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Shi V, Morgan EF. Estrogen and estrogen receptors mediate the mechanobiology of bone disease and repair. Bone 2024; 188:117220. [PMID: 39106937 DOI: 10.1016/j.bone.2024.117220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 07/28/2024] [Accepted: 07/30/2024] [Indexed: 08/09/2024]
Abstract
It is well understood that the balance of bone formation and resorption is dependent on both mechanical and biochemical factors. In addition to cell-secreted cytokines and growth factors, sex hormones like estrogen are critical to maintaining bone health. Although the direct osteoprotective function of estrogen and estrogen receptors (ERs) has been reported extensively, evidence that estrogen signaling also has a role in mediating the effects of mechanical loading on maintenance of bone mass and healing of bone injuries has more recently emerged. Recent studies have underscored the role of estrogen and ERs in many pathways of bone mechanosensation and mechanotransduction. Estrogen and ERs have been shown to augment integrin-based mechanotransduction as well as canonical Wnt/b-catenin, RhoA/ROCK, and YAP/TAZ pathways. Estrogen and ERs also influence the mechanosensitivity of not only osteocytes but also osteoblasts, osteoclasts, and marrow stromal cells. The current review will highlight these roles of estrogen and ERs in cellular mechanisms underlying bone mechanobiology and discuss their implications for management of osteoporosis and bone fractures. A greater understanding of the mechanisms behind interactions between estrogen and mechanical loading may be crucial to addressing the shortcomings of current hormonal and pharmaceutical therapies. A combined therapy approach including high-impact exercise therapy may mitigate adverse side effects and allow an effective long-term solution for the prevention, treatment, and management of bone fragility in at-risk populations. Furthermore, future implications to novel local delivery mechanisms of hormonal therapy for osteoporosis treatment, as well as the effects on bone health of applications of sex hormone therapy outside of bone disease, will be discussed.
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Affiliation(s)
- Vivian Shi
- Boston University, Department of Biomedical Engineering, 44 Cummington St, Boston 02215, MA, USA; Center for Multiscale and Translational Mechanobiology, Boston University, 44 Cummington St, Boston 02215, MA, USA
| | - Elise F Morgan
- Boston University, Department of Biomedical Engineering, 44 Cummington St, Boston 02215, MA, USA; Center for Multiscale and Translational Mechanobiology, Boston University, 44 Cummington St, Boston 02215, MA, USA.
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Polak S, Beever L, Wade A, Fukuoka M, Worth AJ. Biomechanical comparison of titanium alloy additively manufactured and conventionally manufactured plate-screw constructs. N Z Vet J 2024; 72:17-27. [PMID: 37772312 DOI: 10.1080/00480169.2023.2264805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/21/2023] [Indexed: 09/30/2023]
Abstract
AIM To biomechanically compare the bending stiffness, strength, and cyclic fatigue of titanium additively manufactured (AM) and conventionally manufactured (CM) limited contact plates (LCP) of equivalent dimensions using plate-screw constructs. METHODS Twenty-four 1.5/2.0-mm plate constructs (CM: n = 12; AM: n = 12) were placed under 4-point bending conditions. Data were collected during quasi-static single cycle to failure and cyclic fatigue testing until implants plastically deformed or failed. Bending stiffness, bending structural stiffness, and bending strength were determined from load-displacement curves. Fatigue life was determined as number of cycles to failure. Median test variables for each method were compared using the Wilcoxon rank sum test within each group. Fatigue data was also analysed by the Kaplan-Meier estimator of survival function. RESULTS There was no evidence for a difference in bending stiffness and bending structural stiffness between AM and CM constructs. However, AM constructs exhibited greater bending strength (median 3.07 (min 3.0, max 3.4) Nm) under quasi-static 4-point bending than the CM constructs (median 2.57 (min 2.5, max 2.6) Nm, p = 0.006). Number of cycles to failure under dynamic 4-point bending was higher for the CM constructs (median 164,272 (min 73,557, max 250,000) cycles) than the AM constructs (median 18,704 (min 14,427, max 33,228) cycles; p = 0.02). Survival analysis showed that 50% of AM plates failed by 18,842 cycles, while 50% CM plates failed by 78,543 cycles. CONCLUSION AND CLINICAL RELEVANCE Additively manufactured titanium implants, printed to replicate a conventional titanium orthopaedic plate, were more prone to failure in a shorter fatigue period despite being stronger in single cycle to failure. Patient-specific implants made using this process may be brittle and therefore not comparable to CM orthopaedic implants. Careful selection of their use on a case/patient-specific basis is recommended.
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Affiliation(s)
- S Polak
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - L Beever
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - A Wade
- Mechatronics, Electronics and Computer Engineering, School of Food and Advanced Technology, Massey University, Palmerston North, New Zealand
| | - M Fukuoka
- Mechatronics, Electronics and Computer Engineering, School of Food and Advanced Technology, Massey University, Palmerston North, New Zealand
| | - A J Worth
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
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Hu Y, Lian Q, Cao F, Hou X, Li H, Xing L, Wang M, Tian F, Zhang L. Estrogen deficiency impedes fracture healing despite eliminating the excessive absorption of the posterior callus in a semi-fixed distal tibial fracture mouse model. BMC Musculoskelet Disord 2023; 24:803. [PMID: 37817119 PMCID: PMC10563296 DOI: 10.1186/s12891-023-06929-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/28/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Treatment of distal tibial fractures is a challenge due to their specific anatomical location. However, there is no appropriate mouse model to simulate a clinical distal tibial fracture for basic research. The aim of this investigation was to evaluate the feasibility of simulating a clinical fracture of the distal tibia of mice and to investigate the effect of ovariectomy (OVX)-induced osteoporosis on fracture healing in this model. METHODS Sixty female 8-week-old C57BL/6 mice were randomly divided into two groups, either sham or OVX. A semi-fixation distal tibia fracture was established in the right tibia after 8 weeks of OVX. The right tibias were collected at 7, 14, 21, and 28 days post fracture. RESULTS In the semi-fixation distal tibia fracture model, the posterior callus in the sham group showed excessive bone resorption and lower bone mass phenotype compared with the anterior site; a similar trend was not found in the OVX group. At 28 days post fracture, the posterior callus was more mineralized than the anterior callus in the OVX group. Although the fracture healing of the sham group showed a special phenotype in this mode, the progress and quality of fracture healing were still better than those of the OVX group. CONCLUSION A semi-fixed distal tibial closed fracture mouse model was successfully established. In this model, excess bone resorption of the posterior callus impaired normal fracture healing, but not in OVX-induced osteoporotic bone. Although the stress shielding effect was not observed in the OVX group, impaired bone healing caused by OVX was still present. Our results suggest that this fracture model may have potential for studies on distal tibial fractures and stress shielding.
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Affiliation(s)
- Yunpeng Hu
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, Hebei, P. R. China
| | - Qiangqiang Lian
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, P. R. China
| | - Fuyuan Cao
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, P. R. China
| | - Xiaoli Hou
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, P. R. China
| | - Hetong Li
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, Hebei, P. R. China
| | - Lei Xing
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, P. R. China
| | - Mengqin Wang
- Emergency Department, JST, The Fourth Clinical Hospital of Peking University, Beijing, P. R. China
| | - Faming Tian
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, P. R. China.
| | - Liu Zhang
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, Hebei, P. R. China.
- Department of Orthopedic Surgery, Emergency General Hospital, Xibahenanli29, Chaoyang Dis, Beijing, 100028, P. R. China.
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Hussein MA, Kumar AM, Azeem MA, Sorour AA, Saravanan S. Ti-30Nb-3Ag alloy with improved corrosion resistance and antibacterial properties for orthopedic and dental applications produced by mechanical alloying. J Mech Behav Biomed Mater 2023; 142:105851. [PMID: 37068434 DOI: 10.1016/j.jmbbm.2023.105851] [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: 02/14/2023] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 04/19/2023]
Abstract
Titanium alloys have gained popularity as a bioimplant material due to their biocompatibility, low modulus of elasticity, and increased strength. However, other issues, such as corrosion resistance, and infections can reduce the implant's lifespan. This paper aims to fabricate a new Ti-30Nb-3Ag at% alloy with enhanced in vitro corrosion and antibacterial properties by mechanical alloying (MA) followed by powder consolidation. XRD, SEM/EDX, and Vickers microhardness analyses were used to examine the phases compositions, microstructure, and microhardness, respectively. The in vitro corrosion performance of Ti-30Nb-3Ag alloy was inspected in a simulated body medium and artificial saliva. The alloy's antibacterial properties were evaluated in the gram-positive and negative bacterial medium. The results showed that after MA for 60 h, nanocrystalline β-Ti (BCC) and α-Ti (HCP) solid solutions were formed with crystallite sizes of 7.44 and 3.47 nm, respectively. The sintered sample exhibited densifications of 97%, with a microstructure composed of β-Ti, α-Ti, and a minor quantity of ultrafine Ti2Ag phase. The microhardness result showed that Ti-30Nb-3Ag alloy possesses HV 491.5. Ti-30Nb-3Ag alloy has a potent antibacterial capability of 85.75% and 88.81% relative to Ti-6Al-4V alloy and CP-Ti, respectively. In vitro corrosion results revealed that the Ti-30Nb-3Ag alloy exhibited the widespread passive area in the investigated anodic regions and presented the highest impedance values in comparison with the commercial alloys, confirming its improved corrosion resistance performance in both studied mediums. Ti-30Nb-3Ag alloy possibly be a competitive bioimplant material for orthopedic and dental uses owing to its enhanced biocorrosion and antibacterial properties compared to commercial Ti-6Al-4V alloy and CP-Ti.
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Affiliation(s)
- M A Hussein
- Interdisciplinary Research Center for Advanced Materials, King Fahd University of Petroleum & Minerals (KFUPM), Dhahran, 31261, Saudi Arabia.
| | - A Madhan Kumar
- Interdisciplinary Research Center for Advanced Materials, King Fahd University of Petroleum & Minerals (KFUPM), Dhahran, 31261, Saudi Arabia
| | - M A Azeem
- Department of Mechanical Engineering, King Fahd University of Petroleum & Minerals(KFUPM), Dhahran, 31261, Saudi Arabia
| | - A A Sorour
- Interdisciplinary Research Center for Advanced Materials, King Fahd University of Petroleum & Minerals (KFUPM), Dhahran, 31261, Saudi Arabia; Department of Mechanical Engineering, King Fahd University of Petroleum & Minerals(KFUPM), Dhahran, 31261, Saudi Arabia
| | - S Saravanan
- Department of Bioengineering, King Fahd University of Petroleum and Minerals, Dhahran, 31261, Saudi Arabia
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Ishimoto T, Saito M, Ozasa R, Matsumoto Y, Nakano T. Ibandronate Suppresses Changes in Apatite Orientation and Young's Modulus Caused by Estrogen Deficiency in Rat Vertebrae. Calcif Tissue Int 2022; 110:736-745. [PMID: 34989822 PMCID: PMC9108105 DOI: 10.1007/s00223-021-00940-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/24/2021] [Indexed: 11/30/2022]
Abstract
Bone material quality is important for evaluating the mechanical integrity of diseased and/or medically treated bones. However, compared to the knowledge accumulated regarding changes in bone mass, our understanding of the quality of bone material is lacking. In this study, we clarified the changes in bone material quality mainly characterized by the preferential orientation of the apatite c-axis associated with estrogen deficiency-induced osteoporosis, and their prevention using ibandronate (IBN), a nitrogen-containing bisphosphonate. IBN effectively prevented bone loss and degradation of whole bone strength in a dose-dependent manner. The estrogen-deficient condition abnormally increased the degree of apatite orientation along the craniocaudal axis in which principal stress is applied; IBN at higher doses played a role in maintaining the normal orientation of apatite but not at lower doses. The bone size-independent Young's modulus along the craniocaudal axis of the anterior cortical shell of the vertebra showed a significant and positive correlation with apatite orientation; therefore, the craniocaudal Young's modulus abnormally increased under estrogen-deficient conditions, despite a significant decrease in volumetric bone mineral density. However, the abnormal increase in craniocaudal Young's modulus did not compensate for the degradation of whole bone mechanical properties due to the bone loss. In conclusion, it was clarified that changes in the material quality, which are hidden in bone mass evaluation, occur with estrogen deficiency-induced osteoporosis and IBN treatment. Here, IBN was shown to be a beneficial drug that suppresses abnormal changes in bone mechanical integrity caused by estrogen deficiency at both the whole bone and material levels.
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Affiliation(s)
- Takuya Ishimoto
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Mitsuru Saito
- Department of Orthopaedic Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461 Japan
| | - Ryosuke Ozasa
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Yoshihiro Matsumoto
- Product Research Department, Kamakura Research Laboratories, Chugai Pharmaceutical Co., Ltd., 200 Kajiwara, Kamakura, Kanagawa 247-8530 Japan
| | - Takayoshi Nakano
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871 Japan
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Muroi N, Shimada M, Murakami S, Akagi H, Kanno N, Suzuki S, Harada Y, Orima H, Hara Y. A Retrospective Study of Postoperative Development of Implant-Induced Osteoporosis in Radial-Ulnar Fractures in Toy Breed Dogs Treated with Plate Fixation. Vet Comp Orthop Traumatol 2021; 34:375-385. [PMID: 34344053 DOI: 10.1055/s-0041-1731810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to evaluate implant-induced osteoporosis (IIO) development in toy breed dogs treated using internal fixation with digital radiographs as the index of pixel values. STUDY DESIGN There were 226 cases (236 limbs) of toy breed dogs with radial-ulnar fractures. Pixel values were measured on radiographs immediately, 2 weeks and 1 to 12 months after surgery. The ratio of pixel values (PVR) represented the bone mineral areal density based on the humeral condyle in the same image. The dogs were grouped based on the fixation methods, age and status of destabilization. RESULTS There was a significant decrease in the PVR at 1 to 12 months postoperatively for all cases. There were not any significant differences in PVR of antebrachial fractures between those repaired with plates using locking head screws, cortex screws or a combination of locking and cortex screws. Implant-induced osteoporosis persisted at 1 to 12 months postoperatively in dogs aged ≧6 months, while the PVR increased after 3 months in dogs aged <6 months. Based on the destabilization method, there was a significant increase in the PVR at 3 months in the plate removal group. CONCLUSION This study suggests that IIO occurs in small dogs treated with plates and screws. Moreover, patients aged < 6 months showed an early postoperative recovery of bone mineral areal density. Further, screw and plate removal could contribute to the recovery of bone mineral areal density.
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Affiliation(s)
- Norihiro Muroi
- Department of Veterinary Surgery, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, Japan
| | - Masakazu Shimada
- Department of Veterinary Surgery, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, Japan
| | - Sawako Murakami
- Department of Veterinary Surgery, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, Japan
| | - Hiroyuki Akagi
- Department of Veterinary Surgery, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, Japan
| | - Nobuo Kanno
- Department of Veterinary Surgery, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, Japan
| | - Shuji Suzuki
- Department of Veterinary Surgery, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, Japan
| | - Yasuji Harada
- Department of Veterinary Surgery, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, Japan
| | | | - Yasushi Hara
- Department of Veterinary Surgery, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, Japan
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