In vivo fatigue microcracks in human bone: Material properties of the surrounding bone matrix

Association between nanoscale strains and tissue level nanoindentation properties in age-related hip-fractures

Measurement of the properties of bone as a material can happen in various length scales in its hierarchical and composite structure. The aim of this study was to test the tissue level properties of clinically-relevant human bone samples which were collected from donors belonging to three groups: ageing donors who suffered no fractures (Control); untreated fracture patients (Fx-Untreated) and patient who experienced hip fracture despite being treated with bisphosphonates (Fx-BisTreated). Tissue level properties were assessed by (a) nanoindentation and (b) synchrotron tensile tests (STT) where strains were measured at the 'tissue', 'fibril' and 'mineral' levels by using simultaneous Wide-angle - (WAXD) and Small angle- X-ray diffraction (SAXD). The composition was analysed by thermogravimetric analysis and material level endo- and exo-thermic reactions by differential scanning calorimetry (TGA/DSC3+). Irrespective of treatment fracture donors exhibited significantly lower tissue, fibril and mineral strain at the micro and nanoscale respectively and had a higher mineral content than controls. In nanoindentation only nanohardness was significantly greater for Controls and Fx-BisTreated versus Fx-Untreated. The other nanoindentation parameters did not vary significantly across the three groups. There was a highly significant positive correlation (p < 0.001) between organic content and tissue level strain behaviour. Overall hip-fractures were associated with lower STT nanostrains and it was behaviour measured by STT which proved to be a more effective approach for predicting fracture risk because evidently it was able to demonstrate the mechanical deficit for the bone tissue of the donors who had experienced fractures.

Atlas of Human Skeleton Hardness Obtained Using the Micro-indentation Technique

Objectives

Measure and systematically evaluate the distribution of microhardness in the human skeleton.

Methods

Three fresh corpses were obtained, aged 62 (male), 45 (female), and 58 years (male). Soft tissues were removed, and all axial and unilateral appendicular bones were freshly harvested. All three skeletons were examined by X‐ray and computed tomography (CT) to exclude skeletal pathology. Only bones from donors with no known skeletal pathology were included in the study. Axial and unilateral appendicular skeleton bones from each of the three donors were obtained, except for ear ossicles, hyoid bone, tailbone, and 14 phalanges of the foot, for which samples were difficult to obtain. Precision bone specimens with a thickness of 3 mm, which were cut with a Buehler IsoMet 11‐1280‐250 low‐speed diamond saw (Buehler, USA), were obtained from all important anatomic sites in a direction perpendicular to the mechanical axis of each bone. Micro‐indentation (the Vickers hardness test) was performed on the surface of each specimen using a microhardness tester with a diamond indenter. Hardness value (HV) was computed for each indentation. Each bone specimen was divided into several regions of interest. Indentations were carefully made and computed. Then we analyzed the data to identify hardness distribution rules at different anatomic sites.

Results

In total, 5360 indentations were made in 1072 regions of interest in each donor. Hardness of the axial and appendicular bones were all inhomogeneous depending on the anatomic sites, but the distribution of microhardness followed certain rules. The mean hardness value ranged from 24.46 HV (HV = hardness value, kgf/mm²) for the sacrum to 53.20 HV for the shaft of the tibia. The diaphysis was harder than the metaphysis, and the proximal and distal epiphysis had lower values (8.85%– 40.39%) than the diaphysis. Among the long bone diaphyses, the tibia cortical bone (51.20 HV) was the hardest, harder than the humerus (47.25 HV), the ulna (43.26 HV), the radius (42.54 HV), and the femur (47.53 HV). However, in some anatomic sites such as the lumbar vertebra (cortical bone 32.86 HV, cancellous bone 31.25 HV), the cortical shells were sometimes not harder than the internal cancellous bones. The lumbar vertebra (32.86 HV) was harder than the cervical vertebra (28.51 HV) and the thoracic vertebra (29.01 HV).

Conclusions

The distribution of microhardness in the human skeleton follows certain rules. These distribution rules could be used to predict the mechanical properties of bone and progress in this field could provide data for the basis of a new three‐dimensional printing technique, which may lead to new perspectives for custom‐made implants.

Macrobiomineralogy: Insights and Enigmas in Giant Whale Bones and Perspectives for Bioinspired Materials Science

The giant bones of whales (Cetacea) are the largest extant biomineral-based constructs known. The fact that such mammalian bones can grow up to 7 m long raises questions about differences and similarities to other smaller bones. Size and exposure to environmental stress are good reasons to suppose that an unexplored level of hierarchical organization may be present that is not needed in smaller bones. The existence of such a macroscopic naturally grown structure with poorly described mechanisms for biomineralization is an example of the many yet unexplored phenomena in living organisms. In this article, we describe key observations in macrobiomineralization and suggest that the large scale of biomineralization taking place in selected whale bones implies they may teach us fundamental principles of the chemistry, biology, and biomaterials science governing bone formation, from atomistic to the macrolevel. They are also associated with a very lipid rich environment on those bones. This has implications for bone development and damage sensing that has not yet been fully addressed. We propose that whale bone construction poses extreme requirements for inorganic material storage, mediated by biomacromolecules. Unlike extinct large mammals, cetaceans still live deep in large terrestrial water bodies following eons of adaptation. The nanocomposites from which the bones are made, comprising biomacromolecules and apatite nanocrystals, must therefore be well adapted to create the macroporous hierarchically structured architectures of the bones, with mechanical properties that match the loads imposed in vivo. This massive skeleton directly contributes to the survival of these largest mammals in the aquatic environments of Earth, with structural refinements being the result of 60 million years of evolution. We also believe that the concepts presented in this article highlight the beneficial uses of multidisciplinary and multiscale approaches to study the structural peculiarities of both organic and inorganic phases as well as mechanisms of biomineralization in highly specialized and evolutionarily conserved hard tissues.

Clinical hip fracture is accompanied by compression induced failure in the superior cortex of the femoral neck

Hip fractures pose a major health problem throughout the world due to their devastating impact. Current theories for why these injuries are so prevalent in the elderly point to an increased propensity to fall and decreases in bone mass with ageing. However, the fracture mechanisms, particularly the stress and strain conditions leading to bone failure at the hip remain unclear. Here, we directly examined the cortical bone from clinical intra-capsular hip fractures at a microscopic level, and found strong evidence of compression induced failure in the superior cortex. A total of 143 sections obtained from 24 femoral neck samples that were retrieved from 24 fracturing patients at surgery were examined using laser scanning confocal microscopy (LSCM) after fluorescein staining. The stained microcracks showed significantly higher density in the superior cortex than in the inferior cortex, indicating a greater magnitude of strain in the superior femoral neck during the failure-associated deformation and fracture process. The predominant stress state for each section was reconstructed based on the unique correlation between the microcrack pattern and the stress state. Specifically, we found clear evidence of longitudinal compression and buckling as the primary failure mechanisms in the superior cortex. These findings demonstrate the importance of microcrack analysis in studying clinical hip fractures, and point to the central role of the superior cortex failure as an important aspect of the failure initiation in clinical intra-capsular hip fractures.

A prediction of the minke whale (Balaenoptera acutorostrata) middle-ear transfer function

The lack of baleen whale (Cetacea Mysticeti) audiograms impedes the assessment of the impacts of anthropogenic noise on these animals. Estimates of audiograms, which are difficult to obtain behaviorally or electrophysiologically for baleen whales, can be made by simulating the audiogram as a series of components representing the outer, middle, and inner ear (Rosowski, 1991; Ruggero and Temchin, 2002). The middle-ear portion of the system can be represented by the middle-ear transfer function (METF), a measure of the transmission of acoustic energy from the external ear to the cochlea. An anatomically accurate finite element model of the minke whale (Balaenoptera acutorostrata) middle ear was developed to predict the METF for a mysticete species. The elastic moduli of the auditory ossicles were measured by using nanoindentation. Other mechanical properties were estimated from experimental stiffness measurements or from published values. The METF predicted a best frequency range between approximately 30 Hz and 7.5 kHz or between 100 Hz and 25 kHz depending on stimulation location. Parametric analysis found that the most sensitive parameters are the elastic moduli of the glove finger and joints and the Rayleigh damping stiffness coefficient β. The predicted hearing range matches well with the vocalization range.

Microindentation can discriminate between damaged and intact human bone tissue

Bone mineral density and microarchitecture was found to predict 70-95% of bone strength. Microdamage, as factor of bone quality, might help to explain the remaining uncertainties. The goal of this study was to investigate whether microindentation can discriminate between intact and severely damaged human vertebral bone tissue in vitro. One portion from each human vertebral slice (N=35) tested in compression in a previous study was embedded, polished and tested in wet conditions by means of microindentation. The indentation moduli and hardness (HV) of trabecular, osteonal and interstitial bone structural units were computed along the cranio-caudal direction. Each indented region was defined as damaged or intact as seen under a light microscope. A total of 1190 indentations were performed. While both hardness and indentation modulus were independent from gender, both mechanical properties were affected by damage and microstructure. The damaged regions showed 50% lower stiffness and hardness compared to undamaged ones. Interstitial bone was stiffer and harder (13.2±4.4 GPa and 44.7±20.3 HV) than osteonal bone (10.9±3.8 GPa and 37.8±17.3 HV), which was stiffer and harder than trabecular bone (8.1±3.0 GPa and 28.8±11.2 HV) indented in the transverse direction. Moreover, along the axial direction intact trabecular bone (11.4±4.3 GPa) was 16% less stiff than the intact interstitial bone and as stiff as intact osteonal bone. In conclusion microindentation was found to discriminate between highly damaged and intact tissue in both trabecular and cortical bone tested in vitro. It remains to be investigated whether this technique would be able to detect also the damage, which is induced by physiological load in vivo.

Direct comparison of nanoindentation and macroscopic measurements of bone viscoelasticity

Nanoindentation has become a standard method for measuring mechanical properties of bone, especially within microstructural units such as individual osteons or trabeculae. The use of nanoindentation to measure elastic properties has been thoroughly studied and validated. However, it is also possible to assess time dependent properties of bone by nanoindentation. The goal of this study was to compare time dependent mechanical properties of bone measured at the macroscopic level with those measured by nanoindentation. Twelve samples were prepared from the posterior distal femoral cortex of young cows. Initially, dogbone samples were prepared and subjected to torsional stress relaxation in a saline bath at 37 °C. A 5 mm thick disk was subsequently sectioned from the gage length, and subjected to nanoindentation. Nanoindentation was performed on hydrated samples using a standard protocol with 20 indents performed in 20 different osteons in each sample. Creep and stress relaxation data were fit to a Burgers four parameter rheological model, a five parameter generalized Maxwell model, and a three parameter standard linear solid. For Burgers viscoelastic model, the time constants measured by nanoindentation and torsion were weakly negatively correlated, while for the other two models the time constants were uncorrelated. The results support the notion that the viscoelastic behavior of bone at the macroscopic scale is primarily due to microstructural features, interfaces, or fluid flow, rather than viscous behavior of the bone tissue. As viscoelasticity affects the fatigue behavior of materials, the microscale properties may provide a measure of bone quality associated with initial damage formation.

PHOSPHO1 is essential for mechanically competent mineralization and the avoidance of spontaneous fractures

Phosphatases are essential for the mineralization of the extracellular matrix within the skeleton. Their precise identities and functions however remain unclear. PHOSPHO1 is a phosphoethanolamine/phosphocholine phosphatase involved in the generation of inorganic phosphate for bone mineralization. It is highly expressed at sites of mineralization in bone and cartilage. The bones of Phospho1(-/-) mice are hypomineralized, bowed and present with spontaneous greenstick fractures at birth. In this study we show that PHOSPHO1 is essential for mechanically competent mineralization that is able to withstand habitual load. Long bones from Phospho1(-/-) mice did not fracture during 3-point bending but deformed plastically. With dynamic loading nanoindentation the elastic modulus and hardness of Phospho1(-/-) tibiae were significantly lower than wild-type tibia. Raman microscopy revealed significantly lower mineral:matrix ratios and lower carbonate substitutions in Phospho1(-/-) tibia. The altered dihydroxylysinonorleucine/hydroxylysinonorleucine and pyridinoline/deoxypyridinoline collagen crosslink ratios indicated possible changes in lysyl hydroxylase-1 activity and/or bone mineralization status. The bone formation and resorption markers, N-terminal propeptide and C-terminal telopeptide of Type I collagen, were both increased in Phospho1(-/-) mice and this we associated with increased bone remodeling during fracture repair or an attempt to remodel a mechanically competent bone capable of withstanding physiological load. In summary these data indicate that Phospho1(-/-) bones are hypomineralized and, consequently, are softer and more flexible. An inability to withstand physiological loading may explain the deformations noted. We hypothesize that this phenotype is due to the reduced availability of inorganic phosphate to form hydroxyapatite during mineralization, creating an undermineralized yet active bone.

The effect of friction on indenter force and pile-up in numerical simulations of bone nanoindentation

Nanoindentation is a useful technique for probing the mechanical properties of bone, and finite element (FE) modeling of the indentation allows inverse determination of elastoplastic constitutive properties. However, all but one FE study to date have assumed frictionless contact between indenter and bone. The aim of this study was to explore the effect of friction in simulations of bone nanoindentation. Two-dimensional axisymmetric FE simulations were performed using a spheroconical indenter of tip radius 0.6 μm and angle 90°. The coefficient of friction between indenter and bone was varied between 0.0 (frictionless) and 0.3. Isotropic linear elasticity was used in all simulations, with bone elastic modulus E = 13.56 GPa and Poisson's ratio of 0.3. Plasticity was incorporated using both Drucker-Prager and von Mises yield surfaces. Friction had a modest effect on the predicted force-indentation curve for both von Mises and Drucker-Prager plasticity, reducing maximum indenter displacement by 10% and 20% respectively as friction coefficient was increased from zero to 0.3 (at a maximum indenter force of 5 mN). However, friction has a much greater effect on predicted pile-up after indentation, reducing predicted pile-up from 0.27 to 0.11 μm with a von Mises model, and from 0.09 to 0.02 μm with Drucker-Prager plasticity. We conclude that it is potentially important to include friction in nanoindentation simulations of bone if pile-up is used to compare simulation results with experiment.

Hierarchies of damage induced loss of mechanical properties in calcified bone after in vivo fatigue loading of rat ulnae

During fatigue loading of whole bone, damage to bone tissue accumulates, coalesces and leads to fractures. Whether damage affects tissue material properties similarly at the nanoscale (less than 1 μm), microscale (less than 1 mm), and whole bone scale has not been fully evaluated. Therefore, in this study, we examine scale-dependent loss of calcified tissue material properties in rat ulnae, after fatigue loading of rat forearms using the forearm compression model. In vivo fatigue loading was conducted on the right forearms until a displacement end-point was reached. The non-fatigued left forearms served as contralateral controls. Subsequently, three-point bending tests to failure on excised ulnae demonstrated a 41% and 49% reduction in the stiffness and ultimate strength as compared to contralateral control ulnae, respectively. Depth-sensing microindentation demonstrated an average decrease in material properties, such as elastic modulus and hardness, of 28% and 29% respectively. Nanoindentation measured elastic modulus and hardness were reduced by 26% and 29% in damaged bone relative to contralateral controls, respectively. The increased loss of whole bone material properties compared to tissue material properties measured using indentation is mainly attributed to the presence of a macrocrack located in the medial compressive region at the site of peak strains. The similar magnitude of changes in material properties by microindentation and nanoindentation is attributed to damage that may originate at an even smaller scale, as inferred from 10% differences in connectivity of osteocyte canaliculi in damaged bone.

Effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin exposure on bone material properties

Dioxins are known to decrease bone strength, architecture and density. However, their detailed effects on bone material properties are unknown. Here we used nanoindentation methods to characterize the effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on nanomechanical behaviour of bone matrix. Pregnant rats were treated with a single intragastric dose of TCDD (1 microg/kg) or vehicle on gestational day 11. Tibias of female offspring were sampled on postnatal day (PND) 35 or 70, scanned at mid-diaphysis with pQCT, and evaluated by three-point bending and nanoindentation. TCDD treatment decreased bone mineralization (p<0.05), tibial length (p<0.01), cross-sectional geometry (p<0.05) and bending strength (p<0.05). Controls showed normal maturation pattern between PND 35 and 70 with decreased plasticity by 5.3% and increased dynamic hardness, storage and complex moduli by 26%, 13% and 12% respectively (p<0.05), while similar maturation was not observed in TCDD-exposed pups. In conclusion, for the first time, we demonstrate retardation of bone matrix maturation process in TCDD-exposed animals. In addition, the study confirms that developmental TCDD exposure has adverse effects on bone size, strength and mineralization. The current results in conjunction with macromechanical behaviour suggest that reduced bone strength caused by TCDD is more associated with the mineralization and altered geometry of bones than with changes at the bone matrix level.