Interaction of ultrasound waves with bone remodelling: a multiscale computational study.

Abstract

Ultrasound stimulation is thought to influence bone remodelling process. But recently, the efficiency of ultrasound therapy for bone healing has been questioned. Despite an extensive literature describing the positive effect of ultrasound on bone regeneration-cell cultures, animal models, clinical studies-there are more and more reviews denouncing the inefficiency of clinical devices based on low-intensity pulsed ultrasound stimulation (LIPUS) of the bone healing. One of the reasons to cause controversy comes from the persistent misunderstanding of the underlying physical and biological mechanisms of ultrasound stimulation of bone repair. As ultrasonic waves are mechanical waves, the process to be studied is the one of the mechanotransduction. Previous studies on the bone mechanotransduction have demonstrated the key role of the osteocytes in bone mechano-sensing. Osteocytes are bone cells ubiquitous inside the bone matrix; they are immersed in the interstitial fluid (IF) inside the lacuno-canalicular network (LCN). They are considered as particularly sensitive to a particular type of mechanical stress: wall shear stress on osteocytes due to the IF flow in the LCN. Inspired from these findings and observations, the present work investigates the effect of LIPUS on the cortical bone from the tissue to the osteocytes, considering that the impact of the ultrasound stimulation applied at the tissue scale is related to the mechanical stress experimented by the bone cells. To do that simulations based on the finite element method are carried out in the commercial software Comsol Multiphysics to assess the wall shear stress levels induced by the LIPUS on the osteocytes. Two formulations of the wall shear stress were investigated based on two IF flow models inside the LCN and associated with two different values of the LCN permeability. The wall shear stress estimate is very different depending on the assumption considered. One of these two models provides wall shear stress values in accordance with previous works published on bone mechanotransduction. This study presents the preliminary results of a computational model that could provide keys to understanding the underlying mechanisms of the LIPUS.