O objetivo do presente trabalho foi avaliar a microarquitetura, caracterizando a rede de canais e o sistema lacunocanalicular, e também, as propriedades biomecânicas, do osso cortical de ratos Wistar tratados com Ácido Zoledrônico. Vinte e um ratos machos foram divididos da seguinte forma: 12 animais alocados no grupo de animais submetidos ao experimento no quarto mês de idade e 9 alocados no grupo de animais submetidos ao experimento no nono mês de idade. Dentro destes grupos, os mesmos foram divididos em grupos controle e teste, sendo que no grupo teste os animais receberam três doses, no esquema de 7,5 g/kg, semanalmente. Após o uso da medicação, três animais foram eutanasiados nos respectivos períodos, após a última dose: 14 dias, 42 dias e 75 dias. Todos os animais tiveram suas mandíbulas, tíbias e fêmures dissecados. As tíbias e mandíbulas foram descalcificadas e processadas para inclusão em parafina, enquanto que, os fêmures foram armazenados para os testes biomecânicos. Imagens histológicas digitalizadas, provenientes das mandíbulas e tíbias, foram analisadas utilizando o processo de segmentação interativa, acessando as características da microarquitetura da rede de canais. O processo de reconstrução tridimensional, para caracterização do sistema lacunocanalicular, foi realizado nos cortes seriados proveniente das tíbias. Os fêmures foram analisados com os ensaios de microdureza, compressão e flexão em três pontos. Os resultados revelaram que a microarquitetura da rede de canais não foi alterada nas mandíbulas, no entanto, nas tíbias, houve diferença significante apenas nos animais de 4 meses de idade, nos quesitos área dos canais (p 0.0031), desvio-padrão da área (p 0.0338), perímetro dos canais (p 0.0068), desvio padrão do perímetro (p 0.0297) e porcentagem de matriz (p 0.0235). Os testes biomecânicos revelaram resultados que indicavam uma melhora nas características analisadas, que foi correlacionada apenas com o aumento da idade e não com o uso do ácido zoledrônico. A visualização tridimensional possibilitou analisar a distribuição dos osteócitos e dos canais, caracterizando o sistema lacunocanalicular, e constatou-se que nos animais de 4 meses o uso da droga causou uma descontinuidade na estabilidade da distribuição dos osteócitos. Conclui-se que o ácido zoledrônico não interferiu na microarquitetura da rede de canais do osso cortical das mandíbulas, enquanto que nas tíbias, nos animais jovens, houve uma modificação na microarquitetura e no sistema lacunocanalicular, revelando uma topologia mais heterogênea quando comparadas ao grupo controle. As propriedades biomecânicas não sofreram alterações quanto ao uso da droga, sendo evidenciada melhora nos parâmetros analisados relacionada apenas ao aumento de idade nos animais. / The aim of this study was to evaluate the microstructure, characterizing the bone channels network and the lacunocanalicular system, also, the biomechanical properties of the cortical bone of Wistar rats treated with Zoledronic Acid. Twenty-one male rats were separated as follows: 4-month-old (12 animals) and 9 month-old (9 animals). For each age they were divided in control and test group, and the test group received a 7.5 g/kg dose of the drug, once a week, for 3 weeks. In the 4 month-old test group they were euthanized at 14, 42 and 75 days after the drug injection and in the 9-month-old test group they were sacrificed at 14 and 75 days after medication. All animals had their mandible, tibia and femur dissected, and then, the mandible and tibia were decalcified and embedded in paraffin, and, the femur were stored for mechanical tests. Histological images were analyzed through developed algorithms using the SCILAB mathematical environment, getting percentage of bone matrix, ROI areas, ROI perimeters, their standard deviations and Lacunarity, as well, the images were accessed and processed to tridimensional visualization, to characterize the lacunocanalicular system. The femurs were analyzed by microhardness, three point bending and compression testing. The results revealed that the bone channels network in the mandible was not affected by the drug, whereas the tibia in the 4-month-old animals revealed a statistical difference between control and test groups, with the test group revealing more heterogeneity in the channels topography, as seen in results of bone matrix (p=0.0235), ROI area (p=0.0031), ROI area standard-deviation (p=0.0338), ROI perimeter (p=0.0068) and ROI perimeter standard-deviation (p=0.0297). The biomechanical tests showed an increased in strength, and that this event was age-related and not depending on the use of the drug. The tridimensional visualization allowed to analyze the osteocyte distribution in relation to the channels position, characterizing the lacunocanalicular system, and, it was found that the 4-month-old animals the drug caused a discontinuity in the stability of osteocyte distribution. In conclusion, the zoledronic acid not interfere in the bone channels network in the cortical bone of the mandible, however, in the tibia of the young animals, theres been an alteration in bone channels network and in the lacunocanalicular system, revealing more heterogeneity in the topography in these animals. The biomechanical properties were not altered after the use of the drugs, and the increased in strength being age-related.

Proximal humerus fractures are the third most common fractures in the over-65 patient population and their stable fixation remains a key challenge in orthopaedic and trauma surgery. While Open Reduction Internal Fixation by plate has become a well-known treatment modality in the last few decades, clinical studies associate high complication rate with its use. The overall aim of this project was to create a computer-aided design framework for proximal humerus plates using a validated subject-specific humerus-plate finite element model. The framework consisted of three stages: (1) reverse engineering of bone and plate geometry, (2) creation and validation of a finite element model simulating the in vitro testing of the bone-implant construct and (3) parametric optimisation study of implant design using this model. In vitro biomechanical tests were conducted to not only compare the mechanical performance of three key commercially available proximal humerus plates (S3-, Fx- and PHILOS plate) but also the effect of different screw zones. Sixty-five humeri specimens with two-part surgical neck fractures were treated and grouped based on their different screw configurations. Extension, flexion, varus and valgus bending were applied in the cantilever fashion in the elastic tests whereas only varus bending was applied in the plastic tests. The load required to apply 5 mm displacement was measured to determine bone-plate construct stiffness. The S3 plate yielded the stiffest constructs and while the removal of the inferomedial support had the most impact on varus bending stiffness, type of medial support was important: inferomedial screws in the Fx plate achieved higher bending stiffness than blade insertion. Stability of constructs treated with the plate was an interplay of factors such as the plate’s and screws' number, orientation and position. Next, a subject-specific finite element model of the humerus-plate construct was successfully developed that simulated the stiffest of the constructs from the in vitro varus bending tests conducted in this project. The model was validated against the in vitro results. The validated model was then used to perform a parametric optimisation study where the combination of design parameters (height and divergence angle of S3 plate’s inferomedial screws) was determined that achieved optimum bone-plate construct stability (minimum fracture gap change). Out of the 538 designs tested, the optimum design (16o divergence angle and 33o height angle) yielded the lowest fracture gap change (0.156 mm) which was 4.686% lower than the standard finite element model while achieving 5.707% higher varus bending load (54.753 N). The validated model was also used to investigate the issue of using smooth pegs and threaded screws. Twenty-six models with different percentages of screw threading were run to compare their bone-plate construct stiffness. While threading the smooth pegs was found to increase the varus bending stiffness by up to 4.546%, it did not affect all screws equally. Finally, the successful completion of the optimisation study of screw orientation and the clinical investigation promises the implementation of the computational framework for a range of future multi-objective optimisation studies of multiple design parameters especially for the design of implants for other parts of the human body and also for investigations into other clinically relevant questions.

Filamentous fungi are important in an enormous variety of ways to our life, with examples ranging from bioremediation, through the food and drinks industry to human health. These organisms can form huge networks stretching metres and even kilometres. However, their mode of growth is by the extension of individual hyphal tips only a few microns in diameter. Tip growth is mediated by the incorporation of new wall building materials at the soft apex. Just how this process is controlled (in fungi and in cell elongation in other organisms) has been the subject of intense study over many years and has attracted considerable attention from mathematical modellers. In this thesis, we consider mathematical models of fungal tip growth that can be classified as either geometrical or biomechanical. In every model we examine, a 2-D axisymmetric semihemisphere-like curve represents half the medial section of fungal tip geometry. A geometrical model for the role of the Spitzenkorper in the tip growth was proposed by Bartnicki-Garcia et al (1989), where a number of problems with the mathematical derivation were pointed out by Koch (2001). A suggestion is given as an attempt to revise the derivation by introducing a relationship between arc length of a growing tip, deposition of wall-building materials and tip curvature. We also consider two types of geometrical models as proposed by Goriely et al (2005). The first type considers a relationship between the longitudinal curvature and the function used to model deposition of wall-building materials. For these types of models, a generalized formulae for the tip shape is introduced, which allows localization of deposition of wall-building materials to be examined. The second type considers a relationship between longitudinal and latitudinal curvatures and the function used to model deposition of wall-building materials. For these types of models, a new formulation of the function used to model deposition of wall-building materials is introduced. Finally, a biomechanical model as proposed by Goriely et al (2010). Varying arc length of the stretchable region on the tip suggests differences in geometry of tip shape and the effective pressure profile. The hypothesis of orthogonal growth is done by focusing only on the apex of a "germ tube". Following that, it suggests that material points on the tip appear to move in a direction perpendicular to the tip either when surface friction is increased or decreased.

Is osteoarthritis a fate unconditionally vested in genetic makeup, or are joints aggravated into inflammation by the way they are treated? Humans are a complicated conglomeration of experiences, decisions, and inheritance. Osteoarthritis, likewise, has evaded simplicity in any explanation of its causation, so it necessitates a multi-dimensional perspective. This research considers the relevance of Alexander Technique in filling a void in which treatment and management of osteoarthritis is not equally equipped to answer this multi-dimensional causation. Alexander Technique is classified as a movement therapy, but this does not quite encompass the mindset of it—that it is indeed largely a mindset about movement. More concisely, Alexander Technique emphasizes self-awareness about how a person uses his or her body to perform daily tasks. It is physical minimalism, and involves continual recognition of muscle tension along with the ability to let go of any tension that is burdensome and unnecessary. This technique has diminished pain and increased the ease of movement for those who have experienced it, even people with osteoarthritis. To build the argument that osteoarthritis can be hindered through a heightened consideration of how joints are treated, the initial component of this research investigated the vast amount of information already gleaned about the pathogenesis of this disease. The fields of physiology, genetics, immunology, and clinical practice already have much to share, and this knowledge has been combined with studies about the benefits and goals of Alexander Technique to discover the common ground of osteoarthritis treatment. The experimental component assesses the association of Alexander Technique to the minimization of pain from osteoarthritis. An online survey asks osteoarthritis cohorts about the history of their disease, the effect it has had on their pain levels and activities of daily living, and about the efficacy of their management strategies. Because each participant will be asked if he or she has received Alexander Technique lessons, the survey can be used to analyze each respondent’s experience of osteoarthritis with respect to that. It was found that participants who had received Alexander Technique lessons reported an average of one more pain-free day per week, and experienced diminished pain levels for daily physical activities such as walking. Management strategies also indicated the benefit of Alexander Technique; those who had taken lessons less frequently used pain and anti-inflammatory medications and were able to be more physically active than the unexposed group. No statistical significance was achieved from the data, largely owing to small sample size (Alexander Technique, n=12, no Alexander Technique, n=25). This study is a step in the direction of better osteoarthritis management, promoting prevention-minded awareness of joint use and providing preliminary fuel for more extensive research.

Intra-articular fractures (IAFs) often lead to poor outcomes, despite surgeons’ best efforts at reconstructing the fractured articular surface. The objective of articular fracture reduction is to improve joint congruity thereby lower articular contact pressure and minimize the risk of post-traumatic osteoarthritis (PTOA). Surgical fracture reductions performed using less invasive approaches (i.e., percutaneously) rely heavily upon C-arm fluoroscopy to judge articular surface congruity. Based on varied outcomes, it appears that the use of 2D imaging alone for this purpose may prove inadequate. Despite this, there has been little investigation into novel metrics for assessment of reduction quality. This work first explores seven methods for assessment of reduction quality (3 2D, 3 3D, and one biomechanical). The results indicate that metrics which take 3D measurement or joint biomechanics into account when characterizing reduction quality are more strongly correlated with PTOA development. A computer assisted surgery system, which provides up-to-date 3D fracture geometry and contact stress distributions intra-operatively, was developed. Its utility was explored in a series of ten cadaveric tibial plafond fracture reductions, where contact stresses and contact areas were compared in surgeries with vs. without biomechanical guidance. The use of biomechanical guidance caused an increase in surgical time and fluoroscopy usage (39% and 17%, respectively). However, it facilitated decreases in the mean and maximum contact stress by 0.7 and 1.5 MPa, respectively. Contact areas engaged at known deleterious levels (contact stress > 4.5 MPa) were also 44% lower in cases which used guidance. The findings of this work suggest that enhanced visualization of a fracture intra-operatively may facilitate improved long-term outcomes. Further development and study of this system is warranted.

Contexte: La mammographie est une modalité d’imagerie médicale à faible dose permettant la détection du cancer mammaire à un stade précoce. Lors de l'examen, le sein est comprimé entre deux plaques afin d'uniformiser son épaisseur et d'étaler les tissus. Cette compression améliore la qualité clinique de l'examen mais elle est également source d'inconfort chez les patientes. Bien que la mammographie soit la méthode de dépistage la plus efficace du cancer du sein, l’inconfort ressenti peut dissuader les femmes de passer cet examen. Par conséquent, une technique alternative de compression du sein prenant en compte le confort de la patiente, en plus de l’amélioration de la qualité d'image, présente un grand intérêt.Méthodes: Dans ce travail, nous avons proposé un nouvel environnement de simulation permettant l'évaluation de différentes techniques de compression du sein. La qualité de la compression a été caractérisée en termes de confort de la patiente, de la qualité d'image et de la dose glandulaire moyenne délivrée. Afin d'évaluer la déformation du sein lors de la compression, un modèle biomécanique par éléments finis du sein a été développé. Ce dernier a été calibré et évalué en utilisant des volumes IRM d'une volontaire dans trois configurations différentes (sur le dos, le ventre et de côté). Par ailleurs, la qualité d'image a été évaluée en utilisant un environnement de simulation d'imagerie auparavant validé pour la simulation de l'acquisition d'images en mammographie.Résultats: La capacité de notre modèle biomécanique à reproduire les déformations réelles des tissus a été évaluée. Tout d'abord, la géométrie du sein dans les trois configurations a été estimée en utilisant des matériaux Néo-Hookeens pour la modélisation des tissus mous. Les propriétés mécaniques des différents constituants du sein ont été estimés afin que les géométries du sein dans les positions couchée sur le ventre et couchée soient le plus proches possibles des mesures. La distance de Hausdorff entre les données estimées et les données mesurées est égale à 2.17 mm en position couché sur le ventre et 1.72 mm en position couché sur le dos. Le modèle a ensuite été évalué dans une troisième configuration sur le côté, avec une distance de Hausdorff étant alors égale à 6.14 mm. Cependant, nous avons été montré que le modèle Néo-Hookeen ne peut pas décrire intégralement le comportement mécanique riche des tissus mous. Par conséquent, nous avons introduit d'autres modèles de matériaux basés sur la fonction d'énergie de Gent. Cette dernière hypothèse a permis de réduire l'erreur maximale dans la configuration couchée sur le ventre et dos incliné d’environ 10 mm.Le couplage entre la simulation de la mécanique du sein et la simulation d'aquisition d'image nous ont permis d'effectuer deux études préliminaires. Dans la première étude, les différences entre les pelotes de compression standard rigide et flex ont été évaluées. Selon les simulations effectuées, l'utilisation de la pelote flex pour la compression du sein a le potentiel d'améliorer le confort de la patiente sans affecter la qualité de l'image ou la dose glandulaire moyenne.Dans la seconde étude, l'impact du positionnement du sein sur la mécanique globale de la compression mammaire a été étudié. Nos simulations confirment que rapprocher la pelote de compression de la cage thoracique peut augmenter l'inconfort de la patiente. Selon les données estimées, pour une même épaisseur du sein sous compression, la force appliqée au sein peut être s'accroitre de 150%.Conclusion: L'estimation réaliste de la géométrie du sein pour différentes configurations sous l'effet de la gravité, ainsi que les résultats conformes aux descriptions cliniques sur la compression du sein, ont confirmé l'interêt d'un environnement de simulation dans le cadre de nos études. / Background: Mammography is a specific type of breast imaging that uses low-dose X-rays to detect breast cancer at early stage. During the exam, the women breast is compressed between two plates in order to even out the breast thickness and to spread out the soft tissues. This compression improves the exam quality but can also be a source of discomfort. Though mammography is the most effective breast cancer screening method, the discomfort perceived during the exam might deter women from getting the test. Therefore, an alternative breast compression technique considering the patient comfort in addition to an improved clinical image quality is of large interest.Methods: In this work, a simulation environment allowing the evaluation of different breast compression techniques was put forward. The compression quality was characterized in terms of patient comfort, image quality and average glandular dose. To estimate the breast deformation under compression, a subject-specific finite element biomechanical model was developed. The model was calibrated and evaluated using MR images in three different breast configurations (supine, prone and supine tilted). On the other hand, image quality was assessed by using an already validated simulation framework. This framework was largely used to mimic image acquisitions in mammography.Findings: The capability of our breast biomechanical model to reproduce the real breast deformations was evaluated. To this end, the geometry estimates of the three breast configurations were computed using Neo-Hookean material models. The subject specific mechanical properties of each breast's structures were assessed, such as the best estimates of the supine and prone configurations were obtained. The Hausdorff distances between the estimated and the measured geometries were equal to 2.17 mm and 1.72 mm respectively. Then, the model was evaluated using a supine tilted configuration; with a Hausdorff distance of 6.14 mm was obtained in that case. However, we have showed that the Neo-Hookean strain energy function cannot totally describe the rich mechanical behavior of breast soft tissues. Therefore, alternative material models based on the Gent strain energy function were proposed. The latter assumption reduced the maximal error in supine tilted breast configuration by about 10 mm.The coupling between the simulations of the breast mechanics and the X-ray simulations allowed us to run two preliminary studies. In the first study, the differences between standard rigid and flex compression paddles were assessed. According to the performed simulations, using the flex paddle for breast compression may improve the patient comfort without affecting the image quality and the delivered average glandular dose.In the second study, the impact of breast positioning on the general compression mechanics was described. Our simulations confirm that positioning the paddle closer to the chest wall is suspected to increase the patient discomfort. Indeed, based on the estimated data, for the same breast thickness under compression, the force applied to the breast may increase by 150%.Conclusion: The good results we get for the estimation of breast deformation under gravity, as well as the conforming results on breast compression quality with the already published clinical statements, have shown the feasibility of such studies by the means of a simulation framework.

Computational modeling in the field of biomechanics is becoming increasingly popular and successful in practice for its ability to predict function and provide information that would otherwise be unobtainable. Through the application of these new and constantly improving methods, kinematics and joint contact characteristics in pathological conditions of femoroacetabular impingement (FAI) and total hip arthroplasty (THA) were studied using a lower extremity computational model. Patients presenting with FAI exhibit abnormal contact between the femoral neck and acetabular rim leading to surrounding tissue damage in daily use. THA is the replacement of both the proximal femur and acetabular region of the pelvis and is the most common surgical intervention for degenerative hip disorders. A combination of rigid osteoarticular anatomy and force vectors representing soft tissue structures were used in developing this model. Kinematics produced by healthy models were formally validated with experimental data from Burnfield et al. This healthy model was then modified to emulate the desired morphology of FAI and a THA procedure with a range of combined version (CV) angles. All soft tissue structures were maintained constant for each subsequent model. Data gathered from these models did not provide any significant differences between the kinematics of healthy and FAI but did show a large amount of variation in all THA kinematics including incidents of dislocation with cases of lower CV angles. With the results of these computational studies performed with this model, an increased understanding of hip morphology with regards to STS has been achieved.

In this study, a previously designed passive dynamic walker (PDW) is built out of aluminum and plastic. The aim of the study was to produce an asymmetrical PDW and to compare the results to a computer simulation to validate the mathematical model. It also aimed at identifying the limitations of using additive manufacturing to create components for a PDW as well as gain insights on asymmetric systems. Beginning with a five mass kneed model, parameters were varied to produce up to a nine mass kneed model solution. The nine mass model allows more variability in added mass locations and separates the zeroth, first, and second moments of inertia. To validate asymmetric gait, step length and step time of the prototype were compared to the simulation. The walker, unable to produce a steady gait, failed to match the asymmetric simulation. More than four times the amount of symmetric data was found compared to asymmetric data. Successful runs of symmetric gaits were approximately double than for asymmetric gaits. The reason for unequal successes is thought to be due to greater instability of asymmetric systems. This instability is thought to be due to inertia from a constant state of hanging motion. 3D printing proved useful in simplifying components and reducing waste but the polymers used did not have enough strength when mass was added to the system. Joining differing materials on the legs was difficult to keep in place. A smaller more robust design could solve these problems. This study focused on understanding physically asymmetric PDWs. These simple robots separate the neurological and mechanical controls of walking and are advantageous for studying physical parameters of human gait. Once a reliable asymmetric walker is built, further research could alter the foot shape or knee location to reverse the process, thus having a PDW walk symmetric. Once a walker is successfully reverted from walking asymmetrical to symmetrical, these parameters could be then applied to human subjects. An example of this would be for prosthetic foot design.

Remote area staff performing manual patient handling tasks in the absence of patient lifting hoists available in most health care settings are at an elevated risk of musculoskeletal injuries. The objective of this project was to identify the patient handling methods that have the lowest risk of injury. The patient handling task of lifting a patient from floor to a chair or wheelchair is a common task performed in a remote health care setting. The task was performed utilising three methods, these being: (1) heads/tails lift, (2) use of two Blue MEDesign?? slings and (3) use of a drawsheet. The task of the heads/tails lift was broken down into two distinctly separate subtasks: lifting from the (1) head and (2) tail ends of the patient load. These techniques were selected based on criteria including current practice, durability, portability, accessibility, ease of storage and cost to supply. Postural data were obtained using a Vicon 370 three - dimensional motion measurement and analysis system in the Biomechanics & Gait laboratory at the University of New South Wales. Forty reflective markers were placed on the subject to obtain the following joint angles: ankle, knee, hip, torso, shoulder, elbow, and wrist. The raw data were converted into the respective joint angles (Y, X, Z) for further analysis. The postural data was analysed using the University of Michigan???s Three-Dimensional Static Strength Prediction Program (3D SSPP) and the relative risk of injury was based on the following three values: (1) a threshold value of 3,400 N for compression force, (2) a threshold value of 500 N for shear force, and (3) population strength capability data. The effects on changes to the anthropometric data was estimated and analysed using the in-built anthropometric data contained within the 3D SSPP program for 6 separate lifter scenarios, these being male and female 5th, 50th and 95th percentiles. Changes to the patient load were estimated and analysed using the same computer software. Estimated compressive and shear forces were found to be lower with the drawsheet and tail component of the heads/tails lift in comparison to the use of the Blue MEDesign?? straps and head component of the heads/tails lift. The results obtained for the strength capability aspect of each of the lifts indicated a higher percentage of the population capable of both the drawsheet and tail end of the heads/tails lift. The relative risk of back injury for the lifters is distributed more evenly with the drawsheet lift as opposed to the heads/tails (tail) lift where risk is disproportionate with the heavier end being lifted. The use of lifter anthropometrics does not appear to be a realistic variable to base assumptions on which group of the population are capable of safely performing this task in a remote setting. This study advocates the use of the drawsheet lift in a remote setting based on the author???s experience and the biomechanical results obtained in this study. The drawsheet lift is both more accessible and provides a more acceptable risk when more than two patient handlers are involved, in comparison to the other lifts utilised lifting patients from floor to a chair.

Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2007.