Displaying publications 1 - 20 of 23 in total

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  1. Madfa AA, Kadir MR, Kashani J, Saidin S, Sulaiman E, Marhazlinda J, et al.
    Med Eng Phys, 2014 Jul;36(7):962-7.
    PMID: 24834856 DOI: 10.1016/j.medengphy.2014.03.018
    Different dental post designs and materials affect the stability of restoration of a tooth. This study aimed to analyse and compare the stability of two shapes of dental posts (parallel-sided and tapered) made of five different materials (titanium, zirconia, carbon fibre and glass fibre) by investigating their stress transfer through the finite element (FE) method. Ten three-dimensional (3D) FE models of a maxillary central incisor restored with two different designs and five different materials were constructed. An oblique loading of 100 N was applied to each 3D model. Analyses along the centre of the post, the crown-cement/core and the post-cement/dentine interfaces were computed, and the means were calculated. One-way ANOVAs followed by post hoc tests were used to evaluate the effectiveness of the post materials and designs (p=0.05). For post designs, the tapered posts introduced significantly higher stress compared with the parallel-sided post (p<0.05), especially along the centre of the post. Of the materials, the highest level of stress was found for stainless steel, followed by zirconia, titanium, glass fibre and carbon fibre posts (p<0.05). The carbon and glass fibre posts reduced the stress distribution at the middle and apical part of the posts compared with the stainless steel, zirconia and titanium posts. The opposite results were observed at the crown-cement/core interface.
  2. Kaplan E, Baygin M, Barua PD, Dogan S, Tuncer T, Altunisik E, et al.
    Med Eng Phys, 2023 May;115:103971.
    PMID: 37120169 DOI: 10.1016/j.medengphy.2023.103971
    PURPOSE: The classification of medical images is an important priority for clinical research and helps to improve the diagnosis of various disorders. This work aims to classify the neuroradiological features of patients with Alzheimer's disease (AD) using an automatic hand-modeled method with high accuracy.

    MATERIALS AND METHOD: This work uses two (private and public) datasets. The private dataset consists of 3807 magnetic resonance imaging (MRI) and computer tomography (CT) images belonging to two (normal and AD) classes. The second public (Kaggle AD) dataset contains 6400 MR images. The presented classification model comprises three fundamental phases: feature extraction using an exemplar hybrid feature extractor, neighborhood component analysis-based feature selection, and classification utilizing eight different classifiers. The novelty of this model is feature extraction. Vision transformers inspire this phase, and hence 16 exemplars are generated. Histogram-oriented gradients (HOG), local binary pattern (LBP) and local phase quantization (LPQ) feature extraction functions have been applied to each exemplar/patch and raw brain image. Finally, the created features are merged, and the best features are selected using neighborhood component analysis (NCA). These features are fed to eight classifiers to obtain highest classification performance using our proposed method. The presented image classification model uses exemplar histogram-based features; hence, it is called ExHiF.

    RESULTS: We have developed the ExHiF model with a ten-fold cross-validation strategy using two (private and public) datasets with shallow classifiers. We have obtained 100% classification accuracy using cubic support vector machine (CSVM) and fine k nearest neighbor (FkNN) classifiers for both datasets.

    CONCLUSIONS: Our developed model is ready to be validated with more datasets and has the potential to be employed in mental hospitals to assist neurologists in confirming their manual screening of AD using MRI/CT images.

  3. Al-Atabi M, Ooi RC, Luo XY, Chin SB, Bird NC
    Med Eng Phys, 2012 Oct;34(8):1177-83.
    PMID: 22217515 DOI: 10.1016/j.medengphy.2011.12.006
    Computational fluid dynamic (CFD) simulations of the three-dimensional flow structures in realistic cystic ducts have been performed to obtain quantitative readings of the flow parameters to compare with clinical measurements. Resin casts of real patients' cystic ducts lumen that possess representative anatomical features were scanned to obtain three-dimensional flow domains that were used in the numerical analysis. The convoluting nature of the studied cystic ducts resulted in strong secondary flow that contributed towards a dimensionless pressure drop that is four times higher than those of a straight circular tube of an equivalent length and average diameter. The numerical pressure drop results across the cystic duct compared very well with those obtained from clinical observations which indicate that CFD is an appropriate tool to investigate the flow and functions of the biliary system. From the hydrodynamic point of view, the cystic duct lumen seems to serve as a passive resistor that strives to provide a constant amount of resistance to control the flow of bile out of the gallbladder. This is mainly achieved by the coupling of the secondary flow effects and bile rheology to provide flow resistance.
  4. Marconi G, Gopalai AA, Chauhan S
    Med Eng Phys, 2023 Feb;112:103951.
    PMID: 36842774 DOI: 10.1016/j.medengphy.2023.103951
    Powered ankle-foot orthoses can be utilised to overcome gait abnormalities such as foot drop; however, normal gait is rarely restored with compensatory gait patterns arising and prevalence of gait asymmetry. Therefore, this study aims to determine the effect of orthosis mass and mass distribution on the swing phase of gait, to understand residual gait asymmetry with orthosis use. Using a triple compound pendulum model, which accounts for mass distribution of the limb and orthosis, the swing phase of gait is simulated in terms of natural dynamics and the effect of an orthosis on kinematic parameters is quantitatively determined. It was found that additional mass causes faster and shorter steps on the affected side due to rapid knee extension and reduced hip flexion, with particular actuator positions and natural cadence causing varying severity of these effects. Our study suggests that this model could be used as a preliminary design tool to identify subject specific optimum orthosis mass distribution of a powered ankle-foot orthosis, without the need for motion data or experimental trials. This optimisation intends to more accurately mimic natural swing phase kinematics, consequently allowing for the reduction in severity of gait asymmetry and the potential to improve rehabilitative outcomes.
  5. Lim KO, Cheong KC
    Med Eng Phys, 1994 Nov;16(6):526-30.
    PMID: 7858787
    In the fabrication of a bioprosthetic heart valve from bovine pericardial tissues, the tissues are subjected to suturing. The stress-strain response of sutured as well as unsutured strips of this tissue were examined. The stress-strain response was determined using a tensile-testing machine. It was found that suturing weakens the tissue in that sutured strips are more extensible, exhibit a lower stress at rupture and a lower final elastic modulus. In addition, it was also found that the bigger the suture/needle size used the greater the decrease in tissue strength. In all, tissue strength was observed to decrease by 22 to 59% in this study. The weakening of the tissue is attributed to the puncture holes created by the surgeon's needle which create regions of weakness. This response of bovine pericardial tissue to suturing should be given due consideration in the fabrication of a bioprosthetic heart valve using this tissue.
  6. Braz GP, Russold MF, Fornusek C, Hamzaid NA, Smith RM, Davis GM
    Med Eng Phys, 2016 11;38(11):1223-1231.
    PMID: 27346492 DOI: 10.1016/j.medengphy.2016.06.007
    This pilot study reports the development of a novel closed-loop (CL) FES-gait control system, which employed a finite-state controller that processed kinematic feedback from four miniaturized motion sensors. This strategy automated the control of knee extension via quadriceps and gluteus stimulation during the stance phase of gait on the supporting leg, and managed the stimulation delivered to the common peroneal nerve (CPN) during swing-phase on the contra-lateral limb. The control system was assessed against a traditional open-loop (OL) system on two sensorimotor 'complete' paraplegic subjects. A biomechanical analysis revealed that the closed-loop control of leg swing was efficient, but without major advantages compared to OL. CL automated the control of knee extension during the stance phase of gait and for this reason was the method of preference by the subjects. For the first time, a feedback control system with a simplified configuration of four miniaturized sensors allowed the addition of instruments to collect the data of multiple physiological and biomechanical variables during FES-evoked gait. In this pilot study of two sensorimotor complete paraplegic individuals, CL ameliorated certain drawbacks of current OL systems - it required less user intervention and accounted for the inter-subject differences in their stimulation requirements.
  7. Ibitoye MO, Hamzaid NA, Hasnan N, Abdul Wahab AK, Islam MA, Kean VS, et al.
    Med Eng Phys, 2016 Aug;38(8):767-75.
    PMID: 27289541 DOI: 10.1016/j.medengphy.2016.05.012
    The interaction between muscle contractions and joint loading produces torques necessary for movements during activities of daily living. However, during neuromuscular electrical stimulation (NMES)-evoked contractions in persons with spinal cord injury (SCI), a simple and reliable proxy of torque at the muscle level has been minimally investigated. Thus, the purpose of this study was to investigate the relationships between muscle mechanomyographic (MMG) characteristics and NMES-evoked isometric quadriceps torques in persons with motor complete SCI. Six SCI participants with lesion levels below C4 [(mean (SD) age, 39.2 (7.9) year; stature, 1.71 (0.05) m; and body mass, 69.3 (12.9) kg)] performed randomly ordered NMES-evoked isometric leg muscle contractions at 30°, 60° and 90° knee flexion angles on an isokinetic dynamometer. MMG signals were detected by an accelerometer-based vibromyographic sensor placed over the belly of rectus femoris muscle. The relationship between MMG root mean square (MMG-RMS) and NMES-evoked torque revealed a very high association (R(2)=0.91 at 30°; R(2)=0.98 at 60°; and R(2)=0.97 at 90° knee angles; P<0.001). MMG peak-to-peak (MMG-PTP) and stimulation intensity were less well related (R(2)=0.63 at 30°; R(2)=0.67 at 60°; and R(2)=0.45 at 90° knee angles), although were still significantly associated (P≤0.006). Test-retest interclass correlation coefficients (ICC) for the dependent variables ranged from 0.82 to 0.97 for NMES-evoked torque, between 0.65 and 0.79 for MMG-RMS, and from 0.67 to 0.73 for MMG-PTP. Their standard error of measurements (SEM) ranged between 10.1% and 31.6% (of mean values) for torque, MMG-RMS and MMG-PTP. The MMG peak frequency (MMG-PF) of 30Hz approximated the stimulation frequency, indicating NMES-evoked motor unit firing rate. The results demonstrated knee angle differences in the MMG-RMS versus NMES-isometric torque relationship, but a similar torque related pattern for MMG-PF. These findings suggested that MMG was well associated with torque production, reliably tracking the motor unit recruitment pattern during NMES-evoked muscle contractions. The strong positive relationship between MMG signal and NMES-evoked torque production suggested that the MMG might be deployed as a direct proxy for muscle torque or fatigue measurement during leg exercise and functional movements in the SCI population.
  8. Gouwanda D, Gopalai AA
    Med Eng Phys, 2015 Feb;37(2):219-25.
    PMID: 25619613 DOI: 10.1016/j.medengphy.2014.12.004
    Gait events detection allows clinicians and biomechanics researchers to determine timing of gait events, to estimate duration of stance phase and swing phase and to segment gait data. It also aids biomedical engineers to improve the design of orthoses and FES (functional electrical stimulation) systems. In recent years, researchers have resorted to using gyroscopes to determine heel-strike (HS) and toe-off (TO) events in gait cycles. However, these methods are subjected to significant delays when implemented in real-time gait monitoring devices, orthoses, and FES systems. Therefore, the work presented in this paper proposes a method that addresses these delays, to ensure real-time gait event detection. The proposed algorithm combines the use of heuristics and zero-crossing method to identify HS and TO. Experiments involving: (1) normal walking; (2) walking with knee brace; and (3) walking with ankle brace for overground walking and treadmill walking were designed to verify and validate the identified HS and TO. The performance of the proposed method was compared against the established gait detection algorithms. It was observed that the proposed method produced detection rate that was comparable to earlier reported methods and recorded reduced time delays, at an average of 100 ms.
  9. Ramlee MH, Kadir MR, Murali MR, Kamarul T
    Med Eng Phys, 2014 Oct;36(10):1322-30.
    PMID: 25127377 DOI: 10.1016/j.medengphy.2014.05.015
    Pilon fractures are commonly caused by high energy trauma and can result in long-term immobilization of patients. The use of an external fixator i.e. the (1) Delta, (2) Mitkovic or (3) Unilateral frame for treating type III pilon fractures is generally recommended by many experts owing to the stability provided by these constructs. This allows this type of fracture to heal quickly whilst permitting early mobilization. However, the stability of one fixator over the other has not been previously demonstrated. This study was conducted to determine the biomechanical stability of these external fixators in type III pilon fractures using finite element modelling. Three-dimensional models of the tibia, fibula, talus, calcaneus, navicular, cuboid, three cuneiforms and five metatarsal bones were reconstructed from previously obtained CT datasets. Bones were assigned with isotropic material properties, while the cartilage was assigned as hyperelastic springs with Mooney-Rivlin properties. Axial loads of 350 N and 70 N were applied at the tibia to simulate the stance and the swing phase of a gait cycle. To prevent rigid body motion, the calcaneus and metatarsals were fixed distally in all degrees of freedom. The results indicate that the model with the Delta frame produced the lowest relative micromovement (0.03 mm) compared to the Mitkovic (0.05 mm) and Unilateral (0.42 mm) fixators during the stance phase. The highest stress concentrations were found at the pin of the Unilateral external fixator (509.2 MPa) compared to the Mitkovic (286.0 MPa) and the Delta (266.7 MPa) frames. In conclusion, the Delta external fixator was found to be the most stable external fixator for treating type III pilon fractures.
  10. Ramlee MH, Kadir MR, Murali MR, Kamarul T
    Med Eng Phys, 2014 Oct;36(10):1358-66.
    PMID: 25092623 DOI: 10.1016/j.medengphy.2014.07.001
    Subtalar dislocation is a rare injury caused by high-energy trauma. Current treatment strategies include leg casts, internal fixation and external fixation. Among these, external fixators are the most commonly used as this method is believed to provide better stabilization. However, the biomechanical stability provided by these fixators has not been demonstrated. This biomechanical study compares two commonly used external fixators, i.e. Mitkovic and Delta. CT imaging data were used to reconstruct three-dimensional models of the tibia, fibula, talus, calcaneus, navicular, cuboid, three cuneiforms and five metatarsal bones. The 3D models of the bones and cartilages were then converted into four-noded linear tetrahedral elements, whilst the ligaments were modelled with linear spring elements. Bones and cartilage were idealized as homogeneous, isotropic and linear. To simulate loading during walking, axial loading (70 N during the swing and 350 N during the stance phase) was applied at the end of diaphyseal tibia. The results demonstrate that the Mitkovic fixator produced greater displacement (peak 3.0mm and 15.6mm) compared to the Delta fixator (peak 0.8mm and 3.9 mm), in both the swing and stance phase, respectively. This study demonstrates that the Delta external fixator provides superior stability over the Mitkovic fixator. The Delta fixator may be more effective in treating subtalar dislocation.
  11. Bajuri MN, Kadir MR, Raman MM, Kamarul T
    Med Eng Phys, 2012 Nov;34(9):1294-302.
    PMID: 22277308 DOI: 10.1016/j.medengphy.2011.12.020
    Understanding the pathomechanics involved in rheumatoid arthritis (RA) of the wrist provides valuable information, which will invariably allow various therapeutic possibilities to be explored. The computational modelling of this disease permits the appropriate simulation to be conducted seamlessly. A study that underpins the fundamental concept that produces the biomechanical changes in a rheumatoid wrist was thus conducted through the use of finite element method. The RA model was constructed from computed tomography datasets, taking into account three major characteristics: synovial proliferation, cartilage destruction and ligamentous laxity. As control, a healthy wrist joint model was developed in parallel and compared. Cartilage was modelled based on the shape of the articulation while the ligaments were modelled with linear spring elements. A load-controlled analysis was performed simulating physiological hand grip loading conditions. The results demonstrated that the diseased model produced abnormal wrist extension and stress distribution as compared to the healthy wrist model. Due to the weakening of the ligaments, destruction of the cartilage and lower bone density, the altered biomechanical stresses were particularly evident at the radioscaphoid and capitolunate articulations which correlate to clinical findings. These results demonstrate the robust finding of the developed RA wrist model, which accurately predicted the pathological process.
  12. Faruque MR, Islam MT, Misran N
    Med Eng Phys, 2011 Jun;33(5):646-52.
    PMID: 21216175 DOI: 10.1016/j.medengphy.2010.12.004
    The purpose of this paper is to calculate the specific absorption rate (SAR) reduction in a muscle cube with metamaterial attachment. The finite-difference time-domain (FDTD) method has been used to evaluate the SAR in a realistic anatomically based model of the muscle cube. In this paper, we have designed the single-negative metamaterials from a periodic arrangement of split ring resonators (SRRs). By properly designing the structural parameter of the SRRs, the effective medium parameter can be tuned negative at the 900 MHz and 1800 MHz bands. Numerical results concerning the SAR values in the muscle cube in the presence of resonators exhibit significant SAR reduction. These results can provide useful information when designing safety-compliant mobile communication equipment.
  13. Abdullah AH, Todo M, Nakashima Y
    Med Eng Phys, 2017 06;44:8-15.
    PMID: 28373012 DOI: 10.1016/j.medengphy.2017.03.006
    Femoral bone fracture is one of the main causes for the failure of hip arthroplasties (HA). Being subjected to abrupt and high impact forces in daily activities may lead to complex loading configuration such as bending and sideway falls. The objective of this study is to predict the risk of femoral bone fractures in total hip arthroplasty (THA) and resurfacing hip arthroplasty (RHA). A computed tomography (CT) based on finite element analysis was conducted to demonstrate damage formation in a three dimensional model of HAs. The inhomogeneous model of femoral bone was constructed from a 79 year old female patient with hip osteoarthritis complication. Two different femoral components were modeled with titanium alloy and cobalt chromium and inserted into the femoral bones to present THA and RHA models respectively. The analysis included six configurations, which exhibited various loading and boundary conditions, including axial compression, torsion, lateral bending, stance and two types of falling configurations. The applied hip loadings were normalized to body weight (BW) and accumulated from 1 BW to 3 BW. Predictions of damage formation in the femoral models were discussed as the resulting tensile failure as well as the compressive yielding and failure elements. The results indicate that loading directions can forecast the pattern and location of fractures at varying magnitudes of loading. Lateral bending configuration experienced the highest damage formation in both THA and RHA models. Femoral neck and trochanteric regions were in a common location in the RHA model in most configurations, while the predicted fracture locations in THA differed as per the Vancouver classification.
  14. Tiang KL, Ooi EH
    Med Eng Phys, 2016 Aug;38(8):776-84.
    PMID: 27340100 DOI: 10.1016/j.medengphy.2016.05.011
    The majority of the eye models developed in the late 90s and early 00s considers only heat conduction inside the eye. This assumption is not entirely correct, since the anterior and posterior chambers are filled aqueous humor (AH) that is constantly in motion due to thermally-induced buoyancy. In this paper, a three-dimensional model of the human eye is developed to investigate the effects AH hydrodynamics have on the human eye temperature under exposure to external heat sources. If the effects of AH flow are negligible, then future models can be developed without taking them into account, thus simplifying the modeling process. Two types of external thermal loads are considered; volumetric and surface irradiation. Results showed that heat convection due to AH flow contributes to nearly 95% of the total heat flow inside the anterior chamber. Moreover, the circulation inside the anterior chamber can cause an upward shift of the location of hotspot. This can have significant consequences to our understanding of heat-induced cataractogenesis.
  15. Yip WP, Kho ASK, Ooi EH, Ooi ET
    Med Eng Phys, 2023 Feb;112:103950.
    PMID: 36842773 DOI: 10.1016/j.medengphy.2023.103950
    No-touch bipolar radiofrequency ablation (bRFA) is known to produce incomplete tumour ablation with a 'butterfly-shaped' coagulation zone when the interelectrode distance exceeds a certain threshold. Although non-confluent coagulation zone can be avoided by not implementing the no-touch mode, doing so exposes the patient to the risk of tumour track seeding. The present study investigates if prior infusion of saline into the tissue can overcome the issues of non-confluent or butterfly-shaped coagulation. A computational modelling approach based on the finite element method was carried out. A two-compartment model comprising the tumour that is surrounded by healthy liver tissue was developed. Three cases were considered; i) saline infusion into the tumour centre; ii) one-sided saline infusion outside the tumour; and iii) two-sided saline infusion outside the tumour. For each case, three different saline volumes were considered, i.e. 6, 14 and 22 ml. Saline concentration was set to 15% w/v. Numerical results showed that saline infusion into the tumour centre can overcome the butterfly-shaped coagulation only if the infusion volume is sufficient. On the other hand, one-sided infusion outside the tumour did not overcome this. Two-sided infusion outside the tumour produced confluent coagulation zone with the largest volume. Results obtained from the present study suggest that saline infusion, when carried out correctly, can be used to effectively eradicate liver cancer. This presents a practical solution to address non-confluent coagulation zone typical of that during two-probe bRFA treatment.
  16. Yusoff N, Abu Osman NA, Pingguan-Murphy B
    Med Eng Phys, 2011 Jul;33(6):782-8.
    PMID: 21356602 DOI: 10.1016/j.medengphy.2011.01.013
    A mechanical-conditioning bioreactor has been developed to provide bi-axial loading to three-dimensional (3D) tissue constructs within a highly controlled environment. The computer-controlled bioreactor is capable of applying axial compressive and shear deformations, individually or simultaneously at various regimes of strain and frequency. The reliability and reproducibility of the system were verified through validation of the spatial and temporal accuracy of platen movement, which was maintained over the operating length of the system. In the presence of actual specimens, the system was verified to be able to deliver precise bi-axial load to the specimens, in which the deformation of every specimen was observed to be relatively homogeneous. The primary use of the bioreactor is in the culture of chondrocytes seeded within an agarose hydrogel while subjected to physiological compressive and shear deformation. The system has been designed specifically to permit the repeatable quantification and characterisation of the biosynthetic activity of cells in response to a wide range of short and long term multi-dimensional loading regimes.
  17. Haron S, Ray AK
    Med Eng Phys, 2006 Dec;28(10):978-81.
    PMID: 17018258
    A three layer waveguiding silicon dioxide (SiO(2))/silicon nitride (Si(3)N(4))/SiO(2) structure on silicon substrate was proposed as an optically efficient biosensor for calibration of heavy metal ions in drinking water. The catalytic activities of urease and acetylcholine esterase (AchE) were inhibited by the presence of cadmium (Cd(2+)) and lead (Pb(2+)) ions. The detection limit as low as 1 ppb was achieved by employing the technique of total reflection at the interface between the Si(3)N(4) core and composite polyelectrolyte self-assembled (PESA) membranes containing cyclotetrachromotropylene (CTCT) as an indicator.
  18. Abu Osman NA, Spence WD, Solomonidis SE, Paul JP, Weir AM
    Med Eng Phys, 2010 Sep;32(7):760-5.
    PMID: 20678997 DOI: 10.1016/j.medengphy.2010.04.020
    The purpose of this investigation was to vary the load on the patellar tendon bar and to study the subsequent effect this has on the pattern of the pressure distribution at the stump-socket interface. Ten male subjects from the Southern General Hospital in Glasgow, UK participated in this study. Measuring systems utilising strain gauge and electrohydraulic technologies were designed, developed and constructed to enable pressure measurements to be conducted. One transducer, the patellar tendon (PT) transducer, was attached to the patellar tendon bar of the socket such that the patellar tendon bar was capable of being translated by +/-10 mm towards or away from the tendon. The results of this study showed that the position of the patellar tendon bar had no significant effect on the pressure distribution around the socket indicating that it is an unnecessary feature, which, we propose, may be eliminated during manufacture of a trans-tibial socket.
  19. Law JX, Musa F, Ruszymah BH, El Haj AJ, Yang Y
    Med Eng Phys, 2016 Sep;38(9):854-61.
    PMID: 27349492 DOI: 10.1016/j.medengphy.2016.05.017
    Collagen and fibrin are widely used in tissue engineering due to their excellent biocompatibility and bioactivities that support in vivo tissue formation. These two hydrogels naturally present in different wound healing stages with different regulatory effects on cells, and both of them are mechanically weak in the reconstructed hydrogels. We conducted a comparative study by the growth of rat dermal fibroblasts or dermal fibroblasts and epidermal keratinocytes together in collagen and fibrin constructs respectively with and without the reinforcement of electrospun poly(lactic acid) nanofiber mesh. Cell proliferation, gel contraction and elastic modulus of the constructs were measured on the same gels at multiple time points during the 22 day culturing period using multiple non-destructive techniques. The results demonstrated considerably different cellular activities within the two types of constructs. Co-culturing keratinocytes with fibroblasts in the collagen constructs reduced the fibroblast proliferation, collagen contraction and mechanical strength at late culture point regardless of the presence of nanofibers. Co-culturing keratinocytes with fibroblasts in the fibrin constructs promoted fibroblast proliferation but exerted no influence on fibrin contraction and mechanical strength. The presence of nanofibers in the collagen and fibrin constructs played a favorable role on the fibroblast proliferation when keratinocytes were absent. Thus, this study exhibited new evidence of the strong cross-talk between keratinocytes and fibroblasts, which can be used to control fibroblast proliferation and construct contraction. This cross-talk activity is extracellular matrix-dependent in terms of the fibrous network morphology, density and strength.
  20. Harith H, Schmutz B, Malekani J, Schuetz MA, Yarlagadda PK
    Med Eng Phys, 2016 Mar;38(3):280-5.
    PMID: 26739124 DOI: 10.1016/j.medengphy.2015.11.012
    Anatomically precontoured plates are commonly used to treat periarticular fractures. A well-fitting plate can be used as a tool for anatomical reduction of the fractured bone. Recent studies highlighted that some plates fit poorly for many patients due to considerable shape variations between bones of the same anatomical site. While it is impossible to design one shape that fits all, it is also burdensome for the manufacturers and hospitals to produce, store and manage multiple plate shapes without the certainty of utilization by a patient population. In this study, we investigated the number of shapes required for maximum fit within a given dataset, and if they could be obtained by manually deforming the original plate. A distal medial tibial plate was automatically positioned on 45 individual tibiae, and the optimal deformation was determined iteratively using finite element analysis simulation. Within the studied dataset, we found that: (i) 89% fit could be achieved with four shapes, (ii) 100% fit was impossible through mechanical deformation, and (iii) the deformations required to obtain the four plate shapes were safe for the stainless steel plate for further clinical use. The proposed framework is easily transferable to other orthopaedic plates.
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