Biopolymere und Biomechanik von Bindegewebssystemen: 7. wissenschaftliche Konferenz der Gesellschaft Deutscher Naturforscher und Ärzte

519 Pages·1974·21.708 MB·German-English

by  H. Groh (auth.), Prof. Dr. med. Fritz Hartmann (eds.)

7. wissenschaftliche Konferenz
der Gesellschaft Deutscher N aturforscher und Arzte
Biopolymere und Biomechanik
von Bindegewebssystemen
tIerausgegeben von
Fritz tIartmann
unter Mitarbeit von
Christoph tIartung und tIenning Zeidler
Mit 364 Abbildungen
Springer-Verlag Berlin· tIeidelberg . New York 1974
Prof. Dr. med. Fritz Hartmann
Dr. Ing. Christoph Hartung
Dr. med. Henning Zeidler
Medizinische Hochschule Hannover
Medizinische Klinik
D-3 Hannover-Kleefeld
Karl-Wiechert-Allee 9
Library of Congress Cataloging in Publication Data
Gesellschaft Deutscher Naturforscher und Arzte
Biopolymere und Biomechanik von Bindegewebssystemen
English or German.
Bibliography: p.
1. Connective tissues-·Congresses. I. Hartmann,
Fritz, 1920- ed. II. Hartung, C, ed.
III. Zeidler, Hans, 1915- ed. IV. Title.
QM563.G44 1974 611'.0182 74-14943
[SBN-13: 978-3-540-06927-0 e-ISBN-13: 978-3-642-65963-8
00[: 10.1007/978-3-642-65963-8
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Introductory Address on Biopolymers and
Biomechanics of Connective Tissue
Ladies and Gentlemen,
In greeting you on behalf of the GDNA, I particularly wish to mention
that Prof. BOCK, the chairman elect of our 109th Meeting, to be held in
Stuttgart in 1976, is representing the Society here today. You may judge
of our intentions in selecting this theme from our choice of invited
delegates, whose disciplines include engineering, biophysics, anatomy,
biochemistry, and the clinical disciplines of accident and emergency
surgery, orthopedics, and rheumatology.
Our theme forms the link in a chain between "The Macromolecule" (GDNA
Meeting, held in Vienna in 1966 under the chairmanship of O. KRATZKY) and
"Physics and Chemistry in the Service of Other Sciences" (to take place
in Berlin in September 1974 under the chairmanship of MAIER-LEIBNITZ).
Because of the nature of modern scientific research, we are today con
fronted with a problem of communication. Whereas the subjects researched
are very similar, there are enormous differences in our ways of thinking
about them, in the concepts we use, and in the language in which the
results are reported. We need to understand each other's scientific jar
gon! This task presents even more difficulty than Germans have in over
coming their inhibitions about talking English in public.
Connective tissue for us here will be bringing together more things than
the basic meaning of the term implies, i.e. that it unites cells, con
nects muscle and bones and itself merges into capsules, plates, sheaths,
valves, and tubes. For us, it is connecting scientific disciplines and
methods, and experience in their application to various fields: machines,
and human jOints, synthetic fibers, and the fabric of connective tissue.
Our theme provides an opportunity for discussing under common assumptions,
or at least comparable assumptions, tissues so diverse as tendons, cap
sules, cartilage, skin, intervertebral discs the valves of the heart,
lung and liver tissue, and vessels of various kinds.
The general public is interested in medicine mainly from the point of
view of the killer diseases, cancer and cardiovascular disease. However,
the most frequent cause of days missed from work, early retirement be
cause of invalidism and suffering among the elderly is deteriorationy of
the connective-tissue systems of the joints and spine. This in itself
is sufficient reason to research into the origin of such deterioration.
Indeed, Lord ZUCKERMAN placed it among the four most urgent tasks of
medical research.
The term biopolymers is generally understood to apply to the carriers
and transmitters of genetic information that are able to reproduce them
selves; in effect, it includes all living organic polymers, i.e. those
subject to continuous catabolism and metabolism, and whose biologic
functions are associated with their tertiary and quaternary structure.
The biological functions of the biopolymers of connective tissue depend
upon their physical and physicochemical properties. These have to be
redefined in terms of the physics and chemistry of natural and artificial
high polymers. The biopolymers of connective tissue include polypeptides
polymerized to fibers, forming typical tertiary structures with each
other and metabolizing polysaccharides with lateral reticulation that
form quaternary structures, or textures, with the fibers.
VI
At this conference we have given pride of place to the habits of thought
and methods of mechanics, rheology, and tribology, in other words, the
sciences of solid-state properties and lubrication of the moving parts
of machinery. Any artifical replacement of worn connective-tissue systems
must approximate to the properties described in the concepts of rheo
logy and tribology.
By connective tissue system we understand an ordered arrangement of
fibrous elements with viscoelastic inclusions. The three basic types
(Fig. 1) make it clear what are the basic elements and the variations
in the ways in which they combine to form textures •
. ..
. "
.
.. . .
lB
. '.
:.:::. ~ ::~ .:: :~':: .
0.: ....... .
• ... ..... ... .eo .. : ...
..... ": .. : .0:
0° I "'0
- kollagene Fibrillen
• Proteoglycane
1. Loose connective tissue consists of a few thin, very tortuous, loosely
disposed fibers, together with a large amount of basic substance, rich
in glucosamines and poor in sulfates, and containing variable amounts of
water.
Examples of this type are skin, lungs, and vessels. Numerous variations
occur, for instance, in the skin in different parts of the body.
2. Rigid connective tissue consists of many thick, rigidly disposed half
crystalline fiber bundles, together with a small amount of highly poly
merized basic substance, rich in sulfates and containing very little
water.
Examples of this type are tendons, fasciae, dura mater, and fibrous rings.
3. Basic substance, having variable viscoelastic properties and enclosed
by rigid connective tissue.
Examples of this type are joints, intervertebral discs, and the eyes.
The jOint provides a splendid example to illustrate where and how the
rheologic and tribologic phenomena involved in sequential or alternating
processes stand relative to the biochemical, enzymologic, and immunolo
gic phenomena, and the physiology of muscle pains. The biopolymers and
their interconnections can be damaged by oxygen deficiency, release of
aggressive enzymes, precipitation of crystals, and muscular strain. Such
immunopathologic phenomena as the precipitation and phagocytosis of an
tigen-antibody complexes, mechanical attrition, or tearing of fibers
induce the release of aggressive enzymes (Fig. 2).
Connective-tissue systems are of very heterogeneous composition.
For this reason, it is important to consider what property a system will
have under the varying conditions that prevail at its natural site in
the body. Let us take some examples.
VII
Sensibilisierte
phocyten + + +- -..... t!j.--~---1~
. +
Rhagocyten }I'
1t~F~~~~~~~~~y~F---~«( ~~--:----t"'-II
iBebnJ Ch __ ~,
RiB e--..,.~-::---:--:-:~
des
co, ___________
Subchondrale Osleo>skllerc)se/ ~ ·r.1·+--=-=,,:,-=,=~r
nach Mikrolrakluren , Lactat _ --------
----0, ~ __ _
--
mechanische Elemente _=_ _I !I Substratarme.
immunologische Elemenle schlackenreiche
biochemische Elemente_ Synovia
Example 1. Increasing pressure or traction imposes stress on various ele
ments of the quaternary, tertiary, and secondary structures in turn. The
curve representing changes in length is consequently not linear (Fig. 3).
The speed of application of force can also change the elastic properties.
The macromolecules require a certain tissue interval to change position
or direction. A tendon to which a high-impact force is applied can break
like glass, especially when it is already taut. A certain time is also
necessary for it to resume its original shape and lenght after the force
is removed. The time dependence of this molecular displacement is most
clearly seen in the phenomenon of relaxation. Most connective tissues
are not slack, but stressed in their resting position in the body. This
normal state of tension is called turgor and is produced by the pressure
of the proteoglycane gels enclosed between the fibers. It is a constant,
Uingenanderung Faserwerk Fibrillen Peptidketten
~
~Jj;¥lM t,. ~~ ~.'j h»)
.. 41
~, !A1' ~. ~. ~
0 . ).J
,--
- - - -=:-:...-:=--""""=-----'
Dehnen FlieBen ReiBen
P
L-____________~ ~~~~~--~~
_ Dehnung } P ~ plastisches Element Zug
+ __ Entdehnung = Hysterese p ~ Verformungsrest nach
Entlastung
VIII
and may even be a control system, but it is certainly a point at which
pathologic changes can occur. Thus, we may say that at a given time each
connective tissue will be found at a particular point on its pressure
or traction curve.
Stretching, gliding, flowing and tearing are determinded by the melting
points of the fiber elements. These may, particularly under pathologic
condittons, lie within the range of body temperature~. In heterogeneous
systems, the rheologic curves are a function of the melting points of
the macromolecular aggregates.
It is of special importance to take these facts into consideration where
connective tissues have to match the speed of rhythmic stresses without
undue lag. Examples: arteries must work to the speed and frequency of the
pulse; lungs must adapt to the depth and frequency of respiration; inter
vertebral discs must stand up to walking, running, and jumping.
It is rewarding to consider these motor systems from the viewpoint of
biological controls. The macromolecular status of a connective tissue is
not only that of a control system; it also comprises correcting elements,
e.g. degree of polymerization, water content, number and thickness of
the fibrils, and types of polysaccharides. Long-term adaptation, e.g.
to growth, stress, and inactivity, has been studied, but short-term adap
tation has yet to be researched.
Example 2 concerns time and the influence of shearing speed on viscosity
and thixotropy. Aggregates of macromolecules require a certain time to
regroup so as to produce the viscosity that a certain shearing speed re
quires. One could call this a biological time, for the viscoelastic sys
tem regulates a mechanical property within a certain time interval to
allow it to perform a biological function. For this reason it is neces
sary to know the local speeds that can occur, e.g. on the surface of
joints (Fig. 4).
Viskositat
o Schergeschwindigkeit
Example 3 follows on from the foregoing. The Leeds Group (DOWSON, UNS
WORTH and WRIGHT)have examined various types of lubrication. It is
possible that under certain conditions they all occur, not just a single
type. This then raises the question as to which solution is realized at
a given pressure or speed.
At various sites on the surface of the jOints, lubrication of a diffe
rent type is found (Fig. 5). Most jOint surfaces are irregular in shape
and the interface does not fit together snugly; in other words, they
are incongruent. The distribution of forces and,during exercise, of lo
cal speeds also fluctuates. It is important to be aware of this situa
tion in order to understand why certain lesions always occur in the same
place, e.g. thickening of the bone below the cartilage; outgrowth of
cartilage or of new bone (osteophytes); penetration of intervertebral
discs into the spinal column.
IX
I .. I
I .. I
=~:':~'i
~
~\""~'-""'W»\~~\.'*~>'.
Hydrodynamisch Elasto-hydrodynamisch Grenzflachen -
Schmierung
J
..
l
Steifes Element -L~~2·;£..~~J+ ~~~;.:.:; Hyalurono-Protein
3,f~~~f/t.~ i~!: Wasser
Bewegte Flache ::=::=:: Knorpel
.::~; ~:~r .!~i
Druck-selbstgesteuerte DruckangepaBte .. Druck
Schmierung Schmierung _ Scherung
As these examples show, we still have a long way to go before we are
able to measure with sufficient accuracy and completeness the processes
that occur in living connective-tissue systems and until good models
have been developed for the characterization and simulation of these
processes.
We shall have done what we set out to do, and fullfilled the intentions
of our Society, when we have learned to apply research data in the diag
nosis and treatment of pathologic conditions. I hope the work we are
to do at this meeting will take us a step nearer this goal.
Fritz Hartmann
Inhaltsverzeichnis
I. Die in GeZenken auftretenden Krafte/Foraes Oaauring in the
Joints . ........................................................•
H. GROH: Die Krafte bei menschlicher Korperbewegung................ 3
E.L. RADIN: Distribution of Pressure in Loaded Animal Joints ••••••• 13
II. Biomeahanik der GeZenke/ Biomeahanias of Joints ....... ........• 17
B. KUMMER: Biomechanik der Gelenke (Diarthrosen). Die Beanspruchung
des Gelenkknorpels.............................................. 19
K. ALTMANN: Von der Entstehung gelenkkopfahnlicher, knorpelbedeck
ter Gebilde auf den Stumpfenden der teilresezierten Rattenfibula
im Experiment.................. •. ••..•••••••••• .•.•.• .••• .. .• .•• 29
A. UNSWORTH: Oberflachengestaltung und Lastverteilung in HUft- und
Kniegelenk. . • . •• . . •. • . • • ••• • •. •• •• •• •• •• . . • . • . •• • . • . ••• . • . • . •• •. 49
E. ASANG: Individuelle Belastungs- und Verletzungsgrenzen des
menschli chen Beins.............................................. 51
Zusarnrnenfassung der Diskussion zu I und II .••.•.•.•.•.•.•.•.•.•.•.• 58
III. BiorheoZogie der WirbeZsauZe/ BiorheoZogy of the Spine ........ 59
A. NACHEMSON: Lumbar Intradiscal Pressure. Results from in Vitro
and in Vivo Experiments with Some Clinical Implications ••.••.•.. 61
A. NAYLOR, R.D. SHENTALL, and D.C. WEST: Current Investigations on
the Biochemical Aspects of Intervertebral Disc Degeneration and
Herniation. •• . . • . . • •• • . • . . . • . • •• • •• •• •• . • . • .• . • .• . • . • . • . • . • •• . . • 77
J.A. SZIRMAI: The Concept of the Chondron as a Biomechanical Unit .• 87
P. OTTE: Die Expansion des Discus intervertebralis bei Osteoporose. 93
J. KRKMER: Biomechanische Veranderungen im Zwischenwirbelabschnitt
des Menschen und ihre Bedeutung fUr die Behandlung und Praven-
tion bandscheibenbedingter Erkrankungen ••••...••..•••.••••..•.•• 101
Zusarnrnenfassung der Diskussion zu III .•.•••.•.•...•.•.••••.••.••.•• 109
IV. BiorheoZogie von Fasern/BiorheoZogy of Fibers ............. ..... 111
G. ARNOLD und M. ZECH: Biorheologie fast reiner Faserstrukturen im
Vergleich mit ProbestUcken aus hyalinen Knorpel .•...•.•.....•••• 113
R. BOWITZ und Th. NEMETSCHEK: Struktur und Dehnungsverhalten von
Kollagen •.•.•••••••.•..•••.•.•.••••...•.•..•..•.•.•.•.•.•.•.•.•• 125
R. BONART: Diskussionsbemerkungen zur Deutung der Rontgenklein
winkeleffekte bei der Dehnung von nativ-feuchtem Kollagen ••••.•• 137
B. PFEIFFER: Piezoelectric Constants of the Calcified Collagen
Fibril in Human Cortical Bone ••.••.•.•.•.•.•.•••••.•.•••.•.•••.• 143
R. FRICKE: Dependence of Relaxation of Rat Tail Tendons on the
Milieu and on the Influence of a Cytostatic Treatment •.•..•.•.•• 149
M. JKGER: Biomechanical Examinations for the Usefulness of Grafts
with Different Structural and Conservational Connective Tissue
Properties in Orthopedic Surgery................................ 155
XII
Zusarnrnenfassung der Diskussion zu IV............................... 159
V. BiorheoZogie von HerzkZappen/BiorheoZogy of Heart VaZves ......•. 161
M.I. IONESCU, B.C. PAKRASHI, D.A.S. MARY, and G.H. WOOLER: Biologi-
cal Tissue Heart Valve Replacement ••••••••••••••.•••••••••.••••• 163
H. DALICHAU: Bio-Rheologie der durch autologes Bindegewebe ersetz
ten Herzklappen. Mechanische und biologische Ursachen fur ihr
Versagen. • • • • . • • . • • • • • • • . • • • • • • . • • • • • • . • • • • . • • • • • • • • . • • • . . • • • . •• 171
H. ADAMCZAK: Herzklappen aus kunstlichen Werkstoffen ••••••••.•••••• 179
VI. BiorheoZogie von Gefassen/BiorheoZogy of VesseZs ...... ......... 189
Y.C. FUNG: Biorheology of Loose Connective Tissues, Especially
Blood Vessels •••••.•.••••••••••••••.•.••.•••••.••••••••••••••••• 191
C. HARTUNG: Vascular Tissues - a Twophase Material? ••••••••.••••.• 211
O.H. MAHRENHOLTZ: On the Flow of Viscous Fluids in Systems of
Elastic Tubes................................................... 221
H.G. VOGEL: Composition and Properties of Skin During the Ageing
Process and Under the Influence of Desmotropic Compounds •••••.•• 227
G. BUBLITZ: Veranderungen des Bindegewebes nach Einwirkung ionisie-
render Strahlen •.••••••.••••.•••••••.•••••••••••••••.•.••••.•••• 231
Zusarnrnenfassung der Diskussion zu VI... • . • • • • • • • • • • • • • . • • • • . • • • • • •• 235
VII. AnormaZes FZie~verhaZten von HoahpoZymeren/AbnormaZ FZow Be-
havior of High PoZymers ......................................•.. 237
J. KLEIN: Anormales FlieBverhalten von Hochpolymeren ••••••••••••••• 239
E. KUSS: The Pressure-Dependence of Viscosity and its Relation to
Lubrication .••.••.••••.•••••••.••••.•.••••..•.•••••••.••••••••.• 241
E. KILLMANN: Zur Adsorption makromolekularer Stoffe •••••••••••..••• 249
Zusarnrnenfassung der Diskussion zu VII ••..••••••••.••••••••.•.•••••• 258
VIII. BiorheoZogisahe Eigensahaften des GeZenkknorpeZs/BiorheoZogia
Properties of Joint CartiZage .. ...................•............. 259
C.A. McDEVITT and H. MUIR: A Biochemical Study of Experimental and
Natural Osteoarthrosis ••••••••••••••••••.••••••.•••••••••••••••• 261
E.L. RADIN: Experimental Osteoarthrosis in Animals ••.•.•••.•••••••. 269
W. WEGNER: Zur Bio-Rheologie des Epiphysen- und Gelenkknorpels bei
Tieren ..•••••••.•••••••.•.•.••.•.••.•.•.••...•.•.•.••••••..••••• 271
W. PUHL and W. REMUS: Correlation of Various Stress and Surface
Contoures in Articular Cartilage .•••••.••••..•.••.•.•••.••••.•.• 283
I.-E. RICHTER: Oberflachen- und Schichtenstruktur gesunden und
kranken Knorpels ••.••••.•••..•.••••.••••..••.••••.•.••••••.•••.• 291
H.J. REFIOR: Scanning Electron Microscopic Examinations of the Sur
face Behavior of Healthy Articular Cartilage Under Pressure
Forces .••.•.•.••.•••••••••.•..•.••••••.•.•••••••••••••••••••.••• 303
Zusarnrnenfassung der Diskussion zu VIII •••••••.••••••••.••••••.•••.. 307
IX. BiorheoZogisahe Eigensahaften der GeZenkfZussigkeit/BiorheoZo-
gia Properties of Joint FZuid ................. ........•......... 309
H. GREILING: Biorheological Properties and the Proteo Hyaluronate
Content of Synovial Fluid •.•.•.••••.••••••••••.••••••.•••••••••• 311