Skip to main content

Advertisement

Log in

Non-invasive continuous estimation of blood flow changes in human patellar bone

  • Original Article
  • Published:
Medical and Biological Engineering and Computing Aims and scope Submit manuscript

Abstract

A photoplethysmographic (PPG) technique to assess blood flow in bone tissue has been developed and tested. The signal detected by the PPG consists of a constant-level (DC) component—which is related to the relative vascularization of the tissue—and a pulsatile (AC) component—which is synchronous with the pumping action of the heart. The PPG probe was applied on the skin over the patella. The probe uses near-infrared (804 nm) and green (560 nm) light sources and the AC component of the PPG signals of the two wavelengths was used to monitor pulsatile blood flow in the patellar bone and the overlying skin, respectively. Twenty healthy subjects were studied and arterial occlusion resulted in elimination of PPG signals at both wavelengths, whereas occlusion of skin blood flow by local surface pressure eliminated only the PPG signal at 560 nm. In a parallel study on a physical model with a rigid tube we showed that the AC component of the PPG signal originates from pulsations of blood flow in a rigid structure and not necessarily from volume pulsations. We conclude that pulsatile blood flow in the patellar bone can be assessed with the present PPG technique.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Anetzberger H, Thein E, Becker M, Zwissler B, Messmer K (2004) Microsphere accurately predicts bone blood volume. Clin Orthop Relat Res 424:253–265

    Article  Google Scholar 

  2. Arnoldi CC (1991) Patellar pain. Acta Orthop Scand 62(Suppl. 244):12–13

    Google Scholar 

  3. Binzoni T, Leung T, Hollis V, Bianchi S, Fasel JH, Bounameaux H, Hiltbrand E, Deply D (2003) Human tibia bone marrow: defining a model for the study of haemodynamics as a function of age by near infrared spectroscopy. J Physiol Anthropol Appl Human Sci 22:211–218

    Article  Google Scholar 

  4. Bonutti PM, Miller BG, Cremen MJ (1998) Intraosseous patellar blood supply after medial parapatellar arthrotomy. Clin Orthop Relat Res 352:202–214

    Article  Google Scholar 

  5. Borgström P, Clementz LA, Grande PO (1981) A servo-controlled roller pump for constant flow or constant pressure blood perfusion under normal pulsatile or non-pulsatile conditions. Acta Physiol Scand 112:437–442

    Article  Google Scholar 

  6. Challoner AVJ (1979) Photoelectric plethysmography for estimating cutaneous blood flow. In: Rolfe P (ed) Non-invasive physiological measurements, vol. 1. Academic, London, pp. 125–151

  7. Conaghan PG, Vanharanta H, Dieppe PA (2005) Is progressive osteoarthritis an atheromatous vascular disease? Ann Rheum Dis 64:1539–1541

    Article  Google Scholar 

  8. Dye SF (1993) Imaging of the knee. Orthop Rev 22:901

    Google Scholar 

  9. Dye SF, Campagna-Pinto D, Dye CC, Shifflett S, Eiman T (2003) Soft-tissue anatomy anterior to the patella. J Bone Joint Surg Am 85:1012–1017

    Google Scholar 

  10. Fujii M, Nakajima K, Sakamoto K, Kanai H (1999) Orientation and deformation of erythrocytes in flowing blood. Ann N Y Acad Sci 873:245–261

    Article  Google Scholar 

  11. Gelfer Y, Pinkas L, Horne T, Halperin N, Alk D, Robinson D (2003) Symptomatic transient patellar ischemia following total knee replacement as detected by scintigraphy. A prospective, randomized, double-blind study comparing the mid-vastus to the medial para-patellar approach. Knee 10:341–345

    Article  Google Scholar 

  12. Graaf R, Dassel A, Koeölink M, de Mul F, Aarnoudse J, Zilstra W (1993) Optical properties of human dermis in vitro and in vivo. Appl Opt 32:435–437

    Article  Google Scholar 

  13. Groothuis JT, van Vliet L, Kooijman M, Hopman MT (2003) Venous cuff pressures from 30 mmHg to diastolic pressure are recommended to measure arterial inflow by plethysmography. J Appl Physiol 95:342–347

    Google Scholar 

  14. Hughes SS, Cammarata A, Steinmann SP, Pellegrini VD (1998) Effect of standard total knee arthroplasty surgical dissection on human patellar blood flow in vivo: an investigation using laser Doppler flowmetry. J South Orthop Assoc 7:198–204

    Google Scholar 

  15. Iida S, Harada Y, Ikenoue S, Moriya H (1999) Measurement of bone marrow blood volume in the knee by position emission tomography. J Orthop Sci 4:216–222

    Article  Google Scholar 

  16. Kamal A, Harness J, Irving G, Mearns A (1989) Skin photoplethysmography—a review. Comput Methods Programs Biomed 28:257–269

    Article  Google Scholar 

  17. Larsen PD, Hary M, Thiruchelvam M, Galletly DC (1997) Spectral analysis of AC and DC components of the pulse photoplethysmograph at rest and during induction of anaesthesia. Int J Clin Monit Comput 14:89–95

    Article  Google Scholar 

  18. Lindberg LG, Öberg PÅ (1991) Photoplethysmography. Part 2. Influence of light source wavelength. Med Biol Eng Comput 29:48–54

    Article  Google Scholar 

  19. Lindberg LG, Öberg PÅ (1993) Optical properties of blood in motion. Opt Eng 32:253–257

    Article  Google Scholar 

  20. Loaiza LA, Yamaguchi S, Ito M, Ohshima N (2002) Electro-acupuncture stimulation to muscle afferents in anesthetized rats modulates the blood flow to the knee joint through autonomic reflexes and nitric oxide. Auton Neurosci 97:103–109

    Article  Google Scholar 

  21. Lustig JP, London D, Dor BL, Yanko R (2003) Ultrasound identification and quantitative measurement of blood supply to the anterior part of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 96:625–629

    Article  Google Scholar 

  22. Miwa Z, Ikawa M, Iijima H, Saito M, Takagi Y (2002) Pulpal blood flow in vital and nonvital young permanent teeth measured by transmitted-light photoplethysmography: a pilot study. Pediatr Dent 24:594–598

    Google Scholar 

  23. Nitzan M, de Boer H, Turivnenko S, Babchenko A, Sapoznikov D (1994) Power spectrum analysis of spontaneous fluctuations in the photoplethysmographic signal. J Basic Clin Physiol Pharmacol 5:269–276

    Google Scholar 

  24. Nitzan M, Babchenko A, Khanokh B (1999) Very low frequency variability in arterial blood pressure and blood volume pulse. Med Biol Eng Comput 37:54–58

    Article  Google Scholar 

  25. Notzli HP, Swiontkowski MF, Thaxter ST, Carpenter GK, Wyatt R (1989) Laser Doppler flowmetry for bone flow measurements: helium–neon laser light attenuation and depth of perfusion assessment. J Orthop Res 7:413–424

    Article  Google Scholar 

  26. Rakusan K, Ehrenburg I, Gulyaeva N, Tkatchouk E (1999) The effect of intermittent normobaric hypoxia on vascularization of human myometrium. Microvasc Res 58:200–203

    Article  Google Scholar 

  27. Reynolds KJ, Moyle JT, Gale LB, Sykes MK, Hahn CE (1992) In vitro performance test system for pulse oximeters. Med Biol Eng Comput 30:629–635

    Article  Google Scholar 

  28. Sakamoto K, Kanai H (1979) Electrical characteristics of flowing blood. IEEE Trans Biomed Eng 26:686–695

    Article  Google Scholar 

  29. Sandberg M, Lindberg LG, Gerdle B (2004) Peripheral effects of needle stimulation (acupuncture) on skin and muscle blood flow in fibromyalgia. Eur J Pain 8:163–171

    Article  Google Scholar 

  30. Sandberg M, Zhang Q, Styf J, Gerdle B, Lindberg LG (2005) Non-invasive monitoring of muscle blood perfusion by photoplethysmography: evaluation of a new application. Acta Physiol Scand 183:335–343

    Article  Google Scholar 

  31. Scapinelli R (1967) Blood supply to the human patellae. J Bone Joint Surg Br 49:563–570

    Google Scholar 

  32. Wilkinson IB, Webb DJ (2001) Venous occlusion plethysmography in cardiovascular research: methodology and clinical applications. Br J Clin Pharmacol 52:631–646

    Article  Google Scholar 

  33. Zhang Q, Lindberg LG, Kadefors R, Styf J (2001) A non-invasive measure of changes in blood flow of the human anterior tibial muscle. Eur J Appl Physiol 85:567–571

    Article  Google Scholar 

Download references

Acknowledgments

The authors wish to thank Per Sveider and Bengt Ragnemalm for technical assistance, Iréne Lund for statistical advice, and Erik Lundeberg for preparing some of the illustrations.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jan Näslund.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Näslund, J., Pettersson, J., Lundeberg, T. et al. Non-invasive continuous estimation of blood flow changes in human patellar bone. Med Bio Eng Comput 44, 501–509 (2006). https://doi.org/10.1007/s11517-006-0070-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11517-006-0070-0

Keywords

Navigation