Toughness Of Cortical Bone Research Articles

In Vivo Assessment of Bone Quality Without X-rays.

This review summarizes recent advances in the assessment of bone quality using non-X-ray techniques. Quantitative ultrasound (QUS) provides multiple measurements of bone characteristics based on the propagation of sound through bone, the attenuation of that sound, and different processing techniques. QUS parameters and model predictions based on backscattered signals can discriminate non-fracture from fracture cases with accuracy comparable to standard bone mineral density (BMD). With advances in magnetic resonance imaging (MRI), bound water and pore water, or a porosity index, can be quantified in several long bones in vivo. Since such imaging-derived measurements correlate with the fracture resistance of bone, they potentially provide new BMD-independent predictors of fracture risk. While numerous measurements of mineral, organic matrix, and bound water by Raman spectroscopy correlate with the strength and toughness of cortical bone, the clinical assessment of person's bone quality using spatially offset Raman spectroscopy (SORS) requires advanced spectral processing techniques that minimize contaminating signals from fat, skin, and blood. Limiting exposure of patients to ionizing radiation, QUS, MRI, and SORS has the potential to improve the assessment of fracture risk and track changes of new therapies that target bone matrix and micro-structure.

Effect of gamma irradiation and supercritical carbon dioxide sterilization with Novakill™ or ethanol on the fracture toughness of cortical bone.

Sterilization of structural bone allografts is a critical process prior to their clinical use in large cortical bone defects. Gamma irradiation protocols are known to affect tissue integrity in a dose dependent manner. Alternative sterilization treatments, such as supercritical carbon dioxide (SCCO2 ), are gaining popularity due to advantages such as minimal exposure to denaturants, the lack of toxic residues, superior tissue penetration, and minor impacts on mechanical properties including strength and stiffness. The impact of SCCO2 on the fracture toughness of bone tissue, however, remains unknown. Here, we evaluate crack initiation and growth toughness after 2, 6, and 24 h SCCO2 -treatment using Novakill™ and ethanol as additives on ~11 samples per group obtained from a pair of femur diaphyses of a canine. All mechanical testing was performed at ambient air after 24 h soaking in Hanks' balanced salt solution (HBSS). Results show no statistically significant difference in the failure characteristics of the Novakill™-treated groups whereas crack growth toughness after 6 and 24 h of treatment with ethanol significantly increases by 37% (p = .010) and 34% (p = .038), respectively, compared to an untreated control group. In contrast, standard 25 kGy gamma irradiation causes significantly reduced crack growth resistance by 40% (p = .007) compared to untreated bone. FTIR vibrational spectroscopy, conducted after testing, reveals a consistent trend of statistically significant differences (p < .001) with fracture toughness. These trends align with variations in the ratios of enzymatic mature to immature crosslinks in the collagen structure, suggesting a potential association with fracture toughness. Additional Raman spectroscopy after testing shows a similar trend with statistically significant differences (p < .005), which further supports that collagen structural changes occur in the SCF-treated groups with ethanol after 6 and 24 h. Our work reveals the benefits of SCCO2 sterilization compared to gamma irradiation.

Microstructural fatigue fracture behavior of glycated cortical bone.

The current study aims to simulate fatigue microdamage accumulation in glycated cortical bone with increased advanced glycation end-products (AGEs) using a phase field fatigue framework. We link the material degradation in the fracture toughness of cortical bone to the high levels of AGEs in this tissue. We simulate fatigue fracture in 2D models of cortical bone microstructure extracted from human tibias. The results present that the mismatch between the critical energy release rate of microstructural features (e.g., osteons and interstitial tissue) can alter crack initiation and propagation patterns. Moreover, the high AGEs content through the increased mismatch ratio can cause the activation or deactivation of bone toughening mechanisms under cyclic loading. The fatigue fracture simulations also show that the lifetime of diabetic cortical bone samples can be dependent on the geometry of microstructural features and the mismatch ratio between the features. Additionally, the results indicate that the trapped cracks in cement lines in the diabetic cortical microstructure can prevent further crack growth under cyclic loading. The present findings show that alterations in the materials heterogeneity of microstructural features can change the fatigue fracture response, lifetime, and fragility of cortical bone with high AGEs contents. Cortical bone models are created from microscopy images taken from the cortical cross-section of human tibias. Increased glycation contents in the cortical bone sample can change the crack growth trajectories.

The influence of different shaped osteocyte lacunae on microcrack initiation and propagation

BackgroundThe morphology of osteocyte lacunae varies in bones of different ages and bone pathologies. Osteocyte lacunae can cause stress concentration and initiate microcracks. However, the influence of changes in osteocyte lacunar shape on microcrack is unknown. Therefore, the aim of this study was to determine the effects of osteocyte lacunae with different shapes on microcrack initiation and propagation. MethodsOsteon models containing osteocyte lacunae with different shapes were established. The progressive damage analysis method, based on computer simulations, was used to study the evolution of microdamage within the osteon, including the processes of intralaminar and interlaminar microdamage. FindingsModels with larger DoE values can effectively delay or prevent the formation of linear microcracks, which ensures high fracture toughness of cortical bone. It is subjected to stronger mechanical stimulation, making it more sensitive to loads. Models with smaller DoE values increase the load threshold for microdamage generation and reduces its impact on bone mechanical performance, making it less susceptible to microdamage than models with larger DoE values. InterpretationThese findings enhance the limited knowledge of the influence of the lacunar shape on microdamage and contribute to a better understanding of bone biomechanics.

Fatigue crack propagation and fracture toughness of cortical bone are radiation dose-dependent.

Cortical bone allograft sterilized with a standard γ-radiation dose of 25-35kGy has demonstrated reduced static and cyclic fracture resistance compared with unirradiated bone. To mitigate radiation damage, we recently observed a dose-dependent response of high-cycle fatigue behavior of human cortical bone from 0 to 25 kGy, with lower doses exhibiting logarithmically longer fatigue lives. The objectives of this study were as follows: (1) to determine whether fracture toughness, work-to-fracture, and fatigue crack propagation resistance of human cortical bone are also radiation dose-dependent, and (2) to determine the associations of radiation dose and a Raman biomarker for collagen disorder with fracture properties. Compact tension specimens were machined from two donor femoral pairs and allocated to four treatment groups: 0 (unirradiated control), 10, 17.5, and 25 kGy. Fracture toughness specimens were monotonically loaded to failure and the critical stress intensity factor (KC ) was determined. Work-to-fracture was calculated from the load versus displacement integral up to fracture. Fatigue crack propagation specimens were cyclically loaded under constant room-temperature irrigation and fatigue crack growth rate (da/dN) and cyclic stress intensity (∆K) were calculated. Fracture toughness, work-to-fracture, and fatigue crack propagation resistance decreased 18%, 33%, and 15-fold from 0 to 25 kGy, respectively (p < 0.05). Radiation dose was more predictive of fracture properties than collagen disorder. These findings support that quasi-static and fatigue fracture properties of cortical bone are radiation dose-dependent within this dose range. The structural alterations arising from irradiation that cause these losses in fracture resistance remain to be elucidated.

Experimental evaluation of fracture properties of bovine hip cortical bone using elastic-plastic fracture mechanics.

Understanding the fracture mechanics of bone is very important in both the medical and bioengineering field. Bone is a hierarchical natural composite material of nanoscale collagen fibers and inorganic material. This study investigates and presents the fracture toughness of bovine cortical bone by using elastic plastic fracture mechanics. The J-integral was used as a parameter to calculate the energies utilized in both elastic deformation (Jel) and plastic deformation (Jpl) of the hipbone fracture. Twenty four different types of specimens, i.e. longitudinal compact tension (CT) specimens, transverse CT specimens, and also rectangular unnotched specimens for tension in longitudinal and transverse orientation, were cut from the bovine hip bone of the middle diaphysis. All CT specimens were prepared according to the American Society for Testing and Materials (ASTM) E1820 standard and were tested at room temperature. The results showed that the average total J-integral in transverse CT fracture specimens is 26% greater than that of longitudinal CT fracture specimens. For longitudinal-fractured and transverse-fractured cortical specimens, the energy used in the elastic deformation was found to be 2.8-3 times less than the energy used in the plastic deformation. The findings indicate that the overall fracture toughness measured using the J-integral is significantly higher than the toughness calculated by the stress intensity factor. Therefore, J-integral should be employ to compute the fracture toughness of cortical bone.

Influence of non-enzymatic glycation on the mechanical properties of cortical bone

Poor bone quality induced by non-enzymatic glycation (NEG) of bone tissue in patients with type 2 diabetes mellitus (T2DM) is regarded as the major factor of bone fragility and affecting bone mechanical properties. A comprehensive and systemic mechanical investigation for evaluating the effect of NEG on bone was still lacking. In order to provide additional information for the bone quality of T2DM, the effects of NEG on mechanical properties of cortical bone were investigated in terms of elastoplasticity, fracture toughness and viscoelasticity. All samples of cortical bone, including the samples of strength test (n = 20), fracture toughness test (n = 40, quasi-static and fall-like conditions with displacement rates of 10−3 mm/s and 10 mm/s, respectively) and stress relaxation test (n = 20), were harvested from bovine tibiae. The samples of each test were equally divided into incubated-control group and ribose-incubated group. All mechanical tests were performed after incubating all samples for 15 days. Post-yield strain (p = 0.014), post-yield energy (p < 0.0001) and damage fraction (p = 0.040) of ribose-incubated group were significantly lower than those of incubated-control group, but secant modulus (p = 0.029) of ribose-incubated group was significantly higher than that of incubated-control group. In quasi-static condition, the plastic contribution Jpl of fracture toughness (p = 0.043) of ribose-incubated group was significantly lower than that of incubated-control group. In fall-like condition, there were no differences in Jpl, elastic contribution Jel and J-integral in both two groups. The quasi-static Jel (p < 0.0001, p < 0.0001) of incubated-control and ribose-incubated groups and J-integral (p = 0.007) of incubated-control group were all significantly higher than those of fall-like condition. In stress relaxation test, initial modulus E0 (p = 0.040) and equilibrium modulus (p = 0.029) of ribose-incubated group were significantly higher than those of incubated-control group. Reductions of relaxation modulus, which were the differences between two adjacent time points within 700 s–3000 s for ribose-incubated group, were significantly lower than those of incubated-control group. NEG could decrease the post-yield properties and quasi-static facture toughness of cortical bone, especially the plastic contribution of quasi-static fracture toughness. It could also decrease the viscoelasticity of cortical bone. The present study confirmed the negative effects of NEG on the mechanical properties of cortical bone in terms of elastoplasticity, fracture toughness and viscoelasticity, but NEG had no significant effect on the fracture toughness of cortical bone at fall-like loading. These results provided more evidence for increased fragility of cortical bone in patients with T2DM.

Toughening Mechanism of the Bone — Enlightenment from the Microstructure of Goat Tibia

Abstract With the continuous advancement of space exploration missions, the mechanical environment for planetary detectors is becoming increasingly severe. As a result, fatigue, fracture, large deformation and other forms of failures are more likely to occur at the load-bearing structures. As a critical part of the load-bearing structure of a goat, goat tibia has remarkable toughness because of its unique microstructures. In this investigation, firstly, the cortical bone of goat tibia was observed by SEM, and the characteristic microstructures in different regions were identified. Secondly, the cross section of cortical bone was loaded by long-term inplane stress, then the toughness of cortical bone in different regions are obtained and compared based on the orientation and distribution of cracks after the load. Thirdly, a simplified FEM model mimicking typical microstructure of the cortical bone is proposed using cohesive modeling, and then the toughening mechanism of the typical microstructure is validated with numerical simulation. Finally, the toughening mechanisms of cortical bone were discussed according to the SEM observation as well as the numerical simulation. This study of the toughening mechanism of cortical bone can be helpful for the biomimetic design of high-toughness structures.

Effects of Microstructure Characteristics of Cortical Bone on its Microcrack Propagation

Scanning electron microscope (SEM) was used to observe and analyze the microstructure of the cross section of cortical bone. The observation results illustrated that the cortical bone is composed of cylindrical osteons and interstitial bone between osteons, and the osteon are unevenly distributed. Based on the microstructure characteristics of cortical bone, three types of cortical bone mesoscopic analysis models were established. Then, the extended finite element method (X-FEM) was used to simulate the microcrack propagation process in bone. The simulate results show that the crack initiation strain of the two-phase model is 19.1% larger than that of the single-phase model, and the three-phase model is 57.8% larger than that of the two-phase model, which demonstrated that the osteons and cement line can significantly enhance the crack initiation strain of bone. In addition, under the same boundary conditions, the model with cement line can effectively change the propagation path of microcrack and prevent the propagation of crack. Therefore, the cement lines in cortical bone can effectively increase the fracture resistance of bone and enhance the fracture toughness of cortical bone.

What is the influence of two strain rates on the relationship between human cortical bone toughness and micro-structure?

Cortical bone fracture mechanisms are well studied under quasi-static loading. The influence of strain rate on crack propagation mechanisms needs to be better understood, however. We have previously shown that several aspects of the bone micro-structure are involved in crack propagation, such as the complete porosity network, including the Haversian system and the lacunar network, as well as biochemical aspects, such as the maturity of collagen cross-links. The aim of this study is to investigate the influence of strain rate on the toughness of human cortical bone with respect to its microstructure and organic non-collagenous composition. Two strain rates will be considered: quasi-static loading (10-4 s-1), a standard condition, and a higher loading rate (10-1 s-1), representative of a fall. Cortical bone samples were extracted from eight female donors (age 50-91 years). Three-point bending tests were performed until failure. Synchrotron radiation micro-computed tomography imaging was performed to assess bone microstructure including the Haversian system and the lacunar system. Collagen enzymatic cross-link maturation was measured using a high performance liquid chromatography column. Results showed that that under quasi-static loading, the elastic contribution of the fracture process is correlated to both the collagen cross-links maturation and the microstructure, while the plastic contribution is correlated only to the porosity network. Under fall-like loading, bone organization appears to be less linked to crack propagation.

Assessment of Elastic-Plastic Fracture Behavior of Cortical Bone Using a Small Punch Testing Technique.

The fracture properties of cortical bone are directly coupled to its complex hierarchical structure. The limited availability of bone material from many anatomic locations creates challenges for assessing the effect of bone heterogeneity and anisotropy on fracture properties. The small punch technique was employed to examine the fracture behavior of cortical bone in terms of area under the curve values obtained from load-load point displacement behavior. Fracture toughness of cortical bone was also determined in terms of J-toughness values obtained using a compact tension (CT) test. Area under the curve values obtained from the small punch test were correlated with the J-toughness values of cortical bone. The effects of bone density and compositional parameters on area under the curve and Jtoughness values were also analyzed using linear and multiple regression analysis. Area under the curve and J-toughness values are strongly and positively correlated. Bone density and %mineral content are positively correlated with both area under the curve and J-toughness values. The multiple regression analysis outcomes support these results. Overall, the findings support the hypothesis that area under the curve values obtained from small punch tests can be used to assess the fracture behavior of cortical bone.

Experimental Study of Cortical Bone Microstructure and Its Toughening Mechanism

With the increasingly severe mechanical environment of the planetary detectors, fracture and failure are more likely to occur at their load-bearing structures. Therefore, it is urgent to improve the toughness of load-bearing structures. Because of the unique microstructures, goat tibia has remarkable toughness. In this investigation, firstly, the cortical bone of goat tibia was observed by SEM, and the characteristic microstructures were identified. Secondly, the cross section of cortical bone was loaded by long-term inplane stress, then the toughness of cortical bone in different regions were obtained based on the orientation and distribution of cracks after the load. Finally, the toughening mechanisms of cortical bone were discussed. This study of the cortical bone toughening mechanism can be helpful for the biomimetic design of high-toughness materials.

High-speed X-ray visualization of dynamic crack initiation and propagation in bone

The initiation and propagation of physiological cracks in porcine cortical and cancellous bone under high rate loading were visualized using high-speed synchrotron X-ray phase-contrast imaging (PCI) to characterize their fracture behaviors under dynamic loading conditions. A modified Kolsky compression bar was used to apply dynamic three-point flexural loadings on notched specimens and images of the fracture processes were recorded using a synchronized high-speed synchrotron X-ray imaging set-up. Three-dimensional synchrotron X-ray tomography was conducted to examine the initial microstructure of the bone before high-rate experiments. The experimental results showed that the locations of fracture initiations were not significantly different between the two types of bone. However, the crack velocities in cortical bone were higher than in cancellous bone. Crack deflections at osteonal cement lines, a prime toughening mechanism in bone at low rates, were observed in the cortical bone under dynamic loading in this study. Fracture toughening mechanisms, such as uncracked ligament bridging and bridging in crack wake were also observed for the two types of bone. The results also revealed that the fracture toughness of cortical bone was higher than cancellous bone. The crack was deflected to some extent at osteon cement line in cortical bone instead of comparatively penetrating straight through the microstructures in cancellous bone. Statement of SignificanceFracture toughness is with great importance to study for crack risk prediction in bone. For those cracks in bone, most of them are associated with impact events, such as sport accidents. Consequently, we visualized, in real-time, the entire processes of dynamic fractures in notched cortical bone and cancellous bone specimens using synchrotron X-ray phase contrast imaging. The onset location of crack initiation was found independent on the bone type. We also found that, although the extent was diminished, crack deflections at osteon cement lines, a major toughening mechanism in transversely orientated cortical bone at quasi-static rate, were still played a role in resisting cracking in dynamically loaded specimen. These finding help researchers to understand the dynamic fracture behaviors in bone.

Intermittent PTH treatment improves bone and muscle in glucocorticoid treated Mdx mice: A model of Duchenne Muscular Dystrophy.

Duchenne Muscular Dystrophy (DMD) is a progressive muscle disorder caused by genetic mutations of the dystrophin encoding gene. In the absence of functional dystrophin, DMD patients suffer from muscle inflammation and wasting, as well as compromised bone health with increased risk of fracture. The use of high dose glucocorticoids (GC) as the standard therapy also contributes to bone fragility. This study examined the effects of intermittent, daily administered parathyroid hormone (iPTH), an approved bone anabolic therapy, on growing bone and dystrophic muscle in the presence and absence of prednisone treatment using the Mdx mouse model of DMD. Five-weeks of prednisone treatment in Mdx mice decreased cortical bone thickness and area (p < 0.001), with a large increase in endocortical osteoclasts that were significantly improved by PTH treatment (p < 0.001). GC-induced decreases in cortical bone toughness and modulus were improved with iPTH therapy (p < 0.05). Mdx mice showed significantly less bone mass in trabecular compartments of lumbar vertebrae and iPTH treatment, with or without glucocorticoids, significantly improved structural and material properties of this bone. Prednisone improved grip strength and endurance of treadmill running, which were maintained and further improved, respectively, in co-treated Mdx mice. Altogether, our study demonstrates that iPTH therapy significantly ameliorated GC-induced bone loss and maintained or further enhanced the positive effects of GCs on dystrophic muscle function. These findings give insight into the potential for use of teriparatide to treat growing bone in children with DMD.

Relationships between human cortical bone toughness and collagen cross-links on paired anatomical locations.

Human cortical bone fracture processes depend on the internal porosity network down to the lacunar length scale. Recent results show that at the collagen scale, the maturation of collagen cross-links may have a negative influence on bone mechanical behavior. While the effect of pentosidine on human cortical bone toughness has been studied, the influence of mature and immature enzymatic cross-links has only been studied in relation to strength and work of fracture. Moreover, these relationships have not been studied on different paired anatomical locations. Thus, the aim of the current study was to assess the relationships between both enzymatic and non-enzymatic collagen cross-links and human cortical bone toughness, on four human paired anatomical locations. Single Edge Notched Bending toughness tests were performed for two loading conditions: a quasi-static standard condition, and a condition representative of a fall. These tests were done with 32 paired femoral diaphyses, femoral necks and radial diaphyses (18 women, age 81 ± 12 y.o.; 14 men, age 79 ± 8 y.o.). Collagen enzymatic and non-enzymatic crosslinks were measured on the same bones. Maturation of collagen was defined as the ratio between immature and mature cross-links (CX). The results show that there was a significant correlation between collagen cross-link maturation and bone toughness when gathering femoral and radial diaphyses, but not when considering each anatomical location individually. These results show that the influence of collagen enzymatic and non-enzymatic cross-links is minor when considering human cortical bone crack propagation mechanisms.

Application of Small Punch Testing to Evaluate Elastic and Plastic parts of Fracture Energy of Cortical bone

Fracture mechanics approach provides useful information about failure behaviour of cortical bone. The understanding of failure mechanism of cortical bone is important for both medical and engineering researchers. Several toughening mechanisms associated with bone failure are responsible for significant amount of nonlinearity during bone deformation. The present study has been conducted to compare elastic and plastic parts of energy dissipated during bone fracture. Fracture toughness of cortical bone is determined in terms of J-toughness based of elastic-plastic fracture mechanics approach to determine energy dissipated during crack propagation. Total fracture energy is determined with the help of small punch testing in terms of area under curve values. It has been found during this study that elasticity plays an important role during crack propagation, however, plasticity has greater contribution during total fracture of bone staring from crack initiation to crack propagation. A significant linear relationship is obtained between plastic part of J-toughness and plastic part of fracture energy determined in terms of area under curve values. This relationship shows the contribution of various toughening mechanisms during crack initiation as well as its further propagation till fracture.

Strain rate influence on human cortical bone toughness: A comparative study of four paired anatomical sites

Bone fracture is a major health issue worldwide and consequently there have been extensive investigations into the fracture behavior of human cortical bone. However, the fracture properties of human cortical bone under fall-like loading conditions remains poorly documented. Further, most published research has been performed on femoral diaphyseal bone, whereas it is known that the femoral neck and the radius are the most vulnerable sites to fracture. Hence, the aim of this study is to provide information on human cortical bone fracture behavior by comparing different anatomical sites including the radius and the femoral neck acquired from 32 elderly subjects (50 – 98 y.o.). In order to investigate the intrinsic fracture behavior of human cortical bone, toughness experiments were performed at two different strain rates: standard quasi-static conditions, and a higher strain rate representative of a fall from a standing position. The tests were performed on paired femoral neck, femoral, tibial and radius diaphyseal samples. Linear elastic fracture toughness and the non-linear J-integral method were used to take into account both the elastic and non-elastic behavior of cortical bone. Under quasi-static conditions, the radius presents a significantly higher toughness than the other sites. At the higher strain rate, all sites showed a significantly lower toughness. Also, at the high strain rate, there is no significant difference in fracture properties between the four anatomical sites. These results suggest that regardless of the anatomical site (femur, femoral neck, tibia and radius), the bone has the same fracture properties under fall loading conditions. This should be considered in biomechanical models under fall-like loading conditions.

Role of cortical bone in hip fracture.

In this review, I consider the varied mechanisms in cortical bone that help preserve its integrity and how they deteriorate with aging. Aging affects cortical bone in two ways: extrinsically through its effects on the individual that modify its mechanical loading experience and 'milieu interieur'; and intrinsically through the prolonged cycle of remodelling and renewal extending to an estimated 20 years in the proximal femur. Healthy femoral cortex incorporates multiple mechanisms that help prevent fracture. These have been described at multiple length scales from the individual bone mineral crystal to the scale of the femur itself and appear to operate hierarchically. Each cortical bone fracture begins as a sub-microscopic crack that enlarges under mechanical load, for example, that imposed by a fall. In these conditions, a crack will enlarge explosively unless the cortical bone is intrinsically tough (the opposite of brittle). Toughness leads to microscopic crack deflection and bridging and may be increased by adequate regulation of both mineral crystal size and the heterogeneity of mineral and matrix phases. The role of osteocytes in optimising toughness is beginning to be worked out; but many osteocytes die in situ without triggering bone renewal over a 20-year cycle, with potential for increasing brittleness. Furthermore, the superolateral cortex of the proximal femur thins progressively during life, so increasing the risk of buckling during a fall. Besides preserving or increasing hip BMD, pharmaceutical treatments have class-specific effects on the toughness of cortical bone, although dietary and exercise-based interventions show early promise.

Adynamic Bone Decreases Bone Toughness During Aging by Affecting Mineral and Matrix.

Adynamic bone is the most frequent type of bone lesion in patients with chronic kidney disease; long-term use of antiresorptive therapy may also lead to the adynamic bone condition. The hallmark of adynamic bone is a loss of bone turnover, and a major clinical concern of adynamic bone is diminished bone quality and an increase in fracture risk. Our current study aims to investigate how bone quality changes with age in our previously established mouse model of adynamic bone. Young and old mice (4 months old and 16 months old, respectively) were used in this study. Col2.3Δtk (DTK) mice were treated with ganciclovir and pamidronate to create the adynamic bone condition. Bone quality was evaluated using established techniques including bone histomorphometry, microcomputed tomography, quantitative backscattered electron imaging, and biomechanical testing. Changes in mineral and matrix properties were examined by powder X-ray diffraction and Raman spectroscopy. Aging controls had a natural decline in bone formation and resorption with a corresponding deterioration in trabecular bone structure. Bone turnover was severely blunted at all ages in adynamic animals, which preserved trabecular bone loss normally associated with aging. However, the preservation of trabecular bone mass and structure in old adynamic mice did not rescue deterioration of bone mechanical properties. There was also a decrease in cortical bone toughness in old adynamic mice that was accompanied by a more mature collagen matrix and longer bone crystals. Little is known about the effects of metabolic bone disease on bone fracture resistance. We observed an age-related decrease in bone toughness that was worsened by the adynamic condition, and this decrease may be due to material level changes at the tissue level. Our mouse model may be useful in the investigation of the mechanisms involved in fractures occurring in elderly patients on antiresorptive therapy who have very low bone turnover.

Effect of ibandronate on bending strength and toughness of rodent cortical bone: Possible implications for fracture prevention.

ObjectivesThere remains conflicting evidence regarding cortical bone strength following bisphosphonate therapy. As part of a study to assess the effects of bisphosphonate treatment on the healing of rat tibial fractures, the mechanical properties and radiological density of the uninjured contralateral tibia was assessed.MethodsSkeletally mature aged rats were used. A total of 14 rats received 1µg/kg ibandronate (iban) daily and 17 rats received 1 ml 0.9% sodium chloride (control) daily. Stress at failure and toughness of the tibial diaphysis were calculated following four-point bending tests.ResultsUninjured cortical bone in the iban group had a significantly greater mean (standard deviation (sd)), p < 0.001, stress at failure of 219.2 MPa (sd 45.99) compared with the control group (169.46 MPa (sd 43.32)) following only nine weeks of therapy. Despite this, the cortical bone toughness and work to failure was similar. There was no significant difference in radiological density or physical dimensions of the cortical bone.ConclusionsIban therapy increases the stress at failure of uninjured cortical bone. This has relevance when normalising the strength of repair in a limb when comparing it with the unfractured limb. However, the 20% increase in stress at failure with iban therapy needs to be interpreted with caution as there was no corresponding increase in toughness or work to failure. Further research is required in this area, especially with the increasing clinical burden of low-energy diaphyseal femoral fractures following prolonged use of bisphosphonates.Cite this article: Bone Joint Res 2015;4:99–104