A lifespan approach to osteoarthritis prevention Whittaker, J.L.; Runhaar, J.; Bierma-Zeinstra, S. ...
Osteoarthritis and cartilage,
December 2021, 2021-12-00, 20211201, Letnik:
29, Številka:
12
Journal Article
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Prevention is an attractive solution for the staggering and increasingly unmanageable burden of osteoarthritis. Despite this, the field of osteoarthritis prevention is relatively immature. To date, ...most of what is known about preventing osteoarthritis and risk factors for osteoarthritis is relative to the disease (underlying biology and pathophysiology) of osteoarthritis, with few studies considering risk factors for osteoarthritis illness, the force driving the personal, financial and societal burden. In this narrative review we will discuss what is known about osteoarthritis prevention, propose actionable prevention strategies related to obesity and joint injury which have emerged as important modifiable risk factors, identify where evidence is lacking, and give insight into what might be possible in terms of prevention by focussing on a lifespan approach to the illness of osteoarthritis, as opposed to a structural disease of the elderly. By targeting a non-specialist audience including scientists, clinicians, students, industry employees and others that are interested in osteoarthritis but who do not necessarily focus on osteoarthritis, the goal is to generate discourse and motivate inquiry which propel the field of osteoarthritis prevention into the mainstream.
In the last decades, composite materials have been increasingly used in advance engineering fields such as aerospace and automobile industries due to their advantages in terms of stress ...concentrations, structural weight and manufacturing. Joining composite parts in such applications has been increasingly achieved by adhesives compared to welded, riveted or bolted connections. Mechanical testings of adhesively bonded composite joints are often time consuming and expensive due to a number of parameters involved and their analytical modellings are complicated. Therefore, numerical analysis is increasingly used in recent years to overcome these limitations. In this work three-dimensional FE modelling of the single lap joints (SLJs) of angle ply composite adherends subjected to tensile loading was developed using ABAQUS/Explicit. Cohesive zone model was adopted for the modelling of damage in the adhesive layer. The continuum damage mechanic model implemented via a user defined VUMAT subroutine was used to model the intraply damage in composite adherends. The model accounted for the damage initiation, the damage evolution, and the nonlinear shear behaviour of the material. Experiments of the SLJs of ±105s, ±205s, ±455s and ±555s adherends under tensile loading were performed. The adherends were manufactured from glass reinforced polymer matrix and the adhesive layer was AF163-2K. For verification of the developed model, numerical results were compared with those of the experiments mentioned above. The SLJs of ±105s and ±205s adherends failed due to failure in the adhesive layer and those of ±455s and ±555s failed mainly due to failure in the adherends. The peel and shear deformation modes in the adhesive layer were invoked in different ways for different SLJ configurations. The effects of adhesive layer thickness and the overlap length on the response of the SLJ were investigated in detail.
In this paper, the stress field in adhesively bonded joints is predicted by employing an analytical approach together with the finite element method (FEM). To accomplish this, the adhesive joint is ...considered as a bi-material notch. Then, a unified analytical formulation for the in-plane stress and displacement field of bi-material notches is presented in the form of asymptotic series. Subsequently, a numerical procedure based on an over-determined system of equations is used to obtain the coefficients of the series solution for various types of adhesive joints including single lap joint (SLJ), single fillet lap joint (SFLJ), butt joint (BJ), scarf joint (SJ), and single lap joint with an inside taper and adhesive fillet (SLJ-ITAF). By comparing the results obtained from the analytical stress field with the numerical results, the accuracy of the calculated coefficients is evaluated. It is shown that by using the proposed approach one can obtain the stress field within the adhesive layer by using the stress or displacement fields of the adherend. The obtained results also show that neglecting the higher-order terms can result in significant errors while considering the first three non-singular stress terms besides the singular term reveals very good results.
To assess the accuracy of dual-energy CT (DECT) for diagnosing gout, and to explore whether it can have any impact on clinical decision making beyond the established diagnostic approach using ...polarising microscopy of synovial fluid (diagnostic yield).
Diagnostic single-centre study of 40 patients with active gout, and 41 individuals with other types of joint disease. Sensitivity and specificity of DECT for diagnosing gout was calculated against a combined reference standard (polarising and electron microscopy of synovial fluid). To explore the diagnostic yield of DECT scanning, a third cohort was assembled consisting of patients with inflammatory arthritis and risk factors for gout who had negative synovial fluid polarising microscopy results. Among these patients, the proportion of subjects with DECT findings indicating a diagnosis of gout was assessed.
The sensitivity and specificity of DECT for diagnosing gout was 0.90 (95% CI 0.76 to 0.97) and 0.83 (95% CI 0.68 to 0.93), respectively. All false negative patients were observed among patients with acute, recent-onset gout. All false positive patients had advanced knee osteoarthritis. DECT in the diagnostic yield cohort revealed evidence of uric acid deposition in 14 out of 30 patients (46.7%).
DECT provides good diagnostic accuracy for detection of monosodium urate (MSU) deposits in patients with gout. However, sensitivity is lower in patients with recent-onset disease. DECT has a significant impact on clinical decision making when gout is suspected, but polarising microscopy of synovial fluid fails to demonstrate the presence of MSU crystals.
Total joint arthroplasty as a surgical treatment option for trapeziometacarpal joint arthritis is recently revived. The aim of this study is to report on mid- and long-term results of the Elektra ...(single-mobility) and Moovis (dual-mobility) prosthesis for treatment of primary thumb carpometacarpal joint arthritis.
In this retrospective, monocentric, descriptive cohort study, 31 prostheses were evaluated that were implanted by a single surgeon in 26 patients between 2009 and 2019. Indication for surgery was trapeziometacarpal joint osteoarthritis (Eaton/Littler Stage II and III). Clinical and radiological follow-up was performed at a minimum of 24 months. The postoperative assessment included range of motion, pain, strength as well as functional scores (DASH, MHQ). Implant survival and complications were the primary endpoints.
10 Elektra and 21 Moovis prostheses were implanted between 2009 and 2019 with a mean follow-up of 74.2 months in the Elektra and 41.4 months in the Moovis group. The average patients' age at surgery was 64 years. Postoperative pain levels (VAS 0-10) were below 2 at rest and under stress in both groups. Grip/pinch strength and range of motion showed results comparable to the contralateral hand. Opposition was excellent with an average Kapandji index of 9.6 in both groups. Elektra achieved slightly better functional scores in the DASH and MHQ score. Satisfaction was high in both groups, and 96% of the patients would recommend the procedure. Metacarpophalangeal hyperextension > 15° was seen in 3 patients per group preoperatively and was corrected to < 5° post-surgery. 3 Elektra prostheses were revised due to cup loosening and dislocation for cup and/or neck replacement or secondary trapeziectomy. 1 Moovis prosthesis was revised with an exchange of the neck to a larger size due to restricted movement. After the mean follow-up of 7.9 years in Elektra and 3.5 years in MOOVIS, cumulative survival was 68.6% vs. 95.2%, respectively.
In this mid- to long-term retrospective analysis, total joint arthroplasty in primary trapeziometacarpal joint arthritis results in low pain levels, excellent mobility and clinical function. Patient satisfaction is overall high. While revision due to cup loosening occurred more often in patients with single-mobility implants, no cases of dislocation or loosening of components were observed in the dual-mobility group.
The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of the Medical Faculty of Heidelberg University, reference number S-150/2020.
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•Hybrid bonded-bolted joints have a significantly longer fatigue life than only bolted joints.•Under fatigue loading, multi bolt hybrid bonded-bolted joints fail by net-tension at the ...external bolt.•The adhesive between the external bolts of multi bolt hybrid bolted-bonded joint retain its integrity to the end of the fatigue test.•Removing the center bolt does not reduce the fatigue life of multi bolt hybrid bolted-bonded joint.
The fatigue behavior of Hybrid bolted-bonded (HBB) joints is compared with that of only-bolted (OB) joints. Single-lap shear joints fabricated using carbon fiber-reinforced composites with one, two, and three bolts are investigated. The fatigue life of an HBB joint comprises two stages: the first stage corresponds to the fatigue of a bonded joint. The second stage begins when the adhesive fails and corresponds to the fatigue of a bolted joint. The adhesive debonding is progressive. The fatigue life of the HBB joints after the adhesive has debonded is significantly higher than that of equivalent OB joints. For HBB three-bolt assemblies, the integrity of the adhesive between the outer bolts is maintained throughout the fatigue test, and the final failure is caused by the net tension at the outer bolt. Removing the center bolt does not reduce the fatigue life of HBB joints. This implies that multi-bolt assemblies subjected to fatigue can benefit significantly from hybridization while reducing the number of bolts.
Understanding the mechanical behaviour of jointed rock particularly under uniaxial compression is so important for an appropriate design of structures on or within a rock mass. Jointed rocks may ...consist of persistent or non-persistent joints. Typically, the persistent joints can dominate the whole mechanical behaviour of jointed rocks while the effects of non-persistent joints on the rock masses require careful consideration during the characterisation process. Majority of the earlier studies on the non-persistent jointed rocks have included the joints with open smooth surfaces while the behaviour of jointed rocks with non-persistent rough joints has been explored very limitedly. Therefore, in this study, a number of artificial jointed rocks with non-persistent rough joints were tested under uniaxial compression. With the aid of 3D printing technology a wide range of joint roughness has been accommodated inside the artificial samples. The joints were parallel or coplanar. The influences of four different parameters including Joint Roughness Coefficient, bridge length, bridge angle and joint angle on the uniaxial compressive strength, the deformation modulus and the crack coalescence stress of jointed rocks were investigated through multivariate statistical analysis using Response Surface Methodology. In total, 30 experiments were conducted and the resulting failure patterns were classified into six different categories based on their crack coalescence conditions. A number of samples revealed a specific failure pattern known as “fish eye” due to the development of “asperity interlocking cracks” which were associated with the high range of joint roughness. From Response Surface Methodology it was found that all the four parameters had individual and interactive effects on the uniaxial compressive strength and the deformation modulus of jointed rock. Also, it was concluded that the overall mechanical behaviour of a jointed rock with non-persistent rough joints is mainly controlled by the joint angle under uniaxial compression.
•Conduction of a set of uniaxial compressive tests on the jointed rock-like material with non-persistent rough joints•Characterisation of crack coalescence behaviour of non-persistent jointed rocks•Multivariate statistical analysis of mechanical behaviour of jointed rocks based on Response Surface Methodology
In composite structures, the strength of a standard single-lap joint with multiple bolts at best matches the strength predicted by the standard open-hole tension (OHT) test, which is about 50% of the ...tensile strength of the unnotched material. Although bonded joints do not have such limitation, they carry other drawbacks. The advantages of bolting and bonding may be combined in hybrid/bonded-bolted (HBB) joints. This study investigates HBB joints using carbon and glass-fiber reinforced composites with up to three bolts. It is found that multi-bolt specimens with or without adhesive fail in net-tension at the outer bolts like in OHT tests. However, HBB joint is not anymore limited by the OHT strength. The addition of the adhesive increases the strength of a three bolts joints by 70% for cross-ply laminates and 30% for quasi-isotropic laminates. The synergy between the bolts and the adhesive in the HBB system is interpreted by the fact that the outer bolts limit peel stresses and concurrently, the adhesive reduces the stress concentration around the bolts. This is particularly important for the cross-ply configuration where the stress concentrations around the holes are high. Other features observed suggest that for multi-bolted HBB joint, only external bolts are needed. Such joint configuration combines the safety provided by the bolts and the efficient load transfer provided by the adhesive.
Introduction
Patients with haemophilia (PwH) often prefer shod walking over barefoot walking as footwear offers ankle joint stability and comfort during gait. Yet, the biomechanical mechanisms ...contributing to the latter remain poorly understood.
Aim
To explore the effect of shoes on the biomechanical functioning of the ankle and foot complex in PwH with and without haemophilic ankle arthropathy and to determine the amount of ankle joint loading during shod walking.
Methods
We analysed data of PwH without haemophilic ankle arthropathy (n = 5) and PwH with severe haemophilic ankle arthropathy (n = 17) and a control group (n = 17). During 3D gait analysis, a four‐segment kinetic foot model was used to calculate kinematic and kinetic parameters of the ankle, Chopart, Lisfranc and first metatarsophalangeal (MTP 1) joints during both barefoot and shod walking.
Results
We found a significantly greater ankle joint power generation during shod walking compared to barefoot walking in PwH with severe haemophilic ankle arthropathy (P < .001). Chopart joint biomechanics were significantly lowered in all three groups during shod walking compared to barefoot walking. During shod walking, the ankle joint load was significantly lowered in both PwH groups (P = .039 and P = .002), but not in the control group (P = .952).
Conclusion
Explorations in this study uncover a tendency that shoes alter the biomechanical functioning of the ankle and foot complex in PwH and simultaneously lower the ankle joint load during walking.
The paper presents the analysis of the dovetail joint, typical for rafter-collar-beam connection, under tension. The development of wooden structures with these joints, and the general principles of ...their static work are shortly presented. The results of research on: functional joint with proper contact surfaces, joint with loosened contact, and joint with reinforcement were presented. The results confirm that the dovetail joint can transfer tensile forces, some of which are transferred by the wooden dowel. Small loosenings between connected elements does not decrease the load-capacity or stiffness of the joint. The reinforcement changed the static behavior of the joint, as expected. The obtained results present a certain picture of the static behavior of the analyzed connection in the case of tension forces, and the drawn conclusions may be useful for engineers and conservators in design and implementation practice when working with historic wooden structures.
•Dovetail joint between rafter and collar beam is able to transfer tensile forces.•Small loosening does not decrease the capacity or stiffness of the joint.•In dovetail joint under tension some force is transferred by the wooden dowel.•Reinforcement change the character of static behavior of the joint.
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