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Fischer M, Bortel E, Schoon J, Behnke E, Hesse B, Weitkamp T, Bekeschus S, Pichler M, Wassilew GI, Schulze F. Cold physical plasma treatment optimization for improved bone allograft processing. Front Bioeng Biotechnol 2023; 11:1264409. [PMID: 38026873 PMCID: PMC10661279 DOI: 10.3389/fbioe.2023.1264409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
In musculoskeletal surgery, the treatment of large bone defects is challenging and can require the use of bone graft substitutes to restore mechanical stability and promote host-mediated regeneration. The use of bone allografts is well-established in many bone regenerative procedures, but is associated with low rates of ingrowth due to pre-therapeutic graft processing. Cold physical plasma (CPP), a partially ionized gas that simultaneously generates reactive oxygen (O2) and nitrogen (N2) species, is suggested to be advantageous in biomedical implant processing. CPP is a promising tool in allograft processing for improving surface characteristics of bone allografts towards enhanced cellularization and osteoconduction. However, a preclinical assessment regarding the feasibility of pre-therapeutic processing of allogeneic bone grafts with CPP has not yet been performed. Thus, this pilot study aimed to analyze the bone morphology of CPP processed allografts using synchrotron radiation-based microcomputed tomography (SR-µCT) and to analyze the effects of CPP processing on human bone cell viability and function. The analyzes, including co-registration of pre- and post-treatment SR-µCT scans, revealed that the main bone morphological properties (total volume, mineralized volume, surface area, and porosity) remained unaffected by CPP treatment if compared to allografts not treated with CPP. Varying effects on cellular metabolic activity and alkaline phosphatase activity were found in response to different gas mixtures and treatment durations employed for CPP application. It was found that 3 min CPP treatment using a He + 0.1% N2 gas mixture led to the most favourable outcome regarding a significant increase in bone cell viability and alkaline phosphatase activity. This study highlights the promising potential of pre-therapeuthic bone allograft processing by CPP prior to intraoperative application and emphasizes the need for gas source and treatment time optimization for specific applications.
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Affiliation(s)
- Maximilian Fischer
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
| | | | - Janosch Schoon
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Einar Behnke
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Bernhard Hesse
- Xploraytion GmbH, Berlin, Germany
- ESRF: European Synchrotron Radiation Facility, Grenoble, France
| | | | - Sander Bekeschus
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany
| | - Monika Pichler
- Cells + Tissuebank Austria Gemeinnützige GmbH, Krems an der Donau, Austria
| | - Georgi I. Wassilew
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Frank Schulze
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
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Yildirim G, Bergamo ETP, Poudel SB, Ruff RR, Dixit M, Hu B, Mijares DQ, Witek L, Chlebek C, Harrison DE, Strong R, Miller RA, Ladiges W, Bromage TG, Rosen CJ, Yakar S. Long-term effects of canagliflozin treatment on the skeleton of aged UM-HET3 mice. GeroScience 2023; 45:1933-1951. [PMID: 37166526 PMCID: PMC10400751 DOI: 10.1007/s11357-023-00803-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 04/18/2023] [Indexed: 05/12/2023] Open
Abstract
Sodium glucose cotransporter-2 inhibitors (SGLT2is) promote urinary glucose excretion and decrease plasma glucose levels independent of insulin. Canagliflozin (CANA) is an SGLT2i, which is widely prescribed, to reduce cardiovascular complications, and as a second-line therapy after metformin in the treatment of type 2 diabetes mellitus. Despite the robust metabolic benefits, reductions in bone mineral density (BMD) and cortical fractures were reported for CANA-treated subjects. In collaboration with the National Institute on Aging (NIA)-sponsored Interventions Testing Program (ITP), we tested skeletal integrity of UM-HET3 mice fed control (137 mice) or CANA-containing diet (180 ppm, 156 mice) from 7 to 22 months of age. Micro-computed tomography (micro-CT) revealed that CANA treatment caused significant thinning of the femur mid-diaphyseal cortex in both male and female mice, did not affect trabecular bone architecture in the distal femur or the lumbar vertebra-5 in male mice, but was associated with thinning of the trabeculae at the distal femur in CANA-treated female mice. In male mice, CANA treatment is associated with significant reductions in cortical bone volumetric BMD by micro-CT, and by quantitative backscattered scanning electron microscopy. Raman microspectroscopy, taken at the femur mid-diaphyseal posterior cortex, showed significant reductions in the mineral/matrix ratio and an increased carbonate/phosphate ratio in CANA-treated male mice. These data were supported by thermogravimetric assay (TGA) showing significantly decreased mineral and increased carbonate content in CANA-treated male mice. Finally, the sintered remains of TGA were subjected to X-ray diffraction and showed significantly higher fraction of whitlockite, a calcium orthophosphate mineral, which has higher resorbability than hydroxyapatite. Overall, long-term CANA treatment compromised bone morphology and mineral composition of bones, which likely contribute to increased fracture risk seen with this drug.
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Affiliation(s)
- Gozde Yildirim
- David B. Kriser Dental Center, Department of Molecular Pathobiology, New York University College of Dentistry, 345 East 24Th Street, New York, NY 10010-4086 USA
| | - Edmara T. P. Bergamo
- David B. Kriser Dental Center, Biomaterials Division, Department of Molecular Pathobiology, NYU College of Dentistry, New York, NY 10010-4086 USA
| | - Sher Bahadur Poudel
- David B. Kriser Dental Center, Department of Molecular Pathobiology, New York University College of Dentistry, 345 East 24Th Street, New York, NY 10010-4086 USA
| | - Ryan R. Ruff
- David B. Kriser Dental Center, Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY 10010-4086 USA
| | - Manisha Dixit
- David B. Kriser Dental Center, Department of Molecular Pathobiology, New York University College of Dentistry, 345 East 24Th Street, New York, NY 10010-4086 USA
| | - Bin Hu
- David B. Kriser Dental Center, Department of Molecular Pathobiology, New York University College of Dentistry, 345 East 24Th Street, New York, NY 10010-4086 USA
| | - Dindo Q. Mijares
- David B. Kriser Dental Center, Biomaterials Division, Department of Molecular Pathobiology, NYU College of Dentistry, New York, NY 10010-4086 USA
| | - Lukasz Witek
- David B. Kriser Dental Center, Biomaterials Division, Department of Molecular Pathobiology, NYU College of Dentistry, New York, NY 10010-4086 USA
- Department of Biomedical Engineering, Tandon School of Engineering New York University, Brooklyn, NY 11201 USA
| | - Carolyn Chlebek
- Center for Clinical and Translational Research, Maine Medical Center Research Institute, Scarborough, USA
| | | | - Randy Strong
- Geriatric Research, Education and Clinical Center and Research Service, South Texas Veterans Health Care System, San Antonio, TX USA
- Barshop Institute for Longevity and Aging Studies and Department of Pharmacology, The University of Texas Health Science Center, San Antonio, TX USA
| | - Richard A. Miller
- Department of Pathology and Geriatrics Center, University of Michigan, Ann Arbor, MI USA
| | - Warren Ladiges
- Department of Comparative Medicine, School of Medicine, University of Washington, Seattle, WA USA
| | - Timothy G. Bromage
- David B. Kriser Dental Center, Department of Molecular Pathobiology, New York University College of Dentistry, 345 East 24Th Street, New York, NY 10010-4086 USA
| | - Clifford J. Rosen
- Center for Clinical and Translational Research, Maine Medical Center Research Institute, Scarborough, USA
| | - Shoshana Yakar
- David B. Kriser Dental Center, Department of Molecular Pathobiology, New York University College of Dentistry, 345 East 24Th Street, New York, NY 10010-4086 USA
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3
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Toyne JM, Turner BL. Linking isotope analysis and paleopathology: An andean perspective. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2020; 29:117-127. [PMID: 32507722 DOI: 10.1016/j.ijpp.2019.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 10/24/2019] [Accepted: 11/15/2019] [Indexed: 06/11/2023]
Abstract
This paper reviews the significant advances in isotopic investigations in Andean South America and directs scholars to explore new theoretical and analytical directions, specifically the applicability of isotope data to paleopathology. Excellent preservation and large skeletal collections of human remains make the Central Andes ideal for biogeochemical reconstructions and advancements in isotopic methods. Our aims are twofold: first, we present a meta-analysis of stable and radiogenic isotope research in the Central Andes since 1985, and highlight those that combine analyses of isotope ratios and pathological conditions. Second, we discuss useful directions for incorporating stable isotope analysis more explicitly in studies of paleopathology in the Andes more in the future. Principle research foci have described dietary variation and regional population mobility since the 1980s, where early methodological explorations identified significant trends in isotopic variation. For the years 1980-2017, we identified 96 scholarly publications through a meta-data analysis of major peer-reviewed journals, book chapters, and conference proceedings. These demonstrate specific trends in topical and methodological preferences across the Andean region and a shift from 10 publications pre-1997 to 67 in the last 10 years. However, combined isotope and paleopathology studies in this region remain sparse; given the ecological, geological, and cultural complexity of the Central Andes, analyses of pathological conditions in different regions would significantly benefit from the information on diet, mobility, and local ecology that isotope ratios provide. Isotope analysis requires destruction of archaeological tissues, and interpreting isotope data can be complex, but it can also provide unique insights into the pathogenesis of multifactorial conditions and assist differential diagnosis. Therefore, we also discuss research designs for pairing isotopic and paleopathological variables that will allow researchers to better capture disease ecologies in archaeological samples and their variation across different regions, within related sites, and within individual lifespans.
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Affiliation(s)
- J Marla Toyne
- Department of Anthropology, University of Central Florida, Orlando, FL, 32803-1631, United States.
| | - Bethany L Turner
- Department of Anthropology, Georgia State University, PO Box 3998, Atlanta, GA 30302-3998, United States.
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4
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Ascenzi MG. Theoretical mathematics, polarized light microscopy and computational models in healthy and pathological bone. Bone 2020; 134:115295. [PMID: 32088399 DOI: 10.1016/j.bone.2020.115295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/06/2020] [Accepted: 02/18/2020] [Indexed: 12/24/2022]
Abstract
The needs of everyday life, such as counting and measuring, are roots of theoretical mathematics. I believe these roots are why mathematical ideas ground research so amazingly well within many scientific fields. Initially trained as a theoretical mathematician and having collaborated with non-mathematicians in the field of bone research, I address the advantages and challenges of collaborations across fields of research among investigators trained in different disciplines. I report on the mathematical ideas that have guided my research on the mechanics of bone tissue. I explain how the mathematical ideas of local vs. global properties influence my research. Polarized light microscopy (PLM) is a tool that I use consistently, in association with other microscopy techniques, to investigate bone in its healthy state and in the presence of bone disease, in humans and in animal models. I review the results that I and investigators around the world have obtained with PLM. Applied to thin bone sections, PLM yields extinct (black) and bright (white) signals that are interpreted in terms of the orientation of collagen type I, by means of other microscopy techniques. Collagen type I is an elementary component of bone tissue. Its orientation is important for the mechanical function of bone. Images obtained by PLM at a specific bone site yield big data sets regarding collagen orientation. Multiple data sets in respect of multiple sites are often needed for research because the bone tissue differs by location in response to the distinct forces acting on it. Mathematics, defined by philosophers as the theory of patterns, offers the backdrop for pattern identification in the big data sets regarding collagen orientation. I also discuss the computational aspect of the research, pursuant to which the patterns identified are incorporated in simulations of mechanical behaviors of bone. These mathematical ideas serve to understand the role of collagen orientation in bone fracture risk.
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Affiliation(s)
- Maria-Grazia Ascenzi
- Department of Orthopaedic Surgery, University of California, Los Angeles, United States of America.
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5
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Michener S, Bell LS, Schuurman NC, Swanlund D. A Method to Interpolate Osteon Volume Designed for Histological Age Estimation Research. J Forensic Sci 2020; 65:1247-1259. [PMID: 32092159 DOI: 10.1111/1556-4029.14305] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/01/2019] [Accepted: 01/27/2020] [Indexed: 01/16/2023]
Abstract
Aging adult skeletal material is a crucial component of building the biological profile of unknown skeletal remains, but many macro- and microscopic methods have challenges regarding accuracy, precision, and replicability. This study developed a volumetric method to visualize and quantify histological remodeling events in three dimensions, using a two-dimensional serialized approach that applied circular polarizing microscopy and geographic information systems protocols. This approach was designed as a tool to extend current histological aging methodologies. Three serial transverse sections were obtained from a human femoral midshaft. A total sample size of 6847 complete osteons from the three sections was identified; 1229 osteons connected between all sections. The volume of all connected osteons was interpolated using ArcGIS area calculations and truncated cone geometric functions. Each section was divided into octants, and two random samples of 100 and of 30 connected osteons from each octant were generated. Osteon volume was compared between the octants for each random sample using ANOVA. Results indicated that the medial aspect had relative uniformity in osteon volume, whereas the lateral aspect showed high variability. The anterolateral-lateral octant had significantly smaller osteon volume, whereas the posterior-posterolateral octant had significantly larger osteon volume. Results also indicated that a minimum of 100 osteons is statistically more robust and more representative of normal osteon distribution and volume; the use of 30 osteons is insufficient. This research has demonstrated that osteon volume can be interpolated using spatial geometry and GIS applications and may be a tool to incorporate into adult age-at-death estimation techniques.
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Affiliation(s)
- Suzanna Michener
- Centre for Forensic Research, School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, Canada
| | - Lynne S Bell
- Centre for Forensic Research, School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, Canada
| | - Nadine C Schuurman
- Department of Geography, Simon Fraser University, 8888 University Drive, Burnaby, Canada
| | - David Swanlund
- Department of Geography, Simon Fraser University, 8888 University Drive, Burnaby, Canada
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6
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Dalla Via J, Daly RM, Owen PJ, Mundell NL, Rantalainen T, Fraser SF. Bone mineral density, structure, distribution and strength in men with prostate cancer treated with androgen deprivation therapy. Bone 2019; 127:367-375. [PMID: 31189088 DOI: 10.1016/j.bone.2019.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/05/2019] [Accepted: 06/06/2019] [Indexed: 12/26/2022]
Abstract
Androgen deprivation therapy (ADT) improves survival in men with advanced prostate cancer (PCa), but has been associated with compromised skeletal health and increased fracture risk. However, limited previous research has investigated determinants of bone strength beyond DXA-derived areal bone mineral density (aBMD) in this population group. The aim of this cross-sectional study was to investigate the effects of ADT in men with PCa on BMD, bone structure, estimates of whole bone strength and cortical bone distribution. A total of 70 ADT-treated men, 52 PCa controls and 70 healthy controls had DXA lumbar spine and proximal femur aBMD and pQCT distal (4%) and proximal (66%) tibia and radius cortical and trabecular volumetric BMD (vBMD), bone structure, strength and cortical bone distribution assessed. Analyses included BMI and/or tibia/radius length as covariates. On average, ADT-treated men had a higher BMI than PCa (P < 0.05) but not healthy controls. ADT-treated men had 7.2-7.8% lower lumbar spine aBMD than PCa (P = 0.037) and healthy controls (P = 0.010), with a trend for a lower total hip aBMD in the ADT-treated men (P = 0.07). At the distal tibia, total bone area was 6.2-7.3% greater in ADT-treated men than both controls (P < 0.01), but total vBMD was 8.4-8.7% lower in ADT-treated men than both controls (P < 0.01). Moreover, bone strength index (BSI) was 10.8% lower relative to healthy controls only (P < 0.05). At the distal radius, ADT-treated men had lower total and trabecular vBMD (10.7-14.8%, P < 0.05) and BSI (23.6-27.5%, P < 0.001) compared to both controls. There were no other differences in bone outcomes at the proximal tibia or radius. In conclusion, ADT treatment for PCa was associated with lower BMD and estimated compressive bone strength, particularly at trabecular skeletal sites (lumbar spine, and distal tibia and radius), compared to controls, but there were no consistent differences in cortical bone structure, distribution or bending strength.
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Affiliation(s)
- Jack Dalla Via
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Patrick J Owen
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Niamh L Mundell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Timo Rantalainen
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia; Gerontology Research Centre and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Steve F Fraser
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Abstract
It is well known that bone loss accompanies aging in both men and women and contributes to skeletal fragility in the older population, but changes that occur to the bone tissue matrix itself are less well known. These changes in bone quality aggravate the skeletal fragility associated with loss of bone mass. Bone tissue quality is affected by age-related changes in bone mineral, collagen and its cross-linking profiles, water compartments and even non-collagenous proteins. It is commonly assumed that greater tissue mineralization accompanies aging as bone turnover slows down in elderly individuals, but the data for this are weak. However, there may be changes in the quality of the mineral crystals, and the substitutions found within the crystal. Both enzymatically-mediated and non-enzymatically-mediated collagen cross-links multiply with age. The former tend to make the bone stiffer and stronger, but the latter, while making the bone stiffer can also make it more brittle and more likely to fracture. Bone pore water that is not bound to collagen or mineral increases with age as bone mass is lost, but water that is bound to collagen and mineral declines with age. These changes contribute to skeletal fragility by reducing the amount that bone can deform before fracturing. Finally, non-collagenous proteins have physical properties that can alter matrix mechanical properties and can also have molecular signaling functions that regulate bone remodeling. Whether these change with age, how they change, and how this affects skeletal fragility with aging is still largely a black box, and requires much more investigation. The roles of any of these factors in skeletal fragility are difficult to assess clinically as there is no easy or economical way to evaluate them, but a picture of fragility in the aging skeleton is incomplete without them.
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Affiliation(s)
- David B Burr
- Dept. of Anatomy and Cell Biology, Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, United States of America; Dept. of Biomedical Engineering, Indiana University-Purdue University, Indianapolis (IUPUI), United States of America.
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8
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Beresheim AC, Pfeiffer SK, Grynpas MD, Alblas A. Use of backscattered scanning electron microscopy to quantify the bone tissues of mid‐thoracic human ribs. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 168:262-278. [DOI: 10.1002/ajpa.23716] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 09/10/2018] [Accepted: 09/11/2018] [Indexed: 01/08/2023]
Affiliation(s)
- Amy C. Beresheim
- Department of AnthropologyUniversity of Toronto Toronto Ontario Canada
| | - Susan K. Pfeiffer
- Department of AnthropologyUniversity of Toronto Toronto Ontario Canada
- Department of ArchaeologyUniversity of Cape Town Rondebosch Cape Town South Africa
- Department of Anthropology and Center for Advanced Study of Human PaleobiologyGeorge Washington University Washington, D.C
| | - Marc D. Grynpas
- Department of Laboratory Medicine and Pathobiology and Institute for Biomaterials and Biomedical EngineeringUniversity of Toronto Toronto Ontario Canada
- Lunenfeld‐Tanenbaum Research Institute, Mount Sinai Hospital Toronto Ontario Canada
| | - Amanda Alblas
- Division of Anatomy and Histology, Department of Biomedical SciencesStellenbosch University Cape Town South Africa
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9
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Ex vivo cortical porosity and thickness predictions at the tibia using full-spectrum ultrasonic guided-wave analysis. Arch Osteoporos 2019; 14:21. [PMID: 30783777 PMCID: PMC6394459 DOI: 10.1007/s11657-019-0578-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 01/31/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED The estimation of cortical thickness (Ct.Th) and porosity (Ct.Po) at the tibia using axial transmission ultrasound was successfully validated ex vivo against site-matched micro-computed tomography. The assessment of cortical parameters based on full-spectrum guided-wave analysis might improve the prediction of bone fractures in a cost-effective and radiation-free manner. PURPOSE Cortical thickness (Ct.Th) and porosity (Ct.Po) are key parameters for the identification of patients with fragile bones. The main objective of this ex vivo study was to validate the measurement of Ct.Po and Ct.Th at the tibia using a non-ionizing, low-cost, and portable 500-kHz ultrasound axial transmission system. Additional ultrasonic velocities and site-matched reference parameters were included in the study to broaden the analysis. METHODS Guided waves were successfully measured ex vivo in 17 human tibiae using a novel 500-kHz bi-directional axial transmission probe. Theoretical dispersion curves of a transverse isotropic free plate model with invariant matrix stiffness were fitted to the experimental dispersion curves in order to estimate Ct.Th and Ct.Po. In addition, the velocities of the first arriving signal (υFAS) and A0 mode (υA0) were measured. Reference Ct.Po, Ct.Th, and vBMD were obtained from site-matched micro-computed tomography. Scanning acoustic microscopy (SAM) provided the acoustic impedance of the axial cortical bone matrix. RESULTS The best predictions of Ct.Po (R2 = 0.83, RMSE = 2.2%) and Ct.Th (R2 = 0.92, RMSE = 0.2 mm, one outlier excluded) were obtained from the plate model. The second best predictors of Ct.Po and Ct.Th were vBMD (R2 = 0.77, RMSE = 2.6%) and υA0 (R2 = 0.28, RMSE = 0.67 mm), respectively. CONCLUSIONS Ct.Th and Ct.Po were accurately predicted at the human tibia ex vivo using a transverse isotropic free plate model with invariant matrix stiffness. The model-based predictions were not further enhanced when we accounted for variations in axial tissue stiffness as reflected by the acoustic impedance from SAM.
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10
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Gocha TP, Agnew AM. Spatial variation in osteon population density at the human femoral midshaft: histomorphometric adaptations to habitual load environment. J Anat 2015; 228:733-45. [PMID: 26708961 DOI: 10.1111/joa.12433] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2015] [Indexed: 12/01/2022] Open
Abstract
Intracortical remodeling, and the osteons it produces, is one aspect of the bone microstructure that is influenced by and, in turn, can influence its mechanical properties. Previous research examining the spatial distribution of intracortical remodeling density across the femoral midshaft has been limited to either considering only small regions of the cortex or, when looking at the entirety of the cortex, considering only a single individual. This study examined the spatial distribution of all remodeling events (intact osteons, fragmentary osteons, and resorptive bays) across the entirety of the femoral midshaft in a sample of 30 modern cadaveric donors. The sample consisted of 15 males and 15 females, aged 21-97 years at time of death. Using geographic information systems software, the femoral cortex was subdivided radially into thirds and circumferentially into octants, and the spatial location of all remodeling events was marked. Density maps and calculation of osteon population density in cortical regions of interest revealed that remodeling density is typically highest in the periosteal third of the bone, particularly in the lateral and anterolateral regions of the cortex. Due to modeling drift, this area of the midshaft femur has some of the youngest primary tissue, which consequently reveals that the lateral and anterolateral regions of the femoral midshaft have higher remodeling rates than elsewhere in the cortex. This is likely the result of tension/shear forces and/or greater strain magnitudes acting upon the anterolateral femur, which results in a greater amount of microdamage in need of repair than is seen in the medial and posterior regions of the femoral midshaft, which are more subject to compressive forces and/or lesser strain magnitudes.
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Affiliation(s)
- Timothy P Gocha
- Skeletal Biology Research Lab, Division of Anatomy, Injury Biomechanics Research Center, The Ohio State University, Columbus, OH, USA
| | - Amanda M Agnew
- Skeletal Biology Research Lab, Division of Anatomy, Injury Biomechanics Research Center, The Ohio State University, Columbus, OH, USA.,Department of Anthropology, The Ohio State University, Columbus, OH, USA
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11
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Maggiano CM, Maggiano IS, Tiesler VG, Chi-Keb JR, Stout SD. Methods and theory in bone modeling drift: comparing spatial analyses of primary bone distributions in the human humerus. J Anat 2015; 228:190-202. [PMID: 26471797 DOI: 10.1111/joa.12383] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2015] [Indexed: 11/29/2022] Open
Abstract
This study compares two novel methods quantifying bone shaft tissue distributions, and relates observations on human humeral growth patterns for applications in anthropological and anatomical research. Microstructural variation in compact bone occurs due to developmental and mechanically adaptive circumstances that are 'recorded' by forming bone and are important for interpretations of growth, health, physical activity, adaptation, and identity in the past and present. Those interpretations hinge on a detailed understanding of the modeling process by which bones achieve their diametric shape, diaphyseal curvature, and general position relative to other elements. Bone modeling is a complex aspect of growth, potentially causing the shaft to drift transversely through formation and resorption on opposing cortices. Unfortunately, the specifics of modeling drift are largely unknown for most skeletal elements. Moreover, bone modeling has seen little quantitative methodological development compared with secondary bone processes, such as intracortical remodeling. The techniques proposed here, starburst point-count and 45° cross-polarization hand-drawn histomorphometry, permit the statistical and populational analysis of human primary tissue distributions and provide similar results despite being suitable for different applications. This analysis of a pooled archaeological and modern skeletal sample confirms the importance of extreme asymmetry in bone modeling as a major determinant of microstructural variation in diaphyses. Specifically, humeral drift is posteromedial in the human humerus, accompanied by a significant rotational trend. In general, results encourage the usage of endocortical primary bone distributions as an indicator and summary of bone modeling drift, enabling quantitative analysis by direction and proportion in other elements and populations.
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Affiliation(s)
- Corey M Maggiano
- Department of Anthropology, University of West Georgia, Carrollton, GA, USA.,Department of Anthropology, University of Western Ontario, London, ON, Canada
| | - Isabel S Maggiano
- Department of Anthropology, University of West Georgia, Carrollton, GA, USA.,Department of Anatomy and Cell Biology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Vera G Tiesler
- Department for Anthropological Sciences, Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico
| | - Julio R Chi-Keb
- Department for Anthropological Sciences, Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico
| | - Sam D Stout
- Department of Anthropology, The Ohio State University, Columbus, OH, USA
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12
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PEELUKHANA SV, GOENKA S, KIM B, KIM J, BHATTACHARYA A, STRINGER KF, BANERJEE RK. Effect of higher frequency components and duration of vibration on bone tissue alterations in the rat-tail model. INDUSTRIAL HEALTH 2015; 53:245-259. [PMID: 25843564 PMCID: PMC4466877 DOI: 10.2486/indhealth.2014-0117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 01/29/2015] [Indexed: 06/04/2023]
Abstract
To formulate more accurate guidelines for musculoskeletal disorders (MSD) linked to Hand-Arm Vibration Syndrome (HAVS), delineation of the response of bone tissue under different frequencies and duration of vibration needs elucidation. Rat-tails were vibrated at 125 Hz (9 rats) and 250 Hz (9 rats), at 49 m/s(2), for 1D (6 rats), 5D (6 rats) and 20D (6 rats); D=days (4 h/d). Rats in the control group (6 rats for the vibration groups; 2 each for 1D, 5D, and 20D) were left in their cages, without being subjected to any vibration. Structural and biochemical damages were quantified using empty lacunae count and nitrotyrosine signal-intensity, respectively. One-way repeated-measure mixed-model ANOVA at p<0.05 level of significance was used for analysis. In the cortical bone, structural damage quantified through empty lacunae count was significant (p<0.05) at 250 Hz (10.82 ± 0.66) in comparison to the control group (7.41 ± 0.76). The biochemical damage was significant (p<0.05) at both the 125 Hz and 250 Hz vibration frequencies. The structural damage was significant (p<0.05) at 5D for cortical bone while the trabecular bone showed significant (p<0.05) damage at 20D time point. Further, the biochemical damage increased with increase in the duration of vibration with a significant (p<0.05) damage observed at 20D time point and a near significant change (p=0.08) observed at 5D time point. Structural and biochemical changes in bone tissue are dependent upon higher vibration frequencies of 125 Hz, 250 Hz and the duration of vibration (5D, 20D).
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Affiliation(s)
| | - Shilpi GOENKA
- Department of Mechanical and Materials Engineering,
University of Cincinnati, USA
| | - Brian KIM
- Department of Mechanical and Materials Engineering,
University of Cincinnati, USA
| | - Jay KIM
- Department of Mechanical and Materials Engineering,
University of Cincinnati, USA
| | | | - Keith F. STRINGER
- Department of Pathology, Cincinnati Children’s Hospital
Medical Centre, USA
| | - Rupak K. BANERJEE
- Department of Mechanical and Materials Engineering,
University of Cincinnati, USA
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13
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Tatarinov A, Egorov V, Sarvazyan N, Sarvazyan A. Multi-frequency axial transmission bone ultrasonometer. ULTRASONICS 2014; 54:1162-9. [PMID: 24206675 PMCID: PMC4205948 DOI: 10.1016/j.ultras.2013.09.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Revised: 08/12/2013] [Accepted: 09/01/2013] [Indexed: 05/23/2023]
Abstract
The last decade has seen a surge in the development of axial transmission QUS (Quantitative UltraSound) technologies for the assessment of long bones using various modes of acoustic waves. The condition of cortical bones and the development of osteoporosis are determined by numerous mechanical, micro-structural, and geometrical or macro-structural bone properties like hardness, porosity and cortical thickness. Such complex manifestations of osteoporosis require the evaluation of multiple parameters with different sensitivities to the various properties of bone that are affected by the disease. This objective may be achieved by using a multi-frequency ultrasonic examination The ratio of the acoustic wavelength to the cortical thickness can be changed by varying the frequency of the ultrasonic pulse propagating through the long bone that results in the change in composition of the induced wave comprised of a set of numerous modes of guided, longitudinal, and surface acoustic waves. The multi-frequency axial transmission QUS method developed at Artann Laboratories (Trenton, NJ) is implemented in the Bone Ultrasonic Scanner (BUSS). In the current version of the BUSS, a train of ultrasonic pulses with 60, 100, 400, 800, and 1200 kHz frequencies is used. The developed technology was tested on a variety of bone phantoms simulating normal, osteopenic, and osteoporotic bones. The results of this study confirm the feasibility of the multi-frequency approach for the assessment of the processes leading to osteoporosis.
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14
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Goldman HM, Hampson NA, Guth JJ, Lin D, Jepsen KJ. Intracortical remodeling parameters are associated with measures of bone robustness. Anat Rec (Hoboken) 2014; 297:1817-28. [PMID: 24962664 DOI: 10.1002/ar.22962] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 05/21/2014] [Indexed: 11/11/2022]
Abstract
Prior work identified a novel association between bone robustness and porosity, which may be part of a broader interaction whereby the skeletal system compensates for the natural variation in robustness (bone width relative to length) by modulating tissue-level mechanical properties to increase stiffness of slender bones and to reduce mass of robust bones. To further understand this association, we tested the hypothesis that the relationship between robustness and porosity is mediated through intracortical, BMU-based (basic multicellular unit) remodeling. We quantified cortical porosity, mineralization, and histomorphometry at two sites (38% and 66% of the length) in human cadaveric tibiae. We found significant correlations between robustness and several histomorphometric variables (e.g., % secondary tissue [R(2) = 0.68, P < 0.004], total osteon area [R(2) = 0.42, P < 0.04]) at the 66% site. Although these associations were weaker at the 38% site, significant correlations between histological variables were identified between the two sites indicating that both respond to the same global effects and demonstrate a similar character at the whole bone level. Thus, robust bones tended to have larger and more numerous osteons with less infilling, resulting in bigger pores and more secondary bone area. These results suggest that local regulation of BMU-based remodeling may be further modulated by a global signal associated with robustness, such that remodeling is suppressed in slender bones but not in robust bones. Elucidating this mechanism further is crucial for better understanding the complex adaptive nature of the skeleton, and how interindividual variation in remodeling differentially impacts skeletal aging and an individuals' potential response to prophylactic treatments.
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Affiliation(s)
- Haviva M Goldman
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, Pennsylvania; Department of Materials Science and Engineering, Drexel University College of Engineering, Philadelphia, Pennsylvania
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15
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Granke M, Coulmier A, Uppuganti S, Gaddy JA, Does MD, Nyman JS. Insights into reference point indentation involving human cortical bone: sensitivity to tissue anisotropy and mechanical behavior. J Mech Behav Biomed Mater 2014; 37:174-85. [PMID: 24929851 DOI: 10.1016/j.jmbbm.2014.05.016] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 05/13/2014] [Accepted: 05/17/2014] [Indexed: 01/20/2023]
Abstract
Reference point indentation (RPI) is a microindentation technique involving 20 cycles of loading in "force-control" that can directly assess a patient׳s bone tissue properties. Even though preliminary clinical studies indicate a capability for fracture discrimination, little is known about what mechanical behavior the various RPI properties characterize and how these properties relate to traditional mechanical properties of bone. To address this, the present study investigated the sensitivity of RPI properties to anatomical location and tissue organization as well as examined to what extent RPI measurements explain the intrinsic mechanical properties of human cortical bone. Multiple indents with a target force of 10N were done in 2 orthogonal directions (longitudinal and transverse) per quadrant (anterior, medial, posterior, and lateral) of the femoral mid-shaft acquired from 26 donors (25-101 years old). Additional RPI measurements were acquired for 3 orthogonal directions (medial only). Independent of age, most RPI properties did not vary among these locations, but they did exhibit transverse isotropy such that resistance to indentation is greater in the longitudinal (axial) direction than in the transverse direction (radial or circumferential). Next, beam specimens (~2mm×5mm×40mm) were extracted from the medial cortex of femoral mid-shafts, acquired from 34 donors (21-99 years old). After monotonically loading the specimens in three-point bending to failure, RPI properties were acquired from an adjacent region outside the span. Indent direction was orthogonal to the bending axis. A significant inverse relationship was found between resistance to indentation and the apparent-level mechanical properties. Indentation distance increase (IDI) and a linear combination of IDI and the loading slope, averaged over cycles 3 through 20, provided the best explanation of the variance in ultimate stress (r(2)=0.25, p=0.003) and toughness (r(2)=0.35, p=0.004), respectively. With a transverse isotropic behavior akin to tissue hardness and modulus as determined by micro- and nano-indentation and a significant association with toughness, RPI properties are likely influenced by both elastic and plastic behavior of bone tissue.
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Affiliation(s)
- Mathilde Granke
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University, Nashville, TN 37232, United States
| | - Aurélie Coulmier
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University, Nashville, TN 37232, United States; Polytech Marseille, Marseille 13288, France
| | - Sasidhar Uppuganti
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University, Nashville, TN 37232, United States
| | - Jennifer A Gaddy
- Department of Medicine, Vanderbilt University, Nashville, TN 37232, United States; Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN 37212, United States
| | - Mark D Does
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, United States; Institute of Imaging Science, Vanderbilt University, Nashville, TN 37232, United States; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232, United States; Department of Electrical Engineering, Vanderbilt University, Nashville, TN 37232, United States
| | - Jeffry S Nyman
- Department of Orthopaedic Surgery & Rehabilitation, Vanderbilt University, Nashville, TN 37232, United States; Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN 37212, United States; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, United States; Center for Bone Biology, Vanderbilt University, Nashville, TN 37232, United States.
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16
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Fratzl-Zelman N, Roschger P, Fisher JE, Duong LT, Klaushofer K. Effects of Odanacatib on bone mineralization density distribution in thoracic spine and femora of ovariectomized adult rhesus monkeys: a quantitative backscattered electron imaging study. Calcif Tissue Int 2013. [PMID: 23179105 DOI: 10.1007/s00223-012-9673-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Odanacatib (ODN) has been developed as a selective inhibitor of cathepsin K, the major cysteine protease in osteoclasts. In adult rhesus monkeys, treatment with ODN prevents ovariectomy-induced bone loss in lumbar vertebrae and hip. In this study, we evaluate the effects of ODN on bone mineralization density distribution (BMDD) by quantitative backscattered electron imaging in vertebral spongiosa, distal femoral metaphyseal and cortical shaft from monkeys (aged 16-23 years), treated with vehicle (n=5) or ODN (6 mg/kg, n=4 or 30 mg/kg, n=4, PO daily) for 21 months. Dual-energy X-ray absorptiometry was measured in a subset of distal femoral samples. In lumbar vertebrae there was a shift to higher mineralization in samples from ODN-treated groups, compared to vehicle: CaMean (+4%), CaPeak (+3%), CaWidth (-9%), CaLow (-28%) in the 6 mg/kg group and CaMean (+5.1%, p<0.023), CaPeak (+3.4%, p<0.046), CaWidth (-15.7%, p=0.06) and CaLow (-38.2%, p<0.034) in the 30 mg/kg group. In distal femoral metaphyseal cancellous bone, there was a clear tendency toward a dose-dependent increase in matrix mineralization, as in the spine. However, primary and osteonal bone of the distal cortical diaphyses showed no significant change in BMDD, whereas bone mineral density was significantly increased after treatment. In ovariectomized monkeys, this study shows that ODN treatment increased trabecular BMDD, consistent with its previously reported ability to reduce cancellous remodeling. Here, ODN also showed no changes in BMDD in cortical bone sites, consistent with its actions on maintaining endocortical and stimulating periosteal bone formation.
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Affiliation(s)
- Nadja Fratzl-Zelman
- Ludwig Boltzmann Institute of Osteology of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, 1140, Vienna, Austria.
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17
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Turner BL, Klaus HD, Livengood SV, Brown LE, Saldaña F, Wester C. The variable roads to sacrifice: Isotopic investigations of human remains from Chotuna-Huaca de los Sacrificios, Lambayeque, Peru. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2013; 151:22-37. [DOI: 10.1002/ajpa.22238] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 01/14/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Bethany L. Turner
- Department of Anthropology; Georgia State University; Atlanta; GA; 30302-3998
| | | | - Sarah V. Livengood
- Department of Anthropology; University of Arkansas; Fayetteville; AR; 72701
| | - Leslie E. Brown
- Department of Anthropology; University of Wyoming; Laramie; WY; 82071
| | - Fausto Saldaña
- Museo Nacional de Arqueología y Etnografía Hans Heinrich Brüning de Lambayeque; Perú
| | - Carlos Wester
- Museo Nacional de Arqueología y Etnografía Hans Heinrich Brüning de Lambayeque; Perú
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18
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Pathak S, Vachhani SJ, Jepsen KJ, Goldman HM, Kalidindi SR. Assessment of lamellar level properties in mouse bone utilizing a novel spherical nanoindentation data analysis method. J Mech Behav Biomed Mater 2012; 13:102-17. [PMID: 22842281 DOI: 10.1016/j.jmbbm.2012.03.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 03/23/2012] [Accepted: 03/26/2012] [Indexed: 11/18/2022]
Abstract
In this work, we demonstrate the viability of using our recently developed data analysis procedures for spherical nanoindentation in conjunction with Raman spectroscopy for studying lamellar-level correlations between the local composition and local mechanical properties in mouse bone. Our methodologies allow us to convert the raw load-displacement datasets to much more meaningful indentation stress-strain curves that accurately capture the loading and unloading elastic moduli, the indentation yield points, as well as the post-yield characteristics in the tested samples. Using samples of two different inbred mouse strains, A/J and C57BL/6J (B6), we successfully demonstrate the correlations between the mechanical information obtained from spherical nanoindentation measurements to the local composition measured using Raman spectroscopy. In particular, we observe that a higher mineral-to-matrix ratio correlated well with a higher local modulus and yield strength in all samples. Thus, new bone regions exhibited lower moduli and yield strengths compared to more mature bone. The B6 mice were also found to exhibit lower modulus and yield strength values compared to the more mineralized A/J strain.
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Affiliation(s)
- Siddhartha Pathak
- Department of Materials Science and Engineering, Drexel University, Philadelphia, PA 19104, USA.
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19
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Rantalainen T, Nikander R, Daly RM, Heinonen A, Sievänen H. Exercise loading and cortical bone distribution at the tibial shaft. Bone 2011; 48:786-91. [PMID: 21122824 DOI: 10.1016/j.bone.2010.11.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Revised: 11/18/2010] [Accepted: 11/20/2010] [Indexed: 11/26/2022]
Abstract
Cortical bone is not a uniform tissue, and its apparent density [cortical volumetric density (vBMD)] varies around the bone cross-section as well as along the axial length of the bone. It is not yet known, whether the varying vBMD distribution is attributable to modulation in the predominant loads affecting bone. The aim of the present study was to compare the cortical bone mass distribution through the bone cortex (radial distribution) and around the center of mass (polar distribution) among 221 premenopausal women aged 17-40 years representing athletes involved in high impact, odd impact, high magnitude, repetitive low impact, repetitive non-impact sports and leisure time physical activity (referent controls). Bone cross-sections at the tibial mid-diaphysis were assessed with pQCT. Radial and polar vBMD distributions were analyzed in three concentric cortical divisions within the cortical envelope and in four cortical sectors originating from the center of the bone cross-section. MANCOVA, including age as a covariate, revealed no significant group by division/sector interaction in either radial or polar distribution, but the mean vBMD values differed between groups (P<0.001). The high and odd-impact groups had 1.2 to 2.6% (P<0.05) lower cortical vBMD than referents, in all analyzed sectors/divisions. The repetitive, low-impact group had 0.4 to 1.0% lower (P<0.05) vBMD at the mid and outer cortical regions and at the anterior sector of the tibia. The high magnitude group had 1.2% lower BMD at the lateral sector (P<0.05). The present results generate a hypothesis that the radial and polar cortical bone vBMD distributions within the tibial mid-shaft are not modulated by exercise loading but the mean vBMD level is slightly affected.
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Affiliation(s)
- T Rantalainen
- Department of Mechanical Engineering, Lappeenranta University of Technology, Finland.
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20
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Pathak S, Swadener JG, Kalidindi SR, Courtland HW, Jepsen KJ, Goldman HM. Measuring the dynamic mechanical response of hydrated mouse bone by nanoindentation. J Mech Behav Biomed Mater 2010; 4:34-43. [PMID: 21094478 DOI: 10.1016/j.jmbbm.2010.09.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 08/30/2010] [Accepted: 09/05/2010] [Indexed: 10/19/2022]
Abstract
This study demonstrates a novel approach to characterizing hydrated bone's viscoelastic behavior at lamellar length scales using dynamic indentation techniques. We studied the submicron-level viscoelastic response of bone tissue from two different inbred mouse strains, A/J and B6, with known differences in whole bone and tissue-level mechanical properties. Our results show that bone having a higher collagen content or a lower mineral-to-matrix ratio demonstrates a trend towards a larger viscoelastic response. When normalized for anatomical location relative to biological growth patterns in the antero-medial (AM) cortex, bone tissue from B6 femora, known to have a lower mineral-to-matrix ratio, is shown to exhibit a significantly higher viscoelastic response compared to A/J tissue. Newer bone regions with a higher collagen content (closer to the endosteal edge of the AM cortex) showed a trend towards a larger viscoelastic response. Our study demonstrates the feasibility of this technique for analyzing local composition-property relationships in bone. Further, this technique of viscoelastic nanoindentation mapping of the bone surface at these submicron length scales is shown to be highly advantageous in studying subsurface features, such as porosity, of wet hydrated biological specimens, which are difficult to identify using other methods.
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Affiliation(s)
- Siddhartha Pathak
- Department of Materials Science and Engineering, Drexel University, Philadelphia, PA 19104, USA.
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21
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Jørkov MLS, Heinemeier J, Lynnerup N. The petrous bone--a new sampling site for identifying early dietary patterns in stable isotopic studies. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2009; 138:199-209. [PMID: 18773469 DOI: 10.1002/ajpa.20919] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Intraskeletal variation in the composition of carbon (delta(13)C) and nitrogen (delta(15)N) stable isotopes measured in collagen is tested from various human bones and dentine. Samples were taken from the femur, rib, and petrous part of the temporal bone from well-preserved skeletons of both adults (n = 34) and subadults (n = 24). Additional samples of dentine from the root of 1st molars were taken from 16 individuals. The skeletal material is from a medieval cemetery (AD 1200-1573) in Holbaek, Denmark. Our results indicate that the petrous bone has an isotopic signal that differs significantly from that of femur and rib within the single skeleton (P < 0.001 and P < 0.001, respectively), with only minor variation seen between femur and rib. On the other hand, there was no significant difference between the petrous bone and the 1st molar. The intraskeletal variation may reflect differences in turnover rate among skeletal elements. The inner periosteal layer of the petrous bone is formed in uterus and does not undergo any further remodelling after the age of 2 years, whereas the rib and femur have a continuous turnover rate of approximately 5 and 10-20 years, respectively. From the results of this study it is believed the petrous bone may be a new useful bone element and a supplement or a proxy for teeth in the analysis of early dietary patterns as it may reflect diet in fetal stages and early years of life.
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Affiliation(s)
- Marie Louise S Jørkov
- Centre for Forensic Science, School of Conservation Sciences, University of Bournemouth, Dorset BH12 5BB, England, UK.
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22
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Goldman H, Mcfarlin S, Cooper D, Thomas C, Clement J. Ontogenetic Patterning of Cortical Bone Microstructure and Geometry at the Human Mid-Shaft Femur. Anat Rec (Hoboken) 2009; 292:48-64. [DOI: 10.1002/ar.20778] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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23
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Maggiano IS, Schultz M, Kierdorf H, Sosa TS, Maggiano CM, Tiesler Blos V. Cross-sectional analysis of long bones, occupational activities and long-distance trade of the Classic Maya from Xcambó--archaeological and osteological evidence. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2008; 136:470-7. [PMID: 18383157 DOI: 10.1002/ajpa.20830] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Xcambó is a Classic period Maya site (250-700 AD) situated on the northern coast of Yucatan, Mexico. Archaeological evidence suggests that the site began as a salt production center but adopted a more administrative role as a commercial port in the Late Classic period. Economic growth, depending on its magnitude, could have affected the daily occupations of Xcambó's inhabitants. However, this is difficult to infer from the archaeological record. The aim of this study was to directly evaluate this possibility through skeletal analysis. Since diaphyseal robusticity and shape are predominantly influenced by mechanical loading history, long bone cross-sections can be used to access activity patterns. To this end, humeri and femora of 47 male and 35 female adult specimens from two Xcambó population samples were scrutinized. Our analysis satisfies general archaeological expectations and provides additional information on the population's physical response to economic growth. Decreasing robusticity and femoral anterior-posterior rigidity indicate an overall decrease in physical workload and mobility, concomitant with the site's increasing administrative function. We also observed a significant decrease in sexual dimorphism, possibly attributable to the differential response of male and female physical work spheres during socioeconomic change. In general, our findings suggest even nonsubsistence based socioeconomic change can significantly affect the bone structure of a population, rendering activity analysis an important aspect of the reconstruction of living conditions of past populations.
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Affiliation(s)
- Isabel S Maggiano
- Department for Biology, University of Hildesheim, Hildesheim 31141, Germany
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24
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Norman TL, Little TM, Yeni YN. Age-related changes in porosity and mineralization and in-service damage accumulation. J Biomech 2008; 41:2868-73. [PMID: 18703196 DOI: 10.1016/j.jbiomech.2008.06.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Revised: 05/23/2008] [Accepted: 06/23/2008] [Indexed: 10/21/2022]
Abstract
It has been proposed that bone damageability (i.e. bone's susceptibility to formation of damage) increases with the elevation or suppression of bone turnover. Suppression of turnover via bisphosphonates increases local bone mineralization, which theoretically should increase the susceptibility of bone to microcrack formation. Elevation of bone turnover has also been proposed to increase bone microdamage through an increase in bone intracortical porosity and local stresses and strains. The goal of this paper was to investigate the above proposals, i.e., whether or not increases to mineral content and porosity increase bone in-service damageability. To do this, we measured in vivo diffuse damage area (Df.Dm.Ar, %) and microcrack density (Cr.Dn) (cracks/mm(2)) in the same specimen from human cortical bone of the midshaft of the proximal femur obtained from cadavers with an age range of eight decades and examined their relationships with porosity, mineralization and age. Results of this study showed that Cr.Dn and Df.Dm.Ar increased with a decrease in bulk mineralization. This finding does not appear to support the proposal that damage accumulation increases with low bone turnover that results in increases mineralization. It was proposed however that the negative correlation between damage accumulation and mineralization may be attributed to highly mineralized regions of bone existing with under-mineralized regions resulting in an overall decrease in average bone mineralization. It was also found that microdamage accumulates with increasing porosity which does appear to support the proposal that elevated bone turnover that results in increased porosity can accelerate microdamage accumulation. Finally, it was shown that linear microcracks and Df.Dm.Ar accumulate with age differently, but because they correlate with each other, one may be the precursor for the other.
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Affiliation(s)
- Timothy L Norman
- Department of Engineering and Computer Science, Cedarville University, 251 N. Main Street, Cedarville, OH 45314, USA.
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25
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Saïed A, Raum K, Leguerney I, Laugier P. Spatial distribution of anisotropic acoustic impedance assessed by time-resolved 50-MHz scanning acoustic microscopy and its relation to porosity in human cortical bone. Bone 2008; 43:187-194. [PMID: 18407822 DOI: 10.1016/j.bone.2008.02.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Revised: 11/29/2007] [Accepted: 02/13/2008] [Indexed: 12/28/2022]
Abstract
We used quantitative scanning acoustic microscopy (SAM) to assess tissue acoustic impedance and microstructure of cortical bone of human radii with the aim to provide data on regional distribution of acoustic impedance along the circumferential and across the radial directions in the entire cross-section of the radius diaphysis as well as to determine the range of impedance values in transverse (perpendicular to bone axis) and longitudinal (parallel to bone axis) cross-sections. Several microstructural features related to cortical porosity were analyzed in order to determine whether these features differ in different parts of the cortex and to assess the relationship between the microstructure and tissue acoustic impedance. Fifteen fresh bone specimens (human radius) were investigated using a SAM (center frequency of 50 MHz and -6 dB lateral resolution of approximately 23 microm). The sample acoustic impedance was obtained by means of a calibration curve correlating the reflected signal amplitude of reference materials with their corresponding well-known acoustic impedance. Tissue acoustic impedance and microstructural features were derived from the morphometric analysis of the segmented impedance images. A higher porosity was found in the inner cortical layer (mean+/-SD=8.9+/-2.3%) compared to the peripheral layer (2.7+/-1.5%) (paired t-test, p<10(-5)). ANOVA showed that most of the variance can be explained by the regional effect across the radial direction with a minor contribution due to between-sample variability. Similar to porosity, the number and diameter of pores were greater in the inner layer. In contrast to porosity, ANOVA showed that impedance variability can mostly be explained by between-specimen variability. Two-way ANOVA revealed that after compensation for the between-sample variability the variation in acoustic impedance across the radial direction was much larger than that along the circumferential direction. In addition to the significant difference between the inner cortical layer (8.25+/-0.4 Mrayl) and peripheral layer (8.0+/-0.5 Mrayl) (unilateral paired t-test, p<10(-4)), the values in the anterior region (8.2+/-0.5 Mrayl) were found to be significantly higher than those of the posterior region (7.9+/-0.6 Mrayl). Impedance mean value of longitudinal sections was lower than mean value measured in transverse cross-sections, resulting in an impedance acoustic anisotropy ratio of 1.17+/-0.03 in the inner cortical layer and 1.19+/-0.02 in the peripheral layer. SAM is a valuable tool to provide data on the spatial distribution of microstructural and microelastic bone properties that is useful to improve our understanding of the impact of bone microstructure on tissue material properties.
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Affiliation(s)
- A Saïed
- UPMC Univ Paris 06, UMR 7623, LIP, F-75005, Paris, France; CNRS, Laboratoire d'Imagerie Paramétrique, UMR 7623, F-75006, Paris, France.
| | - K Raum
- UPMC Univ Paris 06, UMR 7623, LIP, F-75005, Paris, France; CNRS, Laboratoire d'Imagerie Paramétrique, UMR 7623, F-75006, Paris, France; Q-BAM Group, Department of Orthopedics, Martin Luther University of Halle-Wittenberg, Magdeburger Straße 22, 06097 Halle, Germany
| | - I Leguerney
- UPMC Univ Paris 06, UMR 7623, LIP, F-75005, Paris, France; CNRS, Laboratoire d'Imagerie Paramétrique, UMR 7623, F-75006, Paris, France
| | - P Laugier
- UPMC Univ Paris 06, UMR 7623, LIP, F-75005, Paris, France; CNRS, Laboratoire d'Imagerie Paramétrique, UMR 7623, F-75006, Paris, France
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26
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Kavukcuoglu NB, Denhardt DT, Guzelsu N, Mann AB. Osteopontin deficiency and aging on nanomechanics of mouse bone. J Biomed Mater Res A 2007; 83:136-44. [PMID: 17390367 DOI: 10.1002/jbm.a.31081] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Osteoporosis is a bone disease characterized by low bone mass and deterioration of the tissue leading to increased fragility. Osteopontin (OPN), a noncollageneous bone matrix protein, has been shown to play an important role in osteoporosis, bone resorption, and mineralization. However, OPN's role in bone mechanical properties on the submicron scale has not been studied in any detail. In this study, nanoindentation techniques were utilized to investigate how OPN and aging affect bone mechanical properties. Hardness and elastic modulus were calculated and compared between the OPN-deficient mice (OPN(-/-)) and their age and sex-matched wild-type (OPN(+/+)) controls. The results show that the mechanical properties of the young OPN(-/-) bones (age < 12 weeks) are significantly lower than that of the youngest OPN(+/+) bones. This finding was confirmed by additional microindentation testing. Biochemical analysis using micro-Raman spectroscopy indicated more mineral content in young OPN(+/+) bones. Older (age > 12 weeks) bones did not show any significant differences in mechanical properties with genotype. In addition, OPN(+/+) bones show a decrease in mechanical properties between young and older age groups. By contrast, OPN(-/-) bones showed no significant change in mechanical properties with aging.
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Affiliation(s)
- N Beril Kavukcuoglu
- Department of Materials Science and Engineering, Rutgers University, New Jersey 08854, USA
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27
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Yao W, Cheng Z, Koester KJ, Ager JW, Balooch M, Pham A, Chefo S, Busse C, Ritchie RO, Lane NE. The degree of bone mineralization is maintained with single intravenous bisphosphonates in aged estrogen-deficient rats and is a strong predictor of bone strength. Bone 2007; 41:804-12. [PMID: 17825637 PMCID: PMC3883569 DOI: 10.1016/j.bone.2007.06.021] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 06/15/2007] [Accepted: 06/25/2007] [Indexed: 11/27/2022]
Abstract
The treatment of osteoporotic women with bisphosphonates significantly reduces the incidence of bone fractures to a degree greater than can be explained by an increase in bone mineral density. In this study, 18-month Fischer 344 rats were ovariectomized and treated with a single dose of risedronate (intravenous, iv, 500 microg), zoledronic acid (iv, 100 microg) or continuous raloxifene (2 mg/kg, po, 3x/week). High resolution microCT was used to measure lumbar vertebral bone microarchitecture, the degree of bone mineralization (DBM) and the distribution of mineral. Small angle X-ray scattering was used to investigate mineral crystallinity. We found prolonged estrogen deficiency, reduced trabecular bone volume, and increased micro architecture bone compression strength lowered the degree of mineralization. Treatment with resorptive agents (bisphosphonates>raloxifene) prevented the loss of mineralization, trabecular bone volume and bone compression strength. Crystal size was not changed with OVX or with anti-resorptive treatments. In conclusion, in the aged estrogen-deficient rat model, single intravenous doses of two bisphosphonates were effective in maintaining the compressive bone strength for 180 days by reducing bone turnover, and maintaining the DBM to a greater degree than with raloxifene.
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Affiliation(s)
- Wei Yao
- Department of Medicine, Aging Center, UC Davis Medical Center, Sacramento, CA
| | - Zhiqiang Cheng
- Department of Medicine, Aging Center, UC Davis Medical Center, Sacramento, CA
| | - Kurt J. Koester
- Materials Sciences Division, Lawrence Berkeley National Laboratory, and Department of Materials Science and Engineering, University of California, Berkeley, CA
| | - Joel W. Ager
- Materials Sciences Division, Lawrence Berkeley National Laboratory, and Department of Materials Science and Engineering, University of California, Berkeley, CA
| | - Mehdi Balooch
- Materials Sciences Division, Lawrence Berkeley National Laboratory, and Department of Materials Science and Engineering, University of California, Berkeley, CA
| | - Aaron Pham
- Department of Medicine, Aging Center, UC Davis Medical Center, Sacramento, CA
| | - Solomon Chefo
- Department of Medicine, Aging Center, UC Davis Medical Center, Sacramento, CA
| | - Cheryl Busse
- Department of Medicine, Aging Center, UC Davis Medical Center, Sacramento, CA
| | - Robert O. Ritchie
- Materials Sciences Division, Lawrence Berkeley National Laboratory, and Department of Materials Science and Engineering, University of California, Berkeley, CA
| | - Nancy E. Lane
- Department of Medicine, Aging Center, UC Davis Medical Center, Sacramento, CA
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28
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Yerramshetty JS, Lind C, Akkus O. The compositional and physicochemical homogeneity of male femoral cortex increases after the sixth decade. Bone 2006; 39:1236-43. [PMID: 16860007 DOI: 10.1016/j.bone.2006.06.002] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2005] [Revised: 06/05/2006] [Accepted: 06/06/2006] [Indexed: 10/24/2022]
Abstract
The temporal and spatial fluctuations in the dynamics of secondary osteonal remodeling impart heterogeneity to the compositional quality of bone. Bone mineral density (BMD) fails to reflect this heterogeneity as being a single score, and thus it cannot resolve the overlap between healthy individuals and those who experience fractures. Such information on tissue heterogeneity is lacking in the literature. In the current study, specimens were prepared from mid-diaphyseal portions of human femora (N=16, age range 52-85 years old) and grouped based on the anatomical location (anterior, lateral, medial and posterior quadrants). Raman microscopy was used to obtain multiple measurements from each specimen which allowed the construction of histograms of mineralization, crystallinity and carbonation. The coefficient of variation (COV) and skewness were extracted from histograms as measures of heterogeneity. Results demonstrated that average mineralization of the medial quadrant and the data pooled over quadrants significantly increased with age. The mean carbonation increased within the observed age range for the pooled data. The variations of values about the mean became tighter for mineralization, crystallinity and type-B carbonation with age, indicating an overall reduction in compositional heterogeneity of aging femoral cortex. Skewness values indicated that the distributions of histograms were not Gaussian. We conclude that age-related changes in mean tissue composition are confounded with changes in the variation of tissue make-up about the mean. Future studies will establish as to whether compositional heterogeneity correlates with the mechanical strength of bone.
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29
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Skedros JG, Dayton MR, Sybrowsky CL, Bloebaum RD, Bachus KN. The influence of collagen fiber orientation and other histocompositional characteristics on the mechanical properties of equine cortical bone. ACTA ACUST UNITED AC 2006; 209:3025-42. [PMID: 16857886 DOI: 10.1242/jeb.02304] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study examined relative influences of predominant collagen fiber orientation (CFO), mineralization (% ash), and other microstructural characteristics on the mechanical properties of equine cortical bone. Using strain-mode-specific (S-M-S) testing (compression testing of bone habitually loaded in compression; tension testing of bone habitually loaded in tension), the relative mechanical importance of CFO and other material characteristics were examined in equine third metacarpals (MC3s). This model was chosen since it had a consistent non-uniform strain distribution estimated by finite element analysis (FEA) near mid-diaphysis of a thoroughbred horse, net tension in the dorsal/lateral cortices and net compression in the palmar/medial cortices. Bone specimens from regions habitually loaded in tension or compression were: (1) tested to failure in both axial compression and tension in order to contrast S-M-S vs non-S-M-S behavior, and (2) analyzed for CFO, % ash, porosity, fractional area of secondary osteonal bone, osteon cross-sectional area, and population densities of secondary osteons and osteocyte lacunae. Multivariate multiple regression analyses revealed that in S-M-S compression testing, CFO most strongly influenced total energy (pre-yield elastic energy plus post-yield plastic energy); in S-M-S tension testing CFO most strongly influenced post-yield energy and total energy. CFO was less important in explaining S-M-S elastic modulus, and yield and ultimate stress. Therefore, in S-M-S loading CFO appears to be important in influencing energy absorption, whereas the other characteristics have a more dominant influence in elastic modulus, pre-yield behavior and strength. These data generally support the hypothesis that differentially affecting S-M-S energy absorption may be an important consequence of regional histocompositional heterogeneity in the equine MC3. Data inconsistent with the hypothesis, including the lack of highly longitudinal collagen in the dorsal-lateral ;tension' region, paradoxical histologic organization in some locations, and lack of significantly improved S-M-S properties in some locations, might reflect the absence of a similar habitual strain distribution in all bones. An alternative strain distribution based on in vivo strain measurements, without FEA, on non-Thoroughbreds showing net compression along the dorsal-palmar axis might be more characteristic of the habitual loading of some of the bones that we examined. In turn, some inconsistencies might also reflect the complex torsion/bending loading regime that the MC3 sustains when the animal undergoes a variety of gaits and activities, which may be representative of only a portion of our animals, again reflecting the possibility that not all of the bones examined had similar habitual loading histories.
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Affiliation(s)
- John G Skedros
- Utah Bone and Joint Center, 5323 S. Woodrow Street #202, Salt Lake City, UT 84107, USA.
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30
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Goldman HM, Thomas CDL, Clement JG, Bromage TG. Relationships among microstructural properties of bone at the human midshaft femur. J Anat 2005; 206:127-39. [PMID: 15730478 PMCID: PMC1571464 DOI: 10.1111/j.1469-7580.2005.00385.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Mineralization density and collagen fibre orientation are two aspects of a bone's microstructural organization that influence its mechanical properties. Previous studies by our group have demonstrated a distinctly non-random, though highly variable, spatial distribution of these two variables in the human femoral cortex. In this study of 37 specimens, these variables are examined relative to one another in order to determine whether regions of bone demonstrating higher or lower mineralization density also demonstrate a prevalence of either transversely or longitudinally oriented collagen fibres. An analysis of rank-transformed collagen fibre orientation (as determined by circularly polarized light) and mineralization density (as determined by backscattered electron microscopy) data sets demonstrated that areas of low mineralization density (predominantly in the anterior-lateral cortex) tended to correspond to regions of higher proportions of longitudinally oriented collagen fibres. Conversely, areas of higher mineralization density (postero-medially) tended to correspond to regions of higher proportions of transversely oriented collagen fibres. High variability in the sample led to generally low correlations between the two data sets, however. A second analysis focused only on the orientation of collagen fibres within poorly mineralized bone (representing bone that was newly formed). This analysis demonstrated a lower proportion of transverse collagen fibres in newly formed bone with age, along with some significant regional differences in the prevalence of collagen fibres of either orientation. Again high variability characterized the sample. These results are discussed relative to the hypothesized forces experienced at the midshaft femur.
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Affiliation(s)
- H M Goldman
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, USA.
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31
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Thomas CDL, Feik SA, Clement JG. Regional variation of intracortical porosity in the midshaft of the human femur: age and sex differences. J Anat 2005; 206:115-25. [PMID: 15730477 PMCID: PMC1571459 DOI: 10.1111/j.1469-7580.2005.00384.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2005] [Indexed: 11/27/2022] Open
Abstract
This study investigated age and sex differences in patterns of porosity distribution in the midshaft of the human femur. Cross-sections were obtained from 168 individuals from a modern Australian population. The sample comprised 73 females and 95 males, aged between 20 and 97 years. Microradiographs were made of 100-microm sections and pore and bone areas were determined using image processing software. Initially the sample was divided by age: young (20-44 years), middle (45-64 years) and old (65+ years), but it was found that analysis on the basis of the ratio of medullary area to total subperiosteal area gave clearer results. The cortex was divided into three rings radially and into octants circumferentially and the porosity of each segment was calculated. Results showed that a pattern with raised porosity in the posterior and anterolateral regions, and with greater porosity in the inner parts of the cortex, becomes more pronounced with age. In males this pattern develops steadily; in females there are much greater differences between the middle and older groups than earlier in life. The patterns observed are consistent with progressive bone loss occurring along a neutral axis of the cortex where bending stress is lowest and the mechanical advantage of the bone is least.
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Affiliation(s)
- C David L Thomas
- University of Melbourne, School of Dental Science, Melbourne, Australia.
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