Ageing human bone: factors affecting its biomechanical properties and the role of collagen

Nanomechanical Characterization of Canine Femur Bone for Strain Rate Sensitivity in the Quasistatic Range under Dry versus Wet Conditions

As a strain rate-dependent material, bone has a different mechanical response to various loads. Our aim was to evaluate the effect of water and different loading/unloading rates on the nanomechanical properties of canine femur cortical bone. Six cross-sections were cut from the diaphysis of six dog femurs and were nanoindented in their cortical area. Both dry and wet conditions were taken into account for three quasistatic trapezoid profiles with a maximum force of 2000 μN (holding time = 30 s) at loading/unloading rates of 10, 100, and 1000 μN/s, respectively. For each specimen, 254 ± 9 (mean ± SD) indentations were performed under different loading conditions. Significant differences were found for the elastic modulus and hardness between wet and dry conditions (P < 0.001). No influence of the loading/unloading rates was observed between groups except for the elastic modulus measured at 1000 μN/s rate under dry conditions (P < 0.001) and for the hardness measured at a rate of 10 μN/s under wet conditions (P < 0.001). Therefore, for a quasistatic test with peak load of 2000 μN held for 30 s, it is recommended to nanoindent under wet conditions at a loading/unloading rate of 100–1000 μN/s, so the reduced creep effect allows for a more accurate computation of mechanical properties.

Micromechanical modeling of R-curve behaviors in human cortical bone

The risk of bone fracture increases with age because of a variety of factors that include, among others, decreasing bone quantity and quality due to increasing porosity and crack density with age. Experimental evidence has indicated that changes in bone microstructure and trace mineralization with age can result in different crack-tip strain field and fracture response, leading to different fracture mechanisms and R-curve behaviors. In this paper, a micromechanical modeling approach is developed to predict the R-curve response of bone tissue by delineating fracture mechanisms that lead to microdamage and ligament bridging by incorporating the influence of increasing porosity and crack density with age. The effects of age on fracture of human femur cortical bone due to porosity (bone quantity) and bone quality (crack density) with age are then examined via the micromechanical model.

High-resolution structural insights into bone: a solid-state NMR relaxation study utilizing paramagnetic doping

The hierarchical heterogeneous architecture of bone imposes significant challenges to structural and dynamic studies conducted by traditional biophysical techniques. High-resolution solid-state nuclear magnetic resonance (SSNMR) spectroscopy is capable of providing detailed atomic-level structural insights into such traditionally challenging materials. However, the relatively long data-collection time necessary to achieve a reliable signal-to-noise ratio (S/N) remains a major limitation for the widespread application of SSNMR on bone and related biomaterials. In this study, we attempt to overcome this limitation by employing the paramagnetic relaxation properties of copper(II) ions to shorten the (1)H intrinsic spin-lattice (T(1)) relaxation times measured in natural-abundance (13)C cross-polarization (CP) magic-angle-spinning (MAS) NMR experiments on bone tissues for the purpose of accelerating the data acquisition time in SSNMR. To this end, high-resolution solid-state (13)C CPMAS experiments were conducted on type I collagen (bovine tendon), bovine cortical bone, and demineralized bovine cortical bone, each in powdered form, to measure the (1)H T(1) values in the absence and in the presence of 30 mM Cu(II)(NH(4))(2)EDTA. Our results show that the (1)H T(1) values were successfully reduced by a factor of 2.2, 2.9, and 3.2 for bovine cortical bone, type I collagen, and demineralized bone, respectively, without reducing the spectral resolution and thus enabling faster data acquisition. In addition, paramagnetic quenching of particular (13)C NMR resonances on exposure to Cu(2+) ions in the absence of mineral was also observed, potentially suggesting the relative proximity of three main amino acids in the protein backbone (glycine, proline, and alanine) to the bone mineral surface.

Cortical bone response to the presence of load-bearing percutaneous osseointegrated prostheses

Although the current percutaneous osseointegrated (OI) prosthetic attachment systems are novel clinical treatments for patients with limb loss, there have only been limited translational studies undertaken to date. To bridge this knowledge gap, from a larger study group of 86 animals that were implanted with a novel percutaneous OI implant construct, 33 sheep were randomly selected from the 0-, 3-, 6-, 9- and 12-month groups for histomorphometric analyses of periprosthetic cortical bone tissue. At necropsy, implanted and nonimplanted limbs were harvested and processed for the evaluation of cortical bone porosity and mineral apposition rate (MAR). The data showed a maximum increase in bone porosity within the first 3 months following implantation and then a progressive reduction in porosity to the baseline steady-state ("Time 0") value by 12 months. The data further verified that the MAR increased during the first 6 months of implantation, reaching a plateau between 6 and 9 months, followed by a progressive decline to the baseline steady state. It was concluded that clinical load bearing and falls precautions, taken during the first 3-6 months following percutaneous OI device implantation surgery, could greatly limit bone fractures during this vulnerable time of increasing cortical bone porosity.

The contribution of the extracellular matrix to the fracture resistance of bone

The likelihood of suffering a bone fracture is not solely predicated on areal bone mineral density. As people age, there are numerous changes to the skeleton occurring at multiple length scales (from millimeters to submicron scales) that reduce the ability of bone to resist fracture. Herein is a review of the current knowledge about the role of the extracellular matrix (ECM) in this resistance, with emphasis on engineering principles that characterize fracture resistance beyond bone strength to include bone toughness and fracture toughness. These measurements of the capacity to dissipate energy and to resist crack propagation during failure precipitously decline with age. An age-related loss in collagen integrity is strongly associated with decreases in these mechanical properties. One potential cause for this deleterious change in the ECM is an increase in advanced glycation end products, which accumulate with aging through nonenzymatic collagen crosslinking. Potential regulators and diagnostic tools of the ECM with respect to fracture resistance are also discussed.

Brief communication: Reevaluating osteoporosis in human ribs: the role of intracortical porosity

Osteoporosis is a major health concern in modern society and is continually being evaluated in past populations by quantifying bone loss. Cortical area measures are commonly used in anthropological analyses to assess bone loss in the ribs, but these values are typically based on endosteal expansion and do not account for intracortical bone loss. The objective of this study is to evaluate the effectiveness of using absolute cortical area, compared to traditional cortical area measures to describe global bone loss in elderly ribs. Transverse sections were prepared from sixth ribs of ten elderly subjects, and bone area measurements were made from 100× magnification composites of each rib for calculation of cortical area (Ct.Ar) and percent cortical area (% C/T). In addition, all areas of intracortical porosity were measured and percent porosity area (% Po.Ar) calculated. Absolute cortical area (Ct.Ar(A)) was calculated by subtracting porosity area from cortical area, and a percent absolute cortical area (% C(A)/T) calculated. ANOVA results reveal significant interindividual variation in percent porosity area (% Po.Ar). Percent cortical area and percent absolute cortical area values were compared and results show a mean difference of 4.08% exists across all subjects, with a range of 1.19-11.73%. This suggests that intracortical porosity is variable and does play a role in age-associated bone loss in the rib. All future investigations of osteoporosis should account for intracortical porosity in bone loss.

Quantitative second-harmonic generation microscopy for imaging porcine cortical bone: comparison to SEM and its potential to investigate age-related changes

We propose the use of second-harmonic generation (SHG) microscopy for imaging collagen fibers in porcine femoral cortical bone. The technique is compared with scanning electron microscopy (SEM). SHG microscopy is shown to have excellent potential for bone imaging primarily due its intrinsic specificity to collagen fibers, which results in high contrast images without the need for specimen staining. Furthermore, this technique's ability to quantitatively assess collagen fiber organization is evaluated through an exploratory examination of bone structure as a function of age, from very young to mature bone. In particular, four different age groups: 1 month, 3.5 months, 6 months, and 30 months, were studied. Specifically, we employ the recently developed Fourier transform-second harmonic generation (FT-SHG) imaging technique for the quantification of the structural changes, and observe that as the bone develops, there is an overall reduction in porosity, the number of osteons increases, and the collagen fibers become comparatively more organized. It is also observed that the variations in structure across the whole cross-section of the bone increase with age. The results of this work show that quantitative SHG microscopy can serve as a valuable tool for evaluating the structural organization of collagen fibers in ex vivo bone studies.

The importance of murine cortical bone microstructure for microcrack initiation and propagation

In order to better understand bone postyield behavior and consequently bone failure behavior, this study aimed first to investigate cortical bone microstructure and second, to relate cortical bone microstructure to microdamage initiation and propagation in C57BL/6 (B6) and C3H/He (C3H) mice; two murine inbred strains known for their differences in bone phenotype. Murine femora of B6 and C3H were loaded axially under compression in a stepwise manner. For each loading step, 3D data sets at a nominal resolution of 700 nm were acquired by means of synchrotron radiation-based computed tomography. Cortical bone microstructure was divided into three phases: the canal network, the osteocyte lacunar system, and microdamage. Canal volume density and canal unit volume both correlated highly to crack number density (canal volume density: R(2)=0.64, p<0.005 and canal unit volume: R(2)=0.75, p<0.001). Moreover, the large canal units in C3H bone were responsible for more microdamage accumulation compared to B6 bones. This more pronounced microdamage accumulation due to large intracortical bone voids, which eventually leads to a fatal macrocrack (fracture), represents a potential contributing factor to the higher incidence of bone fractures in the elderly.

Age-related differences in the morphology of microdamage propagation in trabecular bone

Microdamage density has been shown to increase with age in trabecular bone and is associated with decreased fracture toughness. Numerous studies of crack propagation in cortical bone have been conducted, but data in trabecular bone is lacking. In this study, propagation of severe, linear, and diffuse damage was examined in trabecular bone cores from the femoral head of younger (61.3±3.1 years) and older (75.0±3.9 years) men and women. Using a two-step mechanical testing protocol, damage was first initiated with static uniaxial compression to 0.8% strain then propagated at a normalized stress level of 0.005 to a strain endpoint of 0.8%. Coupling mechanical testing with a dual-fluorescent staining technique, the number and length/area of propagating cracks were quantified. It was found that the number of cycles to the test endpoint was substantially decreased in older compared to younger samples (younger: 77,372±15,984 cycles; older: 34,944±11,964 cycles, p=0.06). This corresponded with a greater number of severely damaged trabeculae expanding in area during the fatigue test in the older group. In the younger group, diffusely damaged trabeculae had a greater damage area, which illustrates an efficient energy dissipation mechanism. These results suggest that age-related differences in fatigue life of human trabecular bone may be due to differences in propagated microdamage morphology.

New laboratory tools in the assessment of bone quality

Bone quality is a complex set of intricated and interdependent factors that influence bone strength. A number of methods have emerged to measure bone quality, taking into account the organic or the mineral phase of the bone matrix, in the laboratory. Bone quality is a complex set of different factors that are interdependent. The bone matrix organization can be described at five different levels of anatomical organization: nature (organic and mineral), texture (woven or lamellar), structure (osteons in the cortices and arch-like packets in trabecular bone), microarchitecture, and macroarchitecture. Any change in one of these levels can alter bone quality. An altered bone remodeling can affect bone quality by influencing one or more of these factors. We have reviewed here the main methods that can be used in the laboratory to explore bone quality on bone samples. Bone remodeling can be evaluated by histomorphometry; microarchitecture is explored in 2D on histological sections and in 3D by microCT or synchrotron. Microradiography and scanning electron microscopy in the backscattered electron mode can measure the mineral distribution; Raman and Fourier-transformed infra-red spectroscopy and imaging can simultaneously explore the organic and mineral phase of the matrix on multispectral images; scanning acoustic microscopy and nanoindentation provide biomechanical information on individual trabeculae. Finally, some histological methods (polarization, surface staining, fluorescence, osteocyte staining) may also be of interest in the understanding of quality as a component of bone fragility. A growing number of laboratory techniques are now available. Some of them have been described many years ago and can find a new youth; others having benefited from improvements in physical and computer techniques are now available.

Fabric-mechanical property relationships of trabecular bone allografts are altered by supercritical CO₂ treatment and gamma sterilization

Tissue grafts are implanted in orthopedic surgery every day. In order to minimize infection risk, bone allografts are often delipidated with supercritical CO₂ and sterilized prior to implantation. This treatment may, however, impair the mechanical behavior of the bone graft tissue. The goal of this study was to determine clinically relevant mechanical properties of treated/sterilized human trabecular bone grafts, e.g. the apparent modulus, strength, and the ability to absorb energy during compaction. They were compared with results of identical experiments performed previously on untreated/fresh frozen human trabecular bone from the same anatomical site (Charlebois, 2008). We tested the hypothesis that the morphology-mechanical property relationships of treated cancellous allografts are similar to those of fresh untreated bone. The morphology of the allografts was determined by μCT. Subsequently, cylindrical samples were tested in unconfined and confined compression. To account for various morphologies, the experimental data was fitted to phenomenological mechanical models for elasticity, strength, and dissipated energy density based on bone volume fraction (BV/TV) and the fabric tensor determined by MIL. The treatment/sterilization process does not appear to influence bone graft stiffness. However, strength and energy dissipation of the bone grafts were found to be significantly reduced by 36% to 47% and 66% to 81%, respectively, for a broad range of volume fraction (0.14<BV/TV<0.39) and degree of anisotropy (1.24<DA<2.18). Since the latter properties are strongly dominated by BV/TV, the clinical consequences of this reduction can be compensated by using grafts with lower porosity. The data of this study suggests that an increase of 5-10% in BV/TV is sufficient to compensate for the reduced post-yield mechanical properties of treated/sterilized bone in monotonic compression. In applications where graft stiffness needs to be matched and strength is not a concern, treated allograft with the same BV/TV as an appropriate fresh bone graft may be used.

The relative contributions of non-enzymatic glycation and cortical porosity on the fracture toughness of aging bone

The risk of fracture increases with age due to the decline of bone mass and bone quality. One of the age-related changes in bone quality occurs through the formation and accumulation of advanced glycation end-products (AGEs) due to non-enzymatic glycation (NEG). However as a number of other changes including increased porosity occur with age and affect bone fragility, the relative contribution of AGEs on the fracture resistance of aging bone is unknown. Using a high-resolution nonlinear finite element model that incorporate cohesive elements and micro-computed tomography-based 3d meshes, we investigated the contribution of AGEs and cortical porosity on the fracture toughness of human bone. The results show that NEG caused a 52% reduction in propagation fracture toughness (R-curve slope). The combined effects of porosity and AGEs resulted in an 88% reduction in propagation toughness. These findings are consistent with previous experimental results. The model captured the age-related changes in the R-curve toughening by incorporating bone quantity and bone quality changes, and these simulations demonstrate the ability of the cohesive models to account for the irreversible dynamic crack growth processes affected by the changes in post-yield material behavior. By decoupling the matrix-level effects due to NEG and intracortical porosity, we are able to directly determine the effects of NEG on fracture toughness. The outcome of this study suggests that it may be important to include the age-related changes in the material level properties by using finite element analysis towards the prediction of fracture risk.

Comparison of effects of alfacalcidol and alendronate on mechanical properties and bone collagen cross-links of callus in the fracture repair rat model

Both bone density and quality are important determinants of bone strength. Bone quality is prescribed by matrix characteristic including collagen cross-linking and bone structural characteristics and is important in reinforcement of bone strength. We investigated the effects of alfacalcidol (ALF), a prodrug of calcitriol, and alendronate (ALN), a bisphosphanate, on the mechanical properties and content of enzymatic cross-links in femoral bone using a fracture repair rat model. Forty 3-month-old female Wistar-Imamichi rats were randomized into 4 groups: SHAM (sham-operated+vehicle), OVX (ovariectomy+vehicle), ALF (ovariectomy+ALF, 0.1 microg/kg/d, p.o.) and ALN (ovariectomy+ALN, 10 microg/kg/d, s.c.). Treatment began immediately after SHAM or OVX surgery. Three weeks later, all animals underwent transverse osteotomies at the midshaft of the left femur. Treatment was continued and rats were sacrificed at 12 weeks post-fracture for evaluation by X-ray radiography, micro-CT, pQCT, biomechanical testing and bone histomorphometry. In the ALN group, no new cortical shell appeared and the callus diameter was significantly larger than in the OVX group (p<0.05). Stiffness of fractured callus in the ALF group, but not in the ALN group, was significantly higher than in the OVX group. Young's modulus in the ALN group was significantly decreased compared to the OVX group. Moreover, micro-CT analysis showed that ALN treatment increased the lowly mineralized bone in the callus by, resulting in the highest content of woven bone area and lowest content of lamellar bone. The total amount of enzymatic cross-links in both the ALF and ALN groups was significantly higher than in the OVX control group. Of particular interest, the Pyr-to-Dpyr ratio was significantly decreased by ALF administration, suggesting that ALF but not ALN normalized the enzymatic cross-link patterns in fractured bone to the control level. In conclusion, ALN and ALF treatment increased bone strength via the distinctive effect on bone mass and quality. ALN formed larger calluses and increased enzymatic cross-links despite delayed woven bone remodeling into lamellar bone, whereas ALF treatment induced lamellar bone formation coincided with increasing in the enzymatic cross-linking and normalizing the cross-link pattern in callus to native bone pattern.

Time sequence of secondary mineralization and microhardness in cortical and cancellous bone from ewes

Bone mineral is a major determinant of the mechanical resistance of bones. In bone structural units (BSUs), mineralization of osteoid tissue begins with a rapid primary mineralization followed by a secondary mineralization phase, i.e., a slow and gradual maturation of the mineral component leading to complete mineralization during an unknown period. The aim of this study was to determine the chronology of secondary bone mineralization in ewes, an animal model with a remodeling activity close to humans. Eighteen ewes received different fluorescent labels every 6 months to date the "age" of each labeled BSU. The degree of mineralization of bone (DMB) and Vickers microhardness were measured in labeled BSUs, while mineralization at the crystal level was assessed by Fourier transform infrared microspectroscopy (FTIRM). During the first 6 months of mineralization, degree of mineralization and microhardness significantly increased. They then increased more slowly until at 30 months they reach their maximal values. This progression during secondary mineralization was associated with an improvement of both the maturation and the crystal perfection of the mineral part of bone matrix. Finally, secondary mineralization in BSUs is completed after a period of 30 months. This observation should be taken into account for understanding the effects of long-term treatments of bone diseases.

Mechanical behavior of human cortical bone in cycles of advancing tensile strain for two age groups

The capacity of bone for post-yield energy dissipation decreases with age. To gain information on the causes of such a change, we examined age-related changes in the mechanical behavior of human cadaveric bone as a function of progressive deformation. In this study, tensile specimens from tibiae of nine middle aged and eight elderly donors were loaded till failure in an incremental and cyclic (load-dwell-unload-dwell-reload) scheme. The elastic modulus, maximum stress, permanent strain, stress relaxation, permanent strain energy, elastic release strain energy, and hysteresis energy were determined in each loading cycle at incremental strains. Similar with previous work, the results of the present study also indicated that elderly bone failed at much lower strains compared to middle aged bone. However, no significant differences in the mechanical behavior of bone were observed between the two age groups except for the premature failure of elderly bone. After yielding, the energy dissipation and permanent strain of bone appeared to linearly increase with increasing strain applied, while nonlinear changes occurred in the modulus loss and stress relaxation with increasing strain. Moreover, stress relaxation tended to peak at 1% strain beyond which few elderly bone specimens survived. This study suggests that damaging mechanisms in bone vary with deformation, and aging affects the post-yield mechanisms, thus giving rise to the age-related differences in the mechanical properties of bone, especially the capacity of the tissue for energy dissipation.

Age-related changes in porosity and mineralization and in-service damage accumulation

It has been proposed that bone damageability (i.e. bone's susceptibility to formation of damage) increases with the elevation or suppression of bone turnover. Suppression of turnover via bisphosphonates increases local bone mineralization, which theoretically should increase the susceptibility of bone to microcrack formation. Elevation of bone turnover has also been proposed to increase bone microdamage through an increase in bone intracortical porosity and local stresses and strains. The goal of this paper was to investigate the above proposals, i.e., whether or not increases to mineral content and porosity increase bone in-service damageability. To do this, we measured in vivo diffuse damage area (Df.Dm.Ar, %) and microcrack density (Cr.Dn) (cracks/mm(2)) in the same specimen from human cortical bone of the midshaft of the proximal femur obtained from cadavers with an age range of eight decades and examined their relationships with porosity, mineralization and age. Results of this study showed that Cr.Dn and Df.Dm.Ar increased with a decrease in bulk mineralization. This finding does not appear to support the proposal that damage accumulation increases with low bone turnover that results in increases mineralization. It was proposed however that the negative correlation between damage accumulation and mineralization may be attributed to highly mineralized regions of bone existing with under-mineralized regions resulting in an overall decrease in average bone mineralization. It was also found that microdamage accumulates with increasing porosity which does appear to support the proposal that elevated bone turnover that results in increased porosity can accelerate microdamage accumulation. Finally, it was shown that linear microcracks and Df.Dm.Ar accumulate with age differently, but because they correlate with each other, one may be the precursor for the other.

Exploration of trabecular bone nonlinear elasticity using time-of-flight modulation

Bone tissue contains microcracks that may affect its mechanical properties as well as the whole trabecular structure. The relationship between crack density and bone strength is nevertheless poorly understood. Linear ultrasound techniques being almost insensitive to the level of damage, we propose a method to measure acoustic non- linearity in trabecular bone using time-of-flight modulation (TOFM) measurements. Ultrasonic short bursts times-of- flight (TOF) are modulated as a result of nonlinear interaction with a low-frequency (LF) wave in the medium. TOF variations are directly related to elastic modulus variations. Classical and nonclassical nonlinear parameters beta, delta, and alpha can be derived from these measurements. The method was validated in materials with classical, quadratic, nonlinear elasticity. In dense trabecular bone region, TOFM related to classical, quadratic, nonlinear elasticity as a function of the LF pressure exhibits tension-compression asymmetry. The TOFM amplitude measured in dense areas of trabecular bone is almost one order of magnitude higher than in a low-density area, but the linear parameters show much smaller variations: 5% for ultrasound propagation velocity and 100% for broadband ultrasonic attenuation (BUA). In high-density trabecular bone regions, beta depends on the LF pressure amplitude and can reach 400 at 50 kPa.

Relationships between density and Young's modulus with microporosity and physico-chemical properties of Wistar rat cortical bone from growth to senescence

The aim of this study is to assess density and elastic properties of Wistar rat cortical bone from growth to senescence and to correlate them with morphological and physico-chemical properties of bone. During growth (from 1 to 9 months), bone density and Young's modulus were found to increase from 1659+/-85 to 2083+/-13 kg m(-3) and from 8+/-0.8 to 19.6+/-0.7 GPa respectively. Bone microporosity was found to decrease from 8.1+/-0.7% to 3.3+/-0.7%. Physico-chemical investigations exhibited a mineralization of bone matrix and a maturation of apatite crystals, as protein content decreased from 21.4+/-0.2% to 17.6+/-0.6% and apatite crystal size and carbonate content increased (c-axis length: from 151 to 173 A and CO(3)W%: from 4.1+/-0.3% to 6.1+/-0.2%). At adult age, all properties stabilized. During senescence, a slow decrease of mechanical properties was first observed (from 12 to 18 months, rho=2089+/-14 to 2042+/-30 kg m(-3) and E(3)=19.8 +/-1.3 to 14.8+/-1.5 GPa), followed by a stabilization. Physico-chemical properties stabilized while microporosity increased slightly (from 3.3% to 4%) but not significantly (p>0.05). A multiple regression analysis showed that morphological and physico-chemical properties had significant effects on density regression model. Microporosity had a greater effect on Young's modulus regression model than physico-chemical properties. This study showed that bone structure, mineralization and apatite maturation should be considered to improve the understanding of bone mechanical behaviour.

Evidence for an elementary process in bone plasticity with an activation enthalpy of 1 eV

The molecular mechanisms for plastic deformation of bone tissue are not well understood. We analysed temperature and strain-rate dependence of the tensile deformation behaviour in fibrolamellar bone, using a technique originally developed for studying plastic deformation in metals. We show that, beyond the elastic regime, bone is highly strain-rate sensitive, with an activation volume of ca 0.6 nm3. We find an activation energy of 1.1 eV associated with the basic step involved in the plastic deformation of bone at the molecular level. This is much higher than the energy of hydrogen bonds, but it is lower than the energy required for breaking covalent bonds inside the collagen fibrils. Based on the magnitude of these quantities, we speculate that disruption of electrostatic bonds between polyelectrolyte molecules in the extrafibrillar matrix of bone, perhaps mediated by polyvalent ions such as calcium, may be the rate-limiting elementary step in bone plasticity.

Transmenopausal changes in the trabecular bone structure

INTRODUCTION

Post-menopausal osteoporosis is a disorder of excess skeletal fragility, due partly to changes in bone microstructure. Menopause is known to result in bone loss and reduction in bone mechanical strength. However, the mechanism and nature of microstructural changes at menopause need more detailed description and analyses. The overall hypothesis for this analysis is that the variables describing trabecular bone micro-architecture will be affected by changes in the hormonal status of women just prior to, and early after, last menses, and that volumetric bone density, and trabecular structure will decline significantly. The study was designed to capture true longitudinal transmenopausal changes in three-dimensional (3-D) trabecular bone architecture. Currently, minimal data exist regarding these features.

MATERIALS AND METHODS

Transilial biopsies specimens were obtained from healthy pre-menopausal women (age >46), and repeated at 12 months after the last menstrual period. Bone architecture was quantified in 38 paired specimens using micro-computed tomography (micro-CT-40, Scanco) techniques. Bone biopsies were embedded for histomorphomteric analyses and parts of the analyses have been published elsewhere. Embedded bone biopsies were scanned at 30-mum resolution such that the region of interest was similar to that in the two-dimensional (2-D) histomorphometric analyses. Paired t-tests were used to compare the pre- and post-menopausal bone structural data from each technique.

RESULTS

There was good correlation between standard histomorphometric (2-D) and micro-CT (3-D) measurements. Most of the variables characterizing bone structure in post-menopausal women (from micro-CT) significantly decreased (BV/TV, trabecular number, apparent and tissue density). In addition, both trabecular spacing (Tb.S) and the structure model index (SMI) increased in the post-menopausal women suggesting transformation of trabecular bone from plate- to rod-like structure. The 3-D trabecular connectivity density (Conn.D) was negatively correlated with activation frequency (Ac.f).

CONCLUSIONS

These data suggest that 3-D micro-CT measurements (longitudinal) are comparable to those of standard histomorphometry, and that most of the bone structural measurements are sensitive to changes in women's hormonal status across menopause.

Age-related factors affecting the postyield energy dissipation of human cortical bone

The risk of bone fracture depends in part on tissue quality, not just the size and mass. This study assessed the postyield energy dissipation of cortical bone in tension as a function of age and composition. Specimens were prepared from tibiae of human cadavers in which male and female donors were divided into two age groups: middle aged (51 to 56 years, n = 9) and elderly (72 to 90 years, n = 8). By loading, unloading, and reloading a specimen with rest periods inserted in between, tensile properties at incremental strain levels were assessed. In addition, postyield toughness was estimated and partitioned as plastic strain energy related to permanent deformation, released elastic strain energy related to stiffness loss, and hysteresis energy related to viscous behavior. Porosity, mineral and collagen content, and collagen crosslinks of each specimen were also measured to determine the micro- and ultrastructural properties of the tissue. Age affected all the energy terms plus strength but not elastic stiffness. The postyield energy terms were correlated with porosity, pentosidine (a marker of nonenzymatic crosslinks), and collagen content, all of which varied significantly with age. General linear models suggested that pentosidine concentration and collagen content provided the best explanation of the age-related decrease in the postyield energy dissipation. Among them, pentosidine concentration had the greatest contribution to plastic strain energy and was the best explanatory variable of damage accumulation.

Bone and cartilage tissue constructs grown using human bone marrow stromal cells, silk scaffolds and rotating bioreactors

Human bone marrow contains a population of bone marrow stromal cells (hBMSCs) capable of forming several types of mesenchymal tissues, including bone and cartilage. The present study was designed to test whether large cartilaginous and bone-like tissue constructs can be selectively engineered using the same cell population (hBMSCs), the same scaffold type (porous silk) and same hydrodynamic environment (construct settling in rotating bioreactors), by varying the medium composition (chondrogenic vs. osteogenic differentiation factors). The hBMSCs were harvested, expanded and characterized with respect to their differentiation potential and population distribution. Passage two cells were seeded on scaffolds and cultured for 5 weeks in bioreactors using osteogenic, chondrogenic or control medium. The three media yielded constructs with comparable wet weights and compressive moduli ( approximately 25 kPa). Chondrogenic medium yielded constructs with higher amounts of DNA (1.5-fold) and glycosaminoglycans (GAG, 4-fold) per unit wet weight (ww) than control medium. In contrast, osteogenic medium yielded constructs with higher dry weight (1.6-fold), alkaline phosphatase (AP) activity (8-fold) and calcium content (100-fold) per unit ww than control medium. Chondrogenic medium yielded constructs that were weakly positive for GAG by contrast-enhanced MRI and alcian blue stain, whereas osteogenic medium yielded constructs that were highly mineralized by microCT and von Kossa stain. Engineered bone constructs were large (8mm diameter x 2mm thick disks) and resembled trabecular bone with respect to structure and mineralized tissue volume fraction (12%).

Contribution of the advanced glycation end product pentosidine and of maturation of type I collagen to compressive biomechanical properties of human lumbar vertebrae

Collagen characteristics contribute to bone biomechanical properties. Yet, few studies have analyzed the independent contributions of bone mineral density (BMD) and post-translational modifications of type I collagen to whole bone strength. Thus, the aim of this study was to determine the relative contributions of BMD and both enzymatic and non-enzymatic collagen crosslink concentration to the biomechanical properties of human vertebrae. Nineteen L3 vertebrae were collected after necropsy (age 26-93; 10 males, 9 females). BMD of the vertebral body was measured by DXA, and the vertebrae were compressed to failure to assess the stiffness, failure load and work to fracture. After mechanical testing, the concentration of both enzymatic crosslinks pyridinoline (PYD), and deoxypyridinoline (DPD) as well as, and the non-enzymatic crosslinks pentosidine (PEN) were analyzed in trabecular and cortical bone by reversed-phase HPLC. The extent of aspartic acid isomerization of type I collagen C telopeptide (CTX) was evaluated by ELISA of native (alpha CTX) and isomerized (beta CTX) forms. BMD was significantly positively related with stiffness (R(2) = 0.74; P < 0.0001), failure load (R(2) = 0.69; P < 0.0001) and work to fracture (R(2) = 0.44; P = 0.002). Bivariate regression analysis showed no association between collagen traits and biomechanical properties. However, in a multiple regression model, BMD and trabecular PEN were both significantly associated with failure load and work to fracture (multiple R(2) = 0.83, P = 0.001 and R(2) = 0.67, P = 0.001, respectively). Similarly, BMD and trabecular alpha/beta CTX ratio were both associated with stiffness (multiple R(2) = 0.83, P = 0.015). These findings indicate that post-translational modifications of type I collagen have an impact on skeletal fragility.

Sex differences in long bone fatigue using a rat model

Stress fractures can occur because of prolonged exercise and are associated with cyclic loading. Fatigue is the accumulated damage that results from cyclic loading and bone fatigue damage is of special concern for athletes and army recruits. Existing literature shows that the rates of stress fracture for female athletes and female army recruits are higher than their male counterparts. In this study, we used an ex vivo rat model to investigate the fatigue response of female and male bones. We determined the strain versus number of cycles to failure (S/N) for each sex and found that for a certain initial strain (5,000-7,000 microepsilon) female bones have shorter fatigue life. To further characterize the bone response to fatigue, we also determined the creep that occurred during the fatigue test. From the creep data, for a certain strain range, female bones accumulated greater residual strains and reached the critical strain at a faster rate. In summary, this study demonstrates that female rat bones have a lower resistance to fatigue in the absence of a physiological response such as muscle fatigue or osteogenic adaptation. From these results, we hypothesized that creep was the underlying mechanism that accounted for the fast deterioration of female bones during fatigue.

The influence of water removal on the strength and toughness of cortical bone

Although the effects of dehydration on the mechanical behavior of cortical bone are known, the underlying mechanisms for such effects are not clear. We hypothesize that the interactions of water with the collagen and mineral phases each have a unique influence on mechanical behavior. To study this, strength, toughness, and stiffness were measured with three-point bend specimens made from the mid-diaphysis of human cadaveric femurs and divided into six test groups: control (hydrated), drying in a vacuum oven at room temperature (21 degrees C) for 30 min and at 21, 50, 70, or 110 degrees C for 4 h. The experimental data indicated that water loss significantly increased with each increase in drying condition. Bone strength increased with a 5% loss of water by weight, which was caused by drying at 21 degrees C for 4 h. With water loss exceeding 9%, caused by higher drying temperatures (> or =70 degrees C), strength actually decreased. Drying at 21 degrees C (irrespective of time in vacuum) significantly decreased bone toughness through a loss of plasticity. However, drying at 70 degrees C and above caused toughness to decrease through decreases in strength and fracture strain. Stiffness linearly increased with an increase in water loss. From an energy perspective, the water-mineral interaction is removed at higher temperatures than the water-collagen interaction. Therefore, we speculate that loss of water in the collagen phase decreases the toughness of bone, whereas loss of water associated with the mineral phase decreases both bone strength and toughness.

Do sacrificial bonds affect the viscoelastic and fracture properties of bone?

Sacrificial bonds have been suggested as a toughening mechanism for bone tissue. Ionic bridges formed by divalent calcium ions between collagen molecules have been proposed as candidates for sacrificial bonds. If this mechanism is active at the macroscopic level, we should observe changes in mechanical properties of bone when calcium ions are maintained or removed from the tissue. To test this hypothesis, we measured viscoelastic and monotonic mechanical properties of cortical bone subjected to differing ionic environments. Storage modulus of bone could be changed up to 3.8% by the presence or absence of Na+ or Ca++ in the environment in a reversible fashion when bones were monitored continuously during treatments. A long-term one-time treatment increased the viscoelastic properties of bone soaked in Na+ solutions whereas the viscoelastic properties of bones soaked in Ca++ solutions were maintained. However, the strength and toughness of bone specimens soaked and fractured in treatment solutions were not improved. The presence of Ca++ affected the mechanical behavior of mineralized bone tissue at the macro scale. These effects were reversible, consistent with the original proposal. However, these effects may not necessarily indicate an increase in strength or toughness of the tissue at the macro scale.

The role of collagen in bone strength

Bone is a complex tissue of which the principal function is to resist mechanical forces and fractures. Bone strength depends not only on the quantity of bone tissue but also on the quality, which is characterized by the geometry and the shape of bones, the microarchitecture of the trabecular bones, the turnover, the mineral, and the collagen. Different determinants of bone quality are interrelated, especially the mineral and collagen, and analysis of their specific roles in bone strength is difficult. This review describes the interactions of type I collagen with the mineral and the contribution of the orientations of the collagen fibers when the bone is submitted to mechanical forces. Different processes of maturation of collagen occur in bone, which can result either from enzymatic or nonenzymatic processes. The enzymatic process involves activation of lysyl oxidase, which leads to the formation of immature and mature crosslinks that stabilize the collagen fibrils. Two type of nonenzymatic process are described in type I collagen: the formation of advanced glycation end products due to the accumulation of reducible sugars in bone tissue, and the process of racemization and isomerization in the telopeptide of the collagen. These modifications of collagen are age-related and may impair the mechanical properties of bone. To illustrate the role of the crosslinking process of collagen in bone strength, clinical disorders associated with bone collagen abnormalities and bone fragility, such as osteogenesis imperfecta and osteoporosis, are described.

Trabecular microfracture and the influence of pyridinium and non-enzymatic glycation-mediated collagen cross-links

The propensity of individual trabeculae to fracture (microfracture) may be important clinically since it could be indicative of bone fragility. Whether or not an overloaded trabecula fractures is determined in part by its structural ductility, a mechanical property that describes how much deformation a trabecula can sustain. The overall goal of this study was to determine the structural ductility of individual trabeculae and the degree to which it is influenced by pyridinium and non-enzymatic collagen cross-links. Vertically oriented rodlike trabeculae were taken from the thoracic vertebral bodies of 32 cadavers (16 male and 16 female, 54 - 94 years of age). A total of 221 trabeculae (4 - 9 per donor) were tested to failure in tension using a micro-tensile loading device. A subset of 76 samples was analyzed to determine the concentration of hydroxylysyl-pyridinoline (HP) and lysyl-pyridinoline (LP) cross-links as well as pentosidine, a marker of non-enzymatic glycation. Structural ductility (defined as the ultimate strain of the whole trabecula) ranged from 1.8% to 20.2% strain (8.8 +/- 3.7%, mean +/- SD) and did not depend on age (P = 0.39), sex (P = 0.57), or thickness of the sample at the point of failure (P = 0.36). Pentosidine was the only marker of collagen cross-linking measured that was found to be correlated with structural ductility (P = 0.01) and explained about 9% of the observed variance. We conclude that the ductility of individual trabeculae varies tremendously, can be substantial, and is weakly influenced by non-enzymatic glycation.

Tonic Finite Element Model of the Lower Limb

It is widely admitted that muscle bracing influences the result of an impact, facilitating fractures by enhancing load transmission and reducing energy dissipation. However, human numerical models used to identify injury mechanisms involved in car crashes hardly take into account this particular mechanical behavior of muscles. In this context, in this work we aim to develop a numerical model, including muscle architecture and bracing capability, focusing on lower limbs. The three-dimensional (3-D) geometry of the musculoskeletal system was extracted from MRI images, where muscular heads were separated into individual entities. Muscle mechanical behavior is based on a phenomenological approach, and depends on a reduced number of input parameters, i.e., the muscle optimal length and its corresponding maximal force. In terms of geometry, muscles are modeled with 3-D viscoelastic solids, guided in the direction of fibers with a set of contractile springs. Validation was first achieved on an isolated bundle and then by comparing emergency braking forces resulting from both numerical simulations and experimental tests on volunteers. Frontal impact simulation showed that the inclusion of muscle bracing in modeling dynamic impact situations can alter bone stresses to potentially injury-inducing levels.

Age-dependent fatigue behaviour of human cortical bone

Despite a general understanding that bone quality contributes to skeletal fragility, very little information exits on the age-dependent fatigue behavior of human bone. In this study four-point bending fatigue tests were conducted on aging bone in conjunction with the analysis of stiffness loss and preliminary investigation of nanoindentation based measurements of local tissue stiffness and histological evaluation of resultant tensile and compressive damage to identify the damage mechanism responsible for the increase in age-related bone fragility. The results obtained show that there is an exponential decrease in fatigue life with age, and old bone exhibits different modulus degradation profiles than young bone. In addition, this study provides preliminary evidence indicating that during fatigue loading, younger bone formed diffuse damage, lost local tissue stiffness on the tensile side. Older bone, in contrast, formed linear microcracks lost local tissue stiffness on the compressive side. Thus, the propensity of aging human bone to form more linear microcracks than diffuse damage may be a significant contributor to bone quality, and age related fragility in bone.

Nanoscale deformation mechanisms in bone

Deformation mechanisms in bone matrix at the nanoscale control its exceptional mechanical properties, but the detailed nature of these processes is as yet unknown. In situ tensile testing with synchrotron X-ray scattering allowed us to study directly and quantitatively the deformation mechanisms at the nanometer level. We find that bone deformation is not homogeneous but distributed between a tensile deformation of the fibrils and a shearing in the interfibrillar matrix between them.

Effect of ultrastructural changes on the toughness of bone

The ultrastructure of bone can be considered as a conjunction between the biology and the biomechanics of the tissue. It is the result of cellular and molecular activities of bone formation, and its organization dominates the mechanical behavior of bone. Following this perspective, the objective of this review is to provide a current understanding of bone ultrastructure and its relationships with the toughness of the tissue. Therefore, we first provide a discussion on the organization of bone constituents, namely collagen, mineral, and water. Then, we present evidence on how the toughness of bone relates to its ultrastructure through the formation of micro damage. In addition, attention is given to how damage accumulation serves as a toughening mechanism. Finally, we describe how changes in the ultrastructure-caused by osteogenesis imperfecta, gamma irradiation, fluoride treatment, and aging affect the toughness and competence of bone.

Bone microstructure and elastic tissue properties are reflected in QUS axial transmission measurements

Accurate clinical interpretation of the sound velocity derived from axial transmission devices requires a detailed understanding of the propagation phenomena involved and of the bone factors that have an impact on measurements. In the low megahertz range, ultrasonic propagation in cortical bone depends on anisotropic elastic tissue properties, porosity and the cortical geometry (e.g., thickness). We investigated 10 human radius samples from a previous biaxial transmission study using a 50-MHz scanning acoustic microscope (SAM) and synchrotron radiation microcomputed tomography. The relationships between low-frequency axial transmission sound speed at 1 and 2 MHz, structural properties (cortical width Ct.Wi, porosity, Haversian canal density and material properties (acoustic impedance, mineral density) on site-matched cross-sections were investigated. Significant linear multivariate regression models (1 MHz: R(2) = 0.84, p < 10(-4), root-mean-square error (RMSE) = 38 m/s, 2 MHz: R(2) = 0.65, p < 10(-4), RMSE = 48 m/s) were found for the combination of Ct.Wi with porosity and impedance. A new model was derived that accounts for the nonlinear dispersion relation with Ct.Wi and predicts axial transmission velocities measured at different ultrasonic frequencies (R(2) = 0.69, p < 10(-4), RMSE = 52 m/s).

Human bone collagen synthesis is a rapid, nutritionally modulated process

We developed a direct assay of human bone collagen synthesis using [13C] or [15N] proline and applied it to determine the effects of feeding in young healthy men. Surprisingly, postabsorptive bone collagen synthesis is not sluggish, being approximately 0.07%/h more rapid than that of muscle protein, and capable of being stimulated within 4 h of intravenous feeding by 66 +/- 13%.

INTRODUCTION

All current methods for estimation of bone collagen turnover are indirect, depending on the assay of collagen "markers." Our aim was to develop a direct method for human bone collagen synthesis to be used to study its physiology and pathology, and specifically, in the first instance, the effect of feeding.

MATERIALS AND METHODS

We applied, over 2 h, flooding doses of [13C] and [15N] proline to label iliac crest bone collagen in eight young healthy men. The rate of collagen synthesis was determined as the rate of labeling of collagen hydroxyproline (assayed by gas chromatography-combustion-isotope ratio mass spectrometry in collagen extracted by differential solubility) compared with plasma proline labeling (assayed by gas chromatography-mass spectrometry). We also determined (in a second group of eight young healthy men) the effect of intravenous nutrition (glucose, lipid emulsion, and amino acids (in the ratio of 55%:30%:15% energy, respectively).

RESULTS

Free bone proline labeling was 92 +/- 6% of that of plasma proline, supporting the flooding dose assumption. Human iliac crest bone collagen is heterogeneous, with NaCl-EDTA, 0.5 M acetic acid, pepsin-acetic acid, and hot water-extractable pools being responsible for approximately 1%, 3%, 8%, and 81% of content, respectively. The synthetic rates were 0.58 +/- 0.1, 0.24 +/- 0.05, 0.07 +/- 0.02, and 0.06 +/- 0.01%/h, respectively, giving an average rate of approximately 0.066%/h. [13C] and [15N] proline gave identical results. Intravenous nutrition caused the disappearance of proline label from the procollagen pool and its increased appearance in the less extractable pools, suggesting nutritional stimulation of collagen processing.

CONCLUSION

The results show (1) that iliac crest bone collagen synthesis is faster than generally assumed and of the same order as muscle protein turnover and (2) that feeding increases synthesis by approximately 66%. Given its ability to detect physiologically meaningful responses, the method should provide a new approach to studying the regulation of bone collagen turnover.

In vivo fatigue microcracks in human bone: Material properties of the surrounding bone matrix

Human bones sustain fatigue damage in the form of in vivo microcracks as a result of the normal everyday loading activities. These microcracks appear to preferentially accumulate in certain regions of bone and most notably in interstitial bone matrix areas. These are remnants of old bone tissue left unremodelled, which show a higher than average mineral content and consequently the occurrence of microcracks has been attributed to the possible brittleness brought about by such hypermineralisation. There is a need, therefore, for information on the in situ bone matrix properties in the vicinity of such in vivo microcracks to elucidate the possible causes of their appearance. The present study examined the elastic, strain rate (viscous) and plastic properties of bone matrix in selectively targeted areas by nanoindentation and in both quasistatic and dynamic mode. The results showed that in vivo crack areas are not as stiff as some well-known extremely mineralised and brittle bone examples (bulla, rostrum); the strain rate effects of crack regions were identical to those of other regions of human bone and agreed well with values collected for human bone in the past at the macroscale; while the plasticity index of the crack regions was also not statistically different from most bone examples (including human at random, bovine, bulla and rostrum) except antler, which showed lower plasticity and thus a greater fraction of elastic recovery in indentation energy. It is difficult, therefore, to explain the susceptibility of these interstitial regions to crack in terms of the mineral content and its after-effects on elasticity, viscosity and plasticity alone, but one need to attribute the cracks to the cumulative loading history of these areas, or raise the suggestion that these areas of bone matrix are in some measure 'aged' or material/quality defective.

The aging of Wolff's ?law?: Ontogeny and responses to mechanical loading in cortical bone

The premise that bones grow and remodel throughout life to adapt to their mechanical environment is often called Wolff's law. Wolff's law, however, is not always true, and in fact comprises a variety of different processes that are best considered separately. Here we review the molecular and physiological mechanisms by which bone senses, transduces, and responds to mechanical loads, and the effects of aging processes on the relationship (if any) between cortical bone form and mechanical function. Experimental and comparative evidence suggests that cortical bone is primarily responsive to strain prior to sexual maturity, both in terms of the rate of new bone growth (modeling) as well as rates of turnover (Haversian remodeling). Rates of modeling and Haversian remodeling, however, vary greatly at different skeletal sites. In addition, there is no simple relationship between the orientation of loads in long bone diaphyses and their cross-sectional geometry. In combination, these data caution against assuming without testing adaptationist views about form-function relationships in order to infer adult activity patterns from skeletal features such as cross-sectional geometry, cortical bones density, and musculo-skeletal stress markers. Efforts to infer function from shape in the human skeleton should be based on biomechanical and developmental models that are experimentally tested and validated.

Design and validation of a surrogate humerus for biomechanical testing

At present biomechanical testing of fracture plating strategies is conducted using animal or cadaveric whole bone models. This may introduce experimental error into these studies. This communication summarises the design and validation of a novel bone and fibre-reinforced plastic construct conceived to minimise intra-experimental error. A tubular surrogate humerus was produced with dimension and strength matched to that of the human humerus. Bone inserts placed into the wall of the tube allow for the fixation of the plates with bone screws. Three-point bending tests of the flexural rigidity of the surrogate humerus (EI=100.1 (SD 6.0)Nm(2)) showed it to be comparable to the human humerus. Further, pull-out tests of the screws showed that the bone slots adequately mimicked the whole bone scenario. This testing construct will be used for a comparative study of humeral plating techniques.

Microstructural elasticity and regional heterogeneity in human femoral bone of various ages examined by nano-indentation

The elastic modulus and hardness of secondary osteonal and interstitial bone was examined through the thickness of the cortex of human femora of various ages by nano-indentation. There was a clear difference between the stiffness and hardness of secondary osteonal and interstitial bone, the latter being stiffer (F(1,48)=56.0, P<0.001). There were some differences between the bones of different subjects; however, there were no differences that could be reliably associated with the chronological age of the subject, or with differences in location through the thickness of the cortex (F(2,48)=0.21, P=0.810). Previous studies have been equivocal in relating changes in the macroscopic 'composite' material stiffness of bone to the age of the individual. By combining the results of the nano-tests with histological measures, we were able to produce a good relationship of the microstructural properties at the matrix level with the bending modulus of whole bone (R(2)=0.88, P<0.001) and this improved further by taking into account the age of the individual (R(2)=0.94, P<0.001). Our results suggest that using differences in the volumetric proportions of secondary osteons versus interstitial bone, and the properties of these elements/structures in isolation may be a more accurate method of determining differences in elastic modulus of whole bone between individuals of various ages.