Top

Published in:

Open Access 01-12-2016 | Research article

Load and failure behavior of human muscle samples in the context of proximal femur replacement

Authors: Stefan Schleifenbaum, Michael Schmidt, Robert Möbius, Thomas Wolfskämpf, Christian Schröder, Ronny Grunert, Niels Hammer, Torsten Prietzel

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

Abstract

Background

To ensure adequate function after orthopedic tumor reconstruction, it is important to reattach the remaining soft tissue to the implant. This study aimed at obtaining mechanical properties of textile muscle-implant and muscle-bone connections in a preliminary test.

Methods

Two groups of soft-tissue attachment were mechanically tested and compared: Native bone-muscle samples obtained from human femora and muscles attached to a prosthetic implant by means of Trevira® attachment tubes. Additionally, muscle samples were tested with muscle fibers aligned parallel and perpendicular to the tension load. A uniaxial load was exerted upon all samples.

Results

Failure loads of 26.7 ± 8.8 N were observed for the native bone-muscle group and of 18.1 ± 9.9 N for the Trevira® group. Elongations of 94.8 ± 36.2 % were observed for the native bone-muscle group and 79.3 ± 51.8 % for the Trevira® group. The location of failure was mainly observed in the central area of the muscle fibers. Muscle fibers with parallel fiber orientation (47.6 ± 11.5 N) yielded higher tensile strength than those with perpendicular fiber orientation (14.8 ± 4.1 N).

Conclusions

Our experiments showed that higher forces were transmitted in the origin and insertion areas than in areas of flat soft tissue reconstruction using attachment tubes. The data indicate that the tested material allows reattaching muscles, but without reinforcing the insertion site. Therefore, attachment tubes with region-dependent and potentially anisotropic material behavior might be advantageous to optimize muscle-bone load transmission after surgery, which may allow lower complication rates and shorter physical recovery.

Gosheger G, Gebert C, Ahrens H, Streitbuerger A, Winkelmann W, Hardes J. Endoprosthetic reconstruction in 250 patients with sarcoma. Clin Orthop Relat Res. 2006;450:164–71.CrossRefPubMed

Raiss P, Kinkel S, Sauter U, Bruckner T, Lehner B. Replacement of the proximal humerus with MUTARS tumor endoprostheses. Eur J Surg Oncol. 2010;36:371–7.CrossRefPubMed

Schoof B, Jakobs O, Gehrke T, Gebauer M. Proximal femoral reconstruction after aseptic loosening following proximal femoral replacement for Ewing sarcoma: a case report with one-year follow-up. Hip Int. 2014;24:103–7.CrossRefPubMed

Gosheger G, Hillmann A, Lindner N, Rodl R, Hoffmann C, Burger H, Winkelmann W. Soft tissue reconstruction of megaprostheses using a trevira tube. Clin Orthop Relat Res. 2001:264–71.

Mavrogenis AF, Ruggieri P, Mercuri M, Papagelopoulos PJ. Megaprosthetic reconstruction for malignant bone tumors: complications and outcomes. J Long Term Eff Med Implants. 2008;18:239–51.CrossRefPubMed

Hardes J, Ahrens H, Nottrott M, Dieckmann R, Gosheger G, Henrichs M, Streitburger A. Attachment tube for soft tissue reconstruction after implantation of a mega-endoprosthesis. Oper Orthop Traumatol. 2012;24:227–34.

Wirganowicz PZ, Eckardt JJ, Dorey FJ, Eilber FR, Kabo JM. Etiology and results of tumor endoprosthesis revision surgery in 64 patients. Clin Orthop Relat Res. 1999:64–74.

Roberts P, Chan D, Grimer RJ, Sneath RS, Scales JT. Prosthetic replacement of the distal femur for primary bone tumours. J Bone Joint Surg (Br). 1991;73:762–9.

Hardes J, Gebert C, Schwappach A, Ahrens H, Streitburger A, Winkelmann W, Gosheger G. Characteristics and outcome of infections associated with tumor endoprostheses. Arch Orthop Trauma Surg. 2006;126:289–96.

10.

Jeys L, Grimer R. The long-term risks of infection and amputation with limb salvage surgery using endoprostheses. Recent Results Cancer Res. 2009;179:75–84.CrossRefPubMed

11.

Heisel C, Breusch SJ, Schmid G, Bernd L. Lower limb salvage surgery with MUTARS endoprostheses: 2 to 7 year results. Acta Orthop Belg. 2004;70:142–7.PubMed

12.

Guo W, Yang Y, Tang X, Ji T. Endoprosthetic reconstruction after resection of the tumor of the proximal femur. Zhonghua Wai Ke Za Zhi. 2007;45:657–60.PubMed

13.

Winkelmann W. Reconstruction of the proximal femur with the MUTARS(R) system. Orthopade. 2010;39:942–8.CrossRefPubMed

14.

Kuthe CD, Uddanwadiker RV, Ramteke A. Experimental evaluation of fiber orientation based material properties of skeletal muscle in tension. Mol Cell Biomech. 2014;11:113–28.PubMed

15.

Takaza M, Moerman KM, Gindre J, Lyons G, Simms CK. The anisotropic mechanical behaviour of passive skeletal muscle tissue subjected to large tensile strain. J Mech Behav Biomed Mater. 2013;17:209–20.CrossRefPubMed

16.

van Ee CA, Chasse AL, Myers BS. Quantifying skeletal muscle properties in cadaveric test specimens: effects of mechanical loading, postmortem time, and freezer storage. J Biomech Eng. 2000;122:9–14.PubMed

17.

Hammer N, Lingslebe U, Aust G, Milani TL, Hadrich C, Steinke H. Ultimate stress and age-dependent deformation characteristics of the iliotibial tract. J Mech Behav Biomed Mater. 2012;16:81–6.CrossRefPubMed

18.

Hammer N, Huster D, Fritsch S, Hadrich C, Koch H, Schmidt P, et al. Do cells contribute to tendon and ligament biomechanics? PLoS One. 2014;9:e105037.CrossRefPubMedPubMedCentral

19.

Gottsauner-Wolf F, Grabowski JJ, Chao EY, An KN. Effects of freeze/thaw conditioning on the tensile properties and failure mode of bone-muscle-bone units: a biomechanical and histological study in dogs. J Orthop Res. 1995;13:90–5.CrossRefPubMed

20.

Komatsu F, Mori R, Uchio Y. Optimum surgical suture material and methods to obtain high tensile strength at knots: problems of conventional knots and the reinforcement effect of adhesive agent. J Orthop Sci. 2006;11:70–4.CrossRefPubMed

21.

Steinke H, Lingslebe U, Bohme J, Slowik V, Shim V, Hadrich C, Hammer N. Deformation behavior of the iliotibial tract under different states of fixation. Med Eng Phys. 2012;34:1221–7.

22.

Jagodzinski M, Ettinger M, Haasper C, Hankemeier S, Breitmeier D, Hurschler C, Krettek C. Biomechanische analyse der press-fit-Fixierung von Kreuzbandtransplantaten. Unfallchirurg. 2010;113:532–9.

23.

Evans WJ, Lexell J. Human aging, muscle mass, and fiber type composition. J Gerontol A Biol Sci Med Sci. 1995;50:11–6.CrossRef

24.

Muramatsu T, Muraoka T, Takeshita D, Kawakami Y, Hirano Y, Fukunaga T. Mechanical properties of tendon and aponeurosis of human gastrocnemius muscle in vivo. J Appl Physiol. 2001;90:1671–8.PubMed

25.

Holzapfel BM, Rechl H, Lehner S, Pilge H, Gollwitzer H, Steinhauser E. Alloplastic reconstruction of the extensor mechanism after resection of tibial sarcoma. Sarcoma. 2011;2011:545104.CrossRefPubMedPubMedCentral

26.

Pietschmann MF, Fröhlich V, Ficklscherer A, Hausdorf J, Utzschneider S, Jansson V, Müller PE. Pullout strength of suture anchors in comparison with transosseous sutures for rotator cuff repair. Knee Surg Sports Traumatol Arthrosc. 2008;16:504–10.CrossRefPubMed

27.

Pietschmann MF, Sadoghi P, Hauser E, Scharpf A, Gulecyuz MF, Schroder C, et al. Influence of testing conditions on primary stability of arthroscopic knot tying for rotator cuff repair: slippery when wet? Arthroscopy. 2011;27:1628–36.

28.

Pauwels F. Gesammelte Abhandlungen zur Biomechanik des Bewegungsapparates. Berlin: Springer; 1965.CrossRef

29.

Fukunaga T, Ichinose Y, Ito M, Kawakami Y, Fukashiro S. Determination of fascicle length and pennation in a contracting human muscle in vivo. J Appl Physiol. 1997;82:354–8.PubMed

30.

Herbert RD, Moseley A, Butler JE, Gandevia SC. Change in length of relaxed muscle fascicles and tendons with knee and ankle movement in humans. J Physiol. 2002;539:637–45.CrossRefPubMedPubMedCentral

31.

Kot BC, Zhang ZJ, Lee AW, Leung VY, Fu SN. Elastic modulus of muscle and tendon with shear wave ultrasound elastography: variations with different technical settings. PLoS One. 2012;7:e44348.CrossRefPubMedPubMedCentral

32.

Muramatsu T, Muraoka T, Kawakami Y, Shibayama A, Fukunaga T. In vivo determination of fascicle curvature in contracting human skeletal muscles. J Appl Physiol (1985). 2002;92:129–34.

33.

Benninghoff A. Lehrbuch der Anatomie des Menschen : Teil: Bd. 1., Allgemeine Anatomie und Bewegungsapparat: 2rd ed. München, Berlin, Wien: Urban & Schwarzenberg; 1942.

34.

Eby SF, Cloud BA, Brandenburg JE, Giambini H, Song P, Chen S, et al. Shear wave elastography of passive skeletal muscle stiffness: Influences of sex and age throughout adulthood. Clin Biomech (Bristol, Avon). 2014;30:22–7.CrossRef

35.

Jansen L, Gondos A, Eberle A, Emrich K, Holleczek B, Katalinic A, Brenner H. Cancer survival in Eastern and Western Germany after the fall of the iron curtain. Eur J Epidemiol. 2012;27:689–93.

36.

Leonhardt H, Tillmann B, Töndury G, Zilles K. Rauber/kopsch, anatomie des menschen, vol. 2. Paris: Thieme; 1987. p. 272–3.

37.

Müller PE, Gülecyüz MF, Schröder C, Fröhlich V, Häuser E, Huttel U, Pietschmann MF. Biomechanische aspekte der rotatorenmanschettennaht: einfluss von nahtmaterial, knotentechnik und nahttechnik auf die primärstabilität. Sport-Orthop-Sport-Traumatol-Sports Orthop Traumatol. 2013;29:45–8.

Title: Load and failure behavior of human muscle samples in the context of proximal femur replacement
Authors: Stefan Schleifenbaum
Michael Schmidt
Robert Möbius
Thomas Wolfskämpf
Christian Schröder
Ronny Grunert
Niels Hammer
Torsten Prietzel
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-016-0998-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Load and failure behavior of human muscle samples in the context of proximal femur replacement

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2016

Adhesive capsulitis of the shoulder, treatment with corticosteroid, corticosteroid with distension or treatment-as-usual; a randomised controlled trial in primary care

Socioeconomic factors and self-reported health outcomes in African Americans with rheumatoid arthritis from the Southeastern United States: the contribution of childhood socioeconomic status

Posterior dynamic stabilization in the lumbar spine – 24 months results of a prospective clinical and radiological study with an interspinous distraction device

Antibody response to pneumococcal and influenza vaccination in patients with rheumatoid arthritis receiving abatacept

Increased arterial stiffness in patients with end-stage osteoarthritis: a case-control study

The efficacy of adalimumab in psoriatic arthritis concomitant to overlapping primary biliary cholangitis and primary sclerosing cholangitis: a case report