Abstract

Background Bone mineral density is widely used by clinicians for screening osteoporosis and assessing bone strength. However, its effectiveness has been reported unsatisfactory. In this study, it is demonstrated that bone organic-inorganic phase ratio is a fundamental determinant of bone material quality measured by stiffness, strength, and toughness. Methods and Results Two-hundred standard bone specimens were fabricated from bovine legs, with a specialized manufacturing method that was designed to reduce the effect of bone anisotropy. Bone mechanical properties of the specimens, including Young's modulus, yield stress, peak stress, and energy-to-failure, were measured by mechanical testing. Organic and inorganic mass contents of the specimens were then determined by bone ashing. Bone density and organic-inorganic phase ratio in the specimens were calculated. Statistical methods were applied to study relationships between the measured mechanical properties and the organic-inorganic phase ratios. Statistical characteristics of organic-inorganic phase ratios in the specimens with top material quality were investigated. Bone organic-inorganic phase ratio had strong Spearman correlation with bone material properties. Bone specimens that had the highest material quality had a very narrow scope of organic-inorganic phase ratio, which could be considered as the “optimal” ratio among the tested specimens. Conclusion Bone organic-inorganic phase ratio is a fundamental determinant of bone material quality. There may exist an “optimal” ratio for the bone to achieve top material quality. Deviation from the “optimal” ratio is probably the fundamental cause of various bone diseases. This study suggests that bone organic-inorganic phase ratio should be considered in clinical assessment of fracture risk.

Highlights

  • Bone fracture is a common health concern among elderly people over the world, mainly due to the prevalence of osteoporosis and accident fall in the population [1,2,3,4]

  • Extensive experimental studies have shown that at the material level, there is a relationship between bone strength and Bone density (BD) [5,6,7,8], and BD can be noninvasively measured by imaging technologies such as dual energy Xray absorptiometry and quantitative computed tomography

  • Bone mineral density is recommended by the World Health Organization as a gold reference for the screening of osteoporosis and for the assessment of fracture risk [12, 13]

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Summary

Introduction

Bone fracture is a common health concern among elderly people over the world, mainly due to the prevalence of osteoporosis and accident fall in the population [1,2,3,4]. Bone strength is a key mechanical property for the assessment of fracture risk. Bone mineral density is recommended by the World Health Organization as a gold reference for the screening of osteoporosis and for the assessment of fracture risk [12, 13]. It is demonstrated that bone organic-inorganic phase ratio is a fundamental determinant of bone material quality measured by stiffness, strength, and toughness. Statistical methods were applied to study relationships between the measured mechanical properties and the organic-inorganic phase ratios. Statistical characteristics of organic-inorganic phase ratios in the specimens with top material quality were investigated. Bone organic-inorganic phase ratio is a fundamental determinant of bone material quality. This study suggests that bone organic-inorganic phase ratio should be considered in clinical assessment of fracture risk

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