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THE MISSION of the Department of Biomechanics is to apply principles of engineering and materials science to solve orthopaedic problems by conducting basic and applied research that translates to the development of orthopaedic devices and instrumentation aimed at improved patient care.
HSS and the Department of Biomechanics have successfully opened the first provider-based 3D printing lab for complex, personalized orthopaedic implants. A collaboration between HSS and Lima, a leading global medical device manufacturer based in Italy, the facility will leverage the combination of Lima’s advanced technology and experience along with our expertise in clinical care and biomechanical engineering.
A collaborative effort between the Biomechanics Department, the HSS Sports Medicine Institute, and the University of Vermont confirmed that our computer models of knee stability can identify those at risk of ACL trauma. We used magnetic resonance imaging data to construct models of a pair of male and female ACL-injured cases and corresponding uninjured teammates.
We found that the predicted ACL forces using knee geometries from ACL-injured knees were dramatically higher than those in the uninjured teammate. This finding is a first step towards designing enhanced ACL injury prevention protocols and novel surgical treatments customized to an individual’s sex, sport, age, and level of play.
Several approaches have been proposed to correct flexion contracture during knee replacement surgery, but no consensus has emerged on a surgical strategy to restore full extension. We modified our computational knee model to simulate a flexion contracture and to examine the amount of knee extension that would be restored by incrementally resecting more of the distal femur. What emerged was a simple rule for surgeons to follow: for every millimeter of extra bone resected, the knee will gain 2 degrees of extra extension.
Analysis of the Influence of Species, Intervertebral Disc Height and Pfirrmann Classification on Failure Load of an Injured Disc Using a Novel Disc Herniation Model. Virk S, Meyers KN, Lafage V, Maher SA, Chen T. Spine J. 2020 Nov 3:S1529-9430(20)31205-5. PMID: 33157322
Biomechanical Evaluation of Total Ankle Arthroplasty. Part I: Joint Loads during Simulated Level Walking. Steineman BD, Quevedo González FJ, Sturnick DR, Deland JT, Demetracopoulos CA, Wright TM. J Orthop Res. 2020 Nov 4. Online ahead of print. PMID: 33146417
Biomechanical Evaluation of Total Ankle Arthroplasty. Part II: Influence of Loading and Fixation Design on Tibial Bone-Implant interaction. Quevedo González FJ, Steineman BD, Sturnick DR, Deland JT, Demetracopoulos CA, Wright TM. J Orthop Res. 2020 Oct 8. Online ahead of print. PMID: 33030768
Original research between HSS biomechanical engineers and sports medicine surgeons has revealed that some patients are meniscal loaders, meaning that they heavily load their menisci during their daily activities; others mechanically bypass their menisci, instead placing more load on the cartilage of the knee. This led us to hypothesize that patients who are meniscal loaders are at increased risk for highly altered joint mechanics and joint degeneration after meniscal injury. This hypothesis is being tested through a full mechanical evaluation of partial meniscectomy patients pre- and post-surgery, including using magnetic resonance imaging to quantify joint-level tissue changes. The goal is to develop a predictive model to guide the surgical decision-making process for patients with meniscal injury.
Joint reconstruction, regardless of the joint and regardless of the surgical treatment, can be advanced if we can provide objective measures of joint stability before and after surgery and of the alteration of contact forces intraoperatively to aid in surgical decision-making. We are building a host of tools, including a knee dynamometer and intraoperative pressure sensors, and validating their usefulness through a combination of our computational joint models, imaging markers of joint health and patient-reported outcomes. We aim to develop a suite of patient-specific applications for pre-operative and surgical planning.
Working with surgeons from the Stavros Niarchos Foundation Complex Joint Reconstruction Center (CJRC) at HSS, we have been investigating the patient, surgical and implant design factors that influence the outcomes of revision surgery for failed total hip replacements. Our research combines the extensive expertise of surgeons and engineers with the large clinical caseload of the CJRC, enabling us to identify the key factors that lead to a successful result. We are seeking to develop clear guidelines to classify the types of defects and the associated treatment approaches that lead to a successful revision.