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The theory of critical distances (TCD) has been applied to predict notch-based fracture and fatigue in a wide range of materials and components. The present paper describes a series of projects in which we applied this approach to human bone. Using experimental data from the literature, combined with finite element analysis, we showed that the TCD was able to predict the effect of notches and holes on the strength of bone failing in brittle fracture due to monotonic loading, in different loading regimes. Bone also displays short crack effects, leading to R-curve data for both fracture toughness and fatigue crack propagation thresholds; we showed that the TCD could predict this data. This analysis raised a number of questions for discussion, such as the significance of the L value itself in this and other materials. Finally, we applied the TCD to a practical problem in orthopaedic surgery: the management of bone defects, showing that predictions could be made which would enable surgeons to decide on whether a bone graft material would be needed to repair a defect, and to specify what mechanical properties this material should have.

The fracture of bone due to indentation with a hard, sharp object is of significance in surgical procedures and certain trauma situations. In the study described below, the fracture of bovine bone under indentation was measured experimentally and predicted using the theory of critical distances (TCDs), a theory, which predicts failure due to cracking in the vicinity of stress concentrations. The estimated indentation fracture force was compared with the experimental results in three different cutting directions. Under indentation, the material experiences high levels of compression and shear, causing cracks to form and grow. The direction of crack growth was highly dependent on the bone's microstructure: major cracks grew in the weakest possible structural direction. Using a single value of the critical distance (L=320 microm), combined with a multiaxial failure criterion, it was possible to predict the experimental failure loads with less than 30% errors. Some differences are expected between the behavior of human bone and the bovine bone studied here, owing to its plexiform microstructure.

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Stenting of curved arteries is generally perceived to be more challenging than straight vessels. Conceptually implanting multiple shorter stents rather than a single longer stent into such a curved artery represents a promising concept, but little is known about the impact of such an approach. The objective of this study is to evaluate the effectiveness of using a multiple segment stent rather than a single long stent to dilate a curved artery using the finite element method. A double segment stent (DSS) and a single segment stent (SSS) were modeled. The stents were compared when expanded into a model of a curved artery. The model predicts that the DSS provides higher flexibility, more conformity, and lower recoil in comparison to the SSS. The volume of arterial tissue experiencing high levels of stress due to stent implantation is also reduced for the DSS. It is suggested that a multiple segment stenting system is a potential solution to the problem of higher rates of in-stent restenosis in curved arteries and mechanically challenging environments.