Investigating heterotopic bone behaviour through the development of a finite element model
File(s)stump_model_include.f (4.56 KB) stump_model_example_code.f (45.22 KB)
Supporting information
Supporting information
Author(s)
Rosenberg, Naomi
Type
Thesis
Abstract
Heterotopic ossification (HO) is the formation of mature lamellar bone in tissues that are not usually
osseous. It is a significant risk in blast-related injuries and is seen in approximately 60% of UK military
blast-related amputees. HO can result in reduced range of motion, pain, nerve impingement and can
affect prosthesis fitting. The causes of HO are due to a mix of mechanical and biological, local and
systemic factors. However, as with normal bone formation and remodelling, it may be expected that
heterotopic bone also responds to mechanical stimuli to an extent. Understanding this relationship
further can give insight into possible ways to manipulate the progression of HO and prevent
complications in the future. The objective of this research is to create a mechanically driven
physiological computational model of HO in the residual limb of a trans-femoral amputee. The
current work involved expanding upon previously proposed finite element bone remodelling
algorithms in the literature for the application of heterotopic remodelling in soft tissue. This study
introduced an extra factor to represent the tendency for soft tissue to calcify. This factor increases in
magnitude with proximity to a specified wound site and with tissue strain. Initially, soft tissue is
modelled as hypoelastic with a much lower stiffness to bone. If the density in a soft tissue element
exceeds a certain threshold, the material properties of the element are redefined to become
proportional to the density alike bone. These newly recruited bone elements make up the projected
heterotopic bone geometry. The different parameters within the algorithm were adjusted to
examine their effect on the final outcome of heterotopic bone geometry. With consideration to their
effects, loading was found to significantly alter the geometry of HO. Certain characteristic
appearances of HO outlined in the literature were reproduced by adjusting the loading environment.
osseous. It is a significant risk in blast-related injuries and is seen in approximately 60% of UK military
blast-related amputees. HO can result in reduced range of motion, pain, nerve impingement and can
affect prosthesis fitting. The causes of HO are due to a mix of mechanical and biological, local and
systemic factors. However, as with normal bone formation and remodelling, it may be expected that
heterotopic bone also responds to mechanical stimuli to an extent. Understanding this relationship
further can give insight into possible ways to manipulate the progression of HO and prevent
complications in the future. The objective of this research is to create a mechanically driven
physiological computational model of HO in the residual limb of a trans-femoral amputee. The
current work involved expanding upon previously proposed finite element bone remodelling
algorithms in the literature for the application of heterotopic remodelling in soft tissue. This study
introduced an extra factor to represent the tendency for soft tissue to calcify. This factor increases in
magnitude with proximity to a specified wound site and with tissue strain. Initially, soft tissue is
modelled as hypoelastic with a much lower stiffness to bone. If the density in a soft tissue element
exceeds a certain threshold, the material properties of the element are redefined to become
proportional to the density alike bone. These newly recruited bone elements make up the projected
heterotopic bone geometry. The different parameters within the algorithm were adjusted to
examine their effect on the final outcome of heterotopic bone geometry. With consideration to their
effects, loading was found to significantly alter the geometry of HO. Certain characteristic
appearances of HO outlined in the literature were reproduced by adjusting the loading environment.
Version
Open Access
Date Issued
2017-02
Date Awarded
2017-05
Copyright Statement
Attribution NoDerivatives 4.0 International Licence (CC BY-ND)
Advisor
Bull, Anthony
Sponsor
Engineering and Physical Sciences Research Council
Grant Number
EP/L504786/1
Publisher Department
Bioengineering
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)