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Being an interdisciplinary research area, biomechanics has gained interest among researchers. Biomechanics deals with integration of mechanical phenomenon with the structural and functional aspects of biological systems. Biological systems being very much complex provide a very intricate platform for their analysis. In case of damages created by accidents or sport malfunctions, artificial implants are used for the replacement of bones. These implants may cause incompatibility with the human body, depending on their design and characterization. So, this research aims to analyze the vibrational characteristics of a human femur bone and to predict the safe ranges of frequencies of operation.

The current research is aimed at vibrational characterization of a human femur bone. The model of the femur bone is prepared using SOLIDWORKS software. The material properties of the femur are collected from the available literature and provided with the CAD model. The model is imported to the ANSYS software. Loading patterns as applied on the human body are also applied to the prepared model. Suitable boundary conditions are chosen for normal sitting and standing positions. The natural frequencies of the femur bone and other vibrational parameters are found out.

The first data obtained from the ANSYS software are the natural frequencies and mode shapes of vibration. Other data include the stress distributions, strain distributions, deformation patterns and potential zones of damage. The frequencies and mode shapes enable the safe ranges of human operation and the frequency range to be followed in the designing of implants. The stress distributions enable to know the potential zones of damage so that those areas can be given focus during strength considerations.

The current investigations take into account only normal sitting and walking conditions. This work can be included under static loadings. This can also be extended toward dynamic loading conditions. In the dynamic loading, walking and running conditions can be taken into account. This work focuses on the safe designing of the artificial implants and their compatibility with the human body. This can also be extended toward role of dynamic forces in the damaged bone formation and the role of implant’s characteristics for healing of bones.

Bone damage and ligament fracture are common nowadays due to increasing number of accidents, which may be vehicular or sports. In case of any damage to the skeletal parts, some artificial implant is used to support the damaged part and to help in the process of healing. The designing of the implants must be compatible with the human body. The natural frequencies and mode shapes give an idea that the vibrational parameters of the implant material must fall in the same range as the actual bone. The stress distribution and potential zone damage emphasize on strength considerations.

The current method is a novel approach toward implant designing. Here an analysis of vibrational parameters of the human femur bone is performed. Those parameters include natural frequencies, mode shapes, principal normal stress distributions, principal shear stress distributions, maximum shear elastic strains and total deformation. These parameters reflect an idea about behavior of the femur bone under actual loading conditions. This analysis enables an implant designer to focus on material properties and strength considerations of the implants which are to be used in case of bone damage.

The purpose of this paper is to compare fracture‐fixation and bone‐healing promotion efficacies of an intramedullary (IM) nail‐type and an external osteosynthesis plate‐type femoral trochanteric‐fracture implants using the results of a combined multi‐body dynamics and finite element analyses. For both implants, fracture fixation was obtained using a dynamic hip blade which is anchored to the femur head on one end and is connected to the IM rod/plate on the other. The analysis was carried out for two pre‐fracture conditions of the femur: healthy and osteoporotic.

The musculoskeletal dynamics portion of the analysis was used to obtain realistic physiological loading conditions (i.e. muscle forces and joint reaction forces and moments) associated with four typical everyday activities of a patient, namely, walking, lunging, cycling and egress (i.e. exiting a passenger vehicle). The subsequent structural finite element analysis of the fractured femur/implant assembly was employed to quantify fracture‐fixation efficacy (as measured by the extents of lateral (found to be minor), flexural and torsional displacements of the two femur fragments) and the bone‐healing promotion efficacy (as quantified by the fraction of the fractured surface area which experienced desirable contact pressures).

The results obtained show that, in general, the IM‐rod type of implant out‐performs the osteosynthesis plate type of implant over a large range of scenarios involving relative importance of the bone‐healing promotion and fracture‐fixation efficacies, health condition of the femur and the activity level of the patient. More specifically, the more active the patient and the larger extent of osteoporosis in the femur, the more justifiable is the use of the IM‐rod type of implant.

The present approach enables assessment of the fracture‐fixation performance of orthopedic implants under physiologically realistic loading conditions.

The aim of this paper is to present and evaluate a methodology for automatically constructing and applying the physiologically‐realistic boundary/loading conditions for use in the structural finite element analysis of the femur during various exertion tasks (e.g. gait/walking).

To obtain physiologically‐realistic boundary/loading conditions needed in the femur structural finite element analysis, a whole‐body musculoskeletal inverse dynamics analysis is carried out and the resulting muscle forces and joint reaction forces/moments extracted.

The finite element results obtained are compared with their counterparts available in literature and it is found that the overall agreement is acceptable while the highly automated procedure for the finite element model generation developed in the present work made the analysis fairly easy and computationally highly efficient. Potential sources of errors in the current procedure have been identified and the measures for their mitigation recommended.

The present approach enables a more accurate determination of the physiological loads experienced by the orthopedic implants which can be of great value to implant designers and orthopedic surgeons.

The purpose of this paper is to present a robotic motion compensation system, using ultrasound images, to assist orthopedic surgery. The robotic system can compensate for femur movements during bone drilling procedures. Although it may have other applications, the system was thought to be used in hip resurfacing (HR) prosthesis surgery to implant the initial guide tool. The system requires no fiducial markers implanted in the patient, by using only non-invasive ultrasound images.

The femur location in the operating room is obtained by processing ultrasound (USA) and computer tomography (CT) images, obtained, respectively, in the intra-operative and pre-operative scenarios. During surgery, the bone position and orientation is obtained by registration of USA and CT three-dimensional (3D) point clouds, using an optical measurement system and also passive markers attached to the USA probe and to the drill. The system description, image processing, calibration procedures and results with simulated and real experiments are presented and described to illustrate the system in operation.

The robotic system can compensate for femur movements, during bone drilling procedures. In most experiments, the update was always validated, with errors of 2 mm/4°.

The navigation system is based entirely on the information extracted from images obtained from CT pre-operatively and USA intra-operatively. Contrary to current surgical systems, it does not use any type of implant in the bone to track the femur movements.

This bibliography is offered as a practical guide to published papers, conference proceedings papers and theses/dissertations on the finite element (FE) and boundary element (BE) applications in different fields of biomechanics between 1976 and 1991. The aim of this paper is to help the users of FE and BE techniques to get better value from a large collection of papers on the subjects. Categories in biomechanics included in this survey are: orthopaedic mechanics, dental mechanics, cardiovascular mechanics, soft tissue mechanics, biological flow, impact injury, and other fields of applications. More than 900 references are listed.

The purpose of this paper was development of patient-specific femoral prosthesis using rapid prototyping (RP), a part of additive manufacturing (AM) technology, and comparison of its merits or demerits over CNC machining route.

The customized femoral prosthesis was developed through computed tomography (CT)-3D CAD-RP-rapid tooling (RT)-investment casting (IC) route using a stereolithography apparatus (SLA-250) RP machine. A similar prosthesis was also developed through conventional CT-CAD-CAM-CNC, using RP models to check the fit before machining. The dimensional accuracy, surface finish, cost and time involvement were compared between these two routes.

In both the routes, RP had an important role in checking the fit. Through the conventional machining route, higher-dimensional accuracies and surface finish were achieved. On the contrary, RP route involved lesser time and cost, with rougher surface finish on the prosthesis surface and less internal shrinkage porosity. The rougher surface finish of the prosthesis is favourable for bone ingrowths after implantation and porosity reduce the effective stiffness of the prosthesis, leading to reduced stress shielding effect after implantation.

As there is no AM machine for direct fabrication of metallic component like laser engineered net shaping and electron beam melting in our Institute, the metallic prosthesis was developed through RP-RT-IC route using the SLA-250 machine.

The patient-specific prosthesis always provides better fit and favourable stress distribution, leading to longer life of the prosthesis. The described RP route can be followed to develop the customized prosthesis at lower price within the shortest time.

The described methodology of customized prosthesis development through the AM route and its advantages are applicable for development of any metallic prostheses.

The best treatment for femur fractures is the surgical one within 48 h from the admission to the hospital. These fractures have serious consequences, both in terms of morbidity and socio-economic impact. In the hospital A.O.R.N. Cardarelli of Naples in Italy, the mean pre-operative length of hospital stay (LOS) was nine days and just 4 per cent of patients was operated within the suggested time. Therefore, a diagnostic-therapeutic-assistance path (DTAP) was implemented to improve the process.

This paper analyzes two groups of patients (534 and 562, respectively) before and after the introduction of DTAP, through six sigma (SS) based on define, measure, analyze, improve and control cycle. Age, gender, American Society of Anaesthesiologists (ASA) score, cardiovascular diseases, diabetes and allergies were used as independent subgrouping variables. The t-tests and chi-square were performed to compare the groups, tools of SS were used.

The analyses were conducted considering overall patients and some subgroups. The overall reduction in LOS was about 54 per cent, patients without cardiovascular diseases and with a low ASA score had the highest reduction, more than 60 per cent. All the p-values proved a high statistically significant difference between the two groups.

The influence of the Italian health-care system is a minor limitation while, unfortunately, the lack of a follow-up did not allow quantifying the real gain in health of patients. A lean thinking analysis would suit this context.

There are practical advantages for both hospital and patients: the hospital will have an increase in admissions and more beds available, while patients will benefit of a faster intervention and a shorter wait.

This is the first analysis through SS of DTAP showing its positive influences in terms of both socio-economic impact and patients’ outcome. Policy leaders could use this study as an example to evaluate the introduction of the same clinical pathway in other health facilities.

This chapter uses a dataset of heights calculated from the femurs of skeletal remains to explore the development of stature in England across the last two millennia. We find that heights increased during the Roman period and then steadily fell during the “Dark Ages” in the early medieval period. At the turn of the first millennium, heights grew rapidly, but after 1200 they started to decline coinciding with the agricultural depression, the Great Famine, and the Black Death. Then they recovered to reach a plateau which they maintained for almost 300 years, before falling on the eve of industrialization. The data show that average heights in England in the early nineteenth century were comparable to those in Roman times, and that average heights reported between 1400 and 1700 were similar to those of the twentieth century. This chapter also discusses the association of heights across time with some potential determinants and correlates (real wages, inequality, food supply, climate change, and expectation of life), showing that in the long run heights change with these variables, and that in certain periods, notably the thirteenth and fourteenth centuries, the associations are observable over the shorter run as well. We also examine potential biases surrounding the use of skeletal remains.

To present a custom design and fabrication method for a novel hemi‐knee joint substitute composed of titanium alloy and porous bioceramics based on rapid prototyping (RP) and rapid tooling (RT) techniques.

The three‐dimensional (3D) freeform model of a femur bone was reconstructed based on computerized tomography images via reverse engineering and the 3D reconstruction accuracy was evaluated. The negative image of artificial bone was designed with interconnected microstructures (250‐300 μm). The epoxy resin mould of a hemi‐knee joint and the negative pattern of an artificial bone were fabricated on Stereolithography apparatus. Based on these moulds, a titanium‐alloy hemi‐knee joint and a porous‐bioceramic artificial bone were created by quick casting and powder sintering (known as RT) techniques, respectively. After assembling, a composite hemi‐knee joint substitute was obtained.

The 3D reconstructed freeform model of the femur bone conformed to the original anatomy within a maximum deviation 0.206 mm. The sintered artificial bone had interconnected micropores (250 μm) and microchannels (300 μm). After implanting in vivo, the composite hemi‐knee joint substitute matched well with the surrounding tissues and bones with sufficient mechanical strength.

Further in‐vivo research is needed to provide the evidence for tissue growth into the ceramic structures and long‐term viability and stability of the implant.

This method enhances the versatility of using RP in the fabrication of tissue‐engineered substitutes, especially when individual matching is considered. Although this paper took a customized hemi‐knee joint substitute as an example, it is capable of fabricating other artificial substitutes with a variety of biomaterials.

Based on the unilateral CT images of a patient in stage III for osteonecrosis of the femoral head, three subject‐specific three‐dimensional finite element models of proximal femur are developed by reverse engineering method, including normal model, necrosis model and prothetic model. Based on the same CT set, the material properties are assigned to each finite element model. Then, by finite element analysis, the process of bone grafting for osteonecrosis of the femoral head is simulated. The results indicate that when the necrosis parts of femoral head are removed, the stresses and displacements of proximal femur increase correspondingly, but after the surgery of bone grafting, the stresses and displacements of proximal femur efficiently decrease and become more close to the normal state. The results are useful for a better understanding of the procedure of the bone grafting surgery.