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Ghiasi MS, Chen J, Vaziri A, Rodriguez EK, Nazarian A. Bone fracture healing in mechanobiological modeling: A review of principles and methods. Bone Rep 2017; 6:87-100. [PMID: 28377988 PMCID: PMC5365304 DOI: 10.1016/j.bonr.2017.03.002] [Citation(s) in RCA: 215] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 02/15/2017] [Accepted: 03/15/2017] [Indexed: 02/07/2023] Open
Abstract
Bone fracture is a very common body injury. The healing process is physiologically complex, involving both biological and mechanical aspects. Following a fracture, cell migration, cell/tissue differentiation, tissue synthesis, and cytokine and growth factor release occur, regulated by the mechanical environment. Over the past decade, bone healing simulation and modeling has been employed to understand its details and mechanisms, to investigate specific clinical questions, and to design healing strategies. The goal of this effort is to review the history and the most recent work in bone healing simulations with an emphasis on both biological and mechanical properties. Therefore, we provide a brief review of the biology of bone fracture repair, followed by an outline of the key growth factors and mechanical factors influencing it. We then compare different methodologies of bone healing simulation, including conceptual modeling (qualitative modeling of bone healing to understand the general mechanisms), biological modeling (considering only the biological factors and processes), and mechanobiological modeling (considering both biological aspects and mechanical environment). Finally we evaluate different components and clinical applications of bone healing simulation such as mechanical stimuli, phases of bone healing, and angiogenesis.
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Affiliation(s)
- Mohammad S. Ghiasi
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, USA
| | - Jason Chen
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ashkan Vaziri
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, USA
| | - Edward K. Rodriguez
- Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ara Nazarian
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Hendrikson WJ, van Blitterswijk CA, Rouwkema J, Moroni L. The Use of Finite Element Analyses to Design and Fabricate Three-Dimensional Scaffolds for Skeletal Tissue Engineering. Front Bioeng Biotechnol 2017; 5:30. [PMID: 28567371 PMCID: PMC5434139 DOI: 10.3389/fbioe.2017.00030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 04/25/2017] [Indexed: 01/13/2023] Open
Abstract
Computational modeling has been increasingly applied to the field of tissue engineering and regenerative medicine. Where in early days computational models were used to better understand the biomechanical requirements of targeted tissues to be regenerated, recently, more and more models are formulated to combine such biomechanical requirements with cell fate predictions to aid in the design of functional three-dimensional scaffolds. In this review, we highlight how computational modeling has been used to understand the mechanisms behind tissue formation and can be used for more rational and biomimetic scaffold-based tissue regeneration strategies. With a particular focus on musculoskeletal tissues, we discuss recent models attempting to predict cell activity in relation to specific mechanical and physical stimuli that can be applied to them through porous three-dimensional scaffolds. In doing so, we review the most common scaffold fabrication methods, with a critical view on those technologies that offer better properties to be more easily combined with computational modeling. Finally, we discuss how modeling, and in particular finite element analysis, can be used to optimize the design of scaffolds for skeletal tissue regeneration.
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Affiliation(s)
- Wim. J. Hendrikson
- Department of Tissue Regeneration, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
| | - Clemens. A. van Blitterswijk
- Department of Tissue Regeneration, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
- Complex Tissue Regeneration Department, MERLN Institute for Technology Inspired Regenerative Medicine, University of Maastricht, Maastricht, Netherlands
| | - Jeroen Rouwkema
- Department of Biomechanical Engineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
| | - Lorenzo Moroni
- Department of Tissue Regeneration, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
- Complex Tissue Regeneration Department, MERLN Institute for Technology Inspired Regenerative Medicine, University of Maastricht, Maastricht, Netherlands
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Giorgi M, Verbruggen SW, Lacroix D. In silico bone mechanobiology: modeling a multifaceted biological system. WILEY INTERDISCIPLINARY REVIEWS-SYSTEMS BIOLOGY AND MEDICINE 2016; 8:485-505. [PMID: 27600060 PMCID: PMC5082538 DOI: 10.1002/wsbm.1356] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 06/27/2016] [Accepted: 07/27/2016] [Indexed: 12/04/2022]
Abstract
Mechanobiology, the study of the influence of mechanical loads on biological processes through signaling to cells, is fundamental to the inherent ability of bone tissue to adapt its structure in response to mechanical stimulation. The immense contribution of computational modeling to the nascent field of bone mechanobiology is indisputable, having aided in the interpretation of experimental findings and identified new avenues of inquiry. Indeed, advances in computational modeling have spurred the development of this field, shedding new light on problems ranging from the mechanical response to loading by individual cells to tissue differentiation during events such as fracture healing. To date, in silico bone mechanobiology has generally taken a reductive approach in attempting to answer discrete biological research questions, with research in the field broadly separated into two streams: (1) mechanoregulation algorithms for predicting mechanobiological changes to bone tissue and (2) models investigating cell mechanobiology. Future models will likely take advantage of advances in computational power and techniques, allowing multiscale and multiphysics modeling to tie the many separate but related biological responses to loading together as part of a larger systems biology approach to shed further light on bone mechanobiology. Finally, although the ever‐increasing complexity of computational mechanobiology models will inevitably move the field toward patient‐specific models in the clinic, the determination of the context in which they can be used safely for clinical purpose will still require an extensive combination of computational and experimental techniques applied to in vitro and in vivo applications. WIREs Syst Biol Med 2016, 8:485–505. doi: 10.1002/wsbm.1356 For further resources related to this article, please visit the WIREs website.
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Affiliation(s)
- Mario Giorgi
- Department of Oncology and Metabolism and INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
| | | | - Damien Lacroix
- INSIGNEO Institute for In Silico Medicine, Department of Mechanical Engineering, University of Sheffield, Sheffield, UK.
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Mechanobiological simulations of peri-acetabular bone ingrowth: a comparative analysis of cell-phenotype specific and phenomenological algorithms. Med Biol Eng Comput 2016; 55:449-465. [DOI: 10.1007/s11517-016-1528-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 05/13/2016] [Indexed: 10/21/2022]
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The connection between cellular mechanoregulation and tissue patterns during bone healing. Med Biol Eng Comput 2015; 53:829-42. [DOI: 10.1007/s11517-015-1285-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 03/23/2015] [Indexed: 02/05/2023]
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Burke DP, Khayyeri H, Kelly DJ. Substrate stiffness and oxygen availability as regulators of mesenchymal stem cell differentiation within a mechanically loaded bone chamber. Biomech Model Mechanobiol 2014; 14:93-105. [DOI: 10.1007/s10237-014-0591-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 04/24/2014] [Indexed: 10/25/2022]
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Reifenrath J, Angrisani N, Lalk M, Besdo S. Replacement, refinement, and reduction: Necessity of standardization and computational models for long bone fracture repair in animals. J Biomed Mater Res A 2013; 102:2884-900. [DOI: 10.1002/jbm.a.34920] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 07/30/2013] [Accepted: 07/31/2013] [Indexed: 12/21/2022]
Affiliation(s)
- Janin Reifenrath
- Small Animal Clinic; University of Veterinary Medicine Hannover; Bünteweg 9 30559 Hannover Germany
| | - Nina Angrisani
- Small Animal Clinic; University of Veterinary Medicine Hannover; Bünteweg 9 30559 Hannover Germany
| | - Mareike Lalk
- Small Animal Clinic; University of Veterinary Medicine Hannover; Bünteweg 9 30559 Hannover Germany
| | - Silke Besdo
- Institute of Continuum Mechanics; Leibniz Universität Hannover; Appelstr. 11 30167 Hannover Germany
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Khayyeri H, Isaksson H, Prendergast PJ. Corroboration of computational models for mechanoregulated stem cell differentiation. Comput Methods Biomech Biomed Engin 2013; 18:15-23. [DOI: 10.1080/10255842.2013.774381] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Khayyeri H, Prendergast PJ. The emergence of mechanoregulated endochondral ossification in evolution. J Biomech 2012; 46:731-7. [PMID: 23261239 DOI: 10.1016/j.jbiomech.2012.11.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 10/12/2012] [Accepted: 11/10/2012] [Indexed: 10/27/2022]
Abstract
The differentiation of skeletal tissue phenotypes is partly regulated by mechanical forces. This mechanoregulatory aspect of tissue differentiation has been the subject of many experimental and computational investigations. However, little is known about what factors promoted the emergence of mechanoregulated tissue differentiation in evolution, even though mechanoregulated tissue differentiation, for example during development or healing of adult bone, is crucial for vertebrate phylogeny. In this paper, we use a computational framework to test the hypothesis that the emergence of mechanosensitive genes that trigger endochondral ossification in evolution will stabilise in the population and create a variable mechanoregulated response, if the endochondral ossification process enhances fitness for survival. The model combines an evolutionary algorithm that considers genetic change with a mechanoregulated fracture healing model in which the fitness of animals in a population is determined by their ability to heal their bones. The simulations show that, with the emergence of mechanosensitive genes through evolution enabling skeletal cells to modulate their synthetic activities, novel differentiation pathways such as endochondral ossification could have emerged, which when favoured by natural selection is maintained in a population. Furthermore, the model predicts that evolutionary forces do not lead to a single optimal mechanoregulated response but that the capacity of endochondral ossification exists with variability in a population. The simulations correspond with many existing findings about the mechanosensitivity of skeletal tissues in current animal populations, therefore indicating that this kind of multi-level models could be used in future population based simulations of tissue differentiation.
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Affiliation(s)
- Hanifeh Khayyeri
- Trinity Centre for Bioengineering, School of Engineering, Parsons Building, Trinity College Dublin, Dublin D2, Ireland
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Garijo N, Manzano R, Osta R, Perez M. Stochastic cellular automata model of cell migration, proliferation and differentiation: Validation with in vitro cultures of muscle satellite cells. J Theor Biol 2012; 314:1-9. [DOI: 10.1016/j.jtbi.2012.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 06/10/2012] [Accepted: 08/02/2012] [Indexed: 10/27/2022]
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Reina-Romo E, Gómez-Benito M, Domínguez J, García-Aznar J. A lattice-based approach to model distraction osteogenesis. J Biomech 2012; 45:2736-42. [DOI: 10.1016/j.jbiomech.2012.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 08/16/2012] [Accepted: 09/07/2012] [Indexed: 10/27/2022]
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Prendergast PJ, Galibarov PE, Lowery C, Lennon AB. Computer simulating a clinical trial of a load-bearing implant: an example of an intramedullary prosthesis. J Mech Behav Biomed Mater 2012; 4:1880-7. [PMID: 22098887 DOI: 10.1016/j.jmbbm.2011.06.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 06/08/2011] [Accepted: 06/09/2011] [Indexed: 10/18/2022]
Abstract
Computational modelling is becoming ever more important for obtaining regulatory approval for new medical devices. An accepted approach is to infer performance in a population from an analysis conducted for an idealised or 'average' patient; we present here a method for predicting the performance of an orthopaedic implant when released into a population--effectively simulating a clinical trial. Specifically we hypothesise that an analysis based on a method for predicting the performance in a population will lead to different conclusions than an analysis based on an idealised or 'average' patient. To test this hypothesis we use a finite element model of an intramedullary implant in a bone whose size and remodelling activity is different for each individual in the population. We compare the performance of a low Young's modulus implant (E=20 GPa) to one with a higher Young's modulus (200 GPa). Cyclic loading is applied and failure is assumed when the migration of the implant relative to the bone exceeds a threshold magnitude. The analysis for an idealised of 'average' patient predicts that the lower modulus device survives longer whereas the analysis simulating a clinical trial predicts no statistically-significant tendency (p=0.77) for the low modulus device to perform better. It is concluded that population-based simulations of implant performance-simulating a clinical trial-present a very valuable opportunity for more realistic computational pre-clinical testing of medical devices.
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Affiliation(s)
- P J Prendergast
- Trinity Centre for Bioengineering, School of Engineering, Trinity College, Dublin 2, Ireland.
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Meyer E, Buckley C, Steward A, Kelly D. The effect of cyclic hydrostatic pressure on the functional development of cartilaginous tissues engineered using bone marrow derived mesenchymal stem cells. J Mech Behav Biomed Mater 2011; 4:1257-65. [DOI: 10.1016/j.jmbbm.2011.04.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 04/13/2011] [Accepted: 04/14/2011] [Indexed: 11/30/2022]
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Boyle CJ, Lennon AB, Prendergast PJ. In Silico Prediction of the Mechanobiological Response of Arterial Tissue: Application to Angioplasty and Stenting. J Biomech Eng 2011; 133:081001. [DOI: 10.1115/1.4004492] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
One way to restore physiological blood flow to occluded arteries involves the deformation of plaque using an intravascular balloon and preventing elastic recoil using a stent. Angioplasty and stent implantation cause unphysiological loading of the arterial tissue, which may lead to tissue in-growth and reblockage; termed “restenosis.” In this paper, a computational methodology for predicting the time-course of restenosis is presented. Stress-induced damage, computed using a remaining life approach, stimulates inflammation (production of matrix degrading factors and growth stimuli). This, in turn, induces a change in smooth muscle cell phenotype from contractile (as exists in the quiescent tissue) to synthetic (as exists in the growing tissue). In this paper, smooth muscle cell activity (migration, proliferation, and differentiation) is simulated in a lattice using a stochastic approach to model individual cell activity. The inflammation equations are examined under simplified loading cases. The mechanobiological parameters of the model were estimated by calibrating the model response to the results of a balloon angioplasty study in humans. The simulation method was then used to simulate restenosis in a two dimensional model of a stented artery. Cell activity predictions were similar to those observed during neointimal hyperplasia, culminating in the growth of restenosis. Similar to experiment, the amount of neointima produced increased with the degree of expansion of the stent, and this relationship was found to be highly dependant on the prescribed inflammatory response. It was found that the duration of inflammation affected the amount of restenosis produced, and that this effect was most pronounced with large stent expansions. In conclusion, the paper shows that the arterial tissue response to mechanical stimulation can be predicted using a stochastic cell modeling approach, and that the simulation captures features of restenosis development observed with real stents. The modeling approach is proposed for application in three dimensional models of cardiovascular stenting procedures.
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Affiliation(s)
- Colin J. Boyle
- Trinity Centre for Bioengineering, School of Engineering, University of Dublin, Trinity College, Dublin, Ireland
| | - Alexander B. Lennon
- Trinity Centre for Bioengineering, School of Engineering, University of Dublin, Trinity College, Dublin, Ireland
| | - Patrick J. Prendergast
- Trinity Centre for Bioengineering, School of Engineering, University of Dublin, Trinity College, Dublin, Ireland
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