Characterization of the mechanical and ultrastructural properties of heat-treated cortical bone for use as a bone substitute

Sensitivity of the amide I band to matrix manipulation in bone: a Raman micro-spectroscopy and spatially offset Raman spectroscopy study

The fracture resistance of bone arises from the hierarchical arrangement of minerals, collagen fibrils (i.e., cross-linked triple helices of α1 and α2 collagen I chains), non-collagenous proteins, and water. Raman spectroscopy (RS) is not only sensitive to the relative fractions of these constituents, but also to the secondary structure of bone proteins. To assess the ability of RS to detect differences in the protein structure, we quantified the effect of sequentially autoclaving (AC) human cortical bone at 100 °C (∼34.47 kPa) and then at 120 °C (∼117.21 kPa) on the amide I band using a commercial Raman micro-spectroscopy (μRS) instrument and custom spatially offset RS (SORS) instrument in which rings of collection fiber optics are offset from the central excitation fiber optics within a hand-held, cylindrical probe. Being clinically viable, measurements by SORS involved collecting Raman spectra of cadaveric femur mid-shafts (5 male & 5 female donors) through layers of a tissue mimic. Otherwise, μRS and SORS measurements were acquired directly from each bone. AC-related changes in the helical status of collagen I were assessed using amide I sub-peak ratios (intensity, I, at ∼1670 cm-1 relative to intensities at ∼1610 cm-1 and ∼1640 cm-1). The autoclaving manipulation significantly decreased the selected amide I sub-peak ratios as well as shifted peaks at ∼1605 cm-1 (μRS), ∼1636 cm-1 (SORS) and ∼1667 cm-1 in both μRS and SORS. Compared to μRS, SORS detected more significant differences in the amide I sub-peak ratios when the fiber optic probe was directly applied to bone. SORS also detected AC-related decreases in I1670/I1610 and I1670/I1640 when spectra were acquired through layers of the tissue mimic with a thickness ≤2 mm by the 7 mm offset ring, but not with the 5 mm or 6 mm offset ring. Overall, the SORS instrument was more sensitive than the conventional μRS instrument to pressure- and temperature-related changes in the organic matrix that affect the fracture resistance of bone, but SORS analysis of the amide I band is limited to an overlying thickness layer of 2 mm.

Bovine xenograft application for treatment of a metatarsal nonunion fracture in an alpaca (Vicugna pacos)

CASE HISTORY

A 15-year-old female huacaya alpaca (Vicugna pacos) was referred because of a non-weight-bearing lameness (4/4) in the left pelvic limb caused by a grade three open metatarsal fracture. The referring veterinarian treated the fracture with conservative management using bandages, but it progressively evolved to a non-union.

CLINICAL FINDINGS AND DIAGNOSIS

Clinical examination revealed external wounds on the medial and lateral surfaces of the metatarsus. Radiographs confirmed an open, nonarticular, displaced, diaphyseal fracture of the left metatarsus.

TREATMENT AND OUTCOME

Cancellous bone was sourced from bovine proximal and distal femur epiphyses, followed by a thermal shock procedure to achieve decellularisation, to produce a xenograft. Open reduction and internal fixation of the fracture using locking plates was performed. Alignment of the fracture fragments was corrected and the xenograft was placed at the debrided fracture site to stimulate and harness osteogenesis in situ. Clinical and radiographic follow-up was performed up to 40 weeks postoperatively. Clinical evaluations revealed that the alpaca gradually increased weight bearing following bandage removal 10 days after surgery. Serial radiographs showed correct alignment of the left metatarsus, progressive bone modelling and, complete bone union at 12 weeks. Ten months postoperatively the alpaca showed no signs of lameness and resumed normal activity.

CLINICAL RELEVANCE

For management of a metatarsal non-union, a combination of bovine xenograft application and angular stable internal fixation progressed toward an excellent long-term recovery.

Fracture toughness and work of fracture of hydrated, dehydrated, and ashed bovine bone

Bone, a tri-phase composite, consists of nano-sized apatite minerals, an organic component, and water. Heat-treated bovine cortical bone has been proposed as a candidate for void-filling bone substitute. However, the toughness of heat-treated bone is not yet fully studied. Fracture toughness (K(c)) and work of fracture (W(f)) of hydrated, dehydrated, and ashed bovine bone were estimated using a single-edge V-notched beam method. Thermal gravimetric analysis and differential thermal analysis were used to determine the temperature at which the organics and water were removed. Dehydrated specimens were obtained by placing the samples in a 60 degrees C vacuum oven for 24h or a 110 degrees C furnace for 2h. Ashed specimens were obtained by heat-treating samples at 600 degrees C for 24h. K(c) of bovine specimens decreased from 5.5MPa.m(1/2) for hydrated bone, to 3.8MPa.m(1/2) for dehydrated specimens, and to 0.36MPa.m(1/2) for ashed specimens. W(f) decreased from 7.1 to 1.1kJ/m(2) for dehydrated specimens, and to 0.04kJ/m(2) for ashed specimens. The main reasons for the significant decreases in K(c) and W(f) may be attributed to water's ability in stabilizing collagen structure and to the organics' ability in making bone more ductile. Because of the large decrease in fracture toughness and work of fracture, we suggest that ashed bone is not appropriate for load-bearing bone substitute in areas where bone experiences loadings in flexure.

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.

Influence of the degradation of the organic matrix on the microscopic fracture behavior of trabecular bone

In recent years, the important role of the organic matrix for the mechanical properties of bone has become increasingly apparent. It is therefore of great interest to understand the interactions between the organic and inorganic constituents of bone and learn the mechanisms by which the organic matrix contributes to the remarkable properties of this complex biomaterial. In this paper, we present a multifaceted view of the changes of bone's properties due to heat-induced degradation of the organic matrix. We compare the microscopic fracture behavior (scanning electron microscopy; SEM), the topography of the surfaces (atomic force microscopy; AFM), the condition of bone constituents [X-ray diffraction (XRD), thermogravimetric analysis (TGA), and gel electrophoresis], and the macromechanical properties of healthy bovine trabecular bone with trabecular bone that has a heat-degraded organic matrix. We show that heat treatment changes the microfracture behavior of trabecular bone. The primary failure mode of untreated trabecular bone is fibril-guided delamination, with mineralized collagen filaments bridging the gap of the microcrack. In contrast, bone that has been baked at 200 degrees C fractures nondirectionally like a brittle material, with no fibers spanning the microcracks. Finally, bone that has been boiled for 2 h in PBS solution fractures by delamination with many small filaments spanning the microcracks, so that the edges of the microcracks become difficult to distinguish. Of the methods we used, baking most effectively weakens the mechanical strength of bone, creating the most brittle material. Boiled bone is stronger than baked bone, but weaker than untreated bone. Boiled bone is more elastic than untreated bone, which is in turn more elastic than baked bone. These studies clearly emphasize the importance of the organic matrix in affecting the fracture mechanics of bone.

Biaxial flexure testing of calcium phosphate bioceramics for use in tissue engineering

This study analyzes data from 206 CaP specimens (68 HA, 70 BCP, and 68 beta-TCP) fractured via biaxial flexure testing. Specimens were divided into four groups: (a) Group I, dry; (b) Group II, wet (day 0, immersion time approximately 5-10 s); (c) Group III, after immersion in media for 21 days (day 21); and (d) Group IV, after culturing osteoblasts (OBs) on the surface for 21 days (day 21 with cells). X-ray diffraction verified the presence of minor second phases in HA and beta-TCP while BCP was a biphasic mixture of HA and beta-TCP with minor phases present. The statistical significance (p < 0.05) of differences in the measured biaxial flexure fracture strength, S, between groups was assessed via one-way ANOVA with Tukey's test. Also, a two-parameter Weibull analysis assessed the mechanical reliability of each group. Osteoblasts increase the biaxial flexure fracture strength in a statistically significant way compared to both the HA discs in Groups II and III. Scanning electron microscope examination revealed grain boundary grooving on the sintered surfaces and with thermal expansion anisotropy, likely leads to the observed rapid strength decline upon exposure to media found in Groups II, III and IV.

An X-ray diffraction study of the effects of heat treatment on bone mineral microstructure

A series of human cortical bone specimens has been heated to temperatures up to 1200 degrees C and the mineral content examined in detail by X-ray diffraction. Line profile analysis of the diffraction data has been undertaken to characterise the microstructural (crystallite size and microstrain) features of the mineral at each temperature. Individual profile fitting of several maxima from each diffractogram has also provided precise lattice parameters of the apatite at each temperature. The apatite did not show any significant decomposition over the temperature range although CaO was increasingly formed at temperatures above 600 degrees C. Both finite crystallite size and microstrain contributed significantly to the diffraction peak broadening below 600 degrees C. When heated to > 800 degrees C, the small, rod-like mineral crystallites changed from a highly anisotropically strained state to one with significantly larger equidimensional crystals possessing little microstrain. The findings are discussed in the context of graft bone substitutes and surgical heating of bone.

The role of collagen in determining bone mechanical properties

The hypothesis of this study was that collagen denaturation would lead to a significant decrease in the toughness of bone, but has little effect on the stiffness of bone. Using a heating model, effects of collagen denaturation on the biomechanical properties of human cadaveric bone were examined. Prior to testing, bone specimens were heat treated at varied temperatures (37-200 degrees C) to induce different degrees of collagen denaturation. Collagen denaturation and mechanical properties of bone were determined using a selective digestion technique and three-point bending tests, respectively. The densities and weight fractions of the mineral and organic phases in bone also were determined. A repeated measures analysis of variance showed that heating had a significant effect on the biomechanical integrity of bone, corresponding to the degree of collagen denaturation. The results of this study indicate that the toughness and strength of bone decreases significantly with increasing collagen denaturation, whereas the elastic modulus of bone is almost constant irrespective of collagen denaturation. These results suggest that the collagen network plays an important role in the toughness of bone, but has little effect on the stiffness of bone, thereby supporting the hypothesis of this study.