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Hegarty-Cremer SGD, Borggaard XG, Andreasen CM, van der Eerden BCJ, Simpson MJ, Andersen TL, Buenzli PR. How osteons form: A quantitative hypothesis-testing analysis of cortical pore filling and wall asymmetry. Bone 2024; 180:116998. [PMID: 38184100 DOI: 10.1016/j.bone.2023.116998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/06/2023] [Accepted: 12/24/2023] [Indexed: 01/08/2024]
Abstract
Osteon morphology provides valuable information about the interplay between different processes involved in bone remodelling. The correct quantitative interpretation of these morphological features is challenging due to the complexity of interactions between osteoblast behaviour, and the evolving geometry of cortical pores during pore closing. We present a combined experimental and mathematical modelling study to provide insights into bone formation mechanisms during cortical bone remodelling based on histological cross-sections of quiescent human osteons and hypothesis-testing analyses. We introduce wall thickness asymmetry as a measure of the local asymmetry of bone formation within an osteon and examine the frequency distribution of wall thickness asymmetry in cortical osteons from human iliac crest bone samples from women 16-78 years old. Our measurements show that most osteons possess some degree of asymmetry, and that the average degree of osteon asymmetry in cortical bone evolves with age. We then propose a comprehensive mathematical model of cortical pore filling that includes osteoblast secretory activity, osteoblast elimination, osteoblast embedment as osteocytes, and osteoblast crowding and redistribution along the bone surface. The mathematical model is first calibrated to symmetric osteon data, and then used to test three mechanisms of asymmetric wall formation against osteon data: (i) delays in the onset of infilling around the cement line; (ii) heterogeneous osteoblastogenesis around the bone perimeter; and (iii) heterogeneous osteoblast secretory rate around the bone perimeter. Our results suggest that wall thickness asymmetry due to off-centred Haversian pores within osteons, and that nonuniform lamellar thicknesses within osteons are important morphological features that can indicate the prevalence of specific asymmetry-generating mechanisms. This has significant implications for the study of disruptions of bone formation as it could indicate what biological bone formation processes may become disrupted with age or disease.
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Affiliation(s)
- Solene G D Hegarty-Cremer
- School of Mathematical Sciences, Queensland University of Technology (QUT), Brisbane, Australia; Department of Mathematics and Statistics, The University of Montreal, Montreal, Canada
| | - Xenia G Borggaard
- Clinical Cell Biology, Pathology Research Unit, Dept. of Clinical Research, and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark
| | - Christina M Andreasen
- Clinical Cell Biology, Pathology Research Unit, Dept. of Clinical Research, and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark
| | | | - Matthew J Simpson
- School of Mathematical Sciences, Queensland University of Technology (QUT), Brisbane, Australia
| | - Thomas L Andersen
- Clinical Cell Biology, Pathology Research Unit, Dept. of Clinical Research, and Dept. of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Dept. of Pathology, Odense University Hospital, Odense, Denmark; Dept. of Forensic Medicine, Aarhus University, Aarhus, Denmark
| | - Pascal R Buenzli
- School of Mathematical Sciences, Queensland University of Technology (QUT), Brisbane, Australia.
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Skedros JG, Cronin JT, Dayton MR, Bloebaum RD, Bachus KN. Exploration of the synergistic role of cortical thickness asymmetry ("Trabecular Eccentricity" concept) in reducing fracture risk in the human femoral neck and a control bone (Artiodactyl Calcaneus). J Theor Biol 2023; 567:111495. [PMID: 37068584 DOI: 10.1016/j.jtbi.2023.111495] [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: 01/19/2023] [Revised: 03/24/2023] [Accepted: 04/10/2023] [Indexed: 04/19/2023]
Abstract
The mechanobiology of the human femoral neck is a focus of research for many reasons including studies that aim to curb age-related bone loss that contributes to a near-exponential rate of hip fractures. Many believe that the femoral neck is often loaded in rather simple bending, which causes net tension stress in the upper (superior) femoral neck and net compression stress in its inferior aspect ("T/C paradigm"). This T/C loading regime lacks in vivo proof. The "C/C paradigm" is a plausible alternative simplified load history that is characterized by a gradient of net compression across the entire femoral neck; action of the gluteus medius and external rotators of the hip are important in this context. It is unclear which paradigm is at play in natural loading due to lack of in vivo bone strain data and deficiencies in understanding mechanisms and manifestations of bone adaptation in tension vs. compression. For these reasons, studies of the femoral neck would benefit from being compared to a 'control bone' that has been proven, by strain data, to be habitually loaded in bending. The artiodactyl (sheep and deer) calcaneus model has been shown to be a very suitable control in this context. However, the application of this control in understanding the load history of the femoral neck has only been attempted in two prior studies, which did not examine the interplay between cortical and trabecular bone, or potential load-sharing influences of tendons and ligaments. Our first goal is to compare fracture risk factors of the femoral neck in both paradigms. Our second goal is to compare and contrast the deer calcaneus to the human femoral neck in terms of fracture risk factors in the T/C paradigm (the C/C paradigm is not applicable in the artiodactyl calcaneus due to its highly constrained loading). Our third goal explores interplay between dorsal/compression and plantar/tension regions of the deer calcaneus and the load-sharing roles of a nearby ligament and tendon, with insights for translation to the femoral neck. These goals were achieved by employing the analytical model of Fox and Keaveny (J. Theoretical Biology 2001, 2003) that estimates fracture risk factors of the femoral neck. This model focuses on biomechanical advantages of the asymmetric distribution of cortical bone in the direction of habitual loading. The cortical thickness asymmetry of the femoral neck (thin superior cortex, thick inferior cortex) reflects the superior-inferior placement of trabecular bone (i.e., "trabecular eccentricity," TE). TE helps the femoral neck adapt to typical stresses and strains through load-sharing between superior and inferior cortices. Our goals were evaluated in the context of TE. Results showed the C/C paradigm has lower risk factors for the superior cortex and for the overall femoral neck, which is clinically relevant. TE analyses of the deer calcaneus revealed important synergism in load-sharing between the plantar/tension cortex and adjacent ligament/tendon, which challenges conventional understanding of how this control bone achieves functional adaptation. Comparisons with the control bone also exposed important deficiencies in current understanding of human femoral neck loading and its potential histocompositional adaptations.
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Affiliation(s)
- John G Skedros
- University of Utah, Department of Orthopaedics, Salt Lake City, UT, USA; Research Service, Veterans Affairs Medical Center, Salt Lake City, UT, USA.
| | - John T Cronin
- University of Utah, Department of Orthopaedics, Salt Lake City, UT, USA
| | - Michael R Dayton
- University of Colorado, Department of Orthopedics, Aurora, CO, USA
| | - Roy D Bloebaum
- University of Utah, Department of Orthopaedics, Salt Lake City, UT, USA; Research Service, Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Kent N Bachus
- University of Utah, Department of Orthopaedics, Salt Lake City, UT, USA; Research Service, Veterans Affairs Medical Center, Salt Lake City, UT, USA
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Guo J, Zhou Y, Shang M, Chen W, Hou Z, Zhang Y, Dong W. Morphological characteristics of the surgical neck region in the proximal humerus at different ages. Eur J Med Res 2022; 27:102. [PMID: 35773745 PMCID: PMC9245283 DOI: 10.1186/s40001-022-00724-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of the study was to demonstrate the cortical thickness character in the humeral surgical neck region using 3D cortical bone mapping technique and try to illustrate its morphological changes with age. MATERIAL AND METHODS Normal individuals, including 11 volunteers younger than 18 years, 87 adult men and 46 adult women, were enrolled. The cortical thickness and height of the surgical neck region was measured with Mimic and 3 Matic software. The height of the region was compared and measured. People with an age of 18-30 years was identified as Group I, people in 31-40 years as Group II, people in 41-50 years as Group III, people in 51-60 years as Group IV, and Group V including people ≥ 61 years. RESULTS Compared with the baseline Group I, cortical thickness was significantly decreased by 0.52 mm (P = 0.006) in Group III, by 0.76 mm (P < 0.001) in Group IV, and by 0.77 mm (P < 0.001) in Group V. Age moderately predicted cortical thickness with r = -0.5481. The height of the cortical change region was significantly decreased by 2.25 mm (P = 0.007) in Group II, by 2.98 mm (P < 0.001) in Group III, and by 2.07 mm (P = 0.02) in Group IV. However, no significant decrease was illustrated in Group V (0.57 mm) (P = 0.891). The relation between age and the height of the cortical thickness change region was nonlinear. CONCLUSIONS This study identified an obvious decrease in cortical thickness with aging, and the height was curve fitted with aging in surgical neck region.
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Affiliation(s)
- Jialiang Guo
- The School of Medicine, Nankai University, Tianjin, People's Republic of China.,Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Yali Zhou
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Meishuang Shang
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Wei Chen
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Zhiyong Hou
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Yingze Zhang
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China. .,Chinese Academy of Engineering, Beijing, People's Republic of China. .,NHC Key Laboratory of Intelligent Orthopeadic Equipment (The Third Hospital of Hebei Medical University), Shijiazhuang, People's Republic of China.
| | - Weichong Dong
- Department of Pharmacy, The Second Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.
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Toledano M, Vallecillo C, Gutierrez-Corrales A, Torres-Lagares D, Toledano-Osorio M, Serrera-Figallo MA. Histomorphometric Analysis of Differential Regional Bone Regeneration Induced by Distinct Doped Membranes. Polymers (Basel) 2022; 14:polym14102078. [PMID: 35631960 PMCID: PMC9147672 DOI: 10.3390/polym14102078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 11/20/2022] Open
Abstract
Our objective is to evaluate the regional regenerative potential of calvarial bone in critical-sized defects in a rabbit model using novel nanostructured silica-loaded membranes doped with zinc or doxycycline. Nanostructured membranes of (MMA)1-co-(HEMA)1/(MA)3-co-(HEA)2 loaded with 5 wt% of SiO2 nanoparticles (HOOC-Si-Membranes) were doped with zinc (Zn-HOOC-Si-Membrane) or doxycycline (Dox-HOOC-Si-Membrane). Critical bone defects were created on six New-Zealand-breed rabbit skulls and covered with the membranes. A sham defect without a membrane was used as the control. After six weeks, a histological analysis (toluidine blue technique) was employed to determine the area percentages of newly formed bone, osteoid bone, and soft tissue. The measurements were performed by dividing the total defect area into top (close to the membrane) and bottom (close to the dura mater) regions, or peripheral (adjacent to the old bone) and central (the sum of the remaining zones) regions. The peripheral regions of the defects showed higher osteogenic capacity than the central areas when the membranes were present. The proportion of new bone adjacent to the dura was similar to that adjacent to the membrane only when the HOOC-Si-Membranes and Zn-HOOC-Si-Membranes were used, indicating a direct osteoinductive effect of the membranes.
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Affiliation(s)
- Manuel Toledano
- Faculty of Dentistry, Colegio Máximo de Cartuja s/n, University of Granada, 18071 Granada, Spain; (M.T.); (C.V.)
| | - Cristina Vallecillo
- Faculty of Dentistry, Colegio Máximo de Cartuja s/n, University of Granada, 18071 Granada, Spain; (M.T.); (C.V.)
| | - Aida Gutierrez-Corrales
- Faculty of Dentistry, Oral Surgery Section, University of Sevilla, Avicena s/n, 41009 Sevilla, Spain; (A.G.-C.); (D.T.-L.); (M.-A.S.-F.)
| | - Daniel Torres-Lagares
- Faculty of Dentistry, Oral Surgery Section, University of Sevilla, Avicena s/n, 41009 Sevilla, Spain; (A.G.-C.); (D.T.-L.); (M.-A.S.-F.)
| | - Manuel Toledano-Osorio
- Faculty of Dentistry, Colegio Máximo de Cartuja s/n, University of Granada, 18071 Granada, Spain; (M.T.); (C.V.)
- Correspondence: ; Tel.: +34-958-243-789
| | - María-Angeles Serrera-Figallo
- Faculty of Dentistry, Oral Surgery Section, University of Sevilla, Avicena s/n, 41009 Sevilla, Spain; (A.G.-C.); (D.T.-L.); (M.-A.S.-F.)
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Kwak DK, Oh SH, Lee SJ, Lee SH, Lee YM, Yoo JH. Effect of the additional anteroposterior blocking screw on nail/medullary canal mismatch after cephalomedullary nailing in unstable pertrochanteric fracture : a finite element analysis. Bone Joint Res 2022; 11:152-161. [PMID: 35261280 PMCID: PMC8962853 DOI: 10.1302/2046-3758.113.bjr-2021-0363.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIMS There are concerns regarding nail/medullary canal mismatch and initial stability after cephalomedullary nailing in unstable pertrochanteric fractures. This study aimed to investigate the effect of an additional anteroposterior blocking screw on fixation stability in unstable pertrochanteric fracture models with a nail/medullary canal mismatch after short cephalomedullary nail (CMN) fixation. METHODS Eight finite element models (FEMs), comprising four different femoral diameters, with and without blocking screws, were constructed, and unstable intertrochanteric fractures fixed with short CMNs were reproduced in all FEMs. Micromotions of distal shaft fragment related to proximal fragment, and stress concentrations at the nail construct were measured. RESULTS Micromotions in FEMs without a blocking screw significantly increased as nail/medullary canal mismatch increased, but were similar between FEMs with a blocking screw regardless of mismatch. Stress concentration at the nail construct was observed at the junction of the nail body and lag screw in all FEMs, and increased as nail/medullary canal mismatch increased, regardless of blocking screws. Mean stresses over regions of interest in FEMs with a blocking screw were much lower than regions of interest in those without. Mean stresses in FEMs with a blocking screw were lower than the yield strength, yet mean stresses in FEMs without blocking screws having 8 mm and 10 mm mismatch exceeded the yield strength. All mean stresses at distal locking screws were less than the yield strength. CONCLUSION Using an additional anteroposterior blocking screw may be a simple and effective method to enhance fixation stability in unstable pertrochanteric fractures with a large nail/medullary canal mismatch due to osteoporosis.
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Affiliation(s)
- Dae-Kyung Kwak
- Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Hallym University School of Medicine, Anyang, South Korea
| | - Seog-Hyun Oh
- Department of Biomedical Engineering, Inje University, Gimhae, South Korea
| | - Sung-Jae Lee
- Department of Biomedical Engineering, Inje University, Gimhae, South Korea
| | - Seung-Hun Lee
- Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Hallym University School of Medicine, Anyang, South Korea
| | - Yong-Min Lee
- Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Hallym University School of Medicine, Anyang, South Korea
| | - Je-Hyun Yoo
- Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Hallym University School of Medicine, Anyang, South Korea
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Pérez-Cano FD, Luque-Luque A, Jiménez-Delgado JJ. Towards a 2D cortical osseous tissue representation and generation at micro scale. A computational model for bone simulations. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 197:105774. [PMID: 33032076 DOI: 10.1016/j.cmpb.2020.105774] [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: 04/22/2020] [Accepted: 09/22/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE the acquisition of microscopic images of human bones is a complex and expensive process. Moreover, the objective of obtaining a large data bank with microscopic images in order to carry out massive studies or to train automatic generation algorithms is not an option. Consequently, most of the current work focuses on the analysis of small regions captured by a microscope. The aim is the development of a tool to represent bone tissue at microscopic levels which is suitable for performing physical simulations, as well as for the diagnosis of various diseases. This work includes the whole process from the digitization of a human bone to the generation of bone tissue in a determined area of the bone selected through a cutting plane. METHODS based on the anatomy of the bone structure, the parameters that allow the representation of the bone tissue at mesoscale level have been analyzed. Although the models are randomly generated, they are based on statistical parameters. The model generator is based on the analysis of images of bone tissue and its parameters, performing a representation of each of its relevant structures in a way that fulfils these parameters. RESULTS the tool is useful for the virtual generation of bone tissue that satisfies the main characteristics of the cortical bone. The models obtained have been favorably evaluated in two stages. In the first stage, a scientific group has examined a set of images, in which images of the models generated were mixed with images obtained through traditional methods. Then, the physical characteristics of the generated tissue have been compared with the morphology of the bone tissue. CONCLUSIONS the model generator allows us to perform precise simulations in order to obtain realistic images with physical characteristics in accordance with reality. It is necessary to emphasize that even though the most relevant structures are included, the proposed model generator can be expanded to include new parameters or elements, so that it can be adapted to new needs. It could even break down randomness and parameterize it completely in order to allow the recreation of the tissue conditions of other studies.
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Affiliation(s)
| | - Adrián Luque-Luque
- Computer Graphics and Geomatics Group, Campus Las Lagunillas S/N, Jaén 23071, Spain.
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Park SY, Kim JH, Choi HJ, Ku EJ, Hong AR, Lee JH, Shin CS, Cho NH. Longitudinal changes in bone mineral density and trabecular bone score in Korean adults: a community-based prospective study. Arch Osteoporos 2020; 15:100. [PMID: 32621253 DOI: 10.1007/s11657-020-00731-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 03/30/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED The bone mineral densities (BMDs) of the femoral neck and total hip, and the lumbar spine trabecular bone score (TBS), tended to decrease with age in both men and women, whereas the lumbar spine BMD tended to increase. Lumbar spine BMD is thus inappropriate for evaluating longitudinal changes in bone loss; the lumbar spine TBS is an alternative measure. PURPOSE Aging is associated with a decrease in bone mass and quality. This community-based prospective cohort study investigated longitudinal changes in bone phenotype in Korean adults. METHODS We analyzed data from a prospective community-based cohort study, the Korean Genome and Epidemiology Study. Postmenopausal women and men who underwent dual-energy X-ray absorptiometry at least twice from 2007 to 2014 were included. Longitudinal changes in bone mineral density (BMD) and trabecular bone score (TBS) over 6 years were analyzed by sex, age, and body mass index. RESULTS A total of 1895 subjects were enrolled (men 965; postmenopausal women 929). The femoral neck (FN) BMD, total hip (TH) BMD, and lumbar spine (LS) TBS decreased significantly over time, but the LS BMD increased significantly. In men, the average annual changes were 0.3% in LS BMD (p < 0.001), - 0.33% in FN BMD (p < 0.001), - 0.26% in TH BMD (p = 0.001), and - 0.27% in LS TBS (p < 0.001). In women, the average annual changes were 0.27% in LS BMD (p < 0.001), - 0.67% in FN BMD (p < 0.001), - 0.66% in TH BMD (p < 0.001), and - 0.27% in LS TBS (p < 0.001). The longitudinal decrease in TH BMD over time was significantly greater in women (versus men) and those who were older (versus younger). CONCLUSION The FN and TH BMDs decreased with aging. But, the LS BMD was inappropriate to evaluate longitudinal changes of bone loss. The LS TBS could be alterative.
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Affiliation(s)
- So Young Park
- Department of Endocrinology and Metabolism, Kyung Hee Medical Center, Seoul, Republic of Korea
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyung Jin Choi
- Department of Anatomy, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eu Jeong Ku
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju Si, Republic of Korea
| | - A Ram Hong
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Gwangju, Republic of Korea
| | - Ji Hyun Lee
- Department of Internal Medicine, VHS Medical center, Seoul, Republic of Korea
| | - Chan Soo Shin
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Nam H Cho
- Department of Preventive Medicine, Ajou University School of Medicine, 206 Worldcup-ro, Yeongtong-gu, Suwon, 443-721, South Korea.
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Gustafsson A, Wallin M, Isaksson H. Age-related properties at the microscale affect crack propagation in cortical bone. J Biomech 2019; 95:109326. [DOI: 10.1016/j.jbiomech.2019.109326] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/23/2019] [Accepted: 08/25/2019] [Indexed: 01/11/2023]
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Andreasen CM, Delaisse JM, van der Eerden BCJ, van Leeuwen JPTM, Ding M, Andersen TL. Understanding age-induced cortical porosity in women: Is a negative BMU balance in quiescent osteons a major contributor? Bone 2018; 117:70-82. [PMID: 30240959 DOI: 10.1016/j.bone.2018.09.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 09/10/2018] [Accepted: 09/16/2018] [Indexed: 01/18/2023]
Abstract
Cortical bone is remodeled by intracortical basic multicellular units (BMUs), whose end result can be observed as quiescent osteons in histological sections. These osteons offer a unique opportunity to investigate the BMU balance between the magnitude of bone resorption and subsequent bone formation at the BMU level. Our main objective was to investigate whether the latter parameters change between defined categories of osteons and with age, and to which extend these changes contribute to age-induced cortical porosity. Cortices of iliac bone specimens from 35 women (aged 16-78 years) with a higher porosity with age were investigated. A total of 3084 quiescent osteons reflecting 75% of the intracortical pores were histological examined. The osteons diameter, pore diameter, wall thickness, prevalence and contribution to the porosity were highly variable, but unchanged with age. Next, the osteons were categorized according to whether they reflected the remodeling of existing canals (type 2Q osteons) or the generation of new canals (type 1Q osteons). Type 2Q osteons versus type 1Q osteons: (i) had more frequently a pore diameter > 75 μm (7.4 vs. 1.3%; p < 0.001); (ii) had a larger mean pore diameter (40 ± 10 vs. 25 ± 4 μm; p < 0.001), osteon diameter (120 ± 21 vs. 94 ± 21 μm; p < 0.001) and wall thickness (40 ± 10 vs. 35 ± 9; p < 0.05); (iii) had a larger contribution to the cortical porosity (29 ± 18 vs. 8 ± 8%; p < 0.001); (iv) were more prevalent (44 ± 10 vs. 31 ± 11%; p < 0.001); and (v) were more prevalent with age. Collectively, this study demonstrates that quiescent osteons with age more frequently result from remodeling of existing canals, which in some cases had a more negative BMU balance. Still, the osteons showed no overall age-related change in their pore diameter i.e. BMU balance. In contrast to conventional wisdom, these data show that non-quiescent pores, not pores of quiescent osteons, were the main contributor to a higher cortical porosity.
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Affiliation(s)
- Christina M Andreasen
- Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark; Orthopaedic Research Laboratory, Department of Orthopaedic Surgery & Traumatology, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Denmark.
| | - Jean-Marie Delaisse
- Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark.
| | - Bram C J van der Eerden
- Laboratory for Calcium and Bone Metabolism, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands.
| | - Johannes P T M van Leeuwen
- Laboratory for Calcium and Bone Metabolism, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands.
| | - Ming Ding
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery & Traumatology, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Denmark.
| | - Thomas L Andersen
- Clinical Cell Biology, Vejle Hospital - Lillebaelt Hospital, Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark.
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Helfen T, Sprecher CM, Eberli U, Gueorguiev B, Müller PE, Richards RG, Schmidutz F. High-Resolution Tomography-Based Quantification of Cortical Porosity and Cortical Thickness at the Surgical Neck of the Humerus During Aging. Calcif Tissue Int 2017; 101:271-279. [PMID: 28432379 DOI: 10.1007/s00223-017-0279-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 04/10/2017] [Indexed: 02/02/2023]
Abstract
Fractures of the proximal humerus are highly related to age and osteoporotic bone remodeling. Previous studies have highlighted the cortex as a major side of the bone loss, but the microstructural changes of the humerus have not been evaluated entirely. Sixty-four (n = 64) humeri of a representative collective (18-100 years) were scanned with high-resolution peripheral quantitative computed tomography (82 µm). Bone mineral density (BMD), trabecular bone volume fraction (Tb.BV/TV), cortical thickness (Ct.Th), and cortical porosity (Ct.Po) were determined with respect to four age groups. The BMD (r = -0.42), Ct.Th (r = 0.57), and Tb.BV/TV (r = 0.68) showed an age group-related decrease, while the Ct.Po increased (r = -0.55). The oldest group (80-100 years) revealed an extensively higher Ct.Po of +87% compared to the youngest group (18-44 years), while the Ct.Th and Tb.BV/TV were significantly lower by -35 and -49% (p < 0.05). The main cortical bone loss occurred after 65 years with the Ct.Th (-34%) and Tb.BV/TV (-40%) being clearly lower and the Ct.Po (+93%) clearly higher compared to the youngest group. In summary, osteoporosis leads to an age-related higher Ct.Po and reduced Ct.Th at the humeral cortex of the surgical neck. The bone loss of the cortex predominantly occurs around the age of 65 years and is very likely to reduce the mechanical strength and highly increases the fracture risk.
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Affiliation(s)
- Tobias Helfen
- AO Research Institute Davos, Davos, Switzerland
- Department of General-, Trauma- and Reconstructive Surgery, University of Munich (LMU), Munich, Germany
| | | | | | | | - Peter E Müller
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University of Munich (LMU), Marchioninistrasse 15, 81377, Munich, Germany
| | | | - Florian Schmidutz
- AO Research Institute Davos, Davos, Switzerland.
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University of Munich (LMU), Marchioninistrasse 15, 81377, Munich, Germany.
- BG Trauma Center, University of Tübingen, Tübingen, Germany.
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Chen M, Yuan H. Assessment of porosity index of the femoral neck and tibia by 3D ultra-short echo-time MRI. J Magn Reson Imaging 2017; 47:820-828. [PMID: 28561910 DOI: 10.1002/jmri.25782] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 05/19/2017] [Indexed: 12/23/2022] Open
Affiliation(s)
- Min Chen
- Department of Radiology; Peking University Third Hospital; Beijing P.R. China
| | - Huishu Yuan
- Department of Radiology; Peking University Third Hospital; Beijing P.R. China
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Eneh CTM, Afara IO, Malo MKH, Jurvelin JS, Töyräs J. Porosity predicted from ultrasound backscatter using multivariate analysis can improve accuracy of cortical bone thickness assessment. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2017; 141:575. [PMID: 28147588 DOI: 10.1121/1.4973572] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A rapidly growing area of interest in quantitative ultrasound assessment of bone is to determine cortical bone porosity from ultrasound backscatter. Current backscatter analyses are based on numerical simulations, while there are no published reports of successful experimental measurements. In this study, multivariate analysis is applied to ultrasound reflections and backscatter to predict cortical bone porosity. The porosity is then applied to estimate cortical bone radial speed of sound (SOS) and thickness using ultrasound backscatter signals obtained at 2.25 and 5 MHz center frequencies from cortical bone samples (n = 43) extracted from femoral diaphyses. The study shows that the partial least squares regression technique could be employed to successfully predict (R2 = 0.71-0.73) cortical porosity. It is found that this multivariate approach can reduce uncertainty in pulse-echo assessment of cortical bone thickness from 0.220 to 0.045 mm when porosity based radial SOS was applied, instead of a constant value from literature. Upon further validation, accurate estimation of cortical bone porosity and thickness may be applied as a financially viable option for fracture risk assessment of individuals.
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Affiliation(s)
- Chibuzor T M Eneh
- Diagnostic Imaging Center, Kuopio University Hospital, P.O. Box 100, FI-70029, Kuopio, Finland
| | - Isaac O Afara
- Diagnostic Imaging Center, Kuopio University Hospital, P.O. Box 100, FI-70029, Kuopio, Finland
| | - Markus K H Malo
- Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Jukka S Jurvelin
- Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland
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Tong X, Burton IS, Jurvelin JS, Isaksson H, Kröger H. Iliac crest histomorphometry and skeletal heterogeneity in men. Bone Rep 2016; 6:9-16. [PMID: 28377976 PMCID: PMC5365273 DOI: 10.1016/j.bonr.2016.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 11/10/2016] [Accepted: 11/26/2016] [Indexed: 12/17/2022] Open
Abstract
Purpose The cortical characteristics of the iliac crest in male have rarely been investigated with quantitative histomorphometry. Also it is still unknown how cortical microarchitecture may vary between the iliac crest and fractures related sites at the proximal femur. We studied the microarchitecture of both external and internal cortices within the iliac crest, and compared the results with femoral neck and subtrochanteric femoral shaft sites. Methods Undecalcified histological sections of the iliac crest were obtained bicortically from cadavers (n = 20, aged 18–82 years, males). They were cut (7 μm) and stained using modified Masson-Goldner stain. Histomorphometric parameters of cortical bone were analysed with low (× 50) and high (× 100) magnification, after identifying cortical bone boundaries using our previously validated method. Within cortical bone area, only complete osteons with typical concentric lamellae and cement line were selected and measured. Results At the iliac crest, the mean cortical width of external cortex was higher than at the internal cortex (p < 0.001). Also, osteon structural parameters, e.g. mean osteonal perimeter, were higher in the external cortex (p < 0.05). In both external and internal cortices, pore number per cortical bone area was higher in young subjects (≤ 50 years) (p < 0.05) while mean pore perimeter was higher in the old subjects (> 50 years) (p < 0.05). Several cortical parameters (e.g. osteon area per cortical bone area, pore number per cortical area) were the lowest in the femoral neck (p < 0.05). The maximal osteonal diameter and mean wall width were the highest in the external cortex of the iliac crest (p < 0.05), and the mean cortical width, osteon number per cortical area were the highest in the subtrochanteric femoral shaft (p < 0.05). Some osteonal structural parameters (e.g. min osteonal diameter) were significantly positively correlated (0.29 ≤ R2 ≤ 0.45, p < 0.05) between the external iliac crest and the femoral neck. Conclusions This study reveals heterogeneity in cortical microarchitecture between the external and internal iliac crest cortices, as well as between the iliac crest, the femoral neck and the subtrochanteric femoral shaft. Standard iliac crest biopsy does not reflect accurately cortical microarchitecture of other skeletal sites. The structural asymmetry between cortices of the ilium remains after childhood. In both cortices of the ilium, cortical pore perimeter was higher in the old subjects. The cortical microarchitecture is highly variable between different skeletal sites. Positive correlation is revealed between the external iliac crest and the femoral neck in osteonal characteristics.
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Affiliation(s)
- Xiaoyu Tong
- Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland, POB 1627, FIN-70211 Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, POB 1627, FIN-70211 Kuopio, Finland
| | - Inari S Burton
- Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland, POB 1627, FIN-70211 Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, POB 1627, FIN-70211 Kuopio, Finland
| | - Jukka S Jurvelin
- Department of Applied Physics, University of Eastern Finland, POB 1627, FIN-70211 Kuopio, Finland; Diagnostic Imaging Centre, Kuopio University Hospital, POB 100, FIN-70029 KYS, Kuopio, Finland
| | - Hanna Isaksson
- Department of Biomedical Engineering, Department of Orthopaedics, Lund University, POB 118, SE-221 00 Lund, Sweden
| | - Heikki Kröger
- Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland, POB 1627, FIN-70211 Kuopio, Finland; Department of Orthopaedics, Traumatology, and Hand Surgery, Kuopio University Hospital, POB 100, FIN-70029 KYS, Kuopio, Finland
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Osterhoff G, Morgan EF, Shefelbine SJ, Karim L, McNamara LM, Augat P. Bone mechanical properties and changes with osteoporosis. Injury 2016; 47 Suppl 2:S11-20. [PMID: 27338221 PMCID: PMC4955555 DOI: 10.1016/s0020-1383(16)47003-8] [Citation(s) in RCA: 281] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This review will define the role of collagen and within-bone heterogeneity and elaborate the importance of trabecular and cortical architecture with regard to their effect on the mechanical strength of bone. For each of these factors, the changes seen with osteoporosis and ageing will be described and how they can compromise strength and eventually lead to bone fragility.
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Affiliation(s)
- Georg Osterhoff
- Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Elise F. Morgan
- Department of Mechanical Engineering, Boston University, Boston, MA 02215, USA
| | - Sandra J. Shefelbine
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA 02115, USA
| | - Lamya Karim
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center and Department of Orthopedic Surgery, Harvard Medical School, Boston, MA 02215, USA
| | - Laoise M. McNamara
- Centre for Biomechanics Research (BMEC), Department of Biomedical Engineering, NUI Galway, Galway, Republic of Ireland,National Centre for Biomedical Engineering Science (NCBES), NUI Galway, Galway, Republic of Ireland
| | - Peter Augat
- Institute of Biomechanics, Trauma Center Murnau, Murnau, Germany and Paracelsus Medical University Salzburg, Salzburg, Austria,Corresponding author at: Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik, Murnau Prof.-Kuentscher-Str. 8, D-82418 Murnau am Staffelsee, Germany. Tel.: +49 8841 484563; fax: +49 8841 484573. (P. Augat)
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Pfeiffer S, Heinrich J, Beresheim A, Alblas M. Cortical bone histomorphology of known-age skeletons from the Kirsten collection, Stellenbosch university, South Africa. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 160:137-47. [PMID: 26865244 PMCID: PMC5067612 DOI: 10.1002/ajpa.22951] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 12/08/2015] [Accepted: 01/12/2016] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Normal human bone tissue changes predictably as adults get older, but substantial variability in pattern and pace remains unexplained. Information is needed regarding the characteristics of histological variables across diverse human populations. METHODS Undecalcified thin sections from mid-thoracic ribs of 213 skeletons (138 M, 75 F, 17-82 years, mean age 48 years), are used to explore the efficacy of an established age-at-death estimation method and methodological approach (Cho et al.: J Forensic Sci 47 (2002) 12-18) and expand on it. The ribs are an age-balanced sample taken from skeletonized cadavers collected from 1967 to 1999 in South Africa, each with recorded sex, age, cause of death and government-defined population group (129 "Colored," 49 "Black," 35 "White"). RESULTS The Ethnicity Unknown equation performs better than those developed for European-Americans and African-Americans, in terms of accuracy and bias. A new equation based solely on the study sample does not improve accuracy. Osteon population densities (OPD) show predicted values, yet secondary osteon areas (On.Ar) are smaller than expected for non-Black subgroups. Relative cortical area (Ct.Ar/Tt.Ar) is low among non-Whites. CONCLUSIONS Results from this highly diverse sample show that population-specific equations do not increase estimate precision. While within the published range of error for the method (±24.44 years), results demonstrate a systematic under-aging of young adults and over-aging of older adults. The regression approach is inappropriate. The field needs fresh approaches to statistical treatment and to factors behind cortical bone remodeling.
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Affiliation(s)
- Susan Pfeiffer
- Department of AnthropologyUniversity of TorontoTorontoM5S 2S2Canada
- Department of ArchaeologyUniversity of Cape TownRondeboschSouth Africa 7701
| | - Jarred Heinrich
- Department of AnthropologyUniversity of TorontoTorontoM5S 2S2Canada
| | - Amy Beresheim
- Department of AnthropologyUniversity of TorontoTorontoM5S 2S2Canada
| | - Mandi Alblas
- Department of Biomedical SciencesUniversity of StellenboschCape TownSouth Africa 8000
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