Links between mechanical behavior of cancellous bone and its microstructural properties under dynamic loading

Application of Micro-Computed Tomography for the Estimation of the Post-Mortem Interval of Human Skeletal Remains

It is challenging to estimate the post-mortem interval (PMI) of skeletal remains within a forensic context. As a result of their interactions with the environment, bones undergo several chemical and physical changes after death. So far, multiple methods have been used to follow up on post-mortem changes. There is, however, no definitive way to estimate the PMI of skeletal remains. This research aimed to propose a methodology capable of estimating the PMI using micro-computed tomography measurements of 104 human skeletal remains with PMIs between one day and 2000 years. The present study indicates that micro-computed tomography could be considered an objective and precise method of PMI evaluation in forensic medicine. The measured parameters show a significant difference regarding the PMI for Cort Porosity p < 0.001, BV/TV p > 0.001, Mean1 p > 0.001 and Mean2 p > 0.005. Using a machine learning approach, the neural network showed an accuracy of 99% for distinguishing between samples with a PMI of less than 100 years and archaeological samples.

Effect of Nesfatin-1 on Rat Humerus Mechanical Properties under Quasi-Static and Impact Loading Conditions

The investigations on the response of bone tissue under different loading conditions are important from clinical and engineering points of view. In this paper, the influence of nesfatin-1 administration on rat humerus mechanical properties was analyzed. The classical three-point bending and impact tests were carried out for three rat bone groups: control (SHO), the humerus of animals under the conditions of established osteopenia (OVX), and bones of rats receiving nesfatin-1 after ovariectomy (NES). The experiments proved that the bone strength parameters measured under various mechanical loading conditions increased after the nesfatin-1 administration. The OVX bones were most susceptible to deformation and had the smallest fracture toughness. The SEM images of humerus fracture surface in this group showed that ovariectomized rats had a much looser bone structure compared to the SHO and NES females. Loosening of the bone structure was also confirmed by the densitometric and qualitative EDS analysis, showing a decrease in the OVX bones’ mineral content. The samples of the NES group were characterized by the largest values of maximum force obtained under both quasi-static and impact conditions. The energies absorbed during the impact and the critical energy for fracture (from the three-point bending test) were similar for the SHO and NES groups. Statistically significant differences were observed between the mean F_{i max} values of all analyzed sample groups. The obtained results suggest that the impact test was more sensitive than the classical quasi-static three-point bending one. Hence, F_{i max} could be used as a parameter to predict bone fracture toughness.

Is There an Association Between Bone Microarchitecture and Fracture in Patients who were Treated for High-grade Osteosarcoma? A Controlled Study at Long-term Follow-up Using High-resolution Peripheral Quantitative CT

BACKGROUND

Neoadjuvant chemotherapy in patients with primary osteosarcoma improves survival rates, but it also causes side effects in various organs including bone. Low bone mineral density (BMD) can occur owing partly to chemotherapy or limited mobility. This can cause a higher risk of fractures compared with those who do not receive such treatment. Changes in BMD alone cannot explain the propensity of fractures. Studying microarchitectural changes of bone might help to understand the effect.

QUESTIONS/PURPOSES

(1) Do patients who were treated for osteosarcoma (more than 20 years previously) have low BMD? (2) Do these patients experience more fractures than controls who do not have osteosarcoma? (3) What differences in bone microarchitecture are present between patients treated for high-grade osteosarcoma and individuals who have never had osteosarcoma?

METHODS

We contacted 48 patients who were treated for osteosarcoma and who participated in an earlier study. These patients underwent multimodal treatment including chemotherapy more than 20 years ago. Of the original patient group, 60% (29 of 48) were missing, leaving 40% (19 of 48) available for inclusion in this study; all 19 agreed to participate. There were nine men and 10 women with a mean age of 46 ± 4 years and a mean time from surgery to examination of 28 ± 3 years. BMD was measured by dual-energy x-ray absorptiometry, and any fracture history was assessed using a questionnaire. Additionally, high-resolution peripheral quantitative CT was performed to compare the groups in terms of microarchitectural changes, such as cortical and trabecular area, cortical and trabecular thickness, cortical porosity, and endocortical perimeter. Participants in the control group were selected from a cohort consisting of a population-based random sample of 499 healthy adult women and men. Osteoporosis or low BMD was not an exclusion criterion for entering this study; however, the patients in the control group were selected based on a normal BMD (that is, T score > -1.0 at both the spine and hip). Also, the participants were matched based on age and sex. Differences between patients and controls were assessed using the Wilcoxon rank sum test for continuous variables and a chi-square test for categorical variables. A multiple regression analysis was performed. Model assumptions were checked using histograms and quantile-quantile plots of residuals.

RESULTS

Twelve of 19 patients who were treated for osteosarcoma had either osteopenia (eight patients) or osteoporosis (four patients). More patients with osteosarcoma reported sustaining fractures (11 of 19 patients) than did control patients (2 of 19 controls; p < 0.001). Among all microarchitectural parameters, only the endocortical perimeter was increased in patients compared with the control group (75 ± 15 mm versus 62 ± 18 mm; p = 0.04); we found no differences between the groups in terms of cortical and trabecular area, cortical and trabecular thickness, or cortical porosity.

CONCLUSION

Although patients who were treated for osteosarcoma had osteopenic or osteoporotic BMD and a higher proportion of patients experienced fractures than did patients in the control group, we could not confirm differences in microarchitectural parameters using high-resolution peripheral quantitative CT. Therefore, it seems that bone geometry and microstructural parameters are not likely the cause of the increased proportion of fractures observed in our patients who were treated for osteosarcoma. Until we learn more about the bone changes associated with chemotherapy in patients with osteosarcoma, we recommend that patients undergo regular BMD testing, and we recommend that physicians consider osteoporosis treatment in patients with low BMD. These data might provide the impetus for future multicenter prospective studies examining the association between chemotherapy and bone microarchitecture.

LEVEL OF EVIDENCE

Level III, therapeutic study.

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.

Simulation analysis of impact damage to the bone tissue surrounding a dental implant

Dental implant may suffer transient external impacts. To simulate the effect of impact forces on bone damage is very important for evaluation of damage and guiding treatment in clinics. In this study, an animal model was established by inserting an implant into the femoral condyle of New Zealand rabbit. Implant with good osseointegration was loaded with impact force. A three-dimensional finite element model was established based on the data of the animal model. Damage process to bone tissue was simulated with Abaqus 6.13 software combining dynamic mechanical properties of the femur. The characteristics of bone damage were analyzed by comparing the results of animal testing with numerical simulation data. After impact, cortical bone around the implant and trabecular at the bottom of the implant were prone to damage. The degree of damage correlated with the direction of loading and the magnitude of the impact. Lateral loading was most likely performed to damage cancellous bone. The stress wave formed by the impact force can damage the implant–bone interface and peri-implant trabeculae. The data from numerical simulations were consistent with data from animal experiments, highlighting the importance of a thorough examination and evaluation based on the patient’s medical history.

Comparison of structure and composition of a fossil Champsosaurus vertebra with modern Crocodylidae vertebrae: A multi-instrumental approach

Information on the adaptation of bone structures during evolution is rare since histological data are limited. Micro- and nano-computed tomography of a fossilized vertebra from Champsosaurus sp., which has an estimated age of 70-73 million years, revealed lower porosity and higher bone density compared to modern Crocodylidae vertebrae. Mid-infrared reflectance and energy dispersive X-ray mapping excluded a petrification process, and demonstrated a typical carbonate apatite distribution, confirming histology in light- and electron microscopy of the preserved vertebra. As a consequence of this evolutionary process, the two vertebrae of modern Crocodylidae show reduced overall stiffness in the finite element analysis simulation compared to the fossilized Champsosaurus sp. vertebra, with predominant stiffness along the longitudinal z-axes.

Ontogenetic changes to bone microstructure in an archaeologically derived sample of human ribs

There is considerable variation in the gross morphology and tissue properties among the bones of human infants, children, adolescents, and adults. Using 18 known-age individuals (n_female  = 8, n_male  = 9, n_unknown  = 1; birth to 21 years old), from a well-documented cemetery collection, Spitalfields Christ Church, London, UK, this study explores growth-related changes in cortical and trabecular bone microstructure. Micro-CT scans of mid-shaft middle thoracic ribs are used for quantitative analysis. Results are then compared to previously quantified conventional histomorphometry of the same sample. Total area (Tt.Ar), cortical area (Ct.Ar), cortical thickness (Ct.Th), and the major (Maj.Dm) and minor (Min.Dm) diameters of the rib demonstrate positive correlations with age. Pore density (Po.Dn) increases, but age-related changes to cortical porosity (Ct.Po) appear to be non-linear. Trabecular thickness (Tb.th) and trabecular separation (Tb.Sp) increase with age, whereas trabecular bone pattern factor (Tb.Pf), structural model index (SMI), and connectivity density (Conn.D) decrease with age. Sex-based differences were not identified for any of the variables included in this study. Some samples display clear evidence of diagenetic alteration without corresponding changes in radiopacity, which compromises the reliability of bone mineral density (BMD) data in the study of past populations. Cortical porosity data are not correlated with two-dimensional measures of osteon population density (OPD). This suggests that unfilled resorption spaces contribute more significantly to cortical porosity than do the Haversian canals of secondary osteons. Continued research using complementary imaging techniques and a wide array of histological variables will increase our understanding of age- and sex-specific ontogenetic patterns within and among human populations.

An Investigation on the Correlation between the Mechanical Properties of Human Skull Bone, Its Geometry, Microarchitectural Properties, and Water Content

With increasingly detailed imaging and mechanical analysis, modalities need arises to update methodology and assessment criteria for skull bone analysis to understand how bone microarchitecture and the presence of attached tissues may affect the response to mechanical load. The main aim was to analyze the effect of macroscopic and microstructural features, as well as periosteal attachment, on the mechanical properties of human skull bone. Fifty-six skull specimens from ethanol-phenoxyethanol-embalmed cadavers were prepared from two human cadavers. Assuming symmetry of the skull, all samples from one-half each were stripped of periosteum and dura mater, while the soft tissues were kept intact on the remaining samples on the contralateral side. The specimens were analyzed using microcomputed tomography to assess trabecular connectivity density, total surface area, and volume ratio. The specimens were loaded under three-point bend tests until fracture with optical co-registration. The bone fragments were then lyophilized to measure their water content. With increasingly detailed imaging and mechanical analysis modalities, there is a need to update methodology and assessment criteria for skull bone analysis to understand how the bone microarchitecture and the presence of attached tissues may affect the response to mechanical load. The mechanical properties were negatively correlated to bone thickness and water content. Conversely, most microarchitectural features did not influence either mechanical parameter. The correlation between mechanical response data and morphologic properties remains similar between the results of embalmed tissues presented here and fresh osseous tissue from literature data. The findings presented here add to the existing methodology to assess human skull for research purposes. The interaction between most microarchitectural features in ethanol-phenoxyethanol-embalmed embalmed skull samples and bending stress appear to be minute.

Quasi-static and dynamic in vitro mechanical response of 3D printed scaffolds with tailored pore size and architectures

Scaffold-based Tissue Engineering represents the most promising approach for the regeneration of load bearing skeletal tissues, in particular bone and cartilage. Scaffolds play major role in this process by providing a physical template for cells to adhere and proliferate whilst ensuring an adequate biomechanical support at the defect site. Whereas the quasi static mechanical properties of porous polymeric scaffolds are well documented, the response of these constructs under high strain compressive rates remain poorly understood. Therefore, this study investigates, for the first time, the influence of pore size and geometry on the mechanical behaviour of Polycaprolactone (PCL) scaffolds under quasi static and dynamic conditions. 3D printed scaffolds with varied pore sizes and geometries were obtained using different filament distances (FD) and lay-down patterns, respectively. In particular, by fixing the lay-down pattern at 0/90° and varying the FD between 480 and 980 μm it was possible to generate scaffolds with square pores with dimensions in the range of 150-650 μm and porosities of 59-79%. On the other hand, quadrangular, hexagonal, triangular and complex pore geometries with constant porosity (approx. 70%) were obtained at a fixed FD of 680 μm and imposing four different lay-down patterns of 0/90, 0/60/120, 0/45/90/135 and 0/30/60/90/120/150°, respectively. The mechanical response of printed scaffolds was assessed under two different compression loading regimes spanning five distinct strain rates, from 10^-2 to 2000 s^-1, using two different apparatus: a conventional screw-driven testing machine (Instron 4483) and a Split Hopkinson pressure bar (SHPB) equipped with a set of A201 Flexi-force™ (FF) force sensors and a pulse shaper. Our results show that the mechanical properties of PCL scaffolds are not strain rate sensitive between 1300 and 2000 s^-1 and these strongly depend on the pore size (porosity) rather than pore geometry. Those findings are extremely relevant for the engineering of bone tissue scaffolds with enhanced mechanical stability by providing new data describing the mechanical response of these constructs at high strain rates as well as the at the transition between quasi static and dynamic regimes.

Quantitative study of the influence of swimming therapy on osteoporosis rat models based on synchrotron radiation computed tomogaphy

Osteoporosis is a bone disease with a variety of causes, leading to bone pain and fragility to fracture. Major treatment methods include nutrition therapy, exercise therapy, drug therapy and surgical treatment, among which exercise therapy, such as swimming, is the most effective. To investigate the optimal swimming therapy regime for postmenopausal women, the effects of eight weeks of different intensity swimming exercises were studied in rat models. After the swimming program, lumbar vertebrae were dissected from all the rats and scanned by synchrotron radiation computed tomography (SRCT). Histomorphometry analysis and finite-element analysis were carried out on the trabecular structure of the L4 lumbar based on the acquired SRCT slices. Histomorphometry analysis showed that swimming can alleviate the decrease in bone strength induced by estrogen deficiency, and moderate-intensity swimming was found to have the most significant effect.

Impact of Temporomandibular Joint Discectomy on Condyle Morphology: An Animal Study

PURPOSE

Temporomandibular disorders lead to parafunctional activity that may alter bone remodeling of mandibular components. This animal study aimed to assess the impact of temporomandibular joint discectomy on condylar bone microarchitecture.

MATERIALS AND METHODS

A total of 30 one-month-old Wistar rats were assessed and divided into 3 equal groups (2 test groups and 1 control group) of 10. The first test group underwent disc removal, the second test group underwent disc and condylar cartilage removal, and the 10 remaining rats were analyzed as sham-operated controls, following a split-mouth design. The rats were killed humanely 2 months after surgery, and the respective mandibles were scanned with micro-computed tomography for quantitative morphometric analysis.

RESULTS

There were significant differences among the 3 groups analyzed (disc removal, disc and condylar cartilage removal, and sham-operated control) for bone volume fraction (ratio of bone volume to total volume, P = .044), structure model index (P < .001), fractal dimension (P = .024), and porosity (P = .023). In addition, operated and contralateral nonoperated sides significantly differed for all variables in at least 1 of the test groups (P < .05) but not in the control group (P > .05).

CONCLUSIONS

Within the limitations of this study, our results suggest that discectomy may lead to alterations of the mandibular condylar morphology.

Quantitative study of osteoporosis model based on synchrotron radiation

To investigate the changes of different periods of primary osteoporosis, we made quantitative analysis of osteoporosis using synchrotron radiation computed tomography (SRCT), together with histomorphometry analysis and finite element analysis (FEA). Tibias, femurs and lumbar vertebras were dissected from sham-ovariectomy rats and ovariectomized rats suffering from osteoporosis at certain time points. The samples were scanned by SRCT and then FEA was applied based on reconstructed slices. Histomorphometry analysis showed that the structure of some trabecular in osteoporosis degraded as the bone volume decreased, for femurs, the bone volume fraction (BV/TV) decreased from 69% to 43%. That led to the increase of the thickness of trabecular separation (from 45.05μm to 97.09μm) and the reduction of the number of trabecular (from 7.99 mm(-1) to 5.97mm(-1)). Simulation of various mechanical tests indicated that, with the exacerbation of osteoporosis, the bones' ability of resistance to compression, bending and torsion gradually became weaker. The compression stiffness decreased from 1770.96 Fμm(-1) to 697.41 Fμm(-1), and it matched the histomorphometry analysis. This study suggested that the combination of both analysis could quantitatively analyze the bone strength in good accuracy.