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Pandit A, Indurkar A, Locs J, Haugen HJ, Loca D. Calcium Phosphates: A Key to Next-Generation In Vitro Bone Modeling. Adv Healthc Mater 2024:e2401307. [PMID: 39175382 DOI: 10.1002/adhm.202401307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 08/06/2024] [Indexed: 08/24/2024]
Abstract
The replication of bone physiology under laboratory conditions is a prime target behind the development of in vitro bone models. The model should be robust enough to elicit an unbiased response when stimulated experimentally, giving reproducible outcomes. In vitro bone tissue generation majorly requires the availability of cellular components, the presence of factors promoting cellular proliferation and differentiation, efficient nutrient supply, and a supporting matrix for the cells to anchor - gaining predefined topology. Calcium phosphates (CaP) are difficult to ignore while considering the above requirements of a bone model. Therefore, the current review focuses on the role of CaP in developing an in vitro bone model addressing the prerequisites of bone tissue generation. Special emphasis is given to the physico-chemical properties of CaP that promote osteogenesis, angiogenesis and provide sufficient mechanical strength for load-bearing applications. Finally, the future course of action is discussed to ensure efficient utilization of CaP in the in vitro bone model development field.
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Affiliation(s)
- Ashish Pandit
- Institute of Biomaterials and Bioengineering, Faculty of Natural Sciences and Technology, Riga Technical University, Pulka Street 3, Riga, LV-1007, Latvia
- Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, LV-1007, Latvia
| | - Abhishek Indurkar
- Institute of Biomaterials and Bioengineering, Faculty of Natural Sciences and Technology, Riga Technical University, Pulka Street 3, Riga, LV-1007, Latvia
- Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, LV-1007, Latvia
| | - Janis Locs
- Institute of Biomaterials and Bioengineering, Faculty of Natural Sciences and Technology, Riga Technical University, Pulka Street 3, Riga, LV-1007, Latvia
- Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, LV-1007, Latvia
| | | | - Dagnija Loca
- Institute of Biomaterials and Bioengineering, Faculty of Natural Sciences and Technology, Riga Technical University, Pulka Street 3, Riga, LV-1007, Latvia
- Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, LV-1007, Latvia
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Deng T, Gong S, Cheng Y, Wang J, Zhang H, Li K, Nie Y, Shen B. Stochastic lattice-based porous implant design for improving the stress transfer in unicompartmental knee arthroplasty. J Orthop Surg Res 2024; 19:499. [PMID: 39175032 DOI: 10.1186/s13018-024-05006-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 08/16/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Unicompartmental knee arthroplasty (UKA) has been proved to be a successful treatment for osteoarthritis patients. However, the stress shielding caused by mismatch in mechanical properties between human bones and artificial implants remains as a challenging issue. This study aimed to properly design a bionic porous tibial implant and evaluate its biomechanical effect in reconstructing stress transfer pathway after UKA surgery. METHODS Voronoi structures with different strut sizes and porosities were designed and manufactured with Ti6Al4V through additive manufacturing and subjected to quasi-static compression tests. The Gibson-Ashby model was used to relate mechanical properties with design parameters. Subsequently, finite element models were developed for porous UKA, conventional UKA, and native knee to evaluate the biomechanical effect of tibial implant with designed structures during the stance phase. RESULTS The internal stress distribution on the tibia plateau in the medial compartment of the porous UKA knee was found to closely resemble that of the native knee. Furthermore, the mean stress values in the medial regions of the tibial plateau of the porous UKA knee were at least 44.7% higher than that of the conventional UKA knee for all subjects during the most loading conditions. The strain shielding reduction effect of the porous UKA knee model was significant under the implant and near the load contact sites. For subject 1 to 3, the average percentages of nodes in bone preserving and building region (strain values range from 400 to 3000 μm/m) of the porous UKA knee model, ranging from 68.7 to 80.5%, were higher than that of the conventional UKA knee model, ranging from 61.6 to 68.6%. CONCLUSIONS The comparison results indicated that the tibial implant with designed Voronoi structure offered better biomechanical functionality on the tibial plateau after UKA. Additionally, the model and associated analysis provide a well-defined design process and dependable selection criteria for design parameters of UKA implants with Voronoi structures.
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Affiliation(s)
- Tao Deng
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, China
- School of Mechanical Engineering, Sichuan University, Chengdu, 610065, China
| | - Shan Gong
- Sichuan University-Pittsburgh Institute, Sichuan University, Chengdu, 610207, China
| | - Yiwei Cheng
- Sichuan University-Pittsburgh Institute, Sichuan University, Chengdu, 610207, China
| | - Junqing Wang
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Hui Zhang
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, China
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China
| | - Kang Li
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China.
- Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan, 610041, P.R. China.
| | - Yong Nie
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Bin Shen
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, China
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Liu R, Yang J, Zhu Y, Zhou X, Zhou Q, Liang T, Wang H, Luo Y, Xie Y, Liu H, Zhong Z, Peng G, Zhuang H, Ai S, Jiang L, Zheng C, Zhou Z. A forecasting model for suitable dental implantation in canine mandibular premolar region based on finite element analysis. BMC Vet Res 2024; 20:353. [PMID: 39118061 PMCID: PMC11308459 DOI: 10.1186/s12917-024-04221-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 08/02/2024] [Indexed: 08/10/2024] Open
Abstract
In recent years, dental implants have become a trend in the treatment of human patients with missing teeth, which may also be an acceptable method for companion animal dentistry. However, there is a gap challenge in determining appropriate implant sizes for different dog breeds and human. In this study, we utilized skull computed tomography data to create three-dimensional models of the mandibles of dogs in different sizes. Subsequently, implants of various sizes were designed and subjected to biomechanical finite element analysis to determine the optimal implant size. Regression models were developed, exploring the relationship between the average weight of dogs and the size of premolar implants. Our results illustrated that the regression equations for mean body weight (x, kg) and second premolar (PM2), third premolar (PM3), and fourth premolar (PM4) implant length (y, mm) in dogs were: y = 0.2785x + 7.8209, y = 0.2544x + 8.9285, and y = 0.2668x + 10.652, respectively; the premolar implant diameter (mm) y = 0.0454x + 3.3506, which may provide a reference for determine suitable clinical implant sizes for dogs.
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Affiliation(s)
- Ruiyu Liu
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Jie Yang
- Sichuan Institute of Musk Deer Breeding, Chengdu, China
- Sichuan Science and Technology Resources Sharing Platform of Beagle Dog Breeding and Experimental Technology Service, Chengdu, China
| | - Yiling Zhu
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Xiaoxiao Zhou
- Chengdu Center for Animal Disease Prevention and Control, Chengdu, China
| | - Qiaolin Zhou
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Ting Liang
- Sichuan Institute of Musk Deer Breeding, Chengdu, China
- Sichuan Science and Technology Resources Sharing Platform of Beagle Dog Breeding and Experimental Technology Service, Chengdu, China
| | - Huan Wang
- Sichuan Institute of Musk Deer Breeding, Chengdu, China
- Sichuan Science and Technology Resources Sharing Platform of Beagle Dog Breeding and Experimental Technology Service, Chengdu, China
| | - Yan Luo
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Yue Xie
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
- Key Laboratory of Agricultural Bioinformatics, Ministry of Education, Sichuan Agricultural University, Chengdu, China
| | - Haifeng Liu
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Zhijun Zhong
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Guangneng Peng
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Hao Zhuang
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Shengquan Ai
- New Ruipeng Pet Healthcare Group, Chengdu, China
| | | | - Chengli Zheng
- Sichuan Institute of Musk Deer Breeding, Chengdu, China.
- Sichuan Science and Technology Resources Sharing Platform of Beagle Dog Breeding and Experimental Technology Service, Chengdu, China.
| | - Ziyao Zhou
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China.
- Key Laboratory of Agricultural Bioinformatics, Ministry of Education, Sichuan Agricultural University, Chengdu, China.
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Ding Z, Zhuang Z, Tang R, Qu X, Huang Z, Sun M, Yuan F. Negative association between Body Roundness Index and bone mineral density: insights from NHANES. Front Nutr 2024; 11:1448938. [PMID: 39176032 PMCID: PMC11340502 DOI: 10.3389/fnut.2024.1448938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 07/24/2024] [Indexed: 08/24/2024] Open
Abstract
Background Osteoporosis (OP), affecting millions around the globe, is a prevalent degenerative condition of the bones characterized by a decrease in bone mineral density (BMD) and an increase in bone fragility. A novel anthropometric measure, the Body Roundness Index (BRI), provides a more accurate assessment of body fat distribution compared to traditional metrics. Using data from the National Health and Nutrition Examination Survey (NHANES), this study aims to explore the relationship between BRI and total BMD in U.S. adults aged 20 and above. Methods Data from NHANES (2011-2018) were examined, encompassing 9,295 participants following exclusions. Dual-energy X-ray absorptiometry (DXA) was employed to measure BMD. BRI was calculated using waist circumference (WC) and height. The study accounted for variables such as demographic traits, physical exam results, lab test findings, and survey responses. Weighted multivariable linear regression models and smooth curve fitting methods were utilized to assess the relationship between BRI and total BMD. Results The research found a notable inverse relationship between BRI and total BMD. In the model with full adjustments, an increase of one unit in BRI was linked to a 0.0313 g/cm2 reduction in total BMD (P < 0.0001). Moreover, an inflection point was identified at BRI = 9.5229, where each one-unit rise in BRI beyond this threshold corresponded to a more substantial decrease in total BMD (0.0363 g/cm2). Analysis by subgroups revealed that this negative association was consistent across most demographic and health-related categories. Conclusions The results demonstrate a notable inverse relationship between BRI and total BMD, indicating that a higher BRI could be associated with lower BMD and a potentially greater risk of developing OP. This underscores the significance of accounting for body fat distribution in preventing OP and advocates for the use of BRI as a valuable marker for early intervention approaches.
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Affiliation(s)
- Ziyao Ding
- Department of Spine Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- First Clinical Medical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Zhe Zhuang
- Department of Spine Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- First Clinical Medical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Rongze Tang
- Department of Spine Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- First Clinical Medical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xinzhe Qu
- Department of Spine Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- First Clinical Medical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Zicheng Huang
- Department of Gynecologic Oncology, International Peace Maternity & Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Maji Sun
- Department of Spine Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- First Clinical Medical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Feng Yuan
- Department of Spine Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- First Clinical Medical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
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Sylvester AD, Zbijewski W, Shi G, Meckel LA, Chu EY, Cunningham DL, Wescott DJ. Macroscopic differences in adult human femora are linked to body mass index. Anat Rec (Hoboken) 2024; 307:2846-2857. [PMID: 38284320 DOI: 10.1002/ar.25397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/10/2024] [Accepted: 01/13/2024] [Indexed: 01/30/2024]
Abstract
Bone functional adaptation is routinely invoked to interpret skeletal morphology despite ongoing debate regarding the limits of the bone response to mechanical stimuli. The wide variation in human body mass presents an opportunity to explore the relationship between mechanical load and skeletal response in weight-bearing elements. Here, we examine variation in femoral macroscopic morphology as a function of body mass index (BMI), which is used as a metric of load history. A sample of 80 femora (40 female; 40 male) from recent modern humans was selected from the Texas State University Donated Skeletal Collection. Femora were imaged using x-ray computed tomography (voxel size ~0.5 mm), and segmented to produce surface models. Landmark-based geometric morphometric analyses based on the Coherent Point Drift algorithm were conducted to quantify shape. Principal components analyses were used to summarize shape variation, and component scores were regressed on BMI. Within the male sample, increased BMI was associated with a mediolaterally expanded femoral shaft, as well as increased neck-shaft angle and decreased femoral neck anteversion angle. No statistically significant relationships between shape and BMI were found in the female sample. While mechanical stimulus has traditionally been applied to changes in long bong diaphyseal shape it appears that bone functional adaptation may also result in fundamental changes in the shape of skeletal elements.
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Affiliation(s)
- Adam D Sylvester
- Center for Functional Anatomy and Evolution, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Wojciech Zbijewski
- Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Gengxin Shi
- Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Lauren A Meckel
- Department of Cell Biology and Anatomy, Louisiana State University Health Science Center, Baton Rouge, Louisiana, USA
| | - Elaine Y Chu
- Department of Anthropology, Texas State University, San Marcos, Texas, USA
| | | | - Daniel J Wescott
- Department of Anthropology, Texas State University, San Marcos, Texas, USA
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6
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Martinello PA, Cartagena-Molina AF, Capelletti LK, Fernandes BV, Franco APGDO, Mercuri EGF, Bombarda NHC. Adding mechanobiological cell features to finite element analysis of an immediately loaded dental implant. Eur J Oral Sci 2024; 132:e12992. [PMID: 38771146 DOI: 10.1111/eos.12992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/25/2024] [Indexed: 05/22/2024]
Abstract
Finite element analysis (FEA) has been used to analyze the behavior of dental materials, mainly in implantology. However, FEA is a mechanical analysis and few studies have tried to simulate the biological characteristics of the healing process of loaded implants. This study used the rule of mixtures to simulate the biological healing process of immediate implants in an alveolus socket and bone-implant junction interface through FEA. Three-dimensional geometric models of the structures were obtained, and material properties were derived from the literature. The rule of mixtures was used to simulate the healing periods-immediate and early loading, in which the concentration of each cell type, based on in vivo studies, influenced the final elastic moduli. A 100 N occlusal load was simulated in axial and oblique directions. The models were evaluated for maximum and minimum principal strains, and the bone overload was assessed through Frost's mechanostat. There was a higher strain concentration in the healing regions and cortical bone tissue near the cervical portion. The bone overload was higher in the immediate load condition. The method used in this study may help to simulate the biological healing process and could be useful to relate FEA results to clinical practice.
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Affiliation(s)
| | - Andrés Felipe Cartagena-Molina
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
- Department of Dentistry, State University of Londrina, Londrina, Paraná, Brazil
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7
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Echevarria-Cruz E, McMillan DW, Reid KF, Valderrábano RJ. Spinal Cord Injury Associated Disease of the Skeleton, an Unresolved Problem with Need for Multimodal Interventions. Adv Biol (Weinh) 2024:e2400213. [PMID: 39074256 DOI: 10.1002/adbi.202400213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 07/11/2024] [Indexed: 07/31/2024]
Abstract
Spinal cord injury is associated with skeletal unloading, sedentary behavior, decreases in skeletal muscle mass, and exercise intolerance, which results in rapid and severe bone loss. To date, monotherapy with physical interventions such as weight-bearing in standing frames, computer-controlled electrically stimulated cycling and ambulation exercise, and low-intensity vibration are unsuccessful in maintaining bone density after SCI. Strategies to maintain bone density with commonly used osteoporosis medications also fail to provide a significant clinical benefit, potentially due to a unique pathology of bone deterioration in SCI. In this review, the available data is discussed on evaluating and monitoring bone loss, fracture, and physical and pharmacological therapeutic approaches to SCI-associated disease of the skeleton. The treatment of SCI-associated disease of the skeleton, the implications for clinical management, and areas of need are considered for future investigation.
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Affiliation(s)
- Evelyn Echevarria-Cruz
- Research Program in Men's Health, Aging and Metabolism, and Boston Claude D. Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave Boston, 5th Floor, Boston, MA, 02115, USA
| | - David W McMillan
- The Miami Project to Cure Paralysis, University of Miami Leonard M. Miller School of Medicine, 1611 NW 12th ave, Office 2.141, Miami, FL, 33136, USA
- Department of Neurological Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, 33136, USA
| | - Kieran F Reid
- Research Program in Men's Health, Aging and Metabolism, and Boston Claude D. Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave Boston, 5th Floor, Boston, MA, 02115, USA
- Laboratory of Exercise Physiology and Physical Performance, Boston Claude D. Pepper Older Americans Independence Center for Function Promoting Therapies, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Rodrigo J Valderrábano
- Research Program in Men's Health, Aging and Metabolism, and Boston Claude D. Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave Boston, 5th Floor, Boston, MA, 02115, USA
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Johnston RA, Cowgill LW. The path less traveled: Using structural equation modeling to investigate factors influencing bone functional morphology. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2024:e24999. [PMID: 39049572 DOI: 10.1002/ajpa.24999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 05/01/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVES The relationship between an organism's mechanical environment and its bone strength has been long established by experimental research. Multiple intrinsic and extrinsic factors, including body mass, muscle strength, genetic background, and nutritional and/or hormonal status, are likely to influence bone deposition and resorption throughout the lifespan, complicating this relationship. Structural equation modeling (SEM) is uniquely positioned to parse this complex set of influences. MATERIALS AND METHODS Data from the Third National Health and Nutrition Examination Survey, including sex, total body mass, lean body mass, exercise frequency, peak body mass, and age, were analyzed using SEM to determine how they affect bone strength both individually and combined. RESULTS Body mass is typically the driver of cross-sectional area, but body mass and lean mass have similar effects on the polar moment of area (J). Peak body mass had a strong direct effect on J, despite decreasing strongly with increases in lean mass. Exercise also did not confer a large direct effect on cross-sectional area or J but did modify body mass and lean mass. In females, intentional weight loss was associated with decreased exercise levels. DISCUSSION SEM is a useful tool for parsing complex systems in bone functional morphology and has the potential to uncover causal links in the study of skeletal remodeling, including factors like weight loss or exercise that may have secondary effects.
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Affiliation(s)
- Rob'yn A Johnston
- Department of Anthropology, University of Missouri, Columbia, Missouri, USA
| | - Libby W Cowgill
- Department of Anthropology, University of Missouri, Columbia, Missouri, USA
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Long H, Zhang H, Deng L, Li C, Zhu Y, Ling S, Li D, Zhou X, Liu H, Zhong Z, Peng G, Wang C, Zhou Z. Biomechanics of Dental Implantation in the Giant Panda ( Ailuropoda melanoleuca): A Comparative Study Using Finite Element Analysis. J Vet Dent 2024:8987564241265420. [PMID: 39042890 DOI: 10.1177/08987564241265420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Giant pandas have a high incidence of tooth wear, loss, and fracture since their diet is specifically bamboo. Dental implantation is a common treatment for tooth loss in humans while rarely reported in wild animals. To explore the applicability of dental implantation in giant pandas, this study measured mandible parameters of the giant panda, from an adult skeletal specimen. The mandible bone block model was developed using computer-aided design 3D mechanical drawing software. Implants of different radius and thread types of the third premolar tooth (PM3) were assembled and imported into an analysis software system for finite element analysis. As a result, the reverse buttress implant with a radius of 7.5 mm and 8.3 mm, and a length of 15 mm was found to be the most suitable implant for use in the giant panda PM3. This study provides a reference for appropriate clinical giant panda dental implantation, although, the feasibility of giant panda dental implantation needs to be studied further.
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Affiliation(s)
- Han Long
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, China
| | - Huimin Zhang
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, China
| | - Linhua Deng
- China Conservation and Research Center for Giant Panda, Chengdu, Sichuan, China
| | - Caiwu Li
- China Conservation and Research Center for Giant Panda, Chengdu, Sichuan, China
| | - Yan Zhu
- China Conservation and Research Center for Giant Panda, Chengdu, Sichuan, China
| | - Shanshan Ling
- China Conservation and Research Center for Giant Panda, Chengdu, Sichuan, China
| | - Desheng Li
- China Conservation and Research Center for Giant Panda, Chengdu, Sichuan, China
| | - Xiaoxiao Zhou
- Chengdu Center for Animal Disease Prevention and Control, Chengdu, Sichuan, China
| | - Haifeng Liu
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, China
| | - Zhijun Zhong
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, China
| | - Guangneng Peng
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, China
| | - Chengdong Wang
- China Conservation and Research Center for Giant Panda, Chengdu, Sichuan, China
| | - Ziyao Zhou
- College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, China
- Key Laboratory of Agricultural Bioinformatics, Ministry of Education, Sichuan Agricultural University, Chengdu, Sichuan, China
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10
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Mühling M, Sandriesser S, Dendorfer S, Augat P. Assessment of implant internal stresses under physiological femoral loading: Translation to a simplified bending load model. J Biomech 2024; 172:112229. [PMID: 39004041 DOI: 10.1016/j.jbiomech.2024.112229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 07/01/2024] [Accepted: 07/10/2024] [Indexed: 07/16/2024]
Abstract
The success of surgical treatment for fractures hinges on various factors, notably accurate surgical indication. The process of developing and certifying a new osteosynthesis device is a lengthy and costly process that requires multiple cycles of review and validation. Current methods, however, often rely on predecessor standards rather than physiological loads in specific anatomical locations. This study aimed to determine actual loads experienced by an osteosynthesis plate, exemplified by a standard locking plate for the femoral shaft, utilizing finite elements analysis (FEA) and to obtain the bending moments for implant development standard tests. A protocol was developed, involving the creation and validation of a fractured femur model fixed with a locking plate, mechanical testing, and FEA. The model's validation demonstrated exceptional accuracy in predicting deformations, and the FEA revealed peak stresses in the fracture bridging zone. Results of a parametric analysis indicate that larger fracture gaps significantly impact implant mechanical behavior, potentially compromising stability. This study underscores the critical need for realistic physiological conditions in implant evaluations, providing an innovative translational approach to identify internal loads and optimize implant designs. In conclusion, this research contributes to enhancing the understanding of implant performance under physiological conditions, promoting improved designs and evaluations in fracture treatments.
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Affiliation(s)
- M Mühling
- Institute for Biomechanics, BG Unfallklinik Murnau, Prof.-Küntscher-Str. 8, 82418 Murnau, Germany; Institute for Biomechanics, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria.
| | - S Sandriesser
- Institute for Biomechanics, BG Unfallklinik Murnau, Prof.-Küntscher-Str. 8, 82418 Murnau, Germany; Institute for Biomechanics, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria
| | - S Dendorfer
- Laboratory for Biomechanics, Ostbayerische Technische Hochschule Regensburg, Seybothstraße 2, 93053 Regensburg, Germany; Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Galgenbergstr. 30, 93053 Regensburg, Germany
| | - P Augat
- Institute for Biomechanics, BG Unfallklinik Murnau, Prof.-Küntscher-Str. 8, 82418 Murnau, Germany; Institute for Biomechanics, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria
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11
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Lemaire S, Bouby C, Thiebaud F, Berry-Kromer V. Prosthetic framework improvement using lattice structure: A comparative finite element study of a mandibular implant-supported prosthesis. J Mech Behav Biomed Mater 2024; 155:106538. [PMID: 38608345 DOI: 10.1016/j.jmbbm.2024.106538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVES An alternative option was proposed regarding the prosthetic rehabilitation of a fully edentulous mandible using only four implants. The aim was to reduce the stiffness of the prosthetic framework. To that end, the alternative option consists of a prosthetic framework optimized with a porous structure. Mechanical differences were analyzed between non-prosthetic mandible and restored mandible either with a conventional bulk titanium framework or with this alternative option. The non-prosthetic mandible corresponds to the mandible in its natural state, without prosthesis. This will be considered as the reference for comparison with restored models (mandible with prosthesis). METHODS Three models are used: the first one is the non-prosthetic mandible, the second one is the restored mandible with conventional bulk titanium prosthetic framework, and the third one is the alternative option. Prosthetic framework was optimized with the use of a lattice structure. A numerical analysis was performed (with Abaqus Standard software®) to obtain the effective parameters corresponding to equivalent homogeneous behavior. In the 3 models, physiological boundary conditions were used, considering the activity of several muscles of the masticatory system during three main tasks of mastication (incisive clenching, maximum intercuspation and unilateral molar clenching). RESULTS Numerical simulations allowed to obtain mandibular global kinematics, local displacement at the bone-implant interface and the state of strain at the bone-implant interface, for each masticatory tasks. For this comparative study, the non-prosthetic mandible model was used as a reference to observe the benefits of using a lattice prosthetic framework compared to a conventional bulk titanium framework. CONCLUSION Compared to conventional titanium framework, the lattice prosthetic one appeared to be more respectful of the natural mandible kinematics, given by the reference model. It also resulted in strain values within the physiological loading range.
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Affiliation(s)
- Samuel Lemaire
- Université de Lorraine, CNRS, Arts et Métiers ParisTech, LEM3, Nancy, F-54500, France.
| | - Céline Bouby
- Université de Lorraine, CNRS, Arts et Métiers ParisTech, LEM3, Nancy, F-54500, France
| | - Frédéric Thiebaud
- Université de Lorraine, CNRS, Arts et Métiers ParisTech, LEM3, Nancy, F-54500, France
| | - Valérie Berry-Kromer
- Université de Lorraine, CNRS, Arts et Métiers ParisTech, LEM3, Nancy, F-54500, France
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12
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Wearing SC, Hooper SL, Langton CM, Keiner M, Horstmann T, Crevier-Denoix N, Pourcelot P. The Biomechanics of Musculoskeletal Tissues during Activities of Daily Living: Dynamic Assessment Using Quantitative Transmission-Mode Ultrasound Techniques. Healthcare (Basel) 2024; 12:1254. [PMID: 38998789 PMCID: PMC11241410 DOI: 10.3390/healthcare12131254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 07/14/2024] Open
Abstract
The measurement of musculoskeletal tissue properties and loading patterns during physical activity is important for understanding the adaptation mechanisms of tissues such as bone, tendon, and muscle tissues, particularly with injury and repair. Although the properties and loading of these connective tissues have been quantified using direct measurement techniques, these methods are highly invasive and often prevent or interfere with normal activity patterns. Indirect biomechanical methods, such as estimates based on electromyography, ultrasound, and inverse dynamics, are used more widely but are known to yield different parameter values than direct measurements. Through a series of literature searches of electronic databases, including Pubmed, Embase, Web of Science, and IEEE Explore, this paper reviews current methods used for the in vivo measurement of human musculoskeletal tissue and describes the operating principals, application, and emerging research findings gained from the use of quantitative transmission-mode ultrasound measurement techniques to non-invasively characterize human bone, tendon, and muscle properties at rest and during activities of daily living. In contrast to standard ultrasound imaging approaches, these techniques assess the interaction between ultrasound compression waves and connective tissues to provide quantifiable parameters associated with the structure, instantaneous elastic modulus, and density of tissues. By taking advantage of the physical relationship between the axial velocity of ultrasound compression waves and the instantaneous modulus of the propagation material, these techniques can also be used to estimate the in vivo loading environment of relatively superficial soft connective tissues during sports and activities of daily living. This paper highlights key findings from clinical studies in which quantitative transmission-mode ultrasound has been used to measure the properties and loading of bone, tendon, and muscle tissue during common physical activities in healthy and pathological populations.
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Affiliation(s)
- Scott C. Wearing
- School of Medicine and Health, Technical University of Munich, 80992 Munich, Bavaria, Germany
| | - Sue L. Hooper
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia
| | - Christian M. Langton
- Griffith Centre of Rehabilitation Engineering, Griffith University, Southport, QLD 4222, Australia
| | - Michael Keiner
- Department of Exercise and Training Science, German University of Health and Sport, 85737 Ismaning, Bavaria, Germany
| | - Thomas Horstmann
- School of Medicine and Health, Technical University of Munich, 80992 Munich, Bavaria, Germany
| | | | - Philippe Pourcelot
- INRAE, BPLC Unit, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France
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13
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Kang J, Wu Y, Qiao J. Numerical evaluation of spinal reconstruction using a 3D printed vertebral body replacement implant: effects of material anisotropy. Front Bioeng Biotechnol 2024; 12:1305837. [PMID: 38966191 PMCID: PMC11222561 DOI: 10.3389/fbioe.2024.1305837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 06/03/2024] [Indexed: 07/06/2024] Open
Abstract
Background and objective Artificial vertebral implants have been widely used for functional reconstruction of vertebral defects caused by tumors or trauma. However, the evaluation of their biomechanical properties often neglects the influence of material anisotropy derived from the host bone and implant's microstructures. Hence, this study aims to investigate the effect of material anisotropy on the safety and stability of vertebral reconstruction. Material and methods Two finite element models were developed to reflect the difference of material properties between linear elastic isotropy and nonlinear anisotropy. Their biomechanical evaluation was carried out under different load conditions including flexion, extension, lateral bending and axial rotation. These performances of two models with respect to safety and stability were analyzed and compared quantitatively based on the predicted von Mises stress, displacement and effective strain. Results The maximum von Mises stress of each component in both models was lower than the yield strength of respective material, while the predicted results of nonlinear anisotropic model were generally below to those of the linear elastic isotropic model. Furthermore, the maximum von Mises stress of natural vertebra and reconstructed system was decreased by 2-37 MPa and 20-61 MPa, respectively. The maximum reductions for the translation displacement of the artificial vertebral body implant and motion range of whole model were reached to 0.26 mm and 0.77°. The percentage of effective strain elements on the superior and inferior endplates adjacent to implant was diminished by up to 19.7% and 23.1%, respectively. Conclusion After comprehensive comparison, these results indicated that the finite element model with the assumption of linear elastic isotropy may underestimate the safety of the reconstruction system, while misdiagnose higher stability by overestimating the range of motion and bone growth capability.
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Affiliation(s)
| | | | - Jian Qiao
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, China
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14
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Qiu C, Su K, Luo Z, Tian Q, Zhao L, Wu L, Deng H, Shen H. Developing and comparing deep learning and machine learning algorithms for osteoporosis risk prediction. Front Artif Intell 2024; 7:1355287. [PMID: 38919268 PMCID: PMC11196804 DOI: 10.3389/frai.2024.1355287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/31/2024] [Indexed: 06/27/2024] Open
Abstract
Introduction Osteoporosis, characterized by low bone mineral density (BMD), is an increasingly serious public health issue. So far, several traditional regression models and machine learning (ML) algorithms have been proposed for predicting osteoporosis risk. However, these models have shown relatively low accuracy in clinical implementation. Recently proposed deep learning (DL) approaches, such as deep neural network (DNN), which can discover knowledge from complex hidden interactions, offer a new opportunity to improve predictive performance. In this study, we aimed to assess whether DNN can achieve a better performance in osteoporosis risk prediction. Methods By utilizing hip BMD and extensive demographic and routine clinical data of 8,134 subjects with age more than 40 from the Louisiana Osteoporosis Study (LOS), we developed and constructed a novel DNN framework for predicting osteoporosis risk and compared its performance in osteoporosis risk prediction with four conventional ML models, namely random forest (RF), artificial neural network (ANN), k-nearest neighbor (KNN), and support vector machine (SVM), as well as a traditional regression model termed osteoporosis self-assessment tool (OST). Model performance was assessed by area under 'receiver operating curve' (AUC) and accuracy. Results By using 16 discriminative variables, we observed that the DNN approach achieved the best predictive performance (AUC = 0.848) in classifying osteoporosis (hip BMD T-score ≤ -1.0) and non-osteoporosis risk (hip BMD T-score > -1.0) subjects, compared to the other approaches. Feature importance analysis showed that the top 10 most important variables identified by the DNN model were weight, age, gender, grip strength, height, beer drinking, diastolic pressure, alcohol drinking, smoke years, and economic level. Furthermore, we performed subsampling analysis to assess the effects of varying number of sample size and variables on the predictive performance of these tested models. Notably, we observed that the DNN model performed equally well (AUC = 0.846) even by utilizing only the top 10 most important variables for osteoporosis risk prediction. Meanwhile, the DNN model can still achieve a high predictive performance (AUC = 0.826) when sample size was reduced to 50% of the original dataset. Conclusion In conclusion, we developed a novel DNN model which was considered to be an effective algorithm for early diagnosis and intervention of osteoporosis in the aging population.
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Affiliation(s)
| | | | | | | | | | | | - Hongwen Deng
- Tulane Center for Biomedical Informatics and Genomics, Deming Department of Medicine, School of Medicine, Tulane University, New Orleans, LA, United States
| | - Hui Shen
- Tulane Center for Biomedical Informatics and Genomics, Deming Department of Medicine, School of Medicine, Tulane University, New Orleans, LA, United States
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15
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Millward DJ. Post-natal muscle growth and protein turnover: a narrative review of current understanding. Nutr Res Rev 2024; 37:141-168. [PMID: 37395180 DOI: 10.1017/s0954422423000124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
A model explaining the dietary-protein-driven post-natal skeletal muscle growth and protein turnover in the rat is updated, and the mechanisms involved are described, in this narrative review. Dietary protein controls both bone length and muscle growth, which are interrelated through mechanotransduction mechanisms with muscle growth induced both from stretching subsequent to bone length growth and from internal work against gravity. This induces satellite cell activation, myogenesis and remodelling of the extracellular matrix, establishing a growth capacity for myofibre length and cross-sectional area. Protein deposition within this capacity is enabled by adequate dietary protein and other key nutrients. After briefly reviewing the experimental animal origins of the growth model, key concepts and processes important for growth are reviewed. These include the growth in number and size of the myonuclear domain, satellite cell activity during post-natal development and the autocrine/paracrine action of IGF-1. Regulatory and signalling pathways reviewed include developmental mechanotransduction, signalling through the insulin/IGF-1-PI3K-Akt and the Ras-MAPK pathways in the myofibre and during mechanotransduction of satellite cells. Likely pathways activated by maximal-intensity muscle contractions are highlighted and the regulation of the capacity for protein synthesis in terms of ribosome assembly and the translational regulation of 5-TOPmRNA classes by mTORC1 and LARP1 are discussed. Evidence for and potential mechanisms by which volume limitation of muscle growth can occur which would limit protein deposition within the myofibre are reviewed. An understanding of how muscle growth is achieved allows better nutritional management of its growth in health and disease.
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Affiliation(s)
- D Joe Millward
- Department of Nutritional Sciences, School of Biosciences & Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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16
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Akbas O, Greuling A, Stiesch M. The effects of different grading approaches in additively manufactured dental implants on peri-implant bone stress: A finite element analysis. J Mech Behav Biomed Mater 2024; 154:106530. [PMID: 38552334 DOI: 10.1016/j.jmbbm.2024.106530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/19/2024]
Abstract
Additive manufacturing enables local grading of the stiffness of dental implants through targeted adjustment of the manufacturing parameters to meet patient specific requirements. The extent to which such a manufacturing approach affects the interaction between the implant body and the surrounding bone, and what grading is optimal, is currently insufficiently investigated. This study investigates the effect of different Young's modulus grading approaches on stresses in the peri-implant bone via finite element analysis. The implant geometry was kept constant and in the case of the implant a node-dependent elastic modulus was assigned. In this way, a vertical, a radial and three torus based grading approaches were created and examined. A load was then applied directly to the occlusal surface of the implant crown. It was found that a local grading utilizing a torus shape was most favourable in terms of an effective stress peak reduction. The best torus shape tested achieved a 22 % reduction of maximum principal stress and 6 % reduction of minimum principal stress compared to the uniform material. In clinical settings, this may provide benefits in situations of overload. Based on the results, a graded stiffness in dental implants appears to be of interest for developing advanced, patient-specific implant solutions.
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Affiliation(s)
- Osman Akbas
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany
| | - Andreas Greuling
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany.
| | - Meike Stiesch
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany
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17
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Xie WQ, He M, Yu DJ, Li HZ, Jin HF, Ji BZ, Yang G, Chen LL, Rahmati M, Li YS. Correlation study between bone metabolic markers, bone mineral density, and sarcopenia. J Endocrinol Invest 2024; 47:1559-1572. [PMID: 38097848 DOI: 10.1007/s40618-023-02252-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/19/2023] [Indexed: 02/21/2024]
Abstract
OBJECTIVE To investigate the correlation between bone metabolism markers, bone mineral density (BMD), and sarcopenia. METHODS A total of 331 consecutive patients aged ≥ 60 years who were hospitalized between November 2020 and December 2021 were enrolled. Participants were divided into sarcopenia and non-sarcopenia groups according to the Asian Working Group on Sarcopenia criteria (AWGS, 2019). The clinical data, bone metabolism markers (β-CTX, N-MID, and TP1NP), and BMD were compared between the two groups. RESULTS Age, β-CTX, and N-MID of the sarcopenia group were higher than those of the non-sarcopenia group (P < 0.05), but the BMD T values were lower than those of the non-sarcopenia group (P < 0.05). Binary logistic regression analysis showed that increased femoral neck BMD (FNBMD) was a protective factor for sarcopenia, while increased β-CTX was a risk factor. Pearson/Spearman correlation analysis showed that the diagnostic indices of sarcopenia were positively correlated with FNBMD and negatively correlated with β-CTX and N-MID. Multiple linear regression analysis revealed that BMI and FNBMD significantly positively affected muscle strength and appendicular skeletal muscle mass (ASM). The FNBMD significantly positively affected physical performance, while β-CTX significantly negatively affected muscle strength, ASM, and physical performance. CONCLUSION Increased FNBMD may be a protective factor against sarcopenia, and increased β-CTX may be a risk factor. The FNBMD significantly positively affected the diagnostic indices of sarcopenia, while β-CTX significantly negatively affected them. BMD and bone metabolism marker levels may be considered in early screening for sarcopenia.
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Affiliation(s)
- W Q Xie
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - M He
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - D J Yu
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - H Z Li
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - H F Jin
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - B Z Ji
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - G Yang
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - L L Chen
- Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha, 410000, Hunan, China
| | - M Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khorramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Y S Li
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
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Cerulli C, Moretti E, Grazioli E, Emerenziani GP, Murri A, Tranchita E, Minganti C, Di Cagno A, Parisi A. Protective role of exercise on breast cancer-related osteoporosis in women undergoing aromatase inhibitors: A narrative review. Bone Rep 2024; 21:101756. [PMID: 38577250 PMCID: PMC10990716 DOI: 10.1016/j.bonr.2024.101756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/19/2024] [Accepted: 03/23/2024] [Indexed: 04/06/2024] Open
Abstract
Hormone therapy following surgery reduces the risk of breast cancer (BC) recurrence and progression of hormone-sensitive BC, especially in postmenopausal women. Despite the antitumor efficacy of hormone therapy, particularly of aromatase inhibitors, they cause long-term side effects, mainly bone density reduction. Exercise can slow the rate of bone loss, which reduces the risk of fractures from osteoporosis, and could be an integrative treatment able to mitigate the BC treatment side effects positively impacting bone health. This narrative review aims to discuss studies on the effect of exercise on bone health in BC women undergoing aromatase inhibitors, highlighting the possible role of exercise as complementary to conventional therapies. Additionally, according to the literature revision, exercise practical applications to improve bone health in these patients are summarized.
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Affiliation(s)
- Claudia Cerulli
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
| | - Elisa Moretti
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
| | - Elisa Grazioli
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
| | - Gian Pietro Emerenziani
- Department of Experimental and Clinical Medicine, “Magna Græcia” University, Viale Europa, 88100 Catanzaro, Italy
| | - Arianna Murri
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
| | - Eliana Tranchita
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
| | - Carlo Minganti
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
| | - Alessandra Di Cagno
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
| | - Attilio Parisi
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
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19
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Zhang Y, Kang H, Zhao J, Wang Y, Cai W, Zhang X, Li K, Zhao Y. Neoadjuvant therapy increases the risk of metabolic disorders and osteosarcopenia in patients with early breast cancer. Jpn J Clin Oncol 2024:hyae070. [PMID: 38807545 DOI: 10.1093/jjco/hyae070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/15/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND The purpose of this study is to evaluate the effects of neoadjuvant therapy on glucose and lipid metabolism, bone mineral density (BMD) and muscle, and to explore the relationship between metabolic disorders and changes in body composition, so as to provide better health management strategies for breast cancer survivors. METHODS The clinical data of 43 patients with breast cancer who received neoadjuvant therapy in Xuanwu Hospital from January 2020 to June 2021 were analyzed retrospectively. The biochemical results, including albumin, blood glucose, triglyceride and cholesterol, were collected before neoadjuvant therapy and before surgery. The pectoral muscle area, pectoral muscle density and cancellous bone mineral density of the 12th thoracic vertebra were also measured by chest CT. RESULTS After neoadjuvant therapy, fasting blood glucose, triglyceride and cholesterol were significantly increased, albumin was decreased. At the same time, pectoral muscle area, pectoral muscle density and T12 BMD were decreased. After treatment, BMD was positively correlated with pectoral muscle area, R2 = 0.319, P = 0.037, and BMD was also positively correlated with pectoral muscle density, R2 = 0.329, P = 0.031. Multivariate analysis showed that BMD and pectoral muscle density were correlated with menstrual status, and pectoral muscle area was correlated with body mass index before treatment, none of which was related to glucose and lipid metabolism. CONCLUSION Neoadjuvant therapy can cause glucose and lipid metabolism disorder, BMD decrease and muscle reduction. BMD was positively correlated with muscle area and density after treatment, suggesting that patients had an increased chance of developing osteosarcopenia.
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Affiliation(s)
- Yan Zhang
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hua Kang
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jing Zhao
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yajun Wang
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wei Cai
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaoli Zhang
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Kaifu Li
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ye Zhao
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
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20
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ANGGORO D, PURBA MS, JIANG F, NISHIDA N, ITOH H, ITAMOTO K, NEMOTO Y, NAKAICHI M, SUNAHARA H, TANI K. Elucidation of the radius and ulna fracture mechanisms in toy poodle dogs using finite element analysis. J Vet Med Sci 2024; 86:575-583. [PMID: 38556325 PMCID: PMC11144531 DOI: 10.1292/jvms.23-0520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 03/18/2024] [Indexed: 04/02/2024] Open
Abstract
Fractures occurring in the distal radius and ulna of toy breed dogs pose distinctive challenges for veterinary practitioners, requiring specialized treatment approaches primarily based on anatomical features. Finite Element Analysis (FEA) was applied to conduct numerical experiments to determine stress distribution across the bone. This methodology offers an alternative substitute for directly investigating these phenomena in living dog experiments, which could present ethical obstacles. A three-dimensional bone model of the metacarpal, carpal, radius, ulna, and humerus was reconstructed from Computed Tomography (CT) images of the toy poodle and dachshund forelimb. The model was designed to simulate the jumping and landing conditions from a vertical distance of 40 cm to the ground within a limited timeframe. The investigation revealed considerable variations in stress distribution patterns between the radius and ulna of toy poodles and dachshunds, indicating notably elevated stress levels in toy poodles compared to dachshunds. In static and dynamic stress analysis, toy poodles exhibit peak stress levels at the distal radius and ulna. The Von Mises stresses for toy poodles reach 90.07 MPa (static) and 1,090.75 MPa (dynamic) at the radius and 1,677.97 MPa (static) and 1,047.98 MPa (dynamic) at the ulna. Conversely, dachshunds demonstrate lower stress levels for 5.39 MPa (static) and 231.79 MPa (dynamic) at the radius and 390.56 MPa (static) and 513.28 MPa (dynamic) at the ulna. The findings offer valuable insights for modified treatment approaches in managing fractures in toy breed dogs, optimizing care and outcomes.
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Affiliation(s)
- Dito ANGGORO
- Laboratory of Veterinary Surgery, Joint Graduate School of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | - Melpa Susanti PURBA
- Laboratory of Veterinary Surgery, Joint Graduate School of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Fei JIANG
- Department of Mechanical Engineering, Graduate School of Sciences and Technology for Innovation, Yamaguchi University, Yamaguchi, Japan
| | - Norihiro NISHIDA
- Department of Orthopedic Surgery, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Harumichi ITOH
- Laboratory of Small Animal Clinical Science, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Kazuhito ITAMOTO
- Laboratory of Small Animal Clinical Science, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Yuki NEMOTO
- Laboratory of Veterinary Radiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Munekazu NAKAICHI
- Laboratory of Veterinary Radiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Hiroshi SUNAHARA
- Laboratory of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Kenji TANI
- Laboratory of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
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21
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Afrashtehfar KI, Stawarczyk B, Micovic Soldatovic D, Schmidlin PR. A proof of concept on implant-supported bilateral cantilever bridges: The T-Bridge approach. SWISS DENTAL JOURNAL 2024; 134:1-17. [PMID: 38757922 DOI: 10.61872/sdj-2024-03-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Indexed: 05/18/2024]
Abstract
The concept of bilateral cantilevers on a single central implant (T-design) for three-unit implant-supported fixed dental prostheses (ISFDPs) has not been explored nor tested. This technical hypothesis aimed to explore the feasibility of such an approach as a cost-effective alternative to conventional treatments. Careful considerations regarding implant diameter, length, ideal position, occlusal scheme, and bone remodeling are essential to ensure adequate support, stability, and prevention of complications. In this proof of concept, we present a preliminary case with this novel design to replace missing posterior teeth in a patient with narrow bone conditions. In addition, a series of planned investigations and preliminary results, including preclinical studies, are presented to illustrate our concept and its potential clinical implications. Clinically, after two-year follow-up, healthy and stable peri-implant tissues around the ISFDP exemplarily demonstrated excellent stability, functionality, and comfort, which is supported by acceptable fracture resistance data in vitro, suggesting indeed the practical potential and suitability. Thus, we claim that such a treatment modality has the at least theoretical potential to revolutionize implant dentistry by providing innovative and cost-effective treatment options for patients with partial ISFDPs in very specific cases. Of course, further research and evaluations are necessary to validate the clinical implications of this innovative hypothesis. Implementing the 3-on-1 T-bridge approach in partial ISFDPs could offer a promising alternative to traditional methods. If proven successful, this technique may lead to significant advancements in clinical practice, providing a less invasive cost-effective treatment option.
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Affiliation(s)
- Kelvin I Afrashtehfar
- Evidence Based Practice Unit, College of Dentistry, Ajman University, Ajman City, UAE.
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Berne, Switzerland
- Division of Periodontal and Periimplantitis Sciences, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Private Practice Limited to Implant Dentistry, Richmond, Canada
- Private Practice Limited to Prosthodontics, Abu Dhabi, UAE
| | - Bogna Stawarczyk
- Department of Prosthodontics, Ludwig-Maximilians-University, Munich, Germany.
| | | | - Patrick R Schmidlin
- Division of Periodontal and Periimplantitis Sciences, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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22
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Kunath BA, Beloglowka K, Rainbow R, Ploeg HL. Mechanical loading of ex vivo bovine trabecular bone in 3D printed bioreactor chambers. J Mech Behav Biomed Mater 2024; 153:106470. [PMID: 38422872 DOI: 10.1016/j.jmbbm.2024.106470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 02/05/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
Previous ex vivo bone culture methods have successfully implemented polycarbonate (PC) bioreactors to investigate bone adaptation to mechanical load; however, they are difficult to fabricate and have been limited to a 5 mm maximum specimen height. The objective of this study was to validate a custom-made 3D printed MED610TM bioreactor system that addresses the limitations of the PC bioreactor and assess its efficacy in ex vivo bone culture. Twenty-three viable trabecular bone cores (10 mm height by 10 mm diameter) from an 18-month-old bovine sternum were cultured in MED610TM bioreactors with culture medium at 37 °C and 5% CO2 for 21-days. Bone cores were ranked based on their day 0 apparent elastic modulus (Eapp) and evenly separated into a "Load" group (n = 12) and a control group (n = 11). The Load group was loaded five times per week with a sinusoidal strain waveform between -1000 and -5000 με for 120 cycles at 2 Hz. Eapp was assessed on day 0, 8, and 21 using quasi-static tests with a -4000 με applied strain. Over 21-days, the Eapp of Load group samples tended to increase by more than double the control group (53.4% versus 20.9%) and no visual culture contamination was observed. This study demonstrated that bone organ culture in 3D printed MED610TM bioreactors replicated Eapp trends found in previous studies with PC bioreactors. However, further studies are warranted with a larger sample size to increase statistical power and histology to assess cell viability and bone mineral apposition rate.
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Affiliation(s)
- Brian A Kunath
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada; Centre for Health Innovation, Queen's University, Kingston, ON, Canada.
| | - Kail Beloglowka
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada; Centre for Health Innovation, Queen's University, Kingston, ON, Canada.
| | - Roshni Rainbow
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada; Centre for Health Innovation, Queen's University, Kingston, ON, Canada.
| | - Heidi-Lynn Ploeg
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada; Centre for Health Innovation, Queen's University, Kingston, ON, Canada.
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23
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Pourhassan M, Buehring B, Stervbo U, Rahmann S, Mölder F, Rütten S, Neuendorff NR, Westhoff TH, Babel N, Wirth R. Three-Year Mortality of Older Hospitalized Patients with Osteosarcopenia: Data from the OsteoSys Study. Nutrients 2024; 16:1328. [PMID: 38732575 PMCID: PMC11085630 DOI: 10.3390/nu16091328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Osteosarcopenia, the concurrent presence of sarcopenia and osteopenia/osteoporosis, poses a significant health risk to older adults, yet its impact on clinical outcomes is not fully understood. The aim of this prospective, longitudinal multicentre study was to examine the impact of osteosarcopenia on 3-year mortality and unplanned hospitalizations among 572 older hospitalized patients (mean age 75.1 ± 10.8 years, 78% female). Sarcopenia and low bone mineral density (BMD) were evaluated using Dual Energy X-ray Absorptiometry and the European Working Group on Sarcopenia in Older People (EWGSOP2) and WHO criteria, respectively. Among participants, 76% had low BMD, 9% were sarcopenic, and 8% had osteosarcopenia. Individuals with osteosarcopenia experienced a significantly higher rate of mortality (46%, p < 001) and unplanned hospitalization (86%, p < 001) compared to those without this condition. Moreover, "healthy" subjects-those without sarcopenia or low BMD-showed markedly lower 3-year mortality (9%, p < 001) and less unplanned hospitalization (53%, p < 001). The presence of osteosarcopenia (p = 0.009) increased the 3-year mortality risk by 30% over sarcopenia alone and by 8% over low BMD alone, underscoring the severe health implications of concurrent muscle and bone deterioration. This study highlights the substantial impact of osteosarcopenia on mortality among older adults, emphasizing the need for targeted diagnostic and therapeutic strategies.
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Affiliation(s)
- Maryam Pourhassan
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (N.R.N.); (R.W.)
| | - Bjoern Buehring
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, 44649 Herne, Germany;
- Bergisches Rheuma-Zentrum Wuppertal, 42105 Wuppertal, Germany
| | - Ulrik Stervbo
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr-University Bochum, 44625 Herne, Germany; (U.S.); (N.B.)
| | - Sven Rahmann
- Algorithmic Bioinformatics, Center for Bioinformatics Saar, Saarland University, Saarland Informatics Campus, 66123 Saarbrücken, Germany;
| | - Felix Mölder
- Algorithms for Reproducible Bioinformatics, Genome Informatics, Institute of Human Genetics, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany;
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Sebastian Rütten
- Center for Orthopedics and Trauma Surgery, St. Anna Hospital, St. Elisabeth Gruppe, 44649 Herne, Germany;
| | - Nina Rosa Neuendorff
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (N.R.N.); (R.W.)
| | - Timm Henning Westhoff
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr-University Bochum, 44625 Herne, Germany; (U.S.); (N.B.)
| | - Nina Babel
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr-University Bochum, 44625 Herne, Germany; (U.S.); (N.B.)
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Rainer Wirth
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (N.R.N.); (R.W.)
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24
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Bartz M, Jüttner M, Halmos F, Uhlich E, Klein M, Drumm P, Dreßler E, Martin S, Walter J, Franke J, Wartzack S. Assessment of the Suitability of Selected Linear Actuators for the Implementation of the Load-Adaptive Biological Principle of Redundant Motion Generation. Biomimetics (Basel) 2024; 9:236. [PMID: 38667248 PMCID: PMC11048576 DOI: 10.3390/biomimetics9040236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
The load-adaptive behavior of the muscles in the human musculoskeletal system offers great potential for minimizing resource and energy requirements in many technical systems, especially in drive technology and robotics. However, the lack of knowledge about suitable technical linear actuators that can reproduce the load-adaptive behavior of biological muscles in technology is a major reason for the lack of successful implementation of this biological principle. In this paper, therefore, the different types of linear actuators are investigated. The focus is particularly on artificial muscles and rope pulls. The study is based on literature, on the one hand, and on two physical demonstrators in the form of articulated robots, on the other hand. The studies show that ropes are currently the best way to imitate the load-adaptive behavior of the biological model in technology. This is especially illustrated in the context of this paper by the discussion of different advantages and disadvantages of the technical linear actuators, where ropes, among other things, have a good mechanical and control behavior, which is very advantageous for use in an adaptive system. Finally, the next steps for future research are outlined to conclude how ropes can be used as linear actuators to transfer load-adaptive lightweight design into technical applications.
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Affiliation(s)
- Marcel Bartz
- Department of Mechanical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Engineering Design, Martensstraße 9, 91058 Erlangen, Germany (M.K.)
| | - Michael Jüttner
- Department of Mechanical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Engineering Design, Martensstraße 9, 91058 Erlangen, Germany (M.K.)
| | - Fabian Halmos
- Department of Mechanical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Engineering Design, Martensstraße 9, 91058 Erlangen, Germany (M.K.)
| | - Elias Uhlich
- Department of Mechanical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Engineering Design, Martensstraße 9, 91058 Erlangen, Germany (M.K.)
| | - Max Klein
- Department of Mechanical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Engineering Design, Martensstraße 9, 91058 Erlangen, Germany (M.K.)
| | - Patricia Drumm
- Department of Mechanical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Engineering Design, Martensstraße 9, 91058 Erlangen, Germany (M.K.)
| | - Erkan Dreßler
- Department of Mechanical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Engineering Design, Martensstraße 9, 91058 Erlangen, Germany (M.K.)
| | - Sina Martin
- Department of Mechanical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Institute for Factory Automation and Production Systems, Egerlandstraße 7, 91058 Erlangen, Germany (J.W.)
| | - Jonas Walter
- Department of Mechanical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Institute for Factory Automation and Production Systems, Egerlandstraße 7, 91058 Erlangen, Germany (J.W.)
| | - Jörg Franke
- Department of Mechanical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Institute for Factory Automation and Production Systems, Egerlandstraße 7, 91058 Erlangen, Germany (J.W.)
| | - Sandro Wartzack
- Department of Mechanical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Engineering Design, Martensstraße 9, 91058 Erlangen, Germany (M.K.)
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25
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Roffmann O, Stiesch M, Greuling A. Preventing stress singularities in peri-implant bone - a finite element analysis using a graded bone model. Comput Methods Biomech Biomed Engin 2024; 27:547-557. [PMID: 36942632 DOI: 10.1080/10255842.2023.2190832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/27/2023] [Indexed: 03/23/2023]
Abstract
In finite element analysis bone is often treated as two-layered material that has a discontinuity between the cortical and cancellous bone, which leads to a singularity and incorrect stresses. The goal of this study was to eliminate this singularity and to create a more realistic representation of bone which also considers the transition zone between cortical and cancellous bone as observed in natural bone. This was achieved by modelling bone as a graded material and inserting node-specific values for Young's modulus in the finite element simulation, whereas the transition zone thickness was derived from a CT scan. The modelling was performed semi-automatically, and the maximum principal stresses of the new approach were compared to those of a conventional approach. The new approach was found to effectively avoid singularities and provides more accurate predictions of stress in areas of the bone transition zone. As the approach is automatable and causes rather small overhead it is recommended for use in future work, when the problem at hand requires evaluating stresses close to the former singularity.
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Affiliation(s)
- Oliver Roffmann
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany
| | - Meike Stiesch
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany
| | - Andreas Greuling
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany
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26
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Vendrami C, Shevroja E, Gonzalez Rodriguez E, Gatineau G, Elmers J, Reginster J, Harvey NC, Lamy O, Hans D. Muscle parameters in fragility fracture risk prediction in older adults: A scoping review. J Cachexia Sarcopenia Muscle 2024; 15:477-500. [PMID: 38284511 PMCID: PMC10995267 DOI: 10.1002/jcsm.13418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/01/2023] [Accepted: 11/28/2023] [Indexed: 01/30/2024] Open
Abstract
Half of osteoporotic fractures occur in patients with normal/osteopenic bone density or at intermediate or low estimated risk. Muscle measures have been shown to contribute to fracture risk independently of bone mineral density. The objectives were to review the measurements of muscle health (muscle mass/quantity/quality, strength and function) and their association with incident fragility fractures and to summarize their use in clinical practice. This scoping review follows the PRISMA-ScR guidelines for reporting. Our search strategy covered the three overreaching concepts of 'fragility fractures', 'muscle health assessment' and 'risk'. We retrieved 14 745 references from Medline Ovid SP, EMBASE, Web of Science Core Collection and Google Scholar. We included original and prospective studies on community-dwelling adults aged over 50 years that analysed an association between at least one muscle parameter and incident fragility fractures. We systematically extracted 17 items from each study, including methodology, general characteristics and results. Data were summarized in tables and graphically presented in adjusted forest plots. Sixty-seven articles fulfilled the inclusion criteria. In total, we studied 60 muscle parameters or indexes and 322 fracture risk ratios over 2.8 million person-years (MPY). The median (interquartile range) sample size was 1642 (921-5756), age 69.2 (63.5-73.6) years, follow-up 10.0 (4.4-12.0) years and number of incident fragility fractures 166 (88-277). A lower muscle mass was positively/not/negatively associated with incident fragility fracture in 28 (2.0), 64 (2.5) and 10 (0.2 MPY) analyses. A lower muscle strength was positively/not/negatively associated with fractures in 53 (1.3), 57 (1.7 MPY) and 0 analyses. A lower muscle function was positively/not/negatively associated in 63 (1.9), 45 (1.0 MPY) and 0 analyses. An in-depth analysis shows how each single muscle parameter was associated with each fragility fractures subtype. This review summarizes markers of muscle health and their association with fragility fractures. Measures of muscle strength and function appeared to perform better for fracture risk prediction. Of these, hand grip strength and gait speed are likely to be the most practical measures for inclusion in clinical practice, as in the evaluation of sarcopenia or in further fracture risk assessment scores. Measures of muscle mass did not appear to predict fragility fractures and might benefit from further research, on D3-creatine dilution test, lean mass indexes and artificial intelligence methods.
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Affiliation(s)
- Colin Vendrami
- Interdisciplinary Center of Bone Diseases, Rheumatology Unit, Department of Bone and JointLausanne University Hospital and University of LausanneLausanneSwitzerland
- Internal Medicine Unit, Department of Internal MedicineLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Enisa Shevroja
- Interdisciplinary Center of Bone Diseases, Rheumatology Unit, Department of Bone and JointLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Elena Gonzalez Rodriguez
- Interdisciplinary Center of Bone Diseases, Rheumatology Unit, Department of Bone and JointLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Guillaume Gatineau
- Interdisciplinary Center of Bone Diseases, Rheumatology Unit, Department of Bone and JointLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Jolanda Elmers
- University Library of Medicine, Faculty of Biology and MedicineLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Jean‐Yves Reginster
- WHO Collaborating Center for Public Health Aspects of Musculo‐Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health EconomicsUniversity of LiègeLiègeBelgium
| | - Nicholas C. Harvey
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Olivier Lamy
- Interdisciplinary Center of Bone Diseases, Rheumatology Unit, Department of Bone and JointLausanne University Hospital and University of LausanneLausanneSwitzerland
- Internal Medicine Unit, Department of Internal MedicineLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Didier Hans
- Interdisciplinary Center of Bone Diseases, Rheumatology Unit, Department of Bone and JointLausanne University Hospital and University of LausanneLausanneSwitzerland
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27
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Poudel SB, Frikha-Benayed D, Ruff RR, Yildirim G, Dixit M, Korstanje R, Robinson L, Miller RA, Harrison DE, Strong JR, Schaffler MB, Yakar S. Targeting mitochondrial dysfunction using methylene blue or mitoquinone to improve skeletal aging. Aging (Albany NY) 2024; 16:4948-4964. [PMID: 38535998 PMCID: PMC11006499 DOI: 10.18632/aging.205147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/27/2023] [Indexed: 04/06/2024]
Abstract
Methylene blue (MB) is a well-established antioxidant that has been shown to improve mitochondrial function in both in vitro and in vivo settings. Mitoquinone (MitoQ) is a selective antioxidant that specifically targets mitochondria and effectively reduces the accumulation of reactive oxygen species. To investigate the effect of long-term administration of MB on skeletal morphology, we administered MB to aged (18 months old) female C57BL/J6 mice, as well as to adult male and female mice with a genetically diverse background (UM-HET3). Additionally, we used MitoQ as an alternative approach to target mitochondrial oxidative stress during aging in adult female and male UM-HET3 mice. Although we observed some beneficial effects of MB and MitoQ in vitro, the administration of these compounds in vivo did not alter the progression of age-induced bone loss. Specifically, treating 18-month-old female mice with MB for 6 or 12 months did not have an effect on age-related bone loss. Similarly, long-term treatment with MB from 7 to 22 months or with MitoQ from 4 to 22 months of age did not affect the morphology of cortical bone at the mid-diaphysis of the femur, trabecular bone at the distal-metaphysis of the femur, or trabecular bone at the lumbar vertebra-5 in UM-HET3 mice. Based on our findings, it appears that long-term treatment with MB or MitoQ alone, as a means to reduce skeletal oxidative stress, is insufficient to inhibit age-associated bone loss. This supports the notion that interventions solely with antioxidants may not provide adequate protection against skeletal aging.
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Affiliation(s)
- Sher Bahadur Poudel
- Department of Molecular Pathobiology, David B. Kriser Dental Center, New York University College of Dentistry, New York, NY 10010-4086, USA
| | - Dorra Frikha-Benayed
- Department of Biomedical Engineering, City College of New York, New York, NY 10031, USA
| | - Ryan R. Ruff
- Department of Epidemiology and Health Promotion, David B. Kriser Dental Center, New York University College of Dentistry, New York, NY 10010-4086, USA
| | - Gozde Yildirim
- Department of Molecular Pathobiology, David B. Kriser Dental Center, New York University College of Dentistry, New York, NY 10010-4086, USA
| | - Manisha Dixit
- Department of Molecular Pathobiology, David B. Kriser Dental Center, New York University College of Dentistry, New York, NY 10010-4086, USA
| | - Ron Korstanje
- Jackson Aging Center, Nathan Shock Center for Excellence in the Basic Biology of Aging, The Jackson’s Laboratories, Aging Center, Bar Harbor, ME 04609, USA
| | - Laura Robinson
- Jackson Aging Center, Nathan Shock Center for Excellence in the Basic Biology of Aging, The Jackson’s Laboratories, Aging Center, Bar Harbor, ME 04609, USA
| | - Richard A. Miller
- Department of Pathology and Geriatrics Center, University of Michigan, Ann Arbor, MI 48109, USA
| | | | - John R. Strong
- Geriatric Research, Education and Clinical Center and Research Service, South Texas Veterans Health Care System, San Antonio, TX 78229, USA
- Department of Pharmacology, Barshop Institute for Longevity and Aging Studies, The University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - Mitchell B. Schaffler
- Department of Biomedical Engineering, City College of New York, New York, NY 10031, USA
| | - Shoshana Yakar
- Department of Molecular Pathobiology, David B. Kriser Dental Center, New York University College of Dentistry, New York, NY 10010-4086, USA
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28
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Walle M, Duseja A, Whittier DE, Vilaca T, Paggiosi M, Eastell R, Müller R, Collins CJ. Bone remodeling and responsiveness to mechanical stimuli in individuals with type 1 diabetes mellitus. J Bone Miner Res 2024; 39:85-94. [PMID: 38477745 DOI: 10.1093/jbmr/zjad014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 03/14/2024]
Abstract
Type 1 diabetes mellitus (T1DM) has been linked to increased osteocyte apoptosis, local accumulation of mineralized lacunar spaces, and microdamage suggesting an impairment of the mechanoregulation network in affected individuals. Diabetic neuropathy might exacerbate this dysfunction through direct effects on bone turnover, and indirect effects on balance, muscle strength, and gait. However, the in vivo effects of impaired bone mechanoregulation on bone remodeling in humans remain underexplored. This longitudinal cohort study assessed consenting participants with T1DM and varying degree of distal symmetric sensorimotor polyneuropathy (T1DM, n = 20, median age 46.5 yr, eight female) and controls (CTRL; n = 9, median age 59.0 yr, four female) at baseline and 4-yr follow-up. Nerve conduction in participants with T1DM was tested using DPNCheck and bone remodeling was quantified with longitudinal high-resolution peripheral quantitative-computed tomography (HR-pQCT, 82 μm) at the standard distal sites. Local trabecular bone formation (Tb.F) and resorption (Tb.R) sites were captured by implementing 3D rigid image registration of HR-pQCT images, and the mechanical environment across the bone microarchitecture at these sites was simulated using micro-finite element analysis. We calculated odds ratios to determine the likelihood of bone formation (ORF) and resorption (ORR) with increasing/decreasing strain in percent as markers for mechanoregulation. At the distal radius, Tb.F was 47% lower and Tb.R was 59% lower in T1DM participants compared with CTRL (P < .05). Tb.F correlated positively with nerve conduction amplitude (R = 0.69, P < .05) in participants with T1DM and negatively with glycated hemoglobin (HbA1c) (R = -0.45, P < .05). Additionally, ORF was 34% lower and ORR was 18% lower in T1DM compared with CTRL (P < .05). Our findings represent in vivo evidence suggesting that bone remodeling in individuals with T1DM is in a state of low responsiveness to mechanical stimuli, resulting in impaired bone formation and resorption rates; these correlate to the degree of neuropathy and level of diabetes control.
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Affiliation(s)
- Matthias Walle
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Ankita Duseja
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Danielle E Whittier
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
- Department of Osteoporosis, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tatiane Vilaca
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Margaret Paggiosi
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Richard Eastell
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Ralph Müller
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Caitlyn J Collins
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, United States
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29
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Buck HV, Stains JP. Osteocyte-mediated mechanical response controls osteoblast differentiation and function. Front Physiol 2024; 15:1364694. [PMID: 38529481 PMCID: PMC10961341 DOI: 10.3389/fphys.2024.1364694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/29/2024] [Indexed: 03/27/2024] Open
Abstract
Low bone mass is a pervasive global health concern, with implications for osteoporosis, frailty, disability, and mortality. Lifestyle factors, including sedentary habits, metabolic dysfunction, and an aging population, contribute to the escalating prevalence of osteopenia and osteoporosis. The application of mechanical load to bone through physical activity and exercise prevents bone loss, while sufficient mechanical load stimulates new bone mass acquisition. Osteocytes, cells embedded within the bone, receive mechanical signals and translate these mechanical cues into biological signals, termed mechano-transduction. Mechano-transduction signals regulate other bone resident cells, such as osteoblasts and osteoclasts, to orchestrate changes in bone mass. This review explores the mechanisms through which osteocyte-mediated response to mechanical loading regulates osteoblast differentiation and bone formation. An overview of bone cell biology and the impact of mechanical load will be provided, with emphasis on the mechanical cues, mechano-transduction pathways, and factors that direct progenitor cells toward the osteoblast lineage. While there are a wide range of clinically available treatments for osteoporosis, the majority act through manipulation of the osteoclast and may have significant disadvantages. Despite the central role of osteoblasts to the deposition of new bone, few therapies directly target osteoblasts for the preservation of bone mass. Improved understanding of the mechanisms leading to osteoblastogenesis may reveal novel targets for translational investigation.
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Affiliation(s)
| | - Joseph Paul Stains
- School of Medicine, University of Maryland, Baltimore, MD, United States
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30
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Nasr El-Din WA, Potu BK, Fadel RA, Salem AH, Sequeira RP, Almarabheh A, El-Fark MMO. Impact of maternal topiramate ingestion on ossification of skull and appendicular bones in rat fetuses. Morphologie 2024; 108:100702. [PMID: 37890283 DOI: 10.1016/j.morpho.2023.100702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/16/2023] [Accepted: 07/16/2023] [Indexed: 10/29/2023]
Abstract
The skull and appendicular bones are derived from different embryological sources during their development. The impact of prenatal exposure of topiramate on ossification of these bones is not adequately studied. The goal of this study was to assess the ossification patterns of the craniofacial bones and bones of the forelimbs and hindlimbs in 20-day-old rat fetuses after maternal exposure to topiramate at doses equivalent to human therapeutic doses. Three groups of Sprague-Dawley pregnant rats were used: control, topiramate 50mg/kg/day (T50) and topiramate 100mg/kg/day (T100). Topiramate was given by oral gavage from day 6 to day19 of gestation. Ossification was evaluated in the bones of 20 days fetuses after staining with Alizarin red. Results showed a significant reduction in complete ossified centers of the metacarpal, metatarsal and craniofacial bones in topiramate-exposed fetuses at both doses when compared to the control group. Also, a significant decrease in the length of ossified part of the long bones of the forelimbs and hindlimbs in topiramate-exposed fetuses at both doses was noted when compared to the control group. Crown-rump length and fetal weight were significantly decreased in topiramate treated groups compared to the control group. In all examined groups, there was a positive correlation between the crown-rump length and the lengths of humerus and femur. No abnormalities in the ossified bones and no significant changes in their ossification pattern were observed between the treated groups. In conclusion, prenatal administration of topiramate in doses equivalent to human therapeutic doses delayed ossification and development of craniofacial and appendicular bones in rat fetuses and their effects are not dose dependent at doses investigated. The implications of these findings in women who require topiramate therapy in pregnancy merit further evaluation.
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Affiliation(s)
- W A Nasr El-Din
- Department of Anatomy, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; Department of Human Anatomy and Embryology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - B K Potu
- Department of Anatomy, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
| | - R A Fadel
- Department of Anatomy, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; Department of Human Anatomy and Embryology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - A H Salem
- Department of Anatomy, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; Department of Human Anatomy and Embryology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - R P Sequeira
- Department of Pharmacology and Therapeutics, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - A Almarabheh
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - M M O El-Fark
- Department of Human Anatomy and Embryology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Costa da Silva RG, Sun TC, Mishra AP, Boyde A, Doube M, Riggs CM. Intracortical remodelling increases in highly loaded bone after exercise cessation. J Anat 2024; 244:424-437. [PMID: 37953410 PMCID: PMC10862154 DOI: 10.1111/joa.13969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/18/2023] [Accepted: 10/18/2023] [Indexed: 11/14/2023] Open
Abstract
Resorption within cortices of long bones removes excess mass and damaged tissue and increases during periods of reduced mechanical loading. Returning to high-intensity exercise may place bones at risk of failure due to increased porosity caused by bone resorption. We used point-projection X-ray microscopy images of bone slices from highly loaded (metacarpal, tibia) and minimally loaded (rib) bones from 12 racehorses, 6 that died during a period of high-intensity exercise and 6 that had a period of intense exercise followed by at least 35 days of rest prior to death, and measured intracortical canal cross-sectional area (Ca.Ar) and number (N.Ca) to infer remodelling activity across sites and exercise groups. Large canals that are the consequence of bone resorption (Ca.Ar >0.04 mm2 ) were 1.4× to 18.7× greater in number and area in the third metacarpal bone from rested than exercised animals (p = 0.005-0.008), but were similar in number and area in ribs from rested and exercised animals (p = 0.575-0.688). An intermediate relationship was present in the tibia, and when large canals and smaller canals that result from partial bony infilling (Ca.Ar >0.002 mm2 ) were considered together. The mechanostat may override targeted remodelling during periods of high mechanical load by enhancing bone formation, reducing resorption and suppressing turnover. Both systems may work synergistically in rest periods to remove excess and damaged tissue.
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Affiliation(s)
| | - Tsim Christopher Sun
- Sydney School of Veterinary ScienceUniversity of SydneyCamperdownNew South WalesAustralia
| | - Ambika Prasad Mishra
- Department of Infectious Diseases and Public HealthCity University of Hong KongKowloonHong Kong
| | - Alan Boyde
- Barts and The London School of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - Michael Doube
- Department of Infectious Diseases and Public HealthCity University of Hong KongKowloonHong Kong
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Farage-O’Reilly SM, Cheong VS, Pickering E, Pivonka P, Bellantuono I, Kadirkamanathan V, Dall’Ara E. The loading direction dramatically affects the mechanical properties of the mouse tibia. Front Bioeng Biotechnol 2024; 12:1335955. [PMID: 38380263 PMCID: PMC10877372 DOI: 10.3389/fbioe.2024.1335955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/18/2024] [Indexed: 02/22/2024] Open
Abstract
Introduction: The in vivo tibial loading mouse model has been extensively used to evaluate bone adaptation in the tibia after mechanical loading treatment. However, there is a prevailing assumption that the load is applied axially to the tibia. The aim of this in silico study was to evaluate how much the apparent mechanical properties of the mouse tibia are affected by the loading direction, by using a validated micro-finite element (micro-FE) model of mice which have been ovariectomized and exposed to external mechanical loading over a two-week period. Methods: Longitudinal micro-computed tomography (micro-CT) images were taken of the tibiae of eleven ovariectomized mice at ages 18 and 20 weeks. Six of the mice underwent a mechanical loading treatment at age 19 weeks. Micro-FE models were generated, based on the segmented micro-CT images. Three models using unitary loads were linearly combined to simulate a range of loading directions, generated as a function of the angle from the inferior-superior axis (θ, 0°-30° range, 5° steps) and the angle from the anterior-posterior axis (ϕ, 0°: anterior axis, positive anticlockwise, 0°-355° range, 5° steps). The minimum principal strain was calculated and used to estimate the failure load, by linearly scaling the strain until 10% of the nodes reached the critical strain level of -14,420 με. The apparent bone stiffness was calculated as the ratio between the axial applied force and the average displacement along the longitudinal direction, for the loaded nodes. Results: The results demonstrated a high sensitivity of the mouse tibia to the loading direction across all groups and time points. Higher failure loads were found for several loading directions (θ = 10°, ϕ 205°-210°) than for the nominal axial case (θ = 0°, ϕ = 0°), highlighting adaptation of the bone for loading directions far from the nominal axial one. Conclusion: These results suggest that in studies which use mouse tibia, the loading direction can significantly impact the failure load. Thus, the magnitude and direction of the applied load should be well controlled during the experiments.
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Affiliation(s)
- Saira Mary Farage-O’Reilly
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Healthy Lifespan Institute, University of Sheffield, Sheffield, United Kingdom
- Division of Clinical Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Vee San Cheong
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Future Health Technologies Programme, Singapore-ETH Centre, Singapore, Singapore
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, United Kingdom
| | - Edmund Pickering
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, QLD, Australia
| | - Peter Pivonka
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ilaria Bellantuono
- Healthy Lifespan Institute, University of Sheffield, Sheffield, United Kingdom
- Division of Clinical Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Visakan Kadirkamanathan
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, United Kingdom
| | - Enrico Dall’Ara
- Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Healthy Lifespan Institute, University of Sheffield, Sheffield, United Kingdom
- Division of Clinical Medicine, University of Sheffield, Sheffield, United Kingdom
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Altai Z, Montefiori E, Li X. Effect of Muscle Forces on Femur During Level Walking Using a Virtual Population of Older Women. Methods Mol Biol 2024; 2716:335-349. [PMID: 37702947 DOI: 10.1007/978-1-0716-3449-3_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
Aging is associated with a greater risk of muscle and bone disorders such as sarcopenia and osteoporosis. These conditions substantially affect one's mobility and quality of life. In the past, muscles and bones are often studied separately using generic or scaled information that are not personal-specific, nor are they representative of the large variations seen in the elderly population. Consequently, the mechanical interaction between the aged muscle and bone is not well understood, especially when carrying out daily activities. This study presents a coupling approach across the body and the organ level, using fully personal-specific musculoskeletal and finite element models in order to study femoral loading during level walking. Variations in lower limb muscle volume/force were examined using a virtual population. These muscle forces were then applied to the finite element model of the femur to study the variations in predicted strains. The study shows that effective coupling across two scales can be carried out to study the muscle-bone interaction in elderly women. The generation of a virtual population is a feasible approach to augment anatomical variations based on a small population that could mimic variations seen in a larger cohort. This is a valuable alternative to overcome the limitation or the need to collect dataset from a large population, which is both time and resource consuming.
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Affiliation(s)
- Zainab Altai
- School of Sport Rehabilitation and Exercises Sciences, University of Essex, Colchester, UK
| | - Erica Montefiori
- Department of Mechanical Engineering, Insigneo institute for in silico medicine, University of Sheffield, Sheffield, UK
| | - Xinshan Li
- Department of Mechanical Engineering, Insigneo institute for in silico medicine, University of Sheffield, Sheffield, UK.
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Reid RAG, Davies C, Cunningham C. The developing juvenile talus: Radiographic identification of distinct ontogenetic phases and structural trajectories. J Anat 2024; 244:75-95. [PMID: 37559440 PMCID: PMC10734662 DOI: 10.1111/joa.13940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/20/2023] [Accepted: 07/19/2023] [Indexed: 08/11/2023] Open
Abstract
Trabecular bone architecture in the developing skeleton is a widely researched area of bone biomechanics; however, despite its significance in weight-bearing locomotion, the developing talus has received limited examination. This study investigates the talus with the purpose of identifying ontogenetic phases and developmental patterns that contribute to the growing understanding of the developing juvenile skeleton. Colour gradient mapping and radiographic absorptiometry were utilised to investigate 62 human tali from 38 individuals, ranging in age-at-death from 28 weeks intrauterine to 20 years of age. The perinatal talus exhibited a rudimentary pattern comparable to the structural organisation observed within the late adolescent talus. This early internal organisation is hypothesised to be related to the vascular pattern of the talus. After 2 years of age, the talus demonstrated refinement, where radiographic trajectories progressively developed into patterns consistent with adult trabecular organisation, which are linked to the forces associated with the bipedal gait, suggesting a strong influence of biomechanical forces on the development of the talus.
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Affiliation(s)
- Rebecca A. G. Reid
- Centre for Anatomy and Human Identification, School of Science and EngineeringUniversity of DundeeDundeeUK
| | - Catriona Davies
- Centre for Anatomy and Human Identification, School of Science and EngineeringUniversity of DundeeDundeeUK
| | - Craig Cunningham
- Centre for Anatomy and Human Identification, School of Science and EngineeringUniversity of DundeeDundeeUK
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Kasture S, Khadilkar A, Padidela R, Gondhalekar K, Patil R, Khadilkar V. Effect of Yoga or Physical Exercise on Muscle Function in Rural Indian Children: A Randomized Controlled Trial. J Phys Act Health 2024; 21:85-93. [PMID: 37931617 DOI: 10.1123/jpah.2023-0182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/12/2023] [Accepted: 09/24/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Synergistic effects of yoga or physical exercise (PE) along with protein supplementation on children's muscle function in rural India have not been studied. Hence, we aimed to study the effect of yoga and PE along with protein supplementation on muscle function in healthy 6- to 11-year-old rural Indian children post 6 months of intervention. METHODS A randomized controlled trial on 232 children, recruited into 3 groups, each receiving 1 protein-rich ladoo (148 kcal, 7 g protein/40 g ladoo-an Indian sweet snack) daily and performing (1) yoga (n = 78) for 30 minutes 5 times per week, (2) PE (n = 76) for 30 minutes 5 times per week, or (3) control group (n = 78) no additional exercise. Maximum power, maximum voluntary force (Fmax), and grip strength (GS) were measured. Data were analyzed using paired t tests and a 2-way mixed analysis of variance with post hoc Bonferroni adjustment. RESULTS GS, maximum power, and Fmax within yoga group increased significantly (P < .05) from baseline to endline. GS and Fmax increased significantly within PE group postintervention (P < .001). In controls, GS increased (P < .05) at endline. No significant effect of the intervention was observed on the change in maximum power (P > .05) postintervention. The 2 exercise groups showed significant increase in Fmax compared with the control group (P < .05). Similarly, increase in GS was significantly higher in both the exercise groups compared with the control group (P < .05). No significant difference was observed in change in muscle function between the 2 exercise groups (P > .05). CONCLUSIONS Structured physical activity along with protein supplementation resulted in improved muscle function in children. Yoga and PE showed a comparable impact on muscle force.
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Affiliation(s)
- Sonal Kasture
- Department of Growth and Pediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
- School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
| | - Anuradha Khadilkar
- Department of Growth and Pediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
- School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
| | - Raja Padidela
- Department of Pediatric Endocrinology, Royal Manchester Children's Hospital and Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Ketan Gondhalekar
- Department of Growth and Pediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Radhika Patil
- Department of Physiotherapy, Jehangir Hospital, Pune, Maharashtra, India
| | - Vaman Khadilkar
- Department of Growth and Pediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
- School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
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Kong J, Tian C, Zhu L. Effect of different types of Tai Chi exercise programs on the rate of change in bone mineral density in middle-aged adults at risk of osteoporosis: a randomized controlled trial. J Orthop Surg Res 2023; 18:949. [PMID: 38072989 PMCID: PMC10712169 DOI: 10.1186/s13018-023-04324-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/26/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE To evaluate three Tai Chi (TC) exercise programs as intervention measures to compare their effects on improving rate of change in bone mineral density (BMD) in elderly individuals with osteoporosis (OP) and to propose the optimal exercise duration. METHODS A randomized controlled trial (RCT) was conducted to identify study participants based on inclusion and exclusion criteria. Due to subject attrition, the number of participants analyzed decreased from 60 to 49. These participants were divided into four groups: 24-style TC Chuan group (24TCCG) (n = 13, 7 males/6 females), TC Kung Fu Fan group (TCKFFG) (n = 12, 5 males/7 females), TC Softball group (TCSBG) (n = 11, 6 males/5 females), and a control group (CG) (n = 13, 6 males/7 females). Except for the control group, each group received different TC exercise programs four times a week for 60 min per session, lasting for 16 weeks. BMD was measured using dual-energy X-ray absorptiometry (DXA) at the L2-L4 lumbar vertebrae, Ward's triangle, femoral neck, and greater trochanter. The rate of change of BMD was calculated using the formula. RESULTS Compared with CG, all three TC groups showed significant improvements in BMD changes (P < 0.05), but their effects on the improvement of femoral neck and greater tuberosity BMD change rates were similar (P > 0.05). In addition, compared to the other exercise regimens, 24TCCG demonstrated more significant improvements in BMD at the L2-L4 lumbar vertebrae region and exhibited a more pronounced improvement in Ward's triangle BMD after only 8 weeks (P < 0.05). Short-term (≤ 4 weeks) TCKFFG was more effective than TCSBG in enhancing femoral neck BMD (P < 0.05). However, statistical significance was not found (P > 0.05) in all other cases. CONCLUSION These three TC exercise programs have similar positive effects on the BMD of the femoral neck and greater trochanter. However, compared with other exercise schemes, 24TCC showed a more significant improvement in BMD of the L2-L4 lumbar vertebrae region after just 8 weeks, as well as a more pronounced improvement in BMD of Ward's triangle. In terms of improving femoral neck BMD, TCKFF was found to be more effective than TCSB in less than 4 weeks. This study provides evidence for the effectiveness of TC exercise in improving BMD and preventing OP in the middle-aged and elderly high-risk population.
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Affiliation(s)
- Jianda Kong
- College of Sports Science, Qufu Normal University, Qufu, China
| | - Chunlan Tian
- College of Sports Science, Qufu Normal University, Qufu, China
| | - Lei Zhu
- College of Sports Science, Qufu Normal University, Qufu, China.
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Jafariandehkordi A, Daneshmehr A. Studying the mechanical properties of the mandible and injury prediction under the effect of ossification factors. J Mech Behav Biomed Mater 2023; 148:106209. [PMID: 37918338 DOI: 10.1016/j.jmbbm.2023.106209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND AND OBJECTIVE It is essential to know the quantitative interactions between biological tissues and external mechanical and chemical stimuli. This assists the physicians to better know the quantitative behavior of the tissue and plan more effective therapy. In the literature, the effect of the chemical and mechanical loading was investigated on the bone biological cell activities and some mechanical features, but a lack of prediction of bone injury under the chemical and mechanical factors was sensed. Therefore, the present study aims to investigate the effects of the application of major chemical factors involved in ossification, including RANKL1 (Receptor Activator of Nuclear Factor Kappa Beta Ligand), PTH2 (Parathyroid Hormone), and OPG3 (Osteoprotegerin) on the mandibular bone biological osteoblast and osteoclast activities and mechanical properties. Moreover, the study assesses the bone injury possibility under uniform mastication pressure applied on the premolar tooth in terms of the mechanostat theory undergoing the effects of the chemical factors. METHODS A 3D geometry of the mandible-tooth assembly was generated from the CT image dataset. The geometry was next purified, solidified, and exported to FEM4 (Finite Element Method) software to be meshed, where boundary conditions and loading were applied. Moreover, the mathematical system of differential equations to model the chemical factor effects on osteoblast and osteoclast activities as well as bone matrix volume fraction and elastic stiffness relations were applied. Next, the values of the equivalent strain were calculated to predict the injury states of the bone. RESULTS The results complied with the literature data. The results showed that RANKL and PTH increased the values of the equivalent strain from 450 με to 11500 με, while OPG reduced that from 450 με to 300 με. CONCLUSIONS Therefore, RANKL and PTH doses of this study put the bone at risk of injury compared to the baseline of no dose applied, while OPG secured the bone from injury.
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Zhong S, Shi Q, Van Dessel J, Gu Y, Lübbers HT, Yang S, Sun Y, Politis C. Biomechanical feasibility of non-locking system in patient-specific mandibular reconstruction using fibular free flaps. J Mech Behav Biomed Mater 2023; 148:106197. [PMID: 37875041 DOI: 10.1016/j.jmbbm.2023.106197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023]
Abstract
Mandibular reconstruction with free fibular flaps is frequently used to restore segmental defects. The osteosythesis, including locking and non-locking plate/screw systems, is essential to the mandibular reconstruction. Compared with the non-locking system that requires good adaption between plate and bone, the locking system appears to present a better performance by locking the plate to fixation screws. However, it also brings about limitations on screw options, a higher risk of screw failure, and difficulties in screw placement. Furthermore, its superiority is undermined by the advancing of patient-specific implant design and additive manufacturing. A customized plate can be designed and fabricated to accurately match the mandibular contour for patient-specific mandibular reconstruction. Consequently, the non-locking system seems more practicable with such personalized plates, and its biomechanical feasibility ought to be estimated. Finite element analyses of mandibular reconstruction assemblies were conducted for four most common segmental mandibular reconstructions regarding locking and non-locking systems under incisal biting and right molars clenching, during which the influencing factor of muscles' capacity was introduced to simulate the practical loadings after mandibular resection and reconstruction surgeries. Much higher, somewhat lower, and similar maximum von Mises stresses are separately manifested by the patient-specific mandibular reconstruction plate (PSMRP), fixation screws, and reconstructed mandible with the non-locking system than those with the locking system. Equivalent maximum displacements are identified between PSMRPs, fixation screws, and reconstructed mandibles with the non-locking and locking system in all four reconstruction types during two masticatory tasks. Parallel maximum and minimum principal strain distributions are shared by the reconstructed mandibles with the non-locking and locking system in four mandibular reconstructions during both occlusions. Conclusively, it is feasible to use the non-locking system in case of patient-specific mandibular reconstruction with fibular free flaps based on the adequate safety, comparable stability, and analogous mechanobiology it presents compared with the locking system in a more manufacturable and economical way.
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Affiliation(s)
- Shengping Zhong
- Department of Imaging & Pathology, Biomedical Sciences Group, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Qimin Shi
- Department of Imaging & Pathology, Biomedical Sciences Group, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium; Yantai Research Institute, Harbin Engineering University, Qingdao Avenue 1, 264000, Yantai, PR China
| | - Jeroen Van Dessel
- Department of Imaging & Pathology, Biomedical Sciences Group, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Yifei Gu
- Department of Imaging & Pathology, Biomedical Sciences Group, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium; Department of Dentistry, Dushu Lake Hospital Affiliated to Soochow University, Chongwen Road 9, 215000, Suzhou, PR China
| | - Heinz-Theo Lübbers
- Clinic for Cranio-Maxillofacial Surgery, University Hospital of Zurich, Frauenklinikstrasse 24, Zurich, CH-8091, Switzerland
| | - Shoufeng Yang
- Yantai Research Institute, Harbin Engineering University, Qingdao Avenue 1, 264000, Yantai, PR China.
| | - Yi Sun
- Department of Imaging & Pathology, Biomedical Sciences Group, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Constantinus Politis
- Department of Imaging & Pathology, Biomedical Sciences Group, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
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Florence GE, Oosthuyse T, Bosch AN. Skeletal site-specific effects of jump training on bone mineral density in adults: a systematic review and meta-analysis. J Sports Sci 2023; 41:2063-2076. [PMID: 38305252 DOI: 10.1080/02640414.2024.2312052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 01/19/2024] [Indexed: 02/03/2024]
Abstract
Preserving or preventing declines in bone mineral density (BMD) is imperative. As jumping is a high-impact bone-loading action, this meta-analysis evaluated the efficacy of jump training to improve BMD and bone turnover relative to non-jumping controls in men and women > 18 years, following Preferred Reported Items for Systematic Reviews and Meta-Analysis guidelines. PubMed and COCHRANE Library databases were searched until February 2022. Fifteen articles (19 jumping-trials) met the predetermined search criteria. Eighteen trials were included for BMD data (n = 666 participants). There was a significant small-moderate effect of jumping on femoral neck BMD (%mean difference: 95%CI, +1.50%: 0.83%; 2.17%, p < 0.0001), that remained significant after sub-analysis by age for both younger (+1.81%: 0.98%; 2.65%) and older adults (+1.03%: 0.02%; 2.03%). BMD of total hip (+1.26%: 0.56%; 1.96% vs + 0.06%: -0.96%; 1.08%), and trochanter (+0.84%: 0.20%; 1.48% vs -0.16%: -1.08%; 0.76%) increased significantly with jump training only in younger adults and non-significantly at the lumbar spine (+0.84%: -0.02%; 1.7% vs -0.09%: -0.96%; 0.77%) only in younger but not older adults, respectively. The BMD response to jump training appears to be site-specific, with the highest sensitivity at the femoral neck. No dose-response effect suggests moderate certainty of a gain in femoral neck BMD when performing the median jump-load of 50 jumps four times weekly.
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Affiliation(s)
- Gabriella E Florence
- Institute of Sport and Exercise Medicine, Division of Orthopaedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Tanja Oosthuyse
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Health through Physical Activity, Lifestyle and Sport Research Centre, Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Andrew N Bosch
- Health through Physical Activity, Lifestyle and Sport Research Centre, Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Roland M, Diebels S, Orth M, Pohlemann T, Bouillon B, Tjardes T. Reappraisal of clinical trauma trials: the critical impact of anthropometric parameters on fracture gap micro-mechanics-observations from a simulation-based study. Sci Rep 2023; 13:20450. [PMID: 37993727 PMCID: PMC10665421 DOI: 10.1038/s41598-023-47910-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 11/20/2023] [Indexed: 11/24/2023] Open
Abstract
The evidence base of surgical fracture care is extremely sparse with only few sound RCTs available. It is hypothesized that anthropometric factors relevantly influence mechanical conditions in the fracture gap, thereby interfering with the mechanoinduction of fracture healing. Development of a finite element model of a tibia fracture, which is the basis of an in silico population (n = 300) by systematic variation of anthropometric parameters. Simulations of the stance phase and correlation between anthropometric parameters and the mechanical stimulus in the fracture gap. Analysis of the influence of anthropometric parameters on statistical dispersion between in silico trial cohorts with respect to the probability to generate two, with respect to anthropometric parameters statistically different trial cohorts, given the same power assumptions. The mechanical impact in the fracture gap correlates with anthropometric parameters; confirming the hypothesis that anthropometric factors are a relevant entity. On a cohort level simulation of a fracture trial showed that given an adequate power the principle of randomization successfully levels out the impact of anthropometric factors. From a clinical perspective these group sizes are difficult to achieve, especially when considering that the trials takes advantage of a "laboratory approach ", i.e. the fracture type has not been varied, such that in real world trials the cohort size have to be even larger to level out the different configurations of fractures gaps. Anthropometric parameters have a significant impact on the fracture gap mechanics. The cohort sizes necessary to level out this effect are difficult or unrealistic to achieve in RCTs, which is the reason for sparse evidence in orthotrauma. New approaches to clinical trials taking advantage of modelling and simulation techniques need to be developed and explored.
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Affiliation(s)
- Michael Roland
- Chair of Applied Mechanics, Saarland University, Campus A4 2, 1. OG, 66123, Saarbrücken, Germany.
| | - Stefan Diebels
- Chair of Applied Mechanics, Saarland University, Campus A4 2, 1. OG, 66123, Saarbrücken, Germany
| | - Marcel Orth
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Kirrberger Strasse 100, 66421, Homburg, Germany
| | - Tim Pohlemann
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Kirrberger Strasse 100, 66421, Homburg, Germany
| | - Bertil Bouillon
- Chair for Orthopedic Surgery, Trauma Surgery and Sportstraumatology, Department of Orthopedic Surgery, Trauma Surgery and Sportstraumatology, Cologne Merheim Medical Center, University Witten/Herdecke, Ostmerheimerstrasse 200, 51109, Cologne, Germany
| | - Thorsten Tjardes
- Chair for Orthopedic Surgery, Trauma Surgery and Sportstraumatology, Department of Orthopedic Surgery, Trauma Surgery and Sportstraumatology, Cologne Merheim Medical Center, University Witten/Herdecke, Ostmerheimerstrasse 200, 51109, Cologne, Germany
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Gregori G, Paudyal A, Barnouin Y, Celli A, Segoviano-Escobar MB, Armamento-Villareal R, Napoli N, Qualls C, Villareal DT. Indices of sarcopenic obesity are important predictors of finite element analysis-derived bone strength in older adults with obesity. Front Endocrinol (Lausanne) 2023; 14:1279321. [PMID: 38027147 PMCID: PMC10660264 DOI: 10.3389/fendo.2023.1279321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background The expanding population of older adults with obesity is a public health challenge, in part, because of the increased risk of fractures despite normal or high bone mineral density. Potential factors predisposing to fractures in this group include sarcopenia associated with obesity and impaired bone quality. We aimed to determine the contribution of sarcopenic obesity (SO) indices to bone strength as assessed by microfinite element analysis (μFEA) of high-resolution peripheral quantitative computed tomography (HR-pQCT). Methods One-hundred eighty-nine older (age ≥ 65 years) adults with obesity (BMI ≥ 30 kg/m2) participated in lifestyle intervention trials at our medical center. All underwent baseline measurements of bone strength (failure load and stiffness) using μFEA from HR-pQCT of the distal radius and tibia. In addition, SO indices [appendicular lean mass/weight (ALM/W) and percent body fat (FM%)] by dual-energy X-ray absorptiometry and handgrip strength (HGS) by dynamometry were assessed. SO was diagnosed and staged based on the 2022 ESPEN and EASO expert consensus statement. Results Both ALM/W and HGS were positively correlated explaining 28% to 36% of the variance in failure load and stiffness at the distal radius and tibia (all p < 0.001). In contrast, FM% was negatively correlated explaining 22% to 31% of the variance in failure load and stiffness at the distal radius and tibia (all p < 0.001). The associations of SO indices with failure load and stiffness remained significant after controlling for age, sex, race/ethnicity, diabetes, and 25-OH vitamin D (ALM/W: R 2 = 0.301 to 0.448, HGS: R 2 = 0.346 to 0.472, FM%: R 2 = 0.299 to 0.432) (p < 0.001 to 0.011). SO was diagnosed in 75/189 (40%) participants with 66/75 (88%) having functional or metabolic complications (stage II). Participants with SO had lower failure load and stiffness at the distal radius than participants with no SO (both p < 0.05). Conclusion These findings demonstrate that lower muscle mass and strength and higher fat mass may impair bone quality. Therefore, interventions that focus on preserving muscle mass and strength while reducing fat mass may be important to decrease fracture risk when older adults with obesity undertake lifestyle intervention therapy.
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Affiliation(s)
- Giulia Gregori
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, United States
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey Veterans Affairs (VA) Medical Center, Houston, TX, United States
| | - Arjun Paudyal
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, United States
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey Veterans Affairs (VA) Medical Center, Houston, TX, United States
| | - Yoann Barnouin
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, United States
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey Veterans Affairs (VA) Medical Center, Houston, TX, United States
| | - Alessandra Celli
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, United States
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey Veterans Affairs (VA) Medical Center, Houston, TX, United States
| | - Martha Belen Segoviano-Escobar
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, United States
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey Veterans Affairs (VA) Medical Center, Houston, TX, United States
| | - Reina Armamento-Villareal
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, United States
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey Veterans Affairs (VA) Medical Center, Houston, TX, United States
| | - Nicola Napoli
- Divison of Bone and Mineral Diseases, Washington University School of Medicine, St Louis, MO, United States
- Operative Research Unit of Osteo-metabolic Diseases, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Clifford Qualls
- Department of Mathematics and Statistics, School of Medicine, University of New Mexico, Albuquerque, NM, United States
| | - Dennis T. Villareal
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, United States
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey Veterans Affairs (VA) Medical Center, Houston, TX, United States
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Lau RWL, Cheuk KY, Hung VWY, Yu FWP, Tam EMS, Wong LLN, Zhang J, Lee WYW, Cheng JCY, Lam TP, Lau AYC. Handgrip strength assessment at baseline in addition to bone parameters could potentially predict the risk of curve progression in adolescent idiopathic scoliosis. Front Pediatr 2023; 11:1258454. [PMID: 38027290 PMCID: PMC10655030 DOI: 10.3389/fped.2023.1258454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Adolescent idiopathic scoliosis (AIS) is characterized by deranged bone and muscle qualities, which are important prognostic factors for curve progression. This retrospective case-control study aims to investigate whether the baseline muscle parameters, in addition to the bone parameters, could predict curve progression in AIS. Methods The study included a cohort of 126 female patients diagnosed with AIS who were between the ages of 12 and 14 years old at their initial clinical visit. These patients were longitudinally followed up every 6 months (average 4.08 years) until they reached skeletal maturity. The records of these patients were thoroughly reviewed as part of the study. The participants were categorized into two sub-groups: the progressive AIS group (increase in Cobb angle of ≥6°) and the stable AIS group (increase in Cobb angle <6°). Clinical and radiological assessments were conducted on each group. Results Cobb angle increase of ≥6° was observed in 44 AIS patients (34.9%) prior to skeletal maturity. A progressive AIS was associated with decreased skeletal maturity and weight, lower trunk lean mass (5.7%, p = 0.027) and arm lean mass (8.9%, p < 0.050), weaker dominant handgrip strength (8.8%, p = 0.027), deranged cortical compartment [lower volumetric bone mineral density (vBMD) by 6.5%, p = 0.002], and lower bone mechanical properties [stiffness and estimated failure load lowered by 13.2% (p = 0.005) and 12.5% (p = 0.004)]. The best cut-off threshold of maximum dominant handgrip strength is 19.75 kg for distinguishing progressive AIS from stable AIS (75% sensitivity and 52.4% specificity, p = 0.011). Discussion Patients with progressive AIS had poorer muscle and bone parameters than patients with stable AIS. The implementation of a cut-off threshold in the baseline dominant handgrip strength could potentially be used as an additional predictor, in addition to bone parameters, for identifying individuals with AIS who are at higher risk of experiencing curve progression.
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Affiliation(s)
- Rufina Wing Lum Lau
- School of Medical and Health Sciences, Tung Wah College, Hong Kong, Hong Kong SAR, China
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ka Yee Cheuk
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Vivian Wing Yin Hung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Fiona Wai Ping Yu
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Elisa Man Shan Tam
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Lyn Lee Ning Wong
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jiajun Zhang
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wayne Yuk Wai Lee
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jack Chun Yiu Cheng
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Tsz Ping Lam
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Adam Yiu Chung Lau
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Vignesh R, Sharma V, Basu B. Computational nodal displacement analysis of acetabulum fossa for injection molded cemented polyethylene acetabular liner. J Mech Behav Biomed Mater 2023; 147:106109. [PMID: 37742598 DOI: 10.1016/j.jmbbm.2023.106109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 09/26/2023]
Abstract
The acetabular liner (AL) is one of the key components that determine the functionality and durability of the total hip joint replacement (THR) device. The performance of Ultra high molecular weight polyethylene (UHMWPE)-based AL depends critically on the manufacturing route and its properties, which are evaluated pre-clinically using a host of experimental and computational analyses. The conventional manufacturing of an AL involves multiple stages, including extrusion/compression molding followed by machining, which is time/cost intensive and leads to material loss. In such a scenario, injection molding is a promising alternative, yet its feasbility remains unexplored for the manufacturing of AL for THA applications. Against this backdrop, the two-fold objectives of this work are to report our recent efforts to establish the efficacy of the injection molding of new generation UHMWPE biomaterial; HU (60 wt% HDPE- 40 wt% UHMWPE blend) for manufacturing AL prototype and to present the key biomechanical response analysis of this prototype, in silico. A range of manufacturing relevant material properties, as well as customized mold design to manufacture HU-based AL with external design features, are discussed. Such guidelines are particularly relevant to mold polymeric parts with a higher thickness (>8 mm). As part of the pre-clinical validation of AL with new design features, a less explored in silico approach to assess biomechanical micro-strain in the acetabulum fossa is presented, and the results are analysed in accordance with the mechanostat theory. The outcomes revealed that for a 100 kg subject weight, average micro-strain in the remodelling region was 1132, while it was determined as 723 for a 55 kg subject weight. Such results highlight the influence of subject weight on micro-strain generation and distribution in the acetabulum fossa. The von Mises stress in AL also increased with subject weight from 17 MPa in a subject weight of 55 kg to 28 MPa in a subject weight of 100 kg. Taken together, this work demonstrates the feasibility and competence of this new generation biomaterial in terms of implant manufacturing via injection molding with a clinically desired biomechanical response.
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Affiliation(s)
- R Vignesh
- Laboratory for Biomaterials, Materials Research Centre, Indian Institute of Science, Bangalore 560012, India; Centre of Excellence for Dental and Orthopedic Applications, Material Research Centre, Indian Institute of Science, Bangalore 560012, India
| | - Vidushi Sharma
- Laboratory for Biomaterials, Materials Research Centre, Indian Institute of Science, Bangalore 560012, India; Centre of Excellence for Dental and Orthopedic Applications, Material Research Centre, Indian Institute of Science, Bangalore 560012, India
| | - Bikramjit Basu
- Laboratory for Biomaterials, Materials Research Centre, Indian Institute of Science, Bangalore 560012, India; Centre of Excellence for Dental and Orthopedic Applications, Material Research Centre, Indian Institute of Science, Bangalore 560012, India; Centre for Biosystems Science and Engineering, Indian Institute of Science, Bangalore 560012, India.
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Alghadir AH, Gabr SA, Iqbal A. Hand grip strength, vitamin D status, and diets as predictors of bone health in 6-12 years old school children. BMC Musculoskelet Disord 2023; 24:830. [PMID: 37872520 PMCID: PMC10594896 DOI: 10.1186/s12891-023-06960-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/12/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Vitamin D and calcium-rich foods, exposure to sunlight, and physical activities (PA) play a pivotal role in promoting the production of sufficient vitamin D and improving grip strength needed for better bone health among school children. PURPOSE This study aimed to determine the effects of hand grip muscle strength (HGS), vitamin D in addition to diets, and PA on bone health status among 6-12 years old schoolchildren. METHODS This study was based on a cross-sectional observational design, which was descriptive in nature. A diverse sample of 560 elementary school children aged 6-12 years old were invited to participate in this descriptive cross-sectional study. The Dual-Energy X-Ray Absorptiometry (DXA), QUS technique, and ACTi graph GT1M accelerometer were used respectively as a valid tools to identify BMD, BMC, and other parameters of bone health like c-BUA values and bone stiffness (SI), and physical activity (PA) of all individuals participated in this study. In addition, a hydraulic dynamometer was used to measure hand grip strength among the participants. Moreover, an immunoassay technique was used to measure the serum levels of vitamin 25(OH)D level, and bone metabolism markers; NTX, DPD, Ca, and sBAP in all participants. Bone loss (osteoporosis) was cross-sectionally predicted in 19.64% of the total population, most of whom were girls (14.3% vs. 5.4% for boys; P = 0.01). Compared to boys, the incidence of osteoporosis was higher and significantly correlated in girls with lower HGS, deficient vitamin D, inadequate vitamin D and Ca intake, greater adiposity, poor PA, and lower sun exposure. Also, in girls, lower vitamin 25(OH)D levels, and poor HGS were shown to be significantly associated with lower values of BMD, BMC, SI, and higher values of bone resorption markers; NTX, DPD, and sBAP and lower serum Ca than do in boys. The findings suggested that deficient vitamin D, lower HGS, adiposity, PA, and sun exposure as related risk factors to the pravelence of bone loss among school children, particularly in girls. In addition, these parameters might be considered diagnostic non-invasive predictors of bone health for clinical use in epidemiological contexts; however, more studies are required.
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Affiliation(s)
- Ahmad H Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Sami A Gabr
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Amir Iqbal
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia.
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Sekel NM, Hughes JM, Sterczala AJ, Mroz KH, Lovalekar M, Cauley J, Greeves JP, Nindl BC. Utility of HR-pQCT in detecting training-induced changes in healthy adult bone morphology and microstructure. Front Physiol 2023; 14:1266292. [PMID: 37929211 PMCID: PMC10623356 DOI: 10.3389/fphys.2023.1266292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Healthy bone adjusts its traits in an exceptionally coordinated, compensatory process. Recent advancements in skeletal imaging via High-Resolution Peripheral Quantitative Computed Tomography (HR-pQCT) allows for the in vivo 3-dimensional and longitudinal quantification of bone density, microarchitecture, geometry, and parameters of mechanical strength in response to varying strain stimuli including those resulting from exercise or military training. Further, the voxel size of 61 microns has the potential to capture subtle changes in human bone in as little as 8 weeks. Given the typical time course of bone remodeling, short-term detection of skeletal changes in bone microstructure and morphology is indicative of adaptive bone formation, the deposition of new bone formation, uncoupled from prior resorption, that can occur at mechanistically advantageous regions. This review aims to synthesize existing training-induced HR-pQCT data in three distinct populations of healthy adults excluding disease states, pharmacological intervention and nutritional supplementation. Those included are: 1) military basic or officer training 2) general population and 3) non-osteoporotic aging. This review aims to further identify similarities and contrasts with prior modalities and cumulatively interpret results within the scope of bone functional adaptation.
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Affiliation(s)
- Nicole M. Sekel
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Julie M. Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
| | - Adam J. Sterczala
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kelly H. Mroz
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Mita Lovalekar
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jane Cauley
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Julie P. Greeves
- Army Health and Performance Research, UK Army, Andover, United Kingdom
| | - Bradley C. Nindl
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
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Gomes C, Mesnard M, Ramos A. Bone density and proximal support effects on dental implant stability - Finite element analysis and in vitro experiments. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101512. [PMID: 37209971 DOI: 10.1016/j.jormas.2023.101512] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 03/19/2023] [Accepted: 05/15/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVES The application of dental implants presents the occurrence of implant failures associated with bone proximal support. This study aims to assess implant behavior, in particular implant stability and strain distribution in the bone at different bone densities, and the effect of proximal bone support. MATERIAL AND METHODS Three bone densities (D20, D15, and D10) were considered in the experimental in vitro study, represented by solid rigid polyurethane foam and two conditions of bone support in the proximal region. A finite element model was developed and validated experimentally and a Branemark model at a 3:1 scale was implanted in the experiments; the model was loaded and extracted. RESULTS The results of the experimental models validate the finite element models with a correlation R2 equal to 0.899 and NMSE of 7%. The implant extraction tests for the effect of bone properties in the maximum load were 2832 N for D20 and 792 N for D10. The effect of proximal bone support changes the implant stability was observed experimentally; at 1 mm less bone support decreases by 20% of stability and at 2 mm by 58% for D15 density. CONCLUSIONS Bone properties and bone quantity are important for the initial stability of the implant. A bone volume fraction of less than 24 g/cm3 exhibits poor behavior and is not indicated for implantation. Proximal bone support reduces the primary stability of the implant and the effect is critical in lower bone density.
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Affiliation(s)
- C Gomes
- University of Aveiro, Biomechanics Research Group, Department of Mechanical Engineering, Aveiro 3810-193, Portugal
| | - M Mesnard
- University de Bordeaux, Institut de Mécanique et d'Ingénierie, Department Ingénierie Mécanique et Conception, CNRS UMR 5295, Talence 33405, France
| | - A Ramos
- University of Aveiro, Biomechanics Research Group, Department of Mechanical Engineering, Aveiro 3810-193, Portugal.
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Guan J, Liu T, Yu X, Li W, Feng N, Jiang G, Zhao H, Yang Y. Biomechanical and clinical research of Isobar semi-rigid stabilization devices for lumbar degenerative diseases: a systematic review. Biomed Eng Online 2023; 22:95. [PMID: 37742006 PMCID: PMC10518087 DOI: 10.1186/s12938-023-01156-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 09/15/2023] [Indexed: 09/25/2023] Open
Abstract
While lumbar spinal fusion using rigid rods is a prevalent surgical technique, it can lead to complications such as adjacent segment disease (ASDis). Dynamic stabilization devices serve to maintain physiological spinal motion and alleviate painful stress, yet they are accompanied by a substantial incidence of construct failure and subsequent reoperation. Compared to traditional rigid devices, Isobar TTL semi-rigid stabilization devices demonstrate equivalent stiffness and effective stabilization capabilities. Furthermore, when contrasted with dynamic stabilization techniques, semi-rigid stabilization offers improved load distribution, a broader range of motion within the fixed segment, and reduced mechanical failure rates. This paper will review and evaluate the clinical and biomechanical performance of Isobar TTL semi-rigid stabilization devices. A literature search using the PubMed, EMBASE, CNKI, Wanfang, VIP, and Cochrane Library databases identified studies that met the eligibility criteria. Twenty-eight clinical studies and nine biomechanical studies were included in this systematic review. The VAS, the ODI, and Japanese Orthopedic Association scoring improved significantly in most studies. UCLA grading scale, Pfirrmann grading, and modified Pfirrmann grading of the upper adjacent segments improved significantly in most studies. The occurrence rate of ASD was low. In biomechanical studies, Isobar TTL demonstrated a superior load sharing distribution, a larger fixed segment range of motion, and reduced stress at the rod-screw/screw-bone interfaces compared with titanium rods. While findings from mechanical studies provided promising results, the clinical studies exhibited low methodological quality. As a result, the available evidence does not possess sufficient strength to substantiate superior outcomes with Isobar semi-rigid system in comparison to titanium rods. To establish more conclusive conclusions, further investigations incorporating improved protocols, larger sample sizes, and extended follow-up durations are warranted.
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Affiliation(s)
- Jianbin Guan
- Department of Spine Surgery, Honghui-Hospital, Xi'an Jiaotong University, Xi'an, 710054, China.
| | - Tao Liu
- Department of Spine Surgery, Honghui-Hospital, Xi'an Jiaotong University, Xi'an, 710054, China
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Xing Yu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
| | - Wenhao Li
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Ningning Feng
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Guozheng Jiang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - He Zhao
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Yongdong Yang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
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Fu Q, Bustamante-Gomez NC, Reyes-Pardo H, Gubrij I, Escalona-Vargas D, Thostenson JD, Palmieri M, Goellner JJ, Nookaew I, Barnes CL, Stambough JB, Ambrogini E, O’Brien CA. Reduced osteoprotegerin expression by osteocytes may contribute to rebound resorption after denosumab discontinuation. JCI Insight 2023; 8:e167790. [PMID: 37581932 PMCID: PMC10561722 DOI: 10.1172/jci.insight.167790] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 08/03/2023] [Indexed: 08/17/2023] Open
Abstract
Denosumab is an anti-RANKL Ab that potently suppresses bone resorption, increases bone mass, and reduces fracture risk. Discontinuation of denosumab causes rapid rebound bone resorption and bone loss, but the molecular mechanisms are unclear. We generated humanized RANKL mice and treated them with denosumab to examine the cellular and molecular conditions associated with rebound resorption. Denosumab potently suppressed both osteoclast and osteoblast numbers in cancellous bone in humanized RANKL mice. The decrease in osteoclast number was not associated with changes in osteoclast progenitors in bone marrow. Long-term, but not short-term, denosumab administration reduced osteoprotegerin (OPG) mRNA in bone. Localization of OPG expression revealed that OPG mRNA is produced by a subpopulation of osteocytes. Long-term denosumab administration reduced osteocyte OPG mRNA, suggesting that OPG expression declines as osteocytes age. Consistent with this, osteocyte expression of OPG was more prevalent near the surface of cortical bone in humans and mice. These results suggest that new osteocytes are an important source of OPG in remodeling bone and that suppression of remodeling reduces OPG abundance by reducing new osteocyte formation. The lack of new osteocytes and the OPG they produce may contribute to rebound resorption after denosumab discontinuation.
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Affiliation(s)
- Qiang Fu
- Center for Musculoskeletal Disease Research
- Division of Endocrinology and Metabolism
| | | | - Humberto Reyes-Pardo
- Center for Musculoskeletal Disease Research
- Division of Endocrinology and Metabolism
| | - Igor Gubrij
- Center for Musculoskeletal Disease Research
- Division of Endocrinology and Metabolism
| | | | | | - Michela Palmieri
- Center for Musculoskeletal Disease Research
- Division of Endocrinology and Metabolism
| | - Joseph J. Goellner
- Center for Musculoskeletal Disease Research
- Division of Endocrinology and Metabolism
| | - Intawat Nookaew
- Center for Musculoskeletal Disease Research
- Department of Biomedical Informatics, and
| | - C. Lowry Barnes
- Center for Musculoskeletal Disease Research
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jeffrey B. Stambough
- Center for Musculoskeletal Disease Research
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Elena Ambrogini
- Center for Musculoskeletal Disease Research
- Division of Endocrinology and Metabolism
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA
| | - Charles A. O’Brien
- Center for Musculoskeletal Disease Research
- Division of Endocrinology and Metabolism
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA
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Tabibi MA, Wilund KR, Salimian N, Nikbakht S, Soleymany M, Roshanaeian Z, Nazemi F, Ahmadi S. The effect of intradialytic exercise on calcium, phosphorus and parathyroid hormone: a randomized controlled trial. BMC Nephrol 2023; 24:276. [PMID: 37730530 PMCID: PMC10512624 DOI: 10.1186/s12882-023-03327-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/07/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Patients with kidney failure experience derangements of circulating markers of mineral metabolism and dysregulation of skeletal and cardiovascular physiology which results in high mortality rate in these patients. This study aimed to evaluate the effect of intradialytic exercise on regulation of these abnormalities in patients receiving chronic hemodialysis (HD). METHODS In this randomized controlled trial conducted in an HD center in Iran, adult patients receiving chronic HD were randomized to intradialytic exercise (60 min) in the second hour of thrice weekly dialysis for 6 months (intervention) or no intradialytic exercise (control). The primary outcomes were serum calcium, serum phosphorous and parathyroid hormone levels. Secondary outcomes were serum alkaline phosphatase and calcium-phosphorous product. RESULTS The study included 44 participants randomized to intervention (n = 22) or control (n = 22). During the 6-month intervention period, significant between-group changes were observed in all primary and secondary outcomes between the intervention and control groups. Statistical analyses reveal a significant increase in serum calcium (P < 0.05) as well as a significant decrease in serum phosphorous, parathyroid hormone, alkaline phosphatase and calcium-phosphorous product (P < 0.05). CONCLUSION Intradialytic exercise performed for at least 60 min during thrice weekly dialysis sessions improves bone mineral metabolism in adult patients receiving HD. Further studies should focus on observing and comparing the effect of different types of exercise on bone mineral disorders and all-cause mortality in HD patients. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04916743, Registered on 08/06/2021. Registered trial name: The Effect of Intradialytic Exercise on Calcium, Phosphorous and Parathyroid Hormone: A Randomized Controlled Trial.
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Affiliation(s)
- Mohammad Ali Tabibi
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran.
| | - Kenneth R Wilund
- Department of Kinesiology and Community Health, Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, USA
| | - Nasrin Salimian
- Department of Research and Development, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Saghar Nikbakht
- Department of Kinesiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Mahsa Soleymany
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Zahra Roshanaeian
- Department of Sport Nutrition, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Farzad Nazemi
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Saghar Ahmadi
- Department of Health and Palliative Care, Pardis Specialized Wellness Institute, Isfahan, Iran
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50
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Hughes JM, Guerriere KI, Popp KL, Castellani CM, Pasiakos SM. Exercise for optimizing bone health after hormone-induced increases in bone stiffness. Front Endocrinol (Lausanne) 2023; 14:1219454. [PMID: 37790607 PMCID: PMC10544579 DOI: 10.3389/fendo.2023.1219454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/17/2023] [Indexed: 10/05/2023] Open
Abstract
Hormones and mechanical loading co-regulate bone throughout the lifespan. In this review, we posit that times of increased hormonal influence on bone provide opportunities for exercise to optimize bone strength and prevent fragility. Examples include endogenous secretion of growth hormones and sex steroids that modulate adolescent growth and exogenous administration of osteoanabolic drugs like teriparatide, which increase bone stiffness, or its resistance to external forces. We review evidence that after bone stiffness is increased due to hormonal stimuli, mechanoadaptive processes follow. Specifically, exercise provides the mechanical stimulus necessary to offset adaptive bone resorption or promote adaptive bone formation. The collective effects of both decreased bone resorption and increased bone formation optimize bone strength during youth and preserve it later in life. These theoretical constructs provide physiologic foundations for promoting exercise throughout life.
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Affiliation(s)
- Julie M. Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
| | - Katelyn I. Guerriere
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
| | - Kristin L. Popp
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, United States
| | - Colleen M. Castellani
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, United States
| | - Stefan M. Pasiakos
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
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