MBI Biomechanics

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RESEARCH HISTORY

The investigators at MBI Miami have been on the cutting edge of many developments in Orthopaedics and in musculoskeletal rehabilitation. Our philosophy has always been to develop systems that are more biomechanically compatible with the musculoskeletal system: more compliant with load sharing systems for total joint replacement, fracture fixation, spinal fixation and reconstruction, limb supports, etc.

Our collaboration with more than 200 researchers and clinicians from over 20 countries around the world has resulted in the publication of 11 books, 50 chapters, over 150 journal articles and over 650 abstracts produced as either podium presentations or posters.

2016 Publications and Presentations

Papers

Diamond M, Bonner A, Pedroso D, Milne E, Latta L: “Biomechanical analysis of UCBL with articulated ankle AFO in a simulated stage ii posterior tibial tendon dysfunction”, JSM Foot & Ankle 1(2): 1007, 2016

Patel AA, Alhandi AA, Milne EL, Dy CJ, Latta LL, Ouellette EA: “Biomechanical Analysis of All-Inside, Arthroscopic Suture Repair Versus Extensor Retinaculum Capsulorrhaphy for Triangular Fibrocartilage Complex Tears With Instability” JHSA 31 March: 387-393, 2016


Abstracts

Elliott W, Kaimrajh DN, Milne EL, Ouellette EA, Latta LL: “Acute Stabilization of a Leg with Fractures and Soft Tissue Injuries”. Poster #790, Trans. 62nd Orthop. Research Soc., p. 790, 2016.

Sori A, Asfour A, Alhandi A, Latta L, Travascio F: “Computational Analysis on Post-Fusion Effects of Hardware Preservation of Removal on Proximal Tibia Cartilage and Subchondral Bone”, ”. Poster #815, Trans. 62nd Orthop. Research Soc., p. 815, 2016.

Elmasry S, Asfour S, Gjolaj J, Latta LL, Eismont F, Travascio F: ”Implications of Different Fixation Constructs for Treating Thoracolumbar Burst Fractures on Adjacent Lumbar Spine Levels: A Finite Element Analysis”. Poster #892, Trans. 62nd Orthop. Research Soc., p. 892, 2016

Gottlieb J, Ostermann P, Alhandi A, Kaimrajh DN, Milne EL, Latta LL: “Comparison of cortical vs. pedicle screw loosening in normal and osteoporotic vertebrae”. Poster #897, Trans. 62nd Orthop. Research Soc., p. 897, 2016.

Vijapura A, Kaimrajh DN, Milne EL, Latta LL: “Biomechanical Evaluation of a Synthetic L3-S1 Spine Model”. Poster #898, Trans. 62nd Orthop. Research Soc., p. 898, 2016

Gottlieb J Ostermann P, Alhandi A, Trapana E, Kaimrajh DN, Milne EL, Latta LL: “Comparison of Pedicle Screw Loosening with vs. without PMMA Augmentation in Osteoporotic Vertebrae”. Poster #899, Trans. 62nd Orthop. Research Soc., p. 899, 2016.

Alhandi AA, Travascio F, Alamoudi M, Latta LL, Asfour S, Zych GA: “Biomechanical Analysis of Energy Expenditure by Lower Limbs in Non-Weight Bearing Crutch Ambulation”. Poster #916, Trans. 62nd Orthop. Research Soc., p. 916, 2016

Alhandi A, Pastoriza S, Travascio F, Eltoukhy M, Latta L, Asfour S, Zych GA: “Defining Loading on Lower Limb Joints with Partial Weight Bearing Crutch Ambulation: A Biomechanical Study”. Poster #996, Trans. 62nd Orthop. Research Soc., p. 996, 2016

Alhandi A, Lekic N, Patel A, Lee M, Milne E, Latta L: “A New Device for Reinforcing a Bivalved Fiberglass Short Arm Cast”. Poster #1196, Trans. 62nd Orthop. Research Soc., p. 1196, 2016.

Aguila C, Delcroix GJ, Kaimrajh DN, Milne EL, Temple HT, Latta LL: “Effects Of Gamma Irradiation On The Biomechanical Properties Of Peroneus Tendons”. Poster #1334, Trans. 62nd Orthop. Research Soc., Poster #1334, 2016

Delcroix GJR, Cerminara A, Alhandi AA, Barton MD, Qureshi AH, Cooper S, Kaimrajh DN, Lesniak B, Temple HT, Latta LL: “Viscoelastic Behavior Of ACL Grafts With Vs. Without Pretensioning”. Poster #1517, Trans. 62nd Orthop. Research Soc., p. 1517, 2016

Qureshi A, Alhandi A, Kaimrajh D, Latta L: “ Sawbones® Generation IV Femur as a Biomechanical Model for Stress Concentration in Plate and Screw Constructs”. Poster #1644, Trans. 62nd Orthop. Research Soc., p. 1644, 2016

Alexander J, Morris R, Kaimrajh DN, Milne EL, Latta LL, Flink A, Lindsey RW: “Biomechanical Evaluation of Periprosthetic Refractures Following Distal Femur Locking Plate Fixation”. Poster #1652, Trans. 62nd Orthop. Research Soc., p. 1652, 2016

Patel A, Alhandi A, Dy C, Wherley E, Milne E, Makowski A, Kaimrajh D, Latta L, Ouellette E: “Biomechanical Analysis of All-Inside, Arthroscopic Suture Repair versus Extensor Retinaculum Capsulorrhaphy for Triangular Fibrocartilage Complex Tears with Instability ”. Poster #2061, Trans. 62nd Orthop. Research Soc., p. 2061, 2016

Alhandi A, Patel A, Milne EL, Makowski A-L, Prendes E, Latta LL, Ouellette EA: “Balloon Carpal Tunnel-Plasty versus Endoscopic Carpal Tunnel Release: A Cadaveric Assessment of Median Nerve and Compartment Pressure Changes”. Poster #2063, Trans. 62nd Orthop. Research Soc., p. 2063, 2016.

Solomon R, Asfour S, Grau L, Latta LL, Travascio F: “Post-Operative Implications of Femoral Notching, Overstuff, and Implant Rotation in Total Knee Arthroplasty on Femoral Biomechanics: a Finite Element Study”. Poster #1608, Trans. 62nd Orthop. Research Soc., p. 1608, 2016

Dy C, Wherley E, Ouellette EA, Makowski A-L, Trionfo A, Latta LL, Milne EL: “Characterizing Ulnocarpal Instability In The General Population”. Poster #2064, Trans. 62nd Orthop. Research Soc., p. 2064, 2016.

Elmasry S, Asfour S, Gjolaj J, Latta L, Eismont F, Travascio F: "Treatment of Thoracolumbar Burst Fracture: a Biomechanics Analysis of Three Different Fixation Constructs", Summer Biomechanics, Bioengineering and Biotransport Conference, p. 746-7, National Harbor, MD, 2016

Sori A, Solomon R, Asfour S, Lindsey R, Alhandi A, Latta L, Travascio F: "Computational Analysis on Post-Fusion Effects of Hardware Preservation of Removal on Osteoporotic Proximal Tibia Cartilage and Subchondral Bone", Summer Biomechanics, Bioengineering and Biotransport Conference, National Harbor, MD, 2016

Solomon R, Sori A, Asfour S, Latta L, Alhandi A, Travascio F: "Post-Operative Complications of Computer Assisted Total Knee Arthroplasty in Osteoporotic Femurs and Tibias: A Finite Element Study", Summer Biomechanics, Bioengineering and Biotransport Conference, National Harbor, MD, 2016


Patents

Inventors: Lindsey RW, Gugala Z, Latta LL.
Filed by: Biedermann Technologies, GmbH & Co. IG, Donaueschingen (DE).
Title: Tissue Integraton Design for Seamless Implant Fixation.
Number: US 9,364,330 B2 Date: June 14, 2016.

2015 Publications and Presentations

Chapters:

Latta LL, Milne EL, Mohnani D, Wilson J: “Biomechanics of Orthopaedic Implants”, Chapter 11, in Orthopaedic Implants: Applications, Complications and Management, Lindsey, RW, Gugala, Z (Ed), Marcel Dekker, Inc, NY, NY, CRC Press, 2015 (ISBN-10: 0824728785; ISBN-13: 9780824728786).


Papers

Travascio F, Asfour S, Gjolaj J, Latta L, Elmasry S, Eismont F: "Implications of decompressive surgical procedures for lumbar spine stenosis on the biomechanics of the adjacent segment: a finite element analysis", J Spine, 4:220-3, 2015 (DOI:10.4172/21657939.1000220)

Alexander J, Morris RP, Kaimrajh D, Milne E, Latta L, Flink A, Lindsey RW: “Biomechanical Evaluation of Periprosthetic Refractures Following Distal Femur Locking Plate Fixation Injury”, 46-12: 2368-73, 2015. (DOI:10.1016/j.injury.2015.09.033)

Delcroix GJ-R, Barton M, Qureshi A, Cerminara A, Lesniak BP, Cooper S, Temple HT, Milne EL, Kaimrajh DN, Latta LL: “Pretensioning of anterior tibialis tendons and fan-folded iliotibial bands”. CellR4, 3-5:e1673-80, 2015. (PM-2882)

Olson SA, Schemitsch G, Morwood M, Schemitsch E, Russell TA, Latta LL: “Hot Topics in Biomechanics”, J Orthop Trauma, 29:S1-S5, 2015. (DOI:10.1097/BOT.0000000000000471)

Marmor M, Alta V, Latta L, Lane J, Rebolledo B, Egol KA, Miclau T: “Osteoporotic Fracture Care”, J Orthop Trauma, 29:S53-S56, 2015, (DOI: 10.1097/BOT.0000000000000469)


Abstracts

Qureshi A, AlHandi A, Kaimrajh D, Milne E, Latta L: “The Invalidation of Sawbones as a Biomechanical Model for Stress Concentration”, Poster #250, Proc. 82nd Amer. Acad. Orthop. Surgeons, 16:250, 2015

Elmasry S, Asfour S, Gjolaj J, Latta L, Travascio F, Eismont F: “Changes in Adjacent Segment Biomechanics After Laminectomy and Laminotomy in Lumbar Spine”, Poster #P0674, Trans. Orthop Research Soc., p.P0674, 2015

Asfour S, Elmasry S, Latta L, Gjolaj J, Travascio F, Eismont F: “Comparative Analysis on the Implications of Anterior Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion on Adjacent Segment Biomechanics: a Finite Element Study”, Poster #P1539, Trans. Orthop Research Soc., p.P1539, 2015

Alhandi A, Lowe J, Milne E, Kaimrajh D, Albert J, Latta L: “Mini Fragment Fixation of Clavicle Fractures: A Biomechanical Study” Poster #P0635, Trans. Orthop Research Soc., p.P0635, 2015

Alhandi A, Moore W, Lowe J, Milne E, Kaimrajh D, Latta L: “Axial and Rotational Mal-Reduction (Golf Club Deformity) in Distal Femur Fractures”. Poster #P0646, Trans. Orthop Research Soc., p.P0646, 2015

Alhandi A, Pastoriza S, Travascio F, Eltoukhy M, Latta l, Asfour S, Zych G: “Defining Loading and Moments on Joint with Crutch Ambulation: A Biomechanical Study”. Poster #P1008, Trans. Orthop Research Soc., p.P1008, 2015

Qureshi A, Barton M, Kaimrajh D, Milne E, Latta L, Temple HT: “A Novel Biologic Composite for Use in Orthopaedic Surgery: A Viable Alternative to Bone Cement”, Poster #P1173, Trans. Orthop Research Soc.,p.P1173, 2015

Vijapura A, Alhandi A, Kaimrajh D, Milne E, Latta L, Temple HT: “Biomechanical Properties of an Artificial Ligament Produced from Demineralized Bone for Anterior Cruciate Ligament Reconstruction”, Poster #P0318, Trans. Orthop Research Soc., p.P0138, 2015

Shub J, Lawrie CM, Quinnan SM, Hussain S, Latta L, Milne E: “Are 3.5mm Plates and Screws Ideal Forearm Fixation? Biomechanical Analysis of Diaphyseal Forearm Refracture”. Poster #P1502, Trans. Orthop Research Soc., p.P1502, 2015

Qureshi A, Barton M, Kaimrajh D, Milne E, Latta L, Temple HT: “Allograft Bone Tissue Reconstitution Time and Associated Compressive Strength A Biomechanical Analysis”, Poster #P0307, Trans. Orthop Research Soc., p.P0307, 2015

Gjolaj J, Elmasry S, Asfour S, Latta L, Travascio F,. Eismont F: “'Implications of Decompressive Surgical Procedures for Lumbar Spine Stenosis on the Biomechanics of the Adjacent Segment: a Finite Element Analysis”. Proc. N Amer Spine Soc, Chicago, IL, 2015.

Elmasry S, Asfour S, Gjolaj J, Latta L, Eismont F, Travascio F: “Biomechanical Comparison Between Facet Sparing Laminectomy and Laminectomy with Facetectomy in Lumbar Spine: a Finite Element Analysis”, Poster #653, Proc. Summer Biomech, Bioengr Biotransport Conf., UT, 2015

Patel A, Alhandi A, Milne EL, Makowski A-L, Latta L, Ouellette EA: “Biomechanical Analysis of Reconstruction Methods for Peripheral Triangular Fibrocartilage Complex Tears”. Paper 63, Proc. 70th Ann. Amer. Soc. Surg. Hand, 11:1589, 2015

Alhandi AA, Patel A, Milne EL, Makowski A-L, Latta LL, Ouellette EA: “Balloon carpal tunnelplasty vs endoscopic carpal tunnel release: a cadaveric assessment of median nerve position and compartment pressure changes”, Paper 18, Proc. 70th Ann. Amer. Soc. Surg. Hand, 2015

Alhandi A, Moore W, Lowe J, Milne E, Kaimrajh D, Latta L: “Axial and Rotational Mal-Reduction (Golf Club Deformity) in Distal Femur Fractures”. Paper #420, Proc. AO North Amer., Las Vegas, NV, 2015

Elmasry S, Asfour S, Gjolaj J, Latta L, Eismont F, Travascio F: "Biomechanical Comparison Between Facet Sparing Laminectomy and Laminectomy with Facetectomy in Lumbar Spine: a Finite Element Analysis", Proc. Summer Biomech, Bioengr & Biotransport Conf (SB3C), 2015

Gjolaj J, Elmasry S, Asfour S, Latta L, Travascio F, Eismont F: "Implications of Decompressive Surgical Procedures for Lumbar Spine Stenosis on the Biomechanics of the Adjacent Segment: a Finite Element Analysis", Proc. N Amer Spine Society (NASS) Annual Meeting, 2015

2014 Publications and Presentations

Chapters:

Sarmiento A, Latta LL: “Principles of nonoperative treatment of diaphyseal fractures”, in Encyclopedia of Orthopaedics, edit by Gorzyka, in print, 2014

Sarmiento A, Latta LL: “Tibial fractures”, Chapter 6H, and VJO eVideo: “Application of functional braces for tibial fractures”, in Skeletal Trauma. Basic Science, Management and Reconstruction. 4th Ed Browner, B, Jupiter, J, Krettek, C, Anderson, PP, Elsevier Saunders, Philadelphia, PA. Vol. 1-S1:152-167, 2014


Papers:

Marx R, Clifford P, Latta L, Steinmetz N, Temple H, Mizel M: “The role of the calcaneofibular ligament in chronic ankle pain and instability following severe ankle sprains”, submitted to J Foot Ankle Internat. , 2014

Silverman E, Massel D, Landy DC, Latta L, Robinson R: "The Effect of Viscosity on Cement Penetration in Total Knee Arthroplasty, an Application of the Squeeze Film Effect", accepted to J Arthoplasty, 2014

Norton RP, Milne EL, Kaimrajh DN, Eismont FJ, Latta LL, Williams SK: “Biomechanical analysis of four- versus six-screw constructs for short-segment pedicle screw and rod instrumentation of unstable thoracolumbar compression fractures”. Spine J, 14(8):1734-9, 2014. j.spinee.2014.01.035 /p>


Abstracts:

Latta L, Milne E, Kaimrajh D, Zych G, Temple T, Bettführ J: “Cortical Bone Plugs to Reduce Stress Concentration from Screw Holes in Long Bones”, poster, ORS , 2014

Bettführ J, Milne E, Kaimrajh D, Zych GA, Ganga S, Latta LL, Temple H: “Cortical bone plugs to reduce stress concentration from screw holes in long bones”, Poster #0662, Trans. 60th Orthop. Research Soc., p. 1263-4, 2014

Silverman E, Massel D, Milne E, Latta L, Robinson R: “Liquid Versus Dough Phase Cementation in the Tibial Component of Total Knee Arthroplasty, A Cadaver Study”, Poster #1728, Trans. 60th Orthop. Research Soc., p. 1992-3, 2014

Kaimrajh DM, Milne EL, Qureshi MA, Barton MD, Latta LL, Ouellette EA: “Comparison of Bone Mineral Density in the Distal Radius to Volar Plating Screw Mechanics”, , Trans. 60th Orthop. Research Soc., Poster1036, p. 24078-80, 2014

Ouellette EA, Dy C, Nicolescu R, Clifford P, Kam C, Sawardeker P, Latta L, Makowski A-L, Milne T, Kaimrajh D, Fennema J, Diaz-Granado P: Injury biomechanics of the wrist after a fall on an outstretched hand (FOOSH), Proc. FL Hand Soc., 2014

Ouellette EA, Nicolescu R, Kam CC, Sawardeker P, Clifford P, Latta L: “The Incidence and Characteristics of Carpal Fractures Arising Concurrently with Distal Radius Fractures After a Fall onto an Outstretched Hand”, paper/poster #1383, Proc. Amer. Soc. Surg. Hand, 2014

Ouellette EA, Nicolescu R, Kam CC, Sawardeker P, Clifford P, Latta L: “The Incidence of Scapholunate, Lunotriquetral, and Triangular Fibrocartilage Complex Tears: A Cadaveric Investigation”, paper/poster #1393, Proc. Amer. Soc. Surg. Hand, 2014

Ouellette EA, Nicolescu R, Kam CC, Sawardeker P, Clifford P, Latta L: “The Incidence of Scapholunate and Lunotriquetral Ligament Tears in Distal Radius Fractures: The Effect of Wrist Position and Forearm Rotation During a Fall onto an Outstretched Hand”, paper/poster #1399, Proc. Amer. Soc. Surg. Hand, 2014

Escobar P, Wittels S, Kaimrajh D, Neurlock S, Asfour S, Latta L: “Mechanical characteristics of muscle, skin and fat – elastic moduli for finite element modeling of limbs”, Poster #1173, Trans. 60th Orthop. Research Soc., p. 134-6, 2014

Nicolescu R, Kam C, Sawardeker P, Ouellette EA, Clifford P, Latta L: “The Incidence and Characteristics of Carpal Fractures Arising Concurrently with Distal Radius Fractures After a Fall onto an Outstretched Hand”, Poster #1030, Trans. 60th Orthop. Research Soc., p. 2462-3, 2014

Khundkar T, Elliott IS, Ouellette EA, Nicolescu R, Latta LL, Clifford P: Prevalence of radioscaphocapitate ligament lesions and correlation with associated pathologies: Volar ganglion and distal radius fracture. Trans. 60th Orthop. Research Soc., 2014

Kaimrajh DN, Qureshi A, Barton M, Milne EL, Ouellette EA, Latta L: Comparison of BMD in distal radius to volar plating screw mechanics. Trans. 60th Orthop. Research Soc., 2014

Nicolescu R, Ouellette EA, Clifford P, Kam C, Sawardeker P, Latta L: The incidence and characteristics of carpal fractures arising concurrently with distal radius fractures after a fall onto an outstretched hand. Trans. 60th Orthop. Research Soc.,2014

Ouellette EA, Dy C, Nicolescu R, Clifford P, Kam C, Sawardeker, P, Latta L, Makowski A-L, Milne T, Kaimrajh D, Fennema J, Diaz-Granado P: Injury biomechanics of the wrist after a fall on an outstretched hand (FOOSH), Proc. FL Hand Soc., 2014

2013 Publications and Presentations

Papers:

Delcroix GJ-R, Kaimrajh DN, Baria D, Cooper S, Reiner T, Latta LL, D’Ippolito G, Schiller P, Temple HT: “Histological, biomechanical and biological evaluation of fan folded iliotibial band allografts for anterior cruciate ligament reconstruction”, J Arthroscopic Related Surg,, 29(4):756-765, 2013.

Kam CC, Sawardeker PJ, Jones CM, Latta LL, Ouellette EA, Evans P: Interosseous Ligament Reconstruction Lowers Radiocapitellar Joint Pressures in Essex-Lopresti Injuries, under revision at J Orthop Res, 2013

Kam CC, Sawardeker PJ, Elliott W, Nicolescu R, Latta LL, Ouellette EA: Radiographic Forearm Interosseous Width as a Reliable Predictor of Interosseous Ligament Disruption, under revision at J Orthop Trauma, 2013

Norton RP, Lindsey RW, Baria D, Kaimrajh D, Milne EL, Latta L: “Effects of Lumbosacral Fusion on Sacroiliac Joint Biomechanics”, The Spine Journal, Sept 2013, 13-9, Supp. P.S101

Latta L, Sawardeker P, Kam C, Milne E, Ouellette, Elizabeth: “Biomechanical Differences between Bipolar and Monopolar Radial Heads following Radial Head Arthroplasty”, Bone Joint J 2013 vol. 95-B no. SUPP 34 523

Delcroix GJ-R, Kaimrajh DN, Baria D, Cooper S, Reiner T, Latta LL, D’Ippolito G, Schiller P, Temple HT: “Histological, biomechanical and biological evaluation of fan folded iliotibial band allografts for anterior cruciate ligament reconstruction”, J Arthroscopic Related Surg,, 29(4):756-765, 2013


Abstracts:

Ouellette EA, Dy CJ, Makowsk, A-L, Milne E, Latta LL: Evaluation of an Examination Maneuver for Ulnocarpal Instability: a Biomechanical Study. CORS, Venice, Italy October 12-16, 2013

Nicolescu R, Clifford P, Latta LL, Ouellette EA: “The incidence of scapholunate and lunotriquetral ligament tears in distal radius fracture: The effect of wrist position and forearm orientation during a fall onto an outstretched hand”, Special Emphasis Poster#302, Proc. 126th Ann. Amer. Orthop. Assoc., 2013

Nicolescu R, Ouellette EA Clifford P, Latta LL: “The incidence and characteristics of carpal fractures arising concurrently with distal radius fracture after a fall onto an outstretched hand,” Special Emphasis Poster #301, Proc. 126th Ann. Amer. Orthop. Assoc., 2013

Ouellette EA, Latta LL, Kaimrajh DM, Herndon E, Kam CC, Sawardeker PJ, Elliott W: “The role of soft tissues in rigidity of fracture fixation of upper extremities: application for battlefield use”, ePoster #16099, Proc. Amer. Assoc. Hand Surg., Jan., 2013

Baria D; Lindsey R; Norton R; Kaimrajh DN, Milne EL, Latta LL: “The Effects of Lumbosacral Fusion on Sacroiliac Joint Biomechanics”, Paper #250, Proc. 80th Amer. Acad. Orthop. Surgeons, 14:250, 2013

Dy CJ, Trionfo A, Makowski AL, Milne E, Latta LL, Ouellette EA: “Triquetral Rotational Index: A Measure of Ulnocarpal Instability”, Proc. Amer. Soc. Surg. Hand, 2013

Nicolescu R, Kam C, Sawardeker P, Ouellette EA, Clifford P, Latta LL: “The incidence and characteristics of carpal fractures arising concurrently with distal radius fractures after a fall on an outstretched hand,” Poster #1921, Trans. 59th Orthop. Res. Soc., 38:P1921, 2013

Nicolescu R, Kam C, Sawardeker P, Ouellette EA, Clifford P, Latta LL: “The incidence of scapholunate, lunotriquetral and triangular fibrocartilage complex tears: A cadaveric investigation”, Poster #1919, Trans. 59th Orthop. Res. Soc., 38:P1919, 2013

Asfour S, Cami S, Eltoukhy M, Latta L: “Effect of body mass index (BMI) on gait biomechanics,” Poster #0969, Trans. 59th Orthop. Res. Soc., 38:P0969, 2013

Bettführ J, Kaimrajh DN, Milne EL, Ganga S, Latta LL: “Development of a half ring diametral test to detect stress concentrations in cortical bone”, Poster #1484, Trans. 59th Orthop. Res. Soc., 38:P1484, 2013

Ouellette EA, Latta LL, Milne EL, Kaimrajh DN, Makowski A-L, Herndon E, Kam C, Sawardeker P, Elliott W: “The role of soft tissues in rigidity of fracture fixation of upper and lower extremities,” Poster #0753, Trans. 59th Orthop. Res. Soc., 38:P0753, 2013

Sawardeker P, Elliott W, Kam C, Milne E, Latta LL, Ouellette EA: “Biomechanical differences between bipolar and monoblock radial head following radial head arthroplasty”, Poster #1861, Trans. 59th Orthop. Res. Soc., 38:P1861, 2013

Ouellette E, Elliott W, Latta L, Milne E, Kaimrajh D, Lowe J, Makowski A-L, Herndon E, Kam C, Sawardeker P: “The Role of Soft Tissues in Rigidity of Fracture Fixation of Upper Extremity; Application for Battlefield Use.” AAHS, Naples, FL January 9-12, 2013

Ouellette E, Trionfo A, Makowski A-L, Milne E, Latta L, Ouellette E: “Triquetral Rotational Index: A Measure of Ulnocarpal Instability.” Amer. Assoc. Hand Surg., Naples, FL January 9-12, 2013

Dy C, Ouellette E, Harrison R, Makowski A-L, Milne E, Kaimrajh D, Latta L: “Evaluation of an Examination Maneuver for Ulnocarpal Instability: a Biomechanical Study.” Amer. Assoc. Hand Surg., Naples, FL January 9-12, 2013

Asfour S, Cami S, Eltoukhy M, Latta L: “Effect of body mass index (BMI) on gait biomechanics,” Poster #012, Proc. CaneSearch, Clin. Translat. Science Institute, 2013

Dy C, Ouellette E, Harrison R, Makowski A-L, Milne E, Latta L: “Peripheral TFCC Tears Cause Ulnocarpal Instability: a Biomechanical Study.” Amer. Assoc. Hand Surg., Naples, FL January 9-12, 2013

Cerminara A, Lesniak B, Kaimrajh D, Milne E, Temple H, Latta L: “The effect of pretensioning on the viscoelastic properties of the iliotibial band allograft compared to tibialis anterior allograft”, Proc. Florida Orthop. Soc., P.?, 2013.

Lowe J, Moore W, Latta L, Milne E, Kaimrajh D, Ouellette EA: “Axial and Rotational Mal-Reduction (Golf Club Deformity) in Distal Femur Fractures”, Paper #782, Combined Orthop Research Societies, 2013

Elliott W, Sawardeker P, Kam C, Milne EL, Ouellette EA, Latta LL: “Relation of Load Distribution Between Radiocapitellar and Ulnotrochlear Joints with Radial Head Arthroplasty”, Paper #1074, Trans. Combined Orthop Research Societies, 2013

Elliott W, Sawardeker P, Kam C, Ouellette EA, Latta LL: “Shifting for the forearm bones with improper sizing in radial head arthroplasty”, Paper #1077, Combined Orthop Research Societies, 2013

Elliott W, Kaimrajh D, Sawardeker P, Milne E, Ouellette EA, Latta L: “Importance of Implant Radius of Curvature in Radial Head Arthroplasty”, Paper #1082, Combined Orthop Research Societies, 2013

Ouellette EA, Latta LL, Kaimrajh DM, Herndon E, Kam CC, Sawardeker PJ, Elliott W: “The Role of Soft Tissues in Rigidity of Fracture Fixation of Upper and Lower Extremities; Application for Battlefield Use”, Poster #1208, Trans. Combined Orthop Research Society, 2013

Dy C J, Trionfo A, Makowski A L, Milne E, Latta L L, Ouellette E A: “Triquetral Rotational Index: A Measure of Ulnocarpal Instability”, Paper #1404, Trans. Combined Orthop Research Societies, 2013

Dy C, Makowski A-L, Milne EL, Kaimrajh DN, Latta LL, Ouellette EA: “Peripheral TFCC Tears Cause Ulnocarpal Instability: a Biomechanical Study”, Paper #1409, Trans. Combined Orthop Research Societies, 2013

Dy C J, Makowski A-L, Milne E, Kaimrajh D, Latta L, Ouellette EA: “Evaluation of an Examination Maneuver for Ulnocarpal Instability: a Biomechanical Study”, Paper #1415, Trans. Combined Orthop Research Societies, 2013

Nicolescu R, Ouellette E A, Clifford P, Kam C, Sawardeker P, Latta L: “The Incidence and Characteristics of Carpal Fractures Arising Concurrently with Distal Radius Fractures After a Fall onto an Outstretched Hand”, Poster #1690, Trans. Combined Orthop Research Society, 2013

Nicolescu R, Clifford P, Latta L, Ouellette E A: “The Incidence of Scapholunate and Lunotriquetral Ligament Tears in Distal Radius Fractures: The Effect of Wrist Position and Forearm Rotation During a Fall onto an Outstretched Hand”, Poster #1694, Trans. Combined Orthop Research Society, 2013

Nicolescu R, Kam C, Sawardeker P, Ouellette EA, Clifford P, Latta LL: “The Incidence of Scapholunate, Lunotriquetral, and Triangular Fibrocartilage Complex Tears: A Cadaveric Investigation”, Paper #1700, Trans. Combined Orthop Research Societies, 2013

Kam C, Sawardeker P, Elliott W, Nicolescu R, Latta L, Ouellette EA: “Interosseous Complex Disruption Reliably Increases Radiographic Forearm Interosseous Width – Implications for Healing”, Paper #1706, Trans. Combined Orthop Research Societies, 2013

Kam CC, Sawardeker PJ, Nicolescu R, Kaimrajh DN, Fennema JL, Diaz-Granados PA Milne EL, Latta LL, Ouellette EA:. “Lunotriquetral Ligament Injuries Associated with Distal Radius Fractures: The Effect of Wrist Position and Forearm Rotation During a Fall Onto an Outstretched Hand”, Proc. 29th Orthop. Trauma Assoc., Paper #3642, 2013

Iobst C, Khoury A, Ingwer Z, Kaimrajh D, Milne E, Latta L A: “Safe Technique for Dynamizing the Taylor Spatial Frame”, Proc. 29th Orthop. Trauma Assoc., Poster #3651, 2013.

Gaski G, Quinnan S, Kaimrajh D, Milne E, Latta L: “Biomechanical Analysis of Far Proximal Radial Shaft Fracture Fixation”, Proc. 29th Orthop. Trauma Assoc., Paper #3644, 2013

Sawardeker P, Elliott W, Kam C, Milne E, Latta LL, Ouellette EA: “Biomechanical differences between bipolar and monopolar radial head following radial head arthroplasty”, ePoster and short talk, Kiosk 7,Trans. 26th Internat. Soc. Tech. Arthroplasty Congress, 2013

Nicolescu R, Kam C, Sawardeker P, Ouellette EA, Clifford P, Latta LL: “The Incidence of Scapholunate, Lunotriquetral, and Triangular Fibrocartilage Complex Tears: A Cadaveric Investigation”, Proc. FL Orthop. Soc., May, 2013

Nicolescu R, Kam C, Sawardeker P, Ouellette EA, Clifford P, Latta LL: “The Incidence of Scapholunate, Lunotriquetral, and Triangular Fibrocartilage Complex Tears: A Cadaveric Investigation”, ePoster #1393 at 68th Ann. Meet. Amer. Soc. Surg. Hand, Oct., 2013

Escobar P, Wittels S, Kaimrajh D, Neurlock S, Asfour S, Latta L: “Mechanical characteristics of muscle, skin and fat – elastic moduli for finite element modeling of limbs”, Poster #1173, Trans. 60th Orthop. Research Soc., p. 134-6,

Kaimrajh, DM, Milne, EL, Qureshi, MA, Barton, MD, Ouellette, EA. “Comparison of BMD in the Distal Radius to Volar Plating Screw Mechanics”, Poster1036, p. 24078-80

2012 Publications and Presentations

Published:

Prasarm M, Zych GA, Gaski G, Baria D, Kaimrajh DN, Milne EL, Latta LL: “A Biomechanical Study of 4-Hole Pubic Symphyseal Plating: Locked versus Unlocked Constructs”, Orthop., 20120621-15:1028, 2012

Jones CM, Kam CC, Ouellette EA, Milne EL, Kaimirajh DN, Latta LL: ”Comparison of 2 Forearm Reconstructions for Longitudinal Radioulnar Dissociation: A Cadaver Study”, J Hand Surg Am, 37(4):741-7, 2012

Dy CJ, Ouellette EA, Makowski A, Milne E, Latta L: “Peripheral Triangular Fibrocartilage Complex Tears Cause Ulnocarpal Instability: A Biomechanical Pilot Study”, Clin. Orthop., 470-10:2771-5, PMID:22644423, 2012.

Asfour S, Thompson C, Latta L: “Evaluation of the Performance of Digital Video Analysis of Human Motion: Dartfish Tracking System”, Internat. J. Scientific Engr. Research, 3-3:1-6, 2012

Olsen SA, Marsh JL, DeFrate LE, Anderson DD, Latta LL: “Designing a biomechanics investigation: choosing the right model”, J Orthop Trauma, 26:672-677, 2012

 


Presented at podiums or in posters:

Dy C, Makowski A-L, Milne EL, Kaimrajh DN, Latta LL, Ouellette EA: “Evaluation of an Examination Maneuver for Ulnocarpal Instability: a Biomechanical Study”, Poster #1255, Trans. 58th Orthop. Res. Soc., 37:P1255, 2012

Dy C, Makowski A-L, Milne EL, Kaimrajh DN, Latta LL, Ouellette EA: “Peripheral TFCC tears Cause Ulnocarpal Instability: a Biomechanical Study”, Poster #1263, Trans. 58th Orthop. Res. Soc., 37:P1263, 2012

Sawardeker P, Kam C, Elliott W, Milne EL, Latta LL, Ouellette EA: “Axial Length and Overstuffing Affects Radiocapitellar Pressures, a Cadaveric Study”, Trans. 58th Orthop. Res. Soc., 37:P1251, 2012

Dy C, Trionfo A, Makowski A-L, Milne EL, Latta LL, Ouellette EA: “Triquetral Rotational Index: A Measure of Ulnocarpal Instability”, Poster #1252, Trans. 58th Orthop. Res. Soc., 37:P1252, 2012

Norton R, Milne EL, Kaimrajh DN, Williams S, Eismont F, Latta LL: “Short Segment Fixation of an L1 Compression Fracture - 4 vs. 6 Screws”, Poster #1255, Trans. 58th Orthop. Res. Soc., 37:1255, 2012

Norton R, Milne EL, Kaimrajh DN, Williams S, Eismont F, Latta LL: “Biomechanical Analysis of Short Segment Fixation in an Unstable Thoracolumbar Flexion-Distraction Injury Model: 6-Screw Construct with and without Facet Compression”, Poster #2155, Trans. 58th Orthop. Res. Soc., 37:P2155, 2012

Gaski G, Quinnan S, Milne EL, Kaimrajh DN, Latta LL: “Biomechanical Analysis of Proximal Radial Shaft Fracture Fixation”, Poster #1423, Trans. 58th Orthop. Res. Soc., 37:P1423, 2012

Iobst C, Khoury A, Ingwer Z, Kaimrajh D, Milne EL, Latta LL: “Dynamization of the Taylor Spatial Frame with Modified Shoulder Bolts”, Poster #1429, Trans. 58th Orthop. Res. Soc., 37:P1429, 2012

Kaimrajh DN, Shufflebarger H, Leger G, Serhan H, Milne EL, Latta LL: “Cyclic Testing of a Growing Rod System for Scoliosis Reconstructions”, Poster #2116, Trans. 58th Orthop. Res. Soc., 37:P2116, 2012

Evans P, Flook R, Hajianpour MA, Kaimrajh DN, Milne EL, Latta LL: “Comparison of Crossed K-Wire and Mini-Hoffmann Fixation to Small pin, Non-Bridging External Fixation for Distal Metacarpal Fractures”, Poster #1433, Trans. 58th Orthop. Res. Soc., 37:P1433, 2012

Sawardeker PJ, Duerr RA, Kam CC, Latta LL, Ouellette EA: “Analysis of Vascularity of the Interosseous Ligament Complex”, Poster #2322, (Highlighted for the Hand and Wrist Poster Tour), Trans. 58th Orthop. Res. Soc., 37:P2322, 2012

Elliott W, Kaimrajh DN, Sawardeker PJ, Milne EL, Ouellette EA, Latta LL: “Radius of curvature plays a critical role in implant selection during radial head arthroplasty”, Paper 722, Proc. 79th Amer. Acad. Orthop. Surgeons, 13:P722, 2012

Prasarn M, Zych GA, Baria D, Kaimrajh DN. Milne EL, Latta LL: “Stability of pubic symphysis disruption: locked vs. unlocked vs. hybrid 4-hole pubic symphysis plating, Paper 144, Proc. 79th Amer. Acad. Orthop. Surgeons, 13:P144, 2012

Sawardeker PJ, Duerr RA, Kam CC, Latta LL, Ouellette EA: “Evaluation of blood supply of the interosseous ligament complex in the forearm”, Poster P230, (Highlighted as 1 of 5 most interesting and clinical relevant posters at the Hand and Wrist Poster Tour), Proc. 79th Amer. Acad. Orthop. Surgeons, 13:P230, 2012

Sawardeker PJ, Duerr RA, Kam CC, Latta LL, Ouellette EA: “Radial head arthroplasty alone raises radiocapitellar pressures and alters distal ulnar load in complete longitudinal disruption of the forearm”, Scientific Exhibit, SE64, Proc. 79th Amer. Acad. Orthop. Surgeons, 13:SE64, 2012

Dy C, Makowski A-L, Milne EL, Kaimrajh DN, Latta LL, Ouellette EA: “Evaluation of an Examination Maneuver for Ulnocarpal Instability: a Biomechanical”, proc. Amer. Soc. Surg. Hand, poster#50, 2012

Norton R, Milne EL, Kaimrajh DN, Eismont F, Latta LL: “Biomechanics of short segment fixation in an unstable thoracolumbar flexion-distraction injury model: 6-screw construct with and without facet compression”, Paper #1, Proc. Orthop. Trauma Assoc., 28:148-9, 2012

Williams S, Norton R, Milne EL, Kaimrajh DN, Eismont F, Latta LL: “Short Segment Fixation of an L1 Compression Fracture – 4 vs. 6 Screws”, Paper #56, Proc. Orthop. Trauma Assoc., 28:243-4, 2012

Elliott W, Sawardeker P, Kam CC, Ouellette EA, Latta LL: “Shifting of the Forearm Bones with Improper Sizing in Radial Head Arthroplasty”, Paper #18, Proc. Orthop. Trauma Assoc., 28:175-6, 2012

Alci E, Gottlieb J, Milne E, Kaimrajh D, Latta L: “cortical screw trajectory vs. pedicle screw”, Paper, Proc. Florida Orthop. Soc., June, 2012

Alci E, Gottlieb J, Milne E, Kaimrajh D, Latta L: “cortical screw trajectory vs. pedicle screw”, Paper, Proc. SOA, June, 2012

Alci E, Gottlieb J, Milne E, Kaimrajh D, Latta L: “Comparison of Cortical Trajectory and Traditional Pedicle Screw Loosening with Cyclic Loading”, Proc. 27th N. Amer. Spine Soc., October, 2012

Alci E, Gottlieb J, Milne E, Kaimrajh D, Latta L: “Comparison of Cortical Trajectory and Traditional Pedicle Screw Loosening with Cyclic Loading”, Proc. Lumbar Spine Res. Soc., April, 2012

Sawardeker P, Duerr R, Kam C, Ouellette E: Analysis of the Vascularity of the Interosseous Ligament Complex. ASSH, Chicago, IL September 6-8, 2012

Ouellette EA, Loren L, Milne, T, Kaimrajh D, Makowski AL, Herndon E, Kam C, Sawardeker P, Elliott W: The Role of Soft Tissue in Fracture Stability of Upper and Lower Extremity. Military Health System Research Symposium, Fort Lauderdale, FL August 13-16, 2012

Kam, C., Sawardeker, P., Elliott, W., Milne, E., Kaimrajh, D., Nicolescu, R., Duerr, R., Latta, L., Ouellette, EA.: Arthroplasty Alters Radiocapitellar Loads and Ulnar Kinematics in Complete Essex-Lopresti Injuries. Scientific Exhibit. AAOS, San Francisco, CA February 7-11, 2012

Ouellette EA, Nicolescu R, Clifford P, Kam C, Sawardeker P, Latta L: Fall on Outstretched Hand, FOOSH: Wrist, Carpal bones and Ligament Injuries IWIW, Chicago, IL September 6, 2012.


 

2012 University of Miami / MBI Miami Collaborative Projects

BIOMECHANICS RESEARCH PROJECTS

SPINE RESEARCH:

Our faculty surgeons: Seth K. Williams; Frank Eismont
Our voluntary faculty: Shufflebarger, H
Our resident surgeons: Prasarn, ML; Robert P. Norton; Cuartas, E,
Our UM engineers: Baria, D; Milne, EL; Kaimrajh, DN; Barreto, A; Latta, LL
Outside surgeons: Sukovich, W; Juergen Harms
Outside engineers: Serhan, H; Wilfried, M
Students: Leger, G; Malik, A

Bone anchoring: In osteoporotic vertebral bodies a significant increase in strength of fixation and reduction of loosening under cyclic load with pedicle screws was achieved with a small amount of bone cement injected through the screw and into the threads.*

A strong correlation was found in cadaver spines between decreased bone mineral density and lower screw insertion torque in the vertebral endplates when applying anterior lumbar cages for fusion.*

Cadaver lumbar vertebral bodies had pedicle screws applied with bone cement injected through the screws on one side of the vertebral body, and not in the other side. A small Harms cage was then placed on each side of the superior end plate and the load to cause penetration of the end plate was measured. The same test was repeated on the inferior end plate. In normal vertebral bodies there was no difference in resistance to penetration with or without bone cement, but there was a significant difference in osteoporotic vertebral bodies. The inferior end plates were significantly stronger than the superior end plates for this test.*

Cadaver lumbar vertebral bodies were DEXA scanned to separate “osteopenic” from “normal” groups. A pedicle screw was applied to one side, and a cortical screw applied to the other. Rods were attached to each screw, and to an UHMWPE block (a la ASTM/ISO standardized test) and was loaded from 5 Nm extension, to 5 Nm flexion at 0.25 Hz. for 5,000 cycles and then subjected to screw pull-out test. Screw loosening was monitored by video fluoroscopy using ImagePro software. Loosening occurred early for both screws in the “osteopenic” group, but not in the “normal” group. Screw pull-out strengths for loose pedicle screws was significantly stronger than for loose cortical screws. However, pull-out strength for cortical screws that had not loosened was better than for pedicle screws that had not loosened.+

Fixation of L1 fractures: In a short segment construct of an L1 compression fracture simulated in cadaver spines, the addition of pedicle screw fixation at the L1 level significantly improved the rigidity of the construct.*
Compression of the facet joints within a short segment construct to stabilize a flexion-distraction injury, significantly increased the rigidity of the construct and reduced the loading in the rods in a cadaver model.* The same construct in a corpectomy model was improved, but not significantly, by adding the screws at L1.+

Scoliosis:. An existing synthetic model for testing long thoracic spinal constructs was validated for flexion-extension loading by comparison to human cadaver spines. Constructs from T1 – T10 were then cyclic tested with the synthetic model to evaluate potential loosening of components and wear debris.*

Cadaver spines from T12 – T1 were instrumented with 2 typical configurations for correction of scoliosis with an apex at T5. One configuration used hooks; the other, pedicle screws. The torsional rigidity of each construct was measured both with and without anterior fusion, simulated with bone cement in the intervertebral disc space. The rigidity of the pedicle screw construct without anterior fusion was higher than that of the hook construct with anterior fusion. The implication is that it may be possible to prevent “crank shaft” deformity from occurring with the use of pedicle screw constructs without the need for anterior fusion.*

Cervical spine: Cadaver cervical spines had motions at C6-7 and C3-4 measured before and after single and double level fusions at C4-5 and C5-6. There were significant changes in motion during flexion and extension loading on the whole spine, related to both single level fusions, but more dramatically in double level fusions.*

*These projects have completed the experimental work and were presented at national and international meetings in 2011. Abstracts of each have been published in 2011 and many are in the process of submission for publication scientific journals.

+These projects are ongoing and have more experimental work to be done in 2013 to complete them.


TRAUMA RESEARCH:

Our faculty surgeons: Quinnan, S; Zych, G
Our voluntary faculty: Ouellette EA; Iobst, C; Hajianpour, MA
Our resident surgeons: Prasarn, ML; Robert P. Norton; Gaski, G; Jones, C; Kam C; Sawardeker P; Diaz, V
Our UM engineers: Baria, D; Milne, EL; Kaimrajh, DN; Barreto, A; Latta, LL
Outside surgeons: Ostermann, PAW; Lindsey, R
Outside researchers: Makowski, A-L
Students: Bione, W; Nicolescu R; Fennema J; Diaz-Granados P; Sano, T; Herndon, E; Fernando, H; Khoury, A; Ingwer, Z

Fracture fixation: Cadaver arms instrumented with 2 mm plates on the proximal radius showed no impingement with prono-supination, but 2.4 mm and 3.5 mm plate did impinge. There was also no statistical difference in bending stiffness in 3 planes or failure torque between the 3.5 mm plate and 2 mm 90-90 plating construct.+

The mechanical roles of a titanium mesh cage and an intramedullary nail in the reconstruction of significant segmental defects of the tibia was investigated invitro. Estimates of moments transmitted by the cage and the nail, show almost equal load sharing for the moments applied in valgus, anterior bowing and recurvatum. Only in varus loading did the cage carry most of the moment transmitted across the defect. The axial load transmission was carried primarily by the cage for all loading conditions.*

A non-bridging external fixation configuration was used to stabilize a 5 part, intra-articular fracture of the proximal humerus and humeral head. The construct was loaded in varus within the physiological range for 50,000 cycles. There was no measurable loss of rigidity of the construct or position of the bone fragments after cycling. The pins were each pulled from the pin holders and the pull-out strength of the pin-holder was at least as good as testing of freshly applied pins. So no loosening could be detected.*

Cadaver limb segments have a mid-diaphyseal, oblique fracture simulated by osteotomy in all long bones of the limb segment. In the thighs and upper arms, the femur and humerus are fixed. In the legs and forearms the tibias and radii are fixed. Fixation groups include plate and screws, intramedullary nails and single half-pin external fixators. The axial rigidity of each limb after fracture and fixation is measured under physiological load levels, then a splint or brace is applied with soft tissue compression in the area of the fixed fracture. This procedure is repeated after removing ¼ of the soft tissue circumferentially over ½ the length of the lateral side of each limb segment, and then again after removing 1/3 of the lateral soft tissue. Soft tissue compression with a brace does help to stabilize the limbs with intramedullary nails and those with external fixators, but not the limbs with plate and screw fixation. The role of soft tissue compression diminishes with loss of soft tissue. +

Pelvic fixation: Movements at the sacroiliac joint measured in human cadavers with flexion/extension, torsion and axial compression loading were altered by progressive fusion of L4-5 and then L5-S1.*

CT was used to map BMD regions in the sacrum to optimize the placement of screws for SI fixation. A single, large screw was compared biomechanically to existing screw fixation of the SI joint.* A model of the pelvis with plating of the SP joint showed motions at the SP joint were only slightly different between groups and none were statistically significant, though the vertical translations and the ML plane rotations, with the hybrid fixation were slightly reduced. The same was true for the SI joint vertical translations, but there was a significant improvement with the Hybrid fixation in ML plane rotations, P < 0.02. The closing of the SP joint with lateral load was significantly improved with the hybrid fixation, (P < 0.05). This study showed no advantage for locked plating.*

Distal radius fractures: Matched pairs of cadaver arms had a 5-part, intra-articular fracture of the distal radius fixed with a volar plate on one side, a non-bridging external fixation of the other. Bone fragment movements were recorded by fluoroscopy during loading in flexion, extension, ulnar deviation and radial deviation. The anatomic reduction of the externally fixed side was better than the volar plated side, and was maintained better under load. The plated side was significantly stronger than the externally fixed side.*

Using a simulated ‘fall on an outstretched hand’ model using 3 different hand positions to create a distal radius fracture we found that an ulnarly deviated or neutral wrist position resulted in a displaced distal radius fracture with a very strong linear correlation (0.84 and 0.87 respectively) between BMD and the force needed to create that fracture.+

Using a simulated ‘fall on an outstretched hand’ model using 3 different hand positions to create a distal radius fracture we found that that LT tears are more likely to be associated with fractures of the distal radius with internal forearm rotation and a radially deviated hand position.+

Using a simulated ‘fall on an outstretched hand’ model using 3 different hand positions to create a distal radius fracture we found that an ulnarly deviated wrist position was associated with a new scapholunate interosseous ligament tear in 2 out of 7 cadaveric arms compared to zero in 16 radially deviated or neutral arms.+

*These projects have completed the experimental work and were presented at national and international meetings in 2011. Abstracts of each have been published in 2011 and many are in the process of submission for publication scientific journals.

+These projects are ongoing and have more experimental work to be done in 2013 to complete them.


HAND SURGERY RESEARCH:

Our faculty surgeons: Cardoso, R
Our voluntary faculty: Ouellette EA
Our resident surgeons: Prasarn, ML; Jones, C; Kam C, Sawardeker P
Our UM engineers: Baria, D; Milne, EL; Kaimrajh, DN; Latta, LL
Outside surgeons: Evans, P, Hajianpour, MA
Outside researchers: Makowski, A-L
Students: Nicolescu R, Fennema J, Diaz-Granados P; Herndon, E; Fernando, H, Trionfo, A; Flook, F, Dy, C; Elliott, W, Martins, J

Hand fractures: In human cadaver metacarpals, the multi-plane fixation of the extra-articular fragments provided by the NBX fixator was biomechanically superior to the fixation with 2 parallel pins in the Mini Hoffman fixator *

In human cadaver metacarpals, multi-plane fixation of the intra-articular fragments with the NBX fixator was biomechanically superior to the 2 parallel pins deployed by the Mini Hoffman fixator.*

Wrist injuries: The triquetral rotational index (TRI) is evaluated as an image analysis technique for diagnosis of ulnocarpal wrist instability in 105 healthy volunteers and 120 fresh human cadaver arms.*

Pathology of the TFCC is common cause of ulnar wrist pain but may also present with instability. In a cadaver study, we have demonstrated decreased stiffness in the UC joint after a peripheral-sided TFCC tear.*

Ulnar triquetral resistance to movement was measured in cadaver forearms before and after simulated TFCC tear, after stabilization with a functional brace designed for fracture treatment, and then again after surgical repair of the TFCC. The brace provided significant support to the injured TFCC.*

With supination tests of 30 cadaver arms, the examiner rated 4 wrists as stable and 26 as unstable. In biomechanical testing, the wrists judged to be stable had an average ulno-pisiform motion of 2.0 mm ±0.54 and wrists judged unstable had an average motion of 3.58 mm ±1.26. There was a statistically significant difference between the motion of the "stable" vs. "unstable" wrists.*

Cyclic loads applied to the flexor and extensor tendons in cadaver forearms drive the wrist motion while recording the positions of the carpal bones with fluoroscopy. The loading cycles are recorded for the intact wrist, after cutting the ligaments between the scafoid and lunate bones and then after repair of the simulated injury. These measurements were made with the wrist aligned in neutral, 20° radial deviation and then 20° ulnar deviation.+

Forearm axial injuries: Both lateral ulnotrochlear joint space and distal ulnar deviation showed significant increases corresponding to radial head implant sizing ranging in 2mm length increments, from -2mm to +4mm in cadaver arms.*

Measurements in cadaver arms showed a linear relation between RC and applied axial load, thus a consistent distribution of RC/UT at any load. Equivalence of ∆L values indicate consistent distribution with implant oversizing, showing constant interosseus ligament tension, which points to minimal distal radial translation.*

The percentage difference between radial head implant and capitellar radius of curvatures was plotted against corresponding measured pressures and contact areas in cadavers, showing a positive, linear trend.*

Successful results following radial head arthroplasty are dependent upon proper component position and size. In this cadaveric model progressive radial head lengthening was associated with a stepwise increase in radiocapitellar joint force. Radiocapitellar forces were 1.5 times greater with radial head overstuffing (+4) compared to neutral (0). Sizing of the radial head implant plays a critical role in restoring native radiocapitellar loads and may prevent accelerated wear at the radiocapitellar joint after radial head arthroplasty.*

Few biomechanical studies compare bipolar components to their monopolar counterparts. We examined the force conveyed at the radiocapitellar joint in a head-to-head comparison of bipolar impants to rigid, monopolar implants and found that pressures were notably higher when using monopolar radial heads.*

Axial load transfer was measured in intact cadaver arms and following complete disruption of the interosseous ligament complex, radial head excision and disruption of the DRUJ. Post injury, radial head arthroplasty improved radioulnar axial displacement but not to intact levels, doubled the radiocapitellar pressure and reduced the distal ulnar load by half that of intact arms.*

Axial loading on cadaver forearms with simulated Essex-Lopresti injuries showed that with radial head arthroplasty alone is sufficient to restore near normal biomechanics in partial disruptions of the IOLC. In complete IOLC injuries, radial head replacement alone doubled the radiocapitellar pressure.*

From cadaver studies of the forearm with Essex-Lopresti injury simulation and reconstruction, a method was devised to identify certain landmarks on the plain film X-rays that could be used to accurately determine the proper length of the radial head implant that would restore the length of the forearm. A triangle can be indentified with consistency that must be restored to create the proper length of the forearm.*

Measures of distal ulnar load transfer, radiocapitellar loading and motion of the distal radius and ulna to the carpal row with axial loading were used to monitor changes associated with removal of the radial head, then disruption of the DRUJ, followed by stripping of the interosseous ligament. After complete disruption the measures were repeated. The forearm was then progressively reconstructed by first applying a radial head implant, then repairing the interosseous ligament with either a patellar tendon graft or a tight rope. Next the DRUJ was stabilized with the Herbert sling procedure. The radial head alone did not restore normal load transfer to the forearm. The addition of the patellar tendon or the tight rope made a significant improvement, but still did not control the splaying of the radius and ulna. With the repair of the DRUJ, the normal mechanics of the forearm were almost completely restored.*

X-ray measures in cadaver forearms of the angles of the bones and the gaps in the joints at the elbow and wrist with radial head implants purposely placed at – 2 mm, 0 mm, +2 mm and +4 mm the normal length, showed significant changes in joint alignment and shift of the balance of loading from the radius and ulna at both the elbow and wrist.*

Fresh human forearms with all tissues intact were tested under axial loads with the forearm in neutral position, supination and pronation while the elbow was flexed to 90°and wrist was flexed 20°. The loading and axial stiffness measures were repeated after each of the following changes: 1. transducers placed in the radiocapitellar joint; 2. Transducers placed on the distal ulna; 3. Transducers placed on the interosseous ligament; 4. The skin and muscle tissues were stripped from the arm; 5. Large strain indicators were attached to the distal ulna and proximal radius. The objective was to detect any artifacts that might occur with the typical methods reported in the literature for analyzing the load transfer in the forearm under axial load. Many discrepancies exist in the literature. The hypothesis is that the methods deployed may account for the differences.+

*These projects have completed the experimental work and were presented at national and international meetings in 2011. Abstracts of each have been published in 2011 and many are in the process of submission for publication scientific journals.

+These projects are ongoing and have more experimental work to be done in 2013 to complete them.


SPORTS MEDICINE RESEARCH:

Our faculty surgeons: Temple, HT; Kaplan, LD; Lesniak, B; Malinin, T
Our resident surgeons: Chan, DB; Cerminara, A
Our UM engineers: Asfour, S; Milne, EL; Kaimrajh, DN; Latta, LL
Outside surgeons: Gendler, E
Students: Thompson, C; Mahure, S; Dennis, J; Sugimoto, G; Bass, D

Motion analysis:. Utilizing an inexpensive video camera and a laptop computer a system to evaluate joint kinematics, forces and moments for selected activities was validated by simultaneous measure with a sophisticated motion analysis system.+

ACL reconstruction The strength of specimens fashioned from the iliotibial band were compared to specimens of anterior tibialis tendon, patellar tendons and anterior cruciate ligaments. The fascia lata graft materials were comparable to the patellar tendons and anterior tibialis tendons.*

Decalcified human femoral strips were tested for mechanical strength in tension and shear. Several hundred specimens were divided by age and sex and the results showed that there was a significant trend for specimens to become weaker with age. The strength of the male specimens was greater than the female specimens, but when loads were corrected for cross-sectional area, the material failure stress was very similar between the sexes.* Creep and stress relaxation in ACL’s and ACL reconstruction materials showed similarities among the reconstruction materials, and significantly greater initial creep and stress relaxation than that of ACL’s.+


MISC. AREAS OF RESEARCH:

Our voluntary faculty: Ouellette, EA; Bonner, A
Our resident surgeons: Sawardeker, PJ; Kam, CC
Our UM engineers: Milne, EL; Kaimrajh; DN, Latta, LL
Outside researchers: Wu, D; Hui, D; Arias, J; Abraham, W; Pedroso, D
Students: Duerr, RA; Diamond, M

Orthotics: The UCBL/AFO functional brace controlled the valgus motion that occurs in the subtalar joint/hindfoot complex in a simulated stage II posterior tibial tendon dysfunction lesion in cadavers, while allowing physiologic sagittal motion.*

Vascularity of IOL: The axillary artery in 4 cadaver arms were infused with a combination of India ink and latex. The branches of the blood supply to the interosseous ligament complex was mapped out from the anterior interosseous artery.*

Low-volume resuscitation: A closed fracture of the femur was created by 3 point bend in adult rats, followed by controlled blood loss until each animal reached traumatic shock. The control animals were treated by saline volume resuscitation; the experimental group, by Na+/H+ exchange inhibitor. The survival rate for the control group was 0%; the experimental group was 80%.*

*These projects have completed the experimental work and were presented at national and international meetings in 2011. Abstracts of each have been published in 2011 and many are in the process of submission for publication scientific journals.

+These projects are ongoing and have more experimental work to be done in 2013 to complete them.

 

2011 Publications and Presentations

Published:

Latta LL, Milne EL, Kaimrajh DN. “Building a biomechanical model”, J. Orthop. Trauma, 25-8:454-458, 2011

Prasarn M, Baria D, Milne E, Latta L, Sukovich W. "Adjacent Level Biomechanics Following Single versus Multi-level Cervical Spine Fusion. Laboratory investigation", J. of Neurosurg.: Spine.
10.3171/2011.10.SPINE11116.

Presented at podiums or in posters:

Iobst C, Khoury A, Ingwer Z, Milne E, Kaimrajh D, Latta L. “Optimizing the Dynamization of the Taylor Spatial Frame”, Poster #483, Proc. 78th Amer. Acad. Orthop. Surgeons, 12:847, 2011

Sawardeker P, Kam C, Elliott W, Kaimrajh D, Milne E Ouellette EA Latta L. “Pitfalls of Overstuffing in Radial Head Arthroplasty, A Cadaveric Study”, Poster #334, Proc. 78th Amer. Acad. Orthop. Surgeons, 12:710, 2011

Sawardeker PJ, Kam CC, Elliott W, Martins JD, Latta LL, Ouellette EA. “Radiocapitellar pressure differences in bipolar versus monopolar radial heads”, Poster #293, Proc. 78th Amer. Acad. Orthop. Surgeons, 12:697, 2011

Hajianpour MA, Kaimrajh D, Milne EL, Latta LL. “Biomechanical Evaluation of a Non-Bridging Half-pin Fixator in a Distal Metacarpal Intra-articular Fracture Model”, Poster #1515, Trans. 57th Orthop. Research Soc., 36:P1515, 2011

Kam CC, Sawardeker PJ, Milne EL, Kaimrajh DN, Evans P, Ouellette EA, Latta LL. “Interosseous ligament reconstruction in Essex-Lopresti forearm injuries: patellar tendon allograft vs. a novel suture-button construct”, Podium, Proc. FL Orthop. Soc., OREF Research Symposium, 2011

Kam CC, Sawardeker PJ, Milne EL, Kaimrajh DN, Latta LL, Ouellette EA. “Radiographic forearm interosseous width as a reliable predictor of interosseous ligament disruption”, e-Poster, 66th Annual Meeting of the ASSH, 2011

Prasarn M, Zych GA, Baria D, Kaimrajh DN, Milne EL, Latta LL “Stability of Pubic Symphysis Disruption: Locked versus Unlocked versus Hybrid 4-hole Pubic Symphysis Plating”, Poster #1533, Trans. 57th Orthop. Research Soc., 36:P1533, 2011

Elliott W, Kaimrajh D, Sawardeker P, Milne E, Ouellette EA, Latta L. “Importance of Implant Radius of Curvature in Radial Head Arthroplasty”, Poster #568, Trans. 57th Orthop. Research Soc., 36:P568, 2011

Elliott W, Sawardeker P, Kaimrajh D, Kam C, Milne EL, Ouellette EA, Latta LL. “Relation of load distribution between radiocapitellar and ulnotrochlear joints with radial head arthroplasty”, Poster #569, Trans. 57th Orthop. Research Soc., 36:P569, 2011

Elliott W, Sawardeker P, Kam C, Ouellette EA, Latta L. “Shifting of the Forearm Bones with Improper Sizing in Radial Head Arthroplasty”, Poster #570, Trans. 57th Orthop. Research Soc., 36:P570, 2011

Gendler E, Latta L, Milne E, Sugimoto G, Bass D, Malinin T. “ Age Related Mechanical Characteristics of Decalcified Bone Matrix (DBM)”, Poster #589, Trans. 57th Orthop. Research Soc., 36:P589, 2011

Latta LL, Milne EL, Kaimrajh DN, Ouellette EA. “Stabilizing a TFCC injury with a functional fracture brace – a cadaveric study”, Poster #584, Trans. 57th Orthop. Research Soc., 36:P584, 2011

Iobst C, Khoury A, Ingwer Z, Milne E, Kaimrajh D, Latta L. “Optimizing the Dynamization of the Taylor Spatial Frame”, Podium, Proc. N. Amer. Pediatric Orthop. Soc., at Specialty Day, Amer. Acad. Orthop. Surgeons, 2011

Baria D, Lindsey R, Norton R, Kaimrajh DN, Milne EL, Latta LL. “The Effects of Lumbosacral Fusion on Sacroiliac Joint Biomechanics”, Poster #0655, Trans. 57th Orthop. Research Soc., 36:P??, 2011

Gendler E, Latta L, Milne E, Sugimoto G, Malinin T: “Static Testing of Decalcified Bone Matrix Preparations for ACL Reconstruction”, Poster 0584, 57th Orthop. Res. Soc. Long Beach, CA, Jan 2011

 

ASTM / ISO
ASTM International, a leading developer of international standards , is a trusted source for technical standards for materials, products, systems, and services.

MBI has helped contribute to the development of performance standards and testing standards by having participated in several subcommittees and task forces in the ASTM F04, Medical Devices Committee over the past 40 years. MBI is active in ASTM, and conducts studies at the institute to help develop realistic testing methods which can be standardized.

FDA / EMEA
MBI has helped its partners obtain approval from the FDA and EMEA for various medical devices through their testing methods for use in the USA and Europe.

DISSEMINATION
The investigators of MBI for Biomechanics have presented and published hundreds of papers and abstracts over the past 40 years at the Orthop. Research Soc., Amer. Acad. of Orthop. Surg., Orthop. Trauma Assoc., Internat. Soc. for Prosthetics and Orthotics, Amer. Soc. for Surg. of the Hand, Internat. Soc. for Fracture Repair, Assoc. for Rationale Treat. Fractures, Internat. Meeting for Advanced Spinal Tech., Amer. Soc. Orthop. Tech., Alliance for Med. & Biol. Engr., Soc. of Biomech. and ASTM International.

 

PERSONNEL RESOURCES

The Max Biedermann Institute for Biomechanics has 3 full-time staff members with combined experience in laboratory and clinical research of over 85 years. In addition, because of our close relationship to the University of Miami, Miller School of Medicine’s Departments of Orthopaedics and Rehabilitation, Neurosurgery, Oral Surgery, General Surgery - Division of Trauma and Medicine - Arthritis Division; their faculty, residents and fellows in training collaborate with us on research projects and educational programs. Also, because of our close ties to the University of Miami, College of Engineering’s Departments of Biomedical Engineering, Industrial Engineering, Mechanical Engineering and Electrical Engineering; their faculty, graduate and undergraduate students collaborate with us on research projects and educational programs.

  Loren Latta

Loren Latta
Director MBI Miami,
Professor and Director of Research,
Department of Orthopaedics and Rehabilitation, Leonard M. Miller School of Medicine, University of Miami
llatta@msmc.com

  Ted Milne

Ted Milne
Technical Director MBI Miami
at Mount Sinai Medical Center
tmilne@msmc.com

  David

David Kaimrajh
Operations Manager MBI Miami
at Mount Sinai Medical Center
dkaimraj@msmc.com

 
©2017 Max Biedermann Institute for Biomechanics (MBI Miami). All rights reserved.