The specific mechanisms regulating bone mass are not known, but most investigators agree that bone maintenance is largely dependent upon mechanical demand and the resultant local bone strains. During space flight, bone loss such as that reported by LeBlanc et al. may result from failure to effectively load the skeleton and generate sufficient localized bone strains. In microgravity, a gravity replacement system can be used to tether an exercising subject to a treadmill. It follows that the ability to prevent bone loss is critically dependent upon the external ground reaction forces (GRFs) and skeletal loads imparted by the tethering system. To our knowledge, the loads during orbital flight have been measured only once (on STS 81). Based on these data and data from ground based experiments, it appears likely that interventions designed to prevent bone loss in micro-gravity generate GRFs substantially less than body weight. It is unknown to what degree reductions in external GRFs will affect internal bone strain and thus the bone maintenance response. To better predict the efficacy of treadmill exercise in micro-gravity we used a unique cadaver model to measure localized bone strains under conditions representative of those that might be produced by a gravity replacement system in space.
Toe flexion during terminal stance has an active component contributed by the muscles that flex the toes and a passive component contributed by the plantar fascia. This study examined the relative importance of these two mechanisms in maintaining proper force sharing between the toes and forefoot. Thirteen nonpaired cadaver feet were tested in a dynamic gait stimulator, which reproduces the kinematics and kinetics of the foot, ankle, and tibia by applying physiologic muscle forces and proximal tibial kinematics. The distribution of plantar pressure beneath the foot was measured at the terminal stance phase of gait under normal extrinsic muscle activity with an intact plantar fascia, in the absence of extrinsic toe flexor activity (no flexor hallucis longus or flexor digitorum longus) with an intact plantar fascia, and after complete fasciotomy with normal extrinsic toe flexor activity. In the absence of the toe flexor muscles or after plantar fasciotomy the contact area decreased beneath the toes and contact force shifted from the toes to the metatarsal heads. In addition, pressure distribution beneath the metatarsal heads after fasciotomy shifted laterally and posteriorly, indicating that the plantar fascia enables more efficient force transmission through the high gear axis during locomotion. The plantar fascia enables the toes to provide plantar-directed force and bear high loads during push-off.
Objective: To evaluate the biomechanical behavior of gap and step malreductions in a model of transverse acetabular fracture. Design: Cadaver pelvis loading in simulated single-leg stance with intact acetabulum, after transverse acetabular fracture anatomically reduced, and after step and gap malreduction. Five transtectal transverse fractures; five juxtatectal transverse fractures. Setting: Quasi-static loading of the hip with simulated abductor mechanism to physiologic loads with pressure-sensitive film interposed in the joint to determine contact area and contact pressure within the hip joint. Main Outcome Measurement: Hip joint contact parameters: contact area, peak and mean contact pressure, and load distribution. Results: Step malreduction of the transtectal transverse fracture resulted in significantly increased peak contact pressures (20.5 megapascals) in the superior acetabular articular surface as opposed to the intact acetabulum (9.1 megapascals). Gap malreduction of transtectal transverse fracture and step and gap malreduction of juxtatectal fracture did not result in significantly increased contact pressures in the hip. Conclusion: Step malreduction of a transverse acetabular fracture in the superior articular surface results in abnormally high contact forces and may predispose to the development of posttraumatic arthritis.
Background: The plantar aponeurosis is known to be a major contributor to arch support, but its role in transferring Achilles tendon loads to the forefoot remains poorly understood. The goal of this study was to increase our understanding of the function of the plantar aponeurosis during gait. We specifically examined the plantar aponeurosis force pattern and its relationship to Achilles tendon forces during simulations of the stance phase of gait in a cadaver model. Methods: Walking simulations were performed with seven cadaver feet. The movements of the foot and the ground reaction forces during the stance phase were reproduced by prescribing the kinematics of the proximal part of the tibia and applying forces to the tendons of extrinsic foot muscles. A fiberoptic cable was passed through the plantar aponeurosis perpendicular to its loading axis, and raw fiberoptic transducer output, tendon forces applied by the experimental setup, and ground reaction forces were simultaneously recorded during each simulation. A post-experiment calibration related fiberoptic output to plantar aponeurosis force, and linear regression analysis was used to characterize the relationship between Achilles tendon force and plantar aponeurosis tension. Results: Plantar aponeurosis forces gradually increased during stance and peaked in late stance. Maximum tension averaged 96% ± 36% of body weight. There was a good correlation between plantar aponeurosis tension and Achilles tendon force (r = 0.76). Conclusions: The plantar aponeurosis transmits large forces between the hindfoot and forefoot during the stance phase of gait. The varying pattern of plantar aponeurosis force and its relationship to Achilles tendon force demonstrates the importance of analyzing the function of the plantar aponeurosis throughout the stance phase of the gait cycle rather than in a static standing position. Clinical Relevance: The plantar aponeurosis plays an important role in transmitting Achilles tendon forces to the forefoot in the latter part of the stance phase of walking. Surgical procedures that require the release of this structure may disturb this mechanism and thus compromise efficient propulsion.
We performed a biomechanical study of seventeen hip joints in the pelves of nine cadavera in order to assess the role that the acetabular labrum and the transverse acetabular ligament play in load transmission. The distribution of contact area and pressure between the acetabulum and the femoral head was measured with the hip in four different conditions: intact (seventeen hips), after removal of the transverse acetabular ligament (eight hips), after removal of the entire labrum (nine hips), and after removal of both the transverse acetabular ligament and the labrum (seventeen hips). The hip joint was loaded in simulated single-limb stance, and the measurements were made with use of pressure-sensitive film.A peripheral distribution of load was seen in the intact acetabula. This pattern was altered only minimally after removal of the transverse acetabular ligament or the labrum, or both. When both of these structures were removed, the only significant change was a decrease in the maximum pressure in the posterior aspect of the acetabulum (p = 0.02). No significant changes were detected with regard to the contact area, load, mean pressure, or maximum pressure in the anterior or superior aspect of the acetabulum under any testing condition.CLINICAL RELEVANCE: Our findings indicate that removal of the transverse acetabular ligament or the labrum, or both, does not significantly increase pressure or load in the acetabulum and may not predispose the hip to premature osteoarthrosis.
