Orthopedics Commons^™

An Investigation Of Pelvic Kinematics And Implications For Total Hip Arthroplasty, Kathryn Holland Colone

Electronic Theses and Dissertations

Total hip arthroplasty (THA) is one of the most commonly performed orthopaedic procedures, with approximately 500,000 surgeries performed annually in the United States alone. Although THA is widely regarded as highly successful, postoperative complications persist, highlighting the multifactorial nature of THA outcomes. Previous studies have demonstrated the importance of implant positioning and soft tissue mechanics, yet challenges remain in optimizing surgical decisions on a patient-specific basis. Recent advances in surgical planning tools have shifted the focus of preoperative planning toward optimizing patient-specific outcomes, highlighting the need to better understand how patient anatomy, surgical technique, and joint mechanics interact to influence …

Modeling Structural Support To Facilitate Novel Treatments Of Degenerative Disc Disease, Jose Luis Calderon

Poster Presentations

Over 600 million people worldwide suffered from low back pain in 2020, with projections for 2050 being over 800 million [1]. Annual costs associated with low back pain total over 450 billion dollars in the US alone [2]. This research serves as a proof-of-concept for the use of structural supports to facilitate intervertebral disc healing. This treatment would involve the implementation of these supports along with existing injection treatments to promote regeneration. In both models, along with the combined model, the ability for these supports to alleviate intervertebral disc height loss is shown. This indicates that these supports would serve …

Orthopedic Bone Drill, Logan G. Schmid, Matthew T. Wold, May Geng

Biomedical Engineering

This project aims to design a bone drill for orthopedic procedures which alleviates the heat generated in the bone during drilling.

3d-Printed Alginate Scaffolds Incorporated With Synergistic Strontium/Magnesium - Doped Bioglass Nanoparticles For Bone Regeneration: An In Vivo Evaluation In Rabbit Cranial Defects, Mehraneh Movahedi Aliabadi, Afsaneh Jahani, Seyed Majdoddin Vahidi Toorchi, Ali Moradi, Mohammad Hossein Ebrahimzadeh, Fatemeh Kalalinia, Farkhonde Sarhaddi, Lobat Tayebi, Nafiseh Jirofti

Electrical & Computer Engineering Faculty Publications

Nonunion fractures remain a major orthopedic challenge, highlighting the need for improved bone tissue engineering (BTE) strategies. This study hypothesized that incorporating Sr/Mg-doped 58S bioglass nanoparticles into 3D-printed alginate (Alg) scaffolds would improve their physicochemical, mechanical, and biological properties and enhance bone regeneration. Structural characterization showed that Sr/Mg-doping reduced bioglass size and produced interconnected porous scaffolds. Under wet conditions, Alg scaffold incorporating 2.5%Sr/Mg-doped 58S bioglass showed the highest Young’s modulus (0.4356 ± 0.0244 MPa), whereas under dry conditions, the Alg scaffold incorporating 5%Sr/Mg-doped 58S bioglass achieved the highest value (0.1945 ± 0.0519 MPa). In vitro studies demonstrated biocompatibility and enhanced …

Synthesis And Characterization Of Glass-Ceramic Nanoparticles And Nanobubbles For Integration Into Bone Regenerative Biomaterials, Sun Latt

Honors Undergraduate Theses

Osteoporosis affects over 200 million individuals worldwide and is characterized by an imbalance between osteoclastic bone resorption and osteoblastic bone formation, leading to fragility fractures that significantly diminish quality of life. Current clinical bone cements, such as poly(methyl methacrylate), are limited by poor osseointegration, toxic monomers, and an inability to address the underlying pathophysiology of osteoporosis. This work presents the synthesis, characterization, and systematic in vitro evaluation of a sol-gel-derived, magnesium-incorporated glass-ceramic (GC) nanoparticle within the CaO-MgO-SiO₂ system for incorporation into a novel hydrogel bone cement and bioresorbable magnesium implants. XRD confirmed a biphasic amorphous-crystalline diopside composition, and TEM …

A Chicken Model For Non-Invasive Diagnosis Of Infant Developmental Dysplasia Of The Hip (Ddh) Using Acoustic Transmission Measurements, Aliza Shah

Honors Undergraduate Theses

Developmental dysplasia of the hip (DDH) is a condition characterized by abnormal development and stability of the hip joint. In a healthy infant, the femoral head (ball) fits securely within the acetabulum (socket of the pelvis), allowing for proper joint function. In DDH, the relationship is disrupted, ranging from mild acetabular dysplasia to partial (subluxation) or complete dislocation of the femoral head. This condition represents a range of structural abnormalities that develop during early growth. The integrity of the hip joint is essential for physical mobility, and disruption of this structure can lead to significant functional impairment. DDH may result …

Recreating Fiber Recruitment With Fiber Recruitment Using Additive Manufacturing, Natalia D. Mciver

Biomedical Engineering ETDs

Injured ligaments are often repaired with tendon grafts which may over or under constrain the joint; there is a need for an artificial graft option with the mechanical properties of a native ligament. Crimped fibers within ligaments allow for recruitment which means the viscoelastic properties of stress relaxation and creep are not inversely related. A feasibility study using ACLs and large-scale crimp models to study viscoelasticity, led to an in-depth analysis of the scapholunate interosseous ligament. Using the Modified Kelvin spring-dashpot model, for describing viscoelasticity with a variable stiffness property (time dependent fiber recruitment), we defined the relationship between creep …

A Human Factors Analysis And Classification System (Hfacs) Approach To Compare Cardiovascular, Orthopedics, Trauma Care, And Neurosurgery, Asfandyar Khan

Doctoral Dissertations and Master's Theses

Background: Despite significant progress in patient safety, human error continues to occur at high rates in procedural settings. Traditional safety models tend to focus on retrospective incident analysis, often overlooking the systemic conditions that allow errors to occur. The Human Factors Analysis and Classification System (HFACS) offers a proactive lens to understand how and where errors emerge and is useful for identifying active and latent failures.

Objective: To evaluate the utility and reliability of the Human Factors Analysis and Classification System (HFACS) in categorizing and comparing the pattern of frequencies (events) in cardiovascular, orthopedic, trauma care, and neurosurgical procedure.

Design, …

Surgeon Ergonomics While Performing Total Knee Arthroplasty, Cameron Dahman

Electronic Theses and Dissertations

One of the most prevalent hazards to orthopedic surgeons are musculoskeletal disorders with 97% of arthroplasty surgeons reporting procedural-related musculoskeletal pain and 66% of orthopedic surgeons reporting procedural-related musculoskeletal injury [1], [2], [3]. With the annual number of total knee arthroplasties (TKA) on the rise, orthopedic surgeons are taking on larger annual caseloads and retiring later in life [4], [5]. The goal of this study was to quantify postural demand for 11 discrete surgical steps of TKA to identify ergonomically unfavorable positions surgeons experience while operating. Four orthopedic surgeons performed TKA while their motions were recorded using marker-based motion capture. …

Fabricating Silver-Ceria Polymer Nanocomposite Scaffolds For Biomedical Therapeutic Applications, Shreya S. Pawar

Honors Undergraduate Theses

Improper healing of bone fractures and limited regeneration of bone following bone tumor resection remain a prevalent complication worldwide. Long-term effects of this include joint instability, limited movement, and arthritis. Bone infections (osteomyelitis), reactive oxygen species (ROS) generation via excessive inflammation, and underlying conditions such as osteoporosis can contribute to suboptimal bone tissue regeneration. ROS accumulation stimulates osteoblast apoptosis, while promoting osteoclast differentiation. These processes inhibit mineralization and osteogenesis. Conventional therapeutics involve the utilization of drugs and bone grafts. However, these approaches pose limitations and can result in subsequent complications. Microbial infections, ROS accumulation, and excessive inflammations are factors that …

Innovative Biomechanical And Engineering-Based Assessments Of Hip Mechanics In Individuals With Hip-Related Pain, Holly M. Stanze

Theses and Dissertations--Kinesiology and Health Promotion

Individuals with hip-related pain exhibit altered movement patterns, and worse fear of movement (kinesiophobia), compared to asymptomatic controls. Exacerbation of hip pain during movement and the role of hip symptom duration may help further our understanding of specific movement patterns that are associated with hip-related pain. A better understanding of the potential connections between hip-related symptom duration, kinesiophobia, hip pain during movement, and lower limb mechanics in those with hip-related pain may allow for more efficient referrals to clinicians and lead to more effective rehabilitation. In addition, the impact of hip-related pain on intra-articular hip loading patterns is not well …

Applications Of Computer Vision In Biomechanics And Orthopaedics, William Stewart Burton Ii

Electronic Theses and Dissertations

Machine learning has emerged as a key technology for enabling advanced computer vision systems. These systems now permeate many industries, and have enhanced traditional processes through autonomous interpretation of visual data. In the field of orthopaedics, the increasing prevalence of imaging highlights a need for similar tools. In many cases, however, direct translation of available frameworks fails to resolve the complex problems currently facing this field. Stringent performance requirements, complex visual environments, data scarcity, and implications for patient safety represent domain-specific factors which pose unique challenges to proven techniques. Novel approaches are needed to realize the full benefits of visual …

Assessing The Impact Of Femur Morphological Variations On Pediatric Hip Joint Biomechanics Using Statistical Shape Modeling, Tamara Chambers

Doctoral Dissertations and Master's Theses

This dissertation aimed to (1) quantify morphological variations in the pediatric hip joint and (2) evaluate the sensitivity of an infant musculoskeletal model (MSM) to these variations, considering hip joint center estimation errors. A shape statistical model (SSM) of decedent infant femurs from the Ortolani collection was created using ShapeWorks, capturing key morphological features, such as variations in the femoral neck-shaft and anteversion angles. Seven synthetic femurs were generated from the SSM to create SSM-informed MSMs, which were systematically evaluated through kinematics and kinetics analyses in OpenSim. Incorporating the SSM led to slight changes in the pediatric MSMs’ kinematics but …

Toward Electrical Impedance Sensing Surgical Drill For Tissue Boundary Detection, Harshavardhan Devaraj

Dartmouth College Ph.D Dissertations

Dental implantation is an increasingly common procedure used to treat missing teeth. However, surgical drilling to place the implant poses a high risk of injury to critical anatomy, such as inferior alveolar nerve injury or maxillary sinus perforation. A real-time surgical feedback system sensing proximity of these critical anatomy could reduce injury risks. This dissertation investigates the development of such a system that incorporates an electrical impedance sensor into the tip of a surgical drill.

A simulation framework based on finite element method (FEM) was developed to optimize the sensor as it approached a high impedance boundary. The accuracy of …

Novel Engineering Approaches For Orthopedic Injury Treatment And Infection Diagnosis, Cynthia Co

Bioengineering Dissertations - Archive

Bioengineering has made significant contributions to the treatment of orthopedic injury through interdisciplinary approaches. Central to these advancements are many orthopedic implants, including anchors and joint replacements, which have been designed to restore mobility. Despite their functional efficacy, these products have limited lifespan and are associated with many complications, such as implant-associated infection. The success of implant design and function, both in the short and long term, is paramount for enhancing patient outcomes and overall well-being. Therefore, my thesis work is dedicated to addressing these critical challenges, aiming to maximize their treatment effect while minimizing the implant-associated complications.

Long-term patient …

Editorial: Intervertebral Disc Degeneration And Osteoarthritis: Mechanisms Of Disease And Functional Repair., Graciosa Q Teixeira, Jana Riegger, Raquel M Gonçalves, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

No abstract provided.

Regenerative Medicine For Tendon/Ligament Injuries: De Novo Equine Tendon/Ligament Neotissue Generation And Application, Takashi Taguchi

LSU Doctoral Dissertations

Tendon and ligament injuries are debilitating conditions across species. Poor regenerative capacities of these tissues limit restoration of original functions. The first study evaluated the effect of cellular administration on tendon/ligament injuries in horses using meta-analysis. The cellular administration was effective in restoring ultrasonographic echogenicity and increasing vascularity during early phase of healing. Additionally, it improved microstructural organization of healed tissue in terms of cellularity and fiber alignment. However, the study did not support its use for increasing rate of return to performance, expression/deposition of tendon-specific genes/proteins, or mechanical properties.

The findings led to the second study that engineered implantable …

Development Of A Crosslinked Osteochondral Xenograft And A Collagen Stabilizing Intra-Articular Injection To Remediate Cartilage Focal Lesions To Prevent Osteoarthritis, Mark Lewis Mosher

Theses and Dissertations

Osteoarthritis is one of the most common causes of disability in adults in America. It is a progressive and degenerative disease where the articular cartilage is broken down and lost from the surfaces of bones causing chronic pain and swelling in the joints, and currently has no cure. The most commonly osteoarthritis starts from a focal lesion on the cartilage surface, which will expand on the surface and downwards through the thickness of the tissue. The current gold standard for correcting cartilage focal lesions is the osteochondral autograft/allograft transplantation (OAT), which replaces the defect with a fresh osteochondral graft. The …

Combination Of Statistical Shape Modeling And Statistical Parametric Mapping To Quantify Cartilage Contact Mechanics In Hip Dysplasia, Penny R. Atkins Phd, Shireen Y. Elhabian Phd, Jeffrey A. Weiss Phd, Ross T. Whitaker Phd, Christopher L. Peters Md, Andrew E. Anderson Phd

PanaSoMM

Finite element models can predict subject-specific chondrolabral stresses and help to elucidate the effect of under-coverage and incongruency of the hip joint in patients with dysplasia. However, complex stress patterns are difficult to generalize and evaluate statistically. With an established correspondence across shapes from statistical shape modeling (SSM), statistical parametric mapping (SPM) allows for evaluation of local variability while preserving model subject-specificity. Herein, we evaluated the combined application of SSM and SPM to compare cartilage contact stress between control subjects and patients with dysplasia.

Previously published hip joint contact stresses were mapped onto chondrolabral surface meshes and incorporated into an …

Application Of Statistical Shape Modeling To Predict Clinical Metric Of Femoral Head Coverage In Patients With Developmental Dysplasia, Penny R. Atkins Phd, Praful Agrawal Phd, Joseph D. Mozingo Phd, Keisuke Uemura Md, Phd, Kunihiko Tokunaga Md, Christopher L. Peters Md, Shireen Y. Elhabian Phd, Ross T. Whitaker Phd, Andrew E. Anderson Phd

PanaSoMM

Developmental dysplasia of the hip (DDH) is described as under-coverage of the femoral head by the acetabulum, resulting in mechanical instability. Though DDH is often diagnosed using plain film radiographs, these images cannot adequately capture 3D joint coverage. Herein, we applied a 3D statistical shape model (SSM) to the femur and hemi-pelvis of patients with DDH to objectively measure shape variation and evaluated whether SSM outputs could predict measurements of joint coverage.

The femur and hemi-pelvis were semi-automatically segmented from CT images (83 hips from 47 females with DDH). Surfaces of each hip were reconstructed from segmentations, aligned, and input …

Variations In Surgeon-Applied Loads During Passive Range Of Motion Following Total Knee Replacement With Relevance To Computational Modeling, Cj Bakle Ii

All Theses

Total knee replacement (TKR) is generally considered a successful treatment for musculoskeletal disorders of the knee. However, as many as 20% of patients report some dissatisfaction in their physical function after TKR. And approximately 50% of early revisions needed to address conditions related to component alignment and soft tissue tension to stabilize the knee. During TKR, surgeons manually perform passive range of motion (ROM) assessments to gain feedback perceived as tension in ligaments and other soft tissues. Such assessments are highly subjective and rely on the surgeon's perception of soft tissue tension rather than quantitative objective means. The variability in …

Reporter Chondrocyte Optimization Of Bioinks For Zonal 3d Bioprinting Of Cartilage, Kari Martyniak

Electronic Theses and Dissertations, 2020-2023

Osteoarthritis (OA) is the most common form of arthritis, often thought of as a disease of the elderly, but post traumatic OA predominantly impacts younger individuals. Articular cartilage is the tissue that coats the end of your bones in synovial joints. Since cartilage has limited healing capacity, defects, or injuries to it progressively erodes down to the subchondral bone. Unfortunately, current treatment options all have limitations, particularly for younger patients. Cartilage has a specific zonal architecture that is distinguished by the different cell morphologies and arrangements, biochemical composition, and mechanical properties. 3D bioprinting is a tissue engineering technique that involves …

The Rotator Cuff Tendon-To-Bone Interface: Maturation, Aging, And 3d Bioprinting For Regeneration, Xiping Jiang

Theses & Dissertations

Rotator cuff tendon injuries often occur at the tendon-to-bone interface (i.e., enthesis) area with a high prevalence for the elderly population. In addition, regeneration of the gradient structure of the enthesis is still a significant clinical challenge. Our studies aim to identify the histological, molecular, and biomechanical alterations of the rotator cuff enthesis with maturation and aging, and develop a novel therapeutic method using three-dimensional (3D) bioprinting technique to regenerate a functional enthesis. Striking variations of the entheses were observed both histologically and biomechanically during the maturation process. The histological features did not show many differences at the insertion site …

Modeling And Simulation Of Electromagnetic Fields To Maintain Bone Density During Prolonged Low Gravity Exposure, Austin Tapp, Michael Francis, Michel A. Audette

Electrical & Computer Engineering Faculty Publications

Astronauts in a long term, low-gravity environments experience bone density loss at 10 times the rate of those diagnosed with osteoporosis. One treatment effective at maintaining bone density in osteoporotic individuals is electromagnetic field (EMF) therapy. Tools that induce EMFs are becoming increasingly prevalent, but to amplify osteogenesis and encourage superior bone density retention for astronauts, ideal EMF therapy parameters must be determined on patient-specific bases. Therefore, this study explores simulation environments that elucidate highly favorable EMF factors. Pulsed electromagnetic field and combined magnetic field generating devices are variably introduced near partient-specific, finite element (FE) models of the femur, spine, …

Development Of An Injectable Methylcellulose Hydrogel System For Nucleus Pulposus Repair And Regeneration, Nada A. Haq-Siddiqi

Dissertations and Theses

Low back pain is the most common cause of disability in the world and is often caused by degeneration or injury of the intervertebral disc (IVD). The IVD is a complex, fibrocartilaginous tissue that allows for the wide range of spinal mobility. Disc degeneration is a progressive condition believed to begin in the central, gelatinous nucleus pulposus (NP) region of the tissue, for which there are few preventative therapies. Current therapeutic strategies include pain management and exercise, or surgical intervention such as spinal fusion, none of which address the underlying cause of degeneration. With an increasingly aging population, the socioeconomic …

Designing An Antibiotic Eluting Trauma Screw To Reduce Short Term Infection In Bone Fractures, Dominic Lincoln

Honors Theses

Orthopedic infection in the United States is one of the most common and severe health risks faced by trauma patients. The most prevalent infection is orthopedic and trauma device-related infection (ORDI) and often occurs in long bones at the fracture site. The purpose of this paper is to explore this infection, its causes, and solutions currently on the market while providing novel solutions to the problem. The designs proposed will be evaluated for their effectiveness and value, while attempting to keep costs low for all stakeholders. The feasibility of patenting these ideas will also be considered, as will the testing …

Walking Kinematics In Young Children With Limb Loss Using Early Versus Traditional Prosthetic Knee Prescription Protocols, Mark Daniel Geil, Zahra Safaeepour, Brian Giavedoni, Colleen Coulter

Faculty Articles

The traditional treatment protocol for young children with congenital or acquired amputations at or proximal to the knee prescribes a prosthesis without a working knee joint, based in part on the assumption that a child learning to walk cannot properly utilize a passively flexing prosthetic knee component. An alternative to this Traditional Knee (TK) protocol is an “Early Knee” (EK) protocol, which prescribes an articulating prosthetic knee in the child’s first prosthesis, during development of crawling and transitioning into and out of upright positions. To date, no study has compared samples of children with limb loss at or proximal to …

Computational Approach To Correcting Joint Instability In Patients With Recurrent Patellar Dislocation, Oliver Alvarez, Robert N. Steensen, Paul J. Rullkoetter, Clare K. Fitzpatrick

Mechanical and Biomedical Engineering Faculty Publications and Presentations

Patellar dislocation is a debilitating injury common in active adolescents and young adults. Conservative treatment after initial dislocation is often recommended, but almost half of these patients continue to suffer from recurrent dislocation. The objective of this study was to compare preoperative patellofemoral joint stability with stability after a series of simulated procedures, including restorative surgery to correct to pre-injury state, generic tibial tubercle osteotomy, patient-specific reconstructive surgery to correct anatomic abnormality, less invasive patient-specific surgery, and equivalent healthy controls. Three-dimensional, subject-specific finite element models of the patellofemoral joint were developed for 28 patients with recurrent patellar dislocation. A …

Total Knee Arthroplasty Gap Balancer, Christina Grigorian, Andrew Beckley, Alexandra Rockett

Biomedical Engineering

California Polytechnic State University’s Biomedical Engineering Department worked in conjunction with local San Luis Obispo orthopedic surgeon Dr. Dimitri Delagrammaticas. The goal of the project was to create a surgical tool that assists a surgeon in measuring knee gap distance and balancing collateral ligament tension during a total knee arthroplasty (TKA) surgery. The final product of this project was completed in five months and initially began with understanding our sponsor’s expectations for the device. A portion of time was devoted to conducting research to understand the process of a knee replacement surgery, the requirements of the device, and the limitations …

Development Of A Sonically Powered Biodegradable Nanogenerator For Bone Regeneration, Avi Patel

Honors Scholar Theses

Background: Reconstruction of bone fractures and defects remains a big challenge in orthopedic surgery. While regenerative engineering has advanced the field greatly using a combination of biomaterial scaffolds and stem cells, one matter of difficulty is inducing osteogenesis in these cells. Recent works have shown electricity’s ability to promote osteogenesis in stem cell lines when seeded in bone scaffolds; however, typical electrical stimulators are either (a) externally housed and require overcomplex percutaneous wires be connected to the implanted scaffold or (b) implanted non-degradable devices which contain toxic batteries and require invasive removal surgeries.

Objective: Here, we establish a biodegradable, piezoelectric …