stiffness, and elastic modulus were determined using uniaxial testing. Statistical analysis was performed using the Kruskal-Wallis test followed by Dunn's post hoc test.

Findings

Human semitendinosus tendons (26.59 cm, 18.98 mm²) exhibited the highest tensile strength (38.64 MPa) and an elastic modulus of 518.27 MPa. Porcine foreleg-extensors had comparable cross-sectional area (14.99 mm²), tensile strength (32.26 MPa), and elastic modulus (550.96 MPa) but were shorter (23.08 cm). Hindleg-flexors showed a similar length (25.81 cm) and elastic modulus (610.19 MPa) but lower tensile strength (28.13 MPa) and a substantially larger cross-sectional area (71.91 mm²). Hindleg-extensors were shorter (22.62 cm) with smaller cross-sectional area (11.20 mm²) but exhibited tensile strength (38.82 MPa) and elastic modulus (668.83 MPa) similar to those of the human tendons. Foreleg-flexors were shortest (17.07 cm), with the largest cross-sectional area (112.74 mm²), lowest tensile strength (18.82 MPa), and elastic modulus (155.70 MPa).

Interpretation

Despite differences in morphology, the material properties of tendons were largely consistent. Foreleg-extensors were identified as the most suitable semitendinosus surrogates due to their comparable material and morphological properties. Due to their distinct morphology, foreleg-flexors tendons are least suitable.

在生物力学研究中，猪肌腱经常被用作人类半腱肌腱的替代品，但它们的可比性仍未被探索。方法对猪不同肌腱（前肢伸肌（n = 10）、前肢屈肌（n = 10）、后肢伸肌（n = 10）和后肢屈肌（n = 10））与人半腱肌腱（n = 13）的形态和生物力学特性进行了评价和比较。测量肌腱长度和截面积，采用单轴试验测定最大载荷、抗拉强度、刚度和弹性模量。采用Kruskal-Wallis检验和Dunn事后检验进行统计分析。发现人体半腱肌腱（26.59 cm, 18.98 mm2）的抗拉强度最高，为38.64 MPa，弹性模量为518.27 MPa。猪前腿伸肌的横截面积为14.99 mm2，抗拉强度为32.26 MPa，弹性模量为550.96 MPa，但较短（23.08 cm）。后屈肢的长度（25.81 cm）和弹性模量（610.19 MPa）相似，但抗拉强度（28.13 MPa）较低，横截面积（71.91 mm2）较大。后腿伸肌腱较短（22.62 cm），横截面积较小（11.20 mm2），但拉伸强度（38.82 MPa）和弹性模量（668.83 MPa）与人类肌腱相似。前腿屈肌最短（17.07 cm），横截面积最大（112.74 mm2），抗拉强度最低（18.82 MPa），弹性模量最低（155.70 MPa）。尽管在形态上存在差异，但肌腱的材料特性基本一致。由于前肢伸肌具有相似的材料和形态特征，因此被认为是最合适的半腱动物替代品。由于形态不同，前腿屈肌腱最不适合。

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引用次数: 0

Effects of standard of care and pressure-based 3D-printed custom accommodative insoles on static balance in individuals with diabetes: A pilot study 标准护理和基于压力的3d打印定制调节鞋垫对糖尿病患者静态平衡的影响：一项试点研究

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-08-19 DOI: 10.1016/j.clinbiomech.2025.106653

Mathew Sunil Varre , Kimberly A. Nickerson , Brittney C. Muir

Background

Individuals with diabetes are often prescribed standard of care accommodative insoles to provide extra cushioning and prevent ulcers. Our pressure-based 3D printed custom accommodative insoles have proven effective in reducing plantar pressure in individuals with diabetes. Given that older adults with diabetes have exacerbated balance deficits due to neuropathy, it is essential to examine the impact of these custom accommodative insoles on postural balance in individuals with diabetes. Therefore, the purpose is to examine the effects of custom accommodative insoles on balance during quiet standing in individuals with diabetes.

Methods

Standard of care and pressure-based 3D printed custom accommodative insoles were designed from foot impressions obtained from ten participants with diabetes. Postural balance was assessed during quiet standing for three conditions: no insole, standard of care, and pressure-based 3D printed custom accommodative insoles. Center of pressure measures were computed for all three conditions, and differences between the three insole conditions were evaluated.

Findings

There were no significant differences in the center of pressure measures across the insole conditions. Use of standard of care and pressure-based 3D printed custom accommodative insoles did not negatively affect the postural balance during quiet standing compared to the no insole condition.

Interpretation

This pilot study provides useful information on how the custom accommodative insoles used to prevent ulcers in individuals with diabetes affect postural balance. Static postural balance is not adversely impacted with the use of custom accommodative insoles in individuals with diabetes.

背景：糖尿病患者经常被要求使用可调节的鞋垫，以提供额外的缓冲和预防溃疡。我们基于压力的3D打印定制调节鞋垫已被证明可以有效降低糖尿病患者的足底压力。鉴于老年糖尿病患者由于神经病变而加剧了平衡缺陷，有必要研究这些定制的适应性鞋垫对糖尿病患者姿势平衡的影响。因此，目的是检查定制适应性鞋垫对糖尿病患者安静站立时平衡的影响。方法根据10例糖尿病患者的足印设计标准护理和基于压力的3D打印定制调节鞋垫。在安静站立的三种情况下评估姿势平衡：无鞋垫、标准护理和基于压力的3D打印定制调节鞋垫。计算了所有三种情况下的压力中心测量值，并评估了三种鞋垫条件之间的差异。研究结果：在不同鞋垫条件下，压力测量中心没有显著差异。与没有鞋垫的情况相比，使用标准护理和基于压力的3D打印定制调节鞋垫对安静站立时的姿势平衡没有负面影响。这项初步研究提供了有用的信息，说明用于预防糖尿病患者溃疡的定制适应性鞋垫如何影响姿势平衡。在糖尿病患者中，使用定制的适应性鞋垫不会对静态姿势平衡产生不利影响。

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引用次数: 0

Correlation between various loads and apoptosis in medial platform chondrocytes in knee varus deformity 膝关节内翻畸形中内侧平台软骨细胞凋亡与负荷的关系

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-08-18 DOI: 10.1016/j.clinbiomech.2025.106651

Hongjie Zhang , Zehua Jiang , Ziyang Liu , Zhixiong Hong , Mengqiang Tian , Rusen Zhu

Background

This study aimed to systematically investigate how different degrees of mechanical loading caused by varying varus angles affect stress distribution and chondrocyte apoptosis in the medial tibial plateau of the knee joint. Specifically, it integrates finite-element analysis to simulate biomechanical stress patterns and evaluates the molecular responses (Piezo1, Bax, Bcl-2, and caspase-3 expressions) to elucidate the mechanobiological interplay contributing to cartilage degeneration.

Methods

Four knee models with varus angles (6°, 9°, 12°, and 15°) were constructed from computed tomography images. Finite-element analysis was used to evaluate stress distribution and von Mises stress peaks on the medial tibial platform cartilage. Material properties of biological tissues were included. Clinical samples of corresponding varus angles were analyzed for Piezo1, Bax, Bcl-2, and caspase-3 expression using immunofluorescence and histochemistry.

Findings

The von Mises stress peak contact area of the medial tibial plateau cartilage significantly decreased with increasing varus deformity (p < 0.05), and Piezo1 expression increased with stress load. Elevated Piezo1 expression was associated with significantly higher levels of Bax, Bcl-2, and caspase-3 (p < 0.05).

Interpretation

Pathological mechanical loading accelerates chondrocyte apoptosis via the endogenous apoptotic pathway, promoting the progression of knee osteoarthritis. These findings highlight Piezo1 as a potential therapeutic target for managing stress-induced cartilage degeneration.

本研究旨在系统研究不同内翻角度引起的不同程度的机械负荷对膝关节内侧胫骨平台应力分布和软骨细胞凋亡的影响。具体来说，它整合了有限元分析来模拟生物力学应力模式，并评估分子反应（Piezo1, Bax， Bcl-2和caspase-3表达），以阐明导致软骨退变的力学生物学相互作用。方法利用计算机断层图像构建4个膝内翻角（6°、9°、12°、15°）模型。采用有限元分析评估胫骨内侧平台软骨的应力分布和von Mises应力峰值。包括生物组织的材料特性。采用免疫荧光和组织化学方法分析相应内翻角临床标本中Piezo1、Bax、Bcl-2和caspase-3的表达。结果胫骨平台内侧软骨von Mises应力峰值接触面积随内翻畸形的增加而显著降低（p < 0.05），且Piezo1表达随应力负荷的增加而升高。Piezo1表达升高与Bax、Bcl-2和caspase-3水平显著升高相关（p < 0.05）。病理机械负荷通过内源性凋亡途径加速软骨细胞凋亡，促进膝关节骨关节炎的进展。这些发现突出了Piezo1作为管理应力诱导的软骨变性的潜在治疗靶点。

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引用次数: 0

Tibial tray stability in three cementless total knee arthroplasty systems 三种无骨水泥全膝关节置换术中胫骨托盘的稳定性

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-08-18 DOI: 10.1016/j.clinbiomech.2025.106652

John Kyle Mueller , Charles Lawrie , Charlie Parduhn , Jeff Bischoff , Eik Siggelkow , Cory Trischler , Marc Bandi

Background

Initial stability of cementless total knee arthroplasty tibial trays is necessary for bony ingrowth. The purpose of this study was to characterize the patterns and magnitudes of displacement of three implant systems during physiological loading in terms of tibial tray movement and 3D micromotion.

Methods

Physiological loading (walking and stair descent) from a representative subject was robotically applied to cementless tibial trays implanted in foam tibia models. Three commercially available total knee arthroplasty systems with cementless tibial trays with keels and peripheral pegs from two different manufacturers were tested including symmetric, asymmetric and anatomically shaped tibial trays. Relative displacement between the foam tibia model and tibial tray in response to loading was measured at ten peripheral locations using an optical measurement system.

Findings

All systems showed inferior movement of the posterior tibial tray in response to posterior located tibiofemoral loading, and superior movement of the anterior tibial tray. The system with an anatomic tibial tray design had significantly less micromotion than the systems with an asymmetric and symmetric tibial tray designs during walking (symmetric: 229 ± 30 μm, asymmetric: 205 ± 54 μm, anatomic: 84 ± 22 μm; p < 0.001) and less micromotion than the symmetric tibial tray during stair descent (symmetric: 165 ± 17 μm, asymmetric: 151 ± 65 μm, anatomic: 92 ± 18 μm; p < 0.002).

Interpretation

Total knee arthroplasty system design had an impact on keeled cementless tibial tray initial stability during simulated walking and stair descent in this biomechanical model.

背景：无骨水泥全膝关节置换术胫骨托盘的初步稳定性对骨长入是必要的。本研究的目的是根据胫骨托盘运动和三维微运动来描述生理负荷期间三种种植体系统的位移模式和大小。方法将代表性受试者的生理负荷（步行和下楼梯）机器人应用于泡沫胫骨模型植入的无水泥胫骨托盘。我们测试了来自两家不同制造商的三种商用全膝关节置换术系统，包括对称、不对称和解剖形状的胫骨托盘。利用光学测量系统测量了泡沫胫骨模型与胫骨托盘在10个外围位置响应载荷时的相对位移。结果：所有系统均表现为胫骨后托盘的下移，以响应位于胫骨股骨后的负荷，以及胫骨前托盘的上移。采用解剖式胫骨托架设计的系统在行走时的微动明显小于采用不对称和对称胫骨托架设计的系统（对称：229±30 μm，不对称：205±54 μm，解剖：84±22 μm； p < 0.001），在楼梯下走时的微动明显小于对称胫骨托架设计的系统（对称：165±17 μm，不对称：151±65 μm，解剖：92±18 μm； p < 0.002）。在这个生物力学模型中，全膝关节置换术系统的设计对模拟行走和楼梯下降过程中龙骨无水泥胫骨托盘的初始稳定性有影响。

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引用次数: 0

Biomechanical characterization of cadaveric thigh skin for development of biofidelic simulants 尸体大腿皮肤的生物力学特征用于仿生模拟物的开发

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-08-13 DOI: 10.1016/j.clinbiomech.2025.106650

Pramod Yadav , Gurpreet Singh , Shubham Gupta , Arnab Chanda

Background

Simulants that accurately replicate the mechanical properties of human skin are essential for biomechanical testing, especially for skin prosthetics and grafting. Although there has been a plethora of research related to the testing of skin samples of several locations, particularly the thigh region remains yet to be extensively explored. Previous studies involving thigh skin lack the testing at varying strain rates which could be helpful to develop simulants and improve high-expansion skin grafts.

Methods

This study focused on developing biofieldic simulants that mimic the realistic mechanical behavior of human skin. Uniaxial tensile tests at various strain rates were conducted on cadaver skin samples. Similar tests were also performed on skin simulants made from a two-part elastomer-based polymer with varying shore hardness. The non-linear responses of these simulants were analyzed using Mooney-Rivlin, Neo-Hookean, and Yeoh hyperelastic models.

Findings

The study found that cadaveric skin exhibited mechanical behavior consistent with existing literature. Simulants of different shore hardness precisely mimic the mechanical behavior of cadaveric skin at various strain rates within a certain strain limit. All curve fittings showed a strong correlation coefficient R-square greater than 0.980.

Interpretation

The mechanical properties of the polymer-based material make them ideal for developing simulants that can be modeled and tuned to closely match real thigh skin. Such highly characterized biofidelic skin simulants could provide novel insights for surgical training, trauma research, mechanical repeatability, and the development of various medical models for skin conditions.

准确复制人体皮肤机械特性的模拟物对于生物力学测试，特别是皮肤修复和移植是必不可少的。虽然已经有大量的研究与测试几个位置的皮肤样本有关，特别是大腿区域仍有待广泛探索。先前涉及大腿皮肤的研究缺乏在不同应变率下的测试，这可能有助于开发模拟物和改善高膨胀皮肤移植物。方法本研究的重点是开发模拟人体皮肤真实力学行为的生物场模拟物。对尸体皮肤样品进行了不同应变速率下的单轴拉伸试验。类似的测试也在由两部分弹性体基聚合物制成的皮肤模拟物上进行，这些聚合物具有不同的肖氏硬度。采用Mooney-Rivlin、Neo-Hookean和Yeoh超弹性模型分析了这些模拟装置的非线性响应。研究发现尸体皮肤表现出与现有文献一致的机械行为。不同邵氏硬度的模拟物可以在一定的应变极限内精确地模拟尸体皮肤在不同应变速率下的力学行为。所有拟合曲线的相关系数均大于0.980。聚合物基材料的机械性能使其成为开发模拟物的理想选择，这些模拟物可以建模和调整，以密切匹配真实的大腿皮肤。这种高度表征的仿生皮肤模拟物可以为外科训练、创伤研究、机械可重复性和各种皮肤疾病医学模型的发展提供新的见解。

{"title":"Biomechanical characterization of cadaveric thigh skin for development of biofidelic simulants","authors":"Pramod Yadav , Gurpreet Singh , Shubham Gupta , Arnab Chanda","doi":"10.1016/j.clinbiomech.2025.106650","DOIUrl":"10.1016/j.clinbiomech.2025.106650","url":null,"abstract":"<div><h3>Background</h3><div>Simulants that accurately replicate the mechanical properties of human skin are essential for biomechanical testing, especially for skin prosthetics and grafting. Although there has been a plethora of research related to the testing of skin samples of several locations, particularly the thigh region remains yet to be extensively explored. Previous studies involving thigh skin lack the testing at varying strain rates which could be helpful to develop simulants and improve high-expansion skin grafts.</div></div><div><h3>Methods</h3><div>This study focused on developing biofieldic simulants that mimic the realistic mechanical behavior of human skin. Uniaxial tensile tests at various strain rates were conducted on cadaver skin samples. Similar tests were also performed on skin simulants made from a two-part elastomer-based polymer with varying shore hardness. The non-linear responses of these simulants were analyzed using Mooney-Rivlin, Neo-Hookean, and Yeoh hyperelastic models.</div></div><div><h3>Findings</h3><div>The study found that cadaveric skin exhibited mechanical behavior consistent with existing literature. Simulants of different shore hardness precisely mimic the mechanical behavior of cadaveric skin at various strain rates within a certain strain limit. All curve fittings showed a strong correlation coefficient R-square greater than 0.980.</div></div><div><h3>Interpretation</h3><div>The mechanical properties of the polymer-based material make them ideal for developing simulants that can be modeled and tuned to closely match real thigh skin. Such highly characterized biofidelic skin simulants could provide novel insights for surgical training, trauma research, mechanical repeatability, and the development of various medical models for skin conditions.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"129 ","pages":"Article 106650"},"PeriodicalIF":1.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0