Prothèses totales de genoux. Analyse clinique et numérique des micromouvements de l'implant tibial [Total knee prosthesis. Clinical and numerical study of micromovements of the tibial implant].

INTRODUCTION: The importance of the micromovements in the mechanism of aseptic loosening is clinically difficult to evaluate. To complete the analysis of a series of total knee arthroplasties (TKA), we used a tridimensional numerical model to study the micromovements of the tibial implant. MATERIAL AND METHODS: Fifty one patients (with 57 cemented Porous Coated Anatomic TKAs) were reviewed (mean follow-up 4.5 year). Radiolucency at the tibial bone-cement interface was sought on the AP radiographs and divided in 7 areas. The distribution of the radiolucency was then correlated with the axis of the lower limb as measured on the orthoradiograms. The tridimensional numerical model is based on the finite element method. It allowed the measurement of the cemented prosthetic tibial implant's displacements and the micromovements generated at bone-ciment interface. A total load (2000 Newton) was applied at first vertically and asymetrically on the tibial plateau, thereby simulating an axial deviation of the lower limbs. The vector's posterior inclination then permitted the addition of a tangential component to the axial load. This type of effort is generated by complex biomechanical phenomena such as knee flexion. RESULTS: 81 per cent of the 57 knees had a radiolucent line of at least 1 mm, at one or more of the tibial cement-epiphysis jonctional areas. The distribution of these lucent lines showed that they came out more frequently at the periphery of the implant. The lucent lines appeared most often under the unloaded margin of the tibial plateau, when axial deviation of lower limbs was present. Numerical simulations showed that asymetrical loading on the tibial plateau induced a subsidence of the loaded margin (0-100 microns) and lifting off at the opposite border (0-70 microns). The postero-anterior tangential component induced an anterior displacement of the tibial implant (160-220 microns), and horizontal micromovements with non homogenous distribution at the bone-ciment interface (28-54 microns). DISCUSSION: Comparison of clinical and numerical results showed a relation between the development of radiolucent lines and the unloading of the tibial implant's margin. The deleterious effect of lower limbs' axial deviation is thereby proven. The irregular distribution of lucent lines under the tibial plateau was similar of the micromovements' repartition at the bone-cement interface when tangential forces were present. A causative relation between the two phenomenaes could not however be established. Numerical simulation is a truly useful method of study; it permits to calculate micromovements which are relative, non homogenous and of very low amplitude. However, comparative clinical studies remain as essential to ensure the credibility of results.

Evaluating Roadway Subsurface Drainage Practices, 2013

The bearing capacity and service life of a pavement is affected adversely by the presence of undrained water in the pavement layers. In cold winter climates like in Iowa, this problem is magnified further by the risk of frost damage when water is present. Therefore, well-performing subsurface drainage systems form an important aspect of pavement design by the Iowa Department of Transportation (DOT). However, controversial findings are also reported in the literature regarding the benefits of subsurface drainage. The goal of this research was not to investigate whether subdrains are needed in Iowa pavements, but to conduct an extensive performance review of primary interstate pavement subdrains in Iowa, determine the cause of the problem if there are drains that are not functioning properly, and investigate the effect of poor subdrain performance due to improper design, construction, and maintenance on pavement surface distresses, if any. An extensive literature review was performed covering national-level and state-level research studies mainly focusing on the effects of subsurface drainage on performance of asphalt and concrete pavements. Several studies concerning the effects of a recycled portland cement concrete (RPCC) subbase on PCC pavement drainage systems were also reviewed. A detailed forensic test plan was developed in consultation with the project technical advisory committee (TAC) for inspecting and evaluating the Iowa pavement subdrains. Field investigations were conducted on 64 selected (jointed plain concrete pavement/JPCP and hot-mix asphalt/HMA) pavement sites during the fall season of 2012 and were mainly focused on the drainage outlet conditions. Statistical analysis was conducted on the compiled data from field investigations to further investigate the effect of drainage on pavement performance. Most Iowa subsurface drainage system outlet blockage is due to tufa, sediment, and soil. Although higher blockage rates reduce the flow rate of water inside outlet pipes, it does not always stop water flowing from inside the outlet pipe to outside the outlet pipe unless the outlet is completely blocked. Few pavement surface distresses were observed near blocked subsurface drainage outlet spots. More shoulder distresses (shoulder drop or cracking) were observed near blocked drainage outlet spots compared to open ones. Both field observations and limited performance analysis indicate that drainage outlet conditions do not have a significant effect on pavement performance. The use of RPCC subbase in PCC pavements results in tufa formation, a primary cause of drainage outlet blockage in JPCP. Several useful recommendations to potentially improve Iowa subdrain performance, which warrant detailed field investigations, were made

Evaluating Roadway Subsurface Drainage Practices: Tech Transfer Summary, 2013.

The bearing capacity and service life of a pavement is affected adversely by the presence of undrained water in the pavement layers. In cold winter climates like in Iowa, this problem is magnified further by the risk of frost damage when water is present. Therefore, well-performing subsurface drainage systems form an important aspect of pavement design by the Iowa Department of Transportation (DOT). However, controversial findings are also reported in the literature regarding the benefits of subsurface drainage. The goal of this research was not to investigate whether subdrains are needed in Iowa pavements, but to conduct an extensive performance review of primary interstate pavement subdrains in Iowa, determine the cause of the problem if there are drains that are not functioning properly, and investigate the effect of poor subdrain performance due to improper design, construction, and maintenance on pavement surface distresses, if any. An extensive literature review was performed covering national-level and state-level research studies mainly focusing on the effects of subsurface drainage on performance of asphalt and concrete pavements. Several studies concerning the effects of a recycled portland cement concrete (RPCC) subbase on PCC pavement drainage systems were also reviewed. A detailed forensic test plan was developed in consultation with the project technical advisory committee (TAC) for inspecting and evaluating the Iowa pavement subdrains. Field investigations were conducted on 64 selected (jointed plain concrete pavement/JPCP and hot-mix asphalt/HMA) pavement sites during the fall season of 2012 and were mainly focused on the drainage outlet conditions. Statistical analysis was conducted on the compiled data from field investigations to further investigate the effect of drainage on pavement performance. Most Iowa subsurface drainage system outlet blockage is due to tufa, sediment, and soil. Although higher blockage rates reduce the flow rate of water inside outlet pipes, it does not always stop water flowing from inside the outlet pipe to outside the outlet pipe unless the outlet is completely blocked. Few pavement surface distresses were observed near blocked subsurface drainage outlet spots. More shoulder distresses (shoulder drop or cracking) were observed near blocked drainage outlet spots compared to open ones. Both field observations and limited performance analysis indicate that drainage outlet conditions do not have a significant effect on pavement performance. The use of RPCC subbase in PCC pavements results in tufa formation, a primary cause of drainage outlet blockage in JPCP. Several useful recommendations to potentially improve Iowa subdrain performance, which warrant detailed field investigations, were made.

Training Development for Pavement Preservation, RB07-011, 2013

This research project strives to help the Iowa Department of Transportation (DOT) fully achieve the full benefits of pavement preservation through training on proper selection, design, and application of pavement preservation treatments. In some cases, there is a lack of training when conducting one of these steps and the objective of applying pavement preservation techniques is compromised. Extensive amounts of literature on pavement preservation exist, but a structured approach on how to train staff in selecting, designing, and applying pavement preservation techniques is lacking. The objective of this project was to develop a training-oriented learning management system to address pavement preservation treatments (chip seals, fog seals, slurry systems, and crack seals and fills) as they are dealt with during the phases of selection, design, and construction. Early in the project, it was critical to identify the staff divisions to be trained and the treatments to be included. Through several meetings with the Iowa DOT, three staff divisions were identified: maintenance staff (in charge of selection), design staff, and construction staff. In addition, the treatments listed above were identified as the focus of the study due to their common use. Through needs analysis questionnaires and meetings, the knowledge gap and training needs of the agency were identified. The training modules developed target the gap from the results of the needs analysis. The concepting (selection) training focuses on providing the tools necessary to help make proper treatment selection. The design training focuses on providing the information necessary on the treatment materials (mostly binders and aggregates) and how to make proper material selection. Finally, the construction training focuses on providing equipment calibration procedures, inspection responsibilities, and images of poor and best practices. The research showed that it is important to train each division staff (maintenance, design, and construction) separately, as each staff division has its own needs and interests. It was also preferred that each treatment was covered on an individual basis. As a result of the research, it is recommended to evaluate the performance of pavement preservation treatments pre- and post-training continuously to compare results and verify the effectiveness of the learning management system.

Development of Performance Properties of Ternary Mixtures and Concrete Pavement Mixture Design and Analysis (MDA): Effect of Paste Quality on Fresh and Hardened Properties of Ternary Mixtures, TPF-5(117), 2012

The purpose of this study was to investigate the effect of cement paste quality on the concrete performance, particularly fresh properties, by changing the water-to-cementitious materials ratio (w/cm), type and dosage of supplementary cementitious materials (SCM), and airvoid system in binary and ternary mixtures. In this experimental program, a total matrix of 54 mixtures with w/cm of 0.40 and 0.45; target air content of 2%, 4%, and 8%; a fixed cementitious content of 600 pounds per cubic yard (pcy), and the incorporation of three types of SCMs at different dosages was prepared. The fine aggregate-to- total aggregate ratio was fixed at 0.42. Workability, rheology, air-void system, setting time, strength, Wenner Probe surface resistivity, and shrinkage were determined. The effects of paste variables on workability are more marked at the higher w/cm. The compressive strength is strongly influenced by the paste quality, dominated by w/cm and air content. Surface resistivity is improved by inclusion of Class F fly ash and slag cement, especially at later ages. Ternary mixtures performed in accordance with their ingredients. The data collected will be used to develop models that will be part of an innovative mix proportioning procedure.

Development of Performance Properties of Ternary Mixtures: Field Demonstrations and Project Summary, TPF-5(117), 2012

Supplementary cementitious materials (SCM) have become common parts of modern concrete practice. The blending of two or three cementitious materials to optimize durability, strength, or economics provides owners, engineers, materials suppliers, and contractors with substantial advantages over mixtures containing only portland cement. However, these advances in concrete technology and engineering have not always been adequately captured in specifications for concrete. Users need specific guidance to assist them in defining the performance requirements for a concrete application and the selection of optimal proportions of the cementitious materials needed to produce the required durable concrete. The fact that blended cements are currently available in many regions increases options for mixtures and thus can complicate the selection process. Both Portland and blended cements have already been optimized by the manufacturer to provide specific properties (such as setting time, shrinkage, and strength gain). The addition of SCMs (as binary, ternary, or even more complex mixtures) can alter these properties, and therefore has the potential to impact the overall performance and applications of concrete. This report is the final of a series of publications describing a project aimed at addressing effective use of ternary systems. The work was conducted in several stages and individual reports have been published at the end of each stage.