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Stolle J, Harper CM, Voegele KK, Najafi AR, Taheri M, MacBain J, Siegler S. A statistical analysis of human talar shape and bone density distribution. J Orthop Res 2024; 42:1780-1790. [PMID: 38483072 DOI: 10.1002/jor.25835] [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: 08/22/2023] [Revised: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 07/04/2024]
Abstract
The shape of the talus, its internal structure, and its mechanical properties are important in determining talar behavior during loading, which may be significant for the design of surgical tools and implants. Although recent studies using statistical shape modeling have described quantitative talar external shape variation, no similar quantitative study exists to describe the density distribution of internal talar structure. The goal of this study is to quantify statistical variation in talar shape and density to benefit the design of talar implants. To this end, weight-bearing computed tomography (CT) scans of the ankle were collected in neutral, bilateral standing posture, and three-dimensional models were generated for each talus. Local density derived from the Hounsfield unit of each CT voxel was extracted. A weighted spherical harmonic analysis was performed to quantify the talar external shape. One hundred and seventy-nine volumes of interest were placed in the same relative position within each talus to quantify the talar density. Additionally, a finite element analysis (FEA) was conducted on a talus with both heterogeneous and homogeneous material properties to observe the effect of these properties on the stress and strain response. Significant differences were found in the talar density in sex and age, as well as in the stress and strain response between homogeneous and heterogeneous FEA. These differences show the importance of considering heterogeneity when examining the load response of tarsal bones.
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Affiliation(s)
- Jordan Stolle
- Department of Mechanical Engineering and Mechanics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Christine M Harper
- Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Kristyn K Voegele
- Department of Geology, Rowan University School of Earth and Environment, Glassboro, New Jersey, USA
| | - Ahmad R Najafi
- Department of Mechanical Engineering and Mechanics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Mehrangiz Taheri
- Department of Mechanical Engineering and Mechanics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Joshua MacBain
- Department of Mechanical Engineering and Mechanics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Sorin Siegler
- Department of Mechanical Engineering and Mechanics, Drexel University, Philadelphia, Pennsylvania, USA
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2
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Knowles NK, Kusins J, Columbus MP, Athwal GS, Ferreira LM. Experimental DVC validation of heterogeneous micro finite element models applied to subchondral trabecular bone of the humeral head. J Orthop Res 2022; 40:2039-2047. [PMID: 34855264 DOI: 10.1002/jor.25229] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 11/01/2021] [Accepted: 11/20/2021] [Indexed: 02/04/2023]
Abstract
Subchondral trabecular bone (STB) undergoes adaptive changes during osteoarthritic (OA) disease progression. These changes alter both the mineralization patterns and structure of bone and may contribute to variations in the mechanical properties. Similarly, when images are downsampled - as is often performed in micro finite element model (microFEM) generation - the morphological and mineralization patterns may further alter the mechanical properties due to partial volume effects. MicroFEMs accounting for material heterogeneity can account for these tissue variations, but no studies have validated these with robust full-field testing methods. As such, this study compared homogeneous and heterogeneous microFEMs to experimentally loaded trabecular bone cores from the humeral head combined with digital volume correlation (DVC). These microFEMs were used to compare apparent mechanical properties between normal and OA STB. Morphological and mineralization patterns between groups were also compared. There were no significant differences in tissue or bone mineral density between groups. The only significant differences in morphometric parameters were in trabecular thickness between groups. There were no significant differences in linear regression parameters between normal and OA STB apparent mechanical properties estimated using heterogeneous microFEMs with an element-wise bilinear elastic-plastic constitutive model. Clinical significance: Validated heterogeneous microFEMs applied to STB of the humeral head have the potential to significantly improve our understanding of mechanical variations in the bone that occur during OA progression.
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Affiliation(s)
- Nikolas K Knowles
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan Kusins
- Department of Mechanical and Materials Engineering, The University of Western Ontario, London, Ontario, Canada.,Roth, McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, London, Ontario, Canada
| | - Melanie P Columbus
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - George S Athwal
- Roth, McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, London, Ontario, Canada
| | - Louis M Ferreira
- Department of Mechanical and Materials Engineering, The University of Western Ontario, London, Ontario, Canada.,Roth, McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, London, Ontario, Canada
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3
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Confavreux CB, Follet H, Mitton D, Pialat JB, Clézardin P. Fracture Risk Evaluation of Bone Metastases: A Burning Issue. Cancers (Basel) 2021; 13:cancers13225711. [PMID: 34830865 PMCID: PMC8616502 DOI: 10.3390/cancers13225711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
Major progress has been achieved to treat cancer patients and survival has improved considerably, even for stage-IV bone metastatic patients. Locomotive health has become a crucial issue for patient autonomy and quality of life. The centerpiece of the reflection lies in the fracture risk evaluation of bone metastasis to guide physician decision regarding physical activity, antiresorptive agent prescription, and local intervention by radiotherapy, surgery, and interventional radiology. A key mandatory step, since bone metastases may be asymptomatic and disseminated throughout the skeleton, is to identify the bone metastasis location by cartography, especially within weight-bearing bones. For every location, the fracture risk evaluation relies on qualitative approaches using imagery and scores such as Mirels and spinal instability neoplastic score (SINS). This approach, however, has important limitations and there is a need to develop new tools for bone metastatic and myeloma fracture risk evaluation. Personalized numerical simulation qCT-based imaging constitutes one of these emerging tools to assess bone tumoral strength and estimate the femoral and vertebral fracture risk. The next generation of numerical simulation and artificial intelligence will take into account multiple loadings to integrate movement and obtain conditions even closer to real-life, in order to guide patient rehabilitation and activity within a personalized-medicine approach.
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Affiliation(s)
- Cyrille B. Confavreux
- Centre Expert des Métastases Osseuses (CEMOS), Département de Rhumatologie, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), Hôpital Lyon Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, France
- Université de Lyon, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France; (H.F.); (J.B.P.); (P.C.)
- Institut National de la Santé et de la Recherche Médicale INSERM, LYOS UMR1033, 69008 Lyon, France
- Correspondence:
| | - Helene Follet
- Université de Lyon, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France; (H.F.); (J.B.P.); (P.C.)
- Institut National de la Santé et de la Recherche Médicale INSERM, LYOS UMR1033, 69008 Lyon, France
| | - David Mitton
- Université de Lyon, Université Gustave Eiffel, Université Claude Bernard Lyon 1, LBMC, UMR_T 9406, 69622 Lyon, France;
| | - Jean Baptiste Pialat
- Université de Lyon, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France; (H.F.); (J.B.P.); (P.C.)
- CREATIS, CNRS UMR 5220, INSERM U1294, INSA Lyon, Université Jean Monnet Saint-Etienne, 42000 Saint-Etienne, France
- Service de Radiologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, France
| | - Philippe Clézardin
- Université de Lyon, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France; (H.F.); (J.B.P.); (P.C.)
- Institut National de la Santé et de la Recherche Médicale INSERM, LYOS UMR1033, 69008 Lyon, France
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Fu J, Meng H, Zhang C, Liu Y, Chen D, Wang A, Main RP, Yang H. Effects of tissue heterogeneity on trabecular micromechanics examined by microCT-based finite element analysis and digital volume correlation. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2021. [DOI: 10.1016/j.medntd.2021.100088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Li Z, Betts D, Kuhn G, Schirmer M, Müller R, Ruffoni D. Mechanical regulation of bone formation and resorption around implants in a mouse model of osteopenic bone. J R Soc Interface 2020; 16:20180667. [PMID: 30890053 DOI: 10.1098/rsif.2018.0667] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Although mechanical stimulation is considered a promising approach to accelerate implant integration, our understanding of load-driven bone formation and resorption around implants is still limited. This lack of knowledge may delay the development of effective loading protocols to prevent implant loosening, especially in osteoporosis. In healthy bone, formation and resorption are mechanoregulated processes. In the intricate context of peri-implant bone regeneration, it is not clear whether bone (re)modelling can still be load-driven. Here, we investigated the mechanical control of peri-implant bone (re)modelling with a well-controlled mechanobiological experiment. We applied cyclic mechanical loading after implant insertion in tail vertebrae of oestrogen depleted mice and we monitored peri-implant bone response by in vivo micro-CT. Experimental data were combined with micro-finite element simulations to estimate local tissue strains in (re)modelling locations. We demonstrated that a substantial increase in bone mass around the implant could be obtained by loading the entire bone. This augmentation could be attributed to a large reduction in bone resorption rather than to an increase in bone formation. We also showed that following implantation, mechanical regulation of bone (re)modelling was transiently lost. Our findings should help to clarify the role of mechanical stimulation on the maintenance of peri-implant bone mass.
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Affiliation(s)
- Zihui Li
- 1 Institute for Biomechanics, ETH Zurich , Zurich , Switzerland
| | - Duncan Betts
- 1 Institute for Biomechanics, ETH Zurich , Zurich , Switzerland
| | - Gisela Kuhn
- 1 Institute for Biomechanics, ETH Zurich , Zurich , Switzerland
| | | | - Ralph Müller
- 1 Institute for Biomechanics, ETH Zurich , Zurich , Switzerland
| | - Davide Ruffoni
- 1 Institute for Biomechanics, ETH Zurich , Zurich , Switzerland.,3 Mechanics of Biological and Bioinspired Materials Laboratory, Department of Aerospace and Mechanical Engineering, University of Liège , Liège , Belgium
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Rajapakse CS, Farid AR, Kargilis DC, Jones BC, Lee JS, Johncola AJ, Batzdorf AS, Shetye SS, Hast MW, Chang G. MRI-based assessment of proximal femur strength compared to mechanical testing. Bone 2020; 133:115227. [PMID: 31926345 PMCID: PMC7096175 DOI: 10.1016/j.bone.2020.115227] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/02/2020] [Accepted: 01/07/2020] [Indexed: 12/14/2022]
Abstract
Half of the women who sustain a hip fracture would not qualify for osteoporosis treatment based on current DXA-estimated bone mineral density criteria. Therefore, a better approach is needed to determine if an individual is at risk of hip fracture from a fall. The objective of this study was to determine the association between radiation-free MRI-derived bone strength and strain simulations compared to results from direct mechanical testing of cadaveric femora. Imaging was conducted on a 3-Tesla MRI scanner using two sequences: one balanced steady-state free precession sequence with 300 μm isotropic voxel size and one spoiled gradient echo with anisotropic voxel size of 234 × 234 × 1500 μm. Femora were dissected free of soft-tissue and 4350-ohm strain-gauges were securely applied to surfaces at the femoral shaft, inferior neck, greater trochanter, and superior neck. Cadavers were mechanically tested with a hydraulic universal test frame to simulate loading in a sideways fall orientation. Sideways fall forces were simulated on MRI-based finite element meshes and bone stiffness, failure force, and force for plastic deformation were computed. Simulated bone strength metrics from the 300 μm isotropic sequence showed strong agreement with experimentally obtained values of bone strength, with stiffness (r = 0.88, p = 0.0002), plastic deformation point (r = 0.89, p < 0.0001), and failure force (r = 0.92, p < 0.0001). The anisotropic sequence showed similar trends for stiffness, plastic deformation point, and failure force (r = 0.68, 0.70, 0.84; p = 0.02, 0.01, 0.0006, respectively). Surface strain-gauge measurements showed moderate to strong agreement with simulated magnitude strain values at the greater trochanter, superior neck, and inferior neck (r = -0.97, -0.86, 0.80; p ≤0.0001, 0.003, 0.03, respectively). The findings from this study support the use of MRI-based FE analysis of the hip to reliably predict the mechanical competence of the human femur in clinical settings.
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Affiliation(s)
- Chamith S Rajapakse
- Department of Radiology, University of Pennsylvania, United States of America; Department of Orthopaedic Surgery, University of Pennsylvania, United States of America.
| | - Alexander R Farid
- Department of Radiology, University of Pennsylvania, United States of America
| | - Daniel C Kargilis
- Department of Radiology, University of Pennsylvania, United States of America
| | - Brandon C Jones
- Department of Radiology, University of Pennsylvania, United States of America
| | - Jae S Lee
- Department of Radiology, University of Pennsylvania, United States of America
| | - Alyssa J Johncola
- Department of Radiology, University of Pennsylvania, United States of America
| | | | - Snehal S Shetye
- Department of Orthopaedic Surgery, University of Pennsylvania, United States of America
| | - Michael W Hast
- Department of Orthopaedic Surgery, University of Pennsylvania, United States of America
| | - Gregory Chang
- Department of Radiology, New York University, United States of America
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7
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Knowles NK, Kusins J, Columbus MP, Athwal GS, Ferreira LM. Morphological and Apparent-Level Stiffness Variations Between Normal and Osteoarthritic Bone in the Humeral Head. J Orthop Res 2020; 38:503-509. [PMID: 31556155 DOI: 10.1002/jor.24482] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/13/2019] [Indexed: 02/04/2023]
Abstract
Osteoarthritis (OA) is characterized by morphological changes that alter bone structure and mechanical properties. This study compared bone morphometric parameters and apparent modulus between humeral heads excised from end-stage OA patients undergoing total shoulder arthroplasty (n = 28) and non-pathologic normal cadavers (n = 28). Morphometric parameters were determined in central cores, with regional variations compared in four medial to lateral regions. Linear regression compared apparent modulus, morphometric parameters, and age. Micro finite element models estimated trabecular apparent modulus and derived density-modulus relationships. Significant differences were found for bone volume fraction (p < 0.001) and trabecular thickness (p < 0.001) in the most medial regions. No significant differences occurred between morphometric parameters and apparent modulus or age, except in slope between groups for apparent modulus versus trabecular number (p = 0.021), and in intercept for trabecular thickness versus age (p = 0.040). Significant differences occurred in both slope and intercept between density-modulus regression fits for each group (p ≤ 0.001). The normal group showed high correlations in the power-fit (r2 = 0.87), with a lower correlation (r2 = 0.61) and a more linear relationship, in the OA group. This study suggests that alterations in structure and apparent modulus persist mainly in subchondral regions of end-stage OA bone. As such, if pathologic regions are removed during joint replacement, computational models that utilize modeling parameters from non-pathologic normal bone may be applied to end-stage OA bone. An improved understanding of humeral trabecular bone variations has potential to improve the surgical management of end-stage OA patients. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:503-509, 2020.
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Affiliation(s)
- Nikolas K Knowles
- School of Biomedical Engineering, The University of Western Ontario, London, Ontario, Canada.,Roth
- McFarlane Hand and Upper Limb Centre, St. Josephs Health Care, London, Ontario, Canada.,Collaborative Training Program in MSK Health Research, and Bone and Joint Institute, The University of Western Ontario, London, Ontario, Canada
| | - Jonathan Kusins
- Roth
- McFarlane Hand and Upper Limb Centre, St. Josephs Health Care, London, Ontario, Canada.,Collaborative Training Program in MSK Health Research, and Bone and Joint Institute, The University of Western Ontario, London, Ontario, Canada.,Department of Mechanical and Materials Engineering, The University of Western Ontario, London, Ontario, Canada
| | - Melanie P Columbus
- Department of Medicine, Division of Emergency Medicine, The University of Western Ontario, London, Ontario, Canada
| | - George S Athwal
- Roth
- McFarlane Hand and Upper Limb Centre, St. Josephs Health Care, London, Ontario, Canada.,Collaborative Training Program in MSK Health Research, and Bone and Joint Institute, The University of Western Ontario, London, Ontario, Canada
| | - Louis M Ferreira
- School of Biomedical Engineering, The University of Western Ontario, London, Ontario, Canada.,Roth
- McFarlane Hand and Upper Limb Centre, St. Josephs Health Care, London, Ontario, Canada.,Collaborative Training Program in MSK Health Research, and Bone and Joint Institute, The University of Western Ontario, London, Ontario, Canada.,Department of Mechanical and Materials Engineering, The University of Western Ontario, London, Ontario, Canada
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