Cortical bone tissue resists fatigue fracture by deceleration and arrest of microcrack growth

A review on experimental and numerical investigations of cortical bone fracture

This paper comprehensively reviews the various experimental and numerical techniques, which were considered to determine the fracture characteristics of the cortical bone. This study also provides some recommendations along with the critical review, which would be beneficial for future research of fracture analysis of cortical bone. Cortical bone fractures due to sports activities, climbing, running, and engagement in transport or industrial accidents. Individuals having different diseases are also at high risk of cortical bone fracture. It has been observed that osteon orientation influences cortical bone fracture toughness and fracture mechanisms. Apart from this, recent studies indicate that fracture parameters of cortical bone also depend on many factors such as age, sex, temperature, osteoporosis, orientation, location, loading condition, strain rate, and storage facility, etc. The cortical bone regains its fracture toughness due to various toughening mechanisms. Owing to these factors, several experimental, clinical, and numerical investigations have been carried out to determine the fracture parameters of the cortical bone. Cortical bone is the dense outer surface of the bone and contributes to 80%–82% of the skeleton mass. Cortical bone experiences load far exceeding body weight due to muscle contraction and the dynamics of motion. It is very important to know the fracture pattern, direction of fracture, location of the fracture, and toughening mechanism of cortical bone. A basic understanding of the different factors that affect the fracture parameters and fracture mechanisms of the cortical bone is necessary to prevent the failure and fracture of cortical bone. This review has summarized the advancement considered in the various experimental techniques and numerical methods to get complete information about the fracture mechanisms of cortical bone.

Damage analysis of human cortical bone under compressive and tensile loadings

Developing advanced fracture tools can increase the understanding of crack growth trajectories in human cortical bone. The present study investigates fracture micromechanics of human cortical bone under compressive and tensile loadings utilizing a phase field method. We construct two-dimensional finite element models from cortical microstructure of a human tibia cross section. We apply compression on the cortical bone models to create compressive microcracks. Then, we simulate the fracture of these models under tension to discover influential parameters on microcracks formation and post-yielding behavior. The results show that cement lines are susceptible sites to damage nucleation under compression rather than tension. The findings of this study also indicate a higher accumulation of initial damage (induced by compression) can lead to a lower microscopic stiffness as well as a less resistant material to damage initiation under tension. The simulations further indicate that the post-yielding properties (e.g., toughness) can be dependent on different variables such as morphological information of the osteons, the initial accumulation of microcracks, and the total length of cement lines.

Mesoscale bicontinuous networks in self-healing hydrogels delay fatigue fracture

Load-bearing biological tissues, such as muscles, are highly fatigue-resistant, but how the exquisite hierarchical structures of biological tissues contribute to their excellent fatigue resistance is not well understood. In this work, we study antifatigue properties of soft materials with hierarchical structures using polyampholyte hydrogels (PA gels) as a simple model system. PA gels are tough and self-healing, consisting of reversible ionic bonds at the 1-nm scale, a cross-linked polymer network at the 10-nm scale, and bicontinuous hard/soft phase networks at the 100-nm scale. We find that the polymer network at the 10-nm scale determines the threshold of energy release rate G0 above which the crack grows, while the bicontinuous phase networks at the 100-nm scale significantly decelerate the crack advance until a transition Gtran far above G0 In situ small-angle X-ray scattering analysis reveals that the hard phase network suppresses the crack advance to show decelerated fatigue fracture, and Gtran corresponds to the rupture of the hard phase network.

Stress concentrations and bone microdamage: John Currey's contributions to understanding the initiation and arrest of cracks in bone

The microarchitecture of bone tissue presents many features that could act as stress concentrators for the initiation of bone microdamage. This was first identified by John Currey in a seminal paper in 1962 in which he presented the mechanical and biological evidence for stress concentrations at the bone surface, within the bone through the action of stiffness differentials between architectural features including between lamellae, and at the level of the lacunar and canalicular walls. Those early observations set the stage to consider how microscopic damage to bone tissue might affect the properties of bone at a time when most in the scientific community dismissed microcracks in bone as artifact. Evidence collected in the nearly 60 years since those important initial observations suggest that some of these architectural features in bone tissue are more effective as crack arrestors than as crack initiators. Sites of higher mineralization in the bone matrix, particularly interstitial sites in both cortical and trabecular bone, may serve preferentially as locations for crack initiation, whereas those boundaries identified by Currey as both stress concentrators and stress arrestors are more effective at stopping cracks than at initiating them.

Raman Biomarkers Are Associated with Cyclic Fatigue Life of Human Allograft Cortical Bone

BACKGROUND

Structural bone allografts are an established treatment method for long-bone structural defects resulting from such conditions as traumatic injury and sarcoma. The functional lifetime of structural allografts depends on resistance to cyclic loading (cyclic fatigue life), which can lead to fracture at stress levels well below the yield strength. Raman spectroscopy biomarkers can be used to non-destructively assess the 3 primary components of bone (collagen, mineral, and water), and may aid in optimizing allograft selection to decrease fatigue fracture risk. We studied the association of Raman biomarkers with the cyclic fatigue life of human allograft cortical bone.

METHODS

Twenty-one cortical bone specimens were machined from the femoral diaphyses of 4 human donors (a 63-year old man, a 61-year-old man, a 51-year-old woman, and a 48-year-old woman) obtained from the Musculoskeletal Transplant Foundation. Six Raman biomarkers were analyzed: collagen disorganization, mineral maturation, matrix mineralization, and 3 water compartments. The specimens underwent cyclic fatigue testing under fully reversed conditions (35 and 45 MPa), during which they were tested to fracture or to 30 million cycles ("runout"), simulating 15 years of moderate activity. A tobit censored linear regression model for cyclic fatigue life was created.

RESULTS

The multivariate model explained 60% of the variance in the cyclic fatigue life (R = 0.604, p < 0.001). Increases in Raman biomarkers for disordered collagen (coefficient: -2.74×10, p < 0.001) and for loosely collagen-bound water compartments (coefficient: -2.11×10, p < 0.001) were associated with a decreased cyclic fatigue life. Increases in Raman biomarkers for mineral maturation (coefficient: 3.50×10, p < 0.001), matrix mineralization (coefficient: 2.32×10, p < 0.001), tightly collagen-bound water (coefficient: 1.19×10, p < 0.001), and mineral-bound water (coefficient: 3.27×10, p < 0.001) were associated with an increased cyclic fatigue life. Collagen disorder accounted for 44% of the variance in the cyclic fatigue life, mineral maturation accounted for 6%, and all bound water compartments accounted for 3%.

CONCLUSIONS

Increasing baseline collagen disorder was associated with a decreased cyclic fatigue life and had the strongest correlation with the cyclic fatigue life of human cortical donor bone. This model should be prospectively validated.

CLINICAL RELEVANCE

Raman analysis is a promising tool for the non-destructive evaluation of structural bone allograft quality for load-bearing applications.

Interaction of Microcracks and Tissue Compositional Heterogeneity in Determining Fracture Resistance of Human Cortical Bone

Recent studies demonstrated an association between atypical femoral fracture (AFF) and long-term bisphosphonate (BP) use for osteoporosis treatment. Due to BP treatment, bone undergoes alterations including increased microcrack density and reduced tissue compositional heterogeneity. However, the effect of these changes on the fracture response of bone is not well understood. As a result, the goal of the current study is to evaluate the individual and combined effects of microcracks and tissue compositional heterogeneity on fracture resistance of cortical bone using finite element modeling (FEM) of compact tension (CT) specimen tests with varying microcrack density, location, and clustering, and material heterogeneity in three different bone samples. The simulation results showed that an increase in microcrack density improved the fracture resistance irrespective of the local material property heterogeneity and microcrack distribution. A reduction in material property heterogeneity adversely affected the fracture resistance in models both with and without microcracks. When the combined changes in microcrack density and tissue material property heterogeneity representing BP treatment were evaluated, the models corresponding to BP-treated bone demonstrated reduced fracture resistance. The simulation results also showed that although microcrack location and clustering, and microstructure significantly influenced fracture resistance, the trends observed on the effect of microcrack density and tissue material property heterogeneity did not change. In summary, these results provide new information on the interaction of microcracks, tissue material property heterogeneity, and fracture resistance and may improve the understanding of the influence of mechanical changes due to prolonged BP use on the fracture behavior of cortical bone.

Mechanical Characterization of Bone: State of the Art in Experimental Approaches-What Types of Experiments Do People Do and How Does One Interpret the Results?

PURPOSE OF REVIEW

The mechanical integrity of bone is determined by the direct measurement of bone mechanical properties. This article presents an overview of the current, most common, and new and upcoming experimental approaches for the mechanical characterization of bone. The key outcome variables of mechanical testing, as well as interpretations of the results in the context of bone structure and biology are also discussed.

RECENT FINDINGS

Quasi-static tests are the most commonly used for determining the resistance to structural failure by a single load at the organ (whole bone) level. The resistance to crack initiation or growth by fracture toughness testing and fatigue loading offers additional and more direct characterization of tissue material properties. Non-traditional indentation techniques and in situ testing are being increasingly used to probe the material properties of bone ultrastructure. Destructive ex vivo testing or clinical surrogate measures are considered to be the gold standard for estimating fracture risk. The type of mechanical test used for a particular investigation depends on the length scale of interest, where the outcome variables are influenced by the interrelationship between bone structure and composition. Advancement in the sensitivity of mechanical characterization techniques to detect changes in bone at the levels subjected to modifications by aging, disease, and/or pharmaceutical treatment is required. As such, a number of techniques are now available to aid our understanding of the factors that contribute to fracture risk.

Material heterogeneity, microstructure, and microcracks demonstrate differential influence on crack initiation and propagation in cortical bone

The recent studies have shown that long-term bisphosphonate use may result in a number of mechanical alterations in the bone tissue including a reduction in compositional heterogeneity and an increase in microcrack density. There are limited number of experimental and computational studies in the literature that evaluated how these modifications affect crack initiation and propagation in cortical bone. Therefore, in this study, the entire crack growth process including initiation and propagation was simulated at the microscale by using the cohesive extended finite element method. Models with homogeneous and heterogeneous material properties (represented at the microscale capturing the variability in material property values and their distribution) as well as different microcrack density and microstructure were compared. The results showed that initiation fracture resistance was higher in models with homogeneous material properties compared to heterogeneous ones, whereas an opposite trend was observed in propagation fracture resistance. The increase in material heterogeneity level up to 10 different material property sets increased the propagation fracture resistance beyond which a decrease was observed while still remaining higher than the homogeneous material distribution. The simulation results also showed that the total osteonal area influenced crack propagation and the local osteonal area near the initial crack affected the crack initiation behavior. In addition, the initiation fracture resistance was higher in models representing bisphosphonate treated bone (low material heterogeneity, high microcrack density) compared to untreated bone models (high material heterogeneity, low microcrack density), whereas an opposite trend was observed at later stages of crack growth. In summary, the results demonstrated that tissue material heterogeneity, microstructure, and microcrack density influenced crack initiation and propagation differently. The findings also elucidate how possible modifications in material heterogeneity and microcrack density due to bisphosphonate treatment may influence the initiation and propagation fracture resistance of cortical bone.

Effect of athletic fatigue damage and the associated bone targeted remodeling in the rat ulna

Background

Fatigue damage of the long bones is prevalent in running athletes and military recruits due to vigorous mid- and long-term physical activity. The current study attempted to know the features of bony athletic fatigue damage and to explore the mechanism of fatigue damage repair through bone targeted remodeling process.

Methods

Right ulnae of the Wistar rats were fatigue loaded on an INSTRON 5865 to construct the athletic fatigue damage model, and several time points (i.e. experimental days: 0, 7, 13 and 19) were selected to simulate physiological status, preliminary, mid-term and perennial stage during continuous high-intensive training, respectively. The multi-level responses of rat ulnae under the athletic fatigue loading, including cellular protein expression, micro damage or micro-crack and macro mechanical properties, were tested and statistically analyzed.

Results

Wistar rats, subjected to the athletic fatigue loading protocol, experienced a decrease of ulna fatigue mechanical properties and an active bone resorption of the loaded ulnae in the early stage, whereafter, a hyperactive bone formation and significant improvements of ulnae fatigue mechanical properties were detected. However, a deterioration of quasi-static mechanical properties in the subsequent period implied limitations of bone remodeling to maintain the bearing capacity of bone during long-term strenuous exercise.

Conclusions

In summary, after athletic fatigue loading, bone targeted remodeling is activated and proceeds to repair fatigue damage, but only to a certain extent.

Long-term effects of bisphosphonate therapy: perforations, microcracks and mechanical properties

Osteoporosis is characterised by trabecular bone loss resulting from increased osteoclast activation and unbalanced coupling between resorption and formation, which induces a thinning of trabeculae and trabecular perforations. Bisphosphonates are the frontline therapy for osteoporosis, which act by reducing bone remodelling, and are thought to prevent perforations and maintain microstructure. However, bisphosphonates may oversuppress remodelling resulting in accumulation of microcracks. This paper aims to investigate the effect of bisphosphonate treatment on microstructure and mechanical strength. Assessment of microdamage within the trabecular bone core was performed using synchrotron X-ray micro-CT linked to image analysis software. Bone from bisphosphonate-treated fracture patients exhibited fewer perforations but more numerous and larger microcracks than both fracture and non-fracture controls. Furthermore, bisphosphonate-treated bone demonstrated reduced tensile strength and Young's Modulus. These findings suggest that bisphosphonate therapy is effective at reducing perforations but may also cause microcrack accumulation, leading to a loss of microstructural integrity and consequently, reduced mechanical strength.

Role of cortical bone in hip fracture

In this review, I consider the varied mechanisms in cortical bone that help preserve its integrity and how they deteriorate with aging. Aging affects cortical bone in two ways: extrinsically through its effects on the individual that modify its mechanical loading experience and 'milieu interieur'; and intrinsically through the prolonged cycle of remodelling and renewal extending to an estimated 20 years in the proximal femur. Healthy femoral cortex incorporates multiple mechanisms that help prevent fracture. These have been described at multiple length scales from the individual bone mineral crystal to the scale of the femur itself and appear to operate hierarchically. Each cortical bone fracture begins as a sub-microscopic crack that enlarges under mechanical load, for example, that imposed by a fall. In these conditions, a crack will enlarge explosively unless the cortical bone is intrinsically tough (the opposite of brittle). Toughness leads to microscopic crack deflection and bridging and may be increased by adequate regulation of both mineral crystal size and the heterogeneity of mineral and matrix phases. The role of osteocytes in optimising toughness is beginning to be worked out; but many osteocytes die in situ without triggering bone renewal over a 20-year cycle, with potential for increasing brittleness. Furthermore, the superolateral cortex of the proximal femur thins progressively during life, so increasing the risk of buckling during a fall. Besides preserving or increasing hip BMD, pharmaceutical treatments have class-specific effects on the toughness of cortical bone, although dietary and exercise-based interventions show early promise.

Elastic-plastic fracture toughness and rising JR-curve behavior of cortical bone is partially protected from irradiation-sterilization-induced degradation by ribose protectant

OBJECTIVE

This study tested the hypothesis that pre-treating cortical bone with ribose would protect the rising fracture resistance curve behavior and crack initiation fracture toughness of both bovine and human cortical bone from the degrading effects of γ-irradiation sterilization.

MATERIALS AND METHODS

A ribose pre-treatment (1.8 M for bovine, and 1.2 M for human, in PBS at 60 °C for 24 h) was applied to single-edge notched bending fracture specimens prior to sterilization with a 33 kGy dose of γ-irradiation. Fracture resistance curves were generated with a single specimen method using an optical crack length measurement technique. The effect of the treatment on overall fracture resistance behavior, crack initiation fracture toughness, and tearing modulus was compared with non-irradiated and conventionally irradiation sterilized controls. Hydrothermal isometric tension testing was used to examine collagen network connectivity and thermal stability to explore relationships between collagen network quality and fracture resistance.

RESULTS

The ribose pre-treatment successfully protected the crack growth initiation fracture toughness of bovine and human bone by 32% and 63%, respectively. The rising JR-curve behavior was also partially protected. Furthermore, collagen connectivity and thermal stability followed similar patterns to those displayed by fracture toughness.

CONCLUSIONS

This paper demonstrates that the fracture toughness of irradiation-sterilized bone tissue can be partially protected with a ribose pre-treatment. This new approach shows potential for the production and clinical application of sterilized allografts with improved mechanical performance and durability.

γ-Irradiation sterilized bone strengthened and toughened by ribose pre-treatment

OBJECTIVE

This study tested the hypothesis that a ribose-based pre-treatment would protect the strength, ductility and toughness of γ-irradiation sterilized cortical bone.

METHODS

Experiment 1: The effects of ribose pre-treatment (1.8M in PBS at 60°C for 24h) prior to 33 kGy of irradiation on strength, ductility and toughness (beams in three-point bending) and fracture toughness (J-integral at instability in single edge notched (bending)) were tested against matched non-irradiated and irradiated controls from bovine tibiae. Experiment 2: Three-point bending tests were conducted using beams from human femora (males, 59-67 years). Bone collagen thermal stability and network connectivity were examined using hydrothermal isometric tension testing.

RESULTS

Ribose pre-treatment protected the strength, ductility and toughness of irradiation sterilized bovine and human specimens to differing degrees. Their ultimate strength was not detectably different from non-irradiated control levels; toughness in bovine and human specimens was protected by 57 and 76%, respectively. Untreated human bone was less affected by irradiation and ribose pre-treatment was more effective in human bone than bovine bone.

CONCLUSIONS

This paper presents the first proof-of-principle that irradiation-sterilized bone with improved mechanical properties can be produced through the application of a ribose pre-irradiation treatment, which provides a more stable and connected collagen network than found in conventionally irradiated controls.

The fragile elderly hip: mechanisms associated with age-related loss of strength and toughness

Every hip fracture begins with a microscopic crack, which enlarges explosively over microseconds. Most hip fractures in the elderly occur on falling from standing height, usually sideways or backwards. The typically moderate level of trauma very rarely causes fracture in younger people. Here, this paradox is traced to the decline of multiple protective mechanisms at many length scales from nanometres to that of the whole femur. With normal ageing, the femoral neck asymmetrically and progressively loses bone tissue precisely where the cortex is already thinnest and is also compressed in a sideways fall. At the microscopic scale of the basic remodelling unit (BMU) that renews bone tissue, increased numbers of actively remodelling BMUs associated with the reduced mechanical loading in a typically inactive old age augments the numbers of mechanical flaws in the structure potentially capable of initiating cracking. Menopause and over-deep osteoclastic resorption are associated with incomplete BMU refilling leading to excessive porosity, cortical thinning and disconnection of trabeculae. In the femoral cortex, replacement of damaged bone or bone containing dead osteocytes is inefficient, impeding the homeostatic mechanisms that match strength to habitual mechanical usage. In consequence the participation of healthy osteocytes in crack-impeding mechanisms is impaired. Observational studies demonstrate that protective crack deflection in the elderly is reduced. At the most microscopic levels attention now centres on the role of tissue ageing, which may alter the relationship between mineral and matrix that optimises the inhibition of crack progression and on the role of osteocyte ageing and death that impedes tissue maintenance and repair. This review examines recent developments in the understanding of why the elderly hip becomes fragile. This growing understanding is suggesting novel testable approaches for reducing risk of hip fracture that might translate into control of the growing worldwide impact of hip fractures on our ageing populations.

Microdamage caused by fatigue loading in human cancellous bone: relationship to reductions in bone biomechanical performance

Vertebral fractures associated with osteoporosis are often the result of tissue damage accumulated over time. Microscopic tissue damage (microdamage) generated in vivo is believed to be a mechanically relevant aspect of bone quality that may contribute to fracture risk. Although the presence of microdamage in bone tissue has been documented, the relationship between loading, microdamage accumulation and mechanical failure is not well understood. The aim of the current study was to determine how microdamage accumulates in human vertebral cancellous bone subjected to cyclic fatigue loading. Cancellous bone cores (n = 32) from the third lumbar vertebra of 16 donors (10 male, 6 female, age 76±8.8, mean ± SD) were subjected to compressive cyclic loading at σ/E₀ = 0.0035 (where σ is stress and E₀ is the initial Young’s modulus). Cyclic loading was suspended before failure at one of seven different amounts of loading and specimens were stained for microdamage using lead uranyl acetate. Damage volume fraction (DV/BV) varied from 0.8±0.5% (no loading) to 3.4±2.1% (fatigue-loaded to complete failure) and was linearly related to the reductions in Young’s modulus caused by fatigue loading (r² = 0.60, p<0.01). The relationship between reductions in Young’s modulus and proportion of fatigue life was nonlinear and suggests that most microdamage generation occurs late in fatigue loading, during the tertiary phase. Our results indicate that human vertebral cancellous bone tissue with a DV/BV of 1.5% is expected to have, on average, a Young’s modulus 31% lower than the same tissue without microdamage and is able to withstand 92% fewer cycles before failure than the same tissue without microdamage. Hence, even small amounts of microscopic tissue damage in human vertebral cancellous bone may have large effects on subsequent biomechanical performance.

Distribution of microcrack lengths in bone in vivo and in vitro

It is well known that bone contains small cracks; in vivo these microcracks are constantly growing and being repaired. Too rapid crack growth leads to stress fractures or fragility fractures. In vitro, changes occur in this population of microcracks when subjected to cyclic loading up to and including failure. Normally, the only parameters reported from such investigations are the number density of cracks and their average length. In the present work we examined the microcrack population in more detail. We analysed ten different sets of experimental data including in vivo and in vitro microcracks, plus two theoretical simulations. We showed for the first time that the distribution of crack lengths can be described using the two-parameter Weibull equation. The values of the two constants in the equation varied depending on bone type/species and showed consistent trends during in vitro testing. This is the most detailed study to be conducted on microcrack populations in bone; the results will be useful in future studies including the development of theoretical models and computer simulations of bone damage and failure.

Compressive behaviour of child and adult cortical bone

In this study, cortical bone tissue from children was investigated. It is extremely difficult to obtain human child tissue. Therefore, the only possibility was to use bone tissue, free from any lesion, collected from young bone cancer patients. The compressive mechanical behaviour of child bone tissue was compared to the behaviour of adult tissue. Moreover, two hypotheses were tested: 1) that the mechanical behaviour of both groups is correlated to ash density; 2) that yield strain is an invariant. Small parts of the diaphysis of femora or tibiae from 12 children (4-15 years) and 12 adults (22-61 years) were collected. Cylindrical specimens were extracted from the cortical wall along the longitudinal axis of the diaphysis. A total of 107 specimens underwent compressive testing (strain rate: 0.1 s(-1)). Only the specimens showing a regular load-displacement curve (94) were considered valid and thereafter reduced to ash. It was found that the child bone tissue had significant lower compressive Young's modulus (-34%), yield stress (-38%), ultimate stress (-33%) and ash density (-17%) than the adult tissue. Conversely, higher compressive ultimate strain was found in the child group (+24%). Despite specimens extracted from both children and adults, ash density largely described the variation in tissue strength and stiffness (R(2)=in the range of 0.86-0.91). Furthermore, yield strain seemed to be roughly an invariant to subject age and tissue density. These results confirm that the mechanical properties of child cortical bone tissue are different from that of adult tissue. However, such differences are correlated to differences in tissue ash density. In fact, ash density was found to be a good predictor of strength and stiffness, also for cortical bone collected from children. Finally, the present findings support the hypothesis that compressive yield strain is an invariant.

The effect of antiresorptives on bone quality

BACKGROUND

Currently, antiresorptive therapy in the treatment and prevention of osteoporosis includes bisphosphonates, estrogen replacement, selective estrogen receptor modulators (raloxifene), and denosumab (a human antibody that inactivates RANKL). The original paradigm driving the development of antiresorptive therapy was that inhibition of bone resorption would allow bone formation to continue and correct the defect. However, it is now clear increases in bone density account for little of the antifracture effect of these treatments.

QUESTIONS/PURPOSES

We examined the antifracture benefit of antiresorptives deriving from bone quality changes.

METHODS

We searched the archive of nearly 30,000 articles accumulated over more than 40 years in our research center library using a software program (Refman™). Approximately 250 publications were identified in locating the 69 cited here.

RESULTS

The findings document antiresorptive agents are not primarily anabolic. All cause a modest increase in bone density due to a reduction in the bone remodeling space; however, the majority of their efficacy is due to suppression of the primary cause of osteoporosis, ie, excessive bone remodeling not driven by mechanical need. All of them improve some element(s) of bone quality.

CONCLUSIONS

Antiresorptive therapy reduces risk of fracture by improving bone quality through halting removal of bone tissue and the resultant destruction of microarchitecture of bone and, perhaps to some extent, by improving the intrinsic material properties of bone tissue. Information presented here may help clinicians to improve selection of patients for antiresorptive therapy by avoiding them in cases clearly not due to excessive bone remodeling.

Role of prism decussation on fatigue crack growth and fracture of human enamel

The role of prism decussation on the crack growth resistance of human enamel is evaluated. Miniature inset compact tension (CT) specimens embodying a section of cuspal enamel were subjected to Mode I cyclic or monotonic loads. Cracks were grown in either the forward (from outer enamel inwards) or reverse (from inner enamel outwards) direction and the responses were compared quantitatively. Results showed that the outer enamel exhibits lower resistance to the inception and growth of cracks. Regardless of the growth direction, the near-threshold region of cyclic extension was typical of "short crack" behavior (i.e. deceleration of growth with an increase in crack length). Cyclic crack growth was more stable in the forward direction and occurred over twice the spatial distance achieved in the reverse direction. In response to the monotonic loads, a rising R-curve response was exhibited by growth in the forward direction only. The total energy absorbed in fracture for the forward direction was more than three times that in the reverse. The rise in crack growth resistance was largely attributed to a combination of mechanisms that included crack bridging, crack bifurcation and crack curving, which were induced by decussation in the inner enamel. An analysis of the responses distinguished that the microstructure of enamel appears optimized for resisting crack growth initiating from damage at the tooth's surface.

Ductile sliding between mineral crystals followed by rupture of collagen crosslinks: experimentally supported micromechanical explanation of bone strength

There is an ongoing discussion on how bone strength could be explained from its internal structure and composition. Reviewing recent experimental and molecular dynamics studies, we here propose a new vision on bone material failure: mutual ductile sliding of hydroxyapatite mineral crystals along layered water films is followed by rupture of collagen crosslinks. In order to cast this vision into a mathematical form, a multiscale continuum micromechanics theory for upscaling of elastoplastic properties is developed, based on the concept of concentration and influence tensors for eigenstressed microheterogeneous materials. The model reflects bone's hierarchical organization, in terms of representative volume elements for cortical bone, for extravascular and extracellular bone material, for mineralized fibrils and the extrafibrillar space, and for wet collagen. In order to get access to the stress states at the interfaces between crystals, the extrafibrillar mineral is resolved into an infinite amount of cylindrical material phases oriented in all directions in space. The multiscale micromechanics model is shown to be able to satisfactorily predict the strength characteristics of different bones from different species, on the basis of their mineral/collagen content, their intercrystalline, intermolecular, lacunar, and vascular porosities, and the elastic and strength properties of hydroxyapatite and (molecular) collagen.

Progressive post-yield behavior of human cortical bone in compression for middle-aged and elderly groups

In this study, a progressive loading regimen (load-dwell-unloading-dwell-reloading) was applied on bone samples to examine the compressive post-yield response of bone at increasing strain levels. Cortical bone specimens from human tibiae of two age groups (middle-aged group: 53+/-2 years, 4 females and 4 males, elderly group: 83+/-6 years, 4 females and 4 males) were loaded in compression using the progressive loading scheme. Modulus degradation, plastic deformation, viscous response, and energy dissipation of bone during post-yield deformation were assessed. Although initial modulus was not significantly different between the two age groups, the degradation of modulus with the applied strain in the elderly group was faster than in the middle-aged group. The modulus loss (or microdamage accumulation) of bone occurred prior to plastic deformation. Plastic strain had a similar linear relationship with the applied strain for both middle-aged and the elderly group although middle-aged bone yielded at a greater strain. The viscoelastic time constant changed similarly with increasing strain for the two groups, whereas a higher magnitude of stress relaxation was observed in the middle-aged group. Energy dissipation was investigated through three pathways: elastic release strain energy, hysteresis energy, and plastic strain energy. The middle-aged group had significantly greater capacity of energy dissipation than the elderly group in all three pathways. The information obtained may provide important insights in age-related effects on bone fragility.

In vivo linear microcracks of human femoral cortical bone remain parallel to osteons during aging

Previous studies have examined the density of microdamage within the cortex of long bones mostly from the viewpoint that is perpendicular to the long axis of the bone. The goal of the present work is to conduct a systematic characterization of the microcracks from a viewpoint that is parallel to the long axis of a load-bearing bone, the femur, so as to gain a better understanding of the size, shape and orientation of the microdamage. Longitudinal cross sections were taken at the mid-diaphysis of femurs from 13 male donors (23-85 years old) after being stained with basic fuchsin. The number of cracks, their lengths and orientation with respect to osteons were characterized using brightfield and UV-epifluorescent imaging. The mean crack density was 0.1118+/-0.0417 mm(-2) in the longitudinal plane and it significantly increased with age. The median crack length along the longitudinal plane did not change with age. The crack length in the posterior quadrant was significantly lower than anterior, medial and lateral quadrants. Less than 3% of the cracks were longer than 1 mm, indicating the presence of 'in vivo macroscopic' cracks in bone tissue. It was observed that the 99% of the cracks had angles that were less than 25 degrees with the osteons (median angle of 4.2 degrees with an interquartile range of 5.8 degrees ), indicating that the majority in vivo linear microcracks are parallel to osteons. This parallelism did not differ between quadrants nor changed with age. The remarkably stagnant crack length and crack orientation across decades of aging suggest that either physiological loading profile leading to these in vivo microcracks are not changing notably with age, or, microcrack and osteonal orientations may be relatively insensitive to age-related changes in locomotion. In conclusion, in vivo linear microcracks of the femoral mid-shaft grow in planes parallel to osteons and their lengths do not increase with age.

Stress-strain experiments on individual collagen fibrils

Collagen, a molecule consisting of three braided protein helices, is the primary building block of many biological tissues including bone, tendon, cartilage, and skin. Staggered arrays of collagen molecules form fibrils, which arrange into higher-ordered structures such as fibers and fascicles. Because collagen plays a crucial role in determining the mechanical properties of these tissues, significant theoretical research is directed toward developing models of the stiffness, strength, and toughness of collagen molecules and fibrils. Experimental data to guide the development of these models, however, are sparse and limited to small strain response. Using a microelectromechanical systems platform to test partially hydrated collagen fibrils under uniaxial tension, we obtained quantitative, reproducible mechanical measurements of the stress-strain curve of type I collagen fibrils, with diameters ranging from 150-470 nm. The fibrils showed a small strain (epsilon < 0.09) modulus of 0.86 +/- 0.45 GPa. Fibrils tested to strains as high as 100% demonstrated strain softening (sigma(yield) = 0.22 +/- 0.14 GPa; epsilon(yield) = 0.21 +/- 0.13) and strain hardening, time-dependent recoverable residual strain, dehydration-induced embrittlement, and susceptibility to cyclic fatigue. The results suggest that the stress-strain behavior of collagen fibrils is dictated by global characteristic dimensions as well as internal structure.

Theoretical modelling in bioengineering: 12th Haughton Lecture of the Royal Academy of Medicine in Ireland

This paper is concerned with the role of theoretical modelling in bioengineering research. The subject matter was delivered as the 12th annual Haughton Lecture, presented on 28 January 2006 at the Bioengineering in Ireland conference in Galway. The title of the lecture was "Telling Stories About Bone". The paper begins with some general remarks about what constitutes a scientific theory, and it moves on to a discussion about where ideas for theoretical models come from, taking examples from my own work on the mechanical strength and fracture of bone. I conclude with some advice to budding theoreticians.

Haversian cortical bone model with many radial microcracks: An elastic analytic solution

In this study, the fracture micromechanics of Haversian cortical bone has been considered. To this effect, a two-dimensional micromechanical fibre-ceramic matrix composite tissue materials model has been presented. The interstitial tissue was modeled as a matrix and the osteon was modeled as a fibre, followed by the application of linear elastic fracture mechanics theory. The solution for edge dislocations, in terms of Green's functions, was adopted to formulate a system of singular integral equations for the radial microcracks in the matrix in vicinity of the osteon. The problem was solved for various configurations and the corresponding stress intensity factors were computed. The results of this study indicated that the interaction between microcracks and an osteon was limited to vicinity of the osteon. Furthermore, the effect of microstructure morphology and heterogeneity on the fracture behavior has been established. The interactions between microcracks were also analyzed for various configurations. These selected configurations exhibited the effects of stress amplification and stress shielding.

Fatigue of mineralized tissues: cortical bone and dentin

Gaining a mechanistic understanding of the mechanical properties of mineralized tissues, such as dentin and cortical bone, is important from the perspective of developing a framework for predicting and preventing failure of teeth and whole bones, particularly with regard to understanding the effects of microstructural modifications from factors such as aging, disease, or medical treatments. Accordingly, considerable research efforts have been made to determine the specific mechanisms involved in the fatigue and fracture of mineralized tissues, and to discover how these mechanisms relate to features within the respective microstructures. This article seeks to review the progress that has been made specifically in the area of fatigue, focusing on the research that moves our understanding beyond simple fatigue life (S/N) concepts and instead addresses the separate mechanisms for microdamage initiation, crack propagation, and in the case of bone, repair and remodeling.

The role of the collagen matrix in skeletal fragility

The collagen network in bone provides resistance against fracture and may be susceptible to changes with aging and disease. This review identifies the changes in quality of collagen matrix as contributors to bone fragility. With aging and in diabetes, cross-links accumulate in bone collagen as a result of nonenzymatic glycation and consequently impair matrix properties, increasing bone fragility. Cell-culture and animal studies suggest that the accumulation of cross-links induced by nonenzymatic glycation may be related to a reduction in bone turnover resulting from the altered responses of osteoblasts and osteoclasts to advanced glycation end products.

A non-invasive in vitro technique for the three-dimensional quantification of microdamage in trabecular bone

An accurate analysis and quantification of microdamage is critical to understand how microdamage affects the mechanics and biology of bone fragility. In this study we demonstrate the development and validation of a novel in vitro micro-computed tomography (microCT) method that employs lead-uranyl acetate as a radio-opaque contrast agent for automated quantification of microdamage in trabecular bone. Human trabecular bone cores were extracted from the femoral neck, scanned via microCT, loaded in unconfined compression to a range of apparent strains (0.5% to 2.25%), stained in lead-uranyl acetate, and subsequently re-scanned via microCT. An investigation of the regions containing microdamage using the backscatter mode of a scanning electron microscope (BSEM) showed that the lead-uranyl sulfide complex was an effective contrast agent for microdamage in bone. Damaged volume fraction (DV/BV), as determined by microCT, increased exponentially with respect to applied strains and proportionately to mechanically determined modulus reduction (p<0.001). Furthermore, the formation of microdamage was observed to occur before any apparent stiffness loss, suggesting that the localized tissue yielding occurs prior to the structural yielding of trabecular bone. This non-invasive in vitro technique for the detection of microdamage using microCT may serve as a valuable complement to existing morphometric analyses of bone.

Living with cracks: damage and repair in human bone

Our bones are full of cracks, which form and grow as a result of daily loading activities. Bone is the major structural material in our bodies. Although weaker than many engineering materials, it has one trick that keeps it ahead - it can repair itself. Small cracks, which grow under cyclic stresses by the mechanism of fatigue, can be detected and removed before they become long enough to be dangerous. This article reviews the work that has been done to understand how cracks form and grow in bone, and how they can be detected and repaired in a timely manner. This is truly an interdisciplinary research field, requiring the close cooperation of materials scientists, biologists and engineers.

The role of osteocytes and bone microstructure in preventing osteoporotic fractures

The skeleton alters its geometry following trauma, the introduction of artificial defects and of fatigue-induced microcracks. The precise mechanism by which the skeleton adapts remains unclear. Microcracks might directly affect the cell by damaging the osteocyte cell network or causing apoptosis. Bone microstructure may play an important role in these processes by diverting and arresting propagating microcracks and so prevent fracture failure. This paper discusses the effects of microstructure on propagating cracks, how microdamage may act as a stimulus for bone adaptation and its potential effects on bone biochemistry.

Propagation of surface fatigue cracks in human cortical bone

An understanding of how fatigue cracks grow in bone is of importance as fatigue is thought to be the main cause of clinical stress fractures. This study presents new results on the fatigue-crack growth behavior of small surface cracks (approximately 75-1000 microm in size) in human cortical bone, and compares their growth rates with data from other published studies on the behavior of both surface cracks and many millimeter, through-thickness large cracks. Results are obtained with a cyclically loaded cantilever-beam geometry using optical microscopy to examine for crack growth after every 100-500 cycles. Based on the current and previous results, small fatigue cracks appear to become more resistant to fatigue-crack growth with crack extension, analogous to the way the fracture resistance of cortical bone increases with crack growth. Mechanistically, a theory attributing such behavior to the development of bridges in the wake of the crack with crack growth is presented. The existence of such bridges is directly confirmed using optical microscopy.

Osteonal crack barriers in ovine compact bone

Bone is an anisotropic structure which can be compared to a composite material. Discontinuities within its microstructure may provide stress concentration sites for crack initiation, but act as a barrier to its propagation. This study looks specifically at the relationship between crack length and propagation in compact bone. Beam-shaped bone samples from sheep radii were prepared and stained with fluorochrome dyes and tested in cyclic fatigue under four-point bending in an INSTRON 1341 servo-hydraulic fatigue-testing machine. Samples were tested at a frequency of 30 Hz and stress range of 100 MPa under load control. Specimens were sectioned transversely using a diamond saw, slides prepared and examined using epifluorescence microscopy. Cracks in transverse sections were classified in terms of their location relative to cement lines surrounding secondary osteons. Mean crack length, crack numerical density and crack surface density were examined. Short microcracks (100 microm or less) were stopped at the cement lines surrounding osteons, microcracks of intermediate length (100-300 microm) were deflected as they hit the cement line, and microcracks that were able to penetrate through cement lines were longer (> 400 microm). These data show that bone microstructure allows the initiation of microcracks but acts as a barrier to crack propagation.

Mechanisms of short crack growth at constant stress in bone

This paper describes an experimental study of the growth of small (i.e. sub-millimetre) cracks in samples of cortical bone subjected to a constant tensile stress. Slow, stable crack growth occurred at a rate and angle which were dependent on the orientation of the sample: tests were conducted with the loading axis both parallel and perpendicular to the longitudinal axis of the bone. All cracks showed intermittent growth in which periods of relatively rapid propagation alternated with periods of temporary crack arrest or relatively slow growth. In some cases crack arrest could be clearly linked to microstructural features such as osteons or Volkmann's canals, which acted as barriers to crack growth. Crack-opening displacement increased over time during the arrest periods. These observations suggest a mechanism for the growth of small cracks in bone at constant stress, involving microstructural barriers, time-dependent deformation of material near the crack tip and strain-controlled propagation.

Age-related change in the damage morphology of human cortical bone and its role in bone fragility

Application of cyclic loading results in the formation of distinct strain-dependent microdamage morphologies. It is still unknown; however, how the morphology of microdamage affects age-related increase in bone fragility. In this study, four-point bending fatigue tests were conducted on aging human bone (age 26 to 89) in conjunction with histological evaluation of the resultant tensile (diffuse damage) and compressive (linear microcracks) damage to identify the damage morphologies associated with an increase in age-related bone fragility. The results demonstrate that young donors (38 +/- 9 years) had a longer fatigue life (P < 0.05) and formed more diffuse damage than the older donors (82 +/- 5 years) (P < 0.05). In contrast, old donors had a shorter fatigue life and formed more linear microcracks than the younger donors (P < 0.05). Linear microcracks were longer in older than in younger donors (P < 0.05) and were associated with weak lamellar interfaces. Areas of diffuse damage were, however, larger in younger than in older donors (P < 0.05), and these showed no relationship with the lamellar arrangement of bone. These findings show, for the first time, that the propensity of bone to form a particular damage morphology is subject to change with age and that the propensity of young donors to form diffuse damage over interlamellae linear microcracks plays a critical role in the ability of bone to dissipate energy and resist a catastrophic fracture. Age-related changes in damage morphology may therefore be an important contributor to the increased bone fragility in the elderly.

The behaviour of microcracks in compact bone

This paper summarises four separate studies carried out by our group over the past number of years in the area of bone microdamage. The first study investigated the manner by which microcracks accumulate and interact with bone microstructure during fatigue testing of compact bone specimens. In a series of fatigue tests carried out at four different stress ranges between 50 and 80 MPA, crack density increased with loading cycles at a rate determined by the applied stress. Variations in the patterns of microdamage accumulation suggest that that at low stress levels, larger amounts of damage can build up without failure occurring. In a second study using a series of four-pont bending tests carried out on ovine bone samples, it was shown that bone microstructure influenced the ability of microcracks to propagate, with secondary osteons acting as barriers to crack growth. In a third study, the manner by which crack growth disrupts the canalicular processes connecting osteocytes was investigated. Analysis of individual cracks showed that disruption of the canalicular processes connecting osteocytes occurred due to shear displacement at the face of propagating microcracks, suggesting that this may play some role in the mechanism that signals bone remodelling. In a fourth in vivo study, it was shown that altering the mechanical load applied to the long bones of growing rats causes microcrack formation. In vivo microdamage was present in rats subjected to hindlimb suspension with a higher microcrack density found in the humeri than the femora. Microdamage was also found in control animals. This is the first study to demonstrate in vivo microcracks in normally loaded bones in a rat model.

New insights into the propagation of fatigue damage in cortical bone using confocal microscopy and chelating fluorochromes

Fatigue damage in bone occurs in the form of microcracks and plays an important role in the initiation of bone remodelling and in the occurrence of stress and fragility fractures. The process by which fatigue microcracks in bone initiate and grow remains poorly understood. The aim of this study was to investigate the microscopic tissue changes associated with microcracks during crack propagation in cortical bone and the influence of bone microstructure on this process. Cracks were mechanically initiated and extended longitudinally in a two-stage process, in six bovine tibial compact tension specimens. The sequential application of chelating fluorochromes, xylenol orange followed by calcein, allowed the nature of microcrack damage at different stages of propagation to be monitored by laser scanning confocal microscopy. Specimens were imaged at a focal plane 20 microm below the samples' surface, or as a series of z-plane images collected to a maximal depth of 200 microm and 35 microm for x 4 and x 40 objectives, respectively. Z-series image stacks were then reconstructed using Amira 3.0 software. Confocal images showed that xylenol orange localised to the crack surface and did not migrate into the crack's extension following further mechanical propagation. Similarly, calcein stained the extended crack's surface and displayed minimal incorporation within the original crack. High resolution confocal images provided a detailed visual description of the crack's 'process zone', and 'process zone wake'. Additionally, an 'interface region' was revealed, displaying a clear distinction between the end of the first crack and the commencement of its extension. Confocal images of the interface region demonstrated that the extended crack forms a continuum with the pre-existing crack and propagates through the former process zone. Upon viewing the three-dimensional reconstructed images, we found evidence suggesting a submicroscopic tissue involvement in fatigue damage, in addition to the potential influence of vascular canals and osteocyte lacunae on its propagation through the bone matrix. This study has provided new insights into the process of fatigue damage growth in bone and factors influencing its progression through the bone matrix. Confocal microscopy in combination with sequential chelating fluorochrome labelling is a valuable technique for monitoring microcrack growth in bone.

Micro- and nano-structural analyses of damage in bone

Skeletal fractures represent a significant medical and economic burden for our society. In the US alone, age-related hip, spine, and wrist fractures accounted for more than $17 billion in direct health care costs in 2001. Moreover, skeletal fractures are not limited to the elderly; stress fractures and impact/trauma-related fractures are a significant problem in younger people also. Gaining insight into the mechanisms of fracture and how these mechanisms are modulated by intrinsic as well as extrinsic factors may improve the ability to define fracture risk and develop and assess preventative therapies for skeletal fractures. Insight into failure mechanisms of bone, particularly at the ultrastructural-level, is facilitated by the development of improved means of defining and measuring tissue quality. Included in these means are microscopic and spectroscopic techniques for the direct observation of crack initiation, crack propagation, and fracture behavior. In this review, we discuss microscopic and spectroscopic techniques, including laser scanning confocal microscopy (LSCM), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and Raman spectroscopic imaging for visually observing microdamage in bone, and the current understanding of damage mechanisms derived from these techniques.

Sterilization by gamma radiation impairs the tensile fatigue life of cortical bone by two orders of magnitude

Cortical bone grafts are utilized frequently for skeletal reconstruction, spinal fusion and tumor surgery. Due to its efficacy and convenience terminal sterilization by gamma radiation is often essential to minimize disease transmission and infection. However, the impairment in the material properties of bone tissue secondary to gamma radiation sterilization is a concern since the mechanical functionality of a bone graft is of primary importance. While the extent of this impairment is well investigated for monotonic loading conditions, there does not seem to exist any information on the effects of gamma radiation sterilization on cortical bone's fatigue properties, the physiologically relevant mode of loading. In this study we investigated the degradation in the high-cycle and low-cycle tensile fatigue lives of cortical bone tissue secondary to gamma radiation sterilization at a dose of 36.4 kGy which approximately falls in the higher end of the standard dose range used in tissue banking. The high-cycle and the low-cycle fatigue tests were conducted under load control at initial strain levels of 0.2% and 0.4%, respectively. Monotonic tensile tests were also conducted to compare the impairment of fatigue properties with the impairment of monotonic properties. Results demonstrated that the impairment in both the high-cycle and the low-cycle fatigue lives were two orders of magnitude following sterilization, a change much more pronounced than that observed for monotonic loading. In conclusion, the results suggest that the impairment of the mechanical function of gamma radiation sterilized allografts is even worse in fatigue than monotonically. Therefore, grafts should be designed to minimize functional strains and avoid stress raisers to prevent premature fatigue failures.

Damage mechanisms and failure modes of cortical bone under components of physiological loading

Fatigue damage development in cortical bone was investigated in vitro under different mechanical components of physiological loading including tension, compression, and torsion. During each test, stress and strain data were collected continuously to monitor and statistically determine the occurrence of the primary, secondary, and tertiary stages associated with fatigue and/or creep failure of bone. The resultant microdamage and failure modes were identified by histological and fractographic analysis, respectively. The tensile group demonstrated Mode I cracking and the three classic stages of fatigue and creep suggesting a low crack initiation threshold, steady crack propagation and final failure by coalescence of microcracks. In contrast, the compressive group displayed Mode II cracking and a two-stage fatigue behavior with limited creep suggesting a high crack initiation threshold followed by a sudden fracture. The torsion group also displayed a two-stage fatigue profile but demonstrated extensive damage from mixed mode (Modes II and III) microcracking and predominant time-dependent damage. Thus, fatigue behavior of bone was found to be uniquely related to the individual mechanical components of physiological loading and the latter determined the specific damage mechanisms associated with fatigue fracture.

Microcracks in cortical bone: how do they affect bone biology?

Microcrack accumulation in cortical bone has been implicated in skeletal fragility and stress fractures. These cracks have also been shown to affect the mechanical and material properties of cortical bone. Their growth has been linked to osteocyte apoptosis and the initiation of the remodeling process, which also has a role in their repair. Clinically, osteoporosis is diagnosed using dual energy x-ray absorptiometry. However, evidence now indicates that bone mass alone is insufficient to satisfactorily explain the skeletal fragility of osteoporosis and consideration needs to be given to bone quality in the diagnosis and treatment of the disease. Bone quality includes parameters such as trabecular and cortical microarchitecture, morphology, bone turnover, degree of mineralization of the bone matrix, and significantly, the amount of microdamage present in the bone. Current clinical treatments concentrate on the inhibition of osteoclast activity to maintain bone mass in osteoporotic patients. However, these cells have a major role in removing existing microcracks from the bone matrix, and hence the use of bone resorption- inhibiting drugs may lead to insufficient bone repair and therefore an increase in microdamage accumulation and loss of bone quality.

Aspects of in vitro fatigue in human cortical bone: time and cycle dependent crack growth

Although fatigue damage in bone induced by cyclic loading has been recognized as a problem of clinical significance, few fracture mechanics based studies have investigated how incipient cracks grow by fatigue in this material. In the present study, in vitro cyclic fatigue experiments were performed in order to quantify fatigue-crack growth behavior in human cortical bone. Crack-growth rates spanning five orders of magnitude were obtained for the extension of macroscopic cracks in the proximal-distal direction; growth-rate data could be well characterized by the linear-elastic stress-intensity range, using a simple (Paris) power law with exponents ranging from 4.4 to 9.5. Mechanistically, to discern whether such behavior results from "true" cyclic fatigue damage or is simply associated with a succession of quasi-static fracture events, cyclic crack-growth rates were compared to those measured under sustained (non-cyclic) loading. Measured fatigue-crack growth rates were found to exceed those "predicted" from the sustained load data at low growth rates ( approximately 3 x 10(-10) to 5 x 10(-7) m/cycle), suggesting that a "true" cyclic fatigue mechanism, such as alternating blunting and re-sharpening of the crack tip, is active in bone. Conversely, at higher growth rates ( approximately 5 x 10(-7) to 3 x 10(-5) m/cycle), the crack-growth data under sustained loads integrated over the loading cycle reasonably predicts the cyclic fatigue data, indicating that quasi-static fracture mechanisms predominate. The results are discussed in light of the occurrence of fatigue-related stress fractures in cortical bone.

Axial-shear interaction effects on microdamage in bovine tibial trabecular bone

Because many osteoporotic fractures occur during a fall, understanding the effect of off-axis loads on initiation and propagation of microdamage in trabecular bone should provide further insight into the biomechanics of age-related fractures. Fourteen on-axis cylindrical specimens were prepared from 12 bovine tibiae. Fluorescent stains were used to label the microdamage due to a sequence of compressive and torsional damaging loads. The mean decrease in Young's modulus was over four times greater than that in the shear modulus after the compressive overload, while there was no difference between the decrease in the axial and torsional stiffnesses after the torsional overload. The total microcrack density due to compression was uniform across the radius of the cylindrical specimens, while the mean density of microcracks due to torsional overloading increased from the axis of the cylindrical specimen to the circumference. The high density of microcracks near the axis of the specimen following torsional overloading was unexpected because of the low strains. Nearly 40% of the microcracks due to torsion propagated from pre-existing microcracks caused by axial compression, indicating that existing microcracks may extend at relatively low strain if the loading mode changes. The propagating microcracks were, on average, longer than the initiating microcracks due to either compressive or torsional loading. Damage due to axial compression appears to increase the susceptibility of trabecular bone to damage propagation during subsequent torsional loads, but it has little effect on the elastic properties in shear.

Finite Element Prediction of Proximal Femoral Fracture Patterns Under Different Loads

The main purpose of this work is to discuss the ability of finite element analyses, together with an appropriate anisotropic fracture criterion, to predict the ultimate load and type of fracture in bones and more specifically in the proximal femur. We show here that the use of a three-dimensional anisotropic criterion provides better results than other well-known isotropic criteria. The criterion parameters and the anisotropic elastic properties were defined in terms of the bone tissue microstructure, quantified by the apparent density and the so-called “fabric tensor”, whose spatial distributions were obtained by means of an anisotropic remodeling model able to capture the main features of the internal structure of long bones. In order to check the validity of the results obtained, they have been compared with those of an experimental work that analyzes different types of fractures induced in the proximal femur by a static overload.

The effect of bone microstructure on the initiation and growth of microcracks

Osteonal bone is often compared to a composite material and to metals as discontinuities within the material may provide sites of stress concentration for crack initiation and serve as barriers to crack growth. However, little experimental data exist to back up these hypotheses. Fluorescent chelating agents were applied at specific intervals to bone specimens fatigue tested in cyclic compression at a stress range of 80 MPa. The failed specimens were sectioned and labelled microcracks identified using UV epifluorescence microscopy. Microcrack lengths were measured and their relationship to cement lines surrounding secondary osteons recorded. Microcrack length at the time of encountering a cement line was also measured. Microcracks of less than 100mum stopped growing when they encountered a cement line. Microcracks of greater than 100mum in length continued to grow after encountering a cement line surrounding an osteon. Only microcracks greater than 300mum in length were capable of penetrating osteons and these microcracks were the only ones which were observed to cause failure in the specimen. These experimental data support the hypothesis that secondary osteons act as barriers to crack propagation in compact bone. However, it shows that this microstructural barrier effect is dependent on the crack length at the time of encountering an osteon. For the vast majority of cracks, osteons act as barriers to growth but for the minority of cracks that are long enough and do break through the cement line, an osteon may actually act as a weakness in the bone and facilitate crack propagation.

Stress intensity variations in bone microcracks during the repair process

Microscopic cracks form and grow in compact bone in vivo due to cyclic loading. Their growth can cause stress fractures and has been implicated in the processes of remodelling and adaptation. These cracks are repaired by the actions of BMUs which are mobile resorption cavities. In this work, we studied the interaction between cracks and BMUs by making finite element models representing different stages in the repair process. The tendency of the crack to grow was measured by its stress intensity factor, K. We found that K changes in a complex manner during the repair process, both decreasing and increasing depending on the size of the crack and the type of loading applied. For loading conditions similar to those that exist in vivo, the presence of the BMU can cause K to rise significantly, in some cases by more than 20%, implying a substantial increase in crack growth rate. This information is important for our general understanding of the complexities of the repair process, and especially for the development of theoretical models to simulate damage and repair in bone.

A rate-dependent microcrack-bridging model that can explain the strain rate dependency of cortical bone apparent yield strength

Although there are empirical correlations between strain rate, cortical and cancellous bone apparent stiffness, apparent yield strength, apparent ultimate strength and cortical bone fracture toughness, a mechanistic description for these phenomena is lacking. Microcracking is a major mechanism in cortical and cancellous bone failure, however, microdamage content alone cannot explain the strain rate dependence of bone strength without considering time-dependent behavior of the crack. Using a rate-dependent model of a fiber-bridged microcrack and data from the literature, we demonstrate that the experimental apparent yield strength of bone can be predicted directly from measurements of apparent moduli of elasticity of bone constituents and failure strain of the collagenous matrix. Yield strength predictions for estrogen depleted bone were made using the model and data from ovariectomized sheep. It was predicted that the yield strength of estrogen-deficient bone is comparable to that of normal bone within strain rates associated with physiological activities. For high strain rates, however, the strength of estrogen-depleted bone was predicted to be much weaker than normals suggesting a higher fracture risk due to impact from falls, for individuals with estrogen-depleted bones such as in post-menopausal osteoporosis.