Author
Markus O. Heller
Other affiliations: Charité, Humboldt University of Berlin, University of Ulm
Bio: Markus O. Heller is an academic researcher from University of Southampton. The author has contributed to research in topics: Contact force & Knee Joint. The author has an hindex of 37, co-authored 128 publications receiving 7498 citations. Previous affiliations of Markus O. Heller include Charité & Humboldt University of Berlin.
Topics: Contact force, Knee Joint, Stair climbing, Femur, Gait analysis
Papers published on a yearly basis
Papers
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TL;DR: The paper focuses on the loading of the femoral implant component but complete data are additionally stored on an associated compact disc that contains complete gait and hip contact force data as well as calculated muscle activities during walking and stair climbing and the frequencies of daily activities observed in hip patients.
2,028 citations
TL;DR: The presented approach is considered as a useful means to determine valid conditions for the analysis of prosthesis loading, bone modeling or remodeling processes around implants and fracture stability following internal fixation.
425 citations
TL;DR: A new method is proposed, the symmetrical CoR estimation or SCoRE, in which the coordinates of the joint centre must only remain constant relative to each segment, thus not requiring the assumption that one segment should remain at rest.
387 citations
TL;DR: The data demonstrate that high contact and shear forces are generated during weight bearing combined with knee flexion angles greater than approximately 15° and Clinically, the conditions that produce these larger contact forces should be avoided during post‐operative rehabilitation.
358 citations
TL;DR: The importance of an ensemble of muscle forces to reproduce a physiological strain distribution in the femur is demonstrated by using a finite element model to calculate stresses and strains of a femur with all thigh muscle and joint contact forces.
331 citations
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TL;DR: In this paper, the basic principles involved in designing hierarchical biological materials, such as cellular and composite architectures, adapative growth and as well as remodeling, are discussed, and examples that are found to utilize these strategies include wood, bone, tendon, and glass sponges.
2,274 citations
TL;DR: The paper focuses on the loading of the femoral implant component but complete data are additionally stored on an associated compact disc that contains complete gait and hip contact force data as well as calculated muscle activities during walking and stair climbing and the frequencies of daily activities observed in hip patients.
2,028 citations
TL;DR: The scientific basis of the fixation and function of these new implants has been reviewed and the application of the internal fixator foregoes the need of adaptation of the shape of the splint to that of the bone during surgery, making it possible to apply theinternal fixator as a minimally invasive percutaneous osteosynthesis (MIPO).
Abstract: The advent of 'biological internal fixation' is an important development in the surgical management of fractures. Locked nailing has demonstrated that flexible fixation without precise reduction results in reliable healing. While external fixators are mainly used today to provide temporary fixation in fractures after severe injury, the internal fixator offers flexible fixation, maintaining the advantages of the external fixator but allowing long-term treatment. The internal fixator resembles a plate but functions differently. It is based on pure splinting rather than compression. The resulting flexible stabilisation induces the formation of callus. With the use of locked threaded bolts, the application of the internal fixator foregoes the need of adaptation of the shape of the splint to that of the bone during surgery. Thus, it is possible to apply the internal fixator as a minimally invasive percutaneous osteosynthesis (MIPO). Minimal surgical trauma and flexible fixation allow prompt healing when the blood supply to bone is maintained or can be restored early. The scientific basis of the fixation and function of these new implants has been reviewed. The biomechanical aspects principally address the degree of instability which may be tolerated by fracture healing under different biological conditions. Fractures may heal spontaneously in spite of gross instability while minimal, even non-visible, instability may be deleterious for rigidly fixed small fracture gaps. The theory of strain offers an explanation for the maximum instability which will be tolerated and the minimal degree required for induction of callus formation. The biological aspects of damage to the blood supply, necrosis and temporary porosity explain the importance of avoiding extensive contact of the implant with bone. The phenomenon of bone loss and stress protection has a biological rather than a mechanical explanation. The same mechanism of necrosis-induced internal remodelling may explain the basic process of direct healing.
1,163 citations
TL;DR: Evidence suggests that insufficient biomechanical conditions within the fracture zone can influence early local inflammation and impair bone healing, with particular emphasis on the role of inflammation.
Abstract: Optimal fracture treatment requires knowledge of the complex physiological process of bone healing. The course of bone healing is mainly influenced by fracture fixation stability (biomechanics) and the blood supply to the healing site (revascularization after trauma). The repair process proceeds via a characteristic sequence of events, described as the inflammatory, repair and remodeling phases. An inflammatory reaction involving immune cells and molecular factors is activated immediately in response to tissue damage and is thought to initiate the repair cascade. Immune cells also have a major role in the repair phase, exhibiting important crosstalk with bone cells. After bony bridging of the fragments, a slow remodeling process eventually leads to the reconstitution of the original bone structure. Systemic inflammation, as observed in patients with rheumatoid arthritis, diabetes mellitus, multiple trauma or sepsis, can increase fracture healing time and the rate of complications, including non-unions. In addition, evidence suggests that insufficient biomechanical conditions within the fracture zone can influence early local inflammation and impair bone healing. In this Review, we discuss the main factors that influence fracture healing, with particular emphasis on the role of inflammation.
853 citations
TL;DR: In this article, the authors compared a dynamic solution with two static solutions to estimate muscle forces during normal gait and found that the dynamic solution provided better estimates of muscle forces than the static solution.
677 citations