@article{BhattaraiMayStaatetal.2022, author = {Bhattarai, Aroj and May, Charlotte Anabell and Staat, Manfred and Kowalczyk, Wojciech and Tran, Thanh Ngoc}, title = {Layer-specific damage modeling of porcine large intestine under biaxial tension}, series = {Bioengineering}, volume = {9}, journal = {Bioengineering}, number = {10, Early Access}, publisher = {MDPI}, address = {Basel}, issn = {2306-5354}, doi = {10.3390/bioengineering9100528}, pages = {1 -- 17}, year = {2022}, abstract = {The mechanical behavior of the large intestine beyond the ultimate stress has never been investigated. Stretching beyond the ultimate stress may drastically impair the tissue microstructure, which consequently weakens its healthy state functions of absorption, temporary storage, and transportation for defecation. Due to closely similar microstructure and function with humans, biaxial tensile experiments on the porcine large intestine have been performed in this study. In this paper, we report hyperelastic characterization of the large intestine based on experiments in 102 specimens. We also report the theoretical analysis of the experimental results, including an exponential damage evolution function. The fracture energies and the threshold stresses are set as damage material parameters for the longitudinal muscular, the circumferential muscular and the submucosal collagenous layers. A biaxial tensile simulation of a linear brick element has been performed to validate the applicability of the estimated material parameters. The model successfully simulates the biomechanical response of the large intestine under physiological and non-physiological loads.}, language = {en} } @article{ColomboDriraFrotscheretal.2022, author = {Colombo, Daniele and Drira, Slah and Frotscher, Ralf and Staat, Manfred}, title = {An element-based formulation for ES-FEM and FS-FEM models for implementation in standard solid mechanics finite element codes for 2D and 3D static analysis}, series = {International Journal for Numerical Methods in Engineering}, volume = {124}, journal = {International Journal for Numerical Methods in Engineering}, number = {2}, publisher = {Wiley}, address = {Chichester}, issn = {1097-0207}, doi = {10.1002/nme.7126}, pages = {402 -- 433}, year = {2022}, abstract = {Edge-based and face-based smoothed finite element methods (ES-FEM and FS-FEM, respectively) are modified versions of the finite element method allowing to achieve more accurate results and to reduce sensitivity to mesh distortion, at least for linear elements. These properties make the two methods very attractive. However, their implementation in a standard finite element code is nontrivial because it requires heavy and extensive modifications to the code architecture. In this article, we present an element-based formulation of ES-FEM and FS-FEM methods allowing to implement the two methods in a standard finite element code with no modifications to its architecture. Moreover, the element-based formulation permits to easily manage any type of element, especially in 3D models where, to the best of the authors' knowledge, only tetrahedral elements are used in FS-FEM applications found in the literature. Shape functions for non-simplex 3D elements are proposed in order to apply FS-FEM to any standard finite element.}, language = {en} } @article{BhattaraiHorbachStaatetal.2022, author = {Bhattarai, Aroj and Horbach, Andreas and Staat, Manfred and Kowalczyk, Wojciech and Tran, Thanh Ngoc}, title = {Virgin passive colon biomechanics and a literature review of active contraction constitutive models}, series = {Biomechanics}, volume = {2}, journal = {Biomechanics}, number = {2}, publisher = {MDPI}, address = {Basel}, issn = {2673-7078}, doi = {10.3390/biomechanics2020013}, pages = {138 -- 157}, year = {2022}, abstract = {The objective of this paper is to present our findings on the biomechanical aspects of the virgin passive anisotropic hyperelasticity of the porcine colon based on equibiaxial tensile experiments. Firstly, the characterization of the intestine tissues is discussed for a nearly incompressible hyperelastic fiber-reinforced Holzapfel-Gasser-Ogden constitutive model in virgin passive loading conditions. The stability of the evaluated material parameters is checked for the polyconvexity of the adopted strain energy function using positive eigenvalue constraints of the Hessian matrix with MATLAB. The constitutive material description of the intestine with two collagen fibers in the submucosal and muscular layer each has been implemented in the FORTRAN platform of the commercial finite element software LS-DYNA, and two equibiaxial tensile simulations are presented to validate the results with the optical strain images obtained from the experiments. Furthermore, this paper also reviews the existing models of the active smooth muscle cells, but these models have not been computationally studied here. The review part shows that the constitutive models originally developed for the active contraction of skeletal muscle based on Hill's three-element model, Murphy's four-state cross-bridge chemical kinetic model and Huxley's sliding-filament hypothesis, which are mainly used for arteries, are appropriate for numerical contraction numerical analysis of the large intestine.}, language = {en} } @inproceedings{StaatTran2022, author = {Staat, Manfred and Tran, Ngoc Trinh}, title = {Strain based brittle failure criteria for rocks}, series = {Proceedings of (NACOME2022) The 11th National Conference on Mechanics, Vol. 1. Solid Mechanics, Rock Mechanics, Artificial Intelligence, Teaching and Training, Hanoi, December 2-3, 2022}, booktitle = {Proceedings of (NACOME2022) The 11th National Conference on Mechanics, Vol. 1. Solid Mechanics, Rock Mechanics, Artificial Intelligence, Teaching and Training, Hanoi, December 2-3, 2022}, publisher = {Nha xuat ban Khoa hoc tu nhien va Cong nghe (Verlag Naturwissenschaft und Technik)}, address = {Hanoi}, isbn = {978-604-357-084-7}, pages = {500 -- 509}, year = {2022}, abstract = {When confining pressure is low or absent, extensional fractures are typical, with fractures occurring on unloaded planes in rock. These "paradox" fractures can be explained by a phenomenological extension strain failure criterion. In the past, a simple empirical criterion for fracture initiation in brittle rock has been developed. But this criterion makes unrealistic strength predictions in biaxial compression and tension. A new extension strain criterion overcomes this limitation by adding a weighted principal shear component. The weight is chosen, such that the enriched extension strain criterion represents the same failure surface as the Mohr-Coulomb (MC) criterion. Thus, the MC criterion has been derived as an extension strain criterion predicting failure modes, which are unexpected in the understanding of the failure of cohesive-frictional materials. In progressive damage of rock, the most likely fracture direction is orthogonal to the maximum extension strain. The enriched extension strain criterion is proposed as a threshold surface for crack initiation CI and crack damage CD and as a failure surface at peak P. Examples show that the enriched extension strain criterion predicts much lower volumes of damaged rock mass compared to the simple extension strain criterion.}, language = {en} } @article{TranTrinhDaoetal.2022, author = {Tran, Ngoc Trinh and Trinh, Tu Luc and Dao, Ngoc Tien and Giap, Van Tan and Truong, Manh Khuyen and Dinh, Thuy Ha and Staat, Manfred}, title = {FEM shakedown analysis of structures under random strength with chance constrained programming}, series = {Vietnam Journal of Mechanics}, volume = {44}, journal = {Vietnam Journal of Mechanics}, number = {4}, publisher = {Vietnam Academy of Science and Technology (VAST)}, issn = {0866-7136}, doi = {10.15625/0866-7136/17943}, pages = {459 -- 473}, year = {2022}, abstract = {Direct methods, comprising limit and shakedown analysis, are a branch of computational mechanics. They play a significant role in mechanical and civil engineering design. The concept of direct methods aims to determine the ultimate load carrying capacity of structures beyond the elastic range. In practical problems, the direct methods lead to nonlinear convex optimization problems with a large number of variables and constraints. If strength and loading are random quantities, the shakedown analysis can be formulated as stochastic programming problem. In this paper, a method called chance constrained programming is presented, which is an effective method of stochastic programming to solve shakedown analysis problems under random conditions of strength. In this study, the loading is deterministic, and the strength is a normally or lognormally distributed variable.}, language = {en} } @misc{TopcuMadabhushiStaat2022, author = {Topcu, Murat and Madabhushi, Gopal Santana Phani and Staat, Manfred}, title = {Datasets from FEM Simulations done with COMSOL Multiphysics and Code_Aster}, doi = {10.6084/m9.figshare.19333295.v2}, year = {2022}, abstract = {Datasets from FEM Simulations done with COMSOL Multiphysics and Code_Aster for an elastic stress transfer between matrix and fibres having a variable radius.}, language = {en} } @article{TranStaat2021, author = {Tran, Ngoc Trinh and Staat, Manfred}, title = {Direct plastic structural design under random strength and random load by chance constrained programming}, series = {European Journal of Mechanics - A/Solids}, volume = {85}, journal = {European Journal of Mechanics - A/Solids}, number = {Article 104106}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0997-7538}, doi = {10.1016/j.euromechsol.2020.104106}, year = {2021}, language = {en} } @techreport{StoelzleFeixThomasEngelstaedteretal.2021, author = {St{\"o}lzle-Feix, Sonja and Thomas, Ulrich and Engelst{\"a}dter, Max and Goßmann, Matthias and Linder, Peter and Staat, Manfred and Raman, Aravind Hariharan and Jung, Alexander and Fertig, Niels}, title = {Plattformtechnologie f{\"u}r kardiale Sicherheitspharmakologie basierend auf teilsynthetischem Herzmuskelgewebe (FLEXcyte) : gemeinsamer FuE-Abschlussbericht aller Partner des Verbundprojektes : Projektlaufzeit: 01.10.2018 bis 30.09.2020}, publisher = {Nanion Technologies GmbH}, address = {M{\"u}nchen}, doi = {10.2314/KXP:1813208581}, pages = {IV, 85 Seiten, 2 ungez{\"a}hlte Seiten}, year = {2021}, language = {de} } @misc{JungMuellerStaat2021, author = {Jung, Alexander and M{\"u}ller, Wolfram and Staat, Manfred}, title = {Corrigendum to "Wind and fairness in ski jumping: A computer modelling analysis" [J. Biomech. 75 (2018) 147-153]}, series = {Journal of Biomechanics}, volume = {128}, journal = {Journal of Biomechanics}, number = {Article number: 110690}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0021-9290}, doi = {10.1016/j.jbiomech.2021.110690}, pages = {1 Seite}, year = {2021}, language = {en} } @inproceedings{TranStaat2021, author = {Tran, Ngoc Trinh and Staat, Manfred}, title = {FEM shakedown analysis of Kirchhoff-Love plates under uncertainty of strength}, series = {Proceedings of UNCECOMP 2021}, booktitle = {Proceedings of UNCECOMP 2021}, isbn = {978-618-85072-6-5}, doi = {10.7712/120221.8041.19047}, pages = {323 -- 338}, year = {2021}, abstract = {A new formulation to calculate the shakedown limit load of Kirchhoff plates under stochastic conditions of strength is developed. Direct structural reliability design by chance con-strained programming is based on the prescribed failure probabilities, which is an effective approach of stochastic programming if it can be formulated as an equivalent deterministic optimization problem. We restrict uncertainty to strength, the loading is still deterministic. A new formulation is derived in case of random strength with lognormal distribution. Upper bound and lower bound shakedown load factors are calculated simultaneously by a dual algorithm.}, language = {en} } @article{HacklBuessKammerlohretal.2021, author = {Hackl, Michael and Buess, Eduard and Kammerlohr, Sandra and Nacov, Julia and Staat, Manfred and Leschinger, Tim and M{\"u}ller, Lars P. and Wegmann, Kilian}, title = {A "comma sign"-directed subscapularis repair in anterosuperior rotator cuff tears yields biomechanical advantages in a cadaveric model}, series = {The american journal of sports medicine}, volume = {49}, journal = {The american journal of sports medicine}, number = {12}, publisher = {Sage}, address = {London}, issn = {1552-3365}, doi = {10.1177/03635465211031506}, pages = {3212 -- 3217}, year = {2021}, abstract = {Background: Additional stabilization of the "comma sign" in anterosuperior rotator cuff repair has been proposed to provide biomechanical benefits regarding stability of the repair. Purpose: This in vitro investigation aimed to investigate the influence of a comma sign-directed reconstruction technique for anterosuperior rotator cuff tears on the primary stability of the subscapularis tendon repair. Study Design: Controlled laboratory study. Methods: A total of 18 fresh-frozen cadaveric shoulders were used in this study. Anterosuperior rotator cuff tears (complete full-thickness tear of the supraspinatus and subscapularis tendons) were created, and supraspinatus repair was performed with a standard suture bridge technique. The subscapularis was repaired with either a (1) single-row or (2) comma sign technique. A high-resolution 3D camera system was used to analyze 3-mm and 5-mm gap formation at the subscapularis tendon-bone interface upon incremental cyclic loading. Moreover, the ultimate failure load of the repair was recorded. A Mann-Whitney test was used to assess significant differences between the 2 groups. Results: The comma sign repair withstood significantly more loading cycles than the single-row repair until 3-mm and 5-mm gap formation occurred (P≤ .047). The ultimate failure load did not reveal any significant differences when the 2 techniques were compared (P = .596). Conclusion: The results of this study show that additional stabilization of the comma sign enhanced the primary stability of subscapularis tendon repair in anterosuperior rotator cuff tears. Although this stabilization did not seem to influence the ultimate failure load, it effectively decreased the micromotion at the tendon-bone interface during cyclic loading. Clinical Relevance: The proposed technique for stabilization of the comma sign has shown superior biomechanical properties in comparison with a single-row repair and might thus improve tendon healing. Further clinical research will be necessary to determine its influence on the functional outcome.}, language = {en} } @article{Staat2021, author = {Staat, Manfred}, title = {An extension strain type Mohr-Coulomb criterion}, series = {Rock mechanics and rock engineering}, volume = {54}, journal = {Rock mechanics and rock engineering}, number = {12}, publisher = {Springer Nature}, address = {Cham}, issn = {1434-453X}, doi = {10.1007/s00603-021-02608-7}, pages = {6207 -- 6233}, year = {2021}, abstract = {Extension fractures are typical for the deformation under low or no confining pressure. They can be explained by a phenomenological extension strain failure criterion. In the past, a simple empirical criterion for fracture initiation in brittle rock has been developed. In this article, it is shown that the simple extension strain criterion makes unrealistic strength predictions in biaxial compression and tension. To overcome this major limitation, a new extension strain criterion is proposed by adding a weighted principal shear component to the simple criterion. The shear weight is chosen, such that the enriched extension strain criterion represents the same failure surface as the Mohr-Coulomb (MC) criterion. Thus, the MC criterion has been derived as an extension strain criterion predicting extension failure modes, which are unexpected in the classical understanding of the failure of cohesive-frictional materials. In progressive damage of rock, the most likely fracture direction is orthogonal to the maximum extension strain leading to dilatancy. The enriched extension strain criterion is proposed as a threshold surface for crack initiation CI and crack damage CD and as a failure surface at peak stress CP. Different from compressive loading, tensile loading requires only a limited number of critical cracks to cause failure. Therefore, for tensile stresses, the failure criteria must be modified somehow, possibly by a cut-off corresponding to the CI stress. Examples show that the enriched extension strain criterion predicts much lower volumes of damaged rock mass compared to the simple extension strain criterion.}, language = {en} } @article{HacklNacovKammerlohretal.2021, author = {Hackl, Michael and Nacov, Julia and Kammerlohr, Sandra and Staat, Manfred and Buess, Eduard and Leschinger, Tim and M{\"u}ller, Lars P. and Wegmann, Kilian}, title = {Intratendinous Strain Variations of the Supraspinatus Tendon Depending on Repair Technique: A Biomechanical Analysis Regarding the Cause of Medial Cuff Failure}, series = {The American Journal of Sports Medicine}, volume = {49}, journal = {The American Journal of Sports Medicine}, number = {7}, publisher = {Sage}, address = {London}, issn = {1552-3365}, doi = {10.1177/03635465211006138}, pages = {1847 -- 1853}, year = {2021}, language = {en} } @article{TranStaat2020, author = {Tran, Ngoc Trinh and Staat, Manfred}, title = {Direct plastic structural design under lognormally distributed strength by chance constrained programming}, series = {Optimization and Engineering}, volume = {21}, journal = {Optimization and Engineering}, number = {1}, publisher = {Springer Nature}, address = {Cham}, issn = {1573-2924}, doi = {10.1007/s11081-019-09437-2}, pages = {131 -- 157}, year = {2020}, abstract = {We propose the so-called chance constrained programming model of stochastic programming theory to analyze limit and shakedown loads of structures under random strength with a lognormal distribution. A dual chance constrained programming algorithm is developed to calculate simultaneously both the upper and lower bounds of the plastic collapse limit and the shakedown limit. The edge-based smoothed finite element method (ES-FEM) is used with three-node linear triangular elements.}, language = {en} } @article{HorbachStaatPerezVianaetal.2020, author = {Horbach, Andreas and Staat, Manfred and Perez-Viana, Daniel and Simmen, Hans-Peter and Neuhaus, Valentin and Pape, Hans-Christoph and Prescher, Andreas and Ciritsis, Bernhard}, title = {Biomechanical in vitro examination of a standardized low-volume tubular femoroplasty}, series = {Clinical Biomechanics}, volume = {80}, journal = {Clinical Biomechanics}, number = {Art. 105104}, publisher = {Elsevier}, address = {Amsterdam}, doi = {10.1016/j.clinbiomech.2020.105104}, year = {2020}, abstract = {Background Osteoporosis is associated with the risk of fractures near the hip. Age and comorbidities increase the perioperative risk. Due to the ageing population, fracture of the proximal femur also proves to be a socio-economic problem. Preventive surgical measures have hardly been used so far. Methods 10 pairs of human femora from fresh cadavers were divided into control and low-volume femoroplasty groups and subjected to a Hayes fall-loading fracture test. The results of the respective localization and classification of the fracture site, the Singh index determined by computed tomography (CT) examination and the parameters in terms of fracture force, work to fracture and stiffness were evaluated statistically and with the finite element method. In addition, a finite element parametric study with different position angles and variants of the tubular geometry of the femoroplasty was performed. Findings Compared to the control group, the work to fracture could be increased by 33.2\%. The fracture force increased by 19.9\%. The used technique and instrumentation proved to be standardized and reproducible with an average poly(methyl methacrylate) volume of 10.5 ml. The parametric study showed the best results for the selected angle and geometry. Interpretation The cadaver studies demonstrated the biomechanical efficacy of the low-volume tubular femoroplasty. The numerical calculations confirmed the optimal choice of positioning as well as the inner and outer diameter of the tube in this setting. The standardized minimally invasive technique with the instruments developed for it could be used in further comparative studies to confirm the measured biomechanical results.}, language = {en} } @article{JungStaat2020, author = {Jung, Alexander and Staat, Manfred}, title = {Erratum to "Modeling and simulation of human induced pluripotent stem cell-derived cardiac tissue" [GAMM-Mitteilungen, (2019), 42, 4, 10.1002/gamm.201900002]}, series = {GAMM-Mitteilungen}, volume = {43}, journal = {GAMM-Mitteilungen}, number = {4}, publisher = {Wiley-VCH GmbH}, address = {Weinheim}, issn = {1522-2608}, doi = {10.1002/gamm.202000011}, year = {2020}, language = {en} } @article{RauschHarbrechtKahmannetal.2020, author = {Rausch, Valentin and Harbrecht, Andreas and Kahmann, Stephanie Lucina and Fenten, Thomas and Jovanovic, Nebojsa and Hackl, Michael and M{\"u}ller, Lars P. and Staat, Manfred and Wegmann, Kilian}, title = {Osteosynthesis of Phalangeal Fractures: Biomechanical Comparison of Kirschner Wires, Plates, and Compression Screws}, series = {The Journal of Hand Surgery}, volume = {45}, journal = {The Journal of Hand Surgery}, number = {10}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0363-5023}, doi = {10.1016/j.jhsa.2020.04.010}, pages = {987.e1 -- 987.e8}, year = {2020}, abstract = {Purpose The aim of this study was to compare several osteosynthesis techniques (intramedullary headless compression screws, T-plates, and Kirschner wires) for distal epiphyseal fractures of proximal phalanges in a human cadaveric model. Methods A total of 90 proximal phalanges from 30 specimens (index, ring, and middle fingers) were used for this study. After stripping off all soft tissue, a transverse distal epiphyseal fracture was simulated at the proximal phalanx. The 30 specimens were randomly assigned to 1 fixation technique (30 per technique), either a 3.0-mm intramedullary headless compression screw, locking plate fixation with a 2.0-mm T-plate, or 2 oblique 1.0-mm Kirschner wires. Displacement analysis (bending, distraction, and torsion) was performed using optical tracking of an applied random speckle pattern after osteosynthesis. Biomechanical testing was performed with increasing cyclic loading and with cyclic load to failure using a biaxial torsion-tension testing machine. Results Cannulated intramedullary compression screws showed significantly less displacement at the fracture site in torsional testing. Furthermore, screws were significantly more stable in bending testing. Kirschner wires were significantly less stable than plating or screw fixation in any cyclic load to failure test setup. Conclusions Intramedullary compression screws are a highly stable alternative in the treatment of transverse distal epiphyseal phalangeal fractures. Kirschner wires seem to be inferior regarding displacement properties and primary stability. Clinical relevance Fracture fixation of phalangeal fractures using plate osteosynthesis may have the advantage of a very rigid reduction, but disadvantages such as stiffness owing to the more invasive surgical approach and soft tissue irritation should be taken into account. Headless compression screws represent a minimally invasive choice for fixation with good biomechanical properties.}, language = {en} } @article{GossmannThomasHorvathetal.2020, author = {Gossmann, Matthias and Thomas, Ulrich and Horv{\´a}th, Andr{\´a}s and Dragicevic, Elena and Stoelzle-Feix, Sonja and Jung, Alexander and Raman, Aravind Hariharan and Staat, Manfred and Linder, Peter}, title = {A higher-throughput approach to investigate cardiac contractility in vitro under physiological mechanical conditions}, series = {Journal of Pharmacological and Toxicological Methods}, volume = {105}, journal = {Journal of Pharmacological and Toxicological Methods}, number = {Article 106843}, publisher = {Elsevier}, address = {New York, NY}, doi = {10.1016/j.vascn.2020.106843}, year = {2020}, language = {en} } @article{KnoxBruggemannGossmannetal.2020, author = {Knox, Ronald and Bruggemann, Andrea and Gossmann, Matthias and Thomas, Ulrich and Horv{\´a}th, Andr{\´a}s and Dragicevic, Elena and Stoelzle-Feix, Sonja and Fertig, Niels and Jung, Alexander and Raman, Aravind Hariharan and Staat, Manfred and Linder, Peter}, title = {Combining physiological relevance and throughput for in vitro cardiac contractility measurement}, series = {Biophysical Journal}, volume = {118}, journal = {Biophysical Journal}, number = {Issue 3, Supplement 1}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0006-3495}, doi = {10.1016/j.bpj.2019.11.3104}, pages = {570a}, year = {2020}, abstract = {Despite increasing acceptance of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) in safety pharmacology, controversy remains about the physiological relevance of existing in vitro models for their mechanical testing. We hypothesize that existing signs of immaturity of the cell models result from an improper mechanical environment. We cultured hiPSC-CMs in a 96-well format on hyperelastic silicone membranes imitating their native mechanical environment, resulting in physiological responses to compound stimuli.We validated cell responses on the FLEXcyte 96, with a set of reference compounds covering a broad range of cellular targets, including ion channel modulators, adrenergic receptor modulators and kinase inhibitors. Acute (10 - 30 min) and chronic (up to 7 days) effects were investigated. Furthermore, the measurements were complemented with electromechanical models based on electrophysiological recordings of the used cell types.hiPSC-CMs were cultured on freely-swinging, ultra-thin and hyperelastic silicone membranes. The weight of the cell culture medium deflects the membranes downwards. Rhythmic contraction of the hiPSC-CMs resulted in dynamic deflection changes which were quantified by capacitive distance sensing. The cells were cultured for 7 days prior to compound addition. Acute measurements were conducted 10-30 minutes after compound addition in standard culture medium. For chronic treatment, compound-containing medium was replaced daily for up to 7 days. Electrophysiological properties of the employed cell types were recorded by automated patch-clamp (Patchliner) and the results were integrated into the electromechanical model of the system.Calcium channel agonist S Bay K8644 and beta-adrenergic stimulator isoproterenol induced significant positive inotropic responses without additional external stimulation. Kinase inhibitors displayed cardiotoxic effects on a functional level at low concentrations. The system-integrated analysis detected alterations in beating shape as well as frequency and arrhythmic events and we provide a quantitative measure of these.}, language = {en} } @article{RauschKahmannBaltschunetal.2020, author = {Rausch, Valentin and Kahmann, Stephanie Lucina and Baltschun, Christoph and Staat, Manfred and M{\"u}ller, Lars P. and Wegmann, Kilian}, title = {Pressure distribution to the distal biceps tendon at the radial tuberosity: a biomechanical study}, series = {The Journal of Hand Surgery}, volume = {45}, journal = {The Journal of Hand Surgery}, number = {8}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0363-5023}, doi = {10.1016/j.jhsa.2020.01.006}, pages = {776.e1 -- 776.e9}, year = {2020}, abstract = {Purpose Mechanical impingement at the narrow radioulnar space of the tuberosity is believed to be an etiological factor in the injury of the distal biceps tendon. The aim of the study was to compare the pressure distribution at the proximal radioulnar space between 2 fixation techniques and the intact state. Methods Six right arms and 6 left arms from 5 female and 6 male frozen specimens were used for this study. A pressure transducer was introduced at the height of the radial tuberosity with the intact distal biceps tendon and after 2 fixation methods: the suture-anchor and the cortical button technique. The force (N), maximum pressure (kPa) applied to the radial tuberosity, and the contact area (mm²) of the radial tuberosity with the ulna were measured and differences from the intact tendon were detected from 60° supination to 60° pronation in 15° increments with the elbow in full extension and in 45° and 90° flexion of the elbow. Results With the distal biceps tendon intact, the pressures during pronation were similar regardless of extension and flexion and were the highest at 60° pronation with 90° elbow flexion (23.3 ± 53.5 kPa). After repair of the tendon, the mean peak pressure, contact area, and total force showed an increase regardless of the fixation technique. Highest peak pressures were found using the cortical button technique at 45° flexion of the elbow and 60° pronation. These differences were significantly different from the intact tendon. The contact area was significantly larger in full extension and 15°, 30°, and 60° pronation using the cortical button technique. Conclusions Pressures on the distal biceps tendon at the radial tuberosity increase during pronation, especially after repair of the tendon. Clinical relevance Mechanical impingement could play a role in both the etiology of primary distal biceps tendon ruptures and the complications occurring after fixation of the tendon using certain techniques.}, language = {en} }