Cortical Bone Geometry Research Articles

Geometrically accurate 3D FE models from medical scans created to analyse the causes of sports injuries

Development of Finite Element (FE) modelling techniques has allowed the creation of 3D models based upon high resolution Computed Tomography (CT) images, which have been used to assess the mechanical properties of bone, fixation techniques, and the performance of bone micro-architecture. In this study, a semi-automated process for converting CT data into FE models has been used to investigate if the automated geometry and material properties mapping of mid-shaft cortical bone. In order to develop the process, a porcine femoral specimen was imaged with a spiral CT scanner, allowing the semi-automated creation of a 3D FE model. Inhomogeneous material properties were mapped using the Bonemat algorithm which allows automated adjustment of values from CT data. The 3D model was cropped at the start of each metaphyseal region to isolate the mid-shaft region for testing. Hand calculation of the mid-shaft was undertaken using a composite ellipse solution, which allowed the direction and magnitude of the maximum stresses, and the deflection occurring within the bone mid-shaft to be analysed with respect to the results obtained within the finite element testing. Predictions from the ellipse method correlated significantly well with the stress patterns and maximum deflections achieved within the 3D FE model, validating the modelling process for future testing. Using CT-derived FE analysis to determine failure mechanisms has great potential for use as a tool in fracture analysis. The increased geometrical accuracy has potential for use within Sports Injuries studies, where the inherent complexity of skeletal modelling and multi-factor loading conditions can often lead to errors in simplified solutions. Further understanding of failure mechanisms such as these can be used to influence the design of sports equipment and surfaces, helping to prevent sports injuries in the future.

Effects of repetitive loading on the growth-induced changes in bone mass and cortical bone geometry: A 12-month study in pre/peri- and postmenarcheal tennis players

Pre- and early puberty may be the most opportune time to strengthen the female skeleton, but there are few longitudinal data to support this claim. Competitive female premenarcheal (pre/peri, n = 13) and postmenarcheal (post, n = 32) tennis players aged 10 to 17 years were followed over 12 months. The osteogenic response to loading was studied by comparing the playing and nonplaying humeri for dual-energy X-ray absorptiometry (DXA) bone mineral content (BMC) and magnetic resonance imaging (MRI) total bone area (ToA), medullary area (MedA), cortical area (CoA), and muscle area (MCSA) at the humerus. Over 12 months, growth-induced gains (nonplaying arm) in BMC, ToA, and CoA were greater in pre/peri (10% to 19%, p < .001) than in post (3% to 5%, p < .05 to .001) players. At baseline, BMC, ToA, CoA, and MCSA were 8% to 18% greater in the playing versus nonplaying arms in pre/peri and post players (all p < .001); MedA was smaller in the playing versus nonplaying arms in post only players (p < .05). When comparing the annual gains in the playing arm relative to changes in the nonplaying arm, the increases in ToA and CoA were greater in pre/peri than post players (all p < .05). The smaller the side-to-side differences in BMC and CoA at baseline, the larger the exercise benefits at 12 months (r = -0.39 to -0.48, p < .01). The exercise-induced change in MCSA was predictive of the exercise benefits in BMC in pre/peri players only (p < .05). In conclusion, both pre/peri- and postmenarcheal tennis players showed significant exercise-induced skeletal benefits within a year, with greater benefits in cortical bone geometry in pre/perimenarcheal girls.

A novel underuse model shows that inactivity but not ovariectomy determines the deteriorated material properties and geometry of cortical bone in the tibia of adult rats

Our goal in this study was to determine to what extent the physiologic consequences of ovariectomy (OVX) in bones are exacerbated by a lack of daily activity such as walking. We forced 14-week-old female rats to be inactive for 15 weeks with a unique experimental system that prevents standing and walking while allowing other movements. Tibiae, femora, and 4th lumbar vertebrae were analyzed by peripheral quantitative computed tomography (pQCT), microfocused X-ray computed tomography (micro-CT), histology, histomorphometry, Raman spectroscopy, and the three-point bending test. Contrary to our expectation, the exacerbation was very much limited to the cancellous bone parameters. Parameters of femur and tibia cortical bone were affected by the forced inactivity but not by OVX: (1) cross-sectional moment of inertia was significantly smaller in Sham-Inactive rat bones than that of their walking counterparts; (2) the number of sclerostin-positive osteocytes per unit cross-sectional area was larger in Sham-Inactive rat bones than in Sham-Walking rat bones; and (3) material properties such as ultimate stress of inactive rat tibia was lower than that of their walking counterparts. Of note, the additive effect of inactivity and OVX was seen only in a few parameters, such as the cancellous bone mineral density of the lumbar vertebrae and the structural parameters of cancellous bone in the lumbar vertebrae/tibiae. It is concluded that the lack of daily activity is detrimental to the strength and quality of cortical bone in the femur and tibia of rats, while lack of estrogen is not. Our inactive rat model, with the older rats, will aid the study of postmenopausal osteoporosis, the etiology of which may be both hormonal and mechanical.Electronic supplementary materialThe online version of this article (doi:10.1007/s00774-010-0241-9) contains supplementary material, which is available to authorized users.

Obesity alters cortical and trabecular bone density and geometry in women

The goal in this study was to determine the relationship between body mass index and trabecular and cortical bone using quantitative computed tomography. A higher body mass index (BMI) was positively associated with trabecular and cortical bone parameters, and serum parathyroid hormone, and negatively associated with cortical volumetric bone mineral density (vBMD) and serum 25-hydroxy-vitamin D. When BMI is greater than 35 kg/m(2), adiposity affects vBMD and may explain the higher fracture risk in this population without low BMD. The influence of adult obesity on the trabecular and cortical bone, geometry, and strength has not been fully addressed. The goal in this study was to determine the relationship between body mass index and trabecular and cortical bone mass and geometry, over a wide range of body weights. We examined 211 women (25-71 years; BMI 18-57 kg/m(2)) who were classified into three categories of BMI (kg/m(2)) including normal-weight (BMI<25), overweight and obese-class I (BMI 25-35) and obese-class II-III (BMI>35), and also by menopausal status. Volumetric bone mineral density (mg/cm(3)), trabecular, and cortical components as well as geometric characteristics at the 4%, 38%, and 66% from the distal tibia were measured by peripheral quantitative computed tomography, and serum was analyzed for parathyroid hormone (PTH) and 25-hydroxy-vitamin D (25OHD). Higher BMI was associated with greater values of trabecular bone and cortical BMC and area and PTH (r>0.39, p<0.001), but lower cortical vBMD and 25OHD (r>-0.27, p<0.001). When controlling for lower leg muscle area, fat area was inversely associated with cortical vBMD (r=-0.16, p<0.05). Premenopausal obese women with both higher BMI and PTH had lower cortical vBMD (r<-0.40, p<0.001). While age is a predictor for most bone variables, fat mass explains more variance for vBMD, and lean mass and 25OHD explain greater variance in geometric and strength indices (p<0.05). Severe obesity (BMI>35) increases trabecular vBMD and in the presence of a higher PTH is associated with a lower cortical vBMD without compromising bone geometry and strength. Whether or not a lower cortical vBMD in obesity influences fracture risk over time needs to be further explored.

Cortical bone geometry in relation to prevalent fractures in young healthy men at age of peak bone mass

Cortical bone geometry in relation to prevalent fractures in young healthy men at age of peak bone mass

Prevalent fractures are related to cortical bone geometry in young healthy men at age of peak bone mass

Low areal bone mass is a risk factor for fractures in men. Limited data are available on fractures and bone geometry in men, and the relation with sex steroids is incompletely understood. We investigated prevalent fractures in relation to peak bone mass, bone geometry, and sex steroids in healthy young men. Healthy male siblings (n = 677) at the age of peak bone mass (25 to 45 years) were recruited in a cross-sectional population-based study. Trabecular and cortical bone parameters of the radius and cortical bone parameters of the tibia were assessed using peripheral quantitative computed tomography (pQCT). Areal bone mineral density (aBMD) was determined using dual-energy X-ray absorptiometry (DXA). Sex steroids were determined using immunoassays, and fracture prevalence was assessed using questionnaires. Fractures in young men were associated with a longer limb length, shorter trunk, lower trabecular BMD, smaller cortical bone area, and smaller cortical thickness (p < .005) but not with bone-size-adjusted volumetic BMD (vBMD). With decreasing cortical thickness [odds ratio (OR) 1.4/SD, p <or= .001] and decreasing cortical area (OR 1.5/SD, p <or= .001), fracture odds ratios increased. No association between sex steroid concentrations and prevalent fractures was observed. Childhood fractures (<or=15 years) were associated with a thinner bone cortex (-5%, p <or= .005) and smaller periosteal size (-3%, p <or= .005). Fractures occurring later than 15 years of age were associated with a thinner bone cortex (-3%, p <or= .05) and larger endosteal circumference (+3%, p <or= .05) without differences in periosteal bone size. In conclusion, prevalent fractures in healthy young men are associated with unfavorable bone geometry and not with cortical vBMD when adjusting for bone size. Moreover, the data suggest different mechanisms of childhood fractures and fractures during adult life.

Bone density, geometry, microstructure, and stiffness: Relationships between peripheral and central skeletal sites assessed by DXA, HR-pQCT, and cQCT in premenopausal women

High-resolution peripheral quantitative computed tomography (HR-pQCT) is a new in vivo imaging technique for assessing 3D microstructure of cortical and trabecular bone at the distal radius and tibia. No studies have investigated the extent to which measurements of the peripheral skeleton by HR-pQCT reflect those of the spine and hip, where the most serious fractures occur. To address this research question, we performed dual-energy X-ray absorptiometry (DXA), central QCT (cQCT), HR-pQCT, and image-based finite-element analyses on 69 premenopausal women to evaluate relationships among cortical and trabecular bone density, geometry, microstructure, and stiffness of the lumbar spine, proximal femur, distal radius, and distal tibia. Significant correlations were found between the stiffness of the two peripheral sites (r = 0.86), two central sites (r = 0.49), and between the peripheral and central skeletal sites (r = 0.56-0.70). These associations were explained in part by significant correlations in areal bone mineral density (aBMD), volumetric bone mineral density (vBMD), and cross-sectional area (CSA) between the multiple skeletal sites. For the prediction of proximal femoral stiffness, vBMD (r = 0.75) and stiffness (r = 0.69) of the distal tibia by HR-pQCT were comparable with direct measurements of the proximal femur: aBMD of the hip by DXA (r = 0.70) and vBMD of the hip by cQCT (r = 0.64). For the prediction of vertebral stiffness, trabecular vBMD (r = 0.58) and stiffness (r = 0.70) of distal radius by HR-pQCT were comparable with direct measurements of lumbar spine: aBMD by DXA (r = 0.78) and vBMD by cQCT (r = 0.67). Our results suggest that bone density and microstructural and mechanical properties measured by HR-pQCT of the distal radius and tibia reflect the mechanical competence of the central skeleton.

Daily impact score in long-term acceleration measurements of exercise

Mechanical loading increases and maintains bone mass and strength. Daily stress stimulus and osteogenic index theories have been suggested to describe the osteogenic potential of exercise, using exponential or logarithmic relationships, respectively, between loading numbers and magnitude. Inspired by these theories, the aim of this study was to develop and test a daily impact score (DIS) using long-term continuous acceleration measurements of exercise. Acceleration data were collected during a previous exercise trial, in which the subjects (healthy women, 35–40 years, N=34 in the high-impact exercise group and N=30 in the control group) wore a body movement monitor on their waist during the 12-month study. DIS was calculated from the 12-month average daily acceleration distributions in two ways: DIS Exp adopted from the daily stress stimulus and DIS Log simplified from the osteogenic index. Areal bone mineral density (aBMD) at the proximal femur and cortical bone geometry at the mid-femur were measured at baseline and 12 months. DIS calculated in either of the ways was significantly higher in the exercise group than in the control group. DIS Exp and DIS Log were strongly correlated ( R=0.982). Both DIS Exp and DIS Log were significantly associated with 12-month aBMD changes at the hip ( R up to 0.550, p<0.01 ) and geometry changes at the mid-femur (R up to 0.472, p<0.05) in the exercise group. DIS calculated either from exponential or logarithmic relationship can be used in acceleration-based measurements of daily exercise. DIS was positively related with changes in hip aBMD and mid-femur bone geometry after 12 months of exercise.

Lifelong sedentary behavior aggravates detrimental age associated effects on bone structure of C57BL/6 mice

The aim of this study was to compare the femoral bone structure of lifelong sedentary vs active C57BL/6 mice. Thirty male C57BL/6 mice, aged 2 months, were either: i) sacrificed after arrival (young group; Y; n=10); ii) kept in cages equipped with running wheels, where they could perform voluntary running (aged active group; AA; n=10); iii) kept in cages without running wheel (aged sedentary group; AS; n=10). After 23 months of differential housing AS and AA animals were also sacrificed. In all animals the right femur was collected and processed for histomorphometryc analysis of both epiphyses and mid diaphysis. Right hind limb muscles were collected for citrate synthase (CS) activity determination to confirm physically active and sedentary behaviors.Differences in trabecular microarchitecture and cortical bone geometry were identified between AA and AS groups. AA mice showed significantly increased trabecular perimeter (Tb.Pm) and trabecular number (Tb.N) and decreased trabecular separation (Tb.Sp) at both epiphyses when compared to AS mice. Differences in osteocyte density (Oc.N/mm2) were identified between AS and Y mice but not between AA and Y mice. Our results evidence that skeletal changes usually indentified as a result of ageing, are at least in some extent, due to sedentary behavior. Maintenance of a physically active lifestyle is therefore essential for delaying changes in bone quality throughout life.Grant Funding Source: FCT grant SFRH/BD/38110/2007

Potential of First Arriving Signal to Assess Cortical Bone Geometry at the Hip with QUS: A Model Based Study

There is evidence that quantitative ultrasound (QUS) at the proximal femur involves waves propagating circumferentially in the cortical shell. These waves, in theory, convey information on bone geometrical and material characteristics and thus have the potential to improve fracture risk prediction. In this work, the time-of-flight (TOF) of the first arriving signal (FAS) that corresponds to waves propagating circumferentially is considered. The relationships between the TOF of the FAS and geometrical features of the femoral neck are investigated. Five neck cross-sections from 11 human femurs from females ( > 65 y) were extracted from 3-D X-ray quantitative computed tomography (XR-QCT) datasets. Geometrical parameters including cross-sectional area (CSA), minimum moment of inertia ( I min) and section modulus ( Z) were computed from femoral neck cross-section images. Two-dimensional numerical simulation of US propagation through femoral neck was performed and TOF of the FAS was estimated. TOF was best correlated with I min : R 2 = 0.82 ( p = 10 − 4 ; R M S E = 1390 m m 4 [ 13 % ]) in the region between proximal and mid-femoral neck and with Z : R 2 = 0.55 ( p < 10 − 2 ; R M S E = 480 m m 3 [ 17 % ]) and C S A : R 2 = 0.62 ( p < 5.10 − 3 ; R M S E = 22 m m 2 [ 7 % ]) in the mid-femoral neck. The results suggest that QUS has the potential to assess proximal femur strength based on estimates of geometrical properties of the cortical shell. (E-mail: julien.grondin@upmc.fr)

Fat Mass Exerts a Greater Effect on Cortical Bone Mass in Girls than Boys

It is unclear whether fat mass (FM) and lean mass (LM) differ in the way they influence cortical bone development in boys and girls. The aim of the study was to investigate the contributions of total body FM and LM to parameters related to cortical bone mass and geometry. We conducted a longitudinal birth cohort study, the Avon Longitudinal Study of Parents and Children. A total of 4005 boys and girls (mean age, 15.5 yr) participated in the study. We measured cortical bone mass, cortical bone mineral content (BMC(C)), cortical bone mineral density, periosteal circumference (PC), and endosteal circumference by tibial peripheral quantitative computed tomography. LM had a similar positive association with BMC(C) in boys and girls [regression coefficients with 95% confidence interval (CI); P for gender interactions: boys/girls, 0.952 (0.908, 0.997); P = 0.85]. However, the mechanisms by which LM influenced bone mass differed according to gender because LM was positively associated with PC more strongly in girls [boys, 0.579 (0.522, 0.635); girls, 0.799 (0.722, 0.875); P < 0.0001], but was only associated with cortical bone mineral density in boys [boys, 0.443 (0.382, 0.505); girls, 0.014 (-0.070, 0.097); P < 0.0001]. There was a stronger positive association between FM and BMC(C) in girls [boys, 0.227 (0.185, 0.269); girls, 0.355 (0.319, 0.392); P < 0.0001]. This reflected both a greater positive association of FM with PC in girls [boys, 0.213 (0.174, 0.253); girls, 0.312 (0.278, 0.347); P = 0.0002], and a stronger negative association with endosteal circumference(PC) [boys, -0.059 (-0.096, 0.021); girls, -0.181 (-0.215, -0.146); P < 0.0001]. Whereas LM stimulates the accrual of cortical bone mass to a similar extent in boys and girls, FM is a stronger stimulus for accrual of cortical bone mass in girls, reflecting a greater tendency in females for FM to stimulate periosteal growth and suppress endosteal expansion.

Time-course of exercise and its association with 12-month bone changes

BackgroundExercise has been shown to have positive effects on bone density and strength. However, knowledge of the time-course of exercise and bone changes is scarce due to lack of methods to quantify and qualify daily physical activity in long-term. The aim was to evaluate the association between exercise intensity at 3, 6 and 12 month intervals and 12-month changes in upper femur areal bone mineral density (aBMD) and mid-femur geometry in healthy premenopausal women.MethodsPhysical activity was continuously assessed with a waist-worn accelerometer in 35 healthy women (35-40 years) participating in progressive high-impact training. To describe exercise intensity, individual average daily numbers of impacts were calculated at five acceleration levels (range 0.3-9.2 g) during time intervals of 0-3, 0-6, and 0-12 months. Proximal femur aBMD was measured with dual x-ray absorptiometry and mid-femur geometry was evaluated with quantitative computed tomography at the baseline and after 12 months. Physical activity data were correlated with yearly changes in bone density and geometry, and adjusted for confounding factors and impacts at later months of the trial using multivariate analysis.ResultsFemoral neck aBMD changes were significantly correlated with 6 and 12 months' impact activity at high intensity levels (> 3.9 g, r being up to 0.42). Trochanteric aBMD changes were associated even with first three months of exercise exceeding 1.1 g (r = 0.39-0.59, p < 0.05). Similarly, mid-femoral cortical bone geometry changes were related to even first three months' activity (r = 0.38-0.52, p < 0.05). In multivariate analysis, 0-3 months' activity did not correlate with bone change at any site after adjusting for impacts at later months. Instead, 0-6 months' impacts were significant correlates of 12-month changes in femoral neck and trochanter aBMD, mid-femur bone circumference and cortical bone attenuation even after adjustment. No significant correlations were found at the proximal or distal tibia.ConclusionThe number of high acceleration impacts during 6 months of training was positively associated with 12-month bone changes at the femoral neck, trochanter and mid-femur. These results can be utilized when designing feasible training programs to prevent bone loss in premenopausal women.Trial registrationClinical trials.gov NCT00697957

Associations between leisure physical activity participation and cortical bone mass and geometry at the radius and tibia in a Canadian cohort of postmenopausal women

Few studies have examined the effects of leisure physical activity (PA) participation on bone mass and geometry in postmenopausal women using peripheral quantitative computed tomography (pQCT). The purpose of this study was to determine associations between leisure PA participation and bone mass and geometry at the radius and tibia in a Canadian cohort of healthy postmenopausal women (n=234, mean age 62 years). Leisure PA participation was assessed using the Minnesota Leisure Time Physical Activity Questionnaire and by generating a total activity score (TAS, mean=105, range=0–840). Bone mass and geometry at the distal and midshaft sites of the non-dominant radius and tibia were measured using pQCT. Associations between TAS and bone mass and geometry variables were determined using linear regression models adjusted for clinically relevant confounding variables. TAS was positively and significantly associated with total content, total area, cortical content and cortical area at the midshaft sites of the radius and tibia (p<0.05 for all associations). TAS was also positively and significantly associated with bone bending and torsional strength parameters at the midshaft radius and tibia (p<0.05 for all associations). No associations were observed between TAS and trabecular bone parameters. Leisure PA participation is positively associated with cortical bone mass and geometry as well as bending and torsional strength at weight-bearing and non-weight-bearing bone sites and may have the potential to modify bone strength and influence bone fragility in postmenopausal women.

Six months of disuse during hibernation does not increase intracortical porosity or decrease cortical bone geometry, strength, or mineralization in black bear (Ursus americanus) femurs

Disuse typically uncouples bone formation from resorption, leading to bone loss which compromises bone mechanical properties and increases the risk of bone fracture. Previous studies suggest that bears can prevent bone loss during long periods of disuse (hibernation), but small sample sizes have limited the conclusions that can be drawn regarding the effects of hibernation on bone structure and strength in bears. Here we quantified the effects of hibernation on structural, mineral, and mechanical properties of black bear (Ursus americanus) cortical bone by studying femurs from large groups of male and female bears (with wide age ranges) killed during pre-hibernation (fall) and post-hibernation (spring) periods. Bone properties that are affected by body mass (e.g. bone geometrical properties) tended to be larger in male compared to female bears. There were no differences (p>0.226) in bone structure, mineral content, or mechanical properties between fall and spring bears. Bone geometrical properties differed by less than 5% and bone mechanical properties differed by less than 10% between fall and spring bears. Porosity (fall: 5.5±2.2%; spring: 4.8±1.6%) and ash fraction (fall: 0.694±0.011; spring: 0.696±0.010) also showed no change (p>0.304) between seasons. Statistical power was high (>72%) for these analyses. Furthermore, bone geometrical properties and ash fraction (a measure of mineral content) increased with age and porosity decreased with age. These results support the idea that bears possess a biological mechanism to prevent disuse and age-related osteoporoses.

Administration of high-dose macrophage colony-stimulating factor increases bone turnover and trabecular volume fraction

Macrophage colony-stimulating factor (M-CSF) is a hematopoietic growth factor that plays a critical role in early osteoclastogenesis. To characterize the skeletal effects of M-CSF, we administered soluble M-CSF to mice. It was hypothesized that M-CSF would stimulate bone formation through coupled activity of osteoclasts and osteoblasts. Twenty-four male C57BL/6 J mice (n = 12/group, aged 7 weeks) received subcutaneous injections of human M-CSF [5 mg/(kg day)] or inert vehicle (VEH) for 21 days. M-CSF increased serum bone turnover markers (+57% TRAP-5b and +44% osteocalcin). Microcomputed tomography revealed an anabolic effect on tibial trabecular bone, with higher bone volume fraction (+35%), connectivity density (+79%), and number (+18%), as well as lower trabecular separation (-18%). M-CSF had no significant effect on cortical bone mineral content, geometry, or strength. There was no change in quantitative histomorphometry parameters of femoral cortical bone. These results reveal the complex, site-specific effects of M-CSF. In particular, we have demonstrated an anabolic effect of M-CSF on trabecular bone achieved through coupled activation of osteoblasts. However, in contrast to previous studies, M-CSF was found to have no effect on cortical bone. M-CSF was demonstrated to significantly influence both bone modeling and remodeling in relatively young animals.

Lifetime loading enhances cortical bone geometry and bone mass distribution in older men

Lifetime loading enhances cortical bone geometry and bone mass distribution in older men

Previous Sport Activity During Childhood and Adolescence Is Associated With Increased Cortical Bone Size in Young Adult Men

Physical activity during growth has been associated with altered cortical bone geometry, but it remains uncertain if the physical activity-induced increments in cortical bone size remain when the level of physical activity is diminished or ceased. The aim of this study was to investigate if physical activity during growth is associated with cortical bone geometry in currently inactive young men. In this study, 1068 men (18.9 +/- 0.6 [SD] yr) were included. Cortical bone geometry at the tibia and radius were measured using pQCT. A standardized questionnaire was used to collect information about current and previous sport activity. Subjects who continued to be active (n = 678) and who had been previously active (n = 285) in sports had a wider cortical bone (periosteal circumference [PC], 4.5% and 3.2%, respectively) with increased cross-sectional area (CSA; 12.5% and 6.9%) of the tibia than the always inactive subjects (n = 82). In the currently inactive men (n = 367), regression analysis (including covariates age, height, weight, calcium intake, smoking, and duration of inactivity) showed that previous sport activity was independently associated with cortical bone size of the tibia (CSA and PC). Amount of previous sport activity explained 7.3% of the total variation in cortical CSA. Subjects, who ceased their sport activity for up to 6.5 yr previously, still had greater cortical PC and CSA of the tibia than always inactive subjects. The results from this study indicate that sport activity during growth confers positive effects on bone geometry even though sport activity is ceased.

Two-year Longitudinal Changes in Forearm Cortical Bone Geometry in Postmenopausal Women with Mild Primary Hyperparathyroidism without Parathyroidectomy

Several studies suggest that mild PTH excess does not have any deteriorative effects on bone mineral density (BMD) in several-year-longitudinal studies of patients with mild primary hyperparathyroidism (pHPT) without parathyroidectomy (PTX). However, it remains unknown about the change in bone geometry in pHPT patients without PTX. We examined the longitudinal effects of mild PTH excess on cortical bone geometry in postmenopausal patients with mild pHPT without PTX by using peripheral quantitative computed tomography (pQCT), and we compared them with normal and hypoparathyroidism women. Nine postmenopausal female patients who were diagnosed as pHPT, six postmenopausal female patients with hypoparathyroidism (3 idiopathic and 3 postoperative), and thirty postmenopausal control subjects participated in this study. Radial volumetric (v) BMD and several bone geometry parameters were measured by pQCT at basal line and after 2 years. Cortical vBMD was significantly lower in pHPT group. Moreover, total area and periosteal circumferences were significantly higher in pHPT group. Total and cortical vBMD were significantly decreased after 2 years in control group. However, they were stable in pHPT group after 2-year follow-up. As for bone geometry, cortical thickness and area were also stable in pHPT group during 2-year follow-up, although they were significantly reduced in control group and hypoparathyroidism group. In conclusion, the present longitudinal study revealed that there were no significant changes in radial vBMD and cortical bone geometry in postmenopausal women with mild pHPT, whereas age-related thinning of cortical bone as well as decrease of vBMD were observed in the control and patients with hypoparathyroidism.

Prediction of Colles’ fracture load in human radius using cohesive finite element modeling

Osteoporotic and age-related fractures are a significant public health problem. One of the most common osteoporotic fracture sites in the aging population is distal radius. There is evidence in the literature that distal radius fractures (Colles’ fracture) are an indicative of increased risk of future spine and hip fractures. In this study, a nonlinear fracture mechanics-based finite element method is applied to human radius to assess its fracture load as a function of cortical bone geometry and material properties. Seven three-dimensional finite element models of radius were created and the fracture loads were determined by using cohesive finite element modeling which explicitly represents the crack and the fracture process zone behavior. The fracture loads found in the simulations (731–6793 N) were in the range of experimental values reported in the literature. The fracture loads predicted by the simulations decreased by 4–5% per decade based only on material level changes and by 6–20% per decade when geometrical changes were also included. Cortical polar moment of inertia at 15% distal radius showed the highest correlation to fracture load ( r 2=0.97). These findings demonstrate the strength of fracture mechanics-based finite element modeling and show that combining geometrical and material properties provides a better assessment of fracture risk in human radius.

Ontogenetic Patterning of Cortical Bone Microstructure and Geometry at the Human Mid‐Shaft Femur

The bone growth process has long-lasting effects on adult bone structure and mechanical adaptation, yet the tissue level dynamics of growth are poorly studied. The specific aims of this study were to (1) quantify changes in bone size and shape through ontogeny, (2) describe the distribution of tissue types and patterns of cortical drift and expansion through ontogeny, and (3) explore relationships between cortical drift and ontogenetic variation geometric size and shape. The study utilized 14 juvenile (ages 2-19) mid-shaft femur blocks removed at autopsy from individuals who died suddenly. Eighty-mum-thick sections were imaged using polarized and brightfield microscopy. For descriptive purposes the sample was divided into five age groups. Features of collagen fiber matrix orientation, vascularity (e.g., pore orientation and density), and osteocyte lacunar density and shape were used to classify primary and secondary tissue types in LM images. This information, combined with evaluation of resorptive versus depositional bone surfaces, was used to identify cortical drift direction. A pattern of posterior and medial drift was identified at the mid-shaft femur in the toddler years. The drift pattern shifts antero-laterally in late childhood, predating the appearance of a more adult-like geometry. On the basis of the presence of transitional fibrolamellar bone complex, growth is more rapid during the toddler years and peri-puberty, and slower in early to late childhood and in later adolescence. Extensive variability in histological and geometric organization typifies the sample, particularly beginning in late childhood. The potential implications of this variability for adult fracture risk warrant further study. Anat Rec, 2009. (c) 2008 Wiley-Liss, Inc.