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Xu C, Li H, Zhang C, Ge F, He Q, Chen H, Zhang L, Bai X. Quantitative Analysis of Primary Compressive Trabeculae Distribution in the Proximal Femur of the Elderly. Orthop Surg 2024; 16:2030-2039. [PMID: 38951721 PMCID: PMC11293936 DOI: 10.1111/os.14141] [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: 03/16/2024] [Revised: 06/02/2024] [Accepted: 06/04/2024] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVE As osteoporosis progresses, the primary compressive trabeculae (PCT) in the proximal femur remains preserved and is deemed the principal load-bearing structure that links the femoral head with the femoral neck. This study aims to elucidate the distribution patterns of PCT within the proximal femur in the elderly population, and to assess its implications for the development and optimization of internal fixation devices used in hip fracture surgeries. METHODS This is a retrospective cohort study conducted from March 2022 to April 2023. A total of 125 patients who underwent bilateral hip joint CT scans in our hospital were enrolled. CT data of the unaffected side of the hip were analyzed. Key parameters regarding the PCT distribution in the proximal femur were measured, including the femoral head's radius (R), the neck-shaft angle (NSA), the angle between the PCT-axis and the head-neck axis (α), the distance from the femoral head center to the PCT-axis (δ), and the lengths of the PCT's bottom and top boundaries (L-bottom and L-top respectively). The impact of gender differences on PCT distribution patterns was also investigated. Student's t-test or Mann-Whitney U test were used to compare continuous variables between genders. The relationship between various variables was investigated through Pearson's correlation analysis. RESULTS PCT was the most prominent bone structure within the femoral head. The average NSA, α, and δ were 126.85 ± 5.85°, 37.33 ± 4.23°, and 0.39 ± 1.22 mm, respectively, showing no significant gender differences (p > 0.05). Pearson's correlation analysis revealed strong correlations between α and NSA (r = -0.689, p < 0.001), and R and L-top (r = 0.623, p < 0.001), with mild correlations observed between δ and NSA (r = -0.487, p < 0.001), and R and L-bottom (r = 0.427, p < 0.001). Importantly, our study establishes a method to accurately localize PCT distribution in true anteroposterior (AP) radiographs of the hip joint, facilitating precise screw placement in proximal femur fixation procedures. CONCLUSION Our study provided unprecedented insights into the distribution patterns of PCT in the proximal femur of the elderly population. The distribution of PCT in the proximal femur is predominantly influenced by anatomical and geometric factors, such as NSA and femoral head size, rather than demographic factors like gender. These insights have crucial implications for the design of internal fixation devices and surgical planning, offering objective guidance for the placement of screws in hip fracture treatments.
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Affiliation(s)
- Cheng Xu
- Department of OrthopedicsThe Sixth Medical Center of PLA General HospitalBeijingChina
- Senior Department of OrthopedicsThe Fourth Medical Center of PLA General HospitalBeijingChina
| | - Hang Li
- Department of Hyperbaric OxygenThe Sixth Medical Center of PLA General HospitalBeijingChina
| | - Chao Zhang
- Department of OrthopedicsThe Sixth Medical Center of PLA General HospitalBeijingChina
- Senior Department of OrthopedicsThe Fourth Medical Center of PLA General HospitalBeijingChina
| | - Feng Ge
- Department of OrthopedicsThe Sixth Medical Center of PLA General HospitalBeijingChina
| | - Qing He
- Department of OrthopedicsThe Sixth Medical Center of PLA General HospitalBeijingChina
- Senior Department of OrthopedicsThe Fourth Medical Center of PLA General HospitalBeijingChina
| | - Hua Chen
- Senior Department of OrthopedicsThe Fourth Medical Center of PLA General HospitalBeijingChina
| | - Licheng Zhang
- Senior Department of OrthopedicsThe Fourth Medical Center of PLA General HospitalBeijingChina
| | - Xuedong Bai
- Department of OrthopedicsThe Sixth Medical Center of PLA General HospitalBeijingChina
- Senior Department of OrthopedicsThe Fourth Medical Center of PLA General HospitalBeijingChina
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Aslam Khan MU, Aslam MA, Bin Abdullah MF, Stojanović GM. Current Perspectives of Protein in Bone Tissue Engineering: Bone Structure, Ideal Scaffolds, Fabrication Techniques, Applications, Scopes, and Future Advances. ACS APPLIED BIO MATERIALS 2024. [PMID: 39007509 DOI: 10.1021/acsabm.4c00362] [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: 07/16/2024]
Abstract
In view of their exceptional approach, excellent inherent biocompatibility and biodegradability properties, and interaction with the local extracellular matrix, protein-based polymers have received attention in bone tissue engineering, which is a multidisciplinary field that repairs and regenerates fractured bones. Bone is a multihierarchical complex structure, and it performs several essential biofunctions, including maintaining mineral balance and structural support and protecting soft organs. Protein-based polymers have gained interest in developing ideal scaffolds as emerging biomaterials for bone fractured healing and regeneration, and it is challenging to design ideal bone substitutes as perfect biomaterials. Several protein-based polymers, including collagen, keratin, gelatin, serum albumin, etc., are potential materials due to their inherent cytocompatibility, controlled biodegradability, high biofunctionalization, and tunable mechanical characteristics. While numerous studies have indicated the encouraging possibilities of proteins in BTE, there are still major challenges concerning their biodegradability, stability in physiological conditions, and continuous release of growth factors and bioactive molecules. Robust scaffolds derived from proteins can be used to replace broken or diseased bone with a biocompatible substitute; proteins, being biopolymers, provide excellent scaffolds for bone tissue engineering. Herein, recent developments in protein polymers for cutting-edge bone tissue engineering are addressed in this review within 3-5 years, with a focus on the significant challenges and future perspectives. The first section discusses the structural fundamentals of bone anatomy and ideal scaffolds, and the second section describes the fabrication techniques of scaffolds. The third section highlights the importance of proteins and their applications in BTE. Hence, the recent development of protein polymers for state-of-the-art bone tissue engineering has been discussed, highlighting the significant challenges and future perspectives.
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Affiliation(s)
- Muhammad Umar Aslam Khan
- Department of Mechanical and Industrial Engineering, Qatar University, Doha 2713, Qatar
- Biomedical Research Center, Qatar University, Doha 2713, Qatar
| | - Muhammad Azhar Aslam
- Department of Physics, University of Engineering and Technology, Lahore 39161, Pakistan
| | - Mohd Faizal Bin Abdullah
- Oral and Maxillofacial Surgery Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus Kubang Kerian 16150, Kota Bharu, Kelantan, Malaysia
- Oral and Maxillofacial Surgery Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Health Campus Kubang Kerian 16150, Kota Bharu, Kelantan, Malaysia
| | - Goran M Stojanović
- Faculty of Technical Sciences, University of Novi Sad, T. D. Obradovica 6, 21000 Novi Sad, Serbia
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Vergara-Hernandez FB, Nielsen BD, Popovich JM, Panek CL, Logan AA, Robison CI, Ehrhardt RA, Johnson TN, Chargo NJ, Welsh TH, Bradbery AN, Leatherwood JL, Colbath AC. Clodronate disodium does not produce measurable effects on bone metabolism in an exercising, juvenile, large animal model. PLoS One 2024; 19:e0300360. [PMID: 38626145 PMCID: PMC11020481 DOI: 10.1371/journal.pone.0300360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/23/2024] [Indexed: 04/18/2024] Open
Abstract
Bisphosphonates are commonly used to treat and prevent bone loss, but their effects in active, juvenile populations are unknown. This study examined the effects of intramuscular clodronate disodium (CLO) on bone turnover, serum bone biomarkers (SBB), bone mineral density (BMD), bone microstructure, biomechanical testing (BT), and cartilage glycosaminoglycan content (GAG) over 165 days. Forty juvenile sheep (253 ± 6 days of age) were divided into four groups: Control (saline), T0 (0.6 mg/kg CLO on day 0), T84 (0.6 mg/kg CLO on day 84), and T0+84 (0.6 mg/kg CLO on days 0 and 84). Sheep were exercised 4 days/week and underwent physical and lameness examinations every 14 days. Blood samples were collected for SBB every 28 days. Microstructure and BMD were calculated from tuber coxae (TC) biopsies (days 84 and 165) and bone healing was assessed by examining the prior biopsy site. BT and GAG were evaluated postmortem. Data, except lameness data, were analyzed using a mixed-effects model; lameness data were analyzed as ordinal data using a cumulative logistic model. CLO did not have any measurable effects on the skeleton of sheep. SBB showed changes over time (p ≤ 0.03), with increases in bone formation and decreases in some bone resorption markers. TC biopsies showed increasing bone volume fraction, trabecular spacing and thickness, and reduced trabecular number on day 165 versus day 84 (p ≤ 0.04). These changes may be attributed to exercise or growth. The absence of a treatment effect may be explained by the lower CLO dose used in large animals compared to humans. Further research is needed to examine whether low doses of bisphosphonates may be used in active juvenile populations for analgesia without evidence of bone changes.
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Affiliation(s)
- Fernando B. Vergara-Hernandez
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
- School of Veterinary Medicine, College of Natural Resources and Veterinary Medicine, Universidad Santo Tomas, Viña del Mar, Chile
| | - Brian D. Nielsen
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
| | - John M. Popovich
- Center for Neuromusculoskeletal Clinical Research, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Char L. Panek
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Alyssa A. Logan
- School of Agriculture, College of Basic and Applied Sciences, Middle Tennessee State University, Murfreesboro, Tennessee, United States of America
| | - Cara I. Robison
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
| | - Richard A. Ehrhardt
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Tyler N. Johnson
- Department of Chemical Engineering and Materials Science, College of Engineering, Michigan State University, East Lansing, Michigan, United States of America
| | - Nicholas J. Chargo
- Department of Physiology, College of Natural Science, Michigan State University, East Lansing, Michigan, United States of America
| | - Thomas H. Welsh
- Department of Animal Science, College of Agriculture & Life Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Amanda N. Bradbery
- Department of Animal and Range Sciences, College of Agriculture, Montana State University, Bozeman, Montana, United States of America
| | - Jessica L. Leatherwood
- Department of Animal Science, College of Agriculture and Natural Resources, Tarleton State University, Stephenville, Texas, United States of America
| | - Aimee C. Colbath
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
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Herbst EC, Evans LAE, Felder AA, Javaheri B, Pitsillides AA. 3D profiling of mouse epiphyses across ages reveals new potential imaging biomarkers of early spontaneous osteoarthritis. J Anat 2023; 242:1037-1050. [PMID: 36772893 PMCID: PMC10184544 DOI: 10.1111/joa.13834] [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: 08/12/2022] [Revised: 10/24/2022] [Accepted: 01/16/2023] [Indexed: 02/12/2023] Open
Abstract
Worldwide research groups and funding bodies have highlighted the need for imaging biomarkers to predict osteoarthritis (OA) progression and treatment effectiveness. Changes in trabecular architecture, which can be detected with non-destructive high-resolution CT imaging, may reveal OA progression before apparent articular surface damage. Here, we analysed the tibial epiphyses of STR/Ort (OA-prone) and CBA (healthy, parental control) mice at different ages to characterise the effects of mouse age and strain on multiple bony parameters. We isolated epiphyseal components using a semi-automated method, and measured the total epiphyseal volume; cortical bone, trabecular bone and marrow space volumes; mean trabecular and cortical bone thicknesses; trabecular volume relative to cortical volume; trabecular volume relative to epiphyseal interior (trabecular BV/TV); and the trabecular degree of anisotropy. Using two-way ANOVA (significance level ≤0.05), we confirmed that all of these parameters change significantly with age, and that the two strains were significantly different in cortical and trabecular bone volumes, and trabecular degree of anisotropy. STR/Ort mice had higher cortical and trabecular volumes and a lower degree of anisotropy. As the two mouse strains reflect markedly divergent OA predispositions, these parameters have potential as bioimaging markers to monitor OA susceptibility and progression. Additionally, significant age/strain interaction effects were identified for total epiphyseal volume, marrow space volume and trabecular BV/TV. These interactions confirm that the two mouse strains have different epiphyseal growth patterns throughout life, some of which emerge prior to OA onset. Our findings not only propose valuable imaging biomarkers of OA, but also provide insight into ageing 3D epiphyseal architecture bone profiles and skeletal biology underlying the onset and development of age-related OA in STR/Ort mice.
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Affiliation(s)
- Eva C. Herbst
- Palaeontological Institute & MuseumUniversity of ZurichZurichSwitzerland
- Skeletal Biology Group, Comparative Biomedical SciencesRoyal Veterinary CollegeLondonUK
| | - Lucinda A. E. Evans
- Skeletal Biology Group, Comparative Biomedical SciencesRoyal Veterinary CollegeLondonUK
| | - Alessandro A. Felder
- Skeletal Biology Group, Comparative Biomedical SciencesRoyal Veterinary CollegeLondonUK
- Research Software Development Group, Advanced Research ComputingUniversity College LondonLondonUK
| | - Behzad Javaheri
- Skeletal Biology Group, Comparative Biomedical SciencesRoyal Veterinary CollegeLondonUK
| | - Andrew A. Pitsillides
- Skeletal Biology Group, Comparative Biomedical SciencesRoyal Veterinary CollegeLondonUK
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Ma Y, Guo C, Shen J, Wang Y. Analysis of the topological motifs of the cellular structure of the tri-spine horseshoe crab ( Tachypleus tridentatus) and its associated mechanical properties. BIOINSPIRATION & BIOMIMETICS 2022; 17:066013. [PMID: 36103869 DOI: 10.1088/1748-3190/ac9207] [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: 05/22/2022] [Accepted: 09/14/2022] [Indexed: 06/15/2023]
Abstract
Topological motifs in pore architecture can profoundly influence the structural properties of that architecture, such as its mass, porosity, modulus, strength, and surface permeability. Taking the irregular cellular structure of the tri-spine horseshoe crab as a research model, we present a new approach to the quantitative description and analysis of structure-property-function relationships. We employ a robust skeletonization method to construct a curve-skeleton that relies on high-resolution 3D tomographic data. The topological motifs and mechanical properties of the long-range cellular structure were investigated using the Grasshopper plugin and uniaxial compression test to identify the variation gradient. Finite element analysis was conducted for the sub-volumes to obtain the variation in effective modulus along the three principal directions. The results show that the branch length and node distribution density varied from the tip to the base of the sharp corner. These node types formed a low-connectivity network, in which the node types 3-N and 4-N tended to follow the motifs of ideal planar triangle and tetrahedral configurations, respectively, with the highest proportion of inter-branch angles in the angle ranges of 115-120° and 105-110°. In addition, mapping the mechanical gradients to topological properties indicated that narrower profiles with a given branch length gradient, preferred branch orientation, and network connectedness degree are the main factors that affect the mechanical properties. These factors suggest significant potential for designing a controllable, irregularly cellular structure in terms of both morphology and function.
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Affiliation(s)
- Yaopeng Ma
- College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, People's Republic of China
- Institute of Bio-Inspired Structure and Surface Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, People's Republic of China
| | - Ce Guo
- College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, People's Republic of China
- Institute of Bio-Inspired Structure and Surface Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, People's Republic of China
| | - Jingyu Shen
- College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, People's Republic of China
- Institute of Bio-Inspired Structure and Surface Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, People's Republic of China
| | - Yu Wang
- College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, People's Republic of China
- Institute of Bio-Inspired Structure and Surface Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, People's Republic of China
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Herbst EC, Felder AA, Evans LAE, Ajami S, Javaheri B, Pitsillides AA. A new straightforward method for semi-automated segmentation of trabecular bone from cortical bone in diverse and challenging morphologies. ROYAL SOCIETY OPEN SCIENCE 2021; 8:210408. [PMID: 34386254 PMCID: PMC8334830 DOI: 10.1098/rsos.210408] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/06/2021] [Indexed: 06/13/2023]
Abstract
Many physiological, biomechanical, evolutionary and clinical studies that explore skeletal structure and function require successful separation of trabecular from cortical compartments of a bone that has been imaged by X-ray micro-computed tomography (micro-CT) prior to analysis. Separation often involves manual subdivision of these two similarly radio-opaque compartments, which can be time-consuming and subjective. We have developed an objective, semi-automated protocol which reduces user bias and enables straightforward, user-friendly segmentation of trabecular from the cortical bone without requiring sophisticated programming expertise. This method can conveniently be used as a 'recipe' in commercial programmes (Avizo herein) and applied to a variety of datasets. Here, we characterize and share this recipe, and demonstrate its application to a range of murine and human bone types, including normal and osteoarthritic specimens, and bones with distinct embryonic origins and spanning a range of ages. We validate the method by testing inter-user bias during the scan preparation steps and confirm utility in the architecturally challenging analysis of growing murine epiphyses. We also report details of the recipe, so that other groups can readily re-create a similar method in open access programmes. Our aim is that this method will be adopted widely to create a reproducible and time-efficient method of segmenting trabecular and cortical bone.
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Affiliation(s)
- Eva C. Herbst
- Palaeontological Institute and Museum, University of Zurich, Zurich, Switzerland
| | - Alessandro A. Felder
- Research Software Development Group, Research IT Services, University College London, London, UK
| | - Lucinda A. E. Evans
- Skeletal Biology Group, Comparative Biomedical Sciences, The Royal Veterinary College, London, UK
| | - Sara Ajami
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Behzad Javaheri
- School of Mathematics, Computer Science and Engineering, City University of London, London, UK
| | - Andrew A. Pitsillides
- Skeletal Biology Group, Comparative Biomedical Sciences, The Royal Veterinary College, London, UK
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Alsheghri A, Reznikov N, Piché N, McKee MD, Tamimi F, Song J. Optimization of 3D network topology for bioinspired design of stiff and lightweight bone-like structures. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 123:112010. [PMID: 33812629 DOI: 10.1016/j.msec.2021.112010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 01/17/2023]
Abstract
A truly bioinspired approach to design optimization should follow the energetically favorable natural paradigm of "minimum inventory with maximum diversity". This study was inspired by constructive regression of trabecular bone - a natural process of network connectivity optimization occurring early in skeletal development. During trabecular network optimization, the original excessively connected network undergoes incremental pruning of redundant elements, resulting in a functional and adaptable structure operating at lowest metabolic cost. We have recapitulated this biological network topology optimization algorithm by first designing in silico an excessively connected network in which elements are dimension-independent linear connections among nodes. Based on bioinspired regression principles, least-loaded connections were iteratively pruned upon simulated loading. Evolved networks were produced along this optimization trajectory when pre-set convergence criteria were met. These biomimetic networks were compared to each other, and to the reference network derived from mature trabecular bone. Our results replicated the natural network optimization algorithm in uniaxial compressive loading. However, following triaxial loading, the optimization algorithm resulted in lattice networks that were more stretch-dominated than the reference network, and more capable of uniform load distribution. As assessed by 3D printing and mechanical testing, our heuristic network optimization procedure opens new possibilities for parametric design.
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Affiliation(s)
- Ammar Alsheghri
- Department of Mining and Materials Engineering, McGill University, Montréal, Québec, Canada
| | | | - Nicolas Piché
- Object Research Systems Inc., Montréal, Québec, Canada
| | - Marc D McKee
- Faculty of Dentistry, McGill University, Montréal, Québec, Canada; Department of Anatomy and Cell Biology, McGill University, Montréal, Québec, Canada
| | - Faleh Tamimi
- Faculty of Dentistry, McGill University, Montréal, Québec, Canada
| | - Jun Song
- Department of Mining and Materials Engineering, McGill University, Montréal, Québec, Canada.
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Deering J, Dowling KI, DiCecco LA, McLean GD, Yu B, Grandfield K. Selective Voronoi tessellation as a method to design anisotropic and biomimetic implants. J Mech Behav Biomed Mater 2021; 116:104361. [PMID: 33550142 DOI: 10.1016/j.jmbbm.2021.104361] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 01/12/2021] [Accepted: 01/22/2021] [Indexed: 12/18/2022]
Abstract
The geometry of a metallic scaffold is important for the success of bone implants, where the introduction of porosity can reduce stress shielding effects and allow for bone tissue integration. In this work, porous scaffolds were designed to closely mimic the natural structure of trabecular bone using selective Voronoi tessellation with preferential seeding. A workflow to generate these structures is introduced, where voided regions of seeds in the starting volume create preferential texture during polyhedral expansion, resulting in modified strut orientation in the implant. Anisotropy was digitally characterized by mean-intercept length and star volume distribution measurements to determine similarity to trabecular orientation. This work demonstrates that selective Voronoi tessellation is an effective method to generate biomimetic porous scaffolds with increased anisotropy and tunable strut architecture in three dimensions as a suitable alternative to patient-derived bone geometries.
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Affiliation(s)
- Joseph Deering
- Department of Materials Science and Engineering, McMaster University, Hamilton, ON, Canada
| | - Kierdra I Dowling
- Department of Materials Science and Engineering, McMaster University, Hamilton, ON, Canada
| | - Liza-Anastasia DiCecco
- Department of Materials Science and Engineering, McMaster University, Hamilton, ON, Canada
| | - Griffin D McLean
- Department of Mechanical Engineering, McMaster University, Hamilton, ON, Canada
| | - Bosco Yu
- Department of Materials Science and Engineering, McMaster University, Hamilton, ON, Canada
| | - Kathryn Grandfield
- Department of Materials Science and Engineering, McMaster University, Hamilton, ON, Canada; School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada.
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Tamimi I, Cortes ARG, Sánchez-Siles JM, Ackerman JL, González-Quevedo D, García Á, Yaghoubi F, Abdallah MN, Eimar H, Alsheghri A, Laurenti M, Al-Subaei A, Guerado E, García-de-Quevedo D, Tamimi F. Composition and characteristics of trabecular bone in osteoporosis and osteoarthritis. Bone 2020; 140:115558. [PMID: 32730941 DOI: 10.1016/j.bone.2020.115558] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 07/04/2020] [Accepted: 07/07/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Bone strength depends on multiple factors such as bone density, architecture and composition turnover. However, the role these factors play in osteoporotic fractures is not well understood. PURPOSE The aim of this study was to analyze trabecular bone architecture, and its crystal and organic composition in humans, by comparing samples taken from patients who had a hip fracture (HF) and individuals with hip osteoarthritis (HOA). METHODS The study included 31 HF patients and 42 cases of HOA who underwent joint replacement surgery between 1/1/2013 and 31/12/2013. Trabecular bone samples were collected from the femoral heads and analyzed using a dual-energy X-ray absorptiometry, micro-CT, and solid-state high-resolution magic-angle-spinning nuclear magnetic resonance (MAS-NMR) spectroscopy. RESULTS No differences in proton or phosphorus concentration were found between the two groups using 1H single pulse, 31P single pulse, 31P single pulse with proton decoupling NMR spectroscopy, in hydroxyapatite (HA) c-axis or a-axis crystal length. Bone volume fraction (BV/TV), trabecular number (Tb.N), and bone mineral density (BMD) were higher in the HO group than in the HF group [28.6% ± 10.5 vs 20.3% ± 6.6 (p = 0.026); 2.58 mm-1 ± 1.57 vs 1.5 mm-1 ± 0.79 (p = 0.005); and 0.39 g/cm2 ± 0.10 vs. 0.28 g/cm2 ± 0.05 (p = 0.002), respectively]. The trabecular separation (Tp.Sp) was lower in the HO group 0.42 mm ± 0.23 compared with the HF group 0.58 mm ± 0.27 (p = 0.036). In the HO group, BMD was correlated with BV/TV (r = 0.704, p < 0.001), BMC (r = 0.853, p < 0.001), Tb.N (r = 0.653, p < 0.001), Tb.Sp (-0.561, p < 0.001) and 1H concentration (-0.580, p < 0.001) in the HO group. BMD was not correlated with BV/TV, Tb.Sp, Tb.Th, Tb.N, Tb.PF, 1H concentration or HA crystal size in the HF group. CONCLUSIONS Patients with HO who did not sustain previous hip fractures had a higher femoral head BMD, BV/TV, and Tb.N than HF patients. In HO patients, BMD was positively correlated with the BV/TV and Tb.N and negatively correlated with the femoral head organic content and trabecular separation. Interestingly, these correlations were not found in HF patients with relatively lower bone densities. Therefore, osteoporotic patients with similar low bone densities could have significant microstructural differences. No differences were found between the two groups at a HA crystal level.
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Affiliation(s)
- Iskandar Tamimi
- Department of Orthopedic Surgery, Regional University Hospital of Málaga, Spain.
| | - Arthur Rodríguez González Cortes
- Department of Radiology, Massachusetts General Hospital, Charlestown, USA; Department of Dental Surgery, Faculty of Dental Surgery, University of Malta
| | | | - Jerome L Ackerman
- Department of Radiology, Massachusetts General Hospital, Charlestown, USA
| | | | - Ángel García
- Department of Orthopedic Surgery, Regional University Hospital of Málaga, Spain
| | - Farid Yaghoubi
- Faculty of Dentistry, McGill University, Montreal, Canada
| | | | - Hazem Eimar
- Faculty of Medicine and Dentistry, University of Alberta, Canada
| | - Ammar Alsheghri
- Department of Mining and Materials Engineering, McGill University, Montreal, Canada
| | - Marco Laurenti
- Faculty of Pharmacy, Complutense University of Madrid, Spain
| | | | | | | | - Faleh Tamimi
- Faculty of Dentistry, McGill University, Montreal, Canada
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