Abstract
The piezoelectricity of bone is known to play a crucial role in bone adaptation and remodeling. The application of an external stimulus such as mechanical strain or electric field has the potential to enhance bone formation and implant osseointegration. Therefore, in the present study, the objective is to investigate bone remodeling under electromechanical stimulation as a step towards establishing therapeutic strategies. For the first time, piezoelectric bone remodeling in the human proximal tibia under electro-mechanical loads was analyzed using the finite element method in an open-source framework. The predicted bone density distributions were qualitatively and quantitatively assessed by comparing with the computed tomography (CT) scan and the bone mineral density (BMD) calculated from the CT, respectively. The effect of model parameters such as uniform initial bone density and reference stimulus on the final density distribution was investigated. Results of the parametric study showed that for different values of initial bone density the model predicted similar but not identical final density distribution. It was also shown that higher reference stimulus value yielded lower average bone density at the final time. The present study demonstrates an increase in bone density as a result of electrical stimulation. Thus, to minimize bone loss, for example, due to physical impairment or osteoporosis, mechanical loads during daily physical activities could be partially replaced by therapeutic electrical stimulation.
Highlights
The human skeletal system consists of bones and joints, which maintains the structural integrity of the body, provides sites for muscle attachment, and facilitates body movements (Cowin, 2001)
The end configuration predicted fairly accurate density distribution with the trabecular bone beneath the tibial plateau, greater bone density in the medial region than in the lateral region, intramedullary canal with little trabecular bone, and cortical layers in the distal tibia. These observations are in good accordance with previous studies on tibial bone remodeling performed using commercial software (Rakotomanana, 2000; Perez et al, 2010; Robalo, 2011; Fang et al, 2013; Quilez et al, 2017)
root mean square (RMS) error and mean deviation (MD) were computed for 182 nodal points (Figure 5E) that were selected using a nonprobability convenience sampling technique (Lombardo et al, 2017)
Summary
The human skeletal system consists of bones and joints, which maintains the structural integrity of the body, provides sites for muscle attachment, and facilitates body movements (Cowin, 2001). Bone adapts its structure in response to changes in its mechanical loading environment and this adaptation process is known as bone remodeling (Robling and Turner, 2009). This process has a significant impact on the individual’s health and bone remodeling study is of prime importance. In order to achieve better understanding of mechanical and electrical interactions that occur during these processes, computational analysis of piezoelectric bone remodeling is of great interest in musculoskeletal biomechanics. Bone remodeling has multiple aspects, these are confined to study the response of bone to a particular loading type
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