Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine最新文献

{"title":"Comparison of wear on articular cartilage from polycarbonate-urethane and other implant biomaterials.","authors":"Maha Ead, Andrea Dimitrov, Haoyang Li, Mohammadhamed Shahsavari, Kezhou Wu, Cameron Scott, Chester Jar, Jonelle Melissa Jn Baptiste, Nadr Jomha, Kajsa Duke, Lindsey Westover","doi":"10.1177/09544119251412486","DOIUrl":"10.1177/09544119251412486","url":null,"abstract":"<p><p>Talar replacement procedures offer good clinical outcomes for patients experiencing talar osteonecrosis with collapse. However, there is a potential for cartilage wear as the artificial talus prosthesis articulates against the native articular cartilage (AC) in the ankle joint. Therefore, this study investigated the wear of AC against candidate implant biomaterials with the aim of selecting an appropriate material for use in talar replacement procedures. Cobalt chrome alloy (Co-28Cr-6Mo), titanium alloy (Ti-6Al-4V), ultra-high molecular weight polyethylene (UHMWPE), industrial grade natural polyether ether ketone (PEEK), and polycarbonate-urethane (PCU) were tested against porcine AC submerged in bovine serum using an in vitro customized dual-motion wear testing setup. A total of 43,200 cycles at a frequency of 3 Hz were completed for each test. Both macroscopic and microscopic analyses were used to quantify cartilage wear using the Outerbridge and Osteoarthritis Research Society International (OARSI) clinical grading systems, respectively. In the macroscopic analysis, Ti-6Al-4V demonstrated the most AC wear, followed by Co-28Cr-6Mo, PEEK, UHMWPE, and PCU. In the microscopic analysis, PEEK demonstrated the most AC wear, followed by Ti-6Al-4V, Co-28Cr-6Mo, UHMWPE, and PCU. PCU demonstrated the least amount of AC wear compared to all other biomaterials and showed statistically insignificant differences with the control group (porcine cartilage-on-cartilage) in both macroscopic and microscopic inspections. These results suggest that PCU may be a suitable candidate material for coating talus implants as it demonstrated superior AC wear performance compared to the other biomaterials investigated in this study.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"153-163"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12901665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using an instrumented hammer to predict the lateral hinge fracture in high tibial osteotomy: A cadaveric study.","authors":"Claire Bastard, Manon Bas-Dit Nugues, Giuseppe Rosi, Charles-Henri Flouzat-Lachaniette, Arnaud Dubory, Guillaume Haiat","doi":"10.1177/09544119251410994","DOIUrl":"10.1177/09544119251410994","url":null,"abstract":"<p><p>Open-wedge High-Tibial Osteotomy is the most commonly employed technique addressing varus knee osteoarthritis. During this procedure, the osteotome passes through cortical and trabecular bone. A common complication is lateral hinge fractures, which depends upon when the surgeon stops impacting the osteotome. The aim of the present study is to determine whether an instrumented hammer can be employed to detect (i) the bone type (cortical or trabecular) surrounding the osteotome tip and (ii) when bone is fractured by the osteotome. Seventeen lower-limb specimens were obtained from nine fresh human anatomical subjects. The osteotome was impacted using the instrumented hammer until rupture. Each impact signal was recorded and analyzed. An algorithm was developed to detect the transitions between cortical and trabecular bone and vice versa. Detection was based on the relative variation of <i>τ</i> derived from the force signal as a function of time as the time difference between the second and first impact peaks. The values of <i>τ</i> were significantly lower in cortical bone compared to trabecular bone. Considering the arrival of the osteotome tip in trabecular bone during a medial, a difference of less than 2 impacts between the surgeon and the algorithm was obtained for 71% of the cases. For the lateral osteotomy it was obtained in 81% of the cases. This cadaveric study demonstrated that the instrumented hammer could prevent impacts leading to hinge rupture, which suggests that future clinical trials are warranted.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"100-110"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of various irrigation activations on endodontic sealer penetration during non-surgical endodontic retreatment.","authors":"Abdullah M Albeladi, Faisal Alonaizan, Khalid S Almulhim, Omar Omar, Ashwin C Shetty, Dana Almohazey, Abdul Samad Khan","doi":"10.1177/09544119251414199","DOIUrl":"10.1177/09544119251414199","url":null,"abstract":"<p><p>This study aimed to evaluate the effects of different irrigation activation techniques on root canal sealer penetration during non-surgical root canal retreatment and to determine which sealer type demonstrated greater penetrability into dentinal tubules. Instrumented root canals were allocated to a control group (needle technique) and three experimental groups: sonic activation (EDDY), passive ultrasonic irrigation (PUI), and Laser. The canals were obturated using AH+ and Totalfill BC Hiflow (BC) sealers. Retreatment was performed, and after 2 weeks, three sections from the apex at 3-, 8-, and 12-mm levels were examined using a confocal laser scanning microscope (CLSM) to investigate secondary sealer penetration. A three-way ANOVA followed by a post hoc test was used to analyze penetration depth and percentage. The BC sealer showed a marked difference in penetration depth and percentage compared with the AH+ sealer. The maximum penetration depth was observed in the middle region, where Laser and EDDY activation showed higher penetration depth and percentage values. PUI activation showed the lowest percentage of AH+ sealer penetration. Variations in results were observed in the coronal and apical regions; however, the differences were statistically nonsignificant. The use of Laser and EDDY for irrigation activation is promising in terms of tubule penetration of sealers, and Totalfill BC sealer showed better results than AH plus.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"171-180"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of comminuted extra-articular distal femoral fracture: A finite element study.","authors":"Laureb Rao, Samarth Mittal, Vivek Trikha, Anupam Gupta, Kaushik Mukherjee","doi":"10.1177/09544119251409453","DOIUrl":"10.1177/09544119251409453","url":null,"abstract":"<p><p>In case of extra-articular fractures, internal fixation is usually performed using implants such as Intramedullary nails (IMN), medial plates (MP), and lateral plates (LP). Recently, an innovative \"sandwich\" technique has been introduced for treating acetabular defects. The efficacy of such a technique to treat comminuted extra-articular distal femoral fractures has never been investigated. Therefore, the current study aims to compare the biomechanical performances of three implants, that is, medial plate, lateral plate, and IM nails, with and without the \"sandwich\" bone grafts. A CAD model of composite bone was used in the study. An extra-articular comminuted distal femoral fracture (2.5 cm) was virtually created in the intact femur using the Materialize 3-matics™ software. The fracture fixation was performed using three implant systems (IMN, MP, and LP) with and without bone graft. A tetrahedral volume mesh was generated, and simulations were performed corresponding to the loading condition of the single leg stance of a person. The use of \"sandwich\" bone grafts was observed to reduce implant stresses by 4.4%, 57.3%, and 66.2%, and displacements by 17.4%, 56.6%, and 59.7%, in the cases of IMN, MP, and LP, respectively. The Finite Element results showed that the IM nail provided the best results regarding the von Mises distribution, displacement of the implant bone assembly, displacement of the fracture fragments, and contact sliding. Furthermore, the use of Cerament^®-filled bone grafts considerably reduced von Mises stresses in the implants and the displacements of the implant-bone assembly.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"111-121"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel cervical image recognition framework based on feature cognitive enhancement for improved performance.","authors":"Renling Zou, Jing Xu, Qingbin Fang, Rui Guan, Xuelian Gu, Xiufang Hu, Xuezhi Yin, Kunyang Liu","doi":"10.1177/09544119251412982","DOIUrl":"10.1177/09544119251412982","url":null,"abstract":"<p><p>Cervical cancer ranks as the fourth most prevalent cancer among women worldwide. Early diagnosis facilitates timely intervention and treatment. Traditional colposcopy is a widely employed technique for evaluating cervical lesions. Nevertheless, the growing number of patients with cervical cancer, and the rising workload of doctors may lead to misdiagnosis and underdiagnosis. Therefore, many researchers use deep learning to make paramedical diagnoses of cervical disease. However, the current neural network models for cervical image recognition lead to poor diagnostic results due to limitations in feature extraction. Consequently, this study proposes a novel model for classifying cervical images into normal, cervical intraepithelial neoplasia, and cancerous categories. The model proposes three new modules, namely a Feature Cognitive Screening Module, Multi-scale Feature Classification Module, and Overlapping Sampling Module (FSMO), which can realize the extraction of global features and local feature areas, multi-scale feature fusion classification and short-range interactions in the images, and enhance the edge capturing ability of the model and the proficiency of solving complex problems, thereby elevating prediction accuracy. The results showed that the recognition accuracy of FSMO in the self-constructed cervical image dataset was 91.88%, a precision of 92.91%, a recall of 91.92%, and an F1-Score of 91.99%; and the accuracy is 97.5% under the kaggle dataset. The performance surpasses other advanced models. Consequently, this model holds significant potential for rapid auxiliary diagnosis in cervical imaging, contributing to the early detection and treatment of cervical cancer.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"192-205"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design methods for constant force mechanisms: An overview of developments and future directions.","authors":"Minghui Wang, Yarong Zhang, Hongliu Yu","doi":"10.1177/09544119251401696","DOIUrl":"10.1177/09544119251401696","url":null,"abstract":"<p><p>Constant force mechanisms have been widely applied in various industrial fields but encounter challenges in medical applications due to the risk of soft tissue injuries caused by clamping devices exerting excessive pressure. This study reviews existing design methods for constant force mechanisms through a comprehensive search of databases such as Google Scholar, ScienceDirect, and IEEE Xplore. The reviewed methods include constant force springs, mechanisms based on fixed pulleys, mechanisms utilizing spring energy storage, and compliant mechanisms. However, these designs have limitations, particularly in achieving miniaturization and adapting to the delicate environment of the human body. To address these issues, an emerging design approach combines the superelasticity of shape memory alloys (SMAs) with structural optimization. This method reduces structural complexity, weight, and size, making it highly suitable for medical applications that require simplicity and consistent force output. This approach holds significant potential for advancing the development of safe and effective medical clamping devices.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"77-89"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and preliminary evaluation of a transducer guiding system for hand ultrasound: With a focus on reproducibility and operational stability.","authors":"Mu-Ting Wang, Yu-Chen Lin, Chieh-Hsiang Hsu, Hsiu-Yun Hsu, Tai-Hua Yang, Li-Chieh Kuo, Fong-Chin Su","doi":"10.1177/09544119251414217","DOIUrl":"10.1177/09544119251414217","url":null,"abstract":"<p><p>Various strategies have been proposed to reduce operator-dependent variability in musculoskeletal ultrasound, including mechanical stabilization techniques. However, their effects on image reproducibility and transducer handling remain unclear in anatomically complex regions such as hand. This two-phase study aimed to (1) develop and validate a transducer guiding system for hand ultrasound and (2) evaluate its influence on image reproducibility and operational stability through image-based analyses. In Phase I, test-retest reliability of the guiding system was examined by repeatedly measuring soft-tissue thickness in 30 healthy participants. Intraclass Correlation Coefficients (ICC) ranged from 0.766 to 0.948, demonstrating good to excellent reliability. In Phase II, 16 ultrasound users acquired images under handheld and guiding-system-assisted conditions based on predefined reference images. Image reproducibility was evaluated using Normalized Cross-Correlation (NCC) and ICC, while operational stability was assessed via cosine similarity derived from M-mode segments during the pre-capture period, with group comparisons performed using the Wilcoxon signed-rank test. Novice users showed substantial ICC improvement when using the guiding system (0.487-0.681), approaching the consistency observed in experienced users. Both novice and experienced groups displayed higher NCC and cosine similarity values with the guiding system, indicating improved reproducibility and operational stability. Overall, the guiding system enhanced image outcomes by providing standardized positioning and mechanical stabilization. These findings highlight its potential to improve consistency in hand ultrasound assessments and serve as a supportive tool for novice ultrasound training. The results further demonstrate the feasibility of mechanical stabilization in reducing operator-related variability and enhancing image consistency in hand ultrasound examinations.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"90-99"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of sandblasting and acid etching variables on surface micro-roughness of dental implants: Determination of controlled values.","authors":"Zahra Rajabifard, Seyed Kiarash Seyed Darabi, Amir Ali Dehghanpour, Amirreza Rokn, Gholamreza Rouhi","doi":"10.1177/09544119251411962","DOIUrl":"10.1177/09544119251411962","url":null,"abstract":"<p><p>Dental implantation is the most reliable method for replacing missing teeth. Success rate of dental implants is influenced by osseointegration. Surface roughness of implants influences osseointegration by altering surface area and texture, providing stimulation to cells. Sandblasting and acid-etching are common methods for making implant surfaces rough. Main goal of this study was to investigate effects of sandblasting and acid-etching variables, that is, blasting-pressure and acid-temperature, on surface roughness of implants to find the controlled values of variables for a favorable surface roughness. An acceptable surface roughness was assumed to have an arithmetic average height (Sa) between 1 and 2 µm, and an area developed ratio (Sdr) over 50%. Seventy-two titanium-made analogs were sandblasted with three different pressures, that is, 4, 5, and 6 MPa, and three different durations, that is, 15, 30, and 45 s, and then were etched with two different etching temperature, that is, 60°C and 80°C, and two exposure-time, that is, 5 and 10 min (two repetition for each combination). Surface roughness parameters were then measured using a profilometer. Multi-factorial ANOVA was used as statistical analysis method. Results showed that 14 groups demonstrated favorable Sa (1-2 µm), among which just four groups had acceptable Sdr (Sdr > 50%). Among four parameters stated above, which affect sandblasting and acid-etching processes, it was found that blasting duration is the most effective variable on implants roughness. This work highlights the importance of sandblasting and acid-etching parameters for a controlled titanium dental implant surface, which can achieve surface roughness parameters that correspond to those previously reported in the literature as favorable ones for osseointegration.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"181-191"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonlinear viscoelastic models improve characterisation of 6 DOF intervertebral disc load response at low strain rates.","authors":"Samantha Hayward, Patrick S Keogh, Anthony W Miles, Sabina Gheduzzi","doi":"10.1177/09544119251411015","DOIUrl":"10.1177/09544119251411015","url":null,"abstract":"<p><p>The viscoelastic characteristics of the intervertebral disc (IVD) govern spinal response to applied dynamic loading which is important in understanding how the spine responds to loads experienced in everyday activity. The common method of reporting experimental load response data in terms of linear stiffnesses represents a significant oversimplification of this behaviour. This study presents a method yielding substantially increased accuracy for principal direction load-displacement response of porcine lumbar spine segments. It compares quality of fit to experimental data of nonlinear viscoelastic models and the typical linear stiffness method. Experimental load response data were recorded from six porcine lumbar spine segments tested under 6 DOF cyclic displacement control at low strain rates (0.1 Hz). Model spring and damper coefficients were determined using an optimisation procedure to minimise the differences between model and experimental load response vectors in each axis. Experimental hysteresis area cannot be reproduced using the linear method but was replicated to within 17% by nonlinear viscoelastic models. Fit quality was substantially improved by nonlinear models compared to the linear stiffness model, with RMSE reduced by 60%. Results indicate that three-element nonlinear viscoelastic models are well-suited for characterisation of principal direction load response to cyclic loading, replicating key features.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"139-152"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12901689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of intrinsic and extrinsic conditions on the knee joint loading during double-leg landing using a musculoskeletal model in the sagittal plane.","authors":"Angel Cerda-Lugo, Hugo I Medellín-Castillo, Alejandro González","doi":"10.1177/09544119251401698","DOIUrl":"10.1177/09544119251401698","url":null,"abstract":"<p><p>Knee injuries are prevalent in the sports world, particularly during single and double-leg landings. These injuries can affect various structures of the knee, including ligaments, menisci, condyles, the patellar tendon and others. While body posture at the time of ground impact plays a significant role in the occurrence of such injuries, extrinsic factors such as fall height, contact conditions and landing surface properties are also critical. Additionally, the stiffness-damping characteristics of the human joints may contribute to the risk of knee injury. This paper proposes a new dynamic model to investigate the influence of intrinsic and extrinsic parameters on knee joint forces and moments during a double-leg landing task. The model considers the mass, posture and movement of the body segments, the stiffness-damping of the joints, the ground reaction force and the landing surface conditions. The calibration of the model is based on ground reaction force behaviour reported in the literature. A sensitivity analysis using the Morris method is conducted to evaluate the influence of intrinsic and extrinsic parameters on knee joint forces. The results indicate that foot, shank and thigh posture, as well as the fall height, have the most significant influence on the knee joint forces and moments. This study provides valuable insights into the mechanisms of knee injuries and highlights the importance of considering both intrinsic and extrinsic factors in injury prevention strategies.</p>","PeriodicalId":20666,"journal":{"name":"Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine","volume":" ","pages":"12-24"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}