Drained and Undrained Poroelastic Properties of Healthy and Pathological Bone: A Poro-Micromechanical Investigation

Computational modeling for osteogenic potential assessment of physical exercises based on loading-induced mechanobiological environments in cortical bone remodeling

Osteoporosis and disuse can cause bone loss which reduces the weight-bearing strength of long bones. Physical exercise or mechanical loading prevents bone loss as it promotes bone modeling through osteogenesis, i.e., new bone formation. Several studies have observed distinct bone remodeling responses to physical exercises; nevertheless, the underlying mechanism behind such responses is not well established. Loading-induced pore-pressure and fluid motion act as mechanobiological stimuli to bone cells namely osteocytes which further initiate osteoactivities. The shape of loading waveforms also affects the poromechanical environment of bone. Accordingly, the present study hypothesizes that loading waveforms associated with physiological exercises may expose the bone to different mechanobiological stimuli resulting in distinct bone remodeling. A poromechanical finite element model is developed to compute pore-pressure and interstitial fluid velocity in femoral cortical bone tissue (healthy and osteoporotic) subjected to loading waveforms of three physiological exercises namely walking, running, and jumping. The model also computes the mechanobiological stimulus as a function of fluid velocity. The outcomes indicate that pore-pressure and fluid velocity decrease significantly in osteoporotic bone tissue in comparison with healthy tissue. Jumping and running both improve pore-pressure and fluid velocity in healthy and osteoporotic tissues, whereas running significantly enhances mechanobiological stimulus in both the tissues which indicates a possible explanation for distinct bone remodeling to different physical exercises. The present work also suggests that running may be recommended as a potential biomechanical therapeutic to prevent bone loss. Overall, the present work contributes to the area of orthopedic research to develop effective designs of prophylactic exercises to improve bone health.

Physiological Loading-Induced Interstitial Fluid Dynamics in Osteon of Osteogenesis Imperfecta Bone

Osteogenesis imperfecta (OI), also known as "brittle bone disease," is a genetic bone disorder. OI bones experience frequent fractures. Surgical procedures are usually followed by clinicians in the management of OI. It has been observed physical activity is equally beneficial in reducing OI bone fractures in both children and adults as mechanical stimulation improves bone mass and strength. Loading-induced mechanical strain and interstitial fluid flow stimulate bone remodeling activities. Several studies have characterized strain environment in OI bones, whereas very few studies attempted to characterize the interstitial fluid flow. OI significantly affects bone micro-architecture. Thus, this study anticipates that canalicular fluid flow reduces in OI bone in comparison to the healthy bone in response to physiological loading due to altered poromechanical properties. This work attempts to understand the canalicular fluid distribution in single osteon models of OI and healthy bone. A poromechanical model of osteon is developed to compute pore-pressure and interstitial fluid flow as a function of gait loading pattern reported for OI and healthy subjects. Fluid distribution patterns are compared at different time-points of the stance phase of the gait cycle. It is observed that fluid flow significantly reduces in OI bone. Additionally, flow is more static than dynamic in OI osteon in comparison to healthy subjects. This work attempts to identify the plausible explanation behind the diminished mechanotransduction capability of OI bone. This work may further be extended for designing better biomechanical therapies to enhance the fluid flow in order to improve osteogenic activities in OI bone.

Modeling Progressive Damage Accumulation in Bone Remodeling Explains the Thermodynamic Basis of Bone Resorption by Overloading

Computational modeling of skeletal tissue seeks to predict the structural adaptation of bone in response to mechanical loading. The theory of continuum damage-repair, a mathematical description of structural adaptation based on principles of damage mechanics, continues to be developed and utilized for the prediction of long-term peri-implant outcomes. Despite its technical soundness, CDR does not account for the accumulation of mechanical damage and irreversible deformation. In this work, a nonlinear mathematical model of independent damage accumulation and plastic deformation is developed in terms of the CDR formulation. The proposed model incorporates empirical correlations from uniaxial experiments. Supporting elements of the model are derived, including damage and yielding criteria, corresponding consistency conditions, and the basic, necessary forms for integration during loading. Positivity of mechanical dissipation due to damage is proved, while strain-based, associative plastic flow and linear hardening describe post-yield behavior. Calibration of model parameters to the empirical correlations from which the model was derived is then accomplished. Results of numerical experiments on a point-wise specimen show that damage and plasticity inhibit bone formation by dissipation of energy available to biological processes, leading to material failure that would otherwise be predicted to experience a net gain of bone.

Mandibular biomechanics after marginal resection: Correspondences of simulated volumetric strain and skeletal resorption

Serious mandibular diseases such as tumor or osteonecrosis often require segmental or marginal mandibulectomy, the latter with improved outcome thanks to preserved mandibular continuity. Nevertheless, gradual osteolytic and/or osteosclerotic skeletal changes frequently indicate repetitive resections. Based on the fundamental adaptivity of bone to mechanical loads, the question arose whether resection-related anatomical alterations trigger relevant pathological skeletal adaptations. For a clinical case after mandibular box resection due to progressive osteoradionecrosis (ORN), routine biomechanical loading was simulated by finite element method, respecting pathology-related anatomy, tissue properties, and biting capacity. By 3D-visualization of the mandible's pathological development from follow-up-CT's over four years, remarkable correspondences of skeletal resorptions and increased unphysiological strain were revealed. Higher unphysiological load was correlated with more serious and earlier skeletal alterations. Three months post-operatively, serious buccal destruction at the distal resection corner occurred in correspondence with dominant tensile strain. At the resection, elevated strain caused by reduced alveolar height corresponded to skeletal compromise, observed 8-9 months post-operatively. ORN-related lesions, diagnosed before resection, entailed unphysiological strain coinciding with local skeletal alterations. Simulations with "healthy" instead of pathological tissue coefficients induced quantitative improvements of 25-33%, but without fundamental change. These results suggest a decisive contribution of resection-related biomechanical skeletal adaptations to this patient's mandibular decline with hemimandibulectomy about 2.5 years after the first resection. However, mechanical stress concentrations in sharp angles as the distal resection corner and reduced stability due to decreased alveolar height generally bear the danger of pathological biomechanics and severe skeletal adaptations for patients after mandibular box resection.

Theoretical Explorations Generate New Hypotheses About the Role of the Cartilage Endplate in Early Intervertebral Disk Degeneration

Altered cell nutrition in the intervertebral disk (IVD) is considered a main cause for disk degeneration (DD). The cartilage endplate (CEP) provides a major path for the diffusion of nutrients from the peripheral vasculature to the IVD nucleus pulposus (NP). In DD, sclerosis of the adjacent bony endplate is suggested to be responsible for decreased diffusion and disk cell nutrition. Yet, experimental evidence does not support this hypothesis. Hence, we evaluated how moderate CEP composition changes related to tissue degeneration can affect disk nutrition and cell viability. A novel composition-based permeability formulation was developed for the CEP, calibrated, validated, and used in a mechano-transport finite element IVD model. Fixed solute concentrations were applied at the outer surface of the annulus and the CEP, and three cycles of daily mechanical load were simulated. The CEP model indicated that CEP permeability increases with the degeneration/aging of the tissue, in accordance with recent measurements reported in the literature. Additionally, our results showed that CEP degeneration might be responsible for mechanical load-induced NP dehydration, which locally affects oxygen and lactate levels, and reduced glucose concentration by 16% in the NP-annulus transition zone. Remarkably, CEP degeneration was a condition sine-qua-non to provoke cell starvation and death, while simulating the effect of extracellular matrix depletion in DD. This theoretical study cast doubts about the paradigm that CEP calcification is needed to provoke cell starvation, and suggests an alternative path for DD whereby the early degradation of the CEP plays a key role.

Contribution of fluid in bone extravascular matrix to strain-rate dependent stiffening of bone tissue - A poroelastic study

Osteoporotic fractures represent an increasing cost to society, and its diagnosis methods based on bone density still lack accuracy in identifying risk of fracture. This is why a better understanding of mechanical behavior of bone tissue is of importance, especially when it comes to relating experimental observations to realistic physiological fall loading conditions. This study aims at exploring the stiffening effect of pore fluid in bone extravascular matrix subject to high strain rate loading that is more realistic to simulate a physiological fall. A computational approach is used, where bone tissue microstructure extracted from micro-CT images is modeled using finite elements. The solid phase of bone tissue is modeled as a poroelastic material, a porous matrix filled with fluid. When the extravascular matrix experiences certain volumetric deformation, the fluid in pores presents load carrying capacity, which consequently varies the apparent stiffness of bone tissue. It is shown that effects of fluid stiffening in bone can be significant, depending on the chosen material properties, the amount of volumetric strain in tissue and the loading rate with respect to hydraulic conductivity and drainage conditions. It is also shown that such stiffening effect is influenced by bone microstructure, and is more significant in cortical bone than in trabecular bone.

Poromicromechanics reveals that physiological bone strains induce osteocyte-stimulating lacunar pressure

Mechanical loads which are macroscopically acting onto bony organs, are known to influence the activities of biological cells located in the pore spaces of bone, in particular so the signaling and production processes mediated by osteocytes. The exact mechanisms by which osteocytes are actually able to “feel” the mechanical loading and changes thereof, has been the subject of numerous studies, and, while several hypotheses have been brought forth over time, this topic has remained a matter of debate. Relaxation times reported in a recent experimental study of Gardinier et al. (Bone 46(4):1075–1081, 2010) strongly suggest that the lacunar pores are likely to experience, during typical physiological load cycles, not only fluid transport, but also undrained conditions. The latter entail the buildup of lacunar pore pressures, which we here quantify by means of a thorough multiscale modeling approach. In particular, the proposed model is based on classical poroelasticity theory, and able to account for multiple pore spaces. First, the model reveals distinct nonlinear dependencies of the resulting lacunar (and vascular) pore pressures on the underlying bone composition, highlighting the importance of a rigorous multiscale approach for appropriate computation of the aforementioned pore pressures. Then, the derived equations are evaluated for macroscopic (uniaxial as well as hydrostatic) mechanical loading of physiological magnitude. The resulting model-predicted pore pressures agree very well with the pressures that have been revealed, by means of in vitro studies, to be of adequate magnitude for modulating the responses of biological cells, including osteocytes. This underlines that osteocytes may respond to many types of loading stimuli at the same time, in particular so to fluid flow and hydrostatic pressure.

Is trabecular bone permeability governed by molecular ordering-induced fluid viscosity gain? Arguments from re-evaluation of experimental data in the framework of homogenization theory

It is generally agreed on that trabecular bone permeability, a physiologically important quantity, is governed by the material׳s (vascular or intertrabecular) porosity as well as by the viscosity of the pore-filling fluids. Still, there is less agreement on how these two key factors govern bone permeability. In order to shed more light onto this somewhat open issue, we here develop a random homogenization scheme for upscaling Poiseuille flow in the vascular porosity, up to Darcy-type permeability of the overall porous medium "trabecular bone". The underlying representative volume element of the macroscopic bone material contains two types of phases: a spherical, impermeable extracellular bone matrix phase interacts with interpenetrating cylindrical pore channel phases that are oriented in all different space directions. This type of interaction is modeled by means of a self-consistent homogenization scheme. While the permeability of the bone matrix equals to zero, the permeability of the pore phase is found through expressing the classical Hagen-Poiseuille law for laminar flow in the format of a "micro-Darcy law". The upscaling scheme contains pore size and porosity as geometrical input variables; however, they can be related to each other, based on well-known relations between porosity and specific bone surface. As two key results, validated through comprehensive experimental data, it appears (i) that the famous Kozeny-Carman constant (which relates bone permeability to the cube of the porosity, the square of the specific surface, as well as to the bone fluid viscosity) needs to be replaced by an again porosity-dependent rational function, and (ii) that the overall bone permeability is strongly affected by the pore fluid viscosity, which, in case of polarized fluids, is strongly increased due to the presence of electrically charged pore walls.

Power-law hereditariness of hierarchical fractal bones

In this paper, the authors introduce a hierarchic fractal model to describe bone hereditariness. Indeed, experimental data of stress relaxation or creep functions obtained by compressive/tensile tests have been proved to be fit by power law with real exponent 0 ⩽ β ⩽1. The rheological behavior of the material has therefore been obtained, using the Boltzmann-Volterra superposition principle, in terms of real order integrals and derivatives (fractional-order calculus). It is shown that the power laws describing creep/relaxation of bone tissue may be obtained by introducing a fractal description of bone cross-section, and the Hausdorff dimension of the fractal geometry is then related to the exponent of the power law.

Layered water in crystal interfaces as source for bone viscoelasticity: arguments from a multiscale approach

Extracellular bone material can be characterised as a nanocomposite where, in a liquid environment, nanometre-sized hydroxyapatite crystals precipitate within as well as between long fibre-like collagen fibrils (with diameters in the 100 nm range), as evidenced from neutron diffraction and transmission electron microscopy. Accordingly, these crystals are referred to as 'interfibrillar mineral' and 'extrafibrillar mineral', respectively. From a topological viewpoint, it is probable that the mineralisations start on the surfaces of the collagen fibrils ('mineral-encrusted fibrils'), from where the crystals grow both into the fibril and into the extrafibrillar space. Since the mineral concentration depends on the pore spaces within the fibrils and between the fibrils (there is more space between them), the majority of the crystals (but clearly not all of them) typically lie in the extrafibrillar space. There, larger crystal agglomerations or clusters, spanning tens to hundreds of nanometers, develop in the course of mineralisation, and the micromechanics community has identified the pivotal role, which this extrafibrillar mineral plays for tissue elasticity. In such extrafibrillar crystal agglomerates, single crystals are stuck together, their surfaces being covered with very thin water layers. Recently, the latter have caught our interest regarding strength properties (Fritsch et al. 2009 J Theor Biol. 260(2): 230-252) - we have identified these water layers as weak interfaces in the extrafibrillar mineral of bone. Rate-independent gliding effects of crystals along the aforementioned interfaces, once an elastic threshold is surpassed, can be related to overall elastoplastic material behaviour of the hierarchical material 'bone'. Extending this idea, the present paper is devoted to viscous gliding along these interfaces, expressing itself, at the macroscale, in the well-known experimentally evidenced phenomenon of bone viscoelasticity. In this context, a multiscale homogenisation scheme is extended to viscoelasticity, mineral-cluster-specific creep parameters are identified from three-point bending tests on hydrated bone samples, and the model is validated by statistically and physically independent experiments on partially dried samples. We expect this model to be relevant when it comes to prediction of time-dependent phenomena, e.g. in the context of bone remodelling.

Ductile sliding between mineral crystals followed by rupture of collagen crosslinks: experimentally supported micromechanical explanation of bone strength

There is an ongoing discussion on how bone strength could be explained from its internal structure and composition. Reviewing recent experimental and molecular dynamics studies, we here propose a new vision on bone material failure: mutual ductile sliding of hydroxyapatite mineral crystals along layered water films is followed by rupture of collagen crosslinks. In order to cast this vision into a mathematical form, a multiscale continuum micromechanics theory for upscaling of elastoplastic properties is developed, based on the concept of concentration and influence tensors for eigenstressed microheterogeneous materials. The model reflects bone's hierarchical organization, in terms of representative volume elements for cortical bone, for extravascular and extracellular bone material, for mineralized fibrils and the extrafibrillar space, and for wet collagen. In order to get access to the stress states at the interfaces between crystals, the extrafibrillar mineral is resolved into an infinite amount of cylindrical material phases oriented in all directions in space. The multiscale micromechanics model is shown to be able to satisfactorily predict the strength characteristics of different bones from different species, on the basis of their mineral/collagen content, their intercrystalline, intermolecular, lacunar, and vascular porosities, and the elastic and strength properties of hydroxyapatite and (molecular) collagen.

Interstitial flow and its effects in soft tissues

Interstitial flow plays important roles in the morphogenesis, function, and pathogenesis of tissues. To investigate these roles and exploit them for tissue engineering or to overcome barriers to drug delivery, a comprehensive consideration of the interstitial space and how it controls and affects such processes is critical. Here we attempt to review the many physical and mathematical correlations that describe fluid and mass transport in the tissue interstitium; the factors that control and affect them; and the importance of interstitial transport on cell biology, tissue morphogenesis, and tissue engineering. Finally, we end with some discussion of interstitial transport issues in drug delivery, cell mechanobiology, and cell homing toward draining lymphatics.

'Universal' microstructural patterns in cortical and trabecular, extracellular and extravascular bone materials: micromechanics-based prediction of anisotropic elasticity

Bone materials are characterized by an astonishing variability and diversity. Still, because of 'architectural constraints' due to once chosen material constituents and their physical interaction, the fundamental hierarchical organization or basic building plans of bone materials remain largely unchanged during biological evolution. Such universal patterns of microstructural organization govern the mechanical interaction of the elementary components of bone (hydroxyapatite, collagen, water; with directly measurable tissue-independent elastic properties), which are here quantified through a multiscale homogenization scheme delivering effective elastic properties of bone materials: at a scale of 10nm, long cylindrical collagen molecules, attached to each other at their ends by approximately 1.5nm long crosslinks and hosting intermolecular water inbetween, form a contiguous matrix called wet collagen. At a scale of several hundred nanometers, wet collagen and mineral crystal agglomerations interpenetrate each other, forming the mineralized fibril. At a scale of 5-10microm, the extracellular solid bone matrix is represented as collagen fibril inclusions embedded in a foam of largely disordered (extrafibrillar) mineral crystals. At a scale above the ultrastructure, where lacunae are embedded in extracellular bone matrix, the extravascular bone material is observed. Model estimates predicted from tissue-specific composition data gained from a multitude of chemical and physical tests agree remarkably well with corresponding acoustic stiffness experiments across a variety of cortical and trabecular, extracellular and extravascular materials. Besides from reconciling the well-documented, seemingly opposed concepts of 'mineral-reinforced collagen matrix' and 'collagen-reinforced mineral matrix' for bone ultrastructure, this approach opens new possibilities in the exploitation of computer tomographic data for nano-to-macro mechanics of bone organs.

Consideration of anisotropic elasticity minimizes volumetric rather than shear deformation in human mandible

This article is focused on the role of anisotropic elasticity in the simulation of the load distribution in a human mandible, due to a lateral bite on the leftmost premolar. Based on experimental evidence, orthotropy of the elastic properties of the bone tissue has been adopted. The trajectories of anisotropic elasticity are reconstructed from (i) the organ's geometry and (ii) from coherent structures which can be recognized from the spatial distribution of the grey values coming from computer tomography (CT). A sensitivity analysis comprising various three-dimensional (3D) finite element (FE) simulations reveals the relevance of elastic anisotropy for the load carrying behavior of a human mandible: comparison of the load distributions in isotropic and anisotropic simulations indicates that anisotropy seems to "spare" the mandible from loading. Moreover, a maximum degree of anisotropy leads to kind of load minimization of the mandible, expressed by a minimum of different norms of local volumetric strain, evaluated throughout the organ. The observed optimization with respect to volumetric rather than shear strain seems to confirm the frequently emphazised role of volumetric-strain-induced fluid flow for the stimulation of cellular activity.