Recurring Meeting of Cleveland Clinic Core Team

Date: November 25, 2014

Time: 10:30 AM EST

Means: In person meeting

Attendees:

1. Ahmet Erdemir
2. Craig Bennetts
3. Snehal Chokhandre
4. Robb Colbrunn
5. Tara Bonner

Agenda:

1. Discuss immediate action items from the last meeting.
2. Discuss preparations for oks003 testing.
3. Decide immediate action items for the next meeting.
4. Other.

Immediate Action Items:

• Ahmet
  • If necessary, before oks003 testing, update specifications based on recommendations provided in previous Open Knee(s) specimen pages.
• Robb
  • Check whether freezers are in emergency power supply and explore contingency plans in case of a freezer or power failure.

  • Explore a mechanism to report the version of SimVitro used to collect each data set during joint testing; for now provide the current version of the software manually.

  • Update SimVitro to accommodate gravity compensation of left knees.

• Snehal
  • Schedule a meeting with Andrew (Derwin Laboratory), Tony (Prototype Shop), and Robb to build another tissue thickness measurement system.
  • Contact Jack Andrish to schedule dissection.
  • Contact Shannon (University Hospitals) to confirm scheduling of imaging.
• Snehal and Tara
  • Evaluate the laboratory supplies for oks003 testing readiness.

Notes:

1. Discuss immediate action items from the last meeting.
   • Snehal contacted Science Care (specimen supplier) about the health history of oks005. There were no visible problems. In relation, Ahmet talked to Jack Andrish (physician in Advisory Board). He advised to use universal precautions irrespective of the specimen health care history.
   • Snehal completed re-testing of all compression samples for oks004. She will start tensile tests. She will work with Tara during tensile tests to let her practice tissue testing specifications.
   • Snehal contacted Andrew (from Derwin Laboratory) to ask for design specifications/drawings for tissue thickness testing system. She did not receive a response yet. Robb suspects that they may not have any information as the system was inherited from another institution. Snehal will schedule a meeting with all relevant personnel to explore the possibility to build another system.

   • Robb will provide documentation on SimVitro configuration files. The team had a brief discussion to clarify the extent of the information to be supplied.

   • All team members still need to upload pictures in laboratory cameras and personal devices to relevant Open Knee(s) specimen data folders.
2. Discuss preparations for oks003 testing.
   • Before oks003 testing starts, Ahmet will go all previous specimen pages to update specifications based on recommendations provided there.

   • This is the first left knee to be tested using Open Knee(s) protocols. There may be experimental issues and deviations associated with this. In relation, Robb needs to implement gravity compensation for left knees. It may be useful to note the version of SimVitro used for testing of each Open Knee(s) specimen.

   • Snehal and Tara will go over the laboratory supplies to ensure the team has everything needed for testing. Snehal will also contact Jack Andrish for dissection, and Shannon (from University Hospitals) to confirm MRI scheduling.
   • Workload and schedule for joint level testing was discussed.
     • Snehal will take knee out at 9:00 AM on Sunday (November 30, 2014)
     • Specimen preparation will start at 9:00 AM on Monday led by Tara (December 1, 2014)
     • The team will meet at 8:30 AM on Tuesday for imaging preparation led by Craig (December 2, 2014)
     • The specimen will be aimed to be ready for tibiofemoral joint testing (led by Tara) at 1:00 PM on Tuesday (December 2, 2014)
     • Ahmet and Robb will meet, early morning on Wednesday (7:00 AM) to start patellofemoral joint testing (December 3, 2014). Ahmet will seal the sensor on Monday (4:00 PM, November 30) and Robb will the pressure sensor on Tuesday morning when others are at imaging (10:00 AM, December 2, 2014)
     • Tara needs to leave at 3:30 PM on Monday (December 1, 2014) for class. Ahmet has multiple commitments, on Monday (December 1, 2014 during 1:00 - 3:00 PM) and on Tuesday (December 2, 2014 during 9:00 AM - 12:00 PM).
3. Decide immediate action items for the next meeting.
   • See Immediate Action Items above.
4. Other.
   • The group talked about contingency plans in case of a freezer failure. Open Knee(s) tissue samples are curated in a manner to develop a physical tissue bank for future mechanical testing. A freezer (or power) failure may render these tissues not suitable for mechanical testing. Robb will check if freezer have emergency backup power. There is a dry ice supply at the fourth floor of the Department of Biomedical Engineering (Cleveland Clinic). This resource may be used in case of an emergency, when the tissue samples need to be kept frozen.
   • Ahmet provided a summary of major remarks from the Advisory Board meetings:
     • Last week, Ahmet met with Jack Andrish and Paul Saluan (physicians) and had phone conversations with Trent Guess, Rami Korhonen, and Yasin Dhaher (knee biomechanics scientists/engineers). All the members of the Advisory Board seem to be impressed by the Open Knee(s) team handling of the logistically challenging experimentation procedures.
     • Jack Andrish noted that the elderly knee specimen, even when they are considered healthy, may have cartilage wear. It may be useful to come up with a compartmental and overall score to describe the health status of the knee. This can be obtained from MRI and reported for each knee. Carl Winalski (radiologist) may be able to help in that regard. Jack is willing to help with dissection and he is available most Wednesdays. He is also interested in meeting to review the data.
     • Paul Saluan is willing to help with the dissection. He is not necessarily available but may be able to send residents or fellows to assist the Open Knee(s) team. He has a sincere interest in a modeling and simulation use case incorporating pivot shift loading.
     • Trent Guess mentioned the lack of material properties information for the transverse ligament, which connects the anterior regions of menisci. The team may want to pay attention to this tissue structure during dissections.
     • Rami Korhonen noted the potential importance of subchondral bone properties. The team already keeps tibia and femur bones in freezers, which may later be used for mechanical characterization. Rami also emphasized the potential need to grade the menisci during dissection as in their experience a healthy looking meniscus in the MRI may have visible or mechanical degradation.
     • Yasin Dhaher expressed his interest in cartilage morphology, specifically its thickness map. Ahmet and Yasin may explore a spin-off project to collaborate in this regard.

   • Ahmet mentioned his experience with the updated version of Open Knee(s) - Generation 1 model when using FEBio version 2. There has been segmentation fault issues. Steve Maas (from University of Utah) implemented catching of NaNs generated during the simulations, which seemed to resolve this problem.