A hypothetical mechanism for the stimulation of osteonal remodelling by fatigue damage

Analysis of cutting forces and microdamage during indentation cutting of bone

In surgery, bone can be cut by applying force to a wedge-shaped blade. The published literature is relatively sparse regarding the biomechanics of this type of indentation cutting, especially regarding the relationships between blade geometry, bone quality, cutting force and microdamage. Microdamage created near the cut surfaces can be beneficial, as a trigger for bone remodelling, but it is known that excessive fracture damage can prolong the healing time. In this research, specimens of compact bovine bone were tested by cutting using wedge blades of different geometries. We labelled and measured microdamage occurring during bone cutting for the first time. We found that there were statistically significant effects arising from the variation in wedge angle, edge radius and blade orientation (with respect to bone's anisotropic structure) on both the magnitude of the cutting force and the extent of the microdamage. Interestingly, we found that the amount of damage occurring during cutting is directly correlated to the cutting force which causes the damage, independent of other factors. This work contributes to a better understanding of the biomechanics of this important surgical cutting process.

Relation between cross-sectional bone geometry and double zonal osteon frequency and morphology

OBJECTIVES

While double-zonal osteons (DZ) are characterized by a hyper-mineralized ring inside their lamellae, recent findings suggest that this ring is also defined by a change in the collagen fibers' orientation. Collagen and minerals are essential components to the maintenance of adequate bone strength and their alteration can modify the mechanical properties of the bone tissue. Consequently, the aim of this study is to explore the effect of past loads, as estimated from cross-sectional geometric properties, on the formation of DZ osteons compared to type I (common) osteons.

MATERIALS AND METHODS

The sample consists of paired humerus and femur midshaft sections (n = 23) of Eurocanadian settlers from the historical St. Matthew cemetery, Quebec City (1771-1860). Histomorphometric variables included in this study are osteon density for DZ and type I osteons (DZD; OPD), osteon area (DZOn.Ar; On. Ar), Haversian canal area (DZH.Ar; H.Ar), and the area within the hypermineralized ring (HR. Ar). Loading history is estimated from cross-sectional properties including the following variable: cortical and total area (CA, TA), maximum and minimum second moment of area (I_max , I_min ) and polar moment of area (J).

RESULTS

When the humerus and femur of the same individuals are compared, the femur has a higher OPD, DZD, and relative DZD (DZD/OPD). DZ osteons have a smaller area and Haversian canal area compared to type I osteons. The area within the hypermineralized ring in DZ is higher than the Haversian canal area of the type I osteons. Correlations between the residual scores of the regression of histomorphometric variables and cross-sectional properties of the humerus on the femur were not significant.

DISCUSSION

Based on the analysis of the entire cross-section, the lack of correlation between variations in cross-sectional properties and remodeling combined with the significant differences between humeri and femura suggests that the creation of DZ or type I osteons in the bone tissue might be due to a bone specific response, possibly related to differences in bone tissue age that needs to be further investigated. Definitive conclusion regarding biomechanical loads still seem to be premature as regional variations associated with mechanical properties remain to be explored.

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.

Do forelimb shape and peak forces co-vary in strepsirrhines?

OBJECTIVES

In this study, we explore whether ground reaction forces recorded during horizontal walking co-vary with the shape of the long bones of the forelimb in strepsirrhines. To do so, we quantify (1) the shape of the shaft and articular surfaces of each long bone of the forelimb, (2) the peak vertical, mediolateral, and horizontal ground reaction forces applied by the forelimb during arboreal locomotion, and (3) the relationship between the shape of the forelimb and peak forces.

MATERIALS AND METHODS

Geometric morphometric approaches were used to quantify the shape of the bones. Kinetic data were collected during horizontal arboreal walking in eight species of strepsirrhines that show variation in habitual substrate use and morphology of the forelimb. These data were then used to explore the links between locomotor behavior, morphology, and mechanics using co-variation analyses in a phylogenetic framework.

RESULTS

Our results show significant differences between slow quadrupedal climbers (lorises), vertical clinger and leapers (sifaka), and active arboreal quadrupeds (ring-tailed lemur, ruffed lemur) in both ground reaction forces and the shape of the long bones of the forelimb, with the propulsive and medially directed peak forces having the highest impact on the shape of the humerus. Co-variation between long bone shape and ground reaction forces was detected in both the humerus and ulna even when accounting for differences in body mass.

DISCUSSION

These results demonstrate the importance of considering limb-loading beyond just peak vertical force, or substrate reaction force. A re-evaluation of osseous morphology and functional interpretations is necessary in light of these findings.

EVALUATING THE THEORY OF BONE MECHANOREGULATION IN THE PHYSIOLOGICAL LOADING SCENARIO

In this paper, the theory of bone mechanoregulation under physiological loading was evaluated. The entire right tibiae of wild type (WT, [Formula: see text]) and parathyroid hormone (PTH, [Formula: see text]) treated C57BL/6J female mice were scanned using an in vivo [Formula: see text]CT imaging system at 14, 16, 17, 18, 19, 20, 21, and 22 weeks. The PTH intervention started from week 18 until week 22. Subject-specific finite element (FE) models were created from the [Formula: see text]CT images and physiological loading condition was defined in the FE models. The rates of changes in bone mineral content (BMC), bone mineral density (BMD), and bone tissue density (TMD) were quantified over 40 anatomical compartments across the entire mouse tibia. The resulting values were then correlated to the average 1st principal tensile strain ([Formula: see text]) and the strain energy density (SED) for every compartment at weeks 18, 20, and 22. It was found that: in both groups, [Formula: see text] had a minimal effect on the variability of [Formula: see text]BMC ([Formula: see text]); SED had a significant effect on the variability of [Formula: see text]BMC only in the WT group ([Formula: see text]); [Formula: see text] had a significant effect on the variability of [Formula: see text]BMD only in the PTH group ([Formula: see text]); SED had a significant effect on the variability of [Formula: see text]BMD in both groups ([Formula: see text]); neither SED nor [Formula: see text] had a significant effect on the variability of [Formula: see text]TMD ([Formula: see text]). These results are the first to reveal the mechanism of bone mechanoregulation in the physiological loading scenario.

An Integrated Musculoskeletal-Finite-Element Model to Evaluate Effects of Load Carriage on the Tibia During Walking

Prior studies have assessed the effects of load carriage on the tibia. Here, we expand on these studies and investigate the effects of load carriage on joint reaction forces (JRFs) and the resulting spatiotemporal stress/strain distributions in the tibia. Using full-body motion and ground reaction forces from a female subject, we computed joint and muscle forces during walking for four load carriage conditions. We applied these forces as physiological loading conditions in a finite-element (FE) analysis to compute strain and stress. We derived material properties from computed tomography (CT) images of a sex-, age-, and body mass index-matched subject using a mesh morphing and mapping algorithm, and used them within the FE model. Compared to walking with no load, the knee JRFs were the most sensitive to load carriage, increasing by as much as 26.2% when carrying a 30% of body weight (BW) load (ankle: 16.4% and hip: 19.0%). Moreover, our model revealed disproportionate increases in internal JRFs with increases in load carriage, suggesting a coordinated adjustment in the musculature functions in the lower extremity. FE results reflected the complex effects of spatially varying material properties distribution and muscular engagement on tibial biomechanics during walking. We observed high stresses on the anterior crest and the medial surface of the tibia at pushoff, whereas high cumulative stress during one walking cycle was more prominent in the medioposterior aspect of the tibia. Our findings reinforce the need to include: (1) physiologically accurate loading conditions when modeling healthy subjects undergoing short-term exercise training and (2) the duration of stress exposure when evaluating stress-fracture injury risk. As a fundamental step toward understanding the instantaneous effect of external loading, our study presents a means to assess the relationship between load carriage and bone biomechanics.

Mechanical and metabolic interactions in cortical bone development

OBJECTIVES

Anthropological studies of cortical bone often aim to reconstruct either habitual activities or health of past populations. During development, mechanical loading and metabolism simultaneously shape cortical bone structure; yet, few studies have investigated how these factors interact. Understanding their relative morphological effects is essential for assessing human behavior from skeletal samples, as previous studies have suggested that interaction effects may influence the interpretation from cortical structure of physical activity or metabolic status.

MATERIAL AND METHODS

This study assesses cross-sectional geometric and histomorphometric features in bones under different loading regimes (femur, humerus, rib) and compares these properties among individuals under different degrees of metabolic stress. The study sample consists of immature humans from a late medieval Lithuanian cemetery (Alytus, 14th-18th centuries AD). Analyses are based on the hypothesis that metabolic bone loss is distributed within the skeleton in a way that optimizes mechanical competency.

RESULTS

Results suggest mechanical compensation for metabolic bone loss in the cross-sectional properties of all three bones (especially ribs), suggesting a mechanism for conserving adequate bone strength for different loads across the skeleton. Microscopic bone loss is restricted to stronger bones under high loads, which may mitigate fracture risk in areas of the skeleton that are more resistive to loading, although alternative explanations are examined.

DISCUSSION

Distributions of metabolic bone loss and subsequent structural adjustments appear to preserve strength. Nevertheless, both mechanics and metabolism have a detectable influence on morphology, and potential implications for behavioral interpretations in bioculturally stressed samples due to this interaction are explored. Am J Phys Anthropol 160:317-333, 2016. © 2016 Wiley Periodicals, Inc.

The enigmas of bone without osteocytes

One of the hallmarks of tetrapod bone is the presence of numerous cells (osteocytes) within the matrix. Osteocytes are vital components of tetrapod bone, orchestrating the processes of bone building, reshaping and repairing (modeling and remodeling), and probably also participating in calcium-phosphorus homeostasis via both the local process of osteocytic osteolysis, and systemic effect on the kidneys. Given these critical roles of osteocytes, it is thought-provoking that the entire skeleton of many fishes consists of bone material that does not contain osteocytes. This raises the intriguing question of how the skeleton of these animals accomplishes the various essential functions attributed to osteocytes in other vertebrates, and raises the possibility that in acellular bone some of these functions are either accomplished by non-osteocytic routes or not necessary at all. In this review, we outline evidence for and against the fact that primary functions normally ascribed to osteocytes, such as mechanosensation, regulation of osteoblast/clast activity and mineral metabolism, also occur in fish bone devoid of these cells, and therefore must be carried out through alternative and perhaps ancient pathways. To enable meaningful comparisons with mammalian bone, we suggest thorough, phylogenetic examinations of regulatory pathways, studies of structure and mechanical properties and surveys of the presence/absence of bone cells in fishes. Insights gained into the micro-/nanolevel structure and architecture of fish bone, its mechanical properties and its physiology in health and disease will contribute to the discipline of fish skeletal biology, but may also help answer questions of basic bone biology.

Determinants of microdamage in elderly human vertebral trabecular bone

Previous studies have shown that microdamage accumulates in bone as a result of physiological loading and occurs naturally in human trabecular bone. The purpose of this study was to determine the factors associated with pre-existing microdamage in human vertebral trabecular bone, namely age, architecture, hardness, mineral and organic matrix. Trabecular bone cores were collected from human L2 vertebrae (n = 53) from donors 54–95 years of age (22 men and 30 women, 1 unknown) and previous cited parameters were evaluated. Collagen cross-link content (PYD, DPD, PEN and % of collagen) was measured on surrounding trabecular bone. We found that determinants of microdamage were mostly the age of donors, architecture, mineral characteristics and mature enzymatic cross-links. Moreover, linear microcracks were mostly associated with the bone matrix characteristics whereas diffuse damage was associated with architecture. We conclude that linear and diffuse types of microdamage seemed to have different determinants, with age being critical for both types.

Role of RANK ligand and denosumab, a targeted RANK ligand inhibitor, in bone health and osteoporosis: a review of preclinical and clinical data

BACKGROUND

Postmenopausal osteoporosis results from bone loss and decreased bone strength mediated by an increased rate of bone remodeling secondary to reduced estrogen levels. Remodeling cycles are initiated by osteoclasts, the formation, function, and survival of which depend on RANK ligand (RANKL). RANKL inhibition therefore represents a novel strategy for reducing remodeling and its effects on fracture risk.

OBJECTIVES

The goal of this study was to review the preclinical and clinical evidence supporting the value of RANKL inhibition in conditions of bone loss and to provide the rationale for the use of the fully human antibody denosumab, a RANKL inhibitor, in such conditions.

METHODS

We searched PubMed from January 2005 to May 2011 using the following terms: RANK Ligand, RANKL, denosumab, and NOT cancer, metastatic bone, or rheumatoid in the title.

RESULTS

The search method retrieved 111 articles. Preclinical evidence from several bone disease models suggests that RANKL inhibition leads to increased bone volume, density, and strength. Denosumab prevents RANKL from binding to its receptor, decreasing osteoclast activity and thereby reducing bone resorption and increasing cortical and trabecular bone mass and strength. It has consistently been reported to reduce bone turnover, increase bone density, and reduce the risk of fracture in clinical studies of postmenopausal women. Phase III head-to-head trials comparing denosumab with the bisphosphonate alendronate reported that denosumab was associated with significantly greater increases in bone density. Eczema as an adverse event and cellulitis as a serious adverse event were more common with denosumab than with placebo.

CONCLUSIONS

Preclinical studies defined the role of RANKL in bone remodeling and provided evidence for the therapeutic potential of RANKL inhibition in conditions of bone loss. Clinical studies evaluating RANKL inhibition with denosumab in postmenopausal women have reported significant reductions in vertebral, nonvertebral, and hip fractures, providing evidence compatible with the use of denosumab in postmenopausal women with osteoporosis.

Computational model for the cell-mechanical response of the osteocyte cytoskeleton based on self-stabilizing tensegrity structures

The mechanism by which mechanical stimulation on osteocytes results in biochemical signals that initiate the remodeling process inside living bone tissue is largely unknown. Even the type of stimulation acting on these cells is not yet clearly identified. However, the cytoskeleton of osteocytes is suggested to play a major role in the mechanosensory process due to the direct connection to the nucleus. In this paper, a computational approach to model and simulate the cell structure of osteocytes based on self-stabilizing tensegrity structures is suggested. The computational model of the cell consists of the major components with respect to mechanical aspects: the integrins that connect the cell with the extracellular bone matrix, and different types of protein fibers (microtubules and intermediate filaments) that form the cytoskeleton, the membrane-cytoskeleton (microfilaments), the nucleus and the centrosome. The proposed geometrical cell models represent the cell in its physiological environment which is necessary in order to give a statement on the cell behavior in vivo. Studies on the mechanical response of osteocytes after physiological loading and in particular the mechanical response of the nucleus show that the load acting on the nucleus is rising with increasing deformation applied to the integrins.

Sub-lamellar microcracking and roles of canaliculi in human cortical bone

Bone is a tough biological material. It is generally accepted that bone's toughness arises from its unique hierarchical structure, which in turn facilitates distributed microcracking prior to fracture. Yet, there has been limited progress on the detailed roles of the structural elements in the microcracking process. The present study examines the structure-microcracking relations at the lamellar and sub-lamellar levels of human cortical bone subjected to compressive loading. Laser scanning confocal microscopy revealed a clear influence of the local structure and porosity of the Haversian systems' lamellae on microcrack development. In particular, crack initiation and growth under transverse compression were associated with stress concentration at canaliculi. Later stages of microcracking showed extensive sub-lamellar cracks forming cross-hatched patterns and regularly spaced 0.5-1.7 μm apart. The density, size and regularity of the crack patterns suggest enhanced inelastic deformation capacity through cracking control at the level of mineralized collagen fibril bundles. The present study thus improves the current understanding of the nature of inelastic deformation and microcracking in bone and further suggests that bone's resistance to fracture is achieved through microcrack control at multiple length scales.

Age-related changes in the plasticity and toughness of human cortical bone at multiple length scales

The structure of human cortical bone evolves over multiple length scales from its basic constituents of collagen and hydroxyapatite at the nanoscale to osteonal structures at near-millimeter dimensions, which all provide the basis for its mechanical properties. To resist fracture, bone's toughness is derived intrinsically through plasticity (e.g., fibrillar sliding) at structural scales typically below a micrometer and extrinsically (i.e., during crack growth) through mechanisms (e.g., crack deflection/bridging) generated at larger structural scales. Biological factors such as aging lead to a markedly increased fracture risk, which is often associated with an age-related loss in bone mass (bone quantity). However, we find that age-related structural changes can significantly degrade the fracture resistance (bone quality) over multiple length scales. Using in situ small-angle X-ray scattering and wide-angle X-ray diffraction to characterize submicrometer structural changes and synchrotron X-ray computed tomography and in situ fracture-toughness measurements in the scanning electron microscope to characterize effects at micrometer scales, we show how these age-related structural changes at differing size scales degrade both the intrinsic and extrinsic toughness of bone. Specifically, we attribute the loss in toughness to increased nonenzymatic collagen cross-linking, which suppresses plasticity at nanoscale dimensions, and to an increased osteonal density, which limits the potency of crack-bridging mechanisms at micrometer scales. The link between these processes is that the increased stiffness of the cross-linked collagen requires energy to be absorbed by "plastic" deformation at higher structural levels, which occurs by the process of microcracking.

Effects of estrogen deficiency and bisphosphonate therapy on osteocyte viability and microdamage accumulation in an ovine model of osteoporosis

It has been proposed that osteocyte viability plays an important role in bone integrity, and that bone loss in osteoporosis may be partially due to osteocyte cell death following estrogen depletion. Osteoporosis treatments such as bisphosphonates can inhibit osteocyte apoptosis which in turn may also reduce remodeling. Consequently, microcracks in bone which are normally repaired by bone remodeling may accumulate. This study used an ovine model of osteoporosis to examine the effects of estrogen depletion and bisphosphonates on osteocyte apoptosis and microdamage accumulation. Skeletally mature ewes were randomly assigned into two equal groups; ovariectomy (OVX) and a non-treatment group (control). Half of these animals were sacrificed 12 months post-OVX. Twenty months post-OVX, a number of OVX animals were randomly selected and each received a supra-pharmacological dose of the bisphosphonate, zoledronic acid (Zol). This group and all the remaining animals were sacrificed 31 months post-OVX. A compact bone specimen was removed from the left metacarpal of each animal; half was used for osteocyte apoptosis detection and the remainder for microdamage analysis. Estrogen deficiency resulted in significant increases in the levels of osteocyte apoptosis while zoledronic acid significantly reduced the level of apoptosis in osteocytes. Zoledronic acid treatment resulted in the formation of more microcracks. However, these cracks were shorter than in control or OVX groups which may provide one explanation as to why increased damage levels following bisphosphonate treatment have not lead to increased fractures. This study also provides additional evidence of the importance of estrogen in preserving the osteocyte network.

A cross-linking model for estimating Young's modulus of artificial bone tissue grown on carbon nanotube scaffold

Carbon nanotubes (CNTs) provide a suitable environment for growth and proliferation of bone cells. The elastic properties exhibited by CNTs can enhance mechanical characteristics of bone mineral phase, hydroxyapatite (HAp), precipitated on such a scaffold. In this article, a simplified model for estimating the axial Young's modulus of a representative volume element (RVE) of CNT-HAp composite is presented. The model is based on the idea of HAp formation on functionalized sites on CNTs as cross-links between HAp matrix and CNT. Modeling results show that the reinforcement role contributed by CNT in the RVE causes a significant increase in the Young's modulus of the composite material which is a direct consequence of transferring stresses from the HAp matrix to the CNT through the cross-links. Similar conclusions may be suggested regarding the improvement of overall mechanical properties of the material. The prediction made by the model lies reasonably well within the limits proposed by conventional Rule-of-Mixtures, and sliding below Voigt's model. The Young's modulus predicted by the model lies adjacent to the Hashin-Shtrikman upper bound as a function of the RVE length (or equivalently CNT aspect ratio). The model simulation indicates that an increase in the CNT aspect ratio and/or number of cross-links in the RVE, results in the prediction to move closer to the estimation made by Voigt as the assumption of perfect bonding between composite phases is approached.

The relationship between bone mechanical properties and ground reaction forces in normal and hypermuscular mice

Understanding the relationship between external load and bone morphology is critical for understanding adaptations to load in extant animals and inferring behavior in extinct forms. Yet, the relationship between bony anatomy and load is poorly understood, with empirical studies often producing conflicting results. It is widely assumed in many ecological and paleontological studies that bone size and strength reflect the forces experienced by the bone in vivo. This study examines that assumption by providing preliminary data on gait mechanics in a hypermuscular myostatin-deficient mouse model with highly mineralized and hypertrophied long bones. A small sample of hypermuscular and wild-type mice was video recorded while walking freely across a force platform. Temporal gait parameters, peak vertical and transverse (mediolateral) ground reaction forces (GRFs), vertical impulse, and loading rates were measured. The only gait parameters that differed between the two groups were the speeds at which the animals traveled and the transverse forces on the hind limb. The myostatin-deficient mice move relatively slowly and experienced the same magnitude of vertical forces on all limbs and transverse forces on the forelimb as the wild-type mice; though the myostatin-deficient mice did experience lower mediolateral forces on their hindlimbs compared with the wild-type mice. These preliminary results call into question the hypothesis that skeletal hypertrophy observed in hypermuscular mice is a result of larger GRFs experienced by the animals' limbs during locomotion. This calls for further analysis and a cautious approach to inferences about locomotor behavior derived from bony morphology in extant and fossil species.

Effects of trabecular type and orientation on microdamage susceptibility in trabecular bone

Trabecular architecture becomes more rod-like and anisotropic in osteoporotic and aging trabecular bone. In order to address the effects of trabecular type and orientation on trabecular bone damage mechanics, microstructural finite element modeling was used to identify the yielded tissue in ten bovine tibial trabecular bone samples compressed to 1.2% on-axis apparent strain. The yielded tissue was mapped onto individual trabeculae identified by an Individual Trabeculae Segmentation (ITS) technique, and the distribution of the predicted yielding among trabecular types and orientations was compared to the experimentally measured microdamage. Although most of the predicted yielded tissue was found in longitudinal plates (73+/-11%), the measured microcrack density was positively correlated with the proportion of the yielded tissue in longitudinal rods (R(2)=0.52, p=0.02), but not in rods of other directions or plates. The overall fraction of rods and the fractions of rods along the longitudinal and transverse axes were also correlated with the measured microcrack density. In contrast, diffuse damage area did not correlate with any of these quantities. These results agree with the findings that both in vitro and in vivo microcrack densities are correlated with Structure Model Index (SMI), and are also consistent with decreased energy to failure in more rod-like trabecular bone. Together the results suggest that bending or buckling deformations of rod-like trabeculae may make trabecular structures more susceptible to microdamage formation. Moreover, while simple strain-based tissue yield criteria may account for macroscopic yielding, they may not be suitable for identifying damage.

Characterization of indentation response and stiffness reduction of bone using a continuum damage model

Indentation tests can be used to characterize the mechanical properties of bone at small load/length scales offering the possibility of utilizing very small test specimens, which can be excised using minimally-invasive procedures. In addition, the need for mechanical property data from bone may be a requirement for fundamental multi-scale experiments, changes in nano- and micro-mechanical properties (e.g., as affected by changes in bone mineral density) due to drug therapies, and/or the development of computational models. Load vs. indentation depth data, however, is more complex than those obtained from typical macro-scale experiments, primarily due to the mixed state of stress, and thus interpretation of the data and extraction of mechanical properties is more challenging. Previous studies have shown that cortical bone exhibits a visco-elastic response combined with permanent deformation during indentation tests, and that the load vs. indentation depth response can be simulated using a visco-elastic/plastic material model. The model successfully captures the loading and creep displacement behavior, however, it does not adequately reproduce the unloading response near the end of the unloading cycle, where a pronounced decrease in contact stiffness is observed. It is proposed that the stiffness reduction observed in bone results from an increase in damage; therefore, a plastic-damage model was investigated and shown capable of simulating a typical bone indentation response through an axisymmetric finite element simulation. The plastic-damage model was able to reproduce the full indentation response, especially the reduced stiffness behavior exhibited during the latter stages of unloading. The results suggest that the plastic-damage model is suitable for describing the complex indentation response of bone and may provide further insight into the relationship between model parameters and mechanical/physical properties.

Micro-computed tomography of fatigue microdamage in cortical bone using a barium sulfate contrast agent

Accumulation of microdamage during fatigue can lead to increased fracture susceptibility in bone. Current techniques for imaging microdamage in bone are inherently destructive and two-dimensional. Therefore, the objective of this study was to image the accumulation of fatigue microdamage in cortical bone using micro-computed tomography (micro-CT) with a barium sulfate (BaSO(4)) contrast agent. Two symmetric notches were machined on the tensile surface of bovine cortical bone beams in order to generate damage ahead of the stress concentrations during four-point bending fatigue. Specimens were loaded to a specified number of cycles or until one notch fractured, such that the other notch exhibited the accumulation of microdamage prior to fracture. Microdamage ahead of the notch was stained in vitro by precipitation of BaSO(4) and imaged using micro-CT. Reconstructed images showed a distinct region of bright voxels around the notch tip or along propagating cracks due to the presence of BaSO(4), which was verified by backscattered electron imaging and energy dispersive spectroscopy. The shape of the stained region ahead of the notch tip was consistent with principal strain contours calculated by finite element analysis. The relative volume of the stained region was correlated with the number of loading cycles by non-linear regression using a power-law. This study demonstrates new methods for the non-destructive and three-dimensional detection of fatigue microdamage accumulation in cortical bone in vitro, which may be useful to gain further understanding into the role of microdamage in bone fragility.

Vertebral endplate morphology follows bone remodeling principles

STUDY DESIGN

A finite element model coupled with an iterative bone remodeling algorithm was used to optimize the morphology of the lumbar vertebrae.

OBJECTIVE

To theoretically predict the optimal vertebral density and thickness of the vertebral cortex and endplates.

SUMMARY OF BACKGROUND DATA

Regional bone density variations have been reported. Both density and thickness of the endplate have been shown to increase toward the vertebral periphery. This study sought to address the possibility that the subchondral bone seeks an optimal morphology based on the principles of bone remodeling.

METHODS

An adaptive remodeling algorithm, driven by strain energy density, was applied to a previously validated 3D, nonlinear finite element model of an intact ligamentous L3-L5 segment. Both internal and external remodeling changes were considered.

RESULTS

The density of the vertebral cortex approached that of cortical bone, whereas the thickness of the anterior cortex exceeded that of the posterior shell and either endplate. The endplates thinned regionally over- and underlying the nucleus, increasing in thickness toward the periphery.

CONCLUSION

The similarities between the models of the present investigation and various experimental reports indicate that the changes in the morphology of vertebral bone as the result of a mechanical adaptive process may be described via an adaptive bone remodeling theory.

Predicting trabecular bone microdamage initiation and accumulation using a non-linear perfect damage model

Studies evaluating the mechanical behavior of the trabecular microstructure play an important role in our understanding of pathologies such as osteoporosis, and in increasing our understanding of bone fracture and bone adaptation. Understanding of such behavior in bone is important for predicting and providing early treatment of fractures. The objective of this study is to present a numerical model for studying the initiation and accumulation of trabecular bone microdamage in both the pre- and post-yield regions. A sub-region of human vertebral trabecular bone was analyzed using a uniformly loaded anatomically accurate microstructural three-dimensional finite element model. The evolution of trabecular bone microdamage was governed using a non-linear, modulus reduction, perfect damage approach derived from a generalized plasticity stress-strain law. The model introduced in this paper establishes a history of microdamage evolution in both the pre- and post-yield regions.

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.

Risedronate and alendronate suppress osteocyte apoptosis following cyclic fatigue loading

PURPOSE

The purpose of this study was to determine whether bisphosphonate treatment can prevent or delay osteocyte apoptosis in a cyclic fatigue animal model and if there are differences between two different bisphosphonates in their effects on osteocyte apoptosis.

INTRODUCTION

Fatigue loading induces microdamage in long bones in rats and causes osteocyte apoptosis. In vitro data suggest that the bisphosphonates can prevent osteocyte apoptosis.

MATERIALS AND METHODS

Six month old female Sprague-Dawley rats (n=72) were given a daily subcutaneous (sc) injection of saline vehicle, risedronate (RIS: 0.05 mug/kg per day) or alendronate (ALN: 0.1 mug/kg per day). On the 8th day of drug treatment, an axial compressive load was applied to the right ulna using a load-controlled electromagnetic device (17N, 6000 cycles, 2 Hz, 10% loss of stiffness approximately 1 h). Three, seven or ten days after loading, the animals were sacrificed. Immunohistochemistry for caspase-3 was performed to assess the extent of osteocyte apoptosis in loaded and non-loaded ulnas.

RESULTS

Microdamage (Mdx) created by cyclic loading of the ulna induced a significant increase (p=0.03) in the number of apoptotic osteocytes compared to non-damaged regions of the same ulna, and compared to the contralateral non-loaded ulna. Risedronate and alendronate had an early effect (3 days after loading) on reducing load-induced osteocyte apoptosis. Risedronate significantly reduced the density of apoptotic osteocytes compared to vehicle-treated controls by approximately 50% in the Mdx area, whereas alendronate reduced it by approximately 40%. There were no differences among groups by seven days following loading.

CONCLUSIONS

(1) Low doses of risedronate or alendronate suppressed osteocyte apoptosis induced by fatigue loading of the ulna in rats. (2) There was no difference between the effects of risedronate or alendronate on osteocyte apoptosis at these doses.

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.

Prediction of microdamage formation using a mineral-collagen composite model of bone

Age-related changes in bone quality are mainly manifested in the reduced toughness. Since the post-yield deformation of bone is realized through microdamage formation (e.g., microcracking and diffuse damage), it is necessary to understand the mechanism of microdamage formation in bone in order to elucidate underlying mechanisms of age-related bone fractures. In this study, a two-dimensional shear lag model was developed to predict stress concentration fields around an initial crack in a mineral-collagen composite. In this model, non-linear elasticity was assumed for the collagen phase, and linear elasticity for the mineral. Based on the pattern of the stress concentration fields, the condition for microdamage formation was discussed. The results of our analyses indicate that: (1) an initial crack formed in mineral phase may cause stress concentration in the adjacent mineral layers; (2) the pattern of stress concentration fields depends not only on the spatial but also mechanical properties of the collagen and mineral phases; (3) the pattern of the stress concentration fields could determine either coalescence or scattering of nano cracks around the initial crack.

Bone marrow cell differentiation induced by mechanically damaged osteocytes in 3D gel-embedded culture

Osteocytes are suggested to have a crucial role in the initial resorptive phase of bone turnover after microdamage. To study the role of osteocytes in targeted remodeling, we developed an in vitro model, in which osteocytes can be locally damaged and their interactions with bone marrow cells studied. Our results show that the damaged osteocytes activate the osteoclast precursors by soluble factors and thus can control the initial phase of targeted remodeling.

INTRODUCTION

Microdamage in bone contributes to fractures and acts as a stimulus for bone remodeling. Besides the targeted remodeling, some remodeling may also be random to serve metabolic purposes. Osteocytes have been considered to provide a crucial role in the activation of osteoclastic bone resorption adjacent to the damaged site. This study was aimed to develop a relevant in vitro model of the targeted remodeling and to show that damaged osteocytes can induce the initial bone resorptive stage.

MATERIALS AND METHODS

We developed a new device, in which osteocyte-like cell line MLO-Y4 cells were 3D cultured, subjected to local scratching, and assayed for cell viability. NIH3T3-3 cells were used as a control. Bone marrow cells were cultured on the top of the mechanically damaged MLO-Y4 cells, and the formation of TRACP+ cells was assayed. Additionally, the conditioned medium from scratched cultures was added to bone marrow cultures, and the TRACP activity in cell lysates was quantified. The macrophage-colony stimulating factor (M-CSF) and RANKL secretion in the conditioned medium was assayed by ELISA.

RESULTS

Scratching induced the death of MLO-Y4 cells. When bone marrow cells were cultured over the gel-embedded MLO-Y4 cells, the application of mechanical scratching induced TRACP+ cell differentiation on gel surface. The cells with TRACP+ could be observed in the very restricted region along the scratching path. Additionally, mechanically damaged osteocytes secreted M-CSF and RANKL, and the conditioned medium showed the potential to induce TRACP+ cells in bone marrow culture.

CONCLUSIONS

These findings indicate that soluble factors secreted from damaged osteocytes can locally induce and activate the initial phase of osteoclastic cell formation. This study directly shows the association between the damaged osteocytes and the initiation of resorptive stage in bone remodeling.

Modeling and remodeling responses to normal loading in the human lower limb

Limb bones are designed to be strong enough to support the body and yet be energetically conservative during locomotion. Bones of the distal segment, which are relatively costly to move, are often more slender than bones of the proximal segments, even though they must sustain proportionally greater loads. As a result, they are expected to experience a higher incidence of microdamage. With this constraint in mind, Lieberman and Crompton (1998 Principles of Animal Design, Cambridge: Cambridge University Press, p. 78-86) proposed that bones response to strain varies along the proximo-distal axis of the limb. In order to avoid fatigue fractures due to the accumulation of microdamage, the distal segment, in comparison to the proximal segment, will have an increase in remodeling events to replace damaged bone. In this paper, we test the hypothesis of Lieberman and Crompton (1998) with respect to the human lower limb. With a sample of adult individuals, we compare tibiae and femora for mid-diaphyseal cross-sectional geometry and Haversian remodeling differences. Our results indicate that the human limb is not designed like that of quadrupedal cursorial animals. The tibia is not less resistant in bending and torsion, and does not remodel more than the femur. Our findings fail to support the hypothesis of Lieberman and Crompton (1998) and suggest, instead, that the human lower limb is not designed like a cursorial animal limb. In addition, our results support previous observations that remodeling is not uniform within the cross section of a bone, probably a reflection of different loading histories within the different regions of the cross section.

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.

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.

The past, present, and future of bone morphometry: its contribution to an improved understanding of bone biology

It was not until the 1950s that a better paradigm for bone biology evolved, which led to the birth of bone histomorphometry. Two clinicians, Harold Frost (1958-1964) and Lent Johnson (1964), were responsible for the paradigm stating that the primary function of bone is mechanical load bearing with subsidiary function to participate in plasma calcium homeostasis to support hematopoesis. Dynamic bone histomorphometry was born when Milch et al. (1958) discovered bone localization of tetracycline and Frost generated the methodology to study tetracycline-based dynamic histological analysis of cortical bone remodeling (1961-1965). Dynamic bone histomorphometry did not blossom until Frost, while a Sun Valley Workshop participant, developed it to address trabecular bone dynamics. The combination of Arnold (1948) producing thin sections of plastic-embedded undecalcified bone and Frost's (1977-1983) modification of dynamic cortical bone histology for cancellous bone made it possible to study tetracycline-based dynamic histomorphometry of cancellous bone. It led to the better understanding of basic metabolic unit (BMU) remodelling and to Frost's mechanostat hypothesis, and characterized the rat model to accelerate the development of several drugs in the treatment of bone diseases. Currently, dynamic bone histomorphometry has contributed to studies in bone's mechanical usage windows, mechanical usage setpoint hypothesis, muscle-bone relations, marrow-bone relations, the Utah paradigm of musculoskeletal physiology, apoptosis, genetics (transgenic mice) and bone structure, bone quality, the lacunocanalicular network and bone modelling, and remodeling hypothesis, osteocyte role as mechanosensory, chemosensory, and regulatory in bone maintenance, targeted and untargeted remodeling, the role of permissive agents, etc., items in bone biology expounded briefly by Lent Johnson (1965) and continuously by Harold Frost at the Sun Valley Workshop (1965-2003). Finally, "What's next?" covers how to improve and perpetuate the employing of qualitative histomorphometry in research opportunities in hard tissue research.

Cement lines of secondary osteons in human bone are not mineral-deficient: New data in a historical perspective

Using qualitative backscattered electron (BSE) imaging and quantitative energy dispersive X-ray (EDX) spectroscopy, some investigators have concluded that cement (reversal) lines located at the periphery of secondary osteons are poorly mineralized viscous interfaces with respect to surrounding bone. This conclusion contradicts historical observations of apparent highly mineralized (or collagen-deficient) cement lines in microradiographs. Such conclusions, however, may stem from unrecognized artifacts that can occur during scanning electron microscopy. These include specimen degradation due to high-energy beams and the sampling of electron interaction volumes that extend beyond target locations during EDX analysis. This study used quantitative BSE imaging and EDX analysis, each with relatively lower-energy beams, to test the hypothesis that cement lines are poorly mineralized. Undemineralized adult human femoral diaphyses (n = 8) and radial diaphyses (n = 5) were sectioned transversely, embedded in polymethyl methacrylate, and imaged in a scanning electron microscope for BSE and EDX analyses. Unembedded samples were also evaluated. Additional thin embedded samples were stained and evaluated with light microscopy and correlated BSE imaging. BSE analyses showed the consistent presence of a bright line (higher atomic number) coincident with the classical location and description of the cement line. This may represent relative hypermineralization or, alternatively, collagen deficiency with respect to surrounding bone. EDX analyses of cement lines showed either higher Ca content or equivalent Ca content when compared to distant osteonal and interstitial bone. These data reject the hypothesis that cement lines of secondary osteons are poorly mineralized.

Case report: restoration of edentulous mandible with 4 BOI implants in an immediate load procedure

Dental implants for insertion from the lateral aspects of the jaw bone have been described repeatedly, since 1972. Long term results have been reported. Due to their design, BOI-Implants (basal osseointegration) can be installed even in those cases, where the vertical bone supply is reduced. This applies to the distal areas of the maxilla and the mandible. Furthermore, BOI-implants allow immediate loading as long as a balanced masticatory function can be achieved and maintained. This paper reports on the steps taken to install a full lower bridge in 4 BOI-implants and restoration in a patient with a circular bridge. The bridge was made from CoCr-Alloy and covered with acrylic resin. This treatment technique reduces costs and treatment time by about 50% compared to conventional techniques.

Effects of damage on the orthotropic material symmetry of bovine tibial trabecular bone

The macroscopic mechanical properties of trabecular bone can be predicted by its architecture using theoretical relationships between the elastic and architectural properties. Microdamage caused by overloading or fatigue decreases the apparent elastic moduli of trabecular bone requiring these relationships to be modified to predict the damaged elastic properties. In the case of isotropic damage, the apparent level elastic properties could be determined by multiplying all of the elastic constants by a single scalar factor. If the damage is anisotropic, the elastic constants may change by differing factors and the material coordinate system could become misaligned with the fabric coordinate system. High-resolution finite element models were used to simulate damage overloading on seven trabecular bone specimens subjected to pure shear strain in two planes. Comparison of the apparent elastic moduli of the specimens before and after damage showed that the reduction of the elastic moduli was anisotropic. This suggests that the microdamage within the specimens was inhomogeneous. However, after damage the specimens exhibited nearly orthotropic material symmetry as they did before damage. Changes in the orientation of the orthotropic material coordinate system were also small and occurred primarily in the transverse plane. Thus, while damage in trabecular bone is anisotropic, the material coordinate system remains aligned with the fabric tensor.

The cellular transducer in damage-stimulated bone remodelling: a theoretical investigation using fracture mechanics

This paper reports on some theoretical work which used fracture mechanics concepts to draw conclusions about the nature of the so-called 'cellular transducer': the means by which bone cells detect the presence of damage and thus initiate remodelling and adaptation activities. Using analytical and numerical methods, we estimated the strains and displacements around cracks of the typical size, shape and orientation that normally occur in compact bone. We predicted that it is not possible for osteocytes or their processes to be fractured as a result of direct tensile strains, because the strains generated are much less than the expected failure strains of cellular material. We proposed a new failure mechanism by which osteocyte processes spanning the crack are cut by shearing motions between the crack faces. We predicted that failures of this type can occur. Failures begin to occur if crack lengths become greater than normal (100 microm), so this could act as a signal to initiate repair processes for individual cracks. Very large numbers of cell processes (greater than 1000) will fail if the crack length and/or applied stress reach dangerous levels (300 microm and 60 Mpa, respectively) at which point bone deposition may be required to prevent stress fractures. Similar results also occurred if we proposed a different mechanism of damage detection, involving cells' ability to detect the high levels of strain that occur near crack tips. This work, though based on theoretical mechanics considerations, suggests some biological experiments which might confirm our findings.

The aging of Wolff's ?law?: Ontogeny and responses to mechanical loading in cortical bone

The premise that bones grow and remodel throughout life to adapt to their mechanical environment is often called Wolff's law. Wolff's law, however, is not always true, and in fact comprises a variety of different processes that are best considered separately. Here we review the molecular and physiological mechanisms by which bone senses, transduces, and responds to mechanical loads, and the effects of aging processes on the relationship (if any) between cortical bone form and mechanical function. Experimental and comparative evidence suggests that cortical bone is primarily responsive to strain prior to sexual maturity, both in terms of the rate of new bone growth (modeling) as well as rates of turnover (Haversian remodeling). Rates of modeling and Haversian remodeling, however, vary greatly at different skeletal sites. In addition, there is no simple relationship between the orientation of loads in long bone diaphyses and their cross-sectional geometry. In combination, these data caution against assuming without testing adaptationist views about form-function relationships in order to infer adult activity patterns from skeletal features such as cross-sectional geometry, cortical bones density, and musculo-skeletal stress markers. Efforts to infer function from shape in the human skeleton should be based on biomechanical and developmental models that are experimentally tested and validated.

Regional differences in cortical bone organization and microdamage prevalence in Rocky Mountain mule deer

The limb bones of cursorial mammals may exhibit regional structural/material variations for local mechanical requirements. For example, it has been hypothesized that mineral content (%ash) and secondary osteon population density (OPD) progressively change from proximal (e.g., humerus) to distal (e.g., phalanx), in accordance with corresponding progressive changes in stress and mechanical/metabolic cost of functional use (both greatest in the distal limb). We tested this hypothesis in wild-shot Rocky Mountain mule deer by examining transverse segments from mid-diaphyses of medial proximal phalanges, principal metacarpals, radii, and humeri, as well as the lateral aspects of sixth ribs from each of 11 mature males. Quantified structural parameters included the section modulus (Z), polar moment of inertia (J), cortical area/total area ratio (CA/TA), bone girth, and cortical thickness. In addition, %ash and the prevalence of in vivo microcracks were measured in each bone. Thin sections from seven animals were further examined for OPD and population densities of new remodeling events (NREs). Results showed a significant progressive decrease in %ash from the humerus (75.4% +/- 0.9%) to the phalanx (69.4% +/- 1.1%) (P < 0.0001), with general proximal-to-distal increases in OPD and general decreases in J and Z. Thirteen microcracks were identified in the rib sections, and only two were observed in the limb bones. Although the ribs had considerably greater NREs, no significant differences in NREs were found between the limb bones, indicating that they had similar remodeling rates. Equivalent microcrack prevalence, but nonequivalent structural/material organization, suggests that there are regional adaptations that minimize microcrack production in locations with differences in loading conditions. The progressive proximal-to-distal decrease in %ash (up to 6%); moderate-to-high correlations between OPD, %ash, J, and CA/TA; and additional moderate-to-high correlations of these parameters with each bone's radius of gyration support the possibility that these variations are adaptations for regional loading conditions.

Optimization of bone growth and remodeling in response to loading in tapered mammalian limbs

How bones respond dynamically to mechanical loading through changes in shape and structure is poorly understood, particularly with respect to variations between bones. Structurally, cortical bones adapt in vivo to their mechanical environments primarily by modulating two processes, modeling and Haversian remodeling. Modeling, defined here as the addition of new bone, may occur in response to mechanical stimuli by altering bone shape or size through growth. Haversian remodeling is thought to be an adaptation to repair microcracks or prevent microcrack propagation. Here, we examine whether cortical bone in sheep limbs modulates periosteal modeling and Haversian remodeling to optimize strength relative to mass in hind-limb midshafts in response to moderate levels of exercise at different growth stages. Histomorphometry was used to compare rates of periosteal growth and Haversian remodeling in exercised and sedentary treatment groups of juvenile, subadult and young adult sheep. In vivo strain data were also collected for the tibia and metatarsal midshafts of juvenile sheep. The results suggest that limb bones initially optimize responses to loading according to the varying power requirements associated with adding mass at different locations. In juveniles, exercise induces higher rates of periosteal modeling in proximal midshafts and higher rates of Haversian remodeling in distal midshafts. Consequently, distal element midshafts experience higher strains and, presumably, have lower safety factors. As animals age, periosteal modeling rates decline and Haversian remodeling rates increase, but moderate levels of mechanical loading stimulate neither process significantly.

Microcrack accumulation at different intervals during fatigue testing of compact bone

Fatigue damage in bone occurs in the form of microcracks. This microdamage contributes to the formation of stress fractures and acts as a stimulus for bone remodelling. A technique has been developed, which allows microcrack growth to be monitored during the course of a fatigue test by the application of a series of fluorescent chelating agents. Specimens were taken from bovine tibiae and fatigue tested in cyclic compression at a stress range of 80MPa. The specimens were stained before testing with alizarin and up to three other chelating agents were applied during testing to label microcracks formed at different times. Microcracks initiated in interstitial bone in the early part of a specimen's life. Further accumulation of microcracks is then suppressed until the period late in the specimen's life. Microcracks were found to be longer in the longitudinal than in the transverse direction. Only a small proportion of cracks are actively propagating; these are longer than non-propagating cracks. These results support the concept of a microstructural barrier effect existing in bone, whereby cracks initiate easily but slow down or stop at barriers such as cement lines.