A mechanostatistical approach to cortical bone remodelling: an equine model

Computational Analysis of Bone Remodeling in the Proximal Tibia Under Electrical Stimulation Considering the Piezoelectric Properties

The piezoelectricity of bone is known to play a crucial role in bone adaptation and remodeling. The application of an external stimulus such as mechanical strain or electric field has the potential to enhance bone formation and implant osseointegration. Therefore, in the present study, the objective is to investigate bone remodeling under electromechanical stimulation as a step towards establishing therapeutic strategies. For the first time, piezoelectric bone remodeling in the human proximal tibia under electro-mechanical loads was analyzed using the finite element method in an open-source framework. The predicted bone density distributions were qualitatively and quantitatively assessed by comparing with the computed tomography (CT) scan and the bone mineral density (BMD) calculated from the CT, respectively. The effect of model parameters such as uniform initial bone density and reference stimulus on the final density distribution was investigated. Results of the parametric study showed that for different values of initial bone density the model predicted similar but not identical final density distribution. It was also shown that higher reference stimulus value yielded lower average bone density at the final time. The present study demonstrates an increase in bone density as a result of electrical stimulation. Thus, to minimize bone loss, for example, due to physical impairment or osteoporosis, mechanical loads during daily physical activities could be partially replaced by therapeutic electrical stimulation.

Finite element analysis of bone remodelling with piezoelectric effects using an open-source framework

Bone tissue exhibits piezoelectric properties and thus is capable of transforming mechanical stress into electrical potential. Piezoelectricity has been shown to play a vital role in bone adaptation and remodelling processes. Therefore, to better understand the interplay between mechanical and electrical stimulation during these processes, strain-adaptive bone remodelling models without and with considering the piezoelectric effect were simulated using the Python-based open-source software framework. To discretise numerical attributes, the finite element method (FEM) was used for the spatial variables and an explicit Euler scheme for the temporal derivatives. The predicted bone apparent density distributions were qualitatively and quantitatively evaluated against the radiographic scan of a human proximal femur and the bone apparent density calculated using a bone mineral density (BMD) calibration phantom, respectively. Additionally, the effect of the initial bone density on the resulting predicted density distribution was investigated globally and locally. The simulation results showed that the electrically stimulated bone surface enhanced bone deposition and these are in good agreement with previous findings from the literature. Moreover, mechanical stimuli due to daily physical activities could be supported by therapeutic electrical stimulation to reduce bone loss in case of physical impairment or osteoporosis. The bone remodelling algorithm implemented using an open-source software framework facilitates easy accessibility and reproducibility of finite element analysis made.

Remodelling of trabecular bone in human distal tibia: A model based on an in-vivo HR-pQCT study

An abnormal remodelling process of bones can lead to various bone disorders, such as osteoporosis, making them prone to fracture. Simulations of load-induced remodelling of trabecular bone were used to investigate its response to mechanical signal. However, the role of mechanostat in trabecular-bone remodelling has not yet been investigated in simulations underpinned by a longitudinal in-vivo study in humans. In this work, a finite-element model based on a 6-month longitudinal in-vivo HR-pQCT study was developed and validated to investigate the effect of mechanical stimuli on bone remodelling. The simulated changes in microstructural parameters and density of trabecular bone were compared with respective experimental results. A maximum principal strain (MPS) and a maximum principal strain gradient (∇MPS) were used as mechanical signals to drive a five-stage mechanostat remodelling model, including additional over-strain and damage stages. It was found that the density distribution varied with the studied mechanical signals, along with decreasing with time levels of bone volume fraction BV/TV, trabecular thickness Tb.Th and bone surface area Tb.BS as well as increased trabecular separation Tb.Sp. Among these parameters, BV/TV and Tb.Th together with the bone-remodelling parameters from the MPS model demonstrated a significant correlation with the experimental data. The developed model provides a good foundation for further development and investigation of the relationships between mechanical loading and human-bone microarchitecture.

A first comparison of bone histomorphometry in extant domestic horses (Equus caballus) and a Pleistocene Indian wild horse (Equus namadicus)

The microstructural features of the tissue of long bones subjected to different biomechanical stresses could be a helpful tool for a better understanding of locomotor behavior in extant and extinct mammals, including equids. However, few researches have attempted to describe the bone tissue of extinct horses. In our study, we analyze and compare the histomorphometric features of the bone tissue in extant modern horses, Equus caballus, and Equus namadicus, a Pleistocene Indian extinct wild horse. The number, position, and size of the osteons and Haversian canals of the bone tissue, classifiable as dense Haversian tissue, were considered for the comparison. The results obtained highlight some differences between the analyzed species, E. caballus having fewer and bigger osteons than E. namadicus. The microstructural differences may depend on the different lifestyles and environmental conditions characterizing the two species. The results obtained suggest that comparing the biomechanical properties of extinct and modern horse species may provide indirect information on their paleoenvironment.

A surrogate mechanostatistical microstructural model to inform whole hip cortical bone remodelling

Multiscale models of bone remodelling which incorporate clinically important features at a wide range of spatial scales are computationally intractable. In addition, there is a large gap in existing bone remodelling literature which deals with Haversian-level cortical bone remodelling behaviour and its effect on whole organ bone strength. In this study, we present an integration between continuum mechanics and surrogate modelling as an efficient circumvention to the problem of intractability, linked with an intricate 3D cortical bone remodelling algorithm which captures realistic microanatomical features at the Haversian level. The surrogate model predicted clear differentiation in long-term bone strength changes in clinically significant cases with extremely high computational efficiency.

The challenges of promoting osteogenesis in segmental bone defects and osteoporosis

Conventional clinical management of complex bone healing scenarios continues to result in 5-10% of fractures forming non-unions. Additionally, the aging population and prevalence of osteoporosis-related fractures necessitate the further exploration of novel ways to augment osteogenesis in this special population. This review focuses on the current clinical modalities available, and the ongoing clinical and pre-clinical research to promote osteogenesis in segmental bone defects, delayed unions, and osteoporosis. In summary, animal models of fracture repair are often small animals as historically significant large animal models, like the dog, continue to gain favor as companion animals. Small rodents have well-documented limitations in comparing to fracture repair in humans, and few similarities exist. Study design, number of studies, and availability of funding continue to limit large animal studies. Osteoinduction with rhBMP-2 results in robust bone formation, although long-term quality is scrutinized due to poor bone mineral quality. PTH 1-34 is the only FDA approved osteo-anabolic treatment to prevent osteoporotic fractures. Limited to 2 years of clinical use, PTH 1-34 has further been plagued by dose-related ambiguities and inconsistent results when applied to pathologic fractures in systematic human clinical studies. There is limited animal data of PTH 1-34 applied locally to bone defects. Gene therapy continues to gain popularity among researchers to augment bone healing. Non-integrating viral vectors and targeted apoptosis of genetically modified therapeutic cells is an ongoing area of research. Finally, progenitor cell therapies and the content variation of patient-side treatments (e.g., PRP and BMAC) are being studied. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1559-1572, 2018.

Mathematical modelling of bone adaptation of the metacarpal subchondral bone in racehorses

In Thoroughbred racehorses, fractures of the distal limb are commonly catastrophic. Most of these fractures occur due to the accumulation of fatigue damage from repetitive loading, as evidenced by microdamage at the predilection sites for fracture. Adaptation of the bone in response to training loads is important for fatigue resistance. In order to better understand the mechanism of subchondral bone adaptation to its loading environment, we utilised a square root function defining the relationship between bone volume fraction [Formula: see text] and specific surface [Formula: see text] of the subchondral bone of the lateral condyles of the third metacarpal bone (MCIII) of the racehorse, and using this equation, developed a mathematical model of subchondral bone that adapts to loading conditions observed in vivo. The model is expressed as an ordinary differential equation incorporating a formation rate that is dependent on strain energy density. The loading conditions applied to a selected subchondral region, i.e. volume of interest, were estimated based on joint contact forces sustained by racehorses in training. For each of the initial conditions of [Formula: see text] we found no difference between subsequent homoeostatic [Formula: see text] at any given loading condition, but the time to reach equilibrium differed by initial [Formula: see text] and loading condition. We found that the observed values for [Formula: see text] from the mathematical model output were a good approximation to the existing data for racehorses in training or at rest. This model provides the basis for understanding the effect of changes to training strategies that may reduce the risk of racehorse injury.

Multiscale musculoskeletal modelling, data-model fusion and electromyography-informed modelling

This paper proposes methods and technologies that advance the state of the art for modelling the musculoskeletal system across the spatial and temporal scales; and storing these using efficient ontologies and tools. We present population-based modelling as an efficient method to rapidly generate individual morphology from only a few measurements and to learn from the ever-increasing supply of imaging data available. We present multiscale methods for continuum muscle and bone models; and efficient mechanostatistical methods, both continuum and particle-based, to bridge the scales. Finally, we examine both the importance that muscles play in bone remodelling stimuli and the latest muscle force prediction methods that use electromyography-assisted modelling techniques to compute musculoskeletal forces that best reflect the underlying neuromuscular activity. Our proposal is that, in order to have a clinically relevant virtual physiological human, (i) bone and muscle mechanics must be considered together; (ii) models should be trained on population data to permit rapid generation and use underlying principal modes that describe both muscle patterns and morphology; and (iii) these tools need to be available in an open-source repository so that the scientific community may use, personalize and contribute to the database of models.