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Kadkoy Y, Abraham S, Michael P, Tazin T, Wetterstrand C, O'Connor JP. Novel approaches to correlate computerized tomography imaging of bone fracture callus to callus structural mechanics. Bone Rep 2023; 19:101726. [PMID: 38047269 PMCID: PMC10690537 DOI: 10.1016/j.bonr.2023.101726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/15/2023] [Accepted: 11/12/2023] [Indexed: 12/05/2023] Open
Abstract
Estimating the mechanical properties of bone in vivo without destructive testing would be useful for research and clinical orthopedic applications. Micro-computerized tomography (μCT) imaging can provide quantitative, high-resolution 3D representations of bone morphology and is generally the basis from which bone mechanical properties are non-destructively estimated. The goal of this study was to develop metrics using qualitative and quantitative aspects of bone microarchitecture derived from μCT imaging to estimate the mechanical integrity of bone fracture calluses. Mechanical testing data (peak torque) and μCT image data from 12 rat femur fractures were collected at 4 weeks after fracture. MATLAB was used to analyze the callus μCT imaging data which were then correlated to the empirically determined peak torque of the callus. One metric correlated Z-rays, linear contiguities of voxels running parallel to the neutral axis of the femur and through the fracture callus, to peak torque. Other metrics were based on voxel linkage values (LVs), which is a novel measurement defined by the number of voxels surrounding a given voxel (ranging from 1 to 27) that are all above a specified threshold. Linkage values were utilized to segment the callus and compute healing scores (termed eRUST) based on the modified Radiographic Union Score for Tibial fractures (mRUST). Linkage values were also used to calculate linked bone areas (LBAs). All metrics positively correlated with peak torque, yielding correlations of determination (R2) of 0.863 for eRUST, 0.792 for Z-ray scoring, and 0.764 for a normalized Linked Bone Area metric. These novel metrics appear to be promising approaches for extrapolating fracture callus structural properties from bone microarchitecture using objective analytical methods and without resorting to computationally complex finite element analyses.
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Affiliation(s)
- Yazan Kadkoy
- Department of Orthopaedics, Rutgers-New Jersey Medical School, Newark, United States of America
- Rutgers Biomedical Health Sciences, School of Graduate Studies, Newark, United States of America
| | - Sangeeta Abraham
- Department of Orthopaedics, Rutgers-New Jersey Medical School, Newark, United States of America
- Rutgers Biomedical Health Sciences, School of Graduate Studies, Newark, United States of America
| | - Peter Michael
- Department of Biomedical Engineering, New Jersey Institute of Technology, United States of America
| | - Tasmima Tazin
- Department of Orthopaedics, Rutgers-New Jersey Medical School, Newark, United States of America
| | - Charlene Wetterstrand
- Department of Orthopaedics, Rutgers-New Jersey Medical School, Newark, United States of America
| | - J. Patrick O'Connor
- Department of Orthopaedics, Rutgers-New Jersey Medical School, Newark, United States of America
- Rutgers Biomedical Health Sciences, School of Graduate Studies, Newark, United States of America
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The association between mineralised tissue formation and the mechanical local in vivo environment: Time-lapsed quantification of a mouse defect healing model. Sci Rep 2020; 10:1100. [PMID: 31980656 PMCID: PMC6981157 DOI: 10.1038/s41598-020-57461-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 01/02/2020] [Indexed: 11/08/2022] Open
Abstract
An improved understanding of how local mechanical stimuli guide the fracture healing process has the potential to enhance clinical treatment of bone injury. Recent preclinical studies of bone defect in animal models have used cross-sectional data to examine this phenomenon indirectly. In this study, a direct time-lapsed imaging approach was used to investigate the local mechanical strains that precede the formation of mineralised tissue at the tissue scale. The goal was to test two hypotheses: 1) the local mechanical signal that precedes the onset of tissue mineralisation is higher in areas which mineralise, and 2) this local mechanical signal is independent of the magnitude of global mechanical loading of the tissue in the defect. Two groups of mice with femoral defects of length 0.85 mm (n = 10) and 1.45 mm (n = 9) were studied, allowing for distinct distributions of tissue scale strains in the defects. The regeneration and (re)modelling of mineralised tissue was observed weekly using in vivo micro-computed tomography (micro-CT), which served as a ground truth for resolving areas of mineralised tissue formation. The mechanical environment was determined using micro-finite element analysis (micro-FE) on baseline images. The formation of mineralised tissue showed strong association with areas of higher mechanical strain (area-under-the-curve: 0.91 ± 0.04, true positive rate: 0.85 ± 0.05) while surface based strains could correctly classify 43% of remodelling events. These findings support our hypotheses by showing a direct association between the local mechanical strains and the formation of mineralised tissue.
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Collins CJ, Vivanco JF, Sokn SA, Williams BO, Burgers TA, Ploeg HL. Fracture healing in mice lacking Pten in osteoblasts: a micro-computed tomography image-based analysis of the mechanical properties of the femur. J Biomech 2014; 48:310-7. [PMID: 25498366 DOI: 10.1016/j.jbiomech.2014.11.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 11/17/2014] [Accepted: 11/20/2014] [Indexed: 12/29/2022]
Abstract
In the United States, approximately eight million osseous fractures are reported annually, of which 5-10% fail to create a bony union. Osteoblast-specific deletion of the gene Pten in mice has been found to stimulate bone growth and accelerate fracture healing. Healing rates at four weeks increased in femurs from Pten osteoblast conditional knock-out mice (Pten-CKO) compared to wild-type mice (WT) of the same genetic strain as measured by an increase in mechanical stiffness and failure load in four-point bending tests. Preceding mechanical testing, each femur was imaged using a Skyscan 1172 micro-computed tomography (μCT) scanner (Skyscan, Kontich, Belgium). The present study used µCT image-based analysis to test the hypothesis that the increased femoral fracture force and stiffness in Pten-CKO were due to greater section properties with the same effective material properties as that of the WT. The second moment of area and section modulus were computed in ImageJ 1.46 (National Institutes of Health) and used to predict the effective flexural modulus and the stress at failure for fourteen pairs of intact and callus WT and twelve pairs of intact and callus Pten-CKO femurs. For callus and intact femurs, the failure stress and tissue mineral density of the Pten-CKO and WT were not different; however, the section properties of the Pten-CKO were more than twice as large 28 days post-fracture. It was therefore concluded, when the gene Pten was conditionally knocked-out in osteoblasts, the resulting increased bending stiffness and force to fracture were due to increased section properties.
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Affiliation(s)
- Caitlyn J Collins
- University of Wisconsin-Madison, Department of Mechanical Engineering, Madison, WI, USA
| | - Juan F Vivanco
- University of Wisconsin-Madison, Department of Mechanical Engineering, Madison, WI, USA; Universidad Adolfo Ibáñez, Facultad de Ingeniería y Ciencias, Viña del Mar, Chile
| | - Scott A Sokn
- University of Wisconsin-Madison, Department of Mechanical Engineering, Madison, WI, USA
| | | | | | - Heidi-Lynn Ploeg
- University of Wisconsin-Madison, Department of Mechanical Engineering, Madison, WI, USA.
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Jiang-jun Z, Min Z, Ya-bo Y, Wei L, Ren-fa L, Zhi-yu Z, Rong-jian C, Wei-tao Y, Cheng-fei D. Finite element analysis of a bone healing model: 1-year follow-up after internal fixation surgery for femoral fracture. Pak J Med Sci 2014; 30:343-7. [PMID: 24772140 PMCID: PMC3999007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 01/18/2014] [Accepted: 01/20/2014] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Finite element analysis was used to compare preoperative and postoperative stress distribution of a bone healing model of femur fracture, to identify whether broken ends of fractured bone would break or not after fixation dislodgement one year after intramedullary nailing. Method s: Using fast, personalized imaging, bone healing models of femur fracture were constructed based on data from multi-slice spiral computed tomography using Mimics, Geomagic Studio, and Abaqus software packages. The intramedullary pin was removed by Boolean operations before fixation was dislodged. Loads were applied on each model to simulate a person standing on one leg. The von Mises stress distribution, maximum stress, and its location was observed. Results : According to 10 kinds of display groups based on material assignment, the nodes of maximum and minimum von Mises stress were the same before and after dislodgement, and all nodes of maximum von Mises stress were outside the fracture line. The maximum von Mises stress node was situated at the bottom quarter of the femur. The von Mises stress distribution was identical before and after surgery. Conclusion : Fast, personalized model establishment can simulate fixation dislodgement before operation, and personalized finite element analysis was performed to successfully predict whether nail dislodgement would disrupt femur fracture or not.
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Affiliation(s)
- Zhou Jiang-jun
- Zhou Jiang-jun, MM, Department of Orthopedic, The 184th Hospital of Chinese PLA, Yingtan 335000, Jiangxi Province, China
| | - Zhao Min
- Zhao Min, MM, Department of Orthopedic, The 184th Hospital of Chinese PLA, Yingtan 335000, Jiangxi Province, China
| | - Yan Ya-bo
- Yan Ya-bo, MD, Department of Orthopedic, Xijing Hospital, the Fourth Military Medical University, Xi’an 710032, Shannxi Province, China
| | - Lei Wei
- Lei Wei, MD, Department of Orthopedic, Xijing Hospital, the Fourth Military Medical University, Xi’an 710032, Shannxi Province, China
| | - Lv Ren-fa
- Lv Ren-fa, MM, Department of Orthopedic, The 184th Hospital of Chinese PLA, Yingtan 335000, Jiangxi Province, China
| | - Zhu Zhi-yu
- Zhu Zhi-yu, MB, Department of Orthopedic, The 184th Hospital of Chinese PLA, Yingtan 335000, Jiangxi Province, China
| | - Chen Rong-jian
- Chen Rong-jian, MB, Department of Orthopedic, The 184th Hospital of Chinese PLA, Yingtan 335000, Jiangxi Province, China
| | - Yu Wei-tao
- Yu Wei-tao, MM, Department of Orthopedic, The 184th Hospital of Chinese PLA, Yingtan 335000, Jiangxi Province, China
| | - Du Cheng-fei
- Du Cheng-fei, MD, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
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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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