Massimiliano Baleani

Massimiliano Baleani
Istituto Ortopedico Rizzoli | IOR · Medical Technology Laboratory

M.Sc. (Eng)

About

104
Publications
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2,766
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Publications

Publications (104)
Poster
Full-text available
Digital Image Correlation (DIC) is a practice and effective technique to measure surface strain field of loaded specimens. This non-contact method makes it suitable for measuring strain field in brittle materials like calcium phosphate cement (CPC) formulations [1]. Although DIC has been demonstrated to be accurate in measuring medium-large strain...
Article
Nonunion treatment has a high rate of success, although recalcitrant nonunion may determine the need for amputation. Therefore, new treatment options are continuously investigated in order to further reduce the risk of nonunion recurrence. This study aimed to (i) develop a new large animal model for bone atrophic nonunion and (ii) compare the effic...
Article
Full-text available
Measuring small-magnitude strain fields using a digital image correlation (DIC) technique is challenging, due to the noise-signal ratio in strain maps. Here, we determined the level of accuracy achievable in measuring small-magnitude (<0.1%) homogeneous strain fields. We investigated different sets of parameters for image processing and imaging pre...
Article
Background: To ensure stability of proximal femoral fractures, the hip screw must firmly engage into the femoral head. Some studies suggested that screw holding power into trabecular bone could be evaluated, intraoperatively, through measurement of screw insertion torque. However, those studies used synthetic bone, instead of trabecular bone, as h...
Article
Co alloy modular necks have been introduced in orthopaedics to address mechanical failure of the neck-stem junction (NSJ) observed in Ti alloy dual-modular hip stem. However, following the introduction of Co alloy neck, unexpected adverse soft tissue reactions have been reported. This study investigated the effect of material combination on frettin...
Article
Full-text available
Recently, concerns have been raised about the potential effect of head-neck junction damage products at the local and systemic levels. Factors that may affect this damage process have not been fully established yet. This study investigated the possible correlations among head-neck junction damage level, implant design, material combination, and pat...
Article
Full-text available
Calcium phosphate cements (CPCs) should ideally have mechanical properties similar to those of the bone tissue the material is used to replace or repair. Usually, the compressive strength of the CPCs is reported and, more rarely, the elastic modulus. Conversely, scarce or no data are available on Poisson's ratio and strain-to-crack-initiation. This...
Article
Background: The repair of the myotendinous junction following total hip arthroplasty is challenging as this region is the weakest part of the muscle structure. This study investigated the mechanical behaviour and the mode of failure of different suturing techniques of the myotendinous junction. A new asymmetrical stitch was compared to two widely...
Article
The interference screw technique is commonly used in tenodesis of the long head of the biceps for its well-documented robust fixation strength. Some complications may occur after tenodesis with interference screw such as persistent pain, bone fracture and cyst formation. A new technique using a small "soft anchor" has been proposed to avoid the ris...
Article
Creating a speckle pattern on biological soft tissue, which would be suitable for digital image correlation measurements, is challenging. Speckle patterns should neither cause or require sample dehydration, nor alter the mechanical response, but they should adhere to the tissue surface and withstand large deformations. A two-step procedure has been...
Article
This study addressed side asymmetry between human lower limb long bones. A multiscale approach was taken to investigate differences between contralateral femurs, tibias and fibulas, at body-level (total-body CT-scans, anatomical dissection), organ-level (volume and moments of areas; structural stiffness and strain distribution in bending and torsio...
Article
It has been hypothesised that among different human subjects, the bone tissue quality varies as a function of the bone segment morphology. The aim of this study was to assess and compare the quality, evaluated in terms of hardness of packages of lamellae, of cortical and trabecular bones, at different anatomical sites within the human skeleton. The...
Article
Large diameter heads (LDH) are connected to the stem by means of a Morse taper. An adapter sleeve may be also used to adjust the head offset intraoperatively and/or to change the bearing couple and size. This paper explains the effect of head diameter and friction coefficient on the frictional torque acting on the tapers. A greater frictional torqu...
Article
Understanding the performance of dual-taper modular femoral stems necessitates detailed quantitative assessment. This study reports a repeatable procedure to identify and measure damage on modular taper surfaces and determines whether damage area is a useful parameter for discerning modular femoral stem performance during in vitro corrosion and end...
Article
In this study, cortical bone tissue from children was investigated. It is extremely difficult to obtain human child tissue. Therefore, the only possibility was to use bone tissue, free from any lesion, collected from young bone cancer patients. The compressive mechanical behaviour of child bone tissue was compared to the behaviour of adult tissue....
Article
This study investigated whether changes in hardness of human trabecular bone are associated with osteoarthritis. Twenty femoral heads extracted from subjects without musculoskeletal diseases (subject age: 49-83 years) and twenty femoral heads extracted from osteoarthritic subjects (subject age: 42-85 years) were tested. Sixty indentations were perf...
Article
The availability of a validated subject-specific model of the knee joint would be extremely useful for the orthopaedic surgeon in evaluating the biomechanics of the joint of a patient, especially when suspecting an injury of one or more components. The aim of this paper was to describe a procedure designed and developed to validate a subject-speci...
Article
Uniformity of tissue mineralisation is a strongly debated issue, due to its relation with bone mechanical behaviour. Bone mineral density (BMD) is measured in the clinical practice and is applied in computational application to derive material properties of bone tissue. However, BMD cannot identify if the variation in bone density is related to a m...
Article
Barium sulphate (BaSO4) is commonly used in bone cement as a radiopacifier. The addition of the BaSO4 to the polymeric matrix may cause a decrease in the mechanical properties of the cement. In this work, the effect of adding 10%w/w BaSO4 to a plain polymethylmethacrylate based bone cement was evaluated in terms of endurance limit, fatigue crack pr...
Article
Osteoarthritic cancellous bone was studied to investigate the development of this pathology, and the functional changes it induces in the bone. In order to predict how the morphological alterations of the tissue induced by the pathology can change the mechanical properties of the structure, two different strategies have been used in the literature:...
Article
Full-text available
We investigated the effect of pre-heating a femoral component on the porosity and strength of bone cement, with or without vacuum mixing used for total hip replacement. Cement mantles were moulded in a manner simulating clinical practice for cemented hip replacement. During polymerisation, the temperature was monitored. Specimens of cement extracte...
Article
The hardness of cortical human bone has been measured on osteons in different conditions. However, no data are reported in the literature regarding the effect of cortical tissue condition and indentation location on the measured hardness values. This study aimed to investigate whether the hardness of the human cortical bone evaluated by micro-inden...
Article
Pattern of osteonal classification referred to collagen fiber orientation in a human fibula was studied. Along the length of the whole bone, serial 100-microm parallel cross sections were obtained and analyzed by circularly polarized light microscopy. The distribution of 3 different kinds of osteons (transversal, alternated and longitudinal-hooped)...
Article
Tensile fatigue behaviour of bone cement specimens obtained from cement mantles moulded in vitro, simulating the surgical scenario, was investigated. The effect of stem preheating, before its insertion into the cement dough, on specimen fatigue life was studied. A commercial bone cement was selected for this study. Bone cement mixing was conducted...
Article
The pre-clinical validation of new joint prostheses is an important step in the development process of a new implant design. The high success rate of modern prostheses makes it very difficult to ensure that new designs will exhibit significant improvements combined with a risk of failure as low as that of the designs currently in use. This situatio...
Article
Full-text available
The aim of this study was to investigate intra- and interspecimen repeatability of an experimental procedure, which determines elastic and viscoelastic properties of knee ligaments. The collateral ligaments from sheep were used and the repeatability was evaluated in terms of the coefficient of variation. The results indicated a good intraspecimen r...
Article
It is important to understand the development of osteoarthritis to improve the medical approach to this disease. However, it is still not clear how this disease affects the mechanical behavior and structure of cancellous bone. The aim of this study was to compare osteoarthritic cancellous bone to non-pathologic bone in terms of mechanical behavior...
Article
Human cancellous bone is a heterogeneous material. Despite this, most of the published studies report correlations between mechanical properties and morphometric parameters averaged on the whole specimen. This work investigated whether local variations in morphometric parameters were linked to the localized failure regions of cancellous bone. Addit...
Article
The use of formalin fixed bone tissue is often avoided because of its assumed influence on the mechanical properties of bone. Fixed bone tissue would minimise biological risks and eliminate preservation issues for long duration experimental tests. This study aimed to determine the short- and long-term effects of embalming, using a solution with 4%...
Article
Background: The development of a multiscale model of the human musculoskeletal system able to accurately predict the risk of bone fracture is still a grand challenge. The aim of this paper is to present the Living Human Project, to describe the final system and to review the achievements obtained so far. The Living Human musculoskeletal supermodel...
Article
An experimental-numerical study was performed to investigate the relationships between computed tomography (CT)-density and ash density, and between ash density and apparent density for bone tissue, to evaluate their influence on the accuracy of subject-specific FE models of human bones. Sixty cylindrical bone specimens were examined. CT-densities...
Article
The mechanical strength of human bones has often been investigated in the past. Bone failure is related to musculoskeletal loading, tissue properties, bone metabolism, etc. This is intrinsically a multiscale problem. However, organ-level performance in most cases is investigated as a separate problem, incorporating only part (if any) of the informa...
Article
Antibiotic-loaded bone cement is extensively used in joint arthroplasty, but increasing bacteria resistance against common antibiotics has lead to a demand for alternative drugs. However, bone cement containing new additives must be characterized both biologically and mechanically. This study evaluated elution kinetics, antibacterial activity, and...
Article
Full-text available
This study investigated experimentally the fracture properties, i.e., the fatigue strength, the resistance to crack propagation and the fracture toughness, of an acrylic bone cement (Cemex RX). The mean endurance limit was determined following the staircase method. The endurance limit was estimated at 9.2 MPa. The fatigue crack propagation rate was...
Article
For normal bone, aging has been associated with a decrease of both density and failure strength, and with the development of pathologies such as osteoporosis. Conversely, it has been reported that another common disease, osteoarthritis, may alter these age-related changes in cancellous bone, suggesting that it may have a protective role against ost...
Article
Morphology of the crack surface of surgical bone cements has seldom been studied in the past despite the clinical relevance of cement failure. Previous studies on a specific cement type suggest that crack morphology depends on crack propagation rate. The objectives of this work were: (i) to develop a quantitative indicator for describing crack morp...
Article
This work investigates the effect of adding gentamicin, an antibiotic, on the fracture properties of bone cement. Endurance limit, fatigue crack propagation and fracture toughness were determined for a polymethylmethacrylate-based cement, containing 10% w/w of barium sulphate as radiopacifying agent, and the same formulation modified by the additio...
Article
Hardness of trabecular human bone, evaluated by microindentation testing, has generally been measured on embedded tissues. It was known that this was not ideal but it had been preferred to other conditions (e.g. wet or dehydrated) as the trabeculae could withstand the applied load and the measurements were reliable. The aim of this study was to inv...
Article
The aim of this study was to verify whether a misalignment between the testing direction and the trabecular main direction has a significant effect on the compressive behaviour of cancellous bone. Ten cylindrical specimens were extracted from femoral heads with a misalignment to the trabecular main direction of approximately 20 degrees. Each specim...
Article
Acrylic bone cements have been widely used in orthopaedic surgery for the fixation of artificial joints. In total hip prosthesis, the fracture of PMMA, through crack initiation, propagation and fracture whether at an interface or within the bulk material is of serious concern since it leads to the implant failure. In the present study, cyclic fatig...
Article
The management of infected total hip arthroplasties is a complex issue. Depending on patient characteristics, infecting organisms and personal opinion of the surgeon, treatment options include antibiotic therapy, debridement of surrounding tissues, complete removal of the implant, irrigation and re-implantation of a new prosthesis [4, 5, 8-10, 16,...
Article
Radiopacifying agents are commonly added to bone cements to enhance the visibility of the cement in radiography. The radiopacifiers usually employed may, however, have undesired effects on the mechanical properties of the cement. A potentially new radiopacifier is tantalum, which in the present work was evaluated in terms of radiopacity. Bone cemen...
Article
One cause of early failure of rotator cuff repairs is the pull out of the suture through the tendon. The aims of this study were to investigate the initial strength and failure mode of different tendon grasping techniques and to evaluate an alternative stitch proposed for arthroscopic repair of rotator cuff tendons. Four different stitches were inv...
Article
Full-text available
The increasing resistance of certain bacteria to antibiotics commonly used in bone cements has led to a demand for alternative antibacterial agents. The antibiotics added to bone cements may, however, have detrimental effects on the mechanical properties of the cement. We evaluated the mechanical effects of adding vancomycin and meropenem to bone c...
Article
A miniaturized multiaxial load cell was developed and calibrated to measure the main load components acting across the operated median sternum. The sheep was selected as the animal model for this project. The geometry of the core of the transducer was chosen to fulfill the requirements for a multiaxial load cell with miniaturized dimensions and wit...
Article
Sixteen proximally cemented, collared, and distally splined, Bridge Hip femoral stems with a matte proximal surface and smooth distal surface were retrieved because of loosening. Electron microscopy, with correlated elemental analysis, identified titanium particulate embedded in the internal surface of the cement mantle. Data supported the observat...
Article
Full-text available
This work describes the preliminary results of an ongoing study, that aims to obtain relationships between the experimentally determined mechanical properties of trabecular bone of the human femoral head and the morphometric parameters evaluated by microCT. Thirteen cylindrical samples of human trabecular bone were extracted from the femoral head...
Article
Arthroscopic repair of wide rotator cuff ruptures is burdened by a percentage of recurrences that is greater than the repair carried out when an open technique is used. One of the main reasons for this difference can be searched for in the minor hold of stitching on the tendinous aspect obtained with arthroscopic repair. In fact, when an open techn...
Article
Nowadays, two procedures, based on the recommendation of two American standards (ASTM E399 and ASTM D5045), are used to determine the fracture toughness, K IC , of bone cement. However, there is a lack of knowledge about the equivalence of the two testing methods applied to bone cement. Additionally, in spite of the recommendation of several author...
Article
This study investigated the initial strength and failure mode of different rotator cuff repair techniques. Full or partial re-rupture of the repair is one of the main post-operative complications for rotator cuff repair. The rate of failure is strongly affected by the extension of the tear, increasing in case of large or massive tears up to 62%. Th...
Article
This study investigated the mechanical behaviour under dynamic load of a preformed hip spacer made of antibiotic impregnated bone cement (Spacer G 60, Tecres SpA, Sommacampagna VR, Italy) used in two-stage treatment of infected hip prostheses. In the experimental protocol the spacer was assumed as a temporary hip hemiarthroplasty so was liable to t...