Mechanical Properties Of Trabecular Bone Research Articles

Microstructural and mechanical evaluations of region segmentation methods in classifications of osteonecrosis

Measuring the location of necrotic lesions is necessary to diagnosis of osteonecrosis. Different region segmentation methods of the femoral head were proposed to quantitatively measure necrotic lesions including Japanese Investigation Committee for Avascular Necrosis (JIC) classification and China-Japan Friendship Hospital (CJFH) classification. Biomechanical methods could bring important information to evaluate the reasonability of these classifications. In this study, microstructural and mechanical properties of trabecular bone were quantitatively analyzed according to the region segmentation methods described in these classifications. Microstructural parameters of trabecular bone were analyzed based on micro-CT scanning. Mechanical properties were measured through Nanoindentation and micro-finite element analysis. It was found that microstructural and mechanical properties of trabecular bone in the middle region was more adaptive to load bearing than the medial and lateral regions according to the CJFH classification; lesions in the middle region could bring more changes to microstructure and stress distribution. According to JIC classification, differences of microstructural and mechanical properties among the three regions were not significant. Biomechanical characteristics of trabecular bones could be better distinguished with CJFH classification.

High-Performance Computing Comparison of Implicit and Explicit Nonlinear Finite Element Simulations of Trabecular Bone

Background and objectiveFinite element models built from micro-computed tomography scans have become a powerful tool to investigate the mechanical properties of trabecular bone. There are two types of solving algorithms in the finite element method: implicit and explicit. Both of these methods have been utilized to study the trabecular bone. However, an investigation comparing the results obtained using the implicit and explicit solvers is lacking. Thus, in this paper, we contrast implicit and explicit procedures by analyzing trabecular bone samples as a case study. MethodsMicro-computed tomography-based finite element analysis of trabecular bone under a direct quasi-static compression was done using implicit and explicit methods. The differences in the predictions of mechanical properties and computational time of the two methods were studied using high-performance computing. ResultsOur findings indicate that the results using implicit and explicit solvers are well comparable, given that similar problem set up is carefully utilized. Also, the parallel scalability of the two methods was similar, while the explicit solver performed about five times faster than the implicit method. Along with faster performance, the explicit method utilized significantly less memory for the analysis, which shows another benefit of using an explicit solver for this case study. ConclusionsThe comparison of the implicit and explicit methods for the simulation of trabecular bone samples should be highly valuable to the bone modeling community and researchers studying complex cellular and architectured materials.

Post-yield mechanical properties of bovine trabecular bone – Relationships with bone volume fraction and strain rate

Bone finite element models, which are increasingly used to assess fracture risk in patients with degenerative bone diseases, require extensive experimental data to adequately model the material properties being assigned. Previous studies have demonstrated that bone elastic mechanical properties are dependent on density as well as strain rate, however, the effect these same variables on the post-yield behaviour of trabecular bone has not been thoroughly studied. For this study, bovine femoral samples were tested at several strain rates using three different tests devices: a conventional constant strain rate apparatus for low strain rates, a Drop Weight Impact Test device for the intermediate regime and a Split Hopkinson Pressure Bar System with magnesium bar and a PVCA pulse shaper for high strain rates. Ultimate and plateau stress, as well as absorbed energy were recorded. The results of this experimentation show that post-yield mechanical properties of trabecular bone are strain rate and volume fraction dependant. Two constitutive material models describing the Ultimate strength, Plateau stress and absorbed energy are proposed based on published models valid for elastic properties of trabecular bone.

Numerical predictions of the interaction between highly nonlinear solitary waves and the microstructure of trabecular bone in the femoral head

The unique properties of highly nonlinear solitary waves in granular chains have prompted extensive research in the area of non-destructive testing and led to the development of new diagnostic schemes with potential applications in the healthcare industry. Here, we study numerically the interaction between highly nonlinear solitary waves in a granular chain and the microstructure of trabecular bone in the femoral head. High-resolution finite element models of bone microstructures with varying bone volume fraction are generated using a topology optimization-based bone microstructure reconstruction scheme. The obtained FE models of the trabecular bone were then used to develop a hybrid discrete/finite element model able to simulate the propagation of highly nonlinear solitary waves in a vertical array of steel particles, and their interaction with the adjacent bone microstructure model was studied. Two test modes were considered, one where the granular chain was placed in direct contact with the bone microstructure model, while in the second test mode, a face sheet was included between the chain and the bone model. For both test modes, we found that the characteristic features of the reflected solitary waves are sensitive to the effective compressive modulus of the bone microstructure models and follow similar trends than those obtained for a homogeneous, non-porous solid. It was also found that the use of the face sheet substantially reduces the sensitivity of the predictions to small changes in the bone topology, making it a robust and reliable method for non-destructive evaluation of the effective elastic modulus of cellular materials with small structural dimensions, as it is required for the site-specific evaluation of the mechanical properties of trabecular bone.

Developmental changes in bone mechanics from Florida manatees (Trichechus manatus latirostris), obligate swimming mammals.

Mammals living in aquatic environments load their axial skeletons differently from their terrestrial counterparts. The structure and mechanical behavior of trabecular bone can be especially indicative of varying habitual forces. Here, we investigated vertebral trabecular bone mechanical properties (yield strength, stiffness and toughness) throughout development in Florida manatees (Trichechus manatus latirostris), obligate undulatory swimmers. Thoracic, lumbar and caudal vertebrae were dissected from manatees (N=20) during necropsies. We extracted 6 mm3 samples from vertebral bodies and tested them in compression in three orientations (rostrocaudal, dorsoventral and mediolateral) at 2 mm min-1 We determined variation in mechanical properties between sexes, and among developmental stages, vertebral regions and testing orientations. We also investigated the relationships between vertebral process lengths and properties of dorsoventrally and mediolaterally tested bone. Rostrocaudally tested bone was the strongest, stiffest and toughest, suggesting that this is the principal direction of stress. Our results showed that bone from female subadults was stronger and stiffer than that of their male counterparts; based on these data, we hypothesize that hormonal shifts at sexual maturity may partially drive these differences. In calves, bone from the posterior region was stronger and tougher than that from the anterior region. We hypothesize that as animals grow rapidly throughout early development, bone in the posterior region would be the most ossified to support the rostrocaudal force propagation associated with undulatory swimming.

The effect of bone marrow on the mechanical behavior of porcine trabecular bone

Bone marrow plays an important role on the mechanical properties of trabecular bone. Its effect on the mechanical properties of porcine trabecular bone is studied in this paper. Uniaxial compression at a low strain rate (0.01 s−1 to 20% strain) and stress relaxation tests (600 s at 85, 70 and 55% of the max. load) were done on 90 different femur samples. Half the samples were treated to extract the bone marrow. The average pore size of the trabecular network was 0.280 ± 0.056 mm. Higher values of elastic modulus (37%), 0.2% yield stress (48%), maximum stress (39%), strain at maximum stress (54%), and toughness (300%), were found for the samples which had the bone marrow extracted and were saturated with a saline solution. A linear relation between the applied load and the relaxation stress of was found, which means that the trabecular bone behaves as a linear viscoelastic material. A mathematical approximation of the relaxation response was done using a Kohlrausch-Williams-Watts model for viscoelastic materials. Results show that it is essential to consider the viscoelastic behavior that the marrow has on the mechanical properties of the trabecular bone. The effect that the bone marrow has on the stress relaxation was found to be negligible at low strain rates and in the elastic stage of deformation.

Assessment of the elastic properties of human vertebral trabecular bone using computational mechanical tests and x-ray microtomography—a subvolume analysis

Trabecular bone structures can be modeled as a linear elastic solid, with a heterogeneous and anisotropic structure. The HR-pQCT technique is ideal for the characterization of trabecular bone to measure aspects of bone quality in diseases such as osteoporosis. In this investigation, twelve human vertebrae were used for the investigation of the mechanical properties of trabecular bone by finite element analysis (FEA). A virtual cube sample with 18.5 mm sides was extracted from each vertebrae and four smaller central cubes were obtained from it, with a 20% reduction of volume for each cube. The direct mechanics approach by FEA was performed (FAIM v6.0, Numerics88 Solutions Ltd) and mean values on three mean directions of loading resulting in: E1 = 294 MPa, E2 = 258 MPa, E3 = 153 MPa, G23 = 86 MPa, G31 = 103 MPa, G12 = 100 MPa. The Statistical Analysis was applied showing that E1 values are statically different from E3, and E2 are statically different from E3, with E2 equal to E1. This indicates that there are two different mean directions of loading on these trabecular bone samples of human vertebrae. The assessment of microstructural properties showed a tendency to increased connectivity of trabeculae, which occurs as the reduction of the analyzed subvolumes (100% to 20% or 18.5 mm to 3.7 mm) followed by an addition of bone volume fraction values. Those results highlight the idea that mechanical properties are better described in local regions, in other words, a local assessment with smaller sample size maintain the volume fraction and connectivity improving the prediction of bone strength. The mechanical properties are better associated with microstructural information in the subvolume, reducing the time of scan and radiation dose, which can generate bone quality parameters, for the diagnosis of bone diseases and prediction of fracture risk of bone structures with higher accuracy.

Cathepsin K-deficient osteocytes prevent lactation-induced bone loss and parathyroid hormone suppression.

Lactation induces bone loss to provide sufficient calcium in the milk, a process that involves osteoclastic bone resorption but also osteocytes and perilacunar resorption. The exact mechanisms by which osteocytes contribute to bone loss remain elusive. Osteocytes express genes required in osteoclasts for bone resorption, including cathepsin K (Ctsk), and lactation elevates their expression. We show that Ctsk deletion in osteocytes prevented the increase in osteocyte lacunar area seen during lactation, as well as the effects of lactation to increase osteoclast numbers and decrease trabecular bone volume, cortical thickness and mechanical properties. In addition, Ctsk deletion in osteocytes increased bone Parathyroid Hormone related Peptide (PTHrP), prevented the decrease in serum Parathyroid Hormone (PTH) induced by lactation, but amplified the increase in serum 1,25(OH)2D. The net result of these changes is to maintain serum and milk calcium levels in the normal range, ensuring normal offspring skeletal development. Our studies confirm the fundamental role of osteocytic perilacunar remodeling in physiological states of lactation and provides genetic evidence that osteocyte-derived Ctsk contributes not only to osteocyte perilacunar remodeling, but also to the regulation of PTH, PTHrP, 1,25-Dyhydroxyvitamin D (1,25(OH)2D), osteoclastogenesis and bone loss in response to the high calcium demand associated with lactation.

Network models for characterization of trabecular bone

Trabecular bone is a lightweight, compliant material organized as a web of struts and rods (trabeculae) that erode with age and the onset of bone diseases like osteoporosis, leading to increased fracture risk. The traditional diagnostic marker of osteoporosis, bone mineral density (BMD), has been shown in ex vivo experiments to correlate poorly with fracture resistance when considered on its own, while structural features in conjunction with BMD can explain more of the variation in trabecular bone strength. We develop a network-based model of trabecular bone by creating graphs from micro-computed tomography images of human bone, with weighted links representing trabeculae and nodes representing branch points. These graphs enable calculation of quantitative network metrics to characterize trabecular structure. We also create finite element models of the networks in which each link is represented by a beam, facilitating analysis of the mechanical response of the bone samples to simulated loading. We examine the structural and mechanical properties of trabecular bone at the scale of individual trabeculae (of order 0.1mm) and at the scale of selected volumes of interest (approximately a few mm), referred to as VOIs. At the VOI scale, we find significant correlations between the stiffness of VOIs and 10 different structural metrics. Individually, the volume fraction of each VOI is most strongly correlated to the stiffness of the VOI. We use multiple linear regression to identify the smallest subset of variables needed to capture the variation in stiffness. In a linear fit, we find that node degree, weighted node degree, Z-orientation, weighted Z-orientation, trabecular spacing, link length, and the number of links are the structural metrics that are most significant (p<0.05) in capturing the variation of stiffness in trabecular networks.

Novel β-Ti35Zr28Nb alloy scaffolds manufactured using selective laser melting for bone implant applications

Titanium (Ti) based tissue engineering scaffolds can be used to repair damaged bone. However, successful orthopedic applications of these scaffolds rely on their ability to mimic the mechanical properties of trabecular bone. Selective laser melting (SLM) was used to manufacture scaffolds of a new β-Ti35Zr28Nb alloy for biomedical applications. Porosity values of the scaffolds were 83% for the FCCZ structure (face centered cubic unit cell with longitudinal struts) and 50% for the FBCCZ structure (face and body centered cubic unit cell with longitudinal struts). The scaffolds had an elastic modulus of ∼1 GPa and a plateau strength of 8–58 MPa, which fall within the values of trabecular bone (0.2–5 GPa for elastic modulus and 4–70 MPa for compressive strength). The SLM-manufactured β-Ti35Zr28Nb alloy showed good corrosion properties. MTS assay revealed that both the FCCZ and FBCCZ scaffolds had a cell viability similar to the control. SEM observation indicated that the osteoblast-like cells adhered, spread and grew healthily on the surface of both scaffolds after culture for 7, 14 and 28 d, demonstrating good biocompatibility. Overall, the SLM-manufactured Ti35Zr28Nb scaffolds possess promising potential as hard-tissue implant materials due to their appropriate mechanical properties, good corrosion behavior and biocompatibility. Statement of SignificanceNovel β Ti35Zr28Nb alloy scaffolds with FCCZ and FBCCZ structures were successfully fabricated by selective laser melting (SLM) for biomedical applications. The scaffolds showed values of elastic modulus of ∼1 GPa and plateau strength of 8–58 MPa, which fall within the ranges of the mechanical properties of trabecular bone. The SLM-manufactured β Ti35Zr28Nb alloy showed good corrosion properties. Both SLM-manufactured FCCZ and FBCCZ scaffolds exhibited good biocompatibility, with osteoblast-like cells attaching, growing, and spreading in a healthy way on their surfaces after culturing for different periods up to 28 d.

Relationship between Elastic Module and Porous Structure of Cancellous Bone

Trabecular bone, widely presented in the ends of long bones and chine, is a typically porous structure which provides a multifunction such as light weight, undertaking load, impact energy buffer and hosting marrow cells. The structure of trabecular is a dominant factor for the strength of cancellous bone. The prediction of the trabecular bone’s mechanical properties depending on the trabecular structure is very useful for the diagnosis and treatment of osteoporosis. The object of this study is to establish a relationship between the mechanical properties and topological, morphological parameters of trabecular bone. The 50 3-D data of cancellous bone are selected from the CT images of three caput femurs and disposed in BoneJ, through which the BV/TV, SMI and genus parameters of each samples are obtained. The deformation behaviors of trabecular bone are simulated in ABAQUS through uniaxial compression on the 3-D model derived from stack images. Then linear-regression analyses are conducted on the BV/TV, genus, SMI and apparent Young’s modulus, resulting a high correlation (R^2=0.84) between the Young’s modulus and the hybrid parameter derived from SMI and normalized genus, corresponding to morphological and topological parameter of the samples respectively. The result indicates that it’s promising to establish the relationship between mechanical properties of trabecular bone and their topological and morphological parameters.

Assessing bone quality through mechanical properties in postmenopausal trabecular bone

BackgroundThe inner structure of trabecular bone is a result of structural optimization provided by remodeling processes. Changes in hormonal status related to menopause cause bone tissue loss and micro-architectural deterioration with a consequent susceptibility to fracture. Accumulation of micro-damage in bone, as a function of the rate of production and rate of repair, underlies the development of stress fractures, increasing fragility associated to age and osteoporosis, especially in transmenopausal women. Patients and MethodsQuasi-static and nano-dynamic mechanical characterization were undertaken in trabecular bone from femoral neck biopsies of postmenopausal women. AFM (Atomic Force Microscopy) complementary studies were performed to determine nano-roughness (SRa) and the fibrils width of collagen. Nanoindentations were used to quantify transmenopausal changes in intrinsic mechanical properties of trabecular bone: hardness (Hi), modulus of Young (Ei), complex modulus (E*), tan delta (δ), storage modulus (E') and loss modulus (E"). ResultsAs result of the quasi-static measurements, 0.149 (0.036) GPa and 2.95 (0.73) GPa of Hi and Ei were obtained, respectively. As result of the nano-dynamic measurements, 17.94 (3.15), 0.62 (0.10), 13.79 (3.21 and 6.39 (1.28) GPa of E*, tan (δ), E' and E" were achieved, respectively. 101.07 SRa and 831.28 nm of fibrils width were additionally obtained. ConclusionsThis study poses a first approach to the measurement of bone quality in postmenopausal trabecular bone by combining quasi-static, nano-DMA analysis and tribology of dentin surface through AFM characterization.

Mapping anisotropy improves QCT-based finite element estimation of hip strength in pooled stance and side-fall load configurations

Hip fractures are one of the most severe consequences of osteoporosis. Compared to the clinical standard of DXA-based aBMD at the femoral neck, QCT-based FEA delivers a better surrogate of femoral strength and gains acceptance for the calculation of hip fracture risk when a CT reconstruction is available. Isotropic, homogenised voxel-based, finite element (hvFE) models are widely used to estimate femoral strength in cross-sectional and longitudinal clinical studies. However, fabric anisotropy is a classical feature of the architecture of the proximal femur and the second determinant of the homogenised mechanical properties of trabecular bone. Due to the limited resolution, fabric anisotropy cannot be derived from clinical CT reconstructions. Alternatively, fabric anisotropy can be extracted from HR-pQCT images of cadaveric femora. In this study, fabric anisotropy from HR-pQCT images was mapped onto QCT-based hvFE models of 71 human proximal femora for which both HR-pQCT and QCT images were available. Stiffness and ultimate load computed from anisotropic hvFE models were compared with previous biomechanical tests in both stance and side-fall configurations. The influence of using the femur-specific versus a mean fabric distribution on the hvFE predictions was assessed. Femur-specific and mean fabric enhance the prediction of experimental ultimate force for the pooled, i.e. stance and side-fall, (isotropic: r2=0.81, femur-specific fabric: r2=0.88, mean fabric: r2=0.86,p<0.001) but not for the individual configurations. Fabric anisotropy significantly improves bone strength prediction for the pooled configurations, and mapped fabric provides a comparable prediction to true fabric. The mapping of fabric anisotropy is therefore expected to help generate more accurate QCT-based hvFE models of the proximal femur for personalised or multiple load configurations.

Bone microarchitecture, biomechanical properties, and advanced glycation end-products in the proximal femur of adults with type 2 diabetes.

Skeletal fragility is a major complication of type 2 diabetes mellitus (T2D), but there is a poor understanding of mechanisms underlying T2D skeletal fragility. The increased fracture risk has been suggested to result from deteriorated bone microarchitecture or poor bone quality due to accumulation of advanced glycation end-products (AGEs). We conducted a clinical study to determine whether: 1) bone microarchitecture, AGEs, and bone biomechanical properties are altered in T2D bone, 2) bone AGEs are related to bone biomechanical properties, and 3) serum AGE levels reflect those in bone. To do so, we collected serum and proximal femur specimens from T2D (n = 20) and non-diabetic (n = 33) subjects undergoing total hip replacement surgery. A section from the femoral neck was imaged by microcomputed tomography (microCT), tested by cyclic reference point indentation, and quantified for AGE content. A trabecular core taken from the femoral head was imaged by microCT and subjected to uniaxial unconfined compression tests. T2D subjects had greater HbA1c (+23%, p ≤ 0.0001), but no difference in cortical tissue mineral density, cortical porosity, or trabecular microarchitecture compared to non-diabetics. Cyclic reference point indentation revealed that creep indentation distance (+18%, p ≤ 0.05) and indentation distance increase (+20%, p ≤ 0.05) were greater in cortical bone from T2D than in non-diabetics, but no other indentation variables differed. Trabecular bone mechanical properties were similar in both groups, except for yield stress, which tended to be lower in T2D than in non-diabetics. Neither serum pentosidine nor serum total AGEs were different between groups. Cortical, but not trabecular, bone AGEs tended to be higher in T2D subjects (21%, p = 0.09). Serum AGEs and pentosidine were positively correlated with cortical and trabecular bone AGEs. Our study presents new data on biomechanical properties and AGEs in adults with T2D, which are needed to better understand mechanisms contributing to diabetic skeletal fragility.

A multiscale homogenization procedure using the fabric tensor concept

Bone is a heterogeneous material in which structural levels can be identified, from the microscale to macroscale. Multiscale models enable to model the material using homogenization techniques. In this work, an innovative homogenization technique for trabecular bone tissue is proposed. The technique combines the fabric tensor concept and a bone phenomenological material law, linking the apparent density with the trabecular bone mechanical properties. The proposed methodology efficiently homogenizes the trabecular bone highly heterogeneous medium, allowing to define its homogenized microscale mechanical properties and to reduce the analysis computational cost (when compared with classical homogenization techniques). In order to verify the efficiency of the technique several examples were solved using a confined square patch of trabecular bone under compression. In the end, the results obtained with a classic homogenization technique and the proposed methodology were compared.

A novel use of 3D printing model demonstrates the effects of deteriorated trabecular bone structure on bone stiffness and strength.

Trabecular bone structure is crucial to normal mechanical behavior of bones. Studies have shown that osteoporosis negatively affects trabecular bone structure, mainly by reducing bone volume fraction (BV/TV) and thus increasing fracture risk. One major limitation in assessing and quantifying the effect of this structural deterioration is that no two trabecular structures are identical. Thus, when we compare a group of healthy bones against a different group of bones that experienced resorption (i.e. decreased BV/TV) we only discover an "average" mechanical effect. It is impossible to quantify the mechanical effect of individual structural deterioration for each sample, simply because we never have the same sample in both states (intact and deteriorated structure). 3D printing is a new technology that can assist in overcoming this issue. Here we report a preliminary study that compares a healthy 3D printed trabecular bone model with the same model after bone resorption was simulated. Since the deteriorated structural bone model is derived from the healthy one, it is possible to directly estimate (percentage wise) the decrease of tissue stiffness and strength as a result of bone resorption for this specific structure. Our results demonstrate that a relatively small decrease in BV/TV (about 8%) leads to a dramatic decrease in structural strength (24%) and structural stiffness (17%), (P < 0.01). Structural strength decreased from an average of 9.14 ± 2.85MPa to 6.97 ± 2.44MPa, while structural stiffness decreased from an average of 282.5 ± 63.4N/mm to 233.8 ± 51.2N/mm. This study demonstrates that 3D printing is a novel and valuable tool for quantifying the effect of structural deterioration on the mechanical properties of trabecular bone. In the future, this approach may help us attain better personal fracture risk assessments by CT scanning, 3D printing and mechanically testing individual bone replicas from patients suffering excessive bone resorption.

Experimental repetitive mild traumatic brain injury induces deficits in trabecular bone microarchitecture and strength in mice

To evaluate the long-term consequence of repetitive mild traumatic brain injury (mTBI) on bone, mTBI was induced in 10-week-old female C57BL/6J mice using a weight drop model, once per day for 4 consecutive days at different drop heights (0.5, 1 and 1.5 m) and the skeletal phenotype was evaluated at different time points after the impact. In vivo micro-CT (μ-CT) analysis of the tibial metaphysis at 2, 8 and 12 weeks after the impact revealed a 5%–32% reduction in trabecular bone mass. Histomorphometric analyses showed a reduced bone formation rate in the secondary spongiosa of 1.5 m impacted mice at 12 weeks post impact. Apparent modulus (bone strength), was reduced by 30% (P<0.05) at the proximal tibial metaphysis in the 1.5 m drop height group at 2 and 8 weeks post impact. Ex vivo μ-CT analysis of the fifth lumbar vertebra revealed a significant reduction in trabecular bone mass at 12 weeks of age in all three drop height groups. Serum levels of osteocalcin were decreased by 22%, 15%, and 19% in the 0.5, 1.0 and 1.5 m drop height groups, respectively, at 2 weeks post impact. Serum IGF-I levels were reduced by 18%–32% in mTBI mice compared to contro1 mice at 2 weeks post impact. Serum osteocalcin and IGF-I levels correlated with trabecular BV/TV (r2=0.14 and 0.16, P<0.05). In conclusion, repetitive mTBI exerts significant negative effects on the trabecular bone microarchitecture and bone mechanical properties by influencing osteoblast function via reduced endocrine IGF-I actions.

Correlative Analysis of Vertebral Trabecular Bone Microarchitecture and Mechanical Properties: A Combined Ultra-high Field (7 Tesla) MRI and Biomechanical Investigation.

High-resolution imaging and biomechanical investigation of ex-vivo vertebrae. The aim of this study was to assess bone microarchitecture of cadaveric vertebrae using ultra-high field (UHF) 7 Tesla magnetic resonance imaging (MRI) and to determine whether the corresponding microarchitecture parameters were related to bone mineral density (BMD) and bone strength assessed by dual-energy x-ray absorptiometry (DXA) and mechanical compression tests. Limitations of DXA for the assessment of bone fragility and osteoporosis have been recognized and criteria of microarchitecture alteration have been included in the definition of osteoporosis. Although vertebral fracture is the most common osteoporotic fracture, no study has assessed directly vertebral trabecular bone microarchitecture. BMD of 24 vertebrae (L2, L3, L4) from eight cadavers was investigated using DXA. The bone volume fraction (BVF), trabecular thickness (Tb.Th), and trabecular spacing (Tb.Sp) of each vertebra were quantified using UHF MRI. Measurements were performed by two operators to characterize the inter-rater reliability. The whole set of specimens underwent mechanical compression tests to failure and the corresponding failure stress was calculated. The inter-rater reliability for bone microarchitecture parameters was good with intraclass correlation coefficients ranging from 0.82 to 0.94. Failure load and stress were significantly correlated with BVF, Tb.Sp, and BMD (P < 0.05). Tb.Th was only correlated with the failure stress (P < 0.05). Multiple regression analysis demonstrated that the combination of BVF and BMD improved the prediction of the failure stress from an adjusted R = 0.384 for BMD alone to an adjusted R = 0.414. We demonstrated for the first time that the vertebral bone microarchitecture assessed with UHF MRI was significantly correlated with biomechanical parameters. Our data suggest that the multimodal assessment of BMD and trabecular bone microarchitecture with UHF MRI provides additional information on the risk of vertebral bone fracture and might be of interest for the future investigation of selected osteoporotic patients. N /A.

Micro-finite-element method to assess elastic properties of trabecular bone at micro- and macroscopic level

The objective of the present study is to assess the mechanical behavior of trabecular bone based on microCT imaging and micro-finite-element analysis. In this way two methods are detailed: (i) direct determination of macroscopic elastic property of trabecular bone; (ii) inverse approach to assess mechanical properties of trabecular bone tissue. Thirty-five females and seven males (forty-two subjects) mean aged (±SD) 80±11.7 years from hospitals of Assistance publique-Hôpitaux de Paris (AP-HP) diagnosed with osteoporosis following a femoral neck fracture due to a fall from standing were included in this study. Fractured heads were collected during hip replacement surgery. Standardized bone cores were removed from the femoral head's equator by a trephine in a water bath. MicroCT images acquisition and analysis were performed with CTan® software and bone volume fraction was then determined. Micro-finite-element simulations were per-formed using Abaqus 6.9-2® software in order to determine the macroscopic mechanical behaviour of the trabecular bone. After microCT acquisition, a longitudinal compression test was performed and the experimental macroscopic Young's Modulus was extracted. An inverse approach based on the whole trabecular bone's mechanical response and micro-finite-element analysis was performed to determine microscopic mechanical properties of trabecular bone. In the present study, elasticity of the tissue was shown to be similar to that of healthy tissue but with a lower yield stress. Classical histomorphometric analysis form microCT imaging associated with an inverse micro-finite-element method allowed to assess microscopic mechanical trabecular bone parameters.

Getting PEEK to Stick to Bone: The Development of Porous PEEK for Interbody Fusion Devices.

Interbody fusion cages are routinely implanted during spinal fusion procedures to facilitate arthrodesis of a degenerated or unstable vertebral segment. Current cages are most commonly made from polyether-ether-ketone (PEEK) due to its favorable mechanical properties and imaging characteristics. However, the smooth surface of current PEEK cages may limit implant osseointegration and may inhibit successful fusion. We present the development and clinical application of the first commercially available porous PEEK fusion cage (COHERE®, Vertera, Inc., Atlanta, GA) that aims to enhance PEEK osseointegration and spinal fusion outcomes. The porous PEEK structure is extruded directly from the underlying solid and mimics the structural and mechanical properties of trabecular bone to support bone ingrowth and implant fixation. Biomechanical testing of the COHERE® device has demonstrated greater expulsion resistance versus smooth PEEK cages with ridges and greater adhesion strength of porous PEEK versus plasma-sprayed titanium coated PEEK surfaces. In vitro experiments have shown favorable cell attachment to porous PEEK and greater proliferation and mineralization of cell cultures grown on porous PEEK versus smooth PEEK and smooth titanium surfaces, suggesting that the porous structure enhances bone formation at the cellular level. At the implant level, preclinical animal studies have found comparable bone ingrowth into porous PEEK as those previously reported for porous titanium, leading to twice the fixation strength of smooth PEEK implants. Finally, two clinical case studies are presented demonstrating the effectiveness of the COHERE® device in cervical spinal fusion.