@article{ZellnerHierlMuelleretal., author = {Zellner, Johannes and Hierl, Katja and Mueller, Michael and Pfeifer, Christian and Berner, Arne and Dienstknecht, Thomas and Krutsch, Werner and Geis, Sebastian and Gehmert, Sebastian and Kujat, Richard and Dendorfer, Sebastian and Prantl, Lukas and Nerlich, Michael and Angele, Peter}, title = {Stem cell-based tissue-engineering for treatment of meniscal tears in the avascular zone}, series = {Journal of Biomedical Materials Research Part B Applied Biomaterials}, volume = {101}, journal = {Journal of Biomedical Materials Research Part B Applied Biomaterials}, number = {7}, editor = {Gilbert, Jeremy}, doi = {10.1002/jbm.b.32922}, pages = {1133 -- 1142}, abstract = {Meniscal tears in the avascular zone have a poor self-healing potential, however partial meniscectomy predisposes the knee for early osteoarthritis. Tissue engineering with mesenchymal stem cells and a hyaluronan collagen based scaffold is a promising approach to repair meniscal tears in the avascular zone. 4 mm longitudinal meniscal tears in the avascular zone of lateral menisci of New Zealand White Rabbits were performed. The defect was left empty, sutured with a 5-0 suture or filled with a hyaluronan/collagen composite matrix without cells, with platelet rich plasma or with autologous mesenchymal stem cells. Matrices with stem cells were in part precultured in chondrogenic medium for 14 days prior to the implantation. Menisci were harvested at 6 and 12 weeks. The developed repair tissue was analyzed macroscopically, histologically and biomechanically. Untreated defects, defects treated with suture alone, with cell-free or with platelet rich plasma seeded implants showed a muted fibrous healing response. The implantation of stem cell-matrix constructs initiated fibrocartilage-like repair tissue, with better integration and biomechanical properties in the precultured stem cell-matrix group. A hyaluronan-collagen based composite scaffold seeded with mesenchymal stem cells is more effective in the repair avascular meniscal tear with stable meniscus-like tissue and to restore the native meniscus.}, subject = {Meniskusschaden}, language = {en} } @misc{AuerReinkerSuessetal., author = {Auer, Simon and Reinker, Lukas and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Comparing calculated and measured muscle activity of thigh muscles in dynamic motion.}, series = {27th Congress of the European Society of Biomechanics, 26 - 29 June 2022, Porto, Portugal}, journal = {27th Congress of the European Society of Biomechanics, 26 - 29 June 2022, Porto, Portugal}, pages = {640}, language = {en} } @misc{MelznerPfeiferSuessetal., author = {Melzner, Maximilian and Pfeifer, Christian and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Muskuloskeletal analysis of elbow stability for common injury patterns}, series = {27th Congress of the European Society of Biomechanics, 26 - 29 June 2022, Porto, Portugal}, journal = {27th Congress of the European Society of Biomechanics, 26 - 29 June 2022, Porto, Portugal}, pages = {654}, language = {en} } @misc{EgerBergstraesserDendorferetal., author = {Eger, Maximilian and Bergstraesser, Marcel and Dendorfer, Sebastian and Lenich, Andreas and Pfeifer, Christian}, title = {Influence of radial head prosthetic design on humeroradial stability: Validation of a test rig therefore}, series = {DOKU2022, Deutscher Kongress f{\"u}r Orthop{\"a}die und Unfallchirurgie, 25.-28. 10.2022, Berlin}, journal = {DOKU2022, Deutscher Kongress f{\"u}r Orthop{\"a}die und Unfallchirurgie, 25.-28. 10.2022, Berlin}, publisher = {German Medical Science GMS Publishing House}, address = {D{\"u}sseldorf}, doi = {10.3205/22dkou611}, url = {http://nbn-resolving.de/urn:nbn:de:0183-22dkou6115}, language = {en} } @misc{KoeglerIsmailRusavyetal., author = {K{\"o}gler, Michael and Ismail, Khaled M. and Rusavy, Zdenek and Kalis, Vladimir and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Influence of bed height and stance on accoucheurs lower back and glenohumeral load during simulated childbirth}, series = {31st meeting of Czech Urogynaecological Society, Prague, 2022}, journal = {31st meeting of Czech Urogynaecological Society, Prague, 2022}, language = {en} } @misc{MelznerEngelhardtSuessetal., author = {Melzner, Maximilian and Engelhardt, Leonard and S{\"u}ß, Friedrich and Dendorfer, Sebastian}, title = {Sensitivity evaluation of a musculoskeletal hand model using Latin hypercube sampling}, series = {ESMAC 2020 Abstracts}, volume = {81}, journal = {ESMAC 2020 Abstracts}, number = {Suppl. 1}, publisher = {Elsevier}, doi = {10.1016/j.gaitpost.2020.08.008}, language = {en} } @misc{EngelhardtMelznerHavelkovaetal., author = {Engelhardt, Lucas and Melzner, Maximilian and Havelkova, Linda and Fiala, Pavel and Rybarova, Martina and Christen, Patrik and Dendorfer, Sebastian and Simon, Ulrich}, title = {A new musculoskeletal AnyBody detailed hand model}, series = {European Society of Biomechanics meeting 2019, Vienna, Austria}, journal = {European Society of Biomechanics meeting 2019, Vienna, Austria}, abstract = {The AnyBody™ Modeling System (AMS) [1], is an universally used musculoskeletal simulation software using inverse dynamics. Until now, no complete human hand model is known in the AMS. Also considering other musculoskeletal software platforms, just one detailed entire hand model is recently published [2] but is only based on one subject. The aim of this work is to implement a full detailed hand model for the AMS including all extrinsic and intrinsic muscles using data by the UWB gained through an anatomical study of ten cadaver hands.}, language = {en} } @misc{AuerNieblerEiglspergeretal., author = {Auer, Simon and Niebler, Michael and Eiglsperger, Josef and Kubowitsch, Simone and Renkawitz, Tobias and Achenbach, Leonard and Krutsch, Werner and Dendorfer, Sebastian}, title = {Cognitive stress increases muscle forces in dynamic football specific movements}, series = {European Society of Biomechanics meeting 2019, Vienna, Austria}, journal = {European Society of Biomechanics meeting 2019, Vienna, Austria}, language = {en} } @misc{AurbachSpickaSuessetal., author = {Aurbach, Maximilian and Spicka, Jan and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Musculoskeletal modelling of the shoulder - effects on muscle recruitment and joint reaction force}, series = {European Society of Biomechanics meeting 2019, Vienna, Austria}, journal = {European Society of Biomechanics meeting 2019, Vienna, Austria}, language = {en} } @misc{KubowitschSuessJansenetal., author = {Kubowitsch, Simone and S{\"u}ß, Franz and Jansen, Petra and Dendorfer, Sebastian}, title = {Effect of dual tasking on muscular imbalances}, series = {European Society of Biomechanics meeting 2019, Vienna, Austria}, journal = {European Society of Biomechanics meeting 2019, Vienna, Austria}, language = {en} } @misc{AuerReinkerDendorfer, author = {Auer, Simon and Reinker, Lukas and Dendorfer, Sebastian}, title = {Evaluation of muscle recruitment and muscle models in musculoskeletal simulation of dynamic motion}, series = {26th Congress of the European Society of Biomechanics, July 11-14, 2021, Milan, Italy}, journal = {26th Congress of the European Society of Biomechanics, July 11-14, 2021, Milan, Italy}, address = {Milan}, pages = {8}, abstract = {Musculoskeletal simulation plays an increasingly important role in sports biomechanics. In the last years, the field of application widened from orthopaedics and ergonomics to sports [1]. A muscle recruitment algorithm with a quadratic objective function is usually used to calculate muscle activity in dynamic movements. The agreement of calculated and measured thigh muscle activity has already been investigated [2]. They found a strong agreement for sprinting and running, while the correlation decreased for side-cutting manoeuvres. Nevertheless, the influence of different muscle recruitment criteria on muscle activity in dynamic musculoskeletal simulations is currently unknown. Hence, this study aimed to analyse the effect of different muscle recruitment criteria and muscle models on the correlation of numerical and measured muscle activity in highly dynamic movements.}, language = {en} } @article{AuerSchieblIversenetal., author = {Auer, Simon and Schiebl, Jonas and Iversen, Kristoffer and Subhash Chander, Divyaksh and Damsgaard, Michael and Dendorfer, Sebastian}, title = {Biomechanical assessment of the design and efficiency of occupational exoskeletons with the AnyBody Modeling System}, series = {Zeitschrift f{\"u}r Arbeitswissenschaften}, volume = {76}, journal = {Zeitschrift f{\"u}r Arbeitswissenschaften}, number = {4}, publisher = {Springer Nature}, doi = {10.1007/s41449-022-00336-4}, pages = {440 -- 449}, abstract = {Exoskeletons were invented over 100 years ago but have only become popular in the last two decades, especially in the working industry as they can decrease work-related loads significantly. The most often used exoskeletons are for the lower back and shoulder since these are commonly affected body regions. All devices have in common that their purpose is to reduce internal loads of vulnerable body regions. Nevertheless, there is still little understanding on how biomechanical loading in the human body changes when exoskeletons are used. Therefore, further analyses are needed. A promising candidate for these are musculoskeletal models, which are based on an inverse dynamics approach and can calculate external parameters such as ground reaction forces or other interaction forces as well as internal parameters such as joint reaction forces or muscle activities. The various examples in the literature show that these models are increasingly used for assessing the biomechanical effects of exoskeletons on the human body. Furthermore, musculoskeletal models can calculate biomechanical loadings of humans with and without exoskeletons for all kinds of applications and allow an evaluation of their purpose. Practical Relevance: This article highlights the possibilities of musculoskeletal models for assessing the design and efficiency of occupational exoskeletons. Several practical use cases are described along with distinct descriptions of common implications of musculoskeletal and exoskeleton modeling.}, language = {en} } @article{MelznerPfeifferSuessetal., author = {Melzner, Maximilian and Pfeiffer, Christian and Suess, Franz and Dendorfer, Sebastian}, title = {Musculoskeletal simulation of elbow stability for common injury patterns}, series = {Journal of Orthopaedic Research}, volume = {41}, journal = {Journal of Orthopaedic Research}, number = {6}, publisher = {Wiley}, issn = {1554-527X}, doi = {10.1002/jor.25460}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-54819}, pages = {1356 -- 1364}, abstract = {Elbow stability is derived from a combination of muscular, ligamentous, and bony structures. After an elbow trauma the stability of the joint is an important decision criterion for the subsequent treatment. The decision regarding non-operative/operative care depends mostly on subjective assessments of medical experts. Therefore, the aim of this study is to use musculoskeletal simulations as an objective assessment tool to investigate the extent to which failure of different stabilizers affects the elbow stability and how these observations correspond to the assessment from clinical practice. A musculoskeletal elbow simulation model was developed for this aim. To investigate the stability of the elbow, varus/valgus moments were applied under 0°, 45°and 90° flexion while the respective cubital angle was analyzed. This was performed for nine different injury scenarios, which were also evaluated for stability by clinical experts. With the results, it can be determined by which injury pattern and under which flexion angle the elbow stability is impaired regarding varus/valgus moments. The scenario with a complete failure of the medial and lateral ligaments and a fracture of the radial head was identified as having the greatest instability. The study presented a numerical determination of elbow stability against varus/valgus moments regarding clinical injury patterns, as well as a comparison of the numerical outcome with experience gained in clinical practice. The numerical predictions agree well with the assessments of the clinical specialists. Thus, the results from musculoskeletal simulation can make an important contribution to a more objective assessment of the elbow stability.}, language = {en} } @article{ReinkerDendorfer, author = {Reinker, Lukas and Dendorfer, Sebastian}, title = {Evaluation of acceleration patterns during high-impact jumping exercises}, series = {Gait \& Posture}, volume = {100}, journal = {Gait \& Posture}, number = {Supplement 1, March}, publisher = {Elsevier}, address = {Amsterdam [u.a.]}, doi = {10.1016/j.gaitpost.2022.11.051}, pages = {93 -- 94}, language = {en} } @article{ReinkerBlaesingBierletal., author = {Reinker, Lukas and Bl{\"a}sing, Dominic and Bierl, Rudolf and Ulbricht, Sabina and Dendorfer, Sebastian}, title = {Correlation of Acceleration Curves in Gravitational Direction for Different Body Segments during High-Impact Jumping Exercises}, series = {sensors}, volume = {23}, journal = {sensors}, number = {4}, publisher = {MDPI}, address = {Basel}, doi = {10.3390/s23042276}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-58217}, abstract = {Osteoporosis is a common disease of old age. However, in many cases, it can be very well prevented and counteracted with physical activity, especially high-impact exercises. Wearables have the potential to provide data that can help with continuous monitoring of patients during therapy phases or preventive exercise programs in everyday life. This study aimed to determine the accuracy and reliability of measured acceleration data at different body positions compared to accelerations at the pelvis during different jumping exercises. Accelerations at the hips have been investigated in previous studies with regard to osteoporosis prevention. Data were collected using an IMU-based motion capture system (Xsens) consisting of 17 sensors. Forty-nine subjects were included in this study. The analysis shows the correlation between impacts and the corresponding drop height, which are dependent on the respective exercise. Very high correlations (0.83-0.94) were found between accelerations at the pelvis and the other measured segments at the upper body. The foot sensors provided very weak correlations (0.20-0.27). Accelerations measured at the pelvis during jumping exercises can be tracked very well on the upper body and upper extremities, including locations where smart devices are typically worn, which gives possibilities for remote and continuous monitoring of programs.}, language = {en} } @article{MuehlingSandriesserDendorferetal., author = {M{\"u}hling, Mischa and Sandriesser, Sabrina and Dendorfer, Sebastian and Augat, Peter}, title = {Assessment of implant internal stresses under physiological femoral loading: Translation to a simplified bending load model}, series = {Journal of Biomechanics}, journal = {Journal of Biomechanics}, number = {112229}, publisher = {Elsevier}, issn = {1873-2380}, doi = {10.1016/j.jbiomech.2024.112229}, pages = {17}, abstract = {The success of surgical treatment for fractures hinges on various factors, notably accurate surgical indication. The process of developing and certifying a new osteosynthesis device is a lengthy and costly process that requires multiple cycles of review and validation. Current methods, however, often rely on predecessor standards rather than physiological loads in specific anatomical locations. This study aimed to determine actual loads experienced by an osteosynthesis plate, exemplified by a standard locking plate for the femoral shaft, utilizing finite elements analysis (FEA) and to obtain the bending moments for implant development standard tests. A protocol was developed, involving the creation and validation of a fractured femur model fixed with a locking plate, mechanical testing, and FEA. The model's validation demonstrated exceptional accuracy in predicting deformations, and the FEA revealed peak stresses in the fracture bridging zone. Results of a parametric analysis indicate that larger fracture gaps significantly impact implant mechanical behavior, potentially compromising stability. This study underscores the critical need for realistic physiological conditions in implant evaluations, providing an innovative translational approach to identify internal loads and optimize implant designs. In conclusion, this research contributes to enhancing the understanding of implant performance under physiological conditions, promoting improved designs and evaluations in fracture treatments.}, language = {en} } @unpublished{FoerstlAdlerSuessetal., author = {F{\"o}rstl, Nikolas and Adler, Ina and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Technologies for Evaluation of Pelvic Floor Functionality: A Systematic Review}, publisher = {Center for Open Science}, doi = {10.31219/osf.io/dcqyg}, abstract = {Pelvic floor dysfunction is a common problem in women and has a negative impact ontheir quality of life. The aim of this review was to provide a general overview of the current state oftechnology used to assess pelvic floor functionality. It also provides literature research of the phys-iological and anatomical factors that correlate with pelvic floor health. The systematic review wasconducted according to the PRISMA guidelines. PubMed, ScienceDirect, Cochrane Library andIEEE databases were searched for publications on sensor technology for the assessment of pelvicfloor functionality. Anatomical and physiological parameters were identified through a manualsearch. In the systematic review 115 publications were included. 12 different sensor technologieswere identified. Information on the obtained parameters, sensor position, test activities and subjectcharacteristics were prepared in tabular form from each publication. 16 anatomical and physiologi- cal parameters influencing pelvic floor health were identified in 17 published studies and rankedfor their statistical significance. Taken together, this review could serve as a basis for the develop-ment of novel sensors which could allow for quantifiable prevention and diagnosis, as well as par-ticularized documentation of rehabilitation processes related to pelvic floor dysfunctions.}, language = {en} } @article{RusavyCechovaDendorferetal., author = {Rusavy, Zdenek and Cechova, Hana and Dendorfer, Sebastian and Kalis, Vladimir and Ismail, Khaled M.}, title = {Is the Finnish grip tight enough? A manometric study of two manual perineal protection techniques}, series = {Acta Obstetricia et Gynecologica Scandinavica}, journal = {Acta Obstetricia et Gynecologica Scandinavica}, edition = {Early view}, publisher = {Wiley}, doi = {10.1111/aogs.15033}, language = {en} } @article{SchaefferHerrmannSchratzenstalleretal., author = {Schaeffer, Leon and Herrmann, David and Schratzenstaller, Thomas and Dendorfer, Sebastian and B{\"o}hm, Valter}, title = {Preliminary theoretical considerations on the stiffness characteristics of a tensegrity joint for the use in dynamic orthoses}, series = {Journal of Medical Robotics Research}, journal = {Journal of Medical Robotics Research}, publisher = {World Scientific}, doi = {10.1142/S2424905X23400081}, abstract = {Early motion therapy plays an important role for effective long-term healing of joint injuries. In many cases, conventional dynamic orthoses fail to address the intricate movement possibilities of the underlying joints, limited by their simplistic joint representations, often represented by revolute joints, enabling rotations by only one axis. In this paper, a two-dimensional compliant tensegrity joint for use in biomedical applications is investigated. It consists of two compressed members and five compliant tensioned members. Relative movement possibilities are realized by the intrinsic compliance of the structure. In the development of these systems, the first step is the determination of the static stable equilibrium. This analysis is conducted in this paper by considering the potential energy approach or by using the geometric nonlinear finite element method. The mechanical behavior of the structure is assessed with a specific emphasis on its mechanical compliance. The primary objective of this study is the investigation of the influence of structural parameters on the overall stiffness and movability of the structure. The results underscore the significant effect of member parameters on the stiffness and movability of the compliant tensegrity joint, particularly under varying load magnitudes. These findings provide insights for optimizing the joint's performance, contributing to its potential application in advanced orthotic and exoskeleton devices.}, language = {en} } @inproceedings{DendorferFeldottoWalchetal., author = {Dendorfer, Sebastian and Feldotto, Benedikt and Walch, Blasius and Koch, Patrick and Knoll, Alois}, title = {Co-Development of an Infant Prototype in Hardware and Simulation based on CT Imaging Data}, series = {IEEE International Conference on Cyborg and Bionic Systems (CBS), 2019, Munich}, booktitle = {IEEE International Conference on Cyborg and Bionic Systems (CBS), 2019, Munich}, pages = {6}, abstract = {The development of biomimetic robots has gained research interest in the last years as it may both help under-standing processes of motion execution in biological systems as well as developping a novel generation of intelligent and energy efficient robots. However, exact model generation that builds up on observations and robot design is very time intensive. In this paper we present a novel pipeline for co-development of biomimetic hardware and simulation models based on biological Computer Tomography (CT) data. For this purpose we exploit State of the Art rapid prototyping technologies such as 3D Printing and the Neurorobotics Platform for musculoskeletal simulations in virtual environments. The co-development integrates both advantages of virtual and physical experimental models and is expected to increase development speed of controllers that can be tested on the simulated counterpart before application to a printed robot model. We demonstrate the pipeline by generating a one year old infant model as a musculoskeletal simulation model and a print-in-place 3D printed skeleton as a single movable part. Even though we hereonly introduce the initial body generation and only a first testsetup for a modular sensory and control framework, we can clearly spot advantages in terms of rapid model generation and highly biological related models. Engineering costs are reducedand models can be provided to a wide research community for controller testing in an early development phase.}, subject = {Biomechanische Analyse}, language = {en} } @article{SchmitzNeumannNeumannetal., author = {Schmitz, Paul and Neumann, Christoph Cornelius and Neumann, Carsten and Nerlich, Michael and Dendorfer, Sebastian}, title = {Biomechanical analysis of iliac crest loading following cortico-cancellous bone harvesting}, series = {Journal of Orthopaedic Surgery and Research}, volume = {13}, journal = {Journal of Orthopaedic Surgery and Research}, number = {108}, publisher = {Springer Nature}, doi = {10.1186/s13018-018-0822-1}, pages = {1 -- 8}, abstract = {Background Iliac crest bone harvesting is a frequently performed surgical procedure widely used to treat bone defects. The objective of this study is to assess the biomechanical quantities related to risk for pelvic fracture after harvesting an autologous bone graft at the anterior iliac crest. Methods Finite element models with a simulated harvest site (sized 15 × 20 mm, 15 × 35 mm, 30 × 20 mm and 30 × 35 mm) in the iliac wing are created. The relevant loading case is when the ipsilateral leg is lifted off the ground. Musculoskeletal analysis is utilized to compute the muscle and joint forces involved in this motion. These forces are used as boundary conditions for the finite element analyses. Bone tissue stress is analyzed. Results Critical stress peaks are located between the anterior superior iliac spine (ASIS) and the anterior edge of the harvest site. Irrespective of the graft size, the iliac wing does not show any significant stress peaks with the harvest site being 20 to 25 mm posterior to the ASIS. The harvest area itself inhibits the distribution of the forces applied on the ASIS to extend to the posterior iliac wing. This leads to a lack of stress posterior to the harvest site. A balanced stress distribution with no stress peaks appears when the bone graft is taken below the iliac crest. Conclusion A harvest site located at least 20 to 25 mm posterior to the ASIS should be preferred to minimize the risk of iliac fatigue fracture.}, subject = {Beckenkammknochen}, language = {en} } @article{VoellnerWeberWeberetal., author = {V{\"o}llner, Florian and Weber, Tim A. and Weber, Markus and Renkawitz, Tobias and Dendorfer, Sebastian and Grifka, Joachim and Craiovan, Benjamin}, title = {A simple method for determining ligament stiffness during total knee arthroplasty in vivo}, series = {Scientific Reports}, volume = {9}, journal = {Scientific Reports}, publisher = {Nature}, doi = {10.1038/s41598-019-41732-x}, pages = {1 -- 8}, abstract = {A key requirement in both native knee joints and total knee arthroplasty is a stable capsular ligament complex. However, knee stability is highly individual and ranges from clinically loose to tight. So far, hardly any in vivo data on the intrinsic mechanical of the knee are available. This study investigated if stiffness of the native ligament complex may be determined in vivo using a standard knee balancer. Measurements were obtained with a commercially available knee balancer, which was initially calibrated in vitro. 5 patients underwent reconstruction of the force-displacement curves of the ligament complex. Stiffness of the medial and lateral compartments were calculated to measure the stability of the capsular ligament complex. All force-displacement curves consisted of a non-linear section at the beginning and of a linear section from about 80 N onwards. The medial compartment showed values of 28.4 ± 1.2 N/mm for minimum stiffness and of 39.9 ± 1.1 N/mm for maximum stiffness; the respective values for the lateral compartment were 19.9 ± 0.9 N/mm and 46.6 ± 0.8 N/mm. A commercially available knee balancer may be calibrated for measuring stiffness of knee ligament complex in vivo, which may contribute to a better understanding of the intrinsic mechanical behaviour of knee joints.}, subject = {Biomechanische Analyse}, language = {en} } @article{BenditzAuerSpoerreretal., author = {Benditz, Achim and Auer, Simon and Sp{\"o}rrer, J.F. and Wolkerstorfer, S. and Grifka, Joachim and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Regarding loads after spinal fusion, every level should be seen separately: a musculoskeletal analysis}, series = {European Spine Journal}, volume = {27}, journal = {European Spine Journal}, number = {8}, publisher = {Springer-Verlag}, doi = {10.1007/s00586-018-5476-5}, pages = {1905 -- 1910}, abstract = {The number of spinal fusion surgeries is steadily increasing and biomechanical consequences are still in debate. The aim of this study is to provide biomechanical insights into the sagittal balance of the spine and to compare spinal load before and after spinal fusion. METHOD: The joint reaction forces of 52 patients were analyzed in proximo-distal and antero-posterior direction from the levels T12-L1 to L5-S1 using musculoskeletal simulations. RESULTS: In 104 simulations, pre-surgical forces were equal to post-surgical. The levels L4-L5 and T12-L1, however, showed increased spinal forces compression forces with higher sagittal displacement. Improved restauration of sagittal balance was accompanied by lower spinal load. AP shear stress, interestingly decreased with sagittal imbalance. CONCLUSION: Imbalanced spines have a risk of increased compression forces at Th12-L1. L4-L5 always has increased spinal loads. These slides can be retrieved under Electronic Supplementary Material.}, subject = {Biomechanische Analyse}, language = {en} } @inproceedings{JungtaeublSchmitzGrossetal., author = {Jungt{\"a}ubl, Dominik and Schmitz, Paul and Gross, Simon and Dendorfer, Sebastian}, title = {FEA of the transiliacal internal fixator as an osteosynthesis of pelvic ring fractures}, series = {CMBEBIH 2017, Proceedings of the International Conference on Medical and Biological Engineering 2017}, booktitle = {CMBEBIH 2017, Proceedings of the International Conference on Medical and Biological Engineering 2017}, editor = {Badnjevic, Almir}, publisher = {Springer}, address = {Singapore}, isbn = {978-981-10-4165-5}, doi = {10.1007/978-981-10-4166-2_32}, pages = {212 -- 217}, abstract = {Common Schanz screw systems can be used to stabilize pelvic ring fractures. In order to accommodate for different patient's requirements, implants can be placed in cranio-caudal direction into the os ilium (T1), or into the supraacetabular bone canal, and thus, in dorso-ventral direction (T2). Whereas both techniques are currently used, no data of the biomechanical behavior is available up to this date. The aim of this study is to analyze, whether T2 shows biomechanical advantages with respect to tissue and implant stresses due to the enlarged bone-implant interface. Forces acting on the pelvis were analyzed using motion capture data of a gait cycle obtained by the utilization of a musculoskeletal simulation program. A three dimensional finite element (FE) model of the pelvis with grayscale-based material properties was generated. The muscle and joint reaction forces at toe-off were applied to the FE model and instable pelvis fractures were implemented. The osteosynthesis systems were positioned within the model in order to enable the comparison between the two different surgical techniques. Stresses and displacements were analyzed for bone tissue, fracture zone and implant. T2 lead to approx. 30\% larger displacements in the fracture zone. Von-Mises stresses were larger for T2 in the implant (80 MPa vs. 227 MPa), whereas T1 leads to larger stresses in the bone tissue (200 MPa vs. 140 MPa). Both implantation techniques showed a good biomechanical behavior. Differences could be found with respect to tissue strains and deformations in the fracture zone. If bone quality or fracture healing are of concern, T2 or T1 should be used, respectively. However, both techniques seem to be applicable for cases with no special requirements. Further analyses aim to investigate the behavior under cyclic loading.}, subject = {Beckenbruch}, language = {en} } @article{RenkawitzWeberDullienetal., author = {Renkawitz, Tobias and Weber, Tim A. and Dullien, Silvia and Woerner, Michael and Dendorfer, Sebastian and Grifka, Joachim and Weber, Markus}, title = {Leg length and offset differences above 5 mm after total hip arthroplasty are associated with altered gait kinematics}, series = {Gait \& Posture}, volume = {vol. 49}, journal = {Gait \& Posture}, doi = {10.1016/j.gaitpost.2016.07.011}, pages = {196 -- 201}, abstract = {We aimed to investigate the relationship between postoperative leg length/offset (LL/OS) reconstruction and gait performance after total hip arthroplasty (THA). In the course of a prospective randomized controlled trial, 60 patients with unilateral hip arthrosis received cementless THA through a minimally-invasive anterolateral surgical approach. One year post-operatively, LL and global OS restoration were analyzed and compared to the contralateral hip on AP pelvic radiographs. The combined postoperative limb length/OS reconstruction of the operated hip was categorized as restored (within 5 mm) or non-restored (more than 5 mm reduction or more than 5 mm increment). The acetabular component inclination, anteversion and femoral component anteversion were evaluated using CT scans of the pelvis and the femur. 3D gait analysis of the lower extremity and patient related outcome measures (HHS, HOOS, EQ-5D) were obtained pre-operatively, six months and twelve months post-operatively by an observer blinded to radiographic results. Component position of cup and stem was comparable between the restored and non-restored group. Combined LL and OS restoration within 5 mm resulted in higher Froude number (p < 0.001), normalized walking speed (p < 0.001) and hip range-of-motion (ROM) (p = 0.004) during gait twelve months postoperatively, whereas gait symmetry was comparable regardless of LL and OS reconstruction at both examinations. Clinical scores did not show any relevant association between the accuracy of LL or OS reconstruction and gait six/twelve months after THA. In summary, postoperative LL/OS discrepancies larger than 5 mm relate to unphysiological gait kinematics within the first year after THA. DRKS00000739, German Clinical Trials Register.}, language = {en} } @article{PutzerAuerMalpicaetal., author = {Putzer, Michael and Auer, Stefan and Malpica, William and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {A numerical study to determine the effect of ligament stiffness on kinematics of the lumbar spine during flexion}, series = {BMC Musculoskeletal Disorders}, volume = {17}, journal = {BMC Musculoskeletal Disorders}, number = {95}, doi = {10.1186/s12891-016-0942-x}, abstract = {Background There is a wide range of mechanical properties of spinal ligaments documented in literature. Due to the fact that ligaments contribute in stabilizing the spine by limiting excessive intersegmental motion, those properties are of particular interest for the implementation in musculoskeletal models. The aim of this study was to investigate the effect of varying ligament stiffness on the kinematic behaviour of the lumbar spine. Methods A musculoskeletal model with a detailed lumbar spine was modified according to fluoroscopic recordings and corresponding data files of three different subjects. For flexion, inverse dynamics analysis with a variation of the ligament stiffness matrix were conducted. The influence of several degrees of ligament stiffness on the lumbar spine model were investigated by tracking ligament forces, disc forces and resulting moments generated by the ligaments. Additionally, the kinematics of the motion segments were evaluated. Results An increase of ligament stiffness resulted in an increase of ligament and disc forces, whereas the relative change of disc force increased at a higher rate at the L4/L5 level (19 \%) than at the L3/L4 (10 \%) level in a fully flexed posture. The same behaviour applied to measured moments with 67 \% and 45 \%. As a consequence, the motion deflected to the lower levels of the lumbar spine and the lower discs had to resist an increase in loading. Conclusions Higher values of ligament stiffness over all lumbar levels could lead to a shift of the loading and the motion between segments to the lower lumbar levels. This could lead to an increased risk for the lower lumbar parts.}, language = {en} } @article{WeberDendorferBulstraetal., author = {Weber, Tim A. and Dendorfer, Sebastian and Bulstra, Sjoerd K. and Grifka, Joachim and Verkerke, Gijsbertus Jacob and Renkawitz, Tobias}, title = {Gait six month and one-year after computer assisted Femur First THR vs. conventional THR. Results of a patient- and observer- blinded randomized controlled trial}, series = {Gait \& Posture}, volume = {vol. 49}, journal = {Gait \& Posture}, doi = {10.1016/j.gaitpost.2016.06.035}, pages = {418 -- 425}, abstract = {A prospective randomized controlled trial is presented that is used to compare gait performance between the computer assisted Femur First (CAS FF) operation method and conventional THR (CON). 60 patients underwent a 3D gait analysis of the lower extremity at pre-operative, 6 months post-operative and twelve months post-operative. Detailed verification experiments were facilitated to ensure the quality of data as well as to avoid over-interpreting of the data. The results confirm a similar data-quality as reported in the literature. Walking speed, range of motion and symmetry thereof improved over the follow-up period, without significant differences between the groups. While all parameters do significantly increase over the follow-up period for both groups, there were no significant differences between them at any given time-point. Patients undergoing CAS FF showed a trend to improved hip flexion angle indicating a possible long-term benefit.}, language = {en} } @inproceedings{DendorferKubowitschSuess, author = {Dendorfer, Sebastian and Kubowitsch, Simone and S{\"u}ß, Franz}, title = {How to determine the effect of working conditions on the human body}, series = {11th International Scientific Conference on Production Engineering DEVELOPMENT AND MODERNIZATION OF PRODUCTION (RIM 2017), Sarajevo, Bosnia and Herzegovina}, booktitle = {11th International Scientific Conference on Production Engineering DEVELOPMENT AND MODERNIZATION OF PRODUCTION (RIM 2017), Sarajevo, Bosnia and Herzegovina}, abstract = {Work places and conditions strains the human body, both psychologically and biomechanically. In order to analyse working conditions and in the following to improve them, detailed knowledge about the effect of the different stressors on the body is needed. This manuscript discusses methods on how to evaluate biomechanical and mental loading and its effect on the musculoskeletal system. A possible workflow for the analysis is presented.}, subject = {Arbeitsbedingungen}, language = {en} } @article{IgnasiakDendorferFerguson, author = {Ignasiak, Dominika and Dendorfer, Sebastian and Ferguson, Stephen J.}, title = {Thoracolumbar spine model with articulated ribcage for the prediction of dynamic spinal loading}, series = {Journal of Biomechanics}, volume = {vol. 49}, journal = {Journal of Biomechanics}, number = {6}, publisher = {Elsevier Science}, doi = {10.1016/j.jbiomech.2015.10.010}, pages = {959 -- 966}, abstract = {Musculoskeletal modeling offers an invaluable insight into the spine biomechanics. A better understanding of thoracic spine kinetics is essential for understanding disease processes and developing new prevention and treatment methods. Current models of the thoracic region are not designed for segmental load estimation, or do not include the complex construct of the ribcage, despite its potentially important role in load transmission. In this paper, we describe a numerical musculoskeletal model of the thoracolumbar spine with articulated ribcage, modeled as a system of individual vertebral segments, elastic elements and thoracic muscles, based on a previously established lumbar spine model and data from the literature. The inverse dynamics simulations of the model allow the prediction of spinal loading as well as costal joints kinetics and kinematics. The intradiscal pressure predicted by the model correlated well (R2=0.89) with reported intradiscal pressure measurements, providing a first validation of the model. The inclusion of the ribcage did not affect segmental force predictions when the thoracic spine did not perform motion. During thoracic motion tasks, the ribcage had an important influence on the predicted compressive forces and muscle activation patterns. The compressive forces were reduced by up to 32\%, or distributed more evenly between thoracic vertebrae, when compared to the predictions of the model without ribcage, for mild thoracic flexion and hyperextension tasks, respectively. The presented musculoskeletal model provides a tool for investigating thoracic spine loading and load sharing between vertebral column and ribcage during dynamic activities. Further validation for specific applications is still necessary.}, subject = {Brustwirbels{\"a}ule}, language = {en} } @article{WeberDendorferGrifkaetal., author = {Weber, Tim A. and Dendorfer, Sebastian and Grifka, Joachim and Verkerke, Gijsbertus Jacob and Renkawitz, Tobias}, title = {Does Computer-Assisted Femur First THR Improve Musculoskeletal Loading Conditions?}, series = {BioMed Research International}, volume = {2015}, journal = {BioMed Research International}, editor = {Takagi, Michiaki}, doi = {10.1155/2015/625317}, pages = {ID 625317}, abstract = {We have developed a novel, computer-assisted operation method for minimal-invasive total hip replacement (THR) following the concept of "femur first/combined anteversion," which incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position (CAS FF). The purpose of this study is to assess whether the hip joint reaction forces and patient's gait parameters are being improved by CAS FF in relation to conventional THR (CON). We enrolled 60 patients (28 CAS FF/32 CON) and invited them for gait analysis at three time points (preoperatively, postop six months, and postop 12 months). Data retrieved from gait analysis was processed using patient-specific musculoskeletal models. The target parameters were hip reaction force magnitude (hrf), symmetries, and orientation with respect to the cup. Hrf in the CAS FF group were closer to a young healthy normal. Phase-shift symmetry showed an increase in the CAS FF group. Hrf orientation in the CAS FF group was closer to optimum, though no edge or rim-loading occurred in the CON group as well. The CAS FF group showed an improved hrf orientation in an early stage and a trend to an improved long-term outcome.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{WeberAlMunajjedVerkerkeetal., author = {Weber, Tim and Al-Munajjed, Amir Andreas and Verkerke, Gijsbertus Jacob and Dendorfer, Sebastian and Renkawitz, Tobias}, title = {Influence of minimally invasive total hip replacement on hip reaction forces and their orientations}, series = {Journal of Orthopaedic Research}, volume = {32}, journal = {Journal of Orthopaedic Research}, number = {12}, doi = {10.1002/jor.22710}, pages = {1680 -- 1687}, abstract = {Minimally invasive surgery (MIS) is becoming increasingly popular. Supporters claim that the main advantages of MIS total hip replacement (THR) are less pain and a faster rehabilitation and recovery. Critics claim that safety and efficacy of MIS are yet to be determined. We focused on a biomechanical comparison between surgical standard and MIS approaches for THR during the early recovery of patients. A validated, parameterized musculoskeletal model was set to perform a squat of a 50th percentile healthy European male. A bilateral motion was chosen to investigate effects on the contralateral side. Surgical approaches were simulated by excluding the incised muscles from the computations. Resulting hip reaction forces and their symmetry and orientation were analyzed. MIS THR seemed less influential on the symmetry index of hip reaction forces between the operated and nonoperated leg when compared to the standard lateral approach. Hip reaction forces at peak loads of the standard transgluteal approach were 24\% higher on the contralateral side when compared to MIS approaches. Our results suggest that MIS THR contributes to a greater symmetry of hip reaction forces in absolute value as well as force-orientation following THR.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{PutzerEhrlichRasmussenetal., author = {Putzer, Michael and Ehrlich, Ingo and Rasmussen, John and Gebbeken, Norbert and Dendorfer, Sebastian}, title = {Sensitivity of lumbar spine loading to anatomical parameters}, series = {Journal of Biomechanics}, volume = {49}, journal = {Journal of Biomechanics}, number = {6}, publisher = {Elsevier Science}, doi = {10.1016/j.jbiomech.2015.11.003}, pages = {953 -- 958}, abstract = {Musculoskeletal simulations of lumbar spine loading rely on a geometrical representation of the anatomy. However, this data has an inherent inaccuracy. This study evaluates the influence of defined geometrical parameters on lumbar spine loading utilising five parametrised musculoskeletal lumbar spine models for four different postures. The influence of the dimensions of vertebral body, disc, posterior parts of the vertebrae as well as the curvature of the lumbar spine was studied. Additionally, simulations with combinations of selected parameters were conducted. Changes in L4/L5 resultant joint force were used as outcome variable. Variations of the vertebral body height, disc height, transverse process width and the curvature of the lumbar spine were the most influential. These parameters can be easily acquired from X-rays and should be used to morph a musculoskeletal lumbar spine model for subject-specific approaches with respect to bone geometry. Furthermore, the model was very sensitive to uncommon configurations and therefore, it is advised that stiffness properties of discs and ligaments should be individualised.}, subject = {Wirbels{\"a}ule}, language = {en} } @article{DendorferWeberKennedy, author = {Dendorfer, Sebastian and Weber, Tim and Kennedy, O.}, title = {Musculoskeletal modeling for hip replacement outcome analyses and other applications}, series = {The Journal of the American Academy of Orthopaedic Surgeons}, volume = {22}, journal = {The Journal of the American Academy of Orthopaedic Surgeons}, number = {4}, doi = {10.5435/JAAOS-22-04-268}, pages = {268 -- 269}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @inproceedings{WeberDendorferDullienetal., author = {Weber, Tim A. and Dendorfer, Sebastian and Dullien, Silvia and Grifka, Joachim and Verkerke, Gijsbertus Jacob and Renkawitz, Tobias}, title = {Measuring functional outcome after total hip replacement with subject-specific hip joint loading}, series = {Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine}, volume = {226}, booktitle = {Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine}, number = {12}, doi = {10.1177/0954411912447728}, pages = {939 -- 946}, abstract = {Total hip replacement is an often-performed orthopedic surgical procedure; the amount of procedures undertaken will increase since our life expectancy is growing. In order to optimize function, hip biomechanics should be restored to as near normal as possible. The goal of this pilot study was to determine whether or not it is feasible to compute the vectorial hip reaction force pathways on the head of the prosthesis and the force angles relative to the cup of the prosthesis that occur during gait in total hip replacement patients, serving as an objective measurement of the functional outcome following hip replacement. A three-dimensional gait analysis, measuring ground reaction forces and kinematics, was performed. The data retrieved from the gait analysis was used as the input for the musculoskeletal model to compute vectorial joint reaction forces for data processing. To evaluate the position and orientation of the joint reaction forces, the force path, as well as the force angles for the operated and non-operated joint, has been calculated during the stance phase of the specific leg. The force path for subject 2 on the non-operated side is only located in the posterior-lateral quarter, as is the force path for subject 1. In contrast to this subject, the force path for subject 2 at the operated hip joint can be found only within the anterior quarter of the head of the implant, where it is nearly equally distributed in the medio-lateral half of the prosthesis head. The force-inclination angles on the cup of subject 1, with respect to the plane of the socket face, indicates that the force vector is mainly positioned in the same quadrant when compared with subject 2 (in a cup-fixed coordinate system). The force-anteversion angle behaves similarly to the force-inclination angle, even when the effects are not as pronounced. The proposed methods in this article are aiming to define two functional outcomes of total hip replacement that are related to wear and rim loading. It is accepted that wear is not only a function of time, but a function of use. Owing to the methods listed in this article, we are able to determine a) the applied force and b) the sliding distance (force pathway) in a subject-specific manner. The computed hip-reaction force angles and the distance to the rim cup are a measurement for cup or rim loading, and occurs in the so-called safe-zones. This method may well give us insight into the biomechanical situation during gait, after receiving total hip replacement, that we need to fully understand the mechanisms acting on a hip joint and to prove a possible increase of functional outcome after receiving total hip replacement.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{LenichBachmeierDendorferetal., author = {Lenich, Andreas and Bachmeier, S. and Dendorfer, Sebastian and Mayr, E. and Nerlich, Michael and F{\"u}chtmeier, Bernd}, title = {Development of a test system to analyze different hip fracture osteosyntheses under simulated walking}, series = {Biomedizinische Technik. Biomedical engineering}, volume = {57}, journal = {Biomedizinische Technik. Biomedical engineering}, number = {2}, doi = {10.1515/bmt-2011-0999}, pages = {113 -- 119}, abstract = {The mechanical complications of osteosyntheses after hip fractures are previously investigated by mostly static or dynamic uniaxial loading test systems. However, the physiologic loading of the hip joint during a normal gait is a multiplanar, dynamic movement. Therefore, we constructed a system to test osteosyntheses for hip fractures under physiologic multiplanar loading representative of normal gait. To evaluate the testing system, 12 femora pairs were tested under 25,000 cycles with two standard osteosyntheses (Proximal Femoral Nail Antirotation/Gamma3 Nail). For angular movement, the varus collapse to cut out (∝CO) (∝CO=4.8°±2.1° for blade and ∝CO=7.8°±3.8° for screw) was the dominant failure mode, and only slight rotational angle shifts (∝Rot) (∝Rot=1.7°±0.4° for blade and ∝Rot=2.4°±0.3° for screw) of the femoral head around the implant axis were observed. Angular displacements in varus direction and rotation were higher in specimens reinforced with screws. Hence, the cut out model and the migration directions showed a distinction between helical blade and hip screw. However, there were no significant differences between the different implants. The new setup is able to create clinical failures and allows to give evidence about the anchorage stability of different implant types under dynamic gait motion pattern.}, subject = {H{\"u}ftgelenk}, language = {en} } @article{WongRasmussenSimonsenetal., author = {Wong, Christian and Rasmussen, John and Simonsen, Erik B. and Hansen, Lone and de Zee, Mark and Dendorfer, Sebastian}, title = {The Influence of Muscle Forces on the Stress Distribution in the Lumbar Spine}, series = {The Open Spine Journal}, volume = {3}, journal = {The Open Spine Journal}, number = {1}, doi = {10.2174/1876532701103010021}, pages = {21 -- 26}, abstract = {Introduction: Previous studies of bone stresses in the human lumbar spine have relied on simplified models when modeling the spinal musculature, even though muscle forces are likely major contributors to the stresses in the vertebral bones. Detailed musculoskeletal spine models have recently become available and show good correlation with experimental findings. A combined inverse dynamics and finite element analysis study was conducted in the lumbar spine to investigate the effects of muscle forces on a detailed musculoskeletal finite element model of the 4th lumbar vertebral body. Materials and Methodology: The muscle forces were computed with a detailed and validated inverse dynamics musculoskeletal spine model in a lifting situation, and were then applied to an orthotropic finite element model of the 4th lumbar vertebra. The results were compared with those from a simplified load case without muscles. Results: In general the von Mises stress was larger by 30\%, and even higher when looking at the von Mises stress distribution in the superio-anterior and central part of the vertebral body and in the pedicles. Conclusion: The application of spine muscles to a finite element model showed markedly larger von Mises stress responses in the central and anterior part of the vertebral body, which can be tolerated in the young and healthy spine, but it would increase the risk of compression fractures in the elderly, osteoporotic spine.}, subject = {Lendenwirbels{\"a}ule}, language = {en} } @article{PenzkoferBarnsteinerDendorfer, author = {Penzkofer, Rainer and Barnsteiner, K. and Dendorfer, Sebastian}, title = {The influence of age, shoe type and kicking direction on the severity of head trauma}, series = {Journal of Forensic Biomechanics}, volume = {5}, journal = {Journal of Forensic Biomechanics}, number = {1}, doi = {10.4172/2090-2697.1000116}, abstract = {In the last few years, increasingly kicks to the head were observed as a criminal offense. This study examined the influence of age, shoe type and kicking direction on the severity of head trauma. Male test persons were divided into two groups "Old" and "Young". Both groups were equipped with light sneakers and combat boots. A standard laboratory crash dummy was used to simulate the victim's body. First, the dummy's head, free floating above the ground, was kicked vertically. Second, the dummy's head was kicked horizontally. Established injury criteria were used to quantify the injury risk. No influence concerning the type of foot wear and no difference between the groups "Old" and "Young" could be found. For all analyses, kicking vertically generally lead to a higher risk for the subject compared to kicking horizontally. In this study, only the integral effect of the kicks could be analyzed. A detailed injury pattern cannot directly be derived from the data. Nevertheless, the presented data show the massive potential of injuries associated with head kicks.}, subject = {Kopfverletzung}, language = {en} } @article{RoldanMoralisDendorferetal., author = {Rold{\´a}n, J.C. and Moralis, A. and Dendorfer, Sebastian and Witte, J. and Reicheneder, C.}, title = {Controlled central advancement of the midface after Le Fort III osteotomy by a 3-point skeletal anchorage}, series = {The Journal of craniofacial surgery}, volume = {22}, journal = {The Journal of craniofacial surgery}, number = {6}, doi = {10.1097/SCS.0b013e318231fc8d}, pages = {2384 -- 2386}, abstract = {A 3-point skeletal anchorage with taping screws for distraction osteogenesis after a Le Fort III osteotomy was applied for the first time in a severely mentally impaired patient where intraoral devices had to be avoided. All 3-force application points included the center of resistance, which allowed an optimal control on the resulting moment. A novel device for skeletal long-term retention into the nasal dorsum prevented a relapse, whereas adjustment of the midface position was observed. Fusioned three-dimensional computed tomography analysis revealed real movements not accessible by a conventional cephalometry.}, subject = {Mund-Kiefer-Gesichts-Chirurgie}, language = {en} } @article{RenkawitzDendorfer, author = {Renkawitz, Tobias and Dendorfer, Sebastian}, title = {Orthopedic navigation technology and biomechanical evaluation for total hip replacement}, series = {Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine}, volume = {226}, journal = {Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine}, number = {12}, doi = {10.1177/0954411912458746}, pages = {897 -- 898}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{DendorferHammerLenich, author = {Dendorfer, Sebastian and Hammer, Joachim and Lenich, Andreas}, title = {Characterisation and testing of biomaterials}, series = {Technology and Health Care}, volume = {19}, journal = {Technology and Health Care}, number = {5}, doi = {10.3233/THC-2011-0644}, pages = {357 -- 371}, subject = {Biomaterial}, language = {en} } @article{DePieriAtzoriFergusonetal., author = {De Pieri, Enrico and Atzori, Federica and Ferguson, Stephen J. and Dendorfer, Sebastian and Leunig, Michael and Aepli, Martin}, title = {Contact force path in total hip arthroplasty: effect of cup medialisation in a whole-body simulation}, series = {HIP International}, volume = {31}, journal = {HIP International}, number = {5}, publisher = {Sage}, doi = {10.1177/1120700020917321}, pages = {624 -- 631}, abstract = {Background: Cup medialisation down to the true acetabular floor in total hip arthroplasty with a compensatory femoral offset increase seems to be mechanically advantageous for the abductor muscles due to the relocation of the lever arms (body weight lever arm decreased, abductor lever arm increased). However, limited information is currently available about the effects of this reconstruction type at the head cup interface, compared to an anatomical reconstruction that maintains the natural lever arms. Through a whole-body simulation analysis, we compared medialised versus anatomical reconstruction in THA to analyse the effects on: (1) contact force magnitude at the head cup interface; (2) contact force path in the cup; and (3) abductor activity. Methods: Musculoskeletal simulations were performed to calculate the above-mentioned parameters using inverse dynamics analysis. The differences between the virtually implanted THAs were calculated to compare the medialised versus anatomical reconstruction. Results: Cup medialisation with compensatory femoral offset increase led to: (1) a reduction in contact force magnitude at the head cup interface up to 6.6\%; (2) a similar contact force path in the cup in terms of sliding distance and aspect ratio; and (3) a reduction in abductor activity up to 17.2\% (gluteus medius). Conclusions: In our opinion, these potential biomechanical gains do not generally justify a fully medialised reconstruction, especially in younger patients that are more likely to undergo revision surgery in their lifetime. Cup medialisation should be performed until sufficient press fit and bony coverage of a properly sized and oriented cup can be achieved.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{AurbachSpickaSuessetal., author = {Aurbach, Maximilian and Spicka, Jan and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Evaluation of musculoskeletal modelling parameters of the shoulder complex during humeral abduction above 90°}, series = {Journal of Biomechanics}, volume = {106}, journal = {Journal of Biomechanics}, number = {June}, publisher = {Elsevier}, doi = {10.1016/j.jbiomech.2020.109817}, abstract = {Based on electromyographic data and force measurements within the shoulder joint, there is an indication that muscle and resulting joint reaction forces keep increasing over an abduction angle of 90°. In inverse dynamics models, no single parameter could be attributed to simulate this force behaviour accordingly. The aim of this work is to implement kinematic, kinetic and muscle model modifications to an existing model of the shoulder (AnyBody™) and assess their single and combined effects during abduction up to 140° humeral elevation. The kinematics and the EMG activity of 10 test subjects were measured during humeral abduction. Six modifications were implemented in the model: alternative wrapping of the virtual deltoid muscle elements, utilization of a three element Hill model, strength scaling, motion capture driven clavicle elevation/protraction, translation of the GH joint in dependency of the acting forces and an alteration of the scapula/clavicle rhythm. From the six modifications, 16 different combinations were considered. Parameter combinations with the Hill model changed the resultant GH joint reaction force and led to an increase in force during abduction of the humerus above 90°. Under the premise of muscle activities and forces within the GH joint rising after 90° of humeral abduction, we propose that the Hill type muscle model is a crucial parameter for accurately modelling the shoulder. Furthermore, the outcome of this study indicates that the Hill model induces the co-contraction of the muscles of the shoulder without the need of an additional stability criterion for an inverse dynamics approach.}, subject = {Schultergelenk}, language = {en} } @article{DendorferMaierTayloretal., author = {Dendorfer, Sebastian and Maier, Hans J{\"u}rgen and Taylor, David and Hammer, Joachim}, title = {Anisotropy of the fatigue behaviour of cancellous bone}, series = {Journal of Biomechanics}, volume = {41}, journal = {Journal of Biomechanics}, number = {3}, doi = {10.1016/j.jbiomech.2007.09.037}, pages = {636 -- 641}, abstract = {The fatigue behaviour of materials is of particular interest for the failure prediction of materials and structures exposed to cyclic loading. For trabecular bone structures only a few sets of lifetime data have been reported in the literature and structural measures are commonly not considered. The influence of load contributions which are not aligned with the main physiological axis remains unclear. Furthermore site and species dependent relationships are not well described. In this study five different groups of trabecular bone, defined in terms of orientation, species and site were exposed to cyclic compression. In total, 108 fatigue tests were analysed. The lifetimes were found to decrease drastically when off-axis loads were applied. Additionally, species and site strongly affect fatigue lifetimes. Strains at failure were also found to be a function of orientation.}, subject = {Erm{\"u}dung}, language = {en} } @incollection{DendorferHammerLenich, author = {Dendorfer, Sebastian and Hammer, Joachim and Lenich, Andreas}, title = {Characterisation and testing of biomaterials}, series = {Basic Engineering for Medics and Biologists: An ESEM Primer}, booktitle = {Basic Engineering for Medics and Biologists: An ESEM Primer}, number = {Chapter IV.4.}, editor = {Lee, T. Clive and Niederer, Peter F.}, publisher = {Non Basic Stock Line}, isbn = {978-1607505266}, subject = {Biomaterial}, language = {en} } @article{AurbachŠpičkaSuessetal., author = {Aurbach, Maximilian and Špička, Jan and S{\"u}ß, Franz and Vychytil, J. and Havelkov{\´a}, Leonard and Ryba, T. and Dendorfer, Sebastian}, title = {Torus obstacle method as a wrapping approach of the deltoid muscle group for humeral abduction in musculoskeletal simulation}, series = {Journal of Biomechanics}, volume = {109}, journal = {Journal of Biomechanics}, number = {August}, publisher = {Elsevier}, doi = {10.1016/j.jbiomech.2020.109864}, abstract = {Musculoskeletal models of the shoulder complex are valuable research aids to investigate tears of the supraspinatus and the resulting mechanical impact during abduction of the humerus. One of the major contributors to this motion is the deltoid muscle group and for this, an accurate modeling of the lines of action is indispensable. The aim of this work was to utilize a torus obstacle wrapping approach for the deltoids of an existing shoulder model and assess the feasibility of the approach during humeral abduction. The shoulder model from the AnyBody™ modeling system was used as a platform. The size of the tori is based on a magnetic resonance imaging (MRI) approach and several kinematic couplings are implemented to determine the trajectories of the tori during abduction. To assess the model behavior, the moment arms of the virtual muscle elements and the resultant glenohumeral joint reaction force (GHJF) were compared with reference data from the literature during abduction of the humerus in the range 20°-120°. The root mean square error for the anterior, lateral and posterior part between the simulated muscle elements and reference data from the literature was 3.9, 1.7 and 5.8 mm, respectively. The largest deviation occurred on the outer elements of the muscle groups, with 12.6, 10.4 and 20.5 mm, respectively. During abduction, there is no overlapping of the muscle elements and these are in continuous contact with the torus obstacles, thus enabling a continuous force transmission. This results in a rising trend of the resultant GHJF. The torus obstacle approach as a wrapping method for the deltoid muscles provides a guided muscle pathing by simultaneously approximating the curvature of the deltoid muscle. The results from the comparison of the simulated moment arms and the resultant GHJF are in accordance with those in the literature in the range 20°-120° of abduction. Although this study shows the strength of the torus obstacle as a wrapping approach, the method of fitting the tori according to MRI data was not suitable. A cadaver study is recommended to better validate and mathematically describe the torus approach.}, language = {en} } @article{WeberSuessJerabeketal., author = {Weber, Markus and Suess, Franz and Jerabek, Seth and Meyer, Matthias and Grifka, Joachim and Renkawitz, Tobias and Dendorfer, Sebastian}, title = {Kinematic pelvic tilt during gait alters functional cup position in total hip arthroplasty}, series = {Journal of Orthopaedic Research}, volume = {40}, journal = {Journal of Orthopaedic Research}, number = {4}, publisher = {Wiley}, issn = {1554-527X}, doi = {10.1002/jor.25106}, pages = {846 -- 853}, abstract = {Static pelvic tilt impacts functional cup position in total hip arthroplasty (THA). In the current study we investigated the effect of kinematic pelvic changes on cup position. In the course of a prospective controlled trial postoperative 3D-computed tomography (CT) and gait analysis before and 6 and 12 months after THA were obtained in 60 patients. Kinematic pelvic motion during gait was measured using Anybody Modeling System. By fusion with 3D-CT, the impact of kinematic pelvic tilt alterations on cup anteversion and inclination was calculated. Furthermore, risk factors correlating with high pelvic mobility were evaluated. During gait a high pelvic range of motion up to 15.6° exceeding 5° in 61.7\% (37/60) of patients before THA was found. After surgery, the pelvis tilted posteriorly by a mean of 4.0 ± 6.6° (p < .001). The pelvic anteflexion led to a mean decrease of -1.9 ± 2.2° (p < .001) for cup inclination and -15.1 ± 6.1° (p < .001) for anteversion in relation to the anterior pelvic plane (APP). Kinematic pelvic changes resulted in a further change up to 2.3° for inclination and up to 12.3° for anteversion. In relation to the preoperative situation differences in postoperative cup position ranged from -4.4 to 4.6° for inclination and from -7.8 to 17.9° for anteversion, respectively. Female sex (p < .001) and normal body weight (p < .001) correlated with high alterations in pelvic tilt. Kinematic pelvic changes highly impact cup anteversion in THA. Surgeons using the APP as reference should aim for a higher anteversion of about 15° due to the functional anteflexion of the pelvis during gait.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{WeberMerleNawabietal., author = {Weber, Markus and Merle, Christian and Nawabi, Danyal H. and Dendorfer, Sebastian and Grifka, Joachim and Renkawitz, Tobias}, title = {Inaccurate offset restoration in total hip arthroplasty results in reduced range of motion}, series = {Scientific Reports}, volume = {10}, journal = {Scientific Reports}, number = {13208}, publisher = {Nature}, doi = {10.1038/s41598-020-70059-1}, pages = {9}, abstract = {Offset restoration in total hip arthroplasty (THA) is associated with postoperative range of motion (ROM) and gait kinematics. We aimed to research into the impact of high offset (HO) and standard stems on postoperative ROM. 121 patients received cementless THA through a minimally-invasive anterolateral approach. A 360° hip ROM analysis software calculated impingement-free hip movement based on postoperative 3D-CTs compared to ROM values necessary for activities of daily living (ADL). The same model was then run a second time after changing the stem geometry between standard and HO configuration with the implants in the same position. HO stems showed higher ROM for all directions between 4.6 and 8.9° (p < 0.001) compared with standard stems but with high interindividual variability. In the subgroup with HO stems for intraoperative offset restoration, the increase in ROM was even higher for all ROM directions with values between 6.1 and 14.4° (p < 0.001) compared to offset underrestoration with standard stems. Avoiding offset underrestoration resulted in a higher amount of patients of over 20\% for each ROM direction that fulfilled the criteria for ADL (p < 0.001). In contrast, in patients with standard stems for offset restoration ROM did increase but not clinically relevant by offset overcorrection for all directions between 3.1 and 6.1° (p < 0.001). Offset overcorrection by replacing standard with HO stems improved ROM for ADL in a low number of patients below 10\% (p > 0.03). Patient-individual restoration of offset is crucial for free ROM in THA. Both over and underrestoration of offset should be avoided.}, language = {en} } @article{MelznerSuessDendorfer, author = {Melzner, Maximilian and Suess, Franz and Dendorfer, Sebastian}, title = {The impact of anatomical uncertainties on the predictions of a musculoskeletal hand model - a sensitivity study}, series = {Computer Methods in Biomechanics and Biomedical Engineering}, volume = {25}, journal = {Computer Methods in Biomechanics and Biomedical Engineering}, number = {2}, publisher = {Taylor \& Francis}, issn = {1476-8259}, doi = {10.1080/10255842.2021.1940974}, pages = {156 -- 164}, abstract = {Outputs of musculoskeletal models should be considered probabilistic rather than deterministic as they are affected by inaccuracies and estimations associated with the development of the model. One of these uncertainties being critical for modeling arises from the determination of the muscles' line of action and the physiological cross-sectional area. Therefore, the aim of this study was to evaluate the outcome sensitivity of model predictions from a musculoskeletal hand model in comparison to the uncertainty of these input parameters. For this purpose, the kinematics and muscle activities of different hand movements (abduction of the fingers, abduction of the thumb, and flexion of the thumb) were recorded. One thousand simulations were calculated for each movement using the Latin hypercube sampling method with a corresponding variation of the muscle origin/insertion points and the cross-sectional area. Comparing the standard hand to simulations incorporating uncertainties of input parameters shows no major deviations in on- and off-set time point of muscle activities. About 60\% of simulations are located within a ± 30\% interval around the standard model concerning joint reaction forces. The comparison with the variation of the input data leads to the conclusion that the standard hand model is able to provide not over-scattered outcomes and, therefore, can be considered relatively stable. These results are of practical importance to the personalization of a musculoskeletal model with subject-specific bone geometries and hence changed muscle line of action.}, subject = {Biomechanik}, language = {en} } @inproceedings{AuerKubowitschKrutschetal., author = {Auer, Simon and Kubowitsch, Simone and Krutsch, Werner and Renkawitz, Tobias and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Effect of mental demand on knee forces in professional youth soccer players}, series = {ISBS Proceedings Archive}, volume = {38}, booktitle = {ISBS Proceedings Archive}, number = {1, Art. 28}, abstract = {Soccer is one of the most popular sports all around the world. It is an injurious type of sport with a focus on lower extremities and high psychological pressure during matches. The stressor is linked with injuries and an increased musculoskeletal loading. This study investigates the influence of cognitive stress on the load profile of the knee joint. Twelve professional youth soccer players performed highly dynamic runs with and without additional cognitive stress. The runs were analysed with a musculoskeletal simulation software. The data analysis shows no difference in knee joint reaction loading under additional mental stress compared to the baseline. Yet running times are significantly lower in the baseline. While there is no increase in the joint loads, the running times indicate an altered movement behaviour when the subjects are exposed to additional mental demand.}, subject = {Kniegelenk}, language = {en} } @article{ScheerKubowitschDendorferetal., author = {Scheer, Clara and Kubowitsch, Simone and Dendorfer, Sebastian and Jansen, Petra}, title = {Happy Enough to Relax? How Positive and Negative Emotions Activate Different Muscular Regions in the Back - an Explorative Study}, series = {Frontiers in Psychology}, volume = {Volume 12}, journal = {Frontiers in Psychology}, number = {May 2021}, publisher = {Frontiers Media}, issn = {1664-1078}, doi = {10.3389/fpsyg.2021.511746}, abstract = {Embodiment theories have proposed a reciprocal relationship between emotional state and bodily reactions. Besides large body postures, recent studies have found emotions to affect rather subtle bodily expressions, such as slumped or upright sitting posture. This study investigated back muscle activity as an indication of an effect of positive and negative emotions on the sitting position. The electromyography (EMG) activity of six back muscles was recorded in 31 healthy subjects during exposure to positive and negative affective pictures. A resting period was used as a control condition. Increased muscle activity patterns in the back were found during the exposure to negative emotional stimuli, which was mainly measured in the lumbar and thorax regions. The positive emotion condition caused no elevated activity. The findings show that negative emotions lead to increased differential muscle activity in the back and thus corroborate those of previous research that emotion affects subtle bodily expressions.}, language = {en} }