{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T20:05:45Z","timestamp":1776801945291,"version":"3.51.2"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union\u2019s Horizon","award":["812765"],"award-info":[{"award-number":["812765"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>(1) Background: The kinematic characteristics of disc prosthesis undergoing complex motion are not well understood. Therefore, examining complex motion may provide an improved understanding of the post-operative behavior of spinal implants. (2) Methods: The aim of this study was to develop kinematic tests that simulate multiplanar motion and combined rotational\u2013translational motion in a disc prosthesis. In this context, five generic zirconia-toughened alumina (BIOLOX\u00aedelta, CeramTec, Germany) ball and socket samples were tested in a 6 DOF spine simulator under displacement control with an axial compressive force of 100 N in five motion modes: (1) flexion\u2013extension (FE = \u00b1 7.5\u00b0), (2) lateral bending (LB = \u00b1 6\u00b0), (3) combined FE-LB (4) combined FE and anteroposterior translation (AP = 3 mm), and (5) combined LB and lateral motion (3 mm). For combined rotational\u2013translational motion, two scenarios were analyzed: excessive translational movement after sample rotation (scenario 1) and excessive translational movement during rotation (scenario 2). (3) Results: For combined FE-LB, the resultant forces and moments were higher compared to the unidirectional motion modes. For combined rotational\u2013translational motion (scenario 1), subluxation occurred at FE = 7.5\u00b0 with an incremental increase in AP translation = 1.49 \u00b1 0.18 mm, and LB = 6\u00b0 with an incremental increase of lateral translation = 2.22 \u00b1 0.16 mm. At the subluxation point, the incremental increase in AP force and lateral force were 30.4 \u00b1 3.14 N and 40.8 \u00b1 2.56 N in FE and LB, respectively, compared to the forces at the same angles during unidirectional motion. For scenario 2, subluxation occurred at FE = 4.93\u00b0 with an incremental increase in AP translation = 1.75 mm, and LB = 4.52\u00b0 with an incremental increase in lateral translation = 1.99 mm. At the subluxation point, the incremental increase in AP force and lateral force were 39.17 N and 38.94 N in FE and LB, respectively, compared to the forces in the same angles during the unidirectional motion. (4) Conclusions: The new test protocols improved the understanding of in vivo-like behavior from in vitro testing. Simultaneous translation\u2013rotation motion was shown to provoke subluxation at lower motion extents. Following further validation of the proposed complex motion testing, these new methods can be applied future development and characterization of spinal motion-preserving implants.<\/jats:p>","DOI":"10.3390\/bioengineering11080857","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T05:16:24Z","timestamp":1724649384000},"page":"857","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of Load on Cervical Disc Prosthesis by Imposing Complex Motion: Multiplanar Motion and Combined Rotational\u2013Translational Motion"],"prefix":"10.3390","volume":"11","author":[{"given":"Hossein","family":"Ansaripour","sequence":"first","affiliation":[{"name":"Institute for Biomechanics, D-HEST, ETH Zurich, Gloriastrasse 37\/39, 8092 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen J.","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Institute for Biomechanics, D-HEST, ETH Zurich, Gloriastrasse 37\/39, 8092 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Flohr","sequence":"additional","affiliation":[{"name":"CeramTec GmbH, CeramTec-Platz 1-9, 73207 Plochingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.clinbiomech.2017.03.007","article-title":"Cervical facet force analysis after disc replacement versus fusion","volume":"44","author":"Patel","year":"2017","journal-title":"Clin. 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