Vibration-assisted bone-graft compaction in impaction bone grafting of the femur

The complications of impaction bone grafting in revision hip replacement includes fracture of he femur and subsidence of the prosthesis. In this in vitro study we aimed to investigate whether the use of vibration, combined with a perforated tamp during the compaction of morsellised allograft would reduce peak loads and hoop strains in the femur as a surrogate marker of the risk of fracture and whether it would also improve graft compaction and prosthetic stability. We found that the peak loads and hoop strains transmitted to the femoral cortex during graft compaction and subsidence of the stem in subsequent mechanical testing were reduced. This innovative technique has the potential to reduce the risk of intra-operative fracture and to improve graft compaction and therefore prosthetic stability. © 2007 British Editorial Society of Bone and Joint Surgery.

Techniques to improve the shear strength of impacted bone graft: the effect of particle size and washing of the graft.

BACKGROUND: When fresh morselized graft is compacted, as in impaction bone-grafting for revision hip surgery, fat and marrow fluid is either exuded or trapped in the voids between particles. We hypothesized that the presence of incompressible fluid damps and resists compressive forces during impaction and prevents the graft particles from moving into a closer formation, thus reducing the graft strength. In addition, viscous fluid such as fat may act as an interparticle lubricant, thus reducing the interlocking of the particles. METHODS: We performed mechanical shear testing in the laboratory with use of fresh-frozen human femoral-head allografts that had been passed through different orthopaedic bone mills to produce graft of differing particle-size distributions (grading). RESULTS: After compaction of fresh graft, fat and marrow fluid continued to escape on application of normal loads. Washed graft, however, had little lubricating fluid and better contact between the particles, increasing the shear resistance. On mechanical testing, washed graft was significantly (p < 0.001) more resistant to shearing forces than fresh graft was. This feature was consistent for different bone mills that produced graft of different particle-size distributions and shear strengths. CONCLUSIONS: Removal of fat and marrow fluid from milled human allograft by washing the graft allows the production of stronger compacted graft that is more resistant to shear, which is the usual mode of failure. Further research into the optimum grading of particle sizes from bone mills is required.

Techniques to improve the shear strength of impacted bone graft: The effect of particle size and washing of the graft

Background: When fresh morselized graft is compacted, as in impaction bone-grafting for revision hip surgery, fat and marrow fluid is either exuded or trapped in the voids between particles. We hypothesized that the presence of incompressible fluid damps and resists compressive forces during impaction and prevents the graft particles from moving into a closer formation, thus reducing the graft strength. In addition, viscous fluid such as fat may act as an interparticle lubricant, thus reducing the interlocking of the particles. Methods: We performed mechanical shear testing in the laboratory with use of fresh-frozen human femoral-head allografts that had been passed through different orthopaedic bone mills to produce graft of differing particle-size distributions (grading). Results: After compaction of fresh graft, fat and marrow fluid continued to escape on application of normal loads. Washed graft, however, had little lubricating fluid and better contact between the particles, increasing the shear resistance. On mechanical testing, washed graft was significantly (p < 0.001) more resistant to shearing forces than fresh graft was. This feature was consistent for different bone mills that produced graft of different particle-size distributions and shear strengths. Conclusions: Removal of fat and marrow fluid from milled human allograft by washing the graft allows the production of stronger compacted graft that is more resistant to shear, which is the usual mode of failure. Further research into the optimum grading of particle sizes from bone mills is required. Clinical Relevance: Understanding the mechanical properties of milled human allograft is important when impaction grafting is used for mechanical support. A simple means of improving the mechanical strength of graft produced by currently available bone mills, including an intraoperative washing technique, is described.

Breakdown voltage for superjunction power devices with charge imbalance: An analytical model valid for both punch through and non punch through devices

An analytical model for the electric field and the breakdown voltage (BV) of an unbalanced superjunction (SJ) device is presented in this paper. The analytical technique uses a superposition approach treating the asymmetric charge in the pillars as an excess charge component superimposed on a balanced charge component. The proposed double-exponentialmodel is able to accurately predict the electric field and the BV for unbalanced SJ devices in both punch through and non punch through conditions. The model is also reasonably accurate at extremely high levels of charge imbalance when the devices behave similarly to a PiN diode or to a high-conductance layer. The analytical model is compared against numerical simulations of charge unbalanced SJ devices and against experimental results. © 2009 IEEE.

The effect of shape on the adhesion of fibrillar surfaces.

Experimental data have demonstrated that mushroom-shaped fibrils adhere much better to smooth substrates than punch-shaped fibrils. We present a model that suggests that detachment processes for such fibrils are controlled by defects in the contact area that are confined to its outer edge. Stress analysis of the adhered fibril, carried out for both punch and mushroom shapes with and without friction, suggests that defects near the edge of the adhesion area are much more damaging to the pull-off strength in the case of the punch than for the mushroom. The simulations show that the punch has a higher driving force for extension of small edge defects compared with the mushroom adhesion. The ratio of the pull-off force for the mushroom to that of the punch can be predicted from these simulations to be much greater than 20 in the friction-free case, similar to the experimental value. In the case of sticking friction, a ratio of 14 can be deduced. Our analysis also offers a possible explanation for the evolution of asymmetric mushroom shapes (spatulae) in the adhesion organ of geckos.

A model for the erosive wear of rubber at oblique impact angles

A model has been developed to predict the erosive wear behaviour of elastomers under conditions of glancing impact by small hard particles. Previous work has shown the erosive wear mechanism of elastomers under these conditions to be similar in nature to that of abrasive wear by a sharp blade. The model presented here was developed from the model of Southern and Thomas for sliding abrasion, by combining their treatment of the growth of surface cracks with a model for particle impact in which the force - displacement relationship for an idealized flat-ended punch on a semi-infinite elastic solid was assumed. In this way an expression for the erosive wear rate was developed, and compared with experimental measurements of wear rate for natural rubber, styrene - butadiene rubber and a highly crosslinked polybutadiene rubber. Good qualitative agreement was found between the predictions of the model and the experimental measurements. The variation of erosion rate with impact velocity, impact angle, particle size, elastic modulus of the material, coefficient of friction and fatigue properties were all well accounted for. Quantitative agreement was less good, and the effects of erosive particle shape could not be accounted for. The reasons for these discrepancies are discussed. © 1992 IOP Publishing Ltd.

The role of vibration and drainage in femoral impaction bone grafting.

Vibration is commonly used in civil engineering applications to efficiently compact aggregates. This study examined the effect of vibration and drainage on bone graft compaction and cement penetration in an in vitro femoral impaction bone grafting model with the use of 3-dimensional micro-computed tomographic imaging. Three regions were analyzed. In the middle and proximal femoral regions, there was a significant increase in the proportion of bone grafts with a reciprocal reduction in water and air in the vibration-assisted group (P < .01) as compared with the control group, suggesting tighter graft compaction. Cement volume was also significantly reduced in the middle region in the vibration-assisted group. No difference was observed in the distal region. This study demonstrates the value of vibration and drainage in bone graft compaction, with implications therein for clinical application and outcome.

Long term peripheral nerve regeneration using a novel PCL nerve conduit.

The gold standard in surgical management of a peripheral nerve gap is currently autologous nerve grafting. This confers patient morbidity and increases surgical time therefore innovative experimental strategies towards engineering a synthetic nerve conduit are welcome. We have developed a novel synthetic conduit made of poly ε-caprolactone (PCL) that has demonstrated promising peripheral nerve regeneration in short-term studies. This material has been engineered to permit translation into clinical practice and here we demonstrate that histological outcomes in a long-term in vivo experiment are comparable with that of autologous nerve grafting. A 1cm nerve gap in a rat sciatic nerve injury model was repaired with a PCL nerve conduit or an autologous nerve graft. At 18 weeks post surgical repair, there was a similar volume of regenerating axons within the nerve autograft and PCL conduit repair groups, and similar numbers of myelinated axons in the distal stump of both groups. Furthermore, there was evidence of comparable re-innervation of end organ muscle and skin with the only significant difference the lower wet weight of the muscle from the PCL conduit nerve repair group. This study stimulates further work on the potential use of this synthetic biodegradable PCL nerve conduit in a clinical setting.

Effect of bandgap narrowing on performance of modern power devices

The effect of the bandgap narrowing (BGN) on performance of power devices is investigated in detail in this paper. The analysis reveals that the change in the energy band structure caused by BGN can strongly affect the conductivity modulation of the bipolar devices resulting in a completely different performance. This is due to the modified injection efficiency under high-level injection conditions. Using a comprehensive analysis of the injection efficiency in a p-n junction, an analytical model for this phenomenon is developed. BGN model tuning has been proved to be essential in accurately predicting the performance of a lateral insulated-gate bipolar transistor (IGBT). Other devices such as p-i-n diodes or punch-through IGBTs are significantly affected by the BGN, while others, such as field-stop IGBTs or power MOSFETs, are only marginally affected. © 2013 IEEE.