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Schröder G, Mittlmeier T, Gahr P, Ulusoy S, Hiepe L, Schulze M, Götz A, Andresen R, Schober HC. Regional Variations in the Intra- and Intervertebral Trabecular Microarchitecture of the Osteoporotic Axial Skeleton with Reference to the Direction of Puncture. Diagnostics (Basel) 2024; 14:498. [PMID: 38472970 DOI: 10.3390/diagnostics14050498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Trabeculae in vertebral bodies are unequally distributed within the cervical spine (CS), the thoracic spine (TS), and lumbar spine (LS). Such structures are also unequally distributed within the individual vertebrae. Exact knowledge of the microstructure of these entities could impact our understanding and treatment of fractures caused by osteoporosis and possibly improve surgical approaches. Appropriate investigations could help clarify the pathomechanisms of different forms of osteoporotic vertebral fractures, as well as different changes in morphological findings like the trabecular bone score (TBS). In the present study, we applied punctures to the craniocaudal and ventrocaudal directions and obtained cylinders of cancellous bone from the central portions and marginal regions of cervical vertebrae 5 and 6, thoracic vertebrae 8 and 12, and lumbar vertebrae 1 and 3. We systematically analyzed these samples to determine the bone volume fraction, trabecular thickness, separation, connectivity density, degree of anisotropy, and structure model index. METHODS Using an 8-gauge Jamshidi needle, we obtained samples from three quadrants (Q I: right margin; Q II: central; Q III: left margin) in the frontal and transverse plane and prepared these samples with a moist cloth in a 1.5 mL Eppendorf reaction vessel. The investigations were performed on a micro-CT device (SKYSCAN 1172, RJL Micro & Analytic Company, Karlsdorf-Neuthard, Germany). All collected data were analyzed using the statistical software package SPSS (version 24.0, IBM Corp., Armonk, NY, USA). Student's t test, the Wilcoxon-Mann-Whitney test, the Chi-squared test, and univariate analysis were used for between-group comparisons. The selection of the test depended on the number of investigated groups and the result of the Shapiro-Wilk test of normal distribution. In the case of statistically significant results, a post hoc LSD test was performed. RESULTS In total, we obtained 360 bone samples from 20 body donors. The craniocaudal puncture yielded data of similar magnitudes for all investigated parameters in all three quadrants, with the highest values observed in the CS. Comparisons of the ventrodorsal and craniocaudal microstructure revealed a significantly lower trabecular density and a significantly higher degree of anisotropy in the craniocaudal direction. CONCLUSIONS The results presented different distributions and behaviors of trabecular density, with lower density in the mid-vertebral region over the entire breadth of the vertebrae. Reduced trabecular density caused a higher degree of anisotropy and was, therefore, associated with a lower capacity to sustain biomechanical loads. Fractures in fish vertebrae were easily explained by this phenomenon. The different changes in these structures could be responsible, in part, for the changes in the TBS determined using dual-energy X-ray absorptiometry. These results confirm the clinical relevance of the TBS.
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Affiliation(s)
- Guido Schröder
- Department of Traumatology, Hand and Reconstructive Surgery, Rostock University Medical Center, Schillingallee 35, 18057 Rostock, Germany
| | - Thomas Mittlmeier
- Department of Traumatology, Hand and Reconstructive Surgery, Rostock University Medical Center, Schillingallee 35, 18057 Rostock, Germany
| | - Patrick Gahr
- Department of Traumatology, Hand and Reconstructive Surgery, Rostock University Medical Center, Schillingallee 35, 18057 Rostock, Germany
| | - Sahra Ulusoy
- Faculty of Medicine, University of Rostock, Ernst-Heydemann-Str. 8, 18057 Rostock, Germany
| | - Laura Hiepe
- Institute of Anatomy, Rostock University Medical Center, Gertrudenstraße 9, 18057 Rostock, Germany
| | - Marko Schulze
- Institute of Anatomy and Cell Biology, University of Bielefeld, Morgenbreede 1, 33615 Bielefeld, Germany
| | - Andreas Götz
- Institute for Biomedical Engineering, University Medical Center Rostock, Friedrich-Barnewitz-Straße 4, 18119 Rostock-Warnemuende, Germany
| | - Reimer Andresen
- Institute for Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck und Hamburg, Esmarchstraße 50, 25746 Heide, Germany
| | - Hans-Christof Schober
- OrthoCoast, Practice for Orthopedics and Osteology, Hufelandstraße 1, 17438 Wolgast, Germany
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Schröder G, Baginski AM, Schulze M, Hiepe L, Bugaichuk S, Martin H, Andresen JR, Moritz M, Andresen R, Schober HC. Regional variations in the intra- and intervertebral trabecular microarchitecture of the osteoporotic axial skeleton. Anat Sci Int 2023:10.1007/s12565-023-00726-6. [PMID: 37093524 DOI: 10.1007/s12565-023-00726-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
Trabecular structures in vertebral bodies are unequally distributed in the cervical, thoracic and lumbar spine, and also within individual vertebrae. Knowledge of the microstructure of these entities could influence our comprehension and treatment of osteoporotic fractures, and even surgical procedures. Appropriate investigations may clarify the pathomechanisms of various osteoporotic fractures (fish, wedge-shaped, and flat vertebrae). We obtained three cancellous bone cylinders from the centers and margins of cervical vertebra 3 to lumbar vertebra 5, and investigated these in regard of bone volume fraction, trabecular thickness, separation, trabecular number, trabecular bone pattern factor, connectivity density, and degree of anisotropy. Using a Jamshidi needle®, we obtained samples from three quadrants (QI: right-sided edge, QII: central, QIII: left-sided edge) of 242 prepared vertebrae, and investigated these on a micro-CT device. In all, 726 bone samples were taken from eleven body donors. Bone volume fraction, trabecular thickness, and the degree of anisotropy were significantly lower in QII than in QI and QIII. Trabecular pattern factor, however, was significantly higher in QII than in QI and QIII. The results helped to explain fish vertebrae. Wedge fractures and flat vertebrae are most likely caused by the complex destruction of trabecular and cortical structures. The higher bone volume fraction in the cervical spine compared to the thoracic and lumbar spine accounts for the small number of fractures in the cervical spine. The marked trabecular pattern factor in the center of thoracic and lumbar vertebrae could be a reason for the surgeon to use different screw designs for individual vertebrae.
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Affiliation(s)
- Guido Schröder
- Warnow Clinic, Clinic for Orthopedics and Trauma Surgery, Am Forsthof 3, 18246, Buetzow, Germany.
| | | | - Marko Schulze
- Institute for Anatomy and Cell Biology, University of Bielefeld, Bielefeld, Germany
| | - Laura Hiepe
- Institute for Anatomy, University Medical Center Rostock, Rostock, Germany
| | | | - Heiner Martin
- Institute for Biomedical Engineering, University Medical Center Rostock, Rostock-Warnemuende, Germany
| | - Julian Ramin Andresen
- Clinic for Orthopedic, Trauma and Reconstructive Surgery, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Mario Moritz
- Clinic of Internal Medicine IV, Suedstadt Clinic Rostock, Academic Teaching Hospital of the University of Rostock, Rostock, Germany
| | - Reimer Andresen
- Institute for Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck und Hamburg, Heide, Germany
| | - Hans-Christof Schober
- Clinic of Internal Medicine IV, Suedstadt Clinic Rostock, Academic Teaching Hospital of the University of Rostock, Rostock, Germany
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Schröder G, Hiepe L, Moritz M, Vivell LM, Schulze M, Martin H, Götz A, Andresen JR, Kullen CM, Andresen R, Schober HC. Why Insufficiency Fractures are Rarely Found in the Cervical Spine, Even with Osteoporosis. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2022; 160:657-669. [PMID: 34937100 DOI: 10.1055/a-1647-3914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The human bone structure changes with an increase in age. Both material and structural properties affect bone strength. Despite the ageing of society, however, hardly any data are available on these parameters for elderly individuals. Therefore, in the present study, cancellous bone cylinders were taken from the center of each vertebral body (C3 to L5) and examined with regard to bone volume fraction, trabecular thickness, separation, number of trabeculae, cross-linking, connectivity density and degree of anisotropy. MATERIAL AND METHODS Samples were obtained from 440 body donors using a Jamshidi needle and analysed using microcomputed tomography. Existing deformities, fractures and bone mineral density of each vertebra were recorded by quantitative computed tomography. RESULTS With regard to the microcomputed tomography parameters, statistically significant differences were found between the different sections of the vertebrae: the trabeculae of the cervical vertebrae were significantly thicker and more closely spaced than in the thoracic and lumbar vertebrae. The bone volume fraction was significantly higher in this spinal segment, as was the connection density and the number of trabeculae and cross-links. In addition, the degree of anisotropy was significantly lower in the cervical vertebrae than in the other spinal segments. With regard to quantitative computed tomography, there was a significantly higher bone mineral density in the cervical vertebrae. CONCLUSION Even with osteoporosis, cervical vertebrae fracture significantly later than thoracic and lumbar vertebrae due to their unique microarchitecture and higher density. Thus, the cervical vertebrae has specific properties.
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Affiliation(s)
- Guido Schröder
- Klinik für Orthopädie und Unfallchirurgie, Warnow Klinik, Bützow, Deutschland
| | - Laura Hiepe
- Institut für Anatomie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Mario Moritz
- Klinik für Innere Medizin, Warnow Klinik, Bützow, Germany
| | | | - Marko Schulze
- Institut für Anatomie und Zellbiologie, Universität Bielefeld, Bielefeld, Deutschland
| | - Heiner Martin
- Institut für Biomedizinische Technik, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Andreas Götz
- Institut für Biomedizinische Technik, Universitätsmedizin Rostock, Rostock, Deutschland
| | | | - Claus-Maximilian Kullen
- Institut für Diagnostische und Interventionelle Radiologie/Neuroradiologie, Westküstenklinikum Heide, Akademisches Lehrkrankenhaus der Universitäten Kiel, Lübeck und Hamburg, Heide, Deutschland
| | - Reimer Andresen
- Institut für Diagnostische und Interventionelle Radiologie/Neuroradiologie, Westküstenklinikum Heide, Akademisches Lehrkrankenhaus der Universitäten Kiel, Lübeck und Hamburg, Heide, Deutschland
| | - Hans-Christof Schober
- Klinik für Innere Medizin IV, Klinikum Südstadt Rostock, Akademisches Lehrkrankenhaus der Universität Rostock, Rostock, Deutschland
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Schröder G, Reichel M, Spiegel S, Schulze M, Götz A, Bugaichuk S, Andresen JR, Kullen CM, Andresen R, Schober HC. Breaking strength and bone microarchitecture in osteoporosis: a biomechanical approximation based on load tests in 104 human vertebrae from the cervical, thoracic, and lumbar spines of 13 body donors. J Orthop Surg Res 2022; 17:228. [PMID: 35410435 PMCID: PMC8996654 DOI: 10.1186/s13018-022-03105-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/29/2022] [Indexed: 11/24/2022] Open
Abstract
Background The purpose of the study was to investigate associations between biomechanical resilience (failure load, failure strength) and the microarchitecture of cancellous bone in the vertebrae of human cadavers with low bone density with or without vertebral fractures (VFx). Methods Spines were removed from 13 body donors (approval no. A 2017-0072) and analyzed in regard to bone mineral density (BMD), Hounsfield units (HU), and fracture count (Fx) with the aid of high-resolution CT images. This was followed by the puncture of cancellous bone in the vertebral bodies of C2 to L5 using a Jamshidi™ needle. The following parameters were determined on the micro-CT images: bone volume fraction (BVF), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), degree of anisotropy (DA), trabecular number (Tb.N), trabecular pattern factor (Tb.Pf), and connectivity density (Conn.D). The axial load behavior of 104 vertebral specimens (C5, C6, T7, T8, T9, T12, L1, L3) was investigated with a servohydraulic testing machine. Results Individuals with more than 2 fractures had a significantly lower trabecular pattern factor (Tb.Pf), which also proved to be an important factor for a reduced failure load in the regression analysis with differences between the parts of the spine. The failure load (FL) and endplate sizes of normal vertebrae increased with progression in the craniocaudal direction, while the HU was reduced. Failure strength (FS) was significantly greater in the cervical spine than in the thoracic or lumbar spine (p < 0.001), independent of sex. BVF, Tb.Th, Tb.N, and Conn.D were significantly higher in the cervical spine than in the other spinal segments. In contrast, Tb.Sp and Tb.Pf were lowest in the cervical spine. BVF was correlated with FL (r = 0.600, p = 0.030) and FS (r = 0.763, p = 0.002). Microarchitectural changes were also detectable in the cervical spine at lower densities. Conclusions Due to the unique microarchitecture of the cervical vertebrae, fractures occur much later in this region than they do in the thoracic or lumbar spine. Trial registration Approval no. A 2017-0072.
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Sacher SE, Hunt HB, Lekkala S, Lopez KA, Potts J, Heilbronner AK, Stein EM, Hernandez CJ, Donnelly E. Distributions of Microdamage Are Altered Between Trabecular Rods and Plates in Cancellous Bone From Men With Type 2 Diabetes Mellitus. J Bone Miner Res 2022; 37:740-752. [PMID: 35064941 PMCID: PMC9833494 DOI: 10.1002/jbmr.4509] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 01/13/2023]
Abstract
Individuals with type 2 diabetes mellitus (T2DM) have an increased risk of fragility fracture despite exhibiting normal to high bone mineral density (BMD). Conditions arising from T2DM, such as reduced bone turnover and alterations in microarchitecture, may contribute to skeletal fragility by influencing bone morphology and microdamage accumulation. The objectives of this study were (i) to characterize the effect of T2DM on microdamage quantity and morphology in cancellous bone, and (ii) relate the accumulation of microdamage to the cancellous microarchitecture. Cancellous specimens from the femoral neck were collected during total hip arthroplasty (T2DM: n = 22, age = 65 ± 9 years, glycated hemoglobin [HbA1c] = 7.00% ± 0.98%; non-diabetic [non-DM]: n = 25, age = 61 ± 8 years, HbA1c = 5.50% ± 0.4%), compressed to 3% strain, stained with lead uranyl acetate to isolate microdamage, and scanned with micro-computed tomography (μCT). Individual trabeculae segmentation was used to isolate rod-like and plate-like trabeculae and their orientations with respect to the loading axis. The T2DM group trended toward a greater BV/TV (+27%, p = 0.07) and had a more plate-like trabecular architecture (+8% BVplates , p = 0.046) versus non-DM specimens. Rods were more damaged relative to their volume compared to plates in the non-DM group (DVrods /BVrods versus DVplates /BVplates : +49%, p < 0.0001), but this difference was absent in T2DM specimens. Longitudinal rods were more damaged in the non-DM group (DVlongitudinal rods /BVlongitudinal rods : +73% non-DM versus T2DM, p = 0.027). Total damage accumulation (DV/BV) and morphology (DS/DV) did not differ in T2DM versus non-DM specimens. These results provide evidence that cancellous microarchitecture does not explain fracture risk in T2DM, pointing to alterations in material matrix properties. In particular, cancellous bone from men with T2DM may have an attenuated ability to mitigate microdamage accumulation through sacrificial rods. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Sara E Sacher
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Heather B Hunt
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Sashank Lekkala
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Kelsie A Lopez
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Jesse Potts
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Alison K Heilbronner
- Department of Medicine, Endocrinology and Metabolic Bone Service, Hospital for Special Surgery, New York, NY, USA
| | - Emily M Stein
- Department of Medicine, Endocrinology and Metabolic Bone Service, Hospital for Special Surgery, New York, NY, USA
| | - Christopher J Hernandez
- Research Division, Hospital for Special Surgery, New York, NY, USA.,Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA.,Research Division, Hospital for Special Surgery, New York, NY, USA
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Schröder G, Jabke B, Schulze M, Wree A, Martin H, Sahmel O, Doerell A, Kullen CM, Andresen R, Schober HC. A comparison, using X-ray micro-computed tomography, of the architecture of cancellous bone from the cervical, thoracic and lumbar spine using 240 vertebral bodies from 10 body donors. Anat Cell Biol 2021; 54:25-34. [PMID: 33583827 PMCID: PMC8017461 DOI: 10.5115/acb.20.269] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/06/2020] [Accepted: 12/07/2020] [Indexed: 11/29/2022] Open
Abstract
The vertebral trabecular bone has a complex three-dimensional microstructure with an inhomogeneous morphology. Correct identification and assessment of the weakest segments of the cancellous bone may lead to better prediction of fracture risk. The aim of this study was to compare cancellous bone from 240 vertebrae of the cervical, thoracic and lumbar spine of ten body donors with osteoporosis in regard to bone volume fraction (BVF), trabecular thickness, separation, trabecular number and degree of anisotropy, to ascertain why cervical vertebrae rarely fracture, even with severe osteoporosis. Samples were obtained from all vertebrae with a Jamshidi needle (8 Gauge). The investigations were performed with a micro-computed tomography (micro-CT) device (SKYSCAN 1172, RJL Micro & Analytic GmbH, Karlsdorf-Neuthard, Germany). Existing vertebral fractures and the bone mineral density of the lumbar spine were assessed with quantitative CT. Regarding the micro-CT parameters, statistically significant differences were observed between the various sections of the spine. We found a higher BVF, trabecular number and trabecular thickness, as well as a lower trabecular separation of the cervical vertebrae compared to other vertebrae. In addition, the degree of anisotropy in the cervical spine is lower than in the other spinal column sections. These results are age and sex dependent. Thus, the cervical spine has special structural features, whose causes must be determined in further investigations.
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Affiliation(s)
- Guido Schröder
- Clinic for Surgery, Department of Orthopedics and Trauma Surgery, Buetzow, Germany
| | - Benjamin Jabke
- Department of Internal Medicine, University Medical School Rostock, Rostock, Germany
| | - Marko Schulze
- Institute of Anatomy, University Medical School Rostock, Rostock, Germany
| | - Andreas Wree
- Institute of Anatomy, University Medical School Rostock, Rostock, Germany
| | - Heiner Martin
- Institute for Biomedical Engineering, University of Rostock, Rostock-Warnemuende, Germany
| | - Olga Sahmel
- Institute for Biomedical Engineering, University of Rostock, Rostock-Warnemuende, Germany
| | | | - Claus Maximilian Kullen
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
| | - Reimer Andresen
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
| | - Hans-Christof Schober
- Department of Internal Medicine IV, Municipal Hospital Suedstadt Rostock, Academic Teaching Hospital of the University of Rostock, Rostock, Germany
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Acciaioli A, Falco L, Baleani M. Measurement of apparent mechanical properties of trabecular bone tissue: Accuracy and limitation of digital image correlation technique. J Mech Behav Biomed Mater 2020; 103:103542. [DOI: 10.1016/j.jmbbm.2019.103542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 10/21/2019] [Accepted: 11/15/2019] [Indexed: 01/02/2023]
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Lefèvre E, Farlay D, Bala Y, Subtil F, Wolfram U, Rizzo S, Baron C, Zysset P, Pithioux M, Follet H. Compositional and mechanical properties of growing cortical bone tissue: a study of the human fibula. Sci Rep 2019; 9:17629. [PMID: 31772277 PMCID: PMC6879611 DOI: 10.1038/s41598-019-54016-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/08/2019] [Indexed: 01/28/2023] Open
Abstract
Human cortical bone contains two types of tissue: osteonal and interstitial tissue. Growing bone is not well-known in terms of its intrinsic material properties. To date, distinctions between the mechanical properties of osteonal and interstitial regions have not been investigated in juvenile bone and compared to adult bone in a combined dataset. In this work, cortical bone samples obtained from fibulae of 13 juveniles patients (4 to 18 years old) during corrective surgery and from 17 adult donors (50 to 95 years old) were analyzed. Microindentation was used to assess the mechanical properties of the extracellular matrix, quantitative microradiography was used to measure the degree of bone mineralization (DMB), and Fourier transform infrared microspectroscopy was used to evaluate the physicochemical modifications of bone composition (organic versus mineral matrix). Juvenile and adult osteonal and interstitial regions were analyzed for DMB, crystallinity, mineral to organic matrix ratio, mineral maturity, collagen maturity, carbonation, indentation modulus, indicators of yield strain and tissue ductility using a mixed model. We found that the intrinsic properties of the juvenile bone were not all inferior to those of the adult bone. Mechanical properties were also differently explained in juvenile and adult groups. The study shows that different intrinsic properties should be used in case of juvenile bone investigation.
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Affiliation(s)
- Emmanuelle Lefèvre
- Aix-Marseille Univ., CNRS, ISM Inst Movement Sci, Marseille, France.,Department of Orthopaedics and Traumatology, Institute for Locomotion, APHM, Sainte-Marguerite Hospital, Marseille, France
| | - Delphine Farlay
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM, Lyos UMR1033, F69622, Lyon, France
| | - Yohann Bala
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM, Lyos UMR1033, F69622, Lyon, France.,Laboratoire Vibrations Acoustique, INSA Lyon, Campus LyonTech la Doua, F69621, Villeurbanne Cedex, France
| | - Fabien Subtil
- Univ Lyon, Université Claude Bernard Lyon 1, Equipe Biostatistique Santé - LBBE, F69003, Lyon, France
| | - Uwe Wolfram
- School of Engineering and Physical Science, Heriot-Watt University, Edinburgh, United Kingdom
| | - Sébastien Rizzo
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM, Lyos UMR1033, F69622, Lyon, France
| | - Cécile Baron
- Aix-Marseille Univ., CNRS, ISM Inst Movement Sci, Marseille, France.,Department of Orthopaedics and Traumatology, Institute for Locomotion, APHM, Sainte-Marguerite Hospital, Marseille, France
| | - Philippe Zysset
- ARTORG Center for biomedical engineering research, University of Bern, Bern, Switzerland
| | - Martine Pithioux
- Aix-Marseille Univ., CNRS, ISM Inst Movement Sci, Marseille, France.,Department of Orthopaedics and Traumatology, Institute for Locomotion, APHM, Sainte-Marguerite Hospital, Marseille, France
| | - Hélène Follet
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM, Lyos UMR1033, F69622, Lyon, France.
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Rabelo GD, Portero-Muzy N, Gineyts E, Roux JP, Chapurlat R, Chavassieux P. Spatial Distribution of Microcracks in Osteoarthritic Femoral Neck: Influence of Osteophytes on Microcrack Formation. Calcif Tissue Int 2018; 103:617-624. [PMID: 30022227 DOI: 10.1007/s00223-018-0456-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 07/11/2018] [Indexed: 02/08/2023]
Abstract
Osteophytes have been suggested to influence the bone mechanical properties. The aim of this study was to compare the microcrack density in osteophytes with that in the other parts of the osteoarthritic femoral neck (FN). The presence of microcracks was investigated in the ultra-distal FN and in the osteophytes in samples obtained during hip arthroplasty in 24 postmenopausal women aged 67 ± 10 years. Furthermore, the 3D microarchitecture and the collagen crosslinks contents were assessed by high-resolution peripheral quantitative computed tomography and high-performance liquid chromatography, respectively. Osteophytes were present in the 24 FN, mainly at the level of the inferior quadrant. Microcracks were present in all FN with an average of 2.8 per sample. All observed microcracks were linear. The microcrack density (Cr.N/BV; #/mm2) was significantly higher in cancellous than in cortical bone (p = 0.004), whereas the microcrack length (Cr.Le, µm) was significantly greater in cortical bone (p = 0.04). The collagen crosslinks ratio pyridinoline/deoxypyridinoline was significantly and negatively correlated with Cr.N/BV in the posterior (r' = - 0.68, p = 0.01) and inferior (r' = - 0.53, p = 0.05) quadrants. Microcracks were observed in seven osteophytes in seven patients. When microcracks were present in the osteophyte area, Cr.N/BV was also significantly higher in the whole FN and in the quadrant of the osteophyte compared to the cases without microcrack in the osteophyte (p < 0.03). In conclusion, in FN from hip osteoarthritis microcracks are present in all FNs but in only 23% of the osteophytes. The microcrack formation was greater and their progression was smaller in the cancellous bone than in the cortex. The spatial distribution of microcracks varied according to the proximity of the osteophyte, and suggests that osteophyte may influence microcrack formation related to changes in local bone quality.
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Affiliation(s)
| | | | | | | | | | - Pascale Chavassieux
- INSERM UMR 1033, Université de Lyon, Lyon, France.
- INSERM UMR 1033 - UFR de Médecine Lyon-Est - Domaine Laennec, 7-11, Rue Guillaume Paradin, 69372, Lyon Cedex 08, France.
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3D micro structural analysis of human cortical bone in paired femoral diaphysis, femoral neck and radial diaphysis. J Struct Biol 2018; 204:182-190. [PMID: 30107234 DOI: 10.1016/j.jsb.2018.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 07/30/2018] [Accepted: 08/06/2018] [Indexed: 12/11/2022]
Abstract
Human bone is known to adapt to its mechanical environment in a living body. Both its architecture and microstructure may differ between weight-bearing and non-weight-bearing bones. The aim of the current study was to analyze in three dimensions, the morphology of the multi-scale porosities on human cortical bone at different locations. Eight paired femoral diaphyses, femoral necks, and radial diaphyses were imaged using Synchrotron Radiation µCT with a 0.7 µm isotropic voxel size. The spatial resolution facilitates the investigation of the multiscale porosities of cortical bone, from the osteonal canals system down to the osteocyte lacunar system. Our results showed significant differences in the microstructural properties, regarding both osteonal canals and osteocytes lacunae, between the different anatomical locations. The radius presents significantly lower osteonal canal volume fraction and smaller osteonal canals than the femoral diaphysis or neck. Osteocytes lacunae observed in the radius are significantly different in shape than in the femur, and lacunar density is higher in the femoral neck. These results show that the radius, a non-weight-bearing bone, is significantly different in terms of its microstructure from a weight-bearing bone such as the femur. This implies that the cortical bone properties evaluated on the femoral diaphysis, the main location studied within the literature, cannot be generalized to other anatomical locations.
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11
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Berteau JP, Gineyts E, Pithioux M, Baron C, Boivin G, Lasaygues P, Chabrand P, Follet H. Ratio between mature and immature enzymatic cross-links correlates with post-yield cortical bone behavior: An insight into greenstick fractures of the child fibula. Bone 2015; 79:190-5. [PMID: 26079997 DOI: 10.1016/j.bone.2015.05.045] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 05/28/2015] [Accepted: 05/29/2015] [Indexed: 01/22/2023]
Abstract
As a determinant of skeletal fragility, the organic matrix is responsible for the post-yield and creep behavior of bone and for its toughness, while the mineral apatite acts on stiffness. Specific to the fibula and ulna in children, greenstick fractures show a plastic in vivo mechanical behavior before bone fracture. During growth, the immature form of collagen enzymatic cross-links gradually decreases, to be replaced by the mature form until adolescence, subsequently remaining constant throughout adult life. However, the link between the cortical bone organic matrix and greenstick fractures in children remains to be explored. Here, we sought to determine: 1) whether plastic bending fractures can occur in vitro, by testing cortical bone samples from children's fibula and 2) whether the post-yield behavior (ωp plastic energy) of cortical bone before fracture is related to total quantity of the collagen matrix, or to the quantity of mature and immature enzymatic cross-links and the quantity of non-enzymatic cross-links. We used a two-step approach; first, a 3-point microbending device tested 22 fibula machined bone samples from 7 children and 3 elderly adults until fracture. Second, biochemical analysis by HPLC was performed on the sample fragments. When pooling two groups of donors, children and elderly adults, results show a rank correlation between total energy dissipated before fracture and age and a linear correlation between plastic energy dissipated before fracture and ratio of immature/mature cross-links. A collagen matrix with more immature cross-links (i.e. a higher immature/mature cross-link ratio) is more likely to plastically deform before fracture. We conclude that this ratio in the sub-nanostructure of the organic matrix in cortical bone from the fibula may go some way towards explaining the variance in post-yield behavior. From a clinical point of view, therefore, our results provide a potential explanation of the presence of greenstick fractures in children.
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Affiliation(s)
- Jean-Philippe Berteau
- Institute of Movement Science (ISM), CNRS, UMR 7287, Aix-Marseille University, av. de, Luminy, F-13288 Marseille France; Laboratory of Mechanics and Acoustics (LMA), CNRS, UPR 7051, Aix-Marseille University, Centrale Marseille, 31 chemin Joseph-Aiguier, F-13402 Marseille cedex 20, France; Department of Physical Therapy, College of Staten Island, City University of New York, NY 10314, United States.
| | - Evelyne Gineyts
- INSERM, UMR 1033, F-69008 Lyon, France; Université de Lyon, F-69008 Lyon, France
| | - Martine Pithioux
- Institute of Movement Science (ISM), CNRS, UMR 7287, Aix-Marseille University, av. de, Luminy, F-13288 Marseille France
| | - Cécile Baron
- Institute of Movement Science (ISM), CNRS, UMR 7287, Aix-Marseille University, av. de, Luminy, F-13288 Marseille France
| | - Georges Boivin
- Department of Physical Therapy, College of Staten Island, City University of New York, NY 10314, United States; INSERM, UMR 1033, F-69008 Lyon, France
| | - Philippe Lasaygues
- Laboratory of Mechanics and Acoustics (LMA), CNRS, UPR 7051, Aix-Marseille University, Centrale Marseille, 31 chemin Joseph-Aiguier, F-13402 Marseille cedex 20, France
| | - Patrick Chabrand
- Institute of Movement Science (ISM), CNRS, UMR 7287, Aix-Marseille University, av. de, Luminy, F-13288 Marseille France
| | - Hélène Follet
- INSERM, UMR 1033, F-69008 Lyon, France; Université de Lyon, F-69008 Lyon, France
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12
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Bala Y, Seeman E. Bone's Material Constituents and their Contribution to Bone Strength in Health, Disease, and Treatment. Calcif Tissue Int 2015; 97:308-26. [PMID: 25712256 DOI: 10.1007/s00223-015-9971-y] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 02/11/2015] [Indexed: 12/24/2022]
Abstract
Type 1 collagen matrix volume, its degree of completeness of its mineralization, the extent of collagen crosslinking and water content, and the non-collagenous proteins like osteopontin and osteocalcin comprise the main constituents of bone's material composition. Each influences material strength and change in different ways during advancing age, health, disease, and drug therapy. These traits are not quantifiable using bone densitometry and their plurality is better captured by the term bone 'qualities' than 'quality'. These qualities are the subject of this manuscript.
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Affiliation(s)
- Y Bala
- Laboratoire Vibrations Acoustique, Institut National des Sciences Appliquées de Lyon, Campus LyonTech la Doua, Villeurbanne, France
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13
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Lambers FM, Bouman AR, Tkachenko EV, Keaveny TM, Hernandez CJ. The effects of tensile-compressive loading mode and microarchitecture on microdamage in human vertebral cancellous bone. J Biomech 2015; 47:3605-12. [PMID: 25458150 DOI: 10.1016/j.jbiomech.2014.10.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 09/16/2014] [Accepted: 10/05/2014] [Indexed: 11/26/2022]
Abstract
The amount of microdamage in bone tissue impairs mechanical performance and may act as a stimulus for bone remodeling. Here we determine how loading mode (tension vs. compression) and microstructure (trabecular microarchitecture, local trabecular thickness, and presence of resorption cavities) influence the number and volume of microdamage sites generated in cancellous bone following a single overload. Twenty paired cylindrical specimens of human vertebral cancellous bone from 10 donors (47–78 years) were mechanically loaded to apparent yield in either compression or tension, and imaged in three dimensions for microarchitecture and microdamage (voxel size 0.7×0.7×5.0 μm3). We found that the overall proportion of damaged tissue was greater (p=0.01) for apparent tension loading (3.9±2.4%, mean±SD) than for apparent compression loading (1.9±1.3%). Individual microdamage sites generated in tension were larger in volume (p<0.001) but not more numerous (p=0.64) than sites in compression. For both loading modes, the proportion of damaged tissue varied more across donors than with bone volume fraction, traditional measures of microarchitecture (trabecular thickness, trabecular separation, etc.), apparent Young׳s modulus, or strength. Microdamage tended to occur in regions of greater trabecular thickness but not near observable resorption cavities. Taken together, these findings indicate that, regardless of loading mode, accumulation of microdamage in cancellous bone after monotonic loading to yield is influenced by donor characteristics other than traditional measures of microarchitecture, suggesting a possible role for tissue material properties.
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Duboeuf F, Burt-Pichat B, Farlay D, Suy P, Truy E, Boivin G. Bone quality and biomechanical function: a lesson from human ossicles. Bone 2015; 73:105-10. [PMID: 25532479 DOI: 10.1016/j.bone.2014.12.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 12/08/2014] [Accepted: 12/12/2014] [Indexed: 11/30/2022]
Abstract
In humans, the middle ear contains a chain of three ossicles with a major highly specific mechanical property (transmission of vibrations) and modeling that stops rapidly after birth. Their bone quality has been rarely studied either in noninflammatory ossicles or in those from ears with chronic inflammation. Our primary goal was to assess bone microarchitecture, morphology and variables reflecting bone quality from incuses, in comparison with those from human femoral cortical bone as controls. Secondly, the impact of chronic inflammation on quality of ossicles was documented. The study was performed on 15 noninflammatory incuses from 15 patients (35±32 years, range: 2-91). Comparisons were performed with 13 inflammatory incuses from 13 patients (55±20 years, range: 1-79) with chronic inflammation of the middle ear, essentially cholesteatoma. Microarchitecture and bone mineral density (BMD) were assessed by microcomputed tomography. Microhardness was measured by microindentation. Mineral and organic characteristics were investigated by Fourier transform infrared microspectroscopy. Noninflammatory incuses were composed of a compact, well mineralized bone without bone marrow and with sparse vessels. Remodeling activity was rarely observed. Woven or lamellar textures and numerous osteocytes were observed. In inflammatory incuses, architecture was degraded, organic tissue was abundant and bone cavities contained fibrocellular tissue and adipocytes. BMD of noninflammatory incuses was significantly higher than BMD from both control bones (4 embedded cortical femoral bone samples; age: 72±15 years, range: 50-85) and inflammatory incuses. Noninflammatory incuses were less hard than both control bone (8 cortical femoral bone samples; age: 49±18 years, range: 24-74) and inflammatory incuses. All incuses were more mineralized and less mature than controls. In conclusion, bone quality of incuses (dense, well mineralized, hard) is well adapted to their function of sound transmission. In inflammatory condition, incuses were degraded, thus explaining the decline of hearing. Moreover, microhardness was found higher than in noninflammatory incuses. Compared to bone with remodeling, the mineralization index in incuses does not explain variation of microhardness. Interestingly, a linear multiple regression model indicated that a combination of two variables, i.e., crystallinity index (crystal size/perfection) and carbonation (incorporation of carbonate ions in apatite) explains 26% of the increase in microhardness variability. Because the low remodeling level of ossicles could not prevent the reversibility of their degradation which impacts audition quality, an early management of ear inflammation in chronic otitis is recommended.
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Affiliation(s)
- François Duboeuf
- INSERM UMR 1033, Equipe Qualité Osseuse et Marqueurs Biologiques, Lyon, France; Université de Lyon, Lyon, France.
| | - Brigitte Burt-Pichat
- INSERM UMR 1033, Equipe Qualité Osseuse et Marqueurs Biologiques, Lyon, France; Université de Lyon, Lyon, France.
| | - Delphine Farlay
- INSERM UMR 1033, Equipe Qualité Osseuse et Marqueurs Biologiques, Lyon, France; Université de Lyon, Lyon, France.
| | - Paul Suy
- ENT Department, Hôpital Edouard Herriot, Lyon, France.
| | - Eric Truy
- Université de Lyon, Lyon, France; ENT Department, Hôpital Edouard Herriot, Lyon, France; Lyon Neurosciences Research Center, Brain Dynamics and Cognition Team, CRNL, INSERM UMR 1028, CNRS UMR 5292, Lyon, France.
| | - Georges Boivin
- INSERM UMR 1033, Equipe Qualité Osseuse et Marqueurs Biologiques, Lyon, France; Université de Lyon, Lyon, France.
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15
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Burr DB. The complex relationship between bone remodeling and the physical and material properties of bone. Osteoporos Int 2015; 26:845-7. [PMID: 25526711 DOI: 10.1007/s00198-014-2970-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 11/16/2014] [Indexed: 01/22/2023]
Affiliation(s)
- D B Burr
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, 635 Barnhill Dr, Indianapolis, IN, 46202, USA,
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16
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Seref-Ferlengez Z, Basta-Pljakic J, Kennedy OD, Philemon CJ, Schaffler MB. Structural and mechanical repair of diffuse damage in cortical bone in vivo. J Bone Miner Res 2014; 29:2537-44. [PMID: 25042459 PMCID: PMC4273578 DOI: 10.1002/jbmr.2309] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 06/08/2014] [Accepted: 06/28/2014] [Indexed: 11/08/2022]
Abstract
Physiological wear and tear causes bone microdamage at several hierarchical levels, and these have different biological consequences. Bone remodeling is widely held to be the mechanism by which bone microdamage is repaired. However, recent studies showed that unlike typical linear microcracks, small crack damage, the clusters of submicron-sized matrix cracks also known as diffuse damage (Dif.Dx), does not activate remodeling. Thus, the fate of diffuse damage in vivo is not known. To examine this, we induced selectively Dif.Dx in rat ulnae in vivo by using end-load ulnar bending creep model. Changes in damage content were assessed by histomorphometry and mechanical testing immediately after loading (ie, acute loaded) or at 14 days after damage induction (ie, survival ulnae). Dif.Dx area was markedly reduced over the 14-day survival period after loading (p < 0.02). We did not observe any intracortical resorption, and there was no increase in cortical bone area in survival ulnae. The reduction in whole bone stiffness in acute loaded ulnae was restored to baseline levels in survival ulnae (p > 0.6). Microindentation studies showed that Dif.Dx caused a highly localized reduction in elastic modulus in diffuse damage regions of the ulnar cortex. Moduli in these previously damaged bone areas were restored to control values by 14 days after loading. Our current findings indicate that small crack damage in bone can be repaired without bone remodeling, and they suggest that alternative repair mechanisms exist in bone to deal with submicron-sized matrix cracks. Those mechanisms are currently unknown and further investigations are needed to elucidate the mechanisms by which this direct repair occurs.
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Affiliation(s)
- Zeynep Seref-Ferlengez
- Department of Biomedical Engineering, The City College of New York, City University of New York, New York, NY
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Abstract
This review describes new technologies for the diagnosis and treatment, including fracture risk prediction, of postmenopausal osteoporosis. Four promising technologies and their potential for clinical translation and basic science studies are discussed. These include reference point indentation (RPI), Fourier transform infrared spectroscopy (FTIR), Raman spectroscopy, and magnetic resonance imaging (MRI). While each modality exploits different physical principles, the commonality is that none of them require use of ionizing radiation. To provide context for the new developments, brief summaries are provided for the current state of biomarker assays, fracture risk assessment (FRAX), and other fracture risk prediction algorithms and quantitative ultrasound (QUS) measurements.
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Affiliation(s)
- Bo Gong
- Department of Chemistry, University of Michigan, Ann Arbor, MI, 48109, USA
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