Concepts in Orthopaedic Biomechanics

Basic Science Lectures Department of Orthopaedic Surgery Detroit Medical Center Michele J. Grimm, Ph.D. Director of Orthopaedic Biomechanics

Mechanical Concepts -- Force

Force: A vector quantity that describes the action of one body on another Three attributes must be defined Magnitude Direction Point of Action Forces can either be normal or shear in nature Normal forces act perpendicularly to a surface Shear forces act tangentially to a surface Newton's Second Law: F = m*a

Mechanical Concepts -Compression and Tension

Compression: defined most simply as a "squeeze" When a force is applied to an object to squeeze it, the object is deformed (shortened) along the direction of the compressive force while expanding perpendicular to the force. Tension: opposite of compression, or a "pull" When a force is applied to pull a fixed object, the object is lengthened along the direction of the tensile force while being reduced in size in the direction perpendicular to the force.

Mechanical Concepts -- Stress

Stress: Force normalized to cross-sectional area to eliminate the effect of geometry Units of force/area Newtons/square meter (N/m2) or pascals (Pa) Pounds/square inch (psi)

1 TON

1 TON

1 TON

Area

Area

Area

Mechanical Concepts -- Strain

Strain: The change in length of a material divided by its original overall length Strain is dimensionless and is often expressed as percent strain Ten percent strain means an object has been deformed by one tenth of its original length

DL

L DL

Mechanical Concepts -- Elastic Modulus

Elastic Modulus: Ratio of stress to strain at any point in the elastic (linear) region of deformation (small strains) Also known as modulus of elasticity or Young's modulus Units of stress/strain (Pascals/dimensionless = Pascals) Often (incorrectly) referred to as stiffness True stiffness is defined as the change in force per change in length and is given in units of force/length Stiffness is dependent both on the materials elastic modulus and the objects geometry

Mechanical Concepts -- Elastic Modulus

Determined as the slope of the linear portion of the stress-strain curve Higher elastic modulus indicates that more stress is required to deform a material Ex: A compressive load is applied to functional spinal unit (a disc and 2 vertebral bodies). The vertebral body has a higher elastic modulus than the disc. Therefore, the disc deforms to a greater extent than the vertebral bodies.

Stress Ds De Strain

E = Ds/De

Question 1

The deformation of a material as a result of an applied load is referred to as: (1) Stress (2) Strain (3) Plasticity (4) Elasticity (5) Viscoelasticity

Question 1

The deformation of a material as a result of an applied load is referred to as: (1) Stress (2) Strain (3) Plasticity (4) Elasticity (5) Viscoelasticity

Question 2

The stress produced when a force acts in line with a surface is: (1) Shear (2) Torque (3) Tension (4) Elasticity (5) Compression

Question 2

The stress produced when a force acts in line with a surface is: (1) Shear (2) Torque (3) Tension (4) Elasticity (5) Compression

Question 3

In the Figure, which material has the highest modulus of elasticity?

Stress 5

2 3

Strain

Question 3

In the Figure, which material has the highest modulus of elasticity?

Stress 5

2 3

Strain

Mechanical Concepts -- Mechanical Models

Behavior of materials fits into a combination of three categories Elasticity is characterized by Full recovery of deformation when a load is removed Instantaneous reaction to a force application Linear relationship between force and deformation
Force Force On Off

Deformation

Force

Force

Time

Time

Deformation

Mechanical Models

Plasticity is characterized by Resistance of a body to deformation after a critical (yield) stress is reached After deformation begins, it continues to occur without increased stress Plastic deformation is not recoverable
Force Force On Off

Deformation
0

Force
Critical Force 0 Time Time

Mechanical Concepts -- Mechanical Models

Viscosity is characterized by Time/rate dependence of stress-strain response Higher rate of force application requires higher stress to give desired deformation Force Conversely, a given deformation at a higher strain rate results in an increased force Response to stress is not instantaneous A constant load applied to a viscous element will cause continuous deformation until the load is Deformation removed Deformation is not recoverable

Force

Rate of Deformation F1 F2 F3 F1>F2>F3 Time

Question 4

The Figure represents the behavior of a material characterized as (1) linearly elastic (2) linearly elastic, linearly plastic (3) linearly elastic, perfectly plastic (4) rigid, linearly plastic s (5) rigid, perfectly plastic

Question 4

The Figure represents the behavior of a material characterized as (1) linearly elastic (2) linearly elastic, linearly plastic (3) linearly elastic, perfectly plastic (4) rigid, linearly plastic s (5) rigid, perfectly plastic

Mechanical Concepts -- Strength and Failure

Ultimate Strength: Maximum stress a material supports before failure s NOTE: The elastic modulus and ultimate strength of a material are not necessarily related Yield Strength: The stress at the point where the stress-strain curve undergoes a transition from linear to non-linear behavior Typically the transition between elastic and plastic behavior or the start of plastic deformation in a purely plastic material Rupture: Point at which failure occurs and stress subsequently goes to zero

sy

su

Rupture

Question 5

The Figure shows the stress-strain relationship for a material loaded in uniaxial tension. The ultimate tensile strength of this material is defined by which point?
s
C A B D X E

Question 5

The Figure shows the stress-strain relationship for a material loaded in uniaxial tension. The ultimate tensile strength of this material is defined by which point?
s
C A B D X E

Mechanical Concepts - Ductility

Ductility: Total strain to failure A ductile material will undergo considerable plastic deformation resulting in greater strains before rupture occurs A brittle material (low ductility) will fail soon after the elastic limit is reached
s
Brittle

X Ductile

Mechanical Concepts -- Energy Absorption

Energy Absorption: The area under a load-deformation curve indicates the amount of strain energy absorbed by the material during deformation A portion of the energy may be stored in the material and is recoverable once the stress is removed For a purely elastic material, all of the stored strain energy is recovered

Mechanical Concepts -- Energy Absorption

Most materials have a viscous component to their behavior, so some of the absorbed energy is lost, through conversion to heat, on removal of the stress Lost energy is indicated by the area between the loading and unloading curves on a stress-strain plot This loss of a portion of energy for elastic deformation is termed hysteresis The greater the amount of viscous behavior in a material, the greater the amount of energy lost
s s s

Mechanical Concepts -- Energy Absorption

Energy absorbed during plastic deformation is unrecoverable If plastic deformation proceeds to fracture, the total area under the load-deformation curve is the energy absorbed If the load is removed, the material may return partially to its original state, with recovery of the elastic deformation. However, the plastic deformation will not be recovered and the energy lost will be greater than for only elastic deformation
F
F

Question 6

The energy absorbed by a specimen during a load-tofailure test is determined by calculating the (1) slope of the load-deformation curve (2) hysteresis of the stress-strain curve (3) load at failure multiplied by strain at failure (4) area under the load-elongation curve (5) slope of the stress-strain curve

Question 6

The energy absorbed by a specimen during a load-tofailure test is determined by calculating the (1) slope of the load-deformation curve (2) hysteresis of the stress-strain curve (3) load at failure multiplied by strain at failure (4) area under the load-elongation curve (5) slope of the stress-strain curve

Mechanical Concepts -- Fatigue

Fatigue Fracture: Results from repetitive loading cycles that produce stresses at lower levels than the ultimate stress Dependent both on level of stress and number of cycles Begins with a set of microscopic cracks that propagate and cause failure under repeated loading A material is defined by an endurance limit, a stress up to which it can withstand an infinite number of cycles of loading

Mechanical Concepts -- Fatigue

Above the endurance limit, material behavior can be assessed by an S-n curve relating stress to number of cycles Based on experimental evidence Fatigue can be exacerbated by processes such as corrosion and therefore cannot be expected to be the same for a material in a physiological environment as it was in a bench test
125000 Stress (psi) "S-n curve" Endurance Limit 0.01 0.1 1 10 100 Number of Cycles (millions)

Behavior of Materials

Bone can fracture as a result of a single, high stress (traumatic fracture) Bone is also exposed in vivo to repetitive stresses of various levels Repeated loading of daily activities can result in microdamage Micro-cracks in both the cortical and trabecular bone If microdamage accumulates faster than it can be repaired by physiological processes, the cracks may propagate and result in fracture of the bone This is fatigue fracture This is the proposed mechanism behind stress fractures and atraumatic fractures, such as occur in the vertebrae

Behavior of Materials -- Viscoelasticity

Actual materials often exhibit viscoelastic behavior A combination of purely elastic and viscous behavior discussed above Bone, cartilage, ligaments, and muscle are all viscoelastic to varying extents Ex. Bone or ligament is more likely to rupture or fracture if a load is applied quickly, such as in an impact situation. The deformation may be the same for other loading conditions; however, the high strain-rate results in a higher stress being required to produce the deformation and the stress may then be greater than the ultimate strength of the structure. Stress is partially dependent on strain-rate and the strain itself can change with time for a constant stress Viscoelastic behavior can be described with two basic models

Behavior of Materials -- Viscoelasticity

Model 1: Maxwell Body Creep: Slow, continuing deformation with time under a constant stress Ex: The loss of spinal height over the course of a day is a result of creep behavior in the spine, primarily in the intervertebral discs Stress Relaxation: Reduction in measured stress with time for a constant strain

Deformation

Force Force Off On

Elastic Recovery Time

Force Force Force On Off

Time

Deformation

Structure Deformed

Force

Structure Deformed

Time

Time

Behavior of Materials -- Viscoelasticity

Model 2: Kelvin Body or Voigt Element No instantaneous response to stress due to dash-pot effect Deformation characterized by initial creep behavior which is limited by the extension limit of the spring for that load Recovery after removal of the load is gradual but complete due to the tendency of the spring to return to its original length
Force Deformation On Force Off Force Force On Force Off

Time

Time

Question 7

Strain of a material beyond its elastic limit is defined as (1) Fatigue (2) Relaxation (3) Plastic deformation (4) Creep (5) Stretching

Question 7

Strain of a material beyond its elastic limit is defined as (1) Fatigue (2) Relaxation (3) Plastic deformation (4) Creep (5) Stretching

Question 8

A material is subjected to a constant load and is found to deform with time. The deformation-time curve for this material approaches a steady state with time. The behavior of this material is termed (1) Elastic deformation (2) Plastic deformation (3) Creep (4) Anisotropic deformation (5) Ductility

Question 8

A material is subjected to a constant load and is found to deform with time. The deformation-time curve for this material approaches a steady state with time. The behavior of this material is termed (1) Elastic deformation (2) Plastic deformation (3) Creep (4) Anisotropic deformation (5) Ductility

Question 9

The deformation of a material with respect to its original shape as a result of an applied load is referred to as: (1) Stress (2) Strain (3) Elasticity (4) Plasticity (5) Viscoelasticity

Question 9

The deformation of a material with respect to its original shape as a result of an applied load is referred to as: (1) Stress (2) Strain (3) Elasticity (4) Plasticity (5) Viscoelasticity (3, 4, 5) related to the modulus

Question 10

The resistance of a material to deformation from an applied load is called: (1) Tolerance (2) Stiffness (3) Elasticity (4) Viscoelasticity (5) Plasticity

Question 10

The resistance of a material to deformation from an applied load is called: (1) Tolerance (2) Stiffness (3) Elasticity (4) Viscoelasticity (5) Plasticity

Behavior of Materials

Actual materials are based on a combination of elastic and viscoelastic elements Biological materials such as ligament, tendon, or other soft tissues exhibit the following deformation-time response This behavior can be explained most simply by the following model A plastic element should also be added to the model to account for plastic deformation at high stresses

Deformation

Force On

Force Off

Time

Behavior of Materials

Mechanical properties of a material can be dependent on the direction of loading Behavioral differences are typically related to the structural organization of the material Bone, ligaments, and other tissues have obvious fiber or structural orientations Properties are different for forces applied parallel and perpendicular to those structural orientations This directional dependence is termed anisotropy

Behavior of Materials

Mechanical properties can also vary depending upon the mode of loading Elastic modulus and strength can be different for the same material when loaded in compression, tension, and shear

Question 11

Which of the following is a characteristic property of viscoelastic materials: (1) The material is anisotropic (2) Deformational behavior is independent of time (3) Deformational behavior is independent of the applied strain rate (4) During constant deformation, the internal stress is gradually increased (5) During application of a constant load, the material gradually deforms

Question 11

Which of the following is a characteristic property of viscoelastic materials: (1) The material is anisotropic (2) Deformational behavior is independent of time (3) Deformational behavior is independent of the applied strain rate (4) During constant deformation, the internal stress is gradually increased (5) During application of a constant load, the material gradually deforms

Question 12

A material that has the same mechanical properties in all directions is referred to as: (1) Plastic (2) Ductile (3) Elastic (4) Isotropic (5) Viscoelastic

Question 12

A material that has the same mechanical properties in all directions is referred to as: (1) Plastic (2) Ductile (3) Elastic (4) Isotropic (5) Viscoelastic

Properties of Bone

Bone is a two-phase, anisotropic and viscoelastic material which can react to stresses with self-repair and selfadaptation Cortical and trabecular bone have different mechanical properties, based predominantly on the different densities of the material Cortical bone has an apparent density (mass of bone per total unit volume) of approximately 1.8 g/cm^3 Trabecular bone has an apparent density ranging from 0.1 to 1.0 g/cm^3 depending upon the porosity of the bone, which varies based on anatomic site and between individuals

Properties of Bone

Both cortical and trabecular bone have a higher ultimate strength in compression than in tension Both cortical and trabecular bone are anisotropic, with higher ultimate strength and higher elastic modulus in the direction of predominant structure orientation Changes in bone composition due to disease affect properties: A reduction in bone mineralization results in more ductile, less stiff bones with reduced compressive strength and elastic modulus A reduction in bone protein composition results in more brittle, harder bones with reduced tensile strength and increased elastic modulus

Effect of Age on Bone Properties

Changes due to age can affect bone mechanical properties through both structural changes and changes in material properties Aging results in both cortical and trabecular bone becoming more porous Strength and elastic modulus are both dependent on the amount of bone present (increased porosity --> reduced strength and modulus) In trabecular bone, strength and elastic modulus are also dependent on how the trabecular material is lost An overall thinning of trabeculae will result in different changes in mechanical properties than if some trabeculae are lost completely while others maintain their thickness

Effect of Age on Bone Properties

Aging also results in less ductile bone (more brittle) The maximum strain to failure is reduced as is the ability of bone to absorb energy

Question 13

A long bone is anisotropic because (1) its material properties are strongest in tension (2) its material properties have a directional preference along the long axis (3) its dimensions are not the same in all directions (4) it contains an intramedullary canal (5) it is a porous structure

Question 13

A long bone is anisotropic because (1) its material properties are strongest in tension (2) its material properties have a directional preference along the long axis (3) its dimensions are not the same in all directions (4) it contains an intramedullary canal (5) it is a porous structure

Question 14

Which of the following is the best description of the mechanical properties of wet compact bone in humans? (1) Isotropic (2) Brittle (3) Fatigue-resistant (4) Strain-rate dependent (5) Strongest in tension

Question 14

Which of the following is the best description of the mechanical properties of wet compact bone in humans? (1) Isotropic (2) Brittle (3) Fatigue-resistant (4) Strain-rate dependent (5) Strongest in tension

Question 15

What effect does demineralization have on the biomechanical properties of bone? (1) Increases toughness (2) Increases modulus of elasticity (3) Increases brittleness (4) Decreases stiffness (5) Decreases ductility

Question 15

What effect does demineralization have on the biomechanical properties of bone? (1) Increases toughness (2) Increases modulus of elasticity (3) Increases brittleness (4) Decreases stiffness (5) Decreases ductility

Mechanics of Soft Tissue -Ligament and Tendon

Ligaments and Tendons have a defined fiber orientation based on the arrangement of the collagen fibers Mechanical behavior is anisotropic with greater strength and stiffness along the fiber direction Strength and modulus higher in tension than in compression

Mechanics of Soft Tissue -Ligament and Tendon

Deformation of ligaments and tendons has a characteristic behavior due to the action of Force the fibers Initial "toe" region is a result of the straightening of crimped collagen fibers Linear, elastic region is due to the overall elastic deformation of the structure Stiffness begins to decrease in the plastic region where individual fibers begin to fail Overall failure occurs when stress experienced by the remaining fibers exceeds their ultimate tensile strength

Deform.

Mechanics of Soft Tissue -Ligament and Tendon

Ligaments and tendons exhibit viscoelastic behavior Stiffness and strength are dependent on the loading rate, with increased rates of deformation resulting in increased stiffness and stress Comparison of properties: Ultimate tensile strength: Tendon = 1/2 Bone Ligament < Tendon Elastic modulus Tendon = 5 - 10 % Bone Ligament < Tendon

Question 16

A ligament is subjected to a constant force well below that required to cause its rupture. The ligament will respond to these loading conditions by: (1) Elongating instantly and remaining at that length (2) Elongating instantly and continuing to do so until a constant length is reached (3) Elongating instantly and then shrinking slowly back to its original length (4) Elongating indefinitely (5) Remaining the same length

Question 16

A ligament is subjected to a constant force well below that required to cause its rupture. The ligament will respond to these loading conditions by: (1) Elongating instantly and remaining at that length (2) Elongating instantly and continuing to do so until a constant length is reached (3) Elongating instantly and then shrinking slowly back to its original length (4) Elongating indefinitely (5) Remaining the same length

Mechanics of Soft Tissue -- Cartilage

Cartilage is designed to be loaded predominantly in compression and exhibits substantial anisotropy Properties are highly dependent on the rate of loading At high strain rates, collagen behaves almost elastically At low strain rates, viscoelastic behavior such as creep is very apparent independent of the direction of loading Like ligaments and tendons, cartilage exhibits a toe region in the tension stress-strain curve due to the allignment of the collagen fibers Cartilage has an ultimate tensile strength of approximately 5 % that of bone, while the compressive elastic modulus is about 1 % of bone

Mechanics of Soft Tissue -- Cartilage

The behavior of cartilage under compressive load is influenced by its porous, fluid-filled structure Cartilage can be seen as a matrix of collagen and proteoglycans filled with a large amount of water During the first phase of compression, water is expelled from the gel-like structure and deformation occurs easily resulting in low stiffness and a high level of creep under constant loading Once a large amount of water has been expressed, the structural elements of the matrix support the load, the material becomes stiffer, and creep occurs at a lower rate

Mechanics of Biomaterials -- Metals

Commonly used metals for medical implants Stainless Steel Cobalt-Chromium Alloy Titanium Alloy Elastic moduli of metals are about 1 order of magnitude higher than cortical bone Titanium has an elastic modulus of approximately 1/2 that of stainless steel or cobalt alloys

Mechanics of Biomaterials -- Metals

Fatigue Fracture of metals is an important consideration due to the cyclic loading of orthopaedic implants and the inability of artificial materials to self-repair The endurance limit of typical implant metals is between 250 MPa (Stainless steel) and 400 MPa (Titanium Alloy) Fatigue is quickened due to the effect of corrosion of the metals

Corrosion

Corrosion is a chemical reaction that occurs to form metallic ions and hydroxides. It is extremely common for metals placed in electrolytic solutions, such as the physiological environment. Implant metals rely on the existence of an inert protective layer to resist corrosion Passivation is a reaction that produces a surface coating, typically a metal oxide, on the metallic material which results in an equilibrium solution of metal ions

Corrosion

Implant metals and surface coatings Stainless steel -- chromium oxide Titanium alloy -- titanium dioxide Cobalt-chromium alloy -- none corrosion resistance due to an immunity mechanism While an oxide layer may be generally inactive in vivo, changes in pH -- due to variations in location or disease processes -- may damage the layer and result in corrosion Oxide layers can also be damaged due to mechanical trauma, such as scratching, which can then lead to corrosion Most oxide layers are self-repairing in the presence of oxygen

Corrosion

Multiple types of corrosion Uniform attack: requires a bathing solution with considerable ionic activity (eg. physiological solution) Galvanic attack: when two different metals are in contact in an electrolytic solution, one may tend to release ions to the other anode --> cathode Cathodic material gains protection against corrosion

Corrosion

Stress corrosion: caused by rupture of the passive surface layer as a result of high tensile stresses, allowing local attack at the exposed site If conditions favor passivation, repair of the crack will occur by formation of the oxide layer Continued cyclic loading or the presence of organic molecules may interfere with the repair allowing for continued local attack, resulting in stress concentrations and possible failure

Corrosion

Pitting: galvanic attack which occurs between two adjacent locations on the same metal due to impurities in the alloy which result in a galvanic reaction Intergranular attack: similar to pitting, however the impurities exist in the boundaries between the metal crystals or grains. Results in grain-boundary cracks. Crevice corrosion: A linear and local attack, similar to stress corrosion, which occurs at sites where scratches, seams, or fatigue cracks form defects in the metal oxide coating. These areas typically have low oxygen concentration and so passivation, and coating repair, is inhibited.

Question 17

Which of the following will help prevent corrosion of an implant? (1) An oxide layer (2) Repetitive axial loading (3) Contact of two dissimilar metals (4) Muscle over the implant (5) A layer of fibrin

Question 17

Which of the following will help prevent corrosion of an implant? (1) An oxide layer (2) Repetitive axial loading (3) Contact of two dissimilar metals (4) Muscle over the implant (5) A layer of fibrin

Mechanics of Biomaterials -- Polymers

Polyethylene, polymethyl methacrylate (PMMA), and silicones are commonly used polymers for orthopaedic applications Polyethylene Low friction coefficient reduces wear when used as a bearing surface for joint replacements Low strength Limited resistance to wear which does occur

Mechanics of Biomaterials -- Polymers

PMMA Typically used as bone cement Low viscosity immediately following mixing, allowing for insertion in the medullary canal Low tensile strength, higher compressive strength Silicones (rubber) Very low strength, poor wear behavior High energy absorption properties Used as spacer for small, load-bearing joints

Mechanics of Biomaterials-- Ceramics

Include aluminum oxide, calcium phosphate, and various "bioglasses" Investigated due to chemical inertness for use as implant materials Very brittle, hard, low tensile strength, high modulus High resistance to wear, low friction coefficient when polished, high compressive strength Possibility exists for development of a bio-reactive ceramic which induces bone growth

Mechanical Properties -Biomaterials

Elastic Modulus (GPa) Cortical Bone Cancellous Bone 15 1 200 100 200-230 2 Ultimate Tensile Strength (MPa) 100 2 >500 900 >450 40 80 Ultimate Compressive Maximum Strength Elongation (MPa) 175 3 2% 10% 15-40% 10% 8-10% 500%

Stainless Steel
Titanium Alloy

Cobalt-Chrome
Polymethylmethacrlyate Polyethylene Aluminum Oxide

1
350

40

20
3500

5%
minimal

Question 18

Which of the following is the best description of a comparison of mechanical properties of titanium and cortical bone? (1) Titanium is twice as stiff as bone (2) Titanium has a higher modulus of elasticity than bone (3) Bone has a higher modulus of elasticity than titanium (4) Titanium and bone have the same stiffness (5) Titanium and bone have the same modulus of elasticity

Question 18

Which of the following is the best description of a comparison of mechanical properties of titanium and cortical bone? (1) Titanium is twice as stiff as bone (2) Titanium has a higher modulus of elasticity than bone (3) Bone has a higher modulus of elasticity than titanium (4) Titanium and bone have the same stiffness (5) Titanium and bone have the same modulus of elasticity

Question 19

Compared to a stainless steel bone plate that is the same size, the rigidity of a titanium plate is: (1) Two times greater (2) The same (3) Half as great (4) One-fourth as great (5) One-eighth as great

Question 19

Compared to a stainless steel bone plate that is the same size, the rigidity of a titanium plate is: (1) Two times greater (2) The same (3) Half as great (4) One-fourth as great (5) One-eighth as great

Question 20

The modulus of elasticity of methylmethacrylate bone cement is: (1) The same as that of polyethylene (2) Between the values of cortical bone and cancellous bone (3) Between the values for cobalt-chromium alloy and cortical bone (4) Less than that of cancellous bone (5) Less than that of cortical bone but greater than that of cobalt-chromium alloy

Question 20

The modulus of elasticity of methylmethacrylate bone cement is: (1) The same as that of polyethylene (2) Between the values of cortical bone and cancellous bone (3) Between the values for cobalt-chromium alloy and cortical bone (4) Less than that of cancellous bone (5) Less than that of cortical bone but greater than that of cobalt-chromium alloy