TY - JOUR A1 - Weber, Tim A. A1 - Dendorfer, Sebastian A1 - Grifka, Joachim A1 - Verkerke, Gijsbertus Jacob A1 - Renkawitz, Tobias ED - Takagi, Michiaki T1 - Does Computer-Assisted Femur First THR Improve Musculoskeletal Loading Conditions? JF - BioMed Research International N2 - 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. KW - Hüftgelenkprothese KW - Operationstechnik KW - Computerunterstütztes Verfahren KW - Bewegungsapparat KW - Mechanische Belastung Y1 - 2015 U6 - https://doi.org/10.1155/2015/625317 VL - 2015 SP - ID 625317 ER - TY - JOUR A1 - Weber, Tim A1 - Al-Munajjed, Amir Andreas A1 - Verkerke, Gijsbertus Jacob A1 - Dendorfer, Sebastian A1 - Renkawitz, Tobias T1 - Influence of minimally invasive total hip replacement on hip reaction forces and their orientations JF - Journal of Orthopaedic Research N2 - 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. KW - THA KW - THR KW - Biomechanics KW - Conventional surgery KW - Early recovery KW - Hüftgelenkprothese KW - Minimal-invasive Chirurgie KW - Biomechanik Y1 - 2014 U6 - https://doi.org/10.1002/jor.22710 VL - 32 IS - 12 SP - 1680 EP - 1687 ER - TY - JOUR A1 - Putzer, Michael A1 - Ehrlich, Ingo A1 - Rasmussen, John A1 - Gebbeken, Norbert A1 - Dendorfer, Sebastian T1 - Sensitivity of lumbar spine loading to anatomical parameters JF - Journal of Biomechanics N2 - 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. KW - Musculoskeletal simulation KW - Lumbar spine KW - Parameter study KW - Vertebra KW - Wirbelsäule KW - Belastung KW - Simulation Y1 - 2015 U6 - https://doi.org/10.1016/j.jbiomech.2015.11.003 VL - 49 IS - 6 SP - 953 EP - 958 PB - Elsevier Science ER - TY - JOUR A1 - Dendorfer, Sebastian A1 - Weber, Tim A1 - Kennedy, O. T1 - Musculoskeletal modeling for hip replacement outcome analyses and other applications JF - The Journal of the American Academy of Orthopaedic Surgeons KW - Hüftgelenkprothese KW - Bewegungsapparat KW - Simulation Y1 - 2014 U6 - https://doi.org/10.5435/JAAOS-22-04-268 VL - 22 IS - 4 SP - 268 EP - 269 ER - TY - CHAP A1 - Weber, Tim A. A1 - Dendorfer, Sebastian A1 - Dullien, Silvia A1 - Grifka, Joachim A1 - Verkerke, Gijsbertus Jacob A1 - Renkawitz, Tobias T1 - Measuring functional outcome after total hip replacement with subject-specific hip joint loading T2 - Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine N2 - 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. KW - total hip replacement KW - subject-specific musculoskeletal modeling KW - functional outcome KW - force pathways KW - force angles KW - critical hip joint loading KW - rim loading KW - cup loading KW - Hüftgelenkprothese KW - Biomechanik KW - Lastverteilung KW - Ganganalyse KW - Simulation Y1 - 2012 U6 - https://doi.org/10.1177/0954411912447728 VL - 226 IS - 12 SP - 939 EP - 946 ER - TY - JOUR A1 - Zellner, Johannes A1 - Hierl, Katja A1 - Mueller, Michael A1 - Pfeifer, Christian A1 - Berner, Arne A1 - Dienstknecht, Thomas A1 - Krutsch, Werner A1 - Geis, Sebastian A1 - Gehmert, Sebastian A1 - Kujat, Richard A1 - Dendorfer, Sebastian A1 - Prantl, Lukas A1 - Nerlich, Michael A1 - Angele, Peter ED - Gilbert, Jeremy T1 - Stem cell-based tissue-engineering for treatment of meniscal tears in the avascular zone JF - Journal of Biomedical Materials Research Part B Applied Biomaterials N2 - 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. KW - biomechanics KW - meniscus KW - scaffolds KW - stem cells KW - tissue engineering KW - Meniskusschaden KW - Tissue Engineering KW - Mesenchymzelle KW - Hyaluronsäure Y1 - 2013 U6 - https://doi.org/10.1002/jbm.b.32922 VL - 101 IS - 7 SP - 1133 EP - 1142 ER - TY - JOUR A1 - Lenich, Andreas A1 - Bachmeier, S. A1 - Dendorfer, Sebastian A1 - Mayr, E. A1 - Nerlich, Michael A1 - Füchtmeier, Bernd T1 - Development of a test system to analyze different hip fracture osteosyntheses under simulated walking JF - Biomedizinische Technik. Biomedical engineering N2 - 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. KW - biomechanical implant test KW - dynamic multiplanar loading KW - hip fractureg KW - implant migration KW - patient specific loading KW - Hüftgelenk KW - Knochenbruch KW - Osteosynthese KW - Bewegungsanalyse KW - Simulation Y1 - 2012 U6 - https://doi.org/10.1515/bmt-2011-0999 VL - 57 IS - 2 SP - 113 EP - 119 ER - TY - JOUR A1 - Wong, Christian A1 - Rasmussen, John A1 - Simonsen, Erik B. A1 - Hansen, Lone A1 - de Zee, Mark A1 - Dendorfer, Sebastian T1 - The Influence of Muscle Forces on the Stress Distribution in the Lumbar Spine JF - The Open Spine Journal N2 - 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. KW - Lumbar spine KW - Muscle influence KW - Inverse dynamics KW - Finite element analysis KW - Lendenwirbelsäule KW - Muskelkraft KW - Belastung KW - Finite-Elemente-Methode Y1 - 2011 U6 - https://doi.org/10.2174/1876532701103010021 VL - 3 IS - 1 SP - 21 EP - 26 ER - TY - JOUR A1 - Penzkofer, Rainer A1 - Barnsteiner, K. A1 - Dendorfer, Sebastian T1 - The influence of age, shoe type and kicking direction on the severity of head trauma JF - Journal of Forensic Biomechanics N2 - 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. KW - Head trauma KW - Biomechanics KW - Kicks KW - Kopfverletzung KW - Schädel-Hirn-Trauma KW - Einflussgröße Y1 - 2014 UR - https://www.longdom.org/open-access/the-influence-of-age-shoe-type-and-kicking-direction-on-the-severity-of-head-trauma-2090-2697-1000116.pdf U6 - https://doi.org/10.4172/2090-2697.1000116 VL - 5 IS - 1 ER - TY - JOUR A1 - Roldán, J.C. A1 - Moralis, A. A1 - Dendorfer, Sebastian A1 - Witte, J. A1 - Reicheneder, C. T1 - Controlled central advancement of the midface after Le Fort III osteotomy by a 3-point skeletal anchorage JF - The Journal of craniofacial surgery N2 - 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. KW - Mund-Kiefer-Gesichts-Chirurgie KW - Le Fort III KW - distraction KW - vector KW - anchorage KW - three-dimensional computed tomography analysis KW - Distraktion KW - Knochenbildung KW - Osteotomie KW - Dreidimensionale Bildverarbeitung KW - Computertomografie Y1 - 2011 U6 - https://doi.org/10.1097/SCS.0b013e318231fc8d VL - 22 IS - 6 SP - 2384 EP - 2386 ER -