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Finite Element Modeling of Cellular Mechanics Experiments

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Abstract

The mechanical and biological response of cells to various loading regimes is a subject of great interest in the research field of biomechanics. Extensive utilization of different cellular mechanics experimental designs has been made over the years in order to provide better insight regarding the mechanical behavior of cells, and the mechanisms underlying the transduction of the applied loads into biological reactions. These experimental protocols have limited ability in directly measuring different mechanical parameters (e.g. internal cellular strains and stresses). In addition, they are very costly and involve highly complex apparatuses and experimental designs. Thus, further understating of cellular response can be achieved by means of computational models, such as the finite element (FE) method. FE modeling of cells is an emerging direction in the research field of cellular mechanics. Its application has been rapidly growing over the last decade due to its ability to quantify deformations, strains and stresses in and around cells, thus providing basic understating of the mechanical state of cells and allowing identification of mechanical properties of cells and cellular organelles when coupled with appropriate experiments. In this chapter, we review the two-dimensional (2D) and three-dimensional (3D) reported cell models of various cell types, subjected to different applied mechanical stimuli, e.g. compression, micropipette aspiration, indentation.

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... This well-established numerical analysis method is used in mechanics to model the deformation of complex structures for which an analytical solution is difficult to obtain. Moreover, FEM is well suited to modeling the effects of deformation due to local constraints [30,31]. Among the commonly used software solutions in the industry, Abaqus is an effective option providing many predefined elements for studying complex physical phenomena. ...
... This software provides powerful flexibility and modularity to approximate complete partition by polynomial functions on each element. Consequently, FEM, which provides a discrete solution to a continuous problem, has frequently been used for solid tissue modeling [31,32]. ...
... Moreover, to incorporate topological information, we calculated a spreading distance corresponding to the mean distance between a cell centroid and the centroids of the first order neighboring cells. Because having three or four direct neighbors is a very rare event [31], we decided to measure the mean distance to the five nearest neighbors. ...
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... Responses of cells to external loading are composed of a complex combination of processes, which are difficult to separate experimentally. This has motivated researchers to combine cellular mechanics experiments with computational methods to segment the mechanostructural responses of loaded cells, accounting for the mechanical properties of cells, cellular structures and mechanical interactions between cells and their environment (Slomka and Gefen 2011b). Recent experimental works have shown the effects of increased hydrostatic pressure (uniform compression of cell surface), inducing changes in cell morphology and disruption of the cytoskeleton of adhered cells (Brooker et al. 2018) and reduction in viability of adherent and non-adherent cells (Yabuki et al. 2013). ...
... the medium were quantified through the global cell deformations, GCD (Slomka and Gefen 2011b): ...
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... The mechanical parameters during microinjection (e.g. internal cellular strains and stresses) can be calculated from the model, which is difficult to measure directly by experiments 36,37 . These parameters can be used to explore deformations of the target cell, which can be used to describe cell damage. ...
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... 47 Models incorporating subcellular components, such as the nucleus and cytoskeletal fibers, may provide further insights into intracellular mechanotransduction mechanisms. 48 For such models, the assumption of continuous attachment between chondrocytes and their environment could also be updated to discrete focal cellmatrix attachment sites. 49 Direct validation of chondrocyte strains in the cartilage ECM have yet to be performed and may become more feasible in the near future with new developments in the field. ...
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... More advanced structural phenomena in mechanically loaded cells can be evaluated, with the same principles, using finite element (FE) modeling; a review of the body of work on computational cell modeling is available in [60] . In the context of the above discussion, however, Slomka and Gefen developed an approach to obtain three-dimensional (3D) cell-specific FE models to simulate experiments involving large cell deformations, based on analysis of confocal (z-stack) images of multiple undifferentiated skeletal muscle cells (C2C12 myoblasts) [61,62] . ...
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... The simple structural 3D cell simulations typically employ idealized-shaped geometrical models, usually halfspheres or half-ellipsoids to represent adhered cells in monolayers, or full spheres or ellipsoids to represent cells in a 3D matrix. Otherwise, more advanced geometrical models are reconstructed from confocal or multimodal fluorescence image sets, which provide realistic cell-specific geometries, including the nucleus, vesicles and sub-cellular components (Slomka and Gefen 2011b). ...
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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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The threedimensional finite element (FE) model of eucaryotic cell presented in the paper is based on similar models published recently; it comprehends elements representing cell membrane, cytoplasm and nucleus, and a complex tensegrity structure representing cytoskeleton. In contrast to the previous models, this tensegrity structure consists of several parts. External and internal parts count 30 struts and 60 cables each and their corresponding nodes are interconnected by 30 radial members; these parts represent cortical, nuclear and deep cytoskeletons, respectively. This arrangement enables us to simulate the load transmission from the extracellular space via membrane receptors (focal adhesions) to the central part of the cell (nucleus, centrosome); this ability of the model was tested by simulation of some mechanical tests of isolated cells, in particular tension test with micropipettes, indentation test and magnetic tweezer test. Although material properties of components have been defined as realistic as possible on the base of the mechanical tests with vascular smooth muscle cells, they were not identified in fact and are not unique probably. However, simulations of the tests have shown the ability of the model to simulate the global load-deformation response of the cell under various types of loadings, as well as several substantial global features of the cell behaviour, e.g. “at a distance effect”, non-linear stiffening with increasing load, or linear dependence of stiffness on increasing prestrain.
Article
Deep tissue injury (DTI) is a serious pressure ulcer, involving a mass of necrotic soft tissue under bony prominences as a consequence of sustained tissue deformations. Though several processes are thought to participate in the onset and development of DTI (e.g., cellular deformation, ischemia, and ischemia-reperfusion), the specific mechanisms responsible for it are currently unknown. Recent work indicated that pathological processes at the cell level, which relate to cell deformation, are involved in the etiology. We hypothesized that sustained tissue deformations can lead to elevated intracellular concentration of cell metabolites, e.g., calcium ion (Ca2+), due to a stretch-induced increase in the local permeability of plasma membranes. This may ultimately lead to cell death due to intracellular cytotoxic concentrations of metabolites. In order to investigate this hypothesis, computational models were developed, for determining compression-induced membrane stretches and trends of times for reaching intracellular cytotoxic Ca2+ levels due to uncontrolled Ca2+ influx through stretched membranes. The simulations indicated that elevated compressive cell deformations exceeding 25% induce large tensional strains (>5%, and up to 11.5%) in membranes. These are likely to increase Ca2+ influx from the extracellular space into the cytosol through the stretched sites. Consistent with this assumption, the Ca2+ transport model showed high sensitivity of times for cell death to changes in membrane resistance. These results may open a new path in pressure ulcer research, by indicating how global tissue deformations are transformed to plasma membrane deformations, which in turn, affect transport properties and eventually, cell viability.
Article
This study introduces a new confocal microscopy-based three-dimensional cell-specific finite element (FE) modeling methodology for simulating cellular mechanics experiments involving large cell deformations. Three-dimensional FE models of undifferentiated skeletal muscle cells were developed by scanning C2C12 myoblasts using a confocal microscope, and then building FE model geometries from the z-stack images. Strain magnitudes and distributions in two cells were studied when the cells were subjected to compression and stretching, which are used in pressure ulcer and deep tissue injury research to induce large cell deformations. Localized plasma membrane and nuclear surface area (NSA) stretches were observed for both the cell compression and stretching simulation configurations. It was found that in order to induce large tensile strains (>5%) in the plasma membrane and NSA, one needs to apply more than approximately 15% of global cell deformation in cell compression tests, or more than approximately 3% of tensile strains in the elastic plate substrate in cell stretching experiments. Utilization of our modeling can substantially enrich experimental cellular mechanics studies in classic cell loading designs that typically involve large cell deformations, such as static and cyclic stretching, cell compression, micropipette aspiration, shear flow and hydrostatic pressure, by providing magnitudes and distributions of the localized cellular strains specific to each setup and cell type, which could then be associated with the applied stimuli.
Article
The viscoelastic properties of cells are important in predicting cell deformation under mechanical loading and may reflect cell phenotype or pathological transition. Previous studies have demonstrated that viscoelastic parameters estimated by finite element (FE) analyses of micropipette aspiration (MA) data differ from those estimated by the analytical half-space model. However, it is unclear whether these differences are statistically significant, as previous studies have been based on average cell properties or parametric analyses that do not reflect the inherent experimental and biological variability of real experimental data. To determine whether cell material parameters estimated by the half-space model are significantly different from those predicted by the FE method, we implemented an inverse FE method to estimate the viscoelastic parameters of a population of primary porcine aortic valve interstitial cells tested by MA. We found that inherent differences between the analytical and inverse FE estimation methods resulted in statistically significant differences in individual cell properties. However, in cases with small pipette to cell radius ratios and short loading periods, model-dependent differences were masked by experimental and cell-to-cell variability. Analytical models that account for finite cell-size and loading rate further relaxed the experimental conditions for which accurate cell material parameter estimates could be obtained. These data provide practical guidelines for analysis of MA data that account for the wide range of conditions encountered in typical experiments.
Article
A substantial body of work has been reported in which the mechanical properties of adherent cells were characterized using compression testing in tandem with computational modeling. However, a number of important issues remain to be addressed. In the current study, using computational analyses, the effect of cell compressibility on the force required to deform spread cells is investigated and the possibility that stiffening of the cell cytoplasm occurs during spreading is examined based on published experimental compression test data. The effect of viscoelasticity on cell compression is considered and difficulties in performing a complete characterization of the viscoelastic properties of a cell nucleus and cytoplasm by this method are highlighted. Finally, a non-linear force-deformation response is simulated using differing linear viscoelastic properties for the cell nucleus and the cell cytoplasm.
Article
The way in which the nucleus experiences mechanical forces has important implications for understanding mechanotransduction. Knowledge of nuclear material properties and, specifically, their relationship to the properties of the bulk cell can help determine if the nucleus directly experiences mechanical loads, or if it is a signal transduction mechanism secondary to cell membrane deformation that leads to altered gene expression. Prior work measuring nuclear material properties using micropipette aspiration suggests that the nucleus is substantially stiffer than the bulk cell [Guilak, F., Tedrow, J.R., Burgkart, R., 2000. Viscoelastic properties of the cell nucleus. Biochem. Biophys. Res. Commun. 269, 781-786], whereas recent work with unconfined compression of single chondrocytes showed a nearly one-to-one correlation between cellular and nuclear strains [Leipzig, N.D., Athanasiou, K.A., 2008. Static compression of single chondrocytes catabolically modifies single-cell gene expression. Biophys. J. 94, 2412-2422]. In this study, a linearly elastic finite element model of the cell with a nuclear inclusion was used to simulate the unconfined compression data. Cytoplasmic and nuclear stiffnesses were varied from 1 to 7 kPa for several combinations of cytoplasmic and nuclear Poisson's ratios. It was found that the experimental data were best fit when the ratio of cytoplasmic to nuclear stiffness was 1.4, and both cytoplasm and nucleus were modeled as incompressible. The cytoplasmic to nuclear stiffness ratio is significantly lower than prior reports for isolated nuclei. These results suggest that the nucleus may behave mechanically different in situ than when isolated.
Article
We apply the wetting theory to predict the kinetics of fibroblast spreading onto an adhesive substrate, under simplifying assumptions on the cell structure and geometry. Three main parameters are used: cytoplasmic viscosity, cortical tension, and cell-to-substrate adhesion energy. The viscosity and tension values are taken from previous micromechanical studies. The adhesion energy, ill known, is adjusted by fitting the model predictions to available experimental data of contact radius versus time. The agreement is quite good, justifying such a "macroscopic" view of cell morphology.
Article
Cell adhesion to material surfaces is a fundamental phenomenon in tissue response to implanted devices, and an important consideration in tissue engineering. For example, elucidation of phenomena associated with adhesion of chondrocytes to biomaterials is critical in addressing the difficult problem of articular cartilage regeneration. The first objective of this study was to measure the mechanical adhesiveness characteristics of individual rabbit articular chondrocytes as a function of seeding time to provide further understanding of the cell adhesion process. The second objective was to quantify the force required to separate the plasma membrane from the underlying cytoskeleton as a function of seeding time. After culturing chondrocytes on glass coverslips for 1, 2, 4, 6 h, two biomechanical tests were performed on single chondrocytes: (i) mechanical adhesiveness measurement by the cytodetacher; and (ii) plasma membrane tether formation force measurement by optical tweezers. Cell mechanical adhesiveness increased from 231 ± 149 Pa at 1 h to 1085 ± 211 Pa at 6 h. The cell contact area with the substrata increased from 161 ± 52 μm ² at 1 h to 369 ± 105 μm ² at 6 h. The tether formation force increased from 232 ± 23 pN at 1 h to 591 ± 17 pN at 6 h. Moreover, fluorescence staining by rhodamine‐phalloidin demonstrated the process of actin spreading within the cytoskeleton from 0.5 to 6 h and allowed for measurement of cell height which was found to decrease from 12.3 ± 2.9 μm at 0.5 h to 6.2 ± 0.9 μm at 6 h. © 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.
Article
Although osteoporosis is characterized by quantitative (mass) and qualitative (structural) changes, standard clinical techniques (dual-energy X-ray absorptiometry, DXA) only measure the former. Three-dimensional micro-finite-element (micro-FE) models based on high-resolution images can account for structural aspects as well, and it has recently been shown that an improved prediction of distal radius strength is possible with micro-FE analysis. A clinical application of this technique, however, is limited by its high imaging and computational demands. The objective of this study is to investigate if an improved prediction of bone strength can be obtained as well when only a small part of the radius is used for micro-FE modeling. Images of a 1-cm region of the metaphysis of the distal radius of 54 cadaver arms (mean age: 82 +/- 9 SD) made with a three-dimensional peripheral quantitative computed tomography (pQCT) device at 165- micro m resolution formed the basis for micro-FE models that were used to predict the bone failure load. Following imaging, specimens were experimentally compressed to failure to produce a Colles'-type fracture. Failure loads predicted from micro-FE analyses agreed well with those measured experimentally (R2 = 0.66, p < 0.001). Lower correlations were observed with bone mass (R2 = 0.48, p < 0.001) and microstructural parameters (R2 = 0.47, p < 0.001). Hence, even when only a small region is modeled, micro-FE analysis provides an improved prediction of radius strength.
Article
We investigated the mechanotransduction pathway in endothelial cells between their nucleus and adhesions to the extracellular matrix. First, we measured nuclear deformations in response to alterations of cell shape as cells detach from a flat surface. We found that the nuclear deformation appeared to be in direct and immediate response to alterations of the cell adhesion area. The nucleus was then treated as a neo-Hookean compressible material, and we estimated the stress associated with the cytoskeleton and acting on the nucleus during cell rounding. With the obtained stress field, we estimated the magnitude of the forces deforming the nucleus. Considering the initial and final components of this adhesion-cytoskeleton-nucleus force transmission pathway, we found our estimate for the internal forces acting on the nucleus to be on the same order of magnitude as previously measured traction forces, suggesting a direct mechanical link between adhesions and the nucleus.
Article
Eukaryotic cells are continuously subjected to mechanical forces under normal physiological conditions. These forces and associated cellular deformations induce a variety of biological processes. The degree of deformation depends on the mechanical properties of the cell. As most cells are anchorage dependent for normal functioning, it is important to study the mechanical properties of cells in their attached configuration. The goal of the present study was to obtain the mechanical and failure properties of attached cells. Individual, attached C2C12 mouse myoblasts were subjected to unconfined compression experiments using a recently developed loading device. The device allows global compression of the cell until cell rupture and simultaneously measures the associated forces. Cell bursting was characterized by a typical reduction in the force, referred to as the bursting force. Mean bursting forces were calculated as 8.7+/-2.5 microN at an axial strain of 72+/-4%. Visualization of the cell using confocal microscopy revealed that cell bursting was preceded by the formation of bulges at the cell membrane, which eventually led to rupturing of the cell membrane. Finite element calculations were performed to simulate the obtained force-deformation curves. A finite element mesh was built for each cell to account for its specific geometrical features. Using an axisymmetric approximation of the cell geometry, and a Neo-Hookean constitutive model, excellent agreement between predicted and measured force-deformation curves was obtained, yielding an average Young's modulus of 1.14+/-0.32 kPa.
Article
Endothelial cells possess a mechanical network connecting adhesions on the basal surface, the cytoskeleton, and the nucleus. Transmission of force at adhesions via this pathway can deform the nucleus, ultimately resulting in an alteration of gene expression and other cellular changes (mechanotransduction). Previously, we measured cell adhesion area and apparent nuclear stretch during endothelial cell rounding. Here, we reconstruct the stress map of the nucleus from the observed strains using finite-element modeling. To simulate the disruption of adhesions, we prescribe displacement boundary conditions at the basal surface of the axisymmetric model cell. We consider different scenarios of the cytoskeletal arrangement, and represent the cytoskeleton as either discrete fibers or as an effective homogeneous layer When the nucleus is in the initial (spread) state, cytoskeletal tension holds the nucleus in an elongated, ellipsoidal configuration. Loss of cytoskeletal tension during cell rounding is represented by reactive forces acting on the nucleus in the model. In our simulations of cell rounding, we found that, for both representations of the cytoskeleton, the loss of cytoskeletal tension contributed more to the observed nuclear deformation than passive properties. Since the simulations make no assumption about the heterogeneity of the nucleus, the stress components both within and on the surface of the nucleus were calculated. The nuclear stress map showed that the nucleus experiences stress on the order of magnitude that can be significant for the function of DNA molecules and chromatin fibers. This study of endothelial cell mechanobiology suggests the possibility that mechanotransduction could result, in part, from nuclear deformation, and may be relevant to angiogenesis, wound healing, and endothelial barrier dysfunction.
Article
Optical-sectioning, digital fluorescence microscopy provides images representing temporally- and spatially-resolved molecular-scale details of the substructures of living cells. To render such images into solid models for further computational analyses, we have developed an integrated system of image acquisition, processing, and rendering, which includes a new empirical technique to correct for axial distortions inherent in fluorescence microscopy due to refractive index mismatches between microscope objective immersion medium, coverslip glass, and water. This system takes advantage of the capabilities of ultra-high numerical aperture objectives (e.g. total internal reflection fluorescence microscopy) and enables faithful three-dimensional rendering of living cells into solid models amenable to further computational analysis. An example of solid modeling of bovine aortic endothelial cells and their nuclei is presented. Since many cellular level events are temporally and spatially confined, such integrated image acquisition, processing, rendering, and computational analysis, will enable, in silico, the generation of new computational models for cell mechanics and signaling.
Article
A common but potentially severe malady afflicting permanent wheelchair users is pressure sores caused by elevated soft tissue strains and stresses over a critical prolonged period of time. Presently, there is paucity of information regarding deep soft tissue strains and stresses in the buttocks of humans during sitting. Strain and stress distributions in deep muscle and fat tissues were therefore calculated in six healthy subjects during sitting, in a double-donut Open-MR system, using a "reverse engineering" approach. Specifically, finite element (FE) models of the undeformed buttock were built for each subject using MR images taken at the coronal plane in a non-weight-bearing sitting posture. Using a second MR image taken from each subject during weight-bearing sitting we characterized the ischial tuberosity sagging toward the sitting surface in weight-bearing, and used these data as displacement boundary conditions for the FE models. These subject-specific FE analyses showed that maximal tissue strains and stresses occur in the gluteal muscles, not in fat or at the skin near the body-seat interface. Peak principal compressive strain and stress in the gluteus muscle were 74+/-7% and 32+/-9 kPa (mean+/-standard deviation), respectively. Peak principal compressive strain and stress in enveloping fat tissue were 46+/-7% and 18+/-4 kPa, respectively. Models were validated by comparing measured peak interface pressures under the ischial tuberosities (17+/-4 kPa) with those calculated by means of FE (18+/-3 kPa), for each subject. This is the first study to quantify sub-dermal tissue strain and stress distributions in sitting humans, in vivo. These data are essential for understanding the aetiology of pressure sores, particularly those that were recently termed "deep tissue injury" at the US National Pressure Ulcer Advisory Panel (NPUAP) 2005 Consensus Conference.
Article
The paper deals with problems related to computational modelling of stress-strain states in vascular smooth muscle cells (SMCs). First, motivation for stress-strain analysis of SMCs is presented. Problems of their structure, geometry, constitutive models and initial (stress-free) state are analyzed on the basis of anatomical, histological and physiological knowledge. Various types of computational FE models of SMCs are presented; their constitutive models are identified on the basis of published mechanical tests carried out with SMCs cultured in vitro. Results of two models are presented; the former is a homogeneous model of the cell tension test with hyperelastic constitutive relations of the cell material. The latter model is more complex, it comprehends cortical and deep cytoskeleton, modelled as a tensegrity structure, and homogeneous linear elastic nucleus and remaining cytoplasm; it is used in computational modelling of indentation test. Perspectives, assumptions and limitations of computational modelling of SMCs under physiological load are discussed.
Article
Hemodynamic forces applied at the apical surface of vascular endothelial cells may be redistributed to and amplified at remote intracellular organelles and protein complexes where they are transduced to biochemical signals. In this study we sought to quantify the effects of cellular material inhomogeneities and discrete attachment points on intracellular stresses resulting from physiological fluid flow. Steady-state shear- and magnetic bead-induced stress, strain, and displacement distributions were determined from finite-element stress analysis of a cell-specific, multicomponent elastic continuum model developed from multimodal fluorescence images of confluent endothelial cell (EC) monolayers and their nuclei. Focal adhesion locations and areas were determined from quantitative total internal reflection fluorescence microscopy and verified using green fluorescence protein-focal adhesion kinase (GFP-FAK). The model predicts that shear stress induces small heterogeneous deformations of the endothelial cell cytoplasm on the order of <100 nm. However, strain and stress were amplified 10-100-fold over apical values in and around the high-modulus nucleus and near focal adhesions (FAs) and stress distributions depended on flow direction. The presence of a 0.4 microm glycocalyx was predicted to increase intracellular stresses by approximately 2-fold. The model of magnetic bead twisting rheometry also predicted heterogeneous stress, strain, and displacement fields resulting from material heterogeneities and FAs. Thus, large differences in moduli between the nucleus and cytoplasm and the juxtaposition of constrained regions (e.g. FAs) and unattached regions provide two mechanisms of stress amplification in sheared endothelial cells. Such phenomena may play a role in subcellular localization of early mechanotransduction events.
Article
Mechanical forces play an important role in many microbiological phenomena such as embryogenesis, regeneration, cell proliferation and differentiation. Micromanipulation of cells in a controlled environment is a widely used approach for understanding cellular responses with respect to external mechanical forces. While modern micromanipulation and imaging techniques provide useful optical information about the change of overall cell contours under the impact of external loads, the intrinsic mechanisms of energy and signal propagation throughout the cell structure are usually not accessible by direct observation. This work deals with the computational modelling and simulation of intracellular strain state of uniaxially stretched cells captured in a series of images. A nonlinear elastic finite element method on tetrahedral grids was applied for numerical analysis of inhomogeneous stretching of a rat embryonic fibroblast 52 (REF 52) using a simplified two-component model of a eukaryotic cell consisting of a stiffer nucleus surrounded by a softer cytoplasm. The difference between simulated and experimentally observed cell contours is used as a feedback criterion for iterative estimation of canonical material parameters of the two-component model such as stiffness and compressibility. Analysis of comparative simulations with varying material parameters shows that (i) the ratio between the stiffness of cell nucleus and cytoplasm determines intracellular strain distribution and (ii) large deformations result in increased stiffness and decreased compressibility of the cell cytoplasm. The proposed model is able to reproduce the evolution of the cellular shape over a sequence of observed deformations and provides complementary information for a better understanding of mechanical cell response.
Article
Most trans-tibial amputation (TTA) patients use a prosthesis to retain upright mobility capabilities. Unfortunately, interaction between the residual limb and the prosthetic socket causes elevated internal strains and stresses in the muscle and fat tissues in the residual limb, which may lead to deep tissue injury (DTI) and other complications. Presently, there is paucity of information on the mechanical conditions in the TTA residual limb during load-bearing. Accordingly, our aim was to characterize the mechanical conditions in the muscle flap of the residual limb of a TTA patient after donning the prosthetic socket and during load-bearing. Knowledge of internal mechanical conditions in the muscle flap can be used to identify the risk for DTI and improve the fitting of the prosthesis. We used a patient-specific modelling approach which involved an MRI scan, interface pressure measurements between the residual limb and the socket of the prosthesis and three-dimensional non-linear large-deformation finite-element (FE) modelling to quantify internal soft tissue strains and stresses in a female TTA patient during static load-bearing. Movement of the truncated tibia and fibula during load-bearing was measured by means of MRI and used as displacement boundary conditions for the FE model. Subsequently, we calculated the internal strains, strain energy density (SED) and stresses in the muscle flap under the truncated bones. Internal strains under the tibia peaked at 85%, 129% and 106% for compression, tension and shear strains, respectively. Internal strains under the fibula peaked at substantially lower values, that is, 19%, 22% and 19% for compression, tension and shear strains, respectively. Strain energy density peaked at the tibial end (104kJ/m(3)). The von Mises stresses peaked at 215kPa around the distal end of the tibia. Stresses under the fibula were at least one order of magnitude lower than the stresses under the tibia. We surmise that our present patient-specific modelling method is an important tool in understanding the etiology of DTI in the residual limbs of TTA patients.