585.720.81 - Orthopedic Biomechanics

Course Structure

The course materials are divided into modules which can be accessed by clicking Modules on the left menu. A module will have several sections including the overview, content, readings, discussions, and assignments. You are encouraged to preview all sections of the module before starting. All modules will run for a period of seven (7) days. You should regularly check the Calendar and Announcements for assignment due dates.

Course Topics

Bone Structure & Mechanical Principles

Bone Biomechanics

Biomechanics of Connective Tissue: Articular Cartilage

Biomechanics of Connective Tissue: Ligaments and Tendons

Biomechanics of the Intervertebral Disc

Biomechanics of the Hip

Biomechanics of the Knee

Fracture Fixation Biomechanics

Cervical Spine Biomechanics

Thoracolumbar Spine Biomechanics

Using Standards to Solve Biomechanical Problems

Course Goals

This course is intended to introduce the biomedical engineer to the principles of orthopedic biomechanics. Specific attention will be paid to the direct clinical application of both historical and current technologies that are used to restore form and function to the body. As increasingly complex medical devices are introduced to alleviate and treat degenerating physiology, it is the goal of this course to teach the biomedical engineer the biomechanical relationship between these devices and the musculoskeletal system.

This is not a math course but rather a course on how to use biomechanics to help influence design decisions and construction of medical devices for specific biomechanical environments. The approach to this course is to teach the biomechanical foundations and principles that describe the forces that implants see and what goes into design of implants to handle these forces. There is an intricate balance between the biomechanics of a joint, the surgical intervention to access that joint, the design of an implant that must fit within a specific anatomical structure, and the variation in surgical placement of the implant (e.g., “forgiveness” of an implant). Designs that don’t factor in the peculiarities of an anatomical location or implant placement may lead to unfavorable tissue response which can lead to mechanical failures. An example of this balance of biology and mechanics is when very small micro-motion of a hip implant femoral stem can lead to tiny wear particles which can migrate to the bearing surface and cause 3^rd body wear in the articulating components that in turn leads to major wear and failure of the implant. Rather than just focusing on the pure joint biomechanics, this course translates those principles and foundations into biomechanical and biological considerations for long-term performance of an implant.

Course Learning Outcomes (CLOs)

• 1) Identify key components of the musculoskeletal system
• 2) Differentiate between bone and soft tissue biomechanics
• 3) Identify the principles of joint reconstruction, spinal instrumentation, fracture repair and stabilization.
• 4) Develop appreciation for the interconnectivity between surgical approaches and implant selection, mechanical stabilization, biologic bone formation and clinical improvement

Textbooks

Student Coursework Requirements

It is expected that each module will take approximately 7–10 hours per week to complete. Here is an approximate breakdown: reading the assigned sections of the texts and the assigned journal article (approximately 3–4 hours per week), listening to/watching the audio annotated slide presentations (approximately 2–3 hours per week), and writing assignments (approximately 2–3 hours per week).

This course will consist of the following basic student requirements:

Participation in Class Discussion Boards (10% of Final Grade Calculation)

You are responsible for carefully reading all assigned material and being prepared for discussion. The readings will be one peer-reviewed journal article related to the material covered in the Module. When discussing a journal article selected for the module, critique the article that has been submitted as if you were a reviewing peer to whom the article had been submitted by the prospective publisher. Emphasize your critical assessment of the methodologies and approach rather than a re-statement of the research. Discuss a specific point in the article. Solicit opinions regarding that point from others.

Post your initial response to the discussion questions by the evening of day 3 for that module week (Friday night). Posting a response to the discussion question is part one of your grade for module discussions (i.e., Timeliness).

Part two of your grade for module discussion is your interaction (i.e., responding to classmate postings with thoughtful responses) with at least two classmates (i.e., Critical Thinking). Just posting your response to a discussion question is not sufficient; we want you to interact with your classmates. Be detailed in your postings and in your responses to your classmates' postings. Feel free to agree or disagree with your classmates. Please ensure that your postings are civil and constructive.

We will monitor module discussions and may respond to some of the discussions as discussions are posted if we feel like an important point has been raised or if the discussion is getting off track.

Evaluation of preparation and participation is based on contribution to discussions.

Participation is evaluated by the following grading elements:

1. Timeliness (50%)
2. Critical Thinking (50%)

Participation is graded as follows:

• 9 - 10 = A—Timeliness [regularly participates; all required postings; early in discussion; throughout the discussion]; Critical Thinking [rich in content; full of thoughts, insight, and analysis].
• 8 - 9 = B—Timeliness [frequently participates; all required postings; some not in time for others to read and respond]; Critical Thinking [substantial information; thought, insight, and analysis has taken place].
• 7 - 8 = C—Timeliness [infrequently participates; all required postings; most at the last minute without allowing for response time]; Critical Thinking [generally competent; information is thin and commonplace].
• < 7 = F—Timeliness [rarely participates; some, or all required postings missing]; Critical Thinking [rudimentary and superficial; no analysis or insight is displayed].

Quizzes (10% of Final Grade Calculation)

There will be very short (< 10 questions) quizzes given during each Module for which there is associated textbook (or textbook excerpt) reading. These quizzes will be open book but will be timed in such a way that if you know where to find the material and are familiar with the material they will be easy to complete but if you have not read the text you will easily run out of time hunting for the answer. You will have the entire week to start/begin the quizzes but they will be due by 11:59PM EST (midnight on Day 7) exactly one week from their release. You will take the quizzes through the course Blackboard site. Late submissions will be reduced by one letter grade for each week late (no exceptions without prior coordination with the instructors).

Quizzes are graded as follows:

• 100–90% = A
• 89–80% = B
• 79–70% = C
• <70% = F

Assignments (15% of Final Grade Calculation)

Students are required to complete ALL homework assignments to earn a course grade. Homework assignments will be evaluated and graded on a scale of 0 to 10. Most weeks (as appropriate and outlined in the module section) a homework assignment related to the material covered in the module will be issued. In certain cases the questions posed may be open-ended and require some additional limited research. Please provide a detailed response to the question(s) posed. Your submissions will be due by 11:59PM EST (midnight on Day 7) a week after the Module opens. All assignments are due according to the dates in the Calendar.

Late submissions will be reduced by one letter grade for each week late (no exceptions without prior coordination with the instructors).

Qualitative assignments are evaluated by the following grading elements:

1. Thoroughness of the response (50%)
2. Writing quality and technical accuracy (50%) (Writing is expected to meet or exceed accepted graduate-level English and scholarship standards. That is, all assignments will be graded on grammar and style as well as content.)

Qualitative assignments are graded as follows:

• 9 - 10 = A—All parts of question are addressed; Writing Quality/ Rationale/ Examples/ Outside References [rich in content; full of thought, insight, and analysis].
• 8 - 9 = B—All parts of the question are addressed; Writing Quality/ Rationale/ Examples/ Outside References [substantial information; thought, insight, and analysis has taken place].
• 7 - 8 = C—Majority of parts of the question are addressed; Writing Quality/ Rationale/ Examples/ Outside References [generally competent; information is thin and commonplace].
• < 7 = F—Some parts of the question are addressed; Writing Quality/ Rationale/ Examples/ Outside References [rudimentary and superficial; no analysis or insight displayed].

Course Project
 - Course Project Paper (20% of Final Grade Calculation)
 - Course Project Presentation (20% of Final Grade Calculation)

A course project will be assigned at the beginning of the course. Topic selection for the course project will be due during Module 7, several weeks into the course. The last week will be devoted to submission of the course project. The course project is a review and presentation of a current concept in orthopedic reconstruction. Students should pick an area of interest in orthopedics (i.e. spinal fusion techniques, total knee/hip replacement, artificial disc replacement, trauma stabilization, etc) and write a comprehensive overview of the history and current status in that field. What advantages do the modern implantable device systems offer over the earlier analogues? Do the surgeons possess multiple alternatives for treating a particular condition? What are the biomechanical / biological advantages (drawbacks) of one technique over another? The literature review should be at least 10 pages (including small figures or tables), Times New Roman, Size 12, double-spaced. Based on the literature overview paper, students should prepare a 15-20 slide power point presentation to accompany their paper. Presentations should range 10-15mins in length, with strict duration enforcement. Please contact the course instructors if you need help deciding on a topic or have any questions.

The course project is evaluated by the following grading elements:

1. Student preparation and literature review completeness (as described in Course Project Description) (50%)
2. Student technical understanding of the course project topic (as described in the Course Project Description) (50%)

Course Project is graded as follows:

• 100 – 90 = A— Rich in content; full of thought, insight, and analysis.
• 89 – 80 = B—Substantial information; thought, insight, and analysis has taken place.
• 79 – 70 = C—Generally competent; information is thin and commonplace.
• < 70 = F—Rudimentary and superficial; no analysis or insight displayed.

Exam (25% of Final Grade Calculation)

The midterm exam will be available in Module 7. You will have the entire week to start/begin the exam but it will be due by 11:59PM EST (midnight on Day 7) exactly one week from its initial release. You may use any of the course materials to complete the exam. The exam will be 90min and worth 100 points. You will take this exam through the course site, and the questions will be multiple choice, True/False, fill-in-the-blank, or short answer. T/F questions are worth about 2pts (+/- 1pt) and short answer questions can be worth up to 6pts. Questions for the exam can come from the lectures, the assigned textbook readings, the assigned journal articles, or the discussion forums. Late submissions will be reduced by one letter grade for each week late (no exceptions without prior coordination with the instructors).

Exams are graded as follows:

• 100–90 = A
• 89–80 = B
• 79–70 = C

Grading

Assignments are due according to the dates posted in your Blackboard course site. Assignments are due 7 days from the day they are assigned. Each Module in this course runs from Wednesday to Tuesday. All assignments will be due by 11:59PM EST (midnight on Day 7). You may check these due dates in the Course Calendar or the Assignments in the corresponding modules. We will do our best to post grades 1-2 weeks after assignment due dates.

We generally do not directly grade spelling and grammar. However, egregious violations of the rules of the English language will be noted without comment. Consistently poor performance in either spelling or grammar is taken as an indication of poor written communication ability that may detract from your grade.

A grade of A indicates achievement of consistent excellence and distinction throughout the course—that is, conspicuous excellence in all aspects of assignments and discussion in every week.

A grade of B indicates work that meets all course requirements on a level appropriate for graduate academic work. These criteria apply to both undergraduates and graduate students taking the course.

Grading Policy

EP uses a +/- grading system (see “Grading System”, Graduate Programs catalog, p. 10).

Academic Policies

Deadlines for Adding, Dropping and Withdrawing from Courses

Students may add a course up to one week after the start of the term for that particular course. Students may drop courses according to the drop deadlines outlined in the EP academic calendar (https://ep.jhu.edu/student-services/academic-calendar/). Between the 6th week of the class and prior to the final withdrawal deadline, a student may withdraw from a course with a W on their academic record. A record of the course will remain on the academic record with a W appearing in the grade column to indicate that the student registered and withdrew from the course.

Academic Misconduct Policy

All students are required to read, know, and comply with the Johns Hopkins University Krieger School of Arts and Sciences (KSAS) / Whiting School of Engineering (WSE) Procedures for Handling Allegations of Misconduct by Full-Time and Part-Time Graduate Students.

This policy prohibits academic misconduct, including but not limited to the following: cheating or facilitating cheating; plagiarism; reuse of assignments; unauthorized collaboration; alteration of graded assignments; and unfair competition. Course materials (old assignments, texts, or examinations, etc.) should not be shared unless authorized by the course instructor. Any questions related to this policy should be directed to EP’s academic integrity officer at ep-academic-integrity@jhu.edu.

Students with Disabilities - Accommodations and Accessibility

Johns Hopkins University values diversity and inclusion. We are committed to providing welcoming, equitable, and accessible educational experiences for all students. Students with disabilities (including those with psychological conditions, medical conditions and temporary disabilities) can request accommodations for this course by providing an Accommodation Letter issued by Student Disability Services (SDS). Please request accommodations for this course as early as possible to provide time for effective communication and arrangements.

For further information or to start the process of requesting accommodations, please contact Student Disability Services at Engineering for Professionals, ep-disability-svcs@jhu.edu.

Student Conduct Code

The fundamental purpose of the JHU regulation of student conduct is to promote and to protect the health, safety, welfare, property, and rights of all members of the University community as well as to promote the orderly operation of the University and to safeguard its property and facilities. As members of the University community, students accept certain responsibilities which support the educational mission and create an environment in which all students are afforded the same opportunity to succeed academically. 

For a full description of the code please visit the following website: https://studentaffairs.jhu.edu/policies-guidelines/student-code/

Classroom Climate

JHU is committed to creating a classroom environment that values the diversity of experiences and perspectives that all students bring. Everyone has the right to be treated with dignity and respect. Fostering an inclusive climate is important. Research and experience show that students who interact with peers who are different from themselves learn new things and experience tangible educational outcomes. At no time in this learning process should someone be singled out or treated unequally on the basis of any seen or unseen part of their identity. 
 
If you have concerns in this course about harassment, discrimination, or any unequal treatment, or if you seek accommodations or resources, please reach out to the course instructor directly. Reporting will never impact your course grade. You may also share concerns with your program chair, the Assistant Dean for Diversity and Inclusion, or the Office of Institutional Equity. In handling reports, people will protect your privacy as much as possible, but faculty and staff are required to officially report information for some cases (e.g. sexual harassment).

Course Auditing

When a student enrolls in an EP course with “audit” status, the student must reach an understanding with the instructor as to what is required to earn the “audit.” If the student does not meet those expectations, the instructor must notify the EP Registration Team [EP-Registration@exchange.johnshopkins.edu] in order for the student to be retroactively dropped or withdrawn from the course (depending on when the "audit" was requested and in accordance with EP registration deadlines). All lecture content will remain accessible to auditing students, but access to all other course material is left to the discretion of the instructor.