Multiscale imaging of bone microdamage

Aging decreases osteocyte peri-lacunar-canalicular system turnover in female C57BL/6JN mice

Osteocytes engage in bone resorption and mineralization surrounding their expansive lacunar-canalicular system (LCS) through peri-LCS turnover. However, fundamental questions persist about where, when, and how often osteocytes engage in peri-LCS turnover and how these processes change with aging. Furthermore, whether peri-LCS turnover is associated with natural variation in cortical tissue strain remains unexplored. To address these questions, we utilized confocal scanning microscopy, immunohistochemistry, and scanning electron microscopy to characterize osteocyte peri-LCS turnover in the cortical (mid-diaphysis) and cancellous (metaphysis) regions of femurs from young adult (5 mo) and early-old-age (22 mo) female C57BL/6JN mice. LCS bone mineralization was measured by the presence of perilacunar fluorochrome labels. LCS bone resorption was measured by immunohistochemical marker of bone resorption. The dynamics of peri-LCS turnover were estimated from serial fluorochrome labeling, where each mouse was administered two labels between 2 and 16 days before euthanasia. Osteocyte participation in mineralizing their surroundings is highly abundant in both cortical and cancellous bone of young adult mice but significantly decreases with aging. LCS bone resorption also decreases with aging. Aging has a greater impact on peri-LCS turnover dynamics in cancellous bone than in cortical bone. Lacunae with recent peri-LCS turnover are larger in both age groups. While peri-LCS turnover is associated with variation in tissue strain between cortical quadrants and intracortical location for 22 mo mice, these associations were not seen for 5 mo mice. The impact of aging on decreasing peri-LCS turnover may have significant implications for bone quality and mechanosensation.

Local E-rhBMP-2/β-TCP Application Rescues Osteocyte Dendritic Integrity and Reduces Microstructural Damage in Alveolar Bone Post-Extraction in MRONJ-like Mouse Model

The pathology of medication-related osteonecrosis of the jaw (MRONJ), often associated with antiresorptive therapy, is still not fully understood. Osteocyte networks are known to play a critical role in maintaining bone homeostasis and repair, but the exact condition of these networks in MRONJ is unknown. On the other hand, the local application of E-coli-derived Recombinant Human Bone Morphogenetic Protein 2/β-Tricalcium phosphate (E-rhBMP-2/β-TCP) has been shown to promote bone regeneration and mitigate osteonecrosis in MRONJ-like mouse models, indicating its potential therapeutic application for the treatment of MRONJ. However, the detailed effect of BMP-2 treatment on restoring bone integrity, including its osteocyte network, in an MRONJ condition remains unclear. Therefore, in the present study, by applying a scanning electron microscope (SEM) analysis and a 3D osteocyte network reconstruction workflow on the alveolar bone surrounding the tooth extraction socket of an MRONJ-like mouse model, we examined the effectiveness of BMP-2/β-TCP therapy on the alleviation of MRONJ-related bone necrosis with a particular focus on the osteocyte network and alveolar bone microstructure (microcrack accumulation). The 3D osteocyte dendritic analysis showed a significant decrease in osteocyte dendritic parameters along with a delay in bone remodeling in the MRONJ group compared to the healthy counterpart. The SEM analysis also revealed a notable increase in the number of microcracks in the alveolar bone surface in the MRONJ group compared to the healthy group. In contrast, all of those parameters were restored in the E-rhBMP-2/β-TCP-treated group to levels that were almost similar to those in the healthy group. In summary, our study reveals that MRONJ induces osteocyte network degradation and microcrack accumulation, while application of E-rhBMP-2/β-TCP can restore a compromised osteocyte network and abrogate microcrack accumulation in MRONJ.

Effect of geometrical structure variations on strength and damage onset of cortical bone using multi-scale cohesive zone based finite element method

Three-dimensional multi-scale finite element models were designed to examine the effects of geometrical structure variations on the damage onset in cortical bone at multiple structural scales. A cohesive zone finite element approach, together with anisotropic damage initiation criteria, is used to predict the onset of damage. The finite element models are developed to account for the onset of microdamage from the microscopic length scales consisting of collagen fibres, to the macroscopic level consisting of osteons and the Haversian canals. Numerical results indicated that the yield strain at the initiation of microcracks is independent of variations in the local mineral volume fraction at each structural scale. Further, the yield strain and strength properties of cortical bone are dependent on its structural anisotropy and hierarchical structure. A positive correlation is observed between bone strength and mineral content at each length scale.

Segmentation of trabecular bone microdamage in Xray microCT images using a two-step deep learning method

INTRODUCTION

One of the current approaches to improve our understanding of osteoporosis is to study the development of bone microdamage under mechanical loading. The current practice for evaluating bone microdamage is to quantify damage volume from images of bone samples stained with a contrast agent, often composed of toxic heavy metals and requiring long tissue preparation. This work aims to evaluate the potential of linear microcracks detection and segmentation in trabecular bone samples using well-known deep learning models, namely YOLOv4 and Unet, applied on microCT images.

METHODS

Six trabecular bovine bone cylinders underwent compression until ultimate stress and were subsequently imaged with a microCT at a resolution of 1.95 μm. Two of these samples (samples 1 and 2) were then stained using barium sulfate (BaSO₄) and imaged again. The unstained samples (samples 3-6) were used to train two neural networks YOLOv4 to detect regions with microdamage further combined with Unet to segment the microdamage at the pixel level in the detected regions. Four different model versions of YOLOv4 were compared using the average Intersection over Union (IoU) and the mean average precision (mAP). The performance of Unet was also measured using two segmentation metrics, the Dice Score and the Intersection over Union (IoU). A qualitative comparison was finally done between the deep learning and the contrast agent approaches.

RESULTS

Among the four versions of YOLOv4, the YOLOv4p5 model resulted in the best performance with an average IoU of 45,32% and 51,12% and a mAP of 28.79% and 46.22%, respectively for samples 1 and 2. The segmentation performance of Unet provided better IoU and DICE score on sample 2 compared to sample 1. The poorer performance of the test on sample 1 could be explained by its poorer contrast to noise ratio (CNR). Indeed, sample 1 resulted in a CNR of 7,96, which was worse than the average CNR in the training samples, while sample 2 resulted in a CNR of 10,08. The qualitative comparison between the contrast agent and the deep learning segmentation showed that two different regions were segmented by the two techniques. Deep learning is segmenting the region inside the cracks while the contrast agent segments the region around it or even regions with no visible damage.

CONCLUSION

The combination of YOLOv4 for microdamage detection with Unet for damage segmentation showed a potential for the detection and segmentation of microdamage in trabecular bone. The accuracy of both neural networks achieved in this work is acceptable considering it is their first application in this specific field and the amount of data was limited. Even if the errors from both neural networks are accumulated, the two-steps approach is faster than the semantic segmentation of the whole volume.

The impact of fall-related loading rate on the formation of micro-damage in human cortical bone fracture

The quest for better predictive tools as well as new preventative and therapeutic measures for bone fragility and fracture has highlighted the need for greater mechanistic understanding of the bone fracture process. Cortical bone, the major load bearing part of the bone, employs different toughening mechanisms to either inhibit or slow down crack growth which leads to fracture. Among these toughening mechanisms, is the formation of a micro-damage process zone (MDPZ) around the region of the propagating crack. Investigations into the MDPZ to date have primarily been based on quasi-static or cyclic loading rate experiments which do not necessarily replicate physiological fracture rates. Consequently, the impact of fall-related loading rates on the formation of the micro-damage process zone was investigated comparing these to quasi-static loading rate equivalents. The size of MDPZ was found to be 42% smaller in the high-rate group compared to the quasi-static rate group. The smaller MDPZ size was associated with a brittle, unstable fracture behaviour and an overall smaller fracture resistance measure (J_max). This result points to the possibility of a strain rate hardening mechanism at the heart of micro-damage formation, which is hampered under high loading rates, resulting in lower overall fracture resistance.

Human Occupation of the North American Colorado Plateau ∼37,000 Years Ago

Calibrating human population dispersals across Earth’s surface is fundamental to assessing rates and timing of anthropogenic impacts and distinguishing ecological phenomena influenced by humans from those that were not. Here, we describe the Hartley mammoth locality, which dates to 38,900–36,250 cal BP by AMS 14C analysis of hydroxyproline from bone collagen. We accept the standard view that elaborate stone technology of the Eurasian Upper Paleolithic was introduced into the Americas by arrival of the Native American clade ∼16,000 cal BP. It follows that if older cultural sites exist in the Americas, they might only be diagnosed using nuanced taphonomic approaches. We employed computed tomography (CT and μCT) and other state-of-the-art methods that had not previously been applied to investigating ancient American sites. This revealed multiple lines of taphonomic evidence suggesting that two mammoths were butchered using expedient lithic and bone technology, along with evidence diagnostic of controlled (domestic) fire. That this may be an ancient cultural site is corroborated by independent genetic evidence of two founding populations for humans in the Americas, which has already raised the possibility of a dispersal into the Americas by people of East Asian ancestry that preceded the Native American clade by millennia. The Hartley mammoth locality thus provides a new deep point of chronologic reference for occupation of the Americas and the attainment by humans of a near-global distribution.

The characterization of bovine compact bone fatigue damage using terahertz spectroscopy

Fatigue can cause cracks to propagate from the micro- to the macroscale, which results in a decrease of Young's modulus of the bone. Non-destructive measurements of bone fatigue damage are of great importance for bone quality assessment and fracture prevention. Unfortunately, there is still a lack of effective nondestructive methods sensitive to the initial deterioration during damage accumulation, particularly in the field of orthopedics and biomechanics. In this study, terahertz spectroscopy was adopted to evaluate microscale bone damage. Specifically, the refractive index and Young's modulus of bone samples subjected to different degrees of fatigue damage were tested at a fixed area. Both parameters are found to decrease in two stages under cycled fatigue loading, which is attributed to the initial onset and subsequent development of microdamage during fatigue loading. The change in refractive index reflects the accumulation of fatigue damage as well as the decrease in Young's modulus.

Molecular differences in collagen organization and in organic-inorganic interfacial structure of bones with and without osteocytes

Bone is a fascinating biomaterial composed mostly of type-I collagen fibers as an organic phase, apatite as an inorganic phase, and water molecules residing at the interfaces between these phases. They are hierarchically organized with minor constituents such as non-collagenous proteins, citrate ions and glycosaminoglycans into a composite structure that is mechanically durable yet contains enough porosity to accommodate cells and blood vessels. The nanometer scale organization of the collagen fibrous structure and the mineral constituents in bone were recently extensively scrutinized. However, molecular details at the lowest hierarchical level still need to be unraveled to better understand the exact atomic-level arrangement of all these important components in the context of the integral structure of the bone. In this report, we unfold some of the molecular characteristics differentiating between two load-bearing (cleithrum) bones, one from sturgeon fish, where the matrix contains osteocytes and one from pike fish where the bone tissue is devoid of these bone cells. Using enhanced solid-state NMR measurements, we underpin disparities in the collagen fibril structure and dynamics, the mineral phases, the citrate content at the organic-inorganic interface and water penetrability in the two bones. These findings suggest that different strategies are undertaken in the erection of the mineral-organic interfaces in various bones characterized by dissimilar osteogenesis or remodeling pathways and may have implications for the mechanical properties of the particular bone. STATEMENT OF SIGNIFICANCE: Bone boasts unique interactions between collagen fibers and mineral phases through interfaces holding together this bio-composite structure. Over evolution, fish have gone from mineralizing their bones aided by certain bone cells called osteocytes, like tetrapod, to mineralization without these cells. Here, we report atomic level differences in collagen fiber cross linking and organization, porosity of the mineral phases and content of citrate molecules at the bio-mineral interface in bones from modern versus ancient fish. The dissimilar structural features may suggest disparate mechanical properties for the two bones. Fundamental level understanding of the organic and inorganic components in bone and the interfacial interactions holding them together is essential for successful bone repair and for treating better tissue pathologies.

Effects of Fatigue Damage on the Microscopic Modulus of Cortical Bone Using Nanoindentation

Alterations to the bone structure from cycle loadings can undermine its damage resistance at multiple scales. The accumulation of fatigue damage in a bone is commonly characterized by the reduction in the elastic modulus. In this study, nano-indentation was used for investigating microscopic damage evolution of bovine tibia samples subjected to fatigue loading. Indentation tests were conducted in the same 60 μm × 120 μm area with different degrees of damage, including fracture, and the evolution of reduced modulus was observed. The results showed that bone’s reduced modulus decreased significantly during the initial 40% of the life fraction, whereas it proceeded slowly during the remaining period. As the size of the residual indentations was about 4 μm in length, the degradation of bone’s reduced modulus reflected the accumulation of fatigue damage at smaller scales.

A Review on Multiscale Bone Damage: From the Clinical to the Research Perspective

The investigation of bone damage processes is a crucial point to understand the mechanisms of age-related bone fractures. In order to reduce their impact, early diagnosis is key. The intricate architecture of bone and the complexity of multiscale damage processes make fracture prediction an ambitious goal. This review, supported by a detailed analysis of bone damage physical principles, aims at presenting a critical overview of how multiscale imaging techniques could be used to implement reliable and validated numerical tools for the study and prediction of bone fractures. While macro- and meso-scale imaging find applications in clinical practice, micro- and nano-scale imaging are commonly used only for research purposes, with the objective to extract fragility indexes. Those images are used as a source for multiscale computational damage models. As an example, micro-computed tomography (micro-CT) images in combination with micro-finite element models could shed some light on the comprehension of the interaction between micro-cracks and micro-scale bone features. As future insights, the actual state of technology suggests that these models could be a potential substitute for invasive clinical practice for the prediction of age-related bone fractures. However, the translation to clinical practice requires experimental validation, which is still in progress.

Mechano-Regulation of Trabecular Bone Adaptation Is Controlled by the Local in vivo Environment and Logarithmically Dependent on Loading Frequency

It is well-established that cyclic, but not static, mechanical loading has anabolic effects on bone. However, the function describing the relationship between the loading frequency and the amount of bone adaptation remains unclear. Using a combined experimental and computational approach, this study aimed to investigate whether trabecular bone mechano-regulation is controlled by mechanical signals in the local in vivo environment and dependent on loading frequency. Specifically, by combining in vivo micro-computed tomography (micro-CT) imaging with micro-finite element (micro-FE) analysis, we monitored the changes in microstructural as well as the mechanical in vivo environment [strain energy density (SED) and SED gradient] of mouse caudal vertebrae over 4 weeks of either cyclic loading at varying frequencies of 2, 5, or 10 Hz, respectively, or static loading. Higher values of SED and SED gradient on the local tissue level led to an increased probability of trabecular bone formation and a decreased probability of trabecular bone resorption. In all loading groups, the SED gradient was superior in the determination of local bone formation and resorption events as compared to SED. Cyclic loading induced positive net (re)modeling rates when compared to sham and static loading, mainly due to an increase in mineralizing surface and a decrease in eroded surface. Consequently, bone volume fraction increased over time in 2, 5, and 10 Hz (+15%, +21% and +24%, p ≤ 0.0001), while static loading led to a decrease in bone volume fraction (-9%, p ≤ 0.001). Furthermore, regression analysis revealed a logarithmic relationship between loading frequency and the net change in bone volume fraction over the 4 week observation period (R 2 = 0.74). In conclusion, these results suggest that trabecular bone adaptation is regulated by mechanical signals in the local in vivo environment and furthermore, that mechano-regulation is logarithmically dependent on loading frequency with frequencies below a certain threshold having catabolic effects, and those above anabolic effects. This study thereby provides valuable insights toward a better understanding of the mechanical signals influencing trabecular bone formation and resorption in the local in vivo environment.

Assessment of irradiated socket healing in the rabbit's mandible: Experimental study

As bone healing is altered after external radiation therapy, its evaluation is mandatory and lacks in clinical practice. The aim of the pilot study was to validate micro computed tomography (microCT) as a simple and reliable technique for assessing irradiated bone healing in the rabbit's mandible and compare with histologic findings. Nineteen rabbits (female New Zealand white) were used. The radiation protocol consisted of 5 sessions delivering 8.5 Gy each. MicroCT was performed at D0, D7, D14, D28 and D42 for the control group and D0, D28 and D42 for the irradiated group. A modified Perry's score was determined on histologic samples, and comparison between microCT and histological findings was performed. The main differences between irradiated and non-irradiated rabbits were observed at Day 28 and 42. There was a strong correlation between imaging and histologic findings. Radiation decreases bone quality and bone mineral density. As the correlation was strong between microCT and histologic findings, micro imaging could be considered as a simple and reliable technique to assess bone healing after radiation therapy and allows an easy comparison between samples, without invasive procedures. Great attention should be kept on the parameters and on the region of interest. The development of in-vivo microCT enlarges the perspectives of microCT use in experimental studies, avoiding invasive procedures, and preserving animal lives and well-being, and furthermore lead to clinical applications.

In vivo Labeling of Bone Microdamage in an Animal Model of Type 1 Diabetes Mellitus

Type 1 diabetes mellitus (DM1) is linked to a decrease in bone strength. Bone strength entails both bone mineral density and bone quality. Limited data are available regarding diabetes-induced microdamage, which can severely influence bone quality. This study has investigated bone microdamage as a measure of bone quality in an animal model of DM1. Microdamage in the neck of the femur was labelled in vivo using multiple fluorochromes at 4, 12 and 24 weeks after the onset of DM1. Microcracks were quantified and their morphology analyzed using microscopy techniques. The mean length of microcracks at 24 weeks, and crack numerical and surface densities were significantly higher (p < 0.05) 4 weeks after the onset of DM1 when compared with control. Diffuse damage density was highest at 12 weeks after the onset of DM1. The arrangement of the collagen fibrils became progressively more irregular from 4 to 24 weeks of DM. This is the first study to analyze microdamage in vivo at different time points of DM1. DM1is associated with microcracks from the early stage, however bone microstructure shows toughening mechanisms that arrest their growth but disease progression further deteriorates bone quality resulting in longer microcracks which may increase fracture risk.

Microdamage as a Bone Quality Component: Practical Guidelines for the Two-Dimensional Analysis of Linear Microcracks in Human Cortical Bone

Microdamage is a component of bone quality believed to play an integral role in bone health. However, comparability between existing studies is fraught with issues due to highly variable methods of sample preparation and poorly defined quantification criteria. To address these issues, this article has two aims. First, detailed methods for preparation and analysis of linear microcracks in human ribs, specifically addressing troubleshooting issues cited in previous studies, are laid out. Second, new, partially validated criteria are proposed in an effort to reduce subjective differences in microcrack counts and measures, ensuring more comparable results between studies. Revised definitions based on current literature in conjunction with a digital atlas to reduce observer inaccuracy and bias are presented. The goal is to provide a practical methodology for bone biologists and biomechanists to collect and analyze linear microcracks for basic science research. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

Influence of loading condition and anatomical location on human cortical bone linear micro-cracks

Human cortical bone fracture toughness depends on the anatomical locations under quasi-static loading. Recent results also showed that under fall-like loading, cortical bone fracture toughness is similar at different anatomical locations in the same donor. While cortical bone toughening mechanisms are known to be dependent on the tissue architecture under quasi-static loading, the fracture mechanisms during a fall are less studied. In the current study, the structural parameters of eight paired femoral diaphyses, femoral necks and radial diaphyses were mechanically tested under quasi-static and fall-like loading conditions (female donors, 70 ± 14 y.o., [50-91 y.o.]). Synchrotron radiation micro-CT imaging was used to quantify the amount of micro-cracks formed during loading. The volume fraction of these micro-cracks was significantly higher within the specimens loaded under a quasi-static condition than under a loading representative of a fall. Under fall-like loading, there was no difference in crack volume fraction between the different paired anatomical locations. This result shows that the micro-cracking toughening mechanism depends both on the anatomical location and on the loading condition.

Review of quantitative multiscale imaging of breast cancer

Breast cancer is the most common cancer among women worldwide and ranks second in terms of overall cancer deaths. One of the difficulties associated with treating breast cancer is that it is a heterogeneous disease with variations in benign and pathologic tissue composition, which contributes to disease development, progression, and treatment response. Many of these phenotypes are uncharacterized and their presence is difficult to detect, in part due to the sparsity of methods to correlate information between the cellular microscale and the whole-breast macroscale. Quantitative multiscale imaging of the breast is an emerging field concerned with the development of imaging technology that can characterize anatomic, functional, and molecular information across different resolutions and fields of view. It involves a diverse collection of imaging modalities, which touch large sections of the breast imaging research community. Prospective studies have shown promising results, but there are several challenges, ranging from basic physics and engineering to data processing and quantification, that must be met to bring the field to maturity. This paper presents some of the challenges that investigators face, reviews currently used multiscale imaging methods for preclinical imaging, and discusses the potential of these methods for clinical breast imaging.

The micro-damage process zone during transverse cortical bone fracture: No ears at crack growth initiation

OBJECTIVE

Apply high-resolution benchtop micro-computed tomography (micro-CT) to gain greater understanding and knowledge of the formation of the micro-damage process zone formed during traverse fracture of cortical bone.

METHODS

Bovine cortical bone was cut into single edge notch (bending) fracture testing specimens with the crack on the transverse plane and oriented to grow in the circumferential direction. We used a multi-specimen technique and deformed the specimens to various individual secant modulus loss levels (P-values) up to and including maximum load (Pmax). Next, the specimens were infiltrated with a BaSO₄ precipitation stain and scanned at 3.57-μm isotropic voxel size using a benchtop high resolution-micro-CT. Measurements of the micro-damage process zone volume, width and height were made. These were compared with the simple Irwin's process zone model and with finite element models. Electron and confocal microscopy confirmed the formation of BaSO₄ precipitate in micro-cracks and other porosity, and an interesting novel mechanism similar to tunneling.

RESULTS

Measurable micro-damage was detected at low P values and the volume of the process zone increased according to a second order polynomial trend. Both width and height grew linearly up to Pmax, at which point the process zone cross-section (perpendicular to the plane of the crack) was almost circular on average with a radius of approximately 550µm (approximately one quarter of the unbroken ligament thickness) and corresponding to the shape expected for a biological composite under plane stress conditions.

CONCLUSION

This study reports details of the micro-damage fracture process zone previously unreported for cortical bone. High-resolution micro-CT enables 3D visualization and measurement of the process zone and confirmation that the crack front edge and process zone are affected by microstructure. It is clear that the process zone for the specimens studied grows to be meaningfully large, confirming the need for the J-integral approach and it does not achieve steady state at Pmax in most specimens. With further development, this approach may become valuable towards better understanding the role of the process zone in cortical bone fracture and the effects of relevant modifications towards changes in fracture toughness in a cost effective way.

Effects of Condensation on Peri-implant Bone Density and Remodeling

Bone condensation is thought to densify interfacial bone and thus improve implant primary stability, but scant data substantiate either claim. We developed a murine oral implant model to test these hypotheses. Osteotomies were created in healed maxillary extraction sites 1) by drilling or 2) by drilling followed by stepwise condensation with tapered osteotomes. Condensation increased interfacial bone density, as measured by a significant change in bone volume/total volume and trabecular spacing, but it simultaneously damaged the bone. On postimplant day 1, the condensed bone interface exhibited microfractures and osteoclast activity. Finite element modeling, mechanical testing, and immunohistochemical analyses at multiple time points throughout the osseointegration period demonstrated that condensation caused very high interfacial strains, marginal bone resorption, and no improvement in implant stability. Collectively, these multiscale analyses demonstrate that condensation does not positively contribute to implant stability.

Micro-computed tomography and mechanical evaluation of trabecular bone structure in osteopenic and osteoporotic fractures

PURPOSE

Osteopenia and osteoporosis are the two most common musculoskeletal disorders in the elderly population. We determined whether osteopenic and osteoporotic patients with fractures exhibit differences in trabecular morphology and biomechanical properties of bone.

METHODS

Fourteen osteopenic patients and 28 osteoporotic patients with hip fractures who underwent hemiarthroplasty for proximal femoral fractures caused by low-energy injury were included. Bone mineral density (BMD) measurements were performed. Compression tests and high-resolution micro-computed tomography were used to assess cancellous bone samples obtained from the principal compressive region of the femoral head.

RESULTS

The BMD values were lower in the osteoporotic patients than in the osteopenic patients ( p < 0.05). There was a significant difference in the yield stress values between the groups ( p < 0.05). However, no significant differences in the strain energy density, stiffness and Young's modulus were observed between the groups ( p > 0.05). The mean maximum stress was significantly higher in the osteoporotic patients than in the osteopenic patients ( p < 0.05). Although structural parameters, including bone volume (BV), BV fraction, trabecular thickness, trabecular connectivity density and trabecular number, were higher in the osteopenic patients, the differences were not significant ( p > 0.05). Trabecular separation values were significantly higher in the osteoporotic patients ( p < 0.05).

CONCLUSION

Our results showed that the trabecular morphology and biomechanical properties of bone were not significantly different between osteopenic and osteoporotic patients in terms of some parameters.