Cement lines of secondary osteons in human bone are not mineral-deficient: New data in a historical perspective

Effects of age and loading rate on equine cortical bone failure

Although clinical bone fractures occur predominantly under impact loading (as occurs during sporting accidents, falls, high-speed impacts or other catastrophic events), experimentally validated studies on the dynamic fracture behavior of bone, at the loading rates associated with such events, remain limited. In this study, a series of tests were performed on femoral specimens obtained post-mortem from equine donors ranging in age from 6 months to 28 years. Fracture toughness and compressive tests were performed under both quasi-static and dynamic loading conditions in order to determine the effects of loading rate and age on the mechanical behavior of the cortical bone. Fracture toughness experiments were performed using a four-point bending geometry on single and double-notch specimens in order to measure fracture toughness, as well as observe differences in crack initiation between dynamic and quasi-static experiments. Compressive properties were measured on bone loaded parallel and transverse to the osteonal growth direction. Fracture propagation was then analyzed using scanning electron and scanning confocal microscopy to observe the effects of microstructural toughening mechanisms at different strain rates. Specimens from each horse were also analyzed for dry, wet and mineral densities, as well as weight percent mineral, in order to investigate possible influences of composition on mechanical behavior. Results indicate that bone has a higher compressive strength, but lower fracture toughness when tested dynamically as compared to quasi-static experiments. Fracture toughness also tends to decrease with age when measured quasi-statically, but shows little change with age under dynamic loading conditions, where brittle "cleavage-like" fracture behavior dominates.

Apatite content of collagen materials dose-dependently increases pre-osteoblastic cell deposition of a cement line-like matrix

Bone matrix, mainly composed of type I collagen and apatite, is constantly modified during the bone remodeling process, which exposes bone cells to various proportions of mineralized collagen within bone structural units. Collagen-mineralized substrates have been shown to increase osteoblast activities. We hypothesized that such effects may be explained by a rapid secretion of specific growth factors and/or deposition of specific matrix proteins. Using MC3T3-E1 seeded for 32h on collagen substrates complexed with various apatite contents, we found that pre-osteoblasts in contact with mineralized collagen gave rise to a dose-dependent deposit of Vascular Endothelial Growth Factor-A (VEGF-A) and RGD-containing proteins such as osteopontin (OPN) and fibronectin (FN). This RGD-matrix deposition reinforced the cell adhesion to collagen-mineralized substrates. It was also observed that, on these substrates, this matrix was elaborated concomitantly to an increased cell migration, allowing a homogeneous coverage of the sample. This particular surface activation was probably done firstly to reinforce cell survival (VEGF-A) and adhesion (OPN, FN) and secondly to recruit and prepare surfaces for subsequent bone cell activity.

On the effect of X-ray irradiation on the deformation and fracture behavior of human cortical bone

In situ mechanical testing coupled with imaging using high-energy synchrotron X-ray diffraction or tomography is gaining in popularity as a technique to investigate micrometer and even sub-micrometer deformation and fracture mechanisms in mineralized tissues, such as bone and teeth. However, the role of the irradiation in affecting the nature and properties of the tissue is not always taken into account. Accordingly, we examine here the effect of X-ray synchrotron-source irradiation on the mechanistic aspects of deformation and fracture in human cortical bone. Specifically, the strength, ductility and fracture resistance (both work-of-fracture and resistance-curve fracture toughness) of human femoral bone in the transverse (breaking) orientation were evaluated following exposures to 0.05, 70, 210 and 630 kGrays (kGy) irradiation. Our results show that the radiation typically used in tomography imaging can have a major and deleterious impact on the strength, post-yield behavior and fracture toughness of cortical bone, with the severity of the effect progressively increasing with higher doses of radiation. Plasticity was essentially suppressed after as little as 70 kGy of radiation; the fracture toughness was decreased by a factor of five after 210 kGy of radiation. Mechanistically, the irradiation was found to alter the salient toughening mechanisms, manifest by the progressive elimination of the bone's capacity for plastic deformation which restricts the intrinsic toughening from the formation "plastic zones" around crack-like defects. Deep-ultraviolet Raman spectroscopy indicated that this behavior could be related to degradation in the collagen integrity.

Effects of altered bone remodeling and retention of cement lines on bone quality in osteopetrotic aged c-Src-deficient mice

Cement lines represent mineralized, extracellular matrix interfacial boundaries at which bone resorption by osteoclasts is followed by bone deposition by osteoblasts. To determine the contribution of cement lines to bone quality, the osteopetrotic c-Src mouse model-where cement lines accumulate and persist as a result of defective osteoclastic resorption-was used to investigate age-related changes in structural and mechanical properties of bone having long-lasting cement lines. Cement lines of osteopetrotic bones in c-Src knockout mice progressively mineralized with age up to the level that the entire matrix of cement lines was lost by EDTA decalcification. While it was anticipated that suppressed and abnormal remodeling, together with the accumulation of cement line interfaces, would lead to defective bone quality with advancing age of the mutant mice, unexpectedly, three-point bending tests of the long bones of 1-year-old c-Src-deficient mice indicated significantly elevated strength relative to age-matched wild-type bones despite the presence of numerous de novo microcracks. Among these microcracks in the c-Src bones, there was no sign of preferential propagation or arrest of microcracks along the cement lines in either fractured or nonfractured bones of old c-Src mice. These data indicate that cement lines are not the site of a potential internal failure of bone strength in aged c-Src osteopetrotic mice and that abundant and long-lasting cement lines in these osteopetrotic bones appear to have no negative impacts on the mechanical properties of this low-turnover bone despite their progressive hypermineralization (and thus potential brittleness) with age.

Increased calcium content and inhomogeneity of mineralization render bone toughness in osteoporosis: mineralization, morphology and biomechanics of human single trabeculae

The differentiation and degree of the effects of mineral content and/or morphology on bone quality remain, to a large extent, unanswered due to several microarchitectural particularities in spatial measuring fields (e.g., force transfer, trajectories, microcalli). Therefore, as the smallest basic component of cancellous bone, we focused on single trabeculae to investigate the effects of mineralization and structure, both independently and in superposition. Transiliac Bordier bone cores and T12 vertebrae were obtained from 20 females at autopsy for specimen preparation, enabling radiographical analyses, histomorphometry, Bone Mineral Density Distribution (BMDD) analyses, and trabecular singularization to be performed. Evaluated contact X-rays and histomorphometric limits from cases with osteoporotic vertebral fractures generated two subdivisions, osteoporotic (n=12, Ø 78 years) and non-osteoporotic (n=8, Ø 49 years) cases, based on fracture appearance and bone volume (BV/TV). Measurements of trabecular number (Tb.N.), trabecular separation (Tb.Sp.), trabecular thickness (Tb.Th.), trabecular bone pattern factor (TBPf) and eroded surface (ES/BS) were carried out to provide detailed structural properties of the investigated groups. The mechanical properties of 400 rod-like single vertebral trabeculae, assessed by three-point bending, were matched with mineral properties as quantified by BMDD analyses of cross-sectioned rod-like and plate-like trabeculae, both in superposition and independently. Non-osteoporotic iliac crests and vertebrae displayed linear dependency on structure parameters, whereas osteoporotic compartments proved to be non-correlated with bone structure. Independent of trabecular thickness, osteoporotic rod-like trabeculae showed decreases in Young's modulus, fracture load, yield strength, ultimate stress, work to failure and bending stiffness, along with significantly increased mean calcium content and calcium width. Non-osteoporotic trabeculae showed biomechanically beneficial properties due to a homogeneous mineralization configuration, whereas osteoporotic trabeculae predominantly demonstrated various mineralized bone packets, eroded surfaces, highly mineralized cement lines and microcracks. The Young's moduli of single trabeculae exhibited significantly negative linear correlations with trabecular thickness. Because of increased, but inhomogeneously distributed, calcium content, osteoporotic trabeculae may be subject to shear stresses that render bone fragile beyond structure impairment due to cracks and lacunae.

Vitamin D and bone physiology: demonstration of vitamin D deficiency in an implant osseointegration rat model

PURPOSE

The patient population varies in nutritional deficiencies, which may confound the host response to biomaterials. The objective of this study was to evaluate the effect of a common deficiency of vitamin D on implant osseointegration in the rat model.

MATERIALS AND METHODS

Male Sprague-Dawley rats were maintained under the cessation of vitamin D intake and UV exposure. The serum levels of 1,25(OH)(2)D(3), 25 OHD(3), Ca, and P were determined. Miniature cylindrical Ti6Al4V implants (2-mm long, 1-mm diameter) were fabricated with double acid-etched (DAE) surface or modified DAE with discrete crystalline deposition (DCD) of hydroxyapatite nanoparticles. DAE and DCD implants were placed in the femurs of vitamin D-insufficient and control rats. After 14 days of healing, the femur-implant samples were subjected to implant push-in test and nondecalcified histology. The surfaces of recovered implant specimens after the push-in test were further evaluated by scanning electron microscopy (SEM).

RESULTS

The decreased serum level of 25 OHD(3) demonstrated the establishment of vitamin D insufficiency in this model. The implant push-in test revealed that DAE and DCD implants in the vitamin D-insufficient group (15.94 +/- 8.20 N, n = 7; 15.63 +/- 3.96 N, n = 7, respectively) were significantly lower than those of the control group (24.99 +/- 7.92 N, n = 7, p < 0.05; 37.48 +/- 17.58 N, n = 7, p < 0.01, respectively). The transcortical bone-to-implant contact ratio (BIC) was also significantly decreased in the vitamin D-insufficient group. SEM analyses further suggested that the calcified tissues remaining next to the implant surface after push-in test appeared unusually fragmented.

CONCLUSIONS

The effect of vitamin D insufficiency significantly impairing the establishment of Ti6Al4V implant osseointegration in vivo was unexpectedly profound. The outcome of Ti-based endosseous implants may be confounded by the increasing prevalence of vitamin D insufficiency in our patient population.

Interpreting cortical bone adaptation and load history by quantifying osteon morphotypes in circularly polarized light images

Birefringence variations in circularly polarized light (CPL) images of thin plane-parallel sections of cortical bone can be used to quantify regional differences in predominant collagen fiber orientation (CFO). Using CPL images of equine third metacarpals (MC3s), R.B. Martin, V.A. Gibson, S.M. Stover, J.C. Gibeling, and L.V. Griffin. (40) described six secondary osteon variants ('morphotypes') and suggested that differences in their regional prevalence affect fatigue resistance and toughness. They devised a numerical osteon morphotype score (MTS) for quantifying regional differences in osteon morphotypes. We have observed that a modification of this score could significantly improve its use for interpreting load history. We hypothesized that our modified osteon MTS would more accurately reveal differences in osteon MTSs between opposing "tension" and "compression" cortices of diaphyses of habitually bent bones. This was tested using CPL images in transverse sections of calcanei from sheep, deer, and horses, and radii from sheep and horses. Equine MC3s and sheep tibiae were examined as controls because they experience comparatively greater load complexity that, because of increased prevalence of torsion/shear, would not require regional mechanical enhancements provided by different osteon morphotypes. Predominant CFO, which can reliably reflect adaptation for a regionally prevalent strain mode, was quantified as mean gray levels from birefringence of entire images (excluding pore spaces) in anterior, posterior, medial, and lateral cortices. Results showed that, in contrast to the original scoring scheme of Martin et al., the modified scheme revealed significant anterior/posterior differences in osteon MTSs in nearly all "tension/compression" bones (p<0.0001), but not in equine MC3s (p=0.30) and sheep tibiae (p=0.35). Among habitually bent bones, sheep radii were the exception; relatively lower osteon populations and the birefringence of the primary bone contributed to this result. Correlations between osteon MTSs using the scoring scheme of Martin et al. with CFO data from all regions of each bone invariably demonstrated weak-to-moderate negative correlations. This contrasts with typically high positive correlations between modified osteon MTSs and regional CFO. These results show that the modified osteon MTS can be a strong correlate of predominant CFO and of the non-uniform strain distribution produced by habitual bending.

Bone bonding at natural and biomaterial surfaces

Bone bonding is occurring in each of us and all other terrestrial vertebrates throughout life at bony remodeling sites. The surface created by the bone-resorbing osteoclast provides a three-dimensionally complex surface with which the cement line, the first matrix elaborated during de novo bone formation, interdigitates and is interlocked. The structure and composition of this interfacial bony matrix has been conserved during evolution across species; and we have known for over a decade that this interfacial matrix can be recapitulated at a biomaterial surface implanted in bone, given appropriate healing conditions. No evidence has emerged to suggest that bone bonding to artificial materials is any different from this natural biological process. Given this understanding it is now possible to explain why bone-bonding biomaterials are not restricted to the calcium-phosphate-based bioactive materials as was once thought. Indeed, in the absence of surface porosity, calcium phosphate biomaterials are not bone bonding. On the contrary, non-bonding materials can be rendered bone bonding by modifying their surface topography. This paper argues that the driving force for bone bonding is bone formation by contact osteogenesis, but that this has to occur on a sufficiently stable recipient surface which has micron-scale surface topography with undercuts in the sub-micron scale-range.

Influence of physiological effort of growth and chemical composition on antler bone mechanical properties

Antler is a good model to study bone biology both because it is accessible and because it grows and is shed every year. Previous studies have shown that chemical composition changes as the antler is grown, implying constraints in mineral availability and the physiological effort made to grow it. This study aimed at examining antler mechanical properties to assess whether they reflect physiological effort and whether they are associated with precise mineral bone composition rather than just ash content, which is usually the main factor affecting mechanical properties. We examined Young's modulus of elasticity (E), strength, and work to maximum load, as well as bone mineral composition, along the antler shaft. Then we compared trends between antlers from two populations: captive, well-fed, health-managed deer (n=15), and free-ranging deer with lower food quality and no health treatment (n=10). Greater E, strength and work were found for better fed and health managed deer. In addition, antler chemical composition of both populations differed in Na, Mg, K, Fe and Si, and marginally in Zn, but not in ash or Ca content. Significant and clear divergent trends in mechanical properties supporting greater physiological exhaustion in free-ranging deer were found for all mechanical variables. Detailed models showed that, in addition to ash content, independent factors extracted from principal component analyses on composition affected E and strength, but not work to maximum load. The results suggest that there is an association between bone chemical composition and mechanical properties independently of ash content.

Does chemical composition of antler bone reflect the physiological effort made to grow it?

In a previous study, antler bone chemical composition was found to differ between base and tip. If such variation is in part due to the physiological effort made to grow the antler, composition trends should differ between antlers from deer population differing in mineral or food availability, or body reserves. To assess this, we examined cortical thickness and bone composition along the antler shaft, and compared trends between antlers from two populations: captive, well-fed, health-managed deer (n=15), and free-ranging deer with lower food quality and no health treatment (n=10). Significant and clear divergent trends supporting greater physiological exhaustion in free-ranging deer and high or moderate predictive models were found for cortical thickness (R(2)=61.8%), content of Na (R(2)=68.6%), Mg (R(2)=56.3%), K (R(2)=40.0%), and Zn (34.6%); lower predictive power was found for protein (R(2)=25.6%) and ash content (R(2)=19.5%); and poor predictive power was found for Ca (R(2)=4.3%), Fe (R(2)=11.1%), and Si (R(2)=4.7%). A second part of the study assessed similar antler structures grown at the beginning (brow tine) and end (top tine) of antler growth within captive deer. Greater cortical thickness and ash content was found for brow tine, as well as a smaller protein, K and Mg content. In contrast, no difference was found for Ca, Na, Zn, Fe or Si. The results suggest that thickness and mineral composition reflect the physiological effort made to build antler bone.

Morphology, localization and accumulation of in vivo microdamage in human cortical bone

In vivo, microdamage occurs in the form of linear microcracks and diffuse damage. However, it is unknown whether the age-related changes in bone quality predispose bone to form one type of damage morphology over the other during in vivo loading. In this study, histological and histomorphometrical analyses were conducted on transverse cross sections, obtained from the tibiae of aging human bone (age 19 to 89), to investigate the in vivo accumulation and localization of damage morphologies. The results demonstrate that old donor bone (83+/-3 years) contains more linear microcracks than younger donor bone in the cortices predominantly subjected to compressive (p<0.01) and tensile loading (p<0.01). In contrast, young donor bone (40+/-10 years) contains more diffuse damage than older donor bone in the cortex predominantly subjected to tensile loading (p<0.01). The formation of damage morphology showed no correlation with bone geometry parameters and exhibited distinct preferences with bone microstructure. Linear microcracks formed in the interstitial bone (p<0.01) and were either trapped or arrested by the microstructural interfaces (cement line and lamellar interface) (p<0.05). Areas of diffuse damage, however, were preferentially associated with secondary osteonal bone (p<0.01) and had no relationship with the microstructural interfaces (p<0.01). Based upon these findings, we conclude that age-related changes in bone microstructure, but not bone geometry, play a key role in the propensity of old donors to form linear microcrack over diffuse damage under in vivo loading conditions.

Anisotropy of age-related toughness loss in human cortical bone: a finite element study

A mechanistic understanding of the role of bone quality on fracture processes is essential for determining the underlying causes of age-related changes in the mechanical response of the human bone. In this study, a previously developed cohesive finite element model was used to investigate the effects of age-related changes and the orientation of crack growth on the toughening behavior of human cortical bone. The change in the anisotropy of toughening mechanisms with age was also studied. Finite element method (FEM) simulations showed that the initiation toughness decreased by 3% and 8%/decade for transverse and longitudinal crack growth, respectively. In contrast, fracture resistance curve slope for transverse and longitudinal crack growth decreased by 2% and 3%/decade, respectively. Initiation fracture toughness values were higher for the transverse than for the longitudinal for a given age. On the other hand, propagation fracture toughness values were higher for longitudinal than for transverse crack growth for a given age. With respect to age, the toughness ratio for crack initiation decreased by 6%/decade, but that for propagation showed almost no change (less than 1%). In light of these findings, an analytical model evaluating the crack arresting feature of cement lines, is proposed to explain the factors that determine crack penetration into osteons or its deflection by cement lines.

Assessment of bone mineral and matrix using backscatter electron imaging and FTIR imaging

The resistance of bone to fracture is determined by its geometric and material properties. The geometry and density can be determined by radiographic methods, but material properties such as collagen structure, mineral composition, and crystal structure currently require analysis by invasive techniques. Backscatter electron imaging provides quantitative information on the distribution of the mineral within tissue sections, and infrared and other vibrational spectroscopic methods can supplement these data, providing site-specific information on mineral content as well as information on collagen maturity and distributions of crystal size and composition. This information contributes to the knowledge of "bone quality."

Mineral content changes in bone associated with damage induced by the electron beam

Energy-dispersive x-ray (EDX) spectroscopy and backscattered electron (BSE) imaging are finding increased use for determining mineral content in microscopic regions of bone. Electron beam bombardment, however, can damage the tissue, leading to erroneous interpretations of mineral content. We performed elemental (EDX) and mineral content (BSE) analyses on bone tissue in order to quantify observable deleterious effects in the context of (1) prolonged scanning time, (2) scan versus point (spot) mode, (3) low versus high magnification, and (4) embedding in poly-methylmethacrylate (PMMA). Undemineralized cortical bone specimens from adult human femora were examined in three groups: 200x embedded, 200x unembedded, and 1000x embedded. Coupled BSE/EDX analyses were conducted five consecutive times, with no location analyzed more than five times. Variation in the relative proportions of calcium (Ca), phosphorous (P), and carbon (C) were measured using EDX spectroscopy, and mineral content variations were inferred from changes in mean gray levels ("atomic number contrast") in BSE images captured at 20 keV. In point mode at 200x, the embedded specimens exhibited a significant increase in Ca by the second measurement (7.2%, p < 0.05); in scan mode, a small and statistically nonsignificant increase (1.0%) was seen by the second measurement. Changes in P were similar, although the increases were less. The apparent increases in Ca and P likely result from decreases in C: -3.2% (p < 0.05) in point mode and -0.3% in scan mode by the second measurement. Analysis of unembedded specimens showed similar results. In contrast to embedded specimens at 200x, 1000x data showed significantly larger variations in the proportions of Ca, P, and C by the second or third measurement in scan and point mode. At both magnifications, BSE image gray level values increased (suggesting increased mineral content) by the second measurement, with increases up to 23% in point mode. These results show that mineral content measurements can be reliable when using coupled BSE/EDX analyses in PMMA-embedded bone if lower magnifications are used in scan mode and if prolonged exposure to the electron beam is avoided. When point mode is used to analyze minute regions, adjustments in accelerating voltages and probe current may be required to minimize damage.